Clinical and follow-up study of premature infants with neonatal respiratory distress syndrome managed by the less invasive surfactant administration / 中华实用儿科临床杂志

Objective:To explore the clinical therapeutic effect and follow-up prognosis of preterm infants with neonatal respiratory distress syndrome (NRDS) managed by less invasive surfactant administration (LISA) and traditional intubation-surfactant-extubation (INSURE) of pulmonary surfactant (PS).Methods:Data during hospitalization and follow-up period of 187 NRDS preterm infants (gestational age 24 weeks to 31 + 6 weeks, and birth weight <1 500 g) admitted to the Department of Neonatology, the Women and Children′s Hospital of Chongqing Medical University from March 2019 to February 2021 were retrospectively analyzed.NRDS preterm infants who were injected with PS by LISA were included in the LISA group (144 cases), and those who were injected with PS by INSURE were included in the INSURE group (43 cases). The propensity score matching method was used to correct the confounding factors between groups, and the covariate equilibrium samples between groups were obtained (39 cases in each group). Clinical treatment effect and prognosis of physical development, hearing and vision development, nervous system development, respiratory system diseases and other conditions of the two groups of children were compared using the t test, Chi- square test and other statistical analysis methods as appropriate. Results:(1)Compared with that of the INSURE group, the incidence of BPD [12 cases (33.3%) vs.23 cases (63.9%), χ2=6.727, P=0.009] and ROP [13 cases (36.1%) vs.26 cases (72.2%), χ2=9.455, P=0.002] in the LISA group were significantly lower.The incidence of mild BPD [8 cases (22.2%) vs.16 cases (44.4%), χ2=4.000, P=0.046] and stage Ⅰ-Ⅱ ROP [11 cases (30.6%) vs.22 cases (61.1%), χ2=6.769, P=0.009] in the LISA group was significantly lower than that of the INSURE group.There was no significant difference in the incidence of moderate and severe BPD and stageⅢ ROP and above between groups (all P>0.05). (2)There were no statistical differences in the repeated use of PS, mechanical ventilation rate within 72 h, pneumothorax/pulmonary hemorrhage, grade Ⅲ-Ⅳ periventricula-rintraventricular hemorrhage, stage Ⅱ-Ⅲ neonatal necrotizing enterocolitis, sepsis, abnormal amplitude integrated electroencephalogram, mortality in 36 weeks of corrected gestational age, total oxygen inhalation duration and hospitalization duration between the two groups (all P>0.05). (3)Follow-up within 1 year of corrected age after discharge.There were no significant differences in extrauterine body mass, body length and head circumference development, visual development, hearing development, Neonatal Behavioral Neurological Assessment score at corrected gestational age of 40 weeks, Bayley Scales of Infants Development score at corrected gestational age of 6 months and age of 1 year, pneumonia and re-hospitalization due to respiratory diseases between groups (all P>0.05). Conclusions:PS administration with LISA technology can reduce the incidence of mild BPD and stage Ⅰ-Ⅱ ROP in premature infants with NRDS who had the gestational age of 24-31 + 6 weeks and birth weight<1 500 g, without increasing the risk of other complications.The long-term prognosis of them treated with PS administration with LISA and INSURE is similar.

Mutation characteristics of osteosarcoma: a single center study of 64 cases using next-generation sequencing / 中华病理学杂志

Objective: To investigate the distribution and characteristics of gene mutations in osteosarcoma, and to analyze the frequency and types of detectable mutations, and to identify potential targets for individualized treatment of osteosarcoma. Methods: The fresh tissue or paraffin-embedded tissue samples of 64 cases of osteosarcoma that were surgically resected or biopsied and then subject to next generation sequencing, were collected from Beijing Jishuitan Hospital, China from November 2018 to December 2021. The tumor DNA was extracted to detect the somatic and germline mutations using targeted sequencing technology. Results: Among the 64 patients, 41 were males and 23 were females. The patient age ranged from 6 to 65 years with a median age of 17 years, including 36 children (under 18 years old) and 28 adults. There were 52 cases of conventional osteosarcoma, 3 cases of telangiectatic osteosarcoma, 7 cases of secondary osteosarcoma, and 2 cases of parosteosarcoma. The detection rate of gene mutations was overall 84.4% (54/64). There were 324 variations in 180 mutated genes, including 125 genes with copy number variations, 109 single nucleotide variants, 83 insertions or deletions, and 7 gene fusions. The most common mutated genes were TP53, VEGFA, CCND3, ATRX, MYC, RB1, PTEN, GLI1, CDK4 and PTPRD. Among them, TP53 had the highest mutation rate (21/64, 32.8%), single nucleotide variant was the main mutation type (14/23, 60.9%), and 2 cases carried the TP53 germline mutation. VEGFA and CCND3 showed copy number amplification simultaneously in 7 cases. Conclusions: The high-frequency mutation of TP53 suggests that it plays an important role in the pathogenesis and development of osteosarcoma. VEGFA, CCND3 and ATRX are mutated genes in osteosarcoma and worthy of further studies. Combination of pathologic diagnosis and next generation sequencing with clinical practice can guide individualized treatment for patients with refractory, recurrent and metastatic osteosarcoma.

