Clinical nutrition, medical treatment and nursing constitute the three pillars in searching for the best curative effect. In view of the fact that the management and overall construction of the nutrition department seriously lags behind medical and nursing work, which impairs the quality and image of the hospital and hinders its overall development, the authors, basing themselves on the realities and having their eyes on the future, explore the overall construction of the nutrition department from the perspectives of disciplinary orientation identification, management system, personnel training, and hardware construction. They argue that the key to the construction of the nutrition department lies in identifying disciplinary orientations and implementing policy favor; carrying out the manning quotas and laying solid organizational foundations; strengthening personnel training and grasping key development opportunities; streamlining the management system and safeguarding a healthy development.

Objective To observe the effectiveness of routine nursing plus foot exercise on the peripheral neuropathy and plantar pressure in patients with diabetic foot.Methods Toally 100 patients with diabetic foot were randomly divided into 2 groups.On the basis of routine nursing care,50 patients in the observation group were given foot exercises for 12 weeks,50 patients in the control group were given routine nursing only.Before and after intervention,the Toronto clinical scoring system (TCSS),left and right foot peak pressure variation were observed.Results Before intervention,there was no statistical difference between the two groups' TCSS sore and the peak pressure of left and right foot (P ＞0.05).After intervention,the observation group's average total score of TCSS was lower,there was significantly different between two groups (P＜ 0.001).The peak pressure of left and right foot is lower in the observation group,the difference was statistically significant (P ＜ 0.05).Conclusion Foot exercises is worthy of clinical promotion,because it can improve the peripheral neuropathy of patients with diabetic foot,so as to reduce the plantar pressure,reduce the pain of patients and improve their life quality.

BACKGROUND: Selenium is one of necessary microelement of human body. It acts as the active center of selenium-contained enzyme with antioxidant function, which can clean up internal free radical, effectively catalyze harmful perhydride deoxidizing into innocuous hydroxyl compound,reinforce immunity of human body, prevent and cure cardio-cerebrovascular diseases and cancer.OBJECTIVE: To provide evidence for preventing and treating cardiocerebrovascular diseases via comparison of blood selenium content between patients and healthy persons.DESIGN: Case-control analysis.SETTING: Dalian Railway Medical School, Dalian Railway Hospital, Department of Applied Chemistry, Dalian Railway College.PARTICIPANTS: Totally 319 blood samples (169 males, 150 females)were collected from patients with cardio-cerebrovascular diseases from Dalian Railway Hospital from March 2000 to May 2001. Among them,there were 164 with hypertension, 97 with coronary atherosclerotic heart disease (CAHD), 41 with cardiac dysrhythmia and 17 with cerebral vascular accident. 300 healthy patients (159 males and 141 females) were in the healthy group.METHODS: The blood selenium content of patients with cardio-cerebrovascular diseases was detected with neopolarography.MAIN OUTCOME MEASURES: ①Total level of blood selenium of testees of the two groups. ②Comparison of level of blood selenium between males and females. ③Comparison of level of blood selenium of patients with different diseases.RESULTS: A total of 619 testees were involved in the result analysis. ①The total level of blood selenium of the patient group was lower than that of the healthy group [(114.0±52.5), (146.5±51.0) μg/L,P ＜ 0.001],which was only 76% of that of the healthy persons. ②Content of blood selenium of males and females was normal distribution. There was insignificant difference between males and females (P ＞ 0.10), but the level of blood selenium in females was slightly higher than that of males. ③The levels of blood selenium of patients with hypertension, CAHD, cardiac dysrhythmia were 82.7%, 68.6% and 66.0% of that of healthy persons, respectively, but the difference between males and females was insignificant(P ＞ 0.10). The level of blood selenium of patients with cerebrovascular accident (CVA) was the lowest, (84.4±28.9)μg/L, which was 57.6% of healthy persons.CONCLUSION: The content of blood selenium of patients with cardiocerebrovascular diseases is lower than that of healthy persons. Organic selenium and inorganic selenium should be supplemented moderately.

