Objective To analyze high risk factors for poor prognosis in the refractory neonatal respiratory distress syndrome(NRDS).Methods A retrospective analysis was conducted at NICU in the Affiliated Hospital of Xuzhou Medical university.The newborns with NRDS,chest radiograph for grades 3 and 4,who required mechanical ventilation and pulmonary surfactant(PS)therapy were recruited from January 2014 to December 2015.According to treatment rusults,they were divided into death group(21 cases)and survival group(25 cases).Data regarding antenatal corticosteroid administration,maternal high risk factors,the basic situation of neonatal in the perinatal period,surfactant applications,the blood routine,albumin,lactate dehydrogenase(LDH),creatine kinase(CK),creatine kinase isoenzyme(CK-MB),blood coagulation function with the first 24 hours after birth were collected and analyzed.Results The frequency of using PS in the death group and the survival group was(2±0.9)times and(1.5±0.6)times,the difference between the two groups was statistically significant(t=2.131,P=0.039).Dangerous placenta previa in death group was 19％(4/21),in the survival group was 0％(0/25),the two groups had statistical differences(x2=5.215,P=0.022).CK in death group was(541.5±399.1)U/L,in the survival group was(345.4±173.3)U/L,the difference between of the two groups was statistically significant(t=2.224,P=0.031).Prothrombin time(PT)in the death group was(23.2±6.3)s,in the survival group was(18.5±3.6)s,there was a significant difference between the two groups(t=3.008,P=0.039).Maternal risk factors of premature rupture of the survival group(38.9％)was higher than that of death group(5.0％),the two groups was statistically significant(x2=4.29,P=0.038).The application of prenatal hormone NRDS newborns were more likely to survive,there was statistical difference between two groups(x2=5.197,P=0.023).Multivariate Logistic analysis showed that PT was an independent risk factor for poor prognosis of NRDS.Conclusion PT is an independent risk factor for poor prognosis of neonatal respiratory distress syndrome.

Objective To study the role of transforming growth factor-β1 (TGF-β1),connective tissue growth factor (CTGF)and endothelin-1 (ET-1) in myocardial tissues of the mice with myocardial fibrosis induced by coxsachievirus B3 (CVB3) and the effect of Carvedilol intervention for it in acute stage and chronic phase of viral myocarditis.Methods Forty male BALB/c mice were randomly divided into 4 groups (10 cases in each group):control group,model group,Carvedilol acute phase intervention group,the chronic phase intervention group.Mice in model group and Carvedilol intervention groups were inoculated with CVB3 (100TCID50/0.1 mL) by peritoneal injection fortnightly.Mice in control group were given normal saline(NS) instead equivalently.Mice were poured Carvedilol (10 mg/kg per day for 2 weeks) from the second day in acute phase intervention group and from the fourth week in the chronic phase intervention group,while mice of control group and model group were poured with equivalent NS instead.At the end of 6 weeks,mice were sacrificed.Heart weight index (HWI) was determined.The collagen volume fraction (CVF) of left ventricular myocardial tissue were examined after Masson staining.Expressions of ET-1,TGF-β1 and CTGF were detected by enzyme linked immunosorbent assay and immunohistochemistry staining respectively; the mRNA expression was tested by reverse transcription-polymerase chain reaction.Results Compared with the control group,HWI and CVF of model group increased significantly(all P ＜ 0.01),those of the intervention groups decreased than those of the model group(all P ＜ 0.01),and in the acute phase those of the intervention group were significantly lower than those in chronic phase intervention group(all P ＜ 0.05).The expressions of TGF-β1,CTGF,ET-1 and their mRNA in model group were increased significantly than those in the control group(all P ＜0.01),and were decreased in acute and the chronic phase intervention group than those in model group(all P ＜0.01),while those were significantly lower in acute phase intervention group than those in chronic phase intervention group (all P ＜ 0.01).Conclusions TGF-β1,CTGF and ET-1 may be involved in myocardial fibrosis induced by CVB3.Compared with the chronic phase intervention,the acute phase intervention of Carvedilol can reduce myocardial fibrosis more efficiently by down-regulating the excessive expression of inflammatory factors.

