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Objective:To study the risk factors of extrauterine growth retardation (EUGR) during hospitalization in very preterm infants (VPIs) with birth weight (BW) <1 500 g.Methods:From Jan 2015 to Dec 2020, clinical data of VPIs admitted to neonatal department our hospital were retrospectively studied. The infants were assigned into EUGR group and non-EUGR group according to their weight at discharge. Multivariate logistic regression analysis was used to analyze the risk factors of EUGR in VPIs.Results:A total of 969 VPIs were enrolled, including 400 cases of EUGR (41.3%). Multivariate logistic regression analysis showed that Z-score of BW ( OR=0.057, 95% CI 0.037-0.088, P<0.001) was closely correlated with the occurrence of EUGR and growth velocity (GV) after regain BW ( OR=0.537, 95% CI 0.479-0.602, P<0.001) was a protective factor for EUGR. Maternal hypertension during pregnancy ( OR=1.895, 95% CI 1.059-3.394, P=0.031), asphyxia at birth ( OR=2.508, 95% CI 1.265-3.347, P=0.004) and moderate to severe bronchopulmonary dysplasia (BPD) ( OR=2.660, 95% CI 1.503-4.708, P=0.001) were risk factors for EUGR at discharge. Conclusions:EUGR is still common in VPIs. Increased GV after regain BW, prevention and treatment of moderate to severe BPD may reduce the incidence of EUGR at discharge in VPIs.
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Objective@#To investigate the predictive value of CT-DRAGON score for clinical outcomes after endovascular treatment in patients with acute ischemic stroke.@*Methods@#Patients with acute ischemic stroke underwent endovascular intervention in Xuzhou Central Hospital from May 2015 to June 2019 were enrolled retrospectively. CT-DRAGON score was performed before treatment, and the outcomes of patients were evaluated by the modified Rankin Scale (mRS) at 3 months after treatment, and good outcome was defined as mRS0-2. Multivariate logistic regression analysis was used to determine the independent factors for the outcomes. The receiver operating characteristic (ROC) curve was used to analyze the predictive value of CT-DRAGON score for clinical outcome.@*Results@#A total of 67 patients were enrolled. The age was 68.69±11.63 years. The median CT-DRAGON score was 5 (interquartile interval: 4-7), and the baseline NIHSS score was 17.45±5.19. Thirty-five patients (52.2%) had a good outcome and 32 (47.8%) had a poor outcome, of which 13 (19.4%) died. Multivariate logistic regression analysis showed that higher CT-DRAGON score was an independent predictor for poor outcome (odds ratio 1.997, 95% confidence interval 1.271-3.136; P=0.003). The ROC curve analysis showed that the area under the curve of CT-DRAGON score to clinical outcome was 0.808 (95% confidence interval 0.706-0.911; P<0.001). The optimal cutoff value was 5, the corresponding sensitivity was 65.6%, and the specificity was 80.0%.@*Conclusions@#Baseline CT-DRAGON score can effectively predict the clinical outcome of patients with acute ischemic stroke at 3 months after endovascular treatment.
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Objective To investigate the predictive value of CT-DRAGON score for clinical outcomes after endovascular treatment in patients with acute ischemic stroke.Methods Patients with acute ischemic stroke underwent endovascular intervention in Xuzhou Central Hospital from May 2015 to June 2019 w ere enrolled retrospectively.CT-DRAGON score w as performed before treatment,and the outcomes of patients were evaluated by the modified Rankin Scale (mRS) at 3 months after treatment,and good outcome was defined as mRS 0-2.Multivariate logistic regression analysis was used to determine the independent factors for the outcomes.The receiver operating characteristic (ROC) curve was used to analyze the predictive value of CT-DRAGON score for clinical outcome.Results A total of 67 patients were eurolled.The age was 68.69 ± 11.63 years.The median CT-DRAGON score was 5 (interquartile interval:4-7),and the baseline NIHSS score was 17.45 ±5.19.Thirty-five patients (52.2％) had a good outcome and 32 (47.8％) had a poor outcome,of which 13 (19.4％) died.Multivariate logistic regression analysis showed that higher CT-DRAGON score was an independent predictor for poor outcome (odds ratio 1.997,95％ confidence interval 1.271-3.136;P =0.003).The ROC curve analysis showed that the area under the curve of CT-DRAGON score to clinical outcome was 0.808 (95％ confidence interval 0.706-0.911;P ＜ 0.001).The optimal cutoff value was 5,the corresponding sensitivity was 65.6％,and the specificity was 80.0％.Conclusions Baseline CT-DRAGON score can effectively predict the clinical outcome of patients with acute ischemic stroke at 3 months after endovascular treatment.
