Analgesic effect of buccal acupuncture on patients after lumbar spinal fusion: a randomized controlled trial / 中国针灸

OBJECTIVE@#To observe the effect of buccal acupuncture on pain after lumbar spinal fusion.@*METHODS@#Sixty patients undergoing lumbar spinal fusion were randomly divided into an observation group (30 cases, 1 case dropped off) and a control group (30 cases, 1 case was eliminated). The patients in the control group were treated with routine anesthesia. On the basis of the control group, the patients in the observation group were treated with buccal acupuncture at bilateral back point, waist point, and sacral point for 30 min per treatment. The first acupuncture was given before anesthesia induction, and then once a day postoperation for two days, totally 3 treatments. The dosage of sufentanil, the number of remedial analgesia, and the incidence of nausea and vomiting within 48 h after surgery were compared between the two groups; rest and motion visual analogue scale (VAS) scores at 2 (T1), 8 (T2), 12 (T3), 24 (T4), and 48 (T5) h after surgery were observed; the quality of recovery-15 scale (QoR-15) at 24 and 48 h after surgery were evaluated.@*RESULTS@#The dosage of sufentanil and the number of remedial analgesia within 48 h after surgery in the observation group were lower than those in the control group (P<0.01). There was no significant statistically difference in rest and motion VAS scores between the two groups in T1, T2, T3, T4 and T5 (P>0.05). The QoR-15 scores in the observation group at 24 and 48 h after surgery were higher than those in the control group (P<0.01). The incidence of nausea in the observation group was lower than that in the control group (P<0.05).@*CONCLUSION@#Buccal acupuncture could reduce the amount of postoperative analgesic drugs of patients after lumbar spinal fusion, and promote early postoperative recovery.

Clinical treatment outcomes and their changes in extremely preterm twins: a multicenter retrospective study in Guangdong Province, China / 中国当代儿科杂志

OBJECTIVES@#To investigate the clinical treatment outcomes and the changes of the outcomes over time in extremely preterm twins in Guangdong Province, China.@*METHODS@#A retrospective analysis was performed for 269 pairs of extremely preterm twins with a gestational age of <28 weeks who were admitted to the department of neonatology in 26 grade A tertiary hospitals in Guangdong Province from January 2008 to December 2017. According to the admission time, they were divided into two groups: 2008-2012 and 2013-2017. Besides, each pair of twins was divided into the heavier infant and the lighter infant subgroups according to birth weight. The perinatal data of mothers and hospitalization data of neonates were collected. The survival rate of twins and the incidence rate of complications were compared between the 2008-2012 and 2013-2017 groups.@*RESULTS@#Compared with the 2008-2012 group, the 2013-2017 group (both the heavier infant and lighter infant subgroups) had lower incidence rates of severe asphyxia and smaller head circumference at birth (P<0.05). The mortality rates of both of the twins, the heavier infant of the twins, and the lighter infant of the twins were lower in the 2013-2017 group compared with the 2008-2012 group (P<0.05). Compared with the 2008-2012 group, the 2013-2017 group (both the heavier infant and lighter infant subgroups) had lower incidence rates of pulmonary hemorrhage, patent ductus arteriosus (PDA), periventricular-intraventricular hemorrhage (P-IVH), and neonatal respiratory distress syndrome (NRDS) and a higher incidence rate of bronchopulmonary dysplasia (P<0.05).@*CONCLUSIONS@#There is a significant increase in the survival rate over time in extremely preterm twins with a gestational age of <28 weeks in the 26 grade A tertiary hospitals in Guangdong Province. The incidences of severe asphyxia, pulmonary hemorrhage, PDA, P-IVH, and NRDS decrease in both the heavier and lighter infants of the twins, but the incidence of bronchopulmonary dysplasia increases. With the improvement of diagnosis and treatment, the multidisciplinary collaboration between different fields of fetal medicine including prenatal diagnosis, obstetrics, and neonatology is needed in the future to jointly develop management strategies for twin pregnancy.

