BACKGROUND: Perinatal hypoxic-ischemic encephalopathy(HIE) is the primary cause of neonatal brain injury, which retards the mental development in affected infants.OBJECTIVE: To investigate the influence of early intervention on mental and psychological development in infants with HIE, study the time-effect relation of the early intervention, and to find an optimal time for intervention.DESIGN: A time series of following-up and a non-randomized concurrent controlled investigation.SETTING: Xiangya Hospital and Xiangya School of Medicine Affiliated to Central South University.PARTICIPANTS: From February 1999 to May 2001, in the Pediatric Department of Xiangya Hospital Affiliated to the Central South University, the inpatient and outpatient infants with HIE were selected. There were 32 inpatients in the intervention group, 10 with moderate HIE and 22 with severe HIE. There were 36 outpatients in the control group, 10 with moderate HIE and 26 with severe HIE. Comparison was performed between these two groups.METHODS: BRS and the Infant and Child Mental Development Scales,made by The Institute of Psychology of The Chinese Academy of Science and The China National Children' s Center(CNCC), were adopted in the assessment between the two groups.MAIN OUTCOME MEASURES: Mental Development Index(MDI) and Psychomotor Development Index(PDI) scores of the two groups were compared.were significantly higher in the intervention group(90.50 ± 11.12/90. 34±12.49,94.06±14.96/92.03±13.07,90.78±7.46/91.38 ± 13.87)than those in the control group(62.28±7.44/62.67±6.06, 59.11following-up results showed that one patient in the intervention group had a MDI score at the critical threshold value, and two patients had PDI scores at the critical threshold value. For all the other patients in this group, the MDI/PDI scores of them were above the moderate range. In contrast, all the 36 infants in control group had developed mental deficiencies at that time.CONCLUSION: A quantifiable effect of the intervention can be observed in patients at 3 months of life. This indicates that an early intervention is essential for improving the mental development in infants with HIE.

