OBJECTIVE　To study the bioequivalence of methylprednisolone (MP) tablets in healthy volunteers.METHOD　A rapid and sensitive RP-HPLC assay was modified for the determination of the drug levels in plasma. In a randomized two-way crossover design, 40 mg single dose po domestic (B) and imported (A, MedrolTM) MP tablets, respectively, were given to 18 male healthy volunteers. The parameters were estimated by non-compartment model with a statistic analysis of ANOVA and two one-side t-test.RESULTS　The tmax,cmax,t1/2 and AUC0～∞ of tablet-B and-A were (1.9±0.5) h and (2.1±0.5) h, (597.6±119.8 ) ng*mL-1 and (572.6±121.7) ng*mL-1,(2.2±0.4) h and (2.3±0.4) h,(2528.4±558.8) h*ng*mL-1 and (2571.2±647.4) h*ng*mL-1,respectively.The mean relative bioavailability of the tablet-B vs A was 99.62%. There was no significant difference between the two products.CONCLUSION　The results suggested that these two products were bioequivalent.

Objective To evaluate the effects of phonosurgery combined with voice therapy in patients with vocal polyps accompanied with muscle tension dysphonia (MTD) .Methods The study retrospectively enrolled 117 patients with a diagnosis of vocal polyps accompanied with MTD .All the patients were divided into two groups ac‐cording to the different remedies:the surgery group (n=57) ,and the combination group (n=60) .The Xion acous‐tic analysis was carried out on the two groups before and after therapy .We compared the results in each group ,the results of post-therapy between two groups ,and that of post-therapy with the control group(n=50) .The acous‐tic parameters were jitter percent (jitter) ,shimmer percent (shimmer) ,dysphonia severity index (DSI) .Results The results obtained in the study showed that all the voice analysis parameters were significantly improved after therapy in both the surgery group and combination group(P<0 .05) .Jitter and shimmer in post -therapeutic out‐come of the combination group were lower than those of in surgery group ,and DSI was even higher(P<0 .05) .Jit‐ter and shimmer in post-therapeutic outcome of surgery group were higher than those of in normal group ,and DSI was lower than those of in normal group(P<0 .05) .But there were no clinically significant differences in post -therapeutic outcomes of combination group compared with control group(P>0 .05) .Conclusion As for vocal polyps accompanied with M TD ,successful phonosurgical treatment and voice therapy can improve patients’ voice quality .

Objective:To investigate the relationship between renin-angiotensin system (RAS) and bone mineral density in children with glucocorticoids-induced osteoporosis (GIOP) .Methods:From Apr. 2020 to May. 2021, 53 children with GIOP were recruited in the Children’s Hospital of Taiyuan Maternal and Child Health Hospital and included in the observation group, and 47 children who received glucocorticoid therapy but did not suffer from GIOP were included in the control group. The levels of serum RAS components and bone mineral density of the two groups of pediatric patients were detected and compared, and the risk clinical indicators affecting bone mineral density and GIOP were analyzed.Results:There were no significant differences between the observation group and the control group in terms of gender, age, BMI, disease type, type of glucocorticoid use, use of anti-osteoporosis (OP) drugs, expression levels of Angiotensin converting enzyme 2 (ACE2) or angiotensin II (Ang Ⅱ) (all P>0.05) . The bone density value of the observation group was lower than those of the control group, and the levels of angiotensin converting enzyme (ACE) (1.19±0.23) , angiotensin receptor 1 (AT1R) (1.24±0.24) , angiotensin receptor 2 (AT2R) (1.14±0.17) , and Mas receptor (MasR) (1.11±0.28) were significantly higher than those of the control group (1.00±0.23, 1.00±0.25, 1.00±0.21, 1.00±0.20) , and the differences were statistically significant (all P<0.05) . Pearson analysis showed that bone mineral density was negatively correlated with the levels of ACE ( r=-0.34, P=0.013) , AT1R ( r=-0.41, P=0.002) and AT2R ( r=-0.34, P=0.014) , and stepwise regression model showed that ACE ( t=-2.21, P=0.032) and AT1R ( t=-2.92, P=0.005) were the main factors affecting bone mineral density. Logistic regression model analysis showed that bone mineral density ( OR=0.85, P<0.001) , Ang Ⅱ ( OR=0.53, P=0.041) and AT2R ( OR=2.00, P=0.024) were independent clinical risk factors affecting GIOP (all P<0.05) . Conclusion:RAS components ACE and AT1R are independent risk factors affecting bone mineral density in children with GIOP, and are significantly correlated with bone mineral density in children.

