Objective To study the effect of parenteral nutrition combined with chemotherapy on nutritional status and immunity function of patients with gastrointestinal cancer.Methods 100 gastrointestinal cancer patients were treated as research subjects,and they were randomly divided into the treatment group and the control group.The control group was not given special treatment during chemotherapy,while the observation group patients were given nutritional support according to the gastrointestinal function after admission.The nutrition indicators of ALB,TF,PA, immune function parameters IgA,IgG,IgM,T lymphocyte subsets and T cell immune function indicators(CD +4 ,CD +8 and CD +4 /CD +8 )were counted after the four courses.Results There was no significant difference between the preop-erative and after fourth courses of treatment(t =0.093,P >0.05)between the two groups in nutrition.Within group comparisons,data of Tf and PA levels in the observation group were significant different compared with the control group after fourth courses of treatment (t =3.302,P <0.05).After the first 4 postoperative course,IgM index was statistically significant(t =4.135,P <0.05)different between the two groups,three indicators within the observation group were higher than the preoperative level indicators,the difference was statistically significant(t =3.426,P <0.05).After the first 4 postoperative course,the CD +4 level was significantly higher in the observation group,the difference was statistically significant(t =0.087,P <0.05).Comparison between the two groups after the first four courses,the CD +4 /CD +8 level was higher than that of preoperative patients with a significant difference(t =3.359,P <0.05).Intra -group comparison of the control group,four courses of CD +8 was significantly lower than that of the pre-operative patients(t =3.265,P <0.05).Conclusion Parenteral nutrition combined with chemotherapy can improve the nutritional status of patients with malignant tumors of alimentary tract and improve the body's immune function, give parenteral nutrition support treatment and provide a theoretical basis for the digestive tract malignant tumor during chemotherapy.It is worthy of clinical popularization.

Objective To study the effect of parenteral nutrition combined with chemotherapy on immune function in patients with digestive tract malignant tumor. Methods One hundred patients with digestive tract malignant tumor were selected, and they were divided into the observation group and the control group by random digits table method with 50 cases each. The patients in control group during chemotherapy did not receive special treatment, and the patients in observation group were given parenteral nutrition support according to the gastrointestinal function during chemotherapy. The nutrition index, immune function index and T lymphocyte subsets after treatment were observed. Results The transferrin, prealbumin, IgA, CD4+and CD4+/CD8+levels after treatment in observation group were significantly higher than those in control group: (2.41±0.53) g/L vs. (2.15±0.57) g/L, (0.28±0.07) g/L vs. (0.20±0.08) g/L, (3.25±1.19) g/L vs. (2.85±1.01) g/L, 0.403±0.065 vs. 0.323±0.083 and 2.15±1.02 vs. 1.35±0.73, while the IgM in observation group was significantly lower than that in control group: (1.02 ± 0.35) g/L vs. (1.48±0.78) g/L, and there were statistical differences ( P<0.05). There were no statistical differences in body weight, albumin, IgG, and CD8+between 2 groups (P>0.05). Conclusion Parenteral nutrition combined with chemotherapy can improve the immune function in patients with digestive tract malignant tumor, and provide a theoretical basis for the treatment of parenteral nutrition combination with chemotherapy.

OBJECTIVE:To improve the quality of pharmacist consultation,provide real-time,precise and whole-process medi-cine guidance and to promote rational drug use. METHODS:The functions of electronic pharmacy consultation system(EPCS)in our hospital were introduced,and its effects were evaluated. RESULTS:The system had several modules as multiple dimensional knowledge assistant system,real-time prescription checking engine,electronic consultation record method,pharmacist workload and quality statistical analysis. EPCS provided convenient information access,prescription auditing,consultation record and statisti-cal analysis so as to improve consultation efficiency and accuracy. Compared with before using EPCS,EPCS had enhanced speed of inquiring information by 3.75 times,prescription auditing by 4 times,consultation record by 6 times and statistical analysis by 20 times;return visit rate to potients increased from 0.03% to 0.34%. The number of consulting questions increased month by month. The type of consultation question,the identity of the consultant and others could be classified statistically based on the sys-tem. CONCLUSIONS:EPCS helps pharmacist to build a more scientific and effective consultation platform,and promotes rational drug use in the hospital.

