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The optimization algorithm was developed to calculate the take-off mass more efficiently and accurately, and the missile take-off mass design method based on differential evolution was proposed. The take-off mass of the missile with single-chamber dual-thrust motor was set as the example for optimization design. The design variables and constraints were set up, and the model to optimize take-off mass was established. The parameters of population size and the maximum evolutionary generation were determined according to the optimization model. Finally, the minimum take-off mass was obtained via continuous iterations. Compared with genetic algorithms, differential evolution algorithm demonstrates its faster convergence and more computational accuracy in take-off mass design of missile. [ABSTRACT FROM AUTHOR]

Multiple primary carcinomas of primary encapsulated papillary carcinoma of axillary accessory breast complicated with breast cancer are extremely rare in clinical practice. Due to its low incidence and lacking of specific imaging and clinical manifestations，it is challenging to distinguish axillary accessory breast cancer from breast cancer lymph node metastasis and to the risk of misdiagnosis is high. In this article，a 61-year-old female patient was reported. She was admitted to our hospital due to a lump in the right axil for more than half a year. Ultrasound examination prompted the possibility of benign lesions，and surgical resection was performed for further diagnosis and treatment. Pathological biopsy confirmed the diagnosis of encapsulated papillary carcinoma of the right axillary accessory breast complicated with intraductal carcinoma. One month later，the patient found right breast nodule，and auxiliary examination indicated the risk of breast cancer. She was diagnosed with invasive breast cancer by pathological biopsy. Combined with the diagnosis and treatment experience of this case，literature review was also performed，aiming to improve the diagnosis and treatment of this disease.

Objective To explore the effects of Colla corii asini (CCA) (common name E’jiao) on lung function and pathological injury of the lung tissue in rats with chronic obstructive pulmonary disease (COPD). Methods Twenty-five rats were randomly divided into the control group, COPD model group and treatment group with low, medium and high-doses of CCA (1, 2, 4 g/kg), with 5 rats in each group. The COPD model group and treatment groups were modeled by cigarette smoke exposure with a concentration of (1 100±10)mg/m3 once a day, 90 minutes each time, for 48 consecutive weeks. After the end of the next day, the CCA groups were given by daily oral gavage treatment for 28 days. Lung function was detected by animal lung function instrument and the pathological changes of the lung tissue were assessed by HE staining and microscopy. Results Compared with the control group, TV, EV, Te, RT, EEP and Penh were significantly increased in the COPD model group(P＜0.05), while PEF, PIF, MV, EF50 and f(B) were significantly decreased (P＜0.05). Inflammation and pathological changes of emphysema were observed, and lung tissue lesions were aggravated. Compared with the COPD model group, Te, RT and Penh were significantly reduced in the high-dose CCA group (P＜0.05), while MV, PIF and EF50 were significantly higher (P＜0.05). Less infiltration of inflammatory cells, less alveolar expansion and fewer pulmonary bullae were observed in high-dose CCA-treated rats. The degree of emphysema was reduced, and pathological damage to lung tissue was clearly alleviated. Conclusions CCA improves lung function and alleviates the inflammatory response of the lung tissue in COPD rats.

Objective: To explore the status of malnutrition and dietary behavior characteristics of children aged 3-5 in Tonghua, Nanchang, Changsha, Kunming and Weinan, and to analyze the relationship between them., Methods: Data was from National Nutrition and Health Systematic Survey for 0-18 Years Old Children in China. A total of 1741 children were randomly selected from five cities by multi-stage stratified cluster sampling, and their physical fitness was measured and investigated by questionnaire. Chi-square test and multivariate binomial Logistic regression analysis were used to assess the relationship between nutritional deficiency and diet and feeding behavior., Results: Among the investigated children, the underweight rate, stunting rate and wasting rate were 0.52%, 1.09% and 1.03%, respectively. Dietary behavior restriction was the risk factor for stunting(OR=4.72, 95% CI 1.41-15.84), poor eating habits were the risk factor for wasting(OR=3.64, 95% CI 1.01-13.34). No statistical association was found between underweight and diet and feeding behavior., Conclusion: The incidence of malnutrition among children aged 3-5 years in five urban areas of China is low. There is a correlation between malnutrition and poor diet and feeding behavior. Measures should be taken to correct the poor eating habits of children and the feeding behavior of caregivers, so as to improve the nutritional status of children.

