Pancreatitis in children and the anatomical abnormalities / 中国小儿急救医学

The anatomical abnormalities associated with pancreatitis mainly include pancreas anomalies, pancreaticobiliary maljunction and intestinal duplication.Pancreas anomalies are the most common congenital abnormalities in the triggers of pancreatitis, including pancreas divisum, annular pancreas and heterotopic pancreas prevail.In all these anomalies, the mechanism of pancreatitis is likely due to outlet obstruction.Awareness of these anomalies is necessary to arrange the proper strategy for the treatment of patients with pancreatitis.

Investigation on the mechanism of Kuaisong yin in the prevention and treatment of constipation based on metabonomics / 中国药房

OBJECTIVE To explore the mechanism of Kuaisong yin in the prevention and treatment of constipation. METHODS Slow transit constipation （STC） model was established with Compound difenoxylate tablet in mice and rats. Two batches of mice were divided into blank group， model group， positive control group （Maren soft capsule， 0.64 g/kg）， Kuaisong yin low-dose， medium-dose and high-dose groups （3.2， 6.4， 12.8 g/kg）， with 10 mice in each group. The effect of Kuaisong yin on constipation in mice was evaluated by intestinal propulsion experiment and defecation experiment. Rats were divided into blank group， model group， positive control group （Maren soft capsule，0.36 g/kg）， Kuaisong yin low-dose and high-dose groups （2.4， 4.8 g/kg）， with 7 or 8 rats in each group. They were given relevant medicine once a day for 1 week. The metabonomics of serum and urine of rats were analyzed by UPLC-Q-TOF-MS/MS technology. RESULTS Compared with model group， the ink propulsion rate and 5 h defecation volume of mice in Kuaisong yin high-dose group were significantly increased （P＜0.05）； the first defecation time of mice in Kuaisong yin medium-dose and high-dose groups was significantly shortened， and the quality of defecation was significantly reduced within 5 h （P＜0.05 or P＜0.01）. Serum metabonomics screened 16 compounds （such as proline， propionylcarnitine， hemolytic phosphatidylcholine， etc.） and 6 metabolic pathways （such as sphingomyelin metabolism， arginine and proline metabolism， sphingolipid biosynthesis-lactose and neolactone series）. Urine metabonomics screened 20 different metabolites （such as prostaglandin A2， L-valine， phosphatidylcholine， sphingomyelin， etc.） and 8 metabolic pathways （such as valine， leucine and isoleucine biosynthesis， sphingomyelin metabolism， pyruvate metabolism， etc.）. CONCLUSIONS Kuaisong yin can play a role in improving constipation by regulating different metabolites such as hemolytic phosphatidylcholine， phosphatidylcholine， prostaglandin A2， L-valine， proline， and regulating metabolic pathways such as multiple amino acid metabolism， sphingomyelin metabolism， etc.

Investigation on the mechanism of Compound zaoren granules in improving insomnia based on serum meta-bonomics / 中国药房

OBJECTIVE To study the mechanism of Compound zaoren granule in improving insomnia. METHODS Forty-nine mice were divided into blank group， model group， positive control group 1 （Estazolam tablets 0.5 mg/kg），control group 2 （Shumian capsule 0.6 g/kg）， Compound zaoren granule low-dose， medium-dose and high-dose groups （2.5， 5， 10 g/kg）， with 7 mice in each group. The insomnia model was established by chronic unpredictable mild stress combined with 4-chloro-DL- phenylacetic acid. The behavioral changes of mice were investigated through open field test and pentobarbital sodium synergistic hypnosis experiment， as well as the pathomorphology of mice hypothalamus tissue was observed by HE staining. The metabonomics analysis and multivariate statistical analysis of serum in mice were performed by UHPLC-Q-TOF-MS/MS， and the differential metabolites were screened out； the metabolic pathway analysis was conducted based on MetaboAnalyst 5.0 database. RESULTS Compared with blank group， the total travelling distance， the number of entering the central region and the moving distance in the central region of the model group were significantly reduced （P＜0.05）， the proportion of total rest time was significantly increased （P＜0.05）， the sleep duration of mice was significantly shortened （P＜0.05）， and hypothalamic nerve cells damaged and severely vacuolated. Compared with model group， the total travelling distance of Compound zaoren granule low-dose and medium-dose groups were increased significantly and the proportions of total rest time of those groups were decreased significantly （P＜0.05）， and the sleep duration of mice in Compound zaoren granule high-dose group was prolonged significantly （P＜0.05）； the hypothalamic nerve cells of mice in each administration group recovered to varying degrees， and the hypothalamus histiocytes of mice in the Compound zaoren granules high-dose group were closer to those in the blank group. A total of 18 differential metabolites （such as phenylalanine， taurine， norvaline， methionine） and 4 important amino acid metabolic pathways （L-phenylalanine， tyrosine and tryptophan biosynthesis； taurine and hypotaurine metabolism； L-phenylalanine metabolism； cysteine and methionine metabolism） were identified through metabolomics analysis. CONCLUSIONS Compound zaoren granules can normalize the disordered metabolism in vivo by regulating differential metabolites such as phenylalanine， taurine， and four amino acid metabolic pathways， so as to improve insomnia.

