Autosomal recessive complete signal transducer and activator of transcription 1 deficiency in a newborn: a case report / 中华围产医学杂志

We reported the clinical data of a neonate admitted to the Second Affiliated Hospital (Yuying Children's Hospital) of Wenzhou Medical University in November 2021 with autosomal recessive complete signal transducer and activator of transcription 1 ( STAT1) deficiency identified by whole exome sequencing. The baby boy received bacillus of calmette-guerin (BCG) vaccine 2 d after birth and presented with persistent high fever, increased white blood cell count and increased level of C-reactive protein (CRP) on 21 d after birth. Human cytomegalovirus (HCMV) was detected in both blood and bone marrow specimens. The patient improved after comprehensive treatment with antiviral agents, antibiotics and intravenous gammaglobulin. Oral anti-viral drugs were prescribed on discharge. However, the baby was rehospitalized due to a fever at 55 days. HCMV and Mycobacterium tuberculosis complex were detected in blood samples. The infant was transferred to the Children's Hospital of Fudan University due to persistent high fever even after active management and died after treatment withdrawal at 69 d after birth because of worsening infections and multiple organ failure. A homozygous mutation in the STAT1 gene was detected [c.1011_1012del, NM_007315: exon11: c.1011_1012del (p.V339Pfs*18)] and the child was diagnosed as autosomal recessive complete STAT1 deficiency. We concluded that the clinical manifestations of autosomal recessive complete STAT1 deficiency are bacterial infections caused by lethal low-pathogenic mycobacteria and life-threatening virus infections. Whole exome sequencing is of great value for early diagnosis and timely treatment. The prognosis of this disease is very poor, but the condition of the patients might be improved in a short period with early anti-tuberculosis and anti-viral treatment.

Research Progress on Immune Checkpoint Inhibitors in Treatment of Hepatocellular Carcinoma / 肿瘤防治研究

Hepatocellular carcinoma (HCC) is one of the most common causes of cancer-related death, and most patients with HCC are diagnosed at an advanced stage. Before 2017, tyrosine kinase inhibitors were the main drugs for the treatment of advanced hepatocellular carcinoma. With the emergence of immune checkpoint inhibitors (ICIs), immunotherapy has gradually brought new hope to such patients. At present, the combination of ICIs and other systemic or local treatments has become a potential strategy for the treatment of advanced hepatocellular carcinoma, and some of these combinations have been included in large-scale clinical trials. The main challenges of immunotherapy for advanced hepatocellular carcinoma include the exploration of predictive biomarkers, management of immune-related adverse events, and exploration of effective combination regimens. This article provides the latest research progress on the single or combined use of ICIs and other immunotherapy for hepatocellular carcinoma and discusses the limitations of current research and clinical application and the future development direction.

The role of DDX5 RNA helicases on cancer progression and development / 中国医师杂志

DDX5 helicase (DEAD box helicases 5), also known as P68, is an important member of an ATP dependent RNA helicase.Studies have shown that DDX5 is abnormally expressed in a variety of cancers, targeting a variety of tumor related signal pathways, regulating upstream and downstream factors to affect the occurrence, invasion and migration of tumor cells. This article describes the biological role of DDX5 in malignant tumors and provides prospects for targeted treatment of tumors.

Effects of abdominal massage on the exercise and balance of rats with neonatal hypoxic-ischemic brain injury via 5-HTR1A/cAMP/PKA signaling pathway / 国际中医中药杂志

