OBJECTIVETo study clinical characteristics and evaluate cardiac hemodynamic changes in premature infants with patent ductus ateriosus (PDA).

METHODOne hundred and five infants born at ≤ 34 weeks' gestational age (GA) and ≤2 000 g birth weight (BW) were prospectively enrolled, including 63 males and 42 females, and the mean GA was (31. 1 ± 1.9) weeks and BW (1 401 ± 314) g. Echocardiography was done to detect hemodynamically significant PDA (hsPDA) and to evaluate left ventricular function at 2, 3, 5 and 7 d respectively after birth. On the basis of clinical symptoms and echocardiographic outcome, all the cases were divided into 3 groups: hsPDA group (n = 34), non-hsPDA (nhsPDA) group (n = 44) and non-PDA (nPDA) group (n = 27) to survey and compare general conditions, DA diameter, shunt direction, left ventricular function and complications.

RESULTThe hsPDA group had smaller GA ((30. 5 ± 2. 1) vs. (31. 6 ± 1. 6) weeks, P = 0. 01) and greater proportion of pulmonary surfactant use and mechanical ventilation (2, 3, 5 d of birth) than the nhsPDA and the nPDA group (χ2 = 11. 62, 14. 95, 12. 73, 1:1. 59, P = 0. 00; 0. 00, 0. 01, 0. 01). Univariate and multivariate Logistic regression analysis indicated that the average length of stay (ALOS) was correlated with hsPDA (F =3. 52 and P =0. 03, OR 1. 03 and P =0. 02). The ALOS was longer in the hsPDA group than in the nhsPDA and the nPDA group ((39 ±23)vs. (30 ± 16)and(29 ±13) d, P =0.02, 0.03). There was no significant.difference in rates of mortality/giving-up of treatment among the three groups (5. 9% (2/34)vs. 0 (0/44) and 3. 7% (1/27), χ2 = 5. 26, P = 0. 06). Diastolic blood pressure and mean blood pressure were significantly lower in the hsPDA group than in the other two groups (P all <0. 05) at 2, 3 and 5 days after birth and the pulse pressure was found significantly higher in the hsPDA group than in the nPDA group at 2 d after birth. Univariate and multivariate Logistic regression analysis demonstrated that hsPDA was correlated significantly with neonatal respiratory distress syndrome (NRDS) and bronchopulmonary dysplasia (BPD) (χ2 =7. 34 and 7. 39, P = 0. 02 and 0. 02; OR = 3. 46 and 4. 01, P = 0. 04 and 0. 02). Premature infants with hsPDA had normal left ventricular fractional shortening (FS) and left ventricular ejection fraction (LVEF), although the cardiac output (CO) of left ventricle increased significantly(F = 6. 93, P <0. 01) within seven days of birth. There was no significant difference in cardiac hemodynamic parameters among closed group of hsPDA group, nhsPDA group and nPDA group simutaneously reexamined at 7th day after birth. The CO was extremely significantly different among premature infants who had different GAs and BWs. The lower the GAs and the BWs, the lower the value of CO(F =5. 16 and 14. 87, P all <0. 01). The DA diameter was reduced much more dramatically after ibuprofen treatment than before in hsPDA group(t = 5. 58, P <0. 01).

CONCLUSIONThe GA, PS use and mechanical ventilation were probably associated with hsPDA. The mean blood pressure and diastolic blood pressure were decreased and pulse pressure was increased in preterm infants with hsPDA that correlated significantly with ALOS, NRDS and BPD. In addition, increased CO values were found in hsPDA group. Oral ibuprofen administered to preterm infants for hsPDA at > 24 h of life promoted ductal closure.

Birth Weight ; Bronchopulmonary Dysplasia ; Cardiac Output ; Cyclooxygenase Inhibitors ; therapeutic use ; Ductus Arteriosus, Patent ; physiopathology ; Echocardiography ; Female ; Gestational Age ; Hemodynamics ; Humans ; Ibuprofen ; therapeutic use ; Infant, Newborn ; Infant, Premature ; Infant, Premature, Diseases ; Male ; Pulmonary Surfactants ; Respiration, Artificial ; Respiratory Distress Syndrome, Newborn ; Ventricular Function, Left

