Progress in the treatment of patent ductus arteriosus in extremely low birth weight infants / 国际儿科学杂志

With the progress of perinatal medicine and the improvement of cure rate in preterm infants, the diagnosis and treatment of patent ductus arteriosus in extremely low birth weight infants is a great challenge for neonatal medicine.Continuous left-to-right shunt through catheters can lead to systemic hypotension, pulmonary perfusion, increased left ventricular volume load, prolonged mechanical ventilation, and increased risk of complications and death such as pulmonary hemorrhage, bronchopulmonary dysplasia, necrotizing enterocolitis, and intraventricular hemorrhage.Conservative treatment is still the first choice and drug treatment is not completely effective, while the long-term impact of both on newborns is still unclear, which need a reasonable assessment of the pros and cons.Surgical ligation can improve cardio-pulmonary function, but the indication and time of the arterial catheter are also controversial for its self-closing, thus more evidence-based studies are needed.We review the current management status and controversy of patent ductus arteriosus in extremely low birth weight infants to explore the scientific and effective clinical measures.

Clinicopathological analysis of malignant pleural effusion cell masses from 105 cases / 中国基层医药

Objective:To analyze the pathological types, tissue sources and clinical features of malignant pleural effusion.Methods:Cell masses were collected from 105 cases of malignant pleural effusion diagnosed by immunohistochemical examination after liquid-based cytology between May 2017 and October 2019 in Qidong People's Hospital, China. The pathological, morphological, immunohistochemical and clinical characteristics of the cell masses were analyzed.Results:Immunohistochemistry results showed that pleural effusion malignant cells were from lung adenocarcinoma tissue in 94 (89.52%) cases because they were positive for thyroid transcription factor-1, Napsin A and carcinoembryonic antigen, from small cell lung cancer tissue in one (0.95%) case because they were positive for neural cell adhesion molecule 1 and synaptophysin,from lung squamous cell carcinoma tissue in 2 (1.90%) cases because they were positive for cytokeratin 5/6 and P40, from ovarian adenocarcinoma tissue in 1 (0.95%) case because they were positive for CA125, from breast adenocarcinoma tissue in 4 (3.81%) cases because they were positive for estrogen receptor, progesterone receptor and gross cystic disease fluid protein 15, from the gastrointestinal tract adenocarcinoma tissue in 2 (1.90%) case because they were positive for caudal-type homeobox 2, and from the pancreatic adenocarcinoma tissue in 1 (0.95%) case because they were positive for cancer antigen 19-9 (CA199).Conclusion:Lung adenocarcinoma is the most common cause of malignant pleural effusion. Lung adenocarcinoma cells are positive for thyroid transcription factor-1, Napsin A and carcinoembryonic antigen. The combined use of the three markers can help the diagnosis of lung adenocarcinoma. In addition, lung adenocarcinoma should be differentiated from other types of lung cancer and the tumors from other regions.

Antisense transcription regulates the expression of sense gene via alternative polyadenylation

Natural antisense transcripts (NAT) and alternative polyadenylation (APA) of messenger RNA (mRNA) are important contributors of transcriptome complexity, each playing a critical role in multiple biological processes. However, whether they have crosstalk and function collaboratively is unclear. We discovered that APA enriched in human sense-antisense (S-AS) gene pairs, and finally focused on RNASEH2C-KAT5 S-AS pair for further study. In cis but not in trans over-expression of the antisense KAT5 gene promoted the usage of distal polyA (pA) site in sense gene RNASEH2C, which generated longer 3' untranslated region (3'UTR) and produced less protein, accompanying with slowed cell growth. Mechanistically, elevated Pol II occupancy coupled with SRSF3 could explain the higher usage of distal pA site. Finally, NAT-mediated downregulation of sense gene's protein level in RNASEH2C-KAT5 pair was specific for human rather than mouse, which lacks the distal pA site of RNASEH2C. We provided the first evidence to support that certain gene affected phenotype may not by the protein of its own, but by affecting the expression of its overlapped gene through APA, implying an unexpected view for understanding the link between genotype and phenotype.

Pharmacokinetics and drug concentration monitoring of high-dose tigecycline in patients with septic shock / 中国药科大学学报

This article established a method for the detection of tigecycline in patients with septic shock.The column was Ultimate AQ-C1s(3.0 mm × 100 mm,3 μm).The mobile phase was water (0.2％ Formic acid,5 mmol/L ammonium acetate)-acetonitrile,gradient elution,the ion transitions were performed under ESI positive model at m/z 586.4→513.3 (tigecycline),m/z 338.2→296.0 (linezolid).Calibration curves of tigecycline showed good linear regression in the range of (50.15-2 006) ng/mL.The intra-day and inter-day RSD were below 15％.Plasma sample kept good stability.The cmax and AUC0-12 h of tigecycline in septic shock patients were (1.97 ±0.87) μg/mL and (9.10 ±3.58) mg.h/L.The results showed that after giving high doses tigecycline to patients with septic shock caused by multidrug-resistant strains,the AUC was not significantly higher in severe nosocomial pneumonia patients with conventional doses,and lower than the AUC of sepsis patients at the same dose,did not achieve the desired bactericidal effect.Maybe with the high hemodynamics in septic shock patients increased tigecycline glomerular filtration,and systemic infection leads to increased capillary permeability combined with interstitial edema,so that the distribution of the drug volume increases.In combination with the above,it is recommended that the recommended dose range for tigecycline in patients with septic shock caused by multidrug-resistant strains should be between 150 and 200 mg,and the concentration of tigecycline in the critically ill patients should be monitored and patients in different stages of the disease in a timely manner to adjust the dose.