Aged, 80 and over ; Dyspnea ; etiology ; Glottis ; pathology ; Hematoma ; complications ; Hemophilia A ; complications ; Humans ; Laryngeal Diseases ; complications ; Male

Objective: To evaluate the feasibility,the safety and the effect of early postoperative enteral nutrition in patients with esophageal cancer.Methods: On the first postoperative day,40 patients were randomly divided into two groups.One group was given isocaloric total parenteral nutrition through central vein(TPN group) and the other group was fed with enteral nutrition through nasoenteric tubes or jejunostomy tubes which were inserted during the operation(EEN group).All variables were measured before operation and on postoperative day 1 and 8.Blood was drawn at different time points to assess albumin,prealbumin and transferrin.Immune response was determined by immunoglobins,total lymphocytes,T-lymphocyte subsets and NK cells. Inflammatory response were determined by C-reactive protein,IL-6 and TNF-?.Morbidity,mortality and length of hospital stay were also evaluated. Results: Tolerance of enteral nutrition was excellent.Neither mortality nor serious morbidity occurred in all patients during the period of study.After the study,the levels of serum prealbumin,total lymphocytes,CD3,CD4 and CD4/CD8 ratio in the EEN group were significantly higher than the levels in the TPN group.The concentrations of IL-6 and the length of hospital stay in the EEN group were significantly lower than in the TPN group.Conclusion: Early postoperative enteral nutrition in patients with esophageal cancer is safe,and also has the benefit effects of enhancing the body status of nutrition and immune function,and reducing the inflammatory response and the length of hospital stay.

Some measures were adopted in the fermentation engineering experiment teaching to explore its important role in the quality education.Good effect is achieved in the aspects of cultivating the ability of combining theory with practice,creativeness,thoroughness,and the spirit of hard-working and team coop- eration of the students.

Altitude ; Animals ; Arvicolinae ; Gene Expression ; Hypoxia ; Rats ; Tumor Suppressor Protein p53 ; genetics

ObjectiveTo explore the relationship between the negative co-inhibitor programmed death-1 ( PD-1 ) and the pathogenesis of myasthenia gravis ( MG), by detecting the expression of PD-1 and programmed death ligand-1 ( PD-L1 ) on peripheral blood mononuclear cells (PBMCs) and soluble PD-1 (sPD-1) in plasma from myasthenia gravis patients. MethodsPeripheral blood samples were collected from 45 MG patients and 33 healthy persons without prednisone or other immunodepressant treatment during the half year ahead of withdrawal.The expression of PD-1 and PD-L1 on PBMCs were detected using immuno-fluorescence labeling and flow cytometry, and the concentrations of sPD-1 in plasma were measured using an ELISA kit. Results(1) The proportion of CD4+ PD-1 + T cells, as well as CD14+ PD-L1 +monocytes of the MG group was higher than that of the control group. There were no significant differences in the proportion of CD4+ PD-1 + T cells or CD14+ PD-L1 + monocytes in the MG sub-groups between different genders or MG types. While the proportion of CD4+ PD-1 + T cells of the late-onset MG (age ≥40) group was higher than that of the early-onset MG group (age ＜40). And it was higher in the MG patients with thymoma or thymus hyperplasia than that from the MG patients with normal thymus. The proportion of CD14+ PD-L1 +monocytes from the MG patients with thymoma or thymus hyperplasia group decreased obviously compared with that of the patients with normal thymus group; but no difference could be found between the late-onset group and early-onset group. (2)The concentration of sPD-1 in the plasma from the group of MG patients was(6. 92 ±0. 72) ng/ml,which was higher than that of the healthy control group ( (3.28 ±0. 42) ng/ml),even more, it was significantly higher in the early-onset MG group than that of the late-onset MG group,there was a negative correlation( r =-0. 526, P =0. 000) between the age of onset and the concentration of sPD-1. ConclusionsThe increased expressions of PD-1 on CD4+ T cells and PD-L1 on CD14+ monocytes in MG patients suggested the involvement of the couple of molecules in the pathogenesis of MG.Higher concentration of soluble PD-1 in the plasma of patients with MG suggested that it might disturb the ligation of PD-1 and PD-L1 on T cells and antigen presenting cells, which might result in the abnormal transportation of the negative modulating signal, and accelerate the pathological progress of MG.

OBJECTIVETo observe effect of acupuncture on asthma at acute stage.

METHODSNinety cases of asthma at acute stage were randomly divided into an observation group of 60 cases and a control group of 30 cases. Clinical therapeutic effect and the mechanisms were studied from symptoms and signs, pulmonary function and serum interleukin -4 (IL-4), gamma-interferon (INF-gamma).

RESULTSThe pulmonary function was improved, the vital capacity was increased and attack of asthma was reduced in both the observation group and the control group, but the observation group was better than the control group in the pulmonary function improving degree (P < 0.05).

CONCLUSIONAcupuncture can strengthen the relieving action of medicine on asthma and it is one of effective methods for bronchial asthma.

