Chemical constituents from fruits of Morinda citrifolia and their inhibitory effects on proliferation of synoviocytes in vitro / 中国中药杂志

The chemical constituents from the fruits of Morinda citrifolia were systematically explored by chromatographic fractionation methods including silica gel, octadecylsilyl(ODS) gel, Sephadex LH-20 gel, and preparative high performance liquid chromatography(pre-HPLC). The chemical structures of all isolated compounds were identified on the basis of their physicochemical properties, spectroscopic analyses, as well as the comparisons of their physicochemical and spectroscopic data with the reported data in literature. As a result, 22 isolated compounds from the 90% ethanol extract of the fruits of M. citrifolia were identified, which were moricitritone(1), 2'-deoxythymidine(2), cyclo-(L-Pro-L-Tyr)(3), methyl-5-hydroxy-2-pyridinecarboxylate(4), methyl pyroglutamate(5), bisbenzopyran(6), epipinoresinol(7), 3, 3'-bisdemethyl pinoresinol(8), 3, 3'-bisdemethyltanegool(9), trimesic acid(10), crypticin B(11), kojic acid(12), vanillic acid(13), protocatechoic acid(14), 5-hydroxymethyl furfural(15), blumenol A(16), 1-O-(9Z, 12Z-octadecadienoyl) glycerol(17), mucic acid dimethylester(18), methyl 2-O-β-D-glucopyranosylbenzoate(19), 2-phenylethyl-O-β-D-glucoside(20), scopoletin(21), and quercetin(22). Among them, compound 1 was a new pyrone derivative, compounds 2, 4-7, 10-12, and 17 were isolated from the plants belonging to Morinda genus for the first time, and compound 18 was obtained from M. citrifolia for the first time. Moreover, on the basis of testing the activities of all isolated compounds on inhibiting the proliferation of synovial fibroblasts in vitro by MTS assay, the anti-rheumatoid arthritis activities of all isolated compounds were initially evaluated. The results showed that compounds 1-6, 9, 19, and 20 exhibited remarkable anti-rheumatoid arthritis activities, which displayed the inhibitory effects on the proliferation of MH7A synovial fibroblast cells with the IC_(50) values in the range of(3.69±0.08) to(168.96±0.98) μmol·L~(-1).

Application of self-made multifunctional accessory stent in endoscopic mucosal dissection / 中国实用护理杂志

Objective:To investigate the safety and efficacy of self-made multifunctional endoscopic instrument accessory stent in endoscopic mucosal dissection (ESD).Methods:A total of 80 patients who received ESD in 924th Hospital of Joint Logistic Support Force of Chinese People′s Liberation Army from May 2019 to February 2021 were selected as research object. Random number table method was used to divide patients into control group and experimental group, 40 cases in each group. The experimental group used self-made endoscopic instrument accessory stent, and the control group did not use self-made endoscopic instrument accessory stent. The length of operation, the number of instruments taken by mistake, the number of instruments polluted during operation and the infection of postoperative 3-7 days under the same operation position, operating doctors and nurses were analyzed and compared between the two groups.Results:The incidence of instruments taken by mistake, the incidence of instruments polluted during operation and the infection rate of postoperative 3-7 days were 0.9% (8/856), 1.4% (12/856) and 2.5% (1/40) in the experimental group, which in the control group were 10.8% (96/887), 11.8% (105/887) and 15.0% (6/40) respectively, there were significant differences between the two groups ( χ2=75.92, 75.76, 3.91, all P<0.05). The length of operation in the experimental group was (51.56 ± 2.32) min, and that in the control group was (79.02 ± 2.83) min, the difference was statistically significant ( t=-8.72, P<0.05). Conclusions:When the patients underwent ESD surgery, the self-made multifunctional accessory stent was used to place the required instrument accessory. The length of operation was shorter, the incidence of instruments taken by mistake, the incidence of instruments polluted during operation and the infection rate of postoperative 3-7 days were reduced, the quality of minimally invasive endoscopic surgery was improved.

