ABSTRACT
Objective:To investigate and analyze the necessity and clinical significance of professional neonatal transport team participating in post-natal resuscitation, management and transport of twin neonates after birth.Methods:A total of 298 cases of twin neonates admitted to the Department of Neonatology at the Fifth Medical Center of PLA General Hospital from January 2017 to December 2021 were selected.According to whether the neonatal transport team participated in birth resuscitation and management, they were divided into participation group ( n=136) and case group ( n=162). The resuscitation measures taken after birth, Apgar score, respiratory support during transport, basic information at admission, the first arterial blood gas after admission, complications during hospitalization, length of stay and outcome of the two groups of twins were retrospectively analyzed. Results:Compared with twins in case group, the proportion of tracheal intubation before transport was significantly higher in participation group(5.88% vs.0.62%, χ2=6.997, P=0.013), hospital admissions were significantly shorter[48(7, 115) min vs.87(47, 425) min, Z=-11.593, P<0.001], and significantly lower rates of hypoxia on admission(9.56% vs.17.90%, χ2=4.250, P=0.039), significantly higher percutaneous oxygen saturation[96(86, 100)% vs.95(85, 100)%, Z=-7.274, P<0.001], and higher blood-gas-oxygen partial pressure on admission[(91.02±25.77)mmHg vs.(87.82±25.23)mmHg, t=1.076, P=0.008] were found.The incidence of hypothermia on admission was significantly lower(36.03% vs.47.53%, χ2=4.008, P=0.045), and the differences between two groups were statistically significant( P<0.05). The proportion of critically ill neonates(40.44% vs.24.07%, χ2=9.172, P=0.002), length of hospital-stay[11(4, 76)d vs.9(3, 72) d, Z=-2.684, P=0.014] as well as the intravenous nutrition time[7(0, 42)d vs.5(0, 40) d, Z=-2.470, P=0.014] in participaton group were significantly higher than those in case group, and there were statistically significant differences between two groups( P<0.05). Conclusion:Professional neonatal transport teams play a positive role in neonatal resuscitation and later hospitalization during the pre-transport management of twin neonates.It can improve success rate of tracheal intubation in asphyxia resuscitation of twin neonates.Neonatal transport to the NICU for management takes less time, reducing the incidence of hypoxemia during transport, hypoxia status and hypothermia after admission.Obstetric pediatric medical staff in midwifery hospitals should strengthen the professional training of neonatal asphyxiation resuscitation, improve the skill of neonatal asphyxiation resuscitation and tracheal intubation, and strengthen the post-birth care for twin neonates.
ABSTRACT
Objective:To investigate the current situation of medical social worker supervision in Shanghai, for reference to promote the high-quality development of medical social work.Methods:From June to July 2022, a questionnaire survey was conducted on the in-service medical social workers in all medical institutions with medical social work departments or posts in Shanghai. The questionnaire mainly included demographic information, current status of supervision implementation, and effectiveness of supervision. The data were analyzed descriptively with t test for comparison between groups and the Pearson test was for correlation analysis. Results:A total of 99 medical social workers were included in this study, 65 had received supervision, and medical institutions where 58 people located had established the supervision system. The average scores of actual and expected supervisory support received by medical social workers were 3.71 and 4.20 respectively, and the mean burnout level score was 32.91. The effect of establishing a supervision institutions on burnout was statistically significant ( P<0.05) and actual access to supervision support was negatively associated with burnout ( P<0.05). Conclusions:The overall situation of medical social work supervision in Shanghai was positive, but the demand for supervision was not fully satisfied; Supervision had a positive impact on reducing the burnout level. It is suggested that medical social work should further strengthen the cultivation of supervisory talents, promote the construction of supervisory systems, and improve the quality of supervision.
