Objective To select the components for quality control of Fructus Lycii based on the absorption of its extract. Methods To investigate metabolism of components of Fructus Lycii, everted rat gut sacs was carried out as well as the blood was taken from abdominal aorta,.and all samples were analysised by HPLC. Results There are twelve constituents absorbed between ileum and jejunum of rat , and four constituents were detected in the blood. Compound 2, 3, 4, 5, 6, 9, 10, 11 were absorbed in prototype forms in the intestine directly,and compound 1, 7, 8, 12 were new ones. On the other hand, four compositions(3, 7, 10, 13)could be absorbed into blood through analysis serum samples obtaining from aorta abdominalis of rats. Two of them (3, 10)could be absorbed directly by intestine, while(7)was absorbed into blood in new form . Conclusion Based on the intestinal absorption experiment and analysion of compsition in blood, components (3, 10, 13) can be the quality control ingredients of Fructus Lycii.

Biliary atresia is a serious congenital malformation that threatens the life of newborns.At present, the treatment of biliary atresia mainly relies on Kasai portoenterostomy which is also named hepatoportoenterostomy to correct the dysplastic biliary system.Cholangitis is the most common and intractable complication after Kasai portoenterostomy.The pathogenesis is still unidentified.Many factors including ascending infection of intestinal bacteria, abnormal development of intrahepatic bile duct, surgical injury, reflux of intestinal contentscan and so on can affect the occurrence and development of the disease.The initial time and frequency of cholangitis can affect the postoperative primary liver function, so it is especially important to diagnose and treat it timely.The diagnosis of post-Kasai cholangitis is lack of specificity, mainly based on clinical manifestations, biochemical abnormalities and surgical history.For intractable cholangitis should consider completing radioisotope hepatobiliary imaging, percutaneous cholangiography and single or double-balloon enteroscopy.The main focus of prevention and treatment lies in preoperative care, surgical improvement and postoperative care, as well as drug prevention during disease follow-up.

Objective To compare the relationship between the enzyme‐linked immunosorbent assay(ELISA) reagent and West‐ern blot(WB) confirmation reagent for analyzing the quality lever of human T‐cell lymphotropic virus(HTLV) detection reagent . Methods The WB confirmation reagent was used to detect anti‐HTLV antibody in 156 human serum samples of ELISA prelimina‐ry screening positive .The ELISA cut‐off value(optimal value) was selected by using the two‐graph receiver operating characteristics (TG‐ROC) analytical method .The two‐by‐two table analysis was constructed to analyze the consistency of results detected by the two methods ,moreover the McNemar test was used to evaluate the consistency of detection results .The quality level of HTLV de‐tection reagent was comprehensively evaluated .Results Among 156 serum samples of ELISA preliminary screening positive ,only 40 samples were positive by the WB confirmation ,and other 116 samples were negative .The sensitivity and specificity of ELISA de‐tection reagent obtained by TG‐ROC analysis were 97 .5% and 45 .7% respectively ,the TG‐ROC test also indicated that the detec‐tion results had significant difference between ELISA and WB(P<0 .05) .By adjusting the cut‐off value ,the sensitivity and specific‐ity of ELISA were increased to 88 .8% (parametric method) .In the comparison of the parametric method and the non‐parametric method ,the obtained areas under the curve(AUC) was 0 .923 5(parametric method) ,their results were basically consistent .Conclu‐sion Although above results indicate that the detection results of ELISA reagent are different from those of WB ,but adjusting the cut off value can increase its sensitivity and specificity ,thus increases the reliability of diagnosis result .

Objective:To summarize the evidence on perioperative nutritional management of patients undergoing hepatectomy.Methods:Articles on perioperative nutritional management of patients undergoing hepatectomy were searched by computer in Chinese and English literature databases and guideline networks. The retrieval time limit was from the establishment of the database to September 1, 2021. The quality of the article was independently evaluated, and the evidence of the article that met the quality standards was summarized by 2 nurses in charge, and the strength of evidence recommendation was determined by 9 experts.Results:A total of 12 articles were included, including 5 guidelines, 4 expert consensuses, 1 systematic review and 2 evidence summaries. A total of 22 pieces of evidence were extracted from 6 aspects, namely nutritional risk screening and assessment, nutritional goals, nutritional support methods, nutritional support measures, malnutrition prevention, and health education.Conclusions:The 22 pieces of evidence extracted in this study can provide evidence-based basis for perioperative nutritional management of patients undergoing hepatectomy, and each medical institution can transform and apply the evidence according to the actual clinical situation.

