Incidence and related factors of umbilical venous catheter tip migration / 中华围产医学杂志

Objective:To analyze the incidence and the related factors of umbilical vein catheter (UVC) tip migration within 7 d after umbilical vein catheterization.Methods:This prospective study involved neonates who were successfully indwelled with UVCs in the Department of Neonatology of Gansu Provincial Women and Child-care Hospital from June 2020 to December 2021. The position of the UVC tip, length of umbilical stump, body weight, and abdominal circumference were recorded after the UVCs were inserted successfully, and the changes in these four data at 2, 24, 48, 72 h, and 7 d after catheterization were analyzed and compared. All the subjects were divided into the non-migrate group, inward migration group, and outward migration group. Chi-square test, Mann-Whitney U test, or Kruskal Wallis H test were used for statistical analysis. Results:A total of 157 newborns were enrolled, with 51 cases in the inward migration group, 62 cases in the outward migration group, and 44 cases in the non-migrate group. There were no significant differences among the three groups regarding gestational age, birth weight, gender, born through cesarean section, age at the time of catheterization, use of sedation, and feeding modes (all P>0.05). The migration rates of UVCs tip at 2, 24, 48, 72 h, and 7 d after catheterization were 0, 27.4% (43/157), 27.2% (31/114), 25.3% (21/83), and 29.0% (18/62), respectively. The cumulative migration rates at 24, 48, 72 h, and 7 d were 27.4% (43/157), 47.1% (74/157), 60.1% (95/157), and 72.0% (113/157), respectively. Compared with the non-migrate group, the inward migration group had a shorter umbilical cord stump at 24 and 48 h [0.5 cm (0.4-0.5 cm) vs 0.6 cm (0.5-0.8 cm); 0.4 cm (0.3-0.5 cm) vs 0.5 cm (0.5-0.6 cm), Z=－5.55 and －3.69, both P<0.05], less abdominal circumference increment at 48 and 72 h [0.6 cm (0.5-1.0 cm) vs 0.9 cm (0.7-1.2 cm); 0.6 cm (0.3-0.9 cm) vs 0.9 cm (0.7- 1.3 cm), Z=－2.03 and －2.09, both P<0.05)], and more weight loss percentage [－4.7% (－6.0%-－3.6%) vs －3.1% (－3.7%-－2.2%); －6.0% (－7.5%-－5.0%) vs －3.9% (－5.1%-－2.4%), Z=－3.75 and －2.96, both P<0.05]. The abdominal circumference increased more in the outward migration group at 24, 48, 72 h, and 7 d than those in the non-migrate group [1.6 cm (0.9-1.9 cm) vs 0.7 cm (0.5-0.9 cm); 1.5 cm (1.2-1.8 cm) vs 0.9 cm (0.7-1.2 cm); 1.7 cm (1.3-1.9 cm) vs 0.9 cm (0.7-1.3 cm); 1.6 cm (1.1-1.9 cm) vs 0.9 cm (0.6-1.3 cm), Z=－4.82, －4.79, －3.74, and －3.09, all P<0.05]. Conclusion:The incidence of UVC tip migration is high, which could be affected by dryness and retraction of the umbilical cord stump and the change in neonatal abdominal circumference and body weight.

Application of TSPV 4-step teaching in skill training of gynecologic laparoscopic surgery / 中华医学教育探索杂志

Objective:To explore the application and teaching effect of TSPV (short for theoretical teaching, simulated surgical skills training, practical surgery training, and video-based review) 4-step teaching in skill training of gynecologic laparoscopic surgery.Methods:A total of 30 trainees who participated in gynecologic laparoscopic surgery training were randomly divided into two groups, with 15 in each group. The experimental group received TSPV 4-step teaching, while the control group adopted traditional teaching and completed training and assessment in stages. The general data, training assessment results, teaching feedback and satisfaction survey of the two groups were compared and analyzed. SPSS 20.0 was used for t-test and Chi-square test. Results:There was no statistical difference in age, gender distribution, education background, clinical working experiences and other general data between the two groups. There was no significant difference in the theoretical examination scores between the two groups [(85.3±4.6) vs. (83.4±4.3), P=0.252]. The scores of simulated operation assessment [(91.7±5.2) vs. [(72.4±5.9), P<0.001] and clinical practice assessment [(88.5±4.8) vs. (82.7±6.7), P=0.011] in the experimental group were better that those in the control group. In addition, the experimental group had a better overall evaluation of teaching satisfaction. Conclusion:TSPV 4-step teaching is a more optimized and popular gynecologic laparoscopic training mode, which is recommended to further promote the validation in teaching.

