Objective: To systematically evaluate the effect of colostrum on immunoglobulin A (IgA) levels among premature infants, so as to provide the evidence for improving premature infants' health with colostrum feeding. Methods: Randomized controlled clinical trials (RCTs) or controlled clinical trials (CCTs) pertaining to the effect of colostrum and IgA levels among premature infants were retrieved in national and international databases from inception to September 30, 2022, including CNKI, Wanfang Data, PubMed and Web of Science. Standardized mean difference (SMD) was used as an effect index for meta-analysis. The robustness of the results was evaluated using sensitivity analysis, and the publication bias was evaluated using Begg's test, Egger's test and funnel plot. Results : A total of 650 publications were retrieved initially, and 10 studies were finally included, including 9 RCTs and one1 CCT, with 677 participants. Meta-analysis showed higher secretory salivary secretory IgA levels among premature infants with colostrum feeding than among controls (SMD=0.49, 95%CI: 0.08-0.89), and there were no significant differences between groups in terms of urinary secretory IgA levels (SMD=0.19, 95%CI: -0.39-0.77) or blood IgA levels (SMD=0.29, 95%CI: -0.01-0.59). Sensitivity analysis showed robustness of meta-analysis results, and no publication bias was examined. Conclusion Colostrum feeding may increase salivary secretory IgA levels among premature infants; however, it has no effect on urine salivary secretory IgA levels or blood IgA levels.

Serum p-amyloid peptide(Aβ)40 and Ap42 levels in patients with type 2 diabetes mellitus (T2DM)and atherosclerosis(AS)were detected by ELISA.The results showed that serum Ap40 level in T2DM group was significantly higher than that in the control group[(274.70±159.51 vs 162.63±87.58)pg/ml,P<0.05],especially in the diabetic patients accompanied with AS[(616.95±195.13)pg/m],P<0.01].Serum Ap40 level in simple AS group was also higher than that in control group[(318.52± 188.65)pg/ml,P<0.05].These results suggest that Ap40 is a risk factor of T2DM complicated with AS.However,there was no difference in serum Ap42 levels among various groups.

This study was designed to explone whether catalpol exerts a protective effects on kidney of diabetic rats and its possible mechanism.Insulin-like growth factor- I ( IGF- I ) and protein kinase B (PKB/Akt)mRNA and protein expression in kidney of diabetic rats were up-regulated as results of assessments by RT-PCR,immunohistochemistry and Western blot.Catalpol could partially reduce IGF- Ⅰ and Akt expressions in kidney of diabetic rats,and thus alleviate the damage of kidney.

Objective To investigate the development of auditory and speech skills and the safety and stability among the prelingually deaf children with Nurotron Venus cochlear implants.Methods A total of 78 cochlear implant subjects were recruited from the first of affiliated hospital of Zhengzhou university.They were divided into 5 groups according to the ages at the time of implantation: group A(between 13 and 24 months), group B(between 25 and 36 months),group C(between 37 and 48 months),group D(between 49 and 72 months),group E(between 73 and 96 months).Children were evaluated by IT-MAIS(group A and B) and MAIS(group C,D and E) before the surgery and 1 month,3 months,6 months, and 12 months after surgery.All children were evaluated by MUSS questionnaires 1 months, 3 months,6 months,and 12 months after surgery.Post-operative cochlear radiographs determine the position of the CIs.The complications and usage of The CIs were followed up.Results The auditory and speech ability of children with CIs improved constantly.The auditory and speech of different groups were statistically significant.All the surgeries of 78 cases Nurotron-Venus cochlear implants were successful.Post-operative cochlear radiographs showed electrodes in the normal position.2 cases had processor failures.The remaining CIs were implanted completely.Conclusion Within 1 year, the ability of auditory and speech improved gradually.The scores of auditory and speech about the small age groups are lower than older children in the early days.There is no influence on the audition in 12 months.Small children's scores of speech are lower than older children in 12 months.The better ability to integrate auditory information is , the better the ability to speak is.The Nurotron CIs work safety and effectively.

