[Expert consensus on nutritional management of preterm infants with bronchopulmonary dysplasia].

Inadequate nutrition supply in the early stage after birth is a risk factor for the development of bronchopulmonary dysplasia (BPD) in preterm infants, and it is also closely associated with the progression and clinical outcome of BPD. Optimized nutritional support is of great importance to reduce the incidence and severity of BPD and promote lung development and neurological prognosis. Based on the relevant studies in China and overseas, the expert consensus on BPD nutrition management is developed by the Grading of Recommendations Assessment, Development and Evaluation (GRADE) method. The consensus includes the following seven aspects: the importance of nutrition in BPD, fluid intake, energy intake, enteral nutrition, parenteral nutrition, post-discharge nutrition, and nutrition monitoring and evaluation.

Anticancer Activity of Anthopleura anjunae Oligopeptides in Prostate Cancer DU-145 Cells.

Anthopleura anjunae anti-tumor peptide (AAP-H) is a pentapeptide from the sea anemone Anthopleura anjunae with an amino acid sequence of Tyr-Val-Pro-Gly-Pro that is obtained by alkaline protease enzymatic hydrolysis extraction. In this study, we investigated the inhibitory effects of AAP-H on prostate cancer DU-145 cell proliferation using a methylthiazolyldiphenyl-tetrazolium bromide assay. Cell morphology was analyzed by hematoxylin-eosin staining, acridine orange/ethidium bromide fluorescence staining, Hoechst 33258 fluorescence staining, and scanning electron microscopy. The mitochondrial membrane potential was determined by flow cytometry following JC-1 staining. The cell apoptosis rate was measured by Annexin V-fluorescein isothiocyanate and propidium iodide staining followed by flow cytometric analysis, and the expression of apoptosis-associated proteins was assayed by Western blotting. The results demonstrated that AAP-H induced significant reductions in the number of viable cells and increased cell death in both a dose-dependent and time-dependent manner, with an IC50 of approximately 9.605 mM, 7.910 mM, and 2.298 mM at 24 h, 48 h, and 72 h, respectively. The morphologic characteristics of apoptotic cells were observed after treatment with AAP-H. The mitochondrial membrane potential was markedly decreased, and apoptosis increased after AAP-H treatment. Pro-apoptotic proteins, such as Bax, cytochrome-C, caspase-3, and caspase-9 were increased, but Bcl-2 was decreased. These findings suggest that AAP-H has moderate inhibitory effects on prostate cancer DU-145 cells, and the mechanism might involve the mitochondria-mediated apoptotic pathway. Therefore, AAP-H is a candidate anti-prostate cancer drug or health-care food.

Anti-Fatigue Effect by Peptide Fraction from Protein Hydrolysate of Croceine Croaker (Pseudosciaena crocea) Swim Bladder through Inhibiting the Oxidative Reactions including DNA Damage.

The swim bladder of the croceine croaker (Pseudosciaena crocea) was believed to have good curative effects in various diseases, including amnesia, insomnia, dizziness, anepithymia, and weakness after giving birth, in traditional Chinese medicine. However, there is no research focusing on the antioxidant and anti-fatigue peptides from croceine croaker swim bladders at present. Therefore, the purpose of this study was to investigate the bioactivities of peptide fractions from the protein hydrolysate of croceine croaker related to antioxidant and anti-fatigue effects. In the study, swim bladder peptide fraction (SBP-III-3) was isolated from the protein hydrolysate of the croceine croaker, and its antioxidant and anti-fatigue activities were measured using in vitro and in vivo methods. The results indicated that SBP-III-3 exhibited good scavenging activities on hydroxyl radicals (HO•) (EC50 (the concentration where a sample caused a 50% decrease of the initial concentration of HO•) = 0.867 mg/mL), 2,2-diphenyl-1-picrylhydrazyl radicals (DPPH•) (EC50 = 0.895 mg/mL), superoxide anion radical ( O 2 - •) (EC50 = 0.871 mg/mL), and 2,2'-azino-bis-3-ethylbenzothiazoline-6-sulfonic acid radical (ABTS⁺•) (EC50 = 0.346 mg/mL). SBP-III-3 also showed protective effects on DNA damage in a concentration-effect manner and prolonged the swimming time to exhaustion of Institute of Cancer Research (ICR) mice by 57.9%-107.5% greater than that of the control. SBP-III-3 could increase the levels of muscle glucose (9.4%-115.2% increase) and liver glycogen (35.7%-157.3%), and decrease the levels of blood urea nitrogen (BUN), lactic acid (LA), and malondialdehyde (MDA) by 16.4%-22.4%, 13.9%-20.1%, and 28.0%-53.6%, respectively. SBP-III-3 also enhanced the activity of lactic dehydrogenase to scavenge excessive LA for slowing the development of fatigue. In addition, SBP-III-3 increased the activities superoxide dismutase, catalase, and glutathione peroxidase to reduce the reactive oxygen species (ROS) damage in mice. In conclusion, SBP-III-3 possessed good anti-fatigue capacities on mice by inhibiting the oxidative reactions and provided an important basis for developing the swim bladder peptide functional food.

