AIM: To investigate the correlation between the ocular demodex infection and the composition of meibum lipid flora.METHODS: A non-interventional and observational study was performed on recruited 39 patients in our hospital between July 2020 and February 2021. They were divided into control group(n=14), meibomian gland dysfunction(MGD)group(n=14), and demodex group(FM, n=11)according to the presence or absence of demodex infection or MGD. High-throughput sequencing of V3-V4 fragment of 16S rRNA gene was performed on the meibomian ester samples of the three groups of subjects, and bioinformatics analysis was performed on the sequencing data to study the composition and difference of meibum lipid flora in the subjects of ocular demodex.RESULTS: Pseudomonas and Comamonas in FM group were significantly higher than those in control group and MGD group(P<0.05), while Ralstonia in Demodex infection group was significantly lower than that in control group and MGD group(P<0.05). The microbial richness and community diversity of meibum lipid flora of the MGD group and the FM group were significantly higher than those of the control group(P<0.05).CONCLUSION: Ocular demodex infection changed the composition of meibum lipid flora and increased the microbial richness and community diversity of meibum lipid flora.

OBJECTIVES: To investigate the clinical treatment outcomes and the changes of the outcomes over time in extremely preterm twins in Guangdong Province, China. METHODS: A retrospective analysis was performed for 269 pairs of extremely preterm twins with a gestational age of <28 weeks who were admitted to the department of neonatology in 26 grade A tertiary hospitals in Guangdong Province from January 2008 to December 2017. According to the admission time, they were divided into two groups: 2008-2012 and 2013-2017. Besides, each pair of twins was divided into the heavier infant and the lighter infant subgroups according to birth weight. The perinatal data of mothers and hospitalization data of neonates were collected. The survival rate of twins and the incidence rate of complications were compared between the 2008-2012 and 2013-2017 groups. RESULTS: Compared with the 2008-2012 group, the 2013-2017 group (both the heavier infant and lighter infant subgroups) had lower incidence rates of severe asphyxia and smaller head circumference at birth (P<0.05). The mortality rates of both of the twins, the heavier infant of the twins, and the lighter infant of the twins were lower in the 2013-2017 group compared with the 2008-2012 group (P<0.05). Compared with the 2008-2012 group, the 2013-2017 group (both the heavier infant and lighter infant subgroups) had lower incidence rates of pulmonary hemorrhage, patent ductus arteriosus (PDA), periventricular-intraventricular hemorrhage (P-IVH), and neonatal respiratory distress syndrome (NRDS) and a higher incidence rate of bronchopulmonary dysplasia (P<0.05). CONCLUSIONS There is a significant increase in the survival rate over time in extremely preterm twins with a gestational age of <28 weeks in the 26 grade A tertiary hospitals in Guangdong Province. The incidences of severe asphyxia, pulmonary hemorrhage, PDA, P-IVH, and NRDS decrease in both the heavier and lighter infants of the twins, but the incidence of bronchopulmonary dysplasia increases. With the improvement of diagnosis and treatment, the multidisciplinary collaboration between different fields of fetal medicine including prenatal diagnosis, obstetrics, and neonatology is needed in the future to jointly develop management strategies for twin pregnancy.
Bronchopulmonary Dysplasia/epidemiology* ; Female ; Gestational Age ; Humans ; Infant ; Infant, Extremely Premature ; Infant, Newborn ; Pregnancy ; Respiratory Distress Syndrome, Newborn/epidemiology* ; Retrospective Studies ; Treatment Outcome

Objective:To investigate the implementation status of development supportive care (DSC) for premature infants in hospitals in China and to provide basis for the development of DSC and standard formulation for premature infants in the future.Methods:This study was a cross-sectional study. Using the convenience sampling method, from July to August 2020, 117 hospitals in 22 provinces/ municipalities/ autonomous regions where members of the Pediatric Professional Committee of the Chinese Nursing Association were selected as the survey subjects. The survey was conducted using the "Questionnaire on the Implementation Status of Developmental Support Nursing for Preterm Infants" made by the Pediatric Professional Committee of the Chinese Nursing Association. A total of 117 questionnaires were sent out in this survey, and 106 valid questionnaires were collected, with an effective recovery rate of 90.6%.Results:Among 106 hospitals, 62 (58.5%) carried out DSC for premature infants, 54 (50.9%) regularly carried out DSC training for medical staff, and 40 (37.7%) formulated clinical guidelines or implementation plans for DSC and 99 (93.4%) hospital facilities had no nursing staff certified by DSC. Among the 62 hospitals that had implemented DSC for premature infants, only 6 (9.7%) hospitals carried out corridor visits. There were significant differences in the implementation of DSC for premature infants in different grades and types of hospitals ( P<0.05) . Conclusions:DSC for premature infants has not yet been widely popularized, and the development status is uneven, family-centered nursing mode is limited. It is necessary to strengthen the training of DSC for premature infants professionals, formulate DSC guidelines in line with China and provide talent and institutional guarantees for the development of DSC for premature infants.