Objective: To establish an efficient method for extracting exosomes from large-volume cell perfusate. Methods: EA.HY926, an immortalized cell line produced by the hybridization of human umbilical vein endothelial cells and human lung adenocarcinoma cell line A549, was cultured with M199 culture medium containing 10% fetal bovine serum. Flexcell STR-4000 parallel plate flow chamber system was employed to apply shear stress to EA.HY926. And then the perfusate was collected. The cell debris was removed by centrifugation. The supernatant was freeze-dried into the dry powder and was resuspended by small-volume medium. The dialysis was used to desalt and purify the suspension. The exoEasy Maxi Kit was used to extract the exosomes. The morphology of exosomes was observed by electron microscopy. The size of exosomes was detected by nanometer particle size analyzer. The activity of exosomes was detected by PKH26 staining. BCA protein quantification method was used to detect the protein concentration of exosomes. The expressions of exosomal specific proteins CD9 and CD81 were detected by Western blot. The quantitative RT-PCR was used to detect the expression of related genes in the exosomes. Results: The exosomes extracted by this method were uniform in size, showing a typical and complete vesicle-like structure. The particle size was concentrated at 30～150 nm, and the peak value was at 97.63 nm, indicating that the size was appropriate and the purity was high. Moreover, exosomes-specific protein CD9 and CD81 were expressed. PKH26 could bind to the membranous structure of exosomes and exosomes could be efficiently taken up by cells. Endothelial cells-associated CD31, vWF mRNA, and microRNA molecules such as miR-126, miR-21, miR-155 were expressed in exosomes secreted by EA.HY926. Conclusion: This method can effectively extract structurally intact, high-concentration, high-quality exosomes from large-volume cell perfusate.

Schmallenberg virus (SBV), a novel orthobunyavirus, was first isolated in 2011. SBV preferentially infects the central nervous system of cattle and sheep and causes fever, diarrhea, a drop in milk yields, congenital malformations and stillbirths. Until June 2014, more than 200 scientific publications regarding SBV have been published. Although more than 20 articles on SVB were published in China, most of these articles provided only a brief introduction of the disease without fully discussing the associated disease characteristics. As a new disease, it has been made a focus of the National Research Center for Exotic Animal Diseases at the China Animal Health and Epidemiology Center. In this review, in order to provide a reference for research into SBV in China, we have reviewed the state of current research progress on the etiology, diagnosis and epidemiology of SBV, and vaccine development.

Objective: To investigate the clinical features and diagnosis of infants under 3 months of age with congenital syphilis., Method: Data of 121 infants below 3 months of age with congenital syphilis were collected from January 1997 to May 2007 at the authors' hospital. Their clinical features, laboratory findings and treatment were reviewed., Result: Clinical manifestations of congenital syphilis in the infants were diverse. The disease involved multiple systems such as the skin, respiratory, digestive, blood, and nervous system, skeleton and so on. Among the 121 infants, the manifestations included increased leukocyte count (89.3%), skin damage (59.5%), hepatomegaly (56.2%), splenomegaly (41.3%), anemia (38.8%), fever (28.9%), pathologic jaundice (24.0%), growth retardation after birth (12.4%) and bone damage (54.3%), etc. The rate of misdiagnosis was 17.4 percent, and the kinds of disease misdiagnosed were up to 10., Conclusion: Clinical manifestations of congenital syphilis in infants under 3 months of age were complicated and nonspecific, therefore doctors misdiagnosed it very easily. Clinicians should attach great importance to it. At the same time, the restoration of antemarital examination, vigorously carrying out screening for syphilis and strengthening the management of immigrants are necessary to prevent congenital syphilis.

The interaction of genistein and human serum albumin (HSA) was investigated by fluorescence quenching spectra, synchronous fluorescence spectra and ultra-violet absorption spectra. The results showed that the quenching mechanism of the intrinsic fluorescence of HSA by genistein is due to the formation of genistein-HSA complex, resulting in a static quenching procedure. The binding constants (KA) were 1.00 x 10(6) (27 degrees C), 1.66 x 10(6) (37 degrees C) and 5.25 x 10(6) (47 degrees C), respectively. According to the Förster theory of non-radiation energy transfer, the binding distances (r) were 2.59 nm (27 degrees C), 2.65 nm (37 degrees C) and 2.90 nm (47 degrees C), respectively. The thermodynamic parameters showed that the binding power between genistein and HSA is mainly the electrostatic interaction Synchronous spectrum was used to investigate the conformational change of HSA.

