Objective:To compare improved microbial assay (IMA) and electrochemiluminescence (ECL) for measuring serum folate, and to investigate the linear or non-linear correlation between the results of the two methods.Methods:This comparative study was conducted in National Health Commission Key Laboratory of Reproductive Health from October 2020 to February 2021, in which the folate concentration of 251 serum samples were measured by IMA and ECL. According to the serum folate concentration, the folate status was divided into sufficient (≥13.5 nmol/L), marginal deficiency (6.8≤serum folate<13.5 nmol/L), and deficiency (<6.8 nmol/L). Pearson correlation analysis and multivariate fractional polynomial (MFP) model were used to evaluate the correlation between the results measured by the two methods. The sensitivity of ECL for detecting folate status were calculated based on the IMA results as the golden standard.Results:The average folate concentrations in serum samples measured by ECL and IMA were (19.8±8.2) nmol/L and (23.0±9.7) nmol/L, respectively ( P<0.001). The Pearson correlation coefficient ( r) of the two methods was 0.894 ( P<0.001), yet the MFP model demonstrated non-linear correlation between the two methods. When the IMA results were≤9.1 nmol/L, the r was 0.070 ( P>0.05); when the IMA results were>9.1 nmol/L, the r was 0.867 ( P<0.001); for non-hemolytic serum samples ( n=221), the r was 0.902 ( P<0.001). Additionally, the sensitivity of ECL detecting folate deficiency was 27.78%, and the sensitivity of ECL detecting folate insufficiency (deficiency and marginal deficiency) was 93.33%. Conclusion:When folate concentrations was>9.1 nmol/L), the results of ECL and IMA were highly correlated; yet the correlation between the two methods was weak at lower folate concentrations, indicating that ECL was not applicable for serum folate measurement among folate insufficiency population.

Objective:To explore a fast and accurate method to diagnose children's pneumonia according to respiratory signals, so as to avoid the cancer induction caused by traditional X-ray examination.Methods:A Mach Zehnder optical fiber sensor was used to build a respiratory signals(RSPs) detection system, and the RSPs of the monitored children were extracted according to the vibration signal generated by the children's lung rales. Preprocessing methods such as the discrete cosine transform(DCT) were used to compress and denoise the RSPs. Multi-feature extraction of RSPs was conducted through signal processing methods such as the Hilbert transform and autoregressive (AR) model spectrum estimation. A support vector machine (SVM) classification model was constructed to classify the collected RSPs.Results:The accuracy rate of the proposed RSP classification of children with or without pneumonia was 94.41%, which was higher than the previous methods.Conclusions:The children's pneumonia diagnosis system based on an optical fiber sensor has a higher detection accuracy, and is expected to be widely used in clinical practice.

Objective:To investigate the sleep of infants aged 0 to 5 months and explore its association with feeding patterns.Methods:A cross-sectional survey on infant sleep was conducted from February to August 2019 using "Brief Infant Sleep Questionnaire" posted on a WeChat public account, which mainly included two dimensions of sleep duration and habits. In addition, information on maternal and infant characteristics as well as feeding patterns was also collected. Multiple linear regression and multinomial logistic regression were used to analyze the association between sleep and feeding patterns.Results:This study included 28 444 singleton infants aged 0 to 5 months and their mothers from 31 provincial-level administrative regions in mainland China. The median sleep duration of infants at night and during the day was 9 h and 6 h, respectively. These infants sharing the bed with their parents accounted for 53.5% (15 221/28 444). Of all infants, 46.0% (13 092/28 444) slept on their backs; 84.7% (24 078/28 444) woke up two times or more at night; 58.3% (16 597/28 444) stayed awake 2 h or more at night; 89.7% (25 523/28 444) had a sleep latency of 1 h or more. Falling asleep while being fed was the most common way to fall asleep (40.2%, 11 426/28 444). The numbers of infants who were exclusively breastfed, exclusively formula-fed and mixed-fed were 7 164 (25.2%), 4 097 (14.4%) and 17 183 (60.4%), respectively. Compared with exclusively breastfed infants, exclusively formula-fed infants slept for shorter periods at night (a β=－0.14, 95% CI:－0.22 to－0.06, P<0.05), while mixed-fed infants slept longer (a β=0.08, 95% CI: 0.02-0.13, P<0.05). Exclusively formula-fed infants had less overall sleep time than recommended ( aOR=1.10, 95% CI: 1.00-1.21, P<0.05). Exclusively formula-fed and mixed-fed infants were less likely to sleep in cribs in separate rooms ( aOR=0.50, 95% CI: 0.44-0.56; aOR=0.35, 95% CI: 0.32-0.38; both P<0.05). Exclusively formula-fed infants were less likely to share the bed with their parents ( aOR=0.91, 95% CI: 0.83-0.99, P<0.05), but the likelihood in mixed-fed infants was high ( aOR=1.19, 95% CI: 1.11-1.27, P<0.05). Mixed-fed infants were more likely to sleep on their backs ( aOR=1.12, 95% CI: 1.06-1.18, P<0.05). Exclusively formula-fed infants were more likely to stay awake for four hours or more at night ( aOR=1.12, 95% CI: 1.01-1.25, P<0.05). Conclusions:Exclusively breastfeeding was the best feeding pattern for infant sleep quantity. But much attention should be paid to sleeping habits including sleeping place and sleeping position associated with exclusively breastfeeding to improve infant sleep and feeding.

