Incidence of extrauterine growth retardation and its risk factors in very preterm infants during hospitalization: a multicenter prospective study / 中国当代儿科杂志

OBJECTIVES@#To investigate the incidence of extrauterine growth retardation (EUGR) and its risk factors in very preterm infants (VPIs) during hospitalization in China.@*METHODS@#A prospective multicenter study was performed on the medical data of 2 514 VPIs who were hospitalized in the department of neonatology in 28 hospitals from 7 areas of China between September 2019 and December 2020. According to the presence or absence of EUGR based on the evaluation of body weight at the corrected gestational age of 36 weeks or at discharge, the VPIs were classified to two groups: EUGR group (n=1 189) and non-EUGR (n=1 325). The clinical features were compared between the two groups, and the incidence of EUGR and risk factors for EUGR were examined.@*RESULTS@#The incidence of EUGR was 47.30% (1 189/2 514) evaluated by weight. The multivariate logistic regression analysis showed that higher weight growth velocity after regaining birth weight and higher cumulative calorie intake during the first week of hospitalization were protective factors against EUGR (P<0.05), while small-for-gestational-age birth, prolonged time to the initiation of total enteral feeding, prolonged cumulative fasting time, lower breast milk intake before starting human milk fortifiers, prolonged time to the initiation of full fortified feeding, and moderate-to-severe bronchopulmonary dysplasia were risk factors for EUGR (P<0.05).@*CONCLUSIONS@#It is crucial to reduce the incidence of EUGR by achieving total enteral feeding as early as possible, strengthening breastfeeding, increasing calorie intake in the first week after birth, improving the velocity of weight gain, and preventing moderate-severe bronchopulmonary dysplasia in VPIs.

Risk factors for neutropenia of late newborns / 中国当代儿科杂志

OBJECTIVE@#To study the risk factors and treatment for neutropenia of late newborns (NLN).@*METHODS@#Related clinical data were collected from the preterm infants and critically ill neonates who were admitted to the neonatal intensive care unit from July 2019 to January 2020. A total of 46 newborns with a blood absolute neutrophil count (ANC) of 37 weeks. There was no significant difference between the two groups in the incidence rates of gestational hypertension, premature rupture of membranes > 18 hours and intrauterine distress, 5-minute Apgar score, the duration of positive pressure ventilation, the incidence rate of early-onset sepsis, and the type of initially used antibiotics (@*CONCLUSIONS@#The risk of NLN increases with the presence of late-onset sepsis and the increase in the duration of antibiotic use. NLN is generally a benign process. G-CSF appears to be safe and effective for NLN with severe disease conditions or severe reduction in ANC.

Therapeutic observation on horizontal penetration needling for residual dizziness after repositioning maneuver in patients with benign paroxysmal positional vertigo / 中国针灸

OBJECTIVE@#To observe the effect of horizontal penetration needling at vertigo auditory area and balance area on residual dizziness after successful repositioning maneuver in patients with benign paroxysmal positional vertigo (BPPV).@*METHODS@#Sixty-six patients with residual dizziness after successful repositioning maneuver for BPPV were randomly divided into an observation group (34 cases, 1 case dropped off) and a control group (32 cases, 2 cases dropped off). The patients in the observation group were treated with horizontal penetration needling at vertigo auditory area and balance area, once every other day; three times were taken as a course of treatment, and two courses of treatment were given. The patients in the control group received no acupuncture and medication. The dizziness handicap inventory (DHI) and visual analogue scale (VAS) scores were observed before treatment and after 1 and 2 courses of treatment.@*RESULTS@#Except for the emotional score of DHI in the control group after 1 course of treatment, the sub item scores and total scores of DHI and VAS scores in the two groups after treatment were lower than those before treatment (@*CONCLUSION@#Whether acupuncture or not, residual dizziness after repositioning maneuver for BPPV can be relieved within 2 weeks; horizontal penetration needling at vertigo auditory area and balance area could improve dizziness symptoms and shorten the course of disease.

