Metabolomic changes of neonatal sepsis: an exploratory clinical study / 中国当代儿科杂志

OBJECTIVES@#To study the metabolic mechanism of neonatal sepsis at different stages by analyzing the metabolic pathways involving the serum metabolites with significant differences in neonates with sepsis at different time points after admission.@*METHODS@#A total of 20 neonates with sepsis who were hospitalized in the Department of Neonatology, Hunan Provincial People's Hospital, from January 1, 2019 to January 1, 2020 were enrolled as the sepsis group. Venous blood samples were collected on days 1, 4, and 7 after admission. Ten healthy neonates who underwent physical examination during the same period were enrolled as the control group. Ultra-performance liquid chromatography-quadrupole time-of-flight mass spectrometry was used for the metabonomic analysis of serum samples to investigate the change in metabolomics in neonates with sepsis at different time points.@*RESULTS@#On day 1 after admission, the differentially expressed serum metabolites between the sepsis and control groups were mainly involved in the biosynthesis of terpenoid skeleton. For the sepsis group, the differentially expressed serum metabolites between days 1 and 4 after admission were mainly involved in pyruvate metabolism, and those between days 4 and 7 after admission were mainly involved in the metabolism of cysteine and methionine. The differentially expressed serum metabolites between days 1 and 7 after admission were mainly involved in ascorbic acid metabolism.@*CONCLUSIONS@#The metabolic mechanism of serum metabolites varies at different stages in neonates with sepsis and is mainly associated with terpenoid skeleton biosynthesis, pyruvate metabolism, cysteine/methionine metabolism, and ascorbic acid metabolism.

Theoretical Framework and Key Elements of International Rehabilitation Policy: Contents Analysis of WHO Rehabilitation Policy Documents / 中国康复理论与实践

Objectives:To systematically analyze the framework and contents of World Health Organization (WHO) policy and action strategies on rehabilitation using the theory of WHO health service components, to explore the theoretical bases, methodology, framework and core elements of WHO's international rehabilitation policy. Methods:WHO has launched rehabilitation-related policy documents, mainly including Rehabilitation in Health Systems, Rehabilitation in Health Systems: Guide for Action, Rehabilitation Indicator Menu: a tool accompanying the Framework for Rehabilitation Monitoring and Evaluation (FRAME), Template for Rehabilitation Information Collection (TRIC): a tool accompanying the Systematic Assessment of Rehabilitation Situation (STARS), and established systems of international rehabilitation policy architecture system. Using content analysis, this study analyzed in detail the theoretical basis and methodology of international rehabilitation policy, the policy framework, and the core elements of the action strategy and priority areas of rehabilitation service development in perspective of WHO six building blocks of health system, namely leadership and governance, financing, human resources for health, service delivery, medical technology, and health information systems. Results:WHO rehabilitation policy is developed based on WHO's theories of person-centered health services, social determinants of health, and functioning, disability and health of International Classification of Functioning, Disability and Health. WHO rehabilitation policy recognized that the development of rehabilitation was an important pathway achieving United Nations 2030 Sustainable Development Goals 3, ensure healthy lives and promote well-being for all at all ages, i.e. Unlversal Health Coverage. This paper systematically analyzed WHO's international policy framework, action strategies, and development areas, content and priorities in six major areas: leadership and governance, financing, human resources for health, service delivery, medicine and technology, and health information systems. WHO rehabilitation policies advocates to develop national rehabilitation plans, to establish and improve rehabilitation leaderships and the development of mechanism and capacity of rehabilitation governance, to develop multiple approaches of rehabilitation financing, to integrate rehabilitation into health service system, provides different levels of rehabilitation services in the health service continuum, and to build networks of service delivery, to train professionals, to foster rehabilitation information system within health system, to enhance service quality and service coverage, to focus on key areas and priority programs to meet the diverse needs of different populations, and achieve universal health coverage; to include assistive technology into the rehabilitation service system as a field of medicine and technology; and to collect information on functioning and rehabilitation needs, outcomes and impacts of rehabilitation services in the health information system, and conduct evidence-based researches on rehabilitation systems. Conclusion:The framework and contents of WHO's international rehabilitation policies have systematically reviewed at the macro, meso, and micro levels with the perspective of WHO six building blocks of the health system. The goal of rehabilitation development is to achieve universal rehabilitation coverage. The conceptual theories of rehabilitation are based on the theories of people-centered health services and social determinants of health. Rehabilitation is an important initiative to achieve the United Nations 2030 Sustainable Development Goals. The international rehabilitation health policy system is built on six major areas of rehabilitation: leadership and governance, rehabilitation financing, rehabilitation human resources, rehabilitation service delivery, rehabilitation-related medicine and technology, and rehabilitation and health information system. The policy and action strategies for rehabilitation development, as well as specific implementation paths and methods, at macro, meso and micro levels: theory and policy, policy action, and implementation methods and tools have been reviewed and discussed. The implementation of the WHO rehabilitation policies advocates to take the following actions: strengthening the leadership, governance, planning and coordination capacity of rehabilitation services; constructing a reasonable rehabilitation financing mechanism and raising necessary funds for rehabilitation; improving the training and guarantee mechanism of rehabilitation human resources; enhancing the professional capacity of rehabilitation personnel, improving the capacity of rehabilitation service delivery and improving service quality; improving the quality and accessibility of assistive products and assistive technology services; establishing health information system covering functioning, disability and rehabilitation, and conducting scientific researches on rehabilitation.

