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 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.

Patients with polycystic ovary syndrome ( PCOS) are often confronted with adverse pregnancy outcomes. There is accumulating evidence demonstrating that metformin increases the rate of pregnancy and reduces the occurrence of miscarriage. However, the lack of sufficient evidence for metformin in reducing gestational diabetes mellitus ( GDM) and preeclampsia as well as its long-term safety data for offspring were also noted. The application of metformin in pregnant women with PCOS remains controversial. PCOS is a disease of great heterogeneity. With an increasing understanding of the pathogenesis of PCOS, the individualized treatment is a future trend as the patients with PCOS should be accurately classified to achieve the maximum benefit when metformin is added during pregnancy.

Objective:To observe the glycemic profiles and emotion management in diabetic patients after the outbreak of novel coronavirus disease 2019(COVID-19).Methods:A questionnaire survey was used to observe the blood glucose levels and metabolic indexes before and after the outbreak of COVID-19, and to detect emotion ratings after the outbreak of COVID-19. The aim of the study is to present the effects of the COVID-19 on glycemic and emotional management in diabetic patients.Results:A total of 136 patients were included in this survey. The average age of the patients was 62.5 years old, and the average duration of diabetes was 10.1 years. Glycemic profiles(fasting blood glucose, 2 h postprandial blood glucose, HbA 1C), lipid profiles(triglycerides, low-density lipoprotein cholesterol), and body weight were not significantly different before and after the outbreak of COVID-19( P>0.05). According to emotional scales(scores of anxiety, depression, and sleep-related scales), 76.5% diabetic patients did not develop anxiety symptoms, 61.0%~69.9% diabetic patients did not have depressive symptoms and 52.0% diabetic patients did not have sleep disorder. 19.9% diabetic patients had mild anxiety symptoms, 25.7%~30.9% diabetic patients presented mild depression symptoms and 28.3% diabetic patients had mild sleep disorders. 2.9% diabetic patients had moderate anxiety, 2.2%~8.1% diabetic patients had moderate depression and 14.2% diabetic patients had moderate sleep disorder. Only a very small part of patients presented severe emotional symptoms including 0.7% patients with anxiety symptoms(GAD-7 15 points and above), 2.2% patients with depressive symptoms(PHQ9 and PHQ15 15 points and above)and 5.6% patients with sleep symptoms(PSQI 15 points and above). Compared with asymptomatic patients, neither patients with mild and moderate/severe depression and sleep disorder showed significant difference in HbA 1C, nor did patients with moderate/ severe anxiety symptoms. However, patients with mild anxiety symptoms showed significant lower HbA 1C than asymptomatic patients. Conclusion:After the outbreak of COVID-19, there was an increasing trend in blood glucose, but there was no statistical difference. Body weight, lipids profiles were not different in diabetic patients, either. Most of diabetic patients had mild symptoms of anxiety, depression and sleep disorders. Very few patients presented moderate to severe symptoms of anxiety, depression and sleep disorders.