Objective:To investigate the efficacy and safety of less invasive surfactant administration(LISA) of neonatal respiratory distress syndrome(NRDS).Methods:From July 2017 to December 2018, 50 premature infants with birth weight ≤1 500 g and/or gestational age≤32 weeks diagnosed as NRDS at the Fifth Medical Center of PLA General Hospital were randomly divided into LISA group( n=25)and INSURE group( n=25). The patients in LISA group was inserted fine duct into the trachea through direct laryngoscope under nasal continuous positive airway pressure (nCPAP) and pulmonary surfactant was injected.The INSURE group adopts endotracheal intubation-pulmonary surfactant-nCPAP was performed after unplugging.The changes of vital signs, blood gas indexes, adverse reactions and the incidence of complications were compared between two groups at different time points. Results:There was no significant difference in respiration, heart rate, systolic blood pressure, diastolic blood pressure and PaO 2, PaCO 2, BE, SpO 2 between two groups at different administration time points.Although the pH value of LISA group was lower than that of INSURE group, it was within the normal range.There was no significant difference in bronchopulmonary dysplasia, intraventricular hemorrhage, periventricular leucomalacia and other complications between two groups, and there was no death, air leakage, retinopathy of prematurity and pulmonary hemorrhage in both two groups.In addition, there was no significant difference in hospitalization days, total medical expenses, oxygen use time between the two groups(all P>0.05). Conclusion:Compared with INSURE technology, LISA technology has its feasibility for premature infants with NRDS, but the effectiveness and safety in the practical application need to be further confirmed.

Objective To investigate the effect of esophageal variceal ligation (EVL) on portal hypertensive gastropathy (PHG). Methods Gastroscopic examinations were performed both before and after the EVL in 37 cases of PHG. Results The severity of PHG was correlated with the liver functions, and the morbidity of PHG was higher in cases of Child C (100%, 9/9) than in cases of Child A (60%, 12/20) or Child B (80%, 16/20) ( ? 2=18 452,P =0 001). PHG could be exasperated by the application of EVL, but no statistical significance was seen ( ? 2=3 512,P =0 173). On re-examination of gastroscopy 6~12 months later, no relapse or re-bleeding of esophageal varices or gastric mucosa hemorrhage occurred. Conclusions The worse the liver functions, the higher is the incidence of PHG. EVL treatment creates a tendency to aggravating PHG.

Objective To investigate the influence of coix seed triglyceride combined with transcatheter arterial chemoembolization (TACE) therapy on AFP, CD4﹢CD25﹢regulatory T (Treg) cells and cellular immune function in patients with advanced primary hepatocellular carcinoma (HCC). Methods A total of 50 patients with inoperable HCC, whose imaging examination showed no distant metastasis, were divided into the study group (n=25) and the control group (n=25). Coix seed triglyceride together with TACE was employed for the patients of the study group, while only TACE was adopted for the patients of the control group. For the patients of the study group, transcatheter hepatic artery infusion of 100 ml coix seed triglyceride was carried out during the performance of TACE, and postoperative intravenous drip of coix seed triglyceride (200 ml/d) was used for 5 days. The peripheral blood samples were collected one week before and one month after the treatment to detect the changes of AFP and T lymphocyte subsets (CD3﹢, CD4﹢, CD8﹢,CD4﹢/CD8﹢ and Treg) levels. One month after the treatment, enhanced CT, MRI or PET-CT was performed to evaluate the necrosis degree of the tumor. Results After the treatment, AFP levels was decreased in both groups, when compared the preoperative data the differences were statistically significant (P<0.01); the tumor necrosis rate of the study group was (57.7 ±8.2)%, which was slightly higher than (57.7±8.2)% of the control group, however, the difference was not statistically significant (P>0.05). In the study group, the percentage of Treg cells decreased from preoperative (8.27±6.65)%to postoperative (4.22± 1.59)%, the difference was statistically significant (P<0.01). The percentages of CD3﹢ and CD4﹢ and the ratio of CD4﹢/CD8﹢ increased from preoperative (55.78 ±13.66)%, (43.98 ±14.00)% and 1.22 ±0.64 to postoperative (62.29±10.78)%(P<0.01),(51.82±16.32)% (P<0.05) and 1.54±0.80 (P<0.05) respectively, while the percentage of CD8﹢decreased from preoperative (45.71±12.94)%to postoperative (39.70±12.41)%(P<0.05). In the control group, no statistically significant differences in the above mentioned indexes existed between preoperative data and postoperative ones (P>0.05). Conclusion In treating advanced primary HCC, coix seed triglyceride combined with TACE can reduce the percentage of Treg cells, thus, influence the patient’s cellular immune status and possibly decrease the recurrence rate of HCC after TACE therapy.

