Comparing the prognostic value of 3 diagnostic criteria of bronchopulmonary dysplasia in preterm infants / 中华儿科杂志

Objective: To compare the prognostic value of 3 diagnostic criteria of bronchopulmonary dysplasia (BPD) in preterm infants with gestational age<32 weeks. Methods: The retrospective cohort study was conducted to collect the clinical data of 285 preterm infants with BPD admitted to the Department of Neonatology, Children's Hospital Affiliated to Zhengzhou University from January 2019 to September 2021, who were followed up regularly after discharge. The primary composite adverse outcome was defined as death or severe respiratory morbidity from 36 weeks of corrected gestational age to 18 months of corrected age, and the secondary composite adverse outcome was defined as death or neurodevelopmental impairment. According to the primary or secondary composite adverse outcomes, the preterm infants were divided into the adverse prognosis group and the non-adverse prognosis group. The 2001 National Institute of Child Health and Human Development (NICHD) criteria, 2018 NICHD criteria, and 2019 Neonatal Research Network (NRN) criteria were used to diagnose and grade BPD in preterm infants. Chi-square test, Logistic regression analysis, receiver operating characteristic (ROC) curve and Delong test were used to analyze the prognostic value of the 3 diagnostic criteria. Results: The 285 preterm infants had a gestational age of 29.4 (28.1, 30.6) weeks and birth weight of 1 230 (1 000, 1 465) g, including 167 males (58.6%). Among 285 premature infants who completed follow-up, the primary composite adverse outcome occurred in 124 preterm infants (43.5%), and the secondary composite adverse outcome occurred in 40 preterm infants (14.0%). Multivariate Logistic regression analysis showed that severe BPD according to the 2001 NICHD criteria, gradeⅡand Ⅲ BPD according to the 2018 NICHD criteria and grade 2 and 3 BPD according to the 2019 NRN criteria were all risk factors for primary composite adverse outcomes (all P<0.05). ROC curve showed that the area under the curve (AUC) of the 2018 NICHD criteria and 2019 NRN criteria were both higher than that of the 2001 NICHD criteria (0.70 and 0.70 vs. 0.61, Z=4.49 and 3.35, both P<0.001), but there was no significant difference between the 2018 NICHD and 2019 NRN criteria (Z=0.38, P=0.702). Multivariate Logistic regression analysis showed that the secondary composite adverse outcomes were all associated with grade Ⅲ BPD according to the 2018 NICHD criteria and grade 3 BPD according to the 2019 NRN criteria (both P<0.05). ROC curve showed that the AUC of the 2018 NICHD criteria and 2019 NRN criteria were both higher than that of the 2001 NICHD criteria (0.71 and 0.71 vs. 0.58, Z=2.93 and 3.67, both P<0.001), but there was no statistically significant difference between the 2018 NICHD and 2019 NRN criteria (Z=0.02, P=0.984). Conclusion: The 2018 NICHD and 2019 NRN criteria demonstrate good and comparable predictive value for the primary and secondary composite adverse outcomes in preterm infants with BPD, surpassing the predictive efficacy of the 2001 NICHD criteria.

COVID-19 excess deaths in Eastern European countries associated with weaker regulation implementation and lower vaccination coverage

Background: Since winter 2020, excess deaths due to COVID-19 have been higher in Eastern Europe than most of Western Europe, partly because regulatory enforcement was poor. Methods: This paper analysed data from 50 countries in the WHO European Region, in addition to data from USA and Canada. Excess mMortality and vaccination data were retrieved from “Our World In Data” and regulation implementation was assessed using standard methods. Multiple linear regression was used to assess the association between mortality and each covariate. Results: Excess mortality increased by 4.1 per 100 000 (P = 0.038) for every percentage decrease in vaccination rate and with 6/100 000 (p=0.011) for every decreased unit in the regulatory implementation score a country achieved in the Rule of Law Index. Conclusion: Degree of regulation enforcement, likely including public health measure enforcement, may be an important factor in controlling COVID-19’s deleterious health impacts.

