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.

Cartilage ; surgery ; Humans ; Tympanoplasty

Animals ; Calreticulin ; metabolism ; Male ; Muscle, Skeletal ; metabolism ; Oxidative Stress ; Physical Conditioning, Animal ; Rats ; Rats, Sprague-Dawley

Animals ; Cattle ; China ; epidemiology ; Echinococcosis ; epidemiology ; parasitology ; transmission ; Echinococcus granulosus ; pathogenicity ; Humans ; Seasons

Cellular fibronectin (cFn) is a type of bioactive non-collagen glycoprotein regarded as the main substance used to maintain periodontal attachment. The content of cFn in some specific sites can reflect the progress of periodontitis or peri-implantitis. This study aims to evaluate the expression of cFn messenger RNA (mRNA) in tissues of adult periodontitis and peri-implantitis by real-time fluorescent quantitative polymerase chain reaction (PCR) and to determine its clinical significance. A total of 30 patients were divided into three groups of 10: healthy, adult periodontitis and peri-implantitis. Periodontal tissue biopsies (1 mm×1 mm×1 mm) from each patient were frozen in liquid nitrogen. Total RNA was extracted from these tissues, and the content, purity and integrity were detected. Specific primers were designed according to the sequence, and the mRNA expression levels of cellular fibronectin were detected by real-time PCR. The purity and integrity of the extracted total RNA were both high, and the specificity of amplified genes was very high with no other pollution. The mRNA expression of cFn in the adult periodontitis group (1.526±0.441) was lower than that in the healthy group (3.253±0.736). However, the mRNA expression of cFn in the peri-implantitis group (3.965±0.537) was significantly higher than that in the healthy group. The difference revealed that although both processes were destructive inflammatory reactions in the periodontium, the pathomechanisms were different and the variation started from the transcription level of the cFn gene.
Adult ; Alveolar Bone Loss ; metabolism ; Female ; Fibronectins ; analysis ; genetics ; Gingiva ; metabolism ; Humans ; Male ; Middle Aged ; Peri-Implantitis ; metabolism ; Periodontal Attachment Loss ; metabolism ; Periodontal Index ; Periodontal Pocket ; metabolism ; Periodontitis ; metabolism ; Periodontium ; metabolism ; RNA, Messenger ; analysis ; Real-Time Polymerase Chain Reaction ; Transcription, Genetic ; genetics ; Young Adult

Mild cognitive impairment caused by craniocerebral trauma is the key points and difficulties in judicial authentication. This article has comparative analysis of each mode of event-related potential (classical Oddball, Eriksen flanker task and so on), which can provide a more objective method for such craniocerebral trauma cases in clinical forensic judicial authentication.
Cognitive Dysfunction ; Craniocerebral Trauma ; Evoked Potentials ; Forensic Sciences ; Humans

Objective To investigate the changes and clinical significance of the plasma growth differentiation factor-15 (GDF-15) in patients with chronic congestive heart failure (CHF). Methods A total of 100 patients with CHF were in?cluded in this study (CHF group), and 30 healthy persons were used as control group. CHF group was divided into heart func? tionⅡgrade (n=35),Ⅲgrade (n=32),Ⅳgrade (n=33) groups in accordance with New York Heart Association (NYHA). And CHF group was also divided into left ventricular ejection fraction (LVEF)<0.4 grade (n=52) and LVEF≥0.4 grade (n=48) groups in accordance with LVEF of patients. The plasma GDF-15 and brain natriuretic peptide (BNP) levels were detected by ELISA. The values of LVEF, left ventricular end-diastolic diameter (LVDd), left ventricular systolic diameter (LVDs) and left ventricular fractional shortening (LVFS) were detected by echocardiography. The correlation of GDF-15, NYHA classifi?cation, BNP and index of echocardiography was analyzed between groups. Results Compared with control group, the levels of BNP, GDF-15, LVDd and LVDs were significantly higher in heart failure group, and values of LVEF and LVFS were sig?nificantly lower (P<0.05). The plasma levels of BNP, GDF-15, LVDd and LVDs were in turn increased in control group, LVEF≥0.4 grade group and LVEF<0.4 grade group. The plasma levels of LVFS were in turn decreased, in control group, LVEF≥0.4 grade group and LVEF<0.4 grade group (P<0.05). There were positive correlations between the plasma levels of GDF-15 and BNP, NYHA, LVDd and LVDs (r=0.524, 0.286, 0.453 and 0.531, P<0.05). The plasma level of GDF-15 was negatively correlated with LVEF and LVFS (r=-0.592,-0.587,P<0.05). Conclusion The plasma level of GDF-15 can be used as a new marker for diagnosis, treatment and prognosis in patients with chronic congestive heart failure.

Adenocarcinoma, Follicular ; pathology ; surgery ; Aged ; Aged, 80 and over ; Carcinoma, Papillary ; pathology ; surgery ; Follow-Up Studies ; Humans ; Lymphatic Metastasis ; Middle Aged ; Neck Dissection ; Survival Analysis ; Thyroid Neoplasms ; pathology ; surgery ; Thyroidectomy ; methods

OBJECTIVETo examine the efficacy and safety of dual blockade of the renin-angiotensin-aldosterone system (RAAS) among patients with type 2 diabetic kidney disease.

DATA SOURCESWe searched the major literature repositories, including the Cochrane Central Register of Controlled Trials, MEDLINE and EMBASE, for randomized clinical trials published between January 1990 and October 2015 that compared the efficacy and safety of the use of dual blockade of the RAAS versus the use of monotherapy, without applying any language restrictions. Keywords for the searches included "diabetic nephropathy," "chronic kidney disease," "chronic renal insufficiency," "diabetes mellitus," "dual therapy," "combined therapy," "dual blockade," "renin-angiotensin system," "angiotensin-converting enzyme inhibitor," "angiotensin-receptor blocker," "aldosterone blockade," "selective aldosterone blockade," "renin inhibitor," "direct renin inhibitor," "mineralocorticoid receptor blocker," etc.

STUDY SELECTIONThe selected articles were carefully reviewed. We excluded randomized clinical trials in which the kidney damage of patients was related to diseases other than diabetes mellitus.

RESULTSCombination treatment with an angiotensin-converting enzyme inhibitor supplemented by an angiotensin II receptor blocking agent is expected to provide a more complete blockade of the RAAS and a better control of hypertension. However, existing literature has presented mixed results, in particular, related to patient safety. In view of this, we conducted a comprehensive literature review in order to explain the rationale for dual blockade of the RAAS, and to discuss the pros and cons.

CONCLUSIONSDespite the negative results of some recent large-scale studies, it may be immature to declare that the dual blockade is a failure because of the complex nature of the RAAS surrounding its diversified functions and utility. Further trials are warranted to study the combination therapy as an evidence-based practice.

Angiotensin Receptor Antagonists ; therapeutic use ; Angiotensin-Converting Enzyme Inhibitors ; therapeutic use ; Animals ; Antihypertensive Agents ; therapeutic use ; Diabetes Mellitus, Type 2 ; complications ; Diabetic Nephropathies ; drug therapy ; Humans ; Renin-Angiotensin System ; drug effects

Asthma ; blood ; Child ; Child, Preschool ; Complement Membrane Attack Complex ; analysis ; Enzyme-Linked Immunosorbent Assay ; Female ; Humans ; Intercellular Adhesion Molecule-1 ; blood ; Male ; Vascular Cell Adhesion Molecule-1 ; blood