Objective To explore the clinical value of early enteral nutrition in severe acute pancreatitis （SAP） by percutaneous endoscopic gastrostomy/jejunostomy （PEG/J）.Methods Treatment condition of nighty patients with SAP were retrospectively analysed.The 90 patients were collected peripheral venous blood respectively on 1，?12，?and 18 d after admission to hospital.Forty-five of them were in PEG/J group，?the others were in control group. Serum IL-6，TNF-α and endotoxin were detected by enzyme-linked immunosorbent assay （ELISA），CD4 /CD8 was determinated by indirect immunofluorescence staining method （FITC-labeled）.Results On 12 d and 18 d，the levels of serum IL-6，?TNF-α，?and endotoxin in PEG/J group were lower than those in control group （P＜0.01）.The CD4 /CD8 was significantly higher than that in control group （P＜0.01）.In control group，?2 cases complicated upper gastrointestinal haemorrhage，4 cases complicated pancreatic pseudocysts，?and 2 cases complicated double infection，?the temperature became normal after about 13.5 d.In PEG/J group，?there were not upper gastrointestinal haemorrhage and double infection，but 2 cases also complicated pancreatic pseudocysts，?the temperature became normal after about 10.5 d.Conclusion The clinical effectiveness of early enteral nutrition in SAP by PEG/J is satisfactory.
Objective To evaluate the effect of early clinical interference strategies on preventing the conversion of acute pancreatitis to the severe form and aggravation of severe acute pancreatitis (SAP). Methods The patients with acute pancreatitis admitted to this hospital were divided into two therapeutic phases by different therapeutic methods from January 2001 to December 2008. Patients in the first phase (from January 2001 to December 2004) were treated by the routine management, and the second phase (from January 2005 to December 2008) by the routine management combined with early clinical interference strategies. Then, the ratio of conversion from acute pancreatitis to SAP and prognosis of SAP between two phases were compared. Results Compared with the first phase, the rate of aggravation of acute pancreatitis was significantly decreased in the second phase (4.48% vs. 21.18%), the average healing time of SAP, the incidences of systemic and local complications and the mortality of pancreatitis were reduced (P＜0.05). When early clinical interference strategies were performed, some adverse reaction and complications occurred in 35 cases, but without severe consequence. Conclusion Early clinical interference strategies may serve as a beneficial strategy on preventing the progression of mild acute pancreatitis to the severe form or halting the aggravation of acute pancreatitis.
OBJECTIVE: To search for the operation timing and methods for obstetrical brachial plexus injury (OBPI). METHODS: Thirty-two children with upper OBPI were treated by microsurgical procedure from October 1997 to April 2001. The average age of patients was 10 months, ranged from 3 months to 24 months; of them, 19 were below 6 months while 13 were over 6 months. Surgical procedure included neurolysis(n = 12), coaptation after resection of the neuroma without function (n = 7), phrenic nerve transfer to anterior cord of upper trunk or musculocutaneous nerve (n = 7) and intercostal nerves transfer to musculocutaneous nerve(n = 6). The children underwent operation with microsurgical technique and 7/0 or 9/0 nylon was used for nerve suture. RESULTS: Thirty cases were followed up for 21 months postoperatively; the excellent and good rate was 76.7% (23/30). The results of the children under 6 months were better than those over 6 months. CONCLUSION: The microsurgical operation might be considered at the age of 3-6 month infants who had shown little or no improvement in elbow flexion. Neurolysis and nerve coaptation are superior to neurotization. The appropriate procedure should be selected according to the findings of exploration.
Abstract: Objective To determine the effects of early enteral nutrition (EEN) on postoperative recovery in elderly patients with esophageal cancer. Methods We included 100 elderly patients with esophageal cancer who were admitted at the PLA 100 Hospital between January 2006 and April 2010, and whose diagnoses were confirmed by pathological examination. The patients were divided into an early enteral nutrition (EEN) group and a parenteral nutrition (PN) group, with 50 patients in each group. There were 32 males and 18 females with an average age of 72 years in the EEN group. There were 30 males and 20 females with an average age of 69 years in the PN group. We analyzed the effect of the nutrition administration method on bowel function recovery, hospital stay, complication rate, and nutritional status one week after surgery. Results The anal exhaust time (45.3±12.7 h vs. 73.6±11.7 h), time until anal defecation (80.5 h±15.6 h vs. 140.1±13.2 h), and hospital stay (13.0±1.8 d vs. 15.2±3.3 d) in the EEN group were all shorter than those in the PN group (Plt;0.05). The rates of lung infection, anastomotic leakage, and cardiac complications in the EEN group were significantly lower than those of the PN group (Plt;0.05). One week after the operation, the serum albumin (ALB), peripheral blood lymphocytes, transferrin, and 24 h urea nitrogen (BUN) in the EEN group were higher than those in the PN group (Plt;0.05). Conclusion Compared with parenteral nutrition, enteral nutrition can promote metabolic function in elderly patients after recovery, reduce morbidity, and promote recovery.
OBJECTIVE To introduce the technique of epiphysiolysis and epiphysis grafting in the treatment of early partial closure of the epiphysial plate in children, and evaluate its effect. METHODS Retrospective study was performed in 10 cases of cubitus varus and valgus, or genu varum and valgum due to early partial closure of the epiphysial plate, 6 cases received simple cuneiform osteotomy, and 4 cases received epiphysioloysis and epiphysis grafting. RESULTS Clinical outcoming after 6-month to 5-year’s follow-up showed 1 case deformity of recurrence and 2 cases of non-isometric limb after simple osteotomy, while no recurrence and isometric limb after epiphysiolysis and epiphysis grafting. CONCLUSIONEpiphysiolysis and epiphysis grafting may effectively prevent the recurrence of postoperative deformity, and restore the longitudinal growth of limb.
