Objective To examine the relationship between gender and intraventricular hemorrhage (IVH) in very low birth weight infants (VLBWI) and extremely low birth weight infants (ELBWI).Methods From January 1,1999 to December 31,2012,data on VLBWI and ELBWI,who were admitted to the neonatal intensive care unit of Yuying Children's Hospital within 14 d after birth,were retrospectively collected.The Chi-square test and t test were used to compare neonatal outcomes between male and female infants.The Logistic model was used to analyze the risk factors for IVH.Results A total of 1 008 cases were enrolled,including 615 males and 393 females,895 VLBWI and 113 ELBWI.The incidence of IVH was 15.1％ (152/1 008) and the incidence of severe IVH was 8.4％ (85/1 008).Compared with females,males had a higher total incidence of IVH [17.2％ (106/615) vs 11.7％ (46/393),x2=5.728,P＜0.05] and severe IVH [9.8％ (60/615) vs 6.4％ (25/393),x2=3.896,P＜0.05].These differences were also seen in VLBWI with a birth weight of 1 250 to 1 499 g [IVH:13.7％ (47/344) vs 7.8％ (17/217),x2=4.473,P=0.034; severe IVH:7.6％ (26/344) vs 2.8％ (6/217),x2=5.684,P=0.017].Logistic regression analysis showed that the risk factors for IVH were as follows:gestational age ＜28 weeks (aOR=2.012,95％CI:1.288-3.143,P＜0.05),neonatal respiratory distress syndrome (aOR=l.584,95％CI:1.007-2.492,P＜0.05),invasive mechanical ventilation (aOR=2.743,95％CI:1.826-4.121,P＜0.05),electrolyte disturbance (aOR=2.128,95％CI:1.092-4.149,P＜0.05) and periventricular leukomalacia (aOR=2.901,95％CI:1.312-6.416,P＜0.05),but not male sex (aOR=1.351,95％CI:0.917-1.991,P=0.128).The risk factors for severe IVH were gestational age ＜28 weeks (aOR=2.200,95％CI:1.305-3.708,P＜0.05),invasive mechanical ventilation (aOR=4.714,95％CI:2.809-7.911,P＜0.05) and electrolyte disturbance (aOR=2.232,95％CI:1.047 4.759,P＜0.05),but not male sex (aOR=1.361,95％CI:0.823 2.252,P=0.247).Conclusions Male VLBWI and ELBWI have a higher incidence of IVH and severe IVH,but male sex is not a risk factor for IVH or severe IVH.

The DNA fragments of ag85b、esat-6、hsp65、mpb64 and ag85b-esat-6、hsp65-esat-6、mpb64-esat-6 were amplified by PCR and SOE technique.These seven fragments were inserted into pCDNA3.1(+)vector to construct recombinant plasmids pCA、pCE6、pCH、pCM、pCAE、pCHE and pCME.The seven plasmids were transfected into SP2/0 cell in vitro to detect the expression of target genes.BALB/c mice were intramuscularly vaccinated with the seven plasmids and the control vector pCDNA3.1(+)and PBS respectively.The serum antibodies and the spleen lymphocyte proliferation(SLP)and secreted IFN～? of spleen were tested.The results of indirect ELISA showed the levels of antibodies in all recombinant plasmids groups were significantly higher than the two control groups(P

AIMTo investigate the influence of cytochrom P450 CYP2C9 polymorphism on the pharmacokinetics of tolbutamide.

METHODSAn oligonucleotide microarray was designed and fabricated to genotype the CYP2C9 accurately and quickly. 137 healthy volunteers were genotyped with the array to investigate the frequency of CYP2C9 functional SNPs. Moreover, 1 homozygous mutant, 9 heterozygous and 10 wild-genotypes subjects in the assay were selected randomly and sequenced directly. After orally taking tolbutamide, blood samples and urine samples were collected, and their pharmacokinetics was studied with HPLC.

RESULTSCYP2C9 *1/*3 were found in 9 of 137 volunteers, CYP2C9 *3/*3 in only one, others were all CYP2C9 *1/*1 wild types. CYP2C9 *2, CYP2C9 *4 and CYP2C9 *5 alleles were not detected. Direct sequencing of the purified PCR products of the heterozygotes, mutant homozygotes and ten wild type individuals gave a corresponding result to that genotyped by microarray. Pharmacokinetic outcome showed that the individuals with CYP2C9 *1/*3 or CYP2C9 *3/*3 had slower metabolic elimination of tolbutamide than those with CYP2C9 *1/*1.

