Objective: Enteral nutrition was used to correct the malnutrition in the patients suffered from esophageal rupture postoperatively. Methods: The naso intestinal tube was placed during operation and the enteral nutrition was used postoperatively. The albumin, prealbumin and transferrin were measured before and day1, 5, 8 and 12 after operation. Results: All 27 patients were discharged with no death. Albumin, prealbumin and transferrin decreased on the 1st day postoperatively and reached the preoperative level on the fifth postoperativeday. Conclusion: Enteral nutrition plays an important role in the postoperative treatment for esophageal rupture.

Objective:To explore the variation of tumor cell proteins correlated with cell proliferation and chemo-resis-tance after repeated treatment with chemotherapy drugs.Methods:The human lung cancer cell line(LPET-a-2)was repeat-edly treated with chemotherapy drugs:doxorubicin,etoposide,cisplatin and the combination of the3drugs,and each drug was given at2concentrations.The treatment intervals were recorded.ErbB-2,c-myc,MDR1,MRP,LRP,ref-1and NF-?B were tested by flow cytometry.The cells expressing each protein,the mean and total quantity of each protein after each treat-ment were calculated by different drugs at different concentrations.Results:The levels of every protein decreased along with the time of culture.In high-dose group,every item decreased along with the time of treatment.In low-dose group,there was no rule for the item variation with some decreased and some increased.Conclusion:Low-dose anticancer drugs are easier to induce cell proliferation and chemo-resistance than high-dose one,which suggests that adequate chemotherapy should be given in clinical practice.

Objective To explore the effect of tumor necrosis factor (TNF)-α inhibitors therapy on bone mineral density (BMD) in active rheumatoid arthritis (RA) patients with low bone mass.Methods Sixtytwo active RA patients with low bone mass were treated with a standard treatment of calcium carbonate 0.5 g/d and alfacalcidol 0.25 μg/d,and were divided into two groups.Patients of the control group were treated with methotrexate 10 mg per week,while patients of the experimental group were treated with combined recombinant human type Ⅱ tumor necrosis factor receptor-antibody fusion protein 50 mg per week or adalimumab 40 mg/2 week subcutaneously for 12 months with methotrexate.BMD of lumbar spine (L2-4),femoral neck,trochanter and Ward's triangle region by dual energy X-ray absorptiometry (DEXA),as well as the bone turnover markers serum C telopeptide of type-Ⅰ collagen (CTX-Ⅰ) and serum procollagen type-Ⅰ N propeptide (PINP) were measured by enzyme-linkedimmunosorbent assay (ELISA) in both groups at the baseline,treatment for six-month and twelve-month.T test and Chi-square test was used to process the data.Results ① After 6 months of treatment,the BMD of lumbar spine,femoral neck and trochanter in the group with TNF-α inhibitors were higher than the control group [(0.68±0.08) g/cm2 vs (0.65±0.06) g/cm2,t=2.269,P=0.027; (0.63±0.08) g/cm2 vs (0.58±0.09) g/cm2,t=2.111,P=0.040; (0.61±0.10) g/cm2 vs (0.56±0.07) g/cm2,t=2.203,P=0.032; respectively].And after 12 months,the BMD of all regions were significantly higher thanthe control group [spine,(0.68±0.07) g/cm2 vs (0.62±0.08) g/cm2,t=5.115,P=0.000; femoral neck,(0.63±0.08)g/cm2 vs (0.56±0.08) g/cm2,t=3.475,P=0.001; Ward's triangle region (0.60±0.08) g/cm2 vs (0.56±0.08) g/cm2,t=2.309,P=0.025; trochanter,(0.61±0.10) g/cm2 vs (0.53±0.08) g/cm2,t=3.254,P=0.002; respectively].② Compared to the baseline,BMD of lumbar spine was significantly decreased in the control group after 12 months.While in the group of TNF-α inhibitors,BMD of lumbar spine was increased[(0.66±0.08) g/cm2 vs (0.68±0.07)g/cm2,t=3.411,P=0.001].③ Compared to the baseline,CTX-Ⅰ,a marker of bone resorption was significantly decreased at 6 months and 12 months in the group with TNF-αinhibitors [6 months,(0.33±0.2) ng/ml vs (0.46±0.22) ng/ml,t=5.548,P＜0.01; 12 months,(0.31±0.21) ng/ml vs (0.46±0.22) ng/ml,t=5.974,P＜0.01],while this decline was not found in the control group.PINP,a marker of bone formation was stable in both 2 groups during the study.Conclusion In active RA patients with low bone mass,loss of BMD in the spine and hip can be arrested by the treatmentof TNF-α inhibitors.

