Objective To explore the effects of different operations on respiratory function after colon replacement for esophageal cancer.Methods Fourty patients with esophageal cancer underwent esophagectomy from May 2004 to June 2008,were retrospectively analyzed.The site of esophageal anastomosis was at neck after sternum in 20 cages.at neck through esophageal bed in other 20 cages.Blood gas analysis and pulmonary fuction were monitored in these patients before operation and in 14 days after operation.Results VC% were (42.17±10.15)%、(49.52±9.56)%、(55.67±10.73)%、(60.27±10.52)%in patients after sternum and(37.65±9.52)%、(40.72±10.12)%、(47.02±10.65)%、(52.89±10.82)%in patients through esophageal bed in 5th、7th、10th、14th postoperative day with sigllificant statistical difference;FEV_1% were(60.55±16.71)%、(67.12±16.90)%in patients after sternum and(45.23±16.26)%、(50.52±16.72)%in patients through esophageal bed in 10th、14th postoperative day with significant statistical difference;PaO_2 were(17.56±7.32)mm Hg、(19.67±6.08)mm Hg、(17.17±4.85)mm Hg、(15.43±5.02)mm Hg、(11.32±3.79)mm Hg、(9.67±2.87)mm Hg、(6.98±3.26)mm Hg in patients after sternum and(20.17±7.04)mm Hg、(22.83±6.75)mm Hg、(20.67±4.31)mm Hg、(18.32±4.85)mm Hg、(16.02±3.71)mm Hg、(13.44±2.56)mm Hg、(9.01±3.17)mm Hg in patients through esophageal bed in 1st,2nd,3rd,5th,7th,10th,14th postoperative day with significant statistical difference. Conclusions After esophagectomy,esophageal anastomosis through esophageal bed has significant negative effect on respiratory function.

Objective To explore the mechanisms of individual, social and environmental factors influencing physical activity and the relationships among the factors in patients with type 2 diabetes. Methods A survey was conducted from January to July 2015 among 225 patients with type 2 diabetes using convenience sampling. The questionnaire included 9- item Patient Health Questionnaire, the International Physical Activity Questionnaire,Perceived Social Support Scale, Chinese Walkable Environment Scale, Bandura′s Exercise Self- efficacy Scale. Results The effective questionnaire recovery rate was 98.7%(222/225). Exercise self- efficacy was a mediator of factors influencing physical activity. Exercise self- efficacy and physical activity were positively correlated (β=0.24, P<0.05). Walkable environment only affected physical activity indirectly medicated by exercise self- efficacy (β=-0.26, P<0.05). Perceived social support directly associated with physical activity (β=0.14, P<0.05). Depression not only affected physical activity directly (β=-0.28, P<0.05), but also associated with physical activity indirectly medicated by exercise self-efficacy (β=-0.32, P<0.05). Conclusions Interventions should be taken to increase the perceived social support, improve depression and walkable environment, especially to enhance exercise self- efficacy, so as to improve the physical activity level of patients with type 2 diabetes.

Objective To explore the imaging features and clinical significance of solitary costal hot spots on bone scintigraphy (BS). Methods Eighty-four patients with single costal hot spots were enrolled in the study. The sites of lesions were classified into four types: junction betweenaor rib. The shapes of hot spots were classified into three forms: Punctiform, clumping and strip. The above data were respectively analyzed. Results Single hot spots were mainly showed in the punctiform and strip shapes, and the distribution of punctiform spots were mainly in the sites of junction between costal cartilage and rib and frontal ribs, also mainly due to costal fractures (42/61, 68.85%). The majority of spots in strip shape were costal metastases(18/19, 94.74%). Hot spots in posterior ribs were also mainly costal metastases (24/29,82.76%). Conclusion Useful imaging features can be obtained from BS with al diagnosis of benign and malignant lesions.

Objective To investigate the mycelia growth of the mutant strain Paecilomyces bainier sp229-7 and it's biotransformation from ginsenoside Rb1 to Rd. Methods The substrate was biotransformed by the mutant in different conditions, and the products were analyzed by HPLC. Results The period of vigorous growth of the mutant was 12-48 h. The optimal transformation temperature range was from 27 ℃ to 32 ℃. The best time for adding substrate was 36 h after inoculation and the substrate (Rb1 20 mg/mL) was specifically transformed into ginsenoside Rd. The transformation process was terminated at 72 h. The ginsenoside Rb1 could be transformed to Rd by all of mycelia, crude enzymes and external enzymes. Conclusions Compared with the reference, the mutant of Paecilomyces bainier sp229-7 growth is quicker and the transformation efficiency has been greatly improved. The reaction time can be shortened to 3 days, and the amount of substrate increased at least 20 times.