CONCLUSIONCYP2C9 genetic polymorphism has a significant influence on the pharmacokinetics of tolbutamide. Pharmacogenomic study will be helpful in guiding rational and individualized medication. Key words: tolbutamide; cytochrom P450 CYP2C9; allele; single nucleotide polymorphism; genotyping

Aryl Hydrocarbon Hydroxylases ; genetics ; Cytochrome P-450 CYP2C9 ; Genotype ; Heterozygote ; Homozygote ; Humans ; Oligonucleotide Array Sequence Analysis ; Polymorphism, Single Nucleotide ; Random Allocation ; Tolbutamide ; pharmacokinetics

AIMTo study the changes in rheological properties, namely the parameters of the hysteresis loops and yield stress versus time for human semen after ejaculation.

METHODSEjaculates were obtained from volunteers and immediately put into the test cup of a Brookfield Programmable DV-11 Rheometer, by which the hysteresis loops and yield stress were determined.

RESULTS(1) Yield stress values dropped down from more than 3000 mPa to 60 mPa in about 5 minutes after ejaculation; (2) The shape of the hysteresis loops of shear stress versus shear rate was changed from the counter-clockwise direction, that enclosed a large area, into the clockwise direction, that enclosed a very small area.

CONCLUSIONHuman ejaculate originally possesses semi-solid or visco-elastic body behavior and in 5 minutes after liquefaction, it becomes a thixotropic fluid or shearing thinning fluid with very low viscosity.

Adult ; Elasticity ; Humans ; In Vitro Techniques ; Linear Models ; Male ; Rheology ; Semen ; physiology ; Sperm Motility ; Stress, Mechanical ; Viscosity

Our previous results have demonstrated that insulin reduces myocardial ischemia/reperfusion (MI/R) injury and increases the postischemic myocardial functions via activating the cellular survival signaling, i.e., phosphatidylinositol 3-kinase (PI3-K)-Akt-endothelial nitric oxide synthase (eNOS)-nitric oxide (NO) cascade. However, it remains largely controversial whether c-Jun NH2-terminal kinase (JNK) is involved in the effects of insulin on MI/R injury. Therefore, the aims of the present study were to investigate the role of JNK, especially the cross-talk between JNK and previously expatiated Akt signaling, in the protective effect of insulin on I/R myocardium. Isolated hearts from adult Sprague-Dawley rats were subjected to 30 min of regional ischemia and followed by 2 or 4 h of reperfusion (n=6). The hearts were pretreated with PI3-K inhibitor LY294002, or phosphorylated-JNK inhibitor SP600125, respectively, then perfused retrogradely with insulin, and the mechanical functions of hearts, including the heart rate (HR), left ventricular developed pressure (LVDP) and instantaneous first derivation of left ventricular pressure (+/-LVdp/dt(max)) were measured. At the end of reperfusion, the infarct size (IS) and apoptotic index (AI) were examined. MI/R caused significant cardiac dysfunction and myocardial apoptosis (strong TUNEL-positive staining). Compared with the control group, insulin treatment in MI/R rats exerted protective effects as evidenced by reduced myocardial IS [(28.9 +/- 2.0)% vs (45.0 +/- 4.0) %, n=6, P<0.01], inhibited cardiomyocyte apoptosis [decreased AI: (16.0 +/- 0.7) % vs (27.6 +/- 1.3) %, n=6, P<0.01] and improved recovery of cardiac systolic/diastolic function (including LVDP and +/-LVdp/dt(max)) at the end of reperfusion. Moreover, insulin resulted in 1.7-fold and 1.5-fold increases in Akt and JNK phosphorylation in I/R myocardium, respectively (n=6, P<0.05). Inhibition of Akt activation with LY294002 abolished, and inhibition of JNK activation with SP600125 enhanced the cardioprotection by insulin, respectively. And the abolishment by LY294002 could be partly converted by SP600125 pretreatment. In addition, SP600125 also decreased the Akt phosphorylation (n=6, P<0.05). These results demonstrate that insulin simultaneously activates both Akt and JNK, and the latter further increases the phosphorylation of Akt which attenuates MI/R injury and improves heart function; this cross-talk between Akt and JNK in the insulin signaling is involved in insulin-induced cardioprotective effect.
Animals ; Apoptosis ; Heart ; Insulin ; metabolism ; JNK Mitogen-Activated Protein Kinases ; MAP Kinase Signaling System ; Myocardial Infarction ; Myocardial Ischemia ; Myocardial Reperfusion Injury ; Myocardium ; Myocytes, Cardiac ; Nitric Oxide Synthase Type III ; Phosphatidylinositol 3-Kinase ; metabolism ; Phosphatidylinositol 3-Kinases ; metabolism ; Phosphorylation ; Proto-Oncogene Proteins c-akt ; Rats ; Rats, Sprague-Dawley ; Reperfusion Injury ; Signal Transduction

OBJECTIVETo explore the association between the effort-reward imbalance at work and depressive symptoms among healthcare workers.

