The efficacy of growth hormone (GH) treatment in short children with small for gestational age (SGA) was evaluated and the association of serum insulin-like growth factor-1 (IGF) and IGF-binding protein-3 (IGFBP-3) levels with height increments was investigated.Fifty-five short children with SGA in our hospital from Sep 2009 to Sep 2013 were collected.Before GH treatment, insulin and arginine stimulation test were performed.The children were treated with recombinant GH with 0.15 U · kg-1 · d-1 for at least 12 months.After GH treatment, the height was (120.5 ± 17.63) cm, height SDS was (-1.53 ± 1.04) SDS, HtSDS was-2.04 ± 0.47, bone age was (6.19 ± 2.34) year, growth velocity was (7.24 ± 1.19) cm/year, all these parameters were significant higher than those before GH treatment.Pre-treatment serum levels of IGF-Ⅰ and IGFBP-3 were negatively correlated with post treatment growth velocity(r =-0.37 and r =-0.31;P =0.004 and P =0.021).GH treatment could effectively improve the height of short children with SGA.Children with lower pre-treatment serum levels of IGF-Ⅰ and IGFBP-3 may reach the higher growth velocity.

Objective To evaluate the effect of awake tracheal intubation with intubating larynegeal mask airway (ILMA) on stress responses of hypertensive patients.Methods Sixty hypertensive patients,aged 45-64 yr,with body mass index of 20.3-27.5 kg/m2,of American Society of Anesthesiologists physical status Ⅱ or Ⅲ,undergoing elective abdominal surgery under general anesthesia,were divided into 2 groups (n=30 each) using a random number table:direct laryngoscope group (group D) and ILMA group (group I).At 3 min after topical anesthesia (T1),while epiglottis and glottis were exposed with direct laryngoscope in group D or during ILMA insertion in group I (T2),immediately after completion of intubation (T3),when the maximum change in hemodynamics after intubation appeared (at about 15 s after tracheal tubes were placed,T4),and at 5 min after completion of intubation (T5),mean arterial pressure (MAP) and heart rate (HR) were recorded,and blood samples were collected for determination of plasma epinephrine concentrations by radio-immunity method.Successful intubation at first attempt was recorded.Results Compared with the parameters at T1,the MAP,HR and plasma epinephrine concentrations were significantly increased at T2-4 in group D (P＜0.01),and no significant change was found in the parameters mentioned above at the other time point in group I (P＞0.05).Compared with group D,the MAP,HR and plasma epinephrine concentrations were significantly decreased at T2-4 (P＜0.01),and no significant change was found in the success rate of intubation at first attempt in group I (P＞0.05).Conclusion Awake tracheal intubation with ILMA does not induce strong stress responses and is helpful in avoiding the occurrence of cerebrovascular accidents,thus increasing the safty of awake tracheal intubation in hypertensive patients.

Objective To investigate the clinical effectiveness of gamma knife and microsurgery operation for the treatment of bilateral parasagittal meningiomas.Methods Twenty-six patients with bilateral parasagittal meningiomas were operated by microscopy,and the most parts of the tumor was removed.The remains of the tumor were treated with gamma knife.Results All patients were followed up 5 years.The tumors disappeared in 8 cases,reduced in 11 cases,did not change in 5 cases,and recurred in 2 cases.No severe complications occurred after gamma knife treatment.Conclusion Combined treatment of gamma knife and micriosurgery operation are effective for bialateral parasagittal meningiomas.It not only greatly improves the effectiveness,but also reduces the complications and death rate in patients with bilateral parasagittal meningiomas.

