Improvement of nutritional support strategies after surgery for benign liver tumor through nutritional risk screening: a prospective,randomized, controlled,single-blind clinical study

Objective

The rising of individualized therapy requires nutritional risk screening has become a major topic for each particular disease, yet most of the screenings were for malignancies, less for benign diseases. There is no report on the screening of patients with benign liver tumors postoperatively. We aim to evaluate the nutritional support strategies post operation for benign liver tumors through nutritional risk screening.

Methods

In this prospective, randomized, controlled study, 95 patients who underwent hepatectomy for benign tumors were divided into two groups. Fifty patients in the control group were given routine permissive underfeeding nutritional supply (75 kJ/kg/d), and 45 patients in the experimental group were given lower energy (42 kJ/kg/d) in accordance of their surgical trauma. Routine blood tests, liver/kidney function were monitored before surgery and at the day 1, 3, 5, 9 after surgery, patients were observed for the time of flatus, complications, length of hospitalization (LOH), nutrition-related costs, and other clinical parameters. This completed study is registered with Clinicaltrials.gov, number NCT01292330.

Results

The nutrition-related expenses (494.0±181.0 vs. 1,514.4±348.4 RMB, P<0.05) and the total hospital costs (18,495.2±4735.0 vs. 21,432.7±8,291.2 RMB, P<0.05) for patients in the experimental group were significantly lower than those in the control group. Meanwhile, the lowered energy supply after the surgeries did not have adverse effects on clinical parameters, complications, and LOH.

Conclusions

Patient with benign liver tumors can adopt an even lower postoperative nutritional supply that close to that for mild non-surgical conditions, and lower than the postoperative permissive underfeeding standard.Key Words: Nutritional risk screening, benign liver tumor, individualized therapy, nutrition therapy, permissive underfeeding     

Intracerebroventricular administration of ouabain alters synaptic plasticity and dopamine release in rat medial prefrontal cortex

Intracerebroventricular (ICV) administration of ouabain, a specific Na–K-ATPase inhibitor, in rats mimics the manic phenotypes of bipolar disorder and thus has been proposed as one of the best animal models of mania. Bipolar mania has been known to be associated with dysfunctions of medial prefrontal cortex (mPFC), a brain area critically involved in mental functions; however, the exact mechanism underlying these dysfunctions is not yet clear. The present study investigated synaptic transmission, synaptic plasticity, and dopamine release in Sprague-Dawley rat mPFC following ICV administration of ouabain (5 μl of 1 mM ouabain). The electrophysiological results demonstrated that ouabain depressed the short- and the long-term synaptic plasticity, represented by paired-pulse facilitation and long-term potentiation, respectively, in the mPFC. These ouabain-induced alterations in synaptic plasticity can be prevented by pre-treatment with lithium (intraperitoneal injection of 47.5 mg/kg lithium, twice a day, 7 days), which acts as an effective mood stabilizer in preventing mania. The electrochemical results demonstrated that ICV administration of ouabain enhanced dopamine release in the mPFC, which did not be affected by pre-treatment with lithium. These findings suggested that alterations in synaptic plasticity and dopamine release in the mPFC might underlie the dysfunctions of mPFC accompanied with ouabain administration-induced bipolar mania.     

3D打印模板联合CT引导粒子植入治疗前列腺癌一例报告并文献复习

目的：探讨3D打印模板引导经臀部皮肤直肠两侧后入路行¹²⁵I粒子植入治疗前列腺癌的可行性和安全性。 方法：选取我科一例因直肠反应严重未能完成外放疗的老年前列腺癌患者,应用3D打印模板引导¹²⁵I粒子植入进行补量治疗。术前患者俯卧位真空垫固定,行盆腔CT强化扫描,术前计划满足剂量学要求后,将术前计划传入3D打印机打印模板。术中调整患者体位与术前定位一致,校正模板位置后臀部皮肤局部浸润麻醉,在CT引导下按照术前计划经臀部皮肤直肠两侧后入路穿刺前列腺并植入¹²⁵I粒子。 结果：在3D打印模板引导下,经臀部皮肤直肠两侧后入路可精准穿刺至术前计划位置,粒子植入位置与术前计划一致,靶区及危及器官剂量学参数与术前计划基本一致。术中未出现出血、直肠损伤、尿道损伤等并发症。术后2个月前列腺特异抗原（PSA）由术前的10.16 ng/ml降至6.93 ng/ml。CT复查评价为肿瘤稳定。 结论：局麻下3D打印模板引导经臀部皮肤直肠两侧后入路植入¹²⁵I粒子治疗前列腺癌安全可行,简便省时。     

Down-regulation of beta1-adrenoceptors gene expression by short interfering RNA impairs the memory retrieval in the basolateral amygdala of rats

The influence of basolateral amygdala (BLA) on memory is known to depend critically on adrenergic neurotransmission. However, the roles of noradrenergic receptors on memory retrieval have been elusive and controversial. Here, we investigated the effect of beta(1)-adrenoceptor (beta(1)-AR) on auditory fear memory in the rat BLA. We attenuated the expression of beta(1)-AR by RNA interference, a popular means to specific suppress gene expression. Bilaterally microinjection of beta(1)-AR short interfering RNA (siRNA) could reach a satisfying transfection in the BLA: beta(1)-AR protein expression was reduced transiently by siRNA in vivo at day 3. The behavioral tests indicated that memory retrieval was impaired as beta(1)-AR protein expression was prevented, and the memory was restored when the beta(1)-AR protein got back to normal level. The results suggested that beta(1)-AR might be critical for the retrieval of auditory fear memory.     

某三级甲等医院400例新的及严重的药品不良反应分析

摘 要 目的：了解某三级甲等医院药品不良反应（ADR）发生的特点,为临床安全用药、减少ADR发生提供参考。方法: 对2014～2016年收集上报的新的及严重的ADR从报告类型、年龄、性别、给药途径、药品种类、累及系统 器官方面进行分析。结果:新的及严重的ADR报告共有400例,占报告总数的64.52%;60～74岁患者所占比例最大,为34.25%;发生ADR的男女比例基本相当,男性（50.25%）略高于女性（49.75%）;静脉给药引起ADR例数最多（57.00%）;引起ADR的药品种类最多的为抗感染药物（31.25%）,其中头孢菌素类占比最多（32.00%）;主要累及系统 器官为皮肤及附件损害（33.00%）、胃肠系统损害（15.50%）及肝肾功能损害（14.00%）等。结论:全院应加强ADR监测与上报工作,从而规范药物使用,减少ADR的发生。     

Facial emotion perception abilities are related to grey matter volume in the culmen of cerebellum anterior lobe in drug-naïve patients with first-episode schizophrenia

Brain Imaging and Behavior - Impaired capability for understanding and interpreting the expressions on other people's faces manifests itself as a core feature of schizophrenia, contributing to...     

Modular-level alterations of single-subject gray matter networks in schizophrenia

Brain Imaging and Behavior - Schizophrenia is often regarded as a psychiatric disorder caused by disrupted connections in the brain. Evidence suggests that the gray matter of schizophrenia patients...     

How to select the lowest instrumented vertebra in Lenke 5/6 adolescent idiopathic scoliosis patients with derotation technique

European Spine Journal - To introduce and evaluate our lowest instrumented vertebra (LIV) selection criteria for Lenke type 5/6 adolescent idiopathic scoliosis (AIS) patients with de-rotation...