TPN can not only improve the malnutrition of organism resulted from ma- lignant tumour,but also slimulate the growth of tumour.Therefore,how to make best advantages of TPN is of great concern. From July1 994to December1 995 ,we treat- ed73patietns with malignant tumour in di- gestive tract by applying TPN,and achieved very good curative effects. We sum up our experience as following:1 perioperation and chemotherapy is a good indication oTPN which can reduce post- operation com- plication and enhance effect of chemothera- py;2 Itis contraindication of TPN to termi- nal cancer patients without operation and chemotherapy patients,TPN support is helpless;3 Operation and chemotherapy may aggravate the patients stress and cause a high matabolic rate in organism,so application of TPN should stick to the prin- ciples of metabolic support;4Taking Glu- tamine(GLN) and Se will benefit the treat- ment of tumour;5 It amy be helpful to check the growth of tumour by increasing fat emulsion,decreasing or increasing cer- tain amino acid. The questions mentioned above need futher study.

The original teaching of clinical pharmacy for stomatology course did not let students aware of the importance of drugs in the treatment of oral diseases. The original teaching framework was rearranged:decentralizing knowledge of oral diseased related clinical pharmacy into several mod-ules;setting general knowledge into the oral basic medical module;adding the practice of visiting the pharmacy and manufacturing laboratory. Teaching process was closely combined with clinics and was integrated with disease-centered oral medicine curriculum integration system. Students responded that the teaching effect was better. The rearranged teaching method can enhance students' attention on drug treatment for oral diseases,improve their ability of clinical medication and promote the teaching quality.

Objective To study the presentation,sensitivity of different diagnostic methods,snrgical modalities and pathological findings for patients of substemal goiter. Methods The clinical data of fifty nine cases of substernal goiter surgically treated were retrospectively analyzed. Results The main symptoms of substernal goiter patients were asymptomatic cervical mass(39/59),airway obstruction (13/59),hyperthyroidism(4/59),hoarseness(3/59)and choke(3/59).The sensitivity of chest X-ray,ultrasonography,CT and scintigraphy was 62.8%,15.8%,85.7%,and 50.0%respectively,and the specificity Was 99.4%,99.8%,99.5%and 99.0%,respectively.Standard cervical approach was successful for thyroidectomy operations in 57 cases.One patient underwent thyroidectomy by sternotomic approach,and another one by combined cervici-sternotomic approach.No major complications or perioperative deaths occurred.Pathology revealed nodular goiter in 48 cases.Grave's disease in one,thyroid adenoma in 2,and carcinoma in 8. Conclusions CT and chest X-ray are sensitive diagnostic techniques for substerual goiter.Cervical approach is appropriate for most substernal goiter.

OBJECTIVE To investigate the mechanisms for carbapenem resistance in clinical isolates of Pseudomonas aeruginosa from surgical intensive care unit(SICU).METHODS The minimal inhibitory concentrations(MICs) of various antibiotics were detected with agar dilution method;their ?-lactamases were extracted,types of their enzymes were identified and then their physical and chemical characteristics were studied by three dimentional extract test and isoelectric focusing(IEF) electropheresis;primers specific to IMP and VIM genes were utilized to amplify the metallo-?-lactamase genes.The levels of outer membrane protein OprD2 were measured by Western blot.RESULTS Forty one strains were resistant to imipenem from 49 strains of P.aeruginosa isolated from SICU during 3 years.Among them,34 isolates were found to produce high level of AmpC enzymes.Eight produced extended-spectrum ?-lactamases(ESBLs) at the same time.2 produced ESBLs only.No metallo-?-lactamases were detected.The activity of enzymes in the imipenem resistant group(74.32?53.42) was statistically different from the sensitive one(8.7?16.16,P

