A nutritional survey of 101 uncomplicated primigravidas and the relationship between maternal diet and infant birth weight were investigated. The maternal intake of protein, calcium, riboflavin and retinol during the pregnancy was lower than the amount that RDA suggested especially in the 2nd and 3rd trimesters. The intake of calories, fat, thiamine, riboflavin and nicotinic acid in the 2nd and 3rd trimesters were increased in compa-rision with the 1st. The correlation and stepwise regression analysis indicated that maternal intake of calories, protein, fat, carbohydrate, iron, calcium and riboflavin during pregnancy was significantly correlated to the birth weight.

The biochemical study of the nutritional status of 101 healthy pregnant women and cord blood samples showed that maternal serum protein, albumin, hemoglobin (Hb), iron (Fe), zinc (Zn) and calcium (Ca) were decreased, and serum transferrin and copper (Cu) were increased in the course of gestation.Correlation coefficients and stepwise regression analysis suggested that the concentrations of serum protein, Fe, Zn, Ca,Hb were positively correlated with the intake of calories, proteins, animal foods (especially fish and meats), Ca and vitamin C.The concentration of cord blood Ca,Zn and Fe were found highly related to the maternal serum levels in the late stage of pregnancy (P

Objective To establish axenic cultivation of Pneumocystis carinii (P.c). Methods The organisms of P.c were isolated from the bronchoalveolar lavage fluid (BALF) of the rats with Pneumocystis carinii pneumonia (PCP) and cultured in a medium which was based on IMDM (GIBCO) supplemented with S-adenosyl-L-methionine, putrescine, N-acetyl glucosamine, putrescine, L-cysteine and L-glutamine, and newborn calf serum. The organisms cultured in the system were identified by observing the morphology of cysts in smears stained with Gomori's methenamine silver nitrate stain (GMS). Ultrastructure of the cysts/trophozoites was examined by transmission electron microscopy. The sequences of mitochondria] large ribosomal DNA subunit of the cutured organisms were compared with the Pneumocysti carinii f.sp. ratti variant isolate (GenBank No U20173) and Pneumocystis carinii f.sp.hominis (GenBank No M58605). Results Five isolates of P.carinii received from BALF of 8 rats with PCP were cultured axenically and continuously in the system. The cultured organisms could be stored in frozen condition and used to reinitiate culture, and were amplified by 19-22 times within 72 h. The morphology, ultrastructure and gene sequencing of the cultured organisms confirmed that the isolated organisms were P.carinii. Conclusion Five continuously and axenicly cultured isolates of P.carinii have been received.

OBJECTIVE:To provide reference for the approval of Chinese medicines’patent application in the United States. METHODS:The requirements of patent eligibility in the United States were interpreted;two important patent cases(“Mayo case”and“Myriad case”)were analyzed in recent years,and the effects of“patent eligibility guideline”on Chinese medicines’patent ap-plication in the United States were also analyzed;the suggestions were put forward according to the situation of Chinese medicines’ patent application. RESULTS & CONCLUSIONS:Patent eligibility required that patent protection objects should be included in ob-ject range which could be vested patent right stated in patent law. The analysis of“Mayo case”“Myriad case”and patent eligibility guideline indicated that if related Chinese medicines’patent was to obtain patent approval in the United States,notable difference between the medicine and natural products as well as the order of nature must be clearly stated;technical attributes should be em-phasized,and different patent application ideas were adopted for different types of invention in order to guarantee patent eligibility. At present,small number of Chinese medicine’s patent in the United States come from China,and relevant enterprises should liber-ate themselves from the misperception that Chinese medicines do not hold patent eligibility. Hence,it is suggest that the first claim in the patent should not be too definite in Chinese medicines’patent application,afford more comprehensive application,strength-en patent protection of classic Chinese medicine recipe and stress patent eligibility.

Axillary lymph node status isone of the most important prognostic factors for the patients with breast cancer.Physical examination combining with ultrasound, mammography, CT, MRI and PET-CT can improve the predictive efficiency, but there is still high false negative rate.Ultrasound-guided fine-needle aspiration for axillary lymph node can improve preoperative diagnostic rate effectively.Using mathematical and statistical methods, building models for predicting sentinel lymph node or non-sentinel lymph node status with clinicopathological features helps to calculate the risk of lymph node involvement.Whether screening out patients with low risk of lymph node involvement avoiding axillary surgery is safe or not is still to be evaluated by relevant clinical trials.

