Objective:The purpose of this randomized, controlled, clinical study was to investigate the effects of soybean oil emulsion on inflammatory response and immune function after surgery for esophageal cancer. Methods: Patients who underwent esophagectomy were divided into two groups. Group A( n = 15) ,the control group,received fat - free parenteral nutrition(PN). Group B( n = 18)re-ceived PN with soybean oil emulsion. There was no signficant difference between the two groups in regard to clinical backgrounds or non - protein calorie. Results: In both groups, the serum levels of IL - 6 were significantly higher on the first and third postoperative days. IL-6 levels in group B,however, were significantly higher than in group A. The serum concentration of IL- 10 showed a trend similar to that of IL-6.Serum IL-6 showed a significant positive correlation with IL- 10 on the 3rd day after the operation. The ratio of IL-6 to IL - 10 increased after the operation in both groups, and significant differences were observed between the two groups. CD4+ /CD8+ and NK cell activity significantly decreased postoperatively. Also, between group A and B there were statistically significant differences in CD4+ /CL8+ . Suppression of cellular immunity correlated significantly with serum IL- 6,and was preceded by a rise in serum IL- 6. Conclusion : Perioperative PN with excessive levels of soybean oil emulsion after a severely stressful operation has been shown to increase the production of inflammatory cytokines and promote immunosuppression.

Objective:The purpose of the study was to investigate the effects of enteral nutrition on stress response and gut barrier function after surgery for esophageal cancer. Methods: Patients who underwent esophagectomy were divided into two groups. Group PN (28 patients) served as the control group. Group EN (26 patients) received enteral nutrition. Results: The serum total protein, albumin, prealbumin and transferrin decreased after operation, but there were no differences between the two groups. The serum levels of IL-6 were significantly higher on the first and third postoperative days after the operation in two groups (P

Objectives:The purpose of this study was to investigate the effects of soybean oil emulsion on stress response and immune function after surgery for esophageal cancer. Mehtods:Patients who underwent esophagectomy with thoracotomy were divided into two groups.Group A(15 patients) received fatfree parenteral nutrition(PN) as the control group.Group B(18 patients) were fed by PN with soybean oil emulsion.There was no significant difference between the two groups in regard to either clinical backgrounds,nutritional parameters, or proteins measured before and after the operation. Results:The serum levels of cortisol and IL6 were significantly higher on the first and third postoperative days(P

Objective To investigate the effects of enteral nutrition (EN) for diabetes mellitus on the clinical outcomes of critically ill patients with hyperglycemia.Methods Sixty-four critically il1 patients with hyperglycemia were randomly divided into the control group and intervention group.The control group was given homemade homogenized meals and the study group was given EN for diabetes mellitus.Both were given the same total energy and nitrogen content.EN was applied 3 days after ICU admission and then lasted 14 days.Blood glucose was controled at 6.1-8.5 mmol/L by insulin therapy.No albumin,blood plasma,or parenteral nutrition was provided to all patients.The lactulose mannitol ratio,biochemical indicators,total insulin dosage,and short-term and longterm outcomes were analyzed before and after EN support.The quality of life was evaluated using Stroke Specific Quality of Life Scale.Results Finally 59 patients were enrolled in the study,with 30 in the intervention group and 29 in the control group.The lactulose mannitol ratios in the intervenion group were significantly lower than those in the control group 7 days (0.221 ±0.117 vs.0.299 ±0.154,t =-2.199,P =0.032) and 14 days (0.169 ±0.122 vs.0.305 ±0.129,t =-4.191,P =0.000) after EN support.Meanwhile,the total insulin dosages were also significantly less in the intervention group [7 days,(195 ± 54) vs.(227 ± 60) U ; t =-2.096,P =0.041 ;14 days,(392 ±114) vs.(459 ±118) U; t =-2.221,P =0.030].Compared with the control group,the intervention group had significantly shorter duration of mechanical ventilation [(8.00 ± 1.75) d vs.(6.73 ±2.05) d,t=-2.547,P=0.014] and ICU stay[(10.00±1.95) vs.(8.80±2.17) d,t=-2.233,P=0.030],lower total hospitalization expenses [(56 238.39 ± 17 869.61) vs.(70 395.63 ±20 111.69) Yuan,t =-2.861,P =0.006],and faster recovery of daily activities [(17.59 ± 3.21) vs.(35.34 ± 8.65) scores,t =10.030,P =0.000] and living quality of life [(22.67 ± 4.51) vs.(40.55 ± 8.88) scores,t =9.397,P =0.000] after 90 days of treatment.Conclusion The EN for diabetes mellitus may improve the outcomes of critically ill patients with hyperglycemia compared with blend diet.

Objective: To study the pharmacodynamic effect of Reganling Oral Liquid(RGL) in treating wind heat epidemic syndrome. Methods: After RGL was administered ig to experiment animals, we observed its antifebrile effect by using pathologic hectic rabbit caused by typhoid bacterin and pathologic hectic rat caused by injection of 2,4 dinitro phenol, anti inflammation effect by weighing the tampon acestoma in rat, anti anaphylaxis effect by using delay anaphylactoid mice caused by injection of 2,4 dinitrochloro benzene. The Liquid Tube Observing Method was used to investigate the bacteriostatic activity of RGL on eight kinds of germina in vitro . Results: RGL could evidently inhibit the raising of animal heat caused by bacterin and chemical, and also could markedly restrain the weight of tampon acestoma in rat and delay anaphylactoid in mice. RGL also had remarkably bacteriostatic activity on eight kinds of germina in vitro which mainly caused wind heat epidemic syndrome. Conclusion: RGL had the evident effects of antifebrile, anti inflammation, anti anaphylaxis and bacteriostatic activity in vitro .

