Clinical treatment outcomes and their changes in extremely preterm twins: a multicenter retrospective study in Guangdong Province, China / 中国当代儿科杂志

OBJECTIVES@#To investigate the clinical treatment outcomes and the changes of the outcomes over time in extremely preterm twins in Guangdong Province, China.@*METHODS@#A retrospective analysis was performed for 269 pairs of extremely preterm twins with a gestational age of <28 weeks who were admitted to the department of neonatology in 26 grade A tertiary hospitals in Guangdong Province from January 2008 to December 2017. According to the admission time, they were divided into two groups: 2008-2012 and 2013-2017. Besides, each pair of twins was divided into the heavier infant and the lighter infant subgroups according to birth weight. The perinatal data of mothers and hospitalization data of neonates were collected. The survival rate of twins and the incidence rate of complications were compared between the 2008-2012 and 2013-2017 groups.@*RESULTS@#Compared with the 2008-2012 group, the 2013-2017 group (both the heavier infant and lighter infant subgroups) had lower incidence rates of severe asphyxia and smaller head circumference at birth (P<0.05). The mortality rates of both of the twins, the heavier infant of the twins, and the lighter infant of the twins were lower in the 2013-2017 group compared with the 2008-2012 group (P<0.05). Compared with the 2008-2012 group, the 2013-2017 group (both the heavier infant and lighter infant subgroups) had lower incidence rates of pulmonary hemorrhage, patent ductus arteriosus (PDA), periventricular-intraventricular hemorrhage (P-IVH), and neonatal respiratory distress syndrome (NRDS) and a higher incidence rate of bronchopulmonary dysplasia (P<0.05).@*CONCLUSIONS@#There is a significant increase in the survival rate over time in extremely preterm twins with a gestational age of <28 weeks in the 26 grade A tertiary hospitals in Guangdong Province. The incidences of severe asphyxia, pulmonary hemorrhage, PDA, P-IVH, and NRDS decrease in both the heavier and lighter infants of the twins, but the incidence of bronchopulmonary dysplasia increases. With the improvement of diagnosis and treatment, the multidisciplinary collaboration between different fields of fetal medicine including prenatal diagnosis, obstetrics, and neonatology is needed in the future to jointly develop management strategies for twin pregnancy.

Process optimization of Morinda officinalis with wine steaming by star dot design-response surface methodology / 药学实践杂志

Objective To establish the best wine steaming process for morinda officinalis with monotropein as indicator. Methods Response surface methodology was used to optimize the wine steaming process for morinda officinalis with the amount of rice wine, stewing time, moistening time and the monotropein content as evaluation indexes. Results The best condition was identified with rice wine (rice wine/herbs, g/g) 10%, moistening time 1.0 h, fully steamed and dried. Conclusion The Star dot design-response surface method can be used to optimize the wine steaming process for morinda officinalis.

Modified stoppa approach for pelvic and acetabular fracture treatment / Stoppa modificada para tratamento de fraturas pélvicas e acetabulares

ABSTRACT Objective: A retrospective review aims to investigate the operative methods and therapeutic effects of the modified Stoppa approach for treating pelvic and acetabular fractures. Methods: 18 patients with acetabular fracture of the anterior column and pelvic anterior ring fracture underwent surgical treatment using the modified Stoppa approach. Some of the treatment was combined with the iliac fossa approach or rear K-L approach. Fracture reduction and postoperative function were evaluated using the Matta scoring standard and the Majeed scoring system. The Oxford Centre for Evidence-Based Medicine system was used to grade the literature review and create graded B recommendations. Results: Incision length was 6-12 cm (mean, 10 cm), operative duration was 50-150 minutes (mean, 85 minutes), and intraoperative blood loss volume was 400-1,000 ml (mean, 500 ml). 18 patients were followed up for 12-36 months post-operation. In the results of X-ray films, 12 cases were anatomical reductions and the remaining cases were satisfactory reductions. According to Majeed standard, 13 patients were excellent and five patients were good. Conclusions: Treatment using the modified Stoppa approach was suitable for anterior approaches, in which pelvic and acetabular fractures were sufficiently exposed, the fracture was conveniently reduced, less complications occurred, and curative effect was satisfactory. Level of evidence III, Retrospective comparative study.

