During the fetal-neonatal transition, the body must undergo many important physiological changes to adapt the extrauterine environment. After birth, the blood and energy supply through placenta is stopped with clamping of the umbilical cord and, meanwhile, the pulmonary ventilation function is established when exposure to the air, which results in a series of changes in the respiratory, circulatory and endocrine systems and energy metabolisms, etc. The physiological transition can be relfected in heart rate, blood pressure, oxygen saturation, temperature, and other physiological indicators. The changes of these indicators can be used as references for prevention, diagnosis and treatment of neonatal diseases. This review provides an overview of physiological changes and implications in the lung function, circulatory and endocrine systems, and energy metabolism during the transition at birth as well as intervention measures for abnormal fetal-neonatal transition.

Objective To investigate the role of endoplasmic reticulum stress (ERS) pathway involving protein kinase R-like ER kinase (PERK)-activating transcription factor 4 (ATF4)-CCAAT/enhancer binding protein homologous protein (CHOP) in apoptosis in lungs of rats with bronchopulmonary dysplasis (BPD).Methods Forty eight premature SD rats were divided into BPD group and control group according to random number table.Rats in BPD group were continually exposed to O2 with volumetric concentration factor of 850 mL/L,while rats in control group were exposed to air.Lung tissues in each group were obtained in 7,14 and 21 days respectively.The apoptosis in lung cells was evaluated by terminal dexynucleotifyl transferase-mediated dUTP nick end labeling (TUNEL) assay.The mRNA levels of glucose regulated protein 78 (GRP78),PERK,ATF4 and CHOP were detected by real-time quantitative reverse transcription-polymerase chain reaction (RT-PCR).The protein levels of GRP78,phosphorylated PERK (pho-PERK),ATF4 and CHOP were detected by using Western blot.Results Compared with control group,the lung cells of the rats in BPD group developed more serious apoptosis.Furthermore,the apoptosis index (AI) in lung cells of the rats increased rapidly with the hyperoxia exposure time.This had been statistically verified by comparison with the control group at different timing(7 d:15.50 ± 0.58 vs 1.25 ± 0.50,14 d:27.75 ± 1.71 vs 3.25 ± 0.96,21 d:50.50 ±3.70 vs 4.00 ± 1.15 ;t =57.00,20.58,25.16,all P ＜0.01).The mRNA levels of GRP78,PERK,ATF4 and CHOP in BPD group increased significantly compared to the control group [GRP78:7 d (33.88 ± 3.73) vs (11.65 ± 1.00),14 d (54.50 ±2.18)vs(12.84 ± 1.41),21 d (95.34 ± 7.61)vs(12.43 ±0.59) ;PERK:7 d (5.23 ±0.92)vs (1.45 ±0.46),14 d (7.60 ± 1.56)vs(2.18 ±0.97),21 d (16.55 ±0.50)vs(2.90 ± 1.18) ;ATF4:7 d (23.04 ± 2.45)vs(12.56 ±2.81),14 d (28.66 ±2.66)vs(15.18 ±2.92),21 d (36.63 ±2.99)vs(15.14 ±2.09) ;CHOP:7 d (2.21 ±0.19)vs(0.81 ±0.02),14 d (4.19 ±0.17)vs(0.90 ±0.08),21 d (6.08 ±0.38)vs(0.88 ±0.10) ;all P ＜ 0.05].The protein levels of GRP78,pho-PERK,ATF4 and CHOP in BPD group increased significantly as well [GRP78:7 d (1.33 ±0.03)vs(0.85 ±0.04),14 d (1.31 ±0.02)vs(0.92 ±0.01),21 d (1.82 ±0.28)vs(0.87 ± 0.01);pho-PERK:7 d (0.68±0.02)vs(0.54±0.01),14 d (1.04±0.01)vs(0.65±0.01),21 d (1.29± 0.02)vs(0.73 ±0.01) ;ATF4:7 d (1.26 ±0.01) vs(0.83 ±0.01),14 d (1.39 ±0.02) vs (0.87 ±0.02),21 d (1.67 ±0.02)vs(0.94 ±0.02) ;CHOP:7 d (1.37 ±0.01)vs(0.47 ±0.06),14 d (1.50 ±0.04)vs(0.74 ±0.05),21 d (1.61 ± 0.03) vs (0.55 ± 0.02) ; all P ＜ 0.05].Positive correlation was demonstrated between the expression levels of CHOP protein and AI,PERK,ATF4 in the BPD group (r =0.87,0,92,0.93 respectively,all P ＜ 0.05).Conclusion PERK-ATF4-CHOP mediated ERS may participate in and contribute to the apoptosis mechanism in lungs of rats with BPD.

