Clinicians should assume the responsibility of nutritional therapy for satisfactory outcomes. They should master knowledge on nutritional metabolism, and participate in the administration of nutritional support. Clinicians should be acquainted with new concepts and standardized techniques in this field, such as different requirement of energy, understanding of early nutritional support, and optimal regimens of enteral or parenteral nutrition.
China ; Enteral Nutrition ; Humans ; Nutritional Support ; Parenteral Nutrition

BACKGROUND: Abnormal hemorheologic index was often observed in patients with ischemic cerebrovascular disease. Although this alteration is not the main cause for the onset of cerebral infarction (CI), the changes of hemorrheology should not be ignored.OBJECTIVE: To study the hemorrheologic alterations of patients in different sexes with CI and transient ischemic attack (TIA), and investigate the significance of hemorrheologic index on the treatment of disease and the value of prognostic assessment.DESIGN: Non-randomized controlled and homochronous study based on patients and healthy people.SETTING: Medical physics institute in a university and a neurological department in a university hospital.PARTICIPANTS: Totally 91 CI patients, including 64 males and 27 females with the mean age of (64 ± 9), and 40 TIA patients, including 20 males and 20 females with the mean age of (58 ± 11 ), were selected from the Neurological Department of Qilu Hospital, Shandong University from January to December 2000. Another 84 healthy volunteers, including 52 males and 32 females with the mean age of (56 ± 10), were selected as the control group homochronously.METHODS: 2 mL fasting venous blood from elbow was taken in the morning and heparin was used against coagulation. Blood viscosity was assayed with NXE-1 cone-plate viscometer (made in Chengdu, China).MAIN OUTCOME MEASURES: High blood viscosity, low blood viscosity,plasma viscosity, hematocrit, erythrocyte aggregation index and fibrinogen content of CI or TIA patients in different sexes and the controls.RESULTS: Each item of hemorrheologic index of male CI or TIA patients was significant higher than that of the controls, and the differences were significant (P ＜ 0.05 -0.01 ). Each item of hemorrheologic index of female CI patients was significant higher than that of the controls, and the differences were significant ( P ＜ 0.05 - 0.01). Blood viscosity, plasma viscosity and fibrinogen content of female TIA patients were significant differences from those of the controls ( P ＜ 0.05).CONCLUSION: The increase of hematocrit and fibrinogen content are the main factor causing the increase in blood viscosity.

Aim To study the receptor mechanism of carvedilol(CAR) on heart failure.Methods Established rat model of heart failure was induced by abdominal aortic coarctation.With modified Langendorff model of rat,isoproterenol(ISO),carvedilol,propranolol(PRL) and the specific ?3 adrenergic receptor(?3AR) blocker SR59230A were given perfusion on heart failure and normal rats' hearts.Then the cardiac function was investigated.At the same time,plasma norepinephrine in normal and heart failure group was measured.Results ① The ?dp/dtmax of heart failure group were significantly reduced compared with those of the normal group,and the norepinephrine level was remarkably higher than that of the normal group.② In heart failure group,perfused PRL on the basis of ISO,the maximum rate of left ventricular pressure rise(+dp/dtmax) decreased by 40.37%? 2.52%,the maximum rate of left ventricular pressure decrease(-dp/dtmax) reduced by 41.36%?1.10%;perfused CAR on the basis of ISO,+dp/dtmax decreased by 24.73%? 3.60%,-dp/dtmax reduced by 22.05%?1.27%.There were differences between these two groups,and the cardiac function perfused CAR was better than PRL.③ Perfused CAR in heart failure group,+dp/dtmax increased by 41.57%?14.98%,-dp/dtmax increased by 33.39%?6.41%;perfused ?3AR specific blocker SR59230A,+dp/dtmax increase by 45.75% ?2.64%,-dp/dtmax increased by 42.81% ?9.62%.There were no differences between these two groups.Conclusion Another receptor mechanism of CAR in heart failure model was probably blocked by ?3AR.

