Effects of an mHealth intervention on maternal and infant outcomes from pregnancy to early postpartum for women with overweight or obesity: A randomized controlled trial.

BACKGROUND: Women with overweight (OW) and those with obesity (OB) tend to gain excessive weight during pregnancy, often resulting in adverse outcomes. The long-term effects of mobile health (mHealth) interventions on maternal and infant outcomes remain unclear. AIMS: To examine the effects of an mHealth intervention on OW and OB from the course of their pregnancy to six months postpartum. METHODS: A randomized controlled trial was conducted in northern Taiwan. Ninety-two pregnant women with a body mass index (BMI)of ≥25 kg/m2 were recruited from prenatal clinics at <17 weeks of gestation. Prepregnancy weight was baseline maternal weight, with data collected subsequently at the last assessment before childbirth and six months postpartum. The intervention group (IG) received the mHealth intervention, while the control group (CG) received standard antenatal care. The trial was registered on ClinicalTrials.gov (identifier: NCT04553731) with the initial registration date of September 16, 2020. FINDINGS: The IG tended to have a lower mean body weight than the CG at the last assessment before childbirth (82.23 kg vs 84.35 kg) and at six months postpartum (72.55 Kg vs 72.58 Kg). IG's newborn birth weight was significantly lower than CG's (3074.8 vs. 3313.6 g; p = 0.009). Regression analysis revealed that OB in IG had a significant reduction in weight before childbirth (ß = -7.51, p = 0.005) compared to OB in CG. Compared to OW in CG, both OW in IG (ß = -243.59, p = 0.027) and OB in IG (ß = -324.59, p = 0.049) were associated with decreased newborn birth weight. CONCLUSIONS: mHealth helped women with obesity to successfully manage their GWG and body weight before childbirth and newborns' birth weight, despite this effect not persisting to reduce weight retention at six months postpartum.

Targeting DNA junction sites by bis-intercalators induces topological changes with potent antitumor effects.

Targeting inter-duplex junctions in catenated DNA with bidirectional bis-intercalators is a potential strategy for enhancing anticancer effects. In this study, we used d(CGTATACG)2, which forms a tetraplex base-pair junction that resembles the DNA-DNA contact structure, as a model target for two alkyl-linked diaminoacridine bis-intercalators, DA4 and DA5. Cross-linking of the junction site by the bis-intercalators induced substantial structural changes in the DNA, transforming it from a B-form helical end-to-end junction to an over-wounded side-by-side inter-duplex conformation with A-DNA characteristics and curvature. These structural perturbations facilitated the angled intercalation of DA4 and DA5 with propeller geometry into two adjacent duplexes. The addition of a single carbon to the DA5 linker caused a bend that aligned its chromophores with CpG sites, enabling continuous stacking and specific water-mediated interactions at the inter-duplex contacts. Furthermore, we have shown that the different topological changes induced by DA4 and DA5 lead to the inhibition of topoisomerase 2 activities, which may account for their antitumor effects. Thus, this study lays the foundations for bis-intercalators targeting biologically relevant DNA-DNA contact structures for anticancer drug development.

Facet-switching of rate-determining step on copper in CO2-to-ethylene electroreduction.

Reduction of carbon dioxide (CO2) by renewable electricity to produce multicarbon chemicals, such as ethylene (C2H4), continues to be a challenge because of insufficient Faradaic efficiency, low production rates, and complex mechanistic pathways. Here, we report that the rate-determining steps (RDS) on common copper (Cu) surfaces diverge in CO2 electroreduction, leading to distinct catalytic performances. Through a combination of experimental and computational studies, we reveal that C─C bond-making is the RDS on Cu(100), whereas the protonation of *CO with adsorbed water becomes rate-limiting on Cu(111) with a higher energy barrier. On an oxide-derived Cu(100)-dominant Cu catalyst, we reach a high C2H4 Faradaic efficiency of 72%, partial current density of 359 mA cm-2, and long-term stability exceeding 100 h at 500 mA cm-2, greatly outperforming its Cu(111)-rich counterpart. We further demonstrate constant C2H4 selectivity of >60% over 70 h in a membrane electrode assembly electrolyzer with a full-cell energy efficiency of 23.4%.

Causal association and mediating effect of blood biochemical metabolic traits and brain image-derived endophenotypes on Alzheimer's disease.