Risk factors of hydrocephalus secondary to severe intraventricular hemorrhage in preterm infants / 中国新生儿科杂志

Objective:To study the risk factors of secondary hydrocephalus after severe intraventricular hemorrhage (IVH) in preterm infants for prevention and early identification of post-hemorrhagic hydrocephalus (PHH).Methods:From June 2013 to June 2021, preterm infants with severe IVH admitted to our hospital were retrospectively analyzed. They were assigned into PHH group and non-PHH group. Rank sum test or chi-square test was used for comparison between the two groups and multivariate logistic regression analysis was used to analyze the risk factors of PHH in preterm infants.Results:A total of 246 preterm infants with severe IVH were enrolled, including 68 cases (27.6%) in the PHH group and 178 cases (72.4%) in the non-PHH group. Multivariate logistic stepwise regression analysis showed that male gender ( OR=2.014, 95% CI 1.063-3.817), gestational age ≤30 week ( OR=2.240, 95% CI 1.210-4.146), 5-min Apgar score ≤5 ( OR=3.980, 95% CI 1.483-10.685), placental abruption ( OR=2.940, 95% CI 1.324-6.531) were independent risk factors for PHH in preterm infants and thrombocytopenia was the protective factor for PHH in preterm infants ( OR=0.305, 95% CI 0.147-0.632). The incidence of moderate thrombocytopenia in non-PHH group was significantly higher than PHH group ( P<0.05). No significant differences existed in the incidences of mild and severe thrombocytopenia between the two groups ( P>0.05). Conclusions:Male gender, gestational age ≤30 week, 5-min Apgar score ≤5, placental abruption are risk factors for PHH in premature infants with severe IVH and moderate thrombocytopenia has protective effects.

Risk factors for retinopathy of prematurity in very low birth weight infants / 中国新生儿科杂志

Objective:To study the risk factors for retinopathy of prematurity (ROP) in very low birth weight infants (VLBWIs).Methods:From October 2020 to December 2021, VLBWIs with gestational age(GA) ≤32 weeks admitted to the neonatal department of our hospital were retrospectively studied. According to the occurrence of ROP, they were assigned into ROP group and non-ROP group. The clinical data of the two groups were compared and the risk factors of ROP in VLBWI were analyzed.Results:A total of 251 VLBWIs were enrolled, including 60 cases (23.9%) in ROP group and 191 (76.1%) in non-ROP group. The GA and birth weight (BW) of ROP group were significantly lower than non-ROP group [28(26,30) w vs. 29(28,31) w, 1 035(840,1 285) g vs. 1 260(1 110,1 380) g, respectively, all P<0.001]. The ROP group had longer duration of oxygen therapy [42.0(26.0, 53.5) d vs. 24.0(18.0, 34.0) d], higher incidences of blood transfusion [2.5(1.0, 3.0) times vs. 2.0 (1.0, 2.0) times] and hyperglycemia (80.0% vs. 16.8%), higher average [(5.6±0.5) mmol/L vs. (5.1±0.5) mmol/L] and peak [10.4(7.8,13.2) mmol/L vs. 6.5(6.1,6.8) mmol/L] blood glucose levels in the first week than the non-ROP group (all P<0.001). Multivariate analysis showed that longer duration of oxygen therapy ( OR=1.047, 95% CI 1.008-1.087, P=0.018) and higher peak blood glucose level in the first week ( OR=1.268, 95% CI 1.092-1.474, P=0.002) were the independent risk factors for ROP. Conclusions:Longer duration of oxygen therapy and higher peak of blood glucose level in the first week are risk factors for ROP in VLBWIs.