Research on Rehabilitation Guidelines Using World Health Organization Family International Classifications Framework and Approaches / 中国康复理论与实践

@#Objective To use World Health Organization Family International Classifications (WHO-FICs) to explore the framework and approaches of development and research of guidelines of rehabilitation at levels of policies, community and services.Methods The important documents and tools of rehabilitation at international level, including United Nations Convention on the Rights of Persons with Disabilities, WHO World Report on Disability, Community-based Rehabilitation Guideline, Rehabilitation in Health Service System, and International Classification of Diseases (ICD), International Classification of Functioning, Disability and Health (ICF), and International Classification of Health Intervention (ICHI) of WHO-FICs, had been discussed.Results The framework, classifications, diagnosis and description of diseases and functioning, coding, intervention and functioning evaluation based on ICD-11, ICF and ICHI-β-2 had been established for development and implementation of rehabilitation guidelines and Cochrane rehabilitation.Conclusion The framework and systematic approaches of ontology, classification, terminology, coding, diagnosis and description of diseases and functioning, interventions and evaluations for the development and implementation of rehabilitation guidelines had been developed.

WHO Rehabilitation in Health System: Background, Framework and Approach, Contents and Implementation / 中国康复理论与实践

This paper explored the background, framework and approach, contents and implementation of WHO Rehabilitation in Health System using approaches of ICF and WHO Handbook for Guideline Development. The actions and significances of implementations of seven recommendations and one good practice statements on assistive products had been discussed.

Unmet Needs and Services Development of Rehabilitation for People with Extremely Severe Hearing Disability Using Structural Equation Analysis / 中国康复理论与实践

Objective:To explore the characteristics and the influential factors of unmet needs and services development of rehabilitation for people with extremely severe hearing disability (PSHDs). Methods:A total of 90 052 PSHDs were included. Multiple response was used to analyze the characteristics of unmet needs and services of rehabilitation. The structural equation model of the received service and unmet needs of PSHDs was developed. Results:The reporting rate of unmet needs of rehabilitation for PSHDs, from high to low, were assistive devices (61.5%), nursing care (24.1%), medicine (23.4%), functional training (17.6%) and surgery (2.5%). The reporting rate of received service for PSHDs, from high to low, were assistive devices (58.3%), nursing care (24.4%), medicine (22.4%), functional training (22.0%) and surgery (2.2%). Structural Equation Model showed that the more services received, the more needs for cochlear implantation surgery and speech therapy (P < 0.001); the better family income situation, the more needs for cochlear implantation surgery (P < 0.001); and age factor had significant effects on the unmet needs of cochlear implantation surgery and speech therapy (P < 0.001). Conclusion:PSHDs reported unmet needs and received services mainly included assistive devices, nursing care, medicine and functional rehabilitation training. Those PSHDs who had received services would report more demand of unmet needs, supposed that improving the accessibility and coverage of services should be emphasized in the development of rehabilitation services. According to ICF model, on the basis of the characteristics of the unmet needs of PSHDs, it proposed to take measures to implement precise rehabilitation services to improve the quality of services.

