Predictive validation of existing bleeding and thromboembolic scores in elderly patients with comorbid atrial fibrillation and acute coronary syndrome / 老年心脏病学杂志（英文版）

BACKGROUND@#The validation of various risk scores in elderly patients with comorbid atrial fibrillation (AF) and acute coronary syndrome (ACS) has not been reported. The present study compared the predictive performance of existing risk scores in these patients.@*METHODS@#A total of 1252 elderly patients with AF and ACS comorbidities (≥ 65 years old) were consecutively enrolled from January 2015 to December 2019. All patients were followed up for one year. The predictive performance of risk scores in predicting bleeding and thromboembolic events was calculated and compared.@*RESULTS@#During the 1-year follow-up, 183 (14.6%) patients had thromboembolic events, 198 (15.8%) patients had BARC class ≥ 2 bleeding events, and 61 (4.9%) patients had BARC class ≥ 3 bleeding events. For the BARC class ≥ 3 bleeding events, discrimination of the existing risk scores was low to moderate, PRECISE-DAPT (C-statistic: 0.638, 95% CI: 0.611-0.665), ATRIA (C-statistic: 0.615, 95% CI: 0.587-0.642), PARIS-MB (C-statistic: 0.612, 95% CI: 0.584-0.639), HAS-BLED (C-statistic: 0.597, 95% CI: 0.569-0.624) and CRUSADE (C-statistic: 0.595, 95% CI: 0.567-0.622). However, the calibration was good. PRECISE-DAPT showed a higher integrated discrimination improvement (IDI) than PARIS-MB, HAS-BLED, ATRIA, and CRUSADE (P < 0.05) and the best decision curve analysis (DCA). For thromboembolic events, the discrimination of GRACE (C-statistic: 0.636, 95% CI: 0.608-0.662) was higher than CHA2DS2-VASc (C-statistic: 0.612, 95% CI: 0.584-0.639), OPT-CAD (C-statistic: 0.602, 95% CI: 0.574-0.629) and PARIS-CTE (C-statistic: 0.595, 95% CI: 0.567-0.622). The calibration was good. Compared to OPT-CAD and PARIS-CTE, the IDI of the GRACE score slightly improved (P < 0.05). However, NRI analysis showed no significant difference. DCA showed that the clinical practicability of thromboembolic risk scores was similar.@*CONCLUSIONS@#The discrimination and calibration of existing risk scores in predicting 1-year thromboembolic and bleeding events were unsatisfactory in elderly patients with comorbid AF and ACS. PRECISE-DAPT showed higher IDI and DCA than other risk scores in predicting BARC class ≥ 3 bleeding events. The GRACE score showed a slight advantage in predicting thrombotic events.

Analysis of the association of CYP450 gene polymorphisms with ischemic stroke / 中华医学遗传学杂志

