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Amyotrophic lateral sclerosis (ALS) is a rapid progressive neurodegenerative disease, characterized by the degeneration of both upper and lower motor neurons. The progressive motor unit loss due to lower motor neuron damage is one of the most important pathological process in ALS. However, there are lack of specific biomarkers for early diagnosis and progression monitoring of ALS. The relevant electrophysiologic techniques which quantify the number of motor unit have been developed rapidly in recent years. Among them, the motor unit number estimation (MUNE) and the motor unit number index (MUNIX) have been widely applied to quantify motor unit number loss in ALS. The most recent advances of MUNE and MUNIX in ALS were reviewed.
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OBJECTIVE@#To investigate the current status of antibiotic use for very and extremely low birth weight (VLBW/ELBW) infants in neonatal intensive care units (NICUs) of Hunan Province.@*METHODS@#The use of antibiotics was investigated in multiple level 3 NICUs of Hunan Province for VLBW and ELBW infants born between January, 2017 and December, 2017.@*RESULTS@#The clinical data of 1 442 VLBW/ELBW infants were collected from 24 NICUs in 2017. The median antibiotic use duration was 17 days (range: 0-86 days), accounting for 53.0% of the total length of hospital stay. The highest duration of antibiotic use was up to 91.4% of the total length of hospital stay, with the lowest at 14.6%. In 16 out of 24 NICUs, the antibiotic use duration was accounted for more than 50.0% of the hospitalization days. There were 113 cases with positive bacterial culture grown in blood or cerebrospinal fluid, making the positive rate of overall bacterial culture as 7.84%. The positive rate of bacterial culture in different NICUs was significantly different from 0% to 14.9%. The common isolated bacterial pathogens Klebsiella pneumoniae was 29 cases (25.7%); Escherichia coli 12 cases (10.6%); Staphylococcus aureus 3 cases (2.7%). The most commonly used antibiotics were third-generation of cephalosporins, accounting for 41.00% of the total antibiotics, followed by penicillins, accounting for 32.10%, and followed by carbapenems, accounting for 13.15%. The proportion of antibiotic use time was negatively correlated with birth weight Z-score and the change in weight Z-score between birth and hospital discharge (r=-0.095, -0.151 respectively, P<0.01), positively correlated with death/withdrawal of care (r=0.196, P<0.01).@*CONCLUSIONS@#Antibiotics used for VLBW/ELBW infants in NICUs of Hunan Province are obviously prolonged in many NICUs. The proportion of routine use of third-generation of cephalosporins and carbapenems antibiotics is high among the NICUs.
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Humans , Infant , Infant, Newborn , Anti-Bacterial Agents , Birth Weight , Infant, Extremely Low Birth Weight , Intensive Care Units, Neonatal , Surveys and QuestionnairesABSTRACT
BACKGROUND@#Sleep disorders are common but under-researched symptoms in patients with multiple system atrophy (MSA). We investigated the frequency and factors associated with sleep-related symptoms in patients with MSA and the impact of sleep disturbances on disease severity.@*METHODS@#This cross-sectional study involved 165 patients with MSA. Three sleep-related symptoms, namely Parkinson's disease (PD)-related sleep problems (PD-SP), excessive daytime sleepiness (EDS), and rapid eye movement sleep behavior disorder (RBD), were evaluated using the PD Sleep Scale-2 (PDSS-2), Epworth Sleepiness Scale (ESS), and RBD Screening Questionnaire (RBDSQ), respectively. Disease severity was evaluated using the Unified MSA Rating Scale (UMSARS).@*RESULTS@#The frequency of PD-SP (PDSS-2 score of ≥18), EDS (ESS score of ≥10), and RBD (RBDSQ score of ≥5) in patients with MSA was 18.8%, 27.3%, and 49.7%, respectively. The frequency of coexistence of all three sleep-related symptoms was 7.3%. Compared with the cerebellar subtype of MSA (MSA-C), the parkinsonism subtype of MSA (MSA-P) was associated with a higher frequency of PD-SP and EDS, but not of RBD. Binary logistic regression revealed that the MSA-P subtype, a higher total UMSARS score, and anxiety were associated with PD-SP; that male sex, a higher total UMSARS score, the MSA-P subtype, and fatigue were associated with EDS; and that male sex, a higher total UMSARS score, and autonomic onset were associated with RBD in patients with MSA. Stepwise linear regression showed that the number of sleep-related symptoms (PD-SP, EDS, and RBD), disease duration, depression, fatigue, and total Montreal Cognitive Assessment score were predictors of disease severity in patients with MSA.@*CONCLUSIONS@#Sleep-related disorders were associated with both MSA subtypes and the severity of disease in patients with MSA, indicating that sleep disorders may reflect the distribution and degree of dopaminergic/non-dopaminergic neuron degeneration in MSA.