BACKGROUND: The researches on the onset mechanism and intervention of periventricular leukomalacia (PVL) are affected due to few cases of generally-acknowledged animal model, so it is necessary to establish a reliable animal model for the study of PVL.0BJECTIVE: To establish PVL animal model of the 2-day-old SD rats.DESIGN: Randomized control animal trial.SETTING: Department of Pediatrics, West China Second University Hospital, Sichuan University.MATERIALS: A total of 36 2-day-old SD rats of cleaning grade and either gender, weighing 6-8 g, were provided by the West China Experimental Animal Center of Sichuan University; Mice anti-O4 was purchased by Chemicon Company,rabbit anti-glial fibrillary acidic protein (GFAP), rabbit anti-β-amyloid precursor protein (β-APP), rabbit anti-myeline basic protein (MBP), SABC immunohistochemical kit and DAB color reagent were all offered by Wuhan Boster Biological Technology Co., Ltd. Rabbit anti-mice IgG-FITC was obtained from Zhongshan Golden Bridge BioTechnology Co., Ltd.METHODS: The experiment was accomplished in the Laboratory of Women and Children, West China Second Hospital of Sichuan University between May and December in 2005. Totally 36 rats Were randomly divided into experimental PVL group and control group, 18 in each. The experimental PVL group was subjected to unilateral carotid ligation (UCL), and then they were put into a box filled with 6% oxygen and 94% nitrogen for 4 hours. Six rats were executed at ischemic 72hours, 14 days and 28 days respectively. Meanwhile sham surgeries were performed on the control group without ligation or exposure to hypoxia. And the time segment was identical with that of experimental group. ①Histopathological examination: Rat hearts were fixed by perfusion and stained with hematoxylin-eosin (HE). Light and electronic microscopy were used to observe the brain pathological and ultrastructure changes, ②Immunohistochemistry method was used to detect the distribution and expression of GFAP, β-APP, MBP and O4 in the white matter of both experimental and the control groups 72 hours post-operation. ③Neuroethology examination: Hanging test (rats were forced to hold the horizontal glass rod with forelegs, and the time of dropping was recorded in the distance of 45 cm.Scoring: 1 point: ＜ 10 s; 2 points: 10-30 s; 3 points: 30 s-2 minutes; 4 points: 2-5 minutes; 5 points: ＞ 5 minutes),inclined plane test (rats were laid on the inclined plate at the angle of 45° while rat heads turning upwards at the angle of more than 135°), open field test (square box without summit was divided into 9 equal grills at the bottom, rats were placed in the central grill to observe the activity within 30 seconds. Scoring: 1 point as rats entered the neighbor cage above half the body; 1 point as standing by hind limbs; total scores were the addition of the two), and cylinder test (rats were put in the cylinder of 20 cm×30 cm×5 cm to record the time of initial forepaw of each weight-bearing contact with the wall during a full rear, right (ipsilateral) or left (contralateral) percentage of total forepaw contacts at initiation was calculated.) were tested on the SD rats at 28 days post-operation. Then statistical management was conducted.MATN OUTCOME MEASURES: ①HE stain and electronic microscope were used to detect the histopathology changes after ischemia and hypoxia.②lmmunohistochemistry method was used to detect the expressions of GFAP, β-APP, MBP and O4 in the corresponding cell and tissue after ischemia and hypoxia. ③Neuroethology examination was used to evaluate the rats after ischemia and hypoxia by scores of each test.RESULTS: All 36 rats were involved in the result analysis. ①White matter damage was observed in the periventricular white matter in the PVL group by light and electronic microscopy at the early stage of post-operation; Ventricular dilatation and the loss of medullary sheath were detected in the white matter at the latter stage. ②The integrated optical density (IOD) of GFAP in PVL group was stronger than that of the control group (6 566.93±455.56, 1 069.32±791.71,P ＜ 0.05), and the mean diameter of GFAP-immunoreactive cells was increased in the brain tissue of PVL group compared with those of the control group [(11.69±0.97), (8.24±0.22), P ＜ 0.05]; β-APP immunohistochemistry demonstrated the IOD of PVL group was stronger than that of the control group [(59 304.07±6 864.03), (15 132.29±2 455.52),P＜ 0.05]; MBP IOD of the PVL group was decreased compared with the control group [(21 764.29±1 981.63), (69 174.72±3 199.90), P ＜ 0.05]; The density of O4-immunoreactive pyknotic cells was dramatically increased in the PVL group compared with the control group [(54.08±11.99), (1.25±0.51), P＜ 0.05].③In PVL group, the hanging time was shorter in the hanging test than that of the control group [(1.27±0.14), (4.24±0.59) minutes, P ＜ 0.05]; The turning-around time was longer in the inclined plane test than that of the control group [(7.17±2.32), (3.27±0.82) s, P ＜ 0.05]; The score in the open field test was decreased than that of the control group [(3.68±0.82), (12.67±1.00) s, P ＜ 0.05]; In the cylinder test the activity of the left limb was less than that of the right limb [(19.25±2.77), (64.55±0.36)%, P ＜ 0.05].CONCLUSION: PVL animal model can be successfully established by the method of UCL-hypoxia using the 2-day-old SD rat, and appears the obvious white atter damage, abnormal neurobehavior, reasonable pathological and behavior change.

Objective:To evaluate the feasibility and effectiveness of sentinel lymph node (SLN) detection in the ovarian neoplasms.Methods:A search of the literature describing ovarian SLN was performed using China National Knowledge Infrastructure (CNKI), WANFANG DATA, VIP, PubMed, Embase, web of science, Cochrane library from 2000.01.01 to 2020.07.29. The quality evaluation and data extraction of the included literature were conducted, and the development rate, sensitivity and negative predictive value of SLN were calculated.Results:Eight prospective single-arm studies were included, with heterogeneity I2=57.41%>50%, and the P<0.1. A total of 96 patients with ovarian cancer [Stage International Federation of Gynecology and Obstetrics (FIGO)Ⅰ-Ⅱ] were included, of whom 93 completed systematic pelvic and para-aortic lymphadenectomy after SLN detection. The most common tracers were technetium-99m radioactive colloid ( 99Tc m), blue dye or indocyanine green (ICG), and the most common injection sites were the infundibulopelvic ligaments and the proper ovarian ligaments. The SLN detection rate was 88.5%(85/96) and the average number was 2-3. SLN was found in the ipsilateral or contralateral regions of the tumor, 40.8%(31/76) was found only in the para-aortic, 14.5%(11/76) was found only in the pelvic, and 44.7%(34/76) was found only in the para-aortic and pelvic region. The sensitivity was 90.9%(10/11) and the negative predictive value was 98.8%(82/83) of lymph node metastasis. Conclusions:SLN detection for ovarian neoplasms is feasible, and whether it can effectively predict lymph node status of ovarian cancer still needs large sample, multi-center, prospective clinical studies to further verify.

