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Objective:To study the complications and prognosis of extremely premature infants(EPIs) with gestational age (GA) <28 w.Methods:From January 2016 to December 2020, EPIs with GA <28 w admitted to NICU of our hospital were retrospectively studied. Clinical data of the infants and their mothers during pregnancy were reviewed. According to the prognosis, the infants were assigned into the survival group, the death group and the withdrawal group. According to GA, the infants were assigned into <26 w goup, 26~26 +6 w group, ≥27 w group. According to birth weight (BW), the infants were assigned in to ≤750 g group, 750~999 g group and ≥1 000 g group. SPSS 26.0 was used for data analysis. Results:A total of 265 EPIs were included, 122 (46.0%) in the survival group, 47 (17.7%) in the death group and 96 (36.2%) in the withdrawal group. GA and BW of the survival group were significantly higher than the death group and the withdrawal group ( P<0.05). The incidences of tracheal intubation (92.2%) and pulmonary hemorrhage (42.2%) in the death group were the highest among the three groups. The survival group had the highest application of prenatal glucocorticoids (80.3%) and pulmonary surfactants (99.2%) ( P<0.05). In the survival group, the top 3 common complications were bronchopulmonary dysplasia (BPD) (68.0%), pulmonary infections (65.6%) and neonatal sepsis (34.4%). The survival rate increased with GA and BW. Conclusions:The survival rate of EPIs is closely correlated with GA and BW. EPIs with pulmonary hemorrhage and tracheal intubation have poor prognosis. Prenatal glucocorticoids and pulmonary surfactant may improve clinical outcome. BPD and pulmonary infections are common complications of surviving EPIs.
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Objective:To investigate the efficacy and safety of lenalidomide combined with bortezomib and dexamethasone (RVD) in patients with newly diagnosed multiple myeloma (NDMM).Methods:A total of 100 consecutive NDMM patients treated with RVD from August 2016 to September 2020 at Peking University People′s Hospital were retrospectively analyzed, including response, drug toxicity, follow-up and survival, and subgroup analysis.Results:The median follow-up time was 19.5 (2.0-57.0) months. For patients undergoing autologous stem cell transplantation (ASCT) after RVD regimen, the objective response rate (ORR)/complete response+stringent complete response (CR+sCR)/≥very good partial response (VGPR) rates were 100%, 73.3% (33/45), 95.6% (43/45) respectively. For 54 patients not receiving transplantation, the ORR/CR+sCR/≥VGPR rates were 79.6% (43/54), 18.5% (10/54), 51.9% (28/54) respectively. As to the survival analysis, 2-year progression free survival (PFS) rates were 84.5% and 70.9% in transplant and non-transplant patients respectively ( P=0.102). Two-year overall survival (OS) rates were 100% and 80.8% in transplant and non-transplant patients respectively ( P=0.003). The common hematologic adverse events (AEs) were thrombocytopenia (33%) and neutropenia (25%). Abnormal liver function (43%) and peripheral neuropathy (24%) were recognized more as non-hematologic AEs. Conclusion:RVD as front-line regimen has high efficient response rate and acceptable safety in Chinese NDMM patients.
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【Objective】 To explore the effects of intraoperative autologous blood(ABT) transfusion on thrombelastography(TEG) in patients underwent neurosurgical procedures. 【Methods】 96 patients (49 males and 47 females) aged 15~79 years who received neurosurgical procedures in our hospital from November 2018 to November 2020 were retrospectively analyzed and divided into autologous blood transfusion group(Group A, n=52)and allogeneic blood transfusion group(Group B, n=44)according to different blood transfusion strategy in operation. The red blood transfusion status, hemoglobin (Hb), hematocrit (Hct), platelet (Plt), fibrinogen(Fib), prothrombin time (PT), activated partial thromboplastin time(APTT), and TEG parameters [activated clotting time(ACT), coagulation time (K), angle rate of clot formation(Angle), maximum amplitude(MA)] before and 1 day after surgery were compared between the two groups. 【Results】 The amount of average blood transfusion didn′t differ significantly by groups (P>0.05). The incidence of extra allogeneic blood transfusion was 17.3%(9/52) in group A, and the amount of average allogeneic blood transfusion in group A was significantly lower than that in group B(333.3±81.7 vs 639.8±258.2, P<0.05). Before operation, the differences in Hb, Hct, Plt, Fib, PT, APTT, ACT, K, MA and Angle levels between the 2 groups were not statistically significant (P>0.05). One day after operation, the Hb(g/L) (109.4±15.8 vs 97.0±15.1), Hct (%) (32.0±4.3 vs 28.3±6.1), Plt(×109/L)(154.2±54.2 vs 120.7±41.6), Fib(g/L)(2.2±0.5 vs 1.6±0.6), MA(mm)(65.0±7.2 vs 60.7±8.7) and Angle levels(deg)(69.1±5.2 vs 62.6±9.8) in group A were significantly higher than those in group B(P<0.05), and the PT(s)(11.9±1.5 vs 12.8±0.9), APTT(s)(27.4±3.3 vs 30.4±5.4), ACT(s)(111.0±14.9 vs 119.1±12.3) and K levels(min)(87.2±25.7 vs 106.4±28.0) in group A were significantly lower than those in group B (P<0.05). 【Conclusion】 Intraoperative ABT in patients underwent neurosurgical procedures can reduce allogeneic blood transfusion, has less effect on coagulation function and TEG, and is safe and effective.
