With the rapid development of population aging in various countries around the world,the health and elderly care industry has been paid high attention.The standardization of smart health and elderly care technology and services is particularly important.This paper firstly reviewed the policies related to healthy elderly care in China.By analyzing the industrial standards and provincial standards issued,this paper focused on the policies proposed by the Shanghai Municipal Government for the standardization of smart health and elderly care,as well as the researches on the standard system and the construction of standard families.Shanghai group standards in the field of smart health and elderly care were summarized,including the guidelines for the construction of standard systems,elderly care service platforms,community elderly cafeterias,portable health monitoring terminals,indoor sports services,and home-based elderly care safety monitoring.A series of case analyses of the standardized implementation of the above aspects were also provided.Through standardization research and practice in recent years,it has been fully demonstrated that the standard research plays an important leading role in the field of smart health and elderly care.

Objective To study the characteristics of hyperphenylalaninemia (HPA) and the differences in blood and urine metabolic index and their correlation.Methods A total of 137 patients with HPA diagnosed by the Pediatric Inherit Metabolism and Endocrine Department,Guangdong Women and Children's Hospital,Guangzhou Medical University from January 2014 to June 2017,were enrolled.Tandem mass spectrometry (MS/MS),gas chromatography/ mass spectrometry (GC-MS) and high performance liquid chromatography (HPLC) were used to analyze the concentration of blood and urine metabolites in children,and the patients were divided into different groups according to the drug load test of tetrahydrobiopterin (BH4) and dihydrobiopterindine reductase (DHPR) deficiency.The HPA metabolite analysis of horizontal concentration by statistical differences and correlation analysis were performed.Results Among the 137 cases of HPA,there were 101 cases (73.7％) of phenylalanine hydroxylase deficiency (PAH),and among them 21 cases (15.3％) were classic phenylketonuria (PKU),37 cases were mild PKU (27.0％),43 cases (31.4％) wcrc mild HPA.Thcrc were 22 cases (16.1％) with BH4 reaction,and 79 cases (57.7％) of non-reactive type.Besides,there were 36 cases (26.3％) of tetrahydrobiopterin deficiency (BH4 D),of which 6-pyruvoyl tetrahydropterin synthase deficiency (PTPS) in 34 cases (24.8％) and dihydrobiopterindine reductase deficiency (DHPR) in 2 cases (1.5％).Urinary phenylacetic acid (r =0.673,P ＜ 0.01),phenyllactic acid (r =0.736,P ＜ 0.01),phenylpyruvic acid (r =0.642,P ＜ 0.01) were significantly correlated with blood phenylalanine (Phe) concentration,and the neopterin (N) (r =0.442,P ＜ 0.01) and biopterin (B) (r =0.398,P ＜ 0.01) had low correlation.Urinary phenylacetic acid,phenyllactic acid and phenylpyruvic acid had no correlation with urinary pterin.There were significant differences among PTPS deficiency group,BH4 response type,and non-reactive type(all P ＜ 0.05),but no significant difference between the BH4 reaction type and the non-reactive group (P ＞ 0.05).Conclusions Through the analysis of the different types of HPA metabolic profiles,it can help to master the incidence and characteristics in the region,within a certain concentration range of blood Phe,the phenylacetic acid,phenyllactic acid,phenylpyruvic acid should not be tested by GC-MS alone.Uterine erythropoietin analysis of BH4D classification and identification of BH4 reaction,non-reactive PKU have a supporting role,so master the metabolic index of various types of concentration and relevance of HPA,it can provide basis for early diagnosis,accurate treatment and follow-up.

