Exchange Transfusion, Whole Blood ; methods ; Female ; Follow-Up Studies ; Humans ; Hyperbilirubinemia, Neonatal ; blood ; therapy ; Infant, Newborn ; Male

Adult ; Female ; Humans ; Leukemia, Promyelocytic, Acute ; complications ; drug therapy ; Sinus Thrombosis, Intracranial ; complications ; drug therapy ; Tretinoin ; therapeutic use

Abstract: Objective　To understand the pollution characteristics and sources of PM2.5 in the atmosphere during heating and non-heating periods in Urumqi City in 2021, and provide scientific basis for pollution control during different periods. Method A total of 188 air samples were collected from area A and area B of Urumqi City, and 12 metal elements and 5 water-soluble ions were quantitatively analyzed, and the pollution sources were analyzed by enrichment factor method and principal component analysis method. Results In 2021, the mass concentrations of PM2.5 in areas A and B of Urumqi were 45.0 (20.0, 158) µg/m3 and 28.0 (17.5, 66.0) µg/m3, respectively, with statistically significant difference (Z=-2.870, P<0.05). During the heating period, the concentrations were 110 (68.0, 250) µg/m3 and 61.0 (31.0, 88.0) µg/m3, respectively, with no statistically significant difference (Z=-3.822, P<0.01). During the non-heating period, the concentrations were 18.0 (13.0, 22.3) µg/m3 and 18.0 (12.8, 22.0) µg/m3, respectively, with no statistically significant difference (Z=-0.596, P>0.05). The SNA (the sum of SO42-, NO3-and NH4+) accounted for 71.7% and 23.4% of PM2.5 in A area during heating and non-heating periods, respectively, with statistically significant difference (Z=-8.057, P<0.01); the corresponding proportions in B area were 60.7% and 24.9%, with statistically significant difference (Z=-6.672, P<0.01). During the heating and non-heating periods, the ratios of NO3-/SO42-are 0.63 and 0.54 in A area were 0.63 and 0.54, respectively, with statistically significant difference (Z=-2.382, P<0.05); and the corresponding ratios in B area were 0.72 and 0.53, respectively, with statistically significant difference (Z=-3.182, P<0.05). The ratio of NO3- to SO42- was less than 1 in both heating and non-heating periods in the two areas. and the correlation between five water-soluble ions was significant (P<0.05). The correlation coefficient between NH4+ and SO42-, NO3-and Cl- in A and B areas during heating periods were all >0.9, indicating that NH4+and SO42-, NO3- and Cl- bind in (NH4)2SO4, NH4HSO4, NH4NO3, and NH4Cl. During non-heating periods, the correlation between NH4+ and each ion was slightly lower. During heating periods in area A, Sb, As, Cd, Pb, and Tl were severely enriched (EF>100). During non-heating periods in the same area, As, Cd, Pb, Tl, and Hg were severely enriched (EF>100). During heating periods in area B, Sb, As, Cd, Pb, and Hg were severely enriched (EF>100), and during non-heating periods in the same area, Sb, Cd, and Hg were severely enriched (EF>100). Coal emission, photochemical secondary pollution, motor vehicle exhaust, dust and industrial pollution were the main sources of PM2.5 pollution in the two areas, and the contribution rate of fixed sources was higher than that of mobile sources. Conclusion In 2021, the mass concentration of PM2.5, water-soluble ions and metal elements in Urumqi City were higher in area A than area B, the heating period was higher than the non-heating period, the excess rate of area A was higher than that in area B, and the contribution rate of fixed air pollution was greater than that of mobile sources.

