Objective To evaluate the efficacy and safety of permissive hypercapnia ventilation in mechanically ventilated newborns.Methods PubMed,Embase,the Cochrane Library,China National Knowledge Infrastructure (CKNI),Wanfang Data and Chinese BioMedical Literature Database (CBM) were searched up until March 31,2013.Randomized controlled trials (RCTs) comparing permissive hypercapnia (PHC) group with normocapnia (NC) group in mechanically ventilated newborns were included.The primary outcomes included the incidence of ventilator associated lung injury (VALI),bronchopulmonary dysplasia (BPD),intraventricular hemorrhage (IVH),periventricular leukomalacia (PVL),patent ductus arteriosus (PDA),neonatal necrotizing enterocolitis (NEC),neurodevelopmental injury and the mortality rate.Secondary outcomes included the duration of ventilatory support and the length of hospital stay.The Cochrane Handbook 5.1.0 was used to evaluate the methodological quality and RevMan 5.1 software from Cochrane Collaboration was used for meta-analysis.The fixed effects model or the random effects model was adopted according to the result of heterogeneity.Results (1) A total of 325 articles were searched,and eight RCTs involving 605 newborns (302 newborns in PHC group while 300 newborns in NC group) which met the inclusion criteria were selected.In seven studies,the partial pressure of carbon dioxide (PCO2) was controlled at ＜ 65 mmHg (1 mmHg=0.133 kPa) and pH at ≥ 7.2 in PHC group.In one study,PCO2 was ＞ 52 mmHg and pH＞7.2,without descripition of the upper limit of PCO2.(2) Four articles described the method of random allocation in detail; three described allocation concealment; all eight studies used blinding method for research subjects; two used blinding method for outcome assessment; all eight studies reported complete data; and three articles described the source of other bias.(3) All eight studies reported the incidence of VALI (I2=56％,P=0.03).The random effects model was used for the meta-analysis,and there was significant difference between PHC group and NC group (RR=0.52,95％CI:0.29-0.93,P=0.03).According to the gestational age,the eight studies were divided into two subgroups.One subgroup,including three studies with an average gestational age of 25 weeks (I2=0％,P=0.46),showed no significant difference in the incidence of VALI between PHC and NC group (RR=1.05,95％CI:0.72-1.54,P=0.78).The other subgroup,including five studies with gestational age of ＞27 weeks (I2=0％,P=0.68),showed significant difference in the incidence of VALI between the two groups (RR=0.27,95％CI:0.14-0.50,P＜0.01).The in-hospital mortality and duration of ventilation showed significant difference between the two groups (in-hospital mortality:RR=0.40,95％CI:0.22-0.74,P＜0.01; duration of ventilation:difference in means=-0.75,95％CI:-1.04--0.46,P＜0.01).There was no significant difference in the incidence of BPD,IVH,PVL,PDA,NEC and neurodevelopmental impairment between the two groups (all P＞0.05).Conclusions PHC ventilation in mechanically ventilated newborns can decrease the incidence of VALI,the in-hospital mortality and the duration of ventilation,while its protective efficacy against BPD is not remarkable.It does not increase the risk of IVH,PVL,PDA,NEC and neurodevelopmental injury,when the PCO2 is ＜ 65 mmHg and pH ≥ 7.2.

Objective To investigate the clinical application of alpha lipoic acid on early diabetic nephropathy(DN).Methods Seventy patients with early diabetic nephropathy were randomly divided into two groups.Patients in control group were treated with regular glycemic control methods,while patients in treatment group were received alpha lipoic acid 300 mg static drop treatment for two weeks beside regular treatment.High sensitivity C reaction protein,microalbuminuria and urine creatinine were measured before and after the treatment.Microalbuminuria and urine creatinine were re-measured three months later.Results At the end of two weeks treatment,the levels of high sensitivity C reaction protein in the treatment group decreased from (3.92 ± 4.56) mg/L to (2.24 ± 2.49) mg/L,and there was significant difference (t =2.803,P ＜ 0.05).Microalbuminuria decreased from (127.18 ± 76.91) mg/L to (84.50 ± 122.87) mg/L,and there was significant difference (t =2.501,P ＜ 0.05).The ratio of microalbuminuria and urine creatinine in treatment group decreased from(28.95 ± 30.49) mg/mmol to(13.76 ± 20.83) mg/mmol,and there was significant difference (t =3.616,P ＜ 0.05).While there was no significant difference in the control group before and after regular waglycemic control.At three months after treatment,there were no significant difference regarding of microalbuminuria,the ratio of microalbuminuria and urine creatinine between treatment and control groups (P ＞ 0.05).Conclusion Alpha lipoic acid might be with ability of decreasing the levels of microalbuminuria of diabetic nephropathy in the short term,but further study is needed to verify whether alpha lipoic acid can decrease the level of microalbuminuria in the long term.