Unmet Needs and Services Development of Rehabilitation for People with Hearing Disability Using Logistic Regression Analysis / 中国康复理论与实践

Objective:To explore the characteristics of unmet needs and services of rehabilitation for people with hearing disability (PHD). Methods:A total of 219 473 PHDs administration data of unmet needs and services of rehabilitation at provincial level were sampled (2019) and analyzed the characteristics of needs and services of rehabilitation with multiple response analysis, and the related factors of needs and services with Logistic regression. Results:There were 47 657 (21.7%) PHDs reported their unmet needs of rehabilitation, from high to low were assistive devices (65.5%), medicine (22.7%), nursing care (19.1%), functional training (16.2%) and surgery (2.2%). There were 34 684 (18.8%) PHDs reported their received services, from high to low were assistive devices (59.8%), medicine (22.5%), functional training (19.7%), nursing care (19.4%) and surgery (1.8%). The logistic regression model showed that age, types of household registration and severities of disabilities related with the reported unmet needs and received services (P < 0.001). Conclusion:PHDs mainly reported unmet needs in the fields of assistive devices, medicine, and rehabilitation training. The reported unmet needs for PHDs had matched the received services structurally. It proposed to use modern science and technology to develop services delivery and to improve accessibility and quality of rehabilitation services.

Unmet Needs and Services of Rehabilitation for People with Visual Disability Using Logistic Regression Analysis / 中国康复理论与实践

Objective:To analyze the characteristics of needs and development of rehabilitation services for people with visual disability (PVD). Methods:A total of 241 865 PVDs administration data of unmet needs and services of rehabilitation at provincial level were sampled and analyzed the characteristics of needs and services of rehabilitation, and the related factors of needs and services. Results:There were 50 882 (21.0%) PVDs reported their needs of rehabilitation, from high to low were assistive devices (56.5%), medicine (29.0%), nursing care (24.6%), functional training (15.5%), and surgery (4.2%). There were 43 492 (18.0%) PVDs reported their received services of rehabilitation, from high to low were assistive devices (55.0%), medicine (21.6 %), nursing care (20.8%), functional training (20.7%) and surgery (2.3%). The logistic regression model showed that severities of disabilities related with the reported unmet needs and received services (P < 0.001). Conclusion:PVDs reported unmet needs mainly in the fields of assistive devices, medicine, and nursing care. There is match structure of unmet needs and received services. It is important to provide accessible information environment. Information and communication technology (ICT) are proposed to assistive technology services for PVDs to enhance their capacity of information acquisition and to promote their participations.

Unmet Needs and Services of Rehabilitation for People with Physical Disabilities Using Logistic Regression Analysis / 中国康复理论与实践

Objective:To explore the characteristics of unmet needs and services of rehabilitation for people with physical disabilities (PWPs). Methods:A total of 1 512 438 PWPs administration data of unmet needs and services of rehabilitation at provincial level were sampled and analyzed the characteristics of needs and services of rehabilitation, and the related factors of needs and services. Results:The reported unmet needs of PWPs from high to low were assistive devices assistive devices (55.9%), nursing care (27.0%), medicine (26.3%), functional training (23.9%) and surgery (2.3%). Received service of rehabilitation. The services of rehabilitation for PWPs arranged as assistive devices (48.2%), nursing caring (26.4%), functional training (24.3%), medicine (19.5%) and surgery (1.4%). The logistic regression model showed that age and severity of disabilities had significant effect on the reported unmet needs of rehabilitation and received services for PWPs (P < 0.001). Conclusion:PWPs reported unmet needs mainly in the fields of assistive devices, nursing care, medicine and rehabilitation training. They received primary services included assistive devices, nursing care and rehabilitation training and therapies. The services development will emphasize the accessibility and coverage. According to ICF model, it proposed to take measures to implement individualized and precise rehabilitation services to improve the quality of services.