Horizontal penetration needling method for headache / 中国针灸

The manipulation and key points of professor

Analysis on relationship between syndrome differentiation of migraine and acupuncture effect / 中国针灸

The problems of the syndrome differentiation of migraine in acupuncture treatment were collected, e.g. inconsistency of syndrome differentiation, unclear staging of syndrome differentiation, lack of standardization in comparison between syndrome differentiation and non-differentiation, insufficient research on the factors of syndrome differentiation. In view of the exiting problems, focusing on two aspects of migraine, namely syndrome differentiation and acupuncture effect, the clinical treatment and research are conducted in migraine treated with acupuncture based on syndrome differentiation. It is believed that the comprehensive observation of the relationship between syndrome differentiation and acupuncture effect, as well as the analysis of the relevant factors of syndrome differentiation of migraine should be the focus in future research.

Relationship between Quantitative Monitoring of WT1 Gene and Prognosis in Patients with Acute Leukemia / 中国实验血液学杂志

OBJECTIVE@#To investigate the exprassion of WT1 gene in patients with adult acute myeloid leukemia (AML) and its clinical significance.@*METHODS@#Sixty-three newly diagnosed patients with acute myeloid leukemia were selected. Quantitative RT-PCR was used to detect the expression of WT1 gene in the 63 AML patients and 20 non-AML controls.@*RESULTS@#WT1 gene was highly expressed in AML patents and its expression in the low-risk group was significantly lower than that in middle-risk group and high-risk group (P<0.05), and no significant difference of WT1 gene expression between middle-risk and high-risk group was observed. In the patients of middle-risk and high-risk patients, the expression of WT1 gene in the remission group was significantly lower than that in the patients of non-remission after treatment (P<0.05). The non-remission patients after first treatment in middle-risk and high-risk group were treated with second induction therapy. After second induction therapy, the WT1 expression in remission patients was significantly decreased (P<0.05) in comparison with that in patients still in non-remission. There was a negative correlation between WT1 expression and the 2-year overall survival rate in the newly diagnosed middle and high-risk AML patients.@*CONCLUSION@#The detection of WT1 gene expression can help to divide AML patients into low-/middle-/high-risk groups and to evaluate therapeutic response and clinical prognosis in middle and high-risk AML patients.

Clinical characteristics of hemophagocytic syndrome: analysis of 46 cases / 南方医科大学学报

<p><b>OBJECTIVE</b>To analyze the clinical manifestations, laboratory findings, treatment and prognosis of patients with hemophagocytic syndrome (HPS).</p><p><b>METHODS</b>A retrospective study was carried out to analyze the underlying disease, clinical characteristics, laboratory findings and outcomes of 46 patients with HPS.</p><p><b>RESULTS</b>This cohort included 19 cases of HPS secondary to cancer, 11 cases of HPS secondary to infection, 10 cases of suspected malignant lymphoma based on PET-CT findings (without biopsy), and 6 cases of unknown etiology. The coincidence rate of the clinical characteristics of the patients with the indices listed in HPS-2004 criteria were: fever (100%), elevated serum ferritin (100%), cytopenias (93.48%), splenomegaly (91.30%), hemophagocytosis in the bone marrow, spleen or lymph nodes (84.78%), hypofibrinogenemia (67.39%), and hypertriglyceridemia (54.05%). The cases of cancer, infections and unknown etiology showed significant differences in serum levels of ferritin and β2MG (P<0.05), and significant differences were found in triglycerides, LDH, and fibrinogenemia between the nonfatal and fatal cases (P<0.05).</p><p><b>CONCLUSION</b>HPS can be secondary to various underlying diseases, many associated with Epstein-Barr virus infection. Cancer, especially NK/T-cell lymphoma, is the main cause of HPS. Persistent fever, elevated serum ferritin level and cytopenias are the most sensitive indicators for diagnosis of HPS, and early diagnosis and treatment are critical to lower the mortality rate of this disease.</p>

