Objective To observe the changes of serum IGF-I,VEGF levels in premature infants,and to dis-cuss the predicting values for the development of ROP;Methods Preterm infants admitted into those whose birth weight ( BW)≤1 500g and ( or) gestational age ( GA)≤31 weeks joined in ROP-screen,and those who were diag-nosed as ROP according to ICROP were included into ROP group.In the same time,those who didn't develop ROP were divided into the control group.Serum IGF-I,VEGF were measured one week from their birth or correct gestational age of 31 weeks.Serum IGF-I, VEGF were evaluated with ELISA method.Results The concentration of IGF-I, VEGF:Group ROP[(20.65 ±11.11)μg/L,(195.61 ±105.98)ng/L] were all significantly lower than the control group [(42.86 ±18.72)μg/L,(363.59 ±101.08)ng/L](all P<0.01).There were significant different of birth weight[ROP group (1 229.69 ±232.37)g,the control group (1 401.32 ±171.78)g;t=4.144)],GM[ROP group (3.20 ±1.23)mmol/L,the control group (3.70 ±1.17)mmol/L;t=2.082],the time of oxygen inhaling[ROP group (32 ±22)d,the control group (21 ±12)d;t=-2.856],oxygen inhalation mode(the percentage of mechanical ventilation)[ROP group 33/48(68.8%),the control group 16/50(32.0%);χ2 =16.363] and fertilization way(the percentage of test tube baby)[ROP group 13/48(27.1%),the control group 4/50(8.0%);χ2 =6.262] between ROP and control group (all P<0.05).Conclusion The low serum IGF-I(<28.08μg/L),VEGF(<232.89ng/L) of a premature in the first week or correct gestational age of 31 weeks and (or)BW≤1 500g would probably suggest the development of ROP.

The efficacy of growth hormone (GH) treatment in short children with small for gestational age (SGA) was evaluated and the association of serum insulin-like growth factor-1 (IGF) and IGF-binding protein-3 (IGFBP-3) levels with height increments was investigated.Fifty-five short children with SGA in our hospital from Sep 2009 to Sep 2013 were collected.Before GH treatment, insulin and arginine stimulation test were performed.The children were treated with recombinant GH with 0.15 U · kg-1 · d-1 for at least 12 months.After GH treatment, the height was (120.5 ± 17.63) cm, height SDS was (-1.53 ± 1.04) SDS, HtSDS was-2.04 ± 0.47, bone age was (6.19 ± 2.34) year, growth velocity was (7.24 ± 1.19) cm/year, all these parameters were significant higher than those before GH treatment.Pre-treatment serum levels of IGF-Ⅰ and IGFBP-3 were negatively correlated with post treatment growth velocity(r =-0.37 and r =-0.31;P =0.004 and P =0.021).GH treatment could effectively improve the height of short children with SGA.Children with lower pre-treatment serum levels of IGF-Ⅰ and IGFBP-3 may reach the higher growth velocity.

Objective:To compare the difference of LLD (leg length discrepancy) between robot-assisted and conventional methods of total hip arthroplasty (THA).Methods:Data of 38 patients who had THA performed by robot-assisted or conventional methods from January 2019 to May 2020 were retrospectively analyzed. There were 38 cases (54 hips) in robot-assisted THA group (robot group) with 18 males and 20 females (age 53.5±13.6 years, BMI 26.2±3.4 kg/m 2), and there were 21 cases (32 hips) with osteonecrosis of the femoral head, 17 cases (22 hips) with Crown typeⅠandⅡdevelopmental dysplasia of the hip. There were 38 cases (54 hips) in conventional THA group (conventional group), with 19 males and 19 females, (age 52.3±14.7 years old, BMI 25.7±2.9 kg/m 2), and there were 19 cases (30 hips) with developmental dysplasia of the hip, and 19 cases (24 hips) with osteonecrosis of the femoral head. The operative time, postoperative LLD, Harris score, forgotten joint score-12 (FJS-12) and the difference between preoperative and postoperative LLD between the two groups were compared, and the correlation between surgical methods and the change of hip length was also evaluated. Results:The operation time of the robot group was 73.3±14.1 min and which was 59.3±12.6 min in conventional THA group ( t=2.732, P=0.003). In the robot group, the postoperative LLD was 2.3±3.4 mm, which was less than that of the conventional group 6.7±5.4 mm ( t=3.521, P < 0.001). When the absolute value of LLD was larger than 5 mm as an abnormal value, it was 2.6% (1/38) in the robot group and 47.3% (18/38) in the conventional group. The difference of hip length (HL) in planning and post-operation in the robot group was 2.8±2.2 mm, which was smaller than that in the conventional THA group 7.9±5.3 mm ( t=2.357, P < 0.001). In addition, there was a correlation between the change of hip length results and the postoperative measurement of hip length in the robot group ( r=0.983, P < 0.001). At the last follow-up, Harris score and FJS-12 were recorded in the robot group and coventional group. The scores were 83.1±5.3 and 32.5±4.9 respectively in the robot group, 82.9±7.2 and 31.9±6.7 in the conventional group, respectively. There was no significant difference between the two groups ( t=0.221, 0.356; P=0.819, 0.731). Postoperative bleeding occurred in 1 case in the robot group with postoperative suture healed well. The fracture of the posterior wall of the acetabulum was found in the conventional group and the patient avoids weight bearing 4 weeks after operation. The postoperative recovery was good and no other related complications were found. Conclusion:Robot-assisted THA can accurately restore the length of both legs and reduce LLD compared with conventional THA. The real-time monitoring of LLD during robot operation can give the operator an accurate reference.

