Food additives are a kind of chemical substances added to food to enhance the taste,color and shelf life of food,and have become an indispensable part of the modern food industry.However,growing researches showed that synthetic chemicals used as food additives can be potentially harmful to health.Some food additives may be closely related to asthma,attention deficit hyperactivity disorder,heart disease,cancer,obesity and other health problems.In addition,some food additives may also interfere with hormone secretion,affect growth and development,and affect the healthy growth of children.This study reviews the damage effects of various food additives,such as preservatives,antioxidants,and colorants on body,and proposes the need to improve the safety evaluation of food additives from the perspective of the combined action of chemicals,in order to provide a scientific basis for food safety supervision and consumer health protection.

Objective:To investigate the association between congenital hypothyroidism (CH) and the adverse outcomes during hospitalization in very low birth weight infants (VLBWI).Methods:This prospective, multicenter observational cohort study was conducted based on the data from the Sino-northern Neonatal Network (SNN). Data of 5 818 VLBWI with birth weight <1 500 g and gestational age between 24-<37 weeks that were admitted to the 37 neonatal intensive care units from January 1 st, 2019 to December 31 st, 2022 were collected and analyzed. Thyroid function was first screened at 7 to 10 days after birth, followed by weekly tests within the first 4 weeks, and retested at 36 weeks of corrected gestational age or before discharge. The VLBWI were assigned to the CH group or non-CH group. Chi-square test, Fisher exact probability method, Wilcoxon rank sum test, univariate and multivariate Logistic regression were used to analyze the relationship between CH and poor prognosis during hospitalization in VLBWI. Results:A total of 5 818 eligible VLBWI were enrolled, with 2 982 (51.3%) males and the gestational age of 30 (29, 31) weeks. The incidence of CH was 5.5% (319 VLBWI). Among the CH group, only 121 VLBWI (37.9%) were diagnosed at the first screening. Univariate Logistic regression analysis showed that CH was associated with increased incidence of extrauterine growth retardation (EUGR) ( OR=1.31(1.04-1.64), P<0.05) and retinopathy of prematurity (ROP) of stage Ⅲ and above ( OR=1.74(1.11-2.75), P<0.05). However, multivariate Logistic regression analysis showed no significant correlation between CH and EUGR, moderate to severe bronchopulmonary dysplasia, grade Ⅲ to Ⅳ intraventricular hemorrhage, neonatal necrotizing enterocolitis in stage Ⅱ or above, and ROP in stage Ⅲ or above ( OR=1.04 (0.81-1.33), 0.79 (0.54-1.15), 1.15 (0.58-2.26), 1.43 (0.81-2.53), 1.12 (0.70-1.80), all P>0.05). Conclusion:There is no significant correlation between CH and in-hospital adverse outcomes, possibly due to timely diagnosis and active replacement therapy.

Objective To systematically evaluate the rehabilitation experience of patients after total knee arthroplasty,and to provide references for improving the effect of rehabilitation treatment and formulating related clinical nursing strategies.Methods We searched PubMed,Web of Science,the Cochrane Library,Embase,CINAHL,Scopus,ProQuest,CNKI,Wanfang database,VIP database and Chinese biomedical literature database.A qualitative study on the experiences,feelings,and needs of patients undergoing rehabilitation after total knee arthroplasty was retrieved from the database until April 2023.The quality of literature was evaluated using the Quality Evaluation Criteria of Evidence-Based Health Care Center(2016)of Joanna Briggs Institute in Australia,and the results were summarized and integrated by the aggregation integration method.Results A total of 25 studies were included;82 topics were summarized into 12 categories;4 integrated results were finally formed:rehabilitation treatment was faced with multiple difficulties,and patients lost confidence and needed professional guidance and supervision;unsatisfactory experience in rehabilitation;the perception of the benefits of rehabilitation therapy and the encouragement of medical staff,and firm faith in rehabilitation;seeking understanding and social support can promote the effect of rehabilitation therapy.Conclusion Healthcare professionals should pay attention to and reflect on the challenges and unsatisfactory experiences that patients may face during rehabilitation,and provide them with professional guidance and supervision,as well as personalized rehabilitation treatment.

