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Objective: To evaluate and compare the clinical value of early enteral nutrition (EEN) and total parenteral nutrition (TPN) af-ter esophageal cancer surgery. Methods: We retrospectively analyzed 237 patients who underwent esophageal cancer surgery at Bei-jing Shijitan Hospital from March 2011 to March 2019. They were assigned into two groups based on the postoperative nutritional sup-port used: EEN (136 cases) and TPN (101 cases). Nutritional status, liver function, recovery of gastrointestinal function, days of hospital-ization, and postoperative complications were compared between the two groups after propensity score matching. Results: Using 1 :1 nearest neighbor matching, we successfully matched 91 pairs of patients. The prealbumin (PA) level was significantly higher in the EEN group than in the TPN group 7 days after surgery (P<0.05); however, there was no significant difference in albumin (ALB) level before surgery, 3 or 7 days after surgery. Additionally, the levels of ALT and AST in the EEN group were significantly lower than those in the TPN group 3 and 7 days after surgery (P<0.05). The incidence of acid reflux, vomiting, and diarrhea in the EEN group was higher than that in the TPN group, while the incidence of pulmonary edema and pulmonary infection was lower in the EEN group than in the TPN group (P<0.05). Conclusions: Compared with TPN, EEN is associated with a high incidence of acid reflux, vomiting, and diarrhea after esophageal cancer surgery, but it has a lower impact on liver function. EEN can promote the recovery of intestinal function, improve nutritional indicators, and shorten hospitalization time.
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Double-blind randomized controlled trial design is the most recognized scheme of therapeutic experimental design.On the assessment of the efficacy of traditional medicine, randomized controlled clinical trial design also has the same value.Only when using the research method towards epidemiology to perform the rigorous design on the clinical trial of traditional medicine and make the objective evaluation of its effect, can it get the real understanding and approval from modern medicine.When making the therapeutic clinical trial under the traditional medicine, due to the characteristics of the subject, therapeutic measures usually need to be changed so they cannot be standardized, and the modification may result in the share of multiple intervention components, which leads to the inaccurateness of results under the effect of confounding bias.According to the characteristics of traditional medicine, a new method was proposed for therapeutic clinical trial.Firstly do the randomization with the inclusion criteria made by the same symptom arise in a certain stage of disease, secondly adopt the standardized intervention measures for processing.Eventually confirm whether there is significant statistical difference.The symptom directing standardized interventions have provided the experimental design of the traditional medical clinical therapy with a feasible scheme, which can solve several problems existing in this design.
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Objective To explore the diagnostic value of video bronchoscope-guide transbronchial needle aspiration(TBNA) combined with transbronchial lung biopsy(TBLB) on pulmonary sarcoidosis.Methods Twenty-two patients,definitely diagnosed as stage Ⅰ pulmonary sarcoidosis,were enrolled into the study and accepted TBNA and TBLB.Results The positive diagnostic rates of TBNA and TBLB were 63.6%(14/22) and 40.9%(9/22),but the rate increased to 90.9%(20/22) when the two methods were used together,which showed significant differences(x2=12.24,4.66,P＜0.01 or ＜0.05).Conclusion TBNA combined TBLB test is a safety method with high diagnostic accuracy for pulmonary sarcoidosis.
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OBJECTIVE To find out the situation of the usage of antimicrobials in type Ⅰand type Ⅱ operations during perioperative period and to evaluate the rationality of use. METHODS To check 472 examples of medical record data of discharged patients with type Ⅰand type Ⅱ operations in each department during from Apr to Jun and from Aug to Oct 2006,and make statistics and analysis according to application rate of antibacterial drugs, examining rate of the samples, drug usage by experiences and postoperative infection rate. RESULTS The application rate of antibacterial drugs during perioperative period in our hospital was high;the examining rate of correlated samples was low;the choice of antibacterial drugs mainly depended on experience;the sensitivity of the chosen antibacterial drugs was not strong;the duration of prophylactic drug usage was too long;and the postoperative infection rate was high. CONCLUSIONS It is very important to strengthen standardized administration of prophylactic antibiotic usage during perioperative period in our hospital.
