Objective To investigate the clinical value of INSURE technology in very low and extremely low birth weight infants requiring respiratory support.Methods From June 2010 to August 2012,83 cases of very low and extremely low birth weight infants who had difficulty in breathing and required respiratory support were admitted into First Hospital of Tsinghua University and divided into two groups:INSURE group (n=41) and mechanical ventilation (MV) group (n=42).Infants in INSURE group accepted intubate-pulmonary surfactant-extubate to continuous positive airway pressure and those in MV group accepted intubation with or without pulmonary surfactant treatment,and mechanical ventilation without extubation.Arterial blood gases at 1 h and 12 h after treatment were compared between the two groups by t test.The incidence of respiratory distress syndrome,ventilator associated pneumonia,air leaking,chronic lung disease,intracranial hemorrhage,retinopathy,leukoencephalomalacia disease were compared with Chi-square test.Hospitalization costs,duration of ventilation,oxygen inhalation and hospital stay were compared by rank-sum test.Results (1) PO2 in INSURE group after one hour of treatment were (78.7 ±11.5) mm Hg(1 mm Hg=0.133 kPa),which were higher than those before treatment [(50.1 ±10.8) mm Hg,t=9.737,P＜0.05]; while PCO2 was lower[(48.3±8.9) mm Hg vs (54.9±11.5) mm Hg,t=-3.428,P＜0.05].PO2 in MV group after one hour of treatment were (80.2±10.0) mm Hg,which were higher than those before treatment [(51.3±9.8) mm Hg,t=10.093,P＜0.05]; while PCO2 was lower[(45.6±9.5) mm Hg vs (57.1±12.8) mm Hg,t=-4.526,P＜0.05].(2) There were no difference in PO2 and PCO2 between the two groups after one hour of treatment (P＞0.05).After 12 hours of treatment,no differences were found in PO2[(89.4±11.5) mm Hgvs (90.2±10.8) mm Hg,t=0.093] and PCO2[(44.2±5.9) mm Hg vs (39.1± 7.3) mm Hg,t=0.126] between INSURE group and MV group (P＞0.05 respectively).(3) The incidence of ventilator associated pneumonia,air leaking,intracranial hemorrhage and chronic lung disease in INSURE group were 7.3％ (3/41),4.9％ (2/41),4.9％ (2/41) and 4.9％ (2/41),which were lower than those in MV group [34.1％ (14/42),x2=27.470; 16.7％ (7/42),x2=8.651;19.0％ (8/42),x2 =8.814; 11.9％ (5/42),x2 =4.275](P＜0.05 respectively).Duration of ventilation,oxygen inhalation,neonatal intensive care unit stay in INSURE group were 5 d (3-7 d),8 d (5-11 d) and 16 d (11-25 d),which were all shorter than those of MV group [8 d (4-12 d),Z=-1.947; 12 d (8-22 d),Z=-2.013; 21 d (12-35 d),Z=-1.782](P＜0.05 respectively).Conclusions INSURE technology could be used in very low and extremely low birth weight infants because of less invasiveness,fewer complications,safety and low-cost.