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Humans , Male , Cross-Sectional Studies , Multiple System Atrophy , REM Sleep Behavior Disorder , Severity of Illness Index , SleepABSTRACT
Objective: To evaluate the anti-inflammatory effect of berberine (BBR) on the lipopolysaccharide (LPS)-induced acute phase response and its modulation of the altered bile acid metabolism induced by LPS treatment. Methods: An acute phase response was induced by intraperitoneal injection of LPS (5 mg/kg, ip) in C57BL/6 J mice, and the BBR treatment group was orally administered with BBR (200 mg/ky, ig). The levels of TNFα, IL-1β and IL-6 in the serum were measured using an ELISA kit, and their expression levels in the liver were measured using qRT-PCR. The bile acid pool was measured using a commercial bile acid kit, and the expression levels of enzymes involved in bile acid metabolism were measured by qRT-PCR. The expression levels of CYP7A1, p65 NF-κB and the MAPK signaling pathway was measured using Western blotting. Results: LPS treatment suppressed the expression of CYP7A1 and CYP8B1, and the total bile acid pool was also reduced. Pretreatment with BBR inhibited the pro-inflammatory biomarkers TNFα and IL-1β in the serum, as well as the expression of TNFα, IL-1β and iNOS mRNA in the liver. BBR treatment did not affect the reduction in the bile acid pool size induced by LPS, but significantly increased the concentration of bile acids in the liver, which was consistent with the upregulated expression of CYP7A1 and CYP8B1. The MAPK signaling pathway was activated by BBR treatment, while the p65 NF-κB signaling pathway was inhibited. Conclusion: BBR can offer an anti-inflammatory effect and reverse the inhibition of CYP7A1 and CYP8B1 expression caused by LPS treatment, as well as induce the production of bile acids in liver, probably via MAPK signaling; However, treatment with BBR had no effect on the size of total bile acid pool.
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Objective@#To investigate the prognostic effect of neonatal morbidities on poor outcomes at 12 months corrected age in very low birth weight (VLBW) premature infants .@*Method@#From November 2013 to October 2014, a multi-center retrospective study was conducted in 8 tertiary Maternal and Children′s hospitals in Guangdong, Hunan and Fujian. The premature infants survived to a postmenstrual age (PMA) of 36 weeks with birth weight less than 1 500 g and without congenital diseases were included, and divided into two groups according to poor outcomes. The birth weight, gestational age, morbidities and poor outcomes (death, cerebral palsy, cognitive delay, et al) were recorded. Data were analyzed with Chi-square test to investigate the relationship between morbidities and poor outcomes. And the predictive effect of the top three morbidities were analyzed by Logistic regression analysis.@*Result@#Total of 834 VLBW premature infants (473 boys and 361 girls) finished the follow-up, whose average gestational age and birth weight were (30.6±1.8) weeks and (1 189±159)g. The incidences of BPD, severe ROP, NEC, brain injury and sepsis were 207 (24.8%), 119 (14.3%), 58 (7.0%), 281 (33.7%) and 124 (14.9%), respectively. There were significant differences between the two groups in the incidences of BPD, severe ROP, NEC, brain injury and sepsis(χ2=42.10, 47.20, 4.81, 44.28, 18.63, all P<0.01), which had significant correlation with poor outcomes at 12 months corrected age. The three top morbidities were severe ROP, BPD and brain injury(OR=3.82, 2.90, 2.80). Combined morbidities with BPD, severe ROP and brain injury correlated with higher risk of poor outcomes (one morbidity, OR=3.14, β=1.15; two morbidities, OR=7.31, β=1.99; three morbidities, OR=22.41, β=3.11; all P<0.01).@*Conclusion@#BPD, severe ROP, NEC, brain injury and sepsis were the risk factors of poor outcomes at 12 months corrected age in VLBW infants. And the more combined morbidities with severe ROP, BPD and brain injury, the higher risk of poor outcomes in this population. Trial registration Clinical Trails, NCT03104946.
