Objective To evaluate the reproducibility of measuring renal oxygenation in rat using blood oxygen level-dependent MR imaging(BOLD MRI).Methods Five intact male Wistar rats were included in this study and their body weights were measured before MRI scans.BOLD MRI were performed ou day 1(d1),day 5(d5),day 10(d10),day 30(d30)and day 50(d50)on a 3.0 T MR scanner to measure the apparent spin-spin relaxation(R2*).On d30 and d50,the differences of R2*(△R2*)were calculated between before and 10 min after furosemide injection through the tail vein.The reproducibility of the baseline R2* of 5 times repeated scans were verified by the repeated-measure ANOVA test.The R2* and △R2* between pre-and post-furosemide iniection on d30 and d50 were measured on the codex and the medulla and a paired t test was run to analyze their responses to furosemide and the reproducibility of △R2*.Results The average body weight on d1,d5,d10,d3 and d50 was(150.4±3.7)g、(170.2±7.0)g、(201.0±5.8)g、(306.2±17.0)g and(352.0±12.2)g,respectively,with statistical difference(F=422.103.P＜0.01).The R2* showed no statistical difference in the cortex and medulla among the five scans(P＞0.05).On d30.the R2* of the cortex and medulla was(25.2±1.2)and(32.8±2.2)Hz before and significantly decreased to(21.1±2.2)and(25.9±3.0)Hz after furosemide administration,respectively(P＜0.01).On d50,the R2* of the cortex and medulla was(25.9±0.8)and(34.3±3.9)Hz before and significantly decreased to(20.2±1.5)and(27.0±3.2)Hz after furosemide administration.respectively(P＜0.01).The △R2* on the codex and medulla was(4.1±1.7)and(6.9 4-2.8)Hz on d30 and(5.8±1.1)and(7.3±2.8)Hz on d50,respectively,but there is no significant difference between eortex and medulla(P＞0.05).Conclusion The baseline R2* in the cortex and medulla were reproducible over 50 days and they were not body weighted.On 3.0 T MR scanners.R2* in the codex and medulla decreased significantly after administration of furosemide.

Objective To analyze the changes of renal apparent diffusion coefficient(ADC)value during development in intact rats.Methods Five intact male Wistar rats(1 month of age)were involved in this study.Using SE-echo planar imaging(EPI)sequence to acquire renal DWI at a 3.0 T MR on day 1,day 5,day 10,day 30,and day 50,respectively.The b value was 0 and 500 s/mm2.The ADCs of the cortex and the medulla were measured on the right kidney and the renal volume was calculated by manually renal outling on each slice.The difference of ADC between the cortex and the medulla was analyzed using a paired student t test,and the changes of renal volume and ADCs with rats development were evaluated with a repeated measurement ANOVA.Results The ADC of the cortex was higher than that of the medulla except on day 1(P＜0.01).when b value 0 and 500 s/mm2 were chosen.Renal volume increased with the rat development.from(0.86±0.02)ml to(1.47±0.21)ml.And the ADCs of both the cortex and medulla increased from(1.66±0.14)×10-3mm2/s to(1.96±0.08)×10-3mm2/s for the cortex and from (1.54±0.12)×10-3mm2/s to(1.91±0.09)×10-3mm2/s for the medulla.Conclusion Renal ADCs of both the cortex and medulla increase during the period from 1 to about 3 months of age in rats.The influence of age on renal ADC should be considered when choosing rats aged from 1 to 3 months for MR study.

