Clinical treatment outcomes and their changes in extremely preterm twins: a multicenter retrospective study in Guangdong Province, China / 中国当代儿科杂志

OBJECTIVES@#To investigate the clinical treatment outcomes and the changes of the outcomes over time in extremely preterm twins in Guangdong Province, China.@*METHODS@#A retrospective analysis was performed for 269 pairs of extremely preterm twins with a gestational age of <28 weeks who were admitted to the department of neonatology in 26 grade A tertiary hospitals in Guangdong Province from January 2008 to December 2017. According to the admission time, they were divided into two groups: 2008-2012 and 2013-2017. Besides, each pair of twins was divided into the heavier infant and the lighter infant subgroups according to birth weight. The perinatal data of mothers and hospitalization data of neonates were collected. The survival rate of twins and the incidence rate of complications were compared between the 2008-2012 and 2013-2017 groups.@*RESULTS@#Compared with the 2008-2012 group, the 2013-2017 group (both the heavier infant and lighter infant subgroups) had lower incidence rates of severe asphyxia and smaller head circumference at birth (P<0.05). The mortality rates of both of the twins, the heavier infant of the twins, and the lighter infant of the twins were lower in the 2013-2017 group compared with the 2008-2012 group (P<0.05). Compared with the 2008-2012 group, the 2013-2017 group (both the heavier infant and lighter infant subgroups) had lower incidence rates of pulmonary hemorrhage, patent ductus arteriosus (PDA), periventricular-intraventricular hemorrhage (P-IVH), and neonatal respiratory distress syndrome (NRDS) and a higher incidence rate of bronchopulmonary dysplasia (P<0.05).@*CONCLUSIONS@#There is a significant increase in the survival rate over time in extremely preterm twins with a gestational age of <28 weeks in the 26 grade A tertiary hospitals in Guangdong Province. The incidences of severe asphyxia, pulmonary hemorrhage, PDA, P-IVH, and NRDS decrease in both the heavier and lighter infants of the twins, but the incidence of bronchopulmonary dysplasia increases. With the improvement of diagnosis and treatment, the multidisciplinary collaboration between different fields of fetal medicine including prenatal diagnosis, obstetrics, and neonatology is needed in the future to jointly develop management strategies for twin pregnancy.

Clinical Observation of 2 Kinds of Glucocorticoid Administration Regimens for Elderly Patients with AE-COPD / 中国药房

OBJECTIVE:To investigate the effects and safety of 2 kinds of glucocorticoid administration regimens including 5 d and 15 d on clinical efficacy,pulmonary function,quality of life in elderly patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD). METHODS:A total of 160 elderly patients with AECOPD selected from Haikou Forth People's Hos-pital during May 2013-Dec. 2015 were divided into group A and B according to lottery method,with 80 cases in each group. Both groups received symptomatic treatment as eliminating phlegm and relieving asthma,controlling infection,etc. Based on it,group A was given Methylprednisolone sodium succinate for injection,40 mg/d for 15 d;group B was given Methylprednisolone sodium succinate for injection,40 mg/d for 5 d. Clinical efficacies were compared between 2 groups as well as the levels of pulmonary ven-tilation function indexes,blood gas analysis indexes,Spitzer life quality index scale (QLI) scores before and after treatment. The occurrence of ADR was also compared between 2 groups. RESULTS:Total response rate of group A was 92.50%,and that of group B was 90.00%,without statistical significance(P>0.05). Before treatment,there was no statistical significance in the levels of pulmonary ventilation function indexes,blood gas analysis indexes,QLI scores between 2 groups (P>0.05). After treatment, FVC,FEV1,FEV1% and PaO2 of 2 groups were significantly higher than before treatment,while PaCO2 was significantly lower than before treatment,with statistical significance (P0.05). QLI scores of 2 groups were significantly higher than before treatment,and the group B was significantly higher than the group A, with statistical significance (P<0.05). The incidence of ADR in group B (6.25%) was significantly lower than group A (22.50%),with statistical significance(P<0.05). CONCLUSIONS:Glucocorticoid administration regimen including 5 d and 15 d in the treatment of elderly patients with AECOPD possess the same effects in improving lung function;glucocorticoid administra-tion regimen for 5 d application is superior in effectively improving the quality of life of patients,reducing the risk of ADR,and has clinical value.

