【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 investigate the effect of combination of rope-assisted proprioceptive neuromuscular facilitation(PNF)training and rope-assisted brain-computer interface(BCI)training on upper limb function in stroke patients with hemiplegia. Methods From March,2022 to February,2023,96 inpatients with stroke hemiplegia from the Second Affiliated Hospital of Guangxi Medical University were randomly divided into conventional group(n=32),PNF group(n=32)and combined group(n=32).All the groups received routine rehabilitation treatment.The conventional group re-ceived upper limb PNF training,the PNF group received upper limb rope-assisted PNF training,and the com-bined group received both upper limb rope-assisted PNF training and upper limb rope-assisted BCI training,for four weeks.They were assessed with Functiongal Test for the Hemiplegic Upper Extremity-Hong Kong version(FTHUE-HK),Fugl-Meyer Assessment-Upper Extremities(FMA-UE)and modified Barthel Index(MBI)before and after treatment. Results The intra-group effect(F>341.219,P<0.001),inter-group effect(F>21.705,P<0.001)and interaction effect(F>3.171,P<0.05)were significant in the scores of FTHUE-HK and MBI.The intra-group effect(F=520.472,P<0.001)and inter-group effect(F=41.939,P<0.001)were significant in the scores of FMA-UE,and the interaction effect was not(P>0.05).After treatment,the FTHUE-HK,FMA-UE and MBI scores were the best in the combined group(P<0.05). Conclusion The combination of rope-assisted PNF training with rope-assisted BCI device training could further improve the motor function of the upper limbs in stroke patients with hemiplegia,and enhance their activities of daily liv-ing.

The pharmacy department of medical institutions assumes important responsibilities in the emergency response work.The standard of pharmacy administration in emergencies is formulated based on the principles of scientificity,versatility,instructiveness,and operability,through sorting out problems,collecting opinions and expert argumentation.This standard has 49 standards of 9 key elements from three aspects:emergency mechanism,emergency support,and emergency services.This article aims to introduce the construction method and formulation process of the pharmacy administration in emergency standards,and analyzes the content,to guide for improving emergency response ability of the medical institutions'pharmacy department in emergency events.

Tyrosine kinase inhibitor (TKI) have been proved to be effective in the treatment of advanced non-small cell lung cancer (NSCLC) patients with epidermal growth factor receptor (EGFR) sensitive mutation, which is superior to chemotherapy. However, there are still some patients with sensitive mutations have primary drug resistance. It may be related to the coexistence of susceptible and resistant mutations of EGFR gene, downstream mutations of EGFR pathway, MET amplification and BIM deletion polymorphism. We present 2 cases of primary drug resistance and analyze the reasons.
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Carcinoma, Non-Small-Cell Lung ; diagnostic imaging ; drug therapy ; genetics ; Disease Progression ; Drug Resistance, Neoplasm ; drug effects ; genetics ; ErbB Receptors ; antagonists & inhibitors ; genetics ; Fatal Outcome ; Humans ; Lung Neoplasms ; diagnostic imaging ; drug therapy ; genetics ; Male ; Middle Aged ; Mutation ; Protein Kinase Inhibitors ; therapeutic use ; Treatment Outcome