RESUMO Objetivo: Uma revisão retrospectiva tem como objetivo investigar os métodos operatórios e efeitos terapêuticos da abordagem modificada de Stoppa para o tratamento de fraturas pélvicas e acetabulares. Métodos: 18 pacientes com fratura acetabular da coluna anterior e fratura do anel anterior pélvico foram submetidos a tratamento cirúrgico utilizando a abordagem de Stoppa modificada. Parte do tratamento foi feita em conjunto com a abordagem da fossa ilíaca ou com a abordagem pelo acesso posterior de K-L. A redução da fratura e a função pós-operatória foram avaliadas pelo padrão de pontuação de Matta e o sistema de pontuação de Majeed. O sistema do Oxford Centre for Evidence-Based Medicine foi usado para classificar a revisão de literatura e criar as recomendações de grau B. Resultados: O comprimento da incisão foi de 6 a 12 cm (média de 10 cm), a duração da cirurgia foi de 50 a 150 minutos (média de 85 minutos) e o volume de perda sanguínea intraoperatória foi de 400 a 1.000 ml (média de 500 ml). 18 pacientes foram acompanhados por 12-36 meses após a operação. Nos resultados dos filmes radiográficos, 12 casos foram de reduções anatômicas e os demais casos foram de reduções satisfatórias. De acordo com o padrão de Majeed, 13 pacientes foram considerados excelentes e cinco pacientes foram considerados bons. Conclusões: O tratamento que utilizou a abordagem de Stoppa modificada foi adequado para abordagens anteriores, nas quais as fraturas pélvicas e acetabulares estavam suficientemente expostas, a fratura foi convenientemente reduzida, ocorreram menos complicações e o efeito curativo foi satisfatório. Nível de evidencia III, Estudo retrospectivo comparativo.

Sequence comparison of the hemagglutinin gene of the duck-origin H9N2 subtype avian influenza viruses / 病毒学报

To demonstrate the phylogenetic evolution, the molecular characteristics of the motif of HA protein cleavage site and the varieties at the receptor binding sites of the hemagglutinin gene of the duck-origin H9N2 subtype avian influenza viruses, sequence alignment and phylogenetic analysis were performed by MEGA 4.1 Neighbor-Joining method.. The results revealed that the duck-origin H9N2 AIV viruses originated from CK/BJ/1/94-like and North-Ame-like, all the duck-origin H9N2 AIV viruses from mainland China belonged to CK/BJ/1/94-like and formed multiple genotypes through complicated re-assortment, while other duck-origin H9N2 AIV, isolated from other countries in Aisa, American and European such as Korea, Japan, Alberta, Austria, Switzerland, Iran, belonged to the North-Ame-like phylogenetic lineage. The amino acids at positions 183, 190, and 226 of the receptor binding sites of North-Ame-like group isolates had highly conserved H, E and Q respectively. In contrast with duck-origin H9N2 AIV viruses isolates from mainland China, the amino acids had N at positions 183, A, T, or V at 190, L or Q at 226, which was the same as the chicken-origin H9N2 AIV from mainland China. Most newly isolated chicken-origin H9N2 AIV in Fujian Province in Southern China had L at position 226 emphasized the higher risk of cross-infection between the chicken-origin and duck-origin H9N2 AIV in China.

Effect of methylprednisolone pretreatment on pulmonary permeability and dipalmitoylphosphatidylcholine content in rabbits with reexpansion pulmonary edema / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the effects of methylprednisolone pretreatment on pulmonary lung permeability index and the content of the pulmonary surfactant dipalmitoylphosphatidylcholine (DPPC) in a rabbit model of reexpansion pulmonary edema.</p><p><b>METHODS</b>Twenty-one male New Zealand white rabbits were randomly divided into control group, reexpansion, and reexpansion+methylprednisolone pretreatment groups. The rabbit model of reexpansion pulmonary edema was established using Sakaos method. A bolus dosage of methylprednisolone (3 mg/kg) in reexpansion+methylprednisolone group group or 2.0 ml/kg normal saline in the other two groups was administered intravenously 20 min before reexpansion pulmonary edema. Bronchoalveolar lavage fluid (BALF) and arterial blood samples were collected for measurement of the total protein (TP) and DPPC contents 4 h after reexpansion, and the pulmonary permeability index was calculated.</p><p><b>RESULTS</b>The pulmonary permeability index in methylprednisolone pretreatment group was significantly lower than that in the reexpansion group (0.007∓0.002 vs 0.177∓0.004, P<0.05). Methylprednisolone pretreatment significantly increased DPPC concentration in the BALF as compared with saline treatment in the reexpansion group (61.815∓28.307 vs 101.955∓24.544 µg/ml, P<0.05).</p><p><b>CONCLUSION</b>Methylprednisolone pretreatment can increase pulmonary surfactant content and improve pulmonary permeability in the rabbit model of reexpansion pulmonary edema.</p>

