OBJECTIVE: To observe the characteristics of changes in non-invasive hemodynamic parameters in neonates with septic shock so as to provide clinical reference for diagnosis and treatment. METHODS: A observational study was conducted. The neonates with sepsis complicated with septic shock or not admitted to neonatal intensive care unit (NICU) of the First Affiliated Hospital of Shantou University Medical College were enrolled as the study subjects, who were divided into preterm infant (< 37 weeks) and full-term infant (≥ 37 weeks) according to the gestational age. Healthy full-term infants and hemodynamically stable preterm infants transferring to NICU after birth were enrolled as controls. Electronic cardiometry (EC) was used to measure hemodynamic parameters, including heart rate (HR), mean arterial pressure (MAP), stroke volume (SV), stroke volume index (SVI), cardiac output (CO), cardiac index (CI), systemic vascular resistance (SVR) and systemic vascular resistance index (SVRI), before treatment in the septic shock group, at the time of diagnosis of sepsis in the sepsis without shock group, and before the discharge from the obstetric department or on the day of transferring to NICU in the control group. RESULTS: Finally, 113 neonates with complete data and parental consent for non-invasive hemodynamic monitoring were enrolled, including 32 cases in the septic shock group, 25 cases in the sepsis without shock group and 56 cases in the control group. In the septic shock group, there were 17 cases at the compensated stage and 15 cases at the decompensated stage. There were 21 full-term infants (20 cured or improved and 1 died) and 11 premature infants (7 cured or improved and 4 died), with the mortality of 15.62% (5/32). There were 18 full-term infants and 7 premature infants in the sepsis without shock group and all cured or improved without death. The control group included 28 full-term infants and 28 premature infants transferring to NICU after birth. Non-invasive hemodynamic parameter analysis showed that SV, SVI, CO and CI of full-term infants in the septic shock group were significantly lower than those in the sepsis without shock group and control group [SV (mL): 3.52±0.99 vs. 5.79±1.32, 5.22±1.02, SVI (mL/m²): 16.80 (15.05, 19.65) vs. 27.00 (22.00, 32.00), 27.00 (23.00, 29.75), CO (L/min): 0.52±0.17 vs. 0.80±0.14, 0.72±0.12, CI (mL×s^-1×m^-2): 40.00 (36.67, 49.18) vs. 62.51 (56.34, 70.85), 60.01 (53.34, 69.68), all P < 0.05], while SVR and SVRI were significantly higher than those in the sepsis without shock group and control group [SVR (kPa×s×L^-1): 773.46±291.96 vs. 524.17±84.76, 549.38±72.36, SVRI (kPa×s×L^-1×m^-2): 149.27±51.76 vs. 108.12±12.66, 107.81±11.87, all P < 0.05]. MAP, SV, SVI, CO and CI of preterm infants in the septic shock group were significantly lower than those in the control group [MAP (mmHg, 1 mmHg ≈ 0.133 kPa): 38.55±10.48 vs. 47.46±2.85, SV (mL): 2.45 (1.36, 3.58) vs. 3.96 (3.56, 4.49), SVI (mL/m²): 17.60 (14.20, 25.00) vs. 25.50 (24.00, 29.00), CO (L/min): 0.32 (0.24, 0.63) vs. 0.56 (0.49, 0.63), CI (mL×s^-1×m^-2): 40.01 (33.34, 53.34) vs. 61.68 (56.68, 63.35), all P < 0.05], while SVR and SVRI were similar to the control group [SVR (kPa×s×L^-1): 1 082.88±689.39 vs. 656.63±118.83, SVRI (kPa×s×L^-1×m^-2): 126.00±61.50 vs. 102.37±11.68, both P > 0.05]. Further analysis showed that SV, SVI and CI of neonates at the compensation stage in the septic shock group were significantly lower than those in the control group [SV (mL): 3.60±1.29 vs. 4.73±1.15, SVI (mL/m²): 19.20±8.33 vs. 26.34±3.91, CI (mL×s^-1×m^-2): 46.51±20.34 vs. 61.01±7.67, all P < 0.05], while MAP, SVR and SVRI were significantly higher than those in the control group [MAP (mmHg): 52.06±8.61 vs. 48.54±3.21, SVR (kPa×s×L^-1): 874.95±318.70 vs. 603.01±111.49, SVRI (kPa×s×L^-1×m^-2): 165.07±54.90 vs. 105.09±11.99, all P < 0.05]; MAP, SV, SVI, CO and CI of neonates at the decompensated stage in the septic shock group were significantly lower than those in the control group [MAP (mmHg): 35.13±6.08 vs. 48.54±3.21, SV (mL): 2.89±1.17 vs. 4.73±1.15, SVI (mL/m²): 18.50±4.99 vs. 26.34±3.91, CO (L/min): 0.41±0.19 vs. 0.65±0.15, CI (mL×s^-1×m^-2): 43.34±14.17 vs. 61.01±7.67, all P < 0.05], while SVR and SVRI were similar to the control group [SVR (kPa×s×L^-1): 885.49±628.04 vs. 603.01±111.49, SVRI (kPa×s×L^-1×m^-2): 114.29±43.54 vs. 105.09±11.99, both P > 0.05]. CONCLUSIONS Full-term infant with septic shock exhibit a low cardiac output, high vascular resistance hemodynamic pattern, while preterm infant with septic shock show low cardiac output and normal vascular resistance. At the compensated stage the hemodynamic change is low output and high resistance type, while at the decompensated stage it is low output and normal resistance type. Non-invasive hemodynamic monitoring can assist in the identification of neonatal septic shock and provide basis for clinical diagnosis and treatment.
Humans ; Shock, Septic/physiopathology* ; Infant, Newborn ; Hemodynamics ; Female ; Male ; Case-Control Studies ; Infant, Premature