Objective:Searching, generalising and summarising evidence on non-pharmacological interventions for abnormal pronunciation in thyroidectomised patients.Methods:The literature on abnormal pronunciation in patients undergoing thyroidectomy published in the past 5 years was systematically searched in British Medical Journal (BMJ) Best Practice, UpToDate, Agency for Healthcare Research and Quality, Guidelines International Network, National Institute for Health and Clinical Excellence, Medlive, Cochrane Library, PubMed, CINAHL, Web of Science, China Biomedical Literature Database, China National Knowledge Infrastructure, and Wanfang Database. The search period was from the establishment of the database to December 11, 2022. After literature screening and quality evaluation, the evidence was summarized.Results:A total of eight articles were included, including six guidelines, one expert consensus, and one systematic review. A total of 18 best pieces of evidence were extracted and categorized into four categories, including speech function assessment, neck exercise, speech training, health education and psychological support.Conclusions:This study can provide evidence-based basis for non-pharmaceutical intervention management of abnormal pronunciation in patients undergoing thyroidectomy. When applying evidence, medical and nursing staff should combine it with clinical practice and conduct targeted transformation and application.

Abstract Allergic diseases can occur in all systems of the body, covering the whole life cycle, from children to adults and to old age, can be lifelong onset and even fatal in severe cases. Children account for the largest proportion of the victims of allergic disease, Children s allergies start from scratch, ranging from mild to severe, from less to more, from single to multiple systems and systemic performance, so the prevention and treatment of allergic diseases in children is of great importance, which can not only prevent high risk allergic conditions from developing into allergic diseases, but also further block the process of allergy. At present, there is no consensus on the management system of allergic children in kindergartens and primary schools. The "Consensus on Allergy Management and Prevention in Kindergartens and Primary Schools", which includes the organizational structure, system construction and management of allergic children, provides evidence informed recommendations for the long term comprehensive management of allergic children in kindergartens and primary schools, and provides a basis for the establishment of the prevention system for allergic children.

OBJECTIVE： To study therapeutic effects of Spider toxin oral ulcer powder on recurrent aphthous ulcer （RAU） model rats and its mechanism. METHODS： In vitro antimicrobial activity of the powder was determined by disk diffusion method. 50 healthy SD rats were randomly divided into normal group， model group， positive group （Guilin watermelon frost， 100 mg/kg） and oral ulcer powder high-dose and low-dose groups （70， 35 mg/kg）， with 10 rats in each group. Except for normal group， RAU model was established in the right oral submucosa of rats in other groups by acetic acid method. After modeling， administration groups were smeared with corresponding drugs on ulcers for 3 days. Normal group and model group were not treated. The ulcer surface of rats was observed and the ulcer area was measured on the 1st and 3rd days after administration. The morphological changes of ulcer tissues were observed. The serum levels of SOD， MDA， GSH， TNF-α， IL-1， IL-6 and IFN-γ were detected. The protein expressions of MMP-9， NF-κB， Caspase-3 and PARP in ulcer tissues of rats were detected by immunohistochemistry. RESULTS： The oral ulcer powder showed obvious in vitro bacteriostasis effect. Compared with blank group， oral ulcer and histopathological changes were obvious in model group； serum levels of TNF-α， IL-1， IL-6 and MDA were increased significantly， while the levels of IFN-γ， SOD and GSH were decreased significantly （P＜0.01）； the expression of MMP-9， NF-κB， Caspase-3 and PARP in ulcer tissue were increased significantly （P＜0.05 or P＜0.01）. Compared with model group， the ulcer area of rats in each dosage group was significantly reduced （P＜0.05 or P＜0.01） or nearly healed， the pathological changes of  tissue were significantly alleviated； serum levels of MDA， TNF-α， IL-1 and IL-6 were decreased significantly， while the levels of SOD， GSH and IFN-γ were increased significantly （P＜0.05 or P＜0.01）； the expression of MMP-9， NF-κB， Caspase-3 and PARP in ulcer tissue were decreased significantly （P＜0.01）. CONCLUSIONS： Spider toxin oral ulcer powder shows strong bacteriostasis， detumescence and repair effects， and has obvious therapeutic effect on RAU model rats. Its mechanism may be related to reducing the level of inflammatory factors， mediating the expression of apoptotic factors and regulating immune imbalance.