ABSTRACT
Objective:To investigate the rate and timing of antenatal corticosteroid administration in the singleton preterm infants in our hospital, and explore the relationship between the timing of antenatal corticosteroid administration associated with the causes of preterm delivery and with neonatal outcomes.Methods:The study was a retrospective chart review of clinical data regarding singleton preterm neonates and their mothers from January 2016 and June 2020 at Peking University International Hospital.Optimal administration timing was defined as the first dose of antenatal dexamethasone given ≥48 h and ≤7 d before delivery.Suboptimal administration timing included any antenatal dexamethasone timing(<48 h or >7 d) that did not meet the optimal criteria.Antenatal dexamethasone administration timings were compared among preterm delivery with different causes.The neonatal outcomes of the optimal and suboptimal administration timing groups were compared.Results:The percentage of antenatal dexamethasone use was 89.16%, with 51.35% receiving optimal dexamethasone.Women with premature rupture of membranes were most likely to receive optimal dexamethasone(63.79%), followed by women with complications of pregnancy and other disorders(54.29%). The optimal dexamethasone rate of the women with cervical incompetence and preterm labor was relatively low(20% and 28%, respectively). The incidence of respiratory distress syndrome(RDS) of optimal administration timing group was lower than that in suboptimal administration timing group among neonates at <34 weeks of gestation( P<0.05). But there was no significant difference in the incidence of severe RDS, bronchopulmonary dysplasia, and need for pulmonary surfactant between two groups( P>0.05). The preterm infants with a gestational age between 34 and 34 + 6 weeks had no severe RDS or bronchopulmonary dysplasia.Compared with suboptimal administration timing group, the incidence of RDS and need for pulmonary surfactant of optimal administration timing group did not decrease significantly( P>0.05). Conclusion:The causes of preterm delivery affect the timing of antenatal dexamethasone administration.Optimizing the timing of antenatal dexamethasone administration can reduce the incidence of RDS among neonates less than 34 weeks of gestation.
ABSTRACT
Objective:To investigate the efficacy and safety of less invasive surfactant administration(LISA) of neonatal respiratory distress syndrome(NRDS).Methods:From July 2017 to December 2018, 50 premature infants with birth weight ≤1 500 g and/or gestational age≤32 weeks diagnosed as NRDS at the Fifth Medical Center of PLA General Hospital were randomly divided into LISA group( n=25)and INSURE group( n=25). The patients in LISA group was inserted fine duct into the trachea through direct laryngoscope under nasal continuous positive airway pressure (nCPAP) and pulmonary surfactant was injected.The INSURE group adopts endotracheal intubation-pulmonary surfactant-nCPAP was performed after unplugging.The changes of vital signs, blood gas indexes, adverse reactions and the incidence of complications were compared between two groups at different time points. Results:There was no significant difference in respiration, heart rate, systolic blood pressure, diastolic blood pressure and PaO 2, PaCO 2, BE, SpO 2 between two groups at different administration time points.Although the pH value of LISA group was lower than that of INSURE group, it was within the normal range.There was no significant difference in bronchopulmonary dysplasia, intraventricular hemorrhage, periventricular leucomalacia and other complications between two groups, and there was no death, air leakage, retinopathy of prematurity and pulmonary hemorrhage in both two groups.In addition, there was no significant difference in hospitalization days, total medical expenses, oxygen use time between the two groups(all P>0.05). Conclusion:Compared with INSURE technology, LISA technology has its feasibility for premature infants with NRDS, but the effectiveness and safety in the practical application need to be further confirmed.
ABSTRACT
Objective:To retrospectively analyze the prevalence and genotype distribution of human papillomavirus (HPV) among women in mainland China from the introduction of cervical cancer vaccine to its marketing in China, so as to provide data for comparing HPV prevalence after the application and gradual promotion of HPV vaccine.Methods:Related articles published during 2006 to 2016 were retrieved from PubMed, China National Knowledge Infrastructure (CNKI) and Wanfang databases. Data about HPV infection in women receiving physical examination or routine cervical cancer screening and female outpatients were collected and analyzed.Result:A total of 270 articles were retrieved, in which the sampled women were aged from 13 to 90 years old. Seventy-two articles were about HPV infection in women screened for cervical cancer with a sample size of 580 308 people. The overall results showed that during the 11 years, the five most common high-risk HPV genotypes were HPV52, 16, 58, 68 and 18, and the common low-risk HPV genotypes were HPV81, 43 and 6. The distribution of HPV genotypes varied in different regions, but HPV16, 52 and 58 were always the predominant genotypes. Among the 270 collected articles, 200 analyzed HPV infection in female outpatients with a total of 675 035 cases. The results showed that the top five high-risk HPV genotypes with high prevalence were HPV16, 52, 58, 18 and 33, and the common low-risk types were HPV6, 11 and 81. The analysis of HPV infection rate in seven geographical regions indicated that, although the distribution of the commonly circulating high-risk HPV genotypes varied in different regions, HPV16, 52 and 58 remained the predominant genotypes.Conclusions:The present study showed that the prevalence and genotype distribution of HPV infection varied by region, but HPV16, 52 and 58 were always the most common high-risk genotypes and HPV6 was the predominant low-risk genotype in both women screened for cervical cancer and female outpatients. Besides that, the infections of other high-risk genotypes, such as HPV53 and 68, should also be of concern.
