Objective To evaluate the value of lung sonography in diagnosis of neonatal pulmonary diseases and to provide a reliable and simple method for diagnosing neonatal pulmonary diseases.Methods From May 2012 to August 2012,105 newborns who admitted into Bayi Children's Hospital were enrolled into this study,including respiratory distress syndrome 40 cases (three of them with difficulty in withdrawing mechanical ventilation),meconium aspiration syndrome 17 cases,wet lung of newborn 17 cases and 30 health neonates without lung diseases.Lung ultrasound was performed at bedside by a single expert physician within the first 24 h of life.All patients with neonatal lung diseases were diagnosed by clinical manifestations,arterial blood gas analysis and chest X-ray.Results (1) Lung sonography of normal neonates showed hypo-echo (black),smooth and clear hyper-echoic pleural line.A line was hyper echo too.(2) All 40 neonates with respiratory distress syndrome showed lung consolidation with air bronchograms; abnormal pleural line,disappeared A-lines,pleural effusion and alveolar-interstitial syndrome.Five out of the 40 (12.5％)infants showed pleural effusion.(3) All 18 meconium aspiration syndrome infants showed focal lung consolidation under pleural membrane,alveolar-interstitial syndrome,atypical changes of abnormal pleural line and disappeared A-line in lesion area with lung sonography.(4) All infants with wet lung of newborn (100.0％,17/17) showed double lung point,with which all wet lung of newborn could be diagnosed.(5) Differential diagnosis of respiratory distress syndrome with wet lung of newborn:five infants with severe dyspnea showedwhite lung in X-ray and were diagnosed as respiratory distress syndrome,while sonography only showed severe lung edema and one infant showed pleural effusion which was in accordance with wet lung of newborn,so was their courses of disease.(6) Three cases of respiratory distress syndrome showed dyspnea after withdrawing mechanical ventilation,and lung sonography showed local atelectasis but normal in X-ray.Conclusions Lung ultrasound has many advantages,such as accurate,reliable,no radiation damage,low-cost and simple; therefore,it is feasible in neonatal ward.

Objective To study the expression of intestinal dipeptide transporter 1 (PEPT1) protein in gastric cancer patients at different nutritional status,and to explore the possible regulatory mechanism.Methods According to Nutritional Risk Screening 2002 (NRS 2002) score,a total of 60 gastric cancer patients were divided into nutritional risk group (NRS 2002 score ≥ 3,n =18) and non-nutritional risk group (NRS 2002 score ＜ 3,n =42).With specimens of the small intestinal mucosa taken during operation,the expression of intestinal PEPT1 protein was detected using Western blot.The serum concentration of tumor necrosis factor (TNF-o) were measured using enzyme-linked immunosorbent assay.The expression of PEPT1 in Caco-2 cells treated with different concentrations of TNF-α (20,50,100 μg/L) were detected using Western blot at different time points (24,48,72 hours).Results The expression of intestinal PEPT1 (0.63 vs.0.23,P =0.000) and serum TNF-o concentration (0.23 μg/L vs.0.17 μg/L,P =0.001) in the nutritional risk group were significantly higher than those in the non-nutritional risk group.In Caco-2 cells,those treated with different concentrations of TNF-α (20,50,100 μg/L) for 24 hours had significantly higher PEPT1 expression than the blank group did (0.68 vs.0.54,P =0.005 ; 0.72 vs.0.54,P =0.001 ;0.78 vs.0.54,P =0.000).The Caeo-2 cells treated with 50 μg/L TNF-α for 24,48,and 72 hours had significantly higher PEPT1 expression compared with the cells in the blank group (0.57 vs.0.52,P =0.004 ; 0.75 vs.0.52,P =0.000 ; 0.77 vs.0.52,P =0.000).Conclusion The expression of intestinal PEPT1 protein was increased in gastric cancer patients with nutritional risk,which was probably attributed to the regulation of TNF-α.

OBJECTIVETo compare clinical therapeutic effect of surrounded needling therapy and medication on acute gouty arthritis.

METHODSSixty cases of acute gouty arthritis were randomly divided into a surrounded needling therapy group and a western medicine group, 30 cases in each group. The surrounded needling therapy group was treated with shallow needling on local affected area as main and 4-5 distant acupoints as adjuvant, once each day; the western medicine group was treated with oral administration of Indomethacin and Allopurinol, thrice each day. They were treated for 15 days. The clinical therapeutic effects, the changes of serum uric acid content and the adverse reaction were observed in the two groups.