Objective To access the value of MRI in differential diagnosis between intrahepatic cholangiocarcinoma and atypical hepatic abscess. Methods Retrospectively collecting and analyzing the clinical and MRI imaging data of 19 patients with intrahepatic cholangiocarcinoma (ICC) and 17 patients with atypical hepatic abscess, confirmed by reexamination after anti‐inflammation therapy, surgery or puncture etiology, from June 2011 to July 2018 in Central Hospital of Lishui City.They were divided into ICC and abscess groups.All patients underwent routine liver plain MRI, DWI and contrast‐enhanced MR scan. The MRI features of the two groups (including morphology, boundary, cystic change and necrosis, pseudocapsule, hemorrhage, lipid composition, the signature of lesion in different phases of MRI and surrounding tissue) were studied. Fisher exact test and t test were used. Result This study showed that there was statistical difference between the two groups in the following aspects, the presence of cystic degeneration, the degree of annular enhancement in arterial phase, the homogeneous enhancement in portal venous phase and balanced phase and the central filling enhancement sign (P<0.05).The results showed that necrotic cystic lesion was more common in the abscess group (15/17 cases) than in the ICC group (0/19 cases);in the cases with annular enhancement in arterial phase,the degree of enhancement in the ICC group (13/16 cases) was higher than that in the abscess group (2/9 cases); the enhancement of the central parenchyma of lesion on out‐of‐phase images (1/19 cases) was slower in the ICC group than that in the abscess group (14/17 cases);and the ICC group was likely to present as central filling enhancement compared to the abscess group. Conclusion The presence of cystic lesions in DWI, the enhancement degree of marginal parenchyma, the enhancement speed of central parenchyma and the whole enhancement pattern are essential signs for differentiating intrahepatic cholangiocarcinoma and atypical hepatic abscess. 图1 女,53岁,右肝脓肿.病灶最大径4.0 cm,病灶中的小囊变区在DWI上呈高信号(↑) 图2 女,39岁,右肝脓肿.病灶最大径3.1 cm,病灶中的小囊变区在DWI上呈高信号(↑) 图3 女,66岁,右肝肝内胆管细胞癌(ICC).病灶最大径5.3 cm,横轴面T2WI病灶整体呈不均匀高信号,内见相对更高信号的富黏液区(↑) 图4 男,45岁,右肝ICC.病灶最大径5.8 cm,横轴面T2WI病灶整体呈高低混杂信号,内见散在片状低信号的凝固性坏死区(↑) 图5 与图1为同一患者.横轴面T2WI病灶实质部分呈均匀高信号,小囊变区呈明显高信号(↑) 图6 与图2为同一患者.横轴面T2WI病灶实质部分呈等信号,小囊变区呈明显高信号(↑)图7 与图3为同一患者.增强扫描动脉期横轴面示病灶边缘轻度不规则环形强化 图8 与图4为同一患者.增强扫描动脉期横轴面示病灶强化环有多处中断征象(↑) 图9,10 男,45岁,右肝ICC.病灶最大径5.8 cm,增强扫描动脉期横轴面(图9)示病灶边缘局部显著环形强化,局部强化环明显中断(↑).平衡期横轴面像(图10)示病灶中央有填充强化 图11 与图3,7为同一患者.平衡期横轴面示病灶内富黏液区出现轻微中央填充强化(↑) 图12 与图4、8为同一患者.平衡期横轴面像示病灶中央有填充强化 图13,14 男,59岁,右肝脓肿.病灶最大径4.3 cm,动脉期横轴面像(图13)示脓壁散在强化,周围见片状异常灌注.平衡期横轴面像(图14)示脓壁均匀强化,其内囊变区无强化 图15 与图2,6为同一患者.平衡期横轴面像示脓壁均匀强化呈相对等信号,其内囊变区无强化(↑) 图16 与图1,5为同一患者.平衡期横轴面像示脓壁均匀强化呈相对等信号,其内囊变区无强化(↑)

Medication safety is a top concern for medical institutions. Outpatient prescription standard is designed to standardize prescription, dispensing, and supervision for outpatient and emergency prescriptions at medical institutions. The standard covered prescription authorization management, prescription issuance, prescription dispensing, prescription saving and supervision. These four parts focus on risk exposure of patients′medication safety, and aim at safeguarding patient medication safety, which were formulated according to China′s laws and regulations, domestic and international industrial standards and technical specifications, as well as prescription conditions at medical institutions and experts opinions. The standard covers technical requirements and guidance, management measures and system development, serving as an important basis to guide medical institutions on standardize management of outpatient prescription and emergency prescription.

Objective To discuss the influence of preoperative family purge care for the quality of life of patients with long type of congenital Hirschsprung′s disease (HD) who had enterocolitis history in neonatal period. Preoperative family purge care, which can shorten the HD postoperative treatment, improve the quality of life. Methods A total of 40 cases of patients with long type of congenital HD who had enterocolitis history in neonatal period received 1-stage radical preoperative by family phone call. Nineteen cases from January 2010 to February 2013 were as normal group and 21 cases from March 2013 to April 2016 were as improved group. Routine family purge nursing care 3-6 months were used in both the groups, while the combined nursing care of expanding anus were used in the improved group in addition. Evaluated the effects of postoperative observation indicates: the first defecation time, length of hospital stay, time needed for expanding anus, patency rate of defecation and not patency rate in 9-12 days, need enema intervention to assist defecate rate after postoperative 1 year, the recurrence of enterocolitis at 1-3 years after operation. Results The first defecation time, length of hospital stay, time needed for expanding anus were (39.15±8.23) h, (7.89±0.82)d, (5.17±0.98) min in normal group, (23.79± 7.54) h, (7.10± 0.29) d, (3.15±0.73) min in improved group, and there were significant differences between two groups (t=6.13, 5.46, 15.54, all P<0.01). The patency rate of defecation and not patency rate in 9-12 days were 12/19, 7/19 in normal group, 100.00%(21/21), 0 in improved group, and there were significant differences between two groups (χ2=9.38, P<0.01). The intervention rate of no need for enema, occasionally enema, often enema were 2/19, 12/19, 5/19 in normal group, 76.19%(16/21), 23.81%(5/21), 0 in improved group, and there were significant differences between two groups (χ2=18.25, P<0.01). There was no significant difference in the recurrence of enterocolitis at 1, 2, 3 years after operation between two groups (χ2=2.33, P>0.05). Conclusions Patient with long type of congenital HD who had enterocolitis history in neonatal period neonatal period,received family enema and expanding anus in 3- 6 months before 1-stage radical preoperative can shorten the postoperative HD treatment, improve the quality of life.

