Effects of screen exposure on morbidity risk in children with autism spectrum disorder and language retardation / 中华行为医学与脑科学杂志

Objective:To explore the effects of screen exposure on morbidity risk in children with autism spectrum disorder (ASD) or language retardation.Methods:In a case-control study, 64 children with autism spectrum disorder were selected as the ASD group, 64 children with language retardation as the language retardation group, and 52 normal children as the control group. Descriptive analysis, t-test, Chi-square test, Logistic regression analysis and other statistical methods of SPSS 17.0 software were used to analyze the data.The differences of screen exposure between the case groups and control group were compared to analyze the effects of screen exposure on the diseases. Results:There were statistically significant differences in daily cumulative screen time ( F=27.758), duration of screen exposure ( F=12.516), first-time exposure to screen(χ 2 = 13.749) and parents' explanation during screen contact(χ 2 = 16.368) among the three group (all P<0.05). The proportion of first-time exposure to screen before 1 year old was 65.62% (42/64) in ASD group, 40.63% (26/64) in language retardation group and 33.33%(17/51) in control group. Compared with the control group ((1.42±1.44)h), the ASD group ((4.04±2.00)h) and the language delay group ((3.53±2.07)h) had longer daily cumulative screen time, and the differences were statistically significant (both P<0.05). Compared with the control group ((6.14±4.59) months), children in the ASD group ((11.97±7.32) months) or the language retardation group ((9.96±5.15) months) had the longer duration of screen exposure, and the differences were statistically significant (both P<0.05). Compared with the control group, parents in ASD group and language retardation group elaborated less while the children were exposed to screen, the differences were statistically significant (both P<0.05). Logistic regression analysis showed that cumulative daily exposure time less than 2 hours ( β=-5.338, OR=0.005, 95% CI=0.001-0.120), democratically parenting style ( β=-3.279, OR=0.038, 95% CI=0.003-0.554), paternal age less than 35 years old ( β=-5.432, OR=0.004, 95% CI=0.001-0.691) were protective factors for autism spectrum disorder, while paternal education level below junior college was a risk factor ( β=3.125, OR=22.755, 95% CI=1.866-277.463). Cumulative exposure time less than 2 hours per day ( β=-3.357, OR=0.035, 95% CI=0.002-0.526) was a protective factor for language retardation, and paternal education less than college degree ( β=2.740, OR=15.482, 95% CI=1.350-177.573) was a risk factor for language retardation. Conclusion:Excessive screen exposure has certain effects on morbidity risk of autism spectrum disorder and language retardation, which should be paid more attention to.

Single-center study on the relationship between the clinical features of functional esophagogastric junction outflow obstruction and esophageal motility / 中华消化杂志

Objective:To analyze the clinical characteristics of functional esophagogastric junction outflow obstruction (EGJOO) and to improve the knowledge of functional EGJOO.Methods:From January 2015 to December 2019, at the Gastrointestinal Motility Center of The First Affiliated Hospital with Nanjing Medical University, 91 patients who underwent high resolution esophageal manometry (HREM) and met the EGJOO criteria of Chicago Classification for esophageal motility disorders, 3rd edition and excluded organic diseases by examination such as gastroscopy or upper gastrointestinal radiography were collected. The clinical manifestations, treatment methods, effect and clinical outcome of patients with functional EGJOO, the HREM parameters of patients with different clinical manifestations as well as symptoms and HREM parameters of patients with different treatments were analyzed. Least significant difference test or Tamhanes T2 test, Mann-Whitney U or Wilcoxon test, chi-square test or Fisher exact test were used for statistical analysis. Results:The most common symptom of 91 functional EGJOO patients was dysphagia (34/91, 37.4%). The lower esophageal sphincter pressure (LESP) and the intrabolus pressure during relaxation of the lower esophageal sphincter (IBP LESR) of patients with dysphagia were both higher than those of patients without dysphagia (30.95 mmHg (26.27 mmHg, 39.37 mmHg) (1 mmHg=0.133 kPa) vs. 27.35 mmHg (24.60 mmHg, 34.87 mmHg); (8.25±4.64) mmHg vs. (5.69±4.65) mmHg), and the differences were statistically significant ( Z=2.076, t=2.539; P=0.038, 0.013). Thirty patients (33.0%) had no special treatment, 52 patients (57.1%) were treated with medication, and nine patients (10.0%) underwent peroral endoscopic myotomy (POEM). The incidence of dysphagia before treatment and maximum intrabolus pressure of patients who underwent POEM were both higher than those of patients without special treatment and medication treatment (8/9 vs 43.3%, 13/30 and 25.0%, 13/52; 21.80 mmHg (15.45 mmHg, 28.95 mmHg) vs. 12.20 mmHg (10.00 mmHg, 18.10 mmHg) and 13.70 mmHg (11.07 mmHg, 17.82 mmHg)), and the differences were statistically significant (Fisher exact test, Fisher exact test; Z=2.814, 2.390; P=0.023, P<0.01, P=0.005, 0.017). The incidences of delayed esophageal emptying or esophageal dilation of patients who underwent POEM, without special treatment and with medication treatment was 6/9, 5/14 and 3/18, respectively, and the differences were statistically significant among three groups (Fisher exact test, P=0.039). Among them, the incidence of delayed esophageal emptying or esophageal dilation of patients received POEM before treatment was higher than that of patients with medication treatment (Fisher exact test, P=0.026). The symptoms of 24.2% (22/91) was spontaneously relieved, and two patients (2.2%) developed type Ⅱ achalasia during follow-up. Conclusions:The main manifestation of patients with functional EGJOO is dysphagia. Patients with significantly increased LESP and IBP LESP are more likely to have dysphagia. Patients with obvious signs of esophageal gastric junction obstruction are more inclined to choose POEM treatment. Some patients with functional EGJOO can relieve themselves, and a few patients can develop achalasia.

