As survival of premature infants has increased,nutritional support has become a more prominent component of patient care.Aggressive nutritional strategies can reduce the incidence of extrauterine growth retardation (EUGR),speed up the physical growth and promote the development of intelligence.But excessive weight gain may also increase the risk of obesity and cardiovascular diseases in the future.This review mainly introduces and interprets the enteral nutrient supply for preterm infants:commentary from the European Society for Paediatric Gastroenterology Hepatology and Nutrition (ESPGHAN),2010,to provide an evidence-based medicine nutritional guideline for preterm infants.

Objective To investigate the protective effect of cryptotanshinone (CTS) and donepezil(DON) on amyloid-βprotein (Aβ)-induced apoptosis in SH-SY5Y cells .Methods SH-SY5Y cells were cultured in vitro for establishing the Alzheimer disease (AD) model .The cell viability was detected by the MTT assay .The apoptosis rate was measured by Hoechst 33342 and the expres-sion of Bcl-2 and Bax was detected by Western blot .Results CTS ,DON and their combination could obviously alleviate Aβ-caused injury of SH-SY5Y cells ,increase the cell survival rate ,remarkably up-regulate the expression of Bcl-2 protein ,decrease the expres-sion of Bax protein and inhibit the apoptosis .The effect of the CTS and DON combination for inhibiting apoptosis was significantly stronger than that of the single use of CTS and DON ,the difference had statistical significance(P<0 .05) .Conclusion The combi-nation of CTS and DON has the synergistic protective effect on Aβ-caused injury in SH-SY5Y cells ,its mechanisms may be related with the cooperation regulation of the expression of apoptosis related gene Bcl-2 protein family .

AIM:To investigate isometric force displacement in isolated rat main pulmonary artery rings and right main branch pulmonary artery(second pulmonary artery)rings during hypoxia hypercapnia and the role of mitogen activated protein kinase(MAPK).METHODS:The main pulmonary artery rings were dissected from the male Sprague-Dawley rats and were randomly divided into control group and hypoxia hypercapnia group.The second pulmonary artery rings were also randomly divided into control group,hypoxia hypercapnia group,DMSO incubation group,U0126 incubation group and SB203580 incubation group.The tension changes of pulmonary artery rings were monitored in vitro.RESULTS:Under normoxia conditions,there was no statistically significant change between main pulmonary artery rings and second pulmonary artery rings.A biphasic pulmonary artery contractile response to hypoxia hypercapnia in the second pulmonary artery rings was observed instead of a sharp and transient increase in the main pulmonary artery tension.Both p38 MAPK inhibitor SB203580 and ERK1/2 inhibitor U0126 significantly attenuated the delayed,but not early,contractile phase of the biphasic pulmonary artery contraction.CONCLUSION:Acute hypoxia hypercapnia causes a biphasic pulmonary artery contractile response in the second pulmonary artery,and p38 MAPK and ERK1/2 may be two key mediators in the process.

