Effects of sustained lung inflation combined with pulmonary surfactant on neonatal respiratory distress syndrome: a prospective randomized controlled trial / 中华围产医学杂志

Objective@#To investigate the efficacy and adverse effects of sustained lung inflation (SLI) combined with pulmonary surfactant (PS) in the treatment of neonatal respiratory distress syndrome (NRDS).@*Methods@#This prospective randomized controlled trial included 124 premature infants (gestational age <34 weeks and birth weight <2 000 g) diagnosed with NRDS and in need of PS treatment in Shenzhen Maternity & Child Healthcare Hospital affiliated to Southern Medical University from July 1, 2016 to October 31, 2018. They were randomly divided into experimental or control group, with 62 cases in each. Infants in the experimental group were treated with SLI using T-piece and intratracheal PS, while those in the control group were given PS only. Blood gas analysis and measurement of fraction of inspiration O2 (FiO2) and ratio of partial pressure of oxygen (PO2) over FiO2 were performed before and 1 h after PS injection. Results of the treatments and incidence of complications were compared. Paired samples t-test, two independent samples t-test, rank-sum test and Chi-square test were used for statistical analysis.@*Results@#There were 56 participants in the experimental group and 54 in the control group who were eventually analyzed. In the experimental group, the pH value, partial pressure of carbon dioxide (PCO2), FiO2 and PO2/FiO2 at 1 h after PS injection were all improved compared with those before treatment [pH value: 7.26±0.09 vs 7.19±0.09, t=3.814; PCO2: (51.5±12.6) vs (59.8±16.3) mmHg (1 mmHg=0.133 kPa), t=2.610; FiO2: 26.0 (21.0-31.5)% vs 40.5 (38.5-51.5)%, U=392.000; PO2/FiO2: (284.6±117.9) vs (173.4±59.7) mmHg, t=6.427; all P<0.05]. The overall decrement of FiO2 after PS injection in the experimental group was more significant than that in the control group [-10.0 (-15.0 to -5.0)% vs -5.0 (-8.0 to 0.0)%, U=706.500, P<0.001]. The experimental group had a higher rate of extubation within 24 h than the control group [80% (45/56) vs 71% (32/54), χ2=5.830, P=0.016]. However, no significant differences were shown in total mechanical ventilation time, non-invasive/high-flow nasal cannula ventilation time, the ratio of re-intubation within 72 h, or the incidence of air leak, bronchopulmonary dysplasia, periventricular-intraventricular hemorrhage, necrotizing enterocolitis or patent ductus arteriosus between the two groups (all P>0.05).@*Conclusions@#SLI combined with PS for NRDS babies can increase the rate of extubation within 24 h and promote the down-regulation of FiO2 without causing significant complications.

Clinical study of early inhalation of Budesonide in the prevention of bronchopulmonary dysplasia in very low birth weight infants / 中华实用儿科临床杂志

