Meta-analysis of the clinical efficacy of compound α-ketoacid tablets combined with low-protein diet in diabetic kidney disease / 中华临床营养杂志

Objective:To systematically evaluate the clinical efficacy of compound α-ketoacid tablets in the treatment of diabetic kidney disease (DKD).Methods:CNKI, Wanfang database, EMBASE, PubMed and Cochrane Library database were searched for eligible records published from the establishment of individual database to November 13 th, 2022. The quality of the included studies were assessed, data were extracted, and meta-analysis was conducted using RevMan5.3. Results:A total of 26 randomized controlled trials were included, with a total of 2 790 DKD patients (1 465 in the experimental group and 1 325 in the control group). Multiple parameters were significantly improved in the experimental group compared with the control group, including 24-hour urinary protein, blood creatinine, urea nitrogen, nutritional index, oxidative stress level, fasting blood glucose, glycated hemoglobin, homocysteine, HGF, VEGF, TGF-β1, and systolic blood pressure.Conclusions:Limited low-quality evidence showed that compound α-ketoacid tablets combined with low-protein diet may be related to the improved 24-hour urinary protein, renal function, and glucose metabolism in patients with DKD. Due to the lack of randomized controlled trials designed for respective stages of DKD, the inclusion criteria of our study were relatively general, possibly leading to the lack of pertinence of the results. Some indicators showed apparent heterogeneity among different groups, and more high-quality multi-center studies with large sample sizes are still needed to verify our findings.

The prenatal ultrasonic study of cerebral sulci and gyrus development in fetuses with conotruncal defects at the second and third trimester / 中华超声影像学杂志

Objective To evaluate the development of cerebral sulci and gyrus in fetuses with conotruncal defect(CTD) at the second and third trimester by ultrasound,and to improve clinician′s understanding of the cerebral cortical development in fetuses with CTD.Methods The study was conducted at Shenzhen Maternity and Child Healthcare Hospital Affiliated to Southern Medicial University from December 2015 to January 2017,enrolled 180 women with single fetus,among whom 60 fetuses with CTD and gestational age between 20 weeks to 33+6 weeks were diagnosed by echocardiographic examination.CTD included persistent truncus arteriosous,tetralogy of fallot,transpofition of the great arteries and double outlet of right ventricle.Evaluation indexes of cerebral sulci and gyrus included depth and angle of parietooccipital sulcus,width and depth of sylvian fissure,uncovered width of insular,uncovered insular ratio,depth of calcarine sulcus,head circumference;evaluation indexes of hemodynamics included umbilical artery resistance index,umbilical artery pulsation index,middle cerebral artery resistance index,middle cerebral artery pulsation index,the cerebral-to-placental resistance ratio and the cerebroplacental pulsation ratio.Above indexes were measured for statistical analysis.Results At the whole gestational age in the study,depth of parietooccipital sulcus and width of sylvian fissure in CTD fetuses were smaller than those in the control group,uncovered insular ratio was larger than that in the normal group(P<0.05);middle cerebral artery resistance index,middle cerebral artery pulsation index and the cerebroplacental pulsation ratio in CTD fetuses were lower than those of the control group (P<0.05).Conclusions The change of hemodynamics in fetuses with CTD may be one of the reasons that fetuses with CTD have cerebral cortical hypoevolutism.

Determination of fatty acids in blood, placenta and umbilical cord blood in normal pregnant women / 临床儿科杂志

Objectives To explore the nutritional status of fatty acids in the newborn and their mother, and the role of the placenta in fetal nutrition. Methods The composition of fatty acids in blood, placenta, and neonatal umbilical cord blood were determined and analyzed by gas chromatography in 20 normal pregnant women. Results In 20 pregnant women in the study, average age was 27.0±4.5 years, the average gestational age of their newborns was 38.0±3.0 weeks, the average birth weight of newborns was 3320±127 g. There were 18 types of fatty acids in maternal blood, umbilical cord and placenta, including saturated fatty acids, monounsaturated fatty acids, and polyunsaturated fatty acids. The total fatty acid content in maternal blood (3.51±0.57 g/L) was 5 times higher than that in umbilical cord blood (0.74±0.18 g/L), and there was statistically difference (P<0.05). The content of linoleic acid (LA) in maternal blood was higher than that in umbilical cord blood and placenta; the content of arachidonic acid (AA) and docosahexenoic acid (DHA) in placenta was significantly higher than that in maternal blood and umbilical cord blood; and the content of eicosapentaenoic acid (EPA) in umbilical cord blood was higher than that in maternal blood and placenta. All differences were significant (P<0.05). Conclusions Mothers preferentially transport long chain polyunsaturated fatty acids (AA and DHA) through the placenta to meet the needs of fetal and neonatal growth and development.

