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1.
Neuroscience Bulletin ; (6): 1-15, 2022.
Article in English | WPRIM | ID: wpr-922671

ABSTRACT

Parkinson's disease (PD) is the second most common and fastest-growing neurodegenerative disorder. In recent years, it has been recognized that neurotransmitters other than dopamine and neuronal systems outside the basal ganglia are also related to PD pathogenesis. However, little is known about whether and how the caudal zona incerta (ZIc) regulates parkinsonian motor symptoms. Here, we showed that specific glutamatergic but not GABAergic ZIc


Subject(s)
Animals , Mice , Neurons , Parkinson Disease , Parkinsonian Disorders , Substantia Nigra , Zona Incerta
2.
Article in Korean | WPRIM | ID: wpr-875106

ABSTRACT

Objective@#Although serum ferritin is considered the best measure of total body iron, with low levels indicating iron deficiency, recent studies have shown that high levels are associated with gestational diabetes, premature birth, and low birth weight. This study aimed to analyze the association between serum ferritin levels in the third trimester of pregnancy and low birth weight and preterm birth. @*Methods@#This study included pregnant women who delivered a single fetus at Kangwon National University Hospital between January 2009 and December 2013 and in whom serum ferritin levels were measured between 28 and 34 weeks of gestation. The association between serum ferritin levels measured in the early third trimester of pregnancy and preterm birth and low birth weight infants was analyzed. @*Results@#A total of 1,079 women fulfilled the study criteria and had their serum ferritin level measured during the third trimester (28–33.9 weeks of gestation) and later delivered at Kangwon National University Hospital. Comparison of the group with serum ferritin levels above the 75th percentile and those below the 25th percentile at the beginning of the third trimester revealed that the incidence of preterm births (<34 weeks of gestation, <37 weeks of gestation) and low birth weight were significantly higher in the group with serum ferritin levels above the 75th percentile than those below the 25th percentile (p<0.05). When variable factors were controlled through multiple regression analysis, the group whose serum ferritin levels were above the 75th percentile at 30–31.9 weeks of gestation had the highest risk of preterm birth before 34 weeks of gestation (adjusted odds ratio [OR], 7.85; 95% confidence interval [CI], 1.32–29.9) and low birth weight (adjusted OR, 6.49; 95% CI, 2.10–20.0). @*Conclusion@#In this study, when serum ferritin was high in the third trimester of pregnancy, it was significantly increased with preterm birth (<34 and 37 weeks) and low birth weight. In particular, when serum ferritin levels were high at 30–31.9 weeks of gestation, the risk of premature birth before 34 weeks and low birth weight was statistically highest.

3.
Article in Chinese | WPRIM | ID: wpr-908342

ABSTRACT

Bronchiolitis is the most common lower respiratory tract disorder in infants less than 12 months of age.Wide variation in the management of bronchiolitis exists between Australia and New Zealand, with up to 48% of infants admitted into hospital receiving treatment which is proved by high quality(Cochrane-level) evidence to be no benefit.For this reason, the Australian Guidelines Development Committee has developed the first high-quality Australian guidelines for bronchiolitis.The guideline provide suggestions for the management of children with bronchiolitis in emergency departments and general pediatric wards, and provide evidence for clinical practice.

