Objective To explore the risk factors and outcomes associated with pulmonary hemorrhage in very low and extremely low birth weight infants.Methods Retrospective analysis were performed to predict risk factors for pulmonary hemorrhage in very low and extremely low birth weight infants (birth weight less than 1200g) admitted to NICU of Shengjing Hospital from Jan.2010 to Dec.2015.Infants at similar birth weight without pulmonary hemorrhage were as controls.We compared the characteristics of both maternal and infants.Multivariable Logistic regression models were derived to predict pulmonary hemorrhage.Short outcomes of the infants were assessed.Results Of the 435 neonates,71 developed pulmonary hemorrhage (pulmonary hemorrhage group),364 were as controls (control group).Gestational age[(28.2±1.7)week],birth weight[(936±192)g] in pulmonary hemorrhage group were significantly lower than those in control group[(29.5±2.1)week,(1033±134)g,t=4.776,5.145,P<0.01].Neonatal respiratory distress syndrome(RDS)(76.1%),pulmonary surfactant (PS)use(PS use≥2 courses)[76.1%(9.9%)],patent ductus arteriosus (PDA)(66.2%)were significantly higher than those in control group[41.2%,30.8%(4.1%),38.7%;χ2=33.457,28.970(4.074),32.798,P<0.05].Antenatal corticosteroids utility ratio (21.1%)was lower than that in the control group (41.2%;t=10.177,P< 0.001).Multiple factors Logistic stepwise regression analysis showed that RDS (OR=3.739,95%CI 1.383-10.113,P<0.05 ),PDA (OR=2.206,95%CI 1.205-4.093,P<0.05),and 5 minutes Apgar score <7(OR=2.851,95%CI 1.191-6.828) were independent risk factors of pulmonary hemorrhage,and higher birth weight (OR=0.998,95%CI 0.996-1.000,P<0.05) and the use of antenatal corticosteroids (OR=0.432,95%CI 0.224-0.834,P<0.05) were the protection factors in pulmonary hemorrhage.In pulmonary hemorrhage group,the incidence of intracranial hemorrhage,retinopathy of prematurity and severe bronchopulmonary dysplasia(16.9%,12.7% and 18.3%) were significantly higher than those in control group (5.8%,4.4% and 2.2%;χ2=36.824,7.520 and 33.568,P<0.01);Compared to control group,the mortality in pulmonary hemorrhage group was higher (49.3% vs.14.0%;χ2=46.634,P<0.01).Conclusion Pulmonary hemorrhage in very low and extremely low birth weight infants is associated with multiple factors.Prevention of premature birth and prenatal corticosteroids treatment can help prevent the occurrence of pulmonary hemorrhage.The incidences of poor outcomes are higher in newborns with pulmonary hemorrhage.

Objective To investigate the effectiveness of endoscopy and enteral nutrition (EN) in the treatment of acute biliary pancreatitis (ABP) in elderly patients and its impact on prognosis.Methods Eighty-four elderly patients with ABP were randomly divided into two groups,including 42 cases of combination treatment group,42 cases of routine treatment group.The routine treatment group was managed with normal comprehensive treatment,and in combination treatment group,patients were treated with additional endoscopic retrograde cholangiopancreatography (ERCP),endoscopic sphincterotomy (EST) and endoscopic naso-biliary (ENBD) drainage and EN.The clinical symptoms,serum inflammatory cytokines,complications and prognosis were compared.Results The CRP,TNF-α,IL-2,and serum amylase,glucose,AST after treatment were significantly lowered than those before treatment (P ＜ 0.05).In addition,the levels of CRP,TNF-α,IL-2,and serum amylase,glucose,AST,ALB in combination treatment group were significantly lower than those in routine treatment group (P ＜ 0.05).The time to abdominal pain cessation,time to fever cessation,hospital stay in combination treatment group were (4.6± 1.3),(3.7± 1.3),(13.5± 2.7) d,which were significantly lower than those in routine treatment group [(6.1 ± 1.3),(5.5 ± 2.1),(18.1 ± 3.8) d,P ＜ 0.05].The APACHE Ⅱ score of combination group after treatment was (7.l ± 1.8) point,which was significantly lower than that in routine treatment group [(9.2 ± 2.6) point,t =3.41,P ＜ 0.05)].The incidence rates of ARF,ARDS,peri-pancreatic infection and abdominal hemorrhage,in combination group were 7.1％,4.8％,4.8％,4.8％,respectively,which were significantly lower than those in routine treatment group (23.8％,19.1％,21.4 ％,19.1％,P＜0.05).The mortality in combiration group was 4.8％,which was lower than 16.7％ in routine treatment group with no statistical significant.Conclusions It is a safe and effective to treat elderly ABP patients with endoscopy combined with EN,which can significantly reduce complications and mortality.

