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.

Decoction is the most commonly used dosage form in the clinical treatment of traditional Chinese medicine (TCM). During boiling, the violent movement of various active ingredients in TCM creates molecular forces such as hydrogen bonding, π-π stacking, hydrophobic interactions and electrostatic interactions, which results in the formation of self-assembled aggregates in decoction (SADs), including particles, gels, fibers, etc. It was found that SADs widely existed in decoction with biological activities superior to both effective monomers and their physical mixtures, providing a new idea to reveal the pharmacodynamic material basis of Chinese herbal medicine from the perspective of component interactions-phase structure. Recently, SADs have become a novel focus of research in TCM. This paper reviewed their relevant studies in recent years and found some issues to be concerned in the research, such as the polydispersity of decoction system, instability of active ingredient interactions during boiling, uncertainty of the aggregates self-assembly rules, and stability, purity, yield of the products. In this regard, some solutions and new ideas were presented for the integrated development and clinical application of SADs.

Objective To understand the growth and development status and differences between small for gestational age(SGA)and appropriate for gestational age(AGA)preterm infants during corrected ages 0-24 months,and to provide a basis for early health interventions for preterm infants.Methods A retrospective study was conducted,selecting 824 preterm infants who received regular health care at the Guangzhou Women and Children's Medical Center from July 2019 to July 2022,including 144 SGA and 680 AGA infants.The growth data of SGA and AGA groups at birth and corrected ages 0-24 months were analyzed and compared.Results The SGA group had significantly lower weight and length than the AGA group at corrected ages 0-18 months(P<0.05),while there were no significant differences between the two groups at corrected age 24 months(P>0.05).At corrected age 24 months,85%(34/40)of SGA and 79%(74/94)of AGA preterm infants achieved catch-up growth.Stratified analysis by gestational age showed that there were significant differences in weight and length at corrected ages 0-9 months between the SGA subgroup with gestational age<34 weeks and the AGA subgroups with gestational age<34 weeks and≥34 weeks(P<0.05).In addition,the weight and length of the SGA subgroup with gestational age≥34 weeks showed significant differences compared to the AGA subgroups with gestational age<34 weeks and≥34 weeks at corrected ages 0-18 months and corrected ages 0-12 months,respectively(P<0.05).Catch-up growth for SGA infants with gestational age<34 weeks and≥34 weeks mainly occurred at corrected ages 0-12 months and corrected ages 0-18 months,respectively.Conclusions SGA infants exhibit delayed early-life physical growth compared to AGA infants,but can achieve a higher proportion of catch-up growth by corrected age 24 months than AGA infants.Catch-up growth can be achieved earlier in SGA infants with a gestational age of<34 weeks compared to those with≥34 weeks.

Objective To investigate the protective effect of dandelion flavone(DF)on lipopolysaccharide(LPS)-induced colon epithelial cell injury by intervening oxidative stress and inflammation with AT-specific binding protein 2(SATB2).Methods Colon epithelial cells FHC were cultured.FHC cells were randomly divided into control group(normal cultured),LPS group(10 μg·mL-1 LPS),experimental-L group(10 μg·mL-1 LPS+1 μmol·L-1 DF),experimental-H group(10 μg·mL-1 LPS+5 μmol·L-1 DF),experimental-H+sh-NC group(transfected with sh-NC+10 μg·mL-1 LPS+5 μmol·mL-1 DF),experimental-H+sh-SATB2 group(transfected with sh-SATB2+10 μg·mL-1 LPS+5μmol·L-1 DF).The relative expression level of SATB2 protein in FHC cells was detected by Western blotting.The survival rate of FHC cells in each group was determined by tetramethylazolium blue(MTT).The apoptosis rate of FHC cells in each group was detected by flow cytometry.The levels of malondialdehyde(MDA)and interleukin-6(IL-6)in FHC cells were detected by the kit.Results The relative expression levels of SATB2 protein in control group,LPS group,experimental-H group,experimental-H+sh-NC group and experimental-H+sh-SATB2 group were 0.83±0.09,0.19±0.03,0.66±0.05,0.62±0.07 and 0.23±0.03,respectively;cell viability rates were(100.00±1.00)％,(48.16±4.31)％,(85.31±5.83)％,(81.39±6.47)％and(58.75±5.24)％,respectively;cell apoptosis rates were(3.27±0.81)％,(41.26±2.09)％,(11.35±1.04)％,(10.29±1.26)％and(35.87±2.15)％,respectively;MDA levels were(13.16±1.73),(52.87±3.49),(23.19±2.05),(20.98±3.17)and(44.87±3.05)μmol·L-1,respectively;IL-6 levels were(507.18±103.26),(2 132.09±198.15),(883.16±136.92),(801.69±119.85)and(1 736.29±206.91)pg·mL-1,respectively.The above indicators in the LPS group showed significant differences compared to the control group(all P＜0.05);the above indicators in the experimental-H group showed significant differences compared to the LPS group(all P＜0.05);the above indicators in the experimental-H+sh-SATB2 group showed significant differences compared to the experimental-H+sh-NC group(all P＜0.05).Conclusion DF has a protective effect on LPS-induced colon epithelial cell injury by intervening oxidative stress and inflammation through SATB2.