Cystic hypersecretory carcinoma of the breast is very rare, and has a special histological morphology and immunophenotype. It was understood that it cannot be misdiagnosed as invasive carcinoma of the breast or other benign lesions. This paper reports a case of this tumor treated in our hospital on Apr. 2, 2011. The clinical data, ultrasonic manifestations, histomorphology and immunophenotype were analyzed retrospectively. This study aims to investigate the clinicopathological, immunohistochemistry, diagnosis and prognosis of cystic hypersecretory carcinoma of the breast, so as to improve clinicians’further understanding of it.

Objective To evaluate the CT features of small lung invasive adenocarcinoma with air?containing space and its relationship with pathological types, and to explore the pathological basis of air?containing space. Methods CT and pathological data of fifty patients with surgically proven lung invasive adenocarcinoma with air?containing space in our hospital from January 2012 to December 2017 were retrospectively reviewed. CT image analysis included image features of tumor and air?containing space. Pathological analysis included pathological subtype, differentiation degree. CT features of tumor and air?containing space were compared with regard to pathological types using chi?square test or Fisher exact text. Analysis of variance was used to compare quantitative data satisfying normal distribution, while those data not satisfying normal distribution were compared with Kruskal?Wallis test. In addition, Spearman correlation was used to analyze the correlation between nodule density and pathological types. Results (1) CT features of tumors: Tumors were predominantly located in peripheral lungs (46/50). Most of the tumors were subsolid nodules (37/50). Tumor?lung interface was generally clear (46/50). Tumors are often accompanied by malignant signs such as lobulation (37/50), spicule sign (27/50), air bronchogram sign (43/50), and pleural indentation (36/50). The mean diameter of nodules ranged from 7.50 mm to 18.12 mm, with an average of (12.91±2.85)mm. The nodule density ranged from-657.00 to 73.00 HU with an average of (-213.88±206.16) HU. (2) CT features of air?containing space:Air?containing spaces were commonly solitary (37/50) and were found to be mainly in an eccentric distribution (29/37). The maximum diameter of air?containing space ranged from 1.00 to 16.00mm, and the average diameter was (4.23±3.14)mm. Air?containing spaces less than 5mm were found in 35 cases (70%), and air?containing spaces more than 5mm were found in 15 cases. (3) Comparison of CT features and corresponding pathological types: Nodule density, number of air?containing space, and type of nodule density in different pathological types were statistically different (P<0.05). There was a correlation between nodule density and pathological subtypes (r=0.371, P=0.008). Differences of nodule density, short?dimension of nodule, type of nodule density, spicule sign, pleural indentation among different tumor differentiation degrees were significant (P<0.05). The degree of tumor differentiation was negatively correlated with nodule density (r=-0.451, P=0.001). Conclusion The detection rate of air?containing space in lung invasive adenocarcinomas is 12.7%. Most small lung invasive adenocarcinomas with air?containing space are presented as peripheral subsolid nodule, and there is a certain correlation between their CT features and pathological types. The pathological basis of air?containing space was supposed to be dilated distal bronchiole induced by check?valve mechanism and destruction of alveolar structure by tumor.

OBJECTIVEThe goals, prospects and methods of the Prospective Twin Registry in Southwestern China (TRiSC) are described. The aim of this study is to measure children's behavioral development and psychopathology from phenotypic, genetic and environmental perspectives.

METHODSThe children's self-report, as well as parental and teachers' informant report were used to measure the children's behavior and psychopathology, and the latter was related to the children's general cognitive abilities, and to the parenting style. Other variables of interest such as children's temperament and parental health status were also used.

RESULTSNine thousand and three hundred thirty nine pairs of 0-16 years old twins have been registered, 324 pairs of them were monozygotic based on DNA samples as well as the detailed information on behavioral and cognitive aspects.Analysis has been performed for the influences of genetic and environmental factors on children's behavior and cognition.

CONCLUSIONSchool-based twins recruitment is a helpful method in child and adolescent twin study. TRiSC has been a valuable resource for research on the development of children's behavior and cognition.