OBJECTIVE@#To assess the association of cytochrome P450 (CYP450) gene polymorphisms with the occurrence of ischemic stroke (IS).@*METHODS@#From January 2020 to August 2022, 390 IS patients treated at the Zhengzhou Seventh People's Hospital were enrolled as the study group, and 410 healthy individuals undergoing physical examination during the same period were enrolled as the control group. Clinical data of all subjects were collected, which included age, sex, body mass index (BMI), smoking history and results of laboratory tests. Chi-square test and independent sample t test were used for comparing the clinical data. Multivariate logistic regression analysis was used to analyze the non-hereditary independent risk factors for IS. Fasting blood samples of the subjects were collected, and the genotypes of rs4244285, rs4986893, rs12248560 of the CYP2C19 gene and rs776746 of the CYP3A5 gene were determined by Sanger sequencing. The frequency of each genotype was calculated by using SNPStats online software. The association between the genotype and IS under the dominant, recessive and additive models was analyzed.@*RESULTS@#The levels of total cholesterol (TC), triglyceride (TG), low density lipoprotein (LDL-C), apolipoprotein B (Apo-B) and homocysteine (Hcy) of the case group were significantly higher than those of the control group, whilst the levels of high density lipoprotein (HDL-C) and Apo-A1 (APO-A1) were significantly lower (P < 0.05). Multivariate Logistic regression analysis showed that TC (95%CI = 1.13-1.92, P = 0.02), LD-C (95%CI = 1.03-2.25, P = 0.03), Apo-A1 (95%CI = 1.05-2.08, P = 0.04), Apo-B (95%CI = 1.7-4.22, P < 0.01) and Hcy (95%CI = 1.12-1.83, P = 0.04) were non-genetic independent risk factors for the occurrence of IS. Analysis of the association between the genetic polymorphisms and the risk of IS showed that the AA genotype at rs4244285 of the CYP2C19 gene, the AG genotype and A allele at rs4986893 of the CYP2C19 gene, and the GG genotype and G allele at rs776746 of the CYP3A5 gene were significantly associated with IS. Under the recessive/additive model, dominant model and dominant/additive model, polymorphisms of the rs4244285, rs4986893 and rs776746 loci were also significantly associated with the IS.@*CONCLUSION@#TC, LDL-C, Apo-A1, Apo-B and Hcy can all affect the occurrence of IS, and CYP2C19 and CYP3A5 gene polymorphisms are closely associated with the IS. Above finding has confirmed that the CYP450 gene polymorphisms can increase the risk of IS, which may provide a reference for the clinical diagnosis.

Corrigendum to “Monitoring unbound warfarin in drug combination therapy by pharmacokinetics and fluorospectrometry” Chinese Herbal Medicines 11 (2019) 92–97 (Chinese Herbal Medicines (2019) 11(1) (92–97), (S167463841830145X), (10.1016/j.chmed.2018.10.002)) / 中草药·英文版

When this paper was first published the following ethical statement was omitted in error: Animal experiments were conducted in accordance with the guidelines of Laboratory Animal Ethics Committee of Tianjin University of Traditional Chinese Medicine (TCM-LAEC2019071). The authors would like to apologise for any inconvenience caused. DOI of original article: https://doi.org/10.1016/j.chmed.2018.10.002

Serum antibody levels in COVID-19 patients six months after hospital discharge / 上海预防医学

ObjectiveTo investigate the level of serum antibodies in COVID-19 patients six months after discharge， and to provide data to evaluate the duration of IgM， IgG and neutralizing antibody titers in the patients. MethodsEnzyme-linked immunosorbent assay （ELISA） was used to determine the antibody levels of IgM and IgG， and the new coronavirus live virus neutralization test was used to detect the neutralizing antibodies in the plasma of 181 recovered patients. ResultsThe IgG positive rate was 92.27% （167/181） in COVID-19 patients six months after discharge， while the lgM positive rate was 28.18% （51/181）. Six months after hospital discharge， 117 recovered patients （64.64%） were positive for IgG antibodies and negative for IgM antibodies， indicating that they had produced stable antibodies. This result suggested that they had been infected with the new coronavirus （SARS-CoV-2） and were in the recovery stage. The positive detection rate of neutralizing antibodies was as high as 91.71%. ConclusionSix months after infection with SARS-CoV-2， IgG antibodies produced in the patients continue to exist， and the neutralizing antibodies maintain a high and stable level. Results of this study have important guiding significance for future research on the durability of new coronavirus antibodies.

Serum antibody levels in COVID-19 patients six months after hospital discharge / 上海预防医学

ObjectiveTo investigate the level of serum antibodies in COVID-19 patients six months after discharge， and to provide data to evaluate the duration of IgM， IgG and neutralizing antibody titers in the patients. MethodsEnzyme-linked immunosorbent assay （ELISA） was used to determine the antibody levels of IgM and IgG， and the new coronavirus live virus neutralization test was used to detect the neutralizing antibodies in the plasma of 181 recovered patients. ResultsThe IgG positive rate was 92.27% （167/181） in COVID-19 patients six months after discharge， while the lgM positive rate was 28.18% （51/181）. Six months after hospital discharge， 117 recovered patients （64.64%） were positive for IgG antibodies and negative for IgM antibodies， indicating that they had produced stable antibodies. This result suggested that they had been infected with the new coronavirus （SARS-CoV-2） and were in the recovery stage. The positive detection rate of neutralizing antibodies was as high as 91.71%. ConclusionSix months after infection with SARS-CoV-2， IgG antibodies produced in the patients continue to exist， and the neutralizing antibodies maintain a high and stable level. Results of this study have important guiding significance for future research on the durability of new coronavirus antibodies.