Objective To observe the effect of Bushen Huoxue formula on interleukin-17(IL-17)in rats with recurrent spontaneous abortion(RSA).Methods RS A model rats were constructed by intraperitoneal injection of estradiol benzoate.Forty RSA model rats were randomly divided into model group,control group and experimental-L,-H groups,with 10 rats per group.Another 10 healthy pregnant rats were set as blank group.The experimental-L,-H groups were given 7.77 and 15.54 g·kg-1 of Bushen Huoxue formula solution by gavage.The control group was given 2.10 mg·kg-1of dydrogesterone solution by gavage.The blank group and the model group were given equal amount of 0.9％NaCl by gavage.The dose of administration for the five groups was 10 mL·kg-1,once a day,for 9 days.The number of live fetuses,embryo loss,and embryo loss rate in each group were observed.The proportion of Th 17 cells in the peripheral blood was detected by flow cytometry.The expression levels of interleukin-6(IL-6),IL-17 and IL-23 proteins in the decidual tissues were detected by Western blotting.Results The number of live fetuses in the experimental-H,control,model and blank groups were 11.50±2.84,11.50±3.10,6.30±1.25 and 12.50±3.24;the number of embryos lost were 1.80±0.42,1.90±0.57,4.90±1.37 and 0;the rates of embryo loss were(14.01±4.52)％,(14.79±6.06)％,(43.50±9.49)％and 0;the proportions of Th17 cells in the peripheral blood were(3.12±0.47)％,(3.10±0.59)％,(5.31±1.16)％and(2.54±0.71)％;the relative expression levels of IL-6 protein were 0.19±0.04,0.18±0.05,0.85±0.16 and 0.11±0.03;the relative expression levels of IL-17 protein were 0.28±0.04,0.29±0.05,0.84±0.12 and 0.09±0.01;the relative expression levels of IL-23 protein were 0.35±0.04,0.34±0.06,0.90±0.11 and 0.08±0.01,respectively.Comparing experimental-H group and model group,comparing control group and blank group,the above indexes were statistically significant(all P＜0.05).Conclusion Bushen Huoxue formula can reduce embryo loss,improve placental tissue pathology,reduce Th 17 cell proportion and its related cytokines IL-6,IL-17,IL-23 expression in rats with RSA.

Objective:To examine the burden and trends of acute viral hepatitis in Guangdong Province from 1990 to 2019, and provide reference evidences for hepatitis prevention and control in the province.Methods:Data on acute viral hepatitis (hepatitis A, B, C, and E) in Guangdong from 1990 to 2019 were extracted from the Global Burden of Disease Study 2019 database. The incidence, prevalence, mortality, and disability-adjusted life years (DALY) data were analyzed by age and gender, and the estimated annual percentage change (EAPC) was calculated to describe the changing trends in disease burden.Results:From 1999 to 2019, the standardized incidence, prevalence, mortality, and DALY of acute viral hepatitis in Guangdong were higher than the national averages. In 2019, 51.43% (2 245 087/4 365 221) of acute viral hepatitis cases in Guangdong Province were mainly attributed to hepatitis B, and 77.18% (106/138) of deaths were due to acute hepatitis B. In different age groups, except for acute hepatitis B, which was more common in adults, the incidence rates of other types of viral hepatitis such as hepatitis A, B, and E showed an overall decreasing trend with age. The mortality rates of different types of acute viral hepatitis, except for the <5 age group, increased with age. The overall incidence and mortality rates of acute viral hepatitis were higher in men than in women.Conclusions:The overall burden of acute viral hepatitis in Guangdong declined in 2019, but remained higher than the national level. Further efforts are needed to strengthen hepatitis prevention and screening in different population in Guangdong Province, especially in children and the elderly.