Background: Recent genetic evidence supports that circulating biochemical and metabolic traits (BMTs) play a causal role in Alzheimer's disease (AD), which might be mediated by changes in brain structure. Here, we leveraged publicly available genome-wide association study data to investigate the intrinsic causal relationship between blood BMTs, brain image-derived phenotypes (IDPs) and AD. Methods: Utilizing the genetic variants associated with 760 blood BMTs and 172 brain IDPs as the exposure and the latest AD summary statistics as the outcome, we analyzed the causal relationship between blood BMTs and brain IDPs and AD by using a two-sample Mendelian randomization (MR) method. Additionally, we used two-step/mediation MR to study the mediating effect of brain IDPs between blood BMTs and AD. Results: Twenty-five traits for genetic evidence supporting a causal association with AD were identified, including 12 blood BMTs and 13 brain IDPs. For BMTs, glutamine consistently reduced the risk of AD in 3 datasets. For IDPs, specific alterations of cortical thickness (atrophy in frontal pole and insular lobe, and incrassation in superior parietal lobe) and subcortical volume (atrophy in hippocampus and its subgroups, left accumbens and left choroid plexus, and expansion in cerebral white matter) are vulnerable to AD. In the two-step/mediation MR analysis, superior parietal lobe, right hippocampal fissure and left accumbens were identified to play a potential mediating role among three blood BMTs and AD. Conclusions: The results obtained in our study suggest that 12 circulating BMTs and 13 brain IDPs play a causal role in AD. Importantly, a subset of BMTs exhibit shared genetic architecture and potentially causal relationships with brain structure, which may contribute to the alteration of brain IDPs in AD.

Systematic druggable genome-wide Mendelian randomization identifies therapeutic targets for sarcopenia.

BACKGROUND: There are no effective pharmacological treatments for sarcopenia. We aim to identify potential therapeutic targets for sarcopenia by integrating various publicly available datasets. METHODS: We integrated druggable genome data, cis-eQTL/cis-pQTL from human blood and skeletal muscle tissue, and GWAS summary data of sarcopenia-related traits to analyse the potential causal relationships between drug target genes and sarcopenia using the Mendelian Randomization (MR) method. Sensitivity analyses and Bayesian colocalization were employed to validate the causal relationships. We also assessed the side effects or additional indications of the identified drug targets using a phenome-wide MR (Phe-MR) approach and investigated actionable drugs for target genes using available databases. RESULTS: MR analysis identified 17 druggable genes with potential causation to sarcopenia in human blood or skeletal muscle tissue. Six of them (HP, HLA-DRA, MAP 3K3, MFGE8, COL15A1, and AURKA) were further confirmed by Bayesian colocalization (PPH4 > 90%). The up-regulation of HP [higher ALM (beta: 0.012, 95% CI: 0.007-0.018, P = 1.2*10-5) and higher grip strength (OR: 0.96, 95% CI: 0.94-0.98, P = 4.2*10-5)], MAP 3K3 [higher ALM (beta: 0.24, 95% CI: 0.21-0.26, P = 1.8*10-94), higher grip strength (OR: 0.82, 95% CI: 0.75-0.90, P = 2.1*10-5), and faster walking pace (beta: 0.03, 95% CI: 0.02-0.05, P = 8.5*10-6)], and MFGE8 [higher ALM (muscle eQTL, beta: 0.09, 95% CI: 0.06-0.11, P = 6.1*10-13; blood pQTL, beta: 0.05, 95% CI: 0.03-0.07, P = 3.8*10-09)], as well as the down-regulation of HLA-DRA [lower ALM (beta: -0.09, 95% CI: -0.11 to -0.08, P = 5.4*10-36) and lower grip strength (OR: 1.13, 95% CI: 1.07-1.20, P = 1.8*10-5)] and COL15A1 [higher ALM (muscle eQTL, beta: -0.07, 95% CI: -0.10 to -0.04, P = 3.4*10-07; blood pQTL, beta: -0.05, 95% CI: -0.06 to -0.03, P = 1.6*10-07)], decreased the risk of sarcopenia. AURKA in blood (beta: -0.16, 95% CI: -0.22 to -0.09, P = 2.1*10-06) and skeletal muscle (beta: 0.03, 95% CI: 0.02 to 0.05, P = 5.3*10-05) tissues showed an inverse relationship with sarcopenia risk. The Phe-MR indicated that the six potential therapeutic targets for sarcopenia had no significant adverse effects. Drug repurposing analysis supported zinc supplementation and collagenase clostridium histolyticum might be potential therapeutics for sarcopenia by activating HP and inhibiting COL15A1, respectively. CONCLUSIONS: Our research indicated MAP 3K3, MFGE8, COL15A1, HP, and HLA-DRA may serve as promising targets for sarcopenia, while the effectiveness of zinc supplementation and collagenase clostridium histolyticum for sarcopenia requires further validation.