Objective:To explore the effect of abdominal massage on the behavior of rats with neonatal hypoxia-ischemia and its mechanism.Methods:7-day-old SD rats were made as the HIBD model by the classical method of RICE and then the HIBD model rats were divided into the abdominal massage group and model group according to the random number table method, with 12 rats in each group, and 12 rats were selected as the normal group. The abdominal massage group was given abdominal massage 24 hours after the modeling, and the intervention continued for 28 days. Rats in each group underwent a balance beam test on the 7th, 14th, 21st, and 28th day of the intervention. After the intervention, HE staining was applied to observe the morphological structure of the hippocampal CA1 region of the rats; Quantitative Real-time PCR method was used to measure the serotonin receptor (5-HTR1A) in the hippocampus. The expression of cAMP, PKA and CREB in the hippocampus were measured by immunohistochemistry, and the expression of SYP protein was measured by Western blotting.Results:After the intervention, the cells in the hippocampal CA1 area of the model group were diffusely distributed, the number of neurons reduced, and the condition of inflammatory edema appeared; the cells in hippocampal CA1 area of the abdominal massage group were arranged clearly, and the condition of inflammatory edema has significantly improved; on the 21st and 28th day of the intervention, the balance beam test scores in the abdominal massage group significantly decreased ( P<0.05), and the relative expression of 5-HTR1A mRNA (1.18±0.08 vs. 0.77±0.04) in the abdominal massage group significantly increased ( P<0.05). The expression of cAMP (0.32±0.02 vs. 0.31±0.01), PKA (0.32±0.02 vs. 0.29±0.01),CREB (0.31±0.02 vs. 0.28±0.01) and SYP in the abdominal massage group significantly increased ( P<0.05). Conclusion:Abdominal massage could improve the behavior of neonatal hypoxic-ischemic rats, which may play a role on nerve repair by regulating 5-HTR1A/cAMP/PKA signaling pathway.

The short-term and medium-term outcomes of children with type-Ⅲ congenital esophageal atresia after surgery / 中华胸心血管外科杂志

Objective:To analyze the short-term and medium-term survival status of children with congenital esophageal atresia, and to provide reference for clinical multidisciplinary management of children with congenital esophageal atresia.Methods:The clinical data of neonates with type Ⅲ congenital esophageal atresia who were operated in our hospital between November 2007 to November 2018 and followed up in this hospital were analyzed retrospectively.Results:Among the 62 cases, 16 cases were discharged automatically, 1 case died, and 45 cases were included in the short-term follow-up. 35 cases were classified as gross Ⅲa, 10 as Ⅲb, 5 as long segment type, 44 patients accepted one-stage surgery, 1 infant accepted delayed operation, 9 infants received second operations. Anastomotic leakage occurred in 8 cases (17.8%), anastomotic stenosis in 11 cases (24.4%), recurrence of tracheoesophageal fistula in 2 cases (4.4%), blood flow infection in 14 cases(31.1%), incision infection in 4 cases (8.9%). The medium-term survival status of 38 cases: 2 cases died of aspiration, 29 cases (76.3%) of anastomotic stenosis underwent esophageal dilatation, 5 cases (13.2%) of dysphagia when 1.5 years old, 6 cases (15.8%) of malnutrition. After multidisciplinary collaboration, the survival rate increased (57.1% vs. 85.3%, P=0.013), and the incidence of anastomotic leakage decreased (46.4% vs. 20.6%, P=0.03). Conclusion:The quality of life of children with congenital esophageal atresia can be improved by multidisciplinary cooperation and standardized postoperative follow-up.

Value of body fat parameters in predicting the severity of acute pancreatitis / 临床肝胆病杂志

ObjectiveTo investigate the correlation between body fat parameters and the severity of acute pancreatitis (AP) and the value of body fat parameters in predicting the severity of AP. MethodsA retrospective analysis was performed for the clinical data of 229 patients with AP who were treated in Department of Gastroenterology in The Affiliated Hospital of Southwest Medical University from June 2016 to June 2019. According to the diagnostic criteria for AP, the patients were divided into mild acute pancreatitis (MAP) group, moderate-severe acute pancreatitis (MSAP) group(all P＜0.05), and severe acute pancreatitis (SAP) group, and CT images were used to calculate related body fat parameters ［visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), total adipose tissue (TAT), abdominal muscle area (AMA), VAT/TAT ratio (VTR), and visceral fat-to-muscle ratio (VMR)］. A one-way analysis of variance was used for comparison between multiple groups, and the least significant difference t-test was used for further comparison between two groups. A logistic regression analysis was used to investigate the correlation of the body fat parameters with AP severity. The receiver operating characteristic (ROC) curve was established for each body fat parameter and the area under the ROC curve (AUC) was calculated, and then the Youden index was calculated to determine the optimal cut-off value. ResultsThere were significant differences in age, VAT, TAT, AMA, VTR, and VMR between the three groups (F=4.15, 35.25, 73.02, 7.09, 462.30, and 139.4, all P＜0.05), and further comparison showed that compared with the MAP group, the MSAP group and the SAP group had significant increases in VAT, TAT, VTR, and VMR (all P＜0.05) and a significant reduction in AMA (all P＜0.05). The SAP group had significantly higher VAT, VTR, and VMR than the MSAP group(all P＜0.05). VMR had the largest AUC of 0.84(95% confidence interval: 0.76-0.92) in predicting MSAP and SAP, and had the cut-off value of 138 in predicting the severity of AP, with a sensitivity of 67.5% and a specificity of 90.6%. ConclusionBody fat parameters are correlated the severity of AP. VMR has a unique value in predicting the severity of AP and can be included in the future scoring models for predicting AP severity.

