n admixtures are summarized.

Objective To investigate the effect of continuous renal replacement therapy ( CRRT) on the reg-ulation of Treg/Th17 in patients with severe sepsis,and related inflammatory factors IL-6,IL-17,IL-10,and TNF-α.Methods 60 patients with severe sepsis were randomly divided into two groups,30 cases in each group.The control group received conventional treatment,and the observation group was treated with CRRT on the basis of the control group.Flow cytometry was used to detect the levels of Tregs and Th17 cells,and IL-6,IL-10,IL-17 and TNF-αwere detected by ELISA method.At the same time,the APACHEII score,ICU length of hospital stay were observed and recorded.Results After treatment,APACHE Ⅱscore,ICU length of hospital of the observation group were lower than the control group,there were statistically significant differences(t=4.258,t=4.518,all P<0.05). The expression levels of Th17,Treg and Tregs/Th17 in the observation group were significantly lower than the control group,the differences were statistically significant (t=5.872,4.267,4.285,all P<0.05).The expression levels of IL-6,IL-17,TNF-αin the observation group decreased more significantly than the control group,the differences were statistically significant (t=5.829,5.257,5.983,all P<0.05).But the expression level of IL-10 in the two groups had no obvious change[(35.26 ±18.63) pg/mL vs (35.52 ±20.09) pg/mL,t=2.164,P>0.05].Conclusion CRRT can not only remove the inflammatory mediators of abnormal expression,improve the function of T cells,but also can maintain the balance between Th17 and Treg,improve the immune disorders,and improve the prognosis of sepsis.

Objective To evaluate the effect of iron on the stability of fat emulsion in total nutrient admixture (TNA) in pediatrics. Methods Based on intravenous nutrition preparation and handling protocols, 0,0.25, 0.50, 0.75, and 1.00 mg iron sucrose was added in each 100 ml TNA, respectively, and each dose was prepared for 10 bags. The stability of fat emulsion was observed by electron scanning microscopy. The pH and osmolality were determined at different time points (0, 24, 48, and 72 h). Results The fat particle size, percentages of particles ＞ 0.5 μm, pH value, and osmolality were not significantly different among all the groups at different time points (all P ＞ 0.05). The mean particle sizes of the fat emulsion were ＜ 0.5 μm in all groups within 72 h.No fat particle with diameter ＞ 5 μm was seen in each group. Conclusion TNA containing iron sucrose with concentrations range 0.25-1.00 mg per 100 ml is stable.

Objective To explore the viral etiology spectrum of different age and different seasons for neo-natal pneumonia.Methods Medical records of 1 073 cases of neonatal pneumonia in our hospital were retrospectively analyzed,line direct immunofluorescence assay were used to detect nasopharyngeal secretions of newborns,the test results were statistically analyzed.Results In 1 073 cases with neonatal pneumonia,406 cases were detected positive with virus infected,the positive rate was 37.8%,7 cases were mix infected.334 cases were infected by respiratory syncytial virus(RSV),which had the highest detection rate,accounting for 82.3%;RSV infection rate in 1 -6 month baby was 36.4%,which was higher than the >6 -12 month -old baby with RSV infection rate 26.5%,the difference was statistically significant(χ2 =12.25,P <0.05);RSV infection rate in winter and spring group was 39.7%,which was significantly higher than that in autumn and winter group(13.6%);PIV3 infection rate in winter and spring group was 1.8%,significantly lower than that in autumn and summer group(9.1%),the difference was statistically signifi-cant(χ2 =31.27,P <0.05 ).Conclusion RSV is the most common viral in neonatal pneumonia,more attention should be payed to RSV infection control in small babies and at winter and spring,pay attention to PIV3 infection at autumn and summer.

Objective To evaluate the effects of iron dextran or iron sucrose on the stability of fat emulsion in total nutrient admixture (TNA) in pediatric settings.Methods TNA with different intravenous doses of iron sucrose or iron dextran (0.25,0.5,0.75,or 1.00 mg) were prepared,and each dose was prepared 10 bags.The TNAs were stored at 25 ℃ for 3 days,and the stability of fat emulsion was observed by electron scanning microscopy.Meanwhile,the pH and osmolality were also measured.Results The particle sizes of fat emulsions in TNA with different concentrations of iron sucrose or iron dextran at different time points were not significantly different (F =0.32,P =0.7836 ; F =1.73,P =0.1321,respectively).The mean particle size of the fat emulsion in each group was ＜ 0.5 μm within 72 hours.For TNA containing different concentrations of iron,the percentage of particles ＞ 0.5 μm,pH,and osmotic pressure showed no significant difference at different time points (percentage:F =1.47,P =0.3467 ; F =1.04,P =0.4758.pH:F =0.63,P =0.5942 ; F =0.46,P =0.6825.osmotic pressure:F =1.37,P =0.3648 ; F =0.65,P =0.6023).Conclusion The TNA addeded with iron sucrose or iron dextran with an concentrations of ＜ 1％ is stable.