Objective To characterize the clinical manifestations, laboratory findings of patients with occult sys?temic malignant neoplasms, whose initial manifestation presented as multiple acute cerebral infarcts including coagula?tion function,radiological imaging and microembolic signals (MES) detection by transcranial Doppler sonography (TCD) and to explore the possible underlying mechanisms. Methods All clinical records, laboratory hematological tests includ?ing hypercoagulable states measured by D-dimer levels, brain MRI including DWI, and TCD monitoring MES, the treat?ment and prognosis were retrospectively reviewed in 12 patients with multiple acute cerebral infarcts as the first manifes?tation of occult systemic malignancy. Results The clinical manifestations presented as localized neurological dysfunction, e.g. hemiparesis, aphasia, hemiparesthesia, dysarthria, vertigo and seizures, etc. DWI revealed multiple disseminated acute cerebral infarcts in multiple arterial territories such as the bilateral anterior or anterior plus posterior cerebral circu?lation in all patients. Eleven of 12 patients tested had elevated D-dimer. TCD detected MES in 5 of 7 patients. There were 12 patients diagnosed with occult systemic malignancy including 5 lung cancer, 3 pancreatic cancer, 1 gastric can?cer, 1 colon cancer, 1 endometrial adenocarcinoma and 1 metastatic poorly differentiated mucinous adenocarcinoma with unknown primary. Ten patients already had remote metastasis at diagnosis. The prognosis was usually poor and there were 7 cases with ischemic stroke recurrence, 4 cases with acute myocardial infarction, 3 cases died during hospitaliza?tion. Conclusions When patients present with multiple disseminated acute cerebral infarcts involving multiple arterial territories as initial manifestation, the underlying occult systemic malignancy should be considered. Hypercoagulopathy and MES might provide the clues to the diagnosis.

Objective To investigate the value of shear wave elastography(SWE)to early predict clinical efficacy of breast cancer neoadjuvant chemotherapy(NAC).Methods Fifty-three patients(55 lesions)with breast cancer who underwent NAC were enrolled in this study.SWE was performed at baseline and after the end of 2,4,6 cycles of NAC.According to the postoperative pathological results,the lesions were divided into major pathologic response group and minor pathologic response group.The maximum diameter of the lesions between the baseline and the end of the last cycle of the two groups were measured and the maximum diameter changes(ΔDmax)of the two groups were compared.The maximum elastic modulus(Emax)and the maximum elastic modulus changes(ΔEmax)of the two groups were measured and compared at baseline and after the end of 2,4,6 cycles of NAC.The ROC curves of ΔEmax at the end of 2 and 4 cycles were used to evaluate the predictive value of NAC response.Results The ΔDmax of the major pathologic response group[(64.82±21.06)%]was higher than that of the minor pathologic response group[(26.49±26.1 1)%,P <0.001].With the prolongation of NAC,the values of Emax were significantly decreased in the two groups,but the decreasing degrees were different.The Emax was significantly decreased at the end of 2 cycles in the major pathologic response group(P <0.05),however, at the end of 4 cycles in minor pathologic response group(P <0.05).The value of ΔEmax in the major pathologic response group was higher than that in the minor pathologic response group in every cycle significantly(all P <0.05).The ΔEmax threshold of the 2 cycles for predicting the NAC response was 26.1%(81.8% of sensitivity,75% of specificity),while the threshold of the 4 cycles was 35.5%(87.9%of sensitivity,83.3% of specificity),there was no significant difference between the areas under the two curves(P =0.264).Conclusions The value of ΔEmax in breast cancer lesions can predict the efficacy of NAC early.SWE can provide a valuable complement for two-dimensional ultrasound in the evaluation of NAC efficacy in breast cancer.

Medical electronic endoscope is one of the indispensable tools in medical diagnosis and treatment. With the development of science and technology, electronic endoscope has higher safety and accuracy than traditional optical endoscope. Due to the sophisticated construction and high price, hospitals spend a lot of money on maintenance every year. In order to prolong the working life of electronic endoscope, reduce the incidence of artificial failure and save hospital costs, this study made a retrospective analysis on the common faults of electronic endoscope, and summarized the maintenance strategies for reference.
Electronics, Medical ; Endoscopes ; Retrospective Studies

BACKGROUNDThe mechanisms underlying diabetic encephalopathy are largely unknown, and no effective treatments are available. Catalpol has received much attention due to its numerous biological effects, especially in neuroprotective studies. The aim of this study was to investigate the effects of catalpol on cognitive functions in diabetic rats and the underlying mechanisms.