Effect of "flash" training on improving insulin recognition ability of nurses in non-endocrinology department / 中华医学教育探索杂志

Objective:To explore the effect of "flash" traingingand traditional training on improving the insulin theoretical knowledge and identification ability of nurses in non-endocrinology department.Methods:We selected 443 nurses from the non-endocrine ward of our hospital by stratified sampling, and divided them into the experimental group (227 cases) and the control group (216 cases). Before the training, questionnaires on insulin knowledge were conducted. The experimental group was trained in the form of "flash", and the control group was trained with traditional training. After the training, the theoretical and operational results of the two groups were compared to analyze the error rate of common problems and training satisfaction. Chi-square test and t test were carried out by SPSS 22.0. Results:The scores of questionnaire about insulin identification knowledge and operation in the experimental group were significantly higher than those in the control group, ( P<0.01). The experimental group have significantly better control in insulin classification and insulin onset time than the control group ( P<0.01). The satisfaction of nurse was significantly higher in the experimental group than in the control group ( P<0.01). Conclusion:Non-endocrinology nurses are lack of theoretical knowledge and recognition ability of insulin. The "flash" training can improve their training satisfaction, and ensure the effectiveness and safety of insulin treatment.

Active substance fractions and effects of Shugan Hewei Tang on hippocampal meurotransmitters in rat model of chronic stress-induced depression / 中国中药杂志

To study the antidepressant effect of Shugan Hewei Tang on chronic stress depression model rats, and select the effective substance fractions. Several male SD rats were randomly divided into 17 groups: blank control group, model group, positive control group(fluoxetine), Shugan Hewei Tang high and low dose groups, 6 high and low dose groups of different substance fractions. After modeling for 3 weeks and administration for 1 week, the effective substance fractions were selected according to the body mass and behavioral performance of SD rats in each group; several neurotransmitters in hippocampus of rats were determined by LC-MS/MS method, including norepinephrine(NE), serotonin(5-HT), 5-indoleacetic acid(5-HIAA), r-aminobutyric acid(GABA), and glutamic acid(Glu). Behavioral results after modeling showed that as compared with the blank group, the body mass growth of the model group was significantly reduced(P<0.01); the sugar water consumption was reduced(P<0.01); the distance between the open field and the number of crossing the central area were also significantly reduced(P<0.01, P<0.01); the resting time was increased significantly(P<0.01); and the forced swimming time was significantly prolonged(P<0.01), indicating that the depression model was effective. After intragastric administration, as compared with the model group, the above detection indicators of volatile oils, total polysaccharides and terpenoid in Fluoxetine, Shugan Hewei Tang groups were all changed(P<0.05 or P<0.01). The levels of NE, 5-HT and GABA in the hippocampus of the model group were significantly lower than those in the blank group(P<0.01), and the levels of 5-HIAA and Glu were significantly increased(P<0.01). As compared with the model group, neurotransmitters of the treatment groups were changed obviously or significantly(P<0.05 or P<0.01). Shugan Hewei Tang showed obvious anti-depressant effects, and the volatile oils, total polysaccharides and terpenoids acted as the main active substances. The mechanism of anti-depression may be related to its regulation of various neurotransmitter levels in the hippocampus.

