Objective To investigate the value of guidance and clinical significance of enteral nutritional support therapy using a joint of nutritional risk screening 2002 (NRS2002) and a screening tool for controlling nutritional status (CONUT) after radical resection of colorectal cancer.Methods The clinical data of 180 patients who underwent radical resection of colorectal cancer at the Tumor Hospital of Xinjiang Medical University between June 2012 and June 2014 were retrospectively analyzed.Seventy patients with scores of NRS 2002 ≥ 3 were allocated into the A group including 40 with enteral nutritional support therapy in the A1 group and 30 without enteral nutritional support therapy in the A2 group, 60 patients with scores of NRS 2002 ＜ 3 and negative CONUT was allocated into the B group including 30 with enteral nutritional support therapy in the B1 group and 30 without enteral nutritional support therapy in the B2 group, 50 patients with scores of NRS 2002 ＜ 3 and positive CONUT was allocated into the C group including 25 with enteral nutritional support therapy in the Cl group and 25 without enteral nutritional support therapy in the C2 group.The nutritional status of patients was evaluated using a joint of NRS 2002 and CONUT.There was nutritional risk in patients with scores of NRS 2002≥3 or scores of NRS 2002 ＜ 3 and positive CONUT and no nutritional risk in patients with scores of NRS 2002 ＜ 3 and negative CONUT.Patients and their families would choose whether or not to undergo enteral nutritional support therapy after the risks being informed.Enteral nutritional support therapy included tube feeding enteral nutrition or oral nutriments with calories ≥41.84 k J/(kg · d) for more than 3 days.Observed indicators: (l)Nutritional indicators included fasting serum albumin (Alb), prealbumin and transferrin before operation, at postoperative day 1 and day 7.(2)Postoperative recovery included time to anal exsufflation, time of defecation, time for semifluid diet intake and duration of hospital stay.Measurement data with normal distribution were presented as x ± s, comparison among groups was analyzed using the t test and repeated measures ANOVA, and count data were analyzed using the chi-square test.Results Patients in A, B and C groups had good tolerance without abdominal pain, abdominal distension and diarrhea.Comparisons of nutritional indicators: the levels of fasting serum Alb, prealbumin and transferrin in the A1 group were (29 ±4)g/L, (0.25 ±0.06)g/L and (2.0 ±0.4)g/L before operation, (27 ±4)g/L, (0.19 ± 0.07) g/L, (1.7 ± 0.4) g/L at postoperative day 1 and (33 ± 5) g/L, (0.27 ± 0.05) g/L and (1.9 ± 0.3) g/L at postoperative day 7, respectively.The levels of fasting serum Alb, prealbumin and transferrin in the A2 group were (29 ±5)g/L, (0.24 ±0.04)g/L and(2.0 ±0.4)g/L before operation, (27 ±4) g/L, (0.18 ±0.05)g/L and (1.7 ± 0.4) g/L at postoperative day 1 and (26 ± 4) g/L, (0.16 ± 0.04) g/L and (1.8 ± 0.5) g/L at postoperative day 7, respectively.There were significant differences in the changing trends of the above 3 indicators between the 2 groups (F =3.256, 6.642, 7.152, P ＜0.05).The levels of fasting serum Alb, prealbumin and