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Background:Early administration of enteral nutrition can improve intestinal mucosal barrier in patients with severe acute pancreatitis (SAP),reduce infection and complications;but when should the enteral nutrition be started is still controversial. Aims:To study the effect of different initiation time of enteral nutrition on elderly obese patients with SAP. Methods:The clinical efficacy,hospitalization time,hospitalization cost and the risk of complication were analyzed retrospectively in the two groups of patients with either ultra-early enteral nutrition (group A)or early enteral nutrition (group B),as well as the serum levels of inflammatory cytokines before and after treatment. Results:No significant difference in total effective rate was found between group A and group B (90. 9% vs. 79. 2%,χ2 = 1. 227,P > 0. 05). Compared with group B,the recovery time of blood and urine amylase,and hospitalization time in group A were significantly shortened and the cost of hospitalization was significantly decreased (P < 0. 05). The time of abdominal pain, bloating,vomiting and fever in group A was significantly shorter than that in group B (P < 0. 05). After 14 days of treatment,levels of IL-6,TNF-α and CRP in group A were significantly lower than those in group B (P < 0. 05). The incidence of infection was significantly lower in group A than in group B (P < 0. 05). Conclusions:Compared with early enteral nutrition group,ultra-early enteral nutrition for elderly obese patients with SAP has better efficacy,and has a shorter hospital stay and lower hospitalization cost.
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BACKGROUND:Sustained-release carriers of insulin shaped as microspheres made of different biomaterials have become an issue of concern. OBJECTIVE:To summarize the carrier materials and methods to prepare sustained-release microspheres of insulin. METHODS:Wanfang and PubMed databases were retrieved by computer for articles related to sustained-release carriers of insulin published from 1997 to 2015. The search terms were“insulin, control ed-release carrier, biomaterials”in Chinese and English, respectively. RESULTS AND CONCLUSION:Natural biodegradable polymer materials are preferred to prepare sustained-release microspheres of insulin, including gelatin, alginate, chitosan and its derivatives. These natural materials have good biocompatibility, degradability, film-forming and microsphere-forming abilities. Synthetic biodegradable polymer materials as carrier materials can promote drug stability and effective utilization, and realize targeted drug delivery. According to different physicochemical properties of materials, sustained-release carriers of insulin that meet different requirements can be prepared using emulsion-chemical crosslinking, spray drying and solvent evaporation methods. This review provides new insight into the development of stable drug carriers.
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Background:Tissue microarray has been increasingly used in research of malignancies. It has been revealed that TGF-β signaling pathway contributes to the tumorigenesis and progress of malignancies. Aims:To determine the expressions of Runx3,Smad4,Cdk2 and p21,the key molecules in TGF-β signaling pathway by tissue microarray,and investigate their correlations with clinicopathological features and prognosis of gastric cancer. Methods:A total of 378 paraffin embedded tissue blocks,including 130 gastric cancer tissue and 248 para-cancer tissue from 130 patients undergoing radical resection of gastric cancer were obtained. Tissue microarray and immunohistochemistry were used to determine the expressions of Runx3,Smad4,Cdk2 and p21. Results:The aberrant expression rates of Runx3,Smad4, Cdk21 and p21 in gastric cancer tissue were significantly higher than those in para-cancer tissue(67. 7% ,35. 4% , 63. 8% and 70. 0% vs. 14. 1% ,12. 5% ,18. 1% and 37. 1% ,P < 0. 05,respectively). Aberrant expression of Runx3 was closely correlated with histological grade and lymph node metastasis of gastric cancer( P < 0. 05),while aberrant expressions of Smad4 and p21 were correlated with histological grade only(P < 0. 05);aberrant expression of Cdk2 was correlated with histological grade,lymph node metastasis and TNM staging(P < 0. 05). Pairwise correlations were seen among aberrant expressions of Runx3,Smad4 and p21 in gastric cancer,while Cdk2 was correlated with Runx3 only. Kaplan-Meier survival curve showed that 5-year survival rates in Runx3,Smad4 and p21 aberrant expression groups were significantly lower than those in normal expression groups(P <0. 05). Furthermore,Cox proportional hazard model indicated that Runx3 and Smad4 were independent prognostic factors for gastric cancer. Conclusions:Runx3,Smad4,Cdk2 and p21 might play pivotal roles in tumorigenesis and progression of gastric cancer. As interactions occurred among these four proteins,whether Runx3 and Smad4 could be used for predicting the prognosis of gastric cancer needs to be further studied.
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Objective To explore the diagnosis value and expression of E‐cadherin in the acute pancreatitis .Methods Twenth‐four male SD rats were randomly divided into control group ,mild acute pancreatitis (MAP) group and severe acute pancreatitis (SAP) group ,8 case in each groups .The animal model was established by intraperitoneal injection of L‐arginine .After 24 hours ,the serum levels of amylase and the expression change of variation E‐cadherin were tested .The pancreas tissue was taken for his‐topathological score under microscope .The expression of E‐cadherin at protein level in pancreatic tissue was detected by Western Blot .Results The histological scores of pancreas and serum amylase were significantly higher in the MAP and SAP groups than those in control group (P<0 .05) ,and difference between SAP group and MAP group was also very significant(P<0 .05) .The re‐sult of ELISA showed that the serum E‐cadherin in MAP group[(1 025 .50 ± 131 .33) pg/mL] and SAP group[(1 561 .75 ± 144 .82)pg/mL] were significantly higher than that in control group[(626 .50 ± 72 .12) pg/mL ,P<0 .05] ,and there was significant difference between MAP group and SAP group(P<0 .05) .The result of Western Blot was similar to the result of ELISA .Conclu‐sion E‐cadherin may have diagnosis value in the acute pancreatitis .