Analysis of fat-soluble components of nuts oil from Prunus mira in Derong County by GC-MS / 中成药

AIM To analyze fat-soluble components of nuts oil from Prunus mira Koehne in Derong County.METHODS The nuts oil from P.mira was extracted by hot pressing method and then was isolated and identified by GC-MS,together with relative content determination of various compounds.The results were analyzed by cluster analysis and principal component analysis.RESULTS Twenty compounds were isolated from nuts oil in Duosong Village,with higher contents of β-sitosterol,trans-squalene,oleic acid hydroxypropyl ester,and one endemic compound (4-methyl nonane).Twenty-two compounds were isolated from nuts oil in Ridui Village,with higher contents of β-sitosterol,oleic acid,γ-tocopherol,and one endemic compound (cyclohexane,1,2,4-trimethyl-).Twenty-four compounds were isolated from nuts oil in Ronggong Village,with higher contents of oleic acid,β-sitosterol and trans-squalene.Twenty-two compounds were isolated from nuts oil in Zhangren Village,with higher contents of β-sitosterol,oleic acid,γ-tocopherol,and two endemic compounds (trans-2,4-decadienal and octacosanal).Ten batches of samples were divided into six types.The cumulative contribution rate of the first principal component was 81.86％ in Duosong Village.CONCLUSION Thirty-five compounds in nuts oil from P.mira in Derong County mainly contain oleic acid,β-sitosterol,trans-squalene,γ-tocopherol and vitamin E,with four endemic compounds.

Effects of Gui Zhi Fu Ling Jiao Nang on Hemorheology and Expression of Phenotypic Proteins in Uterine Smooth Muscle Cells in Rats with An Intrauterine Device / 中国医学科学院学报

Objective To observe the effect of Gui Zhi Fu Ling Jiao Nang (GZFLJN) on the expressions of alpha smooth muscle actin (α-SMA) and proliferating cell nuclear antigen (PCNA) in uterine vascular smooth muscle cells (VSMC) of rat models with an intrauterine device (IUD) and to determine the thromboxane B2 (TXB2) and 6-keto-prostaglandin F1α (6-keto-PGF1α) levels in peripheral blood. Methods Female Wistar rats were randomly divided into four groups:normal group (n=16,with normal breed without treatment),model group (n=18,drenching 0.9% normal saline after modeling of IUD),GZFLJN group (n=18),and aminocaproic acid tablets group (n=17). Immunohistochemical SP method was used to detect the expressions of α-SMA and PCNA in uterine VSMC.ELISA was served to detect the levels of TXB2 and 6-keto-PGF1α in peripheral blood. Results The positive rate of α-SMA were (50.89±9.41)%,(26.93±6.80)%,(48.92±6.80)%,and (34.63±7.26)%,respectively,in normal group,model group,GZFLJN group,and aminocaproic acid tablets group;obviously,it was significantly higher in normal group (t=14.43,P=0.00) and GZFLJN group (t=11.37,P=0.00) than that in model group and it was significantly lower in aminocaproic acid tablets group than in normal group (t=9.96,P=0.00) and GZFLJN group (t=8.23,P=0.00). The positive rate of PCNA were (25.66±7.24)%,(61.26±9.98)%,(28.36±9.17)%,and (50.23±8.71)%,respectively,in these four groups;obviously,it was significantly lower in the normal group (t=20.86,P=0.00) and GZFLJN group (t=19.12,P=0.00) than in model group and it was significantly higher in aminocaproic acid tablets group than in normal group (t=17.82,P=0.00) and GZFLJN group (t=16.05,P=0.00). Serum TXB2 level in these four groups were (445.86±24.43),(508.78±12.42),(448.11±9.63),and (498.11±13.63)ng/L;obviously,it was significantly higher in model group than in normal group (t=16.55,P=0.00) and aminocaproic acid tablets group (t=-4.12,P=0.00) and it was significantly lower in GZFLJN group than in model group (t=-15.23,P=0.00) and aminocaproic acid tablets group (t=-12.08,P=0.00). Serum 6-keto-PGF1α level in these four groups were (23.17±1.93),(18.09±0.93),(22.70±1.61),and (20.70±1.41)ng/L,respectively;obviously,it was significantly lower in model group than in normal group (t=-13.98,P=0.00) and aminocaproic acid tablets group (t=5.26,P=0.00) and it was significantly higher in GZFLJN group than in model group (t=11.43,P=0.00) and aminocaproic acid tablets group (t=8.76,P=0.00). Conclusion GZFLJN can regulate the expressions of α-SMA and PCNA of VSMC in the endometrium of IUD rats and the concentrations of TXB2 and 6-keto-PGF1α in the serum.