Systematic Implementation of World Health Organization Family International Classifications in Rehabilitation: Protocol and Roadmap / 中国康复理论与实践

Objective:To explore systematic implementation of World Health Organization Family International Classifications (WHO-FICs) in the field of rehabilitation: the theoretical and policy framework at macro level, governance and management mechanism at meso level, and implementation modules at micro levels, respectively. Methods:The policy and theoretical framework of rehabilitation development was discussed based on the international rehabilitation policy documents of WHO, mainly as World Report on Disability, Global Action Plan on Disability and Rehabilitation in Health Service System. Protocol and roadmap of systematic implementation of WHO-FICs, including International Classification of Diseases (ICD-11), International Classification of Functioning, Disability and Health (ICF), and International Classification of Health Intervention (ICHIβ-2) was proposed. Results:With the use of WHO-FICs, the theoretical and policy framework of rehabilitation was constructed, and the contents and principles of modern rehabilitation services were clarified at macro-level. Rehabilitation is an important part of health service, there are six building blocks: i.e. leadership and governance, financing, human resources for health, service providing, medical technology and health information system. It proposed to use knowledge management system of WHO-FICs, including the classification, nomenclature, definitions, descriptions, terminology and coding systems, to standardize rehabilitation evaluation and statistics. The management and governance system of rehabilitation should be implemented using WHO-FICs. Rehabilitation services are based on the bio-psycho-social model and implemented the principles of people-centered and functioning-oriented. The systematic implementation of WHO-FICs in rehabilitation abide by the model of "Evaluation (ICHI)－Evaluation, Description, Classification and Coding of Functioning (ICF)－Disease Classification, Diagnosis and Coding (ICD)－Rehabilitation Intervention (ICHI)", and with the standardized process of "Evaluation (Functioning and unmet needs)－Diagnose (Disease and Functioning)－Planning of Rehabilitation－Intervention－Evaluation of Outcome". The mic-modules of implementation of WHO-FICs in rehabilitation had been constructed. There were 28 categories of diseases, 7 categories of functioning and 6 categories of rehabilitation interventions in rehabilitation proposed by International Society of Physical and Rehabilitation Medicine. According to ICD-11 and ICF, it proposed to use WHO Disability Assessment Schedule 2.0 (WHODAS 2.0), Brief Model Disability Survey (MDS-B) and VB40 Generic Functioning Domains (VB40), and the ICF core-sets in evaluation of functioning and rehabilitation outcome. The implementation of WHO-FICs in management of medical records and reporting realized the standardized management of medical record, encoding of diseases, functioning and intervention, reporting of performance, and provided tools for billing, reimbursement and payment management of rehabilitation. It proposed to develop WHO-FICs based clinical data sets and big data to implement functioning-related Diagnosis Related Groups and case-mix statistics. Conclusion:With the systematic implementation of WHO-FICs in rehabilitation, the policy and theoretical framework at macro level had been developed. The mechanism of management and governance at meso level had been explored. The application modules and approaches at micro level had been established. A scientific and effective overall solution had been proposed to enhance the scientific, standardized, refined and informatization level, strengthen the level and governance capacity, and improve the quality, safety and the coverage of rehabilitation services.

