Objective To investigate the clinical significance of serum microRNA-151a-3p (miR-151a-3p) expression in peripheral blood of patients with acute cerebral infarction (ACI), and to analyze the correlation between miR-151a-3p and related inflammatory factors, in order to obtain new evidence and ideas in the diagnosis and treatment of ACI. Methods A retrospective analysis was conducted. The clinical data of patients with ACI admitted to Department of Neurology of People's Hospital of Wuhan University from April to July in 2004 were enrolled. 114 ACI patients with first onset and duration of 2-14 days served as the research objects, and in the same period 58 healthy persons with matched age, and gender served as healthy control group. The risk factors of cerebral infarction in ACI patients and levels of serum miR-151a-3p, interleukins (IL-6, IL-8), C-reactive protein (CRP), tumor necrosis factor-α (TNF-α) in all the subjects were completely recorded. The correlation between serum miR-151a-3p and the area and type of cerebral infarction, the causes of infarction as well as the inflammatory cytokines was analyzed. The correlation of 10-year survival rate of patients with different expression levels of miR-151a-3p in patients with ACI was analyzed. Results A total of 114 patients with ACI were enrolled, with 59 male, 55 female, and age ranged 48-63 years with a mean of (55.0±6.7) years. Large infarction was found in 25 cases, middle sized infarction in 26 cases, small infarction in 53 cases, and lacunar infarction in 10 cases. According to the modified Trial of Org 10172 in acute stroke treatment (TOAST), the patients were classified as thrombotic cerebral infarction (AT) 92 cases, embolism (CE) from cardiac origin 10 cases, and small arterial occlusive cerebral infarction (SAD) 12 cases. After eliminating the influence of cerebral infarction risk factors on the expression level of miRNAs, and compared with that of healthy control group, the level of serum miR-151a-3p expression was significantly increased in ACI group (2-ΔΔCt: 2.28±1.85 vs. 1.27±0.98, P < 0.01); the levels of serum miR-151a-3p in large, middle, small, lacunar infarction groups were markedly up-regulated (2-ΔΔCt: 1.78±1.02, 1.92±1.11, 2.22±1.54, 2.61±1.82 vs. 1.27±0.98, all P < 0.05) with no significant difference among different infarction groups. The serum miR-151a-3p expression in AT and CE groups was significantly higher than that of the healthy control group (2-ΔΔCt: 2.01±1.45, 1.99±0.89 vs. 1.27±0.98, both P < 0.05), but no significant difference was found between SAD group and healthy control group (2-ΔΔCt: 1.72±0.30 vs. 1.27±0.98, P > 0.05). The levels of serum IL-6, IL-8, CRP and TNF-α in ACI group were all higher than those of healthy control group [IL-6 (ng/L): 45.21±14.33 vs. 39.70±13.15, IL-8 (μg/L): 29.12±14.92 vs. 22.50±10.12, CRP (mg/L): 6.61±3.02 vs. 5.40±2.75, TNF-α (ng/L): 65.20±16.14 vs. 55.70±14.35, all P < 0.05]. In addition, higher expression of serum pro-inflammatory mediators IL-6, IL-8, CRP and TNF-α were positively correlated with miR-151a-3p (R2 value were 0.092, 0.055, 0.034, 0.036, all P < 0.05). Ten-year survival rate was higher in patients with low expression of miR-151a-3p [with 1.27±1.98 as the boundary, 48.57% (17/35) vs. 34.18% (27/79), log-rank = 3.411, P = 0.045]. Conclusions Up-regulated serum miR-151a-3p may be involved in the pathophysiology of ACI. Therefore, miR-151a-3p may be used as a reference to predict the severity of neurological deficit in clinic.

To observe the clinical efficacy of treatment of infantile brachia plexus injuries with three cooperative therapies of Tuina, Acupuncture and Acupoint injection, which have the function of clearing the meridians. Methods: The affected neck and arm were relaxed with Tuina techniques of one-thumb meditation, grasping and kneading. The points of Jiaji (Ex-B 2) on the neck, Jianjing (GB 21), Futu (LI 18), Jiquan (HT 1), Jianyu (LI 15), Quchi (LI 11), ect were pressed with one thumb. The points of Jiaji (Ex-B 2) on the neck, Tianchuang (SI 16), Futu (LI 18), Jiquan (HT 1), Quchi (LI 11), Waiguan (TE 5), Yangchi (TE 4), Hegu (LI 4)and the corresponding points were inserted with filiform needles and reinforcing-reducing method. The points of Jianyu (LI 15), Jianliao (TE 14), Quchi (LI 11), Shousanli (LI 10),Waiguan (TE 5), Yangchi (TE 4), Hegu (LI 4) were injected with Methylcobalamin injection.The treatment was given once every other day. Results: Of 35 cases, 22 cases were cured, 9 cases greatly improved and 4 cases improved. Conclusion: Three Therapies of Clearing Meridians have a good clinical efficacy for treating infantile brachia plexus injuries.