Objective To compare the difference between modified peroral endoscopic myotomy (Liu?POEM) and conventional POEM for achalasia. Methods Thirty achalasia patients treated with Liu?POEM and 30 with conventional POEM were enrolled. A retrospective study was performed to compare the conventional POEM and Liu?POEM procedures by evaluating total operation time, postoperative complications and symptoms( Eckardt score) . Results The average total operation time of Liu?POEM was 27?13 ±11?42 min and the average myotomy time was 13?20±5?09 min. There was no pneumomediastinum, subcutaneous emphysema or fever. The average total operation time of conventional POEM was 51?22 ± 25?63 min. The average myotomy time was 11?18±7?61 min. There were three cases(10%) of subcutaneous emphysema but recovered after two days without any special treatment. One patient who underwent conventional POEM had fever( the highest temperature was 37?6℃) and his temperature subsided to normal after physical cooling in one day. Postoperative Eckardt scores of patients were all less than 3. After postoperative follow?up of 3 to 12 months, no complications occurred in any patient. Conclusion Liu?POEM is a modified approach to treat achalasia, advantageous over conventional POEM in more simplified operation procedure, shorter operation time and less invasiveness.

Objectives To observe the changes of apoptosis-related proteins during the development of sarcopenia and to explore the effect and mechanism of long-term aerobic exercises and heat shock protein 70 (HSP70) on those changes for the natural aging C57BL/6 mice.Methods After 1 week of acclimatization,50 27-week-old male C57BL/6 mice were randomly divided into a young sedentary control (YS) group,an old sedentary control (OS) group and an old exercises (OE) group.After the gripstrength was measured the mice from group YS were sacrificed at the age of 28 weeks.The mice from group OE exercised on a fiat treadmill at 12rn/minute for 50 min 3 or 4 times a week for 30 weeks with the intensity of 75％ VO2max.At the age of 60 weeks,the mice of group OS and OE were killed after their grip-strength was measured.The gastrocnemius muscle of each group were isolated and weighted,and the sarcopenia index (SI) was measured.Then the total protein of the gastrocnemius muscle was extracted.HSP70 and cleaved caspase-9 expression were examined.The binding rate of HSP70 and Apaf-1 was measured using Co-Immunoprecipitation.TUNEL staining was performed to detect the apoptosis of the gastrocnemius muscle.Results (1) Compared with group YS,SI of group OS decreased significantly by 23.09％,but significant increase was observed in group OE compared to group OS by 30.48％.(2) The grip strength per gram of body weight of group OS decreased significantly by 42.74％ compared to group YS,while that of group OE increased significantly by 21.51％ compared to group OS.(3) The apoptosis index increases by 475.28％ with age.However,the index decreased by 46.41％ in group OE over group OS.(4) Western blotting showed that the expression of cleaved caspase-9 increased significantly by 45.4％ in group OS compared to group YS,while that of group OE decreased significantly by 33.4％ compared to group OS.(5) The binding rate of HSP 70 with Apaf-1 of group OS decreased significantly by 67.11％ compared to group YS,while that of group OE increased significanlty by 306.31％ compared to group OS.Conclusions (1) Gastrocnemius atrophy occurring to mice of 60 weeks can be significanlty delayed through 30-week exercises training.(2) The increasing apoptosis may be involved in the development of age-related sarcopenia and 30-week exercises can significantly attenuate such apoptosis in rodent skeletal muscle.(3) Aerobic exercises increases HSP70/Apaf-1 interaction,which might play an important role in reducing age-related cellular damage and cell death in the skeletal muscle of rats.

Objective: To investigate mechanism on the restenosis after percutaneous transluminal coronary angioplasty (PTCA) with FSZ (Hirudo, Rhizoma Coptidis, Radix et Rhizoma Rhei, Radix Curcumae, Rhizoma Polygonati Odoroti, etc) by studying the protective effects of FSZ on arrhythmia and injury induced by ischemia and reperfusion.Methods:Rats were randomly divided into four groups and administered orally with FSZ. Left coronary artery ligature was used to form ischemia and reperfusion model. Lipid peroxidation (LPO), superoxide dismutase (SOD), cyclic adenosine monophosphate (cAMP), area of myocardial infarction, myocyte ultrastructural injury and occurrence of arrhymia were investigated.Results: FSZ could improve the changes in ST segment. In rats treated with FSZ, the levels of SOD were elevated while cAMP, LPO, and the specific viscosity of whole blood or plasma and the aggregation of the platelet were lowered, keep to improving the hemorheological changes. It also could antagonize the myocardial damage by myocardial ischemia or reperfusion reduced the area of myocardial infarction. Especially, Fufangshuizhijing Capsule reduced the area of left ventricular (LV) compared with the control group remarkably.Conclusion: FSZ could obviously antagonize arrhythmia and the injury induced by the ischemia and reperfusion, FSZ may scavenge oxygen free radical, regulate the second messenger, remarkably improve the local circulation to reduce the specific viscosity of whole blood of plasma and the aggregation of the platelet in rats, protect mitochondria safeguard the cardiac myocyte to treat PTCA.