· AIM: To investigate the influence of TGF-β 2 antisense oligonucleotide(ASON) on the differentiation, proliferation of stromal fibroblast in corneal stroma injury.both eyes of 28 rabbits, the right eyes were served as experimental group, corneal incisions were sutured with 8-0 coated vicryl suture carrying TGF-β 2 ASON; the left eyes were served as control group, corneal incision were sutured with common 8-0 coated vicryl suture. Rabbits were killed at 4, 7, 14 and 28d after surgery, stromal fibroblasts were examined by immune histochemistry and electron microscopy.significantly reduced the numbers of cells expressingα -smooth muscle actin (α -SMA) and proliferating cell nuclear antigen (PCNA). The ultrastructure of fibroblast had no significant difference in two groups.differentiation and proliferation of stromal fibroblast in corneal injury. This will be a new method to adjust corneal wound repair.

Objective:To explore the reliability of Xpert MTB/RIF (Xpert) in the diagnosis of pulmonary tuberculosis and to understand the characteristics of retreated patients, so as to provide clues for the investigation of retreated patients.Methods:905 patients sputum with suspected tuberculosis from July 2019 to December 2019 were collected from the Tuberculosis Department of Changsha Central Hospital. Xpert was used for rapid screening of tuberculosis. MGIT960 and Roche culture method were used for rapid sputum culture and drug sensitivity, respectively. Rifampin (RIF) resistance was compared between Xpert and Roche culture. The gender, age, RIF resistance, occupation and diabetes mellitus of patients with positive Xpert were compared, and the risk factors of RIF resistance were analyzed by binary logistic regression.Results:The total detection rate of Xpert was 28.7%(260/905) in 905 suspected pulmonary tuberculosis patients; RIF resistance rate accounted for 20.8%(54/260) in 260 positive patients, and the main mutation types were probe-E and probe-D. There was no significant difference between traditional drug sensitivity and Xpert method in RIF resistance detection ( P>0.05); There was no significant difference between Xpert method and traditional drug sensitive cases in predicting isoniazid (INH) resistance ( P=0.293); there were significant differences in age ( t=-3.835, P<0.05), gender, RIF resistance rate and proportion of farmers between newly treated and retreated patients (χ 2=5.091, 16.862, 4.808, P<0.05); Binary logistic regression showed that retreatment was a risk factor for RIF resistance ( OR=3.739, P=0.004). Conclusions:Xpert has high clinical value in the diagnosis of pulmonary tuberculosis and RIF resistance; The retreated patients were older, and the proportion of male farmers was larger, with higher resistance rate to RIF.

Objective:To investigate the compliance with early Warfarin anticoagulation therapy after cardiac mechanical valve replacement(MHVR)and its related factors in elderly patients.Methods:The convenience sampling method was used to prospectively recruit 210 patients undergone MHVR at the Ningbo Medical Center of Lihuili Hospital from January 2017 to October 2019.Six months after discharge, face-to-face interviews or telephone follow-ups were conducted to assess general information, warfarin anticoagulation knowledge, anticoagulant treatment compliance and social support.Results:The overall compliance of early Warfarin anticoagulation therapy was excellent, with 99.5% of patients compliant with medication and 99.0% compliant with INR monitoring, both higher than the rate of compliance with advised lifestyle adjustment(92.1%). Anticoagulation knowledge and age were the main influencing factors for compliance in elderly patients after MHVR.Conclusions:The compliance with early Warfarin anticoagulation therapy after MHVR is good in elderly patients in the Ningbo area.The correlation analysis suggests that medical professionals need to promote education on anticoagulation knowledge and pay more attention to anticoagulation compliance in elderly people.

ObjectiveTo investigate the efficacy of acupuncture point injection for fine motor functions in children with cerebral palsy.Methods57 children with cerebral palsy were treated by acupuncture point injection combined with occupational therapy. The efficacy was evaluated by the Peabody Developmental Motor Scale-Fine Motor (PDMS-FM).ResultsThe fine motor quotient (FMQ) of 34 children (59.7%) elevated. The raw scores of grasping subtest (Gr) elevated in 45 children (78.9%) and the raw scores of visual-motor integration (VI) elevated in 53 children (93.0%).ConclusionThe efficacy of acupuncture point injection combined with occupational therapy is significant in children with cerebral palsy.

