Comparison of the effectiveness of two pulmonary surfactant administration methods among premature infants with respiratory distress syndrome / 预防医学

Objective@#To compare the effectiveness of less invasive surfactant administration (LISA) and intubate surfactant extubation (INSURE) on respiratory distress syndrome (RDS) among premature infant, so as to provide insights into improving treatment effects and reducing complications of RDS among premature infants.@*Methods@#A total of 71 premature infants with RDS in Anhui Provincial Maternity and Child Health Hospital were randomly assigned into the LISA and INSURE group, and pulmonary surfactant (PS) administration was carried out by LISA and INSURE with basic support therapy and respiratory support therapy. The general information, arterial blood gas analysis before and after treatment, respiratory support time and incidence of complications were collected and compared between the two groups.@*Results@#There were 31 cases in the LISA group, with a gestational age of (29.81±0.99) weeks and 22 male cases, and 40 cases in the INSURE group, with a gestational age of (30.02±1.13) weeks and 26 male cases. There were no significant differences in basic characteristics (including gestational age, birth weight, gender, etc.) between the two groups (all P>0.05). After administration, the level of PaO2 was lower in the LISA group than in the INSURE group [(78.35±6.55) mmHg vs. (87.68±8.21) mmHg, P<0.05], the level of PaCO2 was higher in the LISA group than in the INSURE group [(43.03±6.34) mmHg vs. (38.68±9.69) mmHg, P<0.05], and the incidence of bronchopulmonary dysplasia was lower in the LISA group than in the INSURE group (48.39% vs. 72.50%, P<0.05). Linear regression analysis showed that with the duration of LISA administration increase (2-7 min), the minimum heart rate of premature infants increased linearly (β=13, P<0.05). @*Conclusions@#Compared with INSURE, LISA administration could slowly improve ventilation oxygenation, reduce hyperventilation and incidence of bronchopulmonary dysplasia among premature infants with RDS. The incidence of slow heart rate may be reduced by appropriately prolonging the administration duration.

Enzyme-linked immunosorbent assays for quantification of MMMAE-conjugated ADCs and total antibodies in cynomolgus monkey sera / 药物分析学报

Antibody-drug conjugates(ADCs)are commonly heterogeneous and require extensive assessment of exposure-efficacy and exposure-safety relationships in preclinical and clinical studies.In this study,we report the generation of a monoclonal antibody against monomethyl auristatin E(MMAE)and the development,validation,and application of sensitive and high-throughput enzyme-linked immunosor-bent assays(ELISA)to measure the concentrations of MMAE-conjugated ADCs and total antibodies(tAb,antibodies in ADC plus unconjugated antibodies)in cynomolgus monkey sera.These assays were suc-cessfully applied to in vitro plasma stability and pharmacokinetic(PK)studies of SMADC001,an MMAE-conjugated ADC against trophoblast cell surface antigen 2(TROP-2).The plasma stability of SMADC001 was better than that of similar ADCs coupled with PEG4-Val-Cit,Lys(m-dPEG24)-Cit,and Val-Cit linkers.The developed ELISA methods for the calibration standards of ADC and tAb revealed a correlation be-tween serum concentrations and the OD450 values,with R2 at 1.000,and the dynamic range was 0.3-35.0 ng/mL and 0.2-22.0 ng/mL,respectively;the intra-and inter-assay accuracy bias％ranged from-12.2％to-5.2％,precision ranged from-12.4％to-1.4％,and the relative standard deviation(RSD)was less than 6.6％and 8.7％,respectively.The total error was less than 20.4％.The development and validation steps of these two assays met the acceptance criteria for all addressed validation parameters,which suggested that these can be applied to quantify MMAE-conjugated ADCs,as well as in PK studies.Furthermore,these assays can be easily adopted for development of other similar immunoassays.