Objective To study the effect of minimal enteral nutrition on the immune system of newborn infants under mechanical ventilation (MV) with intratracheal intubation.Methods Eighty-one patients under MV with intratracheal intubation were divided into two groups:treatment group and control group.Forty patients in treatmet group accepted early minimal enteral nutrition,while other 41 patients in control group accepted normal feeding,then T-lymphocytes (CD3,CD4,CD8),CD4/CD8,immunoglobulins (IgG,IgA,IgM),occurane of secondary infection,time of beginning fully enteral feeding,occurance of abdominal distension were recorded.Results There were no significant differences of T-lymphocytes (CD3,CD4,CD8),CD4/CD8,immunoglobulins (IgG,IgA,IgM) changes between the two groups in which the time of patients beginning MV under intratracheal intubation was less than five days (P ＞ 0.05) ; while comparing patients in the two groups whose MV time was equal or greater than five days,the changes of T-lymphocytes CD3[(37.3 ± 1.6)％,(42.6 ±2.8)％],CD4[(29.1 ±1.7)％,(34.6 ±2.1)％],CD4/CD8 (17.9 ±1.8,18.9 ± 1.6),immunoglobulins IgA[(55.42 ±3.98) mg/L,(129.00 ±7.76) mg/L],IgM[(130.29 ±10.92) mg/L,(317.33 ± 11.64) mg/L] in treatment group were more significant than those in control group(P ＜0.05) ;furthermore the differences of the secondary infection occurance,the time beginning fully enteral feeding,intravenous nutrition and hospital stays in the treatment group [20％ (8/40),(8.56 ± 1.78) d,(10.56 ± 1.78) d,(12.63 ± 1.73) d] were lower significantly than those in the control group [48.78％ (20/41),(10.20 ± 1.65) d,(12.15 ± 1.69) d,(14.15 ± 1.64) d] (P ＜ 0.05).These were no significant differences on abdominal distension and gastric retention between the treatment group [20％ (8/40),17.5％ (7/40)]and the control group [24.39％ (10/41),19.51％ (8/41)] (P ＞ 0.05).Conclusion Early minimal enteral nutrition in infants under long time MV with intratracheal intubation could improve immune function recovery,reduce the occurance rate of secondary infection,shorten the time beginning fully enteral feeding,intravenous nutrition and hospital stay.

Objective To explore the role of family centered cognitive intervention in neonatal nursing. Methods According to the random number table method,100 newborns were randomly divided into observation group and control group,50 cases in each group. The two groups received routine health education,and the observation group received the family centered cognitive intervention. After the intervention, the neonatal physical development status (body weight,height,head circumference) and neonatal disease status of the two groups were analyzed. The active muscle tension, passive muscle tension, primitive reflexes, behavior ability, general evaluation and neonatal behavioral neurological assessment score ( NBNA score ) were evaluated and analyzed. Results The body weight [(4753.88±434.59)g],length[(55.16±1.17)cm],headcircumference[(37.34±0.51)cm]after1month discharge of the observation group were better than those of the control group[(4295. 78 ± 344. 63) g,(52. 25 ± 0.58)cm,(35.67 ±0.21)cm],the differences between the two groups were statistically significant(t =2.564, 6. 235,8. 679,all P<0. 05). The incidence rate of born disease of the observation group was 14. 00%,which of the control group was 32. 00%,there was statistically significant difference between the two groups(χ2 =4. 574,P <0. 01). The active muscle tension,passive muscle tension,behavior ability,original reflection,the general evaluation and NBNA scores of the observation group were significantly higher than those of the control group, the differences were statistically significant(all P<0. 01). Conclusion Family centered intervention can significantly improve the growth status of newborn infants,reduce the incidence of the disease,it is beneficial to improve the patients' neurological behavior,it is worthy of wide application.