Objective To study the changes of intestinal epithelial barrier function in rats with aging.Methods SD rats were divided into 3 groups:3-month-old group (group A),12-month-old group (group B) and 24-month-old group (group C,established by D-galactose injection with the dose of 0.125 g· kg-1 · d-1subcultaneously for 6 weeks) (n=10,each).The terminal ileum was obtained to make microtome section,and the morphology of small intestine mucous membrane,trophonema altitude and thickness were observed under light microscope.Occludin and ZO-1 protein expressions in terminal ileum mucous membrane were detected by immunohistochemistry.The expressions of Occludin and ZO 1 mRNA were determined by semi-quantitative reverse transcription polymerase chain reaction (RT-PCR).Results The small intestinal mucosa thickness and villus height were lower in group C and B than in group A [thickness:(87.6± 6.32) μm,(131.8± 5.22) μm vs.(162.9±7.28) μm; villus height:(56.4±5.38) μm,(76.7±5.40) μm vs.(108.1±6.42) μm;both P＜0.05].The small intestinal mucosa thickness and villus height was lower in group C than in group B (both P＜0.05).Occludin and ZO-1 protein expressions in small intestine tissue were reduced in group C and B as compared with group A [Occludin protein:(2.23±0.60)％,(4.21±0.61)％ vs.(12.31±0.94)％; ZO-1 protein:(2.03±0.54)％,(4.02±0.65) ％ vs.(12.21±0.81)％ ; both P＜0.05],and Occludin and ZO-1 protein expressions were less in group C than in group B (both P＜0.05).The levels of Occludin and ZO-1 mRNA in small intestine tissue were reduced in group C and B as compared with group A [Occludin:(0.20±0.03),(0.38±0.02) vs.(0.66±0.03) ; ZO-1:(0.18±0.03),(0.37±0.02) vs.(0.63±0.03); both P＜0.05],and Occludin and ZO-1 mRNA expressions were less in group C than in group B (both P ＜ 0.05).Conclusions The small intestinal mucosa thickness and villus height are reduced,the levels of Occludin and ZO-1 expressions are significantly decreased in small intestinal mucosa,and the intestinal barrier function is impaired with rat aging.

Objective To investigate the value of drug intervention for difficult weaning from mechanical ventilation. Methods A prospective single-blind randomized controlled trial was conducted. 120 patients with difficult weaning from mechanical ventilation encountered in Department of Critical Care Medicine of Peking University Third Hospital from January 2008 to December 2013 were included,and the patients were divided into treatment group and control group according to random number table,with 60 cases in each group. Patients received furosemide therapy in the treatment group 3 days before weaning up to 48 hours after weaning in order to control negative liquid balance. Enema was given the day before weaning to reduce abdominal pressure. On the weaning day,all of the patients received nitroglycerin and beta blocker or cedilanid to prevent or control elevation of blood pressure and heart rate in the process of weaning. All patients in treatment group received anisodamine in small dosage 2 hours before extubation.The patients in control group received conventional treatment without drug intervention. Baseline indexes of two groups were compared,including the heart rate,respiration rate(RR),mean arterial pressure(MAP),pulse blood oxygen saturation(SpO2),blood gas,hemoglobin(HG),albumin(ALB)and creatinine(Cr). The main reasons of difficulty in weaning,sedative and analgesic drug selection,presence of abdominal discomfort before weaning,interval between sputum suction before extubation,liquid balance at the beginning of the investigation and at time of weaning,24 hours and 48 hours after weaning,failures of spontaneous breathing test(SBT),length of mechanical ventilation,length of ICU stay,and total length of mechanical ventilation and total length of ICU stay during hospitalization. Results There was no statistically significant difference in the heart rate,RR,MAP,SpO2,blood gas,HG,ALB,Cr at the beginning of the investigation between the two groups. The main reasons for difficult weaning in both groups of patients were respiratory dysfunction,cardiac insufficiency,and central nervous system dysfunction. The use of propofol combined dexmedetomidine in the treatment group was more frequent than the control group〔16.7%(10/60)vs. 1.7%(1/60),χ2=8.107,P=0.004〕,and there was no statistically significant difference in the use of other combinations of sedative drugs between the two groups. Abdominal discomfort before weaning was milder in treatment group as compared with control group〔10.0%(6/60)vs. 25.0%(15/60),χ2=4.675,P=0.031〕. The interval between sputum suction before extubation in the treatment group was significantly longer than that of the control group〔hours:1(1,2)vs. 1(1,1),Z=-2.209,P= 0.027〕. SBT failure was less frequent in treatment group compared with control group〔times:0(0,1)vs. 1(1,2),Z=-6.561,P=0.000〕. Liquid balance was better in the treatment group than the control group at time of weaning,24 hours and 48 hours after weaning〔at time of weaning:-567.71 (-755.95,-226.41)vs. 1 256.76(472.48,1 796.63),Z=-9.038,P=0.000;24 hours after weaning:-5.03 (-530.28,245.09)vs. 342.28(125.36,613.25),Z=-4.711,P=0.000;48 hours after weaning:115.50(-450.26, 485.00)vs. 330.00(16.25,575.25),Z=-1.932,P=0.053〕. Compared with control group,length of mechanical ventilation〔days:1.0(1.0,2.0)vs. 2.0(2.0,3.0),Z=-6.545,P=0.000〕,ICU stay time〔days:3.0(3.0,4.0) vs. 4.0(4.0,5.0),Z=-6.545,P=0.000〕,and total length of mechanical ventilation〔days:8.0(6.0,12.0)vs. 11.0(8.0,15.0),Z=-4.091,P=0.000〕and total length of ICU stay during hospitalization〔days:12.5(9.2,19.0) vs. 17.0(12.0,29.5),Z=-2.722,P=0.000〕were all significantly shorter in the treatment group. Conclusions Adjuvant drugs therapy is helpful in patients weaning from the mechanical ventilation,and can shorten length of mechanical ventilation and ICU stay time. Propofol,combined dexmedetomidine,is helpful for weaning.

