With the rise of the incidence of Crohn's disease,clinicians began to recognize and pay attention to this disease.There is no effective method to cure the Crohn's disease currently,and the complications of the Crohn's disease are numerous and complex.Therefore,early diagnosis and treatment are very important.Due to many factors,the problen of diagnostic delay is widespread.Female patients diagnosed younger than 40 years old,the presence of ileal disease,use of non-steroidal anti-inflammatory agents,smoking history,parental symptoms are risk factors of diagnostic delay of Crohn's disease.Delayed diagnosis might increase the risk of complications,especially intestinal stenosis and operation-related complications.Crohn's disease needs to be early diagnosed and treated to improve the prognosis of patients.

OBJECTIVE:To provide reference for the informational and automatic management in Pharmacy intravenous admix-ture service (PIVAS). METHODS:The composition and practical application of PIVAS automatic management system developed in our hospital were introduced,and ratio of irrational medical order,drug dispensing efficiency and the numbers of error before and after application were compared to evaluate its effect. RESULTS & CONCLUSIONS:The work process was intelligently opti-mized,PIVAS automatic management system developed in our hospital composed by automatic prescription audit system,intelli-gent drug dispensing system,intelligent liquid preparation system,automated sorting system and automatic transportation system, which respectively achieved the automated audit of prescription,intelligent drug dispensing and labeling,responsibility traced in drug dispensing,intelligent mixed deployment of intravenous infusion,automated sorting and transportation of finished products of transfusion liquid. The ratio of irrational medical order decreased from 2.07%to 1.73%,time of drug dispensing and labeling short-ened from(3.15±0.53)h to(1.55±0.27)h,numbers of error within daily dispensing decreased from 0.26±0.78 to 0.06±0.13, numbers of error within daily sorting of finished products of transfusion liquid decreased from 6.57 ± 1.76 to 0.07 ± 0.17. The con-struction of the system achieves the information and automation of major work in PIVAS and improves the management level of PI-VAS.

Objective To determine the effectiveness and medical cost-effectiveness of clinical rehabilitation for promoting the functional recovery of sub-acute cerebral infarction patients.Methods Totally 247 sub-acute patients with cerebral infarction were randomly divided into a clinical rehabilitation group of 129 and a routine rehabilitation group of 118.The clinical group received a standardized rehabilitation intervention and drug treatment,while the routine rehabilitation group received routine rehabilitation therapy and drug treatment.The Fugl-Meyer assessment (FMA) and the modified Barthel index (MBI) were used to compare the two groups after the treatment and 3 and 6 weeks later.The hospital cost for six weeks was also compared between the 2 groups.Results At 3 and 6 weeks,improvement in the average FMA and MBI scores was observed in both groups but the inter-group differences were not significant.The total hospital cost of the clinical group was,however,significantly less than that of the others.Conclusion Clinical rehabilitation can improve the motor function and ability in the activities of daily living of stroke patients.It also has economic benefits.

OBJECTIVE:To study the resistance effect of LaCl3 on different varieties of mint under saline-alkali stress with dif-ferent concentrations,and provide theoretical and experimental basis for its planting. METHODS:NaCl saline stress and NaHCO3 alkali stress with low,medium,high concentrations(25,50,100 mmol/L)were conducted for 4 kinds of mint [Mentha haploca-lyx Briq.,Mentha spicata Linn.,Monarda didyma L.,Mentha rotundifolia (Linn.)huds]. Growth indexes (survival rate,plant height,fresh weight and dry weight)were determined,and mint species with good resistance were screened. The effect mechanism of La3+ on growth indexes in saline-alkali stress with different concentrations,osmotic regulation indexes [soluble sugar(SS),solu-ble protein (SP), proline (Pro)], antioxidant activity indexes [superoxide dismutase (SOD), peroxidase (POD), catalase (CAT)],the yield of volatile oil,and resistance were determined. RESULTS:After saline-alkali stress,M. didyma and M. rotundi-folia had low survival rate,which were not suitable for growth under given climatic conditions. For M. haplocalyx and M. spicata, saline-alkali stress with low concentration can significantly increase the growth indexes under no artificial intervention. La3+ can sig-nificantly increase the yield and CAT activity under no stress. Compared with non-spraying La3+group,the SOD,CAT,POD activi-ties of mint added La3+ under saline stress with low,medium,high concentrations,plant height and fresh weight under alkali stress with high concentration,SOD activity and SS content under alkali stress with medium,high concentrations,and POD activity un-der alkali stress with medium concentration were significantly increased. CONCLUSIONS:Spraying La3+ can significantly improve the growth of M. haplocalyx and M. spicata under alkalized soil with medium,high concentrations. Mentha haplocalyx Briq. is se-lected as the mint specy with the best saline-alkali resistance.

