Objective:To establish the methods and standard for the evaluation of rational application of parenteral nutrition ( PN) in primary hospitals. Methods:Medical records with the use of fat emulsion, amino acids (17) and glucose (11%) injection were col-lected. The integrity of the medical records was analyzed, the compatibility of supplementary drugs was evaluated, and basal metabo-lism rate(BMR) was calculated for the relevant assessment. Results:Totally 66. 7% of the patients had incomplete basic parameters of nutritional risk assessment, the cases had different course of treatment but showed no significant difference in total usage of fat emul-sion, amino acids (17) and glucose (11%) injection,and the non-protein calories of fat emulsion, amino acids (17) and glucose (11%) injection accounted for 72. 1% of basal metabolism rate of an individual on average (S=8. 9). Supplementary usage of KCl accounted for 63. 0% of the cases, of which 70. 6% were overdosed;62. 9% of the cases used supplementary alanyl-glutamine with overdosage. Conclusion:In the PN application in our hospital, nutritional risk assessment is basically missed, and there is a great gap between the level of developing reasonable individual program and the requirements in guidelines. Clinical pharmacists should enhance the related monitoring and evaluation in PN application.

Objective To investigate the application value of contrast-enhanced ultrasound in the diagnosis of ovarian masses.Methods Ninety-four patients with ovarian masses were observed and undetermined by conventional ultrasound examinations who were underwent contrast-enhanced ultrasound examinations and were made the time-intensity curve.By analyzing the perfusion characteristics and the quantitative parameters of time-intensity curve,we compared the difference of different masses.Results The perfusion characteristics and the quantitative parameters of the time-intensity curve were different.The arrival time and the time to peak intensity of benign masses were later than those of malignant tumors.The peak iniensity of benign masses was lower than that of malignant tumors.There was a significant difference between the two groups.The arrival time and the time to peak intensity of benign tumors were later than those of malignant tumors.The peak intensity of benign tumors was lower than that of malignant tumors.There was a significant difference between the two groups.The time to peak intensity of non-tumorous lesions was later than that of malignant tumors.The peak intensity of non-tumorous lesions was lower than that of malignant tumors.There was a significant difference between the two groups.The arrival time of non-tumorous lesions was earlier than that of benign tumors.There was a significant difference between the two groups.Conclusion The perfusion characteristics and the quantitative parameters that draw from the time-intensity curve of different masses are different.Contrast-enhanced ultrasound is contributive to the diagnosis and the differential diagnosis of different masses.Contrast-enhanced ultrasound also has great clinical values to those ovarian masses whose ultrasonic appearance is complex and difficult to diagnose qualitatively.

Objective To investigate the association between apolipoprotein E (apoE) genotype polymorphism and cerebral palsy (CP) in Han Chinese children. Methods Two hundred and forty Han Chinese children were selected, including 120 children with cerebral palsy (CP group) and 120 normal children (control group).Polymerase chain reaction-restricted fragment length polymorphism analysis was used to determine the genotype and alleles of apoE genotype in the two groups. Results The genotype distributions of apoE in the two groups were consistent with the existence of a Hardy-Weinberg equilibrium. There were significant differences in the distributions of allelic frequency and apoE genotype between the two groups. Carrying the ε4 allele was related to cerebral palsy, and the overall risk for cerebral palsy was elevated about 5.5-fold among children carrying the ε4 allele.Conclusions There is an association between apoE genotype and cerebral palsy, and apoE's ε4 allele is the associated risk factor.

