Therapeutic efficacy of volume-guaranteed high frequency oscillation ventilation on respiratory failure in preterm infants with a gestational age of 28-34 weeks: a prospective randomized controlled study / 中国当代儿科杂志

OBJECTIVES@#To investigate the therapeutic efficacy of volume-guaranteed high frequency oscillation ventilation (HFOV-VG) versus conventional mechanical ventilation (CMV) in the treatment of preterm infants with respiratory failure.@*METHODS@#A prospective study was conducted on 112 preterm infants with respiratory failure (a gestational age of 28-34 weeks) who were admitted to the Department of Neonatology, Jiangyin Hospital Affiliated to Medical School of Southeast University, from October 2018 to December 2022. The infants were randomly divided into an HFOV-VG group (44 infants) and a CMV group (68 infants) using the coin tossing method based on the mode of mechanical ventilation. The therapeutic efficacy was compared between the two groups.@*RESULTS@#After 24 hours of treatment, both the HFOV-VG and CMV groups showed significant improvements in arterial blood pH, partial pressure of oxygen, partial pressure of carbon dioxide, and partial pressure of oxygen/fractional concentration of inspired oxygen ratio (P<0.05), and the HFOV-VG group had better improvements than the CMV group (P<0.05). There were no significant differences between the two groups in the incidence rate of complications, 28-day mortality rate, and length of hospital stay (P>0.05), but the HFOV-VG group had a significantly shorter duration of invasive mechanical ventilation than the CMV group (P<0.05). The follow-up at the corrected age of 6 months showed that there were no significant differences between the two groups in the scores of developmental quotient, gross motor function, fine motor function, adaptive ability, language, and social behavior in the Pediatric Neuropsychological Development Scale (P>0.05).@*CONCLUSIONS@#Compared with CMV mode, HFOV-VG mode improves partial pressure of oxygen and promotes carbon dioxide elimination, thereby enhancing oxygenation and shortening the duration of mechanical ventilation in preterm infants with respiratory failure, while it has no significant impact on short-term neurobehavioral development in these infants.

Clinical effect of different maintenance doses of caffeine citrate in the treatment of preterm infants requiring assisted ventilation: a pilot multicenter study / 中国当代儿科杂志

OBJECTIVES@#To explore the optimal maintenance dose of caffeine citrate for preterm infants requiring assisted ventilation and caffeine citrate treatment.@*METHODS@#A retrospective analysis was performed on the medical data of 566 preterm infants (gestational age ≤34 weeks) who were treated and required assisted ventilation and caffeine citrate treatment in the neonatal intensive care unit of 30 tertiary hospitals in Jiangsu Province of China between January 1 and December 31, 2019. The 405 preterm infants receiving high-dose (10 mg/kg per day) caffeine citrate after a loading dose of 20 mg/kg within 24 hours after birth were enrolled as the high-dose group. The 161 preterm infants receiving low-dose (5 mg/kg per day) caffeine citrate were enrolled as the low-dose group.@*RESULTS@#Compared with the low-dose group, the high-dose group had significant reductions in the need for high-concentration oxygen during assisted ventilation (P=0.044), the duration of oxygen inhalation after weaning from noninvasive ventilation (P<0.01), total oxygen inhalation time during hospitalization (P<0.01), the proportion of preterm infants requiring noninvasive ventilation again (P<0.01), the rate of use of pulmonary surfactant and budesonide (P<0.05), and the incidence rates of apnea and bronchopulmonary dysplasia (P<0.01), but the high-dose group had a significantly increased incidence rate of feeding intolerance (P=0.032). There were no significant differences between the two groups in the body weight change, the incidence rates of retinopathy of prematurity, intraventricular hemorrhage or necrotizing enterocolitis, the mortality rate, and the duration of caffeine use (P>0.05).@*CONCLUSIONS@#This pilot multicenter study shows that the high maintenance dose (10 mg/kg per day) is generally beneficial to preterm infants in China and does not increase the incidence rate of common adverse reactions. For the risk of feeding intolerance, further research is needed to eliminate the interference of confounding factors as far as possible.