Analysis of NSD1 gene variant in a child with autism spectrum disorder in conjunct with congenital heart disease / 中华医学遗传学杂志

OBJECTIVE@#To explore the clinical characteristics and genetic basis of a child with autism spectrum disorder (ASD) in conjunct with congenital heart disease (CHD).@*METHODS@#A child who was hospitalized at the Third People's Hospital of Chengdu on April 13, 2021 was selected as the study subject. Clinical data of the child were collected. Peripheral blood samples of the child and his parents were collected and subjected to whole exome sequencing (WES). A GTX genetic analysis system was used to analyze the WES data and screen candidate variants for ASD. Candidate variant was verified by Sanger sequencing and bioinformatics analysis. Real-time fluorescent quantitative PCR (qPCR) was carried out to compare the expression of mRNA of the NSD1 gene between this child and 3 healthy controls and 5 other children with ASD.@*RESULTS@#The patient, an 8-year-old male, has manifested with ASD, mental retardation and CHD. WES analysis revealed that he has harbored a heterozygous c.3385+2T>C variant in the NSD1 gene, which may affect the function of its protein product. Sanger sequencing showed that neither of his parent has carried the same variant. By bioinformatic analysis, the variant has not been recorded in the ESP, 1000 Genomes and ExAC databases. Analysis with Mutation Taster online software indicated it to be disease causing. Based on the guidelines from the American College of Medical Genetics and Genomics (ACMG), the variant was predicted to be pathogenic. By qPCR analysis, the expression level of mRNA of the NSD1 gene in this child and 5 other children with ASD was significantly lower than that of the healthy controls (P < 0.001).@*CONCLUSION@#The c.3385+2T>C variant of the NSD1 gene can significantly reduce its expression, which may predispose to ASD. Above finding has enriched the mutational spectrum the NSD1 gene.

Causes of unplanned reoperation in pediatric patients undergoing elective digestive tract surgery and the prognosis / 中华普通外科杂志

Objective:To analyze the causes of unplanned reoperation in pediatric patients after elective digestive tract surgery and the prognosis.Methods:Medical records were reviewed from pediatric patients undergoing unplanned reoperation after elective digestive tract surgery at our department from Jan 2012 to Dec 2019. Primary diagnoses, procedures and levels of index surgeries, causes and procedures of unplanned reoperations, and patients' prognosis were analyzed.Results:There were 39 cases, and the primary diagnoses included biliary disease, anal and colorectal disease, and intestinal disease. There were 4 (10%) cases of level Ⅱ surgeries,and 35 (90%) cases of level Ⅲ&Ⅳ surgeries. The index surgical procedures included 19 (49%) biliary-intestinal procedures, 11 (28%) simple intestinal procedures, and 9 (23%) anal and colorectal procedures. The direct causes of unplanned reoperation included 10 (26%) anastomotic leakages, 8 (20%) adhesive intestinal obstructions, 5 (13%) postoperative intussusceptions, 5 (13%) incisional complications (infection, dehiscence and incisional hernia), 3 (8%) postoperative hemorrhages and 8 (20%) miscellaneous (iatrogenic injury and surgical misjudgment). Patients' prognosis included 24 (62%) full recoveries, 9 (23%) further operations, and 5 (13%) deaths, and 1 (3%) short bowel syndrome.Conclusions:Most pediatric unplanned reoperations after elective digestive tract surgery occur in complex surgical procedures. The most common causes of unplanned reoperation are anastomotic leakage, adhesive intestinal obstruction. Unplanned reoperations are often prone to adverse effects on prognosis.

