Text mining of the media coverage of major public health emergencies: a case study of COVID-19 / 上海预防医学

Objective Based on the text analysis of COVID-19 media report, text mining was used to probe the trend of major public health emergencies and response of the government and social subjects in China. Methods Using the topic model method, we focused on the quantity of news report, topic content, development trend, and emotional tendency, to present the characteristics of media report on China's public health emergency, and the response mechanism of the Chinese government and the whole society. Results The media report and news commentary of COVID-19 showed a consistent trend with the epidemic progress. The governmental response was the main target of media report, while social power, medical progress and other categories also attracted some attention. The development trend of different topics was characterized by continual or periodic variation due to their different attributes. Conclusion The topic model method comprehensively demonstrates the development and response process of the COVID-19 epidemic. The model may provide a new perspective to improve the national public emergency management system.

Evaluation of Erythrocyte Iron Incorporation in Beijing Prepubertal Children Using a Single Stable Isotope Tracer Method / 生物医学与环境科学（英文）

Objective@#To analyze the rate of erythrocyte iron incorporation and provided guidance for the iron nutrition for prepubertal children.@*Methods@#Fifty-seven prepubertal children of Beijing were involved in this study and each subject was orally administered 3 mg of Fe twice daily to obtain a total of 30 mg Fe after a 5-d period. The stable isotope ratios in RBCs were determined in 14th day, 28th day, 60th day, and 90th day. The erythrocyte incorporation rate in children was calculated using the stable isotope ratios, blood volume and body iron mass.@*Results@#The percentage of erythrocyte Fe incorporation increased starting 14 th day, reached a peak at 60 d (boys: 19.67% ± 0.56%, girls: 21.33% ± 0.59%) and then decreased. The erythrocyte incorporation rates of Fe obtained for girls in 60th day was significantly higher than those obtained for boys ( < 0.0001).@*Conclusions@#The oral administration of Fe to children can be used to obtain erythrocyte iron incorporation within 90 d. Prepubertal girls should begin to increase the intake of iron and further studies should pay more attention to the iron status in prepubertal children.

Basal Energy Expenditure of Chinese Healthy Adults: Comparison of Measured and Predicted Values / 生物医学与环境科学（英文）

Objective@#This study aimed to measure the basal energy expenditure (BEE) of Chinese healthy adults and establish an accurate predictive equation for this population.@*Methods@#In total, 470 Chinese healthy adults had their BEE measured using the Cosmed K4b portable metabolic system. Multiple linear regression analysis was applied to develop new optimal equations for predicting BEE. The bias, accuracy rate, concordance correlation coefficient (CCC), and root mean square error (RMSE) were used to evaluate the accuracy of the predictive equations.@*Results@#There was a significant difference in BEE between males and females, with 5,954 kJ/d and 5,089 kJ/d, respectively. People living in rural areas expended significantly higher BEE (5,885 kJ/d) than those in urban areas (5,279 kJ/d). Previous equations developed by Henry, Schofield, Harris-Benedict (H-B), and Liu overestimated the BEE of Chinese healthy adults. The new equations derived from the present study displayed the smallest average bias and RMSE from the measured basal energy expenditure (mBEE). The CCC of the new equations was higher than other predictive equations, but it was lower than 0.8. There was no significant difference in the accuracy rate among all predictive equations.@*Conclusions@#Sex and regional differences in BEE were observed in Chinese healthy adults. Neither the widely used previous predictive equations nor the one derived in the present study were accurate enough for estimating the BEE of Chinese healthy adults. Further study is required to develop more accurate equations for predicting the BEE of Chinese healthy adults aged between 20-45 years.