Four new diphenyl ether derivatives from a mangrove endophytic fungus Epicoccum sorghinum / 中国天然药物

Four new diphenyl ethers, named epicoccethers K-N (1-4), were purified from the fermentation medium of a fungus Epicoccum sorghinum derived from Myoporum bontioides, and identified through HR-ESI-MS and NMR spectral analysis. Except that compound 1 showed moderate antifungal activity against Penicillium italicum and Fusarium graminearum, the other three compounds showed stronger activity against them than triadimefon. All of them showed moderate or weak antibacterial activity towards Staphylococcus aureus and Escherichia coli with O6 and O78 serotypes except that 3 was inactive to E. coli O6.

Effect of intradermal needling combined with oral motor therapy for salivation in children with cerebral palsy: a randomized controlled trial / 中国针灸

OBJECTIVE@#To compare the effect of combination of intradermal needling with oral motor therapy and simple oral motor therapy on salivation in children with cerebral palsy.@*METHODS@#A total of 60 children with salivation in cerebral palsy were randomized into an observation group and a control group, 30 cases in each group. The observation group was treated with intradermal needling (kept for 24 hours each time at Jiache [ST 6], Dicang [ST 4], tongue three needles, etc. ) and oral motor therapy, while the control group was only given oral motor therapy. The intradermal needling was performed 3 times a week, and oral motor therapy was performed 5 times a week, 4 weeks as a course, totally 3 courses of treatment were required. The classification of teacher drooling scale (TDS), drooling severity and Kubota water swallow test, dysphagia disorders survey (DDS) score were compared before treatment and after 4, 8 and 12 weeks of treatment in both groups, and the clinical efficacy was evaluated.@*RESULTS@#After 8 weeks of treatment in the observation group and after 12 weeks of treatment in the two groups, the classification of TDS and drooling severity were improved (P<0.05), and the observation group was better than the control group after 12 weeks of treatment (P<0.05). After 8 and 12 weeks of treatment, the DDS scores of oral period in the observation group were lower than those before treatment (P<0.05). The total effective rate in the observation group was 83.3% (25/30), which was higher than 53.3% (16/30) in the control group (P<0.05).@*CONCLUSION@#The combination of intradermal needling with oral motor therapy can improve salivation symptoms and swallowing function in children with cerebral palsy, the effect is better than oral motor therapy alone, and the effect is earlier.

Analysis of invalid patents associated with schistosomiasis control filed by Chinese applicants / 中国血吸虫病防治杂志

The invalid patents associated with schistosomiasis control were retrieved in the Chinese Patent Database of China National Intellectual Property Administration, the Baiten database and the incoPat database, and the overall trends, legal status, types, patent indexing and technical fields of all retrieved invalid patents were analyzed. As of December 30, 2020, there were totally 859 patents relating to schistosomiasis control, and 512 were invalid patents, with an invalid rate of 59.6%. The number of patent applications and invalid patents peaked in 2018, including 71 patent applications and 53 invalid patents. Among the 511 schistosomiasis control-related invalid patents with complete records, there were 425 invention patents, 81 utility model patents and 5 design patents, and 219 patents (42.9%) were invalid due to the termination of the patented right and 292 (57.1%) due to loss of the right for patent applications. The major technical points included medicines (chemicals), basic research, devices and detections, and the specialized fields were mainly concentrated in A61P33, G01N33, C12N15, C07K14 and A01N65. Our data demonstrate a high invalid rate of patents relating to schistosomiasis control in China. Secondary development and mining of the invalid patents in relation to schistosomiasis are recommended to make use of their values in the national schistosomiasis elimination program of China.

Clinical characteristics and molecular genetics of seven neonates with congenital nephrogenic diabetes insipidus / 中华医学遗传学杂志

OBJECTIVE@#To explore the clinical characteristics, genetic basis and clinical treatment of seven neonates with congenital nephrogenic diabetes insipidus (NDI).@*METHODS@#Clinical data of the patients were collected. High-throughput sequencing was carried out to detect potential variants. Sanger sequencing was used to verify the results.@*RESULTS@#The patients were all males, with the age of onset being 10 to 21 days. All patients were admitted to the hospital for intermittent fever as the first symptom during the neonatal period. Additional symptoms had included polydipsia and polyuria. After the treatment, 5 patients had recovered, the remainders still had NDI symptoms and developmental retardation. Five children were found to harbor pathogenic variants of the AVPR2/AQP2 gene, which included one in-frame mutation of c.645_646insGCACCTACCCTGGGTATCGCC, two missense mutations of c.541C>T and c.419C>A, and two hemizygous deletions of the AVPR2/AQP2 gene. Among these, two were unreported previously. Cases 6 and 7 were a pair of twins. Both had carried homozygous missense variants of c.538G>A of the AVPR2/AQP2 gene, which was known to be pathogenic.@*CONCLUSION@#AVPR2/AQP2 is the main pathogenic gene for congenital NDI, for which two novel pathogenic variants have been discovered in this study. Above results have provided a basis for clinical diagnosis and genetic counseling for the affected pedigrees.