Objective To investigate the clinical features and mechanism and feasibility of plasma exchange (PE) in treating systemic lupus erythematosus (SLE) complicated with acute pancreatitis (AP). Methods A retrospective analysis of SLE associated with AP was done based on the HIS in Tongji Hospital. Totally 24 SLEAP patients were admitted to Tongji hospital from March 2006 to May 2014. Patientsˊ serum amylase, lipase and interleukin (IL)-6 concentration were measured before and after plasma exchange. According to different therapy strategy, patients were divided into two groups. Fifteen patients treated with plasma exchange combination with glucocorticosteroid (GC) were classified as Group A, the other 9 patients who were treated with GC only were classified as group B. At baseline and after treatment, the serum lipid concentration, average daily glucocorticosteroid dosage between group A and B were compared with ANOVA and serum IL-6 concentration between roup A and B were compared with Wilcoxon rank test. Results SLEDAI score in group A patients at baseline (16 ±5) was no statistically different from that in group B (18 ±4) (t=1.31, P=0.320). Average daily GC dosage in group A 31.0 (20.50, 30.08)mg/d was significantly less than that in group B 47.85 (45.58, 59.23) mg/d (Z=35.50, P= 0.002). Serum IL-6 levels in group A and B at baseline was not significantly different 13.14 (11.12,16.57) mg/L vs 14.63 (11.37, 16.37) mg/L (Z=12.20, P=0.300), after 2 weeks treatment, IL-6 level, which was 9.16 (7.93, 10.75) mg/L, decreased significantly in group A while it didnˊt show tendency of decrease in group B, which was 13.62(9.29, 17.63) mg/L (Z=28.50, P=0.039). Serum lipid concentration after 2 weeks therapy in Group A [TC=(5.02 ±0.53) mmol/L, TG=(1.46 ±0.44) mmol/L] decreased significantly compared to baseline [TC=(6.11±0.50) mmol/L, TG=(2.14±0.65) mmol/L] (F=4.46, P=0.010; F=6.09, P=0.002), while similar tendency wasnˊt observed in group B (F=1.57, P>0.05). Conclusion PE combined with GC could lower serum IL-6 levels, reduce the amount of GC and lower serum lipid to improve prognosis. Therefore it might be a safe and effective way and is worthy of continuing to explore its feasibility.

Presently, there are many issues in traditional Chinese medicine (TCM) decoction, such as the uncertain sources of TCM, the lack of reminder for medication taboo, the nonstardard herb operation, and difficult supervision, etc. A digital service system of TCM decoction was established to solve the problems mentioned above. The digital service system mainly includes automatic coding for checking in & out, drug medication taboo database, digital operation in decoction, distribution through 2D code, the corresponding application for mobile phone, and the information supervision platform for TCM decoction. The digital service system of TCM decoction can track the quality & duty of the pieces, remind decoction medicine contraindications, improve the standard operation process of decoction, develop decoction distribution & tracking through cell phone, save the waiting time, and hence provides a new supervising method for TCM decoction. The digital service system of TCM decoction solves the key issues for the formula, operation, delivery and supervision of TCM. In the same vein, this system will expand the market share of TCM decoction and promote the development of TCM.

Objective To evaluate the effects of network video in the continuing nursing care of discharged cervical cancer patients with postoperative catheter.Methods A number of 53 patients with cervical cancer underwent radical hysterectomy in Nantong Tumor Hospital from January to December 2016 were randomly recruited as the observation group. Another 53 patients with cervical cancer underwent radical hysterectomy from January 2012 to December 2015 were retrospectively studied as control group. Patients in the control group were discharged from the hospital with removal catheter after the professional nursing of 15 days. Patients in the observation group were discharged from the hospital with the indwelling catheter one week after the surgery, and the catheter was removed after one week of network video on continuation nursing care.Results After the removal catheter, there were two cases (4％) of increased residual urine, two cases (4％) of urinary retention, and eight cases (15％) of urinary tract infection in the observation group;one case (2％) of increased residual urine, two cases (4％) of urinary retention, and eight cases (15％) of urinary tract infection were found in the control group. No differences were observed between the two groups (P>0.05). The score of patients' satisfaction was (4.85±0.12) in the observation group and (4.82±0.10) in the control group, with no difference between the two groups (t=1.479,P>0.05).Conclusions The application of network video in continuing nursing care of patients with cervical cancer after radical hysterectomy is feasible, whereas the preparation before discharge is required.

