0.05).There were no signifi-cant relation between the expressions of Fas,FasL and bcl-2and IL-8.Conclusion The abnormal expressions of Fas,FasL,bcl-2may play an important role in the pathogenesis of LN.The expression of Fas and FasL may serve as active indexes for SLE and LN.The low level of IL-8may be related to the dysfunction of immunity and needs further research.

OBJECTIVE:To systematically review the efficacy and safety of cinacalcet in the treatment of hemodialysis pa-tients with secondary hyperparathyroidism,and provide evidence-based reference for the clinical treatment. METHODS:Retrieved from Medline,Cochrane Library,EMBase and CBM,randomized controlled trials(RCT)about cinacalcet in the treatment of he-modialysis patients with secondary hyperparathyroidism (SHPT) were collected. Meta-analysis was performed by using Rev Man 5.3.5 software after data extract and quality evaluation by Cochrane systematic Rev Man 5.3.5. RESULTS:Totally 7 RCTs were en-rolled,involving 1 987 patients. Results of Meta-analysis showed cinacalcet can significantly reduce the rate of surgical parathyroid-ectomy[RR=0.23,95%CI(0.06,0.89),P=0.03],incidence of fracture[RR=0.26,95%CI(0.12,0.60),P=0.002] and increase the incidences of hypocalcemia[RR=9.81,95%CI(3.92,4.59),P<0.001],nausea[RR=1.97,95%CI(1.58,2.46),P<0.001] and vomit-ing[RR=1.91,95%CI(1.50,2.42),P<0.001],while it showed no significant effect on the the incidence of all-cause mortality and cardiovascular death. CONCLUSIONS:The clinical efficacy of cinacalcet in the treatment of hemodialysis patients with secondary hyperparathyroidism is good,but there are common adverse reactions such as nausea and vomiting,hypocalcemia.

Objective To discuss the effect of the complete nursing order and guidelines on improving the nursing quality in ICU .Methods The nursing quality , patients ’ satisfaction and the hierarchical training examination scores before and after using the improved nursing order guidelines were compared , from 2012 to 2013 .Totals of 177 patients in 2012 were treated with conventional nursing order system , and 183 patients in 2013 were treated with the improved nursing order guidelines .Results In 2012, totals of 177 patients with 3 566 times nursing observation were included , and 183 patients, with 3 634 times nursing observation were included in 2013.In 2013, oral care failure rate was 0.28%, which was significantly lower than 1.18% in 2012, with a significant difference(χ2 =20.45, P=0.00).In 2013, the bed elevation unqualified rate was 0.33%, which was significantly lower than 1.54% in 2012, with a significant difference (χ2 =28.69,P=0.00).In 2013, the artificial airway ballonet pressure implementation rate was 99.56%,which was significantly higher than 98. 65%in 2012, with a significant difference (χ2 =16.76,P=0.00).In 2013, the patients’ satisfaction scores was (98.08 ±0.67), which was significantly higher than (94.58 ±2.47) in 2012, with a significant difference (t=4.91,P =0.00).The nurse training assessment scores was (89.33 ±9.64) in 2013, which was significantly higher than ( 82.17 ±4.04 ), with a significant difference ( t =2.62, P =0.02 ). Conclusions Nursing order guidelines applied in ICU bedside can promote the improvement of the nursing quality, ensure the safety of nursing care , and let patients receive continuous and homogeneous care .Improved nursing order guidelines not only effectively improve the whole nursing level of ICU , but also provide diversified platform for nurse training at all levels .

Traditional Chinese medicine has a long-standing understanding of the brain;however,the theoretical foundation and treatment approach for diseases related to the brain have not been systematically organized and studied. The three treasures of essence,qi,and spirit are closely associated with the brain in humans. Based on this theory,this study explored the relationship between essence,qi,spirit,and the brain,with the intention that "the brain is the official position of gathering essence,qi,spirit,and in charge of mental activity". It investigated the theoretical implications of the brain,stating that "essence" forms the material basis of the brain's structure,"qi" is fundamental for brain function,and the "conscious spirit" corresponds to the state of the brain,residing in the heart,serving as the external manifestation of the brain,governing aspects like thoughts,consciousness,and emotions. The "primordial spirit" is the axis of the brain,which is rooted in the brain and serves as the internal core of the brain,thereby governing and regulating the central activities of human life. Essence,qi,mental activity,and primordial spirit mutually support and depend on each other,collectively maintaining the function of the brain governing the mental activity. The primordial spirit,which the brain governs,regulating and controlling the essence,qi,and couscious spirit is a specific manifestation of physiological and psychological activities in the human body. This study provides treatment strategies for clinical brainrelated disorders under the theoretical guidance that "the brain is the official position for gathering essence,qi,and spirit,and is in charge of mental activity". These strategies include " nourishing essence and marrow,supplementing qi to ascend clear,and nurturing nourishment and enriching the spirit". This study aims to contribute to the innovation and development of traditional Chinese medicine theories.