Objective To study the correlation between abdominal near-infrared spectroscopy monitoring and the risk of necrotizing enterocolitis (NEC) in preterm infants.Method From September 2015 to June 2016,preterm infants admitted to the NICU of our hospital were enrolled in this study.Nearinfrared spectroscopy (NIRS) was used to monitor the tissue oxygen saturation (StO2) of lower right abdomen of the patients.These preterm infants were assigned into NEC group and non-NEC group depending on whether NEC was developed during hospitalization.The abdominal StO2 within the first week after birth were compared between the two groups.Result A total of 77 infants were enrolled in this study,18 preterm infants in the NEC group and 59 in the non-NEC group.The gestational age and birth weight of the patients in the NEC group were lower than the non-NEC group.The NEC gioup had significantly higher incidences of mechanical ventilation,vasoactive agent usage and comorbidity of infection than the non-NEC group (P ＜0.05).No significant differences in the proportion of gender,application of umbilical venous catheters and the incidence of patent ductus arteriosus between the two groups (P ＞ 0.05).The abdominal StO2 of the NEC group was significantly lower than the non-NEC group (69.0％ ± 5.8％ vs 82.8％ ± 6.7％,P ＜0.001).Multivariate logistic regression analysis showed that lower abdominal StO2 is an independent risk factor for NEC (OR =0.676,95％ CI 0.548 ～ 0.834,P ＜ 0.001).Conclusion Abdominal NIRS monitoring may be helpful for the early diagnosis of NEC.

Objective To search for and investigate the relationship between the differently expressed gene and pulmonary thromboembolism.Methods Peripheral blood mononuclear cells were isolated from pulmonary thromboembolism patients who were diagnosed and sex,age matched healthy controls.To screen differently expressed mRNA fragment which was related to pulmonary thromboembolism.Analyze one of the new ESTs.Simultaneity and homology comparison were made.Results First,fifty-five candidate mRNA fragments were chosen.Analysis of ten candidate mRNA fragments among them(up regulation or down regulation more than 3 times)were made by using Homology search,which confirmed that g44 and g48 were new sequence and were registered to GenBank.Making g44 be probe,northern blot was used to analyze one of the new ESTs.Signal of cross was found in controls and patients with pulmonary thromboembolism.It was significantly strong in the patient group compared with the control group.Conclusion These results reveal that new fragments have a strong expression in pulmonary thromboembolism group than control group.It suggests that these two new gene fragments may play an important role in the process of pulmonary thromoembolism as pathogenic gene.

Objective Through a survey of medical students in autonomous learning, to understand students' learning motivation and learning strategies and find out the existing problems, and to provide the basis for the school to organize autonomous learning and improve the teaching quality. Methods Convenient sampling method was used to extract 1 500 students' autonomous learning scale who were freshman and sophomore, junior students and 1 467 valid questionnaires were collected. According to the corresponding research situation of Zhejiang Normal University, SPSS 19.0 was used to compare the different types of students in the school, and the t test or q test were also done. Results The situation of college students' autonomous learning was better. The girl's average score was (312.51 ±14.03) which was higher than the boys in the school (286.16 ±13.69)and the girls in the control group (302.67 ±10.37). The difference was statistically significant (P<0.05). The average total score of the junior college students (307.92 ±13.84) was better than that of freshman and sophomore (P<0.05), which suggested that junior students had the strongest independent learning ability. Conclusion Colleges and universities should be based on the actual situation of students and formulate corresponding policies and measures from the autonomous learning motivation, the boys dor-mitory management, to ensure the stability of teaching quality improvement.