[Objective]To evaluate the efficacy of different traditional Chinese medicine(TCM)appropriate techniques on patients with coronary heart disease and insomnia by network Meta-analysis.[Methods]A computer-based search of China National Knowledge Infrastructure(CNKI),WanFang,China Science and Technology Journal Database(VIP),China Biology Medicine disc(CBM),PubMed,CINAHL,Web of Science,Embase and the Cochrane Library was conducted to retrieve the literature on the improvement of the efficacy of TCM appropriate technology in patients with coronary heart disease and insomnia.The retrieval time limit was from the establishment date of the database to December 2023.Two researchers independently screened the literature,evaluated the quality of the literature and extracted the information.The Cochrane bias assessment tool was used to evaluate the quality of the literature,Review Manager 5.3 was used for traditional Meta-analysis,and Stata 17 software was used for network Meta-analysis.[Results]A total of 31 studies involving 2 977 patients and 14 TCM appropriate techniques were included.Network Meta-analysis showed that in terms of the total effective rate of insomnia,acupoint massage+five-tone therapy[odds ratio(OR)=7.61,95％confidence interval(CI)(2.05,28.30),P＜0.05]was superior to conventional treatment,and had the best effect compared with other TCM appropriate techniques.In terms of sleep quality score,acupoint application[mean difference(MD)=0.51,95％CI(0.04,8.23),P＜0.05]was superior to conventional treatment,and had the best effect compared with other TCM appropriate techniques.[Conclusion]Existing studies have shown that acupoint massage+five-tone therapy can effectively improve the total effective rate of insomnia.Acupoint application can effectively improve the sleep quality of patients.Medical staff can select appropriate TCM appropriate techniques according to the patient's own situation.

Objective To investigate the serum high mobility group box-1 protein level of children's patients with a-cute traumatic brain injury and it's expression changes and clinical significance. Methods A total of 87 children's patients with acute traumatic brain injury were randomly divided into three groups: severe group (≤8 scores), moderate group(9 to 12 scores) and minor group(13 to 15 scores) according to the patients' Glasgow Coma Scale on admission. Their venous blood were drawn at 3 h, 6 h, 12 h, 24 h, 48 h after injury and the serum HMGB1 were determined by en zyme linked immunosorbent assay(ELISA). The serum HMGB1 concentration were compared between different groups, survivors and non-survivors in 28 days, patients who developed acute lung injury(ALI) or sepsis and who did not deve-lope ALI or sepsis in severe injury group. Results Compared with the minor and moderate group, the serum HMGB1 level in severe group were significantly elevated at each time points(P<0.01). At 6 h, 12 h, 24 h, 48 h time points, the serum HMGB1 level in the moderate group increased significantly compared with the minor group (P<0.01). The serum HMGB1 levels at 24 h after injury were higher in non-survivors compared with survivors (P<0.01). The serum HMGB1 levels in those patients who developed acute lung injury (ALI) or sepsis were higher than who did not develope ALI or sepsis (P<0.01). Conclusion The serum HMGB1 concentration is increased early and may be a ‘alarm signal'prog-nosticating prognosis and complication after acute traumatic brain injury in children.

