Objective: To investigate the effects of ω-3 fish oil fat emulsion on nutritional status and humoral immunity in postoperative patients suffering from gastrointestinal malignancy. Methods: Thirty patients of gastrointestinal malignancy were randomly divided into study group (n = 15) and control group (n = 15). All the patients were assigned to receive total parenteral nutrition with the equal nitrogen and calory,and those in study group received fish oil fat emulsion additionally. Liver and renal function, blood lipid, haemoglobin, albumin, transferrin, total lymphocyte count (TLC) , B lymphocyte subsets (B1, B2), immunoglobin(IgG, IgM, IgA) and complement(C3, C4) were determined preoperatively and 1, 6d postoperatively. Results: There were no significant differences in liver and renal function and blood lipid on postoperative day 6 versus preoperation in all the two groups. TLC, IgG, IgM, C3 on postoperative day 6 were siginificantly higher in the study group(P < 0. 05). Haemoglobin, albumin, transferrin and B lymphocyte subsets were not significantly different between the two groups. Conclusion: Fish oil fat emulsion treatment was safe and tolerated, and could improve the humoral immunity in patients.

Objective To study neuromechanism for uremic restless syndrome (URLS),functional MRI (fMRI) analysis and were used to explor main activity.Methods Resting state functional magnetic resonance imaging (MRI) was performed on 29 patients with uremic restless legs syndrome and 25 healthy controls.The values of the regional homogeneity (ReHo) of the two groups were calculated and analyzed statistically.Result As compared with the control group,patients with uremic restless legs syndrome showed emotional and mental abnormality.Increased ReHo values in bilateral supplementary motor area,bilateral thalamus,left insular lobe,left hippocampus (P＜0.05),and decreased ReHo values in anterior cingulate gyrus,bilateral posterior central gyrus,right amygdala were found in patients with uremic restless legs syndrome (P＜0.05).The severity score of RLS was respectively positively correlated with dialysis duration (r =0.57,P =0.002),PTH level (r =0.419,P =0.033)BAI (r =0.528,P=0.006),and BDI (r =0.567,P =0.003).Conclusion Neuronal activity in related brain area in patients with uremic restless legs syndrome were found.This abnormality provides an objective diagnostic basis for the explanation of restless legs syndrome in maintenance hemodialysis patients.

Objective:To study the effects of penetration enhancers and their combinations on the transdermal delivery of fluoxetine hydrochloride and to discuss the feasibility of transdermal administration of drugs.Methods:The penetration rate of fluoxetine hydrochloride through rat skin in vitro was measured using Valia-Chien diffusion cells and high pressure liquid chromatography was used for analysis.Results:Penetration enhancers,such as Azone,N-methyl-2-pyrrolidone(NMP),oleic acid,and their combinations all had peneration enhancing effect except for propylene glycol(PG).Azone combined with PG or NMP had the most potent enhancing effect.Conclusion:Satisfactory penetration of fluoxetine hydrochloride through rat skin can be obtained by correct combination of enhancers.

Objective To investigate the diagnostic value of susceptibility weighted imaging (SWI)semiquantitative assessment of pathological vascularity in grading cerebral gliomas.Methods Images of thirty-six patients with gliomas(1 5 low-grade and 21 high-grade gliomas)were obtained before therapy.Standard clinical MR imaging and SWI were performed at GE 3.0T scanner.All SWI postprocessed images were reviewed independently by two neuroradiologists and the number of vessels in tumor region were scored. Tumor were graded according to the World Health Organization classification.Results In 1 5 cases of low-grade glioma,semiquanti-tative assessment of pathological vascularity scored 0 in 6 cases,1 in 9 cases.In 21 cases of high-grade gliomas,semiquantitative as-sessment of pathological vascularity scored 2 in 18 cases,3 in 2 cases,1 in 1 case.There was a statistical significance between low-grade and high-grade gliomas(Z =-5.327,P <0.05).The grade of intratumoral pathological vascularity detected on SWI was asso-ciated with tumor grade.Conclusion It is usefull that SWI semiquantitative assessment of pathlogical vascularity in grading cerebral gliomas between low-grade and high-grade.