Analysis of In-hospital Neonatal Death in the Tertiary Neonatal Intensive Care Unit in China: A Multicenter Retrospective Study.

BACKGROUND: Globally, the proportion of child deaths that occur in the neonatal period remains a high level of 37-41%. Differences of cause in neonate death exist in different regions as well as in different economic development countries. The specific aim of this study was to investigate the causes, characteristics, and differences of death in neonates during hospitalization in the tertiary Neonatal Intensive Care Unit (NICU) of China. METHODS: All the dead neonates admitted to 26 NICUs were included between January l, 2011, and December 31, 2011. All the data were collected retrospectively from clinical records by a designed questionnaire. Data collected from each NICU were delivered to the leading institution where the results were analyzed. RESULTS: A total of 744 newborns died during the 1-year survey, accounting for 1.2% of all the neonates admitted to 26 NICUs and 37.6% of all the deaths in children under 5 years of age in these hospitals. Preterm neonate death accounted for 59.3% of all the death. The leading causes of death in preterm and term infants were pulmonary disease and infection, respectively. In early neonate period, pulmonary diseases (56.5%) occupied the largest proportion of preterm deaths while infection (27%) and neurologic diseases (22%) were the two main causes of term deaths. In late neonate period, infection was the leading cause of both preterm and term neonate deaths. About two-thirds of neonate death occurred after medical care withdrawal. Of the cases who might survive if receiving continuing treatment, parents' concern about the long-term outcomes was the main reason of medical care withdrawal. CONCLUSIONS: Neonate death still accounts for a high proportion of all the deaths in children under 5 years of age. Our study showed the majority of neonate death occurred in preterm infants. Cause of death varied with the age of death and gestational age. Accurate and prompt evaluation of the long-term outcomes should be carried out to guide the critical decision.

Characterization of acid-and pepsin-soluble collagens from spines and skulls of skipjack tuna (Katsuwonus pelamis).

Acid-soluble collagen (ASC) and pepsin-soluble collagen (PSC) from the spine (ASC-SP and PSC-SP) and skull (ASC-SK and PSC-SK) of the skipjack tuna, Katsuwonus pelamis, were successfully isolated and characterized. The yields of ASC-SP, PSC-SP, ASC-SK and PSC-SK were (2.47 ± 0.39)%, (5.62 ± 0.82)%, (3.57 ± 0.40)%, and (6.71 ± 0.81)%, respectively, on the basis of dry weight. The four collagens contained Gly (330.2-339.1 residues/1 000 residues) as the major amino acid, and their imino acid contents were between 168.8 and 178.2 residues/1 000 residues. Amino acid composition, SDS-PAGE, and FTIR investigations confirmed that ASC-SP and ASC-SK were mainly composed of type I collagen, and had higher contents of high-molecular weight cross-links than those of PSC-SK and PSC-SP. The FTIR investigation also certified all the collagens had triple helical structure. The denaturation temperatures of ASC-SK, PSC-SK, ASC-SP, and PSC-SP were 17.8, 16.6, 17.6, and 16.5 °C, respectively. All isolated collagens were soluble at acidic pH (1-5) and lost their solubilities when the NaCl concentration was above 2% (W/V). The isolated collagens from the spines and skulls of skipjack tuna could serve as an alternative source of collagens for further application in food, cosmetic, biomedical, and pharmaceutical industries.

Associations of nm23H1, VEGF-C, and VEGF-3 receptor in human prostate cancer.