By referring to the standards and procedures of WHQ Handbook for Guideline Development, under the guidance of relevant laws, regulations, and technical documents, in line with the principle of "evidence-based, consensus-based, experience-based", and based on the best available evidences, fully combined with expert experience and patient preferences, we summarized eight clinical questions in this paper: can traditional Chinese medicine(TCM) treatment improve the clinical symptoms and the degree of dyspnea in patients with stable chronic obstructive pulmonary disease(COPD) Can TCM treatment reduce the number of exacerbations in patients with stable COPD? Can TCM treatment improve the exercise tolerance of patients with stable COPD? Can TCM treatment improve the quality of life of patients with stable COPD? Can TCM treatment delay the decline of lung function in patients with stable COPD? Can TCM treatment improve anxiety and depression in patients with stable COPD? Does the point application therapy benefit patients with stable COPD? Can non-pharmacological treatment benefit patients with stable COPD? Based on these eight clinical problems, the cha-racteristics of TCM itself, and actual clinical situation, the recommendations of TCM to treat the stable COPD were formed in this guideline, with intention to provide advice and guidance to clinicians in the use of TCM to treat stable COPD, to relieve symptoms, improve exercise tolerance, improve health status, prevent disease progression, prevent and treat exacerbations, and improve clinical efficacy. Due to the influence of the user's region, nationality, race and other factors, the implementation of this guideline should be based on the actual situations.
Dyspnea ; Humans ; Medicine, Chinese Traditional ; Pulmonary Disease, Chronic Obstructive/drug therapy* ; Quality of Life ; Treatment Outcome

Aim To investigate the inhibitory effect of cistanche phenylethanol glycosides (CPhGs) on cardiac hypertrophy in rats caused by pressure overload and its related mechanism. Methods Male SD rats(n =70) were randomly divided into control group (Con), sham operation group (Sham), model group (Mod), positive control group (Vst), and different CPhGs dosage (125, 250, 500 mg • kg-1) groups. Cardiac ultrasound indexes, heart-weight to body-weight index (HWI), cardiac histopathological changes, and the area of myocardical cells (AMC) were detected. Plasma ET-1 and BNP levels were detected by Elisa, and protein expressions of phosphorylated PI3K(p-PI3K), PI3K, phosphorylated PKB (p-pKB) and PKB were detected by Western blot. Results Compared with Mod group, LVPWT, HWI, plasma ET-1, BNP and AMC decreased to different degrees. LVEDD, LVEF, LVFS, the protein expressions of myocardial tissues pPI3K and p-PKB increased to different degrees in CPhGs groups. Moreover, the indexes of CPhGs 250 and 500 mg • kg-1 groups were significantly improved compared to those of Mod group (P < 0. 05 or 0. 01). Compared with Vst group, there were no significant difference in CPhGs 500 mg • kg-1 group. Conclusions CPhGs could inhibit cardiac hypertrophy in rats induced by pressure overload, which might be related to the activation of PI3K/PKB signaling pathway.

OBJECTIVE: To investigate the incidence of neonatal asphyxia and possible contributing factors for the development of severe asphyxia in Hubei Enshi Tujia and Miao Autonomous Prefecture, China. METHODS: A total of 16 hospitals in Hubei Enshi Tujia and Miao Autonomous Prefecture were selected as research centers. A retrospective analysis was performed for the clinical data of 22 294 live births in these 16 hospitals from January to December, 2016 to investigate the incidence rate of neonatal asphyxia and possible contributing factors for the development of severe asphyxia. RESULTS: Of the 22 294 neonates born alive, 733 (3.29%) were diagnosed with neonatal asphyxia, among whom 627 had mild asphyxia and 106 had severe asphyxia. The neonates with low maternal education level, maternal anemia during pregnancy, chorioamnionitis, abnormal amniotic fluid, abnormal umbilical cord, placenta previa, placental abruption, Tujia Minority, preterm birth, and low birth weight had a higher incidence of severe asphyxia (P<0.05). CONCLUSIONS The incidence rate of neonatal asphyxia in Hubei Enshi Tujia and Miao Autonomous Prefecture is higher. Low maternal education level, maternal anemia during pregnancy, chorioamnionitis, abnormal amniotic fluid, abnormal umbilical cord, placenta previa, placental abruption, Tujia Minority, preterm birth, and low birth weight may be related to the development of severe neonatal asphyxia.
Asphyxia Neonatorum ; epidemiology ; China ; Humans ; Incidence ; Infant, Newborn ; Retrospective Studies

