Objective Clinical parenteral nutrition( PN) support still lacks in standards on some degree .This paper was to analyze the clinical application of PN support in our hospital in order to provide the basis for clinical rational drug use . Methods Random weighting method was applied to collect 5% hospitalized patients′information from each patient unit each month from April 2012 to March 2013 in Nanjing Gerneral Hospital of Nanjing Military Region .NRS-2002 nutrition risk screening was applied to eval-uate whether the patient needed PN support .Statistical analysis were carried out on patients supported with parenteral nutrition from department distribution, PN detailed components and distribution intervals of aII in one admixture non-protein calorie and nitrogen ra-tio. Results According to the survey, 393 patients had received PN support, including 217 cases′NRS score <3 and 176 cases′NRS score ≥3.General surgery department ranked the first in the cases of usingall in oneadmixture support.Among 133 cases receiving all in one admixture support, the course of 37 cases(27.82%) <7 d.The aII in one admixture non-protein calorie and ni-trogen ratio(100~150∶1) only took up 28.57%. Conclusion Although PN has got wide application in clinical departments, the rationality of prescription should be strengthened .Pharmacists should help doctors set up appropriate prescription from the aspect of pharmacy.

AIM:Todiscusstherelationshipbetweensmallubiquitin-relatedmodifier4(SUMO4)expression and papillary thyroid carcinoma (PTC).METHODS:The mRNA and protein levels of SUMO4 in PTC and normal thyroid tissues were determined by the methods of real-time PCR, Western blot and immunohistochemistry .The relationship be-tween SUMO4 expression and clinicopathologic parameters in PTC was evaluated .RESULTS:The results showed that both the mRNA and protein levels of SUMO 4 expression in PTC were obviously higher than those in normal thyroid tissues ( P<0.01).CONCLUSION:The high level of SUMO4 expression in PTC suggests that SUMO4 plays an important role in PTC development and it is probably a molecular mechanism of PTC .

Abstract: Objective To clarify the long-term evolution of hepatitis B virus (HBV) quasi-species in HBsAg asymptomatic carriers in Long'an county, Guangxi. Methods ELISA was used to detect serological markers of HBV. Viral loads were measured by real time PCR. HBV DNA was extracted from serum by kits. The whole HBV genome was amplified using nested PCR and amplicons were sequenced by next-generation sequencing (NGS). These sequences from NGS were analyzed by the software like Mega. Results Serum samples were collected from 9 HBsAg asymptomatic carriers in Longan County，Guangxi at 4 different time points in 2004, 2007, 2013, 2019 or 2020. A total of 23 serum samples and 309 full-length gene quasi-species sequences were obtained, with an average amount of (0.18±0.07) G sequencing data for each sample. Genotype of 55.54%(5/9) the studied subjects underwent genotype conversion during the long-term evolution process of HBV quasi-species, and the genotyping results of the phylogenetic tree in the PreS/S region are in perfect agreement with the results of the whole genome analysis; recombinant B/C, I/C were found; the Sn ranged from 0 to 0.37 and the genetic diversity ranged from 0 to 0.11, respectively. A total of 21 special single nucleotide/amino acid mutations (7 in the S region, 2 in the X region, 3 in the PreC region and 9 in the BCP region) and 6 deletion mutations were detected, multiple mutations were found and no drug resistant mutations were found; 77.8%(7/9) of the HBV strains carried by the subjects in 2004 had double mutations at nt1 762(A→T) and 1 764(G→A) and a stop mutation at nt1 896(G→A); HBV mutations can be restored from the mutant type to the wild type and (or) vice versa without antiviral drug pressure, and The evolution rate of HBV genome was 2.03×10-5~3.50×10-3.Conclusion HBV genotype, recombinants, genetic complexity and diversity of HBV quasi-species can change over time during in natural infection. The transformation between HBV mutation type and wild type reduces the value of predicting clinical outcomes by genetic types and related mutations to some extent. The HBV genome evolution rate of asymptomatic carriers of HBsAg in Long'an County is very high.

OBJECTIVETo investigate the differences in body composition between Crohn's disease(CD) patients and healthy subjects as well as the characteristics of human body composition in various types of CD.

METHODSA total of 57 CD patients were prospectively selected from the Sixth Affiliated Hospital of Sun Yat-sen University as the study group, while 51 healthy subjects as the control group. Protein content, mineral content, fat content, lean body mass, waist circumference, and hip circumference in the two groups were measured by body composition analyzer. Characteristics of CD at different location and different disease activity index were investigated as well.