Objective To study the survival rate,cause of death and the incidence of complications of extremely low birth weight (ELBW) infants.Method Clinical data of the ELBW infants admitted in our hospital between December 2013 and November 2016 were retrospectively analyzed.The cases were assigned into five groups based on gestational age (GA) or birth weight (BW) to further analyze the survival rates among each group.According to the time of death,the cases were assigned into two groups (death within 7 days or after 7 days) to analyze their direct death causes.ELBW infants were categorized into three groups according to GA (＜ 26 weeks,26-27 weeks and ≥ 28 weeks) or into two groups according to birth weight (＜ 750 g and ≥ 750 g) to analyze the incidence of complications within 14 days or after 14 days.Result A total of 122 ELBW infants were enrolled in this study.The mean GA was 27.6 ± 2.1 (range of 22-33) weeks,mean birth weight was 849 ± 112 (range of 525-995) g.GA and BW were both positively correlated with the survival rate.Among all the studied cases,43 were dead cases.Within these 43 cases,13 of them died within 7 days.The top 3 causes of death of them were neonatal respiratory distress syndrome (RDS),severe asphyxia and pulmonary hemorrhage of neonatal.The other 30 cases died after 7 days,while the top 3 causes of death of them were sepsis,bronchopulmonary dysplasia (BPD) combined with pneumonia and neonatal necrotizing enterocolitis (NEC).The incidences of complications of all 122 ELBW infants within 14 days of hospitalization were as follow:ELBW infants with BW ＜ 750 g had higher morbidity of neonatal severe asphyxia and neonatal blood glucose disorder than ELBW infants with BW ≥ 750 g (37.0％ vs.8.4％,51.9％ vs.24.2％,P ＜0.05);ELBW infants with GA ＜ 26 weeks and 26-27 weeks had higher morbidity of neonatal RDS than ELBW infants with GA≥28 weeks (86.5％ and 94.3％ vs.59.4％,P ＜ 0.05).99 cases of ELBW infants whose duration of hospitalization were more than 14 days were analyzed.The incidences of retinopathy of prematurity (ROP) in GA ＜ 26 weeks group was higher than that in GA between 26-27 weeks group and GA ≥ 28 weeks group (40.7％ vs.18.2％ and 14.3％,P ＜ 0.05).The incidences of BPD and anemia in GA ＜ 26 weeks group and GA between 26-27 weeks group were higher than that in GA≥28 weeks group (BPD:70.4％ and 68.2％ vs.35.7％;anemia:88.9％ and 84.1％ vs.57.1％;P ＜ 0.05).The incidence of sepsis in GA ＜ 26 weeks was higher than that in GA ≥ 28 weeks group (74.1％ vs.39.3％,P ＜0.05).The differences of the incidences of all the complications between BW ＜ 750 g group and BW ≥750 g showed no significance statistically (all P ＞ 0.05).Conclusion As the increasing of GA and BW,the survival rates of ELBW infants increase significantly,and the incidence of complications decline significantly.The complications related to ELBW infants during hospitalization should be prevented to improve the early survival quality of them.

Selecting high-quality patient report outcome measures for patients with liver transplantation may properly assess health condition from their perspective, assist nurses in identifying patients′ reports of health issues, and deliver targeted nursing care for them. This paper reviewed the current status of researches on measurement tools for patient reported outcomes in liver transplantation both domestically and internationally, including the content, characteristics, disadvantages and situation recommendations of the generic and specific measurement tools. The purpose is to provide a reference for choosing patient reported outcomes measurements, symptom management as well as the caring strategies in liver transplantation.

Objective To assess the effects of low-dose esketamine on the median effective dose(ED50)of ciprofol for anesthesia induction in painless gastrointestinal endoscopy.Methods Fifty-nine pa-tients underwent elective painless gastrointestinal endoscopy,26 males and 33 females,aged 18-64 years,BMI 18-30 kg/m2,ASA physical status Ⅰ or Ⅱ,were divided into two groups by random number table method:esketamine combined with ciprofol group(group EC,n = 29)and ciprofol group(group C,n = 30).Group EC received intravenous injection of esketamine 0.3 mg/kg and group C received the same amount of normal saline 2 minutes before administration of ciprofol.The initial anesthesia induction dose of ciprofol was 0.4 mg/kg.If a positive reaction occurs during the examination,the next patient will receive an increase dose of propofol 0.04 mg/kg,otherwise will decrease by propofol 0.04 mg/kg.The positive reaction was defined that the patient's BIS can not be decreased to 60 2 minutes after anesthesia induction,or the cough or body movement reaction occur at level 2 or above when entering the mirror.The dosage of ciprofol,recovery time,discharge time,the occurrence of intraoperative and postoperative adverse reactions were recorded.The ED50,95%effective dose(ED95)and 95%confidence interval(CI)of the two groups were calculated by Probit probability regression analysis.Results Compared with group C,the dosage of ciprofol,the incidence of hypotension and frequency of administration of vasoactive drugs during the exami-nation process in group EC were significantly reduced(P＜0.05).The ED50 of ciprofol for anesthesia in-duction in painless gastrointestinal endoscopy in group EC was 0.21 mg/kg(95%CI 0.12-0.25 mg/kg)and the ED95 was 0.32 mg/kg(95%CI 0.26-0.39 mg/kg).The ED50 of ciprofol for anesthesia induction in painless gastrointestinal endoscopy in group C was 0.37 mg/kg(95%CI 0.32-0.40 mg/kg)and the ED95 was 0.48 mg/kg(95%CI 0.43-0.54 mg/kg).The ED50 and ED95 of ciprofol for anesthesia induction in painless gastrointestinal endoscopy in group EC was significantly lower than that in group C(P＜0.05).There was no significant difference in other frequency of adverse events between the two groups.Conclusion Esketamine 0.3 mg/kg can reduce the ED50 of ciprofol in painless gastrointestinal endoscopy and reduce the dosage of ciprofol during the examination process,which is safe for painless gastrointestinal endoscopy with stable intraoperative circulation.