Chemical constituents of Physalis minima / 中国中药杂志

Fifteen compounds(1-15) were isolated from the 95% EtOH extract of the whole herb of Physalis minima by various chromatography techniques including silica gel, Sephadex LH-20, middle chromatogram isolated gel(MCI), octadecyl silica(ODS), and semi-preparative high performance liquid chromatography(HPLC). Their structures were elucidated by infrared spectroscopy(IR), ultraviolet spectroscopy(UV), high-resolution electrospray ionization mass spectrometry(HR-ESI-MS), nuclear magnetic re-sonance(NMR), and circular dichroism(CD) as(5S)-5,11-dihydroxy-3-methyl-5-pentylfuran-2(5H)-one(1), withaphysalin R(2), withaphysalin Q(3), withaphysanolide A(4), phaseic acid(5), grasshopper ketone(6), 3S,5R-dihydroxy-6S,7-megastigmadien-9-one(7), vanillic acid(8), 2-trans,4-trans-abscisic acid(9), capillasterolide(10), 5,3'-dihydroxy-3,7,4'-trimethoxyflavone(11),(-)-loliolide(12), 4-hydroxyacetophenone(13), acetosyringone(14), and aurantiamide acetate(15). Compound 1 was a new butenolide, and compounds 5-7 and 10-12 were isolated from the Physalis for the first time. Compounds 4, 13, and 15 were isolated for the first time from P. minima. Moreover, their anti-inflammatory activity was evaluated in vitro. Compound 12 was found to possess an inhibitory effect on the transcription of an NF-κB-dependent reporter gene in LPS-induced 293 T/NF-κB-luc cells at 10 μmol·L~(-1), showing an inhibitory rate of 62.31%±4.8%.

Application of gene screening technology in screening common newborn genetic diseases / 中华实用儿科临床杂志

Objective:To detect the genes of common genetic diseases in newborns with the high-throughput sequencing technology based on target gene capture, to study the incidence rate of such diseases, the carrying rate and variant types of pathogenic mutations related to such diseases, and to explore the application value of the high-throughput sequencing technology in screening genetic diseases of newborns.Methods:The heel blood of 1 793 newborns born in Guangdong province from June 2019 to April 2020 were collected, and the exon regions of 138 common genetic disease-related genes in neonates were detected using the high-throughput sequencing technology based on target gene capture.The pathogenicity of the mutations was interpreted according to the " Classification Criteria and Guidelines for Genetic Variation(2017)" , in which known disease and probable disease were considered as positive mutations.The positive mutations were verified by Sanger sequencing technology, and the test results were analyzed with statistical methods.Results:Among the 1 793 newborns, 978 were male and 815 were female.A total of 158 positive cases were screened(8.81%), and 11 positive diseases were detected.Among the positive diseases, there were 41 cases(2.29%)of autosomal recessive deafness type 1A, 40 cases(2.23%)of Gilbert syndrome or Crigler-Najjar syndrome, and 33 cases(1.84%)of glucose-6-phosphate dehydrogenase deficiency(1.84%), 19 cases(1.06%)of familial hypercho-lesterolemia, 18 cases(1.00%) of sodium taurocholate cotransporter peptide deficiency disease, 2 cases(0.11%)of mitochondrial non-syndromic deafness, 2 cases(0.11%)of Citrin deficiency, 1 case(0.06%)of holocarboxylase synthase deficiency, 1 case(0.06%)of β-thalassemia and 1 case(0.06%)of metachromatic leukodystrophies.Of all studied cases, 972 carried one or more positive mutations, involving 85 kinds of diseases in total.The diseases with a high carrying rate were Gilbert syndrome or Crigler-Najjar syndrome(359 cases, 20.02%), autosomal recessive deafness type 1A(302 cases, 16.84%), and sodium taurocholate cotransport peptide deficiency disease(291 cases, 16.22%). The high-frequency mutation sites were UGT1A1 gene c. 211G> A, GJB2 gene c .109G> A and SLC10A1 gene c. 800C> T. Conclusions:The common genetic diseases detected in neonates from Guangdong province are autosomal recessive deafness type 1A, Gilbert syndrome or Crigler-Najjar syndrome, glucose-6-phosphate dehydrogenase deficiency, familial hypercholesterolemia, and sodium taurocholate cotransport peptide deficiency.There are high-frequency carrying mutation sites in the population.Preliminary genetic screening of common neonatal genetic diseases can accumulate data and experience for the development of newborn genetic screening.

mRNA expression of MDR3 gene in the blood of preterm infants with parenteral nutrition-associated cholestasis / 中国当代儿科杂志

