Clinicians should assume the responsibility of nutritional therapy for satisfactory outcomes. They should master knowledge on nutritional metabolism, and participate in the administration of nutritional support. Clinicians should be acquainted with new concepts and standardized techniques in this field, such as different requirement of energy, understanding of early nutritional support, and optimal regimens of enteral or parenteral nutrition.
China ; Enteral Nutrition ; Humans ; Nutritional Support ; Parenteral Nutrition

MRI system,as an imaging diagnosis equipment,plays a very important role in diagnosis and treatment.For the steady avail of MRI system,MRI eliminable faults in CBMDisc(1995~2006) were analyzed.The types and occurrence frequency of MRI eliminable faults were elaborated so as to provide reliable data for reference.

MRI system is composed of many independent subsystems, in which RF, Gradient, Coil, MRI magnet subsystem are the most important and complex subsystems. Every subsystem consists of different components. Based on the analysis of MRI eliminable faults in CBMDisc (1995 ~ 2006), the types and occurrence frequency of MRI eliminable faults are expatiated so as to provide reliable data for reference.

Based on the analysis on "China biomedical medical literature database"(CBMdisc) in the field of MRI Maintenance composed by army writers from May,1994 to 2007,the following results can be obtained: the total number of writers amounts to 75,106 person-time,27 of them are the first writers,and 11 are main writers;among the total 48 pieces of work,33 pieces are written by more then one writer;the unit with the largest number of published writers is Jinan Military Area Command with Nanjing Military Area Command the second,Lanzhou Military Area Command the third;one main writer has a maximum of 7 pieces.The research makes a close study of the army writers in field of MRI maintenance,indicating the lack of intellectual personnel in the domain of Medicine Engineering in military system.

OBJECTIVE:To explore the new drug purchasing mode using autoregressive integrated moving-average (ARIMA) prediction model for improvement of the working quality and efficiency in hospital drug storeroom.METHODS:Drug consumption data from week 1 to week 47 in 2008 were collected.According to ABC method,category A drugs were defined among which 10 kinds of drugs were sampled randomly.Based on the data of from week 1 to week 44 in 2008,software SPSS13 was applied for the modeling and fitting of ARIMA model.The established model was applied to predict the data of from week 45 to 47,with the predicated data compared with the actual consumption data.RESULTS:The predicted purchasing amount using ARIMA model were consistent with the actual consumption data,with prediction accuracy for quantity at 89.19% and prediction accuracy for whole unit of purchased drugs at 97.56%,respectively.CONCLUSIONS:Good fitting and high short-medium term predication accuracy were obtained in the prediction using ARIMA model,and which could provide scientific support for drug purchasing and help manage the drug stock reasonably without appearance of out of stock or overstock.

Technology of radiotheraphy has stepped into an era of digital photography and replaced the screen piece combination system.This thesis briefly expounds the advantages and prospect of computer X-ray photography,and discusses its problems and effective solutions in clinical practice.

Objective To evaluate the prognostic value of urine paraquat (PQ) concentrations combined with poisoning time and creatinine clearance rate (CCr) on prognosis of patients with acute paraquat poisoning (APP). Methods A retrospective case control study was conducted. Clinical data of 96 patients with APP admitted to Department of Emergency of Shengjing Hospital of China Medical University from March 2014 to May 2016 were analyzed. The gender, age, body weight, urine PQ concentrations (determined by semi-quantitative colorimetric method), poisoning time (time from oral poison to urine detection) and CCr of patients were collected, and poisoning index (poisoning index = urine PQ concentrations × poisoning time/CCr) and simplified poisoning index (simplified poisoning index = urine PQ concentrations × poisoning time) were calculated. The patients were divided into death group and survival group according to 2-month outcome after poisoned with clinical data and telephone follow-up. The urine PQ concentrations, poisoning index, and simplified poisoning index between the two groups were compared. Binary classification logistic regression was used to analyze the risk factors affecting prognosis. Receiver-operating characteristic curve (ROC) and diagnostic test were used to analyze the prognostic value of the parameters. Results Compared with survival group, the urine PQ concentrations [mg/L: 30.00 (10.00, 100.00) vs. 10.00 (3.00, 10.00)], poisoning index [mg·h-1·μmol-1: 12.72 (1.86, 33.75) vs. 0.56 (0.18, 1.12)], and simplified poisoning index [mg·h-1·L-1: 600.00 (150.00, 1 000.00) vs. 60.00 (18.00, 120.00)] in death group were significantly increased (all P < 0.01). It was shown by logistic regression analysis that both urine PQ concentrations [odds ratio (OR) = 1.046, 95% confidence interval (95%CI) = 1.006-1.087, P = 0.022] and poisoning index (OR = 1.353, 95%CI = 0.029-1.815, P = 0.031) were independent risk factors affecting the prognosis of patients with APP. It was shown by ROC curve and diagnostic test that the poisoning index had greater area under ROC curve (AUC was 0.902) for evaluating the prognosis of patients with APP. When the best cut-off value was greater than 1.23 mg·h-1·μmol-1, the sensitivity was 90.91%, and the specificity was 73.08%. The AUC of urine PQ concentrations for evaluating the prognosis was 0.759. When the best cut-off value was greater than 20.00 mg/L, the sensitivity was 63.64%, and the specificity was 76.92%. The AUC of simplified poisoning index for evaluating the prognosis was 0.846. When the best cut-off value was greater than 135.00 mg·h-1·L-1, the sensitivity was 81.82%, and the specificity was 76.92%. Conclusion The poisoning index calculated with urine PQ concentrations combined with poisoning time and CCr has prognostic value for prognosis of APP patients, and the prognostic value of poisoning index is greater than that of the urine PQ concentrations alone.

