Objective:The objective of this study was to evaluate the relationship between the adequacy of nutritional therapy and prognosis in trauma patients.Methods:217 trauma patients were included.The nutritional therapy interventions were divided into three groups:low energy therapy (＜50％),moderate energy therapy (50％ ～ 80％),high energy therapy (＞ 80％).General data,hospitalstay,ICU stay,infectious complications and mortality were compared among groups.Results:The protein intake of high energy group was higher than the other two groups (P ＜0.01).High energy therapy was associated with reduced mortality and decreased length of hospital stay.Kaplan-Meier survival analysis indicated that high energy therapy had a significantly higher 60 days cumulative survival rate compared with other groups.Conclusion:High energy therapy is more effective and associated with improved mortality and decreased length of stay.

Objective:To study the clinical significance of examining serum pyridinoline cross-linked N-telopeptides of type I collagen(NTx) and serum bone sialoprotein(BSP) in diagnosing bone metastasis of lung cancer and breast cancer.Methods:A total of 105 patients treated in the Oncology Department of Changhai Hospital were included in this study.Patients were divided into 2 groups:bone metastasis(n=50) and non-bone metastasis groups(n=55).The levels of serum NTx and serum BSP were measured by ELISA.Results:The levels of serum NTx and serum BSP in patients with bone metastasis were significantly higher than in those without bone metastasis(P

Senior citizens have many diseases related to blood stasis, which was often overlooked by clinicians, and thus affected the treatment of the disease. Through analyzing and summarizing of related literature in recent five years of senile constipation treated from blood stasis, we found that the blood stasis is closely linked to senile constipation. Blood stasis in the gut forms constipation, and constipation with the passing of time forms blood stasis in returen. Blood stasis and constipation often influence each other.

Objective To research changes of the terminal height,the level of growth hormone,sexual development and record of formal schooling in Turner syndrome(TS).Methods In 213 cases TS were karyotyped,57 cases growth hormone exciting test were carried out,41 cases sexual development and record of formal schooling were followed up.Results 213 TS were karyotyped in 4 groups:Ⅰ,45,X,78 cases;Ⅱ,mosaicism,60 cases;Ⅲ,with various aberrations of structure of X chromosome,69 cases;Ⅳ,6 cases with Y chromosome.Average terminal height was(139 1?8 3)cm.Of 57 growth hormone exciting tests,growth hormone complete deficiency 16 cases,partly deficiency 30 cases and normal 11 cases.In the follow-up survey of 41 cases TS,record of formal schooling were mainly junior middle school,technological school and secondary speciality school.17 cases had differential degree sexual development and 24 cases had no.Conclusions The terminal heights of TS are markedly lower than normal,growth hormone is deficiency,learning ability decline,hypoplasia of sex gland.

Objective To detect the level of serum melanoma-inbibiting activity (MIA) in patients with uveal melanomas, and investigate the value of MIA in diagnosing and inspecting uveal melanomas. Methods Enzyme-linked immunosorbent assay (ELISA) was used to detect the concentrations of MIA in peripheral serum of 27 patients with uveal melanoma, 6 with melanocyte tumor, 7 with other ocular tumors and 16 healthy individuals, respectively. Results The concentration of MIA in patients with uveal melanoma was significantly higher than that in the healthy ones (16 individuals) and the patients with adenoma of non pigmented ciliary epithelium (4 patients), retinoblastoma (2 patients), and retinal angioma 91 patient). The concnetration of MIA in patients with uveal melanoma without scleral infiltration or remote metastasis was obviously lower than that in the patients with scleral infiltration or remote metastasis, but didn′t differ much from which in the patients with melanocyte tumor. In the patients with uveal melanoma without infiltration or remote metastasis, there was no significant difference of MIA level between patients with spindle cell and mixed and epithelioid cell. Conclusion The level of serum MIA may be an effective index in diagnosing uveal melanoma, which can monitor the metastasis of uveal melanoma.

Objective:To observe the curative effects of the combined application of domperidone, pantoprazole and hydrotalcite tablets in the treatment of bile reflux gastritis ( BRG) and explore the underlying mechanism. Methods:Totally 80 patients with BRG were randomly divided into the treatment group and the control group with 40 cases in each. The treatment group was received panto-prazole, hydrotalcite tablets and domperidone, and the control group was treated by hydrotalcite tablets and domperidone. The efficacy was observed in both groups after 4 weeks. Results:The effective rate of symptom relief in the treatment group and the control group was respectively 92. 5% and 62. 5% (P<0. 05). After the 4 week treatment, the gastritis healing rate in the treatment group was higher than that in the control group (P<0. 05). The improvement of gastric mucosal hyperemia, edema and erosion in the treatment group was better than that in the control group with significant difference (P<0. 05). Cholic acid in gastric juice and gastric acid se-cretion were significantly reduced in both groups after the treatment, while the reduction of gastric acid secretion in the treatment group was more notable than that in the control (P<0. 05). Conclusion:Pantoprazole can be used to control BRG, and the combination of the three drugs shows better efficacy in the treatment of BRG.

