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

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 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.

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%.

Objective To study the effect of the music therapy on the serotonin and tubulin in frontal cortex,hippocampus and hypothalamus of chronic unpredictable mild stress (CUMS) rats,and to explore the neurobiology of the music therapy on stress disorders.Methods Twenty-four male Sprague-Dawley rats were randomly divided equally to music therapy stress group(n=8),stress group(n=8) and normal control group(n=8).Mild chronic unpredictable stress was used for 21 days in a continuous stimulation pattern to establish the CUMS model.The 5-HT,5-HIAA and tubulin levels in the the frontal cortex,hippocampus and hypothalamus were detected.Results The time staying in the centre square in the open field test,the stress group spent less time than that in the control group (P＜0.01),and no significant difference was observed (P＞0.05).Compared with the stress group,the level of 5-HT and 5-HIAA in the hippocampus and the frontal cortex of the music therapy stress and the control group were significantly higher (P＜0.01),however,no significant difference was observed in the hypothalamus among the three groups.Compared with the stress group,the expression of Tyr-tubulin in the hippocampus of the music therapy stress and the control group significantly decreased (P＜0.O1),in contrary,the expression of Acet-tubulin in the hippocampus of the music therapy stress and the control group significantly increased (P＜0.01).However,no significant difference was observed in the frontal cortex and the hypothalamus among the three groups for either Tyr-tubulin or Acet-tubulin (P＞0.05).Conclusions This study indicates that music therapy can increase the release of the 5-HT in the hippocampus and the frontal cortex,and improve the expression of tubulin dynamics of the hippocampus for rats stressed.

Objective To explore the effect of continuous hyperglycemia on learning and memory capacity in rats, and to observe the changes of expressions of ubiquitin and apotosis-related proteins, so as to provide a relative basis for diabetic encephalopathy. Methods The male SD rats were randomly divided into normal control group and diabetes mellitus (DM) group. The DM rats was made by intraperitoneal injection of streptozocin (STZ). The capacities of learning and memory were tested by Y-maze. The structure changes in frontal lobe cortex and hippocampus were observed by Nissl's staining and immunohistochemistry. The apoptosis cell count was measured by terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL). The expressions of Bcl-2 and P53 were assessed by Western-blot analysis. The expression of ubiquitin mRNA was detected by reverse transcription-polymerase chain reaction (RT-PCR). Results In DM rats, the learning and memory capacities were worse than in control rats (P＜0. 05), and the apoptosis cell counts in frontal lobe cortex and hippocampus were higher than in control rats, the expression of Bcl-2 gene was reduced while the expressions of ubiquitin and P53 gene were increased (P＜0. 05). Conclusions In the frontal lobe cortex and hippocampus, the expression of Bcl-2 gene is reduced while the apoptosis cell numbers and ubiquitin P53 gene expression are increased, which may contribute to neurodegeneration in DM rats.

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.

Objective To study the extraction process of kendir leaves in compound kendir leaves tablets. Method The optimum extraction process was selected by the orthogonal design L9(34),with the factors of the concentration of ethanol,the volume of ethanol and the time of extraction,the content of quercetin as the evaluating criteria detected by HPLC. Kromasil C18 column (250 mm?4.6 mm,5 ?m) was used. The mobile phase was acetonitrile-0.5% phosphoric acid (27︰73),detection wavelength was 371 nm,the flow rate was 1.0 mL/min,and the column temperature was 30 ℃. Results The best extraction process of kendir leaves was as follows:85% ethanol,30 times volume of ethanol,extracting for 2 hours in boiling water. Quercetin showed a good linearity in the range of 0.963 0～0.080 3 ?g,r =0.999 8 (n =7). The average recovery of quercetin was 99.46%. Conclusion The extraction process was entirely,and the results of determination are satisfactory.

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 summarize the advancement of breast cancer stem cells and genotyping and analyze the correlation between the two.Methods Relevant literatures about breast cancer stem cells and genotyping,which were published recently were collected and reviewed.Results Cancer stem cell origin theory was supported by researches of correlation between breast cancer stem cells and genotyping,which also explained the complexity of intrinsic subtypes and heterogeneity of breast cancer.Conclusions A new way can be detected to study the formation mechanism and biological characteristics of breast cancer at the cellular and molecular level by researches of correlation between breast cancer stem cells and genotyping,which are expected to provide new strategies and tools for diagnosis and treatment of breast cancer.