A multicenter survey of antibiotic use in very and extremely low birth weight infants in Hunan Province / 中国当代儿科杂志

OBJECTIVE@#To investigate the current status of antibiotic use for very and extremely low birth weight (VLBW/ELBW) infants in neonatal intensive care units (NICUs) of Hunan Province.@*METHODS@#The use of antibiotics was investigated in multiple level 3 NICUs of Hunan Province for VLBW and ELBW infants born between January, 2017 and December, 2017.@*RESULTS@#The clinical data of 1 442 VLBW/ELBW infants were collected from 24 NICUs in 2017. The median antibiotic use duration was 17 days (range: 0-86 days), accounting for 53.0% of the total length of hospital stay. The highest duration of antibiotic use was up to 91.4% of the total length of hospital stay, with the lowest at 14.6%. In 16 out of 24 NICUs, the antibiotic use duration was accounted for more than 50.0% of the hospitalization days. There were 113 cases with positive bacterial culture grown in blood or cerebrospinal fluid, making the positive rate of overall bacterial culture as 7.84%. The positive rate of bacterial culture in different NICUs was significantly different from 0% to 14.9%. The common isolated bacterial pathogens Klebsiella pneumoniae was 29 cases (25.7%); Escherichia coli 12 cases (10.6%); Staphylococcus aureus 3 cases (2.7%). The most commonly used antibiotics were third-generation of cephalosporins, accounting for 41.00% of the total antibiotics, followed by penicillins, accounting for 32.10%, and followed by carbapenems, accounting for 13.15%. The proportion of antibiotic use time was negatively correlated with birth weight Z-score and the change in weight Z-score between birth and hospital discharge (r=-0.095, -0.151 respectively, P<0.01), positively correlated with death/withdrawal of care (r=0.196, P<0.01).@*CONCLUSIONS@#Antibiotics used for VLBW/ELBW infants in NICUs of Hunan Province are obviously prolonged in many NICUs. The proportion of routine use of third-generation of cephalosporins and carbapenems antibiotics is high among the NICUs.

Application of magnetic resonance diffusion tensor imaging in bilirubin-induced neurological dysfunction in neonates / 中国当代儿科杂志

OBJECTIVE@#To study the value of fractional anisotropy (FA) of regions of interest (ROI) on magnetic resonance diffusion tensor imaging (DTI) in bilirubin-induced neurological dysfunction in neonates.@*METHODS@#A total of 91 neonates with hyperbilirubinemia who were hospitalized from January 2017 to January 2018 were enrolled. According to the peak level of total serum bilirubin, they were divided into three groups: mild/moderate increase (n=45), severe increase (n=35), and extremely severe increase (n=11). According to the presence or absence of abnormal neurological manifestations, they were divided into two groups: neurological dysfunction (n=20) and non-neurological dysfunction (n=71). Ten healthy full-term infants were enrolled as the control group. Head DTI was performed for all neonates to measure the FA values of the bilateral globus pallidus, the anterior limb of the internal capsule, the posterior limb of the internal capsule, and the cerebellar dentate nucleus.@*RESULTS@#The extremely severe increase group had significantly lower FA values of the globus pallidus than the control, mild/moderate increase, and severe increase groups (P<0.05). The severe increase group had significantly lower FA values of the globus pallidus than the control group (P<0.05). The extremely severe increase group had significantly lower FA values of the posterior limb of the internal capsule than the control, mild/moderate increase, and severe increase groups (P<0.05). The neurological dysfunction group had significantly lower FA values of the globus pallidus and the posterior limb of the internal capsule than the non-neurological dysfunction group (P<0.05).@*CONCLUSIONS@#Serum bilirubin level combined with the changes in the DTI FA values of the globus pallidus and the posterior limb of the internal capsule can be used to predict the injury of cerebral nuclei and white matter fibers.

