American doctor Koretz and his colleagues have collected the documents on randomized control test(RCT) of total parenteral nutrition(TPN) during past 30 years since 1974.With stringent standard,Dr.Koretz et al performed the Meta-analysis to evaluate the efficacy of TPN.This article summarized the result of Koretz's Meta-analysis and also reviewed the efficacy of TPN on some special clinical conditions such as acute pancreatitis,HIV infection,respiratory disease,burns,home TPN et al.The result couldn't determine the curative effect of TPN.TPN is usually not recommended to be routinely applied on hospital patients,but applicable to selective patients.

Objective:To evaluate the common nursing problems in pharmacy intravenous admixture services(PIVAS).Methods:By strengthening nursing staff training,nurses were required to carry out checking system strictly,use the super-clean work platform collectly and prevent minute granule contamination.Results:Among 170 000 pack of intravenous liquid prepared in PIVAS in the last six months,no transfusion reaction occurred.Medical cost decreased and nursing occupation protection was strengthened.Conclusion:Strict Personal and system management can guarantee the effectiveness of PIVAS.

OBJECTIVE: To explore the genetic basis for a pedigree affected with hereditary multiple osteochondroma (HMO). METHODS: Peripheral blood samples were collected from the proband and members of his pedigree with informed consent. Following extraction of genomic DNA, all coding exons and flanking intronic sequences (-10 bp) of the EXT1 and EXT2 genes were subjected to targeted capture and next generation sequencing (NGS). Suspected variant was verified by Sanger sequencing. RESULTS: A heterozygous nonsense variant (c.1911C>A) was found in exon 10 of the EXT1 gene in the proband and his affected father but not in a healthy sister and normal controls. The variant was classified as a pathogenic based on the guidelines of the American College of Medical Genetics and Genomics (PVS1+PM2+PP1). Bioinformatic analysis predicted that the c.1911C>A variant may be disease-causing via nonsense-mediated mRNA decay and anomalous splicing. CONCLUSION The c.1911C>A variant probably underlay the disease in this pedigree. Discovery of this variant enriched the variant spectrum of HMO.
Codon, Nonsense ; Exons/genetics* ; Exostoses, Multiple Hereditary/genetics* ; Heterozygote ; Humans ; Pedigree

Objective To investigate preventive measures and pathogenic related factors of periodontitis. Methods A total of 138 patients with periodontitis from August 2012 to March 2014 in our department were selected as the experi-mental group. Meanwhile 138 healthy cases matched with the patients within 2 years age difference in the same regions were selected as the control group. Questionnaire survey was used to inquire the basic information, educational status, economic income, acquisition of knowledge in periodontal disease, brushing habits, negative life events and so on. The differences in results between two groups were compared. Results Among 138 patients with periodontitis, there was 1087 disease parts on maxillaries, 872 parts on mandibles, 1243 parts on molars, and 876 parts on anterior teeth and bicuspids. According to Amaitage standard, 138 patients with periodontitis, the rate of mild to moderate periodontitis patients was 81.16% (112 cases), and the rate of severe periodontitis was 18.84% (26 cases). Acquisition of knowledge in periodontal disease, smoking, the frequency and sustained time of brushing per day, negative life events and mouth care between two groups showed statistical significance(P<0.05). There was no significant difference between two groups in age, gender and educational status(P>0.05). Non conditional Logistic regression results showed that: independent pathogenic risk factors of periodontitis included acquisition of knowledge in periodontal disease, the frequency and sus-tained time of brushing per day, negative life events and regular mouth care, and regular mouth care ranked first among these factors(the odds ratio=3.102, P<0.05). Conclusion Periodontitis is the result of interaction of multiple risk factors, therefore, comprehensive measures especially regular mouth care should be adopted to prevent the occurrence of peri-odontitis.

Objective:To investigate the effect of background music therapy on the pain management of school age burn children during function exercises.Methods:A total of 78 burned children of school age were divided into intervention group (39 cases) and control group (39 cases) according to random number table method. The control group received routine function exercises, the intervention group was listening background music during function exercises. The pain degree was evaluated by Face, Legs, Activity, Crying, Consolability (FLACC) scores, children's medical fears was determined by Broome's Child Medical Fear Questionnaire (CMFQ), activities of daily living was assessed by Barthel index.Results:At 1th, 2th, 3th, 5th, 6th, 8th, 10th, the FLACC scores were (3.82±0.46), (3.25±0.49), (3.29±0.57), (3.04±0.59), (2.82±0.58), (2.90±0.48), (2.31±0.32) points in the intervention group, (4.26±0.54), (3.88±0.84), (4.09±0.86), (3.82±0.65), (3.75±0.68), (3.39±0.72), (2.97±0.64) points in the control group, the differences were statistically significant ( t values were 3.457-6.363, all P<0.05). After intervention, the fear medical environment, medical operation fear fear, self scores were (6.84±1.44), (5.28±1.41), (4.18±1.58) points in the intervention group, and (7.96±1.34), (7.56±2.43), (5.78±1.31) points in the control group, the differences were statistically significant ( t=3.511, 4.995, 4.779, all P<0.05). However, the scores of activity of daily life between two groups was no statistical difference ( P>0.05). Conclusions:Background music therapy can alleviate pain degree and medical fear of burn children during function exercises and serve as a useful non-drug strategy for pain management.

