MicroRNA-21 promotes epithelial-mesenchymal transition and migration of human bronchial epithelial cells by targeting poly (ADP-ribose) polymerase-1 and activating PI3K/AKT signaling

Epithelial-mesenchymal transition (EMT ) is known to be involved in airway remodeling and fibrosis of bronchial asthma. However, the molecular mechanisms leading to EMT have yet to be fully clarified. The current study was designed to reveal the potential mechanism of microRNA-21 (miR-21) and poly (ADP-ribose) polymerase-1 (PARP-1) affecting EMT through the PI3K/AKT signaling pathway. Human bronchial epithelial cells (16HBE cells) were transfected with miR-21 mimics/inhibitors and PARP-1 plasmid/small interfering RNA (siRNA). A dual luciferase reporter assay and biotin-labeled RNA pull-down experiments were conducted to verify the targeting relationship between miR-21 mimics and PARP-1. The migration ability of 16HBE cells was evaluated by Transwell assay. Quantitative real-time polymerase chain reaction and Western blotting experiments were applied to determine the expression of Snail, ZEB1, E-cadherin, N-cadherin, Vimentin, and PARP-1. The effects of the PI3K inhibitor LY294002 on the migration of 16HBE cells and EMT were investigated. Overexpression of miR-21 mimics induced migration and EMT of 16HBE cells, which was significantly inhibited by overexpression of PARP-1. Our findings showed that PARP-1 was a direct target of miR-21, and that miR-21 targeted PARP-1 to promote migration and EMT of 16HBE cells through the PI3K/AKT signaling pathway. Using LY294002 to block PI3K/AKT signaling pathway resulted in a significant reduction in the migration and EMT of 16HBE cells. These results suggest that miR-21 promotes EMT and migration of HBE cells by targeting PARP-1. Additionally, the PI3K/AKT signaling pathway might be involved in this mechanism, which could indicate its usefulness as a therapeutic target for asthma.

Progress in resistance mechanism of Klebsiella pneumoniae to polymyxin / 中国药房

With th e massive use of antibiotics ，Klebsiella pneumoniae has shown a trend of multiple drug resistance ， especially carbapenem-resistant K. pneumoniae ，which means that fewer and fewer antibiotics can be used to treat K. pneumoniae infection. Polymyxin has become the last line of defense for the treatment of carbapenem-resistant K. pneumoniae infection due to its unique antibacterial mechanism. However ，with the increase of its use ，the reports of drug-resistant K. pneumoniae strains at home and abroad are also on the rise ，seriously endangering the lives of patients . The author summarizes the resistance mechanism of K. pneumoniae to polymyxin ，and find that the resistance mechanism of K. pneumoniae to polymyxin mainly includes the structural modification of lipopolysaccharide in bacterial outer membrane ，the overexpression of capsular polysaccharide and the overexpression of multidrug efflux pump ，which can provide a basis for the rational use of the drug and the prevention and treatment of drug-resistant K. pneumoniae .

Current Situation Analysis of Pre-prescription Review in Medical Institutions in China / 中国药房

OBJECTIVE：To k now about t he current situation of pre-prescription review in medical institutions in China ，and provide reference for quality improvement of pre-prescription review in medical institutions. METHODS ：Retrieved from PubMed ， the Cochrane library ，EMbase（Ovid platform ），CNKI，CBM，VIP and Wanfang databases ，the studies about pre-prescription review in medical institutions in China were collected during the inception to Mar. 2020. After data extraction of the literatures met the inclusion and exclusion criteria ，descriptive analysis was used. RESULTS ：A total of 38 literatures were included ，involving 29 medical institutions ，of which 25 were third-grade class-A medical institutions （86.21％），22 comprehensive medical institutions （75.86％）；pre-prescription review was carried out from 2007 to 2019. Totally 84.62％ of medical institutions adopted the mode of “systematic review+manual review ”，and the main audited prescriptions were outpatient （emergency）prescriptions（76.00％）. Medical institutions adopting this mode mainly adopted the mode that auditing pharmacists rechecked the problem prescriptions intercepted by the system. The average manual review time of problem prescriptions in 8 medical institutions was within 60 s；the number of auditing pharmacists in 16 reported medical institutions ranged from 1 to 8，and educational degree of auditing pharmacists in 1 reported medical institution were bachelor degree or above. Their professional titles of 6 reported medical institutions were junior or above （83.33％）. Eleven medical institutions had full-time auditing posts （90.91％）. Success rate of problem prescription intervention was 93.99％ ；pre-prescription review could increase the qualification rate of prescription. CONCLUSION：The pre-prescription review in medical institutions in China has achieved certain results ，but still faces some problems，such as imperfect information system ，insufficient ability of auditing pharmacists and poor communication between doctors and pharmacists ，which will be the aspects that should be paid attention to in the future.