Immunomodulatory effects of human amniotic versus bone marrow-derived mesenchymal stem cells on peripheral blood T lymphocytes in vitro / 南方医科大学学报

<p><b>OBJECTIVE</b>To compare the immunomodulatory effects of human amniotic mesenchymal stem cell (hAMSCs) and human bone marrow mesenchymal stem cells (hBMSCs) on peripheral blood T lymphocytes in an in vitro co-culture system.</p><p><b>METHODS</b>hAMSCs and hBMSCs isolated using enzymatic digestion and Ficoll-Hypaque density gradient centrifugation, respectively, were culture-expanded in vitro to obtain the 4th-generation cells. The two MSCs were co-cultured separately with human peripheral blood mononuclear cells stimulated with phytohemagglutinin (PHA-PBMSC) to investigate the changes in T lymphocyte subsets using flow cytomety and the production of interleukin-2 (IL-2) and IL-10 by the T lymphocytes using enzyme-linked immunosorbent assay (ELISA).</p><p><b>RESULTS</b>Co-culture with either hAMSCs or hBMSCs significantly increased the proportions of Treg, Th2 and Tc2 and decreased Th1 and Tc1 cell subsets in the PBMCs as compared with the PBMCs cultured alone (P<0.05), and the changes in the PBMCs were similar between the two co-culture systems (P>0.05). In both of the two co-culture systems, IL-2 production by the lymphocytes was significantly lowered (P<0.05) and IL-10 production was significantly increased (P<0.05) as compared with their levels in the PBMCs cultured alone; no significant difference was found in IL-2 or IL-10 levels between the two co-culture systems (P>0.05).</p><p><b>CONCLUSION</b>The MSCs derived from human amnion and bone marrow have similar immunomodulatory effects on the T lymphocytes, suggesting the possibility of using hAMSCs in the treatment of graft-versus-host disease after allogeneic hematopoietic stem cell transplantation.</p>

Impact of premature rupture of membranes on neonatal complications in preterm infants with gestational age <37 weeks / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the effect of premature rupture of the membrane (PROM) on neonatal complications in premature infants.</p><p><b>METHODS</b>The registration information of 7684 preterm infants with gestational age <37 weeks were collected from the cooperative units in the task group between January 1, 2014 to December 31, 2014. Specially trained personnel from each cooperative units filled in the unified form in a standardized format to record the gender, gestational age, birth weight, PROM, placental abruption, antenatal corticosteroid, Apgar score, amniotic fluid pollution, and complications of the infants. The data were analyzed comparatively between the cases with PROM and those without (control).</p><p><b>RESULTS</b>The preterm mortality rate was significantly lower but the incidences of ICH, NEC, ROP and BPD were significantly higher in PROM group than in the control group (P<0.05). The 95% confidence interval of the OR value was <1 for mortality, and was >1 for ICH, NEC, ROP and BPD. After adjustment for gestational age, birth weight, gender, mode of delivery, placental abruption, placenta previa, prenatal hormones, gestational diabetes mellitus (GDM), gestational period hypertension and 5-min Apgar score <7, the incidences of NEC, ROP and BPD were significantly different between the two groups (P<0.05) with 95% confidence interval of OR value >1, but the mortality rate and incidence of ICH were not significantly different between the two groups (P>0.05).</p><p><b>CONCLUSION</b>PROM is a risk factor for NEC, ROP and BPD in preterm infants, and adequate intervention of PROM can reduce the incidences of such complications as NEC, ROP and BPD in the infants.</p>

Advances in studies on chemical constituents from husks of Xanthoceras sorbifolia and their biological activities / 中草药

