Objective:To investigate the effect of fresh food homogenate instead of traditional liquid and semiliquid diet on the condition of nutrition and aspiration in the early stage of pulling out the na-sogastric tube in patients with moderate dysphagia.Methods:Forty patients with tube feeding were randomly divided into observation group and control group.Each group had 20 cases.After extubation,the observation group ate fresh food homogenate,and the control group were feeding liquid and semi liquid diet.The actual calories intake,protein,carbohydrate,lipid and dietary fiber were recorded on the first day and the fifteenth day of intervention.The values of serum albumin,prealbumin,hemoglobin and total lymphocyte count were measured.The rate of aspiration and constipation was observed continuously during the study.Results:After 2 weeks of intervention,the daily energy and nutrient intake,nutritional biochemical indexes of observation group were higher than those of control group (P ＜ 0.05),and the incidence of aspiration and constipation was decreased in observation group (P ＜ 0.05).Conclusion:Compared with the conventional liquid and semi liquid diet,fresh food homogenate can increase the intake of daily calorie and nutrition in patients with moderate dysphagia in the early stage after the feeding tube was pulled out,improve nutritional status,reduce the aspiration and constipation,and be well tolerated.

Objective To explore the characteristics of chest multi-slice spiral CT and dynamic changes in adult patients with se-vere adenovirus pneumonia.Methods Clinical and CT data of 6 patients with severe pneumonia in an epidemic of the respiratory ade-novirus infection were retrospectively analyzed.The impact of hormone therapy was also studied.Results The first chest CT exami-nations in 6 patients were performed 2.22 ± 0.75 days after fever.CT showed segmental consolidation with ground-glass opacity (GGO)in one case,patchy consolidation with GGO in 3 cases,patchy interstitial changes in one case and small nodules in one case. The duration reaching the standards of severe pneumonia was 6.1 7 ± 0.37 days from the onset.During severe phase chest CT showed a range of lobar consolidation in one case,lobar in 2 cases,segmental in 2 cases or patchy in one case,consolidation with GGO in 5 cases.In all cases the lesions were commonly seen in the lower lobes of bilateral lungs.Multiple lobes were involved in 2 cases.After methylprednisolone treatment,no new lesion was showed but the early lesion was enlarged.During the first 2 to 4 days GGO absorbed completely in 6 cases,consolidation absorbed completely in one case and mostly in 5 cases.Conclusion Chest CT findings of severe adenovirus pneumonia in adult are single or multiple lobar or segmental consolidations with or without GGO which distribute mainly at lower lobes.

ObjectiveTo evaluate the influence of ginkgo dipyridolum injection on blood-rheological and coagulation function in pationts with AECOPD.Methods78 cases of patients with AECOPD were divided into group A (38 cases)and group B (40 cases)by mean of digital random table method.The routine treatment including oxygen inhalation,spasmolytics and anti-infection was given to patients in both groups while ginkgo dipyridolum injection (30 ml/d)was additionally added to patients in group B for two weeks.The blood-rheological and coagulation function were evaluated.ResultsAs for blood-rheological after the treatment,whole blood high shearing viscosity(5.25 ± 1.24)mPa · S,low shearing viscosity (11.12 ±2.43) mPa · S,plasma viscosity (2.06± 0.14 ) mPa · S and hematocrit (45.52 ± 2.78) ％ in the group A indicated significant differences compared to those in group B [ (4.83 ± 1.42)mPa· S,(8.78± 3.02) mPa · S,(1.73 ±0.21) mPa · S,(39.05 ± 3.41) ％],(P＜0.05); as for coagulation function after the treatment,PT (13.14± 1.31 ) S,APTT (30.85±5.24)S,FIB (4.99±1.04)S,D-D (1.42±0.23)mg/L in the group A indicated significant differences compared to those in group B [ (14.78 ± 3.13) S,(36.67 ± 8.12)S,(3.81 ± 0.42) S,(0.84 ±0.39) mg/L],(P＜0.05).ConclusionFor the patients with AECOPD,the ginkgo dipyridolum injection can decrease hood-viscosity,and obviously improve hypercoagulabale state.

