Objective To understand the current situation of breastfeeding duration in children aged 0-5 years in Yunnan Province,and to explore the influencing factors of breastfeeding duration.Methods Using the data of the 6th National Health Service Survey in Yunnan Province,1582 children aged 0～5 years in Yunnan Province were selected as the research subjects,and the Kaplan-Meier method and Cox regression were used to analyze the influencing factors of breastfeeding duration.Results The mean duration of breastfeeding for children aged 0～5 years in Yunnan Province was 9.29 months,and region,time of complementary food addition,time of suckling and family income were the main factors influencing the duration of breastfeeding.Conclusion The duration of breastfeeding for children aged 0～5 years in Yunnan Province deviates significantly from the recommendations provided by both the World Health Organization(WHO)and China's child breastfeeding guidelines.Given the current situation,the relevant departments must enhance their focus on this issue.

Femoral neck fracture (FNF) in the elderly patients is currently a major health challenge worldwide, with excessive consumption of medical resources, high incidence of complications as well as suboptimal outcome and prognosis. Hip joint arthroplasty (HJA) has been the mainstream treatment for FNF in the elderly, but the conventional surgical approaches and techniques are still confronted with a series of bottlenecks such as dislocation, limp and limb length discrepancy. In recent years, direct anterior approach (DAA) for HJA (DAA-HJA) has been a major new choice in the field of joint replacement, which achieves improved clinical effectiveness of HJA in the treatment of elderly FNF, due to the fact that DAA approach involves the neuromuscular interface and accords with the idea of soft tissue retention and enhanced recovery after surgery. However, there is still a lack of unified understanding of standard technique and procedure of DAA-HJA in the treatment of elderly FNF. Therefore, relevant experts from the Hip Joint Group of Chinese Orthopedics Association of Chinese Medical Association, Youth Arthrology Group of Orthopedic Committee of PLA, Orthopedic Committee of Chongqing Medical Association, Branch of Orthopedic Surgeons of Chongqing Medical Doctor Association and Sport Medicine Committee of Chongqing Medical Association were organized to formulate the " Chinese expert consensus on the technical standard of direct anterior hip arthroplasty for elderly femoral neck fracture ( version 2023)" based on evidence-based medicine. This consensus mainly proposed 13 recommendations covering indications, surgical plans, prosthesis selections, surgical techniques and processes, and postoperative management of DAA-HJA in elderly patients with FNF, aiming to promote standardized, systematic and patient-specific diagnosis and treatment to improve the functional prognosis of the patients.

ObjectiveTo study the changes of primary metabolites and phenols in the fruits of Acanthopanax senticosus at different development stages, so as to provide a theoretical basis for the rational utilization of A. senticosus fruit resources. MethodThe primary metabolites and phenols in the fruits at different development stages were determined via gas chromatography-mass spectrometry (GC-MS) and liquid chromatography-mass spectrometry (LC-MS) and then compared by multivariate statistical analysis. ResultA total of 274 chromatographic peaks were obtained by GC-MS-based non-targeted metabonomics and 24 differential metabolites were screened out by multivariate statistical analysis. The differential metabolites were mainly concentrated in pentose phosphate pathway, galactose metabolism, ascorbic acid and aldose metabolism pathways. After color conversion, the pentose phosphate pathway and galactose metabolism were activated and increasing sugars were accumulated. The ascorbic acid and aldose metabolism pathways were active before color conversion, with high accumulation of the end product ascorbic acid. The ultra-high liquid chromatography-mass spectrometry (UPLC-MS) identified 28 phenols in the fruits at different development stages. Flavonoids were accumulated mainly at the green ripening stage before color conversion, and phenolic acids were accumulated mainly after color conversion. ConclusionThe accumulation of primary metabolites and phenols in A. senticosus fruits varies significantly among different development stages

Objective:To investigate the perioperative complications and risk factors of postoperative death in patients with acute Stanford type A aortic dissection (ATAAD).Methods:The perioperative data of 228 patients with ATAAD who underwent continuous surgery in the Affiliated Hospital of Jining Medical University from January 2013 to July 2021 were retrospectively analyzed. The complications were analyzed. According to the survival within 30 days after surgery, they were divided into death group (24 cases) and survival group (204 cases). The risk factors of postoperative death were analyzed by univariate and multivariate logistic regression. The receiver operating characteristic (ROC) curve was drawed to evaluate the predictive efficacy of various risk factors on postoperative death of ATAAD patients.Results:The first three complications before operation were hypoxemia (10.1%, 23/228), pericardial tamponade (7.9%, 18/228), renal insufficiency (5.3%, 12/228), the first three complications after surgery were hypoxemia (75.8%, 173/228), renal insufficiency (26.8%, 61/228) and liver insufficiency (26.3%, 60/228). A total of 24 patients died, the fatality rate was 10.5%(24/228). Logistic regression analysis showed that age≥55 years old ( OR=7.733, 95% CI: 1.986-30.111, P=0.003), preoperative pericardial tamponade ( OR=5.641, 95% CI: 1.546-20.577, P=0.009), cardiopulmonary bypass time (CBP)≥200 min ( OR=1.008, 95% CI: 1.002-1.014, P=0.007) and postoperative renal insufficiency ( OR=5.875, 95% CI: 1.927-17.907, P=0.002) were independent risk factors for early death after ATAAD. The area under the ROC curves of joint prediction was 0.905 (95% CI: 0.820-0.950, P<0.01). The sensitivity and specificity of joint prediction were 88.4%, 76.5%, respectively. Conclusions:ATAAD has many perioperative complications and high mortality. Age≥55 years old, preoperative pericardial tamponade, CPB time≥200 min, and postoperative renal insufficiency were independent risk factors for postoperative death in ATAAD patients.