Objective:To prepare the production of TIGIT-Fc fusion protein using H22 cells stably integrated the gene by lentivirus vector , and to explore the immunoregulatory effect on macrophages by TIGIT-Fc.Methods: TIGIT-Fc fusion gene were constructed by molecular cloning.The fusion gene was then subcloned to plasmids contained the secretion signaling peptide .The secrected TIGIT-Fc fusion gene was inserted into the lentivirus backbone vector.The purified lentivirus vector was the used to infect the murine H22 cell line.TIGIT-Fc protein was purified by protein A column from the ascites of H 22-injected C57BL/6 mice.Macrophages stimulated by lipopolysaccharide ( LPS ) was challenged to TIGIT-Fc treatment or control.Cytokine levels was then detected by ELISA.Results: TIGIT-Fc protein was purified from the ascites of H 22-injected mice.PVR was upregulated in LPS-treated macrophages.IL-10 level was upregulated in TIGIT-Fc treated macrophages.Conclusion: TIGIT-Fc promotes the mature macrophages to secrete anti-inflammatory cytokine IL-10.

Objective To identify risk factors associated with repeat use of pulmonary surfactant ( PS) in the treatment of respiratory distress syndrome ( RDS ) in the term and near-term neonate. Methods There were 130term and near-term new borns with RDS who were treated with pulmonary surfactant were enrolled. These infants were categorized into two groups: single-dose group (85 cases) and repeat-dose group (45 cases). The differences in basic information were compared between the two groups, and logistic regression analysis was used to identify the risk factors for repeat use of pulmonary surfactant.Results TherepeatutilizationrateofPSwas34.6℅.The incidence of asphyxia,maternal gestational hypertension, X-ray RDS grade 3-4, the age of first dose PS,respiratory support time in the repeat-dose group was significantly higher than in the single-dose group (P<0. 05). PaO2/FiO2 and the cure rate in the repeat-dose group were significantly lower than in single-dose group ( P<0. 05 ) . The incidence of sepsis, pulmonary hemorrhage, shock and patent ductus arteriosus ( PDA) in the repeat-dose group was significantly higher than in the single-dose group ( P<0. 05). Further logistic regression analysis showed that birth asphyxia ( OR=5. 674 , 95℅CI 1. 378 -23. 354 , the age of first dose of PS (OR=1.092, 95℅CI 1.002 -1.191)and PDA(OR =23.499, 95℅CI 2.348 -235.152)were the independent risk factors for repeat use of pulmonary surfactant.Conclusions Birth asphyxia,the age of first dose PS and PDA are the risk factors for repeat use of pulmonary surfactant in the treatment of RDS in the term and near -term neonate.

Objective To evaluate the safety to perform 23G vitrectomy with scleral incisions at 5.0 mm behind the limbus.Methods This is a prospective uncontrolled case study.The data of 140 consecutive primary 23G vitrectomy patients (145 eyes) were enrolled in this study.There were 56 males (59 eyes) and 84 females (86 eyes),with the mean age of (56.34 ± 9.98) years and axial length of (23.99± 2.57) mm.There were 139 phakic eye and 6 aphakic eyes.All the eyes received 23G pars plana vitrectomy with scleral incisions at 5.0 mm behind the limbus.To measure the normal Chinese adult parameters of anteroposterior axis of the eyeball,lens thickness and scleral distances from the limbus to the plane passing through the lens posterior apex,the head CT scans of 105 patients without eye diseases in our hospital were studied during the same period of time for these vitrectomy surgeries.Pearson correlation analysis was used to analyze the relationship between age,anteroposterior axis of eyeball,lens thickness and scleral distances from the limbus to the plane passing through the lens posterior apex.Results Surgical related complications included retinal tears close to the scleral incision sites (3/145 eyes,2.1％) and lens injury (3/121 eyes,2.5％).No other surgical complications occurred,such as retinal hemorrhage,supra-choroidal expulsive hemorrhage and iatrogenic retinal detachment.Based on CT images,the average scleral distance from limbus to the plane passing through the lens posterior apex,anteroposterior axis of eyeball and lens thickness was (6.72± 0.81),(24.39± 0.97),(4.22 ± 0.47) mm,respectively.The results of Pearson correlation analysis showed that age and lens thickness had statistically significant correlation (r=0.328 9,P=0.000 6).Conclusion Primary 23G pars plana vitrectomy with incisions at 5.0 mm posterior to the limbus is safe.

OBJECTIVETo study the current status and risk factors of spontaneous abortion of women at reproductive age in rural areas of Shaanxi province.

METHODSPregnant women who lived in Changwu and Bin counties of Shaanxi province were interviewed on their former reproductive history and being followed on the outcomes of pregnancy from 2002 to 2005.

RESULTSThere were 5844 pregnant women under study with a total number of 9638 pregnancies including 1153 spontaneous abortive episodes. Among the pregnant women in rural areas of Shaanxi province, the ratio between spontaneous abortion and pregnancies was 12.0% and the spontaneous abortion rate(SAR) was 13.6%. Ratio between the number of women who had experienced spontaneous abortion and the total number of women under survey was 16.4 %. The risks of having spontaneous abortion would increase among women who were aged > or =30 years and those with more than 3 pregnancies.

