Objective:To summarize the best evidence for safely managing home parenteral nutrition in adults.Methods:Clinical decisions, guidelines, evidence summaries, expert consensus, systematic reviews, Meta-analyses, and so on related to the safety management of home parenteral nutrition in adults were electronically retrieved on UpToDate, Guidelines International Network, Agency for Healthcare Research and Quality, Joanna Briggs Institute Evidence-Based Health Care Center Database, Cochrane Library, PubMed, Web of Science, China National Knowledge Infrastructure, WanFang Data, China Biology Medicine disc and so on. The search period was from database establishment to December 30, 2023. Two researchers who received evidence-based nursing training conducted literature quality evaluation and evidence extraction.Results:A total of 14 articles were included, including three guidelines, six expert consensus, one hospital standard, and four meta-analyses. Thirty-three pieces of evidence were summarized from four aspects: team building, transitional care, preventing and managing complications, monitoring, follow-up, and quality control.Conclusions:The best evidence for safety management of home parenteral nutrition in adults is summarized. Medical and nursing staff should select and apply evidence based on clinical scenarios and patient preferences.

Objective To explore the effect of Rhubarb ultrasonic electrical conduction target penetration therapy on the gastrointestinal function of sepsis patients.Methods A total of 88 cases of inpatient sepsis patients diagnosed and treated at the Second Affiliated Hospital of Guangzhou University of Chinese Medicine from October 2021 to June 2023 were selected as the participants and the patients were divided into the treatment group and the control group by a simple random method.Both groups were given routine treatments such as anti-infection,fluid resuscitation,nutritional support,blood sugar management,and prevention of stress ulcers,while the treatment group was treated with ultrasonic conductance target penetration Rhubarb therapy at Shenque point and Zhongwan point on the basis of the control group.The main observational indexes were the number of bowel sounds in the two groups before treatment and after 3 days,and 7 days of treatment.The secondary observational indexes were gastric retention,serum C-reactive protein(CRP),procalcitonin(PCT),acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ),the first defecation time,time to mechanical ventilation,length of stay in the intensive care unit(ICU),hospitalization cost,and 28 days readmission rate of the two groups.The gastric retention was evaluated and recorded every 4 hours before treatment and 3 days and 7 days after treatment,CRP and APACHE Ⅱ score were evaluated before treatment and 7 days after treatment,the 28-day readmission was followed up by telephone.Results A total of 44 cases in the treatment group and 43 cases in the control group completed the intervention.The difference between the bowel sounds and the amount of gastric retention of the two groups was not statistically significant before treatment,with the prolongation of time,the bowel sounds of the two groups gradually increased and the amount of gastric retention gradually decreased,and the number of bowel sounds in the treatment group increased significantly compared to the control group 3 days and 7 days after treatment[beats/minute:4.49(4.23,4.74)vs.3.07(2.80,3.33)3rd day of and 4.79(4.49,5.10)vs.3.36(3.06,3.66)on the 7th day of treatment,both P<0.01],and the amount of gastric retention was significantly reduced compared with the control group[mL:20.93(9.22,32.64)vs.53.52(41.16,65.88)for 3rd day of and 3.72(0.17,7.28)vs.31.59(24.87,38.31)on the 7th day of treatment,both P<0.01].The first defecation time was significantly shorter in the treatment group than in the control group(hours:25.67±9.99 vs.33.64±11.30,P<0.01).After 7 days treatment,the CRP,PCT,and APACHE Ⅱ score were significantly reduced in the treatment group compared to those in the control group[CRP(mg/L):45.97(35.68,56.26)vs.77.30(57.20,97.38),PCT(μg/L):0.94(0.56,1.31)vs.2.73(1.36,4.09),APACHE Ⅱ score:24.11±7.01 vs.28.06±9.25,all P<0.05],the mechanical ventilation time and ICU length of stay were significantly shortened[mechanical ventilation time(hours):107.05±70.76 vs.168.83±136.62,ICU stay time(days):7.58±3.72 vs.9.70±5.15,both P<0.05],the hospitalization cost and 28-day readmission rate were significantly reduced[hospitalization cost(yuan):80337.89±36483.72 vs.109100.24±87080.84,28-day readmission rate:9.1％(4/44)vs.27.9％(12/43),both P<0.05].Conclusion Rhubarb ultrasonic conductive target penetration therapy is a safe,simple,and effective characteristic therapy of external Chinese medicine that can provide a new basis for the protection of gastrointestinal function in patients with sepsis.

