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Objective:To analyze the implementation of early essential newborn care (EENC) in baby-friendly hospitals in China.Methods:This is an investigation carried out using convenience sampling method. People in charge of labor ward, obstetric wards or neonatology department of the selected hospitals, such as baby-friendly hospitals with birth facilities, primary or higher level of hospitals, or general hospitals or those specialized in obstetrics and gynecology or materal and child health care centers, were selected as the subjects of the survey. Information about EENC practices in these hospitals was collected using a self-designed questionnaire sent through WeChat from April 1 to 30, 2021. Chi-square test was used for statistical analysis. Results:A total of 126 questionnaires were distributed and 124 (124 baby-friendly hospitals) were withdrawn. There were 74 hospitals in the eastern, 18 in the central and 32 in the western region. Among the 124 hospitals, tertiary hospitals, general hospitals, and maternity and child care hospitals accounted for 72.6% ( n=90), 64.5% ( n=80) and 35.5% ( n=44), respectively. There were no significant differences in the hospital type, levels, EENC coverage and training, or implementation of mainly recommended EENC practices among the hospitals in the eastern, central and western regions (all P>0.05). The implementation rate of at least one mainly recommended EENC practice was 79.0% (98/124) and there was no significant difference in the implementation rates among eastern, central and western regions [86.4% (64/74), 13/18 and 65.6% (21/32), χ2=6.60, P=0.159]. A total of 80 (64.5%) hospitals implemented 10 or more recommended EENC practices, and the implementation rates in eastern, central and western regions were 71.6% (53/74), 10/18 and 53.1% (17/32), respectively ( χ2=4.08, P=0.130). Among the 17 mainly recommended measures of EENC, in eastern, central and western hospitals, the implementation rates were 10.8% (8/74), 2/18 and 18.8% (6/32) for mother-infant skin-to-skin contact for 90 min after birth; 66.2% (49/74), 11/18 and 68.8% (22/32) for delayed umbilical cord clamping; and 25.7% (19/74), 7/18 and 21.9% (7/32) for delayed routine care following skin-to-skin contact, respectively ( χ2=6.57, 0.34 and 4.53, all P>0.05). Conclusions:There is a big gap between the implementation of EENC in most baby-friendly hospitals in eastern, central and western China and the recommendation of the World Health Organization. It is necessary to further strengthen and standardize the implementation of EENC practices in baby-friendly hospitals in our country to continuously improve the health of newborns.
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Objective:To understand the attitude, practice status and influencing factors of obstetric medical staff on sexual health care during pregnancy, and to provide reference for carrying out sexual education and training during pregnancy.Methods:A self-designed questionnaire on attitude and practice of obstetric medical staff towards sexual health care during pregnancy was used to investigate 462 obstetric medical staff in Guangdong Province from July to August, 2021,and the influencing factors were analyzed.Results:The attitude score of sexual health care during pregnancy among obstetric medical staff was (29.87 ± 5.96) points, and the practice score was (13.61 ± 1.23) points. Profession and hospital level affected obstetric medical staff′s attitude towards sexual health care during pregnancy ( P<0.05); profession, title and hospital level affected obstetric medical staff′s practice in providing pregnancy sexual health care ( P<0.05). Conclusions:Obstetric medical staff have a negative attitude towards sexual health care during pregnancy, and their active sexual health care behaviors need to be improved. Medical schools and work units need to strengthen the training and management of obstetric-related and reproductive health knowledge and skills to promote the effectiveness of pregnancy sexual education implementation and promotion.
