Objective To investigate bone nutritional status of neonates and their mothers as well as the correlation between them by estimating the concentrations of 25-(OH)D3, calcium and phosphorus in maternal blood and cord blood at birth, and by measuring the bone speed of sound (SOS) of neonates and their mothers with quantitative ultrasound within 3 days after birth. Methods The concentrations of 25-(OH)D3, calcium and phosphorus in the serum were estimated both from 32 pregnant women who had a term delivery and from the umbilical cord at birth. Within 3 days after delivery, the bone SOS values of the mothers measured from their radius and neonates from their tibia were estimated and the correlation between the mothers and their neonates was analyzed. Thirty-nine non-pregnant healthy women who at the same age as the pregnant women were selected as control group and had their bone SOS measured. The difference of bone SOS between pregnant and healthy non-pregnant women was compared. Results There was positive correlation between cord blood and maternal blood 25-(OH)D3 concentration [(14. 7±7. 8) nmol/L and (30. 3±10. 2) nmol/L, r= 0 . 680, P=0. 000]. The calcium and phosphorus concentration in cord blood [2.36±0. 28)mmol/L and (1.57±0.76) mmol/L] were significant higher than that in maternal blood E(2.09± 0. 17) mmol/L and (1.04±0. 28) mmol/L], but no correlation was found (r=0. 146, P=0. 467; r=0. 148, P=0. 445). No significant correlation was shown in the bone SOS between the infants and their mothers[(3054±76)m/s and (4170+241)m/s, r=0. 223, P=0. 220]. The concentration of 25-(OH)D3 in cord blood was closely correlated with the bone SOS of infants(r=0. 412, P=0. 026). The SOS of healthy women was obviously higher than that of pregnant women [(4258±100)m/s vs (41704±241)m/s, P=0. 043]. Conclusions There are close correlations between fetus and their mothers in vitamin D status and also between vitamin D status and fetus bone development. Some pregnant women may be short of vitamin D in autumn and winter in Shanghai and we should monitor the bone nutritional states for pregnant women.

Objective To summarize the onset and the management of serious responsiveness during the tilt table test (TTT), and the prevention measures. Methods Thirty six elderly patients (26 males and 10 females, aged between 60 70) were tested with a tilt angle of 70 degrees for a maximum of 45 minutes and then processed with isoproterenol provocative tilt testing. ECG and blood pressure were monitored during the test and the peripheral intravenous cannula were maintained for all patients with normal saline. Results Twenty one of the 36 patients were defined as positive including 10 showing serious responsiveness. Of the 10 patients, 3 had a history of atherosclerosis involving internal carotid arteries; among the 3 with bradycardia, 2 were associated with II? A V block, and another one was with chronic atrial fibrillation. The serious reponsiveness included asystole for more than 5 seconds(3 cases) , serious bradycardia for more than 1 minute(3 cases) , and serious hypotension for more than 1 minute (4 case), respectively. Those with serious responsiveness were managed with returning to supine position, or intraveneous atropine, or CPR (2 cases), or oxygen given(4 cases). Only 2 hypotensive patients recovered gradually in 10 minute emergent management while others recovered rapidly and with no complication. Conclusions TTT may result in serious responsiveness especially in elderly patients though it is non invasive method. Therefore, proper patient selection according to the indications, control of isoproterenal infusion and close observation of vital signs are important for a safe consequence.

Objective To investigate the feasibility of L-[1- 13 C]phenylalanine breath test to assess liver function and determine the effective parameters of the test for quantitative assessment of liver function in adult. Methods Twelve healthy volunteers served as control group, and 26 liver cirrhotic patients with hepatitis B were divided into three groups, 10 patients in Child-Pugh classification A, 8 in B and 8 in C, An oral dose of 100 mg of nonradiative tracer L-[1- 13 C]phenylalanine were administered to all the subjects. Breath samples were taken before and different intervals within 360 min after administration. 13 CO_2 enrichment was measured by isotope ratio mass spectrometer. Results After the oral administration of L-[1- 13 C] phenylalanine, 13 C excretion reached a peak within 10-30 min. The parameters of 13 CO_2 excretion rate at 30 min ( 13 CO_2ER_ 30 ) , 13 C cumulative excretion of 60 min ( 13 C_ cum60 ), 75 min( 13 C_ cum75 ), 90 min( 13 C_ cum90 ) and 13 CO_2 half excretion time ( t _ 1/2 ) were shown sensitive, which could differentiate significantly the groups( P

