The effect of racemic(?) gossypol and total glycosides of tripterygium wilfordii (GTW) on human sperm acrosome reaction was observed by indirect immunofluorescence and transmission electron microscopy. The results indicate that recemic (?) gossypol and GTW may significantly inhibit human sperm acrosome reaction induced by ionophore A_(23187) at 5mg/L and 10mg/L respectively. The results of TEM shows that racemic (?) gossypol and GTW may injure the sperm plasma membrane.

Objective To investigate drug resistance and carbapenemase genotypes of carbapenemresistant Acinetobacter baumannii.Methods A total of 75 clinical isolated strains of carbapenem-resistant Acinetobacter baumannii were collected from Taizhou Hospital in Zhejiang province during January 2011 and June 2012.Vitek 2 Compact microbial identification system was used for bacterial identification and drug susceptibility test,and modified Hodge test was used to screen strains producing carbapenemases.Genotypes of carbapenamases were determined by polymerase chain reaction.Results All 75 carbapenem-resistant Acinetobacter baumannii strains were resistant to most antibacterial agents except amikacin.The resistant rate to amikacin was 13.3％ (10/75).OXA-23 gene was positive in 69 strains (92.0％),and OXA-51 gene was positive in 67 strains (89.3％).No IMP,VIM and SIM gene was observed.Conclusion OXA enzyme is the main cause of drug resistance in this group of carbapenem-resistant Acinetobacter baumannii,and OXA-23 and OXA-51 genes are the most popular carbapenemnases coding genes.

Objective To discuss the clinical features of neonatal shock retrospectively.Methods Totally 144 neonates were enrolled in this retrospective study from Sep.2006 to Sep.2012 in NICU of Beijing Children's Hospital.Clinical data were collected from our database,including the primary disease,manifestation,laboratory findings,treatment and prognosis.Results According to the severity of shock,28 cases were mild,85 were moderate,31 were severe.Regarding to the type of shock,71 cases were cardiogenic shock,22 cases were hypovolemic shock,51 cases were septic shock.About 69.4％ patients were cured,only 9 cases died.Eight of them died of septic shock.Totally 33 cases in pH ＜7.15 group,2 of them died.In pH≥7.15 group,111 cases were involved,7 of them died.There was no significant difference of mortality between two groups (P =0.959).Conclusion Neonatal shock mostly occurred within 3 days after birth,and cardiogenic shock were dominating.Septic shock increased with age,and were responsible for death.

Objective To evaluate the effect of the standardized training program for resident physicians in Ruijin Hospital,and analyse the problems so as to provide reference to improve the training.Methods Questionnaire surveys were conducted among 113 resident physicians,31 teachers and 43 head nurses in Rujin Hospital by using the simple random sampling and 300.The data was analysed by Kirkpatrick's model in four layers including reaction layer,learning layer,behaviors layer and results layer.Data of reation layer was analysed by ANOVA and data of behaviors layer was compared by paired t-test.Results Reaction layer:the resident physicians' overall satisfaction score for the training is 3.45.Learning layer:all resident doctors participating in the training passed all the exams organised by the hospital.Behaviors layer:Residents made a great progress in many aspects after the standardized training program,and the difference was statistically significant (P＜0.01) according to the analysis of all questionnaires written by residents,clinical teachers and head nurses.Results layer:both the patient complaint rate and the accident rate of the 113 resident physicians was 0 while they all passed the National Medical Licensing Examination and the employment rate was 100％.Conclusions the standardized training program for resident physicians in Ruijin Hospital gets fairly good effect.Resident doctors' quality and ability in many aspects are improved and the overall satisfaction for the training is high,but in salary,benefits and sense of belonging to the hospital,the satisfaction is relatively low.

Adult ; Age Factors ; Aged ; Alanine Transaminase ; blood ; Alkaline Phosphatase ; blood ; Aspartate Aminotransferases ; blood ; China ; Female ; Hepatitis B ; complications ; Hepatitis C ; complications ; Hospitalization ; statistics & numerical data ; Humans ; Liver Cirrhosis, Alcoholic ; complications ; mortality ; pathology ; Male ; Middle Aged ; Survival Rate ; gamma-Glutamyltransferase ; blood