BACKGROUND:Recent studies have shown that adipose-derivedmesenchymal stem cells (ADMSCs) not only have multilineage differentiation potential, but also exert an important role in blood sugar balance and hormone production.OBJECTIVE:To observe the differentiation potential of human ADMSCs (hADMSCs) into functional islet-like cells and the therapeutic effect of hADMSCs transplantation in diabetic rats.METHODS:PDX-1 gene was transfected into hADMSCs by adenovirus. Cell differentiation and insulin secretion were identified and detected by dithizone staining and ELISA, respectively. Twenty male Sprague-Dawley rats were randomly divided into control group (n=4), diabetes group (n=8) and transplantation group (n=8). Rats in the latter two groups were subjected to making diabetic models by 65 mg/kg streptozotocin injection. Afterwards, rats in the transplantation group were given PDX-1 transfected ADMSCs via the tail vein.RESULTS AND CONCLUSION:At 15 days after transfection, the number of insulin positive cells and insulin secretion were both increased significantly (P < 0.05). Fasting glucose levels in the transplantation group decreased significantly (P < 0.05), while the body weight increased significantly (P < 0.05). In the diabetic group, the fasting glucose level still maintained at a high level, and the body weight of rats was significantly decreased. These results implicated that PDX-1 gene could induce hADMSCs differentiating into functional islet-like cells. PDX-1 transfected ADMSCs transplantation is effective in treating diabetic rats, but the mechanism needs further study.

Objective To explore the growing change of sizes of lateral cerebral ventricle in second-third trimester normal fetuses in MRI,to provide the normal reference for clinical monitoring.Methods MRI findings in 98 normal second-third trimester fetuses were retrospectively analyzed.The fetuses were divided into 6 groups according to gestational age (unit:week)including 18-21,22-25,26-29,30-33,34-37 and 38-40 weeks,respectively.The maximum transverse sizes of fetal atrium and occipital horns of lateral ventricle (cm)were measured.The SigmaStat statistical program was used for statistical analysis.Results The length of lateral ventricle atrium horn in 6 groups were 0.35 ± 0.03,0.33 ± 0.05,0.31 ± 0.04,0.30 ± 0.03,0.26 ± 0.05 and 0.25 ± 0.04,respectively,and the ventricle length of occipital horns were 0.91± 0.09,0.84 ± 0.09,0.84 ± 0.1 1,0.81 ± 0.13,0.80 ± 0.1 1 and 0.74 ± 0.13,respectively.The length of lateral ventricle atrium horn and ventricle occipital horns among some differ-ent groups showed significant differences (P <0.05).The length of fetal ventricle atrium and occipital horn were reduced gradually with gestational ages.Conclusion The ventricular length of atrium and occipital horn in second-third trimester normal fetuses reduce gradually with gestational ages.

Objective To explore the change of signal value in the fetal frontal lobe with gestational age in normal second-third trimester fetuses.Methods MRI findings of 125 normal second-third trimester fetuses were divided into 5 groups according to gesta-tional age (unit:week)including 1 7-21,22-26,27 -31,32 -36,37 -40,respectively.The signal values were measured in inferior frontal,middle and upper,respectively.Results The signal value of fetal frontal lobe in 5 groups were 387.38 ± 1 66.75,354.46 ± 1 74.78,342.24±141.23,338.90±1 10.94,310.23±1 18.62,respectively.The signal value was 341.77 ±149.22,35 1.00±145.1 6, 342.85±140.61 in inferior frontal,middle and upper,respectively.The signal value of frontal lobe was 350.34±147.68 in the left and 340.73±144.29 in the right.There were no significant statistical differences on fetal frontal lobe signal value in each group (P>0.05).But the signal value in the frontal lobe had a gradually decreasing trend with fetal age,along with the signal value in the central frontal was higher than the other two parts of the frontal lobe and the left is slightly higher than the right.Conclusion The signal values in frontal lobe of normal second-third trimester fetuses were gradually decreased as gestational age increasing,with the signal values in central frontal lobe was higher than that of in margin of frontal lobe,and the left side was slightly higher than the right.

Objective To investigate the applicability of the K~+ concentration in aqueous humor to estimate postmortem interval(PMI).Methods 30 White New-Zealand rabbit were sacrificed by air embolism and divided into 10 groups.Aqueous humor and vitreous humor were sampled at 0.5h,1h,3h,6h,8h,12h,16h,20h,and 24h after death.The concentration of potassium,sodium and calcium were analyzed by an autoanalyzer and the data were statistically processed by SPSS software for Windows.Results Increase in potassiam concentration in aqueous humor was correlated with the postmortem interval(R~2=0.956).Conclusion Measurement of potassium concentration in aqueous humor may be used for PMI estimation.