Application of extracorporeal membrane oxygenation during bilateral lung transplantation / 中华器官移植杂志

Objective:To explore the effect of extracorporeal membrane oxygenation(ECMO)upon supporting during bilateral lung transplantation(BLTx)for different primary diseases.Methods:The clinical data were retrospectively analyzed for 139 cases of BLTx. They were divided into non-ECMO and ECMO groups. The perieoperative data of two groups were compared.Results:BLTx was successfully performed in all patients. As compared with non-ECMO group, operative duration, mechanical ventilation time and ICU hospitalization time were significantly prolonged in ECMO group ( P<0.05). The proportion of patients with different primary diseases was statistically significant different between two groups( P<0.01). ECMO was employed intraoperatively in all IPAH patients. ECMO proportion was higher in idiopathic pulmonary fibrosis(IPF)patients but lower in chronic obstructive pulmonary disease(COPD)counterparts( P<0.05). In terms of cardiac function indices, patients with a moderate/severe elevation of pulmonary artery pressure had a higher proportion of ECMO application( P<0.001). Moreover, the application of ECMO increased with the severity of tricuspid regurgitation and pulmonary vascular resistance(PVR)( P<0.05). Conclusions:It is both safe and feasible to apply ECMO during BLTx. ECMO support should be given a high priority during BLTx for patients with primary diseases such as IPAH, IPF, severe preoperative PAP, tricuspid regurgitation and PVR. On the other hand, ECMO is sufficient as an alternative choice for COPD patients.

Safety and nosocomial infection control in lung transplantation for a case of COVID-19 with end-stage ARDS / 中华器官移植杂志

Objective:To explore the safety and nosocomial infection control measures of COVID-19 patients of end-stage respiratory failure after lung transplantation.Methods:Lung transplantation was performed for a COVID-19 patient with end-stage respiratory failure after a negative conversion of 2019-nCoV nucleic acid. Before operation, all medical staff received simulated training on nosocomial infection. The procedures were performed in an operation room with a negative pressure environment. The three-grade preventive strategy was implemented and wearing positive pressure protective mask of electric air supply required. During operation, the patient was managed according to the in-hospital protection process. The environment and medical instruments were disinfected after operation.Results:The operation was completed successfully. The 2019-nCoV nucleic acid test was negative for many times after operation. Participants were placed in medical isolation for 14 days after surgery. During the period, nucleic acid test was negative twice.Conclusions:As an exploratory treatment, lung transplantation is a safe option for end-stage respiratory failure in COVID-19 in operation room with a negative pressure environment and implementations of three-grade preventive strategy.

Progress and application of immunodiagnostic methods of giardiasis / 中国血吸虫病防治杂志

@#Giardia lamblia is an important intestinal protozoan which can cause diarrhea in humans. The detection of Giardia infection is performed through the detection methods of pathogen，immunoassay and molecular biology. Currently，the immunodiagnostic methods have good application and development prospect because of high sensitivity and specificity，simple and convenient，and time saving. In this article，we review the main progress and application of immunodiagnostic methods for Giardia infection.

