· AIM:To investigate the incidence and risk factors of retinopathy of prematurity (ROP) in preterm infants.· METHODS:The wide-field digital pediatric Retinal imaging system was used to screen 2203 preterm infants with gestational age ＜ 37wk or birth weight ≤ 2000g in NICU and the Ophthalmology Department of Northwest Women and Children Hospital from January 15,2015 to October 15,2017.The screening results were used to calculate the incidence of ROP and to analyze the risk factors.· RESULTS:Totally 367 infants (621 eyes) were diagnosed as retinopathy among 2203 premature infants and the incidence of ROP was 16.66％;236 cases (399 eyes) of ROP (26.61％) were detected in 887 cases of premature infants in accord with screening standard of the Chinese Premature Retinopathy Screening Guidelines (2014),and 131 cases (222 eyes) of ROP (9.95％) was detected in 1316 cases of premature infants outside the screening standard.In our research,the incidence of ROP was related with gestational age,birth weight,oxygen duration and mechanical ventilation.However,the relationship had not been found with artificial insemination,caesarean birth,gender,polyembryony,acute respiratory distress syndrome (ARDS),hypertensive disorders in pregnancy,gestational diabetes mellitus,intrauterine infection,intrauterine distress,premature rupture of membrane.The incidence of ROP was statistically significant between different gestational age groups,different birth weight groups and different oxygen groups (P＜ 0.05).Logistic analysis showed that gestational age,birth weight,oxygen duration and mechanical ventilation were independent risk factors of ROP.· CONCLUSION:The incidence of ROP is 16.66％ in this study,and there is still a certain proportion outside the screening standard of the Chinese Premature Retinopathy Screening Guidelines (2014).Gestational age,birth weight,oxygen duration and mechanical ventilation are high risk factors for ROP.

ObjectiveTo study the expression of CLAUDIN-11 in the testis tissue of non-obstructive azoospermia (NOA) patients with different severities and investigate its clinical significance.

METHODSSixty-two NOA patients were divided into a hypospermatogenesis (HS) group (n = 30) and a Sertoli cell only syndrome (SCO) group (n =32). The expression of CLAUDIN-11 in the testicular tissue of the patients was detected by immunohistochemistry, that of CLAUDIN-11 mRNA determined by real-time fluorescence quantitative polymerase chain reaction (RT-qPCR), and the levels of serum reproductive hormones measured by chemiluminescent immunoassay.

RESULTSImmunohistochemistry showed that the expression of CLAUDIN-11 was mainly in the cytoplasm of the Sertoli cells around the seminiferous tubule wall in the HS group, but diffusely distributed in the membrane of the Sertoli cells in the SCO group. RT-qPCR revealed a significantly lower expression of CLAUDIN-11 mRNA in the HS than in the SCO group (0.008 ± 0.001 vs 0.013 ± 0.002, t = 10.616, P<0.01). The level of serum luteotropic hormone (LH) was also markedly lower in the HS than in the SCO group (［3.62 ± 1.34］ vs ［4.96 ± 3.10］ IU/L, P<0.05) and so was that of follicle-stimulating hormone (FSH) (［5.36 ± 2.80］ vs ［10.65 ± 9.18］ IU/L, P<0.05).

CONCLUSIONSThe up-regulated expression of CLAUDIN-11 in Sertoli cells may play an important role in the development and progression of spermatogenic dysfunction in NOA patients.

Azoospermia ; genetics ; metabolism ; Claudins ; metabolism ; Follicle Stimulating Hormone ; metabolism ; Humans ; Male ; Oligospermia ; genetics ; metabolism ; RNA, Messenger ; metabolism ; Seminiferous Tubules ; metabolism ; Sertoli Cell-Only Syndrome ; genetics ; metabolism ; Sertoli Cells ; metabolism ; Spermatogenesis ; Testis ; metabolism

OBJECTIVETo explore the technique and therapeutic effect of bridge wire splint fixation with ankle dorsiflexion for the treatment of femoral shaft fractures in young children. Methods:From June 2006 to June 2012,45 young children with femoral shaft fractures were treated by bridge wire splint fixation with ankle dorsiflexion,which was designed according to arch bridge mechanical principle and structure. There were 31 males and 14 females with an average age of 3.2 years old ranging from 8 months to 5.5 years old; 14 cases were upper 1/3 femoral fractures,26 cases were middle 1/3 femoral fractures,5 cases were lower 1/3 femoral fractures; 20 cases were transverse fractures, 14 cases were oblique fractures,6 cases were spiral frac- tures, and 5 cases were comminuted fractures. X-ray, follow-up imaging changes,clinical curative effect and complications were assessed.