4.
Article in Chinese | WPRIM | ID: wpr-907838

ABSTRACT

Objective:To investigate the effects of cell adhesion molecule 1 (CADM1) promoter methylation in ovarian cancer on gene transcription and protein expression levels, and the regulation mechanism of mirNA-148A on CADM1 methylation levels.Methods:A total of 86 patients with ovarian cancer who received surgical treatment in the Affiliated Hospital of Hangzhou Normal University from Jun. 2018 to Jun. 2020 were selected as study subjects. The methylation level of CADM1 gene CpG island in ovarian cancer tissues and adjacent tissues was quantitatively detected. Quantitative real-time polymerase chain reaction was used to detect the mRNA and mirNA-148a expressions of CADM1 gene. The CADM1 gene and DNMT1 protein levels were detected by Western blot. Human ovarian cancer SKOV3 cells were treated with different concentrations of methyltransferase inhibitors (5-Azacytidine, 5-aza) , and CADM1 mRNA expression was detected 72 h later. Human ovarian cancer cell lines SKOV3 were transfected with mir-335-5p mimic, inhibitor and negative control respectively. Then mir-335-5p expression level and CADM1 gene methylation level were detected after transfection.Results:The methylation level of CADM1-1 island in ovarian cancer tissues was 2.89%±0.82%, significantly higher than that of paracancerous normal tissues 1.86%±0.68% ( t=4.936, P<0.001) , and that of CADM1-2 island in ovarian cancer tissues was 3.12%±0.93%, significantly higher than that of paracancerous normal tissues (2.27%±0.69%, t=5.114, P<0.001) . Pearson correlation analysis showed that the methylation level of CADM1-1 island and CADM1-2 island in ovarian cancer tissues was significantly negatively correlated with the relative mRNA expression (r was -0.615 and -0.582, respectively, and both P<0.001) , and with the protein expression level of CADM1 (r was -0.521 and -0.612, respectively, and both P<0.001) . The relative expression level of mirNA-148a in ovarian cancer tissues was 1.53±0.42, significantly lower than that in paracancer tissues (2.59±0.73, t=6.113, P<0.001) . After treatment with different concentrations of 5-AZA, mRNA expression levels of CADM1 gene in SKOV3 cells were significantly higher in the low concentration group and the high concentration group than in the control group (both P<0.05) , and mRNA expression levels in the high concentration group were significantly higher than in the low concentration group ( P<0.05) . After mirNA-148A transfected SKOV3 cells, the relative expression levels of mirNA-148a in the mimic group were significantly increased, while those of inhibitor group were significantly decreased ( P<0.001) . The DNMT1 expression level and CADM1 gene methylation level of mimic group were significantly decreased, while those of inhibitor group were significantly increased (P<0.001) . Conclusion:In ovarian cancer, miRNA-148a can regulate the DNA methylation level of CADM1 gene by acting on the downstream target protein DNMT1, thus affecting the mRNA and protein expression levels of CDM1 gene and participating in the pathogenesis of ovarian cancer.

