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

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 examine whether the existence of the donor-and-recipient-derived DNA chimerism in recipient’s plasma can be a predictive marker for the status of transplanted organ.Methods:One hundred and twenty-six female patients who had been transplanted with male kidney were enrolled in the present study.In these female recipients,the SRY1,DYZ11st and DYZ12nd genes on the Y chromosome from the plasma were prospectively examined using reverse transcription polymerase chain reaction (RT-PCR).Results:SRY1,DYZ11st and DYZ12nd sequences were detected in the cell-free blood (plasma) of 97 (77%) of 126 female patients with male kidney.The average time-span when the transplanted kidneys functioned was 8.7 years and 5.4 years among microchimerism-positive and microchimerism-negative recipients,respectively.The frequency of the patients who had acute rejection after renal transplantation was approximately 10% and 28%in microchimerism-positive and microchimerism-negative recipients,respectively.Serum creatinine levels in microchimerism-positive patients were significantly lower than those in microchimerism-negative patients.Conclusion:These results suggest that plasma DNA microchimerism is present in certain patients following renal transplantation and measurement of plasma DNA microchimerism using quantitative RT-PCR might be a useful predictor for the acceptance of transplanted kidneys.

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.

Objective To study the feasibility of laparoscopic radical gastrectomy.Methods From August 2006 to May 2007,31 patients with gastric cancer received laparoscopic radical gastrectomy(radical distal gastrectomy in 26 cases and radical total gastrectomy in 5).Results Among the cases,1 was converted to an open surgery,2 were treated completely by laparoscopic radical gastrectomy;and in the other 28 cases,the radical gastrectomy was performed under the assistance of laparoscopy.Lymph node dissection of D1+? was performed on 2 patients and D2/D2+ was adopted in the other 29.One case was done in combination with partial liver dissection.The median operative time was 5 h(range 4.5-7 h).The median blood loss was 150 ml(range,100-600 ml).One patient received blood transfusion during the operation.Intraoperative spleen injury occurred in one case.The median number of harvested lymph nodes was 20(range,14-33).No patient died after the surgery.The median time for gastrointestinal function recovery was 4 d(range 3-6 d).One patient developed gastroparalysis after the operation and was cured by conservative therapy.One of the patients had bleeding of the jejunal pouch after total gastrectomy.And one showed subluxation of the articulatio cricothyroideus.No anastomotic leakage and lung infection occurred after the surgery.And no recurrence or metastasis was found during a 2-to 8-month follow-up(median,5).Conclusion Laparoscopic radical gastrectomy is feasible and safe.

Objective To detect the proliferation of neural stem cells (NSC) and analyze the effects of taurine on NSC proliferation in rats with fetal growth restriction (FGR).Methods For in vivo experiment,pregnant rats were randomly divided into three groups:control group (n=5),FGR group (n=7) and taurine group (n=6) [treated with taurine,300 mg/(kg · d)].Rats in the latter two groups were fed with 40％ of food intake in control group throughout pregnancy to establish the FGR model.Fatty acid binding protein-7 (FABP-7) expression in brains was detected by immunohistochemistry.For in vitro experiment,pregnant rats were divided into two groups including control group and FGR group.FGR modeling was established in the same way as above.On the 14.5 day of pregnancy,NSC were isolated and cultured for five days to form neurospheres with different concentrations of taurine (control,0,5,10,15,20,30,40 mmol/L).Immunofluorescence staining was used to detect the expression of NSC-specific marker FABP-7.CCK8 test was used to detect the cell proliferating index.Neurospheres were collected at the end of culture and disaggregated to get the total number of viable cells.One-way ANOVA,Kruskal-Wallis Test,SNK-test and Tamhane's test were used for statistical analysis.Results Compared with the control group (18 012±3 016),the number of FABP-7-positive cells in FGR model group (10 173±1 728) was decreased (P＜0.05),but increased in taurine group (19 518±3 201) (F=200.8,P＜0.05).Free-floating neurospheres could be formed in both control and FGR groups and the cells within neurospheres were mostly FABP-7-positive and were then considered as NSC.The proliferation indexes in control,FGR,FGR+5 mmol/L taurine,FGR+10 mmol/L taurine,FGR+15 mmol/L taurine,FGR+20 mmol/L taurine,FGR+30 mmol/L taurine,FGR+40 mmol/L taurine groups were 1,0.80±0.07,0.92±0.11,1.33±0.24,1.20±0.15,1.11 ±0.14,0.80±0.12 and 0.82±0.08,respectively.The proliferation indexes in FGR groups treated with 10,15 or 20 mmol/L of taurine were significantly higher than that of FGR group without taurine interference (P＜0.05).The total cell numbers in the eight groups were (24.5 ± 0.6)× 105,(20.23 ± 1.09)× 105,(22.80 ±0.86) × 105,(27.53± 1.22)× 10s,(25.30±1.05)× 105,(22.70±0.72)× 105,(21.80± 1.80)× 105 and (18.06 ± 0.90)× 105,respectively.Compared with the FGR group without taurine interference,those treated with 5,10,15 or 20 mmol/L of taurine showed higher total cell numbers (all P＜0.05 or ＜0.01),while that treated with 40 mmol/L oftaurine was lower.Conclusions The number and proliferation of NSC in FGR fetal rat brains is significantly decreased,however,these could be reversed by antenatal supplementation of taurine.The best effect is shown when l0 mmol/L of taurine is given.