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Objective:To study the clinical characteristics of neonatal onset of diabetes mellitus.Methods:Neonatal onset diabetes mellitus infants admitted to Children's Hospital of Fudan University from January 2003 to December 2020 were selected for retrospective analysis. All clinical characteristics including the basic conditions, family history, clinical manifestations, laboratory examination, diagnosis and treatment were recorded and analyzed.Results:There were 21 cases of diabetes mellitus diagnosed during neonatal period, including 13 males and 8 females. There were 16 term infants and 5 premature infants with gestational age between 34 weeks and 40 weeks. The birth weight ranged from 1 420 g to 3 450 g, including 14 low birth weight infants, 2 very low birth weight infants and 13 small for gestational age infants. Four infants had family history of diabetes. All diabetic infants with onset time within 28 days after birth included 10 cases within 10 days, 4 cases between 11 days and 20 days, 7 cases between 21 days and 28 days. Hyperglycemia was the main feature of 21 infants, and their blood glucose was ≥11.1 mmol/L for many times, with a maximum of 41.98 mmol/L. Only 2 cases had ketoacidosis and 8 cases were complicated with infections. Genetic testing was performed in 6 neonates,2 cases of ABCC8 gene pathogenic variant, 1 case of KCNJ11 and 1 case of INS pathogenic variant, and 2 cases of negative results. Insulin was mainly used in the initial stage of treatment, and then orally glibenclamide was taken in 9 infants. After treatment, 15 patients had stable blood glucose and were discharged with medication. 5 infants were withdrawn the treatment and discharged, and 1 infant combined with other serious illness died after giving up the treatment by the parents.Conclusions:When diabetes is diagnosed during the neonatal period, it is helpful to choose the appropriate treatment and get good results.
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Objective To investingate the effect of SGK1 expression level on the prognosis of patients with NSCLC,and provide new biological predictors for the prognosis assessment of patients with NSCLS.Methods One hundred and twenty patients with NSCLC received radical resection in Hanzhong 3201 hospital from Jan 2011 to Dec 2013 were selected.There were 75 males and 45 females,age (63.15 ± 16.44) years,age range 45-80 years.According to the results of immunohistochemical staining,the SGK1 cut-off value determined by the integral was determined,and NSCLC patients were divided into SGK1 high expression group (n =70) and SGK1 low expression group(n =50).The relationship between the expression of SGK1 and clinicopathological features (age,sex,smoking history,alcoholism history,BMI,tissue type,tumor diameter,T stage,N stage,TNM stage,differentiation degree) in NSCLC were analyzed,and the overall survival rate in NSCLC were also analyzed.Followup was carried out by telephone or patient admission.The follow-up period was up to June 1,2018.Chest X-ray and ultrasonography were reviewed every 3 to 6 months after operation,and enhanced CT or MRI were performed if the results were abnormal.The measurement data conforming to normal distribution were expressed by t test and showed by (Mean ± SD);the counting data were tested by x2 test;the 5-year overall survival rate was used as the endpoint event for univariate analysis,and the significant variables for univariate analysis were analyzed by COX risk ratio model for multivariate analysis.The cumulative survival curve was drawn by Kaplan-Meier method,and the difference was tested by Log-rank method.Results The expression level of SGK1 in tissues was not related to age,sex,smoking history,alcoholism,BMI,tissue type and tumor diameter (P ＞ 0.05),but it was related to T stage,N stage,TNM stage and differentiation degree (P ＜ 0.05).The univariate and multivariate COX risk ratio model showed that TNM stage and SGK1 expression were independent factors affecting the 5-year overall survival rate of NSCLC patients (P ＜ 0.05).The results of Kaplan-Meier survival curve showed that the 5-year overall survival rate in NSCLC with low expression of SGK1 was significantly higher than that in NSCLC with high expression of SGK1 (P ＜ 0.05).Conclusions The expression of SGK1 in tissues is closely related to the prognosis of patients with NSCLC.The high expression of SGK1 in tissues is not conducive to the prognosis of patients with NSCLC.
