Objective:To investigate the association between congenital hypothyroidism (CH) and the adverse outcomes during hospitalization in very low birth weight infants (VLBWI).Methods:This prospective, multicenter observational cohort study was conducted based on the data from the Sino-northern Neonatal Network (SNN). Data of 5 818 VLBWI with birth weight <1 500 g and gestational age between 24-<37 weeks that were admitted to the 37 neonatal intensive care units from January 1 st, 2019 to December 31 st, 2022 were collected and analyzed. Thyroid function was first screened at 7 to 10 days after birth, followed by weekly tests within the first 4 weeks, and retested at 36 weeks of corrected gestational age or before discharge. The VLBWI were assigned to the CH group or non-CH group. Chi-square test, Fisher exact probability method, Wilcoxon rank sum test, univariate and multivariate Logistic regression were used to analyze the relationship between CH and poor prognosis during hospitalization in VLBWI. Results:A total of 5 818 eligible VLBWI were enrolled, with 2 982 (51.3%) males and the gestational age of 30 (29, 31) weeks. The incidence of CH was 5.5% (319 VLBWI). Among the CH group, only 121 VLBWI (37.9%) were diagnosed at the first screening. Univariate Logistic regression analysis showed that CH was associated with increased incidence of extrauterine growth retardation (EUGR) ( OR=1.31(1.04-1.64), P<0.05) and retinopathy of prematurity (ROP) of stage Ⅲ and above ( OR=1.74(1.11-2.75), P<0.05). However, multivariate Logistic regression analysis showed no significant correlation between CH and EUGR, moderate to severe bronchopulmonary dysplasia, grade Ⅲ to Ⅳ intraventricular hemorrhage, neonatal necrotizing enterocolitis in stage Ⅱ or above, and ROP in stage Ⅲ or above ( OR=1.04 (0.81-1.33), 0.79 (0.54-1.15), 1.15 (0.58-2.26), 1.43 (0.81-2.53), 1.12 (0.70-1.80), all P>0.05). Conclusion:There is no significant correlation between CH and in-hospital adverse outcomes, possibly due to timely diagnosis and active replacement therapy.

Objective:To investigate the effect of repetitive transcranial magnetic stimulation (rTMS) on the hippocampal lipidome in a rat model of chronic unpredictable stress(CUS).Methods:Twenty-four SD rats were randomly assigned to the following 3 groups ( n=8 for each group): sham group, CUS group and CUS+ rTMS group. The sham group received only sham stimulation and rats in the CUS and CUS+ rTMS group were subjected to CUS stimulation. Then, rats received 5 Hz rTMS (5 Hz, 1.26 Tesla) or sham rTMS for 7 days. After the last stimulation, all rats underwent sucrose preference test, open filed test and forced swimming test so as to observe the effect of rTMS on depressive behavior. Then, rats were sacrificed, and the levels of lipid composition in hippocampus were determined by high performance liquid chromatography mass spectrometry and analyzed by lipid search software version 4.1 and SIMCA-P 14.1.The software of SPSS 19.0 was used for statistical analysis. Univariate analysis of variance was used for comparison among groups, and Tukey test was used for multiple comparison. Results:(1)There were significant differences in open field test, sugar preference test and forced swimming test among the three groups( F=6.853-7.466, all P<0.05). In the open field experiment, the exploring time and percentage of movement distance in central area of rats in CUS group((50.72±6.38)s, (11.41±1.55)%) was significantly less than that of sham group ((86.06±7.31)s, (18.60±1.21)%) and CUS+ rTMS group((79.87±7.87)s, (16.74±1.27)%)(all P<0.05). The results of sucrose preference test showed that the percentage of sucrose intake of rats in CUS group ((37.63±6.06)%) was significantly lower than that in sham group ((68.30±6.39)%) and CUS+ rTMS group ((62.68±5.50)%)(both P<0.05) . In forced swimming test, the immobility time of rats in CUS group ((137.60±13.36)s) was significantly longer than that of sham group ((80.57±10.36)s)) and CUS+ rTMS group ((86.14±11.49)s) (both P<0.05). (2)The levels of lipid composition in hippocampus were significantly different in the three groups( F=3.826-15.440, all P<0.05). The contents of phosphatidylethanolamine (PE) ((20 850±956.56)×10 7, (24 133.33±1 242.04)×10 7), phosphatidylinositol (PI) ((788.78±136.11)×10 7, (953.65±131.26)×10 7), lysophosphatidylcholine (LPC) ((340.29±35.66)×10 7, (275.32±35.78)×10 7), creatine phosphate (CerP) ((239.65±18.14)×10 7, (293.82±38.28)×10 7), sphingosine (So) ((22.96±4.04)×10 7, (15.36±3.87)×10 7), diglyceride (DG) ((3.35±0.85)×10 7, (4.57±1.02)×10 7) and monoglyceride (MG) ((6.71±0.82)×10 7, (7.94±0.91)×10 7)in hippocampus of rats in CUS group were significantly higher than those of sham group(all P<0.05), while the phosphatidic acid(PA) ((424.52±33.38)×10 7, (509.22±42.09)×10 7) and acyl carnitine(AcCa) ((2.68±0.33)×10 7, (3.39±0.33)×10 7) decreased(both P<0.05). Compared with CUS group, the contents of PE(21 816.67±928.26)×10 7, PI(83.16±91.52)×10 7, LPC(323.59±33.91)×10 7, CerP(236.39±32.02)×10 7, So(23.35±4.46)×10 7, DG(3.16±0.85)×10 7 and MG(7.03±0.26)×10 7 in the hippocampus of CuS+ rTMS group decreased, while the contents of PA(421.55±44.28)×10 7 and ACCA(2.56±0.32)×10 7 in the hippocampus of CUS+ rTMS group increased (all P<0.05). Conclusion:The levels of glycerophospholipids, glyceroglycerides, sphingolipids, fatty acids and other lipids in the hippocampus of CUS model rats are abnormal. And the 5 Hz rTMS intervention can ameliorate the depression like behavior and the disturbances of lipid in hippocampus of CUS model rats.

Objective:To investigate the surgical treatment strategies of mesh infection after tension-free repair of inguinal hernia.Methods:The retrospective and descriptive study was conducted. The clinical data of 88 patients with mesh infection after tension-free inguinal hernia repair who were admitted to Beijing Chaoyang Hospital Affiliated to Capital Medical University from March 2013 to May 2018 were collected. There were 85 males and 3 females, aged from 14-84 years, with an average age of 58 years. All patients underwent debridement. Observation indicators: (1) surgical and postoperative situations; (2) follow-up. Follow-up using outpatient examination or telephone interview was conducted to detect wound healing, recurrence of inguinal hernia, postoperative pain and reinfection after operation up to July 2019. Measurement data with normal distribution were represented as Mean± SD, and measurement data with skewed distribution were represented as M (range). Count data was described as absolute numbers. Results:(1) Surgical and postoperative situations: 88 patients underwent debridement successfully. Of the 88 patients, 71 cases underwent laparoscopic exploration before undergoing debridement, and 17 cases underwent open debridement directly. Of the 71 patients who underwent laparoscopic exploration, 63 cases had intact peritoneum with no infection observed in intestine and bladder after laparoscopic abdominal exploration, and then were transferred to open debridement. Four cases with small bowel fistula confirmed by laparoscopic exploration were transferred to open debridement combined with small bowel resection and anastomosis after separating tissue adhesion. Three cases with mesh infection confirmed by laparoscopic exploration underwent the treatment of opening peritoneum and removing the infection mesh through posterior approach under laparoscopy. One case with bladder fistula confirmed by laparoscopic exploration underwent bladder repair after removing infection mesh under laparoscopy. Of the 88 patients, 82 cases had mesh infection including 31 cases with mesh completely removed, 51 cases with the infected part of mesh removed; 28 cases had the sutures co-infected removed. Six of the 88 patients who only suffered from superficial infection underwent the treatment of removal of infected sinus tract. Of the 84 patients who underwent open debridement, 65 cases underwent primary suture after indwelling