General rules for infant formula for special medical purposes were published by National Health and Family Planning Commission of the People’s Republic of China in 2010. Lactose-free or low lactose formula is suggested to be a part of treatment in bottle-fed infants with acute diarrhea. Lactase is suggested to be taken before each feeding in breastfeeding infants with acute diarrhea. Partial hydrolyzed formula (pHF) can be added when the breast milk is insufifcient and it is mainly used during the transition from extensively hydrolyzed formula to standard formula during allergy treatment. Extensively hydrolyzed formula should be suggested as the nutritional support during milk avoidance for most of cow’s milk allergy infants. Amino acid formula is the clinical tool to diagnose the cow’s milk allergy and provides the nutritional support to severe cow’s milk allergy infants. Although preterm/low birth weight formula can decrease the rate of the extrauterine growth retardation and sustain the fast growth of preterm babies with insufifcient breast milk, Breast-milk with fortiifer is strongly recommended as the main nutritional support to keep preterm and low birth weight infants’ growth. Infants with disorders of amino acid catabolism should choose speciifc formula.

Objective To explore the early diagnosis and treatment of bronchopulmonary dysplasia (BPD) in premature. Methods Observing and analyzing the onset ,diagnosis of BPD and the outcome treated by dexamethasone in 12 cases that were hospitalized in NICU during the period from January 1994 to January 1999.The follow up study was done for 6 to 12 months after their discharge. Results All of these 12 infants treated by dexamethasone were cured and discharged. The time period of hospitalization was 31 to 67(50?14) days. The one year follow up study after discharge showed that the prognosis of 11 patients were good, only 1 infant suffered from repeated respiratory tract infection. Conclusion Careful observation on clinical manifestations and lab work should be done to those premature babies who suffered from BPD easily for early diagnosis. The early application of dexamethasone in infants with BPD showed perfect results.

Objective To evaluate the value of ultrasound-guided mammotome in the diagnosis and therapy of breast tumor.Methods From May 2006 to February 2009,a total of 205 cases diagnosed with breast tumor by physical examination or ultrasonography underwent ultrasound-guided mammotome in our department.In the patients,142 cases had single tumor and 63 cases showed multiple tumors.Among the 205 cases,impalpable lesions were detected by ultrasonography in 58 patients.Mammotome biopsy system with 11 G/8 G needles were used in the operation.After the surgery,pathological examination was carried out,and short-and medium-term follow-up results of the patients were analyzed.Results In the 205 cases,totally 356 tumors were detected.The size of the tumors ranged from 0.3 to 3.5 cm in diameter.The operation time of the patients was 10.2 min in average(1-50 min).After the surgery,22 patients showed bruise in the surgical area,and 19 patients developed hematoma(three of them received puncture of the hematoma).Post-operative pathological examination showed fibroadenoma in 98 cases,breast hyperplasia in 246 cases(154 of them were complicated with fibroadenoma),7 had intraductal papilloma,4 were diagnosed with breast cyst,and 1 showed tubular adenoma.Follow-up was achieved in 132 patients for 2 to 36 months,during the period,residual tumor was detected in 4 patients(3.0%).All the patients were satisfied with the cosmetic results of the surgery.Conclusions Ultrasound-guided mammotome is a minimally invasive procedure that can safely and reliably diagnose and remove breast tumor,particularly multiple tumors and impalpable lesions.The cosmetic results of the operation are satisfying.

Objective: To summarize the application progress of three-dimensional (3D) printed metal prosthesis in joint surgery. Methods: The related literature was extensively reviewed. The effectiveness of 3D printed metal prosthesis in treatment of joint surgery diseases were discussed and summarized, including the all key issues in prosthesis transplantation such as prosthesis stability, postoperative complications, bone ingrowth, etc. Results : 3D printed metal prosthesis has good matching degree, can accurately reconstruct and restore joint function, reduce operation time, and achieve high patient satisfaction in short- and medium-term follow-up. Its application in joint surgery has made good progress. Conclusion : The personalized microporous structure prostheses of different shapes produced by 3D printing can solve the problem of poor personalized matching of joints for special patients existing in traditional prostheses. Therefore, 3D printing technology is full of hope and will bring great potential to the reform of orthopedic practice in the future.

