Objective:Investigating the expression of HIV-1 co-receptors CXCR4,CCR5 and chemoking SDF-1 in human placentae and trophoblasts is to explore the mechanism of in-utero transmission of human immunodeficiency virus type 1(HIV-1).Methods:Using semi-quantitative reverse transcriptase-polymerase chain reaction,detected the transcripts of CXCR4,CCR5 in placenta tissues and trophoblasts.Immunocytochemistry and immunohistochemistry analysis revealed the expression of CXCR4,CCR5 in primary cultured first trimester trophoblasts and villous tissue.Also the expression of SDF-1 in villi of first trimester,and the presence of SDF-1 in the culture of isolated trophoblasts were examined by in situ hybridization,immunohistochemistry and enzyme-linked immunosorbent assay.Results:CXCR4 and CCR5 mRNA were detected in placentae of various gestational phases and in first trimester trophoblasts.However,primary cultured trophoblasts were found to be reactive only with antibodies against CXCR4.In the villous tissue sections,CXCR4 was found in trophoblasts,while CCR5 in stromal cell and/or Hofbauer cell.First trimester trophoblasts expressed SDF-1 strongly and secreted SDF-1 in vitro.Conclusion:CXCR4 and CCR5 were expressed in placentae.Hence,they maybe involved in in-utero transmission of HIV-1 as co-receptors.However,SDF-1 expressed in trophoblasts may protect fetus from being invaded by X4-HIV-1.R5-HIV-1 may infect CCR5+ stromal cells and/or Hofbauer cells through placental disruptions.

Objective To classify and grade the environments with Oncomelania hupensis snails inside embankment in marsh-land and lake areas,so as to improve the work efficiency and realize the systematic management. Methods The schistosomiasis endemic area Liaodi and Xiongdi villages in Jiangling County,Hubei Province were selected as the experiment villages,and the environments with snails in the two villages were divided into sections with a length of 500m,then the snail situation were sur-veyed by the systematic sampling method with 10m and 50m a frame respectively. The environments were classified according to the discovery of infected snails and wild fecal contamination,and the numbers of sites with snails and their areas in different class-es were recorded. Meanwhile,the data of sites with infected snails in Jingzhou City during the recent 5 years were collected and graded according to the average density of snails,so as to discuss the correlativity between the grades of environments with snails and the numbers of sites with infected snails and the occurrence rate of frames with snails. Results There were 1 967 sites with in-fected snails in Jingzhou City during the recent 5 years,and there was a positive correlation between the grades of environments with snails and the occurrence rate of frames with snails(rs=0.77,P<0.01),when the grade was 5,the constituent ratio of num-bers of sites with infected snails was 3.1%,and when the grade was 2-3,the ratio raised to 56.3%. There were 39 sites with snails in the two villages,the Class 1,2 and 3 environments included 1,18 and 20 sites,with the areas of 1 080,51 640 m2 and 41 220 m2 , respectively. There were no statistically significant difference between the grades divided by snail survey with 10m and 50m a frame(χ2=4.667,P>0.05),but the time-consuming of the former was 3 times of the latter. Conclusions The classification and grading of the environments with snails inside embankment in marshland and lake areas can master the key point of the snail survey. The subsection and setting frames at a suitable distance can save time and manpower,improve work efficiency,as well as understand the distribution of snail status of the environment with snails,which can realize the sort management of the snail envi-ronments inside embankment.

