OBJECTIVETo understand the incidence and relevant affecting factors of infant vitamin K deficiency bleeding (VKDB) in Shandong Province.

METHODSWith stratified cluster sampling, 28 156 live newborns from five districts and six counties were surveyed for the condition of bleeding from their birth to 6 months based on standard diagnostic criteria. A 1:2 matched case-control study of VKDB was performed.

RESULTSAn overall incidence of VKDB was 3.27 per thousand in Shandong; higher in the rural areas (4.96 per thousand ) than in the urban areas (1.19 per thousand ). Most of the bleeding cases were breast-fed babies (about 95.57%) and incidence of VKDB in pre-term babies (22.52 per thousand ) was higher than that in term ones (2.96 per thousand ). Mothers' drug taking during pregnancy, asphyxia at birth, breast-feeding and illness within two weeks after birth were risk factors for it. Use of vitamin K after birth and bottle-feeding were protective factors for it.

CONCLUSIONSIncidence of VKDB is higher in Shandong Province, as compared to other areas all over the country at the same time period. It is very important to prevent VKDB, focusing on high-risk babies in the rural areas, including those of preterm, breast-fed and suffering illness after birth.

Bottle Feeding ; Case-Control Studies ; China ; epidemiology ; Humans ; Incidence ; Infant ; Infant, Newborn ; Vitamin K ; therapeutic use ; Vitamin K Deficiency Bleeding ; epidemiology ; prevention & control

Objective To construct vector expressing soluble mPDL1-hIgGFc and study its effect on the proliferation and apeptosis of cells in vitro. Methods The extrncellular domain of mPDL1 gene was amplified from pmPDL1 vector by PCR and inserted into phIgGFc vector. The recombinant pmPDL1-hIgGFc was transfected into CHO cells by LipofectAMINETM2000, and the transfected cells were named as CHOp. The expression of mPDL1-hIgGFc in the culture supernatants of CHOp was assayed by ELISA and Western blot. The effects of CHOp culture supernatants on mixed lymphocyte culture(MLC) was analysed by Flowm-etry. Results The extracellular domain of mPDL1 gene were obtained from PCR. DNA sequencing and the identification of digestion by HindⅢ and KpnⅠ indicated the recombinant plasmid pmPDL1-hIgGFc was suc-cessfully constructed. ELISA and Western blot analysis proved that the CHOp could express mPDL1-hIgG-Fc. CHOp culture supernatants could inhibit lymphocyte proliferation and induce the apoptosis of the activa-ted T cells in MLC in vitro in a dose-dependent manner. Conclusion The mPDL1-hIgGFc protein could in-hibit lymphocyte proliferation and induce the apoptosis of the activated T cells.