RESULTSThe total effective rate was 93.3% in the surrounded needling therapy group and 80.0% in the western medicine group, with a significant difference between the two groups (P < 0.01); the serum uric acid contents before and after treatment were (516.85 +/- 48.63) micromol/L and (293.77 +/- 68.45) micromol/L in the surrounded needling therapy group, and (509.66 +/- 51.11) micromol/L and (333.66 +/- 89.22) mciromol/L in the western medicine group, respectively, with significant differences before and after treatment in the two groups (both P < 0.05), and with a significant difference in the serum uric acid content after treatment between the two groups (P < 0.01). The surrounded needling therapy group had no adverse reaction, and the adverse reaction rate of the western medicine group was 46.7%, with a significant difference between the two groups (P < 0.01).

CONCLUSIONSurrounded needling therapy is superior to the western medicine in the therapeutic effect on acute gouty arthritis, and it is a safe and effective method for acute gouty arthritis.

Acupuncture Points ; Acupuncture Therapy ; Acute Disease ; therapy ; Adult ; Aged ; Allopurinol ; therapeutic use ; Arthritis, Gouty ; blood ; drug therapy ; therapy ; Humans ; Indomethacin ; therapeutic use ; Male ; Middle Aged ; Treatment Outcome ; Uric Acid ; blood

OBJECTIVETo compare the curative effects of primary osteoporosis treated with heat-sensitive point moxibustion and Gaitianli (Oyster Shell and Calcium Carbonate Chewable) tablets for oral administration and explore the treatment mechanism.

METHODSSixty cases of primary osteoporosis were randomly divided into a heat-sensitive point moxibustion group (moxibustion group) and a Gaitianli tablets group (medication group), 30 cases in each group. In the moxibustion group, the heat sensitized points were searched around Zusanli (ST 36), Pishu (BL 20), Shenshu (BL 23) and Mingmen (GV 4) and treated by heat-sensitive point moxibustion; in medication group, Gaitianli tablets were taken by oral administration, 3 pills for once and 3 times a day. The curative effects, bone mineral density (BMD), alkaline phosphatase (S-AKP) and urinary calcium to creatinine ratio (U-Ca/Cr) in both groups were observed before and after treatment.

RESULTSThe total effective rate was 86.7% (26/30) in moxibustion group, superior to that of 76.7% (23/30) in medication group (P < 0.05). After treatment, the BMD of lumbar vertebrae (L2-L4) mean was improved (P < 0.05), and the S-AKP and U-Ca/Cr were reduced (all P < 0.05); in medi cation group, the indexes above were no obvious changes (all P > 0.05).

CONCLUSIONThe therapeutic effect of primary osteoporosis treated with heat-sensitive point moxibustion is superior to that with Gaitianli tablets for oral administration. The mechanism is restraining bone resorption, increasing bone strength, keeping balance of bone metabolism, in order to increase bone mineral density and improve the clinical symptoms.

Acupuncture Points ; Aged ; Alkaline Phosphatase ; blood ; Bone Density ; Calcium ; urine ; Creatinine ; urine ; Female ; Humans ; Male ; Middle Aged ; Moxibustion ; methods ; Osteoporosis ; metabolism ; therapy

Objective To explore the independent risk factors of the prolonged time of retention ICU after type A aortic dissection operation,to establish a corresponding perioperative risk assessment system.Methods A total of 509 consecutive patients with type A aortic dissection were enrolled in the study from September 2011 to May 2016,among which,418 patients received emergency operation.The prolonged retention time of ICU was considered as endpoint event.A perioperative assessment system was established through the analysis of related risk factors of the most common complications after type A aortic dissection operation.The possible risk factors of prolonged retention time of ICU were introduced into a single factor analysis.The meaningful variables in the single factor analysis were introduced into logistic regression analysis.The independent risk factors which were obtained from logistic regression analysis were used to establish risk prediction modeL,and the ROC curve and Hosmer-Lemeshow goodness of fit test were used to evaluate the model.Results The perioperative mortality rate was 8.64％,the prolonged retention time of ICU was 5.06 days,and 98 cases exceeded 7 days.The results of logistic regression analysis showed that age,the history of stroke,obesity,emergency operation,cardiopulmonary bypass time,deep hypothermic circulatory arrest time,renal inadequacy,massive transfusion,hypoxemia,and pulmonary infection were the independent risk factors for prolonged retention time of ICU.Accordingly,a mathematical model was established.The area under ROC cure for prediction model(AUC) =0.761,Hosmer-Lemeshow goodness of fit test P =0.512.Conclusion The logistic model estabhshed in this study can successfully predict ICU retention time after type A aortic dissection operation,and the efficacy was predicted satisfactorily.