Objective:To prepare monoclonal antibody ( mAb ) against human testis-specific conserved gene ( hTSC29 ) peptides and characterize its immunological and biological features.Methods:According to bioinformatics analysis and prediction of the antigenicity, surface property, hydrophilicity and flexibility of hTSC29, a 18-amino acid residue partial peptide of hTSC29 was synthesized,then immunized the BALB/c mice for preparing antiserum.The mAb against hTSC29 was produced using the routine hybridoma technique.The properties of the mAb against hTSC29 were identified by ELISA, Western blot and immunohistochemistry staining.Results:After cell fusion and subcloning, one hybridoma cell lines secreting specific mAb against hTSC29 protein were obtaind.The Ig subclass of the mAb was IgG2b(κ).ELISA detection showed that the titer of mAbs in cultured was 1∶104.Western blot analysis proved that the mAb could specifically recognize Mr 60 000 protein in human testis total protein.The hTSC29 protein main located at circumference of spermatocyte and spermatid in human testis tissue by immunohistochemistry staining and immunofluorescence assay.Conclusion:One hybridoma cell lines which can secrete specific mAb against hTSC29 protein with high titers and specificity have been established successfully.The mAb will provide efficient tools for functional studies of hTSC29 expressed in spermatogenesis.

Objective: To investigate the clinical characteristics of early term and full term neonates, and analyze the risk factors associated with short term outcomes in early term neonates. Method: Neonates with birth weight (BW) ≥2 500 g from year 2013 were analyzed retrospectively based on American Congress of Obstericians & Gynecologists (ACOG) latest definition of term infants. According to inclusion and exclusion criteria, early term (gestational age 37-38 weeks) and full term(gestational age 39-40 weeks) neonates were included, whose morbidity constituent proportion was analyzed by χ² test or Fisher accuracy test or t test or Wilcoxon test. Risk factors associated with short term outcomes in early term population were analyzed by Logistic regression analysis. Result: There were 3 002 discharged term infants being investigated, among whom 1 303 cases were included(768 males and 535 females), and 37, 38, 39 and 40 weeks′ gestational age newborns were 160, 324, 450 and 369 respectively. Compared with full term neonates(n=819), early term neonates (n=484) had longer length of hospital stay (LOS)(6.0(5.0, 9.0) vs. 6.0(4.0, 8.0), Z=2.830, P=0.005), higher usage rate of intravenous antibiotics(86.4%(418/484) vs. 80.1%(656/819), χ²=8.009, P=0.005), higher assisted ventilation rate(9.5%(46/484) vs. 2.9%(24/819), χ²=25.528, P<0.01), higher pulmonary surfactant administration rate(4.3%(21/484) vs. 1.1%(9/819), χ²=14.006, P<0.01), as well as higher hypoglycemia incidence(3.9%(19/484) vs. 1.2%(10/819), χ²=10.226, P=0.001). There were no statistically significant differences in 1 min Apgar score (9(9, 10)vs. 9(9, 10), Z=0.860, P=0.390), 5 min Apgar score (10(9, 10) vs. 10(9, 10), Z=0.810, P=0.418), white blood cell count (15 (11, 21) ×10⁹ /L vs.15 (11, 22) ×10⁹ /L, Z=0.880, P=0.379), hemoglobin count(180 (159, 205) vs. 182 (160, 204) g/L, Z=0.560, P=0.576), or platelet count(303(234, 372) ×10⁹/L vs. 301(237, 391) ×10⁹/L, Z=0.550, P=0.584). BW between 2 500 g and 2 999 g(OR 1.69, 95% CI: 1.10-2.62, χ² =5.614, P=0.018), wet lung(OR=2.61, 95% CI: 1.61-4.24, χ²=15.023, P=0.000)and pneumonia(OR 1.88, 95% CI: 1.14-3.08, χ²=6.192, P=0.013) were risk factors in early term neonates′ short term adverse outcomes. Conclusion Early term newborns are still at their "immature" state, and respiratory disorders are major risk factors associated with short term outcomes. Hence, early delivery during 37-38 weeks should be avoided as possible as we can.

