【Objective】 To analyze the association of sexual development characteristics and phases with the cognitive and behavioral development of adolescents aged 10 to 14 in rural areas of Shaanxi Province, in order to provide scientific reference for enhancing adolescent health. 【Methods】 The study population was selected from a birth cohort study′s follow-up data for the adolescent phase. The Tanner quintile method was used to assess sexual development, the Wechsler Intelligence Scale for Children, Fourth Edition (WISC-Ⅳ) was used to assess cognitive development, and the Youth Self-Rating Scale(YSR-2001) was used to assess behavioral development. Generalized linear models was used to examine the association of the stages of adolescent sexual development with their cognitive and behavioral development. 【Results】 A total of 1 887 adolescents were enrolled in this study, with 1 111 (58.9%) boys. The proportion of boys and girls who have started sexual development was 78.22% and 89.30%, respectively. The detection rate of behavioral problems in adolescents was 9.70%, with 11.80% in boys and 6.70% in girls, and the gender difference was significant (χ²=13.517, P<0.001). Compared to adolescents in Tanner stage Ⅰ, adolescents in stage Ⅲ had a higher total cognitive score of 2.19 (95%CI: 0.15 - 4.23), and a higher total score of 3.84 (95%CI: 0.85 - 6.83,P<0.05) in stages Ⅳ-Ⅴ. The detection rate of total behavioral problems of children in Tanner stages Ⅳ-Ⅴ was 2.63 times (95%CI:1.27 - 5.46,P<0.05) higher than that in stage Ⅰ. In boys, the rate of detection of internalizing problems was 3.96 times(95%CI:1.60 - 9.81,P<0.01) higher than that in stage Ⅰ, and the detection rate of internalizing problems was 2.88 times(95%CI:1.19 - 7.01,P<0.05) higher than that in stage Ⅰ. 【Conclusions】 There is a significant correlation of sexual developmental phrase with cognitive and behavioral development among adolescents aged 10 - 14 years in rural Shaanxi Province. The detection rate of adolescent behavioral problems increases with the increase of sexual development level and cognitive level, and there are significant gender differences.

【Objective】 To explore the impact of intrapartum antibiotic prophylaxis (IAP) on antibiotic resistance genes (ARGs) in the gut microbiota of infants up to 6 months of age and their longitudinal changes, in order to provide theoretical basis for the rational use of antibiotics and antibiotic resistance control. 【Methods】 Fecal samples were collected within 3 days, 2 months, and 6 months from a maternal and birth cohort conducted between January 2018 and June 2019. A panel of 6 common ARGs (aac(6′)-Ib, qnrS, blaTEM, ermB, mecA, tetM) were tested, the absolute abundance and positive detection rate by qPCR were calculated. Nonparametric and linear mixed model (LMM) analysis were used to assess the influence of IAP on the absolute abundance of antibiotic resistance genes and the longitudinal changes in their abundance at the three time points. 【Results】 A total of 157 samples from 65 singleton infants were analyzed, including 15 mothers (23.1%) who received IAP. The detection rate of ARGs was high in infants up to six months of age, and the abundance of ARGs tended to increase over time. IAP significantly increased the abundance of the mecA gene in the gut microbiota of vaginally delivered infants at 6 months of age (6.1±1.1 in the VDIAP group vs. 3.8±4.6 in the VDno-IAP group, P=0.046). Additionally, in cesarean section infants, there was a significant increase in the abundance of aac(6′)-Ib genes at 2 months (β=3.81, ,P<0.05), P<0.05] and 6 months of age (β=4.89, ,P<0.001), P<0.001) compared to 3 days of age. 【Conclusions】 The findings suggest that IAP can increase the abundance of ARGs in 6-month-old infants, and this effect is still significant after stratifying by delivery mode. Therefore, the rational and standardized use of intrapartum antibiotics may help reduce the development of antibiotic resistance.