RESULTSForty-five patients were followed up for 6 to 21 months (averaged 12 months). All fractures were reached clinical bone healing after 5 to 7 weeks (averaged 6 weeks) fixation. Seven cases appearred limb soft tissue complications, including buttocks bedsore,dorsal foot and Achilles tendon epidermal necrosis, and healed after dressing and removal of external fixation. During follow-up,the original overlap angle and lateral displacement were remodeled, and limbs were restored to the normal line of force and bone structure. According to Flynn standard, 35 cases got excellent results, 8 cases good, 2 cases fair.

CONCLUSIONThe bridge wire splint fixation with ankle dorsiflexion for the treatment of femoral. shaft fractures in young children (less than 6 years old) is safe,feasible, simple,and has raliable effect, which can be applied in primary hospitals.

Ankle ; surgery ; Bone Wires ; Child ; Child, Preschool ; Female ; Femoral Fractures ; surgery ; Femur ; surgery ; Follow-Up Studies ; Fracture Fixation, Intramedullary ; instrumentation ; Humans ; Infant ; Male ; Treatment Outcome

Objective This study observed the clinical curative effects of aldose reductase inhibitor epalrestat in treat-ment of diabetic sensory neuropathy. Methods Thirty-four diabetic sensory neuropathy patients were selected. The nerve electrophysiological data were collected before and after treating with epalrestat. Results The ratios of nerve con-ductive velocity in peroneal nerve sensory showed slowing down than normal before and after the treatment, which were respectively 61% and 32%; The ratios of the nerve conductive velocity in tibial nerve sensory nerve segment 1 showed slowing down before and after the treatment,which were respectively 97% and 65%; The nerve conductive velocity of the peroneal sensory nerve after treatment was significantly faster than that before treatment, the nerve conductive ve-locity of the the tibial nerve sensory nerve motion segments in 1 after treatment was significantly faster than that before treatment. Conclusion Epalrestat is one of the effective methods in the treatment of diabetic peripheral neuropathy.

OBJECTIVETo explore the clinical value and efficacy of reduced field intensity modulated radiation therapy (RF-IMRT) for patients with advanced cervical cancer.

METHODSSeventy-one patients with stage IIB-IIIB cervical cancer, who underwent reduced field IMRT (RF-IMRT group) and 72 patients treated with conventional radiotherapy (c-RT group) in Shandong Cancer Hospital between 2005 August and 2011 August, were enrolled in this study. The RF-IMRT plans were as follows: whole pelvic IMRT plan was performed to deliver an initial dose of 30 Gy, then the irradiated volume was reduced to lymphatic drainage region as well as paracervix and parametrium for an additional 30 Gy boost. Conventional 2-field RT plan was performed in these patients using ADAC Pinnacle 3 planning system, to be given the same prescription dose, and to compare the irradiation dose of organs at risk (OARs). At the same time, conventional 2-field RT was performed in 72 patients of the c-RT group. Concurrent chemotherapy and intracavitary brachytherapy were also performed in the two groups. The treatment response, toxicities, normal tissue avoidance, and survival were assessed.

RESULTSSixty-six patients of the RF-IMRT group and 65 patients of the c-RT group fulfilled the treatment plan. IMRT plans yielded better dose conformity to the target (0.711 ± 0.057 vs. 0.525 ± 0.062, P = 0.032) and better sparing of the rectum, bladder and small intestine (rectum: 41.6 ± 6.8 vs. 50.8 ± 3.2, P = 0.016; bladder: 40.2 ± 2.9 vs. 51.4 ± 1.8, P = 0.007; small intestine: 22.3 ± 2.6 vs. 35.8 ± 3.9, P = 0.004). The mean dose delivered to the planning target volume (PTV) was significantly higher in the RF-IMRT group than that in the c-RT group (60.8 vs. 51.2 Gy, P = 0.006). The RF-IMRT patients experienced significantly lower acute and chronic toxicities with comparable short-term effects than did those treated with conventional RT (P > 0.05). No significant differences were found between the two groups for 1-, 3-, and 5-year overall survival (OS) rates, while a significantly higher progression-free survival (PFS, 65.2% vs. 46.2%, P = 0.031) rate was observed in the RF-IMRT group.

CONCLUSIONSRF-IMRT yields higher dose distributions and lower toxicities compared with conventional RT, and both the tumor target volume and pelvic lymphatic drainage region achieve curative dose irradiation, the adjacent organs at risk are well protected, and with tolerable adverse reactions. Yet, RF-IMRT provides comparable clinical outcomes and higher PFS.