transferrin in the B1 group were (37 ± 4) g/L, (0.28 ± 0.05) g/L and (2.0 ± 0.3) g/L before operation, (36 ± 4) g/L, (0.21 ± 0.06) g/L and (1.7 ± 0.5) g/L at postoperative day 1 and (38 ± 4) g/L, (0.30 ± 0.05) g/L and (1.9 ± 0.5) g/L at postoperative day 7, respectively.The levels of fasting serum Alb, prealbumin and transferrin in the B2 group were (36 ±4)g/L, (0.28 ±0.06)g/L and (2.1 ±0.4)g/L before operation, (36 ±3)g/L,(0.23 ±0.04)g/L and (1.7 ±0.4)g/L at postoperative day 1 and (37 ±4)g/L, (0.22 ±0.07)g/L and (1.8 ± 0.5) g/L at postoperative day 7, respectively.There was no significant difference in the changing trends of the above 3 indicators between the 2 groups (F =1.562, 0.625, 2.223, P ＞ 0.05).The levels of fasting serum Alb,prealbumin and transferrin in the C1 group were (28 ± 4) g/L, (0.35 ± 0.06) g/L and (2.1 ± 0.4) g/L before operation, (26 ±4)g/L, (0.17 ± 0.07)g/L and (1.7 ± 0.4)g/L at postoperative day 1 and (34 ± 5)g/L,(0.35 ±0.05)g/L and (1.8 ± 0.3)g/L at postoperative day 7, respectively.The levels of fasting serum Alb,prealbumin and transferrin in the C2 group were(28 ± 5)g/L, (0.34 ± 0.04)g/L and (2.0 ± 0.4)g/L before operation, (26 ± 4) g/L, (0.16 ± 0.05) g/L and (1.7 ± 0.4) g/L at postoperative day 1 and (25 ± 4) g/L,(0.16 ±0.04) g/L and (1.8 ±0.5)g/L at postoperative day 7, respectively.There were significant differences in the changing trends of the above 3 indicators between the 2 groups (F =5.625, 4.225, 8.221, P ＜0.05).Postoperative recovery: time to anal exsufflation, time of defecation, time for semifluid diet intake and duration of hospital stay were (1.9 ± 0.5) days, (2.3 ± 0.5) days, (8.6 ± 1.2) days, (14.7 ± 1.1) days in the A1 group and (3.0 ± 0.5) days, (4.5 ± 0.6) days, (11.4 ± 2.2) days, (17.8 ± 1.3) days in the A2 group, respectively,with significant differences between the 2 groups (t =-0.644,-12.200,-8.710,-11.650, P ＜ 0.05).Time to anal exsufflation, time of defecation, time for semifluid diet intake and duration of hospital stay were (1.2 ± 0.3)days, (3.2 ±0.7)days, (10.3 ± 1.4)days, (14.7 ±2.0)days in the B1 group and (1.5 ±0.5)days, (3.7 ± 0.6) days, (11.0 ± 1.2) days, (16.1 ± 1.5) days in the B2 group, respectively, with no significant difference between the 2 groups (t =-1.929,-1.033,-1.019,-1.171, P ＞0.05).Time to anal exsufflation, time of defecation, time for semifluid diet intake and duration of hospital stay were (1.8 ± 0.7) days, (2.1 ± 0.5) days,(7.6±1.2)days, (13.9 ±1.2)days in the C1 group and (3.1 ±0.5)days, (4.5 ±0.7)days, (11.4±2.4)days,(17.6 ± 1.3) days in the C2 group, respectively, with significant differences between the 2 groups (t =-5.934,-10.950,-10.010,-11.700, P ＜ 0.05).Conclusions A joint application of NRS2002 and CONUT after radical resection of colorectal cancer is exact and feasible for evaluating nutritional status of patients and guiding enteral nutritional support therapy.Patients should select nutritional support therapy after operation if there is nutritional risk.The proper nutritional support therapy can improve the postoperative nutritional status of patients with colorectal cancer, enhance the postoperative recovery and reduce the duration of hospital stay.

