Risk factors and clinical outcomes of early-onset pulmonary hypertension in preterm infants with gestational age≤ 32 weeks / 中国新生儿科杂志

Objective:To study the risk factors and clinical outcomes of early pulmonary hypertension in preterm infants with gestational age(GA)≤32 w.Methods:From October 2017 to May 2021,preterm infants with GA≤ 32 w admitted to NICU of our hospital were retrospectively studied. According to their echocardiography 2 w after birth, the infants were assigned into early-onset pulmonary hypertension (ePH) group and non-PH group. SPSS 21.0 statistical software was used to analyze the general status, complications and clinical outcomes of the two groups. Multiple logistic regression was used to analyze the risk factors of early-onset PH.Results:A total of 183 cases were enrolled, including 24 in the ePH group and 159 in the non-PH group. The incidences of birth asphyxia, hemodynamically significant patent ductus arteriosus (hsPDA), FiO 2≥30% within 6 h after birth, late-onset PH, severe bronchopulmonary dysplasia(BPD) and intracranial hemorrhage(ICH) in the ePH group were significantly higher than the non-PH group( P<0.05). hsPDA was the independent risk factor for early-onset PH ( OR=11.781, 95% CI 4.192-33.108). Conclusions:Preterm infants with GA≤32 w and early-onset PH are at increased risks of ICH, late-onset PH and severe BPD, hsPDA is the independent risk factor for early-onset PH.

Clinical features of five cases of congenital esophageal atresia complicated with gastric perforation / 中国小儿急救医学

Objective:To investigate the clinical characteristics of congenital esophageal atresia with gastric perforation, and to improve pediatricians′ understanding of this disease.Methods:The clinical data of five neonates with congenital esophageal atresia and gastric perforation treated in the neonatal intensive care unit of the Affiliated Hospital of Qingdao University from 2012 to 2022 were analyzed retrospectively.Results:Among the five neonates, four were boys and one was girl.The gestational age was 28 + 5 to 37 + 6 weeks, the birth weight was 1 100~2 350 g. All of them had dyspnea and feeding difficulties after birth.Gastric perforation occurred in three cases during invasive mechanical ventilation, one case during non-invasive ventilation, and one case during nasal catheter oxygen inhalation.Emergency primary gastric repair was performed, followed by secondary esophageal anastomosis.All the patients were cured and discharged from hospital. Conclusion:Gastric perforation is a rare complication of congenital esophageal atresia, which is more common in premature infants and low birth weight infants.Mechanical ventilation may promote the occurrence of gastric perforation.If gastric perforation is complicated, repair should be performed as soon as possible, and esophageal anastomosis surgery should be performed early after stability to improve the final outcome.

The effects of maternal placental chorionic hemangioma on neonatal clinical outcome / 中国新生儿科杂志

Objective:To study the effects of different sizes of maternal placental chorionic hemangioma (PCH) on neonatal clinical outcome.Methods:February 2013 to December 2020, neonates whose mothers with PCH delivered in our hospital were retrospectively analyzed. According to the diameter of PCH, the neonates were assigned into giant PCH group (diameter≥4 cm) and ordinary PCH group (diameter<4 cm). Clinical characteristics and outcomes were compared between the two groups.Results:A total of 35 cases were enrolled in the study. 13 cases (37.1%) were male, 12 cases (34.3%) were Cesarean section delivered, 11 cases (31.4%) were premature infants, 12 cases (34.3%) had low birth weight and 12 cases (34.3%) were admitted to NICU, 7 cases (20.0%) had intrauterine distress, cardiac enlargement and abnormal hematological indexes, respectively, 6 cases (17.1%) needed respiratory support; 5 cases (14.2%) had increased amniotic fluid and fetal edema, respectively, 4 cases (11.4%) received blood transfusion, 3 cases (8.5%) had postnatal asphyxia, 2 cases (5.7%) had brain injury and 2 cases (5.7%) had congenital malformation. 15 cases were in the giant PCH group and 20 cases in the ordinary PCH group. Compared with the ordinary PCH group, the giant PCH group had significantly higher incidences of prematurity, low birth weight, increased amniotic fluid, intrauterine distress, NICU hospitalization, fetal edema, cardiac enlargement, respiratory support, abnormal hematological indexes, blood transfusion and mortality ( P<0.05). Conclusions:Maternal complications with giant PCH may significantly increase the risk of neonatal complications, thus perinatal monitoring should be strengthened.【 Key words】Placental chorionic hemangioma; Infant, newborn; Clinical outcome

