Objective To investigate the risk factors for bronchopulmonary dysplasia(BPD)in twin preterm infants with a gestational age of<34 weeks,and to provide a basis for early identification of BPD in twin preterm infants in clinical practice.Methods A retrospective analysis was performed for the twin preterm infants with a gestational age of<34 weeks who were admitted to 22 hospitals nationwide from January 2018 to December 2020.According to their conditions,they were divided into group A(both twins had BPD),group B(only one twin had BPD),and group C(neither twin had BPD).The risk factors for BPD in twin preterm infants were analyzed.Further analysis was conducted on group B to investigate the postnatal risk factors for BPD within twins.Results A total of 904 pairs of twins with a gestational age of<34 weeks were included in this study.The multivariate logistic regression analysis showed that compared with group C,birth weight discordance of>25%between the twins was an independent risk factor for BPD in one of the twins(OR=3.370,95%CI:1.500-7.568,P<0.05),and high gestational age at birth was a protective factor against BPD(P<0.05).The conditional logistic regression analysis of group B showed that small-for-gestational-age(SGA)birth was an independent risk factor for BPD in individual twins(OR=5.017,95%CI:1.040-24.190,P<0.05).Conclusions The development of BPD in twin preterm infants is associated with gestational age,birth weight discordance between the twins,and SGA birth.

Objective: To investigate the response characteristics of patients with locally advanced/metastatic non-squamous non-small cell lung cancer (nsq-NSCLC) treated with tislelizumab in combination with chemotherapy in the first line. Methods: Patients with nsq-NSCLC who achieved complete or partial remission after treatment with tislelizumab in combination with chemotherapy or chemotherapy alone in the RATIONALE 304 study, as assessed by an independent review board, were selected to analyze the response characteristics and safety profile of the responders. Time to response (TTR) was defined as the time from randomization to the achievement of first objective response. Depth of response (DpR) was defined as the maximum percentage of tumor shrinkage compared with the sum of the baseline target lesion length diameters. Results: As of January 23, 2020, 128 patients treated with tislelizumab in combination with chemotherapy achieved objective tumor response (responders), representing 57.4%(128/223) of the intention-to-treat population, with a TTR of 5.1 to 33.3 weeks and a median TTR of 7.9 weeks. Of the responders (128), 50.8%(65) achieved first remission at the first efficacy assessment (week 6), 31.3%(40) at the second efficacy assessment (week 12), and 18.0%(23) at the third and subsequent tumor assessments. The percentages of responders who achieved a depth of tumor response of 30% to <50%, 50% to <70% and 70% to 100% were 45.3%(58/128), 28.1%(36/128) and 26.6%(34/128), respectively, with median progression-free survival (PFS) of 9.0 months (95% CI: 7.7 to 9.9 months), 11.5 months (95% CI: 7.7 months to not reached) and not reached (95% CI: 11.8 months to not estimable), respectively. Tislelizumab plus chemotherapy were generally well tolerated in responders with similar safety profile to the overall safety population. Conclusion: Among responders to tislelizumab in combination with chemotherapy for nsq-NSCLC, 82.0%(105/128) achieves response within the first two tumor assessments (12 weeks) and 18.0%(23/128) achieves response at later (18 to 33 weeks) assessments, and there is a trend toward prolonged PFS in responders with deeper tumor response.
Humans ; Antibodies, Monoclonal, Humanized/therapeutic use* ; Antineoplastic Combined Chemotherapy Protocols/adverse effects* ; Carcinoma, Non-Small-Cell Lung/pathology* ; Lung Neoplasms/pathology* ; Treatment Outcome

To establish a quantitative analysis of multi-components by single marker(QAMS) method for five flavonoids in Rhododendron anthopogonoides and verify its feasibility and applicability in the medicinal materials of R. anthopogonoides. With hyperoside as the internal reference, relative correction factors(RCF) of rutin, quercetin, quercitrin and kaempferol were established by high-performance liquid chromatography(HPLC) analysis. RCFs were used to calculate the content of each component, system durability and relative retention time. Simultaneously, QAMS and external standard method(ESM) were used to determine the content of five flavonoids in 12 batches of R. anthopogonoides from different origins. The results were statistically analyzed to verify the accuracy and feasibility. The fingerprints and cluster analysis data of R. anthopogonoides analyzed and discussed differences among the batches. According to the results, the RCFs of rutin, quercetin, quercetin and kaempferol in R. anthopogonoides were 1.242 6, 0.990 5, 0.535 0, and 0.781 3, respectively. The RCFs represented a good reproducibility under different experimental conditions. Besides, there was no significant difference between QAMS and ESM. Besides, the fingerprint and cluster analysis data showed the consistency between the classification and with the origin distribution of the herbs. In conclusion, the QAMS method shows a good stability and accuracy in the quality control of R. anthopogonoides.
Chromatography, High Pressure Liquid ; Drugs, Chinese Herbal ; Flavonoids ; Medicine, Tibetan Traditional ; Reproducibility of Results ; Rhododendron

