Objective:To investigate whether intestinal rehabilitation therapy (IRT)could optimize the effectiveness of IRT in patients with short bowel syndrome (SBS) caused by acute mesenteric ischemia (AMI) with chronic multivessel lesions.Methods:Clinical data of 18 hospitalized patients diagnosed with AMI leading to SBS and undergoing IRT at the Eastern Theater General Hospital of the People's Liberation Army from Jan 2012 to Oct 2023 was retrospectively analyzed.Result:Following IRT, the revascularization group showed significantly greater increases in ASMI and grip strength compared to the control group [(0.28±0.26) kg/m 2vs. (0.02±0.21) kg/m 2, P=0.033, and (0.97±0.33) kg vs. (0.48±0.34) kg, P=0.007, respectively]. Similarly, the increase in EN intake was significantly higher in the revascularization group compared to the control group [(572.5±93.6) ml/d vs. (375.2±176.3) ml/d, P=0.012], accompanied by a greater improvement in intestinal nitrogen absorption rate [(25.06±14.06)% vs. (13.84±4.62)%, P=0.034] and a more substantial decrease in GSRS scores [(-15.88±3.94) vs. (-6.33±5.13), P=0.030]. Moreover, there were significant differences in the composition of EN formulations between the two groups after IRT ( P=0.046). Additionally, SF-36 scores at discharge were significantly higher in the revascularization group than that in the control group for five indicators including BP, GH, VT, SF, and MH ( P<0.05). Conclusions:For patients with SBS resulting from AMI by chronic multivessel lesions, revascularization therapy may not leading to higher growth in weight and hematological nutritional indicators during IRT, but it is beneficial for improving muscle function, improving EN absorption, increasing the likelihood of PN independence, relieving gastrointestinal symptoms, and enhancing overall quality of life.

Objective:We aimed to develop a novel visualized model based on nomogram to predict postoperative overall survival.Methods:This was a multicenter, retrospective, observational cohort study, including participants with histologically confirmed gastric and colorectal cancer who underwent radical surgery from 11 medical centers in China from August 1, 2015 to June 30, 2018. Baseline characteristics, histopathological data and nutritional status, as assessed using Nutrition Risk Screening 2002 (NRS 2002) score and the scored Patient-Generated Subjective Global Assessment, were collected. The least absolute shrinkage and selection operator regression and Cox regression were used to identify variables to be included in the predictive model. Internal and external validations were performed.Results:There were 681 and 127 patients in the training and validation cohorts, respectively. A total of 188 deaths were observed over a median follow-up period of 59 (range: 58 to 60) months. Two independent predictors of NRS 2002 and Tumor-Node-Metastasis (TNM) stage were identified and incorporated into the prediction nomogram model together with the factor of age. The model's concordance index for 1-, 3- and 5-year overall survival was 0.696, 0.724, and 0.738 in the training cohort and 0.801, 0.812, and 0.793 in the validation cohort, respectively.Conclusions:In this study, a new nomogram prediction model based on NRS 2002 score was developed and validated for predicting the overall postoperative survival of patients with gastric colorectal cancer. This model has good differentiation, calibration and clinical practicability in predicting the long-term survival rate of patients with gastrointestinal cancer after radical surgery.