Effects of early nutrition on bronchopulmonary dysplasia in premature infants / 中华临床营养杂志

Objective:To investigate the effects of nutritional intake in the first two weeks of life on bronchopulmonary dysplasia (BPD) in preterm infants with gestational age (GA) ≤ 32 weeks.Methods:A retrospective case-control study was conducted 154 preterm infants with birth weight ≤ 1500 g and GA ≤ 32 weeks were enrolled from neonatal intensive care unit (NICU) of Affiliated Hospital of Qingdao University between January 1, 2016 and December 31, 2017. These infants were divided into BPD group or non-BPD group. All clinical and nutritional data were collected and analyzed to investigate the effects of early-life (within 2 weeks after birth) nutritional intake on BPD.Results:Among a total of 154 eligible neonates, 68 were without BPD and 86 with BPD (55.8%). Mild, moderate and severe BPD accounted for 39.5% (34/86), 58.1%(50/86)and 2.4%(2/86)of all BPD cases respectively. GA and birth-weight of BPD group were significantly lower than that of non-BPD group [(28.35 ± 1.55)weeks vs. (30.12 ± 1.23)weeks; (1050.91 ± 190.6)g vs. (1205.88 ± 195.83)g, both P = 0.000]. The duration of mechanical ventilation in BPD group was longer than that in non-BPD group [(2.65 ± 1.08)days vs. (0.47 ± 0.12)days, P < 0.05]. The incidences of complications in BPD group, including neonatal asphyxia, sepsis and patent ductus arteriosus, were all higher than those in non-BPD group( P < 0.05). The fluids and caloric intake, enteral fluids and caloric intake were significantly lower in BPD group on Day 7 and 14 of life ( P < 0.05). The macronutrient intake in BPD group was also consistently lower, reaching statistical significance for carbohydrate intake on Day 7 and 14 of life, and for protein and lipid intake on Day 14 of life ( P < 0.05). Multivariate logistic regression analysis showed that mechanical ventilation ( OR = 2.257, 95% CI: 1.143~4.456, P = 0.019) and GA ( OR = 0.325, 95% CI: 0.215~0.49, P = 0.000) were high-risk factors for BPD. The decreased odds of developing BPD were associated with higher levels of enteral calories on Day 14 of life ( OR = 0.96, 95% CI: 0.94~0.98, P = 0.000), fluids on Day 7 of life ( OR = 0.927, 95% CI: 0.876~0.981, P = 0.009) and protein intake on Day 14 of life ( OR = 0.044, 95% CI: 0.011~0.177, P = 0.000). Conclusions:GA and mechanical ventilation were independent high-risk factors for BPD. Higher intake of protein and enteral calories were protective factors. Proactive early enteral nutrition support, adequate protein intake and decreasing the duration of mechanical ventilation may reduce the risk of BPD.

Application of antenatal corticosteroids of late preterm and term infants / 国际儿科学杂志

Respiratory diseases are serious complications of premature infants, especially respiratory distress syndrome , and also the main cause of early death.antenatal corticosteroids can significantly reduce respiratory complications in preterm infants before 34 weeks of gestation, but there is no consensus on the application of Antenatal corticosteroids in late preterm infants and term infants.The review summarizes the recent studies on the use of antenatal corticosteroids in the outcome of late preterm and term infants, especially in the respiratory system, in order to guide clinical treatment.

Clinical high-risk factors of metabolic bone disease in very low birth weight infants / 中华临床营养杂志

