Objective To evaluate the effectiveness of maternal prenatal education on promoting breastfeeding rate for preterm infants in neonatal intensive care unit (NICU).Methods Gravidas who were admitted to Peking University First Hospital for any risk of preterm delivery from November 2013 to December 2014 and preterm infants admitted to the NICU (length of stay ≥ 5 d) of the same hospital during the same period were involved.All the gravidas received prenatal education and completed questionnaires.Two hundred and ninety-five preterm infants who met the inclusion criteria were divided into two groups including education group (n=125) and non-education group (n=170) according to whether their mothers received prenatal education or not.Conditions of the preterm infants during hospitalization and after discharge and breastfeeding rates were comparatively analyzed between the two groups.T test,Chi-test and Wilcoxon rank-sum test were used for statistical analysis.Results (1) There were 380 gravidas received questionnaires.Among them,346 (91.1％)completed the questionnaires and were recruited in this study.Only 31.8％ (110/346) of these gravidas were active in learning more about breastfeeding and 46.2％ (160/346) of them lacked confidence in breastfeeding after the appearance of preterm delivery signs.There were significant improvements in their attitudes towards considering breastfeeding seriously and discussing with their family,confidence in breastfeeding,the importance of colostrum and how to breastfeed a preterm infant in hospital after maternal prenatal education (all P＜0.001).Prenatal education was thought to be helpful in 77.5％ (268/346) of the gravidas.(2) The two groups of preterm infants showed good homogeneities in gestational age,gender,birth weight and other basal conditions as well as in incidences of in-hospital complications and conditions after discharge (all P＞0.05).Proportions of breast milk intake (breast milk intake over total dairy intake) in preterm infants were higher in education group than those in non-education group within 5 d after birth [0.0 (0.0-16.5)％ vs 0.0 (0.0-2.5)％,Z=-3.422],＞5-≤ 7 d [33.7 (0.0-82.8)％ vs 0.0 (0.0-50.3)％,Z=-3.070],＞7-≤ 14 d [75.2(23.5-96.4)％ vs 47.6(0.0-92.2)％,Z=-2.345] and during hospitalization [58.4 (21.0-78.8)％ vs 31.9 (0.0-71.7)％,Z=-3.902] (all P＜0.05).Breastfeeding rates were higher in education group than those in non-education group at the age of 5 d [47.2％(59/125) vs 27.1％ (46/170),x2=12.747],7 d [70.4％ (88/125) vs 51.2％ (87/170),x2=11.031],three months [83.3％(65/78) vs 56.1％ (60/107),x2=15.297] and six months [64.5％ (49/76) vs 49.1％ (53/108),x2=4.282] (all P＜0.05).Exclusive breastfeeding rates in the first,third and sixth months after birth were higher in education group [45.7％(53/116),42.3％ (33/78) and 36.9％ (28/76)] than those in non-education group [21.3％ (32/150),28.0％ (30/107)and 22.2％ (24/108)] (22=17.847,4.091 and 4.703,all P＜0.05),respectively.Conclusions Most gravidas with risk factors of preterm delivery have no confidence on breastfeeding.Prenatal maternal education is an effective and feasible intervention to improve breastfeeding rate for preterm infants in NICU from early hospitalization till six months after birth.

Objective To investigate the clinical features and treatment protocol and prognosis for the hypophosphataemic osteomalacia related to adefovir dipivoxil.Methods Analysis was made upon a case of patient with chronic hepatitis B developed hypophosphataemic osteomalacia after administration of adefovir dipivoxil.Literature review was carried out to survey the global prevalence of hypophosphataemic osteomalacia after administration of adefovir dipivoxil among patients with chronic hepatitis B.Results The clinical symptoms started paralleling to the time taking adefovir dipivoxil,and alleviated after the patient withdrawn adefovir dipivoxil 10 weeks and was given phosphorus.Meanwhile,serum inorganic phosphorus recovered to normal ( 0.98 mmol/L),which lowest level was 0.77 mmol/L.Systematic review of the literature showed that hyperphosphaturia related to adefovir dipivoxil was dose-dependent,time-dependent and reversible.All reported cases of hypophosphataemic osteomalacia secondary to adefovir dipivoxil ( 10mg/d) were from Asian population.ConclusionsAdefovir dipivoxil induced hypophosphataemic osteomalacia is rarely seen in clinical practice.Those patients with chronic hepatitis B who take adefovir dipivoxil,no matter dosages,should take periodical examinations including blood calcium and serium inorganic phosphorus to monitor whether hypophosphataemic osteomalacia occurs.Other anti-virus drugs could be used when it happens.