The acute and long-term outcome of patients with ST segment elevation myocardial infarction concurrent with chronic total occlusion / 中华心血管病杂志

Objective: To evaluate the acute and long-term outcome of patients with ST segment elevation myocardial infarction (STEMI) concurrent with chronic total occlusion (CTO) undergoing primary percutaneous coronary intervention (PCI). Methods: 11 905 STEMI patients from the China Acute Myocardial Infarction Registry were enrolled in this study and divided into CTO group and non-CTO group according to the angiography results of primary PCI. 1∶3 propensity score matching was used to match the patients between the two groups. The primary endpoint was in-hospital mortality and mortality at 1-year post PCI. The secondary endpoint was major adverse cardiovascular events (MACE) including death, re-myocardial infarction, revascularization, heart failure associated readmission, stroke and major bleeding at 1-year post PCI. Results: There were 931 CTO patients (7.8%) in this cohort (male=755 (81.1%), mean age (62.2±11.4 years)). The rest 10 974 patients were STEMI without CTO (male=8 829 (80.5%),mean age (60.0±11.8) years). After propensity score matching, 896 patients were enrolled in CTO group and 2 688 in non-CTO group. In-hospital mortality was significantly higher in the CTO group than in non-CTO group (4.2% vs. 2.4%, P=0.006). The ratio of all cause death, cardiac death, and MACE at 1-year follow up was also significantly higher in the CTO group than in non-CTO group (8.5% vs. 4.4%, P<0.001, 5.3% vs. 2.6%, P=0.001, 35.1% vs. 23.3%, P<0.001, respectively). Multiple regression analysis showed that CTO (HR=1.54, 95%CI 1.06-2.22, P=0.022), advanced age (HR=1.06, 95%CI 1.04-1.08, P<0.001), and previous heart failure history (HR=4.10, 95%CI 1.90-8.83, P<0.001) were independent risk factors of 1-year mortality. Conclusions: The in-hospital and 1-year mortality increased significantly in STEMI patients concurrent with CTO. CTO, advanced age and history of heart failure are independent risk factors of 1-year death among STEMI patients.

Cost-effectiveness Analysis of Insulin Analogues and Human Insulin in the Treatment of Type 2 Diabetes Mellitus Based on Net-benefit Regression Framework / 中国药房

OBJECTIVE：To compare the cost-effectiveness of insulin analogues and human insulin in the treatment of type 2 diabetes mellitus ，to reduce economic burden of patients ，and to provide new ideas for non-randomized pharmacoeconomic research. METHODS ：Retrospective data of a Third-grade Class-A hospital were adopted and 533 patients with type 2 diabetes were taken as object to balance the difference between groups through propensity score matching ，and construct net-benefit regression framework so as to analyze the cost-effectiveness of insulin analogues and human insulin in the treatment of type 2 diabetes mellitus. RESULTS ：There was a positive relationship between the efficacy and cost of the two therapeutic schemes ，i.e. insulin analogues were more effective than human insulin ，and the difference of total effective rate between the two schemes was 14.5％. The corresponding treatment cost of insulin analogues was higher than that of human insulin ，and the average total cost difference was 960.3 yuan. The cost of insulin analogues was 66.23 yuan more than that of human insulin for each additional unit of clinical effect （total effective rate ）. Results of net-benefit regression analysis showed that critical value of willingness to pay of therapy plan was 16 947.5 yuan. CONCLUSIONS ：When the willingness to pay is more than 16 947.5 yuan，the insulin analogue scheme is suitable ；on the contrary ，the human insulin analogue scheme is suitable. The propensity scoring technology used for the net-benefit regression analysis can broaden the source of avaliable data for non-randomized pharmacoeconomic evaluation.

