Objective To explore the clinical characteristics in twin premature infants in order to provide some guidance for clinical work in future.Methods The clinical data of 593 premature infants hospitalized in Department of Pediatrics,the Affiliated Hospital of Kunming Medical University were collected from June 2010 to June 2012,in terms of gestational age,birth weight and neonatal complications.A retrospective analysis was performed for the data.The premature infants were divided into 2 groups:study group of 131 twin premature infants and control group of 462 singleton premature infants.The 131 twin premature infants in study group were divided into large double group(n =64) and small double group(n =67) according to delivery time.The clinical data of premature infants in each group were statistically analyzed.Results The gestational age of study group was (34.23 ± 1.90) weeks,which in control group was (33.91 ± 1.82) weeks,and there was no significant difference between the 2 groups(t =1.689,P =0.092).The birth weight in study group [(1 921.64 ± 414.05)g] had statistically significant difference compared with control group [(2 164.98 ± 495.85) g] (t =-5.209,P =0.000).The study group of incidence of premature rupture of membranes was 16.79％ (22/131 cases)and which in the control group was 32.68％ (151/462 cases),and there was statistically significant difference between the 2 groups (x2 =12.472,P =0.000) ;the incidence of neonatal asphyxia of study group was 9.92％ (13/131 cases) and that of the control group was 17.10％ (79/462 cases),there was statistically significant difference between the 2 groups (x2 =4.010,P =0.045) ; the incidence of respiratory distress syndrome in study group was 6.87％ (9/131 cases) and that in the control group was 3.03 ％ (14/462 cases),the difference was statistically significant between the 2 groups (x2 =4.037,P =0.045) ; the incidence of apnea in study group was 4.58％ (6/131 cases) and that in the control group was 0.65％ (3/462 cases),the difference was statistically significant between the 2 groups(x2 =8.085,P =0.004) ; the incidence of meconium aspiration syndrome of study group was 0 and that of the control group was 3.90％ (18/462 cases),there was statistically significant difference (P =0.018) ;the incidence of neonatal hypoglycemia of study group was 27.48％ (36/131 cases) and that of the control group was 16.67％ (77/462 cases),the difference was statistically significant between the 2 groups (x2 =7.738,P =0.005) ;the incidence of sepsis of study group [16.79％ (22/131 cases)] was significantly higher than that of the control group [8.44％ (39/462 cases)],and the difference was statistically significant between the 2 groups (x2 =7.715,P =0.005) ;the incidence of extrauterine growth retardation of study group was 6.10％ (8/131 cases) and that of the control group was 2.38％ (11/462 cases),the difference was statistically significant between the both groups (x2 =4.568,P =0.033).In the study group,the incidence of neonatal sepsis in big double group was 29.68％ (19/64 cases),and that in small double was 14.93％ (10/67 cases),there was statistically significant difference between the 2 groups(x2 =4.138,P =0.042).The other complications between the big double group and small double group had no significant difference.Conclusions The incidence rates of acute respiratory distress syndrome,apnea,neonatal hypoglycemia,sepsis and extrauterine growth retardation of twin premature infants are higher than the singleton premature infants in the neonatal period.But the incidence rate of meconium aspiration syndrome is a higher in singleton premature infants.

Objective To explore the influence of Clostridium butyricum on the expression of vascular endothelial cell growth factor (VEGF) and its receptor 2 (VEGFR-2), proliferating cell nuclear antigen (PCNA), and tight junction protein claudin-2 in intestinal tissue in newborn rat with necrotizing enterocolitis (NEC). Methods Forty-eight-hour-old Sprague-Dewley (SD) rats were randomly divided into model group, control group, low-dose group, mid-dose group, and high-dose group, 12 rats each. Rats in each group were fed with milk substitute. The NEC model were created by hypoxia and cold stimulation for 3 consecutive days in model group, low-dose group, mid-dose group, and high-dose group. Meanwhile, low-dose group, mid-dose group, and high-dose group were intervened by being fed with Clostridium butyricum 0.2, 0.4, and 0.8 g/(kg·d), respectively. All rats in each group were sacriifced on day 4 and the intestines tissue was obtained. The pathological changes had been observed. The expression of VEGF, PCNA, and claudin-2 were detected by immunohistochemistry. The expression of VEGFR-2 was detected by RT-PCR. Results The intestines pathological scores was signiifcantly different among ifve groups (P?0 . 05 ). Conclusion The expression of VEGF, VEGF-2 , and claudin-2 were higher in rats with NEC, while the expression of PCNA was lower. Supplementation of Clostridium butyricum may protect newborn rats by its act on these factors.

Obj ective To determine the value of serum ferrifin (SF) in diagnosing systemic juvenile idiopathic arthritis (sJIA) with macrophage activation syndrome(MAS).Methods In this study,40 patients with sJIA at the First Affiliated Hospital of Kunming Medical University from December 2012 to December 2015 were divided into 2 groups:sJIA group and sJIA with MAS group,while 20 patients with acute fever at the First Affiliated Hospital of Kunming Medical College were selected as a control group.Before and after treatment,SF was measured with radioimmunological method in 3 groups.Statistical analysis was made by undertaking SPSS 18.0 software.Thedata obtained were analyzed by variance,comparison between groups was made by t-test,and the comparison among groups of enumeration data was tested by chi-square.The differences among groups were considered significant (P ＜ 0.05).Results The levels of SF before treatment in the sJIA group,the sJIA with MAS group and the control group were (2 413.50 ±606.73) μg/L,(7 052.77 ± 2 828.43) μg/L and (135.05 ±32.75) μg/L,respectively.The levels of SF in sJIA group and sJIA with MAS group were proved to be greater than those of the control group (F =92.63,P ＜ 0.01).The level of SF in sJIA with MAS group was significantly higher than that of the sJIA group,and the difference between 2 groups was statistically significant (t =9.19,P ＜ 0.01).The level of SF for 95％ patients in sJIA group was ≤4 000 μg/L.The level of SF of 83％ patients in So-JRA with MAS group was ＞4 000 μg/L,and there was a significance between 2 groups(x2 =25.61,P ＜ 0.01).If the criteria of diagnosis of sJIA with MAS was SF above 4 000 μg/L,the sensitivity was 83.33％,specificity was 95.45％,positive predictive value was 93.75％ and negative predictive value was 87.50％.The level of SF after treatment in sJIA group and sJIA with MAS group [(228.40 ± 78.02) μg/L and (259.55 ± 86.46) μg/L] were lower than that before treatment (t =16.53,10.02,all P ＜ 0.01).Conclusions The levels of SF can be abnormally elevated in cases of sJIA with MAS.Taking the SF above 4 000 μg/L as a criteria of diagnosis of sJIA with MAS would contribute to the early diagnosis and reduction of mortality in sJIA patientswith MAS.

Rab27a gene can participate in the secretion, transportation and exocytosis of T lymphocytes, mast cells, neutrophils, pancreatic β cells and hematopoietic cells through its encoded proteins, and participate in the development of diseases such as albinism, cancer, diabetes, inflammation and thrombosis. In addition, the secretion regulation of Rab27a to exosomes has also received much attention. The current research status of the secretion of exosome and the genetically modified exosomes of Rab27a gene in the treatment of diseases such as inflammatory injury, thrombosis and tumor were reviewed.