Objective:To explore the effect of comprehensive intervention program based on the concept of fast track surgery in early enteral nutrition tolerance and rehabilitation in patients with esopha geal cancer.Methods:93 selected patients were divided into the intervention group and the conventional control group according to the admission time.Patients in intervention group were treated with comprehensive intervention,and control group were given routine nursing care.Enteral nutrition intolerance incidence,the first time of bowel sounds,the first time exhaust and defecation and complications were compared between the two groups.Results:36 patients from 47 patients (76.60％) in the intervention group could tolerate the early feeding,while 24 patients from 46 patients (52.17％) in the control group could tolerate.There was significant difference between two groups (P ＜ 0.05).The first time of exhaust,bowel sounds and defecation,and the hospitalization time of patients in the intervention group were better than that in the conventional control group (P ＜ 0.01).Incidence rate of incision infection,pulmonary infection and intestinal obstruction in patients of the comprehensive intervention group was lower than that in the control group (P ＜ 0.05).Conclusion:Compared with the traditional treatment,the comprehensive intervention can effectively reduce the enteral nutrition intolerance incidence,promote the recovery,reduce hospitalization time and the incidence of postoperative complications,and improve the life quality of patients after surgery.

Objective To explore the experience of mothers who provide the first direct breast-feeding for preterm infants in hospital. Methods Using qualitative phenomenological research methods, eleven mothers who provided the first direct breast-feeding for preterm infants in hospital participated in semi-structured interviews. Results Four themes were concluded: the motivation of direct breast feeding in hospital, the lack of experience in breastfeeding, the psychological experience of breastfeeding, and the breast feeding health guidance for premature infants in the hospital expected by mothers. Conclusions Mothers who provide premature infants the first direct breast-feeding in hospital were facing many problems ,there is an urgent need to develop the hospital health guidance , to provide effective social support, helping them transit to direct breastfeeding smoothly and safely after discharge.

Object To extract and separate the chemical constituents from the root of Isatis indigotica Fort (Cruciferae) Methods The root of I. indigotica was percolated with 95% ethyl alcohol, partitioned in solvents of different polarities and finally isolated on silica gel and macroporous resin columns The purified compounds obtained were identified and structurally elucidated by their physicochemical properties and spectral analysis Results Two compounds were obtained and named as isaindigotidione (Ⅰ) and (E)-3-(3′, 5′-dimethoxy-4′-hydroxybenzylidene)-2-indolinone Conclusion The two compounds were new

Objective To evaluate the diagnostic accuracy of dual-energy subtraction chest digital radiography(DR) for detecting coronary artery calcification as compared with multi-detector row CT(MDCT).Methods 35 patients underwent dual-energy subtraction chest DR and ECG-gated MDCT for detection of coronary artery calcifications.The radiation dose of both DR and CT were noted respectively.Two senior and two junior radiologists reviewed the radiogram and assessed the calcifications in LAD,LCX and RCA totaling 105 vessels.ROC curve plotting were used for evaluation with CAC calculated from MDCT as the gold standard.Paired t test was calculated to compare the different radiation dose between DR and CT.Results 27.6% vessels(29/105) showed calcification on DR.The positive incidence in LAD was 48.5%(17/35),LCX 22.8%(8/35),and RCA 11.4%(4/35).The ROC area was 0.866,0.854,0.725,0.642 respectively,with a CAC score of more than 300.The average radiation dose was 0.469?0.22 mGy for DR,and 12.29?1.40 mGy for MDCT,showing significant differences.Conclusion Chest DR with dual energy subtraction can be used for screening of coronary artery calcification with relatively higher sensitivity for LAD.

Puerarin injection has been widely used for the treatment of cardiac/cerebral blood vascular diseases. The clinical statistical investigation had confirmed that puerarin injection can induce acute intravascular hemolysis, which effected the use of puerarin injection seriously. The review was focus on the research progress of the hemolysis of puerarin injection including the work in laboratory and clinic. The potential hemolysis mechanism and allergen of the puerarin injection were summarized and discussed.
Animals ; Drugs, Chinese Herbal ; administration & dosage ; adverse effects ; Hemolysis ; drug effects ; Humans ; Isoflavones ; administration & dosage ; adverse effects ; Models, Animal ; Pueraria ; chemistry

Objective To optimize the forming process of Wuzibushen Capsules. Methods Category and ratio of accessories were investigated by taking moisture absorption percentage as index. The inspected angle of repose, bulk density and critical relative humidity were also investigated. Results Starch was used as the excipien. Remedium cardinale and starch in the ratio of 1.15∶1.25 was more appropriate, 60% alcohol was added, dried at 60 ℃. Granules had a good fluidity, critical relative humidity was about 62%. Conclusion The forming technology was reasonable and provide reliable basis for production.

