Objective: To review the clinical effect of early enteral nutrition in patients with carcinoma of esophagus after operation.Methods: Nutrient canal was indwelt through Fresubin(TP) was given through the nasal-intestinal tube in 120 cases with carcinoma of esophagus after operation.Results: The complications such as anastomotic leakage,lung infection and incisional infection in the patients receiving early enteral nutrition were much less than those in control group.No death occurred.The time for bowel function recovery was much shorter.Conclusion: Early enteral nutrition can promote the recovery of gastrointestinal function,improve the nutrition,decrease the occurrence of complications and raise the successful rate of operation in operative patients with esophagus carcinoma.

Objective To investigate whether exogenic brain derived neurotrophic factor (BDNF) can permeate placental barrier into fetus and further through fetal blood brain barrier(BBB) after transient ischemia. Methods Seventeen day pregnant rats were selected. The uterine arteries of the rats were clamped for 30 minutes in experimental group. BDNF labeled with 125 I was injected into the rats through caudal veins. The radioactivity of BDNF in different fetal organs was measured at 24 h, 48 h and 72 h. Results 125 I BDNF was detected in amniotic fluid, placenta and fetal organs including brain, heart, lung, liver and kidney. This indicated that BDNF partly permeated placental barrier. The permeability of BDNF through placenta barrier and fetal BBB increased with the increased dose injected. BDNF reached the fetal brain through BBB under hypoxia eschemia condition. The rates of penetration of BDNF through placental barrier and BBB increased under the condition of fetal ischemia and hypoxia. Conclusions Exogenic BDNF may partly go through placental barrier and BBB into fetal brain, which makes it possible for BDNF to be a treatment for fetus suffered from ischemia and hypoxia.

Objective To investigate the value of MRI combined with serum CA125 test in the diagnose of ovarian tumor.Methods To investigate the MRI and serum CA125 level of healthy control group (40 cases),benign tumor group (52 cases),and the malignant tumor group (43 cases).Results Of 95 patients with ovarian masses,CA125 was detected in the malignant patients with the sensitivity of 79.3 ％,specificity of 72.6 ％ and accuracy of 75.1％.MRI was 73.8 ％,81.2 ％,and 82.6 ％ respectively.Combined with CA125 and MRI was 69.4 ％,97.3 ％,and 88.6 ％.Youden' s index of combined detection was significantly higher than single detection (MRI combined with CA125 and single MRI u =1.97,P =0.012 5,and CA125 u =1.96,P =0.012 0).Conclusion MRI combined with CA125 could improve the accuracy of diagnosis ovarian neoplasm in clinic.

PurposeTo investigate the image quality of Dual Source CT (DSCT) high pitch prospective scan in acute chest pain examination by using triple-rule-out (TRO) protocol and its responses to heart beat rate change.Materials and Methods Thirty-two consecutive patients who planned to undergo TRO acute chest pain examination were enrolled and randomly divided into research group and control group. The conventional retrospective spiral scanning protocol was applied to the patients in the control group, while the high pitch prospective spiral scanning mode was used in the research group. CT value, noise level, SNR, CNR and radiation dosage in aorta and pulmonary arteries were recorded and compared between the two groups, and the image quality of the coronary arteries was scored subjectively.Results No significant difference was found in the aspects such as CT value, noise level, SNR, CNR radiation dosage in aorta and pulmonary arteries (P>0.05); however, the subjective scoring for coronary artery in the research group (85.5%) was significantly lower than that in the control group (93.9%) (χ2=8.33,P<0.05). Considering the influence of severe heart rate changes, we excluded those patients whose heart rate variance was more than 5 beats/min (control group:n=5; research group:n=4) and then compared the image quality of the two groups again. The subsequent results showed no difference (χ2=0.12,P>0.05). In addition, the radiation dosage in the control group was significantly higher than that in the research group [(20.8±6.2) mSvvs. (2.3±0.4) mSv;t=17.142,P<0.01].Conclusion DSCT high pitch prospective scanning in TRO protocol shows high success rate in examining patients with acute chest pain whose heart beat rate is lower than 80 beats/min and heart beat variance is less than 5 beats/min. The image quality has no difference with that derived from retrospective scan but with far more less radiation dose (2.3±0.4) mSv. This method thus is promising and can be widely promoted clinically.

