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Objective:To investigate the ultrasonic characteristics and evolution pattern of fetal adrenal hematoma (AH).Methods:A retrospective analysis was conducted on the clinical data of one fetal AH diagnosed at the Affiliated Hospital of Jining Medical University. The study involved a comprehensive search of the relevant cases of fetal AH published from January 1, 1989, to December 31, 2022, in the Yiigle database, China National Knowledge Infrastructure Database, Wanfang Database, and PubMed Database. The clinical features, sonographic characteristics, interventions, and prognosis of fetal AH were summarized. Descriptive statistical analysis was used.Results:(1) Case: An ultrasound at 36 +3 weeks of pregnancy detected a mixed echogenic nodule at the fetal left adrenal region, with clear border and no obvious blood flow signal. Fetal AH was considered. Observations from the close ultrasound follow-up on the case before and after birth, and one year and eight months after birth presented a gradual transformation of the lesion from mixed echogenic to solid echogenic and a reduction following enlargement in lesion size. The lesion was ultimately liquefied and absorbed. (2) Literature review: A total of 12 cases of fetal AH that had clear diagnosis and ultrasound data were retrieved and added to the present case, for a total of 13 cases. Neither prenatal maternal nor postnatal typical clinical manifestations were observed in fetal AH cases. In cases with large hemorrhage and/or bilateral adrenal hemorrhage, mild jaundice and feeding difficulties may be present. Two cases were terminated, one live baby died of heart failure due to vein of Galen aneurysmal malformation, other ten had good prognosis. Fetal AH ultrasound image features demonstrated time-dependent changes, progressing in the sequence of anechoicity, solid echogenicity, mixed echogenicity, and complete absorption of the lesion, or residual hyperechogenicity. Conclusions:Fetal AH is a rare condition that exhibits characteristic transformations in ultrasound image features over time. Conducting close follow-up ultrasound examinations is the preferred and crucial approach to the diagnosis of fetal AH.
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Sesquiterpenoids are natural compounds composed of 15 carbon atoms, which can be divided into sesquiterpene alcohols, ketones, lactones, aldehydes, and carboxylic acids according to oxygen groups. These compounds are widely distributed in nature, and their physiological activities are diverse. For example, many sesquiterpenes with potential anticancer effects have been found for anti-tumor effects, including cytotoxicity, antioxidant, immune regulation, cell proliferation, and so on. In addition, some sesquiterpenoids have good application prospects in antibacterial, anti-inflammatory, and anti-cardiovascular diseases. Malignant tumors, inflammation, bacterial diseases, and cardiovascular diseases are the main diseases that cause human death, and natural products have unique advantages in the treatment of these diseases. Therefore, the development of new drugs that are easy to promote has become a new research hotspot. In this paper, the sesquiterpenes extracted from the natural components of Chinese herbs and plants with anti-tumor, anti-inflammatory, antibacterial, and anti-cardiovascular activities, such as Xanthium, Atractylodes, Convolvulus, Acanthium, Ligularia, Artemisia, Ligularia, Ligularia, Labiaceae Mint, Acanthophyllum, Turmeria, Ginger, and other Chinese herbs and plants, were discussed. The biological activities and related mechanisms of this compound were reviewed, which provided a reference for further research and clinical application of sesquiterpenes.
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Objective To study the genotoxicities of raceanisodamine hydrochloride injection. Methods Bacterial reverse mutation test, in vitro Chromosomal aberration test and in vivo Micronucleus test were performed to investigate the genotoxicities of raceanisodamine hydrochloride injection. Results The Ames test showed that raceanisodamine hydrochloride injection did not increase mutagenicity for TA1535, TA102, TA100, TA98 and TA97 strains at the dosage of 0.5, 5, 50, 500, 5000 μg per plate under two parallel system conditions (±S9). Results of CA test indicated that there was no statistical difference between raceanisodamine hydrochloride injection groups (doses of 58.75,117.5 and 235.0 μg/ml) and the solvent control group under two parallel system conditions (±S9). In MNT test, with doses of 7.5, 15.0 and 30.0 mg/kg respectively, the micronucleus induction rate of bone marrow of ICR mice was not statistically significant (P>0.05) when compared with that of vehicle control group in all dose groups. Conclusion Under the conditions of these study, the results indicated that raceanisodamine hydrochloride injection had no mutagenicity to Salmonella typhimurium, had no aberration effect on the chromosome of mammalian cultured cells, and had no effect on inducing micronucleus of bone marrow polychromatic erythrocytes in ICR mouse. All test results showed that raceanisodamine hydrochloride injection had no potential carcinogenicities and genetic toxicities under the test conditions.
