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.

Objective　To investigate, compare and filtrate the collagenase inhibitor effects among six kinds of eye drops for clinical use.Methods　The collagenase inhibitor’s effects were detected by rat's collagen and collagenase with comassie brilliant blue colorimetric method.Results　The inhibitting collagenase effects among six kinds of eye drops were different: the effect of cartopril was the strongest；the acetylcysteine and sodium edetate were more strong and the sodium citrate, sodium hyposulfite and tetracycline were less strong.Conclusion　 0.5g*L-1cartopril eye drops has stronger efficacy to inhibit collagenase, with less side effect or stimulation，more convenient resource and preparation than other eye drops.

Objective To clone human chemokine ELC and express the ELC fusion protein. Methods Total RNA from human inflammatory tonsil was extracted and the cDNA was generated with reverse transcription. Mature ELC gene was amplified with PCR and NcoⅠand EcoRⅠ sites were added to the 5′ and 3′ terminal respectively, and then cloned into pET32a(+). E.coli DH5? was transformed with the recombinant plasmid, and positive clones were selected. The inserted DNA was verified by enzyme digestion and DNA sequencing. The fusion expression vector of mature ELC was formed with deletion mutation. ELC expression was analyzed by SDS-PAGE and Western blotting and the ELC fusion protein was purified. Results Human chemokine ELC was successfully cloned and the fusion protein was expressed and purified. Conclusion The ELC fusion protein was expressed with solubility.

Objective To find out an optimal anesthesia and the d osage used in painless gastroscopy, and to evaluate its efficiency. Meth ods 200 patients undergoing painless gastroscopy were divided into 4 gr oups randomly. 2?g/kg iv of propofol was used in group Ⅰ, fentani 1?g/kg + pr opofol 2?g/kg in group Ⅱ, rimifentani 0.5?g/kg + propofol 1.5?g/kg in grou p Ⅲ, and rimifentani 0.75?g/kg + propofol 0.75?g/kg in group Ⅳ. Observed o bjects induced starting time and depth of anaesthesia, HR, R and SpO2 during o peration, side effects such as cough reflex and larynx spasm, time of regaining consciousness, postoperative side effects such as nausea and vomiting. R esult Significant differences (P≤0.01) were found between group Ⅳand the other 3 groups in starting time and depth of anaesthesia, side effects , time of regaining consciousness and suppression of respiration during operatio n. Conclusion Combined rimifentani 0.75?g/kg + propofol 0.75 ?g/kg are optimal anestheties in painless gastroscopy if side effects are preve nted.

Objective To study on the directing role of multi-slice spiral CT and multiplanar reformation(MPR)in bronchoscopy and enhance the yield of peripheral pulmonary carcinoma(PPC).Methods This study was carried in 60 PPC patients from Respiratory Department in the First Hospital Affilliated to Suzhou University during 2002—2005.They underwent MSCT.Images were reconstructed with MPR(CPR)to evaluate the relationship between PPC and bronchi and the type of BS was identified.Compare the diagnosed yields of bronchoscopic multiple diagnostic procedure(BMDPs)with types of BS.Results (1)In all patients the third to the seventh level branches of the bronchi were clearly shown.The tumor-bronchus relationship was identified as four types on MSCT.(2)MSCT demonstrated the BS in 22 of 25 adenocarcinomas and 13 of 17 squamous-cell carcinomas and 4 of 6 small cell lung carcinomas and 4 of 8 bronchiolo-alveolar carcinomas.(3)BS typeⅠwas shown in 15of 48(31.3%).Type Ⅱ was seen in 7 of 48(14.6%).Type Ⅲ was shown in 12 of 48(25%)squamous tumors.Type Ⅳ was seen in 14 of 48(29.2%).(4)Total positive rate of bronchoscopy was 58.3%,73.3% with BS and 13.3% without BS.Type of BS was closely associated with positive rate of BMDPs.Conclusion Axial CT and MPR can show the relationship between PPC and bronchi better.BS can direct fiberoptic bronchoscopy(FOB)diagnosis procedure and enhance the yield of PPC.