Background: Decision-making concerning the treatment of choroid plexus tumor (CPT) in pediatric patients remains a topic of considerable debate. The aim of this work was to describe clinical features and prognostic risk factors of CPT in the pediatric population and to provide theoretical opinions regarding clinical decisions for CPT. Methods: The data of 96 patients with CPT and younger than 14 years were retrospectively analyzed. Clinical characteristics such as pathological type of CPTs, rate and severity of hydrocephalus, treatment and outcome, and recurrence were investigated. For categorical variables, the Pearson's Chi-square test was performed. The Mann-Whitney U-test was used for comparisons between nonnormally distributed parameters. Log-rank test was used for progression-free survival (PFS). Results: The study included 70 choroid plexus papilloma (CPP) cases, 17 atypical choroid plexus papilloma (aCPP) cases, and 9 choroid plexus carcinoma (CPC) cases. Compared with patients with CPP or aCPP, patients with CPC had a shorter disease course (median: CPP, 4 months; aCPP, 2 months; CPC, 1 month; H: 23.5, P < 0.001), higher rate of acute hydrocephalus (CPP, 27.1%; aCPP, 52.9%; CPC, 77.8%; χ = 10.9, P < 0.05), and lower incidence of cure rate (CPP, 85.7%; aCPP, 70.5%; CPC, 33.3%; χ = 13.5, P < 0.05). The severity of hydrocephalus with tumor in the lateral or third ventricle was significantly higher than that with tumors in the fourth ventricle (severe hydrocephalus: lateral ventricle, 51.7%; third ventricle, 47.0%; fourth ventricle, 11.1%; χ = 26.0, P < 0.001). Patients with gross total surgical resection had no better PFS than those with partial resection because of the use of adjuvant therapy in the latter (χ = 4.0, P > 0.05). Patients with CPC experienced shorter time for recurrence than those with CPP or aCPP (χ = 40.1, P < 0.0001). Conclusions Our results indicated that CPP in the fourth ventricle could trigger serious clinical symptoms at an early stage, requiring early intervention. Adjuvant treatment might be necessary for patients with partially resected CPP, aCPP, and CPC to achieve a favorable outcome.
Child ; Child, Preschool ; Choroid Plexus Neoplasms ; mortality ; pathology ; surgery ; Female ; Humans ; Hydrocephalus ; etiology ; Infant ; Male ; Neoplasm Metastasis ; Neoplasm Recurrence, Local ; Prognosis ; Risk Factors

Objective To establish a method for specific gene editing of the second exon of mouse MAD2L1 gene by CRISPR/Cas9, and analyze its off-target effect. Methods The gene editing site for MAD2L1 gene was designed by CHOP?CHOP, and the Cas9?MAD2L1 vector was constructed based on the designed editing site. Cas9?MAD2L1 was then transfected into NIH/3T3 cells and screened with puromycin, followed by observing GFP expression using fluorescence microscopy. The genomic DNA from transfected cells was extracted and a partial fragment of MAD2L1 gene was amplified by PCR. T7E1 analy?sis and Sangger sequencing were used for gene editing and off?target analysis. Results After Cas9?MAD2L1 transfection and puromycin screening, a large number of GFP?expressing cells were observed under the fluorescence microscope. Combined the PCR result with TE71 analysis, the amplified 228 bp PCR products can be digested into 166 bp and 62 bp fragments. The se?quencing result showed that the second exon of MAD2L1 gene was successfully edited, and the off?target effect was undetected in our system. Conclusions The method for specific gene editing of the second exon of mouse MAD2L1 gene by CRISPR/Cas9 is successfully established, and off?target effect of MAD2L1 gene is not detected.

OBJECTIVETo evaluate the follow-up efficacy and safety on slow transit constipation (STC) treated with individualized deep puncture at Tianshu (ST 25).

METHODSOne hundred and twenty-eight cases of STC were randomized into a deep puncture group (64 cases), a western medication group (31 cases) and a shallow puncture group (33 cases) at the ratio of 2:1:1. In the deep puncture group, electroacupuncture of deep puncture was applied to bilateral Tianshu (ST 25). The needle was inserted perpendicularly and slowly at the acupoint and went deeply till penetrating the peritoneum, about 20 to 65 mm in depth. In the western medication group, lactulose oral liquid was prescribed for oral administration. In the shallow puncture group, electroacupuncture of shallow puncture was done at bilateral Tianshu (ST 25). The needle was inserted perpendicularly and slowly, 5 to 8 mm in depth. The treatment lasted 4 weeks in the three groups and the follow-up visit of 12 weeks and 6 month after treatment was performed respectively. The weekly defecation frequency, patient's satisfaction and safety of deep puncture at Tianshu (ST 25) were assessed before and after treatment in each group.

