Objective To investigate the value of fast track surgery (FTS) principles in the perioperative management of liver cancer patients after hepatectomy.Methods Forty patients with primary liver cancer who were admitted to the First People's Hospital of Qinzhou from September 2011 to July 2013 were enrolled in this prospective study.All the patients were randomly divided into the FTS group (20 patients) and the control group (20 patients) according to the random number table.The perioperative management of patients in the FTS group was guided by the FTS principles,patients in the control group were managed with traditional methods.The intraoperative condition,time for portal occlusion,operation time,volume of intraoperative blood loss and blood transfusion,time to drainage tube removal,time to flatus and defecation,duration of postoperative hospital stay,expenses,changes of C-reactive protein on postoperative day 1,3,6,recovery of hepatic function and incidence of postoperative complications.All patients were followed up via phone call and out-patient examination till September 2013.All data were analyzed using the t test or chi-square test.The non-normal distribution paramenters were analyzed using the rank sum test.Results All patients were cured with no perioperative death.The time for postoperative drainage tube removal,time to flatus and defecation,duration of postoperative hospital stay and expenses were (2.3 ± 1.0)days,(2.5 ±0.5)days,(3.1 ±0.7)days,(7.0 ±0.8)days and (3.6 ±0.3) × 104 yuan in the FTS group,and (4.6 ± 0.7) days,(4.3 ± 0.7) days,(4.8 ± 0.4) days,(8.5 ± 0.9) days and (4.1 ± 0.3) ×104 yuan,with significant differences between the 2 groups (t =0.74,0.34,1.70,0.23,0.57,P ＜ 0.05).The levels of C-reactive proteins at postoperative day 1,3,6 were (56 ±7)mg/L,(122 ±7)mg/L and (35 ±7)mg/L in the FTS group,and (198 ± 24) mg/L,(137 ± 5) mg/L and (49 ± 8) mg/L,with significant differences between the 2 groups (F =64.91,P ＜0.05).The levels of prealbumin at postoperative day 1,3,6 were (196 ± 14) mg/L,(243 ± 17) mg/L,(260 ± 10) mg/L in the FTS group,and (198 ± 24) mg/L,(199 ± 16) mg/L and (245 ± 7) mg/L in the control group,with significant differences between the 2 groups (F =22.69,P ＜ 0.05).The levels of alanine transaminase at postoperative day 1,3,6 were (379 ±34)U/L,(166 ± 12)U/L,(49 ± 14)U/L in the FTS group,and (367 ±75)U/L,(210 ±28)U/L,(197 ±22)U/L in the control group,with significant differences between the 2 groups (F =4.51,P ＜ 0.05).One patient was complicated with peritoneal effusion and 1 with thoracic effusion in the FTS group; 4 patients was complicated with peritoneal effusion,3 with thoracic effusion,4 with pulmonary infection and 2 with incisional infection in the control group,with no significant difference in the complication between the 2 groups (x2 =0.78,1.11,4.44,2.11,P ＞ 0.05).All the patients were followed up for 2-24 months,no patients received reoperation or re-admitted to the hospital due to complications.Conclusion The application of FTS principle in the perioperative management of liver cancer patients after hepatectomy is safe and effective,it could alleviate the post-operative stress reaction and accelerate the recovery of liver function and patients' condition.

Objective To investigate the relationships between the severity of non-alcoholic fatty liver disease (NAFLD) and metabolic syndrome (MS).Methods One hundred and twenty-seven cases of NAFLD patients were selected from March 2011 to August 2012 in the First Hospital Affiliated to Fujian Medical University,of them,61 patients with mild NAFLD,45 patients with moderate and 21 patients with severe.And 21 cases without NAFLD were selected as control group during the same hospitalized period.All objects received the measures of height,body weight,waist circumference (WC),blood pressure; Liver ultrasonic examination,the examination of fasting plasma glucose,blood fat and hepatic function detections were also handed by special people.Results The proportion of overweight in the control group and the three NAFLD subgroups were 57.1％ (12/21),88.5％ (54/61),95.6％ (43/45) and 100％ (21/21) respectively (x2 =18.376,P ＜0.001) ;The proportion of the obesity in control group and the three NAFLD subgroups were 19.0％ (4/21),44.3％ (27/61),64.4％ (29/45) and 71.4％ (15/21) respectively(x2 =16.440,P =0.001).The proportion of the metabolic syndrome of the control group and the three NAFLD subgroups were 14.3％ (3/21),45.9％(28/61),71.1％ (32/45) and 71.4％ (15/21) respectively (x2 =22.637,P ＜ 0.05).All three subgroups of NAFLD were higher than the control group (x2 =6.641,P ＜ 0.05 ; x2 =18.562,P ＜ 0.05 ; x2 =14.000,P ＜0.05,respectively).The severity of NAFLD was positively correlated with BMI,WC,TG,FBG,SBP,and DBP (r =0.467,0.503,0.386,0.369,0.279,0.295,P ＜ 0.01),and negatively correlated with HDL-C (r =-0.209,P ＜0.05).Conclusion The severity of NAFLD had significant correlations with metabolic syndrome's components.

