OBJECTIVE:To provide reference and evidence for rational use of clinical nutrition. METHODS:The types of en-teral and parenteral nutrition and the cost of prescription were analyzed statistically in 17 third grade class A general hospitals,3 third grade class A special hospitals and 14 secondary general hospitals from Shanghai area during 2011 to 2013. RESULTS:Nutri-tion preparations were mainly used by hospitalized patients. Total cost of nutrition preparations in outpatient and emergency depart-ment respectively occupied 8.14%,8.77% and 8.89% of total cost of nutrition preparations in the hospital during 2011-2013. The parenteral nutrition was the main form of nutritional support. There were only three kinds of enteral nutrition in top ten nutrition preparations in the list of prescription cost. Although seven out of ten kinds of nutrition preparations were given enterally which was the main mode for outpatients and emergency patients,the cost of prescriptions of parenteral nutrition increased faster compared to enteral nutrition,especially alanyl-glutamine. CONCLUSIONS:Parenteral nutrition is the main mode of nutrition support,especial-ly for inpatients;great attention should be paid to the increase of the cost of prescriptions about parenteral nutrition in outpatients and emergency patients.

Objective:To compare the concordance between subjective experience and clinician-rated in different treatment phrase of elderly patients with depressive disorder,and to explore the relevant factors.Methods:Sixty-nine consecutive elderly patiems with depressive disorder diagnosed with International Classification of Diseases-10 criteria were included.The Visual Scale for Depression(VSD) were used to evaluate subjective experience of depression,while the Hamilton Depression Scale (HAMD),Hamilton Anxiety Scale (HAMA),Minimum Mental State Examination (MMSE) were used by clinician to evaluate depression symptom,anxiety symptom and cognition at baseline,2-,4-and 52-week of the treatment respectively.Results:Compared with baseline,VSD scores were increased at 2 weeks and 4 weeks [(2.7 ± 1.6),(5.3 ± 2.0) vs.(7.0 ± 1.8),P ＜ 0.001],HAMD scores were decreased at 2 weeks and 4 weeks [(36 ± 11),(17 ±9) vs.(9 ±8),P ＜0.001],HAMA scores were decreased at 2 weeks and 4 weeks [(27 ± 10),(14 ±8) vs.(7 ±6),P ＜0.001].No significant differences were found between 4 weeks and 52 weeks.There was no correlation between VSD and HAMD scores at baseline and 2 weeks.There were significant correlations among scores of VSD and HAMD(r =-0.31,-0.74,Ps ＜ 0.05),HAMA (r =-0.36,-0.76,Ps ＜ 0.05) at 4 weeks and 52 weeks.Using logistic regression analysis,the concordance between VSD and HAMD related with the factors of HAMD,higher scores of anxiety/somatization factor were associated with lower concordance (OR =0.87),and higher scores of weight factor (OR =1.86),diurnal variation factor (OR =2.00),hopelessness factor (OR =1.13) were associated with higher concordance.Conclusion:Compared with acute depression phase,concordance between subjective experience and clinician-rated for depression may be higher at depression remission phase in elderly patients with depression,which suggests that characteristics of depression symptom may have a certain impact on the self-awareness for depression experience.

Twenty-three patients with pain from osteoporotic vertebral fractures,aged 65-90 yr,weighing 51-78 kg,received an image intensifier-assisted nerve-root block with a 6-8 ml mixture of 0.5 ％ lidocaine,mecobalamine 0.5 mg and betamethasone sodium phosphate injection 5.26 mg in a prone or lateral position.The VAS scores before operation,at 0,1 week,1 and 3 months after operation were 8.6 ± 0.9,1.5 ± 0.7,2.8 ± 0.9,1.6 ± 0.5 and 2.5 ± 0.7,respectively.VAS scores were significantly lower at each time pint after operation than before operation (P ＜ 0.05).According to modified MacNab standard,the effectiveness of treatment was rated as excellent/good in 87％ of the patients.No complication such as bleeding,hematoma,infection,pneumothorax,hemopneumothorax,headache was found during or after operation.Selective nerve-root block is effective in the treatment of pain resulting from osteoporotic vertebral fractures in patients.