Prenatal ultrasonic research of fetal optic chiasma / 中华超声影像学杂志

Objective To research fetal optic nerve,optic chiasma and optic tract size using high resolution prenatal ultrasound,establish a scan method and the reference range of optic nerve,optic chiasma and optic tract in normal fetus.Methods Based on the section of circulus arteriosus cerebri,the probe were rotated to get the chiasma section for measuring the diameter of bilateral optic nerve,optic tract and area of optic chiasma in 453 normal fetus respectively.Used gestation age and corresponding biological parameters as independent variables,the regression equation was established analyse the gender differences.Results 26-33 weeks was the preferable gestational age to visualize the chiasma section.It had good repeatability except chiasma area.The bilateral optic nerve and optic tract diameter,optic chiasma diameter and area had an increased along with the gestational age reposefully.There was no significant difference between the two sides of optic nerve and the gender.Conclusions Prenatal ultrasound can assess the size and shape of fetal optic nerve,optic chiasma and optic tract.The normal reference range,established by ultrasound,is helpful to diagnose the abnormality of optic chiasma.

Fatty acid composition of human breast milk in Shanghai and Chongqing of China / 临床儿科杂志

Objective Since there are significant variation of the dietary structure recent years in China,it is necessary to re-investigate the fatty acid composition of human breast milk for the presentation of the latest data of fatty acid composition in China. Methods Using a gas chromatography GC-2010,the composition of fatty acids was detected in the human colostrums and the mature breast milk(consecutively from postnatal day 1 to day 7 and from postnatal day 42)obtained from 62 healthy postpartum women in Shanghai and Chongqing,two big cities of China,from Jan to July,2008. Results The level of total fatty acid(TFA)tended to increase significantly from the colostrums to the mature breast milk. No significant difference in the level of TFA was found between two cities. The significantly higher monounsaturates(MUFA)level(44.06% vs. 33.85%,P ＜ 0.01)and lower linoleic acid(LA,C18 : 2n-6)level(18.43% vs. 27.62%,P ＜ 0.01)of the mature breast milk were observed in Chongqing women compared with those in Shanghai women. The docosahexenoic acid(DHA)level of the mature breast milk in Shanghai women was significantly higher than that in Chongqing women(0.41% vs. 0.29%,P ＜ 0.01). There was no significant difference in the level of arachidonic acid(AA,C20 : 4n-6)between two cities. Conclusions The fatty acid composition in human breast milk tends to vary with the extension of the lactation. There is significant difference in the fatty acid compositions in human breast milk between Shanghai and Chongqing owing to different dietary habits in the different regions of China.

The trends of changes in children's blood lead levels since the introduction of lead free gasoline in Shanghai / 中华流行病学杂志

<p><b>OBJECTIVE</b>To describe trends of changes in blood lead levels in children aged 1 - 6 years during the time period before and after introducing lead free gasoline in Shanghai 1997 and 1999.</p><p><b>METHODS</b>Blood lead levels of 1 969 children aged 1 - 6 years were determined by a sampling survey in five districts of Shanghai in August and September, 1997. Blood lead levels of the same population were re-determined by the same method from April to June in 1998 and from August to September in 1999. Filter paper blood lead test was carried out monthly using the filter paper blood lead proficiency testing program of Centers for Disease Control in the United States. The results from blood lead samples were under acceptable ranges during the study.</p><p><b>RESULTS</b>The geometric means of blood lead levels were 83 microgram/L in 1997, 80 microgram/L in 1998 and 76 microgram/L in 1999, respectively. The prevalence rates of childhood lead poisoning (blood lead level was equal or more than 100 microgram/L) were 37.8% in 1997, 25.7% in 1998 and 24.8% in 1999. The amounts of decrease on average blood lead levels in the five districts between 1997 and 1999 were 10 microgram/L, 11 microgram/L, 6 microgram/L, 4 microgram/L and 2 microgram/L, respectively.</p><p><b>CONCLUSION</b>Lead poisoning is a preventable disease. The average levels of lead in young children in Shanghai decreased significantly after the introduction of lead free gasoline to Shanghai. Lead emissions from vehicles running on leaded gasoline was one of the important contributors to increase the children's blood lead levels in Shanghai. Lead poisoning is not evenly distributed among children in Shanghai, resulting in the different levels of decline.</p>

Comparison of the quantitative ultrasound bone measurements between Shanghai and Caucasian infants at birth / 中华围产医学杂志

Objective To compare the bone status between Shanghai and Caucasian infants at birth by quantitative ultrasound (QUS) and evaluate its clinical application. Methods An ultrasound bone sonometer, Omnisense (Sunlight Medical Ltd, Israel), was used to measure the bone speed of sound (SOS) of tibia in 157 Shanghai infants, and then compared with those of Caucasian. Results No significant difference of SOS was found between male [n=88, (2968?115) m/s] and female infants [n = 69, (2956?105) m/s](P=0. 524). The SOS of premature infants [(2935?96) m/s] was lower than that of full-term infants [2984?116) m/s] (P = 0. 005). Comparing with Caucasian infants, the tibial SOS was lower in Shanghai infants. The differences of SOS, which were defined as Z-Score, in Shanghai infants were more remarkable in female infants (-0. 81?0.92 Z-Score) than that of male (-0. 55?0. 97 Z-Score), and in full-term infants ( -0. 80?1. 03 Z-Score)than in premature infants (-0. 50?0. 83 Z-Score) , and in infants with normal birth weight than in infants with lower birth weight. Conclusions QUS is suitable for evaluating bone status in infants. Shanghai infants have lower bone strength than Caucasian's and the difference becomes more significant in the last trimester.