OBJECTIVES: To investigate the risk factors for neonatal asphyxia in Hubei Enshi Tujia and Miao Autonomous Prefecture and establish a nomogram model for predicting the risk of neonatal asphyxia. METHODS: A retrospective study was conducted with 613 cases of neonatal asphyxia treated in 20 cooperative hospitals in Enshi Tujia and Miao Autonomous Prefecture from January to December 2019 as the asphyxia group, and 988 randomly selected non-asphyxia neonates born and admitted to the neonatology department of these hospitals during the same period as the control group. Univariate and multivariate analyses were used to identify risk factors for neonatal asphyxia. R software (4.2.2) was used to establish a nomogram model. Receiver operator characteristic curve, calibration curve, and decision curve analysis were used to assess the discrimination, calibration, and clinical usefulness of the model for predicting the risk of neonatal asphyxia, respectively. RESULTS: Multivariate logistic regression analysis showed that minority (Tujia), male sex, premature birth, congenital malformations, abnormal fetal position, intrauterine distress, maternal occupation as a farmer, education level below high school, fewer than 9 prenatal check-ups, threatened abortion, abnormal umbilical cord, abnormal amniotic fluid, placenta previa, abruptio placentae, emergency caesarean section, and assisted delivery were independent risk factors for neonatal asphyxia (P<0.05). The area under the curve of the model for predicting the risk of neonatal asphyxia based on these risk factors was 0.748 (95%CI: 0.723-0.772). The calibration curve indicated high accuracy of the model for predicting the risk of neonatal asphyxia. The decision curve analysis showed that the model could provide a higher net benefit for neonates at risk of asphyxia. CONCLUSIONS The risk factors for neonatal asphyxia in Hubei Enshi Tujia and Miao Autonomous Prefecture are multifactorial, and the nomogram model based on these factors has good value in predicting the risk of neonatal asphyxia, which can help clinicians identify neonates at high risk of asphyxia early, and reduce the incidence of neonatal asphyxia.
Infant, Newborn ; Humans ; Male ; Pregnancy ; Female ; Nomograms ; Retrospective Studies ; Cesarean Section ; Risk Factors ; Asphyxia Neonatorum/etiology*

OBJECTIVE: To investigate the current status and further development of Panax genus and 6 important individual species including P. notoginseng, P. quinquefolium, P. vietnamensis, P. japonicus, P. stipuleanatus and P. zingiberensis. METHODS: The bibliometric analysis was based on the Web of Science core database platform from Thomson Reuters. Totally, 7,574 records of scientific research of Panax species published from 1900-2019 were analyzed. The statistical and visualization analysis was performed by CiteSpace and HistCite software. RESULTS: The academic research of Panax species increase promptly. Plant science is the main research field while research and experimental medicine and agricultural engineering will be the further development tendency. Particularly, the discrimination research of P. notoginseng will be the research tendency among Panax species, especially diversity research. In addition, P. vietnamensis deserves more attention in the genus Panax. CONCLUSION This research provides a reference for further research of the genus and individual species.
Bibliometrics ; Panax

OBJECTIVE: To investigate the current status of antibiotic use for very and extremely low birth weight (VLBW/ELBW) infants in neonatal intensive care units (NICUs) of Hunan Province. METHODS: The use of antibiotics was investigated in multiple level 3 NICUs of Hunan Province for VLBW and ELBW infants born between January, 2017 and December, 2017. RESULTS: The clinical data of 1 442 VLBW/ELBW infants were collected from 24 NICUs in 2017. The median antibiotic use duration was 17 days (range: 0-86 days), accounting for 53.0% of the total length of hospital stay. The highest duration of antibiotic use was up to 91.4% of the total length of hospital stay, with the lowest at 14.6%. In 16 out of 24 NICUs, the antibiotic use duration was accounted for more than 50.0% of the hospitalization days. There were 113 cases with positive bacterial culture grown in blood or cerebrospinal fluid, making the positive rate of overall bacterial culture as 7.84%. The positive rate of bacterial culture in different NICUs was significantly different from 0% to 14.9%. The common isolated bacterial pathogens Klebsiella pneumoniae was 29 cases (25.7%); Escherichia coli 12 cases (10.6%); Staphylococcus aureus 3 cases (2.7%). The most commonly used antibiotics were third-generation of cephalosporins, accounting for 41.00% of the total antibiotics, followed by penicillins, accounting for 32.10%, and followed by carbapenems, accounting for 13.15%. The proportion of antibiotic use time was negatively correlated with birth weight Z-score and the change in weight Z-score between birth and hospital discharge (r=-0.095, -0.151 respectively, P<0.01), positively correlated with death/withdrawal of care (r=0.196, P<0.01). CONCLUSIONS Antibiotics used for VLBW/ELBW infants in NICUs of Hunan Province are obviously prolonged in many NICUs. The proportion of routine use of third-generation of cephalosporins and carbapenems antibiotics is high among the NICUs.
Anti-Bacterial Agents ; Birth Weight ; Humans ; Infant ; Infant, Extremely Low Birth Weight ; Infant, Newborn ; Intensive Care Units, Neonatal ; Surveys and Questionnaires