Research progress in diagnosis and intervention of sarcopenia in patients with head and neck cancer / 国际生物医学工程杂志

Sarcopenia is a common clinical syndrome in cancer patients and is becoming an independent poor prognostic factor. Studies have shown that an appropriate increase in protein, vitamin D, Omega-3, and other nutrient intake combined with exercise, while ensuring appropriate energy intake, can improve or even reverse sarcopenia. In this review, the research progress in the assessment and diagnosis, epidemiological features, clinical outcomes, and interventions for sarcopenia in patients with head and neck cancer was reviewed.

Relationship between autophagy and oxidative stress during remifentanil-induced hyperalgesia in rats with incisional pain / 中华麻醉学杂志

Objective:To evaluate the relationship between autophagy and oxidative stress during remifentanil-induced hyperalgesia in the rats with incisional pain.Methods:Thirty-two clean-grade healthy male Sprague-Dawley rats, weighing 230-250 g, aged 2-3 months, were divided into 4 groups ( n=8 each) using a random number table method: incisional pain group (I group), remifentanil + incisional pain group (RI group), autophagy inhibitor 3-methyladenine + remifentanil + incisional pain group (MRI group) and autophagy agonist rapamycin group + remifentanil + incisional pain group (RRI group). The model of incision pain was developed and the equal volume of normal saline was intravenously infused simultaneously for 60 min.In RI, MRI and RRI groups, the model of incision pain was developed and remifentanil 1 μg·kg -1·min -1 was simultaneously infused for 60 min.In MRI group, 3-methyladenine 15 mg/kg was intraperitoneally injected at 12 h before developing the model, and rapamycin 10 mg/kg was intraperitoneally injected at 12 h before developing the model in RRI group.Thermal paw withdrawal latency (TWL) and mechanical paw withdrawal threshold (MWT) were measured at 24 h before infusion of remifentanil or normal saline (T 0) and at 2, 6, 24 and 48 h after the end of infusion (T 1-4). The rats were sacrificed after the end of behavioral testing, and the lumbar enlargement segments of the spinal cord were harvested for determination of the expression of autophagy microtubule-associated protein 1 light chain 3Ⅱ (LC3Ⅱ), Beclin-1 and P62 (by Western blot), activity of superoxide dismutase (SOD) (by xanthine oxidase method) and content of malondialdehyde (MDA) (by thiobarbital method). Results:Compared with the baseline at T 0, PWT was significantly decreased and TWL was shortened at T 1-4 in the four groups ( P<0.05). Compared with I group, MWT was significantly decreased and TWL was shortened at T 1-4, the expression of LC3 Ⅱand Beclin-1 was up-regulated, the expression of P62 was down-regulated, SOD activity was decreased, and MDA content was increased in RI group ( P<0.05). Compared with RI group, MWT was significantly decreased and TWL was shortened at T 1-4, the expression of LC3 Ⅱand Beclin-1 was down-regulated, the expression of P62 was up-regulated, SOD activity was decreased, and MDA content was increased in MRI group ( P<0.05), and MWT was significantly increased and TWL was prolonged at T 1-4, the expression of LC3 Ⅱand Beclin-1 was up-regulated, the expression of P62 was down-regulated, SOD activity was increased, and MDA content was decreased in RRI group ( P<0.05). Conclusions:Autophagy is involved in the process of remifentanil-induced incisional hyperalgesia through regulating the level of oxidative stress in rats.

