【Objective】 To analyze the effects of different fortified feeding methods on nutritional metabolism and growth rate of preterm very low birth weight infants (VLBWI), in order to provide new clues for improving the prognosis of the preterm infants. 【Methods】 A total of 115 cases of premature VLBWI admitted to Department of Neonatology, The First Affiliated Hospital of Kunming Medical University from January 2019 to December 2020 were included in this study, and were divided into fortified breastfeeding group (HFM group), mixed feeding group, and premature formula feeding group (PF group) based on their feeding methods. The effects of different feeding methods on the nutritional metabolism and growth rate of premature VLBWI were analyzed. 【Results】 1) The hospitalization time of infants in the HFM group was shorter than that in PF group and mixed feeding group (t=7.185, 6.924, P<0.05). 2) The proportion of necrotizing enterocolitis (NEC) in the HFM group during hospitalization was lower than that in the PF group (P<0.05); the proportions of late onset septicemia(LOS) and extra uterine growth restriction(EUGR) in the HFM group during hospitalization were lower than those in the PF group (χ²=5.030, 4.147, P<0.05); the proportion of LOS was lower than that of the mixed feeding group(χ²=6.589, P<0.05). 3) During hospitalization, the proportions of abdominal distension, bloody stools and increased eosinophils in the HFM group were lower than those in the PF group (P<0.05), which in mixed feeding group was lower than those in PF group (Fisher exact test, P<0.05). 4) At discharge, the weight and length growth rate of the HFM group were higher than those of the mixed feeding group (t=3.722, 0.425, P<0.001) and the PF group (t =6.015, 0.496, P< 0.001). 【Conclusion】 Fortified breastfeeding can more effectively increase the growth rate of VLBWI in premature infants, improve nutritional metabolism, reduce complications and adverse feeding reactions related to premature infants, and is safer and more effective.

Objective:To explore the relationship of infertility-related stress and depression of infertility women, and the effect of coping style and resilience in it.Methods:A cross sectional study was conducted in 230 infertility women who treated with Assisted Reproductive Technology in Reproductive Medical Center of the First Affiliated Hospital of Soochow University using convenience sampling method from April 2020 to April 2021 with self-made general information questionnaire, Fertility Problem Inventory, Simplified Coping Style Questionnaire, 10-item Connor-Davidson Resilience Scale and Patients' Health Questionnaire Depression Scale-9 item. And correlation and effect analysis was conducted.Results:Two hundred and nineteen questionnaires were finally collected, the effective recovery rate was 95.2%(219/230). The score of Fertility Problem Inventory was (136.21 ± 27.38) points, the score of Simplified Coping Style Questionnaire was (34.26 ± 7.66) points, the score of 10-item Connor-Davidson Resilience Scale was (27.50 ± 6.78) points, the score of Patients' Health Questionnaire Depression Scale-9 item was (4.26 ± 3.83) points. Correlation analysis results showed that infertility-related stress of infertility women was positively correlated with negative coping ( r=0.20, P<0.01) and depression ( r=0.26, P<0.01), negative coping was positively correlated with depression ( r=0.23, P<0.01). Effect analysis results showed that negative coping had a partial mediating effect between infertility-related stress and depression, and the mediating effect size was 0.05, accounting for 15.63% of the total effects. Resilience moderated the second half path of the mediation relationship ( β=-0.137, t=-2.11, P<0.05). Conclusions:The infertility-related stress is a positive predictor of depression. Negative coping has a mediating effect between infertility-related stress and depression, and resilience moderates the effect of negative coping on depression.

Objective:To study the clinical characteristics, diagnosis, complications and prognosis of neonatal varicella.Methods:From September 2008 to December 2019, the clinical data of hospitalized neonates with varicella in our hospital were retrospectively analyzed.Results:A total of 33 cases of neonatal varicella were reviewed, including 18 males and 15 females, 32 full-term infants and 1 premature infant. The gestational age (GA) was (38.8±1.2)w and birth weight (BW) was (3 670±247)g. The onset of the disease occurred at 14.0 (8.0,19.0)d and was diagnosed at 18.0 (11.5,23.0)d. The hospital stay duration was (8.1±3.7)(2~20)d. All mothers denied varicella history or varicella vaccination. Among the 33 infants, 29 had a history of varicella/zoster exposure. All 33 infants had typical rash and 25 had fever, body temperature (38.3±0.6) ℃ and duration (2.4±1.4) d. 13 cases were congenital varicella, 20 cases were acquired varicella. 24 cases abnormality of cardiac enzymes, 11 cases skin infection, 8 cases liver damage, 4 cases pneumonia, 6 cases granulocytopenia/agranulocytosis, 9 cases anemia, 4 cases sepsis and 1 case viral encephalitis were diagnosed. 20 infants received intravenous antiviral therapy (acyclovir), 17 were treated with antibiotics, 15 were given intravenous immunoglobulin (IVIG), 8 received both antiviral therapy and IVIG and 6 were treated with recombinant human granulocyte stimulating factor. 31 infants were cured and discharged. 2 infants were discharged after improvement of rashes. All infants reported complete recovery on telephone follow-up.Conclusions:Most neonatal varicella cases have a definite exposure history. Besides rashes, complications including pneumonia, liver damage, myocardial injury, granulocytopenia/agranulocytosis, viral encephalitis are common. Intravenous antiviral therapy with acyclovir and combined treatment of IVIG and symptomatic support can often achieve a good prognosis.

