Objective To investigate the effects of early nasal intermittent positive pressure ventilation (NIPPV) compared with early continuous positive airway pressure (NCPAP) in low birth weight preterm infants with respiratory distress syndrome (RDS).Methods We performed a prospective,randomized controlled trial involving 364 low birth weight preterm infants with respiratory distress syndrome within 6 hours of birth.The infants were randomly assigned to NIPPV (n=188) or NCPAP (n=176) groups.Non invasive ventilation was initiated in the neonatal intensive care unit (NICU).The rate of mechanical intubation (within 3 days or 7 days),the use of pulmonary surfactant (PS),the rate of complications and mortality were compared between the two groups.Mann Whitney U,t and Chi-square tests were used for statistical analysis.Results The average time of invasive mechanical ventilation in NIPPV group were lower than that in NCPAP group[2.0 (1.0-4.0) d vs 7.0 (3.0-8.5) d,U=-3.457,P=0.001].The need for intubation and mechanical ventilation by day 3 and day 7 in the NIPPV group were less than those in the NCPAP group [day 3:4.8％ (9/188) vs 10.8％ (19/176),x2=4.621,P=0.032; day 7:9.0％ (17/188) vs 16.5％ (29/176),x2=4.551,P=0.033].In the NIPPV group,infants who got PS therapy was less than that in the NCPAP group [3.2％ (6/188) vs 8.5％ (15/176),x2=4.752,P=0.029].There was no significant difference in the fatality rate between the NIPPV and the NCPAP group [12.8％ (24/188) vs 10.8％ (19/176),P ＞ 0.05].There were no significant difference in the incidence of air leak,intracranial hemorrhage,periventricular leukomalacia,retinopathy of prematurity,necrotizing enterocolitis,patent ductus arteriosus,and bronchopulmonary dysplasia between the NIPPV group and the NCPAP group.Conclusion Among low birth weight prcterm infants with RDS,the early use of NIPPV reduces the need for PS,intubation and invasive ventilation compared with NCPAP.

Objective To explore whether the amount of lipocalin-2 in the biofluid could reflect the onset of sepsis-induced acute lung injury (ALI) in mice.
Methods Lipopolysaccharide (LPS, 10 mg/kg) injection or cecal ligation and puncture (CLP) was performed to induce severe sepsis and ALI in C57 BL/6 male mice randomly divided into 5 groups (n=10 in each group):group A (intraperitoneal LPS injection), group B (intravenous LPS injection via tail vein), group C (CLP with 25%of the cecum ligated), group D (CLP with 75%of the cecum ligated), and the control group (6 sham-operation controls plus 4 saline controls). All the mice received volume resuscitation. Measurements of pulmonary morphological and functional alterations were used to identify the presence of experimental ALI. The expressions of lipocalin-2 and interleukin (IL)-6 in serum, bronchoalveolar lavage fluid (BALF), and lung tissue were quantified at both protein and mRNA levels. The overall abilities of lipocalin-2 and IL-6 tests to diagnose sepsis-induced ALI were evaluated by generating receiver operator characteristic curves (ROC) and computing area under curve (AUC).
Results In both group B and group D, most of the“main features”of experimental ALI were reproduced in mice, while group A and group C showed septic syndrome without definite evidence for the presence of ALI. Compared with septic mice without ALI (group A+group C), lipocalin-2 protein expression in septic mice with ALI (group B+group D) was significantly up-regulated in BALF (P<0.01) and in serum (P<0.01), and mRNA expression boosted in lung tissues (all P<0.05). Lipocalin-2 tests performed better than IL-6 tests in recognizing sepsis-induced ALI cases, evidenced by the larger AUC of the former (BALF tests, 0.8800 versus 0.6625;serum tests, 0.8500 versus 0.7000). Using a dual cutoff system to diagnose sepsis-induced ALI, BALF lipocalin-2 test exhibited the highest positive likelihood ratio (13.000) and the lowest negative likelihood ratio (0.077) among the tests of lipocalin-2 and IL-6 in blood and BALF. A statistically significant correlation was found between lipocalin-2 concentration in BALF and that in serum (Spearman r=0.8803, P<0.0001).
Conclusions Lipocalin-2 expression is significantly up-regulated in septic ALI mice compared with those without ALI. Lipocalin-2 tests with a dual cutoff system could be an effective tool in distinguishing experimental ALI cases.