Objective To evaluate the feasibility of PerkinElmer Genetic Screening Processor(GSP) in the application of newborn screening for congenital hypothyroidism (CH) and congenital adrenal hyperplasia (CAH) by detecting thyroid-stimulating hormone (TSH) and 17-OH-progesterone(17-OHP).Methods The dried-blood spots specimens from Centers for Disease Control and Prevention(CDC) and the quality control in the reagent kit were detected and the accuracy,precision and linearity were calculated.A total of 1 012 samples of TSH(60 of positive and 952 negative samples) and 991 samples of 17-0HP(34 positive and 957 negative samples)were detected.The initial cut-off value was determined by ROC curve determined.The consistency between the results from GSP and clinical diagnosis was analyzed.Results The average of within-run coefficient of variation(CV) of TSH and 17-OHP were 6.69％ to 12.6％ and 7.52％ to 9.29％,and the average of between-run CV were 6.91％ to 10.96％ and 6.86％ to 12.36％,respectively.The average of bias of TSH and 170HP were-14.28％ to-0.74％ and-0.45％ to 12.54％.The linearity of GSP detection was fine.The initial cut-off values were 23.43 U/mL(TSH) and 21.42 ng/mL(17-OHP).The sensitivity of GSP detection was 100％ and the specificity of TSH and 17-OHP were 98.11％ and 99.58 ％ respectively.The results of GSP detection showed good consistency with clinical diagnosis.Conclusion As the first real automatic fluorescence immunoassay analyzer,GSP could be used in routine clinical diagnosis for CH and CAH.

Objective To evaluate the color Doppler ultrasonography and contrast enhanced ultrasound (CEUS) findings of congenital intrahepatic portosystemic venous shunts (IPSVS).Methods Nineteen patients of congenital IPSVS were examined with color Doppler ultrasonography and CEUS.All patients were confirmed by CT angiography.The hepatic artery arrival time (HAAT),portal vein arrival time (PVAT),and hepatic vein arrival time (HVAT) on CEUS were recorded.The interval time between hepatic artery arrival time and hepatic vein arrival time (HA-HVTT) and the interval time between portal vein arrival time and hepatic vein arrival time (PV-HVTT) were calculated.Results The types of IPSVS between portal and systemic veins were based on Park's classification.Color Doppler ultrasonography showed abnormal communication between the portal vein branch and the hepatic veins,duplex Doppler ultrasonography showed abnormal spectral pattern from the portal vein such as undulating,triphasic waveform mimicked that of the hepatic vein.CEUS demonstrated abnormal communication between portal vein branch and hepatic vein.HVAT,HA-HVTT,and PV-HVTT were shorter statistically in congenital IPSVS group than those in cirrhosis and normal groups.Conclusions Congenital IPSVS is a rare vascular abnormality that is usually asymptomatic.Color Doppler ultrasonography is a useful tool for diagnosis of congenital IPSVS.CEUS provides helpful data for the diagnosis and differential diagnosis of congenital IPSVS.

Objective To study the prognosis of gastroesophageal reflux disease ( GERD) in children, and explore the factors which impacts on the prognosis of GERD. Methods One hundred and thirteen children with GERD were enrolled on the basis of positive result of 24-hour pH-monitoring between January 2007 and November 2011. The number of patients who were followed up was 87,and the parents of children were contacted with the telephone. The prognosis was evaluated by comparing the degree of patients′symptom relief,and the cumulative symptom relief rate was calculated by Kaplan-meier product limit method. The univariate Log-rank test and the COX proportional hazardmodel multivariate analysis were applied to detect the factors impacting on the prognosis,including age,gender,the regularity of treatment,reflux index,and Boix-Ochoa standard score,with esophageal hiatal hernia or without,receiving surgical treatment or not,the diet and lifestyle improved or not,receiving anti-acid treatment or not,as well as with allergies his-tory or without. Results At last,76 out of 87 children had symptom relieved. Survival curve showed the cumulative symptom relief rate at different time points,the median cumulative symptom relief rate reached 6 months,the final relief rate was close to 90. 0%,and the continuous treatment time was 44 months. The study showed that 14. 9% (13/87 ca-ses) of children′s growth and development were affected and the life and learning in 16. 1% (14/87 cases) of children were impacted. Age (P=0. 012,Wald=6. 376) and the regularity of treatment (P=0. 000,Wald=13. 059) were the risk factors in the prognosis of GERD. Conclusions Age and the treatment regularity were the factors in the prognosis. The children aged more than 1-year old have poor prognosis compared with those less than 1-year old,and the irregular treatment is the risk factor in the prognosis.