OBJECTIVE@#To study the association between the expression of the MDR3 gene and the pathogenesis of parenteral nutrition-associated cholestasis (PNAC) in preterm infants.@*METHODS@#Among the preterm infants who were admitted to the hospital from June 2011 to November 2017 and received parenteral nutrition for more than 14 days, 80 who did not develop PNAC were enrolled as non-PNAC group, and 76 who developed PNAC were enrolled as PNAC group. On days 1, 14, 30, 60 and 90 after birth, serum hepatobiliary biochemical parameters [alanine aminotransferase (ALT), total bilirubin (TBil), direct bilirubin (DBil), total bile acid (TBA) and gamma-glutamyl transpeptidase (γ-GT)], fibrosis indices [hyaluronic acid, laminin, procollagen III N-terminal peptide and type IV collagen] and clinical manifestations were observed. Real-time quantitative PCR was used to measure the mRNA expression of MDR3 in both groups, and the correlation between the mRNA expression of MDR3 and serum hepatobiliary biochemical parameters was analyzed.@*RESULTS@#In the PNAC group, serum levels of hepatobiliary biochemical parameters and fibrosis indices increased on day 14 after birth and reached the peak on day 30 after birth, followed by a reduction on day 60 after birth. On days 14, 30, 60 and 90 after birth, the PNAC group had significantly higher serum levels of hepatobiliary biochemical parameters and fibrosis indices than the non-PNAC group (P<0.05). The PNAC group had higher relative mRNA expression of MDR3 in peripheral blood cells than the non-PNAC group (P<0.05). In the PNAC group, the relative mRNA expression of MDR3 in peripheral blood cells was negatively correlated with serum levels of hepatobiliary biochemical parameters (ALT, TBil, DBil, TBA and γ-GT) (P<0.001).@*CONCLUSIONS@#High mRNA expression of MDR3 in preterm infants may be associated with the development of PNAC, and further studies are needed to identify the mechanism.

Effect of B Lymphocyte-Induced Mature Protein-1 Expression in Bone Marrow Mononuclear Cells on Prognosis of Patients with Multiple Myeloma / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To study the effect of B lymphocyte-induced mature protein-1(Blimp1) expression in bone marrow mononuclear cells on the prognosis of patients with multiple myeloma.</p><p><b>METHODS</b>Forty-eight patients with multiple myeloma from January 2014 to January 2015 were selected. The expression of Blimp1 in the bone marrow of all the patients was measured. According to the median score of Blimp1 expression level, the patients was divided into low expression group (L group, 22 cases) and high expression group (H group, 26 cases). The related influencing factors of different Blimp1 expression levels, the clinical efficacy, immunophenotypic changes and progression-free survival(PFS) were compared between different Blimp1 expression groups.</p><p><b>RESULTS</b>There were no significant differences in sex, age, type, stage and treatment stage between the 2 groups (P> 0.05). The total remission rate of the low expression group was significantly higher than that in the high expression group (P<0.05). However before treatment, there was no significant difference in the positive rate of CD19, CD38, CD56, CD138 and minimal lesion between the 2 groups (P> 0.05); after treatment the positive expression rates of CD38, CD56, CD138 and minimal lesion in the low expression group were significantly lower than those in the high expression group. While the positive expression rate of CD19 was significantly higher than that in high expression group (P<0.05). The PFS of 1, 2 and 3 years in the low expression group was significantly higher than that in the high expression group (P<0.05).</p><p><b>CONCLUSION</b>The MM patients with the high in staging and the larger in diffeculty of treatment possess high Blimp1 expression, however, the therapeutic efficacy and prognosis of MM patients with low Blimp1 expression are significantly better than those of MM patients with high Blimp1 expression.</p>

Regulating effect of glycyrrhetinic acid on bronchial asthma smooth muscle proliferation and apoptosis as well as inflammatory factor expression through ERK1/2 signaling pathway

Objective To study the influence of glycyrrhetinic acid (GA) on bronchial asthma (BA) smooth muscle proliferation and apoptosis as well as inflammatory factor expression and its molecular mechanism. Methods Male SD guinea pigs were selected and made into asthma models, bronchial asthma smooth muscle cells were cultured and divided into BA group, GA group and GA + LM group that were treated with serum-free RPMI1640 culture medium, serum-free RPMI1640 culture medium containing 50 ng/mL glycyrrhetinic acid, serum-free RPMI1640 culture medium containing 50 ng/mL glycyrrhetinic acid and 100 ng/mL LM22B-10 respectively; normal guinea pigs were collected and bronchial smooth muscle cells were cultured as control group. The cell proliferation activity as well as the expression of proliferation and apoptosis genes, inflammatory factors and p-ERK1/2 was determined. Results Proliferation activity value and mRNA expression of Bcl-2, TNF-α IL-4, IL-6, YKL-40, protein expression of p-ERK1/2 of airway smooth muscle cell in BA group were significantly higher than those of control group while mRNA expression levels of Bax, caspase-9 as well as caspase-3 were significantly lower than that of control group (P < 0.05); proliferation activity value and mRNA expression of Bcl-2, TNF-α IL-4, IL-6, YKL-40, protein expression of p-ERK1/2 of airway smooth muscle cell in GA group were significantly lower than those of BA group (P < 0.05) while the mRNA expression levels of Bax, caspase-9 as well as caspase-3 were significantly higher than those of BA group (P < 0.05); proliferation activity value and mRNA expression of Bcl-2, TNF-α IL-4, IL-6, YKL-40 of airway smooth muscle cell in GA + LM group were significantly higher than those of GA group (P < 0.05) while mRNA expression levels of Bax, caspase-9 as well as caspase-3 were significantly lower that of GA group (P < 0.05). Conclusion GA can inhibit the proliferation of bronchial smooth muscle cells and reduce the expression of inflammatory factors by inhibiting the phosphorylation of ERK1/2.

