To analyze the effect of the treatment of dual plane breast augmentation ( one part of the implantation was located behind breast parenchyma and the other part was located behind the pectoralis majior muscle) use areo-lar papillaris incision. Using the areolar papillaris incision complete dual plane breast augmentation. For some breast potsis patients the superfluous areolar papillaris skin was removed and suspension fixation was performed at the same time. Some patients were followed up for 3-months to 2-years. All surgical outcomes were satisfactory with natural breast shapes, and there were no complications such as capsular contracture, prosthesis shift or burst. U-sing the areola papillaris incision can complete dual plane breast augmentation surgery without endoscopic guid-ance;surgery is simple under directvision.

Objectives:To observe the role of combined use of early micro feeding and intravenous nutrition in low birth weight(LBW) infants. Methods:Fifty four cases of LBW infants were randomly divided into two groups.Early micro feeding and intravenous nutrition were given in one group(EF & IN group) and another group(Control group) was given only with intravenous nutrition.The times of intravenous nutritional support requirement and hospital stay,the increase in body weight and the changes in serum bilirubin,lipids and creatinine were compared between the two groups. Results:The times of intravenous nutritional support and hospital stay were shortened and the body weight was increased in EF & IN group. The levels of serum bilirubin and creatinine and the serial concentrations of lipids on the day 7 and 14 after birth were significantly lower than those in control group. Conclusions:The combination of early,micro feeding and intravenous nutrition is superior to the only use of intravenous nutrition in shortrenning the critical course,increasing the body weight,beginning the oral intake and decreasing the possible injuries from total parenteral nutrition.

Objective To explore the mechanism of intrauterine growth restriction (IUGR) via observing the change of mitochondria in IUGR placenta. Methods Placenta samples were collected from 30 singleton pregnancies at the time of elec-tive caesarean section. Fifteen of them were appropriate for gestational age and 15 were IUGR. Mitochondrial morphology was observed by transmission electron microscopy, DNA copies were analyzed by real-time quantitative PCR and membrane potential was assayed by lfow cytometry. Results Signiifcant morphological changes of placental mitochondria were observed under transmission electron microscopy in IUGR, mitochondrial DNA copies in IUGR placenta were signiifcantly increased (P<0.01) and membrane potential decreased dramatically (P<0.01). Conclusions It is suggest that impaired mitochondrial function in IUGR may involve in IUGR pathogenesis.

AIM: This study is to detail its possible mechanisms that homocysteine (Hcy) induces injury of cultured endothelial cells.METHODS: Hcy in sequential concentrations was added into the cultured human umbilial vein endothelial cells for 24 hours in serum-free medium. The lipid peroxidation, release of LDH, cell total protein content, cell apoptosis and necrosis were assessed. RESULTS: Hcy increased the apoptosis of endothelial cells.In high Hcy concentration the cells also showed obvious injurious and necrotic morphological changes. Lipid peroxidation increased, with LDH releasing up and cell total protein content down, and they showed a positive dose-effect relationship with the Hcy concentration. All the above effects of Hcy was strengthened by low density lipoprotein (LDL) which may suggest synergetic effects of Hcy and LDL.CONCLUSION: Our results indicate that Hcy has a strong oxidizing effect, which may be one of its major mechanism for injury of EC.

Objective Measurement of ankle brachial index (ABI) is a simple method of assessing lower limb arterial blood supply,while measurement of toe brachial index (TBI)has only been advocated as an alternative.The aim of this study was to obtain information about whether TBI should be taken in type 2 diabetes,even when ABI is normal,and to evaluate the relationship between TBI and atherosclerosis.Methods In a crosssection study,ABI,TBI,and carotid intimal-medial thickness (IMT) were measured on 979 outpatients with type 2 diabetes in Ruijin Hospital.Those with normal ABI (0.9 ≤ABI ＜ 1.3,n = 945) were divided into two groupsnormal TBI group(TBI≥0.6,n=893) and low TBI group(TBI＜0.6,n=52),and then the clinical and laboratory data were compared between these two groups.Furthermore,the relationship between TBI and atherosclerosis was investigated.Atherosclerosis was defined as the maximum IMT ≥ 1.1 mm.Results Low ABI and low TBI were detected in 1.3% and 6.6% of the patients,respectively.Comparison of the clinical and laboratory data between the two groups showed that age and HbA1C values were significantly higher in the low TBI group.Furthermore,TBI was inversely associated with IMT(β=-0.217,P＜0.01),an indicator for atherosclerosis of the carotid artery.Multiple logistic regression analysis revealed that decline of TBI was an independent risk factor of atherosclerosis (OR=1.30,95% CI 1.01-1.69,P＜0.05).Conclusion In type 2 diabetes,the decline of TBI is associated with atherosclerosis,indicating the necessity for diabetic patients to detect TBI,even when ABI is within normal range,in order to detect peripheral artery disease in early stage,and reduce the risk for atherosclerosis.