Objective To understand the influence of family integrated care (FICare) model to the human breastfeeding rate of preterm infants in neonatal intensive care units (NICUs).Method It is a multicenter cluster randomized controlled trail for intervention and prognosis.According to inclusion and exclusion criteria,preterm infants with gestation age 28 ～ 35 weeks in 9 NICUs of tertiary hospitals in 8 provinces in China were enrolled and divided into FICare and control group.Mothers of FICare infants were invited to stay in NICU ward at bedside for no less than 3 hours per day.Under the supervision of nurses,FICare infants'mothers complete 13 items of infants'caring skills including Six-step Hand Washing and hand hygiene,positioning the baby,changing diapers and estimating urine output,skin and mouth caring,kangaroo care and so on.The primary outcome is the human breastfeeding rate.Secondary outcomes include feeding parameters and FICare-related parameters.SPSS 20.0 software is used for the data analysis.Result (1) There were 212 infants and 215 infants enrolled in FICare group and control group,respectively.There was no significant difference between 2 groups in gender,gestational age,birth weight (BW),Z-score of BW,singleton percentage,antenatal steroid completion,diagnosis,day of life (DOL) for starting feeds (P ＞ 0.05).(2) There was no significant difference between 2 groups in DOL for full feeding (P ＞ 0.05).The median age of starting breastfed in both groups was DOL 4.There were 202 cases (87.3％) in FICare group and 80 cases (34.9％) in control group be successfully breastfed.The rate of formula feeding,incidence of nosocomial infection,DOL for regaining BW,decrease of BW AZ score in FICare group was significantly lower than the control group,and the weight gain velocity after regaining BW in FICare group was significantly higher than the control group (P ＜ 0.05).(3) The implementation of FICare and completion of antenatal steroid were the independent protective factors for breastfeeding (OR =27.703,95％ CI 14.531 ～ 52.816;OR =9.496,95％ CI 4.768 ～ 18.912),while nosocomial infection and delayed DOL for starting breastfeeding were the independent risk factors for breastfeeding (OR =0.380,95％CI 0.182 ～0.795;OR =0.847,95％ CI 0.734 ～0.977).Conclusion FICare is significantly beneficial to the breastfeeding rate of preterm infants in NICUs.FICare may decrease the severity of extrauterine growth retardation.

Objective:To analyze the diagnosis, treatment, and outcomes of neonates with deep venous thrombosis (DVT) of the extremities and torso.Methods:The clinical diagnosis, treatment and outcomes of seven neonates with DVT of the extremities and torso admitted to Beijing Children's Hospital, Capital Medical University from March 2016 to March 2020 were retrospectively analyzed. Paired t test and paired rank sum test were used to compare the difference of coagulation indexes before and after the anticoagulant therapy. Results:Among the seven neonates with DVT of the extremities and torso, six were male and five were term infants, with the gestational age of (37.9±2.5) weeks and birth weight of (2 989±619) g. The median age at admission was 2.0 d and the age at diagnosis was 3.0 d. Except for one case of left common femoral vein thrombosis with limb swelling on the affected side, the other cases were all found with DVT by routine abdominal ultrasound examination after admission. Six cases received heparin treatment with the median duration of 8.5 d (1.8-28.8 d), including four cases of thrombosis in the portal venous, one in the postcava and renal venous, and one in the left common femoral vein. Among the six cases, the thrombus disappeared in five cases, which were confirmed by vascular ultrasound examination during follow-up, and in another case, the thrombus was shrinked significantly but remained. After the treatment, the platelet count [(464.5±128.9)×10 9/L vs (142.5±104.2)×10 9/L, t=－5.019, P=0.004] and antithrombin-Ⅲ level [(67.08±28.87)% vs (46.05±12.60)%, Z=－2.201, P=0.028] were increased and the D-dimers was decreased [0.392 mg/L(0.250-0.884 mg/L) vs 2.511 mg/L(0.755-14.033 mg/L), Z=－2.201, P=0.028] with no reports of heparin-related side-effect. One case with advanced postcaval thrombosis did not receive heparin anticoagulant therapy, but the thrombosis disappeared 270 d after diagnosis during follow-up. Conclusions:DVT of the extremities and torso may have no specific symptoms during the neonatal period and the overall prognosis is good. Heparin anticoagulant therapy is recommended until thrombosis disappears for patients with large thrombosis or significantly high level of D-dimer. The course of heparin treatment varies greatly among individuals, and close monitoring is required.