Objective To study the effect of early pulmonary surfactant (PS) treatment on oxygenation in neonates with acute respiratory distress syndrome (ARDS). Methods Clinical data of neonates with ARDS were retrospectively analyzed. All neonates with ARDS were divided into control group and treatment group. Neonates in treatment group were given PS at a dose of 70-100 mg/kg through the endotracheal tube. Results Among 64 neonates with ARDS, 18 neonates in treatment group were treated with PS, while other interventions were same with 46 neonates in control group. The PaO2/FiO2 and ventilation efifciency index were statistically higher in treatment group than those in control group at 6 h, 12 h, 24 h and 48 h (P<0.05). The oxygenation index and respiratory index were statistically lower in treatment group than those in control group at the same time points (P<0.05). Compared with control group, the treatment group also had a signiifcantly shorter duration of assisted ventilation and oxygen treatment (P<0.05). Conclusions Early treatment with PS in neonates with ARDS could improve the pulmonary compliance and oxygenation, and reduce the duration of assisted ventilation and oxygen treatment, and thus yield better prognosis.

Objective To study the oxygenation of the pulmonary surfactant replacement therapy for acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) in neonates.Methods Ninetyeight eligible neonates with ALI and ARDS were divided into two groups,treatment group (n =30) and control group(n =68).Thirty infants in treatment group were injected with pulmonary surfactant 70 ～ 100 mg/kg via tracheal intubation.The rest of the treatment measures were same in treatment and control group.Results There were no differences between the two groups in gender,gestational age,birth weight and ALI/ARDS.After the pulmonary surfactant replacement therapy for ALl and ARDS,the PaO2/FiO2 and ventilator efficiency index were higher in treatment group than that in control group at 6 h,12 h,24 h,48 h;the oxygenation index and respiratory index were shorter in treatment group than that in control group at the same time.The differences at all time points were statistically significant (P ＜ 0.05).The treatment group also had a significantly shorter duration of assisted ventilation[(66 ± 13) h vs (80 ± 18) h,(82 ±26) h vs (101 ±36) h] and oxygen treatment time [(86±13) h vs (104± 16) h,(103 ±25) h vs (125 ±29) h] (P ＜0.05).Conclusion The application of the pulmonary surfactant replacement treatment in neonates with ALI and ARDS could improve rapidly in dynamic compliance and oxygenation,decrease duration of assisted ventilation and supplemental oxygen administration,thus yield better prognosis.

Objective To study the expression of basic ifbroblast grouth factor (bFGF) and transforming growth factorβ1 (TGF-β1) in different stages of myocardial ifbrosis (CFs). Methods CFs of neonatal Sprague-Dawley rats were isolated with the method of trypsin digestion and differential anchoring velocity, then cultured in vitro. The generation 2-4 of CFs were used for the experiment and randomly divided into 2 groups:the control group were cultured without AngII , and the test group were cultured with AngII 10-6 mol/L. The test group were cultured for 12, 24, 48, and 72 h respectively, and then the synthesis of col agen were measured by ELISA, the bFGF, TGF-β1-mRNA expression was measured by RT-PCR, and the bFGF and TGF-β1 protein expression was measured by western blot analyses. Results Compared with those of control group, the expressions of bFGF and TGF-β1 both in gene and in protein in the test groups increased gradual y with the timing (P?

OBJECTIVE In this study,nine different levels of known teratogenic embryos toxic com-pounds (aceta minophen,methi mazole,indo metacin,methotrexate,ascorbic acid,isoniazid,penicillin G,saccharin ,5-fluorouracil )were used to validate the established evaluation method of zebrafish e mbryo develop mental toxicity in our laboratory via zebrafish e mbryonic develop ment toxicity tests. METHODS By water bath method,zebrafish embryos of post-fertilization 2 h (2 hpf)were exposed to different concentrations of compounds.Observe and record the nu mber of malformations and dead e mbryo in 24,48,72,144 hpf.After three parallel experiments,get EC50 ,LC50 through software and calculate the teratogenic indices (TI =LC50 /EC50 )of the positive drug and recorded it as teratogens.If there is no teratogenic index recorded it as non-teratogens.Co mpare the results with the existing animal experiments and clinical trials to obtain the sensitivity and specificity.RESULTS Based on the results, exposure to aceta minophen (TI =2.07),methi mazole (TI =2.91 ),indo methacin (TI =1 .67),5-flu-orouracil (TI =8.31 ),methotrexate (TI =1 .31 ),showed various levels of teratogenic effects,and the corresponding TI′s were calculated.Methi mazole appeared more obvious skeletal deformities;indo m-ethacin toxicity is mainly reflected in abnormal heart,blood circulation and other endpoints;5-FU at lower doses that result in higher mortality rates,but also took place over the lacking of pig mentation;aceta min-ophen for the heart,liver and other target organ toxicity,pericardial cyst;methotrexate appears signifi-cant so mites,skeletal deformity.Since the IT′s for ascorbic acid,isoniazid,penicillin G,saccharin can-not be calculated,these compounds are considered to show negative results,indicating that the data fro m the nine compounds in zebrafish test are consistent with traditional animal experiments and clinical information,the sensitivity of 100% and specificity of 100%.CONCLUSION Though validation test,it has been de monstrated that the established zebrafish embryos develop mental toxicity evaluation method can be applied to early screening of drug toxicity.

