Objective:To investigate the dynamic changes of thyroid function and risk factors of hypothyroidism and delayed thyroid stimulating hormone (TSH) elevation in late preterm infants.Methods:This study retrospectively recruited 782 late preterm infants admitted to Nanjing Medical University First Affiliated Hospital and performed thyroid function monitoring from January 2017 and December 2019. Thyroid function test was performed in all cases at 4-7 d after birth and repeated at 2-4 weeks of age for those with normal results or two weeks after the first test for those with abnormal. The test would be continued if the second test was abnormal and stopped until the thyroid function became normal or hypothyroidism was diagnosed, based on which, these infants were divided into hypothyroidism ( n=11) and non-hypothyroidism groups ( n=771), or delayed TSH elevation ( n=71) and normal thyroid function groups ( n=450). The characteristics of thyroid hormone changes and perinatal data were compared between different groups using two independent sample t-test and Chi-square test, and risk factors of hypothyroidism and delayed TSH elevation were analyzed using logistic regression tests. Results:(1) Dynamic changes of thyroid function: among these 782 late preterm infants, five infants were found with transient hypothyroxinemia at the first test, and became normal at the second test; 249 (31.8%) exhibited hyperthyrotropinemia, and four of them were diagnosed with hypothyroidism based on the second and the third results; 71(9.1%) with delayed TSH elevation all became normal later; 11(1.4%) were diagnosed with hypothyroidism and treated with thyroxine, among which, seven cases were diagnosed at the first test, three at the second test and one at the third test. (2) Risk factors for hypothyroidism: lower birth weight was noted for infants with hypothyroidism compared with those without [(2 140.9±455.1) vs (2 464.1±474.0) g, t=-2.247, P=0.025]. Multivariate logistic regression analysis found that for every one gram reduction in birth weight, the risk of hypothyroidism elevated by 0.002 times ( OR=1.002, 95% CI: 1.000-1.004, P=0.045). (3) Risk factors for delayed TSH elevation: the birth weight was lower [(2 395.4±420.9) vs (2 523.6±462.3) g, t=-2.200, P=0.028], and the proportion of small for gestational age and twin pregnancy were higher in the delayed TSH elevation group than those in the normal thyroid function group [15.5% (11/71) vs 7.1% (32/450), χ2=5.690, P=0.017; 29.6% (21/71) vs 18.7% (84/450), χ2=4.537, P=0.033]. Multivariate logistic regression analysis found that small for gestational age ( OR=4.366, 95% CI: 1.649-11.564, P=0.003) and twin pregnancy ( OR=1.943, 95% CI: 1.048-3.600, P=0.035) were independent risk factors for delayed TSH elevation. Conclusions:Late preterm infants have a high incidence of different kinds of thyroid dysfunction. Thyroid function monitoring is necessary for late preterm infants because those with lower birth weight are more susceptible to develop hypothyroidism, and those small for gestational age infants and twins are more susceptible to develop delayed TSH elevation.

Adult ; China ; epidemiology ; Hepatitis B ; prevention & control ; Hepatitis B Vaccines ; Humans ; Practice Guidelines as Topic ; Vaccination

Atrial Fibrillation ; surgery ; Catheter Ablation ; methods ; Humans

Objective: To study the acute and long-term toxicity of brucea javanica oil subnanoemulsion injections ( BJOSI ) . Methods:The mice were given BJOSI by intravenous injection. The acute toxicity was observed and LD50 in mice was calculated by Bliss method. To observe the long-term toxicological effects, Beagle dogs were injected intravenously BJOSI once a day for 8-week du-ration with the dose of 20, 10 and 6 ml·kg-1 , respectively followed by 3-week recovery period. Results:LD50 of BJOSI in mice was 7. 388 g·kg-1 with 95% confidence limits of 6. 306-8. 656 g·kg-1 . The long term toxicity test showed that all the detected indices were within normal range in all groups, including general state, weight changes,hematological indices,biochemical indices,EEG,organ coefficients, morphological and histological changes, while there was an upward tendency of ALT and Cr in every BJOSI group without dose-effect correlation. The dogs could completely recover in three weeks after the administration. Conclusion:The results suggest that BJOSI has low toxicity,while the pathological changes are reversible, and attention should be paid to the function of liver and kidney.