Objective:To investigate the clinical, neuropsychological and regional cerebral blood flow (rCBF) characteristics in patients with psychiatric symptoms caused by nitrous oxide abuse.Methods:Twelve patients with psychiatric symptoms caused by nitrous oxide abuse were enrolled from February 2018 to February 2020 in the Department of Neurology, China-Japan Friendship Hospital and the First Hospital of Tsinghua University.All patients were scored with the brief psychiatric rating scale (BPRS), Hamilton depression scale (HAMD), Hamilton anxiety scale (HAMA), mini-mental state examination (MMSE) and Montreal cognitive assessment (MoCA). The SPECT/CT images were collected with low-energy and high-resolution collimator.After the pictures were reconstructed, 18 brain regions were automatically sketched and calculated by Database Comparison software.The statistical value of the difference between the general mean value of each brain region and that of the corresponding region of interest in the same age group was estimated.Results:(1)The clinical manifestations of 12 patients were anxiety, depression, hallucination, delusion, and 7 patients were accompanied by cognitive decline.(2)Neuropsychological examination: BPRS score was 57.83±11.15 (anxiety depression factor was 3.94±0.47; lacking active factor was 3.25±0.85; thinking disturbance factor was 3.21±1.27; activity factor was 2.28±0.56; hostility factor was 3.14±1.24). The score of self-knowledge impairment was 2.92±1.08, the score of inability to work was 4.50±1.17, the score of HAMD was 32.75±10.13, the score of HAMA was 18.67±5.80, the score of MMSE was 27.67±2.50, and the score of MoCA was 24.58±3.78.(3)SPECT showed that compared with the general mean value of the corresponding regions of interest of normal people, the patients showed hypoperfusion in the frontal lobe (7 patients, 58.30%) and the temporal lobe (8 patients, 66.70%).Conclusion:Nitrous oxide abuse has an obvious effect on rCBF.The psychiatric symptoms include anxiety, depression, hallucination, delusion and so on, which affect the ability to work and learn.SPECT has important value in the diagnosis of nitrous oxide abuse, and indicates changes in local brain functional activity.

Objective To summarize surgical treatment of Takayasu arteritis,and analysis the drug treatment effect during the perioperative period.Methods Retrospective analysis 46 patients with Takayasu's arteritis disease and received cardiovascular surgery between January 2010 to December 2015,in Anzhen Hospital.By collecting their clinical characteristics,preoperative drug therapy,surgical treatment,pathological examination results to analyze operation conditions,effect of drugs and preoperative conditions.Results The perioperative mortality rate was 2.2％ and the complication rate was 23.9％ in 46 patients.There were 34 patients with symptomatic relief in the perioperative period,11 patients didn't take hormone drugs before operation.There were 11 cases of complications during the perioperative period,of which 7 patients were in active stage and 10 patients had not been used before operation.Conclusion The surgical treatment of patients with Takayasu's arteritis disease can effectively improve symptoms.The patients in Takayasu's arteritis active stage will affect the outcome of the surgery.Rational use of hormone drugs before surgery,can effectively control the patient's condition,improve the rate of remission of symptoms,and effectively reduce the incidence of perioperative complications.