Effect of pregnancy related anxiety on executive function of preschool children and gender difference / 中国学校卫生

Objective@#To understand the effect of pregnancyrelated anxiety on preschool childrens executive functions(EFs) and gender difference in order to optimize the early development environment of offspring life.@*Methods@#This study was based on the ChinaAnhui Birth Cohort Study. Pregnant women from Maternal and Child Health Care Hospital in Maanshan, Anhui province between October 2008 and October 2010 were recruited. The general information of pregnant women and the pregnancyrelated anxiety were collected prospectively in the first trimester of pregnancy. A cohort of 3 556 children aged 3-5 were followed up and their basic characteristics were collected. Executive function of preschool children was assessed by Behavior Rating Inventory of Executive FunctionPreschool Version(BRIEF) (parent version).@*Results@#In boys, compared with the control group, pregnancyrelated anxiety in the first trimester of pregnancy was associated with the risk of abnormality in working memory, planning/organization and GEC[OR(95%CI)=1.40(1.06-1.85), 1.64(1.06-2.54), 1.89(1.27-2.82)]. Anxiety in the both trimesters of pregnancy was associated with the risk of abnormality in inhibition, working memory, planning/organization and GEC[OR(95%CI)=2.60(1.45-4.67), 2.45(1.69-3.57), 2.23(1.28-3.88), 3.27(2.03-5.28)]. In girls, pregnancyrelated anxiety in the first trimester of pregnancy was associated with the risk of abnormality in inhibition and working memory[OR(95%CI)=1.79(1.13-2.83), 1.45(1.07-1.98)]. Anxiety in the third trimester of pregnancy was associated with the risk of abnormality in inhibition[OR(95%CI)=2.26(1.17-4.38)]. Anxiety in both trimesters of pregnancy was associated with the risk of abnormality in inhibition and working memory[OR(95%CI)=2.45(1.40-4.28), 2.02(1.35-3.01)].@*Conclusion@#Pregnancyrelated anxiety significantly affected the executive function of preschool children, and there was a significant doseresponse relationship. Pregnancyrelated anxiety primarily affects working memory, planning/organization and GEC function in boys, and the working memory, inhibition function in girls.

The Training Effect of Ability to Timely Screening for Congenital Heart Disease among Primary Medical Workers in Yunnan Province / 昆明医科大学学报

Objective To improve the early diagnosis of congenital heart disease (CHD), investigate the awareness, screening knowledge and screening ability of CHD among health care providers in the rural areas of Yunnan province and discover an effective way to improve the related knowledge and skills of CHD screening. Methods From 2015 September to 2017 April, we set up charity mobile schools and chose eight areas as the investigating and training sites. We designed two questionnaires, and adopted the theoretical training as the main method combined with the training of clinical skills. We investigated and trained a total of 1022 medical staff. The training content include the awareness of CHD,the knowledge and skills of CHD screening. We also evaluated the outcomes of the training. Results A total of 2044 questionnaires were collected. After training, the number of objects which would screen CHD in future increased, and the cognition of the incidence and common clinical manifestations of CHD, Eisenmanger's syndrome,cardiac auscultation, pulse oximetry and the related knowledge of CHD were also improved; 563 took the test on practical skills of CHD detection. The correct rate of auscultation, period of murmurs and characteristics of murmurs was 98.22%(553),30.55%(172) and 28.60%(161). The correct rate of murmurs in ventricular septal defect,atrial septal defect and patent ductus arteriosus was 45.47%(256), 39.79 (224) and 50.80%(286) respectively. Online training was advised by 244 trainees. Increasing investment in congenital heart disease screening was suggested by 652 trainees. Conclusions The awareness of CHD screening in grassroots medical workers of Yunnan province is insufficient. It is an effective way to establish charity mobile school and to train the grassroots medical staff with the theory and practical knowledge to improve the awareness,screening knowledge and screening skills of CHD. The next step suggests that we can improve the early diagnosis of congenital heart disease (CHD).