Objective To clone human papillomavirus type 16 genome from Anhui province, analyze genome se-quence of HPV16 and study its genomic characteristics. Methods Five pathological specimens of cervical cancer from Anhui province were collected and the total DNA was extracted. Specific primers were designed to clone HPV16 genome in four fragments. The sequence of four fragments was assembled manually and nucleotide sequence was analyzed after sequencing. Results A cervical pathological sample containing HPV16 was detected and the genome sequence with full length of 7 906 nts (GenBank accession number:KC935953) was obtained. Sequence alignment of genome nucleotide sequence showed that HPV16 of Thailand and HPV16 of Japan were more similar to HPV16 of Anhui (HPV16-Anhui) than other HPV genome nucleotide sequence, their similarity reached 99. 5%. Phylogeny tree analysis demonstrated that HPV16-Anhui and other 7 HPV16 clustered into a single branch. Con-clusion HPV16 genome nucleotide sequence is obtained from Anhui province for first time with great significance for further understanding of HPV16 variation from Anhui even east China.

An automated analytical method for simultaneous determination of vitamin A and E in livers, fortified infant formulae and eggs has been developed based on on-line solid phase extraction (SPE) coupled with a dual gradient high performance liquid chromatography system with column-switching. Firstly, food samples were centrifuged after saponified in mixture solution of anhydrous alcohol, potassium hydroxide and ascorbic acid at 80 ℃ for 30 min. Secondly, the saponified sample was loaded and washed on the first dimension extraction column using methanol-water (60∶40, V/V). Afterwards, the targeted analytes were trapped and enriched on the SPE column. Finally, the trapped analytes were transferred to the second dimension analysis column by valve-switching technique for the following separation and determination. Several key factors such as the type of SPE columns, elution buffer as well as pH of washing solution were optimized. The results showed that the calibration curves of vitamin A and E were linear in the range of 0 . 02-20 mg/L with correlation coefficient (R2) more than 0. 9998. In addition, the limits of detection (S/N=3) were found in the range of 3. 0-30. 0 μg/L. The spiked recoveries of the vitamin A and E from livers, eggs and fortified infant formulae ranged from 87 . 3% to 115 . 0% with the relative standard deviations ( RSDs ) of 1 . 8% -4 . 6%. The developed method is simple, sensitive and rapid to determine vitamins A and E in animal derived food.

Objective To investigate the relationships between low one-minute Apgar score and the prognosis of extremely preterm infants (EPI) and extremely low birth weight infants (ELBWI). Methods Altogether 50 EPI and ELBWI who had a low one-minute Apgar score ( ≤ 7) and were admitted to the Neonatal Intensive Care Unit (NICU) of Peking University Third Hospital from January 1,2010 to December 31, 2015 were enrolled in this study. All of them were divided into two groups according to their Apgar score: mild group (4-7) and severe group (0-3). Medical records of the subjects were reviewed and an at least 18 months follow up study was conducted. Conditions of all subjects during perinatal period and hospitalization were summarized. Outcomes and follow-up results were compared between the two groups by using Fisher exact test. Results (1) General information: Fifty infants were involved, among which 37 had a mild low Apgar score and 13 had a severe low Apgar score. The mean gestational age was (27.7±2.1) weeks and the mean birth weight was (884.4±174.3) grams. (2) Main complications (some infants with more than one complication): There were 42 cases of neonatal respiratory distress syndrome, 12 cases of pulmonary hemorrhage, 21 cases of bronchopulmonary dysplasia, 31 cases of patent ductus arteriosus, 36 cases of intraventricular hemorrhage, 22 cases of white matter damage and six cases of retinopathy of prematurity. (3) Outcomes: The survival rate was 48% (24/50) and the mortality rate was 52% (26/50). Among the 26 infants, five died despite treatment and 21 died within 72 hours after their parents giving up treatment. There were no significant differences in the survival rates, mortality rates and rates of abandon treatment between the two groups [43% (16/37) vs 8/13; 11%(4/37) vs 1/13; 46% (17/37) vs 4/13; Fisher exact test, all P>0.05]. (4) Follow-up results: Twenty-one infants were followed-up to at least 18 months of age, among which four were normal, 10 had growth retardation and recurrent respiratory tract infection and seven had motor development retardation. The incidence of motor development retardation in severe group was higher than that in mild group, and the difference between them was statistically significant (5/8 vs 2/13, Fisher exact test, P=0.046). Conclusions EPI or ELBWI with a low one-minute Apgar score have many nosocomial complications, resulting in high mortality and high incidence of motor development retardation.