Pediatric myofibroma/myofibromatosis of the soft tissue and bone: a clinicopathological analysis of 28 cases / 中华病理学杂志

Objective: To investigate the clinicopathological features, diagnosis and differential diagnosis of pediatric myofibroma/myofibromatosis of the soft tissue and bone. Methods: All cases of pediatric myofibroma/myofibromatosis of the soft tissue and bone diagnosed between January 2011 and December 2018 were retrieved from the surgical pathology records in the Department of Pathology, Beijing Jishuitan Hospital, Beijing, China. Clinical and radiological data were collected. H&E and immunohistochemistry were used to examine histological and immunophenotypic features and to make the diagnosis and differential diagnosis. The relevant literature was also reviewed. Results: Twenty-eight cases of pediatric myofibroma/myofibromatosis of the soft tissue and bone were respectively collected. The patients' ages ranged from 2 months to 14 years, with a mean age of 7 years. There were 7 females and 21 males. There were 12 cases located in soft tissue, including the finger (n=9), upper arm (n=1) and foot (n=2). There were 14 cases located in the bone of limb, including the femur (n=8), tibia (n=4), clavicle (n=2), fibula (n=2) and radius (n=1). There were 2 cases of myofibromatosis involving multiple bones. Radiology showed lytic lesions in the bone. The proliferation of spindle-shaped myofibroblasts arranged in fascicles with indistinct eosinophilic cytoplasm and bland nuclei, with no pleomorphism and cytological atypia. The characteristic histologic structure was the biphasic nodular growth pattern with cellular and paucicellular regions. The tumors might arrange in a hemangiopericytoma-like pattern. The stroma varied between dense fibrosis and myxoid changes. The reactive new bone formation and inflammatory cell infiltration also existed. Immunohistochemical study showed that the SMA was positive. The surgical resections were performed. One of the patients had tumor recurrence as a result of 11-month follow-up. Conclusions: The pediatric myofibroma/myofibromatosis of the soft tissue and bone is a very rare benign tumor and has a good prognosis. It has a characteristic morphology and its differential diagnosis from other spindle cell tumors could be made with the immunohistochemical analysis.

Clinical efficacy observation of omalizumab on patients with moderate to severe allergic asthma for one year / 中华预防医学杂志

To observe the symptom control, pulmonary function changes and safety of use of omalizumab in patients with moderate to severe allergic asthma for 1 year. A small sample self-controlled study before and after treatment was conducted to retrospective analysis involved 17 patients with moderate to severe asthma who received omalizumab therapy for 12 months in Peking University People's Hospital and Beijing Jishuitan Hospital from January 2020 to December 2021. The clinical symptoms and pulmonary function changes were compared before treatment, after 6 months and 12 months of treatment, and the clinical data such as the use of other drugs and adverse reactions were observed. Statistical data are collected using the median method, and non-parametric paired Wilcoxon analysis was used for pairwise comparison. Before treatment with omalizumab, the patients' FeNO value was 79(58, 121) ppb, and the total serum IgE was 228(150.5, 345.5) IU/ml. After 6 months of omalizumab therapy, the percent predicted value of the forced expiratory volume in 1 second (FEV1%) before inhaled bronchodilator increased from 86.70(82.65, 91.35)% to 90.90(87.70, 95.85)% (Z=-3.626, P<0.001). The FEV1%pred after inhaled bronchodilator increased from 92.60(85.75, 96.90)% to 94.30(89.95, 98.15)% (Z=-2.178, P=0.029). The absolute value of improvement in FEV1 decreased from 150(95, 210)ml to 50(20, 125) ml (Z=-2.796, P=0.005), and the improvement rate decreased from 6.60(3.80, 7.85)% to 1.90(0.75, 4.85)% (Z=-2.922, P=0.003). After 12 months of treatment, the FEV1%pred before inhaled bronchodilator further increased to 92.90 (91.60, 98.15)% (Z=-3.575, -2.818, and P<0.001, 0.005 compared with before treatment and 6 months after treatment, respectively). The FEV1%pred after inhaled bronchodilator increased to 96.80 (91.90, 101.25)% (Z=-3.622, -1.638, and P<0.001, 0.008 compared with before treatment and after 6 months of treatment, respectively). The absolute value of improvement in FEV1 was 70 (35, 120) ml (P=0.004, 0.842 before treatment and 6 months after treatment, respectively), and the improvement rate was 3.0(1.0, 5.0)% (Z=-2.960, -0.166, and P=0.003, 0.868, compared with before treatment and after 6 months of treatment, respectively). After 12 months of treatment, ACT increased from 13 (10.5, 18) before treatment to 24 (23, 25) (Z=-3.626,P<0.001). Only 1 patient experienced an injection site skin reaction during treatment. Therefore, after 6 months and 12 months of treatment with omalizumab, the patient's lung function improved and symptoms were relieved, which could effectively prevent the acute exacerbation of asthma. Omalizumab treatment is safe and well tolerated, and no effect on blood pressure and blood glucose was observed.

