Aim: To establish a method for the determination of pantoprazole sodium and its related substances. Methods: A column packed with octadecylsiance bonded silica gel (250 mm × 4. 6 mm, 5 pjn) was used. The 0. 01 mol/L monopotassium phosphate solution( adjusted with phosphoric acid to pH 7. 0) -acetonitrile were adopted as the mobile phase, a gradient elution was programmed as follows: 0→30 min(90:10-60:40), 30→45 min(60: 40→15: 85); the detection wavelength was 289 nm; the column temperature was 40 ℃; the flow rate was 1. 0 mL/min. Results: Pantoprazole sodium, the intermediates and its related substances could be well separated. A good linear relationship was obtained over the range of 6. 96-48. 72 μg/mL( r =0. 999 9). The limit detection and quantisation of pantoprazole sodium were 8.51 ng and 17.0 ng, respectively. Conclusion: This method can be applied to control the related substances of pantoprazole sodium and determine pantoprazole sodi-um.

Objective To investigate the anatomical structure of the first plantar lumbrical muscle in the foot and to measure the relevant data which could provide anatomical basis for repairing thumb and finger defects with the transplantation of toes accompanied with the first lumbrical muscle,and to explore the marphological function of the first lumbrical muscle of the foot.Methods From March,2016 to January,2018,a systematic and detailed dissection of the 50 formalin-fixed feet was performed to observe the exact position of the starting and ending points of the first lumbrical muscle,and a Vernier caloper was used to measure the relevant record data.Results The first lumbrical muscle originates from the medial portion of the flexor digitorum lungus tendon of the second toe,and the length of the ventral muscle was [55.87±8.67(79.30-41.16] mm.There were 2 endpoints in the tendon.The first one was in the medial tubercle of the proximal phalanges.The second one was aponeurosis of the dorsal toe and the tendon was divided into proximal and distal segments with the medial tubercle as the mark point.The length of the proximal segment was [15.34±4.81(5.52-25.18] mm,the width of the proximal segment was [2.31±1.12(3.28-1.21)] mm,the thickness was [0.44±0.14(0.28-0.68)] mm;the length of the distal segment was [11.51±4.06(3.46-14.90)] mm,the width was [6.10±1.44(9.36-3.70)] mm,and the thickness was [0.18±0.09(1.10-0.38)] mm.The length and thickness of the proximal segment was signifantly larger than those of the distal segment (P＜0.05).Conclusion The first lumbrical muscle has the function of maintaining the balance and stability of both the toe and the arch during movement,flexuring the metatarsophalangeal joint,extending the interosseous joint of the extensor phalangeal,adducting the second toe;also the function of preventing the second toe from pronation during foots' movement.

Objective:To analyze the distribution of ages at the interhospital transfer of outborn very preterm infants in China and to compare their perinatal characteristics and outcomes at discharge and neonatal intensive care unit (NICU) treatment.Methods:A total of 3 405 outborn very premature infants with a gestational age of 24-31 +6 weeks who were transferred to the NICUs of the Chinese Neonatal Network (CHNN) in 2019 were included in this retrospective study. According to the age at transfer, they were divided into three groups: early transfer (≤1 d), delayed transfer (>1-7 d) and late transfer (>7 d) groups. Analysis of variance, t-test, Chi-square test (Bonferroni correction), Kruskal-Wallis test and Wilcoxon rank-sum test were used to compare the general clinical condition, treatment, and outcomes at discharge among the three groups. Results:The median gestational age was 29.7 weeks (28.3-31.0 weeks) and the average birth weight was (1 321.0 ± 316.5) g for these 3 405 infants. There were 2 031 patients (59.6%) in the early transfer group, 406 (11.9%) in the delayed transfer group and 968 (28.4%) in the late transfer group. Infants who received continuous positive airway pressure ventilation and tracheal intubation in the delivery room accounted for 8.4% (237/2 806) and 32.9% (924/2 805), respectively. A total of 62.7% (1 569/2 504) of the mothers received antenatal glucocorticoid therapy and the ratio in the early transfer group was 68.7% (1 121/1 631), which was higher than that in the delayed transfer group [56.1% (152/271), χ2=16.78, P<0.017] and the late transfer group [49.2% (296/602), χ2=72.56, P<0.017]. The total mortality rate of very premature infants was 12.7% (431/3 405), and the mortality rates in the early, delayed and late transfer groups were 12.4% (252/2 031), 16.3% (66/406) and 11.7% (113/968), respectively ( χ2=5.72, P=0.057). The incidences of severe intraventricular hemorrhage, late-onset sepsis, necrotizing enterocolitis, and bronchopulmonary dysplasia at the corrected gestational age of 36 weeks or discharge were all higher in the delayed and late transfer groups than in the early transfer group, respectively. The incidences of retinopathy of prematurity, retinopathy of prematurity requiring treatment and bronchopulmonary dysplasia at the corrected gestational age of 36 weeks or discharge in the late transfer group were significantly higher than that in the delayed transfer group (Bonferroni correction, all P<0.017). In the late transfer group, the median age of very premature infants at discharge was 66.0 d (51.0-86.0 d), and the corrected gestational age at discharge was 38.9 weeks (37.1-41.2 weeks), and both were greater than those in the early transfer [48.0 d (37.0-64.0 d), Z=260.83; 36.9 weeks (35.7-38.3 weeks), Z=294.32] and delayed transfer groups [52.0 d (41.0-64.0 d), Z=81.49; 37.4 weeks (36.1-38.7 weeks), Z=75.97] (all P<0.017). Conclusions:Many very premature infants need to be transferred to higher-level hospitals after birth. The later the very premature infants are transferred, the higher the incidence of complications will be. It is suggested that intrauterine or early postnatal transport may improve the prognosis of very premature infants.

