In this study, we obtained the TiO2 films with different thickness by micro-are oxidation (MAO) on commercially available pure titanium. By altering the duration time, we got the films 5 microm, 10 microm, and 20 microm in thickness, respectively. XRD and SEM were employed to characterize the phase, composition and microstructure of the films. The MAO film, which was about 5 microm thick, was porous and even with the pore size about 1 microm. No other crystalline phase except anatase was detected by XRD. The film, which was 10 microm thick, was similar to the former. The pores were well separated and homogeneously distributed over the surface. The XRD pattern indicated that the film was composed of anatase and a minor amount of rutile, whereas the pore size of 20 microm film was about 4-6 microm and was bigger than the others. Furthermore, the small cracks were easy to observe. XRD pattern showed that the Ti peak was significantly reduced and new Ca, P, O containing compound was formed in addition to rutile and anatase with the film thickness increasing. There were significant differences in regard to surface roughness of the three groups. These findings suggest that the film thickness has an intense effect on the quality of the MAO coating. By changing the film thickness, we can extensively change the composition, structure and chemical properties of the surface layer on titanium.
Coated Materials, Biocompatible ; chemistry ; Oxidation-Reduction ; Porosity ; Surface Properties ; Titanium ; chemistry

Objective: To understand the changing trend of the teaching environment of the elementary and secondary schools in Zhengzhou, and to provide data for further improving the teaching environment of the elementary and secondary schools. Methods: A survey of teaching facilities and teaching aids in 534 secondary and primary schools in Zhengzhou was conducted from 2014 to 2018 by using a stratified random sampling method. Results: Teaching facilities: the qualified rate of the railings in the outer corridor of the teaching building was 88.8% (474), the qualified rate of classroom lighting was 79.6% (425), the qualified rate of the light desk distance was 82.8% (442), and the qualified rate of black plate lights 86.1% (460), the qualified rate of each year was statistically significant ( χ 2=9.97, 23.74, 80.10, 53.33, P <0.05); the qualified rate of classroom area per capita was 52.8% (282), the qualified rate of the outer corridor width of the teaching building was 64.0% (342), the qualified rate of each year showed no statistical difference( χ 2=7.38, 8.71, P >0.05). Teaching ancillary facilities: the proportion of centralized water supply was 65.0% (347), toilet with hand washing facilities was 81.6% (436), these two indicators showed an increasing trend, hand washing facilities in campus was 70.6% (377), showed a decreasing trend, the rate of each year differed significantly( χ 2=88.62, 42.71 , 123.53, P <0.05). Conclusion The overall situation of teaching environment in Zhengzhou primary and secondary schools is relatively good, the qualified rate of most indicators of teaching facilities increased from 2014 to 2018. However, there are still some indicators to be strengthened.

Objective:To explore the differences of renal dynamic imaging parameters between operation group and non-operation group in infants with severe hydronephrosis, so as to accumulate theoretical basis for diuretic renal scintigraphy to help the treatment decision making.Methods:A total of 107 infants (age: 3(2, 6) months; 90 males and 17 females) with severe hydronephrosis, who underwent diuretic renal scintigraphy between March 2018 and October 2021 in Shanxi Children′s Hospital were retrospectively reviewed. All patients were diagnosed with ureteropelvic junction obstruction and divided into operation group ( n=87) and no-operation group ( n=20). The differences of differential renal function (DRF), peak time, half-time and drainage curve between the two groups were compared with the independent-sample t test or χ2 test, and the correlation between the renal function of the affected side and the anteroposterior pelvic diameter (APD) was analyzed with Pearson correlation analysis. Results:The operation group included 17 patients with DRF<40%, 60 patients with DRF between 40%-55%, and 10 patients with DRF>55%(supernormal renal function). The 40%-55% was considered as normal DBF, and the rest were abnormal. Infants with abnormal renal function in the operation group ( n=27) were more than those in the non-operation group ( n=3), but there was no statistical difference ( χ2=2.07, P=0.150). The proportion of obstruction curve in the operation group (85.1%, 74/87) was significantly higher than that in the non-operation group (55.0%, 11/20; χ2=7.24, P=0.007). Compared with the non-operation group, the peak time of affected kidney in the operation group was significantly longer ((22.77±7.52) vs (15.26±10.29) min; t=3.78, P<0.001), as well as the peak time of contralateral kidney ((11.25±8.47) vs (6.65±5.75) min; t=2.30, P=0.023). There was a negative correlation between the DRF of the affected side and the APD ( r=-0.48, P<0.001). Conclusions:The DBF is mostly in the normal range in infants with severe hydronephrosis, and supernormal renal function is common. The previous operation indication (DRF<40%) is not suitable for the infants, and it needs to be analyzed combined with the type of curve and the APD determined by color Doppler ultrasound. The prolongation of contralateral renal peak time may be an important parameter for the surgical evaluation of severe hydronephrosis in infants.