drainage tube, 19 cases kept incision opening including 13 cases undergoing continuous drainage with vacuum sealing drainage device after postoperative dressing change and 6 cases undergoing the treatment of dressing change. The operation time, volume of intraoperative blood loss and duration of postoperative hospital stay of 88 patients were 60 minutes(range, 15-175 minutes), 14 mL(range, 2-200 mL) and 22 days (range, 1-101 days), respectively. All patients underwent postoperative extubation successfully. There were 56 cases of class A healing, 15 cases of class B healing and 17 cases of class C healing in 88 patients. Seventy-one of 88 patients underwent bacterial culture examination of intraoperative pyogenic fluid and sutures, of which 27 cases had negative results, 32 cases had staphylococcus aureus infection, 5 cases had staphylococcus haemolyticus infection, 5 cases had pseudomonas aeruginosa infection, 5 cases had enterococcus faecium infection, 4 cases had staphylococcus hominis subsp infection, 3 cases had proteus mirabilis infection, 2 cases had serratia marcescens infection, 2 cases had streptococcus agalactiae infection, 2 cases had escherichia coli infection and 1 case had achromobacter xylose oxidation subsp infection. There were some cases undergoing more than 2 kinds of bacterial infection. (2) Follow-up: 88 patients underwent postoperative follow-up for 14 to 76 months, with a media follow-up time of 32 months. Of the 88 patients, 5 cases underwent postoperative recurrence of inguinal hernia including 3 undergoing transabdominal preperitoneal inguinal hernia repair, 1 undergoing open preperitoneal inguinal hernia repair and 1 undergoing partial extraperitoneal inguinal hernia repair. One case had postoperative pain with the visual simulation score of 2-4 and received no special treatment. Seventeen cases had postoperative reinfection, in which 3 achieved wound healing after dressing change and 14 achieved wound healing after surgical removal of the infected tissue completely including 7 cases with residual mesh infection and 2 cases with residual suture infection.Conclusions:Surgical strategy of mesh infection after tension-free repair of inguinal hernia is complicated. Removal of the infected mesh by surgery is an effective treatment.

Objective: To establish a simple method for isolation, purification and cultivation of primary retinal microvascular pericytes (RMPs) from mice. Methods: Retinas were isolated from mice following with mechanical morcel, enzymatic digestion and filtration.The retinal fragments were incubated with low glucose DMEM with 20% fetal bovine serum after 24 hours pre-incubation.Differential digestion was used for purification of primary RMPs.Morphological examination of cells was performed by phase contrast microscopy, and further characterization was analyzed by immunocytochemistry.Functional assay was evaluated by the pericytes-endothelial cells (ECs) co-culture system.The treatment and use of experimental animals followed the regulations on the administration of experimental animals promulgated by the state science and technology commission. Results: Cells migrated out of fragments after 24 hours of incubation, and developed into small or large colonies gradually.The cells and their subpassages presented typical pericyte morphology with large irregular triangular cell bodies and multiple long processes.No contact inhibition was observed.Most cells uniformly expressed the cellular markers α-smooth muscle actin (α-SMA) and platelet-derived growth factor receptor-β (PDGFR-β), a few cells expressed the cellular markers glial fibrillary acidic protein (GFAP), but no cell expressed von Willebrand factor (vWF). The purity rate of RMPs was up to 97%.In the co-culture system, RMPs directly contacted with ECs to form the capillary-like cords in vitro. Conclusions A simple method for the isolation, purification cultivation of mouse RMPs is established, and active RMPs can be readily obtained by this method.