Observation on destroyed architecture of splenic lymphoid follicles in mice infected with Schistosoma japonicum by immunohistochemistry / 中国血吸虫病防治杂志

Objective To observe the destroyed architecture of splenic lymphoid follicles in mice infected with Schistosoma japonicum by immunohistochemistry. Methods The mice infected with S. japonicum(20 cercariae/mouse)for 8 weeks were sacrificed,and the splenic samples were paraffin embedded and sliced. The sections were first stained by hematoxylin and eosin to observe the massive structure of splenic lymphoid follicles,and then B cells,follicular dendritic cells(FDC)and germinal center cells were labeled with anti-B220,anti-CD21 or anti-Ki67 antibodies respectively by immunohistochemistry to observe the distribution of the specific cells of lymphoid follicles. Results The results of HE staining showed that the structure of lym-phoid follicles in spleens of infected mice was blurred,the number and area of follicles were significantly reduced compared to those of the normal mice. The immunohistochemical staining showed that the splenic T/B lymphocyte segregation ,FDC network and germinal centers of the infected mice all disappeared. Conclusion The structure of splenic lymphoid follicles in the mice infected with S. japonicum is obviously damaged.

Follow-up study on neuropsychological behavior development of preterm and low birth weight infants / 中华行为医学与脑科学杂志

Objective To study the neuropsychological behavior development of preterm infants and low birth weight infants,and to provide a reference to the early prevention and intervention on developmental retardations.Methods A total of 101 preterm infants and/or low birth weight infants received the infant development test of 0 ～ 6 year-old children intelligence developmental scale for neurological development and autism behavior checklist(ABC).Results 25 boys and 5 girls suffered from different psychological mental disorders.The occurrences were as follows:10 cases with mental retardation,9 cases with the language development delay,9 cases with motor retardation,1 case with cerebral palsy and 1 case with autism spectrum disorder.The incidence of intelligence problems were that language retardation (18.9％),the fine motor (16.8％),the adapative ability (12.6％),social action (9.5 ％) and the motor delay (3.2％).There were significant differences in the scores of social communication(x2=8.88,P=0.003),adaptive ability(x2=7.41,P=0.007),the fine motor(x2 =6.22,P=0.01) and total developmental quotient(x2 =5.58,P=0.02) between city children'and rural area.The behavioral problems more consisted in self-care ability and language retardation.Conclusion Preterm infants and low birth weight infants are exposed to language,fine motor,adaptive and communication ability problems,especially the children living in country.It is necessary to improve the early education and intervention for the rural preterm infants and low birth weight infants.

Advancement of Th17 cells in bronchopulmonary dysplasia / 国际儿科学杂志

T helper 17 cells(Th17) are a recently discovered CD4+ T cells subsets,a new member of the Th1,Th2 family.Recent studies have found that IL-17 produced by Th17 can induce bronchial epithelial cells,endothelial cells and fibroblasts secreting IL-6,IL-8,ranulocyte colony-stimulating factor and tumor necrosis factor alpha and other cytokines,and promot recruitment of neutrophils in lung.Present studies show that th17plays an important role in the bronchopulmonary dysplasia incidence mechanism,and provides a new research direction in the prevention and treatment.

Application of ECMO in lung transplantation / 中华器官移植杂志

Objective To summarize the experiences of extracorporeal membrane oxygenation (ECMO) technique in human lung transplantation. MethodsECMO was used in 45 patients undergoing lung transplantation.There were 32 cases of dilated pulmonary fibrosis and pulmonary hypertension,4 cases of chronic obstructive pulmonary disease,2 cases of pneumosilicosis,2 cases of phthisis,one case of diffuse panbronchiolitis,2 cases of bronchiectasis and 2 cases of primary pulmonary hypertension. In 3 patients, ECMO conduit was used as a bridge to the lung transplantation for 13,19 and 6 days respectively before operation,and ECMO support was done after the operation.In 40 patients ECMO support was done during operation.In 2 patients without using cardiopulmonary bypass, ECMO support was done after operation because of primary graft dysfunction.Results In 40 patients undergoing ECMO support during operation,the ECMO conduit was removed in 37 patients immediately after the operation.ECMO mean blood flow was (2.8 ± 0.6)L/min,running time was (7.7 ± 0.9) h,and 31 patients survived. In 3 patients undergoing postoperative ECMO support,ECMO was removed in 2 cases at 36th h and 6th day after the operation respectively,and the remaining one died from acute renal failure 2 weeks after the operation though the continuing hemofiltration was applied through ECMO conduit. In 2 patients without using cardiopulmonary bypass and 3 patients using ECMO during operation,ECMO support was used initially or again after operation because of PGD or acute heart failure.Three patients were cured,and 2 patients were died from multiple system organ failure.Conclusion ECMO is an important auxiliary tool in lung transplantation for preoperative,intraoperative and postoperative supports. As the transition bridge to recipients,ECMO can be used for preoperative supports; during operation,it can stabilize the haemodynamics,and postoperation,it can improve severe pulmonary function dysfunction and PGD.

