Objective: To investigate the prevalence of nutritional risk,malnutrition and application of nutritional support in department of digestive trad in our hospital in Ningbo.Methods: The information of 205 patients were collected in our hospital.Nutrition status was assessed according to Nutrition Risk Screening(NRS) published by ESPEN in 2002.Results: A total of 205 patients were enrolled,and 189 patients(92.2%)underwent NRS 2002.Prevalence of malnutrition was 20.0% and nutritional risk was 32.7%.Totally 18 patients(8.8%) receiving nutritional support had a NRS2002≥3.The PN∶EN ratio was 2.6 ∶1. Conclusion: A large proportion of inpatients were at nutritional risk or malnutrition in our hospital.The application of PN and EN is inappropriate in inpatients.Evidence-based guidelines are required to improve this situation.

OBJECTIVE:To explore the role of clinical evidence-based pharmacy in anticoagulant treatment strategies during continuous renal replacement therapy (CRRT). METHODS:Taking a thrombocytopenia patient of anticoagulant treatment during CRRT for instance,clinical pharmacists analyzed the evidence of taken argatroban anticoagulant therapy during CRRT for high risk blooding and thrombocytopenia patients based on evidence-based pharmacy combined with clinical data,monitored the efficacy and safety and evaluated the treatment process. RESULTS:Totally five literature about anticoagulant treatment strategies during CRRT for high risk blooding and thrombocytopenia patients were obtained,including one systematic review,one RCT and three cohort studies. Based on the above evidences,good results were achieved in the clinical practice of this patient,no thrombotic or hemor-rhagic complications occurred in this patient,platelet count and coagulation indicators of patients also improved. CONCLUSIONS:Evidence-based pharmacy plays an important role in anticoagulant treatment strategies during CRRT.

AIMTo evaluate CYP3A activity of hum an liver microsomes by the ratio of lidocaine(LDC) to its metabolites. M ETHODSIn 1 g?L -1 microsomal protein lidocaine was incubated at 37 ℃ for 1 hour. Lidocaine, monoethylglycinexylidide(MEGX) and glycinexylidide(GX) were determined by HPLC. RESULTSThe linear regress equations fo r LDC, MEGX and GX were = 0 293 4 X- 0 005 661 (r= 0 9 99 7 )、= 0 791 3 X- 0 008 916 (r= 0 999 3 ) and = 0 679 9 X- 0 007 770 (r= 0 998 5 ). The best conditio n for the incubation test in vitro was 2 0 mg?L -1 LDC plus 1 0 g ?L -1 microsomal protein for 60 min. The mean (MEGX+GX)/LDC ratio was 3 2 8. CONCLUSIONThe (MEGX+GX)/LDC ratio can be used to evaluate C YP3A activity of human liver microsomes.

Objective To explore the clinical efficacy and safety of intraoperative radiotherapy (IORT) for the patients with unresectable locally advanced pancreatic cancer. Methods Cochrane library, PubMed, EMbase, CBM, CNKI, VIP database and WANFANG database were used to retrieve, in addition to manual retrieval important literature references and conference papers. The randomised controlled trials, cohort study, controlled clinical trials of the IORT in unresectable locally advanced pancreatic cancer were searched. According to the inclusion criteria and exclusion criteria, after the extraction of literature and data, RevMan 5.3 software was used for meta-analysis. Results The total of 1 401 articles were retrieved, 7 met the inclusion criteria, including 1 for randomized controlled trials, 4 for cohort study, 2 for case-control study. 313 cases in the IORT group, 362 cases in the control group, and meta-analysis showed that IORT group was better than control group in overall survival (OS) (Z=4.15, P<0.000 1, RR=2, 95%CI 1.05-2.94). Because lack of complete data in local control rate, pain remission rate, complications, descriptive analysis was done, rather than meta-analysis. Conclusions IORT may improve the OS of patients with unresectable locally advanced pancreatic cancer and the local control rate, and effectively alleviate pain with favorale safety but it still needs high quality randomized controlled trials to confirm.

OBJECTIVE:To evaluate the economic effectiveness in different pharmacotherapeutic schemes for Hp infection in children.METHODS:To analyze four therapeutic schemes for Hp infection in children with cost - effectiveness analysis.RESULTS: The cost- effectiveness ratios of four therapeutic schemes were 14.92,8.85,8.37 and 8.58 respectively. CONCLUSIONS: scheme C(clarithromycin + bismuth potassium citrate + metronidazole)is the best one.

Objective:To find out the current situation of and objectively evaluate the use of the antidiabetic agents so as to provide reference information to the departments of production, sales and consumption of the agents. 　Methods:A analytic review of 6,639 020 prescriptions during the period of 1995～1999 was made regarding the costs and DDDs.　Results: In recent 5 years, the annual increase rate of the expenses for was(36.03±11.92)%; and that of DDDs was 20.05%. The order of expenses for various antidiabetic agents from high to low was as follows: glicalazide, acarbose, glipizide and metformin, while that of DDDs was glicalazide, glipizide, metformin and acarbose. The percentage of expenditure for oral versus the injection antidiabetic agents was(87.08±3.50)% to(12.92±3.50)%. 　Conclusion: The antidiabetic agents is a kind of common drugs with a bright future of development.

