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Objective:To study the current status of longitudinal extrauterine growth restriction (EUGR) in extremely preterm infants (EPIs) and to develop a prediction model based on clinical data from multiple NICUs.Methods:From January 2017 to December 2018, EPIs admitted to 32 NICUs in North China were retrospectively studied. Their general conditions, nutritional support, complications during hospitalization and weight changes were reviewed. Weight loss between birth and discharge > 1SD was defined as longitudinal EUGR. The EPIs were assigned into longitudinal EUGR group and non-EUGR group and their nutritional support and weight changes were compared. The EPIs were randomly assigned into the training dataset and the validation dataset with a ratio of 7∶3. Univariate Cox regression analysis and multiple regression analysis were used in the training dataset to select the independent predictive factors. The best-fitting Nomogram model predicting longitudinal EUGR was established based on Akaike Information Criterion. The model was evaluated for discrimination efficacy, calibration and clinical decision curve analysis.Results:A total of 436 EPIs were included in this study, with a mean gestational age of (26.9±0.9) weeks and a birth weight of (989±171) g. The incidence of longitudinal EUGR was 82.3%(359/436). Seven variables (birth weight Z-score, weight loss, weight growth velocity, the proportion of breast milk ≥75% within 3 d before discharge, invasive mechanical ventilation ≥7 d, maternal antenatal corticosteroids use and bronchopulmonary dysplasia) were selected to establish the prediction model. The area under the receiver operating characteristic curve of the training dataset and the validation dataset were 0.870 (95% CI 0.820-0.920) and 0.879 (95% CI 0.815-0.942), suggesting good discrimination efficacy. The calibration curve indicated a good fit of the model ( P>0.05). The decision curve analysis showed positive net benefits at all thresholds. Conclusions:Currently, EPIs have a high incidence of longitudinal EUGR. The prediction model is helpful for early identification and intervention for EPIs with higher risks of longitudinal EUGR. It is necessary to expand the sample size and conduct prospective studies to optimize and validate the prediction model in the future.
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The coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) with high pathogenicity and infectiousness has become a sudden and lethal pandemic worldwide. Currently, there is no accepted specific drug for COVID-19 treatment. Therefore, it is extremely urgent to clarify the pathogenic mechanism and develop effective therapies for patients with COVID-19. According to several reliable reports from China, traditional Chinese medicine (TCM), especially for three Chinese patent medicines and three Chinese medicine formulas, has been demonstrated to effectively alleviate the symptoms of COVID-19 either used alone or in combination with Western medicines. In this review, we systematically summarized and analyzed the pathogenesis of COVID-19, the detailed clinical practice, active ingredients investigation, network pharmacology prediction and underlying mechanism verification of three Chinese patent medicines and three Chinese medicine formulas in the COVID-19 combat. Additionally, we summarized some promising and high-frequency drugs of these prescriptions and discussed their regulatory mechanism, which provides guidance for the development of new drugs against COVID-19. Collectively, by addressing critical challenges, for example, unclear targets and complicated active ingredients of these medicines and formulas, we believe that TCM will represent promising and efficient strategies for curing COVID-19 and related pandemics.
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Pyrethroids, a broad class of synthetic organic insecticides applied in daily life, are highly toxic in the water environment and can cause organisms to develop symptoms of neurotoxicity.Environmental exposure has become one of the important factors explored during child growth and development in recent years, and the exposure of pyrethroids in the environment has gradually increased, making their effects on child growth and development also highly valued.A large number of studies at home and abroad have found that pyrethroids have effects on multi system development: exposure during pregnancy can lead to intrauterine growth restriction, malformations, etc.Postnatal exposure can lead to cognitive retardation, abnormal pubertal development, and may also increase the risk of allergic diseases, wheeze, cough, and acute lymphoblastic leukemia.This article provides a review of the effects of pyrethroid exposure on growth and developmental processes in children.