Objective To investigate the cerebral haemodynamics change and morbidity of periventricular-intraventricular hemorrhages(PIVH) in premature infants with or without patent ductus ateriosus (PDA).Methods Bedside Echocardiography and transcranial sonography (TCS) were performed on 85 cases of preterm infants in 48 h,48 to 96 h,96 to 120 h,120 to 168 h after birth (gestational age≤34 weeks and birth weight≤2 000 g).PDA,peak systolic velocity (Vs),end-diastolic velocity (Vd),pulsatility index (PI) and resistant index (RI) of anterior and middle cerebral artery(ACA and MCA) and PIVH were monitored simutaneously.Results According to the Echocardiography and clinical symptoms,all the cases were divided into 3 groups:haemodynamic significant PDA group (hsPDA group,n =23),non-hsPDA group(nhsPDA group,n =38) and non-PDA group(nPDA group,n =24).The mean birth weight and gestational age did not differ significantly among the 3 groups.Single and multiple Logistic analysis indicated that invasive mechanical ventilation less than 48 h after birth was related to hsPDA (x2 =11.182,P =0.019; OR =10.06,P =0.039).Repetitive measurement deviation analysis found that:Vd of ACA and MCA were lower in the hsPDA group than those in the nhsPDA group (P =0.000,P =0.001) and the nPDA group (P =0.003,P =0.013),while PI and RI were higher than in the other 2 groups.Compared with non-closed group,at 7 days after birth in hsPDA group,RI and PI of closed group were significantly lower,while Vd was significantly higher.Nevertheless,there was no significant difference in hemodynamic parameters when comparison with nPDA group at 7 days after birth.There was no statistical difference in the grading and severity of PIVH with or without PDA.However,the rate of severe PIVH was found higher in hsPDA group than the other 2 groups(17.39％ vs 8.33％ vs 5.26％,x2 =2.405,P =0.280).Conclusions The invasive mechanical ventilation less than 48 h after birth was probably associated with preterm hsPDA.HsPDA could result in major cerebral haemodynamic changes and increase the morbidity of severe PIVH.

Objective To observe the changes of plasma neuropeptide Y(NPY) and neurotensin(NT) levels in patients with essential hypertension and the relationship between those changes and damage of cardiac function. Methods Eighty patients of essential hypertension and 28 normal controls were chosen. The cardiac function was divided into 3 classes on the standard of New York Heart Association(NYHA). The plasma NPY,NT concentration was determined by radioimmunoassay. Results The level of NPY in hypertension patients was higher than that of the normal controls(P

Objective: To observe the regulatory effects of miRNA-31 (miR-31) on LATS2 and cardiomyocyte hypertrophy via down-regulating miR-31 expression in rat's cardiomyocytesin vitro. Methods: Rat's cardiomyocytes were isolated and cultured for 10 daysin vitro, according to different intervention methods, the cells were divided into 4 groups:①Blank control group,②AngII intervention group,③Lentivirus with miR-31 inhibitor infection group,④Negative lentivirus infection group. On day-8, gene expressions of MiR-31, LATS2, cardiac hypertrophy ANP and β-MHC were examined by qRT-PCR; on day-10, cell morphology was observed by fluorescence staining. LATS2 protein expression was examined by Western blot analysis. Dual luciferase reporter plasmids were transfected into 293T cells, then luciferase activity was detected to identify the targeting effect of miR-31 on LATS2. Results: Compared with Blank control group, AngII intervention group showed increased gene expressions of miR31, cardiac hypertrophy ANP and β-MHC,P<0.05, enlarged cardiomyocyte surface,P<0.05; while decreased gene and proteinexpressions of LATS2,P<0.05. Compared with AngII intervention group, Lentivirus with miR-31 inhibitor infection group had down-regulated expressions of miR31, cardiac hypertrophy ANP and β-MHC,P<0.05, reduced cardiomyocyte surface, P<0.05; while slightly increased LATS2 gene expression and obviously increased protein expression,P<0.05. Dual luciferase reporter assay presented that relative luciferase activity of TRAF6-3' UTR+miR-146b was significantly decreased than TRAF6-3' UTR+miR-NC,P<0.01 and relative luciferase activity of LATS2-3' UTR+ miR-31 was signiifcantly reduced than LATS2-3' UTR-NC+miR-31,P<0.01. Conclusion: Cardiomyocytes hypertrophy could be reversed at certain degree by down-regulating miR-31; the targeting effect of miR-31 on LATS2 was involved in cardiomyocyte hypertrophyregulation.