Objective To investigate the effect of EMG-triggered stimulation on drop foot for poststroke hemiplegia. Methods 36 hemiplegic patients were randomized into routine group (n=18) and EMG-triggered stimulation group (triggered group, n=18). 2 groups were assessed by Fugl-Meyer Assessment (FMA), range of motion (ROM) of ankle dorsiflexion and iEMG values before and after treatment. Results The scores of FMA, degrees of ROM, iEMG values of the tibialis anterior, and co-contraction ratio improved in 2 groups after treatment (P<0.05), and the triggered group had better effect than the routine group (P<0.05). Conclusion EMG-triggered stimulation can improve muscle strength, and decrease co-contraction ratio.

Objective To compare the effects of different maternal rats food restriction on newborn rats.Methods Pregnant rats were randomly divided into 4 groups:3 model groups and control group.The model groups were given middling food restriction throughout pregnancy,severe food restriction from pregnant day 14,severe food restriction from pregnant day 7,respectively.Effects of maternal rats food restriction on newborn rats in growth,main organs weight,and small for gestational age(SGA) occurrence were compared.And his-(tiocyte) morphology of cerebra and stomach were observed.Results The weight,height,trail length,and weight of cerebra,heart,lung,(liver),stomach,spleen,and kidney of newborn rats in model groups were significantly different from those in control group(all P

Objectives To evaluate the clinical value of neoadjuvant chemotherapy (NACT) in the treatment of local advanced cervical cancer. Methods We searched the clinical trials on the treatment of local advanced cervical cancer with NACT followed by surgery versus initial surgery on English and Chinese published literatures from the main medical data resources (MEDLINE, PUBMED, ELSEVIER ScienceDirect, CNKI). The data about positive pelvic nodes, interstitial infiltration, vascular invasion, positive surgical margin, 3-year overall survival (OS), 3-year disease-free survival (DFS), 5-year OS, 5-year DFS were extracted from these papers, and a meta-analysis was applied. Result The hazard ratio (HR) of positive pelvic nodes on NACT group versus control group was 0. 54(95% CI 0. 33 ～0. 86), HR of interstitial infiltration was 0. 45(95% CI 0. 24 ～0. 86), HR of vascular invasion was 0. 25(95% CI 0. 16 ～0. 38), all differences were statistically significant. And HR of positive surgical margin was 0. 45 ( 95% CI 0. 21 ～0. 99), P = 0. 05, which indicated the difference was not statistically significant. And there were also no significant difference on the HR of 3-year OS, 3-year DFS, 5-year OS and 5-year DFS, and their RR were 1.18(95% CI 0. 84 ～ 1.66) ,1.31 (95% CI 0. 96 ～ 1.78) ,0. 89(95% CI 0. 68 ～ 1.15) ,and 0. 99(95% CI 0. 71 ～ 1.93) respectively. Conclusion For local advanced cervical cancer, NACT could reduce pathological risk factors but it did not improve the survival.

Objective:To investigate the defect types and reconstruction methods of maxillary defects. Methods:The database of 1 107 cases with maxillary defects in Peking University School and Hospital of Stomatology from January 1985 to December 2010 was established. There construction methods were re-viewed. The defect types were classified according to Brown classification system. Results: In the 1 107 cases, 1 104 cases could be classified according to Brown classification system. The most common type was 2a with 559 cases (50. 6%). Among all the 1 107 cases, 349 cases were reconstructed with auto-transplantation, 443 cases with prosthesis, 107 cases untreated, and 208 patients lost to the follow-up. There was a significant growing trend over time for the application of free flaps and a downward trend of prosthesis. The most popular free flaps were fibular flap (88 cases) and radial forearm flap (75 cases) . Rectus abdominis flap and anterolatreal thigh flap were fit for extensive maxillary defects. Conclusion:The most common defect type is 2a. Free flap has become the dominant option for maxillary reconstruc-tion. Free flaps could be selected according to the maxillary defect types.