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OBJECTIVE To optimize the formulation of a porcine fibrin patch (abbreviated as “DBT”). METHODS Based on single-factor tests, with the contents of fibrinogen, thrombin and collagen before freeze-drying as the factors, with the overall desirability (OD) value of adhesion strength, holding viscosity and water absorption as response value, the formulation of DBT was optimized by Box-Behnken-response surface methodology, and the verification tests were conducted. RESULTS According to the results of the single factor tests and Box-Behnken-response surface methodology, combined with the actual production, the optimal formulation of DBT was 6.5 mg/cm2 of fibrinogen, 8.0 IU/cm2 of thrombin and 5.6 mg/mL of collagen. The average OD value of 3 validation tests was 0.726 6 (RSD=0.58%, n=3), and the relative error of which with the predicted value (0.733 0) was -0.87%. CONCLUSIONS The optimal formulation of DBT is stable and feasible.
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It is essential that public hospitals,as the main body of China's health care service system,must uphold the overall leadership of the Communist Party of China(CPC)to achieve high-quality development in the new era,which requires the deep integration of Party building and hospital operation.Since the CPC's 18th National Congress,public hospitals have actively strengthenedprimary-level Party building by consolidating the foundation,which has largely contributed to advancing the Healthy China Initiative and optimizing the allocation of medical resources.However,there remain some problems in the integration of Party building and hospital operation,such as insufficient understanding of the integration and simple methods to achieve it,lead-ing to inadequate integration in some hospitals.By analyzing of the causes of above problems,based on Sun Yat-sen Memorial Hospital,Sun Yat-sen University's practices in Party building,the author actively explores the effective path of deep integration of party building and business work in public hospitals from the aspects of promoting party building and theoretical learning,sys-tem design,team building and business characteristics.In order to provide useful references for public hospitals to achieve high-quality development in the new era.
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Objective:To explore the application effect of case-based learning (CBL) based on UMU interactive mobile learning in the teaching of standardized training of respiratory medicine.Methods:A total of 80 trainees who had standardized training in Department of Respiratory Medicine of Daping Hospital from June 2019 to June 2020 were enrolled as the research objects. They were randomly divided into observation group ( n=42) and control group ( n=38). The control group was given traditional teaching mode, while observation group was given CBL based on UMU interactive mobile learning. The assessment results, control situations of core competence and teaching satisfaction after training were compared between the two groups. SPSS 20.0 was conducted for chi-square test and t test. Results:The scores of professional theoretical knowledge, case analysis ability and clinical operation skills in observation group were higher than those in control group ( P<0.05). The total control rate of core competence in observation group was significantly higher than that in control group (95.24% vs. 78.95%) ( P<0.05), and the teaching satisfaction rate of observation group was significantly higher than that of control group (100% vs. 84.21%) ( P<0.05). Conclusion:Application of CBL based on UMU interactive mobile learning in the teaching of standardized training of respiratory medicine is not only conducive to improving the teaching quality, but also conducive to cultivating core competence, clinical thinking ability and problem-solving ability of the training students, with higher teaching satisfaction.
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Objective:To investigate the prognosis of severe hyperbilirubinemia in full-term infants who met the exchange transfusion criteria and were treated by blood exchange transfusion and phototherapy.Methods:A total of 168 full-term infants with severe hyperbilirubinemia who met the criteria for exchange transfusion and were hospitalized in the Neonatology Department of seven tertiary hospitals in Hebei Province from June 2017 to December 2018 were retrospectively included. According to the treatment protocol, they were divided into two groups: exchange transfusion group (38 cases) and phototherapy group (130 cases). Two independent sample t-test and Chi-square test were used to compare the clinical manifestations and follow-up results between the two groups. Multivariate logistic regression was used to analyze the risk factors for poor prognosis. Results:Neonatal severe hyperbilirubinemia in the exchange transfusion and phototherapy group were both mainly caused by hemolytic disease [42.1%(16/38) and 29.2%(38/130)], sepsis [28.9%(11/38) and 11.5%(15/130)] and early-onset breastfeeding jaundice [15.8%(6/38) and 11.5%(15/130)]. Total serum bilirubin level on admission in the exchange transfusion group was significantly higher than that in the phototherapy group [(531.7±141.3) vs (440.0±67.4) μmol/L, t=3.870, P<0.001]. Moreover, the percentage of patients with mild, moderate and severe acute bilirubin encephalopathy in the exchange transfusion group were higher than those in the phototherapy group [15.8%(6/38) vs 3.8%(5/130), 7.9%(3/38) vs 0.8%(1/130), 13.2%(5/38) vs 0.0%(0/130); χ2=29.119, P<0.001]. Among the 168 patients, 135 were followed up to 18-36 months of age and 12 showed poor prognosis (developmental retardation or hearing impairment) with four in the exchange transfusion group (12.9%, 4/31) and eight in the phototherapy group (7.7%, 8/104). Multivariate logistic regression analysis showed that for full-term infants with severe hyperbilirubinemia who met the exchange transfusion criteria, phototherapy alone without blood exchange transfusion as well as severe ABE were risk factors for poor prognosis ( OR=14.407, 95% CI: 1.101-88.528, P=0.042; OR=16.561, 95% CI: 4.042-67.850, P<0.001). Conclusions:Full-term infants who have severe hyperbilirubinemia and meet the exchange transfusion criteria should be actively treated with blood exchange transfusion, especially for those with severe ABE, so as to improve the prognosis.