Effect of equal concentration of Helicobacter pylori suspension on gastric mucosa in mice by different gavage methods / 中南大学学报(医学版)

To investigate the effects of equal concentration of Helicobacter pylori suspension on gastric mucosal infection in mice by different gavage methods. 
 Methods: Six-week-old male C57BL/6 mice were infected by a suspension of Brucella broth containing the same amount of NCTC11637 Helicobacter pylori suspension by A, B, C, and D methods. For method A, the mice were intragastrically administered with Helicobacter pylori suspension (0.2 mL per mouse), once two day for 5 times; for method B, the mice were intragastrically administered with Helicobacter pylori (0.2 mL per mouse) once a day for 5 times; for method C, the mice were perfused with 0.4 mL per mouse of Helicobacter pylori suspension on the first day, then once a day and 0.2 mL per mouse for 3 times; for method D, the mice were administrated with 0.4 mL per mouse Helicobacter pylori suspension on the first day, 0.2 mL per mouse every other day for 3 times. For method E, the mice received equal amounts of normal saline. The mice were killed at 2, 4, and 6 weeks after gavage. The gastric mucosa was detected by rapid urease test for Helicobacter pylori infection, and gastric mucosa was taken for HE staining to observe the degree of infection.
 Results: After 2 weeks of gavage, the infection rates of the mice in A, B, C, and D group were 33.3%, 50.0%, 66.7%, and 33.3%, respectively. The degree of inflammation infection was as following order: C group>B group>D group>A group>E group. The infection rates of mice after 4 weeks of gavage in the A, B, C, and D groups were 50.0%, 83.3%, 83.3%, and 66.7%, respectively. The degree of inflammation infection was as following order: C group>B group>D group>A group>E group. After 6 weeks of gavage, the infection rate in A, B, C, and D groups was 100%, while the degree of inflammation infection was as following order: C group>D group>B group>A group>E group.
 Conclusion: At the acute stage of Helicobacter pylori infection, different gavage methods show different infection rates in mice, and the degree of inflammation is different. At the chronic stage, different gavage methods display the same infection rate in mice with different degree. The gavage method that 0.4 mL Helicobacter pylori suspension on the first day, then once a day and 0.2 mL for 3 times is most conducive to Helicobacter pylori colonization in the gastric mucosa of mice. This method can induce the the most seriou inflammatory infection and is beneficial to the successful establishment of the Helicobacter pylori infection model.

THE EFFECT OF CLINICAL PATHWAY OF NURSING ON HEALTH EDUCATIONIN PA-TIENTS UNDERGOING TONSILLECTOMY / 现代医院

Objective To analyze the effect of clinical pathway of nursing on health education in patients undergoing tonsil-lectomy.Methods Participants included 180 patients undergoing tonsillectomy in our hospital from September 2012 to September 2013 were randomly divided into the clinical pathway of nursing group ( experimental group) and the traditional nursing group ( control group) with 90 cases in each group.The sleep quality, heart rate, blood pressure, body weight, hemorrhage, health education com-pliance rate and nursing service satisfaction were recorded and compared between the two groups.Results The sleep quality, health education compliance rate and nursing service satisfaction in the experimental group was better than that in the control group;The inci-dence of heart rate speed up, blood pressure increase, loss weight, the standard rate of health education, hemorrhage and the satisfac-tion of nursing quality was lower than that in the control group.There was statistical significance in the difference between the two groups (p<0.05).Conclusion Health education with the clinical pathway of nursing can improve the quality of nursing, promote the rehabilitation and increase the nursing service satisfaction .

