Objective Reviewing the surgical outcome of neonates with critical congenital heart diseases(CHD) in the past five years,to summarize the experiences of the treatment for neonates with critical CHD .Methods From Jan.2009 to Dec.2013,521 neonates with critical CHD were admited,all of them were received surgical treatment.Age ranged from 1day to 28 days, mean(21 ±6) days;weights ranged from 2.1 kg to 3.6 kg, mean(2.8 ±0.5)kg.All the children were received op-eration,and cared in cardiac intensive care unit(CCU) postoperatively.Results 22 cases died after surgery,the hospital mor-tality was 4.2%.68 children were left sternal open after the primary repair;39 children inhaled nitric oxide(NO) for the post-operative pulmonary hypertension;22 children needed peritoneal dialysis for acute renal failure;3 children used extracorporeal membrane oxygenation(ECMO) as circulatory support.Follow-up found 18 cases(12.1%) of TGA occurred supravalvular pul-monary stenosis after the arterial switch operation;12 cases(11.0%) of CoA/VSD&IAA/VSD had recoarctation after the aortic arch reconstruction;7 cases(5.6%) of TAPVD occurred postoperative pulmonary venous obstruction.Conclusion Early in-tervention of neonates with critical CHD has achieved excellent results.The time of operation, surgical techniques, cardiopul-monary bypass techniques and perioperative management are key factors to improve the outcome of critical CHD .

Objective:To compare the efficacy and safety between direct anterior approach (DAA) and posterior approach (PA) in total hip arthroplasty.Methods: This study evaluated postoperative results of 92 consecutive total hip arthroplasties performed by a single surgeon;44 from the DAA,and 48 from PA.The age,body mass index,operation time,blood loss,hospital stay,positioning of the artificial hip,postoperative Harris score and postoperative complications were recorded and analyzed.Results: Both the average age of the patients separately (58.0±11.9) years in DAA group and (61.0±10.4) years in PA group and the body mass index (25.1±3.7) in DAA group and (24.7±3.3) in PA group,showed no significant difference between the two groups.The DAA group had significantly reduced the hospital stay (3.8±1.7) days vs.(4.9±2.3) days for the PA group (P<0.05) and operation time was (76.0±17.4) min in DAA group,and (71.0±14.3) min in PA group (P>0.05).The amount of blood loss: in group DAA (238.0±55.3) mL,and in group PA (387.0±61.2) mL (P<0.05).There was no statistical difference in the positioning of the artificial hip: the cup anteversion in DAA group and PA group was 17.3°±5.3° vs.18.6°±5.1°,the cup inclination was 38.5°±5.7° vs.37.7°±5.2°.In DAA group,there was significantly less use of assistive devices [(24.6±7.8) d vs.(31.7±10.2) d,P<0.05],and the pain was significantly lower.Harris score at the end of 6 weeks of the follow-up: in DAA group 85.7±5.4,and in PA group 81.3±6.1 (P<0.05);at the end of the last follow-up: in DAA group 93.4±4.7,and in PA group 92.3±5.3 (P>0.05).Complications were encountered in the two groups.There were two intraoperative complications (4.4％),1 great trochanter fracture and 1 lateral cutaneous nerve injury in DAA group.No dislocation was observed in DAA group.One dislocations and 1 groin pain were recorded in PA group.No prosthesis loosening,deep vein thrombosis,sciatic nerve injury and other complications occurred in the two groups.Conclusion: Total hip arthroplasty using the anterior approach allows for superior recovery and better stability.