Effect of umbilical vein catheterization on portal vein blood flow and its relationship with gastrointestinal complications in neonates / 中华围产医学杂志

Objective:To explore the effect of umbilical vein catheterization (UVC) on portal vein blood flow velocity (PBFVe) and its relationship with gastrointestinal (GI) complications in neonates.Methods:A prospective study was conducted on neonates with indications for UVC and achieving one-time successful catheterization at Gansu Provincial Women and Child-care Hospital from March 2019 to March 2021. Successful UVC was defined as the umbilical catheter reaching the entrance of the inferior vena cava and right atrium through the ductus venosus. PBFVe was measured by bedside ultrasound before and after UVC. All subjects were divided into two groups as those with GI complications anytime from insertion to withdrawal (complication group), and those with no GI complications (no complication group) to compare the PBFVe value before UVC and the percentage of decrease in PBFVe after UVC. Multivariate logistic regression analysis and receiver operating characteristic (ROC) curve were used to analyze the risk factors of GI complications and the predictive value of the percentage of decrease in PBFVe after UVC.Results:Of 91 subjects included, 59.3% (54/91) had no GI complications, and 40.7% (37/91) had. After UVC, PBFVe was decreased than before in neonates both with and without GI complications [(11.3±1.8) vs (14.7±2.4) cm/s; (12.4±1.7) vs (14.2±1.8) cm/s, t=－16.92 and－17.62, respectively, both P<0.05]. PBFVe before UVC were similar between the two groups. However, the complications group had a lower PBFVe after UVC ( t=－2.98, P=0.004) and a higher percentage of decrease in PBFVe [(22.5±6.0)% vs (12.6±4.9)%, t=8.65, P<0.001] when compared with the no complications group. Multivariate logistic regression analysis showed that the body weight was the protector of GI complications ( OR=0.294, 95% CI:0.089-0.974, P=0.045), and the percentage of decrease in PBFVe was the risk factor ( OR=1.478, 95% CI:1.249-1.749, P<0.001). The area under the curve of the percentage of decrease in PBFVe for predicting GI complications was 0.919 (95% CI:0.843-0.966, P<0.001). The cut-off value was 16.9% with a sensitivity of 89.2% and a specificity of 85.2%. Conclusions:UVC can reduce the PBFVe of neonates. The more the PBFVe decreases, the greater the possibility of GI complications.

Diameter of ductus venous and angle between ductus venous and sagittal part of left portal vein associated with success rate of neonatal umbilical venous catheterization / 中华围产医学杂志

Objective:To explore the effect of the angle between sagittal part of left portal vein and ductus venous(AsLPVDV), and the diameter of ductus venous(DDV) on the success rate of umbilical venous catheterization (UVC) in neonates.Methods:This was a retrospective study including 80 neonates requireing UVC in Gansu Provincial Women and Child-care Hospital from April 2020 to January 2021. According to the results of UVC, they were grouped into the success group(successful insertion of catheter, n=76) and failure group(failed to insert, n=4), or one-time success group (successful after first insertion attempt, n=43) and non-one-time success group(successful after several attempts or failed to insert, n=37). The AsLPVDV and the DDV were measured before UVC by bedside ultrasound. For those with obstruction of catheterization were guided by pressing the abdomen in right side recumbent position under real-time ultrasound monitoring. The success rate of UVC and the differences of AsLPVDV and DDV among different groups were compared. Chi-square test, t test, or U test were adopted for the comparison among groups. Receiver operating characteristic (ROC) curve was used to evaluate the sensitivity and specificity of the AsLPVDV and the DDV in predicting the one-time success of UVC. Results:The total success rate of UVC was 95%(76/80) and the one-time success rate was 53.8%(43/80). A larger AsLPVDV and DDV were observed in the success group compared with the failure group [(142.2±8.3)° vs (133.6±3.2)°, (3.0±0.4) vs(1.8±0.4) mm, t=6.284 and 2.064, both P<0.05] as well as in one-time success group compared with the non-one-time success group [(147.5±6.2)° vs (135.2±4.7)°, (3.1±0.3) vs (2.8±0.6) mm, t=9.956 and 2.939, both P<0.05]. Area under the curve of AsLPVDV and DDV in predicting one-time success of UVC were 0.944(95% CI:0.869-0.983) and 0.811 (95% CI:0.708-0.890), respectively. The cut-off value was 140.4° for AsLPVDV and 2.9 mm for DDV, with the sensitivity of 93.0% and 90.7%, and specificity of 91.9% and 64.9%, respectively. Conclusions:The success rate of UVC is related to AsLPVDV and DDV. AsLPVDV is of high value in predicting the one-time success of UVC.

