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Objective:To analyze the clinical features, treatment, and outcomes of fetal/neonatal atrial flutter (AFL) at the onset of the perinatal period to improve the management of this condition.Methods:This retrospective study analyzed the clinical data, treatment, and follow-up results of fetal/neonatal AFL cases transferred to Shanghai Children's Medical Center from November 2013 to August 2021. Clinical characteristics, cardioversion procedures, and outcomes were summarized. Descriptive method was used for statistical analysis.Results:A total of 21 fetuses/neonates presenting with AFL in the perinatal period were involved in this study, including 17 males and four females. Ten of them were born at full term, and 11 were preterms. All of the patients were delivered by cesarean section at 32 to 41 gestational weeks [ (36.6±1.9) weeks] with a birth weight of 2 130 to 4 450g [ (3 059±528) g]. Increased fetal heart rate was all detected after 32 weeks of gestation, and three of them were diagnosed with AFL by fetal echocardiography before being born. The heart rate remained elevated in all cases after birth. All were diagnosed as AFL based on an electrocardiogram on the day of birth, which showed a 2 to 6 over one ratio of atrioventricular conduction. Among the six cases of cardiac insufficiency and low blood pressure complicated by dyspnea and cyanosis, the symptoms were relieved in four cases after mask oxygenation and two cases after ventilation. Among the 21 cases, one was converted spontaneously to normal sinus rhythm and the other 20 recovered after medication or electrical cardioversion. Seven cases were initially treated by drug conversion with a success rate of 5/7 and hospitalized for 23 d (13-25 d). There was one with cardiac insufficiency before treatment and three newly developed cardiac insufficiency during treatment among the seven cases. Thirteen cases were offered electrical cardioversion initially, and the success rate of cardioversion was 12/13. There were five cases of cardiac insufficiency before treatment, while no new cases of cardiac insufficiency was reported during treatment. The duration of hospitalization was 11 d (9-14 d). Apart from one case, the rest 20 infants were followed up from one month to eight years old, and no recurrence was reported.Conclusions:For fetal/neonatal AFL with the onset during the perinatal period, the symptoms mainly manifest in late pregnancy. Its diagnosis depends on fetal echocardiography before birth or electrocardiogram after birth, and electrical cardioversion is a fast and effective measure. While the prognosis of perinatal-onset AFL is generally good.
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Objective:To study the clinical characteristics of neonatal community-acquired Novel Coronavirus (COVID-19) Omicron variant infection.Methods:From March 30 to May 15, 2022, the epidemiological characteristics, clinical manifestations and outcomes of neonatal cases of community-acquired COVID-19 Omicron variant infection admitted to the isolation ward of our hospital were analyzed.Results:A total of 7 neonates infected with community-acquired COVID-19 Omicron variant were treated, including 3 males and 4 females. All of them were term infants with clear epidemiological exposure history. The infection was originated from caregivers of close contact (parents or babysitters). The main clinical symptoms was upper respiratory tract infection, including fever (6 cases), nasal congestion (6 cases), cough (5 cases), runny nose (2 cases), poor appetite (2 cases) and diarrhea (1 case). On admission, no abnormalities were found in blood routine examination and C-reactive protein (CRP). All but one case had normal serum amyloid A (SAA). No obvious abnormalities were found on chest X-ray. All patients were isolated in single-patient rooms after admission. They received standard symptomatic treatment and regular nucleic acid tests. The first negative nucleic acid results came on median 17 d(8~26 d) after the onset of the disease. The patients were discharged after two consecutive (24 h apart) nucleic acid tests with CT value ≥35 and continued health-monitor at home. On discharge, 5 patients had nasal congestion and 2 of them had cough. During the follow-up 4~6 weeks after discharge, all patients gradually recovered without positive nucleic acid results.Conclusions:All 7 neonates with community-acquired COVID-19 Omicron variant infection have epidemiological exposure history. The main clinical symptoms are long-lasting upper respiratory tract infections. It takes a relatively long time for the nucleic acid to turn negative, however, the overall short-term prognosis is good.
