Objective To observe the effect of preoperative enteral nutritional support combined with modified Ivor-Lewis surgery for esophageal cancer on lung function and mRNA expression of GATA-binding protein 3(GATA3)and forkhead protein P3(Foxp3)in peripheral blood.Methods Sixty esophageal cancer patients who underwent modified Ivor-Lewis surgery in our hospital from January 2022 to October 2023 were selected and divided into two groups by simple random method.The control group was given conventional diet before operation,and the observation group was given enteral nutrition support before operation.The two groups were compared in terms of nutritional support.Results Both groups showed significantly decreases in one-second exertion expiratory volume/exertion lung volume(FEV1/FVC)(P<0.05),FVC(P<0.05),FEV1(P<0.05)and the levels of peripheral blood GATA3(P<0.05),Foxp3 mRNA(P<0.05)expression compared with those at admission(P<0.05),but no significant differences in pulmonary function(P>0.05),peripheral blood GATA3(P>0.05),and Foxp3 mRNA(P>0.05)expression between them at 1 week postoperatively.Both groups exhibited significantly lower levels of albumin,prealbumin,haemoglobin,transferrin,PNI and body mass and body mass index at admis-sion as compared to those at one week after surgery(P<0.05).The observation group showed significantly higher levels of albumin,prealbumin,haemoglobin,transferrin,and PNI at 1 week postoperatively(P<0.05),but no significant differences in ventilation time,defecation time,drain retention time,hospitalisation time,and compli-cation rate as compared to the control group(P>0.05).Conclusion Preoperative enteral nutritional support combined with modified Ivor-Lewis surgery for esophageal cancer improves postoperative nutritional status,and ren-ders less effect on postoperative lung function and peripheral blood GATA3 and Foxp3 mRNA expression.

Identifying the compound formulae-related xenobiotics in bio-samples is full of challenges.Conventional strategies always exhibit the insufficiencies in overall coverage,analytical efficiency,and degree of automation,and the results highly rely on the personal knowledge and experience.The goal of this work was to establish a software-aided approach,by integrating ultra-high performance liquid chromatography/ion-mobility quadrupole time-of-flight mass spectrometry(UHPLC/IM-QTOF-MS)and in-house high-definition MS2 library,to enhance the identification of prototypes and metabolites of the compound formulae in vivo,taking Sishen formula(SSF)as a template.Seven different MS2 acquisition methods were compared,which demonstrated the potency of a hybrid scan approach(namely high-definition data-independent/data-dependent acquisition(HDDIDDA))in the identification precision,MS1 coverage,and MS2 spectra quality.The HDDIDDA data for 55 reference compounds,four component drugs,and SSF,together with the rat bio-samples(e.g.,plasma,urine,feces,liver,and kidney),were acquired.Based on the UNIFI? platform(Waters),the efficient data processing workflows were estab-lished by combining mass defect filtering(MDF)-induced classification,diagnostic product ions(DPIs),and neutral loss filtering(NLF)-dominated structural confirmation.The high-definition MS2 spectral li-braries,dubbed in vitro-SSF and in vivo-SSF,were elaborated,enabling the efficient and automatic identification of SSF-associated xenobiotics in diverse rat bio-samples.Consequently,118 prototypes and 206 metabolites of SSF were identified,with the identification rate reaching 80.51％and 79.61％,respectively.The metabolic pathways mainly involved the oxidation,reduction,hydrolysis,sulfation,methylation,demethylation,acetylation,glucuronidation,and the combined reactions.Conclusively,the proposed strategy can drive the identification of compound formulae-related xenobiotics in vivo in an intelligent manner.

【Objective】 To explore the effects of early application of erythropoietin (EPO) in patients with anemia after renal transplantation. 【Methods】 Patients who underwent renal transplantation in the First Affiliated Hospital of Soochow University were retrospectively analyzed. According to whether EPO was applied after operation, the patients were divided into EPO group and routine group. Patients with delayed renal function recovery were excluded, and the remaining patients were further analyzed. The general, laboratory and follow-up data of the two groups were compared, and adverse drug reactions were observed. 【Results】 The hemoglobin (P=0.026), red blood cell count (P=0.038) and hematocrit (P=0.011) in EPO group were higher than those in the routine group 2 weeks after operation, while the postoperative serum creatinine level was lower (P=0.001). Since the first week after operation, the reticulocyte count in EPO group was significantly higher than that in routine group (P<0.01). There was a negative correlation between hemoglobin and serum creatinine in EPO group at week 1 (r=-0.375, P=0.010) and week 2 (r=-0.386, P=0.008). During the treatment, 6 patients showed transient elevation of serum potassium, which returned to normal after symptomatic treatment, and no obvious adverse drug reactions were observed. 【Conclusion】 Continuous application of erythropoietin in the early stage after renal transplantation can significantly improve anemia in renal transplant patients and promote the recovery of renal function.