Objective To evaluate the relationship betweenα2 adrenergic receptors and expression of Nav1. 8 in dorsal root ganglion (DRG) neurons, and to illuminate the mechanism of dexmedetomidine-induced reduction of acute visceral pain in rats. Methods Thirty-two clean-grade healthy adult male Spra-gue-Dawley rats, aged 6-8 weeks, weighing 180-220 g, were divided into 4 groups ( n=8 each) using a random number table method: control group ( group C ) , acute visceral pain group ( group VP ) , dexmedetomidine group (group D), and dexmedetomidine plus atipamezole group (group DA). In VP, D and DA groups, 10-3 mmol∕L capsaicin 1. 3 ml was injected into the rectum at a dose of 10-3 mmol∕L to establish the acute visceral pain model, while the equal volume of normal saline was given instead in group C. Atipamezole 1 mg∕kg was subcutaneously injected through the back of the neck at 20 min before establishing the model in group DA. Dexmedetomidine 10μg∕kg was injected through the tail vein at 15 min before establishing the model in D and DA groups, while the equal volume of normal saline was given instead at the correspording time points in C and VP groups. The visceral pain behavior score was recorded at 1 h after establishing the model. The animals were then sacrificed, and DRGs of the lumbar segment (L3-6) were removed for determination of the number of Nav1. 8 positive DRG neurons (by immunohisto-chemistry) and expression of Nav1. 8 mRNA (by quantitative real-time polymerase chain reaction). Results Compared with group C, the visceral behavior scores and the number of Nav 1. 8 positive DRG neurons were significantly increased, and the expression of Nav 1. 8 mRNA was up-regulated in VP, D and DA groups (P<0. 05). Compared with group VP, the visceral behavior score and the number of Nav1. 8 positive DRG neurons were significantly decreased, and the expression of Nav 1. 8 mRNA was down-regulated in D and DA groups (P<0. 05). Compared with group D, the visceral behavior scores and the number of Nav1. 8 positive DRG neurons were significantly increased, and the expression of Nav1. 8 mRNA was up-regulated in group DA ( P<0. 05) . Conclusion The mechanism by which dexmedetomidine reduces acute visceral pain is related to activatingα2 adrenergic receptors and to down-regulating the expression of Nav1. 8 in DRG neu-rons of rats.

Objective To evaluate the effect of intrathecal dexmedetomidine on expression of sub-stance P (SP) and c-fos in the spinal dorsal horns of rats with visceral pain. Methods Thirty-two clean-grade healthy adult male Sprague-Dawley rats, weighing 250-300 g, were divided into 4 groups ( n=8 each) using a random number table method: control group (C group), visceral pain group (VP group), dexmedetomidine group (D group) and dexmedetomidine plus atipamezole group (DA group). VP, D and DA groups received intraperitoneal injection of 0. 9％ acetic acid 10 ml∕kg to establish the model of visceral pain, while group C received the equal volume of normal saline instead. At 10 min before the model was es-tablished, dexmedetomidine 20 μl (1μg∕kg) and dexmedetomidine 1μg∕kg plus atipamezole 1μg∕kg (20μl) were intrathecally injected in D and DA groups, respectively, and the equal volume of normal saline 20μl was given instead in C and VP groups. Visceral pain index ( VPI) was recorded at 1 h after intraperito-neal injection, and then rats were sacrificed, and the dorsal horns of the spinal cord ( L4-6 ) were removed for determination of the expression of SP and c-fos by immunohistochemistry. Results Compared with group C, VPI was significantly increased, and the expression of SP and c-fos was up-regulated in VP, D and DA groups (P<0. 05). Compared with group VP, VPI was significantly decreased, and the expression of SP and c-fos was down-regulated in D and DA groups (P<0. 05). Compared with group D, VPI was signifi-cantly increased, and the expression of SP and c-fos was up-regulated in group DA ( P<0. 05) . Conclusion Intrathecal dexmedetomidine reduces the visceral pain through inhibiting the expression of SP and c-fos in the spinal dorsal horns, which is related to the α2-adrenergic receptor in spinal dorsal horns of rats.

