Objective To investigate the changes of protein and energy intakes and the z-score of weight for age in appropriate for gestational age (AGA) and small for gestational age (SGA) preterm infants with gestational age less than 34 weeks. Methods The data from 314 hospitalized premature infants ( 268 cases of AGA and 46 cases of SGA) during January 2012 to December 2014 were retrospectively collected. The intakes of protein and energy and the changes of weight within 2 weeks after birth were compared. Results Compared with AGA group, the hospital stays, durations of parenteral and enteral nutrition and total enteral nutrition, and time to achieve full dose feeding were signiifcantly longer in SGA group (P?

OBJECTIVE: To study the value of ADRB2, GLCCI1, FCER2 gene detection in individualized medication of children with refractory asthma.METHODS: Clinical pharmacists participated in therapy for 2 cases of refractory asthma, and comprehensively analyzed risk factors as its pathogenic factors (allergens and pathogens of respiratory infections), lung function indexes and family history. It was suggested to conduct anti-asthmatic drugs gene [p2-adrenergic receptor (ADRB2), glucocorticoid induced transcriptional 1 gene (GLCCI1), low affinity IgE receptor (FCER2)] testing. According to detection results, the suggestions were put forward such as increasing the dose of Glucocorticoid for inhalation, stopping β2 receptor agonist, additionally using anticholinergic drug. RESULTS: The clinical physicians adopted the suggestions of clinical pharmacists. After optimizing refractory asthma therapy plan according to the results of gene testing and clinical factors, 2 patients were stable and the number of seizures decreased significanthy. CONCLUSIONS: Gene test can provide evidence for the formulation of individualized therapy in asthma children.

Objective To study the dynamic changes of blood carnitine and acylcarnitine levels in preterm infants during parenteral and enteral nutritional support,and the relationship between carnitine status and nutritional patterns,gestational age (GA) and weight gain.Method From January 2017 to December 2017,preterm infants admitted to the neonatal intensive care unit (NICU) within 24 hours after birth and received parenteral nutrition support were enrolled.They were assigned into 4 groups according to their GA:ultra-premature infants (＜ 28 weeks),very premature infants (28 ～ 31 weeks),mid premature infants (32 ～ 33 weeks) and late premature infants (34 ～ 36 weeks).They were assigned into 2 groups according to their average daily weight gain:＜ 15 g/(kg · d) group and ≥15 g/(kg · d) group.Blood samples were collected and examined as dried-blood spot specimens on filter paper for four times:after born,given total parenteral nutrition,given enteral combined parenteral nutrition,and given total parenteral nutrition.The concentrations of free carnitine and acylcarnitine were detected using liquid chromatographytandem mass spectrometry (LC-MS/MS).SPSS 21.0 statistical software was used for statistical analysis.Result A total of 124 preterm infants and 410 samples were collected.As the infants experienced gradual transition from parenteral nutrition to enteral nutrition,the free carnitine and most acylcarnitines levels were decreasing (C3,C4,C10DC,C12,C12∶1,C12DC,C14,C16,C16∶ 1,C16-OH and C18,P＜0.05).Preterm infants with small GA showed higher levels of C4-OH (P =0.001) and C5 (P =0.001).Preterm infants with lower velocity of weight gain showed lower concentration of C5-OH (P =0.006) in the early postnatal period.Conclusion Free carnitine and acylcarnitine in preterm infants during the early postnatal period are decreasing with the transition from parenteral nutrition to enteral nutrition,indicating that the exogenous nutrition is relatively insufficient.C4-OH and C5 levels are negatively correlated with GA.In addition,lower level of C5-OH may indicate slow weight gain during the early postnatal period.