Objective To explore the neuroprotective effects ofβ-aescinate on brain edema in rats of traumatic brain injury (TBI). Methods A total of 78 male SD (Sprague Dawley) rats were randomly divided into three groups: sham-operation group (Sham), traumatic brain injury group (TBI) andβ-aescinate group, with 26 rats in each group. Rats of Sham group were anesthetized and surgically prepared only, but were not induced by cortical contusion. Electronic brain cortical damage impactor (eCCI) was used for establishing TBI model in TBI group and β-aescinate group after opening the bone window. TBI group was only established TBI model, but no intervention. After establishment of TBI model in β-aescinate group, β-aescinate (5 mg/kg body weight) was intraperitoneally injected, once every 24 hours. The modified neurological severity scores (mNSS) was used for evaluating changes of neurological function. After 48 hours, SD rats were sacrificed for hematoxylin and eosin (H&E) staining (n=6). Additionally, water content of the brain tissue was evaluated using the wet-to-dry weight ratio (n=10). Evans blue assay was performed to investigate the blood-brain barrier (BBB) permeability (n=4). The expression of aquaporin 4 (AQP4) was measured by Western blot assay (n=6). Results Compared with the Sham group, neurologic deficit, increased brain water content and the expression of AQP4 were found in TBI group (all P<0.05). Moreover, BBB permeability was destroyed. However, β-aescinate can improve the neurological function, reduce the brain water content and significantly decrease the expression of AQP4 in TBI rats. The BBB permeability was significantly improved in treatment group (all P<0.05). Conclusion These findings suggest that β-aescinate can reduce cerebral edema and improve neurological outcome in SD rats after TBI. This neuroprotection may be related with the down-regulation of AQP4 protein.

Objective To evaluate the feasibility and efficacy of endoscopic push?radial dissection (EPRD)for benign esophageal stricture(BES). Methods Clinical data of 24 patients diagnosed as having BES who received EPRD were analyzed. The procedure and efficacy were evaluated. Results All 24 patients underwent EPRD successfully with mean operation time being 32 min(15?45 min).The mean esophageal stric?ture incision length was 3?? 2 cm (1?? 0?8?? 0 cm).No severe complications related to EPRD occurred, or trans?ferred for surgery. Patients were followed up for 1?5 months (mean 2?? 8 months). Dysphagia was relieved signif?icantly during the follow?up in 23 patients where endoscopy could go through smoothly. But dysphagia re?oc?curred in one patient 2 weeks after the operation, who underwent a second EPRD and stent implantation, then dysphagia was relieved. Conclusion EPRD is safe, feasible and effective for benign esophageal stricture.

BACKGROUND:In elderly patients with unstable intertrochanteric fracture, because of poor general condition and poor bone condition, on one hand, the internal fixation of fracture may lead to nonunion. On the other hand, patients stil need longer time in bed and hip joint fixation, and may result in complications of long-term bed rest. Artificial femoral head replacement is a safe operation mode, can solve the problem of early ambulation of patients. OBJECTIVE:To observe the repair effect of bipolar artificial femoral head replacement on unstable femoral intertrochanteric fracture in elderly patients. METHODS: A total of 39 elderly patients with unstable femoral intertrochanteric fractures, who were treated in the Department of Orthopedics, 101 Hospital of Chinese PLA from 2005 to 2014, were enroled in this study. There were 21 males and 18 females, at the age of 80-96 years old, averagely 85 years old. They al received bipolar artificial femoral head replacement. Harris score was measured to assess hip joint function at 1 year after replacement. The incidence of complications was recorded. RESULTS AND CONCLUSION:A total of 39 cases were folowed up for 1-5 years. The wound of al patients was healed in the primary stage. No cardiovascular or cerebrovascular accident appeared. Al patients passed safely through the perioperative period. No severe complications occurred. Hip joint function was assessed according to Harris score at 1 year after replacement: excelent in 13 cases, good in 20 cases, average in 4 cases, poor in 2 cases, with an excelent and good rate of 85%. No dislocation appeared. The results suggest that bipolar artificial femoral head replacement can be used to treat femoral intertrochanteric fracture in elderly patients. The postoperative recovery time was short; bleeding was less; complications were few. Hip joint function recovered wel. For elderly patients with femoral intertrochanteric fracture, bipolar artificial femoral head replacement is an ideal safe effective repair method.