Abnormal healing after skin injury may lead to pathological scar. The emergence of pathological scar not only affects the cosmetic appearance, but also causes psychological and physiological dysfunction in severe cases. The study on the mechanism of pathological scar is of great significance for the treatment of scar. Among them, animal scar model is one of the important method to study pathological scar at present. The ideal animal model of scar should be as close as possible to human pathological scar in histology, cytology and other aspects. This article systematically expounds the rodent model, rabbit ear model and porcine model of traditional scar animals, and the new technology animal scar model, combined with the recent research which has been widely used in the field of scar.

Abnormal healing after skin injury may lead to pathological scar. The emergence of pathological scar not only affects the cosmetic appearance, but also causes psychological and physiological dysfunction in severe cases. The study on the mechanism of pathological scar is of great significance for the treatment of scar. Among them, animal scar model is one of the important method to study pathological scar at present. The ideal animal model of scar should be as close as possible to human pathological scar in histology, cytology and other aspects. This article systematically expounds the rodent model, rabbit ear model and porcine model of traditional scar animals, and the new technology animal scar model, combined with the recent research which has been widely used in the field of scar.

Objective:To investigate the efficacy and feasibility of urethroplasty using inner prepuce graft combined with Orandi flap for the treatment of the obliterated penile urethral atresic stricture.Methods:From January 2016 to September 2019, the clinical data of 18 obliterated penile urethral stricture cases were analyzed retrospectively. All the patients were treated using inner prepuce flap combined with Orandi Flap. The average age of the patients was 62.1 years old (range 20-81 years old). Ten cases had suprapubic cystostomy before operation. The maximum flow rate was 1.6-6.2 ml/s, with an average of 4.2ml/s. The intubation general anesthesia and lithotomy position was used. The foreskin of penis was incised longitudinally. The urethra was exposed and the segment of stricture was opened longitudinally. The range of stricture length was measured with soft ruler, ranging from 2.0 to 7.5 cm, with an average of 5.0cm. After the fibrotic tissue was completely removed, the dorsal inner prepuce was incised with needed length and width for harvesting a free skin flap in order to transplant and reconstruct the dorsal urethral. The Orandi flap was used to cover the ventral urethra, and a F14-16 silicone catheter was retained. The length range of the inner prepuce graft was 2.0-7.5 cm, with an average of 5.1cm; the width was 1.2-1.8 cm, with an average of 1.4cm. The length of Orandi flap was 2.2-7.7 cm, with an average of 6.0cm; the width was 1.0-1.5 cm, with an average of 1.3 cm. The catheter was removed 3-4 weeks after operation. The patients were then followed up after 3, 6 and 12 months postoperatively and then with annual assessments for the symptoms, urinary flow rate, and urethrography or soft urethroscopy when necessary.Results:All of the 18 operations were completed successfully. The patients were followed up for 6-36 months, with an average of 22 months. There were 5 patients with terminal dripping, 4 patients with recurrent urinary tract infection within half a year after operation, and antibiotic treatment being effective. The quality of life scores at 3 months and 6 months after operation were 0.8 (0-2) and 0.6 (0-1), respectively, which were statistically significant compared with before operation ( P<0.001). Conclusions:The use of free inner prepuce flap combined with Orandi flap is an effective treatment for the obliterated penile urethral atresic stricture, especially for the patients who are unwilling or unsuitable to harvest the oral mucosa. It has the advantages of convenient harvesting and less complications.

Objective To research the effect of pure interbody fusion and interbody cage fusion under minimally invasive transforaminal lumbar interbody fusion treat to single segment of lumbar disc herniation,analysis clinical value the two methods.Methods A total of 61 cases single segment lumbar disc herniation were treated with MIS-TLIF surgery,were divided into pure interbody fusion group (group A) and interbody fusion Cage group (group B) according to different fusion methods.Operative time,blood loss and postoperative drainage were recorded in two groups,the clinical efficacy were tested by using of visual analogue score (VAS),Japanese Orthopedic Association scores (JOA),Oswestry disability index (ODI) score and Macnab standard,the interbody fusion ability were evaluated by power lumbar X-ray film and CT 3D reconstruction.Results The gender,age,disease duration and disease segments in two gracps were not found statistically significant difference (P＞0.05).Also,two groups of patients,blood loss,postoperative drainage has no significant difference (P＞0.05).After the operation,the VAS score,ODI score,JOA score and Macnab criteria,the last follow-up of intervertebral fusion rate in in tuo groups were not found statistically significant difference (P＞0.05).While the operative time,postoperative disc height changes were found significant difference between two groups (P＜ 0.05).Conclusion MIS-TLIF simple fusion for lumbar disc herniation will be available with equal clinical efficacy fusion rate compared with cage fusion.