Objective To study the effect of minimal enteral nutrition on the immune system of newborn infants under mechanical ventilation (MV) with intratracheal intubation.Methods Eighty-one patients under MV with intratracheal intubation were divided into two groups:treatment group and control group.Forty patients in treatmet group accepted early minimal enteral nutrition,while other 41 patients in control group accepted normal feeding,then T-lymphocytes (CD3,CD4,CD8),CD4/CD8,immunoglobulins (IgG,IgA,IgM),occurane of secondary infection,time of beginning fully enteral feeding,occurance of abdominal distension were recorded.Results There were no significant differences of T-lymphocytes (CD3,CD4,CD8),CD4/CD8,immunoglobulins (IgG,IgA,IgM) changes between the two groups in which the time of patients beginning MV under intratracheal intubation was less than five days (P ＞ 0.05) ; while comparing patients in the two groups whose MV time was equal or greater than five days,the changes of T-lymphocytes CD3[(37.3 ± 1.6)％,(42.6 ±2.8)％],CD4[(29.1 ±1.7)％,(34.6 ±2.1)％],CD4/CD8 (17.9 ±1.8,18.9 ± 1.6),immunoglobulins IgA[(55.42 ±3.98) mg/L,(129.00 ±7.76) mg/L],IgM[(130.29 ±10.92) mg/L,(317.33 ± 11.64) mg/L] in treatment group were more significant than those in control group(P ＜0.05) ;furthermore the differences of the secondary infection occurance,the time beginning fully enteral feeding,intravenous nutrition and hospital stays in the treatment group [20％ (8/40),(8.56 ± 1.78) d,(10.56 ± 1.78) d,(12.63 ± 1.73) d] were lower significantly than those in the control group [48.78％ (20/41),(10.20 ± 1.65) d,(12.15 ± 1.69) d,(14.15 ± 1.64) d] (P ＜ 0.05).These were no significant differences on abdominal distension and gastric retention between the treatment group [20％ (8/40),17.5％ (7/40)]and the control group [24.39％ (10/41),19.51％ (8/41)] (P ＞ 0.05).Conclusion Early minimal enteral nutrition in infants under long time MV with intratracheal intubation could improve immune function recovery,reduce the occurance rate of secondary infection,shorten the time beginning fully enteral feeding,intravenous nutrition and hospital stay.

Objective To explore the role of family centered cognitive intervention in neonatal nursing. Methods According to the random number table method,100 newborns were randomly divided into observation group and control group,50 cases in each group. The two groups received routine health education,and the observation group received the family centered cognitive intervention. After the intervention, the neonatal physical development status (body weight,height,head circumference) and neonatal disease status of the two groups were analyzed. The active muscle tension, passive muscle tension, primitive reflexes, behavior ability, general evaluation and neonatal behavioral neurological assessment score ( NBNA score ) were evaluated and analyzed. Results The body weight [(4753.88±434.59)g],length[(55.16±1.17)cm],headcircumference[(37.34±0.51)cm]after1month discharge of the observation group were better than those of the control group[(4295. 78 ± 344. 63) g,(52. 25 ± 0.58)cm,(35.67 ±0.21)cm],the differences between the two groups were statistically significant(t =2.564, 6. 235,8. 679,all P<0. 05). The incidence rate of born disease of the observation group was 14. 00%,which of the control group was 32. 00%,there was statistically significant difference between the two groups(χ2 =4. 574,P <0. 01). The active muscle tension,passive muscle tension,behavior ability,original reflection,the general evaluation and NBNA scores of the observation group were significantly higher than those of the control group, the differences were statistically significant(all P<0. 01). Conclusion Family centered intervention can significantly improve the growth status of newborn infants,reduce the incidence of the disease,it is beneficial to improve the patients' neurological behavior,it is worthy of wide application.

Objective: Anesthesia-induced cognitive impairments are common for elder patients after surgery. Oxidative stress is the predominant factor contributing to the impairments. This study was to assess the therapeutic potential of an anti-oxidative naturally occurring flavonoid, chrysin, in attenuating sevoflurane-induced cognitive impairments in rat models. Methods: Rat models of cognitive impairments were constructed by exposing aged rats (18 months old) to sevoflurane for 2 h. Chrysin was administered via oral gavage at the dose of 25, 50, and 100 mg/kg/day for seven days. The elevated plus maze test was used to assess anxiety and explorative behaviors. Spatial memory tests were performed using novel object recognition test, object location memory task, and water maze experiments. Oxidative stress was evaluated by measuring levels of malondialdehyde, nicotinamide adenine dinucleotide phosphate, 4-hydroxynonenal, and glutathione using colorimetric assays. Quantitative real-time polymerase chain reaction and Western blot were used to analyze how chrysin affects nuclear factor E2-related factor (Nrf) signaling. Results: While sevoflurane anesthesia led to significant decline in cognitive performance in object recognition test, object location memory task, and water maze test, chrysin exerted significant effects in alleviating the impairments. Oxidative stress was also reduced in the hippocampus tissue of rats after chrysin intake. Nrf signaling was activated by chrysin treatment in sevoflurane-induced cognitive impairment models. Conclusion Chrysin was effective in alleviating cognitive impairments induced by sevoflurane anesthesia, which was at least in part facilitated by its effects in reducing oxidative stress via activating Nrf signaling.