Role of DNA methyltransferase 3A in hematological malignancies / 上海交通大学学报（医学版）

DNA methyltransferase 3A (DNMT3A) is one of the critical epigenetic modifiers responsible for de novo DNA methylation. DNMT3A mutations are identified in some kinds of hematological malignancies, especially in acute myeloid leukemia (AML) with high frequency, indicating poor prognosis. Recent researches have shown that abnormalities of epigenetic related genes such as DNMT3A play important roles in the development and progression of hematological malignancies, which was named as class Ⅲ mutation associated with the pathogenesis of AML. In this review, the progresses of clinical and basic researches about DNMT3A mutation in hematological malignancies were summarized.

Promoting effect of intermedin and adrenomedullin on cerebral microcirculation in rat models of cerebral ischemia / 中国比较医学杂志

Objective To explore the effect of intermedin ( IMD ) and adrenomedullin ( ADM ) on cerebral microcirculation in rats with cerebral ischemia. Methods Rat cerebral ischemia ( CI) model was established by middle cerebral artery occlusion. 40 SPF male adult Sprague-Dawley ( SD) rats were randomly divided into three groups:CI+NS ( normal saline) group, CI+ADM group and CI+IMD group, which were used to observe the changes of brain surface microcirculatory perfusion with a laser Doppler flowmeter. Results The differences of brain surface microcirculatory perfusion were statistically significant among the CI+NS group, CI+ADM group and CI+IMD group ( F=53. 426, P<0. 05 ) . Multiple comparison showed that the brain surface microcirculatory perfusion in the CI+IMD group was higher than that of the CI+NS group and CI+ADM group. Conclusions Intermedin can improve the cerebral microcirculation in rats with cerebral ischemia, and its therapeutic effect is better than adrenomedullin.

Role of DNA methyltransferase 3A in hematological malignancies / 上海交通大学学报（医学版）

DNA methyltransferase 3A (DNMT3A) is one of the critical epigenetic modifiers responsible for de novo DNA methylation. DNMT3A mutations are identified in some kinds of hematological malignancies, especially in acute myeloid leukemia (AML) with high frequency, indicating poor prognosis. Recent researches have shown that abnormalities of epigenetic related genes such as DNMT3A play important roles in the development and progression of hematological malignancies, which was named as class Ⅲ mutation associated with the pathogenesis of AML. In this review, the progresses of clinical and basic researches about DNMT3A mutation in hematological malignancies were summarized.

Construction of the training mode of emergency medical personnel in traditional Chinese Medicine Colleges / 中华医学教育探索杂志

Establishing emergency medicine training mode of integrated traditional Chinese and Western medicine in traditional Chinese Medicine College is of great significance.Through the construction of clinical skills teaching materials,the construction of training base and standard operating procedures (SOP) management,first aid training and related drama contests,and improving teachers' comprehensive quality,we set up emergency medicine training mode of traditional Chinese medicine and Western medicine,which helps students make comprehensive use of first aid knowledge and practical skills of traditional Chinese medicine and Western medicine for syndrome differentiation.

Research advances in pharmacological effects of Ophiacordyceps sinensis in treatment of liver diseases / 临床肝胆病杂志

Ophiacordyceps sinensis has been used as a traditional natural drug for at least 600 years. It has various pharmacological activities and has been widely used in clinical practice. This article summarizes the research on the pharmacological effects of Ophiacordyceps sinensis in liver diseases and points out that Ophiacordyceps sinensis has definite therapeutic effects in liver diseases including liver injury of various causes, liver fibrosis, and liver tumors. The bioactive components of Ophiacordyceps sinensis, such as cordyceps polysaccharides, cordycepin, cordycepic acid, and ergosterol, may play vital roles in the pharmacological activities of Ophiacordyceps sinensis.

