OBJECTIVE:To explore the clinical significance of water-soluble vitamins for injection in supportive care of postoperative tumor patients undergoing chemotherapy.METHODS:Water-soluble vitamins for injection was given to64post operative patients with gastrointestinal malignancy in treatment group for3days before chemotherapy and for7days after chemotherapy;adenosine triphosphate,coenzyme a and kalium chloratum were given to60patients in control group for the same period.Nutritional and oral mucosa condition,hemoglobin and hepatic function were observed before and after chemotherapy.RESULTS:Appetite increased in71.8%patients in treatment group,none was observed in control group(P

entrate graft can block pathologic process and improve the inclusion of femoral head and increase blood circulation of femoral head, which is beneficial to its recovery.

Objective To evaluate mini-dose pre-injection test in the use of contrast-enhanced magnetic resonance angiography (CEMRA), and to inspect the possibility of contrast medium peak-time prediction by age, body weight and heart rate.Methods The data from mini-dose pre-injection test of contrast medium before vertebral artery CEMRA were retrospectively reviewed in 55 patients. The linear correlation and regression of the data including age, body weight, heart rate, and the reaching-time, peak-value-time, duration and peak-value-signal of contrast medium was performed by using SPSS software.Results The age (n=55, =62 years old, M=59 years old), body weight (n=55, = 63 kg), heart rate (n=40, =73 beats per minute), peak-value-time (n=55,=17.5 seconds), peak signal intensity (n=55,=472), and duration of contrast (n=49,=10.35 seconds)were analyzed. No statistically significant correlation existed between peak-value-time of contrast medium and the age (r=0.231, t=1.728, P=0.090), body weight (r=0.118, t=0.865, P=0.392), and heart rate (r= -0.046, t=-0.284, P=0.776). The peak-value-time correlated negatively with peak signal intensity (r=-0.322, t=-2.56, P=0.016)and positively with duration of contrast (r=0.658, t=5.99, P=0.000). The peak signal intensity was negatively correlated with body weight(r=-0.356, t=-2.77, P=0.008). The linear regression analysis show b=-0.284, t=-2.285, P=0.026 between peak-value-signal and peak-value-time, b=-0.322, t=2.590, P=0.012 between peak-value-signal and body weight.Conclusion Mini-dose pre-injection test was more helpful to adjust the rate of contrast medium injection and determine the time delay during scanning. But the prediction of contrast peak-time based on age, body weight and heart rate was unreliable.

C groups and coincidence with pathological changes.After treatment fourth and twelfth weeks,ALP activity,calcium content was higher in group A than group B (?