Objective To study the effects of modified Sanxiang Decoction on gastrointestinal transmission function of patients with functional bloating (FB). Methods Sixty cases of FB patients were randomly divided into treatment group (40 cases) and control group (20 cases). Treatment group was given modified Sanxiang Decoction, while control group was given placebo granules, one bag each time. Twice a day, taking it after mixing it with water. Gastrointestinal symptoms, 48 h GITT, and adverse reactions were recorded. Results There was statistical significance in TCM symptom scores between before and after treatment in the two groups (P<0.05). After treatment, the total score of abdominal distension, belching, anorexia and TCM symptoms of the treatment group were lower than the control group, with statistical significance (P=0.000, 0.000, 0.010, 0.003). The total effective rate was 82%(33/40) in the treatment group, 30%(6/20) in thecontrol group;the treatment group was better than the control group (P<0.05). A total of 30 patients completed gastrointestinal transit test, of which delayed 48 h GITT pass rate accounted for 54% (16/30). Compared with the control group, the 48 h GITT of the treatment group was more obviously improved than that of the control group with statistical significance (P=0.002). There were no significant adverse reactions in both groups. Conclusion Most of FB patients have the problem of abnormal intestinal motility. Modified Sanxiang Decoction can improve the symptoms of patients with FB, promote gastrointestinal motility, and improve intestinal transmission function.

Objective To investigate the safety and feasibility of laparoscopic total/subtotal proctocolectomy. Methods Laparoscopic total/subtotal proctocolectomy was performed in 8 cases from March 2003 to November 2005, including 1 case of multiple colorectal tumors, 3 cases of ulcerative colitis, 2 cases of familial adenomatous polyposis, and 2 cases of slow transit constipation. The operation included ileal pouch-anal canal anastomosis in 3 cases, ileal pouch-rectum anastomosis in 3 cases, and cecum-rectum anastomsis in 2 cases. A prophylactic ileostomy was conducted in 5 cases. Results The operation was laparoscopically conducted in all the 8 cases, without conversions to open surgery. No fatal case was encountered. The operative time was 5.5~7.5 h (median, 6 h). The intraoperative blood loss was 150~400 ml (median, 200 ml). There was no intra- or post-operative blood transfusion. The patients began to take diet at 48 h postoperatively. Follow-up observations in 8 cases for 4~31 months (median, 25 months) showed 1 case of intraabdominal infection and 1 case of anastomsis stenosis. Conclusions Laparoscopic total/subtotal proctocolectomy is safe and feasible.

Objective To study the safety of laparoscopic total mesorectal excision for middle and lower rectal cancer.Methods A retrospective comparison was made between 52 cases of open total mesorectal excision from December 2002 to December 2005(Open Group) and 49 cases of laparoscopic mesorectal excision from January 2003 to June 2006(Laparoscopic Group).Results There was no difference in baseline parameters between the two groups.As compared with the Open Group,the Laparoscopic Group presented less blood loss [for anterior resection: 160?106 ml(n=37) vs 298?186 ml(n=36),t=-3.908,P=0.000;for abdominoperineal resection: 180?153 ml(n=10) vs 356?170 ml(n=14),t=-2.604,P=0.016].The recovery time of bowel functions was shorter in the Laparoscopic Group than in the Open Group(2.4?1.8 d vs 3.6?1.5 d;t=-3.648,P=0.000).The overall complication rate in the Laparoscopic Group(14.3%,7/49) was lower than that in the Open Group(44.2%,23/52)(?2=10.834,P=0.001).No significant difference was seen between the two groups in the number of lymph node resected(12.7?6.5 vs 13.6?7.0;t=-0.668,P=0.505),with negative margins in both groups.Follow-up observations were carried out in 45 cases in the Laparoscopic Group(91.8%) for 2～42 months and in 47 cases in the Open Group(90.4%) for 6～42 months,respectively.The local recurrence rate was respectively 4.4% in the Laparoscopic Group(2/45) and 4.3% in the Open Group(2/47). Conclusions Laparoscopic total mesorectal excision for middle and lower rectal cancer is safe and feasible.

0.05).Conclusions Laparoscopic resection of colorectal carcinoma is feasible and safe for elderly patients.The method can reduce the rate of postoperative complications.