Objective To compare the clinical efficacy and safety of levetiracetam tablet and carbamazepine tablet in the treatment of children's intractable epilepsy.Methods A total of 96 children with intractable epilepsy were randomly divided into control group and treatment group with 48 cases per group.Control group was given carbamazepine 4-8 mg · kg-1 · d-1,tid,oral.Treatment group was given levetiracetam 4 mg · kg-1,bid,the maximum dose was 16 mg · kg-1 at the speed as 4 mg · kg-1 with every 2 weeks.Two groups were treated for 8 months.The clinical efficacy,neurocognitive function test [verbal intelligence quotient(VIQ),performance intelligence quotient (PIQ),total intelligence quotient(TIQ) and short-term visual memory],and adverse drug reactions were compared between two groups.Results After treatment,the total effective rates in treatment and control groups were 87.50％ (42 cases/48 cases) and 79.17％ (38 cases/48 cases) with significant difference (P ＜ 0.05).After treatment,the main indexes in treatment and control groups were compared:VIQ were (106.97 ± 5.65) and (95.25 ± 3.28) points,PIQ were (116.45 ± 5.16) and (103.61 ± 2.74) points,TIQ were(119.92 ± 4.69) and(95.20 ± 3.24) points,short-term visual memory were (18.45 ± 2.17) and (13.84 ± 1.81) s,the differences were statistically significant (all P ＜ 0.05).The adverse drug reactions of two groups were based on emotional,drowsiness,palpitations and dizziness,also,the incidences of adverse drug reactions in treatment and control groups were 12.50％ and 16.67％ without significant difference (P ＞ 0.05).Conclusion Levetiracetam tablet has a definitive clinical efficacy in the treatment of children's intractable epilepsy,which is better than carbamazepine tablet.Levetiracetam tablet can improve the cognitive ability for children's intractable epilepsy,without increasing the incidence of adverse drug reactions.

OBJECTIVETo investigate the effect of premature rupture of the membrane (PROM) on neonatal complications in premature infants.

METHODSThe registration information of 7684 preterm infants with gestational age <37 weeks were collected from the cooperative units in the task group between January 1, 2014 to December 31, 2014. Specially trained personnel from each cooperative units filled in the unified form in a standardized format to record the gender, gestational age, birth weight, PROM, placental abruption, antenatal corticosteroid, Apgar score, amniotic fluid pollution, and complications of the infants. The data were analyzed comparatively between the cases with PROM and those without (control).

RESULTSThe preterm mortality rate was significantly lower but the incidences of ICH, NEC, ROP and BPD were significantly higher in PROM group than in the control group (P<0.05). The 95% confidence interval of the OR value was <1 for mortality, and was >1 for ICH, NEC, ROP and BPD. After adjustment for gestational age, birth weight, gender, mode of delivery, placental abruption, placenta previa, prenatal hormones, gestational diabetes mellitus (GDM), gestational period hypertension and 5-min Apgar score <7, the incidences of NEC, ROP and BPD were significantly different between the two groups (P<0.05) with 95% confidence interval of OR value >1, but the mortality rate and incidence of ICH were not significantly different between the two groups (P>0.05).

CONCLUSIONPROM is a risk factor for NEC, ROP and BPD in preterm infants, and adequate intervention of PROM can reduce the incidences of such complications as NEC, ROP and BPD in the infants.

Apgar Score ; Birth Weight ; Female ; Fetal Membranes, Premature Rupture ; pathology ; Gestational Age ; Humans ; Incidence ; Infant, Newborn ; Infant, Newborn, Diseases ; etiology ; Infant, Premature ; Pregnancy ; Risk Factors

OBJECTIVETo observe the therapeutic effect and relevant mechanism of shuxuening Injection (SI) in treating patients with active ulcerative colitis (UC).

METHODSTotally 91 patients with active UC were randomly assigned to 2 groups, 44 in the control group and 47 in the treatment group. Patients in the control group received routine treatment, while patients in the treatment group additionally received intravenous injection of SI (15 mL), twice daily for 14 days in total. Colonoscopy was performed before and after treatment. The therapeutic effect was assessed by Mayo scoring system and the grading of activities evaluated by Baron endoscope. Serum levels of IL-6 and TNF-α were detected by ELISA. The activity of SOD was detected by xanthine oxidase method. The content of MDA was detected by thiobarbituricacid (TBA). Besides, 20 healthy subjects were recruited as the healthy control group.

RESULTSTotally 82 patients completed the study (40 in the control group and 42 in the treatment group). There was no statistical difference in serum levels of IL-6, TNF-α, SOD, MDA, the Mayo score and endoscope grading between the two groups before treatment (P >0. 05). Compared with the healthy control group, serum levels of IL-6, TNF-α, MDA significantly increased (P <0.01), and the serum SOD level decreased (P < 0. 05) in the treatment grup and the control group before treatment. Compared with before treatment in the same group, serum levels of IL-6, TNF-α, MDA, the Mayo score and endoscope grading all decreased in the treatment group and the control group after treatment (P <0. 01, P <0. 05). Compared with the control group after treatment, serum levels of IL-6, TNF-α, MDA, the Mayo score and endoscope grading all decreased (P <0.01, P <0.05), the serum SOD level increased (P <0.05) in the treatment group after treatment. The serum SOD level was obviously negative correlated with serum levels of IL-6, TNF-a, Mayo score, and endoscope score (r = -0. 621, -0.638, -0. 509, -0.787, P <0.01). The serum MDA level was obviously positive correlated with serum levels of IL-6, TNF-α, Mayo score, and endoscope score (r =0.711, 0. 882, 0. 525, 0. 639, P <0.01).