Objective: To investigate the intake of liquid dairy products and identify its influencing factors among the fourth grade students in Nanjing City. Methods: The fourth grade students were selected as the study subjects in Nanjing City using a multi-stage random cluster sampling method in September 2020. Their general information, frequency of liquid dairy product intake one week prior to survey and mean intake amount per time were collected. According to the 2016 Dietary Guidelines for Chinese Residents, weekly intake of liquid dairy products of 2 100 g and greater was defined eligible. Factors affecting the frequency and amount of liquid dairy product intake were identified using multivariable logistic regression analysis. Results: A total of 2 268 questionnaires were allocated and 2 216 valid questionnaires were recovered, with an effective recovery rate of 97.71%. The respondents included 1 199 boys ( 54.11% ) and 1 017 girls ( 45.89% ). The frequency of liquid dairy product intake was (6.41±4.86) times per week, and the median intake amount was 1 250.00 g per week (interquartile range, 1 750.00 g per week). There were 607 students ( 27.39% ) consuming liquid dairy products of 2 100 g and greater a week, and 1 016 students ( 45.85% ) consumed liquid dairy products for 7 times and more a week. Multivariable logistic regression analysis showed that living in urban areas ( OR=1.204, 95%CI: 1.005-1.443 ), knowing nutrition labels ( OR=1.221, 95%CI: 1.021-1.460 ), periodical measurement of body weight (OR=1.486, 95%CI: 1.098-2.011) and restricted intake of sugar-containing drinks ( OR=1.264, 95%CI: 1.005-1.590 ) facilitated the intake of liquid dairy products for 7 times and more a week, and students with periodical measurement of body weight were more likely to consume liquid dairy products for 2 100 g and greater a week ( OR=1.821, 95%CI: 1.240-2.676 ). Conclusions Inadequate intake of liquid dairy products is found among the fourth grade students in Nanjing City. Residence, awareness of nutrition labels, periodical measurement of body weight, and parental restriction of sugar-containing drink intake affect the intake of liquid dairy products.

OBJECTIVETo investigate the expression of beta-dystroglycan (beta-DG) and the roles of tissue inhibitor of metalloproteinases (TIMPs) on beta-DG in salivary adenoid cystic carcinoma (SACC).

METHODSbeta-DG in highly lung metastatic cell line ACC-M and lowly lung metastatic one ACC-2 was tested by immunocytochemistry with different concentrations (10, 15, 20, 25 micromol x L(-1)) of TIMPs, and that without the regulation of TIMPs was served as controls. beta-DG was detected in seven specimens of SACC and ten cases of normal salivary gland tissues which were considered as a comparison group by immunohistochemistry.

RESULTSThere was no positive beta-DG immune-staining at the ACC-2 and ACC-M cell lines without TIMPs in the cell culture. beta-DG expressed after the regulation of TIMPs. beta-DG expression was localized predominantly in basement membrane of the acinus, while the negative results were distributed in the carcinoma cells and around the cancer cell nests.

CONCLUSIONBeta-DG is widely expressed by transmembrane protein that plays important roles in connecting the extracellular matrix to the cytoskeleton, the fracture of this structure means that it is easy to invade and transfer, so restoration of beta-DG expression by TIMPs is considered to be critical for successful treatment of SACC.

Objective To investigate the prevalence of mutation in the locus 306 of embB gene in multi-drug resistant (MDR) Mycobacterium tuberculosis (TB) and evaluate the prospects for using it as a molecular marker to detect MDR-TB.Methods The 291 strains enrolled in this study were from the reference laboratory of Shanghai municipal centers for disease control and prevention, all of which had been tested for drug susceptibility.Mutation in embB 306 was screened both by amplification refractory mutation system (ARMS) and DNA sequencing.The mutation frequencies of embB 306 in the sample groups varied in drug resistance were statistically analyzed.Results 38(51.4% ) of the 74 MDR-TB were embB 306-mutant (X2 =93.8,P＜0.01).Of the 24 TB resistant to at least two drugs but not MDR, 9(37.5% ) were embB 306 mutant (X2 =60.1 ,P＜0.01 ).But only two(4.9% ) embB 306-mutant strains were found in 41 strains resistant to only one drug (X2 =6.8,P=0.0093).None embB 306-mutant strains were found in 152 pansensitive strains.The specificity of using embB 306 as a molecular marker for detecting multi-drug resistant TB was 94.9% (206/217).Conclusions As a molecular marker for screening drug resistant TB,especially MDR-TB, the gene locus embB 306 shows a relatively high sensitivity and specificity, promising a sound future for its application in clinics to realize fast screening of patients infected with MDR-TB and to provide evidence for appropriate medication.