Blepharoptosis and dysarthria in a boy aged 2 years / 中国当代儿科杂志

A boy, aged 2 years and 4 months, had a sudden onset of blepharoptosis of the right eyelid, accompanied by the mouth deviated to the right side, drinking cough, nystagmus, and developmental regression. Cranial MRI showed softening lesions formed after infarction of the right dorsolateral medulla oblongata, while head CT angiography showed no imaging of the proximal part of the V4 segment of the right vertebral artery. The child was diagnosed with dorsolateral medulla oblongata syndrome and was treated with gamma globulin to regulate immune function, with mannitol to reduce neuronal edema, with low-molecular-weight heparin sodium to improve local hypercoagulation of occluded blood vessels, with hyperbaric oxygen to improve local ischemia and hypoxia and promote the recovery of brain function, and with neuromuscular electrical stimulation to promote the recovery of neuromuscular function. Before discharge, only mild right ataxia and Horner syndrome remained. This article reports the first case of infantile dorsolateral medulla oblongata syndrome and provides experience for the diagnosis and treatment of the disease.

A study on the effect of the Luohu healthcare group reform:An analysis based on the patients'perspective / 中国卫生政策研究

Objective: The study aimed to explore the initial effect of the Luohu healthcare group reform in Shenzhen based on the patient’s perspective. Methods: The questionnaire survey was conducted to investigate the views of patients in 3 hospitals and 23 community health centers in Luohu district. Results: A total of 936 valid ques-tionnaires were collected and analyzed. The valid response rate was 94. 55% . More than 90 percent of the total sur-veyed patients provided a good or very good evaluation on the healthcare services, service attitude, medical referral services and interpretation, communication skills, and better family doctor skills. More than 80 percent of the sur-veyed patients perceived well or very well on medical treatment, the convenience of medical referral, the referral process of the community health centers, and the specialists serving in community health centers mechanism. Conclu-sions: The results showed that patients had a slightly high satisfaction with family doctors and community health cen-ter, and after the group was founded, the proportion of patients who preferred going to community health centers after illness has been increasing significantly more than before. In future, a further development of the advantages of healthcare group should be brought into action and improve the relevant supporting policies. The long-term effect de-serves a further observation.

A study on the effect of the Luohu healthcare group reform:An analysis based on the employees'perspective / 中国卫生政策研究

Objective: The study aimed to explore the initial effect of the Luohu Healthcare Group Reform in Shenzhen based on the employee’s perspective. Methods: The questionnaire survey was conducted to investigate the views of employees in 3 hospitals and 23 community health centers in Luohu district. Results: A total of 480 ques-tionnaires were distributed and only 412 valid questionnaires were collected and analyzed. The valid response rate was 85. 83% . 37. 21% of doctors responded that they had motive power to work in community health centers; 75. 38 per-cent of employees stated that their healthcare organization changed a lot; Employees’average work satisfaction scores, interpersonal relationship and healthcare organization development were all above 4. 20, and the consistency of em-ployee evaluation was high. Conclusions: Most of the surveyed employees evaluated the initial stage of the Luohu health reform positively. Since the hospital group started to operate two years ago, the development of the affiliated health facilities has been on an upward trend. The formation of vertical alliance within the hospital group has e-merged; and physicians of secondary and higher-grade hospitals have had increasing willingness of working at the community health centers, especially in the departments of internal medicine and traditional Chinese medicine. The hospital group has been guiding all affiliated facilities to develop its unique signature specialty so that facilities can col-laborate with each other and evolve as a whole. Group employees have expectations that the hospital group will coordi-nate and incorporate interests of all stakeholders, fulfill the commitments, and develop a better future for the group.

Policy analysis of health system reform in Luohu district of Shenzhen City / 中国卫生政策研究

Health system reform at district-level is an important but often neglected component in health system reform of China. According with the national policy-strategy guidance and the local health needs and problems within its jurisdiction,Luohu District has taken a series of effective reform measures for promoting a comprehensive reform since 2015,in which the crucial part was the establishment of"LuoHu Hospital Group". The reform in Luohu was initiated by the district-level government under the favorable policy and external conditions. The district government departments explored and innovated,and developed a featured district-level health system reform road. This experi-ence shows that district-level government should be an active actor in the local health system reform in China. The re-form in Luohu is still on the way,and more effect is yet to emerge, but the experience is of important reference for the health system reform in other regions/cities of China.