Objective To evaluate the effect of dexmedetomidine on visceral pain in rats and the role of α2 adrenergic receptors in locus coeruleus (LC).Methods Thirty-two healthy adult male SpragueDawley rats,weighing 250-300 g,were divided into 4 groups (n=8 each) using a random number table method:control group (group C),visceral pain group (group VP),dexmedetomidine group (group DEX) and α2-adrenergic receptor antagonist atipamezole group (group AP).α2-adrenergic receptor antagonist atipamezole 522 μg/kg was intramuscularly injected in group AP,and the equal volume of normal saline was given instead in C,VP and DEX groups.At 10 min after intramuscular injection,dexmedetomidine 10 μg/kg was injected via the tail vein in DEX and AP groups,and the equal volume of normal saline was given instead in C and VP groups.VP,DEX and AP groups received intraperitoneal injection of 0.9％ acetic acid 10 ml/kg to make the visceral pain model at 15 min after injection via the tail vein.The cumulative visceral pain score was recorded within 60 min after acetic acid injection.The number of c-fos positive cells in LC was detected by immunohistochemistry,and the content of norepinephrine (NA) in the spinal cord were detected by enzyme-linked immunosorbent assay at 2 h after acetic acid injection.Results Compared with group C,the cumulative visceral pain scores,the number of c-fos positive cells in LC and content of NA in the spinal cord were significantly increased in VP,DEX and AP groups (P＜0.05).Compared with group VP,the cumulative visceral pain scores,the number of c-fos positive cells in LC and content of NA in the spinal cord were significantly decreased in DEX and AP groups (P＜0.05).Compared with group DEX,the cumulative visceral pain scores,the number of c-fos positive cells in LC and content of NA in the spinal cord were significantly increased in group AP (P＜0.05).Conclusion Dexmedetomidine can alleviate visceral pain in rats,and the mechanism is partially related to activating α2 adrenergic receptors in LC.

Objective:To study disease spectrum and genetic profiles of inborn errors of metabolism (IEM) among newborns in selected areas of Nanning city.Methods:From July 2019 to December 2021, neonates born and received IEM screening in our hospital were prospectively enrolled. Heel blood samples were tested using tandem mass spectrometry as IEM screening. Neonates with positive results were called back for recheck. Whole exome sequencing was used to detect possible pathogenic genes in suspected cases and IEM was diagnosed combining clinical manifestations. Sanger sequencing method was used for the diagnosed neonates and their parents to confirm the diagnoses.Results:A total of 16 207 live-birth neonates were enrolled. For initial IEM screening, 1 423 neonates were positive (8.8%) and 1 311 were called back (92.1%). 15 cases were suspected with IEM and 8 were diagnosed. The overall detection rate was 1∶2 026. Among 8 confirmed cases, 4 cases had amino acid metabolism disorders (2 cases of phenylketonuria, 1 case of Citrin deficiency and 1 case of tyrosinemia), 2 cases had organic acid metabolism disorders (1 case of methylmalonic acidemia and 1 case of glutaric acidemia) and 2 cases had fatty acid oxidation disorders (1 case of carnitine palmitotransferaseⅡdeficiency and 1 case of primary carnitine deficiency). 5 cases had homozygous genetic variants (2 in PAH, and 1 in SLC25A13, SLC22A5 and FAH, respectively) and 3 had heterozygous genetic variants (1 in CPT2, MUT, and GCDH, respectively). During follow-up, all 8 cases had normal growth and developmental outcomes after standardized treatment.Conclusions:The overall detection rate of IEM is high, with varied genetic profiles in selected areas of Nanning. Timely genetic testing may lead to early diagnosis and treatment and improve the quality of life of neonates.