Objective To investigate the preventive and adverse effects of postnatal inhalation of Budesonide in early stage on bronchopulmonary dysplasia (BPD) in very low birth weight infants.Methods A total of 105 cases of high risk premature infants with BPD,who were born in the Neonatal Intensive Care Unit (NICU) from Shenzhen Maternity and Child Healthcare Hospital from July 15,2015 to December 25,2016,and their gestational age ≥ 27 weeks and ＜ 32 weeks or birth weight ≥ 1 000 g and ＜ 1 500 g were collected for a prospective randomized controlled trial,and were randomly divided into 3 groups:early inhalation group(34 cases),late inhalation group(34 cases) and non-inhalation group(37 cases).The oxygen time,and the incidence of BPD,periventricular-intraventricular hemorrhage (IVH),retinopathy of prematurity (ROP),necrotizing enterocolitis of the newborns (NEC),patent ductus arteriosus in preterm infants (PDA),sepsis and hyperglycemia of infants in 3 groups were compared.Results The average oxygen time in early inhalation group was 9 days,while in late inhalation group and the non-inhalation group was 15 days and 18 days,respectively.The average oxygen time in early inhalation group was significantly lower than that in the late inhalation group and the non-inhalation group,with the difference being statistically significant (H =6.09,P ＜ 0.05).The noninvasive ventilation time in early inhalation group was 3 days,while both the late inhalation group and non-inhalation group were 6 days.The noninvasive ventilation time in early inhalation group was significantly lower than that in the late inhalation group and non-inhalation group,with the difference being statistically significant (H =6.17,P ＜0.05).The incidence of BPD in the early inhalation group,late inhalation group and non-inhalation group were 14.7％ (5/34 cases),20.6％ (7/34 cases) and 37.8％ (14/37 cases),respectively.The incidence of BPD in non-inhalation group was significantly higher than that in the early inhalation group and late inhalation group,with the difference being statistically significant (x2 =12.017,P ＜ 0.05).There were no significant differences in IVH,ROP,NEC,PDA,sepsis and hyperglycemia among the 3 groups (all P ＞ 0.05).Conclusions Postnatal inhalation of Budesonide in early stage in high risk very low birth weight infants can reduce the incidence of BPD and the oxygen time,and the adverse reactions are not obvious.

Significance of monitoring non-invasive cardiac output parameters on the treatment of premature infants with patent ductus arteriosus / 中国新生儿科杂志

Objective To evaluate the value of monitoring non-invasive cardiac output parameters in medical treatment of patent ductus arteriosus (PDA) in premature infants.Method Premature infants with PDA diagnosed three days after birth (gestational age:28 ～ 31 weeks or birth weight of 1 000 ～ 1 799 g) admitted to the neonatal intensive care unit (NICU) of our Hospital from February 2016 to August 2016 were enrolled in the study.These premature infants were assigned into treated PDA group (the treatment group) and untreated PDA group (the observation group) based on results of non-invasive cardiac output parameters CI and MD,with aorta CI ≥2.95 L/(min · m2),MD ≥21.50 m/min and pulmonary artery CI ≥4.55 L/(min · m2),MD ≥26.50 m/min as cut-off values.Statistical analysis was carried out using t test,x2 test.The closure rate of arterial duct of two groups and changes in non-invasive cardiac output parameters before and after the closure of arterial duct in the treatment group were compared.Result The overall closure rate of arterial duct was 85.1％ (57/67).The closure rate of arterial duct of the treatment group was 70.8％ (17/24),that of the observation group was 93.0％ (40/43),and the difference had statistical significance (P ＜ 0.05);Comparing the following parameters before and after ductal closure in the treatment group,the difference of pulmonary artery flow time (FT),aorta stroke volume index (SVI) and the integral of the flow profile (Vti) had statistical significance (P ＜ 0.05) [(217.6±19.3) ms vs.(235.8 ±21.4) ms,(22.4±6.0)ml/m2 vs.(25.2 ±7.7)ml/m2,(15.1 ± 4.1) cm vs.(17.2 ±5.3) cm].In the treatment group,after arterial duct was closed,aorta and pulmonary artery CI,MD decreased to some degree,but the difference had no statistical significance (P ＞ 0.05).Conclusion Non-invasive cardiac output parameters including aorta and pulmonary artery CI,MD have certain guiding significance for PDA drug treatment among premature infants;after PDA drug treatment,arterial duct closure condition cannot be judged simply by the changes of aorta and pulmonary artery CI,MD,ultrasonic cardiogram examination results should also be considered.