Objective To adopt Orem self-care model to assestt the dependency care ability of care-givers for surgery orphans and analyze its defective level of dependency case,then propose corresponding nursing policy. Methods 16 caregivers for surgery orphans were surveyed with self-made questionnaire which included the general condition of the caregivers,the nursing situation for orphans and the require-ment for dependency care ability of the caregivers.Results All questionnaires were withdrew.The pro-portion of providing correct primary care for orphans was up to 62.50%～93.75%.But the proportion of pro-viding correct rehabilitation exercises was lower than 43.75%.96% caregivers wished to obtain the relative nursing knowledge by training and improve their dependency care ability.Conclmions The caregivers' dependency care ability can meet the needs of orphans' basic dependency care.But the defect still exists,the nurses should adopt different nursing compensation for different orphans and different care defects.

Objective To investigate the incidence of the ETV6/RUNX1 fusion gene among Chinese pediatric patients with B-ALL and its effect on the prognosis. Methods A total of 723 patients with B-ALL from January 1, 2007 to December 31, 2014 were enrolled in this study. All patients were detected ETV6/RUNX1 fusion gene by FISH. Clinical data and ETV6/RUNX1 were combined to analyze the clinical prognosis. Results Among the 723 patients, 151 were with ETV6/RUNX1 positive B-ALL, accounting for approximately 20.89%(151/723) of B-precursor cases;91 patients were with recurrence, including 10 patients with ETV6/RUNX1 positive B-ALL, and the recurrence rate of ETV6/RUNX1 positive B-ALL was 10.99%(10/91). Among 10 recurrent patients with ETV6/RUNX1 positive B-ALL, 9 patients relapsed more than 300 days later after diagnosis, while the recurrence times among the patients with ETV6/RUNX1 negative was very different. Although the recurrence times between the two groups showed no signiifcant difference (P?=?0.09), the recurrence times of ETV6/RUNX1 positive patients were mainly found at the end of clinical chemotherapy, while the recurrence time of ETV6/RUNX1 negative patients were mainly at maintaining chemotherapy period, there was a signiifcant difference between the distribution of recurrence time (P?

Objective To compare the effectiveness and safety of Onyx and n-butyl-2-cyanoacryhte (NBCA) for the embolization of cerebral arteriovenous malformations (AVMs).Methods The clinical data of 53 patients with cerebral AVMs (31 in the NBCA group and 22 in the Onyx group) were analyzed retrospectively.The safety and effectiveness of the 1-year follow-up were compared.The size of AVMs (diameters ＜3 cm,3-6 cm,and ＞6 cm) and the Spetzler-Martin grade were used to conduct subgroup analysis.Results There were no significant differences in the baseline data and AVM morphologies.The embolization rate in the Onyx group was significantly higher than that in the NBCA group (P ＜ 0.05),but there were no significant differences in the incidences of postoperative hemorrhage (1/22 vs.1/31;P=1.000)and neurological deficit (1/22 vs.3/31;P=0.633) in the 1-year follow-up after procedure.The subgroup analysis showed that the embolization rates of the small and medium-sized cerebral AVMs in the Onyx group were significantly higher than those in the NBCA group (all P ＜ 0.05),and the embolization rates of cerebral AVMs with different Spetzler-Martin grades in were significantly higher than those in the NBCA group (all P ＜0.05).Conclusion Onyx is equivalent to NBCA in safety but better in efficacy.

Objective To investigate the diagnostic value of heart-type fatty acid binding protein (H-FABP) versus cardiac trofonin I (cTnI) and creatinekinase-MB (CK-MB) in early diagnosis of acute myocardial infarction (AMI) in elderly patients.Methods 67 patients with acute chest pain were selceted sequentially and divided into AMI group (n＝30) and non-AMI group (n=37).Plasma H-FABP level was rapidly detected by using colloidal gold reagent plate and solid phase immunochromatographic assay for qualitative determination within and after 6 hours of AMI onset.Plasma levels of cTnI and CK-MB were determined within and after 6 hours of onset.The diagnositic value of H-FABP,cTnI and CK-MB in AMI was compared within and after 6 hours of onset.Results The sensitivity of H-FABP was better than that of cTnI and CK-MB within 6 hours of onset (93.3％ vs.46.6％,23.3％,both P＜0.05).The negative predictive value of H-FABP was better than that of cTnI and CK-MB within 6 hours of onset (94.7％ vs.69.8％,61.1％,both P＜ 0.05) While,positive predictive value and specificity were basically the same between H-FABP,versus cTnI and CK-MB.H-FABP and cTnI levels had significant differences between AMI and non AMI group after 6 hours of onset (all P＜0.05).Plasma levels of cTnl and CK-MB were higher after 6 hours than within6 hours [cTnI (4.10±1.79) mg/L vs.(1.45±1.31) mg/L,CK MB(180.52± 158.70) U/L vs.(20.02± 7.97) U/L,both P＜0.05].Conclusions As compared with cTnI and CK-MB,within 6 hours after AMI onset,H-FABP as a new myocardial necrosis marker has higher sensitivity,specificity,positive and negative predictive values in the diagnosis of AMI.While,after 6 hours of AMI onset,H-FABP has the same diagnostic value as cTnI and CK-MB.