OBJECTIVE: To provide a reference about choosing the methods of isolating exosomes derived from tumor cells including laryngocarcinima Hep-2 cells by comparing advantages and defects of two methods of isolation and extraction exosomes. METHOD: Previously, laryngocarcinoma Hep-2 cells were cultivated massively, then the cells were processed with hot shock in 42 degrees C for 1 h. Sucrose density gradient centrifugation ultrafiltration (method 1): cells culture supernatant 90 ml was gathered, the supernatant was clarified through a 3/0.8 μm small filter to remove impurities and fragments which in larger diameter. Then the filtering fluid was concentrated and purified through sucrose density gradient centrifugation and ultrafiltration, the concentrated fluid was obtained. Exosome Isolation Kit (method 2): cells culture supernatant 4 ml was gathered, the solutions of the kit were added into the supernatant in proper sequence, then filtered by the special column, the concentrated fluid was obtained. Both products are observed by high resolution transmission electron microscopy. RESULT: Both methods could isolate and extract exosomes feasibly. In single high power view of transmission electron microscopy, exosomes of method 1 disperse better, but lower density, and more impurity in background, exosomes of method 2 arrange closer, higher density, and less impurity. CONCLUSION Exosome isolation Kit require less supernatant, cost less time, process procedure briefly, harvest higher yield. It may become a new option of isolating exosomes derived from Laryngocarcinoma Hep-2 cells.
Cell Line, Tumor ; Exosomes ; ultrastructure ; Humans ; Laryngeal Neoplasms ; pathology ; Microscopy, Electron, Transmission

Objective To evaluate the therapeutic efficacy of intratympanic dexamethasone injections combined with prednisone in patients with idiopathic sudden sensorineural hearing loss. Methods A total of 71 patients diagnosed with sudden hearing loss were treated with intratympanic dexamethasone injections plus prednisone (B group) or prednisone alone (A group). Hearing was evaluated by pure tone audiogram performed before initial treatment and at 4 weeks following the final treatment. Results The total recovery rate after the treatment was 81.8% in the B group and 55.3% in the A group. The diflference between two groups was statistically significant (P < 0.05). Conclusion The present study suggests that sudden sensorineural hearing loss patients treated with intratympanic dexamethasone combined with prednisone have a higher likelihood of hearing recovery than those treated with prednisone alone.

Objective To understand the situation of off-label use of sildenafil, so as to provide reference for developing off-label drug use policy. Methods A stratified random sampling method was used to collect prescription data of sildenafil in Guangdong Women and Children Hospital in 2015. The off-label drug use situation was analyzed according to drug labels. The situations of drug use in all departments were summarized, and off-label drug use occurrences were analyzed.Results A total of 1044 prescriptions with sildenafil were collected and analyzed to discover the occurrence of off-label use was up to 69. 54%. The top 3 departments of off-label use of sildenafil were assisted reproductive center, heart center and neonatal intensive care unit (NICU). The top 3 types of off-label use were non-indication(50. 35%), over drug population(31. 76%) and over drug administration(17. 89%). The top 3 diseases for non-indications were infertility, pulmonary hypertension and congenital heart disease. Conclusion Sildenafil off-label use was common in Guangdong Women and Children Hospital in 2015, especially in assisted reproductive center, heart center, and NICU. The result suggests that more clinical studies about sildenafil on cardiovascular system are expected to provide more evidence for drug use, so as to ensure the safety of drug use in special populations and avoid potential medical risk.

Objective To investigate the feasibility of spleen-preserving splenic hilar lymph nodes dissection on the radical resection for advanced proximal gastric cancer. Methods Six patients with advanced proximal gastric cancer were performed D2 lymphadenectomy from May 2012 to May 2013 in our hospital. The operation time,bleeding quantity,the number of lymph nodes,postoperative complications were re-corded. Results The surgery was successful. The intraoperative blood loss was 50 ~250 mL,with the average of 120 mL. The number of lymph nodes was 3~9 after the operation with the average of 5. One patient supervened with lymphorrhagia and recovered after treatment. During the follow-up period from one month to one year, no local recurrence and distant metastasis occurred, nor the death. Conclusion Conducting theD2 lymphadenectomy for the patients with the advanced proximal gastric cancer can preserve the spleen while safely and throughly dissect the splenic hilar lymph nodes.

