Objective To characterize contemporary electrographic neonatal seizures by video electroencephalogram (VEEG) and to assess the value and the limitations of two-channel (C3-C4/T3-T4) amplitude-integrated electroencephalogram (aEEG) plus original EEG signals used to diagnose neonatal seizure with video EEG as a golden standard.Methods Sixty-six neonates admitted to Children's Hospital of Fudan University from January 2011 to July 2011 with clinical or suspected clinical seizure were investigated and bedside VEEG were recorded for more than 3 hours.VEEG signals were transformed into three kinds of aEEG signals by Galileo NT PMS software:one-channel aEEG (C3-C4),one-channel aEEG (C3-C4) plus original EEG,two-channel aEEG (C3-C4/T3-T4) plus original EEG.Electrical seizure activity on VEEG was signed out with respect to its occurrence,duration and localization of seizure onset; while aEEG seizure was recorded only with its occurrence.The relationship between aEEG and VEEG was analyzed by Spearman analysis.The value and the limitations of aEEG to diagnose neonatal seizure were evaluated by sensitivity,specificity,positive predictive value and negative predictive value.Results A total of 62 traces were suitable for analysis.(1) VEEG showed 39 seizure activities,among which 8 status epilepticus; and the rest 31 neonates had 352 non-status epilepticus electrical seizures,79.3％ (279/352) of which occurred over the centrotemporal region.(2) Eight cases with status epilepticus on VEEG were all diagnosed as status epilepticus on aEEG.For non-status epilepticus electrical seizures,the sensitivity of aEEG for detection of electrical seizures was as followed:49.1％ (173/352) for one-channel aEEG,54.5 ％ (192/352) for one-channel aEEG plus original EEG,81.2％ (286/353) for two-channel aEEG plus original EEG.Results from one-channel aEEG,one-channel aEEG plus original EEG and two-channel aEEG plus original EEG were all related to VEEG (ρ =0.790,0.907 and 0.953,respectively,P＜ 0.01).(3) Sensitivity of seizure detection was 66.7％ (26/39,95％ CI:0.62-0.81) for one-channel aEEG,74.4％(29/39,95％ CI:0.78-0.96) for one-channel aEEG(C3-C4) plus original EEG and 89.7％ (35/39,95％ CI:0.89-1.00) for two-channel aEEG(C3-C4/T3-T4) plus original EEG.Conclusions VEEG might help aEEG in diagnosis of neonatal seizure.two-channel aEEG (C3-C4/T3-T4) plus original EEG could significantly increase the sensitivity of neonatal seizures indentification.

Objective:To explore the application effect of interactive group management mode in puerpera with postpartum diastasis recti abdominis, and to provide reference for optimizing the health management of puerpera with rectus abdominis separation.Methods:This study was a randomized controlled trial. Convenience sampling method was used to select 114 puerpera with postpartum diastasis recti abdominis who were treated in Maternal and Child Health Hospital of Zhenjiang City from January to June 2022 as the research objects. According to the random number table method, the postpartum women were divided into an intervention group and a control group with 57 cases each. The intervention group received interactive group management for 12 weeks, while the control group received routine health guidance. Before and after the intervention, the two groups were evaluated by diastasis recti abdominis, rehabilitation knowledge-attitude-practice, general self-efficacy, and the duration of the first-level test results of the eight-level abdominal bridge.Results:The 55 cases were included in the final intervention group, while 56 cases were included in the control group. After intervention, the separation distance of rectus abdominis of the intervention group was (2.27 ± 0.47) cm, and that of the control group was (2.48 ± 0.39) cm. The difference between the two groups was statistically significant ( t = 2.53, P<0.05). The knowledge-attitude-practice total score and each item score of diastasis recti abdominis rehabilitation in the intervention group were (106.84 ± 5.78), (61.53 ± 4.29), (25.42 ± 2.26), (19.89 ± 1.89) points respectively while in the control group were (73.77 ± 8.33), (38.48 ± 7.56), (20.73 ± 3.07), (13.55 ± 1.99) points. The differences between the two groups were statistically significant ( t values were 9.16 -24.28, all P<0.01). The general self-efficacy score of the intervention group was (27.47 ± 3.16) points, and that of the control group was (26.05 ± 3.43) points. The difference between the two groups was statistically significant ( t = 2.26, P<0.05). The first-level test time of eight-level abdominal bridge in the intervention group was (80.29 ± 11.50) s, which was significantly higher than (29.39 ± 6.09) s in the control group, and the difference was statistically significant ( t = 29.20, P<0.01). The completion rate of exercise in the intervention group was (90.20 ± 1.83)%. Higher than (69.52 ± 8.04)% in the control group, with a statistically significant difference ( t = 13.73, P<0.01). Conclusions:Interactive group management can significantly ameliorate the separation distance of diastasis recti abdominis, increase the level of knowledge-attitude-practice of diastasis recti abdominis rehabilitation and the compliance of rehabilitation exercise, improve the self-efficacy, prolong the first-level test time of eight-level abdominal bridge, and improve the abdominal core muscle strength for puerpera.