URA3 affects artemisinic acid production by an engineered Saccharomyces cerevisiae in pilot-scale fermentation / 生物工程学报

CRISPR/Cas9 has been widely used in engineering Saccharomyces cerevisiae for gene insertion, replacement and deletion due to its simplicity and high efficiency. The selectable markers of CRISPR/Cas9 systems are particularly useful for genome editing and Cas9-plasmids removing in yeast. In our previous research, GAL80 gene has been deleted by the plasmid pML104-mediated CRISPR/Cas9 system in an engineered yeast, in order to eliminate the requirement of galactose supplementation for induction. The maximum artemisinic acid production by engineered S. cerevisiae 1211-2 (740 mg/L) was comparable to that of the parental strain 1211 without galactose induction. Unfortunately, S. cerevisiae 1211-2 was inefficient in the utilization of the carbon source ethanol in the subsequent 50 L pilot fermentation experiment. The artemisinic acid yield in the engineered S. cerevisiae 1211-2 was only 20%-25% compared with that of S. cerevisiae 1211. The mutation of the selection marker URA3 was supposed to affect the growth and artemisinic acid production. A ura3 mutant was successfully restored by a recombinant plasmid pML104-KanMx4-u along with a 90 bp donor DNA, resulting in S. cerevisiae 1211-3. This mutant could grow normally in a fed-batch fermentor with mixed glucose and ethanol feeding, and the final artemisinic acid yield (> 20 g/L) was comparable to that of the parental strain S. cerevisiae 1211. In this study, an engineered yeast strain producing artemisinic acid without galactose induction was obtained. More importantly, it was the first report showing that the auxotrophic marker URA3 significantly affected artemisinic acid production in a pilot-scale fermentation with ethanol feeding, which provides a reference for the production of other natural products in yeast chassis.

Reoperation for biliary-enteric strictures after hepaticojejunostomy in children with congenital biliary dilatation / 中华普通外科杂志

Objective:To evaluate clinical characteristics and treatment of postoperative anastomotic stricture in pediatric congenital biliary dilatation patients.Methods:The clinical data of 24 children with postoperative anastomotic stricture from Apr 2012 to Oct 2019 in Beijing Children's Hospital was retrospectively analyzed.Results:There were 6 males and 18 females. Patients were divided into bile- leak group (BL, n=6) and non bile-leak group (NBL, n=18) based on whether there was anastomotic leakage after primary surgery. The main symptoms in BL group was persistent obstructive jaundice, and recurrent cholangitis in NBL group. Postoperative symptoms were first shown in an average of 7.0 months in BL group, compared to 59.0 months in NBL group, P<0.05. In BL group, 4 underwent redoing hepaticojejunostomy, 2 underwent anastomosis plasty. In NBL group, 3 underwent redoing hepaticojejunostomy, 15 did anastomosis plasty with multiple biliary stones found necessitating extraction. After reoperation, one patient had bile leakage, 2 patients had recurrent cholangitis within one-month, 21 patients had uneventful recovery. Five were found to have biliary stones in long-term follow-up. Conclusions:Biliary-enteric anastomotic leakage can cause stricture in postoperative patients of congenital biliary dilatation ,reoperation is necessary in symptomatic patients.

Research progress on protective effect of liver ischemia-reperfusion injury after liver transplantation / 国际外科学杂志

Hepatic ischemia-reperfusion injury is the most common complication after liver transplantation. Oxidative stress, autophagy, and inflammatory response caused by excessive reactive oxygen species production are significant steps that cause liver ischemia-reperfusion injury. What′s more, nuclear factor erythroid 2-related factor 2 is considered to be a major regulator of the antioxidant response, the PI3K-Akt-mTOR signaling pathway is considered to be an important pathway of autophagy, and the HMGB1-TLR4-NF-κB signaling pathway is considered to be a key signaling pathway which leads to inflammation. Based on the above signaling pathways and regulatory factor, this article shows that the antioxidant, anti-inflammatory and autophagy regulation effects of genes, molecules and drugs on hepatic ischemia-reperfusion cells, to explore the protective effects on hepatic ischemia-reperfusion cells.

