Operable cancer patients should receive nutritional risk screening or/and nutritional assessment before surgery.Perioperative nutrition support therapy should be planned and implemented for the patients with nutritional risk or malnutrition,but not necessarily following special nutritional formula.Reducing the time of preoperative fasting,providing reasonable preoperative nutrition support,and early postoperative feeding in combination may be the preferred strategy for perioperative nutritional intervention and management.Because the disease of cancer patients is complicated and changeable,perioperative nutrition support is not only a technology,but also an “art”.The guidelines,disease information,and clinical experience should be “cleverly tailored and combined” to promote the outcome-improving effect of nutrition support therapy.

Objective:To explore the effects and mechanisms of insulin postconditioning on myocardial protection in isolated rat hearts.Methods:32 Wistar rats were randomly divided intocontrol group,ischemia/reperfusion group(I/R group),low dose insulin postconditioning group(L-POST group)and high dose insulin postconditioning group(H-POST group),with 8 rats in each group.Langendorff and neely perfusion models were steadily established,then the rat hearts were arrested by cardioplegia(St.Thomas No.2 solution,STH-2)after perfusion for 30 min.These arrested hearts were remained for 30 min at 4℃and then underwent reperfusion for 60 min.In L-POST group and H-POST group,the arrested hearts were reperfused by Krebs-Henseleit buffer solution(K-H)with insulin.The content changes of myocardial eNOS and PKC were detected by immunohistochemistry and Western blo(tWB),the AI(Apoptosis index,AI)of cardiomyocyte was detected by TUNEL.Results:Compared with control group,higher expression of eNOS and PKC and higher AI were detected in I/R group、L-POST group and H-POST group (P

flower, changed with the blossoming period. CONCLUSION: It may be a relationship between the content and blossoming period.

Objective To analyze the situations of hospital infection among patients with Chronic Hepatitis B and explore the characteristics and risk factors.Methods Totally 315 patients with Chronic Hepatitis B were chosen and studied to analyze the infection body sites,distributions of pathogens and the risk factors which might cause reproductive tract infections.Results The analysis of 315 cases showed that the infection rate was 17.14％ (54 cases),and the most infection sites was abdominal infection(37.04％).Eightyfour pathogens were detected and the gram-negative bacteria were 52 plant of most(61.9％).Hospital infections of patients with Chronic Hepatitis B were closely related to age,hospital time,using of antibiotics,clinical stage,hypoproteinemia,invasive manipulation and underlying disease.Conclusion It is effective to reduce the infections by treating early,promote the nursing mind and nutritions.Using the antibiotics reasonable and enhance the educations of psychology.

Objective To evaluate the test-retest reliability and internal consistency of a Chinese version ofthe PRWE in a group of patients with distal radius fracture and to compare it with the original PRWE. MethodsThe original PRWE was translated into Chinese. Test-retest reliability was obtained by repeating the PRWE to thesame subjects in one week interval and presented by intra-class correlation coefficient (ICC), internal consistencywas measured by Cronbachs coefficient alpha. Results The Chinese PRWE has good test-retest reliability and in-ternal consistency which are equivalent to the results from the English PRWE. The ICC for the Chinese PRWE rangedfrom 0. 88 to 0. 92. and Cronbach Alpha for the Chinese PRWE ranged from 0. 87 to 0. 97. Conclusion The Chi-nese version of PRWE is equivalent to the original PRWE with acceptable level of reliability and internal consistency.It is a good functional assessment tool for patients with distal radius fractures.