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Objective ToexplorethevalueofMRIinthediagnosisofcoronaryarteryandmyocardiallesionsinchildrenwithKawasaki disease.Methods CardiacMRIof38patientswithKawasakidiseasewereretrospectivelyanalyzed.MRIsequencesincludedthree dimensionalsteady-statefreeprecession (3D-SSFP)coronaryarteryimaging,first-passperfusiontoassessmyocardialischemia,late gadolinium-enhancedmagneticresonanceimaging(LGE-MRI)toassessmyocardialhistologyfeatures,and2D-SSFPcinesequenceto evaluatecardiacfunction.Themaximumdiametersofcoronaryaneurysmsmeasuredin3D-SSFPwerecomparedwiththosemeasured inechocardiography(ECHO)byBland-Altmananalysis.Results Amongthe38cases,therewere28cases(73.7%)withaneurysmal dilatationinrightcoronaryartery(RCA)orleftcoronaryartery (LCA).Thehighestincidenceofaneurysmaldilatationwasinleft anteriordescendingbranch (LAD)in23cases,andfollowedbyRCAin19cases.ThemaximumdiameterofRCAaneurysm (7.66± 2.10)mm washigherthanthatofLADaneurysm (6.11±1.96)mm withP<0.05.Myocardialfirst-passperfusionin5casesshowed leftventricularandventricularseptumsubendocardialischemia,LGE-MRIin5casesshowedmyocardialdelayedenhancementinleft ventricularfreewallandventricularseptum,andtheleftventricularejectionfractionsin4caseswerelessthan50%,withanaverage of(34.0±15.9)%.3D-SSFPandECHOshowedgoodconsistencyinthemaximaldiametermeasurementofRCAandLADaneurysm. Conclusion TheimagingfeaturesindifferentsequencesofMRIcanbeusedtocomprehensivelyevaluatethecoronaryarteryand myocardialhistologicalcharacteristicsofKawasakidisease,includingcoronaryaneurysms,thrombosis,myocardialfibrosisandchanges ofventricularfunction.
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Objective To assess the association between vitamin D levels during pregnancy and the risk of offspring's wheeze.Methods We searched electronic databases of PubMed and EMbasefrom published studies until July 2017.A random-effects meta-analysis was conducted among 11 birth cohort studies.Results Eleven studies on the association between maternal vitamin D status and childhood wheeze met our inclusion criteria.Maternal vitamin D status during pregnancy was associated with childhood wheeze(OR =0.97,95% CI:0.96 ~ 0.99).Maternal intake of vitamin D(pooled OR =0.51,95 % CI:0.37 ~ 0.64),cord blood 25 (OH)D levels at birth (pooled OR =0.94,95% CI:0.9 ~ 0.98) were associated with childhood wheeze.Furthermore,maternal vitamin D stasus were only associated with childhood early wheeze(OR =0.92,95% CI:0.89 ~0.96),but not with late-onset or persistent wheeze.Conclusion High levels of vitamin D during pregnancy are inversely associated with the risk of wheeze during childhood.
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Summer school is an important reform of the teaching organization mode home and abroad. The purpose is to make the best use of the limited teaching resources to meet the needs of the students. In recent years, a lot of universities has accumulated abundant experiences to set up summer school in China. This article focuses on the practice of summer school in Beijing University of Chinese Medicine, in order to provide some promoting strategies for summer school in domestic universities of Traditional Chinese Medicine in future.
