Objective To explore the impact of early repetitive painful procedures on subsequent pain behaviors and physiological indicators in full-term infants.Methods Sixty-two full-term neonates were enrolled (male 36 cases,female 26 cases) from the medical center of neonatal care at Nanjing Children's Hospital Affiliated to Nanjing Medical University from March to May in 2009.The data of all painful procedures were performed on those neonates and their responses to them were collected by using digital video recording were collected.The Neonatal Facial Coding System C(NFCS) and Neonatal Infant Pain Scale(NIPS) were used prospectively to evaluate the pain response to painful procedures.Results The average experience of pain caused by operation on newborn at the hospital was 56.5 times (12-249 times),and the daily average was 5.9 times (4-26 times).After they were exposed to more than 10 repetitive pain procedures,the full-term neonates showed the declining pain response assessed by NFCS and NIPS during the subsequent painful procedures (NFCS:P10=0.012,P20=0.015,P30=0.041;NIPS:P10=0.006,P20=0.015,P30=0.049),and the temporarily enhanced pain response was observed in the preparation phase of the subsequent painful procedures (NFCS:P2＜0.001,P3＜0.001,P4=0.004,P5=0.009;NIPS:P2＜0.001,P3＜0.001,P4=0.045,P5 =0.031).Bnt there was no difference in preparation phase.There was no alternation in latency and crying time after repetitiing painful procedures,but the proportion of crying neonates in the preparation phase of the painful procedures was increased(P=0.032).Conclusions After exposed to repetitive pain,full-term neonates expressed hypoalgesia during subsequent painful procedures,but the temporary irritation was enhanced during the following phases exposed to stress.

BACKGROUND:Studies have demonstrated that Fe-Cr-Mo soft magnetic aloy has desired magnetic properties and machining properties. Surface Cr6+ plating treatment can significantly enhance the corrosion resistance in oral environment, but its biosecurity needs further testing. OBJECTIVE: To evaluate the biocompatibility of Fe-Cr-Mo soft magnetic aloy with chromium plating. METHODS:Logarithmic growth phase L929 cel suspension was obtained and seeded in 96-wel plates at a cel concentration of 6×107/L. Pure titanium extract, Fe-Cr-Mo soft magnetic aloy original extract, Cr6+-plated Fe-Cr-Mo soft magnetic aloy and PVC extract were added respectively. After 5 days of culture, cel morphology and adherent circumstances were observed. The absorbance value was detected using cel counting kit-8 assay. The relative growth rate of cels in each group was calculated. The cytotoxicity grades of materials were evaluated. RESULTS AND CONCLUSION:In the pure titanium extracts group, the cels with normal morphology showed good adherent growth and no cytotoxicity. In the Fe-Cr-Mo soft magnetic aloy original extract group, the cel morphology and growth status were both good, with occasionaly individual cel lysis. Scattered reddish brown particles were visible in the culture solution, showing no or very mild cytotoxicity. In Cr6+-plated Fe-Cr-Mo soft magnetic aloy extract group, the cels grew wel and showed no or very mild cytotoxicity. In PVC extract group, more than 70% of cels were vacuole-shaped and presented with pyknosis or dissolution, there was a large number of cel debris, and cel growth was inhibited in over 50% cels, showing moderate cytotoxicity or above. The cytotoxicity of Cr6+-plated Fe-Cr-Mo soft magnetic aloy extract was grade 0-1. These results demonstrate that Fe-Cr-Mo soft magnetic aloywith chromium plating has good biocompatibility.