Effect of Early Weight-bearing on Appropriate Population with Intertrochanteric Fracture after Surgery / 中国康复理论与实践

Objective:To observe the effect of early weight-bearing on the appropriate population with intertrochanteric fracture after surgery. Methods:From April, 2017 to December, 2018, a total of 45 patients with Evans-Jensen type II intertrochanteric fracture and fracture reduction as positive medial cortex support (PMCS) after proximal femoral nail anti-rotation (PFNA) fixation were randomly divided into control group (n = 22) and experimental group (n = 23). Weight-bearing as tolerated (WBAT) was initiated from six weeks after surgery in the control group, and within 48 h after surgery in the experimental group. The frequency of WBAT in two groups increased gradually from three times a day for ten minutes a time to five times a day for 20 minutes a time until clinical healing of fracture. The length of stay, hospital cost, the fracture healing time and the complication incidence were compared between two groups, as well as the scores of Visual Analogue Scale (VAS) and Harris Hip Score at six weeks, three months and six months after surgery. Results:Compared with the control group, the length of stay was shorter (t = 3.716, P < 0.01), the hospital cost was lower, but no significant difference was found (t = 1.540, P > 0.05), and the fracture healing time was shorter (t = 6.248, P < 0.001) in the experimental group. The complication incidence was lower in the experimental group, but there was no significant difference (χ2= 2.198, P > 0.05). Six weeks, three months and six months after surgery, there was no significant difference in the score of VAS between two groups (t < 1.330, P > 0.05). The score of Harris Hip Score was significantly higher in the experimental group than in the control group six weeks after surgery (t = -5.115, P < 0.001), however, no significant difference was found in other time points (|t| < 1.799, P > 0.05). Conclusion:Early weight-bearing within 48 h after PFNA fixation for Evans-Jensen type II intertrochanteric fractures and reduction with PMCS could shorten the length of stay, shorten the bony healing time and promote early recovery of hip function.

Seroprevalence of Toxoplasma gondii infections among patients with autoimmune diseases / 中国血吸虫病防治杂志

Objective To understand the seroprevalence of Toxoplasma gondii infections among patients with autoimmune diseases, so as to provide the scientific evidence for the management of toxoplasmosis in patients with autoimmune diseases. Methods A total of 237 patients with definitive diagnosis of autoimmune disease were selected as the study subjects, including 79 cases with systemic lupus erythematosus, 71 cases with rheumatoid arthritis and 87 cases with inflammatory bowel disease, while 237 healthy volunteers served as controls. The serum anti-T. gondii IgG antibody was detected using enzyme-linked immunosorbent assay (ELISA) in patients with autoimmune diseases and healthy controls, and the detection of serum IgG antibody against T. gondii was compared between the autoimmune disease patients and healthy controls. Results The seroprevalence of serum IgG antibody against T. gondii was significantly greater in patients with autoimmune diseases than in healthy controls (29.96% vs. 4.22%; χ2 = 55.41, P < 0.01), and the seroprevalence of T. gondii infection was all significantly higher in patients with systemic lupus erythematosus (31.65%), rheumatoid arthritis (23.94%) and inflammatory bowel disease (33.33%) than in healthy controls (χ2 = 45.25, 26.58 and 50.95; all P values < 0.01). Conclusion The seroprevalence of anti-T. gondii IgG antibody is significantly higher in patients with autoimmune diseases than in healthy controls, and T. gondii infection may be a potential risk factor for the development of systemic lupus erythematosus, rheumatoid arthritis and inflammatory bowel disease.