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Objective:To study the predictive value of hour-specific total serum bilirubin(TSB) nomogram combined with clinical risk factors in the risk of hyperbilirubinemia.Method:Perinatal clinical data of newborns born in Shanghai Pudong New Area Health Care Hospital for Women and Children, Shanghai Pudong New Area People's Hospital and Shanghai Pudong Hospital from August 2017 to July 2018 were collected in this prospective study. Transcutaneous bilirubin (TcB) was monitored before discharge from hospital. Enrolled neonates were followed up for 28 days. The patients were assigned to neonatal hyperbilirubinemia group (NHB) and non-hyperbilirubinemia group (Non-HB) according to the occurrence of hyperbilirubinemia. The predictive value of models for the risk of hyperbilirubinemia was evaluated by receiver operating characteristic (ROC) curves and Logistic regression analysis.Result:A total of 8 664 newborns were included in this study, with 1 196 cases of hyperbilirubinemia, with an incidence of 13.8%. Logistic regression analysis showed that maternal blood type O, premature rupture of membranes, male gender, gestational age 35~37 weeks, subcutaneous ecchymosis/cranial edema, and breastfeeding were independent risk factors for NHB ( P<0.05). The area under receiver operative characteristic curve (ROC) of predischarge bilirubin risk zone only was 0.874(95% CI 0.861~0.885, P<0.05)and for all independent risk factors was 0.664 (95% CI 0.647~0.680, P<0.05). The area under ROC curve was 0.891 (95% CI 0.880~0.902, P<0.05) by combining predischarge bilirubin risk zone with clinical risk factors. Conclusion:Predischarge bilirubin risk zone combined with clinical risk factors can reasonably predict neonatal hyperbilirubinemia well.
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Objective:To evaluate intestinal stenting in patients of left colon cancer complicated with acute intestinal obstruction and analyze its short-term and long-term efficacy.Methods:Sixty patients who suffered from left colon cancer complicated with acute intestinal obstruction at the First Department of General surgery, Chengdu Second People's Hospital from Sep 2016 to Sep 2019 were retrospectively enrolled. According to treatment methods, the patients were divided into the stent implantation staged surgery group (24 patients ) and the control group receiving emergency surgery (36 patients).Results:There was no significant difference in perioperative course between the two groups. There was no significant difference in three year overall survival rate or recurrence and metastasis rate between the two groups. Preoperative bowel preparation rate in stent implantation group was obviously higher than the control group (100% vs. 44%, P=0.000). The laparoscopic surgery rate of the stent implantation group was higher than the control group (21% vs. 0, χ2=9.857， P=0.002). The enterostomy rate of the stent implantation group was lower than the control group (0 vs. 19%, χ2=10.237， P=0.005). There was a higher rate of one-stage excision and anastomosis in the stent implantation group than in the control group (100% vs. 81%, χ2=7.760， P=0.005).There was a higher lymph nodes deissection rate in the stent implantation group than in the control group, [11(7-14) vs. 6(3-10), Z=-2.672， P=0.006]. Conclusions:For patients who suffered from left colon cancer complicated with acute intestinal obstruction, the intestinal stent can improve the bowel preparation to a greater extent, which can increase the proportion of one-stage anastomosis and reduce enterostomy rate.
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Human milk plays an irreplaceable role in nutrition, immune promotion and psychological development of infants.And it can also decrease the risk of infectious disease, overweight/obesity, diabetes and other diseases.Therefore, the guidelines of various countries advocate that human milk is the optimal choice for infants.However, cases of food allergy in infants fed with human milk are common in clinical practice.Some studies have found that there are some active food antigens in human milk, which can stimulate immune responses and cause allergic symptoms in infants.At present, the mechanism of food allergy in infants fed with human milk is not clear, and this paper is to review the progress in this field in recent years.