CONCLUSIONTo reduce the incidence of spontaneous abortion among rural area women, the approaches should include: strengthening the family planning management, reducing of the frequency of pregnancy, extending the pregnancy interval and avoiding advanced ageing pregnancies.

Abortion, Induced ; Abortion, Spontaneous ; epidemiology ; Adult ; China ; Female ; Humans ; Pregnancy ; Reproduction ; Risk Factors ; Rural Health ; Young Adult

Objective To construct the competency model of excellent and common clinical medicine undergraduates according to the competency theory . Methods Literature search was used to screen competency model. Behavioral event interview was used to interview 32 excellent clinical experts. Open questionnaire survey was conducted to 100 clinical medical undergraduates. We compiled the primary competency dictionary based on the above results. To determine the final competency dictionary, Delphi method of 50 experts was used to determine the final competency dictionary. According to the competency dictionary, a questionnaire survey was made to test the excellent and ordinary undergraduate students. Results The 38 features of behavioral event interview and 42 features of open questionnaire survey were combined to 51 features, which were used as the first round of expert questionnaire. Two rounds of expert consultation reached a high degree of coordination. 4 first level indicators: knowledge and skills, social role+values+service characteristics, self-concept and consciousness, personality quality and motivation and 36 features were established as final compentency model. 80 excellent clinical medical undergraduates got score of 143.65 ±23.53, while 100 ordinary undergraduates got score of 133.55 ±35.31 (t=2.29,P=0.023), which indicated the competency model could distinguish excellent and ordinary clinical under-graduates . Conclusion This competency model of clinical undergraduate students is reliable and practical, which can be used in future clinical undergraduate training and evaluation.

AIM: To explore the probable mechanisms of diabetes-induced arrhythmias. METHODS: Diabetes was induced in male SD rats,using a single injection of alloxan into tail vein. Untreated age-matched animals were used as controls. All animals were observed by 2,4,6 and 8 weeks,respectively. Transmembrane potentials were recorded with conventional glass microelectrodes. RESULTS: Action potential duration(APD) at all level (APD10,APD20,APD30,APD50,APD70,APD90) was significantly lengthened in right ventricular papillary muscle from week 2 of diabetes. At week 8,APD was more lengthened at any level of repolarization than that at week 2. No differences were observed in the maximum rate of depolarization(V_ max ),overshoot(OS) and action potential amplitude(APA) as well as the resting membrane potential(RP) from the 2th to 8th week of diabetes. CONCLUSION: The results indicate that prolongation of APD may be prominently responsible for the increased incidence of cardiac re-entry-arrhythmias and sudden death,especially at late stages of diabetes.

OBJECTIVE: To evaluate the immuno-modulatory effect of short course administration of somatostatin (stilamin) continuously at early stage in patients with severe acute pancreatitis (SAP). METHODS: Thirty-nine patients with SAP (22 men, 17 women; the middle age was 49 years)were randomly allocated into control group (20 patients treated with non-surgical integrated traditional Chinese and Western medicine) and treatment group (19 patients treated with somatostatin administered intravenously at a dosage of 250 mug/h for consecutive 72 hours as well as the treatment for the control group). Laboratory parameters, including the expressions of CD(3), CD(4) and CD(8) in lymphocytes (tested by flow cytometry) and C reactive protein (CRP), and indexes of therapeutic effect, including the occurrence of organic dysfunction, local complication and mortality between the two groups were compared. Another group of 30 healthy volunteers (19 men, 11 women; the middle age was 47 years) were recruited for testing the normal levels of CD(3), CD(4) and CD(8). RESULTS: (1) The levels of CD(3), CD(4) and CD(4)/CD(8) in lymphocytes before treatment in both groups were significantly lower than those in the healthy subjects (P<0.05), but there were no statistical differences between the two groups. At the 4th day, CD(3), CD(4) and CD(4)/CD(8) increased significantly in the treatment group (P<0.05) while no changes in the control group; the levels of CD(4) and CD(4)/CD(8) in the treatment group were also higher than those in the control group (P<0.05). (2) The CRP levels of the 2 groups showed no statistical difference before and 4 days after the treatment, but the CRP level in the treatment group was significantly lower than that in the control group at the 7th day (P<0.05). WBC count, serum levels of amylase, lipase, lactate dehydrogenase, aspartate aminotransferase, as well as the score of APACHE II in the treatment group recovered more quickly than those in the control group (P<0.05). (3) The occurrences of organic dysfunctions, local complications and mortality in both groups were not statistically different. CONCLUSION: The short course administration of somatostatin continuously at early stage can reduce the inflammatory response, up-regulate the cell immune function and improve the conditions of the patients with SAP, but its effect on mortality and morbidity needs further study.