RESULTSIn the deep puncture group, the weekly defecation frequency was (1.79 +/- 1.05) times/week before treatment and was (3.90 +/- 1.43) times/week after 4-week treatment. It was (3.49 +/- 1.46) times/week in 12-week follow-up visit after treatment and was (3.51 +/- 1.42) times/week in 6-month follow-up visit after treatment. In the deep puncture group, the improvements in weekly defecation frequency, patient's satisfaction and short-term efficacy were same as those in the western medication group and the shallow puncture group (all P > 0.05). The long-term efficacy in follow-up visit was better remarkably than that in the western medication group (P < 0.05, P < 0.01). Besides, the combined medication was reduced and no adverse reaction occurred.

CONCLUSIONThe individualized deep puncture at Tianshu (ST 25) is effective in the treatment of STC and achieves the satisfactory long-term efficacy. This therapy displays the good effective advantage and deserves to be promoted in clinical practice of acupuncture and moxibustion therapeutic program as compared with the first-tier line of medication, lactulose oral liquid, recommended at home and abroad, in terms of the evidence-based medicine.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Aged ; Constipation ; physiopathology ; psychology ; therapy ; Defecation ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Patient Satisfaction ; Treatment Outcome ; Young Adult

Adolescent ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Logistic Models ; Lung Diseases, Interstitial ; diagnostic imaging ; Male ; Radiography, Thoracic ; methods ; Tomography, X-Ray Computed ; methods

ObjectiveTo explore the curative effect in the patients with internal endometriosis by interventional therapy.MethodsUsing Seldinger technique,34 cases with internal endometriosis wereperformed bilateral uterine artery embolization.Observed postoperative menstrual quantity,dysmenrrhea degree,anemia and the change of the volume of uterine lesions.ResultsAll the patients were followed up for 1-3 years,menstrual quantity average decreasd of 59.1％P ＜ 0.05 ),the symptoms of dysmenorrhea was significantly eased in 28 cases (82.4％,28/34).All the patients of anemia haemoglobin were back to normal,volume of uterus average reduced 43.8％P ＜ 0.05 ),lesion was obviously smaller or disappear.Ultrasonography showed myometrium and blood flow signal of lesion was was obviously reduced.Conclusion Internalendometriosis by interventional therapy can get good results,symptoms improve significantly.

Objective To investigate the diagnosis and treatment of intracranial venous sinus thrombosis caused by trauma. Methods The clinical data of 13 patients had definite diagnosis by clinic and imaging, were analyzed retrospectively. Three patients received removal of hematoma and bone flap operation; 2 received anticoagulant therapy in early phase and intravenous thrombolysis; 2 accepted intrasinus interventional catheter-directed thrombolysis; ventriculoperitoneal shunt operation was performed in 1 patient for enjoying sub-optimal effects of conservative treatment; and the other 5 patients with transverse sinus embolism accepted conventional treatment for their symptom-free or having mild symptom. Results Intracranial venous sinus thrombosis caused by trauma was likely to locate in the superior sagittal sinus and transverse sinus; these patients mostly manifested as severe diffuse brain swelling combined with a fractured skull, epidural hematoma or intracerebral hematoma. Ten patients got clinical cure, 2 focal symptom and 1 mild mental retardation. Three days to 6 months after treatment, good results were noted in 8 patients performed DSA and in 5 patients performed MRV. Conclusion Early treatment should be given once the definite diagnosis is made in patients with intracranial venous sinus thrombosis caused by trauma, and anticoagulant and thrombolytic therapy are the main methods.

Objective To explore the influence of combined warming measure on intraoperative temperature and coagulation function in patients during gynecologic laparoscopic surgery. Methods A total of 70 patients undergoing gynecologic laparoscopic surgery were randomly divided into the intervention group ( n =35 ) and the control group ( n = 35 ). The intervention group received combined warming measure including using inflatable warming blanket, beating transfusion and rinses, while the regular nursing was performed in the control group. The core body temperature of the patients were recorded before operation, 1 hour after the beginning of operation and at the completion of operation. The amounts of blood loss were recorded as well. The index of coagulation function before and after operation were detected. Results Compared with the intervention group, the core body temperature 1 hour after the beginning of operation and at the completion of operation were lower; the amounts of blood loss were larger; the thrombin time prolonged; the fibrinogen and peripheral blood platelets were lower in the control group. There were statistical meanings in all of the defferences ( P ＜ 0. 05 ).Conclusions Combined warming measure can effectively prevent intraoperative hypothermia, improve the coagulation function disorders and reduce the amounts of blood loss. The method can be used in clinic widely.