10.3969/j.issn.2095-4344.2013.24.022

Objective To investigate the influence of enteral nutrition (EN) via feeding pump-based continuous infusion (FPBCI) on nutrition support-associated complications in stroke patients. Methods Totally 53 patients were randomized into BPBCI group (n = 28) and control group (bolus feeding) (n = 25 ). The nutrition support-associated complications including bloating, diarrhea, hyperglycemia, and regurgitation-associated low respiratory tract infection were compared between these two groups. Results The incidences of nutrition support-associated complications were significantly lower in BPBCI group than in control group (bloating: 14.3%vs. 64.0%, P=0.0002; diarrhea: 25.0% vs. 52.0%, P=0.0429; hyperglycemia: 17.9% vs. 44.0%, P=0. 0385 ). There was no significant difference in regurgitation-associated lower respiratory tract infection between these two groups (32. 1% vs. 40.0% , P = 0. 5516). Conclusion Compared with conventional bolus feeding,BPBCI may greatly decrease tube-feeding related complications.

Abstract Diagnosis-related groups (DRGs), designed to reflect the complexity of grouped cases and the consumption of medical resources, has been utilized for evaluating hospital specialty capabilities and assessing performance. A provincial tertiary hospital in Zhejiang Province has developed a management model based on DRGs performance evaluation with strengthening the medical record quality control, optimizing disease admission structures, and refining data analysis. This article introduced the application of DRGs performance evaluation in this hospital, and proposed suggestions for improvement, including leveraging artificial intelligence and big data and integrating clinical pathway management to further enhance medical care quality. These insights provided the reference for high quality development of hospitals.

A quantitative method using ultrahigh-performance liquid chromatography was established to simultaneously determine ten ginsenoside active ingredients including ginsenoside Rg6, F4, Rk3, Rh4, 20(S) -Rg3, 20(R) -Rg3, Rk1, Rg5, 20(S)-Rh2 and 20(R)-Rh2 in steamed notoginseng. The ten ginsenosides of steamed notoginseng with different head numbers, parts, and steaming time were determined by this method. An Acquity BEH C18 chromatographic column (2.1 mm x 100 mm, 1.7 microm) was used to perform the determination, which was maintained at 35 degrees C throughout the analysis. Mobile phase was composed of water and acetonitrile with flow rate at 0.3 mL x min(-1) under gradient elution, and detection wavelength was set to 203 nm for monitoring the separation. The results demonstrate ginsenoside Rg6, F4, Rk3, Rh4, 20 (S)-Rg3, 20 (R) -Rg3, Rk1, Rg5, 20 (S)-Rh2 and 20(R) -Rh2 have shown good linearity (R2 > or = 0.999 8) within 0.46-115, 2.06-515, 1.632408, 3.216-804, 1.392-348, 1.4-350, 0.496-248, 3.012-1 506, 0.82-205 and 0.832-208 mg x L(-1), and their average recoveries were 97.00%, 97.96%, 98.86%, 95.27%, 98.67%, 98.02%, 95.53%, 96.63%, 99.57% and 103.6%, respectively. The proposed approach was quick and accurate and portrayed excellent repeatability and determination efficiency. The quality of steamed notoginseng was effectively controlled, which served as a foundation for establishing a normalized processing technique and quality standard for ensuring the reliability and consistency of its clinical efficacy.
Chromatography, High Pressure Liquid ; methods ; Ginsenosides ; analysis ; Panax notoginseng ; chemistry ; Reproducibility of Results ; Steam

Objective To evaluate the efficacy and safety of transurethral plasmakinetic resection of the prostate(PKRP).Methods A total of 56 patients with symptomatic benign prostatic hyperplasia(BPH) underwent the PKRP.The weight of the prostate ranged 36~110 g(mean,50.3?26.4 g).All the patients were followed for 1~6 months postoperatively.Results The duration of the procedure was 25~100 min(mean,56?26 min),the weight of resected prostate was 10~89 g(mean,50?22 g),and the intraoperative blood loss,35~200 ml(mean,75?49 ml).No transurethral resection syndrome occurred.On 1,3,and 6 postoperative months of follow-up,the peak flow rate(Qmax) increased from 6.7?2.9 ml/s preoperatively to 17.4?5.1 ml/s,20.8?3.9 ml/s,and 21.6?4.6 ml/s,respectively,the international prostate symptom score(IPSS) decreased from 23.2?3.8 preoperatively to 6.9?1.7,6.1?2.1,and 5.9?1.5,respectively,and the quality of life(QOL) decreased from 5.7?1.5 preoperatively to 2.7?0.7,2.4?0.5,and 1.9?0.9,respectively.The differences between pre-and post-operative periods in the three indicators were all statistically significant(P