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Homocysteine(Hcy) is an intermediate product of methionine metabolism.It is considered that Hcy is an independent etiological factor of cardiovascular disease,and blood Hcy level is closely related to many diseases.Patients with kidney disease may have different levels of homocysteine.The study has found that Hcy may not only be related to kidney damage,but also make the risk of cardiovascular disease in patients with kidney disease increased.The relationship between Hcy and kidney disease is briefly introduced in this article in order to provide a new basis for prevention,diagnosis and treatment of kidney disease and complications.
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Objective To investigate the clinical features,diagnosis,treatment and prognosis of Dementia with Lewy Body (DLB) in order to improve doctors' understanding and experience.Methods Thirteen cases of clinicall diagnosed DLB were analyzed.The clinical manifestations,neurological examination,laboratory tests,treatment and prognosis were analyzed.Results All of 13 patients had fluctuating dementia.Among them,11 were diagnosed with probable DLB,and 2 were diagnosed with possible DLB.There were 8 cases (8/13) with volatility cognitive impairment,8 cases (8/13) with Parkinson's syndrome,8 casess (8/13) with visual hallucinations,13 cases (13/13) with memory loss,4 patients with limb tremor (4/13),5 cases with delirium (5/13),3 cases with increased sleep (3/ 13),1 case with silence (1/13),9 cases with anxiety and depression (9/13),one case with dizziness (1/13),6 cases with abnormal dysplasia (6/13),and one case with abnormal sensitive to diazepam (1/13).The cognitive function fluctuated,the condition deteriorated and two patients died during the follow-up from 6 months and 5 years.Conclusions Lewy body dementia is an irreversible and progressive neurodegenerative disease.Comprehensive understanding of its clinical features is helpful for the early diagnosis and treatment,which may in turn improve the prognosis.
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Angiotensin converting enzyme (ACE) gene is one of the major candidate genes for genetic susceptibility to kidney disease,but there is still a controversy on the correlation between ACE gene polymorphism and kidney disease.In this paper,the research on the correlation between ACE gene polymorphism and kidney disease in children is reviewed.
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Paramyxovirus Tianjin strain, a new genotype of Sendal virus, was isolated from the lungs of common cotton-eared marmoset that died of severe respiratory infection in the marmoset colonies. The 19.28% IgM positive rate in the young children with acute respiratory tract infection suggested a close relationship between Tianjin strain and humans. Hemagglutinin-neuraminidase (HN) is its major transmembrane glycoprotein responsible for viral attachment, penetration and release. To clear the relationship between HN structure and function of paramyxovirus Tianjin strain, rHN1, rHN2 and rHN3 overlapping the ectodomain of HN protein were expressed. Their antigenicity and hemaglutination activity, as well as cross reactivity to standard antisera against influenza virus type A, type B were analyzed. The results indicated expressed rHNs have the natural antigenicity.The segment rHN2 possesses more linear epitopes exposed on the surface of the native I-IN protein than found in segments rHN3 and rHN1. The hemagglutination activity of segment rHN3 is higher than that of segments rHN2 and rHN1, and partially dependent on the three-dimensional conformation of HN3 protein. Cross-reactivity between rHNs and standard antisera against influenza virus type A, type B suggested that rHNs might not be the best alternative as specific antigens to detect virus in clinicalserum specimens.
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Background and purpose:Nowadays, the golden standard of diagnosis for malignant hydrothorax or ascites is exfoliocytology examination, but the missed diagnosis rate is too high. Other methods including immunologic test, telomerase activation test, conjugation of chromosome analysis with cytological examination test, and RT-PCR test. But none of them was widely used due to high cost or high false positive rate. Immunomagnetic beads (IMB) technique is a popular method all over the world in recent years. It was mainly used in isolating and purifying cells, but it was rarely used to detect cancer cells in patients with hydrothorax or ascites so far. Our aim was to fi nd an effi cient way to detect the cancer cells in patients with cancer related hydrothorax or ascites and to improve the corresponding diagnosis rate. Methods:In the experiments, both the traditional exfoliocytology examination method and IMB technique were used to detect the cancer cells in the hydrothorax or the ascites for comparison. Results:Using IMB technique and exfoliocytology method, the positive rates in 30 patients with cancers were 63.3% (19/30) and 23.3% (7/30), respectively, and the false positive rates in 30 patients without cancers were 3.3% (1/30) and 0.0% (0/30), respectively. It could be observed that the positive rate using IMB technique was much higher than that using exfoliocytology method (P0.05). Conclusions:The present study demonstrated that IMB technique is an accurate, sensitive, fast and economic method in detecting the cancer cells in patients with cancer related hydrothorax or ascites, especially for diagnosis and therapy in the early clinical stage. Due to the high effi ciency, IMB technique could be used after exfoliocytology examination to improve the diagnosis rate..