Objective:To investigate the role of dietary fiber in the intestinal rehabilitation for patients with ultra-short bowel syndrome.Methods:This study included 34 inpatients diagnosed with ultra-short bowel syndrome in the General Surgery Department of the Eastern Theater General Hospital of the People's Liberation Army from January 2012 to October 2023. Patients were grouped based on whether they received intestinal rehabilitation and whether dietary fiber was added to the treatment plan, and were divided into three groups: nutritional therapy group (11 cases), growth hormone + glutamine intestinal rehabilitation treatment group (10 cases) and growth hormone injection + glutamine + dietary fiber intestinal rehabilitation treatment group (13 cases). The therapeutic regimen and its changes, pre- and post-treatment parameters of hematology, nutrition, intestinal absorption, fecal consistency, and quality of life were recorded and compared, and the impact of different treatment regimens on clinical outcomes was analyzed.Results:Compared with nutrition treatment group and growth hormone + glutamine intestinal rehabilitation treatment group, growth hormone injection + glutamine + dietary fiber intestinal rehabilitation treatment group, the increase of enteral nutritional fluid, the decrease of parenteral nutritional energy, the increase of intestinal moisture absorption, the decrease of defecation times and the appreciation of hemoglobin were significantly increased, and the difference was statistically significant ( P<0.05). At the same time, the levels of insulin-like growth factor 1 and insulin-like growth factor binding protein were significantly increased after treatment ( P<0.01). Conclusions:Nutritional support combined with intestinal rehabilitation can significantly improve the nutritional status and intestinal absorption rate of ultra-short bowel syndrome patients. The use of dietary fiber in the intestinal rehabilitation regimen for ultra-short bowel syndrome patients yields more significant benefits, as evidenced by improved clinical outcomes.

It is difficult to treat severe burn combined injury caused by high voltage. This paper reports the successful treatment of a patient with large cranial area third degree burn, skull exposure, local skull carbonization combined with cerebrospinal fluid leakage caused by ten thousand volts high voltage current. Vacuum sealing drainage was given to protect the wounds from infection after multiple limited debridement in the early stage. The external of the inactivated skull was cleaned in the later stage. Finally, the bilateral anterolateral thigh flap combined with multiple burr holes was used to repair the wound. There were no severe postoperative complications, and the therapeutic effect was satisfactory.

It is difficult to treat severe burn combined injury caused by high voltage. This paper reports the successful treatment of a patient with third degree burn of extra large cranial area, skull exposure, local skull carbonization combined with cerebrospinal fluid leakage caused by ten thousand volts high voltage current. Vacuum sealing drainage was given to protect the wounds from infection after multiple limited debridement in the early stage. The external plate of the inactivated skull was cleaned in the later stage. Finally, the bilateral anterolateral thigh flap combined with multiple burr holes was used to repair the wound. There were no severe postoperative complications, and the therapeutic effect was satisfactory.

It is difficult to treat severe burn combined injury caused by high voltage. This paper reports the successful treatment of a patient with large cranial area third degree burn, skull exposure, local skull carbonization combined with cerebrospinal fluid leakage caused by ten thousand volts high voltage current. Vacuum sealing drainage was given to protect the wounds from infection after multiple limited debridement in the early stage. The external of the inactivated skull was cleaned in the later stage. Finally, the bilateral anterolateral thigh flap combined with multiple burr holes was used to repair the wound. There were no severe postoperative complications, and the therapeutic effect was satisfactory.

It is difficult to treat severe burn combined injury caused by high voltage. This paper reports the successful treatment of a patient with third degree burn of extra large cranial area, skull exposure, local skull carbonization combined with cerebrospinal fluid leakage caused by ten thousand volts high voltage current. Vacuum sealing drainage was given to protect the wounds from infection after multiple limited debridement in the early stage. The external plate of the inactivated skull was cleaned in the later stage. Finally, the bilateral anterolateral thigh flap combined with multiple burr holes was used to repair the wound. There were no severe postoperative complications, and the therapeutic effect was satisfactory.

To improve the cavitation-to-tissue ratio (CTR) of cavitation imaging during the treatment with high-intensity focused ultrasound (HIFU), we proposed a pulse inversion based broadband subharmonic cavitation imaging method (PIBSHI). Due to the fact that the subharmonic signal is a unique nonlinear vibration characteristic of cavitation bubbles, we extracted the broadband subharmonic signal to get a high-CTR cavitation imaging. The simulation showed that the subharmonic signal produced by cavitating bubbles with different sizes varied, and the signal was stronger than other subharmonics when the bubbles' resonant frequency was close to 1/2 subharmonic frequency. Further experiment results demonstrated that compared with the conventional B-mode images, broadband subharmonic cavitation imaging (BSHI) has improved the CTR by 5.7 dB, and the CTR was further improved by 3.4 dB when combined with pulse inversion (PI) technology. Moreover, when the bandwidth was set to 100%~140% of the 1/2 subharmonic frequency in PIBSHI, the CTR was the highest and the imaging showed the optimal quality. The study may have reference value for the development of precise cavitation imaging during HIFU treatment, and contribute to improve the safety of HIFU treatment.
High-Intensity Focused Ultrasound Ablation ; Ultrasonography

