OBJECTIVE To investigate the improvement effects of azithromycin on bronchopulmonary dysplasia （BPD） in neonatal rats based on hypoxia-inducible factor-1α（HIF-1α）/HIF-2α/vascular endothelial growth factor （VEGF） pathway. METHODS Sixty newborn SD rats were randomly divided into negative control group （NC）， BPD group， azithromycin group and budesonide group （positive control）， with 15 rats in each group. Rats in NC group were given normal breathing air， while rats in other three groups were exposed to high-concentration oxygen for 14 days to establish BPD rat models. After successful modeling， rats in azithromycin group were intraperitoneally injected with azithromycin 200 mg/kg， and rats in budesonide group were atomized with budesonide 1.5 mg/kg once a day for 14 consecutive days， while rats in BPD group and NC group were not treated. Pathological changes of lung tissue， radial alveolar count and mean alveolar intercept of rats were observed in each group. The white blood cell count in bronchoalveolar lavage fluid （BALF） and the levels of tumor necrosis factor-α （TNF-α）， interleukin-6 （IL-6）， IL-1β， superoxide dismutase （SOD）， catalase （CAT） and malondialdehyde （MDA） were detected； mRNA and protein expressions of VEGF， HIF-1α， HIF-2α were also detected. RESULTS Compared with NC group， the lung tissue in BPD group was obviously damaged； the white blood cell count， average alveolar intercept and the levels of TNF-α， IL-6， IL-1β and MDA were significantly increased； the radial alveolar count， SOD and CAT levels， the relative expressions of VEGF， HIF-1α， HIF-2α mRNA and protein were significantly decreased （P＜0.05）. Compared with BPD group， the changes of the above indexes in azithromycin group and budesonide group were significantly reversed （P＜0.05）. CONCLUSIONS Azithromycin can obviously improve the symptoms of BPD in rats， reduce inflammation and oxidative stress， and exert lung protection， the mechanism of which may be realized by activating HIF-1α/HIF-2α/VEGF pathway.

Objective:To investigate the clinical characteristics, management and outcome of aortic dissection (AD) in pregnant women with pre-eclampsia.Methods:Clinical characteristics, management, and prognosis of nine patients with pre-eclampsia complicated by AD who were admitted to the First Affiliated Hospital of Zhengzhou University from January 2013 to April 2021 were retrospectively summarized using descriptive statistical analysis.Results:(1) Clinical features: The incidence of pre-eclampsia complicated by AD among the total deliveries and pre-eclampsia deliveries were 18/100 000 (9/49 166) and 182/100 000 (9/4 943), respectively. All the nine cases of pre-eclampsia complicated by AD, with an average age of (36.6±4.2) years, presented clinical symptoms in the second or the third trimester that were mainly manifested as chest and back pain (8/9) and the average gestational week at onset was (31.0±4.7) weeks. Seven cases were confirmed by transthoracic echocardiography (TTE) and computed tomography angiography (CTA), one by TTE and magnetic resonance angiography, and one by TTE+MRI+CTA. The main classification of AD was Stanford B (8/9). In the grading of blood pressure during pregnancy, except for one case without data, eight cases were severe. (2) Management: Four women did not receive any antihypertensive treatment. However, blood pressure remained uncontrolled in the other five cases despite antihypertensive managment. Except for one death before operation due to rapid deterioration, the other eight cases all received initial treatment and thoracic endovascular aortic repair (TEVAR). Four cases underwent TEVAR prior to the termination of pregnancy. Two cases were delivered by cesarean section first, and TEVAR was performed 5 and 6 days after delivery, respectively. The other two cases undenwent cesarean section and TEVAR at the same time. Lung infection ( n=6) was the main postoperative complication. (3) Delivery: Among the nine patients, one patient died, and the average termination time of the eight patients (six underwent cesarean section, including two cases with fetal death, two underwent vaginal delivery following fetal death) was (32.9±3.6) weeks and none of them had postpartum hemorrhage. (4) Maternal-infant outcomes: Follow-up of the eight surviving women showed that one had numbness in one side of the limbs, one with occasional heart palpitations, and the rest had good outcomes. There were four live births, including two with low birth weight and one with neonatal asphyxia, and five stillbirths. During the 7-83 months of follow-up, all four children grew well. Conclusions:Pregnant women with pre-eclampsia should actively control blood pressure to avoid AD. Once symptoms such as chest and back pain occur, the possibility of AD should be considered. Active treatment after diagnosis of AD can improve maternal and fetal survival rate.