OBJECTIVE： To systematically review the efficacy and safety of colesevelam hydrochloride combined with other hypoglycemic drugs in the treatment of T2DM， and to provide evidence-based reference for clinical treatment of T2DM. METHODS： Retrieved from PubMed， Embase， Medline， Cochrane Library， CJFD， VIP and Wanfang database during database establishement-Jul. 2019， randomized controlled trials （RCT） about the efficacy and safety of colesevelam hydrochloride combined with other hypoglycemic drugs （trial group） vs. placebo or other hypoglycemic drugs （control group） in the treatment of T2DM were collected. After extracting data from clinical studies that met the inclusion criteria， the quality of the studies was evaluated by Cochrane System Evaluator Manual 5.1.0. Meta-analysis was conducted by using Rev Man 5.3 statistical software in respects of the levels HbA1c， FPG， LDL-C， the incidence of total ADR， incidence of hypoglycemia and incidence of gastrointestinal ADR. RESULTS： A total of 11 RCTs were included， involving 2 625 patients. Results of Meta-analysis showed that HbA1c levels [MD＝－0.37， 95％CI（－0.51， －0.22），P＜0.001]， FPG level [MD＝－0.47， 95％CI（－0.88， －0.07）， P＝0.02] and LDL-C level [MD＝－0.38， 95％CI（－0.49， －0.28）， P＜0.001] in trial group were significantly lower than control group， with statistical significance. In terms of safety， the incidence of total ADR [OR＝1.24， 95％CI（1.06， 1.45）， P＝0.007] and gastrointestinal ADR [OR＝1.78，95％CI（1.05， 3.02），P＝0.03] in trial group were significantly higher than control group， with statistical significance. There was no significant difference in the incidence of hypoglycemia [OR＝1.03， 95％CI（0.62，1.72），P＝0.90]. CONCLUSIONS： Colesevelam hydrochloride combined with other hypoglycemic drugs can effectively reduce the levels of HbA1c， FPG and LDL-C in T2DM patients， but attention should be paid to the occurrence of gastrointestinal ADR.

Objective To understand the levels of water fluoride,tea fluorosis and the severity of drinking tea type of endemic fluorosis in Xinjiang from 2014 to 2016,and to provide a basis for making prevention and control measures.Methods In 2014-2016,a cross-sectional study was conducted to select six counties with serious fluorosis in Xinjiang as monitor counties,one diseased township was selected from five directions including east,south,west,north and center in each county,one village was selected in each township,and 10 families were selected to investigate the situation of brick tea drinking.Drinking water and brick tea samples were collected for detection of fluorine content,and epidemiological methods were used to analyze the prevalence of dental fluorosis and skeletal fluorosis.Results In 2014-2016,resident population per capita brick tea consumptions were 3.9-4.4 kg,per capita brick tea fluorine intakes were 4.6-6.1 mg,and the mean of tea fluorine was 433.1,385.2,432.7 mg/kg,respectively,the differences were not statistically significant (F =0.33,P ＞ 0.05);the means of water fluorine were 0.06-1.26 mg/L,and they were 0.38,0.37,0.33 mg/L,respectively,the differences were not statistically significant (F =2.64,P ＞ 0.05).The survey results showed that dental fluorosis of children aged 8-12 was 243 in three years,with a detection rate of 4.47％ (243/5 442) and the range of 0.08-0.14,which was negative.The skeletal fluorosis of adults aged 36-45 was 25 in 2015,with a detection rate of 2.75％ (25/910).Conclusions The fluorine content of some tea in drinking tea type of endemic fluorosis areas in Xinjiang is high,and the fluorine content of some water samples has exceed the standard of drinking water type disease area (1.2 mg/L).The prevalences of dental fluorosis and skeletal fluorosis are acceptable;it is recommended to maintain the previous prevention and control policies and to further monitor the tea market.

