Objective To investigate the effect of early enteral nutrition combined with synbiotics agents on normal intestinal flora,fecal SIgA and infectious complications in patients with hypertensive intracerebral hemorrhage.Methods Fifty-three patients with hypertensive intracerebral hemorrhage were randomly divided into early enteral nutrition group (control group,n =26) and early enteral nutrition combined with synbiotics group (study group,n =27).The patients in control group started receiving enteral nutrition (RuiSu) within 24 to 48 hours after injury ; Patients in study group received a enteral nutritional support which as well as control group,but added synbiotics (Golden Bifid) in the first 14 days of enteral nutritional support.Stool specimens were Collected on day 0,day 4,day 8,day 15 of enteral nutrition support for quantitative analysis of normal intestinal flora and detection of stool SIgA through enzyme-linked immunosorbent assay.The difference of two groups in infectious complications were observed.Results On nutritional support day 8 and day 15,escherichia coli (P =0.004,P =0.004) and enterococci (P =0.032,P =0.048) expression were lower in study group than the control group,bifidobacteria (P =0.046,P =0.024) expression were higher in study group than the control group.During the study period lactobacillus,bacteroides and clostridium were no statistically significant between the two groups (P ＞ 0.05).Fecal SIgA expression in study group was higher than control group (P =0.035) on nutritional support dayl5.The incidence of infectious complications in study group was lower than the control group (33.33％ vs.46.15％),but there was no significant difference (P =0.230).Conclusion compared with ordinary enteral nutrition,enteral nutrition combined with synbiotics agents can be effective in improving intestinal flora imbalance and increase intestinal immune function in patients with hypertensive intracerebral hemorrhage.

Objective To study the nutritional status in different age patients with esophageal cancer during radiotherapy. Methods Ninety nine patients with esophageal carcinoma accepted radiotherapy in Zhejiang Cancer Hospital from June 2012 to August 2013 were enrolled. Patients were divided into two groups by their age: the younger age<60 years; and the older age ≥60 years. Nutritional status was measured weekly during radiotherapy, and European Nutritional Risk Screening (NRS) 2002 were used to evaluate the risk of malnutrition. Results The malnutritional incidence during radiotherapy was 23.5%-29.4% and 33.8%-49.2% in the younger group and the older group, respectively. Compared with baseline nutritional parameters, triceps skinfold thickness (TSF) of the<60 years group started to differ at the first week after the start of radiotherapy (first week to the sixth week:9.14±8.67;7.80±2.90;7.62±2.83;7.56± 2.79;7.90±2.91;7.36±2.67, respectively, all P<0.01);compared with baseline nutritional parameters(2.09± 1.28), ≥60 years group started to differ at the second week (2.34 ± 1.24, P<0.05) after the start of radiotherapy for NRS2002 the third week, 2.49 ± 1.24, P=0.016;the fourth week, 2.51 ± 1.30;P=0.013, the fifth week, 2.55 ± 1.29, P=0.006; the sixth week, 2.57 ± 1.26, P=0.004. There was no significant difference between each time point for TSF in>60 years group (P>0.05). No significant difference was found for body mass index (BMI), arm circumference (AC), arm muscle circumference (AMC) in each group (P>0.05). Conclusion The elderly patients with esophageal cancer had significantly increased risk of malnutrition and decreased nutritional status than the younger patients during radiotherapy. Early start of nutrition interventions in the elderly patients may be benefitted.

AIM: To observe the level of vascular endothelial growth factor (VEGF) secreted by monocytes cultured with electrical burn serum, and to explore the effect of VEGF on monocyte-endothelial cell adhesion.METH-ODS:The electrical burn serum of the rat was prepared.The normal serum from the rats without treating electric current was also collected for control.The contents of VEGF and its soluble receptor sFlt-1 in electrical burn group were determined by double-antibody sandwich ELISA.THP-1 cells were randomly divided into normal serum group and electrical burn serum group.The contents of VEGF and sFlt-1 in the culture supernatants were measured by double-antibody sandwich ELISA. THP-1 cells were also randomly divided into another 4 groups:normal serum group, electrical burn serum group, normal serum +inhibitor group and electrical burn serum +inhibitor group.THP-1 cells, which were incubated with the serum for 3 h and 6 h, were labeled with calcein-AM and then were added into the well with monolayer of endothelial cell line EA.hy926 to detect monocyte-endothelial cell adhesion.RESULTS:The levels of serum VEGF of the rats with electrical burns were significantly increased, the levels of serum sFlt-1 were significantly decreased as compared with the controls. The levels of VEGF secreted by THP-1 cells cultured with electrical burn serum were significantly increased, the levels of sFlt-1 were decreased correspondingly.Electrical burn serum enhanced monocyte-endothelial cell adhesion, sFlt-1 inhibi-ted the adhesion between monocytes and endothelial cells.CONCLUSION:The monocytes exposed to the electrical burn serum secrete VEGF, which enhance the adhesion between monocytes and endothelial cells.Blockage of VEGF activity may effectively inhibit monocyte-endothelial cell adhesion.