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Objective To evaluate the clinical therapeutic effect of Shenfu injection (参附注射液) on patients with chronic obstructive pulmonary disease at acute exacerbation stage (AECOPD) and approach its therapeutic mechanism. Methods Fifty-eight patients with AECOPD were divided into a Shenfu group (30 cases) and a control group(28 cases); the Shenfu group received 50 ml Shenfu injection and 5% glucose 250 ml intravenous drip once a day at the base of conventional therapy,while the control group received conventional therapy only. The therapeutic course of both groups was 14 days. The clinical therapeutic effects of both groups were observed, the serum levels of tumor necrosis factor-? (TNF-?), interleukin-2 (IL-2) were measured by enzyme-labeled immunosorbent assay (ELISA), and the lung function of both groups was measured before and after the treatment. Results The total effective rates was 93.3% (28/30) and 85.7% (24/28) in the treatment group and the control group, respectively. In the comparison before and after treatment, the levels of TNF-? in both groups were decreased obviously (both P0.05). Conclusion Shenfu injection has a definite clinical curative effect in the treatment of AECOPD, it may decrease obviously the serum level of TNF-?, increase the level of IL-2 and improve the lung function in the patients with AECOPD.
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Objective: To investigate the mechanism of curative effects of Guben Fangchuan capsule (固本防喘胶囊) on chronic obstructive pulmonary disease(COPD). Methods: Using double blind control method , 86 elderly COPD patients in in acute exacerbating stage were divided into treatment group and control group (n=43 in each group). The conventional treatment of the two groups was the same. Additionally, the patients in the treatment group were given Guben Fangchuan capsules orally. The levels of interleukinCD*28 (ILCD*28) and eotaxin in phlegm were detected by enzyme linked immunoadsorbent assay (ELISA). Chymase activity in phlegm was determined by spectrophotometry. They were compared before and after treatment. Results: ①The activity of chymase, the levels of ILCD*28, eotaxin, neutrophil (NEU) and eosinophil (EOS) in phlegm in patients with intermediate and severe COPD patients were lower after treatment in treatment group than those of the patients before treatment and control group (all P
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Objectives:The present study was undertaken to investigate the effects of recombinant growth hormone(rhGH) on protein metabolism during intraabdominal infection. Methods : The study was made up of two parts: animal experiments and clinical studies. All animals were divided into three groups: normal control, sepsis control and rhGH therapy groups. All patients were divided into two groups: infection control and rhGH therapy groups. Expressions of hepatic albumin mRNA and muscle myosin heavy chain mRNA were detected. Results: In septic animals, rhGH accelerated nitrogen retention and recovery of body weight, improved concentrations of plasma albumin and muscle protein. Expressions of hepatic albumin mRNA and myosin heavy chain mRNA decreased significantly after infection. By using rhGH, expression of albumin mRNA and myosin heavy chain mRNA increased obviously. In clinical study, plasma concentrations of albumin, prealbumin and transferrin were higher than infectious controls after rhGH administration. Conclusions: rhGH improved nitrogen balance and protein synthesis of liver and muscle during sepsis .More studies were needed to determine weather rhGH was an effective metabolic intervention method during sepsis.
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OBJECTIVE： To determine the gentamycin sulphate,ephedrine hydrochloride and dexamethasone sodium phosphate in nasal drops without need of separation.METHODS： Gentamycin was determined via the dihydrolutidine derivatives produced by Hantzsh reaction using UV-spectrophotometry.The detecting wavelengths was 330nm.A dual-wavelength spectrophotometry was used for determination of ephedrine hydrochloride and dexamethasone sodium phosphate.The detecting wavelengths were 256.5nm and 241.6nm and the reference wavelengths were 228.4nm and 266.4nm for ephedrine hydrochloride and dexamethasone sodium phosphate,respectively.RESULTS： The average recovery rates of gentamycin sulphate,ephedrine hydrochloride and dexamethasone sodium phosphate were 100.74％ (CV=0.2％ ,r=0.9 999,n=5),100.15％ (CV=0.66％ ,r=0.9 997,n=5)and 99.46％ (CV=0.35,r=0.9 996,n=5)respectively.CONCLUSION： This method is simple,rapid,accurate and stable and suitable for rapid quality control of compound gentamycin sulphate nasal drops.
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Recent studies have indicated that miRNA is an important element that regulates gene expression at the post transcriptional level.MiRNAs play important roles in development and progression of chronic disorders of many organs.This review summarizes the recent researches on the association of miRNA with chronic liver diseases.