It has widely spread thta critical li lness is characterizedas a sat te of immunosuppression and inflammation,and patients are unable to provide their own nourishment.So it has lead to the ed velopment of un tritional support por ducts or interventions designed to enhance the host immune response and/or suppress the inflammation.But there′s still a lot of controversy about immunonutrition in critically ill patients.This pa-per reviewed the research status of immunonutrition and nutritional support products.

[Objective] To observe the cure effect of Buhuangjin Zhengqi Powder(BZP)on chronic gastritis of splenic-gastric wet heat syndrome.[Method] Randomly divide 100 cases into treatment group(1)with BZP and control group(2)with Mosapride for comparison.[Result] The tongue moss change of group 1 was much better than group 2,so was cure effect.[Conclusion] Revised BZP has definite effect on the said disease.

Objective To summarize the principle and structure of objective structured clinical examination(OSCE)in the graduation practice examination of undergraduate nursing students.Methods A OSCE model was designed with a case running through the whole process of it by referring to the classic model of OSCE and applied it to the graduation practice examination of undergraduate nursing students of grade 2004.Results 75.0%students believed that the setup of OSCE location was reasonable and 78.1%of them thought that they were used to this kind of examination.100.0%of them considered that this examination model could objectively evaluate the general clinical capacity and at the same time make clear the future purpose of next internship stage. Conclusion The OSCE model could objectively evaluate the general clinical ability of students and truly reflect the existing problems,thus provide benefitable reforrences for the next internship stage.

Objective:To study the chemical constituents of the peels collected from Citrus changshan-huyou Y.B.Chang,and further screen the bioactive components as the lead structures.Methods: These compounds were isolated by repeated flash column chromatography on silica gel and Sephadex LH-20.The structures of isolated compounds were elucidated by using IR,EIMS,and NMR analyses.Results: One novel compound along with nine known compounds were obtained and identified as huyoujiasu(Ⅰ),3-hydroxy-4-methoxybenzoic acid(Ⅱ),3,4-dihydroxybenzoic acid(Ⅲ),fatty acid(Ⅳ),gly-ceride(Ⅴ),6,7-dimethoxycoumarin(Ⅵ),6′,7′-dihydroxybergamottin(Ⅶ),daucossterol A(Ⅷ),daucossterol B(Ⅸ) and huyou-triterpenoid(Ⅹ).Conclusion: One new compound,Huyoujiasu,was obtained from these peels by repeated column chromatography,and the other known compounds were isolated from this fruit for the first time as well.

Objective To compare the effects of Graves thyrotoxicosis patients treated by long-term use of anti-thyroid drug ( ATD) and without long-term use of ATD ,and to explore the application value and safety of ATD be-fore 131 I treatment.Methods 62 cases with Graves hyperthyroidism were divided into the two groups according to whether received the long-term ATD treatment.The curative effects,hormone level and safety were compared.Results The success rate of ATD group was 43.75%, the success rate of without ATD treatment group was 56.67%, the difference between the two groups had statistical significance (Ridit=15.152,P=0.000).The thyroid mass,FT3, FT4 ,TSH levels after treatment between two groups had no significant differences , but the difference of the highest iodine uptake rate in 24h had significant difference (t =6.954,P<0.05).The adverse reactions in ATD treated group and ATD untreated group were 7 cases(21.88%) and 3 cases(10.00%),there was statistically significant difference between the two groups(χ2 =4.563,P=0.032).Conclusion Long-term ATD therapy before 131I treatment can reduce the highest iodine uptake rate in 24h,reduce the clinical curative effect and increase adverse reaction rate .

Five compounds, huyouyisu (1), vomifoliol (2), isoferulic acid (3), 1,2,3-trihydroxy-phenol (4) and p-hydroxy-phenol (5), were isolated from the peels of Citrus changshan-huyou Y.B.Chang for the first time by utilizing repeated column chromatography on silica gel. Among them, huyouyisu (1) is a new compound. The structure was elucidated by using 1D and 2D spectra.

Objective To observe the treatment effect of low molecular weight heparin (LMWH) in the treatment of unstable angina pectoris.Methods LMWH (0.4～0.6 ml Bid) was used through subcutaneous injection in 36 cases of unstable angina pectoris for 14 days on end.Results The clinical effective rate was 66.67%.The drug was effective in the decreasing of the frequency and time of angina pectoris,and also in the decreasing of nitroglycerin consumption as well as in the improvement of the scope and severity of cardiac ischemia by ECG.Conclusion LMWH is an effective and safe drug for the treatment of unstable angina pectoris.

Objective To define a suitable and adequate sample volume for the detection of bacterial contamination in cord blood (CB) via BacT/ALERT system. Methods A total of 1 376 cord blood units were routinely screened for aerobic and anaerobic microorganisms by culturing the erythrocyte fraction(EF) or plasma fraction(PF) with 20 ml and 10 ml sample volume. The microbial contamination was detected by BacT/ALERT 3D system, and the results of this method were compared with the improved Martin/thiogly collate broth(22 ℃) and thioglycollate broth(35 ℃).Results The rates of positive BacT/ALERT results were 1.16%(10 ml) and 1.24%(20 ml) for PF, and 3.20%(20 ml) for EF. The positive rate of Martin/thiogly collate broth(22 ℃/35 ℃) was 1.00% for EF. Conclusion Using BacT/ALERT system for microbial detection in cord blood bank can enhance the security of umbilical cord blood transplantation.

Objective To explore the role of infection control in preventing infections in pregnancy-at-term(PAT)parturients with cervical incompetence. Method The strategies of infection control for 80 PAT parturients with cervical incompetence were enforced,including enhanced disinfection of hands,wards,cunnus,intensified care to skin,limited examinations of anus and pubes and prevention of complications. Results All the parturients and their babies were well and safe with one exception,who developed with infection but were cured and discharged by anti-infection managements,complement of energy and increase of nutrition intake. Conclusion Infection control may prevent the infections in PAT parturients with cervical incompetence,enhance the perinatal quality and ensure the safety of mothers and babies.

Objective To further study on the chemical constituents in the peels of Citrus changshan-huyou.Methods The chemical constituents were separated by repeated silica gel column chromatography,the structures were determined by spectral analyses.Results Ten compounds were obtained and identified as huyoujiasu(2'-hydroxy-malonyl-3,4-dihydroxybenzoic acid,Ⅰ),3'-hydroxy-4',5,6,7,8-pentamethoxyflavone(Ⅱ),eriodictyol(Ⅲ),tetracosanoic acid(Ⅳ),glyceryl dodecanoate(Ⅴ),neoeriocitrin(Ⅵ),naringin(Ⅶ),neohesperidin(Ⅷ),4-methoxy-3-hydroxybenzoic acid(Ⅸ),and 3,4-dihydroxybenzoic acid(Ⅹ).Conclusion 2'-hydroxy-malonyl-3,4-dihydroxybenzoic acid is a new compound and the above ten compounds are obtained from this plant for the first time.