ABSTRACT
Objective@#To improve the current understanding on the imaging features of pancreatic schwannoma.@*Methods@#Clinical data of pancreatic schwannoma patients admitted in Changhai Hospital affiliated with Navy Medical University from January 1989 to January 2019 were retrospectively analyzed, related literature on pancreatic schwannomas was retrieved through the Chinese and English database, and clinical and imaging features of pancreatic schwannoma were analyzed.@*Results@#A total of 84 cases were analyzed, including 3 cases of pancreatic schwannomas in Changhai hospital, and 81 cases reported in the literature. The age of onset was 17-78 years old, with an average of 55 years. There were 30 males and 54 females. The main symptoms were abdominal pain or the detection of pancreatic mass via body check. Pancreatic schwannoma was mainly in pancreatic head, and the lesion has a long diameter of 1-18 cm with an average of 4.6 cm, which can be solid, cystic (most frequent) and cystic-solid. The border of the lesion from the normal tissue was clear, and semi-transparent capsule composed of neural external membrane and fiber were often found. 15 patients underwent endoscopic ultrasonography guided fine needle aspiration, and diagnostic accuracy was 73.3%(11/15). No typical findings for pancreatic schwannoma was detected on CT. MRI was performed in 35 cases, and 12 cases had complete data. The characteristics of target sign were tumor tissue in completely low signal at T1WI, and in partially low signal and partially high signal at T2WI, and completely opposite signal characteristics of T2WI area after T1 enhancement, referring to the finding that low T2WI signal part was gradually enhanced to be high signal, but high signal part was not enhanced and in low signal.@*Conclusions@#Pancreatic schwannoma is rare, and its target signs by MRI have imaging features which can help to improve the preoperative diagnosis.
ABSTRACT
Objective:To explore the value of 3.0 T high resolution MRI (HR-MRI) in the follow-up of drug treatment in acute and non-acute ischemic stroke caused by middle cerebral artery (MCA) plaque.Methods:The perspective study enrolled patients with ischemic stroke caused by MCA stenosis from October 2012 to October 2015 in the department of Neurology and Neurosurgery of Changhai Hospital Affiliated to Naval Medical University. All the patients underwent HR-MRI and then were divided into acute and non-acute stroke groups according to the intervels of the last symptom onset to the time of HR-MRI examination. All patients were informed consent to receive antiplatelet drug and intensive lipid therapy and followed up with HR-MRI. The HR-MRI sequence including T 2WI, T 1WI and contrast-enhanced T 1WI of vessel wall, and T 2WI and DWI of brain were routinely performed. T-test of paired samples was used to evaluate the changes of stenosis rate of vascular lumen, plaque enhancement degree, plaque volume and plaque burden on HR-MRI, and the NIHSS score of nervous system and blood biochemical indicators of the patients before and after treatment. Chi square test was used to compare the difference in ischemic event recurrcence between the acute and the non-acute stroke group. Results:A total of 31 acute stroke patients and 20 non-acute stroke patients were enrolled in the study. The mean follow-up time of acute stroke group was (671.71±522.86) days. Compare with the baseline, the stenosis rate of vascular lumen ( P=0.039), plaque enhancement degree ( P<0.001), plaque volume ( P=0.024) and plaque burden ( P=0.031) were all improved after the drug treatment, the NIHSS score of nervous system was also significantly improved, and the levels of total cholesterol (TC) and low density lipoprotein cholesterol (LDL-C) in 12 patients were significantly decreased. The mean follow-up time of patients with non-acute stroke was (695.35±555.90) days. The stenosis rate of vascular lumen, plaque enhancement degree, plaque volume and plaque burden were slightly improved, but without statistical significance ( P>0.05). There were no significant changes in NIHSS score of nervous system, TC, triglyceride (TG) and LDL-C ( P>0.05), however the high density lipoprotein cholesterol (HDL-C) was significantly increased than that in the baseline ( P=0.02). During the follow-up period, no new cerebral infarction was found in the DWI images of the two groups. Six patients had transient ischemic attack (TIA) recurrence in the acute stroke group and 5 patients in the non-acute stroke group, there was no significant difference between both groups(χ 2=0.229, P= 0.632). Conclusion:HR-MRI can be used as an important evaluation method for the follow-up of MCA atherosclerotic plaque therapy. After antiplatelet therapy and intensive lipid-lowering therapy, the plaque volume and burden of MCA offending plaque, and plaque enhancement decreased in acute stroke patients but there was no significant change in non-acute patients.
