Through a systematic review and analysis on the related literature and guidlines at home and abroad on the prehabilitation of gastrointestinal neoplasms, this paper sorts out the implementation contents and evaluation methods of the trimodal prehabilitation which includes three aspects: exercise, nutrition and psychology, and found that there is still not standardized content at present. This paper provides the foundation for later evidence-based research. And designed to provide evidence for trimodal prehabilitation nursing practice content, in order to promote the enhanced recovery of the patients with gastrointestinal neoplasm after surgery better.

Objective To investigate the effects of iodine on the pathogenesis of Graves′ disease (GD). Methods The thyroid epithelium cells (TEC) from GD patients and para adenoma normal tissue from thyroid adenoma patients wereculturedrespectivelywithdifferentNaⅠconcentrations from 0 to 1 mg/L. The HLA DR expression of TEC was detected with Western blot. Meanwhile, the morphological change of TEC was observed after treatment of NaⅠ by scanning electronmicroscope (SEM). Results (1) When the concentration of NaⅠ in culture medium was over 100 ?g/L, the amount of HLA DR expression of TEC increased in GD group (P

Pancreatic ductal adenocarcinoma (PDAC) is one of the most aggressive and lethal human cancers. Cur-rent studies on the relationship between complicated type 2 diabetes mellitus (T2DM) and PDAC prognosis have demonstrated inconsis-tent results. The present study aimed to determine the relationship between complicated T2DM and the clinicopathological characteris-tics of PDAC, and evaluate whether complicated T2DM is a significant predictor for overall survival in patients with resectable PDAC. Methods: In this study, clinicopathological characteristics were observed in 136 patients who underwent surgery for PDAC at the Shengjing Hospital of China Medical University between January 2009 and February 2011. The relationship between complicated T2DM and overall survival of PDAC patients was analyzed using univariate and multivariate analyses. Results:The median age of pa-tients was 60 years (range: 35-80 years). Among the 136 patients, 76(55.9%) were male. The prevalence of complicated T2DM was 27.9%in 136 PDAC cases. Preexisting T2DM was not associated with any of the clinicopathological characteristics (all P>0.05). Uni-variate analysis showed that complicated T2DM (P=0.045), maximum diameter (P=0.011), histological differentiation (P=0.013), pT stage (P=0.034), vessel invasion (P=0.032), and pTNM stage (P=0.030) were significantly associated with the overall survival of PDAC patients. The median overall survival time was 14.2 months for T2DM patients, and 18.8 months for non-T2DM patients. In mul-tivariate analysis, complicated T2DM [hazard ratio (HR), 1.873;95%confidence interval (CI), 1.187-2.954;P=0.007], poorly differenti-ated tumor (HR, 2.647;95%CI, 1.413-4.957;P=0.002), and maximum diameter≥4.0 cm (HR, 1.699;95%CI, 1.094-2.640;P=0.018) were the independent predictors associated with poor overall survival. Conclusion:Complicated T2DM was associated with poor prog-nosis. It could be used as a prognostic predictor in patients with resectable PDAC. If confirmed, these findings may provide a novel ap-proach for individualized adjuvant therapy.

BACKGROUND:Hydroxyapatite/gel nano-composite has the same mechanical strength to the natural bone, but its ability to repair bone defects and osteogenic effect need to be confirmed by further studies.
OBJECTIVE:To explore the repair effect of hydroxyapatite/gel bionic composite in skul defects of rabbits.
METHODS: The hole-like calvarium defect models were established in rabbits, and treated with hydroxyapatite/ gel composites (hydroxyapatite/gel group), autologous skul as positive control (autologous bone group) and
nothing as negative control (blank group). The repairing condition in the skul defect areas were observed and analyzed by X-ray and CT at 4, 8, 12 weeks after implantation.
RESULTS AND CONCLUSION: After 8 weeks, X-ray assessment showed that normal-like bone tissue appeared in the defect region of the autologous bone group; in the hydroxyapatite/gel group, dense bone with similar
morphology to normal bone tissue was found in the central site of defect region, and the boundary was slightly blurred. After 12 weeks, the hydroxyapatite/gel showed blurred edge compared with autologous bone, and the center of the composite was disconnected; in the blank group, a clear and regular transmitted shadow was
observed. After 12 weeks, CT examination showed that the hydroxyapatite/gel was connected tightly with the surrounding normal bone tissue. As a new bionic composite, the hydroxyapatite/gel can achieve good effect in repairing skul defects of rabbits.