Objective To investigate the influence of the concept of collaborative innovation on the construction of a scientific research system for regional liver pathology center from multiple perspectives, and to explore its application significance. Methods A total of 1246 liver biopsy specimens which were examined in Department of Pathology in Wuxi Second People's Hospital and Wuxi Fifth People's Hospital from January 2014 to September 2020 were collected, among which the specimens examined before the founding of the regional liver pathology center were collected as nI group, and those examined after the founding of the center were collected as nII group. According to the examination time of the first, second, or third year after founding, the nII group was further divided into nIIa group, nIIb group, and nIIc group. A multi-perspective analysis was performed based on five indices, i.e., number of liver biopsy specimens, growth rate of liver biopsy specimens, growth rate of internal collaborative departments, growth rate of external collaborative units, and evaluation of the collaborative and innovative scientific research system. Results The growth rate of liver biopsy specimens in the nI group was 15.51%; after the founding of the regional liver pathology center, the highest growth rate of 187.76% was observed in the nIIa group, and a relatively stable growth rate of 76.35% was observed in the nIIb group. There was a gradual increase in the number of specimens in internal collaborative departments, with a growth rate of 50% in the nIIa group and 83.33% in the nIIb group, while the number of external collaborative units increased steadily, with a growth rate of 100% in the nIIa group and 50% in the nIIb group. The nII group showed a diversified increasing trend in the evaluation indices of the scientific research system. Conclusion It is a new perspective for the construction of regional disciplinary scientific research system to grasp the opportunity of policy-supported development and innovate the effective cooperation mode between internal departments and external units under the concept of collaborative innovation.

Objective:To assess the efficacy, safety of adding intralesional compound betamethasone injection to EEBD to reduce restricture.Methods:77 patients, treated in The first people's hospital of YancHeng from January, 2015 to December, 2018, were randomized to receive EEPD combined with either compound betamethasone injection or placebo injection. A total of 2 ml of compound betamethasone injection or an identical volume of normal saline solution as a placebo was injected per site using a 23-gauge needle immediately after EEPD. Patients and treating physicians were blinded to the treatment. The primary endpoint was the number of dilations required to resolve the stricture、restricture-free survival、time required to resolve the stricture and adverse events.Results:During the 4-years study period, Finally , 74 patients , who were randomized to either the steroid group (37 cases) or placebo group (37 cases), comprised the per-protocol population .The median number of EEPD required to resolve strictures was 2.0( IQR 1.0-3.0) in the steroid group and 3.0 ( IQR 3.0-4.5) in the placebo group ( P<0.001). After 6 months of follow-up, 27.0% of patients who had received steroid injections remained recurrence free compared with 3.5% of those who had received saline injections( P<0.001). The median time of EEPD required to resolve the stricture was 88 days( IQR 0-98 days)in the steroid group and 131 days( IQR 97-157 days)in the placebo group( P<0.001). No adverse events occurred related to the EEPD or steroid injection occurred. Conclusion:Endoscopic esophageal probe dilation combined with compound betamethasone injection shows promising results for the prevention of stricture recurrence in patients of anastomotic strictures.

RNAscope is a new generation of in situ hybridization technology and with the advantage of new probe design, it is now being gradually applied to a wide range of research fields, and its research scope is constantly expanding. Our country has large number of liver disease patients, so there is a great demand for histological testing and research evaluation based upon biological information. This technology has unique specificity and sensitivity in situ level, which makes up for the technical defects of immunohistochemistry and traditional in situ hybridization. Realizing the multiplicity and monomolecular level detection, the qualitative and quantitative analysis of nucleic acid level can be carried out in many aspects of the field of liver disease, and the visual evaluation can be achieved by combining it with tissue in situ to highlight the value of "gold standard". This article summarizes the recent year’s application of RNAscope technology carried out in liver histology field.

Objective: To analyze the clinical effect of modified standard traumatic craniectomy and standard large trauma craniectomy in the treatment of severe craniocerebral trauma.And to evaluate the clinical value of modified standard traumatic craniectomy in the treatment of severe craniocerebral trauma. Methods: Ninety-two patients with severe craniocerebral trauma treated in Rugao Bo′ai Hospital (GCS3-8, acute subdural hematoma) from January 2015 to January 2017 were divided into two groups using random envelope drawing method, with 46 cases in each group.The control group was treated by standard large trauma craniectomy, and the observation group was treated by modified standard traumatic craniectomy.The intracranial pressure levels and activity of daily living scale (ADL) were compared between the two groups. Results: At 1 d, 5 d, 10 d after operation, the intracranial pressure levels of the observation group were (23.19±2.82)mmHg, (15.26±2.77)mmHg and (11.22±2.75)mmHg, respectively, which were lower than those of the control group[(28.12±2.32)mmHg, (19.14±2.17)mmHg and (14.23±2.17)mmHg](t=47.544, 37.922, 29.504, all P<0.05). At 6 months after operation, according to ADL, the good rate of postoperative recovery in the observation group (67.39%, 31/46) was significantly higher than the control group (45.65%, 21/46), the difference was statistically significant(χ²=4.423, P<0.05). Conclusion The modified standard traumatic craniectomy has a certain value in the treatment of patients with severe craniocerebral trauma.