ABSTRACT
Objective:To improve the current understanding on the imaging features of pancreatic schwannoma.Methods:Clinical data of pancreatic schwannoma patients admitted in Changhai Hospital affiliated with Navy Medical University from January 1989 to January 2019 were retrospectively analyzed, related literature on pancreatic schwannomas was retrieved through the Chinese and English database, and clinical and imaging features of pancreatic schwannoma were analyzed.Results:A total of 84 cases were analyzed, including 3 cases of pancreatic schwannomas in Changhai hospital, and 81 cases reported in the literature. The age of onset was 17-78 years old, with an average of 55 years. There were 30 males and 54 females. The main symptoms were abdominal pain or the detection of pancreatic mass via body check. Pancreatic schwannoma was mainly in pancreatic head, and the lesion has a long diameter of 1-18 cm with an average of 4.6 cm, which can be solid, cystic (most frequent) and cystic-solid. The border of the lesion from the normal tissue was clear, and semi-transparent capsule composed of neural external membrane and fiber were often found. 15 patients underwent endoscopic ultrasonography guided fine needle aspiration, and diagnostic accuracy was 73.3%(11/15). No typical findings for pancreatic schwannoma was detected on CT. MRI was performed in 35 cases, and 12 cases had complete data. The characteristics of target sign were tumor tissue in completely low signal at T 1WI, and in partially low signal and partially high signal at T 2WI, and completely opposite signal characteristics of T 2WI area after T 1 enhancement, referring to the finding that low T 2WI signal part was gradually enhanced to be high signal, but high signal part was not enhanced and in low signal. Conclusions:Pancreatic schwannoma is rare, and its target signs by MRI have imaging features which can help to improve the preoperative diagnosis.
ABSTRACT
Objective:To evaluate the value of lung ultrasound in diagnosis of transient tachypnea in newborns.Methods:Chinese and English literature search regarding lung ultrasound for the diagnosis of transient tachypnea of the newborn were retrieved in the PubMed Database, Embase Database, Springer, Cochrane library, Wanfang Database and CNKI from inception to August 2018.The Quality Assessment of Diagnostic Accuracy Studies(QUADAS-2) tool was used to assess the quality of studies.The pooled sensitivity, specificity, positive likelihood ratio(PLR), negative likelihood ratio(NLR), and diagnostic odds radio(DOR) were calculated by Meta-Disc 1.4 software, and SROC curve was drawed.Results:A total of eight articles (five in English and three in Chinese) involving 1 582 patients were included.Meta-analysis showed heterogeneity among studies, and random effect model was used.The pooled sensitivity was 0.70 (95% CI was 0.66~0.74), the pooled specificity was 0.96 (95% CI was 0.94~0.97), PLR was 18.71 (95% CI 8.41~41.63), NLR was 0.12 (95% CI was 0.05~0.29), DOR was 279.96 (95% CI was 48.86~1 604.22), area under SROC(AUC) was 0.99, and Cochran-Q was 0.95, respectively. Conclusion:Pulmonary ultrasound has a preferable value for diagnosis of transient tachypnea in newborns.
ABSTRACT
Precision medicine, imaging first. Radiomics, a method of machine learning in artificial intelligence, provides valuable diagnostic, prognostic or predictive information through quantitative analysis on the tumor's region of interest to support personalized clinical decisions and improve individualized treatment, which could lay a solid foundation for achieving the precision medicine. This review provides a latest advance of the radiomic application of the precision medicine for lung cancer.
Subject(s)
Animals , Humans , Artificial Intelligence , Lung Neoplasms , Diagnosis , Machine Learning , Precision Medicine , MethodsABSTRACT
Objective@#To evaluate the cost-utility of different immunization strategies for rabies in China, and to provide a reference for determining the optimal immunization strategy.@*Methods@#The system dynamics model was used to simulate the epidemic of canine rabies and a decision tree model was conducted to analysis different immune strategies. Relevant probabilities were obtained through literature search and on-site investigation. Sensitivity analysis was used to explore the important influenced factors.@*Results@#At baseline, from a social perspective, 70% vaccination of dogs was the optimal strategy compared to current vaccination strategy (43% vaccination in dogs, human category-Ⅱ exposure vaccination/category-Ⅲ exposure vaccination combined with RIG). The total cost was 14 084 354 CNY, and the total utility value was 22 078 616.23 QALYs, and the incremental cost-utility ratio was-62 148 147 CNY/QALY; if human vaccination was considered, 55% vaccination of dogs combined with strategy one was the optimal strategy, its incremental cost-utility ratio was-444 620 557 CNY/QALY. The probability that an injured dog carries rabies virus was the most sensitive parameter. When it was greater than 0.005 03, strategy four was the optimal strategy. When it was less than 82/100 000, strategy one was the optimal strategy; when it was between 82/100 000 and 120/100 000, strategy two was the optimal strategy; when it was between 120/100 000 and 503/100 000, strategy two was the optimal strategy.@*Conclusion@#It was conducive to increase the vaccination coverage of canine for the prevention and control of rabies.