Child ; DNA, Antisense ; genetics ; DNA, Viral ; genetics ; Genetic Therapy ; methods ; Humans ; RNA, Antisense ; genetics ; Respiratory Syncytial Virus Infections ; therapy ; Respiratory Syncytial Virus, Human ; genetics ; pathogenicity

Background:Acute hepatic failure( AHF)is a common pathophysiological process of end-stage liver disease with complex etiology,difficulty in diagnosis and high mortality rate. Aims:To investigate the protective effect of nicotinamide on AHF in mice. Methods:AHF model in mice was established by intraperitoneal injection with D-galactosamine 700 mg/kg and lipopolysaccharide 10 μg/kg. Fifty-four mice were divided into blank control group,nicotinamide control group, AHF model group and low,moderate,high dose(400,800,1 000 mg/kg)nicotinamide groups,levels of ALT,AST, TNF-α and IL-6 were determined,HE staining was used to examine hepatic histological injury,liver cell apoptosis was measured by TUNEL assay,and protein expression of Caspase-3 was detected by Western blotting. Another 40 mice were divided into AHF model group,saline group and low,moderate,high dose(400,800,1 000 mg/kg)nicotinamide groups,mortality rate was observed dynamically. Results:Compared with blank control group and nicotinamide control group,levels of ALT and AST were significantly increased(P<0. 05),infiltration of inflammatory cells and necrosis of cells and levels of TNF-α and IL-6 were significantly increased( P <0. 05 ),and apoptosis of liver cells and protein expression of Caspase-3 were significantly increased in AHF model group(P <0. 05). In groups pretreated with low, moderate and high dose nicotinamide,all the above-mentioned indices were significantly improved in a dose-dependent manner(P<0. 05). Survival rate in low,moderate,high dose nicotinamide groups was significantly higher than that in AHF model group(37. 5%,62. 5%,100% vs. 0%,P all <0. 05). Conclusions:Nicotinamide could protect mice from AHF via inhibiting inflammatory response and hepatocyte apoptosis,thereby increase the survival rate.

Purpose To study the therapeutic methods of fatigue syndrome. Methods Seventy-nine cases of fatigue syndrome were treated by Tuina manipulation and a comprehensive assessment of main complaints and accompanied symptoms was made. Results After 3month's Tuina treatment, 21 cases were cured, 43 cases improved, 15 cases obtained no effects. Conclusion Tuina has a unique therapeutic effect on fatigue syndrome.

The Risk-sharing agreements have achieved remarkable success in improving patients'access to drugs, lowering the uncertainty of the drugs cost-effectiveness, financial risk control and other aspects of medical in-surance fund , so they have attracted widespread attention by the concerned governments and insurers .This paper sys-tematically reviewed the patient access schemes in UK from several aspects , including the origin of the program , clas-sification , application processes and the implementation effects as well .The results of the research indicated that Chi-na has basically met the conditions for implementation of the risk-sharing agreements .In order to gradually promote the risk-sharing agreements implementation , this paper suggests that China should clarify the main root of risk-sharing agreements implementation , establish risk-sharing agreements standardization process and strengthen the application of health technology assessment in health resources allocation to improve the Chinese medicines bargaining system more scientifically and efficiently .

ObjectiveTo study the clinical effect of locking compression plate fixation in treatment of the elders with unstable fractures of the distal radius. Methods17 cases with unstable distal radius fractures were treated by volar locking compression plate. The function of the carpal joints and the bone healing conditions were evaluated after operations. ResultsAll cases were followed-up for 7 to 16 months ( mean 12. 6 months). Union was obtained in all the patients after 11.4 weeks. The clinical outcomes were evaluated according to modified X-rays and wrist assessment. 12 cases were graded as excellent and 4 as good. 1 case were graded as poor. The overall satisfactory rate was 94. 1％. ConclusionThe unstable distal radial fractures could be effectively treated with open reduction and LCP fixation through volar approach.

Objective To investigate effect of monosialotetrahexosy-1 ganglioside (GM1) on the autophagic neuronal death induced by spinal cord injury.Methods Ninety SD rats were randomly divided into sham group,isotonic saline group and GM1 group,with 30 rats per group.Spinal cord injury at T10 segment was induced by Allen method in the isotonic saline group and GM1 group.Expression of endogenous LC3 was detected by florescence microscope.Ratio of LC3-Ⅱ and LC3-Ⅰ,and expression of Beclin-1 were detected by Western blot.Results LC3 was significantly up-regulated in the isotonic saline group,as compared to the sham group (P ＜0.05).Also,an up-regulation of LC3 and a decline of autophagic body formation were observed in GM1 group,as compared to isotonic saline group (P ＜0.05).Expressions of LC3-Ⅱ and Beclin-1 and ratio of LC3-Ⅱ to LC3-Ⅰ were significantly increased in the isotonic saline group,as compared to the sham group (P ＜ 0.05).Expressions of LC3-Ⅱ and Beclin1 and ratio of LC3-Ⅱ to LC3-Ⅰ significantly were decreased in the GM1 group,when compared to the isotonic saline group (P ＜ 0.05).Conclusion GM1 inhibits autophagic neuronal death after spinal cord injury and hence exerts protective effect on the neurons.