BACKGROUND: Nitric oxide synthase(NOS) is the key factor for the synthesis of nitric oxide (NO) . Because NO combines with oxygen, hemoglobin and other substances in vivo easily and deactivates quickly, and it is not exactly determined, so determining the activity of NOS is the important link for further studying the pathogenesis of NO in cerebral ischemia/reperfusion (I/R)injury.OBJECTIVE: To study the effect of different types of NOS in the process of cerebral I/R injury.DESIGN: Randomized and controlled animal experiment.SETTING: Instituteof Cerebrovascular Disease, Affiliated Hospital of Medical College of Qingdao University.MATERIALS: This experiment was carried out in the Shandong Key Laboratory of Prevention and Treatment for Encephalopathy from May to December 2005. Twenty-eight adult healthy male Wistar rats, of clean grade, weighing from 220 to 260 g, were provided by the Experimental Animal Center of Shandong University. The involved rats were randomly divided into sham-operation group (n =4) and cerebral ischemia group (n =24). Six time points were set in cerebral ischemia group: ischemia 1 hour reperfusion 6 hours, 12 hours, 1 day, 3 days, 7 days and 14 days, 4 rats at each time point.METHODS: Rat models of middle cerebral artery occlusion/reperfusion were established by suture-occluded method through inserting a suture into the left internal-external carotid artery. The expressions of different types of NOS at different time points after cerebral I/R were detected by immunohistochemical technique.MAIN OUTCOME MEASURES: ①Toluidine blue-stained two groups of nerve cells; ② The expression and distribution of neuronal NOS (nNOS), endothelial NOS (eNOS) and inducible NOS(iNOS) at different time points.RESULTS: ①Karyopyknosis and cell debris appeared in the nerve cells of the injured region of cerebral ischemia group,and there were no significant differences of cells among different time points. ② Six hours after reperfusion, the expressions of nNOS, eNOS and iNOS were found in the neurons of brain tissue and increased with the elongation of time of reperfusion. The regions in which different types of NOS in neurons of brain tissue were expressed were cortical area and corpora striata. nNOS and iNOS were highly expressed within 12 hours to 7 days after reperfusion in the brain, and eNOS was highly expressed within a short time period, i.e. 6 hours to 3 days after reperfusion. eNOS expression increasing and decreasing occurred earlier than nNOS and iNOS. But the expressions of three kinds of NOS all reached peak on the first day after reperfusion. The changing tendencies of the expression of three kinds of NOS in the cortical area and corpora striata were the same basically.CONCLUSION: After cerebral I/R injury, the high expression of eNOS occurs early and lasts for a short time, while that of nNOS and iNOS occurs late and lasts for a long time.

Objective To probe into the employment and turnover changes of health workers at township health centers,for analysis of the incentive preferences and methods characteristic of such people.Methods Questionnaire and interview investigations were made for 16 health centers to learn their personnel turnover from 2008 to 2010 in Junan county,Shandong province,and to learn their incentive preferences.Results Health workers of turnover tendency are mostly found among women,clinicians and nurses of college or above degree and those less than 39 years old.The top five incentive factors for such health workers are as follows:better working environment; better pay; better security for living; better hospital management; and better career development opportunities.Conclusion Township health centers should seize policy support of the health reform,by focusing on not only economic incentives such as the income and living conditions of health workers of turnover tendency,but also on non-economic factors such as career development opportunities.

Objective To study the effects and mechanisms of Lovastatin preconditioning on cardiac myocyte apoptosis in acute ischemic and reperfused (I/R) rat hearts. Methods 24 Sprague-Dawley male rats were randomly divided into three groups: control group (C); Lovastatin group (L) treated with lovastatin 15 mg/kg once a day for two weeks; Lovastatin and L-NAME group (N) treated with the same dose of Lovastatin with L group and L-NAME 30 mg/kg once a day for two weeks. Rat heart models of I/R were established with coronary occlusion 30 mintues and reperfusion 30 mintues of the left anterior descending artery after two-week administration. Expression of Bcl-2,Bax protein and myocardium apoptosis were investigated in every group. Results There was no change in blood lipin, expression of Bax protein was increased (P

ObjectiveTo approach effects of acupuncture on ganglioside in rats with acute cerebral ischemia.Methods204 Wistar rats were randomly divided into the normal group, model group, acupuncture group and medicine group, and middle cerebral artery embolism has been made by thread-ligation method in the latter three groups. Ganglioside content in the rat brain had been measured respectively after cerebral ischemia 1,2,3,5,7,12 and 24 hours.ResultsThe content of lipid-bound sialic acid (LBSA) has decreased significantly after the acute cerebral ischemia, but LBSA contents of the acupuncture group and medicine group were higher significantly than that of the model group, and these two groups have been similar in curative effect, and have difference only at embolism 2,3 and 5 hours.Conclusion Acupuncture can regulate ganglioside and play the role of cerebral protection and neuroplasticity.

Objective To explore the effects of early acupuncture on the expression of neurofilament protein (NFP) in the brain and the neurobehavior of the neonatal rats with brain injury. Methods The pregnant Wistar rats were randomly divided into two groups: lipopolysaccharide (LPS) group and control group, which were consecutively injected intraperitoneally with LPS or saline. The full-term newborn rats from LPS group were randomly divided into acupuncture group and model group. Acupuncture group was acupunctured from postnatal 8 d. They were evaluated with hanging test, and the expression of NFP was detected with immunohistochemical stain 21 d after birth. Results Both the scores of hanging test and the expression of NFP were the highest in the control group, the lowest in the model group and medium in the acupuncture group (P<0.01). Conclusion Acupuncture may increase the expression of NFP and improve locomotor function of the neonatal rats with brain injury caused by intrauterine infection.