ABSTRACT
Objective@#To study the molecular epidemiology and genetic variation of coxsackievirus B5 (CV-B5) in certain areas in China.@*Methods@#MEGA 6.0 software was used to analyze the complete VP1 region of CV-B5 isolated strains from certain areas of China by retrieving the GenBank nucleotide database. Besides, the phylogenetic tree was constructed, the homology of nucleotide and amino acids were calculated and the rate of evolution was estimated.@*Results@#A total of 189 Chinese CV-B5 isolated strains were included in this study. Most of Chinese CV-B5 isolated strains belonged to genotype C, accounted for 90.5%. Compared with the genotype A, the homology of nucleotide sequences and amino acid sequences of complete VP1 region of 189 Chinese isolated strains were 79.8%-82.8% and 92.6%-97.9%, respectively; moreover, the nucleotide and the amino acid homology of 189 Chinese CV-B5 isolated strains among themselves ranged from 80.3% to 100.0% and ranged from 91.5% to 100.0%, respectively. The estimated rate of evolution of the CV-B5 was 4×10-3 substitutions/site/year.@*Conclusions@#The majority of CV-B5 isolated strains belonged to genotype C, and subgenotype C1 and C2 were co-circulating together in certain areas of China.
ABSTRACT
Objective@#To evaluate the lipid and calorie content in breast milk samples from neonatal intensive care unit of the Fifth Medical Center of Chinese People's Liberation Army General Hospital, and to explore the correlation between the lipid and calorie content of breast milk and perinatal factors, so as to provide ideas and methods for individualized feeding of neonates.@*Methods@#A total of 305 breast milk samples from 183 neonatal mothers in Fifth Me-dical Center of Chinese People′s Liberation Army were tested for fat and calorie by adopting Creamatocrit dynamic breast milk analyzer. All breast milk samples were sent to the breast milk bank of neonatal intensive care unit within 24 hours after collection and refrigeration. Breast milk samples were rewarmed at 37 ℃ for 30 minutes and then determined by the same nurses in the same environment from 1000 to 1100 Am daily. SPSS 17.0 was used for statistical analysis and P<0.05 was used for statistical analysis.@*Results@#The fat content of 305 breast milk samples from 183 infants was (45.65±26.76) g/L and the caloric content was(762.61±206.64) kcal/L(1 kcal=4.184 kJ). There was no significant difference between colostrum, transitional milk and mature milk in terms of fat (F=2.053, P=0.130) and calorie(F=0.830, P=0.437)content.There was no significant difference in colostrum (fat: F=1.119, P=0.331, calorie: F=2.928, P=0.058), transitional milk (fat: F=0.530, P=0.590, calorie: F=1.377, P=0.257), and mature milk (fat: F=0.612, P=0.545, calorie: F=1.101, P=0.337) in terms of fat content and calorie content among different gestational weeks newborns.Multiple linear regression analysis showed that mothers with pregnancy complications were important factors affecting breast milk lipid and calorie content.Mothers with hypertension during pregnancy are important factors affecting the lipid content of mature milk.@*Conclusions@#Breast milk calorie content may be higher than the industry-standard 670 kcal/L, and Creamatocrit dynamic breast milk analyzer can be used to determine the content of breast milk calories and fat, which can be more accurate assessment of neonatal calories and fat intake.Whether the mother is complicated with complications or not during pregnancy is an important factor affecting the colostrum fat and caloric content.