COVID-19 excess death rate in Eastern European countries associated with weaker regulation implementation and lower vaccination coverage

AimThe objective of this analysis was to assess the association of excess COVID-19 mortality with regulation enforcement and vaccination rate in selected countries. MethodsThis analysis included 50 countries pertinent to the WHO European Region, in addition to USA and Canada. Excess mortality and vaccination data were retrieved from "Our World In Data" database, while regulation implementation was measured from a well-respected, standardized measure. Outpatient visits were also included in the analysis. Multiple linear regression was used to assess the independent association between excess mortality and each covariate. ResultsExcess mortality increased by 4.1/100 000 for every percent decrease in vaccination rate and with 6/100 000 for every decreased unit in the regulatory implementation score a country achieved in the Rule of Law Index. ConclusionDegree of regulation enforcement, likely including public health measure enforcement, may be an important factor in controlling COVID-19s deleterious health impacts.

Targeting GATA1 and p2x7r Locus Binding in Spinal Astrocytes Suppresses Chronic Visceral Pain by Promoting DNA Demethylation / 神经科学通报·英文版

Irritable bowel syndrome is a gastrointestinal disorder of unknown etiology characterized by widespread, chronic abdominal pain associated with altered bowel movements. Increasing amounts of evidence indicate that injury and inflammation during the neonatal period have long-term effects on tissue structure and function in the adult that may predispose to gastrointestinal diseases. In this study we aimed to investigate how the epigenetic regulation of DNA demethylation of the p2x7r locus guided by the transcription factor GATA binding protein 1 (GATA1) in spinal astrocytes affects chronic visceral pain in adult rats with neonatal colonic inflammation (NCI). The spinal GATA1 targeting to DNA demethylation of p2x7r locus in these rats was assessed by assessing GATA1 function with luciferase assay, chromatin immunoprecipitation, patch clamp, and interference in vitro and in vivo. In addition, a decoy oligodeoxynucleotide was designed and applied to determine the influence of GATA1 on the DNA methylation of a p2x7r CpG island. We showed that NCI caused the induction of GATA1, Ten-eleven translocation 3 (TET3), and purinergic receptors (P2X7Rs) in astrocytes of the spinal dorsal horn, and demonstrated that inhibiting these molecules markedly increased the pain threshold, inhibited the activation of astrocytes, and decreased the spinal sEPSC frequency. NCI also markedly demethylated the p2x7r locus in a manner dependent on the enhancement of both a GATA1-TET3 physical interaction and GATA1 binding at the p2x7r promoter. Importantly, we showed that demethylation of the p2x7r locus (and the attendant increase in P2X7R expression) was reversed upon knockdown of GATA1 or TET3 expression, and demonstrated that a decoy oligodeoxynucleotide that selectively blocked the GATA1 binding site increased the methylation of a CpG island in the p2x7r promoter. These results demonstrate that chronic visceral pain is mediated synergistically by GATA1 and TET3 via a DNA-demethylation mechanism that controls p2x7r transcription in spinal dorsal horn astrocytes, and provide a potential therapeutic strategy by targeting GATA1 and p2x7r locus binding.

The lower COVID-19 related mortality and incidence rates in Eastern European countries are associated with delayed start of community circulation

BackgroundThe purpose of this analysis was to assess the variations in COVID-19 related mortality and incidence rates in relation to the time differences in the commencement of virus circulation and containment measures in different countries of the European Region. MethodsThe data for the current analysis (N=50 countries) were retrieved from the John Hopkins University dataset on the 7th of May 2020, with countries as study units. A piecewise regression analysis was conducted with mortality and cumulative incidence rates introduced as dependent variables and time interval (days from the 22nd of January to the date when 100 first cases were reported) as the main predictor. The country average life expectancy at birth was statistically adjusted for in the regression model. ResultsMortality and incidence were strongly and inversely intercorrelated with days from January 22, respectively -0.83 (p<.0001) and -0.73 (p<.0001). Adjusting for average life expectancy, between days 33 to 50 from the 22th of the January, the average mortality rate decreased by 30.4/million per day (95% CI: 23.2, 37.1, p<0.0001). During interval 51 to 73 days, the change in mortality was no longer statistically significant but still showed a decreasing trend. A similar relationship with time interval was found in incidence. Life expectancy was not associated with mortality rate. ConclusionCountries in Europe which observed the earliest COVID-19 circulation, suffered the worst consequences in terms of health outcomes, specifically mortality. The drastic social isolation measures, undertaken especially in Eastern European countries, where community circulation started after March 11th, may have been timely. This may explain their significantly lower COVID-related mortality compared with the Western European countries.