Regulating effect of glycyrrhetinic acid on bronchial asthma smooth muscle proliferation and apoptosis as well as inflammatory factor expression through ERK1/2 signaling pathway

OBJECTIVE@#To study the influence of glycyrrhetinic acid (GA) on bronchial asthma (BA) smooth muscle proliferation and apoptosis as well as inflammatory factor expression and its molecular mechanism.@*METHODS@#Male SD guinea pigs were selected and made into asthma models, bronchial asthma smooth muscle cells were cultured and divided into BA group, GA group and GA + LM group that were treated with serum-free RPMI1640 culture medium, serum-free RPMI1640 culture medium containing 50 ng/mL glycyrrhetinic acid, serum-free RPMI1640 culture medium containing 50 ng/mL glycyrrhetinic acid and 100 ng/mL LM22B-10 respectively; normal guinea pigs were collected and bronchial smooth muscle cells were cultured as control group. The cell proliferation activity as well as the expression of proliferation and apoptosis genes, inflammatory factors and p-ERK1/2 was determined.@*RESULTS@#Proliferation activity value and mRNA expression of Bcl-2, TNF-α, IL-4, IL-6, YKL-40, protein expression of p-ERK1/2 of airway smooth muscle cell in BA group were significantly higher than those of control group while mRNA expression levels of Bax, caspase-9 as well as caspase-3 were significantly lower than that of control group (P < 0.05); proliferation activity value and mRNA expression of Bcl-2, TNF-α, IL-4, IL-6, YKL-40, protein expression of p-ERK1/2 of airway smooth muscle cell in GA group were significantly lower than those of BA group (P < 0.05) while the mRNA expression levels of Bax, caspase-9 as well as caspase-3 were significantly higher than those of BA group (P < 0.05); proliferation activity value and mRNA expression of Bcl-2, TNF-α, IL-4, IL-6, YKL-40 of airway smooth muscle cell in GA + LM group were significantly higher than those of GA group (P < 0.05) while mRNA expression levels of Bax, caspase-9 as well as caspase-3 were significantly lower that of GA group (P < 0.05).@*CONCLUSION@#GA can inhibit the proliferation of bronchial smooth muscle cells and reduce the expression of inflammatory factors by inhibiting the phosphorylation of ERK1/2.

Effect of nucleolin silencing on differentiation of rat neural stem cells in vitro and the molecular mechanism / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the effect of nucleolin silencing on the differentiation of rat neural stem cells (NSCs) and the role of Wnt signaling pathway in mediating such effect.</p><p><b>METHODS</b>Adenovirus vectors expressing small interfering RNA (siRNA) against nucleolin were constructed, verified, and packaged in HEK293A cells. The adenovirus was then transfected into NSCs isolated from neonatal SD rats and the differentiation of the NSCs was examined by detecting the expressions of neuron specific encloase (NSE) and glial fibrillary acidic protein (GFAP) using immunocytochemistry. The expressions of nucleolin, nestin, Wnt3, and β-catenin in the cells were determined with Western blotting.</p><p><b>RESULTS</b>Restriction endonuclease and sequencing analysis verified successful construction of the adenoviral vector expressing nucleolin siRNA (nucleolin-siRNA2). Infection of rat NSCs with nucleolin-siRNA2 significantly lowered nucleolin protein expression as compared with that in negative and blank control groups (P<0.05). The percentages of NSE-positive cells and GFAP-positive cells were significantly higher in NSCs infected with nucleolin-siRNA (P<0.01); the infection also resulted in obviously lowered expression of nestin protein and increased expressions of Wnt3 protein and β-catenin nucleoprotein in the cells.</p><p><b>CONCLUSIONS</b>Nucleolin silencing by adenovirus-mediated RNA interference induces the differentiation of NSCs into neurons and astrocytes, which is related with the activation of Wnt signaling pathway.</p>