Measurement of plasma concentration and bioavailability of nolatrexed dihydrochloride in mice / 南方医科大学学报

<p><b>OBJECTIVE</b>To establish a methods based on high-performance liquid chromatogram-mass spectrum for measuring the plasma concentration of nolatrexed dihydrochloride and investigate the pharmacokinetic profile and absolute bioavailability of the drug in mice.</p><p><b>METHODS</b>Nolatrexed dihydrochloride were injected intravenously at 50 mg/kg or administered orally at 200 mg/kg in mice, and blood samples were collected at various time points following drug administration. The plasma concentration of nolatrexed dihydrochloride in mice was determined using high-performance liquid chromatogram-mass spectrum. The pharmacokinetic parameters were calculated using DAS software, and the absolute bioavailability of orally and intravenously administered was assessed according to the ratio of their area under the curve (AUC).</p><p><b>RESULTS</b>The method showed good linear relationship within the drug concentration range of 0.01-40 mg/L (r=0.9995, P<0.001). The recovery of nolatrexed dihydrochloride from the mouse plasma was more than 85%, and the intra- and inter-day precision expressed as the relative standard deviation was less than 15%. The half-life (T(1/2)), AUC, distribution factor and plasma clearance (CL) for intravenously administered nolatrexed dihydrochloride (50 mg/kg) were 3.020-/+0.017 h, 89.972-/+0.425 mg/L/h, 0.831-/+0.106 L/kg, and 0.556-/+0.093 L/h/kg, respectively. The T(1/2), AUC, peak time (T(max)) and peak concentration (C(max)) for orally administered drug were 5.046-/+0.191 h, 84.893-/+9.923 mg/L/h, 1.000-/+0.012 h, and 18.000-/+0.0140 mg/L, respectively. The absolute bioavailability of nolatrexed dihydrochloride in mice was 23.58%.</p><p><b>CONCLUSION</b>The absolute bioavailability of nolatrexed dihydrochloride in mice determined in this study provides an experimental basis for development of the oral preparation of the drug.</p>

Relationship between serum levels of insulin-like growth factor I and growth hormone and neonatal hypoxic-ischemic encephalopathy / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To study the serum levels of insulin-like growth factor I(IGF-I)and growth hormone (GH) in neonates with hypoxic-ischemic encephalopathy (HIE) and to investigate the relationship of serum levels of IGF-I and GH with the severity of HIE.</p><p><b>METHODS</b>Serum levels of IGF-I and GH were measured within 72 hrs (acute stage) and on the 26-28th days (convalescence stage) of life in 53 HIE neonates. There were 30 babies in the mild HIE group, 15 babies in the moderate HIE group, and 9 babies in the severe HIE group. Thirty normal newborns were used as the control group. Neonatal behavioral neurological assessment (NBNA) was performed on HIE neonates at the acute and convalescence stages.</p><p><b>RESULTS</b>The IGF-I levels of the mild, moderate and severe HIE groups measured within 72 hrs of life were 59.65 +/- 29.61, 33.56 +/- 17.32, and 23.58 +/- 13.57 ng/mL respectively and those of the three HIE subgroups on the 26-28th days after birth were 89.26 +/- 48.65, 71.46 +/- 38.35, and 54.39 +/- 26.39 ng/mL respectively. The serum IGF-I levels of HIE neonates at both acute and convalescence stages were significantly lower than those of the control group (71.23 +/- 35.42 and 96.54 +/- 52.38 ng/mL respectively; both P < 0.01), and associated with the severity of HIE as well as NBNA scores. GH levels were not significantly correlated to the severity of HIE and NBNA scores.</p><p><b>CONCLUSIONS</b>Serum IGF-I levels can be used as a marker for estimating the severity and the outcome of neonatal HIE.</p>

