Objective To investigate the causes of nutritional risks among inpatients in middle and small hospitals in Guangxi Zhuang Autonomous Region of China. Methods All the screened subjects were surveyed through classified collection of medical records and telephone follow-up. Factors including education background of patients and their family members, career, income, residence, medical payment methods, grade of hospital, and awareness of nutrition were analyzed. Results Lower education background of patients and their family members,less income, and self-funded health care payment were significantly associated with higher nutritional risks ( P ＜0. 01 ). The scores of malnutrition risks were significantly lower in patients whose careers were involved with culture, education and health and in patients whose family members had higher education levels (P ＜ 0.01 ). The nutrition risk was also significantly higher in patients from the rural areas than those from urban areas ( P＜0.01 ). It was also significantly higher in middle and small hospitals than in tertiary hospitals ( P＜0.01). Patients who had good awareness of nutritional knowledge had significantly lower incidence of nutritional risk (P ＜ 0. 01 ). Conclusion Low education level and poor economy in Guangxi are the main reasons for high nutritional risks.

OBJECTIVE:To study the induction effect of paeoniflorin on the apoptosis of lung adenocarcinoma A549 cells. METHODS:MTT method was used to detect the viability of A549 cells 48 h after the cells were cultured with paeoniflorin of 0 (negative control),5,10,20 and 40μmol/L. 24 h after A549 cells were cultured with paeoniflorin at the above-mentioned concen-trations,enzyme-linked immunosorbent assay was employed to detect the viability of cysteinyl aspartate specific proteinase 3(Cas-pase-3),and Western blot to determine the protein expression of Bcl-xl,Bax,nuclear factor κB p65(NF-κB p65)and phosphory-lated nuclear factorκB p65(NF-κB pp65). RESULTS:Compared to the negative control group,A549 cells cultured with paeoniflo-rin of 5-40 μmol/L for 48 h showed lower cell viability;A549 cell cultured with paeoniflorin of 5-40 μmol/L for 24 h showed high-er activity of Caspase-3 and the expression of Bax;A549 cell cultured with paeoniflorin of 10-40 μmol/L for 24 h showed lower protein expression of Bcl-xl and NF-κB pp65. There were statistically difference(P<0.01 or P<0.05). CONCLUSIONS:Paeoni-florin induces the apoptosis of A549 cells by a mechanism which may be related to the activation of NF-κB signaling pathway and regulation related gene expression.

Polycentric governance theory of public goods provides a new approach for the goal of Basic medical care and health service for all.From the perspective of the public goods property of basic medical care and health service,the paper analyzed the predicament brought one-center supply mode,and designed the basic medical care and health service polycentric supply mode on the basis on the polycentric governance theory.On the basis,it proposed the polycentric supply synergetic development strategies.

Frailty is a pre-disabled stage and associated with increased vulnerability to adverse health outcomes. Frailty has high preva-lence in older population. There are 2 principal emerging models of frailty, which are the phenotype model and the frailty index model. Many studies have developed tools to detect frailty, including self-report scales, such as PRISMA-7, Groningen Frailty Indicator (GFI), Ed-monton Frail Scale (EFS) and Simple Frailty Questionnaire (FRAIL);and single assessments, such as gait speed, timed up-and-go test, grip strength, pulmonary function test. Intervention of exercise and/or nutrition are benefical for frail older adults.

Objective To evaluate the MRI findings and clinical features of methotrexate-induced acute encephalopathy in children.Methods The clinical data and brain MRI obtained in 13 children with methotrexate-induced acute encephalopathy were retrospectively reviewed.The MRI features were analyzed , including information on the location , the signal intensity and follow-up MRI study was performed.Results Of the 13 patients , 2 patients suffered from seizure.Five patients had dysphasia , of which 4 patients had evidence of hemiparesis , 1 patient had right facial palsy.Five patients had unilateral weakness.And left hemiparesis was observed in 1 patient.DWI revealed well demarcated asymmetrical hyperintensity lesions within the centrum semiovale and/or periventricular white matter in 10 patients, corresponding to areas of hypointensity on ADC maps.One case showed hyperintensity areas in the bilateral supratentorial cortex and subcortical white matter on T 2-weighted images with subtle high-intensity on DWI.In all 10 cases there were resolution of the diffusion abnormality , 8 cases displayed residual FLAIR signal abnormalities involving areas of previously seen diffusion restriction , 5 cases showed decreased range of the lesion , 1 case was progressive, and 2 cases were stable.One case with hyperintensity areas in the supratentorial cortex and subcortical white matter showed small residual hyperintensity on T 2-weighted images and resolution of the diffusion abnormality.Conclusions MTX-induced acute encephalopathy often manifests as stoke-like symptoms.DWI is the imaging modality of choice for the detection of acute MTX neurotoxicity , and asymmetrical restricted diffusion in the deep white matter is the characteristic sign.Cytotoxic edema induced by MTX is transient and reversible .

