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 develop a simple and efficient method for constructing a middle fragment-deleted mutant of MHC class Ⅱ molecule transactivator(CⅡTA)mutant with the 109~(th)to 226~(th) amino acid codons deleted.Methods: Two gene fragments at each end of the deleted CⅡTA gene were obtained by OE-PCR method and were mixed together for 8 PCR cycles without primers to achieve effective overlapping,then 2 primers was added for amplification of the desired fragments.The amplification products were subsequently cloned into eukaryotic vector pIRES for identification.Results: A mutant of CⅡTA with the 109~(th)to 226~(th) amino acids deleted was successfully constructed.Conclusion: This modified OE-PCR technique overcomes some shortcomings of traditional method and is very suitable for constructing mutants with middle fragment deletion,making it worth to be popularized.

Young Cadre talents in the hospital will be the most important influence factor of the future of the development of Medical care .Their training must includes management , medical skill , science study and so on and be different from the other professions .This study selected the Young Cadre talents of a hospital as the object .And we got the basic condition of the personal , training requirement and the development situation of them , then put for-ward some proposals and methods on how to foster and develop them by these methods below : literature research , questionnaire survey , field survey , statistical analysis , case analysis , interviews with 360 degree and so on .

Objective To explore the curative effect of the single pore video-assisted thoracoscopic surgery and thoracic closed drainage for patients with acute pyothorax by comparing the advantage and disadvantage of two methods.Methods The clinical data of 65 patients with acute pyothorax in our hospital from January 2012 to June 2015 were retrospectively analyzed.Of which 30 patients underwent single pore video-assisted thoracoscopic surgery were as observation group,35 cases received thoracic closed drainage were as the control group.The cura-tive effect of two methods for acute pyothorax was compared by analyzing the result data of two groups.Results The postoperative chest tube indwelling time,length of hospital stay,postoperative antibiotics of observation group were significantly less than those of the control group,the difference was statistically significant(P<0.05).And the incidence of postoperative complications,the proportion of the chronic pyothorax and secondary tube rate of observation group were lower than those of the control group,the difference was statistically significant(P<0.05). Conclusion The single pore video-assisted thoracoscopic surgery is safe and effective for treatment of acute pyothorax, which is worth promoting.

Objective To identify the expression of long non-coding RNAs(lncRNAs) and their putatively modulated cytokines in human immunodeficiency virus(HIV)-1 infected monocytes and to explore the role of lncRNAs in immunomodulation of HIV-affected host cells.Methods RNAs arrays were used to screen the lncRNAs differentially expressed in HIV-infected monocytes and subsequently confirmed by quantitative real time PCR (qRT-PCR).A siRNA was designed and transfected to the human monocytes, followed by interleukin(IL)-1β, IL-10 and tumor necrosis factor(TNF)-α detection with ELISA.Results The results of the screening assays and qRT-PCR showed that the expression of lncRNA-n266623 was up-regulated in monocytes after HIV-1 infection;the secretions of IL-1β,IL-10 and TNF-α in human monocytes were significantly enhanced following transfection of siRNA targeting lncRNA-n266623 in the monocytes.Conclusion The HIV-1 infection can promote the expression of lncRNA-n266623 which may inhibit the expressions of IL-1β, IL-10 and TNF-α in monocytes and negatively regulate the immune response to HIV-1 infection.