Objective To explore the high-risk factors of metabolic bone disease (MBD) in premature infants by retrospective analysis of the clinical data so as to provide evidence for optimal clinical management. Methods Clinical data of premature infants with birth weight<1500 g admitted in our hospital from January 2016 to December 2017 were retrospectively analyzed. Infants with serum alkaline phosphatase ( ALP )>500 IU/L and blood phosphorus <1. 5 mmol/L were selected as MBD group and premature infants with birth weight <1500 g were selected randomly as non-MBD group. General data, pulmonary surfactant, continuous positive airway pressure, mechanical ventilation, start time of enteral nutrition, parenteral nutrition ( PN) time, breast feeding time and breast milk fortifier adding, drug usage, hospitalization time and complications were re-corded and compared between the two groups. Results A total of 440 premature infants with birth weight<1500 g were admitted to the hospital during the study period. 58 [ 13. 2％ ( 58/440) ] infants were enrolled in the MBD group, among which infants with birth weight<1000 g accounting for 56. 9％ ( 33/58) . High birth weight (OR=0. 62, 95％ CI:0. 389-0. 990) was an independent protective factor of MBD in premature in-fants. The higher the birth weight, the lower the risk of MBD in premature infants. The longer duration of breast feeding time ( OR= 2. 191, 95％ CI:1. 628-2. 950) , later initial time of enteral feeding ( OR=2. 695, 95％CI:1. 710-4. 248), longer duration of PN (OR=6. 205, 95％ CI:3. 359-11. 463) time, longer duration of respiratory supporting time ( OR=1. 046, 95％ CI:1. 026-. 067) , longer hospital stay time ( OR=1. 703, 95％ CI:1. 109-2. 615) and small for gestational age ( OR=2. 965, 95％ CI:1. 163-5. 658) were inde-pendent risk factors of MBD in premature infants. The duration of PN was the most important independent risk factor of MBD in premature infants (OR=6.205, 95％ CI: 3.359-11.463). Conclusion Multiple factors can lead to MBD of premature infants. The high birth weight is an independent protective factor of MBD and the duration of PN is the most important independent risk factor of MBD in premature infants.

Study progress of mitochondrial DNA depletion syndromes / 中华实用儿科临床杂志

Mitochondrial DNA(mtDNA)depletion syndromes(MDS)is a type of autosomal recessive genetic disease characterized by a severe reduction in mtDNA content caused by mutations in the nuclear gene,which results in impaired energy production in affected tissues and organs. According to phenotype,MDS are usually classified as 4 forms:myopathic,encephalomyopathic,hepa - tocerebarl and neurogastrointestinal. The following 9 types of related genes have been reported:a myopathic form associated with mutations in TK2;an encephalomyopathic form associated with mutations in SUCLA2,SUCLGl,or RRM2B;a hepa-tocerebral form associated with mutations in DGUOK,MPVl7, POLG,or Cl0orf2;and a neurogastrointestinal form associated with mutations in TYMP. Some MDS can lead to early death in newborns and infants,so early identification is very important. Combination of biochemical testing,histopatholo-gy,respiratory chain complex testing and mtDNA quantification is needed for the diagnosis. The final diagnosis requires genetic testing.

Effects of xenon on the expression of EphB4 and EphrinB2 mRNA in neonatal rats with white matter damage / 中国新生儿科杂志

Objective To investigate the pathogenesis of white matter damage (WMD) and the effects of xenon intervention on the expression of EphB4 and EphrinB2 mRNA in the brain tissue of neonatal rats.Method Three-day-old SD rat pups (n =96) were randomly assigned into sham group (n =24),model group (n =24),xenon intervention group 1 (n =24) and xenon intervention group 2 (n =24).The WMD model was established by injected of lipopolysaccharide (LPS) 0.05 mg/kg combined with ligation of the right carotid artery for 1 h in the last three groups.Rats in xenon intervention group 1 inhaled 50％ xenon immediately for 3 h after modeling,while rats in xenon intervention group 2 inhaled 50％ xenon for 3 h at 2 h after modeling.After the completion of xenon intervention,6 rat pups in each groups were sacrificed at 0 h,24 h,48 h and 72 h.The pathologic examination of periventricular tissue was conducted with hematoxylin-eosin staining (HE) and the expression of EphB4 and EphrinB2 mRNA was assayed by real-time quantitative polymerase chain reaction (RT-PCR).Statistical analysis was then performed.Result (1)The structure of white matter in model group became loose,band net-like,with significant nucleus pyknosis.The pathological damages in xenon intervention group 1 and 2 were lighter at 24 h,48 h and 72 h than model group,with less karyopycnosis.(2) Compared with the sham group,the expressions of EphB4 and EphrinB2 mRNA at 0 h,24 h,48 h and 72 h were significantly higher in the model group and xenon intervention group 1 and 2 (P ＜ 0.05),except for the EphB4 mRNA in xenon intervention group 1 at 72 h (P ＞ 0.05).The expressions of EphB4 and EphrinB2 mRNA at each time point in xenon intervention group 1 and 2 were decreased significantly than the model group (P ＜ 0.05),except for the EphB4 mRNA in xenon intervention group 2 at 72 h (P ＞ 0.05).However,there was no statistically significant difference on EphB4 and EphrinB2 mRNA between two xenon intervention groups at each time point (P ＞ 0.05).Conclusion The expression of EphB4 and EphrinB2 mRNA are appreciably increased in brain tissue of neonatal rats with WMD,which indicates the reactive angiogenesis.The intervention with xenon may play a neuroprotective role through reducing the expressions of EphB4/EphrinB2 mRNA and angiogenesis,and early intervention may be better.

