Risk factors for peripherally inserted central catheterization-associated bloodstream infection in neonates / 中国当代儿科杂志

OBJECTIVES@#To study the features of catheter-related bloodstream infection (CRBSI) or central line-associated bloodstream infection (CLABSI) after peripherally inserted central catheterization (PICC) in neonates admitted to the neonatal intensive care unit (NICU) and the risk factors for CRBSI or CLABSI.@*METHODS@#A retrospective analysis was performed on the medical data of the neonates who were treated and required PICC in the NICU of the Children's Hospital, Zhejiang University School of Medicine from June 1, 2018 to May 1, 2020. The catheterization-related data were collected, including placement time, insertion site, removal time, and antimicrobial lock of PICC. The multivariate logistic regression model was used to investigate the risk factors for CRBSI or CLABSI in the neonates.@*RESULTS@#A total of 446 neonates were enrolled, with a mean gestational age of (30.8±4.0) weeks, a mean birth weight of (1 580±810) g, a median age of 9 days, and a median duration of PICC of 18 days. The incidence rates of CLABSI and CRBSI were 5.6 and 1.46 per 1 000 catheter days, respectively. Common pathogens for CLABSI caused by PICC included Staphylococcus epidermidis (n=19) and Klebsiella pneumoniae (n=11), and those for CRBSI caused by PICC included Klebsiella pneumoniae (n=6). The risk of CLABSI caused by PICC increased significantly with prolonged durations of PICC and antibiotic use, and the PICC-related infection probability at head and neck was significantly lower than that in the upper and low limbs (P<0.05), while the above conditions were more obvious in neonates with a birth weight of <1 500 g. The risk of CRBSI caused by PICC decreased with the increase in gestational age (P<0.05).@*CONCLUSIONS@#CRBSI and CLABSI remain serious issues in NICU nosocomial infection. The identification of the risk factors for CRBSI and CLABSI provides a basis for improving the quality of clinical care and management.

Mortality and life lost due to lung cancer among Longyou residents / 预防医学

Objective To learn the mortality and trend of lung cancer among Longyou residents, and to provide scientific basis for comprehensive prevention and control of lung cancer. Methods Data from the surveillance of lung cancer mortality among Longyou residents from 2010 to 2016 were collected. Crude mortality rate, standardized mortality rate of lung cancer (standardized by the 2010 national census data), potential years of life lost rate (PYLLR) and standard potential years of life lost rate (SPYLLR) were calculated. Descriptive analysis was conducted in the gender, age distribution and potential life loss caused by lung cancer. Results From 2010 to 2016, there were 1555 cases of lung cancer in Longyou County, with a mortality rate of 48.17/100000 and a standardized mortality rate of 38.05/100000, ranking first among the deaths of malignant tumors.The mortality rate of lung cancer increased year by year (P<0.01) .The annual mortality rate of males lung cancer was 72.05/ 100000, higher than that of females (P<0.001) .The mortality rate of males with lung cancer increased year by year (P<0.01), with an average annual growth rate of 4.69％. The annual growth rate of females with lung cancer mortality was 2.49％, but there was no significant increase (P>0.05) .Lung cancer mortality increased with age (P<0.001), of which 1243 cases died of lung cancer, accounting for 79.94％ of total lung cancer deaths. The potential life loss of lung cancer from 2010 to 2016 was 12471 person-years, with PYLLR of 4.41‰and SPYLLR of 3.72‰. The SPYLLR of males with lung cancer was 5.31‰ and that of females was 1.95‰. Conclusion The mortality rate of Lung cancer among residents in Longyou County has been increasing, which mainly endangers people over 60 years old. The mortality rate and PYLLR of males with lung cancer are higher than that of females.

Relative analysis of OPN and its related signal molecules in hepatocellular carcinoma / 中华肝脏病杂志

Osteopontin (OPN) has close relationship with metastasis in hepatocellular carcinoma but its downstream signal pathways have not been well defined in hepatocellular carcinoma. The object of this study is to identify the associated signal pathways in human HCC tissues. The expressions of OPN, intergrin aV, CD44v6, P-FAK, FAK, P-Src, Src, P-ERK and P-AKT were assayed using TMA analysis. The relationship of OPN with P-ERK, P-Src and P-AKT were explored and the role in HCC metastasis was analysed. The expression levels of OPN, intergrin aV, CD44v6, P-FAK, P-Src, Src, P-ERK and P-AKT in HCC tissue were significantly higher than that in normal tissue (P value is less than 0.05). No significant difference was found between the expression levels of FAK in HCC tissue and normal tissue (P value is more than 0.05). OPN expression was significantly associated with Integrin av (P value is less than 0.01), CD44V6 (P value is less than 0.01) and P-ERK (P value is less than 0.05) but not with P-Src, P-FAK and P-AKT (P value is more than 0.05). The expressions of P-FAK (P value is less than 0.05), P-Src (P value is less than 0.01) and P-AKT (P value is less than 0.05) were significantly associated with Integrin av and the P-FAK expression was also significantly associated with CD44V6 (P value is less than 0.01). OPN promotes HCC metastasis though Integrin av/CD44V6/MAPK pathway in human HCC.