Outcomes of resuscitation and perinatal risk factors of 39 dying full-term neonates suffered from severe asphyxia / 中华围产医学杂志

Objective To investigate the prenatal or intrapartum risk factors,resuscitation and its outcomes among full term but dying newborns after severe asphyxia (Apgar score was 0～1 at 1 min after birth).Methods Totally,39 dying full-term newborns,who were admitted to the neonatal intensive care unit of Shenzhen Maternity&Child Healthcare Hospital,Southern Medical University from January,2003 to June,2014 were analyzed retrospectively.Information on perinatal influencing factors and outcomes of resuscitation were collected and analyzed with Chi-square test.Results All of the babies were divided into died (n=7,18％,one refused to further treatment) and survived group [n=32,among which 15 suffered from hypoxic-ischemic encephalopathy(HIE) (seven mild,seven moderate and one severe case)].Fetal heart beat was undetectable in more babies in the died group than in the survived group [2/7 vs 0％(0/32),x2=4.695,P=0.028].There were 19 infants with Apgar score ≤ 5 at 5 min,and seven of them died (7/19).The other 12 survived with HIE occurred in eight cases (four mild,three moderate and one severe case) and the rest four babies did not report any neurological complications.Among the ten infants with Apgar score ≤ 5 at 10 min,seven died or refused to treatment and the other three survived with moderate HIE.Conclusions Most of the dying term babies may have promising outcomes after effective resuscitation,especially for those with Apgar score over 5 at 5 min.However,for those dying term babies with Apgar score remains ≤ 5 at 5 min,management after resuscitation should be strengthened to reduce the occurrence of any sequelae or complications.

Research progress on pharmacotherapy of calcific aortic valve disease / 浙江大学学报·医学版

With the population aging and declining incidence of rheumatic heart disease, calcific aortic valve disease (CAVD) has become the most frequent valve disease and the common cause of aortic valve replacement. Patients with CAVD need to cope with a deteriorating quality of life and valve replacement is the only effective clinical option for the patients. Therefore, early pharmacotherapy is of great significance in prevention or slow-down of the progression of CAVD. For years CAVD was considered to be a passive wear and tear process of valves, but now it is recognized as an active and multi-factorial process. Histopathologic studies have revealed that inflammation, disorder of calcium and phosphorus metabolism and dyslipidemia are involved in the process of CAVD. Clinical trials of CAVD pharmacotherapy have been carried out based on those histopathologic studies. Statin, renin-angiotensin inhibitors and anti-osteoporosis drug are well studied in recent years. This article reviews the recent research progress of the pharmacotherapy for CAVD.

Clinical observation of stellate ganglion block combined buflomedil in vertebral artery type of cervical syndrome / 重庆医学

Objective To explore clinical effect of the stellate ganglion block combined buflomedil in the treatment of vertebral artery type of cervical syndrome (CSA).Methods One hundred and twenty cases of CSA were included in the study,and randomly divided into two groups.Study group (60 cases)patients were treated by stellate ganglion block therapy combined with buflomedil intravenous;the controlled group (60 cases)was treated with buflomedil intravenous therapy only.In the treatment,vertebral-basi-lar artery mean flow velocity (Vm)was measured before and after treatment and comparison of Vm difference was the clinical ba-sis.According to the CSA standard of clinical cure,the clinical curative effect was observed.Results After treatment,the total ef-fective rate of study group was 95.00%,total effective rate of control group was 71.67%,the difference statistically significant (χ2 =24.474,P <0.05).vertebral artery blood flow velocity of the two groups after treatment increased more obvious than that of before treatment,the difference was statistically significant (P <0.05),vertebral artery blood flow velocity after treatment of study group (38.44±2.20)cm/s was significantly higher than that of the control group (34.36±3.50)cm/s,the difference was statisti-cally significant (t=7.645,P <0.05).basilar artery blood flow velocity of the two groups after treatment increased more obvious than that of before treatment,the difference was statistically significant (P <0.05),basilar artery blood flow velocity after treat-ment of study group(56.34±4.10)cm/s was significantly higher than that of the control group (47.69±3.90)cm/s,the differ-ence was statistically significant (t= 11.841,P <0.05).Conclusion The clinical efficacy of stellate ganglion block combined bu-flomedil in treatment of vertebral artery type of cervical syndrome is obvious.The cure rate with respect to the drug treatment has significant advantages and the therapy is worthy of further promotion.