Objective To compare the therapeutic effect of preoperative chemoradiotherapy or postoperative adjutant chemoradiotherapy for locally advanced rectal cancer.Methods The clinical data of 76 patients with locally advanced rectal cancer from 2011 to 2016 in Guizhou Provincial People's Hospital were retrospectively analysed.A total of 30 cases received preoperative chemoradiotherapy (group A),5 of them received concurrent chemoradiotherapy combined with bevacizumab target treatment.The other 46 cases (group B) were given post-operative adjutant chemoradiotherapy.Both group A and group B were treated with intensity-modulated radiation therapy (IMRT).The chemoradiotherapy regime was as follows:the median of target volume dose was 50.4 Gy (45.0-55.8 Gy);the median of chemotherapy sessions was 26 times (24-28 times).Capecitabine tablets (825 mg/m2,twice a day) were also given on the date of chemotherapy.The clinical data and follow-up results of all patients were compared between the two groups.Results The five-year disease free survival rates of group A and group B were 66.7％ and 57.7％,respectively;and the five-year overall survival rates of group A and group B were 81.8％ and 73.0％,respectively,no statistically significant difference was found between the two groups (P=0.599,0.489).The anus-preserving rates of patients with tumor below peritoneal reflection in group A and group B were 56.52％ and 25.00％,there was statistically significant difference (P=0.045).In the group A,86.6 ％ patients resulted in down-staging,including 3 cases with complete pathologic response.Conclusion Preoperative chemotherapy could down tumor stage and improve rates of anal preservation and local control without increasing possibility of postoperative complications.Preoperative chemotherapy in combination with bevacizumab target treatment may be more effective in lowering tumor stage.

Objective:To investigate the hypoglycemic effect of curcumin on type 2 diabetic rats and its effect on the signaling pathway of endoplasmic reticulum stress RNA-dependent protein kinase like-CCAAT/enhancer binding protein homologous protein (PERK-CHOP).Methods:A total of 45 male SD rats were randomly divided into normal control group, model group and curcumin treatment group, with 15 rats in each group. The rats were given high-fat as well as high-sugar diet and intraperitoneally injected with streptozotocin (35 mg/kg, twice, once/day) to establish type 2 diabetes rat model. After the successful establishment of the model, the rats in the curcumin treatment group were given intragastrically with 200 mg/kg curcumin for 30 days. Serum adiponectin level was detected by ELISA, glucose was detected by glucose oxidase, Western blot was used to detect the expressions of PERK, p-PERK, CHOP and ATF4 protein levels in the pancreatic tissues of rats in each group, and mRNA expressions of PERK and CHOP in the pancreatic tissues of rat in each group were detected by real-time PCR.Results:Compared to the model group, the level of blood glucose (14.86 ± 2.77 mmol/L vs. 30.04 ± 3.25 mmol/L) in the curcumin treatment group significantly decreased, and the serum adiponectin level (94.12 ± 16.34 mg/L vs. 53.91 ± 9.08 mg/L) significantly increased ( P<0.05). The expressions of PERK mRNA (0.85 ± 0.07 vs. 1.64 ± 0.28), CHOP mRNA (0.53 ± 0.04 vs. 1.18 ± 0.33), PERK (1.12 ± 0.31 vs. 2.24 ± 0.43), P-PERK (1.23 ± 0.19 vs. 3.89 ± 0.32), CHOP (0.65 ± 0.07 vs. 0.92 ± 0.11) and ATF4 (0.73 ± 0.26 vs. 1.15 ± 0.31) in the curcumin treatment group significantly decreased ( P<0.05). Conclusions:Curcumin has hypoglycemic effect on type 2 diabetes rats, which can enhance the sensitivity of target tissues to insulin by increasing adiponectin levels. Curcumin can down-regulate the expression of PERK/P-PERK/CHOP/ATF4 protein levels in endoplasmic reticulum stress signal pathway, and reduce stress degree.

OBJECTIVETo analyze the R1 rate of the pancreatic head carcinoma resection specimens which delt with a unified protocol by two different R1 criteria.

METHODSBetween November 2011 and October 2013, a unified pathological protocol was prospectively used to handle 70 consecutive pancreatioduodenectomy specimens for pancreatic ductal adenocarcinoma. Apart from the pancreatic transection margin, the bile duct and stomach/jejunum margins, different colors were used to stain the anterior surface, the superior mesenteric vein (SMV) groove margin, the superior mesenteric artery (SMA) margin, and the posterior surface. Axial slicing technique was used to dissect the pancreatioduodenectomy specimens.