Objective To observe the clinical efficacy and safety of immediate-effect moxibustion combined with massage for the treatment of knee stiffness after knee ligament reconstruction surgery.Methods A total of 138 patients after knee ligament reconstruction surgery were randomly divided into control group and observation group,69 cases in each group.The control group received joint rehabilitation therapy,which included TDP light radiation,joint exercise by continuous passive motion apparatus,contraction and relaxation of quadriceps femoris muscle and ankle pump.The treatment group was given immediate-effect moxibustion combined with massage based on the treatment for the control group.The treatment lasted from postoperative day 3 to 14.Before and after treatment,Lysholm knee joint scores,joint activity scores and activities of daily living(ADL) scores of the two groups were observed.Results After treatment,the Lysholm knee joint scores,joint activity scores and ADL scores of the two group were obviously increased (P ＜ 0.05 or P ＜ 0.01 compared with those before treatment),and the increase in the observation groups was superior to that in the control group,the differences of the alove indexes except for joint activity scores being statistically significant between the two groups (P ＜ 0.05 or P ＜ 0.01).Conclusion Immediate-effect moxibustion combined with massage is effective on preventing knee from postoperative ankylosis after knee ligament reconstruction surgery.

Normal lung tissues are inevitably exposed to X-ray in thoracic radiotherapy,causing radiation-induced lung injury (RILI).The main pathological manifestations include the accumulation of inflammatory cells,release of cytokines,accumulation and proliferation of fibroblasts,and excessive deposition of alveolar interstitial collagen in the irradiated region.RILI severely affects the treatment compliance and quality of life and even threatens the life in the patients receiving radiotherapy.In recent years,numerous studies have found that Th1/Th2 imbalance is closely associated with the development and progression of RILI,and the cytokine network plays an executive role in the progression of RILI.Therefore,restoring the Th1/Th2 balance in vivo may provide a new way to prevent and treat RILI.

Prosthesis revision and service life after artificial joint replacement is highly correlated with the biocompatible responses among prosthesis per se, host, and manipulating technique. Artificial prosthesis consists of two parts: metal part and rigid plastic components. Many metals such as stainless steel, cobalt-chrome-molybdenum alloy and titanium alloy can be used as prosthesis materials. The plastic materials mainly include wear-resisting polythene, plastic bone cement that is used to embed the prosthesis into osseous substance. Host defines as the patients with various joint injury, mainly the elderly. Anesthesia is a key step in replacement. Artificial joint replacement is performed in patients under anesthesia. Different anesthesia methods bring variable influences on biocompatibility after surgery. In addition, complications of anesthesia may aggravate tissue lesions around operation sites in the early stage after replacement, leading to joint loosening or inadequate joint range of motion. Appropriate anesthesia, modified artificial joint design and joint replacement technique can prolong the serve life of artificial joint.

International services trade in the light of the principles of WTO makes a dif-ference in medical domain when confronting the direction of the global educational services. The Ministry of Education Project,"The Research of medical distance education and practice pattern in rural areas in west China",establishes an educational platform of modern service in central China, invests nursing human resources of west China and outputs vocational standard patients in east China,which provides school of medicine,especially English class of Chinese system,with abundant social teaching resources and has been adopted as Shanghai Human Resources Training Project.

Myocardial fibrosis is a predominant pathological change of radiation-induced heart disease (RIHD) in late stage.It often occurs several or more than ten years after radiotherapy and can lead to myocardial remodeling, impaired cardiac function, and heart failure.At present there is no effective method to prevent or reverse the development of radiation-induced myocardial fibrosis.Many cells, cytokines, and other factors are involved in the development and progression of myocardial fibrosis in RIHD and some of them have been validated.But most investigators focused on the pathological changes and related mechanisms in early stage, and myocardial fibrosis was just regarded as an endpoint event.The definitive mechanisms of myocardial fibrosis in late stage remain unclear.This paper reveiws the studies about general mechanisms of myocardial fibrosis in RIHD and summarizes the roles of microcirculation dysfunction, mast cells, several cytokines, hypoxia, oxidative stress, and renin-angiotensin system, and points out the future research direction of the pathogenesis of myocardial fibrosis in RIHD.It provides new ideas for discovering the potential targets for clinical intervention of myocardial fibrosis in RIHD.

Acetylcholine ; metabolism ; Acetylcholinesterase ; metabolism ; Animals ; Brain ; enzymology ; metabolism ; Female ; Hypoxia, Brain ; physiopathology ; Ischemic Preconditioning ; methods ; Male ; Memory ; physiology ; Mice ; Random Allocation ; Reperfusion Injury ; prevention & control

An effective method has been developed for laboratory scale production of IgG. Hybridomas were cultured in serum-free media with 2% IgG-free ascites. Cell density of up to 3.55 × 10 6cells/ml and antibody concentration of 135μ g/ml after purification were abtained, which is four time more than total production of that of IgG concentration in serum-free media. This in vitro method allows great improvement in antibodies production in batch tissue culture. The method reported here is easy to handle and is economical and universally adaptable.