Effects of Different Doses of Budesonide Combined with Ipratropium Bromide on Rational Symptom, Lung Function and Arterial Blood Gas Indexes of AECOPD Patients / 中国药房

OBJECTIVE:To investigate the safety and effects of different doses of budesonide combined with ipratropium bro-mide on rational symptom,lung function and arterial blood gas indexes of patients with acute exacerbation of chronic obstructive pulmonary diseases (AECOPD). METHODS:186 AECOPD inpatients were selected and randomly divided into low-dose,medi-um-dose and high-dose groups,with 61 cases in each group. All groups received routine treatment as ipratropium bromide 500 μg+0.9%Sodium chloride injection(NS)2 ml,oral inhalation with oxygen drive atomization nebulizer,oxygen flow rate of 4-5 L/min, 15-20 min/time,tid. Low-dose,medium-dose and high-dose group were additionally given Budesonide suspension 0.5,1.0,2.0 mg+NS 2 ml respectively,oral inhalation with oxygen drive atomization nebulizer,oxygen flow rate of 4-5 L/min 20 min/time,bid. Pa-tients in 3 groups were treated for 7 days. Pulmonary function,MRC score,arterial blood gas indexes and ADR were compared among 3 groups before treatment,3 and 7 days after treatment. RESULTS:FEV1% of 3 groups were significantly improved after treatment;3 and 7 days after treatment,FEV1% of high-dose group was higher than that of medium-dose and higher than that of low-dose group,with statistical significance(P0.05). After treatment,there was statistical significance in PaCO2 and PaO2 among 3 groups (P<0.05),and the improvement of high-dose group was better than those of medium-dose and better than that of low-dose group,with statistical significance(P<0.05). No severe ADR was found in 3 groups. CONCLU-SIONS:Aerosol inhalation of 2.0 mg budesonide combined with ipratropium bromide can effectively improve pulmonary function, rational symptoms and arterial blood gas indexes with good safety.

Clinical observation on delayed encephalopathy after carbon monoxide poisoning treated with acupuncture to restore consciousness combined with hyperbaric oxygen treatment / 中国针灸

<p><b>OBJECTIVE</b>To compare the efficacy differences on delayed encephalopathy after carbon monoxide poisoning (DEACMP) between acupuncture to restore consciousness combined with hyperbaric oxygen treatment and simple hyperbaric oxygen treatment.</p><p><b>METHODS</b>Forty-one patients with DEACMP were randomly divided into an observation group (21 cases) and a control group (20 cases). In the observation group, acupuncture was applied at Neiguan (PC 6), Shuigou (GV 26), Baihui (GV 20), Sishencong (EX-HN 1), Fengchi (GB 20), Hegu (LI 4), Sanyinjiao (SP 6) and Taichong (LR 3), and hyperbaric oxygen treatment was given as well. In the control group, simple hyperbaric oxygen treatment was used. The treatment was adopted once every day, and continuous 5 days' treatment made one session in the two groups. There were two days at the interval between two sessions and 6 sessions in the two groups. The changes of scores of mini mental state examination (MMSE) and Barthel index (BI) for activity of daily life and routine electroencephalogram (EEG) before and after treatment were compared.</p><p><b>RESULTS</b>After treatment, the scores of MMSE and BI and EEG were all improved compared with those before treatment (all P<0.01). The raise of the scores of MMSE and BI in the observation group was more obvious than that in the control group (both P<0.05) and the improvement of EEG abnormal condition in the observation group was also superior to that in the control group after treatment (P<0.05).</p><p><b>CONCLUSION</b>Acupuncture to restore consciousness combined with hyperbaric oxygen could obviously improve the cognitive function, activity of daily life and changes of EEG, and it is better than simple hyperbaric oxygen treatment.</p>

Tyrosine kinase inhibitory activity of dehydroabietylamine derivatives tested by homogeneous time-resolved fluorescence based high throughput screening model / 中国天然药物

Protein tyrosine kinases (PTKs) are attractive targets in searching for therapeutic agents against many diseases. In this study, a series of dehydroabietylamine derivatives were first determined to show PTK inhibitory activity using a high-throughput screening (HTS) method based on homogeneous time-resolved fluorescence (HTRF) technology. The structure-activity relationships of the dehydroabietylamine derivatives were established, and it was found that the compounds with a nitrogen-containing side chain had better inhibitory activity. Further studies showed that the compounds substituted with halogen in the phenyl ring resulted in higher inhibitory activity on the epidermal growth factor receptor (EGFR), and can be a guide to modify the structure of dehydroabietylamine derivatives. Dehydroabietylamine derivatives might be a new class of multi-targeted and effective PTK inhibitors with structure modifications.