To review the research progress in the chemical constituents from the husks of Xanthoceras sorbifolia and their biological activities for the first time. After a detailed investigation on the literatures at home and abroad, we had found that the primary chemical constituents from the husks of X. sorbifolia were triterpenoids and polyphenols (such as flavonoids, phenolic acids, coumarins etc), sterols, alkaloids, and so on. The biological activities of the chemical constituents from the husks of X. sorbifolia showed mainly as improving the ability of learning and memory, anticancer effects, inhibition on tyrosinase, curing cardiovascular and cerebrovascular diseases, anti-oxidant and anti-inflammatory effects, and inhibiting pancreatic lipase activity. Xanthoceraside is a primary triterpenoid saponin purified from the husks of X. sorbifolia, with highest content and a variety of biological activities. The husks as the waste of the oil-extracting from X. sorbifolia, this paper provides the references for further understanding and utilization of the medicinal values in the husks of X. sorbifolia.

Meta - analysis of clinical randomized controlled trials comparing ReZOOM with ReSTOR multifocal intraocular lenses in cataract surgery / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To systematic review the effectiveness of refractive multifocal intraocular lens ( MIOL ) ReZOOM vs diffractive MIOL ReSTOR in the treatment of cataract. METHODS: Randomized controlled trials comparing refractive MIOL ReZOOM with diffractive MIOL ReSTOR were identified by searching CENTRAL, MEDLINE, EMbase, WANFANG MED ONLINE, CMJD, SinoMed, and CNKI. Related journals also were hand-searched. Methodological quality of randomized controlled trials ( RCTs ) was evaluated by simple evaluate method that recommended by the Cochrane Collaboration. Data extracted by two reviewers with designed extraction form. RevMan software ( release 5. 2 ) was used for data management and analysis. RESULTS:A total of 7 trials (846 eyes) were included for systematic review. Subgroup analyses were used according to different model comparison of ReSTOR MIOL. The results showed a significant difference in the mean of the best distance corrected intermediate visual acuity ( BDCIVA) in the ReZOOM MIOL group with WMD=-0.11, 95% CI (-0.16, -0.06) (P CONCLUSION: Patients implanted with ReZOOM MIOL can provide better BDCIVA; patients implanted with ReSTOR MIOL show better UCNVA, are less likely to appear light halo, glare and other visual adverse reactions; correction in spectacles cases, patients implanted with ReZOOM or ReSTOR MIOL have considerable performances in the far and near visual acuity.

Lipopolysaccharide induced activin A-follistatin imbalance affects cardiac fibrosis / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Inflammation plays a pivotal role in cardiac remodeling, especially in myocardial fibrosis. Abnormal growth of cardiac fibroblasts is critically involved in the pathophysiology of cardiac hypertrophy/remodeling. Previous study has demonstrated that many inflammation stimulating factors trigger transforming growth factor-β (TGF-β) induction and reactive myocardial fibrosis. Activin A (ACT A) is a member of TGF-β superfamily, and follistatin (FS) is an activin-binding protein, i.e. an antagonist of ACT A. Our previous studies have shown that ACT A-FS imbalance occurs in rats with heart failure (HF), and overexpression of ACT A can lead to ventricular remodeling, and resultant HF. Low expression of FS after myocardial infarction further exacerbated HF. The pathogenic change resulting from overexpression of ACT A is consistent with that of overexpression of angiotensin II (AngII). Ventricular remodeling includes cardiocyte remodeling and myocardial interstitial collagen deposition and fibrosis. Therefore, the present study was designed to investigate the effects of inflammatory factors on the ACT A-FS and the secretions of cardiac fibroblasts in order to explore in depth the mechanism of myocardial fibrosis.</p><p><b>METHODS</b>A rat model with HF was established, and the results showed that there was a greater degree of cardiac fibrosis in HF rats. In addition, we found that there was an imbalance of the ACT A/FS system in HF rats, which was characterized by increased levels of ACT A. Further, primary rat cardiac fibroblasts were cultured and the MTT assay was performed to determine the effect of the inflammatory factor-bacterial endotoxin lipopolysaccharide (LPS) on cardiac fibroblast proliferation.</p><p><b>RESULTS</b>The results showed that LPS can stimulate the cardiac fibroblasts to proliferate in a dose-dependent manner. Cellular immunohistochemical staining showed that the rat cardiac fibroblasts themselves could express ACT A and FS proteins, and stimulation by LPS could apparently promote the cultured primary rat cardiac fibroblasts to secrete ACT A, but inhibit the secretion of FS. The results also showed that ACT A promoted, in a dose-dependent manner, the proliferation of the cultured primary rat cardiac fibroblasts, and the expression of collagen types I and III. Moreover, ACT A promoted, in a dose dependent manner, the cardiac fibroblasts to secrete nitric oxide (NO), and unregulated the expression of inducible nitric oxide synthase (iNOS) mRNA.</p><p><b>CONCLUSIONS</b>These results suggest that the inflammatory mediator LPS can promote ACT A-FS imbalance in cardiac fibroblasts, mainly overexpression of ACT A. Overexpression of ACT A promotes the proliferation and the secretion of collagens in cardiac fibroblasts through autocrine/paracrine stimulation of NO, and is involved in the pathological process of myocardial fibrosis.</p>

