Objective To investigate the influence of setting up of Division of Neonatology and Neonatal Intensive Care Unit(NICU) on neonatal mortality rate(NMR) in local perinatal center. Methods (1) NMR and survival rate of very low birth weight (VLBW) infants and triplet and quadruplet from 17283 newborns during Jan 1,1990 and Dec 31,1992 before NICU was set up (group A) were cmpared to that from 32 716 newborns during Jan 1,1993 and Dec, 31,2000, after NICU was set up(group B).(2) NMR and survival rate of VLBW infants in the process of NICU was developed was investigated. (3)NMR after the NICU was opened to the whole community. Results (1)NMR was 8.62 per 1000 in group A and 3.00 per 1000 in group B. Corrected Mortality Rates was 6.36 per 1000 and 1.74 per 1000 respectively (P

Objective To assess the influence of laparoscopic sleeve gastrectomy (LSG) on the nutritional status in patients with obesity.Methods From August 2014 to July 2015, 24 obese patients underwent LSG in Dongfang Hospital Affiliated to Tongji University.Weight and nutritional status of these patients were measured pre-operatively and 3, 6, and 12 months after surgery.Results The mean body weight of the 24 obesity patients was (81.94±21.39) kg, (78.83±24.49) kg, (62.67±10.79) kg 3, 6, and 12 months after surgery, respectively, which were significantly lower than the preoperative body weight [(99.02±23.92)kg] (P=0.004).The serum levels of albumin, hemoglobin, and trace elements (including calcium, iron, zinc, magnesium, and copper) showed no significant change after surgery (all P>0.05).Plasma vitamin D[25(OH)D] increased significantly from (13.1±4.1)μg/L preoperatively to (19.8±5.3)μg/L 12 months after surgery (P=0.031).Folic acid was (6.2±3.9)μg/L before LSG and significantly increased to (14.2±9.2) μg/L 3 months later surgery (P=0.009);the folic acid level gradually decreased 6 and 12 months after LSG but was still higher than the preoperative level.Conclusion Vitamin D deficiency is present in obese patients before LSG.After surgery, while the serum albumin and trace elements have no obvious change, the vitamin D and folic acid levels remarkably increase.

Objective:To prepare monoclonal antibodies specifically against an immunogenic fragment in ectodomain of prostate-specific membrane antigen ( PSMA ).Methods: An polypeptide immunogenic fragment in the ectodomain of PSMA was predicted by biological information technology,and then it was expressed prokaryotically.BALB/c mice were immunized with the prokar-ytically expressed recombinant polypeptide antigen,to prepare the monoclonal antibodies specifically against an immunogenic fragment in ectodomain of PSMA by hybridoma technology,purification of monoclonal antibody by affinity chromatography,characterization of the monoclonal antibodies by Western blot.The radioimmunoimaging in prostate cancer model was performed by using the labeled McAb.Results:Throught the software analysis,we got the antigen fragment in the ectodomain of PSMA containing 310aa sequences higher specificity, artificially synthesized gene sequence of the region, and constructed a prokaryotic expression vector pET-32a-r-ectodomain-PSMA,by prokaryotic expression we obtained the 50 kD target antigen,after hybridization,the three positive hybridoma cell lines (5E6,4A5 and 4D7) were selected by ELISA using target antigen,the isotypes of 5E6 and 4A5 were IgG2a,the isotypes of 4D7 were IgG1,the titer of three monoclonal antibodies was above 1∶256 000.Western blot results showed that the prepared monoclonal anti-bodies could binding specifically to the antigen in the ectodomain of PSMA.Radioimmunoimaging in prostate cancer animal model results further confirm that the prepared monoclonal antibodies could combinate with the antigen in the ectodomain of PSMA in the animal body, and make the tumor imaging.Conclusion: The prepared monoclonal antibodies can specifically recognizes the PSMA antigen,which laid the foundation for the immunodiagnosis and immunotherapy of prostate cancer.

