Objective To compare the effect of parenteral nutrition and enteral nutrition with different start time on acute pancreatitic patients.Methods Randomized controlled trials comparing enteral and parenteral nutrition in acute pancreatitic patients published from January 1996 to January 2011 were searched in MEDLINE,EMBASE,Cochrane databases,Wanfang science library,and China National Knowledge Infrastructure.The information about study design,patient characteristics,and outcomes were extracted by two independent analysers before processed with RevMan 4.2 software.Results Altogether 14 trials were included.When started after 24 hours of admission,enteral nutrition,in comparison with total parenteral nutrition,resulted in a statistically significant reduction in the risks of infections (P =0.0004),surgical intervention (P =0.0200),organ failure (P =0.0400),and morality (P =0.0002) in acute pancreatitic patient.When started within 48 hours of admission,enteral nutrition,in comparison with total parenteral nutrition,resulted in a statistically significant reduction in the risks of infections (P =0.0000),surgical intervention (P =0.0001),organ failure (P =0.0006),and mortality (P =0.0300) in acute pancreatitic patients.Conclusions The time of the commencement of nutriton has an influence on the benefits of enteral nutrition.Enteral nutrition started between 24 hours and 48 hours of admission is more effective than within 24 hours or after 48 hours of admission.

Objective To learn about the current situation of nosocomial infections and disinfection and sterilization in some basic medical institutions,then to investigate strategy in regulating the management of nosocomial infections,and to propose the improving measure.Methods With unified questionnaire,the following were investigated:(1)the management,organization and rules and regulations of nosocomial infections and disinfection and sterilization,(2)installation and usage of disinfection armamentaria,and(3)usage and disposal after using of disposable medical products in some basic medical institutions.The data were analyzed statistically by SPSS 13.0 statistics software.Results Some basic medical institutions were deficient in organization,rules and regulations about the management of nosocomial infections,lacked disinfection armamentaria,with disinfectants often used incorrectly.The qualified ratio of the effect of disinfection monitored was low(66.9%).Medical wastes and disposable medical products were disposed of inappropriately.Conclusions To normalize the management of nosocomial infections,training should be reinforced,investment increased and awareness and health supervision enhanced.Meanwhile,air disinfection must be fulfilled more intensively.

Objective To explore the correlation of serum HBV-DNA load,transaminase(ALT)and total bile acid (TBA)levels with hepatitis B virus (HBV)infection patterns to assess HBV infectivity.Methods The fluorescent quantitative PCR was used to detect serum HBV-DNA in 308 patients with HBV infection.ELISA was adopted to detect the HBV markers.The continuous mo-nitoring method was adopted to detect serum ALT and the cycling enzymatic method was adopted to detect serum TBA.Results The HBV-DNA content and serum ALT level had staitstical differences among the 3 infection patterns of HBsAb,HBeAg and HB-cAb positive,HBsAg,HBsAb,and HBcAb positive and 1,5 positive (P <0.05),the partial patients with HBeAg negative had the active HBV replication in vivo;HBV-DNA copy number in the patients with HBeAg negative was positively correlated with ALT level (P <0.05).Serum TBA level had no statistical difference among three knds of HBV infection patterns (P >0.05).Conclusion Serum HBV-DNA content and ALT activity have the correlation with the different HBV infection patterns,which could reflect the HBV replication and the infectivity intensity in some extent.

Objective To investigate the risk distribution of breast cancer for location and time of recurrence metastasis in molecular subtype.Methods We studied retrospectively the female patients who were diagnosed as invasive ductal breast cancer in our hospital from July 2004 to June 2012,detected ER,PR,and HER2 expressions in the paraffin sections.The patients with recurrence metastasis were divided into local recurrence and distant metastasis with the first transfer site as standard for analyzing the distribution in molecular subtype and the time of the first site of recurrence metastasis.Results Sixty two patients were encountered recurrence metastasis,including 23 patients with local recurrence,and 39 patients with distant metastasis,death 11.The rates of distant metastasis for patients who belonged to HER2 type and basal-like type were higher than that of local recurrence (P =0.01,P =0.001).The risk distribution of recurrence metastasis time in molecular recurrence metastasis showed that 35 percent of recurrence metastasis time of luminal A type was first 3 years,75 percent of molecular subtype of basa1-1ike type recurrence metastasis time in first 3 years and advanced.The peak of luminal B and HER2 type was first 3 years,and very low in 5 years.Conclusions Molecular subtype of breast cancer is an important complement for TNM method in accurately assessing the patients of recurrence metastasis for location and time,and is helpful for the individual screening of patients for recurrence metastasis.