Objective: To investigate the specifity of amyloid precursor protein(APP), brain derived neurotrophic factor (BDNF)and gamma aminobutyric acid(GABA) in peripheral blood in children with autism spectrum disorder, so as to explore the biomarkers for early screening of ASD and its relationship with the severity of ASD. Methods: A total of 41 children diagnosed with autism from January to December 2019 were enrolled in the ASD group. Meanwhile, 41 healthy children with normal growth and development who were examined in the same period were selected as control group. And the sera total sAPP, sAPP α, sAPP β, BDNF and GABA of all participants were tested by sensitive enzyme linked immunosorbent assay method, and were compared between the two groups. Results: The serum sAPP level in ASD group(2 132.98±333.28 ng/mL) was higher than control group(1 734.76 ±357.97 ng/mL),the serum sAPP α level(335.11±33.87 pg/mL) was higher than control group(274.84±32.12 pg/mL) and the serum GABA level(4.17±0.95 μmol/L)was lower than control group(6.35±0.84 μmol/L). GABA level (4.17±0.95 μmol/L) was lower than that of control group (6.35±0.84 μmol/L), the differences were statistically significant ( t =3.92, 4.25, -7.27, P < 0.05 ). In addition, the serum GABA level in children with severe ASD (3.48±0.77 μmol/L)was lower than children with mild to moderate (4.94±0.98 μmol/L).The difference was significant ( t =-3.31, P <0.05). ROC curve showed that total sAPP( AUC = 0.77 ,95% CI =0.66-0.87), sAPP α( AUC =0.77,95%CI=0.67-0.87), and GABA ( AUC =0.95,95% CI =0.90-0.93)had diagnostic efficacy for ASD( P <0.05), among which the AUC of GABA was the largest (0.95)and its sensitivity(85.65%) and specificity(80.76%) were the highest. The results of binary Logistic regression showed that the abnormal expression of sAPPα ( OR =1.04,95% CI = 1.00- 1.07) and GABA( OR =0.02,95% CI =0.00-0.32) were associated with risk for ASD( P <0.05). Conclusion Considering the specific change of total sAPP, sAPPα andGABA in peripheral blood in ASD children, total sAPP, sAPP α and GABA can be considered as promising biomarkers in the early diagnosis of ASD, among which GABA has the highest sensitivity and specificity.

Objective To investigate the role of CCAAT enhancer binding protein A (C/EBPα) in lung development by analyzing the relationship between dynamic expression of C/EBPα protein and cell differentiation in rat lung tissue.Methods According to the histological stages of rat lung development,lung tissues were collected on 15.5 d (the late pseudoglandular period),17.5 d (the canalicular period),19.5 d (the early saccular period) of embryonic age and at 12 h (the middle saccular period),on 4 d (the late saccular period),7 d (the alveolar period,the alveolar stage),14 d (the alveolar period,the equilibrium stage) of postnatal age.The lung morphologic appearance was observed by using HE staining.Western blot was used to detect the expressions of C/EBPα and surfactant Protein (SP)-A,SP-B,SP-C,SP-D.Phosphatidylcholine (PC) assay kit was utilized to analyze the secretion of PC.Periodic acid-schiff (PAS) staining was used to evaluate the amcunt of glycogen in lung tissue.Results (1) C/EBPαt and SP-A began to express on 15.5 d of embryonic age (0.36 ±0.02,0.01 ±0.01),while SP-B,SP-C and SP-D started to express on 17.5 d of embryonic age (0.33 ±0.06,0.01 ±0.01,0.11 ±0.08).All of them increased with the development of lung,and C/EBPα,SP-A,SP-C reached the highest level at 12 h of postnatal age (3.48 ±0.05,3.24 ± 0.19,1.26 ± 0.21),and SP-D on the postnatal 4 d (1.48 ± 0.10),then gradually decreased,while the expression of SP-B continued to rise.The levels of C/EBPα and SPs maintained stable on postnatal 14 d.The C/EBPα protein level was positively correlated with SPs at embryonic age of 15.5 d,17.5 d,19.5 d and postnatal age 12 h (r =0.999,0.991,0.982,0.951,all P ＜ 0.05).(2) The level of PC was very low at embryonic age of day 15.5 [(60.50 ± 1.30) μg/g].With the development of lung,the secretion of PC increased gradually,but there was no significant correlation between the expression of PC and C/EBPoα(all P ＞ 0.05).(3) The level of glycogen was high in the late pseudoglandular stage (15.5 d) (585.50 ± 2.20),the content of glycogen decreased with the development of lung,especially on the canalicular (embryonic day 17.5) and during early saccular period (embryonic day 19.5),and then it became stable during the alveolar period (postnatal age 7 d).The expression of C/EBPα had negative correlation with the content of glycogen in fetal lung(r =-1.000,P ＜ 0.01).Conclusion C/EBPα plays an important role in rat lung development,as it may promote lung maturation by regulating the synthesis and secretionof SPs and PC.

