Objective To compare the effects of continuous versus intermittent feedings on the growth of very low birth weight infants. Methods Databases of Pubmed,Embase,Ovid,the Cochrane library and CBM were searched through internet,and citations of relevant original studies were also searched manually by using keywords of 'ontinuous,intermittent,nasogastric,premature,very low birth weight' Meta analysis was done on the results of these studies. Results Seven eligible studies with 434 infants were identified,among them,217 were fed using continuous nasogastric gavage,and other 217 were fed by intermittent nasogastric gavage. The result of the Meta analysis revealed that there was no statistical difference in the growth of the infants between two feeding methods. Conclusions Feeding methods are associated with similar outcomes when calorie intake is guaranteed.

Objective To explore the feasibility of using portable γ spectrometer to rapidly identify the low activity of depleted uranium and the underlying conditions.Methods Firstly,high purity germanium (Ge) γ spectrometer was used to analyze energy spectrum of DU samples (5 g) and calculate nuclide percentage of 235U in an attempt to ascertain the properties of these DU samples.The portable γ spectrometer was used to provide the evidences for identification of DU samples.Secondly,portable γ spectrometer was also used to identify DU samples of same group.These samples contain 1 g DU powder and 0-5 g environmental clay powder,which were sealed with double layer pocket,and then detected with a distance of 1-5 cm during the longest detection time of 10 min.According to the detection of nuclide activity of 238U and 235U in the samples and the subsequent calculation of specific activity,the nuclide percentage composition was calculated and the existence of DU was confirmed if this value of 235U was less than 0.718％.Results The activity of 238U was detected using portable γ spectrometer under all test conditions,while the activity of 235U was detectable only under certain test conditions (MA ≥ 1 g,DN ≤ 1 cm).Under the condition that the 238U and 235U was both detected,the nuclide percentage of 235U was all less than 0.718％,which suggested that the DU was confirmed.Conclusions The energy spectrum of low activity of DU and the type of nuclide could rapidly be identified and evaluated by using portable γ spectrometer.This is same as the conclusions obtained with high purity Ge γ spectrometer,α spectrometer and ICP-MS.

Objective · To evaluate the association between the abnormal maternal serum markers of alpha fetoprotein (AFP), human chorionic gonadotrophin (hCG) and unconjugated estriol (uE3) in the second trimester screening and the adverse obstetric outcomes other than trisomy 21 (T21),trisomy 18 (T18) and open neural tube defects (ONTD), and to provide local data for supporting evidence based clinical managements. Methods · A retrospective cohort study was performed in the women who received second trimester maternal serum screening in the International Peace Maternal and Child Health Hospital between 2012 and 2014, with naturally conceived singleton pregnancies. Obstetric outcomes were followed up by searching electronic medical records within the hospital. Abnormal level of marker was defined as a MOM value ≥ 99th (P99) or ≤ 1st percentile (P1) of the overall screened population. Incidence of an adverse obstetric outcome was compared between the groups with abnormal markers and the control with all markers in normal. Results · ① A total of 25616 pregnancies were included in this study, in which 4526 were identified as having various adverse obstetric outcomes. Among them 4143 pregnancies were with isolated and 383 pregnancies were with co-occurring two or more adverse outcomes. ② When compared to pregnancies with normal levels of all three serum markers, pregnancies with decreased AFP or decreased hCG did not show associations with any adverse obstetric outcomes. However, pregnancies with increased AFP, increased hCG or decreased uE3 were at increased risk for a variety of abnormal pregnancy outcome. In 18 pregnancies with an outcome of fetal chromosomal abnormalities other than T21 and T18, 9 presented with either increased AFP, increased hCG or decreased uE3, with relative risk ratios of 13.33、35.00 and 59.00, respectively. ③ The performance of those markers tended to be improved in a subset of adverse obstetric outcomes, including low birth weight

Objective To compare the efficacy of alfentanil and remifentanil in minimizing the propofol injection pain. Methods A total of 175 adult female patients undergoing gynecological procedures with general anesthesia were randomly divided into four groups.Patients received alfentanil 1mg(2 mL,AL group,n=43),remifentanil 0.01 mg(2 mL,REM1 group,n=43),remifentanil 0.02 mg(2 mL,REM2 group,n=45) or normal saline(2 mL,control group,n=44) 30 seconds prior to propofol administration.Visual analogue scale(VAS) was employed to evaluate the subjective feelings of pain due to propofol injection,and adverse effects were recorded. Results One patient in REM2 group and one patient in control group were excluded due to difficulty in venous catheterization.The injection pain in AL group,REM1 group and REM2 group was significantly less severe than that in control group(P

