Objective To study the difference in occurrence of complications and health economics between early enteral nutrition (EN) and total parenteral nutrition (TPN) in patients with alimentary tract carcinoma after surgical operation.Methods Totally,164 patients with alimentary tract carcinoma hospitalized at the Department of General Surgery in China-Japan Friendship Itospital,Beijing during September 2003 to December 2005 with nutritional intervention,84 cases with early EN and 80 with TPN within 24 to 48 hours after surgical operation,were reviewed.Nutrition index,complications,recovery of gastrointestinal movement,length of hospital stay after operation and total cost of the patients were analyzed. Results Serum level of prealbumin in EN group was (309?49) mg/L,significantly higher than that in TPN group of (277?46) mg/L (P

Objective To explore the effect of Dexamethasone(DEX)on the proliferation and the expression of fibroblast growth factor(FGF)- 1,FGF - 2 and interleukin - 6(IL - 6)mRNA in hyperoxia - exposed human em-bryo lung fibroblasts(MRC - 5). Methods High oxygen volume fraction of 950 mL/ L was used to establish hyperoxia -damaged cell models,then treated with different concentrations of DEX(10 - 4 ,10 - 6 ,10 - 8 ,10 - 9 ,10 - 10 ,10 - 11 ,10 - 12 mol/ L),respectively. The proliferation activity of the cells was evaluated by methyl thiazolyl tetrazolium(MTT)at 24 h,48 h,72 h,and the optimal hyperoxia - exposed time and concentration of DEX were chosen;then they were divided into air group,hyperoxia group and hyperoxia + DEX group. The mRNA expressions of FGF - 1,FGF - 2 and IL - 6 were detected by quantitative real - time PCR at 48 h. Results Cell proliferation activity of the hyperoxia group was lower than that of the air group and there were significant differences at 48 h and 72 h(all P ﹤ 0. 05). Compared with the hyperoxia group,cell proliferation activity of the hyperoxia + DEX group increased with the concentration of DEX decreasing,reaching the peak at 10 - 9 mol/ L,and then gradually decreased with the concentration of DEX decreasing. Cells were cultured for 48 h,compared with the air group,the level of FGF - 1 mRNA was lower,FGF - 2 and IL - 6 mRNA were higher in the hyperoxia group(P ﹤ 0. 05). Compared with hyperoxia group,the level of FGF - 1 mRNA was higher,FGF - 2 and IL - 6 mRNA were lower in hyperoxia + DEX group(P ﹤ 0. 05). Conclusions Exposure to high oxygen volume fraction of 950 mL/ L for 48 h can cultivate optimal hyperoxia - damaged cell models,and DEX can protect the cell from hyperoxia injury and 10 - 9 mol/ L was the optimal concentration. Enhanced the expression of FGF - 1 mRNA and inhibited expression of FGF - 2 mRNA may be one of the mechanism that DEX protects the cells from hyperoxia injury.

Objective To determine the risk factors and clinical features of mild vascular cognitive impairment due to subcortical small vessel disease (mVCI-SSVD).Methods Detailed demographic data,vascular risk factors, past and present history were collected and carefully neurological examination, National Institutes of Health Stroke Scale (NIHSS), as well as Hachinski ischemic score (HIS) were performed on 56 mVCI-SSVD patients.Further, the demographic data and vascular risk factors of mVCI-SSVD patients were compared with those of 80 normal control subjects.Results Proportions of smoking (39.3% (22/56)), hypertension (67.9% (38/56)), and diabetes (25.0% (14/56)) were higher in the patient group than in the normal control group (21.3% (17/80) , 47.5% (39/80), 11.3% (9/80)).Odds ratio (2.32(95% CI 1.05-5.13),2.15 (95% CI 1.02-4.54),2.26(95% CI 0.86-5.92)) between the two groups was statistically significant (P value: 0.039, 0.045, 0.047).There was no difference in terms of hyperlipidemia and cardiac disease between groups.Fifty percent (28/56) mVCI-SSVD patients had a clear stroke history.Twenty-six point eight percent (15/56) patients developed the cognitive impairment with an acute onset.Neurological focal signs presented in 20 patients (35.7%).Twenty four (42.9%) patients with HIS ≤ 4 points.Thirty eight cases (67.9%) scored 0 on NIHSS.Conclusions Current study suggested that smoking, hypertension, and diabetes may be risk factors for mVCI-SSVD.While hyperlipidemia and cardiac disease do not increase the risk of mVCI-SSVD.Unlike mVCI caused by large vessel disease, about half mVCI-SSVD patients lack of stroke history.Most patients show a relatively insidious onset and free of significant neurological focal signs.

