Objective To investigate the risk factors and predictors of poor outcome in full-term neonates with severe hyperbilirubinemia. Methods Data were retrospectively collected from 326 neonates with severe hyperbilirubinemia hospitalized between January 1, 2012 and December 31, 2012. Results A total of 326 full-term neonates with severe hyperbilirubinemia were included in this study (181 males and 145 females). The average gestational age was 39.12±1.17 weeks. Two hundred and sixty (260) cases were followed up successfully by phone while 66 cases were lost to follow-up. Infection (74.40%) and hemolytic disease (51.19%) were the main causes of severe hyperbilirubinemia. Multiple factors regression analysis found that threshold TSB was an independent risk factor of poor outcome (OR=2.02, 95%CI:1.13~3.62, P=0.018). The outcome of neonates with BIND scored between 0-6 had poor prognosis and some of them were reversible, and the outcome in those scored between 7-9 were of worse prognosis. Threshold TSB, USB and B/A ratio in group of poor outcome were signiifcantly higher than those in other groups and their area under the ROC curve evaluating the prognosis was 0.682, 0.671 and 0.698, respectively. With TSB at 474.5 μmol/L, UCB at 449.15 μmol/L and B/A at 0.923 mg/g, Youden index was the higest. The results of BAEP, OSE, MRI and NBNA were not signiifcantly different between groups with or without poor outcome. Conclusions Threshold TSB is an independent risk factor of poor outcome in full-term newborns with severe hyperbilirubinemia. BIND score is a very good predictor of outcome. TSB threshold, USB and B/A ratio are the predictors of outcome, but their diagnostic values are limited. NBNA, hearing screening and hyperintense globus pallidus on T1W1 in the acute phase of jaundice might not related with neurologic prognosis.

Objective To discuss which drainage method is more efficient in treatment of choledocholithiasis with obstructive jaundice. Methods Compared the difference of serum total bilirubin,direct bilirubin, the variation of serum total bilirubin and direct bilirubin before and after drainage and daily biliary drainage by endoscopic nasobil-iary drainage (ENBD) and endoscopic nasobiliary drainage with continuous negative-pressure suction after three days. Results The daily biliary drainage about the patients by ENBD with continuous negative-pressure suction is much more effective than the patients by ENBD. The serum total bilirubin and direct bilirubin about the patients by ENBD with continuous negative-pressure suction is less than the patients by ENBD after three days. The variation of serum total bilirubin and direct bilirubin before and after drainage about the patients by ENBD with continuous neg-ative-pressure suction is more than the patients by ENBD. Conclusion The ENBD with continuous negative-pres-sure suction is more effective for choledocholithiasis with obstructive jaundice.

Hazardous Substances ; Risk Assessment ; methods ; Workplace

[Summary] Extracellular calcium is essential for the regulation of a variety of biological processes. Calcium-sensing receptor (CaSR) plays a central role in maintaining Ca2+ homeostasis, while G-protein α-11 (Gα11 ) subunit and adaptor-related protein complex 2 sigma (AP2σ) are also involved in CaSR signaling transduction. Loss- or gain-of-function mutations of these encoding genes cause different types of familial hypocalciuric hypercalcaemia (FHH) and autosomal dominant hypocalcaemia (ADH). Calcimimetic and calcilytic drugs are useful in treating these FHH and ADH disorders. The current paper is a Chinese translation of a review entitled as “Disorder of the calcium-sensing receptor and partner proteins: insights into the molecular basis of calcium homeostasis” published in 《 Journal of Molecular Endocrinology》(2016,57:R127-R142) with the permission from the author and the journal.

The identification of the specific cause in every patient has important clinical implications, because ischemic stroke is an etiologically heterogeneous disease. The Trial of Org 10172 in Acute Stroke Treatment (TOAST) classification can be used to define the etiology of stroke. However, TOAST classification can not be completed timely on admission of patients with acute stroke, which has impacted early guidance of clinical treatment. This article reviews the biological markers of early differential-diagnostic significance of the TOAST classification.