Objective To explore the effect of quality control circle ( QCC ) on non-standard implementation of aseptic operation related medical staffs. Methods Through QCC activities, a total of 950 operation related medical staffs had been investigated non-standard implementation status of aseptic operation, and analyzed the causes, made out and carried out its countermeasures. Results Non-standard implementation of aseptic operation declined from 690 person-time to 175 person-time, and the target completion rate was 105%, improvement rate 75%, of which spreading towels did not reached standard declined from 327 person-time to 99 person-time. The off operation table people, who was too near from the sterile stage, declined from 134 person-time to 33 person-time, while not using the non-contact wear gloves declined from 71 person-time to 12 person-time. Conclusions QCC activities can significantly reduce the person-time of non-standard implementation of aseptic operation and effectively improve the quality of work.

Objective:To study the respiratory morbidity and the risk factors of respiratory complications in late-preterm infants.Methods:The data of 959 late-preterm infants in 21 hospitals in Beijing from October 2015 to April 2016 were collected.These infants were divided into the respiratory morbidity group (237 cases) and the control group (722 cases) according to whether they had short-term respiratory morbidity after birth.Clinical data of the two groups were compared.Results:Among the 959 late-preterm babies, 530 were male and 429 were female.Two hundred and thirty-seven cases (24.7%) developed short-term respiratory morbidity after birth.Infectious pneumonia developed in the most cases (81 cases, 8.4%), followed by transient tachypnea (65 cases, 6.8%), amniotic fluid aspiration (51 cases, 5.3%), and respiratory distress syndrome (24 cases, 2.5%) successively.All the infants recovered and discharged.There were no differences between gender and maternal age between 2 groups (all P>0.05). Compared with the control group, more late-preterm infants were delivered by cesarean section (73.4% vs.59.7%, χ2=14.43, P<0.001) and the 1-minute Apgar score was lower [(9.41±1.66) scores vs.(9.83±0.53) scores, t=5.40, P<0.001] in the respiratory morbidity group.The differences were statistically significant.There were more cases with maternal complications in the respiratory morbidity group that in the control group (66.7% vs.58.6%, χ2=4.877, P=0.027), but no difference in various complications between 2 groups was observed ( P>0.05). In the respiratory morbidity group, the most frequent complications were maternal hypertension and preeclampsia (27.8% vs.22.6%, χ2=2.728, P=0.099). There were no differences between 2 groups in gestational age, birth weight and birth length (all P>0.05). There were more infants small for gestational age and large for gestational age in the respiratory morbidity group than in the control group (18.8% vs.14.1%, 6.3% vs.2.4%, χ2=8.960, P=0.011). The duration of hospitalization of the respiratory morbidity group was significantly longer than that of the control group [(9.00±4.42) d vs.(6.82±4.19) d, t=6.676, P<0.001] since the infants with respiratory morbidity needed to be hospita-lized. Conclusions:Respiratory diseases occur in about 1/4 of late-preterm infants.Infants who are delivered by cesarean section and whose mothers are complicated with the maternal hypertension and preeclampsia should be monitored closely.Respiratory support should be provided for infants not appropriate for gestational age who are more likely to suffer from respiratory diseases, so that they can successfully pass through the transition period.