BACKGROUND: It has been demonstrated that insulin-like growth factor-1 (IGF-1) is a kind of neurotrophic factor and protects from cerebral ischemia/reperfusion injury, the expression of IGF-1 is associated with the attack of ischemic stroke. The effects of IGF-1 and its receptor (IGF-1R) on neurobehavioral function are to be further studied.OBJECTIVE: To observe the effects of IGF-1 and IGF-1R on neurobehavioral function in rat models of cerebral ischemia/reperfusion injury.DESIGN: A randomized controlled observation.SETTING: Institute of Cerebrovascular Diseases, Affiliated Hospital of Qingdao University Medical College.MATERIALS: The experiments were carried out in Shandong Key Laboratory for Prevention and Treatment of Brain diseases. Twenty-eight healthy adult Wistar rats of clean degree, weighing 220-260 g, were provided by the experimental animal center of Shandong University.METHODS: The rats were randomly divided into experimental group (n =24) and sham-operated group (n =4). The middle cerebral artery occlusion/reperfusion (MCAO/R) models were established by inserting a thread through left external-internal carotid arteries. The sham-operated rats were given the same treatments except inserting thread. ①Neurologic deficit test: The rats in the experimental group were assessed according to Bederson standard after 1-hour ischemia and 6, 12-hour, 1, 3, 7 and 14-day reperfusion respectively. The sham-operated rats were assessed at corresponding time points; Without neurologic deficit was marked as 0 point; flexion of anterior claws as 1 point; unable to act against the pushing from the contralateral side as 2 points; circling while walking as 3 points; shaking as 4 points;unconscious mind as 5 points. ② Sample collection and treatment: The samples in the experimental group were collected after 1-hour ischemia and 6, 12-hour, 1, 3, 7 and 14-day reperfusion, and those in the sham-operated group ere collected at 24 hours postoperatively. The rats were anesthetized, brain samples were got at about 5 mm posterior to optic chiasma after brains were removed completely, then serial coronal sections (5 μm) were prepared, and 1 from 10 sections was stuck to the cover glasses treated with poly-L-lysine. ③ Morphological observation of neurons: The neurons in brain were observed by toluidine blue staining. ④ Detection of IGF-1 and IGF-1R: The expressions of IGF-1 and IGF-1R in cortex and striatum were detected with immunohistochemical technique, 4 fields were randomly selected to count the positive cells under high-power microscope (×400).MAIN OUTCOME MEASURES: ① The neurologic deficit; ② Morphological changes of neurons in brain; ③ Expressions of IGF-1 and IGF-1R in cortex and striatum.RESULTS: All the 28 rats were involved in the analysis of results. ① The neurologic deficit: The scores of neurologic deficit were (1.50±058) and (1.50±0.78) in rats after 7 and 14-day reperfusion, which were lower than that in rats after 6-hour reperfusion [(3.00±0.00), P ＜ 0.05]. ② Morphological changes of neurons in brain: The neurons in ischemic area appeared as paryopyknosis and became irregular in shape, there were obvious gaps around the cells, also deeply stained as purplish blue, nucleolus disappeared, and there were many scattered cellular fragments. ③ Expressions of IGF-1 and IGF-1R in cortex and striatum: The numbers of IGF-1 positive cells in cortex were (8.75±2.06), (11.13±1.14),(19.75±3.18), (17.38±3.11 ) and (11.23±2.28) respectively in rats after 6, 12-hours and 1, 3, 7-day reperfusion, which all were higher than that in sham-operated rats [(3.88±1.46), P ＜ 0.05], the numbers of IGF-1 positive cells in striatum were(8.25±2.21), (11.34±2.21), (18.23±2.64), (18.56±2.34) and (11.31±2.14) respectively in rats after 6, 12 hours and 1, 3, 7days reperfusion , which were also higher than that in sham-operated rats [(4.12±2.24), P ＜ 0.05]. The numbers of IGF-1R positive cells in cortex were (7.63±1.50), (10.50±2.34), (15.55±3.12), (15.37±3.01), (8.86±2.75) respectively in rats after 6, 12-hours and 1,3,7-day reperfusion, which all were higher than that in sham-operated rats [(4.13±1.81), P ＜0.05]. Those in striatum were (8.33±2.31), (10.24±2.09), (14.72±2.17), (14.24±2.77), (8.38±2.05), which were also higher than that in sham-operated rats [(3.76±2.35), P ＜ 0.05].CONCLUSION: The neurological function is damaged after cerebral ischemia/reperfusion, but it has a trend of self-recovery. The expressions of IGF-1 and IGF-1R are mainly distributed in cortex and striatum. Higher expressions of IGF-1 and IGF-1R maintain during 12 hours to 7 days after reperfusion and have a peak value at 1-3 days, which suggests that early expression of IGF-1 and IGF-1R are certain related to the recovery of neurological function.