Evaluation of white matter myelination in preterm infants using DTI and MRI / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the features of white matter myelin development in preterm infants using magnetic resonance imaging (MRI) and diffusion tensor imaging (DTI).</p><p><b>METHODS</b>A total of 31 preterm infants with a gestational age of ≤32 weeks and a birth weight of <1 500 g were enrolled. According to head MRI findings, these infants were divided into preterm group with brain injury (12 infants) and preterm group without brain injury (19 infants). A total of 24 full-term infants were enrolled as control group. Head MRI and DTI were performed at a gestational age or corrected gestational age of 37-40 weeks. Fractional anisotropy (FA) and apparent diffusion coefficient (ADC) were measured for the same regions of interest in the three groups.</p><p><b>RESULTS</b>The preterm group with brain injury showed a significantly lower FA value of the posterior limb of the internal capsule than the preterm group without brain injury and full-term control group (P<0.05). The preterm groups with and without brain injury showed significantly lower FA values of frontal white matter and lenticular nucleus than the full-term control group (P<0.05). The FA value of occipital white matter showed no significant differences among the three groups (P>0.05). Compared with the full-term control group, the preterm groups with and without brain injury showed significantly higher ADC values of the posterior limb of the internal capsule, lenticular nucleus, occipital white matter, and frontal white matter (P<0.05).</p><p><b>CONCLUSIONS</b>After brain injury, preterm infants tend to develop disorder or delay of white matter myelination in the posterior limb of the internal capsule. At a corrected full-term gestational age, the preterm infants with and without brain injury have a lower grade of maturity in periventricular white matter and grey matter than full-term infants.</p>

Value of early application of different doses of amino acids in parenteral nutrition among preterm infants / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To study the short-term response and tolerance of different doses of amino acids in parenteral nutrition among preterm infants.</p><p><b>METHODS</b>This study included 86 preterm infants who had a birth weight between 1 000 to 2 000 g and were admitted to the hospital within 24 hours of birth between March 2013 and June 2014. According to the early application of different doses of amino acids, they were randomized into low-dose group (n=29, 1.0 g/kg per day with an increase of 1.0 g/kg daily and a maximum of 3.5 g/kg per day), medium-dose group (n=28, 2.0 g/kg per day with an increase of 1.0 g/kg daily and a maximum of 3.7 g/kg per day), and high-dose group (n=29, 3.0 g/kg per day with an increase of 0.5-1.0 g/kg daily and a maximum of 4.0 g/kg per day). Other routine parenteral nutrition and enteral nutrition support were also applied.</p><p><b>RESULTS</b>The maximum weight loss was lower and the growth rate of head circumference was greater in the high-dose group than in the low-dose group (P<0.05). The infants in the medium- and high-dose groups had faster recovery of birth weight, earlier attainment of 100 kcal/(kg·d) of enteral nutrition, shorter duration of hospital stay, and less hospital cost than those in the low-dose group (P<0.05). Blood urea nitrogen (BUN) levels in the high-dose group increased compared with the other two groups 7 days after birth (P<0.05). The levels of creatinine, pH, bicarbonate, bilirubin, and transaminase and the incidence of complications showed no significant differences between groups (P>0.05).</p><p><b>CONCLUSIONS</b>Parenteral administration of high-dose amino acids in preterm infants within 24 hours after birth can improve the short-term nutritional status of preterm infants, but there is a transient increase in BUN level.</p>

Relationship between plasma motilin level and feeding intolerance in preterm infants / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To observe changes in plasma motilin (MOT) level among preterm infants after birth, to investigate the relationship between plasma motilin level and feeding intolerance (FI), and to clarify the possible risk factors.</p><p><b>METHODS</b>A total of 112 preterm infants were divided into feeding tolerance (FT) group (n=59) and FI group (n=53). Their plasma MOT levels were measured by radioimmunoassay on days 1, 4, 7 and 14 of life. The clinical data of FI group were collected and subjected to multivariate logistic regression analysis.</p><p><b>RESULTS</b>Compared with the FT group, the FI group showed significantly lower plasma MOT levels on days 1, 4, 7 and 14 of life (P<0.05), and there was a positive correlation between plasma MOT level and gestational age, age in days, and volume of enteral feeding in the FI group. The lower the gestational age, the longer the FI duration. There was a negative correlation between the plasma MOT level on day 1 of life and the FI duration (r=-0.913, P<0.001). Gestational age and prenatal use of glucocorticoid were protective factors for FI, while fetal distress, placental abnormality and perinatal infection were risk factors for FI.</p><p><b>CONCLUSIONS</b>Change in plasma MOT level may be closely related to the development of FI in preterm infants. Early monitoring of plasma MOT level may be useful for predicting the occurrence of FI.</p>