We studied the expression of the non-metastatic clone 23 type 1 (nm23H1) gene, vascular endothelial growth factor (VEGF)-C, and its receptor VEGFR-3 using an in situ hybridization technique and immunohistochemical analyses with prostate cancer tissues and adjacent benign tissues of 52 human archival cases. The association between VEGF-C expression, microlymphatic count (MLC), and staining intensity for nm23H1 and VEGFR-3 was used to evaluate tumor metastasis and survival rate. MLC values were significantly higher in tumorous tissue than in non-cancerous tissue. VEGF-C mRNA, VEGFR-3, and nm23H1 were highly expressed in tumorous tissue. VEGFR-3 expression was greater in VEGF-C mRNA-positive tumors than in VEGF-C mRNA-negative tumors. The association of VEGFR-3 expression with VEGF-C mRNA and MLC suggested that the poor prognosis and tumor metastasis associated with VEGFR-3 expression may be due, in part, to its role in promoting angiogenesis. VEGF-C expression was significantly associated with tumor lymphangiogenesis, angiogenesis, and immune response as a potent multifunctional stimulating factor in prostate cancer. Expression of nm23H1 was significantly inversely correlated with lymph node metastasis. Furthermore, there was a strong negative correlation between the expression of nm23H1, VEGF-C mRNA, and MLC. These findings provide important information for prophylactic, diagnostic, and therapeutic strategies for prostate cancer.

Protective effect of polysaccharides from Sargassum horneri against oxidative stress in RAW264.7 cells.

This study was designed to investigate chemical composition and the protective effects of polysaccharides isolated from Sargassum horneri against hydrogen peroxide (H2O2)-induced oxidative injury in RAW264.7 cells. Results showed that isolated polysaccharides (SHSc) and the major fractions (SHS1, SHS0.5) contained sulfate ester, and SHS1 was high fucose-containing sulfated polysaccharide. After preincubation with three isolated polysaccharides, RAW264.7 cells viability were significantly restored and decreased in cellular LDH release (P<0.05). SHS1 and SHS0.5 decreased intracellular ROS level, intracellular NO and malonic dialdehyde (MDA) level (P<0.05), restoring activities of superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) (P<0.05), decreasing inducible nitric oxide synthase (iNOS) (P<0.05). Moreover, preincubation of SHS1 with RAW264.7 cells resulted in the increase of the gene expression level of endogenous antioxidant enzymes such as MnSOD and GSH-Px (P<0.05). These results clearly showed that SHSc and its fractions could attenuate H2O2-induced stress injury in RAW264.7 cells, and a similar efficiency in protecting RAW264.7 cells against H2O2-induced oxidative injury between SHS1 and Vitamin C. Taken together, our findings suggested that SHS1 can effectively protect RAW264.7 cells against oxidative stress by H2O2, which might be used as a potential natural antioxidant in the functional food and pharmaceutical industries.

[Clinical review of enteral feeding of extremely low birth weight infants].

OBJECTIVE: To review the clinical data of enteral feeding of extremely low birth weight infants (ELBWI), and analyze the influencing factors. METHOD: From Jan. 2000 to Jan. 2010, data of 31 ELBWI from Peking Union Medical College Hospital were retrospectively collected. ELBWI were assigned to different groups according to the time achieving full enteral feeding, comparison was done between two groups for enteral feeding. RESULT: Twenty-four infants were analyzed, their mean gestational age was (29.0 ± 1.8) weeks (26.14 - 34.43 weeks), birth weight (882 ± 67) g (730 - 970 g), there were 11 infants in group A, whose time for achieving full enteral feeding was (27 ± 6)days, there were 13 infants in group B, whose time achieving full enteral feeding was (46 ± 10)days. The ratio of asphyxia (18.2% vs. 61.5%, P = 0.047), duration of umbilical vein catheterization longer than 10 days (18.2% vs. 61.5%, P = 0.047), and duration of mechanical ventilation longer than 14 days (27.3% vs. 76.9%, P = 0.038) in group A was higher than in group B. The milk volume on the 21st and 28th day in group A was much more than that in group B [(88.9 ± 35.4) ml vs. (37.4 ± 34.9) ml, P = 0.002; (121.1 ± 37.4) ml vs. (53.2 ± 33.1) ml, P = 0.000]. There were no significant differences between the two groups in gestational age, birth weight, patent ductus arterious, erythrocytosis, dysglycemia, sepsis, the time to begin enteral feeding, the beginning milk volume, the adding milk volume in the 1st, 2nd week, and the milk volume on the 3rd, 7th, 14th day. CONCLUSION: Asphyxia, duration of umbilical vein catheterization, and duration of mechanical ventilation are likely to influence the enteral feeding of ELBWI, ELBWI with successful enteral feeding could show good tolerance in the 3rd week. But individual program should be made for enteral feeding of ELBWI, because enteral feeding could be influenced by multiple factors.

