Objective To investigate the value of fast track surgery (FTS) principles in the perioperative management of liver cancer patients after hepatectomy.Methods Forty patients with primary liver cancer who were admitted to the First People's Hospital of Qinzhou from September 2011 to July 2013 were enrolled in this prospective study.All the patients were randomly divided into the FTS group (20 patients) and the control group (20 patients) according to the random number table.The perioperative management of patients in the FTS group was guided by the FTS principles,patients in the control group were managed with traditional methods.The intraoperative condition,time for portal occlusion,operation time,volume of intraoperative blood loss and blood transfusion,time to drainage tube removal,time to flatus and defecation,duration of postoperative hospital stay,expenses,changes of C-reactive protein on postoperative day 1,3,6,recovery of hepatic function and incidence of postoperative complications.All patients were followed up via phone call and out-patient examination till September 2013.All data were analyzed using the t test or chi-square test.The non-normal distribution paramenters were analyzed using the rank sum test.Results All patients were cured with no perioperative death.The time for postoperative drainage tube removal,time to flatus and defecation,duration of postoperative hospital stay and expenses were (2.3 ± 1.0)days,(2.5 ±0.5)days,(3.1 ±0.7)days,(7.0 ±0.8)days and (3.6 ±0.3) × 104 yuan in the FTS group,and (4.6 ± 0.7) days,(4.3 ± 0.7) days,(4.8 ± 0.4) days,(8.5 ± 0.9) days and (4.1 ± 0.3) ×104 yuan,with significant differences between the 2 groups (t =0.74,0.34,1.70,0.23,0.57,P ＜ 0.05).The levels of C-reactive proteins at postoperative day 1,3,6 were (56 ±7)mg/L,(122 ±7)mg/L and (35 ±7)mg/L in the FTS group,and (198 ± 24) mg/L,(137 ± 5) mg/L and (49 ± 8) mg/L,with significant differences between the 2 groups (F =64.91,P ＜0.05).The levels of prealbumin at postoperative day 1,3,6 were (196 ± 14) mg/L,(243 ± 17) mg/L,(260 ± 10) mg/L in the FTS group,and (198 ± 24) mg/L,(199 ± 16) mg/L and (245 ± 7) mg/L in the control group,with significant differences between the 2 groups (F =22.69,P ＜ 0.05).The levels of alanine transaminase at postoperative day 1,3,6 were (379 ±34)U/L,(166 ± 12)U/L,(49 ± 14)U/L in the FTS group,and (367 ±75)U/L,(210 ±28)U/L,(197 ±22)U/L in the control group,with significant differences between the 2 groups (F =4.51,P ＜ 0.05).One patient was complicated with peritoneal effusion and 1 with thoracic effusion in the FTS group; 4 patients was complicated with peritoneal effusion,3 with thoracic effusion,4 with pulmonary infection and 2 with incisional infection in the control group,with no significant difference in the complication between the 2 groups (x2 =0.78,1.11,4.44,2.11,P ＞ 0.05).All the patients were followed up for 2-24 months,no patients received reoperation or re-admitted to the hospital due to complications.Conclusion The application of FTS principle in the perioperative management of liver cancer patients after hepatectomy is safe and effective,it could alleviate the post-operative stress reaction and accelerate the recovery of liver function and patients' condition.

Administration, Inhalation ; Bronchiolitis ; drug therapy ; Bronchodilator Agents ; administration & dosage ; therapeutic use ; Budesonide ; administration & dosage ; therapeutic use ; Female ; Humans ; Infant ; Male ; Poly I-C ; administration & dosage ; therapeutic use