Objective To investigate the changes of corneal biomechanics of intrastromal correction (INTRACOR) femtosecond technique to treat presbyopia.Methods A prospective,clinical self-control clinical trial was designed.Twenty-four presbyopic patients with emmetropia or mild hyperopia were enrolled in this study.The INTRACOR procedure was performed using the Technolas femtosecond laser in the nondominant eye.Uncorrected distance visual acuity (UCDVA),uncorrected near visual acuity (UCNVA) and spherical equivalent (SE) were recorded in preoperation and postoperative 12 months,and the quality of life of postoperative patients was evaluated.The corneal deformation parameters including highest concavity deformation amplitude (HC-DA),highest concavity peak distance (HC-PD),highest concavity radius (HC-R),non-contact intraocular pressure and the central corneal thickness (CCT) were measured using the Corvis ST visualization biomechanical analyzer in preoperation and postoperative 1 month,3,6 and 12 months,respectively.This study followed the Declaration of Helsinki.Written informed consent was obtained from each subject prior to entering study cohort.This study protocol was approved by Ethic Committee of Affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine (No.SDZYYDXYKYYLL2011.06).Results Compared with preoperation,UCNVA of all 24 (100％) eyes was improved at 12 months postoperatively with minimal or no change in UCDVA.The mean spherical equivalent was (+0.35± 0.29)D and (-0.37 ± 0.29)D before and 12 months after operation,with a significant difference beteeen them (t=-7.39,P＜0.01).No significant differences were seen in the intraocular pressure,CCT and HC-PD values between preoperation and postoperative 1 month,3,6,12 months (F =1.273,1.347,2.434;all at P ＞ 0.05).Compared with preoperation,the postoperative 1 month,3,6,12 months HC-R values were significantly declined,HC-DA values were significantly increased,with significant differences between them (all at P＜0.05),and no significant differences were found in HC-R and HC-DA between the postoperative adjacent time points (all at P＞0.05).Corneal aspherical index (Q Value) was-0.28±t0.10 at 12 months postoperatively,which was increased compared with the preoperation,and the maximum value added value (diff-K) of the central corneal curvature was (2.55±0.81)D.Conclusions INTRACOR treatment of presbyopia can effectively improve near vision,increase postoperative corneal biomechanical maximum HC-R and HC-DA,negatively increase the corneal central curvature increased aspheric index,which suggests that corneal biomechanics of central cornea is weakened after intrastromal femtosecond presbyopic treatment,and the hyperprolate mutifocal corneal shape is formed under normal intraocular pressure.

Objective To observe the clinical significance of serum pancreatic stone protein/regenerating protein (PSP/reg) in neonatal bacterial infectious diseases.Methods 92 cases of newborns with bacterial infection in our hospital from June 2016 to May 2017 were enrolled in the study.They were divided into severe infection group (36 cases) and mild infection group (56 cases) according to the severity of the infection.At the same period 58 newborns without infectious diseases in our hospital were also chosen as control group.The serum levels of PSP/reg,procalcitonin (PCT) and C-reactive protein (CRP) were quantitatively measured by enzyme-linked immunosorbent assay (ELISA).Results The serum levels of PSP/reg,PCT and CRP in severe infection group were significantly higher than those in mild infection group (P ＜0.01) and control group (P ＜ 0.01),while the levels of PSP/reg,PCT and CRP in mild infection group were significantly higher than those in control group (P ＜ 0.01).The levels of PSP/reg 3 day after treatment in both severe and mild infection group were significantly lower than those before treatment (P ＜0.01),while the level of PSP/reg in severe infection group was higher than that in another group.After treatment,the levels of PSP/reg,PCT and CRP in the two infection groups were significantly decreased (P ＜0.01),and there was no significant difference between the two groups after healing (P ＞ 0.05).Conclusions The level of PSP/reg is correlated with the severity of neonatal bacterial infectious disease.The change of serum PSP/reg level may be useful in the evaluation of therapy in neonatal bacterial infection.

Objective To investigate the effect of optimizing rescue time for patients with acute st-elevation myocardial infarction (STEMI) in the hospital. Methods A retrospective analysis of the clinical data of 133 patients with ST-elevation myocardial infarction who were hospitalized in the first affiliated hospital of university of science and technology of china during July,2016 to June,2017 was performed. Timeline in the rescue, the result of coronary reperfusion and satisfaction degree of patients were analyzed. Results The rapid evaluation time (F=2.609, P=0.046),emergency handling time(F=7.581, P=0.032), login and logout time (F=5.667, P=0.017)and visit-ballon time (F=8.942, P=0.007) were shortened quarter by quarter . The average time of each project in the four quarters showed a statistically significant difference. The difference of TIMI classification of coronary flow reperfusion among the four quarters was statistically significant (H=8.402, P=0.038). The satisfaction degree of each quarter showed a statistically significant difference (the third quarter of 2016:94.68±2.38, the fourth quarter of 2016:96.72± 5.10, the first quarter of 2017:97.23 ± 7.64,the second quarter of 2017:98.36 ± 4.86;F=7.891,P=0.048). Conclusions Enhancing timeliness of emergency care can remarkably shorten rescue time, improve satisfaction degree of patients and help to improve the success rate of emergency treatment for patients with STEMI.