Dyspnea and ventilator dependence after birth in a full-term female infant / 中国当代儿科杂志

A female infant, aged 43 days, had shortness of breath, cyanosis, groan, and dyspnea since birth. Physical examination showed cyanosis of lips and three-concave sign, and multiple lung imaging examinations showed diffuse ground-glass opacities in both lungs. The girl was given anti-infective therapy and continuous mechanical ventilation but there were no significant improvements in symptoms. Gene testing confirmed a compound heterozygous mutation, c.1890C>A(p.Tyr630Ter)+c.3208G>A(p.Ala1070Thr), in the ABCA3 gene, with the former from her father and the latter from her mother. Pathological examination of the lungs indicated pulmonary interstitial disease. The girl was diagnosed with infantile diffuse pulmonary interstitial disease caused by mutations in the ABCA3 gene. When full-term neonates experience shortness of breath and dyspnea after birth, pulmonary imaging suggests diffuse ground-glass changes, and conventional treatment is not effective (ventilator-dependent), congenital pulmonary surfactant metabolism defects needs to be considered. Gene testing, which can provide a basis for early intervention, prognostic evaluation, and genetic counseling, should be performed as early as possible.

Suspension Culture and Alkaloid Content of Pinelliae Rhizoma Tuber Under Stimulation of Salicylic Acid / 中国实验方剂学杂志

Objective: To study the suspension culture of tuber and its alkaloid content based on the stimulation of salicylic acid. Method: The tubers of Pinelliae Rhizoma in suspension tube were treated with different concentrations of exogenous salicylic acid to analyze the growth status. The content of alkaloids in tuber was detected by HPLC. Test conditions:chromatographic column for Agilent Eclipse plus C18 column (4.6 mm×250 mm,5 μm),mobile phase of acetonitrile water(4:96),the column temperature was maintained at 35℃,detection wavelength for inosine 250 nm,guanosine 260 nm,volume flow rate 1.0 mL·min-1. Result: The results showed that the exogenous salicylic acid had a certain effect on the growth of suspension tuber of Pinelliae Rhizoma. When the salicylic acid concentration was 150 μmol·L-1,the culture lasted for 25 days and the fresh weight reached the maximum value of 7.483 8 g. It also accumulates a certain amount of alkaloids. The linear range of guanosine was 0.03-0.45 μg (R2=0.999 6). After 10-days cultivatation in the salicylic acid concentration of 50 μmol·L-1,guanosine content of Pinelliae Rhizoma tubers reached a maximum of 1.353 3 mg·g-1. The linear range of inosine 0.003-0.045 μg (R2=0.999 5). When the salicylic acid concentration was 200 μmol·L-1,cultured for 30 days,the content of inosine in Pinelliae Rhizoma tubers reached the maximum value of 0.149 8 mg·g-1. Conclusion: The results of this experiment provide a reference for the study of tissue culture and rapid propagation of Pinelliae Rhizoma tubers and regulation of alkaloids,which are of great significance for the development of Pinelliae Rhizoma industry.

Principle of Physical Activity in Patients with Post-polio Syndrome (review) / 中国康复理论与实践

Proper physical activities may improve strength and endurance, and improve flexibility and coordination, which contrib-ute to improving the quality of life and independence in patients with post-polio syndrome (PPS). Patients should exer-cise in a controlled and sensible manner, avoiding intensive training and excessive muscle use, for fear that exacerbated symptoms and further loss of muscle strength appear. Exercises should not be performed until the patients have been checked and evaluated by experts, followed closely and with certain conditions. The exercise intensity should be adjust-ed and not exceed the patient's fatigue threshold. Individualized exercise prescription should be carried out after disease, surgery or injury.

Prevention of Falls in Patients with Poliomyelitis Sequelae and Post-polio Syndrome(review) / 中国康复理论与实践

Falls and fall-related injuries are common and important issues among the patients with poliomyelitis sequelae and post-polio syndrome(PPS).They have the same risk factors of falls as general elderly;in addition,fatigue,muscle and joint pain caused by poliomyelitis sequelae and PPS,and the inability to tolerate the cold can also lead to falls.Falls of-ten result in physical injury,further disability,fear of falling,and then avoidance of activity.In order to reduce falls of the patients with poliomyelitis sequela and PPS,we should evaluate the fall carefully,correct and eliminate the patient's misconceptions,analyze the cause and the mechanism,and reduce the risk factors,give the multi-disciplinary compre-hensive management plan and intervention measures,in order to maintain a healthy lifestyle,and prevent falls and avoid further disability.