Objeetive To evaluate the protective effects of decorin on the inner blood-retinal barrier function under high-glucose plus hypoxia conditions,and explore its potential mechanism.Methods The human umbilical vein endothelial cells (HUVEC) were cultured,and the effect of decorin with different concentrations on HUVEC viability was determined by using the cell counting kit-8 assay (CCK-8).At different hours after incubation under high-glucose plus hypoxia conditions (25 mmol · L-1 D-glucose + 100 μmol · L-1 CoCl2),the suppression effects of various concentrations of decorin on the vascular endothelial growth factor (VEGF) expression of HUVEC was detected by enzyme-linked immunosorbent assay (ELISA).HUVEC were divided into normal control group (5.5 mmol · L-1 D-glucose),high-glucose plus hypoxia group (25 mmol · L-1 D-glucose + 100 μmol · L-1 CoCl2),mannitol control group(5.5 mmol· L-1 D-glucose +19.5 mmol · L-1 mannitol) and decorin treatment group (25 mmol · L-1 D-glucose+ 100 μmol · L-1 CoCl2 + 100 nmol · L-1 decorin).HUVEC barrier function was evaluated by detecting transepithelial electrical resistance (TER) and permeability of fluorescein isothiocyanate-dextran (FITC-dextran).The content of tight junction proteins (claudin-5,occludin,and ZO-1) and p38 mitogen-activated protein kinase (MAPK) phosphorylation were examined by Western blotting.Results According to the results of CCK-8,the survival rates of HUVEC in all groups were more than 90％,different concentrations of decorin showed no significant effect on HUVEC survival (all P ＞ 0.05).According to the results of CCK-8 and ELISA,the stimulation of hypoxia for 48 hours and 100 nmol · L-1 decorin was taken as the condition of further experiment.At 14 days,TER of HUVEC reached its peak of (170.67 ±9.07) Ω.TER of high-glucose plus hypoxia group (97.33 ±6.11)Ω was significantly lower than that of decorin treatment group (157.67 ± 11.72)Ω (P ＜0.05).The FITC-dextran permeability of high-glucose plus hypoxia group increased to (2.12 ±0.07) times of normal control group(P ＜0.05).Decorin reversed this effect to (1.16 ± 0.03) times of normal control group (P ＜ 0.05).The expression of claudin-5,occludin and ZO-1 in high-glucose plns hypoxia group were 0.38 ±0.05,0.43 ±0.02,0.25 ± 0.02,compared to the normal control group (0.72 ±0.05,0.90 ±0.01,0.75 ±0.02),there were statistical differences (all P ＜0.05).The expression of claudin-5,occludin and ZO-1 m decorin treatment group were 0.65 ±0.08,0.87 ±0.03,0.60 ±0.01,there were statistical differences compared with high-glucose plns hypoxia group (all P ＜0.05).The ration of p-p38 MAPK/p38 MAPK in high-glucose plus hypoxia group (0.88 ± 0.02) was increased,while the decorin treatment group (0.58 ± 0.04) reached the level of the normal control group (0.56 ±0.02),there was statistical difference compared with high-glucose plns hypoxia group (P ＜0.05).Conclusion Decorin can protect the HUVEC barrier function under high-glucose plus hypoxia conditions and inhibit the activation of p38 MAPK signaling pathway.So it may be used to treat diabetic retinopathy.

The neuroretinal injuries of diabetic retinopathy (DR) include retinal neuronal damage and reactive gliosis,both of which are induced by hyperglycemia and presented as early features of DR.They promote to develop mutually and accelerate the progression of DR.The molecular mechanisms study of neuronal damage mainly focuses on the alterations of extracellular environment and related signaling pathways,include inflammation,oxidative stress,endoplasmic reticulum stress,the formation of advanced glycation end products,glutamate toxicity and so on.These alterations mainly result in neuronal apoptosis and autophagy.The damaged neurons activate the glial cells with apparent changes in morphology,cell counts and the level of intracellular protein expression.In non-proliferative DR,glial cells are moderately hypertrophic and slightly increased in numbers.In proliferative DR,there is a significant rise in glial cell number with enhanced level of inflammatory factors and vascular active substances which lead a further neuronal damage.Signaling pathways of extracellular signal-regulated kinase 1/2,c-Fos and p38 mitogen-activated protein kinase are associated with their activation.Researches on the molecular mechanisms and signaling pathways of the DR will promote controlling the DR progression at the cellular level.

Objective To explore the effect of hospital-community-based collaborative management on elderly out-patients with chronic heart failure (CHF).Methods A total of 228 out-patients with CHF were randomly assigned to the community-based health management group (n =106 ) and the hospitalcommunity-based collaborative health management group (n =122).In community-based health management group,the patients only received community-based health management,while in hospital-community-based collaborative health management group the patients accepted comprehensive health management.One year later,medication compliance,readmission rate,mortality,average length of hospitalization,medical costs and Minnesota living with heart failure questionnaire (LiHFe) were compared between the two groups.Results No statistically significant differences in clinical data were found between the two groups at baseline.After one year,medication compliance was significantly improved in hospital-community-based collaborative health management group when compared to community-based health management group ( x2 =8.97,P ＜ 0.05 ).Readmission rate,averagelengthof hospitalizationandmedicalcostsof hospital-community-based collaborative health management group were lower than community-based health management group (x2 =9.91 ; t =3.78,3.61 ; all P ＜ 0.05 ).One year ago,the items of LiHFe including physical dimension,emotion,symptom and social dimension and total score showed no significant between the two group (t =0.42,0.81,0.66,0.44,0.41 ; all P ＞ 0.05 ).While one year later,all the scores of hospital-communitybased collaborative health management group were significantly declined( t =6.37,11.81,6.16,9.64,9.13;P ＜ 0.05 ).Mortality showed no significant difference between the two groups ( x2 =0.247,P ＞ 0.05 ).Conclusion Hospital-community-based collaborative management for health care may be a practical and valuable strategy for decreasing readmission rate and medical burden and improving quality of life of elderly patients with CHF.