Objective To explore the influences of health belief model education on training of international classifiction of functioning,disability and health (ICF) generic set in nurses.Methods Eighty-four nurses from 28 hospitals received a set of education of ICF generic set based on health belief model.Nurses' knowledge and belief of ICF generic set were evaluated before and after education.Results The score of ICF generic set knowledge after education was (5.63±0.75) points,which was higher than that of before education 1 (2) points,and there was significant difference (Z=10.092,P＜ 0.05).The scores of ICF generic set belief and perceived susceptibility and perceived barriers dimensions were (63.01±7.04),(11.21±1.45),(13.87±2.68) points after education,and (59.62±6.25),(10.11±3.07),(12.68±3.63) points before education,and there were significant differences(t=3.301,2.986,2.414,P＜ 0.05).Conclusions The heath belief model education can improve the ICF generic set knowledge level of nurses,enhance the nurses' confidence and lower the possible perceived barriers in the application of ICF generic set,and thereby can improve the ICF generic set belief level of nurses.

Crohn's disease (CD) is a chronic inflammatory disorder affecting any part of the digestive tract which relapses and remits throughout the disease course. It occurs in individuals with genetic susceptibility and involves an abnormal response of the immune system to the external environment. Besides, improved hygiene, abuse of antibiotics, westernization of diet with high sugar and fat are thought to be associated with rapidly increasing incidence of CD. Certain components of foods may influence gut inflammation through antigen presentation and alteration of the microflora. This article aims mainly to review diet-related clinical studies to outline its roles in the pathogenesis and progress of disease, and then give some evidence-based suggestions.
Crohn Disease ; Diet ; Genetic Predisposition to Disease ; Humans

Crohn disease (CD) is a chronic inflammatory disease which progressively affects the digestive tract with unknown etiology. During the disease course, intestinal fibrosis will gradually develop in many CD patients and results in irreversible fibrosis stricture, causing refractory abdominal pain and even intestinal obstruction, and necessitating one or more surgical interventions. Thus far the exact etiology of CD remains unknown. It is believed that genetic, environmental and immunologic factors are involved, which may also predict the development of intestinal fibrosis. Recent studies have found the association of mutations in genes, such as NOD2, ATG16L1, CX3CR1, IL-23R and MMP3 with the fibrogenic phenotype of CD. In addition, serum extracellular matrix molecules, growth factors, miRNAs and microbial antibodies have also been linked to the fibrogenesis in CD patients, however the results of researches were divergent. Therefore it is of significance to explore noninvasive markers of intestinal fibrosis with high sensitivity and specificity, and the high-throughput proteomic technique may be an approach that deserves further investigation. Screening the high-risk patients for the fibrostenotic phenotype of CD by susceptibility genes, and early detection of intestinal fibrosis using noninvasive serum markers, will help improve the treatment outcomes and reduce the surgical rates. The article aims at summarizing the current susceptibility genes and serum markers of intestinal fibrosis in CD.

OBJECTIVETo observe the therapeutic effects of S-Adenosyl-L-methionine(SAMe) in the treatment of cholestasis after total parenteral nutrition (TPN).

METHODSThirty SD rats were randomly divided into control group, hypercalorie group, hypercalorie adds SAMe group; sepsis group and sepsis adds SAMe group; their stages of cholestasis were compared. Sixteen patients received SAMe because of cholestasis after prolonged TPN.