Objective To investigate the risk factors for bronchopulmonary dysplasia(BPD)in twin preterm infants with a gestational age of<34 weeks,and to provide a basis for early identification of BPD in twin preterm infants in clinical practice.Methods A retrospective analysis was performed for the twin preterm infants with a gestational age of<34 weeks who were admitted to 22 hospitals nationwide from January 2018 to December 2020.According to their conditions,they were divided into group A(both twins had BPD),group B(only one twin had BPD),and group C(neither twin had BPD).The risk factors for BPD in twin preterm infants were analyzed.Further analysis was conducted on group B to investigate the postnatal risk factors for BPD within twins.Results A total of 904 pairs of twins with a gestational age of<34 weeks were included in this study.The multivariate logistic regression analysis showed that compared with group C,birth weight discordance of>25%between the twins was an independent risk factor for BPD in one of the twins(OR=3.370,95%CI:1.500-7.568,P<0.05),and high gestational age at birth was a protective factor against BPD(P<0.05).The conditional logistic regression analysis of group B showed that small-for-gestational-age(SGA)birth was an independent risk factor for BPD in individual twins(OR=5.017,95%CI:1.040-24.190,P<0.05).Conclusions The development of BPD in twin preterm infants is associated with gestational age,birth weight discordance between the twins,and SGA birth.

Dendrobium officinale is a Chinese herbal medicine with the same origin as medicine and food,and it is commonly used in making soup and tonic diet,etc.Dendrobium officinale and its compound preparations are widely used in clinical practice.This article used keywords such as"Dendrobium officinale"and"clinical"to search for relevant literature on clinical research on Dendrobium officinale in CNKI,Wanfang,VIP,PubMed and other databases over the past 10 years.It is found that Dendrobium officinale and its compound preparations were mainly used in the treatment of internal medicine(such as chronic gastritis,diabetes,bronchitis,hypertension,coronary heart disease,etc.),surgery,gynecology,pediatrics,ophthalmology and other diseases,and had good clinical effects.It is a Chinese herbal medicine with the development value.This article provides a comprehensive and systematic summary and analysis of the clinical application of Dendrobium officinale,aiming to provide reference for its rational clinical application and further development and research.

OBJECTIVE: To evaluate the efficacy and safety of Cidan Capsule combined with adjuvant transarterial chemoembolization (TACE) in patients with a high risk of early recurrence after curative resection of hepatocellular carcinoma (HCC). METHODS: A multicenter, randomized controlled trial was conducted in patients with high-risk recurrence factors after curative resection of HCC from 9 medical centers between July 2014 and July 2018. Totally 249 patients were randomly assigned to TACE with or without Cidan Capsule administration groups by stratified block in a 1:1 ratio. Postoperative adjuvant TACE was given 4-5 weeks after hepatic resection in both groups. Additionally, 125 patients in the TACE plus Cidan group were administrated Cidan Capsule (0.27 g/capsule, 5 capsules every time, 4 times a day) for 6 months with a 24-month follow-up. Primary endpoints included disease-free survival (DFS) and tumor recurrence rate (TRR). Secondary endpoint was overall survival (OS). Any drug-related adverse events (AEs) were observed and recorded. RESULTS: As the data cutoff in July 9th, 2018, the median DFS was not reached in the TACE plus Cidan group and 234.0 days in the TACE group (hazard ratio, 0.420, 95% confidence interval, 0.290-0.608; P<0.01). The 1- and 2-year TRR in the TACE plus Cidan and TACE groups were 31.5%, 37.1%, and 60.8%, 63.4%, respectively (P<0.01). Median OS was not reached in both groups. The 1- and 2-year OS rates in TACE plus Cidan and TACE groups were 98.4%, 98.4%, and 89.5%, 87.9%, respectively (P<0.05). The most common grade 3-4 AEs included fatigue, abdominal pain, lumbar pain, and nausea. One serious AE was reported in 1 patient in the TACE plus Cidan group, the death was due to retroperitoneal mass hemorrhage and hemorrhagic shock, and was not related to study drug. CONCLUSIONS Cidan Capsule in combination with TACE can reduce the incidence of early recurrence in HCC patients at high-risk of recurrence after radical hepatectomy and may be an appropriate option in postoperative anti-recurrence treatment. (Registration No. NCT02253511).