A clinical study on the treatment of postherpetic neuralgia with pulsed radiofrequency of the dorsal root ganglion with pain management

@#This study aimed to investigate the clinical efficacy of pulsed radiofrequency (PRF) of the dorsal root ganglion (DRG) with pain management as treatment of post-herpetic neuralgia (PHN). A total of 78 patients with PHN in the thoracolumbar region were randomly divided into two groups (n = 39 for each group): Group A, oral drug treatment only; Group B, DRG PRF of the thoracic spinal nerve combined with oral drug treatment. The numerical rating scale (NRS) scores of both groups were observed before treatment and at 1, 4, 8, and 12 weeks after treatment. The results showed that the NRS scores of both groups were significantly decreased after treatment (P < 0.05). In addition, the NRS score in Group B decreased significantly more than in Group A (P < 0.05). In conclusion, DRG PRF with pain management is a safe and effective treatment for elderly PHN patients, and it can quickly alleviate pain symptoms.

Gene mutation and expression profiles in acute lymphoblastic leukemia based on the next-generation sequencing and their relationship with prognosis / 白血病·淋巴瘤

Objective:To investigate the gene mutation and expression profiles in patients with acute lymphoblastic leukemia (ALL) and the effect of gene mutations on the prognosis of patients.Methods:DNA samples from 128 newly diagnosed ALL patients in the First Affiliated Hospital of Soochow University from June 2016 to June 2017 were collected. The targeted specific next-generation sequencing technology was used to analyze 51 gene mutations related to hematological malignancies, and the occurrence spectrum was described. Because the gene mutation spectrum varied with the subtype of disease, the gene mutations involved 8 types of pathways including DNA methylation, chromosomal modification, transcriptional regulation, tumor suppression, signal transduction, RNA splicing, adhesive complexes and other pathways. The effects of clinical factors and gene mutations on overall survival (OS) and relapse-free survival (RFS) were analyzed by Kaplan-Meier method and Cox regression model.Results:Of the 128 patients, the results of next-generation sequencing showed that 86 patients (67.2%) harbored at least one mutation, and 27 patients (21.1%) harbored ≥3 mutations based on the next-generation sequencing. In all ALL patients, the genes with high mutation rates were JAK (10.9%, 14/128), NOTCH1 (10.1%, 13/128), KRAS (8.6%, 11/128), SETD2 (7.0%, 9/128), CSMD1 (7.0%, 9/128), ETV6 (7.0%, 9/128), and RUNX1 (7.0%, 9/128). In B-cell acute lymphoblastic leukemia (B-ALL) patients, the genes with high mutation rates were KRAS (9.4%, 10/106), CSMD1 (7.5%, 8/106), JAK (7.5%, 8/106), PTPN11 (6.6%, 7/106), SETD2 (5.7%, 6/106), TET2 (5.7%, 6/106), TP53 (5.7%, 6/106), and PAX5 (5.7%, 6/106). While in T-cell acute lymphoblastic leukemia (T-ALL) patients, the genes with high mutation rates were NOTCH1 (54.5%, 12/22), PHF6 (27.3%, 6/22), JAK (27.3%, 6/22), RUNX1 (22.7%, 5/22), and ETV6 (18.2%, 4/22). In 128 ALL patients, the total frequency of gene mutations was 181 times. Among them, signal transduction, transcriptional regulation, tumor suppression and chromosomal modification-related gene mutations occurred more frequently, and similar phenomena were found in T-ALL and B-ALL. In terms of clinical features, male patients were more likely to present gene co-mutations( P=0.002), and mutations involved in tumor suppressor pathways were also more common in male patients ( P=0.054). The older the patient, the greater the possibility of mutations involved in transcriptional regulation and DNA methylation regulatory pathway-related genes ( P=0.067, P=0.009). T-ALL was more susceptible to have gene mutations than B-ALL ( P=0.002), and easily had gene co-mutations ( P < 0.01), and mutations mainly involved in signal transduction, transcriptional regulation, tumor suppression and chromosome modification were dominant (all P < 0.05). Cox regression univariate analysis showed that younger age of onset and allogeneic hematopoietic stem cell transplantation could significantly prolong the OS time of ALL patients ( P=0.005, P=0.003), but the difference was not statistically significant on RFS (both P > 0.05). However, 8 types of regulatory pathways were irrelevant to OS and RFS in ALL patients (all P > 0.05). The ALL patients with JAK gene mutation had short OS time ( P=0.024). Conclusions:Gene mutations are prevalent in ALL patients, the frequency spectrum varies with the subtype of disease and involves a variety of signaling pathways. Among them, signal transduction, transcriptional regulation, tumor suppression and chromosomal modification pathway-related genes have high mutation rates. The co-occurrence of gene mutations is a frequently phenomenon in ALL patients and it indicates genetic complexity and instability of ALL patients. JAK family gene mutations usually indicate poor prognosis, but the effects of other gene mutations on the prognosis of ALL need to be further explored.