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Objective:To investigate the prognosis of severe hyperbilirubinemia in full-term infants who met the exchange transfusion criteria and were treated by blood exchange transfusion and phototherapy.Methods:A total of 168 full-term infants with severe hyperbilirubinemia who met the criteria for exchange transfusion and were hospitalized in the Neonatology Department of seven tertiary hospitals in Hebei Province from June 2017 to December 2018 were retrospectively included. According to the treatment protocol, they were divided into two groups: exchange transfusion group (38 cases) and phototherapy group (130 cases). Two independent sample t-test and Chi-square test were used to compare the clinical manifestations and follow-up results between the two groups. Multivariate logistic regression was used to analyze the risk factors for poor prognosis. Results:Neonatal severe hyperbilirubinemia in the exchange transfusion and phototherapy group were both mainly caused by hemolytic disease [42.1%(16/38) and 29.2%(38/130)], sepsis [28.9%(11/38) and 11.5%(15/130)] and early-onset breastfeeding jaundice [15.8%(6/38) and 11.5%(15/130)]. Total serum bilirubin level on admission in the exchange transfusion group was significantly higher than that in the phototherapy group [(531.7±141.3) vs (440.0±67.4) μmol/L, t=3.870, P<0.001]. Moreover, the percentage of patients with mild, moderate and severe acute bilirubin encephalopathy in the exchange transfusion group were higher than those in the phototherapy group [15.8%(6/38) vs 3.8%(5/130), 7.9%(3/38) vs 0.8%(1/130), 13.2%(5/38) vs 0.0%(0/130); χ2=29.119, P<0.001]. Among the 168 patients, 135 were followed up to 18-36 months of age and 12 showed poor prognosis (developmental retardation or hearing impairment) with four in the exchange transfusion group (12.9%, 4/31) and eight in the phototherapy group (7.7%, 8/104). Multivariate logistic regression analysis showed that for full-term infants with severe hyperbilirubinemia who met the exchange transfusion criteria, phototherapy alone without blood exchange transfusion as well as severe ABE were risk factors for poor prognosis ( OR=14.407, 95% CI: 1.101-88.528, P=0.042; OR=16.561, 95% CI: 4.042-67.850, P<0.001). Conclusions:Full-term infants who have severe hyperbilirubinemia and meet the exchange transfusion criteria should be actively treated with blood exchange transfusion, especially for those with severe ABE, so as to improve the prognosis.
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This study aimed to explore the role of miR-130a-3p in cardiomyocyte hypertrophy and its underlying mechanisms. Pressure-overload induced myocardial hypertrophy mice model was constructed by thoracic aortic constriction (TAC). , norepinephrine (NE) was used to stimulate neonatal rat cardiomyocytes (NRCMs) and H9c2 rat cardiomyocytes to induce hypertrophic phenotypes. The expression of miR-130a-3p was detected in mice hypertrophic myocardium, hypertrophic NRCMs and H9c2 cells. The mimics and inhibitors of miR-130a-3p were transfected into H9c2 cells to observe the role of miR-130a-3p on the hypertrophic phenotype change of cardiomyocytes separately. Furthermore, whether miR-130a-3p regulated hypertrophic related signaling pathways was explored. The results showed that the expression of miR-130a-3p was significantly decreased in hypertrophic myocardium, hypertrophic NRCMs and H9c2 cells. After transfection of miR-130a-3p mimics, the expression of hypertrophic marker genes, atrial natriuretic peptide (ANP), brain natriuretic peptide (BNP) and β-myosin heavy chain (β-MHC), and the cell surface area were notably down-regulated compared with the control group (mimics N.C. + NE group). But after transfection of miR-130a-3p inhibitor, the expression of ANP, BNP and β-MHC in H9c2 cells increased significantly, and the cell area increased further. By Western blot, it was found that the protein phosphorylation level of Akt and mTOR were down-regulated after over-expression of miR-130a-3p. These results suggest that miR-130a-3p mimics may alleviate the degree of cardiomyocyte hypertrophy, meanwhile its inhibitor can further aggravate cardiomyocyte hypertrophy. Over-expression of miR-130a-3p may attenuate cardiomyocytes hypertrophy by affecting the Akt pathway.
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Animals , Mice , Rats , Atrial Natriuretic Factor , Cardiomegaly , MicroRNAs , Genetics , Myocardium , Pathology , Myocytes, Cardiac , Pathology , Myosin Heavy Chains , Natriuretic Peptide, Brain , Nonmuscle Myosin Type IIB , Proto-Oncogene Proteins c-aktABSTRACT
Objective:To establish the clinical practice teaching protocol for nursing undergraduates in midwifery for the purpose to improve the clinical teaching efficiency.Methods:Under the guidance of the core competency index system of midwives established by Lu Hong, based on the literature review and focused group interviews, the preliminary clinical practice teaching protocol was developed by using the Competency Outcomes and Performance Assessment (COPA) model. The clinical practice teaching protocol was improved and finalized through the expert meeting.Results:The teaching objective of the clinical practice teaching protocol was confirmed, and four practical teaching blocks were formed: comprehensive professional skill training, prenatal care, intrapartum care (including neonatal care), postpartum care (including neonatal care and women's health care). Among them, comprehensive professional skill training ran throughout the whole practice teaching process, and the proportions of practice time in the other sections were: 25%, 55% and 20% respectively(practice time of each section/whole practice time). The core elements of teaching project included: core competency, teaching content, teaching method, practice quantity requirement, assessment method and major practice place.Conclusion:The construction process of the clinical practice teaching protocol was prudent and reasonable. The protocol could reflect the core competency of midwives and the characteristics of midwifery. It could also fit the current situation of midwifery practice, with good operability and easy implementation.