Objective: To investigate the incidence and pathogen distribution of ventilator-associated pneumonia (VAP) among preterm infants admitted to level Ⅲ neonatal intensive care units (NICU) in China. Method: A prospective study was conducted in 25 level Ⅲ NICU, enrolling all preterm infants <34 weeks gestational age admitted to the participating NICU within the first 7 days of life from May 2015 to April 2016. Chi-square test, t test and Mann-Whitney U test were used for statistical analysis. Result: A total of 7 918 patients were enrolled, within whom 4 623(58.4%) were males. The birth weight was (1 639±415) g and the gestational age was (31.4±2.0) weeks; 4 654(58.8%) infants required non-invasive mechanical ventilation and 2 154(27.2%) required intubation. Of all the mechanically ventilated patients, VAP occurred in 95 patients. The overall VAP rate was 7.0 episodes per 1 000 ventilator days, varying from 0 to 34.4 episodes per 1 000 ventilator days in different centers. The incidence of VAP was 9.6 and 6.0 per 1 000 ventilator days in children′s hospitals and maternity-infant hospitals respectively, without significant differences (t=1.002, P=0.327). Gram-negative bacilli (76 strains, 91.6%) were the primary VAP microorganisms, mainly Acinetobacter baumannii (24 strains, 28.9%), Klebsiella pneumonia (23 strains, 27.7%), and Pseudomonas aeruginosa (10 strains, 12.0%). Conclusion The incidence of VAP in China is similar to that in developed counties, with substantial variability in different NICU settings. More efforts are needed to monitor and evaluate the preventable factors associated with VAP and conduct interventions that could effectively reduce the occurrence of VAP.

Objective: To investigate whether GIV , a coiled helix structural domain protein containing 88A , has an effect on the neuroinflammatory response in a model of cerebral ischemia⁃reperfusion injury. Methods: A middle cerebral artery embolization⁃reperfusion model (MACO/R) and an oxygen glucose deprivation/reoxygenation model ( OGD 6 h + R 24 h) of BV2 microglia were constructed in C57BL/6 mice , and the area of cerebral infarction was detected by TTC staining; the Longa neurobiological score was used to evaluate the degree of neurological deficit in mice ; ELISA was used to detect the release of IL⁃6 and TNF⁃α in the supernatant of peripheral blood and cell cultures , and Western blot was used to detect the protein expression of GIV , TREM2 and TLR4 in the cortical area around the infarct foci in mice ; different concentrations of lipopolysaccharide (LPS , 1 , 5 , 10 μg/ml) were used to stimulate BV2 cells for 24 h to establish a neuroinflammation model , qRT⁃PCR was performed to detect the mRNA levels of IL⁃6 , TNF⁃α and IL⁃1β , and Western blot was used to detect the expression of GIV ; OGD/R culture treatment was performed after knocking down the expression of GIV gene using siRNA interference technique ;ELISA was performed to detect the release concentration of IL⁃6 and TNF⁃α in cell culture medium supernatant;protein immunoblotting was performed to detect the knockdown efficiency of GIV. Results : Both the successfully constructed MCAO/R and OGD/R models activated the neuroinflammatory response and induced a decrease in protein expression of GIV ; MCAO/R induced increased concentrations of IL⁃6 and TNF⁃α release in peripheral blood of mice and promoted the protein expression of TREM2 and TLR4 ; LPS activated IL⁃6 , IL⁃1β and TNF⁃α expression in BV2 cells , but did not affect GIV expression ; siRNA interference with GIV gene expression further in creased the expression of inflammatory factors IL⁃6 and TNF⁃α . Conclusion The GIV gene may be characteristically involved in regulating the neuroinflammatory response induced by cerebral ischemia⁃reperfusion injury , and it may be a potential therapeutic target for cerebral ischemia⁃reperfusion injury.