Molecular Mechanism of Salviae Miltiorrhizae Radix et Rhizoma against Bladder Cancer： Based on Network Pharmacology and In Vitro Experiment / 中国实验方剂学杂志

ObjectiveTo predict the potential targets and possible related signaling pathways of Salviae Miltiorrhizae Radix et Rhizoma against bladder cancer （BC） based on network pharmacology and verify the potential molecular mechanism through in vitro cell experiment. MethodActive components of Salviae Miltiorrhizae Radix et Rhizoma were retrieved from Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform （TCMSP） and BC-related targets were searched from GeneCards and Online Mendelian Inheritance in Man （OMIM）. Via Venny2.1， the potential targets of Salviae Miltiorrhizae Radix et Rhizoma against BC were screened out and the Venn diagram was plotted. Protein-protein interaction （PPI） network was constructed by STRING， followed by Gene Ontology （GO） term enrichment and Kyoto Encyclopedia of Genes and Gnomes （KEGG） pathway enrichment with DAVID. Cell Counting Kit-8 （CCK-8） assay was employed to detect the inhibitory effect of tanshinone ⅡA （Tan ⅡA）， cryptotanshinone （CPT）， and luteolin （LUT） at different concentration （0， 1， 2， 4， 8， 16， 32 μmol·L-1） on the proliferation of BC T24 and 5637 cells， propidium iodide （PI） staining to analyze the apoptosis of 5637 cells induced by Tan ⅡA， CPT， and LUT （0， 4， 8 μmol·L-1）， and Western blotting to detect the regulatory effect of Tan ⅡA （0， 4， 8， 16 μmol·L-1） on the expression of key target proteins. ResultA total of 65 active components and 39 anti-BC targets of Salviae Miltiorrhizae Radix et Rhizoma were screened out. The anti-BC targets were mainly involved in the KEGG pathways of neuron-ligand-receptor interaction， phosphatidylinositol 3-kinases （PI3K）/protein kinase B （Akt） signaling pathway， epidermal growth factor receptor （EGFR） tyrosine kinase inhibitor resistance， and hypoxia inducible factor （HIF）-1 signaling pathway. As for the CCK-8 assay， compared with the blank group， Tan ⅡA， CPT， and LUT significantly inhibited the proliferation of T24 and 5637 cells， particularly the 5637 cells. The half maximal inhibitory concentration （IC50） of Tan ⅡA on 5637 cells was significantly lower than that of CPT and LUT. Moreover， compared with the blank group， Tan ⅡA， CPT， and LUT all induced the apoptosis of 5637 cells， and the effect followed the order of Tan ⅡA>CPT>LUT （P<0.05）. Western blot showed that Tan ⅡA significantly reduced the expression of EGFR， p-PI3K， and p-Akt in 5637 cells in a concentration-dependent manner compared with the blank group （P<0.05）. ConclusionSalviae Miltiorrhizae Radix et Rhizoma exerts therapeutic effect on BC through multiple components， multiple targets， and multiple pathways. The mechanism is the likelihood that it down-regulates the expression of EGFR， p-PI3K， and p-Akt proteins， thus further inhibits cell proliferation， and induces apoptosis.

Effects of intervention program from prenatal period to delivery room on outcomes of extremely preterm infants / 中华围产医学杂志

Objective:To analyze the outcomes of extremely preterm infants (EPIs) after the implementation and quality improvement of an intervention program from the prenatal period to delivery room and the factors influencing the mortality of EPIs.Methods:This was a retrospective study involving 185 EPIs admitted to neonatal intensive care unit (NICU) of Chongqing Health Center for Women and Children from July 1, 2014, to June 30, 2021. The intervention program from the prenatal period to delivery room was implemented in our hospital in January 2018, according to which, EPIs who were admitted before this time were grouped as the historical group ( n=45) and those who were admitted after as the program group ( n=140). The survival rate and morbidity of the two groups were analyzed and compared using t test, Mann Whitney U test, and Chi-square test. The factors influencing the mortality of EPIs were analyzed by univariate screening and logistic regression. Results:(1) The median gestational age of these EPIs was 26 +6 weeks, ranging from 23 +3 to 27 +6 weeks, and the median birth weight was 950 g, ranging from 390 g to 1 290 g. (2) After the intervention, the proportion of patients in whom the neonatologists were involved in prenatal consultation, women who received a full course of antenatal corticosteroid and magnesium sulfate, and cesarean delivery as well as the neonatal temperature on admission to NICU all increased significantly [77.1% (108/140) vs 8.9% (4/45); 67.9% (95/140) vs 35.6% (16/45); 67.1% (94/140) vs 48.9% (22/45); 44.3% (62/140) vs 17.8% (8/45); 36.6 ℃ (36.3-36.9 ℃) vs 35.2 ℃ (35.0-35.3 ℃), respectively, χ2 or Z values were 66.41, 14.81, 4.85, 10.17 and－9.34, respectively, all P<0.05]. Both delayed cord clamping (DCC) and nasal continuous positive airway pressure (nCPAP) were included in the intervention program, with implementation rates from zero before to 67.9% (95/140) and 89.3%(125/140), respectively. Compared to the historical group, the proportion of infants with 1-minute Apgar score ≤3, endotracheal intubation in the delivery room or mechanical ventilation within 72 h after birth were decreased in the program group [7.1% (10/140) vs 17.8% (8/45), 37.1% (52/140) vs 73.3% (33/45), 38.6% (54/140) vs 57.8% (26/45), χ2 values were 4.39, 17.96 and 5.12, respectively. all P<0.05]. (3) After the intervention, the overall survival rate of EPIs and that among those with gestational age from 27 to 27 +6 weeks were significantly improved [72.9% (102/140) vs 53.3% (24/45), OR=2.349, P=0.015; 84.1% (53/63) vs 56.6% (13/23), OR=4.077, P=0.007]. Although the incidence of periventricular and intraventricular hemorrhage, late-onset sepsis, and retinopathy of prematurity showed a downward trend, the differences were not statistically significant (all P>0.05) (4) Multivariate logistic regression analysis showed that 1-minute Apgar score ≤3 ( OR=8.890, 95% CI:2.005-39.412), low 5-minute Apgar score ( OR=1.468, 95% CI:1.103-1.953), and higher rate of mechanical ventilation within 72 h ( OR=7.165, 95% CI:2.942-17.449) were independent risk factors for the mortality of EPIs; and using nCPAP in the delivery room ( OR=0.314, 95% CI:0.137-0.719) and birth weight ( OR=0.996, 95% CI:0.993-0.999) were protective factors. Conclusions:Early interventions for EPIs in the prenatal period or the delivery room, the quality improvement program, including intrapartum temperature management, DCC, and nCPAP, is likely to improve the survival rate and outcome of EPIs.