Sanitation status of centralized air ventilation system of public places in Putuo District, Shanghai, 2014-2018 / 上海预防医学

Objective To investigate the sanitation status of centralized air ventilation system in Putuo District of Shanghai, to analyze correlation between different indexes and to provide basis for improving the health status of public places and strengthening health supervision. Methods According to the requirements of WS 394-2012 The Sanitation Criterion of the Centralized Air Ventilation System in Public Places, 18 centralized air ventilation systems in public places in Putuo District of Shanghai were randomly selected for sampling, testing and evaluation during 2014-2018, and 9 indexes of air supply, inner surface of air duct and indoor air were analyzed for correlation. Results The overall qualified rate of centralized air ventilation system in 10 hotels, 4 restaurants and 4 supermarkets was 86.0%.The over standard rate of PM10, bacteria and fungi in air supply was 3.4%, 31.8% and 33.0%, respectively, but β-hemolytic streptococcus was not detected.The dust amount and microbial index on the inner surface of the air duct were up to standard.Another two indexes of fresh air quantity and Legionella pneumophila were tested in the hotel.The qualified rate of fresh air quantity was 25.6%, the positive rate of Legionella pneumophila type 1(LP1) in cooling water was 30.0%, and no Legionella pneumophila was detected in condensate water.The correlation analysis of 9 indexes showed that there was a significant positive correlation between PM10 in air supply and in indoor air; the amount of microbial pollution on the inner surface of air duct and in air supply; and the amount of microbial pollution in air supply and in indoor air. Conclusions In Putuo District, the general sanitary condition of the centralized air ventilation system in public places is not to be optimistic.The qualified rate of bacteria and fungi in the air supply and fresh air quantity is low, and Legionella pneumophila was detected.The indoor air quality can be improved by installing efficient air purification device and regular cleaning and disinfection.

Meta-analysis of the Efficacy and Safety of Prophylactic Use of Low-dose Aspirin in Patients with Chronic Renal Disease / 中国药房

OBJECTIVE：To evaluate the efficacy and safety of prophylactic use of low-dose aspirin in patients with chronic renal disease ，and to provide reference for evidence-based reference for rational use in the clinic. METHODS ：Retrieved from PubMed，Embase，Cochrane Library ，CNKI，VIP，Wanfang database ，RCTs about prophylactic use aspirin 75-150 mg/d（aspirin group）versus no aspirin and other antiplatelet drugs or placebo （control group ）were collected from inception to May 14th，2019. Relevant data were extracted. After quality evaluation with bias risk assessment tool recommended by Cochrane system evaluator manual 5.1.0，Meta-analysis of the incidence of cardiovascular events ，renal events and bleeding events in patients with chronic renal disease was performed by using Rev Man 5.3 software. RESULTS ：A total of 5 RCTs were included ，involving 4 728 patients；among them ，there were 2 392 persons in aspirin group and 2 390 persons in control group. Results of Meta-analysis showed that there was no statistical significance in the incidence of cardiovascular events [OR ＝0.59，95％CI（0.13，1.12），P＝0.11] and the incidence of renal events [OR ＝0.42，95％CI（0.08，2.23），P＝0.31] between aspirin group and control group. The incidence of bleeding events [OR ＝2.12，95％CI（1.23，3.66），P＝0.007] in aspirin group was significantly higher than control group. After exculsion of two heterogeneity literatures ，the incidence of cardiovascular events [OR ＝0.27，95％CI（0.13，0.55），P＝0.000 3] in aspirin group was significantly lower than control group. CONCLUSIONS ：Prophylactic use of low-dose aspirin can prevent cardiovascular events in patients with chronic renal disease to certain extent. The low-dose aspirin should be used carefully to prevent cardiovascular events in chronic renal disease patients with high risk of bleeding.