Objective:To evaluate the effect of oral iodized oil pills on iodine nutrition and thyroid function of pregnant women in Xinjiang Uygur Autonomous Region (Xinjiang).Methods:From May to July 2017, one county was selected from Ili Prefecture without taking iodized oil pills, Aksu Prefecture taking iodized oil pills once a year, and Kashgar Prefecture taking iodized oil pills twice a year in Xinjiang as survey sites, respectively; 100 pregnant women (evenly distributed in early, middle and late pregnancy) were selected from each survey county, the general data, urine and blood samples were collected, and urinary iodine and thyroid function indicators [free triiodothyronine (FT 3), free thyroxine (FT 4), thyrotropin (TSH), anti thyroglobulin antibody (TgAb), and anti thyroid peroxidase antibody (TPOAb)] were tested. Results:A total of 308 pregnant women were investigated, and 289 were finally included in the analysis, with an average age of 25 years; the body mass index (BMI) was (22.69 ± 3.07) kg/m 2. The occupation distribution was mainly farmer, accounting for 93.77% (271/289); most of them had junior high school education or below, accounting for 71.97% (208/289). The median urinary iodine of early, middle and late pregnant women in Kashgar Prefecture was 712.87, 604.50 and 656.23 μg/L, respectively, which were in iodine excess state. The iodine nutrition level of early pregnant women in Ili Prefecture and Aksu Prefecture was in iodine super suitability state, and the iodine nutrition level of middle and late pregnant women was in the iodine suitability state. The difference of median urinary iodine in early, middle and late pregnancy women between different regions was statistically significant ( Z = 53.02, 49.60, 44.66, P < 0.001). In addition, the urinary iodine of women in Kashgar Prefecture during each pregnancy period was significantly higher than that in Ili Prefecture and Aksu Prefecture ( P < 0.05). There were statistically significant differences in the levels of FT 3 among women in early pregnancy, FT 4 and TSH among women in middle pregnancy between different regions ( F = 4.59, 10.92, Z = 8.61, P < 0.05 or < 0.001). Among them, the level of FT 3 in early pregnancy in Kashgar Prefecture was lower than that in Ili Prefecture ( P < 0.05); the level of FT 4 in Kashgar Prefecture during middle pregnancy was higher than that in Ili Prefecture, and the level of TSH was lower than that in Ili Prefecture ( P < 0.05). There was no significant difference in TgAb positive rate, TPOAb positive rate and double antibody positive rate of early, middle and late pregnant women between different regions ( P > 0.05). The detection rates of hypothyroxinemia in early pregnant women in Ili Prefecture, Aksu Prefecture and Kashgar Prefecture were 13.9% (5/36), 3.2% (1/31) and 0 (0/33), respectively, and there was a statistically significant difference between different regions ( P = 0.036). The detection rates of subclinical hyperthyroidism in middle pregnant women were 0 (0/35), 0 (0/40), 17.6% (6/34), respectively, and there was a statistically significant difference between different regions ( P = 0.001). Conclusions:The results of urinary iodine in the three regions are in line with the iodine nutrition distribution under their respective iodine supplement strategies. Pregnant women in Kashgar Prefecture present iodine excess status after taking iodized oil pills; at the same time, the serum FT 3, FT 4 and TSH levels of pregnant women in Kashgar Prefecture are affected by iodine nutrition levels. Although it is scientific and effective to implement the intensified iodine supplement measures for pregnant women, it is still necessary to further study the suitability of oral iodine oil pills to ensure that pregnant women are at an suitability iodine nutrition level.

