Delivery room resuscitation and short-term outcomes of extremely preterm and extremely low birth weight infants: a multicenter survey in North China / 中华医学杂志(英文版)

BACKGROUND@#Delivery room resuscitation assists preterm infants, especially extremely preterm infants (EPI) and extremely low birth weight infants (ELBWI), in breathing support, while it potentially exerts a negative impact on the lungs and outcomes of preterm infants. This study aimed to assess delivery room resuscitation and discharge outcomes of EPI and ELBWI in China.@*METHODS@#The clinical data of EPI (gestational age [GA] <28 weeks) and ELBWI (birth weight [BW] <1000 g), admitted within 72 h of birth in 33 neonatal intensive care units from five provinces and cities in North China between 2017 and 2018, were analyzed. The primary outcomes were delivery room resuscitation and risk factors for delivery room intubation (DRI). The secondary outcomes were survival rates, incidence of bronchopulmonary dysplasia (BPD), and risk factors for BPD.@*RESULTS@#A cohort of 952 preterm infants were enrolled. The incidence of DRI, chest compressions, and administration of epinephrine was 55.9% (532/952), 12.5% (119/952), and 7.0% (67/952), respectively. Multivariate analysis revealed that the risk factors for DRI were GA <28 weeks (odds ratio [OR], 3.147; 95% confidence interval [CI], 2.082-4.755), BW <1000 g (OR, 2.240; 95% CI, 1.606-3.125), and antepartum infection (OR, 1.429; 95% CI, 1.044-1.956). The survival rate was 65.9% (627/952) and was dependent on GA. The rate of BPD was 29.3% (181/627). Multivariate analysis showed that the risk factors for BPD were male (OR, 1.603; 95% CI, 1.061-2.424), DRI (OR, 2.094; 95% CI, 1.328-3.303), respiratory distress syndrome exposed to ≥2 doses of pulmonary surfactants (PS; OR, 2.700; 95% CI, 1.679-4.343), and mechanical ventilation ≥7 days (OR, 4.358; 95% CI, 2.777-6.837). However, a larger BW (OR, 0.998; 95% CI, 0.996-0.999), antenatal steroid (OR, 0.577; 95% CI, 0.379-0.880), and PS use in the delivery room (OR, 0.273; 95% CI, 0.160-0.467) were preventive factors for BPD (all P < 0.05).@*CONCLUSION@#Improving delivery room resuscitation and management of respiratory complications are imperative during early management of the health of EPI and ELBWI.

Protective Effect of Zengye Decoction () on Submandibular Glands in Nonobese Diabetic Mice / 中国结合医学杂志

OBJECTIVE@#To investigate the protective effect of Zengye Decoction (, ZYD) on the submandibular glands (SMGs) in nonobese diabetic (NOD) mice.@*METHODS@#Twenty-seven female NOD mice were randomly equally divided into 3 groups: the model group, the hydroxychloroquine (HCQ) group, and the ZYD group. Nine C57/B6 mice served as the normal group. After 1-week acclimation, the HCQ and ZYD groups were intragastrically administered with HCQ and ZYD, respectively, and the normal and model groups were administered with normal saline. Changes in the salivary flow rate were observed. Mice from all 4 groups were sacrificed at the age of 20 weeks. The serum and SMGs were collected. Serum cytokines gamma-interferon (IFN-γ), interleukin-10 (IL-10) were detected by enzyme-linked immunosorbent assay. Histological changes in the submandibular glands were examined by hematoxylin and eosin staining. The mRNA expression of IFN-γ, IL-10 and vasoactive intestinal peptide (VIP) in the submandibular glands were measured by real-time polymerase chain reaction.@*RESULTS@#Compared with the model group, the salivary flow of the ZYD group significantly increased (P<0.05), the extent of the histological changes was ameliorated (P<0.05), and the Th1/Th2 cytokine imbalance was remedied (P<0.05). In the ZYD-treated mice, the VIP mRNA was up-regulated (P<0.05).@*CONCLUSIONS@#ZYD is beneficial in protecting structure and function of SMGs in NOD mice. The mechanism may be associated with the correction of the Th1/Th2 cytokine imbalance, and with the prevention of a progressive decline of the VIP level.

Study on the Performance Management System under the Model of "Medical Group" in a Tertiary Hospital / 中国卫生经济

It pointed out the shortcomings of current salary system in hospitals,and put forward a "medical group" model performance allocation plan based on the technology position,workload,target management and service quality.The performance of the whole scheme was divided into clinical department and medical department.The business projects of the clinical departments,such as outpatient registration fee,operation fee,were calcultated according to the the doctor's proportion of the project operation rate points and the use of accounting,and evaluated the service qualifies of doctors based on medical record classification;medical departments calculated the projects according to the accounting system of accounting unit.Aiming at implementing the public welfare of public hospitals and stimulated medical staff working enthusiasm,the level of technical content,the degree of risk of size,strength and management responsibilities of work load and other factors were comprehensively considered to construct a set of fair and external competitive performance management system.

