Risk factors for necrotizing enterocolitis and establishment of prediction model of necrotizing enterocolitis in preterm infants / 中国当代儿科杂志

OBJECTIVES@#To investigate the risk factors for necrotizing enterocolitis (NEC) in preterm infants, and to establish a scoring model that can predict the development and guide the prevention of NEC.@*METHODS@#A retrospective analysis was performed on the medical data of preterm infants who were admitted to the Department of Neonatology,Bethune First Hospital of Jilin University, from January 2011 to December 2020. These infants were divided into two groups: NEC (298 infants with Bell II stage or above) and non-NEC (300 infants). Univariate and multivariate analyses were performed to identify the factors influencing the development of NEC. A nomogram for predicting the risk of NEC was established based on the factors. The receiver operator characteristic (ROC) curve and the index of concordance (C-index) were used to evaluate the predictive performance of the nomogram.@*RESULTS@#The multivariate logistic regression analysis showed that grade ≥2 intracranial hemorrhage, peripherally inserted central catheterization, breast milk fortifier, transfusion of red cell suspension, hematocrit >49.65%, mean corpuscular volume >114.35 fL, and mean platelet volume >10.95 fL were independent risk factors for NEC (P<0.05), while the use of pulmonary surfactant, the use of probiotics, and the platelet distribution width >11.8 fL were protective factors against NEC (P<0.05). The nomogram showed good accuracy in predicting the risk of NEC, with a bootstrap-corrected C-index of 0.844. The nomogram had an optimal cutoff value of 171.02 in predicting the presence or absence of NEC, with a sensitivity of 74.7% and a specificity of 80.5%.@*CONCLUSIONS@#The prediction nomogram for the risk of NEC has a certain clinical value in early prediction, targeted prevention, and early intervention of NEC.

Effects of miR-361-5p on malignant biological behaviors of renal cell carcinoma ACHN cells / 中国肿瘤生物治疗杂志

@#Objective: To investigate the effect of miR-361-5p on proliferation, invasion, migration, apoptosis and cell cycle of renal cell carcinoma ACHN cells. Methods: MiR-361-5p mimics and miR-361-5p inhibitor were transfected into ACHN cells, respectively. The expression of miR-361-5p in the transfected cells was detected by Real-time quantitatibse PCR; and the proliferation, migration, invasion, cell cycle and apoptosis of cells were detected by MTT assay, Scratch-healing assay, Transwell assay and flow cytometry, respectively. Results: Comparedwiththecontrolgroupandmimics-NCgroup,theexpressionofmiR-361-5pwas increased significantly in ACHN cells of -miR-361-5p mimics group (P<0.01), the abilities of cell proliferation, invasion and migration were decreased significantly (all P<0.01), and the apoptosis rate was increased (P<0.01). Compared with the control group or inhibitor-NC group, the expression of miR-361-5p was significantly decreased in ACHN cells of miR-361-5p inhibitor group (P<0.01), the abilities of cell proliferation, invasion and migration were increased (all P<0.01), the cell cycle was accelerated (P<0.01), and the apoptosis rate was decreased (P<0.05). Conclusion: miR-361-5p can inhibit the proliferation, invasion and migration of renal cell carcinoma ACHN cells, and induce cell apoptosis, which plays an important inhibitory role in the development of renal cell carcinoma.

Epidemiological characteristics of family clusters of COVID-19in Henan Province / 预防医学