Expression of long noncoding RNA linc00261 in hepatocellular carcinoma and its association with postoperative outcomes / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the expression of long noncoding RNA linc00261 in hepatocellular carcinoma (HCC) and its correlation with the clinicopathological features and postoperative outcomes of the patients.</p><p><b>METHODS</b>Real-time fluorescence quantitative PCR (qRT-PCR) was used to detect the expression of linc00261 in surgical specimens of HCC and adjacent tissues from 74 patients. The correlation of the expression level of linc00261 in HCC with the clinicopathological parameters of the patients was analyzed using Chi-square test. The Cox's proportional hazards regression model was used to assess the value of linc00261 in predicting the prognosis of HCC patients after operation. The expression of linc00261 was also examined in 5 HCC cell lines using qRT-PCR. The HCC cell lines MHCC-LM3 and SNU-449 were transfected with small interfering RNAs targeting linc00261 for linc00261 knockdown, and the changes in the cell proliferation, migration and invasion abilities were observed using CCK-8 assay and Transwell assay.</p><p><b>RESULTS</b>The expression level of linc00261 in HCC was significantly correlated with AFP (=0.032), tumor size (=0.007), microscopic vascular invasion (MVI; =0.01), and TNM stage (=002). The patients with lowered expressions of linc00261 in HCC tissues had a significantly shortened tumor-free survival time ( < 0.05), and a lowered expression of linc00261 was identified as an independent risk factor affecting postoperative recurrence-free survival time of the patients ( < 0.05). In HCC cell lines MHCC-LM3 and SNU-449 cells, linc00261 knockdown obviously promoted the cell migration and invasion ( < 0.01) but did not significantly affect cell proliferation ( > 0.05).</p><p><b>CONCLUSIONS</b>Linc00261 may serve as a new prognostic biomarker for predicting the postoperative outcomes of the patients with HCC.</p>

Investigation on Medical Students' Ethical Cognition of Assisted Reproductive Technology / 中国医学伦理学

Objective:To investigate the medical students' cognition of ethical issues in assisted reproductive technology (ART) and discuss the importance of ethical education in medical colleges and universities.Methods:A questionnaire survey about the ethical cognition of assisted reproductive technology was conducted among 632 medical students.The questionnaire included the donation and management of gametes and embryos,and offspring problems.Results:Medical students agreed with most of the current ART-related laws and regulations.however,44.8％ of medical students considered that criteria of donating eggs should be relaxed,such as allowing women who do not receive ART treatment be paid for eggs.In addition,a total of 39.0％ of medical students supported the legalization of surrogacy technology in china.Conclusion:Medical students exists a certain misunderstanding in egg donation and surrogacy technology.We should give more training to medical students in ethical knowledge.In addition,our country can supplement and perfect the current laws and regulations to a certain extent.

Analysisof clinical risk factors of moderate and severe bronchopulmonary dysplasia in premature infants / 中国综合临床

Objective To explore the high risk factors of different degrees of premature infants with bronchopulmonary dysplasia (BPD) and to provide theoretical basises for the clinical prevention of BPD.Methods The clinical datas of 64 cases patients with BPD who were diagnosed and hospitalized in Neonatology Department of Affiliated Hospital of Qingdao University from June in 2009 to March in 2016 were retrospective analyzed,from several aspects to analyze the BPD's high risk factors,such as the mother's factors,the perinatal factors,treatments after birth and complications.Results There were 27 moderate and mild cases,19 moderate cases and 18 severe cases in children who were diagnosed BPD;different degrees of BPD patients in gender,5 minute's apgar score,the repeated application of PS,long time of mechanical ventilation,high concentration of oxygen inhalation,neonatal pneumonia,blood transfusion and neonatal anemia's differences were significant in the severity of BPD difference (P =0.003,0.033,0.006,0.002,0.001,0.000,0.001,0.001,0.036,0.004).Conclusion Strengthen resuscitation in delivery room,shorten the mechanical ventilation time and reduce the high concentration oxygen inhalation,prevent and reduce the infection after delivery,reduce latrogenic blood loss and the number of blood transfusion are important measures to alleviate the severity of BPD.