ABSTRACT
Objective To investigate the ability of quantitative radiomic method based on highresolution magnetic resonance imaging (HR-MRI) to distinguish between culprit plaques and non-culprit plaques of intracranial atherosclerosis.Methods Patients with middle cerebral artery and basilar artery stenosis underwent HR-MRI in Changhai Hospital Affiliated to the Naval Medical University from September 2013 to October 2016 were analyzed retrospectively.The minimum lumen area,plaque burden,severity of luminal stenosis,intraplaque hemorrhage (IPH),enhancement rate,and 109quantitative radiomic characteristics of the culprit and non-culprit plaques were measured.For clinical features and traditional plaque morphology,multivariate logistic regression models were used to determine independent risk factors for culprit plaque.A random forest-supervised machine learning method was used to determine the radiomic characteristics of distinguishing between symptomatic plaques and asymptomatic plaques.The receiver operating characteristic (ROC) curve was constructed,and the diagnostic efficacy was described by the area under the curve (AUC).Results During the study,158 subjects were enrolled,and they aged (59.42± 11.62) years.The plaques of 75 patients were located in middle cerebral artery,and the plaques of 83 patients were located in basilar artery.There were 111 symptomatic patients and 47 asymptomatic patients.Multivariate logistic regression analysis showed that smoking (odds ratio [OR] 2.724,95％ confidence interval [CI] 1.200-6.183),IPH (OR 11.340,95％ CI 1.441-89.221),and enhancement rate (OR 6.865,95％ CI 1.052-44.802) were the independent risk factors for culprit plaques.The AUC of these three characteristics for predicting symptomatic plaques were 0.605,0.584,and 0.590,respectively.The combination of the three cloud improve the test efficacy for the intracranial atherosclerotic culprit plaques,AUC could reached 0.714.Radiomic analysis showed that 22 radiomic characteristics extracted from T-2 weighted imaging,T1 weighted imaging,and contrast-enhanced T1 weighted imaging were associated with the culprit plaques.Their AUCs were 0.801,0.835,and 0.846,respectively.After the combination of all morphological and radiomic characteristics,AUC could reach 0.976,the accuracy rate was 87.4％.However,the difference was not statistically significant compared to the combined AUC of all radiomic characteristics (0.953) (P=0.275).Conclusion Radiomic analysis could accurately distinguish between the culprit plaques and non-culprit plaques of intracranial atherosclerosis,and is superior to the traditional morphological methods.
ABSTRACT
Objective@#To investigate the effect of hypertensive disorder complicating pregnancy (HDCP) on the mortality and early complications of premature infants.@*Methods@#The general clinical data of preterm infants with gestational age 24-36+ 6 weeks were collected from the cooperative units in the task group from January 1, 2013 to December 31, 2014.According to the severity of HDCP, the infants were divided into 4 groups: HDCP group, preeclampsia group, eclampsia group and non HDCP group, the mortality and major complications of preterm infants were compared, and the influencing factors were analyzed.@*Results@#The mortality rate of preterm in the HDCP group was significantly higher than that of non HDCP group, and there was statistical significance (χ2=9.970, P=0.019). Eclampsia had a highest fatality rate (4.8%) in the early stage, compared with non HDCP group (2.2%), and the difference was statistically significant.Comparison of HDCP group (1.8%) and eclampsia group (3.2%) suggested that there was no statistically significant difference.The incidence of respiratory distress syndrome (RDS) in preterm in HDCP group was significantly higher than that of non HDCP group, and there was statistical significance (χ2=13.241, P=0.004). Eclampsia group showed the highest incidence (35.4%), compared with non HDCP group (16.2%), the difference was statistically significant, but compared with HDCP group (19.9%), preeclampsia group (17.1%), there was no significant diffe-rence.The incidence of bronchopulmonary dysplasia (BPD) in preterm in HDCP group was significantly higher than that of non HDCP group (χ2=9.592, P=0.022), the highest incidence showed up in eclampsia group (9.7%), compared with non HDCP group (2.0%) and HDCP group (1.7%), the difference was statistically significant.But there was no statistically significant difference, compared with preeclampsia group.As the degree of HDCP aggravated, the incidence of BPD gradually rose.There was no significant impact on necrotizing enterocolitis (NEC), retinopathy of prematurity (ROP), intraventricular hemorrhage (IVH) and sepsis of HDCP (χ2=7.054, 7.214, 0.358, 3.852; P=0.070, 0.065, 0.949, 0.278). Considering the overall outcome of the child, that was, whether the child died or survived, he had at least one complication, and HDCP had an effect on it (χ2=15.697, P=0.001), so the incidence increased while the degree of HDCP rose gradually.After adjusting gestational age, birth weight, sex, way of delivery, placental abruption and front placenta, prenatal hormonal, gestational diabetes, neonatal asphyxia and other factors, the results displayed that HDCP was the factor leading to the death of premature baby (OR=2.159, 95%CI: 1.093-4.266), and comparison between preeclampsia and eclampsia showed no statistical difference (P=0.714, 0.389); HDCP had no significant influence on RDS, BDP, ICH, NEC, ROP and sepsis.@*Conclusions@#HDCP leads to increased risk of premature death, but also leads to the increased incidence of RDS and BPD, but it had no obvious effect on NEC, ROP, IVH, sepsis and other complications.
