Objective:To study the current status of longitudinal extrauterine growth restriction (EUGR) in extremely preterm infants (EPIs) and to develop a prediction model based on clinical data from multiple NICUs.Methods:From January 2017 to December 2018, EPIs admitted to 32 NICUs in North China were retrospectively studied. Their general conditions, nutritional support, complications during hospitalization and weight changes were reviewed. Weight loss between birth and discharge > 1SD was defined as longitudinal EUGR. The EPIs were assigned into longitudinal EUGR group and non-EUGR group and their nutritional support and weight changes were compared. The EPIs were randomly assigned into the training dataset and the validation dataset with a ratio of 7∶3. Univariate Cox regression analysis and multiple regression analysis were used in the training dataset to select the independent predictive factors. The best-fitting Nomogram model predicting longitudinal EUGR was established based on Akaike Information Criterion. The model was evaluated for discrimination efficacy, calibration and clinical decision curve analysis.Results:A total of 436 EPIs were included in this study, with a mean gestational age of (26.9±0.9) weeks and a birth weight of (989±171) g. The incidence of longitudinal EUGR was 82.3%(359/436). Seven variables (birth weight Z-score, weight loss, weight growth velocity, the proportion of breast milk ≥75% within 3 d before discharge, invasive mechanical ventilation ≥7 d, maternal antenatal corticosteroids use and bronchopulmonary dysplasia) were selected to establish the prediction model. The area under the receiver operating characteristic curve of the training dataset and the validation dataset were 0.870 (95% CI 0.820-0.920) and 0.879 (95% CI 0.815-0.942), suggesting good discrimination efficacy. The calibration curve indicated a good fit of the model ( P>0.05). The decision curve analysis showed positive net benefits at all thresholds. Conclusions:Currently, EPIs have a high incidence of longitudinal EUGR. The prediction model is helpful for early identification and intervention for EPIs with higher risks of longitudinal EUGR. It is necessary to expand the sample size and conduct prospective studies to optimize and validate the prediction model in the future.

OBJECTIVE：To preliminarily s tudy the potential mechanism of astragaloside Ⅳ on allergic rhinitis （AR）model mice. METHODS ：C57/BL6 mice were randomly divided into blank group ，model group and astragaloside Ⅳ group，with 10 mice in each group. Except for blank group ，AR model was prepared by sensitization and challenge with ovalbumin on day 0，7，14 and 21-27. Astragaloside Ⅳ group was given astragaloside Ⅳ 40 mg/kg intraperitoneally at the dose of 0.02 mL/g on the 15th to 27th day of modeling （given the drug 1 h before challenge sensitization on the 21st to 27th day ）. Blank group and model group were given constant volume of normal saline intraperitoneally ，once a day. Twenty-four hours after sensitization from the last challenge ， the infiltration of inflammatory cells in the nasal mucosa of each group was observed ，and the contents of interleukin 4（IL-4）， IL-5 and interferon gamma （IFN-γ）in the nasal lavage fluid were measured. The levels of reactive oxygen species （ROS），and the count of phosphorylated Janus kinase 2（p-JAK2）and phosphorylation signal transduction and activation of transcription protein 6 （p-STAT6）positive cells in the nasal mucosa and spleen as well as the phosphorylation levels of JAK 2 and STAT 6 proteins in spleen tissue （i.e. p-JAK 2/JAK2 ratio，p-STAT6/STAT6 ratio）were also determined. RESULTS ：Compared with blank group ，the number of inflammatory cells in the nasal mucosa （eosinophils and mast cells ）in the model group ，the contents of IL- 4 and IL- 5 in the nasal lavage fluid ，and the levels of ROS in the nasal mucosa and spleen tissues in the model group ，the count of p-JAK 2 and p-STAT 6 positive cells increased significantly ，the p-JAK2/JAK2 ratio，p-STAT6/STAT6 ratio in the spleen tissue were significantly increased （P＜0.05），and the content of INF-γ in the nasal lavage fluid was significantly decreased（P＜0.05）. Compared with model group ，the count of inflammatory cells infiltrated in the nasal mucosa ，the contents of IL- 4 and IL- 5 in the nasal cavity lavage fluid ，the level of ROS and the number of p-JAK 2 and p-STAT 6 positive cellsin the nasal mucosa and spleen tissue as well as the p-JAK2/JAK2 ratio and p-STAT 6/STAT6 ratio in spleen tissue were decreased significantly （P＜0.05），and the content of INF-γ in nasal lavage fluid was significantly increased（P＜0.05）. CO NCLUSIONS：Astragaloside Ⅳ can effectively improve the inflammatory response in AR model mice ，the mechanism of which may be related to down-regulation of JAK2/STAT6 signaling pathway and ROS level.