CONCLUSIONSI could improve inflammatory injury and clinical symptoms of patients with active UC, and its mechanism might be associated with antioxidant and scavenging oxygen free radicals.

Colitis, Ulcerative ; blood ; drug therapy ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Inflammation ; drug therapy ; Interleukin-6 ; blood ; Tumor Necrosis Factor-alpha ; blood

AIMTo observe protective effects of safflower injection (SI) on lung ischemia/reperfusion injury (LIRI) and investigate its potential mechanism.

METHODSRabbit lung model of ischemia/reperfusion injury was constituted in vivo. The rabbits were randomly divided into three groups: sham-operation group (S group), ischemia/reperfusion group (I/R group) and ischemia/reperfusion plus safflower injection group (SI group). Malondialdehyde (MDA) content, superoxide dismutase (SOD) and xanthine oxidase (XO) activities in serum were measured. The lung tissue sampled at the end of the experiment was assayed for wet/dry weight ratio (W/D), injured alveoli rate (IAR) and ultrastructural changes were observed under electron microscope. The expression of COX-1 and COX-2 were measured by immunohistochemistry (IHC). The expressions of COX-1mRNA and COX-2mRNA were observed by in situ hybridization (ISH).

RESULTSIn I/R group, XO and MDA increased and SOD decreased in serum, while the same changes happened in SI group but less severely(P<0.01). The value of W/D and IAR was much higher in I/R group than S group, but decreased in SI group. Electron microscope showed obvious ultrastructural injury brought by LIRI in I/R group, which was greatly attenuated in SI group. The IHC and ISH demonstrated that COX-2 and COX-2mRNA in pulmonary tissue of I/R group were significantly higher than those of SI group (P < 0.01). The difference of COX-1 and COX-1mRNA in pulmonary tissue among the three groups was not significant.

CONCLUSIONThe ischemia/reperfusion lung injury insults induced the regulation of COX-2 in lung. Safflower injection may attenuate lung ischemia/reperfusion injury through inhibiting cyclooxygenase-2 expression.

Animals ; Carthamus tinctorius ; Cyclooxygenase 1 ; metabolism ; Cyclooxygenase 2 ; metabolism ; Lung ; drug effects ; enzymology ; physiopathology ; Malondialdehyde ; blood ; Rabbits ; Reactive Oxygen Species ; metabolism ; Reperfusion Injury ; metabolism ; Superoxide Dismutase ; blood ; Xanthine Oxidase ; blood

AIMTo observe protective effects of polydatin (PD) during lung ischemia/reperfusion injury (LI/RI) and investigate its potential mechanism .

METHODSRabbit lung model of ischemia/reperfusion injury was constituted in vivo. The 40 rabbits were randomly divided into four groups (n = 10): control group (C group), ischemia/reperfusion group (I/R), PD + I/R group (PD) and PD+ polymyxin B (PMB) + I/R group (PMB). The blood specimen gathered at different time points were tested for the content of melondialdehyde (MDA) and the enzyme activity of superoxide dismutase (SOD). The lung tissue sampled at the end of the experiment were assayed for wet/dry weight ratio (W/D), injured alveoli rate (IAR) and observing ultrastructure changes under electron micro scope.

RESULTS(1) The activity of SOD showed a similar time-dependent decline in I/R group and PMB group during I/R, while in PD group this tendency was milder (P < 0.01 vs I/R group). (2) In contrast to the results above, the level of MDA markedly increased in I/R and PMB group, but was slowed down in PD group (P < 0.01 vs I/R group). (3) The value of W/D) and IAR was much higher in I/R and PMB group (P < 0.05 or P < 0.01 vs C group). In PD group, it was decreased (P < 0.01 vs I/R group or PMB group). (4) Electron microscope showed obvious ultrastructure injury brought by LI/RI in I/R group and PMB group, which was greatly attenuated in PD group.

CONCLUSIONPD can protect lung from LI/RI, and PKC may participate in its mechanisms.

Animals ; Female ; Glucosides ; pharmacology ; Lung ; blood supply ; Male ; Protective Agents ; pharmacology ; Protein Kinase C ; metabolism ; Rabbits ; Random Allocation ; Reperfusion Injury ; metabolism ; physiopathology ; prevention & control ; Stilbenes ; pharmacology