5.
Article in Chinese | WPRIM | ID: wpr-905826

ABSTRACT

Objective:To explore the protective effect of Gegen Qinliantang on the intestinal mucosal epithelial barrier function of ulcerative colitis (UC) mice, and to explore its mechanism of action in the treatment of ulcerative colitis via matrix metallopeptidase-9 (MMP-9)/p38 mitogen-activated protein kinase (p38 MAPK) signaling pathway. Method:The 48 female C57BL/6 mice were randomly divided into normal group, model group, sulfasalazine group (0.3 g·kg<sup>-1</sup>) and Gegen Qinliantang high, medium and low dose groups (2.84,1.42,0.71 g·kg<sup>-1</sup>). The UC murine model was established by 3% dextran sulfate sodium (DSS). Gegen Qinliantang and sulfasalazine were intragastrically administered on the 8<sup>th</sup> day after the model was established for 7 days, and the normal group was treated with the same amount of normal saline. Colon tissues were collected after the last administration, and the pathological changes of colon tissues were detected by hematoxylin-eosin (HE) staining. The expression of tight junction (TJ) proteins such as Occludin and zonula occludens-1(ZO-1) in colon tissues was detected by immunohistochemistry (IHC), and the expression levels of tumor necrosis factor-alpha (TNF-<italic>α</italic>), interleukin-1<italic>β</italic> (IL-1<italic>β</italic>), and MMP-9 mRNA in colon tissues were detected by Real-time polymerase chain reaction (Real-time PCR). The expression of phosphorylated p38 MAPK (p-p38 MAPK), p38 MAPK and MMP-9 protein in colon tissues was detected by Western blot. Result:Compared with normal group, the body weight of mice decreased (<italic>P</italic><0.01) and disease activity index (DAI) score increased significantly (<italic>P</italic><0.01) in model group, the colon tissues of the model group were damaged more obviously, the expression of occludin and ZO-1 proteins in model group was significantly reduced (<italic>P</italic><0.01), and the relative expression levels of TNF-<italic>α</italic>, IL-1<italic>β</italic>, and MMP-9 mRNA in model group were significantly increased (<italic>P</italic><0.01), the expression of p-p38 MAPK and MMP-9 in model group was significantly increased (<italic>P</italic><0.01). Compared with model group, the body mass and DAI score of the sulfasalazine group and Gegen Qinliantang group were significantly improved (<italic>P</italic><0.05,<italic>P</italic><0.01), the colonic tissues damage were significantly improved, and the expression of Occludin and ZO-1 protein was significantly increased (<italic>P</italic><0.05,<italic>P</italic><0.01), the relative expression levels of TNF-<italic>α</italic>, IL-1<italic>β</italic>, and MMP-9 mRNA were significantly decreased (<italic>P</italic><0.01), and the expression of p-p38 MAPK and MMP-9 was significantly decreased (<italic>P</italic><0.01). The changes in the middle dose group were the most obvious among the various dose groups of Gegen Qinliantang. Conclusion:Gegen Qinliantang repairs the intestinal mucosal barrier function by inhibiting the expressions of MMP-9 and inflammatory cytokines such as TNF-<italic>α</italic> and IL-1<italic>β</italic>, blocking the activation of the p38 MAPK signaling pathway, and increasing the expressions of tight junction protein.

6.
Article in Chinese | WPRIM | ID: wpr-905269

ABSTRACT

Objective:To compare the prediction of Ischemic Stroke Predictive Risk Score (iScore), Preadmission Comorbidities, Level of Consciousness, Age, and Neurologic Deficit (PLAN), Acute Stroke Registry and Analysis of Lausanne (ASTRAL) and Totaled Health Risks in Vascular Events (THRIVE) for short- and long-term death for patients with acute ischemic stroke (AIS). Methods:From August, 2015 to June, 2018, 323 AIS patients in emergency ward were included, and followed up 30 days, three months and a year after including. Receiver operating characteristic (ROC) curve was used to analyze the predictive effects of iScore, PLAN, ASTRAL and THRIVE. Results:The all-cause mortality 30 days, three months and a year after including was 12.4% (40/323), 17.3% (56/323) and 25.7% (83/323), respectively. The area under curve (AUC) from more to less arranged as iScore, PLAN, ASTRAL and THRIVES. There was significant difference of AUC between iScore and THRIVE (Z > 1.990, P < 0.05), but not among the others (Z < 1.943, P > 0.05). Conclusion:iScore, PLAN, ASTRAL and THRIVE may predict short- and long-term death of AIS patients in the emergency well, and iScore is the best. However, the procedure of iScore is complex, it is recommended to use PLAN and ASTRAL for emergency.

7.
Article in English | WPRIM | ID: wpr-902977

ABSTRACT

Korea has entered a stage of low fertility, with a total fertility rate of 1.178 in 2002 and 0.92 in 2019. The low birth rate has led to the closure of obstetric hospitals and clinics from 1,371 maternity health facilities in 2003 to 541 in 2019, which is 39.5% compared to 2003. Since 2011, the Ministry of Health and Welfare has been operating an “Obstetrically Underserved Areas Support Project,” however, a shortage of obstetrician-gynecologists (OB/GYNs) who can participate in labor and delivery is a major problem. In 2019, there were 5,800 OB/GYNs practicing. Of these, 4,225 (72.8%) were working in obstetrics-gynecology hospitals, each responsible for 2,855 fertile women. Their average age was 51.8 years. A total of 2,659 (45.9%) worked in clinics and 3,110 (73.6%) were working in metropolitan districts. Only 124 OB/GYNs (2.9%) worked in vulnerable rural areas. OB/GYNs working in obstetric hospitals were responsible for 113.8 newborns in 2019. Their average age was 50.1 years. Of them, 67.4% were working in hospitals, 74.1% in urban areas, and only 60 specialists (2.3%) were working in rural areas. To establish a safe childbirth environment during an era of low fertility, it is important to have obstetricians in charge of childbirth. The government should establish a comprehensive long-term plan to resolve the shortage of OB/GYNs.