Objective To discover the mutations of rare thalassemia genes by sequencing of α and β-globin genes,to understand the frequency of rare mutations and to enrich thalassemia gene mutation spectrum in Chinese population.Methods For the cases of phenotype and genotype inconsistent,the 1st generation of sequencing was performed for α or β-globin gene coding region sequence analysis.Results A total of 102 patients with rare thalassemia gene mutations were found by sequencing,including 79 cases of β-thalassemia with 35 kinds of mutant types,and 23 cases of α-thalassemia with 11 kinds of mutant types.Conclusion The thalassemia gene sequencing could reveal rare mutations in genes,identify the genotype of patients,provide important support for prenatal diagnosis of rare thalassemia families,and reduce the missing rate and birth rate of children with thalassemia.

Objective To observe the human papillomavirus(HPV) prevalence and its distribution character among females in Changzhou and to provide epidemiological data for the prevention of cervical cancer and development of HPV vaccine .Methods The clinical material consisted of 32215 women ,who were from Changzhou Hospital T .C .M ,Changzhou Maternal and Child Health Care ,The Second People's Hospital of Changzhou and Changzhou Wujin Hospital from January 2014 to June 2016 .17 kinds of high-risk subtypes (HPV16 ,18 ,31 ,33 ,35 ,39 ,,45 ,51 ,52 ,53 ,56 ,58 ,59 ,66 ,68 ,73 ,82) and 6 kinds of low-risk subtypes (HPV6 ,11 ,42 ,43 ,81 ,83) were detected .All cases were divided into six groups according to the age (<20 ;>21 to 30;31 to 40 ;41 to 50 ;51 to 60 ;and>61) and the age distribution of women infected with HPV and genotypes of HPV were analyzed .Results Out of 32215 cervical cell specimens ,8396 cases were detected HPV infections with the position rate of 26 .06% .In seventeen types of high-risk HPV ,HPV 16 (4 .55% ) were the most common subtype ,followed by 52 (4 .43% ) ,58 (2 .75% ) ,53 (2 .42% ) ,51 (2 .16% ) ,68 (1 .85% ) ,56 (1 .73% ) ,33 (1 .40% ) ,18 (1 .38% ) ,66 (1 .33% ) ,59 (1 .26% ) ,39 (1 .08% ) ,31 (1 .02% ) ,35 (0 .89% ) ,45 (0 .42% ) ,73 (0 .26% ) ,and 82 (0 .15% ) .Six types of low-risk HPV were detected ,of which HPV 81 (2 .96% ) was the most common subtypes ,followed by 43 (1 .86% ) ,42 (1 .62% ) ,6 (1 .27% ) ,11 (0 .80% ) and 83 (0 .26% ) .Conclusion The predominant genotypes of HPV 16 and ,52 infection in female reproductive tract are the highest .

Objective To study the prevalence of thrombocytosis in patients with non-small-cell lung cancer (NSCLC) and its correlation with clinicopathological features.Methods 156 patients with advanced NSCLC were retrospectively analyzed.The platelets degree between the groups with different sex,age,smoking,histological type of advanced NSCLC was compared and analyzed statistically.The relationship between the platelet count and chemotherapy effects was analyzed.Single analysis and Cox regression analysis were used for TTP and OS.Results Compared with the healthy persons,Plt significantly elevated in group with advanced NSCLC (36.5 ％,57/156 vs 5.0 ％,5/100) (P ＜ 0.01),and thrombocytosis group responded poorly to chemotherapy (22.8 ％,13/57 vs 39.4 ％,39/99) (P ＜ 0.05).The TTP (3.0 months vs 5.2 months) and OS (11.2 months vs 14.2 months) of Plt elevated group were significantly shorter than those of normal group.Conclusion Thrombocytosis is closely related to progress and metastasis of advanced NSCLC.Platelet count can be used as an assistant index in the prognosis judgment of patients with advanced NSCLC.