MSC-Derived Extracellular Vesicles Alleviate NLRP3/GSDMD-Mediated Neuroinflammation in Mouse Model of Sporadic Alzheimer's Disease.

Alzheimer's disease (AD) is the most common neurodegenerative disease, with sporadic form being the predominant type. Neuroinflammation plays a critical role in accelerating pathogenic processes in AD. Mesenchymal stem cell (MSC)-derived small extracellular vesicles (MSC-sEVs) regulate inflammatory responses and show great promise for treating AD. Induced pluripotent stem cell (iPSC)-derived MSCs are similar to MSCs and exhibit low immunogenicity and heterogeneity, making them promising cell sources for clinical applications. This study examined the anti-inflammatory effects of MSC-sEVs in a streptozotocin-induced sporadic mouse model of AD (sAD). The intracisternal administration of iPSC-MSC-sEVs alleviated NLRP3/GSDMD-mediated neuroinflammation, decreased amyloid deposition and neuronal apoptosis, and mitigated cognitive dysfunction. Furthermore, it explored the role of miR-223-3p in the iPSC-MSC-sEVs-mediated anti-inflammatory effects in vitro. miR-223-3p directly targeted NLRP3, whereas inhibiting miR-223-3p almost completely reversed the suppression of NLRP3 by MSC-sEVs, suggesting that miR-223-3p may, at least partially, account for MSC-sEVs-mediated anti-inflammation. Results obtained suggest that intracisternal administration of iPSC-MSC-sEVs can reduce cognitive impairment by inhibiting NLRP3/GSDMD neuroinflammation in a sAD mouse model. Therefore, the present study provides a proof-of-principle for applying iPSC-MSC-sEVs to target neuroinflammation in sAD.

Association Between Family Functioning and Health-related Quality of Life in Stroke SurvivoreInformal Family Caregiver Dyads

Purpose@#Stroke survivors and their informal family caregivers may share the impact of the disease, which may affect family functioning and quality of life (QoL) for both. This study compared the perceptions of stroke survivors and informal family caregivers regarding family functioning and QoL and examined the QoL of those reporting effective versus ineffective family functioning. @*Methods@#A cross-sectional study design and convenience sampling were used. Stroke survivoreinformal family caregiver dyads were recruited from a medical university hospital. We assessed participants’ demographic and clinical variables, including disease severity, family functioning, and QoL. Independent t-test, paired t-test, Wilcoxon signed-rank test, and ManneWhitney U test were used to analyze the data. @*Results@#Seventy-one stroke survivoreinformal family caregiver dyads participated in the current study. Most stroke survivors and informal family caregivers reported effective family functioning, with no significant differences. However, significant differences existed in the seven domains (physical functioning, role-physical, bodily pain, general health, vitality, social functioning, and role-emotional) of QoL, except emotional health. Stroke survivors reporting ineffective family functioning had a significantly lower mental component summary score, unlike informal family caregivers. @*Conclusions@#Our findings suggest that family functioning is crucial to ensure stroke survivors’ QoL, particularly regarding their mental health. Health professionals should prioritize mental health assessments and provide appropriate care interventions for stroke survivors in the first 1e6 months after stroke onset.