Objective To investigate the safety and efficacy of tension-free mesh repair in the treatment of incarcerated groin hernia,and to compare the outcome of biological mesh and polypropylene mesh repairment.Methods A retrospective study was conducted on 118 patients admitted from Jan 2013 to Dec 2017 receiving emergency incarcerated groin hernia repair in Beijing Chao-Yang Hospital.The incidence of surgical site infection (SSI),perioperative mortality,sepsis and ileus were compared.In the follow-up,the postoperative foreign body sensation,chronic pain,seroma/hematoma and recurrence were recorded.The outcome of different surgical procedures (with mesh/without mesh,biological mesh/polypropylene mesh,TAPP/Lichtenstein repair) were compared and analyzed.Results 14 cases received suture repair (group A),104 cases underwent TAPP (n=44) repair or Lichtenstein repair (n =60) with meshes,including 23 cases using biological mesh (group B) and 81 cases using polypropylene mesh (group C).After 20.5 months of follow-up (ranging from 6-65 months),3 cases in group A (21.4％) developed recurrence,the rate was significantly higher than that of group B (4.3％) and group C (0).The incidence of seroma/hematoma in group B was higher than that in group A (7.1％) and group C (7.4％).There were no significant differences between the 3 groups regarding the postoperative adverse events rate,SSI,mortality,sepsis and ileus (all P ＞ 0.05).Conclusions Tension-free mesh repair in the treatment of emergency incarcerated groin hernia is safe and effective,which can reduce the recurrence rate of hernia,without increasing the risk of infection.

Objective To investigate the application value of DynaMesh-IPST stoma dedicated mesh in parastomal hernia repair.Methods The retrospective cohort study was conducted.The clinical data of 281 patients with parastomal hernia of abdominal wall who were admitted to Beijing Chao-Yang Hospital of Capital Medical University between March 2013 and April 2017 were collected.Of 281 patients undergoing laparoscopic combined with open parastomal hernia repair with artificial materials,151 using DynaMesh-IPST stoma dedicated mesh and 130 using ordinary anti-adhesive mesh were respectively allocated into the DynaMesh-lPST mesh group and ordinary mesh group.Observation indicators:(1) intra-and post-operative situations;(2) follow-up.Follow-up using outpatient examination and telephone interview was performed to detect hernia recurrence and long-term complications at 1-,3-,6-month and 1 year postoperatively up to June 2018.Measurement data with normal distribution were represented as (x)±s and comparison between groups was done by the t test.Measurement data with skewed distribution were described as M (P25,P75) and M (range),and comparison between groups was done using rank sum test.Comparison of count data between groups was analyzed using the chi-square test.Results (1) Intra-and post-operative situations:281 patients underwent successfully laparoscopic combined with open parastomal hernia repair with artificial materials.The operation time,volume of intraoperative blood loss and duration of postoperative hospital stay were 100 minutes (60 minutes,120 minutes),(34± 15)mL,17 days (13 days,24 days) in the DynaMesh-IPST mesh group and 100 minutes (85 minutes,120 minutes),(42± 36)mL and 20 days (16 days,25 days) in the ordinary mesh group,with statistically significant differences between groups (Z=2.166,t=2.654,Z=2.795,P＜0.05).The postoperative incisional infection and intestinal leakage were respectively detected in 18 and 2 patients in the DynaMesh-IPST mesh group and 36 and 7 patients in the ordinary mesh group,showing a statistically significant difference of incisional infection between groups (x2 =11.194,P＜0.05),and no statistically significant difference of intestinal leakage between groups (x2 =4.234,P＞ 0.05).Of 54 patients with postoperative incisional infection,4 were cured after removing mesh and clearing up infection,50 were cured after dressing change,local debridement and drainage.(2) Follow-up:279 of 281 patients including 149 in the DynaMesh-IPST mesh group and 130 in the ordinary mesh group were followed up for 20-44 months with a median time of 32 months.During the follow-up,10 patients had hernia recurrence including 4 in the DynaMesh-IPST mesh group and 6 in the ordinary mesh group.Six of them underwent reoperation (4 with keyhole hernia recurrence,1 with mesh bulging out because of abdominal weakness at stoma,1 with parastomal recurrence after mesh removal due to intestinal leakage) and 4 had regular reexamination after fixation with abdominal belt.There was no statistically significant difference of hernia recurrence between groups (x2 =0.318,P＞0.05).Twenty-seven patients (14 in the DynaMesh-IPST mesh group and 13 in the ordinary mesh group) with intestinal obstruction were improved by conservative treatment,showing no statistically significant difference between groups (x2 =0.043,P＞0.05).Ten patients (6 in the DynaMesh-IPST mesh group and 4 in the ordinary mesh group) with stoma stenosis were improved after local stoma remodeling,showing no statistically significant difference between groups (x2=0.007,P＞ 0.05).Ninteen patients (4 in the DynaMesh-IPST mesh group including 1 complicated with hernia recurrence and 15 in the ordinary mesh group including 2 complicated with hernia recurrence) with stoma prolapse were improved after local stoma remodeling,showing a statistically significant difference between groups (x2 =8.756,P ＜ 0.05).Conclusion Parastomal hernia repair with DynaMesh-IPST stoma dedicated mesh is safe and feasible,with satisfactory effects.

