Objective:To study the current status of longitudinal extrauterine growth restriction (EUGR) in extremely preterm infants (EPIs) and to develop a prediction model based on clinical data from multiple NICUs.Methods:From January 2017 to December 2018, EPIs admitted to 32 NICUs in North China were retrospectively studied. Their general conditions, nutritional support, complications during hospitalization and weight changes were reviewed. Weight loss between birth and discharge > 1SD was defined as longitudinal EUGR. The EPIs were assigned into longitudinal EUGR group and non-EUGR group and their nutritional support and weight changes were compared. The EPIs were randomly assigned into the training dataset and the validation dataset with a ratio of 7∶3. Univariate Cox regression analysis and multiple regression analysis were used in the training dataset to select the independent predictive factors. The best-fitting Nomogram model predicting longitudinal EUGR was established based on Akaike Information Criterion. The model was evaluated for discrimination efficacy, calibration and clinical decision curve analysis.Results:A total of 436 EPIs were included in this study, with a mean gestational age of (26.9±0.9) weeks and a birth weight of (989±171) g. The incidence of longitudinal EUGR was 82.3%(359/436). Seven variables (birth weight Z-score, weight loss, weight growth velocity, the proportion of breast milk ≥75% within 3 d before discharge, invasive mechanical ventilation ≥7 d, maternal antenatal corticosteroids use and bronchopulmonary dysplasia) were selected to establish the prediction model. The area under the receiver operating characteristic curve of the training dataset and the validation dataset were 0.870 (95% CI 0.820-0.920) and 0.879 (95% CI 0.815-0.942), suggesting good discrimination efficacy. The calibration curve indicated a good fit of the model ( P>0.05). The decision curve analysis showed positive net benefits at all thresholds. Conclusions:Currently, EPIs have a high incidence of longitudinal EUGR. The prediction model is helpful for early identification and intervention for EPIs with higher risks of longitudinal EUGR. It is necessary to expand the sample size and conduct prospective studies to optimize and validate the prediction model in the future.

Objective:To investigate the predictive value of preoperative D-dimer level for futile recanalization (FR) after mechanical thrombectomy (MT) in patients with acute ischemic stroke (AIS).Methods:It was a nested case-control study. A total of 116 patients with large vessel occlusion (LVO) stroke, who underwent successful recanalization (modified Thrombolysis in Cerebral Infarction, mTICI≥2b) after MT at the Stroke Unit of Beijing Hospital from August 2018 to January 2022,were consecutively enrolled, including 72 males (62.1%) with the age of (72.8±13.1) years. According to the 3-month modified Rankin Scale (mRS) score after MT, patients were divided into the meaningful recanalization group (mRS 0-2, n=41) and the futile recanalization group (mRS 3-6, n=75). The baseline clinical data of enrolled patients was collected. Logistic regression analysis was used to identify the independent risk factors for FR after MT in patients with AIS. Receiver operating characteristic (ROC) curve was used to evaluate the predictive value of D-dimer for FR. Results:Multivariate logistic regression analysis showed that high baseline systolic blood pressure (SBP) ( OR=1.038, 95% CI: 1.012-1.065, P=0.004), baseline National Institutes of Health Stroke Scale (NIHSS) score≥12 ( OR=10.157, 95% CI: 3.624-28.470, P<0.001) and high preoperative D-dimer level ( OR=4.536, 95% CI: 1.379-14.922, P=0.013) were independent predictors of FR after MT in AIS patients with LVO. ROC curve analysis indicated a good predictive value of preoperative D-dimer for the occurrence of FR ( AUC=0.733, 95% CI: 0.638-0.829, P<0.05), the optimal cut-off value of D-dimer was 2.65 μg/L(Lg), with the Youden index, sensitivity, specificity and accuracy of 0.435, 53.3%, 90.2% and 66.4%, respectively. Conclusion:High preoperative D-dimer level is an independent predictor of futile recanalization after MT in AIS patients with LVO, which shows good predictive ability for futile recanalization.