Objective:To explore the strategies and complications of the submucosal tunneling endoscopic resection (STER) in the treatment of esophageal duplicated cyst (EDC).Methods:From January 2013 to December 2019, at Department of Gastroenterology, Taizhou Hospital of Zhejiang Province, the clinical data of 11 hospitalized patients with EDC diagnosed by pathological examination who underwent STER were collected. The clinical featured, computed tomography (CT) findings, endoscopic findings, postoperative efficacy, complications and pathological results after operation were summarized.Results:Among the 11 patients, there were 6 males and 5 females, the age ranged from 13 to 67 years, and the mean age was (43.0±18.2) years. One case presented with swallowing obstruction, 1 case with belching, 4 cases with upper abdominal pain, and the remaining 5 cases had no specific clinical symptoms. Under endoscopy, the lesions of 11 patients were hemispherical or mound-shaped with smooth surface submucosal masses in the esophageal cavity, which were soft to touch. Under endoscopic ultrasonography, they all appeared as hypoechoic masses with clear boundary located in the esophageal muscularis propria. The results of CT scan of 9 patients showed round low-density cystic masses, among them 7 cases showed mild enhancement. The maximum diameter of the cysts was 1.5 to 4.4 cm, with mean maximum diameter being (2.8±0.8) cm, and the maximum diameter of most patients (7 cases) were 2 to 3 cm. The other two patients showed only slightly thickened esophageal wall on CT. Five lesions occurred in the horizontal mediastinum of the lower esophagus. All the 11 patients underwent STER operation successfully, among them 6 patients received simple STER and the cysts were completely resected, and the other 5 patients received STER and cauterization with argon ion for the residual cyst wall. The pathological results after operation indicated that 6 cases were congenital esophageal cysts and 5 cases were bronchogenic cysts. The median follow-up time (range) of 11 patients was 42 months (12-86 months). Ten patients recovered well after the operation, and local recurrence, malignant transformation or metastasis were not found. One case had recurrence, and was treated with STER and cauterization with argon ion for residual cyst wall and cured. No complications such as bleeding, fistula, mediastinal infection or death occurred during and after operation in all the 11 patients.Conclusions:STER is a minimally invasive, safe and effective treatment for EDC, and may be a new treatment for EDC.

Objective To investigate the performance of MSCT in the diagnosis of metanephric adenoma.Methods The imaging data of 5 cases of metanephric adenoma confirmed by operation and pathology in our hospital were collected and analyzed retrospectively.The location, size, shape, density and enhancement of the lesion were further retrospectively analyzed.Results In the incorporated 5 cases of metanephric adenoma, the male to female ratio of cases was 1:4, all were unilateral, including 2 cases of the right kidney,3 cases of the left kidney,2 cases were located in the upper pole, 2 cases in the polar region, 1 case in the lower pole of the kidney.Maximum diameter of the metanephric adenoma ranged from 2.9 cm to 8.4 cm, with an average value of 4.8 cm.The shape of metanephric adenoma was classified into: round (3 cases) and oval (2 cases).On plain scanning slightly lower density was found in 2 cases, equidensity in 2 cases and slightly higher density in 1 case.Furthermore,1 case had small punctatel calcification in the edge of the lesion,1 case with renal papillary carcinoma.4 cases underwent plain and enhanced scanning,and 1 case plain scanning,in which slight density increase after intravenous enhancement was showed in 3 cases,moderate enhancement in 1 case,more uniform enhancement in 3 cases,uneven enhancement in 1 case,delayed enhancement in 4 cases.Conclusion The characteristic MSCT features of metanephric adenoma have a certain specificity.Preoperative correct understanding is helpful to guide the operation scheme.