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Objective To investigate the values of serum thymidine kinase 1 (TK1) and soluble NKG2D (natural killer cell group 2D) ligand (soluble major histocompatibility complex class Ⅰ-related chain A,sMICA) in predicting the prognosis of colorectal cancer patients undergoing radical resection.Methods 45 patients and 45 healthy subjects were included.Perioperative serum TK1 and NKG2D ligand levels were measured in 45 patient and 45 healthy controls.Patients were divided into high TK1 group and low TK1 group,and high sMICA group and low sMICA group according to the ROC.Results Perioperative TK1 were (4.42 ± 1.42) and (2.98 ± 0.54) pmol/L,sMICA were (135 ± 79) and (100 ± 81)pg/ml,which were significantly higher than those in healthy controls (P =0.000).The postoperative TKI and sMICA levels decreased significandy (P =0.000 and 0.042).The 3 and 5 years cumulative survival rates in the high TK1 group were 84％ and 34％,compared with that of 90％ and 75％in the low TK1 group (P =0.023).The 3 year and 5 year cumulative survival rates in high sMICA group were 61％ and 31％,compared with 71％ and 52％ in low sMICA group (P =0.148).Conclusion Patients serum thymidine kinase levels were negatively corelated with the prognosis of colorectal cancer after radical resection.
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Objective To investigate the effect of elevating the root of tongue bare-handed to assist ProSeal laryngeal mask airway insertion in patients with tongue body hypertrophy under general anesthesia. Methods Sixty ASAⅠ~Ⅲgrade patients with tongue body hypertrophy undergoing surgery in general anesthesia were randomly divided into two groups:30 cases in each group. After anesthesia induction ,laryngeal mask airway was inserted in the observation group with assistance of elevating the root of tongue bared-handed ,while inserted in the control group by standard method.Insertion time ,success rate of the first and secondary and total insertion ,pharyngolaryneal complications at 24 hours after removal were recorded ,as well as the success rate of gastric tube intubation was recorded. Results Compared with the control group ,insertion time was significantly shortened (P < 0.05). Success rate of the first and total insertion were increased (P < 0.05).Success rate of gastric tube intubation was increased(P < 0.05),and pharyngolaryneal complications were decreased (P < 0.05) in the observation group. Conclusions Elevating the root of tongue bare-handed to assist ProSeal laryngeal mask airway insertion in patients with tongue body hypertrophy is a simple and fast method with high success rate ,good apposition and less complications. Its efficacy is better than that of the standard method.
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Objective To systematically evaluate the optimal indwelling time of double?J stent in the treatment of ureteral complicated calculi post?ureteroscopy. Methods A total of 161 patients with complicated ureteral calculi were enrolled in this study from August 2012 to August 2015. All patients received the treatment of ureteroscopic holmium YAG Laser lithotripsy and were randomly divided into 3 groups according to varied double?J stent indwelling time: group A 6 weeks (n = 51). Complications of three groups were compared and the hydronephrosis after removing double?J stent was recorded. Results The rate of complications of group C was significantly higher than that in group A and group B (P<0.017). However,group A(10/43)has a higher rate of ureterostenosis after removing double?J stent compared with group B(4/67)and group C(3/51),while no statistical significance was observed between group B and group C. Conclusion The incidence of complications after lithotripsy increased with the indwelling time of double?J stent,but the short indwelling time would led to ureterostenosis. Therefore,the optimal indwelling time of double?J stent after flexible ureteroscopy was 2 to 6 weeks,and the indwelling time for patients with injury ureteral mucosa could be appropriately prolonged.