Objective To establish a serum-free primary culture method for cortical neurons of new-born rats .Methods The cortical tissue was digested and the cells were planted in the medium containing 10% fetal bovine serum ,and then maintained feed-ing with neurobasal medium containing B27 after 4 to 8 h .The morphology was observed under phase-contrast microscope .RT-PCR ,Western blot and immunocytochemistry were applied to identify the expression of NSE gene and protein in neurons .Results A large number of neurons began to adhere to the cover glasses after 2 to 8 h .They showed different shapes-shuttle ,triangle pyram-idal ,or no regular after clinging to the plate .Their processes connected to nets and were different in length and thickness .They well developed at the 7th to 10th day .The isolated and cultured cells were confirmed as neurons by RT-PCR ,Western blot and immuno-cytochemistry .Conclusion This technique is an easy and practical tool for primary culture of new-born rats cortical neurons with high purity ,and can be used as an in-vitro model of research .

Objective To investigate the effect of 6-week high-intensity interval training(HIIT) on the body composition and the autophagy activation in skeletal muscle of C57BL/6 mice,and explore the underlying role of adenosine 5'-monophosphate(AMP)-activated protein kinase(AMPK)α2 in this process.Methods Thirty-six 4-week old male mice with the genotype AMPKα2+/+(n=12),AMPKα2+/-(n=12) and AMPKα2-/-(n=12),were randomly divided into a control(n=6) and an HIIT group(n=6) respectively.The mice from the HIIT group exercised on a motor-driven rodent treadmill for 5 days a week,lasting 6 weeks.The procedure of HIIT included the intensity of 85％ VO2max(20m/min) for 2 min/day and 50％ VO2max(8m/min) for 1 min/day with 12 cycles alternately.The body weight,body mass index(BMI),total body water and fat mass were measured and analyzed after the 6-week exercise.The protein expression of AMPKα2,pAMPK-Thr172,LC3Ⅱ/Ⅰ,Beclin1 and p62 in the skeletal muscle tissue were detected using Western blotting.Results Before exercise,there was no significant difference between the mice of the same genotype in the body weight.However,a significant decrease was observed in the body weight of all the HIIT mice,and BMI of the AMPKα2+/+ and AMPKα2+/-mice undergoing HIIT.There were no significant differences in the total body water between the control and HIIT groups of the same genotype after the intervention.There was significant decrease in the body fat mass in the HIIT group of AMPKα2+/+ and AMPKα2+/-mice after the intervention,while the decrease was not significant in the HIIT AMPKα2-/-mice.The protein expression of pAMPK-Thr172,LC3Ⅱ/Ⅰ and Beclin1 increased significantly,and that of p62 decreased significantly in the skeletal muscle of the AMPK+/+ and AMPK+/-mice after HIIT intervention,but not the AMPK-/-mice.Conclusion HIIT can improve health indicators(i.e,body weight,BMI and fat mass) and enhance autophagy activation in the skeletal muscle through increasing the phosphorylation of AMPKot2.

