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

Objective:To investigate the relationship between serum Mir-137 and Mir-140 levels and clinicopathological features of breast cancer patients and recurrence and metastasis after postoperative chemotherapy with adriamycin + cyclophosphamide + docetaxel (ACT) .Methods:Female breast cancer patients who received chemotherapy of ACT regimen after modified radical mastectomy or breast-conserving radical mastectomy in Tongcheng People’s Hospital from Jan. 2017 to Apr. 2019 were included as research objects, and 60 healthy subjects who underwent physical examination in our hospital during the same period were included as healthy control group. Two ml of fasting peripheral venous blood was extracted from all patients before surgery and 1 week after the end of chemotherapy, and the relative expression levels of Mir-137 and Mir-140 in serum were determined by quantitative real-time polymerase linked reaction. Clinicopathological data were collected, including age, menopausal status, pathological type, TNM stage, estrogen receptor (ER) status, progesterone receptor, PR and human epidermal growth factor receptor-2 (HER2) status. All breast cancer patients were followed up for 3 years after surgery, and postoperative recurrence, distant metastasis and death time were recorded according to medical records and follow-up results.Results:The relative expression of Mir-137 in breast cancer patients was 0.89±0.15, significantly lower than that in healthy controls (1.34±0.21) ( t=4.985, P<0.001) . The relative expression of Mir-140 in breast cancer patients was 0.83±0.14, significantly lower than that in healthy controls (1.18±0.17) ( t=4.245, P<0.001) . Serum Mir-137 level was correlated with TNM stage, ER status and HER2 status in breast cancer patients ( t=2.56, 2.06, 2.24, P=0.003, 0.007, 0.004) , and serum Mir-140 level was correlated with TNM stage and HER2 status in breast cancer patients ( t=1.954, 2.114, P=0.008, 0.006) . After chemotherapy, the relative expression levels of serum Mir-137 and serum Mir-140 in breast cancer patients were 1.05±0.16 and 0.97±0.18, respectively, significantly higher than those before surgery ( t=2.689 and 3.051, P=0.004 and 0.002, respectively) . A total of 17 patients developed recurrence or distant metastasis within 3 years, and the 3-year progression-free survival rate was 71.67% (43/60) . The mir-137 level of patients with recurrent metastasis was 0.74±0.14, significantly lower than that of patients without recurrent metastasis (0.94±0.13) , the difference was statistically significant ( t=4.149, P<0.001) . The mir-140 level of patients with recurrent metastasis was 0.73±0.10, which was significantly lower than that of patients without recurrent metastasis (0.87±0.13) , the difference was statistically significant ( t=3.634, P<0.001) . ROC curve analysis showed that the sensitivity and specificity of serum Mir-137 expression level in predicting recurrence and metastasis of breast cancer patients were 82.4% and 79.1%, respectively. The sensitivity and specificity of serum Mir-140 expression level in predicting recurrence and metastasis of breast cancer patients were 82.4% and 69.8%, respectively. Kaplan-meier survival curve analysis showed that the 3-year progression-free survival rate of patients with low Mir-137 level was significantly lower than that of patients with high Mir-137 level ( P=0.025) . There was no significant difference in 3-year progression-free survival between patients with low mir-140 level and those with high Mir-140 level ( P=0.282) . Conclusion:Serum Mir-137 and Mir-140 levels are related to clinicopathological features and the efficacy of ACT chemotherapy after operation, which can be used as indicators to evaluate the disease and prognosis.