Effect of opioid analgesics on human sperm motility in vitro / 中华麻醉学杂志

ObjectiveTo assess the effects of fentanyl (F),alfentanil (A),sufentaril (S),butorphanol (B),dezocine (D) and pentazocine (P) on human sperm motility in vitro.MethodsTwenty samples of semen with normal sperm motility were collected.The semen was mixed with HTF liquid culture medium and sperm concentration was adjusted to (40-80) × 106/ml.Then semen suspension 50 μl was added into the culture dishes.The semen suspensions were randomly divided into 3 groups:group Ⅰ control-semen suspension 50 μl + 0.9％ NaCl 50 μl.GroupⅡ single opioid-semen suspension 50 μl + 50 μl of 4 concentrations of F,A,S,B,D and P (10-3,10-4,10-5,10-7 mol/L).Group Ⅲ combined opioid-naloxone-semen suspension 50 μl + 25 μl of 3concentrations of naloxone (2 × 10-8,1 × 10-7,2 × 10-7 mol/L) + 25 μl of 4 concentrations of F,A,S,B and D.After being incubated for 1 h the sperm motility was assessed by sperm analyzer and the amplitude of change in sperm motility was calculated.Median inhibition concentration (IC50) and complete inhibition concentration ( IC100 ) of the 6 opioids were calculated from concentration-response curve.Results( 1 ) The shape of concentration-response curve for F,A and S was straight line.The maximal decrease in sperm motility was (56 ± 5)％(F),(58±7)％ (A) and(79±:6)％ (S).(2) The shape of concentration-response curve for B,D and P was sigmoid.Low concentrations of B,D and P did not affect sperm motility.Median and high concentrations of B and D could inhibit sperm motility.The maximal inhibition was 100％.High concentration of P increased sperm motility.The maximal increase was (19 ± 6)％.(3) Naloxone shifted the concentration-response curve for F,A,S,B and D to the right,and decreased the maximal inhibitory effect of F,A and S dose-dependently but did not affect the maximal inhibitory effect of B and D.(4) IC50 was in the order of A≈ F ＞ D ＞ S≈- B.IC100 was D ＞ B.ConclusionF,A and S inhibit sperm motility by acting on opioid receptor on human sperms while B and D act through opioid or nonopioid pathways.P can increase sperm motility.

The relationship between plasma homocysteine levels and diabetic peripheral neuropathy / 中华内科杂志

Objective To explore the relationship between plasma homocysteine levels and diabetic peripheral neuropathy (DPNP). Methods A crossectional analysis was conducted on 227 patients with type 2 diabetes. Peripheral neuropathy was confirmed using electromyography (EMG). The risk factors possibly associated with diabetic neuropathy or plasma homocysteine levels were analyzed in relation to likelihood of occurrence of DPNP. Results Eighty patients with neuropathy and 147 patients without neuropathy were included. Plasma homocysteine levels were significantly higher in patients with diabetic neuropathy [( 12. 6 ± 3.6 ) μmol/ L] than without diabetic neuropathy [( 8. 2 ± 0. 9 ) μmol/L] ( P ＜0. 001 ), and the relationship remained significant after adjusting for duration of diabetes, glycosylated hemoglobin A1c (HbA1c), age, renal status, serum folate acid and vitamin B12, and metformin [OR 1.15( 1.02-1.28 ) ,P ＜ 0. 05]. In addition, per increase of 4. 0 μmol/L plasma homocysteine was closely related to the occurrence of neuropathy after controlling for per unit increase of other confounding factors [OR 1.17(0. 94-1.33), P ＜ 0. 05]. Conclusions Hyperhomocysteinemia was an independent risk factor for the occourence of diabetic peripheral neuropathy.