Dignity and Related Factors in Patients with Cancer: A Cross-Sectional Study

Purpose@#Dignity is a basic human right that is related to psychological distress factors in patients with cancer such as depression and demoralization. Hence, the dignity issue is of great importance to healthcare professionals. The present study aimed to advise healthcare professionals regarding the related distress factors of dignity in patients with cancer by investigating its relationship with patients’ demographics, disease characteristics, and psychological distress. @*Methods@#This was a cross-sectional study design. A convenience sample of 267 patients with cancer from a medical center was recruited into this study. Each patient completed demographics and disease characteristics questionnaires, the Patient Dignity Inventory Mandarin Version, the Demoralization Scale Mandarin Version (DS-MV), and the Patient Health Questionnaire-9 (PHQ-9). Data were analyzed with SPSS 22.0 software. @*Results@#Dignity was significantly correlated with age, demoralization, and depression. Cancer patients aged 65 or above were more likely to have a lower sense of dignity. In the present study, the sensitivity and specificity of the Patient Dignity Inventory Mandarin Version for demoralization (DS-MV≥30) were 84.8% and 79.1% and for depression (PHQ-9≥10) were 73.8% and 70.9% in patients with cancer with an aggregate score of 35 or above. @*Conclusions@#Dignity is significantly correlated with personal demographic characteristics and psychological distress in patients with cancer. The results provide reference data for healthcare professionals to understand and enable dignity in patients with cancer and aid in the development of methods that promote their dignity.

Relationship Between Trunk Control Ability and Respiratory Function in Stroke Patients: A Scoping Review and Meta-Analysis

Purpose@#Hemiparesis in stroke survivors has been reported to affect respiratory function. The relationship between trunk control and respiratory function, however, is not well understood. We aimed to map the state of the association between the trunk and respiratory function as well as evaluate the effect of a respiratory function training intervention on trunk control for stroke survivors. @*Methods@#A scoping review and meta-analysis of observational and interventional studies were performed. Cochrane Library, CINAHL with Full Text (EBSCO), Medline (Ovid), and PubMed were searched using the terms stroke, respiratory, and trunk control. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) checklist was used to examine the sections of each report. @*Results@#A total of 102 studies were identified, of which 12, published between 2011 and 2022, were included in the meta-analysis or narrative synthesis. Three studies were included in the meta-analysis of the correlation between trunk control and respiratory function parameters (forced vital capacity [FVC], forced expiratory volume during the first breath [FEV1], maximal inspiratory pressure [MIP], and maximal expiratory pressure [MEP]) with effect sizes (Fisher's z) for all outcomes, which ranged from small to intermediate (between 0.21 and 0.39). Furthermore, five studies were included in the meta-analysis of the effect of respiratory function training intervention on trunk control. An overall effect size (Cohen's d) of 1.47 corresponds to a large effect. We also found significant improvements in MIP and MEP but not in FVC and FEV1 for stroke survivors with the interventions. @*Conclusions@#Respiratory training, use of diaphragmatic resistance exercise or abdominal breathing, use of a pressure threshold-loading device, and the performance of functional strengthening exercises for the trunk muscles were found to increase patients’ trunk control and improve their respiratory muscle strength.

The Effectiveness of Dignity Therapy as Applied to End-of-Life Patients with Cancer in Taiwan: A Quasi-Experimental Study

Purpose@#The aim of the study was to determine the effectiveness of dignity therapy for end-of-life patients with cancer. @*Methods@#This study used a quasi-experimental study design with a nonrandomized controlled trial.Dignity therapy was used as an intervention in the experimental group, and general visit was used in the control group. Thirty end-of-life patients with cancer were recruited, with 16 in the experimental group and 14 in the control group. Outcome variables were the participants' dignity, demoralization, and depression. Measurements were taken at the following time points: pre-test (before intervention), posttest 1 (the 7th day), and post-test 2 (the 14th day). The effectiveness of the intervention in the two groups was analyzed using the generalized estimating equation, with the p value set to be less than .05. @*Results@#After dignity therapy, the end-of-life patients with cancer reflected increased dignity signifi-cantly [β= -37.08, standard error (SE) = 7.43, Wald x2= 24.94, p < .001], whereas demoralization (β= -39.55, SE = 6.42, Wald x2= 37.95, p < .001) and depression (β= -12.01, SE = 2.17, x2= 30.71, p< 001) were both reduced significantly. @*Conclusion@#Clinical nurses could be adopting dignity therapy to relieve psychological distress and improve spiritual need in end-of-life patients with cancer. Future studies might be expanded to looking at patients vis-a -vis end-of-life patients without cancer to improve their psychological distress. These results provide reference data for the care of end-of-life patients with cancer for nursing professionals.