Coexpression of the mutated BRCA1 mRNA and p53 mRNA and its association in Chinese prostate cancer.

The mutations of BRCA1 and p53 genes have been simultaneously characterized in many tumors. However, their coexpression and associations have not been investigated quantitatively in prostate cancer. In the present study, the expressions of the mutated BRCA1 mRNA and p53 mRNA were examined in 48 Chinese prostate cancer cases and 10 corresponding adjacent benign tissues with in situ hybridization. The 5-year survival rates of the corresponding patients after operation were investigated. The results showed that the positive expressions of the mutated BCRA1 mRNA and p53 mRNA are involved in prostate cancer (P < 0.05). Moreover, there is a closed negative association between the expressions of the mutated BRCA1 gene and p53 gene in the mRNA level with the progression, angiogenesis, metastasis, and survival rate of prostate cancer. Their coexpression and negative association suggest that the two altered tumor suppressor genes might interact functionally in prostate cancer to provide a potential signal determining a prognosis of the tumor metastasis and survival rate. Further work will be done to elucidate the interaction mechanisms in prostate cancer.

[Clinical characteristics and long-term follow-up analysis of three cases with newborn aristolochic acid nephropathy].

OBJECTIVE: To summarize the clinical characteristics and prognosis of newborn aristolochic acid nephropathy induced by akebia. METHOD: Retrospective analysis of clinical manifestations, therapy and prognosis was made upon data of 3 newborn infants with renal function lesion induced by akebia. RESULT: Three infants who were fed with Chinese herbal medicines containing akebia trifoliate suffered from acute renal failure, renal glomerular and tubular injury, with symptoms of vomiting, diarrhea, and oliguria. Laboratory tests manifested hyperpotassemia, hyponatremia, elevation of serum creatinine and urea nitrogen, and metabolic acidosis. Renal glomerular lesion was mild, presented with proteinuria and increased serum ß(2) microglobin. Renal dysfunction was manifested with alkaline urine, glucosuria, positiveness of urine glucose, ketone and aminoaciduria, and increased urine ß(2) microglobin excretion. After symptomatic treatment for 3 to 4 weeks, the renal function of these infants recovered. Proteinuria, aminoaciduria and glucosuria turned negative within 5 to 8 months, 3 months to 1 year, and 9 months to 3 years, respectively. Urine pH decreased to 7.0 after 5.0 - 5.5 years. All cases took citric acid mixtures for 5.5 to 6 years. A 12-years follow-up demonstrated that serum creatinine of 3 cases were within normal range during the first 11 years of life, however recent follow-up showed increased serum creatinine of case 1 and case 2, except for serum creatinine of case 3 remained normal. The estimated glomerular filtration rate (eGFR) of all the 3 cases decreased. Among which, eGFR of case 1 and case 2 were lower than 90 [ml/(min·1.73 m(2))], and decreased 1.1 [ml/(min·1.73 m(2))] and 0.6 [ml/(min·1.73 m(2))] per year during recent six years, respectively. No obvious decrease of eGFR was observed in case 3. Blood gas analysis and urine routine were normal, yet blood and urine ß(2) microglobin excretion were still high. Urinary N-acetyl-ß-D-glucosaminidase increased again after having returned to normal. CONCLUSION: Newborn aristolochic acid nephropathy induced by akebia might induce acute renal failure and renal tubules injury. Renal function could recover after symptomatic treatment in short-term. Nevertheless, glomerular filtration rate presents a slow descending tendency and renal tubules lesion lasted for many years, which requires a long-term follow-up.

[Comparison of efficacy among early, conventional and late intravenous gamma globulin treatment of Kawasaki disease].