The system of meridians and acupoints in the traditional Chinese medication (TCM) builds up a complex network. We analyze the features and properties of the system of meridians and acupoints as a complex network based on knowledge of TCM and mathematics. The system shows some important features of complex networks such as the small-world effect and the scale-free property. A preliminary discussion on the robustness of the meridian system as a complex network, and the biomedical functions of such robustness is also given.

Objective To establish the reference intervals of total cholesterol (TC),triglyceride (TG),high density lipoprotein (HDL-C)and low density lipoprotein (LDL-C)in the healthy population in Hengshui region.Methods 16 403 healthy individuals were collected from the various counties and cities in this region and detected the above 4 blood lipid indexes (TC,TG,HDL-C, LDL-C)by adopting the automatic biochemical analyzer.The subjects were grouped according to different genders and ages and the detection results were performed the statistical analysis.Results TC 3.17-7.20 mmol/L;TG 0.08-3.16 mmol/L;HDL-C 0.94-2.30 mmol/L;LDL-C 1 .14 -4.59 mmol/L.Conclusion The differences of blood lipid detection results exist in males and fe-males in Hengshui region,the results are different among different age groups,it is suggested that different genders and different age groups should establish their own normal reference intervals in order to provide the diagnostic basis for clinic.

Objective To investigate the distribution of Helicobacter pylori (Hp) infections among general population in Tianjin. Methods Individuals (n=11 096) who visited our hospital for medical examination and H. Pylori infection screen were included in the research objects. Rapid urease method was utilized to rapidly detect H. pylori infection among the popultion. Individuals were grouped based on their gender, age and occupations, and then were analyzed. Results H. pylori-positive rate was 30.52%(3 386/11 096) in 11 096 individuals, in which there were 34.77%(1 784/5 131) male and 26.86%(1 602/5 965) female respectively. Individuals were divided into 5 groups according to their ages:19 to 29 years old group, 30 to 39 years old group, 40 to 49 years old group, 50 to 59 years old group, 60 to 69 years old group and 70 to 92 years old group. The positive rates of H. pylori increased with age:19.50%( 379/1 944 ) in 19-29 years old group, 25.82%(650/2 517 ) in 30-39 years old group, 31.59%( 908/2 874 ) in 40-49 years old group, 37.48%(915/2 441 ) in 50-59 years old group, 41.09%( 353/859 ) in 60-69 years old group and 39.18%(181/462) in 70-92 years old group. The differences in positive rates between different age groups were all of statistically significant (P<0.05). Individuals were also divided into seven groups according to their occupations: medical worker group, worker group, teacher group, engineer group, clerk group, civil worker group and other career group. The positive rates of H. pylori infection were 25.42%(586/2 305), 29.35%(1 062/3 618), 30.61%(360/1 176), 32.49%(116/357), 33.44%(205/613), 34.52%(455/1 318)and 35.23%(602/1 709) respectively. The positive rate was 25.42% (586/2 305) medical workers, which was lower than that of other occupation groups with significant difference (P<0.002). Conclusion Good management of H. pylori diagnosis and treatment in mid-dle age and elderly together with popularizing knowledge of H.pylori prevention can effectively reduce H.pylori incidence.