Investigation and analysis of a case of occupational acute severe organic fluoride poisoning / 环境与职业医学

Through an occupational hygiene survey of an occupational acute severe organic fluoride poisoning accident caused by the leakage of pilot test materials, the cause of the incident was analyzed, the diagnosis of the occupational disease was established, and the measures to be taken by the enterprise were discussed, aiming to provide reference for the occupational health management and prevention of similar poisoning accidents in chemical industry.

Monomer Components of Chinese Herbal Medicines Regulate PI3K/Akt Signaling Pathway to Inhibit Bladder Cancer： A Review / 中国实验方剂学杂志

Bladder cancer is the most prevalent malignant tumor in the urinary tract in China. Western medical treatments， including long-term regular endoscopy， intravesical chemotherapy， immunotherapy， and radical cystectomy， are effective， whereas the high recurrence rate still plagues both doctors and patients. Among the classical signaling pathways involved in the formation and progression of bladder cancer， the phosphatidylinositol 3-kinase （PI3K）/protein kinase B （Akt） signaling pathway is a key one. Modern pharmacological studies have demonstrated that Chinese herbal medicines and their monomer components can alleviate the discomfort， prolong the survival， and improve the quality of life of the patients undergoing tumor treatment. The relevant literature in the past decade has revealed that flavonoids， terpenoids， polysaccharides， gambogic acids， bibenzyls， and alkaloids from Chinese herbal medicines regulate the PI3K/Akt signaling pathway to play a role in the proliferation， apoptosis， invasion， migration， drug resistance， and autophagy of bladder cancer cells， thereby exerting the activity against bladder cancer. Although some targets and the potential mechanisms of the monomer components in the treatment of bladder cancer have been clarified， the research on the monomer components is limited to in vitro cellular experiments and animal experiments. Researchers face the great challenge in the application of the monomer components from Chinese herbal medicines into clinical practice. We summarized the recent studies about the regulatory effects of monomer components from Chinese herbal medicines on the PI3K/Akt signaling pathway in bladder cancer， aiming to give insights into the research on the drug therapy of bladder cancer and the underlying mechanism.

Monomer Components of Chinese Herbal Medicines Regulate PI3K/Akt Signaling Pathway to Inhibit Bladder Cancer： A Review / 中国实验方剂学杂志

Bladder cancer is the most prevalent malignant tumor in the urinary tract in China. Western medical treatments， including long-term regular endoscopy， intravesical chemotherapy， immunotherapy， and radical cystectomy， are effective， whereas the high recurrence rate still plagues both doctors and patients. Among the classical signaling pathways involved in the formation and progression of bladder cancer， the phosphatidylinositol 3-kinase （PI3K）/protein kinase B （Akt） signaling pathway is a key one. Modern pharmacological studies have demonstrated that Chinese herbal medicines and their monomer components can alleviate the discomfort， prolong the survival， and improve the quality of life of the patients undergoing tumor treatment. The relevant literature in the past decade has revealed that flavonoids， terpenoids， polysaccharides， gambogic acids， bibenzyls， and alkaloids from Chinese herbal medicines regulate the PI3K/Akt signaling pathway to play a role in the proliferation， apoptosis， invasion， migration， drug resistance， and autophagy of bladder cancer cells， thereby exerting the activity against bladder cancer. Although some targets and the potential mechanisms of the monomer components in the treatment of bladder cancer have been clarified， the research on the monomer components is limited to in vitro cellular experiments and animal experiments. Researchers face the great challenge in the application of the monomer components from Chinese herbal medicines into clinical practice. We summarized the recent studies about the regulatory effects of monomer components from Chinese herbal medicines on the PI3K/Akt signaling pathway in bladder cancer， aiming to give insights into the research on the drug therapy of bladder cancer and the underlying mechanism.