Development of an immunochromatographic strip for detection of Zika virus NS1 antigen / 热带医学杂志

@#Abstract：Objective To develop a colloidal gold immunochromatographic strip ⁃ based method for the rapid detection of Zika virus（ZIKV）NS1 antigen. Methods The gold nanoparticles modified with the anti⁃ZIKV NS1 monoclonal antibody as the detection probe were coated on the glass ⁃fiber pad. The anti ⁃ZIKV NS1 monoclonal antibody and the goat anti ⁃mouse polyclonal antibody were immobilized on a nitrocellulose membrane as the test line and the control line，respectively. In order to achieve critical results，the ratio of the optical density （OD）of the test line to that of the control line was compared. Serial diluted ZIKV NS1 standard antigen was applied to evaluate sensitivity of the immunoassay. The culture supernatant and serum samples for arboviruses（ZIKV，Dengue virus, Japanese encephalitis virus and Chikungunya virus） were utilized to demonstrate the specificity of the method. Results The detection result could read by naked eyes within 20 minutes. The visual cut ⁃off level for the test strip was achieved at 100 ng/mL of the Zika virus NS1 standard antigen. No cross⁃reactions with Dengue virus，Japanese encephalitis virus and Chikungunya virus were observed. The strip could remain good stability within 36 weeks whether stored in 4 ℃ or room temperature（22-25 ℃）. Conclusion Apart from stability， the method was convenient，rapid and specific for ZIKV NS1 antigen，which showed a promising potential in the point of care test and the screening test.

Interpretation of Detection of Intestinal Helminthes—The Kato-Katz Method (WS/T 570–2017) / 中国血吸虫病防治杂志

The criteria for the Kato-Katz thick smear are compiled following the Management Measures for Health Criteria and GBT 1.1–2009 Standardization Working Guidelines. The criteria are composed of five chapters, including the range of application, terms and definitions, equipments, reagent materials, and testing procedures. Three informative appendices (identification of helminth eggs in human faeces, counting method of eggs in Kato-Katz thick smear, and other considerations) are appended. The criteria have been issued by the National Health and Family Planning Commission of the People’s Republic of China, it provides a technical reference for the detection of helminth eggs in human faeces in medical institutions and disease prevention and control institutions.

Interpretation of Detection of Intestinal Helminthes—The Kato-Katz Method (WS/T 570–2017) / 中国血吸虫病防治杂志

The criteria for the Kato-Katz thick smear are compiled following the Management Measures for Health Criteria and GBT 1.1–2009 Standardization Working Guidelines. The criteria are composed of five chapters, including the range of application, terms and definitions, equipments, reagent materials, and testing procedures. Three informative appendices (identification of helminth eggs in human faeces, counting method of eggs in Kato-Katz thick smear, and other considerations) are appended. The criteria have been issued by the National Health and Family Planning Commission of the People’s Republic of China, it provides a technical reference for the detection of helminth eggs in human faeces in medical institutions and disease prevention and control institutions.