Hemangioma ; pathology ; Humans ; Joint Diseases ; pathology ; Male ; Middle Aged ; Synovial Membrane ; pathology

Objective To provide insights into the evaluation index and evaluation methods of clinical thinking of nursing staff.Methods 14 nursing experts in Heilongjiang province were interviewed by a halfstructured in-depth outline with 8 questions.Themes were obtained by phenomenological data analysis method,including coding,classification,explanation of phenomena and significance,refining essence and elements.Results Two themes of evaluation approach of clinical thinking of nursing staff was obtained:evaluation index and evaluation method.Basic theoretical knowledge,basic practical skills,strain capacity,communication ability,originality of thinking and critical thinking are subthemes of the evaluation index.The best way of evaluating methods is combining multiple evaluations.Conclusions Cultivation of clinical thinking of nursing staff requires efforts from schools and hospitals to establish a scientific,rigorous evaluation approach.

OBJECTIVETo evaluate the occurrence and prognosis of telbivudine (LdT) therapy-associated elevations in creatine kinase (CK) in chronic hepatitis B (CHB) patients.

METHODSForty-nine patients treated with LdT from 2004 to 2010 were evaluated for development of CK elevation. In particular, the occurrences of grade 3/4 CK elevations (7-times the upper limit of normal (ULN)) and muscle damage were assessed over duration of the LdT treatment.

RESULTSThe rate of CK elevation increased with duration of LdT treatment (1 year: 61.2%; 5 years: 95.9%). In addition, the severity of CK elevation showed a trend for increasing with duration of LdT treatment, with grade 1/2 CK elevations increasing from 57.1% at year 1 to 81.6% at year 5 and grade 4 increasing from 4.1% at year 1 to 14.3% at year 5. Grade 3/4 CK elevations were observed in seven patients between LdT treatment weeks 36 and 168, but occurred most frequently between weeks 52 and 104, when the maximum peak value occurred (35.8-times the ULN). LdT treatment was stopped in two patients due to excessive CK elevation and one patient due to myositis. The majority of cases of LdT-associated grade 3/4 CK elevations were self-limiting, transient (decreasing to grades 0 or 2 within 2-3 weeks), and present without myalgia.

CONCLUSIONElevation of CK was not rare in CHB patients treated with LdT, but most cases resolved spontaneously. In general, the severity and persistence of CK elevation was not sufficient to warrant withdrawal of LdT.

Adolescent ; Adult ; Aged ; Antiviral Agents ; adverse effects ; therapeutic use ; Creatine Kinase ; metabolism ; Hepatitis B, Chronic ; drug therapy ; metabolism ; Humans ; Middle Aged ; Thymidine ; analogs & derivatives ; therapeutic use ; Young Adult

Objective To assess the changes in iodine status and dietary iodine intake among Shanghai residents since common salt was iodized 20 years ago.Methods As-CE Catalysis spectrophotometry was used to determinate the urine iodine level in school-age children,pregnant women,wet nurse and adults of Shanghai between 1995 and 2015.B ultrasonic was used to determinate the thyroid volume of school-age children.And then the goiter rate was calculated.Direct titration or arbitration methods were applied to detect the household salt iodine level quantitatively.The survey was conducted by using 3 days 24-hour dietary questionnaire and condiment weighing methods to analyze the level of iodine intake and sources for the cases of all iodized salt consumption and all consumption of non-iodized salt.Results The median urine iodine concentration (UIC) of school age children was 72.3 μg/L in 1995,rose to 214-231 μg/L from 1997-1999,and then became stable between 100 μg/L and 200 μg/L since 2002.The goiter rate was below 5% among children aged 8-10 from 1995-2015 in Shanghai.The median urine iodine of pregnant women was between 126.5 μg/L and 139.8 μg/L.The median UIC of other populations were all between 100 μg/L and 200 μg/L: with adults,lactating women,infants and young children and women of childbearing age,the median urinary iodine was 138.4,123.1-131.1,150.1 and 125.6 μg/L.The qualified iodized salt at household consumption rate was 90% from 2001 to 2009,the percentage declined year by year from 2010.In the cases of all taking iodine salt,the median iodine intake volume for male aged 7-10,11-13,14-18 and over 18 was 200.3,235.5,252.7 and 215.4 μg/L;women aged 7-10,11-13,14-18 and over 18 was 193.0,213.8,208.3 and 186.1 μg/L.The contribution rate of iodine salt in the diet were 51.6%-54.1% and 49.1%-53% in men and women.Kelp,seaweed and fish and shrimp on the contribution of iodine are 7.6%-16.6% and 4.5%-7.4%.Conclusion In the past about 20 years,iodine nutritional status of residents in Shanghai has stabilized totally in a appropriate and safe level.However,the iodine nutrition of pregnant women was insufficient.As iodized salt is the major source of dietary iodine in coastal areas,it is still necessary to continue the policy of universal salt iodized in Shanghai to ensure residents'' needs for iodine and control the risk of iodine deficiency.