Objective:To evaluate the biocompatibility of Ti-75 alloy(TA) as a substrate of composite implant (CI) and the role of the shear strength of TA-coating in the CI-bone interface. Methods:A transcortical implant model was used. A total of 32 implants of CI and TA were implanted into bilateral femur of 4 adult mongrel dogs. the animals were killed 3 and 6 months after surgery. The implant-bone interfaces were observed by morphological examination and the interface shear strength was measured by push-out test. After push-out test, the failure interfaces were observed by SEM. Results:Osseo-integration was confirmed in the both interfaces of CI and TA with bone. The interface strength(MPa) of CI in 3 and 6 month was 7. 84? 0.99 and 12. 76? 1. 45, that of TA 3. 71? 1. 10 and 6. 33? 0. 89 respectively (P

The study aims to investigate the effect of the ratio of long axis to short axis (RLS) of upright polypropylene infusion bag on discharging process and to search the best RLS. Aiming at five different RLS (1. 5 : 1, 2 : 1, 3 : 1, 4 : 1 and 5 : 1, respectively) with the volume of 100 mL, 250 mL and 500 mL, respectively, based on finite element method, analyzing the variation of stress distribution, emptying rate, drugging space and steadiness coefficient, etc. For the bags of the same volume, emptying rate increased with increasing of RLS, but the steadiness coefficient decreased with increasing of RLS. The specific increasing amplitude of emptying rate and decreasing range of steadiness coefficient were as follows: 20% and 49% for 100 mL infusion bag, 9% and 51% for 250 mL infusion bag, and 11% and 46% for 500 mL infusion bag, respectibvely, when RLS increased from 1. 5 : 1 to 5 : 1. Comparatively speaking, the increasing amplitude of the emptying rate is remarkably less than the decreasing range of the steadiness coefficient. By comprehensive consideration of both emptying rate and steadiness coefficient, lower RLS is recommended for upright polypropylene infusion bag.
Drug Delivery Systems ; instrumentation ; Finite Element Analysis ; Polypropylenes

Objective To explore the role of chromokinesin KIF4A in gastric cancer cell invasion using gastric cancer cells SGC-7901 and chromokinesin KIF4A deficient gastric cancer cells (SGC-shKIF4A).Methods Expression levels of KIF4A in controlling gastric cancer cells (SGC-shNC) and SGC-shKIF4A cells were determined by Western Blot.Invasion of gastric cancer cells were assessed using Transwell invasion assay and the number of cells passing through the matrigel was counted.Changing numbers of cortactin in SGC-7901,SGC-shNC,and SGC-shKIF4A cells were analyzed by immunofluorescence staining.Results Compared to the SGC-shNC cells,invasion ability of SGC-shKIF4A cells was increased.Compared to other cells,the numbers of cortactin in SGC-shKlF4A cells was also increased suggesting invadopodia in these cells was increased(P＜0.01).Conclusions Chromokinesin KIF4A acts as a tumor suppressor by inhibiting gastric cancer cells invasion and the results provides strong evidences for KIF4A serving as one of potent targets for gastric cancer prognostics and treatment in clinic.

0\^05). Conclusion MMP\|2 and MMP\|9 may serve as indicators of invasion and malignant phenotype.Neither of them can represent the phenotype of metastasis,but both can represent that of matrix degradation.Moreover,MMP\|9 may play more important role in glioma invasion than does MMP\|2.