Bone defects caused by different causes such as trauma, severe bone infection and other factors are common in clinic and difficult to treat. Usually, bone substitutes are required for repair. Current bone grafting materials used clinically include autologous bones, allogeneic bones, xenografts, and synthetic materials, etc. Other than autologous bones, the major hurdles of rest bone grafts have various degrees of poor biological activity and lack of active ingredients to provide osteogenic impetus. Bone marrow contains various components such as stem cells and bioactive factors, which are contributive to osteogenesis. In response, the technique of bone marrow enrichment, based on the efficient utilization of components within bone marrow, has been risen, aiming to extract osteogenic cells and factors from bone marrow of patients and incorporate them into 3D scaffolds for fabricating bone grafts with high osteoinductivity. However, the scientific guidance and application specification are lacked with regard to the clinical scope, approach, safety and effectiveness. In this context, under the organization of Chinese Orthopedic Association, the Expert consensus for the clinical application of autologous bone marrow enrichment technique for bone repair ( version 2023) is formulated based on the evidence-based medicine. The consensus covers the topics of the characteristics, range of application, safety and application notes of the technique of autologous bone marrow enrichment and proposes corresponding recommendations, hoping to provide better guidance for clinical practice of the technique.

Objective: To explore the relevant factors of behavioral development among 30-month-old infants in rural area, Shaanxi Province. Methods: The behavioral development among 977 infants aged 30-month-old was evaluated in Changwu and Binxian of Shaanxi province from July 2006 to August 2008. The inclusion criteria included single live birth between January 2004 and February 2006, mother had participated in a community-based intervention study named "Impact of multi-micronutrient supplementation during pregnancy on low birth weight and premature delivery" . Infants who had obvious deformity or other birth defects, infants who could not complete the questionnaire survey, physical examination were excluded from the study. The self-designed questionnaire was used to investigate the information of feeding patterns, disease status, physical development, and immunization status of the infants, and their behavioral development were assessed by Bayley scales of infant development (BSID). General Linear Model was used to adjust the possible confounding factors, and the analysis of variance was performed to explore the effects on the behavioral development among infants aged 30-month-old. Results: Among the infants in the study, the average age was (30.6±0.6) months old, the mean birth weight was (3 199.1±405.9)g. After adjusted the mothers' age of delivery, educational level and occupation of the parents, family ecnomic conditions and the number of children, infants whose mother exposed to toxic chemicals during pregnancy had lower score in activity (-0.179±0.961) and lower score in concentration (-0.177±1.099) compared with infants with unexposed mother (0.058±1.006, P=0.001; 0.057±0.960, P=0.003). Similarly, infants whose mother took drugs during pregnancy had lower score in persistent behaviors (-0.070±1.000) compared with infants whose mother did not(0.085±1.006, P=0.017). Compared with normal birth infants(0.043±0.981, P=0.007; 0.021±0.984, P=0.034), infants less than gestational age and low birth weight had lower score in concentration(-0.198±1.063 and-0.389±1.285, respectively). After adjusted the delivery gestational age of mothers, the months of infants, the mothers' age of delivery, educational level and occupation of the parents, family ecnomic conditions, the number of children, and the main orderlies of infants, the score of activity of infants suffered from diseases in early month age was-0.049±0.992, which was lower than those who did not(0.207±1.011, P=0.001). The infants with Rickets signs had lower score in motor coordination (-0.218±0.896) than normal infants (0.031±1.011, P=0.013). Infants whose mother with adequate micronutrient supplementation in pregnancy had higher score in concentration (0.066±0.966) than those whose mother with insufficient supplementation (-0.062±1.027, P=0.043). Furthermore, infants with fine protein added and minerals and vitamins added had higher score in activity and concentration compared with those insufficient, who scored 0.078±1.013 and 0.496±0.872 (-0.254±0.924, P<0.001; 0.001±0.997, P=0.033), respectively. Conclusion Micronutrient supplementation during pregnancy and reasonable nutrition added during childhood could affect behavioral development among infants.