Objective To explore the application of question-based lectures made by students in teaching chapter of nuclear chemical and biological weapon damage among field military nursing.Methods The participants were junior students of four-year undergraduate program.Questions on emergency treatment and care of chemical and biological weapon damage were proposed after a lecture by teacher.Students were divided into three groups after class and each group was assigned to a lecture on emergency treatment and care of one kind of weapon damage.Students had to collect information and prepare PPT for the next lecture.After lectures given by students at next class,discussion on the lectures was organized and comments were given by teachers.Results All students approved this kind of teaching activities,97.44％ believed that it can arouse their interest in study,94.87％ participated in the collection of data,89.74％ took part in the discussion,and 87.18％ obtained the sense of achievements.Conclusion Question-based lectures made by students are helpful in stimulating their interest in learning,cultivating their abilities of acquiring and applying knowledge.The teaching activities achieve the preferable results through proper application and meticulous organization.

Objective To evaluate the effect of ultra-low dose naloxone on postoperative hyperalgesia caused by large-dose remifentanil.Methods Forty ASA Ⅰ-Ⅲ adult patients,scheduled for gastrointestinal surgery,were randomly assigned into 2 groups (n =20 each):large dose remifentail group (group R) and ultra-low dose naloxone group (group N).Anesthesia was induced with iv injection of remifentanil,propofol and cisatracurium and maintained with inhalation of sevoflurane and infusion of remifentanil.The patients were tracheal intubated and mechanically ventilated.In group R,remifentanil was infused at a rate of 0.25 μg· kg-1 · min-1 starting from the beginning of skin incision.The infusion rate was adjusted according to hemodynamics during operation and subsequently increased/decreased by 0.05 μg· kg-1· min-1 each time.In group N,naloxone was infused at 0.1 μg·kg-1· h-1 while infusing remifentanil,naloxone infusion was stopped at the beginning of peritoneum closure and the other treatments were similar to those previously described in group R.All patients were sent to post-anesthesia care unit after surgery and stayed there for 90 min.Morphine was given when need.The patient-controlled intravenous analgesia was used for postoperative analgesia after leaving post-anesthesia care unit.The first pain time was calculated.The morphine consumption and complications such as nausea,vomiting and pruritus were recorded at 15,30,60 and 90 min and 2,6,24,48 and 72 h after surgery.Results Compared with group R,the morphine consumption was significantly reduced at each time point after surgery,the first pain time was prolonged,and incidence of nausea was decreased (P ＜ 0.05),while no significant change was found in the incidence of vomiting and prutirus in group N (P ＞ 0.05).Conclusion Infusing ultra-low dose naloxone (0.1μg· kg-1 ·h-1) during operation can attenuate postoperative hyperalgesia caused by large-dose remifentanil in patients.

Objective To discussi the feasibility and indication of selective primary suture after choledo-chotomy. Methods The selected patients were intra-operatively randomized to have either primary suture or T tube drainage after choledochotomy. Comparison of the clinical effects in different groups was done. Re-sults Totally 161 cases were randomized into two groups: the primary sutures group 85 cases and the T tube drainage group 76 cases. All patient had no serious or long-term complications. The average hospital stay in primary suture group was significantly shorter (8.5±3.2) d than T-tube group(16.3±6.5) d. Conclusion Under strict indications, the primary suture after choledochotomy is feasible, and has advantages compared with the traditional method.