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Procalcitonin(PCT), an important inflammatory suggestive marker of bacterial infection, has been widely used for the diagnosis of infectious diseases and guidance of antibiotic therapy in adults and children.Recent studies have shown that PCT, as a highly sensitive and specific inflammatory indicator, also has promising applications in the diagnosis and differential diagnosis, disease judgement, prognosis analysis, and antibiotic guidance of neonatal sepsis.Early PCT in neonates is characterized by physiological elevation, and it is important to understand the changing characteristics and influencing factors of PCT in neonates for an accurate clinical judgement of the disease.Therefore, we review the application value of PCT in neonatal sepsis.
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Heat stress refers to a series of stress reactions such as heat balance disturbance and physiological dysfunction when the body is exposed to the thermal environment for a long time. Studies have found that heat stress can damage intestinal morphology, such as length of intestinal villi, number of goblet cells, and depth of the crypt, affecting the digestion and absorption functions. It also can increase the permeability of the intestinal barrier by damaging the tight junction of the intestinal epithelium, which in turn allows endotoxin and bacteria to enter the blood circulation from the intestinal cavity to cause a systemic inflammatory response. At the same time, heat stress can disrupt the homeostasis of intestinal microbiota, increase pathogenic bacteria, and change downstream metabolites such as short-chain fatty acids. In addition, heat stress can inhibit the occurrence of hippocampal neurons and reduce the number of neurons; decrease the density of synapses; damage important organelles of neurons; induce inflammation of the central nervous system, and then lead to cognitive dysfunction. The brain-gut axis is a two-way signal axis between the intestine and the brain. Intestinal microorganisms and the intestinal barrier can participate in central nervous system regulation, and the brain can change the intestinal homeostatic function and affect the quality of the intestinal barrier through the hypothalamic-pituitary-adrenal axis (HPA axis). The interaction plays an essential role in the body's homeostasis. Therefore, this article reviewed current understandings on the impacts of heat stress on the gut and cognitive function, aiming to provide a reference for subsequent research.
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Objective:To evaluate the effect of Activin-A on spinal inflammatory response in rats with incisional pain and the relationship with p38 mitogen-activated protein kinase (MAPK) signaling pathway.Methods:Forty-eight SPF healthy male Sprague-Dawley rats, aged 1 month, weighing 100-150 g, were divided into 4 groups ( n=12 each) by the random number table method: sham operation group (S group), incisional pain group (I group), sham operation + antagonist group (SA group) and incisional pain + antagonist group (IA group). The rat model of incisional pain was prepared in group I and group IA.At the first 30 min of model preparation, the antagonist follicle statin 5 μg/kg was intraperitoneally injected in SA and IA groups, and the normal saline 5 μg/kg was intraperitoneally injected in S and I groups.At 24 h before model preparation (T 0) and 2, 6 and 24 h after model preparation (T 1-3), 3 rats in each group were randomly selected to measure the thermal paw withdrawal latency (TWL). Then 3 rats in each group were randomly sacrificed, and the spinal cord L 4-6 segments were taken for determination of the expression of Activin-A and p38 MAPK mRNA (by quantitative real-time polymerase chain reaction) and contents of tumor necrosis factor-α (TNF-α) and interleukin (IL)-1β (by enzyme-linked immunosorbent assay). Results:Compared with group S, the TWL was significantly shortened, the contents of TNF-α and IL-1β were increased, and the expression of Activin-A and p38 MAPK mRNA was up-regulated at T 1-3 in I and IA groups ( P<0.05), and no significant change was found in each parameter in group SA ( P>0.05). Compared with group SA, the TWL was significantly shortened, the contents of TNF-α and IL-1β were increased, and the expression of Activin-A and p38 MAPK mRNA was up-regulated at T 1-3 in I and IA groups ( P<0.05). Compared with group I, the TWL was significantly prolonged, the contents of TNF-α and IL-1β were decreased, and the expression of Activin-A and p38 MAPK mRNA was down-regulated at T 1-3 in group IA ( P<0.05). Conclusions:Activin-A is involved in spinal inflammatory response through activating the p38 MAPK signaling pathway in rats with incisional pain.