Objective:Chemiluminescence immunoassay was used to detect the levels of anticardiolipin antibody (aCL) -IgA/IgG/IgM and anti-β2-glycoprotein Ⅰ antibody (aβ2GPⅠ) -IgA/IgG/IgM in healthy non-pregnant and pregnant women to explore the changes of antiphospholipid antibody in different pregnancy periods.Methods:This prospective study was conducted in Shandong Provincial Maternal and Child Health Care Hospital Affiliated to Qingdao University, involving normal pregnant women who underwent prenatal examination and healthy non-pregnant women with no history of adverse pregnancy who underwent progestational eugenic health examination from April 2020 to August 2021. The levels of aCL-IgA/IgG/IgM and aβ2GPⅠ-IgA/IgG/IgM were detected using BIO-FLASH chemiluminescence immunoassay analyzer and P95 as well as P99 were calculated, respectively. The difference in the six data between non-pregnant and pregnant women was compared using Mann-Whitney U test. Kruskal-Wallis H test was used to compare the change of each antibody in different pregnancy periods and Spearman correlation was used to analyze the correlation between different trimester and the levels of aCL-IgA/IgG/IgM and aβ2GPⅠ-IgA/IgG/IgM. Results:A total of 454 cases met the inclusion criteria, and 435 cases were included in the analysis after excluding 19 cases, among them 110 were non-pregnant women and 325 were pregnant women, including 110 cases in the first trimester (≤13 +6 weeks), 110 cases in the second trimester(14 +0-27 +6 weeks), and 105 cases in the third trimester (≥28 weeks). P99 value of aCL-IgA/IgG/IgM and aβ2GPⅠ-IgA/IgG/IgM in the non-pregnant women were 7.31, 14.70, 7.92, 3.58, 13.60, and 4.95 CU, which in the pregnant women were 5.90, 12.78, 5.70, 1.60, 10.65, and 3.90 CU, and were all lower than the cut-off value of 20 CU that given by the analyzer manufacturer. The levels of aCL-IgA/IgG/IgM, and aβ2GPⅠ-IgG/IgM in the pregnant women were significantly decreased comparing with the non-pregnant women [aCL-IgA: 1.90 CU (1.40-2.70 CU) vs 2.90 CU (2.20-3.83 CU), Z=－7.14; aCL-IgG: 3.00 CU (2.20-4.50 CU) vs 6.10 CU (4.20-7.83 CU), Z=－10.26; aCL-IgM: 1.40 CU (1.10-2.30 CU) vs 2.65 CU (2.08-3.73 CU), Z=－8.87; aβ2GPⅠ-IgG: 3.50 CU (2.60-4.90 CU) vs 4.75 CU (3.60-5.93 CU), Z=－5.45; aβ2GPⅠ-IgM: 0.70 CU (0.50-1.20 CU) vs 1.00 CU (0.60-1.53 CU) , Z=－3.73; all P<0.001]. The aCL-IgA level in the third trimester was higher than those in the first and second trimester (both P<0.05). The levels of aCL-IgG/IgM in the second trimester and aβ2GPⅠ- IgG in the second and third trimesters were significantly decreased than those in the first trimester (all P<0.05). Spearman analysis showed that aCL-IgG/IgM, aβ2GPⅠ-IgA/IgM had no significant correlation with the pregnancy period (the first, second and the third trimester) (all P>0.05). However, a weak correlation between the aCL-IgA, aβ2GPⅠ- IgG and the pregnancy period was observed ( r=0.28 and－0.49, both P<0.001) Conclusions:P99 value of aCL-IgA/IgG/IgM and aβ2GPⅠ-IgA/IgG/IgM levels in normal pregnant women and non-pregnant women are lower than the cut-off value of 20 CU given by the analyzer manufacturer. The levels of aCL-IgA/IgG/IgM and aβ2GPⅠ-IgG/IgM during pregnancy are lower than those before pregnancy and fluctuate with the pregnancy period, but have no significant correlation with the pregnancy period. The clinical diagnosis of antiphospholipid syndrome should be made according to the cut-off values of aCL-IgA/IgG/IgM and aβ2GPⅠ-IgA/IgG/IgM determined by each laboratory.

The prevalence of metabolic syndrome among the 2057 urban adults in Wuhan was 10.74%, being 13.47% in males and 4.99% in females.The prevalence increased with aging,blood uric acid level and insulin resistance index.

Objective To formulate and standardized the procedure of bowl preparation before transrectal ultrasound-guided prostate biopsy. Methods The standardized transrectal ultrasound-guided prostate biopsy flowchart were formulated based on the best evidences and recommendations. One hundred and forty patients selected with suspected of prostate cancer and scheduled for transrectal ultrasound-guided prostate biopsy was equally assigned to two groups, the control group was given routine hospital practice before biopsy, and the observation group followed the formulated flowchart. Monitoring two groups for complications, time cost for bowl preparation, medical billing and the average day of hospitalization. Results The incidence of complications and the number of hospitalization days between two groups were comparable, the observation group in bowl preparation time was (3.75 ± 0.78) min, the control group in bowl preparation time was (11.88 ± 1.93) min, the difference of two groups showed statistical significance (t=15.643, P<0.01). The observation group in medical bill was￥(81.62±15.62), the control group in medical bill was ￥(427.78 ± 76.87), the difference of two groups showed statistical significance (t=-36.964, P<0.01). Conclusions Application of evidence-based practice to formalize bowl preparation and antibiotic use in transrectal ultrasound-guided prostate biopsy patient can facilitate the clinical nurses to provide homogenized care to prostate biopsy patients as well as improve the efficiency of nursing work.