Recently, salvia miltiorrhiza has made a great progress in research of central nervous system (CNS) injury and neurodegeneration. Salvia miltiorrhiza and its active ingredients can exert multiple effects involving reduction of cell loss, attenuation of oxidative stress, improvement of micro-circulation and promotion of neuroregeneration, and show a protective effect on CNS diseases. Regulation of oxidative stress and removing accumulated metabolite may be the important mechanisms by which salvia miltiorrhiza exerts neuroprotective effects. This study will systematically discuss the pharmacological effects and possible mechanisms of salvia miltiorrhiza based on the core pathological changes in CSN diseases, and evaluate its drug safety through combing the related toxicology researches to provide a reference for clinical transformation of Chinese medicine in threatment of CNS diseases.

Objective To explore the effects of teach-back method on the compliance of functional exercises in postoperative patients with breast cancer. Methods Totally 105 postoperative patients with breast cancer admitted in our hospital from March to September 2015 were selected as the control group, and 114 patients from October 2015 to March 2016 were selected as the intervention group. Patients in the intervention group received the functional exercises based on teach-back method, while patients in the control group received routine health education method. The mastery skill score and compliance of functional exercise one day before discharge in two groups were compared. Results The mastery skill score of functional exercise one day before discharge was (63.73±5.51) in the intervention group, which was significantly higher than (56.45±4.88) in the control group ( P<0.05);the constituent ratio of fully compliance, partial compliance and noncompliance status in the intervention group one day before discharge were 64. 91%, 25. 44%, 9. 65%, and they were obviously superior to the control group (47.62%, 36.19%, 16.19%) (P<0.05). Conclusions Teach back method can effectively improve the skill and compliance of functional exercise in postoperative patients with breast cancer.

Objective To investigate the effects of whole grain-bean mixed staple food on intestinal microecology,anthropometric,and metabolic parameters of obese people.Methods Totally 87 obese people were divided with random number table into whole grain-bean mixed staple food group (test group) and refined grains staple food group (control group).Body weight (BW),body mass index (BMI),waist circumference (WC),hip circumference (HC),waist/hip ratio (WHR),fasting plasma glucose (FPG),triglyceride (TG),total cholesterol (TC),high-density lipoprotein cholesterol (HDL-C),low-density lipoprotein cholesterol (LDL-C),and colony count of intestinal flora (bacillus bifidus,lactobacillus,clostridium perfringens,enterobacteria,enterococcus,bacteroides) were measured at baseline and 3 months after intervention.Results Ten people were excluded from this research,6 in the test group and 4 in the control group.Mter 3 months of dietary intervention,BW,BMI,WC,HC,and WHR were significantly lower in the test group than in the control group [(69.45 ± 7.07) kgvs.(72.42 ±5.79) kg,P=0.000; (26.08 ±1.48) kg/m2 vs.(27.27 ±0.81) kg/m2,P=0.000; (82.48±9.30) cm vs.(86.96±4.93) cm,P =0.000; (90.08 ±6.57) cm vs.(92.42 ±6.67) cm,P =0.000; 0.92 ±0.11vs.0.95 ±0.10,P =0.003].The levels of FPG,TC,and LDL-C in the test group were significantly lower than those in the control group [(4.92 ± 0.75) mmoL/L vs.(5.41 ± 1.21) mmoL/L,P=0.037; (3.85±1.13) mmoL/L vs.(4.38 ±1.26) mmoL/L,P=0.046; (3.55 ±1.04) mmoL/L vs.(4.16 ± 1.40) rnmoL/L,P =0.033] ; the level of HDL-C in the test group was significantly higher than that in the control group [(1.13 ± 0.37) mmoL/L vs.(0.92 ± 0.26) mmoL/L,P =0.004].The colony counts of intestinal bacillus bifidus,lactobacillus,and bacteroides in the test group were significantly higher than in the control group [(7.94 ± 0.58) lg CFU/g vs.(6.95 ± 0.38) lg CFU/g,P =0.000 ; (7.67 ± 0.46) lg CFU/g vs.(6.96 ± 0.57) lg CFU/g,P =0.000 ; (5.53 ± 0.44) lg CFU/g vs.(4.80 ±0.23) lg CFU/g,P =0.000],while the colony count of clostridium perfringens was significantly lower than in the control group [(4.40 ± 0.49) lg CFU/g vs.(5.11 ± 0.63) lg CFU/g,P =0.000].Conclusions In obese people,whole grain-bean mixed staple food can improve anthropometric parameters,some lipid metabolic parameters,and intestinal flora.The underlying mechanism may involve promoting the survival and proliferation of probiotics,thereby improving glucose and lipid metabolism.

