The use of parenteral nutrition in an acute care hospital

<p><b>INTRODUCTION</b>Parenteral nutrition (PN) is an important supportive therapy. However, it is expensive and associated with significant complications. Our aim is to describe the patients given PN in 2006, to compare with the 2001 cohort and determine if PN had been prescribed for the appropriate indications.</p><p><b>MATERIALS AND METHODS</b>A retrospective cohort study of adult patients receiving PN between January and December 2006 was undertaken in a single institution. Appropriateness of indications for PN was based on the American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.) guidelines 2002.</p><p><b>RESULTS</b>One hundred and eighty-two patients received 194 courses (102 males, 92 females) of PN. Median age was 62 years (range, 16 to 100). Eighty-two percent were surgical patients and 18% were medical patients. Median PN duration was 9 days (range, 2 to 115). Common indications were surgeons' anticipation of non-functioning gut postoperatively [47 (24.2%) courses], postoperative complications [33 (17.0%) courses] and postoperative ileus [31 (16.1%) courses]. Indications for PN met A.S.P.E.N. guidelines in 93.3% of cases compared to 78.3% in 2001. In 1.5% of cases, we were unable to determine if the indications met the guidelines. Ten courses did not meet the guidelines; 3 had PN for <7 days preoperatively, 6 had PN because the managing team thought the patients were critically ill and 1 was given PN for refusal to eat because of depression.</p><p><b>CONCLUSION</b>Since 2001, there has been an increase in the proportion of PN given for appropriate indications. However, physician education with respect to the benefit of PN for preoperative and critically ill patients with functioning guts needs reinforcing.</p>

Treatment of Epigastric Pain by Earthly Branch-adopted Method / 针灸推拿医学（英文版）

In accordance with the principle to. tonify its mother in deficiency and to sedate its son in excess, 19 cases of epigastric pain were treated by Five Shu-Transmitting Points of the stomach meridian and the results showed cure in 15 cases, remarkable effect in 2 cases,improvement in 1 case, failure in 1 case and the effective rate being 94.7%.