ObjectiveTo investigate the incidence and risk factors in retinopathy of prematurity (ROP) at matched gestational age.Methods Data collected by the medical records of neonates from November 2007 to December 2010 in our neonatal database were analyzed.Patients'information was recorded from birth to discharge from NICU.Data included age after birth (hours),gestational age,body weight at birth,treatment,and maternal demographics.The statistical study was carried out by SPSS version 13.0 software.Mann - Whitney U test was used for numerate data.Fisher's exact probability test and Pearson's chi - square test were used to compare quantitative variables between independent groups.P values were considered significant when they were less than 0.05 ( two - sided).ResultsThe incidence of ROP was 5.38％.Gestational age of ROP group and control group was matched ( P =0.387 ),but difference in body weight at birth was significant ( P =0.045 ).Age after birth was significantly different ( P =0.013 ).Apnea and anemia were significantly different between two groups (P ＜ 0.01). The differences in duration of hospitalization,NCPAP and use of antibiotics between two groups were significant ( P ＜ 0.002,0.000 and 0.000,respectively).ROP group differed from control group greatly in hospitalization expenses.Multiple stepwise logistic regression analysis showed that oxygen supplenentation ( P =0.0237 ) and infection ( P =0.0118) were risk factors of ROP. ConclusionsThe incidence of ROP in NICU in Beijing Children's Hospital was 5.38％.Inhalation of oxygen supplementation and infection were risk factors of ROP.

OBJECTIVE:To establish the quality standard for Siwei jiangmei tablets. METHODS:TLC method was used for the qualitative identification of Salvia miltiorrhiza,Artemisiae Scopariae Herba and Taraxaci Herba. HPLC method was adopted for the content determination of chlorogenic acid. The determination was performed on Agilents TC-C18column with mobile phase consisted of acetonitrile-3% acetic acid(10:90,V/V)at the flow rate of 1.0 mL/min. The detection wavelength was set at 327 nm,and column temperature was 25 ℃. The sample size was 10 μL. RESULTS:TLC spots of S. miltiorrhiza, Artemisiae Scopariae Herba and Taraxaci Herba were clear and well-separated without interference from negative control. The linear range of chlorogenic acid was 0.26-0.79 μg for(r=0.999 9). The limits of quantitation and detection were 0.26,0.12 μg, respectively. RSDs of precision,stability and reproducibility tests were lower than 1.0%. The recoveries were 96.11%-101.96%(RSD=1.98%,n=9). CONCLUSIONS:Established standard can be used for quality control of Siwei jiangmei tablets.

ObjectiveTo investigate the risk factors for new-onset diabetes after incipient acute pancreatitis (AP). MethodsA retrospective analysis was performed for 95 patients with post-acute pancreatitis diabetes mellitus (PPDM-A) after incipient AP who were admitted to The Affiliated Hospital of Southwest Medical University from June 2013 to January 2020 (PPDM-A group), and 190 patients without diabetes after incipient AP during the same period of time were selected at a ratio of 2∶1 and were enrolled as non-PPDM-A group. Baseline data and clinical data were collected. The t-test or the U test was used for comparison of continuous data, and the chi-square test or the Fisher’s exact test was used for comparison of categorical data; a logistic regression analysis was used for multivariate analysis. Results There were significant differences between the two groups in body mass index (BMI), body weight, and proportion of patients with a drinking history, hyperuricemia, or fatty liver disease (all P＜0.05), while there were no significant differences between the two groups in age, male sex, and proportion of patients with a smoking history, a family history of diabetes, or hypertension (all P＞0.05). There were also significant differences in etiologies (biliary, hyperlipidemic, and alcoholic AP) between the two groups (P＜0.05). Compared with the non-PPDM-A group, the PPDM-A group had significantly higher triglyceride, blood glucose, white blood cell count (WBC), C-reactive protein, and proportion of patients with blood glucose ＞11.1 mmol/L on admission (all P＜0.05), while there were no significant differences in Ca2+, blood amylase, and blood lipase between the two groups (all P＞0.05). Compared with the non-PPDM-A group, the PPDM-A group had significantly higher incidence rates of acute peripancreatic necrotic collections and acute peripancreatic fluid collections, proportion of patients with multiple onset of AP, and proportion of patients with CTSI score ＞4 (all P＜0.05), while there were no significant differences in the proportion of patients with systemic inflammatory response syndrome and disease severity between the two groups (both P＞0.05). The multivariate analysis showed that the outcome of PPDM-A in alcoholic AP patients was 5.868 times that in biliary AP patients (95% confidence interval ［CI］: 1.607-21.418, P=0.007), and the outcome of PPDM-A in hyperlipidemic AP patients was 3.312 time that in biliary AP patients (95%CI: 1.593-6.887, P=0.001). The outcome of PPDM-A in overweight patients was 3.694 times that in patients with normal BMI (95%CI: 1.575-8.667, P=0.003), and the outcome of PPDM-A in obese patients was 5.964 times that in patients with normal BMI (95%CI: 2.516-14.139, P＜0.001). Multiple onset of AP (OR=4.522,95%CI: 2.298-8.900, P＜0.001), blood glucose on admission ＞11.1 mmol/L (OR=6.749,95% CI: 3.381-13.469, P＜0.001), CTSI score ＞4 (OR=1.176,95%CI: 1008-1.371, P=0.039), and WBC (OR=1.082,95%CI: 1.009-1.160, P=0.026) were independent risk factors for PPDM-A. ConclusionMultiple onset of AP, alcoholic AP, hyperlipidemic AP, blood glucose on admission ＞11.1 mmol/L, overweight or obesity, CTSI score ＞4, and WBC are independent risk factors for PPDM-A, which can provide a reference for formulating strategies to prevent or reduce the onset of PPDM-A.

