Objective:To investigate the effects of slowly release(SR) carbohydrate system on glucose and lipide metabolism in the elder patients with type 2 diabetes. Methods:The previous enteral nutrition was replaced totally or partially with Glucerna in 11 cases of elder patients with type 2 diabetes for 1-3 months.The changes in hemoglobin, lymphocyte counts, serum albumin, total protein, glycemia, postprandial 2 hours blood glucose,glycosylated hemoglobin, triglyceride, cholesterol, kidney function,electrolytes and the symptoms of gastrointestinal tract were observed. Result:Total protein(P

Objective To investigate the effects of enteral nutrition support with different doses of glutamine on nutritional status and gastrointestinal function in elderly critically ill patients.Methods Totally 90 critically ill patients were randomly divided into three group:the control group without glutamine (group A),enteral nutrition with low glutamine [0.3 g/(kg· d)] (group B),and high glutamine [0.6 g/(kg· d)] groups (group C).Fasting blood samples were collected on days 1,7,and 14 after the initiation of study,and then the indicators including serum diamine oxidase,glutamine,transferin (TF),prealbumin (PA),hemoglobin (HGB),albunin,and nitrogen balance were determined.In addition,the gastrointestinal complications including bloating,diarrhea,and gastric retention were recorded.Results On the 7th and 14th days,the serum glutamine levels in groups B and C were (1 886.8 ±420.5),(2 228.6 ±440.2) μg/L;(1 889.6 ± 436.1),(2 174.3 ± 440.8) μg/L,respectively,which were significantly higher than those in group A [(1 612.0 ±493.5),(1 869.7 ±559.8) μg/L] (P =0.027,P =0.008).The serum diamine oxidase levels were also significantly lower in group B [(2 310 ± 1 271),(1 602.5 ± 1 137.9) U/L] and group C [(2 076.3 ±567),(1 586.3 ±530.9) U/L] than in group A [(3 250 ±923),(2 476 ±862) U/L] (P =0.000,P =0.000).The serum TF and PA levels were significantly increased on the 7th day (P =0.023,P =0.047),and the HGB was significantly higher on 14th day (P =0.003),The number of patients who had undergone successful implementation of enteral nutrition were 4 and 3 in groups B and C,and the number of patients who had achieved the target volume of enterral nutrition was 25 and 27 in groups B and C,which were significantly larger than those in group A (12 and 13,respectively) (P =0.008,P =0.000).The gastrointestinal complication was also significantly decreased after the administration of enterral nutrition with glutamine.Conclusions Enteral nutrition with glutamine can improve intestinal mueosa barrier and nutritional status in elderly critically ill patients.Thus,it helps to reduce gastrointestinal complications and transition time of total enteral nutrition.

OBJECTIVE: The safety of rush immunotherapy (RIT) in Chinese allergic rhinitis (AR)patients is unknown. The purpose of this prospective was to assess the safety differences between RIT and conventional immunotherapy in Chinese AR patients, and then discuss the clinical application feasibility of RIT. METHOD: A one-year study period was set for this study. The enrolled patients were divided into 2 groups according to their preference of therapy: RIT or conventional immunotherapy using standardized house dust mite allergen vaccine. For safety evaluation, the local and systemic adverse reactions were recorded throughout the both groups initial phase. Week 0 (W0), Week 2 (W2), Week 5 (W5), Week 17 (W17) were set as observation time points for leukotriene (LT-B4) and so on. The Generalized Mixed Linear Model with SPSS13. O and the chi-square test with SAS 9. 1.3 were used for Statistics. RESULT: Fifty-two cases were enrolled into the RIT group, of which 49 patients have completed the established treatment study, and 3 cases were lost to follow-up. In the conventional immunotherapy group, 35 cases were enrolled, of which 32 have completed established treatment study, and 3 cases were lost to follow-up. The local and systemic adverse events of AR RIT appeared to be similar to those of conventional therapy and LT-B4 was descended steadily in the two groups. CONCLUSION Processed in advance Chinesear with drugs, RIT is similar to the safety of conventional immunotherapy.
Humans ; Immunotherapy ; methods ; Linear Models ; Prospective Studies ; Rhinitis, Allergic ; therapy