Effects of small tidal volume combined with PEEP on extravascular lung water during one-lung ventilation in patients undergoing thoracic surgery / 中华麻醉学杂志

Objective To investigate the effects of small tidal volume combined with PEEP on extravascular lung water during one-lung ventilation (OLV) in patients undergoing thoracic surgery. Methods Forty ASA Ⅰ or Ⅱ patients of both sexes aged 45-80 yr undergoing esophagectomy for esophageal cancer were randomly assigned into 2 groups (n = 20 each):group Ⅰ IPPV (VT 9 ml/kg ,RR 12 bpm) and group Ⅱ IPPV +PEEP (VT 6 ml/kg, RR 15 bpm, PEEP 5 cm H-2O). FiO2 was 100% and I:E 1:2 in both groups. Anesthesia was induced with fentanyl 3-5 μg/kg, propofol 1.0-1.5 mg/kg and vecuronium 0.10-0.15 mg/kg and maintained with continuous infusion of propofol 4-7 mg· kg- 1 · h - 1 and vecuronium 0.07-0.08 mg- kg- 1 · h - 1 and intermittent iv boluses of fentanyl. Double lumen endobronchial tube was inserted. Correct position was confirmed by bronchoscopy. Right internal jugular vein was cannulated. A 4F thermodilution catheter was inserted into right femoral artery and connected to PICCO monitor. Extravascular lung water (EVLW), EVLW index (EVLWI),pulmonary vascular permeability index (PVPI), cardiac output (CO) and oxygenation index (OI) were recorded before anesthesia (T0, baseline), at 30 min of two lung ventilation (T1), 30 min and 1 h of OLV (T2, T3),before extubation (T4) and 18 h after operation (T5). Airway peak pressure (Ppeak) was recorded at T1-4. Results EVLWI and PVPI were significantly higher in group IPPV + PEEP than in group IPPV. There was no significant difference in Ppeak, CO and OI at any time point between the 2 groups. In group IPPV there was no significant change in EVLW and EVLWI during and after mechanical ventilation, while PVPI was significantly increased at T1 as compared with the baseline before anesthesia. In group IPPV + PEEP EVLW was significantly increased at T2 and PVPI was significantly increased at T1 and T2 compared with the baseline at T0. Conclusion OLV with IPPV + PEEP results in more EVLW and it exerts no significant effect on lung function.

Predicting value of plasma homocysteine concentrations for diabetic retinopathy / 中国医师进修杂志

Objective To explore the relationship between plasma homocysteine levels and diabetic retinopathy (DR).MethodIn 40 DR patients and 63 non-DR patients,the indexes including plasma homocysteine concentrations,duration of diabetes,ages,blood pressure,preprandial blood glucose(PBG),plasma GHbA,e,plasma lipids,serum folie acid and semm vitamin B12 were analyzed.ResultsPlasma homocysteine level was significantly higher in DR patients (12.9μmol/L) than that in non-DR patients (7.8μ.mol/L) (P＜0.01),and the relationship remained significant correlation after adjusted for duration of diabetes,GHbA1c,ages,serum folic acid and serum vitamin B12(OR = 1.23,P＜0.05).ConclusionHyperhomocysteinimia is a risk factor and an independent predieator of DR.

Effect of Zhengtian Pills on Hemodynamics and TCD of Patients with Blood-stasis Pattern of Migraine / 中成药

Objective: To investigate the clinical effect of Zhengtian Pills on blood-stasis pattern of migraine with hemodynamics and TCD as markers. Methods: 30 patients with blood-stasis pattern of migraine were given drug Zhengtian Pills for a month. The hemodynamic marker, integrating value of nail fold microcirculation and TCD before and after treatment were compared. Results: There were significant differences in hemodynamic marker, integrating value of nail fold microcirculation and TCD between before and after treatment (P

Effect of Pregnancy on the Immune Response against Trichinella spiralis Infection in Mice / 中国寄生虫学与寄生虫病杂志

0.05).Serum absorbance value of progesterone injected virgin mice(0.299) was significantly higher than that of no-injectedvirgin mice(0.191)(t=2.955,P0.05).Conclusion Pregnancy has a synergetic effect on immune response of mice against T.spiralis infection,which may be related with the increased level of serum anti-Trichinella antibody and enhanced ability of sera in mediating the death of pre-encapsulated larvae in ADCC.