Objective:Through analyzing pulmonary function and clinical characteristics of preterm infants with bronchopulmonary dysplasia (BPD) from 0 to 6 months, the characteristics of pulmonary function in infants with BPD were investigated.Methods:A retrospective study was conducted on 85 infants hospitalized in the Department of Neonatology of the First Affiliated Hospital of Shantou University Medical College from December 2015 to December 2017, including 25 preterm infants with BPD (BPD group), 30 preterm infants without BPD (preterm control group), and 30 term infants without respiratory diseases (full-term control group), respectively.Pulmonary function were tested in preterm infants at 37 to 41 weeks of corrected age as well as at 6 months of corrected age, and full-term infants at 3 days to 1 week after birth as well as at 6 months old.The outcomes of respiratory system diseases at 6 months of corrected age in two groups of preterm infants were followed up.Results:(1) While preterm infants at 37 to 41 weeks of corrected age and full-term infants at 3 days to 1 week after birth, time to peak tidal expiratory flow/expiratory time(TPTEF/TE)and volume to peak tidal expiratory flow/exhaled volume(VPTEF/VE) of BPD group were lower than those of the other two groups ( P<0.05), while the differences between preterm control group and full-term control group is not significant.VPTEF, peak expiratory flow (PEF), tidal expiratory flow when 75% of tidal volume reminds in the lung (TEF75%), TEF50%, TEF25% in BPD group and preterm control group were lower than those in the full-term group ( P<0.05). The differences between BPD group and preterm control group were not significant ( P>0.05). The BPD group had significantly lower TPTEF/TE, VPTEF/VE and ratio of tidal expiratory flow and tidal inspiratory flow when 50% of tidal volume reminds in the lung (TEF50%/TIF50%) and higher VPTEF, PEF, TEF25% at 6 months of corrected age than those at 37 to 41 weeks of corrected age ( P<0.05). While at 6 months of corrected age, the BPD group had higher PEF than that in the preterm control group ( P<0.05). There was no statistically significant difference between that in the occurrence of lower respiratory tract infections (43.3% vs.16.7%), wheezing (21.7% vs.8.3%), rehospitalization (39.1% vs.16.7%) between BPD group and preterm control group within 6 months of corrected age ( P>0.05). Conclusion:Infants with BPD had small airway obstruction at 37 to 41 weeks of corrected age and may not improve significantly at 6 months of corrected age.

Objective To evaluate a fast-hardening strontium-calcium phosphate scaffold using a two-step reaction in room temperature.Methods The original powder phase consisted of tetracalcium phosphate (TTCP),dicalcium phosphate anhydrous (DCPA) and strontium hydrogen phosphate (DSPA).The liquid phase consisted of 20wt％ citric acid and 12wt％ polyvinylpyrrolidone K-30.Groups were designed as Sr-0,Sr-5,Sr-10,and Sr-20,according to the molar ratios of Sr/(Sr + Ca) being 0,5％,10％,and 20％ in the powder phase,respectively.The ratio 0.5 mL/g in the liquid to solid phase was used for mixing.After the scaffold was prepared,its setting time,compression strength,phase composition and structural morphology,ions release and pH value of the substrates were analyzed.Results Addition of citric acid accelerated the setting reaction.Acceptable setting time was achieved by optimizing composition of the original powder and liquid phases.On the other hand,the compression strength,phase composition and structural morphology were not affected by addition of strontium.In addition,calcium and strontium ions were detected in the substrates,without any significant change in the pH value.Conclusion This two-step reaction can be used to prepare a fast hardening strontium-calcium phosphate scaffold in room temperature.

Objective To explore ways to improve effect of antiretroviral therapy in acquired immune defi-ciency syndrome patients with comorbid malnutrition, in an effort to enhance quality of life and reduce cost. Methods 126 AIDS patients with comorbid malnutrition were randomly divided into treatment group ( n=63) and control group (n=63). Patients in the treatment group were given nutrition support besides antiretroviral ther-apy (ART), while those in the control group only received ART. After 3 months, the two groups were compared in terms of body mass index, skinfold thickness, CD4+T cell count and human immunodeficiency virus load. Re-sults The two groups were comparable before treatment in BMI, skinfold thickness, CD4+T cell count and HIV load (P>0. 05). After treatment, the treatment group, compared with the controls, had higher BMI [ (23. 23± 3. 15) kg/m2vs. (17. 25±1. 83) kg/m2], thicker skinfold [ (42. 9±6. 8) mm vs. (34. 5±5. 2) mm in males;(97. 6±17. 4) mm vs. (92. 3±14. 7) mm in females], higher CD4+T cell count (χ2=12. 573, P<0. 01), and lower HIV load (χ2=8. 683, P<0. 01). Conclusion Nutrition support may improve treatment of AIDS patients with comorbid malnutrition, as manifested in better BMI, skinfold thickness, CD4+T cell count and HIV load.