Objective To detect the dynamic Th17 cells in a murine model of irritable bowel syn-drome ( IBS) and to study the effect of aryl hydrocarbon receptor ( Ahr) on Th17 cells activation .Methods Thirty BALB/c male mice were randomly divided into three groups including experiment group ,control group and Ahr antagonist group .A murine model of IBS was established by perfusing three nitrobenzene sulfonic acid (TNBS) into the colon of mice.Equal volume of saline was used to set up the control .The mice in Ahr antagonist group were intraperitoneally injected with 10 μg Ahr antagonist for four consecutive days .All mice were evaluated for visceral hypersensitivity and colonic mucosal inflammation .Mesenteric lymph nodes (MLNs) and peripheral blood mononuclear cells (PBMCs) were detected by flow cytometry through staining Th17 cells.The distribution of Ahr and IL-17A in colon and the number of Th17 cells activated by Ahr (Ahr and IL-17A double positive ) were detected by double immunofluorescence staining .Results ( 1 ) The percentage of Th17 cells in MLNs was significantly increased in experiment group followed by those in Ahr antagonist group and control group (P<0.05).(2)Compared with control group,the number of Th17 cells in peripheral blood samples was significantly increased in experiment group and Ahr antagonist group ( both P<0.05 ) ,but there was no difference between Ahr antagonist group and experiment group ( P=0.642 ) .( 3 ) The number of Ahr-activated Th17 cells ( Ahr+IL-17A+) was significantly increased in experiment group (10.00±1.58) as in comparison with that in control group (3.80±0.83,P<0.05),but the number was de-creased with Ahr antagonist intervention ( 5.80 ±0.83 , P<0.05 ) .Conclusion The number of activated Th17 cells was increased in MLNs and peripheral blood samples from mice with IBS .Ahr played an important role in the activation of Th17 cells in intestines.However,the number of Ahr-activated Th17 cells in intestinal mucosa and the proportion of Th 17 cells in MLNs could be down-regulated through blocking Ahr .

Objective To explore the accuracy and feasibility of dual-source CT(DSCT)in evaluating the left ventricular function compared with echocardiography.Methods 30 cases of coronary heart disease were continuously collected in our hospital ,and dual-source CT and echocardiography were examined in a week.Left ventricular function parameters (LVEDV,LVESV,LVSV)were measured,and paired sample t test was compared to show whether there was any difference between the two methods,Rates betweengroups were compared with Chi-square test,Pearson correlation analysis method was applied to calculate the correlation between the two methods.Results There was no statistically significant difference for LVEDV,LVESV,LVSV,LVEF parameters between the two methods (t test,P >0.05).By Pearson test,the correlation coefficient was r=0.770-0.938(P <0.05),in which the high relation between the two methods was showed.Conclusion A strong accuracy of dual-source CT in evaluating left ventricular function is demonstrated.Dual-source CT angiography is a noninvasive assessment of coronary tree,whereas the analysis of the left ventricular parameters provides additional information of cardiac function without further radiation exposure or scan time,which can provide a more intuitive and system information for clinical.

Focal intrahepatic strictures (FIHS) refers to local strictures or stenosis of the intrahepatic bile duct induced by various factors. FIHS is easily leading to misdiagnosis and miss diagnosis. At present, most of the techniques or examinations for making position as well as qualitative diagnosis of FIHS have poor sensitivity. Paying more attention to the medical history and combined applications of various inspection methods might help to improve the diagnostic level of FIHS. In terms of treatment, we suggested for patients with suspected malignant strictures or those who were failure of medical treatment, dilation, drainage and pathological diagnosis of FIHS could be conducted by endoscopy before determining the indications and procedures of surgery based on a new anatomy classification system of FIHS.

BACKGROUND:Deluxe-PS knee prosthesis is designed based on the anatomical characteristics of the Chinese peoples’ knee joint, especial y the morphological features of femoral condyle. The distance between median and lateral knee prosthesis femoral condyle is less than that of the imported prosthesis for 3.5 mm.
OBJECTIVE:To explore the short-term efficacy of Deluxe-ps knee prosthesis in simultaneous bilateral total knee arthroplasty.
METHODS:Fifteen knee osteoarthritis patients (30 knees) were included as the experimental group, and treated with simultaneous bilateral knee arthroplasty by Deluxe-ps knee prosthesis. Twenty patients (40 knees) in the control group were treated with simultaneous bilateral knee arthroplasty by PFCSigma knee prosthesis. The knee society score, hospital for special surgery knee score and knee joint range of motion were compared between two groups;the operation time and the intraoperative blood loss were compared between two groups.
RESULTS AND CONCLUSION:The patients in both groups were fol owed-up for 12 to 24 months, with an average of 16 months. Postoperative knee pain was relieved, and the joint function was recovered satisfactorily. The knee society score, hospital for special surgery knee score and knee joint range of motion in two groups were improved significantly after treatment (P<0.05). There were no significant differences in postoperative knee society score, hospital for special surgery knee score and knee joint range of motion between two groups (P>0.05), and there was no significant difference in intraoperative blood loss between two groups (P>0.05), while there was significant difference in operation time between two groups (P<0.05). The results showed that the short-term effect of Deluxe-ps knee prosthesis in simultaneous bilateral total knee arthroplasty was satisfied.