This paper reports 17 cases of hypomagnesemic convulsiens of the newhorn that were admitted from Se-Ptember 1981 to January 1983. Only 2 patients were breast-fed.Symptoms and signs of hypomagnesemia are indistinguishable from these of hypocalcemia unless the serum magne-sium is determ ined. Serum magnes iumlevels had been determined in 50 normal children. The average value-2 standard deviation=2.17-2?0.34=1.49mEq/L.We defined hypomagnesemia as the serum magnesium lcvels below 1.48mEg/L. The serum magnesium levels of 17 patients varied from 0.65 to 1.46m Eq/L. Of 10 cases serum calcium le-vel6mg/dl.2.5%MgSO_4 was given intraveno-usly by continuous infusion in a dose of 2-4ml/kg every 12 hours. After the convulsions had been controlled a dose of 25% MgSO_4 was given intramuscul-arly in a dose of 0.4ml/kg twice daily Convulsions usually ceased after 1--4doses of MgSO_4, but the serum magne-sium levels did not rise to normal le-vels until 2-6 days. The convulsions could not be controlled by repeated ad-ministrations of calcium gluconate in 5 patients who had both hypomagnes-emja and hypocalcemia. Only after theadministiation of MgSO_4 did the serum calicum levels rise to the normal level and the convulsions cease.Electrocardjograms recorded in 7 patients all were abnormal but 1 case,so we should pay attention to the inf-luence of magnesium upon the heart.

Objective To analyze the clinical competency test results of general practitioners (GPs) in Shanghai Pudong New Area.Methods Total 1 160 GPs from Pudong New Area attended the clinical ability tests,all participated in theory test and 327 GPs attended practice skill tests.The results were reviewed by computer and the scores were automatically generated.Results The average score and pass rate of theory test were (64.24 ± 12.23) points and 64.2％ (745/1 155),respectively.The average scores of GPs with master or above degree were the highest (67.09 ± 13.38 points),however,the pass rate of GPs with undergradnate degree was the highest (69.7％,349/501).GPs with senior professional title got the highest average score and pass rate [68.26 ± 9.92 points and 82.7％ (43/52),respectively].Introduction to General Practice (69.7％),Internal Medicine (68.6％) and Cancer (66.9％) were the top 3 subjects with the highest correct rate.The pass rate of clinical skills was 39.1％ (128/327),GPs with master degree or above (192.87) and those with junior professional titles (171.08) had the highest scores.GPs with master degree or above (50.0％,8/16) and those with intermediate professional title (40.1％,97/242)had the highest pass rate.Conclusions The analysis shows that the average score and pass rate of both theory test and clinic practice skills test are not satisfactory among GPs in Shanghai Pudong New Area.The clinical ability of GPs need to be further improved,and the study of some specific disciplines need to be further strengthened.

OBJECTIVETo identify the expression characteristics of the 1700001022RIK (RIKEN cDNA 1700001022) gene in mice and explore its function by bioinformatic analysis.

METHODSUsing the expression profile of gene microarray, we detected the expression of a new testis-specific gene, 1700001022RIK, in mice. We analyzed its expression characteristics in the testis tissue and their changes in different developmental stages of the testis by RT-PCR, real-time RT-PCR, Western blot, and immunohistochemistry. We performed bioinformatic analysis using a bioinformatic software.

RESULTSThe 1700001022RIK gene was specifically expressed in the mouse testis in an age-dependent manner, most highly in the adult mice. The 1700001022RIK protein was mainly expressed in the spermatogonia, spermatocytes, and round spermatids of the adult mice. Bioinformatic analysis showed that the 1700001022RIK protein amino acid sequence had a high similarity in human and mice, which indicated that this gene was highly conserved in mammals.

CONCLUSION1700001022RIK is a testis-specific gene mainly expressed in the spermatogonia, spermatocytes, and round spermatids of seminiferous tubules, which might be involved in the regulation of spermatogenesis.

Age Factors ; Animals ; Blotting, Western ; Computational Biology ; DNA, Complementary ; Gene Expression ; Genomics ; Male ; Mice ; Molecular Chaperones ; genetics ; Seminiferous Tubules ; Spermatids ; Spermatocytes ; Spermatogenesis ; genetics ; Spermatogonia ; Testis

OBJECTIVETo examine the effects of Han's acupoint and nerve stimulator (HANS) electroacupuncture on the expression of NPY in periaqueductal grey (PAG) of heroin addicted rats.

METHODSHeroin was injected subcutaneously according to the principle of daily increasing dose in rats of experimented group. The ability of special learning and memory were tested by Morris water maze; The expression of NPY in PAG of rat were detected by immunohistochemistry.