Objective To evaluate the feasibility , safety, therapeutic effects and adverse reactions of CT-guided radiofrequency ablation (RFA)for adrenocortical adenoma with Cushing's syndrome.Methods From Jan.2009 to Dec.2013, 24 patients with 24 tumors diagnosed as adrenocortical adenoma with Cushing's syn-drome received CT-guided percutaneous RFA.The average tumor size was(2.1 ±0.7)cm(ranging from 1.1 to 3.9 cm) .RFA was performed under real-time computed tomography guidance .Technical success was defined as disappearance of tumor enhancement on contrast CT imaging 1 week after RFA .Clinical success was defined as improvement in serum cortisol, adreno-cortico-tropic-hormone(ACTH)and symptoms within the follow-up.Patho-logical diagnosis was acquired through the needle biopsy after RFA procedure .Results RFA was technically successful in all the 24 patients.No conversion occured.During operation, patients suffered blood pressure fluc-tuation but no one experienced a hypertensive crisis .Mild postoperative lumbar pain occurred in 6 patients . Tumor enhancement disappeared in CT scan .The mean follow-up was 18 months, ranging from 3 to 36 months. Both serum cortisol and ACTH basically returned to normal levels , and the symptoms related to Cushing's syn-drome gradually disappeared .No severe complications occurred during this procedure .Histopathology results showed all were adrenal cortical adenomas .No serious complication occurred to any patient during RFA .Conclu-sion CT-guided RFA for adrenocortical adenoma with Cushing's syndrome is a feasible , safe, effective and mini-mally invasive treatment with few complications .

BACKGROUND:Posterior hip dislocation combined with femoral head fractures easily induced femoral head necrosis, ectopic ossification, osteoarthritis and deep vein thrombosis. Different therapeutic methods should be utilized according to the type of fracture.
OBJECTIVE:To investigate the factors affecting the therapeutic effects and complications fol owing surgery of posterior hip dislocation combined with femoral head fractures.
METHODS:Twenty-eight patients, who had been diagnosed as posterior hip dislocation combined with femoral head fractures in the 101 Hospital of Chinese PLA from September 2004 to May 2010, were enrol ed in this study. According to Pipkin typing, operative approach and the time from injury to surgery, therapeutic effects were evaluated using radiographs and the recovery conditions of hip function (Epstein method), and the occurrence of complications was recorded.
RESULTS AND CONCLUSION:A total of 28 patients were fol owed up from 1 to 5 years, averagely 2.8 years. Using the Epstein method, there were excellent in 6 cases, good in 12 cases, average in 7 cases, and poor in 3 cases, with an excellent and good rate of 64%. The therapeutic effects in patients with Pipkin I and II were good, with excellent and good rates of 100%and 78%, respectively. Moreover, the complications were less, with a rate of 17%and 22%, respectively. The therapeutic effects of patients with Pipkin III and IV were poor, especial y, Pipkin IV patients, whose excellent and good rate was only 20%and the incidence of complications was 80%. No significant difference in the incidence of complications was detected in patients undergoing Smith-Peterson anterior approach and K-L posterior approach (P>0.05). No significant difference in the incidence of complications was detectable among patients from three groups (the time from fracture to operation<12 hours, 12-48 hours, and>48 hours) (P>0.05). Results indicated that the choice of treatment method should be determined by the type of fracture. The prognosis depends on the patient’s age, time of treatment, types of fracture and dislocation, methods of treatment and related measures of prevention of complications.

Objective To explore the effect of psychological rehabilitation on patients with limb motor dysfunction. Methods 136 cases of hospitalized patients who needed rehabilitation therapy and training were divided into observation group and control group. The control group received conventional rehabilitation, and the observation group received psychological rehabilitation (psychotherapy and medicine) in addition. Symptom Checklist-90 (SCL-90), Fugl-Meyer Assessment (FMA) and modified Barthel Index (MBI) were assessed before and 8 weeks after treatment. Results Most of the 136 patients were involved in psychological problems, including anxiety, depression, somatization,fear, hostility. There was no difference in the scores of SCL-90, FMA and MBI between 2 groups before treatment (P>0.05). After 8 weeks treatment, the scores of SCL-90 were lower, except psychotism (P>0.05), in the observation group than in the control group (P<0.05),the scores of FMA and MBI were higher in the observation group than in the control group (P<0.01). Conclusion The psychological rehabilitation plays an important role in rehabilitation of limb motor dysfunction.

Objective To understand the psychological status of stroke patients during rehabilitation. Methods 58 stroke patients were detected with Symptom Checklist (SCL-90) after 2 weeks. Results All the patients presented various psychological problems with various degrees after 2 weeks. There was no difference in types and degrees of psychological problem between hemorrhagic and ischemic stroke patients (P>0.05). The scores of depression, anxiety, terror, forced and interpersonal sensitivity were higher in serious limb paralysis patients than in mild ones (P<0.01). Conclusion The incidence of psychological problem is really high in patients after stroke. The more serious limb paralysis is, the more serious psychological problem is.