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Objective:To investigate the expression level of TRPM7 in breast cancer tissues and adjacent carcinoma tissues and to analyze its clinicalpathological characteristics.Methods:The expressions of TRPM7 in 87 breast cancer and 47 adjacent tissues were detected by immunohistochemistry, and then the relationship between expression and clinicopathological characteristics was analyzed.Results:The positive rate of TRPM7 in breast cancer tissues was 66.7%, significantly higher than that in para-cancer tissues (10.6%) ( P<0.001) . Meanwhile, TRPM7 expression was much higher in those with tumor diameter≥2 cm ( P=0.023) , TNM stage III ( P=0.001) and lymph node metastasis ( P=0.015) . The expression of TRPM7 has nothing to do with patients’ age ( P=0.455) or histological grade ( P=0.577) . Conclusions:High expression of TRPM7 is associated with the development of breast cancer. TRPM7 may become a potential biological indicator to monitor the prognosis of breast cancer in the future.
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Objective To explore the clinical features of chronic myelogenous leukemia (CML) combined with solid malignant neoplasms. Methods The clinical data of 8 CML patients with solid malignant neoplasms who were admitted to the Affiliated Tumor Hospital of Zhengzhou University, the Central Hospital of Nanyang City, the First Affiliated Hospital of Science and Technology University of Henan, and the Central Hospital of Xinxiang City from August 2006 to August 2018 were analyzed retrospectively. The clinical features, treatment and prognosis of the patients were summarized with the review of literature. Results Among the 8 patients, 3 were male and 5 female, aged 40-76 years, with a median of 50 years old. Seven cases were in CML chronic phase, and 1 was in accelerated phase. Seven patients were treated with tyrosine kinase inhibitor (TKI), and only 1 patient was treated with hydroxyurea. In 8 patients, two cases presented with synchronous multiple primary cancer (SMPC), 6 cases presented with heterochrony multiple primary cancer (HMPC). two patients received the operation, 1 patient received the operation and chemotherapy, 4 patients received chemotherapy, and 1 patient received the isotope treatment. One SMPC patient died and another one was under treatment, and 6 HMPC patients were under treatment. ConclusionsThe relationship between CML and solid malignant neoplasm is under discussion, but patients with CML and solid malignant neoplasm are not unusual. Clinicians should raise awareness to avoid misdiagnosis. The treatment should follow the two main lines that are comprehensive treatment and individualized treatment.
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Objective@#To detect the expression of CRLF2 in adult Ph negative acute B lymphocytic leukemia (B-ALL) in newly diagnosed cases, and to investigate the relationship between CRLF2 and the general clinical characteristics, efficacy and prognosis.@*Methods@#103 cases of newly diagnosed adult B-ALL patients were investigated from Apr 2016 to Dec 2017 in the Department of Hematology, Henan Cancer Hospital. Bone marrow samples was used to detect the expression of CRLF2 in leukemic cells. The expression of CRLF2 ≥20% was defined as CRLF2-high group and <20% was defined as CRLF2-low group. The clinical characteristics and prognosis of the two groups were compared.@*Results@#The Median overall survival (OS) and disease free survial (DFS) in CRLF2-high group were 9.0 months and 4.25 months, respectively. CRLF2-low group were 15.5 months and 10.25 months, respectively. There was a statistically significant difference in median OS and DFS between the two groups (P=0.007, P=0.000) . The 18-month OS and DFS in CRLF2-high group were 38.6% and 25.1%, respectively. CRLF2-low group were 57.8% and 42.3%, respectively. Multivariate analysis showed high expression of CRLF2 was an independent risk factor for OS (HR=2.991, 95% CI 1.429-6.261, P=0.004) and DFS (HR=2.374, 95%CI 1.146-4.960, P=0.041) in patients.@*Conclusion@#Patients with high expression of CRLF2 had poor prognosis.
