Objective:To investigate the effect of enteral nutrition support one week before surgery and postoperative periods on the postoperative immune function and nutritional status in old patients with gastric cancer. Methods:A retrospective analysis was con-ducted on 77 stomach cancer patients who were admitted and received surgical treatment in our hospital. Among the patients, 38 re-ceived enteral nutrition support one week before surgery and early period of postoperation, and were labeled as the experimental group. The remaining 39 patients did not receive enteral nutrition support one week before surgery and early period of postoperation, and were named as the control group. The levels of prealbumin, albumin, transferrin, CD4+T (%), CD8+T (%), and CD4+/CD8+cells were also an-alyzed before surgery and 1 d and 8 d after surgery. Results:No statistical differences in the gender, age, site of tumor, TNM staging, and differentiated degree were found between the two groups. All operations were successful and the patients recovered well after sur-gery. In the nutritional status, the levels of prealbumin, albumin, and transferrin in the patients of the two groups had no significant dif-ference (P>0.05). On the first day after the surgery, the levels of prealbumin, albumin, and transferrin were significantly low in both groups;the control group had lower levels than the experimental group (P<0.05). No differences in the levels of CD4+T (%), CD8+T (%), and CD4+T/CD8+T cells were found between the two groups (P>0.05). On the first day after surgery, the levels of CD4+T (%), CD8+T (%), and CD4+T/CD8+T cells were significantly low in both groups;the control group had lower levels than the experimental group (P<0.05). Conclusion:Elderly patients with gastric cancer who receive appropriate enteral nutrition support one week before sur-gery would have better immune function and nutritional status after surgery than those who did not, and the recovery of old patients im-proved.

Objective To discuss the diagnosis and treatment of iatrogenic urethral injuries and preventive measures.Methods Various clinical parameters in 26 cases of iatrogenic urethral injury between January 2006 to January 2014 were analyzed retro-spectively.Results Twenty-five cases were confirmed in the operation,1 case of confirmed 2 days postoperatively.All patients were follow-up visit for 3-24 months normal renal function,only 1 case of urethral stricture.Conclusion Through effective prevention, early diagnosis and treatment,close follow-up visit can minimize the patient′s occurrence of iatrogenic urethral injury.

Objective To compare of the effect of portaazygous devascularization(PADV) and combination operation(splenorenal shunt plus portaazygous devascularization)on the treatment of esophageal variceal bleeding(EVB).Methods 28 cases of EVB admitted from October 1995 to October 2000 were divided randomly into two groups:(1)PADV group (14 cases);(2) combination operation(14 patients).The free portal pressure(FPP) and portal veinous flow(PVF)were measured intraoperatively; and pre and post-operative barium meal and therapeutic effect between 2 groups were compared.Results The average value of FPP of PADV group and combination operation group reduced (4.81?7.26)cmH 2O and (10.03?2.66)cmH 2O respectively after operation, there were significant difference (both P

Objective To development a cooling crystallization process that is suitable for industrial preparation of purified dihydromyricetin.Methods Screen design was used to investigate effects of process parameters such as,temperature,concentration ethanol aqueous,quantity of activated charcoal and adsorption time on yield and purity of dihydromyricetin.Purity was verified by high performance liquid chromatography and thin layer chromatography.The solubility of dihydromyricetin in water at viable temperature and ethanol proportion was also determined by UV spectrophotometry.The solid form was characterized by thermal analysis and powder X-ray diffractometry.Results When temperature was ＞ 85 ℃,ethanol concentration ＜ 10％,dosage of activated charcoal 0.1％-0.3％,and adsorption time 1-3 min,yield of dihydromyricetin was more than 70％,and the purity greater than 98％.The crystals,prepared by cooling crystallization from water and ethanol aqueous,had the same physical form and crystal habit.Conclusion Cooling crystallization from low concentration of ethanol aqueous gets higher yield and the process is more robust than crystallization from water.