[Objective]To establish the reference intervals of thyroid hormones in pregnant women from Sanming city and compare them with those from other areas in China.[Methods]The study recruited 605 pregnant women and 229 non-pregnant healthy women who visited Sanming First Hospital between March 29 and June 28,2023.Blood samples were se-quentially collected from the participants to determine the serum levels of thyroid stimulating hormone(TSH),free triiodo-thyronine(FT3)and free thyroxine(FT4).The reference intervals of thyroid hormones were established by using a percen-tile range of P2.5 to P97.5 and their changes in different periods of pregnancy were analyzed and compared with those from oth-er areas in China.[Results]There were significant differences in levels of TSH,FT4 and FT3 at different periods of pregnan-cy(all P<0.05).Compared with non-pregnant women,women in first trimester had significantly decreased levels of TSH and FT4,but similar level of FT3.Since the second trimester,TSH level displayed rising tendency,while FT3 and FT4 lev-els showed gradual decrease.The reference intervals of thyroid hormones in the first,second and third trimester of pregnan-cy in Sanming city were TSH(0.068,2.943)μU/mL,FT3(4.302,6.888)pmol/L,FT4(8.240,14.719)pmol/L;TSH(0.419,3.274)μU/mL,FT3(4.074,6.629)pmol/L,FT4(6.726,11.980)pmol/L;TSH(0.422,3.570)μU/mL,FT3(3.741,5.850)pmol/L,FT4(6.103,10.347)pmol/L,respectively.Significant differences were found in the reference in-tervals of thyroid hormones during pregnancy among different areas in China.[Conclusions]The levels of TSH,FT3,FT4 during pregnancy are different from those during non-pregnancy,and also significantly differ in different periods of preg-nancy.Reference intervals of thyroid hormones in pregnant women are affected by various factors such as geographic loca-tion,ethnicity and laboratory test method,etc.Therefore,establishing the population-specific reference intervals of thy-roid hormones will benefit for the diagnosis and treatment of thyroid disease in pregnant women from Sanming city.

The aim of this study was to refold the OvisAries leukocyte antigen (OLA) class Ⅰ protein with peptides derived from sheeppox virus (SPPV) to identify SPPV T cell epitopes. Two pairs of primers were designed based on the published sequence of a sheep major histocompatibility complex Ⅰ to amplify the heavy chain gene of OLA Ⅰ α-BSP and the light chain gene of OLA Ⅰ-β₂m. Both genes were cloned into a pET-28a(+) expression vector, respectively, and induced with ITPG for protein expression. After purification, the heavy chain and light chain proteins as well as peptides derived from SPPV were refolded at a ratio of 1:1:1 using a gradual dilution method. Molecular exclusion chromatography was used to test whether these peptides bind to the OLA Ⅰ complex. T-cell responses were assessed using freshly isolated PBMCs from immunized sheep through IFN-γ ELISPOT with peptides derived from SPPV protein. The results showed that the cloned heavy chain and light chain expressed sufficiently, with a molecular weight of 36.3 kDa and 16.7 kDa, respectively. The protein separated via a Superdex^TM 200 increase 10/300 GL column was collected and verified by SDS-PAGE after refolding. One SPPV CTL epitope was identified after combined refolding and functional studies based on T-cell epitopes derived from SPPV. An OLA Ⅰ/peptide complex was refolded correctly, which is necessary for the structural characterization. This study may contribute to the development of sheep vaccine based on peptides.
Animals ; Capripoxvirus ; Epitopes, T-Lymphocyte/genetics* ; Peptides/genetics* ; Poxviridae Infections ; Sheep ; Sheep Diseases