Two cases of cleidocranial dysplasia(CCD) were reported and the characteristics of CCD were analyzed. The propositus verification method was used to family members for general health and oral specialized examination. All patients expressed developmental abnormality of crania, teeth and clavicle.
Clavicle ; Cleidocranial Dysplasia ; Humans ; Tooth

OBJECTIVETo analyze the mutations of the RUNX2 gene in a family with cleidocranial dysplasia (CCD).

METHODSThe general health status of family members with CCD was investigated through propositus verification method. Oral specialized examination and radiological examination were performed. The peripheral venous blood of the proband and her parents and sisters was collected. Genomic DNA was extracted, and the RUNX2 gene from this DNA was amplified by polymerase chain reaction (PCR). DNA sequences were analyzed with the Blastn program.

RESULTSAfter Blastn analysis, heterozygous C to T transition mutation at nucleotide 568 occurred in exon 2, which converted arginine to tryptophane at codon 190 (c.568C>T, CGG-->TGG).

CONCLUSIONRUNX2 gene is responsible for the CCD in the Chinese family under study. The c.568C>T mutation is the molecular basis of the CCD in the family.

Asian Continental Ancestry Group ; Base Sequence ; Cleidocranial Dysplasia ; genetics ; Core Binding Factor Alpha 1 Subunit ; genetics ; DNA Mutational Analysis ; Exons ; Humans ; Mutation ; Pedigree ; Polymerase Chain Reaction

Objective To investigate the clinical characteristics, imaging features and treatment strategies of pial arteriovenous fistula. Methods From January 2013 to December 2017,12 patients with pial arteriovenous fistula confirmed by cerebral angiography and received treatment at the Department of Neurosurgery,Xuanwu Hospital, Capital Medical University were retrospectively recruited. All patients underwent endovascular embolization with Glubran 2,coil + Glubran 2 or Onyx 18. Some patients underwent balloon-assisted embolization. The embolization effect (complete occlusion,subtotal occlusion,partial occlusion) and postoperative complications were observed. Patients were followed up to evaluate symptom relief and radiological outcomes (previous lesions not visualized by re-examination imaging). Results For the initial symptoms,there were 6 headaches, 3 seizures,2 intracranial hemorrhages, and 1 tinnitus. After embolization, 11 patients had complete occlusion of the fistula and One patient had subtotal occlusion. Six patients underwent balloon-assisted embolization. One patient developed a decrease in muscle strength in the left limb after embolization. There were no deaths. Eleven patients completed the followup. The median follow-up time was 13. 4 (5. 2,26. 7) months. Nine patients had symptoms disappeared. One patient still had headache and 1 patient received oral antiepileptic drugs to control seizures. The fistulas were not visualized by angiopathy in all 11 patients. One patient developed dural arteriovenous fistula and arteriovenous malformation in superior sagittal sinus, straight sinus and sinus confluence. The patient was cured by embolization. Conclusions Pial arteriovenous fistula is a rare clinical disease, which is often characterized by headache, seizure, etc. Endovascular therapy is a safe and effective treatment method.

Objective The decease of varicose vein and telangiectasis of lower extremity has always been difficult to treat.Regular treatments and medicines are invalid.This research aimed to study the effect of foam sclerotherapy and the long-pulsed 1064 nm Nd∶YAG laser in treatment of reticular veins and telangiectasis of lower extremity.Methods From January 2012 to June 2012,excluding deep and superficial veins valve insufficiency of the lower extremity through duplex uhrasonography,72 patients with simple reticular veins and telangiectasis of the lower extremity were treated with foam sclerosing agent injection combined with Nd∶YAG 1064 nm laser therapy.Results Of the 72 patients,cure was achieved in 38 cases,significantly effective in 32 cases,effective in 2 cases,and total effective rate was 100％.Follow-up showed that after 3 months 1 case was dissatisfied,3 cases were discontent,6 relatively satisfied,32 satisfied,and 30 very satisfied;after 12 months no cases were very dissatisfied,1 cases were discontent,9 relatively satisfied,28 satisfied,and 34 cases very satisfied.There were no severe complications in all cases.Conclusions Foam sclerotherapy and Nd:YAG 1064 nm laser can be used for different stages of the treatment process and different caliber of blood vessels.Treatment with foam sclerotherapy and Nd∶YAG 1064 nm laser for reticular veins and telangiectasia of lower extremity is a safe,simple and effective way.

OBJECTIVETo observe the ultrastrual changes of the skin between the continuous tissue expansion and the conventional tissue expansion.

METHODSTwelve white piglets were used for this study on an animal model of tissue expansion with the continuous tissue expansion group and the conventional tissue expansion group. The tissue samples in each group were harvested and prepared for the transmission electron microscope observation.