Programmed Necrosis Inducers for Cancer Treatment / 中国医学科学院学报

Programmed necrosis,a mode of cell death independent of Caspase,is mainly mediated by receptor-interacting protein kinase-1 (RIPK1),receptor-interacting protein kinase-3 (RIPK3),and mixed lineage kinase domain-like protein (MLKL).Studies have demonstrated that programmed necrosis has the dual role of promoting and inhibiting tumor growth and thus we can control the development of tumor by regulating programmed necrosis.The drugs capable of inducing programmed necrosis show potential anti-tumor activity.In addition,inducing programmed necrosis is an effective way to overcome tumor resistance to apoptosis.This paper summarized the mechanisms of programmed necrosis and its relationship with tumors.We focused on the antitumor activity of programmed necrosis inducers including natural products,chemotherapeutic drugs,death receptor ligands,kinase inhibitors,inorganic salts,metal complexes,and metal nanoparticles.These agents will provide new therapeutic candidates for the treatment of tumors,especially the tumors acquiring resistance to apoptosis.

Comparison of surgical effects between extension and flexion type of distal radius fracture / 中国骨伤

OBJECTIVE@#To compare therapeutic effects of internal fixation with volar locking plate in treating extension and flexion type of distal radius fracture (DRF).@*METHODS@#From January 2015 to June 2018, 103 patients with DRF were retrospectively analyzed. According to original fracture displacement direction, patients were divided into extension fracture(Colles) group and flexion fracture (Smith) group. In Colles fracture group, there were 24 males and 44 females aged from 20 to 79 years old with an average of (59.0±13.4) years old;according to AO classification, 9 patients of type A2, 13 patients of type A3, 16 patientsof type C1, 17 patients of type C2 and 13 patients of type C3;the time from injury to operation ranged from 2 to 9 days with an average of (3.9±0.8) days. In Smith fracture group, there were 15 males and 20 females, aged from 27 to 87 years old with an average of (60.1±15.3) years old;according to AO classification, 4 patienst of A2, 7 patients of A3, 14 patients of C1, 5 patients of C2 and 5 patients of C3;the time from injury to operation ranged from 2 to 6 days with an average of (4.1±0.9) days. Operation time, fracture healing time and postoperative complications were recorded between two groups. Disabilities of arm, shoulder and hand (DASH) score at 6 and 8 weeks, 6 and 8 months were used to evaluate functional recovery of affected limbs during each follow up. Volar tilt, radial inclination and radius height were measured at 8 months after operation. Mayo score was measured at 8 months after operation to evaluate recovery of limb function.@*RESULTS@#All patients were followed up for 8 to 30 months with an average of (14.8±4.3) months, and no difference in follow up between two groups (@*CONCLUSION@#Patients with Colles fracture and Smith fracture could receive good reduction and fixation through volar locking plate. The radiographic parameters of both groups recovered satisfactorily after operation. Recovery of volar tilt of Smith fracture group is better than that of Colles fracture group, and early recovery function of Colles fracture group is better than that of Smith group, but there is no significant difference in long-term wrist joint function and incidence of postoperative complications between two groups.

Current status and influencing factors of attempted smoking among adolescents in Jiading District， Shanghai / 上海预防医学

Objective:To understand the current status of smoking attempt among adolescents in Jiading District of Shanghai and to explore the influencing factors so as to provide suggestions for further intervention and control of tobacco smoking among adolescents. Methods:A total of 3 745 students from grade one to grade three from seven junior high school in Jiading District， Shanghai， were selected to participate in the survey by stratified cluster random sampling method. Anonymous internet questionnaire survey was conducted and the survey data， including main demographic information and smoking attempt， was analyzed by binary logistic regression test. Smoking attempt was defined as the teenagers had smoked at least one puff prior to the time of questionnaire survey. Results:A total of 3 630 valid questionnaires were collected and the rate was 96.9%（3 630/3 745）. Overall 4.4%（158/3 630） of participants had smoking attempt. The results of binary logistic regression test showed that compared with women， men had higher risk of attempted smoking （P<0.05）. Compared with registered residence in Shanghai， the risk of smoking behavior was higher among adolescents who were not registered residence in Shanghai （P<0.05）. Smoking behavior among family members， classmates and friends were risk factors for adolescents to attempt smoking （P<0.05）. When the number of family smoker was higher than 2， the risk of young students trying to smoke was significantly higher （P<0.05）. Compared with the students who believed smoking was harmful to adolescents' health， it was a risk factor for those who considered trying to smoke might be harmful or harmless to try smoking （P<0.05）. Conclusion:Smoking control in Jiading District schools has achieved some success， and the proportion of teenagers trying to smoke is low. However， further enhancement of smoking control among young people is still in need and we should devote more attention on male adolescents with non-Shanghai residence registration， and family smoke-free environment.