Value of estrogen for preventing postpartum hemorrhage and shortening birth process in induce abortion / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the clinical efficacy of estrogen in preventing postpartum hemorrhage and shortening the birth process during induced abortion.</p><p><b>METHODS</b>Totally 320 puerperants for termination of pregnancy for medical reasons were randomly assigned into 2 groups, the estrogen group (n=175) and the control group (n=145), and the former were given oral estrostilben 3 mg thrice a day from the day before acrinol injection to the end of delivery. The amount of blood loss 2 h after delivery, cases of postpartum hemorrhage, and the duration of total birth process were recorded.</p><p><b>RESULTS</b>Significant differences were noted in blood loss 2 h after delivery between estrodiol and control groups (123.3-/+81.8 vs 206.3-/+114.4 ml). Two cases of postpartum hemorrhage were found in estrogen group and 10 in control group. The duration from acrinol injection to delivery was similar between the two groups (31-/+11 vs 33-/+12 h), but the former had significant shorter duration from contraction onset to delivery than the latter (6.03-/+3.19 vs 9.7-/+5.9 h). No side-effects were found in either group.</p><p><b>CONCLUSION</b>Estrogen given before delivery can be effective in stimulating uterine contraction for preventing postpartum hemorrhage and shortening the birth process in women undergoing induced abortion.</p>

Clinical value of adjuvant therapy with estrogen for postpartum hemorrhage / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the clinical efficacy of estrogen in management of postpartum hemorrhage due to uterine atony.</p><p><b>METHODS</b>Totalling 112 puerperants with postpartum hemorrhage due to uterine atony were randomly assigned into 2 groups and received routine managements for uterine atony such as uterine massage and uterotonics administration. The puerperants in one group (n=52) was treated with 4 mg estradiol benzoate injected intramuscularly, and the amount of blood loss 2 h after delivery and between 2 and 24 h after delivery was recorded.</p><p><b>RESULTS</b>There were significant differences in vaginal blood loss at 2 h after delivery between the 2 groups (P<0.05). The puerperants with estrodiol benzoate treatment had blood loss of 589.6-/+226.4 ml at 2 h and 110.8-/+76.2 ml within 2-24 h after delivery, which were both less than those in the control group (864.5-/+359.5 ml and 161.5-/+98.3 ml, respectively). Postpartum hysterectomy was performed in 3 cases of the control group while none in estradiol benzoate-treated group. In the mothers and neonates, no major adverse effects were observed.</p><p><b>CONCLUSION</b>Estrogen shows cooperative efficacy with uterotonics in stimulating uterine contraction for managements of postpartum hemorrhage due to uterine atony, and can be of value in clinical application.</p>