Objective To investigate the relationship between histological chorioamnionitis(HCA) and the outcome of preterm labor. Methods A total of 218 cases of premature delivery in the Department of Obstetrics and Gynecology of our hospital from January, 2015 to December, 2017 were divided into two groups according to the result of placenta pathological diagnosis. The observation group was diagnosed with histological chorioamnionitis by placenta pathology examination. The control group was not diagnosed with histological chorioamnionitis. The delivery gestational week, the rate of premature rupture of membranes, the rate of puerperal infection, the rate of postpartum hemorrhage, the rate of wound healing failure, the average body mass of newborn infants, the rate of early-onset sepsis, asphyxia, respiratory distress syndrome rate, pathological jaundice rate, neonatal mortality between the two groups were compared. And the impact of histological chorioamnionitis on the outcome of preterm labor was explored. Results The delivery gestational week of the observation group was (32. 0±1. 0) weeks, and the rate of postpartum hemorrhage, the rate of premature rupture of membranes, the rate of puerperal infection and the rate of wound healing were 21. 24％, 80. 50％, 16. 81％, 11. 50％, respectively. The delivery gestational week of the control group was(34. 0±1. 0) weeks, and the rate of postpartum hemorrhage, the rate of premature rupture of membranes, the rate of puerperal infection and the rate of wound healing were 10. 48％, 65. 70％, 7. 62％, 3. 81％, respectively. The delivery gestational week of the observation group was small. And the rate of premature rupture of membranes, wound healing failure rate, puerperal infection rate, postpartum hemorrhage rate in the observation group was significantly higher than that of the control group, and the difference was statistically significant(P＜0. 05). The mean neonatal weight in the observation group was(1710±355)g,and the asphyxia rate, early-onset sepsis rate, respiratory distress syndrome rate, pathological jaundice rate and neonatal mortality were 21. 24％, 33. 63％, 38. 05％, 19. 47％ and 9. 73％. The mean neonatal weight in the control group was(2270±450)g,and the asphyxia rate, early-onset sepsis rate, respiratory distress syndrome rate, pathological jaundice rate, neonatal mortality were 9. 52％, 18. 10％, 12. 38％, 8. 57％, 2. 86％. The average body weight of infants in the observation group was low. And the rates of early onset sepsis, asphyxia, respiratory distress syndrome, pathological jaundice and neonatal mortality were significantly increased. The difference was significant (P＜0. 05). Conclusion The placental pathology examination in all preterm patients should be done to avoid missed diagnosis of HCA, and to help early diagnosis and treatment of pregnant women with intrauterine infection and high-risk newborns and improve prognosis.

The patient was a 21 days-old baby girl,admitted to Guangdong Women and Children Hospital because of "poor intake,seldom crying and no activity in 1 day".The major clinical manifestations included hypotonia,aggravation of the conscious disturbance,pancytopenia,intractable acidosis and hyperammonemia,so,inherited metabolic disorders should be considered.Screening of inherited metabolic diseases with blood and urine samples,genetic test and active treatments were carried out.After targeted next-generation sequencing,a novel homozygotic frame shift mutation in PCCB gene:c.838_839insC (L280Pfs * 11) was identified,which was validated by Sanger sequencing.This mutation had not been reported in the mutation database,and bioinformatic analysis of this mutation indicated disease-causing.So,the diagnosis of propionic acidemia was identified.The baby was in a critical condition,and despite active treatment,her conscious disturbance was aggravated,and the spontaneous breathing disappeared.Subsequently,the baby died of pneumonia.Propionic acidemia is a relatively common genetic metabolic disease in newborns.The severity and the clinical phenotypes of propionic acidemia varied,which often made the diagnosis difficult.When the baby is presented with developmental delay,hypotonia,recurrent convulsion and vomiting,etc,which can't be explained by common diseases of children,propionic acidemia may be considered.Next generation sequencing analysis of the complicated cases can easily to pinpoint a disease-causing gene,which lays a solid foundation for accurate diagnosis and treatment of the patients.