OBJECTIVE:To evaluate the clinical efficacy of Shuanghuanglian injection in the treatment of acute exacerbation of chronic obstructive pulmonary disease (AECOPD),and to observe its effects on the plasma levels of C-reactive protein (CRP),procalcitonin(PCT)and interleukin-6(IL-6). METHODS:A total of 100 AECOPD patients were randomly divided into observation group and control group,with 50 cases in each group. Control group received routine treatment,such as controlled oxygen therapy,intravenous dripping of moxifloxacin,bronchodilator for relieving asthma,mucolytic for eliminating phlegm,nu-tritional support. Observation group was additionally given Shuanghuanglian injection 1 ml/(kg·d)added into 5% Glucose injec-tion 250 ml intravenously,qd,on the basis of control group. Treatment course of 2 groups lasted for 10 d. Clinical efficacies of 2 groups were compared as well as the changes of serum levels of CRP,PCT and IL-6 before and after treatment and the occur-rence of ADR. RESULTS:After treatment,total effective rate of observation group was 96.0%,which was significantly higher than 82.0% of control group,with statistical significance(P<0.05). Before treatment,there was no statistical significance in se-rum levels of CRP,PCT and IL-6 between 2 groups (P>0.05). After treatment,serum levels of CRP,PCT and IL-6 were de-creased significantly in 2 groups,and those of observation group were significantly lower than those of control group,with statis-tical significance (P<0.05). There was no statistical significance in the incidence of ADR between 2 groups (P>0.05). CON-CLUSIONS:Shuanghuanglian injection can effectively improve serum inflammatory factors of AECOPD patients,and shows good clinical efficacy and safety.

Objective To investigate the impact of isoniazid (INH)-resistant Mycobacterium tuberculosis (Mtb) on the prevalence and dissemination of multi-drug resistant tuberculosis (MDR-TB).Methods A total of 251 patients diagnosed with tuberculosis in designated hospitals of Guanyun,Jiangsu and Deqing,Zhejiang from 2010 to 2011 were included in the study.The drug susceptibility tests (DST) were performed on all the Mtb isolates available from the sputum cultures.Mycobacteral interspersed repetitive units-variable number tandem repeats (MIRU-VNTR) was conducted for genotyping for all available Mtb isolates.Chi-square test,Fisher exact test,ANOVA and non-conditional Logistic regression modelling were applied for data analysis.Results Among 251 patients with Mtb isolates and DST results available,72 (28.7％) were resistant to INH,including 13 were INH mono-drug resistant.Of the remaining 59 INH-resistant Mtb,34 (13.5％) were resistant to rifampin TB and 25 were resistant to streptomycin and/or ethambutol.The clustering analysis based on MIRU-VNTR genotyping revealed 29 clustered genotypes (including 105 isolates) and 146 unique genotypes (including 119 isolates).Twentyfive clusters contained drug resistant Mtb and 16 clusters of them comprised by 37 INH-resistant isolates and 20 MDR-TB isolates,which accounted for 51.4％ of the INH-resistant isolates and 58.8％ of the MDR-TB isolates.Single factor analysis showed that sex,age,previous tuberculosis treatment history and sputum smear results were all related to INH-resistant tuberculosis and MDR-TB (all P ＜ 0.05).Multiple factors analysis showed that previous tuberculosis treatment history was risk factor of MDR-TB (OR=8.40,95 ％CI:3.342-21.105),while the risk factors of INH-resistant tuberculosis were previous tuberculosis treatment history (OR=3.52,95％CI:1.570-7.910),pulmonary caviry (OR=2.27,95％CI:1.075-4.799) and sputum smear results (OR=0.50,95％CI:0.275-0.892).Conclusions That INH-resistant strain may evolve to the MDR-TB after recent transmission is a possible trend.Patients with previous treatment history and advanced age are at high risk of INH-resistant tuberculosis and MDR-TB.

Objectives To explore the nutritional status of fatty acids in the newborn and their mother, and the role of the placenta in fetal nutrition. Methods The composition of fatty acids in blood, placenta, and neonatal umbilical cord blood were determined and analyzed by gas chromatography in 20 normal pregnant women. Results In 20 pregnant women in the study, average age was 27.0±4.5 years, the average gestational age of their newborns was 38.0±3.0 weeks, the average birth weight of newborns was 3320±127 g. There were 18 types of fatty acids in maternal blood, umbilical cord and placenta, including saturated fatty acids, monounsaturated fatty acids, and polyunsaturated fatty acids. The total fatty acid content in maternal blood (3.51±0.57 g/L) was 5 times higher than that in umbilical cord blood (0.74±0.18 g/L), and there was statistically difference (P<0.05). The content of linoleic acid (LA) in maternal blood was higher than that in umbilical cord blood and placenta; the content of arachidonic acid (AA) and docosahexenoic acid (DHA) in placenta was significantly higher than that in maternal blood and umbilical cord blood; and the content of eicosapentaenoic acid (EPA) in umbilical cord blood was higher than that in maternal blood and placenta. All differences were significant (P<0.05). Conclusions Mothers preferentially transport long chain polyunsaturated fatty acids (AA and DHA) through the placenta to meet the needs of fetal and neonatal growth and development.

