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Objective: To systematically evaluate the correlation between prenatal steroid exposure and hypoglycemia in late preterm neonates. Methods: Eight databases in either Chinese or English, including PubMed, the Cochrane Library, Embase, Medline, Scopus, CNKI, Wanfang and VIP, were searched to extract the studies on the correlation between prenatal steroid exposure and hypoglycemia in late preterm neonates published from the establishment of each database to December 2022. The Meta-analysis was performed using Stata 14.0 statistical software. Results: A total of 9 studies were included in this Meta-analysis, including 6 retrospective cohort studies, 2 prospective cohort studies and 1 randomized controlled trial (RCT) study, involving 9 143 premature infants. The Meta-analysis showed that prenatal steroid exposure increased the risk of late preterm neonatal hypoglycemia (RR=1.55, 95%CI 1.25-1.91, P<0.001). The similar correlation between prenatal steroid exposure and hypoglycemia in late preterm neonates was all found in the following subgroups: North America (RR=1.57, 95%CI 1.37-1.80, P<0.001), enrolling pregnant women with gestational diabetes (RR=1.62, 95%CI 1.26-2.08, P<0.001), A-grade literature quality (RR=1.43, 95%CI 1.14-1.79, P=0.002), criteria for hypoglycemia ≤40 mg/dl (1 mg/dl=0.056 mmol/L, RR=1.49, 95%CI 1.28-1.73, P<0.001), sample size of 501-1 500 (RR=1.69, 95%CI 1.19-2.40, P=0.003) and >1 500 (RR=1.65, 95%CI 1.48-1.83, P<0.001), steroid injection dosage and frequency of 12 mg 2 times (RR=1.66, 95%CI 1.50-1.84, P<0.001), the time interval from antenatal corticosteroid administration to delivery of 24-47 h (RR=1.98, 95%CI 1.26-3.10, P=0.003), unadjusted gestational age (RR=1.78, 95%CI 1.02-3.10,P=0.043) and unadjusted birth weight (RR=1.80, 95%CI 1.22-2.66, P=0.003). Meta-regression results showed that steroid injection frequency and dose were the main sources of high heterogeneity among studies (P=0.030). Conclusion: Prenatal steroid exposure may be a risk factor for hypoglycemia in late preterm neonates.
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Female , Humans , Infant , Infant, Newborn , Pregnancy , Birth Weight , Hypoglycemia/chemically induced , Infant, Premature , Randomized Controlled Trials as Topic , Steroids/adverse effects , Prenatal Exposure Delayed EffectsABSTRACT
Objective To investigate the current situation of radiological health technical service institutions and their technical services in China, and to provide a basis for better utilizing radiological health technical service resources and strengthening institutions’ capability building. Methods From October to December 2021, we conducted quality monitoring, ability comparison, capability building surveys, and other investigations on radiation health technical services to collect information on the qualifications and technical services of radiation health service institutions. The data were pooled and analyzed using SPSS software. Results By the end of 2021, there were 608 radiological health technical service institutions across China, with 47.0% of them located in the eastern region, and the percentage of institutions in the health system (42.6%) was less than that in the non-health system (57.4%). Institutions of grade A offered 62.3% of technical services, while institutions of grade B provided 37.7% of technical services; technical services provided by the non-health system and the health system accounted for 84.2% and 15.8%, respectively; institutions in the health system at the province, prefecture, and county levels offered 37.1%, 50.6%, and 12.3% of technical services, respectively. Conclusion In recent years, the proportion of institutions in the non-health system has increased significantly, but the proportion of institutions in the health system with radiological health qualifications is small, and the development is uneven in the numbers of institutions, technical services, and professional and technical personnel in the eastern, central, and western regions and at the province, prefecture, and county levels in China. It is necessary to further encourage and support health system institutions in strengthening capability building and applying for radiological health qualifications, and to increase construction and investment in the western region and at the district/county levels, in order to improve the overall capability and level of radiological health technical services in the country.