Application of nursing intervention in prevention of urinary retention after total knee arthroplasty / 中国实用护理杂志

Objective To investigate the effect of preoperative nursing intervention in the prevention of postoperative retention of urine of patients after total knee arthroplasty. Methods 128patients underwent total knee arthroplasty were divided into the intervention group and the control group (64 cases in each group) by random number table.The patients in the control group received routine nursing care and the patients in the intervention group accepted preoperative nursing intervention 3 to 5 days before surgery. The incidence of post-operation urinary retention, catheterization, satisfaction degree and compliance of the patients were compared between the two groups. Results The incidence rate of post-operation urinary retention and catheterization of the patients was respectively 15.6%(10/64) and 7.8%(5/64) in the intervention group,lower than 34.4%(22/64) and 23.4%(15/64) in the control group. The difference was statistically significant (χ2=6.00, 5.93, respectively, P<0.05). The satisfaction degree and compliance of patients were respectively 95.3%(61/64) and 75.0%(48/64) in the intervention group, higher than 85.2%(52/64) and 31.3%(20/64) in the control group,the difference was statistically significant (χ2=6.12, 24.60,respectively, P < 0.05). Conclusions Preoperative nursing intervention have good effect in the prevention of postoperative retention of urine and improving satisfaction degree of patients underwent total knee arthroplasty.

Progress and prospects on pharmacological research of cordycepin / 中国生化药物杂志

Objective Cordycepin exhibits varieties of pharmacological effects including anti-pathogen, anti-inflammatory, immune-modulatory, and anti-cancer activities.Recent studies indicate cordycepin may also have significant therapeutic potential in many diseases, such as metabolic disorders, oxidative injury and central nervous system diseases through different mechanisms , which are gradually clarified.The current progress and future prospects are reviewed in this paper.

Establishment of standard operation procedure of the teaching base for emergency medicine simulation / 中国医学装备

Objective:To study the significance of standard operating procedures of construction emergency medical simulation teaching-based. Methods:Emergency medical simulation teaching base on the construction of standard operating procedures mode. Results:SOP model was used in emergency medicine in practice teaching and management, it improved the connotation of practical teaching system construction;and was helpful to improve the practice teaching content construction. Evaluation is beneficial to improve the practice teaching system. Evaluation is beneficial to improve the practice teaching system. To strengthen the emergency medical simulation base radiation ability, promote the standardization of practice teaching and management level, this itself is a kind of innovation, but still need to constantly improve and improve. Conclusion:Explore with Chinese characteristics of Chinese and western medicine combined with emergency medicine education mode, cultivate high-quality talents in the field of traditional Chinese and western medicine emergency.

Analysis of operation feasibility in ventricular septal defects and congestive heart failure newborns / 中华实用儿科临床杂志

Objective To evaluate the feasibility and safety on closing ventricular septal defects (VSDs) under cardiopulmonary bypass(CPB) in neonatal patients with VSD and congestive heart failure.Methods From Oct.2010 to Sep.2012,16 newborn infants with VSD and congestive heart failure in Neonatal Intensive Care Unit(NICU),the Bayi Children's Hospital Affiliated to Beijing Military General Hospital,were selected as the observed group,VSD repair operation was done under CPB.As the control group,18 patients in Pediatrical Cardiac Surgical Department were randomly selected in the same period in hospital,and selective VSD repair operations were done under CPB.Between the 2 groups,demographics(body weight,gender,VSD diameter),clinical characteristics (CPB time,aortic crossclamp time) and early outcomes were compared.Results For the diameter of VSD and gender,there were no significant difference between the 2 groups (P ＞ 0.05).For the body weight,the patients in control group [(8.27 ± 3.39) kg] were more heavier than those in observed group [(3.69 ± 0.72) kg] (P ＜ 0.01).In the operation period,there were no significant differences in CPB time and aortic crossclamp time between 2 groups(all P ＞ 0.05).The lactate value of the patients in observed group [(2.76 ± 1.12) mmol/L] was significantly higher than that in control group [(1.65 ±0.34) mmol/L] (P ＜ 0.01).At the same time,the ventilation time [(3.69 ± 1.66) days] and PICU stay [(9.75 ± 3.44) days] were significantly longer than those in control group[(2.00 ±0.89) days and (6.17 ± 1.98) days] (all P ＜ 0.01).All the patients in the 2 groups discharge out of the hospital,there was no significant difference in outcome.Conclusions The newborns with VSD and congestive heart failure in NICU,can be not improved after the medical management,then closing the VSD is feasible and safe under CPB.

