Anemia of prematurity is very common in preterm infant.Phlebotomy losses and inadequate production of erythropoietin are the main reasons.Treatment of anemia of prematurity includes delayed umbilical cord clamping at delivery,decreasing phlebotomy losses,use of red cell growth factors such as erythropoietin properly,red blood cell transfusions,which are based on indications and guidelines.In this article we review recent studies in preventing and treating anemia in preterm infants.

With the rapid development of medical and health sciences,the pressure on the new skills learning for health professionals has also increased.Advanced training has become important opportunity for the career development of the health professionals.This study takes a third—grade class —A hospital to conduct a case study,using the questionnaire to collect information and analyzed the factors that might affect the pressure for advanced training.This paper also discussed how to improve the quality of advanced training by reduce the pressure of the medical staff from the view point of hospital and individuals.

Japanese encephalitis virus (JEV) is a single-stranded and positive-sense RNA, which has a single ORF (open reading frame), encoding a polyprotein precursor. Non-structural protein 3 (NS3) plays an important role in processing the polyprotein precursor and has become an important drug target of flavivirus. In this study, NS2BH-NS3 gene was amplified by PCR and subcloned to the prokaryotic expression plasmid, resulting pET30a-NS2BH-NS3. The fusion protein was expressed in Escherichia coli BL21 (DE3) in soluble form after induction by Isopropyl beta-D-1-Thiogalactopyranoside (IPTG). The recombinant protein was purified by Ni-NTA affinity column. Then a fluorescence resonance energy transfer (FRET) method was used to determine enzymatic activity and the assay conditions were optimized. After screening 113 compounds, we found two compounds inhibiting the activity of NS2BH-NS3. This study provides a convenient and cost-effective method for screening of JEV NS3 protease inhibitor.
Encephalitis Virus, Japanese ; enzymology ; Escherichia coli ; metabolism ; High-Throughput Screening Assays ; Protease Inhibitors ; chemistry ; RNA Helicases ; metabolism ; Recombinant Fusion Proteins ; metabolism ; Serine Endopeptidases ; metabolism ; Viral Nonstructural Proteins ; metabolism

Aim Poly (methoxypolyethyleneglycol cyanoacrylate-co-hexadecyl cyanoacrylate) (PEGPHDCA) and PHDCA niosomes were prepared and the influence of the PEG chain length on the niosomes physicochemical characteristics, complement consumption and phagocytic uptake were studied. Methods The physicochemical parameters of PEG-PHDCA niosomes were characterized in terms of particle size, zeta potential, surface PEG density and fixed aqueous layer thickness. The relationship between physicochemical characteristics and in vitro complement consumption and phagocytic uptake was further illustrated. Results Experimental results showed that PEG10000-PHDCA had most loose structure and least PEG surface density among three groups. Configuration simulation through fixed aqueous layer thickness confirmed that PEG folding and less flexibility of the PEG chains of PEG10000-PHDCA niosomes were accountable for its poor stealth effects. Compared with PEG2000-PHDCA, PEG5000-PHDCA showed a thicker fixed aqueous layer (FALT) of 4. 20 nm, less negative zeta potential of -10.03 mV, and consumption and phagocytic uptake. Conclusion Excessive chain length of PEG was not necessary for stealth effects of PEG-PHDCA niosomes. PEG5000-PHDCA niosomes had best effects on evading complement consumption and subsequent phagocytic uptake.

Embryonic stem cells(ESCs) are pluripotent cells derived from the inner cell mass of blastocyst-stage embryos, possessing permanent self-renewal and indefinite proliferative capacity in vitro. And ESCs could differentiate into the hematopoietic cell fate. Therefore ESCs may provide an alternative for hematopoietic stem cell transplantation and blood cells transfusion. Furthermore, ESCs differentiation could also provide a powerful model system to better understand the hematopoietic development and the mechanism involved. The current status for efforts to differentiate ESCs into hematopoietic lineages were reviewed.

