The mechanism of apnea in premature infants is complicated.Central nervous system undevelopment is the fundamental cause of apnea.Some other factors such as infection and anemia also could lead to apnea.At present,caffeine is used to treat premature apnea,and other drugs and methods also have certain effect.In this paper,we reviews pathogenesis and treatment of premature apnea,in order to provide new understanding of the pathogenesis and prevention of apnea.

Objective To evaluate the accuracy of prediction equations in calculating energy expenditure in elderly patients with type 2 diabetes mellitus (T2DM).Methods In 75 elderly T2DM patients hospitalized in our hospital between August 2014 and August 2015,the resting energy expenditure (REE)measured with indirect calorimetry was compared with those calculated with six different prediction equations.Statistical analysis was performed with paired t-test,the percentage of individual coincidence,and BlandAltman method.Results The measured REE of the patients was (1 513.2 ± 240.6) kcal/d.There were statistically significant differences between the measured REE and the values predicted with Harris-Benedict,Owen,Mifflin,and Liu equations (all P ＜ 0.05),while no statistically significant differences were observed between the measured REE and the values predicted with FAO/WHO/UNU and Schofield equations (both P ＞0.05).FAO/WHO/UNU equation showed the smallest average difference from the measured value (-18.9 kcal/d),but the 95％ consistency limit (-363.3 kcal/d,325.5 kcal/d) was still beyond the acceptable clinical range.Conclusion The accuracy of prediction equations in estimating REE in elderly patients with T2DM may be dissatisfactory.

[Objective]To explore the surgical plan of lumbar degenerative de novo scoliosis combined with vertebral stenosis(LDDS) and evaluate the surgical efficiency.[Method]From July 2003 to Jan.2007,32 LDDS patients were diagnosed and operated in the author’s hospital.The X-ray,computed tomography and MRI radiological data were measured carefully preoperately which included the Cobb’s angle,vertebral rotational and lateral subluxation degree.All the patients were treated by posterior decompression and pedicle screw internal fixation,and the surgery,fluoroscopic time and bleeding amount were recorded.Patients were administered pre- and postoperatively with clinical outcome surveys of Visual Analogue Pain Score(VAS),Low Back Outcome Score(LBOS).Pre- and postoperative measurements of the Cobb's angle and lumbar lordosis of the involved segments were analyzed.[Result]The surgery time was 4?0.5 hours,the average bleeding amount was 400?30 ml,the fluoroscopic time was 30?5 min.All the patients were followed from 8 months to 4 years,and radiography was proceeded on 8 and 16 months respectively post surgery.Twenty-four cases got good bone fusion,and mean Cobb's angle decreased from 37.2 to 18.4 degrees,mean focal lordosis increased from 13.1 to 16.4 degrees,mean vertebral rotation angle decreased from 14.2 to 9.8 degrees,mean preoperative measures of VAS and LBOS improved from 5.3?2.2 and 24.8?15.6,respectively to 2.2?2.1 and 44.8?18.0 at last follow-up,the Cobb’s angle,lumbar lordosis and the degree of vertebral rotation had significantly difference pre and post surgery(t test,P

Objective To investigate the efficacy of modified VDLP (vincristine + daunorubicin + L-asparaginase + prednisone) for acute lymphoblastic leukemia (ALL) in elderly patients and its adverse reactions.Methods 31 elderly patients diagnosed as ALL at the initial visit from Jan.2009 to Dec.2014 were randomly divided into the experiment group (n=16) and the control group (n=15).Patients in the control group received traditional VDLP chemotherapy (vincristine 2 mg at 1,8,15 days;daunorubicin 30-40 mg/m2 at 1,2,15,16 days;L-asparaginase 6 000-10 000 U at 11,14,17,20 days;prednisone 1 mg/kg at 1 to 14 days),whereafter underwent a gradual dose reduction and drug withdrawal within 1-2 weeks.Patients in the experiment group received the modified VDLP chemotherapy (vincristine 2mg at 1,8,15 days;daunorubicin 30-40 mg/m2 at 1-3 days;L-asparaginase 6 000-10 000 U at 11,14,17,20 days;prednisone 1 mg/kg at 1 to 14 days),whereafter underwent a gradual dose reduction and drug withdrawal within 1-2 weeks.The complete response (CR) rate and complications were recorded.Results The CR rates were 53.3％ in modified VDLP group and 58.3％ in VDLP group,and there was no statistically significant difference between two groups (P ＞ 0.05).The treatment-related mortality and the incidence of severe infection had significant differences between the modified VDLP and VDLP groups (6.3％ vs.46.3％,31.3％ vs.66.7％,both P＜0.05).Conclusions Compared with VDLP,the modified VDLP is more tolerable and suitable for the elderly patients with ALL.