Cost-effectiveness evaluation of seven screening strategies for nasopharyngeal carcinoma / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To evaluate the cost-effectiveness of different screening strategies for nasopharyngeal carcinoma (NPC) and recommend a preferable NPC screening strategy.</p><p><b>METHODS</b>A Markov simulation model was constructed based on the natural history of NPC. Seven strategies (A. Annual screening; B. Annual screening for (Epstein-Barr virus, EBV) EBV-seropositive subjects, triennial screening for seronegative subjects; C. Biennial screening; D. Triennial screening; E. 4-year screening; F. 5-year screening; G. 6-year screening) were evaluated. The NPC-pickup rate, cost, quality-adjusted life-years (QALYs) and incremental cost-effectiveness ratio (ICER) were calculated.</p><p><b>RESULTS</b>The ICERs of the 7 strategies were 83 111.6, 47 768.9, 50 164.7, 40 016.2, 34 272.8, 32 215.6, and 32 248.0 Yuan/QALY, respectively. The discounted QALYs of the strategies were 23 079.9, 22 955.6, 22 810.4, 22 636.5, 22 522.7, 22 445.0, and 22 361.9 years, respectively. The ICERs of the strategies were less than three times of the average per capita gross domestic product (89 976 Yuan) in China in 2010. The strategy A achieved a highest NPC pick-up rate (81.7%), a highest discounted QALY and a smallest number of NPC death (681), but a highest discounted cost and a greatest ICER. Compared with the strategy A, the strategy B achieved a little smaller NPC pick-up rate (73.1%), a little smaller number of NPC death (707), however, the ICER of the strategy B decreased by 38.2%.</p><p><b>CONCLUSION</b>The strategy B (annual screening for EB virus seropositive subjects and triennial screening for seronegative subjects) is a preferable option for NPC screening.</p>

Preliminary study of the value of contrast-enhanced ultrasound with high-frequency linear-array transducer in the diagnosis of carotid stenosis / 南方医科大学学报

<p><b>OBJECTIVE</b>To study the value of contrast-enhanced ultrasound with high-frequency linear-array transducer in the diagnosis of carotid stenosis.</p><p><b>METHODS</b>The carotid arteries of 31 patients was examined with color Doppler ultrasound (CDU), harmonic contrast ultrasound (HCU) and digital subtractive angiography (DSA), respectively. The result of DSA was used as the golden standard for evaluating the accuracy, sensitivity and specificity of CDU and HCU in the diagnosis of carotid stenosis.</p><p><b>RESULTS</b>Satisfactory images of 62 carotid arteries were obtained from the patients using HCU with high-frequency linear-array transducer. After intravenous injection of contrast agent, densely dotted hyperechogenic signals were found in the vascular lumen, with stronger intensity than that of the vascular walls. The filling defect areas in the lumen indicated vascular stenosis. Thirty carotid stenoses were detected by DSA, and 25 by CDU. The accuracy, sensitivity and specificity of CDU was 83.3%, 82.0% and 84.9%, respectively. HCU identified 29 carotid stenoses with accuracy, sensitivity and specificity of 96.7%, 96.7% and 97.0%, respectively, significantly higher than those of CDU (P<0.05).</p><p><b>CONCLUSION</b>HCU with high frequency linear-array transducer has better the accuracy than CDU and may serve as a good alternative for diagnosis of carotid stenosis.</p>

Clinical observation of the changes of serum helper T-lymphocytes (TH) cytokines in patients with HIV-infection and opportunistic infection / 中华预防医学杂志

<p><b>OBJECTIVE</b>To observe the changes of serum helper T-Lymphocyte (Th) cytokines at each stage in patients with human immunodeficiency virus (HIV) infection and with opportunistic infection.</p><p><b>METHODS</b>Seventeen normal subjects were studied as controls. Among the 85 patients with HIV-infection studied, 31 had opportunistic infection. The study was divided into stage A, B, and C according to the standards set forth by The US Centers for Disease Control and Prevention (CDC). 17, 29, and 39 subjects were respectively at stage A, B, and C. The levels of the CD4+ T cells and the CD8+ T cells were measured by flow cytometry (FCM), while the levels of interleukin-2 (IL-2), interferon-gamma (IFN-gamma), interleukin-6 (IL-6), and interleukin-10 (IL-10) were measured using enzyme-linked immunosorbent assay (ELISA). All data were analyzed with statistic software SPSS11.0.</p><p><b>RESULTS</b>The level of the CD4+ T cells was (361.85 +/- 230.61) 10(6)/L in the experimental group, lower than that of the control group (772.41 +/- 161.56) 10(6)/L (t = 6.992, P < 0. 01). The level of IL-2 was (61.82 +/- 63.59) pg/ml, lower than that of the control group (111.25 +/- 66.14) pg/ml (t = 2.907, P < 0.01). In the experimental group, the level of the CD8+ T cells was 713.36 +/- 317.59 10(6)/L, higher than that of the control group (583.24 +/- 96.28) 10(6)/L (t = 3.127, P < 0.01), the level of IL-10 was (1362.70 +/- 869.49) pg/ml, higher than that of the control group (818.54 +/- 276.22) pg/ml (t = 4.704, P < 0.01), and the level of IL-6 was (1883.14 +/- 1058.61) pg/m, higher than that of the control group [(1208.52 +/-745.36) pg/ml] (t = 2.502, P < 0.05). Along with the progression of the disease, the level of IL-2 in the experimental group was decreasing gradually, reaching (51.72 +/- 62.28) pg/ml at stage C and (69.02 +/- 62.77) pg/ml at stage B, both of which were lower than those of the control group. The levels of IL-6 and IL-10 rose gradually and were (2040.27 +/- 1078.95) pg/ml and (1472.10 +/-982.03 ) pg/ml respectively at stage C, higher than those of the control group. At stage B, the level of IL-10 was (1347.35 +/- 780.95) pg/ml, higher than that of the control group (818.54 +/- 276.22) pg/ml. The level of IL-6 was (2236.24 +/- 1052.42) pg/ml in patients with opportunistic infection, higher than that in those without opportunistic infection (1680.43 +/- 1017.05) pg/ml (t = 2. 395, P < 0. 05).</p><p><b>CONCLUSION</b>Dynamical measure of the levels of the serum IL-2, IL-6 and IL-10 in patients with HIV infection is a must. Therefore, the progression of AIDS can be controlled by increasing the level of IL-2, decreasing the levels of IL-6 and IL-10, and adjusting the balance of TH1/TH2 cells.</p>