Objective To evaluate the clinical effects and immune function of shenqi 11 flavor capsule as an adjuvant treatment in advanced NSCLC patients during chemotherapy.Methods 58 cases of advanced NSCLC were divided into two groups by mean of digital random table method,with 29 patients in each group.GP scheme chemotherapy was applied to patients in group B,using gemcitabine (1000 mg/m2) on the 1st and 8th day intravenously (procedure should be finished within 30 minutes) and cisplatin (75 mg/m2) on the 1st day intravenously.Each cycle was 3 weeks,two cycles in total.Same scheme was applied to patients in group A and with an addition of shenqi 11 flavor capsule(1.65 g/time,3 times/d) throughout the whole procedure of chemothrapy.Recent curative effect,life quality,toxic reactions and changes in immune indexes of both groups were observed.Results Short-term response rate in group A was 48.27％ and 41.38％ in the group B (x2=0.279,P＞0.05),which showed no significant differences between the two groups.Toxic reactions such as leukopenia,hematochrome decrease and gastrointestinal reactions in the group B were significantly severe compared to group A after chemotherapy(x2 were 4.678,4.549 and 4.687 respectively,P＜0.05).As for immune indexes after chemotherapy,CD3+ (55.21 ± 3.28) ％,CD4+ (38.84±5.13) ％,CD8+ (29.86±4.83) ％,CD4+/CD8+( 1.29± 0.17) and NK cells (20.12± 2.11 ) ％in the group B indicated significant differences compared to those in group A[(62.96±4.12)％、(45.21±3.43)％、(25.23±2.79)％、(1.82±0.21)、(25.78±3.36)％],(P＜0.05).The life quality was 58.62％ in group A and 31.03％ in the group B,which showed significant difference (x2=4.462,P＜0.05).Conclusion Shenqi 11 flavor capsule as an adjuvant treatment in advanced NSCLC patients during chemotherapy can not only improve life quality of patients,alleviate the symptoms,but also enhance their immune function.

AIM: To evaluate whether tolerogenic dendritic cells (DC) loaded with heat shock protein 60 (HSP60) inhibit the progression of aortic atherosclerotic plaque in hypercholesterolemic apolipoprotein E (Apo-E) -null mice. METHODS: Bone marrow derived DC of the mice were loaded with HSP60 and co-cultured with rapamycin to generate tolerogenic DC. The tolerogenic DC, DC loaded only HSP60 and PBS were injected into the ApoE-null mice at 8 weeks of age for three times at a one-week interval. 8 weeks after the last injection, aorta were harvested for HE staining and anti-CD4~+T cell immunostaining. Responses of pleenic cells to HSP60 were also evaluated. RESULTS: Compared with DC, DC_ HSP60 expressed higher levels of CD86, and stimulated T lymphocytes to proliferation significantly, while the tolerogenic DC expressed lower levels of CD86, and inhibited T lymphocytes to proliferation. After immunization with different injection, the numbers of CD4~+ T cells in plaque were increased significantly in DC_ HSP60 group vs in PBS group (P

Objective:Cholangiocarcinoma (CCA) is a malignant tumor derived from bile duct epithelial cells with extremely poor prognosis. The Hippo-Yes-associated protein (YAP)/transcription activator with PDZ binding motif (TAZ) signaling plays a critical role in cancer stem cell biology. Previous studies have shown that the positive expression of YAP/TAZ in CCA predicts larger tumor size and unfavorable clinical outcomes. We aim to evaluate the prognostic value of YAP/TAZ detection in CCA patients.Methods:CCA patients who underwent radical resection were retrospectively analyzed at our institution from January 2011 to June 2016. Postoperative pathological specimens were scored by YAP/TAZ immunohistochemical staining. The prognostic value of YAP/TAZ was analyzed by multivariate Cox-proportional hazards model.Results:A total of 91 CCA patients were enrolled. During a median follow-up time of 11.0 months, 69.2% patients relapsed and 45.1% died. The median OS and DFS were 10.7 months and 8.8 months respectively. The YAP/TAZ dual positive patients owned a worse TNM stage ( P=0.015), poorer tissue differentiation ( P=0.007), and a higher CA199 than those in negative patients. Multivariate Cox analysis identified that YAP/TAZ dual positivity as a significant factor predicted poorer OS ( P=0.010) and DFS ( P=0.028) in CCA patients after radical resection. In subgroup analysis, YAP/TAZ combination also significantly predicted OS ( P=0.044) and DFS ( P=0.043) in CCA patients with positive lymphatic metastasis and/or surgical margin who required adjuvant therapy. Conclusions:YAP/TAZ positivity is an independent predictive factor for survival in CCA patients after radical resectiony.