Anti-Bacterial Agents ; administration & dosage ; therapeutic use ; Child ; Community-Acquired Infections ; diagnosis ; epidemiology ; therapy ; Humans ; Pneumonia ; diagnosis ; epidemiology ; therapy

Retinopathy of prematurity( ROP),a leading cause of childhood visual impairment,is a vascular proliferative retinopathy in premature infants. Although the hallmark of ROP is abnormal retinal vasculature, a growing body of research in animals and observations in patients support a critical role for the neural retina in the ROP disease process. ROP can affect the foundation of the retina and optical nerve during the development duration in childhood, presenting with abnormalities in electroretinogram and multifocal electroretinogram. In addition,it was found that ROP has different degrees of influence on the development of the dioptric system ,which will result in refractive error as the child progress to adulthood. The relationship of the electrophysiology features or refractive abnormality and ROP was summarized in this article.

Objective To investigate the relationship between the preterm infants after premature rupture of the membranes(PROM)brain injury and some cellular factors in the umbilical cord blood and amniotic fluid,and ana-lyze the biological markers with great predictive value,and provide a theoretical basis for early monitoring of brain injury in premature infants. Methods One hundred and thirty - nine singleton infants with PROM,their gestation less than 34 weeks,were evaluated. The umbilical cord blood and amniotic fluid of cytokines,including interleukin - 1β(IL - 1β),IL - 4,IL - 6,IL - 8,IL - 10,IL - 17A,tumor necrosis factor alpha(TNF - α),granulocyte colony - stimu-lating factor(G - CSF),monocyte chemotactic protein - 1(MCP - 1),S100B protein and soluble intercellular adhe-sion molecule - 1(sICAM - 1)levels were measured with Luminex liquid chip. All the premature infants underwent brain imaging for the diagnosis of brain damage. All cases were divided into brain injury group and non - brain injury group based on brain imaging examination. Results The concentration of IL - 10 in cord blood was significantly lower in the brain injury group than that in the non - brain injury group,and the difference was statistically significant(P ﹤0. 05). The levels of IL - 1β,IL - 6,IL - 8,TNF - α,G - CSF,MCP - 1,S100B and sICAM - 1 in the brain injury group were significantly higher than those of non - brain injury group,and the differences were statistically significant (all P ﹤ 0. 05). The levels of IL - 1β,IL - 6,IL - 8,TNF - α,G - CSF,MCP - 1 and sICAM - 1 in the amniotic fluid were significantly higher than those of non - brain injury group,and the differences were statistically significant(all P ﹤ 0. 05),but amniotic fluid S100B protein level was similar between 2 groups,which had no statistical significance (P ﹥ 0. 05). To predict the value of brain damage in premature infants,the highest sensitivity in cord blood was S100B protein,the highest specificity was IL - 6. The highest sensitivity in amniotic fluid was IL - 1β,and the highest specificity was IL - 8. The levels of IL - 4 and IL - 17A in the umbilical cord blood and amniotic fluid,IL - 10 in amniotic fluid were very low,and had no predictive value for brain damage. Conclusions Many biological markers in umbilical cord blood and amniotic fluid provide information about the risk of brain injury in premature infants. The highest sensitivity in cord blood was S100B protein,the highest specificity was IL - 6. The highest sensitivity in amniotic fluid was IL - 1β,the highest specificity was IL - 8. Changes in inflammation - related biomarkers suggest that brain damage in the preterm infants might be associated with intrauterine inflammation.

Objective To investigate the mastery of clinical students' doctor-patient communi-cation skills and to assess the teaching effectiveness about the doctor-patient communication, and then propose some improvement ideas. Methods We conducted a study in students of clinical medicine of Nanjing Medical University in Grade 2009, using Objective Structured Clinical Examination (OSCE) after internship, which included graduation assessment of doctor-patient communication skills. Then we analyzed the doctor-patient communication skills and related scores of students trained in different clinical medical programs. Results The average score of doctor-patient communication skills of 549 students was (82.72±4.23), of which, the average score of 329 five-year students of clinical medicine was (81.88±4.23) and the average score of seven-year students was (83.96±3.91) in. The average score of seven-year students of clinical medicine was significantly higher than five-year students (P=0.000). Moreover, there was a significant positive correlation between the total score of OSCE and the score of doctor-patient communication skills in both five-year and seven-year students of clinical medicine (five year program students' score correlation coefficient was 0.520, P=0.000;seven year pro-gram students' score correlation coefficient 0.416, P=0.000). Conclusion The teaching effectiveness of doctor-patient communication has proved to be quite effective, and it is definitely of great significance in improving clinical students' doctor-patient communication skills. The score of the assessment of the doctor-patient communication reflects not only the training effectiveness of the communication skills, but also the comprehensive capacity.