Seroprevalence of Toxoplasma gondii and Toxocara infections among pregnant women in Hangzhou City / 中国血吸虫病防治杂志

Objective To investigate the prevalence of Toxoplasma gondii and Toxocara infections among pregnant women in Hangzhou City, so as to provide baseline data for decreasing birth defects and improving the population quality. Methods A total of 235 pregnant women receiving prenatal diagnosis at the First People’s Hospital of Yuhang District during the period between February 2018 through December 2019 were recruited as the observation group, and 235 age-matched, non-pregnant healthy women at the same hospital during the same period served as the control group. The subjects’medical records were captured from the hospital management information system. Blood samples were collected from the observation and control groups and detected for the presence of IgG antibodies against T. gondii and Toxocara using an enzyme-linked immunosorbent assay (ELISA). The seroprevalence of the IgG antibodies against T. gondii and Toxocara was compared between the observation and control groups. Results The subjects in the observation group had a mean age of 26.5 ± 4.3 years (range, 23 to 31 years), and gestational ages of 10 to 27 weeks, and the subjects in the control group had a mean age of 26.1 ± 5.7 years (range, 20 to 30 years). The seroprevalence rates of IgG antibodies against T. gondii (28.51% vs. 4.68%; χ2 = 34.85, P < 0.01) and Toxocara (24.26% vs. 5.11%; χ2 = 25.77, P < 0.01) were both significantly higher in the observation group than in the control group, and the seroprevalence of T. gondii and Toxocara co-infections was also significantly greater in the observation group than in the control group (13.19% vs. 2.13%; χ2 = 17.49, P < 0.01). Conclusions The seroprevalence rates of T. gondii and Toxocara infections and their co-infections are all high among pregnant women in Hangzhou City. Screening of T. gondii and Toxocara infections is strongly recommended during pregnancy.

Optimization of Anti-infective Program for A Obese Patient with Pulmonary Infection after Stroke by Clinical Pharmacists / 中国药房

OBJECTIVE： To explore the methods and ideas for clinical pharmacists to optimize anti-infective treatment programs in obese patients with pulmonary infection. METHODS： The clinical pharmacist optimized the anti-infection regimen of an obese patient with post-stroke pulmonary infection （BMI＝34.602 kg/m2） admitted to our hospital， and adjusted the dose adjustment and drug replacement of piperacillin tazobactam in the obese patient. And the selection of methicillin-resistant Staphylococcus aureus （MRSA） drugs and dose determination were proposed. RESULTS： According to the patient’s body weight and guidelines， the dose of piperacillin tazobactam was adjusted from 4.5 g， q12 h to 4.5 g， q6 h； the antibiotic was changed to moxifloxacin due to pathogenic changes， the dose was 0.4 g， qd， no need to increase When diagnosed as pneumonia caused by MRSA infection， linezolid was used instead of vancomycin for infection treatment in obese patients， and the dose was determined to be 600 mg， q12 h. The physician adopted the above recommendations. After treatment， the patient’s temperature decreased， cough and sputum eased， and the laboratory indicators returned to normal and discharged smoothly. CONCLUSION： Clinical pharmacists can participate in the drug treatment of special obese patients by exerting their own professional advantages： by adjusting the type， dose and frequency of antibacterial drugs， patients can obtain individualized treatment， improve the safety and effectiveness of patients’ medication， and finally obtain satisfactory results.