The need for special medical services are described and analyzed from the connotation of the characteristics of several types and models,in the hope of providing reference for the study of special need of medical services.

Objective: To manage various medical consumable scientifically in different consumable materials, the new separate-store management of consumable management was developed. Methods: The medical consumable depot could be divided into the general consumable depot, the in vitro diagnostic products (IVD) depot and the high-value consumable depot, different management modes could be provided varying from different consumable depots mentioned above. Results:Different items of management processes are regulated, the full-cost accounting of consumables are promoted and the social and economic benefits of hospitals are enhanced. Conclusion: This management mode had the characteristics of normalization and practice.

OBJECTIVE:To recommend modern work model for hospital pharmacy. METHODS: Based on the practice of the construction of modernized dispensary in our hospital, we analyzed the constructions of automated outpatient dispensary and integrated tidy and clear inpatient dispensary as well as informationized traditional Chinese medicine dispensary, the practice of clinical pharmacy and the production of hospital preparations etc. RESULTS & CONCLUSIONS: The modernized pharmacy work pattern carried out in our hospital embodies patients-oriented and rational drug use-based idea, and due to which, informationization and digitalization of pharmacy management has been achieved basically; therefore, this model deserves to be followed by other hospitals.

OBJECTIVE:To establish a sound clinical pharmaceutical care system in contagious hospital.METHODS:The working model for clinical pharmacy in our hospital was introduced.RESULTS & CONCLUSION:The rational drug use level was enhanced by the pharmaceutical care provided for both outpatient and inpatients including establishing information system,setting consulting room,establishing medication histories for outpatients,pharmacists' going to clinic to make up for any possible deficiencies or vacancies,collect drug information,give medication lectures among physicians and patients,carry out monitoring of ADR,and make individualized medication scheme etc.

Objective To explore the efficacy of calmodulin antagonist berbamine(BBM) in down-regulating survivin mRNA. Methods Human breast cancer cell line MCF7 and its adriamycin-resistant counterpart MCF7/ADR were used in the study. The cells were cultured with different concentration of BBM for 72 hours. The mRNA expression level of survivin gene in both MCF and MCF7/ADR cells was detected by semi-quantitative RT-PCR. Results After treating MCF7 and MCF7/ADR cells by 20?mol/L BBM, the mRNA expression level of survivin gene decreased from 0.43?0.02 to 0.21?0.04 in MCF7 cells, and from 0.57?0.05 to 0.45?0.04 in MCF/ADR cells(P

The change of myocatdial protein kinase C (PKC) activity during ische-mia and reperfusion was studied in isolated Langendorff perfused rat hearts. The enzymeactivity was determined by measuring the incorporation of ~(32)P from (r-~(32)P) ATP intohistone. The cytosolic PKC activity was similar in control, ischemic and reperfused hearts;however, there were significant increases in the membrane PKC activity during ischemia and reperfusion There were 1.68, 1.88, 2.18 and 1.34 fold increases of the membrane PKC activity at 15, 30, 45 and 60 minutes after ischemia respetively Following15 minutes of ischemia, repetfusion of heart only caused 1.37 fold increase in the mem-brane PKC activity, compared with that at 15 minutes after ischemta no siginificant differ-ence was found. These results suggested, that the signal transduction mediated by PKC wasimpaired during the development of ischemic and post-ischemic reperfusion injuty of theheart. Panaxadiol saponin decreased the enhanced membrane PKC avtivity induced by is-chemia by 62.5%.

Mammalian target of rapamycin (mTOR)is an atypical serine/threonine protein kinase,which is a key protein kinase regulating cell growth,proliferation,translation,metabolism and autophagy.It's first known beca- nuse inhibited by rapamycin.Research indicated that mTOR plays a key regulating role in physiological and patho- logical process of cardiovascular system.The present article mainly reviewed research progress of mTOR signal path- way effect in cardiovascular system.