ABSTRACT
Objective To evaluate and compare the effectivity and safety of mini-percutaneous nephrolithotomy (mPNL) and flexible ureteroscopic lithotripsy (FURL) for diameter 10 to 20 mm renal stone in obese patients. Methods This was a multicenter prospective study. One hundred and ten obese patients (body mass index≥28.0 kg/m2) with diameter 10 to 20 mm kidney stone from January 2015 to May 2017 were selected. The patients were divided into mPNL group (58 cases) and FURL group (52 cases) according to the patients′ will. The operation time, hospitalization time, complication, one-stage stone removal rate and ultimate stone removal rate were compared between 2 groups. Results The operation time, hospitalization time and incidence of complication in FURL group were significantly lower than those in mPNL group: (66.7 ± 21.9) min vs. (85.7 ± 33.4) min, (72.5 ± 23.7) h vs. (120.8 ± 33.5) h and 9.6% (5/52) vs. 31.0% (18/58), and there were statistical differences (P＜0.05). There were no statistical differences in the one-stage stone removal rate and ultimate stone removal rate between 2 groups (P＞0.05). In aspect of postoperative bleeding, hemoglobin decreased after operation (15.8 ± 9.7) g/L in mPNL group; no hemorrhage occurred in FURL group, and no significant changes in hemoglobin were observed before and after operation. Conclusions Both mPNL and FURL achieve satisfactory stone-free rates in obese patients with diameter 10 to 20 mm renal stone. Compared with mPNL, FURL has shorter operation time and lower incidence of complication.
ABSTRACT
Objective To study the effect of puncture length per cubic centimeter of prostate biopsy on the detection rate of prostate cancer. Methods The clinical data of 254 prostate cancer patients who had underwent the first prostate biopsy by transrectal ultrasound guidance from September 2013 to November 2017 were retrospectively analyzed. The patients were divided into prostate cancer group and non prostate cancer group according to biopsy pathologic results. The total prostate specific antigen (TPSA), prostate volume, puncture length per needle, puncture length per cubic centimeter of prostate, volume of per needle and percentage of the sampled prostate volume were compared between 2 groups, and the relationship between puncture length per cubic centimeter of prostate and prostate cancer detection rate were analyzed. Results Among the 254 patients, the prostate cancer was in 67 cases (prostate cancer group), and the benign lesion was in 187 cases (non prostate cancer group). The prostate cancer detection rate was 26.4% (67/254). There were no statistical differences in age, puncture length per needle and volume of per needle between 2 groups (P＞0.05). The TPSA, puncture length per cubic centimeter of prostate and percentage of the sampled prostate volume in prostate cancer group were significantly higher than those in non prostate cancer group: (13.8 ± 6.8)×103 ng/L vs. (8.5 ± 3.9)×103 ng/L, (3.42 ± 0.12) mm/cm3 vs. (2.83 ± 0.18) mm/cm3 and (2.75 ± 0.31)% vs. (2.24 ± 0.25)%, the prostate volume was significantly lower than that in non prostate cancer group: (45.8 ± 15.5) cm3vs. (56.3 ± 13.8) cm3, and there were statistical differences (P＜0.05). Receiver operating characteristic curve analysis showed that area under the curve was 0.628, 95% CI 0.561 to 0.695. The cutoff value of puncture length per cubic centimeter of prostate was 3.40 mm/cm3, with the sensitivity of 59.8% and the specificity of 64.8% . Conclusions The puncture length per cubic centimeter of prostate and percentage of the sampled prostate volume are important morphometric parameters in the determination of prostate cancer. The detection rate of prostate cancer is the highest , when puncture length per cubic centimeter of prostate is≥3.40 mm/cm3.