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This study researched the results transformation problem in medical universities,sorted the current situation in this filed,analyzed the causes of the low transformational rate.Then by referring to the domestic and overseas experience,the author designed the classified transforma tional path of medical research results according to their respective features,finally put forward policy suggestions for institutional guarantee policy to promote the transformation of medical universities.
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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
<p><b>OBJECTIVE</b>To understand factors as social support, situation of depression and related risk factors among migrant women of reproductive age in some areas of Wuhan.</p><p><b>METHODS</b>Cluster sampling method and face-to-face interview with structured questionnaire were used to investigate 316 migrant women in Wuhan.</p><p><b>RESULTS</b>The overall prevalence rate of depression was 32.3%.</p><p><b>RESULTS</b>from binary logistic regression analysis showed that factors as: under pressure (OR = 4.010, 95%CI: 1.672 - 9.617), having had negative life events (OR = 2.050, 95%CI: 1.170 - 3.591) or tight relations with neighbors (OR = 2.537, 95%CI: 1.053 - 6.113), not quite satisfied (OR = 4.247, 95%CI: 1.521 - 11.855) or satisfied (OR = 2.411, 95%CI: 1.111 - 5.233), on his/her own health status etc., might serve as the possible risk factors for depression. In scores related to social support, and the utilization of such support, there were statistically significant differences seen between the groups with depression and the one without.</p><p><b>CONCLUSION</b>The prevalence of depression among migrant women of reproductive age appeared to be high in some areas on Wuhan. Factors as: under pressure, having had negative life events, tight relations with neighbors, status on satisfaction of one's own health situation as well as related social support, seemed to be the main risk factors for depression in this population.</p>
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Adolescent , Adult , Female , Humans , Middle Aged , Young Adult , China , Epidemiology , Depression , Epidemiology , Prevalence , Risk Factors , Social Support , Surveys and Questionnaires , Transients and MigrantsABSTRACT
<p><b>OBJECTIVE</b>To observe abnormal metabolic changes caused by ischemic cerebral apoplexy and the regulating action of Tongsaimai pellets on abnormal metabolism by analyzing the change of small molecules in plasma of ischemic cerebral apoplexy rat. To find the potential biomarkers, and to explore metabolic mechanisms of Tongsaimai pellets.</p><p><b>METHOD</b>Rat models of middle cerebral artery occlusion was established with electric coagulation, and rats were divided into 4 groups, model group, sham-operation group, Tongsaimai pellets group and positive control group. Tongsaimai pellets and positive control group were orally administrated by 13.2 g x kg(-1) x d(-1) of crude drugs and 32 mg x kg(-1) x d(-1) of Nimodipine respectively, m odel and sham-operation group by equal volume of distilled water for a week. Plasma of model and sham-operation group were collected, and plasma of Tongsaimai pellets and positive control group were collected on the 1st, 3rd , 7th day after administration. Endogenous metabolites of four groups were determined with GC-MS. Partial least squares discriminant analysis (PLS-DA) was applied to analyze multivariate data and set up model, and T-test was used in significant statistical analysis.</p><p><b>RESULT</b>Compared with sham-operation group rats, pyruvic acid, taurine and hydroxyproline obviously increased in model group rats, while lactic acid, glyceric acid, aminomalonic acid, fructose, tryptophan and leucine significantly decreased, so these metabolites were potential metabolic biomarkers. These endogenous metabolites except taurine got restoration in Tongsaimai group rats.</p><p><b>CONCLUSION</b>Abnormal metabolite level in plasma can be certainly recovered by Tongsaimai pellets, and the treatment of Tongsaimai pellets can be connected with the regulation of related metabolic pathways.</p>