OBJECTIVESTo investigate the transmission process of severe acute respiratory syndrome (SARS) and to evaluate the infectiveness of SARS patients in different periods of disease epidemics.

METHODSStandardized questionnaire was used to conduct case investigation and contact tracing by combining the field investigation and telephone interview. Transmission process, infectivity, transmission chain and contact history of SARS were studied through data analyses.

RESULTSOn 25th March 2003, a 91 year old man was admitted to Hospital J in Beijing with stroke and fever. He died on 30th March. From 31st March, there was an outbreak of SARS among his contacts in the family and in the hospital he was admitted to. Contacts would include his relatives, other co-patients and health care workers in the Hospital J. Chinese Field Epidemiology Training Program trainees conducted an investigation of the outbreak. Among the 207 contacts of the index cases through different generations, there were 36 cases of SARS (attack rate 17%) patients with one death. There were 12 cases having directly contact with the index case and 13 cases with one secondary case. The transmission chains of this outbreak could clearly be depicted. All the cases had close contacts during the symptomatic period of their index patients. Among the relatives, 85% of the cases had 3 - 5-day contact with their index patients after the onset of the illnesses. There was no significant difference between the two attack rates-70% for whose who had contact with the patient before and after illness onset) and 67% for those who only had contact after the onset of the illness. Out of the 44 social acquaintances and 38 of the family members who had contacts with the index patients during the incubation period, no one was found ill. Among the close contacts at the hospital who had no protection when providing care to the patient, the attack rate was found over 80%.

CONCLUSIONSAll the secondary cases of this outbreak had a history of direct and close contacts to the index patients after the onset of the illness. There was no evidence indicating that SARS cases were infectious during their incubation period.

Aged ; Aged, 80 and over ; China ; epidemiology ; Humans ; Infectious Disease Transmission, Patient-to-Professional ; Male ; Severe Acute Respiratory Syndrome ; epidemiology ; prevention & control ; transmission

OBJECTIVETo explore types of organic components and pollution level of di-n-butyl phthalate (DBP) between human milk and cow milk products.

METHODSForty healthy postpartum women with an average age of (27.44 ± 3.43) years old were selected, and a 5 ml sample of breast milk were collected. Four different brands of fresh cow milk and 1 brand of milk powder were randomly selected in the market. A total of 15 samples were collected with 3 from each brand, and the qualitative analysis of types of organic components and quantitative analysis of DBP were conducted by gas-chromatography and mass-spectrometry (GC/MS) method.

RESULTSA total of 176 different types of organic components were detected in 40 samples of human milk (averaged at (10.58 ± 4.16) types per sample); 37 different types were detected in 12 samples of fresh cow milk (averaged at (8.67 ± 1.61) types per sample); while 31 types of organic components were detected in 3 samples of milk powder (averaged at (12.67 ± 0.58) types per sample). It was obvious that the types of organic components in milk powder were significantly higher than the other two groups (t = 2.09, 4.00, P < 0.05). The most frequent organic component in human milk and cow milk was 9-octadecenoic acid (45.00% (18/40) in human milk; 53.33% (8/15) in cow milk). DBP concentrations were (57.78 ± 35.42) µg/L, (20.76 ± 6.60) µg/L and (0.45 ± 0.05) mg/kg (equal to (66.78 ± 7.60) µg/L) in human milk, fresh cow milk and milk powder, respectively. The DBP concentration in fresh cow milk was significantly lower than those in human milk and milk powder (t = 37.02, 46.02, P < 0.05).

CONCLUSIONBoth human milk and cow milk contain different types of organic pollutants, some of which have toxic effects on reproduction and human development.

Adult ; Animals ; Cattle ; Dibutyl Phthalate ; analysis ; Diethylhexyl Phthalate ; analysis ; Environmental Pollutants ; analysis ; Female ; Humans ; Milk ; chemistry ; Milk, Human ; chemistry

BACKGROUNDHepatocellular carcinoma tends to present at a late clinical stage with poor prognosis. Therefore, it is urgent to explore and develop a simple, rapid diagnostic method, which has high sensitivity and specificity for hepatocellular carcinoma at an early stage. In this study, the serum proteins in patients with hepatocellular carcinoma or liver cirrhosis and in normal controls were analysed. Surface enhanced laser desorption/ionization time-of-flight mass (SELDI-TOF-MS) spectrometry was used to fingerprint serum protein using the protein chip technique and explore the value of the fingerprint, coupled with artificial neural network, to diagnose hepatocellular carcinoma.

