An investigation of severe neonatal hyperbilirubinemia in 13 hospitals of Jiangsu Province, China / 中国当代儿科杂志

OBJECTIVE@#To investigate the incidence of severe neonatal hyperbilirubinemia and the management on the treatment and follow-up of this disease in Jiangsu Province, China.@*METHODS@#The neonates with severe hyperbilirubinemia who were admitted to 13 hospitals in Jiangsu Province from January to December, 2018, were enrolled as subjects. A retrospective analysis was performed on their mediacal data and follow-up data.@*RESULTS@#In 2018, 740 neonates with severe hyperbilirubinemia were reported from the 13 hospitals in Jiangsu Province, accounting for 2.70% (740/27 386) of the total number of neonates admitted to the department of neonatology. Among these neonates, 620 (83.8%) had severe hyperbilirubinemia, 106 (14.3%) had extremely severe hyperbilirubinemia, and 14 (1.9%) had hazardous hyperbilirubinemia. Four neonates (0.5%) were diagnosed with acute bilirubin encephalopathy. A total of 484 neonates (65.4%) were readmitted due to severe hyperbilirubinemia after discharge from the delivery institution, with a median age of 7 days, among whom 214 (44.2%) were followed up for jaundice at the outpatient service before readmission, with a median age of 6 days at the first time of outpatient examination. During hospitalization, 211 neonates (28.5%) underwent cranial MRI examinations, among whom 85 (40.3%) had high T1WI signal in the bilateral basal ganglia and the globus pallidus; 238 neonates (32.2%) underwent brainstem auditory evoked potential examinations, among whom 14 (5.9%) passed only at one side and 7 (2.9%) failed at both sides. The 17 neonates with acute bilirubin encephalopathy or hazardous hyperbilirubinemia were followed up. Except one neonate was lost to follow-up, and there were no abnormal neurological symptoms in the other neonates.@*CONCLUSIONS@#Neonates with severe hyperbilirubinemia account for a relatively high proportion of the total number of neonates in the department of neonatology. Jaundice monitoring and management after discharge from delivery institutions need to be strengthened. For neonates with severe hyperbilirubinemia, relevant examinations should be carried out more comprehensively during hospitalization and these neonates should be followed up comprehensively and systematically after discharge.

Clinical efficacy of compound glycyrrhizin tablets in the treatment of children with nonalcoholic fatty liver disease / 中国当代儿科杂志

Department of Pediatrics, First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China. zhuchuanlong@jsph.org.cn.

Targeting c-Myc on cell growth and vascular endothelial growth factor expression in IN500 glioblastoma cells / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The level of c-Myc is closely associated with high pathological grade and the poor prognosis of gliomas. Vascular endothelial growth factor (VEGF) is the most important angiogenic factor that potently stimulates the proliferation and migration of vascular endothelial cells. This study aimed to address the biological importance of c-Myc in the development of gliomas, we downregulated the expression of c-Myc in the human glioblastoma cell line IN500 and studied the in vitro effect on cellular growth, proliferation, and apoptosis and the expression of VEGF and the in vivo effect on tumor formation in a xenograft mouse model.</p><p><b>METHODS</b>IN500Δ cells were stably transfected with shRNA-expressing plasmids for either c-Myc (pCMYC-shRNA) or as a control (pCtrl-shRNA). Following establishment of stable cells, the mRNA expressions of c-Myc and VEGF were examined by reverse transcription (RT)-PCR, and c-Myc and VEGF proteins by Western blotting and immunohistochemistry. Cell-cycle progression and apoptosis were determined by flow cytometry. The in vivo effect of targeting c-Myc was determined by subcutaneous injection of stable cells into immunodeficient nude mice.</p><p><b>RESULTS</b>The stable transfection of pCMYC-shRNA successfully knocked down the steady-state mRNA and protein levels of c-Myc in IN500, which positively correlated with the downregulation of VEGF. Downregulating c-Myc in vitro also led to G1-S arrest and enhanced apoptosis. In vivo, targeting c-Myc reduced xenograft tumor formation and resulted in significantly smaller tumors.</p><p><b>CONCLUSIONS</b>c-Myc has multiple functions in glioblastoma development that include regulating cell-cycle, apoptosis, and VEGF expression. Targeting c-Myc expression may be a promising therapy for malignant glioma.</p>