Establishment and identification of C57BL/6 mouse model with radiation-induced pulmonary fibrosis / 中华放射肿瘤学杂志

Objective:To establish the mouse model with radiation-induced pulmonary fibrosis, and to identify and analyze it from the aspects of function, imaging and pathology.Methods:Thirty C57BL/6 mice were randomly divided into the control group, 16 Gy irradiation group and 20Gy irradiation group. The mice in the irradiation groups received a single 16 Gy or 20 Gy chest X-ray irradiation, and underwent functional examination, imaging examination and pathological examination at 3 and 6 months after irradiation.Results:At 6 months after irradiation, hair on the chest and back of the mice turned white and fell off, and the airway resistance was increased significantly. CT images showed extensive patch shadows and consolidation in the lung. Three dimensional reconstruction suggested that the lung of mice was distorted and deformed, and the volume was decreased significantly. Pathological examination confirmed that there was extensive pulmonary fibrosis.Conclusions:Significant pulmonary fibrosis occurs after 6 months of chest irradiation in mice. The animal model of radiation-induced pulmonary fibrosis in C57BL/6 mice was successfully established.

Single- or dual-antiplatelet therapy after transcatheter aortic valve replacement: A protocol of systematic review and meta-analysis.

BACKGROUND: The evidence related to bleeding and thromboembolic events after transcatheter aortic valve replacement (TAVR) compared single antiplatelet therapy (SAPT) with dual antiplatelet therapy (DAPT) treatment are inconsistent. Moreover, there are some limitations such as small sample size and the risk of bias in existing studies. We will conduct a comprehensive systematic review and meta-analysis to explore the safety and efficacy of SAPT or DAPT after TAVR. METHODS: A comprehensive literature search of PubMed, EMBASE, The Cochrane Library, Cochrane Central Register of Controlled Trials will be searched to retrieve studies involving SAPT versus DAPT after TAVR. Two investigators will independently select studies, extract data, and assess the quality of the included study. Any disagreement will be resolved by the third investigator. The study will use a random-effects model to pool the results of all studies and use the relative risk and 95% confidence intervals to summarize individual trial outcomes and estimate pooled effect. The study will use the Grading of Recommendations Assessment, Development, and Evaluation to assess the certainty of evidence. RESULTS: This study will provide high-quality evidence for treatment of TAVR in terms of effectiveness and safety. CONCLUSION: This systematic review aims to provide evidence for treatment of TAVR in different antiplatelet therapies. REGISTRATION: The systematic review and meta-analysis is registered in the OSF REGISTRIES (10.17605/OSF.IO/Q42TE) international prospective register.

A Quality-by-Control Approach in Pharmaceutical Continuous Manufacturing of Oral Solid Dosage via Direct Compaction.

The pharmaceutical industry has been undergoing a paradigm shift towards continuous manufacturing, under which novel approaches to real-time product quality assurance have been investigated. A new perspective, entitled Quality-by-Control (QbC), has recently been proposed as an important extension and complementary approach to enable comprehensive Quality-by-Design (QbD) implementation. In this study, a QbC approach was demonstrated for a commercial scale tablet press in a continuous direct compaction process. First, the necessary understanding of the compressibility of a model formulation was obtained under QbD guidance using a pilot scale tablet press, Natoli BLP-16. Second, a data reconciliation strategy was used to reconcile the tablet weight measurement based on this understanding on a commercial scale tablet press, Natoli NP-400. Parameter estimation to monitor and update the material property variance was also considered. Third, a hierarchical three-level control strategy, which addressed the fast process dynamics of the commercial scale tablet press was designed. The strategy consisted of the Level 0 built-in machine control, Level 1 decoupled Proportional Integral Derivative (PID) control loops for tablet weight, pre-compression force, main compression force, and production rate control, and Level 2 data reconciliation of sensor measurements. The effective and reliable performance, which could be demonstrated on the rotary tablet press, confirmed that a QbC approach, based on product and process knowledge and advanced model-based techniques, can ensure robustness and efficiency in pharmaceutical continuous manufacturing.

Long noncoding RNA TUG1 promotes renal cell carcinoma cell proliferation, migration and invasion by downregulating microRNA­196a.