8.
Article in English | WPRIM | ID: wpr-902401

ABSTRACT

Objective@#To objectively and subjectively assess and compare the characteristics of monoenergetic images [MEI (+)] and polyenergetic images (PEI) acquired by dual-energy CT (DECT) of patients with breast cancer. @*Materials and Methods@#This retrospective study evaluated the images and data of 42 patients with breast cancer who had undergone dual-phase contrast-enhanced DECT from June to September 2019. One standard PEI, five MEI (+) in 10-kiloelectron volt (keV) intervals (range, 40–80 keV), iodine density (ID) maps, iodine overlay images, and Z effective (Z eff) maps were reconstructed. The contrast-to-noise ratio (CNR) and the signal-to-noise ratio (SNR) were calculated. Multiple quantitative parameters of the malignant breast lesions were compared between the arterial and the venous phase images. Two readers independently assessed lesion conspicuity and performed a morphology analysis. @*Results@#Low keV MEI (+) at 40–50 keV showed increased CNR and SNR breast lesion compared with PEI, especially in the venous phase ([CNR: 40 keV, 20.10; 50 keV, 14.45; vs. PEI, 7.27; p < 0.001], [SNR breast lesion: 40 keV, 21.01; 50 keV, 16.28; vs.PEI, 10.77; p< 0.001]). Multiple quantitative DECT parameters of malignant breast lesions were higher in the venous phase images than in the arterial phase images (p < 0.001). MEI (+) at 40 keV, ID, and Z eff reconstructions yielded the highest Likert scores for lesion conspicuity. The conspicuity of the mass margin and the visual enhancement were significantly better in 40-keV MEI (+) than in the PEI (p = 0.022, p = 0.033, respectively). @*Conclusion@#Compared with PEI, MEI (+) reconstructions at low keV in the venous phase acquired by DECT improved the objective and subjective assessment of lesion conspicuity in patients with malignant breast lesions. MEI (+) reconstruction acquired by DECT may be helpful for the preoperative evaluation of breast cancer.

9.
Acta Pharmaceutica Sinica ; (12): 1826-1831, 2021.
Article in Chinese | WPRIM | ID: wpr-887030

ABSTRACT

The direct acting substances of Cuscuta chinensis in vivo were preliminarily identified through the correlation analysis of "metabolites-effect identification" model. The ovariectomized female rats were i.g administered with 95% ethanol extract part, 40% ethanol elution part and n-butanol extract part of Cuscuta chinensis. The serum fingerprints of different parts and times of administration were established by UPLC/Q-TOF-MS. At the same time, serum estradiol (E2), follicle-stimulating hormone (FSH) and luteinizing hormone (LH) levels were detected. Bivariate correlation analysis and grey correlation analysis were used to screen estrogenic components. The results showed that nine direct acting substances in vivo highly related to estrogen effect were found in the drug containing serum, which were hyperoside, astragalin, methyl quercetin glucuronide, quercetin-diglucuronide, quercetin, apigenin, isoquercitrin, kaempferol glucuronide and kaempferol. We can preliminarily screen out the direct acting substance of estrogen effect of Cuscuta chinensis in vivo based on the research idea of serum spectrum effect correlation. It provides a reliable basis for revealing the estrogeneffective substances of Cuscuta chinensis and confirming the quality markers. This experiment was approved by Harbin University of Commerce Ethics Committees (Approval No. HSDU2020-065).