The regulating role of mutant IkappaBalpha in expression of TIMP-2 and MMP-9 in human glioblastoma multiform / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Our previous studies demonstrated that mutant IkappaBalpha (IkappaBalphaM) inhibited the occurrence, growth and angiogenesis of human glioblastoma multiform (GBM). However, the specific mechanism by which IkappaBalphaM regulates protein-degrading enzymes secreted from GBM to inhibit invasion and metastasis has remained unclear. The aim of the present study was to investigate the regulatory role and significance of IkappaBalphaM genes in the expression of tissue inhibitor of metalloproteinase (TIMP)-2 and matrix metalloproteinase (MMP)-9 in human GBM.</p><p><b>METHODS</b>We established the following four GBM cell lines stably expressing IkappaBalphaM by plasmid construction, gene transfection and screening for IkappaBalphaM protein expression: mutant IkappaBalpha-transfected cells (G36Delta-M), wild-type IkappaBalpha-transfected cells (G36Delta-W), empty plasmid transfected cells (G36Delta-P) and untransfected cells (G36Delta). The TIMP-2 and MMP-9 expression was detected by RT-PCR and Western blotting. Tumor cells were then implanted subcutaneously into nude mice to establish an animal model of ectopic tumor growth, and TIMP-2 and MMP-9 expression was determined by immunohistochemical methods.</p><p><b>RESULTS</b>The results showed that there was a significant increase in TIMP-2 expression and a significant decrease in MMP-9 expression in the G36Delta-M group at both the RNA and protein levels compared with the G36Delta-W group, G36Delta-P group and G36Delta group. Similar results were observed in the immunohistochemical staining analysis of tumor tissues. In the G36Delta-M group, TIMP-2 expression was significantly higher while MMP-9 expression was significantly lower than in the other three groups.</p><p><b>CONCLUSIONS</b>Our findings indicate that IkappaBalphaM inhibits the activation of NF-kappaB. It significantly up-regulates TIMP-2 expression in human malignant glioma cells and down-regulates the expression of MMP-9. Thus, IkappaBalphaM maintains the integrity of the extracellular matrix and further inhibits the growth and metastasis of tumor tissues.</p>

GJB2 gene mutation in deaf patients / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To detect the GJB2 gene mutation in patients with autosomal-recessive deafness, and analyze the relationship between clinical phenotype and gene mutation.</p><p><b>METHODS</b>Forty-two patients were examined clinically by pure tone audiometry, acoustic impedance and auditory brainstem response. The complete coding region of the GJB2 gene was amplified by polymerase chain reaction (PCR) and the PCR products were subjected to automatic DNA sequencing.</p><p><b>RESULTS</b>Two cases had homozygous mutation of 235delC. One of them had sensorineural hearing loss while the other had mixed hearing loss. Heterozygous mutation of 176del16bp was detected in a pair of twins who had mixed hearing loss. The 109G to A, 79G to A and 341A to G mutations were observed in both the patients and the controls.</p><p><b>CONCLUSION</b>Homozygous 235delC mutation is one of the pathogeni c mutations which could occur in patients with mixed hearing loss. The heterozygous 176del16bp mutation combined with environmental factor may cause hearing loss. The 109G to A, 79G to A and 341A to G variants were considered to be polymorphisms of the GJB2 gene.</p>

The relationship between the effect of amlodipine on carotid intimal-medial thickness and angiotensin converting enzyme genotypes in elderly hypertensive patients / 中华心血管病杂志