Effect of targeted inhibition of the expression of chemokine receptor 4 gene by small interfering RNA on the invasion and proliferation of nasopharyngeal carcinoma cells / 新乡医学院学报

Objective To investigate the effect and its mechanism of targeted inhibition of the expression of chemokine receptor 4(CXCR4) gene by small interfering RNA (siRNA) on the invasion and proliferation of nasopharyngeal carcinoma cells.Methods Forty-two nasopharyngeal carcinoma tissue and its adjacent tissues in the First Affiliated Hospital of Xinxiang Medical University from January 2014 to December 2016 were collected.The expression of CXCR4 mRNA and protein in nasopharyngeal carcinoma tissue and its adjacent tissues were detected by real time-polymerase chain reaction and Western blot.The human nasopharyngeal carcinoma cell line CNE-2Z were divided into blank control group,negative control group and CX-CR4 transfection group.The cells in blank control group were not given any treatment;the cells in negative control group were transfected nonsense siRNA sequence;the cells in CXCR4 transfection group were transfected CXCR4 targeting siRNA sequence.The protein expression of CXCR4,matrix metalloproteinases-2 (MMP-2),MMP-9,β-catenin,Cyclin D1 were detected by Western bloting after 48 h of transfection.The proliferation and invasion ability of the cells were detected by cell counting kit and Transwell chamber.Results The expression of CXCR4 mRNA in nasopharyngeal carcinoma tissue and adjacent tissues was 5.526 ±0.143,0.953 ±0.091 respectively;the expression of CXCR4 protein in nasopharyngeal carcinoma tissue and adjacent tissues was 0.522 ± 0.047,0.053 ± 0.011 respectively.The expression of CXCR4 mRNA and protein in nasopharyngeal carcinoma tissue were significantly higher than those in adjacent tissues (P ＜ 0.05).The protein expression of CXCR4,MMP-2,MMP-9,β-catenin,Cyclin D1 in cells,cell survival rate and the number of cell invasion in CXCR4 transfection group were significantly lower than those in the blank control group and negative control group (P ＜ 0.05);however,there was no significant difference in above indexes between the blank control group and negative control group (P ＞ 0.05).Conclusion Inhibiting of CXCR4 gene expression in nasopharyngeal carcinoma CNE-2Z cells can significantly decrease the proliferation and invasion ability of cancer cells,and the mechanism may be related to down regulation of Wnt/β-catenin signaling pathway.

Risk factors for congenital anal atresia / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the risk factors for the development of congenital anal atresia in neonates.</p><p><b>METHODS</b>A total of 70 neonates who were admitted to 17 hospitals in Foshan, China from January 2011 to December 2014 were enrolled as case group, and another 70 neonates who were hospitalized during the same period and had no anal atresia or other severe deformities were enrolled as control group. Univariate and multivariate logistic regression analyses were used to investigate the risk factors for the development of congenital anal atresia.</p><p><b>RESULTS</b>The univariate analysis revealed that the age of mothers, presence of oral administration of folic acid, infection during early pregnancy, and polyhydramnios, and sex of neonates showed significant differences between the case and control groups (P<0.05). The multivariate logistic regression analysis revealed that infection during early pregnancy (OR=18.776) and male neonates (OR=9.304) were risk factors for congenital anal atresia, and oral administration of folic acid during early pregnancy was the protective factor (OR=0.086).</p><p><b>CONCLUSIONS</b>Infection during early pregnancy is the risk factor for congenital anal atresia, and male neonates are more likely to develop congenital anal atresia than female neonates. Supplementation of folic acid during early pregnancy can reduce the risk of congenital anal atresia.</p>

Efficacy controlled observation on acupuncture and western medicine for gastrointestinal dysmotility in liver cirrhosis / 中国针灸