BACKGROUND: At present, there are investigations on the expression of cytokines and adhesion molecular in ischemia-reperfusion injury at abroad,but they do not involve in the relative studies on endogenous cytokines and adhesion molecular on microvascular endothelial surface following injury.The expression of endogenous interleukin-1(IL-1) is limited only at mRNA level.OBJECTIVE: To prove into the mechanism of the expression of intercellular adhesion molecular 1 and its regulation factor IL-1 in spinal ischemia-reperfusion injury.DESIGN: A randomized grouping design, animal experiment.SETTING: Department of Sports Medicine, College of Physical Education Affiliated to Jilin UniversityMATERIALS: This experiment was carried out at the Central Laboratory,China-Japan Union Hospital, Jilin University between March 2003 and January 2004. Totally 77 healthy male Wistar rats were randomly divided into normal control group (n=7), simple ischemia group (n=14) and ischemia-reperfusion group (n=56). Among the rats in the simple-ischemia group, 7 rats suffered from blood flow block for 30 minutes and 7 rats for 60 minutes; Rats in the ischemia-reperfusion group were assigned into 8 subgroups according to 8 time phases, respectively at reperfusion for 30,60 minutes, 2, 4, 6,9, 12 and 24 hours following spinal ischemia, with 7 rats at each time phase.METHODS: Spinal ischemia-reperfusion injury animal models were created with Zivin method. The expressions of vascular endothelial intercellular adhesion molecule-1 (ICAM-1) mRNA and IL-1β mRNA following spinal ischemia-reperfusion injury were detected with reverse transcriptionpolymerase chain reaction, immunohistochemistry and immunofluorescent confocal laser scanning microscope technique.MAIN OUTCOME MEASURES: The expression of IL-1β mRNA, activity of IL-1 polypeptide, expression of ICAM-1 mRNA and protein and activity of myeloperoxidase (MPO).RFSULTS: Totally 77 animals were enrolled and all of them entered the stage of result analysis. ① The expression of IL-1β mRNA (A value)was significantly higher in the ischemia-reperfusion group than in the simple ischemia group and normal control group, with significant difference (respectively 1.07±0.33,0.60±0.22,0.57±0.12,t=3.751 7,11.852 6,P ＜ 0.01).② Activity of IL-1 polypeptide (A value )was significantly higher in the ischemia-reperfusion group than in the simple ischemia group and normal control group, with significant difference [respectively (33.7±3.2),(23.8±4.5), (23.1±2.1),t=2.798 8,9.962 7,P ＜ 0.01]. ③ ICAM-1 mRNA(A value)was significantly higher in ischemia-reperfusion group than in simple ischemia group and normal control group, with significant difference[respectively 0.94±0.12,0.52±0.11,0.51±0. 10,t=0.327 0,6.127 4, P＜0.01].④The expression of ICAM-1 protein was significantly higher at ischemiareperfusion for 4,6 and 12 hours than in simple ischemia group and normal control group, with significant difference [Respectively (316.90±26.00),(361.40±18.00),(406.00±23.00),(164.21±2.00),(180.00±32.00) μg/L,t=1.410 3,9.119 3 ,P ＜ 0.01]. ⑤ The activity of MPO was significantly higher at ischemia-reperfusion for 12 hours than in simple ischemia group and normal control group, with significant difference [respectively (15.00±2.00),(7.50±1.67),(6.67±1.00) nkat/g, t=3.012 2,P ＜ 0.01].CONCLUSION: Following reperfusion injury, inflammatory reaction in spinal cord is important molecular basis for causing blood spinal barrier impairment, and plays an important role in the process of secondary spinal cord injury.