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Objective The primary aim of this study was to examine the proportion and natural history of Helicobacter pylori (Hp) negative bleeding peptic ulcers. Methods The study was designed as a multiple-center, case-control study conducted in 14 endoscopy centers in China from April 2006 to March 2007. Each center was expected to recruit 30 peptic ulcer patients with bleeding ( PUB group) and 30 without (PU group). All screened patients with upper gastrointestinal bleeding received endoscopy within 24 hours of admission. Biopsy specimens were taken from the antrum to determine Hp infection by rapid urease test and pathology. Patients with negative Hp infection at first examination were asked to receive urease breathe test (UBT) one month later. Results A total of 617 patients were enrolled with 263 in PUB group and 354 in PU group. There is no significant difference in demographic characters between 2 groups ( P ＞0. 05). The rate of Hp infection in PUB group ( 161/263, 61.2% ) was significantly lower than that in PUgroup (311/354, 87. 9%, P ＜0. 001 ). The incidence of complex ulcer in Hp positive PUB patients was 7.5% ( 12/161 ), which is significantly higher than that in Hp negative PUB patients ( 1/102, 1.0% , P =0. 018). In PUB group, no significant differences were found between Hp positive and negative patients in regarding of age, sex, rates of haematemesis, duodenal ulcer and gastric ulcer, and size of ulcer ( P ＞0. 05 ). Among 102 Hp negative cases in PUB, no positive case was found in UBT one month later. Conclusion We have demonstrated a rise in the incidence of Hp negative bleeding ulcers in China. The idiopathic ulcer was not rare, and might have a higher tendency to cause bleed.
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Objective To investigate oxidative stress in the kidney of diabetic rat in order to tobserve the effect of Tianli Decoction(TLT) on diabetic nephropathy. Methods The rats were devided into five groups:TLD-High dose group,TLD-Low dose group,Captopril(Cap) + HB419 group,pathologic control group,normal control group. Alloxan was used to induce the diabetic model of rats. After 8 weeks,blood glucose,blood lipid,urinary protein and the ratio of kidney weight to body weight in the rats of five groups were measured. The content of MDA and the renalintrinsic anti-oxidatantenzyme activities such as SOD and GSH-Px were evaluated. Results Comparing with normal group,the level of blood glucose,blood lipid,urinary protein and the ratio of kidney weight to body weight in diabetic group were significantly increased. The content of MDA in renalortex was increased,whereas the activities of anti-oxidatantenzyme were decreased. Conclusion Oxidativestress existed in the kidney of diabeticrats. The deficiency of intrinsic anti-oxidatantenzyme may contribute to the development of diabetic nephropathy. TLT can revers the obove changes.
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OBJECTIVE:To investigate the utilization of aspirin in patients with type 2 diabetes mellitus.METHODS:The utilization of aspirin in 510 inpatients with type 2 diabetes mellitus in the department of Endocrinology in our hospital from April 2004 to April 2007 was analyzed retrospectively.RESULTS:Of the total 510 cases,68.2% received aspirin,with daily dose reached 50～100mg.Aspirin was more often used in patients complicated with coronary heart disease and hypertension(P
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BACKGROUND:Bone mineral density(BMD) is still regarded as the standard of early diagnosis and treatment of osteoporosis(OP) at present.But it is found in detection that different sex,age and skeleton location have different OP detection rate,so it is necessary to analyze the difference. OBJECTIVE:To compare the difference of OP detection rate at different skeleton location between males and females with the increase of age. DESIGN:A cross-sectional study taking patients as the subjects. SETTING:Endocrine department of an artillery general hospital of Chinese PLA. PARTICIPANTS:A total of 147 patients,including 54 males and 93 females, aged from 50 to 78 years old,who were hospitalized in our outpatient clinic from September 2000 to January 2002,were selected and divided into 3 groups according to age,50 to 59 years old group (n=46,13 males and 33 females),60 to 69 years old group (n=66,26 males and 40 females) and 70 to 79 years old group (n=35,15 accordance with the OP diagnostic criteria recommended by WHO[1]. Exclusive criterion: secondary OP patients caused by chronic disease of liver,kidney, heart, and gastrointestinal tract and some endocrine disease such as diabetes,hyperthyroidism and so on. INTERVENTIONS:Every subject filled in the history questionnaire in detail.Height and body mass were measured accurately and body mass index(BMI) was calculated (kg/m2).A new type of Norland Excell plus dual-energy X-ray absorptiometry(DEXA) was used to detect BMD(g/cm2) of L2- 4 and proximate femur(neck of femur, Ward's triangle,greater trochanter).The detected values were compared with the normal data of young adults of the same sex and the T value(SD) was obtained. RESULTS:OP in lumber vertebra was predominant in female climacteric(χ 2=10.14,P< 0.01),and the detection rate of OP in lumber vertebra and neck of femur increased with age(χ 2=7.41, P< 0.05).OP in simple neck of femur increased significantly in males after 60 yeas old(χ 2=9.11,P< 0.05). Females were more liable to suffer from OP in simple lumber vertebra and in both lumber vertebra and neck of femur(χ 2=8.04,P< 0.05;χ 2=14.26,P< 0.01).Age had significant negative correlation with BMD in neck of femur,Ward's triangle and great trochanter of females(r=- 0.364,- 0.389, P< 0.01;r=- 0.504,P< 0.001),while BMI was positively correlated with L2- 4,neck of femur and great trochanter significantly(r=0.306,0.329,0.338,P< 0.05). CONCLUSION:Detection rate of OP changes with skeleton detecting location and age.It is very significant to recognize and evaluate these objective phenomena correctly for the diagnosis and treatment of OP.