Objective To investigate neurogenesis in the dentate gyrus of adult rat following conditioned fear stimulus.Methods 24 adult male rats were randomly divided into conditioned fear stimulus group and control group,and all rats were intraperitoneally injected bromodeoxyuridine(BrdU)3 days before conditioned fear stimuli.Animals in conditioned fear stimulus group were given monotone matching foot shock and made conditioned fear stimulus model,animals in control group only give monotone.Freezing time was detected before stimuli and 7th,14th days after stimuli,then rats were sacrificed 7th or 14th day after fear conditioned stimulus,and immunohistochemistry for Brdu was detected.Results Behavioral assessment showed that the percents of freezing time in conditioned fear stimulus group 7th,14th days after conditioned fear stimulus were significantly high(88.68%,91.33%)than those in control group(11.18%,14.23%,P<0.01)and before stimulus(24.11%,16.11%,P<0.01).Compared to control group(1567±28,580±5),Brdu positive cells in dentate gyrus of rat in conditioned fear stimulus group(1364±21,296±22)were decreased,and it reached to a statistical significance on 14th day (P<0.05).Conclusion The decreased neurogenesis in the dentate gyrus of adult rat following conditioned fear stimuli may have relation to fear and other emotion memory.

Objective To explore the methods and effects of specialty training for wound care. Methods Fourteen nurses working and studying in the wound care center received specialty training of wound care. Their current knowledge and train-ing needs were assessed through writing test and symposium before the training. Then,the training contents and plan were de-signed. The training duration was identified as 3-6 months. The open teaching method was applied in the training directed by the entrostomal therapists(ET). According to the evaluation index,the nurses were asked to finish a reading report in the first month,a case report in the second month,and group discussion on a case of complicated wound care the third month. In ad-dition,they needed to finish the exam of wound care theory and skills every three months. The correlations between perfor-mance in the examination and the nurses' age,years of working experlence,educational level,professional title,duration and times of training by correlation analysis. Results The times of training was significantly correlated with the performance in the examination(r=-0.49,P<0.05),especially with the performance of case report,reading report,and group discussion on compli-cated wound care(r=0.51,-0.60,P<0.05). There was no correlation between the performance with nurses' age,years of working experience,educational level,professional title and duration of training. Conclusion One time of specialty training at least 3 months can achieve good effect. The times of training is correlated with the training effect,especially in case report,reading report and group discussion on complicated wound care.

Background Research comfirmed that second mitochondrial activator of caspase (Smac) is a promoting tumor cell apoptosis protein.Our previous study showed that the expression level of Smac in LECs is obviously higher in cataract than that in normal eyes.We assumed that silencing Smac gene in LECs can inhibit the apoptosis of LECs.The way to transfect Smac siRNA into LECs is a key step.Objective This study was to construct siRNA lentiviral vector of Smac and identify its silencing efficiency in human lens epithelial B3 cell line (HLE-B3) and establish low-expressed Smac HLE-B3 line.Methods Based on the genebank and our previous study,siRNA sequence of Smac was designed and composed.The synthetic double-stranded DNA was linked to the lentiviral vector GVll8 by T4 DNA ligase and then transformed DH5α competent cells.The plasmids were transformed into the DH5α competent cells.Recombinant colonies were screened by PCR and sequenced.Recombinant plasmids and two other auxiliary plasmids were used to infect 293T cells.Cell culture supernatant was collected for the measurement of viral titer.Recombinant lentiviral vector was used to infect HLE-B3 cells to calculate the viral multiplicity of infection (MOI) under the fluorescence microscope.Transfection efficiency was examined by calculating the GFP-positive cells.HLE-B3 cells were divided into negative control group,siRNA plasmid tranfected group and GV118-Smac-siRNA1 tranfected group.The relative expression levels of Smac mRNA in the cells were detected and compared among the three groups by real-time fluorescent quantitative PCR.Results GV118-Smac-siRNA was successfully constructed with the positive colonies 340 bp and blank vector colonies 299 bp,and viral titer was 3.0× 108 TU/ml.At a MOI of 100,the infecting efficiency of the vector on HLE-B3 cells was about 82％ and the cytotoxicity was low.The relative expression levels of Smac mRNA were (101.290±8.349)％,(92.330±6.320)％ and (32.540±4.221)％ in the negative control group,siRNA plasmid tranfected group and GV118-Smac-siRNA1 tranfected group,respectively,showing a significant difference among the three groups(F =32.871,P＜0.01),and the relative expression level of Smac mRNA was significantly lower in the GV118-Smac-siRNA1 tranfected group than that in the negative control group (P =0.000).However,no significant difference was found in the Smac mRNA expression between the blank plasmid group and the negative control group (P=0.535).Conclusions GV118-Smac-siRNA lentiviral vector is successfully constructed.Smac-siRNA can effectively inhibit the expression of Smac mRNA in human LECs.