The Effectiveness of Dignity Therapy as Applied to End-of-Life Patients with Cancer in Taiwan: A Quasi-Experimental Study

Purpose@#The aim of the study was to determine the effectiveness of dignity therapy for end-of-life patients with cancer. @*Methods@#This study used a quasi-experimental study design with a nonrandomized controlled trial.Dignity therapy was used as an intervention in the experimental group, and general visit was used in the control group. Thirty end-of-life patients with cancer were recruited, with 16 in the experimental group and 14 in the control group. Outcome variables were the participants' dignity, demoralization, and depression. Measurements were taken at the following time points: pre-test (before intervention), posttest 1 (the 7th day), and post-test 2 (the 14th day). The effectiveness of the intervention in the two groups was analyzed using the generalized estimating equation, with the p value set to be less than .05. @*Results@#After dignity therapy, the end-of-life patients with cancer reflected increased dignity signifi-cantly [β= -37.08, standard error (SE) = 7.43, Wald x2= 24.94, p < .001], whereas demoralization (β= -39.55, SE = 6.42, Wald x2= 37.95, p < .001) and depression (β= -12.01, SE = 2.17, x2= 30.71, p< 001) were both reduced significantly. @*Conclusion@#Clinical nurses could be adopting dignity therapy to relieve psychological distress and improve spiritual need in end-of-life patients with cancer. Future studies might be expanded to looking at patients vis-a -vis end-of-life patients without cancer to improve their psychological distress. These results provide reference data for the care of end-of-life patients with cancer for nursing professionals.

Application of operation bed and C-arm digital metrology adjustment in the percutaneous vertebroplasty for osteoporotic thoracolumbar vertebral fractures / 中国骨伤

OBJECTIVE@#To explore the application effect of operation bed and C-arm digital metrology adjustment in percutaneous vertebroplasty for osteoporotic thoracolumbar vertebral fractures.@*METHODS@#Ninty-four patients with osteoporotic thoracolumbar vertebral fractures admitted to our hospital from February 2015 to February 2017 were divided into control group and observation group according to random number table method, with 47 cases in each group. Control group adjusted C-arm and operating bed based on experience. For observation group surgical bed and C arm were measured and adjusted digitally and metrologically during percutaneous vertebroplasty. The operation time, times of fluoroscopy, hidden blood loss and bone cement volume were recorded in two groups. The clinical efficacy of two groups was observed by visual analogue score (VAS) and Oswestry Disability Index(ODI). Cobb angle and height of injured vertebrae before and after surgery were analyzed by imaging data.@*RESULTS@#The operation time, times of fluoroscopy, and hidden blood loss were significantly lower in observation group than in control group (0.05); VAS and ODI of observation group were significantly lower than that of the control group(<0.05); there was no significant difference in Cobb angle and height of injured vertebrae before and after operation between two groups. There were 3 cases of cement leakage, 1 case of urinary tract infection, 1 case of pulmonary infection, 2 cases of bedsore in observation group with complication rate was 14.89%(7/47); there were 8 cases of cement leakage, 2 cases of spinal nerve injury, 1 case of urinary tract infection, 3 cases of pulmonary infection, 2 cases of bedsore in control group with complication rate was 34.04% (16/47). The incidence of complications in observation group was significantly lower than that of control group (<0.05).@*CONCLUSIONS@#Operation bed and C-arm digital metrology adjustment can improve the surgical effect in percutaneous vertebroplasty for osteoporotic thoracolumbar vertebral fractures and promote rapid recovery.

Construction of real-time polymerase chain reaction detection for infection-related cytokines of tree shrew / 生物医学工程学杂志

Tree shrew is a novel and high-quality experimental animal model. In this study, the real-time polymerase chain reaction methods were established to detect infection-related cytokines interleukin-6 (IL-6), IL-8, IL-10, IL-17A, interferon-γ (IFN-γ) and housekeeping gene glyceraldehyde-phosphate dehydrogenase ( ) of tree shrew. The results indicated that the establised methods had good specificity. The high point of the linear range of these reagents reached 1 × 10 copies, and the low points ranged from 10 copies (IL-6, IL-17A), 100 copies (IL-10, ) to 1 000 copies (IL-8, IFN-γ). In this interval, the linear correlation coefficient of each reagent was greater than 0.99. The lowest detectable values of IL-6, IL-8, IL-10, IL-17A, IFN-γ and were 8, 8, 4, 8, 128 and 4 copies, respectively. The results showed that the established detection methods had good specificity, sensitivity and wide linear range. The methods were suitable for detection of multiple concentration range samples, and could be used for the subsequent studies of tree shrew cytokines.