Objective To explore the effect of arsenic trioxide maintenance therapy on the long-term recur-rence rate in patients with acute promyelocytic leukemia ( APL ) . Methods From December 2011 to December 2013,60 patients with APL in the First People's Hospital of Huzhou were selected and divided into control group and observation group according to random number table, with 30 cases in each group. All patients received the same induction therapy and consolidation therapy. During the maintenance treatment period, all - trans retinoic acid ( ATRA) was given to the control group,and arsenic trioxide was used in the observation group. The serum levels and incidence of adverse reactions in the two groups were detected and compared after two cycles of the maintenance therapy. Three years of follow - up was conducted after treatment to record and compare the recurrence rate and survival rate in the two groups. Results The levels of TC and TG after 1 and 2 cycles of treatment were higher than those before treatment in both two groups(all P<0. 05),but the levels of lipid indicators in the observation group were lower than those in the control group,and the differences were statistically significant (t=2. 044,2. 175,all P<0. 05). The incidence rates of retinoic acid syndrome,elevated intracranial pressure and other adverse reactions in the observation group during the treatment were lower than those in the control group(6. 67％ vs. 26. 67％,6. 67％ vs. 30. 00％,6. 67％ vs. 26. 67％),and the differences were statistically significant(χ2 =0. 043,0. 023,0. 043,all P<0. 05). The survival rates after 2 and 3 years of treatment in the observation group were higher than those in the control group(90. 00％ vs. 66. 67％,83. 33％ vs. 60. 00％),and the differences were statistically significant(χ2 =4. 812,4. 812,all P<0. 05). The recurrence rate after 3 years of treatment in the observation group was lower than that in the control group(10. 00％ vs. 33. 33％),and the difference was statistically significant(χ2 =4. 812,P <0. 05). Conclusion For patients with APL, the application of arsenic trioxide in the maintenance therapy can produce no significant effect on their lipid metabolism, and at a certain extent, can help reduce the incidence of adverse reactions and recurrence rate,and improve the survival rate.

Objective To evaluate the effects of ulinastatin postconditioning and combination of ulinastatin preconditioning and postconditioning on myocardial apoptosis in patients undergoing cardiac valve replacement with cardiopulmonary bypass (CPB).Methods Eighty New York Heart Association (NYHA) class Ⅱ or Ⅲ patients of both sexes,aged 21-59 years,scheduled for cardiac valve replacement with CPB,were randomly divided into four groups (n =20 each):normal saline control group (group C),ulinastatin preconditioning group (group U1),ulinastatin postconditioning group (group U2) and ulinastatin preconditioning plus postconditioning group (group U3).In group U1,uinastatin 20000 U/kg was infused via the central vein at 500-1000 U·kg-1 · min-1 after endotracheal intubation until 10 minutes before blocking the ascending aorta.In group U2,ulinastatin 10000 U/kg was infused via the aortic root at 4000-5000 U· kg-1 · min-1 at 5-7 minutes before opening the aorta.In group U3,ulinastatin preconditioning and postconditioning were performed as described in groups U1 and U2.In group C,the same volume of normal saline was infused instead of ulinastatin.Blood samples were taken from the radial artery at 10 minutes before blocking the ascending aorta,40 minutes after blocking the ascending aorta,45 minutes after opening the aorta and at the end of operation for determination of plasma concentrations of tumor necrosis factor-alpha (TNF-α) and soluble tumor necrosis factor receptor 1 (sTNF-R1).Myocardial tissues were obtained from the right atrial appendage at 45 minutes after opening the aorta for determination of the expression of TNF-α,bcl-2,bax,caspase-3,and apoptosis.The bcl-2/bax ratio and apoptotic index were calculated.Results Plasma concentrations of TNF-α and sTNF-R1 and the expression of TNF-α,bax,caspase-3 and apoptotic index were lower and the expression of bcl-2 and bcl-2/bax ratio were higher in groups U1,U2 and U3 than in group C and they were lower in group U3 than in groups U1 and U2 (P ＜ 0.05).Conclusion Ulinastatin postconditioning can inhibit myocardial apoptosis in patients undergoing cardiac valve replacement with CPB,and the efficacy of combination of ulinastatin preconditioning and postconditioning is stronger than that of ulinastatin postconditioning.The mechanism is involved in balancing the expression of bax and bcl-2 and down-regulating the expression of TNF-α and its receptor.