Objective To investigate the correlation of the vascular endothelial growth factor (VEGF) gene variations in the promoter region with the sporadic Alzheimer' s disease (SAD) in Chinese Han population for better understanding the mechanism of SAD. MethodsThe polymorphisms of 279 SAD Chinese Han patients from Northern China were analyzed by comparing with those from 317 healthy individuals using the method of polymeraee chain reaction-restriction fragment length polymorphism ( PCR-RFLP) or direct sequencing.The commercial statistics package SPSS 11.5 was used to compare the distribution of the allele and the genotype, and to analyze their correlations with SAD. ResultsThree polymorphism sites were found for the VEGF promoters in the Chinese Han sample group including -2578C/A,- 2549I/D and- 1154G/A.- 2549I/D and- 2578C/A exhibiting strong linkage disequilibrium. Individuals with the A allele at position -2578 had an insertion of 18 nucleotides at -2459I/D, whereas CC homozygotes did not contain th es were found between the SAD patients and the controls in the 3 VEGF polymorphisms. After adjusting the data for gender, age and the ApoE ε4 allele using Logistic regression, the - 1154G/G genotype of the VEGF promoter might increase the risk of SAD in Chinese Han population.Among the subgroup without the ApoE ε4 allele, -2549D/-1154G haplotype might increase the risk for SAD (OR = 1.325, 95％ CI 1.023--1.716, P=0.033). ConclusionsThree polymorphism sites ( -2578C/A, -254911D, and -1154G/A) are found in the VEGF promoter regions in Chinese Han population. The-1154G/G genotype of the VEGF promote appears to increase the risk of SAD in Chinese Han population.In the absence of ApoE ε4, the -2549D/-1154G haplotype of the VEGF promoter appears to affect the risk for SAD.

Objective To develop a portable automatic tourniquet.Methods Using microcomputer and pressure sensor,the pressure and hemostatic time of current pressurized tourniquet were controlled.Results Portable automatic tourniquet was composed of gasbag pressurized bandage,electric micro-pump,pressure sensor,preamplifier,impact damper,A/D converter,single-chip micro-computer controller,data memory,keyboard and its interface circuit,display and its interface circuit,photoelectronic control circuit,etc.Conclusion Portable automatic tourniquet is small,light,safe and convenient.Besides,rapid hemostasia and automatically controlled & stable pressure enable it to be used both in the war and at peace time.[Chinese Medical Equipment Journal,2008,29(2):21-23]

AIM: To study the therapeutic effect of Angeng Recipe(AGR) on the female climacteric rats. METHODS: Female SD rats were collected and randomly divided into climacterium,AGR(low dose,medium dose and high dose),nilestriol and young control groups.The level of hormone in serum and hypothalamus was analyzed after using AGR,the alteration of organ coefficient of uterus,adrenal,appendix cerebri and thymus were detected,the apoptosis of ovary granulosa cells was detected by fluorescence microscope and flow cytometer. RESULTS: E_2 contents in high dose group were higher than those in the climacterical group.FSH contents in high dose group were lower than those in the climacterical group.Uterus and adrenal gland viscera coefficient of high dose group,medium dose and low dose group were higher than that of climacterical group,The apoptosis of cells in medium dose group showed lower than that in the climacterical group. CONCLUSION: AGR could adjust the function of endocrine secretion by the effect on ovaries and appendices suprasphenoidalis directly or indirectly,and the mechanism of action was multitarget and the regulation was entirety.AGR could relieve the degeneration of sexual gland axis,and improve symptomatic in climacteric.

Based on literature research and data analysis, the current development situations of the large comprehensive hospitals in the underdeveloped area were analyzed objectively.In addition, with the practical situation of Guangxi, the article did not only elaborate the necessity of establishing a research oriented hospital, but also the way for the construction of research oriented hospital in the underdeveloped area.