Application of percutaneous vertebroplasty with the second injection for poor dispersion bone cement of Kümmel disease / 中国骨伤

OBJECTIVE@#To investigate clinical effect of percutaneous vertebroplasty with second injection for poor dispersion bone cement of Kümmel disease.@*METHODS@#Eighty-eight patients with Kümmel disease were treated with vertebroplasty from February 2014 to December 2017, and 16 patients were found cement dispersion unsatisfactory during initial cement injection and were undertaken second cement injection during operation. Among patients, there were 1 male and 15 females aged from 63 to 82 years old with an average age of 72.7 years old. Distribution of fractured vertebrae were followed: 1 patient was on T₁₀, 1 patient was on T₁₁, 3 patients were on T₁₂, 8 patients were on L₁, 1 patient was on L₂, and 2 patients were on L₃. VAS and ODI score were compared before operation, 2 days after operation and the latest following-up, anterior vertebral height and local kyphosis angle of fractured vertebrae with intravertebral cleft were also observed. Postoperative complication was recorded.@*RESULTS@#All patients were followed up from 5 to 22 months with average of 14.1 months. ODI score before operation, 2 days after operation and the latest following-up were 72.3±12.1, 56.8±5.0 and 12.1±5.3 respectively; VAS score before operation, 2 days after operation and the latest following-up were 7.8±0.6, 3.0±0.4 and 2.4±0.7, respectively; ODI score at 2 days was improved compared with before operation, while ODI and VAS score at the latest following-up was improved than that of 2 days after operation. Vertebral anterior compression rate and Cobb angle of the fractured vertebrae with intravertebral cleft were respectively corrected from (37.8±5.4)% and (15.1±2.0)°preoperative, to (4.7±1.4)% and (4.4±2.2)° at 2 days after operation, (4.9±1.5)% and (4.8±2.4)° at the latest following-up, there was significant difference between before operation and 2 days after operation, while there was no difference between 2 days after operation and the latest following-up. Three patients occurred cement leakage without pulmonary embolism and neurological impairment. Four patients occurred adjacent vertebrae fracture. There was no incidence of recollapsed vertebrae during follow-up period.@*CONCLUSIONS@#Percutaneous vertebroplasty for Kümmel disease could receive satisfactory clinical results when cement dispersion was inadequate during initial cement injection by the second injection, and effectively prevent occurrence of vertebral re-collapse.

Pertussis antibody titers in pregnant women's venous blood and cord blood—a survey from three women and children's hospitals in Beijing / 中国新生儿科杂志

Objective To study the levels of antibodies against bordetella pertussis among pregnant women and neonates in Beijing. Method From December 2016 to March 2017, pregnant women and their newborns from three women and children′s hospitals in Beijing were enrolled in this study. 3 ml of venous blood from the mothers and 3 ml of umbilical cord blood from neonates were drawn.Pertussis bacillus IgG antibody (PER-IgG) and pertussis toxin IgG antibody (PT-IgG) were tested using enzyme-linked immunosorbent assay. χ2 test was used to compare the positive rate of pertussis IgG antibodies in maternal and cord blood in the three hospitals. Correlational analyses of the antibodies levels in each hospital were conducted. The demographic characteristics, history of cough during pregnancy and history of DTaP vaccination of the mothers were collected via questionnaires. Result A total of 612 pairs of venous blood and cord blood samples were collected, including 4 mothers delivered twins and 616 cases of cord blood sample were collected. No history of pertussis were found in the 612 mothers. Among the 616 cases of umbilical cord blood, positive rate of PER-IgG was 13.3％ (82/616), positive rate of PT-IgG was 0.5％ (3/616). Among 612 cases of venous blood from the mothers, positive rate of PER-IgG was 7.7％ (47/612), positive rate of PT-IgG was 0.3％ (2/612). Positive rates of PER-IgG and PT-IgG in the mothers′ venous blood were not correlated with their residences (P=0.676 and 0.544). Positive rates of PER-IgG (r=0.842, P<0.001) and PT-IgG (r=0.619, P<0.001) in the mothers′ blood were positively correlated with the positive rate in umbilical cord blood. Conclusion This study shows that the positive rate of PER-IgG is very low in the maternal and umbilical cord blood in Beijing. Positive correlations of PER-IgG and PT-IgG between mother and umbilical cord blood were existed. Most mothers and their newborns do not have enough protection against pertussis.