Objective To evaluate the efficacy and safety in treatment of patients with mild to moderate Alzheimer’s disease (AD). Methods A total of 233 patients with mild to moderate potential AD were enrolled in a 16-week multi-center double blind clinical trial. All patients were randomized into two groups. 110 patients in galantamine group and 108 patients in donepezil group were enrolled in efficacy analysis. The scales of Alzheimer’s Disease Assessment Scale-Cognitive Subscale (ADAS-cog), Alzheimer’s Disease Cooperative Study Activities of Daily Living Scale (ADCS-ADL) and The Neuropsychiatric Inventory (NPI) were used to assess the effect at both baseline and the end of 16 weeks. Safety issues, including vital signs, lab assays and ECG examinations were measured. Results Patients in both groups were obviously improved in the total score of ADAS-cog (-5.4?6.4) in the galantamine group and (-4.0?7.3) in the donepezil group, P=0.098). 76% patients of the galantamine group had a score of ADAS-cog less than 20 at the end of 16 weeks treatment, which was higher than that of the donepezil group (58%, P=0.015). The sub-score of speech ability in ADAS-cog were improved in the galantamine group (baseline 2.8?2.9,16 weeks 1.8?2.5) compared with the donepezil group (baseline 2.8?3.0, 16 weeks 2.3?2.9, P=0.035). No significant difference of ADSC-ADL and NPI scale was found between the two groups (P=0.447 and 0.936 respectively). The sleep/night behavior was improved in the donepezil group (baseline 14%, 16 weeks 10%) compared with the galantamine group (baseline 23%, 16 weeks 22%, P=0.012). Two drug-related severe adverse events occurred during the trial, which were platelet reduction in the galantamine group and acute drug-induced hepatic injury in the donepezil group. The incidence of adverse events was 44% in the galantamine group and 47% in the donepezil group respectively. Galantamine had little influence on vital signs and lab assays. Conclusion Safe and well tolerated, galantamine improves the cognition, activities of daily living and neuropsychiatric symptoms of patients with mild to moderate AD.

Objective To observe the comprehensive clinical effect of biofeedback combined with psychological nursing on the treatment of functional constipation ( FC) .Methods A total of 76 cases of FC were collected and randomly divided into control group ( 38 cases ) and observation group ( 38 cases ) by random number method .Patients in control group were treated with biofeedback treatment; and patients in the observation group were treated with biofeedback combined with individualized psychological nursing . Health state survey questionnaire ( SF-36 ) , self-rating anxiety scale ( SAS) and self-rating depression scale ( SDS ) were applied to evaluate two group′s quality of life and psychological status before and after intervention.Improvement of clinical situation of two groups was compared .Results After treatment, the symptom scores of two groups were significantly lower than those before treatment .Improvement of difficult defecation(0.84 ±0.50), endless defecate feeling (0.84 ±0.38) and anal or rectal obstruction (0.53 ± 0.51)of observation group was superior to that of the control group (t=2.458,2.598,2.167;P<0.05). After treatment , the scores of SF-36 of two groups were higher than those before intervention . Four dimensions of vitality(90.22 ±11.54), emotional function(89.57 ±13.51), mental health(86.28 ±9.47) and general health ( 89.09 ±9.81 ) of observation group were better than those of control group ( t =-2.184,-2.196,-3.831,-2.238;P<0.05).After treatment, the scores of SAS (43.41 ±6.96)and SDS (40.57 ±6.69)of the observation group were lower than those of the control group (t=2.195,2.356;P<0.05).Conclusions Biofeedback combined with psychological nursing not only can obviously improve the patients′clinical symptoms , but also improve the patients quality of life and abnormal mental state .