The surveillance of foodborne diseases in a district of Shanghai from 2014 through 2018 / 上海预防医学

Objective:To determine the incidence of foodborne diseases in a district of Shanghai from 2014 through 2018 and characterize the epidemiology of foodborne diseases， and provide scientific evidence for the prevention and control of foodborne diseases. Methods:Using the National Foodborne Disease Surveillance and Reporting System， we collected the surveillance information of foodborne disease in the district from 2014 through 2018， and conducted a descriptive analysis of the surveillance results. Results:A total of 7 767 cases of foodborne diseases were identified in the district， Shanghai from 2014 through 2018， with the peak （30.56%） in July-August. The cases were likely to be aged 60-69 years （24.30%）， retired （45.68%）， and clerks （30.48%）. The places where suspicious food was consumed were mainly households （58.54%）. The suspected food was principally aquatic animals and their products （39.09%）， followed by multiple food （20.92%）， meat and meat products （11.82%）. A total of 1 904 cases with foodborne diseases were examined for pathogens， in which 473 tested positive （positive rate 24.84%）， including norovirus （n=145，19.91%）， diarrhea-causing Escherichia coli （n=211，11.08%）， Vibrio parahaemolyticus （n=83，4.36%）， Salmonella （n=59，3.10%）， campylobacter （n=4，0.21%）， and Shigella （n=2，0.11%）. Conclusion:Summer is the incidence peak of foodborne diseases in the district. Senior people aged 60-69 years have the highest incidence. Dining venues are mainly households and restaurants. Suspected food is mainly aquatic products and their products， multiple food， and meat and meat products. Predominant pathogens are norovirus， diarrhea-causing Escherichia coli， and V. paraheamolyticus.

Risk factors for endotracheal intubation during resuscitation in the delivery room among very preterm infants / 中国当代儿科杂志

OBJECTIVE@#To explore the risk factors for endotracheal intubation during resuscitation in the delivery room among very preterm infants.@*METHODS@#A retrospective analysis was performed for 455 very preterm infants who were admitted to the neonatal intensive care unit from January 2017 to December 2019. They were divided into an intubation group (@*RESULTS@#The intubation rate was 17.4% (79/455). Compared with the intubation group, the non-intubation group had significantly higher gestational age, birth weight, and rates of caesarean birth, delayed cord clamping (DCC), resuscitation quality improvement, regular use of antenatal glucocorticoids in mothers and premature rupture of membranes > 18 hours (@*CONCLUSIONS@#Very preterm infants with younger gestational age, birth weight < 750 g, maternal diabetes mellitus, placenta previa or placenta previa status may have a higher risk for endotracheal intubation after birth. The regular use of antenatal glucocorticoids and DCC can reduce the risk of intubation during resuscitation in very preterm infants.

Sanitation status of centralized air ventilation system of public places in Putuo District, Shanghai, 2014-2018 / 上海预防医学

Objective To investigate the sanitation status of centralized air ventilation system in Putuo District of Shanghai, to analyze correlation between different indexes and to provide basis for improving the health status of public places and strengthening health supervision. Methods According to the requirements of WS 394-2012 The Sanitation Criterion of the Centralized Air Ventilation System in Public Places, 18 centralized air ventilation systems in public places in Putuo District of Shanghai were randomly selected for sampling, testing and evaluation during 2014-2018, and 9 indexes of air supply, inner surface of air duct and indoor air were analyzed for correlation. Results The overall qualified rate of centralized air ventilation system in 10 hotels, 4 restaurants and 4 supermarkets was 86.0%.The over standard rate of PM10, bacteria and fungi in air supply was 3.4%, 31.8% and 33.0%, respectively, but β-hemolytic streptococcus was not detected.The dust amount and microbial index on the inner surface of the air duct were up to standard.Another two indexes of fresh air quantity and Legionella pneumophila were tested in the hotel.The qualified rate of fresh air quantity was 25.6%, the positive rate of Legionella pneumophila type 1(LP1) in cooling water was 30.0%, and no Legionella pneumophila was detected in condensate water.The correlation analysis of 9 indexes showed that there was a significant positive correlation between PM10 in air supply and in indoor air; the amount of microbial pollution on the inner surface of air duct and in air supply; and the amount of microbial pollution in air supply and in indoor air. Conclusions In Putuo District, the general sanitary condition of the centralized air ventilation system in public places is not to be optimistic.The qualified rate of bacteria and fungi in the air supply and fresh air quantity is low, and Legionella pneumophila was detected.The indoor air quality can be improved by installing efficient air purification device and regular cleaning and disinfection.

Current status of tobacco control in public places in Jiading District of Shanghai / 上海预防医学

Objective To investigate the current status of tobacco control in public places in Jiading District, after the introduction of "Tobacco Control Regulation in Public Places of Shanghai" (amendment), providing basic data for further implementing regulations. Methods The method of field observation was adopted to conduct the monitoring in 14 representative public places, including site staff in 109 places in April and September. Results The display rate of tobacco control propaganda increased(χ2=10.588, P < 0.001), but the posting rate of pictures for smoking control warnings decreased(χ2=6.272, P=0.012);the differences between two monitoring results were both statistically significant; the smoking rate in the staff within the workplaces decreased to 5.17%(χ2=20.973, P < 0.05);the differences between two monitoring results were both statistically significant. Conclusion The situation of tobacco control in Jiading District public places is good, but in some places smoking control should be further strengthened, and the intensity of tobacco control in public places should be maintained.