Association between haptoglobin polymorphism and acute coronary syndrome in Chinese / 中华急诊医学杂志

Objective To assess the association of Haptoglobin(Hp) polymorphism with acute coronary syndrome(ACS) in Chinese. Method A total of 112 patients with ACS including 57 patients with acute myocardial infarction and 55 patients with unstable angina pectoris confirmed with angiography and 121healthy controls were recruited in this study. Polymerase chain reaction (PCR) method was utilized to genotype Hpl and Hp2 alleles and genotype frequencies in cases and controls were compared. All polymorphisms were test of Hardy-Weinberg equilibrium in both groups separately. The differences of genotypes and alleles between two groups were analyzed with x2 test. The association between Hp polymorphism and the risk of ACS was estimated by odds ratio (OR) and their 95% confidence intervals (95% CI), and the comprehensive evaluation of the factors associated with ACS were determined by using multivariate logistic regression analysis. P ＜0.05 was considered to be statistically significant. Results The frequency of Hp2-2 genotype was significantly higher in ACSs than in controls (0. 571 vs. 0. 355, P = 0. 001; OR = 2. 419, 95% CI:1. 427 ～4. 100), multivariate Logistic regression analysis indicates that Hp2-2 genotype is an independent risk factor to ACS (P = 0.002; OR = 2.557,95% CI: 1. 392 - 4.637). Similarly, the Hp2 allele frequency in ACS groups was significantly higher than that in the control subjects (0. 759 vs. 0. 616, P =0.001; OR = 1. 965,95% CI 1. 316 ～2. 934). Conclusion The Hp2-2 genotype is associated with ACS in Chinese. Hp2-2 genotype may be an independent risk factor to ACS, and Hp2 allele may be a genetic susceptibility factor to ACS in Chinese.

Polymorphisms in the coagulation factor VII gene and the risk of myocardial infarction in patients undergoing coronary angiography / 中华医学杂志(英文版)

<p><b>OBJECTIVE</b>To investigate whether coagulation factor VII (FVII) polymorphisms play a role in the pathogenesis of coronary artery disease (CAD) and/or myocardial infarction (MI) in a series of Hans.</p><p><b>METHODS</b>The Arg(353)Gln and HVR4 polymorphisms of FVII gene were determined in 374 patients undergoing selective coronary angiography by PCR and restriction fragment length polymorphism assay.</p><p><b>RESULTS</b>The FVII genotype distribution was in accordance with Hardy-Weinberg equilibrium. The frequencies of FVII genotypes or alleles did not show significant differences between the CAD group and the controls or between the males and the females. The frequencies of carriers of the Gln(353) allele and (Arg/Gln + Gln/Gln) genotypes were significantly higher in the CAD patients without MI than in those with MI (P = 0.031, odds ratio 0.37, 95% CI: 0.15 - 0.94). However, HVR4 polymorphisms were not significantly different between the two groups (P > 0.05).</p><p><b>CONCLUSION</b>Carrying the F VII Gln(353) gene may be a protective factor against MI in the Chinese Hans.</p>

The G894T mutation of the endothelial nitric oxide synthase gene is associated with coronary atherosclerotic heart disease in Chinese / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To investigate the association of the endothelial nitric oxide synthase (eNOS) gene polymorphism with coronary atherosclerotic heart disease (CHD) in Chinese Han nationality.</p><p><b>METHODS</b>For 106 patients with CHD and 108 unrelated health individuals, the G894T mutation at exon 7 of the endothelial nitric oxide synthase gene was studied by using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) analysis.</p><p><b>RESULTS</b>(1) Among the normal subjects of Chinese Han nationality, the frequencies of the eNOS/GG, GT and TT genotypes were 0.9095, 0.0883 and 0.0021, respectively. The G and T allele frequencies were 0.9537 and 0.0463. (2) The authors assumed the effects of the T allele to be dominant (GT and TT combined vs GG). The GT+TT genotype frequencies in CHD and myocardial infarction (MI) subgroup were 0.2219 and 0.2387, respectively. The frequencies of eNOS/GT+TT genotypes in CHD patients, as well as MI subgroup were significantly higher than that of the normal subjects (P<0.05), respectively. The frequencies of T allele in CHD, MI subgroup were significantly higher than that in the normal subjects (P<0.01), respectively. (3) This mutation was not related to the number of affected vessels in the 58 patients who had angiographically documented artery narrowing (P>0.05).</p><p><b>CONCLUSION</b>The G894T mutation of the endothelial nitric oxide synthase gene may be a marker for genetical predisposition of CHD in Chinese Han population.</p>