RESULTSIntracellular fluid, extracellular fluid, weight, protein content, fat content, lean body mass, muscle weight, body fat ratio, waist hip ratio, body weight ratio, arm muscle circumference, arm circumference, quality of cells, BMI and basal metabolic rate in CD patients were significantly lower than those in control group(all P<0.05). Proportion of protein-deficiency patients and fat-deficiency patients were 66.7% and 47.4% respectively. Protein content, fat content, and lean body mass in ileocolic CD patients were lower than those with small bowel and colonic CD(all P<0.05). Protein content, fat content, lean body mass in patients with high disease activity index were lower than those in patients with low and medium index, but higher basal metablic rate was found in the former group(all P<0.05).

CONCLUSIONSThe human body composition in patients with CD are different from healthy people. Disease location and disease activity index have an impact on protein content, fat content, and lean body mass.

Objective:To explore the demand and mode of palliative care for emergency dying patients by analyzing the case data of emergency death and cardiopulmonary resuscitation.Methods:The data of 776 cases of emergency clinical death and cardiopulmonary resuscitation in the Second Affiliated Hospital of Soochow University from 2017 to 2020 were retrospectively analyzed.Results:A total of 687 patients were included with (70.38 ± 16.57) years old, and 49.8% (342/687) of them were 75 years old and above; among them, 36.0% (247/687) patients or their families chose not to give cardiopulmonary resuscitation (DNR) in the last stage of their lives,and 63.2%(156/247) of DNR patients were 75 years old and above. The top four etiology of DNR were cerebral hemorrhage, respiratory failure, multiple organ dysfunction syndrome and out of hospital cardiac and respiratory arrest.After successful cardiopulmonary resuscitation, 37.5% (45/120) of the patients' family members chose to give up treatment again. The median stay time of DNR patients in the emergency room was 738.7 minutes.Conclusions:The patients who choosed DNR were mainly 75 years old and above, with cerebral hemorrhage, respiratory failure, multiple organ failure and cardiac and respiratory arrest. The detention of these patients in the emergency room increases the congestion of the emergency room, and at the same time, they can not get a peaceful palliative care environment. It is suggested that emergency medical staff should strengthen the awareness and improve the ability of palliative care. A relative independent area and corresponding soothing palliative treatment and nursing should be given to the DNR patients.

Hydatid disease imposing serious threat on human health and great loss in livenotstock pastoralism remains a major public health problem in western China. To assess and monitor the effect of control program on transmission dynamics, we used the prevalence of cystic echinococcosis in slaughtered sheep at slaughterhouse as an indicator during the period of 2007 to 2013 in Emin County, Xinjiang Uygur Autonomous Region, China. The results showed a significant decline trend of prevalence in all age groups during the 7 years when the control program was implemented; particularly, the rate was reduced by 72% after first 3 years. Among the sheep slaughtered, the age distribution evidenced that the prevalence increased significantly as the sheep grew older. The baseline data indicated that the rate was 4.5% at the age <1, 6.7% at age 2~, and reached to the highest 17.9% at age > or =4 years. Earlier response to the intervention pressure was seen in the sheep at the younger age. Significant decline started from 2008 at the age <1, from 2009 at age of 1~, 2010 at 2~ to 3~, and the latest, in 2012 at age > or =4. This study demonstrated that the prevalence of cystic echinococcosis in slaughtered sheep may be used as an indicator to assess and monitor the transmission status during and after control program providing information for betterment of performance to sustain control strength.
Abattoirs/statistics & numerical data ; Animals ; China/epidemiology ; Echinococcosis/epidemiology/parasitology/prevention & control/*veterinary ; Female ; Male ; Prevalence ; Sheep ; Sheep Diseases/epidemiology/parasitology/*prevention & control

Objective To investigate the differences in body composition between Crohn′s disease (CD) patients and healthy subjects as well as the characteristics of human body composition in various types of CD. Methods A total of 57 CD patients were prospectively selected from the Sixth Affiliated Hospital of Sun Yat-sen University as the study group, while 51 healthy subjects as the control group. Protein content, mineral content, fat content, lean body mass, waist circumference, and hip circumference in the two groups were measured by body composition analyzer. Characteristics of CD at different location and different disease activity index were investigated as well. Results Intracellular fluid, extracellular fluid, weight, protein content, fat content, lean body mass, muscle weight, body fat ratio, waist hip ratio, body weight ratio, arm muscle circumference, arm circumference, quality of cells, BMI and basal metabolic rate in CD patients were significantly lower than those in control group (all P<0.05). Proportion of protein-deficiency patients and fat-deficiency patients were 66.7% and 47.4% respectively. Protein content, fat content, and lean body mass in ileocolic CD patients were lower than those with small bowel and colonic CD (all P<0.05). Protein content, fat content, lean body mass in patients with high disease activity index were lower than those in patients with low and medium index, but higher basal metablic rate was found in the former group (all P<0.05). Conclusions The human body composition in patients with CD are different from healthy people. Disease location and disease activity index have an impact on protein content, fat content, and lean body mass.