Colorectal cancer (CRC) is one of the leading causes of death worldwide. Thus, the development of new therapeutic targets for CRC treatment is urgently needed. SGK1 is involved in various cellular activities, and its dysregulation can result in multiple cancers. However, little is known about its roles and associated molecular mechanisms in CRC. In present study, we found that SGK1 was highly expressed in tumor tissues compared with peri-tumor samples from CRC patients. In vitro experiments revealed that SGK1 overexpression promoted colonic tumor cell proliferation and migration and inhibited cell apoptosis induced by 5-fluorouracil (5-FU), while SGK1 shRNA and inhibitors showed the inverse effects. Using CRC xenograft mice models, we demonstrated that knockdown or therapeutic inhibition of SGK1 repressed tumor cell proliferation and tumor growth. Moreover, SGK1 inhibitors increased p27 expression and promoted p27 nuclear accumulation in colorectal cancer cells, and p27 siRNAs could attenuate the repression of CRC cell proliferation induced by SGK1 inhibitors. Collectively, SGK1 promotes colorectal cancer development via regulation of CRC cell proliferation, migration and survival. Inhibition of SGK1 represents a novel strategy for the treatment of CRC.
Animals ; Apoptosis ; Cause of Death ; Cell Proliferation ; Colon ; Colorectal Neoplasms* ; Fluorouracil ; Heterografts ; Humans ; In Vitro Techniques ; Mice ; Repression, Psychology ; RNA, Small Interfering

Objective To compare the outcomes of percutaneous pedicle instrumentation combined with vertebral augmentation or vertebra pedicle instrumentation for treatment of osteoporotic thoracolumbar fractures (OVCF) in elderly patients.Methods A retrospective case cohort study was conducted on 62 patients with OVCF manifesting non-neurological symptoms treated from January 2009 to January 2012.There were 22 males and 30 females,with a mean age of 61.3 years (range,55 to 70 years).Fracture level was T11 in 8 patients,T12in 20,L1 in 22 and L2 in 12.Treatments included percutaneous pedicle instrumentation combined with vertebral fracture fixation in 36 patients (Group A) and percutaneous pedicle instrumentation combined with vertebral augmentation in 26 patients (Group B).Operation time,intraoperative blood loss,anterior vertebral body height,sagittal Cobb angle and visual analogue score (VAS) were compared between the two groups.Results All patients were followed up for average 46.5 months (range,36 to 58 months).Operation time in Group A [(82.6 ±16.2) min] was shorter than that in Group B [(96.8 ± 20.6) min] (P ＜ 0.05).Blood loss in Group B [(40.5 ± 10.2) ml] was less than that in Group A [(52.2 ± 15.5) ml] (P ＜ 0.05).Before operation and 3 days and 1 year after operation,the anterior vertebral body height and sagittal Cobb angle in Group A showed no significant differences compared to Group B (all P ＞ 0.05).At the final follow-up,the ratio of anterior vertebral height and Cobb angle in Group B [(87.8 ± 2.5) ％,(7.8 ± 3.5) °] were better than these in Group A [(82.6 ±3.2)％,(9.1 ± 1.8)°] (P＜0.05).VAS showed no statistical significance between the two groups before and after operation (P ＞ 0.05).Bone cement leakage was seen in four patients in Group B.During the perioperative period,there were 3 patients with lung infection in Group A and 1 patient with lower limb deep vein thrombosis in Group B.No implant failure occurred in both groups.Conclusion Both procedures are effective in treating elderly patients with OVCF,but percutaneous pedicle instrumentation combined with vertebral augmentation is associated with better results in maintaining vertebral height and preventing kyphosis.