Objective To compare the difference in binocular visual function after implantation of different types of intraocular lenses(IOL).Methods A total of 63 patients(126 eyes)with age-related cataract who underwent phacoe-mulsification combined with IOL implantation in Yantai Affiliated Hospital of Binzhou Medical University from October 2021 to June 2023 were collected.Among them,22 patients(44 eyes)were implanted with monofocal IOL in both eyes(mono-focal group),21 patients(42 eyes)were implanted with monofocal and multifocal IOL in both eyes,respectively(mixed group),and 20 patients(40 eyes)were implanted with multifocal IOL in both eyes(multifocal group).Another 22 patients(44 eyes)with physiological presbyopia were selected from the medical examination center of the same hospital during the same period as the control group.Uncorrected distance visual acuity(UDVA),uncorrected near visual acuity(UNVA),defocus curve,amplitude of accommodation(AMP),positive relative accommodation(PRA),negative relative accommo-dation(NRA),binocular cross-cylinder(BCC),accommodative convergence/accommodation ratio(AC/A),rupture point at the near point of convergence(NPC),near-far distance positive fusional vergence(PFV)and negative fusional vergence(NFV)rupture points,and near-far distance stereopsis of patients in the four groups were recorded and compared during the 3-month follow-up.Results After three months of follow-up,there was no significant difference in UDVA among the four groups(P＞0.05),while the UNVA of patients in the multifocal group and the mixed group was better than that in the control group and the monofocal group(all P＜0.05).The defocus curves of patients in the mixed group and the multifocal group were bimodal.There were statistically significant differences in AMP,NRA,PRA,and BCC among the four groups(all P＜0.05).There was no statistically significant difference in the AC/A ratio and far-distance NFV and PFV rupture points among the four groups(all P＞0.05).There were statistically significant differences in NPC rupture point and near-distance NFV and PFV rupture points among the four groups(all P＜0.05).There was no statistically significant difference in the proportion of patients with normal far-distance stereopsis among the four groups(P＞0.05).The proportion of pa-tients with normal near-distance stereopsis in the mixed group was significantly lower than that in the other three groups(all P＜0.05).Conclusion Multifocal IOL can effectively improve postoperative UDVA and UNVA in cataract patients.Binocular implantation of multifocal IOL is beneficial to the reconstruction of binocular visual function in far-and near-dis-tance conditions after cataract surgery.The mixed implantation of monofocal and multifocal IOL affects the recovery of near-distance binocular stereopsis in the short term.

OBJECTIVE To establish the quality standard of the leaves of Litchi chinensis Sonn.. METHODS The identification of medicinal properties, microscopic characteristics, TLC and content determination method of the leaves of Litchi chinensis Sonn. was conducted. The moisture, total ash, acid insoluble ash and extract of the leaves of Litchi chinensis Sonn. were determined according to Chinese Pharmacopoeia(Volume IV), 2020. RESULTS The leaves of Litchi chinensis Sonn. under forest exhibited specific properties in characteristics, microscopic features and TLC results. The moisture content of the medicinal materials was 2.66%-6.42%, the total ash content was 2.96%-4.52%, the acid insoluble ash content was 0.17%-0.94%, the water soluble extract was 15.38%-19.87%, and the alcohol soluble extract was 24.94%-30.33%. The eight components of gallic acid, protocatechin, catechin, epicatechin, rutin, astragalin, quercetin and kaempferol had a good linear relationship in 0.003 3-0.052 0 mg·mL-1, 0.006 9-0.109 6 mg·mL-1, 0.013 0-0.208 0 mg·mL-1, 0.057 5-0.920 0 mg·mL-1, 0.013 4-0.213 6 mg·mL-1, 0.013 2-0.211 2 mg·mL-1, 0.002 9-0.045 6 mg·mL-1, 0.003 6-0.056 8 mg·mL-1(r>0.999). The average sample recovery rate was 97.43%-102.97% and the RSD was 1.70%-2.90%. CONCLUSION The established quality standard of the leaves of Litchi chinensis Sonn. medicinal material has good specificity, accuracy and reproducibility, which can be used for quality control research of the leaves of Litchi chinensis Sonn..