In the current situation,how to adapt to the new medical reform and determine its development goal has become the primary concern of the managers of No.1 Affiliated Hospital of Hebei North University.The internal and external conditions were analyzed by the method of SWOT and the advantages,disadvantages,opportunities and challenges facing the hospital were also observed.Finally,a series of countermeasures were put forward in accordance with the strategies by SWOT.

Objective To explore the value of serum microRNA-155-5p and -133a-3p (miR-155-5p and miR-133a-3p) expression for the diagnosis and prognosis evaluation of sepsis. Methods A prospective observational study was conducted. 105 sepsis patients admitted to emergency intensive care unit (EICU) of the First Affiliated Hospital of Zhengzhou University from January 2015 to January 2016 were enrolled. They were divided into three groups according to the severity: 35 patients with sepsis, 35 with severe sepsis, and 35 with septic shock. At the same time, 35 healthy persons were selected as the control group. According to the prognosis, the patients were divided into improved group (n = 70) and in-hospital death group (n = 35). The clinical data of all the subjects were collected. The mRNA expressions of miR-155-5p and miR-133a-3p were determined by reverse transcription-polymerase chain reaction (RT-PCR). The receiver-operating characteristic curve (ROC) was plotted to evaluate their clinical value for the diagnosis and prognosis of sepsis. The binary logistic regression was used to analyze the risk factors affecting the prognosis of sepsis patients. Results ① The mRNA expressions of serum miR-155-5p and miR-133a-3p were gradually increased with the aggravation of sepsis. The mRNA expression of miR-155-5p (2-ΔCt) in sepsis, severe sepsis, sepsis shock groups was 1.89±0.48, 2.21±0.41, 2.79±0.73 (F = 23.737, P = 0.000), and the mRNA expression of miR-133a-3p (2-ΔCt) was 1.38±0.31, 1.74±0.65, 2.08±0.47, respectively (F = 27.710, P = 0.000). It was shown by ROC curve analysis that the area under the ROC curve (AUC) of serum miR-155-5p and miR-133a-3p for the diagnosis of sepsis was 0.855 [95% confidence interval (95%CI) = 0.761-0.949] and 0.769 (95%CI = 0.666-0.872) respectively. The cut-off value of miR-155-5p for the diagnosis of sepsis was 1.64, the sensitivity was 85.3%, and specificity was 80.6%. While the cut-off value of miR-133a-3p was 0.82, the sensitivity and specificity were 97.9% and 54.8% respectively. ② Compared with improved group, the patients of in-hospital death group were more serious, and procalcitonin (PCT), C-reactive protein (CRP), D-dimer, lactic acid (Lac), sequential organ failure assessment (SOFA) score, acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score, and the mRNA expressions of miR-155-5p and miR-133a-3p were significantly increased (all P < 0.05). While there was no statistically significant difference in gender, age, white blood cells (WBC), serum creatinine (SCr) between the two groups (all P > 0.05). It was shown by binary logistic regression analysis that Lac [odds ratio (OR) = 0.514, 95%CI = 0.260-0.893, P = 0.024], sepsis severity (OR = 0.039, 95%CI = 0.023-2.955, P = 0.016), SOFA score (OR = 0.668, 95%CI = 0.474-0.825, P = 0.001), serum miR-155-5p expression (OR = 0.117, 95%CI = 0.020-0.530, P = 0.007) were the risk factors affecting the prognosis of patients with sepsis. Conclusions The expression of serum miR-155-5p and miR-133a-3p may be used as specific indicators for the diagnosis of sepsis. And the expression of miR-155-5p can be used as independent impact factor for the estimation of sepsis prognosis.

OBJECTIVETo investigate the application and effects of external fixator under the guidance of damage control therapy in limb open fracture.

METHODSFrom May 2008 to January 2013,72 cases with severe limb open fractures (Unincor- porated shock) were divided into control group and observation group (36 cases in each group). In observation group, 36 patients (including 22 males and 14 females) were treated by external fixator at stage I, as soon as possible after waiting for patients physiology conditions being stable,the stage II fracture operation was performed. In control group, 36 patients (24 males and 12 females) were treated by the first stage open reduction. The hospital admission time, open fracture severity score (OFSS),operation duration,operative blood loss,X-ray expose times, callus appear time, fracture healing time, postoperative infection rate, complications and Johner-Wruhs accceccment were recorded and evaluated.