OBJECTIVETo measure related cost, effectiveness and benefit of needle and syringe exchange (NSP) in two provinces of Southwest China.

METHODSBetween September 2012 and February 2013, program files and questionnaires were used to collect the information about cost, effectiveness and benefit of NSP during three program years (July 2009 to June 2010, July 2010 to June 2011, July 2011 to June 2012 ) in 31 counties of two provinces of Southwest China. Unit cost indicators including cost of providing per syringe and cost of covering per IDU, number of new HIV infections avoided by providing needle and syringe exchange were used to evaluate the effectiveness of NSP, and the benefit indicators included the fees for ART, hospitalization cost and follow up of new HIV infection avoided by NSP. NEAR model was used to calculate the cases averted by NSP. Chi-square test was used to analyze the different percentage of allocation areas between two provinces.

RESULTSBetween July 2009 and June 2012, 25 374 041 yuan were totally used for NSP. In province A, the top investment area was management (1 848 485 yuan) while it was comprehensive intervention (5 452 355 yuan) in province B. The cost of providing per syringe was 3.67 yuan, and it decreased from 6.96 to 4.01 in province A and decreased from 3.38 to 2.17 in province B with the increasing needles distributed. The cost of covering per IDU was 712.71 yuan and the unit cost decreased from 882.85 to 574.95 in province A and decreased from 760.48 to 625.07 in province B with the growing number of IDUs intervened. A total of 1 307 new HIV infection were avoided by providing NSP, so 19 413.96 yuan would be used to avoid per IDU infecting HIV. A total of 367 507 488 yuan of HIV/AIDS related expenditure were avoided by NSP and the cost benefit ratio was 14.48.

CONCLUSIONNSP has a good cost-benefit ratio and should be promoted.

China ; Cost-Benefit Analysis ; Drug Users ; HIV Infections ; prevention & control ; Humans ; Needle-Exchange Programs ; economics ; Substance Abuse, Intravenous ; Surveys and Questionnaires ; Syringes

OBJECTIVE:To prepare Bevacizumab(BEV)multivesicular liposomes(BEV-MVLs)with sustained-effect,and to study their in vitro release characteristics. METHODS:BEV-MVLs were prepared by double emulsion method. Box-Behnken design-response surface methodology was used to optimize the prescription with the concentration of glycerol trioleate(TO)in organic phase,ratio of 1,2-dioleoyl-sn-glycero-3-phosphocholine(DOPC)-cholesterol(CH)(mol/mol),the concentration of L-lysine in external water phase as factors,using encapsulation rate as index. The morphology of BEV-MVLs was observed by inverted fluorescence microscope and SEM;particle size was determined by laser particle size analyzer;the BEV content was determined by HPLC and calculate the encapsulation rate and in vitro accumulative release rate.RESULTS:The optimized prescription was as follows as TO of 2.72 mmol/L in organic phase,DOPC-CH ratio of 0.67(mol/mol)and L-lysine of 40 mmol/L in external water phase. The encapsulation rate of BEV-MVLs was(80.65±4.42)%(n=3),and relative error of it to predicted value was 2.54%. The liposomes were spherical in appearance shape and uniform in size,and they were typical non-concentric vesicle structure with average particle size of 16.80 μm. 30 d in vitro accumulative release rate was about 92%. CONCLUSIONS:Prepared BEV-MVLs show sustained-effect,and their encapsulation rate reaches the expected effect.