OBJECTIVE:To investigate the effect of different doses ambroxol hydrochloride on lung protection of patients in perioperative thoracotomy. METHODS:60 patients in perioperative thoracotomy were randomly divided into control group(30 cas-es)and observation group(30 cases). Control group received 30 mg Ambroxol hydrochloride injection from 1 week before surgery to 1 week after surgery,adding into 100 ml 0.9% Sodium chloride injection,intravenously,twice a day. Observation group re-ceived 300 mg Ambroxol hydrochloride injection from preoperative 1 week to postoperative 1 week,adding into 100 ml 0.9%Sodi-um chloride injection,intravenously,twice a day. All patients received the second-generation cephalosporin antimicrobial drugs for anti-infection after surgery. lung surfactant-associated protein A(SP-A),intercellular adhesion molecule(ICAM-1)levels preopera-tive 1 week and postoperative 1 week,and incidence of postoperative complications in 2 groups were observed. RESULTS:Preop-erative 1 week,there were no significant differences in the SP-A and ICAM-1 in 2 groups(P>0.05). Postoperative 1 week,SP-A and ICAM-1 in control group and ICAM-1 in observation group were significantly higher than preoperative 1 week,but SP-A and ICAM-1 in observation group were lower than control group,the differences were statistically significant(P<0.05),there were no significant differences in SP-A in preoperative 1 week and postoperative 1 week(P>0.05). The incidence of postoperative compli-cations in observation group was significantly lower than control group,the difference was statistically significant(P<0.05). CON-CLUSIONS:The effect of high-doses ambroxol hydrochloride on lung protection of patients in perioperative thoracotomy is signifi-cantly superior to small dose,which can reduce the incidence of lung complications.

Objective To investigate the situation of medical waste management in medical institutions of Hubei Prov-ince,and put forward the improvement strategies.Methods The questionnaires were designed according to the relevant standards,situation of medical waste management in 75 hospitals in Hubei Province was investigated by stratified sampling, 73 available questionnaires were got.Results The construction of medical waste management software and hardware in 73 hospitals were basically met the requirements of the standards,the qualified rates in organization and system management, classification and disposal of medical waste in departments were all >90%;83.56% (61/73)of the hospitals carried out the best environmental practice(BEP)for medical waste;application of more than 40 kinds of disposable medical devices and supplies were reduced;76.71% (56/73)of hospitals’soft infusion bags were collected and recycled by designated company;only 21.54%(14/65)of hospitals send pathological chemical waste liquid to hazardous waste disposal center;disposal ways of orthopedic stainless steel plates were different,56.16% (41/73 )of hospitals treated plates as medical waste,only 35.62%(26/73)of hospitals informed patients how to deal with it,and signed informed consent with patients. Conclusion Medical waste management in medical institutions in Hubei Province has been paid more and more attention, but for special categories of medical waste disposal,such as soft infusion bags(bottles),orthopedic stainless steel plates, and pathological chemical waste liquid,there are some problems,training still needs to be strengthened,the classification and disposal of medical waste needs to be standardized further.

Adolescent ; Adult ; China ; epidemiology ; Female ; Humans ; Male ; Middle Aged ; Occupational Diseases ; epidemiology ; Poisoning ; epidemiology ; Young Adult

ObjectiveTo study the amplification and expression of HER-2 gene and protein in breast cancer and to investigate the relationship between HER-2 gene and Ki-67 、P53 、ER、PR、lymph node metastasisandTNMstaging.MethodsFluorescenceinsituhybridization(FISH) and immunohistochemistry(IHC) method were used to detect the amplification and expression of HER-2 and the expression of Ki-67、P53、ER、PR in 150 cases of breast cancer. Results49 out of 150 cases were amplificated,positive rate of HER-2 gene was 32.68％.In the 32 patients whose expression of HER-2 protein was ( + + + ),HER-2 gene was expressed in 28 cases.In The 46 patients whose expression of HER-2 protein was ( + + ),HER-2 was expressed in 16 cases.In the 26 patients whose expression of HER-2 protein was ( + ),HER-2 was expressed in 3 cases.In the 47 cases that the expression of HER-2 protein was negative,there were 45 cases that the expression HER-2 gene was negative.The expression of HER-2 was correlated with ER,PR expression and TNM staging,but not significantly related with age,Ki-67,P53 and lymph node metastasis.ConclusionsFISH and IHC correlate well with each other in the determination of HER-2 gene amplication and protein expression in cases of invasive breast cancer.