Tracking evaluation on implementation of Criteria for Control and Elimina-tion of Malaria(GB 26345-2010)in Yunnan Province / 中国血吸虫病防治杂志

Objective To understand the knowledge,usage,applicability of the standard and the suggestions on the imple-mentation of Criteria for Control and Elimination of Malaria(GB 26345-2010)among malaria prevention and control staff of disease control and medical institutions at all levels in Yunnan Province,so as to provide the evidence for the implementation and revision of the standard.Methods Malaria prevention and control workers at 192 institutions in 16 prefectures and cities of Yunnan Province were surveyed.The malaria prevention and treatment workers at county-level center for disease control and pre-vention(CDCs),county-level medical institutions and township hospitals in Tengchong City and Yingjiang County of Yunnan Province were investigated on the spot.The knowledge and usage,problems and recommendations encountered in the implemen-tation of the standard were collected.Results Totally 444 questionnaires were collected,of which 428 were valid and the valid rate of questionnaires was 96.4％.Among them,the proportion of those who knew the standard was 86.7％(371/428),and the channel of knowledge acquirement was mainly the education and training,accounting for 50.7％(188/371).The total awareness rate of objective indicators in the standard content was 65.9％(282/428).Among the frequency of utilization,the "occasional use" of this standard was the majority,accounting for 33.6％(144/428).Among the applications,the highest proportion of ap-plying to the "regular malaria prevention and control work" was 59.3％(191/322),and only 19.3％(62/322)applied to the "as-sessment for malaria elimination".In the standard suitability assessment,the proportion of considering the standard to be fully applicable was 91.3％(391/428),and the proportion of considering the standard to be revised was 8.7％(37/428).The agen-cies where the respondents were located have taken corresponding measures to promote the implementation of the standard.A to-tal of 43 proposals for the implementation of the standard were collected,relating to personnel and supporting conditions.Con-clusions Combined with the actual situation,the standard should be strengthened practically.At the same time,the standard learning,training,and publicity should be strengthened to raise the implementation level.Its implementation in Yunnan Prov-ince should be sequentially consolidated and steadily promoted.

Acute Effect of Carotid Artery Stenting on Hemodynamics / 中国循环杂志

Objective: To investigate the acute effect of carotid artery stenting (CAS) on hemodynamics. Methods: We retrospectively analyzed 170 consecutive patients who received CAS in our hospital from 2014-09 to 2015-09. The acute effects of proximal internal CAS on blood pressure (BP) and heart rate (HR) were studied, the patients were followed-up for a month to observe the relationship between CAS and peri-operative adverse events occurrence. Results: ① Compared with pre-operative condition, the all day mean systolic blood pressure (SBP) from (126.6±15.1, 93-175) mmHg decreased to (117.7±13.7, 87-158) mmHg, P<0.01, all day mean DBP from (72.8±11.5, 49-100) mmHg decreased to (67.3±10.3, 48-90) mmHg, P<0.01, and all day HR from (66.3±6.8, 49-84) bpm decreased to (62.6±7.2, 49-88) bpm, P<0.01. ② The incidence of hemodynamic instability (HI) was 51.8％ (88/170) and the occurrence rates of thypertension, hypotension and bradycardia were 3.5％ (6/170), 39.4 ％ (67/170) and 22.4％ (38/170) respectively. Multivariate regression analysis showed that HI was closely related to gender, history of hypertension, bilateral CAS and carotid bifurcation lesions. Upon HI onset, BP and HR could be restored to normal via intravenous infusion of vasoactive drugs and 6 (3.5％) patients having the medication time more than 24 hours. ③ Peri-operative adverse events happened in 8 (4.7％) patients including 4 transient ischemic attack, 2 minor stroke and 2 major stroke (1 patient died). The ratio of adverse events was 2.4％ (2/82) in Non-HI group and 6.8％ (6/88) in HI group, P=0.32. In HI group, the incidences of hypertension, hypotension, bradycardia and hypotension combining bradycardia were 16.7％ (1/6), 6.8％ (3/44), 0％ (0/15) and 8.7％ (2/23) respectively, compared with the overall patients' group, P=0.669, P=0.723, P=0.793 and P=0.658 respectively. Conclusion: HI incidence was relatively high in peri-operative period of CAS; gender, history of hypertension, bilateral CAS and carotid bifurcation lesions were the independent predictors for CAS occurrence. It is important to reasonably use vasoactive drugs in time for preventing and reducing HI related adverse events.