Purpose: Whether a dilated intrahepatic bile duct (IHBD) has any effect on the prognosis of choledochal cyst (CC) remains controversial. We aimed to summarize the clinical characteristics and prognosis of CC with IHBD dilatation. Methods: One hundred ninety-two children diagnosed with CC were identified, including 127 without IHBD dilatation (group A) and 65 with IHBD dilatation (group B). A retrospective analysis was performed to explore the clinical characteristics and prognosis of CC with IHBD dilatation based on clinical indices, symptoms, and complications. Results: Compared with group A, incidences of jaundice and fever were higher in group B (P = 0.010 and P = 0.033). Preoperative total bilirubin, direct bilirubin, and indirect bilirubin were increased in group B compared to group A (P = 0.005, P < 0.001, and P = 0.014), as were preoperative ALT, AST, γ-GT, and total bile acid (P = 0.006, P = 0.025, P < 0.001, and P = 0.024). The risk of liver fibrosis or cirrhosis was significantly increased for group B compared with group A (P = 0.012) and also occurred earlier in group B (P = 0.006). In the dilated IHBDs, 95.4% (62 of 65) recovered to normal, and more than half of dilated IHBDs (37 of 65) recovered to normal in 1 week. Conclusion Most IHBDs can recover to normal postoperatively in a short time, and proactive treatment is recommended for CC patients with IHBD dilatation for significant abnormal liver functions.

Objective: In this study, a new surgical technique was developed to reconstruct the lateral nail fold in the duplicated thumbs with a common nail and postoperative outcomes were evaluated. Methods: From December 2012 to October 2015, sixteen duplicated thumbs with a common nail were treated in our hospital using a flap from resected finger pulp which did not include the nail and phalanx. Unilateral inverting suture was performed between the flap and nail bed to reconstruct the lateral nail fold and nail groove. Postoperative outcomes were evaluated by Wang-Gao scoring system (total 12). Results: The follow-up period ranged from 10 to 45 months. The reconstructed nails were smooth and had a natural lunula, and the nail width was about 80%-100% of their normal sides. There was a right angle between the nail epithelium and lateral nail fold in four cases, and an acute angle in two cases. The reconstructed nails were asymmetrical in these thumbs. One patient showed a hypertrophy in the lateral nail fold. The reconstructed nails were evaluated by Wang-Gao scoring system: 10 in 2 cases, 11 in 4 and 12 in 10. All the cases had excellent results. Conclusions The nail width usually is more than 80% of the normal sides in the radial polydactyly with a common nail. The surgical technique can reconstruct a natural lateral nail fold and nail groove, and avoid the nail deformity caused by the Bilhaut-Cloquet procedure.

OBJECTIVE: To assess the clinical application of preoperative retrograde portal venography for children with cavernous transformation of the portal vein (CTPV). METHODS: The clinical data of 8 cases of CTPV admitted in the Children's Hospital of Zhejiang University from January 2018 to September 2019 were retrospectively analyzed. Preoperative retrograde portography was performed to determine the corresponding vascular morphology and size of portal vein system. If the retrograde portography showed that the left branch of the shadow portal vein was unobstructed and its diameter was greater than 3 mm, Rex shunt would be performed after anatomic exploration of Rex recess; if retrograde portography showed that the diameter of left portal vein was less than 3 mm, but the diameter of left renal vein dissected during shunt operation was greater than 5 mm, Warren operation was selected. The patients were followed up for 1, 3 and 6 months after discharge, and then were followed up every 6 months. RESULTS: Retrograde portal venography was successfully performed in 8 child patients.The anatomical position and size of main portal vein and its left and right branches, left renal vein and other important vessels were determined. Among them, there was the well-developed left and right branches of portal vein in 4 child patients, in which the left and right branches of portal vein converged together, but did not communicate with the main portal vein. In addition, the left branch diameter of the portal vein was greater than 3 mm, and the anatomical exploration results during shunt were consistent with it, so Rex shunt was performed. In the other 4 cases, the left branch diameter of the portal vein was small (less than 3 mm) in 3 cases, and the right branch was not clearly developed. Moreover, the left branch of the portal vein was poorly developed and almost occluded in 1 case. However, the left renal vein in these 4 child patients was well developed, the blood flow was unobstructed and the diameter was greater than 5 mm, so Warren operation was performed. Seven patients recovered well after the operation, and the other one had digestive tract rudimentary one year after operation, and the condition was stable after conservative treatment. CONCLUSIONS The preoperative retrograde portal venography can be used to evaluate the portal vein system in children with CTPV, which provides important clinical basis for making appropriate treatment plan before surgery.
Child ; Humans ; Portal Vein/surgery* ; Portography ; Retrospective Studies