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 discuss the less invasive stabilization system(LISS)in treatment of fractures around the knee joint.Methods Between February 2002 and December 2005,103 cases of periarticular fractures of knee joint were treated with LISS in our department.There were 58 cases of comminuted distal femoral fracture and 45 cases of comminuted proximal tibia fracture.Follow-ups were conducted once per week during the first four weeks and once per month in the following months to observe whether such complications as loosening of internal fixators and nail breakage would occur.Results All the cases were followed up for a mean time of 16.5 months(range, 6 to 27 months).Loosening and breakage of internal fixation was found in only one case,while others obtained bony union.In fractures of types A and C,the knee range of motion varied from 95?to 145?(average,130?)and 85?to 140?(average,110?)in flexion respectively.HSS score:excellent in 84 cases(81.6%),good in 15 cases (14.6%),fair in three cases(2.9%),and poor in one case(0.9%).Conclusions The LISS can be the best choice for the treatment of periarticular fractures around the knee joint,but we should take care to implant the plate and screws in a proper position and direction and avoid early weight-bearing.In application of the 13-hole plate, large incision should be made to approach the distal tibia for fear of damaging the superficial peroneal nerve.

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 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 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.

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.

Our university actively carried out the reform and innovation of the training mode of clinical medicine postgraduates . We implemented the standardized training of resident physicians throughout postgraduate training process , and carried out the comprehensive reform of the training mode of cultivating master degree students of clinical medicine and the standard training of resident doctors. Meanwhile, we trained the master degree students with the synergy of medical education and strengthened the cultivation of students' clinical practice ability, to cultivate qualified doctors for the country, and to improve the quality of postgraduate training.

Objective:To explore the participation ways of clinical pharmacists in clinical drug treatment to improve the rationality of drug use through the involvement in the drug treatment of patients with liver injury induced by hepatitis B virus reactivation caused by chemotherapy .Methods:Clinical pharmacists provided advice on drug use in accordance with evidence -based medicine , developed in-dividualized treatment program with clinicians and promoted clinical rational drug use .Results:Clinical pharmacist gave advice to cli-nicians based on the causes of liver function damage , hepatoprotective and anti HBV drug selection and evidence-based medicine , and the liver function of the patient was recovered rapidly .Conclusion:Clinical pharmacists can provide pharmaceutical service , partici-pate in individualized treatment of cancer patients , avoid delay of effective drug treatment , and effectively improve drug treatment level and medical quality .

Objective To explore the value of biomechanics parameter of rabbit abdominal aortic atheroma using velocity vector imaging(VVI).Methods Ten of 45 male New Zealand rabbits were chosen as normal control group randomly,the rest experimental rabbits were made atheromatous plaque model.The rabbits were examined by two-dimensional ultrasound and VVI respectively.The intima-media thickness(IMT) or thickness of plaques of abdominal aorta 1 cm from right renal artery branch were recorded.Maximum tangential velocity,strain and strain rate of IMT or plaques were measured using VVI.Then the rabbits were killed for pathological and immuno-histochemical examination.Results Based on pathology,the rabbites were divided into 4 groups:control group(group A,n=10),group of pathological endometrial thickening(group B,n=9),group of thick fibrous cap atheromatous plaques (group C,n=15) and group of thin fibrous cap atheromatous plaques (group D,n=11).The difference of plaques thickness and biochemical indicators had no statistically significant between group B and C(P>0.05),both bigger than group A and B (P<0.05).The difference of Vmax,Smax and SRmax had statistically significant each group(P<0.05).With Vmax>0.46×10-2 cm/s,Smax>0.37%,SRmax>1.415×10-2 s-1 to find the vulnerable plaques,the sensitivity were 75.0%,84.4%,84.4% respectively,specificity were 70.8%,91.7%,83.3% respectively.Conclusions VVI can identify plaque biomechanics parameter of different progression periods,which is expected to be a reliable method to find vulnerable plaques earlier in clinic.

Objective To compare the results of three dose verification solutions of esophageal carcinoma IMRT plans. Methods Seven esophageal carcinoma cases were planned with Pinnacle 8.0 h.The MATRIXX and Delta4 were chosen as the two-dimensional dosimetry and three-dimensional dosimetry.IMRT plans and Delta4 phantom plans were also recalculated by Monte Carlo. Gamma values were evaluated for MATRIXX and Delta4 with 3 mm/3% gamma criteria. For the comparison of Pinnacle, Delta4 and Monte gamma maps, the dose distribution in central plane, dose profiles and dose-volume histograms were used to evaluate the agreement. Results The gamma maps comparison show that with 3 mm/3% gamma criteria an over 98% pass ratio was obtained by MATRIXX measurement. A 94. 4% gamma pass ratio whicl.contains 4 fields gamma pass ratio lower than 90%, was obtained by Delta4 measurement. A 97.6% and 99. 8% gamma pass ratio was obtained between the Delta4 measurement and Monte Carlo simulation with 2 mm/2% and 3 mm/3% gamma criteria. The dose distribution in central plane and dose profiles from Pinnacle calculation were almost in agreement with both the Monte Carlo simulation and Delta4 measurement. The DVH plot have slightly differences between Pinnacle and Delta4 measurement as well as Pinnacle and Monte Carlo simulation, but have excellent agreement between Delta4 measurement and Monte Carlo simulation. Conclusions It was shown that all the three methods can be used very efficiently to verify esophageal carcinoma IMRT delivery, Delta4 and Monte Carlo simulation no data missed. The primary advantage of Delta4 is the fact it can measure true 3D dosimetry while Monte Carlo can simulate in patients CT images but not in phantom.