OBJECTIVE：To establish HPLC fingerprints of different polar parts of Zhuang medicine Calonyction muricatum ， and to study its spectrum-effect relationship with analgesic and anti-inflammatory effects. METHODS ：The total part ，ethyl acetate part，n-butanol part and water part of C. muricatum were prepared. HPLC fingerprints of different polar parts were established by HPLC method combined with the Similarity Evaluation System of TCM Chromatogramtic Fingerprint （2012A），and the common peaks were identified. Using writhing times and ear swelling degree in mice as analgesic and anti-inflammatory indexes ，analgesic and anti-inflammatory activity of different polar parts of C. muricatum were investigated. The correlation of the common peaks of HPLC fingerprint with analgesic and anti-inflammatory indexes was analyzed by grey correlation analysis ，bivariate correlation analysis and partial least square （PLS） method. RESULTS ： There were 11 common peaks for the different polar parts of C. muricatum ，and 5 components were identified by reference comparison，i.e. neochlorogenic acid （peak 3），chlorogenic acid （peak 5）， cryptochlorogenic acid （peak 6）， isochlorogenic acid A （peak 10），isochlorogenic acid C （peak 11）. The grey correlation analysis showed that the correlation between all common peaks and analgesic and anti- inflammatory effects were greater than 0.6 （except the correlation between peak 6 and analgesic effects ），showing correlation relationship ；the correlation of peaks 3，7 and 10 with analgesic and anti-inflammatory effects were all greater than 0.8，which was highly related. Bivariate correlation analysis showed that the correlation of peak 1，3，4，7，9，10，11 with analgesic and anti-inflammatory effects were all greater than 0.6，showing correlation relationship. PLS method showed that peaks 1，3，4，7，9，10，11 contributed greatly to playing an analgesic and anti-inflammatory role. CONCLUSIONS ：HPLC fingerprints of different polar parts of C. muricatum is established and five common peak components were identified. Neochlorogenic acid ，isochlorogenic acid A ，isochlorogenic acid C and chemical components represented by peaks 1，4，7，9 may be the pharmacodynamic substances of C. muricatum to exert analgesic and anti-inflammatory effects.

Objective:To analyze the clinical characteristics and prognostic factors of gastric stump cancer.Method:The clinical data of 126 gastric stump cancer patients from Jan 1995 to Dec 2014 were collected . We analyzed the survival and prognosis of patients in terms of gender, tumor location, size, clinicopathological stage and treatment methods.Results:For primary surgery, B-Ⅱ GI reconstruction were more likely associated with gastric stump cancer, accounting for 69.8% of the total cases, and cancer was more likely to occur at the anastomotic stoma and in its vicinity, accounting for 62.3%. The 1'- , 3'- , and 5-year survival rates of 126 patients were 90.4%, 57.9%, and 41.2%, respectively. The 1'-, 3'- and 5-year overall survival rates in radical operation group were 96.9%, 74.2% and 53.6% respectively, while it was 69.0%, 3.4% and 0 respectively in palliative operation group (all P<0.01). Univariate analysis showed that tumor size, invasion depth, lymph node metastasis, distant organ metastasis, TNM stage, histological type, treatment mode and chemotherapy were related to the prognosis (all P<0.01). By multivariate analysis, radical resection and chemotherapy were protective factors for the prognosis ( P<0.01). Conclusion:Most gastric stump cancer are associated with distal subtotal gastrectomy and B-Ⅱ reconstruction . Radical resection is an effective therapy for gastric stump cancer.

Objective:To select the animal model more consistent with the pathophysiology of abdominal compartment syndrome (ACS) through the comparative study of the methods of multiple water sacs superimposed compression and gas perfusion.Methods:Ten experimental pigs were randomly divided into two groups ( n = 5): the "constant volume model" (constant volume model group) and the "constant pressure model" (constant pressure model group) of intra-abdominal hypertension. The models were prepared by the method of water sac superposition and pressurization, and artificial pneumoperitoneum respectively. The abdominal pressures of both groups were 25 mmHg (1 mmHg = 0.133 kPa) and observed for 4 hours. The pressure was measured once an hour for 4 hours and the pressure-time curves of the two groups were drawn respectively. The experimental animals were sacrificed 4 hours after modeling. The heart and lung were harvested, and the histopathological changes were observed by hematoxylin-eosin (HE) staining. Results:Two groups of experimental pigs were successfully modeled. The abdominal pressure gradually increased at 0, 1, 2, 3, 4 hours after operation in the constant volume model group (mmHg: 25.0±0, 27.1±0.2, 29.4±0.1, 30.9±0.2, 33.1±0.1), and there was a positive correlation between the abdominal pressure and time (functional equation: Y1 = 25.102 0+1.996 0 X1; R2 = 0.996 2, P = 0.000 1). The abdominal pressure value in the constant pressure model group at 0, 1, 2, 3, 4 hours were maintained 25 mmHg, and there was no linear correlation between the abdominal pressure and time (functional equation: Y2 = 25). HE staining showed that in the constant volume model group, the myocardial fibers were accompanied with hyaline degeneration, significantly reduced transverse lines, part of myocardial fiber atrophy, and visible nuclear aggregation; hemorrhage, chronic inflammatory cell infiltration and inflammatory exudation were found in the lung tissues. In the constant pressure model group, partial atrophy of myocardial fiber, partial hypertrophy, focal hyaline degeneration, disappearance of local striae, hyaline degeneration of myocardial fiber, dilation and congestion of intermyocardial artery were observed. Slight hyperplasia of alveolar epithelium in some areas, heart failure cells, dilation and congestion of bronchi and trachea artery, a large number of red blood cells and uniform light staining substances in lumen were found. Conclusion:After the model was made by the method of multiple water sacs, the pressure of the abdominal cavity continued to increase with the development of the disease, which was in line with the clinical pathological changes of ACS, and was more suitable for making the animal model of the intra-abdominal hypertension.