Clinical Efficiency of Modified Erchentang on Children Bronchiolitis / 中国实验方剂学杂志

Objective:To observe the clinical efficacy and safety of modified Erchentang (Juhong Tanke liquid) on children bronchitis with syndrome of sputum, cough, dys-expectoration, wheezing and pulmonary function. Method:A total of 200 children patients aged below 24 months were randomly divided into control group and observation group by random number table, with 100 cases in each group. Children in each group received basic clinical treatment, while children in treatment group was also given modified Erchentang (Juhong Tanke liquid), 2-5 mL each time, 3 times a day. Both groups were treated for 15 days. Clinical respiratory tract symptom and sign scores, cough, sputum, dys-expectoration and wheezing were evaluated and compared. Pulmonary function was detected before and after treatment for 15 days. Analysis parameters were respiratory rate (RR), tidal volume per kilogram (VT/kg), inspiratory/expiratory (TI/TE), peak time of expiratory flow (TPTEF), time to peak ratio (TPTEF/TE), peak expiratory flow (PEF), volume in peak time of expiratory flow (VPTEF), volume ratio in peak flow (PFV), terminal flows per peak expiratory flow (25/PF), rate of mid-expiratory to mid-inspiratory flow (ME/MI), respiratory resistance (Rrs), functional residual capacity per kilogram (FRC/kg) and compliance per kilogram (Crs/kg). Result:After treatment for 5 days, both groups have obviously alleviation in sputum, cough, dys-expectoration wheezing and airway function. After treatment for 5 days, sputum, cough, dys-expiratory and wheezing in treatment group were all alleviated comparing with those of control group (PConclusion:Modified Erchentang (Juhong Tanke liquid) has shown marked efficacy in children bronchitis to alleviate clinical symptoms and improve pulmonary function, with no adverse reaction, and thus is worth further promotion and application in clinic.

Effects of end time of night feeding on the growth and development of infants/toddlers / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the effects of end time of night feeding on body height, body weight, nutritional status, and prevalence rate of dental caries in children at the age of 30 months.</p><p><b>METHODS</b>A total of 416 children who were born from January 2014 to September 2015 and had completed a physical examination as required were enrolled. During the physical examination performed at the age of 30 months, the comprehensive child care record and a self-made questionnaire were used. The children who continued to receive night feeding after the age of 6 months were enrolled as study group (n=269), and those for whom night feeding was ended at the age of 6 months were enrolled as control group (n=147). The two groups were compared in terms of body height, body weight, incidence rate of overweight/obesity, and prevalence rate of dental caries at the age of 30 months.</p><p><b>RESULTS</b>Compared with the control group, the study group had a significantly lower body height (92.4±3.0 cm vs 93.3±2.8 cm; P<0.05), a significantly higher incidence rate of overweight/obesity (23.8% vs 12.2%; P<0.05), and a significantly higher prevalence rate of dental caries (14.9% vs 7.5%; P<0.05) at the age of 30 months.</p><p><b>CONCLUSIONS</b>Night feeding continued after the age of 6 months can affect the growth and development of infants/toddlers, cause overnutrition, and increase the prevalence rate of dental caries.</p>

Application of three-dimensional printed skull in the teaching of human anatomy / 基础医学与临床

Objective This experiment aimed to find out the feasibility of applying 3D printing technology to anato-my education. Methods We constructed 3D printed skull using a cadaveric skull as template.26 participants were recruited from Peking Union Medical College. All participants studied cranial anatomy with 3D printed skulls as teaching materials,and then assessed practicability of 3D printed skulls by subjective assessment questionnaires. Results 57% participants considered that 3D printed skulls can present defined cranial anatomical structures.More than 90% participants agreed that 3D printed models helped spatial comprehension and study of anatomy.88% par-ticipants suggested 3D printing can solve the problem of ethics.84% participants agreed to apply 3D printed models into cranial anatomy education. Conclusions The efficacy of 3D printing had been confirmed in anatomical educa-tion. Further application of 3D printing technology in medical education needs carrying out.

Application of three-dimensional printed skull in the teaching of human anatomy / 基础医学与临床

Objective This experiment aimed to find out the feasibility of applying 3D printing technology to anato-my education. Methods We constructed 3D printed skull using a cadaveric skull as template.26 participants were recruited from Peking Union Medical College. All participants studied cranial anatomy with 3D printed skulls as teaching materials,and then assessed practicability of 3D printed skulls by subjective assessment questionnaires. Results 57% participants considered that 3D printed skulls can present defined cranial anatomical structures.More than 90% participants agreed that 3D printed models helped spatial comprehension and study of anatomy.88% par-ticipants suggested 3D printing can solve the problem of ethics.84% participants agreed to apply 3D printed models into cranial anatomy education. Conclusions The efficacy of 3D printing had been confirmed in anatomical educa-tion. Further application of 3D printing technology in medical education needs carrying out.