Aim To investigate the effect of Ginsen-oside Rh2 on apoptosis in human colorectal cancer cell SW480,and to explore the possible mechanism of it. Methods The proliferation activity of SW480 treated with Ginsenoside Rh2 was measured CCK-8 assay.Ap-optosis rates were evaluated by FCM.Hoechst 33258 staining was used to observe cell nucleus morphologi-cal;change SW480 cells were treated with Ginsenoside Rh2,and the protein expressions of Bcl-2,Bax,p53, cleaved caspase-3 ,PI3 K,AKT,P-AKT,GSK-3β,P-GSK-3βwere detected by Western blot;SW480 cells were treated with LY294002,Rh2,LY294002+Rh2, the expressions of PI3 K,AKT,P-AKT,GSK-3β,P-GSK-3βwere detected by Western blot.Results The proliferation of SW480 cells was significantly inhibited by Ginsenoside Rh2 in dose-dependent and time-de-pendent manner.FCM showed the inducing apoptosis effect of Ginsenoside Rh2 was significantly different from that of control group.Hoechst 33258 staining in-dicated clearly cell apoptosis in Ginsenoside Rh2 treat-ment groups.Western blot showed Ginsenoside Rh2 decreased expression of Bcl-2,increased expression of Bax,p53 and cleaved caspase-3,PI3K/AKT/GSK-3βpathway proteins PI3 K,P-AKT,P-GSK-3βdecreased obviously,AKT and GSK-3βwere not changed signifi-cantly in SW480.SW480 cells were separately treated with LY294002,Rh2,LY294002 +Rh2,there were no significant difference in AKT and GSK-3βprotein a-mong all groups,and the expression of PI3 K,P-AKT, P-GSK-3βdecreased more obviously in LY294002 +Rh2 group compared with LY294002 and Rh2 alone. Conclusion Rh2 induces colorectal cancer cell apop-tosis through PI3 K/AKT/GSK-3βpathway,which ac-tivates p53 and cleaved caspase-3,and destroys the balance of Bcl-2/Bax.

BACKGROUND: Pancreas-kidney transplantation is an effective treatment for diabetes combined with final stage renal disease. However, as the patients suffer diabetes for a long period of time, and cardiovascular system disease is complex, pre- and post-transplantation treatment is very important for successful pancreas-kidney transplantation.OBJECTIVE: To discuss immunosuppressant, coagulant, perioperative and postoperative treatment during pancreas-kidney transplantation to provide some clinical experience for pancreas-kidney transplantation.METHODS: Clinical data of 5 cases undergoing simultaneous pancreas-kidney transplantation in Department of Urinary Surgery, the 309 Hospital of Chinese PLA General Hospital between 2003 and 2008 were retrospectively analyzed to summarize the application of immunosuppressants and anticoagulant drugs and perioperative clinical monitoring focus. RESULTS AND CONCLUSION: There were 5 male patients with an average age of 43 years, and suffered type I diabetes mellitus complicated with final stage renal disease. The preoperative insulin dosage was 1.5-2.4 U/(kg·d). One case had diabetic retinopathy and fundus oculi hemorrhage for many times; two cases showed apparent coronary atherosclerotic heart disease with preoperative cardiac ejection fraction of 52% and 50%. Exocrine of transplanted pancreas had been considered by the intestinal fluid drainage. A total of 3 cases were complete rehabilitation. Of them, 1 case developed acute rejection in the first seven days after operation, but renal function restored with the hormones impact; 1 case had postoperative acute rejection of transplanted duodenum as well as intestinal fistula, eventually, transplanted pancreas was ectomized, but transplanted kidney was preserved; two cases succeeded in restoring and no complications occurred; 1 had postoperative gastrointestinal bleeding and died from multiple organ failure. Simultaneous pancreas-kidney transplantation is the most effective way to treat the diabetes mellitus with terminal nephropathy. Because of complications in the transplanted exocrine pancreas with bladder drainage, it has been replaced by the enteric drainage. Recovery of the transplanted kidney function is important for successful transplantation. After operation, oral FK should be taken when the serum creatinine returned to 300 umol/L. The application of clotting drug is one of the important factors for recovery of transplanted pancreatic function. Jejunostomy is an important therapeutic measure to prevent the reflux of intestinal juice to the transplanted pancreas in perioperative period. In the follow-up period cathartic drugs are recommended to prevent constipation and reduce the occurrence of acute pancreatitis caused by intestinal fluid reflux.