Analysis of Chinese citizens' traditional Chinese medicine health culture literacy level and its influence factors in 2017 / 中国中药杂志

To analyze the TCM health culture level and influence factors of Chinese citizens in 2017. PPS sampling combined with random sampling was used to select the residents aged between 15-69 years old in 30 provinces as the respondents,and a questionnaire study was conducted to investigate their TCM health culture level. In 2017,there were 87 287 valid questionnaires for Chinese citizens' TCM health culture level,including 48. 25% male and 51. 75% female,with a sex ratio of 1 ∶ 1. 073. In 2017,the overall TCM health culture level was 13. 39%,specifically 18. 77% for the urban areas and 10. 51% for the rural areas. Compared with people who were illiterate or less literate,people with an educational background of elementary school,junior high school,high school/vocational/technical school and junior college/university had a higher TCM health culture level,and the OR values were 1. 584( 95% CI[1. 166,2. 152]),2. 827( 95%CI[1. 839,4. 345]),5. 651( 95%CI[3. 637,8. 781]),9. 785( 95%CI[6. 187,15. 477]) in order. With civil servants as the reference,medical workers had a higher TCM health culture level( OR = 1. 829,95%CI[1. 279,2. 616]),while farmers had the lowest TCM health culture level( OR = 0. 493,95% CI[0. 349,0. 697]). Compared with people with the annual household income per capita of 20 000 yuan and below,people with the annual household income per capita between 20 000-50 000,50 000-80 000,80 000 yuan or above had a higher TCM health culture level,and the OR values were 1. 176( 95% CI[0. 963,1. 437]),1. 458( 95%CI[1. 168,1. 820]) and 1. 930( 95%CI[1. 509,2. 469]). Based on the differences between urban and rural areas,the influence factors of citizens' TCM health culture level include education,occupation and income.

Influence of Familiarity on Energy Intake and Plasma Gut Hormone Concentration in Lean and Overweight Young Male Students / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>This study is to examine the influence of familiarity on energy intake, eating behavior, and concentration of the plasma gut hormones in lean and overweight young male subjects.</p><p><b>METHODS</b>Twenty-eight lean and twenty-eight overweight participants were recruited. Their food consumption was documented and analyzed when they had a test meal while they were paired with friends or strangers at the same weight stature. Their eating behavior was recorded with cameras hidden in the carton, and postprandial plasma gut hormone concentration were measured.</p><p><b>RESULTS</b>Compared with overweight strangers (OS), overweight friends (OF) had increased food consumption, prolonged and decreased number of chews per 10 g food. Compared with OS, postprandial plasma concentration of cholecystokinin-8 was significantly lower in OF group at 30, 60, and 90 min, whereas the concentration of glucagon-like peptide 1 was significantly lower at 60 and 90 min. Plasma ghrelin concentration was significantly higher in the OF group than that in the OS group at 90 and 120 min. No significant differences in gut hormone concentration were observed between lean strangers (LS) and lean friends (LF) groups at all time points.</p><p><b>CONCLUSION</b>Familiarity plays an important role in increasing energy intake and in changing of postprandial gut hormone concentration in overweight individuals.</p>

Investigation on Toxoplasma gondii infection in liver disease patients in Hangzhou City / 中国血吸虫病防治杂志

Objective To understand the Toxoplasma gondii infection in liver disease patients in Hangzhou City.Methods A total of 1 200 patients with liver diseases were enrolled,including 300 patients with liver cancer,300 cases with hepatitis B,300 cases with hepatic fibrosis and 300 cases with fatty degeneration of the liver,while 1 200 healthy people served as controls.The serum anti-T.gondii IgG and IgM antibodies were detected in the subjects using ELISA assay.Results The seropositive rates of anti-T.gondii IgG and IgM antibodies were 24.00％(288/1 200)and 1.17％(14/1 200)in the liver disease patients,and 11.42％(137/1 200)and 1.08％(13/1 200)in the healthy controls,respectively.There was a significant difference in the seropositive rate of anti-T.gondii IgG antibody between the liver disease patients and controls(Χ 2=65.19,P<0.01),and no significant difference was seen in the seropositive rate of anti-T.gondii IgM antibody between the liver disease patients and con-trols(Χ 2=0.04,P>0.05).The seropositive rates of anti-T.gondii IgG antibody were 26.00％,25.00％,23.33％and 21.67％in the patients with liver cancer,hepatitis B,hepatic fibrosis and fatty degeneration of the liver,respectively,and no significant difference was detected among these patients with four types of liver diseases(Χ2=1.79,P>0.05).Conclusion The seroposi-tive rate of anti-T.gondii IgG antibody is high in liver disease patients in Hangzhou City,and the management and health educa-tion of toxoplasmosis should be given to patients with liver diseases.