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Objective To study the clinical features,diagnosis,genetic characteristics and treatment of congenital disorder of glycosylation type Ⅰg (CDG-Ⅰg) and to raise the awareness of CDG-Ⅰg among the clinicians.Method The data of one child with CDG-Ⅰg admitted to Shanghai Children's Medical Center affiliated to Shanghai Jiaotong University School of Medicine was studied retrospectively.Literatures were retrieved with key words including "congenital glycosylation disorder Ⅰg","ALG12","congenital glycosylation defect Ⅰg","CDG-Ⅰg" and "congenital disorder" in the Chinese knowledge network,VP database,Wanfang database,Biomedicine,PubMed and the Web of Science database from data established until January 2018.We summarized the clinical and genetic characteristics of CDG-Ⅰg.Result An one-day-old male infant admitted to the Hospital due to "poor response with hypoglycemia" manifested with facial deformity,hypotonia,inverted nipples,micropenis and undescended testes.He had intermittent hypoglycemia and recurrent infection,treated with antimicrobials,glucose rehydration and hormone therapy.Serum insulin,growth hormone level,blood and urine metabolic screening were normal.The patient was compound heterozygous for ALG12 mutations,c.432C ＞ A,p.Cys144 * and c.904T ＞ C,p.Tyr302His,each of his parents carried a pathogenic mutation.The patient died in follow-up for unknown reasons.No reported cases of CDG-Ⅰg from China have so far been reported yet.We reviewed the other 8 cases CDG-Ⅰg (4 males and 4 females) born in foreign countries,5 of them with neonatal onset.Common clinical manifestaions include facial deformity,hypotonia,hypogenitalism,coagulopathy,hypoimmunity,recurrent infection,electroyte imbalance etc.The ALG12 gene has 11 mutation sites.Conclusion CDG-Ⅰg is a rare autosomal recessive disorder.Most reported patients had onset in neonatal period.It seems that the association of facial deformity,psychomotor retardation,hypotonia,coagulopathy,male hypogenitalism and hypoglycemia might be a clue to the diagnosis of CDG-Ⅰg.Gene detection of ALG12 can confirm the diagnosis.This disorder has no specific treatment yet.
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Objective To study the content variation of selegiline and its metabolites in urine, and based on actual cases, to explore the feasibility for the identification of methamphetamine abuse and selegiline use by chiral analysis. Methods The urine samples were tested by chiral separation and LC-MS/MS method using CHIROBIOTICTM V2 chiral liquid chromatography column. The chiral analysis of metham-phetamine and amphetamine were performed on the urine samples from volunteers of selegiline use and drug addicts whom suspected taking selegiline. Results After 5 mg oral administration, the positive test time of selegiline in urine was less than 7 h. The mass concentrations of R(-)-methamphetamine and R(-)-amphetamine in urine peaked at 7 h which were 0.86μg/mL and 0.18μg/mL and couldn't be de-tected after 80 h and 168 h, respectively. The sources of methamphetamine and amphetamine in the urine from the drug addicts whom suspected taking selegiline were analysed successfully by present method. Conclusion The chiral analysis of methamphetamine and amphetamine, and the determination of selegi-line's metabolites can be used to distinguish methamphetamine abuse from selegiline use.
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Objective To study the clinical characteristics and current treatment options of neonatal congenital portosystemic shunt (CPSS).Method A newborn infant diagnosed with CPSS complicated with iliac artery-umbilical vein fistula was studied.CNKI,VIP,WanFang and Pubmed databases were searched using CPSS and Abernethy malformation as keywords.A total of 8 papers on neonatal CPSS were retrieved from 2006 to 2016.Result The case treated in our hospital was a boy with symptom of dyspnea and cyanosis.His ultrasound cardiograph showed pulmonary hypertension,and the heart and abdominal CT scan showed portosystemic shunt,dilated portal vein and umbilical vein,patent ductus venosus (PDV) and iliac artery-umbilical vein fistula.A total of 25 patients were analyzed including our patient and 24 cases reported in 8 papers.Cases of intrahepatic shunt (n =22) were nore common than extrahepatic shunt (n =3),and most cases could be diagnosed with ultrasound.Congenital heart diseases,intrauterine growth retardation,cutaneous hemangioma were common complications of CPSS.Abnormal liver function (52.0％),hyperammonemia (28.0％),pulmonary arterial hypertension (12.0％),dyspnea (12.0％) were common clinical manifestations of neonatal CPSS.Most CPSS cases were treated non-operatively during neonatal periods,and in 40.0％ of cases the shunts were closed spontaneously,but mortality was 20.0％ among previous cases.Conclusion Abnormal hepatic function is the most common clinical symptom of neonatal CPSS.Cases of extrahepatic shunts and complicated with PDV are dangerous and operation should be done as soon as possible,meanwhile complications should be treated appropriately.