Objective:To establish a method for the separation and determination of ketoprofen enantiomer .Methods:A pre-col-umn derivation RP-HPLC method was used with L-alanine-β-naphthylamine ( L-Ala-β-NA) as the derivation reagent .The RP-HPLC conditions were as follows: a Hypersil ODS-2 column (250 mm ×4.6 mm,5 μm) was applied, the mobile phase was acetonitrile-0.025 mol· L-1 phosphate buffer solution (40∶60, v/v) and the flow rate was 1.0 ml· min-1 , the detection wavelength was set at 245 nm and the column temperature was 25℃.The injection volume was 10μl.Results:Base line separation was achieved for the sep-aration of enantiomer from ketoprofen , and the retention time for S-(+) -ketoprofen and the R-(-) -ketoprofen was 24.2 min and 26.0 min, respectively.Dexketoprofen within the range of 0.025-0.125 mg had a good linear relationship (r=0.998 1) and the aver-age recovery was 90.93%(RSD =4.10%, n=9 ).Conclusion:The method is simple, accurate and reliable, which can be applied in the separation and determination of ketoprofen .

Objective To evaluate the effects and mechanism of valerian extract treatment on bleomycin-induced pulmonary fibrosis of rats. Methods After healthy Wistar rats(irrespective of sex)were given diethyl ether inhalation anesthesia, giving a single intratracheal instillation of bleomycin at a dose of 5 mg/kg to make a pattern of pulmonary fibrosis. 65 survival rats were randomly divided into four groups: Valerian high-dose groups(n = 16), Valerian low-dose groups(n = 16), Colchicine group(n = 16)and Model group (n = 17).Each group was given a dose of 100 mg/kg valeian extract everyday, a dose of 20 mg/kg valeian extract Valeian extract , a dose of 100μg/kg colchicine and a dose of 10ml/kg after second day. And in each groups, 6 rats were killed on day 7, 10 rats were killed on day 28 after instillation respectively. Rats in control group (n = 8) were instilled with saline intractracheally and saline was given everyday with a dose of 10ml/kg. Control group was killed on day 28. After rats were killed, The right lower pulmonary lobes were harvested for HE-staining, Masson-staining was used to observe the transformation of pulmonary tissue and immunohistochemistry was used to examine transforming growth factor-β1 (TGF-β1) which was analyzed by image analysis system. Results No obvious transformation were found in control group. The alveolitis in valerian and colchicine groups were ameliorated, compared with model group on day 7. The expressions of TGF-β1 in control group were lower than that in model group, and the mean integrated optical densities of TGF-β1 in control group were lower than that in mod-el group(P<0.05). The pulmonary fibrosis in valerian and colchicine group were ameliorated, compared with model group on day 28. The expressions of TGF-β1 in valerian and colchicine group were lower than that in model group. There were no significant differences between the valerian group and the colchicine group. Conclusion Valerian extract could reduce the degree of alveolitis and fibrosis induced by bleo-mycin through suppressing of TGF-β1.

