Apnea ; Humans ; Hyperbilirubinemia ; Infant

Objective To study the clinical characteristics and imaging features of perinatal autosomal recessive polycystic kidney disease ( ARPKD) and a systematic review of the literature was performed to improve awareness of the disease. Methods A newborn with infantile ARPKD admitted to the neonatal department of our hospital was studied and her clinical data and imaging features retrospectively reviewed. CNKI, CBMdisc, MEDLINE and Embase databases were searched using autosomal recessive, perinatal and polycystic kidney as keywords. 9 case reports were retrieved from 2005 to 2015 and a total of 9 patients were analyzed. Results The gestational age of patients with infantile ARPKD was from 33 to 37 weeks. 6 of them were diagnosed using prenatal ultrasound and one patient was diagnosed using genetic sequencing. One of 10 infants had a family history, 4 patientsˊ mothers had abnormal pregnancy history (spontaneous abortion or miscarriage) and 7 (70. 0%) patients with respiratory failure needed mechanical ventilation. The ultrasound of all the patients showed enlarged and hyperechogenic kidneys. 9 patients died, and only one patient was alive after renal transplant. Conclusions The characteristics of perinatal APRKD are enlarged and polycystic kidneys, hepatic cysts and liver fibrosis. Infants with this disease have poor outcomes and high mortality rate. Respiratory failure and renal failure are the main causes of death in the neonatal period and early diagnosis and treatment are necessary.

Objective To study the risk factors and prognosis of very/extremely low birth weight preterm (VLBW/ELBW) infants with bronchopulmonary dysplasia (BPD) during the first three years of life.Method From January 1st to December 31st,2012,a retrospective study was conducted on the VLBW/ELBW preterm infants with ＞ 28 days of hospitalization in the NICU of our hospital.The infants were assigned into BPD group (FiO2 ＞ 21％) and non-BPD group depending on the oxygen requirement on the 28th day after birth.The incidences of bronchitis,pneumonia,wheezing and re-hospitalization during the first three years of life were analyzed.The pulmonary function tests were performed at one-year-age.Independent-sapmles t test,Kruskal-wallis test and x2 test were used to compare the results between the two groups.Result A total of 72 patients were enrolled into this study.34 patients in the BPD group and 38 in the non-BPD group.The gestational age,birth weight and the use of INSURE technique of BPD group were significantly lower than non-BPD group,while the duration of hospital stays were longer than non-BPD group (P ＜0.05).The ratio of male,neonatal respiratory distress syndrome (RDS),patent ductus arteriosus (PDA),intrauterine infection,mechanical ventilation,nosocomial infection and the inhalation of high concentrations of oxygen were significantly higher in BPD group than non-BPD group (P ＜ 0.05).Incidences of bronchitis and wheezing during 0 ～ 1,1 ～ 2 and 2 ～ 3 years of age in the BPD were significantly higher than non-BPD group,separately.No significant differences existed in the incidences of pneumonia and re-hospitalization between the two groups.Pulmonary function test showed that the respiratory rate (RR) and peak tidal expiratory flow in the BPD group were significantly higher than non-BPD group,while the tidal volume,peak expiratory time and peak expiratory volume were significantly lower in BPD group than non-BPD group (P ＜ 0.05).Conclusion BPD often occurs in preterm infants with gestational age less than 32 weeks.It may cause impaired pulmonary function,characterized by obstruction in small airway,and increases the risk of bronchitis and wheezing during the first three year of life.

In order to understand the students'knowledge mastery,assess teaching effects and improve the quality of teaching,this article analyzed the test papers of Neurology among the five-year program clinical medicine students of Grade 2006 in our College.The results indicated that the mean score of the exam was 87.29 with a standard deviation of 7.90.The distribution was negatively skewed.The degree of difficulty was 0.78 and the discrimination is 0.19.The reliability was 0.59.It demonstrated that the test papers had a good reliability,the design of the test papers was too easy and could not reasonablely discriminate the degree in evaluating the students'mastery of the course.Therefore,we shoud pay attention to appropriate difficulty and ensare quality in preparing test papers to scientifically evaluate teaching quality.