Objective To explore the relationship between congenital vesical ureteral reflux(VUR) and bladder dysfunction in children through videourodynamic examination.Methods Sixty-seven children with congenital VUR in the First Affiliated Hospital of Zhengzhou University from Apr.2011 to Jul.2013 were included,and their clinical information of urnary tract infection,detrusor activity,dysfunctional voiding and grade of VUR were recorded.All the children were categorized as normal,isolated detrusor overactivity (DO)and dysfunctional voiding (DV) (with or without DO) according to the manifestation of urodynamic patterns,who were also divided into groups of low grade (Ⅰ-Ⅱ) VUR or high grade (Ⅲ-Ⅴ) VUR.Data of video-urodynamic examination,urinalysis,and voiding cystourethrogram were collected to investigate the relationship between bladder dysfunction,sides and grade of VUR and urinary tract infection.Results Totally 73.1％ (49/67 cases) of children with VUR were found having bladder dysfunction,which consisted of 49.3％ (33/49 cases) of DO,23.8％ (16/49 cases) of DV.Children with isolated DO tended to manifest unilateral,low grade reflux (grade Ⅰ-Ⅱ) with less urinary infection.However,children with DV,isolated or combined with DO manifest bilateral,high grade reflux(grade Ⅲ-Ⅳ),and often with urinary infection.Conclusions Video urodynamic study is useful for evaluation of bladder function in children with VUR,which is important in management of VUR.

Objective To assess the value of the urine flow acceleration(UFA)versus maximum urinary flow rate (Qmax) for diagnosis of bladder outlet obstruction (BOO) in benign prostate hyperplasia (BPH).Methods A total of 50 men with BPH and 50 normal men were included in this study.Urodynamic examinations were performed in all patients according to the recommendations of the International Continence Society.Prostate volume,UFA and Qmax of each patient were analyzed and the results were compared between two groups.Results The UFA and Qmax of BPH group were much lower than that of the control group [(2.05±0.85)ml/s2 vs.(4.60±1.25)ml/s2 ; (8.50±1.05)ml/s vs.(13.00±3.35)ml/s,P＜0.05].The prostate volume in BPH group was increased compared with control group [(28.6±9.8) ml vs.(24.2±7.6)ml,P＜0.05].As diagnosis standard of UFA＜2.05 ml/s2 and Qmax＜ 10 ml/s,the sensitivity and specificity of UFA and Qmax in diagnosing BOO were (88％,75 ％)vs.(81％,63％).While compared with the result of P-Q chart,the Kappa values in correspondence analysis were 0.55 vs.0.35.The sensitivity,specificity and Kappa value of UFA in diagnosing BOO in BPHs were slightly higher than that of Qmax in comparison with the gold standard (BOO diagnosed by P-Q figure).Conclusions The UFA is a useful urodynamics parameter in diagnosing BOO of BPH.

Objective To detect the regulation of CXCL16 synthesis and shedding in first-trimester human trophoblasts. Methods Firstly, we analyzed the expression and secretion of chemokine CXCL16 in primary cultured trophoblasts by immunochemical staining and ELISA. Then we determined the soluble and cell-associated CXCLI6 respectively with and without treatments of cytokine IFN-γ, TNF-α, IL-4 and ADAM10 by ELISA. Results Trophoblast expressed and secreted CXCL16 in a stable level. Cytokine IFN-γ induced both synthesis and secretion of CXCL16 significantly ( P <0. 01 ) in trophoblasts. ADAM10 increased the shedding of chemokine domain of CXCL16 from trophoblasts but didn't influence the synthesis of CXCL16 protein in trophoblast. Conclusion IFN-γ and ADAM10 play important roles in production and shedding of transmembrane CXCL16 in first-trimester trophublasts.

