OBJECTIVE:To discuss the way to establish a scientific and rational quality guarantee system for total nutrient admixture(TNA).METHODS:The regulations and measures adopted to guarantee TNA quality were analyzed on the basis of TNA preparation practice in the hospital.RESULTS&CONCLUSION:TNA quality can be guaranteed to be secure and stable in quality by establishing an efficient quality guarantee system for TNA.

Objective To evaluate the influences of abnormal glucose challenge test (GCT) on pregnancy outcomes and neonatal anthropometric data in women with normal oral glucose tolerance test (OGTT).Methods Totally 214 women who delivered in the First Affiliated Hospital of Sun Yat-sen University from November 2006 to December 2007 were enrolled.50 g GCT was performed at 24-28 weeks of gestation and 75 g OGTT would be followed if GCT≥7.8 mmol/L.Those patients,whose OGTT results below the following criteria (5.3 mmoL/L,10.0 mmol/L,8.6 mmol/L,7.8 mmol/L),were classified as normal OGTT.Altogether,116 of the 214 women with abnormal GCT and normal OGTT were collected as the study group and the rest 98 women with normal GCT as the control group.The pregnant outcomes of the two groups were analyzed.The neonatal anthropometry,including birth weight,body length,head circumference and shoulder circumference,were recorded.Other neonatal anthropometric data,such as upper arm circumference,tricep skinfold thickness and hypodermic fat thickness of abdomen were measured by a tape measure within 24 hours after birth.Results (1) Pregnant outcomes:No significant difference was found in the rate of assisted vaginal delivery,polyhydramnios,premature rupture of membranes and fetal distress between the study and control group[10.3% (12/116) vs 4% (4/98),5.2% (6/116) vs 10% (10/98),13.8% (16/116) vs 17% (17/98),20.7% (24/116) vs 13% (13/98),P ＞0.05,respectively],but the rate of cesarean section,spontaneous vaginal delivery and large for gestational age babies in the study group were different from those of the control[72.4% (84/116) vs 51% (51/98),17.2%(20/116) vs 45% (44/98),25.9% (30/116) vs 6% (6/98),P ＜0.05,respectively].(2)Neonatal anthropometry:The birth weight of the study group was significantly higher than that of the control group[(3.4 ±0.4) kg vs (3.3±0.4) kg,P ＜0.05],but no significant difference was shown in any other neonatal anthropometric results between the study and control group,including body length[(49.9 ±1.3)cm vs (49.7±1.4) cm],head circumference[(33.4±1.5)cm vs (33.8±1.7) cm],shoulder circumference [(35.4±2.3)cm vs (35.0±2.3)cm],upper arm circumference[(11.0±0.7)cm vs (10.9±0.8)cm],tricep skinfold thickness[(9.7±1.0)mm vs (9.9± 1.4)mm]and hypodermic fat thickness of abdomen[(7.2±1.2)mm vs (7.2+1.0)mm;all P＞0.05].Conclusion Women with abnormal GCT alone may have no significant influences on neonatal anthropometric data,but might have more cesarean section,large for gestational age babies,and neonatal birth weight than those women with normal GCT.

Objective To investigate the changes in nunmber and function of natural killer ( NK ) cells in patients with newly-diagnosed type 1 diabetes mellitus.Methods Cell courning was performed in peripheral blood mononuclear cell ( PBMC ) subsets in 43 cases with newly diagnosed type 1 diabetes ( T1D ),14 cases with newly diagnosed type 2 diabetes( T2D ) and 21 cases of normal controls by flow cytometry sorting.And then,isolating and collecting NK cells were performed in T1D patients and normal controls.Real time PCR was performed to evaluate the mRNA expression levels of NK cell activity related genes IFN-γ,perforin,NKp46,and NKp30 in NK cells.Results Compared to normal controls,both the proportion and the absolute counting of NK cells in PBMC from patients with T1D were significantly decreased [( 102±86 )/μl vs ( 355±264 )/μ1,P＜0.01],while only the proportion of CD4+ cell were slightly increased( P＜0.05 ).No statistical difference was observed regarding CD8+ T cells ( P＞0.05 ).mRNA expression levels of NK cell activity related genes perforin and NKp46 in NK cells were remarkably down-regulated ( P＜0.05 ),while IFN-γ and NKp30 were not changed compared with normal controls.Conclusions The reduced number and functional deficiency of NK cells may lead to the immune dysfunction in T1D and play an important role in the development of T1D.

