Objective To investigate the incidence of the peripherally inserted central catheter (PICC) complications in neonates. Methods A retrospective analysis of PICC in 201 cases in our neonatal intensive care unit (NICU) from January 2015 to October 2016, who were divided into the central group and non-central group according to the position of the catheter tip. Compare unplanned extubation rate, catheter-related bloodstream infection rate, catheter indwelling time of PICC catheter and removing reasons between these two groups. Results One hundred and sixty-five cases in central group and thirty-six cases in non-central group. The unplanned extubation rate of the central group was 18.2% (30/165) while 22.2% (8/36) of non-central group, the difference wasnot statistically significant (χ2=0.315, P=0.639). The difference of the catheter-related bloodstream infection rate (P=0.471), the catheter indwelling time and removing reasons between these two groups were not statistically significant(P>0.05). Conclusions Even if the position of PICC tip is not in superior or inferior vena, it still can be used in neonatal population, but should pay attention to safe medical care.

To explore the effect of insulin therapy on serum level of insulin-like growth factor-I(IGF-I)in patients with type 2 diabetes mellitus.The results showed that serum IGF-I level increased[(126.70±51.91 vs 90.04±43.68)μg/L,P<0.01]and was positively correlated with insulin level in patients with type 2 diabetes mellitus after exogenous insulin therapy(r=0.298,P<0.05).

Objective:To provide reference for clinical pharmacists participating in the therapy of idiopathic membranous nephrop-athy patients. Methods:The drug use in 3 cases of idiopathic membranous nephropathy participated by clinical pharmacists was ana-lyzed. Results:When idiopathic membranous nephropathy was treated with glucocorticoid combined with tacrolimus, it was necessary to master the drug selection, dose and blood concentration of the drugs, course and time of the treatment and adverse reactions etc. In addition, the effectiveness and safety should be unified. Conclusion:Clinical pharmacists should pay close attention to the rational drug use, compliance of patients and adverse reactions through participating in the therapy of idiopathic membranous nephropathy.

Objective: To investigate the effects of different extracts of Smilax china L on the activity of ovarian cancer cells. Methods:Solvent extraction method was used to extract the active ingredients of Smilax china L. , and CCK-8 assay method was ap-plied to detect the influence of different Smilax china L. extracts (0, 50, 100, 150 and 200μg·ml-1 ) on the survival rate of ovarian cancer cells including low invasiveness A2780 cells and high invasiveness HO-8910PM cells. At the same time, the status of the two kinds of ovarian cancer cells at different time points (24, 48 and 72 h) was observed. Results:The IC50 of N-butanol extracts (SCR-B) on HO-8910 and A2780 ovarian cancer cells was 47. 5 μg· ml-1 and 69. 2 μg· ml-1 , respectively, and that of ethyl acetate ex-tracts (SCR-E) on A2780 and HO-8910 cells was 147. 9 μg· ml-1 and 166. 0 μg· ml-1, respectively. Smilax china L. extracts had the inhibition against both A278 and HO-8910PM ovarian cells in a dose-and time-dependent manner. Conclusion:The inhibitory activity of SCR-B against ovarian cancer cells is stronger than that of SCR-E, and SCR-B has stronger inhibition against A2780 cells than against HO-8910 cells. SCR-B has better inhibition against ovarian cancer cells.

To study action mechanism and time of administration of indomethacin in SMAO shock rabbits. Method:Thirty-two SMAO shock rabbits were randomly divided into four groups: control group A,indomethacin 5mg/kg I.V. at the occlusion of superior mesenteric artery (group B), indomethacin 5mg/kg L V. immediately after clamp being removed(group C) and the same dose 30min after clamp being removed(group D). Survival rate,hemodynamics, plasma calcium, myocardial calcium, TXB_2 and 6-keto-PGF_1. levels were observed in 4h shock period. Myocardial apecmen were examined with electronic microscope. Result: After indomethacin I.V,the survival rate was higher and bemodynamie better than those of controll. The plasma calcium level remained stable in indomethacin groups. Myocardial calcium content of group B and C was lower than that of group D and A. The TXB_2 and 6-ketoPGF_1. contents were similar in all groups. Under electronic microscope, the damages were slightest in group C and most serious in group D and A among the four groups. Conclusion:Indomethacin has a beneficial effect on the SMAO shock rabbits ,the mechanism of which can be related to improving myocardium contractivity as well as to blocking calcium channel,rather than the action through prostaglandins. The time of administration should be early as possible after shock.