Infectious endophthalmitis refers to the acute suppurative inflammation of the uveal and retinal, with acute onset, severe symptoms, and poor prognosis.Early diagnosis and effective treatment is particularly important.Based on the way of intraocular infection, endophthalmitis can be divided into endogenous endophthalmitis and exogenous endophthalmitis.In the East Asian, liver abscess is the main source of endogenous endophthalmitis, and Klebsiella pneumoniae is the main pathogen.Liver abscess endophthalmitis is a serious cause of blindness caused by intraocular infection.A liver infection disseminated through hematogenous and the primary focus was hidden, which makes the disease was easy to be confused with immune related uveitis, causing high misdiagnosis rate, delaying the best time for diagnosis and treatment.In this article we reviewed the etiology, clinical features, diagnosis and treatment and prognosis of endogenous endophthalmitis caused by liver abscess.Clinicians should maintain a high index of suspicion to the endogenous endophthalmitis caused by liver abscess.

There is a high incidence of esophageal cancer(EC) in China.The survival and prognosis of EC is unoptimistic due to the lack of efficient early diagnostic markers.There is an urgent demand of novel biomarkers with more stability,sensitivity and specificity.miRNAs are a class of small non-coding single stranded RNAs consisting of 21-23 nucleotides,which are involved in the pathological and physiological process of life activities.miRNAs are stable not only in tumor tissues,but also in serum/plasma.There are significant differences in the expression patterns of circulating miRNAs between two main types of EC.They are closely related to the occurrence and progression of EC,which make circulating miRNAs a novel kind of biomarkers for differential diagnosis,early supervision of esophageal cancer,and prognosis.

Objective To assess the preventive effects of FK506 and Leflunomide (Lef) on islet xenograft acute rejection in rat-to-mouse models. Methods The islets of rat were transplanted under the kidney capsule of streptozotocin-induced diabetic mouse. The recipients were randomly divided into control group, un-treatment group, mono-therapy group and combination-therapy group. All immunosuppressants were administrated daily from 0 to 9 days. CD4 +\, CD8 + T-cell subsets and IL-2 were examined on the 5?th day after transplantation. Results Compared with un-treatment group, xenoislet survival could be significally prolonged in mono-therapy group. Combination-therapy of FK506 with Lef could significantly prolong the survival of xenoislet when compared with FK506 or Lef used alone. The number of CD4 + T-cells in mono-therapy group and combination-therapy group was much less than in un-treatment group. Conclusion Both FK506 and Lef can suppress proliferation of CD4 + T-cells and prevent or delay islet xenograft rejection.

Objective To investigate the baseline factors that influenced prognosis after intravenous thrombolytic therapy. Methods All 82 patients received intravenous urokinase (UK) for acute ischemic stroke. The modified Rankin scale score at 90 days was dichotomized into good outcome (mRS 0-1) and poor outcome (mRS 2-6) as the primary outcome measure. Multivariable logistic regression method was used to analyze independent predictors of good outcome. Results The mRS was good in 36.6% and poor in 63.4%. Univariate analysis indicated that age, time from stroke onset to treatment, atrial fibrillation, pretreatment ESS score, baseline serum glucose, early ischemic changes on baseline CT scans and dose of UK were shown correlated significantly with mRS. However, the multivariate logistic regression did select the ESS score, time to treatment, dose of UK and serum glucose as the independent predictors of good outcome. Conclusion Pretreatment ESS score, time to treatment, dose of UK and baseline serum glucose should be independently predictive of outcome in patients with acute cerebral infarction treated by intravenous UK.

Objective To establish the biostereometric system of breast volume measurement and to estimate the precision and reliability of the designed system. Methods Biostereometric system of breast volume measurement was built upon the biostereometrics based on computer stereo vision and image processing. One laser projector was used as illuminating source, two CCD cameras were mounted for photo-taken, a series of parallel points were provided through a piece of grating. The volumes of 12 female breast models were tested by water displacement (golden standard) and biostereometric analysis. Results The maximum size of marks we photographed was within 120 mm?140 mm?80 mm. The characters of the system was rapid, non-contact and noninvasive. The validity and reliability of determination of breast volume between biostereometric system and golden standard had no significant difference, compared to water displacement (P=0.473). Conclusions Biostereometric system of breast volume measurement will be suited for the clinical application. The study offers a noninvasive, non-contact, rapid and accurate morphologic method and provides a new theory foundation for morphological analysis.