Objective To evaluate the accuracy of contrast enhanced ultrasonography (CEUS) in determining the depth of myometrial invasion in endometrial carcinoma in stage Ⅰ.Methods Seventy-six patients previously diagnosed of endometrial carcinoma by curettage of uterine underwent transabdominal sonography (TAS) and CEUS to assess myometrial invasion,among which 48 patients proved to endometrial carcinoma in stage Ⅰ after total abdominal hysterectomy and bilateral salpingo-oophorectomy were studied.The findings of TAS and CEUS to determine endometrial carcinoma IA (no myometrial involvement or invasion of the inner half of the myometrium) and IB( invasion of the outer half of the myometrium) were compared with pathology after abdominal hysterectomy.Results Twenty one tumours (43.75%,21/48) were enhanced earlier than or simultaneously as myometrium and cervix,among which 12 cases were IA stages,while 9 cases were IB stages (P<0.05);and 27 tumors (56.25%,27/48)were enhanced late than myometrium and cervix.There was no statistical difference between TAS and CEUS in detecting endometrial carcinoma in IA and IB(P>0.05).The sensitivity,specificity,positive predictive value,negative predictive value and accuracy of TAS and CEUS in diagnosing endometrial carcinoma in IB were 61.25% vs 69.23%,77.14% vs 85.71%,50.00% vs 64.28%,72.92% vs 88.23%,72.92% vs 81.25% respectively.Conclusions CEUS is not superior to TAS in detecting deep invasion of endometrial carcinoma in stage Ⅰ.

Objective To explore the prevalence of sialorrhea and its clinical correlation with dysphagia in Chinese patients with Parkinson′s disease ( PD ).Methods One hundred and sixteen consecutive patients with a clinical diagnosis of PD were selected.Demographic data included sex , age, years of education, age at onset of PD, clinical genotype, disease duration, treatment, Hoehn and Yahr (H&Y) stage.Sialorrhea was assessed using the Unified Parkinson′s Disease Rating Scale (UPDRS) Ⅱitem number 6.All patients were studied with videofluoroscopic study of swallowing ( VFSS).Results The prevalence rate of sialorrhea in PD was 59.5% (69/116, 95% CI 50.6%-68.4%).Males were more likely to develop sialorrhea than females (47/70 vs 22/46,χ2 =4.298, P=0.038).PD patients′sialorrhea correlated with oral dysphagia:with food leaking from the mouth ( liquid r=0.229, P=0.014; juice r=0.197, P=0.034;pudding viscosities r=0.231, P=0.013;solid food r=0.255, P=0.006), with more than 1 ml of oral food residues (liquid r=0.319, P<0.01;solid food r=0.185, P=0.047), with delay in food transfer to the root of the tongue (liquid r=0.279, P=0.002; juice r=0.209, P=0.024), and delayed swallow transfer ( pudding viscosities r=0.257, P=0.005).Sialorrhea score was not related to H&Y stage, clinical course and levodopa equivalent doses (LED).The prevalence rate of dysphagia in PD was 87.1%(95% CI 81.0% -93.2%).Liquid was more likely to cause pharyngeal dysphagia ( P=0.03).With the increase in H&Y stage , so did the oral and pharyngeal stages of dysphagia.Late and mid-course was more likely to develop oral and pharyngeal dysphagia than those with early clinical course .Conclusions Sialorrhea and dysphagia are common non-motor symptoms in PD patients.Sialorrhea is more prevalent in males and correlates with oral phase of dysphagia.Liquid is more likely to cause pharyngeal dysphagia.With increase in H&Y stage , so did oral and pharyngeal dysphagia.Even though late clinical course is more likely to develop oral and pharyngeal dysphagia than early clinical course , the comparison between late and intermediate clinical courses does not reach statistical significance .