Objective:To investigate the pathogenic gene locus and prenatal genetic diagnosis of 54 families with oculocutaneous albinism (OCA).Methods:This retrospective study enrolled 54 OCA probands and their families from Gansu Province Maternal and Child Health Care Hospital from May 2014 to May 2020. TYR gene variation screening was performed on the probands by Sanger sequencing. Those with negative results were analyzed by high-throughput sequencing, and further verification was performed on their parents by Sanger sequencing. Among the 54 families, 15 ml amniotic fluid were collected from 16 women at 18-21 gestational weeks in their subsequent pregnancy. Sanger sequencing combined with short tandem repeats sequence for linkage analysis were performed for genetic analysis. All data were analyzed using descriptive statistical analysis. Results:Out of the 54 OCA probands, 48 were diagnosed as OCA1, five were OCA2 and one was OCA4 based on the Sanger sequencing and high-throughput sequencing detection. A total of 26 different variation sites were involved in the 48 OCA1 probands, including 15 missense mutations, five nonsense mutations, three splicing mutations, and three frame-shift mutations, among which, c.929insC (29%, 28/96) was the most frequent mutation, followed by c.896G>A (11%, 11/96), c.832C>T (8%, 8/96) and c.703T>C (5%, 5/96). The diagnosis was confirmed in all 16 fetuses in the 16 families that underwent prenatal diagnosis. Five of them were affected and their mothers chose to terminate the pregnancies, the other 11 pregnancies continued to delivery, including seven heterozygous carriers and four fetuses without the same pathogenic allele as the proband. Maternal contamination was excluded in all prenatal samples using short tandem repeat for linkage analysis. All 11 children were in good health during telephone follow-up one month after birth. Postnatal validations were consistent with the prenatal tests.Conclusions:Genetic diagnosis could accurately identify various types of OCA and help to provide prenatal diagnosis and fertility consultation for subsequent pregnancies.

Objective ] To analyze the incidence and mortality of liver cancer and survival situation among permanent residents in Yangpu District of Shanghai from January 2002 to December 2012, and compare these data with the statistics obtained from Qidong City of Jiangsu Province. [ Methods] The data on liver cancer among permanent residents in Yangpu District were collected from the database of cancer registration and management system in Shanghai.The temporal trend in the incidence and mortality of liver cancer was assessed and compared with the related statistical data from Qidong City of Jiangsu Province.Kaplan-Meier analysis with log-rank test was performed for survival analysis. [ Results] A total of 3 389 cases of liver cancer were diagnosed from January 2002 to December 2012 . The standardized incidence rate was 15.70/105 in males, significantly higher than 5.45/105 in females ( P<0.05) .A total of 3 026 cases died of liver cancer during this period.The standardized mortality rate was 13.38/105 in males and 4.66/105 in females ( P<0.05).The median survival time was 0.41 years in total, 1.40 years in those who received surgery, significantly higher than 0.35 years in those without surgery ( P <0.05 ) .The ratios between Yangpu District and Qidong City were around 1 ∶3 in both incidence and mortality rates, and about 2 ∶1 in survival rate. [ Conclusion] The mortality of liver cancer close to its incidence among permanent residents in Yangpu District of Shanghai during 2002-2012. Both the incidence and mortality of liver cancer were significantly higher in males than in females.Surgical resection significantly prolongs overall survival time and improves prognosis.Early diagnosis and prompt surgical resection can improve the overall survival rate of liver cancer patients.HBV infection may be the major risk factor of liver cancer in Yangpu District, while liver cancer in Qidong City is likely to be caused by the interaction among many factors including HBV infection, exposure to aflatoxin, genetic factors, drinking water pollution, and lack of microelement.

OBJECTIVESTo explore the significance of PTEN (phosphatase and tensin homolog deleted on chromosome 10) in the development of human primary hepatocellular carcinoma (HCC).

METHODSPTEN protein expression in cancerous liver tissues and paired para-carcinoma liver tissues from 60 HCC patients was detected by immunohistochemistry and PTEN mRNA expression was analyzed by northern blot. The significance of PTEN in the development of HCC was analyzed by investigating the relationship between the expression levels of PTEN protein and mRNA, and the clinicopathological parameters of HCC patients.

RESULTSPTEN protein was immunohistochemically stained in the cytoplasmic region of para-carcinoma liver tissues in all the 60 patients, while only 48.3% (29/60) of the patients were positive for PTEN protein in cancerous liver tissues. The positive rate of PTEN protein in HCC tissues were relative to the histological gading and the presence of tumor thrombus. In grade I - II, III, and IV, the positive rates were 84.0%, 23.8%, and 21.4% respectively, and in the group with tumor thrombus was 26.7%, while in the group without tumor thrombus was 55.6%. Northern blot showed that there existed four PTEN mRNA transcripts with the length of 5.5kb, 4.4kb, 2.4kb, and 1.8kb respectively. The level of PTEN mRNA expression in HCC tissues was much lower than that in the paired para-carcinoma liver tissues. The low expression level of the 5.5kb and 4.4kb transcripts was significantly associated with serum AFP value, presence of tumor thrombus, state of satellite lesion and histological grading. The low expression level of the 2.4kb transcript in HCC was significantly associated with the presence of tumor thrombus and satellite lesions in HCC patients. However, no evident relationship between the lowered expression level of the 1.8kb transcript and the clinicopathological parameters of HCC was observed in these 60 patients.