Objective:To report two cases of steroid-resistant nephrotic syndrome (SRNS) caused by LAMB2 gene mutation, and summarize the characteristics of genotype, clinical and pathological phenotypes of children with LAMB2 gene mutation. Methods:Two cases with SRNS caused by LAMB2 gene mutation were from Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology in December 2013 and September 2019. The demographic, family history and clinical data of two cases were collected, and the peripheral blood genomic DNA was captured and sequenced by whole exome sequencing. PubMed, Medline, CNKI and Wanfang databases were searched to summarize the clinicopathological phenotypes and genotypes of patients with LAMB2 mutation. Results:Among the two cases with SRNS caused by LAMB2 gene mutation, the clinical phenotypes were all manifested as nephrotic level of proteinuria and hypoalbuminemia, and there was no extrarenal clinical manifestation. One case presented with basement membrane delamination and the other with focal segmental glomerulosclerosis (FSGS). LAMB2 mutations of two cases were Exon32 c.5390G>T(p.Cys1797Phe), Exon19 c.2557C>T(p.Arg853*) and Exon27 c.4370G>A(p.R1457Q), Exon23 c.3325G>A(p.E1109K), respectively. In literature retrieval, there were 37 cases with LAMB2 gene mutation, including 24 cases with renal biopsy data, 13 cases of focal segmental glomerulosclerosis (FSGS), 4 cases of minimal change disease, one case of diffuse mesangial sclerosis, one case of IgM nephropathy, two cases of thin basement membrane nephropathy, and three cases of mesangial hyperplasia. Among them, eight cases had basement membrane delamination tear. Among the 37 cases, 11 cases were homozygous, 22 cases were complex heterozygosity, and 4 cases were heterozygous mutation. Conclusions:LAMB2 mutation may cause delamination tear of glomerular basement membrane. The clinical phenotype is congenital nephrotic syndrome or SRNS. The literature review shows the extrarenal manifestations caused by LAMB2 mutation are mostly various ocular abnormalities, as well as respiratory, digestive and nervous system abnormalities, and the time of progression to end-stage renal disease is also different.

The purpose of value-based healthcare is to effectively control medical costs on the basis of comprehensively improved healthcare quality, which is the key focus of medical system reform in China. Improving information system framework, establishing scientific evaluation methods and transforming medical insurance payment methods are the impetus for value-based healthcare practice in China. "Screening, assessment and intervention" is the critical step in standardized medical nutrition management. In line with the connotation of value-based healthcare, nutritional risk screening aims to improve clinical outcomes. The diagnosis of malnutrition per the Global Leadership Initiative on Malnutrition (GLIM) criteria enables the inclusion into Diagnosis Related Groups (DRGs). Oral nutritional supplement is the preferred medical nutrition treatment for patients at nutritional risk or with malnutrition and insufficient food intake. Standardized application can reduce weight loss, improve clinical outcomes, save medical costs and improve the health and survival of malnourished elderly patients at a lower cost, exemplifying the value-based healthcare model.