Objective To investigate the early diagnosis of myocardial injury after neonatal asphyxia based on the clinical manifestations of myocardial injury, electrocardiogram (ECG), cardiac enzymes and tissue Doppler echocardiography. Methods From January 1, 2013 to June 30, 2014, 101 cases of neonatal asphyxia in the neonatal intensive care unit of the First Hospital of Tsinghua University, with gestational age> 37 weeks and birth weight > 2 500 g, were enrolled. Apgar scores were used to diagnose neonatal asphyxia. Myocardial damage after neonatal asphyxia was diagnosed according to the hypoxia history, clinical presentation, ECG and cardiac enzymes. According to the umbilical arterial blood gas analysis, severe asphyxia was divided into two groups:the severe asphyxia with severe acidosis group and the severe asphyxia without acidosis group. The incidence of myocardial damage, clinical manifestations associated with myocardial damage, ECG and myocardial enzymes [creatine kinase isoenzyme MB (CK-MB) and cardiac troponin T (TnT); control group involved 50 cases for the same period of admission with newborn jaundice] and echocardiography (control group involved 30 cases for the same period with normal term delivery) were compared among the three groups [mild asphyxia (n=72), severe asphyxia with severe acidosis (n=18) and severe asphyxia without severe acidosis (n=11)]. One-way ANOVA, the LSD test, Kruskal-Wallis test for independent samples, Chi–square test and Fisher's exact test were used for statistical analysis. Results (1) The incidence of myocardial damage after asphyxia was 34.6%(35/101). It was higher in the severe asphyxia group than in the mild asphyxia group [62.1%(18/29) vs 23.6% (17/72), χ2=7.549, P=0.006]; and it was higher in the severe asphyxia with severe acidosis group than in the severe asphyxia without severe acidosis group (14/18 vs 4/11, Fisher's exact test, P=0.048). (2) Clinical manifestations: The proportion of bradycardia was greater in the severe asphyxia with severe acidosis group (13/14) than in the severe asphyxia without severe acidosis group (1/4) and the mild asphyxia group (7/17);the differences were statistically significant (Fisher's exact test, P=0.019 and 0.007). (3) ECG: Eighteen cases (51.4%, 18/35) showed ECG abnormalities. (4) Cardiac enzymes:CK-MB 48 h after birth in the severe asphyxia with severe acidosis group, severe asphyxia without severe acidosis group, mild asphyxia group and the control group were 78.72 (34.63-122.01), 31.71 (21.33-37.12), 23.11 (14.61-36.02) and 11.82 (8.64-18.93) μg/L, respectively. CK-MB in the severe asphyxia with severe acidosis group was higher than in the severe asphyxia without severe acidosis group, mild asphyxia group and the control group (H=48.425, 90.040 and 96.045, respectively, all P<0.01). After treatment for 5-7 days, there was no statistically significant difference in these four groups (H=7.165, P=0.416). TnT 48 h after birth in the four groups was 0.19 (0.12-0.39), 0.11 (0.06-0.34), 0.07 (0.05-0.13) and 0.06 (0.04-0.08) μg/L, respectively. TnT in the severe asphyxia with severe acidosis group was higher than in the other three groups (H=45.753, 44.665 and 61.215, respectively, all P < 0.01). Despite the reduced TnT level after treatment for 5-7 days, TnT in the severe asphyxia with severe acidosis group was higher than that in the other three groups (H=17.520, 21.122 and 43.286, respectively, all P<0.01). (5) Echocardiography:Twenty cases (57.1%, 20/35) showed abnormalities. The values of mitral systolic peak velocity and late diastolic peak velocity in the severe asphyxia with severe acidosis group were lower than those in the control group found by tissue Doppler echocardiography [(3.4±0.3) vs (4.8±0.3) cm/s, (4.1±0.2) vs (6.0±1.1) cm/s, respectively, t=3.293 and 2.542, both P < 0.05]. Conclusions Myocardial damage can occur after neonatal asphyxia. Cord blood pH value should be combined to determine the severity of asphyxia. Myocardial damage is more serious in the severe asphyxia with severe acidosis group. Clinical manifestations should be taken seriously, and laboratory examinations should be improved for early diagnosis and treatment.

Objective To understand the effects of various decoration materials and furniture on indoors air quality. Methods Formaldehyde, benzene and ammonia were monitored in indoor air of some residential buildings in Guangzhou. The residential rooms were divided into two groups, one was simply decorated group, the other was completely decorated group and the two groups were compared. The questionnaire was also carried out. Results The average concentrations of formaldehyde of the two groups were 0.338 mg/m3 and 0.027 mg/m3 respectively, the rates of exceeded standard were 57.14%, 6.67% respectively, and the difference between the two groups was obvious (P

Atherosclerosis ; genetics ; Chromosomes, Human, Pair 9 ; Humans ; RNA, Long Noncoding

Objective To investigate whether the gamma-aminobutyric acid (GABAB) receptor genes,including gabbr1 gene and gabbr2 gene,are the susceptible genes for simple febrile seizures (sFS) by screening mutation of gabbr1 gene and gabbr2 gene and to study the possible association between sFS and the 2 genes.Methods All exons and flanking introns of gabbr1 gene and gabbr2 gene were amplified with polymerase chain reaction (PCR) and sequenced to screen the possible mutation on 60 children with sFS in the northern China in Han nationality population.One hundred and one healthy children from the same area were selected as controls,and the genotypes of single nucleotiole polymorphisms (SNPS) (rs29220,rs29230,rs29267 on gabbr1 gene and rs1000440,rs3205936,rs2304391 on gabbr2 gene) were typed by PCR-restriction fragment length polymorphism.EH1.20 software was used to estimate haplotype frequency to study the association with the haplotype as genetic marker between case group and control group.Results No mutation associated with sFS was found in the 60 sFS cases.In all sequenced regions,23 SNPs were identified in both genes:6 SNPs in gabbr1 gene and 17 SNPs in gabbr2 gene.The frequencies of the 6 SNPs were complied well with the Hardy-weinberg equilibrium in sFS group and normal group.Genotype proportions and allele frequencies of 6 SNPs were not significantly different between both groups.The haplotypes of 3 SNPs in gabbr1 gene and in gabbr2 gene distributions were not significantly different between 2 groups.Conclusions No mutations and associations were identified between sFS with both GABAB receptor genes(gabbr1 gene and gabbr2 gene).They may not be the susceptibility gene for simple febrile seizures in Han nationality population in northern China.