OBJECTIVE: To compare the rates of intravenous gamma globulin (IVIG) non-responder and coronary complication among early, conventional and late IVIG treatment in children with Kawasaki disease (KD). METHODS: All children with KD and IVIG treatment were retrospectively analyzed at 45 hospitals in Beijing during the 5-year period from 2000 through 2004. The time of IVIG treatment was classified as early (Day 1 - 4), conventional (Day 5 - 9) and late treatment group (Day 10 or later). The efficacy of IVIG was judged by the rate of IVIG non-responder. Echocardiography was used to assess the coronary complication at acute (1 - 2 weeks after onset) and sub-acute (3 - 6 weeks after onset) stage. RESULTS: A total of 1052 patients (680 boys, 372 girls) aged 2 months to 13.8 years were included. They were grouped as early, conventional and late treatment in 108, 763 and 181 children respectively. The rate of IVIG non-responders was higher in early (28.7%, 31/108) as compared with conventional (11.9%, 91/763) and late treatment group (7.2%, 13/181, both P < 0.01). The incidences of coronary complications were similar in early (17.6%, 19/108 and 5.9%, 4/68) and conventional treatment group (18.3%, 140/ 763 and 5.5%, 25/452), while significantly higher in late treatment group (33.7%, 61/181 and 12.8%, 15/117) in acute and sub-acute stages (both P < 0.01). CONCLUSIONS: IVIG treatment in children with KD for a disease duration of 1 - 4 days appeared to increase the rate of IVIG non-responders. Children with IVIG given at Day 10 or later had a higher incidence of acute and sub-acute coronary complications. IVIG given at Day 5 - 9 seems to be the best time for IVIG therapy in KD.

[Effects of three intravenous gamma globulin regimens on Kawasaki disease and relevant coronary complication rates in pediatric patients: a comparative study].

OBJECTIVES: To compare the effects on Kawasaki disease (KD) of 3 different intravenous gamma globulin (IVIG) regimens and coronary complication rates in children with Kawasaki disease (KD). METHODS: The clinical data of 1052 children with KD treated in 45 hospitals in Beijing from 2000 through 2004, 680 male and 372 female, aged 2 months-13.8 years, 656 (60.1%) undergoing IVIG 2 g/kg for one dose (single dose group), 292 (26.7%) undergoing 1 g.kg(-1).d(-1) for 2 days (2 d group), and 104 (9.5%) undergoing 400 - 600 mg.kg(-1).d(-1) for 4 - 5 d (4 - 5 d group) in addition of oral administration of aspirin, were analyzed retrospectively. Echocardiography was used to assess the occurrence of coronary complications 1 - 2 weeks after onset (acute stage) and 3 - 6 weeks after onset (sub-acute stage). RESULTS: The rate of IVIG non-responder of the 2 d group was 20.9%, significantly higher than those of the single dose group and 4 - 5 d group (9.9% and 8.7% respectively, both P < 0.01). There were no significant differences in rates of coronary complication, pericardial effusion, and mitral regurgitation at the acute stage among the 3 groups (all P > 0.05). However, the rates of coronary complication and of coronary aneurysm at the sub-acute stage of the single dose group were 5.1% and 1.6%, significantly lower than those of the 4 - 5 d group (11.6% and 4.7%) and 2 d group (9.8% and 5.4%, P = 0.035 - 0.047) were significantly lower in single dose group (5.1% and 1.6%) as compared to those in 4 - 5 d group and (11.6% and 4.7%) and 2 d group (9.8% and 5.4%) (P = 0.035 - 0.047). CONCLUSION: IVIG 2 g/kg in a single dose has lower rates of coronary complications and IVIG non-responders in children with KD, and is recommended for initial KD therapy.

[Study on the correlation between the expressions of nm23H1 mRNA, VEGF-C mRNA and lymphatic metastases, survival rate with gastric cancer].