Objective To investigate the protective effect of Guanxinning(GXN)tablet on dilated cardiomyopathy(DCM),and to explore its effect and mechanism in pyroptosis of cardiomyocytes via the NLRP3/ASC/Caspase-1 pathway.Methods Rats were divided into GXN low-dose,GXN high-dose,digoxin,model control,and normal control groups.The DCM model was induced by multiple intraperitoneal injections of 17.5 mg/kg doxorubicin(DOX).The drug was administered at the same time as the model was established for 10 weeks.After the last administration,echocardiography was used to assess cardiac function indexes.After sacrificing the rats,serum was collected to measure IL-1β and IL-18 levels.RT-PCR was used to detect mRNA expression of NLRP3,ASC,Caspase-1,NF-κB,TXNIP,IL-1β,and IL-18.Immunohistochemistry and immunofluorescence staining and Western Blot were used to assess NLRP3,ASC,Caspase-1,IL-1β,and IL-18,GSDMD and GSDMD-NT protein,and TUNEL staining result.Changes in the microstructure of cardiomyocytes were observed by transmission electron microscopy.Results Compared with the normal control group,IVSs,IVSd,LVPWs,FS,SV,EF,and HR of the model control group were significantly reduced,LVIDs,ESV,and serum IL-1β and IL-18 were significantly increased,NLRP3,ASC,Caspase-1,NF-κB,TXNIP,IL-1β and IL-18 mRNA expression was significantly increased,and NLRP3,ASC,Caspase-1,IL-1β,IL-18 and GSDMD-NT protein expression and the TUNEL staining area were increased significantly,and the microstructure of cardiomyocytes changed significantly.Compared with the model control group,GXN significantly increased IVSs,SV,FS,EF,and HR,significantly reduced LVIDs,ESV,and the serum levels of IL-1β and IL-18,and reduced NLRP3,ASC,Caspase-1,NF-κB,TXNIP,IL-1β,and IL-18 mRNA expression,NLRP3,ASC,Caspase-1,IL-1β,IL-18 and GSDMD-NT protein expression,and the TUNEL staining area.Additionally,the microstructure was improved significantly.Conclusions GXN alleviates cardiomyocyte pyroptosis in rats with DCM by inhibiting the NLRP3/ASC/Caspase-1 pathway.

Objective To study the effects and mechanisms of Smilax glabra flavonoids(SGF)on myocardial hypertrophy and cardiac inflammation induced by isoproterenol(ISO)in mice.Methods C57/6J mice were randomly divided into a normal group,ISO model group(1.25 mg/(kg·d)),SGF low-dose group(50 mg/(kg·d)),and SGF high-dose group(100 mg/(kg·d)).The SGF groups were given prophylactic SGF for 7 days before modeling,then subcutaneous ISO injection was given to each group,and echocardiography was performed after continuous injection for 7 days.Serum was separated from orbital blood,and the NT-proBNP and inflammatory factor(IL-1β,IL-6,and TNF-α)contents of the blood were detected.Myocardial specimens were collected,and pathological changes to myocardial tissue were observed.Myocardial ROS levels were detected by DHE staining.The mRNA levels of heart-related hypertrophy genes and changes in the expression of key proteins in the inflammatory pathway of NLRP3/Caspase-1/IL-18 in myocardial tissue were detected.Results SGF prophylactic administration decreased IVSd,IVSs,and EF in echocardiography and increased LVIDs,LVIDd,and LVESV.The IL-1 β,IL-6,TNF-α,and NT-proBNP contents of blood decreased,and the mRNA expression levels of the heart-related hypertrophy genes for ANP,BNP,and β-MHC were subdued.The increase in myocardial ROS levels was also inhibited.The protein expression of NLRP3,Caspase-1(p20),and IL-18,which are key factors in the NLRP3/caspase-l/IL-18 inflammatory pathway,was down-regulated in myocardial tissue.The hypertrophy and disordered arrangement of cardiomyocytes were improved,the increase in fibroblast numbers outside myocardial fibers was reduced,and the infiltration of inflammatory cells and fibrosis of myocardial tissue were alleviated.Conclusions SGF can improve ISO-induced myocardial hypertrophy and cardiac inflammation in mice and may act through the NLRP3/Caspase-1/IL-18 inflammatory pathway.