Objective@#To learn the epidemiological characteristics of family clusters of COVID-19 in Henan Province from January 23 to February 22, 2020, so as to provide reference for the prevention and control. @*Methods@#The data of family clusters of COVID-19 in Henan Province from January 23 to February 22 was retrieved from Public Health Emergency Management System, the epidemiological characteristics of time, space, population distribution and clinical feasures were analyzed. @*Results@#By February 22, there were 202 family clusters of COVID-19, with 546 cases reported in Henan Province, including 493 ( 90.29% ) confirmed cases and 53 ( 9.71% ) asymptomatic cases. There were 247 ( 45.24% ) imported cases and 299 ( 54.76% ) local cases. Most of the clusters were reported from January 25 to February 7, with 129 clusters accounting for 63.86% . The cases reported before February 5 were mainly imported ( 153 cases, 57.09% ) , after that local cases were predominant ( 168 cases, 68.29% ) . Eighteen cities in Henan Province all reported family clusters of COVID-19, with Xinyang, Zhengzhou, Nanyang, Zhumadian and Shangqiu as the top five. Most of the confirmed cases ( 430, 87.22% ) were mild. The median and longest incubation period was 8 and 17 days, respectively. The intergenerational distribution was dominated by first-generation and second-generation cases ( 537 cases, 98.35% ) . A total of 5 635 close contacts were tracked down, of whom 262 were secondary cases, with an incidence rate of 4.65%. The first cases of the family clusters were mainly imported from other provinces ( 149 cases, 73.76% ) .@*Conclusions @#The family clusters of COVID-19 in Henan Province were concentrated from January 25 to February 7. The source of infection mainly comes from other provinces. Most of the cases are first-and second-generation cases, with longer incubation period. Close contacts have higher incidence rate.

Effect and safety of plasma exchange combined with plasma bilirubin absorption in the treatment of liver failure associated with hepatitis B virus / 新乡医学院学报

Objective To investigate the clinical effect of plasma exchange(PE)combined with plasma bilirubin ad-sorption(PBA)in the treatment of liver failure associated with hepatitis B virus(HBV). Methods A total of 75 patients with HBV related liver failure were selected from May 2014 to May 2016 in the People's Hospital of Guangxi Zhuang Autonomous Region. The patients were divided into PE group,PBA group and PE combined PBA(PE + PBA)group according to their will, 25 cases in each group. The levels of serum alanine aminotransferase(ALT),total bilirubin(TBIL),albumin(ALB),prothrom-bin time(PT),prothrombin activity(PTA),serum creatinine(SCr)and blood ammonia were compared among the three groups before and after treatment,and the adverse reactions were observed. Results There was no significant difference in serum ALT,TBIL,ALB and SCr levels among the three groups before treatment(P > 0. 05). The levels of serum ALT,TBIL and SCr after treatment were significantly lower than those before treatment in the three groups(P < 0. 05). The level of serum ALB af-ter treatment was significantly higher than that before treatment in the PE group and the PE + PBA group(P < 0. 05),but the level of serum ALB after treatment was significantly lower than that before treatment in the PBA group (P < 0. 05). There was no significant difference in serum ALT,TBIL and SCr levels among the three groups after treatment(P > 0. 05). The serum ALB levels in the PE group and the PE + PBA group was significantly higher than that in the PBA group after treatment(P <0. 05). There was no significant difference in serum ALB level between the PE group and the PE + PBA group after treatment (P > 0. 05). There was no significant difference in the PT,PTA and blood ammonia level among the three groups before treat-ment(P > 0. 05). Compared with before treatment,the PT shortened significantly after treatment,the PTA increased significant-ly,and the blood ammonia level decreased significantly in the three groups(P < 0. 05). Compared with the PBA group,the PT shortened significantly,the PTA increased significantly,and the blood ammonia level decreased significantly in the PE group and the PE + PBA group after treatment(P < 0. 05). There was no significant difference in PT,PTA and blood ammonia level between the PE group and the PE + PBA group after treatment(P > 0. 05). The plasma consumption of patients in the PE group and the PE + PBA group was(2908. 11 ± 287. 91)and(1107. 24 ± 213. 67)mL respectively,the plasma consumption in the PE + PBA group was significantly less than that in the PE group(t = 23. 782,P < 0. 05). The treatment time of patients in the PE group,the PBA group and the PE + PBA group was(2. 90 ± 0. 87),(3. 02 ± 0. 77),(3. 22 ± 0. 69)h respectively;there was no significant difference in the treatment time among the three groups(F = 1. 881,P > 0. 05). The total effective rate in the PE group,the PBA group and the PE + PBA group was 64. 0％(16 / 25),56. 0％(14 / 25),64. 0％(16 / 25),respectively;there was no significant difference in the total effective rate among the three groups(χ2 = 7. 281,P > 0. 05). The incidence of eryth-ra,chill and rigor,numbness and convulsion,infection and errhysis in the PE group was 32. 0％(8 / 25),28. 0％(7 / 25), 16. 0％(4 / 25),8. 0％(2 / 25),8. 0％(2 / 25),respectively. The incidence of erythra,chill and rigor,numbness and convul-sion,infection and errhysis in the PBA group was 16. 0％(4 / 25),16. 0％(4 / 25),12. 0％(3 / 25),4. 0％(1 / 25),4. 0％(1 /25),respectively. The incidence of erythra,chill and rigor,numbness and convulsion,infection and errhysis in the PE + PBA group was 20. 0％(5 / 25),20. 0％(5 / 25),12. 0％(3 / 25),4. 0％(1 / 25)and 4. 0％(1 / 25),respectively. The incidence of erythra,chill and rigor,numbness and convulsion,infection and errhysis in the PBA group and the PE + PBA group was signifi-cantly lower than that in the PE group(P < 0. 05). There was no significant difference in the incidence of erythra,chill and rig-or,numbness and convulsion,infection and errhysis between the PBA group and the PE + PBA group(P > 0. 05). Conclusion PE combined with PBA is effective,safe and feasible in the treatment of HBV related liver failure,and it can reduce plasma consumption.