Objective To explore the treatment methods and prognostic factors of metachronous liver metastases from gastric cancer.Methods The clinicopathological data of 102 patients with metachronous liver metastases from gastric cancer who were admitted to the Cancer Hospital of Tianjin Medical University from January 1996 to December 2008 were retrospectively analyzed.Sixty-four patients received systemic chemotherapy,19 received systemic chemotherapy + transcatheter arterial chemoembolization (TACE),and 19 received systemic chemotherapy + radical resection of the metachronous liver cancer.Patients were re-examined every 3 months within the first 3 years after operation,and every 6 months after postoperative year 3,and every 1 year after postoperative year 5.Physical examination,laboratory test and imaging examination were done during the follow-up.The followup was ended in October 2013.The cumulative survival rates of the patients were calculated and compared using the Kaplan-Meier method and the Log-rank test,respectively.The prognostic factors were analyzed using the COX regression model.Results The disease was alleviated in 15 patients,progressed in 27 patients,and the condition was stable in 22 patients after systemic chemotherapy.The disease was alleviated in 6 patients,progressed in 4 patients and the condition was stable in 9 patients after systemic chemotherapy + TACE.Of the 19 patients received systemic chemotherapy + radical resection of the metachronous liver cancer,1 was complicated with incisional infection,and no patient died perioperatively.Sixteen patients died of gastric cancer recurrence including 10 patients with local recurrence and 6 patients with multiple lesions recurrence.Eight patients missed the follow-up,the others were followed up for 9-149 months.The overall median survival time was 8 months (range,2-70 months),and the 1-,3-,5-year survival rates were 40.2％,17.7％ and 6.8％,respectively.The median survival time of the 64 patients who received systemic chemotherapy was 5 months (range,2-37 months),and the 1-,3-,5-year survival rates were 15.6％,3.5％ and 0,respectively.The median survival time of the 19 patients who received systemic chemotherapy +TACE was 6 months (range,3-36 months),and the 1-,3-,5-year survival rates were 26.1％,6.5％ and 0,respectively.The median survival time of the 19 patients who received systemic chemotherapy + radical resection of the metachronous liver cancer was 15 months (range,5-70 months),and the 1-,3-,5-year survival rates were 63.2％,31.6％ and 16.8％,respectively.The prognosis of patients who received systemic chemotherapy + radical resection of the metachronous liver cancer was superior to those who received systemic chemotherapy or systemic chemotherapy + TACE (x2=23.900,P ＜ 0.05).The results of univariate analysis showed that diameter and differentiation of primary tumor,extra-hepatic metastasis,type and number of liver metastases and treatment regimen were correlated with the prognosis of patients with metachronous liver metastases from gastric cancer (x2=6.307,7.908,4.375,45.188,18.234,23.900,P ＜ 0.05).The results of multivariate analysis showed that type and number of liver metastases were independent factors influencing the prognosis of patients with metachronous liver metastases from gastric cancer (OR=5.217,3.292,95％CI:1.428-2.882,1.054-2.514,P＜0.05).Conclusions Surgical resection of the metachronous liver cancer is important to improve the survival of patients.The type and number of liver metastases are important factors in deciding the treatment methods.

Autophagy is a pathway of intracellular degradation, in which autophagic vacuoles are formed to transport intracellular biomacromolecules and damaged organelles to lysosomes. Autophagy plays an important role in the maintenance of the dynamic balance of liver function. Abnormal liver cells can be eliminated by autophagy. This article reviews the close relationship of autophagy with the proliferation of liver cells, non-parenchymal liver cells, and hepatic stem cells. Analysis has shown that autophagy may restore the volume and function of the liver by promoting the proliferation of liver cells and hepatic stem cells, which can be stopped in time to prevent tumor development. Autophagy may promote the activation of non-parenchymal liver cells during liver dysfunction, which can inhibit the regeneration of liver cells, and, in the meantime, lead to the development and progression of liver fibrosis. When the tumor is being formed, autophagy plays an important role in the transformation of normal cells into cancer cells; malignant regeneration of liver cells is activated but not terminated in time.