The correlations between the expression of nm23H1 mRNA,VEGF-C mRNA, VEGFR-3 and neoangiogenesis, hyperplasia of micro-lymphatic, tumor metastases in gastric cancer were studied, the results supplied an experimental foundation for clinical treatment and prognosis. All the specimens were marked by VEGFR-3 antibody, the expressions of nm23H1 mRNA, VEGF-C mRNA were detected in 78 cases of gastric cancer in situ hybridization with EnVision and Leica-Qwin computer image analysis system. The Weidner's highest vessel density counting method was used to analyse micro-lymphatics count (MLC) of the specimens, and the patients' viability after operation was investigated. The positive expression of nm23H1 mRNA in gastric cancer was 69.23% (54 cases). There was negative correlation between the positive expression of nm23H1 mRNA and lymph node metastasizing, TNM staging, MLC (P < 0.01 or P < 0.05). The expression of VEGF-C mRNA was 46.15% (36 cases). It was positive related to the lymph node metastasis, TNM stages, MLC in gastric cancer (P < 0.01 or P < 0.05), and was significantly different compared with adjacent nontumorous tissue (P < 0.01 or 0.05). The expression of nm23H1 in stage I and II gastric cancer was high, while in stage III and IV the expression was lower or even none. The MLC (8.37 +/- 2.29/mm2) in gastric cancer was higher than that in adjacent nontumorous tissue (4.82 +/- 3.48/mm2), which has statistical significance (P < 0.05). There was negative correlation between the expression of nm23H1 mRNA and VEGFR-3 (p < 0.05, r = 0.8479), but positive correlation between VEGF-C mRNA and VEGFR-3 (P < 0.05, r = 0.8362). The MLC (10.82 +/- 2.51/mm2) in those who died in five years (48 cases) was higher than that (6.53 +/- 2.09/mm2) in those who were still alive, the difference has statistical significance (P < 0.05). In different tumor pathology grading, different differentiation, the nm23H1 positive expression is significantly different (P < 0.05). Higher the nm23H1 expressed, lower the tumor lymph metastasized, but the viability rate was higher, so the nm23H1 gene was thought to have the effect of suppressing gastric cancer occurring and lymph metastasizing. Higher the VEGF-C mRNA expressed, higher the tumor lymph metastasized, but the viability rate was lower. There is close correlation between the VEGFR-3 expression and gastric cancer lymph metastasizing. The higher MLC level indicated neoangiogenesis in gastric cancer. VEGF-C promote neoangiogenesis induced by tumor and play an important role in lymph metastasizing.

[Study on the correlationship between the expression of nm23H1mRNA, TGF-beta1mRNA and tumor metastases, survival rate with prostate cancer].

All the specimens were marked by CD31 antibody, the expression of nm23HlmRNA, TGF-beta1mRNA was detected in 42 cases of prostate cancer in situ hybridization with EnVision and Leica-Qwin computer image analysis system. The Weidner's highest vessel density counting method was used to analysis the microvessel density(MVD) of the specimens,and the patients' viability rate after operation was investigated. The correlation between the expression of nm23H1mRNA, TGF-betamRNA,CD31 and neoangiogenesis, hyperplasia of microvessel, tumor metastases in prostate cancer was studied. The positive expression of nm23H1mRNA in prostate cancer was 66.67% (28 cases). There was negative correlation between the positive expression of nm23H1mRNA and bone metastasizing, TNM staging,MVD in prostate cancer (P < 0.05). The positive expression of TGF-beta1mRNA was 78.75% (33 cases), and was positive correlative to the bone metastasis, TNM stages, MVD in prostate cancer (P < 0.05). It is significantly different (P < 0.01 or P < 0.05) with that in adjacent nontumorous tissue. The MVD (78.51 +/- 10.29/mm2) in prostate cancer was significantly (P < 0.05) higher than that in adjacent nontumorous tissue (34.19 +/- 9.27/mm2). The MVD (92.41 +/- 15.42/mm2) in those who died in five years (18 cases) was significantly higher (P < 0.05) than that (62.79 +/- 13.58/mm2) in those who were still alive. In tumor pathology grading,different differentiation, the difference of nm23H1mRNA positive expression was statistically significant (P < 0.05). Higher the nm23H1mRNA expressed,lower the bone metastasized,and higher the viability rate was. Therefore, the nm23H1 gene was thought to have the effect of suppressing prostate cancer occurring and bone metastasizing. Higher the TGF-beta1mRNA expressed, higher the tumor bone metastasized, and lower the viability rate was. Therefore, the TGF-beta1 gene was thought to have the promote genesis and metastasize of prostate cancer. There is close correlation between the CD31 expression, MVD and prostate cancer bone metastasizing. The higher MVD level indicated neoangiogenesis in prostate cancer. TGF-beta1mRNA promote neoangiogenesis induced by tumor and play an important role in bone metastasizing.

[Correlation between the expression of VEGF-C mRNA, VEGFR-3, CD31 and tumor metastases in Chinese with prostate cancer].