RESULTS(1) Escape latency and searching distance in heroin-addiction group were significantly increased compared with those of normal group during the place navigation test (P < 0.05). However, in acupuncture group, escape latency and searching distance was obviously shortened compared with those of heroin-addiction group (P < 0.05). The exploring time and distance of original platform area in proportion to the total distance in heroin-addiction group significantly decreased compared with those of normal group during spatial probe test (P < 0.05). The exploring time and distance of original platform area in proportion to the total distance in acupuncture group was increased compared with those in heroin-addiction group (P < 0.01). (2) The expression of NPY of heroin-addiction group was lower than that in normal group in PAG, while those of acupuncture group was higher than that in the heroin-addiction group (P < 0.05).

CONCLUSIONThe learning and memory induced by heroin-addiction could be reversed and the expression of NPY in PAG was increased by HANS in rats.

Animals ; Electroacupuncture ; Heroin Dependence ; metabolism ; Male ; Maze Learning ; Memory ; Neuropeptide Y ; metabolism ; Periaqueductal Gray ; metabolism ; Rats ; Rats, Wistar

OBJECTIVETo investigate the potential role of serum citrulline level in evaluating the intestinal absorptive area and capacity in patients with short bowel syndrome (SBS).

METHODSSerum citrulline concentration was determined using high performance liquid chromatography (HPLC) in SBS patients (n=22) and healthy controls (n=33). In SBS patients, the remnant small bowel lengths and diameters were measured by radiography, and their 5- hour urine D- xylose excretion and intestinal protein absorption were also determined. The correlationship of serum citrulline level with remnant small bowel length, surface area, protein and D- xylose absorption was analyzed. The 6 patients receiving intestinal rehabilitative therapy, serum citrulline level, protein and D- xylose absorption after therapy were also measured.

RESULTSSerum citrulline level of SBS patients was significantly lower than that of healthy controls [(5.94+/- 2.65) vs [(16.87 +/- 5.97) micromol/L, P < 0.01]. In SBS patients, serum citrulline was positively correlated with remnant small bowel length and surface area (r=0.82 and r=0.86 respectively). There was also a significant correlationship of serum citrulline level with 5- hour D- xylose excretion (r=0.56) and intestinal protein absorption (r=0.48). Serum citrulline, 5- hour D- xylose excretion and intestinal protein absorption were all significantly raised in patients after rehabilitative therapy, although no correlation of increasing percentage was found among above three parameters.

CONCLUSIONSSerum citrulline concentration is positively correlated with intestinal absorptive area and capacity in SBS patients. It is a potential marker for evaluating the severity of intestinal failure and the efficacy of rehabilitative therapy in short bowel patients.

Adolescent ; Adult ; Aged ; Case-Control Studies ; Citrulline ; blood ; Female ; Humans ; Intestine, Small ; metabolism ; Male ; Middle Aged ; Short Bowel Syndrome ; blood ; metabolism ; physiopathology ; Xylose ; metabolism ; Young Adult

Diastole ; physiology ; Exercise ; physiology ; Fractional Flow Reserve, Myocardial ; Heart Rate ; Humans ; Systole ; physiology ; Young Adult

OBJECTIVETo explore the effect of temperature dropping process in cold air on the coagulation function both in healthy and hypertensive rats.

METHODSTwenty-four male healthy Wistar rats and 24 male spontaneous hypertensive rats (SHR) were randomly divided into the minimum temperature group (Tim), Tmin control group (Tmin-c), recovery temperature group (Tr) and Tr control group (Tr-c), With the simulated temperature dropping process of a cold air, collected from Zhangye city in March of 2011, the groups of Tmin and Tr were exposed to this process. Both at the Tmin and Tr, blood were collected from the rats for coagulation function measurements.

RESULTSCompared with the control group, no significant difference was found in the results of activated partial thrombin time(APIT), pro-thrombin time (PF) and thrombin time (TT) between any groups in any strains (P > 0.05). The fibrinogen (Fbg) and fibrinogen-time were found to be obvious higher and shorter in Tmin and Tr of healthy rats and in Tmin of hypertensive rats in contrast to the control group. Hypertensive rats had higher level of fibrinogen and shorter level of fibrinogen-time.