Comprehensive management strategy for critical newborns with transposition of great arteries / 中华实用儿科临床杂志

Objective To summarize the clinical experience of comprehensive management of critical newborns with transposition of great arteries (TGA) by neonatologists and cardiac surgeons.Methods Seventeen critical newborns with TGA rescued by combined efforts of neonatologists and pediatric cardiac surgeons from Oct.2010 to Oct.2012were retrospectively analyzed.Results Of the 17 newborns(14 cases were male,3 cases were female),9 cases were TGA with ventricular septal defect(TGA/VSD),8 cases TGA with intact ventricular septal defect (TGA/IVS).The babies aged from 1-45 days,weighed from 2.7-4.6 kg at operation.Of the 9 cases TGA/VSD babies,3 cases were treated with prostaglandins E (PGE) for hypoxemia correction and selective operation opportunity ;2 cases underwent emergency arterial switch operation (ASO) for severe cardiac shock.All of the 8 cases TGA/IVS babies received PGE treatment preoperatively for life threatening hypoxemia,and 4 cases of them underwent emergency ASO.There were 12 cases delayed sternal closure and 5 cases of them were emergency babies.Peritoneal dialysis was employed for 6 cases and extracorporeal membrane oxygenation (ECMO) for l case.There were 6 cases with postoperative incision infection,including 5 emergencies.Thirteen newborns survived and 4 cases died at hospital:one case complicated with postoperative septicemia and severe mediastinitis which leaded to pericardium patch rupture and fatal pulmonary arterial hemorrhage;one case with abnormal inferior vena cava connection and severe low cardiac output syndrome;one case with disseminated intravascular coagulation (DIC) due to septicemia and severe mediastinitis postoperatively,one case with abnormal coronary artery during surgery and difficult coronary artery transplantation and insufficient blood supply after aorta was open.Conclusions Correcting hypoxemia and stabilizing the severe babies are critical in NICU to avoid emergency surgery.Emergent ASO is the optimized medical therapy for those with persistent severe hypoxemia and heart failure.

Study on BALB/c mice with EV71 infection by diverse inoculation routes / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To study the characteristics of EV71 JN200804 strain infection in one-day old BALBI c mjce and to establish a animal model of EV71 infection , and to provide information and technical support for the evaluation of the EV71 vaccine and antiviral medicine.</p><p><b>METHODS</b>One-day old BALBic mice were infected with EV71 JN200804 strain through oral( PO) ,intracranial(IC) ,intraperitoneal (IP), intramuscular (IM) routes, respectively. All mice were sacrificed at paralysis of hind limbs and collected organs for viral isolation, RT -PCR and pathological examination, and the electrophysiology were detected before sacrifice.</p><p><b>RESULTS</b>All mice infected through IC, IP and IM routes were paralyzed in hind limbs at 4-5 days and died at 7 days about, the hypokinesia and lethargy of mice were observed through PO routes. The viruses could be isolated and detected in the muscle from mice infected through IC, IP and IM routes and in the spinal cord through IC routes by viral isolation and RT-PCR. The neurogenic and myogenic disorders were detected by electromyography. Histopathologically, the varied pathologic changes were observed in the mouse cerebellum , spinal cord , muscle , heart, lung, liver and kidney.</p><p><b>CONCLUSION</b>EV71 JN200804 strain can infect one-day old BALBI c mice and induce paralysis of hind limbs, its animal infection model may apply to study of EV71 infection pathogenesis and antiviral medicine, and evaluation of the EV71 vaccine.</p>