Objective:To construct Z-score ranges for normal fetal middle cerebral artery peak systolic velocity(MCA-PSV).Methods:From May 2017 to October 2019, 865 normal singleton fetuses of 10th to 40th gestational weeks underwent prenatal ultrasound in the Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region. Using fetal biometric parameters as independent variables, and measurement of MCA-PSV on standard section as dependent variables, the regression analyses of the mean(M) and the standard deviation(SD) for each parameter were calculated separately and then the best fitting equation was selected. A group of diseases which might cause the abnormal MCA-PSV were assessed using these standards.Results:①Strong correlations were found between MCA-PSV and fetal biometric parameters ( r=0.935-0.939, P<0.001). ②Quadratic or cubic regression equations were fitted to the models of the means of the MCA-PSV, whereas linear equations were fitted to the SDs. ③In these case groups, intrauterine growth restriction, severe preeclampsia, intrauterine infection and homozygous α-thalassemia-1 demonstrated Z-score>2 reflective of increased MCA-PSV with varying degrees, especially with the homozygous α-thalassemia-1 fetus being the most significant (17/20, 85%). Conclusions:The calculation of Z-score for MCA-PSV as a function of fetal biometric parameters is intuitive and simple, it can be used as an important indicator especially for homozygous α-thalassemia-1.

In this study, we used next-generation sequencing methods to screen 300 individuals for BRCA1 and BRCA2. A novel mutation (c.849dupT) in BRCA2 was identified in a female patient and her unaffected brothers. This mutation leads to the truncation of BRCA2 functional domains. Moreover, BRCA2 mRNA expression levels in mutation carriers are significantly reduced compared to noncarriers. Immunofluorescence and western blot assays showed that this mutation resulted in reduced BRCA2 protein expression. Thus, we identified a novel mutation that damaged the function and expression of BRCA2 in a family with breast cancer history. The pedigree analysis suggested that this mutation is strongly associated with familial breast cancer. Genetic counsellors suggest that mutation carriers in this family undergo routine screening for breast cancer, as well as other malignancies, such as prostate and ovarian cancer. The effects of this BRCA2 mutation on drug resistance should be taken into consideration during treatment.
Blotting, Western ; BRCA2 Protein ; Breast Neoplasms* ; Breast* ; Drug Resistance ; Female ; Fluorescent Antibody Technique ; Genes, BRCA2 ; High-Throughput Nucleotide Sequencing ; Humans ; Mass Screening ; Nonsense Mediated mRNA Decay* ; Ovarian Neoplasms ; Pedigree ; Prostate ; RNA, Messenger ; Siblings

To investigate the effects of molybdenum (Mo) and/or cadmium (Cd) on antioxidant function and the apoptosis-related genes in duck spleens. Sixty healthy 11-day-old ducks were randomly divided into six groups of 10 ducks (control, low Mo group, high Mo, Cd, low Mo + Cd, and high Mo + Cd groups). All were fed a basal diet containing low or high dietary doses of Mo and/or Cd. Relative spleen weight, antioxidant indices, apoptosis-related gene mRNA expression levels, and ultrastructural changes were evaluated after 120 days. The results showed that the relative spleen weight decreased significantly in the high Mo + Cd treatment group which compared with control group. Malondialdehyde levels increased and xanthine oxidase and catalase activities decreased in the Mo and/or Cd groups compared with levels in the control group. Bak-1 and Caspase-3 expressions were upregulated in the high Mo + Cd group, while Bcl-2 was downregulated. In addition, mitochondrial crest fracture, swelling, vacuolation, deformed nuclei, and karyopyknosis in both Mo + Cd treated groups were more severe than in the other groups. The results suggest that Mo and/or Cd can induce oxidative stress and apoptosis of spleen via effects on the mitochondrial intrinsic pathway. Moreover, the results indicate the two elements have a possible synergistic relationship.
Apoptosis* ; Cadmium* ; Caspase 3 ; Catalase ; Diet ; Ducks* ; Malondialdehyde ; Molybdenum* ; Oxidative Stress ; RNA, Messenger ; Spleen* ; Xanthine Oxidase