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Neonatal infection related diseases are the main causes of neonatal death and disability.Traditional inflammatory factors, such as peripheral blood leucocyte count, C-reactive protein and procalcitonin play an important role in indicating neonatal infectious diseases.However, its sensitivity, specificity and effectiveness still need to be improved.Many studies have shown that the expression of serum amyloid A(SAA)increase significantly in various infectious diseases of neonates, and it has received more and more attention as a new type of infection-related indicator.This article reviews the research progress on the structural characteristics of serum amyloid A, detection methods and its clinical application in various neonatal infectious diseases, follow-up of disease changes, guidance of antibiotic use and evaluation of prognosis.
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Objective To provide the reference resource for the safe clinical use of the compound of diphenhydramine hydrochloride and caffeine by observing its effects on the nervous system, cardiovascular system and respiratory system in experimental animals. Methods Single dose of the compound of diphenhydramine hydrochloride and caffeine was given to animals orally. The effects on climbing ability of mice and blood pressure, electrocardiogram, respiration rate and amplitude in beagle dogs were observed and recorded. Results With the dosage of the compound of diphenhydramine hydrochloride and caffeine (diphenhydramine hydrochloride / caffeine ratio is 1/2.4) at 51, 102, 204 mg/kg, there was no significant effect on the climbing ability in mice. With the dosages of 14.2, 28.3, 56.6 mg/kg for male Beagle dogs and 5.66, 14.2, 28.3 mg/kg for female Beagle dogs, no significant effects were observed in systolic blood pressure, diastolic blood pressure, mean arterial pressure, heart rate, ECG(P wave, R wave , T wave, QRS time, PR interval, QT interval), respiratory rate and amplitude. Conclusion Under the experimental conditions, single oral dose of the compound of diphenhydramine hydrochloride and caffeine has no significant effect on the nervous system, cardiovascular system and respiratory system in experimental animals. Those results suggest that the compound of diphenhydramine hydrochloride and caffeine is a safe agent for clinical use.
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Objective To evaluate the genetic toxicity of Wentilactone A. Methods The classical genotoxicity test combination (Ames test, in vitro CHO cell chromosome aberration test and mouse bone marrow micronucleus test) was used to detect the genotoxicity of Wentilactone A. Results Ames test suggested that Wentilactone A was not mutagenic against Salmonella typhimurium with or without the metabolic activation system (S9) at five doses of 5 000, 500, 50, 5, and 0.5 μg/dish. CHO cell chromosome aberration test suggested that the CHO cells cultured in 4 h and 24 h did not induce chromosomal aberrations in three dose groups at the final concentration of 23.74, 47.48, 94.96 μg/ml, with and without S9. The mouse bone marrow micronucleus test showed no significant difference in the bone marrow micronucleus induction rate of cells at three doses of 100, 200, and 400 mg/kg treated for 24 h and at dose of 400 mg/kg treated for 48 h compared with the solvent control group (P>0.05). Conclusion These results indicated that Wentilactone A did not exhibit genetic toxicity based on the Ames test, CHO chromosomal aberration test and micronucleus assay. It was suggested that Wentilactone A had no genetic toxicity and potential carcinogenicity.
