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 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.

Non-alcoholic fatty liver disease (NAFLD) incidence is rapidly increasing and become the most common chronic liver disease globally. NAFLD also possesses a risk of developing cardiovascular, kidney, and other diseases. To date, NAFLD still faces difficulties in early diagnosis and treatment options. Thus, early detection, prevention, optimally individualized treatment selections, and prediction of prognosis all are the keys in clinical NAFLD control. Although there are assessment tools available for NAFLD severity appraisal using different clinical parameters, it becomes a hot topic of research in the field for how to optimize non-invasive assessment methodologies. Artificial intelligence (AI) and machine learning are increasingly being used in healthcare, especially in assessment and analysis of chronic liver disease, including NAFLD. This review summarized and discussed the most recent progress of AI and machine learning in differential diagnosis of NAFLD and evaluation of NAFLD severity, in order to provide treatment selections, i.e., the novel AI diagnosis models based on the electronic health records and laboratory tests, ultrasound and radiographic imaging, and liver histopathology data. The therapeutic models discussed the personalized lifestyle changes and NAFLD drug development. The NAFLD prognosis model reviewed and predicted how NAFLD-changed liver metabolisms affect prognosis of patients. This review also speculated future prospective research hot spots and development in the filed for how to utilize the existing AI models to distinguish NAFLD and non-alcoholic steatohepatitis (NASH) and assess NAFLD fibrosis status.