Objective To establish an ELISA for detecting antibody against Aspergillus fumigatus pectate lyase A(anti-PlyA),and evaluate its diagnostic value for invasive aspergillosis (IA).Methods An indirect ELISA for IgG antibody a-gainst PlyA was established using PlyA as coating antigen.The serum from 97 IA patients,80 non-IA patients and 200 healthy donors were tested,the results were compared with anti-DPPV (antibody against Aspergillus fumigatus dipeptidyl peptidase V fragment)and anti-TR (antibody against Aspergillus fumigatus thioredoxin reductase).Results The intra-as-say coefficients of variation of the ELISA method for detecting anti-PlyA was 5.3%,and inter-assay coefficients of variation was 10.9%.The sensitivity and specificity of diagnosis of IA were 62.9% and 90.4%,respectively.The positive rates of an-ti-PlyA in non-neutropenic and neutropenic IA patients were 43.8% and 72.3%,respectively (χ2 =7.493,P <0.05).There was no significant difference between the positive rates of anti-PlyA (62.9%),anti-TR (60.8%),and anti-DPPV (67.0%) (χ2 =0.562,P > 0.05).When combined anti-PlyA,anti-TR,and anti-DPPV,the diagnostic sensitivity for IA patients in-creased to 92.8%.Conclusion An ELISA for detecting anti-PlyA was successfully established.The diagnostic value of these three kinds of antibody was superior in non-neutropenic IA patientsto that in neutropenic IA patients.The combined detec-tion of three antibodies could provide higher sensitivity.

Objective To study the mechanisms of Chinese medicine Euphorbia kansui induced liver damage. Methods 40 mices were selected and radomly divided into four groups according to the dose of Chinese medicine Euphorbia kansui used,there were 4 g/kg group(1/8 LD50 ),2 g/kg group(1/16 LD50),1 g/kg group(1/32 LD)50,and control group,which were given saline. After continuous administration for 21 d by ig,the body weight and liver coefficient of mice in all groups were determined,liver histological changes were detected by HE staining. The serum enzymatic activity of alanine aminotransferase (ALT)and aspartate aminotransferase (AST),the levels of superoxide dismutase (SOD)and glutathione peroxidase (GSH-Px),the content of malondialdehyde (MDA),superoxide anion radical (O2-·)and hydroxyl radical (OH·)were all measured by ultraviolet spectrophotometry. The changes of reactive oxygen species (ROS)content were detected by flow cytometry. Results With the increase dose of Chinese medicine Euphorbia kansui,the body weight of rats were decreased,and liver coefficient were increased(P<0.05). The serum ALT,AST activity were significantly increased,SOD and GSH-Px activity were significantly decreased(P<0.05),MDA content were increased significantly,radical O2-·, OH·and intracellular ROS levels were all increased (P<0.05 ). Conclusion Chinese medicine Euphorbia kansui induced liver injury though lipid peroxidation.

Objective The systemic inflammatory response syndrome ( SIRS) can be caused by infection and non-infection factors, which have similar clinical features but differ in treatment and prognosis .Rapid synthesis of procalcitonin ( PCT) during infec-tion can be used as a biomarker for the early diagnosis of sepsis .The present study aims to assess the value of the serum PCT level in the etiological diagnosis and prognosis of SIRS in the surgical ICU . Methods We retrospectively analyzed the data on 166 cases of SIRS from the surgical ICU in Jinling Hospital between June 2014 and June 2015 .The data obtained were associated with the patients'demograph-ics, primary diseases, laboratory results, and clinical outcomes.We analyzed the serum PCT values , blood culture results , and clinical outcomes. Results Totally, 131 of the patients were diagnosed with sepsis, with a median value of serum PCT of 2.43 (0.81-10.51) ng/mL, of whom 109 were PCT-positive (≥0.47 ng/mL), with a positive rate of 83.2%.Among the 35 non-infection SIRS patients, the mean level of serum PCT was 0.23 (0.1 -0.39) ng/mL, with a positive rate of 17.14%(6/35).There were statistically significant differences between the two groups in both the ser-um PCT level and positive rate (P<0.05).The PCT-positive rate was significantly higher in the bacteria-infected than in the fungi-in-fected group (86.5%[83/96] vs 74.3%[26/35], P<0.05), with a median value of 4.28 (1.05-14.59) ng/mL and 0.89 (0.37-1.59) ng/mL, respectively, so was it in the survivors than in the non-survivors (94.4%[34/36] vs 78.9%[75/95], P<0.05), with a median value of 12.89 (4.76-47.73) ng/mL and 1.41 (0.54-4.00) ng/mL, respectively. Conclusion The se-rum PCT level might be used to distinguish between sepsis and non-infection SIRS, significantly higher in bacteria-infected and survival groups than in fungi-infected and non-survival groups .Serum PCT determination contributes to the etiological diagnosis and prognosis of SIRS.