10.
Article in Chinese | WPRIM | ID: wpr-884602

ABSTRACT

Human microbiota is composed of bacteria, viruses, fungi and other microorganisms, which are distributed in the oral cavity, nasal cavity, intestine, vagina and skin, etc. Human microbiota plays a pivotal role in the metabolism, immunity, hormones and homeostasis of the host. It can protect the host and maintain the homeostasis, and provoke the incidence of inflammation and tumors. Microbiota has been found to modulate the efficacy and toxicity of chemotherapy and immunotherapy for certain types of tumors. Nevertheless, large-scale studies in the context of radiation therapy have not been performed. In this article, the relationship between the microbiota and the radiotherapy response and toxicity changes of cancer patients was summarized, aiming to develop the optimal treatment plan for patients, and provide evidence for the prevention and treatment of radiotherapy-induced injury.

11.
Article in Chinese | WPRIM | ID: wpr-883217

ABSTRACT

Objective:To analyze the causes and clinical features of chronic suppurative lung disease(CSLD) in children.Methods:We retrospectivly analyzed the primary disease, imaging changes, electronic fiber bronchoscope changes, blood gas analysis, lung function, treatment outcome and other clinical data of CSLD in children hospitalized in our hospital from September 2018 to February 2020.Results:A total of 14 children with CSLD were collected, including six males and eight females, aged (5.9±2.7) years old.Among 14 cases of CSLD, six cases were diagnosed with upper airway cough syndrome, three cases with upper airway cough syndrome and bronchial asthma, two cases with cough variant asthma, and one case with combined immunodeficiency disease.There were different degrees of purulent inflammation under electronic fiber bronchoscopy, and three cases had airway inflammatory stenosis.The lavage fluid suggested neutrophil inflammation.Blood gas analysis was normal in ten cases and hypoxemia in four cases.In seven cases, pulmonary function examination was abnormal in six cases, and one case had emphysema on lung CT examination.After intravenous administration of antibiotics and sequential oral antibiotics, the symptoms of 14 children were relieved.Fourteen cases were followed up for 12 weeks.Among them, 12 cases had complete relief of clinical symptoms, one case had repeated cough with combined immunodeficiency disease, and one case was lost to follow-up.Conclusion:CSLD mostly has primary disease.Electronic fiber bronchoscopy is not only a necessary examination of CSLD, but also one of the important means for treatment.Purulent inflammation of the airways can lead to abnormal obstructive lung.Sufficient course of treatment and standardized use of antibiotics are the key to the treatment for CSLD.

12.
Article in Chinese | WPRIM | ID: wpr-882815

ABSTRACT

Clinical data of 2 children with cystic fibrosis (CF) and Pseudomonas aeruginosa infection in the Department of Pediatrics of Sichuan Provincial People′s Hospital from April 2018 to June 2019 were retrospectively analyzed.Patient 1 was an 11-year-old girl with no history of recurrent respiratory infections. Pseudomonas aeruginosa was found in the first sputum culture.A large number of yellow and white secretions were visible under repeated fiberoptic bronchoscopy.Chest CT showed multiple spots and tree-in-bud signs around the bronchi of both lungs. CFTR gene test results revealed 3 heterozygous mutations: c.2909G>A (chr7: 117246728), c.*133T>A (chr7: 117307295) and c. *125delT (chr7: 117307285). The other patient was a 7-year-old boy with a history of recurrent respiratory infections.His parents were close relatives.Multiple cultures of sputum and bronchoalveolar lavage fluid of the boy were Pseudomonas aeruginosa, and chest CT suggested dilation and inflammation in bronchi of both lungs.Gene detection showed that the c. 380T>G homozygous mutation at chromosome chr7-117171059 resulted in an amino acid change p. leu127stop (nonsense mutation). This article suggests that CF should be considered for Pseudomonas aeruginosa infected children having signs of bronchiectasis on chest CT and a large number of secretions under bronchoscopy.Besides, it is necessary for such kind of children to perform genetic testing in time to confirm the diagnosis as soon as possible.

