Objective To investigate the incidence of brain injury and analyze the risk factors in very low birth weight infants (VLBWI),in order to explore methods to improve neurodevelopmental outcome.Methods This was a retrospective study in which we reviewed the incidence of brain injury in 326 VLBWI who admitted to our NICU from October 2007 to September 2014.The differences of general characteristics,high-risk perinatal factors,complications of prematurity and respiratory support in brain injury group (n =132) and no brain injury group(n =194) were analyzed,and Logistic regression was used to analyze the related risk factors.Results In 326 VLBWI,premature brain injury was observed in 132 cases(incidence of 40.49％).Hemorrhagic brain injury was observed in 80 cases(incidence of 24.54％,80/326),in whom total 66 cases (20.25％,66/326) with periventricular-intraventricular hemorrhage (PVH-IVH),41 cases with PVH-IVH grade Ⅰ-Ⅱ,25 cases with PVH-IVH grade Ⅲ-ⅣV.Non-hemorrhagic brain injury was observed in 52 cases (incidence of 15.95 ％,52/326),in whom 46 cases with periventdcular leukomalacia (14.11％,46/326).There were no statistically significant differences in general characteristics except gender differences between the two groups.Further analysis of the 28 factors including high-risk perinatal factors,premature complications and respiratory support between the two groups,showed that there were significant differences in 16 factors including asphyxia,chorioamnionitis,antenatal steroid use,neonatal respiratory distress syndrome,hypoxemia,apnea,pulmonary hemorrhage,patent ductus artedosus,hypotension,acidosis,hypocapnia,anemia,hyperglycemia,thrombocytopenia,high frequency ventilation and extrautedne growth retardation.Further binary Logistic regression analysis showed that antenatal steroids use was negatively correlated with brain injury,chorioamnionitis,acidosis,and patent ductus arteriosus were positively correlated with brain damage,the relative risks of premature brain injury was 0.108,7.222,3.045 and 4.565 respectively.Conclusion The mortality rate and the incidence of brain injury in VLBWI are still high.Chorioamnionitis,acidosis and patent ductus arteriosus are closely associated with premature brain damage.Antenatal steroids can prevent premature brain injury.We should pay much attention to these risk factors in the perinatal management of VLBWI,in order to decrease the incidence of premature brain injury.

Objective:To assess whether familial occurrence has an influence on the morphological characteristics of patients with nonsyndromic cleft lip and/or palate (NsCL/P).Methods:A case-control analysis was performed on the morphological characteristics of familial group and sporadic group,using medical records of 1967 patients with NsCL/P treated in the Affiliated Stomatological Hospital of Nanchang University from 2002 to 2014.Results:164 (8.34％) cases presented a positive history of cleft in their families.The cleft types,the positive familial rate of cleft lip only (CLO),cleft lip and alveolar ridge(CLA),cleft lip and palate (CLP) and cleft palate only (CPO) were 8.11％,8.54％,6.19％ and 9.65％ respectively.A positive family history of NsCL/P was associated with 0.66 times risk of CPO (P =0.036,OR =0.66,95％ CI 0.44-0.98) compared to those of CLO,CLA and CLP.In familial group of CLP,the lateral incidence of male patients was different from that of female patients (P ＜ 0.001).There was no significant difference between familial group and sporadic group on birth weights,parental child-bearing age and clinical manifestations of patients.Conclusion:Familial occurrence might have an influence on cleft type,laterality and gender of the patients with NSCL/P.

Objective To observe the effect of bone morphogenetic protein-7 (BMP-7) on proliferation,activation and TGF? signaling in TGF?1 inducing hepatic stellate cells (HSC),and its anti-fibrosis mechanism.Methods Human HSC LX-2 cell line was treated with BMP-7 at different concentrations (80,40,20 ng/ml) and TGF?1(5 ng/ml).Proliferation of HSC LX-2 cells was detected with cell counting kit-8 (CCK8).Expressions of ?-smooth muscle actin (?-SMA) and collagen Ⅰ,as well as TGF receptors Ⅰ and Ⅱ (TGF?RⅠ,TGF?RⅡ) mRNA,Smad 3,7 mRNAs,were detected by immunocytochemical assay and RT-PCR,respectively.Results No significant difference was found in proliferation of LX-2 cells before and after treatment with TGF?1.BMP-7 used at different concentrations (80,40,20 ng/ml) inhibited the proliferation of LX-2 with an inhibition rate of 28.9%,19.6% and 10.5%,respectively (P

To construct “developmental assessment” in the course of emergency nursing and inten-sive care nursing by applying the combination of formative assessment and summative evaluation, the com-bination of qualitative assessment and quantitative assessment and the incorporation of self-assessment and other evaluation. Specifically, this project contains investigation activity (accounting for 10%), operating activity (10%), checking on work attendance and homework evaluation (15%), reflection activity (15%), comprehensive design experiment evaluation (20%) and theoretical evaluation (30%). Process evaluation and self-evaluation are highlighted, especially feedback and improvement after evaluation. Through multi stage and multi form evaluation, the goal of emergency and critical care professional education has been achieved, which has promoted the development of student nurses' quality and overall development.