Objective Since there are significant variation of the dietary structure recent years in China,it is necessary to re-investigate the fatty acid composition of human breast milk for the presentation of the latest data of fatty acid composition in China. Methods Using a gas chromatography GC-2010,the composition of fatty acids was detected in the human colostrums and the mature breast milk(consecutively from postnatal day 1 to day 7 and from postnatal day 42)obtained from 62 healthy postpartum women in Shanghai and Chongqing,two big cities of China,from Jan to July,2008. Results The level of total fatty acid(TFA)tended to increase significantly from the colostrums to the mature breast milk. No significant difference in the level of TFA was found between two cities. The significantly higher monounsaturates(MUFA)level(44.06% vs. 33.85%,P ＜ 0.01)and lower linoleic acid(LA,C18 : 2n-6)level(18.43% vs. 27.62%,P ＜ 0.01)of the mature breast milk were observed in Chongqing women compared with those in Shanghai women. The docosahexenoic acid(DHA)level of the mature breast milk in Shanghai women was significantly higher than that in Chongqing women(0.41% vs. 0.29%,P ＜ 0.01). There was no significant difference in the level of arachidonic acid(AA,C20 : 4n-6)between two cities. Conclusions The fatty acid composition in human breast milk tends to vary with the extension of the lactation. There is significant difference in the fatty acid compositions in human breast milk between Shanghai and Chongqing owing to different dietary habits in the different regions of China.

Objective To describe the distribution and spatial clustering of active pulmonary tuberculosis patients in Funing county of Jiangsu Province,China,and to determine the rules of recent transmission in TB patients and help establish the strategy of TB control with the results of genetic typing of Mycobacterium tuberculosis (M.TB).Methods Newly reported and retreated tuberculosis patients registered in Funing county,Jiangsu Province between Jun 1,2009 and Nov 30,2010 were recruited as research subjects.Geographic information system was applied to analysis the spatial clustering of tuberculosis patients.The M.TB isolates were genotyped by mycobacterial interspersed repetitive units (MIRU).Cluster was defined as two or more patients' M.TB isolates harboring identical MIRU genotype.Results During the study period,there were a total of 681 active pulmonary tuberculosis patients reported.Global Moran's I value and local Moran's I value indicated a random and sporadical manner instead of global spatial clustering of tuberculosis patients in Funing county.Spatial scan statistics (SaTScan) showed that the patients in Guoshu town was statistically significant in spatial clustering (RR=1.85,P=0.036).Among 169 strains of M.TB,27 strains distributed in 12 clusters,which indicated recent transmission among patients within the cluster.Conclusions In rural areas with high tuberculosis incidence,it is less likely to have massive tuberculosis outbreak.Sporadic transmission of tuberculosis may have played an important role in the transmission of tuberculosis in high prevalence area.

Objective: To evaluate the influence of recombinant human brain natriuretic peptide(rhBNP)on ventricular remodeling and ventricular systolic synchrony in patients with acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI).Methods: A total of 48 patients with AMI after PCI were randomized into two groups: rhBNP Group (n=25) and Routine treatment Group (n=23).Two dimension echocardiography was used to measure the index of left ventricular end-diastolic volume (LVEDVI), the index of left ventricular end-systolic volume (LVESVI), left ventricular ejection fraction (LVEF), the index of left ventricular mass (LVMI), the movement index of infarcted regional wall (RWMI) at 1 week, 4 weeks and 24 weeks after the treatment procedure.And at 1 week and 24 weeks period, equilibrium radionuclide angiography was performed respectively to evaluate the ventricular systolic synchrony.Results: ①1 week after PCI, LVESVI in rhBNP group was decreased and LVEF was increased than that in Routine treatment group (P<0.05, respectively).4 and 24 weeks after PCI, LVEDVI, LVESVI, LVEF were significantly different in rhBNP group than those in Routine treatment group (P<0.05,respectively).24 weeks after PCI, RWMI and LVMI were significantly decreased in rhBNP group than those in Routine treatment group(P<0.05,respectively).②24 weeks after PCI, phase shift, full width at half maximum and peak phase standard deviation were significantly improved in rhBNP group than those in Routine treatment group (P<0.05, respectively).Conclusion: Intravenous injection of rhBNP could inhibit left ventricular remodeling and improve left ventricular function.

Objective To introduce experiences with non-elongated cheiloplasty and rectangular mucomuscular complex flaps of double vermilion for repairing bilateral cleft lips. Methods 29 patients (20 males and 9 females) with bilateral cleft lips underwent operations of non-elongated cheiloplasty and rectangular mucomuscular complex flaps of double vermilion. There were 15 bilateral complete cleft lips, 11 bilateral incomplete cleft lips and 3 bilateral mixed cleft lips. The deformity of white lips was reconstructed with traditional non-elongated cheiloplasty. When repairing the vermilion, the rectangular mucomuscular complex flaps which included mucous membrane of vermilion and part of orbicularis oris in double vermilion were designed, and vermilion of fore lip was incised along boundary of wet lip and dry lip. Then rectangular mucomuscular complex flaps of double vermilion were rotated downward and inward to be sewn with fore lip. At the step, the end of orbicularis otis should be sewn widely and fitly in order to form a normal annular structure. Results The wounds of all the patients were healed at one stage. The height and width of patients' upper lips were proper and the center tubercles of the upper lips were obvious. No whistling deformity appeared. Conclusion The method for repairing bilateral cleft lips is simple and reliable. Less tissues could be excised and the satisfactory form and function of nose and lip could be achieved. It is worthy to be applied in clinical practice.