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Objective To establish a UPLC-MS/MS method for the determination of aztreonam and metronidazole in blood.Methods Cefradine and chloramphenicol were used as the internal standard.Blood sample was made by protein precipitation with acetonitrile,and then was seprated by HPLC.Multiple reaction monitoring mode (MRM) for the parent ion and ion monitoring was used for each compound.Results The linearity of aztreonam in the range from 10 to 5 000 ng/mL and metronidazole in the range from 1 to 1 000 ng/mL were good (r＞0.995).The quantification limit of the method for aztreonam and metronidazole were 5 and 0.5 ng/mL,respectively (S/N =3 ∶ 1).The inter-day and intra-day relative standard deviations (RSD) were less than 10 ％.The established method was used to detect aztreonam and metronidazole in a medical dispute case,the concentrations of aztreonam and metronidazole in the blood were 438 ng/mL and 15 μg/mL,respectively.Conclusions The method developed in the study is simple,sensitive and reproducible with its successful application into the qualitative and quantitative analysis of aztreonam and metronidazole.
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Objective To explore the differential diagnosis of hydrops fetalis and the rare presentations of neonatal congenital hypothyroidism. Methods The data of one congenital hypothyroidism diagnosed neonate with hydrops fetalis leading to birth asphyxia and respiratory failure were retrospectively analyzed. The relevant literatures were reviewed. Results A Uyghur female infant by cesarean delivery at gestational age of 38+5 week for intrauterine distress, presented general edema with cyanosis and dyspnea after birth. Trachea cannula was used to assist ventilation. At one-day old, the thyroid function examination showed that the serum thyroid stimulating hormone was>100 mU/L and the free thyroid was 6 . 56 pmol/L. Moreover, ultrasonographic examination indicated the thyroid aplasia. The clinical symptoms were improved after the treatment with the levothyroxine tablets replacement, and breathing machine was removed at 8-day old. The dosage of drug was adjusted by clinical manifestation and laboratory monitoring. The patient was discharged at 18-day old with the medicine and was followed-up. Conclusions Congenital hypothyroidism can be the pathogenesis of hydrops fetalis and its differential diagnosis should be paid attention.
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Objective To analyze the real world status of traditional known cardiovascular risk factors in patients with coronary heart disease ( CHD ) .Methods 6040 in-hospital patients with CHD or suspected CHD undergoing angiography from 01/01/2013 to 02/28/2015 were retrospectively analyzed . According to angiography result , patients with severe coronary artery lesion and undergoing percutaneous coronary intervention (PCI) were enrolled in the PCI group (n=2808) and patients without severe coronary artery lesion and not undergoing PCI or CABG were enrolled in the No-PCI/CABG group (n=3232).Patients in the PCI group were further divided into 3 subgroups which were STEMI group , NSTEMI/UA group and stable angina (SA) group.Results (1) Compared with the No-PCI/CABG group, patients in the PCI group have higher ratio of male patients (75.4% vs.53.1%, P<0.0001), older average age (64.83 ±0.20 vs. 63.39 ±0.18 years old , P <0.0001 ) , and higher existing rates of traditional risk factors including hypertension (66.7%vs.54.7%, P<0.0001 ) , diabetes/impaired glucose tolerance ( IGT ) ( 37.0% vs. 20.8%, P<0.0001), stroke(7.0%vs.5.4%,P=0.0098)and chronic kidney disease (CKD) (4.3%vs. 2.8%, P=0.001 ) , but there was no statistic difference in existing rates of dyslipidemia between the two groups.(2)In the PCI group,female patients had higher prevalence of hypertension (74.1%vs.64.3%, P<0.001), diabetes/IGT (42.5%vs.35.3%, P=0.0007) and stroke (9.4%vs.6.2%, P=0.0054) than the male patients.There were no significant sex difference in these comorbidities as above in No-PCI/CABG group.Female patients had higher prevalence of dyslipidemia than male patients in both PCI and No -PCI/CABG groups.(3) Among all the 3 PCI subgroups, STEMI patients presented with youngest average age (62.54 ±0.45 vs.65.15 ±0.28 vs.66.17 ±0.34 years old, P<0.0001) and highest male patient ratio (83.9%vs.72.9% vs.72.3%, P<0.0001).Patients in the SA subgroup had the highest prevalence of hypertension and prior revascularization including PCI and CABG .Patients in the NSTEMI/UA subgroup had the highest rates of diabetes/IGT.No significant differences were observed in the prevalence of dyslipidemia , CKD and stroke among all the subgroups .Conclusions Hypertension and diabetes are the leading risk factors of coronary artery disease , and prior revascularization is also an important cause of stable angina and NSTEMI /UA undergoing PCI.Patients requiring PCI were found to be more of male gendor , but female patients has higher prevalence of traditional cardiovascular risk factors including hypertension , diabetes/IGT or stroke than male patients.