Acute Effect of Carotid Artery Stenting on Hemodynamics / 中国循环杂志

Objective: To investigate the acute effect of carotid artery stenting (CAS) on hemodynamics. Methods: We retrospectively analyzed 170 consecutive patients who received CAS in our hospital from 2014-09 to 2015-09. The acute effects of proximal internal CAS on blood pressure (BP) and heart rate (HR) were studied, the patients were followed-up for a month to observe the relationship between CAS and peri-operative adverse events occurrence. Results: ① Compared with pre-operative condition, the all day mean systolic blood pressure (SBP) from (126.6±15.1, 93-175) mmHg decreased to (117.7±13.7, 87-158) mmHg, P<0.01, all day mean DBP from (72.8±11.5, 49-100) mmHg decreased to (67.3±10.3, 48-90) mmHg, P<0.01, and all day HR from (66.3±6.8, 49-84) bpm decreased to (62.6±7.2, 49-88) bpm, P<0.01. ② The incidence of hemodynamic instability (HI) was 51.8％ (88/170) and the occurrence rates of thypertension, hypotension and bradycardia were 3.5％ (6/170), 39.4 ％ (67/170) and 22.4％ (38/170) respectively. Multivariate regression analysis showed that HI was closely related to gender, history of hypertension, bilateral CAS and carotid bifurcation lesions. Upon HI onset, BP and HR could be restored to normal via intravenous infusion of vasoactive drugs and 6 (3.5％) patients having the medication time more than 24 hours. ③ Peri-operative adverse events happened in 8 (4.7％) patients including 4 transient ischemic attack, 2 minor stroke and 2 major stroke (1 patient died). The ratio of adverse events was 2.4％ (2/82) in Non-HI group and 6.8％ (6/88) in HI group, P=0.32. In HI group, the incidences of hypertension, hypotension, bradycardia and hypotension combining bradycardia were 16.7％ (1/6), 6.8％ (3/44), 0％ (0/15) and 8.7％ (2/23) respectively, compared with the overall patients' group, P=0.669, P=0.723, P=0.793 and P=0.658 respectively. Conclusion: HI incidence was relatively high in peri-operative period of CAS; gender, history of hypertension, bilateral CAS and carotid bifurcation lesions were the independent predictors for CAS occurrence. It is important to reasonably use vasoactive drugs in time for preventing and reducing HI related adverse events.

Ventilator-associated pneumonia among premature infants <34 weeks′ gestational age in neonatal intensive care unit in China: a multicenter study / 中华儿科杂志

Objective@#To investigate the incidence and pathogen distribution of ventilator-associated pneumonia (VAP) among preterm infants admitted to level Ⅲ neonatal intensive care units (NICU) in China.@*Method@#A prospective study was conducted in 25 level Ⅲ NICU, enrolling all preterm infants <34 weeks gestational age admitted to the participating NICU within the first 7 days of life from May 2015 to April 2016. Chi-square test, t test and Mann-Whitney U test were used for statistical analysis.@*Result@#A total of 7 918 patients were enrolled, within whom 4 623(58.4%) were males. The birth weight was (1 639±415) g and the gestational age was (31.4±2.0) weeks; 4 654(58.8%) infants required non-invasive mechanical ventilation and 2 154(27.2%) required intubation. Of all the mechanically ventilated patients, VAP occurred in 95 patients. The overall VAP rate was 7.0 episodes per 1 000 ventilator days, varying from 0 to 34.4 episodes per 1 000 ventilator days in different centers. The incidence of VAP was 9.6 and 6.0 per 1 000 ventilator days in children′s hospitals and maternity-infant hospitals respectively, without significant differences (t=1.002, P=0.327). Gram-negative bacilli (76 strains, 91.6%) were the primary VAP microorganisms, mainly Acinetobacter baumannii (24 strains, 28.9%), Klebsiella pneumonia (23 strains, 27.7%), and Pseudomonas aeruginosa (10 strains, 12.0%).@*Conclusion@#The incidence of VAP in China is similar to that in developed counties, with substantial variability in different NICU settings. More efforts are needed to monitor and evaluate the preventable factors associated with VAP and conduct interventions that could effectively reduce the occurrence of VAP.