Objective: To study the osteoinductive activity of chimeric molecule of bone morphogenetic protein(BMP)2 and BMP7 expressed in mammalian cells. Methods: Sequences encoding mature peptides of BMP2 and BMP7 were separately amplified by PCR and then linked by overlap-extension PCR with a DNA sequence encoding a flexible peptide (Gly_4Ser)_3 between them. The chimeric DNA sequence was cloned into secretory expression plasmid pcDNA3/sec and then the recombinant plasmid pcDNA3 -BMP2/7 was transfected into CHO-K1 cells. In the presence of G418,cells that stably expressed BMP2/7 were screened out. Thereafter, the conditioned culture medium of the transfected cells was collected and used to treat C3H10T1/2 cells. RT-PCR was employed to study the activity of the recombinant product in inducing osteoblast differentiation. Results: The expression products of chimeric BMP2/7 significantly enhanced the mRNA expression levels of osteoblast phenotype genes, such as alkaline phosphatase, osteocalcin and osteoblast specific transcription factor runt-related transcription factor 2 in C3H10T1/2 cells(P < 0.01). Conclusion: The chimeric expression products of BMP2/7 are capable of forming heterodimers and thus effectively induce non-bone derived cells to differentiate into osteoblasts.

Objective To investigate the incidence and clinical presentation of breast milk transmitted cytomegalovirus (CMV) infection among preterm infants with birth weight≤1500 g.Methods Preterm infants enrolled in this study met the following inclusion criteria: birth weight≤1500 g, fed with CMV-positive breast milk and admitted into Neonatal Intensive Care Unit of Children's Hospital of Fudan University within 72 hours after birth from October 2015 to July 2016. And those with congenital digestive tract malformation or congenital CMV infection were excluded. Breast milk and infants' urine samples were regularly screened for CMV DNA by fluorescent quantitative polymerase chain reaction. Symptoms and laboratory findings in infants with CMV infection transmitted via breast milk were documented and analyzed. Differences in relevant parameters were analyzed usingChi-square test, Fisher's exact test,t test or Mann-WhitneyU test where appropriately.Results Sixty preterm infants breastfed with CMV DAN-positive milk were recruited. Among them, 19 (31.7%) developed breast milk-acquired CMV infection as their urine samples were positive for CMV DNA, while the others were negative for CMV DNA (infected group:n=19; non-infected group:n=41). The average CMV copies in breast milk, gestational age and birth weight of the infected group were all significantly higher than those of the non-infected group [3.76 (3.18-4.50) vs 3.47 (3.00-4.88) Log10 copies/ml,Z=-2.042;(30.4±2.1) vs (28.4±2.3) weeks,t=3.175; 1290 (750-1500) vs 1110 (575-1480) g,Z=-2.837; all P<0.05). Fewer infants in the infected group than in the non-infected group received blood transfusion [5/19 vs 56.1%(23/41),χ2=4.627,P<0.05]. Ages of the infants with CMV infection ranged from 26 to 164 days (median age of 92 days). Six out of the 19 infants had clinical symptoms concurrent with viral excretion in urine and the ages of these symptomatic infants of infection were earlier than those of the asymptomatic ones without significance [(72±34) vs (97±28) days,t=-1.710,P>0.05]. Four infants (21.1%, 4/19) had severe organ damage and/or positive IgM antibodies to CMV in serum, and were treated with antiviral therapy. Two had mild symptoms and were not given antiviral therapy. All of the six symptomatic infants were followed-up for one to six months, during which time the complete blood cell count and results of biochemical test and fundus examination were back to normal.Conclusions The incidence of breast milk-acquired CMV infection among preterm infants with birth weight≤ 1500 g was 31.7%, and no severe symptoms were reported in this study.