Adenocarcinoma ; drug therapy ; pathology ; radiotherapy ; Brachytherapy ; Carcinoma, Squamous Cell ; drug therapy ; pathology ; radiotherapy ; Chemoradiotherapy ; Disease-Free Survival ; Female ; Follow-Up Studies ; Humans ; Middle Aged ; Neoplasm Staging ; Organs at Risk ; Radiotherapy Dosage ; Radiotherapy Planning, Computer-Assisted ; Radiotherapy, Intensity-Modulated ; adverse effects ; methods ; Remission Induction ; Survival Rate ; Uterine Cervical Neoplasms ; drug therapy ; pathology ; radiotherapy

OBJECTIVETo explore the association between dyslipidemia and different subtypes of hypertension among Zhejiang population.

METHODSFrom June to October in 2010, 19 113 local residents aged ≥ 18 years old were selected among 7571 families from fifteen counties in Zhejiang by four stage stratified-random sampling method. A self-designed questionnaire was adopted to collect information on demographic characteristics, physical activity and life style. At the same time, physical examinations including height, weight, blood pressure and blood lipids were carried out.

RESULTSA total of 19 113 participants completed the interviews, physical examinations and collected the blood samples.Excluding those who did not meet the criteria, 14 731 were finally enrolled in the study. The prevalence rates of isolated systolic hypertension (ISH), isolated diastolic hypertension (IDH), systolic and diastolic hypertension (SDH) were 7.16% (1055/14 731, standardized rate:5.46%), 4.60% (677/14 731, standardized rate:4.41%), 7.09% (1045/14 731, standardized rate:5.75%), respectively. Among normal blood pressure group, subjects with normal TC, high TC and abnormal TC were separately 10 571 (88.43%), 1173 (9.81%) and 210 (1.76%); subjects with normal HDL-C and low HDL-C were separately 6885 (57.60%) and 5069 (42.40%); subjects with normal TG, high TG, abnormal TG were separately 9952 (79.91%), 1213 (10.15%) and 1189(9.95%).In ISH group, subjects with normal TC, high TC and abnormal TC were separately 826 (78.29%), 188 (17.82%) and 41 (3.89%); subjects with normal HDL-C and low HDL-C were separately 666(63.13%) and 389 (36.87%); subjects with normal TG, high TG and abnormal TG were separately 737 (69.86%), 150 (14.22%) and 168 (15.92%). Multi factor analysis showed that high TG and abnormal TG were associated with ISH (OR (95%CI):1.43 (1.16-1.76), 1.65 (1.34-2.03) respectively). Among IDH group, subjects with normal TC, high TC, abnormal TC were separately 556(82.13%), 99(14.62%) and 22 (3.25%); subjects with normal HDL-C, low HDL-C were separately 335 (49.48%) and 342 (50.52%); subjects with normal TG, high TG, and abnormal TG separately were 402 (59.38%), 107 (15.81%) and 168 (24.82%). The multi factor analysis showed that high TG and abnormal TG could increase the risk of IDH (OR(95%CI):1.57 (1.24-1.98), 2.18 (1.76-2.70) respectively). Among SDH group, subjects with normal TC, high TC and abnormal TC were 817 (78.18%), 193 (18.47%) and 35 (3.35%); subjects with normal HDL-C and abnormal HDL-C were separately 599 (57.32%) and 446 (42.68%); subjects with normal TG, high TG, abnormal TG were separately 675 (64.59%), 164 (15.69%) and 206 (19.71%). The multi factor analysis showed that high TC, high TG and abnormal TG were also associated with the increased risk of SDH (OR (95%CI):1.38 (1.14-1.67), 1.43(1.18-1.75), 1.73 (1.43-2.10) respectively).

CONCLUSIONDyslipidemia is an important factor of different subtypes of hypertension among Zhejiang population, especially triglycerides. Dyslipidemia screening should be strengthened to reduce the risk of cardiovascular diseases.

