Objective To explore the nutrition support route of enteral nutrition (EN) and parenteral nutrition(PN) on the cellular immune function of patients after esophagectomy.Methods Sixty-two patients with esophageal surgery were randomly divided into EN group and the PN group,and each was 31 cases.Cellular immune indexes(including T lymphocyte subsets,natural killer cells,B lymphocytes) were measured at the preoperation,the postoperative 1st day and 8th day.The t test was preformed to compare the measurement data of two groups,and repeated measures analysis of variance was used to compare multiple time points of measurement data of two groups.Results The levels of CD3,CD4,CD8,CD4/CDS,NK cells and B cells in EN group at before operation were (60.46 ± 6.41) ％,(39.03 ± 5.64) ％,(25.06 ± 5.39) ％,(1.60 ± 0.24),(13.86 ±4.91)％,(13.14 ± 3.81)％ respectively,and those indices at 8th day after operation were (65.18 ±7.81)％,(40.45 ±6.82)％,(22.81 ±4.47)％,(1.78 ±0.16),(16.97 ±4.85)％,(15.69 ± 3.88)％ respectively,and the differences were statistically significant(P ＜ 0.05).The levels of CD4,CD4/CD8,NK cells and B cells in PN group at before operation were (59.78 ± 5.17) ％,(39.10 ± 5.49) ％,(24.94 ± 3.97) ％,1.57 ±0.20,(14.02 ± 4.47) ％,(12.96 ± 3.39) ％ respectively,significantly different from that of 8th days ((59.78 ±5.17)％,(39.71 ±5.63)％,(24.74 ±3.80),(1.62 ±0.15),(15.35 ±4.31)％,(14.33 ±3.43) ％ respectively),and there were significant difference compared to before operation in terms of CD4,CD4/CD8,NK cells and B cells.At the 8th day after operation,there was significant difference between in EN group and PN group in terms of CD3,CD8,CD4/CD8,NK cells and B cells(P ＜0.05).Conclusion Early EN for patients after esophageal carcinoma operation can significantly improve the cellular immune function of patients.

Objective To investigate the significance of early postoperative enteral nutrition with esophageal cancer in the elderly. Methods A total of 62 cases of esophageal cancer patients aged 70 years and older were randomly divided into the enteral nutrition(EN)group and the parenteral nutrition(PN)group. In preoperative and the first day and eighth day of postoperative serum albumin,prealbumin,peripheral blood lymphocytes,serum immunoglobulin(IgG,IgM,IgA),complement C3 and C4 were measured,and the postoperative infectious complications and cardiovascular complications were observed. Results During the eighth day after operation,the statistic analysis of the data between EN group and PN group showed: tALB = 2. 535,tPA = 2. 880,tLymphocyte =2. 720,tIgA =2. 166,tIgM =2. 065 ,tC3 =4. 103 ,tC4 =2. 478,P ＜0. 05. The result indicated that the EN group was better than the PN group in improving the nutritional status of patients,strengthened the immune system. The complication comparison between the two groups after operation: x2 Infection = 4. 24,x2 Cardiovascular =15.55,P ＜ 0. 05. The result indicated that the EN group had lower incidence of infectious complications and cardiovascular complications than the PN group. Conclusions Early enteral nutrition can significantly improve the nutritional status of elderly patients with esophageal cancer after postoperative,enhance immunity,and reduce the incidence of complications.

Objective To probe into the indication, operative skill of intrapericardial pneumonectomy, the prevention and cure in postoperative complication of intrapericardial pneumonectomy for locally advanced lung canc-er. Methods The clinical data of 43 cases of locally advanced lung cancer undergoing intrapericardial pneumonec-tomy from February 1998 to November 2007 were retrospectively analyzed. Results No surgical death occurred. The main postoperative complication was arrhythmia, acute pulmonary edema and pneumonia, with incidence as 41. 86%. The 1-,3- and 5-year postoperative survival rate was 79.1% ,30.2% and 11.6%. Conclusions The intrap-ericardial pneumonectomy skill not only can improve resection rate, reduce exploration rate, but also offer more oppor-tunity of further therapy in a part of locally advanced lung cancer.