Efficacy and safety of low dose MMC to prevent haze in TransPRK with moderate and high myopia / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To investigate the efficacy and safety of low dose mitomycin C (MMC) to prevent haze in trans photorefractive keratectomy (TransPRK) with moderate and high myopia, and to observe the changes of corneal density.METHODS: Sixty-one patients underwent TransPRK with moderate and high myopia.Eyes were divided into research group (0.1g/L MMC for 40s) and control group(0.2g/L MMC for 40s) randomly.There were 21 patients in research group and 40 patients in control group.Cornea epithelial healing time, pain score, visual acuity, manifest refraction, haze and cornea density were analyzed.RESULTS: The epithelial healing time (0.1g/L group: 3.86±1.11d, 0.2g/L group: 4.23±1.27d) and pain score (0.1g/L group: 2.01±0.58, 0.2g/L group: 1.79±0.7) were no significant difference between two groups(P=0.667, P=0.582).It was similar in spherical equivalent at 1mo and 3mo post-operation(0.1g/L group: 0.28±0.25, 0.05±0.23D;0.2g/L group:-0.13±0.17, 0.07±0.22D;P=0.178, P=0.490).The BCVA of control group decreased at 1mo and improved to the same level as pre-operation at 3mo(F=15.847, P<0.001);0.1g/L group showed the same trend, but the changes were no significant difference(F=3.038, P=0.093).There were also no significant difference in Haze between two groups post-operation(z=-0.709, P=0.479;z=-0.478, P=0.633).The change of cornea density was matched with the BCVA (0.1g/L group F=27.399, P=0.001;0.2g/L group F=8.313, P=0.001)and it was similar between two groups.CONCLUSION: The using of low dose MMC to prevent haze in TransPRK with moderate and high myopia is safe and effective.It is therapeutic equivalence to regular dose (0.2g/L).Besides the slit lamp, we can use the corneal density to measure the corneal transparency.

Simultaneous determination of four flavonoids in Wikstroemia indica by HPLC / 中国中药杂志

The HPLC method was established to simultaneously determine the contents of myricetin, luteolin, apigenin and kaempferol in Wikstroemia indica ( L. ) C. A. Mey. The method was carried out on a Diamonsil C18 column (4. 6 mm x 250 mm, 5 µm) eluted with the mobile phases of water containing 0.15% phosphoric acid and acetonitrile in gradient mode. The UV detection wavelength was 365 nm. The flow rate was 1.0 mL · min(-1) and the column temperature was set at 30 °C. All the standard compounds showed a good linearity in the range of 0.100 8-1.008 (r = 0.999 2), 0.484 8-4.848 (r = 0.999 0) , 1. 354-13. 54 (r = 0.999 6), 0.316 8-3.168 mg · L(-1) (r = 0.999 0) for myricetin, luteolin, apigenin and kaempferol, respectively. The average recoveries of these four flavonoids were 98.5%, 100.9%, 99.7% and 98.9% with RSD 1.2%, 1.7%, 0.81% and 1.6%, respectively. In conclusion, the method is simple, rapid and accurate. It can be applied for the quality control of Wikstroemia indica.

Ligustrazine fought against cisplatin induced ototoxicity in guinea pigs / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To study the protective effect of Ligustrazine Injection (LI) against cisplatin-induced ototoxicity and to explore its mechanism.</p><p><b>METHODS</b>Thirty healthy adult guinea pigs were randomly divided into three groups, 10 in each group, i.e., the normal control group, the cisplatin group, and the LI group. Guinea pigs in the normal control group were intraperitoneally injected with normal saline at 3 mL/kg for 7 consecutive days. Those in the cisplatin group were intraperitoneally injected with cisplatin at 3 mg/kg for 7 consecutive days. Those in the LI group were intraperitoneally injected with LI at 140 mg/kg for 7 days, but cisplatin (3 mg/kg) was intraperitoneally injected from the opposite side starting from the 4th day. Brainstem auditory evoked potential (BAEP) was performed in all animals before and after injection. All animals were sacrificed after the final testing under anesthesia and their cochleas collected. Half the cochleas of each group were collected for silver nitrate staining of cochlear basilar membrane stretched. The other half the cochleas of each group made into paraffin sections to observe the apoptosis of cochlea cells by TUNEL method and the expression levels of c-Jun detected by immunohistochemistry.</p><p><b>RESULTS</b>There was no statistical difference in the difference of BAEP threshold among the 3 groups before injection (P > 0.05), but the BAEP threshold increased in the cisplatin group and the LI group (P < 0.05). Besides, it was higher in the cisplatin group (P < 0.05). In the cisplatin group, most hair cells were missing, spiral ganglion cells obviously decreased, more TUNEL positive cells occurred, and the expression of c-Jun was stronger. But the aforesaid impairment in the LI group was obviously lessened (P < 0.05).</p><p><b>CONCLUSIONS</b>LI showed certain antagonist effect on cisplatin-induced ototoxicity. Its mechanism might be associated with scavenging oxygen radicals of the cochlea tissue, improving the microcirculation, and fighting against apoptosis.</p>