Effects of deep learning- versus atlas-based automatic contouring methods on the contouring of organs-at-risk in rectal cancer / 中国基层医药

Objective:To investigate the effects of deep learning-based AiContour ??versus atlas-based Raystation ?? automatic contouring methods on the contouring of organs-at-risk on CT images of patients with rectal cancer who undergo radiotherapy, providing evidence for clinical application. Methods:Fifty patients with rectal cancer who received treatment during January to June 2020 in Zhejiang Provincial People's Hospital (Affiliated Hospital of Hangzhou Medical College) were included in this study. The CT images from 20 patients with rectal cancer that had been contoured by experienced radiotherapist were selected as target images and automatically contoured using the data template library of AiContour ?? and Raystation ?? automatic contouring methods. Hausdorff distance, mean distance to agreement, dice similarity coefficient, Jaccard coefficient were used to quantitatively evaluate the accuracy of the volume of contour of organs-at-risk automatically sketched by the two methods. Results:There was no significant difference in Hausdorff distance in left femoral head [(6.81 ± 2.66) vs. (7.24 ± 2.10)], right femoral head [(7.38 ± 3.91) vs. (8.14 ± 3.71)], pelvis [(24.00 ± 9.01) vs. (24.66 ± 9.67)] between AiContour ?? and Raystation ?? automatic contouring methods ( tleft femoral head = -0.831, tright femoral head = -0.821, tpelvis = -0.357, all P > 0.05). Significant differences were observed in mean distance to agreement, dice similarity coefficient and Jaccard coefficient of organs-at-risk (all P < 0.05). The mean values of dice similarity coefficient automatically sketched by AiContour ?? method were > 0.7. The DSC of left kidney, right kidney, rectum and bladder automatically sketched by Raystation ?? method were < 0.7, and the dice similarity coefficient values of other organs-at-risk automatically sketched by Raystation ?? method were > 0.7. In addition, Hausdorff distance, mean distance to agreement and Jaccard coefficient values of organs-at-risk automatically sketched by AiContour ?? method were superior to those automatically sketched by Raystation ??. Conclusion:After slight modification, the organs-at-risk automatically sketched by AiContour ?? and Raystation ?? methods can meet clinical requirement. The contouring effects provided byAiContour ?? method were superior to those provided by Raystation ?? method.

Research Progress on the Pharmacological Effects of Echinacoside / 医药导报

Echinacoside has various pharmacological effects, such as antioxidative, antisenescence, neuroprotection, antiinflammation, promotion of cicatrization, hepatoprotection, promotion of bone formation, and antitumor activity. There are some progress in its pharmacokinetics study. Echinacea has therapeutic effect on diseases in various systems. It has great significance to further research and develop echinacoside.

Infection and inflammatory response in elderly patients with oral and maxillofacial surgery / 中国医师杂志