Objective:To evaluate the relationship betweenparacardial adipose tissue (PAT) volume, body mass index (BMI) and severe coronary artery stenosis in young people by quantitative measurement of 256-slice spiral CT.
Methods: A total of 150 patients younger than 45 years and received coronary angiography (CAG) in our hospital were divided into 2 groups:Lesion group, the patients with severe main coronary branch stenosis and Control group, patients with normal coronary artery. n=75 in each group. The height, body weight and BMI were recorded in all patients;imaging data was uploaded to the workstation to calculate the volumes ofepicardiumadipose tissue (EAT) volume,pericardial outsideadipose tissue volume and PAT volume, the correlation among 3 parameters were analyzed respectively.
Results:Compared with Control group, Lesion group had increased BMI (28.169±2.203) kg/m2 vs (24.960±3.041) kg/m2 and PAT volume (178.676±3.041) ml vs (99.0616±3.041) ml, all P<0.05. Compared with Control group,no matter male or female, Lesion group had larger PAT volume, P<0.01.EAT volume was related to pericardial outside adipose tissue volume (r=0.837, P<0.001) and PAT volume (r=0.971, P<0.001);pericardial outside adipose tissue volume was related to PAT volume (r=0.944, P<0.001).
Conclusion:PAT volume and BMI were obviously correlated to severe coronary artery stenosis in young people.

Objective To explore the detection trend of vaginal intraepithelial neoplasia(VaIN)of lower genital tract from 2013 to 2015. Methods A retrospective analysis was undertaken of colposcopy-directed biopsy of cervical, vaginal and vulvar intraepithelial neoplasia lesions include cervical intraepithelial neoplasia (CIN), VaIN and vulvar intraepithelial neoplasia (VIN) in Obstetrics and Gynecology Hospital of Fudan University from January 2013 to December 2015. Results (1) Overall data of CIN, VaIN and VIN:a total of 16732 cases were diagnosed of lower genital intraepithelial neoplasia in 3 years, accounting for 23.20% (16732/72128) of total colposcopy-directed biopsy cases. Among them, CIN, VaIN and VIN accounted for 19.48%(14053/72128), 2.67%(1923/72128), 1.05%(756/72128) of total colposcopy-directed biopsy cases of the lower genital tract, 83.99%(14053/16732), 11.49%(1923/16732), 4.52%(756/16732) of total lower genital intraepithelial neoplasia, respectively. (2) Annual data of CIN, VaIN and VIN from 2013 to 2015. The annual proportion of CIN in all intraepithelial neoplasia of lower gential tract was basically stable, consisting of 86.02%(3955/4598),83.25%(4795/5760) and 83.20%(5303/6374), respectively. The annual proportion of VaIN was gradually increasing, consisting of 8.09% (372/4598), 12.45%(717/5760) and 13.08%(834/6374), respectively. The annual proportion of VIN was gradually decreasing, consisting of 5.89% (271/4598), 4.31% (248/5760) and 3.72% (237/6374), respectively. Conclusion The increasing detection of VaIN from 2013 to 2015 might correlate with the increasing attention to inspection of the entire vaginal wall.

Objective To explore the anti-infection mechanism of carboxyamidotriazole (CAI) through studying the effects of CAI on the proliferation, apoptosis and degranulation of RBL-2H3 mass cells.Methods Compound 48/80 (C48/80) was used to induce the model of activation and degranulation in RBL-2H3 cells.The morphological change of cell degranulation was observed by neutral red staining.The release levels of histamine and β-hexosaminidase were measured by ELISA method and chromogenic assay, respectively.The cell activity was determined by CCK-8 method.And cell apoptosis was detected by Hoechst 33342 fluorescent staining.Results Compared with the control group, 10, 20, 40 μmol/L CAI inhibited C48/80-induced degranulation of RBL-2H3 cells in different degrees.CAI (20, 40 μmol/L) reduced the histamine release (P<0.01), and CAI (40 μmol/L) decreased the β-hexosaminidase release (P<0.01).In addition, the viability and apoptosis of RBL-2H3 cells were not affected at the concentrations of CAI used.Conclusions CAI can effectively inhibit the activation and degranulation of RBL-2H3 mast cells, and this effect is not through cytotoxicity.The anti-infection effect of CAI may partially due to the down-regulation of mast cell activity.

Communication skills are the basic requirement for general practitioners,the continuous improvement of communication skills is the guarantee of the service quality.It is crucial to establish an effective evaluation system in the training of communication skills for general practitioners.This article reviews the current status of evaluation scales of doctor-patient communication skill commonly used in China and other countries to provide reference for the establishment of the communication skill evaluation system for general practitioners which is suitable for China's condition.