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.

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.

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.

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 investigate the effect of Guizhi Fuling pills on levels of serum MAPK, ERK and VEGF in patients with endometriosis. Methods 60 patients with endometriosis were selected and according to the random control table were divided into the experiment group and the control group, 30 cases each.The control group were treated with conventional acetate goserelin sustained-release implantation agent subcutaneous injection, the experiment group were treated by Guizhi Fuling pill treatment.After treatment, the clinical efficacy, serum MAPK, ERK-5, VEGF, ERK, T-cad and VE-cad levels of the patients were compared.Results Compared with the control group, the clinical total effective rate was higher in the experiment group (P<0.05);MAPK and ERK-5 levels in serum were lower (P<0.05), ERK level in serum was lower(P<0.05);T-cad and VE-cad levels in serum were lower(P<0.05);VEGF level in serum was lower(P<0.05).Conclusion Guizhi Fuling pill can block the cell signal transduction pathway through inhibition of MEK and ERK activity, thereby inhibit abnormal endometrial proliferation and cell division cycle, can effectively inhibit the proliferation and differentiation of the tumor.

Method of selecting points in foot-hand same-name meridians was used to treat 24 cases of Osteoarthritis of knee joint, and the therapeutic results showed 15 cases were cured, 4 cases got significant effect and 4 cases got improvement.

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.

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.

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.