METHODSThe effort-reward imbalance at work was conceptualized in terms of the Chinese version of the effort-reward imbalance (ERI) model. Depressive symptoms were assessed by the Chinese version of the Center of Epidemiology Survey Depression (CES-D) scale. The data came from the cross-sectional survey of 1 179 healthcare workers aged between 18 and 73 employed in 6 affiliated hospitals of Zhejiang University. The questionnaire comprised questions on the effort-reward at work, over-commitment, the full CES-D scale of depression and a range of other characteristics. Univariate analyses were used with Spearman's correlation, Mann-Whitney test, Pearson chi(2) test and likelihood chi(2) test. Multivariate logistic regression analyses was used to discover factors associated with depressive symptoms.

RESULTSThe prevalence of depressive symptoms among healthcare workers was 48.12% (95% CI: 45.08% to 51.16%). The prevalence of depressive symptoms among nurses was 52.40% (95% CI: 47.87% to 56.93%) higher than doctors' 44.70% (95% CI: 10.64% to 48.77%) with the significant difference (chi(2) = 6.077, P = 0.014). Positive associations were found between the high effort-low reward, level of work-related over commitment and depressive symptoms (OR = 1.859, 95% CI: 1.337 to 2.585; OR = 2.207, 95% CI: 1.656 to 2.942) among healthcare workers, respectively.

CONCLUSIONThe high effort-low reward and the work-related over-commitment have a negative impact on healthcare workers' health.

Adolescent ; Adult ; Aged ; Depression ; epidemiology ; psychology ; Female ; Humans ; Logistic Models ; Male ; Medical Staff, Hospital ; psychology ; Middle Aged ; Models, Psychological ; Occupational Health ; Prevalence ; Surveys and Questionnaires

Objective:A structural equation model of the influencing factors on caregiver preparedness at discharge of patients with chronic heart failure was constructed based on the individual and family self-management theory, and the main paths influencing caregiver preparedness were explored.Methods:This study was a cross-sectional survey. A total of 345 caregivers of patients with chronic heart failure who were hospitalized in the Fourth Affiliated Hospital of China Medical University from October 2020 to August 2021 were selected as research objects by convenience sampling method, and they were investigated by Caregiver Preparedness Scale, Family APGAR Index, Herth Hope Index, Social Support-Rating Scale, Simplified Coping Style Questionnaire. The influencing factors on caregiver preparedness at discharge of patients with chronic heart failure were analyzed.Results:The total score of Caregiver Preparedness Scale, Family APGAR Index, Herth Hope Index, Social Support-Rating Scale, and Positive and Negative Coping Subscale of Simplified Coping Style Questionnaire in patients with chronic heart failure was (20.79 ± 4.92), (8.05 ± 1.43), (35.34 ± 4.47), (43.89 ± 6.56), (24.38 ± 5.21), (11.21 ± 4.26) points. Caregiver preparedness in patients with chronic heart failure was positively correlated with family function, hope, positive coping and social support ( r values were 0.213-0.383, all P<0.01), and negatively correlated with negative coping ( r=-0.546, P<0.01). Family function and social support in patients with chronic heart failure could directly or indirectly affect caregiver preparedness (total effect value: 0.380, 0.212), hope and negative coping directly affected caregiver preparedness (total effect value: 0.200, -0.433), and could account for 39% of the total variation in caregiver preparedness. Conclusions:Caregiver preparedness of patients with chronic heart failure needs further improvement. The effective ways to improve caregiver preparedness are to pay attention to family function, improve hope level, increase social support and reduce negative coping.