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@#Objective Based on intra-set correlation analysis, this paper deconstructs the clinical medical records of traditional Chinese medicine (TCM) Master ZHOU Zhongying in treating thyroid cancer, and analyzes the experience in “mechanism-syndrome-medicine-prescription” for thyroid cancer. Methods Through Medcase data processing platform, based on Frequent Pattern (FP)-Growth enhanced correlation analysis algorithm, the medical records of Professor ZHOU Zhongying for the treatment of thyroid cancer from June 1, 2001 to February 28, 2015 were analyzed within the set. Results This study involved 43 medical records, 43 patients, and 167 visits. After processing intra-set correlations, 28 groups of highly correlated symptoms, 21 groups of highly correlated tongue images, 10 groups of highly correlated pulse conditions, 28 groups of highly correlated pathogenesis, 34 groups of highly correlated herbs, and 26 groups of highly correlated western medicine diagnosis were selected. Professor ZHOU Zhongying treats thyroid cancer according to syndrome differentiation. Symptoms with more association rules included neck swelling, neck pain, cough, and dry mouth; tongue images with more association rules included dark purple tongue, dark red tongue, and fissured tongue; pulse conditions with more association rules were wiry pulse, thready pulse, small pulse, and slippery pulse; the pathogenesis with more association rules was phlegm and blood stasis, damp-heat accumulation, and impairment of both Qi and Yin; herbs with more association rules were Chaihu (Bupleuri Radix), Zeqi (Sun Euphoribiae Herb), and Tiandong (Asparagi Radix); western medicine diagnosis with more association rules included thyroid cancer, insomnia, and chronic gastritis. Conclusion Thyroid cancer mostly presents as deficiency in origin and excess in manifestations. The basic pathogenesis is phlegm and blood stasis, damp-heat accumulation, and impairment of both Qi and Yin, which are closely related to liver, kidney, and spleen. Professor ZHOU Zhongying adopts both attack and supplement approaches as the general treatment principle, with a strong emphasis on regulating Qi and relieving depression, eliminating phlegm and resolving stagnation, eliminating dampness and turbidity, clearing fire and destroying poison, moistening dryness and softening hard mass, invigorating Qi and nourishing Yin, and paying attention to nourishing liver and kidney, invigorating spleen and stomach, while protecting the heart and lungs.
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Objective:To construct a system for evaluating the professional capability of provincial radiological health institutions.Methods:Based on the Donabedian model and the main professional responsibilities of provincial radiological health institutions, the logical framework and indicator database of the capability evaluation system were initially constructed, the Delphi expert consultation method and analytic hierarchy process were further used to determine each indicator and its weight. The self-assessment test was carried out throughout the provincial radiological health institutions by using the system established in this study.Results:The evaluation system included 3 primary-class indicators, 11 second-class indicators, 30 third-class indicators and 76 fourth-class indicators. Taking 100 points as the full score, the self-assessment scores of the 29 provincial institutions ranged from 28.7 to 97.7 with an average of 78.7, and the scores conform to the normal distribution.Conclusions:The system established in this study are scientific, comprehensive and operable, which can be used as an effective tool to evaluate the professional capability of provincial radiological health institutions.
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To provide a reference for the application and scientific management of radiological health service testing standards, we systematically analyzed the current status of the testing items and standards in the testing of radiological health service agencies, discussed the deficiency in the update, improvement and standard framework of radiological health service testing standards and the role of radiological health service testing.