Objective:To establish the quality standard for infantile bronchitis traditional Chinese medicine lotion. Methods:TLC was used for the qualitative identification of Ephedra herba, Paeonia lactiflora Pall. , Poria cocos, Fructus aurantii and Epimedium brev-icornu Maxim. . HPLC was used for the content determination of ephedrine hydrochloride, pseudoephedrine hydrochloride and paeoni-florin. The chromatography conditions for ephedrine hydrochloride and pseudoephedrine hydrochloride were as follows: an AElichrom Pdar-Phenyl Polyphenyl ether-bonded phenyl-bonded silica column (250 mm × 4. 6 mm, 5μm) was used, the mobile phase was aceto-nitrile-0. 2% phosphoric acid solution (1 :99), the flow rate was 1. 0ml·min-1, the detection wavelength was 210 nm, the column temperature was 30℃ and the injection volume was 10 μl. The chromatography conditions for paeoniflorin were as follows:an Inertsil ODS-3 C18 column (250 mm × 4. 6 mm, 5 μm) was used, the mobile phase was acetonitrile-0. 1% phosphoric acid solution (15:85), the flow rate was 1. 0 ml·min-1, the detection wavelength was 230 nm, the column temperature was 30℃ and the injection vol-ume was 10 μl. Results:The TLC results of Ephedra herba, Paeonia lactiflora Pall. , Poria cocos, Fructus aurantii and Epimedium brevicornu Maxim. showed clear spots with good resolution. Ephedrine hydrochloride, pseudoephedrine hydrochloride and paeoniflorin had a good linear relationship within the range of 10.11-101.10 μg·ml-1(r=0.9996), 10.08-100.80 μg·ml-1(r=0.9991) and 20.50-102.5 μg·ml-1(r =0.9996), respectively. The average recovery was 98.80% (RSD =1.87%, n =6), 98.77%(RSD=1. 72%, n=6) and 99. 57% (RSD=1. 56%, n=6), respectively. Conclusion: The established quality standard can be used for the quality control of infantile bronchitis traditional Chinese medicine lotion.

Objective: To establish a microbial limit test method for compound benzocaine gel.Methods: According to the general principles of Chinese Pharmacopoeia (2015 edition), method applicable experiments were performed respectively for the routine method, neutralization method and dilution & neutralization method.Using the recovery ratio of test bacteria as the index, the medium of dilution & neutralization method was adopted in the total aerobic microbial count and total combined yeasts and molds count, and the neutralization method was used for the control bacteria detection.The neutralizing agents were polysorbate 80 and lecithin.Results: The method of dilution & neutralization could eliminate the bacteriostasis of the drug, and the recovery ratio of each test bacteria was within the range of 0.5-2.0, which was in line with the requirements of Chinese Pharmacopoeia.Escherichia coli, Pseudomonas aeruginosa and Staphylococcus aureus could be detected out in the positive control bacterial test,and bacteria were not detected out in the negative test.Conclusion: The method can be used for the microbial limit test for compound benzocaine gel.