Influence of cyclooxygenase-2 inhibitor on the expressions of surfactant protein B and transforming growth factor β1 of newborn rats in hyperoxia environment / 中华实用儿科临床杂志

Objective To investigate the effects of selective cyclooxygease-2 inhibitor on pulmonary surfactant protein(SP-B) and transforming growth factor(TGF-β1) of hyperoxic lung injury in newborn rats.Methods One hundred and five SD rats were randomly divided into 3 groups (35 cases in each group):air group (group Ⅰ),in which the rats were exposed to room air;hyperoxia group(group Ⅱ),in which the rats were exposed to hyperoxia(850 mL/L oxy gen);Celecoxib group(group Ⅲ),in which the rats were exposed to heyperoxia(850 mL/L oxygen) and intraperitoneally injected with 5 mg/kg Celecoxib.The lungs of rats were removed on 3 d,7 d,14 d after birth and the following indices were measured:lung section from the lower right lung were stained with HE,and the histological changes was examined;the contents of SP-B and TGF-β1 in the bronchoalveolar lavage fluid of left lung was determinated by using enzyme-linked immunosorbent assay (ELISA);right upper lung was immunohistochemically stained to measure the contents of SP-B and TGF-β1,quantitative real-time PCR(RT-PCR) was used to detect the mRNA expression of SP-B and TGF-β1.Results There were no inflammatory cells and exudation in the lung in group Ⅰ;in group Ⅱ,the structure disorder,pulmonary edema,and inflammatory infiltrates were found;but the damage was obviously alleviated in group Ⅲ.Protein expression could be better detected by ELISA,at the time of 14 day,SP-B was expressed at different levels in3 groups:(29.93±6.40) ng/L in group Ⅰ,(18.20 ±3.70) ng/L in group Ⅱ and (19.63 ±10.20) ng/L in group Ⅲ,SP-B level in group Ⅱ was significantly lower than that in group Ⅰ (t =13.152,P ＜ 0.01),and the expres sion in group Ⅲ was significantly higher than that in group Ⅱ (t =5.190,P ＜ 0.01).TGF-β1 was expressed at different levels in 3 groups:(34.73 ±2.30) μg/L in group Ⅰ,(41.66 ± 1.80) μg/L in group Ⅱ and (38.03 ±0.20) μg/L in group Ⅲ,and the level of TGF-β1 was significantly higher in group Ⅱ than that in group Ⅰ (t =6.584,P ＜ 0.01),but the expression of group Ⅲ was significantly lower than that in group Ⅱ (t =5.609,P ＜ 0.01).The expression of mRNA was detected by RT-PCR,and at the time of 14 day,SP-B mRNA was expressed at different levels in 3 groups:3.14 ±0.10 in group Ⅰ,0.81 ±0.06 in group Ⅱ and 1.12 ±0.06 in group Ⅲ,and SP-B level in group Ⅱ was significantly lower than that in the group Ⅰ (t =55.050,P ＜0.01),and the expression in group Ⅲ was significantly higher than that in group Ⅱ (t =10.305,P ＜ 0.01).TGF-β1 mRNA was expressed at different levels in the 3 groups:1.94 ±0.03 in group Ⅰ,13.26 ±0.43 in group Ⅱ and 6.49 ±0.26 in group Ⅲ,the level of TGF-β1 was significantly higher in group Ⅱ than that in group Ⅰ (t =75.471,P ＜ 0.01),while the expression of group Ⅲ was significantly lower than that in group Ⅱ (t =38.470,P ＜ 0.01).Conclusions Cyclooxygenase-2 inhibitor can attenuate hyperoxic lung injury in rats,and the mechanism might be related to the reduction of prostaglandin.

Analysis of high-risk factors of white matter damage in premature infants / 中国综合临床

Objective To identify high?risk factors of white matter damage ( WMD ) in premature infants,in order to reduce the incidence and improve the prognosis of brain injury?Methods Five hundred and seventy?seven cases of preterm infants treated from January 2012 to December 2013 in the Pediatrics Department of Affiliated Hospital of Qingdao University were slecteted?According to MRI of the brain at 2 weeks after birth, all the patients were divided into WMD group(133 cases) and the control group(444 cases)?Single?factor and multifactor logistic regression were used for the analyses of the high?risk factors of WMD?Results WMD incidence was 23?05%( 133/577) in 577 cases of premature infants,with 108 cases( 81?2%) of focal injury,5 cases(3?8%) of diffuse injury and 20 cases(15?0%) of periventricular leukomalacia(PVL) injury?There was significant statistically difference in different gestational age( P=0?017)?Multi factor Logistic regression analysis showed that metabolic acidosis(OR=4?489,P=0?000),asphyxia(OR=3?519,P=0?000),perinatal infection ( OR=2?650,P=0?003) were independent risk factors for WMD,while cesarean( OR=0?293,P=0?000) was protective factor for WMD?Conclusion WMD is a complex interaction outcome of multiple risk factors in premature infant?Perinatal hypoxia and infection are the main risk factors of WMD in premature infants.