Clinical investigation of formula feeding in extremely low birth weight infants / 中华儿科杂志

<p><b>OBJECTIVE</b>To explore the relationship between gastric retention and full enteral feeding during the course of feeding in extremely low birth weight (ELBW, birth weight <1 000 g) infants.</p><p><b>METHOD</b>A total of 43 ELBW infants were fed with formula according to the strategy for premature infants feeding of Canadian Society of Neonatology. The information such as gastric retention, the time they finish full enteral feeding and sucking spontaneously and complication were recorded. These infants had transition to full enteral feeding step by step since initiating formula feeding on the second day of life. The volume of gastric retention and the duration of gastric retention was analyzed with the time of attaining full enteral feeding and sucking spontaneously by linear regression.</p><p><b>RESULT</b>Forty-one infants finished the course, the remaining 2 infants got necrotizing enterocolitis (NEC) and were rescued by surgery. The incidence was 4.6%. In 18 infants full enteral feeding could not be initiated successfully on the second day of life, the incidence was 43.9%. The peak duration of gastric retention was the first week of feeding. The average time of attaining enteral feeding was (26.71 ± 12.24) days. The proportion of different residual contents was simlar, the major content was milky content after 3 weeks of feeding. The gastric retention time had a significant effect of on the time of attaining full enteral feeding (β = 1.045, P = 0.001) and sucking well (β = 0.787, P = 0.034) .</p><p><b>CONCLUSION</b>The course of formula feeding ELBW infants to attaining full enteral feeding was a long period, in the early stage of formula feeding the occurrence of gastric retention was high; the amount of formula during the first week of feeding should be slowly increased as compared to the second week; the present strategy and aggressive strategy should be done 2 weeks later. The time of attaining full enteral feeding can be predicted by the duration of gastric retention.</p>

Effect of health education on blood pressure control in hypertensive population from a community of Wuzhou city / 心血管康复医学杂志

Objective:To study effect of health education on blood pressure control in patients with hypertension through community survey and perform health education.Methods:Residents from Datang street community re-ceived systematic sampling and questionnaire.A total of 490 patients with hypertension detected during census were regarded as subjects,and they were randomly divided into routine treatment group (n=240)and health education group (n=250).Health education group received health education,and effects were compared between two groups. Results:Compared with routine treatment group after intervention,there were significant rise in awareness rate of preventive and therapeutic knowledge [diagnostic value of hypertension (49.17% vs.58.40%),risk factors of hy-pertension (30.41% vs.58.00%),antihypertensive medication (58.75% vs.79.60%)]and control rate of blood pressure (23.33% vs.60.80%),and significant reduction in blood pressure [(147.68±13.97)/(89.30±12.43)mm-Hg vs.(143.57±13.53)/(85.73±11.54)mmHg]in health education group,P<0.05 or<0.01. Conclusion:Carry-ing out targeted health education possesses active significance for prevention and treatment of hypertension.

Evaluation of SAA and CD64 in early diagnosis of neonatal septicemia / 临床儿科杂志

10.3969/j.issn.1000-3606.2013.06.008

Early diagnosis of sepsis with C-reactive protein, serum amyloid A and CD64 in very low birth weight infants / 中华围产医学杂志

Objective To investigate the value of C-reactive protein (CRP),serum amyloid A (SAA) and CD64 in early diagnosis of sepsis in very low birth weight infants (VLBWI).Methods Fifty-four VLBWI suspected to sepsis and 20 VLBWI without infection in neonatal intensive care unit of the Second Hospital of Wenzhou Medical College from May 2010 to May 2012 were enrolled in this study.CRP,SAA and CD64 of sepsis group were measured at 0 and 24 hour after suspected bacterial infection; and those of control group were measured at corresponding age.CRP and SAA were detected by enzyme-linked immunosorbent assay,and CD64 was detected by flow cytometry.The difference between groups was compared by Mann-Whitney U test.Receiver operating characteristic curve was used to predict the sensitivity and specificity of the three biomarkers on sepsis.Results Fifty-four VLBWI were suspected with sepsis,and 37 patients were finally diagnosed.The levels of the three biomarkers in sepsis group were higher than those of control group not only at 0 h [CRP:13.3 mg/L(4.6-67.2 mg/L) vs 4.4 mg/L(1.6-11.2 mg/L),Z=-2.308; SAA:95.7 mg/L(4.5-265.9 mg/L) vs 7.3 mg/L(2.5-16.9 mg/L),Z=-2.425; CD64:7306 fluorescent antibody molecules/cell (2667-10 853 fluorescent antibody molecules/cell) vs 2502 fluorescent antibody molecules/cell (1839-3017 fluorescent antibody molecules/cell),Z=-3.704],but also at 24 h[CRP:35.4 mg/L (7.7 106.5 mg/L) vs 3.2 mg/L (1.1-7.8 mg/L),Z-5.501; SAA:359.3 mg/L (3.8-503.2 mg/L) vs 6.6 mg/L (3.0-12.7 mg/L),Z =-2.818; CD64:8304 fluorescent antibody molecules/cell (2819-11 758 fluorescent antibody molecules/cell) vs 2563 fluorescent antibody molecules/cell (1760-3154 fluorescent antibody molecules/cell),Z =-7.670],P＜0.05 respectively.The best cutoff value of CD64 was 2934 fluorescent antibody molecules/cell,with the sensitivity of 81.1％ at 0 h and 91.9％ at 24 h; and the specificity of 90.0％ at 0 h and 80.0％ at 24 h.Although SAA had similar sensitivity (0 h:83.8％; 24 h:86.5％) as CD64,its specificity was relatively low(0 h:65.0％; 24 h:55.0％).Both the sensitivity (0 h:62.2％; 24 h:70.3％) and specificity (0 h:70.0％; 24 h:70.0％) of CRP were low.Combination of the three infection biomarkers could increase the sensitivity (0 h:91.9％; 24 h:97.2％) and specificity (0 h:95.0 ％ ; 24 h:90.0％).Conclusions Combination of CRP,SAA and CD64 might improve the diagnostic accuracy of sepsis in VLBWI.