Zinc Absorption from Representative Diet in a Chinese Elderly Population Using Stable Isotope Technique / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To determine the dietary zinc absorption in a Chinese elderly population and provide the basic data for the setting of zinc (Zn) recommended nutrient intakes (RNI) for Chinese elderly people.</p><p><b>METHODS</b>A total of 24 elderly people were recruited for this study and were administered oral doses of 3 mg 67Zn and 1.2 mg dysprosium on the fourth day. The primary macronutrients, energy, and phytic acid in the representative diet were examined based on the Chinese National Standard Methods. Fecal samples were collected during the experimental period and analyzed for zinc content, 67Zn isotope ratio, and dysprosium content.</p><p><b>RESULTS</b>The mean (± SD) zinc intake from the representative Chinese diet was 10.6 ± 1.5 mg/d. The phytic acid-to-zinc molar ratio in the diet was 6.4. The absorption rate of 67Zn was 27.9% ± 9.2%. The RNI of zinc, which were calculated by the absorption rate in elderly men and women, were 10.4 and 9.2 mg/d, respectively.</p><p><b>CONCLUSION</b>This study got the dietary Zn absorption in a Chinese elderly population. We found that Zn absorption was higher in elderly men than in elderly women. The current RNI in elderly female is lower than our finding, which indicates that more attention is needed regarding elderly females' zinc status and health.</p>

Comparison of Undernutrition Prevalence of Children under 5 Years in China between 2002 and 2013 / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To describe the undernutrition status of children under 5-year in China, and study the trend between 2002 and 2013).</p><p><b>METHODS</b>The study was based on two national surveys. Undernutrition was determined against WHO's 2006 growth standards. The prevalence in 2013 and 2002 was weighted by China sixth National Population Census (2010). The relationship between undernutrition and gender/age groups/different areas use weighted logistic regression.</p><p><b>RESULTS</b>The results indicated the overall prevalence of stunting, underweight, and wasting of Chinese children under 5-year was 8.1%, 2.4%, and 1.9% in 2013, respectively. The prevalence of stunting was higher for children aged 12-47 month, while underweight was higher for children aged 48-59 month. The prevalence of undernutrition was higher in rural areas than in urban areas, especially in poor rural areas. There was a decline of stunting, underweight, and wasting between 2002 and 2013 among the children, with greater reduction in rural areas than in urban areas.</p><p><b>CONCLUSION</b>The prevalence of undernutrition of children under 5-year remains high in rural areas especially in poor rural areas in China. It is urgent to take action to control undernutrition in the vulnerable areas and subgroups.</p>

Effect of eletroacupuncture with close-to-bone needling treatment on expression of Sox9, VEGF and ColX in impaired cartilage of rabbits with knee osteoarthritis / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the effect of eletroacupuncture with close-to-bone needling treatment on expression of Sox9, vascular endothelial growth factor (VEGF) and type X collagen (ColX) in impaired cartilage of rabbits with knee osteoarthritis (KOA) and explore its possible mechanisms.</p><p><b>METHODS</b>Forty New Zealand rabbits were randomized equally into normal control group, KOA model group, eletroacupuncture with close-to-bone needling group (CN group), and normal thrust needing group (NTN group). In the latter 3 groups, KOA was induced by Hulth-Telhag treatment and evaluated with X-ray examination, and 6 weeks after the modeling, eletroacupuncture for 20 min was administered in CN and NTN groups at the acupoints "Zusanli", "Waixiyan", "Neixiyan", "Liangqiu" and "Yinlingquan" in the left knee joints once daily for 5 days as a treatment cycle. After 5 treatment cycles, the rabbits were examined for behavioral changes, cartilage morphology, and Mankin scores; The protein and mRNA expressions of S0x9, VEGF, and ColX were examined using Westen blotting, immunohistochemistry, and RT-PCR as appropriate.</p><p><b>RESULTS</b>The rabbits in the model, CN and NTN groups showed significant changes in behaviors and cartilage histomorphology after the modeling and after the treatments. HE staining showed that cartilage injury was repaired and tended to recovery in CN and NTN groups. The cartilage pathologies was severer in the model group than in the normal control, CN and NTN groups (P<0.01); Sox9 protein increased and VEGF mRNA level decreased in CN and NTN groups after treatment as compared with those in the model group (P<0.01).</p><p><b>CONCLUSION</b>Eletroacupuncture with close-to-bone needling can effectively improve KOA in rabbits probably by enhancing Sox9 and reducing VEGF and ColX expressions in the cartilage to inhibit hypertrophic differentiation of the chondrocytes, maintain chondrogenic phenotype and repair cartilage cells.</p>