Effects of patient-controlled infraclavicular brachial plexus block for postoperative pain and surgical efficacy in patients with terrible tyriad of the elbow / 中国骨伤

<p><b>OBJECTIVE</b>To study the effects of ultrasound guided inter-scalene brachial plexus block and patient-controlled infraclavicular brachial plexus block for postoperative pain and surgical efficacy in patients with terrible tyriad of the elbow.</p><p><b>METHODS</b>From March 2015 to August 2016, 60 patients with terrible tyriad of the elbows were treated in Ningbo No.6 Hospital with ASA I to II internal fixation. There were 32 males and 28 females, ranging in age from 16 to 70 years old, with a mean age of (55.6±18.2) years old. All the patients were divided into two groups(30 cases in each group): controlled intermuscular groove brachial plexus block (group C), infraclavicular brachial plexus block(group I). All catheters were placed using ultra-sound visualization and injected 0.33% ropivacaine 30 ml preoperatively. After regaining consciousness, all patients connected the electronic pump. The solution contained 0.2% ropiva-caine and the pump was setup to deliver a 5 ml bolus dose, with a 15 min lock out interval and background infusion at 5 ml/h. Both analgesia lasted until 5 d after operation. The patients underwent rehabilitation exercise everyday for 5 consecutive days starting from 24 h after operation.VAS score was recorded at 24 h, 48 h, 72 h and 4 d, 5 d after operation during rest and rehabilitation exercise time. The elbow articular range of motion and Mayo elbow performance score (MEPS) were recorded at 6 d after operation. Catheter-related adversereactions (such as oozing from the insertion site, obstruction, prolapse) were recorded.</p><p><b>RESULTS</b>The success rate of blockade was 100% during insertion in both groups. Compared with group C, the VAS score at 3 d during rest time and 3, 4, 5 d after operation during rehabili-tation exercise were decreased(2.5±0.5 vs. 3.8±1.1, 3.0±0.4 vs. 5.0±0.9, 2.5±0.4 vs. 4.5±1.2, 2.1±0.3 vs. 4.1±1.0,<0.05). The elbow articular range of motion and MEPS were increased(-2.19±18.01)° vs.(-8.19±12.16)°, (45.15±11.20)° vs. (22.15±7.02)°, (19.06±6.75)° vs. (9.10±2.48)°, (17.08±5.18)° vs. (10.12±3.15)°, (80.80±9.50) points vs. (64.90±11.21) points. The incidence of insertion site, obstruction, prolapse was 15, 5 and 10 cases respectively in group C, but without any catheter-related adverse reactions happened in group I (<0.05).</p><p><b>CONCLUSIONS</b>Patient-controlled infraclavieular brachial plexus block can be effectively used for postoperative pain after fixation for terrible tyriad of the elbows, and it can increase surgical outcome.</p>