Relationship between plasma levels of vasoactive intestinal peptide and feeding intolerance in preterm infants / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To study the changes of plasma vasoactive intestinal peptide (VIP) levels and the relationship of plasma VIP levels with feeding intolerance (FI) in preterm infants.</p><p><b>METHODS</b>Plasma VIP concentrations were measured using radioimmunoassay in 53 preterm infants with FI 1, 4, 7 and 14 days after birth. Fifty-nine preterm infants without FI served as the control group.</p><p><b>RESULTS</b>The fasting plasma concentrations of VIP in the FI group 1, 4 and 7 days after birth (129 ± 46, 144 ± 32 and 166 ± 31 pg/mL respectively) were significantly lower than those in the control group (195 ± 63, 197 ± 31 and 205 ± 34 pg/mL respectively) (P<0.05). The increased plasma VIP concentrations were associated with the increased gestational age, age in days and enteral feeding volume in the FI group. By 14 days, the plasma concentrations of VIP in the FI group (198 ± 41 pg/mL) were similar to those in the control group (202 ± 48 pg/mL) (P>0.05). The younger the infant's gestational age, the more prolonged the FI. Plasma levels of VIP on day 1 of life in the FI group were negatively correlated with the duration of FI (r=-0.799, P<0.05).</p><p><b>CONCLUSIONS</b>Plasma levels of VIP might be related to the development of FI in preterm infants and might serve as a predictor of FI.</p>

Relationship between serum estradiol levels in the early postnatal period and the occurrence of hyaline membrane disease and bronchopulmonary dysplasia in neonates / 中国当代儿科杂志

<p><b>OBJECTIVE</b>This study examined the changes of serum levels of estradiol during the early postnatal period in neonates in order to investigate the possible relationship between the serum estradiol levels and the occurrence of pulmonary hyaline membrane disease (HMD) and bronchopulmonary dysplasia (BPD).</p><p><b>METHODS</b>Fifty-nine premature infants with the gestational age between 26 and 32 weeks and 61 full-term infants with the gestational ages between 37 and 42 weeks were enrolled. Serum levels of estradiol were measured on postnatal days 1, 3 and 7.</p><p><b>RESULTS</b>Serum levels of estradiol decreased rapidly after birth in both premature and term infants and there were significant differences among different postnatal ages groups. However, there were no significant differences in the serum estradiol levels between the premature and term groups on postnatal days 1, 3 and 7. Serum estradiol levels measured in premature infants with HMD were not statistically different from those in premature infants without HMD on all time points. Serum estradiol levels in premature infants with BPD were higher than those in premature infants without BPD on postnatal day 3, but there were no noticeable differences on postnatal days 1 and 7.</p><p><b>CONCLUSIONS</b>Serum estradiol levels decline rapidly within 7 days after birth in both premature and term infants. Serum estradiol levels in the early postnatal period are not associated with the occurrence of HMD and BPD, suggesting that serum estradiol in the early postnatal period can not be used as a marker for predicting the development of HMD and BPD.</p>

Expression of caspase-3 in rat kidney with renal tubular damage induced by lipopolysaccharide and hypoxia / 南方医科大学学报

<p><b>OBJECTIVE</b>To observe the expression of caspase-3 in the kidney of a rat model of renal tubular damage induced by endotoxin and hypoxia and explore the mechanism of renal tubular damage.</p><p><b>METHODS</b>Ten rats were anesthetized with artificial ventilation and received 2 mg/kg lipopolysaccharide (LPS) injection through the penile vein. The FiO2 was reduced 90 min later from 21% to 5%, and the ventilation was withdrawn after another 90 min. Immediately after ventilation withdrawal, the kidney of the rats were obtained for immunocytochemistry and HE staining.</p><p><b>RESULTS</b>HE staining showed obvious hyperemia in most of the glomeruli, mild swelling of the endothelial and mesangial cells, severe swelling and turbidity in the proximal tubular epithelial cells without obvious changes in most of the distal proximal tubules. A small portion of the interstitial epithelial cells showed swelling and turbidity, and the entire renal interstitium appeared hyperemic but without inflammatory cell infiltration. Immunocytochemistry detected the presence of caspase-3 in the cytoplasm, and most of the distal renal tubule cells were positive for caspase-3, while only occasional cells showed caspase-3 positivity in the proximal tubular epithelial cells. Most of the proximal tubular epithelial and glomerulus cells were negative for caspase-3.</p><p><b>CONCLUSIONS</b>Endotoxin and hypoxia can induce renal damage, particularly in the proximal renal tubule cells, and the distal tubular epithelial cells sustain relatively light damage. Caspase-3 is strongly expressed in the distal renal tubular cells, suggesting that in renal tubular damage induced by endotoxin and hypoxia, cell degeneration, necrosis and apoptosis coexist in the tubular epithelial cells; degeneration and necrosis occur primarily in the proximal tubular epithelial cells, while apoptosis is obvious in the distal renal cells.</p>

