ObjectiveTo explore the application of peripherally inserted central venous catheter (PICC)and central venous catheter (CVC) in the surgical parenteral nutrition.MethodThe operation time,success rate,indwelling duration,abnormal biopsy,and adverse reactions of PICC and CVC were retrospectively compared.ResultsCVC had significantly shorter operation time than PICC groups [ (28.67 ±5.13) min vs.(45.20 ±6.89)min,P =0.035 ).The mean indwelling duration was significantly longer in PICC group than in CVC group [ ( 114.85 ± 10.29) d vs.(24.78 ± 8.42) d,P =0.033 ].PICC group was superior to CVC group in terms of five complication items,while only phlebitis was more frequent/severe in CVC group.ConclusionsPICC may be more suitable for long-term ( ＞4 weeks) catheter-based nutrition.CVC has short operation time and fast flow rate,and therefore is most suitable for rescue treatment for critically ill patients.

BACKGROUND: Chondron is a basic microanatomical unit of articular cartilage. lncreasing evidence suggests that the pericellular matrix (PCM) is a distinct functional compartment in articular cartilage, influencing the metabolic, micromechanical environment, and degeneration of chondrocytes. But the precise functions and action mechanism need further investigation.OBJECTIVE: To review the literature pertinent to the morphology, function, isolation of the chondron in articular cartilage, and its degenerative events during the progression of osteoarthritis (OA).METHODS: This review summarized the articles published in the PubMed database before July 2009. In addition, recent data and figure of our laboratory on the morphology and biomechanics of chondron and chondrocyte were supplemented. RESULTS AND CONCLUSION: The PCM is primarily characterized by the presence of type Ⅵ collagen, and these components are widespread in the expansive extracellular matrix (ECM) in newborns, while in mature the components are mainly localized to a narrow pericellular zone. The three-dimensional morphology of chondron has been recently quantified in situ with fluorescence confocal microscopy, and the mechanical properties of the isolated individual chondrons and their PCM are measured using the micropipette technique and atomic force microscopy. More studies have shown that the presence of the PCM in chondrons has a profound influence on chondrocyte gene expression. At the same time, structural, histochemical and biomechanical studies indicate the chondron and their PCM may undergo degenerative processes with osteoarthritis, similar to those occurring in the ECM, Although the precise function of the PCM is unknown, increasing evidence in vivo or in vitro suggests that the PCM is a basic microanatomical unit in articular cartilage, influencing the metabolic and micromechanical environment of chondrocytes.Department of Orthopedics, the Second Hospital of Shanxi Medical University, Shanxi Key Laboratory of Bone and Soft Tissue Injury Repair,Taiyuan 030001,Shanxi Province,China

Objective:To study the effects of Naoling tablet on Aristolochia acid A from Aristolochia fangchi,preliminary explore the deintoxication of Aristolochia fangchi.Methods:Absorption value of Aristolochhia aicd A was determined by HPLC after Aristolochi fangchi decocted with Naoling tablet,the change of content of Aristolochia acid A was observed .Results:the content of Aristolochia acid A from Aristolochia fangchi was markedly decreased after Naoling tablet was added.Conclusion:Naoling tablet can markedly decreased the content of Aristolochhia aicd A from Aristolochia fangchi.

Objective To explore a suitable mode of prenatal ultrasound diagnosis of fetal malformations with early neonatal surgical treatment. Methods Nine fetus with surgical malformations diagnosed prenatally by ultrasound in our hospital from Mar. 1998 to Dec. 2000 were analysed. Results There were two cases diagnosed in the second trimester, 7 in the third trimester, including 1 duodeneal atresia with annular pancreas, 1 abdominal wall defect, 1 congenital diaphragmatic hernia, 1 huge omphalocele, 1 high imperforate anus, 4 hydronephrosis (2 mild and 2 severe). Six cases were operated in neonatal period, two were treated conservatively, and one did induced abortion. All cases recovered except 1 death. Conclusions The mode of prenatal ultrasound diagnosis with surgery in early neonatal period is a suitable way in China before the fetal surgery is applied. It is important to make effort to increase sensitivity of sonographic diagnosis of fetal malformation and to get early treatment in perinatal period.

Objective To study the effects of Ziyin Bushen Pill on Aristolochia acid A in Aristolochia fangchi,and preliminary study on reducing poisonous effects of Ziyin Bushen Pill to Aristolochia fangchi.Methods Absorption of Aristolochhia acid A in the mingled decoction of Aristolochia fangchi and Ziyin Bushen Pill by HPLC,and the change of Aristolochia acid A was observed.Results Aristolochia acid A content of Aristolochia fangchi was markedly decreased after Ziyin Bushen Pill was added.Conclusion Ziyin Bushen Pill can markedly decreased Aristolochhia acid A content of Aristolochia fangchi.

Objective To investigate the effects and probable mechanism ofShenfu injection on the oxidaitve damage of H2O2-induced PC12 cells.Methods PC12 cells were cultured and exposed to 100μmol/L H2O2 for 1 h to establish the oxidative damage model. The protective effect ofShenfu injection was observed by the cell survival rate measured by colorimetric MTT assay, and the leakage rate of lactic dehydrogense (LDH). Western blot methods were used to detect the expression of NF-κB signaling pathway.Results Compared with the model group,Shenfu injection at 5, 10, 20 ml/L could improve the PC12 cells survival rate (83.11% ± 2.59 %, 87.99% ± 0.59%, 85.26% ± 1.07%vs. 73.82% ± 1.82%;P<0.01 orP<0.05), decrease the LDH leakage rate (32.75% ± 4.10%, 28.52% ± 1.14%, 35.79% ± 1.62%vs. 64.34% ± 3.18%;P<0.01 or P<0.05). Western blot results showed thatShenfu injection could protect the PC12 cells from oxidaitve damage by suppressing the p-p65/p65 (1.30 ± 0.10, 1.17 ± 0.06, 1.37 ± 0.15 vs. 1.70 ± 0.10;P<0.01 orP<0.05), p-IκBα/IκBα (1.07 ± 0.12, 1.00 ± 0.10, 1.03 ± 0.06 vs. 1.17 ± 0.06; P<0.01 orP<0.05).ConclusionShenfu injection has a obvious antioxidant effect on PC12 cells in vitro.