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Objective To investigate the prognostic value of serum P-cadherin( P-cad)level in patients with non-small cell lung cancer(NSCLC). Methods A total of 80 patients with NSCLC in Hanzhong 3201 Hospital of Shaanxi Province from January 2012 to December 2013 were selected as study subjects. The relationships between serum P-cad level and clinicopathological characteristics were analyzed. The Cox regres-sion analysis was used to analyze the risk factors affecting prognosis of NSCLC patients. The survival curve was drawn by Kaplan-Meier method and the difference test was carried out by log-rank method. Results There were significant differences in lymph node metastasis(χ2 = 14. 31,P < 0. 001),vascular invasion(χ2 = 5. 56, P = 0. 018)among NSCLC patients with different levels of serum P-cad. Multivariate Cox regression analysis showed that lymph node metastasis(HR = 0. 856,95％ CI:0. 702-0. 955,P = 0. 012),TNM stage(ⅢA HR =1. 315,95％ CI:1. 058-1. 991,P = 0. 024;ⅢB HR = 1. 448,95％ CI:1. 124-2. 215,P = 0. 011;Ⅳ HR =1. 569,95％ CI:1. 182-2. 441,P < 0. 001)and high level of serum P-cad(HR = 1. 815,95％ CI:1. 224-3. 562,P < 0. 001)were risk factors for progression-free survival in NSCLC patients,and lymph node metasta-sis(HR = 0. 755,95％ CI:0. 652-0. 915,P = 0. 022),poor differentiation(HR = 1. 622,95％ CI:1. 112-2. 015,P < 0. 001),TNM stage(ⅢA HR = 1. 335,95％ CI:1. 064-2. 014,P = 0. 011;ⅢB HR = 1. 489, 95％ CI:1. 129-2. 297,P < 0. 001;Ⅳ HR = 1. 622,95％ CI:1. 192-2. 501,P < 0. 001)and high level of serum P-cad(HR = 1. 677,95％ CI:1. 193-2. 668,P < 0. 001)were risk factors for overall survival of NSCLC patients. The results of Kaplan-Meier survival curve showed that the overall survival and progression-free survival of patients with high level of serum P-cad were shorter than those of patients with low level of serum P-cad(χ2 = 5. 18,P = 0. 015;χ2 = 5. 48,P = 0. 011). Conclusion High level of serum P-cad is closely related to poor prognosis in NSCLC patients.
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Objective To summarize and analyze the adverse reactions caused by cancer chemo-therapy drugs in clinical practice and the specific influencing factors,so as to make more scientific and ef-fective chemotherapy for the treatment of cancer patients.Methods 80 cases of cancer patients treated in our hospital from December to October 2013 in were selected as the research objects.Results Adverse effects of cancer chemotherapy drugs emerged strictly speaking is inevitable,the patient should be the high-est incidence of bad hair in the digestive system,boil down to:nausea,loss of appetite,alopecia and diar-rhea.Conclusions Fully grasp the application of chemotherapeutic drugs adverse reaction and its influen-cing factors,and for making treatment scheme,for improving the treatment effect has important clinical sig-nificance.
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BACKGROUND:Glial scar and cavity formation fol owing spinal cord injury inhibits axonal entrance, so limited axonal regeneration, less secretion of neurotrophic factor and inhibitors in the microenvironment of axonal growth are considered as major impediments for impacting functional recovery of patients with spinal cord injury. OBJECTIVE:To analyze literatures home and abroad related to the biological characters of astrocytes and glial scar hyperplasia after spinal cord injury, and to provide a theoretical basis for the mechanism underlying glial scar formation fol owing spinal cord injury. METHODS:PubMed and Wanfang databases were retrieved using the keywords“astrocytes, reactive astrogliosis, glial scar, spinal cord injury”in English and Chinese, respectively. Final y 62 literatures were selected for overview. RESULTS AND CONCLUSION:Currently, studies concerning the biological characters of astrocytes, reactive astrogliosis and glial scar formation fol owing spinal cord injury have achieved some progresses. Studies mainly focus on the sole impediment for spinal cord injury, and treatment also aims at inhibiting single factor, but interactions among factors have not been confimed. In addition, the regulatary mechanisms of specific intracel ular and extracel ular signal molecule in the astrocytes, and effective control and interference of glial scar formation fol owing spinal cord injury stil need in-depth study.