Objective To investigate blood plasma melatonin level in night-shift nurses and explore the relationship of blood plasma melatonin level with nervous system symptom (insomnia、anxiety、depression). Methods ELISA were used for detection of blood plasma melatonin level in 80 night-shift nurses of different age group. Results Blood plasma melatonin level of shift work nurses (36to40、41to45 yearold) were significant lower than the corresponding age group of the control group, the nervous system symptom of these age group night-shift nurses correlated to melatonin level of melatonin. Conclusions Blood plasma level of melatonin have a close relation to nervous system symptom(insomnia、anxietydepression).

Objective:To investigate the prenatal ultrasound detection and prognosis of fetuses with cysts of filum terminale.Methods:A retrospective analysis was conducted on 68 fetuses with cysts of filum terminale that underwent level Ⅲ systematic ultrasound examination and were successfully followed up at the Third Affiliated Hospital of Zhengzhou University from January 2020 to June 2023. The analysis included the initial detection time, cyst size, accompanying abnormalities, whether the cysts disappeared in utero, outcomes, and postnatal follow-up. Descriptive statistical analysis was performed.Results:The earliest ultrasound detection of filum terminale cysts was at 21 weeks and 4 days of gestation, with a median length of 4.3 mm (range 2.0-19.5 mm). Among the 68 cases, 69% (47/68) were isolated filum terminale cysts, and 31% (21/68) were non-isolated filum terminale cysts. Structural abnormalities associated with non-isolated filum terminale cysts were most commonly cardiovascular (7/21, 33%), urogenital (6/21, 29%), and neurological (6/21, 29%) systems. Prenatal ultrasound follow-up was performed in 41 cases, with an intrauterine disappearance rate of 63% (26/41). The disappearance rates for isolated and non-isolated filum terminale cysts were 67% (22/33) and 4/8, respectively. The earliest disappearance was at 25 weeks of gestation, with the shortest duration being 12 days. Prenatal genetic testing was conducted in 10 cases, with no definite pathogenic variants detected. There were 10 cases of induced labor, including two cases of isolated filum terminale cysts and eight cases of non-isolated filum terminale cysts. The remaining 58 cases resulted in live births, with postnatal follow-up ranging from 3 months to 3 years, showing no abnormal findings.Conclusion:Most fetal cysts of filum terminale are isolated and can spontaneously disappear in utero, with a generally good prognosis.

By summarizing the concept, features and drawing of mind mapping, and reviewing the application of mind mapping in hospital admission guidance, preoperative preparation, intraoperative coordination and pain control, postoperative complications prevention, rehabilitation training, discharge guidance, and the aspect of patients' self-management ability, this paper aimed at expanding the application scope of mind mapping, and point out the application future and prospects of mind mapping in health education.

OBJECTIVETo explore common biological pathways for attention deficit hyperactivity disorder (ADHD) and low birth weight (LBW).

METHODSThei-Gsea4GwasV2 software was used to analyze the result of genome-wide association analysis (GWAS) for LBW (pathways were derived from Reactome), and nominally significant (P< 0.05, FDR< 0.25) pathways were tested for replication in ADHD.Significant pathways were analyzed with DAPPLE and Reatome FI software to identify genes involved in such pathways, with each cluster enriched with the gene ontology (GO). The Centiscape2.0 software was used to calculate the degree of genetic networks and the betweenness value to explore the core node (gene). Weighed gene co-expression network analysis (WGCNA) was then used to explore the co-expression of genes in these pathways.With gene expression data derived from BrainSpan, GO enrichment was carried out for each gene module.

RESULTSEleven significant biological pathways was identified in association with LBW, among which two (Selenoamino acid metabolism and Diseases associated with glycosaminoglycan metabolism) were replicated during subsequent ADHD analysis. Network analysis of 130 genes in these pathways revealed that some of the sub-networksare related with morphology of cerebellum, development of hippocampus, and plasticity of synaptic structure. Upon co-expression network analysis, 120 genes passed the quality control and were found to express in 3 gene modules. These modules are mainly related to the regulation of synaptic structure and activity regulation.

CONCLUSIONADHD and LBW share some biological regulation processes. Anomalies of such proces sesmay predispose to ADHD.