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Nowdays, Chinese medicine training has two modes, apprentice education and college education. The two modes showed the differences in the source of students, teaching content, methods and effect of the education. The two models should be combined to cultivate excellent talents of Chinese Medicine. Additionally, different training should be conducted according to different goals. This article focused on the traning mode of Chinesae medicine talents at Beijing University of Chinese Medicine in recent years, put forward some issues in future education and provided some promoting strategies to combine traditional apprentice education and college education.
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Objective To explore the mental health status of physical examination population,and provide the basis for mental health guidance.Methods The SCL-90 scale in the cloud service system of PEM was used to evaluate the gender, marriage, age, education, income and other factors in the physical examination cases of our hospital.Results The positive rate of SCL-90 in 809 patients was 27.94%.Female scores,and the scores of somatization, obsessive-compulsive symptoms, depression, anxiety, terror of women were higher than those of men except paranoid.Unmarried population scores and the scores of all factors were higher than those of married and divorced people.The scores of all factors in the 18-<30 year-old cases was the highest among all cases;the scores of depression,hostility and paranoid was decreased with the increase of age;the score of somatization, obsessive-compulsive symptoms, interpersonal sensitivity, anxiety, terror,spirit of 50-60 year-old cases were the lowest among all cases.The higher the degree of education,and the more economic income, the lower the psychological evaluation of each factors scored.Conclusion The mental health problems of female,unmarried,low age,low education,low-income groups are grim.
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Objective To explore the effect of calories supplement or protein supplement on the skeletal muscle in the elderly.Methods The ambulatory elderly (≥65 yrs) with reduced handgrip strength and/or gait speed were enrolled,who did not suffer from any neurological or arthritic disease impairing mobility,or any severe pulmonary or heart disease,or chronic kidney failure.The subjects were recruited with their written informed consent from clinical practices in five hospitals in China.The subjects were randomized to control group(n=26),nutrition supplementation (Nutren 400 kcal/ d) group (n=27) or protein supplementation(Biopro Protein 20 g/d) group (n=21).All the subjects were given healthy lifestyle education.The physical performances i.e.gait speed and handgrip strength were measured at baseline and at 2 and 3 months of followed up.Lean soft tissue mass (muscle mass) was measured by BIA at baseline and at 3 months of follow-up.Results A total of 74 subjects completed the trial,including 26 in controls,27 in Nutren,and 21 in protein group.At the end of the trial,the changes from baseline in appendicular muscle mass were-490.0 g (95%CI:-801.9--245.5,P=0.001)in control group,90.0 g (95%CI:-346.8--442.0,P=0.241) in Nutren group,and 290.0 g (95%CI:-746.6-20.1,P=0.007) in protein group.There were no significant difference in above indices among the three groups (P=0.051),except between Nutren group and control group (P=0.020).The handgrip strength and gait speed in the three groups were improved obviously as compared with those at baseline,but not statistically significant between different groups.Conclusions Caloric supplementation group may have greater effect in maintaining muscle mass than the protein supplement group in the elderly.Both the caloric supplement and the protein supplement produce no additional effect on muscular function as compared with healthy lifestyle education.
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Objective To analysis the health related quality of life (HRQOL)in emigrants with rheumatoid arthritis(RA) in Three‐Gorge Reservoir area ,and to study the influencing factors on HRQOL .Methods Self‐rating depression scale(SDS) was used to assess degree of depression in emigrants with rheumatoid arthritis in Three‐Gorge Reservoir area ,and SF‐36 scalec was used to assess the HRQOL of these patients .The one‐way ANOVA and stepwise regression analysis were used to study the influence fac‐tors of HRQOL .Results SDS scores showed that there were 110 peoples with depressive symptoms (67 .5% ) ,including mild de‐pression 58 cases(35 .6% ) ,moderate depression 39 cases(23 .9% ) ,severe depression 13 cases(8 .0% ) .Stepwise regression analysis showed that :SDS score ,DAS‐28 classification ,age ,sex ,treatment ,education ,occupation ,physical exercis ,economic income ,health insurance and alcohol consumption influenced the HRQOL scores of patients with IBS .DAS‐28 classification ,economic income , health insurance ,sex ,treatment were the main influencing factors ,with the unstandardized partial coefficients of -39 .211 ,31 .512 , 25 .866 ,-42 .348 ,-51 .235 .Conclusion Most of emigrants with RA in Three‐Gorge Reservoir area suffering from depressive symptoms ,and the HRQOL scores of them is not optimistic .The results suggested that more attention must be paid to the elderly , low‐income ,women ,low education ,DAS‐28 classification and no occupation .Quiting drinking ,receiving treatment ,psychological treatment ,strengthen exercise and expanding the scope of medical insurance all can improve patients′health related quality of life .