Objective To investigate the profiles of serum nerve grow factor profile (NGF),neurotrophin (NT)-3,as well as brain-derived neurotrophic factor (BDNF) in patients with dermatomyositis (DM) complicated with interstitial lung damage (ILD).Methods Forty-seven patients were divided into 2 groups:ILD group (30 patients) and non-ILD group (17 patients).Twenty healthy blood donors were used as controls.Serum levels of NGF,NT-3,as well as BDNF were measured serum by enzyme-linked immunosorbent assay (ELISA).ANOVA was used to compare serum level of NTs.When a significant difference was found,the exact P-values were calculated using the student's t-test or t-test followed by Bonferroni's correction.Pearson test was used for correlation analysis.Results The serum NGF levels in healthy control group,the non-ILD group and the ILD group were (182±43),(308±72),(480±96) pg/ml respectively.There was statistically significant difference between the three groups (F=90.3,P＜0.01),and the serum NGF levels were elevated significantly in ILD and non-ILD patient groups as compared with healthy controls (t=12.9 and t=6.5 respectively,both P＜0.01).The serum level of NGF was significantly higher in ILD group than that in the non-ILD group (t=6.4,P＜0.01).There was no significant difference in the serum levels of NT-3 among the two patient groups and healthy controls.On the contrary,BDNF levels were significantly decreased in both ILD [(792± 106) pg/ml] and non-ILD patients groups [(963±93) pg/ml] when compared with healthy controls [(1 281±107) pg/ml] (t=15.9 and t=9.6 respectively,both P＜0.01).The decrease was also significant in ILD group when compared with non-ILD group (t=5.6,P＜0.01).Moreover,NGF and BDNF both showed significant correlation with serum C-reactive protein (CRP) level in ILD group by applying Pearson correlation analysis (r=0.56,P＜0.01; r=-0.48,P＜0.05 respectively).Conclusion Neurotrophins may play an import role in the pathogenesis of DM.

BACKGROUND: Forest frog is a rare medicinal animal in China, but the skin of forest frog is waste after Oviductus Ranae production. The forest frog skin is rich of collagen, and is large in quantity without pollution and disease risk. So the forest frog skin has potential to be developed into collagen sponge; however, there is no research on collagen sponge preparation as yet.OBJECTIVE: To optimize the preparation of collagen sponge from forest frog skin, and to investigate the physical properties and in vitro cell compatibility.METHODS: Chitosan and glutaraldehyde were used to modify collagen sponge from forest frog skin. Chitosan/collagen (w/w) (1:1, 1:2, 1:4) and glutaraldehyde concentration (1%, 1.5% and 2%) were selected as the experimental factors.The significant water absorbency, mechanical properties and thermal denaturation temperature were chosen as the indexes. Using the orthogonal experimental design, we optimized collagen sponge preparation process. We also investigated the in vitro cell compatibility and surface morphology of the collagen sponge. The nine kinds of collagen sponges from forest frog skins were co-cultured with human foreskin fibroblasts to detect cell proliferation.RESULTS AND CONCLUSION: When the chitosan/collagen was 1:1 and the glutaraldehyde concentration was 1%, we could get the collagen sponge with ideal water absorbency (water absorption capacity=5.22), mechanical properties (elongation at break=10.96%) and thermal denaturation temperature (81.24 ℃). The aperture of the forest frog skin collagen sponge was 200-400 μm, and the pores were consistent in the size and arranged regularly. Except the chitosan/collagen of 1:4 and the glutaraldehyde concentration of 1% or 5%, all kinds of forest frog skin collagen sponges could promote the viability of human foreskin fibroblasts and exerted benefits to cell viability and growth. To conclude,the forest frog skin collagen sponge has good biocompatibility and apparent morphology, in aggreement with the requirements of biological materials.

Objective:To study preoperative MRI imaging and its enhanced mode on tumor features in predicting microvascular invasion (MVI) in patients with hepatocellular carcinoma (HCC).Methods:The clinical data of patients with a solitary HCC who underwent MRI examination followed by surgical resection at the General Hospital of Ningxia Medical University from January 2017 to June 2019 were studied. The patients were divided into the MVI (+ ) and MVI (-) groups according to the findings on postoperative pathological diagnosis. The relationship between the rates of MVI and MRI tumor features including diffusion weighted imaging (DWI) signal, enhancement mode, enhancement type and other imaging characteristics were analysed.Results:Of 84 patients with HCC enrolled into this study, there were 65 males and 19 females. Their age (Mean±SD) was (54.94±11.51) years. MVI (+ ) was found in 46 patients and MVI (-) in 38 patients. The maximum tumor diameters (Mean±SD) of the two groups were (7.08±3.45) cm and (4.28±2.47) cm ( P<0.01). Single-factor analysis and comparison of imaging characteristics of the two groups of patients showed tumor DWI signal, tumor encapsulation, enhancement mode, tumor edge smoothness, abnormal enhancement around tumors, and intratumoral arteries were significantly different ( P<0.05); There were no significant differences in T 1WI signals, T 2WI signals, tumor periphery, and enhancement types between groups. After inputting MVI(+ ) as a risk factor into the logistic regression model, tumor maximum diameters >6.33 cm, type 3/4 enhancement mode, and unsmoothness of tumor edge were independent risk factors (all P<0.05). Through combined diagnosis using ROC curve analysis with a cut-off value of 0.53, the area under the curve was 0.881, the sensitivity 0.870, specificity 0.789, and the Youden index 0.659. Conclusion:The multivariate logistic regression model and combined diagnosis using ROC curve analysis improved the diagnostic efficacy of MVI in its prediction of HCC on imaging studies. The risk predictors were easy to use and to promote in clinical practice.