Background and purpose:Gestational trophoblastic neoplasm (GTN) is a spectrum of disease arising from trophoblastic cells, and the majority of patients with GTN have favorable outcome because of the sensi-tivity to chemotherapy. While the cure rate for high-risk patients is still 70% to 80% as a result of drug resistance and disease recurrence. This study aimed to evaluate the clinical characteristics and outcome of patients with high-risk GTN.Methods:The clinical records of patients with high-risk GTN treated in Obstetrics and Gynecology Hospital of Fudan University from Jan. 2003 to Jan. 2013 were analyzed and reviewed retrospectively from the aspect of different treatment.Results:Fifty-one patients with high-risk GTN were admitted to this hospital. Among 51 high-risk GTN patients, 46 patients were evaluated retrospectively and 5 patients were excluded for incomplete treatments. Of the 46 patients with high-risk GTN, 27 patients were treated by chemotherapy alone, 19 patients received chemotherapy and adjuvant surgical therapy. Forty-four patients received EMA-CO (VP-16+Act-D+MTX/VCR+CTX) as a ifrst-line chemotherapy, 81.82% (36/44) had complete remission and 8 patients developed resistance to EMA-CO. EMA-EP (VP-16+Act-D+MTX/VP-16+cisplatin) was used as second-line chemotherapy for the 8 patients resistant to EMA-CO, 6 patients (2 underwent adjuvant surgical therapy) achieved remission and 2 patients died as a result of drug-resistance and disease progression. For the remaining 2 patients, one was treated by 5-FU+KSM and pulmonary resection, and the other was treated by MTX for misdiagnosis as ectopic pregnancy and then converted to EMA-CO for the pathological diagnosis of choriocarcinoma after surgery. Both of them achieved complete remission. Ultimately, 95.65% (44/46)patients achieved complete remission. Among the 19 patients who underwent adjuvant surgical therapy, 94.70% (18/19) patients achieved complete remission after chemotherapy and adjuvant surgery, and the remaining one patient died of disease progression.Conclusion:Standard combination chemotherapy is crucial in the treatment of high-risk GTN. The role of adjuvant surgery in the management of high-risk GTN should not be underestimated.

Objective To evaluate the value of phased array probe of transesophageal echocardiography miniature (micro-TEE) in the neonatal and infant cardiac surgery intraoperation.Methods Micro-TEE probe was used in children with weight ≤5 kg undergoing cardiac surgery to detect the atrial and ventricular cavity size,the left and right ventricular outflow tract diameter were detected by transthoracic echocardiography(TTE) 3-7 d after operation,and compared with the measured value immediately after the TEE.Results Before and after intubation,airway index not statistically significant (P ＞ 0.05).Preoperative TEE and TTE inspection results were consistent with intraoperative diagnosis.Postoperative TEE measuring intracardiac structural data (each room,chamber size and left and right ventricular outflow tract diameter) and postoperative TTE measurement value representing the difference was not statistically significant (P ＞ 0.05).Conclusions Micro TEE intraoperative guardianship of low birth weight infants is safe and feasible,and can supplement and improve the preoperative diagnosis,and can accurately and timely evaluate postoperative curative effect.