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OBJECTIVE:To establish a method for the determination of 7 residual solvents(ethanol,n-hexane,benzene,tolu-ene,xylene,styrene,divinylbenzene)in Liuwei dihuang glycoside. METHODS:The column was DB-624 capillary column,carri-er gas was nitrogen,flow rate was 5.0 ml/min;detector was a hydrogen flame ionization detector with temperature of 250 ℃(pro-grammed temperature);equilibrium temperature was 80 ℃,sample loop temperature was 90 ℃,and transfer line temperature was 100 ℃;the equilibrium time of vial heating was 30 min,sample loop filling time was 0.05 min,injection time was 1.0 min;the carrier gas pressure was 95 kpa,and the vial pressure was 60 kpa. RESULTS:The linear range was 25-500 μg/ml for ethanol(r=0.998 7),0.025-10μg/ml for n-hexane(r=0.998 8),0.025-10μg/ml for benzene(r=0.999 9),0.1-40μg/ml for toluene(r=1.000 0),0.25-100 μg/ml for xylene(r=0.999 9),0.5-500 μg/ml for styrene(r=1.000 0) and 0.5-500 μg/ml for divinylbenzene (r=1.000 0);RSDs of precision,stability and reproducibility tests were lower than 4%;recoveries were 99.60%-102.70%(RSD=1.08%,n=9),90.70%-100.30%(RSD=4.51%,n=9),100.10%-109.80%(RSD=3.82%,n=9),99.50%-110.00%(RSD=4.40%,n=9),100.00%-109.10%(RSD=3.50%,n=9),93.40%-102.30%(RSD=3.73%,n=9) and 99.70%-101.70%(RSD=0.79%,n=9),respectively;the low limits of detection were 1.000,0.025,0.025,0.025,0.100,0.025,0.250 μg/ml respectively. CONCLUSIONS:The method is simple,stable and reproducible,and can be used for the determination of residual solvents(etha-nol,n-hexane,benzene,toluene,xylene,styrene,divinylbenzene)in Liuwei dihuang glycoside.
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<p><b>OBJECTIVE</b>To explore the clinical and survival significance of CD20 positive adult patients with B-lineage acute lymphoblastic leukemia (B-ALL).</p><p><b>METHODS</b>The clinical features and survival of 168 adult patients with B-ALL diagnosed and treated in our department from May 2007 to July 2011 were analyzed retrospectively, 58 expressed CD20 and 110 not.</p><p><b>RESULTS</b>The sex, distribution of age, anemia, thrombocytopenia, infiltration of liver, spleen and lymph nodes, the expression of myeloid lineage marker, incidence of Ph chromosome, complete remission within 4 weeks showed no significant differences in CD20 positive and negative groups (P>0.05); median white blood cell count at diagnosis and the rate of patients with high white blood cell count in CD20 positive group were 19.2×10⁹/L and 37.9% respectively, which were significantly higher than those of 6.93 × 10⁹/L and 20.9% in CD20 negative group (P<0.05); cumulative incidence of relapse between two groups showed significant difference (P<0.05); multivariable analysis for overall survival and progress-free survival identified CD20 positivity as independent predictor.</p><p><b>CONCLUSION</b>The expression of CD20 in adult patients with B-ALL appeared to be associated with high white blood cell count and poor prognosis.</p>
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Adult , Humans , Antigens, CD20 , Cell Lineage , Disease-Free Survival , Leukocyte Count , Precursor B-Cell Lymphoblastic Leukemia-Lymphoma , Recurrence , Remission Induction , Retrospective Studies , Survival AnalysisABSTRACT
<p><b>OBJECTIVE</b>To explore the clinical features and survival of patients with CD56 expression in de- novo acute myeloid leukemia（AML）with t（8;21). .</p><p><b>METHODS</b>Clinical data of 82 de novo AML with t（8;21）who were newly diagnosed from Jan 2008 to Apr 2014 were analyzed retrospectively, 50 expressed CD56 and 32 not. Clinical characteristics and prognoses were compared between patients expressing and nonexpressing CD56.</p><p><b>RESULTS</b>There were no statistically significant differences in terms of age, gender, white blood cell count（WBC）, percentage of bone marrow blasts, extramedullary infiltration rate, the early mortality or the presence of additional cytogenetic abnormalities between CD56 + and CD56- groups（P＞0.05). The expressions of lymphatic antigens CD19 between CD56 + and CD56- groups showed significant difference （30.0% vs 53.1% , P=0.036). The complete remission and 3-year overall survival（OS）showed no significant differences between CD56+ and CD56-groups, while 3- year disease- free survival（DFS）showed significant differences（25.8% vs 46.9%, P=0.014). Multivariable analysis for DFS identified CD56 positivity as an independent predictor. DFS of who received allogeneic hematopoietic stem cell transplantation（HSCT）was better than those treated with intermediate- dose cytarabine/high dose cytarabine（IDAC）as postremission therapy.</p><p><b>CONCLUSION</b>The expression of CD56 in de-novo AML with t（8;21) appeared to be associated with poorer prognosis.</p>