Objective To investigate the differences in body composition between Crohn′s disease (CD) patients and healthy subjects as well as the characteristics of human body composition in various types of CD. Methods A total of 57 CD patients were prospectively selected from the Sixth Affiliated Hospital of Sun Yat-sen University as the study group, while 51 healthy subjects as the control group. Protein content, mineral content, fat content, lean body mass, waist circumference, and hip circumference in the two groups were measured by body composition analyzer. Characteristics of CD at different location and different disease activity index were investigated as well. Results Intracellular fluid, extracellular fluid, weight, protein content, fat content, lean body mass, muscle weight, body fat ratio, waist hip ratio, body weight ratio, arm muscle circumference, arm circumference, quality of cells, BMI and basal metabolic rate in CD patients were significantly lower than those in control group (all P<0.05). Proportion of protein-deficiency patients and fat-deficiency patients were 66.7% and 47.4% respectively. Protein content, fat content, and lean body mass in ileocolic CD patients were lower than those with small bowel and colonic CD (all P<0.05). Protein content, fat content, lean body mass in patients with high disease activity index were lower than those in patients with low and medium index, but higher basal metablic rate was found in the former group (all P<0.05). Conclusions The human body composition in patients with CD are different from healthy people. Disease location and disease activity index have an impact on protein content, fat content, and lean body mass.

Objective:To analyse the clinical significance of selective single embryo transfer by time-lapse mo-nitoring(TLM)or conventional morphology assessment(CMA)in vitro fertilization/intracytoplasmic sperm in-jection and embryo transfer(IVF/ICSI-ET),and to initially explore the predictive value of Raman spectral analy-sis of embryo culture medium for clinical pregnancy rate.Methods:The study is a prospective randomized con-trolled clinical trial.We assigned 139 patients treated with IVF/ICSI-ET in Reproductive and Genetics Center of Suzhou Municipal Hospital from April 2019 to July 2020,which were randomly assigned to either the CMA or the TLM group.We performed selective single-embryo transfer(fresh cycle and FET)after selecting the optimal em-bryos with TLM or CMA respectively.If the patient's first embryo transfer was unsuccessful,a second one would be performed to compare the differences in the cumulative live birth rate of embryo transfer and other pregnancy outcomes between the two groups.Meanwhile,we collected 15 μl of embryo culture medium at day 3 after IVF/ISCI fertilization for Raman spectroscopy analysis.Results:There were no differences in cumulative live birth,cu-mulative clinical pregnancy,cumulative premature birth,cumulative early spontaneous abortion,cumulative ectopic pregnancy and LGA or SGA between TLM and CMA groups(P＞0.05).The Neonatal sex ratio in the TLM group was lower than that in the CMA group,but the difference was not significant(P＞0.05).Raman spectros-copy analysis of embryo culture medium predicted the clinical pregnancy rate with 67.21％accuracy.Conclu-sions:In young women with a good ovarian reserve,the advantage of using TLM to evaluate embryos is not obvi-ous,so we should remain vigilant that embryo selection based on morphokinetic parameters may affect the sex ratio.Raman spectroscopic analysis of embryo culture medium is not yet able to effectively predict the planting ability of embryos.

Objective:To explore the association of DNA methylation with immune response to hepatitis B (HepB) vaccine in Han nationality children from Guangxi province.Methods:A total of 263 children aged 8-9 months who had completed HepB immunization program were recruited from three hospitals in Guangxi province by using unmatched case-control method. Children with the HepB surface antibody concentration(Anti -HBs)<100 mIU/ml was set as the case group and ≥100 mIU/ml as the control group. Multiplex PCR and heavy sulfite sequencing were used to treat the samples. Illumina platform was used for high-throughput DNA methylation sequencing of IFNG gene target regions and CpG sites. Unconditional logistic regression was used to analyze the association between cytosine-phospho-guanosine DNA methylation at 18 loci of IFNG gene and HepB immune response level. Results:There were 104 children in the case group and 159 in the control group. The median ( Q1, Q3) level of anti -HBs in two groups were 62.34 (30.06, 98.88) mIU/ml and 1 089.10 (710.35, 1 233.45) mIU/ml. The methylation levels of IFNG_1 gene 44 and 93 locus in the case group were higher than those in the control group ( P<0.05). The unconditional logistic regression model showed that the DNA methylation level of IFNG_1 gene at 44 ( OR=1.18, 95% CI: 1.03-1.35) and 93 ( OR=1.21, 95% CI: 1.07-1.38) locus was associated with the HepB response level. Conclusion:The changes of DNA methylation at locus 44 and 93 of IFNG_1 gene may be relevant factors affecting the response level of HepB in Han nationality children from Guangxi province.