OBJECTIVE:To investigate the status quo and problems of application of parenteral nutrition in our hospital. METHODS:Cases of parenteral nutrition support(PN)from January to June in 2008 were reviewed and analyzed statistically. RESULTS:The problem of 637 patients treated with PN included indication,duration,prescription composition and incompatibility. CONCLUSION:The application of PN in our hospital is partly rational,nevertheless there are also some problems needed to be improved.

Objective To observe the clinical efficacy of umbilicus application withDa Huang (Rheum Officinale) during 5-7 a.m. in treating senile constipation after hip fracture.Method Fifty-nine elderly patients with constipation after hip fracture were randomized into a treatment group of 30 cases and a control group of 29 cases. The treatment group was intervened by umbilicus application withDa Huang (Rheum Officinale) during 5-7 a.m, while the control group was by umbilicus application withDa Huang (Rheum Officinale) at any time but avoiding 5-7 a.m. period. After a treatment course, the therapeutic efficacy was evaluated based on bowel movement frequency and shape of stool, and the two groups were compared with each other.Result The total effective rate and markedly-effective rate were respectively 93.3% and 70.0% in the treatment group versus 82.8% and 37.9% in the control group. The between-group difference in the total effective rate was statistically insignificant (P>0.05); there was a significant difference in comparing the markedly-effective rate between the two groups (P<0.01).Conclusion Umbilicus application withDa Huang (Rheum Officinale) during 5-7 a.m. is an effective method in treating senile constipation after hip fracture.

Objective To study the levels of interleukin(IL)-2 ,interferon-γ(IFN-γ) and IL-10 in peripheral blood and the effec-tive concentration of lactate dehydrogenase(LDH) in serum of patients with acute leukemia .Methods 65 patients with acute leuke-mia were divided into non-remission group(n=35) and remission group(n=30) .50 healthy volunteers were used as control group . The levels of IL-2 ,IFN-γ ,IL-10 in peripheral blood were measured by enzyme linked immunosorbent assay(ELISA) .The effective concentration of LDH was measured by automatic biochemical analyzer .Results The levels of IL-2 ,IFN-γin non-remission group were significantly decreased compared with control group and remission group(P<0 .05) ,but the level of IL-10 in non-remission group was significantly increased compared with control group and remission group(P<0 .05) .The effective concentration of LDH in non-remission group was significantly higher than that in control group or remission group(P<0 .05) .Conclusion The levels of IL-2 ,IFN-γand IL-10 in peripheral blood and the effective concentration of LDH in serum of patients with acute leukemia have changed .Clinical detection of IL-2 ,IFN-γ,IL-10 and LDH may contribute to the early diagnosis of patients with acute leukemia .

Objective To Study the expressions and significance of nitric oxide (NO) and forkhead box protein 3 (FOXP3) in patients with pulmonary tuberculosis .Methods Serum NO levels were measured by Griess colorimetric reaction .Flow cytometry was used to determine the number of CD4+CD25+ T cells in peripheral blood .The expression of FOXP3 mRNA was measured by real‐time polymerase chain reaction .Results Serum NO level in patients was (15 .71 ± 1 .26)μmol/L ,higher than the (5 .45 ± 0 .98)μmol/L of healthy controls (P<0 .05) .CD4+ CD25+ T cells comprised (4 .57 ± 0 .85)% of CD4+ T cells in patients ,higher than the (1 .83 ± 0 .49)% in healthy controls (P<0 .05) .CD4+ CD25+ T cells in the peripheral blood of patients with pulmonary tuberculosis highly expressed FOXP3 .Conclusion Patients with pulmonary tuberculosis could be with an increased level of NO and FOXP3 ,which might have important role in the pathogenesis of pulmonary tuberculosis .

Objective To investigate bacterial resistance of Streptococcus pneumoniae against erythromycin and clindamycin, and resistance phenotypes of erythromycin resistant S. pneumoniae. Methods The MICs of erythromycin and clindamycin against 345 strains of S. pneumoniae were tested with agar dilution method, the phenotypes of erythromycin resistant S. pneumoniae were detected by double disc test. Results The resistance rates of S. pneumoniae to erythromycin and clindamycin were 53.0%(183/345) and 49.6%(171/345), respectively. Among erythromycin resistant S. pneumoniae , the percentages of cMLS, iMLS and M phenotype were 90.3% (159/176), 5.7% (10/176) and 4.0%(7/176), respectively. Conclusions The resistance rate of S.pneumoniae against erythromycin is very high in Shanghai. The main phenotype is cMLS.

Gestational hyperlipidemic pancreatitis is an uncommon complication of pregnancy that incurs a high risk of morbidity and mortality of both maternal and fetal patients.We described the response of continous renal replacement therapy in a woman with extreme gestational hyperlipidemia and severe pancreatitis.Five consecutive plasma exchanges didn't lead to a remarkable reduction(10.4% and 4.8%,for the first and fourth times,respectively) at triglyceride levels as the literatures have reported,which reveals that plasma exchange and continous veno-venous heamofiltration may be importment,instead of crucial methods in dealing with gestational hyperlipidemic pancreatitis.Abstract:SUMM ARY Gestational hyperlipidem ic pancreatitis is an uncommon complication of pregnancy that in-curs a high risk ofmorbid ity and mortality of both maternal and fetal patients.W e described the response of continous renal replacement therapy in a woman with extreme gestational hyperlipidem ia and severe pancreatitis.Five consecutive plasma exchanges d idn’t lead to a remarkable reduction(10.4% and 4.8%,for the first and fourth times,respectively) at triglyceride levels as the literatures have reported,which reveals that plasma exchange and continous veno-venous heamofiltration may be importment,in-stead of crucialmethods in dealing with gestational hyperlipidem ic pancreatitis.