OBJECTIVETo perform a prospective,multicenter,open,randomized study to determine a treatment regimen for treatment-naive patients with refractory chronic hepatitis C (RHC) using the predictive value (PV) of early virological response (EVR).

METHODSA total of 438 patients from 18 hospitals were recruited between December 2008 and December 2010 and administered peg-interferon/ribavirin treatment for 12 weeks. Patients who achieved complete EVR (cEVR) were assigned to group A for a 48-week course of treatment, while patients without cEVR were randomly allocated to either group B 1 for a 72-week course of treatment or to group B2 for a 96-week course of treatment. Serum hepatitis C virus RNA levels at baseline,treatment weeks 4, 12 and 24, end of treatment, and post-treatment week 24 were measured and used to evaluate the efficiency of therapy.

RESULTSThe overall sustained virological response (SVR) rate was 85.1%. In all, 91.0% of patients achieved cEVR and were assigned to group A, which had an SVR rate of 90.8%. There was no statistically significant difference in the SVR rates of groups B1 and B2 (29.4% vs. 25.0%, P more than 0.05). The positive PV of rapid virological response (RVR), cEVR and delayed virological response (DVR) for SVR was 93.4%, 90.8% and 77.8% respectively, and the negative PV of RVR, EVR and DVR for SVR was 28.0%, 93.3% and 100% respectively. Overall, 66.9% of the patients experienced adverse events (AEs), but only 1.9% of patients experienced sevcre AEs.

CONCLUSIONThe majority of Chinese RHC treatmentna(i)ve patients (91.0%) can achieve cEVR and a high SVR rate with a low rate of severe AEs using the cEVR guided personal treatment regimen.

