Objective To evaluate the safety and effects of feeding very low birth weight infants and extremely low birth weight infants with human donors' milk in China.Methods One hundred and ninety-nine very low birth weight infants and extremely low birth weight infants (VLBWI/ELBWI) admitted to NICU in Nanjing Maternity and Child Health Care Hospital were analyzed retrospectively (from August 1,2013 to July 31,2014) one year before and one year after the establishment of human donors' milk bank.Only 1 infant's parents(1/199 cases) refused to use donor milk,and 198 infants were fed with donors' milk since their own mothers' milk was unavailable.One hundred and forty-eight infants admitted to NICU from August 1,2012 to July 31,2013 were chosen as the control group,who were fed with formula milk since their own mothers' milk was unavailable.The mortality,incidence of necrotizing enterocolitis (NEC) and sepsis,time to full enteral feeding and hospital stay between 2 groups were analyzed.Results One year before the establishment of breast milk bank,there were 148 cases of very low or extremely low birth weight infants receiving mixed feeding,and 16 cases of them had neonatal necrotizing enterocolitis,the incidence rate was 10.81％.Since the establishment of human milk bank,187 women donated breast milk in the first year and 260 555 mL of human milk were collected and delivered.Only 1 infant (1/199 cases) refused to use donor milk,and 198 infants were fed with donors' milk since their own mothers' milk was unavailable.Nine babies with VLBWI/ELBWI were diagnosed as NEC in donor milk feeding group,and 16 cases were diagnosed as NEC in formula-feeding group.The incidence rate of NEC was lower in the donor-milk-feeding group (4.52％ vs 10.81％,x2 =5.02,P ＜ 0.05).Donor-milk-feeding group reached full enteral feeding[(16.4 ± 5.3) d vs (18.2 ± 6.2) d,t =2.84,P ＜ 0.05] and had shorter period of hospital stay[(35.1 ± 9.5) d vs (37.3 ± 10.4) d,t =2.05,P ＜ 0.05] compared with formula feeding group.The mortality and incidence of sepsis had no difference between 2 groups (all P ＞ 0.05).Conclusions Donors' breast milk is associated with a lower risk of NEC,sooner full enteral feeding and shorter hospital stay.Further research is needed to confirm these findings and measure the growth and long term neurodevelopment effects of donors' breast milk.

The Human Milk Banking Association of North America(HMBANA) is a professional association for supporters of non-profit donor human milk banking.HMBANA develops guidelines for donor human milk banking practices.The construction of China's human milk bank has just begun in few areas in 2013.To further promote the development and implementation of donor human milk banking in our country,this review introduce the guideline for establishment and operation of a donor human milk bank which drafted by HMBANA in 2013.The guideline can provide the basis for the development of human milk bank in our country.

Objective To study the relationship between the T helper cells (Th22)/interleukin (IL)-22 and rheumatoid arthritis (RA) with interstitial lung disease (ILD), and to define the clinical significance of Th22 cells for RA. Methods The quantity of Th22 cells in the peripheral blood from 40 patients with RA (20 RA with ILD, 20 RA without ILD) were examined by flow cytometry, the level of IL-22 in the sera was detected by enzyme-linked immunosorbent assay (ELISA). Comparisons between groups were analyzed by t-test, rank sum test, and the correlation of parameters were tested by linear correlation analysis. Results The quantities of CD4+IL-22+ cells (Th22) in RA patients [(0.15 ±0.07)%] were significantly higher than normal controls [(0.09 ±0.05)%] (t=4.097, P<0.01), and IL-22 levels in RA patients [(83 ±7) ng/L] were significantly higher than normal controls [(61±5) ng/L] (t=13.057, P<0.01). The quantities of Th22 cells in RA-ILD patients [(0.18±0.07)%] were significantly higher than RA-NILD patients [(0.13±0.05)%] (t=2.919, P=0.008), and IL-22 levels in RA-ILD patients [(87±6) ng/L] were significantly higher than RA-NILD patients [(80±6)ng/L] (t=3.624, P=0.001). The quantities of Th22 cells were positively correlated with erythrocyte sedimentation rate (ESR), rheumatoid factor(RF) and 1.4 disease activity score (DAS)28 (r=0.336, 0.377, 0.577, P<0.05),and the level of IL-22 were also positively correlated with ESR and DAS28 (r=0.406, 0.576, P<0.05). Conclusion The quantities of Th22 cells and IL-22 level are increased in RA patients, especially in RA-ILD patients. The quantities of Th22 cells and IL-22 level are positively correlated with ESR and DAS28. It may play a certain role in RA especially in RA with ILD.

