Objective:To explore high-risk factors of respiratory distress syndrome (RDS) and to compare the clinical efficacy of calf pulmonary surfactant (PS) combined with budesonide suspension and poractant alfa injection in the treatment of RDS in premature infants.Methods:A retrospective analysis was conducted. Preterm infants who were born in the obstetrics department of Liaocheng People's Hospital and admitted to the neonatal intensive care unit (NICU) within 24 hours from July 2016 to July 2020 were enrolled. The clinical data of these patients including perinatal conditions, clinical features, therapeutic regimens of PS and outcomes were collected and analyzed. According to the diagnostic criteria of neonatal respiratory distress syndrome (NRDS), premature infants were divided into NRDS group and non-NRDS group. First, the clinical data of the two groups were compared to analyze the related factors of NRDS. Then the related factors of NRDS were confirmed by Logistic regression analysis. In addition, according to the trapeutic regimens of PS, the children were divided into calf PS combined with budesonide suspension group and poractant alfa injection group, and the efficacy of the two PS was compared.Results:① A total of 1 690 preterm infants were included, including 297 preterm infants were diagnosed with NRDS which accounted for 17.6% of live preterm infants. There were significant differences in gender, gestational age (GA), birth parity, birth weight (BW), asphyxia of newborn, caesarean section, premature rupture of membrane, placental abruption, gestational diabetes and father's smoking addiction (maternal exposure to smoke during pregnancy) between NRDS group and non-NRDS group (male: 71.0% vs. 59.0%; GA: < 28 weeks was 4.1% vs. 0.1%, 28 weeks ≤ GA < 34 weeks was 70.0% vs. 29.9%, 34 weeks ≤ GA < 37 weeks was 25.9% vs.70.0%; birth parity: 2 (1, 3) vs. 2 (1, 3); BW: < 1 000 g was 4.1% vs. 0.4%, 1 000 g ≤ BW < 1 500 g was 31.3% vs. 6.5%, 1 500 g ≤ BW < 2 500 g was 51.5% vs. 58.9%, 2 500 g ≤ BW < 4 000 g was 12.8% vs. 33.1%, BW≥4 000 g was 0.3% vs. 1.1%; asphyxia of newborn: 50.8% vs. 14.6%; caesarean section: 71.7% vs. 65.0%; premature rupture of membrane: 66.7% vs. 42.2%; premature rupture of fetal membranes: 11.4% vs. 5.2%; gestational diabetes: 12.1% vs. 7.0%; father's smoking addiction: 80.8% vs. 71.5%, all P < 0.05), but there was no significant difference in prenatal use of dexamethasone (DEX) between NRDS group and non-NRDS group (80.1% vs. 84.1%, P > 0.05). Binary multivariate Logistic regression analysis showed that GA, gender, cesarean section, premature rupture of membranes, gestational diabetes, father's smoking addiction and neonatal asphyxia were the risk factors of RDS [odds ratio ( OR) and 95% confidence interval (95% CI) were 0.621 (0.557-0.693), 2.043 (1.478-2.825), 1.365 (1.036-1.797), 0.697 (0.506-0.961), 3.223 (1.906-5.449), 1.836 (1.261-2.673), 3.596 (2.622-4.933), all P < 0.05]. ② A total of 160 patients diagnosed with grade Ⅲ/Ⅳ NRDS were included to analyze the efficacy of PS. Among them, 42 cases were treated with calf PS combined with budesonide suspension, and 118 cases were treated with poractant alfa injection. Compared with the poractant alfa injection group, the total oxygen consumption time of the calf PS group was shorter [days: 9.0 (5.0, 19.0) vs. 13.0 (6.0, 26.0)], the hospitalization expenses were lower [ten thousand Yuan: 3.46 (2.88, 5.18) vs. 4.58 (3.08, 6.06)], and the incidence of bronchopulmonary dysplasia (BPD) was lower (11.9% vs. 28.8%), with statistically significant differences (all P < 0.05). Conclusions:In addition to GA, gender, cesarean section, premature rupture of membranes, gestational diabetes, and neonatal asphyxia, the father's smoking addiction (maternal smoke exposure during pregnancy) is an important risk factor of RDS in premature infants. The efficacy of prenatal use of DEX for prevention of RDS in preterm infants is affected by many factors, such as prenatal smoke exposure, timing of use, multiple fetuses, etc. Calf PS combined with budesonide suspension is better than poractant alfa injection in reducing the incidence of BPD.

Stem cells are those with long-term self-renewal and produce differentiated cells at least one end of the cell capacity. Stem cell transplantation can be used for the treatment of many kind of liver diseases which includes acute liver failure, inherited metabolic liver diseases, as well as end-stage liver disease. This Article summarizes the types of stem cell types applied for treatment of liver diseases, stem cell tracing technology, as well as the clinical application of stem cells. It also discusses the problems existed and the research focus.