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Objective To analyze the risk factors associated with allergic disease in preterm infants during the first year of life. To investigate whether there was any association between peripheral blood eosinophils and allergic di-sease during the first year of life benefit of hydrolyzed formula feeding in preterm infants. Methods A nested case -control study was conducted in a cohort of artificial feeding preterm infants admitted to Neonatal Intensive Care Unit, Shanghai Children's Medical Center from January 2012 to April 2013. The preterm infants were monitored from birth up to 1 year of age and the findings were related to development of allergic disease. Individuals with allergic disease during the first year of life(cases)were matched with gender,as previously described with two individuals(controls)who re-mained event - free during the study. The risk factors associated with allergic disease in preterm infants during the first year of life were analyzed. And whether there was any association between peripheral blood eosinophils and allergic di-sease during the first year of life benefit of a hydrolyzed formula feeding in preterm infants was investigated. Different variables in control and case individuals were compared with t test for normal distribution measurement date,χ2 tests for categorical variables and Mann - Whitney U test for non - normal distribution measurement date,and multiple conditio-nal Logistic regression were used to investigate the risk factors associated with allergic disease in preterm infants. Results Thirty - four individuals were in cases and 68 individuals were in controls. In a conditional multivariable Logistic model,peripheral blood eosinophils of preterm infants at full enteral feeding(EOS - 2)(OR = 5. 941,95% CI:1. 165 - 41. 375,P ﹤ 0. 05),and family history of allergy(OR = 3. 316,95% CI:1. 201 - 9. 152,P ﹤ 0. 05)were the two independent risk factors for allergic disease in preterm infants during the first year of life. Individuals fed with standard preterm formula after birth,the association between EOS - 2 and allergic disease was significantly enhanced (OR = 21. 459,95% CI:1. 686 - 273. 152,P ﹤ 0. 05). By contrast,in individuals fed with hydrolyzed formula,the risk of EOS - 2 was substantially attenuated(OR = 1. 708,95% CI:0. 148 - 19. 743,P ﹥ 0. 05). Conclusions Peripheral blood eosinophils of preterm infants at full enteral feeding EOS - 2 and family history of allergy were the 2 independent risk factors for allergic disease in preterm infants during the first year of life. Contrast to individuals fed with standard preterm formula after birth,individuals fed with hydrolyzed formula had lower association between factors of peripheral blood eosinophils and family history of allergy,and allergic disease during the first year of life.