Objective: To discuss the clinical effect of Dahuang Zhechong Wan on pelvic pain caused by endometriosis with Qi stagnation and blood stasis syndrome and study the mechanism of action. Method: One hundred and twenty-six patients were randomly divided into control group (64 cases) and observation group (62 cases) by random number table. Both groups' patients got Duphaston from the 5^th to 25^th days of menstrual cycle, 1 tablet/day, 2 times/days. Patients in control group got Sanjie Zhentong Jiaonang at the first day of menstruation, 4 grains/time, 3 times/days. Patients in observation group got Dahuang Zhechong Wan, 3 g/time, 2 times/days. The treatment in two groups continued for 3 menstrual cycles. Before treatment and at the first, second and third menstrual cycles after the treatment, visual analogue score (VAS) of pain was used for dysmenorrheal. Before AND after the treatment, scores of symptoms, signs, Qi stagnation and blood stasis syndrome and endometriosis were scored by endometriosis health profile-5 (EHP-5). And hemorheology was detected, and levels of matrix metalloproteinases-2 (MMP-2), MMP-9, tumor necrosis factor-α (TNF-α), interleukin-1 (IL-1), prostaglandin E₂ (PGE₂), prostaglandin F_2α(PGF_2α) and substance P (SP) were detected. Result: By rank sum test, the clinical effect of disease in observation group was better than that in control group (Z=2.198, P<0.05). At the first, second and third menstrual cycles, score of VAS was lower than that in control group (P<0.01). After treatment, scores of symptoms, signs, Qi stagnation and blood stasis syndrome and EHP-5 were lower than those in control group (P<0.01). And the ameliorate of hemorheological indices, such as the whole blood viscosity (high shear and low shear), plasma viscosity, erythrocyte sedimentation rate and platelet aggregation rate, were all better than those in control group (P<0.01). And levels of MMP-2, MMP-9, TNF-α, IL-1, PGF_2α and SP were lower than those in control group (P<0.01), whereas level of PGE₂ was higher than that in control group (P<0.01). Conclusion: In addition to treatment of progestogen, Dahuang Zhechong Wan can relieve pelvic pain, improve quality of life and clinical effect, and regulate levels of prostaglandins, matrix metalloproteinases and proinflammatory factors.

To investigate the current status of the postpartum weight retention (PPWR) in Kaifu District of Changsha, and explore the influential factors with PPWR based on the generalized estimating equation model.
 Methods: A cluster sampling method was applied to select women who gave birth at the health service centers of 3 street communities in Kaifu District of Changsha during 2015. According to the inclusion and exclusion criteria, 783 cases were finally included in the study. Data on PPWR were collected prospectively by using the self-made questionnaire at 1, 3, 6 and 8 months after childbirth. Analysis were performed to investigate the associations between PPWR and its potential factors with generalized estimation equation model.
 Results: The mean PPWR of women was gradually decreased with the increase of postpartum time, and 34.6% of them have returned to the pre-pregnancy weight in the 8 months postpartum. Our findings revealed that gestation weight gain (GWG), pre-pregnancy body mass index, feeding patterns, and delivery mode were significantly associated with maternal PPWR (P<0.05). In contrast, maternal age, educational level, per capita income of family, parity and postpartum depression were not contributed to PPWR (P>0.05).
 Conclusion: GWG is one of the most important predictors for PPWR. The key to reducing PPWR is to control GWG systematically. Early targeted interventions and health education should be taken to prevent women from excessive PPWR at the first-year postpartum, in particular to the women who underwent cesarean deliveries and breastfed their infants. It is conducive to reduce the risks of overweight or obesity caused by PPWR.
Body Mass Index ; Female ; Gestational Weight Gain ; Humans ; Obesity ; Overweight ; Postpartum Period ; Pregnancy

