Objective To summarize the management of cardiopulmonary bypass(CPB) for infants below 10 kilograms with congenital heart diseases.Methods From Jan 2010 to Apr 2011,the clinical datas of 122 infants aged from 1.5 months to 2 years with body weight 3 to 10 kilograms,who underwent open heart surgery under mild or moderate hypothermia CPB were retrospectively analyzed.Results Among all the 122 infants,CPB time was 13 ～ 118 min [(62.69 ± 21.48) min],aortic cross-clamp time was 0 to 86 min [(35.47 ± 19.51) min].All patients were spontaneous resuscitation and successfully weared from the machine,no severe complications associated with CPB occurred,3 infants died (2.46％,3/122) after operation.Conclusion Using membrane oxygenator,circuit tubing and artery filter with less priming,and highflow perfusion during CPB,maintaining hemodynamics stable,holding reasonable hematocrit and colloid osmotic pressure,good myocardial protection and ultrafiltration are the significant elements of the management of CPB in infants with weight less than 10 kilograms.

Objective To study the differentially expressed genes and analyze its functional pathways of retinopathy of prematurity(ROP),in order to discover the pathogenesis and provide the theoretical basis for the prevention and treatment of ROP.Methods Fetal eyeballs of induced labor were obtained and retinal microvascular endothelial cells were isolated and cultured.The endothelial cells were divided into 7 groups according to the medium of cobalt chloride (CoC12) concentration (0 μ mol/L,100 μ mol/L,150 pμmol/L,200 μmol/L,250 pμmol/L,300 μmol/L,350 μmol/L),and 150 μmol/L CoCl2 was finally used to induce ROP model in vitro.Retinal microvascular endothelial cells were verified by adopting Ⅷ factor and CD31 antibody fluorescence staining.RNA purification,gene chip hybridization and signi-ficant analysis of microarrays were performed to screen differentially expressed genes.Genes functional pathways were studied by using gene ontology analysis software.Results (1) The proliferation activity of vascular endothelial cells decreased when CoCl2 ≥ 150 μmol/L(F =21,P ＜ 0.05).(2) In 150 μmol/L CoC]2 group,blue nucleus and green cytoplasm were visible in the second and the third generation vascular endothelial cells stained by factor Ⅷ antibody,and red fluorescence could also be observed in the cytoplasm by means of CD31 monoclonal antibody staining.However,only blue nucleus was detected in the group without CoCl2.(3)There were 326 genes differently expressed in retinal micro vascular endothelial cells induced by CoCl2 in vitro,among whom,198 genes were up-regulated and 128 genes were down-regulated.Up-regulated expression genes were 1.5 times more than those of the down-regulated genes.(4)Ten biological pathways including cell hypoxia,angiogenesis suppression and iron ion transport etc.may play important roles in ROP pathogenesis.Conclusions Hypoxic retinal microvascular endothelial cells induced by CoCl2 can successfully be used to induce cell model of ROP in vitro.Differentially expressed genes may play an important role in ROP development.Functional pathway such as hypoxic cells,inhibition of angiogenesis,iron ion transport may be associated with ROP pathogenesis.

