Objective To analyze the current dietary application of medium-chain triglycerides (MCT) in hospitalized patients,and clarify the appropriate indications and the role of MCT in clinical practice through evidence-based evaluation.Method A retrospective analysis was conducted on 46 cases of hospitalized patients who were administered dietary MCT between January,2012 and December,2013 in Peking Union Medical College Hospital.Results Dietary MCT were utilized in a small but increasing number of patients,who distributed in departments of gastroenterology,pediatrics,pneumology,general internal medicine,and general surgery.37.0％ of the patients had malnutrition,while 56.5％ had hypoalbuminemia.The leading indications of MCT therapy were gastrointestinal dysfunction (21 cases) and lymph circulation disorder (15 cases),while dyslipidemia (5 cases),exocrine pancreatic insufficiency (4 cases),and intractable epilepsy (1 case) served as other indications of MCT administration.Conclusions The indications of current dietary MCT application are approximately consistent with evidence from literature.However,given the scarcity of relevant researches and limited clinical application,further clinical researches with larger samples on dietary MCT are needed to provide more high-quality evidences for guidance of clinical practice.

Sarcopenia is a syndrome characterized by progressive and generalised loss of skeletal muscle mass and strength with a risk of adverse outcomes such as physical disability, poor quality of life and increasing risk of infection and mortality. Inadequate intake of nutrients (especially protein) might block muscle protein synthesis, and accelerate age-related sarcopenia progress. Age-related decline in skeletal muscle mass as well as muscle functions has been regarded as major health issues in elderly people. The domestic and foreign literature related to impact of nutritional intervention on muscle protein synthesis and muscle functions in elderly people were retrieved to evaluate the effect of nutritional intervention on muscle protein synthesis and muscle functions in elderly people.

Objective To evaluate the dietary risk factors and rational nutritonal intervention for gout and hyperuricemia.Methods PubMed,EMBASE,OVID,Cochrane Library,China National Knowledge Infrastructure (CNKI),and Chinese Wanfang Database were searched for literature related to dietary risk factors and medical nutritonal intervention for gout/hyperuricemia from January 2000 to December 2015.Strict screening of the searched literature was performed based on inclusion and exclusion criteria.The bias risk evaluation tool recommended by the Cochrane Handbook and the Newcastle-Ottawa Scale (NOS) scale were used to assess the quality of included literature.With odds ratios (OR) of gout/hyperuricemia for subjects with different dietary preferences as the main effect indicator,a meta-analysis was conducted,with data collected from literature and summarized by RevMan 5.1 software.Results Nine studies were included eventually.Compared with subjects with lowest intake of red meat,seafood,alcohol,sweented soft drinks or natural juice,the OR for gout/hyperuricemia among subjects with highest intake of these foods was 1.39 (95％ CI:1.18-1.63,P ＜0.0001),1.59 (95％ CI:1.33-1.90,P＜0.00001),3.14 (95％ CI:2.17-4.53,P＜0.00001),1.69 (95％ CI:1.17-2.43,P =0.005),and 1.46 (95％ CI:1.18-1.80,P =0.000 5),respectively.In contrast,compared with subjects with lowest intake of dairy products,vegitables (containing purine-rich vegetables) or coffee,the OR for gout/hyperuricemia among subiects with highest intake of these foods was 0.50 (95％ CI:0.40-0.64,P＜0.00001),1.01 (95％ CI:0.85-1.19,P=0.95),0.48 (95％ CI:0.30-0.78,P =0.003),respectively.Conclusions Patients with gout or hyperuricemia should avoid or restrict the intake of high-purine animal foods (especially red meat and seafood),alcohol,high fructose or corn syrupsweetened foods,while abstinence of purine-rich vegetables is not required.Regular intake of dairy products and coffee is recommended for such patients.

Objective To investigate the effect of hyperthermia combined with chemotherapy on the changes of immunity balance of Th1/Th2 and cytokines such as interleukin-2 (IL-2),interferon-γ (IFN-γ),IL-4,IL-10,and vascular endothelial growth factor (VEGF) in non-small cell lung cancer (NSCLC) patients.Methods Fifty patients with advanced NSCLC were randomly divided into thermochemotherapy group (n =25,received whole body hyperthermia combined TP chemotherapy),and chemotherapy group (n =25,received TP chemotherapy alone).The immunity balance of Th1/Th2,IL-2,IFN-γ,IL-4,IL-10,and VEGF levels before therapy and 1 week after therapy were observed.At the same time,the above observation indices were also detected as normal control in 20 healthy volunteers.Results Compared to the chemotherapy group,the proportion of Th1 cells from thermochemotherapy group was significantly increased after therapy (P =0.002) and that of Th2 cells was dropped markedly (P =0.006).There was no difference in the levels of IL-2,IFN~,IL4,IL-10,and VEGF between thermochemotherapy and chemotherapy groups before therapy (P ＞ 0.05).However,the expressions of ILA,IL-10,and VEGF in the NSCLC group were significantly higher than normal group (P ＜ 0.01).The IL-2 and IFN-γ levels were significantly decreased in NSCLC group (P ＜0.01).After therapy 1 week,the concentration of IL-2 and IFN-γfrom thermochemotherapy and chemotherapy groups were higher than before,with statistical significance (P ＜0.01).In addition,IL-4 and IL-10 levels of two groups were significantly decreased in comparison with before therapy (P ＜ 0.01),and it showed a striking difference in cytokines (IL-2,IFN-γ,IL-4,and IL-10) between two groups (P ＜ 0.05).However,the concentration of VEGF in chemotherapy group patients before and after chemotherapy had no significant difference (P ＞ 0.05).The concentration of VEGF from thermochemotherapy group patients after therapy were lower than chemotherapy group patients,the difference had statistical significance (P ＜ 0.01).Conclusions Thermochemotherapy can significantly prompt the Th2 to Th1 shift in both cells and cytokines of advanced NSCLC compared to chemotherapy alone.Moreover,thermochemotherapy also reduces the expression of VEGF,which may prevent the formation of new blood vessels in tumor tissue.