Humans ; Early Detection of Cancer ; Endoscopy ; Esophageal Neoplasms/epidemiology* ; Risk Factors ; Mass Screening

Na⁺/H⁺ antiporter (NHX) gene subfamily plays an important role in plant response to salt stress. In this study, we identified the NHX gene family members of Chinese cabbage and analyzed the expression patterns of BrNHXs gene in response to abiotic stresses such as high temperature, low temperature, drought and salt stress. The results showed that there were 9 members of the NHX gene family in Chinese cabbage, which were distributed on 6 chromosomes respectively. The number of amino acids was 513-1 154 aa, the relative molecular weight was 56 804.22-127 856.66 kDa, the isoelectric point was 5.35-7.68. Members of BrNHX gene family mainly existed in vacuoles, the gene structure is complete, and the number of exons is 11-22. The secondary structures of the proteins encoded by the NHX gene family in Chinese cabbage had alpha helix, beta turn and random coil, and the alpha helix occurred more frequently. Quantitative real-time PCR (qRT-PCR) analysis showed that the gene family members had different responses to high temperature, low temperature, drought and salt stress, and their expression levels differed significantly in different time periods. BrNHX02 and BrNHX09 had the most significant responses to these four stresses, and their expression levels were significantly up-regulated at 72 h after treatments, which could be used as candidate genes to further verify their functions.
Genome, Plant ; Multigene Family ; Stress, Physiological/genetics* ; Brassica/metabolism* ; Gene Expression Regulation, Plant ; Phylogeny ; Plant Proteins/metabolism*

Objective:To observe the lipogenic or osteogenic differentiation of decellularized adipose matrix (DAM) in the periosteal microenvironment.Methods:From June 2020 to December 2020, adipose tissue obtained by human liposuction was prepared as DAM at the National Institute of Plastic Surgery. Six male SD rats of 4 to 6 weeks were selected and implanted into the subperiosteum of the rat parietal bone according to the same initial volume. After 12 weeks, adipogenesis and osteogenic differentiation of DAM were observed by gross specimens, histological staining, and immunofluorescence staining. Label-free quantitative protein mass spectrometry was used for detection of osteogenic-associated proteins in DAM.Results:Vascularization around the DAM was evident. Adipogenesis and angiogenesis were observed in DAM by H&E and Masson staining, while OCN immunofluorescence staining confirmed osteogenic differentiation of DAM. The osteogenic differentiation related proteins were screened by mass spectrometry.Conclusions:In the microenvironment of periosteum, DAM mainly differentiates towards adipose tissue, but a few of them havs the potential to differentiate towards osteogenesis, which might be related to some of the osteogenesis-related proteins contained in DAM.