Objective:To detect the levels of PA,FN,RBP,CRP,Iron,Zinc,VitD in peripheral blood of children with HFMD and to explore the relationship between them and the disease .Methods:The levels of PA,FN,RBP and CRP were detected by immune turbidimetric assay;and the levels of Iron and Zinc were detected by flame atomic absorption spectrometry ;while the levels of VitD were detected by electro chemilumin escence .Results:The levels of PA,FN,RBP,Iron,Zinc and VitD in the severe group were lower than those in other groups ,while the levels of CRP were higher than those in other groups ( P<0.05 );and the levels of PA ,FN and RBP in the general group were lower than that in the control group , while the levels of CRP were higher than that in the control group ( P<0.05 ) .And no significance were found of the levels of Iron ,Zinc and VitD in the general group and the control group ( P>0.05 ) .The levels of PA,FN,RBP,Fe,Zn and VitD in the convalescence were higher than those in the acute phase of the severe cases (P<0.01), and lower than those in the control group ( P<0.05 );And no statistical significance were found of the levels of CRP between the convalescent phase of severe cases and the control group (P>0.05).There were negative correlation between the levels of PA ,FN,RBP and the state of HFMD(P<0.05),while there were positive correlation between the levels of CRP and the state of HFMD (P<0.05). And there were low negative correlation between the levels of Iron , Zinc, VitD and the state of HFMD ( P <0.05 ), respectively.Conclusion:There were nutritional deficiency in severe cases of HFMD ,and the nutritional status should be assessed dy-namically,then proper amount of nutrition should be supplement .

Objective: To assess the impact of viable myocardium in left ventricular aneurysm (LVA) and ventricular arrhythmia on prognosis of LVA patients.
Methods: A total of one hundred and sixty LVA patients who received99Tcm-MIBI SPECT and18F-FDG PET were enrolled, including 139 male and 21 female with the mean age of (58 ± 10) years.There were 42 (26.3%) patients combining ventricular arrhythmia. LVEDV, LVESV and LVEF were detected. Semi-quantitative analysis of myocardium perfusion imaging was conducted, viable myocardium in aneurysm was deifned as the perfusion-metabolism mismatch score (MMS) ≥ 2.0. According to myocardium viability, the patients were divided into 2 groups: No viability group,n=97 and With viability group,n=63;based on ventricular arrhythmia, the patients were divided into another 4 groups: Group①, viability-, ventricular arrhythmia-, n=68, Group②, viability-, ventricular arrhythmias+,n=29, Group③, viability+, ventricular arrhythmias-,n=50 and Group④, viability+,ventricular arrhythmias+,n=13. The average follow-up time was (50 ± 7) months, the end point was cardiac death. The survival curve was obtained by Kaplan-Meier method and survival rates were compared by Log-rank analysis.
Results: The mean LVEF in 160 patients was (34 ± 11) %, cardiac death occurred in 19 (11.9%) patients. Long-term survival rates in Groups①,② and③ were 94.1%, 89.7% and 86.0%, respectively,P>0.05; while in Group④, the survival rate was 61.5%, which was lower than the other 3 groups,P=0.004. Multivariate Cox regression analysis showed that female (HR=5.101, 95% CI 1.853-14.044, P=0.002), GPET-ESV (HR=1.009, 95% CI 1.002-1.015,P=0.013), interaction between MMS and ventricular arrhythmia (HR=1.368, 95%CI 1.113-1.681,P=0.003) were independent risk factors for cardiac death;while surgical treatment (HR=0.199, 95% CI 0.054-0.742,P=0.016) could decrease the risk of cardiac death.
Conclusion: Patients with viable aneurysm and ventricular arrhythmia had poor long-term prognosis; while early and active treatment is needed for them (surgery with anti-arrhythmic therapy).