Objective To preliminarily analyze the credibility and validity of Chinese Medical Constitution Questionnaire(CMCQ).Methods CMCQ was used to investigate the distribution of Chinese medical constitution types of 450 women inpatients with postoperative nausea and vomiting (PONV) after gynecologic laparoscopic surgery from March to October of 2013.Credibility and validity were analyzed by Cronbach's α coefficient and factor analysis.Results Mixed constitution was identified in 184 (40.9％) patients.Cronbach's α coefficient of two dimensions (yang deficiency and qi stagnation) of CMCQ was proper,being 0.815 and 0.803 respectirely,while that of the dimension of harmony type was the lowest (0.514).The total variance explained by 9 common factors extracted from the results of factor analysis was only 48.5％.Conclusion CMCQ may need further revision based on the results of clinical application.

The paper introduces the system design of internet platform in novelty assessment and selective dissemination of informa-tion of medical science and technology project in Zhejiang province, including the exploitation of environment , processing of novelty as-sessment and selective dissemination of information as well as main function design. This system has noticeable advantages, such as com-prehensive functions, multiple participation, transparent service process, which could finish the relevant work on the internet, improve the quality of information service and enhance the efficiency.

Objective To investigate the clinical efficacy of domestic porous tantalum rod in treatment of early avascular necrosis of femoral head (ANFH).Methods A prospective study was made on 18 cases (19 hips) diagnosed as early ANFH treated by domestic porous tantalum rod from July 2014 to December 2015.There were 14 males and four females, with a mean age of 44.2 years (range, 30-62 years).According to the modified Ficat staging, four cases were identified as stage Ⅱa and 14 stageⅡb.Efficacy of the treatment was evaluated by Harris score, Womac score, radiological images of the hip, complications and bone growth.Results All cases were followed up for 8-24 months (mean, 16 months).No complications such as infection, wound healing problems, immunological rejection, tantalum rod breakage, loosening or displacement were observed at last follow-up.Harris score was (82.7±9.0)points, (84.5±10.8)points and (87.2±10.0)points at postoperative 3, 6 and 12 months respectively, significantly higher than that pre-operation [(75.5±11.9)points] (P<0.05).Harris score was rated excellent in 10 cases, good in three, fair in five and poor in one at the last follow-up, with the excellent and good rate of 68%.Womac score was (17.4±9.4)points, (12.4±7.3)points, and (11.1±8.4)points at postoperative 3, 6 and 12 months respectively, significantly lower than that pre-operation [(28.3±13.1)points] (P<0.05).Seventeen cases (18 hips) showed no obvious deterioration in femoral head necrosis, with femoral head survival rate of 95%.One case underwent total hip arthroplasty after operation because of progressive hip pain and collapsed femoral head.Bone ingrowth was detected in the porous tantalum biomaterial after operation.Conclusion Domestic porous tantalum rod can effectively promote bone ingrowth, relieve pain, prevent the collapse of the femoral head, delay total hip arthroplasty time and finally improve hip function in treatment of early avascular necrosis of femoral head.

Objective To detect the recombinant intermediates of hepatitis B virus (HBV) between genotype B and C in vitro. Methods Vector Plenti6/V5-D-topo-X was genetically modified by genotype B and C to transfect HepG2 cells. Then the HepG2 cells were amplified and sequence of the nucleic acid after the transinfection was tested and compared with RDP3Beta40 software package and bootscanning procedure in SimPlot program package. Results Three recombinant intermediates of HBV between genotype B and C were identified in vitro. Genotype C in the precore region plus the core gene spanning nucleotide positions from 1740-1838 to 2443-2485 contributed to the recombination with genotype B. Isolate R1 recombinant intermediate had 2 break points at nt2170-2172 and nt2188-2189. Nucleic acid changed from CAC to TGT and from GA to AC, respectively. Isolate R2 recombinant intermediate had a break point at nt1740-1 838, and 3 bases changed in different nucleic acid sites: from A to T at nt1740, from C to T at nt1753, and from G to A at nt1838, respectively. Isolate R3 recombinant intermediate had a break point at nt2443-2483, and 4 bases changed in different nucleic acid sites: from C to T at nt2443, from A to G at nt2452, from T to C at nt2480, and from C to T at nt2483, respectively. Conclusion The recombinant intermediates of HBV between genotype B and C have been detected in vitro and the changes have been identified in the precore region plus the core gene in genotype B and C.