Objective To investigate the content of intestinal fatty acid binding protein (IFABP) and its clinical significance in patients with severe sepsis.Methods A prospective observational study was conducted.Fifty patients with severe sepsis admitted to intensive care unit (ICU) of the First Affiliated Hospital of China Medical University from July to December 2012 were enrolled,and 20 healthy patients served as control group.The concentrations of serum IFABP,interleukin-6 (IL-6),and tumor necrosis factor-α (TNF-α) were determined with enzyme-linked immunosorbent assay (ELISA) on days 0,1 and 3 after ICU admission.Acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) and sequential organ failure assessment (SOFA) score,28-day prognosis,acute gastrointestinal injury (AGI) grade were recorded at the same time.Furthermore,the contents of IFABP were compared between control group and the severe sepsis group,abdominal infection group and non-abdominal infection group,the survival group and the death group,as well as among different AGI-grade groups.Correlation analysis of IFABP and inflammatory factors,IFABP and two scores,and IFABP and time of stay in ICU and mechanical ventilation were studied.Multivariate logistic regression and analysis of 28-day outcome of the patients were also studied.Results IFABP levels were increased in severe sepsis patients on days 0,1 and 3 compared with those of healthy control group (mg/L:731.90 ±53.91,592.07 ±41.94,511.85 ±47.97 vs.439.88 ±23.68,all P =0.000).There was no statistical significance of IFABP levels between abdominal infection group and non-abdominal infection group,the survival group and the death group,or among different AGI-grade groups.The correlation analysis showed that IFABP was statistically related with IL-6 (r=0.794,P=0.000),TNF-α (r=0.878,P=0.010),APACHE Ⅱ score (r=0.428,P=0.000) in patients with severe sepsis.Significant correlations were also found between IFABP and IL-6 (r=0.812,P=0.000),TNF-α (r=0.885,P=0.000) in abdominal infection group,as well as in non-abdominal infection group (IL-6:r=0.739,P=0.000; TNF-α:r=0.828,P=0.000).As shown by multivariate logistic regression analysis,SOFA scores on days 0,1,3 were the independent risk factors for death [odds ratio (OR) was 1.624 (P=0.004),1.411 (P=0.027),1.740 (P=0.012),respectively],but IFABP level,AGI grade,and APACHE Ⅱ score had no influence on death rate.Conclusion IFABP concentrations in patients with severe sepsis were significantly increased,and it is correlated well to IL-6,TNF-α and APACHE Ⅱ score,but did not related obviously with AGI grade and the prognosis of the patients.

Objective To analyze the epidemiological characteristics of reported emergency public health events at schools from 2006 to 2013, and provide a scientific basis for better disposal of school-related events. Methods The reported emergency public health events at schools in Tianjin from 2006 to 2013 were collected, and descriptive epidemiological analysis was conducted on data. Results A total of 267 reported emergency public health events at school in Tianjin during 2006-2013, of which 257 infectious disease events, accounting for 96.25%. The incident occurred in primary schools and nurseries. The peak was from March to June and October to December for the incident. The top three species of disease onset were influenza (2 360 cases), chicken pox (2 032 cases) and mumps (1 813 cases). There was a correlation between the duration and interval from onset of the first case to report of emergency public health events(rs=0.522,P＜0.05). Conclusion In recent years, school public health emergency events are high momentum, mainly in rural areas, primary schools and nurseries. Timely detection and disposal of emergency public health events can reduce the harm generated by them.

Objective To determine the relationship between acceptance of disability and posttraumatic stress response in patients with brachial plexus injury. Methods Total 160 patients with brachial plexus injury were recruited and investigated with the Impact of Event Scale-Revised (IES-R) and the Acceptance of Disability Scale (ADS). Results The total score of ADS was (79.07±11.99) which showed medium level of acceptance of disability. The total score of IES-R was 4-66 (33.51±14.41), which showed that most of the patients suffered from posttranmatic stress response. Significantly negative correlation was found between acceptance of disability and posttraumatie stress response(r=-0.480, P<0.001). Conclusions Nurses should pay more attention to the acceptance of disability and posttranmatic stress response in patients with brachial plexus injury, and provide appropriate health education and effective psychological intervention to improve the patients' mental health and quality of llfe.

Objective To discuss the influence of comprehensive rehabilitative nursing by traditional Chinese medicine(TCM)the neural function impairment, activity of daily living(ADL)and accompanying complications of patients in acute phase of cerebral apoplexy. Methods 238 patients from 3 cooperative hospitals from September in 2004 to September in 2006 were randomly chosen and divided into the test group(117 cases)and the control group(121 cases).The medication treatment in the two groups were basically the same. The comprehensive rehabilitative nursing with traditional Chinese medicine was adopted in the test group and the control group received routine nursing intervention. The clinical nerve function limitation score(CNS)and the ADL were evaluated within the first week and the 4th week after intervention. The incidence rate of complications was also determined. Results The CNS and ADL results in the observation group were better than those in the control group(P＜0.01).The incidence rate was lower than that in the observation group. Conclusion The comprehensive rehabilitative nursing by TCM could facilitate the functional recovery of limbs and improve activity of daily living.This intervention could be applied in clinic, family and community because of its characteristics such as simplicity, feasibility and little adverse effect.