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Objective To explore the impacts of enriched environment(EE),which has different initiation time points and intensity,on the neural and ethological prognosis and contents of myelin basic protein(MBP)of neo-natal rats with hypoxic - ischemic brain damage(HIBD). Methods HIBD rat models were established. Rats were divided into the early,the intermediate and the late intervention groups,which experienced EE from 7,14 and 21 days after HIBD for 14 days. The early and intermediate intervention groups were then divided into 6 - h and 24 - h groups, which experienced EE intervention for 6 hours or 24 hours respectively each day. Trapeze tests and water maze tests were carried out to detect the neural and ethological prognosis. Immunohistochemical method was used to detect MBP of the brain white matter,and the percentages of positive cells with MBP were detected by an image analyzer. The con-tents of MBP were measured. Results The trapeze test scores of the early and intermediate sham operation group,HI group,early 6 - h and 24 - h EE groups and the intermediate 6 - h and 24 - h EE groups,the late sham operation group,the late HI and late EE intervention group were(4. 05 ± 0. 88)scores,(2. 35 ± 1. 02)scores,(3. 67 ± 1. 12) scores,(3. 50 ± 1. 41)scores,(3. 50 ± 0. 93)scores,(3. 56 ± 1. 13)scores,(4. 00 ± 0. 89)scores,(2. 17 ± 1. 17)scores,(3. 50 ± 0. 92)scores,respectively. The trapeze test scores of early,intermediate and late EE groups were higher than those of the HI groups in the same period. There was no significant difference between the early,the intermediate 6 - h EE groups and 24 - h EE groups. Scores of water maze of each corresponding group were(40. 68 ± 23. 77)seconds,(56. 66 ± 10. 96)seconds,(46. 49 ± 19. 27)seconds,(51. 72 ± 20. 46)seconds,(38. 20 ± 18. 36)seconds,(47. 96 ± 20. 65)seconds,(38. 63 ± 20. 44)seconds,(59. 66 ± 13. 81)seconds and(45. 93 ± 22. 45)seconds,respectively. The water maze scores of the early,the intermediate 6 - h EE group and the late 24 -h EE groups were higher than those of the HI groups in the same period. There was no significant difference between the early,the intermediate 6 - h EE groups and the 24 - h EE groups. The relative abundance of MBP of the early and intermediate and the late HI groups were 6. 32 ± 1. 63 and 6. 74 ± 2. 19,and significantly less than that of the sham groups in the same periods,which were 9. 09 ± 1. 69 and 9. 37 ± 2. 46. The relative abundance of MBP of early 6 - h and 24 - h groups,the intermediate 6 - h and 24 - h groups and the late EE group was 7. 84 ± 2. 51,8. 05 ± 1. 86, 8. 89 ± 2. 29,8. 48 ± 2. 67 and 7. 98 ± 2. 09,respectively,which was significantly higher than that of the HI groups in the same periods. It showed that the neural and ethological prognosis of neonatal rats with HIBD could be improved,no matter the intervention began in the early,the intermediate or the late periods,or the intervention time was 6 hours or 24 hours each day. And relative abundance of MBP in the white matter increased with EE. Conclusions EE interven-tion has a long window stage for young rats. EE intervention could improve the neural and ethological prognosis of rats with HIBD. EE intervention could elevate the contents of MBP in the white matter,which could be one of the mecha-nisms for EE to improve the neural and ethological prognosis of rats with HIBD.
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Objective To explore the curative effect of ursodeoxycholi acid on retinopathy of prematurity (ROP) caused by high concentration of oxygen in newborn rats. Methods The model of ROP was established. Neonatal rats were divided into normal control group, ROP model group, low dose ursodeoxycholi acid treatment group (10mg/kg) and high dose ursodeoxycholi acid treatment group (40mg/kg). Rats were sacrificed at days 17. The new retinal vessels were observed and counted under lfuorescence microscope. Results The new retinal vessels in ROP rats were hyperplastic, twisted and unevenly distributed. There was signiifcant difference in the number of new retinal vessels among different groups (P=0.000). The number of new retinal vessels of rats in ROP group, low-dose group and high-dose group was signiifcantly more than that in control group (P=0.000). The number of new retinal vessels in low-dose group and high-dose group was significantly less than that in ROP group (P0.05). Conclusions Ursodeoxycholi acid could inhibit the angiogenesis of retina and could have curative effect on ROP.
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Objective To study the effect of breast milk on secretion of Ghrelin and Peptide YY (PYY)during different periods in SD rats.Methods Sprague-Dawley (SD) rats were randomly divided into breast milk-fed group(BG) and formula-artificial fed group(FG) with 20 in each group.After 21 days both of the 2 groups were fed by same forage.Ten of each group were experimentized in day 21 equivalently weaning period,and rest rats were experimentized at the 50th day equivalently childhood.Real-time PCR was used to determine the mRNA of PYY,Ghrelin from gastric,colon.Immunohistochemistry was used to determine Ghrelin,PYY protein expression in the gastrointestinal tract tissues.Results There were no difference between body weight and gastrointestinal mucosal development of 2 rat groups in day 21 and day 50(P ＞0.05),mRNA and protein expression of Ghrelin and PYY in breast milk-fed group were higher than formula-artificial fed group in both day 21 and day 50 (all P ＜ 0.05).Conclusions The Ghrelin and PYY levels of breast milk-fed rats is higher than formula-artificial fed ones,and this phenomenon continues to their childhood.Breast milk protects offspring from obesity by influencing the secretion of brain-gut peptide and has long-term consequences on the regulation of food intake and energy balance from neonatal period to their later life.