Objective: To investigate clinicopathological features of carcinoma showing thymus-like elements (CASTLE) in the head and neck regions. Methods: Clinicopathological data of 7 patients with CASTLE in the head and neck regions were retrospectively reviewed.Immunohistochemical staining and in situ hybridization for EBER were performed. BRAF^V600E mutation was examined by ARMS method in 6 cases. Results: There were 5 females and 2 males with age between 49 and 78 years (average of 65.6 years). All tumors were solitary nodular lesions with an infiltrative border, including 6 intrathyroid tumors and 1 extrathyroid tumor in the laryngeal pharynx.The tumors were 1.7-4.1 cm in diameter (average of 3.0 cm). Four cases demonstrated lymph node metastasis.All patients were alive without metastasis during follow-up, except one consultation case (with FNA sample) developed recurrence at the primary site. The cases showed different immunoreaction to CD5, diffuse immunoreaction with p63, CK5/6 and CD117, but negative staining for TTF1, TG and calcitonin. One case showed positive immunoreaction with Synin less than 30% tumor cells. The Ki-67 labeling index was between 3% and 90%. No BRAF^V600E mutation and EB virus infection were detected. Conclusions Extrathyroid CASTLE involving laryngeal pharynx shows the similar morphological and immunohistochemical features with intrathyroid CASTLE.Immunohistochemical markers of CD5 and CD117 are helpful in the diagnosis. Ki-67 labeling index can be high in CASTLE, especially in lymphoepithelioma type. CD5-negative CASTLE may have neuroendocrine differentiation. BRAF^V600E mutation and EB virus may not be involved in the carcinogenesis of CASTLE.

Objective:To treat the chronic non-atrophic gastritis patients induced by Helicobacter pylori with Qingweizhitong Weiwan combined with standard triple therapy,and to detect the differential expression of related immflammation genes with PCR array,and to clarify its mechanism.Methods: Ten patients with chronic non-atrophic gastritis complicated with Helicobacter pylori infection were used as treatment group and 10 health people were used as health control group. The patients in treatment group were treated with Qingweizhitong Weiwan combined with standard triple therapy for 14 d. The blood samples of the subjects in treatment group and health control group were collected before and after treatment,and QIAGEN human antibacterial response PCR array was performed to test the total RNA inperipheral blood and to analyze the differential expressions of 84 inflammation-related genes.Results:The differential expressions of 20 inflammation-related genes were found.Compared with health control group,the expression levels of 20 genes in treatment group before treatment were up-regulated (Fold-change>2);after treatment,the expression levels of 20 genes were down-regulated,and 11 of them were similar to the level in health control group (Fold-change< 2).More specifically,part of 20 genes was related to NLRP3 inflammasome.Compared with health control group,the gene expression levels of CASP1,IL1B,NLRP3,and PYCARD in treatment group before treatment were up-regulated (P <0.05).Compared with before treatment,the expression levels of CASP1,IL1B,NLRP3,and PYCARD in treatment group after treatment were down-regulated (P <0.05).Conclusion:The mechanism of Qingweizhitong Weiwan combined with standard triple therapy in the treatment of chronic non-atrophic gastritis patients induced by Helicobacter pylori may be related to inhibiting the expressions of NLRP3 inflammasome-related genes and interfering the antimicrobial innate immune response.

OBJECTIVE:To systematically review the effect of ticagrelor versus prasugrel on platelet reactivity,and provide evi-dence-based reference for clinical treatment. METHODS:Retrieved from PubMed,CJFD and Wanfang Database,randomized con-trolled trials(RCT)about the effect of ticagrelor versus prasugrel on platelet reactivity were collected. Meta-analysis was performed by using Rev Man software after data extract and quality evaluation by Cochrane 5.1.0. RESULTS:Totally 17 RCTs were enrolled,involv-ing 2 757 patients. Results of Meta-analysis showed,regardless of Verity Now(VN)detection method [MD=15.43,95%CI(-0.39, 31.25),P=0.06] or vasodilator stimulus phosphoprotein(VASP)detection method [MD=-3.04,95%CI(-8.98,2.90),P=0.32], ticagrelor and prasugrel had the same effects on platelet reactivity under loading dose,the differences were not statistically significant;regardless of VN detection method [MD=-48.94,95%CI(-58.04,-39.84),P<0.001] or VASP detection method [MD=-14.32, 95%CI(-20.45,-8.20),P<0.001],the effects of ticagrelor were better than prasugrel on platelet reactivity under maintenance dose,the differences were statistically significant. CONCLUSIONS:At the loading dose,there was no difference between ticagrelor and prasugrel,but ticagrelor has more benefits than prasugrel under maintenance dose.