Adolescent ; Adolescent Development ; Asian Continental Ancestry Group ; genetics ; Behavior ; Child ; Child Development ; Child, Preschool ; China ; Cognition ; Environment ; Female ; Follow-Up Studies ; Genetics, Behavioral ; Human Development ; physiology ; Humans ; Infant ; Infant, Newborn ; Male ; Mental Health ; Prospective Studies ; Registries

Objective To explore the effect of multimodal exercise combined with enteral nutrition dur-ing radiotherapy in the patients with esophageal cancer complicating diabetes.Methods A total of 52 patients with esophageal cancer complicating diabetes in Zhejiang Provincial Tumor Hospital from January to Decem-ber 2021 were selected as the study subjects and divided into the control group(n=27)and intervention group(n=25)by using the random number table method.The control group implemented the routine exercise scheme,while the intervention group was given the multimodal exercise intervention on the basis of routine exercise.The blood glucose metabolism indicators,related biochemical indicators during radiotherapy and the incidence rate of adverse events during exercise were compared between the two groups.Results The levels of fasting blood glucose,random blood glucose and blood glucose before sleep in the intervention group during radiotherapy were(7.79±1.61)mmol/L,(9.47±1.77)mmol/L and(9.97±3.02)mmol/L,which were lower than(11.84±3.47)mmol/L,(14.18±5.42)mmol/L and(14.62±3.83)mmol/L in the control group with statistically significant differences(P<0.05).During the radiotherapy period,the levels of albumin,total protein and prealbumin in the intervention group were(37.96±2.13)g/L,(68.13±5.02)g/L and(232.89±41.11)g/L,which were lower than(36.05±2.89)g/L,(64.96±5.95)g/L and(207.76±47.59)g/L in the control group with statistically significant differences(P<0.05).The incidence rates of adverse e-vents such as falls,hypoglycemia and accidental extubation during multimodal exercise in the intervention group were lower than those in the control group,and the differences were statistically significant(P<0.05).Conclusion The multimodal exercise could significantly improve the nutritional status during radiotherapy in the patients with esophageal cancer complicating diabetes,stabilize the blood glucose level of the patients,and has good feasibility and safety.

Objective To analysis the change of hip joint in healthy infants by ultrasound,and establish the normal reference value of the developmental dysplasia of the hip(DDH). Methods A total of 8 000 healthy infants from 0 to 24 weeks were collected from the Multi-center study of 10 children′s medical centers. Among them,3 855 infants(2 065 females and 1 790 males) with complete data and follow-up were included in this study. All subjects were divided into 6 groups ( ＜4,4～7,8～11,12～15,16～19 and≥20 weeks group). α angle,femoral head length and width,femoral head coverage ratio by acetabulum ( FHC) were measured in the coronal view on the neutral position;distance from pubis to femoral head ( P-H) and distance from ischium to femoral head ( I-H ) were measured in the transverse view on neutral position;distance from femoral head topubis ( H-P) was measured in the posterolateraltransverse view on the flexion position. The results of each group changes with age were analysised. Results ① The α angle of healthy infants from 0 to 20 weeks were increased with age,the difference among the groups were statistically significant( P ＜0.05),but there was no significant difference between 16～19 and ≥20 weeks group( P ＞0.05). ②The femoral head length and width of all age groups were increased with age,the difference among all the groups was statistically significant( all P ＜0.05). ③ FHC from 0 to 20 weeks were increased with age,the difference among the groups were statistically significant( P ＜0.05) except between 16～19 and ≥20 weeks group( P ＞0.05). ④ The P-H and I-H in all age groups showed no statistically significant ( all P＞0.05). ⑤The H-P of all age groups were increased with age,the difference between the groups were statistically significant(all P ＜0.05).Conclusions The development of hip joints have the certain regular developmental pattern in healthy infants less than 5 months of birth and are relatively constant after birth more than 5 months. The ultrasound normal reference value of the hip joints can be used for the early diagnosis of the DDH.

