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Objective To explore the effect of fish oil fat emulsion as perioperative nutritional support on patients with liver cirrhosis and portal hypertension.Methods Randomized controlled clinical trial was performed between September 2011 and September 2017 in patients with liver cirrhosis and portal hypertension who underwent pericardial devascularization and splenectomy.Hypocaloric total parenteral nutritional support (TPN) started from the first day after the operation for 5 consecutive days.Patients were divided into experimental group and control group according to thetype of fat emulsion used.43 patients in experimental group were applied for fish oil fat emulsion injection (10％ Omegaven) + medium long chain structure fat emulsion (20％STG) and 42 patients in control group were applied for medium long chain structure fat emulsion (20％STG).Liver function (total bilirubin and alanine aminotransferase),nutrition index (serum albumin and prealbumin),inflammatory mediators (TNF-α,IL-6 and IL-10) were measured before and after the operation,and the clinical outcomes were observed.Results There was no statistically significant difference in liver function and nutritional indices between the experimental group and the control group (P＞0.05).The inflammatory mediators like TNF-u,IL-6 and IL-10 on the first day after surgery were significantly higher than those before surgery in both groups [experiment group:(225.54±54.78) vs.(61.49±16.47),(74.94±6.36) vs.(39.84±2.77),(77.53±11.4) vs.(46.05±6.13) ng/L;control group:(229.26±62.15) vs.(63.48±13.76),(77.23±7.83)vs.(40.64±3.34),(73.89±7.97)vs.(44.88±5.72) ng/L;P＜ 0.01].With the progress of time,the proinflammatory factors like TNF-α and IL-6 decreased after the operation and the range of decrease was higher in experiment group than in control group [d4-d 1:(-56.88± 31.63) vs.(-35.96±20.02),(-13.52±5.20) vs.(-6.38±2.84) ng/L;d7-d1:(-150.67±42.58) vs.(-132.79±53.35),(-27.04±8.97) vs.(-20.85±6.38) ng/L;P＜ 0.05].The range of increase in anti-inflammatory media IL-10 was higher in experiment group than in the control group (d4-d1:(14.22±13.08) vs.(5.64±3.58) ng/L;d7-d1:(17.78±5.58) vs.(-37.96±11.43) ng/L;P＜0.05).The incidence of grade Ⅲ complications and total complications (4.7％ vs.21.4％,23.3％ vs.45.2％) and hospitalization time [(10.12 ±1.48) vs.(12.33±2.04) d] in the experimental group were significantly lower than those in the control group (P＜0.05).Conclusions In patients with liver cirrhosis and portal hypertension,perioperative nutritional support of fish oil fat emulsion can reduce systemic inflammatory response and operative complications and promote rapid recovery through its two-way regulation of inflammatory mediators.
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@#Objective To apply the Comprehensive Function Assessment for Disabled Children in family care for children with cerebral palsy. Methods From May, 2014 to May, 2015, 120 cerebral palsy children were equally divided into control group and observation group. The control group accepted routine rehabilitation, and the observation group accepted targeted family rehabilitation program based on the evaluation of Comprehensive Function Assessment for Disabled Children. They were assessed with Comprehensive Function Assessment for Disabled Children before and three months after rehabilitation. Results The scores of cognitive function, language function, exercise abil-ity, self-care movement and social adaptation ability improved in both groups after rehabilitation (t>2.498, P<0.05), and improved more in the observation group than in the control group (t>2.062, P<0.05). Conclusion The application of Comprehensive Function Assessment for Disabled Children may help to plan a targeted rehabilitation nursing program for the nurses and the parents, that benefits the rehabilitation for children with cerebral palsy.