A study on the relationship between the Wnt receptor signaling pathway and severe retinopathy of prematurity / 中国新生儿科杂志

Objective To study the relationship of Wnt receptor signaling pathway and severe retinopathy of prematurity (ROP).Method From January 2011 to June 2015,preterm infants with severe ROP admitted to the NICU of our hospital were enrolled prospectively.Preterm infants with similar gestational age,gender,and age (in days) admitted to our hospital during the same period were selected as the control group.FZD4,LRP5,and ND gene mutations in Wnt receptor signaling pathway were examined.Result A total of 61 Chinese preterm infants were screened for these three candidate genes of Wnt receptor signaling pathway,32 in ROP group and 29 in control group.ND and FZD4 gene mutations were not found among all cases.Eight types of LRP5 mutations were found in 26 cases of ROP group,including 7 cases of Exon18 missense mutation [c.3989C ＞ T;p.Ala1330Val (rs3736228)],5 cases of Exon8 synonymous mutation (c.1647T ＞ C;p.Phe549Phe),5 cases of Exon6 intronic mutation [c.1412 + 8G ＞ A (rs4988319)],3 cases of Exon2 missense mutation [c.266A ＞ G;p.Gln89Arg (rs41494349)],2 cases of Exon21 intronic mutation [c.4349-17C ＞ T (rs372086596)],2 cases of Exon19 synonymous mutation (c.4089C ＞ T;p.Asp 1363 Asp),one case of Exon9 synonymous mutation (c.1 932G ＞ A;p.Glu644Glu),and one case of Exon16 missense mutation (c.3580C ＞T;p.Arg1194Cys).Three types of LRP5 mutations were found in 6 cases of the control group,including 4 cases of Exon8 synonymous mutation,one case of Exon19 synonymous mutation,and one case of Exon9 synonymous mutation.The positive rates of Exonl8 missense mutation and Exon6 intronic mutation in severe ROP group were significantly higher than the control group (P ＜ 0.05).Conclusion LRP5 gene mutations in Wnt receptor signaling pathway may be associated with the occurrence of severe ROP.

Efficacy and prognostic analysis of ICE regimen for 84 patients with relapsed/refractory diffuse large B-cell lymphoma / 上海交通大学学报（医学版）

Objective · To evaluate the efficacy and prognostic factors of ifosfamide-cisplatin-etoposide (ICE) chemotherapy as salvage regimen for patients with relapsed/refractory diffuse large B-cell lymphoma (DLBCL).Methods · A retrospective analysis was performed on 84 relapsed/refractory DLBCL patients who were treated with ICE salvage regimen at Ruijin Hospital (Shanghai Jiao Tong University School of Medicine,China) from July 2004 to June 2016.Overall survival (OS) was analyzed by Kaplan-Meier method and multivariate Cox proportional hazards models.Results· Of the 84 patients who were treated with ICE regimen,37 (44.0％) patients had responses,including 26 (31.0％) achieving complete remission.The median number of cycles per patient was 3 (range 1-6 cycles).The 1-year and 2-year OS rates were 49.5％ and 30.0％,respectively.The median OS time was 12.2 months.On univariate analysis,patients with early progression/recurrence (P=0.041) and a high-intermediate/high risk according to the international prognostic index (IPI) (P=0.024) and NCCN-IPI (P=0.002) had poorer outcomes.While improved outcome was found in patients in complete remission after chemotherapy (P=0.000).The multivariate analysis revealed that the intermediate-high/high risk according to NCCN-IPI was an independent risk factor,and remission after chemotherapy was an independent prognostic factor for prolonging survival.Conclusion· The ICE regimen can be used as an effective salvage therapy for patients with relapsed/refractory DLBCL.

Efficacy of heated humidified high-flow nasal cannula in preterm infants aged less than 32 weeks after ventilator weaning / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the efficacy of heated humidified high-flow nasal cannula (HHHFNC) and nasal continuous positive airway pressure (nCPAP) in preterm infants aged 26-31(+6) weeks with respiratory distress syndrome after ventilator weaning.</p><p><b>METHODS</b>A total of 161 preterm infants were randomly divided into two groups after ventilator weaning: HHHFNC treatment (n=79) and nCPAP treatment (n=82). The two groups were subdivided into 26-28(+6) weeks and 29-31+6 weeks groups according to the gestational age. The treatment failure rate, reintubation rate within 7 days after extubation, incidence of complications, and mortality during hospitalization were compared between the two groups.</p><p><b>RESULTS</b>The treatment failure rate and reintubation rate showed no significant differences between the HHHFNC and nCPAP groups. The preterm infants aged 26-28(+6) weeks in the HHHFNC group had a significantly higher treatment failure rate than those in the nCPAP group (P<0.05), while the reintubation rate showed no significant difference. As for the preterm infants aged 29-31(+6) weeks, the treatment failure rate and reintubation rate showed no significant differences between the two groups. The incidence of complications and mortality showed no significant differences between the HHHFNC and nCPAP groups.</p><p><b>CONCLUSIONS</b>In preterm infants aged 29-31(+6) weeks, HHHFNC has a similar efficacy as nCPAP after ventilator weaning, while in those aged less than 29 weeks, HHHFNC should be used with great caution if selected as the first-line noninvasive respiratory support.</p>