Objective To determine gene bcl 2 and bad protein expression in tissues of breast cancer and precancerous lesions, its relation with estrogen receptor (ER) and progesterone receptor(PR), and lymph node metastasis.Methods Using immunohistochemical method, the expression of bcl 2 and bad gene were observed in 8 cases of normal breast tissues, 19 cases of simple breast hyperplasia, 20 cases of breast atypical hyperplasia and 48 cases of breast cancer. Results bcl 2 expression was positive in all normal breast tissues and simple hyperplasia, compared to 58 33% in breast cancer and 85 0% in atypical hyperplasia(all P

Objective: To explore an ideal method for culturing autologous chondrocytes while maintaining their cartilaginous phenotype by combining monolayer culture with three-dimensional culture. Methods: Chondrocytes were cultured by routine monolayer culture method, then the chondrocytes of fourth passage were seeded into alginate beads for three-dimensional culture following standard protocols. The cell morphology was observed by inverted microscope at predefined time points. The cell viability and proliferation were tested by trypan blue and LIVE/DEAD® Kit, respectively. And extracellular matrix formation was examined by toluidine blue staining. Results: The cartilaginous phenotype of chondrocytes could only be maintained by passage 2 and 3 after monolayer culture. Three-dimensional culture could gradually regain and maintain the cartilaginous phenotype of de-differentiated chondrocytes (P4). Cells of P1-3 by monolayer culture could maintain 90% activity, which decreased from P4. The cytoactivity of cells by three-dimensional culture method was always above 90%. The total doubling rate till P6 by monolayer culture (28 days) was 44 times that by three-dimensional culture. The staining intensity of cartilaginous extracellular matrix was significantly decreased after P4 by monolayer culture (P<0.05). For three-dimensional method, the staining intensities of cartilaginous extracellular matrix at day 21 and 28 were significantly higher than that at day 7 (P<0.05). Conclusion: Monolayer culture allows proper proliferation of chondrocytes, and following three-dimensional culture in alginate beads can regain the cartilaginous phenotype of chondrocytes, thus achieving the aim of both amplification and maintenance of the cartilaginous phenotype.

10.3969/j.issn.1000-8179.2013.12.005

Objective To investigate the risk factors associated with feeding intolerance in very low birth weight infants (VLBWI) and to investigate the beneficial factors for preventing feeding intolerance.Methods Retrospectively analysis was carried out in 151 VLBWI cases in our hospital from January 2005 to November 2010.Logistic regression analysis was performed to find the risk factors of feeding intolerance.Results The overall rate of feeding intolerance in VLBWI was 47.7 ％ (72/151).Dysporia and infection were associated with feeding intolerance in VLBWI (Wald x2 =7.748 and 4.555,P =0.05 and 0.033 respectively).Gender,multifetation were not associated with feeding intolerance(Ps ＞0.05).Conclusion The feeding intolerance is associated with dysporia and infection in VLBWI.

Objective To observe efficacy and safety of long-term Statins treatment in elderly patients aged over 80 years,and to provide clinical evidence for the rational use of Statins.Methods 224 patients aged 80 years and over were divided into two groups:Statin group given Statins (n=107),and control group not given Statin (n=117).The serum levels of total cholesterol (TC),lowdensity lipoprotein cholesterol (LDL-C),high-density lipoprotein cholesterol (HDL-C) and triglyceride (TG) were measured,and liver and renal function,alanine aminotransferase (ALT),creatine phosphokinase (CPK) and epidermal growth factor receptor (EGFR) were tested.Results Pretreatment levels of TC and LDL-C levels were (4.6 ± 1.0) and (2.6 ± 0.8) mmol/L and were decreased to (4.3±0.9) and (2.4±0.6) mmol/L after 1 year treatment (t=3.535,3.448,both P＜0.05).The target rate in statin group for LDL C was 35.5 ％ in patients at very high risk.There were no significant differences in levels of ALT,CK and eGFR between pre-and post-treatment in both two groups [(20.2±9.2) U/L vs.(21.4±12.1) U/L,(86.5±53.9) U/L vs.(86.6±67.5) U/Land (53.1±17.3) ml/min vs.(51.9±18.0) ml/min,all P＞0.05].Compared with pre-treatment,1 year treatment showed that glucose level was increased [(5.9± 1.0) mmol/L vs.(6.0± 1.0) mmol/L,t=2.287,P＜0.05].Conclusions Long-term Statin treatment in elderly patients is safe and effective.We should correctly administer statin drugs,and closely monitor the safety indicators.

Adult ; Female ; Humans ; Male ; Occupational Diseases ; Organometallic Compounds ; poisoning