Objective:To determine the role and mechanism of tranilast preventing the progression of tubulointerstilial ifbrosis in diabetic kidney disease (DKD).
Methods:Sprague-Dawley rats were randomly divided into a control group (n=6), DKD model group (n=8), low dose tranilast group [200 mg/(kg.d), n=8], and high dose tranilast group [400 mg/(kg.d), n=8]. Tranilast was administered daily after the model was built. Rats were sacrificed at day 56, 24 hour urine was collected to measure 24-hour urine albumin excretion, and blood was collected to determine the renal function and serum albumin. Then the kidneys were harvested and subjected to studies. The expression of C3aR, E-cadherin,α-SMA, fibronectin(FN), collagen I (Col I), stem cell factor (SCF) and c-kit were detected by immunohistochemical staining respectively. The expression of E-cadherin,α-SMA, FN, Col I, SCF and c-kit protein was analyzed by Western blot, and the expression of FN, Col I, SCF and c-kit mRNA was examined by RT-PCR. Results:Tranilast can inhibit the inifltration of mast cells in the kidneys of DKD rats. The expression ofα-SMA in the kidneys of DKD rats inereased signiifcantly (P<0.05), while the expression of E-cadherin decreased (P<0.05). Tranilast increased the expression of E-cadherin and decreased the expression ofα-SMA in the prophase of DKD dose dependently. The expressions of FN and Col I were increased in the tubulointerstitial ifelds in DKD model rats (P<0.05). After the tranilast treatment, these changes were relieved to a certein degree (P<0.05). The expression of SCF and c-kit in the tubular and interstitial tissue was slight. The increased expressions of SCF and c-kit protein and mRNA in DKD model rats were downregulated by tranilat (P<0.05). The expressions of SCF and c-kit were positively correlated with the infiltration degree of mast cells and the expressions of FN, Col I.
Conclusion:Mast cells participate in and aggravate the renal tubulointerstitial fibrosis in DKD rats. Tranilast can reverse the EMT of renal tubular cells and inhibit the tubulointersitial fibrosis of DKD by blocking the inifltration of mast cells induced by SCF/c-kit pathway.

Objective:To investigate the current status of primiparas′ postpartum fatigue and paternal involvement, and to explore the relationship between primiparas′ postpartum fatigue and paternal involvement, and to provide reference basis for developing targeted intervention measures to alleviate postpartum fatigue of primiparas.Methods:A cross-sectional survey was conducted on 347 primiparas from Affiliated Hospital of Yangzhou University, Yangzhou Maternal and Child Health Care Hospital from September to December 2020 by convenience sampling. The survey instruments included the general information questionnaire, the Parenting Alliance Inventory (PAI), and the Postpartum Fatigue Scale (PFS).Results:The total score of PAI was (86.51 ± 12.07) points, and the level of paternal involvement was high. The total score of PFS was (16.68 ± 4.12) points. 95.97% (333/347) of primiparas had varying degrees of postpartum fatigue. There was a significant negative correlation between paternal involvement and primiparas′ postpartum fatigue ( r=-0.327, P<0.01). The results of multiple stratified regression analysis showed that paternal involvement was included in the influencing factor model of primiparas′ postpartum fatigue, which could independently explain 9.7% variation of primiparas′ postpartum fatigue. Conclusions:The higher level of paternal involvement could predict the lower level of primiparas′ postpartum fatigue. Medical staff should pay attention to the participation level of the spouses of primiparas in childcare, and improve the participation level of the spouses of primiparas in scientific ways to alleviate the postpartum fatigue of primiparas.