BACKGROUND: Brain injury can induce the increased expression of basic fibroblast growth factor (bFGF) in brain,whereas FGFR is a very important player in the cell proliferation and differentiation, angiogenesis, skeletogeny, etc.OBJECTIVE: To observe the effect of bFGF and its receptor on neuronal apoptosis following cerebral ischemia/reperfusion injury in rats.DESIGN: A randomized grouping design and animal experiment.SETTING: Institute of Cerebrovascular Disease, Affiliated Hospital of Qingdao University Medical College.MATERIALS: Twenty-eight healthy adult Wistar rats of clean degree, weighing 220-260 g, were provided by the experimental animal center of Shandong University. Rabbit-anti-rat bFGF and fibroblast growth factor receptor-1(FGFR-1) monoclonal antibodies were provided by Wuhan Boster Biological Technology, Co.,Ltd.METHODS: The experiment was carried out in Shandong Key Laboratory for Prevention and Treatment of Brain diseases.① The rats were randomly divided into experimental group (n =24) and sham-operated group (n =4). Models of middle cerebral artery occlusion/reperfusion (MCAO/R) were established by thread occlusion via left external-internal carotid arteries, and 4 rats in the experimental group were sampled at 1-hour ischemia/6, 12-hour, 1, 3, 7 and 14-day reperfusion respectively. The rats in the sham-operated group were given the same treatment without inserting thread.After anesthesia, the brain was removed completely by cutting head, then the brain tissue at about 5 mm posterior to optic chiasma was cut down, then serial coronal sections (5 μm) were prepared. ② The brain tissues were stained with ematoxylin-eosin (HE), and the forms of neurons were observed under microscope. ③ TdT-mediated dUTP-biotin nick end labeling (TUNEL) method: there were buffy granules in nucleus which was positively stained (apoptosis). Four fields were randomly selected from cortex and striatum to count positive cells under high-power microscope (×400). ④ The sections were stained with rabbit-anti-rat bFGF and FGFR-1 monoclonal antibodies, 4 fields were randomly selected from cortex and striatum to count positive cells under high-power microscope (×400).MAIN OUTCOME MEASURES: Apoptosis and the expressions of bFGF and FGFR-1.RESULTS: All the 28 rats were involved in the analysis of results. ① In the experimental group, the neurons in the ischemic sites were obviously decreased, some neurons appeared as paryopyknosis and became irregular, also deeply stained as purplish blue, nucleolus disappeared, and there were many scattered cellular fragments. ② In the sham-operated group, there were a few apoptotic neurons in the brain tissue, and the apoptotic neurons were obviously increased after ischemia, which mainly observed in cortexes and striatums of frontal and paritetal lobes. In the experimental group, apoptotic cells in cortexes began to increase gradually at 6 hours, and there were more cells at 12hours and 3 days, which reached the peak value at 1 day, and began to decrease at 3 day, but there were still more apoptotic cells at 14 days than in the sham-operated group. The number of apoptotic neurons and the changing trend in striatums were generally the same as those in cortexes (P ＞ 0.05). ③ In the sham-operated group, there were weak bFGF expression in the neurons of brain tissue, but there were fewer lightly stained positive cells. After cerebral ischemia, the bFGF expressions were increased, mainly observed in cortexes and striatums. The bFGF expression appeared at 6 hours after cerebral ischemia/reperfusion, and the number was increased gradually and deeply stained as the time of reperfusion prolonged (Figure 3), it reached the peak value at 1-3 days, and then weakened gradually, but it was still higher than in the sham-operated group at 14 days [(5.01 ±1.71), (5.21 ± 1.62) cells/visual field; (2.03± 1.73),(2.46± 1.38) cells/visual field, P ＜ 0.05]. ④ In the sham-operated group, lightly stained FGFR-1 positive cells could be observed in brain tissue. At 6 hours after cerebral ischemia/reperfusion, the FGFR positive cells began to increased in cortexes and striatums, which were the most at 1-3 days, and gradually decreased after 3 days, and the number was still a little more than that in the sham-operated group at 14 days [(5.01± 1.41), (5.20± 1.33) cells/visual field; (2.25±1.67),(2.32± 1.61 ) cells/visual field].CONCLUSION: After cerebral ischemia/reperfusion, the expressions of endogenous bFGF and FGFR-1 may be activated in cortex and striatum, then inhibit the neuronal apoptosis, and play its neuroprotective role.