Objective? To evaluate the effects of the "hospital-community-family" linked continuing care model dominated by nurses on the complication and self-care ability of patients receiving percutaneous transhepatic cholangiodrainage (PTCD). Methods? Totally 108 patients with malignant obstructive jaundice treated in the Department of Hepatobiliary Surgery, the Second Affiliated Hospital of Guangzhou Medical University from May 2016 to March 2018 were selected by convenient sampling and divided into two groups according to the random number table. Patients in the treatment group (n=54) received the "hospital-community-family" linked continuing care, while patients in the control group (n=54) received conventional health education before discharge. The incidence rate of complications and patients' self-care ability 3 months post discharge were evaluated in the two groups. Results? The incidence rates of biliary tract infection, PTCD catheter obstruction or pullaway, wound infection and pipeline related hospitalization in the treatment group 3 months post discharge were 18.52%, 1.85%, 1.85% and 11.11% respectively, lower than those of the control group, 40.74%, 12.96%, 11.11% and 27.78% (χ2=8.000, 5.290, 4.182, 7.289; P＜0.05). The total score of self-care ability of the treatment group 3 months post discharge was (135.09±7.08), higher than that of the control group, which was (104.72±5.33), (t=25.174,P＜0.01). Conclusions? The "hospital-community-family" linked continuing care model dominated by nurses can reduce the incidence rate of catheter-associated complications after discharge in PTCD patients and enhance their self-care ability.

Objective To explore influence of intra-operative pituitrin therapy on the recent and long-term effects in patients with interstitial tubal pregnancy by laparoscopic surgery.Methods A total of 69 patients with interstitial tubal pregnancy by laparoscopic surgery were randomly divided into control group (n=31) and observation group (n=38).In the control group,the ectopic pregnancy was directly removed and the pregnancy tissue was taken.The observation group was injected with 6 U pituitrin at the uterine horn.After the contraction of the uterus,the pregnancy tissue was removed.Effect and the serum β-HCG,P,E2 changes were compared.Results In the observation group,operation time,intra-operative blood loss,salpingectomy ratio were lower than the control group,and β-HCG,P,serum E2 levels after 1 weeks were significantly lower than the control group (P<0.05).Ratio of patients with persistent ectopic pregnancy was significantly lower than the control group,and tubal patency ratio was significantly higher than the control group (P<0.05).Conclusion The effect of pituitrin on laparoscopic tubal interstitial pregnancy is stronger,and the decrease of serum-HCG,P and E2 is beneficial to the recovery of patients.

Objective To explore influence of intra-operative pituitrin therapy on the recent and long-term effects in patients with interstitial tubal pregnancy by laparoscopic surgery.Methods A total of 69 patients with interstitial tubal pregnancy by laparoscopic surgery were randomly divided into control group (n=31) and observation group (n=38).In the control group,the ectopic pregnancy was directly removed and the pregnancy tissue was taken.The observation group was injected with 6 U pituitrin at the uterine horn.After the contraction of the uterus,the pregnancy tissue was removed.Effect and the serum β-HCG,P,E2 changes were compared.Results In the observation group,operation time,intra-operative blood loss,salpingectomy ratio were lower than the control group,and β-HCG,P,serum E2 levels after 1 weeks were significantly lower than the control group (P<0.05).Ratio of patients with persistent ectopic pregnancy was significantly lower than the control group,and tubal patency ratio was significantly higher than the control group (P<0.05).Conclusion The effect of pituitrin on laparoscopic tubal interstitial pregnancy is stronger,and the decrease of serum-HCG,P and E2 is beneficial to the recovery of patients.

Objective To investigate the current requirement of transitional care on surgical patients and provide evidences for the establishment of accurate transitional care on surgical patients.Methods A total of 363 cases of patients after the surgery in a grade A class three hospital in Guangzhou city of Guangdong province were selected using convenience sampling. Questionnaire of transitional care requirement in surgical patients was applied in the investigation of transitional care requirement.Results A total of 363 surgical patients from 10 wards were surveyed. 51.8% (188) of patients did not need others assistance; 54.0% (196) of patients completely met the needs with home care; the requirement of further consultation and disease related knowledge accounted for 72.7% (264) and 69.1% (251) of patients; for the "who provides the transitional care services", 53.7% (195) of patients chose the multidisciplinary team, while 17.4%(63)chose the specialist nurse; for the methods of transitional care, 62.5% (227) of patients preferred telephone follow-up, and 28.7% (104) of patients preferred WeChat and message exchange; 68.3% (248) of patients chose one month of follow-up, while 28.2% (106) of patients chose two months of follow-up.Conclusions The surgical patients have good self-care ability, but still need the transitional care. We should take multidisciplinary team and the specialist nurses as the dominant, and use telephone interview and WeChat SMS exchange for one or two months to provide accurate transitional care according to the evaluation results before the discharge.