OBJECTIVETo conduct health economic evaluation of the prevention of mother-to-child HIV among pregnant women in Dehong prefecture, Yunnan province, China from 2004 to 2013.

METHODSData on cost were collected mainly from the annual prevention of mother-to-child transmission (PMTCT) reporting system of Dehong prefecture, and supplemented by HIV PMTCT-related resource allocation data from local health bureau. Effectiveness indexes were from local continuous HIV surveillance system and annual reported data. Cost-effectiveness and cost-utility analysis were used to conduct the health economic evaluation.

RESULTSFrom 2004 to 2013, 283980 pregnant women were screened for HIV, 2 059 were detected as positive, and the HIV positive rate was 0.73%. The total cost of the PMTCT program was 14 227 000 RMB after discounting, and the unit cost of positive case finding was 4 200 RMB. A total of 26 cases of adults and 325 infants were avoided HIV infection, and the cost-effectiveness ratio (CER) was 40 500 RMB/case. The total obtained quality adjusted life years (QALY) from the program was 8 911.5, each one of which cost 1 600 RMB/QALY. If the feeding pattern were breast feeding, CER would be 42 800 RMB/case and each one of QALY would cost 2 200 RMB.

CONCLUSIONBased on the cost-effectiveness and cost-utility analysis, the HIV PMTCT of Dehong prefecture had economic value, which indicates that continued investment is needed to strengthen local HIV PMTCT work.

Acquired Immunodeficiency Syndrome ; Adult ; Child ; China ; Cost-Benefit Analysis ; Costs and Cost Analysis ; Female ; HIV Infections ; Health ; Humans ; Infant ; Infectious Disease Transmission, Vertical ; Mothers ; Pregnancy ; Quality-Adjusted Life Years

OBJECTIVETo understand the characteristics and retention situation of clients in extension clinic of methadone maintenance therapy.

METHODSFrom December 20, 2010 to March 10, 2011, the system sampling method was used to get the cases. A total of 462 heroin addicts from 22 methadone maintenance therapy clinics and extension clinics located in Mangshi, Ruili, Longchuan, Yingjiang, Lianghe of Dehong prefecture, Yunnan province were interviewed, and the demographic characteristics, quality of life, urine testing results for morphine of the patients between the extension MMT clinic and standard MMT clinic were also collected and compared. A cohort study was conducted to analyze retention situation of the new clients with Kaplan Meier method during 9 months treatment.

RESULTSOf the 462 cases, 239 cases were from standard MMT clinic, and 223 cases were from the extension MMT clinic. Among them, 117 cases were new research objects into the group during the investigation. Among the clients of extension MMT clinic, 96.7% (147/152) of them were males, 37.5% (57/152) were Dai nationality, and 61.2% (93/152) were married, 38.8% (59/152) with primary school education, 95.4% (145/152) lived with their family or relatives, 96.7% (147/152) could arrive at the clinic from their habitation within 15 minutes. The positive detection rates 72% (13/18), 71% (24/34), 58% (30/52), 29% (15/52), 14% (6/44), 14% (4/29), 15% (5/34), 17% (6/35), 6% (2/33), 16% (5/31) of urine-morphine testing among new clients of extension MMT clinics decreased as the period of treatment lengthened (χ(2) = 61.04, P < 0.05). The period of retention of the clients in extension MMT clinics was 175-days averagely, with an average retention 122 days of when withdrawing. The retention rates of the clients were 52% (37/71)and 61% (28/46) at 9th month of the extension MMT clinics and standard MMT clinics respectively. There was no difference in the retention rate between those of two types of clinics (χ(2) = 0.82, P = 0.37) .