Objective To explore the CT features and differential diagnosis of ovarian fibrothecoma,and to compare with postoperative pathological findings.Methods The clinical data,CT appearances and pathological signs of 15 patients with ovarian fibrothecoma and 7 patients with granulosa cell tumor were analyzed retrospectively.The plain CT values and enhanced CT values(ΔCT)of fibrothecomas and granulosa cell tumors were compared with each other.Results The ovarian fibrothecomas showed solid or cystic-solid masses with well-defined margin,mild delayed enhancement or no obvious enhancement on CT.The CT features were correspond to the pathological signs. The plain CT values of fibrothecoma and granulosa cell tumor had no significant difference(t=0.745,P=0.467).The mean ΔCT values of fibrothecoma was significantly lower than that of granulosa cell tumor(t=2.537,P=0.041).Conclusion Ovarian fibrothecoma has characteristic CT features,combined with the clinical data,which may help to improve the diagnosis.

Objective To evaluate the effect of luteolin on the growth,migration and vasculogenic mimicry formation of a melanoma cell line B16.Methods In vitro cultured B16 melanoma cells were divided into 4 groups:low-,middle-and high-dose luteolin groups treated with 2.5,5,10 μmol/L luteolin respectively,and control group treated with 0.1％ dimethyl sulfoxide (DMSO).Scratch assay,Transwell invasion assay and vascular channel formation assay were performed to assess the migration,invasion of and vascular channel formation by melanoma cells.A model of subcutaneous transplanted B 16 melanoma was established in 12 C57 mice,which were randomly and equally divided into 4 groups:control group gavaged with ultrapure water,low-,middle-and high-dose luteolin groups gavaged with 10,20,40 mg/kg luteolin respectively every day.The above treatment for the tumor-bearing mice lasted till day 28,and then these mice were sacrificed.Meanwhile,the lung and tumor tissues of the mice were excised,and the growth,metastasis and vasculogenic mimicry of transplanted melanoma were observed.Immunofluorescence and immunohistochemical studies were performed to evaluate the effects of luteolin on the expression of vascular endothelial cadherin (VE-cadherin),vascular endothelial growth factor receptor 1 (VEGFR1),VEGFR2,matrix metalloproteinase-2 (MMP-2) and MMP-9 in the transplanted melanoma.Means were compared among several groups by using one-way analysis of variation or rank sum test.Results In vitro study showed that the relative scratch width at 48 hours significantly differed among the control group,low-,middle-and high-dose luteolin groups (0.47 ± 0.04,0.64 ± 0.04,0.73 ± 0.03,0.84 ± 0.04 respectively;F =34.51,P ＜ 0.001),and the migration ability of B16 cells was significantly lower in the low-,middle-and high-dose luteolin groups than in the control group (all P ＜ 0.05).At 24 hours,there were significant differences in the number of cells crossing the Transwell membrane among the control group,low-,middle-and high-dose luteolin groups (281.00 ± 8.79,169.00 ± 15.35,92.00 ± 14.79 and 57.00 ± 13.72 respectively;F =275.30,P ＜ 0.001),and the invasive ability was significantly lower in the low-,middle-and high-dose luteolin groups than in the control group (P ＜ 0.01).Meanwhile,the number of formed vascular channels also differed among the above 4 groups (20.00 ± 2.77,11.00 ± 1.28,7.00 ± 1.86 and 2.00 ± 1.32 respectively;F =48.61,P ＜ 0.001),and the number of vascular channels was significantly lower in the low-,middle-and high-dose luteolin groups than in the control group (all P ＜ 0.01).In vivo study showed that the tumor size significantly differed among the control group,low-,middle-and high-dose luteolin groups (5.10 ± 1.72,4.02 ± 2.13,2.98 ± 0.92,1.49 ± 1.13 cm3 respectively;F =28.76,P ＜ 0.001),and was significantly lower in the low-,middle-and high-dose luteolin groups than in the control group (t =3.86,7.11 and 13.06 respectively,all P ＜ 0.01).CD31-PAS double staining showed that the number of vasculogenic mimicry was significantly higher in the control group than in the low-,middle-and high-dose luteolin groups (all P ＜ 0.01).In vivo and in vitro studies both showed that the expression of vasculogenic mimicry-related markers in the cells or mouse tumor tissues was significantly lower in the high-dose luteolin group than in the control group (P ＜ 0.05).Conclusion Luteolin can effectively inhibit the growth,metastasis and vasculogenic mimicry formation of melanoma.