ABSTRACT
Objective To evaluate the immune effects of virus-like particles ( VLPs) assembled from the capsid protein VP1 of a recombinant norovirus ( NoV) GⅡ. 17 genotype. Methods The recombi-nant NoV GⅡ. 17 VP1 VLPs were purified, and then tested by SDS-PAGE and Western blot to analyze the purity. The size, morphology and diameter distribution of the recombinant VLPs were detected by transmis-sion electron microscopy ( TEM) and dynamic light scattering ( DLS) analyzer. The recombinant VP1 VLPs adsorbed by aluminium adjuvant were used to immunize BALB/c mice. Serum samples were collected after immunization. Specific antibody level and neutralizing antibody activity were evaluated with enzyme linked immunosorbent assay ( ELISA) and histo-blood group antigen ( HBGA)-VLP blocking test. Cross-reactivity of serum samples with GⅠ. 1 and GⅡ. 4 VP1 VLPs were detected. Moreover, cross-protection against GⅠ. 1 and GⅡ. 4 VP1 VLPs was analyzed. Results The purity of the recombinant NoV GⅡ. 17 VP1 VLP was greater than 90％ and specific bands were detected by Western blot. TEM images and DLS experiments showed that VLPs were 30-50 nm in size with good morphology and uniformity, indicating that the recombi-nant VLPs were similar to the wildtype virus. High titers of specific antibodies were detected in serum sam-ples of the immunized mice. A certain degree of cross-reactions between serum samples and VP1 VLPs of NoV GⅠ. 1 and GⅡ. 4 were observed, but no cross-protection was detected. Conclusion The recombinant GⅡ. 17 VP1 VLPs in combination with aluminum adjuvant can induce higher titers of HBGA blocking anti-bodies in mice, suggesting that it could be used as a candidate target antigen for norovirus vaccine.
ABSTRACT
Objective To investigate the relationship between the interleukin (IL)-35 and the recovery of renal graft function. Methods Clinical data of 45 recipients receiving renal transplantation from donation after cardiac death (DCD) were retrospectively analyzed. According to the presence of delayed graft function (DGF) after renal transplantation, all recipients were divided into the immediate graft function (IGF) group (n=32) and DGF group (n=13). The serum creatinine (Scr) level and estimated glomerular filtration rate (eGFR) in the recipients were statistically compared between two groups at 1, 2, 3, 7, 14, 28 d and 3, 6 and 12 months after renal transplantation. The IL-35 levels in the serum and urine samples of the recipients were statistically compared between two groups at 1, 2, 3, 7, 14, 28 d following renal transplantation. Results In the DGF group, the renal function was restored slowly. Compared with the IGF group, the Scr level was significantly higher, whereas the eGFR was considerably lower in the DGF group at postoperative 7 d (both P<0.05). At 1 year after surgery, there was no significant difference in the Scr level between two groups. Compared with the IGF group, the eGFR in the DGF group was significantly lower at postoperative 1 year (P<0.05). At 1, 2, 3, 7, 14 d after operation, the serum levels of IL-35 in the DGF group were evidently lower than those in the IGF group (all P<0.05). Compared with the IGF group, the serum level of IL-35 in the DGF group was significantly increased at postoperative 28 d (P<0.05). At postoperative 1, 2, 3, 7 d, the IL-35 levels in the urine samples in the DGF group were significantly lower than those in the IGF group (all P<0.05). At postoperative 14 and 28 d, the IL-35 levels in the urine samples did not significantly differ between two groups (both P>0.05). Conclusions The low levels of IL-35 in the serum and urine of recipients after renal transplantation are associated with the incidence of DGF to certain extent, prompting that excessively weak systemic and local anti-inflammatory responses early after renal transplantation and uncontrolled excessive inflammatory response are probably the pivotal causes of DGF.
ABSTRACT
Objective To evaluate the cost-utility of different hepatitis E vaccination strategies in women aged 15 to 49.Methods The Markov-decision tree model was constructed to evaluate the cost-utility of three hepatitis E virus vaccination strategies.Parameters of the models were estimated on the basis of published studies and experience of experts.Both methods on sensitivity and threshold analysis were used to evaluate the uncertainties of the model.Results Compared with non-vaccination group,strategy on post-screening vaccination with rate as 100％,could save 0.10 quality-adjusted life years per capital in the women from the societal perspectives.After implementation of screening program and with the vaccination rate reaching 100％,the incremental cost utility ratio (ICUR) of vaccination appeared as 5 651.89 and 6 385.33 YuaWQALY,respectively.Vaccination post to the implementation of a screening program,the result showed better benefit than the vaccination rate of 100％.Results from the sensitivity analysis showed that both the cost of hepatitis E vaccine and the inoculation compliance rate presented significant effects.If the cost were lower than 191.56 Yuan (RMB) or the inoculation compliance rate lower than 0.23,the vaccination rate of 100％ strategy was better than the post-screening vaccination strategy,otherwise the post-screening vaccination strategy appeared the optimal strategy.Conclusion Post-screening vaccination for women aged 15 to 49 from social perspectives seemed the optimal one but it had to depend on the change of vaccine cost and the rate of inoculation compliance.