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Objective@#To explore the clinical effect of Zhenwu decoction in the treatment of acute heart failure(AHF), and its influence on cardiac function, cardiomyocyte apoptosis factor and serum level of brain natriuretic peptide(BNP).@*Methods@#94 patients with AHF were enrolled in the study.According to their treatment time number, 47 cases with odd numbers were selected as control group, who were given west medicine for treatment, while 47 cases with even numbers were selected as observation group, who were given Zhenwu decoction on the basis of control group.The clinical treatment effect of the two groups was evaluated, and the levels of BNP, soluble Fas(sFas), soluble Fas ligand (sFasL), tumor necrosis factor-α(TNF-α), and cardiac function indicators including left ventricular ejection fraction(LVEF), stroke volume(SV), left ventricular end diastole(LVEDd), left ventricular end of systolic diameter(LVEDs) before and after treatment were compared.@*Results@#The total effective rate of the observation group was 91.49%(43/47), which was higher than that of the control group 65.96%(31/47), the difference between the two groups was statistically significant(χ2=8.871, P<0.05). After treatment, the LVEF and SV in the observation group were (52.77±4.41)% and (79.00±6.54)mL, respectively, which were higher than those in the control group[(43.15±3.88)%, (69.22±4.80)mL], while the LVEDd and LVEDs of the observation group were (50.55±3.43)mm, (37.44±2.73)mm, respectively, which were lower than those of the control group[(59.52±4.02)mm, (42.04±3.20)mm], the differences were statistically significant(t=7.454, 7.042, 6.768, 6.890, all P<0.05). After treatment, the levels of sFas, sFasL and TNF-α in the observation group were (2.65±0.30)μg/L, (0.21±0.08)μg/L, (1.20±0.13)ng/L, respectively, which were lower than those of the control group[(3.38±0.37)μg/L, (0.33±0.12)μg/L, (1.48±0.20)ng/L], the differences were statistically significant(t=6.438, 6.703, 6.185, all P<0.05). After treatment, the BNP level in the observation group was (252.77±27.43)ng/L, which was lower than that in the control group[(387.67±41.97)ng/L], the difference was statistically significant(t=6.870, P<0.05).@*Conclusion@#The curative effect of routine treatment of western medicine combined with Zhenwu decoction in the treatment of AHF is exact, which can significantly improve the clinical symptoms and cardiac function, reduce myocardial cell apoptosis and BNP level, and it has high clinical value, which is worthy of popularization and application.
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Objective To investigate the clinical characteristics,prenatal risk factors and antibiotic resistance of neonatal early-onset blood stream infection caused by group B Streptococcus (GBS) and to provide evidence for the management of GBS infection.Methods From January 1,2001 to May 31,2017,55 neonates diagnosed with GBS-associated early-onset blood stream infection in the International Peace Maternity & Child Health Hospital were enrolled.They were divided into two groups:GBS early-onset sepsis (GBS EOS) group (n=40) and bacteremia group (n=15).Clinical data were retrospectively analyzed and compared between the two groups with two independent-samples t test and Chi-square test.Results The incidence of neonatal GBS-associated early-onset blood stream infection was 0.31%o (55/179 738).Those neonates with bacteremia had no clinical manifestations.However,in the GBS EOS group,the main manifestations were respiratory abnormalities [respiratory distress (35%,14/40) and apnea (10%,4/40)],jaundice (40%,16/40) and poor perfusion [low blood pressure,etc.32%(13/40)],and the main abnormal results of blood routine test were increased C-reaction protein [>10 mg/L,100% (40/40)] and elevated white blood cell count [>25 × 109/L,78% (31/40)].Compared with GBS EOS group,bacteremia group had a lower rate of vaginal delivery [1/15 vs 52% (21/40),x2=9.549,P-0.002] and higher rates of maternal fever [15/15 vs 55% (22/40),x2=10.034,P=0.002],chorioamnionitis [15/15 vs 68% (27/40),x2=6.384,P=0.012] and empirical administration of antibiotics to infants [15/15 vs 70% (28/40),x2=5.759,P=0.016].All tested GBS strains were susceptible to penicillin,ampicillin and vancomycin,but resistant to clindamycin (42%,22/53) and erythromycin (46%,24/52).Conclusions GBS is one of the predominant pathogens causing neonatal early-onset blood stream infection.Respiratory distress,apnea,jaundice and poor perfusion are the main manifestations.Penicillin and ampicillin are the treatment choice for neonatal early-onset GBS infection.Active and appropriate intrapartum management of pregnancies with high risk of intrauterine GBS infection as well as prophylactic prescription of antibiotics to infants may help to prevent or alleviate the symptoms of neonatal early-onset blood stream infection.
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Clinical practice teaching in out-patient department is an important part of general internal clinical teaching for medical students. From 2010, eight-year program medical students in Huazhong University of Science and Technology began their clinical rotation practice in the out-patient department of general internal medicine. The one-on-one tutoring style was used in clinical teaching. We combined teacher demonstration teaching method with teacher supervision teaching method in clinical practice, and carried out periodical case discussion. At the end of each rotation stage, regular teaching evaluation and examination was taken. It has been proved that our teaching mode can not only help the students improve their professional and practical levels of clinical skills, and also help them gain the clinical working abilities and the professional spirits, which is worthy of further promotion.