Objective To explore the value of video-assisted thoracoscopy for the diagnosis of indeterminate solitary pulmonary nodules.Methods A total of 42 patients with indeterminate solitary pulmonary nodules(

BACKGROUND: Posterior lumbar interbody fusion(PLIF) has been an effective method for treating the instability of the lumbar spine.OBJECTIVE: To explore the changes in mobilization range after treatment of lumbar segmental instability with titanium-coated fusion cages (Prospace).DESIGN: A before-and-after controlled observational trial based on the patients.SETTING: Orthopedic department of a university-affiliated hospital.PARTICIPANTS: Totally 16 patients with lumbar instability(4 males and 12 females aged 37 to 68 years with the average age of 51.6 years) were treated by posterior lumbar interbody fusion(PLIF) using titanium-coated cage from December 2002 to. December 2003. There were 4 cases of disc herniation, 6 lumbar spinal stenosis, 3 degenerative spondylolisthesis and 3 isthmic spondylolisthesis, among which 5 cases were spondylolisthesis Ⅰ and one spondylolisthesis Ⅱ.METHODS: All the cases received PLIF. In each case, double cages were inserted with the postlateral bone graft and pedicle screw systems were supplemented. The radiology and clinical effects before and after operation were compared.MAIN OUTCOME MEASURES: ① The average height of disc space and foramina and mobilization range of the vertebral bodies before and after operation; ② The Oswestry Disability Index score.RESULTS: All the cases were followed up for 6 to 16 months with an average of 12 months. The total fusion rate was 100%, and the postoperative height of disc space and foramina recovered satisfactorily. The Qswestry Disability Index score was 44. 2 ± 3.9 before operation and 25.5 ± 3.6 after operation with a significant difference. The rate of excellent and good curative effects was 93.8%.CONCLUSION: The titanium-coated cage used in PLIF to treat lumbar instability can achieve good immediate stability after operation.

Objective To explore the expression and significance of let-7a2 in lung adenocarcinoma.Methods To adapt technology of realtime PCR with reference of U6, the expression of let-7a2 in tumor tissues and normal tissues was detected in 15 cases of resected lung adenocarcinoma. The laboratorial data were analysed by measure of 2~(-△△CT) method. The analysed data were managed by statistics. Results The expression of let-7a2 in lung adenocarcinoma tissue was significantly lower than that in lung normal tissue (0.8733±0.4821 vs 2.4527±1.0111). This difference possess markedness significance(t=6.816, P<0.001).Conclusion The expression of let-7a2 in lung adenocarcinoma is obviously lower and is concerned with the course of lung cancer evolution.

Objective To prepare human anti-postsynaptic neurotoxin monoclonal antibody from phage antibody library using recombined postsynaptic short-chain neurotoxins ofLapemis curtus.Methods The three postsynaptic neurotoxins were expressed inEscherichia coli and phage antibodies against neurotoxins were screened. The obtained scFvs were further constructed to full antibodies. The antigen binding ability, biochemical and pharmacokinetic characteristics of the depurated antibodies were evaluated, and the anti-toxin effects of the antibody drugs were verifiedin vivo.Results Two positive scFvs with specific binding ability to all the three neurotoxins were obtained after 4 rounds of panning, and then the full antibodies were generated, expressed and purified. Antibody binding specificity was further confirmed. Pharmacokinetics of these two antibodies, SM-SD-911 and SM-SD-861 were similar to a conventional IgG molecule. SM-SD-911 and SM-SD-861 also showed strong antitoxin effectin vivo. Conclusionfull human anti-postsynaptic neurotoxin antibody has been successfully obtained by using recombinant neurotoxin technology and a large phage antibody library which may achieve clinical efficacy in navy medical applications.

Objective To observe the efficacy of Chinese herbal fumigant sitz bath for different exposure durations on patients for the complicatiors after mixed hemorrhoidectomy.Methods One hundred and twenty patients with mixed hemorrhoidectomy were randomized into four groups(2 treatment groups and 2 control groups) with 30 cases in each group.The treatment groups were treated with the Chinese Herbal fumigant sitz bath for 10 minutes and 15 minutes respectively;while the control groups were treated with the hemorrhoids lotion for 10 minutes and 15 minutes respectively.The severity of pain,edema,bleeding,constipation and urinary disturbance were scored on the second,seventh and fourteenth days after treatment.Data were analyzed statistically.Results Chinese herbal fumigant Sitz baths for 10 minutes could significantly reduce postoperative pain,edema and bleeding symptoms[(1.72±1.23) points,(0.72±1.25) points,(0.91±1.37) points,respectively,P ＜0.05],followed sequentially by groups of Chinese herbal fumigant Sitz baths for 15 minutes [(1.79±1.21)points,(0.89±1.28) points,(1.03±1.24) points]; The hemorrhoids lotion for 10 minutes ((1.86±1.25) points,(1.14±1.47) points,(1.49±1.56)) and 15 minutes[(2.03±1.48) points,(1.05±1.29) points,(1.39±1.47) points,respectively,P ＜ 0.05]With the successful cases of 27,21,18,and 6 in the groups,respectively.Though the overall response rates of for the groups of 10 min's treatment,15min's treatment and 10 min's control were not significantly different between each other(P =0.0634,P =0.2560),they showed a superior efficacy in the overall response rate to the 15 min's control group(P =0.0064,P =0.0365,P =0.0089),respectively.Conclusion Chinese herbal fumigant Sitz baths for 10minutes have a success rate of 100％ on alleviating complications after mixed hemorrhoidectomy.It has a prominent efficacy on reducing postoperative edema and bleeding symptoms than other treatments studied in this program.