Objective:To analyze the correlation and diagnostic value of serum homocysteine (Hcy), methionine (Met) and cysteine (Cys) in patients with chronic heart failure (CHF).Methods:One hundred and seventy-eight patients with acute decompensation CHF (CHF group) and 70 healthy persons (healthy control group) from October 2018 to September 2019 in Affiliated Zhongshan Hospital of Dalian University were continuously enrolled. In CHF group, heart failure with reduced ejection fraction (HFrEF) was in 53 cases, heart failure with mid-range ejection fraction (HFmrEF) was in 50 cases, and heart failure with preserved ejection fraction (HFpEF) was in 75 cases. Serum levels of Hcy, Met and Cys were detected by tandem mass spectrometry. Serum level of N-terminal brain natriuretic peptide precursor (NT-proBNP) was detected by electrochemical luminescence immunity. The left ventricular end-diastolic diameter (LVEDd), left ventricular end-systolic diameter (LVESd) and early diastolic peak blood flow velocity of mitral valve annulus/early diastolic peak velocity of mitral annulus (E/e′) were detected by echocardiography, then left ventricular eject fraction (LVEF) was calculated. Correlation was analyzed by Pearson correlation analysis. The receiver operator characteristic (ROC) curve was drawn, and the area under curve (AUC) was used to evaluate the efficacy of serum Hcy, Met, Cys, NT-proBNP and LVEF in the diagnosis of CHF.Results:The Hcy, Met, Cys, NT-proBNP, LVEDd and E/e′ in CHF group were significantly higher than those in healthy control group: (12.64 ± 5.02) μmol/L vs. (8.71 ± 3.47) μmol/L, (23.38 ± 5.75) μmol/L vs. (20.52 ± 4.18) μmol/L, (343.45 ± 44.49) μmol/L vs. (290.53 ± 48.38) μmol/L, (5 759.43 ± 3 806.22) pg/L vs. (40.24 ± 31.91) pg/L, (52.67 ± 12.27) mm vs. (46.41 ± 12.27) mm and (17.32 ± 5.61)% vs. (9.54 ± 2.64)%, the LVEF was significantly lower than that in healthy control group: (45.27 ± 4.93)% vs. (62.37 ± 5.41)%, and there were statistical differences ( P<0.01 or <0.05). The Hcy and Cys in patients with HFmrEF and HFrEF were significantly higher than those in patients with HFpEF: (16.29 ± 8.18) and (18.68 ± 8.99) μmol/L vs. (13.75 ± 6.48) μmol/L, (346.64 ± 51.85) and (361.40 ± 52.34) μmol/L vs. (329.35 ± 55.16) μmol/L, and there were statistical differences ( P<0.05); there were no statistical differences between patients with HFmrEF and patients with HFrEF ( P>0.05). The serum Met in patients with HFrEF was significantly higher than that in patients with HFpEF and HFmrEF: (28.74 ± 8.22) μmol/L vs. (24.76 ± 7.60) and (25.15 ± 6.96) μmol/L, and there was statistical difference ( P<0.05); there was no statistical difference between patients with HFpEF and patients with HFmrEF ( P>0.05). Pearson correlation analysis result showed that serum Hcy, Met and Cys were positively correlated with NT-proBNP ( r = 0.632, 0.206 and 0.455; P<0.01), positively correlated with E/e′( r = 0.463, 0.198 and 0.346; P<0.01), and negatively correlated with LVEF ( r = -0.491, -0.152 and -0.330; P<0.05 or <0.01). ROC curve analysis result showed that ROC the cut-off value for the diagnosis of CHF with serum NT-proBNP based on the maximum Youden index (0.994) was 120 pg/L, and AUC was 0.994 (95% CI was 0.997 to 1.000); the cut-off value for the diagnosis of CHF with serum Hcy based on the maximum Youden index (0.646) was 10.56 μmol/L, and AUC was 0.899 (95% CI 0.859 to 0.939); the cut-off value for the diagnosis of CHF with serum Met based on the maximum Youden index (0.218) was 25.58 μmol/L, and AUC was 0.637 (95% CI 0.563 to 0.711); the cut-off value for the diagnosis of CHF with serum Cys based on the maximum Youden index (0.391) was 298.05 μmol/L, and AUC was 0.765 (95% CI 0.700 to 0.830); the AUC of LVEF less than 0.5. Conclusions:Serum Hcy, Met and Cys levels in patient with CHF are significantly increased, which are positively correlated with NT-proBNP and E/e′, negatively correlated with LVEF. Moreover, serum Hcy has certain application value in the diagnosis of CHF.