Objective To identify risk factors associated with repeat use of pulmonary surfactant ( PS) in the treatment of respiratory distress syndrome ( RDS ) in the term and near-term neonate. Methods There were 130term and near-term new borns with RDS who were treated with pulmonary surfactant were enrolled. These infants were categorized into two groups: single-dose group (85 cases) and repeat-dose group (45 cases). The differences in basic information were compared between the two groups, and logistic regression analysis was used to identify the risk factors for repeat use of pulmonary surfactant.Results TherepeatutilizationrateofPSwas34.6℅.The incidence of asphyxia,maternal gestational hypertension, X-ray RDS grade 3-4, the age of first dose PS,respiratory support time in the repeat-dose group was significantly higher than in the single-dose group (P<0. 05). PaO2/FiO2 and the cure rate in the repeat-dose group were significantly lower than in single-dose group ( P<0. 05 ) . The incidence of sepsis, pulmonary hemorrhage, shock and patent ductus arteriosus ( PDA) in the repeat-dose group was significantly higher than in the single-dose group ( P<0. 05). Further logistic regression analysis showed that birth asphyxia ( OR=5. 674 , 95℅CI 1. 378 -23. 354 , the age of first dose of PS (OR=1.092, 95℅CI 1.002 -1.191)and PDA(OR =23.499, 95℅CI 2.348 -235.152)were the independent risk factors for repeat use of pulmonary surfactant.Conclusions Birth asphyxia,the age of first dose PS and PDA are the risk factors for repeat use of pulmonary surfactant in the treatment of RDS in the term and near -term neonate.

OBJECTIVETo investigate the effect and safety of extracorporeal shock wave (ESW) in the treatment of pain symptom of type III B prostatitis.

METHODSWe treated 50 cases of type III B prostatitis by ESW once a week for 4 weeks. Then we evaluated the clinical effect and safety of the therapy based on the NIH-CPSI scores, visual analogue scale (VAS) scores, IIEF-5 scores, prostate volume and morphous, state of urination, color of urine, results of routine semen analysis, and changes of cytokines (IL-6, TNF-α and IL-1β) in expressed prostatic secretion (EPS).

RESULTSAll the patients successfully accomplished the treatment. Compared with the baseline, decreases were observed after 4 weeks of cytokine treatment in the pain scores (14. 61 ± 1. 82 vs 9. 36 ± 1. 47, P <0. 01), urination symptom scores (4. 59 ± 1. 01 vs.4. 66 ± 0. 89, P >0. 05) , quality of life scores (6. 51 ± 1. 03 vs 4. 56 ± 1. 02, P <0. 01), NIH-CPSI (25. 43 ± 1. 72 vs 18. 28 ± 2. 32, P <0. 01 ), and VAS (6. 59 ± 1. 10 vs 3. 02 ± 1. 07, P < 0. 01). The concentration of IL-6 in the EPS was significantly increased ([55.82 ± 6. 28] vs [86.59 ± 4. 55] ng/ml, P <0. 01) , while the level of TNF-α ([3.89 ± 0. 12] vs [3. 19 ± 0.22] ng/ml, P<0.01) and that of IL-1β ([3.21 ± 1.01] vs [1.48 ± 0.95] ng/ml, P< 0. 01) remarkably reduced after treatment. However, there were no statistically significant differences in IIEF-5 scores (18. 58 ± 2. 03 vs 18. 51 1. 89, P >0. 05) or various sperm parameters before and after treatment (P >0. 05). And no significant changes were observed in the prostate volume, morphous or internal echoes.

CONCLUSIONThe ESW therapy is effective and safe for the pain symptom of type III B prostatitis.

Adult ; Body Fluids ; Humans ; Interleukin-1beta ; metabolism ; Interleukin-6 ; metabolism ; Male ; Middle Aged ; Pain ; etiology ; metabolism ; Pain Management ; methods ; Prostatitis ; complications ; metabolism ; therapy ; Quality of Life ; Spermatozoa ; physiology ; Tumor Necrosis Factor-alpha ; metabolism ; Ultrasonic Therapy ; methods ; Urine