Objective : To investigate the prevalence of occupational injury and identify its influencing factors among workers in a steel enterprise in Gansu Province, so as to provide insights into prevention of occupational injury among steel workers. Methods: Workers were sampled from a steel enterprise in Gansu Province using a cluster sampling method from January to March 2022, and participants' demographics, occupational history and occupational injury were collected using questionnaire surveys. The type of job and site and type of injury were analyzed among workers with occupational injuries, and factors affecting workers' occupational injuries were identified using a multivariable logistic regression model. Results: A total of 12 089 questionnaires were allocated and 10 725 valid questionnaires were recovered, with an effective recovery rate of 88.71%. The respondents included 9 412 males (87.77%) and 1 312 females (12.23%), and had a median age of 36.00 (interquartile range, 15.00) years. Junior college and above was the predominant educational level (6 056 workers, 56.47%), and the respondents had a median length of service of 10 (interquartile range, 11) years. The prevalence of occupational injury was 5.25% among respondents. Overhaul worker was the main type of job (11.90%), and object strike was the predominant type of occupational injury (18.25%), while the lower limb was the predominant site of injury (27.82%). Multivariable logistic regression analysis identified men (OR=2.464, 95%CI: 1.580-3.843), age (30 to 39 years, OR=2.561, 95%CI: 1.643-3.993; 40 to 49 years, OR=5.197, 95%CI: 2.679-10.079; 50 years and older, OR=10.620, 95%CI: 6.788-16.615), exposure to high temperature (OR=1.400, 95%CI: 1.165-1.683), operating equipment failure (OR=1.291, 95%CI: 1.048-1.591), absence of personal safety protection equipment (OR=1.555, 95%CI: 1.064-2.273) and safety behavior scores (OR=0.967, 95%CI: 0.937-0.996) as factors affecting occupational injuries among workers in a steel enterprise. Conclusions Men and overhaul workers are at a high risk of occupational injuries in this steel enterprise. Objectstrike is the predominant type of injury and lower limb is the main site of injury. The risk of occupational injuries is affected by gender, age, working environments, equipment status and safety behaviors.

Objective To investigate the present situation of retinopathy of the prematurity(ROP)in Guang-dong Province.Methods A total of 1 52 hospitals engaged in neonatal medical service were selected from 1 3 cities in Guangdong Province by stratified random sampling method.The questionnaires of present situation and influential factors for ROP in Guangdong Province were distributed to the hospital officers to survey the special equipment in the Neonato-logy Department,ROP specialists and their training collected,the collected related equipment and the present situation of the disease,et al.Eventually,1 22 questionnaires was collected,and the return rate was 80.26%.One hundred and twenty -two hospitals entered into the study,including 50 tertiary hospitals,72 secondary and primary hospitals.Statisti-cal analysis was done with SPSS 1 9.0.Results Tertiary hospitals were better than secondary and primary hospitals in terms of conducting the oxygen monitoring (χ2 =1 8.639,P <0.01 ),ROP screening (χ2 =40.054,P <0.01 )and ROP treatment(χ2 =8.262,P <0.05).The restriction factors in the present situation of ROP were lack of specialists,tech-nology and equipment,especially the first two factors.The difference in lack of specialists and technology between tertia-ry hospitals and the lower -level hospitals was significant(χ2 =4.520,P <0.05).There were 63 hospitals able to con-duct ROP screening,and 1 6 hospitals without equipment could carry out ROP screening through referral or inviting the experts from other hospitals.Fifty -nine hospitals which couldn′t carry out ROP screening had to refer patients to other hsopitals or invite the experts from other hospitals for consultation of high risk patients.Conclusions The present situation of ROP in the tertiary hospitals in Guangdong Province is generally satisfactory,while that in the secondary and primary hospitals stays behind.The constraints for present situation of ROP examination and treatment were lack of spe-cialists,technology and equipment.The hospitals that can′t implement ROP screening should establish regional co -operation by referral and resource sharing to improve the present situation of ROP in Guangdong Province.