Objective: To evaluate the CT features of small lung invasive adenocarcinoma with air-containing space and its relationship with pathological types, and to explore the pathological basis of air-containing space. Methods: CT and pathological data of fifty patients with surgically proven lung invasive adenocarcinoma with air-containing space in our hospital from January 2012 to December 2017 were retrospectively reviewed. CT image analysis included image features of tumor and air-containing space. Pathological analysis included pathological subtype, differentiation degree. CT features of tumor and air-containing space were compared with regard to pathological types using chi-square test or Fisher exact text. Analysis of variance was used to compare quantitative data satisfying normal distribution, while those data not satisfying normal distribution were compared with Kruskal-Wallis test. In addition, Spearman correlation was used to analyze the correlation between nodule density and pathological types. Results: (1) CT features of tumors: Tumors were predominantly located in peripheral lungs (46/50). Most of the tumors were subsolid nodules (37/50). Tumor-lung interface was generally clear (46/50). Tumors are often accompanied by malignant signs such as lobulation (37/50), spicule sign (27/50), air bronchogram sign (43/50), and pleural indentation (36/50). The mean diameter of nodules ranged from 7.50 mm to 18.12 mm, with an average of (12.91±2.85)mm. The nodule density ranged from-657.00 to 73.00 HU with an average of (-213.88±206.16) HU. (2) CT features of air-containing space: Air-containing spaces were commonly solitary (37/50) and were found to be mainly in an eccentric distribution (29/37). The maximum diameter of air-containing space ranged from 1.00 to 16.00mm, and the average diameter was (4.23±3.14)mm. Air-containing spaces less than 5mm were found in 35 cases (70%), and air-containing spaces more than 5mm were found in 15 cases. (3) Comparison of CT features and corresponding pathological types: Nodule density, number of air-containing space, and type of nodule density in different pathological types were statistically different (P<0.05). There was a correlation between nodule density and pathological subtypes (r=0.371, P=0.008). Differences of nodule density, short-dimension of nodule, type of nodule density, spicule sign, pleural indentation among different tumor differentiation degrees were significant (P<0.05). The degree of tumor differentiation was negatively correlated with nodule density (r=-0.451, P=0.001). Conclusion The detection rate of air-containing space in lung invasive adenocarcinomas is 12.7%. Most small lung invasive adenocarcinomas with air-containing space are presented as peripheral subsolid nodule, and there is a certain correlation between their CT features and pathological types. The pathological basis of air-containing space was supposed to be dilated distal bronchiole induced by check-valve mechanism and destruction of alveolar structure by tumor.

Objective To monitor the susceptibility of clinical isolates to antimicrobial agents in tertiary hospitals in major regions of China in 2022.Methods Clinical isolates from 58 hospitals in China were tested for antimicrobial susceptibility using a unified protocol based on disc diffusion method or automated testing systems.Results were interpreted using the 2022 Clinical &Laboratory Standards Institute(CLSI)breakpoints.Results A total of 318 013 clinical isolates were collected from January 1,2022 to December 31,2022,of which 29.5％were gram-positive and 70.5％were gram-negative.The prevalence of methicillin-resistant strains in Staphylococcus aureus,Staphylococcus epidermidis and other coagulase-negative Staphylococcus species(excluding Staphylococcus pseudintermedius and Staphylococcus schleiferi)was 28.3％,76.7％and 77.9％,respectively.Overall,94.0％of MRSA strains were susceptible to trimethoprim-sulfamethoxazole and 90.8％of MRSE strains were susceptible to rifampicin.No vancomycin-resistant strains were found.Enterococcus faecalis showed significantly lower resistance rates to most antimicrobial agents tested than Enterococcus faecium.A few vancomycin-resistant strains were identified in both E.faecalis and E.faecium.The prevalence of penicillin-susceptible Streptococcus pneumoniae was 94.2％in the isolates from children and 95.7％in the isolates from adults.The resistance rate to carbapenems was lower than 13.1％in most Enterobacterales species except for Klebsiella,21.7％-23.1％of which were resistant to carbapenems.Most Enterobacterales isolates were highly susceptible to tigecycline,colistin and polymyxin B,with resistance rates ranging from 0.1％to 13.3％.The prevalence of meropenem-resistant strains decreased from 23.5％in 2019 to 18.0％in 2022 in Pseudomonas aeruginosa,and decreased from 79.0％in 2019 to 72.5％in 2022 in Acinetobacter baumannii.Conclusions The resistance of clinical isolates to the commonly used antimicrobial agents is still increasing in tertiary hospitals.However,the prevalence of important carbapenem-resistant organisms such as carbapenem-resistant K.pneumoniae,P.aeruginosa,and A.baumannii showed a downward trend in recent years.This finding suggests that the strategy of combining antimicrobial resistance surveillance with multidisciplinary concerted action works well in curbing the spread of resistant bacteria.