Objective To evaluate the effectiveness of lumbosacral plexus block combined with the use of dexmedetomidine in elderly patients undergoing proximal femoral nail antirotation (PFNA).Methods A total of 60 patients received elective PFNA were divided into tracheal intubation combined with inhalation anesthesia group (group G) and ultrasound and nerve stimulator-guided lumbosacral plexus block following with dexmedetomidine infusion group (group N).Then we observed HR,SBP,DBP for both groups at the time entering the theater (T0),immediately after tracheal intubation or after dexmedetomidine infusion (T1),skin incision moment (T2) and 30 minutes after skin incision (T3).Visual analogue scale (VAS) scores were assessed for both groups at the time point of 2,6,12,24 and 48 hours after surgery.The number of use of patient controlled intravenous analgesia (PCIA),assessment of consciousness status 1-3 days after surgery,adverse reactions were recorded for both groups as well.The following post-surgery data were recorded:the time of first feeding,first urination and first ambulation,the length of hospitalization,the expense of hospital stay.Results HR,SBP,DBP of the group G changed more significantly at T1,T2,T3 than those of T0 (P＜0.05).The VAS scores and the number of use of PCIA of group N were lower than those of group G at all time points after operation (P＜0.05).The group N had lower CAM-CR scores and less adverse reactions of nausea and vomiting and dizziness than those of group G on days 1 to 3 after surgery (P＜0.01).Compare to group G,the group N were early in terms of post-operation first feeding,first urination and first ambulation (P＜0.01).The length of hospitalization was shorter and the cost of the hospital stay was lower in the group N than the group G (P＜0.01).Conclusion Ultrasound and nerve stimulator-guided lumbosacral plexus block combined with low dose of dexmedetomidine could meet the needs of elderly patients undergoing PFNA.

OBJECTIVE: To explore the difference of mitochondrial DNA 4,834 bp deletion mutation in tissues of inner ear, kidney and skeletal muscle and to discuss the possible mechanism of this kind of mutation in doxorubicin induced mtDNA 4,834 bp deletion mutation rat model. METHOD: Twenty-eight Wistar rats were randomly divided into two groups, one was experimental group (18 rats), the other was the blank control group (10 rats). The rats of experimental group were treated with intraperitoneal injection doxorubicin (1 mg/kg) twice a week for 3 months. The blank controls received an equivalent volume of saline instead. The tissues of inner ear, kidney and skeletal muscle were harvested and the mitochondrial DNA 4,834 bp deletion mutation was detected by nested-PCR (nested polymers chain reaction) technique. The product of PCR was sequenced directly. RESULT: Two rats of the experimental group and the blank group died during the experiment. The frequency of the mitochondrial DNA 4,834 bp deletion mutation of inner ear, kidney and skeletal muscle were 68.75% (11/16), 75.00% (12/16) and 100.00% (16/16) respectively. The difference of this kind of mutation between tissues of the inner ear and the skeletal muscle was statistic significance (P < 0.05). There were no significant difference between the inner ear tissue and the kidney tissue (P > 0.05). None of the rats of the blank control group carry this kind of mitochondrial DNA mutation. CONCLUSION The mitochondrial DNA 4,834 bp deletion mutation could be induce by doxorubicin in rats, and a notable difference were found of the frequencies of this kind of mutation between tissues of the inner ear and the skeletal muscle. So it suggested that this kind of mitochondrial DNA common deletion mutation was tissue specific.
Animals ; DNA, Mitochondrial ; genetics ; Doxorubicin ; toxicity ; Ear, Inner ; Gene Deletion ; Kidney ; metabolism ; Muscle, Skeletal ; metabolism ; Rats ; Rats, Wistar ; Sequence Deletion ; drug effects

We analyze the epidemiology,clinical features,and outcome of the patients with Creutzfeldt-Jakob diseases (CJD) in Guizhou Province from 2010 to 2015.The epidemiology,clinical characteristics and follow-up data of CJD suspected patients obtained from Guizhou CJD surveillance network were analyzed.The testing results of cerebrospinal fluid (CFS) and blood from the patients were also collected and analyzed.Results showed that a total of 11 CJD cases was found from 23 reported CJD suspected patients in Guizhou from 2010 to 2015,including 8 probable sporadic CJD(sCJD) cases,2 possible sCJD cases and 1 genetic CJD(gCJD) case.In 11 cases,rapidly progressive dementia was the major initial symptom,following by mental symptoms,extrapyramidal symptoms,signs and cerebellum cortical blindness.Clinical symptoms of progressive dementia were the main symptoms,following by visual or cerebellar dysfunction,myoclonus,cone system/extrapyramidal dysfunction,and akinetic mutism.Most of cases were abnormal in MRI (45.45％) and 14-3-3 protein detection in CSF(70％).The 14-3-3 blood samples of prion gene 129 amino acids (PRNP)polymorphisms were M/M type,excepting for 1 case gCJD confirmed diagnosis cases with D178N mutation in PRNP gene.Eleven CJD cases did not show season and regional clusterings and vocational tendency.The majority of the cases were male,the median age was 65,and mainly were the Han nationality.For all cases of CJD reported during that year for follow-up,the lost-tofollow-up rate was 27％,and the majority of cases died within one year.The sCJD cases were the majority in CJD cases of Guizhou Province,2010-2015.The epidemiological characteristics were similar to the national monitoring cases in the same period.