Objective: To investigate the methods and short-time clinical results of reconstruction of Paprosky type Ⅲ acetabulum bone defects by using tantalum augments. Methods: A total of 17 patients (17 hips) with Paprosky type Ⅲ acetabulum bone defects, treated with tantalum augments in revision of total hip arthroplasty at Department of Orthopedics Surgery in General Hospital of Chinese People′s Liberation Army were retrospectively analyzed from March 2014 to May 2016.There were 6 males and 11 females aged from 23 to 74 years with an average of (50.2±16.3) years. Tantalum augments or TM-Cup augment (the cup-on-cup technique) were used to reconstruct the defects.The TM-Cup augment was the tantalum revision cup which was removed titanium ring. The cup-on-cup technique combined TM-Cup augment and biological acetabulum cup. Augments were served as the nonresorptive structural allograft in revision of total hip arthroplasty. Harris hip score was used to evaluate clinical effects. The vertical position of the rotation center was measured and analyzed. Radiographic assessments of the acetabular components were performed by DeLee-Charnley and the Anderson criteria and recorded postoperative complications. Results: All the patients were followed up from 3 to 29 months with an average of (16.2±5.4) months, tantalum augments and biological acetabulum cup were used in 13 patients, the TM-Cup augment and biological acetabulum cup were used in 4 patients. At the time of the latest follow-up, the mean Harris hip score increased compared to preoperatively (86.8±8.3 vs. 30.0±12.0) (t=12.78, P<0.01), the average vertical location of the center of rotation was decreased ((25.3±9.8) mm vs.(47.6±10.5)) mm (t=4.95, P<0.01). All the tantalum augments and biological acetabulum cups were stable, there were no infection, dislocation and other complications. Conclusions The use of tantalum augments could be considered as an effective management of Paprosky type Ⅲ defects providing good clinical and radiographic outcomes in the short term.The cup-on-cup technique which was used in reconstruction of severe superior-invagination acetabular bone defects and restoration relatively normal center of rotation had special application value.

This paper reviews the clinical researches on acupuncture and moxibustion and Tuina therapy for hemiplegia, due to cerebral apoplexy. It is found that acupuncture and Tuina therapy mainly includes acupuncture, moxibustion, massage, electroacupuncture, as well as the combination of acupuncture and Chinese medicine, acupuncture and massage therapy or the combination of modern rehabilitation technics. The researches showed that all treatments have good clinical effect and few adverse reactions. However, most of the researches focus on self-control, and lacks comparability. There stilllacks strict RCT and unified standard of operation scheme. Besides, the researches on the mechanism should be strengthened.

Objective:To explore the high-risk factors for parenteral nutrition associated cholestasis（PNAC）in extremely/ultra-low birth weight infants，and establish a risk Alignment Diagram prediction model.Methods:We retrospectivly analyzed the clinical data of hospitalized extremely/ultra-low birth weight infants admitted to Neonatology Department at Quanzhou Children's Hospital from January 2019 to December 2020，using multivariate Logistic regression analysis to screen for independent risk factors for the occurrence of PNAC.An Alignment Diagram model prediction model for PNAC was constructed by using R software，and the performance of the model was evaluated through receiver operating characteristic curves.Results:A total of 203 extremely/ultra-low birth weight infants were included，with a median gestational age of 29.14（28.00，30.86）weeks and a median birth weight of 1　170（1　000,1　300）g.Among them，26（12.81%）cases developed PNAC.Multivariate Logistic regression analysis showed that the duration of parenteral nutrition（ OR=1.015 ，95% CI 1.003-1.034），the cumulative amount of glucose（ OR=1.014 ，95% CI 1.001-1.028），small for gestational age（ OR=3.455 ，95% CI 1.127-10.589），and neonatal sepsis（ OR=3.142 ，95% CI 1.039-9.503）were independent risk factors for PNAC（ P＜0.05）；The four independent risk factors mentioned above were introduced into R software to construct an Alignment Diagram model，the area under the receiver operating characteristic curve was 0.835（95% CI 0.842-0.731），and the results of the Hosmer Limeshow goodness of fit test show that：χ 2=5.34，degree of freedom=8， P=0.72.A calibration curve indicated good consistency between the predicted probability of the model and the actual occurrence rate，with good accuracy. Conclusion:The Alignment Diagram model constructed based on four independent risk factors of the duration of parenteral nutrition，glucose accumulation，small for gestational age infants，and neonatal sepsis exhibits high predictive ability，and is expected to provide an intuitive and convenient visualization tool for preventing or reducing the occurrence of PNAC in extremely/ultra-low birth weight infants