Objective:To examine the effects of liraglutide on the transforming growth factor-β1(TGF-β1)/Smads signaling pathway in renal tissues of elderly rats with type 2 diabetes mellitus(T2DM)and to explore the underlying mechanisms.Methods:A total of 75 healthy elderly male Sprague-Dawley rats aged 20 months and weighing(500±100)g were divided into the normal control group(Group N, n=25)and the model group( n=50)by using a random number table.Rats in the model group were given high-glucose and high-fat diets for 8 weeks and then were injected with a single dose(30 mg/kg)of 1% streptozotocin into the abdominal cavity.Forty-eight rats in the model group were successfully molded and were divided into the T2DM group(Group D, n=24)and the intervention group(Group LD, n=24). Rats in Group LD were abdominally injected with liraglutide in a dose of 200 μg·kg -1·d -1, and the other two groups were given an equal volume of saline.At the end of 4, 8 and 12 weeks, eight rats in each group were randomly selected and 24-hour urine collections were made to measure 24-hour urinary protein.Then the rats were anesthetized, blood samples were collected for biochemical tests, and renal tissues were removed for microscopic examination of pathological changes after HE staining.The expression of type Ⅳ collagen(Col-Ⅳ)was detected by using an immunohistochemical method, and the mRNA expression of TGF-β1, Smad3 and Smad7 was detected by using real-time fluorescence quantitative polymerase chain reaction.One-way analysis of variance was used for comparisons between the groups, and the LSD-t test was used for pairwise comparisons. Results:Compared with Group N, Group D showed thickening of the glomerular basement membrane, mesangial proliferation and interstitial fibrosis at each time-point, which grew worse with time, and the expression of TGF-β1 mRNA, Smad3 mRNA and Col-Ⅳ also increased significantly(12-week: 0.69±0.01 vs.0.15±0.01, 0.51±0.02 vs.0.02±0.01, 183.33±2.08 vs.221.67±2.08, t=89.22, 60.87 and 24.52, P<0.05), while Smad7 mRNA levels decreased( t=13.42, P<0.05). Compared with Group D, the degree of renal fibrosis was reduced, and the expression of TGF-β1 mRNA, Smad3 mRNA and Col-Ⅳ at 12-week significantly decreased( t=71.703, 37.58 and 20.04, P<0.05), while Smad7 mRNA increased( t=9.96, P<0.05)in Group LD.With prolonged intervention of liraglutide, the lesions were mitigated, the expression of TGF-β1 mRNA, Smad3 mRNA and Col-Ⅳ decreased, and Smad7 mRNA increased gradually( P<0.05)in Group LD. Conclusions:Liraglutide has anti-renal fibrosis effects via inhibiting the TGF-β1/Smads pathway, thereby reducing the production of Col-Ⅳ, and can delay the progression of renal lesions in elderly T2DM rats.

OBJECTIVETo investigate the expressions of miR-143 and miR-145 in gastric cancer tissues and their biological functions.

METHODSA set of gastric cancer metastasis-related miRNAs was screened by comparing the miRNA profiles between the primary gastric cancer and matched liver metastasis. Among these miRNAs, expressions of miR-143 and miR-145 were further validated. The influence on metastasis was analyzed by transwell assay.