Objective To research the endometrial receptivity by established the endometriosis rat model in intimal window period.Methods The autologous endometrial tissues of 22 sexually mature SD rats were transplanted into the homonymy abdomi-nal wall and offside uterine mesometrium.After four weeks,we randomly dissected two rats and observed the growth of etopic en-dometrium.The EMs rats were mated with male rats in the same cage and vaginal plug was observed in the next day.The histomor-phology of eutopic and ectopic endometrial was observed in the fifth day of pregnancy.Results Ectopic endometrium was grown in the abdominal wall and mesometrium,which formed a small bulge cystic mass in 20 rats.All foci was showed adhesion to the sur-rounding tissues in a different extent.In the light microscope,the morphology of ectopic endometrial was as the same as nomal en-dometrium.The establishment of the endometriosis rat mode is successful.Vaginal plug was positive the next day.Nonoperative side uterine was full of fluid in the fifth day of pregnancy.Eutopic and ectopic endometrium were in the secretory phase..Conclusion It is a successful method to establish a rat model of endometriosis by autotransplantion of endometrium.The endometrium of EMs model rats is in embryo implantation window period,and it provides a convenient model for studying endometrial receptivity.

Objective To observe the effect of electroacupuncture at extensors plus acupoints based on syndrome differentiation on the wrist-ankle activity in post-stroke hemiplegia. Method A total of 168 patients with post-stroke hemiplegia were randomly divided into a control group and a treatment group, 84 cases each. Both groups were prescribed with Western medication, based on which, the control group received electroacupuncture at acupoints based on syndrome differentiation, and the treatment group received electroacupuncture at extensors plus acupoints based on syndrome differentiation. The changes of electromyography (EMG) in the two groups after the intervention were observed, and the clinical efficacies were compared between the two groups.Results The total effective rate was 95.1% in the treatment group versus 91.0% in the control group, and the between-group difference was statistically significant (P<0.05). After the intervention, the EMG of extensor carpi radialis in the treatment group was significantly different from that in the control group (P<0.05); the between-group difference was statistically insignificant in comparing the EMG of tibialis anterior muscle (P>0.05), but the intra-group differences were statistically significant in both groups(P<0.05). The value of M-amp/H-amp was changed significantly in both groups after the treatment (P<0.01), but the between-group difference was statistically insignificant after the treatment (P>0.05).Conclusion Electroacupuncture at extensors plus acupoints based on syndrome differentiation can increase the motor unit of carpi radialis and decrease the spasm of gastrocnemius in post-stroke hemiplegia, and consequently produce a remarkable clinical efficacy.

Objective To investigate the effects of cochlear implantation on residual hearing and to evaluate the potential impact of long -term electrical stimulations on residual hearing .Methods 58 hearing impaired children with cochlear implants were included in this study .All subjects could cooperate with behavioral audiometry .Audio-metric evaluations were carried out pre -implantation and 3 ,12 ,24 months post -implantation respectively .Of 58 subjects ,43 were followed up more than 1 year and 17 were followed up more than 2 years .Results All 58 subjects showed significant differences (P<0 .05) between pre- and 3 months post-implantation of residual hearing at the individual frequencies of 0 .25 ,0 .5 ,1 ,2 and 4 kHz .43 subjects followed up more than 1 year showed statistic differences (P<0 .05) between pre- and 3 months post -implantation ,pre- and 12 months post-implantation at 0 .25 ,0 .5 ,1 ,2 and 4 kHz respectively .Comparing 3 months with 12 months post -implantation ,there were sta-tistic differences at 0 .25 and 0 .5 kHz ,while no significant difference (P>0 .05) at 1 ,2 and 4 kHz .Of 17 subjects followed up more than 2 years ,there were significant differences (P<0 .05) between pre- and various return visits post-implantation .Post-implantation return visits ,there were significant differences between 3 months and 12 , 24 months at 0 .25 and 0 .5 kHz respectively ,not any significant differences on 1 ,2 and 4 kHz .There were no sig-nificant differences on each frequency between 12 months and 24 months post- implantation .Conclusion Residual hearing after cochlear implantation could decrease to some extent for various reasons .There were significant differ-ences between 3 and 12 months post-implantation at 0 .25 and 0 .5 kHz .Not any significant differences were ob-served between 12 months and 24 months post-implantation at each frequency .

