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Objective:To establish an ultra-high-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) method for plasma caffeine concentration detection, and to explore the clinical value of caffeine therapeutic drug monitoring (TDM) in the treatment of premature infants with respiratory distress syndrome (RDS).Method:Take the plasma sample in a centrifuge tube, add the caffeine deuterated isotope internal standard, then add the protein precipitant, vortex the mixture thoroughly, and centrifuge the supernatant to enter the mass spectrometry analysis. The mobile phase were methanol and water, gradient elution; the column temperature was 45 ℃, the method was established using Shimadzu LC-30AD-CL liquid system and AB SCIEX 4500 QTRAP mass spectrometer, and the sensitivity, specificity, linearity, accuracy imprecision, matrix effect, and carry-over of the method were evaluated. Sample from 30 patients diagnosed with neonatal RSD were collected in the Department of Neonatology of Renmin Hospital of Wuhan University from February to April 2021, then detected the trough concentration of caffeine in premature infants with RDS after taking the same dose of caffeine to assess the impact of individual variation on caffeine drug concentration.Results:The detection limit of caffeine was 0.02 μg/ml, and the lowest limit of quantification was 0.05 μg/ml. It showed good linearity ( R2=0.9986, R>0.99) in the concentration range from 1.0 to 100.0 μg/ml, specificity (recovery rate of 85.52%-114.12%), accuracy (recovery rate 85.97%-114.53%), intra-day and inter-day imprecision ( CV 6.01%-11.28%), matrix effects and carryover pollution were negligible. The trough concentration of 30 preterm infants with RSD after taking the same dose of caffeine (10 mg/kg) was (25.45±11.61) μg/ml, and the coefficient of variation was 44.88%. Conclusion:This study established an accurate and reliable UPLC-MS/MS method with low sample consumption to monitor the blood concentration of caffeine; caffeine TDM has certain clinical application value, which can be used to assist RDS diagnosis and treatment and improve the efficacy of caffeine.
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Capillary leak syndrome( CLS)is a group of clinical syndromes which caused by various causes of capillary endothelial damage,increased vascular permeability,resulting in a large amount of plasma protein infiltration into the interstitial space. It is one of the common critical cases in Neonatal Intensive Care Unit. As the complicated pathogenesis,blurred clinical stage and often neglected due to other complications,clinical treatment of CLS is difficult. Currently,there is no uniform diagnostic criteria,and the diagnosis is mainly based on clinical manifestation and labora-tory examination. The treatment of it is empiric but no specific treatment. Primary disease treatment and fluid manage-ment are the critical parts of the treatment of CLS. Now,the etiology,pathogenesis,clinical diagnosis and treatment of the disease were explained combined with the domestic and foreign literature and clinical diagnosis and treatment prac-tices,which aims to improve clinicians′understanding of the disease and the level of clinical diagnosis and treatment.
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Vitamin D is an active derivative of fat-soluble steroid,which can promotes the absorption of Ca in the intestine and maintains the concentrations of serum Ca in blood as well as phosphate.Recent researches found that the lack of vitamin D would increase the risk of respiratory diseases,cardiovascular diseases,autoimmune diseases,neuropsychiatric diseases,tumors and other metabolic diseases in addition to affecting the development of bones.More studies have shown that low vitamin D levels is related to respiratory diseases in children.In this review,the physiological characteristics of vitamin D and the relationship with respiratory diseases in children were discussed.
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Vitamin D is an active derivative of fat-soluble steroid, which can promotes the absorption of Ca in the intestine and maintains the concentrations of serum Ca in blood as well as phosphate.Recent researches found that the lack of vitamin D would increase the risk of respiratory diseases, cardiovascular diseases, autoimmune diseases, neuropsychiatric diseases, tumors and other metabolic diseases in addition to affecting the development of bones.More stu-dies have shown that low vitamin D levels is related to respiratory diseases in children.In this review, the physiological characteristics of vitamin D and the relationship with respiratory diseases in children were discussed.
ABSTRACT
Capillary leak syndrome(CLS)is a group of clinical syndromes which caused by various causes of capillary endothelial damage, increased vascular permeability, resulting in a large amount of plasma protein infiltration into the interstitial space.It is one of the common critical cases in Neonatal Intensive Care Unit.As the complicated pathogenesis, blurred clinical stage and often neglected due to other complications, clinical treatment of CLS is difficult.Currently, there is no uniform diagnostic criteria, and the diagnosis is mainly based on clinical manifestation and laboratory examination.The treatment of it is empiric but no specific treatment.Primary disease treatment and fluid management are the critical parts of the treatment of CLS.Now, the etiology, pathogenesis, clinical diagnosis and treatment of the disease were explained combined with the domestic and foreign literature and clinical diagnosis and treatment practices, which aims to improve clinicians′ understanding of the disease and the level of clinical diagnosis and treatment.