After the antidepressant patents were retrieved from Innography, their distribution, R& D level, hot spots and core patents were analyzed , which showed that the largest number of antidepressant patents was produced in USA, the medicinal preparations containing organic active ingredients were the hot spots, the technological and economic strengths of Pfizer, Novo and Sanofi-Aventis were relatively tremendous.The law-suited patents, reex-amined patents and patent strength were mined.

Objective To evaluate the treatment of acute cholecystitis patients through laparoscopic cholecystectomy (LC). Methods 387 cases of acute cholecystitis patients who underwent LC were studied retrospectively . Results Of the 387 cases, there were 359 cases of calculus incarcerated cholecystitis , 152 cases of cholecystitis with acute inflammatory symptoms for 72 h or more, 10 cases were converted to Laparotomy (2.6%).The operations lasted for 30~200 min(63.09 ±26.62 min on average),with blood loss about 10~500 mL(51.41 ±32.41 mL on average),and drainage was adopted in 183 cases.No complications developed fol-lowing the surgeries in 3 to 24 months, indicating a 100% cure rate. Conclusion If with good command of rules and techniques during LC operations , It is both safe and feasible to treat acute cholecystitis patients through LC operations .

Child ; Humans ; Lupus Nephritis ; complications ; Male ; Nephritis, Interstitial ; etiology ; Prognosis

OBJECTIVETo examine whether TLR-4 has an effect on hemorrhage induced changes in lung, and to investigate the change of heme oxygenase-1 (HO-1) on acute lung injury (ALI) induced by hemorrhagic shock in mice.

METHODSForty-eight male mice, including C3H/HeN mice and C3H/HeJ mice, were randomly divided into sham group (n=12), hemorrhagic shock group with twelve mice in each phase. Blood pressure (BP) was monitored continuously by attaching carotid artery catheter to a strain gauge pressure transducer/ polygraph. Arterial blood samples were taken for blood gas analysis. A mouse model of non-lethal hemorrhagic shock and resuscitation was used to observe pulmonary myeloperoxidase (MPO) activity and wet/dry weight ratio (W/D). The expression of HO-1 was observed by means of RT-PCR and immunohistochemistry. IL-6 and IL-10 in lung tissue homogenate were assayed by enzyme-linked immunosorbent assay (ELISA). The pulmonary pathologic changes were observed under electron microscope and light microscope.

RESULTSCompared with sham group, the expression of HO-1 in lung tissue was significantly higher in Hem 24 h and Hem 48 h of C3H/HeN mice (P less than 0.01). The expression of HO-1 mRNA and the levels of IL-6, IL-10 and MPO in lung tissue were markedly increased in Hem 24 h (P less than 0.01 or P less than 0.05); Compared with C3H/HeN mice, the expression of HO-1 mRNA and the levels of IL-6 and IL-10 in C3H/HeJ mice significantly decreased in Hem 24 h and Hem 48 h (P less than 0.01 or P less than 0.05), and the W/D, MPO in C3H/HeJ mice were obviously lower in Hem 24 h (P less than 0.05). The injuries of lung tissues after hemorrhagic shock have been demonstrated by histological examination with electron microscope and light microscope.

CONCLUSIONSTLR-4 and HO-1 might modulate the balance of pro- and anti-inflammatory processes in inflammatory reaction of hemorrhagic shock-induced ALI, and the activation of Toll-like receptor might induce the transcription activity of HO-1, which may play a key role in acute lung injury.

Acute Disease ; Animals ; Heme Oxygenase-1 ; metabolism ; Lung ; pathology ; physiopathology ; Male ; Mice ; Mice, Inbred C3H ; Random Allocation ; Shock, Hemorrhagic ; physiopathology ; Toll-Like Receptor 4 ; physiology

OBJECTIVETo investigate the postburn changes in gastric mucosal blood flow (GMBF) and Na(+)-K(+)-ATPase activity and their effects on gastric transmucosal potential difference (GTPD) in severely scalded rats.