Objective To analyze the application value of optical coherence tomography (OCT)in the diagnosis of normal tension glaucoma (NTG).Methods 50 NTG patients (92 eyes)were selected as control group, at the same period 50 cases in our hospital physical examination center for the health examination were selected as the observation group.The optic disc and retinal nerve fiber layer thickness were measured by OCT.The disc diameter, disc area,depending on the cup diameter,optic cup area in the optic disc parameters were observed and compared between the two groups.Results The optic disc diameter between the control group and the observation group had no significant difference (t =1.02,P >0.05),the differences among the remaining nine parameters were significant (t =3.11,2.85,5.63,5.21,4.13,3.06,3.10,6.58,4.36,all P <0.05).Conclusion OCT can measure and analyze the optic disc and retinal nerve fiber layer quantitatively,it is reproducible,clinical early diagnosis of NTG is of great significance,it is worth popularization and application.

Objective:To explore changes of central retinal vascular caliber and fractal dimension (Df) and their cor‐relation with blood pressure in hypertensive population .Methods :A total of 2169 subjects>30 years old were en‐rolled in this cross‐sectional study .They were divided into hypertension group (n=819) and non‐hypertension group (n=1350) .Fundus photos were collected in all subjects ,and semi‐automatic software was used to quantitatively ana‐lyze central retinal vascular caliber and Df ,and they were compared between two groups .Results:Compared with non- hypertension group ,there were significant reductions in central retinal arteriolar equivalent [CRAE ,(135.2 ± 10.72) μm vs .(132.25 ± 11.56) μm] ,central retinal venular equivalent [CRVE ,(184.95 ± 16.29) μm vs . (182.52 ± 17.07)μm] and Df [ (1.38 ± 0.05) vs .(1.34 ± 0.05)] in hypertension group , P<0.01 all .After adjus‐ting for age and gender ,analysis of covariance indicated that CRAE and Df of hypertension group were still signifi‐cantly lower than those of non - hypertension group (P<0.01 both) .Linear correlation analysis indicated that sys‐tolic blood pressure (SBP) ,diastolic blood pressure (DBP) and pulse pressure (PP) were inversely correlated with CRAE and Df ( r= -0.340~ -0.174 , P<0.01 all) .After adjusting for cardiovascular risk factors ,multi‐factor linear regression analysis indicated that CRAE and Df were still inversely correlated with SBP ,DBP and PP (stand‐ardizedβ= -0.190~ -0.134 ,P<0.01 all) .Df of hypertension course >5 years group was significantly lower than that of ≤5 years group [ (1.33 ± 0.05) vs .(1.35 ± 0.05)] , P<0.01. Conclusion:CARE ,Df are significantly in‐versely correlated to SBP ,DBP and PP in hypertensive population ,while correlation of Df is most .

Objective To investigate clinical features , outcomes and prognosis gerontol delirium . Methods Patients with gerontol delirium diagnosed between January 2011 and January 2013 were identified by a retrospective review of records in the Nanjing General Hospital of Nanjing Military Command .Totally 132 patients were included , 59 females and 73 males, with a median age of 71.4 years (range 65-97).The diagnostic criteria were based on the DSM-Ⅳ and Delirium Rating Scale.Dementia, depression, mental retardation and other cognitive dysfunction were excluded .General condition of patients , etiology , clinical features , treatment and prognosis were all performed using the SPSS 20.0 for windows.A P value of <0.05 was considered as significant . Results Disturbance of consciousness were observed in all 132 patients.Old age, coma and serious infection in the course , endotracheal intuba-tion and(or) tracheotomy, a variety of basic diseases all come up with poor prognosis . Conclusion Delirium progresses quickly. Etiological treatment can help to control the conditions of delirium .