OBJECTIVETo investigate the effect of fish oil on intestinal Paneth cells in mouse with abdominal infection.

METHODSFifty C57BL/6J mouse were randomly divided into five groups (n=10 each): control group, sham group, infection group (cecal ligation and puncture, CLP), fish oil group (0.4 g/kg fish oil, intragastric administration every day, FO) and long chain triglyceride group (0.4 g/kg soybean oil, intragastric administration every day, LCT). The mouse were sacrificed and the terminal ileum was collected for lysozyme, cryptdin 4 and secreted phosphatidase A2 (sPLA2) analysis at the fourth day after operation. The changes of mouse body weight and intestinal mucosa pathology were observed.

RESULTSThe body weight, the mRNA levels of lysozyme, cryptdin 4 and sPLA2 and the protein level of lysozyme of Paneth cells in the infection group were reduced compared with the control group (0.78±0.34 vs. 1.83±0.11, 0.99±0.44 vs. 2.02±0.33, 0.92±0.25 vs. 1.50±0.27, 0.31±0.06 vs. 0.45±0.05, all P<0.05), meanwhile the intestinal villi collapse and breakage occurred obviously. Fish oil could up-regulate the mRNA and protein expression of lysozyme (1.23±0.27 vs. 0.78±0.34 and 0.62±0.23, 0.38±0.07 vs. 0.31±0.06 and 0.32±0.06, all P<0.05) and alleviate the mucosa injury compared with the infection group and LCT group.

CONCLUSIONSThe function of intestinal Paneth cells is damaged apparently after cecal ligation and puncture. Fish oil can relieve this injury.

Animals ; Cecum ; Fish Oils ; Intestinal Mucosa ; Intestine, Small ; Intraabdominal Infections ; Mice ; Mice, Inbred C57BL ; Paneth Cells ; Up-Regulation

Objective To investigate the effect of fish oil on intestinal Paneth cells in mouse with abdominal infection. Methods Fifty C57BL/6J mouse were randomly divided into five groups(n=10 each): control group, sham group, infection group (cecal ligation and puncture,CLP), fish oil group (0.4 g/kg fish oil, intragastric administration every day, FO) and long chain triglyceride group (0.4 g/kg soybean oil, intragastric administration every day, LCT). The mouse were sacrificed and the terminal ileum was collected for lysozyme, cryptdin 4 and secreted phosphatidase A2(sPLA2) analysis at the fourth day after operation. The changes of mouse body weight and intestinal mucosa pathology were observed. Results The body weight, the mRNA levels of lysozyme, cryptdin 4 and sPLA2 and the protein level of lysozyme of Paneth cells in the infection group were reduced compared with the control group (0.78±0.34 vs. 1.83±0.11, 0.99±0.44 vs. 2.02±0.33, 0.92±0.25 vs. 1.50±0.27, 0.31± 0.06 vs. 0.45 ±0.05, all P<0.05), meanwhile the intestinal villi collapse and breakage occurred obviously. Fish oil could up-regulate the mRNA and protein expression of lysozyme (1.23±0.27 vs. 0.78± 0.34 and 0.62±0.23, 0.38±0.07 vs. 0.31± 0.06 and 0.32±0.06, all P<0.05) and alleviate the mucosa injury compared with the infection group and LCT group. Conclusions The function of intestinal Paneth cells is damaged apparently after cecal ligation and puncture. Fish oil can relieve this injury.