Objective:To explore the role of DKK-1 andβ-catenin expressions in progression of proximal gastric cancer (PGC). Methods:The expression of DKK-1 andβ-catenin in 61 cases with PGC and para-neoplastic tissues and 20 cases with normal gastric mucosa was detected by immunohistochemistry. The related clinical significance in the cases was studied. Results:The positive expression rate of DKK-1 and the abnormal expression rate ofβ-catenin in the tissue sections of PGC were 34.4%(21/61) and 68.9%(42/61), respectively. The positive expression rate of DKK-1 and the abnormal expression rate ofβ-catenin in para-carcinoma tissues were 8.2%(5/61) and 6.6%(4/61) , respectively. The positive expression rate of DKK-1 and the abnormal expression rate ofβ-catenin in normal gastric mucosa were 15.0%(3/20) and 10.0%(2/20), respectively. The expression rate was significantly higher in PGC than that in the other tissues (P<0.05). The expression of DKK-1 was positively related to that ofβ-catenin in PGC (r=0.454, P<0.05), but not in the others. Conclusion:Higher expressions of DKK-1 and the abnormal expression ofβ-catenin are closely related to the occurrence of PGC.

[ABSTRACT]AIM:Toinvestigatetheroleofcysteine-rich61(Cyr61/CNN1)inproliferationandmigrationof bone marrow mesenchymal stem cells ( BMSCs ) .METHODS: The lentiviral vector carrying CCN 1 ( Lenti-GFP-CCN1 ) was constructed and then transfected into the rat BMSCs .The cells were divided into non-transfection group , transfection group ( transfected with Lenti-GFP-CCN1 ) and negative control group ( Lenti-GFP ) .The fluorescence intensity of the transfected BMSCs was observed under inverted fluorescence microscope .The effects of CCN1 on the proliferation and mi-gration of BMSCs were detected by MTT assay and scratch wound healing assay .RESULTS:The proliferation of BMSCs transfected with Lenti-GFP CCN1 had no significant difference compared with negative control group and control group .The width/thickness ratio of migrated BMSCs in wound healing was significantly higher in Lenti-GFP-CCN1 group than that in negative control group and control group (P<0.05).CONCLUSION:Exogenous CCN1 promotes the migration of BMSCs.

ObjectiveTo observe the efficacy of maintenance hormonal treatment after response to chemotherapy in advanced breast cancer. Methods8 patients with advanced breast cancer were treated with chemotherapy,maintenance hormonal therapy were given after response to chemotherapy.The efficacy was evaluated every 2 cycles of chemotherapy and 2 months of endocrine therapy according to RECIST standard.Results8 patients received chemotherapy for 2-8 cycles (median 4 cycles). All patients got PR, the duration of chemotherapy was 1-6 months (median 2 months), the time to failure of chemotherapy was 4 months. Until the last follow-up day (31th December 2010), the time to progression was 6-86 months (median 13.5 months).Survival was 6-86 months(median 21.5 months).Seven patients quit the chemotherapy due to severe side effects of hematologic toxicity,fatigue or nausea vomiting.One patient died because of allergy to paclitaxol.Conclusion Maintenance hormonal treatment after patients with metastatic breast cancer response to chemotherapy may prolong the duration of effective therapy and improve the QOL.

Objective To investigate the characteristics of co-infection in initial treatment acute leukemia induction chemotherapy.Methods The clinical features of 179 untreated acute leukemia patients with nosocomial infection were analyzed after combined chemotherapy.Results In the 179 patients,151cases achieved complete remission,the complete remission rate was 84.4 ％,82 cases suffered from nosocomial infections,the incidence of infection was 45.8 ％.The sites of infection were oral,anal,lung,as well as primary foci was not clear bacteremia.In 428 specimens,the isolated bacterial colony counted a total of 66,the number of fungal colonies was 9,the bacterial colony was G-bacteria-based.G-bacteria had different degrees of resistance to many antibiotics.Extended-spectrum β-lactamases strains had not been detected in these specimens.Conclusion Acute leukemia patients is easy to co-infection after chemotherapy.Control and prevention of nosocomial infections should run throughout the entire treatment process,application of laminar flow bed helps reduce the newly diagnosed acute leukemia patients with nosocomial infection incidence.

Objective To discuss spinal fusion effect of lumbar intertransverse process in rabbits by using bone marrow stromal stem cells(MSCs)in conjunction with bone morphogenetic protein(BMP)and freeze-dried demineralized bone matrix(FDBM)as scaffold.Methods To separate and cultivate MSCs in vitro,with FDBM as scaffold,osteogenesis was induced by BMP.Sixty Japan white rabbits were randomly divided into three groups.Group A was MSCs+FDBM+BMP,group B was FDBM,group C was autogenous ilium cancellous bone(AIB).Lumbar intertransverse process was fused in lumbar five to six.Rabbits were killed at 8 weeks after operation.The general observation and imageology were used to assess the fusion condition.To estimate the implantation using DR image.Gray scale analysis of DR image caculated the osteogenic density and acreage.The CT scan and three-dimensional reconstruction was used to observe the fusion configuration of lumbar intertransverse process.Results The fusion mass character in group A and C was hard,the morphology was not regulation.The fusion mass was almost absorbed in group B beside little tissue approach transverse process.There were high density image between intertransverse processes,osteogenic density were nonuniform in group A and C.There were nonunion in group B.Consistent callus were existed between intertransverse process in group A and C.There were not consistent callus in group B.Group A was similar to group C in osteogenesis density and acreage.Group B was the worst.There were cartilage and newly born bone trabecular formation in group A and group C.Between transverse process were mainly fiber tissue in group B.Conclusion MSCs in conjunction with BMP and FDBM has the similar osteogenic capability to the AIB and better osteogenic capability than that of FDBM alone when spinal fusion of lumbar intertransverse process is performed in rabbits.