Key word: Hedyotis L ; triterpenoids; spectroscopic characteristics

Object To compare the contents of chlorogenic acid in the different processed crude drugs of Lonicera fulvotomentosa Hsu et S.C. Cheng. Methods The contents of chlorogenic acid were deter mined by HPLC. Chromatographic conditions included Hypersil C 18 column and the mobile phase consisting of a mixture of acetonitrile 0 4% phosphoric acid (13∶87). Chlorogenic acid was detected at 327 nm wavelength. Results The contents of chlorogenic acid were 0 54%, 0 81%, 0 57% in the sun cured flower bud, white bloom, gold flower in L. fulvotomentosa and 2 14%, 1 65%, 2 04% in the steaming sun cured crude drugs, respectively. Conclusion The contents of chlorogenic acid in the steaming sun cured crude drugs are higher than those in the sun cured crude drugs.

BACKGROUND: The injury of blood-brain barrier following cerebral ischemia reperfusion is a considerate pathological basis for injury caused by cerebral ischemia and reperfusion.OBJECTIVE: To investigate the effects of four most basic Chinese medicinal herbs, or safflower, peach seed, ligusticum and red peony with actions of activating blood and resolving the stasis on the contents of nitric oxide, immunoglobulins, C-reactive protein (CRP) and complements (immunological indices) of serum and cerebral homogenate, as well as the morphological and structural changes of cerebral tissue cells in rats with ischemia and reperfusion to vertify relationship between time effectiveness and quantitative effectiveness.DESIGN: A randomized controlled study, and evaluation by single blind.MATERIALS: The experiment was completed in the Laboratory of Traumatology Institute of Guangzhou Red Cross Hospital from January 2001 to De cember 2002. Safflower, peach seed, szechwan lovge rhizome and red peony are concentrated granules of single decocting pieces, the blood activating and stasis resolving decoction was prepared at 2.5 g/L according to 1:1:1:2 ratio.Totally 138 adult female SD rats were selected for the experiment,weighing 280-300 g, provided by Animal Center of Guangzhou University of TCM.INTERVENTIONS:The models rats with middle cerebral artery occlusion were set up by thread ligation(24 hours reperfusion after 2 hours middle cerebral artery occlusion).All 138 rats were randomly divided into 6 groups with 23 in each group.Sham operation group:The vessels were ligated but the middle cerebral artery was not occluded.No.1 medicated group: The BASR was by gavage given in a dose of 2 g/kg 30 minutes before operation. No. 2 medicated group: The BASR was by garage given in a dose of 2.5 g/kg 30 minutes before operation. No. 3 medicated group: The BASR was by garage given in a dose of 2 g/kg for consecutive 7 days be fore operation. No. 4 medicated group: The BASR was by gavage given in a dose of 2.5 g/kg for consecutive 7 days before operation.Control group:the same volume of saline was by gavage given for consecutive 7 days before operation. ① Scoring of dysneuria (5-score system: 0-1 score meant mild dysneuria, 2-4 scores meant severe dysneuria) for all rats were performed after consciousness following 2 hours ischemia and 24 hours reperfusion.② After 24 hours reperfusion,10 rats in each group were at random selected for assay of levels of CRP, complement 3 (C3) and complement 4 (C4) (rate nephelometry), and concentration of nitric oxide (nitrate reductase method)in both cerebral homogenate and serum.③ After 24hours reperfusion, 10 rats in each group were at random selected, and after anesthesia was completed, the brain was quickly collected through decapitation, put into a 110 ℃ drying oven till its constant weight, then the water content in brain was calculated.④ The cerebral cytomorphology in every group was observed under light microscope. ⑤ After reperfusion, 3 rats in each group were randomly selected for preparation of coronal section of cerebral tissue,the cerebral ultrastructure in each group was observed under transmission electronic microscope.MAIN OUTCOME MEASURES: ① The results of dysneuria scoring in each group. ② The levels of CRP, C3 and C4, and concentration of nitric oxide in both cerebral homogenate and serum.③ The water content in brain. ④ The cerebral cytomorphology and the cerebral ultrastructure. RESULTS: All 138 rats entered into the result analysis. ① Comparison of the extents of dysneuria of rats in each group: The ratio of severe dysneuria after 24 hours ischemic reperfusion in all medicated groups was obviously lower than that in control group(P ＜ 0.01),and the ratio in No.4 medicated group was lower than that in No.2 medicated group(P ＜ 0.05).