Objective To evaluate the efficacy and safety of focal fractional laser treatment(FFLT)for atrophic acne scars. Methods A randomized, self-controlled study was performed. A total of 20 patients with atrophic facial acne scars were enrolled into this study. Treatments were randomly administered in a split-face manner. Half of each subject′s face received FFLT(FFLT side), and the other half underwent full-face fractional CO2 laser resurfacing(control side), for one session. All the patients were followed up for 3 months after the treatment. Evaluation was based on the ECCA grading scale (échelle d′évaluation clinique des cicatrices d′acné)and patient satisfaction score. A VISIA skin detector was used to take photographs and evaluate skin texture. Moreover, physical parameters of the skin, including erythema index, melanin index and transepidermal water loss (TEWL), were measured. Adverse effects were recorded and evaluated. Statistical analysis was carried out by paired t test, Wilcoxon paired rank test, Fisher′s exact test and repeated-measure analysis of variance. Results The ECCA score decreased from 51.24 ± 17.61 at the baseline to 34.46 ± 14.99 at 3 months after the treatment at the FFLT side(t = 7.886, P < 0.05), and from 50.96 ± 18.96 to 38.29 ± 14.86 at the control side(t =6.123, P < 0.05), and was significantly lower in the FFLT side than in the control side (t = 4.462, P < 0.05)at 3 months after the treatment. The improvement rate was significantly higher in the FFLT side than in the control side (32.75% vs. 24.86%, P = 0.016 by Fisher′s exact test)at 3 months after the treatment. Decreased pain and edema scores were observed at the FFLT side compared with the control side at 1 hour after the treatment (both P < 0.05), but no significant difference was noted in the duration of erythema or crusting between the two sides (both P > 0.05). Compared with those before the treatment, skin texture scores decreased in both sides (both P < 0.05), and were significantly lower in the FFLT side than in the control side at 3 months after the treatment(P < 0.05). The erythema index was significantly lower in the FFLT side than in the control side in both scarred areas and non-scarred areas on day 1 after the treatment (both P < 0.05). Both melanin index and TEWL at the FFLT side were significantly increased in scarred areas, but decreased in non-scarred areas compared with those at the control side within 3 days after the treatment (all P < 0.05). Similarly, the water content of the stratum corneum at the FFLT side was significantly lower in scarred areas, but higher in non-scarred areas compared with that at the control side between day 1 and 7 after the treatment (both P < 0.05). No significant difference was observed in the erythema index, TEWL or water content of the stratum corneum between the FFLT side and control side at scarred areas or non-scarred areas(all P > 0.05)from 2 weeks to 3 months after the treatment(all P > 0.05). Conclusion FFLT can improve therapeutic outcomes in atrophic acne scars with reduced adverse reactions.

OBJECTIVETo evaluate the effects of compound whole grain-soybean on insulin resistance and serum adipocytokines levels in impared fasting glucose population.