Objective Visual electrophysiology and optical correlation tomography angiography(OCTA)were used to investigate differences in preoperative retinal function in patients with type 2 diabetic cataract(DC)without obvious retinopathy(NDR)and to determine the clinical application of whole-process blood glucose man-agement(WBGM)for improving postoperative vision in DC patients.Methods This study investigated the preop-erative and postoperative visual electrophysiology(N75,P100,photopic FERG,and scotopic FERG),peripapil-lary retinal nerve fiber layer(pRNFL)and peripapillary capillary vessel density(ppVD)data,as well as trends in these data changes during blood glucose management intervention.Results As the course of T2DM progressed,FBG and HbA1c increased,the N75 and P100 lategraduancy periods of patients gradually lengthened,and the photopic FERG,scotopic FERG,pRNFL,and ppVD values decreased at each postoperative time point.At the same time,the best corrected visual acuity(BCVA)of patients after surgery gradually decreased(P<0.05).Compared with that at 1 week after surgery,the BCVA of Group A(without whole-process blood glucose manage-ment)gradually increased at 1 month and 3 months after surgery but showed a downward trend at 1 year after sur-gery.The BCVA of Group B(with whole-process blood glucose management)gradually stabilized at 1 month after surgery,and at all time points after surgery,the BCVA of Group B was better than that of Group A.The results showed that N75 and P100 in Group A were greater than those in Group B,while the photopic and scotopic FERG,pRNFL,and ppVD(%)in Group A were lower than those in Group B.In addition,N75 and P100 in Group A showed a gradual prolongation trend at various time points after surgery,while photopic FERG,scotopic FERG,pRNFL,and ppVD(%)showed a gradually decreasing trend.However,the above data in Group B gradu-ally stabilized at 3 months after DC surgery,approaching the preoperative level of the group(P<0.05).In the state of whole blood glucose management,although N75 and P100 both reached their longest durations at 1 week af-ter surgery,N75,P100,photopic FERG,scotopic FERG,and pRNFL showed a gradually decreasing trend at 1 month and 3 months after surgery,while ppVD(%)gradually increased(P<0.05).At various time points from 3 months to 1 year after surgery,the overall trend of the above indicators remained stable and close to the preoperative values(P>0.05).Conclusion According to the results of the quantitative analysis of visual electrophysiology and OCTA,in DC patients without obvious retinopathy and with the worsening of diabetes,retinal function decreased,but whole-process blood glucose management effectively restored retinal function and improved visual quality after surgery.

OBJECTIVE To study the improvement effects of poria acid on insulin resistance in rats with polycystic ovary syndrome （PCOS） and its mechanism. METHODS One hundred and twenty-six female rats were randomly separated into blank group， PCOS group， poria acid low-dose group （8.33 mg/kg）， pachymic acid high-dose group （33.32 mg/kg）， ethinylestradiol cyproterone group （positive control group， 0.34 mg/kg）， recombinant rat high mobility group protein B1 protein （rHMGB1） group （8 μg/kg）， and poria acid high dose+rHMGB1 group （33.32 mg/kg poria acid+8 μg/kg rHMGB1）， with 18 rats in each group. Except for the blank group， the rats in all other groups were given Letrozole suspension intragastrically to construct the PCOS model. After successful modeling， administration was performed once a day for 4 weeks. After medication， the fasting blood glucose and fasting insulin levels， and insulin resistance index （HOMA-IR） were measured in rats； the levels of follicle-stimulating hormone （FSH）， luteinizing hormone （LH） and testosterone （T） in rat serum， and the levels of interleukin-1β （IL-1β） and tumor necrosis factor- α （TNF- α） in ovarian tissue were detected； ovarian coefficients of rats were calculated； the pathological changes of ovarian tissue were observed； the expressions of HMGB1， receptor for advanced glycosylation elaine_ tanghong@sina.com end product （RAGE） and phosphorylated nuclear factor κB p65 （p-NF-κB p65） proteins were determined in ovarian tissue of rats. RESULTS Compared with the blank group， the pathological injury of ovarian tissue of rats in the PCOS group was serious， the levels of fasting blood glucose and fasting insulin， HOMA-IR and ovarian coefficient were increased， the levels of serum LH and T were increased， while the levels of FSH were decreased； the levels of IL-1β and TNF-α， the expressions of HMGB1， RAGE and p-NF-κB p65 protein in ovarian tissue were increased， with statistical significance （P＜0.05）. Compared with the PCOS group， pathological damage of ovarian tissue was reduced in poria acid low-dose and high-dose groups and ethinylestradiol cyproterone group， and fasting blood glucose， fasting insulin levels， HOMA-IR and ovarian coefficient were decreased； serum LH and T levels were decreased， while FSH levels were increased； the levels of IL-1β and TNF-α and the expressions of HMGB1， RAGE and p-NF-κB p65 protein in ovarian tissue were decreased， with statistical significance （P＜0.05）. The trend of corresponding indexes in rHMGB1 group was opposite to the above （P＜0.05）. Compared with poria acid high-dose group， the changes of the above indexes were reversed significantly in poria acid high-dose+rHMGB1 group （P＜0.05）. CONCLUSIONS Poria acid may improve insulin resistance and inhibit inflammatory reaction in PCOS rats by inhibiting HMGB1/ RAGE pathway.