Objective Rapid elevation of the IgG antibody against Candida Enolase ( Eno ) has been observed in patients with invasive candidosis in an early stage .The present study was to confirm the association of Candida colonization with humoral im-mune anamnestic response of the dominant antigen . Methods Twenty-four mice were randomized into group 1 treated by oral Candi-da colonization plus intraperitoneal infection ( immunocompetent , n=8) , 2 treated with immunosuppressant in addition to the treatment of group 1 ( immunocompromised , n=8) , 3 treated by oral Candida colonization only ( immunocompetent , n=4) and 4 treated by in-traperitoneal injection only( immunocompetent, n=4).The number of Eno-specific memory B-cells in the spleen and the levels of IgG , IgM and IgA antibodies were determined in the peripheral blood of the immunocompetent and immunocompromised invasive candidiasis mice . Results At 7 days after invasive infection , there were significantly more Eno-specific memory B-cells in the mice of groups1 ( 47.25 ± 13.81) and 2 (43.14±15.95) than in groups 3 (8.00±3.74) and 4(8.50±2.38) (P<0.01), with no statistically significant differences between either groups 1 and 2 or groups 3 and 4 (P >0.05).Eno-IgG antibodies were detected in the serum of the mice of the first two groups in the early stage of invasive infection and positively corre -lated with antigen-specific memory B-cells (r=0.737,P <00.1 ). Conclusion Rapid elevation of the Eno-IgG antibody level in the early stage of invasive infection after Candida colonization may be attributed to the rapid proliferation of humoral immune memory cells.

Objective To investigate and analyze the capabilities of Plasmodium microscopic examinations in medical and health organizations in Dongxihu District,Wuhan City,so as to provide evidences for achieving the standard of malaria elimina?tion and malaria control in the future. Methods The basic information of the laboratorians and the hardware facilities in 15 mi?croscopic examination stations of Plasmodium were collected and analyzed from 2010 to 2015. Meanwhile,the quality of mak?ing,dyeing,cleanliness of all the negatives blood smears were evaluated,and all the positive smears were re?checked in the dis?trict during the period above mentioned. Results Totally,there were 28 laboratorians and 9 qualified microscopes in 15 micros?copy stations in Dongxihu District. The age of the laboratorians in the first?level and third?level organizations was mainly from 40 to 50 years old,but the age of those in the second?level organizations was from 20 to 30 years old. The years for microscopic ex?amination working of most of the laboratorians in the first?level and third?level organizations were more than 15 years,while the working years of those in the second?level organizations were mainly less than 10 years. The education level of the laboratorians in the first?level organization was mainly(50.00%)junior college,while the education levels of those in the second and third or?ganizations were mainly bachelor. From 2010 to 2015,8 561 blood smears were produced and 539 of them were reviewed,the co?incidence rates of review were all 100%,and the average qualified rates of making,dyeing,and cleanliness of the negative blood smears were 82.08%,79.92%and 83.33%,respectively. All the rates mentioned above in 2015 were higher than those in 2010(χ2=26.45,16.85,13.93,all P<0.01). Conclusion The capability of microscopic examinations of Plasmodium has improved obviously in Dongxihu District,but the human resources construction and hardware input in this district should be im?proved,meanwhile,the check on the quality control of microscopic examinations of Plasmodium should be continued,so as to guarantee the sustainable and healthy development of malaria control work in this district.

A total of 169 patients with short-duration type 2 diabetic mellitus (DM) were divided into atherosclerosis (AS) group and non-AS group according to the intima-media thickness (IMT) of three conducting arteries.The level of serum amyloid A (SAA) was assayed by ELISA.The results showed that SAA level of type 2 DM patients increased significantly, patients in AS group showed higher SAA level than that in non-AS group, and SAA level was positively correlated with age, body mass index, waist hip ratio and IMT of common carotid artery.Age, C-reactive protein and SAA level are the major risk factors for IMT of common carotid artery.