Differential proteomic analysis of liver in apoE/LDLR double-gene mutant mice / 中国病理生理杂志

5 fold) were noted.Six significant differential proteins in gel were identified by LTQ-ESI,e.g.endoplasmin precursor,acidic leucin-rich nuclear phosphoprotein 32 family member A,serotransferrin precursor,stress-70 protein precursor,fibronectin precursor,complement C3 precursor,fibrinogen gamma polypeptide.CONCLUSION: The protein profile of apoE-/-/LDLR-/-mouse liver exhibits significant difference compared to that of WT mice.The results imply that lipid metabolism relative polygenetic mutation contributes to the alteration of mouse liver protein expression profile,especially that lipid metabolism related perhaps participates in dysfunction in lipid metabolism during atherogenesis.

Effects of high fat/high cholesterol diet on differentially expressed gene of the liver in treble genes mutant mice / 中国病理生理杂志

AIM: To study the effects of dietary factor on liver gene expression profile in apoE~(-/-)/LDLR~(-/-)/Lepr~(db/db) mice and atherogenesis. METHODS: The gene expression profile was determined by using cDNA microarray. Total plasma TC and TG level were measured with COD-PAP and GPO-PAP methods respectively. The morphological characters of the aorta were also observed. RESULTS: Among the 4000 target genes, 78 and 114 genes were up-and down-regulated, respectively, in treble genes mutants fed with high fat high cholesterol diet compared with that of regular chow littermates, including lipid metabolism, carbohydrate, cell skeleton and immune related genes. Atherogenic diet induced severe plasma hyperlipidemia even in the early stage and also accelerated atherogenesis in the treble genes mutant mice. CONCLUSION: The data suggest that atherogenic diet aggravates abnormal plasma lipid metabolism and induces severe hyperlipidemia, and atherogenesis in the treble genes mutant mice as well.

Association of F ⅩⅢ Val34Leu with coronary heart disease / 中国病理生理杂志

0.05)). The Val/Leu genotype and Leu allele frequencies in subjects without MI were significantly higher than that in subjects with MI (P

Relationship between serum concentrations of IL-18, IL-10, IL-6 and acute coronary syndrome / 中国病理生理杂志

AIM: To examine the relation between serum concentrations of interleukin-18, interleukin-10, interleukin-6 and acute coronary syndrome (ACS). METHODS: Serum concentrations of IL-18, IL-10, IL-6 were measured in 17 patients with acute myocardial infarction (AMI), 30 patients with unstable angina pectoris (UAP), 15 patients with stable angina pectoris (SAP) and 20 controls by enzyme-linked immunosorbent assay (ELISA) and radioimmunoassay (RIA).The relation between IL-18, IL-6 and IL-10 was compared. RESULTS: Serum concentrations of IL-18, IL-6 were significantly increased in the AMI and UAP groups in comparison with the SAP and control groups. Conversely, serum concentrations of IL-10 were significantly decreased in the AMI and UAP groups in comparison with the SAP and control groups. The correlation of concentrations of IL-18 and IL-6 had no significance; but the levels of IL-18 and IL-6 were negatively correlated with IL-10. CONCLUSION: Serum IL-18, IL-6 concentrations increase while serum IL-10 concentration decreases in patients with acute coronary syndromes. The inflammatory imbalance between IL-18, IL-6 and IL-10 may play an important role in the instability of atherosclerotic plaque.