Objective To detect the expression of aquaporin 1 in pancreas of rats with acute necrotizing pancreatitis (ANP) and to study the effect of Dachengqi decoction on it.MethodsOne hundred and sixty male SD rats were randomly divided into control group ( C group,n =32 ),ANP group ( n =32),Dexamethasone group (De group,n =32),Acetazolamide group (A group,n =32) and Dachengqi decoction group (DD group,n =32).ANP model was induced by retrograde injection of 5％ sodium taurocholate into the biliary and pancreatic duct.Rats in De group received dexamethasone (4 mg/kg) intravenously after ANP induction; while rats in A group received 1 ml acetazolamide via gastric lavage 2 h before ANP induction; rats in DD group received 2 ml Dachengqi decoction via gastric lavage 48,24,2h before ANP induction; rats in C group received laparotomy.Eight rats in each group were sacrificed at 3 h,6 h,12 h and 18h after induction of ANP models.Quantity of ascites and levels of serum amylases were measured.Pathological changes in pancreas tissue were detected by HE and electron microscope.Capillary permeability in pancreas tissue was detected by Evans Blue (EB) extravasations method.AQP1 expression in pancreas tissue was detected by real-time PCR and Western blotting.ResultsLevels of serum amylase in ANP group was significantly higher,and the pancreatic injuries were obvious ; the levels of serum amylase in De group and DD group was lower than that in ANP group,and the pancreatic injuries were attenuated.The levels of serum amylase in A group were higher than that in ANP group,and the pancreatic.injuries were more severe than that in ANP group.Six hours after ANP induction,the levels of EB in pancreas were (13.44 ±2.56),(126.35 ± 14.80),(86.31 ± 14.46),( 108.99 ± 15.07 ),(78.29 ± 16.85 ) mg/L In C group,ANP group,De group,A group and DD group,and the expression of AQP1 mRNA in pancreatic tissue was ( 170.07 ± 22.48 ) ％,( 83.93 ± 8.98 ) ％,( 117.09 ±10.70 ) ％,( 69.00 ± 8.98 ) ％,( 112.82 ± 11.79 ) ％ ; and the expression of AQP1 protein was 0.23 ± 0.06,0.10 ±0.02,0.32 ±0.03,0.13 ±0.02,0.45 ±0.04.The content of EB in ANP group was higher than that in C group,while the expression of AQP1 mRNA and protein in ANP group was significantly lower than that in C group (P ＜ 0.05 ).The content of EB in De group and DD group was significantly lower than that in ANP group,while the expression of AQP1 mRNA and protein was significantly higher than that in ANP group (P ＜ 0.05).ConclusionsAQP1 plays an important role in the pathogenesis of capillary endothelial barrier dysfunction in rats with ANP.Dachengqi Decoction can attenuate pancreatic injuries of rats by regulating the expression of AQP1.

OBJECTIVE： To study the anti－ metastatic action of equal/unequal－ fork－ peptide of YIGSR.METHODS： To observe the influence of drugs on metastasis of melanoma B16 to lung in mice.RESULTS： The metastatic rate of lung in 46 mice of control and experimental groups was 100％ ,21 days after inoculating melanoma B16 cells via caudal vein.Injection of YIGSR in combination with tumor cells could reduce the number of metastatic nodules in a dose－ dependent manner.The numbers of metastatic nodules in 100μ g～ 200μ g equal fork peptide group and same dosage unequal fork peptide group were significantly different from that in control group(P<0.05;P<0.01 respectively).50μ g equal fork peptide group was different from control group.The synthetic peptide could not decrease the weight of the lung with metastatic lesions.CONCLUSION： YIGSR derivants have effective antimetastatic actions.Its mechanism may related to the inhibiting effect on formation of cancer cell emboli,which retain in microvessels of remote target organs,and multiplicate and penetrate blood vessels to form micrometastatic lesions.