Cut-off Values of Diagnostic Indices to Detect Iron Deficiency in Chinese Breast-fed Infants / 生物医学与环境科学（英文）

Iron deficiency anemia is one of the most prevalent nutritional deficiency worldwide. The commonly used cut-off values for identifying iron deficiency are extrapolated from older children and may not be suitable for infants. Therefore, our study aimed to establish appropriate cut-off values for the evaluation of iron status in Chinese infants. Pregnant women who delivered at ⋝37 gestational weeks with normal iron status were recruited. Later, infants with normal birth weight and who were breastfed in the first 4 months were selected. Blood samples were collected to assess hemoglobin, serum ferritin, soluble transferrin receptor, mean corpuscular volume and free erythrocyte protoporphyrin. Cut-offs of all iron indices were determined as the limit of 95% confidence interval.

Application of UPLC-MS/MS Method for Analyzing B-vitamins in Human Milk / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To determine ten B-vitamins in human milk by ultra-high performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS).</p><p><b>METHODS</b>The pretreated human milk samples were adequately separated and quantified within 11 min by UPLC-MS/MS with an Acquity UPLC HSS T3 column (2.1×100 mm, 1.8 µm). The mobile phase was a gradient of 2.5 mmol/L ammonium formate aqueous solution and acetonitrile at a flow rate of 0.35 mL/min. Stable isotope internal standards were used in the analysis, to correct for the method variability, including matrix and ionization effects. The homogenized human milk samples were deproteinzed using methanol, unknown contaminants were extracted with diethyl ether and hydrophobic phase was discarded. The analytes were monitored via ESI+ionization and detected in multiple reaction monitoring (MRM) with three acquisition functions.</p><p><b>RESULTS</b>Calibration curves ranged from 0.5-160 ng/mL (thiamin, riboflavin, biotin, nicotinic acid, pyridoxine, pyridoxamine, pyridoxal), and 2.5-800 ng/mL (pantothenic acid, FAD and nicotinamide) (R2=0.990-0.999). The relative recovery ranged from 80.1% to 120.2%; accuracy was determined to be 98.3% to 108.0%. Intra-day and inter-day variation were 3.4%-19.9% and 5.9%-18.1%, respectively. The limit of quantification (LOQ) for all vitamins was between 0.25 and 3 µg/L.</p><p><b>CONCLUSION</b>This method was successfully applied for simultaneous analysis of ten B-vitamins in human milk.</p>

Protein requirements in healthy adults: a meta-analysis of nitrogen balance studies / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>The goal of this study was to analyze protein requirements in healthy adults through a meta-analysis of nitrogen balance studies.</p><p><b>METHODS</b>A comprehensive search for nitrogen balance studies of healthy adults published up to October 2012 was performed, each study were reviewed, and data were abstracted. The studies were first evaluated for heterogeneity. The average protein requirements were analyzed by using the individual data of each included studies. Study site climate, age, sex, and dietary protein source were compared.</p><p><b>RESULTS</b>Data for 348 subjects were gathered from 28 nitrogen balance studies. The natural logarithm of requirement for 348 individuals had a normal distribution with a mean of 4.66. The estimated average requirement was the exponentiation of the mean of the log requirement, 105.64 mg N/kg•d. No significant differences between adult age, source of dietary protein were observed. But there was significant difference between sex and the climate of the study site (P<0.05).</p><p><b>CONCLUSION</b>The estimated average requirement and recommended nutrient intake of the healthy adult population was 105.64 mg N/kg•d (0.66 g high quality protein/kg•d) and 132.05 mg N/kg•d (0.83 g high quality protein/kg•d), respectively.</p>