RESULTSAmong the 70 patients, 3, 30 and 37 patients were classified as well, moderately and poorly differentiated respectively;7, 15 and 48 patients were classified as pT1, pT2 and pT3 respectively.Forty patients (57.1%) had metastases in regional lymph nodes (pN1) , and 16 patients (22.9%) had metastases in para-aortic nodes.Resection of the portal vein and/or the superior mesenteric vein was performed in 13 patients (18.6%) .When applying the UICC criteria, 26 cancer resections were classified R1 (37.1%) , 33 margins were turned out to be R1. The SMV groove margin and SMA margin were infiltrated in 13 specimens (13/33, 39.4%) respectively.When applying the Royal College of Pathologist's criteria, 39 cancer resections were classified R1 (55.7%) , 51 margins were turned out to be R1. The SMV groove margin and SMA margin were infiltrated in 18 (18/51, 35.3%) and 19 (19/51, 37.3%) specimen respectively.Until April 2014, the median follow-up was 18(range 6-42) months.

CONCLUSIONSApplying the unified protocol for pancreatic head ductal adenocarcinoma specimens results in an significant R1 rate of the resection margins, and the R1 rate is related to the R1 criterion. The SMV groove margin and SMA margin are the two most frequent sites of R1.

Adenocarcinoma ; pathology ; Carcinoma, Pancreatic Ductal ; pathology ; Diagnostic Techniques and Procedures ; Humans ; Lymph Nodes ; pathology ; Mesenteric Artery, Superior ; surgery ; Pancreas ; pathology ; Pancreatic Neoplasms ; pathology ; Portal Vein ; surgery

In order to further research into the EEG information of rats epileptic model, we applied different nonlinear dynamic methods. After having analyzed the EEG signal of rat falling sickness by means of approximate entropy and correlation dimension, we adopted a the new method, unstable periodic orbits, which was used to analyze complex activity of neurons system to look for the change regularity of change in the EEG signal in the whole course of rat's falling sickness. We found period 1 orbits and period 2 orbits to be statistically significant in the data of ictal time of epilepsy. At the same time, we found period 1 orbits to be statistically significant in the data of preictal time of epilepsy.
Animals ; Disease Models, Animal ; Electroencephalography ; Entropy ; Epilepsy ; physiopathology ; Nonlinear Dynamics ; Rats ; Signal Processing, Computer-Assisted

Objective:To understand the 10-year risk of ischemic cardiovascular disease (ICVD) in hypertensive patients in communities in Shenzhen, and to provide baseline data for the comprehensive implementation of community-based hypertension health management measures based on ICVD risk assessment.Methods:From July 2017 to June 2018, 200 community health service centers in 10 districts of Shenzhen were selected by multi-stage random sampling to investigate hypertensive patients in communities aged≥35. After the patients who met the inclusion criteria signed the informed consent form, the demographic characteristics, physical examination, and laboratory tests were conducted. The absolute risk of ICVD in 10 years was evaluated by using the ICVD risk assessment module from the Shenzhen community health service information system. According to the China 10-year risk for ICVD score tables, recommended by the Chinese cardiovascular disease prevention guidelines, the risk grade of ICVD was estimated and analyzed. In addition, the relative risk was used to eliminate the influence of gender and age, and the single sample t-test was used for comparisons with the larger population. Results:30 015 hypertensive patients from communities were investigated, including 16 165 (53.86%) males and 13 850 (46.14%) females, aged 35-102 years, with a median age of 59.0. 6 405 (21.34%), 5 771 (19.23%) and 17 839 (59.43%) were at high, medium and low risk of ICVD, respectively. The absolute risk was 3.77%, 95% CI (3.72%-3.82%). The risk grades of ICVD in 10 years was different as per gender, age, marital status, population type， smoking, family history of hypertension, history of diabetes mellitus, systolic blood pressure, body mass index, and total cholesterol level, P values were all<0.001. The risk grades of ICVD in males, married patients, floating populations, having a total cholesterol <5.20 mmol/L, non-smokers, non-diabetics, and having a family history of hypertension were lower than that of other characteristics, and increased with age, systolic blood pressure, and body mass index. Further analysis of 15 652 patients aged 35-59 years old showed that the 10-year risk of ICVD in patients with hypertension in communities was slightly higher than that of the larger population, and the relative risk was 1.27, 95% CI (1.25-1.28), t=37.648, P<0.001. In males, relative risk was 0.94, 95% CI (0.93-0.95), t= 9.906, P<0.001, and there were no significant trend changes among age groups. In females, relative risk was 2.05, 95% CI (2.01-2.09), t=72.207, P<0.001, and increased with age. Conclusion:The 10-year risk of ICVD in hypertensive patients is often at a high level in Shenzhen, so it is necessary to carry out the risk assessment of ICVD in the community. The effect of community hypertension health management on reducing the risk of ICVD may vary between genders. The risk of ICVD in male patients is lower than that of males in the larger population, but in female patients it is still much higher.