Objective To evaluate clinical risk factors for Meropenem resistant Pseudomonas aeruginosa (MRPA) infection in surgical intensive care unit. Methods Retrospective case-control study was designed. Resultant MRPA and Meropenem sensitive Pseudomonas aeruginosa ( MSPA) cases were paired with respective control group. Candidate clinical factors including gender, malignancy, duration of ICU stay, length of operation, volume of blood loss, transfusion, kind of incision ( clean/contaminated/ infected) , and previous antibiotics history were examined by bivariates and multivariate regression. Results Risk factors for MRPA infection included duration of ICU stay before infection (odds ratio [ OR] = 2. 234, 95% confidence interval [ CI] = 1. 710 - 2. 918), administration of third generation cephalosporins (OR = 2. 885, 95% CI = 1. 133 - 7. 345) and Imipenem ( OR = 1. 238, 95% CI = 1. 469 - 35. 659). A long ICU stay (OR = 2. 284, 95% CI = 1. 772 - 2. 945), malignancy (OR =4.796, 95%CI = 2.001 -11.491), previous medication of quinolones ( OR = 3.563, 95% CI = 1.499 - 8.468) and third generation cephalosporins (OR = 3. 796, 95% CI = 1. 543 - 9. 343) were associated with MSPA infection. Conclusion MRPA infection was affected by multiple clinical factors. Short ICU stay, restrict use of third generation cephalosporins and Imipenem may help to prevent MRPA infection.

Objective: To investigate the prevalence and influencing factors of latent tuberculosis infection (LTBI) among freshmen in a vocational college in Xinjiang Uygur Autonomous Region, so as to provide insights into tuberculosis control in vocational colleges. Methods : All freshmen enrolled in a vocational college in Xinjiang Uygur Autonomous Region in 2020 were recruited and participants' demographics, life style, history of tuberculosis contacts, frequency of ventilation and disinfection in dormitories and classrooms and awareness of core tuberculosis control knowledge were collected through questionnaire surveys. LTBI was detected among freshmen by means of purified protein derivative test (PPD skin test) and chest X-ray scans, and the factors affecting LTBI were identified using a multivariable logistic regression model. Results: A total of 5 463 freshmen were screened for LTBI, with a screening rate of 100.00%, and the participants included 2 151 men and 3 312 women, with a male/female ratio of 0.65︰1, and had a mean age of (16.83±1.05) years. A total of 388 freshmen were detected with LTBI, with a detection rate of 7.10%, and no active pulmonary tuberculosis was detected. The prevalence of LTBI was 9.44% in men and 5.59% in women. Multivariable logistic regression analysis identified males (OR=1.587, 95%CI: 1.281-1.965), smoking (OR=2.108, 95%CI: 1.355-3.278) and a history of tuberculosis of families (OR=2.851, 95%CI: 1.615-5.034) as risk factors for LTBI among freshmen, and knowing core tuberculosis control knowledge as a protective factor of LTBI among freshmen (OR=0.276, 95%CI: 0.218-0.350). Conclusions The risk of LTBI was associated with gender, smoking, history of tuberculosis of families and understanding of the core tuberculosis control knowledge among freshmen in this vocational college in Xinjiang Uygur Autonomous Region. Health education about the core tuberculosis control knowledge is recommended to be reinforced among students in vocational colleges in Xinjiang Uygur Autonomous Region.