<p><b>OBJECTIVE</b>To investigate the association between the anti-atherosclerotic effects of amlodipine and angiotensin converting enzyme (ACE) gene insertion/deletion (I/D) polymorphism in elderly essential hypertensive (EH) patients.</p><p><b>METHODS</b>A total of 220 EH patients were treated with amlodipine (2.5 - 10 mg, once daily) for twelve months and complete data were obtained from 208 patients with genotypes of II (n = 90), ID (n = 91) and DD (n = 27). The indices of carotid arterial were compared before and post amlodipine treatment in patients with identical genotype and among different ACE genotypes and each genotype post therapy.</p><p><b>RESULTS</b>The carotid mean intimal-medial thickness (MIMT) was slightly decreased in EH patients with ID and DD genotypes and significantly decreased in EH patients with II genotype (0.96 +/- 0.12 vs. 0.92 +/- 0.13, P < 0.01) compared to pre-treatment values. The decreased degree of MIMT (DeltaMIMT) in II genotype was significantly higher in II genotype than those in ID or DD genotype (0.05 +/- 0.03 vs. 0.01 +/- 0.02, 0.01 +/- 0.03 respectively, P < 0.01). The post treatment plaque score (PS) in patients with II genotype was significantly reduced (4.85 +/- 2.51 vs. 3.90 +/- 2.36, P < 0.05). Multivariate linear regression analysis showed the baseline SBP, the decreased degree of SBP (DeltaSBP) and the II genotype were the major factors affecting the DeltaMIMT.</p><p><b>CONCLUSION</b>Hypertensive patients carrying II genotype ACE genotype are the best responders for the anti-atherosclerotic effects of amlodipine.</p>

Clear cell carcinoma of salivary gland: a clinicopathologic study of 10 cases / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To analyze the clinicopathologic features of clear cell carcinoma of salivary gland.</p><p><b>METHODS</b>All cases of salivary gland tumors enrolled from January 1985 to May 2004 were reviewed, and ten cases of CCC were identified and analyzed by clinicopathology and immunohistochemistry.</p><p><b>RESULTS</b>Seven tumors were from palate, one was from base of tongue, one in retromolar region, and one in floor of mouth. The mean age of five men and five women was 55 years. Microscopically, the tumors were predominantly composed of trabeculae, cords, nests, solid sheets of clear cells and a few eosinophilic cells, and the two kinds of tumor cells were surrounded by hyalinized stroma. Immunohistochemically, EMA and CK8 were positive in all cases, CK18 in five cases, CKHMW in two cases. CK10/13, S-100, SMA and Calponin were negative in all cases. There was no evidence of recurrence of disease or metastasis in eight followed-up patients.</p><p><b>CONCLUSIONS</b>CCC is a distinctive low grade malignant salivary gland neoplasm, arising mainly in the minor salivary glands, and it may originate from intercalated-duct reserve cells.</p>

Long-term results of different treatment modalities in 464 hypopharyngeal squamous-cell carcinoma patients / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To present the treatment results and to identify the most effective therapeutic plan of different therapeutic modalities in patients with squamous-cell carcinoma of hypopharynnx.</p><p><b>METHODS</b>A retrospective review of 464 patients with squamous-cell carcinoma of the hypopharynx treated between 1958 and 1998 was accomplished. The clinical characteristics, results of different treatments were analyzed by SPSS 10.0 statistic software.</p><p><b>RESULTS</b>Of 464 patients, the age ranged from 20 to 88 years (mean 56.3 years) and the male to female ratio was 5.5:1. The primary lesion of 383 were originated from the pyriform sinus, 40 from posterior pharyngeal wall and 41 from the postcricoid area. According to the UICC 1997 TNM staging system, 75% had T3 or T4 lesion or 92.2% stage III or IV on presentation. 65% had neck metastases. 202 patients were treated with preoperative radiation plus surgery (R + S), 22 with surgery plus postoperative radiation (S + R), 26 surgery alone (S), 40 patients with salvage surgery after radiotherapy failure (RF) and 174 patients with radiotherapy alone. The overall 5-year survival rate was 34.2%. The overall 5-year survival rate of R + S group was 46.3%, S + R group was 49.2%, S alone group 22.8%, RF group was 40.8%, radiotherapy alone group 18.0% (P < 0.01). The overall 5-year survival rate of R + S group was higher than that of S alone group (P = 0.046). The rate of larynx preservation in R + S group was 39.6% in contrast to that of S + R and S alone group of 16.7% (P = 0.003).</p><p><b>CONCLUSION</b>The survival rate of patients with squamous-cell carcinoma of the hypopharynx treated with combined therapy (R + S or S + R) is better than the other therapeutic modalities. R + S combined is able to offer an obviously higher rate of larynx preservation (39.6% vs 16.7%).</p>