Objective To investigate the bacteria distribution and drug resistance of lower respairory tract infection of re‐spairtory wards .Methods Sputum from patients with low respiratory tract infection was collected ,K‐B methods and minimun in‐hibitory concentration were used to make distribution and antibiotic resisitance .Results Five hundred and twenty‐nine strains were isolated ,of which gram negative organisms accounted for 416(78 .8% ) ,and gram positive organisms accounted for 88(16 .6% ) ,and fungi accounted for 25(4 .7% ) .In whtich ,the pseudomoas aeruginosa(25 .0% )and acinetobacter baumannii(13 .0% )accounted for the first and second one .Pseudomoas aeruginosa showed varying degrees of resistance to most commomly used antibacterials ,but there were still some alternatives .Acinetobacter baumannii had higher resistance to most commomly used antibacterial ,except for cefoperazone sulbactam .Cefoperazone sulbactam showed high susceptibility to most gram negative organisms and gram positive or‐ganisms .Conclusion In the respiratory wards ,gram negative organisms were predominant in low respiratory tract infection .Pseud‐omoas aeruginosa and acinetobacter baumannii play a main role .The later is resistant to most commonly used antibacterials and the former showes high resisitance except for a few antibacterials .

Objective To summarizes the experiences and technique of complex transradial percutaneous coronary intervention (PCI) using sheathless guide catheter (Sheathless Eaucath, ASAHI) for 60 patients with coronary heart disease. Methods Retrospectively analyzed the data from 60 patients received PCI using sheathless guide catheter. Results PCI were performed on a total of 60 patients with complex lesions. Angiographic success was achieved in 95.0%and failed in three patients with CTO. 7 patients were with left main lesions, and 32 patients were with bifurcation lesions(including 7 patients with left main lesions and 2 patients with CTO), and 13 patients were with CTO, and the other 17 patients were with tortuous and calcified lesions. Sheathless guide catheters of 7.5Fr were used for PCI in all patients, and all catheters successfully passed through the radial artery and were put in place. No other vascular complications associated with the use of the catheter occurred. Sheathless guide catheters were respectively JL(8 patients), PB(2 patients), AL(2 patients), and JR(1 patient) in 13 patients with CTO, and were respectively JL(8 patients), JR(6 patients), SPB(2 patients), AL(1 patient) in 17 patients with tortuous and calcified lesions. JL or JR were used in all 32 patients with bifurcation. Conclusions Use of the Sheathless of 7.5 Fr is safe and feasible, and allows complex interventions to be undertaken transradially with a high success rate.

Aim To study the effect of S-methylisothiourea(SMT) on adriamy ci n (ADM) induced myocardial lipid peroxidation in rats.Methods T hirty-two Wistar rats were randomly divided into four groups: control group;SMT treated group ( SMT5.0 mg?kg -1,iv,only 1 time);ADM treated group (ADM 5.0 mg?kg -1, ip, only 1 time ); ADM with SMT treated group (the dos ageand method of ADM and SMT were similar to ADM treated group and SMT treated g roup, respectively).24 hour after of administration of the drugs, rats of all t he groups were killed.TBA method, DTNB method, nitrate reductase method, pyrogal lol autoxidation method and hemoglobin-oxidation method were used to determine the contents of lipid peroxide(LPO)and nitric oxide (NO), the activities of glut athione peroxidase (GPx) and superoxide dismutase (SOD) in myocardium, respectiv ely. The level of nitrotyrosine (NT) was determined by immunohistochemical metho d in myocardium.Results SMT significantly reduced the contents of LPO and NO, the activity of inducible nitric oxide synthase (iNOS), the level of NT in myocardium (P0.05).Conclusion SMT can inhibit myocardial lipid peroxidation induced by ADM. The mechanism may be that SMT can selective ly inhibited the activity of iNOS in myocardium induced by ADM, reduce productio n of NO in myocardium, thereby reduce production of peroxynitrite and protect the activities of SOD and GPx in myocardium.