Current status of tobacco control in public places in Jiading District of Shanghai / 上海预防医学

Objective To investigate the current status of tobacco control in public places in Jiading District, after the introduction of "Tobacco Control Regulation in Public Places of Shanghai" (amendment), providing basic data for further implementing regulations. Methods The method of field observation was adopted to conduct the monitoring in 14 representative public places, including site staff in 109 places in April and September. Results The display rate of tobacco control propaganda increased(χ2=10.588, P < 0.001), but the posting rate of pictures for smoking control warnings decreased(χ2=6.272, P=0.012);the differences between two monitoring results were both statistically significant; the smoking rate in the staff within the workplaces decreased to 5.17%(χ2=20.973, P < 0.05);the differences between two monitoring results were both statistically significant. Conclusion The situation of tobacco control in Jiading District public places is good, but in some places smoking control should be further strengthened, and the intensity of tobacco control in public places should be maintained.

miR-214 promotes the progression of liver fibrosis by activating hepatic stellate cells / 上海交通大学学报（医学版）

Objective • To explore the biological role of miR-214 in the activation of hepatic stellate cells (HSCs) and the procession of liver fibrosis and its possible mechanism. Methods • Quantitative real-time PCR (qPCR) was used to detect the expression of miR-214 in the activation of HSCs and the progression of liver fibrosis in rats induced by CCl4 (liver fibrosis model). HSC-T6 cells were treated with lentivirus infection and divided into miR-214 overexpression group, miR-214 knockout group and negative control lentivirus group (mock group). qPCR and Western blotting were used to detect the gene and protein expression levels of collagen type 1 (COL1) and α-smooth muscle actin (α-SMA) in the three groups, respectively. Transwell assay and flow cytometry were used to detect the migration and apoptosis of HSCs in the three groups, respectively. Double luciferase reporter gene assay was used to detect weather Hif1an was the target gene of miR-214, and then qPCR and Western blotting were used to detect the expression levels of HIF1AN in the three groups, the activation of HSCs and the liver fibrosis model. Results • miR-214 was upregulated during HSCs activation and the progression of liver fibrosis (both P<0.05). Compared with the mock group, the gene and protein expressions of COL1 and α-SMA in the miR-214 overexpression group were increased, and HSCs migration ability was increased and apoptosis rate was decreased (all P<0.05); the expressions of COL1 and α-SMA in the miR- 214 knockdown group were decreased, and HSCs migration ability was decreased (all P<0.05). Double luciferase reporter gene assay showed that Hif1an was the target gene of miR-214. Compared with the mock group, the gene and protein expressions of HIF1AN in the miR-214 overexpression group were decreased (both P<0.05), and those in the miR-214 knockdown group were increased (both P<0.05). The expression of HIF1AN was decreased during HSCs activation and the progression of liver fibrosis (all P<0.05). Conclusion • miR-214 may promote the migration and activation of HSCs by targeting Hif1an, and then promote the progression of liver fibrosis, suggesting that miR-214 may be a new marker and potential target for the treatment of liver fibrosis.

Resuscitation quality improvement and its outcomes in very low birth weight infants from 2017 to 2019 / 中华围产医学杂志