The application of extracorporeal membrane oxygenation for surgical treatment of coronary artery disease / 中华外科杂志

<p><b>OBJECTIVE</b>To summarize the results and experiences on extracorporeal membrane oxygenation (ECMO) for post-cardiac surgery of coronary artery disease.</p><p><b>METHODS</b>From June 2004 to November 2006, sixteen patients with the mean age of (58 +/- 11) years old undergoing cardiac surgical procedures were placed on ECMO using a heparin-bonded circuit. Fourteen patients were male and two patients were female. Thirteen patients underwent on pump coronary artery bypass surgery (CABG) and three patients underwent off-pump coronary artery bypass grafting. The duration of ECMO support, stay of intensive care unit (ICU stay), complications and turnovers were recorded.</p><p><b>RESULTS</b>The mean duration of ECMO support was 51 hours, and the mean duration of ICU stay was 5 days. Thirteen patients (81.3%) were successfully weaned form ECMO, ten patients (62.5%) were discharged from hospital. The main complications were bleeding, infection, renal failure and ischemia of the lower limbs with the incidence of 18.8%, 37.5%, 25% and 18.8% respectively.</p><p><b>CONCLUSION</b>ECMO is an acceptable technique for shortterm treatment of refractory low cardiac output after cardiac surgery of coronary artery disease.</p>

Cerebral distribution of propofol at cerebral propofol uptake equilibrium in dogs / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the cerebral distribution of propofol during continued infusion at a constant rate when the cerebral propofol uptake reaches equilibrium in dogs.</p><p><b>METHODS</b>Six healthy 1-year-old male dogs were used in this study. The venous channel was established in the great saphenous vein of the right posterior limb. Anesthesia was induced with a single bolus injection of propofol (7 mg/kg), followed by propofol infusion at a constant rate of 70 mg/(kg.h) using a microinfusion pump. The blood samples were taken from the right internal carotid and internal jugular vein at 30 min (T30) and 50 min (T50) during propofol infusion for measurement of plasma propofol concentrations with high performance liquid chromatography (HPLC). At T50, the frontal lobe, parietal lobe, temporal lobe, hippocampus, cingulate gyrus, thalamus, midbrain, pons, and cerebellum were dissected respectively for determination of propofol concentrations.</p><p><b>RESULTS</b>Propofol concentrations in the internal carotid artery and internal jugular vein blood plasma were 3.107-/+1.067, 3.095-/+1.085 microg/ml at T30 and 3.091-/+1.101, 3.117-/+1.091 microg/ml at T50, respectively, showing no significant differences (P>0.05). Propofol concentrations in the frontal lobe, parietal lobe, temporal lobe, hippocampus, cingulate gyrus, thalamus, midbrain, pons, cerebellum at T50 were 3.085-/+1.123, 3.116-/+1.125, 3.073-/+1.159, 3.117-/+1.090, 3.075-/+1.178, 3.073-/+1.146, 3.075-/+1.151, 3.102-/+1.174, and 3.072-/+1.192 microg/g respectively, suggesting homogeneous propofol distribution in these cerebral tissues (P>0.05).</p><p><b>CONCLUSION</b>At T50, the cerebral uptake of propofol reached equilibrium when propofol is distributed homogeneously in the cerebral tissues in dogs.</p>

Inhibitory effect of polysaccharides on the six-alpha-helix bundle formation of HIV gp41 protein / 南方医科大学学报

<p><b>OBJECTIVE</b>To compare the in vitro inhibitory effect of expolysaccharides from Streptomyces, polysaccharides of Ganoderma lucidum and rice bran on six-alpha-helix bundle formation of HIV gp41 protein.</p><p><b>METHODS</b>The amount of six-alpha-helix bundle formed in the presence of N36 and C34 was tested by ELISA in response to treatments with different doses of polysaccharides.</p><p><b>RESULTS</b>Expolysaccharides from Streptomyces potentially inhibited six-alpha-helix bundle formation with the effective concentration (IC(50)) of 145.48-/+7.25 mg /L. Polysaccharides of Ganoderma lucidum and rice bran showed no effect on the six-alpha-helix bundle formation.</p><p><b>CONCLUSION</b>Expolysaccharides from Streptomyces can inhibit the six-alpha-helix bundle formation of HIV gp41, whereas polysaccharides of Ganoderma lucidum and rice bran do not exhibit such activity.</p>