BACKGROUND:Notch singling pathway is very important for cellproliferation and differentiation, but its role is stil unknown during chondrogenesis of human umbilical cord mesenchymal stem cells. OBJECTIVE:To investigate the effect of N-[N-(3,5-difluorophenacetyl-L-alanyl)]-(S)-phenylglycinet-butyl ester (DAPT) on inducing human umbilical cord mesenchymal stem celldifferentiation into chondrocytes. METHODS:Human umbilical cord mesenchymal stem cells were isolated from human umbilical cord, then were induced to differentiate into chondrocytes. There were four experimental groups:non-induced group, high-glucose Dulbecco’s modified Eagle’s medium containing 5%fetal bovine serum and 1%double antibody;induced group, induced medium containing 6.25 mg/L insulin, 6.25 mg/L transferrin, 10μg/L transforming growth factor beta 1, 0.1μmol/L dexamethasone, 50 mg/L vitamin C, 5%fetal bovine serum and 1%double antibody;dimethyl sulfoxide group, induced medium containing 0.1%dimethyl sulfoxide;DAPT group, induced medium containing 5μmol/L DAPT. RESULTS AND CONCLUSION:After chondrogenic induction, the morphology of human umbilical cord mesenchymal stem cells became polygon and positive for toluidine blue and immunofluorescence staining;the expression of Jag-1, PS-1, Notch-1 and Hes-1 decreased significantly (P<0.01). After the addition of DAPT, compared with the induced group, the relative gene expression of Jag-1, PS-1 and Hes-1 decreased markedly (P<0.01), the relative gene expression of Notch-1 decreased obviously as wel (P<0.05), and the contents of proteoglycan and col agen type II proteins decreased significantly (P<0.01). At the same time, the relative gene expression of proteoglycan decreased obviously (P<0.05), and the relative gene expression of col agen type II decreased in part. Notch signaling pathway exists in human umbilical cord mesenchymal stem cells, once chondrogenesis begins, the signaling strength wil decline rapidly. DAPT may prevent human umbilical cord mesenchymal stem cells from differentiating into chondrocytes by Jag-1-Notch-1-Hes-1 pathway.

OBJECTIVE:To investigate the utilization and trend of bisphosphonates drugs in patients with bone metastasis of breast cancer from Zhejiang province,so as to provide reference for the further promotion of their rational use. METHODS:The utilization of this type of drugs in 11 hospitals of Zhejiang province during 2010-2015 was analyzed statistically,counted and ranked by using the method of cost ranking analysis and DDDs analysis in the respect of amount,DDDs,DDC,etc. RESULTS:The amount of bisphosphonates drugs was increased steadily in 6 years(increasing greatly in 2011),increased by 96.26% in 2015,compared to 2010. Top 3 drugs in the list of amount were Zoledronic acid for injection(imported),Zoledronic acid for injection(domestic)and Pamidronate disodium for injection. Among them,Zoledronic acid for injection(imported)basically showed an upward trend,while Pamidronate disodium for injection showed decline trend. Top 3 drugs in the list of DDDs were Zoledronic acid for injection(domestic),Zoledronic acid for injection(imported)and Pamidronate disodium for injection;DDDs of Zoledronic acid for injection(domestic)and Zoledronic acid for injection(imported)were generally on the rise,while that of Pamidronate disodium for injection showed an overall downward trend. B/A value of bisphosphonates ranged 0.33-2.00,among which B/A value of Zoledronic acid for injection(domestic)was 2.00 and that of Zoledronic acid for injection(imported)was 0.50 during 2012-2015. The first and second drugs in the list of DDC were Clodronate disodium for injection and Zoledronic acid for injection(imported). CONCLUSIONS:The total amount of bisphosphonates drugs in patients with bone metastasis of breast cancer from 11 hospitals of Zhejiang province during 2010-2015 was increased steadily. Some varieties of second and third generation bisphosphonates with definite curative effect,good safety and reasonable price are dominant in clinical use. The selection and use of bisphosphonates is basically reasonable,but price is still the primary factor restricting the further wide application of some varieties.