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Objective:To investigate the synergistic killer effect of natural killer cells(NK cells) combined with tamoxifen(TAM) on breast cancer cells(BCC)through the experiment in vitro,and to explore its mechanism.Methods:Three kinds of BCC with different receptor expression levels were selected for the experiment.Blank control group, different concentrations of TAM groups and different time groups were set up.MTT assay was used to detect the inhibitory rates of proliferation of cells,and the final experiment concentration of 5 μmol·L-1 was determined.The cells were divided into natural-release group,largest-release group,TAM group,NK cells group, and combined-experimental group(BCC+NK cells+TAM),and the synergistic killer effect of NK cells combined with TAM in different effector-target ratios were detected with Calcein-AM release assay.In ELISA assay the cells were divided into blank control group (NK cells),NK cells+TAM group, NK cells+BCC group and combined-experimental group,and the levels of IFN-γ and TNF-α in the NK cells in various groups were measured.In flow cytometry detection the cells were divided into blank control group (NK cells),NK cells+TAM group,NK cells+ BCC group, and combined-experimental group,and the expression levels of NKp46,CD158a,CD158b,CD158b2,and CD158e were determined;while the cells were divided into blank control group (BCC),BCC+TAM group,BCC + NK cells group, and combined-experimental group,and the expression levels of the MICA,ULBP1 and ULBP2 were detected.Results: The MTT assay results showed that the inhibitory rates of proliferation of 3 kinds of BCC had obvious time-and concentration-dependence (P<0.05).The Calcein-AM release assay results showed that the killing-rates of BCC in TAM groups were increased with the increase effector-target ratios of compared with NK cells group;and the killing-rate in combined experimental group was obviously higher than those in NK cells and TAM groups(P<0.05).The ELISA assay results showed that the levels of TNF-α and IFN-γ of NK cells in various experimental groups with BCC or not were increased compared with blank control group(P<0.05 or P<0.01);the levels were significantly increased when combined with TAM (P<0.05).The flow cytometry results showed that the NKp46 expression levels in various experimental groups were elevated compared with blank control group(P<0.05);the expression levels of CD158a, CD158b,CD158b2, and CD158e were significantly decreased(P<0.05);the expression levels MICA,ULBP1, and ULBP2 in BCC were significantly increased (P<0.05).Conclusion:The NK cells combined with TAM has the synergistic killer effect on the BCC in vitro.The synergetic mechanism may be as follows: TAM could increase the secretion of TNF-α and IFN-γ of NK cells to enhance their cytotoxicity;TAM also could up-regulate the expression levels of activating receptors and activating ligands,and down-regulate the expression levels of inhibitory receptors to increase the killing ability of NK cells.
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Objective To explore the value of magnetic resonance imaging (MRI)different planes in the diagnosis of uterine sep-tum.Methods The MR images of 28 cases with hysteroscopy surgery proved congenital uterine septum were analyzed retrospective-ly.The MRI findings in different planes of uterine septum were compared.Results 28 cases of congenital uterine septum malforma-tion were shown by magnetic resonance imaging in different planes.The sensitivity of oblique coronal for the uterine septum was not only higher than the conventional axial and oblique axial,but also higher than normal coronal (P <0.05).The oblique coronal was the most sensitive MRI imaging position for diagnosis of uterine septum,especially for complete uterine septum malformation.The uterine septum morphology and signal characteristics was fully visualized and accurately measured by the oblique coronal T2 WI.The oblique axial T2 WI displayed a continuous cross-sectional image of uterine septum and played a complementary role on the diagnosis of uterine septum.In contrast,a poor display was observed for uterine septum on sagittal plane.Conclusion Congenital uterine sep-tum can be clearly demonstrated by MRI oblique coronal and oblique axial joint application.
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Objective To discuss the diagnostic value of multi-slice spiral CT (MSCT) in distinguishing the severe acute respiratory syndrome (SARS) from community acquired pneumonia (CAP), and to evaluate the prognosis in these two groups. Methods A retrospective study was performed on 64 cases with SARS (28 men, 36 women, aged 18-93 yrs, mean age 42.3 yrs) and 46 inpatients with CAP (29 men,17 women, aged 28-88 yrs, mean age 70.1 yrs). Pathogens of respiratory tract were found in 23 patients of CAP. All of patients underwent MSCT scanning of the chest. Results The sensitivity, specificity, and accuracy for diagnosis of SARS using a combination of 3 factors, including ground-glass opacities of lung parenchyma in chest CT, age, and WBC counts were 93.8%, 60.9% and 80.0%, respectively. The sensitivity, specificity, and accuracy for excluding SARS using a combination of consolidation of lung lesions, fiber stripe components and thicken bronchus wall of lung CT in CAP patients were 91.3%, 82.8%, and 86.4%, respectively. The death in SARS and CAP was 7 (10.9%) and 4 (8.7%), respectively. The late follow-up results indicated that 48.8% (21/43 cases) of SARS cases left abnormal manifestations in the lung. The lung sequela of the patients over 50 yrs tended to be severe with the age. Conclusion In outbreak region of SARS, MSCT plays an important role in early diagnosis, but we need to closely combine the density features of lung lesions and other manifestations of lung with clinical condition of patients to increase the accuracy for the differential diagnosis of SARS from CAP. The prognosis of patients over 50 yrs with SARS is relatively poor.