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Objective To fully grasp the professional technical capabilities of provincial level radiological health technical institutions, and so as to provide the basis for giving full play to the role of provincial level radiological health technical institutions, exploring and planning the development direction of radiological health technical institutions in China. Methods From September to December, 2019, National Institute for Radiological Protection, China CDC issued questionnaires to 37 provincial level radiological health technical institutions. The basic situation of department setting, number and composition of professional and technical personnel, equipment and radiological health work of the institutions that undertake radiological health related responsibilities were investigated, summarized and analyzed. Results Thirty-seven provincial level institutions participated in this survey, including 24 centers for Disease Control and Prevention, 11 institutions for Occupational Disease Control and Prevention, and 2 other institutions related to radiological health.Most of the institutions were qualified for radiological health related testing or evaluation; Thirty institutions had set up independent radiological health departments. There were 627 people engaged in radiological health professional and technical work, 83.4% of whom were officially on the staffs, and 16.6% are contract staffs.The distribution of gender, age, qualifications, professional title and working years in the radiological health was relatively reasonable, but only 25.8% of the staffs had the radiological education background. From 2014 to 2018, the number of radiological health professional and technical personals inflows and outflows was 164 and 65, respectively. Each institution undertakes 14.6 radiological health responsibilities in average. The annual workload of provincial level institutions was large, but there were relatively few laboratories and instruments for radionuclide measurement and internal radiation measurement. Conclusion The provincial level radiological health technical institutions still need to strengthen the capability building and make up the short board, play the leading and guiding role in provincial regions, so as to promote the further development of the national radiological health work.
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In this paper, the notice of "Opinions of the State Administration for Market Regulation on further promoting the reform of qualification accreditation of inspection and testing institutions" (No. 206 [2019] which issued on October 25, 2019 has aroused our reflection to concern the development trend of qualification accreditation of radiological health technical service institutions. In order to adapt to the changes under the new situation and avoid the risks of technical review that may be faced in the qualification accreditation of radiation health technical service institutions in the future and to discussed the ways that radiological health technical service institutions can be used to confirm the testing ability in the qualification certification process.
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Objective@#To assess the risk of public health emergencies in Zhejiang Province, March 2021. @*Methods@#An expert counsel was conducted to assess the risk of coronavirus disease 2019 ( COVID-19 ) , enteritis due to norovirus, chicken pox and influenza by professionals in Zhejiang CDC, based on the information from infectious disease and public health emergency surveillance in Zhejiang Province, domestic health administrative departments, World Health Organization, and European CDC. @*Results@#In March 2021, the risk of imported COVID-19 epidemic will be high in Zhejiang Province, and the possibility of local spread could not be ruled out. The possibility of a large-scale outbreak of enteritis due to norovirus and a small-scale outbreak of chickenpox in schools and kindergartens could not be ruled out after the new term begins. An increased risk of influenza epidemic is predicted in collective units such as schools and kindergartens, yet the risk of a large-scale one will be low.@*Conclusion@#High attention should be paid to COVID-19 and enteritis due to norovirus, and general attention should be paid to chicken pox and influenza outbreak.
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OBJECTIVE: To understand the current status of the capability in building primary radiological health technical institutions in China.METHODS: A total of 38 prefecture level radiological health technical institutions from 27 provinces, autonomous regions and municipalities in China were selected as the research subjects using the judgment sampling method, and their qualification, department settings from 2014 to 2018, related conditions of professional and technical personnel, 22 items of radiation health technical work development, 14 kinds of radiation health related laboratory settings and six types of instruments and equipment were investigated and analyzed. RESULTS: A total of 37 radiological health technical institutions provided feedback data. Among them, 30 were Centers for Disease Control and Prevention, and seven were institutions for Occupational Disease Control and Prevention. Among the 37 institutions, 31(83.7%) had radiological health-related qualifications and 12(32.4%) institutions had set up independent radiological health departments. There were 294 professional and technical personnel in radiological health field, with an average of eight persons for each institution. The ratio of male to female was 1.7 ∶1.0. The proportion of professionals younger than 50 years was 82.0%, and 83.0% professionals had an educational background with bachelor′s degree or above. Only 11.9% of the professionals had radiation health education background, and 81.3% had medical and health related educational background. There were 74.8% of the professionals who had intermediate title or above, and 60.2% had less than 10 years of service. From 2014 to 2018, the annual total inflow of personnel showed a decreasing trend(P<0.01), while the total outflow showed an increasing trend(P<0.01). Among the 37 institutions, each institution undertook an average of nine radiological health technical tasks. The individual dose-monitoring laboratory had the largest number of laboratories related to radiological health and the largest sample handling capacity. On average, each institution was equipped with only 0.5 instruments and equipment for each type of radiological health technical work. CONCLUSION: The distribution of age, educational background and professional title of the staffs in the municipal radiological health technical institutions in China is reasonable, but the laboratory construction and equipment allocation still need to be strengthened.