Objective To Evaluate the efficacy and safety of Qingre-Huoxue Recipe ( QHR ),Qingre -Huoxue Recipe and Methotrexate(QHR+MTX) in improving clinical symptoms of dampness-heat and blood-stasis syndrome of rheumatoid arthritis.Methods According to multi-center,randomized,and control intervention design,142 RA patients were randomly divided into QHR group (71 cases) and QHR+MTX group (71 cases).With clinical symptoms as evaluation indexes,FAS set and PP set were adapted for analysis.Results FAS set analysis:Both groups can significantly reduce pain VAS score [ (4.82 ± 1.98) vs (4.31 ± 1.85) ],reduce tenderness and swollen joint number[(4.87±4.05)vs(4.20±3.36)、(8.72±6.24)vs(7.14±5.03)respectively],shorten morning stiffness [ (39.56 ± 46.68) min vs (36.65 + 42.58) min] and significantly reduce the symptoms of fatigue[ (4.13 ±2.34) vs (3.74 ±2.20) ],also with good security.But there was no statistically significant difference between the two groups.Conclusion Qingre-Huoxue Recipe with MTX had no significant advantage in improving clinical symptoms in patients with the dampness-heat and blood-stasis syndrom of RA than without MTX.

Objective: To investigate the plasma effective constituents of Beagle dogs after oral administration with the extract of Polygonum multiflorum thunb. Methods: Based on the established HPLC fingerprints, comparison was carried out among the blank plasma, plasma containing drug, Polygonum multiflorum thunb. Simultaneously, the retention time and UV spectrogram were utilized as index to evaluate the relation among the fingerprint peaks so as to confirm the original of peaks. Result: Fourteen components were detected after oral administration. Four of them were the original components existed in Polygonum multiflorum thunb and ten of them were metabolites. Conclusion: Studying on the constituents and metabolites in plasma is useful to research the effective substances of Chinese medicine of Polygonum multiflorum thunb in vivo.

Background and purpose:To investigate the induction of apoptosis by epigallocatechin-3-gallate(EGCG) in xenograft nude mice with human gastric cancer cells and its molecular mechanism. Methods:Human gastric cancer cells were planted into nude mice in order to establish the cancer model, the different dosages of EGCG were injected intraperitoneally in the nude mice. After treatment, flow cytometry (FCM) was used to detect the apoptosis of implanted tumor cells. Immunohistochemical staining was used to detect the expression of apoptosis-related genes like Bal-2 and Bax in implanted tumor.Results:EGCG significantly inhibited tumor growth after being injecting intraperitoneally in the nude mice. The apoptotic cells in implanted tumor could be detected by flow cytometry with PI staining. The expressions of Bax、Caspase-3 were upregulated and Bcl-2 expression was downregulated in implanted tumor.Conclusions:EGCG could significantly inhibit tumor growth in xenograft nude mice with human gastric cancer cells through inducing apoptosis. The down-regulation of Bcl-2 expression and up-regulation of Bax expression observed could result in the activation of Caspase-3, the pathway might account for the induction of apoptosis.