Objective: To investigate the influencing factors of smoking tendency of adolescents and to analyze the influence of e-cigarette on smoking tendency of teenagers and the possible interaction, to provide evidence for tobacco control measures. Methods: Stratified multistage cluster probability sampling method was used to select 6 178 students from junior middle school, high school and vocational high school students in Shanghai for questionnaire survey from September to October 2019. Students with smoking tendency were taken as case group, adolescents with same sex and similar age(within 1 year) were mathed in 1∶3 ratio. A total of 631 adolescents with smoking tendency and 1 870 non-smoking tendency were included in the study. Conditional Logistic regression was used to analyze the influencing factors and possible interactions. Results: After adjusting gender, age and other covariates, conditional Logistic analysis results showed that the smoking tendency of middle school students was associated with factors such as their friends smoking, trying cigarettes and trying e-cigarettes. The OR value and 95%CI were 3.26(2.47-4.29), 5.90(3.76-9.24), and 3.28(2.11-5.10), respectively. The interaction analysis results showed that the OR value and 95%CI of the multiplying interaction between friends smoking and trying e-cigarettes, trying smoking and trying e-cigarettes were 8.62(4.90-15.17) and 12.01(6.02-23.95), respectively. There was no additive interaction. Conclusion Tobacco control interventions, such as e-cigarette harm publicity and peer education, can help to change teenagers smoking tendency and further reduce their tobacco use rate.

Objective:To estimate the iodine nutrition level of pregnant women and children in Xinjiang.Methods:Using cluster random sampling method, from March to September in 2018, in the whole district, county (city, district) was treated as a unit to conduct sampling; each county (city, district) was divided into five areas (east, west, south, north, middle), 40 children aged 8 - 10 and 20 pregnant women in each area were randomly selected, salt samples and urine samples were collected to measure iodine content, and B-ultrasound method was used to detect thyroid volume in children.Results:Among 94 counties (cities, districts), 18 859 salt samples were collected from children and 9 070 salt samples from pregnant women. The median salt iodine (interquartile range) for children was 26.65 (23.70, 29.80) mg/kg, and the median salt iodine (interquartile range) for pregnant women was 26.60 (23.80, 29.80) mg/kg. Totally 17 736 qualified iodized salt samples and 109 non-iodized salt samples consumed by children were tested, the coverage rate of iodized salt was 99.42% (18 750/18 859), qualified rate of iodized salt was 94.59% (17 736/18 750), the consumption rate of qualified iodized salt was 94.05% (17 736/18 859), and the non-iodized salt rate was 0.58% (109/18 859). Totally 8 533 qualified iodized salt samples and 57 non-iodized salt samples consumed by pregnant women were tested, the coverage rate of iodized salt was 99.37% (9 013/9 070), the qualified rate of iodized salt was 94.67% (8 533/9 013), the consumption rate of qualified iodized salt was 94.08% (8 533/9 070), and the non-iodized salt rate was 0.63% (57/9 070). Twelve counties (cities, districts) had a consumption rate of qualified iodized salt lower than 90% for children, and 14 counties (cities, districts) had a consumption rate of qualified iodized salt lower than 90% for pregnant women. Totally 18 862 8 - 10 years old children's urine samples were detected, median urinary iodine was 227.0 μg/L, no county (city, district) was found with median urinary iodine < 100 μg/L. A total of 9 070 pregnant women's urine samples were detected, median urinary iodine was 182.0 μg/L, and 23 counties (cities, districts) had a median urinary iodine less than 150 μg/L. B ultrasound was used to detect thyroid volume in 18 787 children aged 8 - 10 years, 231 children had goiter, and the goiter rate was 1.23%, ranged from 0 to 12.05%, and 2 counties (cities, districts) had goiter rate > 5%.Conclusions:There are still some areas in Xinjiang with the consumption rate of qualified iodized salt < 90%. Children's iodine nutrition is greater than the appropriate amount (200 - 299 μg/L), pregnant women's iodine nutrition is appropriate (150 - 249 μg/L), and children's goiter rate generally meets national elimination and control standards (< 5%). Monitoring of iodized salt should be strengthened, and iodine nutrition levels in children and pregnant women should be continuously monitored.