Objective:To explore the effect of dialectical diet on traditional Chinese medicine (TCM) syndrome score of cirrhotic ascites patients based on "Gu Ben Kai Qu" theory.Methods:From March 2019 to January 2020, 84 patients with liver cirrhosis and ascites admitted to Shuguang Hospital Affiliated to Shanghai University of TCM were randomly divided into two groups according to the different dialectical types of the subjects, 14 cases in each group. Three non-syndrome differentiation diet groups were given routine nursing care of liver cirrhosis ascites. On the basis of routine nursing, the corresponding medicinal diet was selected according to syndrome differentiation based on "Gu Ben Kai Qu" theory. Patients with spleen and kidney yang deficiency syndrome selected Shenqi lean meat decoction. Patients with Yin deficiency of liver and kidney selected Wolfberry and ophiopogon spareribs decoction. Patients with qi stagnation and blood stasis syndrome selected Danggui Sanqi spareribs decoction. The TCM syndrome score scale for liver disease and the curative effect evaluation of cirrhosis ascites were used to evaluate the effect.Results:Eighty effective cases were included. On the first day of admission, the 14th day and the second week after discharge, the TCM syndrome scores of liver disease were as follows: the group (a1b1) with the spleen and kidney yang deficiency syndrome was 46.38±8.56, 34.20±8.42, 31.40±4.22, respectively. The group (a1b2) with the liver kidney yin deficiency syndrome was 41.50±8.71, 31.35±8.63, 31.12±4.94. The group(a1b3) with the qi stagnation and blood stasis syndrome was 45.92±7.86, 35.17±7.57, 30.83±7.32, respectively. The non-syndrome differentiation diet group (a2b1) with the spleen and kidney yang deficiency syndrome was 46.29±8.38, 39.79±7.65, 36.64±6.83, respectively. The non-syndrome differentiation diet group (a2b2) with the liver and kidney yin deficiency syndrome was 40.50±8.12, 38.10±8.93, 35.38±8.24, respectively. The non-syndrome differentiation diet group (a2b3) with the qi stagnation and blood stasis syndrome was 45.62±7.99, 41.83±7.31, 38.83±7.96, respectively. The comparison of TCM syndrome scores of liver disease at three time points was statistically significant ( χ2 value was 63.998, P<0.05), and the comparison between groups was statistically significant ( χ2 value was 20.993, P<0.05). On the 14th day and the second week after discharge, there were significant differences between the groups with the syndrome differentiation diet and another three groups with non-syndrome differentiation diet ( F values were 3.244, 3.489, all P<0.05). Conclusions:Based on the theory of "strengthening the foundation and opening channels", the syndrome differentiation group can effectively reduce the TCM syndrome score of patients with cirrhosis ascites, improve the symptoms and enhance the curative effect. With the development of time, the score of TCM syndrome in patients with liver disease become lower. On the 14th day of admission, patients with Yin deficiency of liver and kidney given medicated diets had significant effect; patients with spleen kidney yang deficiency syndrome or qi stagnation and blood stasis had significant effect in 2 weeks after discharge; which can effectively improve the clinical symptoms of patients with cirrhosis ascites to worthy of clinical application.

Objective:To comprehensively analyze the current research status, hotspots, and development trends in the field of fatigue in maintenance hemodialysis patients both domestically and internationally in order to provide reference for future research directions.Methods:Relevant literature on the fatigue status of maintenance hemodialysis patients from the establishment of the database to the publication before December 30, 2022 was retrieved through CNKI, VIP database, Wanfang database, and Web of ScienceTM core collection database, and visualized using CiteSpace 6.1.R3 for analysis.Results:A total of 152 Chinese articles and 110 English articles were included. Analysis showed that foreign publications were first published in 1996, while domestic publications were first published in 2011, and the number of publications has shown a significant upward trend since 2017. The research focus at home and abroad mainly focuses on the influencing factors and intervention measures of fatigue in dialysis patients. Foreign researchers have paid more attention to the correlation between "depression" emotions and the positive intervention of aerobic exercise. In addition, China is actively exploring traditional Chinese medicine therapy aromatherapy to alleviate patient fatigue.Conclusions:In the future, clinical workers should pay attention to fatigue assessment in maintenance hemodialysis patients and explore the influencing factors of fatigue through large-scale longitudinal studies, in order to better provide intervention targets for the treatment of fatigue; Simultaneously conduct high-quality prospective intervention studies to maximize the improvement of fatigue status in such patients and form standardized guidelines for promotion and application.

OBJECTIVE Alzheimer disease(AD)is a neurodegenerative disease with clinical hallmarks of pro-gressive cognitive impairment.Synergistic effects of Aβ-tau cascade reaction are tightly implicated in AD patholo-gy,and microglial NLRP3 inflammasome activation drives neuronal tauopathy through microglia and neurons cross-talk.However,the underlying mechanism of how Aβ medi-ates NLRP3 inflammasome remains unclear.Shab related potassium channel member 1(Kv2.1)as a voltage gated po-tassium channel widely distributed in the central nervous system and plays an important role in regulating the out-ward potassium flow in neurons and glial cells.In current work,we aimed to explore the underlying mechanism of Kv2.1 in regulating Aβ/NLRP3 inflammasome/tau axis by using a determined Kv2.1 inhibitor drofenine(Dfe).METHODS Cell-based assays including Western blot-ting and immunofluorescence staining against primary microglia or neurons were carried out to expound the role of Kv2.1 channel in NLRP3 inflammasome activa-tion and subsequent neuronal tau hyperphosphorylation.For animal studies,new object recognition,Y-maze and Morris water maze were performed to evaluate the ame-lioration of Kv2.1 inhibition through either Kv2.1 inhibitor Dfe treatment or adeno-associated virus AAV-ePHP-si-Kv2.1injectionon5×FADADmodel mice.Assays of histol-ogy and immunostaining of tissue sections and Western blotting of brain tissues were performed to verify the con-clusion of cellular assays.RESULTS We reported that oligomeric Aβ(o-Aβ)bound to microglial Kv2.1 and pro-moted Kv2.1-dependent potassium leakage to activate NLRP3 inflammasome through JNK/NF-κB pathway sub-sequently resulting in neuronal tauopathy.Treatment of either Kv2.1 inhibitor Dfe or AAV-ePHP-si-Kv2.1 for brain-specific Kv2.1 knockdown deprived o-A β of its capability in inducing microglial NLRP3 inflammasome activation and neuronal tau hyperphosphorylation,while improved the cognitive impairment of 5×FAD AD model mice.CONCLUSION Our results have highly addressed that Kv2.1 channel is required for o-Aβ driving NLRP3 inflammasome activation and neuronal tauopathy in AD model mice and highlighted that Kv2.1 inhibition is a prom-ising therapeutical strategy for AD and Dfe as a Kv2.1 inhibitor shows potential in the treatment of this disease.