Study on risk assessing indicator system after schistosomiasis transmission interruption in Wuxi City / 中国血吸虫病防治杂志

Objective To establish a risk assessing indicator system after the transmission interruption of schistosomiasis in Wuxi City,so as to provide evidences for formulating strategies on schistosomiasis control and prevention. Methods A primary risk assessing indicator system was established based on the literature review. Alternative indicators were scored and screened to establish a final indicator system through two rounds of Delphy method and the related normalized weights and combined weights were also calculated. Results The risk assessing indicator system was established through two rounds of expert consultation in-cluding 3 first grade indicators and 15 second grade indicators. Among the first grade indicators,the normalized weights of natu-ral environment,key populations and social environment were 0.3706,0.2929 and 0.3365,respectively. Among the second grade indicators,the migrant population accounted for the highest combined weight of 0.1252 compared to domestic animal of 0.0371. The authority degree among the first grade indicators was between 0.91 and 0.93,while the authority degree among the second grade indicators was between 0.79 and 0.92. Conclusion The scientific and authoritative risk assessing indicator sys-tem after the transmission interruption of schistosomiasis is established,which provides the evidences for risk assessment on schistosomiasis transmission in Wuxi City.

Neurodevelopmental features of preterm infants at the corrected age of 1 year / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the neurodevelopmental level of preterm infants at the corrected age of 1 year and the effect of complications on neurodevelopment.</p><p><b>METHODS</b>The clinical data and follow-up data of hospitalized preterm infants were retrospectively studied. The Bayley Scales of Infant Development was used to assess the neurodevelopmental level. Preterm infants were divided into groups according to gestational age, birth weight, and the presence or absence of complications. The mental development index (MDI) and psychomotor development index (PDI) were compared between groups.</p><p><b>RESULTS</b>At the corrected age of 1 year, compared with the late preterm infants, the early preterm infants had significantly lower MDI and PDI (P<0.05) and significantly higher rates of retarded intellectual and psychomotor development (P<0.01). Compared with the normal birth weight group, the low birth weight group had significantly lower MDI and PDI (P<0.01) and significantly higher rates of retarded intellectual and psychomotor development (P<0.01). The preterm infants with hyperbilirubinemia, birth asphyxia or neonatal respiratory distress syndrome (NRDS) had significantly lower MDI and PDI than those without such complications (P<0.05).</p><p><b>CONCLUSIONS</b>Lower gestational age and birth weight are associated with worse intellectual and psychomotor development in preterm infants. Complications, such as hyperbilirubinemia, birth asphyxia and NRDS, have adverse effects on neurodevelopment of preterm infants.</p>

Advances in research on childhood neutropenia / 中国当代儿科杂志

Neutrophils, an important type of human immune cells, are involved in host defense against infections. Neutropenia refers to a group of diseases manifesting as a reduction in the absolute value of mature neutrophils and is often accompanied by an increased risk of bacterial infection. According to etiology and pathogenesis, neutropenia is classified into congenital and acquired neutropenia. This article reviews the current research status and advances in the etiology of neutropenia in children. A deep understanding of the etiology of neutropenia helps to improve the diagnosis and treatment of this disease.