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ABSTRACT Background: The association of prostate cancer antigen 3 (PCA3) polymorphism (SNP, rs544190G>A) with metastatic prostate cancer in European descent has been reported. Our aim of the current study was to re-validate the effect of PCA3 polymorphism on prostate cancer risk in an Eastern Chinese population and then estimate possible genetic discrepancies among population. Materials and Methods: Taqman assay was employed to determine genotype of SNP rs544190 in 1015 ethnic Han Chinese patients with prostate cancer and 1032 cancer-free controls. Simultaneously, odds ratios (OR) and 95% confidence intervals (95%CI) for risk relationship were calculated by logistic regression models. Results: The statistically significant relationship between PCA3 rs544190G>A and higher prostate cancer risk was not found. Stratification analysis revealed that there was no remarkable association of rs544190 variant AG/AA genotype with prostate cancer risk in every subgroup, except for patients with Gleason score ≤7(3+4). Conclusion: Although the results demonstrated that SNP rs544190 was not involved in prostate cancer risk in Eastern Chinese descent, unlike in European population, these might have clinical implications on prostate cancer heterogeneity around the World. To validate these findings, well-designed studies with different ethnic populations are warranted.
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Humans , Male , Aged , Prostatic Neoplasms/genetics , Risk Assessment/methods , Polymorphism, Single Nucleotide/genetics , Asian People/genetics , Antigens, Neoplasm/genetics , Prostatic Neoplasms/ethnology , Prostatic Neoplasms/pathology , Smoking/adverse effects , Case-Control Studies , Gene Expression , Logistic Models , China , Risk Factors , Genetic Association Studies , Neoplasm Grading , Genotype , Neoplasm StagingABSTRACT
Objective To observe the effect of nicorandil on slow-flow phenomenon in percutaneous coronary intervention (PCI) in patients with acute non-ST segment elevated myocardial infarction (NSTEMI). Methods A total of 159 NSTEMI patients were enrolled. Based on the TIMI flow of target lesion blood vessels after PCI, patients were divided into two groups. There were 31 cases in no flow/slow flow group (TIMI≤2), and 128 cases in normal group (TIMI=3). The general clinical data, immediate TIMI flow grade of infarct-related artery (IRA) after PCI treatment, post-operative corrected TIMI frame count (CTFC), TIMI myocardial perfusion grade (TMPG), thrombolysis in myocardial infarction signs of a blood clot, number of diseased vessels and major adverse cardiac events were compared between the two groups. The patients in no flow/slow flow group were given nicorandil, and changes of blood flow before and after treatment were observed. The influence factors of no flow/slow flow were analyzed by multifactor Logistic regression. Results The proportions of patients with history of smoking, the proportion of patients with diabetes history, the proportion of patients with hyperlipidemia, the proportion of patients with low blood pressure in operation, and the number of implanted stents, the proportions of patients took tirofiban in operation, post-operative CTFC, the proportions of patients with thrombosis signs were significantly higher in no flow/slow flow group than those in the normal group (P<0.05). There were no significant differences in heart rates in operation, IRA distribution and the number of lesion vessels between the two groups. There were also no significant differences in the incidence of MACE and left ventricular ejection fraction between the two groups. After the application of nicorandil, the proportion of patients with TIMI blood flow 3 and proportions of cTFC and TMPG were significantly higher than before treatment (P<0.05). Results showed that smoking history, history of diabetes, multiple stents (more than 3), hypotension in PCI, and signs of blood clot were factors influencing the slow flow of coronary arteries. Conclusion Nicorandil can significantly improve the no flow/slow flow in PCI in patients with NSTEMI.
