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 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 .

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.

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 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.

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.

BACKGROUND:Poly-D,L-lactic-co-glycolic acid (PLGA) that was characterized as absorbable,weak cytotoxicity,and adjustable hardness was ideal to be synthetized artificial spinal dura mater.Because of lacking of functional group at the surface of PLGA,it should be modified to fit the demand of satisfied biocompatibility.OBJECTIVE:To study the biocompatibility of PLGA membrane modified by type-Ⅰ collagen and chitosan.DESIGN,TIME AND SETTING:Contrast observation study,which was carded out in the Biochemistry and Molecular Biology Laboratory Shanghai University of Traditional Chinese Medicine from May to December 2007.MATERIALS:Porous PLGA membrane was provided by Jinan Banzheng Biology-Technology Co.,Ltd.,type-Ⅰ collagen by Sigma Company,USA,chitosan by Shanghai Qisheng Biological Agent Medical Apparatus and Instrument Company,and L929 L cell by Cellular Institute of Shanghai Academy of Life Science,Chinese Academy of Science.METHODS:PLGA membrane (P membrane),PLGA/type-Ⅰ collagen composite membrane (PG membrane),PLGA/type-Ⅰ collagen/chitosan (9:1) composite membrane (PGC 9:1 membrane) and PLGA/type-Ⅰ collagen/chitosan (5:5) composite membrane (PGC 5:5 membrane) were produced through a certain process.MAIN OUTCOME MEASURES:Contact angle,absorption rate and cytotoxicity were tested.Morphological changes of L929 L cell cultured for 1,3,and 7 days were observed under fiberscope.RESULTS:Contact angle was shown as PG membrane＜PGC 9:1 membrane＜PGC 5:5 membrane＜P membrane (P＜0.01 );absorption rate was shown as P membrane＜PGC 5:5 membrane＜PGC 9:1 membrane＜PG membrane (P＜0.01).L929 L cell was characterized as well distribution,expansion and appearance after inoculation of PG membrane,PGC 9:1 membrane and PGC 5:5 membrane.Cytotoxic experiment (MTT methods) showed that,on the 1st day,there was no significant difference in absorbency among groups (P＞0.05).On the 3rd and 7th days,there were significant differences between P membrane and PG membrane or PGC 9:1 membrane,and between PGC 9:1 membrane and PCK2 5:5 membrane (P＜0.05).PGC 9:1 membrane could further improve cell adhesion and proliferation,and PGC 5:5 membrane could inhibit cell proliferation and differentiation.CONCLUSION:Type-Ⅰ collagen and chitosan appended to the exterior of PLGA can enhance the biocompatibility of membrane.In terms of biocompatibility,PLGA/type-Ⅰ collagen/chitosan (9:1) composite membrane can be fit to the qualification as a type of material of artificial spinal dura mater.

ObjectiveTo evaluate the clinical value of contrasted X-ray in diagnosis of breast lesions.Methods29 patients who were confirmed as breast lesions verified by surgery and histopathology were enrolled in this study.All the lesions were evaluated by plain and contrasted X-ray.The lesion detectability of X-ray,and contrasted series.Results29 patients had 26 malignant and 5 benign lesions.There were significant differences between benign and malignant tumors on enhancement homogenity,morphology and margin characteristics.According to the morphology character and enhancement pattem.The distribution proved significantly different ( x2 =26.43,P ＜ 0.05 ).The diagnostic indices for the lesions morphology had the sensitivity of 83.8％ (26/31) and specificity of 76.9％ (20/26).ConclusionEnhanced X-ray was better than plain exam on lesion detection.Benign and malignant breast tumors could be differentiated according to the morphology characteristic and enhancement pattern.

Objective To explore the diagnosis and treatment of cerebral embolism from pulmonary embolism (PE).Methods The clinical data of 5 cases with PE accompanied by cerebral embolism covering a period from October of 2007 to July of 2011 were retrospectively analyzed.Results In this study,the average age of 5 cases (all female) was 46.5 years old.PE was diagnosed through enhanced CT and ECT in lung among all 5 cases.Moderate to severe pulmonary hypertension was confirmed by echocardiogram.Two cases was patent foramen ovale and one was congenital atrial septal defect.Each patient was diagnosed to be new-onset cerebral infarction by MRI.Three cases underwent cerebral arterial thrombolysis.All of them survived and long-term anticoagulant treatment with Warfarin.INR was adjusted between 2.0 and 2.5 by change of Warfarin dose.Among them,one patient had cerebral embolism again just 3 days after the latest cerebral embolism; the other 4 patients did not suffer from cerebral embolism during the follow-up.Conclusions Paradoxical cerebral embolism is common.For clinical patients with PE,especially pulmonary hypertension accompanied by systemic circulation arterial embolism or unexplained systemic cerebral arterial embolism,paradoxical cerebral embolism should be considered.