Objective:To investigate the effect of acupoint application combined with modified electroconvulsive therapy (MECT) on life control in patients with bipolar disorder.Methods:A total of 98 patients with bipolar disorder who received treatment in The Third People's Hospital of Huzhou from January to December 2022 were included in this study. They were randomly divided into a control group and an observation group ( n = 49 per group). The control group received acupoint application, while the observation group received acupoint application combined with MECT. All patients were treated for 2 weeks. Before and after treatment, Personal Mastery Scale (PMS), Self-Perceived Burden Scale (SPBS), Perceived Social Support Scale (PSSS), and Bipolar Disorder Self-rating Questionnaire (BSQ) scores were compared between the two groups. The severity of the disease and clinical efficacy were assessed in each group. Results:Before treatment, there were no significant differences in PMS, SPBS, and PSSS scores between the two groups (all P > 0.05). After treatment, PMS scores in the observation and control groups were (31.2 ± 4.5) points and (27.8 ± 4.1) points, respectively, and PSSS scores in the two groups were (66.6 ± 12.3) points and (63.2 ± 10.1) points, respectively. After treatment, PMS and PSSS scores in the observation and control groups were significantly increased compared with those measured before treatment in the corresponding groups [observation group: PMS score (15.6 ± 3.3) points, PSSS score (32.1 ± 6.2) points, control group: PMS score (15.2 ± 3.1) points, PSSS score (34.7 ± 6.6) points, t = 20.50, 16.23, 17.53, 16.54, all P < 0.05]. After treatment, SPBS scores in the observation and control groups [(16.2 ± 3.4) points, (17.7 ± 3.6) points] were significantly decreased compared with those measured before treatment in the corresponding groups [observation group: (30.9 ± 5.8) points, control group: (28.1 ± 5.5) points, t = 15.31, 11.07, both P < 0.05]. After treatment, PMS score in the observation group was significantly higher than that in the control group ( t = 4.45, P < 0.05). Before treatment, there was no significant difference in BSQ score between the two groups ( P > 0.05). After treatment, BSQ scores in the observation and control groups [(14.6 ± 6.5) points, (20.1 ± 7.5) points] were significantly decreased compared with those measured before treatment in the corresponding groups [observation group: (39.5 ± 10.2) points, control group: (36.4 ± 9.5) points, t = 12.32, 21.20, both P < 0.05]. After treatment, BSQ score in the observation group was significantly lower than that in the control group ( t = 5.60, P < 0.05). The overall response rate in the observation group was significantly higher than that in the control group ( χ2 = 4.90, P < 0.05). The Spearman test showed a significant negative correlation between PMS and BSQ scores ( r = -0.689, P < 0.05). Conclusion:Acupoint application combined with MECT therapy can improve life control in patients with bipolar disorder and increase clinical efficacy .

OBJECTIVE: To assess the association of single nucleotide polymorphisms (SNPs) of microRNA-146a (miR-146a) with clinical features of rheumatoid arthritis (RA). METHODS: In 126 patients with RA and 102 matched healthy controls, SNPs of miR-146a rs2910164 locus were determined with a high-resolution melting method. The association of such polymorphisms with disease activity score in 28 joints (DAS28) and clinical features of RA was assessed. RESULTS: The distribution of SNPs of miR-146a rs2910164 among RA patients did not differ from that of the control group. No significant association was found between miR-146a rs2910164 polymorphism with DAS28. However, RA patients with a GG genotype had a greater chance to develop extra-articular manifestations (P<0.01). CONCLUSION Polymorphisms of miR-146a rs2910164 locus is not an independent risk factor for RA, though its GG genotype may be associated with extra-articular manifestations of RA.
Arthritis, Rheumatoid ; genetics ; Case-Control Studies ; Genetic Predisposition to Disease ; Genotype ; Humans ; MicroRNAs ; genetics ; Polymorphism, Single Nucleotide