AIM: To investigate the changes of corneal cytology of patients with different degrees of xerophthalmia of the types of deficient aqueous production and over evaporation with confocal microscopy. METHODS:Retrospective case series was adopted with three - dimensional corneal topography and anterior segment analysis system (Sirius system). A total of 33 typical dry eye patients (total 65 eyes) with deficient aqueous production and 28 typical dry eye patients (total 55 eyes) with over evaporation were selected from optical center of the First Affiliated Hospital of Harbin Medical University from December 2016 to June 2017, which were grading according to dry eye degrees. The corneal epithelial cell (surface epithelial cell, pterygoid epithelial cell, basal epithelial cell), Langerhans cell (dendritic cell),stroma (deep stromal layer and superficial stromal layer), the density and form of endothelial cells were observed and analyzed with the confocal microscope. RESULTS: Confocal microscope showed that the number of corneal epithelial cells decreased with the increasing of dry eye severity in patients with tear deficiency and evaporative. The results were statistically significant (P<0.01). The sizes of each layer of corneal epithelium cells were uneven, and the arrangement was irregular. The diameter of corneal sub-epithelial nerve fiber of deficient aqueous production dry eye became thinner with irregular arrangement. With the increase in severity of dry eye,the degree of curvature and branches gradually increased. The activation degree of Langerhans cells of evaporative dry eye was directly proportional to the severity of dry eye(P<0 01). There was no significant changes in the number of superficial stromal cells in the two types of dry eye (P>0 05). The number of deep stromal cells in the two types of dry eye had no relations with the severity of dry eye (P>0. 05). There was no significant changes in the number of corneal endothelial cells in the two types of dry eye (P>0.05). CONCLUSION:The Sirius system can be used for non-contact and non-invasive examination and classification. And there is changes of the density and morphology in each layers of cornea cells of two types of dry eye with the confocal microscope.

Background: Obstructive sleep apnea syndrome (OSAS) is prevalent in obesity and is associated with many metabolic abnormalities. The relationship between OSAS and bone metabolism is still unclear. The aim of this study was to investigate the relationship between the severity of OSAS and bone metabolic markers. Methods: A total of 119 obese males were enrolled in this study in spring months from 2015 to 2017. All candidates underwent polysomnography, and their bone mineral density (BMD) and the serum levels of total procollagen type 1 N-terminal propeptide (t-P1NP), N-terminal midfragment of osteocalcin (N-MID), β-C-terminal telopeptide of type 1 collagen (β-CTX), vitamin D (VD), and parathyroid hormone (PTH) were measured. The analysis of variance and Pearson correlation analysis were performed for data analyses. Results: No significant differences in the mean values of BMD were observed among the obesity, mild-to-moderate OSAS, and severe OSAS groups; and the serum levels of t-P1NP and β-CTX in the severe OSAS group were significantly higher than those in the obesity group (48.42 ± 23.78 ng/ml vs. 31.98 ± 9.85 ng/ml, P < 0.001; 0.53 ± 0.24 ng/ml vs. 0.41 ± 0.13 ng/ml, P = 0.011, respectively). The serum level of VD in the obesity group was significantly higher than those in the mild-to-moderate and severe OSAS groups (both P < 0.001), and decreased as the severity of OSAS increased (P < 0.001). The serum level of PTH in the severe OSAS group was significantly higher than those in the obesity and mild-to-moderate OSAS groups (both P < 0.001). The results of correlation analysis indicated that the level of apnea-hypopnea index (AHI) was correlated with the levels of t-P1NP (r = 0.396, P < 0.001), VD (r = -0.404, P < 0.001), and PTH (r = 0.400, P < 0.001), whereas the level of minimum Osaturation (SaOmin) was correlated with the levels of VD (r = 0.258, P = 0.016) and PTH (r = -0.376, P < 0.001). Conclusions The levels of bone resorption and formation markers in patients with severe OSAS were significantly increased compared to obese men, and the severity of OSAS was correlated with the serum levels of t-P1NP, VD, and PTH.
Biomarkers ; blood ; Bone Density ; Bone and Bones ; metabolism ; Humans ; Male ; Middle Aged ; Obesity ; complications ; Parathyroid Hormone ; Polysomnography ; Sleep Apnea, Obstructive ; complications