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 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 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.

A highly sensitive fluorescence spectroscopic method was established for the selective determination of estradiol, which took advantages of the excellent molecular recognition capability of aptamer and the energy transfer between the specific fluorescent groups. The effects of the pH value, buffer constituent and concentration, the concentration of DNA, the experimental temperature and response time on the detection of estradiol were studied. Under the optimal conditions (50 mmol/L BR buffer solution with pH value at 7. 4, 1. 0×10-7 mol/L for each DNA strand, incubation at 45 ℃, response time 19 min), the change of the fluorescence intensity (ΔI) versus the logarithm of the concentration of estradiol ( lgC) was linear over a concentration range from 1. 0×10-11 mol/L to 5. 0×10-9 mol/L with good linear correlation (r=0. 9953). The limit of detection (LOD) was found to be 6. 0×10-12 mol/L (S/N=3). This method was successfully applied to the detection of estradiol in human urine, with the recovery in the range of 94. 0%-103. 5%. This method showed good precision and accuracy.

Objective To express the immunodominant epitopes of the branched chain 2 oxo acid dehydrogenase complex (BCOADC), the pyruvate dehydrogenase complex (PDC), the 2 oxo glutarate dehydrogenase complex (OGDC) and a triple hybrid clone (designated as BPO), and use BPO as a tool for the detection of M2 specific for primary biliary cirrhosis (PBC). Methods The cDNA fragments encoding the M2 reactive epitopes of BCOADC, PDC and OGDC were amplified using PCR with total RNA extracted from human peripheral mononuclear blood cell. The fragments were cloned into pQE 30 and then transformed into plasmid E.coli M15. Its products were induced by isopropylthio ? D galactoside and confirmed with SDS PAGE and Western blot. Results Four specific proteins induced from the transformants containing the fused plasmid were shown to have antigenic reactivity with PBC sera, but not with normal control sera. Conclusions We succeeded in expressing three immunodominant epitopes and a hybrid clone which can be used as a powerful and specific method for the diagnosis of PBC.

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 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 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.