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Objective To assess the application value of high time-resolved MR angiography (TR-MRA) in postoperative follow-up study of children with congenital heart diseases. Methods Seventy-three patients (median age 6 years, range 1-20 years) with congenital heart diseases who underwent TR-MRA scan after operation were retrospectively analyzed. Twenty-nine cases also were performed conventional contrast-enhanced MRA and forty-four cases were performed phase-contrast MRA. A 3D T1-weighted fast gradient-echo sequence was used for time-resolved three-dimensional MRA (10-20 dynamic data sets, less than three seconds per dynamic data set). The flow dynamics and morphology of pulmonary circulations, lung perfusion and collaterals flow direction were noted. All imaging quality was evaluated by using 5 scales. Left and right pulmonary artery flow volumes were measured and left and right pulmonary artery ratio was noted. SPSS22.0 was used in statistic analysis. The statistical analysis of comparing imaging quality was performed by using paired t-test. The intermodality agreement between TR-MRA and phase contrast in assessing left and right pulmonary perfusion was tested by Kappa coefficient. Results In 73 cases, imaging scores were over 3 and imaging quality was good enough for diagnosis. In 29 cases, there was no statistic difference between TR-MRA and conventional CE-MRA in demonstrating great vessels (P>0.05) except that CE-MRA scores(3.77 ± 0.39)was higher than TR-MRA scores(3.44 ± 0.55)of inferior vena cava (IVC). There was statistic difference(t=3.68,P=0.01)between two sequences. TR-MRA could qualitatively demonstrate the pulmonary perfusion comparing to the results of PC. In PC sequence, there were 8 cases with symmetric and 36 cases with asymmetric left and right pulmonary perfusion. In TR-MRA sequence, there were 6 cases with symmetric and 38 cases with asymmetric left and right pulmonary perfusion. There was an excellent agreement between PC and TR-MRA (Kappa=0.83,P=0.01). Conclusions TR-MRA not only supplies with high spatial resolution imaging which demonstrates postoperative great arteries anatomy and also with high temporal resolution imaging which can demonstrate the preferential or balanced pulmonary blood flow and collaterals flow direction. TR-MRA is a very important sequence in follow-up study of congenital heart disease.
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Objective To investigate the role of soluble triggering receptor expressed on myeloid cell-l (sTREM-1) in children with community acquired pneumonia.Methods One hundred and seventy-six children with community acquired pneu-monia, 98 cases were mild and 78 cases were servere, were recruited. Thirty healthy children were recruited as control group. The white blood cell count (WBC), neutrophil percentage (N%), C-reactive protein (CRP), procalcitonin (PCT), interleukin-6 (IL-6), interleukin-10 (IL-10), and sTREM-1 were measured.Results The levels of WBC, N%, CRP, IL-6, IL-10, IL-6/IL-10, PCT, and sTREM-1 were signiifcantly different among children with mild pneumonia, severe pneumonia, and healthy controls. All of the indicators were elevated in children with mild and severe pneumonia than those in healthy controls (P<0.05). IL-6/IL-10 sTREM-1 were further signiifcantly elevated in children with severe pneumonia than children with mild pneumonia (P<0.05). IL-6/IL-10 was positively correlated with sTREM-1 (r=0.42,P<0.05).Conclusions sTREM-1 may help for evaluating the severity and outcome of children with community acquired pneumonia.