CircRNA in female gestational and gynecological diseases / 中华检验医学杂志

Circular RNA (circRNA) is a ubiquitous class of noncoding RNAs (ncRNAs) in all kingdoms of life with diverse structures.CircRNA is an endogenous noncoding RNA molecule with covalently close cyclic structure which does not have 5'end cap and 3'poly (A) tail.It is found to be evolutionary conservative and stable with tissue specificity.CircRNAs have many biological functions.In addition to acting as miRNA sponges,many other functions are being revealed,including regulator of gene transcription,and splicing and protein translation.It is involved in ovarian epithelial neoplasms,pre-eclampsia and other development.CircRNAs could regulate the expression of numerous gynecological cancer-related microRNA (miRNAs).The circRNA-miRNA-messenger RNA(mRNA) axis is a known regulatory pattern of several cancer-associated pathways,with both agonist and antagonist effects on carcinogenesis.Numerous studies have shown that circRNAs may become potential targets and clinical diagnostic markers for reproductive and gynecological diseases.This review focuses on the biogenesis and properties of circRNAs,databases of circRNA,their functions and potential significance in gestational,tumor and gestational diseases.

Progression of diagnosis and treatment in pediatric colorectal carcinoma / 中华胃肠外科杂志

Colorectal carcinoma (CRC) is the third most common malignancy in adults. Pediatric colorectal carcinoma (PCRC) is a rare non-embryonal tumor with a significantly lower incidence compared to adults. The clinical manifestations of PCRC are not typical, and pediatricians usually have no enough experience in diagnosis and treatment. Therefore, early diagnosis is extremely difficult, which would always lead to late clinical stages when diagnosis is made. At present, the pathogenesis of PCRC is still not clear, and many countries have started to carry out researches at the level of genes, molecules and cells. In both tumor primary tumors and distant metastases, PCRC has obvious difference in distribution from adults, and the proportion of pathological type of mucous adenocarcinoma (including the signet ring cell carcinoma) was significantly higher than that of adults. Although treated according to adult colorectal cancer guidelines, PCRC has been unable to achieve ideal efficacy with poor prognosis and lower long-term survival rate. The purpose of this paper is to summarize the epidemiological characteristics, pathogenesis, clinical symptoms, pathological types, treatment and prognosis of colorectal cancer in children by reviewing the latest literatures at home and abroad.

Relationship between PI3K∕Akt signaling pathway and autophagy during acute lung injury in septic mice / 中华麻醉学杂志

Objective To evaluate the relationship between phosphatidylinositol 3?kinase∕serine?threonine kinase(PI3K∕Akt)signaling pathway and autophagy during acute lung injury in septic mice. Methods Thirty?six male C57BL∕6 mice, aged 6-8 weeks, weighing 20-25 g, were divided into 3 groups(n=12 each)using a random number table: sham operation group(group SH), sepsis group (group S)and PI3K inhibitor LY294002 plus sepsis group(group LY+S). Sepsis was induced by cecal ligation and puncture in S and LY+S groups. LY294002 30 mg∕kg was intraperitoneally injected at 2 h be?fore operation in group LY+S. Arterial blood samples were taken at 24 h after operation for blood gas analy?sis, PaO2was recorded, and oxygenation index was calculated. Lung specimens were obtained for examina?tion of pathological changes which were scored and for determination of autophagosome count(using trans?mission electron microscope), wet∕dry weight ratio(W∕D ratio)and expression of Akt, phosphorylated Akt(p?Akt), Beclin?1 and microtubule?associated protein 1 light chain 3 Ⅱ(LC3 Ⅱ). The p?Akt∕Akt ratio was calculated. Results Compared with group SH, oxygenation index was significantly decreased,and the W∕D ratio and pathological score were increased in S and LY+S groups, the autophagosome count was significantly increased, p?Akt∕Akt ratio was increased, and the expression of Beclin?1 and LC3Ⅱ was up?regulated in group S(P<0.05). Compared with group S, oxygenation index was significantly de?creased, and the W∕D ratio was increased, the autophagosome count was decreased, pathological scores were increased, p?Akt∕Akt ratio was decreased, and the expression of Beclin?1 and LC3Ⅱwas down?regu?lated in group LY+S(P<0.05). Conclusion PI3K∕Akt signaling pathway activation mediates autophagy and is involved in the endogenous protective mechanism of acute lung injury in septic mice.