OBJECTIVE: To carry out genetic testing for a child with Marfan syndrome (MFS) and explore its genotype-phenotype correlation. METHODS: Peripheral blood samples of the child and his parents were collected for the extraction of genomic DNA and subjected to whole exome sequencing (WES). Candidate variants were verified by Sanger sequencing. Functional impact of the variant was predicted by using bioinformatic software. RESULTS: The child, a 13-year-old male, has featured Marfanoid habitus, with arm span exceeding his height, tapering fingers and toes, pectus excavatum and scoliosis, but absence of typical cardiovascular system diseases such as aortic dilation, thoracic-abdominal aortic aneurysm, mitral valve prolapse, and lens dislocation. The child has harbored a novel splice site variant c.7383_7413del (p. N2461Kfs*211) of the FBN1 gene, which was not found in his parents and younger brother. The variant was unreported previously. CONCLUSION The novel variant of p. N2461Kfs*211 of the FBN1 gene probably underlay the MFS in this child. Above finding has enriched the genotypic and phenotypic spectrum of MFS.
Male ; Humans ; Marfan Syndrome/genetics* ; Fibrillin-1/genetics* ; Mutation ; Genotype ; Genetic Association Studies

Objective:To explore the types of venous access, indwelling time and the correlation with catheter-related bloodstream infection (CRBSI) of very and extremely low birth weight infants (VLBW & ELBW) in NICU.Methods:The self-designed venous access data collection form was used to collect the venous access data of VLBW & ELBW infants who were admitted to NICU of Children′s Hospital of Fudan University from January to December 2019. SPSS 22.0 software was used for data analysis, description and binary Logistic regression analysis.Results:A total of 218 cases were collected, including 9 cases of peripheral intravenous (PIV), 30 cases of PIV+ umbilical vein catheter (UVC), 43 cases of PIV+PICC, 136 cases of PIV+UVC+PICC. The average indwelling time of UVC was 6 days, the average indwelling time of PICC was 22 days. There were 23 cases (10.55%) got CRBSI and 195 cases (89.45%) without CRBSI. Binary Logistic regression analysis showed that birth weight ( OR=1.003, 95% CI 1.000-1.006, P<0.05) and combination form of venous access ( OR=0.139, 95% CI 0.023-0.834, P<0.05) of VLBW & ELBW infants were associated with CRBSI. Conclusions:In NICU, PIV, UVC and PICC are the three main ways to indwell venous access for VLBW & ELBW infants. The occurrence of CRBSI is closely related to the type and combination of indwelling venous access.

Gap junctions mediate direct communication between cells; however, toxicological cascade triggered by nonessential metals can abrogate cellular signaling mediated by gap junctions. Although cadmium (Cd) is known to induce apoptosis in organs and tissues, the mechanisms that underlie gap junction activity in Cd-induced apoptosis in BRL 3A rat liver cells has yet to be established. In this study, we showed that Cd treatment decreased the cell index (a measure of cellular electrical impedance) in BRL 3A cells. Mechanistically, we found that Cd exposure decreased expression of connexin 43 (Cx43), increased expression of p-Cx43 and elevated intracellular free Ca2+ concentration, corresponding to a decrease in gap junctional intercellular communication. Gap junction blockage pretreatment with 18β-glycyrrhizic acid (GA) promoted Cd-induced apoptosis, involving changes in expression of Bax, Bcl-2, caspase-3 and the mitochondrial transmembrane electrical potential (Δψm). Additionally, GA was found to enhance ERK and p38 activation during Cd-induced activation of mitogen-activated protein kinases, but had no significant effect on JNK activation. Our results indicated the apoptosis-related proteins and the ERK and p38 signaling pathways may participate in gap junction blockage promoting Cd-induced apoptosis in BRL 3A cells.
Animals ; Apoptosis/*drug effects ; Cadmium/*toxicity ; Calcium/metabolism ; Cell Communication/drug effects ; Connexin 43/genetics ; Enzyme Activation/drug effects ; Gap Junctions/*drug effects ; Gene Expression Regulation/drug effects ; Hepatocytes/cytology/*drug effects ; Rats ; Signal Transduction/drug effects