Adult ; Aged ; China ; epidemiology ; Dyslipidemias ; epidemiology ; Female ; Humans ; Hypertension ; blood ; classification ; epidemiology ; Lipids ; blood ; Male ; Middle Aged ; Risk Factors

Objective: To observe the effects of the early intervention with Didang Decoction (DDD) on macroangiopathy in type 2 diabetic rats. Methods: The type 2 diabetic rat model was established using high-fat diet and Streptozotocin (STZ), and the rats were divided into control, model, Pioglitazone (2.7 mg/kg), Simvastatin (1.8 mg/kg), early-, mid-, and late-term DDD-intervene groups (ig administered with 3.24 g/kg DDD once daily, before 4 weeks, at the same time, and after 4 weeks of STZ administration, respectively), the rats in each group were administered until 24 weeks of STZ administration. The immunohistochemical and pathological changes of intercellular cell adhesion molecule-1 (ICAM-1) and vascular cell adhesion molecule-1 (VCAM-1) in the aorta were observed, and the expression of nuclear factor-kappa B (NF-κB) and matrix metalloproteinases-9 (MMP-9) in aorta was detected using Western blotting. Results: Compared with the model group, the ICAM-1 expression decreased in early- and mid-term DDD-intervene groups, and Simvastatin group (P < 0.05), the VCAM-1 expression decreased in early-term DDD-intervene and Simvastatin groups (P < 0.05), the protein expression of NF-κB and MMP-9 was lower in early- and mid-term DDD-intervene groups (P < 0.05), and it is the most obvious in early-term DDD-intervene group. Conclusion: The contents of ICAM-1 and VCAM-1 as well as the protein expression of NF-κB and MMP-9 in type 2 diabetic rats decrease after early-term DDD-intervene, which could regulate NF-κB signaling pathway to delay the development of diabetic macroangiopathy.

Objective We conducted an epidemiologic investigation to determine the source of infection on an avian influenza (H5N1) case who returned from Guangzhou,in Hong Kong.Methods Data related to epidemiologic investigation,medical observation on close contacts,Syndromic Surveillance on poultry salesmen,emergency monitoring,detection of the samples,source tracing on potential Avian influenza virus (H5,H7,H9) infected people,situation on environment pollution by avian influenza virus in the markets etc.were gathered.The determination of infection source was through comparing the different genes between the case and positive environmental samples.Results The infected case witnessed the procedure of how a live duck was killed,in market A in Guangzhou during May 17th to 19th.The case was diagnosed as respiratory tract infection in 2 Third-grade-Class A hospitals in Guangzhou on May 23th and 24th.The diagnosis was made as Avian influenza cases on May 26th after going back to Hong Kong.23 close contacts and 34 markets poultry salesmen did not show any ILI related symptoms.However,2 poultry salesmen from the markets nearby the place where the Avian influenza case stayed,were detected having positive H9 avian influenza antibody,with the H9 positive rate as 6.06％ (2/33).Among the environmental samples in the 2 markets nearby home of the patient,chopping block was found to have carried H5,with positive rate as 9.8％(5/51) while poultry cage was found to carry H9,with the positive rate as 2.0％(1/51).A H5 positive sample was found with clade 2.3.2.1,same to the case,from a chopping block at the market B where the sources of poultry was the same as market A.Conclusion The source of infection seemed to come from the markets in Guangzhou,that calling for the strengthening of poultry market management,for avian influenza prevention.History related to contact of poultry should be gathered when a diagnosis of respiratory tract infection was made.Timely sampling and testing should be made to improve the sensitivity of diagnosis.

OBJECTIVETo design ABC damage variable and positioning system for acetabular fracture and explore the feasibility and clinical practical value of the system through the multi-center analysis of 1122 acetabular fractures.

METHODSAccording to acetabular three-column conception, and pelvic ring lesions damage direction caused by acetabular fracture domino effect and injury degree of proximal femur joint, it defined class A as any column acetabular fracture; class B as any two-column acetabular fracture; class C as front, dome and posterior mixture acetabular fracture. Lower case English letters a, m, p represented front, dome, posterior fracture, respectively. Acetabular damage variables: 1 was simple displaced fractures; 2 was comminuted fractures; 3 was compression fractures. Pelvic ring lesions damage variables: alpha was sacroiliac joints or sacroiliac fracture horizontal separation deflection; beta was sacroiliac joints or sacroiliac fracture vertical separation deflection; gamma was pubic symphysis separation/superior and inferior ramus of pubis fracture deflection; alpha beta gamma delta was compound floating damage. Proximal humerus joint damage variables: I was femoral head fracture; II was femoral neck fracture; II was intertrochanteric fractures of femur; IV was I to III compound fracture. The ABC damage variable positioning system for acetabular fracture was made up by the above-mentioned variables. The statistics from March 1997 to February 2010 showed 1122 cases acetabular fractures with 18 cases of double side acetabular fracture and 1140 cases of acetabular fractures. The pelvics anterior-posterior view, ilium and obturator oblique view, and 2/3D-CT materials were analyzed and researched.