Objective:To investigate the prevalence of malnutrition in hospitalized elderly patients with cancer in China using the Global Leadership Initiative on Malnutrition (GLIM) criteria.Methods:The data of 854 elderly cancer patients were extracted from the database of multi-center investigation and research on the dynamic changes of nutritional status of hospitalized patients in China led by the Geriatric Nutritional Support Group of Chinese Society of Parenteral and Enteral Nutrition. Changes in anthropometrics, nutritional risk and malnutrition prevalence from admission were collected at discharge and were compared among patients with different cancer types.Results:The prevalence of nutritional risk (NRS 2002 score ≥ 3 points) and malnutrition diagnosed per GLIM criteria were 63.23% and 42.74% at admission, and 69.44% and 42.86% at discharge. When further graded, prevalence of moderate malnutrition decreased from 24.12% at admission to 10.07% at discharge, and that of severe malnutrition increased from 18.62% to 32.79%, both with statistical significance. There were significant differences in anthropometric and laboratory parameters between malnutrition and non-malnutrition groups diagnosed per GLIM criteria.Conclusions:The GLIM criteria is applicable for the diagnosis of malnutrition in elderly cancer patients. Elderly cancer patients should be screened for nutritional risk, and GLIM criteria can be used to diagnose malnutrition. The changes of nutritional status should be dynamically monitored during hospitalization

Intestinal barrier function impairment can lead to bacterial and toxin translocation in critically ill patients and is an important factor in gut-derived infections and even multiple organ failure. Early enteral nutrition (EEN) can nourish the intestine, prevent bacterial translocation, effectively maintain intestinal barrier function and immune function and provide metabolic substrates for the body, bringing clinical benefits. For critically ill patients such as those with severe acute pancreatitis, severe burns and severe traumatic brain injury and those after major abdominal surgery, there is evidence-based proof supporting EEN while in patients with uncontrolled shock and severe hypoxemia and acidosis, the initiation of EEN should be delayed. EEN in critically ill patients can be applied orally or through nasogastric tube. Dietary fiber-free intact protein preparations are recommended at initiation and administration via continuous pumping can improve EEN gastrointestinal tolerability.

In recent years, enteral and parenteral nutrition has seen vigorous development, and relevant diagnosis and treatment system in clinical nutrition has been further improved. The updates of nutrition guidelines and consensus for different disease categories and different populations are conducive to guiding the comprehensive development of clinical diagnosis and treatment. With the focus on "medical nutrition, standardization and innovation", here we presented the latest progress on clinical nutrition under diverse clinical settings, including neurology, hepatology, nephrology, geriatrics, surgery, oncology, pediatrics, pharmacy, etc., comprehensively covering the basic research, clinical research, the latest guideline consensus, treatment strategy, disease management and other perspectives.

Objective:To investigate the prevalence of malnutrition in hospitalized patients with lung cancer in China using the global leadership initiative on malnutrition (GLIM) criteria.Methods:A retrospective analysis was performed with 623 lung cancer patients selected from the national multi-center prospective investigation database in 2014. The diagnosis of malnutrition was according to GLIM criteria with muscle mass reduction not included. The prevalence of malnutrition in patients with lung cancer was investigated and the correlation between malnutrition diagnosis per GLIM criteria and anthropometry as well as laboratory indexes was explored.Results:Among the 623 lung cancer patients, 33.5% (209) were at nutritional risk as per Nutritional Risk Screening 2002, 17.8% (111) were malnourished as per GLIM criteria. There were significant differences in age, body weight, body mass index, arm circumference, leg circumference, grip strength, hemoglobin, albumin, total protein and prealbumin between malnutrition and non-malnutrition groups as diagnosed with GLIM criteria ( P<0.05). Conclusions:The nutritional risk and malnutrition prevalence in lung cancer patients are relatively high. The nutritional risk screening of lung cancer patients should be standardized and the GLIM criteria can be used for the diagnosis of malnutrition.

Micronutrients (MNs), including vitamins and trace elements, play an indispensable role in human metabolism, immune function and other aspects. Due to the chronic microinflammation and long-term chemoradiotherapy, patients with malignant tumors often suffer from malnutrition, resulting in different degrees of MNs deficiency. In severe cases, MNs deficiency is closely related to the adverse clinical outcomes. Therefore, reasonable MNs supplementation is of great significance in improving the prognosis and quality of life of patients with tumors. Recently, multiple guidelines have made recommendations on the application of MN supplementation in various clinical settings, providing evidence for the standardized MN supplementation in patients with malignant tumors.