METHODSAccording to inclusion and exclusion criteria, 163 cases of impared fasting glucose (IFG) Chinese Han population from the age of 40 to 75 years old, were screened from 12 community health centers of three main districts of Nanjing city by the multi-stage cluster and simple randomization method from March to September, 2008. The IFG subjects were randomly divided into the intervention group (87 individuals) and control group (76 individuals) by quasi-experimental design. The intervention group was provided with compound whole grain-soybean and health education, while only health education was provided for the control group. Body mass index (BMI), waist-to-hip ratio (WHR), lipid profiles, fasting blood glucose (FBG), fasting insulin (FINS) and homeostasis model assessment of insulin resistance (HOMA-IR), adipocytokines including leptin, lipocalin 2 (LCN-2) and adiponectin (ADP) levels were measured before and after the half a year intervention period. Chi square test was used to analyze the distribution differences. Two-sample t-test was used to compare the differences of the two groups before and after the half a year intervention period, and paired t-test was used to compare the differences between before and after intervention in the intervention group or control group. Wilcoxon rank sum test was used to compare the differences of all indexes between after and before dietary intervention.

RESULTSAfter dietary intervention for half a year on the IFG population, BMI ((24.87 ± 3.69) kg/m(2)), FBG((6.27 ± 0.24) mmol/L), FINS((7.14 ± 1.05) mU/L) , HOMA-IR (1.99 ± 0.31), leptin ((13.07 ± 2.22) µg /L), LCN-2 ((67.42 ± 18.20) µg/L) of intervention group were decreased significantly compared to the levels of BMI ((25.16 ± 4.07) kg/m(2)), FBG((6.40 ± 0.28) mmol/L), FINS ((7.32 ± 1.54) mU/L), HOMA-IR (2.08 ± 0.45), leptin ((13.43 ± 2.52) µg/L), LCN-2((74.87 ± 17.81) µg/L) before dietary intervention, t values were 4.48, 7.08, 2.05, 3.39, 3.28 and 6.36, respectively, and all P values were < 0.05, while ADP ((5.07 ± 1.51) mg/L) of intervention group after dietary intervention was increased significantly compared to the level of ADP ((4.92 ± 1.53) mg/L) before dietary intervention, t = -2.47 and P < 0.05. The medians (P25, P 75) of differences after and before dietary intervention in the intervention group were BMI (-0.25(-0.68, 0.02) kg/m(2)), FBG (-0.08 (-0.20, 0.00) mmol/L), FINS (-0.15(-0.32, 0.00) mU/L), HOMA-IR (-0.07(-0.12, -0.03)), leptin (-0.36(-0.77, 0.12) µg/L), LCN-2 (-5.85(-14.29, -0.71) µg/L) and ADP (0.15(-0.13, 0.36) mg/L), and the medians of differences of after and before dietary intervention in the control group were BMI (0.00(-0.23, 0.29) kg/m(2)), FBG (0.00(-0.03, 0.04) mmol/L), FINS (-0.01(-0.13, 0.04) mU/L), HOMA-IR (-0.01(-0.05, 0.02)), leptin (-0.07 (-0.57, 0.46) µg/L), LCN-2 (-0.85(-5.39, 1.63) µg/L) and ADP (0.02(-0.19, 0.13) mg/L). There were significantly statistical differences between them (Z values were -3.65, -4.88, -3.08, -5.23, -2.16, -4.43 and 3.05, all P values were <0.05).

CONCLUSIONDietary intervention of compound whole grain-soybean can improves glucose level, increase insulin sensitivity and ameliorate insulin resistance state of IFG population.

Adipokines ; blood ; Adiponectin ; blood ; Aged ; Apolipoproteins ; blood ; Blood Glucose ; metabolism ; Female ; Humans ; Insulin ; blood ; Insulin Resistance ; Male ; Middle Aged ; Soybeans ; Waist-Hip Ratio

Objective To investigate the effect of Roy Adaptation Model(RAM)in patients with adolescent insanity.Methods One hundred patients with adolescent insanity during October 2011 to March 2012 were randomized in equal number into two groups by random digit table:the study group and the control group.The former were intervened with RAM and the latter received routine care and health education.Seven weeks after intervention,Hamilton Depression Rating Scale(HAMD),Hamilton Anxiety Scale(HAMA) and Observation Scale(NOSIE)were used for the assessment. Results After intervention,the scores on HAMD and HAMA in the study group were significantly lower,compared to the control group(P<0.01).The scores on social function,social interest,subjective support and use of social support were all significantly higher than those of the control group(all P<0.01). Conclusions RAM can improve their ability of the patients with adolescent insanity to adapt to the environment.It may improve their mental state and their quality of life.

