Since 1960s,total parental nutrition(TPN) has had a great development,while complications after long term of TPN has also been recognized.This article reviews intestinal permeability changes after TPN,its possible mechanism and some recent research progresses.

Myeloid-derived suppressor cells (MDSCs) are a group of heterogeneous and immature myeloid-derived cells,which accumulate largely in blood,lymphoid organs,spleen and tumor tissue and so on under the different pathogenic conditions such as infection,trauma,hematosepsis,especially tumor and so on.MDSCs can suppress tumor immune through many mechanisms.The number of MDSCs in periphery blood of patients is closely related with tumor stage,tumor burden,remote metastasis and prognosis.The major results are from laboratory mice.Because of the complexity of MDSCs in patients with tumor,there are many difficulties and debate on the research of them,and the researches of human MDSCs progress slowly.

OBJECTIVE:To study the use and developmental tendency of psychotolytics in hospitals of Guangdong province.METHODS:The psychotolytics used in hospitals of Guangdong province during the period of2000～2004were an-alyzed statistically in respect to consumption sum,DDDs and average daily expense.RESULTS&CONCLUSIONS:Both consumption sum and DDDs of psychotolytics in the past5years increased to a large extent.Benzodiazepine topped the list of anti-anxiety drugs.The consumption of2nd generation antipsychotics increased year by year.On the whole,the consumption of antidepressants increased annually,of which,fluoxetine,flupentixol/melitracen and paroxetine were the most frequently used drugs.However,the consumption of tricyclic antidepressants has a significant reduction.

Objective To describe the clinical features and observe the effect of vitrectomy on traumatic avulsion of vitreous base with giant retinal dialysis.Methods Seven cases with giant retinal dialysis(rang 120～150?) secondary to traumatic avulsion of vitreous base and PVR grade B to C 3 were retrospectively reviewed.All eyes had recieved vitrectomy,scleral buckle and lenses removed,and six eyeballs underwent postoperative sequential fluid-gas exchange.Results In most cases,the dialyses and avulsed vitreous base developed in the temponate quadrants and complicated lenses dislocation,pupilloparalysis,and vitreous hemorrhage.All cases attained success after disappearance of the intraocular tamponate.The major complication was elevated intraocular pressure,which was transient.Conclusions Giant retinal dialysis may result from traumatic avulsion of vitreous base.These dialysis often become clinical manifestation for several days or longer following ocular contusion.Vitrectomy is a very effective management for these cases.

Objective To study the guided interstitial implantation of125I seeds combined with S-1 in the treatment of elderly patients with pancreatic cancer treatment in CT, to evaluate the clinical value of the actual.Methods60 cases of elderly patients with pancreatic cancer in Pujiang People's Hospital from January 2013 to December 2016 were selected as the research object in this study.They were randomly divided into two groups, the control group and the experimental group, each with a total of 30 cases.The control group of patients with S-1 in the treatment.The experimental group with,125I implantation combined with S-1 treatment.Comparative analysis of the control group and the experimental group of patients with treatment effect and toxicity.ResultsAfter different treatment, 30 patients in the experimental group, 9 patients were invalid, the total effective number of cases was 21 cases, the effective rate was 70%.The control group of 30 patients, 19 patients were invalid, the total effective number of cases was 11 cases, the effective rate was 36.7%.Therefore, the effective rate of the experimental group was significantly higher than that of the control group, with statistical difference (P<0.05).The disease control rate of the experimental group was 90%, the clinical benefit rate was 50%, the control rate of the patients in the control group was 60%, and the clinical benefit rate was about 23.3%,.The control rate of patientsand the clinical benefit rate of the experimental group was significantly higher than that of the control group, with statistical difference (P<0.05).There was no significant difference between the experimental group and the control group.ConclusionCT guided interstitial implantation of125I seeds combined with S-1 in the treatment of elderly patients with pancreatic cancer can improve the treatment efficiency to a great extent, to help alleviate the suffering of patients, with further clinical promotion and application significance.

Objective To explore the methods and effects of specialty training for wound care. Methods Fourteen nurses working and studying in the wound care center received specialty training of wound care. Their current knowledge and train-ing needs were assessed through writing test and symposium before the training. Then,the training contents and plan were de-signed. The training duration was identified as 3-6 months. The open teaching method was applied in the training directed by the entrostomal therapists(ET). According to the evaluation index,the nurses were asked to finish a reading report in the first month,a case report in the second month,and group discussion on a case of complicated wound care the third month. In ad-dition,they needed to finish the exam of wound care theory and skills every three months. The correlations between perfor-mance in the examination and the nurses' age,years of working experlence,educational level,professional title,duration and times of training by correlation analysis. Results The times of training was significantly correlated with the performance in the examination(r=-0.49,P<0.05),especially with the performance of case report,reading report,and group discussion on compli-cated wound care(r=0.51,-0.60,P<0.05). There was no correlation between the performance with nurses' age,years of working experience,educational level,professional title and duration of training. Conclusion One time of specialty training at least 3 months can achieve good effect. The times of training is correlated with the training effect,especially in case report,reading report and group discussion on complicated wound care.