Objective To evaluate the effects of ulinastatin postconditioning and combination of ulinastatin preconditioning and postconditioning on myocardial apoptosis in patients undergoing cardiac valve replacement with cardiopulmonary bypass (CPB).Methods Eighty NYHA class Ⅱ or Ⅲ patients of both sexes,aged 21-59,scheduled for cardiac valve replacement with CPB,were randomly divided into 4 groups ( n =20 each):normal saline control group ( group C ),ulinastatin preconditioning group ( group U1 ),ulinastatin postconditioning group (group U2 ) and ulinastatin preconditioning plus postconditioning group(group U3 ).In group U1,uinastatin 20 000U/kg was infused via central vein at 500-1000 U·kg-1 ·min-1 from after tracheal intubation until 10 min before ascending aortic cross-clamping.In group U2,ulinastatin 10 000 U/kg was perfused via aortic root at 4000-5000 U· kg-1 · min-1 at 5-7 min before aortic unclamping.In group U3,ulinastatin preconditioning and postconditioning were performed as described in groups U1 and U2.In group C same volume normal saline was infused instead of ulinastatin.Blood samples were taken from radial artery at 10 min before ascending aortic cross-clamping,40 min after ascending aortic cross-clamping,45 min after aortic unclamping and the end of operation for determination of plasma concentrations of TNF-α and soluble tumor necrosis factor receptor 1 (sTNF-R1).Myocardial tissues were obtained from right atrial appendage at 45 min after aortic unclamping for determination the expression of TNF-d,Bcl-2,Bax and caspase-3 and apoptosis.The Bcl-2/Bax ratio and apoptotic index were calculated.Results Plasma concentrations of TNF-α and sTNF-R1 and the expression of TNF-α,Bax,caspase-3 and apoptotic index were lower,the expression of Bcl-2 and Bcl-2/Bax ratio were higher in groups U1,U2 and U3 thah group C and in group U3 than groups U1,U2 ( P ＜ 0.05 ).Conclusion Ulinastatin postconditioning can inhibit myocardial apoptosis in patients undergoing cardiac valve replacement with CPB,and efficacy of combination of ulinastatin preconditioning and postconditioning is stronger than that of ulinastatin postconditioning.The mechanism is involved in balancing the expression of Bax and Bcl-2 and down-regulating the expression of TNF-α and its receptor.

Objective The abnormal ankle-brachial index ( ABI) is associated with the incidence of cardiocerebral vascular diseases, but little is known about its relationship with cerebral microbleeds (CMB).This study aimed to investigate the correlation be-tween ABI≤0.9 and different distribution patterns of CMB . Methods We enrolled 187 patients with acute lacunar infarction , inclu-ding 115 non-CMB cases and 72 CMB cases (20 strictly lobar, 24 strictly deep, and 28 lobar and deep).We analyzed the differences between the two groups and the association of abnormal ABI with the occurrence and distribution of CMB by logistic regression analysis . Results ABI≤0.9 was found in 57 (30.5%) of the patients, with a significantly higher incidence rate in the CMB group than in the non-CMB group (43.1%vs 22.6%, P=0.003).The level of ABI was negatively correlated with the number of CMBs (r=-0.211, P=0.006).Multivariate logistic regression analysis after adjusted for confounders indicated that ABI ≤0.9 was significantly associated with the presence of CMB (OR=2.363;95%CI:1.181-4.729), deep CMB (OR=3.434;95%CI:1.283-9.187), and lobar and deep CMB ( OR=2.837;95%CI:1.098-7.333) in patients with ischemic cerebrovascular disease . Conclusion Decreased ABI is a risk factor of CMB, particularly deep CMB, in patients with ischemic stroke.