Therapeutic experiences of 25 patients with pediatric spontaneous biliary duct perforation / 中华肝胆外科杂志

Objective To summarize our therapeutic experiences on patients with pediatric spontaneous biliary duct perforation.Methods We retrospectively analyzed the clinical data of patients diagnosed as spontaneous biliary duct perforation who were admitted into the Department of Pediatric General Surgery,the Beijing Children Hospital from January 2008 to December 2014,and summarized the therapeutic experiences.Results There were 7 boys and 18 girls,with a average age of 2.4 years (range 11 months to 10 years).Twenty-one patients (84.0％) were diagnosed by ultrasonography.Two patients were treated with conservative therapy and were discharged home.The remaining 23 patients were treated with emergent surgery.Of these patients,9 were treated with cholecystostomy and abdominal drainage (the cholecystostomy group),and the remaining 14 were treated with choledochal drainage and abdominal drainage (the choledochal drainage group).The mean hospitalization stay for the cholecystostomy group was 25.2 days,and 3 patients developed comphcations (33.3％).The mean hospitalization stay for thecholedochal drainage group was 16.1 day,and 2 patients developed complications (14.2％).Twenty-four patients were diagnosed to suffer from congenital choledochal cysts or pancreaticobiliary maljunction by imaging studies during or after surgery.Elective choledochal cystectomy with hepaticojejunostomy were performed on 23 stable patients who developed no severe complications.Conclusions Pediatric spontaneous bile duct perforation is closely related with congenital choledochal cysts,and the pathological basis in diagnosis is pancreaticobiliary maljunction.Bile duct elastic fiber hypogenesis and specific blood supply are important to the onset of perforation.Abdominal ultrasonography plays an important role in the diagnosis.Patients with peritoneal irritation and non-localized perforation should be operated in time,and choledochal drainage with abdominal drainage is a good treatment choice.All patients diagnosed as congenital choledochal cysts or pancreaticobiliary maljunction should undergo elective choledochal cystectomy with hepaticojejunostomy.

Non-invasive prenatal diagnosis for beta-thalassemia by detecting paternal CD41-42 mutation in cell-free DNA derived from maternal plasma with droplet digital PCR / 中华医学遗传学杂志

OBJECTIVE@#To establish a non-invasive method for beta-thalassemia by detecting parental CD41-42 mutation in cell-free DNA derived from maternal plasma with droplet digital PCR (ddPCR).@*METHODS@#Beta-actin gene and beta-thalassemia gene CD41-42 mutation were respectively set as the reference and target sequences. A novel method was established based on Bio-Rad ddPCR technique with specific primers and TaqMan probes for the two genes. The accuracy, sensitivity and detective linearity range of the developed method were evaluated by detection of the target gene gradient concentration samples. The applicability was also evaluated by testing 20 maternal plasma samples.@*RESULTS@#The ddPCR method could accurately detect the beta-thalassemia CD41-42 mutation in cell-free DNA derived from maternal plasma. Within the target sequence concentration ratio of 5.00%-0.50%, the relative errors were all < 0.05, the linear regression equation was Y=1.0101-X-0.0071 and R=0.9994. The results of 20 maternal plasma cell-free DNA samples were all consistent with those of the follow-up testing.@*CONCLUSION@#A ddPCR method for detecting parental CD41-42 mutation in cell-free DNA from maternal plasma was developed. The method is simple, rapid, accurate, and can be applied for non-invasive prenatal diagnosis for couples simultaneously carrying the CD41-42 mutation.

Relationship between heme oxygenase-1 expression and autophagy during acute lung injury in septic mice / 中华麻醉学杂志