Objective To explore the application effect of postural animation video instruction mode in elderly patients undergoing epidural anesthesia. Methods A total of 300 patients with epidural anesthesia were registered from January 2015 to February 2016. The patients were divided into trial group and control group with 150 cases each. The trial group was preoperatively interviewed by the postural anatomy video instruction mode, and the control group was only preoperatively interviewed by oral interpretation. The epidural anesthesia effect and anxiety between the two groups were compared. Results The difference of anesthesia posture and anatomical position, the average time of epidural puncture, the success rate of one puncture and the degree of anxiety before and after mission were 90.67% (136/150), (14.50 ± 10.20) s, (425.60 ± 78.30) s, 97.33% (146/150) and (21.65 ± 6.62) points respectively. The control group was 22.00%(33/150), (112.60 ± 60.80) s, (589.40 ± 90.70)s, 82.67%(124/150) and (6.65 ± 5.40) points respectively. There were significant differences between the two groups (χ2=8.79, t=13.54-19.88, all P < 0.01). Conclusions The postural anatomical video teaching mode can relieve anxiety, improve the degree of fit of epidural anesthesia and the success rate of puncture, shorten the time of posture, thus shorten the average time of epidural puncture, improve the quality of nursing in the operating room, work efficiency.

OBJECTIVETo study resistance evolution pathway of HIV-1 CRF_BC under drug selection pressure, and compare with B subtype.

METHODSBased on the reverse transcriptase region of CRF_ 97BC HIV-1 from 588 treatment-naive and 274 treatment patients, selection pressure based method was used to select resistance-associated mutations, and Bayesian network was used to construct the resistance evolutionary pathway under antiretroviral therapy. Meanwhile, it was constructed that the resistance evolutionary pathway for B subtype with the same regimens using the data from HIV resistance database, and made a comparison with CRF_07BC.

RESULTSThe major resistance mutations for CRF_07BC were identified including K103N, Q197K, V179D and Y188L. While for B subtype, the major resistance mutations include M184V, K103N,Y181C, T69N,G190A, K238T,Y188H and P225H. Much difference was observed between these two classes. However, the classical TMA1 (41L, 210W and 215Y) and TMA2 (67N, 70R and 219E/Q) pathways exist in both pathways. As different from B subtype, the predicted major drug resistance mutations for CRF_07BC did not contain TAM-related mutations, and nucleoside reverse transcriptase inhibitor-related mutations and non-nucleoside reverse transcriptase inhibitor-related mutations were mutually depending on each other.

CONCLUSIONHIV-1 CRF_07BC showed distinctive resistance evolutionary pathway, the mutations K103N,Q197K,V179D and Y188L were the major resistance mutations, and different resistance evolutionary pathways were observed between HIV-1 CRF_07BC and B subtype.

Anti-HIV Agents ; pharmacology ; Bayes Theorem ; Drug Resistance, Viral ; genetics ; Evolution, Molecular ; HIV-1 ; drug effects ; enzymology ; genetics ; Humans ; Mutation ; RNA-Directed DNA Polymerase ; genetics

Objective To research the metabolism and distribution ofsilybin in normal rats and liver injury model rats.Methods The normal rats group and immunity liver injury rat models were fed with the same dose ofsilybin capsule,and HPLC was used to determine the silybin concentration in biological samples in different time.Results The silybin concentration in the normal group in biological samples was higher than the model group at different time.In the normal group,the consequence of silybin concentration in each viscera distribution from top to bottom was liver＞kidneys＞plasma＞heart,while in the model group the fact was kidneys＞heart＞liver＞plasma.Conclusion The difference of metabolism and distribution of silybin in normal rats and liver damage model rats was obvious.

OBJECTIVE:To prepare the compound tinidazole washing liquid and to establish the quality control method for this medicine.METHODS:Tinidazole and chloromycetin were taken as the chief components for the preparation of the washing liquid;the contents of the chief components were determined by the dual-wavelength spectrophotometric method.RESULTS:The linear ranges for the concentration determination of tinidazole and chloromycetin were6.4～12.8mg/L and8.0～16.0mg/L respectively;the average recoveries of tinidazole and chloromycetin were100.09%and100.00%respectively,the relative standard deviations(RSD)of which were0.17%and0.22%respectively.CONCLUSION:The preparation is simple in preparation,accurate in content determination,stable and reliable in quality.