RESULTSEach damage variables distribution situation in 1140 cases of acetabular fracture involved A in 237 cases (20.8%), B in 605 cases (53.1%), C in 298 cases (26.1%);front column fracture in 808 cases(70.9%), dome fracture in 507 cases (44.5%), posterior fracture in 1026 cases (90%). Acetabular variables: variabe 1 in 203 cases of simple displaced fracture (17.8%); variabe 2 in 516 cases of comminuted fracture(45.3%); variabe 3 in 421 cases of compression fracture (36.9%); 249 cases of pelvic ring lesions damage (21.8%), 75 cases femoral head fracture (6.6%); 18 cases of double side acetabular fracture and relative pelvic ring and proximal humerus joint variables (1.58%). Key part and curative effect elements of 1140 cases acetabular fracture: 507 cases of dome or posterior acetabular fracture (44.5%); 421 cases of compression fracture (36.9%); 249 cases of pelvic ring variables (21.8%); 75 cases of proximal humerus joint variables (6.6%); 486 cases of simple Aa/pl/2,Bapl/2 acetabular fracture (42.6% ).

CONCLUSIONCompression fracture, especially defected compression fracture, takes important part in acetabular damage variables, and also presents that acetabular fracture with pelvic ring and proximal femoral damage variables are not rare at all. The relationship of the acetabular fracture damage variables, and its percentage shows the key points and elements in clinical treatment: weight-bearing to dome accounts for 44.5%; compression to defects account for 36.9%, pelvic ring to float accounts for 21.8%; dome fracture to double side fracture account for 6.6%. The system has significant guiding effects on clinic in terms of evaluation of injury severity, anatomic localization, difficulty index, alternative strategy, operative approach, effect of treatment,and prognosis. And the most important thing is that the system creates the comparison of damage variables in same type of fracture and the communication of homo-language and explores a new method.

Acetabulum ; injuries ; Adolescent ; Adult ; Aged ; Child ; Female ; Fractures, Bone ; classification ; diagnostic imaging ; Humans ; Male ; Medical Informatics ; methods ; Middle Aged ; Tomography, X-Ray Computed ; Young Adult

BACKGROUND AND OBJECTIVECytokine-induced killer (CIK) cells and autologous dendritic cells-CIK (DC-CIK) cells co-cultured with autologous dendritic cells (DCs) and CIK cells are commonly used for immunotherapy recently. We compared the anti-tumor immune response of CIK cells, autologous DC-CIK cells, and semi-allogeneic DC-CIK cells to explore a more effective anti-tumor adoptive immunotherapy approach.

METHODSPeripheral monocytes were isolated from patients with renal carcinoma, lung cancer, or maxillary squamous cell carcinoma and their healthy adult children. Isolated cells were cultured and induced as DCs and CIK cells in vitro. CIK cells from patients were co-cultured with autologous DCs and DCs from their children respectively, generating DC-CIK cells and semi-allogeneic DC-CIK cells. The anti-tumor activities of autologous CIK cells, autologous DC-CIK cells, and semi-allogeneic DC-CIK cells were measured by LDH assay. Intracellular staining was used to test the secretion of cytokines. Flow cytometry was applied for detecting the phonotype changes of these three types of cells. Cell proliferation and cell apoptosis were detected by 5,6-carboxyfluorescein diacetate succinimidyl ester (CFSE) and Annexin V/PI respectively.

RESULTSCompared with autologous CIK cells and DC-CIK cells, semi-allogeneic DC-CIK cells significantly enhanced the anti-tumor activity and IFN-gamma secretion, reduced IL-4 secretion, increased the ratio of CD3(+)CD56(+) cells and CD3(+)CD8(+) cells, decreased the number of CD4(+)CD25(+) cells, promoted cell proliferation, and lessened cell apoptosis.

CONCLUSIONSSemi-allogeneic DC-CIK cells had a stronger anti-tumor effect than did autologous CIK cells and DC-CIK cells. Our results provided experimental evidence for clinical application of DC-CIK cells.

Apoptosis ; Carcinoma, Squamous Cell ; metabolism ; pathology ; Cell Line, Tumor ; Cell Proliferation ; Cells, Cultured ; Coculture Techniques ; Cytokine-Induced Killer Cells ; cytology ; immunology ; metabolism ; Cytokines ; metabolism ; Cytotoxicity, Immunologic ; Dendritic Cells ; cytology ; immunology ; metabolism ; Hep G2 Cells ; Humans ; Immunotherapy, Adoptive ; Interferon-gamma ; secretion ; Interleukin-4 ; secretion ; K562 Cells ; Kidney Neoplasms ; metabolism ; pathology ; L-Lactate Dehydrogenase ; metabolism ; Lung Neoplasms ; metabolism ; pathology ; Maxillary Neoplasms ; metabolism ; pathology