Objective To discuss the value of video-assisted thoracoscopic repair in the treatment of pectus excavatum in children.Methods Thoracoscopic sternum elevation with an internal steel bar(Nuss procedure) was performed in 45 children with pectus excavatum.Preoperatively,a curved steel bar was prepared and the site of incision and the lowest part of the depression were labeled with methylene blue.Under right-sided thoracoscopic vision,the bar was inserted into the retrosternal tunnel thereby correcting deformity. Results The steel bar was placed safely in all the 45 patients.The operation time was 35~80 min(mean,60 min).The intraoperative blood loss was less than 5 ml.The length of postoperative hospital stay was 4~10 days(mean,7 days).Forty children were followed for 3~30 months(mean,16.5 months).Short-term complications included pneumothorax in 1 patient and pneumonia in 1 patient.Long-term complications included bar shift after 1 year in 1 patient and persistent sternal pain in 2 patients(which had been cured by oral and local analgetic administration).The bar had been removed in 10 children,all of whom had good cosmetic results.Conclusions Video-assisted thoracoscopic Nuss procedure is safe and effective in the management of pectus excavatum in children,with advantages of short operation time,simple performance,satisfactory cosmetic results,and fewer complications.

Objective To research the best extracting technology of simiaoyongan decoction.Methods As the total contents of chlorogenic acid and harpagoside to be evaluation indicator, adopted L9 (34 ) orthogonal design to select out the best extraction.The main determination was by HPLC method.Results Accounted by the total contents of the two composi-tions, the influential effects of the experimental results were extraction solvent >reflux times >the volume of extraction>the circumfluence time.Conclusion The best extracting technology is adding 10-fold times of 50% alcohol, percolating 1 hours, and three times.

Background The surgery for retinal detachment induced by macular hole in high myopic eye has a lower success rate in comparison with other rhegmatogenous retinal detachment.A combination procedure of vitrectomy and heavy silicone oil tamponade for retinal detachment induced by macular hole in high myopic eye has been used,but different outcomes are reported.Objective This study was to assess the efficacy of heavy silicone oil tamponade for the treatment of retinal detachment with macular hole in high myopic eye.Methods The clinical data of 20 eyes of 20 patients who received vitrectomy combined heavy silicone oil tamponade surgery for retinal detachment induced by macular hole in high myopia under the informed consent in Beijing Tongren Eye Center from September 2007 to December 2009 were retrospectively analyzed.The 20 G vitrectomy was used during the surgery.In addition,other procedures,such as epiretinal membrane peeling,retinotomy,endo-laser photocoagulation,phacoemulsification and intraocular lens (IOL) implantation were optionally performed as necessary.No special position was required after the surgery.Heavy silicon oil was removed via pars plana,and retinal reattachment after heavy silicon oil removal was defined as success of surgery.Postoperative LogMAR vision,intraocular pressure,retinal reattachment and complications were observed and evaluated.Results The preoperative average spherical equivalent refractive error was (-14.3 ±3.0) D in the eyes.Among the 20 eyes,there were 7 (35％) recurrent retinal detachment and 7 eyes (35％) complicated with choroidal detachment preoperatively.After surgery,the retinas were reattached in 95％ eyes (19/20),including retinal reattachment after first operation in 18 eyes (90％) and after second surgery in 1 eye (5％).A localized retinal detachment was still existed after a second surgery in the other 1 eye.The mean LogMAR vision improved from preoperative 2.77 ±0.81 to postoperative 1.22±0.46 (P =0.000).All the phakic eyes developed different degrees of sub-capsular cataract.Long-term ocular hypertension was found in 2 eyes after surgery.Conclusions The combination of vitrectomy and heavy silicone oil endotamponade is a safe and effective approach to retinal detachment with macular hole in high myopic patients.This procedure may improve vision and offers comfortable position after surgery for the patients.

The endoplasmic reticulum (ER) serves several important functions, mainly post-translational modification, folding and assembly of newly synthesized secretary proteins, synthesizing lipids and cellular calcium storage. Various factors can disrupt ER homeostasis and disturb its functions, which leads to the accumulation of unfolded and misfolded proteins and to potential cellular dysfunction and pathological consequences, collectively termed ER stress. Recent progress suggests that ER stress plays a key role in the immune response, diabetes, tumor growth, and some neurodegenerative diseases. In particular, ER stress is involved in several processes of cardiovascular diseases, such as ischemia/reperfusion injury, cardiomyopathy, cardiac hypertrophy, heart failure, and atherosclerosis. Further research on the relation of ER stress to cardiovascular diseases will greatly enhance the understanding of these pathological processes and provide novel avenues to potential therapies.

OBJECTIVE:To analyze the characteristics of adverse drug reactions(ADR) induced by antituberculosis drugs so as to provide references for the rational use of drugs in the clinic.METHODS:409 ADR cases induced by 5 main antituberculosis drugs in domestic medical journal from Jan.1997 to Dec.2006 were collected and analyzed statistically.RESULTS:Many systems were involved in ADR,such as skin,urinary system,neural system,hematological system,etc.,which were associated with allergic reaction and toxicity of drugs.Acute renal failure(ARF),drug eruption,fever and anaphylactic shock showed high incidences.CONCLUSION:Attention should be paid to ADR induced by antituberculosis drugs to standardize treatment.