Clinical research of multi-channel minimally invasive percutaneous nephrolithotomy in combination with Yag laser in complex renal calculi / 中国医师进修杂志

Objective To investigate the effect of multi-channel minimally invasive percutaneous nephrolithotomy in combination with Yag laser in complex renal calculi operation. Methods Eighty six complex renal calculi patients were divided into two groups, study group (46 cases) was treated with multi-channel minimally invasive percutaneous nephrolithotomy combined with Yag laser, control group was treated with single-channel minimally invasive percutaneous nephrolithotomy combinated with extracorporeal shock wave treatment. Comparison of gravel removed time, stone clearance rate,postoperative hemoglobin decreasing rate, blood transfusion rate of surgery,length of stay time and operative complications were done between the two groups, the results were analysed statistically. Result The gravel removed time was (102±23) min in study group, and ( 121 ± 28) min in control group, there was no significant difference between the two groups(P ＞ 0.05 ). In study group, postoperative hemoglobin decreasing rate was 6.5%(3/46), blood transfusion rate of surgery was 17.4% (8/46), stone clearance rate was 82.6%( 38/46 ), length of stay time was (5.6 ± 1.7) d,while those in control group was 12.5%(5/40),22.5%(9/40),72.5%(29/40), (7.4 ± 1.8) d,respectively. There was statistical significance between the two groups(P＜ 0.05 ). Conclusion Multi-channel minimally invasive percutaneous nephrolithotomy in combination with Yag laser in the treatment of complex renal calculi has the shorter operation time, less blood loss,less complications and higher stone clearance rate, and is worthy of promotion.

Anti-tumor Effect of Zhongjiefeng Injection and Its Combination with Adriamycin / 中药新药与临床药理

Objective To study the anti-tumor effect of Zhongjiefeng Injection in vitro and its combination with adriamycin.Methods MTT assay was adopted to determine the in-vitro anti-tumor effect,IC50 was used to measure the direct anti-tumor effect,and Jing' s formula was applied to analyze the combination of the drugs.Results Zhongjiefeng Injection can inhibit the proliferation of Bel 7402(human hepatoma cells),HCT-8(human colon cancer cells),and the IC50 was 33.13 mg/mL for Bel 7402 and 52.39 mg/mL for HCT-8 respectively.Zhongjiefeng Injection at the concentrations of 3.125,6.25,12.5 mg/mL showed an efficancy potentiation action with doxorubicin on the inhibition of HCT-8 cells in vitro,and 25,50 mg/mL showed a synergic effect on HCT-8 .Conclusion Zhongjiefeng Injection has a certain in-vitro inhibitory effect on the growth of Bel 7402 and HCT-8,its combination with doxorubicin in vitro can produce synergic effects(a simple combined or enhanced effects)to HCT-8 cells,especially high concentrations of Zhongjiefeng Injection with doxorubicin.It is suggested that Zhongjiefeng Injection in the doubled dosage may have a better synergistic effect with doxorubicin in clinical treatment of colon cancer.