ObjectivesTo systematically review the status quo of studies on the influencing factors of early puberty timing.MethodsWe searched VIP, CNKI, CBM, WanFang Data, PubMed, Ovid, Web of Science, EBSCO and The Cochrane Library to collect studies on the influencing factors of early puberty timing published up to November 16th, 2016. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, quantitative analysis and qualitative synthesis methods were used to analyze the studies.ResultsA total of 146 studies were included, among which 74 were case-control studies. The results showed that: the influencing factors on early puberty timing mainly included 10 aspects: obesity, dietary preference and nutritional intake, environmental endocrine disruptors, genetic, social psychologycal stress, social economic status, lifestyle, intrauterine fetal growth, maternal age at menarche and weight, adverse factors during pregnancy.ConclusionsThe current systematic review showed that obesity, genetic, environmental endocrine disruptors, intrauterine fetal growth and early maternal age at menarche may increase the risk of early puberty timing, while other factors remain controversial. While the definition of early puberty timing and related factors have not been unified, most studies focus on females and qualitative data with lack of in-depth analysis. Therefore high quality cohort studies and studies on males are required.
【Abstract】Objective To investigate the recent studies on the biocharacters of keratin family (e.g. genetic mutations and abnormal expressions) and their relationships with the malignant tumors. Methods The literatures of recent years on the biocharacters of keratin family (e.g. genetic mutations and abnormal expressions) and their relationships with the malignant tumors were reviewed. Results Keratin family is a kind of structural proteins in cell which plays an important role in cytomechanics and regulates cell-cycle. The mutations of keratin genes (mRNA) or the overexpression of keratin proteins would interfere with the order of cell-cycle or the integrity of cytomechanics, and lead to some diseases and malignant tumors finally. Conclusion The studies on biocharaters of keratin family (e.g. genetic mutations and abnormal expressions) are helpful in the diagnosis, staging and the evaluation of prognosis of some diseases and cancers, e.g. liver cirrhosis, breast cancer, rectum carcinoma, etc.
Objective To evaluate the diagnostic efficiency of serum soluble CD26 （sCD26） on the diagnosis of colorectal cancer. Methods The serum sCD26 concentration of 59 colorectal cancer patients, 51 colorectal benign disease patients, and 41 healthy volunteers were detected by ELISA. The diagnostic efficiency of sCD26 and carcinoma embryonic antigen （CEA） was assessed by receiver operating characteristics （ROC） analysis. The association between sCD26 and colorectal cancer was assessed by logistic regression which included CEA in the model. Results Increased serum sCD26 was observed in colorectal cancer patients （P＜0.01）, but the differences of sCD26 in different Dukes stages were not statistic significance （P=0.78）. The area under cure （AUC） of sCD26 confirmed by ROC analysis was 0.72 〔95% confidence interval （CI）：0.63-0.82, P＜0.01〕. The diagnostic sensitivity and specificity for sCD26 at 526 μg/L, the optimal diagnostic threshold, were 0.59 （95% CI： 0.48-0.72） and 0.80 （95% CI： 0.67-0.90）, respectively. Positive serum sCD26 was associated with colorectal cancer after adjusted for CEA with odds ration （OR） 5.17 （95% CI：1.72-15.53, P＜0.01）, as confirmed by logistic regression. Increased positive rate of serum sCD26 was observed in patients at Dukes A stage （P=0.03）, but not Dukes B, C, and D stage （P＜0.05）. Conclusions Serum sCD26 has high diagnostic performance for colorectal cancer. The association of sCD26 is independent of serum CEA. Compared to serum CEA, sCD26 has more potential to be an early biomarker for colorectal cancer diagnosis.
Objective To explore the methods of early diagnosis of arteriosclerosis obliterans of lower extremity (ASOLE). Methods The related literatures on ASOLE detection means adopted clinically were reviewed, and their advantages and disadvantages were compared.Results Asymptomatic ASOLE could be discovered by determination of ankle brachial index (ABI) and toe brachial index (TBI), which was a good index for arterial function assessment of lower extremity. Pulse wave velocity (PWV) was more vulnerable and less sensitive than ABI, and therefore more suitable for screening of a large sample. ASI was an index to assess arterial structure and function, and it had a good correlation with PWV. Flow-mediated dilation (FMD) was a measurement evaluating the function of endothelial cell; Pulse wave measurement was simple, sensitive, and its result was reliable. Color Doppler ultrasonography could localizate the lesion and determine the degree of stenosis at the same time. Multiple-slice CT angiography (MSCTA) was more accurate than color Doppler ultrasonography, but its inherent shortcomings, such as nephrotoxicity of contrast agent, was still need to be resolved. 3D-contrast enhancement magnetic resonance angiography (CEMRA) had little nephrotoxicity, but a combination of other imaging methods was necessary. Microcirculation detections required high consistency of the measurement environment, but they were simple, sensitive and noninvasive, and therefore could be used for screening of ASO. Conclusion Publicity and education of highrisk groups, and reasonable selection of all kinds of detection means, are helpful to improve the early diagnosis of ASOLE.
Objective To discuss the feasibility and safety of early enteral nutrition (EN) on treatment of severe acute pancreatitis (SAP) and its influence. Methods The advancement about application of early EN on treatment of SAP in recent years were reviewed. Results In patients with SAP, early EN via catheter placed in the jejunum could protect the integrity of intestinal barrier and reduce infectious complications. But no consensus had been reached about the starting time, ingredient and infusion mode yet. Conclusion Early EN may have positive effects on treatment of SAP, but further researches are still needed.