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Purposes To examine the factors related to the choice of cytoreductive nephrectomy (CN) for patients with metastatic clear cell renal cell carcinoma (mCCRCC), and compare the population-based survival rates of patients treated with or without surgery in the modern targeted therapy era. Materials and Methods From 2006 to 2009, patients with mCCRCC were identified from SEER database. The factors that affected patients to be submitted to CN were examined and propensity scores for each patient were calculated. Then patients were matched based upon propensity scores. Univariable and multivariable cox regression models were used to compare survival rates of patients treated with or without surgery. Finally, sensitivity analysis for the cox model on a hazard ratio scale was performed. Results Age, race, tumor size, T stage and N stage were associated with nephrectomy univariablely. After the match based upon propensity scores, the 1-, 2-, and 3-year cancer-specific survival rate estimates were 45.1%, 27.9%, and 21.7% for the no-surgery group vs 70.6%, 52.2%, and 41.7% for the surgery group, respectively (hazard ratio 0.42, 95%CI: 0.35-0.52, log-rank P<0.001). In multivariable Cox proportional hazard regression model, race, T stage, N stage and median household income were significantly associated with survival. Sensitivity analysis on a hazard ratio scale indicated that the hazard ratio might be above 1.00 only when the unknown factor had an opposite effect on survival which was 3-fold than CN. Conclusion The results of our study showed that CN significantly improves the survival of patients with metastatic CCRCC even in the targeted therapy era. .
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Female , Humans , Male , Middle Aged , /genetics , Cell Movement , Cell Proliferation , Carcinoma, Non-Small-Cell Lung/genetics , Lung Neoplasms/genetics , RNA Interference , /metabolism , Cell Line, Tumor , Carcinoma, Non-Small-Cell Lung/metabolism , Carcinoma, Non-Small-Cell Lung/mortality , Carcinoma, Non-Small-Cell Lung/pathology , Gene Expression Regulation, Neoplastic , Kaplan-Meier Estimate , Lung Neoplasms/metabolism , Lung Neoplasms/mortality , Lung Neoplasms/pathology , Neoplasm Staging , Risk Factors , RNA, Messenger/metabolism , Time Factors , TransfectionABSTRACT
<p><b>OBJECTIVE</b>To study the characteristics of amplitude integrated electroencephalography (aEEG) in preterm infants and changes of maturation with gestational age.</p><p><b>METHODS</b>aEEG monitoring was done within 3 days of age with domestically produced digital aEEG set (CFM3000). Duration of each recording was at least 4 hours. The continuity, sleep-wake cycle, voltage and bandwidth of all aEEG tracing were analyzed.</p><p><b>RESULTS</b>The percent of continuity background increased from 30% of 28 weeks to 85.7% of 36 weeks (χ(2) = 28.2, P = 0.026); the percent of mature sleep-wake cycle increased from 10% of 28 weeks to 100% of 36 weeks (χ(2) = 192.4, P < 0.01). Low bound voltage increased with gestational age, from (6.8 ± 1.7) µV (28 w) to 9.7 - 10.1 µV (35 - 36 w) (F = 11.4, P < 0.01). Bandwidth of the narrow band decreases gradually with gestational age, from 1.45 cm (28 w) to (0.86 ± 0.24) cm (36 w) (F = 8.731, P < 0.01). The correlation coefficient for continuity, sleep-wake cycle, low bound voltage and bandwidth of narrow band, and total scores were 0.32, 0.81, 0.38, 0.55 and 0.78 respectively (P < 0.05).</p><p><b>CONCLUSION</b>The older the gestational age of infants at birth, the more mature the aEEG pattern, manifested as increased continuity and sleep-wake cycle, the higher low bound voltage and more narrowed bandwidth with increased gestational age.</p>