Objective To knock out the entire LuxS gene of Streptococcus mutans UA159 strain via homologous recombination and construct a LuxS-deleted mutant strain of S.mutans.Methods The erythromycin resistance gene(Eymr)was inserted between the two DNA fragments located in the upper and downstream of LuxS gene that had been amplified by PCR.Then the two DNA fragments along with the inserted Eymr were engineered into pUCl9 plasmid to construct the recombination plasmid pUCluxKO.Electrotransformation of S. mutans cells with pUCluxKO-mutant resulted in the isolation of erythromycin resistant S.mutans,transformants,which was then subjected to polymerase chain reaction,Vibrio harveyi BBl70 luminescence bioassay and sequencing analysis.Results Restriction endonuclease analysis showed that pUCluxKOmutant vector had been successfully recombined.The deletion of LuxS of S. mutans mutants was confirmed bv PCR with primers specific for the genes of LuxS and the erythromycin resistance.S.mutans mutant could not induce bioluminescence.indicating the mutant had been successfully recombined.The constructed Chinese S.mutans showed good stability after 20 generations of cultivation.Conclusion The S.mutans gene allelic exchange plasmid is constructed correctively and a LuxS-negative mutant of S.mutans has been constructed.which can be helpful for further study of the role of LuxS in the pathogenesis of S.mutans.

Objective To investigate the clinical effects of synthetic medical calcium phosphate and calcium sulfate as the bone replacements for bone defects.MethodsA total of 85 bone trauma patients combined with bone defects treated between February 2000 and October 2011 were randomized to calcium phosphate group ( n =43 ) and calcium sulfate group ( n =42 ) according to bone substitutes.The patients had orthopedic conventional treatment and then received external fixation ( external fixators,plasters) or internal fixation (plates,needles).Forty-three patients in the calcium phosphate group were all treated with medical calcium phosphate and 42 patients in the calcium sulfate group were all treated with medical calcium sulfate.Postoperative complications,fracture healing time and bone substitute absorption time of the two groups were observed and compared.ResultsAfter artificial bone filling for bone defects,all fractures were healed,with average healing time of 12.5 weeks ( range,9-17 weeks) in the calcium phosphate group and 11.3 weeks (range,7-15 weeks) in the calcium sulfate group.No complications or abnormal reactions occurred in the calcium sulfate group,whereas four patients with incision exudation was founded in the calcium phosphate group,and was cured after dressing change.The average follow-up period was 54.5 weeks (range,14-70 weeks).Average absorption time of bone substitute for the calcium phosphate group was 7.3 weeks,longer than that for the calcium sulfate group (P ＜ 0.05 ).Conclusions Medical calcium phosphate and calcium sulfate artificial bones can both be used as bone substitutes and are characterized by convenience,safety and good healing under the auxiliary of internal and external fixators.The calcium sulfate is sturdier and has relatively stronger supporting ability than the calcium phosphate.As the bone substitute,the calcium sulfate has more precise clinical effects,fewer complications and shorter healing time than the calcium phosphate.

Objective:To evaluate the efficiency of using artificial intelligence reading label system in diabetic retinopathy (DR) grading training among junior ophthalmologists and medical students.Methods:520 diabetic fundus images were randomly divided into 8 groups with 65 images in each group. 13 junior ophthalmologists and medical students were selected as the research objects. Each of them read 8 groups of pictures and evaluated the DR grading of each fundus image. The sensitivity, specificity and diagnostic test consistency (Q-kappa value) of grading results were analyzed with the DR grading given by 3 senior ophthalmologists as the gold standard. The average Q-kappa values of 13 subjects were compared between the first four times and the last four times.Results:Through 8 round reading, the average Q-kappa was elevated from 0.67 to 0.81. Average Q-kappa of round 1 to 4 was 0.77, and average Q-kappa of round 5 to 8 was 0.81. The participants were divided into two groups. Participants in group 1 were junior ophthalmologists and participants in group 2 were medical students. Average Q-kappa of group 1 was elevated from 0.71 to 0.76. Average Q-kappa of group 2 was elevated from 0.63 to 0.84.Conclusions:The artificial intelligence reading label system was a useful tool in training junior ophthalmologists and medical students in doing diabetic retinopathy grading.