A difficult and complicated case study: neonatal intrahepatic cholestasis caused by citrin deficiency / 中国当代儿科杂志

Neonatal intrahepatic cholestasis caused by citrin deficiency (NICCD) is a kind of inborn errors of metabolism, with the main clinic manifestations of jaundice, hepatomegaly, and abnormal liver function indices. As a mitochondrial solute carrier protein, citrin plays important roles in aerobic glycolysis, gluconeogenesis, urea cycle, and protein and nucleotide syntheses. Therefore citrin deficiency causes various and complicated metabolic disturbances, such as hypoglycemia, hyperlactic acidemia, hyperammonemia, hypoproteinemia, hyperlipidemia, and galactosemia. This paper reported a case of NICCD confirmed by mutation analysis of SLC25A13, the gene encoding citrin. The baby (male, 6 months old) was referred to the First Affiliated Hospital with the complaint of jaundice of the skin and sclera, which it had suffered from for nearly 6 months. Physical examination showed obvious jaundice and a palpable liver 5 cm below the right subcostal margin. Liver function tests revealed elevated enzymatic activities, like GGT, ALP, AST, and ALT, together with increased levels of TBA, bilirubin (especially conjugated bilirubin), and decreased levels of total protein/albumin and fibrinogen. Blood levels of ammonia, lactate, cholesterol, and triglyceride were also increased, and in particular, the serum AFP level reached 319,225.70 microg/L, a extremely elevated value that has rarely been found in practice before. Tandem mass analysis of a dried blood sample revealed increased levels of free fatty acids and tyrosine, methionine, citrulline, and threonine as well. UP-GC-MS analysis of the urine sample showed elevated galactose and galactitol. The baby was thus diagnosed with suspected NICCD based on the findings. It was then treated with oral arginine and multiple vitamins (including fat-soluble vitamins A, D, E, and K), and was fed with lactose-free and medium-chain fatty acids enriched formula instead of breast feeding. After half a month of treatment, the jaundice disappeared, and the laboratory findings, including liver function indices, blood levels of ammonia, lactate and AFP, were returned to normal level. The baby was followed up for 6 months. It developed well, and the abnormal laboratory findings, including MS-MS and UP-GC-MS analysis results, have been corrected, except a slightly elevated lactate level sometimes. SLC25A13 gene mutation analysis for the patient revealed a compound heterozygote of mutation 851del4 and 1638ins23 and therefore NICCD was definitely diagnosed.

Study on Cysteinyl Leukotriene Receptor Antagonist Depressing Acute Asthma Airway Inflammation / 实用儿科临床杂志

Objective To investigate the effects of montelukast(MK),a selective cysteinyl leukotriene receptor 1 antagonist on interleukin(IL)-5 and eotaxin expression as well as serum total immunoglobulin E(IgE) production during MK treatment of mouse acute asthma airway inflammation.Methods Sensitized Balb/c mice were challenged by ovabumin(OVA)to establish the acute asthmatic mo-(del).Twenty-five mg/kg of MK(MK group) or Saline(Saline group)were given by intravenously for 3 days.Cellular infiltration of bronchoalveolar larvage fluid(BALF) were assessed by Wright staining.Production of IL-5 and eotaxin in the lung or BALF and serum IgE were determined by enzyme linked immunosorbent assay(ELISA).The expression of IL-5 and eotaxin mRNA were measured by semi-quantified reverse transcriptase-polymerase chain reaction(RT-PCR).Plasma MK level was determined by liquid chromatography.Results After 24 h OVA challenge,the numbers of total white blood cells,neutrophils and eosinophils(EOS)of BALF were(26.0?18.9)?10~7/L,(5.92?8.09)?10~7/L and(0.74?0.88)?10~7/L in MK treatment group.They were significantly reduced compared with those in Saline group,respectively(P80%.The level of IL-5 in BALF and lung tissue were(48.52?14.45) ng/L and(27.40?9.62) ng/g protein in MK group,which significantly declined compared with that in saline group;BALF eotaxin level declined too.Serum IL-5 and total IgE level were also significantly reduced;IL-5 mRNA expression in lung significantly decreased.Eotaxin and its mRNA expression in lung were not decreased significantly.Conclusion MK(exerts) its anti-inflammatory effect mainly through the suppression of IL-5 and IgE production.