CONCLUSIONSDown-regulation of PTEN expression may play an important role in the development of HCC and the expression level of PTEN may be a potential adjuvant parameter in forecasting the progress and prognosis of HCC.

Adult ; Biomarkers, Tumor ; Carcinoma, Hepatocellular ; metabolism ; Female ; Humans ; Liver Neoplasms ; metabolism ; Male ; Middle Aged ; PTEN Phosphohydrolase ; Phosphoric Monoester Hydrolases ; biosynthesis ; genetics ; RNA, Messenger ; biosynthesis ; genetics ; RNA, Neoplasm ; biosynthesis ; Tumor Suppressor Proteins ; biosynthesis ; genetics

OBJECTIVETo evaluate the safety and effect of selective resection of the branches of the two dorsal penile nerves in the treatment of primary premature ejaculation (PPE).

METHODSFrom September 2003 to December 2006, 483 PPE patients aged 21-71 years (mean 32) underwent selective resection of the branches of the two dorsal penile nerves, with only 2 of the branches reserved, 3 resected in 89 cases, 4 in 183, 5 in 125, 6 in 38, 7 in 32, 8 in 12, 9 in 3 and 10 in 1. The patients could have sexual intercourse 4 weeks after the operation and were followed up for 3-36 months.

RESULTSNo infection, hemorrhage and erectile dysfunction were observed. Decreased penile sensibility was noted in all the patients, obviously prolonged ejaculation latency in 352, improvement in 93 and failure in 38, with a total effectiveness rate of 92.13%.

CONCLUSIONSelective resection of the branches of the two dorsal penile nerves, which can definitely reduce the sensivity of the penis, is a safe and effective surgical option for the treatment of PPE.

Adult ; Aged ; Denervation ; methods ; Ejaculation ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Penis ; innervation ; Sexual Dysfunction, Physiological ; physiopathology ; surgery ; Treatment Outcome ; Young Adult

Objective:To investigate the manifestations of liver injury in hospitalized patients with coronavirus disease 2019 (COVID-19), to investigate the prognosis indicators of the disease, and to provide the reference for clinical diagnosis and treatment.Methods:From January 10 to February 14, 2020, at Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, the data of 333 hospitalized patients with COVID-19 were collected. The changes of alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBil), direct bilirubin (DBil), indirect bilirubin (IBil) and albumin of the first liver function test after admission and the reexaminations of liver function test during hospitalization period in patients with liver injury were retrospectively analyzed. Student t test and Chi-square test were used for statistical analysis. Results:Liver injury occurred in 39.6% (132/333) of COVID-19 patients. There was no statistically significant difference in the rate of liver injury between patients in intensive care unit (ICU) and in general ward (45.6%, 26/57 vs. 38.4%, 106/276; χ2=1.026, P>0.05). 67.4% (89/132) of COVID-19 patients with liver injury presented with increased ALT or AST level on admission. During hospitalization, the level of ALT was higher than that of the first examination after admission ((60.28±50.44) U/L vs. (42.25±32.21) U/L), and the difference was statistically significant ( t=-3.230, P<0.05). The levels of ALT and AST of 71.2% (94/132) patients were both <80 U/L, which indicated that most of the patients showed mild liver injury. The patients with elevated level of TBil, DBil and IBil accounted for 3.9% (13/333), 5.4% (18/333) and 2.4% (8/333) of the COVID-19 patients, respectively. The albumin level of COVID-19 patients with liver injury during hospitalization was lower than that of the first examination after admission ((31.8±5.1) g/L vs. (33.7±5.4) g/L), and the difference was statistically significant ( t=2.712, P<0.05). The albumin levels at first examination on admission and reexamination during hospitalization of patients in ICU were both significantly lower than those of patients in general ward ((29.3±3.7) g/L vs. (34.8±5.1) g/L and (27.6±2.8) g/L vs. (32.9±5.1) g/L), and the differences were statistically significant ( t=4.928 and 4.783, both P<0.05). Conclusions:The incidence of liver injury in COVID-19 patients is high. A slight increase in aminotransferase levels is particularly common. Bilirubin abnormality is relatively rare and mild. The level of albumin may be one of the indicators for the severity and prognosis of COVID-19.