Objective To investigate the intracellular delivery of siRNAs through the applications of ultrasound targeted microbubbles destruction(UTMD)and biodegradable nanoparticles carriers.Methods Preparation of nanoparticles with and without RGD sequences,parameters optimization via L16(45)orthogonal design,control experiments in groups of optimization,RGD targeted nanoparticles,non-RGD nanoparticles and blank control, and determinations by inverted fluorescence microscope and flow cytometry were performed.Results The uptake and fluorescence intensity of PC-3 cells in group of RGD targeted nanoparticle was (93.49±1.37)% and 34.28±2.06 respectively,and that in group of optimization was (88.33±1.24)% and 30.59±3.93 respectively(P＞0.05).Whereas the uptake and fluorescence intensity of PC-3 cells in group of non-RGD nanoparticles was(71.24±2.80)% and 18.39±0.90 respectively,and that in group of optimization was (84.78±2.13)% and 27.18±0.91 respectively(P＜0.05).ConclusionsThe applications of UTMD with RGD targted nanoparticles cannot increase the intracellular delivery of siRNAs.

Objective To investigate the feasibility of virtual touch tissue quantification(VTQ) for the assessment of chronic allograft nephropathy(CAN).Methods 48 patients with normal renal function and 50 patients with CAN were checked by color Doppler and VTQ technique.All the results were compared　between two groups.Results Mean VTQ-values were significantly different between the two groups( P ＜ 0.05).ROC curve displayed that VTQ value of 2.51 m/s could be used to diagnose CAN,the sensitivity,specificity,positive predictive value and negative predictive value were 76.0％,52.1％,60.3％ and 65.7％,respectively.The diagnostic efficiency was 62.2％.Conclusions Parenchymal stiffness measured by VTQ is stable and repeatable,which can be used to diagnose patients with CAN and to monitor renal function.

Objective To establish biological reference intervals of neonatal T lymphocyte subsets and IgG, IgA,IgMlevels in 24 -hour newborns in Guangxi.Methods Maternal history and neonatal clinical data were evalua-ted and recorded.Venous blood samplings were collected within 24 hours of birth and were sent for testing in half an hour.The neonates were divided into the early -preterm,the late -preterm and the term neonates group,1 1 0 cases for each group.The parturients were divided into Dexamethasone treatment group and without Dexamethasone treatment group.Data in neonates and the parturients and the sex were analyzed by SPSS 1 7.0 software and the biological refe-rence values were calculated.Results The two -sided reference intervals of 95% in the early -preterm group,the late -preterm group and the term neonates group were as follows:CD3 +:52.07 -88.92 g/L,58.1 6 -90.42 g/L, 56.1 5 -95.67 g/L;CD4 +:25.20 -59.26 g/L,31 .27 -72.91 g/L,28.44 -82.66 g/L;CD8 +:7.30 -36.26 g/L, 9.1 3 -38.49 g/L,1 1 .09 -48.99 g/L;CD4 +/CD8 +:0.34 -4.58,0.34 -4.58,0.32 -3.80;CD1 9 +:3.95 -27.59 g/L,4.04 -30.94 g/L,4.08 -38.70 g/L;NK cell:1 .34 -6.64 g/L,2.88 -8.92 g/L,3.07 -9.35 g/L;IgA:0.000 4 -0.039 6 g/L,0.000 0 -0.069 0 g/L,0.000 0 -0.069 0 g/L;IgM:0.001 6 -0.1 58 4 g/L,0.020 0 -0.1 40 0 g/L,0.020 0 -0.420 0 g/L;IgG:3.22 -1 0.98 g/L,1 .1 0 -1 4.62 g/L,5.00 -1 3.66 g/L.Moreover the ca-ses with Dexamethasone treatment were as follows:the late -preterm infants CD8 + 1 0.35 -40.33 g/L,NK 3.1 0 -9.46 g/L,term NK 6.60 -9.50 g/L;those in without Dexamethasone treatment:the late -preterm infants CD8 +8.42 -34.96 g/L,NK 2.94 -7.80 g/L,term NK 2.98 -8.94 g/L;according to gender,the males in the late -pre-term infants CD8 + 8.26 -35.66 g/L,term CD3 + 51 .90 -92.94 g/L;females in the late -preterm infants CD8 +1 1 .08 -40.68 g/L,term CD3 + 61 .1 0 -96.1 4 g/L.Conclusions Testing values of neonatal T lymphocyte subsets and IgG,IgA,IgM levels in 24 -hour newborns in Guangxi disperse largely and show some differences among the early -preterm neonates,the late -preterm neonates and the term neonates,and maternal Dexamethasone treatment during pregnancy and gender play a role in neonatal immunity.