Objective:To summarize the best evidence for safely managing home parenteral nutrition in adults.Methods:Clinical decisions, guidelines, evidence summaries, expert consensus, systematic reviews, Meta-analyses, and so on related to the safety management of home parenteral nutrition in adults were electronically retrieved on UpToDate, Guidelines International Network, Agency for Healthcare Research and Quality, Joanna Briggs Institute Evidence-Based Health Care Center Database, Cochrane Library, PubMed, Web of Science, China National Knowledge Infrastructure, WanFang Data, China Biology Medicine disc and so on. The search period was from database establishment to December 30, 2023. Two researchers who received evidence-based nursing training conducted literature quality evaluation and evidence extraction.Results:A total of 14 articles were included, including three guidelines, six expert consensus, one hospital standard, and four meta-analyses. Thirty-three pieces of evidence were summarized from four aspects: team building, transitional care, preventing and managing complications, monitoring, follow-up, and quality control.Conclusions:The best evidence for safety management of home parenteral nutrition in adults is summarized. Medical and nursing staff should select and apply evidence based on clinical scenarios and patient preferences.

Heart failure with high prevalence is the endpoint of many cardiovascular diseases. Once diagnosed， patients usually need lifelong medication， which seriously affects their quality of life. The drugs commonly used to treat heart failure include angiotensin-converting enzyme inhibitors， beta-blockers， aldosterone receptor antagonists， and diuretics. However， the long-term use of those drugs can lead to side effects such as hypotension， depletion of body fluid， and electrolyte imbalance and even increase mortality. According to the theory of traditional Chinese medicine （TCM）， Qi deficiency and blood stagnation is the major cause of heart failure and when Qi is not moving， blood is not flowing. Therefore， the TCM clinical treatment of heart failure uses the Chinese medicinal materials which replenish Qi， activate blood， and dispell stasis to treat both internal cause and external symptoms. Recent studies have demonstrated that Chinese herbal medicines such as Astragali Radix， Ginseng Radix et Rhizoma， Notoginseng Radix et Rhizoma， Salviae Miltiorrhizae Radix et Rhizoma， Angelicae Sinensis Radix， as well as the compound formulas such as Buyang Huanwutang， Simiao Yongantang， Qili Qiangxin capsules， and Qishen Yiqi drops， play a significant role in the prevention and treatment of heart failure via replenishing Qi， activating blood， and dispelling stasis. Inhibition of oxidative stress and inflammatory responses， mitigation of myocardial fibrosis， improvement of calcium cycling， and protection of mitochondrial function represent the key mechanisms for the treatment of heart failure with Chinese medicinal materials. Focusing on the pathogenic mechanisms and signaling pathways of heart failure， this paper systematically describes the pharmacological effects， molecular mechanisms， and research progress in the clinical application of Chinese medicinal herbs with effects of replenishing Qi， activating blood， and dispelling stasis and their compound formulas in the prevention and treatment of heart failure， aiming to provide scientific evidence for the development and clinical use of anti-heart failure Chinese medicinal materials.

Objective: To investigate the effects of mono-carbonyl analogues of curcumin (L6H21) on paraquat (PQ) -induced injury in HK-2 cell line and explore its underlying mechanisms. Methods: Cultured HK-2 cells were challenged by PQ with or without L6H21 treatment. Cell viability and apoptosis were determined by CCK-8 assay and flow cytometry, respectively. Gene expressions and protein levels of apoptotic and inflammatory factors were assessed by RT-PCR, ELISA, and western blot. Intracellular ROS production was detected by DCFH-DA staining. Superoxide dismutase (SOD) and malondialdehyde (MDA) were examined by chemical colorimetry. Results: 1) PQ challenge significantly inhibited HK-2 cells proliferation, which was prevented by L6H21 administration. PQ dramatically induced HK-2 apoptosis evidenced by increasing expressions of caspase-9, caspase-3 and Bax, while decreasing Bcl-2 level. However, PQ induced these apoptotic effects in HK-2 cells were reversed by L6H21. Similarly, PQ exposure obviously enhanced activity of NF-κB and levels of cytokines (TNF-α、IL-6) in HK-2 cells, which was inhibited by L6H21. Furthermore, administration of L6H21 inhibited PQ induced ROS and MDA production, and promoted SOD level in HK-2 cells. Conclusion L6H21 administration inhibits PQ-induced apoptosis in HK-2 cells possibly by reducing inflammation and oxidative damage.

Objective To study the application value of endoscopic purse-string sutures with titanium clips and endoloops for the gastric wall defect during endoscopic full-thickness resection (EFTR). Methods Data of iffteen hospitalized patients with gastric submucosal tumor (SMT) undergone EFTR was reviewed. The patients were all applied with endoscopic purse-string sutures with titanium clips and endoloops, which was performed after the EFTR when the gastric walls were perforated artiifcially. Results The gastric tumors were complete successfully resected in the iffteen patients through endoscopic surgery, applied the purse-string sutures with titanium clips and endoloops after the EFTR when the gastric walls were perforated artiifcially. Approximately, ifve clips were utilized on average. Postoperative surgical wound healing was followed up for 6 months, no tumors recurred. Conclusion It is safe, minimally invasive treatment method for rapid rehabilitation in endoscopic full-thickness resection utilized purse-string sutures with titanium clips and endoloops.