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<p><b>OBJECTIVE</b>Since 1986, the reference of birth weight for gestational age has not been updated. The aim of this study was to set up Chinese neonatal network to investigate the current situation of birth weight in China, especially preterm birth weight, to develop the new reference for birth weight for gestational age and birth weight curve.</p><p><b>METHOD</b>A nationwide neonatology network was established in China. This survey was carried out in 63 hospitals of 23 provinces, municipalities and autonomous regions. We continuously collected the information of live births in participating hospitals during the study period of 2011-2014. Data describing birth weight and gestational age were collected prospectively. Newborn's birth weight was measured by electronic scale within 2 hours after birth when baby was undressed. The evaluation of gestational age was based on the combination of mother's last menstrual period, ultrasound in first trimester and gestational age estimation by gestational age scoring system.</p><p><b>STATISTICAL ANALYSIS</b>the growth curve was drawn by using LMSP method, which was conducted in GAMLSS 1.9-4 software package in R software 2.11.1.</p><p><b>RESULT</b>A total of 159 334 newborn infants were enrolled in this study. There were 84 447 male and 74 907 female. The mean birth weight was (3 232 ± 555) g, the mean birth weight of male newborn was (3 271 ± 576) g, the mean weight of female newborn was (3 188 ± 528) g. The test of the variables' distribution suggested that the distribution of gestational age and birth weight did not fit the normal distribution, the optimal distribution for them was BCT distribution. The Q-Q plot test and worm plot test suggested that this curve fitted the distribution optimally. The male and female neonatal birth weight curve was developed using the same method.</p><p><b>CONCLUSION</b>Using GAMLSS method to establish nationwide neonatal birth weight curve, and the first time to update the birth weight reference in recent 28 years.</p>
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Feminino , Humanos , Recém-Nascido , Masculino , Peso ao Nascer , China , Idade Gestacional , Recém-Nascido de Baixo PesoRESUMO
This paper explored the multi-angle, comprehensive and systematic clinical prac-tice teaching system for international students. Six teaching methods were integrated: bedside teach-ing, standardized patients teaching, electronic patients clinic teaching, Chinese students one-to-one help foreign students, a variety of English clinic small presentation and many after-school social activi-ties. The multi-angle, comprehensive and systematic clinical practice teaching system was evidently a better choice than traditional teaching system for international students.
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Medical educational internationalization has already made teaching medical courses in English more and more important.Nephrology department in Tongji hospital affiliated to Tongji medical college,Huazhong university of science and technology has assumed the responsibility of teaching in English for medical students of five-year program,six-year program,seven-year program,eight-year program,and abroad student for several years.They practiced teaching in English in theory teaching,PBL teaching and clinical teaching according to the characteristics and requisitions of students in different educational systems.They accumulated some experiences,which was conducive to improving the quality of teaching in English.
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Teaching urinary system diseases by problem-based learning method for eight-year program medical students was applied in nephrology department in affiliated Tongji hospital of Huazhong university of science and technology since 2008.They had accumulated experiences in compiling teaching plan,fostering teachers,practicing teaching and evaluating teaching.These steps may future intensify education reform on long schooling system and improve teaching quality of eight-year program.
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Patent ductus arteriosus (PDA)is a common disease among premature neonates and the management of which has always been a challenge to the neonatologists. Early treatment has been advocated as the first-line approach, and drug induced closure is yet the most effective, inexpensive, and convenient method. During the last two decades,indomethacin was often given as conservative treatment, and its closure rate in PDA was approximately 46% ~ 89%. However,indomethacin may increase the number of undesirable or harmful effects including renal damage, intraventricular hemorrhage, necrotizing enterocolitis, and enterobrosis,etc. Recently,ibuprofen is rapidly emerging as a new promising drug for treatment of PDA in preterm infants with closure rate of 73.0% ~95.5%. It is used as standard therapy to close PDA,and it has less influence on the hemodynamics of kidneys, brain and gastrointestinal tract. The surgery is needed in patients with drug treatment failure and cardio-pulmonary function damage.