Objective To study the risk values of glycosylated hemoglobin ( HbA1c) screening patients with diabetes mellitus(DM) and pre-diabetes(PreD) in different age and sex.Methods HbA1c results from10 840 in Taizhou Hospital in 2012 were retrospectively collected , and CHAID analysis of decision tree was used in preliminary hierarchy .Age was further divided into five groups according to the preliminary results , then one-way ANOVA and linear regression were utilized to determine the differences between age groups and the prediction intervals (PI) of HbA1c,respectively.The upper limit value of 95%PI of HbA1c was set as diabetes risk values ( DRVs).By comparison of the sensitivity of DM patients screening by DRVs in 1 889 cases whose HbA1c were between 6.0%to 6.5%and the upper limit value of traditional HbA1c reference intervals to verify the screening value ofDRVs .Then the DRVs of HbA1c were utilized to screen DM in the population whose HbA 1c is were 6.0%-6.5% in 2008,and followed their re-examination records toverify the screening value of the DRVs toin PreD patients. Results (1) On the basis of the initially root of decisiontree by age , the populationwas divided into 9 groups ( P =0.000, F =231.462).By calculatingthe 95% confidence interval(CI) of each group and merging reasonably,it was finally divided into 5 groups:20-30years,31-40years,41-50years,51-60years and >60years (F=434.342, P=0.000).(2)Using the method of linear regression , the 95% PI of HbA1c of the 5 groups showed as following:20-30 years, males 4.6%-5.9%, females 4.6%-5.9%.31-40 years, males 4.8%-6.0%, females 4.7%-6.0%.41-50 years, males 4.9%-6.2%, females 4.8%-6.1%.51-60 years, males 5.0%-6.3%, females 4.9%-6.2%.>60 years, males 5.1%-6.4%, females 5.0%-6.3%.The traditional HbA1c reference interval was4.8%-6.3%.(3) The screening sensitivity of DM by the upper limit value of traditional HbA1c reference interval and DRVs in group which HbA1c was between 6.0%-6.5% were 34.5%and 48.1%,respectively.(4) Reviewing of the group with HbA1c between 6.0%-6.5% and not diagnosed as DM in 2008, 49 hadnegative DM screening results by using the upper limit value of traditional HbA1c reference interval but were positive in our setting DRVs , and 13 have developed to DM now , which accounted for 26.5%.Conclusion HbA1c DRVs need to be set hierarchically between different age and sex groups as a supplement to the traditional reference interval , which has a great significance for the diagnosis and treatment of DM and also forthe screening and intervention of PreD patients.

Purpose:To determine the impact of serum tissue polypeptide specific antigen (TPS) in the treatment for advanced cancer patients. Methods:Serum TPS was examined in 60 advanced cancer cases. 42 of the patients received hepatic arterial chemoembolization or chemotherapy. For those with tumors derived from digestive system, TPS monitoring was performed in serial during the therapeutic courses. Results:No significant differentiation was observed in terms of age, gender, disease or tumor stage. Patients with initial TPS lower than 300 U/L had the most favorable response rate to treatment (PR,CR or MR) of 52.94%, while those with initial TPS higher than 1000 U/L showed no evidence of remission after therapy. 55.56% of the latter developed into PD ( P

Objective To explore the behavioral and electrophysiological characteristics of prefrontal executive control in macaca mulatas. Methods Three macaca mulatas were used for behavioral research. Neuronal activities of the prefrontal cortex were recorded in two monkeys while visual discriminated go/no go tasks were being performed. Results ① The response time was (419?18)ms, (376?26)ms and (540?21)ms in three monkeys while performing go/no go tasks; ② A total of 41 tetrodes penetrations were made in the PFC of two monkeys. A total of 92 task related neurons were sampled and categorized as 5 types: visual signal related neurons, decision making related neurons, go movement related neurons, reward related neurons and multi events related neurons; ③ When it was correct, the discharge rate of a neuron to a go signal was significantly higher than that to a no go signal during cue period; the discharge rate of a decision making neuron in a go task was significantly higher than that in a no go task. However, when it was wrong, the situation was on the contrary during delay period. Conclusions ① The prefrontal cortex contains various kinds of neurons; ② There are two types of errors in executing go/no go tasks: cue period error and delay period error.

Objective To explore the effect of oral motor therapy on dysarthria in children with cerebral palsy. Methods 65 cerebral palsychildren with dysarthria were divided into observation group and control group. All the children received basic rehabilitation, and the observation group received oral motor therapy additionally. The articulation of children was observed before and after treatment. Results Theefficiency rate of the observation group (84.8%) was significantly higher than that of the control group (15.6%) (P<0.001). Conclusion Oral motor therapy is effective on dysarthria in children with cerebral palsy.

ObjectiveTo observe the effect of the designed cervical orthosis(CO) and the finished collar in the treatment of vertebroarterial cervical spondylopathy.Methods70 patients with vertebral artery type cervical spondylosis were divided into designed cervical orthosis group (35 casese) and the finished collar group (35 casese) separately.ResultsThe excellent and good rate of the designed cervical orthosis group was 94-3% while that of the finished collar group was 71-4%. There was significant difference between the two groups after 4 weeks of treatment(P<0-01).ConclusionThe designed cervical orthosis(CO) in the treatment of vertebroarterial cervical spondylopathy is more effective than finished collar.