Prevalence of self-reported allergy, food hypersensitivity and food intolerance and their influencing factors in 0-36 months old infants in 8 cities in China / 中华儿科杂志

<p><b>OBJECTIVE</b>To measure the prevalence, the possible causes and the influencing factors of allergy, food hypersensitivity and food intolerance in 0-36 month old infants in 8 cities in China.</p><p><b>METHOD</b>Totally 2632 infants from the outpatient departments of prevention and health care of two representative hospitals in 8 Chinese cities were randomly selected by applying multistage cluster sampling method from October 2011 to March 2012, and a one-on-one survey to infants' parents was conducted to investigate infants' sensitization status.</p><p><b>RESULT</b>Self-reported infant allergy rate was 17.97% (473/2632) ; self-reported food hypersensitivity and food intolerance rates were 6.53% (172/2632) and 4.26% (112/2632) , respectively. The proportion of self-reported food hypersensitivity of 0-12 months old infants was 4.47% (74/1656) and their top five allergens in a descending order were eggs (28.38%) , shrimp (25.68%) , fish (21.62%) , milk (18.92%) and wheat (4.05%) . The proportion of self-reported 13-36 months old infant's food hypersensitivity was 10.05% (98/976) . The top five allergens were shrimp (33.93%) , fish (26.79%) , eggs (23.21%) , milk (12.50%) and soy (3.57%) in 13-24 months group, while fish (38.24%) , shrimp (35.29%) , eggs (20.59%) , milk (20.59%) and peanuts (2.94%) in 25-36 months group. Both 7-12 and 13-24 month old were the highest incidence (both of them were 11.98%, 58/484) of age for developing food hypersensitivity and 7-12-month old was also the highest incidence (8.47%, 41/484) of age for food intolerance. The self-reported food intolerance rate was 3.68% (61/1656) and 5.23% (51/976) in the two age groups, respectively. Age, parental history of allergy and father's educational level (OR was 2.452, 1.482 and 2.598, respectively, P < 0.01) were the risk factors of food hypersensitivity; within two weeks of sickness (OR = 1.267, P < 0.05) was the risk factor of food intolerance.</p><p><b>CONCLUSION</b>Infancy was the most vulnerable period of life of getting allergy, therefore, it is necessary for all infants to prevent allergy through a variety of effective strategies.</p>

Evaluation of the protein requirement in Chinese young adults using the indicator amino acid oxidation technique / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To accurately calculate the protein requirements in Chinese young adults using the indicator amino acid oxidation technique.</p><p><b>METHODS</b>Nine women and ten men received a restricted daily level of protein intake (0.75, 0.82, 0.89, 0.97, and 1.05 g/kg), along with L-[1-13C]-leucine. Subjects' protein requirement was determined by a biphasic linear regression crossover analysis of F13CO2 data. In doing so, a breakpoint at the minimal rate of appearance of 13CO2 expiration specific to each level of dietary protein was identified. This trial was registered with the Chinese clinical trial registry as ChiCTR-ONC-11001407.</p><p><b>RESULTS</b>The Estimated Average Requirement (EAR) and the Recommended Nutrient Intake (RNI) of protein for healthy Chinese young adults were determined to be 0.87 and 0.98 g/(kg•d), respectively, based on the indicator amino acid oxidation technique.</p><p><b>CONCLUSION</b>The EAR and RNI of mixed protein are 5% and 16% that are lower than the current proposed EAR and RNI (0.92 and 1.16 g/(kg•d), respectively), as determined by the nitrogen balance method. The respective EAR and RNI recommendations of 0.87 and 0.98 g/(kg•d) of mixed protein are estimated to be reasonable and suitable for Chinese young adults.</p>