Norcantharidin potentialize the chemosensitivity of adriamycin through the NF-κB/IκBα signaling pathway / 中华血液学杂志

<p><b>OBJECTIVE</b>To explore the synergetic effect of norcantharidin (NCTD) and adriamycin (ADR) on the proliferation and apoptosis of multiple myeloma (MM) cells.</p><p><b>METHODS</b>Human MM cell line U266 cells were treated with NCTD alone (10 µmol/L) or in combination with ADR (0.25 µmol/L). MTT and Annexin V/PI staining were used to determine cell viability and apoptosis. The protein expression of nuclear factor-κB P65 (NF-κB P65), phosphorylated NF-κB p65 (p-NF-κB p65), NF-κB P65 inhibitor IκBα, phosphorylated IκBα (p-IκBα), survivin, Bcl-2 and Bax were determined by Western blot. Immunohistochemistry was used to determine the expression of vascular endothelial growth factor (VEGF).</p><p><b>RESULTS</b>(1) NCTD potentiated the cytotoxicity and pro-apoptotic effects induced by ADR. The combination of NCTD and ADR had synergistic anti-proliferation effect. (2) Combination of ADR and NCTD downregulated the expression of nuclear NF-κB P65 and cytoplasm p-IκBα induced by ADR. The expression of nuclear NF-κB P65 and cytoplasm p-IκBα decreased from 2.08 ± 0.29 and 0.39 ± 0.07 to 0.48 ± 0.08 and 0.02 ± 0.01 respectively, while the expression of the cytoplasm NF-κB P65 and IκBα were unchanged in the ADR alone group and the combined group. (3) The expression of survivin and bcl-2 decreased from 0.31 ± 0.05 and 0.23 ± 0.05 to 0.03 ± 0.02 and 0.05 ± 0.02, while the expression of Bax increased from 0.46 ± 0.06 to 0.62 ± 0.08 respectively in ADR alone group and combined group. (4) The positive rate of VEGF in ADR group and combination group were (44.6 ± 4.4)% and (27.0 ± 2.1)% respectively, indicating that NCTD could potentiate the inhibition effect on VEGF induced by ADR.</p><p><b>CONCLUSIONS</b>The results suggest that NCTD can potentialize the chemosensitivity of multiple myeloma cells to ADR through regulating NF-κB/IκBα signaling pathway and NF-κB-regulated gene products including survivin, Bcl-2, Bax and VEGF.</p>

Correlative factors of the hydatidiform mole deterioration and clinical significance of matrix metalloproteinase 9 in gestational trophoblastic disease / 中国医师进修杂志

Objective To discuss the possibility of prognosing the hydatidiform mole deterioration and metastasis by detecting the expression of matrix metalloproteinase 9(MMP-9)in different type of trophoblastic disease,and analyze the correlative factors of the hydatidiform mole deterioration,so as to improve the criterion of hydatidiform mole prognosis.Methods The expression of MMP-9 in 30 cases of normal human(Iess than 12 weeks)cytotrophoblast cells,32 cases of partial hydatidiform mole,93 cases of complete hydatidiform mole,30 cages of invasive mole and 5 cases of choriocarcinoma were detected by immunohistochemical streptavidin-pemxidase.The factors as the age of onset,uterine size,luteinizing cyst,β-human chorionic gonadotropin hCG of 7 cases of the hydatidiform mole deterioration were analyzed.Results The expression of MMP-9 was detected in all types of trophoblastic cells,with the development of the malignant transformation the stainning Was markedly increased in the invasion of the normal human cytotrophoblast cells(X2=23.49,P＜0.05).Conclusion The difference of MMP-9 expressin gestational trophoblasts is helpful to predict the hydatidiform mole deterioration and metastagis,the hydatidiform mole deterioration correlates with the age of onset,β-hCG,uterine size,luteinizing cyst.