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Animals , Male , Rats , Brain Ischemia , Blood , Drug Therapy , Drugs, Chinese Herbal , Therapeutic Uses , Fructose , Blood , Glyceric Acids , Blood , Hydroxyproline , Blood , Lactic Acid , Blood , Leucine , Blood , Malonates , Blood , Metabolomics , Methods , Pyruvic Acid , Blood , Rats, Sprague-Dawley , Stroke , Blood , Drug Therapy , Taurine , Blood , Tryptophan , BloodABSTRACT
Objective To set up a scientific, objective, reasonable, qualitative and quantitative,operational evaluation index system of clinical science and technology achievements, which provides the reference to evaluating clinieal science and technology achievements scientifieally. Methods The Delphi method was used to investigate 30 experts for weight of the index via questionnaire. Results The response rate was 100%. The Kendall's concordance coefficient was up to 0. 963. The final index system includes three first-class indicators, eight second-class indicators and 18 third-class indicators. The weight coefficeient of each class was identified. Conclusion The experts showed enthusiasm for this investigation. The agreement of respondents was high after two rounds of investigation. The index system can be used in comprehensive evaluation for science and technology achievements in clinical medicine. The index system takes a guiding effect for science and technology achievements to solve clinical services and problems.
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Objective To verify the evaluation index system of clinical science and technology achievements, taking the evaluation of science and technology achievements in Guangdong province as a demonstration. Methods We specified the criteria for grading each index included in the evaluation index system that we proposed before. 5 experts in clinical medicine were invited to evaluate 20 achievements applying for the Award of Guangdong Science and Technology Achievements in 2010. The weighted sum of scores for each achievement was calculated and used for further analysis. The reliability and validation of the system were assessed. Results The Cronbach's ? coefficient of the index system was 0. 91, indicating good reliability. There were high correlation of each measure with the total score and their affiliated grade one index. The scores that the experts graded were correlated with the original results of evaluation (rs= 0. 71, P ＜0. 000 1), but there remained some inconsistence. Conclusion The demonstration based on investigation data indicates that the evaluation system is easy to handle and has satisfactory reliability and validation. It can be applied to the evaluation of science and technology achievements in clinical medicine.
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The intellectual property rights weight much in the research capacity of a university.This article focuses on the practice and achievements of Southern Medical University in the field of intellectual property management after the transformation of the university.
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Objective Although principal components analysis profiles greatly facilitate the visualization and interpretation of the multivariate data,the quantitative concepts in both scores plot and loading plot are rather obscure.This article introduced three profiles that assisted the better understanding of metabolomic data.Methods The discriminatory profile,heat map,and statistic profile were developed to visualize the multivariate data obtained from high-throughput GC-TOF-MS analysis.Results The discriminatory profile and heat map obviously showed the discriminatory metabolites between the two groups,while the statistic profile showed the potential markers of statistic significance.Conclusion The three types of profiles greatly facilitate our understanding of the metabolomic data and the identification of the potential markers.