ObjectiveTo investigate the effects of dexmedetomidine on postoperative cognitive function and monocytes Toll-like receptor 2 (TLR2)and TLR 4 expression in elderly patients.MethodsForty-five ASA Ⅰ or Ⅱ elderly patients aged ≥65 yr weighing 53-72 kg were randomly divided into 3 groups: control group (group Ⅰ ) and different doses of dexmedetomidine groups(groups Ⅱ and Ⅲ ).Dexmedetomidine 1.0 μg/kg was injected iv over 15 min after anesthesia induction,and then was infused at a rate of 0.5 μg·kg-1 ·h-1 (group Ⅱ ) or 1.0 μg· kg-1 ·h-1 (group Ⅲ ) untile the end of operation.Group Ⅰ received equal volume of normal saline.Blood samples were taken before anesthesia induction,at 1.5 h after the beginning of operation,at the end of operation and at 24 h after operation(T,-T5 ) for determination of monocytes TLR2 and TLR4 expression by flow cytometrybased method.Postoperative cognitive function was evaluated at 1 d before and 7 d after operation with Mini-mental state examination and Wechsler memory scale and Wechsler adult intelligence scale,and the postoperative cognitive dysfunction was recorded.ResultsThe incidence of postoperative cognitive dysfunction and monocytes TLR2 and TLR4 expression were significantly lower in groups Ⅱ and Ⅲ than in group Ⅰ,and in group Ⅲ than in group Ⅱ (P ＜ 0.05).ConclusionDexmedetomidine can prevent postoperative cognitive dysfunction in elderly patients,and the mechanism may be related to down-regulation of monocytes TLR2 and TLR4 expression.

This study examined the expression of cell adhesion molecule 1 (CADM1) in pancreatic cancer and the possible mechanism. The expression of CADM1 was detected by immunohistochemistry in tissues of pancreatic cancer, pancreatitis, and normal pancreas. The plasmid pcDNA3.1-Hygro(+)/CADM1 was transfected into PANC-1 cells (a pancreatic cancer cell line). The expression of CADM1 in the transfected cells was determined by RT-PCR and Western blotting. Cell growth was measured by the MTT method and cell apoptosis by flow cytometry. The results showed that CADM1 was weakly expressed in tissues of pancreatic cancer in contrast to its high expression in normal pancreatic and pancreatitis tissues. The expression level of CADM in pancreatic caner was intensely correlated with the differentiation degree, lymph node metastasis and TNM stages. The growth of CADM1-transfected PANC-1 cells was significantly suppressed in vitro by a G1 cell cycle arrest and apoptosis occurrence. It was concluded that re-expression of CADM1 inhibits the growth of pancreatic cancer cells and induces their apoptosis in vitro. As a tumor suppressor gene, CADM1 plays an important role in the occurrence, progression and metastasis of pancreatic cancer.

Objective To survey ST-segment resolution in STEMI patients undergoing emergency percutaneous coronary intervention (PCI) and to find the specific clinical features of patients with inadequate ST-segment resolution.Methods A total of 198 patients were divided into two groups according to the ratio of ST-segment resolution:relatively adequate ST-segment resolution group (＞ 50％) and inadequate STsegment resolution group (＜ 50％).The clinical features,infarct-related artery and PCI-related evants were evaluated,and major adverse cardiovascular events (MACE including target vessel revascularization,recurrent myocardial infarction,or death) were recorded during hospitalization and follow-up period.Multivariate logistic analysis was used to identify relevant factors influencing ST-segment resolution of STEMI patients after treatment with PCI.The Statistical analyses of data were carried out using SPSS 10.0 software.Results (1) There were 156 patients with relativey adequate ST-segment resolution and 42 patients with inadequate ST-segment resolution.Of them,there were higher percentage of patients aged over 75years in the inadequate ST-segment resolution group than those in the relatively adequate ST-segment resolution group (9 cases,21.4％ vs.14 cases,9.0％ ; P ＜0.05).(2) In inadequate ST-segment resolution group,thetotal ischemic time was significant longer [(5.2 ±2.2) h vs.(3.0 ± 1.6) h,P ＜0.01].The infarctrelated artery (IRA) was more common at left anterior descending coronary artery (LAD) (27 cases,64.3％ vs.69 cases,44.2％; P ＜ 0.05) and there were fewer patients with TIM grade 3 of IRA in inadequate ST-segment resolution group after primary PCI than that in relative adequate ST-segment resolution group (32 cases,76.2％ vs.140 cases,89.7％ ; P ＜ 0.05).There was a lower rate of using GP Ⅱ b/Ⅲ a receptor antagonist and a higher rate of prescribing IABP in inadequate ST-segment resolution group.(3) There is a higher incidence of MACE during hospitalization and follow-up period in patients with inadequate ST-segment resolution.(4) Multivariate logistic analysis indicated that age over 75 years,LAD occlusion,the total ischemic time were related to ST-segment resolution.Conclusions The patients with age over 75 years,LAD occlusion,longer ischemia time,and unemployment GP Ⅱ b/Ⅲ a receptor antagonist before PCI were prone to get inadequate ST-segment resolution and poor prognosis.Age over 75 years,LAD occlusion,and longer ischemic time were independent risk factors of the inadequate ST-segment resolution in STEMI patients after emergency PCI.