Objective To observe the changes of nerve fibers of internal capsule and motor function in patients with thalamic hematoma treated by minimally invasive procedures using diffusion tensor imaging (DTI).Methods Twenty-two patients with thalamic hematoma were randomized into minimally invasive treatment group (MI group) and medication treatment group (MT group).The patients in MT group were given conventional medical treatment,and those in MI group were performed intracranial hematoma elimination by the minimally invasive procedures within 24 h of admission and medical treatment was also given.The patients in both MI group and MT group underwent a whole-brain DTI on admission and 2 weeks after the admission.The integrity of corticospinal tract (CST) in the internal capsule ipsilateral to the hematoma side and the contralateral side and their fractional anisotropy (FA) values were determined.The modified National Institutes of Health Stroke Scale (mNIHSS) were performed on admission,2 weeks and 1 month after onset of initial hemorrhage.Results DTI showed that fibers in the internal capsule ipsilateral to the hematoma either decreased in number or interrupted because of hematoma-induced damages in both groups,and the CST FA values on admission were significantly lower (0.432±0.022 and 0.410±0.028 for MI and MT groups,respectively) than the control values.The number of fibers and the FA values of CST in the internal capsule 2 weeks after the hematoma being evacuated were increased significantly as compared with those on admission.As FA values of CST in internal capsule increased,the mNIHSS scores decreased after the surgery and the motor function improved gradually.Conclusion Minimally invasive procedures for thalamic hematoma evacuation can effectively reduce the degree of injury to the motor function,and DTI can observe the changes of CST after the surgery directly.

Objective To assess the influence of different interventional injection routes of raltitrexed on the liver function, histology and pharmacokinetics in experimental rabbits, and to discuss the feasibility, safety and advantages of local application of raltitrexed. Methods A total of 25 New Zealand white rabbits were randomly and equally divided into 5 groups with 5 rabbits in each group: group A (using peripheral intravenous injection), group B (employing hepatic arterial infusion), group C (adopting hepatic artery embolization with Lipiodol), group D (hepatic artery embolization with gelfoam particles), and group E (direct puncture of liver and injection). Clinical equivalent dose (0. 17 mg/kg) raltitrexed injection was given to each experimental rabbit. At 5, 15, 30, 60, 120 and 180 min after the treatment, venous blood sample was collected for pharmacokinetic analysis. At 6 h and one week after administration of drug, liver functions were tested, and histological specimens of liver tissues were made at the same time. Results The peripheral blood drug concentrations at 5 and 60 min in group A were 0. 91 μg/mL and 0 μg/mL respectively, at 5 and 180 min in group B were 1. 73 μg/mL and 0. 37 μg/mL respectively, at 5 and 180 min in group C were 0. 82 μg/mL and 0. 08 μg/mL respectively, at 5 and 180 min in group D were 0. 94 μg/mL and 0. 08 μg/mL, and at 5 and 60 min in group E were 0. 39 μg/mL and 0. 13 μg/mL respectively. Six hours after administration of drug, the serum levels of AST, ALT in group C, group D and group E were significantly increased (P＜0. 0l), which returned to normal levels in one week after the treatment. The severity of liver tissue degeneration and necrosis detected in each group varied, in a severity - decreasing order, from group E, group C, group D, group B and group A. In group E, the surrounding normal liver tissue had no obvious necrosis. Conclusion The rabbit' s liver has no significant first pass elimination effect to raltitrexed. The equivalent dose of raltitrexed administered through the hepatic artery can cause obvious hepatocellular injury. Direct puncture and injection produce limited liver injury. Clinically, the dose of raltitrexed can be adjusted based on the degree of super selective catheterization condition and tumor size. (J Intervent Radiol, 2018, 27:247-251)

OBJECTIVETo evaluate the therapeutic effect of retained copper wires combined with pingyangmycin (PYM) injection for complicated cavernous venous malformation.

METHODSThe location of venous malformation was detected by physical examination and MRI. The copper wires in 0.2 mm width were used to puncture the lesion repeatedly and retained in the lesion to form a net. After that, 8 mg PYM was injected into the residue malformed veins. 8-10 days later, the copper wires were taken out and necrotic tissue was squeezed out. The wounds of punctual holes healed through dressing. The patients received postoperative MRI to evaluate the therapeutic effect.

RESULTSFrom Jan. 2002 to Dec. 2008, 45 cases were treated. The patients were followed up for 1-3 years. 51.1% (23/45) of the lesions shrinked markedly or even disappeared. 42.2% (19/45) of the lesions reduced. 6.67% (3/45) of the lesions didn't change. There was no complication like invasive infection.

CONCLUSIONSIt is very effective to treat complicated cavernous venous malformation with retained copper wires combined with pingyangmycin injection.

Arteriovenous Malformations ; therapy ; Bleomycin ; analogs & derivatives ; therapeutic use ; Catheters, Indwelling ; Child ; Copper ; therapeutic use ; Female ; Humans ; Injections, Intralesional ; Male ; Young Adult