Objective To observe the role of community popular opinion leader (POL) intervention on ocular epidemic study. Methods During the process of epidemiological survey of eye disease in Shenyang City,the community POL was interviewed to observe the change of the follow-up population from 2015 to 2016 and the effects of the POL intervention were analyzed. Results The study population follow-up rate was significantly improved after POL intervention (χ2 = 85.42,P < 0.01),the male-to-female ratio was balanced (χ2 = 6.51, P = 0.01),and more participants were willing and hoped to participate in the epidemic study for a long time. Conclusion Community POLs can improve the follow-up rate of epidemiological surveys and mobilize the enthusiasm of the population to participate in epidemiological investigations.

BACKGROUND:In recent years,there have been many studies on the mechanism of exosomal non-coding RNA in gestational diabetes mellitus,but there is a lack of the latest systematic review of exosomes from different sources,especially placental sources. OBJECTIVE:To summarize the changes and potential roles of microRNA(miRNA),long non-coding RNA(lncRNA),circular RNA(circRNA),and exosomes in gestational diabetes mellitus to provide potential targets for early screening and treatment of clinical gestational diabetes mellitus. METHODS:A literature search was conducted on PubMed,Web of Science,China National Knowledge Infrastructure,WanFang Data,and VIP databases to retrieve relevant articles on non-coding RNA or exosomal non-coding RNA in relation to gestational diabetes mellitus.A total of 74 articles were included for review. RESULTS AND CONCLUSION:(1)Non-coding RNAs play important pathological and physiological roles in the lifecycle activities,and increasing evidences suggest that non-coding RNAs are involved in the occurrence and development of gestational diabetes mellitus by regulating various physiological functions.This provides a new direction for the research of gestational diabetes mellitus.(2)Exosomes are widely present in the human body.Various cells can secrete exosomes,such as red blood cells,epithelial cells,and placental cells.Non-coding RNAs found in exosomes from different sources have been demonstrated to play a role in the pathogenesis,diagnosis,and treatment of gestational diabetes mellitus.(3)MiRNA and gestational diabetes mellitus:The role of peripheral blood miRNA in gestational diabetes mellitus is mainly to affect the functions of trophoblast cells,pancreatic beta cells and blood glucose levels in gestational diabetes mellitus;placental miRNA can reflect the severity of gestational diabetes and impair the function of trophoblast cells.(4)LncRNA and gestational diabetes mellitus:Peripheral blood lncRNA can induce insulin resistance through the phosphatidylinositol 3-kinase/protein kinase B pathway and may provide new insights for the diagnosis and treatment of gestational diabetes mellitus;placental lncRNA can regulate proliferation and migration of placental trophoblast cells,promoting the occurrence and development of gestational diabetes mellitus.(5)CircRNA and gestational diabetes mellitus:Peripheral blood and placental circRNA can induce the occurrence and development of gestational diabetes mellitus by impairing the proliferation,migration and metabolism of placental trophoblast cells.(6)Non-coding RNA in exosomes and gestational diabetes mellitus:Peripheral blood non-coding RNA in exosomes can affect gestational diabetes mellitus blood glucose levels and glucose homeostasis,and participate in the occurrence and development of gestational diabetes mellitus by influencing placental function.(7)Non-coding RNA has the potential to serve as biomarkers for early diagnosis of gestational diabetes mellitus.Additionally,engineered exosomes can better achieve targeted therapy for gestational diabetes mellitus.These latest findings provide a reference for both basic research and clinical translation of gestational diabetes mellitus.(8)In the future,improvements in the extraction and purification methods of peripheral blood exosomes should be improved,and factors such as race,diet and physical activity should be excluded to improve the reproducibility of results.Further prospective clinical studies are required to explore the clinical application of circulating non-coding RNA and exosomes in the prediction and diagnosis of gestational diabetes mellitus.