Objective To investigate the clinical significance of pre-operative ancl intra-operative insulinomas localization, and improve the diagnostic accuracy. Methods 75 patients with suspected insulinomas who were treated surgically were enrolled; all the patients had pathological evidence of insulinomas. The data of pre-operative ultrasound, CT, MRI and intra-operative ultrasound and surgical palpation were collected and analyzed. Results The sensitivity of localization procedures was as follows: ultrasonography 30.7% ( 23/75 ), CT 40.0% (24/60) , MRI 45.4% ( 22/48 ) , while surgical palpation was 80.4% , intra-operative ultrasound 96.4%. The accuracy of intra-operative procedures was higher than that of pre-operative procedures. Conclusions It was difficult to accurately localize insulinomas before operation, but intra-operative palpation and iutra-operative US was easy to perform and highly accurate. Therefore, too much emphasis should not be placed on pre-operative imaging tests.

OBJECTIVE: To explore the association between low flow rate and reperfusion injury during the process of preserving liver by cold machine perfusing perfluorochemical oxygen carder solution. METHODS: Forty-four male adult Wister rats were randomly divided into normal, control, experimental Ⅰ and experimental Ⅱ groups. In the normal group, the removed liver was performed isolated reperfusion guided by Clavien method. In the other 3 groups, the removed liver was infused through the portal vein by the 4-5 ℃ conserved perfluorochemical oxygen carder solution. The infused rate was controlled at 0.4, 0.2, 0.1 mL/(min·g) with 18 hours perfusion, After that, isolated reperfusion was performed. The activity of aspartate aminotransferase, alanine transaminase and endotheiin mass concentration of the effluent was detected at minutes 10, 30, and 60 after reperfusion. The histopathological changes of liver under light and election microscopy were also observed. RESULTS: The activity of aspartate aminotransferase, alanine transaminase and endothelin mass concentration had no remarkable differences between the experimental Ⅰ group and control group (P > 0.05). The differences between the experimental Ⅱ group and control group were remarkable (P < 0.05). The light and electron microscopy showed that the histopathological changes of liver in the control and experimental Ⅰ groups was lightener than experimental Ⅱ group. CONCLUSION: During the process of preserving liver by cold machine perfusion, the rate of 0.1 ml/(min·g) perfluorochemical oxygen carder solution increase the injury of hepatocyte and sinusoidal endothelial cells, which eventually result in severity of reperfusion injury.

A total of 60 infants with severe persistent pulmonary hypertension (PPHN) at our NICU from January 2006 to December 2012 were divided into research group[(n =32,high-frequency oscillatory ventilation(HFOV) plus sildenafil)]and control group (n =28,HFOV only).Mean pulmonary arterial pulmonary arterial (MPAP),blood gas analysis,oxygenation index (OI),PO2 to fraction of inspired oxygen ratio (PO2/FiO2) before and after treatment were compared between two groups.After 3-day treatment,MPAP (mm Hg)(32 ±6) vs.(43 ±9)mm Hg,PCO2(mm Hg)(36 ±9) vs.(43 ±9),OI(56 ±22) vs.(85 ±21) in research group were significantly lower than those in control group(P ＜ 0.05) ; in comparison with control group,PO2(mm Hg) (89 ±15) vs.(72 ±22),PO2/FiO2(mm Hg) (223 ± 18) vs.(196 ±24) in research group were significantly higher(P ＜ 0.05).The time of ventilation use (d) (5.4 ± 1.3) vs.(6.3 ± 1.6) in research group was shorter than that of control group(P ＜0.05) while research group showed a higher clinical efficiency rate(％) (81.2 vs.50.0) (P ＜0.05).A combination of HFOV and sildenafil for severe PPHN can significantly reduce MPAP,shorten the duration of ventilation use and improve cure rate.