Clinical comparative study of two kinds of conservative treatment regimens for patients with non -ruptured tubal pregnancy / 中国基层医药

Objective To investigate clinical effects of methotrexate and laparoscopic salpingotomy in the treatment of non -ruptured tubal pregnancy.Methods 150 children with non -ruptured tubal pregnancy were cho-sen and randomly divided into A group (75 children)with methotrexate treatment and B group (75 children)with laparoscopic salpingotomy.The hospital staying time,the degree of tubal patency,intrauterine pregnancy rate,ectopic pregnancy rate,ovarian volume and number of follicles after treatment of the two groups were compared.Results The hospital staying time of A group and B group were (21.56 ±4.98)d,(7.91 ±1.42)d,the hospital staying time of B group was significantly shorter than A group (t =2.27,P 0.05).The number of follicles in 1 month,3 months and 6 months after treatment of B group was significantly better than A group (t =2.57,2.06, 2.10,all P <0.05).Conclusion Compared with methotrexate treatment,laparoscopic salpingotomy in the treatment of non -ruptured tubal pregnancy can efficiently shorten hospital staying time,higher the degree of tubal patency, improve the long -term outcome,and is helpful to reduce the effect of ovarian function.

Neuroprotective potentials of recombinant human erythropoietin in premature rats with white matter damage / 中华实用儿科临床杂志

Objective To investigate the neuroprotective potentials of recombinant human erythropoietin ( rhEPO) in premature rats with white matter damage. Methods Pregnant rats ( gestational age 15 days) were injected lipopolysaccharide (LPS) (300 μg/kg) intraperitoneally to make cerebral white matter lesions. Another 10 cases of pregnant rats were injected saline (1 mL/kg) intraperitoneally as controls. All preterm rats were born by caesarean sec-tion on embryonic day 21. According to the different processing method,the preterm rats were randomly divided into LPS+rhEPO group (18 cases),LPS+ normal saline (NS) group (18 cases),NS+rhEPO group (18 cases) and NS+NS group (18 cases) ,and they were injected rhEPO (5 000 IU/kg) or 9 g/L saline 1 mL/kg intraperitoneally imme-diately after birth,respectively. The cerebral white matter injury was evaluated with HE staining,and levels of CD68 ,gli-al fibrillary acidic protein (GFAP),myelin basic protein (MBP) were detected by immunofluorescence method 3 and 7 days after birth. Assessment of nerve behavior was done 2 weeks after birth. Results HE staining showed that the white matter lesions were less in LPS+rhEPO group than those in LPS+NS group 3 and 7 days after birth,while NS+rhEPO group and NS+NS group had no cerebral white matter lesions. The expressions of CD68 in LPS+rhEPO group,NS+rhEPO group,NS+NS group significantly decreased compared with LPS+NS group (F=7. 456,P0. 05). No significant differences were found between LPS+rhEPO group and the other groups in evaluation of long-term neural development(all P>0. 05). The val-ues of F by the open field test,suspension test,slope hill test,and resistance to capture test were 2. 09,0. 53,0. 11,0. 37, respectively. Conclusions A single large dose (5 000 IU/kg) rhEPO has neuroprotective effect on the cerebral white matter lesions in the premature rats by inhibiting microglia and astrocyte activation in a short time. The long-term effort remains unknown.

Clinical high-risk factors of parenteral nutrition-associated cholestasis in very low birth weight infants / 中华临床营养杂志