Objective:To explore the damage of panretinal photocoagulation (PRP) to the subbasal nerve plexus (SNP) and its related mechanisms by comparing SNP changes in wide-field mosaic between before and after PRP treatment in diabetic patients.Methods:A randomized controlled study was conducted.Fifty-seven patients (114 eyes) with type 2 diabetes mellitus and binocular diabetic retinopathy (DR) stage IV to receive PRP treatment in Shanxi Eye Hospital from April to November 2019 were enrolled.The subjects were randomly divided into horizontal-vertical laser group and vertical-horizontal laser group according to a random number table.Twenty-nine eyes from 29 patients were assigned to the horizontal-vertical laser group with the photocoagulation sequence of temporal-nasal-inferior-superior.Twenty-eight eyes from 28 patients were assigned to the vertical-horizontal laser group with the photocoagulation sequence of inferior-superior-temporal-nasal.The severer eyes of each subject were chosen as the treatment eye and the contralateral eyes were chosen as the control eye.Corneal confocal laser scanning microscopy (CCM) was performed before PRP treatment, 1 week after each photocoagulation, and 1 month after the completion of PRP treatment to collect images of the SNP over an area of 2-3 mm around the whorl-like pattern.Captured images at each time were merged into one image by using the Photoshop CC 2017 image processing software, and then the nerve fiber length (NFL) of whorl-like pattern was measured by Neuron J image analysis software.McGill pain questionnaire was used to investigate the pain of patients after each photocoagulation.The NFL changes of SNP at different time points were compared between different eyes and different photocoagulation sequence groups.The study protocol adhered to the Declaration of Helsinki and was approved by an Ethics Committee of Shanxi Eye Hospital (No.201804b). Written informed consent was obtained from each patient prior to entering the study cohort.Results:After PRP treatment, there were different degrees of neural structure loss of SNP nerve fibers in 11 treatment eyes, but there was no significant change in SNP nerve fibers in the control eyes.There were significant differences in NFL between the treatment eyes and the control eyes at various time points ( Feyes=2.020, P=0.039; Ftime=4.062, P=0.001). In the horizontal-vertical laser group, different degrees of neural structure loss on the photocoagulation side were found in SNP nerve fibers after the first and second photocoagulation.In the vertical-horizontal laser group, different degrees of neural structure loss on the photocoagulation side were found in SNP nerve fibers after the third and fourth photocoagulation.There was no significant difference in NFL of treatment eyes between the two groups ( Fgroup=0.099, P=0.754), but there was a significant difference in NFL at various time points before and after treatment ( Ftime=5.231, P<0.001). There were 9 (9/57) patients who complained of pain after PRP, which occurred at the first time of photocoagulation in 7 of them. Conclusions:SNP damage may occur after PRP in patients with DR, and SNP is prone to be damaged on the photocoagulation side when performing horizontal photocoagulation.

Objective:To investigate the immobilizing effect of full-thickness skin subcutaneous grafting on allogeneic full-thickness skin graft in rats.Methods:The experimental research method was used. The inbred male Brown-Norway rats ( n=10) and Lewis rats ( n=10) were used as donors and recipients respectively. After subcutaneously full-thickness separation of a 2.2 cm×2.2 cm area on the nape of the recipient rat, a full-thickness skin of 2.0 cm×2.0 cm taken from the abdomen of the donor rat was subcutaneously grafted, and the donor site was pulled together and sutured. The autologous skin over the allograft in the recipient rat was excised 5-6 d after grafting, and the stitches were removed 7 d after excision. Within 2 months after grafting, the feeding, activity, and survival of the donor and recipient rats, behavior of tearing and scratching the wounds of the recipient rats, the wound condition after autologous skin excision in recipient rats, and the survival and hair growth of the grafted allogeneic skin were observed. Results:Within 2 months after grafting, the donor and recipient rats all ate normally and could move freely with no abnormal death. No tearing or scratching of the wounds occurred in recipient rats. There was a small amount of exudation and partial epidermal desquamation after autologous skin excision in recipient rats. All transplanted allografts survived, which were free of infection and necrosis, with new hairs growing out smoothly.Conclusions:The immobilizing method of full-thickness skin subcutaneous grafting of allogeneic full-thickness skin graft in rats is simple and time-saving without postoperative dressing change, with reliable pressure fixation and high survival rate of skin grafts, which can be promoted for animal skin grafting models.