RESULTSExpressions of miR-143 and miR-145 down-regulated significantly in gastric cancer tissues compared to adjacent normal tissues(miR-143, 0.028±0.005 vs. 0.052±0.014, P=0.058; miR-145, 0.922±0.135 vs. 1.722±0.285, P=0.007), and decreased significantly in the metastatic lesion compared with the primary lesion(miR-143, 0.059±0.025 vs. 0.182±0.045, P=0.021; miR-145, 0.164±0.076 vs. 0.594±0.283, P=0.042). Expressions of miR-143 and miR-145 were significantly correlated(r=0.400, P=0.000), and they synergistically inhibited gastric cancer cell migration.

CONCLUSIONmiR-143 and miR-145 may take part in the progression of gastric cancer metastasis, and they may have synergetic effects.

Cell Movement ; Gene Expression Regulation, Neoplastic ; Humans ; Liver Neoplasms ; MicroRNAs ; Stomach Neoplasms

OBJECTIVETo investigate the expression of serum endothelial cell specific molecule 1 (ESM-1) in gastric cancer and to evaluate the effect of serum ESM-1 as a potential serum biomarker.

METHODSSerum ESM-1 was detected by enzyme-linked immunosorbent assay (ELISA) and CEA, CA19.9, CA72.4 were detected by electrochemiluminescence immunoassay (ECLIA) in 102 patients with gastric cancer preoperatively. At the same time, serum ESM-1, CEA, CA19-9, CA72-4 in 41 healthy adults volunteers were detected with the same method. In addition, the follow-up data of all the patients were collected.

RESULTSCompared to healthy volunteers, the serum ESM-1 level in gastric cancer patients increased (P<0.01). The sensitivity and specificity of serum ESM-1 were 73.9% and 51.2% respectively. In contrast, the sensitivities of CEA, CA19-9 and CA72-4 were only 16.1%, 18.3% and 23.2% respectively. High level of serum ESM-1 indicated poor outcomes (P<0.05).

CONCLUSIONSSerum ESM-1 increases in the peripheral blood of the gastric cancer patients. It may be a potential serum marker to help diagnosis and prediction of prognosis of gastric cancer patients.

Adult ; Aged ; Aged, 80 and over ; Biomarkers, Tumor ; blood ; Case-Control Studies ; Female ; Humans ; Male ; Middle Aged ; Neoplasm Proteins ; blood ; Proteoglycans ; blood ; Sensitivity and Specificity ; Stomach Neoplasms ; diagnosis

Objective To evaluate the efficacy and safety of preoperative intra-aortic balloon pump(IABP) insertion in acute myocardial infarction(AMI) without cardiogenic shock(CS) patients receiving off-pump coronary artery bypass grafting ( OPCABG).Methods 444 consecutive AMI patients who underwent isolated OPCABG from January 2009 to December 2016 were enrolled.158 patients who underwent preoperative IABP placement(IABP group) and the other of 286 patients who did not have IABP placement(control group).The in-hospital mortality rate, postoperative complications, mechanical ventilation time, ICU stay and hospital length were compared between the two groups.Results The overall mortality was 5.0%.135 pairs of patients were matched.The preoperative IABP insertion showed benefits in postoperative survival rate compared with the control group(0 vs.5.9%, P＝0.004).However, patients with preoperative IABP were more likely to prolong duration of mechanical ventilation and ICU stay.The postoperative length of stay in hospital didn't show significant difference between the two groups.Conclusion Survival advantage was observed from preoperative IABP insertion in AMI patients without CS under-going OPCABG.