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Objective To investigate the relationship between hypoxia inducible factor-1?、angiopoietin2 and vascular endothelial growth factor and angiogenesis in hepatocellular carcinoma(HCC).Methods The(expression) of hypoxia inducible factor-1?、angiopoietin2 and vascular endothelial growth factor mRNA was(detected) in 52 HCC surgical specimens.And microvessel density(MVD) in tissue specimens of patients with coexpression of the parameters was examined.Results Of the 52 surgical specimens,36 cases had over(expression) of HIF-?、angiopoietin and VEGF protein,and coexpression of HIF-? and angiopoietin and VEGF mRNA in 38 of 52 cases.The expression of HIF-?、angiopoietin was related with the expression of VEGF(r_1= 0.783,P
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ObjectiveTo study the early diagnosis and prevention of fungal infection in severe acute pancreatitis(SAP). Method 1.SAP patients from July 1998 to June 2002 were prospectively randomized into 3 groups: garlicin prevention group, fluconazole (low dosage) prevention group and control group, the incidence of fungal infection in SAP was compared between the groups. For fungal infection patients, the fungal clearance and mortality rate were observed. 2.Clinical data of SAP patients with fungal infection and with simple bacterial infection was compared by multivariate logistic regression, and clinical characters and risk factors of fungal infection were evaluated. Results 1.There were lower incidences of fungal infection in garlicin group (16% vs. 30%,P
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Objective To investigate the effects and mechanism of magnetic microsphere combination of cisplatin with nano or micron ferric oxide particle on human hepatoma cell(HHC). Methods A human hepatoma cell line BEL-7402 was used in this study, 0.04?g/ml～8?g/ml of cisplatin(CDDP), cisplatin nano-ferric oxide magnetic microsphere(nCDDPmm) and micro-ferric oxide magnetic microsphere(mCDDPmm) were administered to the culture solution for culturing the BEL-7402 cell as the experimental groups,and in the control groups were administered with cisplatin 0?g/ml and magnetic microsphere without cisplatin respectively. The optic density of viable cell, cytotoxity index, growth curve of cell, cell cycle, proliferation index and apoptosis were assayed by MTT method, cell count and flow cytometry respectively. Results (1)The viable cell's optic density decreased and the cytotoxity index increased in human hepatoma cell following increasing dosages of CDDP, nCDDPmm and mCDDPmm in culture solution,presenting a dose-dependent manner(r value of three drugs were 0.95, 0.91 and 0.89 respective, P 0.05)between nCDDPmm and mCDDPmm. (3)Apoptosis rate of hepatoma cell increased ( P
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Objective To study the clinical characteristic and correlation factors of fungal infection in severe acute pancreatitis(SAP). Methods Clinical data of SAP patients with fungal infection (fungus infection group-F1 group) and with bacterial infection (bacteria infection group, B1 group) in January,1994-December,2001 were retrospective analysed and compared. Results There were 40 cases in F1 group, 84 cases in B1 group. There were no significant difference in age, sexual, causes, APACHE II score between the two groups, Hospitalization in F1 was significantly longer than that in B1 group (57.7d∶42.7d, P= 0.044 ).Diabetes-mellitus, SAP grade II, multi-operation, intestinal and/or bile duct fistulas were related to fungal infection in SAP; mortality in F1 group was significantly higher than that in B1 group (P= 0.02 ). Conclusions Diabetes-mellitus, SAP grade II, multi-operation, intestine and/or bile duct fistulas are the risk factors of patients with severe acute pancreatitis developing fungal infection; fungus infection can increase the mortalily of SAP patients.Extra-pancreas fungal infection is commonly seen in digestive tract, respiratory tract and urinary system. unknown consciousness change and massive bleeding may indicate that the patient is complicated with fungal infection.
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Objective To investigate the diagnosis and treatment of malignant fibrous histiocytoma (MFH) in abdominal cavity. Methods The clinical manifestations, imaging examination, pathology, methodology, effect of treatment and prognosis of 28 MFH patients were retrospectively analyzed. Results Tumors were in the retroperitoneal space in 17 cases, within abdominal cavity in 6, in mesentery in 3 cases, and in the abdominal wall in 2 cases. The clinical symptoms were body weight loss, abdominal pain and mass. B ultrasonography and CT scanning showed mass in the abdomen. 24 cases were with multiplefoci,4 cases were with a single mass. Seventeen cases underwent complete tumor resection,11 cases with partial resection, 16 cases received postoperative chemotherapy and 14 cases with postoperative radiotherapy. The overall survival rate of 1-, 3- and 5- year was 76.9%,26.9% and 3.9%,respectively. Conclusion MFH is most often located in retroperitoneal space, surgical resection was the treatment of choice. The prognosis in patients with MFH might be improved by complete resection combined with chemotherapy or/ and radiotherapy.
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Objective To determine the prevention and therapy of fungal infection in patients with severe acute pancreatitis (SAP). Methods Seventy patients with SAP admitted from July,1998 to June,2002 were randomly divided into 3 groups: garlicin prevention group, fluconazole (low dosage) prevention group and control group.The incidence of fungal infection, the fungal clearance and mortality after the treatment were compared. Results The incidence of fungal infection in garlicin group and fluconazole group was lower than that in control group. (16%∶30%,P