Objective To explore the apoptosis effect of docetaxel combined gamma knife on hepatoma cell SMMC-7721 subcutaneous xenograft in nude mice.Methods Subcutaneous xenogyaft models were constructed and were divided into two groups:control group and experimental group.The experimental group was treated with docetaxel 60ug/0.3ml once every 3 days for 6 times and gamma irradiation once every other day for 6 times (with indoor temperature of 137Cs radiation source irradiating the tumor and of fractionated schedule 5Gy with the total dose of 10Gy every time).The control group was treated with physiological saline with the same dose of 60 ug/0.3 mL.Tumor growth was observed.Tumor samples were cut 30 days after the treatment and TUNEL was used to detect the apoptosis of tumor cells.Results Tumor growth rate in experimental group significantly slowed down.Apoptotic index in experimental groups was significantly higher than that in control group (P ＜ 0.05) Cornclusion Docetaxel combined gamma knife can inhibit the growth of hepatocellular carcinoma in nude mice.

Magnetic resonance (MR) images can be used to detect lesions in the brains of patients with multiple sclerosis (MS). An automatic method is presented for segmentation of MS lesions using multispectral MR images in this paper. Firstly, a Pd-w image is subtracted from its corresponding T1-w images to get an image in which the cerebral spinal fluid (CSF) is enhanced. Secondly, based on kernel fuzzy c-means clustering (KFCM) algorithm, the enhanced image and the corresponding T2-w image are segmented respectively to extract the CSF region and the CSF-MS lesions combinatoin region. A raw MS lesions image is obtained by subtracting the CSF region from CSF-MS region. Thirdly, based on applying median filter and thresholding to the raw image, the MS lesions were detected finally. Results were tested on BrainWeb images and evaluated with Dice similarity coefficient (DSC), sensitivity (Sens), specificity (Spec) and accuracy (Acc). The testing results were satisfactory.
Algorithms ; Brain ; pathology ; Humans ; Image Enhancement ; Magnetic Resonance Imaging ; Multiple Sclerosis ; diagnosis ; Sensitivity and Specificity

Objective To develop a new method for the rapid determination of lomefloxacin,gatifloxacin,ciprofloxacin and oflox-acin in plasm and urine by solid phase extraction(SPE)and capillary electrophoresis.Methods The capillary was fused silica capil-lary with id/od of 75/365 μm and effective/total length of 40/47 cm.The running buffer was 40 mmol/L borate buffer at pH 9.0. Separation voltage was 13 kV.Temperature was 20 ℃.Detection wave-length was set at 280 nm.The sample was analyzed after the pretreatment of SPE.Results The analysis of lomefloxacin,gatifloxacin,ciprofloxacin and ofloxacin was completed in 6 minutes with satisfied accuracy and precision.Good linearity was found within the range of 1-40 μg/mL,and the r was 0.998 7,0.997 6, 0.998 3 and 0.994 2 respectively.The recoveries of four quinolones in plasm and urine ranged from 80.1% to 107.6%,and the rel-ative standard deviations(RSD)ranged from 2.1% to 6.2%.Conclusion This method is fast,simple,precise and it might be feasi-ble for the determination of lomefloxacin,gatifloxacin,ciprofloxacin and ofloxacin in plasm and urine samples.

As an effective vehicle for bio-research and for gene therapy, Lentiviral Vector (LV) has been drawn large attention in recent years. However, transcriptional read-through limits its application. In order to understand the extend of LV read-through in chromosome, a reliable method to assess transcriptional read-through rate is needed. Here, we report the method as follows: 293T cells were transfected with the lentiviral transfer vectors which borne with two LTRs at its two ends in order to mimic the state of "proviral vectors" in chromosome. Using the primers specific for 3'U5 and 3'U3, read-through and total transcripts were reverse transcribed, respectively. These two cDNAs were quantified by realtime PCR using the primers and probe specific for 5'end of 3'U3. Read-through rate was then calculated by the division of the two. Meanwhile, read-through product of green fluorescence protein was also analyzed by Fluorescence Activated Cell Sorter. They both reciprocally proved the principal and confirmed that self-inactivated LV appeared higher read-through rate than the wild type one. The method described in this article, therefore, provides a useful technique to study how to reduce read-through rate, and improve the bio-safety of LV.
Flow Cytometry ; Genetic Therapy ; Genetic Vectors ; Green Fluorescent Proteins ; biosynthesis ; HEK293 Cells ; Humans ; Lentivirus ; Transfection