RESULTSAll patients were followed up for 8 to 12 months (10.4 in averaged). The mean operation duration, operative blood loss, callus appear time, fracture healing time the mean operation duration reespectively were (56.79±8.87) min, (216.16±18.21) ml, (5.32±0.71) weeks, (12.79±2.52) weeks in observation group,and (104.53±9.28) min, (439.93±14.65) ml, (4.97±1.26) weeks, (14.81±2.63) weeks in control group. According to Johner-Wruhs acccecement,there were were 33 cases in excellent,2 in good,and 1 in poor in observation group,non-union of fracture in 1 case,local infection occurred in 1 cases; in control group 25 cases in excellent,6 in good, and 5 in poor, non-union of fracture in 1 case,local infection occurred in 8 cases. There were significant differences in operation duration, operative blood loss, callus appear time, fracture healing time, postoperative infection rate, complications (P<0.05). There were no significant differences in hospital admission time, open fracture severity score and X-ray expose times (P>0.05).

CONCLUSIONUnder the guidance of damage control therapy,using external fixator measures to treat patients with open fractures of limbs is worth popularizing in clinical application because it can shorten the operation time, less blood loss, reduce the infection rate and complications, improve the success rate of surgery and recovery rate.

Adult ; Aged ; External Fixators ; Extremities ; injuries ; surgery ; Female ; Fracture Healing ; Fractures, Open ; surgery ; Humans ; Male ; Middle Aged ; Operative Time ; Postoperative Complications ; epidemiology

Hip fracture patients preoperative and postoperative exist hidden blood loss which often affect patients' wound healing, increase the probability of infection, prolong rehabilitation exercise, influence postoperative effect. At the same time, the body's blood loss increase the activation of the blood clotting mechanism, promote the incidence of deep vein thrombosis, bleeding and deep vein thrombosis has become the main causes of high risk in hip operation. It is very important to stop bleeding, anticoagulation should not be ignored, so how to effectively deal with the prominent contradiction between the postoperative anticoagulation and bleeding or looking for a best balance has become a intractable problems in hip fracture treatment.
Anticoagulants ; therapeutic use ; Blood Loss, Surgical ; prevention & control ; Hip Fractures ; complications ; surgery ; Humans ; Intraoperative Complications ; drug therapy ; etiology ; prevention & control

OBJECTIVETo study the anatomic mechanism of tear trough deformity and palabromalar groove deformity.

METHODSSix cadavers (12 sides, 3 male, 3 female, an average age of 67.2 years) with tear trough deformity and palpbromalar groove deformity underwent lower eyelid and periorbital area dissection.

RESULTSTear trough deformity and palabromalar groove deformity locate at the junction of thin eyelid skin and thick cheek skin. Skin is closely attached to the orbicularis oculi muscle. The superior horder of the malar fat pad covers the junction of the palpebral and orbital portions of the orbicularis muscle, and does not descend with malar fat pad, which is also corresponded to the location of tear trough and palphromalar groove. The gap between the orbicularis oculi muscle and the levator labii superioris alaeque nasi muscle is not correspond to tear trough. The orbicularis retaining ligament arises from the orbital rim and ends at the junction of the palpebral and orbital portions of the orbicularis muscle, and the ligament connects with the deep part of the orbicularis muscle which directly attaches to the infraorbital rim. Suborbicular oculi fat pads locate at the inferolateral of the orbital region, thin and flabby. Orbital septal arises from the infraorbital rim, and the orbital fat extrudes anteriorly and inferiorly.

CONCLUSIONSTear trough deformity and palabromalar groove deformity are resulted from combination of age-related relaxation, atrophy and ptosis of layers of tissues. The orbital septal and the orbicularis retaining ligament prevent tissues from descending, which makes tear trough deformity and palabromalar groove deformity more visible.

Aged ; Cadaver ; Eyelids ; anatomy & histology ; Female ; Humans ; Male ; Orbit ; anatomy & histology ; Skin Aging