The dried rattan stem of the Fibraurea Recisa Pierre plant contains the active ingredient known as fibrauretine (FN). Although it greatly affects Alzheimer's disease (AD), the mechanism of their effects still remains unclear. Proteomics and transcriptomics analysis methods were used in this study to determine the mechanism of FN in the treatment of AD. AD model is used through bilateral hippocampal injection of Aβ1-40. After successful modeling, FN was given for 30 days. The results showed that FN could improve the cognitive dysfunction of AD model rats, reduce the expression of Aβ and P-Tau, increase the content of acetylcholine and reduce the activity of acetylcholinesterase. The Kyoto Encyclopedia of Genes and Genomes enriched differentially expressed genes and proteins are involved in signaling pathways including metabolic pathway, AD, pathway in cancer, PI3K-AKT signaling pathway, and cAMP signaling pathway. Transcriptomics and proteomics sequencing resulted in 19 differentially expressed genes and proteins. Finally, in contrast to the model group, after FN treatment, the protein expressions and genes associated with the PI3K-AKT pathway were significantly improved in RT-qPCR and Western blot and assays. This is consistent with the findings of transcriptomic and proteomic analyses. Our study found that, FN may improve some symptoms of AD model rats through PI3K-AKT signaling pathway.

Objective: To investigate the inhibitory effect of AKR1B10 inhibitor combined with sorafenib on hepatocellular carcinoma (HCC) xenograft growth. Methods: HepG2 xenograft model was established in nude mice. The mice were then randomly divided into four groups: control group, epalrestat monotherapy group, sorafenib monotherapy group and combination treatment group. Tumor volume, tumor weight, T/C ratio and the change in body weight of nude mice in each group were compared to evaluate the curative effect. Immunohistochemistry staining was used to detect the expression of Ki-67 in tumor tissues to evaluate the proliferation status of tumor cells. One-way analysis of variance was used to compare the differences between the groups. Student’s t-test was used to test means of two groups and chi-square test was used for multiple samples. Results: The differences of the grafted tumor volume before and after treatment between the control group, epalrestat group, sorafenib group and combined therapy group was 238.940 ± 39.813, 124.991 ± 84.670, -26.111 ± 11.518, and -54.072 ± 17.673(mm³), respectively, (F = 37.048, P < 0.001). The tumor mass were 0.273 ± 0.140, 0.158 ± 0.078, 0.079 ± 0.054, 0.045 ± 0.024 (g), (F = 16.594, P < 0.001); T/C ratio were 100%, 57.9%, 28.9%, 16.5%, and Ki-67 positive rate were 23.295 ± 6.218, 13.503 ± 3.392, 7.325 ± 2.257, 4.664 ± 1.189 (%), (χ² = 822.203, P < 0.001) . The tumor volume (t = -3.579, P = 0.002) and Ki-67 positive rate (t = -10.003, P < 0.001) in epalrestat monotherapy group were significantly lower than control group. The tumor volume (t = 2.056, P = 0.025), tumor mass (t = 2.101, P = 0.043), and Ki-67 positive rate (t = -2.850, P = 0.005) in combination treatment group were significantly lower than sorafenib monotherapy group. Compared with the control group, the body weight of nude mice in the treatment group decreased to a certain extent, but there was no statistically significant difference between epalrestat monotherapy group and control group (t = -1.599, P = 0.262), and combined therapy and sorafenib monotherapy group (t = -0.051, P = 0.96). Conclusion AKR1B10 inhibitor enhanced the inhibitory effect of sorafenib on hepatocellular carcinoma xenograft.