Study on Ability and Influential Factors for Pharmaceutical Care of Clinical Pharmacists in the Hospital / 中国药房

OBJECTIVE:To provide reference for improving pharmaceutical care in the hospital. METHODS:A total of 712 clinical pharmacists were selected from 38 third grade class A hospitals in 17 provinces and cities by convenient sampling to investi-gate the ability of pharmacectical care and influantial factors. Single and multiple factor Logistic regression analysis were conducted for the results. RESULTS:The single factor analysis showed that there was significant difference in the communication between clinical pharmacists and patients or medical staffs,the listening attitude of the patients,attitude towards job prospects,understand-ing about the connotation of clinical pharmacy,the timeliness of drug supply,smoothness degree of channel,the timeliness of coordi-nation,smooth development of pharmaceutical care(P<0.05). The multiple factor analysis showed that due to good communication with the doctor [OR=1.819,95%CI(1.469,2.253)],pharmacists could understand definition and connotation of pharmaceutical care [OR=2.263,95%CI(1.722,2.973)],and the male pharmacists [OR=0.558,95%CI(0.382,0.813)] with positive attitude to the pharmacists [OR=1.506,95%CI(1.309,1.733)] believed to provide good pharmaceutical care. CONCLUSIONS:This investigation can reflect the present situation of hospital pharmaceutical service in China to a certain extent. It is suggested to improve pharmaceuti-cal care ability of pharmacists through strengthening resource disposition and the cooperation between physicians and pharmacist.

Nutritional status of vitamin D and its influencing factors in preterm infants at the early stage after birth / 中华临床营养杂志

Objective To investigate the nutritional status of vitamin D in preterm infants after birth and further explore its possible influencing factors, so as to guide clinical vitamin D therapy and to screen the preterm infants who are at high risk of vitamin D deficiency.Methods Retrospective analysis was conducted in the neonatal department of our hospital from April 21st, 2014 to February 5th, 2016.The serum 25(OH)D level in preterm infants were measured 2 weeks after birth.Data including gender, season of birth, time to initiation of breastfeeding were collected.According to the 25(OH)D levels[25(OH)D≤37.5 nmol/L, 37.5 nmol/L≤50.0 nmol/L, and 25(OH)D>50.0 nmol/L], all the preterm infants were divided into three groups: vitamin D deficiency, insufficiency, and sufficiency groups.The influencing factors of vitamin D in preterm infants were screened by using statistical method.Results The mean 25(OH)D level of 172 preterm infants was (43.1±16.7)nmol/L.In vitamin D deficient, insufficient, and sufficient groups, there were 68 (40％), 50 (29％) and 54(31％) cases of preterm babies, respectively.The mean values of 25(OH)D in these three groups were (27.8±16.7)nmol/L, (42.4±3.4)nmol/L, and (63.0±11.7)nmol/L, respectively.Only the season of birth had significant difference among three groups (P=0.013): 44.2％ of the preterm infants born in winter had vitamin D deficiency, which was higher than those in spring (41.7％), summer(33.3％), and autumn (38.1％);44.2％ of the preterm infants born in winter had vitamin D insufficiency, which was much higher than those in spring (30.6％), summer (25.1％), and autumn (19.0％);furthermore, only 11.6％ of the preterm infants born in the winter had vitamin D sufficiency, which was much lower than those in spring (27.8％), summer (41.2％), and autumn (42.9％) (OR=4.655, 95％ CI=1.716-12.627, P=0.003).Conclusion Vitamin D deficiency in preterm infants 2 weeks after birth is prevalent, and winter birth is a risk factor of vitamin D deficiency and insufficiency in preterm infants.

Tuberous sclerosis complex secondary to fetal heart occupying lesions: a case report and literature review / 临床儿科杂志

Objective To explore the clinical characteristics of tuberous sclerosis complex (TSC). Methods The clinical data of one child with TSC were collected. The clinical features and gene mutation were analyzed. Results A 36-day-old girl had abnormal nodules found by echocardiography, which was considered multiple cardiac rhabdomyomas. There were multiple hypomelanotic macules distributed over the skin surface of the trunk and legs. Cranial MRI showed cortical nodules, subependymal nodules and cerebral white matter radial migration line. A mutation in the TSC2 gene (c.4541-4544delCAAA) was found by second generation high-throughput sequencing technology and tuberous sclerosis complex was confirmed. Conclusion Gene detection is helpful in the early diagnosis of tuberous sclerosis complex.