Objective To investigate the incidence of infection and the effect of anti-infection prophylaxis in renal transplanted patients after Basiliximab induction therapy. Methods A total of 204patients who have received renal transplantation and Basiliximab induction therapy from January 1,2001 to December 31, 2010 in our hospital have been retrospective analysed in this study. These patients were divided into a prophylaxis group (118 cases) with Ganciclovir + Sulfadiazine +Trimethoprim therapy and a control group (86 cases) without any anti-infection prophylaxis.Furthermore, 440 transplanted patients in the same peroid without any induction therapy were also analysed. They were also devided into two groups: an anti-infection prophylaxis group (206 cases)and a control group (234 cases) without any anti-infection prophylaxis. Results In the prophylaxis group with Basiliximab induction therapy, there were 23 patients (19. 5 %, 23/118)experienced hospitalization due to infection, 3 cases (13. 0 %,3/23) among them were severe infection, and 3patients (13.0 %, 3/23) died from vital infection. In the non-prophylaxis control group with Basiliximab induction therapy, 27 patients (31.4 %, 27/86) had infection complication, 7 patients (25.9 % ,7/27) among them were severe infection, and 4 patients(14. 8 % ,4/27)died. The incidence of infection between the above two groups is significantly different (P＜0. 05). In the prophylaxis group without induction therapy, the incidence of infection was 15.0 % (31/206), there were no severe infection cases but 7 patients (22. 6 %, 7/31) died from infection. In the non-prophylaxis control group without induction therapy, the incidence of infection was 12. 8 % (30/234), 3 cases among them were severe infection(10. 0 %,3/30)and 5 patients died from infection (16. 7 %, 5/30).The incidence of infection in Basiliximab induced patients without anti-infection prophylaxis is significantly higher than that in patients without induction therapy and anti-infection prophylaxis (31.4 % vs. 12.8 %,P＜0.01). Conclusion Basiliximab induction therapy increased the risk of infection, but not the rate of mortality. It is necessary to give anti-infection prophylaxis in renal transplanted patients with Basiliximab induction therapy.

Objective To investigate the infection following the lymphocytes deleted agent (ATG) and IL-2 receptor antagonists (Basilixinab and Daclizumab)-based induction therapy after renal trausplantation.Methods A retrospective analysis was carried out on 701 kidney transplant recipients between Jan. 1,2005 to Dec.31,2010.According to exclusive and inclusive criteria,finally 549 patients were evaluated,including 429 patients treated with ATG (ATG group) and 120 patients with anti-CD25 monoclonal antibodies (monoclonal antibodies group; 86 patients with Basiliximab,and 34 patients with Daclizumab).The incidence of acute rejection,infection rate,infection time,hospital stay,severe infection rate and mortality were analyzed.After operation,the patients received an immunosuppression therapy including Tacrolimus (cyclosporine A),Mycophenolate-Mofetil and prednisone to present rejection. Part of the patients were treated with ganciclovir and sulfamethoxazole sulfadiazine and trimethoprim for infection prevention.Results The acute rejection rate in ATG group and monoclonal antibodies group was 15.9％ (68/429) and 10.0％ (12/120),and there was no statistically significant difference (P＞0.05).The infection rate in ATG group was 11.9％ (51/429),including 13.7％ (7/51) with severe infection,and mortality was 7.8％(4/51).The infection rate was 15.0％ (18/120) in monoclonal antibodies group,including 11.1％ (2/18) with severe infection,and mortality was 5.6％ (1/18).There was no statistically significnat difference in infection rate,severe infection rate and mortality between two groups (P＞0.05).The hospital stay in ATG group and monoclonal antibodies group was 25.8 days and 19.1 days respectively (P＜0.05).Dead cases had not received regular anti-infection treatment,and the patients age was over 50 years.Conclusion The infection risk and mortality between these two induction therapies are identical,but hn comparison to the patients using ATG,the infection of patients using anti-CD25 monoclonal antibodies is easier to control.Anti-infection prophylaxis is important to reduce infection rate and decrease infectious mortality.