Objective: To summarize the experience of extracorporeal membrane oxygenation (ECMO) to rescue a neonate with severe low cardiac output syndrome following open heart surgery., Methods: The patient was a male, 2 d, 2.8 kg, G3P2 full-term neonate with gestational age 40 weeks, born by Cesarean-section with Apgar score of 10 at 1 min. He was admitted due to severe dyspnea with oxygen desaturation and heart murmur on the second day after birth. Physical examination showed clear consciousness, cyanosis, dyspnea, RR 70 bpm and a grade II/6 heart murmur. Bp was 56/45 mm Hg (1 mm Hg = 0.133 kPa) and SpO2 around 65%. Blood WBC 13.1 x 10(9)/L, N 46.1%, Hb 238 g/L, Plt 283 x 10(9)/L, CRP < 1 mg/L. Echocardiographic findings: TGA + ASD + PDA with left ventricular ejection fraction (LVEF) of 60%. After supportive care and prostaglandin E1 (5 ng/kg/min) treatment, his condition became stable with SpO2 85 - 90%. On the 6(th) day of life, the baby underwent an arterial switch procedure + ASD closing and PDA ligation. The time of aorta clamp was 72 mins. The cool 4:1 blood cardioplegia was given for 2 times during aortal clamp. Ultrafiltration was used. The internal and external volumes were almost equal and the electrolytes and blood gas and hematocrit (36%) were normal during extracorporeal bypass. Due to a failure (severe low cardiac output) to wean from cardiopulmonary bypass (263 min) with acidosis (lactate 8.8 mmol/L), low blood pressure (< 39/30 mm Hg), increased LAP (> 20 mmHg), bloody phlegm, decreased urine output [< 1 ml/(kg.h)], a V-A ECMO was used for cardio-pulmonary support. ECMO setup: Medtronic pediatric ECMO package (CB2503R1), carmeda membrane oxygenator and centrifugal pump (bio-console 560) were chosen. Direct cannulation of the ascending aorta (Edward FEM008A) and right atrium (TF018090) was performed using techniques that were standard for cardiopulmanory bypass. The ECMO system was primed with 400 ml blood, 5% CaCl(2)1g, 5% sodium bicarbonate 1.5 g, 20% mannitol 2 g, albumin 10 g, and heparin 5 mg. The blood was re-circulated until the temperature was 37 degrees C and blood gases and the electrolytes were in normal range. The patient was weaned from bypass and connected to V-A ECMO. Management of ECMO: the blood flow was set at 150 - 200 ml/kg/min. Venous saturation (SvO2) was maintained at the desired level (75%) by increasing and decreasing extracorporeal blood flow. Systemic blood pressure was maintained at 76/55 - 80/59 mm Hg by adjusting blood volume. Hemoglobin was maintained between 120 - 130 g/L. Platelet count was maintained at > 75,000/mm3 and ACT was maintained at 120 - 190 s. The mechanical ventilation was reduced to lung rest settings (FiO2 35%, RR 10 bpm, PIP 16 cm H(2)O, PEEP 5 cm H2O) to prevent alveolar collapse. Inotropic drug dosages were kept at a low level., Results: The patient was successfully weaned from ECMO following 87 hours treatment. LVEF on day 1, 2 and 3 following ECMO were 20%, 34% and 43% respectively. The circulation was stable after weaning from ECMO with Bp 75/55 mm Hg, HR 160 bpm and LAP 11 mm Hg under inotropic drug suppor with epinephrine [(0.2 microg/(kg.min)], dopamine [(8 microg/(kg.min)], milrinone [(0.56 microg/(kg.min)]. The blood gases after 1 h off-ECMO showed: pH 7.39, PaO2 104 mm Hg, PaCO2 45 mm Hg, lactate 3.8 mmol/L, Hct 35%, K(+) 3.8 mmol/L, Ca(++) 1.31 mmol/L. The serum lactate was normal after 24 h off-ECMO. On day 22 off-ECMO, the baby was successfully extubated and weaned from conventional ventilator. On day 58, the patient was discharged. Serial ultrasound imaging studies revealed no cerebral infarction or intracranial hemorrhage during and after ECMO. At the time of hospital discharge, the patient demonstrated clear consciousness with good activity, normal function of heart, lung, liver and kidney. However, more subtle morbidities, such as behavior problems, learning disabilities should be observed ria long term follow-up. The main ECMO complications were pulmonary hemorrhage, bleeding on the sternal wound, tamponade, hemolysis and hyperbilirubinemia., Conclusion: ECMO is an effective option of cardio-pulmonary support for neonate with low cardiac output syndrome following open heart surgery.