AIM: To compare the impacts of adriamycin(ADM) intermittent and continuous heat infusion on respiration, heart rate and temperature of the rabbit as well as the concentration of ADM in VX-2 tumor for the verification of the safety and effectiveness of intermittent heat infusion through VX-2 transplanted tumor model in rabbit liver.METHODS: VX-2 tumor models were established respectively in the thighs of 30 New Zealand rabbits. All 30 rabbits were randomly allocated into three groups with 10 rabbits each. After catheterizing into femoral artery, which was demonstrated as the supply artery of tumors by digital subtraction angiography(DSA), animals in three groups were infused with 100 mL saline at normal temperature and ADM, 100 mL saline at 60 ℃ and ADM continuously and 100 mL saline at 60 ℃ and ADM intermittently respectively. During infusion, the 43 ℃ to 45 ℃ lasting time in the tumor tissues of the two 60 ℃ groups was measured. After infusion, the respiration(time/minute), heart rate(beats/minute) and temperature(℃ )of the rabbits in each group as well as the concentrations of ADM in tumor tissue were measured immediately.RESULTS: The concentration of ADM was (7. 1 ± 2.2) mg/L in normal temperature infusion group, (17.2 ± 1.6) mg/L in 60 ℃ continuous infusion group and(16.5 ±3.4) in 60 ℃ intermittent infusion group. There were significant differences among three groups( F = 48.95, P = 0. 000), but there was no significant difference between 60 ℃ intermittent infusion group and 60 ℃ continuous infusion group( P ＞ 0. 05). 43℃ to 45 ℃ lasting time was(22.5 ±1.4) minutes in 60 ℃continuous infusion and (24.3±2.4)minutes in 60 ℃intermittent infusion group( F =4.20, P ＞ 0.05) . There were significant differences among three groups in respiration, heart rate and temperature( F = 14. 58, 33.07, 10.00, P ＜ 0.01), but there was no significant difference in the respiration, heart rate and temperature between 60℃ intermittent infusion and normal temperature infusion group ( P ＞ 0. 05).CONCLUSION: Intermittent thermochemotherapy is a more effective and safe interventional thermochemotherapy method compared with continuous heat infusion.

Objective To investigate the diagnostic value of transbronchial lung biopsy (TBLB) under virtual bronchoscopic navigation (direct path), endobronchial ultrasonography with a guide sheath (GS) and rapid on-site evaluation (ROSE) for solitary pulmonary nodules (SPNs). Methods One hundred and seventy-eight patients who were underwent transbronchial lung biopsy in the Tianjin Medical University General Hospital between January 2015 to December 2016 were retrospectively evaluated. CT images of all patients showed solitary pulmonary nodules surrounded by lung tissue, and ROSE was undergone during the procedure. The patients were divided into conventional (C-TBLB) group, virtual bronchoscopic navigation (VBN) group, endobronchial ultrasonography with a guide sheath (GS) group, and virtual bronchoscopic navigation combined with endobronchial ultrasonography with a guide sheath group (combination) depending on the different devices. The diagnostic yield and the location or the effect of lesion on the diagnostic rate were compared between four groups. The coincidence rate of ROSE and the histopathological findings of TBLB were compared. The value of ROSE for the early diagnosis of disease was further evaluated. Results The diagnostic rates were 32.5％(13/40), 66.7％(24/36), 68.2％(30/44) and 75.8％(44/58) for C-TBLB group, VBN group, GS group and combination group, respectively. There were significant differences in diagnostic rates between C-TBLB group and other tree groups (χ2=8.853, 10.677 and 18.293, P<0.008). But there were no significant differences in diagnostic rates between VBN group, GS group and combination group (P>0.008). The diagnostic rates for peripheral pulmonary nodules were 12.5％ (2/16), 42.9％ (6/14), 40.0％ (4/10) and 75.9％(22/29) in C-TBLB group, VBN group, GS group and combination group. The diagnostic rate was significantly higher in combination group than that of other three groups (χ2=17.434, P<0.05). The result of ROSE was consistent with result of histopathology (Kappa = 0.775, P<0.001). The sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of ROSE during transbronchial biopsy for solitary pulmonary nodules were 90.7％, 87.0％, 86.7％, 90.9％ and 88.8％, respectively. No pneumothorax, hemoptysis or other serious complications were found in patients. Conclusion Virtual bronchoscopic navigation, endobronchial ultrasonography with a guide sheath for solitary pulmonary nodules by transbronchial lung biopsy can improve the diagnostic rate of solitary pulmonary nodules.