Objective:To analyze the diagnosis and treatment of neonatal neuroblastoma (NB) by summarizing its clinical characteristics.Methods:This study retrospectively recruited 14 neonates with NB in Beijing Children's Hospital (National Center for Children's Health) from February 1, 2015, to February 1, 2020. Medical records and follow-up data as of February 29, 2020, were collected, and clinical staging based on International Neuroblastoma Staging System, risk grouping based on American Childhood Oncology Group risk grouping system, diagnosis, treatment, and prognosis were analyzed. According to whether surgical treatment was performed in the neonatal period or not, these subjects were divided into surgical and non-surgical groups. A descriptive statistical analysis was used for data analysis.Results:(1) Neonates with NB accounted for 0.063% (14/22 006) of the total number of newborns admitted to the hospital during the same period. The 14 cases were all full-term aged 15 d (8 h-23 d) at admission. Tumors were found in seven cases in prenatal examinations, while others presented with shortness of breath (three cases), abdominal distension (two cases), fever (one case), and dysuria and difficult defecation after birth (one case). (2) The primary tumor sites included the adrenal gland (eight cases), posterior mediastinum (three cases), retroperitoneum (two cases), and sacrococcygeal (one case). Three cases had extensive diffuse liver metastasis at admission. (3) Except for two cases who refused to examine, the serum neuron-specific enolase of 12 cases was 57.2 ng/ml (35.9-158.3 ng/ml) during hospitalization, and the urine vanillyl-mandelic acid creatinine of four cases was 2 304.940 (685.748-9 595.314). (4) Primary tumor sites were found in 14 cases by imaging examination. Bone scanning was performed in three cases, including one with a concentrated shadow of the right sacroiliac joint and two with no abnormalities. Ten cases underwent bone marrow aspiration and all with normal results. (5) Of the ten neonates received surgery (the surgical group), nine had the primary tumor wholly removed, without chemotherapy after the operation, and the tumor-free survival period was 19 months (1-45 months). One case (case 5) had a substantial primary tumor that could not be completely resected. The patient underwent a second surgery five months after the first operation due to disease progression and received postoperative chemotherapy. The child had stopped chemotherapy for 24 months and survived without a tumor. (6) In the non-surgical group (cases 11 to 14), the tumor in case 11 who refused chemotherapy shrank spontaneously after discharge, and the patient survived for 20 months with the tumor. The parents of the case 12 withdrew treatment during hospitalization, while the primary tumor and metastases disappeared after discharge, and the specific tumor markers gradually decreased to normal levels. The patient has been tumor-free survived for 25 months. Case 13 received mediastinal tumor resection and chemotherapy during infancy. At the end of the follow-up, chemotherapy had been stopped for 12 months, and the patient survived without a tumor. Case 14 withdrew treatment and died. (7) Among the ten cases in the surgical group, one patient's pathological result indicated a composite tumor, while the others were low differentiated neuroblastoma. There was no MYCN gene amplification, 1p36 deletion, or 11q23 deletion in the ten cases. (8) Among the ten children in the surgical group, nine were in stage 1, and one was in stage 4S (case 5). Nine cases were classified into extremely low-risk groups, while the other was in the low-risk group. The four cases in the non-surgical group could not be grouped by risk. Conclusions:Clinical manifestations of neonatal NB are often atypical. NB in stage 4S might resolve spontaneously, and expectant observation may be considered. The overall prognosis of neonatal NB is generally good, but further researches are needed.

Objective To explore the establishment of a prognostic model based on machine learning algorithm to predict primary graft dysfunction (PGD) in patients with idiopathic pulmonary fibrosis (IPF) after lung transplantation. Methods Clinical data of 226 IPF patients who underwent lung transplantation were retrospectively analyzed. All patients were randomly divided into the training and test sets at a ratio of 7:3. Using regularized logistic regression, random forest, support vector machine and artificial neural network, the prognostic model was established through variable screening, model establishment and model optimization. The performance of this prognostic model was assessed by the area under the receiver operating characteristic curve (AUC), positive predictive value, negative predictive value and accuracy. Results Sixteen key features were selected for model establishment. The AUC of the four prognostic models all exceeded 0.7. DeLong and McNemar tests found no significant difference in the performance among different models (both P>0.05). Conclusions Based on four machine learning algorithms, the prognostic model for grade 3 PGD after lung transplantation is preliminarily established. The overall prediction performance of each model is similar, which may predict the risk of grade 3 PGD in IPF patients after lung transplantation.