Objective To explore the effect of applying syndrome differentiation and medicated diet in patients with liver cirrhosis as cites based on"Gu Ben Kai Qu"theory of TCM. Methods Seventy patients of liver cirrhosis as cites were randomly divided into observation group (35 cases) and control group(35 cases).The control group was cared with care routine of liver cirrhosis as cites,The observation group was based on care routine traditional nursing and implementation of dialectical medicalated meal which based on "Gu Ben Kai Qu" theory of TCM. The two groups of patients were used to assess the efficacy of liver cirrhosis as cites,urine volume,abdominal circumference,weight,TCM syndrome scale of liver disease. Results The urine volume on the 7th day, the 14th day, 2 weeks after discharge,the weight and the abdominal circumference on the 2 weeks after discharge from the patients in the observation group were respectively(1.90±0.52)L,(2.09±0.56)L,(2.02±0.35)L,(59.36±8.19)kg,(89.56±7.24)cm,while they were(1.63±0.36)L,(1.79±0.40)L,(1.82±0.38)L,(63.33±8.21)kg,(93.57±7.56)cm in the control group,the difference between the two groups was statistically significant (F=6.083, 6.484, 5.030, 4.108, 5.144,all P<0.05). The efficacy of liver cirrhosis as cites from the patients in the observation group were cured 40.0%(14/35),improved 42.9%(15/35),not cured 17.1%(6/35),while they were cured 22.9%(8/35),improved 40.0%(14/35),not cured 37.1%(13/35),the difference between the two groups was statistically significant (Z=2.012,P<0.05). The efficacy of TCM Syndromes on liver disease from the patients in the observation group were respectively[significant effect 37.1%(13/35),valid 45.7% (16/35),invalid 17.2%(6/35)],[significant effect 60.0%(21/35),valid 28.6%(10/35),invalid 11.4%(4/35)], while they were respectively [significant effect 20.0%(7/35), valid 42.9%(15/35), invalid 37.1%(13/35)], [significant effect 40.0%(14/35),valid 25.7%(9/35),invalid 34.3%(12/35)],the difference between the two groups was statistically significant(Z=2.065,2.104,all P<0.05). Conclusions Based on"Gu Ben Kai Qu"theory of TCM,the implementation of dialectical diet can effectively improve efficacy of liver cirrhosis as cites, reduction rate of TCM symptoms scale, urine volume,reduce the weight,shrink down the abdominal circumference,worthy of clinical application.

OBJECTIVE： To study the effects of ADRB2 （rs1042713） gene polymorphism on therapeutic efficacy of anticholinergic drug in the treatment for refractory asthma pediatric patients. METHODS： 171 children with refractory asthma were selected from outpatient department of Kunming Children’s Hospital during Nov. 2016 to Jul. 2019. The distribution of ADRB2 （rs1042713） genotype， the clinical efficacy [asthma control test （C-ACT） score， FEV1， FVC， PEF， maximal mid-expiratory flow （MMEF）] of anticholinergic drug were analyzed statistically； the response of different genotypes to the use of anticholinergic drug were also analyzed statistically. RESULTS： 148 of 171 refractory asthmatics pediatric patients were administered anticholinergic drug， among them 50 of the 71 AA genotype and 36 of the 77 GA genotype responded to anticholinergic drug treatment. Statistical analysis showed that 71 children with AA refractory asthma had improved C-ACT score， FEV1， FVC， PEF and MMEF， there was statistical significance， compared with GA genotype （P＜0.05）； the response rate of the AA genotype to anticholinergic drugs was 2.71 times that of the GA genotype [OR＝2.71， 95％CI （1.38， 5.34）， P＝0.005]. CONCLUSIONS： The detection of ADRB2 （rs1042713） gene polymorphism has some guiding significance in the treatment of refractory asthma with anticholinergic drugs， and the response of AA genotype is better.