A randomized controlled trial of acupuncture treatment of acute ischemic stroke / 中国针灸

<p><b>OBJECTIVE</b>To explore effects of acupuncture on ability of daily living (ALD) and the incidence rate of disability and mortality of the patient of acute ischemic stroke.</p><p><b>METHODS</b>Forty patients with acute ischemic stroke were randomly assigned to an acupuncture group and a control group, 20 cases in each group. The treatment group were treated with acupuncture for 3-4 weeks, 5 times each week, and routine therapy. The control group were treated with routine therapy alone.</p><p><b>RESULTS</b>No statistically significant differences between the two groups in the score of neurological defection, and the incidence rate of disability and mortality at following survey of 3 and 6 months were found.</p><p><b>CONCLUSION</b>Acupuncture is safe and feasible for stroke at early stage.</p>

Protective effects of glutamine on the intestinal mucosal barrier in young rabbits under hemorrhagic shock / 中国当代儿科杂志

<p><b>OBJECTIVE</b>Glutamine (Gln) is now considered as conditionally essential amino acid with many biological activities. This study aimed to investigate whether it has protective effects on the intestinal mucosal barrier in young rabbits under hemorrhagic shock.</p><p><b>METHODS</b>Eighteen young rabbits aged 26 +/- 3 days were randomly assigned into 3 groups: Control (no treatment), Low-dose Gln (L-Gln, 0.5 g/kg daily) and High-dose Gln (H-Gln, 1.0 g/kg daily) treatment groups. Gln was administered by gastric tube daily for 7 days and then hemorrhagic shock was induced by blood withdrawing from femoral artery. Plasma levels of diamine oxidase (DAO) and serum levels of interleukin-8 (IL-8) were measured before shock, and at 2, 6 and 24 hrs after resuscitation. Ileum tissues located approximately 5 cm away from the ileocecal valve was removed for histological examination, lymphocyte distribution, polymorphonuclear (PMN) count and assessing the height, width and surface area of the villi.</p><p><b>RESULTS</b>Plasma levels of DAO and serum levels of IL-8 at 6 and 24 hrs after resuscitation in the L-Gln and the H-Gln groups decreased significantly compared with those of the Control group. L-Gln and H-Gln also resulted in a decrease in the PMN counts and the lymphocyte percentage in the ileum compared with the Control group. Exfoliation and atrophy of villous epithelial cells occurred and the height and surface area of villous were reduced in the Control group. The ileum morphology of the two Gln treatment groups was found to be nearly normal. There were no differences between the L-Gln and the H-Gln groups.</p><p><b>CONCLUSIONS</b>Gln within a therapeutic dose has protective effects on intestinal mucosal barrier in young rabbits under hemorrhagic shock.</p>

ADR Case Reports in Our Hospital:Analysis of 221 Cases / 中国药房

OBJECTIVE: To probe into the characteristics and regularity of the adverse drug reaction(ADR) occurred in our hospital.METHODS: 221 ADR cases collected in our hospital from Jan.2007 to Dec.2008 were analyzed statistically in respect of patients' age and sex,route of administration,drug categories,organs and systems involved in ADR and the clinical manifestations etc.RESULTS: 14 major drug categories were involved in the 221 ADR cases,with antiinfective drugs showing the highest proportion in terms of incidence of ADR,followed by traditional patent drugs and drugs for cardiovascular system.The ADR occurred chiefly via intravenous route.CONCLUSION: Great importance should be attached to ADR monitoring.