To systematically evaluate the clinical effect of indirect calorimetry (IC)-guided nutritional support therapy in critically ill patients.

Electronic databases CNKI, Wanfang data, VIP, PubMed, Embase, Springer, Ovid, CINAHL and the Cochrane Library were searched using the following key words: indirect calorimetry, resting energy measurement, metabolic car, resting energy expenditure, predictive equations, prediction formula, energy delivery, nutritional support therapy, and Harris-Benedict. All databases were published from January 2002 to August 2022. The experimental group was guided by the IC method, and the control group was guided by the PE method. We used the Cochrane risk-of-bias tool to assess the quality of the included studies. The main outcome indicators were the 90-day mortality, 180-day mortality, mechanical ventilation time, intensive care unit(ICU)stays, total length of hospital stays, and infection incidence of critically ill patients admitted to the ICU. The secondary outcome indicators were average energy delivery levels and protein delivery levels. The literature search was conducted independently by 2 researchers using standardized methods. Meta-analysis was performed using RevMan 5.4.

A total of 931 patients were enrolled in 7 RCTs, including 468 patients in the IC group and 463 patients in the PE group. The summary results showed that compared with the PE group, the 90-day mortality rate (RR=0.77, 95%CI=0.60 to 0.98, P=0.03)of the IC group patients was significantly lower, and the 180-day mortality rate had no significant change(RR=0.95, 95%CI=0.71 to 1.27, P=0.73), which did not shorten the mechanical ventilation time (MD=0.87, 95%CI=-0.81 to 2.56, P=0.31), and ICU hospital stays(MD=-0.46, 95%CI=-2.84 to 1.92, P=0.70) and total length of hospital stays(MD=0.23, 95%CI=-3.27 to 3.72, P=0.90), and the incidence of infection did not decrease(MD=1.18, 95%CI=0.73 to 1.91, P=0.51). The average energy delivery in the IC group was significantly higher than that in the PE group (MD=619.91, 95%CI=407.81 to 832.02, P<0.01) and the protein delivery level was also significantly higher than that in the PE group(MD=14.13, 95%CI=2.45 to 25.61, P=0.02).

This meta-analysis indicates that IC-guided energy delivery reduces 90-day mortality and increases mean daily energy intake and protein intake in critically ill patients; mechanical ventilation time, ICU stays, and total length of stays are not prolonged; it has no significant effect on infection incidence and 180-day mortality. This finding encourages the use of IC-guided energy delivery during critical nutrition support. But more high-quality studies are still needed to confirm these findings.

To conduct a meta-analysis of the efficacy and safety of rosuvastatin and atorvastatin in the treatment of coronary heart disease (CHD) with hyperlipidemia (HPL).

The literatures were retrieved from China HowNet, Wanfang Database, Weipu Database, China Biomedical Database and PubMed from the database establishment to January 2020 and those related to the rosuvastatin and atorvastatin in the treatment of coronary heart disease with hyperlipidemia were screened. In the clinical study, the experimental group was treated with rosuvastatin and the control group was treated with atorvastatin. For the extracted data and quality evaluation of the included literature, meta analysis was performed using Revman5.3 software. Heterogeneity among studies was judged by χ2 test. The odds ratio (OR) and 95% confidence interval (95% CI) were used to evaluate the outcome indicators, and the continuous variable was used to calculate the average difference (MD). A funnel chart was used to assess publication bias.

A total of 1487 patients were included in the standard-matched literature, including 752 patients in the test group and 735 patients in the control group. Compared with the control group, patient's clinical symptom in the test group were significantly improved (OR=5.88, 95%CI: 3.31~10.43, P<0.05); serum total cholesterol (TC), triglyceride (TG), low density lipoprotein (LDL-C) were reduced(MD=-0.28, 95%CI: -0.31 to -0.24, P<0.05; MD=-0.36, 95%CI: -0.39 to -0.33, P <0.05; MD=-0.65, 95% CI: -0.69~-0.61, P <0.05). At the same time, the decline of HDL-C and NO was inhibited (MD=0.30, 95% CI: 0.28 ~ 0.33, P<0.05; MD=13.19, 95%CI: 11.70-14.68, P<0.05).

Rosuvastatin has higher clinical efficacy and better lipid-lowering effect in treating CHD combined with HPL.

To observe the protective effect of vitamin B₆ (VB₆)and Fengnuoan (20AA compound amino acid) on peripheral blood cells of X-ray irradiated mice.

The mice were randomly divided into five groups: control group, model group, VB₆ group, Fengnuoan group and combined group. Except the control group, the mice in the other four groups received X-ray irradiation. From the 4th day before irradiation to the 10th day after irradiation, the mice in control group and the model group were injected with normal saline intraperitoneally, the mice in VB₆ group, Fengnuoan group and combined group were injected intraperitoneally with VB₆, fenoan, and the compound solution of VB₆ and fenoan respectively. The mice were killed on the 11 th day after irradiation, and the blood routine and peripheral blood lymphocyte subsets were detected.

Compared with the control group, the total number of leukocytes, neutrophils, lymphocytes, monocytes, erythrocytes, platelets, NK cells, total T cells, CD4⁺ and CD8⁺ T cells and hemoglobin concentration in the peripheral blood of X-ray irradiated mice were significantly reduced (P<0.05), the ratio of CD4 to CD8 was significantly increased. Fengnuoan, VB₆ and compound of Fengnuoan and VB₆ could increase the total number of leukocytes, lymphocytes, platelets, NK cells, total T cells, B cells, CD4⁺ and CD8⁺ T cells of X-ray irradiated mice (P<0.05). Compound was better than VB₆ in increasing the number of total T cell [(41.94%±10.90%) vs (32.14%±5.86%)] and CD4⁺ T cell [(33.11%±10.00%) vs (25.01%±4.64%)], and better than Fengnuoan in increasing the total number of leukocytes [(6.3±0.6)×10⁹/L vs (3.7±0.5)×10⁹/L]and lymphocytes [(5.3±0.4)×10⁹/L vs (3.4±0.3)×10⁹/L].

Fengnuoan and VB₆ could protect the peripheral blood cells of mice irradiated by X-ray. The protective effect of combined VB₆ and fenuoan is better than that of single application.