The expressions of VEGF-C mRNA, VEGFR-3 and CD31 were studied in order to investigate the correlation between them and neoangiogenesis, hyperplasia of micro-lymphatics and tumor metastases. 34 cases of prostate cancer tissue and 12 cases of adjacent nontumorous tissue specimens were tested. They were marked by VEGFR-3 and CD31 with immunohistochemistic staining and analyzed with image, the micro-lymphatics count (MLC) and microvessel density (MVD) were counted using Weidner's highest vessel density count method; the expression of VEGF-C mRNA was inspected in situ hybridization. The expression of VEGF-C mRNA was 44.12% positive in 34 cases of prostate cancer, the MLC (8.26 +/- 2.73)mm2 and MVD (74.82 +/- 11.76)mm2 in prostate cancer were significantly higher than those in adjacent nontumorous tissue (MLC, 4.82 +/- 3.48/mm2; MVD, 32.86 +/- 5.41/mm2). In addition, there was a correlation between the expression of VEGF-C mRNA and micro-lymphatics metastases and there was a positive correlation between the expression of VEGFR-3 and CD31. The expressions of VEGF-C mRNA , MLC, MVD in stage III and IV and those who have lymph metastasis were higher than those in stage I and II and those who have no lymph metastasis; the expressions of VEGFR-3 and CD31 in VEGF-C mRNA positive groups were significantly higher than those in negative groups. The difference of histopathologic grading in prostate cancer had no statistical significance. VEGF-C could accelerate the hyperplasia of micro-lymphatics and neoangiogenesis induced by tumor and play an important role in tumor lymph metastases. There was a close correlation between the expressions of VEGFR-3, CD31 and tumor metastases. The increase of MLC and MVD on prostate cancer indicated the hyperplasia of new micro-lymphatics and neoangiogenesis in the tumor tissue, which could also be a signal to determine the tumor metastases in clinic.

[Early diagnosis of the premature infant nosocomial infection by clinical assessment].

OBJECTIVE: To study the possibility of bacterial infections in the hospital among the premature and low birth weight newborns by scoring their clinical assessments and laboratory examinations. METHODS: From January 2002 to January 2003, 62 newborns with birth-weight less than 2,000 g were divided into two groups, infected group and control group, based on the current diagnostic standards for newborns. We scored the newborns according to the severity of their illnesses based on their clinical manifestations and laboratory examination, and compared the scores obtained before and after effective antibiotic treatment. RESULTS: It was found that the scores were significantly different (P < 0.01) between the infected group and the control group before treatment; while after antibiotic treatment, the difference was no longer significant (P > 0.05). In the infected group, the scores obtained pre- and post-treatment were significantly different (P < 0.01). In the control group, in those with the scores >or= 11 before antibiotic treatment, the scores significantly decreased (P < 0.01) after-treatment; but in those with the scores < 11, the score did not decrease (P > 0.05). These results indicate that the current diagnostic criteria for newborns may not be sensitive enough for premature infants, low birth weight infants and very low birth weight infants. CONCLUSION: Scoring the low birth weight premature infants with their clinical manifestations has the advantages in judging the possibility of infection and monitoring the effectiveness of the anti-infection treatment.

[The enteral feeds in very low birthweight infants].

OBJECTIVE: The study aimed to investigate the clinical characteristics of enteral feeding in very low birthweight infants (VLBWI), to determine the risk factors associated with feeding intolerance, and to analysis the beneficial factors in order to improve gut motility and maturation. METHODS: The study was carried out in 38 VLBWI, birthweight (1,314 +/- 180) g, in the NICU of authors' department. They were divided into feeding tolerance and intolerance groups, and earlier enteral feeding and later groups. Comparison was made between two groups about the associate factors. RESULTS: The incidence of feeding intolerance was 55 per cent. There was a significant difference in two groups about the clinical factors (gestational age, birth weight, the age of the first feeding, time of full enteral feeding and the hospitalized days). The significant risk factors associated with feeding intolerance were the smaller gestational age, umbilical catheterization, theophylline therapy, and delay of the time when the first feed was commenced. CONCLUSION: If vital signs are stable, trophic feeding in VLBWI should be commenced as soon as possible during the first 6 days of life. Early trophic feeding, slowly increase the feeding volume, carefully fast, and moving bowel were suggested and will improve feeding tolerance and gastrointestinal maturation.