Objective To investigate the accuracy of NGAL in prediction of acute kidney injury (AKI) complicated by sepsis. Methods Blood and urine samples were collected at different time points in 74 sepsis patients, and 17 AKI patients were got from them.Cysteine Cys C levels were detected with Latex enhanced turbidimetric immunoassay (LETIA). Urine NGAL and Scr levels were detected with solid-phase sandwich enzyme-linked immunosorbent assay and creatinine enzymatic assay respectively. At the same time, 57 non-AKI patients were set as controls. Dynamic changes of urine NGAL and Scr were observed in sepsis patients in test and control group. ROC curve was used to evaluate the performance of AKI diagnosis by urinary NGAL.Results The Scr base line was (59. 38 ±16. 72) μmol/L.The median time of diagnose of AKI was 24 (12, 48) h past-sepsis diagnosis, while the Scr was(100. 35± 28. 26) μmol/L. Of the group, 17 cases of sepsis were diagnosed with AKI, accounting for 23% (17/74) prevalence. In sepsis group, base line value[(0. 61 ± 0. 15) mg/L] of serum Cys C was not upregulated at 2, 4 and 6 h, which was (0. 63 ± 0. 14) mg/L, (0. 68 ± 0. 16) mg/L and (0.65±0. 14) mg/L respectively. As to 8 h [(0. 85 ± 0. 22) mg/L], a slight upregulation was found with no significant difference (t = 1.63, P ＞ 0. 05).A trend of gradual increase of serum Cys C levels was found in sepsis AKI group at 12, 18, 24, 36, 48 and 72 h. A significant difference was found compared with base line (t = 2. 81, 2.98, 3.05, 3.11, 3. 38,3. 17,P ＜0.01). NGAL level[(96.21 ±45.32) μg/L] was significantly higher than base line value [(4. 98 ± 1.65) μg/L]. Subsequently, in each time point from the 2 h to 48 h, a trend of gradual increase in urinary NGAL levels was showed. The differences were significant compared with the baseline values (t =2. 74,2. 83,2. 91,3.04,3.15,3.22,3. 31,3.45,3.57 ,P ＜0. 01). Urinary NGAL levels of sepsis AKI group were significantly higher than those in non-AKI group at different time points with significant difference (t =2. 69,2. 73,2. 84,2. 96,3.02,3. 13,3.29,3.43,3.54,3.22,P ＜0. 01). ROC curve was selected to analyze diagnostic performance of urinary NGAL levels in AKI patients 2 h post-sepsis. Area under ROC curve was obtained as 0. 935, 95% confidence interval was 0. 683-0. 971. When cut-off value of urinary NGAL for patients 2 h post-sepsis was 50 μg/L, the sensitivity, specificity and accuracy were 94. 4%, 87. 5% and 96. 8% in AKI diagnosis respectively. Conclusions The occurrence of AKi can be accurately predicted by urinary NGAL levels 2 h post-sepsis , and its AKI diagnosis time is earlier than that of Scr. Urine NGAL can be used as early marker of AKI complicated by sepsis.

In vivo,dendritic cells(DCs)are the most powerful antigen-presenting cells (APCs).DCs based neoplasm immunotherapy has recently become the focus of research.DCs can be used not only as separate cell vaccine to mediate anti-tumor immunity,but can also be combined with cytokines,immune cells,and other methods in tumor immunotherapy. In animal models and clinical trials,DC-based immunotherapy as well as other tumor immunotherapy strategies have gained more significant progress.

Sepsis may result in a high mortality.Fish oil,which riches in ω-3 polyunsaturated fatty acids.has anti-inflammatory and immune regulatory functions.ω-3 fatty acids,which are special immune nutrient substrates,participate in the energy provision as well as improve organ function and regulate proinnammatory/anti-inflammatory cytokines.The ideal function of fish oil is associated with dosage,time of initiation and duration of application.

Objective To establish a comprehensive nutritional assessment scale for hospitalized patients with objective and subjective nutritional assessment indicators. Methods The hierarchical structure model was established to evaluate the nutritional status of hospitalized patients by analytic hierarchy process,and the weight coefficients of various assessment indicators were worked out by Satty product method,then the comprehensive nutritional assessment scale for hospitalized patients was established. ResuIts The newly established comprehensive nutritional assessment scale included 11 subjective and objective indicators,and the weight coefficients of indicators varied.The leading three important indicators for nutritional assessment were serum prealbumin(2.3),serum albumin(2.3)and degree of weight loss(1.6).Conclusion With both snbjective and objective indicators,the new comprehensive nutritional assessment scale established with analytic hierarchy process transforms the qualitative indicator into the quantitative one.It is a new attempt to apply the mathematical theory into the area of clinical medicine.

For more than a century, surgical treatment of gastric cancer is always a subject of debate, es-pecially for the extent of lymph nodes dissection for advanced gastric cancer (AGC). In this article, we re-viewed the advances on lymph node excision in AGC.