Objective　To establish animal model for hypertrophic scar and study the characters of its morphology and collagen metabolism. Methods　A total of 64 round wounds (diameter of 6 mm each) with total skin loss were made on the ventral side of rabbit ear using a trephine. Morphology and collagen metabolism of scar wounds were studied at 14,21,35,70 and 98 days after operation, respectively. Results　There were 76% elevated scars developed (45/59 wounds) on the ventral side of rabbit ear at 21 days and 46% elevated scars disappeared (11/24) at 98 days after operation. There were numerous fibroblast proliferation and whorl-arranged collagen fibers at 21 and 35 days. The number of fibroblast decreased, but irregular-arranged fibers still presented in the elevated scars at 70 and 98 days after operation. Hydroxyproline content in elevated scars at 21 days was higher than that in normal skin (P<0.05), and at 35 days was 3 times as that in normal skin and at 98 days was also markedly higher than that in normal skin (P<0.05). Conclusion　Excessive deposition of collagen is a characteristic of hypertrophic scar in rabbits. The conversion of normal scarring to hypertrophic scarring in rabbits occurs at 14～21 days after operation. Both development and regression of hypertrophic scar in rabbit are quicker than that in human.

Objective To construct tissue-engineered skin via in vitro inoculation of epidermal stem cells(ESCS)onto de-epidermized dermis.Methods Skin tissue was obtained from the foreskin of a healthy 6-year-old child.and keratinocytes were isolated by two-step trypsinization method followed by the collection of ESCS via rapid adhesion by collagen Ⅳ.The ESCS were identified by morphological observation and immunohistochemical staining with K19 and integrin β1.To construct tissue-engineered skin,selected ESCS were seeded onto the surface of de-epidermized dermis followed by a one-week culture immersed in the medium and a subsequent 4-week culture at the air-medium interface.The tissue-engqneered skin was evaluated with haematoxylin & eosin(HE)staining as well as keratin immunohistochemistry.Results Micro scopically,cultured ESCs showed a paving stone-like appearance and grew into colonies.Immunohistochemistry revealed that the ESCs were positive for integrin-β1 and keratin 19.After 5 weeks of culture,3-6 layers of epidermal cell were observed on the dermis with the formation of stratum corneum.Keratin protein was observed in the artificial epidermal skin.Conclusion Tissue-engineered skin is successfully constructed with epidermal stem cells and de-epidermized dermis in vitro.

Objective To evaluate volume doubling time (VDT) and net mass doubling time of tumor (nMDT) of pulmonary pure ground glass nodules (PGGN) of different pathological types and to investigate whether VDT and nMDT can help to differentiate invasive pulmonary adenocarcinomas from minimally invasive adenocarcinomas and preinvasive lesions.Methods Fifty-one pathologically confirmed pGGNs in 46 patients were retrospectively evaluated,in whom at least two HRCT scans were obtained preoperatively (median scan times,3 times;range,2-6 times) with 1-month or longer follow-up interval (median follow-up interval,251 days;range,30-1 552 days).According to the rechecked results of the postoperative pathological section,51 pGGNs were divided into two groups:group A,invasive adenocarcinoma (IAC),30 pGGNs (58.8％);group B,21 pGGNs (41.2％),including 8 minimally invasive adenocarcinoma (MIA),7 adenocarcinomas in situ (AIS) and 6 atypical adenomatous hyperplasia (AAH).The volume,cumulative percentage of volume growth and VDTs of pGGNs were automatically acquired by Lung VCAR (advantage windows 4.6,GE HealthCare).Subsequently,the mass,cumulative percentage of mass growth and nMDTs of pGGNs were calculated.The count data and measurement data between two groups were compared using Fisher exact probability and Mann-Whitney U test,respectively.A pairwise comparision were performed by using Wilcoxon signed-rank test.Subsequently,the receiver operating characteristic (ROC) curve was used to determine the optimal cut-off values of VDT and nMDT for the differential diagnosis of IAC and MIA/AIS/AAH,and calculated the area under the curve (AUC).Results The median VDT and nMDT of 51 pGGNs were 1 854.11 days (range,165.22—+∞ days) and 1 138.45 days (range,95.92—+ ∞ days),respectively.The median nMDT was shorter than the median VDT,and the difference was significant (Z=-2.444,P=-0.O15).The median VDTs of IAC and MIA/AIS/AAH were 847.07 days (165.22—+∞ days) and 4 460.09 days (691.14—+∞ days),respectively.The median nMDTs of IAC,MIA/AIS/AAH were 769.93 days (95.92—+∞ days) and 3814.77 days (611.56—+∞ days),respectively.The median VDT and nMDT of IAC were significantly shorter than those of MIA/AIS/AAH (Z=-3.443,-3.860,P＜ 0.01,respectively).Differentiating IAC from MIA/AIS/AAH,the optimal cutoff value of VDT was 2095.86 days (sensitivity,71.4％;specificity,80.0％),the optimal cutoff value of nMDT was 1 169.77 days (sensitivity,81.0％;specificity,76.7％).Conclusions In pulmonary pGGNs,IAC showed significantly shorter VDT and nMDT than MIA/AIS/AAH.When VDT is shorter than 2 095.86 days or nMDT is shorter than 1 169.77 days,IAC is suggested.