Objective:To analyze the risk factors of bronchopulmonary dysplasia(BPD)in very preterm infants(VPI), and to provide scientific basis for the prevention and treatment of BPD in VPI.Methods:A prospective multicenter study was designed to collect the clinical data of VPI in department of neonatology of 28 hospitals in 7 regions from September 2019 to December 2020.According to the continuous oxygen dependence at 28 days after birth, VPI were divided into non BPD group and BPD group, and the risk factors of BPD in VPI were analyzed.Results:A total of 2 514 cases of VPI including 1 364 cases without BPD and 1 150 cases with BPD were enrolled.The incidence of BPD was 45.7%.The smaller the gestational age and weight, the higher the incidence of BPD( P<0.001). Compared with non BPD group, the average birth age, weight and cesarean section rate in BPD group were lower, and the incidence of male infants, small for gestational age and 5-minute apgar score≤7 were higher( P<0.01). In BPD group, the incidences of neonatal respiratory distress syndrome(NRDS), hemodynamically significant patent ductus arteriosus, retinopathy of prematurity, feeding intolerance, extrauterine growth restriction, grade Ⅲ~Ⅳ intracranial hemorrhage, anemia, early-onset and late-onset sepsis, nosocomial infection, parenteral nutrition-associated cholestasis were higher( P<0.05), the use of pulmonary surfactant(PS), postnatal hormone exposure, anemia and blood transfusion were also higher, and the time of invasive and non-invasive mechanical ventilation, oxygen use and total hospital stay were longer( P<0.001). The time of starting enteral nutrition, cumulative fasting days, days of reaching total enteral nutrition, days of continuous parenteral nutrition, days of reaching 110 kcal/(kg·d) total calorie, days of reaching 110 kcal/(kg·d) oral calorie were longer and the breastfeeding rate was lower in BPD group than those in non BPD group( P<0.001). The cumulative doses of amino acid and fat emulsion during the first week of hospitalization were higher in BPD group( P<0.001). Multivariate Logistic regression analysis showed that NRDS, invasive mechanical ventilation, age of reaching total enteral nutrition, anemia and blood transfusion were the independent risk factors for BPD in VPI, and older gestational age was the protective factor for BPD. Conclusion:Strengthening perinatal management, avoiding premature delivery and severe NRDS, shortening the time of invasive mechanical ventilation, paying attention to enteral nutrition management, reaching whole intestinal feeding as soon as possible, and strictly mastering the indications of blood transfusion are very important to reduce the incidence of BPD in VPI.

Objective: To investigate the effect of hypertensive disorder complicating pregnancy (HDCP) on the mortality and early complications of premature infants. Methods: The general clinical data of preterm infants with gestational age 24-36^{+ 6} weeks were collected from the cooperative units in the task group from January 1, 2013 to December 31, 2014.According to the severity of HDCP, the infants were divided into 4 groups: HDCP group, preeclampsia group, eclampsia group and non HDCP group, the mortality and major complications of preterm infants were compared, and the influencing factors were analyzed. Results: The mortality rate of preterm in the HDCP group was significantly higher than that of non HDCP group, and there was statistical significance (χ²=9.970, P=0.019). Eclampsia had a highest fatality rate (4.8%) in the early stage, compared with non HDCP group (2.2%), and the difference was statistically significant.Comparison of HDCP group (1.8%) and eclampsia group (3.2%) suggested that there was no statistically significant difference.The incidence of respiratory distress syndrome (RDS) in preterm in HDCP group was significantly higher than that of non HDCP group, and there was statistical significance (χ²=13.241, P=0.004). Eclampsia group showed the highest incidence (35.4%), compared with non HDCP group (16.2%), the difference was statistically significant, but compared with HDCP group (19.9%), preeclampsia group (17.1%), there was no significant diffe-rence.The incidence of bronchopulmonary dysplasia (BPD) in preterm in HDCP group was significantly higher than that of non HDCP group (χ²=9.592, P=0.022), the highest incidence showed up in eclampsia group (9.7%), compared with non HDCP group (2.0%) and HDCP group (1.7%), the difference was statistically significant.But there was no statistically significant difference, compared with preeclampsia group.As the degree of HDCP aggravated, the incidence of BPD gradually rose.There was no significant impact on necrotizing enterocolitis (NEC), retinopathy of prematurity (ROP), intraventricular hemorrhage (IVH) and sepsis of HDCP (χ²=7.054, 7.214, 0.358, 3.852; P=0.070, 0.065, 0.949, 0.278). Considering the overall outcome of the child, that was, whether the child died or survived, he had at least one complication, and HDCP had an effect on it (χ²=15.697, P=0.001), so the incidence increased while the degree of HDCP rose gradually.After adjusting gestational age, birth weight, sex, way of delivery, placental abruption and front placenta, prenatal hormonal, gestational diabetes, neonatal asphyxia and other factors, the results displayed that HDCP was the factor leading to the death of premature baby (OR=2.159, 95%CI: 1.093-4.266), and comparison between preeclampsia and eclampsia showed no statistical difference (P=0.714, 0.389); HDCP had no significant influence on RDS, BDP, ICH, NEC, ROP and sepsis. Conclusions HDCP leads to increased risk of premature death, but also leads to the increased incidence of RDS and BPD, but it had no obvious effect on NEC, ROP, IVH, sepsis and other complications.