Objective:To explore the effects of pregnancy complicated with Takayasu arteritis (TA) on maternal and fetal outcomes.Methods:The clinical data of 17 TA patients with pregnancy and finally terminated admitted to the First Affiliated Hospital of Zhengzhou University from January 2012 to December 2020 were collected and the maternal and infant outcomes were retrospectively analyzed.Results:Among the 24 pregnancies in 17 TA patients in our hispital, 11 patients in our hospital were primiparous (46%, 11/24) and 13 patients were multiparous (54%, 13/24); 4 cases of chronic hypertension before pregnancy (17%, 4/24), and 20 cases of non-hypertension (83%, 20/24) were abserved. Apart from the thoracoabdominal artery type, 15 cases (63%, 15/24) of brachiocephalic type, 8 cases (33%, 8/24) of extensive type, and 1 case of pulmonary artery type (4%, 1/24) were included in TA classification; the renal artery was damaged in 7 cases (7/8) of the extensive type. Among the 24 pregnancies of 17 TA patients, 8 cases of pregnancy complications occurred, including 4 cases (17%, 4/24) of preeclampsia, one case of (4%, 1/24) new-onset hypertension during pregnancy, exacerbation of existing hypertension, thrombocytopenia and ischemic stroke respectively; 3 cases of induced abortion, 1 case of induced labor, and 20 cases of final delivery were found. Of the 20 final deliveries, 3 cases (15%, 3/20) were delivered through the vagina; 17 cases (85%, 17/20) were delivered by cesarean section; 3 cases (15%, 3/20) of fetal growth restriction and 6 cases of oligohydramnios (30%, 6/20) were occurred. The median gestational age of pregnancy termination of 17 full-term neonates (85%, 17/20) and 3 premature neonates (15%, 3/20) was 38.4 weeks (range:29.6-40.9 weeks). All premature women were complicated with pre-eclampsia or severe pre-eclampsia, which lead to premature birth; the birth weight of the neonates was (2 791±783) g. Neonatal asphyxia occurred in 3 cases (15%, 3/20), and 6 cases (30%, 6/20) were admitted to the neonatal intensive care unit. None of the newborns died. The patients were followed up for 3 months to 7 years. Except for one case who underwent surgical treatment 3 years after delivery and died of intraoperative hemorrhage, the other 16 patients were in stable condition; all the newborns grew and developed well. The incidences of maternal and infant adverse events were higher in those with chronic hypertension, renal artery involvement, and no use of hormones and aspirin during pregnancy, but the differences were not statistically significant (all P>0.05). Conclusions:Pregnancy with TA has adverse effects on maternal and infant outcomes. To reduce the occurrence of maternal and child adverse events, the condition of TA patients should be fully assessed before pregnancy, multidisciplinary cooperation, regular treatment, strengthened monitoring of the condition, timely treatment of complications, selection of appropriate delivery methods after pregnancy, and vigilance of postpartum complications should be properly carried out.

Objective:To evaluate the fit of titanium alloy removable partial denture framework fabricated by selective laser melting(SLM) technique.Methods:7 Kennedy Ⅲ Ti-6Al-4V removable titanium alloy partial denture frameworks were fabricated by SLM technology.An optical scanner was used to scan the gypsum model adhered with the silicone rubber film obtained by the impression method before and after removal of the film.Geomagic Qualify 2013 software was used to analyze the gap between the model and the tissue surface of the major connector of the framework,the fit of the frame work was evaluated.Results:The overall 3D deviation between the titanium alloy frameworks and the gypsum model was (0.221 9±0.07) mm.Conclusion:The fit of the titanium alloy removable partial denture framework made by SLM technology can basically met the clinical requirements.

Objective: To evaluate the processing accuracy, internal quality and suitability of the titanium alloy frameworks of removable partial denture (RPD) fabricated by selective laser melting (SLM) technique, and to provide reference for clinical application. Methods: The plaster model of one clinical patient was used as the working model, and was scanned and reconstructed into a digital working model. A RPD framework was designed on it. Then, eight corresponding RPD frameworks were fabricated using SLM technique. Three-dimensional (3D) optical scanner was used to scan and obtain the 3D data of the frameworks and the data was compared with the original computer aided design (CAD) model to evaluate their processing precision. The traditional casting pure titanium frameworks was used as the control group, and the internal quality was analyzed by X-ray examination. Finally, the fitness of the frameworks was examined on the plaster model. Results: The overall average deviation of the titanium alloy RPD framework fabricated by SLM technology was (0.089±0.076) mm, the root mean square error was 0.103 mm. No visible pores, cracks and other internal defects was detected in the frameworks. The framework fits on the plaster model completely, and its tissue surface fitted on the plaster model well. There was no obvious movement. Conclusions The titanium alloy RPD framework fabricated by SLM technology is of good quality.