Objective Through the investigation of Tongxuan Lifei prescription and Tongxuan Lifei prescription to reduce Ephedrae Herba on the respiratory system,central system,urinary system,circulatory system and digestive system of model rats with wind-cold superficies symptoms,to explore the effect of the ascending and floating of Ephedrae Herba on the efficacy of Tongxuan Lifei prescription and to provide theoretical basis for clinical prescription.Methods 60 SD rats were randomly divided into normal group(CON),model group(M),paracetamol group(Y,0.455 g·kg-1),Ephedrae Herba group(MH,2.340 g·kg-1),Tongxuan Lifei prescription group(TX,4.326 g·kg-1)and Tongxuan Lifei prescription to reduce Ephedrae Herba group(TX-MH,3.920 g·kg-1),10 rats in each group.Except for the CON group,the rats of the groups were modeled with fan blowing and cold stimulation.The model was successful when the rats appeared in a state of crouching or condensed,decreased spontaneous activity,hunched back,sneezing,and elevated body temperature.After successful modeling,the corresponding drugs(10 mL·kg-1)were given respectively,and the rats in the CON and M group were given the same volume of distilled water for 4 consecutive days.The basic state of the rats was observed,ammonia induced cough,phenol red excretion and levels of inflammatory factors(IgE,IL-4,IFN-γ)in BALF,lung histopathological sections and oxidative stress(MDA,SOD and GSH-Px)levels were determined to investigate the effects of TX and TX-MH on the respiratory system.The effects of TX and TX-MH on the central system were investigated by the open field experiment,the sleep time of rats and the levels of inflammatory factors(IgE,IFN-γ,IL-4)in serum.The effects of TX and TX-MH on digestive system were investigated by gastrointestinal motility and levels of motilin(MTL),somatostatin(SST)and gastrin(GT)in plasma.The effects of TX and TX-MH on the urinary system were investigated by the levels of toe sweat secretion,urine volume,serum creatinine(CRE)and blood urea nitrogen(BUN).The effects on the circulatory system were investigated by the rat cardiac function and the levels of serum NO.Results TX could increase the body weight and decrease the body temperature of rats with wind-cold superficies symptoms;TX could stimulate the central system,improve the respiratory system,enhance the urinary-sweat system,and has no obvious effect on the circulatory system and digestive system.The effects of TX-MH on the respiratory system and the central system is obviously weakened,and the circulatory system and the digestive system are basically not affected.In general,the effect of TX is better than that of TX-MH,which indicates that the removal of Ephedrae Herba,the ascending and floating medicine,weakens the effect of TX on"promoting cold"and"xuanfei relieving cough".Conclusion The Ephedrae Herba's ascending and floating medicinal properties play an important role in the efficacy of Tongxuan Lifei prescription's"promoting cold"and"xuanfei relieving cough".

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 explore the interventional effect of β-sitosterol on ovalbumin(OVA)-induced allergic asthma rats and its potential mechanism.Methods:SD male rats were randomly divided into normal group(CON),model group(M),positive drug dexamethasone group(DEX,0.075 mg/kg)and β-sitosterol group(Sit,50 mg/kg).A rat model of allergic asthma was estab-lished by intraperitoneal injection of OVA with aluminum hydrogen solution,and nebulized inhalation of OVA to stimulate.Rats were given intragastric administration 30 min before aerosol challenge,and after continuous administration for 7 days,the indicators of cough and asthma and tracheal phenol red excretion were detected.HE staining was used to observe pathological changes of lung tis-sue.Flow cytometry was used to detect reactive oxygen species(ROS)generation,apoptosis level and ratios of Th17 and Treg cells in peripheral blood.Biochemical method was used to detect contents of MDA,and activities of T-SOD and GSH-Px in rat lung tissues.ELISA was used to detect levels of Th17 and Treg-related cytokines(TNF-α,IL-4,IL-6,IL-17A,and IL-35).Results:Compared with model group,β-sitosterol significantly prolonged the incubation period of cough and gasp in rats with allergic asthma,reduced the frequency of cough and gasping,and promoted the excretion of phenol red in trachea;significantly reduced inflammatory infiltration in lung tissue of asthmatic rats;observably reduced MDA content in lung tissue,ROS of primary lung cell and apoptosis levels of asthmatic rats,increased the activities of T-SOD and GSH-Px;markedly reduced proportion of Th17 cells and levels of pro-inflammatory cyto-kines TNF-α,IL-4,IL-6 and IL-17A,increased proportion of Treg cells and levels of anti-inflammatory cytokine IL-35.Conclusion:β-sitosterol can ameliorate airway inflammation and oxidative damage in OVA-induced allergic asthmatic rats,and its mecha-nism may be related to the regulation of β-sitosterol on Th17/Treg immune imbalance and oxidative stress response.