13.
Journal of Integrative Medicine ; (12): 191-202, 2021.
Article in English | WPRIM | ID: wpr-881011

ABSTRACT

Primary Sjogren's syndrome (pSS) is a chronic autoimmune disease involving exocrine glands. Current studies have found that the occurrence of the disease is closely related to genetic, environmental and neuroendocrine factors, as well as abnormal activation of T and B lymphocytes. The etiology and pathogenesis of pSS is complex, and there is a lack of specific targeted drugs. Traditional Chinese medicines (TCMs) have been comprehensively investigated for their treatment effects on pSS. Through a systematic review of the literature, we summarized the TCMs used to treat pSS, and find that there are four major ways that TCMs are used, including upregulation of aquaporin proteins, suppression of cell apoptosis, suppression of the abnormal activation of B lymphocytes and suppression of the abnormal activation of T lymphocytes (balancing T helper type [Th]1/Th2 & Th17/Treg and suppressing follicular helper T [Tfh] cells). However, there are not enough data about the active constituents, quality control, pharmacokinetics, toxicity and modern preparations of these TCMs; therefore, more investigations are needed. This paper highlights the importance of TCMs for treating pSS and provides guidance for future investigations.

14.
Journal of Integrative Medicine ; (12): 89-103, 2021.
Article in English | WPRIM | ID: wpr-881005

ABSTRACT

The processing of Chinese herbal medicine is a form of pharmaceutical technology developed over thousands of years, in order to increase efficiency and decrease toxicity of herbs in traditional Chinese medicine (TCM). Herbal processing is essential for safe and effective application of TCM in clinical practice, as it alters the active chemical components and therefore the functions of herbal medicines. Alkaloid-rich herbal medicines in TCM are commonly processed by cleansing, cutting, processing by dry stir-frying, stir-frying with liquid adjuvants, and processing by water decoction. In addition, commonly used adjuvants for processing alkaloid-rich herbal medicines are river sand, wine, vinegar, brine, honey and herbal juice. For alkaloid-rich herbal medicines, the main chemical reactions that occur during processing include hydrolysis, oxidation, replacement, decomposition and condensation. This paper aimed to summarize the processing methods and mechanisms for alkaloid-rich Chinese herbal medicines, and provide much-needed theoretical support and scientific evidence for understanding those mechanisms and effects. Information on processing methods for alkaloid-rich herbal medicines was collected from classic books of herbal medicine, PhD and MSc dissertations, online scientific databases including PubMed, SciFinder, Scopus, Web of Science, Baidu Scholar and Google Scholar. This paper should help to advance our knowledge of the processing mechanisms and aid in the development of processing methods for alkaloid-rich Chinese herbal medicines.

