Objective To identify iron nutritional status in very low birth weight infants (VLBWI) and its influence factors.Methods A total of 115 babies admitted from January to December 2014 were included in the study.Serum ferritin of new born infants was analyzed.The clinical data of gestational age,birth weight,hemoglobin,iatrogenic blood loss,cumulative volume of blood transfusion and pregnancy maternal diseases(diabetes,hypertension and anemia) were analyzed.Results The serum ferritin of 115 VLBWI were 100.8 to 210.3 μg/L,the average were(140.32 ± 13.21) μg/L;the minimum serum ferritin of babies born ＜ 32 weeks gestational age were(124.5 ± 31.3) μg/L.Smaller the VLBWI gestational age,the lower the basic baby serum ferritin(F =14.367,P =0.000).More severe the maternal anemia,the lower the basic baby serum ferritin levels [no anemia:(230.9 ± 68.7) μg/L,mild anemia:(189.5 ± 75.3) μg/L,moderate anemia:(133.5 ± 88.1) μg/L,severe anemia:(122.2 ± 56.8) μg/L;P ＜ 0.05].Lower the level of hemoglobin,the lower the basic level of serum ferritin(P ＜ 0.05).Volume of blood transfusion had a huge impact on the last serum ferritin levels (P ＜ 0.05).Conclusion Improvement of the basic baby serum ferritin level in the early stage is useful to ensure the VLBWI iron reserves.It is necessary to regularly monitor serum ferritin during hospitalization and even after discharge.

Objective To investigate the safety and clinical effect of Ⅰ-stage resection of colon cancer and synchronous liver metastasis after conversion therapy.Methods The retrospective descriptive study was adopted.The clinical data of 1 patient with sigmoid cancer with synchronous multiple liver metastases who was admitted to the Zhongshan Hospital of Fudan University in April 2013 were collected.The patient was diagnosed as sigmoid cancer with multiple lymph nodes surrounding colon and 5 metastatic lesions found in liver by preoperative imaging examination,and the maximum diameters of 2 metastatic lesions were 4.5 cm and 3.6 cm.The pathological results of colonoscopy indicated adenocarcinoma.After discussion of the multidisciplinary team,liver metastatic lesions were significantly reduced through mFOLFOX6 chemotherapy combined with bevacizumab treatment,and then patient underwent Ⅰ-stage resection of colon cancer with synchronous liver metastasis by the surgical procedures of partial hepatectomy + 3D laparoscopy-assisted radical resection of sigmoid cancer.The patient received convention treatment of antibiotic,nutrition support therapy and mFOLFOX6 adjuvant chemotherapy.The changes of lesions in liver and tumor markers were observed by tumor marker test,abdominal/pelvic CT and MRI in the upper abdomen after conversion therapy.The operation time,volume of intraoptrative blood loss,number of lymph nodes dissected and vital sign were observed in the operation.The liver function,time for out-off-bed activity,time to anal exsufflation,time of drainage tube removal,duration of hospital stay,complications,results of pathological examination and recurrence and mnetastasis of tumor were observed after operation.After discharge from hospital,the patient underwent monthly tumor marker test,B ultrasound and chest X-ray examination till January 2014 and abdominaL/pelvic CT,magnetic resonance imaging (MRI) in the upper abdomen and colonoscopy every 6 months.The follow-up of outpatient examination and telephone interview was performed to detect the recurrence and metastasis of tumor up to September 2015.Results After preoperative 4-cycle chemotherapy,the diameters of 2 metastatic lesions in liver reduced to 3.2 cm and 2.0 cm,the levels of carcinoembryonic antigen(CEA) and CA19-9 (tumor marker) were reduced to 95.9 μg/L and 252.4 kU/L.The patient underwent successful Ⅰ-stage resection of colon cancer and synohronous liver metastasis.The operation time,volume of intraoperative blood loss,numbers of lymph nodes dissected and cancerous nodes were 208 minutes,250mL,14 and 1,respectively.The patient had no blood transfusion and metastasis,with the stable vital signs and good postoperative recovery.The levels of alanine transaminase (ALT) and aspartate transaminase (AST) were 1 147 U/L and 2 631 U/L at postoperative day 1,101 U/L and 37 U/L at postoperative day 7,respectively.The out-off-bed activity,anal exsufflation,drainage tube removal and discharge from hospital were occurred at postoperative day 2,3,7 and 9,respectively.No anastomotic fistula,bleeding and infection were occurred aftcr operation.The patient was diagnosed as with ulcerated sigmoid adenocarcinoma in T3N1cM1 stage (combining with liver metastasis).The patient received adjuvant therapy of mFOLFOX6 and oral capecitabine at postoperative day 40,and was followed up for 30 months with a good quality of life and without metastasis and recurrence.Conclusion Ⅰ-stage resection of colon cancer with synohronous liver metastasis can be used for initial unresectable colon cancer with liver metastasis after conversion therapy,and it is safe and feasible,with a good therapeutic effect.