BACKGROUND:The healing of mandibular fractures after rigid internal fixation is influenced by many factors,including the material of the bone plate,fracture site,and bone density of the patient.However,there are relatively few studies on the relationship between the stability of mandibular fracture fixation in different bone qualities and they lack a scientific basis. OBJECTIVE:To analyze the stability of fixation of mandibular fractures with different bone qualities with bioabsorbable plates and miniature titanium plates by finite element analysis. METHODS:Three-dimensional finite element models of class Ⅰ-Ⅳ mandibular fractures were developed according to the bone quality classification method proposed by ZARB and LEKHOLM.The fractures at the median mandibular symphysis,mandibular body,and mandibular angle were simulated under different bone qualities.Bioabsorbable bone grafting plates(or miniature titanium plates)were placed at each fracture site for fixation and to simulate the state of healthy side occlusion.Finite element analysis on the model was used to analyze the relative displacement of the fracture segments and the stress distribution of fixators. RESULTS AND CONCLUSION:(1)The maximum stress value during fixation with titanium plates increased gradually with the increase of bone class,in which the maximum stress value of titanium plates was the highest in the mandibular body class Ⅳ bone group,which was 382.74 MPa and 96.11 MPa in the miniature titanium plate and bioabsorbable plate groups.The results for mandibles of the same bone type showed that the maximum stress value of titanium plates was much higher than that of bioabsorbable plates.(2)For fractures of the median middle of the mandible in types Ⅲ and Ⅳ,the displacement of the fracture breaks at the fixation site was large and exceeded the limiting value of bone healing(>150 μm),regardless of whether the fixation was performed with a miniature titanium plate or a bioabsorbable plate.For type Ⅳ mandibular fractures,the fracture end displacement in the bioabsorbable plate group exceeded the healing limit value,and the fracture end displacement in the miniature titanium plate group was close to the healing limit value.Under the same bone quality and fracture site,the fracture displacement of the miniature titanium plate group was smaller than that of the bioabsorbable plate group.(3)The results showed that the strength and stiffness of the two internal fixations were sufficient to support bone healing of fractures at three sites of the types Ⅰ-Ⅳ mandible,and the fixation stability of the bioabsorbable plate was almost the same as that of the miniature titanium plate,which could provide early healing conditions for fractures.Mandibular bone type should be taken into consideration in the treatment of mandibular fracture.The higher the mandibular bone grade,the worse the stability of fracture fixation,and the more likely the complications such as poor bone healing will occur after surgery.

Objective The objective of this study was to explore the differences of serum metabolomics between small cell lung cancer(SCLC)patients and healthy volunteers,and to discover serum potential biomarkers for identification and small cell lung cancer staging. Methods Ultra-performance liquid chromatography time of flight mass spectrometry(UPLS-TOF/MS)was used to establish the serum metabolic profile of SCLC. Principal Component Analysis(PCA)and orthogonal hidden variables were analyzed by the EZinfo2. 0 software. Orthogonal Partial Least Squares Discriminant Analysis(OPLS-DA)was used to analyze the metabolic differ-ences between the case and normal control groups. Through cluster analysis using HMDB and METLIN database to search for the exact mass-to-charge ratio of the difference,preliminary identification of some substances with significant differences was carried out. Results Ten differential metabolites such as lysophosphatidylcholine between patients and control groups were screened and identi-fied by mass spectrometry and database search. There were 10 different metabolites such as glycocholic acid in the contour analysis of SCLC patients with different stages. Conclusion There is a significant difference in serum metabolism between SCLC patients and healthy controls. The discovery of differential metabolites provides experimental evidence for the identification of small cell lung cancer and potential markers of staging.

Purpose: The aim of this study was to compare the effectiveness and outcomes of percutaneous ablation guided by ultrasonography (US) and computed tomography (CT) in colorectal liver oligometastases (CLOM). Methods: This study included patients with CLOM treated with percutaneous ablation from January 2008 to January 2021 in this observational study. Only lesions visualized on both CT and US images were further analyzed according to whether patients’ initial ablation treatments utilized US guidance or CT guidance. The Kaplan-Meier method was used to estimate local tumor progression (LTP)–free survival after propensity score matching (PSM). The LTP-free survival and treatment-related outcomes were compared between these two groups. Results: PSM identified 116 patients from each group, with 269 and 238 lesions in the USguided and CT-guided groups, respectively. US-guided ablation had a shorter average procedure time and lower cost than CT-guided ablation (27.54±12.06 minutes vs. 32.70±13.88 minutes, P=0.003; $2,175.13±618.17 vs. $2,455.49±710.25, P=0.002). For patients >60 years of age, the cumulative LTP rate at 1 year was lower in the US-guided group than in the CT-guided group (17.8% vs. 25.1%, P=0.038). For patients with perivascular liver lesions, the cumulative LTP rate at 1 year was lower in the US-guided group (14.4% vs. 28.2%, P=0.040). Conclusion For patients whose age is >60 years or who have perivascular liver lesions, USguided ablation is better than CT-guided ablation, with a shorter treatment time and lower costs when both ablation methods are feasible for patients.