Objective To analyze strain characteristics of hypertrophic cardiomyopathy(HCM) and explore the clinical value of strain rate imaging in differentiating HCM from hypertensive left ventricular hypertrophy(H-LVH). Methods Parameters of strain and strain rate were obtained and compared among 23 HCM patients, 30 patients with H-LVH and 20 healthy people(control group). Results In HCM group, systolic strain(?_ sys ),peak systolic strain rate(SR_ sys ), early diastolic strain rate(SR_ dia ) obtained from inter-ventricle septum(IVS) were smaller than that obtained from left ventricle posterior wall(LVPW), while SR_a increased in IVS. ?_ sys ,SR_ sys ,SR_ dia in both patients with HCM and H-LVH were smaller than that in control group, while atrial systolic strain rate(SR_a) increased in HCM group and H-LVH group. ?_ sys , SR_ sys , SR_ dia , SR_a obtained from IVS and ?_ sys , SR_ dia obtained from LVPW in HCM group showed statistic differences compared with H-LVH group. Conclusions Strain rate imaging could accurately detect the abnormal regional myocardial function of HCM and can be applied as a useful tool in discriminating HCM from H-LVH.

OBJECTIVE: To explore the feasible monitoring techniques for the buried free flap. METHOD: Buried free flaps in reconstruction were monitored using combined monitoring techniques in five cases of advanced hypopharyngeal cancer The monitoring effects were analyzed retrospectively. RESULT: The operations were carried out successfully and all the five patients got primary healing of incision without vascular crisis. Four patients need combined monitoring techniques to confirm the microcirculatory results of the buried free flap. CONCLUSION Application of Doppler combined with flap island was feasible on monitoring the blood supply of post-operative buried free flap, it is a good monitoring technique.
Aged ; Carcinoma, Squamous Cell ; diagnostic imaging ; pathology ; surgery ; Free Tissue Flaps ; blood supply ; Head and Neck Neoplasms ; diagnostic imaging ; pathology ; surgery ; Humans ; Hypopharyngeal Neoplasms ; diagnostic imaging ; pathology ; surgery ; Hypopharynx ; Male ; Middle Aged ; Postoperative Period ; Retrospective Studies ; Squamous Cell Carcinoma of Head and Neck ; Surgical Flaps ; blood supply ; Ultrasonography, Doppler

Objective To determine the effect of Nuclear factor-erythroid 2-related factor 2 ( Nrf2 ) on acute hephrotoxicity induced by CCl4 in male rat.Methods 20 male Wistar rats were randomly divided into control group and CCl4 group, 10 rats in each group, another 10 male Wistar rats were transgenic rats microinjection through the carrier, obtained the Nrf2-tk gene integration and specific transgenic rats, as the CCl4 +Nrf2 integration group.The groups was given 1%polysorbate 80 for 4 days,Then the CCl4 and CCl4 +Nrf2 integration group were intraperitoneally injected with a single dose of CCl47.5 mg· kg-1 and were killed 24 h after CCl4 injection.The serum chemical parameters including asparate aminotransferase ( AST) ,alanine aminotransferase ( ALT) and lactate dehydrogenase ( LDH) were measured.Also malonaldehyde ( MDA) ,glutathione ( GSH) ,oxidized glutathione ( GSSG) levels in the liver as well as glutathione ( GSH)/oxidized glutathione ( GSSG ) ratios were detected. Histopathologic changes in the liver were examined. Results F1generation TK transgenic rats in liver and testis and other tissues and organs were not detected the transcription of Nrf2-tk, indicating that Nrf2-tk expression in tissues is specific good.Nrf2 significantly reduced serum AST, ALT and LDH levels in a dose-dependent manner.The results of MDA levels and GSH/GSSG ratios in liver and kidney showed that Nrf2 reduced CCl4-induced hepatic lipid peroxidation,and ameliorated glutathione depletion.The histopathologic results showed that Nrf2 restrained liver and kidney damage induced by CCl4 .Conclusion Nrf2 can effectively protect male rat from acute hepatotoxicity and nephrotoxicity induced by CCl4 .

Objective: To evaluate the role of enteral nutrition with dietary fiber and medium chain triglycerides in postoperative patients with gastric cancer. Methods: Forty patientswith gastric cancer receivedenteral diet with dietary fiber and medium chain triglycerides for 7 days. Enteral feeding was initiated 48hours after surgery. Host biochemistryindicators, nutritional parameters and immunity were monitored. Results: With surgical trauma, patients'nutritional status and immunity were impaired, and after nutritional support, the nutritional and immune parameters increased significantly. Conclusions: In postoperative patientswith gastric cancer, enteral nutrition with dietary fiber and medium chain triglycerides can improve the nutritional status and immunity.