Objective: To investigate the role of LncRNA RP11-20 G6.3 and Toll-like receptor 4(TLR4)/nuclear factor kappa-B(NF-κB) signaling pathway in airway inflammation and remodeling in chronic obstructive pulmonary disease(COPD). Methods: The wild-type(WT) and TLR4 knock out(KO) C57 BL/6 male mice were used to construct COPD model. The expression of TLR4/NF-κB signaling pathway protein was analyzed by Western blot; the levels of interleukin-1β(IL-1β), interleukin-6(IL-6) and tumor necrosis factor-α(TNF-α) in bronchoalveolar lavage fluid( BALF) were detected by enzyme-linked immunosorbent assay( ELISA). The differentially expressed LncRNAs were identified by RNA sequencing and functional enrichment analysis,and the competing endogenous RNAs( ceRNA) networks were predicted using RNAhybrid. Luciferase reporter was used to explore relationships between genes. Results: In COPD model, compared with WT mice, the lung inflammation of TLR4-/-mice was significantly reduced,the expression of NF-κB related protein,the levels of inflammatory factors( IL-1β,IL-6 and TNF-α) in BALF and Masson trichromatic staining area significantly decreased in TLR4-/-mice. RNA sequencing and functional enrichment analysis confirmed that RP11-20G6. 3 was one of the differentially expressed LncRNA. RP11-20G6. 3 was up-regulated in lung tissue of COPD patients,and its expression was significantly correlated with FEV1( ρ = 0. 549,P = 0. 047). RP11-20G6. 3 plasmid intervention aggravated the inflammation of lung tissue in TLR4-/-COPD mice,and increased the Masson tricolor area around bronchi and the levels of inflammatory factors( IL-1β,IL-6 and TNF-α) in BALF. Luciferase reporter gene analysis showed that RP11-20G6. 3 acted as a ceRNA for miR-34c-5p in COPD,and sponges the latter to upregulate Col1a1. Conclusion TLR4/NF-κB relays the damage signals following COPD and activates the downstream RP11-20G6. 3/miR-34c-5p/Col1a1 ceRNA network which triggers airway inflammation and remodeling.

Objective:To explore the white matter structural characteristics in patients with bipolar disorder(BD)using diffusion tensor imaging(DTI)and investigate their relationship with cognitive function.Methods:A total of 15 patients with BD type Ⅰ and 26 patients with BD type Ⅱ who met the Diagnostic and Statistical Manual of Mental Disorders,Fourth Edition(DSM-Ⅳ)diagnostic criteria and 37 normal controls were included.Cognitive function was assessed with the Trail Making Test(TMT)and Repeatable Battery for the Assessment of Neuropsy-chological Status(RBANS).The tract-based spatial statistics(TBSS)method was used to explore the differences in fractional anisotropy(FA)and mean diffusivity(MD)among the three groups and perform correlation analyses with cognitive function.Results:Patients with BD Ⅰ and BD Ⅱ had lower scores in attention(P＜0.001),delayed memory(P＜0.01),and total scores(P＜0.001)on the RBANS compared to the normal control group.They also exhibited lower FA values in the corpus callosum and right superior corona radiata compared to the normal control group(P＜0.05).In the BD Ⅰ group,there was a positive correlation between FA values in the genu of corpus cal-losum and visuospatial/constructional scores(r=0.74,P＜0.05),while in the BD Ⅱ group,a positive correlation was found between FA values in the same region and language function scores(r=0.55,P＜0.05).Conclusion:It suggests that patients with bipolar disorder may have impaired white matter integrity in the corpus callosum and right superior corona radiata,which may be associated with cognitive impairment.

OBJECTIVE To explore the current status and challenges of informatization construction for clinical trial centralized pharmacy based on the relevant experience of The First Affiliated Hospital, Zhejiang University School of Medicine. METHODS Review the development of clinical trial drug management and informatization process, along with the management experience of the hospital where the author works, and then introduce the framework and specific operation details of the informatization system when conducting centralized management method, summarize the problems encountered at present and propose future prospects. RESULTS Informatization construction played a significant role in the management of central pharmacies in clinical trial, enabling them to adapt to the complex management needs of investigational products and meet the high standards and strict requirements of Good Clinical Practice(GCP) and related regulations. However, the development of the current information system was still not perfect, and there were problems that need to be solved. CONCLUSION Each hospital needs to pay attention to the informatization construction of the central pharmacy of the clinical trial, improve and perfect the centralized management method of the investigational products, and explore modern technologies and equipments, which are of immense importance for the construction of the clinical trial pharmacy management that conforms to the development trend of drug clinical trials and GCP.