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Humans , Bone Marrow , CD56 Antigen , Chromosome Aberrations , Chromosomes, Human, Pair 21 , Chromosomes, Human, Pair 8 , Cytarabine , Disease-Free Survival , Hematopoietic Stem Cell Transplantation , Leukemia, Myeloid, Acute , Prognosis , Remission Induction , Retrospective Studies , Survival AnalysisABSTRACT
<p><b>OBJECTIVE</b>To explore the inhibitory effect of thalidomide combined with interferon (IFN) on the human acute myeloid leukemia cell line Kasumi- 1 and its mechanism.</p><p><b>METHODS</b>The inhibitiory effect of Kasumi- 1 cells by thalidomide, interferon or combination was detected by CCK- 8 method, the apoptosis by flow cytometry, the expression of apoptosis related proteins by Western blot, vascular endothelial growth factor (VEGF) concentration in culture supernatant by ELISA.</p><p><b>RESULTS</b>Thalidomide inhibited the proliferation of Kasumi- 1 in a dose- dependent manner from 50 μg/ml to 500 μg/ml with an IC₅₀ of (451.13 ± 6.92）μg/ml at 24 h and (362.50 ± 14.52）μg/ml at 48 h. IFN also demonstrated the inhibitory capacity in a dose-dependent manner from 500 U/ml to 5 000 U/ml, with an IC₅₀ of (2 209 ± 127) U/ml at 24 h and (1 393±63) U/ml at 48 h. The apoptosis rates of Kasumi-1 cells treated with thalidomide 350 μg/ml or IFN 1 400 U/ml for 48 h were (14.68 ± 2.61) % and (21.71 ± 0.71)%, respectively, significantly higher than control group (P<0.01). In combination group the inhibition and the apoptosis rate were (88.50 ± 2.40) % and (41.95 ± 3.41)%, significantly higher than control and each single agent group (P<0.01). The VEGF concentrations of combination group [(94.61 ± 5.46) ng/L decreased significantly, as compared to thalidomide group [(141.11 ± 3.70) ng/L and IFN group [(119.90 ± 2.00) ng/L (P < 0.05). Western blot analysis showed Bcl-2 expression of Kasumi-1 cells decreased, while p-P38, Bax, cytochrome C, cleaved-Caspase-3, 8, 9 increased after treated with thalidomide 350 μg/ml or IFN 1 400 U/ml for 48 h. When treated with the combination agents, the expression of Bcl-2 further decreased and p-P38, Bax, cytochrome C, cleaved-Caspase-3, 8, 9 further increased as compared with each single agent (P < 0.05).</p><p><b>CONCLUSION</b>Thalidomide and IFN could synergistically inhibit the proliferation of Kasumi-1 cells probably through inducing apoptosis via the mitochondrial pathway, death receptor pathway and P38 MAPK pathway, as well as inhibiting VEGF secretion.</p>
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Humans , Apoptosis , Caspases , Metabolism , Cell Line, Tumor , Cell Proliferation , Interferons , Pharmacology , Leukemia, Myeloid, Acute , Pathology , MAP Kinase Signaling System , Thalidomide , Pharmacology , Vascular Endothelial Growth Factor A , MetabolismABSTRACT
To strengthen the pediatric residents' communication ability in rediatric residency standardized training is very important for improving quality of medical provider-patient relationship and prevent medical disputes. At present, in China's pediatric medical units at all levels of medical care for the hospitalized children groups there exist such characteristics as only child, parents doting over their children, excessive stress and fear in diagnosis and treatment and so on. From the analysis of current status, it can be seen that in clinical practice, pediatric physicians' doctor-patient communi-cation is affected by three aspects: children, parents, physicians , and there exist such problems as children's lack of coordination, parents' lack of medical care knowledge, residents' lack of clinical and communication experience. Therefore, it is necessary to strengthen the special training of pediatric residents' doctors and patients in the standardized training period, establish the feedback mechanism of communication between doctors and patients and. make targeted improvements in view of the weak link in the communication between doctors and patients, so as to improve the training program of the pediatric residents' doctor-patient communication ability.