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Objective To explore the feasibility and safety of application of left new axillary vein puncture for critical disease via lateral approach in anterior thoracic wall.Methods Totally 100 critical patients were randomly divided into left side group and right side group.Extrathoracic puncture point was located with clavicle and puncture was pointed to cricoid cartilage.The axillary vein catheterization was carried out via lateral approach in anterior thoracic wall.Success rate and puncture times,depth,operating time and complications were recorded respectively. Results Success rate had no significant difference between the two groups(χ2 =0.613,P >0.05).Puncture times, depth,operating time and complications had no significant differences between the two groups(t =0.338,0.126, 0.361,all P >0.05).The total complications rate had no significant difference between the two groups(χ2 =0.149, P >0.05).Guide wire and catheter were inserted smoothly.The two groups had no pneumothorax and hemothorax. Conclusion The left new axillary vein puncture via lateral approach in anterior thoracic wall with clavicle and cricoid cartilage as surface marker was easy and safe without serious complications.It was suitable for critical disease.
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Neonatal hypoxic-ischemic encephalopathy has high mortality,high morbidity,as well as the lack of effective treatment,which remain difficult problem in the medical profession.Progesterone has been confirmed protective effect for neonatal hypoxic-ischemic encephalopathy as nerve steroid hormone,and has been used in clinical trials Ⅱ.We review the progess in progesterone in hypoxic-ischemic encephalopathy.
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Objective To investigate the optimum dose of dezocine combined with ropivacaine for elderly patient -controlled epidural analgesia(PCEA)after transurethal resection of prostate (TURP)surgery.Methods Totally 90 elderly patients underwent TURP surgery with ASAⅡ-Ⅲ were randomly divided into three groups,30 cases in each group.For postoperative epidural analgesia,they were treated with different mixed liquor as following:group F:fentanyl 0.3mg +1.192% ropivacaine 20mL +normal saline to 100mL,group D1:dezocine 5mg +1.192% ropiva-caine 20mL +normal saline to 100mL,group D2:dezocine 7.5mg +1.192% ropivacaine 20mL +normal saline to 100mL.VAS and Bruggrmann Comfort Scale(BCS)and sedation score at 4,8,12,24,36,48h and side -effects,sleep quality score and general satisfaction score at 24,48h after operation were recorded.The ratio of best analgesia was evaluated.Results VAS of 4,8,12,24,36,48h after operation had no significant differences among three groups (F =1.65,1.72,1.75,1.73,1.58,1.63,all P >0.05).BCS of all points had no significant differences among three groups(F =1.48,1.51,1.44,1.38,1.38,1.38,all P >0.05).Sedation score of all time points had no significant differences among three groups(F =1.55,1.60,1.61,1.00,1.00,1.00,all P >0.05).Sleep quality score of 24,48h after operation had no significant differences among three groups(F =1.76,1.84,all P >0.05).General satisfaction score of 24,48h after operation had no significant differences among three groups(F =1.73,1.72,all P >0.05).The excellent and good rates of analgesia in three groups were 90.0%,93.3% and 93.3% respectively,and there were no significant difference (χ2 =0.873,0.873,all P >0.05).Compared with group F and group D1,the incidence rates of nausea and vomit were significantly increased in group D2(χ2 =4.25,4.32,all P <0.05),and the incidence rates of dizziness were significantly increased in group D2 (χ2 =4.36,4.08,all P <0.05 ),and the incidence rates of drowsiness was significantly increased in group D2(χ2 =7.85,7.85,all P <0.05).There were no pruritus and respir-atory depression in three groups.Conclusion The optimum dose of dezocine combined with ropivacaine for elderly PCEA after TURP surgery is 5mg.It can provide adequate pain relief and higher satisfaction with less side -effects.