Objective To assess the incidence of extrauterine growth retardation (EUGR) in very low birth weight (VLBW) preterm infants and to evaluate the effects of nutritional support and morbidities on EUGR.Methods Data of VLBW preterm infants ＜ 34 weeks of gestation admitted to the Neonatal Intensive Care Unit (NICU) of the First Affiliated Hospital of Sun Yat-Sen University between January 1,2005 and December 31,2010 were reviewed.Those VLBW preterm infants were divided into the EUGR group (n=67) and the non-EUGR group (n=40).Perinatal data,growth data,nutritional information and morbidities were compared between the two groups.The incidence of EUGR in VLBW preterm infants was assessed and the associated risk factors were analyzed.Independent samples t,Chi-square and rank sum tests and Logistic regression analysis were used for statistical analyses.Results A total of 107 VLBW infants survived to discharge.The average gestational age in the EUGR group was much lower than that in the non-EUGR group [(30.0±2.1) weeks vs (30.9 ± 1.1) weeks,t=2.904,P=0.002].However,the incidences of small for gestational age (SGA) and maternal hypertension in the EUGR group was higher than that in the non-EUGR group [SGA:53.7％ (36/67) vs 15.0％ (6/40),x2=15.575,P ＜ 0.01; maternal hypertension:40.3％ (27/67) vs 20.0％ (8/40),x2=4.689,P=0.030].Standard deviation score (SDS) of birth weight and weight at discharge in the EUGR group was lower than that in the non-EUGR group [SDS of birth weight:(--1.9±0.8) vs (--1.1±0.7),t=5.418; weight at discharge:-2.6 (-3.0--2.0) vs-0.5 (-0.9--0.1),U=30.271; both P ＜ 0.01].The velocity of weight gain in the EUGR group was lower than that in the non-EUGR group [(12.0±4.4) g/(kg · d) vs (16.1±4.0) g/(kg · d),t=1.879,P=0.036],while the maximum percentage of weight loss and the age at maximum weight loss in the EUGR group was higher than that in the non-EUGR group [percentage of weight loss:(13.2± 1.7)％ vs (9.0± 1.6)％,t=12.832,P ＜ 0.01; age:(13.4±3.5) vs (10.9±4.3) d,t=3.113,P=0.001].The time to achieve full enteral feeds,3 g/(kg · d) protein and 120 kcal/(kg · d) calories intake were longer in than the EUGR group [(39.7 ± 8.2) vs (30.8±6.1) d,t=6.293,P=0.007; (21.4±5.8) vs (17.5±1.3) d,t=4.286,P=0.002; (28.4±6.0) vs (20.3±5.4) d,t=7.198,P=0.015; 1 kcal=4.184 k J].The cumulative caloric deficit and cumulative protein deficit in the first two weeks of life in the EUGR group were significantly higher than those in the non-EUGR group [(600.9±49.3) vs (536.4 ± 55.2) kcal/kg,t=6.082,P ＜ 0.01; (17.4 ± 0.8) vs (12.4 ± 0.8) g/kg,t=31.279,P=0.003,respectively].The incidences of late-onset infection and bronchopulmonary dysplasia (BPD) in the EUGR group was significantly higher than that in the non-EUGR group [77.6％ (52/67) vs 40.0％ (16/40),x2=15.300,P ＜ 0.01;38.8％ (26/67) vs 17.5％ (7/40),x2=5.330,P=0.040,respectively].The length of oxygen therapy and mechanical ventilation in the EUGR group were significantly longer than that in the non-EUGR group [(44.5 ±4.5) vs (32.5± 1.5) d,t=20.042,P=0.030; 9.5(6.5-44.0) d vs 6.2(5.0-35.5) d,U=19.195,P=0.004,respectively].Logistic regression analysis showed that SGA,gestational age,BPD,late-onset infection,time to achieve full enteral feeds and 3 g/(kg · d) protein intake and the cumulative caloric deficit in the first two weeks after birth were the independent risk factors for EUGR (all P ＜ 0.05).Conclusions EUGR remains a serious issue in VLBW preterm infants,especially SGA,in the NICU.An early aggressive nutritional strategy,prevention of BPD and infection,and improvement of perinatal care may facilitate a reduction in the occurrence of EUGR.