Objective To investigate the distribution characteristics and risk factors of intracranial and extracranial aterial lesions in Chinese patients with ischemic stroke . Methods In this multi‐center study ,2 310 continuously inpatients with ischemic stroke diagnosed in 20 stroke screening and prevention project base hospitals from June 2015 to M ay 2016 were enrolled . Carotid ultrasonography and transcranial color‐coded sonography or transcranial Doppler were performed in all patients to confirm the presence of cerebral artery stenosis or occlusion . According to the distribution of lesions ,the subjects were divided into 2 groups :the simple intracranial artery stenosis group and the simple extracranial artery stenosis group . T he difference of risk factors between the two groups was compared . Results Of the 2 310 patients with ischemic stroke ,1 516 ( 65 .6% ) had simple intracranial artery stenosis and 794 ( 34 .4% ) had simple extracranial artery stenosis . T he incidence of anterior circulation artery stenosis was higher in the group of intracranial artery stenosis than that in the extracranial artery stenosis group ( 68 .1% vs 48 .7% , P ＜0 .001) . Posterior circulation artery stenosis and combined anterior with posterior circulation artery stenosis were more common in patients with extracranial artery stenosis group than those in intracranial artery stenosis group ( 36 .4% vs 22 .1% ,14 .9% vs 9 .8% ;all P ＜0 .001) . Univariate analysis of risk factors for stroke showed that patients with intracranial arterial stenosis had a higher prevelence of hypertension , diabetes ,obesity ,and family history of stroke ,and their systolic blood pressure ,diastolic blood pressure , body mass index ( BM I) ,fasting blood‐glucose ,glycosylated hemoglobin ,triacylglycerol ,total cholesterol , and low‐density lipoprotein cholesterol were significantly higher than those in the extracranial arterial stenosis group ( all P ＜ 0 .05 ) . T he proportion of elderly ( ≥ 65 years old ) ,male and smokers in the extracranial arterial stenosis group was significantly higher than that in the intracranial arterial stenosis group ( all P ＜0 .05) . Multivariate logistic regression analysis showed that elderly ( ≥65 years old) ,male , and smoking history were independent risk factors for extracranial arterial stenosis ( OR＝ 2 .012 ,1 .637 , 1 .325 ,respectively ;all P ＜0 .05) . While hypertension ,diabetes ,less physical activity ,and high BM I levels were independent risk factors for simple intracranial arterial disease ( OR ＝ 1 .301 ,1 .252 ,1 .248 ,1 .030 , respectively ;all P ＜0 .05) . Conclusions There are significant differences in the distribution characteristics and risk factors of intracranial and extracranial aterial lesions in patients with ischemic stroke in China .

Objective To analyze the correlation between smoking and occurrence of intracranial artery stenosis.Methods From June 2015 to May 2016,a total of 10 711 inpatients with transient ischemic attack (TIA) or ischemic stroke from 20 basel hospitals of nationwide were enrolled using a cross-sectional study,76 patients with unknown smoking and smoking cessation years were excluded.Finally,a total of 10 635 patients were enrolled.Transcranial color coded sonography and/or transcranial Doppler were used evaluate the intracranial artery stenosis lesions.The basic risk factors for cerebrovascular disease (age,sex,smoking and smoking years,whether smoking cessation and years,hypertension,diabetes,hyperlipidemia,atrial fibrillation,and family history of stroke) were recorded.According to the different smoking years,the smoking years were divided into five groups:non-smoking,smoking time ≤10-year,11 to 20-year,21 to 30-year,and >30-year groups for trend chi square test.According to the different smoking cessation years in the smokers,the smoking cessation years were divided into four groups:non-cessation,cessation time 1 to 10-year,11 to 20-year,and >20-year groups for trend chi square test.The effects of different smoking years and different smoking cessation years on the occurrence of intracranial arterial stenosis were analyzed.Results The incidence of intracranial artery stenosis in the smokers (40.4%[1 433/3 547]) was significantly higher than that in the non-smoking patients (29.4%[2 085/7 088]).There was significant difference (χ2=128.850,P<0.01),and the incidence of cerebral infarction in the smokers (91.6%[3 250/3 547]) was significantly higher than the non-smokers (85.0%[6 027/7 088]).There was significant difference (χ2=92.328,P<0.01).Smoking was an independent risk factor for intracranial artery stenosis (OR,1.603;95%CI 1.456-1.765;P<0.01).With the increase of smoking years,the detection rate of intracranial arterial stenosis increased gradually (trend χ2=115.437,P<0.01).Whether giving up smoking had no significant effect on the incidence of intracranial artery stenosis in patients with ≥20 years of smoking (trend χ2=1.043,P=0.307).Conclusions Smoking is an independent risk factor for affecting intracranial artery stenosis;the risk of disease increases with the number of smoking years.Long-term smokers (≥20 years) cannot reduce the effect on intracranial artery stenosis,even if they give up smoking.