Objective To observe the influence of post-operative swallowing painwith Disposcope endoscope or Macintosh laryngoscope in patients with difficult visible glottis. Methods Thirty-six patients scheduled for elective surgery under general anesthesia whose glottis was not visible underMacintosh laryngoscope (according to Cormach-Lehane Grading of laryngoscopic view) were randomized into 2 groups (n = 18 each):Disposcope endoscope group (group D) and Macintosh laryngoscope group (group M). The rate of glottis exposure and successful intubation, swallowing pain at 30 min, 1, 3 d after extubation were observed. Results Compared with group M , the successful rate of glottis exposure and first intubation was significantly higher than thatin group D (P < 0.05). Swallowing pain VAS was higher in group M than in group D at 1d afterextubation (P < 0.05). Conclusions Compared with Macintosh laryngoscope , Disposcope endoscope in patients with difficult visible glottis could induce higher successful rate of glottis exposure and first intubation , shorter time of intubation and lower VAS of swallowing pain at 1d after extubation.

Objective To analyze the advantages and disadvantages of various harmonic magnetic resonance elasticity reconstruction algorithms.Methods Different reconstruction algorithms were categorized according to their mathematical hypotheses.The influence of different assumptions on elasticity reconstruction was investigated with experiments and from mathematical fundamentals.Results The finite element full inversion method had higher precision while more computational time.The algorithms with local homogeneity and incompressibility assumptions were faster while less accurate.The algorithms considering the local change of elastic moduli could effectively reduce boundary artifacts.Conclnsion Different assumptions of algorithms may cause levels of errors between the estimated and real elastic moduli.The selection of elasticity reconstruction algorithms in practical experiment requires a comprehensive tradeoff.

Objective To investigate the mobilization effect of low-does granulocyte-colony stimulation factors(G-CSF) on allogenic peripheral stem cell transplantation (PBSCT) and the best acquisition time for haemopoietic stem cell. Methods G-CSF was administered subcutaneously at 5μg·kg~(-1)·d~(-1)to 108healthy donors. The mobilization effects were assayed by mononuclear cell count,flow cytometry and colonyforming units analysis.Results Onfourth day,fifty day and sixth day, the ratio of CD_(34)~+ were (0.71 ±0.08)%, (1.09±0.09) %, (0.57±0.08) %, respectively. The CFU-GM yield were (93.33±44.51)/10~5MNC, (124.61±57.85)/ 10~5MNC, (80.25±49.24)/10~5MNC, respectively. The number of CD_(34)~+ were (3.33±1.36)×10~6/kg, (4.14±1.67) ×10~6/kg, (2.79±1.47)×l0~6/kg, respectively. The ratio and number of CD_(34)~+ cell of PBSC collections of fifth day was higher than that of the fourth day (P <0.05). And the fourth day was higher than that of the sixth day(P < 0.05). Twice day (fourth day and fifth day) collection can obtain enough CD_(34)~+ cell for PBSCT. There were no significant adverse effects. Conclusion Low-does G-CSF takes good effects on the mobilization of PBSC. And it was better to collect stem cell on fourth day and fifth day rather than on fifth day and sixth day after mobilization.

Objective To investigate the effect of potassium sodium dehydroandroandrographolide succinate injection on helper T cells in peropheral blood and the content of products of oxidative stress in patients with pulmonary infection.Methods 80 community patients with acquired pneumonia in our hospital were selected as the research subjects.They wererandomly divided into observation group and control group,40 cases in each group.The control group was treated with routine treatment of community-acquired pneumonia,patients in the observation group were given conventional treatment combined with potassium sodium dehydroandroandrographolide succinate injection.The peripheral blood T cell subsets,inflammatory cytokines and oxidative stress were compared in two groups.Results After treatment,malondialdehyde,advanced oxidation protein products of the observation group were (14.61 ± 1.65)U/L,(42.67 ± 5.62)μmol/L,respectively,which were lower than those of the control group.Glutathione peroxidase,superoxide dismutase of the observation group were (243.57 ± 33.64) μg/mL,(21.63 ± 3.78) μg/mL,respectively,which were higher than those of the control group,the differences were statistically significant(t =15.155,15.432,7.651,4.726,all P ＜ 0.05).After treatment,Thl7 of the observation group was (1.03 ± 0.15) ％,Thl7/Treg was (0.21 ± 0.03),which were lower than those of the control group,and Treg was higher than that of the control group,the differences were statistically significant (t =7.315,14.805,4.541,all P ＜0.05).The total effective rate of the observation group was 87.50％,which was significantly higher than 77.50％ of the control group (x2 =2.385,P ＜ 0.05).Conclusion Potassium sodium dehydroandroandrographolide succinate injection can contribute to the improvement of community acquired pneumonia in patients with peripheral blood T cell subpopulation structure,reduce the level of oxidative stress,improve the therapeutic effect,it is worthy of clinical application.