Objective:To investigate the effects of enriched environments on behavioral development at toddler period of preterm who had experienced early repeated operative pain.Methods:A cross-sectional study was conducted. A total of 80 high-risk preterm children of 2 years of age, who had experienced repeated pain stimuli in the neonatal intensive care unit (NICU), were enrolled as preterm group from the High-risk Children Clinic of Children′s Hospital of Nanjing Medical University from October 2016 to March 2021. Furthermore, 39 full-term healthy children, aged 2 years, who were undergoing routine check-ups during the same period, were selected as the full-term group. The preterm group was further divided into preterm intervention group and preterm non-intervention group based on the implementation of enriched environment interventions. Data of neonatal characteristics from 3 groups were collected. Growth and development indicators at the age of 2 years were measured. Neuropsychological development evaluated by Gesell developmental scale. Behavioral development evaluated by child behavior check list. The salivary cortisol levels in response to novelty (baseline, task, end) were collected. The family environment, including maternal parenting pressure, were evaluated through a survey questionnaire. One-way ANOVA and least significant difference (LSD) tests were used to compare physical development, maternal parenting stress, Gesell neuropsychological development, and behavioral problems among the 3 groups. A repeated-ANOVA and LSD tests were employed to compare the patterns of salivary cortisol secretion. Pearson correlation analysis was used to explore the influencing factors related to neuropsychological and behavioral development and cortisol level.Results:There were 44 cases in the preterm intervention group (17 males, gestational age of (31.3±2.8) weeks), and 36 in the preterm non-intervention group (29 males, gestational age of (32.5±2.6) weeks). The full-term group consisted of 39 children (23 males, gestational age of (39.3±2.1) weeks). At 2 years of age, the height, weight, and head circumference of the preterm intervention group and non-intervention group were all lower than those of the full-term group (all P<0.05).The Gesell developmental schedule showed that the preterm non-intervention group scored all lower in gross motor, fine motor, adaptive, language and personal-social domains compared to the full-term group (91±7 vs. 97±6, 88±9 vs. 94±6, 89±8 vs. 99±8, 84±10 vs. 100±15, 89±7 vs. 95±6), with statistical significance (all P<0.01). The preterm intervention group scored all higher than the preterm non-intervention group in gross motor, fine motor, adaptive and language domains (all P<0.05), with no significant difference compared to the full-term group (all P>0.05). The number of needle painful procedures during hospitalization in NICU of the non-intervention group was negatively correlated to the adaptive development quotient ( r=-0.48, P<0.05). Furthermore, the preterm non-intervention group exhibited higher scores in social withdrawal, depression, somatic complaints, aggression, and destructive behaviors compare to the full-term group and preterm intervention group ( F=8.07, 5.67, 7.72, 7.90, 7.06; all P<0.05); while the preterm intervention group showed no significant difference compared to full-term group (all P>0.05). Behavioral problems (social withdrawal and depression) in the preterm non-intervention group were positively correlated with maternal parenting stress ( r=0.66, 0.50; both P<0.05). In response to novel visual stimuli and cognitive challenges, the preterm non-intervention group had significantly higher salivary cortisol levels compared to the full-term group ( P=0.006), which were negatively correlated with the frequency of early painful procedures ( r=-0.83, -0.80; both P<0.01). There was no significant difference in cortisol secretion pattern between the intervention group and the full-term group ( P=0.772). Conclusion:Enriched environmental interventions can improve neuropsychological development, decrease behavioral problems, and down-regulate consistent high cortisol response to task in preterm infants who have experienced repeated procedural pain in the NICU by the age of 2 years.

AIM: To study the distribution characteristics of steady-state trough concentration (C

OBJECTIVETo investigate the association of parameters in dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) using reference region model with prognostic factors and molecular subtypes of breast cancer.

METHODSMRI and pathological data of 50 patients with pathologically confirmed invasive ductal carcinoma of the breast were retrospectively analyzed. Reference region model was applied to analyze pharmacokinetic quantitative parameters including volume transfer constant (RR K), rate constant (K) and the ratio of Kto extracellular space volume (K/V). The associations of the above parameters with prognostic factors and molecular subtypes of breast cancer were analyzed.

RESULTSRR Kand Kwere significantly higher in patients of histological grade 3 compared with those of histological grade 1 & 2 (all<0.05); and the patients with estrogen receptor (ER)-negative and/or progesterone receptor (PR)-negative also had higher RR Kand Kthan those with ER-positive or PR-positive (all<0.05). For immunohistochemistry, RR Kand Kwere significantly higher in triple negative breast cancer compared with luminal type breast cancer (all<0.05).

CONCLUSIONSHigh RR Kand Kare associated with poor prognosis of breast cancer, and which can also be used to distinguish molecular subtypes of breast cancer.