CONCLUSIONThe temperature dropping process induced the increase of plasma Fbg both in the healthy and hypertensive subjects, which might be the reason to explain the higher occurrence of cardiovascular diseases event especially these activated through the formation of thrombin during cold air stress. Besides, the coagulation function of healthy subjects was more likely to be affected by cold air than the hypertensive subjects.

Animals ; Blood Coagulation ; Cold Temperature ; Hypertension ; physiopathology ; Male ; Rats ; Rats, Inbred SHR ; Rats, Wistar ; Thrombin Time

Objective:To investigate the efficacy and safety of fecal microbiota transplantation (FMT) in the treatment of irritable bowel syndrome (IBS), and to explore the effects of FMT on the gut microbiota of IBS patients.Methods:From September 2016 to August 2017, at Guangzhou First People′s Hospital, 28 hospitalized IBS patients who underwent FMT treatment were enrolled. Before FMT, four and 12 weeks after FMT, all the IBS patients completed the irritable bowel syndrome quality of life scale (IBS-QOL), irritable bowel syndrome severity scoring system (IBS-SSS) and gastrointestinal symptom rating scale (GSRS). 16S rDNA sequencing was performed before FMT and four weeks after FMT. The effects of FMT on gut microbiota diversity and microbiota structure of IBS patients were analyzed respectively from the level of phylum, family and genus, and linear discriminant analysis effect size (LEfSe) was further used to screen the different bacteria. Paired t test and paired rank sum test were used for statistical analysis. Results:Twelve weeks after FMT, the scores of the six dimensions of IBS-QOL including dysthymia, behavioral disorder, auto imagery, health concerns, eating avoidance, and relationship expansion were all lower than those before FMT (43.750, 22.656 to 56.250 vs. 48.438, 32.031 to 60.938; 37.500, 18.750 to 56.250 vs. 46.429, 21.429 to 62.500; 31.250, 14.063 to 42.188 vs. 31.250, 18.750 to 50.000; 41.667, 27.083 to 56.250 vs. 50.000, 41.667 to 66.667; 54.167, 43.750 to 72.917 vs. 66.667, 58.333 to 83.333; 8.333, 0.000 to 33.333 vs. 16.667, 8.333 to 33.333, respectively), and the differences were statistically significant ( Z=-2.157, -3.429, -2.274, -3.197, -3.042 and -2.329, all P<0.05). Twelve weeks after FMT, the scores of the two dimensions of IBS-QOL including behavioral disorder and relationship expansion were both lower than those of four weeks after FMT (37.500, 18.750 to 56.250 vs. 39.286, 19.643 to 62.500 and 8.333, 0.000 to 33.333 vs. 16.670, 2.083 to 41.667, respectively), and the differences were statistically significant ( Z=-1.998 and -2.110, both P<0.05). Four and 12 weeks after FMT, the scores of IBS-SSS and GSRS were both lower than those before FMT ((190.32±106.51), (201.43±102.48) vs. (245.93±86.10) and 5.50, 4.00 to 9.00 and 5.50, 4.00 to 8.75 vs. 7.00, 6.00 to 9.75), and the differences were statistically significant ( t=4.402 and 3.848, Z=-3.081 and -3.609; all P<0.01). No serious adverse reactions occurred in the patients after FMT. At the phylum level, after FMT the abundance of Verrucomicrobia in the feces of IBS patients was richer than that before FMT (6.74% vs. 0.37%); at the family level, after FMT the abundance of Verrucomicrobiaceae in the feces of IBS patients was richer than that before FMT (6.74% vs. 0.37%); at the genus level, after FMT the abundance of Akkermansia was richer than that before FMT (6.74% vs. 0.37%); and the differences were statistically significant (all Z=-2.589, all P=0.010). The results of LEfSe method indicated that four weeks after FMT the abundance of Akkermansia in the gut microbiota of IBS patients was richer than that before FMT (6.74% vs. 0.37%), and the difference was statistically significant (linear discriminant analysis value=4.5, P=0.049). Conclusions:FMT is safe and effective in the treatment of IBS. The mechanism may be through upregulating the diversity of gut microbiota and changing the structure of gut microbiota of IBS patients.