BACKGROUND:Bone tissue remodeling is closely related to stress loading.Currently,there are few studies or guidelines on the relationship between bone and occlusal adjustment of implant prostheses and there is also a lack of scientific evidence. OBJECTIVE:To investigate the effects of different implant occlusal gaps on stress distribution,stress peak and displacement at the implant-bone interface under Ⅰ-Ⅳ bone conditions by a finite element method. METHODS:After scanning the equal-scale tooth model with an optical scanner,equal-scale models of the upper right first molar Straumann 4.8×8 mm BL RC implant and its related components was constructed using Solidworks 2022.Then,using Mimics,Geomagic,and Solidworks software,the maxillary and mandibular bone models of class Ⅰ-Ⅳ bones were established based on the bone classification proposed by ZARB and LEKHOLM in the literature,and the NORTON and TRISI bone density classification method.The models were assembled with the occlusal gaps of 0,20,40,60,80,and 100 μm for the restorations,and an additional set of homogeneous models without density ratio settings was constructed for comparison.After the above models were imported into Hypermesh for meshing,the material assignment,boundary constraints and parameter setting were performed for the finite element analysis.Finally,250 N was used as the loading force to simulate the maxillary and mandibular stress conditions.Stress distribution,peak stress and displacement of the implant-bone interface in each group of models were analyzed and compared. RESULTS AND CONCLUSION:Under the same loading conditions,the stresses in the implant restorations were evenly distributed with the occlusal contact points.When the occlusal gap reached 80 and 100 μm,stress interruptions occurred in the implant crowns under class Ⅰ bone and class Ⅱ,Ⅲ and Ⅳ bones,respectively.The displacement of the implant-bone interface was mainly concentrated in the cortical bone region around the implant and transmitted down the long axis of the implant to the cancellous bone region at the bottom.With the changes of class Ⅰ-Ⅳ jaw bones,the displacement and Von Mises stress in the cortical bone region increased in all groups,and were greater than those in the cancellous bone region.The Von Mises stress in the cancellous bone region was similar to that in the cortical bone region except that it showed a downward trend from class Ⅱ bone.However,when the occlusal gap increased,the stress and displacement peak values in the cortical bone and the cancellous bone showed a decreasing trend.The stress of the implant-bone interface was between 20 MPa and 60 MPa when the occlusal gap was 0-40 μm for class Ⅱ-Ⅳ bones and 60 μm for class Ⅳ bone,and the stress of the other groups was less than 20 MPa.The Von Mises stress was mainly concentrated in the neck of the implant,and the peak value of von Mises stress in class Ⅱ-Ⅳ bones with the occlusal gap of 20 μm was higher than that(144.10 MPa)in class Ⅰ bone with the occlusal gap of 0 μm.In the homogeneous model with different elastic moduli,the distribution of stress and displacement was more uniform than that in the heterogeneous model and the occlusal space should increase with the decrease of jaw bone density in clinical practice.To conclude,from the perspective of biomechanics,the alveolar bone should be taken into account in the occlusal adjustment of implant denture.An occlusal gap of 20-40 μm between a single dental implant and a natural tooth in the opposite jaw is a relatively suitable solution for occlusal adjustment under different bone conditions.However,due to the particularity of finite element analysis method,it needs to be further studied in combination with clinical practice.