Premature white matter injury (WMI) is the immature white matter injury caused by ischemia,hypoxia and inflammation,which will affect normal neurodevelopment process and cause poor neurological outcomes.MRI has been widely used in early diagnosis of WMI because it can reflect the anatomical and pathological changes of WMI in premature infants.Functional MRI,such as diffusion-tensor imaging and magnetic resonance spectroscopy,can help quantitative assessment of the severity of WMI and neurodevelopment process so as to predict its neurodevelopment prognosis.This review summarizes the progresses in the application of MRI in the quantitative assessment of WMI and brain development in preture infants and its neurological outcomes.

Objective To analyze the clinical features of nested variant of bladder urothelial carcinoma.Methods The clinical data of 13 patients with nested variant of bladder urothelial carcinoma treated in our hospital from July 2014 to April 2018 were retrospectively analyzed.There were 10 males and 3 females and the mean age was 64.6(37-81) years.All 13 cases had symptom of hematuria,3 cases with anemia,1 cases with urinary frequency,urgency and dysuria,1 case with all the above symptoms.Six cases underwent transurethral resection of the bladder tumor (TURBT),7 cases underwent radical cystectomy.Results All 13 cases had nested structures in pathology.Six cases did immunohistochemistry but none of them were specific.Twelve cases were high-grade invasive urothelial carcinoma,of which 2 cases were associated with carcinoma in situ,and 1 case was low-grade invasive.Two patients' pathological stages were ≤T1,4 patients in T2 phase,and 7 patients in T3-4 phase.Four patients who underwent TURBT received intravesical instillation chemotherapy,and 3 patients who underwent radical cystectomy and 1 patient with TURBT received intravenous chemotherapy.One patient with TURBT received both intravesical chemotherapy and intravenous chemotherapy.The remaining 4 patients who underwent radical cystectomy did not receive special treatment.The progression-free survival time of 13 patients was 2-39 months,of which 2 patients relapsed,1 patient metastasized,1 patient with tumor progression,and 2 patients with non-tumor specific death.Conclusions The clinical features of nested variant of urothelial carcinoma special.However,the pathology of nested variant of bladder urothelial carcinoma has a unique nested structure.At present,TURBT and radical cystectomy are still the main treatment modalities for nested variant of bladder urothelial carcinoma,and the prognosis of which is poor.

Objective To evaluate the clinical efficacy of a combination of Ilizarov technique, bone grafting and ankle traction for treatment of nonunion of the distal tibia within 2 cm around the ankle joint. Methods A retrospective study was performed on the patients who had been treated at Department of Orthopaedics, Sir Run Run Shaw Hospital from September 2014 to January 2018 for nonunion of the distal tibia within 2 cm around the ankle joint. They were 8 men and 4 women, aged from 32 to 56 years ( average, 41 years). Their injury was all unilateral, involving 5 left and 7 right ankles. They had all received internal fixation at other hospitals for 6 to 18 months. After we treated them simultaneously with Ilizarov technique, bone grafting and ankle traction, they could walk with crutches as soon as 3 days after surgery in some cases. Their affected limbs were then subjected to gradual weight-bearing walking until they could walk normally without any aid 3 to 6 months after surgery. Their postoperative ankle functions were evaluated according to the ankle-hindfoot scores of the American Orthopedic Foot and Ankle Society ( AOFAS) system. Results The 12 patients were effec-tively followed up for 12 to 24 months ( average, 19 months). All their incisions healed well with no incision or pin-tract infection. All their bone nonunions healed after circular external fixation for 12 to 36 weeks. Their AOFAS scores ranged from 75 to 96 points, showing good functional recovery of the ankle joint. Conclusion A combination of Ilizarov technique, bone grafting and ankle traction is an effective treatment for nonunion of the distal tibia within 2 cm around the ankle joint, leading to preservation of the ankle function and prevention of posttraumatic ankle osteoarthritis.