Long noncoding RNA taurine upregulated gene 1 (lncRNA TUG1) and microRNA­196a (miR­196a) have been reported to serve important roles in the development of renal cell carcinoma (RCC). However, their potential mechanisms have not been completely elucidated. The aim of the present study was to clarify the biological functions of lncRNA­TUG1 and miR­196a, in addition to investigating the interaction between lncRNA­TUG1 and microRNA­196a, providing a novel insight into RCC tumorigenesis. The present study comprised two parts. In the first part, lncRNA­TUG1 was confirmed as an oncogene, via reverse transcription­quantitative polymerase chain reaction (RT­qPCR) analysis, MTT assay, flow cytometry analysis, and migration and invasion assays. In the second part, the association between lncRNA­TUG1 and miR­196a, and the molecular mechanism, was illustrated via RT­qPCR analysis, MTT assay, dual luciferase reporter assay and western blotting. The results of the present study demonstrated that lncRNA­TUG1 was able to promote RCC cell proliferation, migration and invasion in vitro by suppressing miR­196a. Additionally, lncRNA­TUG1 achieved its biological functions by regulating the expression levels of RAC­α serine/threonine­protein kinase, mitogen­activated protein kinase and extracellular signal­regulated kinase via inhibition of miR­196a. In conclusion, the present findings proposed a novel potential therapeutic target, the lncRNA­TUG1­miR­196a axis, which may be applicable to the treatment of RCC.

Effect of gender on in-hospital mortality in patients with acute ST-elevated myocardial infarction undergoing primary percutaneous coronary intervention / 解放军医学杂志

Objective To investigate the effect of gender on in-hospital mortality in patients with acute ST-elevated myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI). Methods To retrospectively analyze the data collected from the Management System of Cardiovascular Interventional Treatment in Military Hospitals. A total of 8878 consecutive patients with acute STEMI undergoing PPCI were enrolled, including 7137 males and 1741 females. Data were grouped by gender to evaluate the impact of gender difference on the in-hospital mortality, and the impact was further evaluated by a propensity score analysis to adjust the differences of patients' ages in baseline characteristics between females and males. Results Compared with that in male patients, female patients were older (P<0.05), more likely to have hypertension, diabetes, cerebrovascular disease and cardiac dysfunction (P<0.05), but less likely to have history of PCI (P<0.05). The proportions of suffering from triple vessel disease and postoperative hemorrhage were higher in females than in males (P<0.05). Both symptomonset-to-balloon time and door-to-balloon time were longer in female patients than in male patients (P<0.05). Female patients also presented higher in-hospital mortality (4.4% vs 2.4%, P<0.001). The impact of gender on in-hospital mortality disappeared by a propensity score matching adjusting the differences in baseline characteristics between females and males (Female vs Male: 4.4% vs 4.0%, P=0.610). Multi-logistic regression showed that female was not an independent predictor for in-hospital mortality, while age, cardiac dysfunction, slow blood flow and postoperative hemorrhage were the independent predictors for in-hospital mortality. Conclusion Female itself is not an independent predictor for in-hospital mortality in patients with acute STEMI undergoing PPCI.

Characteristics and impact factors of ocular damage effects induced by transitional near-infrared laser:a review / 军事医学

The transitional near-infrared (NIR) laser was defined as ranging from 1.3μm to 1.4μm, within which the most sensitive tissue to laser damage changed from the retina to the cornea.The ocular damage effect has attracted much attention due to the increased varieties and output power of laser in this spectrum region in recent years.Compared with visible and mid-and-far infrared wavelengths, the ocular damage effect induced by transitional NIR wavelengths has many peculiarities and impact factors due to the bulk absorptionby ocular media.This paper reviews the existing ocular damage threshold data and analyzes the characteristics, impact factors and unresolved issues relating to ocular effects induced by laser radiation over the transition zone.

Long-term follow-up and analysis of prediction of mortality after percutaneous coronary intervention in patients with acute ST segment elevation myocardial infarction / 解放军医学杂志

Objective To explore the risk factors for mortality after percutaneous coronary intervention (PCI) in patients with acute ST segment elevation myocardial infarction (STEMI). Methods The patients who were admitted with STEMI to our hospital between July 2008 and November 2012 undergoing PCI during hospitalization were enrolled. Case control study was conducted to observe these patients during the follow-up period for exploring the independent predictors of survival. Results A total of 3551 consecutive patients were enrolled in this study. These patients were followed up for 5 years with a median followup time of 406[179, 892] days. A total of 106 deaths occurred during the follow-up period. Estimated 5-year survival rate was 88.6% by Kaplan-Meier method. Female, age, diabetes, stroke, dysarteriotony, renal insufficiency, elevation of creatinine kinase isoenzyme MB (CK-MB), left ventricular end diastolic dimension, anemia, anterior myocardial infarction, PCI complications and intra-aortic balloon pump (IABP) were independent risk factors for mortality, whereas complete revascularization was associated with decreased risk of mortality. Conclusions Long-term mortality rate of patients with STEMI is higher even after successful PCI. Less PCI complications and early complete revascularization are independent predictors for decreasing mortality rate during follow-up period.