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Objective SGA and IURG fetuses are important risk factors for metabolic disease in adulthood,but the mechanism is not clear.In this study,Irisin levels in umbilical cord blood of different birth weight and IURG neonates were measured and the relationship between Irisin and neonatal weight,gestational age and other factors was explored.Methods This study was conducted in the cross-sectional study of neonates born in our hospital from 2014 to 2016.Newborns were divided into small-for-gestational age (SGA),greater-than-gestational age (LGA),gestational age (AGA) and newborns with intrauterine growth restriction (IUGR).The levels of irisin in umbilical cord blood of 4 newborns were detected.Results In this study,there were a total of 110 cases of newborns.The mean gestational age and mean birth weight of newborns in the SGA group was lower than that in the other three groups(P =0.000).The mean Irisin levels in the SGA and IUGR groups [54.4(45.6-66.7) ng/ml,53.7 (40.3-62.4) ng/ml] were significantly lower than those in the AGA group [67.7 (53.8-78.1) ng/ml,64.7 (53.6-71.2) ng/ml] (P =0.000).The mean insulin levels in the LGA group [7.54(0.83-58.96)mIU/ml] were significantly higher than those in the AGA group [38.00(34.40-39.30)mIU/ml] and IU-GR [3.86(0.49-16.15)] and SGA [4.19 (0.62-14.42)mIU/ml] (P =0.000).In the present study,the correlation analysis showed that Irisin level in neonatal umbilical cord blood was significantly correlated with neonatal gestational age (r =0.22,P ＜ 0.01),fetal weight (r =0.17,P ＜0.01) and maternal age (r =-0.12,P =0.021).However,only in the LGA group,the level of Irisin in cord blood of neonates was positively correlated with insulin level (r =0.41,P =0.042).Multivariate linear regression analysis revealed that SGA (β =-0.14,P =0.02) and fetal weight (β =0.05,P =0.008) were independent risk factors for neonatal umbilical cord blood Irisin levels.Conclusion There was a positive correlation between irisin level and neonatal umbilical cord blood birth weight.The levels of irisin in the neonates of the SGA and IURG groups were significantly lower than those of the AGA and LGA groups,but irisin levels did not differ between the SGA and IURG groups and between AGA and LGA groups.And irisin levels in the LGA group were positively correlated with insulin levels.Our results also reveal that singleton infants of mothers with preeclampsia had lower cord blood irisin levels compared to infants of mothers without preeclampsia.
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BACKGROUND:The discovery and concept of pulp tissue-derived stem cells is beneficial to the understanding of tooth development and regeneration and repair mechanisms from the cellular level. OBJECTIVE:To understand the induced differentiation capacity and induced conditions in vitro of human dental pulp stem cells into neuron-like cells. METHODS:Pulp tissue was separated from human healthy third molars. Single cellsuspensions were prepared and seeded into 6-wel plates containing alpha-modified minimum essential medium supplemented with 15%fetal bovine serum. Subconfluent cultures (first passage) of colony forming cells were induced with butylhydroxy anisole, forskolin,β-mercaptoethanol, basic fibroblast growth factor. RESULTS AND CONCLUSION:Immunofluorescence and reverse transcription-PCR assay showed that human dental pulp stem cells positively expressed stro-1, Col-I, dentin sialoprotein after 2 weeks of induction. Nestin and neuron-specific enolase were strongly expressed, but the gingival fibroblasts were negatively expressed. It indicates that adult stem cells in human dental pulp have a high neuron-like celldifferentiation potential under a certain inductive condition.
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Object To study the effects of chronic prenatal exposure to cocaine on hepar in the newborn rabbit at birth. Methods The pregnant Japan long ear white rabbits were divided randomly into cocaine group( N =12) and normal control( N =12). Pregnant rabbits were treated with cocaine hydrochloride 5 mg/kg or normal saline 1 ml/kg intravenously, one time daily from day 15 of pregnancy until day 30 respectively. Serum aspartate aminotransferase(AST), albumin(ALB), total bilirubin(T BIL), hepatic glutathione(GSH) were examined. Results (1)The levels of serum AST, T-BIL were significantly higher in the cocaine group than that in the control group( P