Impact of a bundle on prevention and control of healthcare associated infections in intensive care unit / 华中科技大学学报（医学）（英德文版）

Inpatients in the intensive care unit (ICU) are at high risk for healthcare-associated infections (HAIs). In the current study, a bundle of interventions and measures for preventing and controlling HAIs were developed and implemented in the ICU by trained personnel, and the impact of the bundle was evaluated. The incidence of HAIs, the adjusted daily incidence of HAIs and the incidence of three types of catheter-related infections before and after the bundle implementation were compared. The execution rate of the bundle for preventing and controlling ventilator-associated pneumonia (VAP) was increased from 82.06% in 2012 to 96.88% in 2013. The execution rate was increased from 83.03% in 2012 to 91.33% in 2013 for central line-associated bloodstream infection (CLABSI), from 87.00% to 94.40% for catheter-associated urinary tract infection (CAUTI), and from 82.05% to 98.55% for multidrug-resistant organisms (MDROs), respectively. In total, 136 cases (10.37%) in 2012 and 113 cases (7.72%) in 2013 involved HAIs, respectively. Patients suffered from infection of the lower respiratory tract, the most common site of HAIs, in 134 cases (79.29%) in 2012 and 107 cases (74.30%) in 2013 respectively. The incidence of VAP was 32.72‰ and 24.60‰, the number of strains of pathogens isolated was 198 and 173, and the number of MDROs detected in the ICU was 91 and 74 in 2012 and 2013, respectively. The percentage of MDROs among the pathogens causing HAIs was decreased in each quarter of 2013 as compared with the corresponding percentage in 2012. In 2013, the execution rate of the bundle for preventing and controlling HAIs was increased, whereas the incidence of HAIs and VAP decreased as compared with that in 2012.

Impact of a bundle on prevention and control of healthcare associated infections in intensive care unit / 华中科技大学学报（医学）（英德文版）

Inpatients in the intensive care unit (ICU) are at high risk for healthcare-associated infections (HAIs). In the current study, a bundle of interventions and measures for preventing and controlling HAIs were developed and implemented in the ICU by trained personnel, and the impact of the bundle was evaluated. The incidence of HAIs, the adjusted daily incidence of HAIs and the incidence of three types of catheter-related infections before and after the bundle implementation were compared. The execution rate of the bundle for preventing and controlling ventilator-associated pneumonia (VAP) was increased from 82.06% in 2012 to 96.88% in 2013. The execution rate was increased from 83.03% in 2012 to 91.33% in 2013 for central line-associated bloodstream infection (CLABSI), from 87.00% to 94.40% for catheter-associated urinary tract infection (CAUTI), and from 82.05% to 98.55% for multidrug-resistant organisms (MDROs), respectively. In total, 136 cases (10.37%) in 2012 and 113 cases (7.72%) in 2013 involved HAIs, respectively. Patients suffered from infection of the lower respiratory tract, the most common site of HAIs, in 134 cases (79.29%) in 2012 and 107 cases (74.30%) in 2013 respectively. The incidence of VAP was 32.72‰ and 24.60‰, the number of strains of pathogens isolated was 198 and 173, and the number of MDROs detected in the ICU was 91 and 74 in 2012 and 2013, respectively. The percentage of MDROs among the pathogens causing HAIs was decreased in each quarter of 2013 as compared with the corresponding percentage in 2012. In 2013, the execution rate of the bundle for preventing and controlling HAIs was increased, whereas the incidence of HAIs and VAP decreased as compared with that in 2012.