[Objective]To explore the value of the application of the arthroscope in unicompartmental knee arthroplasty(UKA)for the patients with medial osteoarthritis of the knee.[Method]A clinical retrospective study has been done on 30 knees in 21 patients.The patients were evaluated in preoperative X-rays,physical examination,the knee society score(KSS)evalution,the presentation of arthroscopical examination as well as the ultimate operation method.[Result]Arthroscopic examination showed that the osteoarthritis were mainly located in medial compartment of the knee.Tibia terrace cartilage and condyle of femur showed outbrige Ⅲ～Ⅳ degrees degeneration.26/30(87%)of the patients showed medial menisci injury in different degree,and 4/30(13.3%)of the patients showed lateral menisci degenerated,and pathological changes of osteoarthritis were located at front medial compartment.And 19/30(63%)of the patients combined Ⅰ～Ⅳ degrees of localized or broad patellar cartilage degeneration,the lateral compartment normal or localized patellar cartilage degeneration less than Ⅱ degrees for all patients.The result of the arthroscopic examination was consistent with the preoperative clinical examination and the imaging examination.All the patients received Oxford Ⅲ prosthesis UKA by microinvasive approach and there was no case that had to change operation method due to arthroscope detection.[Conclusion]1.The main purpose for the application of the arthroscopic in UKA is to deal with other disease inside the knee rather than to confirm the indication of the operation.2.Arthroscopy is an effective way for the patients combined lateral menisci injury and other compartmental mild osteoarthritis.

Myelodysplastic syndromes (MDS) is one of clonal disorders of hematopoietic stem cells.Cytogenetic,molecular genetic and epigenetic aberrances are critical to diagnosis,prognosis and treatment of MDS.5q-,-7/7q-and 20q-are the most frequent cytogenetic aberrance in MDS.Fusion genes,genetic mutation and deletion are the most important mechanisms for every subtype of MDS.Aberrant methylation plays an essential role in both initial and secondary MDS.All these aberrances are very significant for the development and transformation of MDS.Genetic and epigenetic alterations are new targets for MDS diagnosis and treatment.

Iodine is a micronutrient that is essential for the production of thyroid hormones.Either iodine deficiency or excess will not only affect the synthesis and secretion of thyroid hormone but also be related to the occurrence and development of thyroid diseases.Iodine deficiency can cause endemic goiter,cretinism,hypothyroidism and thyroid cancer;high incidence of hyperthyroidism,hypothyroidism,autoimmune thyroid disease,goiter,and thyroid cancer are associated with excessive iodine intake.It is essential to assess iodine nutritional status for the populations,particularly those with thyroid diseases.

In recent years,pharmacological researches of Chinese medicine found that the single Chinese medicines of activating blood and dissolving stasis,such as Drynaria and Bidentata and Salvia and Panax notoginseng had very good effects of resisting osteoporosis,significantly improving bone mineral density(BMD)and bone mineral content(BMC),promoting bone formation,and preventing bone absorption.Based on the documentations from home and abroad,the overview had analyzed the current situation for providing new ideas and methods of osteoporosis prevention and treatment.

Objective To evaluate the value of echocardiography in patients with isolated anomalous origin of right pulmonary artery from ascending aorta. Methods The eehoeardiographie results of five patients with isolated anomalous origin of right pulmonary artery from ascending aorta were reviewed retrospectively. Results Severe pulmonary hypertension occurred in all the patients,besides accompanied with patent duetus arterious, no other congenital malformations combined. Three patients underwent operation. Patent ductus arterious was missed in one patient's diagnosis. Another patient was missed isolated anomalous origin of right pulmonary artery from ascending aorta in several echoeardiographic examinations, once misdiagnosed as complete transposition of the great arteries. Conclusions There are many anatomic and hemodynamic similarities in patients with isolated anomalous origin of right pulmonary artery from ascending aorta. Grasping their common charaeters and exploring multi-position and multi-section are helpful to make correct diagnosis.

Objective: To establish a method for determination of isofraxidin in Xiaoerkaiwei Oral Liquid (Radix Acanthopanacis Senticosi, Endothelium Corneum Gigeriae Galli, Semen Alpiniae Katsumadai, Semen Pharbitidis, etc.) by RP HPLC. Methods: The HPLC system consisted of Symmetry C 18 column(3.9m?150mm, 5?m), methanol water (0.1% formic acid) (30∶70) mixture as a mobile phase, detection wavelength at 342nm, 0.8mL?min -1 of flow rate and column temperature at 30℃.Results: The calibration curves of the isofraxidin were linear ( r =0.9993). The precision were perfect ( RSD =1.87). The samples were stable in 6 h. The average recovery of Xiaoerkaiwei Oral Liquid was 102.4% with RSD of 1.76%.Conclusion: This method is simple, quick and specific, suitable for the quality control.