Objective To investigate the predictive efficacy of serum aminoterminal brain natriuretic pep-tide precursor(NT-proBNP),hypersensitive C-reactive protein(hs-CRP),D-dimer(D-D)and procalcitonin(PCT)in heart failure after acute myocardial infarction(AMI),Methods A total of 100 AMI patients admit-ted to the hospital from July 2021 to July 2023 were enrolled in the study as the observation group,In addi-tion,100 healthy people who underwent physical examination in the hospital during the same period were en-rolled as the control group,The serum levels of NT-proBNP,hs-CRP,D-D and PCT were detected and com-pared between the observation group and the control group,The AMI patients enrolled in the study were fur-ther divided into the heart failure group(31 cases)and the non-heart failure group(69 cases)according to the presence or absence of heart failure.The serum levels of NT-proBNP,hs-CRP,D-D,and PCT were compared between the two groups,Univariate analysis and multivariate Logistic regression analysis were used to analyze the risk factors of heart failure after AMI,Receiver operating characteristic(ROC)curve and decision curve a-nalysis(DCA)were used to analyze the predictive efficacy of serum NT-proBNP,hs-CRP,D-D and PCT for heart failure after AMI.Results The levels of serum NT-proBNP,hs-CRP,D-D and PCT in the observation group were higher than those in the control group(P＜0.05).The serum levels of NT-proBNP,hs-CRP,D-D and PCT in the complicated heart failure group were higher than those in the non-heart failure group(P＜0.05),Body mass index(BMI),smoking history,hypertension,number of diseased vessels,serum uric acid(SUA),low-density lipoprotein cholesterol(LDL-C),NT-proBNP,hs-CRP,D-D and PCT were risk factors for heart failure after AMI(P＜0.05).ROC curve analysis showed that the area under the curve(AUC)of combined detection of serum NT-proBNP,hs-CRP,D-D and PCT for predicting heart failure after AMI was 0.857(95％CI:0.811-0.948),the sensitivity was 96.12％,and the specificity was 91.28％,which were higher than the corresponding efficacy indexes of single detection(P＜0.05).DCA analysis showed that when the high-risk threshold was 0-0.99,the net benefit rate was greater than 0,which had clinical significance,When the threshold was 0-0.76,the net benefit rate of combined detection of serum NT-proBNP,hs-CRP,D-D and PCT was better than that of serum NT-proBNP,hs-CRP,D-D and PCT alone.Conclusion Combined detection of serum NT-proBNP,hs-CRP,D-D and PCT can improve the predictive efficiency of AMI compli-cated with heart failure,BMI,smoking history,hypertension,number of diseased vessels,SUA,LDL-C,NT-proBNP,hs-CRP,D-D and PCT are risk factors for AMI complicated with heart failure.

BACKGROUND: In the process of bone defect healing, the use of biological materials loaded with drugs for local defect intervention can accelerate the repair of the defect, which provides a new method for the local treatment of bone defects. OBJECTIVE: To introduce the local application of bone tissue engineering scaffolds loaded with bisphosphonates in bone defect repair and to summarize the effects of bone tissue engineering scaffolds as a drug delivery system on the bone defect healing. METHODS: The authors retrieved PubMed, Web of Science, Springerlink, Medline, WanFang and CNKI databases with "bisphosphonates, alendronate, zoledronate, bone defect, bone tissue engineering" as key words for relevant articles published from 2006 to 2018. Initially, 235 articles were retrieved, and finally 70 articles were selected for further analysis. RESULTS AND CONCLUSION: Bisphosphonate drug is an effective inhibitor of osteoclast dissolution. It can form a drug sustained release system on the local defect by being loaded to composite scaffolds, promote the formation of new bone and accelerate the healing of the defect. For the drug delivery system of bisphosphonates, suitable scaffold materials are crucial to the osteogenic effect of composite scaffolds in the defect area. At present, the carrier materials used for bisphosphonate-loaded composite scaffolds are mainly divided into organic materials and inorganic materials. Most polymeric organic materials can directly load bisphosphonates to form good drug sustained release in the local area and obviously exert their pro-osteogenic effects, while natural materials and most inorganic materials are often combined with other materials to form composite materials as carriers to optimize the carrier performance. Most studies have also confirmed that these composite materials loaded with bisphosphonates in the defect area exert osteogenic effect in the defect area.

Objective: To study the relationship between morphological characteristics, grading, diagnosis and prognosis in phyllodes tumors (PT) of the breast. Methods: A retrospective study was carried out on 83 PTs diagnosed between 1999 and 2003 that were classified semi-quantitatively according to the WHO recommendation. Follow-up data was available for some cases, and Cox regression analysis was used to evaluate factors affecting metastasis and recurrence. Results: All cases were classified into the benign (57.8%), borderline (28.9%) and malignant (13.3%). The overall recurrence rate for the 72 cases with follow-up data was 20.8% (15/72), and was 17.5% (7/40) in benign, 22.7% (5/22) in borderline and 3/10 in malignant PT, respectively, with no significant difference (P>0.05). The median interval between the initial diagnosis and the first recurrence was 24 months. Lung or bone metastases occurred in 1/22 borderline and 3/10 malignant PT patients 5 years post-surgery. The mitotic count and the degree of stromal cell atypia were significantly correlated with recurrence (P=0.001 and P=0.006). Multivariate analysis showed that severe stromal cell atypia was an independent predictor of recurrence-free survival in PT [HR=6.40 (95% CI=1.378 to 29.732), P=0.018]. Conclusions Each parameter in the histological grading of PT may have different prognostic value, and markedly increased mitotic count and were predictive of relapse.