Objective To evaluate the levels of total serum bilirubin(TSB),amplitude integrated electroencephalogram(aEEG) monitoring and brainstem auditory evoked potential(BAEP) individually and in combination for the early diagnosis of neonatal acute bilirubin encephalopathy by receiver operating charac-teristic( ROC) curve. Methods Clinical data was retrospectively analyzed. A total of 152 infants were diag-nosed with hyperbilirubinemia,including 119 cases of non-bilirubin encephalopathy group and 33 cases of bil-irubin encephalopathy group. The detection results of peak serum bilirubin,aEEG,BAEP combined with the three methods were determined with ROC curve analysis. Results The areas under ROC curve of TSB lev-el,aEEG,BAEP and in combination were 0. 900,0. 738,0. 767,0. 925,respectively,the corresponding sensi-tivity(specificity) in the cut-off point were 90. 91%(78. 15%),87. 88%(59. 66%),65. 52%(87. 91%), 93. 10%(82. 42%),respectively. It showed that the area under ROC curve of the maximum,the comprehen-sive assessment in diagnostic sensitivity and specificity of the combination of three methods were better than any single detection method by ROC curve. Conclusion The methods of TSB level,aEEG and BAEP play an important role in the diagnosis of neonatal bilirubin encephalopathy,and combination with the three meth-ods can improve the accuracy of diagnosis.

Objective:To investigate the malignant potential of histopathological class B3 and B5a lesions by ultrasound-guided core needle biopsy (CNB).Methods:Retrospective analysis of the histopathological results of 712 breast lesions that successively underwent CNB process and surgical resection in the Shanghai General Hospital from January 2018 to December 2022, of which 47 lesions were reported as class B3 and 70 lesions as class B5a.Results:CNB identified 47 category B3 lesions, comprising 19 cases of atypical ductal hyperplasia, 17 papillary lesions, 8 phyllodes tumors, and 3 complex sclerosing lesions. Of these cases, surgical pathology was in full agreement with CNB pathology in 27 instances, indicating a concordance rate of 57.4% (27/47) and an inconsistency rate of 42.6% (20/47). Out of the 20 inconsistent cases, 70.0% (14/20) were upgraded based on the findings from the surgical pathology.Specifically, 4 cases of atypical ductal hyperplasia and 2 cases of intraductal papilloma were upgraded to invasive breast cancer (B5b) after surgery. Among the 4 cases with puncture pathology indicating atypical ductal hyperplasia and one complex sclerosing lesion, these five lesions were upgraded to ductal carcinoma in situ (B5a) after surgery. Two puncture pathologies were diagnosed as atypical ductal hyperplasia, and these were upgraded to ductal carcinoma in situ with microinvasion (B5b) after surgery. One puncture pathology indicated a borderline phyllodes tumor, and this was upgraded to malignant phyllodes tumor (B5b) after surgery. And 30.0% (6/20) resulted in downgrade after surgery, specifically 4 cases of atypical ductal hyperplasia, which were downgraded to breast adenopathy (B2). Of these, 1 puncture pathology was identified as atypical ductal hyperplasia and one as a borderline phyllodes tumor, which were both downgraded to fibroadenoma (B2). Seventy lesions were diagnosed as B5a lesions by CNB pathology, with 28 of them showing complete concurrence with the surgical pathology, a concordance rate of 40.0% (28/70), and an inconsistency rate of 60.0% (42/70). Of the 42 cases with discrepancies, all 42 were upgraded, yielding an upgrading rate of 100% (42/42). Of these, 21 were upgraded to ductal carcinoma in situ with microinvasion (B5b) and 21 to invasive breast cancer (B5b).Conclusions:Lesions with CNB pathology in categories B3 and B5a have a high rate of postoperative escalation. B3 and B5a lesions should be treated with considerable care, especially atypical ductal hyperplasia, which should be surgically resected, and CNB examination should be performed twice if necessary.