Total energy expenditure of 16 Chinese young men measured by the doubly labeled water method / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>Doubly labeled water (DLW) method is the gold standard for measuring total energy expenditure (TEE). We used this method to measure TEE in Chinese young men.</p><p><b>METHODS</b>Sixteen healthy young men age 23±1 years with body mass index 22.0±1.4 kg/m2 were recruited. TEE was measured by the DLW method, and basal energy expenditure (BEE) was determined by indirect calorimetry. We also conducted 24-h activity, energy balance and factorial approach to estimate energy requirements of the subjects.</p><p><b>RESULTS</b>TEE of subjects by DLW method was 9.45±0.57 MJ/day (2258±180 kcal/day). The 24-h activity was 10.80±0.33 MJ/day (2582±136 kcal/day). The energy requirement, derived from energy balance observations, was 9.93±1.32 MJ/day (2373±315 kcal/day). The BEE of 6.65±0.28 MJ/day (1589±67 kcal/day), calculated by the adjusted Schofield equation, was significantly higher (P<0.001) than that measured by indirect calorimetry, 5.99±0.66 MJ/day (1433±158 kcal/day). The TEE derived from the factorial approach was 10.31±0.43 MJ/day (2463±104 kcal/day).</p><p><b>CONCLUSION</b>The TEE of Chinese young men measured by the DLW method was about 10% lower than the current recommended nutrient intake (RNI), suggesting that the RNI for Chinese men maybe overestimated. Further studies are warranted to determine the value of the estimated energy requirement.</p>

Association between high fat-low carbohydrate diet score and newly diagnosed type 2 diabetes in Chinese population / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To study the association between high fat-low carbohydrate diet score and newly diagnosed type 2 diabetes in Chinese population.</p><p><b>METHODS</b>Data about 20 717 subjects aged 45-59 years from the cross-sectional 2002 China National Nutrition and Health Survey were analyzed. High fat-low carbohydrate diet was scored according to the energy of carbohydrate, fat, and protein.</p><p><b>RESULTS</b>Of the 20 717 subjects, 1 332 were diagnosed with hyperglycemia and 662 were newly diagnosed with type 2 diabetes. Multivariate adjusted analysis showed that the highest score of type 2 diabetes patients was 2.75 (95% CI: 2.09-3.61). The score of type 2 diabetes patients was 1.87 (95% CI: 1.35-2.58) after further adjustment for their socioeconomic status and physical activity. No significant difference was found in the odds ratio after further adjustment for BMI, blood pressure, lipid level, and energy intake. No evidence was observed for the relation between high fat-low carbohydrate-diet score in type 2 diabetes patients due to high family income, less education, physical activity, overweight, hypertension, high TG, or low HDL level.</p><p><b>CONCLUSION</b>High fat-low carbohydrate diets, far different from traditional Chinese diets, are associated with the high incidence of type 2 diabetes in Chinese population.</p>

The influence of preventive iron supplementation to iron nutritional status in breastfed infants / 中华预防医学杂志