Consideration on Cultivation Mechanism of Clinical Medicine Postgraduates Based on Post Competency / 昆明医科大学学报

Objective To analyze the problems and reasons in the clinical medicine postgraduate cultivation.We stated the competency of clinical medicine postgraduates according to the transition of health demands global medical development and practical requirements for clinical personnel. Me thods Questionnaire surveys combined with interviews were conducted, and statistical analysis was performed. In the first part, we selected the permanent staff with qualifications of medical clinicians, including: chief physicians, associate chief physicians, physicians, residents, accounting for 72％ of the interviewees; And related personnel, including nurses, administrators and patients, were also interviewed, accounting for 28％ of the total. 90 questionnaires were distributed, and 86 valid questionnaires were recovered, with an effective rate of 95.56％. In the second part, graduate students with clinical professional degrees were selected for interviews, 96 questionnaires were distributed, and 92 valid questionnaires were collected, and the effective rate was 95.83％.Re s ults There was a certain gap between the expected goal and the actual situation of the post competency of clinical professional degree graduate students, and the gap had a certain statistical significance. The clinical professional degree graduate students paid more attention to the doctor-patient communication, teamwork. Conclus ions We elaborated the required post competence for clinical medicine postgraduates on the basis of its content and characteristic. We propose to strengthen the cultivation of clinical medicine postgraduates by the reform and support of the government enhanced construction of teachers improved course plan and cultivation process perfected assessment system in order to make the students competent to their posts.

Effects of extracorporeal cardiac shock wave therapy in patients with ischemic heart failure / 中华心血管病杂志

<p><b>OBJECTIVE</b>To evaluate the feasibility, safety and efficiency of extracorporeal cardiac shock wave therapy (CSWT) in patients with ischemic heart failure.</p><p><b>METHODS</b>Fifty patients with ischemic heart failure and left ventricular ejection fraction (LVEF) < 50% were randomized to CSWT (shots/spot at 0.09 mJ/mm(2) for 9 spots, 9 times within 3 month) or control group. Dual isotope simultaneous acquisition single-photon emission computed tomography with (99)Tc(m)-sestamibi/(18)F-fluorodeoxyglucose ((99)Tc(m)-MIBI/(18)F-FDG) was performed before randomization and at 1 month after CSWT/control to locate and evaluate viable myocardium region. Canadian cardiovascular society (CCS) class sores, NYHA, Seattle Angina Questionnaire (SAQ), 6-min walk test (6 MWT), left ventricular ejection fraction (LVEF), left ventricular end-diastolic dimension (LVEDD) and the dosage of nitroglycerin use were compared between two groups at each time point.</p><p><b>RESULTS</b>All patients completed the study protocol without procedural complications. At 1 month, patients in CSWT group experienced improvement in NYHA (P < 0.01), CCS (P < 0.01), SAQ (P = 0.021), 6 MWT (P = 0.012) and dosage of nitroglycerin use (P < 0.01) compared to baseline. LVEF [45.0 (39.0, 48.0) vs. 47.0 (42.0, 50.0) P = 0.001], LVEDD [58.0 (56.0, 59.0) vs. 56.0 (55.0, 58.0) P = 0.002], summed perfused score [23.0 (20.5, 24.5) vs. 20.0 (18.0, 22.0) P < 0.01] and metabolic score [25.0 (23.0, 26.0) vs. 24.0 (21.5, 25.0) P = 0.028] were also improved in CSWT group. All these parameters remained unchanged in control group between baseline and at 1 month. CSWT was independent factor for improved cardiac function, quality of life and echocardiography parameters after adjusting for known factors which might affect outcome.</p><p><b>CONCLUSION</b>CSWT could improve symptom, cardiac function, quality of life and exercise tolerance in patients with ischemic heart failure, CSWT might serve as a new, non-invasive, safe and efficient therapy for these patients.</p>

Effects of Long-term Administration of Low-dose FTY720 on Survival of Murine Cardiac Allograft / 华中科技大学学报（医学）（英德文版）