Objective To discuss the relationship between lung function before and after radiotherapy and radiation-induced pneumonitis in locally advanced non-small-cell lung cancer.Methods 76 patients were evaluated by pulmonary function tests before radiotherapy and in 1 month and 3 month after radiotherapy respectively.Results All patients were treated radiotherapy with irradiation dose of 60-70 Gy,the radiation pneumonitis occurred in 26 patients (group A),22 patients were grade 1,3 patients were grade 2,1 patient grade 3 and no patient was grade 4 and 5.50 patients without radiation pneumonitis were group B.There were significant difference between group A and group B for FEV1 before radiotherapy [(51.67±19.03) ％,(69.03± 14.54) ％,t =2.34,P ＜ 0.05].There were no significant difference between in 1 month and 3 months after radiotherapy for FVC (P ＞ 0.05).There was significant difference between in 1 month and 3 months after radiotherapy for DLCO (group A,P ＜ 0.01; group B,P ＜ 0.05).Conclusions For locally advanced non-small-cell lung cancer patients,the lower of FEV1 before radiotherapy inclineds to develop radiation pneumonitis,DLCO levels are lower significantly in patients prones to radiation pneumonitis.FEV1 and DLCO are sensitive indicators to predict radiation pneumonitis.

Objective To establish a method for simulataneous determination of 18 free amino acids in snake venom. Methods Preparation of free amino acid samples by membrane. HPLC analysis was performed after derivatization by using phenyl isothiocyanate (PITC) as a derivative reagent, samples were analyzed on Ultimate LP-C18 column with gradient elution column of 0.05 mol/L sodium acetate buffer and methanol-acetonitrile- water (40:40:20), and current speed was1.0 mL/min, and the column temperature was set at 35℃, and detection wavelength was 254nm. Results The 18 kinds of amino acids showed a good linearity with the correlation coefficients ≥0.99. The recovery rate was 74.59%~110.62%. Snake venom contained 17 kinds of amino acids, the total content of amino acids was 0.2%. Conclusion The method was accurate, reproducible and reliable, and can be used for the determination of amino acids in snake venom and related products.

Objective To evaluate the effects of L-alanyl-L-glutamine (LALG) intensified parenteral nutrition support in advanced malignant carcinoma patients.Methods 68 patients were randomly divided into two groups,control group (n =34) received only parenteral nutrition,treatment group (n =34) received parenteral nutrition combined with a dose of 0.3 g ·(kg·d)-1 LALG.Nutrition status and immune functions were determined at pre-therapy and 15th days after therapy.Results After the therapy,the pALB and TRF of treatment group were significantly increased [(24.9±8.06) mg/dl vs (27.3±6.05) mg/dl; (1.62±0.43) g/L vs (2.06±0.32) g/L].Before therapy,no significant change in IgA,IgM and IgG was found in two groups (P ＞ 0.05).After the therapy,IgA and IgG of the treatment group after the therapy were significantly different from those before the therapy [(2.85±1.43) mg/L vs (3.63±5.36) mg/L; (0.95±0.43) mg/L vs (1.13±0.09) mg/L],IgA,IgM and IgG of the control group had no difference compared with those before the therapy (P ＞ 0.05),CD4+ of treatment group was significandy different compared with those of control group [(39.19±4.23) ％ vs (36.62±3.58) ％] (P ＜ 0.05).There is no significantly difference between CD:/ CD8+ CD8+ of treatment group and those of control therapy (P ＞ 0.05).After therapy,the score of quality of life in treatment group was higher than that in control group (P ＜ 0.05).Conclusion LALG intensified parenteral nutrition has better effects on improvement of the nutrition and immune functions.