We report a case of a 35-year-old right-handed male patient with drug-resistant mesial temporal lobe epilepsy who developed ipsilateral occipital hematoma after right temporal anterior lobectomy and amygdalohippocampectomy. Patient did not report taking any drugs with anticoagulant effect, such as aspirin or valproate. There was no past history of hypertension and the pre-operation tests were normal. Pre-operative brain magnetic resonance imaging revealed no abnormality in the right occipital lobe. Overdraining of cerebrospinal fluid may have triggered this remote cerebellar hemorrhage.

ObjectiveTo develop a quantitative method for simultaneously determining multi-components in Rhei Radix et Rhizoma using one chemical reference substance.MethodsThe contents of multi-components were calculated by the UV relative correction factors (RCFs) of chrysophanol,physcion,and rhein to emodin.ResultsThe values of RCFs at 274 nm for rhein,chrysophanol,and physcion to emodin were 0.712,0.674,and 1.051.The calibration curves were linear over the ranges of 0.02-4.08,0.02-4.12,0.07- 12.92,and 0.02-3.68 μg/mL for rhein,emodin,chrysophanol,and physcion,respectively.The contents of emodin in 18 samples were determined by the extemal standard method,and the contents of the other three anthraquinone aglycones were calculated according to their RCFs.ConclusionNo significant difference is found in comparison with the classical method,indicating that the RCFs have high reliability within their linear ranges and could be used in quality control of Rhei Radix et Rhizoma.The quantitative analysis of multi-component with a single marker is especially suitable for herbal medicines containing unstable or hard to be purified components as quality control markers.

Objective To explore the effect of the cancer pain nursing team in standardized nursing inter-vention of pain in elderly cancer patients.Methods 76 patients in Department of Pain in our hospital were selected in our research.A random number table method was used to divide them into the control group and the observation group,with 38 cases in each group.Conventional treatment and nursing care was given to control group.The observa-tion group received routine treatment and nursing care by cancer pain nursing team,which the content of nursing was same,but the nursing method is different.Before and after the intervention,impact on pain intensity,adverse reactions and satisfaction for medical and nursing were compared between the two groups.Results Before nursing intervention, the pain score between the two groups had no statistically significant difference(P >0.05).After nursing interven-tion,pain score of the observation group was 1.5 (1,2)points,which was lower than 2(1,3)points in the control group,the observation group had better analgesic effect than the control group (Z = -4.385,P =0.000).The incidence rate of adverse reaction of the observation group was 13.16%,which was lower than 47.37% of the control group,the difference between the two groups was statistically significant(χ2 =10.537,P =0.001).The satisfaction for medical nursing process in the observation group was (9.74 ±0.45 )points,which was higher than (9.42 ± 0.76)points of the control group (t =2.213,P =0.030).Conclusion For senile cancer patients,the cancer pain nursing team could implement the standardized nursing intervention to relieve the body pain level,reduce the adverse drug reactions,so as to improve the quality of life.

Objective To evaluate the effects of tofacitinib on liver function in rheumatoid arthritis (RA) patients.Methods Literature search was performed in databases including PubMed,Cochrane Library,China National Knowledge Infrastructure and Wanfang to identify randomized controlled trials about RA treated with tofacitinib.The retrieval time was up to August 2016.Meta-analysis was conducted by Revman 5.5 software.Results A total of 7 studies were included,involving 2 965 patients.The results of Meta-analysis revealed that the incidence of alanine transaminase (ALT)＞1 upper limit of normal (ULN) in patients receiving both 5 mg and 10 mg bid tofacitinib was significantly higher than placebo [5 mg bid tofacitinib:RR=1.48,95％CI (1.20,1.82),P=0.000 2;10 mg bid tofacitinib:RR=1.67,95％CI (1.37,2.05),P＜0.01];there was no significant difference in the incidence of ALT＞3 ULN [5 mg bid tofacitinib:RR=1.81,95％CI (0.57,5.79),P=0.32;10 mg bid tofacitinib:RR=1.36,95％CI (0.57,5.25),P=0.49];the incidence of aspartate transaminase (AST)＞1 ULN was significantly higher than placebo [5 mg bid tofacitinib:RR=1.59,95％CI (1.25,2.03),P=0.000 2;10 mg bid tofacitinib:RR=1.90,95％CI(1.50,2.40),P＜0.01],there was no significant difference in the incidence of AST＞3 ULN [5 mg bid tofacitinib:RR=1.17,95％CI (0.27,5.17),P=0.83;10 mg bid tofacitinib:RR=0.95,95％CI (0.26,3.44),P=0.94].Conclusion Tofacitinib slightly increases ALT and AST in patient with RA.Due to the limited sources and lack of domestic studies,more randomized controlled trials are still needed to verify the above conclusion.