<p><b>OBJECTIVE</b>To observe the therapeutic effect of acupuncture on gastrointestinal dysmotility in liver cirrhosis.</p><p><b>METHODS</b>Forty cases of gastrointestinal dysmotility in liver cirrhosis were randomized into an acupuncture group and a motilium group, 20 cases in each one. In the acupuncture group, on the basis of the conventional treatment, electroacupuncture was applied at Zusanli (ST 36), Sanyinjiao (SP 6) and Taichong (LR 3) for 30 min, once a day. In the motilium group, on the basis of the conventional treatment, motilium was taken orally 30 min before meals, 10 mg each time, three times a day. The treatment was required for 2 weeks in both groups. The changes in the digestive tract symptom score and liver function Child-Pugh score were observed and the efficacy was assessed.</p><p><b>RESULTS</b>The total effective rate of digestive tract symptoms was 85.0% (17/20) in the acupuncture group and 70.0% (14/20) in the motilium group. The score improvements in abdominal distention, belching and vomiting in the acupuncture group were superior to those in the motilium group (all P < 0.05). In the acupuncture group, the liver function Child-Pugh total score was 8.40 +/- 0.22 before treatment and reduced to 5.36 +/- 0.17 after treatment, in which the scores for ascites, serum bilirubin and albumin were all reduced (all P < 0.05) and the reducing range was increased in tendency with the improvements in digestive tract symptoms. In the motilium group, Child-Pugh score was not changed obviously as compared with that before treatment. CONCLUSION Acupuncture effectively alleviates digestive tract symptoms and improves liver function for the patients of liver cirrhosis, its efficacy on gastrointestinal dysmotility in liver cirrhosis is superior to motilium.</p>

Clinical analysis of 134 cases of HEV-related liver failure / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To study the clinical features of hepatitis E virus-related liver failure.</p><p><b>METHODS</b>134 patients with HEV-related liver failure were analyzed retrospectively.</p><p><b>RESULTS</b>HEV-related liver failure accounted for 8.45 percent of the total number of hepatitis E patients in the hospital. Of the 134 patients, 68 were infected with simple HEV, 66 had the superinfection with HBV. The average age of simple HEV-related liver failure patients (56.12 +/- 14.29) was higher than that of HBV superinfectiong liver failure patients (P < 0.05). The ratio of elderly patients (> or = 60 years) in simple HEV-related liver failure patients (45.59%) was significantly higher than that of the other group (13.64%, P < 0.05). The ratio of direct bilirubin/total bilirubing (0.72 +/- 0.07, 0.69 +/- 0.08), and serum alanine aminotransferase [(1250.90 +/- 1593.97) U/L, (616.26 +/- 797.62) U/L] were significantly higher in simple HEV-related liver failure patients than in HBV superinfectiong liver failure patients (P < 0.05), but the total bilirubing had no significant difference (P > 0.05). The disease outcome and stage were no-significant difference in the two groups (P > 0.05). CONCLUSION; Simple HEV-related liver failure patients may have older age, higher aminotransferase, higher ratio of direct bilirubin/total bilirubin, but disease outcome and stage were no-significant difference in the two groups.</p>

Genetic transformation of Pinellia ternata with Agrobacterium tumefaciens-mediated sHSP genes / 中国中药杂志

<p><b>OBJECTIVE</b>To establish an efficient genetic transformation system of Pinellia ternata.</p><p><b>METHOD</b>With petioles from test-tube seedlings of P. ternata as explants, Agrobacterium tumefaciens mediation method was adopted to explore the effect of phenolic substances, A. tumefaciens's concentration, infection time, pre-incubation time and co-cultivation time on genetic transformation efficiency of P. ternata.</p><p><b>RESULT AND CONCLUSION</b>The genetic transformation efficiency could be effectively enhanced by infecting in A. tumefaciens culture containing AS 40 mg x L(-1) for 15 min for three days. The petioles were put into the differentiation medium containing 150 mg x L(-1) Kan and 350 mg x L(-1) Carb to screening and cultivation. After around 30 days, microtubers could be observed at both sides of the petioles. Gus staining and PCR verification on the regenerated plants showed that the exogenous gene sHSP had been integrated into genome of P. ternata.</p>