Objective:To explore the high-risk factors for parenteral nutrition associated cholestasis（PNAC）in extremely/ultra-low birth weight infants，and establish a risk Alignment Diagram prediction model.Methods:We retrospectivly analyzed the clinical data of hospitalized extremely/ultra-low birth weight infants admitted to Neonatology Department at Quanzhou Children's Hospital from January 2019 to December 2020，using multivariate Logistic regression analysis to screen for independent risk factors for the occurrence of PNAC.An Alignment Diagram model prediction model for PNAC was constructed by using R software，and the performance of the model was evaluated through receiver operating characteristic curves.Results:A total of 203 extremely/ultra-low birth weight infants were included，with a median gestational age of 29.14（28.00，30.86）weeks and a median birth weight of 1　170（1　000,1　300）g.Among them，26（12.81%）cases developed PNAC.Multivariate Logistic regression analysis showed that the duration of parenteral nutrition（ OR=1.015 ，95% CI 1.003-1.034），the cumulative amount of glucose（ OR=1.014 ，95% CI 1.001-1.028），small for gestational age（ OR=3.455 ，95% CI 1.127-10.589），and neonatal sepsis（ OR=3.142 ，95% CI 1.039-9.503）were independent risk factors for PNAC（ P＜0.05）；The four independent risk factors mentioned above were introduced into R software to construct an Alignment Diagram model，the area under the receiver operating characteristic curve was 0.835（95% CI 0.842-0.731），and the results of the Hosmer Limeshow goodness of fit test show that：χ 2=5.34，degree of freedom=8， P=0.72.A calibration curve indicated good consistency between the predicted probability of the model and the actual occurrence rate，with good accuracy. Conclusion:The Alignment Diagram model constructed based on four independent risk factors of the duration of parenteral nutrition，glucose accumulation，small for gestational age infants，and neonatal sepsis exhibits high predictive ability，and is expected to provide an intuitive and convenient visualization tool for preventing or reducing the occurrence of PNAC in extremely/ultra-low birth weight infants

To prepare recombinant human retinol binding protein 4 (RBP4) by using the baculovirus expression system and to detect its immunogenicity, the fusion DNA fragment of secretory signal peptide SS64 and human RBP4 gene was subcloned into a baculovirus transfer vector pFastBac-dual(pFBd), and the corresponding recombinant transfer plasmid was transformed into E. coli strain DH10bac, after transposition recombinant shuttle bacmid was screened out. The logarithmic phase Sf9 cells were transfected with the recombinant bacmid and then the recombinant baculovirus containing hRBP4 expression box were generated. After amplification of recombinant baculovirus, the recombinant baculovirus seeds were obtained. To express human RBP4, logarithmic phase Sf9 cells were infected with the virus seeds and SDS-PAGE and Western blotting were used to detect and identify the expression. Finally, to prepare a batch of RBP4 protein, logarithmic phase Sf9 cells in suspension culture were infected with recombinant baculovirus seeds and the supernatant was harvested after 120 hours post-infection for purification. Finally for preparation of polyclonal antibody and evaluation of immunogenicity, the recombinant hRBP4 from insect cells and from E. coli were immunized rabbits. Restriction enzyme digestion and sequencing confirmed that the recombinant baculovirus transfer plasmid was constructed correctly, and subsequently recombinant RBP4-bacmid was generated successfully. SDS-PAGE and Western blotting analysis suggested that human RBP4 protein was highly expressed in Sf9 cells with the molecular weight of approximately 23 kDa. The recombinant RBP4 protein could be secreted into the medium efficiently, and the expression level was calculated amount of 100 mg/L. Finally the rabbit antiserum was harvested after recombinant RBP4 immunization, therein the titer of antiserum against baculovirus recombinant RBP4 is 1:100 000 whereas the titer of antiserum against E. coli recombinant RBP4 is only 1:10 000. Overall, human RBP4 was high efficiently expressed successfully with good antigenicity in baculovirus system, and high affinity antiserum was obtained. A solid foundation was laid for the next step of the preparation of human serum RBP4 detection kit.
Animals ; Baculoviridae ; genetics ; Blotting, Western ; Cloning, Molecular ; Electrophoresis, Polyacrylamide Gel ; Escherichia coli ; Genetic Vectors ; Humans ; Immune Sera ; Insecta ; Rabbits ; Recombinant Proteins ; biosynthesis ; immunology ; Retinol-Binding Proteins, Plasma ; biosynthesis ; immunology ; Sf9 Cells ; metabolism ; Transfection