Objective To investigate the characteristics and influencing factors of infection in elderly patients with oral and maxillofacial surgery,and to explore the effect of infection on inflammatory response-related proteins,in order to guide the clinical treatment.Methods A total of 653 cases of patients aged more than 60 who were treated with oral and maxillofacial surgery during January 2004 to December 2015 in Shenzhen People's hospital was involved and divided into infected group (n =48) and uninfected group (n =605) according to whether postoperative nosocomial infection was occurred.The characteristics and influencing factors of infection were observed.A total of 171 cases of healthy volunteers whose age and sex were matched with patients were collected as control group.The expressions of inflammatory responserelated proteins in 3 groups were compared.Results The main site of postoperative nosocomial infection was lower respiratory tract,with 15 cases of patients,accounting for 31.3％.A total of 48 strains of pathogens was isolated,the main pathogenic bacteria were Streptococcus pyogenes,with 8 strains,accounting for 16.7％.Streptococcus pyogenes had high drug resistance to erythromycin and clindamycin,and had high sensitivity to penicillin G and meropenem.Aged more than 70,operation time more than 3 h,the primary diseases as malignant tumor were the independent risk factors for postoperative nosocomial infection (P ＜0.05).Blood interleukin (IL)-1,IL-2,IL-6,IL-10,tumor necrosis factor α (TNF-α),transforming growth factor β (TGF-β) and interferon-γ (IFN-γ) in infected group were more than uninfected group and control group.The differences were statistically significant (P ＜ 0.05).Conclusions The rate of infection in elderly patients with oral and maxillofacial surgery is still high in our hospital.The main site of infection is lower respiratory tract and the main pathogens were Streptococcus pyogenes.Aged more than 70,operation time more than 3 h,the primary diseases as malignant tumor were the independent risk factors for postoperative nosocomial infection.Infection can lead to peripheral inflammatory factor levels increase significantly.

Searching of journal club and lab meeting jointly applied to academic postgraduate training of obstetrics and gynecology / 中华医学教育探索杂志

Academic medical postgraduate recruitment and training is facing a new dilemma due to the overall implementation of resident standardization training and the combination of postgraduate education in professional master degree of clinical medicine and resident standardization training.We optimize and marry together journal club and lab meeting education methods in academic medical postgraduate training of obstetrics and gynecology on the basis of its teaching characteristics, and develop a new form of academic graduate student training of obstetrics and gynecology.This new method is expected to effectively improve the academic postgraduates' research interests, research capacity and the teaching quality of obstetrics and gynecology for academic postgraduates.

Studies on pharmacokinetics of hydroxysafflor yellow A in Carthamus tinctorius and its compound preparation in rat / 中国中药杂志

<p><b>OBJECTIVE</b>To develop a RP-HPLC method for the determination of the concentration of hydroxysafflor yellow A in rat plasma, to study the pharmacokinetics of Carthamus tinctorius extration and Naodesheng tablet, and to investigate the effect of other components on the pharmacokinetics of hydroxysafflor yellow A.</p><p><b>METHOD</b>The rats were orally treated with Carthamus tinctorius extration and Naodesheng capsule respectively. Blood samples were collected in heparinized eppendorf tube via the oculi chorioideae vein. Plasma was separated by centrifugation at 10 000 r x min(-1) for 10 min, and two-times methanol in volume was added to deposit proteins. After centrifugation, the upper liquid was transferred to filter. The concentration of hydroxysafflor yellow A in serum was determined by RP-HPLC. The stationary phase was C18, and methanol-acetonitrile-0.7% orthophosphoric acid (26: 2:72) was taken as the mobile phase, A UV detector was used at 403 nm. The pharmacokinetic parameters were calculated with 3p97 program.</p><p><b>RESULT</b>A good linear relationship of hydroxysafflor yellow A was obtained in the range of 0.03 and 2.56 mg x L(-1), the lowest limit of determination was 10 microg x L(-1), and the lowest limit of quantitation was 30 microg x L(-1). The mean recoveries were (99.3 +/- 1.4)%, (92.8 +/- 1.8)%, (98.4 +/- 2.0)% for high, middle, low concentrations of the samples respectively. The plasma concentration-time curves of hydroxysafflor yellow A were fitted with two-compartments model. The AUC)0-t), AUC(0-infinity), C(max) and T(max) of hydroxysafflor yellow A were increased in the Naodesheng group, compared with 50 mg x kg(-1) C. tinctorius extract group.</p><p><b>CONCLUSION</b>The HPLC method was selective, accurate and sensitive. The results indicated that the other herbs improved the absorption of hydroxysafflor yellow A and increased the bioavailability of hydroxysafflor yellow A significantly.</p>

Studies on pharmacokinetics of ferulic acid, Rhizoma Chuanxiong and Naodesheng capsule in rat / 中国中药杂志