Seasonal influenza vaccination is the most effective way to prevent influenza virus infection and complications from infection. Currently, China has licensed trivalent inactivated influenza vaccine (IIV3) and quadrivalent inactivated influenza vaccine (IIV4), including split-virus influenza vaccine and subunit vaccine. Except for a few major cities, influenza vaccine is a category Ⅱ vaccine, which means influenza vaccination is voluntary, and recipients must pay for it. To strengthen the technical guidance for prevention and control of influenza and operational research on influenza vaccination in China, the National Immunization Advisory Committee (NIAC) Influenza Vaccine Technical Working Group (TWG), updated the 2014 technical guidelines and compiled the "Technical guidelines for seasonal influenza vaccination in China (2018-2019)" . The main updates in this version include: epidemiology, disease burden, types of influenza vaccines, northern hemisphere influenza vaccination composition for the 2018-2019 season, IIV3 and IIV4 immune response, durability of immunity, immunogenicity, vaccine efficacy, effectiveness, safety, cost-effectiveness and cost-benefit. The influenza vaccine TWG provided the recommendations for influenza vaccination for the 2018-2019 influenza season based on existing scientific evidence. The recommendations described in this report include the following: Points of Vaccination clinics (PoVs) should provide influenza vaccination to all persons aged 6 months and above who are willing to be vaccinated and do not have contraindications. No preferential recommendation is made for one influenza vaccine product over another for persons for whom more than one licensed, recommended, and appropriate product is available. To decrease the risk of severe infections and complications due to influenza virus infection among high risk groups, the recommendations prioritize seasonal influenza vaccination for children aged 6-59 months, adults ≥60 years of age, persons with specific chronic diseases, healthcare workers, the family members and caregivers of infants <6 months of age, and pregnant women or women who plan to become pregnant during the influenza season. Children aged 6 months through 8 years require 2 doses of influenza vaccine administered a minimum of 4 weeks apart during their first season of vaccination for optimal protection. If they were vaccinated in 2017-2018 influenza season or a prior season, 1 dose is recommended. People more than 8 years old require 1 dose of influenza vaccine. It is recommended that people receive their influenza vaccination by the end of October. Influenza vaccination should be offered as soon as the vaccination is available. For the people unable to be vaccinated before the end of October, influenza vaccination will continue to be offered for the whole season. Influenza vaccine is also recommended for use in pregnant women during any trimester. These guidelines are intended for use by staff members of the Centers for Disease Control and Prevention at all levels who work on influenza control and prevention, PoVs staff members, healthcare workers from the departments of pediatrics, internal medicine, and infectious diseases, and staff members of maternity and child care institutions at all levels.

Objective: To evaluate the protective effect of granulocyte-colony stimulating factor(G-CSF) on neonatal rats after hypoxic-ischemic brain damage(HIBD)and its effect on endoplasmic reticulum (ER) stress. Methods: According to the random number table, a total of 54 Sprague-Dawley (SD) rats aged 7 days were divided into 3 groups(18 rats in each group): Sham group, HIBD group and G-CSF group, and the improved Rice method was used to establish a neonatal rat model of HIBD.A dose of 50 μg/kg of G-CSF was administered intraperitoneally 1 hour after HIBD (G-CSF group), while the rats in HIBD group and Sham group received saline only.At 24 hours of HIBD, pups were euthanized to quantify brain infarct volume by using 2, 3, 5-Triphenyltetrazolium chloride.Hematoxylin-Eosin (HE) staining was used to observe the changes of brain structure.Neuronal cell death was determined by using terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling (TUNEL). Then the expressions of glucose-regulated protein 78 (GRP78), cysteinyl aspartate specific proteinase 12 (Caspase-12), CCAAT/enhancer binding-protein homologous protein (CHOP) were assessed by Western blot and immunofluorescence staining. Results: Twenty-four hours after operation, HE staining showed that no significant neuronal damage was observed in Sham group.The brain tissue structure of rats in the HIBD group was significantly damaged, while some improvement was observed in the G-CSF group.The infarction volume in HIBD group[(25.40±5.15)%] increased compared with that in the Sham group[(0.31±0.15)%] and the G-CSF group[(16.36±4.97)%], and the differences were statistically significant(all P<0.05). There was increased positive expression of GRP78 protein in HIBD group, compared with that in the Sham group and the G-CSF group[(49.38±10.06)% vs.(9.12±4.50)%, (30.61±6.35)%], and the differences were statistically significant (all P<0.05). The percentage of apoptosis in the hippocampal CA1 region and conex in HIBD group [(44.84±11.54)%, (48.23±14.07)%] were higher than those in the G-CSF group [(17.87±7.20)%, (26.18±9.96)%], and the differences were statistically significant (all P<0.05). The expression of GRP78, CHOP and Caspase-12 in the HIBD group (0.63±0.24, 0.72±0.21, 0.68±0.25) were higher than those in the Sham group (0.20±0.08, 0.28±0.08, 0.23±0.07), and the G-CSF group (0.39±0.13, 0.51±0.18, 0.48±0.16), and the differences were statistically significant (all P<0.05). Conclusions G-CSF exerts neuroprotective effect on the neonatal rats after HIBD.G-CSF may be an effective treatment of HIBD by reducing ER stress-induced neuronal apoptosis.

In December 2019, novel coronavirus pneumonia epidemic occurred in Wuhan, Hubei Province, and spread rapidly across the country. In the early stages of the epidemic, China adopted the containment strategy and implemented a series of core measures around this strategic point, including social mobilization, strengthening case isolation and close contacts tracking management, blocking epidemic areas and traffic control to reduce personnel movements and increase social distance, environmental measures and personal protection, with a view to controlling the epidemic as soon as possible in limited areas such as Wuhan. This article summarizes the background, key points and core measures in the country and provinces. It sent prospects for future prevention and control strategies.