Objective: Neonatal septicemia is a common and severe infection, which often results in death. Early diagnosis and treatment of neonatal septicemia may help decrease neonatal mortality. Recently, many studies sought to explore the possibility of early diagnosis of this disease. The high affinity Fcgamma-receptor I (CD(64)) was purposefully chosen as a potential marker for identifying neonatal septicemia. The present study was designed to evaluate neutrophil CD(64) level for early diagnosis of neonatal septicemia., Methods: Eighty-nine suspected neonatal septicemia cases were recruited into the study. Five non-specific indices, i.e., C-reactive protein (CRP), micro-erythrocyte sedimentation rate (mESR), white blood cell count, platelet count and the ratio of immature neutrophil count to total neutrophil count were measured for each patient. The patients were divided into septicemia group (n = 39) and non-septisemic infection group (n = 50) according to the diagnostic criteria for neonatal septicemia. Nineteen hospitalized neonates with non-infectious diseases were enrolled as controls (n = 19). The levels of peripheral blood neutrophil CD(64) were measured by using flow cytometry. The positive rate, sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of CD(64) were calculated., Results: The levels of peripheral blood neutrophil CD(64) in septicemia patients were (75.6 +/- 8.9)%, which were significantly higher than those of non-septisemic infection group (29.1 +/- 6.2)% and control group (5.1 +/- 1.1)% (P < 0.05), respectively. There were no significant differences in the levels of CD(64) expression between the patients with Gram-negative (79.5 +/- 3.5)% and Gram- positive (76.4 +/- 5.0)% (P > 0.05) bacterial infection. The levels of CD(64) of the cases with septicemia significantly decreased at day 10 of treatment with antibiotics. The detection of CD(64) (cutoff value > 30%) for suspected septicemia showed high sensitivity (97.4%), specificity (84.0%), PPV (82.6%), and NPV (97.6%). The positive rate of CD(64) detection (62.9%) was much higher than that of the blood culture test (19.1%) and that of the five nonspecific indices (29.2%, P < 0.05, respectively)., Conclusion: The expression of CD(64) increased in neonatal septicemia cases. The measurement of cell surface expression of CD(64) on neutrophils may be helpful to early diagnosis, evaluation of severity of infection and observation of therapeutic effects for neonatal septicemia.

Objective: The authors compared the protective ventilation strategies with the assistance of pulmonary mechanic measurements (PM) to the conventional ventilation practice in order to investigate the incidence of VALI, explore the best ventilator settings in RDS and the clinical effects of hypercapnia in neonates., Methods: One hundred and ten newborn infants, diagnosed as respiratory distress syndrome of neonatal and needed ventilator support, were recruited from the intensive care unit from 1994 to 2001. Infants with RDS were divided into non-pulmonary mechanics measurement (NPM) group and pulmonary mechanics measurement (PM) group. The ventilator settings, artery blood gas analysis, ventilator-associated lung injury and other clinical data were analyzed and compared., Results: In the PM group, expiratory tidal volume of (7.70 +/- 1.05) ml/kg, C(20)/C of (1.98 +/- 0.92) and time constant of (0.09 +/- 0.03) sec were measured. Ventilator setting in PM group [PIP of (26.7 +/- 1.7) cmH(2)O, MAP of (11.9 +/- 2.0) cmH(2)O, Ti of (0.45 +/- 0.10) sec] were significantly less than those in NPM group [PIP of (30.5 +/- 3.4) cmH(2)O, MAP of (14.9 +/- 3.4) cmH(2)O, Ti of (0.75 +/- 0.10) sec P < 0.001, respectively]. No differences were noted in demographic data between the two groups regarding to the pH (7.30 +/- 0.04 vs 7.31 +/- 0.10), PaO(2) [(59 +/- 16) vs (57 +/- 17) mmHg], heart rate [(145 +/- 6) vs (144 +/- 8) bpm] and blood pressure [(39.0 +/- 3.6) vs (40.0 +/- 4.6) mmHg], except for PaCO(2) in PM group which was significantly higher than that in NPM group [(48 +/- 6) vs (40 +/- 10) mmHg, P < 0.001]. OI in PM group was significantly less than that in NPM group (14 +/- 8 vs 19 +/- 13, P < 0.05). Incidence of ventilator-associated lung injury in PM group was significantly lower than that in NPM group (13% vs 32%, P < 0.05). No differences were noted in demographic data between the two groups regarding to the length of ventilator support [(4.2 +/- 1.7) vs (3.9 +/- 1.8) day], length of supplemental oxygen requirements [(13 +/- 7) vs (11 +/- 7) day], length of hospitalization [(22 +/- 11) vs (19 +/- 14) day], mortality (8% vs 14%), incidence of PDA (33 vs 36%) and IVH (40% vs 42%)., Conclusions: The assistance use of pulmonary mechanics measurement can guide the ventilator adjustment and decrease the ventilator-associated lung injury in neonatal RDS. The low PIP, low tidal volume, shorter inspiratory time and adequate PEEP strategies in the treatment of RDS showed no significant effects on the oxygenation in neonates. The mild permissive hypercarbia in newborn did not increase the incidence of IVH.