Objective To investigate the effect of minocycline on isoflurane-induced hippocampal neuroapoptosis and cognitive dysfunction in aged rats. Methods Forty-five male SD rats were randomly assigned into 3 groups ( n=15): blank control group ( group C) , 1.5% isoflurane group ( group I) and 50 mg??kg-1 minocycline+1.5% isoflurane group ( group M+I) . Minocycline was injected intraperitoneally 12 h before the start of anesthesia for group M+I.Group I and group M+I were exposed to 1.5% isoflurane for 4 h, while group C were exposed to 30% O2-70% N2.At the end of anesthesia, five rats in each group were randomized to analyse arterial blood gas. The other rats in each group were sent back to their home cage until they were fully awake.Fourteen days after anesthesia, Morris water maze was used to assess the cognitive function, and then hippocampi of rats were dissected for detection of the expression of cleaved caspase3, Bax and Bcl-2. Results No difference was found in arterial gas analysis among the 3 groups (P>0.05).Compared with group C, the rats in the group I spent more time locating the platform on the third and fourth training days and the time percentage that the rats in group I spent in the target quadrant was much less (P<0.05).However, these changes were reversed in group M+I (P<0.05).The isoflurane-induced increased level of Bax and cleaved caspase3 and decline of anti-apoptotic factor Bcl-2 were restored by minocycline pretreatment ( P<0.05) . Conclusion Minocycline could attenuate cognitive dysfunction induced by isofluranein aged rats.The mechanism is associated with inhibition of hippocampal neuroapoptosis which is increased by isoflurane.

Objective To investigate the clinical efficacy of laparoscopic hepatectomy.Methods The clinical data of 258 patients who received laparoscopic hepatectomy at the First Affiliated Hospital of Fujian Medical University from March 2010 to January 2013 were retrospectively analyzed.There were 196 patients with primary hepatic cancer,45 with hepatic hemangioma,13 with hepatic focal nodular hyperplasia,2 with hepatic metastatic cancer,1 with carcinoma of gallbladder and 1 with hepatic hamartoma.All patients were followed up via phone call or out-patient examination till March 2013.Results A total of 142 patients received single hepatic segmentectomy,98 received multiple hepatic segmentectomy,18 received multiple lesions resection.Fifty-one patients received hepatic tumorectomy + cholecystectomy.All the operations were successfully done under laparoscope without conversion to the open surgery.The mean tumor diameter and the operation time were (5 ± 3) cm (range,1.0-11.5 cm) and (113 ± 56) minutes (range,50-310 minutes),respectively.Intraoperative hepatic portal occlusion was performed on 122 patients,and the time for hepatic portal occlusion was (15 ± 7)minutes.The volume of intraoperative blood loss was (211 ± 195)mL (range,10-650 mL),and blood transfusion was not needed.The capsule of the tumor was complete.The distance between the resection margin and the malignant tumor was above 1.5 cm,and there was no residual tumor in the resection margin.The hepatic function was back to the normal level in 1 week after the operation,and no patient had hepatic failure.The duration of postoperative hospital stay was (7.2 ± 1.3)days (range,5-10 days).One patient was complicated with bile leakage,6 with slight peritoneal effusion,and other patients had no postoperative complications.The rate of follow-up was 91.47％ (236/258),and the time of follow-up was (16 ± 10) months.A total of 199 patients with malignant hepatic tumors were followed up.During the follow-up,180 patients had tumor-free survival; 18 patients had postoperative tumor recurrence; 1 patient had omental metastasis and received surgical resection.Thirty-seven patients with benign hepatic tumor survived without complication during the follow-up.Conclusion Laparoscopic hepatectomy is effective for the treatment of hepatic tumors.Multiple hepatic inflow occlusion under laparoscope in a short time may improve the safety of surgery,without prolonging the recovery time of patients.

Objective To establish the reference interval of serum urea nitrogen (BUN) ,creatinine(Cr) ,uric acid(UA) for the healthy adults of Hengshui City .Methods 16 403 cases of healthy adults of different areas in the city were enrolled in the study .By using automatic biochemical analyzer ,3 kidney function indicators(BUN ,Cr ,UA) were determined .According to different sex and age groups ,statistical analysis was performed .Results The reference intervals of 3 kidney function indicators for healthy people in Hengshui City were as follows ,BUN :2 .75-7 .05 mmol/L for male and 2 .24-6 .58 mmol/L for female;Cr:49 .69-87 .96 μmol/L for male and 35 .82-72 .22 μmol/L for female;UA :209 .51 -500 .06 μmol/L for male and 146 .25 -389 .69 μmol/L for female . Conclusion The reference intervals established could basically reflect the concentrations of 3 kidney function indicators for the healthy adults in Hengshui City ,which could provide a reference .

The reason for the construction of standard operation process(SOP) in equipment application and maintenance is expatiated.The content and how to construct the system are also discussed.Many problems in equipment application and management are solved.The efficiency of all kinds of equipment in the construction of mobile medical service corps are enhanced.