RESULTSThe interspace among basal cells and spinose cells was increasing and the numbers of cell conjunctures were decreasing in the both groups. However, these changes in the continuous tissue expansion group were more obvious than in the conventional tissue expansion group. In the dermal layer of the skin, the ultrastructure of collagen fibers were basically normal. But, the fibroblasts and capillary endothelia cells were more activated in the continuous tissue expansion group, compared with the conventional tissue expansion group. The fibroblast apoptosis and collagenolysis spots were observed in both of the groups, while the red blood cells were also found in the tissue leaked outsides from the blood vascular cavities.

CONCLUSIONTissue expansion may result in tissue growth and tissue degeneration in the same time.

Animals ; Microscopy, Electron ; Skin ; cytology ; ultrastructure ; Swine ; Tissue Expansion ; methods

Recent studies showed that pathology of alcoholic encephalopathy was associated with cerebral vascular damage. TMP (tetramethyl- pyrazine) is widely used in the treatment of cerebrovascular diseases, however, it has not been reported whether TMP can relieve alcohol-induced cerebral vascular damages. The study was performed to investigate the learning and memory, cerebrovascular pathological changes and the expressions of vascular endothelial growth factor (VEGF) and serum levelsofendothelin-1 (ET-1) in the rat model of chronic alcoholic encephalopathy, and explore the effects of TMP intervention on alcoholic encephalopathy. In the present study, the rat model of chronic alcoholic encephalopathy was established by the gavage administration of alcohol; the learning and memory ability was tested by Morris water maze; the expression of VEGF was measured by RT-PCR and Western blot; and the serum levels of ET-1 was measured by radioimmunoassay. We found that alcohol intoxication impaired learning and memory, induced VEGF overexpression and increased ET 1 concentrations. TMP intervention improved learning abilities, increased the VEGF expression and reduced ET-1 level. These results indicate that TMP exhibits therapeutic effects on chronic alcoholic encephalopathy.
Alcohol-Induced Disorders, Nervous System ; complications ; drug therapy ; physiopathology ; Animals ; Cerebrovascular Circulation ; drug effects ; Disease Models, Animal ; Endothelin-1 ; blood ; Learning ; drug effects ; Male ; Memory ; drug effects ; Pyrazines ; pharmacology ; therapeutic use ; Random Allocation ; Rats ; Rats, Wistar ; Vascular Endothelial Growth Factor A ; analysis ; Vasodilator Agents ; pharmacology ; therapeutic use

【Objective】 To achieve supervision and management of the whole business process of blood center, raise productivity and ensure blood quality by enabling blood center managers comprehensively grasp the key business operation situation of the whole process at anytime and anywhere. 【Methods】 A whole business process supervision and management system was established covering background of preparation, business scope, content of position supervision and management, overall framework design, interface design of management and supervision management, physical database design, program development and online debugging, and was integrated with the blood bank management information system. The display and management were through a mobile APP to record key indicators of business process from blood collection to blood supply timely and comprehensively. Statistical analysis was conducted on total collection volume, total preparation volume and total supply volume, as well as discarding rate of test unqualified and of non-test unqualified (lipemic blood excluded) in 2023 and 2022. 【Results】 We established a mobile APP based on a blood bank management information system for business supervision and management of whole process, and achieved management by phones. After its implementation in 2023, the total collection volume, total preparation volume and total supply volume in 2023 were all higher than those in 2022, with growth rates of 5.88% (13 247/225 454 U), 4.73% (24 156/510 698 U), and 6.70% (34 814/519 914 U), respectively. The discarding rate in 2023 was lower than that in 2022 (0.54%, 2 868/534 854 U) vs (0.60%, 3 047/510 698 U) (P<0.01), and the non-test unqualified discarding rate (lipemic blood excluded) in 2023 was significantly lower than that in 2022(0.12%, 649/534 854 U) vs (0.19%, 991/510 698 U)(P<0.01). 【Conclusion】 The construction of supervision and management system of a whole business process based on blood bank management information system can meet the standardized service needs of managers at anytime and anywhere, continuously raise productivity and the standardization and scientific level of blood bank management, thus ensuring blood supply.

Objective: To explore the effects of intervention programs during primipara, using the Information-motivation-behavioral skills model (IMB) intervention model on initial exclusive breastfeeding. Method: 206 women of primiparas who were registered to the top three hospitals were selected in Shandong province, 2018. These women were hospitalized in the obstetrics/gynaecology wards during the later periods. IMB model was used to support the intervention programs at the following stages: antenatal period, 1 day postpartum, 3-4 days postpartum and 42 days postpartum. Questionnaire regarding self-efficacy energy meter, knowledge and behavior related to breastfeeding, were used before and after the intervention programs. Results: Through intervention programs, statistically significant differences in breastfeeding self-efficacy scores between the four stages (F=150.680, P=0.000) were recorded. Significant differences were also noticed in scores on knowledge of breastfeeding (F=176.556, P=0.000). Conclusion The application of IMB intervention model in women at childbearing age seemed to be helpful in improving the effect of primary breastfeeding in women at childbearing age.