Objective: To investigate the effects of two nanotopographies of ultraviolet (UV)-treated titanium surface on macrophage biological behaviour and inflammatory cytokines secretion, and to provide basis for clinical application of UV-treatment in dental implant modification. Methods: Titanium disks were allocated into two groups. Samples in one group were acid-etched in hydrofluoric acid (Acid Ti group), and those in the other group were acid-etched and anodized (Anodization group) to form two nanotopographies respectively. The surface morphology was evaluated by field-emission scanning electron microscopy (FE-SEM). The samples were stored in the dark for 8 weeks. Thirteen samples from each group were exposed to UV-irradiation for 48 h (Acid Ti+UV group and Anodization+UV group), UV-untreated samples from Acid Ti and Anodization groups served as control. Hydrophilicity of samples was measured using contact angle measuring device. After 4, 24 and 72 h of incubation, macrophage cell adhesion and proliferation were conducted using cell counting kit-8. Cytokine/chemokine secretions [tumor necrosis factor-α (TNF-α), monocyte chemotactic protein-1 (MCP-1) and macrophage inflammatory protein-1α (MIP-1α)] were measured from cell culture supernatants at 24 and 72 h using magnetic luminex assay. Cell morphology was examined using FE-SEM after 2 h of incubation. Results: Micropitted/nanopillar and micropitted/nanotubular topographies were observed in Acid Ti group and Anodization group respectively. Contact angles in Acid Ti+UV and Anodization+UV groups (20.2°±2.8° and 0.0°±0.0°) were significantly smaller than those in the Acid Ti and Anodization groups (P<0.05). Cell adhesion and proliferation in all groups at 4 and 24 h showed no difference (P>0.05). Cell proliferation in Acid Ti+UV and Anodization+UV groups at 72 h were (0.92±0.13) and (1.10±0.08) respectively, which were significantly higher than those in Acid Ti and Anodization groups. TNF-α concentration in Acid Ti+UV and Anodization+UV groups at 72 h were (1.03±0.11) and (0.87±0.10) ng/L, MCP-1 were (301.7±50.3) and (240.8±18.7) ng/L, MIP-1α were (224.9±30.6) and (233.9±14.9) ng/L respectively, which were significantly lower than those in Acid Ti and Anodization groups (P<0.05). Conclusions UV treatment can increase hydrophilicity of two titanium surface topographies, especially of Anodization+UV group. UV-treated titanium surfaces can promote macrophage proliferation and reduce the inflammatory response in vitro.

BACKGROUND: Antenatal corticosteroids (ACS) can significantly improve the outcomes of preterm infants. This study aimed to describe the ACS use rates among preterm infants admitted to Chinese neonatal intensive care units (NICU) and to explore perinatal factors associated with ACS use, using the largest contemporary cohort of very preterm infants in China. METHODS: This cross-sectional study enrolled all infants born at 24 +0 to 31 +6 weeks and admitted to 57 NICUs of the Chinese Neonatal Network from January 1st, 2019 to December 30th, 2019. The ACS administration was defined as at least one dose of dexamethasone and betamethasone given before delivery. Multiple logistic regressions were applied to determine the association between perinatal factors and ACS usage. RESULTS: A total of 7828 infants were enrolled, among which 6103 (78.0%) infants received ACS. ACS use rates increased with increasing gestational age (GA), from 177/259 (68.3%) at 24 to 25 weeks' gestation to 3120/3960 (78.8%) at 30 to 31 weeks' gestation. Among infants exposed to ACS, 2999 of 6103 (49.1%) infants received a single complete course, and 33.4% (2039/6103) infants received a partial course. ACS use rates varied from 30.2% to 100% among different hospitals. Multivariate regression showed that increasing GA, born in hospital (inborn), increasing maternal age, maternal hypertension and premature rupture of membranes were associated with higher likelihood to receive ACS. CONCLUSIONS The use rate of ACS remained low for infants at 24 to 31 weeks' gestation admitted to Chinese NICUs, with fewer infants receiving a complete course. The use rates varied significantly among different hospitals. Efforts are urgently needed to propose improvement measures and thus improve the usage of ACS.
Humans ; Infant, Newborn ; Infant ; Pregnancy ; Female ; Gestational Age ; Infant, Premature ; Intensive Care Units, Neonatal ; Cross-Sectional Studies ; Adrenal Cortex Hormones/therapeutic use*

Malignant peripheral nerve sheath tumor (MPNST) is a rare invasive soft tissue sarcoma that originates from peripheral nerve branches and peripheral nerve sheaths. Early radical surgery is an effective treatment for MPNST. Since it is insensitive to radiotherapy and chemotherapy, the disease manifests a rapid progression, poor prognosis and high mortality. In recent years, the translational researches on the driving factors and therapeutic targets of MPNST have been rapidly developed, including the pathways of NF1-Ras, Raf-MEK-ERK, PI3K-AKT-mTOR, Wnt signaling, and abnormal expressions of apoptotic proteins, the general loss of polycomb repressive complex 2 (PRC2), upregulation of the HDAC family, abnormal expressions of receptor tyrosine kinases, expressions of programmed cell death ligand (PD-L1), aurora kinase and various microRNAs.This review summarizes the current translational researches on potential therapeutic targets of MPNST, and the clinical trials which provide helpful information for MPNST targeted therapy.