Objective:To investigate the effects of Maijun'an Tablets on expression of endothelin-1(ET-1) and nitricoxide synthase(NOS) in tissues and plasma of spontaneous hypertensive rats (SHR). Methods:12 spontaneous hypertensive rats (SHR) were divided randomly into normal control group and drug administration group. Rats in drug administration group were orally given with Maijun'an Tablets (hydrochlorothiazide 10 mg?kg-1.d-1,puerarin 36 mg?kg-1.d-1 and total alkaloid of rhynchophylla 122 mg?kg-1.d-1) once a day for 4 weeks,and rats in control group were orally dosed with equal amount of physiological saline. All animals were sacrificed after 4 weeks. The mRNA and protein contents of ET-1 and NOS in plasma,liver,kidnay and blood vessel were determined. Results:Compared with the control group,Maijun'an Tablets can effectively reduce blood pressure of SHRs,regulate down the content of ET-1 and regulate up the content of NOS at mRNA and protein levels. Conclusion:The up-regulation of NOS and down-regulation of ET-1 at mRNA and protein levels were the major antihypertensive machnisam of Maijun'an Tablets for SHRs.

Objective: To study the difference between the acid resistance of Streptococcus mulans Ingbritt C international standard strain and the acid resistance of LuxS mutant strain. Methods: Solutions of Streptococcus mulans standard strain and LuxS mutant strain with same density were prepared and cultured at pH 3. 5 to 7. 0 BH1 liquid for same period. Terminal growth situation was compared. After being acidized in pH 5.5 BHI liquid, the two strains were cultured at pH 3.0 BHI liquid. The acid tolerance responses of the two strains were compared. Results; (DAt pH 6.0 to 7. 0, the difference of growth between Streptococcus mulans standard strain and LuxS mutant strain was not significant at the same pH value, and the differences of bacterial growth situation under three different pH values were not significant. (1)At pH 4.5 to 5.5, the difference of growth between the two strains was significant. (2)At pH 3.0,the survival rate of LuxS mutant strain(0.006 5% )was significantly lower than the standard strain (0.078% ). (3)At pH 5.5, the survival rate of LuxS mutant strain(0.747% ) was lower than the standard strain(8.65% )by about 10 times after the pre-acidification. Conclusion; (4)At sub-lethal pH value, there is significant difference of aciduricity between Streptococcus mu-tans standard strain and LuxS mutant strain. The acid resistance of standard strain is stronger than that of LuxS mutant strain. The two strains both display the capability of acid tolerance responses. LuxS mutant strain is more sensitive to acid inactivation, but the capability of acid tolerance responses still exists.

Objective: To analyse the nutritional components and flavorous substance of the white yak,s milk. Method: In collecting the raw milk of eighteen white yaks,dry substance,protein,fat and ash were detected by routine methods;mineral elements by ICPV-1000S inductively coupled plasma atomic emission spectroscopy,amino acids by 835-Shimadzu amino acid analyzer,volatile substances by GC-MS. Results: The milk of white yak contained dried substance (18.38%),protein (6.53%),fat (5.64%),minerals (0.87%), TAA(6.36%), EAA(2.56%),two limiting amino acids (Met and Trp), EAA / TAA (40.25%), EAA/ NEAA (67.37%); seven flavorous substances: esters, alcohols,ketones and aldehydes,etc. Conclusion: The milk of white yak has distinct propertis: high protein,high fat,high energy,abundant minerals,agreeable flavor,abundant amino acid. So the milk of white yak is an excellent nutritional resource.

The decreased occupational dose limit for eye lens has lead to an extensive focus on the eye lens dose monitoring and protection for occupational staff in interventional procedures.Based on the literature investigation of existing measurement and calculation results,the efficiency and influence factors of eye lens protective equipments for interventional staff are analyzed,and the suggestions for selection and use of them are provided.The main contribution to the eye lens dose to interventional staff is unshielded radiation which reaches the eyes directly.The key factors to inflence the efficiency of eye lens protective equipment is the geometric conditions such as structure,beam projection,position arrangement and operator postures,instead of lead equivalent thickness.Equipment of 0.5 mm lead equivalent thickness is enough to protect the eye lens of interventional staff.The combination of lead glasses and lead barrier can provide better protection in clinical practice.