Objective To investigate the clinical characteristics and high-risk factors of parenteral nutrition-associated cholestasis (PNAC) in very low birth weight infants (VLBWI),so as to guide the prevention and treatment of this condition.Methods A retrospective analysis was conducted with the data of 141 VLBWI collected from January 2013 to October 2014 in Affiliated Hospital of Qingdao University.These VLBWI were of gestational age ≤ 34 weeks and received parenteral nutrition (PN) for ＞ 14 days in Neonatal Intensive Care Unit.According to the existence of PNAC,they were divided into PNAC group (n =32) and non-PNAC group (n =109) and analyzed in terms of clinical features.Results Between the non-PNAC and the PNAC groups,univariate analysis showed significant differences in gestational age [(30.84 ± 1.55) weeks vs.(29.68 ±2.04) weeks,t=2.952,P=0.005],birth weight [(1 267.92±160.39) gvs.(1 050.63 ±229.74) g,t=6.064,P=0.000],hospital stay [(43.26 ±14.43) d vs.(66.47 ±22.25) d,t =-6.622,P=0.000],fasting time [(6.30±5.23) d vs.(11.94±7.92) d,t＝-4.723,P=0.000],PN duration [(32.40 ± 13.72) d vs.(57.59 ± 27.65) d,t =-7.039,P =0.000],the maximum daily dosage of amino acid [(3.61 ±0.27) g/ (kg·d) vs.(3.78±0.35) g/ (kg·d),t=-3.012,P=0.003];concurrent infection (56.88％ vs.87.50％,x2 =10.046,P =0.002),pneumonia (32.11％ vs.68.75％,x2 =13.790,P =0.000),necrotizing enterocolitis (0.92％ vs.9.38％,x2 =6.420,P =0.037),neonatal respiratory distress syndrome (55.05％ vs.78.13％,x2 =5.503,P =0.019),bronchopulmonary dysplasia (19.27％ vs.46.88％,x2 =9.918,P=0.002),congenital heart disease (4.59％ vs.21.88％,x2 =7.405,P =0.007);application of pulmonary surfactant (33.94％ vs.59.38％,x2 =6.682,P =0.010),continuous positive airway pressure ventilation (60.55％ vs.87.50％,x2 =8.085,P =0.004),mechanical ventilation (22.94％ vs.43.75％,x2 =5.356,P =0.021) and peripherally inserted central catheter (44.04％ vs.81.25％,x2 =13.737,P =0.000).Multivariate Logistic regression analysis revealed that PN duration was an independent high-risk factor of PNAC (B =0.069,OR =1.071,95％ CI =1.039-1.104,P =0.000).Conclusions Many factors are associated with PNAC,in which PN duration is an independent high-risk factor.Early enteral nutrition and shortened duration of PN may be protective measures for PNAC.

Clinicopathologic features and association with Epstein-Barr virus infection in 235 cases of Hodgkin lymphoma from northern China / 中华病理学杂志

<p><b>OBJECTIVE</b>To study the clinicopathologic features of Hodgkin lymphoma (HL) occurring in northern China, association with Epstein-Barr virus (EBV) infection and concordance between EBV protein immunohistochemistry (IHC) and in-situ hybridization (ISH).</p><p><b>METHODS</b>Two hundred and thirty-five cases were collected and their HE and IHC slides were reviewed to confirm the diagnosis and sort of HLs. All cases were performed with IHC staining for LMP-1 protein and ISH of EBV-encoded RNAs (EBER) was done in 101 cases to detect the existence of EBV.</p><p><b>RESULTS</b>The incidence peak was between age 25 and 35 years, followed by another peak between age 56 to 60 years. There were 135 males and 100 females. The tumor involved lymph nodes in 217 cases, and extranodal sites in 18 cases. There were 3 cases of nodular lymphocyte predominant Hodgkin lymphoma (NLPHL) and 232 cases of classical Hodgkin lymphoma. All tumors were stained for CD30, CD20, CD3. CD30 was expressed in 227 cases (96.6%), CD20 was expressed in 53 cases (22.5%) with different level of intensity. CD3 was expressed only in 1 case (0.4%). CD15 staining was performed in 224 cases and 117 (52.2%) cases were positive. PAX-5 were performed in 213 cases and 160 (75.1%) cases showed weak to moderate expressions. Two hundred and thirty-five cases were immunohistochemically stained with LMP1 and 72 (30.6%) cases were positive. Meanwhile, EBER ISH were applied in 101 cases, and 40 cases (39.6%) were found positive. LMP1 was expressed in 30 cases among those EBER-positive cases, while LMP1 was only detected in 5 cases of the EBER-negative cases. There was no statistically significantce between LMP1 IHC and EBER ISH by pared chi-square test (P = 0.3), the overall concordance rate was 85.2%.</p><p><b>CONCLUSIONS</b>There was a bimodal age distribution in our group of HL cases from the northern part of China, with slight male predominance and mainly nodal involvement. Nodular sclerosis (NS) and mixed cellularity (MC) were major histologic subtypes. When it was compared with the EBER ISH method in detection EBV infection of HL, the more economical and convenient LMP1 IHC showed both high degree of consistency and overall concordance rate.</p>