Objective To explore the clinical value of serum cathepsin L (CL),matrix metalloproteinase-9 (MMP-9) and heparanase (Hpa) detection in determining the degree of ovarian cancer invasion and metastasis.Methods Enzyme-linked inmunosorbent assay (ELISA) and electrochemiluminescencl immunoassay (ECLIA) were used to detect the serum content of MMP-9,Hpa,CL in 217 cases with untreated ovarian cancer before surgery( in FIGO Ⅰ - Ⅱ stage 83 cases,Ⅲ-Ⅳstage 134 cases),100 cases with benign ovarian tumors and 101 healthy women control.All of the patients from Guangxi Medical University Affiliated Tumor Hospital,from September 2003 to October 2009.The relationship between the clinical pathological factors of ovarian cancer and serum content of MMP-9,Hpa,CL was analyzed.On the basis of clinical pathological diagnosis as “gold standard”,the ROC curves was drawed to evaluate the clinical value of serum CL,MMP-9,Hpa combined detection in determining the degree of ovarian cancer invasion and metastasis before surgery.Results The serum content of CL,MMP-9 and Hpat in patients with ovarian cancer were (21.23 ± 8.17),( 193.95 ± 42.49),(7.68 ± 2.32) μg/L respectively,which was higher than that in patients with benign ovarian tumors [ ( 10.97 ± 3.84),( 143.66 ± 28.47),( 4.86 ± 1.37) μg/L respectively ] and normal control [ (5.59 ± 1.75),( 57.99 ± 1 1.42),( 2.77 ± 0.80) μg/L respectively ],there was difference statistically significant ( t value CL was - 13.242,- 13.498 respectively; MMP-9 was - 14.521 and - 21.290 respectively; Hpa was - 10.896 and - 18.280 respectively,P ＜ 0.001).The serum content of CL [ ( 21.59 ± 8.24) μg/L ] in patients with epithelial ovarian cancer ( EOC) was significantly higher than that [ ( 19.57 ± 7.69) μg/L ] in non-epithelial carcinoma ( F =1 1.209,P =0.048).The serum CL,MMP-9 and Hpa content in FIGO Ⅰ -Ⅱ stage patients was (19.66 ± 7.83),(182.63 ±42.30),(7.21 ±2.05) μg/L,which was lower than that (22.64 ±8.31),(202.81 ±39.74),(8.51 ± 1.92) μg/L in FIGO Ⅲ-Ⅳ stage patients ( F value was 12.452,70.565 and 195.122respectively,P value was 0.030,0.002 and 0.000 respectively).In patients with EOC,the serum CL,MMP-9 and Hpa content in eases with poorly differentiated was ( 23.04 ± 7.67),( 200.12 ± 40.82),(8.22 ± 1.92) μg/L respectively,which was also higher than that in cases with high-moderate differentiated [ ( 18.54 ± 7.30),( 173.43 ± 39.37),(7.20 ± 2.51) iμg/L respectively;F value was 24.545,60.286 and 9.077 respectively; P was 0.004,0.035 and 0.001 respectively ].The serum content of CL and MMP-9(22.96 ± 8.41),(200.44 ±43.82) μg/L respectively in patients with invasion and metastasis in the abdominal cavity was higher than that without invasion and metastasis in the abdominal cavity [ ( 19.07 ±7.36),( 181.04 ± 36.10) μg/L,F value was 12.210,18.084 ; P value was 0.030,0.010 ] ; There was statistically significant relatioship between serum levels of Hpa and patients with distant metastasis ( F =9.430,P =0.042).On base of pathological diagnosis as gold standard,ROC curve showed the sensitivity was 60.9％ (70/115),69.6％ ( 80/115) and 72.2％ ( 83/115) and specificity was 57.4％ ( 26/62),67.2％(20/62) and 68.9％ (19/62),as serum levels of CL,Hpa,MMP-9 preoperative were detected as tumor markers to determine whether there was cancer invasion and metastasis outside the pelvis.Conclusions There is related with CL,MMP-9 and Hpa levels increase and tumor occurrence and progression in ovarian cancer.The serum content of MMP-9,Hpa,CL detection would be certain clinical reference value to determine extent of invasion and metastasis of ovarian cancer before surgery.