Comparison of Positron Emission Tomography Using 2-18F-fluoro-2-deoxy-D-glucose and 3-deoxy-3-18F-fluorothymidine in Lung Cancer Imaging / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The detection of solitary pulmonary nodules (SPNs) that may potentially develop into a malignant lesion is essential for early clinical interventions. However, grading classification based on computed tomography (CT) imaging results remains a significant challenge. The 2-[18F]-fluoro-2-deoxy-D-glucose (18F-FDG) positron emission tomography (PET)/CT imaging produces both false-positive and false-negative findings for the diagnosis of SPNs. In this study, we compared 18F-FDG and 3-deoxy-3-[18F]-fluorothymidine (18F-FLT) in lung cancer PET/CT imaging.</p><p><b>METHODS</b>The binding ratios of the two tracers to A549 lung cancer cells were calculated. The mouse lung cancer model was established (n = 12), and micro-PET/CT analysis using the two tracers was performed. Images using the two tracers were collected from 55 lung cancer patients with SPNs. The correlation among the cell-tracer binding ratios, standardized uptake values (SUVs), and Ki-67 proliferation marker expression were investigated.</p><p><b>RESULTS</b>The cell-tracer binding ratio for the A549 cells using the 18F-FDG was greater than the ratio using 18F-FLT (P < 0.05). The Ki-67 expression showed a significant positive correlation with the 18F-FLT binding ratio (r = 0.824, P< 0.01). The tumor-to-nontumor uptake ratio of 18F-FDG imaging in xenografts was higher than that of 18F-FLT imaging. The diagnostic sensitivity, specificity, and the accuracy of 18F-FDG for lung cancer were 89%, 67%, and 73%, respectively. Moreover, the diagnostic sensitivity, specificity, and the accuracy of 18F-FLT for lung cancer were 71%, 79%, and 76%, respectively. There was an obvious positive correlation between the lung cancer Ki-67 expression and the mean maximum SUV of 18F-FDG and 18F-FLT (r = 0.658, P< 0.05 and r = 0.724, P< 0.01, respectively).</p><p><b>CONCLUSIONS</b>The 18F-FDG uptake ratio is higher than that of 18F-FLT in A549 cells at the cellular level. 18F-FLT imaging might be superior for the quantitative diagnosis of lung tumor tissue and could distinguish lung cancer nodules from other SPNs.</p>

Case-control study on the effect of ulinastatin on postoperative complications in elderly patients undergoing hip joint replacement / 中国骨伤

<p><b>OBJECTIVE</b>To evaluate the preventive effects of ulinastatin (Uti) on postoperative complications in elderly patients undergoing hip joint replacement.</p><p><b>METHODS</b>From Angust 2009 to June 2010, 160 elderly patients undergoing selective hip joint replacement with ASA I to II were assessed according to American Society of Anesthesiologists classification, including 81 males and 79 females ranging in age from 65 to 83 years (mean 73.9 years). All the patients were divided into 2 groups according to random number table (80 patients in each group): control group (group C) and ulinastatin group (group U). The patients in Group U received intravenous injection of ulinastatin with a dose of 10,000 U/kg before skin incision,and then with dose of 5000 U/kg respectively at 1, 2 and 3 days after operatio. The patients in Group C received the same volume of normal saline instead of ulinastatin. Blood samples were taken preoperatively,at the end of surgery and 1, 2, 3 days after operation for determination of ALT, AST, Scr, BUN and Plasma D-dimer. Deep vein thrombosis and postoperative cognitive dysfunction (POCD) were also examined through color Doppler ultrasonography and neuroeognirive assessment on the postoperative 3 days respectively.</p><p><b>RESULTS</b>Compared with the preoperative values, the contents of ALT, AST, Scr, BUN and plasma D-dimer in each group all increased. Compared with group C,the values of ALT, AST, Scr, BUN and plasma D-dimer decreased markedly (P < 0.05). The incidence rate of DVT and POCD was 0 and 3.75% in group U, which were lower than those of patients in the group C (40%, 27.5%) respectively.</p><p><b>CONCLUSION</b>Intravenous infusion of ulinastatin during operation can protect important organ function, correct blood hypercoagulability, lower the occurrence of DVT and POCD, and prevent the postoperative complications in some degree.</p>