Evaluation of lymphatic emboli in gastric cancer by D2-40/CKpan dual immunostain and its significance / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the evaluation of lymphatic emboli by D2-40/CKpan dual immunostain and its prognostic significance in advanced primary gastric adenocarcinoma.</p><p><b>METHODS</b>Tissue samples of 108 cases of advanced gastric adenocarcinoma with radical gastrectomy were collected from Chinese PLA General Hospital in 2001. Lymphatic emboli were evaluated by D2-40/CKpan dual immunostain on consecutive sections, and compared with routine HE staining. The correlation of lymphatic emboli with lymph node metastasis and overall survival was analyzed by Pearson Chi-squared test and univariate survival analysis, respectively.</p><p><b>RESULTS</b>Lymphatic emboli were detected in 73/108 (67.6%) cases by D2-40/CKpan staining, compared to 57/108 (52.8%) by HE staining. There was significant difference (P=0.007). Lymphatic emboli on HE staining revealed false negative in 24/108 cases and false positive in 8/108 cases. A significant correlation was found between lymphatic emboli and lymph node metastasis on HE staining (P=0.024), while it was not found on D2-40/CKpan staining (P=0.422). The overall survival rate was significantly different between lymphatic emboli positive and negative cases on HE staining (P=0.043). The overall survival rate was lower in lymphatic emboli positive cases on HE staining. Lymphatic emboli evaluated on D2-40/CKpan staining had no prognostic value (P=0.402).</p><p><b>CONCLUSION</b>D2-40/Ckpan dual immunostaining is more sensitive for lymphatic emboli in gastric adenocarcinoma but may not predict lymph node metastasis and survival, while HE staining may.</p>

Diagnosis and treatment of biliary complications after liver transplantation: analysis of 258 cases / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the approaches to diagnosis, treatment and prevention of the biliary complications after orthotopic liver transplantation (OLT).</p><p><b>METHODS</b>The clinical data were collected from 258 adult patients receiving orthotopic liver transplantation between August, 2004 and December, 2011, among whom 56 patients with biliary complications were identified to analyze the diagnosis and treatment of the complications.</p><p><b>RESULTS</b>The incidence of biliary complication was 22.13% in the 258 recipients of secondary liver transplantation. Of the 56 patients with biliary complication, 32 (57.14%) had biliary stricture and 24 (42.86%) had bile leakage; 36 (64.29%) patients presented a simple type of biliary complication and 20 (35.71%) had a composite type, including bile leakage, biliary obstruction, biliary calculi, biliary tract infections, biliary sludge formation, and biliary tract bleeding. Thirty-one patients (55.36%) underwent routine endoscopic retrograde cholangiopancreato- graphy (ERCP), percutaneous transhepatic cholangiography (PTC) and other endoscopic or interventional treatments, and 23 (74.19%) were cured or showed improvement, while 3 died due to multiple organ dysfunction syndrome (MODS).</p><p><b>CONCLUSION</b>Appropriate surgical approaches and skills in bile duct anastomosis are crucial to reduce the incidence of biliary complications following liver transplantation. Non-surgical treatment (including ERCP) is the primary option, followed by surgical bile duct exploration, for the management of biliary complications; liver retransplantation is the most effective life-saving means for patients with liver graft non-function. But still, prevention of biliary complications is of pivotal importance to improve the outcome of liver transplantation.</p>

Surgical techniques and perioperative management for improving the success rate of orthotopic liver transplantation in rats / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the surgical techniques and appropriate perioperative management for ensuring successful orthotopic liver transplantation (ROLT) in rats.</p><p><b>METHODS</b>Based on the double-cuff technique of Kamada, we modified the surgical techniques of separation, perfusion and cold preservation of the donor liver, shearing and anastomosis of the suprahepatic vena cava with optimized postoperative infusion protocols and animal care.</p><p><b>RESULTS</b>Two hundred and seventy rats underwent ROLT and a learning curve of the success rate was built to reflect the improvement of techniques. The learning curve showed steep improvements over the exploration stage, breakthrough stage and maturation stage, and the success rates increased sharply over time (0%, 71.1%, and 94.5%, respectively) until finally reaching over 90%. The shearing and anastomosis of the suprahepatic vena cava remained the most critical and difficult techniques in ROLT modeling.</p><p><b>CONCLUSION</b>Proficient microsurgical techniques and meticulous nursing can reduce postoperative complications, enhance operational success rate and extend the survival time after ROLT.</p>