Mechanism of donor T cell migration and homing in the pathophysiology of acute graft-versus-host disease - review / 中国实验血液学杂志

Migration of donor T cells to the host second lymphoid organs and homing of activated donor T cells into the target tissues play crucial role in the pathophysiology of acute graft-versus-host disease (aGVHD). More deep understanding of the mechanisms for donor T cell migration and homing reveals an important significance in preventing the initiation of aGVHD. In this review, the migration of donor T cells to host second lymphoid organs, homing of donor activated T cells into the target organs, homing of regulating T cells into target organs, the mechanisms of T cell migration and homing in process of aGVHD and its study prospects were summarised.

Assessment of insular development in small for gestational age infants / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To study the insular development of small for gestational age (SGA) infants.</p><p><b>METHODS</b>The insular area and circle were measured by cerebral ultrasonography in 92 SGA infants. The results were compared with those from 109 appropriate for gestational age (AGA) infants.</p><p><b>RESULTS</b>The insular area and circle were positively correlated with the birth weight and gestational age in SGA infants. The insular area in SGA infants with a gestational age of either >37 weeks (451 +/- 92 mm2 vs 516 +/- 116 mm2; p<0.01) or < or = 34 weeks (248 +/- 78 mm2 vs 314 +/- 80 mm2; p<0.01) was significantly less than that in the AGA infants. The insular circle in SGA infants with a gestational age of >37 weeks was also significantly less than that in the AGA infants (92 +/- 11 mm vs 97 +/- 11 mm; p<0.05).</p><p><b>CONCLUSIONS</b>The insular development of SGA infants seems to be immature. The insular development may be assessed based on the insular area and circle measured by cerebral ultrasonography.</p>

Chronic effects of low-dose hydrochlorothiazide in patients with mild to moderate essential hypertension / 中华心血管病杂志

<p><b>OBJECTIVE</b>To investigate the chronic efficacy of low-dose hydrochlorothiazide (HCTZ) in patients with mild-to-moderate hypertension.</p><p><b>METHODS</b>After a 2-weeks placebo run-in period, 232 patients with mild or moderate hypertension were recruited and received HCTZ (12.5 mg once daily) therapy for one year. Patient compliance and blood pressure were monitored and serum BUN, Cr, glucose, electrolytes, and lipids were measured before, 6 weeks and 1 year after treatment.</p><p><b>RESULTS</b>(1) Reduction of SBP, DBP and MAP were more significantly at 1 year [(10.45 +/- 17.28) mm Hg, (8.45 +/- 11.06) mm Hg, (9.12 +/- 10.88) mm Hg] than that at 6 weeks post therapy [(6.01 +/- 16.05) mm Hg, (2.90 +/- 10.33) mm Hg, (3.94 +/- 10.68) mm Hg, all P < 0.05]. Blood pressure were reduced to normal in 35.1% patients at 1 year and in 20.3% patients at 6 weeks (P < 0.05). (2) No patient developed diabetes mellitus or hypokalemia during therapy while the serum uric acid at 1 year post therapy was significantly higher than that at before therapy (P < 0.05).</p><p><b>CONCLUSION</b>The study indicates that low dose HCTZ is an effective and safe antihypertensive agent for patients with mild-to-moderate hypertension and uric acid changes during therapy need to be monitored.</p>

Effect of acute exposure to microwave from mobile phone on DNA damage and repair of cultured human lens epithelial cells in vitro / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To investigate the DNA damage of human lens epithelial cells (LECs) caused by acute exposure to low-power 217 Hz modulated 1.8 GHz microwave radiation and DNA repair.</p><p><b>METHODS</b>Cultured LECs were exposed to 217 Hz modulated 1.8 GHz microwave radiation at SAR (specific absorption rate) of 0, 1, 2, 3 and 4 W/kg for 2 hours in an sXc-1800 incubator and irradiate system. The DNA single strand breaks were detected with comet assay in sham-irradiated cells and irradiated cells incubated for varying periods: 0, 30, 60, 120 and 240 min after irradiation. Images of comets were digitized and analyzed using an Imagine-pro plus software, and the indexes used in this study were tail length (TL) and tail moment (TM).</p><p><b>RESULTS</b>The difference in DNA-breaks between the exposure and sham exposure groups induced by 1 and 2 W/kg irradiation was not significant at every detect time (P > 0.05). As for the dosage of 3 and 4 W/kg there was difference in both group immediately after irradiation (P < 0.01). At the time of 30 min after irradiation the difference went on at both group (P < 0.01). However, the difference disappeared after one hour's incubation in 3 W/kg group (P > 0.05), and existed in 4 W/kg group.</p><p><b>CONCLUSION</b>No or repairable DNA damage was observed after 2 hour irradiation of 1.8 GHz microwave on LECs when SAR < or = 3 W/kg. The DNA damages caused by 4 W/kg irradiation were irreversible.</p>