Objective: To investigate the early diagnosis and treatment for burn complicated with severe paroxysmal sympathetic hyperactivity (PSH). Methods: Medical records of patients with burn complicated with severe PSH, admitted to our department from April 2016 to March 2019 and meeting the inclusion criteria were analyzed retrospectively. There were 4 males and 1 female, aged 17 months to 39 years, with an average of (21±16) years. During occurrence of PSH, the vital signs of patients were routinely monitored and oxygen were given. Other treatment included central venous catheterization and infusion of electrolyte solution, infusion of plasma according to patients′ condition, use of opioid analgesics and benzodiazepine sedatives, physical cooling and drug cooling, and establishment or maintenance of artificial airway and use of ventilator. Heart rate was controlled below 120 beats per minute in adults and 140 beats per minute in children with comprehensive treatment dominated by analgesia and sedation. Besides, single or multiple vasoactive agents, even in large doses were used to maintain normal blood pressure of patients. The occurrence characteristics, time, and treatment outcome of PSH were analyzed. Results: PSH happened rapidly, with a sharp increase in several minutes to dozens of minutes. Five patients were with symptoms such as high body temperature, shortness of breath, very fast heart rate, normal or elevated systolic blood pressure, hyperhidrosis, and dystonia at the onset. The symptoms occurred simultaneously or successively. According to the Clinical Feature Scale, the above-mentioned 6 indexes achieved the highest score of 3 points except of systolic blood pressure. Four patients showed dilated pupils and impaired consciousness. Among the patients, PSH occurred in the acute exudation stage in 3 patients, in the fluid reabsorption stage in 1 patient, and in the late repair stage in 1 patient. PSH of patients lasted for 3 hours to 12 days. The symptoms of 4 patients were effectively controlled, and 1 patient died of deterioration. No PSH occurred in the cured patients during follow-up of 3 to 14 months. Conclusions Burn complicated with PSH can occur at any time before wound repair and in patients with different injury conditions. The causes of PSH include sudden burn, persistent pain, fright and fear, strange environment, low blood volume, and other adverse stimuli, and PSH is more likely to occur in children with underdeveloped brain function. Intravenous infusion of analgesics sedatives, physical therapy and medication to lower body temperature, stabilizing blood pressure and respiration are effective measures to treat PSH. PSH should be distinguished from the common complications of burns, such as sepsis, cerebral edema, hyperpyretic convulsion, transfusion response, stress disorder, etc.

Objective:To explore the effects of artificial dermis combined with autologous skin in repairing the wounds with exposed bone and/or tendon in fingers of children after electric burns.Methods:A retrospective observational study was conducted. From January 2017 to December 2022, 14 children with bone and/or tendon exposed wounds in fingers after electric burns who met the inclusion criteria were admitted to Zhengzhou First People's Hospital, including 9 males and 5 females, aged 2 to 11 years. A total of 38 fingers were affected, with 1 wound per finger. After debridement, artificial dermal coverage combined with vacuum sealing drainage was performed in all the wounds in the first stage, with wound area of 2.0 cm×1.0 cm-4.5 cm×2.5 cm after debridement. The second stage surgery was performed to close the wound with autologous thin intermediate thickness skin graft. Then the children were told to perform functional rehabilitation exercise as early as possible. The survival of autologous skin graft was observed at the 7 th day after the second stage surgery. The wound healing time was recorded. After 12 months of follow-up, the Vancouver scar scale was used to evaluate the scar hyperplasia at the skin grafting site of the affected finger; the total action mobility (TAM) of the affected finger joint was measured for evaluating the functional recovery of the affected finger; a self-made efficacy satisfaction rating table was used to investigate the parents' satisfaction with the curative effect of the children. Results:At the 7 th day after the second stage surgery, all the children had good survival of autologous skin grafts. The wound healing time was (24.1±2.7) d. After 12 months of follow-up, the scar score at the skin grafting site of the affected finger was 5.2±2.4; the TAM of the affected finger joint was (177±40)°; the functional assessment was good in 12 fingers, medium in 23 fingers, and poor in 3 fingers; the parents' satisfaction with the curative effect of the children in the survey was very satisfied in 10 cases, satisfied in 3 cases, and dissatisfied in 1 case. Conclusions:The combination of artificial dermis and autologous thin intermediate thickness skin graft is an alternative surgical method that can effectively repair the bone and/or tendon exposed wounds in fingers of children after electric burns. After wound healing, the scars are slight, the finger function is well recovered, and the parents of the children are highly satisfied with the curative effect of the children, which is worthy of clinical promotion.

ObjectiveTo study the sexually transmitted infections （STIs） in pregnant women with non-local household registration in Xuhui District and analyze the risk factors for STIs. MethodsFrom April 2020 to March 2022， pregnant women with non-local household registration who received their first prenatal examination in a general hospital in Shanghai Xuhui District were selected to conduct a status survey of STIs. Logistic regression model was used to analyze the influencing factors of bacterial vaginitis and ureaplasma uaplasma infection. ResultsThe top three infection rates in the pregnant women were Ureaplasma urealyticum （13.2%）， bacterial vaginosis （9.8%） and mycotic vaginitis （4.7%）. Age between 25 and 35 years （aOR=0.53，95%CI： 0.28‒0.98） and monthly income ≥8 000 yuan （aOR=0.30，95%CI： 0.11‒0.82） were significantly correlated with ureaplasma uaplasma infection. Pregnancy number of 2 （aOR=4.95， 95%CI： 1.59‒15.46）， first sexual relationship occurred before marriage （aOR=2.83， 95%CI： 1.04‒7.74）， husband's alcoholism （aOR=3.83， 95%CI： 1.08‒13.56）， high school education （aOR=0.27， 95%CI： 0.08‒0.93）， and husband's travel history （aOR=0.30， 95%CI： 0.12‒0.79） were significantly correlated with bacterial vaginitis. ConclusionPregnant women with more gestation times， first sexual intercourse before marriage and husband with heavy drinking are more likely to be infected with bacterial vaginosis. Pregnant women with younger age and lower income are more likely to be infected with Ureaplasma urealyticum. Follow-up and monitoring should be strengthened in these groups.