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Objective To explore the expression and role of LAT 1 in mouse uterus on early placenta formation on day 8 of pregnancy (D8).Methods One hundred and twenty 6-8-week old SPF female Kunming mice were used in this study.Immunohistochemistry was applied to determine the localization of LAT 1 protein in the mouse uterus on D8 of preg-nancy.The ectoplacental cones (EPCs) were dissected out from D8.5 uterus, and then cultured in vitro with different con-centrations of BCH (2-aminobicyclo-(2,2,1)-heptane-2-carboxylic acid, specific antagonist of LAT1) and L-leucine ( substrate of LAT1) to determine the role of LAT1 during the EPC attachment and outgrowth .Results LAT1 protein was highly expressed in secondary decidual zone and also positively expressed in the mouse uterus on D 8.As a specific antago-nist of LAT1, BCH significantly suppressed the ectoplacental cone outgrowth , whereas L-leucine showed no significant effect on it.Conclusions LAT1 is expressed in the mouse uterus during early placenta formation and promotes ectoplacen -tal cone outgrowth , suggesting that LAT1 may promote the trophoblast invasion into maternal decidual tissue , and partici-pates in the early formation of placenta .
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Objective To evaluate the effects of postconditioning with ischema and propofol on retinal injury induced by limb ischemia-reperfusion (LIR) in rats.Methods Twenty-four male Wistar rats were randomly divided into 3 groups (n =8 each) using a random number table:sham operation group (group S),group LIR,and propofol postconditioning + postconditioning + ischemic LIR group (group P + I + LIR).The model of LIR was established by separating and ligating the femoral artery and vein of bilateral hind limbs for 60 min followed by reperfusion.In group P + I + LIR,the animals were subjected to 4 episodes of 60 min ischemia-5 min reperfusion-5 min ischemia-5 min reperfusion and to 4 cycles of propofol 500 μg· kg-1 · min-1 infused intraperitoneally at the same time (during reperfusion)-no propofol infusion during second ischemia.At 120 min of reperfusion,blood samples were collected from the abdominal aorta for determination of serum malondialdehyde (MDA) concentrations.The eyeball was removed and the retina was cut into sections which were stained with H.E.and examined by microscopy.Results Compared with group S,the serum MDA concentration was significantly increased in group LIR,and no significant change was found in the serum MDA concentration in group P + I + LIR.The serum MDA concentration was significantly lower in group P + I + LIR than in group LIR.The structure of retina was normal in group S,oedema was found in all the layers of retina,vacuolar degeneration was observed in the most of ganglionic layers,and the structure disturbance was found in group LIR.The pathological changes of retina were significantly attenuated in group P + Ⅰ + LIR.Conclusion Postconditioning with ischema and propofol can attenuate retinal injury induced by LIR,and the mechanism is related to inhibition of lipid peroxidation in rats.
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Objective To discuss the relation between level of Hs-CRP and glycometabolic disturbance in patients with acute coronary syndrom. Methods 155 patients with acute coronary syndrome were divided into 3 groups according to the WHO standard of diabetes diagnosis,normal glucose tolerance group(group A,44 cases),impaired glucose tolerance group(group B,60 cases),diabetes group(group C,51 cases). All cases were checked by the 75g glucose tolerance test, blood Glucose, insulin, HbA1c,lipid,hypersensitive C reaction protein(hs-CRP). 95 patients were checked by coronary angiography(CAG). Statistic comparison were measured among three groups including the levels of hs-CRP,insulin,HbA1c,lipid and coronary artery lesions. Results The levels of Hs-CRP,PBG, FINS, PINS,HbA1c,TC,LDL-C in both group B and C were higher than those in group A;The levels of TG,PINS were not found significant differences between group B and C. The level of Hs-CRP was correlated with the levels of PBG,PINS,HbA1c,TC,LDL-C. The coronary artery lesions showed by CAG in group B and C were more severe than those in group A,coronary multivessel changes in group B and C were more frequent than in group A,it had no significant difference between group B and C.Conclusion Compared with the patients of normal glucose tolerance, patients with glycometabolic disturbance have higher levels of hs-CRP,their coronary artery lesions are more severe.