METHODSA rat model of diabetes was established by streptozotocin injection, followed by intraperitoneal infusion of catalpol after 10 weeks. Two weeks later, the Morris water maze was used to test the spatial learning performance. Nissl staining was performed to evaluate the morphological changes in the hippocampus. Expression of protein kinase Cγ (PKCγ) and caveolin-1 (Cav-1) in the hippocampus were assessed by reverse transcription PCR and Western blotting. Activities of anti-oxidative enzymes such as glutathione (GSH), superoxide dismutase (SOD) and catalase (CAT) and levels of malonaldehyde (MDA) were measured using commercial kits.

RESULTSSignificant hippocampal neuronal injury was observed in rats with streptozotocin-induced diabetes. Moreover, cognitive dysfunction was associated with markedly increased oxidative stress in the brain. Catalpol treatment significantly attenuated cognitive deficits, neuronal damage, and oxidative stress in the brain of diabetic rats. Biochemical analyses showed that catalpol reversed the down-regulation of PKCγ and Cav-1 expression in the diabetic rats.

CONCLUSIONSSpatial memory in diabetic rats is associated with the expression of PKCγ and Cav-1. Catalpol treatment markedly attenuated oxidative stress, reversed the alteration of PKCγ, Cav-1 and spatial memory deficits.

Animals ; Caveolin 1 ; metabolism ; Diabetes Mellitus, Experimental ; drug therapy ; metabolism ; physiopathology ; Hippocampus ; drug effects ; metabolism ; Iridoid Glucosides ; therapeutic use ; Male ; Neuroprotective Agents ; therapeutic use ; Oxidative Stress ; drug effects ; Protein Kinase C ; metabolism ; Rats ; Spatial Memory ; drug effects ; physiology

Objective To monitor the susceptibility of clinical isolates to antimicrobial agents in tertiary hospitals in major regions of China in 2022.Methods Clinical isolates from 58 hospitals in China were tested for antimicrobial susceptibility using a unified protocol based on disc diffusion method or automated testing systems.Results were interpreted using the 2022 Clinical &Laboratory Standards Institute(CLSI)breakpoints.Results A total of 318 013 clinical isolates were collected from January 1,2022 to December 31,2022,of which 29.5％were gram-positive and 70.5％were gram-negative.The prevalence of methicillin-resistant strains in Staphylococcus aureus,Staphylococcus epidermidis and other coagulase-negative Staphylococcus species(excluding Staphylococcus pseudintermedius and Staphylococcus schleiferi)was 28.3％,76.7％and 77.9％,respectively.Overall,94.0％of MRSA strains were susceptible to trimethoprim-sulfamethoxazole and 90.8％of MRSE strains were susceptible to rifampicin.No vancomycin-resistant strains were found.Enterococcus faecalis showed significantly lower resistance rates to most antimicrobial agents tested than Enterococcus faecium.A few vancomycin-resistant strains were identified in both E.faecalis and E.faecium.The prevalence of penicillin-susceptible Streptococcus pneumoniae was 94.2％in the isolates from children and 95.7％in the isolates from adults.The resistance rate to carbapenems was lower than 13.1％in most Enterobacterales species except for Klebsiella,21.7％-23.1％of which were resistant to carbapenems.Most Enterobacterales isolates were highly susceptible to tigecycline,colistin and polymyxin B,with resistance rates ranging from 0.1％to 13.3％.The prevalence of meropenem-resistant strains decreased from 23.5％in 2019 to 18.0％in 2022 in Pseudomonas aeruginosa,and decreased from 79.0％in 2019 to 72.5％in 2022 in Acinetobacter baumannii.Conclusions The resistance of clinical isolates to the commonly used antimicrobial agents is still increasing in tertiary hospitals.However,the prevalence of important carbapenem-resistant organisms such as carbapenem-resistant K.pneumoniae,P.aeruginosa,and A.baumannii showed a downward trend in recent years.This finding suggests that the strategy of combining antimicrobial resistance surveillance with multidisciplinary concerted action works well in curbing the spread of resistant bacteria.