<p><b>OBJECTIVE</b>To establish a RP-HPLC method to determine the pharmacokinetics of ferulaic acid of ferulaic acid, Rhizoma Chuanxiong extraction and Naodesheng capsule in rat and assess the effect of other components in medical material and in compound on the pharmacokinetics of ferulaic acid.</p><p><b>METHOD</b>The rats were orally treated with referential ferulaic acid, Rhizoma Chuanxiong extraction and Naodesheng capsule repectively. Blood samples were collected by cutting rats tails. Plasma was separated by centrifugation at 10,000 r x min(-1) for 10 min, and two-times methanol in volume was added to deposit proteins. After centrifugation, the upper liquid was transferred to filter. The concentration of ferulaic acid in serum was determined by RP-HPLC. The stationary phase was C18, and methanol-0.5% acetic acid (30:70) was taken as the mobile phase, A UV detector was used at 320 nm. The pharmacokinetic parameters were calculated with 3p97 program.</p><p><b>RESULT</b>A good linear relationship of ferulaic acid was obtained from 0.05-1 mg x L(-1), the lowest limits of determination were 13 microg x L(-1). The plasma concentration-time curves of ferulaic acid were fitted with two-compartment models properly. The pharmacokinetics parameterst AUC(0-t), Cmax, CL of ferulaic acid showed significant differences between referential group and the other groups.</p><p><b>CONCLUSION</b>The method applied for determination of ferulaic acid content in blood was simple, accurate and feasible for the study of ferulaic acid pharmacokinetics in rats. The results indicated that the other ingredients of Rhizoma Chuanxiong had remarkable influence on the pharmacokinetics of ferulaic acid. However, compatibility promotes the ferulic's absorption, enhances the ferulic's biological exploitability.</p>

Autosecretion of the Fresh Leukemic Cells from Patients with Acute Myeloid Leukemia in Vitro and Apoptosis in the Cells / 中国医师杂志

To investigate the effects of granulocyte macrophage colony stimulating factor (GM-CSF) which was secreted from the fresh leukemic cells of patients with acute myeloid leukemia (AML) and recombinant human GM-CSF(rhGM-CSF) on the apoptosis of the primary incubative AML cells,the level of GM-CSF was measured by means of radioimmunoassay,the DNA ladder was detected by using DNA electrophoresis,and the percentage of apoptotic cells,percentage of expression and the mean fluorescence intensity(MFI) of bcl-2 were respectively assayed by means of flow cytomtric analysis.After the fresh leukemic cells from 5 cases were incubated for 24 hours,GM-CSF in 3 of 5 cases were seen,their percentage of apoptotic cells was less than the other 2 cases,and the MFI of bcl-2 in the 3 of 5 cases was obviously enhanced.After the fresh leukemic cells were treated with cytarabine (Ara-C) 5?g/ml in combination with rhGM-CSF 5?g/ml for 24 hours,the percentage of apoptotic cells was more than the cells treated with Ara-C alone and it upward to (56 4?7 4)%(p

Separation,purification and preliminary structure analysis of Ramulus Mori polysaccharide / 中成药

AIM: To study the isolation,purification and characterization of Ramulus Mori polysaccharide. METHODS: Ramulus Mori was extracted by boiling water. The raw extract was precipitated fractionally by alcohol deproteinized,passing through DEAE ion exchange cellulose ( DEAE-52) and SephadexG-100,obtained RMPS1 and RMPS2. The composition and characterization of Ramulus Mori polysaccharide were researched by TLC、IR、 GC、HPLC and smith degradation. RESULTS: The molecular weight of RMPS1 and RMPS2 were 5. 8 ? 105 and 6. 5 ? 105; RMPS1was made up of rhammose、arabinose、glucose and galactose with the molarity rate of 1. 08 ∶ 1 ∶ 1. 40 ∶ 1. 57; RMPS2 of rhammose、glucose and galactose with the molarity rate of 11. 38 ∶ 1 ∶ 1. 35. Smith degradation showed that the main linkage form in RMPS1 and RMPS2 was 1→2 and 1→4 glycosidic linkages,But some 1→3 glycosidic linkages also existed in the molecules; infrared spectrum showed that both had the polysaccharide characteristic absorption peaks. CONCLUSION: The structures of RMPS1 and RMPS2 are first determined from Ramulus Mori.