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Objective To investigate the expressions of brain-derived nerve growth factor (BDNF) and growth-associated protein 43 (GAP-43) in the hypothalamus of rats inflicted with restraint stress and their relationship with behavioral changes.Methods Forty male SD rats were divided into control group,restraint stress 7-day group,restraint stress 14-day group,restraint stress 21-day group according to the random number table,with 10 rats per group.Behavior changes were observed by open-field test,serum levels of corticotrophin releasing hormone (CRH) by enzyme-linked immunosorbent assay,and expressions of BDNF and GAP-43 in the hypothalamus by western blotting.Results Restraint stress 7-day group exhibited increases in spanning lattice times (50.0 ± 7.0),standing times (11.4 ± 2.1)and modification times (11.2 ± 2.7) compared with all other groups (P < 0.05).Restraint stress 14-day group and restraint stress 21-day group showed significant decreases in spanning lattice times (35.5 ±7.5,29.4 ± 6.8),standing times (7.8 ± 4.9,5.6 ± 3.9) and modification times (6.7 ± 2.9,4.4 ±2.6) compared with control group (42.6 ± 5.4,8.9 ± 4.3,and 7.9 ± 3.0) (P < 0.05).Restraint 14-day and 21-day groups showed significant increases in serum CRH level [(750.73 ± 123.68) pg/ml and (793.06 ± 115.84)pg/ml] compared with that in restraint stress 7-day group [(500.48 ± 88.71)pg/ml,P <0.05],but all were lower than (336.72 ±45.34) pg/ml in control group (P <0.05).Levels of BDNF and GAP-43 in the hypothalamus were the lowest in control group (0.672 ± 0.185 and 0.694 ±0.253).However,restraint stress increased the expressions of BDNF and GAP-43 in the hypothalamus,with the highest level in restraint stress 21-day group (1.357 ± 0.524 and 1.486 ± 0.679) (P < 0.05).Conclusion Restraim stress can up-regulate BDNF and GAP-43 proteins in the hypothalamus,and lead to plasticity changes that may relate to stress-related behavior.
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Objective]To observe the clinical effect of Yinlai Decoction Addition and Subtraction on treating Pediatric Cold about lung-stomach heat retention syndrome.[Method]This study adopted the research design method of case series reports, continuously included 40 Pediatric Cold children with lung-stomach heat retention syndrome treated by Yinlai Decoction Addition and Subtraction from November 2011 to December 2012. Through clinical visiting, we could assess the treatment outcome of this time on the basis of evaluation standard. [Results]33 patients were cured, 5 patients turned better and 5 patients had no effect, the total effective rate was 95.00%. [Conclusion]Yinlai Decoction had clearing and dispersing function, it could treat lung and stomach simultaneously, therefore, it had obvious efficacy in Pediatric Cold about lung-stomach heat retention syndrome.
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According to operative modalities,128 patients with unilateral benign thyroid disease were divided into hemithyroidectomy group (n =68) and subtotal thyroidectomy group (n =60).The operative duration of hemithyroidectomy group was (63 ± 14) min,intraoperative blood loss (54 ± 15) ml,postoperative drainage volume (64 ± 10) ml and hospitalization stay (5.9 ±0.8) days.The hospital charge of (8 335 ± 278) yuan was less than that of subtotal thyroidectomy group (P < 0.05).The incidence rate of postoperative hoarseness,water bucking,low calcium and hypothyroidism had no significant inter-group difference (P > 0.05).But the postoperative recurrence rate of hemithyroidectomy was significantly lower than that of subtotal thyroidectomy group (P < 0.05).Treating patients of unilateral benign thyroid disease with hemithyroidectomy yield excellent efficacies.It is worthy of wider clinical application.
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Objective To explore the over-expression of the CCAAT enhancer binding proteinα(C/EBPα)in hepatic stellate cells (HSC-T6) which activated by protease-activated receptor 1(PAR1) ,to explore its possible relationship with cell proliferation ,cell activation and collagen secretion of HSC-T6 cell .Methods HSC-T6 cells were divided into 4 groups ,control group ,SFLLR group;vehicle plasmid+SFLLR group ,C/EBPαplasmid+SFLLR group .The eukaryotic vector harboring the full length of C/EBPαcD-NA was transfected into PAR1 activated HSC-T6 cell ,then Western blot was applied to detect the expression of α-smooth muscle actin(α-SMA) and collagen I and evaluate the effect of transfection on proliferation of HSC-T6 by MTT .Results The expression of α-SMA and collagen I in C/EBPαplasmid+SFLLR group were dramatically decreased compared with other 3 groups ,as well as proliferation after 48 h(P<0 .05) .Conclusion Over-expression of C/EBPαgene by transfection had inhibitory influence on prolif-eration ,activation and collagen secretion of HSC-T6 which were activated by PAR1 .