The establishment of cardiac-specific human Neuregulin-2 transgenic mice and cardiacfunction analysis / 中国比较医学杂志

Objective To study the effects of NRG2 on cardiac structure and function , we established the cardiac-specific human NRG2 transgenic mice and investigate the effect of NRG2 on cardiac structure and function under pressure overload situation .Methods The transgenic vector was constructed by insertion of the human NRG2 gene under the α-MHC promoter.The transgenic mice were generated by microinjection and were all maintained on a C57BL/6J genetic background .The genotype of transgenic mice was identified by PCR and the expression level of target gene was determined by western blot .Transverse aortic constriction ( TAC) was applied to prepare the pressure overload induced cardiomyopathy mice model .The cardiac structure and function of the transgenic mice were compared and analysized by echocardiographic and pathological observation .Results Transgenic mice with high level of NRG2 in heart tissues were established.The left ventricular wall thickness (LVPWD) was increased, and to 15.6% at 3 months old compared with that of the non transgenic ( NTG) mice.The hypertrophy of left ventricular wall caused by pressure overload was removed due to the expression of NRG2 .Meanwhile, cardiac disarray and fibrosis were increased obviously compared with that of the NTG mice.Conclusion The transgenic expression of NRG2 in heart tissues could shorten the pathological process of hypertrophy, but accelerated the process of heart failure (HF).

Analysis of main risk factors causing foodborne diseases in food catering business / 中华预防医学杂志

<p><b>OBJECTIVE</b>To study main risk factors that cause foodborne diseases in food catering business.</p><p><b>METHODS</b>Data from references and investigations conducted in food catering units were used to establish models which based on @Risk 4.5 with Monte Carlo method referring to food handling practice model (FHPM) to make risk assessment on factors of food contamination in food catering units. The Beta-Poisson models on dose-response relationship to Salmonella (developed by WHO/FAO and United States Department of Agriculture) and Vibrio parahaemolyticus (developed by US FDA) were used in this article to analyze the dose-response relationship of pathogens.</p><p><b>RESULTS</b>The average probability of food poisoning by consuming Salmonella contaminated cooked meat under refrigeration was 1.96 × 10(-4) which was 1/2800 of the food under non-refrigeration (the average probability of food poisoning was 0.35 at room temperature 25°C). The average probability by consuming 6 hours stored meat under room temperature was 0.11 which was 16 times of 2 hours storage (6.79 × 10(-3)). The average probability by consuming contaminated meat without fully cooking was 1.71 × 10(-4) which was 100 times of consuming fully cooked meat (1.88 × 10(-6)). The probability growth of food poisoning by consuming Vibrio parahaemolyticus contaminated fresh seafood was proportional with contamination level and prevalence.</p><p><b>CONCLUSION</b>The primary contamination level, storage temperature and time, cooking process and cross contamination are important factors of catering food safety.</p>

Construction and identification of a vector inserted with gene of T7 RNA polymerase / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To develop a system to rescue virus by intracellular expression of T7 RNA Polymerase.</p><p><b>METHODS</b>The gene of T7 RNA Polymerase was amplified and cloned to VR1012 by molecular biological technology. The expression plasmid VR-1a was then identified. VR-1a and EV71 infectious plasmid were co-transfected in Vero cell. CPE was observed and viral gene viral antigen were detected.</p><p><b>RESULTS</b>The gene of T7 RNA Polymerase was successfully cloned into vector VR1012. Vero cell developed to CPE after being transfected VR-1a and EV71 infectious plasmid. EV71 gene was amplified by RT-PCR from the culture. EV71 antigen was also detected by ELISA.</p><p><b>CONCLUSION</b>The method can be used to rescue virus. It could apply to immunologic research of EV71 DNA vaccine.</p>

The application of concept maps in teaching of EFL writing at college / 中华医学教育探索杂志

Concept-map can be seen as supplementary tool and strategy for teaching and learning of English writing,in addition,that can help the student open their mind,organize the article,inspire their creativity and cultivate the habit of English thinking,the purpose of that is improvement of writing level.