RESULTSBile flow, serum levels of total bile acid and gamma-glutamyl transpeptidase were elevated markedly in hypercalorie and sepsis groups. Hepatocellular fatty degeneration, dilatation of cholangiole, and bile sludge could be seen microscopically, while SAMe administration in hypercalorie adds SAMe and sepsis adds SAMe groups could increase bile flow, decrease serum total bile acid and gamma-glutamyl transpeptidase levels. Microscopic findings were normal, no dilated cholangiole or bile sludge could be found. Cholestasis and abnormal results of liver function test were the main clinical manifestations of 16 patients before SAMe administration. Three weeks after SAMe administration, their serum levels of total bilirubin, alkaline phosphotase, gamma-glutamyl transpeptidase, alanine aminotransferase(ALT), and aspartate aminotransferase(AST) were decreased markedly; they became normal in the 4 th week.

CONCLUSIONSAMe could prevent and treat cholestasis without discontinuation of TPN.

Adult ; Animals ; Cholestasis ; drug therapy ; metabolism ; pathology ; Female ; Humans ; Liver ; pathology ; Male ; Middle Aged ; Parenteral Nutrition, Total ; adverse effects ; Rats ; Rats, Sprague-Dawley ; S-Adenosylmethionine ; therapeutic use

OBJECTIVETo investigate the effect of rehabilitation therapy for short bowel syndrome on patient nutritional status and intestinal adaptation.

METHODSThe rehabilitation therapy included enteral or parenteral nutrition, glutamine, recombinant human growth hormone and rehabilitative diet. From January 1997 to July 2000, twenty - seven patients with short bowel syndrome received the treatment. The average age of the patients was 38.5 +/- 19.3 years, and the length of residual small intestine ranged from 15 to 80 cm, with an average of 46.8 +/- 23.4 cm. The ileocecal valve was preserved in 14 cases, and the average time between the onset of short bowel syndrome and the rehabilitation therapy was 86 +/- 105 days.

RESULTSAfter the treatment, nutritional status of the patients improved markedly, and intestinal absorptive capacity improved. Eight patients were followed up for more than 2 years, among whom 4 (50%) were weaned from total parenteral nutrition. Thirteen patients were followed up for more than 1 year, and 10 patients (76.9%) were weaned from total parenteral nutrition.

CONCLUSIONSRehabilitation therapy for short bowel syndrome can improve patient nutritional status effectively and promote intestinal adaptation, providing a new hope for these patients. The therapeutic effects are related to the length of the residual small intestine, patients age and duration between massive intestinal resection and start of the treatment. Early initiation of rehabilitation therapy promotes intestinal adaptation and increases patients ability to wean from total parenteral nutrition.

Adolescent ; Adult ; Aged ; Blood Proteins ; metabolism ; Body Weight ; Child ; Female ; Follow-Up Studies ; Hemoglobins ; metabolism ; Humans ; Intestinal Absorption ; Male ; Middle Aged ; Serum Albumin ; metabolism ; Short Bowel Syndrome ; rehabilitation ; Treatment Outcome

OBJECTIVESTo evaluate the essentials for successful management of entero-cutaneous fistulas and their.

METHODSWe analyzed. The therapeutic results of 1 168 cases treated in a single center from January. 1971 to December. 2000.

RESULTSIn these patients, the cure rate of fistulas was 93% and 37.1% after non-operative treatment. Most cases died of sepsis (60/65 cases, 93.2%) with a total mortality of 5.5%. In 659 cases who had undergone operation for enteric fistula, 647 (98.2%) recovered. The cure rate, mortality rate and successful rate of operation (94.2%, 4.4%, 99.7%) in the period of January. 1985 - December. 2000 were better than those (90.4%, 8.2%, 95, 5%) in the early period of January 1971 December 1984 (P < 0.05).

CONCLUSIONSThe change of therapeutic strategy, improved technique in control of sepsis, rational nutritional support and careful monitoring of vital organs are essential to the management of enteric fistulas. How to increase the spontaneous closure of fistula, the therapeutic rate of specific enteric fistula (e.g. IBD, radiation enteritis) and the operative rate of enteric fistula in the early period requires further study.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; Digestive System Fistula ; mortality ; therapy ; Female ; Humans ; Infant ; Male ; Middle Aged ; Nutritional Physiological Phenomena ; Postoperative Complications ; microbiology ; mortality ; Treatment Outcome