Aging changes of somatostatin (SS) mRNA-positive neurons in the dorsal hippocampus of old rats were studied by in situ hybridization histochemistry and image analysis. In the young rats,SS mRNA-positive cell bodies were mainly located in the pyramidal and polymorphic cell layers of the CA1 and CA2 regions, and in the strata radiatum and polymorphic cell layer of the CA3 region, and in the polymorphic cell layer of dentate gyrus. In the old rats,SS mRNA-positive cell bodies were concentrated in the polymorphic cell layer and denate gyrus. A marked decrease of number of SS mRNA-positive cell bodies and a significant increase of gray value of SS mRNA-positive cell bodies were found in the dorsal hippocampus and dentate gyrus of the old rats as compared with the young rats. No significant age difference in the sectional area of SS mRNA-positive cell bodies was observed in the dorsal hippocampus. The results showed that there were apparent changes with aging of the SS mRNA-positive cell bodies in the dorsal hippocampus of the rats. The significance of the changes remains to be studied further.

Objective To construct the eukaryotic expression vector for mouse microRNA miR-21 and identification its expression activ-ity in 293 cells. Methods The genomic sequence containing pre-miR-21 was amplified from mouse genomic DNA by PCR and cloned into the pRC/CMV plasmid. The constructed recombinant plasmid pRC/CMV-mmu-miR-21 was transfected to 293 cells by lipofectamine 2000, and the stably transfected cells were screened with G418,from which total RNA was extracted for detecting the expression of mature miR-21 by northern blot. In the meantime,a luciferase report plasmid examing the activity of miR-21 named pmiR-21-Luc reporter was also construc-ted,and luciferase activity analysis indicated the product of pRC/CMV-mmu-miR-21 indeed had biological activity. Results Both restriction enzyme digestion analysis and sequencing proved the recombinant plasmids were constructed correctly. The miR-21 was highly expressed in the screened clones of 293 cells and it had good biological activity. Conclusion The eukaryotic expression plasmid of mouse miR-21 was successfully constructed,which laid the foundation of further investigation of the role of miR-21 during skin wound healing.

Background During the past two decades, a number of rating scales were developed to facilitate diagnosis and assessment of subjects with social anxiety disorder. One of the most commonly used scales for the assessment of social anxiety disorder is the Liebowitz social anxiety scale (LSAS). The LSAS is widely used in epidemiologic investigations and clinical researches,and its assessment in the pharmacotherapy efficacy for social anxiety disorder is superior to any other scale. So we designed this study to explore the validity and reliability of the LSAS in Chinese patients with social anxiety disorder and normal control, and to find the difference of the scores between the patients self -report version and clinician-administered version. Methods Fifty five patients meeting the DSM-Ⅳ diagnostic criteria for social anxiety disorder and 168 normal controls who were screened from 222 college students were rated by LSAS, social phobia scale and self-made General Information Forms. Results The Cronbath α of LSAS for the patients and the normal controls was 0.83 and 0.77, respectively. The 4-week test-retest reliability for total scores and its factors scores of LSAS in 31 normal controls were ranging from 0.68 to 0.79. The ROC area under curve value in discriminating the patients from normal controls was 0.87±0.03; the total score of 35 was considered to be the best cut-off score for LSAS, then its sensitivity was 0.77 and its specificity was 0.81; and no significant difference between the self-report version and clinician-administered version. Conclusions The LSAS is good in internal consistency and test-retest reliability, and has high sensitivity and specificity in discriminating the patients and the controls. There is no significant difference in the total score and each factor scores of LSAS between self-report version and clinician-administered version.

Objective To perform a DNA-based prenatal diagnosis in a family with recessive dys-trophic epidermolysis bullosa, and to develop a strategy to eliminate matemal cell contamination in arnniotic fluid samples. Methods Amniocentesis was carried out at gestation week 16, amniotic fluid culture was used to separate fetal cells from maternal blood cells. Peripheral blood was obtained from the proband, and her parents. Genomic DNA was extracted from peripheral blood and aminotic cells. Subsequently, PCR and direct sequencing were performed to detect pathogenic mutations in the COL7A1 gone. Karyotype analysis was used to confirm paternal information in amniotic fluid. Linkage analysis between micro-satellite markers was performed to confirm the fetal genotype. Resulta Centrifugation showed visible contamination of aminotic cells by blood cells. Direct sequencing revealed that the proband was a carrier of both maternal mutation, R525X in exon 12, and paternal mutation, R2610X in exon 105, while the fetus only carried the maternal mutation, R525X. The second direct sequencing and hapiotype analysis after elimination of mater-nal blood cells by amniotic fluid culture confirmed that the fetus was a carrier of maternal mutation with nor-real phenotype. The pregnancy continued and a clinically unaffected girl was born at gestation week 40.Conclusion The accuracy of DNA-based prenatal diagnosis could be improved by the combination of direct sequencing, amniotic fluid culture, karyotype analysis and linkage analysis, etc.