Kinesin Family Member 11 Enhances the Self-Renewal Ability of Breast Cancer Cells by Participating in the Wnt/β-Catenin Pathway / 한국유방암학회지

Clinical findings of 16 cases of neonatal influenza / 临床儿科杂志

Objective To investigate the clinical features, laboratory diagnostics, treatments, and prognosis of neonates infected with influenza. Methods The clinical data of 16 neonates diagnosed as influenza admitted to the neonatal ward from January 2015 to May 2017 were retrospectively analyzed. Results Of the 16 neonates, 11 were male and 5 were female. Mean age was 18.5 days. 75% (12/16) of them were reported to be exposed to family members with common cold- like symptoms before hospitalization. Clinical manifestations included nasal obstruction (11/16), fever (10/16), cough (10/16), and rhinorrhea (8/16). Influenza antigen rapid detection (colloidal gold method) was positive in all cases. Influenza immunofluorescence assays were performed in 15 cases, only 6.67% (1/15) was positive. Sputum culture was performed in 13 cases, 8 of which were positive. Of them, 75% (12/16) neonates were diagnosed with pneumonia. Only 12.5% (2/16) neonates were treated with neuraminidase inhibitor. All cases recovered well and were discharged after antibiotic treatment. Conclusions Neonates contacted with family members displaying common cold-like symptoms should be examined for influenza in time. The common clinical manifestations include catarrhal symptoms, fever and cough. The sensitivity of the influenza immunofluorescence assay is lower as compared with the colloidal gold method. Pneumonia may often be developed in neonatal influenza. The prognosis of neonatal influenza is satisfactory if treated.

A family affected by multiple acyl-CoA dehydrogenase deficiency due to compound heterozygous mutations on ETFDH and literature review / 中国新生儿科杂志

Objective To improve the understanding of clinical phenotype and genotype of multiple acyl-CoA dehydrogenase deficiency (MADD) in neonates.Method The clinical data of a neonates with the diagnosis of MADD and treated in the Neonatal Department of Children's Hospital of Capital Institute of Pediatrics in December 2016 were analyzed.The literature collected from Wanfang database,CNKI and PubMed database from 1976 January to 2017 June was retrieved.Using "glutaric acidemia type Ⅱ ","multiple acyl CoA dehydrogenase deficiency","infant" and "neonate" as the key words.The phenotype and genotype characteristics were summarized.Result This boy was a full-term low birth weight infant with abnormal family history.He was admitted to hospital with recurrent episodes of poor response,respiratory distress and hyperlactacidemia.B-mode ultrasound abdominal examination suggested polycystic kidney disease.Laboratory tests revealed non-kenotic hypoglycemia,refractory metabolic acidosis,elevated lactate and muscle enzymes,hyperammonemia,abnormal coagulation function test.Mass spectrometry analysis showed that multiple acyl-carnitine increased.Urine gas chromatography-mass spectrometry showed significantly increased levels of lactic,glutaric,2-hydroxypentanedioic,dicarboxylic,and 4-hydroxybenzene lactic acids.The infant was given high doses of vitamin B2,L-carnitine,and other symptomatic treatments,but the condition did not improve.He died 5 days later.The gene test showed ETFDH gene compound heterozygous mutations,one missense mutations from the father with normal phenotype c.770A ＞ G (p.Y257C),a frameshift mutation from the mother with normal phenotype c.1281-1282 deletion mutation of AA (p.I428Rfs6).The protein structures of the mutations were predicted to be deleterious.Frameshift mutation c.1281-1282 deletion mutation of AA (p.I428Rfs6) were not included in the gene bank.A total of 21 cases with MADD were found from the literature.The clinical characteristics including:male (76.2％),dyspnea (52.4％),poor response (52.4％),hypoglycemia (47.6％),hepatomegaly (47.6％),elevated muscle enzymes (42.9％),immediate onset within 24 hour of birth (42.9％),abnormal family history (38.1％),malformation (38.1％),hyperammonemia (33.3％),metabolic acidosis (28.6％).81.0％of the patients were given vitamin B2 treatment,71.4％ of carnitine,28.6％ of coenzyme Q10,28.6％ of low fat,low protein and high carbohydrate feeding.However,the prognosis of these patients was poor,76.2％ died,and 42.9％ died within 1 week after birth,and 23.8％ survived.But all showed different degrees of mental retardation during follow-up periods.Conclusion Neonatal onset MADD can be characterized by dyspnea,poor response,hypoglycemia,hepatomegaly and elevated muscle enzymes.The disease is more common in early male neonates.It can be treated with vitamin B2 and L-carnitine,but with poor prognosis and high mortality.In this case,there were 2 sites in the ETFDH gene that formed complex heterozygous mutation:c.770A ＞ G (p.Y257C) and c.1281-1282 deletion mutation of AA (p.I428Rfs6),while the latter is a new mutation.