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Objective To construct eukaryotic expression plasmid pIRESneo3-pigment epithelium-derived factor (PEDF) and detect its transient expression in SP2/0 cells. Methods Specific primers were designed based on the mature peptide sequence of human PEDF cDNA in the GenBank. Human PEDF gene was cloned into the eukaryotic expression vector pIRESneo3. The PEDF DNA was transfected into SP2/0 with LipofectamineTM 2000. The recombinant human PEDF protein expressed in SP2/0 cell culture supernatant was identified by Western blot and enzyme-linked immunosorbent assay. The biological activity of the recombinant human PEDF was measured by 3-(4,5-dimethylthiazol-z-y1)-2,5-diphenytetrazolium bromide(MTT) method. Results PCR amplification, restriction enzyme digestion and DNA sequencing confirmed that the mature peptide sequence of human PEDF cDNA was successfully cloned into the eukaryotic expression vector pIRESneo3. And the plasmid was transfected into SP2/0 cells, which could secret PEDF. Western blot analysis showed that there was only one obvious band at the position of relative molecular weight of 50 000, and it is equivalent to the expected value. Enzyme-linked immunosorbent assay suggested that the content of PEDF began to rise after transfection, and peaked at 36 h [(0.92±0.04) μg/ml]. The proliferation of human umbilical vein endothelial cell line was significantly inhibited by supernatant after transfection of 36 h (P<0.05). Conclusions The eukaryotic expression plasmid pIRESneo3-PEDF had been successfully constructed and active human PEDF was transiently secreted, which made a foundation for further study of stable expression and purification of PEDF. This protein could be a potential medication for preventing and managing retinopathy of prematurity.
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Objective To observe the serum estradiol level in newborns at different gestational age and the infants with retinopathy of prematurity (ROP), and explore the relationship between these changes and ROP. Methods A total of 178 newborns hospitalized in the Children's Hospital of Fudan University were enrolled in the study. They were divided into three groups based on the gestational age, < 32 weeks group, 32-37 weeks group and term group. The three groups were further divided into non-oxygen and oxygen subgroups. Infants with birth weight less than 2000 g were evaluated for ROP and those diagnosed as ROP were under ROP group (n=6). Serum estradiol levels were measured every week from birth to discharge with radioimmunoassay. Results Serum estradiol levels of newborns quickly declined after birth. In the non-oxygen subgroups, serum estradiol levels in 32 ~ 37 weeks group were remarkably higher than those of term group in the first week [(3506±1376) pmol/L vs (1717±179) pmol/L,P<0. 05] and the third week [(1431±92) pmol/L vs (996±102) pmol/L, P<0. 05]; Serum estradiol levels in <32 weeks group was only remarkably higher than those of term group in the first week [(3173± 1369) pmol/L vs (1717± 179) pmol/L,P<0. 05]; Serum estradiol level in the <32 week group was (560±355) pmol/L, lower than that in the 32-37 weeks group [( 1124 ± 128) pmol/L] (P<0. 05). There was no difference of serum estradiol levels in the oxygen and non-oxygen subgroups of the same group. There was no significant difference of serum estradiol levels between the ROP group and <32 weeks group. Serum estradiol levels in ROP group was lower than that of premature group without ROP at 29 and 32-36 weeks of corrected gestational age, but no statistical difference was shown. Conclusions Very low serum estradiol level in premature infants may be related to the development of ROP, but further clinical studies are required.
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OBJECTIVE To prevent and control the incidence of nosocomial infection,and improve the inner quality of nosocomial infection management.METHODS A total of 49 363 cases of inpatients in the recent four years were retrospectively analyzed.RESULTS Of them 2 409 cases were infected,the incidence was 4.88%.The lower(respiratory) tract ranked the first place (34.16%) and the highest infected rate was in medicine(department)((8.29%).) Totally 505 isolates of bacteria were found,of which Gram-negative ones accounted for 45.15%,(Gram-)positives 25.15%,fungi were for 29.70%.CONCLUSIONS The incidence of nosocomial infection is(connected) with following factors such as age,inpatient factor,invasive diagnosis and treatment manipulation,the misusage of(antibiotics),and the environment quality.