Objective:To explore management experience for post-adolescent postoperative urethral stricture of hypospadias in a single center.Methods:The clinical data of 71 cases of postoperative urethral stricture of post-adolescent hypospadias from January 2015 to December 2019 were retrospectively analyzed. The average age was 27.7(12-65) years. The mean duration of urethral stricture was 33.4(1-240) months. The number of prior surgeries was 2.5(1-9). There were 32 cases of ectopic urethral orifice, including 22 on penile, 8 on scrotum and 2 on perineum. There were 17 cases of urethral stricture with penile curvature, 11 with urethra-cutaneous fistula, 9 with urethral diverticulum, 11 with urethral calculus and 25 with urethral infection. Ten patients kept suprapubic tubes; 61 patients were able to urinate on their own, but suffered from dysuria and weak steam. The average maximum uroflow rate of 71 cases was 4.7(0-11.2) ml/s. The primary urethral reconstruction procedures were performed on 33 cases, included 11 penile or scrotal septum flap urethroplasty, 2 urethral diverticulum wall flap urethroplasty, 12 oral mucosal urethroplasty and 8 urethrotomy. Thirty-three cases underwent two-staged surgery. For patients with penile curvature greater than 30 degrees, the penis was straightened with a urethrotomy in first stage. Besides, the dorsal skin of penis or oral mucosal graft were transferred to the ventral side of the penis to the preset urethral plate. In second-stage, Denis Brown urethroplasty was performed on 23 patients, tubularized incised plate (Snodgrass) urethroplasty on 6, and oral mucosa inlay urethral plate (Snodgraft) urethroplasty on 4. In 5 cases, preplacing of oral mucosa was done in the second stage with a third-staged urethroplasty. Penile curvature was relieved by ventral scar resection with the folding the dorsal tunica albuginea of corpus cavernosum when necessary.Results:The mean follow-up time was 30.5(4-59) months. Sixty-one patients got satisfying postoperative urination, with an average maximum uroflow rate of 22.7 ml/s (15.8-37.2 ml/s). Restenosis occurred in 10 cases, and urethral fistula in 7 cases. Re-stricture patients underwent urethrotomy in 5 cases, augmented urethroplasty with flap in 4 cases, and urethroplasty with oral mucosal graft in 1 case. Among the 7 patients with urethral fistula, 5 were cured by one fistula repair, and 1 cured by second repair; the rest one was left untreated. 2 patients still had penile curvature after operation.Conclusions:It is difficult to manage post-adolescent postoperative urethral stricture of hypospadias, especially for patients with residual penile curvature greater than 30 degrees and lack of penile skin. Performing correction of the curvature and reconstruction of the urethral plate in first stage and Denis Brown urethroplasty or Snodgrass urethroplasty in second or third stage could achieve good results.

The main treatment strategies for chronic pancreatitis in young patients include therapeutic endoscopic retrograde cholangio-pancreatography (ERCP) intervention and surgical intervention. Therapeutic ERCP intervention is performed much more extensively for its minimally invasive nature, but a part of patients are referred to surgery at last. Historical and follow-up data of 21 young patients with chronic pancreatitis undergoing duodenum-preserving total pancreatic head resection were analyzed to evaluate the outcomes of therapeutic ERCP intervention and surgical intervention in this study. The surgical complications of repeated therapeutic ERCP intervention and surgical intervention were 38% and 19% respectively. During the first therapeutic ERCP intervention to surgical intervention, 2 patients developed diabetes, 5 patients developed steatorrhea, and 5 patients developed pancreatic type B pain. During the follow-up of surgical intervention, 1 new case of diabetes occurred, 1 case of steatorrhea recovered, and 4 cases of pancreatic type B pain were completely relieved. In a part of young patients with chronic pancreatitis, surgical intervention was more effective than therapeutic ERCP intervention on delaying the progression of the disease and relieving the symptoms.