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Objective To evaluate the timing of postoperative parenteral nutrition support for gastrointestinal tumor patients with a definite nutritional risk.Methods Using a randomized control clinical research methods,80 gastrointestinal cancer patients were randomly divided into study group (40 cases) and control group (40 cases).In the study group parenteral nutrition support started on postoperative day 2,while in the control group it started on postoperative day 1.Flatus passing,the rate of infectious complications,the rate of systemic inflammatory response syndrome,postoperative nutrition support related expenses,and the duration of postoperative hospital stay were recorded.Results There was no significant differences between the two groups (P ＞ 0.05) in age,sex,body mass index,use of glutamine,disease and type of surgery.Compared with the control group,patients in the study group had earlier postoperative flatus passing [(3.33± 1.10) d vs.(4.03 ± 1.51) d,P =0.020],less systemic inflammation response syndrome (8/40 vs.17/40,P =0.030),shorter postoperative hospital stay [(3.33±1.10) d vs.(4.03±1.51) d,P=0.020] and lower nutrition support costs [(2144.49 ±1210.96) RMB vs.(2915.99 ± 1615.68) RMB,P =0.018].There was no significant difference in postoperative nutrition index,peristalsis recovery time and infectious complications between the two groups (all P ＞ 0.05).Conclusions In patients undergoing surgery for GI tumors,parenteral nutrition support started on post-op day 2 promotes the recovery of gastrointestinal function,while decreasing medical cost.
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OBJECTIVE@#To compare morphine and codeine concentration in urines of heroin abusers and codeine users and to discuss the judgment index to distinguish between heroin abuser and codeine user.@*METHODS@#The urines of heroin abusers and codeine users were collected at different time periods. After protein precipitation, the urine samples were conducted for the qualitative and quantitative analysis of morphine and codeine by UPLC-MS/MS. And the results were all statistically analyzed.@*RESULTS@#Statistical analysis showed that morphine and codeine concentration in urines of heroin abusers and codeine users were both abnormal distributions. The probability of the heroin abuser would be more than 95% and less than 5% for the codeine user when the concentration of morphine in urine sample was more than 67 ng/mL. The probability of the codeine user would be more than 95% and less than 5% for the heroin abuser when the concentration of morphine in urine sample was less than 67 ng/mL.@*CONCLUSION@#The morphine concentration in urine could be used as a criterion to distinguish the heroin abuser from the codeine user, while the codeine concentration could not.
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Humans , Administration, Oral , Chromatography, High Pressure Liquid , Codeine/urine , Forensic Toxicology/methods , Heroin Dependence/urine , Morphine/urine , Solutions , Substance Abuse Detection/methods , Tandem Mass Spectrometry/methodsABSTRACT
The effects of testosterone on norepinephrine release were investigated in the isolated rat hearts. Sprague-Dawley male rats (n=120) were randomized to testosterone and control groups. The rats in testosterone group were perfused with modified Krebs-Henseleit buffer containing different concentrations of testosterone (0.1, 1.0, 10.0, and 100.0 nmol/L, respectively). Myocardial ischemia was induced by globally stopping the perfusion flow. Exocytotic norepinephrine release was induced by electrical field stimulation at 5 V (effective voltage) and 6 Hz (pulse width of 2 ms) for 1 min. The overflow of norepinephrine was determined by high pressure liquid chromatography and electrochemical detection (HPLC-EC). Following acute ischemia, testosterone (1.0, 10.0 and 100.0 nmol/L) significantly reduced norepinephrine release (P0.05). Electrical stimulation of the ventricle evoked norepinepherine release, and this was diminished by the perfusion with testosterone at the concentrations of 1.0, 10.0 and 100.0 nmol/L (P<0.01). It is suggested that testosterone suppresses ischemia- and electrical stimulation-induced norepinepherine release in the isolated rat hearts.