Objective:To investigate the iodine nutrition status of residents and its changing trend in Baoji City, Shaanxi Province during the 10 years implementation of a new salt iodine standard, evaluate the prevention and treatment effects, and provide a basis for implementing iodine supplementation measures scientifically.Methods:From 2013 to 2015, each county (district) in Baoji City, Shaanxi Province was divided into 5 districts based on east, west, south, north, and central regions. One town (street, referred to as the town) was selected from each district, and four administrative villages were selected from each town. Fifteen residents from each administrative village were selected to collect edible salt samples from their homes and test the iodine content of the salt. At the same time, one primary school was selected from each selected town, and 42 children (age and gender were balanced) aged 8 - 10 were selected from each primary school for thyroid palpation examination. From 2016 to 2022, each county (district) was divided into 5 districts based on east, west, south, north, and central regions. One town was selected from each district, and one primary school was selected from each town. Forty-two non boarding students aged 8 - 10 were selected from each primary school to undergo thyroid palpation examination, and edible salt samples were collected from their home to detect salt iodine content. At the same time, 4 administrative villages were selected from each town, and 10 households were selected from each administrative village to collect edible salt samples and test the salt iodine content; 21 pregnant women were selected from each of the 5 towns in each county (district) to collect edible salt samples and test the salt iodine content. From 2013 to 2022, synchronous collection of urine samples from children and pregnant women (early, middle, and late pregnancy were balanced) was conducted to detect urine iodine content. Direct titration method was adopted for determination of salt iodine content, and arbitration method was adopted for Sichuan salt and other fortified edible salt (GB/T 13025.7-1999). Thyroid examination was performed according to the Diagnostic Criteria for Endemic Goiter (WS 276-2007). Urine iodine was detected by Arsenic Cerium Catalytic Spectrophotometric Method for Determination of Iodine in Urine (WS/T 107 - 2006).Results:From 2013 to 2022, a total of 37 609 household edible salt samples were collected. The coverage rate of iodized salt, the qualified rate of iodized salt and the consumption rate of qualified iodized salt for each year ranged from 98.00% to 100.00%, 94.16% to 99.55%, and 92.28% to 99.67%, respectively. The median range of salt iodine was 22.42 to 26.80 mg/kg. A total of 25 437 children aged 8 - 10 were examined, and the annual incidence of thyroid enlargement (goiter) ranged from 0.35% to 3.02%. A total of 33 270 urine samples were collected, including 21 698 from children and 11 572 from pregnant women. The median range of urine iodine for children in each year was 203.70 - 275.47 μg/L, median range of urine iodine in pregnant women was 167.65 - 218.57 μg/L. The median urine iodine in children showed a decreasing trend from 2013 to 2022 ( Z = 3.04, P = 0.002); the median urine iodine of pregnant women did not show a significant decrease ( Z = 1.61, P = 0.110). Conclusions:During the 10 years implementation of the new salt iodine standard in Shaanxi Province, all indicators of iodine deficiency disorders monitoring in Baoji City have met the standards and maintained the elimination status of iodine deficiency disorders. The urine iodine levels of children have shown a downward trend, while urine iodine levels of pregnant women do not show significant changes. It is recommended that Baoji City expand the scope of iodine nutrition monitoring for key populations, and effectively carry out iodine supplementation measures scientificlly guided by monitoring information, tailored to local conditions, and classified guidance.