Expression and action of vascular endothelial growth factor and its receptor in a rat model of retinopathy of prematurity / 中华儿科杂志

<p><b>OBJECTIVE</b>To explore the expression of vascular endothelial growth factor (VEGF) and its receptors (flt-1 and flk-1) in the retina of retinopathy of prematurity (ROP), and its relation to the alteration of retinal blood vessels.</p><p><b>METHODS</b>Eighty-six newborn Sprague-Dawley rats were randomly divided into hyperoxia and air groups, then each group was further divided into 1, 3, 7 and 14 days subgroups. The rats in hyperoxia group inhaled 75% oxygen and ROP model was thus set up. These animals were sacrificed respectively after 1, 3, 7 and 14 days, then the retinal endothelial cells were marked by CD34 to observe the change of retinal blood vessels. The expression of VEGF, flt-1 and flk-1 in the retina was measured by immunohistochemistry.</p><p><b>RESULTS</b>The retinal capillary density index (RCDI) in control group increased as days went on (F = 21.589, P < 0.01, but it was the least on the 7th day in hyperoxia group, after the rats had been returned to air for 7 days, RCDI increased significantly (F = 67.885, P < 0.01); In the control group, the expression of VEGF and flk-1 was the strongest in the retina on the 7th day, the result had significant difference as compared with the 1st and 14th day (P < 0.05). The expression of VEGF and flk-1 on the 7th day in hyperoxia group was weaker than that of control group (P < 0.05). But on the 14th day in hyperoxia group, they were stronger than that of control (P < 0.05). The localization of the expression of flt-1 was changed when blood vessels altered, but there was no significant difference in expression intensity as a whole (P > 0.05).</p><p><b>CONCLUSION</b>When the premature retina was exposed to hyperoxia, the expression of VEGF and flk-1 was reduced, and retinal blood vessels were also decreased; but the expression of VEGF and flk-1 was stronger in retina when premature rats were exposed to relative hypoxia, and the retinal blood vessels also increased significantly. It is concluded that VEGF and flk-1 may play important roles in the development of retinal blood vessels and its change in ROP. However, flt-1 has less effect compared with flk-1.</p>

Relationship between Serum Advanced Glycation End Products Levels of Diabetic Mothers and Adverse Cardiovascular Function of Newborn Infants / 实用儿科临床杂志

Objective To explore the relationship between serum advanced glycation end products(AGEs) levels in gestation diabetic mother(GDM) and cardiovascular function of newborn infants.Methods Sixty mid-gestation GDM and 72 late-gestation GDM fulfilling the inclusion criteria were recruited,72 mid-gestation and 80 late-gestation mothers with no pregnancy complications were collected as controls.Fasting blood glucose and serum AGEs levels were analyzed in each group.Clinical data of GDM and their babys were collected.Accor-ding to cardiovascular function of neonates,these neonates were divided into 2 groups:normal neonate group with normal cardiovascular function and anormal neonate group with anormal cardiovascular function.Maternal serum AGEs levels,blood glucose between mid-gestation groups and late-gestation groups were compared.Factors which affected the prevalence of complications of fetal outcome in GDM were analyzed.Results 1.Mid-gestation and late-gestation GDM groups had higher serum AGEs levels and fasting blood glucose compared with those of their respective controls(Pa0.05).3.Abnormal fetal outcome in GDM had significantly higher maternal serum AGEs levels than that in controls with normal fetal outcome(P

Analysis on Drug Resistance of Pathogenic Bacteria in Neonatal Hospital Infection / 实用儿科临床杂志

Objective To study the situation of pathogenic bacteria of neonate infection in hospital,so can guide clinical doctors use antibiotic rationally. Method The secretions of 159 neonates′ umbilous and eye matter orders were collected to be used as the specimen and the drug susceptibility experiment was done using MIC and K-B methods together in 159 neonates with hospital infection.Results One hundred and eighty-nine pathogenic bacterias were isolated from 1613 specimens.According to our materials,staphylococci aureus was the most important pathogenic bacteria,then staphylococci heamolyticus,staphylococci epidermidis,encherichia coli ,enterobater cloucac ,klebsiella pneumoniae.MRSA- positive rate was 52.6%,ESBLs-positive in E coli was 21%,inklebsiella pneumoniae was 20%.Drugs of sensitivity for Gram positive coccus were vancomycin(0) clindamycin(8.5%) cipnofloxacin(12.2%);the drugs of sensitivity for Gram negative ord were imipenem (4.4%),cipnofloxacin(5.3%),amikacin(12.7%).Conclusion It is instructive that use antibiotic rationally for controlling neonate infection in hospital.