The nutritional status, serum protein, albumin, calcium, zinc, iron, SF, FEP, vitamin A, activity of RBC transketolase, and blood glutathione redu-ctase of 349 normal primigravidas, 30 healthy non-pregnant women and 42 toxemic gravidas were estimated longitudinally from the 1st trimester to delivery. It was noted that serum protein, albumin, Ca, Zn, and Fe decreased markedly in the course of pregnancy. The content of serum vitamin A showed no variation or decrease in the 3rd trimester in 1/3 of the pregnant women observed. Insufficiency of thiamine and riboflavin were noted in 16.7% and 47% of the normal pregnant women respectively. The adequate nutrients intakes in pregnancy were considered to be: Energy, +200 kcal/d; Protein, + 15g/d in the 2nd trimester and +25g/d in the 3rd trimester; Calcium 1000 mg/d in the 2nd trimester and 1500mg/d in the 3rd trimester; Zinc, 20mg/d; Iron 26 or 30 mg/d by supplementation if possible; vitaminA 1000 ?gRE/d; both thiamine and riboflavin 1.8 mg/d.

Objective The present study was to investigate the feasibility of use of high resolution magnetic reso?nance vessel wall imaging(HR-VWI)in evaluation of intracranial aneurysms. Methods We prospectively collected data from patients who had intracranial aneurysms and received HR-VWI scan before surgical treatment or conservative treatment. Aneurysms were divided into ruptured group (n=12) and unruptured group (n=88). Aneurysm site, size, neck, aspect ratio(AR), daughter sac and aneurysmal wall enhancement scale were analyzed in both groups. Univariate and multivariate Logistic regression were performed to evaluate the risk factors of aneurysm rupture. Subgroup analysis was also performed to study symptomatic and asymptomatic unruptured aneurysms. Results Aneurysm size(t=2.187,P=0.031),AR(t=3.164,P=0.002),incidence of daughter sac(P=0.012) and aneurysmal wall enhancement scale(P<0.001)were higher in ruptured aneurysm group. Multivariate Logistic regression showed that aneurysmal wall enhance?ment scale was the only independent risk factor of ruptured aneurysms(P=0.002). Subgroup analysis showed aneurysm wall enhancement scale(P<0.001) and AR(t=3.939,P<0.001) were higher in symptomatic unruptured aneurysms. Conclusion Aneurysm wall enhancement on HR-VWI is more frequently seen in ruptured aneurysms and symptomatic unruptured aneurysms. Histological study is needed for better understanding of the mechanism of aneurysm wall enhance?ment.

OBJECTIVE:To investigate the development of drug therapy of rheumatoid arthritis,and to provide reference for the study of this field in China. METHODS:All literatures were retrieved during 2005-2016 using Web of ScienceTM(called"WoS"for short)core collection as database,"Rheumatoid arthritis""Rheumatoid-arthritis""Drug therapy""Medication"as subjects,set-ting literature type as"Article""Review". Bibliometric analysis method was used to list and analyze literatures about drug therapy of rheumatoid arthritis by annual number of articles published,source journals,subjects,agencies,authors and hot issues. RE-SULTS:A total of 2 528 literatures were retrieved from WoS core collection. The number of literatures showed an overall trend of growth.Those literatures came from more than 800 journals,among which top 10 journals published 689 literatures about drug ther-apy of rheumatoid arthritis(27.25%).A total of 18 subjects were involved,and the number of literatures in"Clinical medicine"was the largest,with 1 884 literatures(74.53%).A total of 3 431 research institutions were involved,and the largest number of literatures were issued by the Harvard University,with 68 literatures in total(2.69%). A total of 14 325 researchers were in-volved,and top 10 researchers published 240 literatures about drug therapy of rheumatoid arthritis(9.49%). The frequency of 25 keywords was greater than or equal to 100 times,that of 12 was greater than or equal to 150 times."Rheumatoid-arthritis"had the highest frequency(1 740 times). In basic scientific index(ESI)database,there were 35 literatures with high citation fre-quency. CONCLUSIONS:With the literatures of rheumatoid arthritis therapy increasing year by year,the focus of research in this field is focused on the diagnosis of rheumatoid arthritis and clinical efficacy. In China,no institution or author enters the world front rank in this research field.Attention should be paid to the clinical study on drug therapy of rheumatoid arthritis.