Objective To explore the reasons and influencing factors of unplanned removal of implantable venous access port (IVAP) in tumor patients, and analyze its influencing factors, so as to explore the corresponding clinical interventions. Methods A total of 1 029 cases of tumor patients who were implanted IVAP in Zhejiang Cancer Hospital from January 1st, 2009 to December 31st, 2016 were recruited by convenience sampling method. Univariate analysis and Logistic regression analysis were applied to analyze the influencing factors of unplanned port-taking. Results Finally 1 002 tumor patients were recruited excluding patients who died or lost follow-up. Excluding patient's subjective factors, catheter-related blood stream infection (CRBSI), catheter clamping syndrome, and pain around infusion seat were the main causes of unplanned removal of IVAP. Univariate analysis revealed that there were significant differences in unplanned port removal among patients with different catheterization veins, infection and coagulation function (χ2=15.691, 14.425, 16.732; P＜ 0.001). Logistic regression analysis showed that internal jugular vein catheterization (OR=8.272), infection (OR=2.592) and coagulation (OR=2.709) were the main factors. Conclusions Medical staff should strictly control the causes and influencing factors of unplanned removal of IVAP when implanting and maintaining the use of IVAP for patients, so as to prolong the use time of infusion port.

Objective:To prepare for mAb of progesterone receptor. It would provide support for the immunohistochemistry behind. Methods:Target gene connected together with a carrier by seamless cloning method. The target protein that expression by inducing was collected. And with cell fusion method , the monoclonal antibodies were preparation. Then the mAb were detected by IHC. Results: The mAb ( clone 7C7 ) was detected and it found positive for the breast, uterine fibroid tissue, showed negative in colorectal cancer tissue, smooth muscle tissue, the goal of the claim were achieve. Conclusion: Finally, we found the method that prepare for mAb was far beyond our imagination. The result of IHC on different samples about mAb(7C7)obtained compliance with an-ticipation. Study on the difference between the PR-A and PR-B had significance.

Objective To investigate the association of serum ubiquitin carboxy-terminal hydrolase L1 (UCH-L1) level with severity,progression and prognosis of traumatic brain injury (TBI).Methods Sixty TBI patients,admitted to our hospital from March 2012 to June 2013,were chosen in our study,and divided into moderate TBI group (Glasgow coma scale [GCS] scores:9-12,n=30) and severe TBI group (GCS scores:3-8,n=30);30 healthy controls were chosen.The serum UCH-L1 levels 12 and 24 h,and 2,3 and 5 d after TBI were detected using enzyme-linked immunosorbent assay (ELISA).Additionally,the correlations between serum UCH-L1 level and both imaging data and prognosis of TBI were analyzed.Results As compared with that in the control group,the mean serum UCH-L1 level in moderate TBI group and severe TBI group 12 and 24 h,and 2 and 3 d after TBI was significantly increased (P＜0.05);as compared with that in the moderate TBI group,the serum UCH-L1 level in severe TBI group 12 and 24 h,and 2 and 3 d after TBI was significantly increased (P＜0.05).The serum UCH-L1 level in the moderate TBI group reached the peak at 12 h after TBI,then gradually declined and presented no significant difference 5 d after TBI in comparison with controls.In severe TBI group,serum UCH-L1 level reached the first peak at 12 h,then gradually decreased,and rose again for the second peak 3 d after TBI.Serum UCH-L1 level was closely related with imageological changes and negatively correlated with prognosis of TBI (r=-0.412,P=0.030).Conclusion Serum UCH-L1 level appears to have potential clinical utility in providing valuable information about severity,progression and prognosis of TBI.