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OBJECTIVE@#To analyze the clinical significance of ocular vestibular evoked myogenic potentials (oVEMP) and cervical vestibular evoked myogenic potentials (cVEMP) in primary unilateral benign paroxysmal positional vertigo (BPPV).@*METHOD@#Fifty-two patients with unilateral primary BPPV (BPPV group) and 38 normal subjects (control group) received ocular vestibular evoked myogenic potential (oVEMP) and cervical vestibular evoked myogenic potential (cVEMP) test using tone burst stimuli. The response rate, latency and amplitude were analyzed.@*RESULT@#In BPPV group, the response rate of oVEMP was 46.15% in lesioned side and 48.08% in healthy side, respectively. The response rate of cVEMP was 67.31% in lesioned side and 65.38% in healthy side, respectively. In control group, the response rate on the left ear was 84.21% for oVEMP and 92.11% for cVEMP. On the right ear, was 81.58% for oVEMP and 94.74% for cVEMP in control group, there was no significant difference in cVEMP and oVEMP P1, N1 N1-P1 latency and amplitude between left and right ear. The interaural amplitude ratio and asymmetry of cVEMP and oVEMP was significantly different between BPPV group and control group (P<0.05).@*CONCLUSION@#Unilateral primary BPPV with bilateral impaired vestibular otolith pathways function can be objectively evaluated by oVEMP and cVEMP detection. Abnormal oVEMP responses were more frequently detected than cVEMP.
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Adult , Female , Humans , Male , Middle Aged , Young Adult , Benign Paroxysmal Positional Vertigo , Case-Control Studies , Prospective Studies , Vestibular Evoked Myogenic Potentials , PhysiologyABSTRACT
Objective To investigate the angiogenesis effects of Salvia miltiorrhiza in heterotopically grafted frozen-thawed mouse ovaries. Methods The ovaries thawed after cryopreservation were xenografted into the donated kidney capsules of 8- to 12-week adult male mice. The mice were divided into two groups, saline and Salvia miltiorrhiza groups, the mice either in the saline or in Salvia miltiorrhiza groups were administered I.p. Daily either saline(0.5ml) or Salvia miltiorrhiza(0.5g)respectively, from the day prior transplantation. The two groups were sacrificed 1 day,2 days and 7 days after transplantation respectively, the grafts from thawed,1 day,2 days,7 days were removed for follicle counting, immunohistochemical studying and detecting of the mRNA expression of vascular endothelial growth factor(VEGF). Results The number of follicles and survival rates in grafts after transplantation of Salvia miltiorrhiza group were more than that of saline group (P<0.05);the expression of VEGF increased after transplantation,peaked on day 7,there was no difference between the two groups (P>0.05);the apoptosis index of Salvia miltiorrhiza group was less than that of saline group (P<0.05), the mRNA expression of VEGF188 and VEGF164 of Salvia miltiorrhiza group was more than that of saline group on 48 hours after transplantation(P<0.05). Conclusion Salvia miltiorrhiza may provide benefits for folliculogensis and decreasing the apoptosis index of follicles. Nevertheless,a increase in the VEGF188 and VEGF164 isoform in the Salvia miltiorrhiza group may suggest the positive effect of exogenous Salvia miltiorrhiza therapy in the early stage of angiogenesis.