Suppressing the growth of Hep-2 human laryngeal cancer cells by silencing survivin gene in vitro and in vivo / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To study the effect of silencing survivin on the growth of Hep-2 human laryngeal cancer cells in vitro and in vivo.</p><p><b>METHODS</b>Hep-2 cells were transfected with pGCsilencer-siRNA-survivin (psi-survivin)by Lipofectamine 2000. The mRNA and protein expressions of survivin were detected by semi-quantitative RT-PCR and Western blot, respectively. Cell proliferation activity was measured by MTT assay. Apoptosis was assessed by flow cytometry. The implanted tumors were formed from injected Hep-2 cells in nude mice. After the tumor formation, psi-survivin was injected into peritumor tissues. The growth of tumor were observed. The tumor volume was calculated and the tumor growth curve was plotted. The expression of survivin in tumor tissues was detected by Western blot. The tumor cell apoptosis was observed by Tunel staining.</p><p><b>RESULTS</b>The sequence-specific siRNA of survivin inhibited the expressions of survivin mRNA and protein. The inhibition rates of survivin mRNA and protein expression were 54.4% and 37.0% respectively. Also the growth of Hep-2 cells was inhibited significantly, with a decrease by 71.7%. By the day 32 of tumor growth, the mean tumor volumes were (1443.9 ± 230.5) mm(3) (x(-) ± s) in saline control group, (1348.5 ± 198.4) mm(3) in plasmid-negative control group, and (624.6 ± 188.4) mm(3) in psi-survivin group, respectively (t = -5.917, P < 0.01). In the implanted tumors injected with psi-survivin, survivin protein expression was down-regulated significantly, with a inhibition rate of 41.8%. Tunel staining showed the apoptosis occurred in the implanted tumors.</p><p><b>CONCLUSION</b>Silencing survivin could significantly inhibit the growth of Hep-2 human laryngeal cancer cells in vitro and in vivo.</p>

Expression of ghrelin and calcium channels in pancreas of neonatal rats with different birth weight / 浙江大学学报·医学版

<p><b>OBJECTIVE</b>To investigate the effect of the intrauterine environment on pancreas ghrelin and L-type calcium channels of islet like cell clusters (ICCs) in neonatal rats.</p><p><b>METHODS</b>Different birth weight neonatal rat models were established. The samples of entire pancreas or ICCs were collected at the first day after birth. Ghrelin, Cav1.2, Cav1.3 mRNAs and proteins were determined using real-time RT-PCR and immunohistochemistry respectively.</p><p><b>RESULT</b>The real-time RT-PCR revealed that ghrelin mRNA in SGA group were significantly higher than that of the AGA group (P <0.05). Cav1.2 mRNA of SGA group and LGA group was significantly lower than that of the AGA group; Cav1.3 mRNA of SGA group was significantly lower than that of the AGA group (P <0.05). The results of integral OD value of immunohistochemistry were consistent with those of real-time RT-PCR.</p><p><b>CONCLUSION</b>Intrauterine nutritional status may affect pancreatic endocrine cells differentiation and maturity, resulting in the difference of expression ghrelin and calcium channels in ICCs.</p>

Expression of thyroid transcription factor-1 in hepatocellular carcinoma / 上海第二医科大学学报

Objective To investigate the value of thyroid transcription factor-1(TTF-1) in the diagnosis and biological behavior assessment of hepatocellular carcinoma (HCC). Methods Thirty liver specimens obtained from benign lesions were analysed, among which 25 were hepatic cirrhosis and inflammatory diseases, and the other 5 were adenomas. And there were 176 specimens of liver tumors, among which 142 were HCC (well differentiated, n=12; moderately differentiated, n=57; poorly differentiated, n=73), 17 were intrahepatic cholangiocellular carcinoma (ICC) and the other 17 were liver metastatic carcinoma (MC). The expression of TTF-1 was examined immunohistochemically in the above tissues, and the difference in expression of TTF-1 among different tissues was examined by Fisher's exact test, Kruskal-Wallis test and Spearman rank correlation analysis. Results TTF-1 was significantly expressed in the cytoplasms of all the hepatocytes besides tumors and liver benign lesions. The expression rate of TTF-1 in HCC was 78.9% (112/142), however, TTF-1 was negatively expressed in ICC and MC(P

Clinicopathology of mixed epithelial and stromal tumor of kidney / 上海第二医科大学学报

Objective To investigate the pathological features and differential diagnosis of mixed epithelial and stromal tumor of the kidney(MESTK). Methods Three patients with MESTK were studied by light microscopy and immunohistochemistry,and related literatures were reviewed. Results In the three patients,two were females and one was male,with the mean age of 20 years old.Examined grossly,the tumors were well circumscribed and typically composed of multiple cysts and solid areas.Microscopically,the tumors were composed of epithelial and spindle cells,both of the which were well differentiated with no atypia and mitosis of the nuclei.The immunohistochemical staining showed positive for the cytokeratin in the epithelial cells,and Vimentin,SMA,actin,PgR or ER and WT-1 in the spindle cells.No tumor recurrence and metastasis was found in all the three patients by 25 to 29 months of follow up. ConclusionMESTK is an uncommon mixed renal neoplasm with a favorable prognosis.

Analysis of Comparative Genomic Hybridization in Pleomorphic Xanthoastrocytoma / 上海第二医科大学学报

Objective To detect genetic alterations in pleomorphic xanthoastrocytoma (PXA), and to investigate the mechanism of development of this neoplasm. Methods Three patients with PXA were studied. Comparative genomic hybridization (CGH) was performed to study chromosomal imbalances in PXA. Using immunohistochemical analysis, the expression of EGFR was detected in PXA. Results Using CGH analysis, genetic imbalance was detected on at least one chromosome for each case. One patient revealed multiple genetic alterations, including gains of 2p14-pter, 4p15-pter, 7p21-qter, 11q24-qter, 12 and 15q14-qter,as well as losses of 8p11.2-pter, 9p11-p23, 10p12-pter, and 13q14-qter. This patient experienced tumor recurrence and died one year later. Gain on Chromosome 7 and loss on Chromosome 8p were demonstrated in 2 of the 3 patients. Immunohistochemically, no EGFR positive reaction was found in all cases. Conclusion Detection of genetic alterations is very important in understanding the pathogenesis of PXA.