Objective:To estimate the correlation between DR and diabetic corneal nerve damage by comparing changes of corneal sub-basal nerve plexus (SNP) in the whorl-like region in different DR stages.Methods:In this cross-sectional study, 66 eyes of 66 type 2 diabetes patients aged 50-65 years old in Shanxi Eye Hospital from September 2018 to January 2019 were included.The subjects were divided into non-diabetic retinopathy group (NDR), non-proliferative diabetic retinopathy group (NPDR) and proliferative diabetic retinopathy group (PDR) accordingly, the right eyes were enrolled.20 eyes of 20 age and gender matched age-related cataract patients were also included as control group.All the subjects underwent confocal corneal microscopy to observe the morphology of SNP in the whorl-like region and measure the nerve fiber length (NFL) in this area.Covariance analysis using disease course as the covariate was used to analyze the differences of NFL value among groups, and Spearman rank correlation analysis was used to analyze the correlation between NFL value and DR stages.The study protocol was approved by the Ethics Committee of Shanxi Eye Hospital.Written informed consent was obtained from each patient prior to entering the study cohort.Results:The whorl-like region were observed in all the eyes.In the control group, nerve fibers were uniform in thickness, densely distributed with regular course, and most of the tested eyes had intact whorl-like structure.Nerve fibers in different DR groups all showed generally decrease in diameter and density, with increase in tortuosity, accompanied by different degrees of whorl-like structure loss.Eyes in the NDR group and NPDR group mainly showed nerve structure loss in the whorl-like center; while some eyes in the PDR group also showed nerve structure loss in the inferior and temporal of the whorl-like region.The NFL values were (21.08±4.74), (16.47±6.35), (14.95±3.90), and (11.61±3.24)mm/mm 2 in the control group, the NDR group, the NPDR group, and the PDR group, respectively, the overall difference was statistically significant ( F=10.541, P<0.001). The NFL value in the control group was significantly higher than those in the different DR groups, the differences were statistically significant (all at P<0.01). Spearman rank correlation analysis showed that there was a significant negative correlation between NFL value and DR stages ( rs=-0.356, P=0.003). Conclusions:Diabetic SNP damage occurs earlier than DR, and progress gradually with the development of DR; Different stages of DR are accompanied by different degrees of nerve structure loss; The structure loss begins at the whorl-like center and gradually develops to downward and the temporal side.The ophthalmologists should take the condition of ocular surface into account when treating ocular fundus diseases of diabetic patients.

OBJECTIVE: To investigate the prevalence and influencing factors of work-related musculoskeletal disorders(WMSDs) among workers in a cement plant. METHODS: A total of 196 workers in a cement plant were selected as study subjects using a judgment sampling method. A revised Musculoskeletal Injury Questionnaire was used to investigate the occurrence of WMSDs in workers in the past year. RESULTS: The detection rate of WMSDs in different parts of the body of workers in the cement plant was 18.4%-32.1%. The detection rates of WMSDs in all parts of the body from high to low was as follows: shoulder(32.1%), neck(30.6%), upper back(24.0%), ankle/foot(24.0%), lower back(23.5%), hip/thigh(22.4%), wrist/hand(21.4%), elbow(18.4%), and knee(18.4%). Multivariate logistic regression analysis results showed that keeping the neck in the same posture for a long time was a risk factor for neck WMSDs [odds ratio(OR)=2.29, P<0.05). Frequent turning around was a risk factor for WMSDs on the neck and lower back(waist)(OR were 3.06 and 3.32, P<0.05). Maintaining the same posture for a long time on the back was a risk factor for shoulder and upper back WMSDs(OR were 3.22 and 2.34, P<0.05). Hard work was a risk factor for shoulder and upper back WMSDs(OR were 2.60 and 2.58, P<0.05). Driving a vehicle was a risk factor for lower back(waist) and ankle/foot WMSDs(OR were 2.54 and 3.17, P<0.05). Carrying objects heavier than 20 kilograms and frequent overtime working were risk factors for ankle/foot WMSDs(OR were 3.03 and 2.54, P<0.05). CONCLUSION: The most frequent parts of the body having WMSDs in the cement production workers are shoulders and necks. Occupational factors(turning around or keeping the same posture of neck and back) are risk factors of WMSDs on shoulder and neck.