Objective:To investigate the effect of different pressure balloon dilation combined with prying reduction and bone graft fixation in the treatment of thoracolumbar fractures and the risk factors of postoperative re-fracture.Methods:One hundred cases of thoracolumbar fracture patients admitted to Cangzhou Integrated Traditional Chinese and Western Medicine Hospital in Hebei Province from March 2019 to June 2021 were selected. Prospective randomized controlled study method was used and random number table method was used to divide them into three groups: incomplete expansion group (33 cases), moderate expansion group (33 cases) and complete expansion group (34 cases). All the 3 groups were treated with balloon dilation combined with prying reduction and bone graft fixation. The pressure of balloon dilation in incomplete dilation group, moderate dilation group and complete dilation group was 100 psi, 150 psi and no more than 200 psi respectively, and the volume of balloon dilation was 0.5∶1, 1∶1 and 1.5∶1 respectively. The operation time, intraoperative bleeding volume, postoperative drainage volume, vertebral anterior margin recovery rate and hospital stay, as well as local Cobb angle, visual analog scale (VAS) and Oswestry disability index (ODI) scores before and after operation were compared among the three groups. According to the follow-up of whether there is re-fracture after surgery, the clinical data of the re-fracture group and the non re-fracture group were compared, and the risk factors of the re-fracture after surgery were analyzed. The measurement data with normal distribution was expressed as: independent sample t-test was used for comparison between two groups, one-way ANOVA or repeated measurement ANOVA was used for comparison between three groups, and SNK-q test was used for comparison between two groups. Counting data were expressed in cases or cases (%), and compared between groups by χ 2 Inspection. Logistic regression was used to analyze the risk factors of refracture after thoracolumbar fracture. Results:There was no significant difference in operation time, intraoperative blood loss and postoperative drainage volume among the three groups ( P=0.096, 0.328 and 0.344, respectively). The recovery rate of vertebral anterior edge height in moderate expansion group was higher than that in incomplete expansion group and complete expansion group ((84.15±4.21)% vs (70.18±7.44)%, (75.94±6.56)%), and the hospitalization time was shorter than that in incomplete expansion group and complete expansion group ((10.38±2.35) d vs (15.18±3.44), (14.59±2.48) d) (all P<0.001). Before treatment, there was no significant difference in Cobb angle, VAS and ODI scores among the three groups (all P>0.05). After treatment, the Cobb angle, VAS and ODI scores of patients in the three groups were lower than those before treatment, and the moderate expansion group were lower than those in the incomplete expansion group and the complete expansion group ((14.08±2.15) ° vs (16.48±4.85) °, (15.06±3.45) °, (1.81±0.53)% vs (2.25±0.41), (2.31±0.42), (18.16±2.18)% vs (20.48±4.85), (20.01±4.45) points) (all P<0.001). 100 patients were followed up until the fracture was healed. They were divided into re-fracture group (15 cases) and non re-fracture group (85 cases) according to whether there was re-fracture after operation. The results of multifactor logistic regression analysis showed that body mass index and bone mineral density were protective factors for patients with thoracolumbar fracture after operation (odds ratio was 0.66 and 0.15 respectively, 95% confidence interval: 0.51~0.86, 0.05~0.42, P values were 0.006 and <0.001 respectively), The old wedge-shaped change of the vertebral body and the abnormal structure of the lumbar spine are the risk factors for postoperative re-fracture (odds ratio 4.22 and 6.36, 95% confidence interval 1.14-15.56 and 1.43-28.21, respectively, P values were 0.027 and 0.015). Conclusions:In the treatment of thoracolumbar fracture with prying reduction and bone grafting fixation, the effect of balloon expansion pressure of 150 psi is better. Body mass index (BMI) and bone mineral density (BMD) were protective factors for postoperative re-fracture of patients with thoracolumbar fracture. Old wedge-shaped change of vertebral body and abnormal lumbar structure are risk factors for postoperative re-fracture.