Objective:To investigate the prognosis of marginal donor heart in heart transplantation.Methods:The clinical data of consecutive heart transplant recipients and donors in Zhengzhou 7th. People’s Hospital from April 2018 to November 2022 were retrospectively included. According to the definition of marginal donor hearts, the patients were divided into conventional donor hearts group (117 cases) and marginal donor hearts group ( 62 cases), the data before and after heart transplantation of the two groups were analyzed.Results:The main reason for the formation of marginal donor hearts was the cold ischemia time of donor hearts >6 h; it was easier to receive marginal donor hearts with ECMO and MV before operation; the use of marginal donor hearts in heart transplantation increased postoperative mechanical ventilation time, surgical post-intensive care unit length of stay; patients with marginal donors had lower survival than conventional donors, but did not produce a significant difference in survival after heart transplantation.Conclusion:The application of marginal donor heart in heart transplantation is an effective method to solve the shortage of heart organs and reduce the death of transplant waiting persons.

Objective:To summarize the clinical features of intestinal Beh?et′s disease, so as to provide reference for the diagnosis of the disease.Methods:From April 1 2014 to January 31 2019, the clinical data of 47 patients diagnosed as intestinal Beh?et′s disease at the Second Hospital of Hebei Medical University were retrospectively analyzed, which included initial symptoms, gastrointestinal symptoms, complications, erythrocyte sedimentation rate (ESR), the levels of C reactive protein (CRP), hemoglobin, serum albumin, results of acupuncture test, gastrointestinal involved site and ulcer shape. At the same time, gender differences of clinical manifestations were compared. Chi-square test was used for statistical analysis.Results:Among 47 patients with intestinal Beh?et′s disease, the initial symptoms of 26 (55.3%) cases were gastrointestinal symptoms. Abdominal pain was the most common symptom, the others were diarrhea, anorexia, abdominal distension and perianal abscess, and the incidence rate was 80.9%(38/47), 46.8% (22/47), 42.6% (20/47), 36.2% (17/47) and 2.1% (1/47), respectively. The main complications were gastrointestinal bleeding, perforation and obstruction, and the incidence rates was 40.4% (19/47), 4.3% (2/47) and 4.3% (2/47), respectively. Thirty-seven (78.7%) patients had different degrees of hypoalbuminemia (serum albumin<35 g/L). The CRP level of 36(76.6%) patients increased. The ESR of 36 (76.6%) patients increased. Twenty-two (46.8%) patients had mild anemia (hemoglobin<90 g/L). The acupuncture test was positive in 25 (53.2%) patients. The involved sites of gastrointestinal tract were terminal ileum and ileocecal junction, colon, esophagus, duodenum and jejunum, stomach, and rectum, the proportion was 57.4% (27/47), 27.2% (13/47), 23.4% (11/47), 23.4% (11/47), 17.0% (8/47) and 8.5% (4/47), respectively. All 47 (100.0%) patients had oral ulcers. 62.1%(18/29) patients presented with multiple ulcers under endoscope. The shape of ulcer was round ulcer, irregular ulcer, and longitudinal ulcer, the proportion was 48.3% (14/29), 34.5% (10/29) and 17.2 (5/29), respectively. The incidence rate of genital ulcer of female patients with intestinal Beh?et′s disease was higher than that of male patients with intestinal Beh?et′s disease (85.7%, 18/21 vs. 30.8%, 8/26), and the difference was statistically significant ( χ2=14.189, P<0.01). There were no significant differences between the female group and the male group in the incidence rate of oral ulcer, abdominal pain, diarrhea, and positive rate of acupuncture test (100.0%, 21/21 vs. 100.0%, 26/26; 85.7%, 18/21 vs. 76.9%, 20/26; 42.9%, 9/21 vs. 50.0%, 13/26; 52.4%, 11/21 vs. 58.3%, 14/26, all P>0.05). Conclusions:The common clinical symptoms of intestinal Beh?et′s disease are oral ulcers, abdominal pain, diarrhea and genital ulcer. Female patients with intestinal Beh?et′s disease are more likely to develop genital ulcer than male patients with intestinal Beh?et′s disease. Multiple ulcers are more common under endoscopy, which are round ulcer, irregular ulcer and longitudinal ulcer. The most common sites are the terminal ileum and ileocecal junction, followed by colon, esophagus and other parts.