METHODSRats were inflicted with hot water scald on the back. Laser Doppler blood flow meter, electric physiological recorder meter and biochemical method were employed in the study to determine the changes in GMBF, GTPD and gastric mucosal Na(+)-K(+)-ATPase activity in the rats before injury and at 3, 6, 12, 24 and 48 PBHs. Normal rats served as controls, The above indices were also detected at the corresponding time points. All the data was collected and analyzed for their correlation.

RESULTSThe GMBF and Na(+)-K(+)-ATPase activity was at 3 - 24 PBHs were evidently lower in the scalded rats than those in controls (P < 0.05 - 0.01). GTPD was decreased significantly at 6 - 48 PBHs (P < 0.05 - 0.01). was above three indices reached the lowest values at 12 PBH. By correlation analysis the results indicated that the Na(+)-K(+)-ATPase activity The decreased in accordance with a decrease in GMBF (r = 0.527, P < 0.01). The GTPD decrease could both be induced by GMBF decrease and Na(+)-K(+)-ATPase activity decrease (r = 0.453 and 0.527, respectively, P < 0.01).

CONCLUSIONThe decrease in GMBF and Na(+)-K(+)-ATPase activity occurred in severely scalded rats, both changes might be the major cause of postburn gastric mucosal barrier injury.

Animals ; Burns ; metabolism ; physiopathology ; Gastric Mucosa ; blood supply ; metabolism ; physiopathology ; Male ; Membrane Potentials ; Rats ; Rats, Wistar ; Sodium-Potassium-Exchanging ATPase ; metabolism

OBJECTIVETo identify the proteins that could improve the resistance of human sperm to cryopreservation using comparative proteomics.

METHODSA total of 31 semen samples from 10 donors were divided into a high recovery and a low recovery group. Differentially expressed proteins in sperm and seminal plasma were detected and compared between the two groups by two-dimensional differential gel electrophoresis and mass spectrometry.

RESULTSTotally, 22 differentially expressed proteins were found in the two groups, 12 seminal plasma proteins, 9 sperm proteins, and 1 belonging to both. These identified proteins were involved in the maturation, movement, energy metabolism, DNA repair and other activities of spermatozoa.

CONCLUSIONMany proteins were identified in sperm and seminal plasma that might influence the resistance of human sperm to cryopreservation.

Adult ; Cryopreservation ; Humans ; Male ; Proteomics ; Semen ; metabolism ; Seminal Plasma Proteins ; metabolism ; Sperm Motility ; Spermatozoa ; metabolism ; Young Adult

Objective: To study the outcome of perforator flap combined with mesh in repairing cicatricial abdominal hernia after deep burn. Methods: From June 2000 to June 2016, 11 cases of cicatricial abdominal wall hernia after deep burn were treated. 8 cases were caused by electrical burn, 2 cases by stove burn and 1 case by molten iron burn. All of them were Ⅳ degree burn of abdominal wall. The overall treatment time was 1-11 years, with the average of 4.1 years. The hernias were 6 cm × 6 cm to 12 cm × 11 cm in size. The abdominal wall hernia was repaired following the process of scar excision, mesh and perforator flap transfer and defect repairment. 3 kinds of mesh materials were used, polypropylene mesh (n=7), composite mesh (n=2), and acellular allogenic dermis (n=2). The size of meshes ranged from 8 cm ×8 cm to 16 cm ×13 cm. Meanwhile, paraumbilical perforator flaps were used in 5 patients, and anterolateral thigh perforator flaps were 6. The flaps were 18 cm ×10 cm to 22 cm ×13 cm in size. Results: All 11 cases of abdominal wall hernia were repaired. Follow-up period was 6 months to 2 years. There was no recurrence was found. The shape of the flap was satisfying. Conclusions The perforator flap combined with mesh is a good method to repair cicatricial abdominal wall hernia after deep burn.