Analysis of In-hospital Neonatal Death in the Tertiary Neonatal Intensive Care Unit in China: A Multicenter Retrospective Study / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Globally, the proportion of child deaths that occur in the neonatal period remains a high level of 37-41%. Differences of cause in neonate death exist in different regions as well as in different economic development countries. The specific aim of this study was to investigate the causes, characteristics, and differences of death in neonates during hospitalization in the tertiary Neonatal Intensive Care Unit (NICU) of China.</p><p><b>METHODS</b>All the dead neonates admitted to 26 NICUs were included between January l, 2011, and December 31, 2011. All the data were collected retrospectively from clinical records by a designed questionnaire. Data collected from each NICU were delivered to the leading institution where the results were analyzed.</p><p><b>RESULTS</b>A total of 744 newborns died during the 1-year survey, accounting for 1.2% of all the neonates admitted to 26 NICUs and 37.6% of all the deaths in children under 5 years of age in these hospitals. Preterm neonate death accounted for 59.3% of all the death. The leading causes of death in preterm and term infants were pulmonary disease and infection, respectively. In early neonate period, pulmonary diseases (56.5%) occupied the largest proportion of preterm deaths while infection (27%) and neurologic diseases (22%) were the two main causes of term deaths. In late neonate period, infection was the leading cause of both preterm and term neonate deaths. About two-thirds of neonate death occurred after medical care withdrawal. Of the cases who might survive if receiving continuing treatment, parents' concern about the long-term outcomes was the main reason of medical care withdrawal.</p><p><b>CONCLUSIONS</b>Neonate death still accounts for a high proportion of all the deaths in children under 5 years of age. Our study showed the majority of neonate death occurred in preterm infants. Cause of death varied with the age of death and gestational age. Accurate and prompt evaluation of the long-term outcomes should be carried out to guide the critical decision.</p>

Measurement of frontal lobe volume and thalamic volume in fetuses with congenital heart disease at different gestational weeks using three dimensional ultra sonography and its clinical value

Our study aimed to investigate the measurement of frontal lobe volume and thalamic volume in fetuses with congenital heart disease [CHD] at different gestational weeks using three dimensional [3-D] ultrasonography and its clinical value. Then, 238 pregnant women who received obstetric ultrasonography in ultrasound department of Internal Medicine of our hospital were enrolled between March 2013 to April 2014. In this study, 85 fetuses were diagnosed to develop CHD by prenatal fetal echocardiography, and the other 153 fetuses were normal. Frontal lobe volume, thalamic volume and cerebral blood flow was determined by color Doppler ultrasonic diagnostic apparatus [type: GE Voluson E8]. The level of MCA-PI and CPR in CHD fetus group performed significantly lower than that in normal fetus group [P<0.05], but the level of UA-PI performed significantly higher than that in normal fetus group [P<0.05]. When gestational age <30 weeks, there was no significant difference in thalamic volume and frontal lobe volume between the two groups [P>0.05]; when gestational age >/= 30 weeks, the level of CHD fetus group performed significantly lower thalamic volume and frontal lobe volume than that in normal fetus group [P<0.05]. When gestational age <30 weeks, there was no significant difference in BPD, HC, and GA between the two groups [P>0.05]; when gestational age >/= 30 weeks, the level of BPD, HC and GA in CHD fetus group performed significantly lower than that in normal fetus group [P<0.05]. If gestational age <30 weeks, CHD performed a small impact on fetal frontal lobe volume and thalamic volume; if gestational age >/= 30 weeks, the level of frontal lobe volume and thalamic volume in fetuses with CHD performed significantly lower than that in normal fetuses