Acupuncture Therapy ; Asthma ; therapy ; Humans ; Interferon-gamma ; blood ; Lung ; Vital Capacity

Objective To evaluate the treatment effect of hand reconstruction with bilateral multiple toe transplantation. Methods There are four schedules as follow applied in 102 cases: (1) bilateral second toes to thumb and index finger transplantation in 86 cases; (2) wrap-around flap to thumb and second toe on opposite side to index or middle finger transplantation in 11 cases; (3) wrap-around flap to thumb and bilateral second toes to index and middle fingers transplantation in 8 cases; (4) bilateral wrap-around flap to bilateral thumb and second toe to index finger transplantation in 1 case. Results All reconstructed finger survived in 102 cases except for partial wrap-around flap necrosis in one case and second toe in two cases. Sixty-two patients got more than one-year following up. Two points discrimination in reconstructed finger was between 8 to 14 mm in all cases. The reconstructed finger grew synchronously with toe among children. Thumb opposition function recovered in all cases except for one case. Donor site: no limp or hallux eversion observed in all cases. Conclusion There is less damage on foot and most hand function recovery using bilateral multiple toe transplantation to repair hand or multiple fingers defect.

OBJECTIVETo probe clinical therapeutic effect of acupuncture on diabetic retinopathy and the mechanism.

METHODSOne hundred and twenty cases of diabetic retinopathy were randomly divided into an observed group and a control group, 60 cases in each group. On the basis of routine diabetic treatment, the observation group were treated with the acupoints for regulating the spleen and stomach, and the control group with the acupoints around eye mainly. Clinical therapeutic effect was evaluated by eye fundus condition, blood glucose, blood lipids, nitric oxide (NO) and endothelin (ET) levels.

RESULTSThe needling method for regulating the spleen and stomach not only can improve the eye fundus condition, but also has benign regulative action on metabolism of blood glucose and blood lipids, and NO and ET levels, with significant differences as compared with those in the control group (P < 0.05, P < 0.01).

CONCLUSIONThe needling method for regulating the spleen and stomach is an effective therapy for diabetic retinopathy, and the mechanism is possibly related with the regulation of levels of vascular active substances, NO and ET.

Acupuncture Therapy ; methods ; Blood Glucose ; analysis ; Diabetic Retinopathy ; blood ; physiopathology ; therapy ; Endothelins ; blood ; Humans ; Lipids ; blood ; Nitric Oxide ; blood ; Spleen ; physiopathology ; Stomach ; physiopathology

Objective To compare the clinical effects of microneurosurgery by supraorbital key-hole or endonasal transsphenoidal approaches in the treatment of pituitary adenoma and investigate their complications. Methods We retrospectively analyzed the data of 87 patients with pituitary adenoma of which the anteroposterior diameter was less than 3 cm. These patients, admitted to our hospital from May, 2006 to June, 2008, were operated in an endoscope-assisted microsurgical manner via a supraorbital key-hole approach (n=42) or an endonasal transsphenoidal approach (n=45). The efficacy of these two approaches was compared and their complications were observed. Results The excision rate of the pituitary adenoma developing on or around the sella turcica operated through the supraorbital key-hole approach was significantly higher than that through the endonasal transsphenoidal approach(P< 0.05); while that of microadenoma or adenoma developing towards the sphenoid sinus operated through the supraorbital keyhole approach was statistically lower than that through the endonasal transsphenoidal approach (P<0.05). No obvious differences on the improvement of endocrine secretion, visual acuity and field was noted in these two approaches (P>0.05). The incidence rate of epistaxis and unilateral dysosphresia in the supraorbital key-hole approach was significantly lower as compared with that in the endonasal transsphenoidal approach (P<0.05). Conclusion Rarely having such complications as dysosphresia, epistaxis and sphenoiditis, neuroendoscopic surgery through supraorbital key-hole approach is the best way of treating the pituitary adenoma developing on or around the sella turcica and worth to promote in clinic.

Objective To investigate the expression of GOLPH3 in the tumor tissues of patients with gliomas and evaluate its clinical significance. Methods Seventy-six patients with brain gliomas (13 with grade Ⅰ, 27 grade Ⅱ, 25 grade Ⅲ and 11 with glioblastoma) performed surgical excision in our hospitals from July 2008 to December 2009 were chosen and 9 cases of normal brain tissues from patients performed decompression operation resulting from cerebral hernia were selected as the controls in our experiment. RT-PCR and Western-blotting were used to detect the mRNA and protein expressions of GOLPH3. Results The results investigated by RT-PCR and Western-blotting were consistent,revealing that the mRNA and protein expression rate of GOLPH3 in glioma tissues was not significantly different between different grades of tumors (P＞0.05), but their expression value was obviously significant between different grades of tumors and increased in a grade-dependent manner (P＜0.05). And minimal mRNA and protein expressions of GOLPH3 were found in the tissues of controls. The up-regulative protein expression of GOLPH3 was positively correlated to the malignancy-grade of the gliomas (r,=0.961, P=0.000). Conclusion The mRNA and protein expressions of GOLPH3 are noted with positive correlation to the pathological grades of the gliomas, indicating th at GOLPH3 may play an important role in the generation and development of gliomas.