METHODSOf the 106 serum samples obtained, 52 were from patients with hepatocellular carcinoma, 22 from patients with liver cirrhosis and 32 from healthy volunteers. The samples were randomly assigned into a training group (n = 70, 35 patients with hepatocellular carcinoma, 14 with liver cirrhosis, and 21 normal controls) and a testing group (n = 36, 17 patients with hepatocellular carcinoma, 8 with liver cirrhosis, and 11 normal controls). An artificial neural network was trained on data from 70 individuals in the training group to develop an artificial neural network diagnostic model and this model was tested. The 36 sera in the testing group were analysed with blind prediction by using the same flowchart and procedure of data collection. The 36 serum protein spectra were clustered with the preset clustering method and the same mass/charge (M/Z) peak values as those in the training group. Matrix transfer was performed after data were output. Then the data were input into the previously built artificial neural network model to get the prediction value. The M/Z peaks of the samples with more than 2000 M/Z were normalized with biomarker wizard of ProteinChip Software version 3.1 for noise filtering. The first threshold for noise filtering was set at 5, and the second was set at 2. The 10% was the minimum threshold for clustering. The statistical analysis of the data of serum protein mass spectrum was performed in the groups (normal vs. hepatocellular carcinoma, and liver cirrhosis vs. hepatocellular carcinoma) with the t test.

RESULTSComparison between the groups of hepatocellular carcinoma and normal control: The mass spectra from 56 samples (hepatocellular carcinoma and normal controls) in the training group were analysed and 241 peaks were obtained. In addition, 21 peaks from them were used for comparison between the groups of hepatocellular carcinoma and normal controls (P < 0.01). Only 2 peaks at 3015 M/Z and 5900 M/Z were selected with significant difference (P < 10 (-9)). A model was developed based on these two proteins with different M/Z. It was confirmed that this artificial neural network model can be used for comparison between the groups of hepatocellular carcinoma and normal controls. The sensitivity was 100% (17/17), and the specificity was 100% (11/11). Comparison between the groups of hepatocellular carcinoma and liver cirrhosis: The mass spectra from 49 samples in the training group (including patients with hepatocellular carcinoma and liver cirrhosis) were analysed and 208 peaks were obtained. In addition, 21 peaks from them were used for comparison between the groups of hepatocellular carcinoma and liver cirrhosis (P < 0.01). Only 2 peaks at 7759 M/Z, 13134 M/Z were selected with significant difference (P < 10 (-9)). A model was developed based on these two proteins with different M/Z. It was confirmed that this artificial neural network model can be used for comparison between the groups of hepatocellular carcinoma and liver cirrhosis. The sensitivity was 88.2% (15/17), and the specificity was 100% (8/8).

CONCLUSIONSThe specific biomarkers selected with the SELDI technology could be used for early diagnosis of hepatocellular carcinoma.

Adult ; Aged ; Aged, 80 and over ; Blood Proteins ; analysis ; Carcinoma, Hepatocellular ; blood ; diagnosis ; Female ; Humans ; Liver Cirrhosis ; blood ; Liver Neoplasms ; blood ; diagnosis ; Male ; Middle Aged ; Neural Networks (Computer) ; Peptide Mapping ; Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization ; alpha-Fetoproteins ; analysis

A novel transformation method was firstly established using glass beads in Dunaliella salina (D. salina). The results showed that the GUS gene, a reporter gene, was successfully expressed in D. salina. Cells of D. salina presented blue color under the microscope after stained. In addition, different factors which influenced transformation were optimized including the transformation consecutive time, rotate speed, concentration of the plasmid and PEG 6000. The experiment indicated that this fit together can obtain the best results for D. salina transformation: adding 150 microL PEG and 90 microL plasmid DNA to 800 microL culture of D. salina (10(6) cells/mL) containing 300 mg glass beads, swirling 12 seconds under the rotate speed 2400r/min. This newly method can be used as a potential tool in the research of D. salina gene engineering with the advantage of more simpleness, convenience, quickness and less expense.
Chlorophyta ; genetics ; DNA ; chemistry ; genetics ; Genetic Engineering ; methods ; Glass ; Glucuronidase ; genetics ; metabolism ; Histocytochemistry ; Microspheres ; Plasmids ; genetics ; Polyethylene Glycols ; chemistry ; Time Factors ; Transformation, Genetic ; genetics