Effects of ulinastatin on coagulation function and deep vein thrombosis in patients undergoing hip joint replacement / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the effects of ulinastatin (Uti) and low-molecular-weight heparin (Lmwh) on coagulation function and deep vein thrombosis (DVT) in patients undergoing hip joint replacement.</p><p><b>METHODS</b>From March to December 2010 150 ASAI-II patients with average age of 72.5 (65 - 85) years undergoing hip joint replacement were randomly divided into 3 groups (n = 50 each): normal saline (NS) control group (Group C), Uti group (Group U) and Lmwh group (Group L). Group U received intravenous infusion of ulinastatin (10 000 U/kg) at preoperative, perioperative and after operation 1, 2 and 3 d, respectively. Group C received the same volume of NS instead of Uti. Group L were injected Lmwh subcutaneously (3200 U/d) at preoperative, after operation 1, 2 and 3 d. Blood samples were taken before operation (T(0)), at the end of surgery (T(1)), 1 d (T(2)), 2 d (T(3)) and 3 d (T(4)) after operation for determination the values of R, K, α angle, MA and CI, using thromboelastography, and the DVT were also examined through color Doppler ultrasonography at 3 d after operation.</p><p><b>RESULTS</b>Compared with T(0), R, K were shorter, α angle, MA and CI were larger in group C, the values at T(2) were up to the peak then declined at T(4). Compared with group C, the value of R, K were larger, the value of α angle, MA and CI were shorter in group U and group L. The DVT checked by ultrasonography were found in 20 cases in group C, 1 case in group U, and zero case in group L. The differences were no statistically significant between group U and group L.</p><p><b>CONCLUSION</b>Intravenous infusion of Uti during the period of operation can correct the hypercoagulability of blood and decrease the incidence of DVT after operation.</p>

Effect of ulinastatin on post-operative cognition disorders in elderly patients undergoing hip joint replacement / 中国骨伤

<p><b>OBJECTIVE</b>To evaluate the effect of ulinastatin on post-operative Cognition disorders in elderly patients undergoing hip joint replacement.</p><p><b>METHODS</b>Forty ASA I or II elderly patients undergoing selective hip joint replacement, aged > or = 65 years, were randomly divided into 2 groups (n = 40 each): control group and ulinastatin group. Ulinastatin group received iv infusion of ulinastatin (10,000 u/kg) after skin incision, (5,000 U/kg) after operation 1, 2, 3 d respectively, included 21 males and 19 females with an average age of (75.00 +/- 7.81) years old. Control group received the same volume of normal saline instead of ulinastatin, included 20 males and 20 females with an average age of (72.80 +/- 7.25) years old. Neuroeognitive testing was performed on the preoperative day and on the 3th postoperative day and post-operative cognition disorders was defined as 1 SD decline from baseline on neurocognitive assessment. Serum S100beta protein were measured before operation, at the end of surgery, 3, 24 h and 3 d after operation.</p><p><b>RESULTS</b>The incidence rate of postoperative cognition disorders was 2.5% in ulinastatin group, there were lower than those of patients in the control group (25%) (P < 0.05); In control group, the scales for MMSE before and after operation were (25.2 +/- 2.1), (22.6 +/-2.5) scores and the level of serum S100beta protein at T0-4 were (0.041 +/- 0.012), (0.125 +/- 0.031), (0.178 +/- 0.036), (0.142 +/- 0.038), (0.048 +/- 0.015) microg/L. As well in ulinastatin group, above date were (25.9 +/- 2.4), (24.8 +/- 2.1), (0.040 +/- 0.013), (0.095 +/- 0.021), (0.116 +/- 0.017), (0.087 +/- 0.019) and (0.043 +/- 0.012) respectively. Compared with preoperative, MMSE evaluation scale was decreased on the 3th postoperative day and the S100beta was increased markedly at T1-3 in control group (P < 0.05); Compared with control group, MMSE evaluation scale was increased and the S100beta was decreased markedly at T1-3 in ulinastatin group (P < 0.05 ).</p><p><b>CONCLUSION</b>Intravenous infusion of ulinastatin during operation can prevent the occurrence of POCD in elderly patients.</p>