15.
Journal of Integrative Medicine ; (12): 158-166, 2021.
Article in English | WPRIM | ID: wpr-881000

ABSTRACT

OBJECTIVE@#This study tests whether long-term intake of Allium tuberosum (AT) can alleviate pulmonary inflammation in ovalbumin (OVA)-induced asthmatic mice and evaluates its effect on the intestinal microbiota and innate lymphoid cells (ILCs).@*METHODS@#BALB/c mice were divided into three groups: phosphate buffer saline, OVA and OVA + AT. The asthmatic murine model was established by sensitization and challenge of OVA in the OVA and OVA + AT groups. AT was given to the OVA + AT group by oral gavage from day 0 to day 27. On day 28, mice were sacrificed. Histopathological evaluation of lung tissue was performed using hematoxylin and eosin, and periodic acid-Schiff staining. The levels of IgE in serum, interleukin-5 (IL-5) and IL-13 from bronchoalveolar lavage fluid (BALF) were measured by enzyme-linked immunosorbent assay. The ILCs from the lung and gut were detected by flow cytometry. 16S ribosomal DNA sequencing was used to analyze the differences in colon microbiota among treatment groups.@*RESULTS@#We found that long-term intake of AT decreased the number of inflammatory cells from BALF, reduced the levels of IL-5 and IL-13 in BALF, and IgE level in serum, and rescued pulmonary histopathology with less mucus secretion in asthmatic mice. 16S ribosomal DNA sequencing results showed that AT strongly affected the colonic bacteria community structure in asthmatic mice, although it had no significant effect on the abundance and diversity of the microbiota. Ruminococcaceae and Desulfovibrionaceae were identified as two biomarkers of the treatment effect of AT. Moreover, AT decreased the numbers of ILCs in both the lung and gut of asthmatic mice.@*CONCLUSION@#The results indicate that AT inhibits pulmonary inflammation, possibly by impeding the activation of ILCs and adjusting the homeostasis of gut microbiota in asthmatic mice.

16.
Article in Chinese | WPRIM | ID: wpr-880413

ABSTRACT

Osteoporosis is one of the common metabolic diseases, which can easily lead to osteoporotic fractures. Accurate prediction of bone biomechanical properties is of great significance for the early prevention and diagnosis of osteoporosis. Bone mineral density measurement is currently used clinically as the gold standard for assessing bone strength and diagnosing osteoporosis, but studies have shown that bone mineral density can only explain 60% to 70% of bone strength changes, and trabecular bone microstructure is an important factor affecting bone strength. In order to establish the connection between trabecular bone microstructure and bone strength, this paper proposes a prediction method of trabecular bone modulus based on SE-DenseVoxNet. This method takes three-dimensional binary images of trabecular bone as input and predicts its elastic modulus in the z-axis direction. Experiments show that the error and bias between the predicted value of the method and the true value of the sample are small and have good consistency.


Subject(s)
Biomechanical Phenomena , Bone Density , Cancellous Bone/diagnostic imaging , Elastic Modulus , Humans , Osteoporosis/diagnostic imaging
17.
Article in English | WPRIM | ID: wpr-922396

ABSTRACT

OBJECTIVES@#To study the effect of different maintenance doses of caffeine citrate on the success rate of ventilator weaning in very preterm infants (gestational age of ≤32 weeks) with respiratory distress syndrome (RDS).@*METHODS@#A total of 162 preterm infants with RDS who were admitted to the hospital from January 2016 to December 2018 were enrolled in this prospective trial. These infants had a gestational age of ≤32 weeks and required invasive mechanical ventilation. They were randomly divided into a high-dose caffeine group and a low-dose caffeine group, with 81 infants in each group. Within 6 hours after birth, both groups were given caffeine at a dose of 20 mg/kg. After 24 hours, the high- and low-dose caffeine groups were given caffeine at a maintenance dose of 10 mg/kg and 5 mg/kg, respectively. The two groups were compared in terms of re-intubation rate within 48 hours after ventilator weaning, durations of ventilation and oxygen therapy, enteral feeding, weight gain, and the incidence rates of complications and adverse reactions during hospitalization.@*RESULTS@#The high-dose caffeine group had a significantly lower re-intubation rate within 48 hours after ventilator weaning than the low-dose caffeine group (@*CONCLUSIONS@#A high maintenance dose of caffeine can safely and effectively reduce the incidence rate of apnea after ventilator weaning and the failure rate of ventilator weaning in RDS preterm infants with a gestational age of ≤32 weeks, and therefore, it holds promise for clinical application.