60 years) received parenteral nutritional support in the period of perioperation.When parenteral nutrition was applied,average non protein calorie intake was 85.4 kJ/(kg?d), and NPC∶N value was 118∶1. Results:PA,TRF and electrolyte were significantly increased after parenteral nutritional support.The nutritional indices did not change and were kept within normal range during parenteral nutrition. Conclusions:Parenteral nutrition is one of the important perioperative treatments in elderly patients with obstruction caused by colon cancer.It is safe and effective to use parenteral nutrition with low fat and glucose in elderly patients.

Cardiovascular disease is the most important factor that affect the lifetime of uremia patients. Recently, scientists pay closer attention to study the mechanism of cardiac injury in uremia patients. In this article, we will make an overview on mechanism of cardiac injure caused by uremia toxin, secondary hyperparathyroidism, calcium-phosphorus metabolic disorder, rennin-angiotensin-aldosterone system.

Objective To explore the effect of hemorrhage on cell apoptosis in the hippocampal CA1 region of rats under controlled hypotension (CH).Methods A total of 36 Sprague Dawley rats were randomly divided into 2 groups: Group C (with no CH) and Group H (with CH).According to different ratios of blood loss to total blood volume, Group C and Group H were redivided into 6 subgroups (6 in each group):C_1,H_1(10%);C_2,H_2(20%);C_3,H_3 (30%). Induced by so-dium nitroprusside and esmolol, the mean aterial pressure in Group H was decreased to 50～55 mmHg and kept for 10 minutes, and then blood loss was started, keeping the pump speed. Without CH, the same style of hemorrhage was performed in Group C. The aterial pressure was increased 60 minutes later after the hemorrhage.Expression of bcl-2 and caspase-3 protein was detected by immunohistochemical method, and apoptosis cells were detected by TUNEL staining. Results The average optical density of bcl-2 and caspase-3 was higher in Group H_3 than that in Group C_3(P＜0.05). There were more apoptosis cells examined by TUNEL in Group H_3 than in Group C_3(P＜0.05).Conclusion Thirty percent blood loss under controlled hypotension can induce cell apoptosis in hippocampal CA1 region in rats.

[Objective]To study the screw trajectory in the posterior atalanto-axial transarticular screw fixation.[Methods](1)The anatomical parameters related to the screw fixation were measured on 30 paired dry atlantoaxial specimens;(2)The X ray and CT scan were taken after C1、2 was fixed by posterior transarticular screws on 6 cadavers.These iterms were used to explore the anatomical relation of the vertebral artery and the screw trajectory in the posterior C1、2 fixation.[Results]The depth of the vertebral artery groove on the inferior surface of the superior facet of the axial was(5.86 1.45)mm;the vertebral artery groove extented the superior facet up to its medial third in 15 sides,up to the middle third and its lateral third respective in 35 and 9 sides,and the ideal screw trajectory medial angle of these specimens were(26.4?3.44)?,(16.1?2.44)?,(15.1?2.24)? respectively。The shortest distance between the vertebral artery and the screw trajectory lied in the topmost point of the vertebral artery groove of the axial on CT images,and the interval was(2.75～5.78)mm.[Conclusion]The position of vertebral artery groove of the axial is the key to decide the angle of the screw trajectory.The shortest interval between screw trajectory and vertebral artery,safe for posterior atalanto-axial transarticular screw fixation,locates on the inferior surface of the superior facet of the axial.

[Objective] To analyze the mechanics of neotype retropharyngeal cervical hook-plate(RCHP)for atlantoaxial instability with biomechanical testing.[Methods]Six fresh adult craniocervical specimens(C0～3)used for testing the biomechanical instability were all putted into following five test courses:intact,instability(Type ⅡOdontoid fracture),RCHP,Anterior C1、2 transarticular screw fixation,brooks.Repeated statistical analysis of the data was performed using the SPSS 13.0 software package.Measures were performed with SNK testing method to determine whether significant differences existed,P=0.05.[Results]Biomechanical testing showed that,compared with the controlled group and the injured group,each fixation course significantly decreased ROM in all test modes.In the ROM of flexion,there was no significant difference between RCHP and Brooks(P=0.525),but both of them was higher than anterior C1、2 transarticular screw fixation(P