Objective:To understand quality improvement (QI) in resuscitation and its impacts on the outcomes in very low birth weight infants (VLBWI).Methods:This was a retrospective study involving 318 cases of VLBWI born in Chongqing Health Center for Women and Children and transferred to the Neonatal Intensive Care Unit (NICU) in the same hospital from January 1, 2017 to December 31, 2019. All recruited VLBWIs were divided into three groups based on chronological order: pre-QI group (born in 2017, n=83), under-QI group (born in 2018, n=102) and post-QI group (born in 2019, n=133). The implementation and effects of different resuscitation strategies, including body temperature management, delayed cord clamping (DCC), respiratory support [continuous positive airway pressure (CPAP) in the delivery room, positive pressure ventilation or tracheal intubation] and oxygen therapy [initial fraction of inspired oxygen (FiO 2), maximum FiO 2 and pure oxygen resuscitation], and the neonatal outcomes in each year were analyzed and compared by trend Chi-square test, Kruskal-Wallis H test, Wilcoxon rank-sum test, analysis of variance and LSD test. Results:(1) The proportion of antenatal steroid exposure increased gradually during the three years [44.6% (37/83), 47.1% (48/102), 72.2% (96/133); χ2trend=18.218, P<0.001]. (2) From 2017 to 2019, the incidence of hypothermia on admission decreased [100.0% (83/83), 90.2% (92/102), 33.8% (45/133); χ2trend=136.042, P<0.001], without increasing the proportion of hyperthermia [0.0% (0/83), 1.0% (1/102), 0.0% (0/133); χ2trend=2.124, P=0.346]. (3) The proportion of VLBWIs receiving DCC increased annually [0.0% (0/83), 29.4% (30/102), 90.2% (120/133); χ2trend=178.659, P<0.001], and the concentration of capillary hemoglobin within 12-24 h after birth also increased [(190.1±34.8), (202.0±29.7), (213.6±32.3) g/L; LSD test, P<0.05]. The incidence of suspected polycythemia (capillary hematocrit >68%) increased annually[7.2%(6/83), 7.8%(8/102), 17.3(23/133); χ2trend=5.825, P=0.016]; While the incidence of confirmed polycythemia (venous hematocrit >65%) was not increased[1.3%(1/80), 2.0%(2/100), 4.8%(6/126); χ2trend=2.333, P=0.127] after excluding those untested cases. (4) The use of CPAP in delivery room increased annually [0.0% (0/83), 28.4% (29/102), 87.2%(116/133); χ2trend=167.721, P<0.001], while that of positive pressure ventilation [44.6% (37/83), 31.9% (32/102), 28.6% (38/133); χ2trend=5.371, P=0.020], and the proportion of intubation within 1 min after birth [100.0% (31/31), 45.0% (9/20), 35.0%(7/20); χ2trend=37.467, P<0.001] and overall intubation [37.3% (31/83), 19.6% (20/102), 15.0% (20/133); χ2trend=13.566, P<0.001] decreased year by year. There was no difference in the percentage of infants receiving chest compression or epinephrine, or with low Apgar scores during the three years (all P>0.05). (5) The initial inhaled FiO 2 [30%(21%-100%), 30%(21%-100%) vs 40(25%-100%)] as well as the highest FiO 2 [40%(21%-100%), 30%(21%-100%) vs 40%(25%-100%)] were significantly lower in 2018 and 2019 than in 2017(all P<0.017). The proportion of infants receiving pure oxygen resuscitation decreased year by year [13.3% (11/83), 1.0% (1/102), 0.8% (1/133); χ2trend=17.719, P<0.001]. There was no statistical difference in radial artery blood gas analysis, the proportion of infants receiving pulmonary surfactant or mechanical ventilation, the highest value of percutaneous bilirubin, the incidence of hyperbilirubinemia, necrotizing enterocolitis, periventricular intraventricular hemorrhage, bronchopulmonary dysplasia, or mortality during hospitalization (all P>0.05). Conclusions:Resuscitation QI program helps reduce the incidence of hypothermia, increased the hemoglobin level after birth, and lessen the use of positive pressure ventilation and tracheal intubation in VLBWIs, without influencing the resuscitation effect or increasing the risk of short-term adverse outcomes.

Expression of long-chain non-coding RNA CTA-796E4.4 in bladder cancer and its effect on cell proliferation and invasion / 中国医师进修杂志

Objective:To investigate the expression of long-chain noncoding RNA (lncRNA) CTA-796E4.4 in bladder cancer tissues and cell lines, and to observe its effect on the proliferation and invasion of bladder cancer cells and to explore its possible molecular mechanism.Methods:The expression of CTA-796E4.4 in 73 bladder cancer tissues and adjacent tissues, 4 kinds of bladder cancer cell lines (UM-UC-3, BIU-87, 5637, T24) and normal bladder epithelial cells in the First People′s Hospital of Tianmen City from November 2016 to January 2019 were detected by qPCR. UM-UC-3 cells infected with recombinant lentivirus (LV-CTA-796E4.4) carrying the CTA-796E4.4 gene were taken as an experimental group, and UM-UC-3 cells infected with negative control lentivirus (LV-NC) were as a control group. The effect of over expression of CTA-796E4.4 on the expression of Forkhead box transcription factor O1 (FOXO1) mRNA was detected by qPCR. The expression of FOXO1 protein was detected by Western blotting, Thiazolyl blue (MTT) method Transwell invasion assay was respectively used to examine the effect of high expression of CTA-796E4.4 on proliferation and invasion of UM-UC-3 cells.Results:The expression level of CTA-796E4.4 in bladder cancer tissue was lower than that in para cancerous tissue (1.22 ± 0.33 vs. 4.30 ± 0.64) and the difference was statistically significant ( P < 0.01). The expression of CTA-796E4.4 in bladder cancer cells was lower than that in bladder cancer epithelial cells (0.11 ± 0.03, 0.61 ± 0.03, 0.33 ± 0.03, 0.73 ± 0.04 vs.1.01 ± 0.10) ( P < 0.01). After LV-CTA-796E4.4 infection, the expression of CTA-796E4.4 was significantly increased ( P < 0.01) and the expression of FOXO1 gene was increased ( P < 0.01). High expression of CTA-796E4.4 significantly inhibited cell proliferation and invasion of UM-UC-3 cells ( P < 0.05). Conclusions:The expression of lncRNA CTA-796E4.4 is decreased in bladder cancer and cell lines. High expression of CTA-796E4.4 inhibites the proliferation and invasion of UM-UC-3 cells. The molecular mechanism may be that up-regulation of CTA-796E4.4 can promote the expression of FOXO1.