ObjectiveTo explore the clinical and imageological features of reversible posterior leukoencephalopathy syndrome(RPLS) during gestation period.MethodsClinical and imageological data of 4 pregnant women with RPLS were analyzed retrospectively.ResultsHeadache, seizure, confusion and visual loss were the mainly clinical manifestations. At MR imaging, the brain typically demonstrated focal regions of symmetric hemispheric edema which may disappear in several weeks. The parietal and occipital lobes were most commonly affected, followed by the frontal lobe cerebral vasoconstriction syndrome. Three of the four patients suffered eclampsia which happened in two days after delivery.ConclusionThere are distinctively clinical features in posterior leukoencephalopathy syndrome during gestation period. Most of them are invovled in patients with eclampsia.

Objective To observe the serum γ-glutamyltransferase (γ-GGT) levels in patients with chronic hepatitis B virus (HBV) infection in different immune status and investigate their relationship with HBV DNA loads and ALT levels. Methods Blood samples were collected from 191 patients with chronic HBV infection in different immune status, including inactive HBV carrier state (group B,n = 55), immune tolerance phase (group C, n=47), HBeAg-negative CHB (group D, n =17), immune-reactive phase (group E, n=72) and 61 healthy individuals ( group A) for the detection of the serum γ-GGT, ALT level and HBV DNA loads. Results γ-GGT level were obviously higher in groups D and E than those in groups of A, B and C (P<0.01). Correlation analysis showed that the γ-GGT levels were positively correlated with serum ALT , AST levels in HBeAg-negative CHB and immune-reactive phase , but not correlated with HBV DNA loads. Conclusions The levels of γ-GGT are different during different immune status in patients with chronic HBV infection. The increased serum γ-GGT level may be an indicator for patients with chronic HBV infection entering immune active phase. The liver inflammation is the major impact factor to the γ-GGT levels.

Objective To investigate the value of prognosis of NT-proBNP in severe sepsis and septic shock patients .Methods 70 patients with sepsis admitted to our hospital were divided into general sepsis group (n=23) ,severe sepsis group(n=28) and sep-tic shock group(n=19) according to the severity of the disease ,the plasma NT-proBNP ,lactic acid ,C-reactive protein were meas-ured within 1 h after admission ,and calculated the 24 h acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) .Results (1) Plasma NT-proBNP concentration ,lactic acid ,CRP and APACHE Ⅱ score in severe sepsis group ,septic shock group was sig-nificantly higher than that of general sepsis group(P< 0 .05);Plasma NT-proBNP concentration ,CRP and APACHE Ⅱ score in septic shock group was significantly higher than severe sepsis group (P<0 .05) .(2)70 cases of patients with sepsis with 15 cases died and 55 cases survived .Plasma NT-proBNP concentration ,lactate ,CRP and APACHEⅡscore of death patients was significantly higher than the survival patients(P<0 .01) .(3) Plasma NT-proBNP concentration at the time of sepsis patients admitted to hospi-tal with positively correlated to APACHE Ⅱscores(r=0 .528 ,P<0 .01) .Conclusion The plasma NT-proBNP is closely related to the prognosis of patients with sepsis ,early detection of plasma concentration of NT-proBNP helps to evaluate the prognosis of pa-tients w ith sepsis .