CONCLUSIONMost of the clients in extension MMT clinics lived with their family or relatives, and spent less time on the way to the clinics. After 9 months methadone maintenance therapy, the quality of life of clients in extension clinics was improved while addiction among them decreased. The extension clinic was an effective strategy for retention in remote areas.

China ; Cohort Studies ; Demography ; Heroin Dependence ; Humans ; Male ; Methadone ; Opiate Substitution Treatment ; Quality of Life ; Substance-Related Disorders ; Treatment Outcome

OBJECTIVETo understand provider initiated HIV testing and counseling (PITC) in a region with high HIV/AIDS epidemic in China, and analyze its effect to early detection of HIV infections.

METHODSBetween January and December, 2013, 37 county level medical institutions were selected as the study sites, among which, 19 were public medical institutions and 18 were private institutions. According to the related regulation, procedures and contents of PITC, the study was implemented among outpatients and inpatients who seek for doctors in these medical institutions and PITC were provided for them. The 'Individual Investigation Form' was used to record the information and high-risky factors, and the respondents were taken venous blood and given HIV screening and confirmation. All available serum samples of newly found HIV/AIDS cases were tested using the BED HIV Incidence Capture Enzyme Immunoassay (BED-CEIA) to differentiate the long-term infections and new infections (early detected infections). Chi-square analysis was used to compare the differences of characteristics of newly infected patients.

RESULTSBetween January and December, 2013, a total of 37 medical institutions provided PITC. 55 164 person times were received HIV screening, among which 658 were HIV positive, and 598 were confirmed to be HIV positive. The 598 cases were all provided transferring service. The differences of age, marital status, education levels, transmission routes and testing institutions had statistical significance to early detection (χ(2) equals to 23.54, 10.50, 17.96, 21.22 and 4.80; P equals to < 0.001, 0.005, < 0.001, < 0.001 and 0.029, respectively). And the early detection proportions among patients aged from 20 to 29 and from 50 to 84 were 47.1% (114/242) and 42.1% (24/57), respectively; the proportions among single and married patients were 37.8% (56/148) and 38.9% (143/368), respectively; the proportion among patients with high school education levels were 42.6% (26/61); the proportion among patients transmitted by fixed heterosexual sexual partners was 46.0% (86/187); the proportion among private hospitals was 40.3% (58/144).

CONCLUSIONA certain proportion of HIV infections were early detected by PITC in this region. The HIV early detection proportions among specific age group and population with spouse/fixed sexual partners were relatively high.

Acquired Immunodeficiency Syndrome ; diagnosis ; epidemiology ; Adult ; Aged ; Aged, 80 and over ; China ; Counseling ; Early Diagnosis ; Epidemics ; HIV Infections ; diagnosis ; epidemiology ; Humans ; Marital Status ; Mass Screening ; Middle Aged ; Outpatients ; Surveys and Questionnaires ; Young Adult

OBJECTIVE: To carry out genetic and metabolite analysis for an infant with cerebral creatine deficiency syndrome type 2 (CCDS2). METHODS: Clinical data of the child was collected. Whole-exome sequencing was carried out to identify potential variants by next generation sequencing. Candidate variants were confirmed by Sanger sequencing. Metabolites were determined by tandem mass spectrometry and magnetic resonance spectroscopy. Treatment was carried out following the diagnosis and genetic counseling for the affected family. RESULTS: Two novel heterozygous variants (c.289delC and c.392-1G>C) of the GAMT gene were identified in the proband, which were respectively inherited from her father and mother. In silico analysis suggested both variants to be pathogenic. Creatine (Cr) level of the child was very low, and cerebral guanidinoacetate (GAA) level was slightly increased. But both had recovered to normal in two weeks, and cerebral Cr level was significantly improved after two months. Intellectual and motor development of the child were significantly improved. CONCLUSION The child was diagnosed with CCDS type 2, for which pathogenic variants of the GAMT gene may be accountable. Treatment has attained a satisfactory effect for the patient.