Effect of occupational stress on hypertension / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To explore the effect of occupational stress on hypertension.</p><p><b>METHODS</b>498 workers whose accumulative length of service was more than two years were investigated with questionnaire by method of cluster sampling from a thermal power plant in Henan province in China; 446 respondents returned qualified questionnaire including 281 male and 165 female Han People. After the patients with secondary hypertension, diabetes patients, and patients with liver or kidney disease were excluded, 84 workers (58 males and 26 females) were diagnosed as hypertension. The occupational stressors, personalities, buffering factors and occupational strain were measured by using the Job Demand-control Model, the Effort-reward Imbalance Model questionnaires and Occupational Stress Measurement Scale. Main risk factors for the development of hypertension such as heredity, body mass index, high salt diet, alcohol use, smoking habit and lack of physical activity were investigated. 498 whole blood samples were collected from workers in field epidemiologic survey. All of the samples were detected TG, CHO and FPG by common biochemistry methods. Multivariate logistic regression analysis were used to determine the relationship between occupational stressors and prevalence rate of hypertension. The difference of morbidity of hypertension between different stress level subjects was analyzed by chi2 test.</p><p><b>RESULTS</b>(1) Logistic regression analysis of the hypertension by all occupational stressors and risk factors of hypertension indicated that not only some common factors such as parents' hypertensive history, BMI, alcohol use and TG, but also responsibility for person, work locus of control and social support were significantly correlated with elevated risks of hypertension. (2) Logistic regression analysis of the hypertension by main dimensions of effort-reward imbalance model and risk factors of hypertension indicated that parents' hypertensive history, BMI, alcohol use, TG, and effort were significantly correlated with elevated risks of hypertension. Logistic regression analysis indicated the risk of hypertension had an effect on the FRI and effort (OR was 1.71 and 2.43 respectively). (3) For the job strain model, results indicated that parents' hypertensive history, UMI, alcohol use, TG, work locus of control and social support were significantly correlated with elevated risks of hypertension. But the main dimensions of job strain model (job demands and decision latitude) didn't enter regression equation. (4) The difference of prevalence of hypertension between high- and low stress level groups in male was statistically significant (OR = 3.13, P < 0.01), but the case was not the same in female (P > 0.05).</p><p><b>CONCLUSIONS</b>Occupational stress might be risk factor of hypertension; The predictive power of effort-reward imbalance model for the development of hypertension would be larger than that of job strain model.</p>

HPLC fingerprint of the components of Radix Angelicae Sinensis / 药学学报

A chemical fingerprint method was developed for investigating the variance of constituents between the whole roots and prepared slices of Radix Angelicae Sinensis (the roots of Angelica sinensis) using HPLC. 19 Radix Angelicae Sinensis whole roots collected from 16 different habitats and 28 commerial drugs including 6 whole roots, 1 root head and 21 prepared slices were analyzed. The component fingerprint of Radix Angelicae Sinensis with 12 common peaks was established. Common peaks 2, 5 and 6 could not be detected in most of the prepared slice samples. Except peaks 11 and 12, all the other peaks in graphics of the prepared slice samples mostly showed lower responses than those of the whole root samples. The whole roots and prepared slices could also be divided into two groups based on the clustering analysis results done by SAS 8.2. Meanwhile, the Similarity Evaluation System for Chromatographic Fingerprint of TCM 2004 software was applied for data analysis. Except samples y-17, s-3, s-5 and s-6, the similarities of the whole root samples were over 0.973, while the similarities of the prepared slice samples were all below 0.969. All the results demonstrated that there was distinguished difference in chemical components between the whole roots and prepared slices of Radix Angelicae Sinensis. Our experiments suggested to maintain the active components, whole roots of Radix Angelicae Sinensis should be a better choice than prepared slices for medicine trade and the storage of Radix Angelicae Sinensis should be taken care of.

Expressions of Interferon Gamma and Transforming Growth Factor Bata1 in Hyperoxia-Induced Lung Injury and Their Significances / 实用儿科临床杂志

Objective To observe the dynamic changes of interferon gamma(IFN-?) and transforming growth factor bata1(TGF-?_1) in animal model of hyperoxia-induced lung injury,and to explore the mechanism of fibrosis.Methods Thirty-two juvenile Wistar rats were randomly divided into room-air group and hyperoxia group,the hyperoxia group were further divided into 3 subgroups of hyperoxia-exposure for 3,7 and 14 days.The mRNA levels of IFN-? and TGF-?_1 in the lung were measured by reverse-transcription polymerase chain reaction(RT-PCR).The expressions of IFN-? and TGF-?_1 protein were measured by immunohistochemical(stai)-ning.Results The level of IFN-? mRNA of groups under hyperxia-exposure for 3,7 and 14 days were higher than that of control group.The expression of IFN-? mRNA notably elevated and was up to its peak(P