Objective To investigate the in vitro effects of quercitrin on the proliferation and the cytotoxicity of human γδT cells.Methods Peripheral blood mononuclear cells (PBMCs) were isolated from healthy subjects and cultured with isopentenyl pyrophosphate and IL -2 to induce human γδT cells.The hu-manγδT cells were cultured with quercitrin at various concentrations for 48 hours.CCK-8 kits were used to analyze the in vitro proliferation and cytotoxic activities of γδT cells.Flow cytometry was performed to meas-ure the expression of granzyme B and perforin in γδT cells.The expression of p-ERK, p-Akt and Bcl-2 at protein level were detected by Western blot .Results The percentage of human γδT cells in PBMCs was in-creased from (2.96±1.83)%to (88.94±2.36)%after 10 days of culture.The quercitrin at concentrations of 10 to 80 μg/ml could promote the growth of γδT cells and up-regulate the expression of granzyme B , per-forin, p-ERK, p-Akt and Bcl-2 in a dose dependent manner .The cytolytic activities of γδT cells against co-lonic carcinoma cells ( HCT116 ) were enhanced by quercitrin .Conclusion Quercitrin could promote the proliferation of γδT cells and enhance the expression of granzyme B and perforin at certain concentrations in vitro.ERK1/2 and Akt signal transduction systems might be involved in the process .

AIM:To investigate the expression of transmembrane protein 16A(TMEM16A) in Fischer rat thy-roid follicular epithelial ( FRT) cells and its electrophysiologic properties .METHODS: The eukaryotic expression vector of pUB6/V5-TMEM16A was constructed and transfected into FRT cells by liposome-mediated transfection .In order to ob-tain the high efficiency of gene transfection and expression , the quantity and ratio of lipid/DNA complexes were optimized . The FRT cells stably expressing TMEM16A were gained by the selection with blasticidin and confirmed by the techniques of RT-PCR and immunofluorescence .The expression and location of TMEM 16A in the FRT cells were observed under an in-verted fluorescence microscope .TMEM16A protein was associated with calcium-dependent chloride current , as measured with halide-sensitive fluorescent protein and patch-clamp technique .RESULTS: The results of double digestion and se-quencing indicated that TMEM16A was cloned into pUB6/V5.The results of RT-PCR and immunofluorescence confirmed that TMEM16A was expressed in the FRT cells after transfection with TMEM16A.The classical calcium-activated chloride channel currents were recorded in the FRT cells stably expressing TMEM 16A by the technique of patch-clamp and halide-sensitive fluorescent protein YFP-H148Q/I152L.CONCLUSION:The protein expression of TMEM16A in the FRT cells was observed.TMEM16A is the molecular identity of calcium-activated chloride channels .

Objective To investigate the association of urinary albumin-to-creatinine ratio (UACR) and the diameter of retinal vessel in population with essential hypertension in Fujian coastal area.Methods Central retinal artery and vein equivalents (CRAE and CRVE) were measured from the avoiding mydriatic digitized photographs and semi-automatic fundus analysis software,as well as albumin and urine creatinine.Results There were significant differences in CRAE levels among the normal control group,normoalbuminuria with essential hypertension group and microalbuminuria with essential hypertension group [(135.68 ± 10.10) μm,(129.79 ± 10.48) μm,(125.29 ± 11.17) μm,all P values ＜0.01].The CRAE levels were significantly negative correlated with UACR (r =-0.29,P ＜ 0.01).Linear regression analysis showed CRAE was associated with UACR in the patients with hypertension(β =-5.0,P ＜ 0.01).Logistic regression analysis showed,systolic blood pressure (β =1.08,P =0.02) was risk factor for CRAE abnormality.The CRAE abnormality was increased in turn in the normal control group,normoalbuminuria with the essential hypertension group and microalbuminuria with essential hypertension group (P ＜ 0.01).Conclusion The reduction of central retinal artery diameter are associated with the hypertensive renal damage.UACR and CRAE could be used to evaluate the microvascular lesions and be used as an indicator to assess the target organs damage in essential hypertension patients.