Anti-angiogenesis mechanism plays a vital role in tumor targeting immunotherapy. Based on the amino acid sequence of an anti-VEGFR-2 scFv-Fc fusion antibody (AK404R-Fc), this article is aimed to generate an anti-VEGFR-2 human IgG1-like full length antibody (Mab-04). Firstly, the light chain (L-chain) and heavy chain (H-chain) were obtained by overlap PCR and then linked to eukaryotic expression vector pcDNA3.1, separately. The recombinant plasmids (pcDNA3.1-L-chain and pcDNA3.1-H-chain) were then co-transfected into CHO-k cells using liposome transient transfection. Subsequently, Mab-04 antibody was expressed and purified by Protein A affinity chromatography. Western blotting was applied to identify the expression of Mab-04 and its affinity was detected by ELISA assay. DNA sequencing revealed the successful construction of recombinant plasmids and Western blotting assay proved the successful expression of full-length antibody (1 microg x mL(-1)). Finally, ELISA assay illustrated that the binding of the antibody to its antigen was in a concentration-dependent manner (IC50: 50 nmol x L(-1)). These outcomes above indicated that Mab-04 was successfully expressed and assembled, which laid the foundation for further preparation and antineoplastic activity study.

AIM: To retrospectively analyze selection of operation, surgery effect, complications and treatment methods of super high myopia combined with rhegmatogenous retinal detachment( RRD) .
METHODS:A total of 47 cases(47 eyes) with the super high myopia patients combined with RRD who accepted scleral buckling of external pressure, vitrectomy combined silicone oil filling, or intravitreous gas injection were chosen in our hospital from Jan. 1, 2011 to Jan. 1, 2016. Best corrected visual acuity ( BCVA), intraocular pressure, retinal reattached rate, closure rate of holes and the postoperative complications of patients in half year were analyzed.
RESULTS:Half a year postoperation, BCVA of twenty-four cases underwent vitrectomy combined silicone oil filling were improving(71%), and eight cases with scleral buckling surgery were enhanced ( 73%) . Statistical test showed the surgical treatment could significantly improve patients'eyesight, especially PPV with silicone oil, but the BCVA of patients with scleral buckling of external pressure in this study had no obvious significance according to the rank sum test. Compare with other surgery, pars plana vitrectomy( PPV ) combined silicone oil filling had more complications, such as high intraocular pressure and diplopia.
CONCLUSION: The therapy of super high myopia patients with rhegmatogenous retinal detachment need many years' clinical experience, surgical skill of clinician and according to the number, the shape and the site of the retinal holes and area of detached retina, they need to choose the right means of surgery, and timely deal with postoperative complications, in order to improve the patients' postoperative retina, reset rate and visual function.

Diabetic retinopathy(DR), one of the most common retinal vascular disease, is one of the causes of blindness for people over the age of 50.In the early stage of DR, microvascular cells are damaged, expand, start to leak, form micro hemangioma, then show occlusion, and non-perfusion area come into being, eventually form new blood vessels because of ischemia and hypoxia of retina.Illness develop into proliferative diabetic retinopathy(PDR).With the aggravation of the disease, PDR can cause the formation of fibrovascular membrane, the more serious fibrillation of epiretinal membrane, resulting in traction retinal detachment(tRD).Present studies suggest that aquaporins, the essential component of new blood vessels, including aquaporin 1 and aquaporin 4, play a significant pole in the development of diabetic retinopathy, causing the destruction of blood retinal barrier, inducing retinal edema, even macular edema, and participating in the formation of retinal angiogenesis.