OBJECTIVE To investigate the efficacy and safety of different doses of zinc in the treatment of diarrhea in children， and to provide a reference for clinical safe and rational drug use. METHODS Retrieved from PubMed， Cochrane Library， Embase database， randomized controlled trials about zinc （zinc group） versus placebo or conventional treatment （control group） in the treatment of diarrhea in children were collected from the inception to October 2022. Then， the quality of the included literature was evaluated by the Cochrane Handbook 6.0， and meta-analysis and sensitivity analysis were performed by RevMan 5.3 software. RESULTS Finally， 25 RCTs were included， with a total of 8 618 children. The results of meta-analysis showed that in terms of duration of diarrhea， in zinc ＜20 mg group， the zinc group was significantly shorter than the control group [SMD＝ －0.39， 95%CI（－0.71， －0.08）， P＝0.01]， but in subgroups of ＜6 months old， there was no significant difference between the two groups [SMD＝0.01， 95%CI（－0.10， 0.11）， P＝0.88]. In zinc 20 mg group， the zinc group was significantly shorter than the control group [SMD＝－0.52， 95%CI（－0.80， －0.23）， P＝0.000 3]. In zinc ＞20 mg group， the zinc group was significantly shorter than the control group [SMD＝－0.83， 95%CI（－1.39， －0.27）， P＝0.004]. In zinc ＞10 mg （age ≤12 months） or zinc ＞ 20 mg （age ＞12 months） group （short for “constant dose group”）， the zinc group was significantly shorter than the control group [SMD＝－0.16， 95%CI（－0.27， －0.06）， P＝ 0.003]. In the aspect of diarrhea rate after 7 days of treatment，there was no significant difference in the diarrhea rate after 7 E-mail：lihuiying@etyy.cn days of treatment between the zinc group and the control group： in zinc ＜20 mg group[OR＝1.28，95%CI （0.96，1.70），P＝0.09]， in zinc 20 mg group [OR＝0.40， 95%CI （0.15，1.01），P＝ 0.05]， in constant dose group [OR＝0.64， 95%CI （0.28， 1.44）， P＝0.28]. In terms of vomiting rate， in zinc ＜20 mg group， the vomiting rate of zinc group was significantly higher than that of the control group [OR＝2.13， 95%CI （1.68， 2.70）， P＜0.001]； in constant dose group， vomiting rate of zinc group was significantly higher than that of the control group [OR＝1.84， 95%CI （1.44， 2.34）， P＜0.001]. CONCLUSIONS Zinc can significantly shorten the duration of diarrhea in children（6 months and above）， but low doses can increase the risk of vomiting， which should be taken attention in clinical.

OBJECTIVE To investigate the efficacy and safety of clobazam in the additional treatment of refractory epilepsy in children， and provide reference for clinically safe and rational drug use. METHODS The literatures about additional clobazam treatment for refractory epilepsy in children were searched from PubMed， The Cochrane Library， Embase， CNKI， VIP and Wanfang database during the inception to November 2023. After literature screening and data extraction， the quality of included literature was evaluated according to quality evaluation tool for methodological evaluation indicators of non-randomized controlled trial， and then meta-analysis of single-group rate and sensitivity analysis were performed by using RevMan 5.3 software. RESULTS Finally， 18 one-arm studies were included， with a total of 1 424 children. The results showed that compared with before additional treatment， the proportion of patients with seizures-free （proportion of patients with seizure reduction of 100%） was 24%[95%CI （0.18，0.32）， P＜0.000 01] after conversion； the proportion of patients with seizure reduction ≥75% was 32%[95%CI（0.25，0.40）， P＜0.000 1] after conversion； the proportion of patients with seizure reduction ≥50% was 53%[95%CI（0.44，0.61），P＜0.000 01]； the proportion of patients with seizure reduction ＜50% or no change was 35%[95%CI（0.24，0.49），P＝0.04] after conversion； the proportion of patients with seizure increase was 9%[95%CI（0.05，0.18），P＜0.000 01] after conversion. The proportion of patients with adverse reactions was 31%[95%CI（0.23，0.40），P＜0.000 1] after conversion； the proportion of patients with discontinuation due to adverse reactions was 10%[95%CI（0.07， 0.15）， P＜0.000 01] after conversion. The common adverse drug reactions were drowsiness， fatigue and behavior change， etc. The results of the sensitivity analysis showed that the study was robust. CONCLUSIONS Clobazam is an effective additional therapy for refractory epilepsy in children， but its adverse effects should be vigilant.