Objective:To analyze the clinical and physical tactors associated with acute bone marrow suppression in concurrent chemo-radiotherapy for rectal cancer and to provide a reference standard for the best clinical treatment plan. Methods:Retrospective analy-sis was performed on 62 patients with rectal cancer who received concurrent radiotherapy and chemotherapy in our department. The pelvis was contoured for each patient in the radiotherapy treatment planning system and divided into three subsites: lumbosacral spine, ilium, and lower pelvis. Prognostic clinical and physical factors were analyzed by univariate and multivariate analyses. Evaluated prognostic clinical factors included sex, age, clinical stage, original hemoglobin levels, and chemotherapy, operation, and radiation modes;physical factors included V5, V10, V15, V20, V25, V30, V35, V40, V45, V50, Dmax, and Dmean of lumbosacral spine, ilium, low-er pelvis, and pelvis. Results:The percentage of patients who developed acute bone marrow suppression (≥2 grade) was 61.3%(38/62).Univariate analysis of related factors revealed statistically significant differences were sex, chemotherapy, lumbosacral spine V45, il-ium V20, and ilium V30. Multivariate logistic regression analysis indicated that chemotherapy and ilium V30 are the risk factors for acute bone marrow suppression. The receiver operating curve showed that the threshold of ilium V30 was 44%. Conclusion:Acute bone marrow suppression is influenced by more than one factor;local control rate of the tumor and acute bone marrow suppression are tradeoffs in rectal cancer treatment. An appropriate chemotherapy method should be selected, and ilium V30 must be maintained below 44%to prevent bone marrow suppression in rectal cancer patients.

Objective To explore the relationship between immunohistochemistry of LN,FN,p53 and TIMES in human brain glioma(BG). Methods Transmission electronic microscope(TEM) and immunohistochemistry were used to investigate the morphological characteristics of micrangiums in BG and the expression of LN,FN,p53 in BG and intracranial metastatic tumors. Results 1.It was found that base laminas beneath endothelial cell with locally or extensively thickened were intact and continuous in BG.The increasing thickness of BM was consistent with the staining of LN and FN and related to p53 immunostaining.BM of p53-protein positive cases grew thicker than that of p53-protein negative ones.2.Micrangiums BM in all BG were positive for LN and FN.The more malignant the BG was,the stronger the LN and FN staining became and the thicker the blood vessel walls grew(P0.05).Conclusion One of the reasons that BMs in TIMES in BG thicken may be the over expression of LN and FN of brain micrangium endothelial cells.Also,the influence of p53 on TIMES is associated with the functional state of endothelial cells.Micrangiums endothelial cells may be play a role in regulating TIMES.

OBJECTIVE To summarize the clinical experience of endoscopic thyroidectomy via suprasternal approach. METHODS Endoscopic thyroidectomy via suprasternal approach was performed in 35 patients with ultrasonic scalpel. RESULTS Operations were successfully performed in 35 patients. The mean operation times were 130 (105～190) minutes in 24 cases with subtotal lobectomy and 4 case with total lobectomy, 60 (50~70) minutes in 2 cases with isthmectomy, 228 (185～270) minutes in 2 case with bilateral subtotal lobectomy, 163 (140～215) minutes in 3 case with subtotal lobectomy and the contralateral ademona resection. The bleeding during operation was 5 to 40ml and the average hospital stay time was 4 (3～5) days. CONCLUSION Endoscopic thyroidectomy via suprasternal approach is a safe way with good cosmetic value.

The most common complication in patients with end-stage liver disease is mal-nutrition, which is caused by the metabolic disorders of sugar, protein and fat for the metabolic dys-function of liver during the perioperative period of liver transplantation. Nutritional support is very important during the liver transplantation.Perioperative nutritional support can improve the nutri-tional status of patients, increase the chance of liver transplantation, reduce postoperative mortality and improve outcome. By reviewing the recent interventions of perioperative nutrition support for liver transplantation, and analyzing nutritional screening and nutritional assessment tools and their advantages and disadvantages, the authors emphasize the rational assessment of early nutrition, provide reasonable and personalized parenteral and enteral nutrition support, especially for energy, protein and other nutrients. We also emphasize the importance of long-term reasonable nutrition support, monitoring and diet nutrition education in order to provide reference and suggestion for improving the nutritional status of liver transplantation patients and to provide evidence-based basis for constructing standardized perioperative nutrition support program of liver transplantation.