② Comparison of water contents in brain of rats in each group:The water contents in sham operation group and all medicated groups were obviously lower than that in control group (P ＜ 0.05). ③ Comparison of the nitric oxide concentration in cerebral homogenate of rats in each group: The concentration in sham operation group and all medicated groups were obviously lower than that in control group (P ＜ 0.01). The concentration in No. 3medicated group was obviously lower than that in No. 1 medicated group (P ＜ 0.05).The concentration in No.4 medicated group was obviously lower than that in No. 2 medicated group (P ＜ 0.01). ④ Comparison of the nitric oxide concentration in serum of rats in each group:The concentrations in sham operation group and all medicated groups were obviously lower than that in control group(P ＜ 0.01).The concentration in No.3 medicated group was higher than that in No. 1 medicated group (P ＜ 0.05). The concentration in No. 4 medicated group was higher than those in No. 2 and in No. 3 medicated groups (P ＜ 0.05). ⑤ Comparison of the levels of CRP in cerebral homogenate and serum of rats in each group: The levels in sham operation group and all medicated groups were lower than that in control group(P ＜ 0.05-0.01).The level in No.3 medicated group was lower than that in No. 1 medicated group (P ＜ 0.01). The level in No. 4 medicated group was lower than those in No. 2 and in No. 3 medicated groups (P ＜0.05-0.01).⑥ Comparison of the levels of C3 in cerebral homogenate and serum of rats in each group:The levels in sham operation group and all medicated groups were lower than that in control group (P ＜ 0.05-0.01). The level in No.3 medicated group was lower than that in No.1 medicated group (P ＜ 0.05). The level in No. 4 medicated group was lower than those in No. 2 and in No. 3 medicated groups (P ＜ 0.01). ⑦ Comparison of the levels of C 4 in cerebral homogenate and serum of rats in each group:The levels in sham operation group and all medicated groups were lower than that in control group (P ＜ 0.05-0.01). The level in No. 3 medicated group was lower than that in No. 1 medicated group (P ＜ 0.05). The level in No.4 medicated group was lower than those in No. 2 and in No. 3 medicated groups (P ＜ 0.01). ⑧ Comparison of the condition of cerebral edema of rats in each group:In control group there was obvious cerebral congestive edema,indicating an obvious infection;while in medicated groups the extent of cerebral edema was milder than that in control group.⑨ Changes of cerebral ultrastructure of rats in each group:The ultrastructure in sham group was normal. In control group, there obvious edema of cells, capillaries and sheaths in the marginal zone of cortex necrosis,and reduction of organelles of neuron. As well. In No. 3 and No. 4 medicated groups, the limits of cell membranes were clear, the structure was integral, the chondriosomes were rich and even in size,the medullated fibers were morphologically normal.And in No.1 and No.2 medicated groups the changes were between the twoCONCLUSION:① The scoring of dysneuria in rats was decreased after the blood-activating and stasis-resolving medicine was given,and it was lower in rats that were given a longer period of medication,indicating that the improved extent for dysneuria is related to prolonged medication.②The nitric oxide concentration of cerebral tissue in rats that recevied the blood-activating and stasis-resolving medicine was decreased, and the nitric oxide concentration of serum in the rats was increased,indicating that the blood-activating and stasis-resolving medicine can reverse the anomalies of nitric concentration in different tissues after ischemic reperfusion so as to reduce cerebralinjury.③ The levels of C3 and C4 of cerebral tissue and serum in rats that received the blood-activating andstasis-resolving medicine were obviously decreased,indicating that the medicine may reduce the cerebral injury through triggering complement system;and the CRP was also get decreased,further suggesting that the medicine can inhibiting infective reaction.④ The longer the period of medication,the milder the cerebral injury, and the dose of 2.5 g/L was better in effect.