BACKGROUND:Resection of femoral neck in the conventional total hip replacement greatly influences the equilibrium of forces jn the proximal fetour and causes disequilibrium of bone reconstruction,easily resulting in bone absorption,prosthesis loosening and dislocation.OBJECTIVE:To investigate the biocompatibility between materials and host in the total hip replacement with femoral neck preserved.DESIGN,TIME AND SETTING:A retrospective case analysis was performed in the Department of Orthopedics,the 180 Hospital of Chinese PLA between September 2000 and December 2006.PARTICIPANTS:Twenty-five patients.10 males,15 females,aged 47 years old(range 31-56 years old)were recruited for this study.Twelve patients suffered from femoral head necrosis-caused hip joint disease and osteoarthrosis(bilaterally affected in 5 patients),eight femoral head necrosis(femoral head necrosis subsequent to femoral neck fracture healing in 2 patients),three acetabular dysplasia necrosis of femoral head,and two infra-head femoral neck fracture nonunion.The course of disease averaged 6 years old ranging from 2-10 years.METHODS:Modified hip ioint posterior approach was used to expose the hip joint.Femoral head was resected from the femoral head-neck iuncture.Cartilago acetabularis was stripped and then artificial acetabulum was installed.Femoral proximal medullary cavity was expanded.Artificial femoral head was installed.Finally,all artificial joints were reduced.MAIN OUTCOME MEASURES:(1)Biocompatibility between prosthesis and host.(2)Function recovery of hip joint.RESULTS:All wounds were primarily healed.Patients were followed up for 0.5-6 years on average.Follow-up results demonstrated good hip joint motion and normal walking gait.X-ray showed well-positioned artificial hip joint,absence of prosthesis loosening and dislocation,as well as good femoral neck sclerotin.CONCLUSl0N:The preservation of femoral neck in total hip replacement is fit to the physiological compliance of proximal femar and prevents osteoporosis-induced prosthesis loosening and dislocation in the proximal femur.

From June 2017 to September 2019, 5 patients who were diagnosed as having benign severe pyloric stenosis underwent fully covered stent placement using a new stenting method at the First Affiliated Hospital of Zhengzhou University. Five patients were performed successfully without serious complications. Postoperative barium meal radiograph revealed that the stents were in good location and the acontrast agent passed smoothly. The liquid diet was commenced 1-3 days after surgery. No vomiting, abdominal pain and diarrhea occurred. During the follow-up, all the patients had improved weight and nutritional status. Four patients underwent stent removal 3-4 months postoperatively. One patient was found that the stent had migrated to stomach 3 months after discharge. After removing the stent, balloon dilation and mucosal resection was performed for the mild pyloric stenosis. All 5 patients had an additional follow-up of 3 months, and no symptoms and restenosis occured. These preliminary results showed that the new stenting method of fully covered stent placement is feasible, safe and effective in the treatment of benign pyloric stenosis.

Objective:To study the safety and effectiveness of endoscopic full-thickness resection(EFR) in the treatment of large gastric stromal tumors with diameter of 5-7 cm.Methods:Data of 36 patients with large gastric stromal tumors (5-7 cm) who received EFR or surgery (including laparoscopic and open surgery) in the First Affiliated Hospital of Zhengzhou University and confirmed by postoperative histopathology from January 2017 to October 2018 were retrospectively analyzed. Patients were divided into endoscopic group (9 cases) and surgical group (27 cases) according to different resection methods. The perioperative indicators and the total incidence of complications in the two groups were compared.Results:In terms of perioperative indicators, the median operation time of the endoscopic group was significantly longer than that of the surgical group (4.0 hours VS 2.0 hours, P<0.01), and the postoperative fasting time (4.55±0.88 days VS 6.22±2.24 days, t=-2.15, P=0.03) and hospital stay (6.88±1.26 days VS 10.03±2.90 days, t=-3.13, P<0.01) were significantly shorter than those of the surgical group. The median visual analogue scores (VAS) of abdominal pain of the endoscopic group on the first postoperative day (3 VS 6, P<0.01)and the third postoperative day (1 VS 3, P<0.01) were significantly lower than those of the surgical group. The hospitalization cost was significantly less than that of the surgical group (55±14.7 thousand yuan VS 73±24.3 thousand yuan, t=-2.11, P=0.04). In term of the total incidence of complications, the endoscopic group was 11.1% (1/9), which was higher than that of the surgical group [7.4% (2/27)], but there was no statistically significant difference( P=1.00). Conclusion:EFR is safe and effective in the treatment of large gastric stromal tumors (5-7 cm), and has the advantages of less invasiveness, rapid postoperative recovery, and lower hospitalization cost. But how to shorten the operation time is an urgent problem to be solved.