Objective? To construct a risk assessment scale for patients with acute myocardial infarction (AMI) and reperfusion arrhythmia after percutaneous coronary intervention (PCI) by Delphi expert consultation at home and abroad. Methods? From 1st January 2017 to 31st December 2017, we preliminarily drew up risk factors related to patients with AMI and reperfusion arrhythmia after PCI by retrieving and analyzing the heart surgery related risk assessment scale at home and abroad; and we confirmed the weight of risk factors by two rounds of expert consultation on scientific nature, suitability and operability of risk factors with the method of Delphi method and the expert evaluation method. Results? The recovery rates of questionnaire were 90% and 95% respectively in two rounds of expert consultation, and the authority coefficient was 0.89 and 0.93. The risk assessment scale constructed for patients with AMI and reperfusion arrhythmia after PCI included 3 first-level risk factors, 13 second-level risk factors. Among weight of risk factors by two rounds of expert consultation, the variation coefficients were all less than 0.2, and the coordination coefficient ranged from 0.20 to 0.34. Conclusions? All the experts participating in the investigation are positive with the high consistency of expert opinion, good coordination, professional representativeness and high authority. The constructed risk assessment scale can effectively assess the risk of AMI patients after PCI, reduce the processing time of reperfusion arrhythmia, enhance the ability of nurses to predict the reperfusion arrhythmia of those patients so as to early decrease the incidence of reperfusion risk.

Objective To explore the predictors of reperfusion arrhythmia (RA) after PCI in patients with acute myocardial infarction (AMI) using Meta-analysis, and to provide evidence for clinical diagnosis and treatment of RA.Methods Firstly, the inclusion and exclusion criteria were restricted and the search strategy was planned. The clinical trials that related to emergency PCI treatment in AMI patients and published before 31st December 2016 were included by two researchers in this study by searching PubMed, CINAHL Database, MEDLINE, Web of Science, Cochrane Libraray, CBM, VIP, CNKI and Wanfang Database. After evaluating the quality of the literature, the Review Manager 5.3 software was used for Meta-analysis.Results A total of 10 studies including 13923 participants were enrolled. The Meta-analysis showed that the risk factors for RA after PCI in AMI patients included: smoking (OR=1.73; 95％CI 1.17-2.56;P<0.01), TIMI0 flow grade (OR=2.74; 95％CI 2.15-3.49;P<0.01), inferior MI (OR=4.52; 95％CI 2.47-8.42;P<0.01), right coronary artery infarction (OR=3.19; 95％CI 1.07-9.58;P=0.04), multi-vasculopathy (OR=3.05; 95％CI 1.83-5.09;P<0.01), renal failure (OR=2.81; 95％CI 1.45-5.43;P< 0.01), time from symptom onset to PCI≤6 h (OR=2.41; 95％CI 1.43-4.07;P<0.01), and duration of operation >1 h (OR=4.03; 95％CI 1.60-10.15;P<0.01). The protective factors included hypertension history (OR=0.76; 95％CI 0.63-0.93;P<0.01) and pre-infarction angina (OR=0.20; 95％CI 0.13-0.30;P<0.01). There were no significant differences in age (OR=1.03; 95％CI 0.95-1.11;P=0.48), history of diabetes (OR=1.26; 95％CI 0.29-5.47;P=0.75), and Killip grade>1 (OR=2.22; 95％CI 0.90-5.48;P=0.08).Conclusions The risk factors for RA after PCI in AMI patients include smoking, TIMI0 flow grade, inferior MI, right coronary artery infarction, multi-vasculopathy, renal failure, time from symptom onset to PCI ≤6 h, and duration of operation >1 h. The hypertension history and pre-infarction angina are protective against RA after PCI in AMI patients.