The solvent extraction of rare earths with mixtures of di-( 2-ethylhexyl) phosphoric acid (D2EHPA,H2A2) and sec-nonylphenoxy acetic acid (CA100,H_2B_2) has been carried out. The separation abilities among rare earths were determined and compared with those with D_2EHPA alone. The mechanism of synergistic extraction of lanthanum was discussed. The methods of slope analysis and constant mole were used to examine the extraction stoichiometry. Effects of acidities,concentrations of extractants,and temperature on the extractabilities have been investigated. The results showed that the synergistic effects decrease with increasing atomic numbers of rare earths. At proper ratios of the extractants,the separation abilities of some rare earths with D2EHPA +CA100 were higher than those with D2EHPA alone,which may be applied to the separation of these rare earths. The extracted complex of lanthanum with D2EHPA + CA100 was determined as LaH5A6B2. The synergistic extraction is endothermically driven.

Mitral valve disease is one of the most popular heart valve diseases. Precise positioning and displaying of the valve characteristics is necessary for the minimally invasive mitral valve repairing procedures. This paper presents a multi-resolution elastic registration method to compute the deformation functions constructed from cubic B-splines in three dimensional ultrasound images, in which the objective functional to be optimized was generated by maximum likelihood method based on the probabilistic distribution of the ultrasound speckle noise. The algorithm was then applied to register the mitral valve voxels. Numerical results proved the effectiveness of the algorithm.
Algorithms ; Heart Valve Diseases ; diagnostic imaging ; Humans ; Likelihood Functions ; Mitral Valve ; diagnostic imaging ; pathology ; Patient Positioning ; Probability ; Ultrasonography

Objective:To summarize the clinical features and risk factors of periventricular venous cerebral infarction (PVI) in premature infants to prompt an early diagnosis.Methods:Clinical data of 16 premature newborns diagnosed with PVI by ultrasound in the Department of Pediatrics of Peking University Third Hospital from January 1, 2013, to December 31, 2018, were retrospectively collected. The clinical manifestations, ultrasound findings, risk factors and outcomes were analyzed. Two allocations were performed to the patients: mild PVI group ( n=5) or severe PVI group ( n=11) according to the degree of brain injury suggested by ultrasound findings; and typical PVI group (onset time was 6-96 h after birth; n=14) or atypical PVI group (onset time was less than 6 h or more than 96 h after birth; n=2) according to the onset time. Chi-square or Fisher's exact test was used to analyze the differences in high risk factors and prognosis between the groups. Univariate and multivariate logistic regression analysis were used to analyze the high risk factors related to different groups. Correlations of the severity of brain injury and the onset time with PVI prognosis were analyzed using univariate analysis. Results:(1) The gestational age of the 16 infants with PVI was 25 +2-33 +1 weeks (median 27 weeks). The birth weight ranged from 660 g to 1 760 g (median 1 065 g). All cases showed PVI under ultrasongraphy one week after birth, among which 11 was diagnosed and the other five were misdiagnosed as periventricular intraventricular hemorrhage Grade Ⅲ. Five cases presented with convulsion, while the others did not show any specific symptoms. All cases were shown periventricular intraventricular hemorrhage GradeⅢ or above. Bilateral hemispheres were involved in seven cases, left hemisphere in five and right in four. There were 15 cases with massive infarction and six with midline displacement. Obstructive hydrocephalus occurred in six cases 4-25 d after birth, and eight patients had brain parenchyma softening 5-25 d after birth. (2) The incidence of asphyxia in the mild PVI group was lower than that in the severe PVI group (1/5 vs 10/11, P=0.013) and asphyxia was a high risk factor of severe PVI ( OR=40.000, 95% CI: 1.982-807.100). (3) There was no significant difference in the clinical risk factors between the typical and atypical PVI groups (all P>0.05). (4) Among the 16 cases, nine died, one was lost to follow-up, five had delayed intelligence and motor development and one had normal growth and development. No significant difference in the prognosis (died or discharged after improvement) was found between the mild and severe PVI groups, or between the typical and atypical PVI groups ( P=0.365 or 0.700). Conclusions:PVI usually occurs in very or extremely low birth weight premature infants within one week after birth. Clinical manifestations of PVI include convulsions, but most are non-specific. Asphyxia may lead to severe PVI. PVI has a higher short-term mortality as well as a higher incidence of long-term neurological sequelae.