Objective To explore the level of free fatty acid (FFA)in ischemic stroke (IS) patients and its correlation with insulin resistance (IR).Methods This study was case-control study.Patients who were diagnosed with IS were followed up from June,2011 to September,2012 in Tianjin Third Central Hospital.The 180 IS patients were divided into large infarct(57),middle infarct(63)and small infarct (60) according to the area of infarct.At the same time,60 healthy persons were selected as control group.The plasma FFA,fasting insulin (FINS),fasting blood glucose (FBG),homeostasis model assessment (HOMA)-IR,triacylglycerol (TG),total cholesterol (TC),high density lipoprotein cholesterol-C (HDL),low density lipoprotein cholesterol-C(LDL),lipoprotein A1 (APOA1) and lipoprotein B (APOB) in 180 IS patients were measured and compared with that of control group.The correlation between FFA and IR was analyzed by using pearson linear correlation.The relationship between FFA and HOMA-IR was analyzed by using multiple stepwise multivariate analysis.The t test and analysis of variance were used for statistical analysis.Results Compared to normal control,the level of FFA,FINS,FBG,FIB,TG,TC,LDL,APOB and HOMA-IR in IS patients were higher,the difference was statistically.The level of HDL,APOA1 in IS patients were lower than that of normal control.The level of FFA,FINS,HOMA-IR,FBG,TG,TC,HDL,LDL,APOA1 and APOB in IS patients related to the area of infarct.The level of FFA,FINS,HOMA-IR,FBG,TG,TC,LDL,APOB in large infarct were higher than those in middle infarct and small infarct.The level of HDL,APOA1 in large infarct were lower than those in middle infarct and small infarct,the difference were statistically.In IS patients,FFA had positive correlation to FINS,FBG and HOMA-IR (r =0.870,0.497,0.792,P ＜ 0.001),but had no correlation to age (r =0.008,P ＞ 0.05).In IS patients,HOMA-IR was dependent variable,but FFA,FINS,FBG,TG,TC,HDL,APOA1 and APOB were independent variable.FFA was independent risk factor to HOMA-IR,besides FINS,FBG,TC,LDL and APOB.Conclusion FFA elevates in IS patients,FFA has correlation to IR and it is a dependent risk factor to IS patients.

OBJECTIVE: To explore the curative effect of nasal type extranodal NK/T-cell lymphoma by sequential chemotherapy combined radiotherapy compared with chemtherapy. METHOD: Fifty-seven cases of nasal type extranodal NK/T-cell lymphoma confirmed by pathological morphology and immuno-histochemistry were divided into chemotherapy combined radiotherapy group (34 cases) or chemotherapy group (23 cases). Twenty-three patients in the chemotherapy group alternately applied CHOP, VDLP and MEOP regimen after each two treatments into the clinical observation; Chemotherapy combined radiotherapy group of 34 patients, in addition to the above chemotherapy, applied three-dimensional conformal radiation therapy of the primary site by linear accelerators. Then all of patients were ceased treatment and followed up 3-5 years. RESULT: (1) After treatment, effective rate of two groups was 91.2% and 87.0%, there was no obvious difference (P > 0.05); After follow up about 1 year, effective rate of two groups was 76.5% and 73.9%, there was no obvious difference (P > 0.05); (3) After follow up about 3 years and 5 years, disease free survival (DFS) of two groups was 61.3%, 47.6% and 43.5%, 21.4%, there was obvious difference (P < 0.05). (4) Long-term survival is closely related to treatment mode. (5) B symptoms, advanced (III, IV) stage, the International Prognostic Index (IPI), KPS scores were correlated with prognosis, and were independent prognostic factors. CONCLUSION Treatment with chemotherapy and radiotherapy for nasal type extranodal NK/T-cell lymphoma had obvious curative effect and may improve long-term survival efficiently compared with chemotherapy alone.
Adult ; Antineoplastic Combined Chemotherapy Protocols ; Combined Modality Therapy ; Female ; Humans ; Lymphoma, Extranodal NK-T-Cell ; drug therapy ; radiotherapy ; therapy ; Male ; Middle Aged ; Radiotherapy ; methods ; Treatment Outcome ; Young Adult