Objective To evaluate the relationship between heme oxygenase-1 (HO-1) expression and autophagy during acute lung injury in septic mice.Methods Forty-eight male C57BL/6 mice,aged 6-8 weeks,weighing 20-25 g,were randomly divided into 4 groups (n=12 each) using a random number table:sham operation group (group SH),sepsis group (group CLP),HO-1 agonist hemin plus sepsis group (group Hemin+CLP) and HO-1 inhibitor SnPP plus sepsis group (group SnPP+CLP).Sepsis was induced by cecal ligation and puncture in CLP,Hemin+CLP and SnPP+CLP groups.Hemin 50 μmol/kg and SnPP 50 μmol/kg were intraperitoneally injected at 2 h before operation in Hemin + CLP group and SnPP+CLP group,respectively.Arterial blood samples were taken at 24 h after operation for blood gas analysis,PaO2 was recorded,and oxygenation index was calculated.Lungs were removed for examination of pathological changes which were scored and for determination of autophagosome count (with an electron microscope),weight/dry weight ratio (W/D ratio) and expression of HO-1,Becling-1 and microtubule-associated protein 1 light chain 3 Ⅱ (LC3 Ⅱ) in lung tissues (by Western blot).Results Compared with group SH,oxygenation index was significantly decreased,and W/D ratio,autophagosome count and pathological scores were increased in CLP,Hemin+CLP and SnPP+CLP groups,and the expression of HO-1,Beclin-1 and LC3 Ⅱ was significantly up-regulated in CLP and Hemin+CLP groups (P＜0.05).Compared with group CLP,oxygenation index and autophagosome count were significantly increased,W/D ratio and pathological scores were decreased,and the expression of HO-1,Beclin-1 and LC3 Ⅱ was up-regulated in group Hemin+CLP,and oxygenation index and autophagosome count were significantly decreased,W/D ratio and pathological scores were increased,and the expression of HO-1,Beclin-1 and LC3 Ⅱ was downregulated in group SnPP+CLP (P＜0.05).Conclusion Up-regulated expression of HO-1 mediates autophagy,which is involved in the endogenous protective mechanism underlying acute lung injury in septic mice.

Predictive effect of neonatal morbidities on the poor outcomes at 12 months corrected age in very low birth weight premature infants / 中华儿科杂志

Objective@#To investigate the prognostic effect of neonatal morbidities on poor outcomes at 12 months corrected age in very low birth weight (VLBW) premature infants .@*Method@#From November 2013 to October 2014, a multi-center retrospective study was conducted in 8 tertiary Maternal and Children′s hospitals in Guangdong, Hunan and Fujian. The premature infants survived to a postmenstrual age (PMA) of 36 weeks with birth weight less than 1 500 g and without congenital diseases were included, and divided into two groups according to poor outcomes. The birth weight, gestational age, morbidities and poor outcomes (death, cerebral palsy, cognitive delay, et al) were recorded. Data were analyzed with Chi-square test to investigate the relationship between morbidities and poor outcomes. And the predictive effect of the top three morbidities were analyzed by Logistic regression analysis.@*Result@#Total of 834 VLBW premature infants (473 boys and 361 girls) finished the follow-up, whose average gestational age and birth weight were (30.6±1.8) weeks and (1 189±159)g. The incidences of BPD, severe ROP, NEC, brain injury and sepsis were 207 (24.8%), 119 (14.3%), 58 (7.0%), 281 (33.7%) and 124 (14.9%), respectively. There were significant differences between the two groups in the incidences of BPD, severe ROP, NEC, brain injury and sepsis(χ2=42.10, 47.20, 4.81, 44.28, 18.63, all P<0.01), which had significant correlation with poor outcomes at 12 months corrected age. The three top morbidities were severe ROP, BPD and brain injury(OR=3.82, 2.90, 2.80). Combined morbidities with BPD, severe ROP and brain injury correlated with higher risk of poor outcomes (one morbidity, OR=3.14, β=1.15; two morbidities, OR=7.31, β=1.99; three morbidities, OR=22.41, β=3.11; all P<0.01).@*Conclusion@#BPD, severe ROP, NEC, brain injury and sepsis were the risk factors of poor outcomes at 12 months corrected age in VLBW infants. And the more combined morbidities with severe ROP, BPD and brain injury, the higher risk of poor outcomes in this population. Trial registration Clinical Trails, NCT03104946.