<p><b>OBJECTIVE</b>To analyze the effects to iron status who were given preventive iron supplements for two months from when they were breast-fed to four-month-old.</p><p><b>METHODS</b>A total of 123 infants in four-month-old age who were breast-fed were randomly divided into iron supplementation group (63 cases) and control group (60 cases), iron supplementation group was supplied with low-dose iron (1 mg×kg⁻¹×d⁻¹) for two months with no intervention for control group. Blood samples were collected to test C reactive protein and iron status indicators in six-month-old age group infants, and the growth indices were measured and compared on the gender difference of iron status at and 6 months.</p><p><b>RESULTS</b>After 2 months of low-dose iron supplementation, the hemoglobin of iron supplementation group (26 cases) increased about 5.5 g/L while the control group (34 cases) increases about 0.0 g/L (median), 95% confidence intervals were -7.0 - 13.0 g/L and -9.0 - 15.0 g/L, respectively. The hemoglobin increase of iron supplementation group was higher than the control group, the difference was statistically significant (u = -2.326, P < 0.05). The other iron nutritional status and the growth did not show any significant difference between iron supplementation group and control group (P > 0.05). At age 6 month, the MCV of the boys were (75.89 ± 3.34) fl, while the girls were (77.20 ± 3.17) fl. The boys had lower values of MCV than the girls, and the gender difference was statistically significant (t = 4.73, P < 0.05). The other iron nutritional status did not show any significant gender difference (P > 0.05).</p><p><b>CONCLUSION</b>Low-dose iron supplementation of breast-fed infants at 4-month-old can increase the hemoglobin level when they were 6-month-old, and had no measurable side effect on growth.</p>

The effects of iron stores and growth of delayed umbilical cord clamp timing on term breastfed infants at 4 months / 中华预防医学杂志

<p><b>OBJECTIVE</b>To explore whether delayed umbilical cord clamp timing of newborn can improve iron stores of infant period and growth and development.</p><p><b>METHODS</b>Mother-infant pairs were randomly assigned to early clamping (94 cases, < 15 s after delivery) and delayed clamping (64 cases, 1 min after delivery) by draw lots, and followed up until 4 months postpartum. Infant hematological status, iron status, the level of growth and development of infants after 4 months were measured respectively. Transcutaneous bilirubin at the third day after delivery was also measured.</p><p><b>RESULTS</b>At 4 month age, the median of serum ferritin and mean of corpuscular volume value in delayed group were 87.30 µg/L and (79.62 ± 4.13) fl, significantly higher than the values in early group (64.3 µg/L, (78.21 ± 4.38) fl), respectively (Z = -2.36, t = 2.23, both P values < 0.05). The hematocrit value was (33.59 ± 2.48)%, higher than that in early group (32.76 ± 2.69)% (t = 1.95, P = 0.05). There was no statistically significant difference at other iron nutrition indicators and infants' weight and body length at 4 month (P > 0.05). Under the different cut-off values (hemoglobin (Hb) < 105 g/L and Hb < 110 g/L, respectively), the prevalence of anemia in delay and early clamping group were 6.25% (4/64), 21.86% (14/64), and 12.77% (12/94), 34.04% (32/94), respectively (both P values > 0.05).</p><p><b>CONCLUSION</b>Delayed umbilical cord clamp timing until 1 min can improve iron stores of breastfed infants at 4 month; there is no significant adverse effects to growth.</p>

Treatment of lumbar spinal stenosis in the elder by micro-endoscopic discectomy / 中国骨伤

<p><b>OBJECTIVE</b>To explore the clinical effects of micro-endoscopic discectomy(MED) in treatment of lumbar spinal stenosis in the elder.</p><p><b>METHODS</b>The data of 376 cases of the lumbar spinal stenosis were treated by MED from December 2003 to December 2009, 47 cases of them aged above 60 years old. Of them, 43 old patients were followed up for 3 months to 6 years. There were 27 males and 16 females,with an average age of 68.3 years old ranging from 60 to 91 years. The average age was 68.3 years. The course was from 3 months to 15 years (averaged 3.5 years). The clinical effects of postoperation were observed and evaluated according to Nakai standard.</p><p><b>RESULTS</b>Forty-three patients were followed up for 3 months to 6 years. The incision of all the patients had no infection and achieved primary healing. The clinical effect of the patients were evaluated by Nakai standard. The results were excellent in 26 cases,good in 12,fair in 5.</p><p><b>CONCLUSION</b>MED has characteristics of less injury,fast recovery and thorough decompression to nerve roots. It is a kind of good method for treating lumbar spinal stenosis in the elder if the indication were grasped strictly.</p>