Subject(s)
Caffeine , Citrates , Humans , Infant , Infant, Newborn , Infant, Premature , Prospective Studies , Respiratory Distress Syndrome, Newborn/therapy , Ventilator Weaning
18.
Article in English | WPRIM | ID: wpr-895273

ABSTRACT

Korea has entered a stage of low fertility, with a total fertility rate of 1.178 in 2002 and 0.92 in 2019. The low birth rate has led to the closure of obstetric hospitals and clinics from 1,371 maternity health facilities in 2003 to 541 in 2019, which is 39.5% compared to 2003. Since 2011, the Ministry of Health and Welfare has been operating an “Obstetrically Underserved Areas Support Project,” however, a shortage of obstetrician-gynecologists (OB/GYNs) who can participate in labor and delivery is a major problem. In 2019, there were 5,800 OB/GYNs practicing. Of these, 4,225 (72.8%) were working in obstetrics-gynecology hospitals, each responsible for 2,855 fertile women. Their average age was 51.8 years. A total of 2,659 (45.9%) worked in clinics and 3,110 (73.6%) were working in metropolitan districts. Only 124 OB/GYNs (2.9%) worked in vulnerable rural areas. OB/GYNs working in obstetric hospitals were responsible for 113.8 newborns in 2019. Their average age was 50.1 years. Of them, 67.4% were working in hospitals, 74.1% in urban areas, and only 60 specialists (2.3%) were working in rural areas. To establish a safe childbirth environment during an era of low fertility, it is important to have obstetricians in charge of childbirth. The government should establish a comprehensive long-term plan to resolve the shortage of OB/GYNs.

19.
Article in English | WPRIM | ID: wpr-894697

ABSTRACT

Objective@#To objectively and subjectively assess and compare the characteristics of monoenergetic images [MEI (+)] and polyenergetic images (PEI) acquired by dual-energy CT (DECT) of patients with breast cancer. @*Materials and Methods@#This retrospective study evaluated the images and data of 42 patients with breast cancer who had undergone dual-phase contrast-enhanced DECT from June to September 2019. One standard PEI, five MEI (+) in 10-kiloelectron volt (keV) intervals (range, 40–80 keV), iodine density (ID) maps, iodine overlay images, and Z effective (Z eff) maps were reconstructed. The contrast-to-noise ratio (CNR) and the signal-to-noise ratio (SNR) were calculated. Multiple quantitative parameters of the malignant breast lesions were compared between the arterial and the venous phase images. Two readers independently assessed lesion conspicuity and performed a morphology analysis. @*Results@#Low keV MEI (+) at 40–50 keV showed increased CNR and SNR breast lesion compared with PEI, especially in the venous phase ([CNR: 40 keV, 20.10; 50 keV, 14.45; vs. PEI, 7.27; p < 0.001], [SNR breast lesion: 40 keV, 21.01; 50 keV, 16.28; vs.PEI, 10.77; p< 0.001]). Multiple quantitative DECT parameters of malignant breast lesions were higher in the venous phase images than in the arterial phase images (p < 0.001). MEI (+) at 40 keV, ID, and Z eff reconstructions yielded the highest Likert scores for lesion conspicuity. The conspicuity of the mass margin and the visual enhancement were significantly better in 40-keV MEI (+) than in the PEI (p = 0.022, p = 0.033, respectively). @*Conclusion@#Compared with PEI, MEI (+) reconstructions at low keV in the venous phase acquired by DECT improved the objective and subjective assessment of lesion conspicuity in patients with malignant breast lesions. MEI (+) reconstruction acquired by DECT may be helpful for the preoperative evaluation of breast cancer.

20.
Article in English | WPRIM | ID: wpr-888787

ABSTRACT

Mushrooms are abundant in bioactive natural compounds. Due to strict growth conditions and long fermentation-time, microbe as a production host is an alternative and sustainable approach for the production of natural compounds. This review focuses on the biosynthetic pathways of mushroom originated natural compounds and microbes as the production host for the production of the above natural compounds.


Subject(s)
Agaricales/chemistry , Bacteria/metabolism , Biological Products/metabolism , Biosynthetic Pathways , Fermentation , Metabolic Engineering
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