Objective To investigate the infection status of hepatitis virus among the perinatal women in Nanjing.Methods 523 samples of perinatal women's serum were selected.The hepatitis virus markers were detected by the ELISA kit,the quantitive detection of HBV surface-antibody was detected by electrochemiluminescence immunoassay.Results The positive rate of anti-HAV IgM was 0.19％,47 cases were HBV surface antigen-positive,accounted for 8.99％,183 cases were HBV surface antibody-positive,accounted for 35.00％,224 cases were all negative HBV markers,accounted for 42.83％.The quantitive detection of HBV surface-antibody in high concentration was significant higher than middle concentration and low concentration (all P ＜ 0.05).The positive rate of anti-HCV IgG was 1.34％,anti-HDV IgG was all negative.The positive rate of anti-HEV IgM was 0.57％.The positive rate of anti-HEV IgG was 24.28％.With the advance of age,the positive rate of anti-HEV IgG had an increasing trend,with significant difference among groups (P ＜ 0.05).Conclusion There are important significances in the detection of hepatitis virus markers in pregnancy monitoring,it can improve the quality of the population.

Objective To analyze the overseas imported malaria situation of Shijiazhuang City from 2012 to 2015,so as to provide the evidence for exploring the prevention and control strategy. Methods The data of overseas imported malaria were collected and analyzed with the descriptive method including Plasmodium species,population characteristics,epidemic focus distribution,onset time,diagnosis and treatment in Shijiazhuang City from 2012 to 2015,and the time from the onset to first medical visit,time from first medical visit to being diagnosed,and time from onset to being diagnosed of different Plasmodium species were analyzed respectively with the statistical analysis method. Results A total of 92 overseas imported malaria cases were reported in Shijiazhuang City from 2012 to 2015,including 88 cases from African countries(falciparum malaria taking 53.41％),and 4 cases from Southeast Asian and other countries(vivax malaria taking 50％). Eighty-nine cases were distributed in 28 counties(districts)of 6 cities in Hebei Province,except 2 persons with foreign nationalities and 1 with Anhui Province cen-sus register. The male and young adults were dominant. The median time from the onset to seeing a doctor was one day and the median time from seeing a doctor to being diagnosed was five days. Most cases were reported by the Fifth Hospital of Shijia-zhuang which was the sentinel hospital. Totally 42.39％of the cases were misdiagnosed when the first visit to a doctor. All of the cases were laboratory confirmed and 100％of them received the standard treatment after diagnosis. Conclusions The overseas imported malaria cases are increasing rapidly with years and the malignant malaria cases were more than other malaria cases in Shijiazhuang City. It is necessary to further strengthen the long-term cooperation mechanism between the medical institutions and the entry-exit inspection and quarantine department. The technician training should be strengthened to avoid the severe cas-es and death cases.

Adolescent ; Colon, Ascending ; pathology ; Colonic Neoplasms ; pathology ; surgery ; Colonic Polyps ; pathology ; surgery ; Diagnosis, Differential ; Follow-Up Studies ; Ganglioneuroma ; pathology ; surgery ; Humans ; Male

Surgical resection remains the only curative option of treatment for hepatocellular carcinoma,but centrally located tumors remain problematic.Extended right or left hepatectomy removes 60％ to 85％ of the hepatic parenchyma and is associated with more hepatic failure.Mesohepatectomy,resection of central hepatic segments (Couinaud's segments Ⅳ,Ⅴ,Ⅷ) and leaving the right and left segments in situ,preserves more functional hepatic tissues than extended hepatectomy.Despite its technical demands,mesohepatectomy should be considered as an alternative treatment for central huge hepatic tumors.