Objective To apply Six-minute Walk Test (6MWT) in acute stroke patients and analyze the results. Methods From Novem-ber, 2014 to January, 2015, 29 acute stroke patients with multiple or single infarction accepted 6MWT. The distance, distance per minute, blood pressure and heart rate before and after test, adverse events or discomforts during the test were recorded. Weak and fatigue scores were calculated. Results The mean of distance in acute stroke patients was (240.1±17.2) m, that was (46.8±3.3)%of the predicted values in the healthy. Male patients walked (255.4±21.40) m, not different from (214.9±28.4) m in female (t=-1.151, P=0.26). The distance liked to be negatively correlated with age (r=-0.356, P=0.058). The distance was similar in each minute. Weak score was (46.8±3.3)%, fatigue score was mostly between-20 and 20, and no correlation was found between them. Blood pressure and heart rate increased significantly at the end of the test (t>2.476, P<0.05). Few of patients complained mild discomforts. Conclusion 6MWT is safe and suitable for acute stroke patients for physical mobility judgement, but adverse events need to be cared.

Fatigue not only affects people′s lives and work, but also causes diseases .Numerous studies have shown that some phytochemicals can promote body energy metabolism and regeneration , improve physical condition , resist fatigue growth and accelerate fatigue alleviation .This paper reviewed the recent research progress , domestic and overseas , in the anti-fatigue effect of phytochemicals .

Objective To assess the differences in nutrient composition by chemical analysis method and weighing method,A corps of armed police forces daily dietary nutrient intakes were investigated in Tianjin,to understand the status of the actual intakes of dietary nutrient.Methods A dietary survey was performed using the weighing method and with ref-erence to China food composition database in 2002.The intake of each nutrient was calculated through chemical analysis;Nutritional analysis was used in the collection of duplicate food portions during the dietary survey.Results For most of the main dietary nutrients(protein,fat and carbohydrates),minerals (Na,K,Mg,Ca,Zn,Cu and Se)and vitamins (β-car-otene,vitamin E,thiamine,riboflavin,vitamin C,niacin,and vitamin A),the calculated values of intakes were found to exceed those obtained via chemical analysis.Conclusion Differences of the two methods of dietary survey were ultimately due to the analysed values were below the calculated ones.So it is necessary to improve methods of food storage and trans-portation in order to obtain adequate nutrition and to improve the health of troops.

Objective:To compare the adaption of cobalt-chromium prostheses fabricated by selective laser melting(SLM)and conven-tional lost wax technique(LW)method.Methods:Cobalt-chromium crowns and three-unit fixed dental prostheses(FDPs)were fabrica-ted by selective laser melting(SLM)or by conventional lost wax technique(LW)respectively(n =5).Marginal fit and internal fit were examined using a light-body silicone.After setting,each silicon film was cut into 2 parts and the thickness of silicon layer was measured at 1 00 ×magnification using a digital microscope,the data of marginal gap(MG)and internal gap(IG)were statistically analysed by ANOVA and SPSS statistical package version 1 7.0.Results:The MG and IG(μm)of cobalt-chromium alloy crowns in EOS M270 group were 42.28 ±1 1 .58 and 1 25.75 ±47.67,in EOS M280 group 46.54 ±8.4 and 1 28.22 ±54.1 8,in LW group 48.66 ±1 2.08 and 1 35.37 ±46.89.The MG and IG(μm)of three-unit FDPs in EOS M270 group were 40.55 ±1 0.04 and 1 33.09 ±39.80,in EOS M280 group 45.36 ±1 0 and 1 38.94 ±50.61 ,in LW group 54.24 ±1 2.04 and 1 51 .87 ±61 .94(P <0.05),respectively.Conclu-sion:The marginal fit of the SLMgroup is superior to that of the LW group and significantly smaller than 1 20 μm of clinical generally accepted standards.SLMsystem can satisfy the clinical requirements.

Objective To study the relationship between vitamin D deficiency and severe bronchial pneumonia in children. Methods A total of 58 children with severe pneumonia complicated by a lack of vi-tamin D from January 2011 to December 2013 were enrolled in this study,the serum 25-( OH) D3 was detec-ted by the high performance liquid chromatography-tandem mass spectrometry. All the children were random-ly divided into two groups,the vitamin D treatment group( observation group) and without vitamin D treat-ment group(control group),control group received conventional treatment,and the observation group re-ceived vitamin D based on the same treatment with the control group. Results The serum 25-( OH) D3 of the observation group increased significantly( P<0. 01 ) . ( 2 ) The symptoms such as cough, asthma, fever and pulmonary rales in the observation group disappeared more quickly than that of the control group,and the av-erage cure days of heart failure,respiratory failure and encephalopathy as well as the average length of stay in the observation group were less than those of control group,and there were significant differences between two groups(P<0. 01). (3) The total efficiency of the observation group and control group was 96. 42% and 73. 33% respectively,and there was significant difference between two groups(χ2 =6. 693,P<0. 01). (4) Blood oxygen pressure and oxygen saturation of the observer group were significantly improved,CO2 partial pressure decreased obviously, the differences were statistically significant between two groups ( P <0. 01 ) . Conclusion During the treatment periods in children with severe pneumonia,vitamin D supplements could relieve symptoms promptly,shorten the duration,improve the 25-( OH) D3 levels,and vitamin D deficiency may also be the underlying cause of severe pneumonia in children.