This study examined the effect of long-term administration of low-dose FTY720 on survival of murine cardiac allograft and the possible mechanism.Murine models of abdominal heterotopic heart transplantation were established.Low-dose FTY720 (0.3 mg/kg) was administrated to the animals 4 days before the transplantation of cardiac allografis until the occurrence of rejection or the observation terminals.The animals without FTY720 treatment and those with syngencic cardiac grafts transplanted served as controls.The mean survival time (MST) of grafts,and T lymphocyte subsets in gratis,peripheral blood and lymphoid organs were measured by histopathological examination or flow cytometry,and compared among groups.The results showed that the MST of allografts in FTY720-treated mice was more than 40 days,significantly longer than that in the untreated group (MST=8 days,P＜0.01).After the long-term administration of FTY720,the proportion of CD4+ and CD8+ lymphocytes in peripheral blood was diminished significantly,but the proportion ofCD4+ lymphocytes was increased in mesenteric lymph nodes (MLNs) and spleen.lmmunofluorescence staining revealcd that the infiltration of CD4+ and CD8+ lymphocytes in allografts was significantly inhibited after long-term administration of low-dose FTY720.It was concluded that low-dose long-term administration of FTY720 could promote T lymphocytes in lymphatic organs and decrease their infiltration in allografts,resulting in the inhibition of rejection and the long-term survival of allografts.

Effects of Folate Deficiency during Pregnancy of Rats on Expression of Foliate Binding Proteins Gene and WNT Signal Transduction Pathway in Heart of Offspring / 实用儿科临床杂志

Objective To study the expressions of foliate binding protein 1(Folbp1),Wnt and ?-catenin genes on the heart of offspring during the development of embryo,whose mother was deficient of folic acid.Methods Control group involving 18 rats and study group involving 18 rats were choosen from the total 36 adult female SD rats randomly copulate with the male normal rats after feeding different fodder for 2 weeks.The heart of the 13.5,17.5 days embryos and the newborns were obtained.The expressions of Folbp1,Wnt and ?-catenin genes mRNA at the 3 periods were evaluated by RT-PCR.Results The expressions of Folbp1,Wnt and ?-catenin genes mRNA of the study group were significantly weaker than those of the control group in heart of the 13.5,17.5 days embryos and the newborns(all P

Clinical observation on effect of tongnao huoluo acupuncture therapy in treating acute cerebral infarction at ultra-early or acute stage / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To evaluate the efficacy and safety of Tongnao Huoluo acupuncture (TNHLA) therapy in treating acute cerebral infarction at ultra-early stage (within 6 hrs after attack) or acute stage (within 6-48 hrs after attack).</p><p><b>METHODS</b>The effect of TNHLA in the two stages was observed separately (treated group) and compared with the effect treated with immediate thrombolysis by intravenously given urokinase 12 million units in ultra-early stage or simple body acupuncture in acute stage (control group), and with those treated with intravenous dripping of normal saline (placebo group). In the meantime, all groups treated with low molecular dextran injection for 14 days, cytidine diphosphate choline and entric soluble aspirin for 28 days.</p><p><b>RESULTS</b>Effect of TNHLA in the treated group was insignificantly different to that after thrombolysis of the control group in the ultra-early stage, but significantly higher than that of body acupuncture in acute stage. The intracranial hemorrhage rates in the treated, control, and placebo group were 3.3%, 4.0%, and 8.0% respectively.</p><p><b>CONCLUSION</b>TNHLA is effective and safe in treating acute cerebral infarction at ultra-early stage or acute stage.</p>

Effects of Folate Deficiency during Pregnancy on Expression of NKx2.5 Gene in Heart of Offspring / 实用儿科临床杂志

Objective To study the expression of NKx2.5 on the heart of offspring during the development of embryo,whose mother is deficient of folic acid.Methods 1.Control group involving 18 rats and study group involving 18 rats were chosen from the total 36 adult female SD rats randomly copulate with the male normal rats after feeding different fodder for 2 weeks.The heart of the 13.5 days,17.5 days embryos and the newborns were obtained;2.the expression of NKx2.5mRNA by RT-PCR was observed;3.the expression of NKx2.5 protein by Western-blotting was investigated.Results 1.The expression of NKx2.5 mRNA of study group was weaker than control group in heart of the 13.5 days,17.5 days embryos and the newborns(P