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 To investigate the necessity and feasibility of digit fusion with an advanced island flap in thumb dysplasia of radial polydactyly.Methods From February 2007 to January 2015,we collected the patients with radial polydactyly,whose nail width or thumb girth was less than 80％ of contralateral side.Among them,some patients were also associated with radial deviation deformities in two thumbs or a shorter radial thumb compared with ulnar thumb.In these cases,an island compound flap,which was based on proper palmar digital artery (PPDA) in radial thumb and contained nail,part distal phalanx and skin,combining with ulnar side of ulnar thumb was used to reconstruct a new thumb.Only the patients with a smaller thumb girth were treated by an island flap to augment the thumb size.There were 26 patients,including 29 sides.Preoperative Doppler ultrasonic examination was assigned to observe the amount and distribution of princepspollicisartery(PPA) and PPDA.Appearances were evaluated by Wang -Gao scoring system and functions were evaluated by Tata scoring system.Results There were two basic artery forms through preoperative ultrasonography and surgical exploration in 29 hands:both thumbs only had one PPDA;the main thumb had two while the extra thumb still had one.The former was responsible in 82.76％ (24 hands).All cases were operated according to preoperative design using an island compound flap.26 hands in 23 patients were followed up more than 6 months.Flap results included survival in 22 patients,tension vesicle in 2 patients and tip necrosis in 2 patients.The incision was infected in one patient with the treatment of changing dressing regularly.The function results were excellent in 21 patients,good in 4,fair in 1.Aesthetic results were excellent in 13 patients,good in 4 and fair in 1.Conclusions There is always one developed PDAA in extra thumb,which can be used to design a flap.The longitudinal advanced flap can also eliminate the tension caused by unequal length in two thumbs.Using an axial or island flap to reconstruct a new thumb can not only change the appearance,but also make the reconstructed thumb acquire two sets of blood supply and nerve system.

Objective To investigate the necessity and feasibility of digit fusion with an advanced island flap in thumb dysplasia of radial polydactyly.Methods From February 2007 to January 2015,we collected the patients with radial polydactyly,whose nail width or thumb girth was less than 80％ of contralateral side.Among them,some patients were also associated with radial deviation deformities in two thumbs or a shorter radial thumb compared with ulnar thumb.In these cases,an island compound flap,which was based on proper palmar digital artery (PPDA) in radial thumb and contained nail,part distal phalanx and skin,combining with ulnar side of ulnar thumb was used to reconstruct a new thumb.Only the patients with a smaller thumb girth were treated by an island flap to augment the thumb size.There were 26 patients,including 29 sides.Preoperative Doppler ultrasonic examination was assigned to observe the amount and distribution of princepspollicisartery(PPA) and PPDA.Appearances were evaluated by Wang -Gao scoring system and functions were evaluated by Tata scoring system.Results There were two basic artery forms through preoperative ultrasonography and surgical exploration in 29 hands:both thumbs only had one PPDA;the main thumb had two while the extra thumb still had one.The former was responsible in 82.76％ (24 hands).All cases were operated according to preoperative design using an island compound flap.26 hands in 23 patients were followed up more than 6 months.Flap results included survival in 22 patients,tension vesicle in 2 patients and tip necrosis in 2 patients.The incision was infected in one patient with the treatment of changing dressing regularly.The function results were excellent in 21 patients,good in 4,fair in 1.Aesthetic results were excellent in 13 patients,good in 4 and fair in 1.Conclusions There is always one developed PDAA in extra thumb,which can be used to design a flap.The longitudinal advanced flap can also eliminate the tension caused by unequal length in two thumbs.Using an axial or island flap to reconstruct a new thumb can not only change the appearance,but also make the reconstructed thumb acquire two sets of blood supply and nerve system.

Objective:To summarize and analyze the modalities and experience of retrograde distal perfusion with distal perfusion catheter (DPC) via cannulation of the posterior tibial artery in veno-arterial extracorporeal membrane oxygenation(V-A ECMO).Methods:The clinical data of 15 patients who were treated with V-A ECMO and underwent DPC placement via the posterior tibial artery in our hospital from January 2022 to June 2023 were retrospectively analyzed.Results:The V-A ECMO catheterization method in 15 patients was percutaneous puncture catheterization, and all of them underwent surgical incision to indwelling retrograde DPC through the posterior tibial artery: 6 cases of preventive catheterization, 9 cases of remedial catheterization, the success rate of one-time catheterization was 93.33%, and the type of catheter was mainly 6 F sheath (66.67%). There was no ALI in preventive catheterization, and one case of osteofascial compartment syndrome occurred in remedial catheterization, and the catheterization time was (20.73 ± 3.47) min.Conclusions:In V-A ECMO, placement of DPC via the posterior tibial artery for retrograde distal perfusion is perfectly feasible, and has a high success rate, which can prevent or treat lower extremity ischemia.