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<p><b>AIM</b>To explore the effect of cerebellar fastigial nuclei (FN)on lymphocyte function and the pathway mediating the effect.</p><p><b>METHODS</b>Kainic acid (KA) was microinjected into bilateral FN of rats to destroy neuronal bodies in the FN. On the eighth day after the surgery, lymphocyte percentage in the peripheral blood and level of sheep red blood cell(SRBC)-specific IgM antibody in the serum were measured by using blood corpuscle counter and enzyme-linked immunosorbent assay (ELISA), respectively.A technology of electrolytic lesion was used to destroy the projections of cerebellar FN neurons to hypothalamus in decussation of superior cerebellar peduncle(xscp).</p><p><b>RESULTS</b>On the eighth day after the microinjection of KA into the bilateral FN of rats, the Nissl-stained neuronal bodies in the FN disappeared and glia could proliferated within the damaged FN. In the nuclei close to FN, the interposed nuclei and the dentate nuclei, Nissl-stained neurons still could be seen. On the control cerebellar sections, in which FN was infused with saline, we could see the normal Nissl-stained neurons in the FN and the other two nuclei.On day 8 following the effective FN lesions, both the lymphocyte percentage in the peripheral blood and the level of anti-SRBC IgM antibody in the serum were significantly increased in comparison with those of control rats infused with saline in the FN. On the eighth day after electrolytic lesion of the fibres in xscp, the FN-hypothalamic projections were damaged and there were no visible BDA-positive endings in hypothalamus. Meanwhile, both the lymphocyte percentage in the peripheral blood and the level of anti-SRBC IgM antibody in the serum were remarkably enhanced relative to those of control rats with sham lesion of xscp.</p><p><b>CONCLUSION</b>The electrolytic lesion of the FN-hypothalamic projections in xscp causes an enhancement of lymphocyte function similar to that of KA lesions of neuronal soma in the FN. These findings suggest that the cerebellohypothalamic projections participate in mediating the modulation of lymphocyte function by the cerebellum.</p>
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Animals , Female , Male , Rats , Cerebellar Nuclei , Allergy and Immunology , Wounds and Injuries , Hypothalamus , Allergy and Immunology , Physiology , Kainic Acid , Lymphocyte Count , Lymphocytes , Cell Biology , Allergy and Immunology , Neural Pathways , Allergy and Immunology , Physiology , Neuroimmunomodulation , Physiology , Rats, Sprague-DawleyABSTRACT
<p><b>AIM</b>To investigate effect of cerebellar fastigial nuclei (FN), one of three deep nuclei in cerebellum, on lymphocyte function, and possible central pathway involved in the effect.</p><p><b>METHODS</b>Kainic acid (KA) was microinjected into bilateral FN of rats. On the eighth day after the surgery, lymphocytes from the mesenteric lymph nodes were incubated to measure their proliferative reaction to concanavalin A (Con A) by means of colorimetric assay of methyl thiazole tetrazolium (MTT), and natural killer (NK) cells from the spleen were cultured to evaluate their cytotoxicity to YAC-1 cells with the aid of flow cytometric assay. Simultaneously, glutamate content in the hypothalamus was determined by high performance liquid chromatography (HPLC). As control, 0.9% saline was microinjected into the bilateral FN of rats. When these experiments ended, cerebellar sections and Nissl stain for each rat were made to observe the location and extent of the lesions. If the lesion areas were not in the bilateral FN or not limited in the FN, the results were discarded.</p><p><b>RESULTS</b>On day 8 following the KA injection of FN, the Nissl-stained cerebellar sections showed the neuronal bodies in the FN were effectively damaged by KA. Simultaneously, the lymphocyte proliferation induced by Con A was significantly increased and the NK cell cytotoxicity to YAC-1 target cells was remarkably enhanced when compared with those of the control animals microinjected with saline in their bilateral FN. At the same time as these changes of lymphocyte functions occurred, glutamate content in the hypothalamus was markedly reduced relative to that in the control hypothalamus.</p><p><b>CONCLUSION</b>Effective lesions of cerebellar bilateral FN of rats can cause an enhancement of lymphocyte functions, including increase of proliferation of T cells and cytotoxicity of NK cells. The cerebello hypothalamic glutamatergic projections may be involved in the pathway of cerebellar FN immunomodulation.</p>