Analysis of the use of narcotic drugs and the first class of psychotropic drugs in inpatient pharmacy of Wuhan Red Cross Hospital from 2011 to 2015 / 中国基层医药

Objective To analyze the use of narcotic drugs and the first class of psychotropic drugs in inpatient pharmacy of Wuhan Red Cross Hospital from 2011 to 2015.Methods Using the defined daily dose (DDD) which recommended by WHO as an index, and the dispensatory and clinical routine dose recommended by Chinese Pharmacopoeia and New Materia Medica as references.Adopting DUI as the statistic index, the drug's variety, quantity, sums and use frequency of the narcotic drugs and the first psychotropic drugs in inpatient pharmacy of our hospital from 2011 to 2015 were analyzed.Results According to the results, there was an increasing trend in sales amount from 2011 to 2015,among them,4 kinds of injections, 2 kinds of oral tablets,1 kind of transdermal patch and 1 kind of the sustained-release tablets.The sales amount of narcotic drugs showed an upward trend year by year.Conclusion In the past 5 years,the use of narcotic drugs and the first class of psychotropic drugs in inpatient pharmacy of the hospital are basically rreasonable, but it still needs to continuously strengthen the knowledge management of narcotic drugs and the related training, so as to ensure safe and effective use of medication in patients.

Effects of Different Beverages Consumption on 21 km Running Performance and Physiological Functions in Female Recreational Marathon Runners / 中国运动医学杂志

Objective To compare the effect of a carbohydrate-electrolyte-protein solution (CEPS,2％ protein plus 4％ carbohydrate),carbohydrate-electrolyte solution (CES,6％ carbohydrate),and non-caloric sweetened placebo (PLA)on 21 km running performance of female recreational marathon runners.Methods In a randomized cross-over design,12 female recreational marathon runners (age:33.4 ± 2.1 years,body mass index:21.10 ± 0.6 kg/m2,and maximal oxygen consumption:48.5 ± 1.9 mL/kg/min)performed a 21 km time trial (TT)run on three occasions separated by at least 28 days.During the first 5 km,participants ran on the treadmill with 70％VO2max.Thereafter,the participants ran at whatever speed they wished for the remaining 16 km of the performance run.In each main trial,participants ingested the CEPS,CES,or PLA at a rate of 150 mL every 2.5 km.The blood samples,gas samples,heart rate,core temperature,and subjective measures were conducted every 5 km throughout the exercise.Results Time of TT run completion was slightly shorter (P ＜ 0.05)in the CES trial (97.8 ±1.6 min)than in the PLA trial (102.4 ± 2.4 min),with no significant differences between the CEPS trial (100.7 ± 2.9 min)and the other two trials (P＞0.05).There were no differences in core temperature,blood lactate,heart rate,CHO oxidation rate,fat oxidation rate,CHO oxidation amount,and fat oxidation amount among the different trials (all P＞0.05).The average blood glucose was higher in CES trial than PLA trial (P＜0.05).The average respiratory exchange rate was higher in CEPS trim than PLA trial (P＜0.05).Conclusion Compared with ingesting the PLA,ingesting the 6％ CES improves the 21 km TT run performance in recreational female runners.However,no additional benefit of CEPS was observed on endurance performance.

Effects of shaped soft silicone foam dressing on prevention of pressure ulcer in spine surgery / 中国实用护理杂志

Objective To investigate the effects of soft silicone foam dressing on the prevention of intraoperative pressure ulcer in patients undergoing spine surgery. Methods A total of 232 patients were divided into control group and experimental group (116 cases each group) by coin slot method. The control group was treated with conventional pressure ulcer prevention and treatment. The experimental group was treated with conventional intervention measures. Soft silicone foam dressing paste use, the end of surgery to observe the two groups of patients under the chin skin condition. Results In the control group, there were 10 cases at stage I in the lower part of the skin, and 5 cases (4 cases of skin blisters and 1 case of partial cortical absence) at stageⅡ. 2 cases in the experimental group were at stage I; no cases were at stageⅡ, the two groups were no stage Ⅲ and above pressure ulcer occurred in the experimental group under the chin pressure ulcer was significantly lower than the control group, The difference was statistically significant (χ2=10.727, P<0.05). Conclusion Conventional pressure ulcer prevention and control interventions combined with shaped soft silicone foam dressing for skin protection of special parts of chin under prone position surgery is beneficial to prevention of intraoperative pressure ulcers.