Basement Membrane ; pathology ; ultrastructure ; Biopsy ; Glomerulonephritis, IGA ; pathology ; Humans ; Kidney ; pathology ; ultrastructure ; Kidney Glomerulus ; pathology ; ultrastructure ; Lupus Nephritis ; pathology ; Microscopy, Electron, Transmission ; Paraffin Embedding ; Specimen Handling ; methods

Objective To research and develop an index system for training evaluation of national health emergency response.Methods A combinative approach was applied,including core expert group discussion,on-site investigation into parameters applied in Delphi assessment by field experts,national reviews by provincial health departments.Results Firstly,a framework of index system was constructed by core expert group based on literature;Secondly,the index was screened by mean score from field experts' investigation and suggestion of core experts,then an index system was formulated with 5 first level indexes,19 second level indexes and 46 third level indexes;Thirdly,index weight was determined according to the mean weight by field experts investigation and adjusted suggestion of core experts;Finally,the index system for training evaluation of national health emergency response was approved by Ministry of Health and applied to the whole nation.Conclusions The combinative approach is practical in research and developing index system.The index system covers a full range of related factors,and is applicable at provincial level.However,attention should be paid to improving training after evaluation.

Objective: To compare the effectiveness and security of instant single intravesical instillation of pirarubicin and multiple instillations at two weeks after transurethral resection of bladder tumor (TUR-Bt) for prevention of non muscle-invasive bladder cancer recurrence. Methods: We recruited 162 non muscle-invasive bladder cancer patients from Mar 2003 to Jun 2005. They were randomly divided into 2 groups: 80 cases received instant single intravesical instillation of pirarubicin post operation (group RG) and 82 cases were given multiple intravesical perfusions of pirarubicin regularly after two weeks of operation (group CG). The recurrence rates and side effects between the two groups were compared. Results: Totally six patients lost follow-up. The two groups both had 78 valid follow-up cases. The follow-up period was 24 to 48 months. The recurrence rate was 25.6% (20/78) in group RG, and 17.9% (14/78) in group CG. There was no significant difference between the two groups. The recurrence rates of G2 and G3 tumor were 42.5% (17/40) in group RG, and 20.9% (9/43) in group CG. The recurrence rate of group CG was lower than that in group RG in subset tumor at higher grade (G2 and G3). Conclusion: The total effectiveness of instant single intravesical instillation of chemotherapy is similar to multiple instillations of chemotherapy after two weeks of TUR-Bt for preventing the recurrence of non muscle-invasive bladder cancer. But multiple instillations can better decrease the recurrence of non muscle-invasive bladder cancer at higher pathological grade (G2 and G3).

Adolescent ; Adult ; Child ; Child, Preschool ; Female ; Fistula ; surgery ; Humans ; Hyoid Bone ; surgery ; Infection ; Male ; Middle Aged ; Thyroglossal Cyst ; surgery ; Young Adult

Thyroid cancer is one of the most common malignant tumors in the human endocrine system . It is one of the common diseases in head and neck ,thyroid and breast surgery .Its incidence rate is increasing year by year .With the development of ultrasonography and fine needle aspiration biopsy ,as well as the auxiliary exami-nation of gene detection technology ,the detective rate of early diagnosis of papillary thyroid microcarcinoma ( PT-MC) is getting higher and higher .Compared with conventional surgery , highlighting the advantages of minimally invasive surgery , endoscopic and ultrasound guided percutaneous ablation and other new surgical methods are gradually applied in clinical treatment .Combined with the new guideline ,the present paper reviews the progress in the diagnosis and treatment of papillary thyroid microcarcinoma .

Transcatheter arterial chemoembolization (TACE) is the main treatment method for advanced hepatocellular carcinoma (HCC). As a non-invasive functional MR imaging, diffusion weighted imaging (DWI) can relfect the functional changes in tumor before morphologic changes. In the follow-up of HCC after TACE, DWI can detect new lesions and distinguish necrotic neoplastic tissue and residual neoplastic tissue timely and accurately.

Objective: Design a test phantom with a full function, simple structure and high accuracy which is used for MRI’s Quality Control. Methods: Through a intensive study in imaging principle of MRI and parameters which effect the image quality ,first come up with the phantom’s performance data, and then determine the technical solutions including the choosing material, processing technology, the machining precision, at last develop a trial set of MRI test phantom using the method of numerical control machining. Make a comparative experiment between this phantom and the similar imported one to analyze the consistency of the results by the two phantoms. Results: The result of all the technical parameters of this phantom is consistent with the result of the imported one. There are some extra test components which the imported phantom doesn’t contain. Some performance data like the low contrast resolution are superior to the imported phantom. Conclusion:This MRI test phantom can satisfy the requirement of the daily quality control work in hospital.

Objective To investigate the MRI features of spinal epidural angiolipomas.Methods Clinical and MRI data of 18 patients with spinal epidural angiolipomas confirmed pathologically were retrospective analyzed.The MRI features of lesion site,size,shape,signal,bone destruction,enhancement and typing were observed and analyzed.Results One case of 18 cases were located in cervical vertebra,15 cases were thoracic vertebra,and 2 cases were lumbar vertebra.Ten cases formed paravertebral lump through foramen intervertebrale and damaged adjacent bones.MRI showed that T1W1 signal intensity was either isointense (n 11),mixed intense (n=5) or hyperintense (n =2).T2WI showed signal intensity was hyperintense (n=13) or mixed intense (n=5).The fat signal was seen in 5 cases,both T1W1 and T2W1 showed hyperintense.All the 18 cases showed remarkable enhancement.Ⅰ type (lesions confined to the spinal canal) was 8 cases (8/18,44.44％),Ⅱ type (lesions were dumbbell-shaped to the spinal canal) was 10 cases (10/18,55.56％).Conclusion The location of occurrence and the manifestations of MRI in spinal epidural angiolipomas have certain characteristics,which provides important clues to the preoperative diagnosis.