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OBJECTIVE@#To establish a gas chromatography-mass spectrometry (GC-MS) method for determination of propofol in human blood.@*METHODS@#Propofol and 2-(tert-Butyl)-4,6-dimethylphenol (internal standard) were isolated from human blood samples with liquid-liquid ether extraction. The organic layer was collected after centrifugation and dried using the water bath. The extracted residue was analyzed by GC-MS.@*RESULTS@#Propofol and the internal standard showed a good separation with a good linear concentration ranged from 0.02 to 10 microg/mL in blood. The linear function was y = 0.313 6 x-0.006 8 with the correlation coefficient of 0.9997. The precision of intra-day and inter-day were less than 4.8% and the lower limit of detection of propofol was 0.005 microg/mL. Propofol concentration of blood was 0.14 microg/mL using this method in the practice work.@*CONCLUSION@#The GC-MS method is rapid, sensitive, reliable and suitable for qualitative and quantitative analysis propofol of blood in forensic toxicological analysis and clinical drug monitoring.
Subject(s)
Humans , Male , Anesthetics, Intravenous/poisoning , Drug Monitoring/methods , Forensic Toxicology/methods , Gas Chromatography-Mass Spectrometry/methods , Molecular Structure , Propofol/poisoning , Reproducibility of Results , Sensitivity and SpecificityABSTRACT
Objective To explore the effects of lactoferrin on T cells ( the levels of CD4 + T and CD8 +T lymphocytes) and the development of intestinal mucous membrane (villus heights, crypt depths, villus circumferences, and villus areas) in neonatal SD rats. Methods Totally 96 neonatal (one week old) SD rats were equally and randomly divided into twelve groups, in which animals were fed with lactoferrin at a dose of 1.0 g/( kg · d) (dose Ⅰ group), 3.0 g/(kg · d) (dose Ⅱ group), or 5.0 g/(kg · d) (dose Ⅲ group) for 2, 3, or4 weeks,with corresponding blank control groups. Rats in the dosage groups were killed at the set time points and the levels of venous blood CD4 + and CD8 + T lymphocytes were detected using immunofluorescence method. Jejunum ( 1 cm)and ileum (1 cm) specimens were obtained for pathological sectioning, and the villus height, crypt depth, villus circumferences, and villus areas were measured through image analysis system. Results The CD4 + T lymphocyte levels at two weeks were significantly different among dose I group, dose Ⅱ group, and control groups ( all P ＜0. 05).The CD8 + T lymphocyte levels at two weeks were significantly different among dose Ⅱ group, dose Ⅲ group,and control groups ( all P ＜ 0. 05 ). The villus heights, crypt depths, villus circumferences, and villus areas of jejunum at two weeks between feeding groups and control groups were not significantly different ( all P ＞ 0. 05 ), while the condition in ileum was on the contrary. The CD4 + T lymphocyte levels at three weeks were significantly different between feeding groups and control groups ( P ＜ 0. 05 ). The CD8 + T lymphocyte levels at three weeks between dose Ⅲ group and control groups were significantly different ( P ＜ 0. 05 ). The villus heights, crypt depths, villus circumferences, and villus areas of jejunum and ileum at three weeks were significantly different between feeding groups and control groups ( all P ＜ 0. 05 ). The CD4 + T lymphocyte levels at four weeks between feeding groups and control groups were significantly different (P ＜0. 05). The CD8 + T lymphocyte levels at four weeks were significantly different among dose Ⅱ group, dose Ⅲ group, and control groups ( all P ＜ 0. 05 ). Except villus areas of ileum, the villus heights, crypt depths, villus circumferences of jejunum and ileum, and villus areas of jejunum at four weeks were significantly different between feeding groups and control groups ( all P ＜ 0.05 ). Conclusions Lactoferrin can promote the levels of CD4 + and CD8 + T lymphocytes in venous blood and facilitate the development of the mucous membranes of jejunum and ileum. However, such effects are affected by the dose and timing of lactoferrin feeding.