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Although the treatment has made great progress in breast cancer, there are still many problems. For example, primary or secondary on chemotherapy drug resistance and the limitation of treatment in triple-negative breast cancer. So, targeted therapy has become a new strategy to improve this situation. Previous studies showed that the occurrence of breast cancer may be related to the activation of PI3K/Akt/mTOR signaling pathways, and mTOR is an index to judge the prognosis. Parts of breast cancers can obtain clinical benefit with mTOR inhibitors, and it might be a potential treatment target in breast cancer.
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<p><b>OBJECTIVE</b>Since 1986, the reference of birth weight for gestational age has not been updated. The aim of this study was to set up Chinese neonatal network to investigate the current situation of birth weight in China, especially preterm birth weight, to develop the new reference for birth weight for gestational age and birth weight curve.</p><p><b>METHOD</b>A nationwide neonatology network was established in China. This survey was carried out in 63 hospitals of 23 provinces, municipalities and autonomous regions. We continuously collected the information of live births in participating hospitals during the study period of 2011-2014. Data describing birth weight and gestational age were collected prospectively. Newborn's birth weight was measured by electronic scale within 2 hours after birth when baby was undressed. The evaluation of gestational age was based on the combination of mother's last menstrual period, ultrasound in first trimester and gestational age estimation by gestational age scoring system.</p><p><b>STATISTICAL ANALYSIS</b>the growth curve was drawn by using LMSP method, which was conducted in GAMLSS 1.9-4 software package in R software 2.11.1.</p><p><b>RESULT</b>A total of 159 334 newborn infants were enrolled in this study. There were 84 447 male and 74 907 female. The mean birth weight was (3 232 ± 555) g, the mean birth weight of male newborn was (3 271 ± 576) g, the mean weight of female newborn was (3 188 ± 528) g. The test of the variables' distribution suggested that the distribution of gestational age and birth weight did not fit the normal distribution, the optimal distribution for them was BCT distribution. The Q-Q plot test and worm plot test suggested that this curve fitted the distribution optimally. The male and female neonatal birth weight curve was developed using the same method.</p><p><b>CONCLUSION</b>Using GAMLSS method to establish nationwide neonatal birth weight curve, and the first time to update the birth weight reference in recent 28 years.</p>
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Female , Humans , Infant, Newborn , Male , Birth Weight , China , Gestational Age , Infant, Low Birth WeightABSTRACT
BACKGROUND:Total knee replacement is regarded an effective treatment of knee osteoarthritis, based on the transformation of biology-psychology-social medicine pattern, the concept of“quality of life”has attracted increasing concerns. OBJECTIVE:To observe the effects of total knee replacement surgery on the pain, function and quality of life among elder patients with severe knee osteoarthritis. METHODA total of 102 elder patients with severe knee osteoarthritis were recruited from the Second Affiliated Hospital of Inner Mongolia Medical University between January 2010 and January 2013. The clinical manifestations and 12-month fol ow-up outcomes were observed and recorded. The involved patients were randomly divided into two grouptreatment group (59 cases, receiving total knee replacement) and control group (43 cases, receiving expectant treatment such as drugs, but no surgery). Patients were evaluated using HSS scale and WHOQOL-100 scale before surgery and 12 months after surgery. Furthermore, the correlation between influencing factors and HSS and WHOQOL-100 scores was analyzed. RESULTS AND CONCLUSION:At 12 months postoperatively, the HSS scores of patients in treatment group was (82.03±10.17) points, which was obviously higher than that in control group (P0.50). The regression analysis shows that marital status (β=1.988), complication (β=2.035) and HSS scores (β=2.108) are the main influencing factors for the quality of life among patients undergoing replacement. Experimental findings indicate that, HSS score is an effective indicator to assess the effect of total knee replacement on the pain and function of elder patients with severe knee osteoarthritis. WHOQOL-100 is introduced to further improve the assessment of quality of life after total knee replacement surgery in severe knee osteoarthritis. The marital status, complication and HSS scores are the key influencing factors for the quality of life among severe knee osteoarthritis patients. Deep vein thrombosis affects the out-of-bed time, and the mate-accompanying during the fol ow-ups plays a positive role on the quality of life and mental state of patients.
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Retinopathy of prematurity (ROP) remains a major cause of childhood blindness and visual impairment.ROP is a multifactorial disease which is associated with prematurity,low birth weight and oxygen treatment.Evidence for a genetic basis for susceptibility to ROP is examined which may help to find a new way to prevent or treatment of ROP in the future.