Effect of the proximal level on post-laminoplasty loss of lordosis / 中国骨伤

<p><b>OBJECTIVE</b>To analyze the effect whether or not retaining muscle ligament complex of C2 attachment on cervical spine kyphotic deformity after single open-door laminoplasty.</p><p><b>METHODS</b>A total 40 patients with cervical spondylotic myelopathy underwent single open-door laminoplasty from February 2011 to June 2014 were retrospectively analyzed. Of them, single open-door for C₃-C₆ was 40 cases (group A), including 28 males and 12 females, with an average age of (68.4±9.3) years old;and single open-door for C₄-C₆ plus C₃ laminectomy decompression (in order to protect the muscle ligament complex of C₂ attachment) was 40 cases (group B), including 26 males and 14 females, with an average age of (66.8±8.4) years old. Japanese Orthopaedic Association (JOA) score, visual analogue scale (VAS), Cobb angle of sagittal plane from C₂-C₇, cervical range of motion were used to evaluate effects before operation and at the latest follow-up.</p><p><b>RESULTS</b>All the patients were followed up from 24 to 31 months with an average of(26.5±3.4) months. There was no significant differences in VAS, JOA scores and cervical range of motion before surgery between two groups (>0.05) and all above items were significantly improved at the latest follow-up (<0.05), but there was no significant difference between two groups(>0.05). There was no significant difference in cervical Cobb angle before surgery between two groups(>0.05), and postoperative Cobb angle had obviously improved in two groups(<0.05), but the improvement of group B was better than that of group A.</p><p><b>CONCLUSIONS</b>Starting the laminoplasy on C₄ level and retainning the muscle ligament complex of C₂ attachment can obviouly decrease cervical spine syphotic deformity.</p>

Unilateral Wiltse intermuscular approach and contralateral decompression for the treatment of thoracolumbar burst fracture / 中国骨伤

<p><b>OBJECTIVE</b>To compare the clinical effects and multifidus muscle injury of different approaches, including unilateral Wiltse intermuscular approach and intramuscular approach combined with contralateral decompression, in treating thoracolumbar burst fracture.</p><p><b>METHODS</b>Forty-three patients with thoracolumbar burst fracture were enrolled in the study from January 2010 to December 2014, including 29 males and 14 females with an average age of 42.3 years old(ranged from 21 to 64 years old). The patients were treated with posterior pedicle screw fixation and unilateral decompression and were divided into Wiltse intermuscular approach group (group A) and intramuscular approach group (group B) according to surgical approach. Operation time and intraoperative bleeding were recorded for all patients; visual analogue scale(VAS) was compared 1 d preoperatively, 1 week, 12 months postoperatively between two groups; preoperation and 12 months postoperatively, the fractured vertebral canal and two-sides multifidus muscle of the same section were observed and compared by CT measure between two groups.</p><p><b>RESULTS</b>All the patients were follow-up for 14 to 21 months with an average of 16.3 months. Partial wound non-healing occurred in 3 patients and the wound ultimately healing after debridgement suture and change dressings. No screw breakage was found. There was significant difference in operation and intraoperative bleeding operation between two groups (<0.05), while there was no significant difference in VAS score of 1 d preoperatively, 1 week, 12 months postoperatively between two groups(>0.05). As for CT measurement results, postoperative vertebral canal narrow ratio was significant decreased in all patients(<0.05), while perioperative changes of the two-sides multifidus muscle cross section area and density were significant in group A (<0.05), but there was no significant difference in group B (>0.05). Neurologic status of all patients got recovery at final follow-up.</p><p><b>CONCLUSIONS</b>The method of unilateral Wiltse intermuscular approach combined with contralateral decompression for the treatment of thoracolumbar burst fracture has good clinical effects, also it is less invasive and less damage to multifidus muscle compared with intramuscular approach.</p>