Objective:To explore the influencing factors of acute bilirubin encephalopathy (ABE) in neonates with severe hyperbilirubinemia.Methods:A total of 123 cases of severe neonatal hyperbilirubinemia (serum total bilirubin > 342 μmol/L) in our hospital from January 2018 to May 2020 were retrospectively analyzed.According to the occurrence of ABE, they were divided into ABE group (28 cases) and non-ABE group (95 cases). The perinatal data and laboratory examination results between two groups were compared.The variables with statistical differences in univariate analysis were included in multivariate Logistic regression analysis.Results:Univariate analysis showed that the hemoglobin level and hematocrit of ABE group were higher than those of non-ABE group.The total bilirubin value, length of hospital stay, natural childbirth, mixed feeding, infection with craniocerebral hemorrhage were all higher than those in the non-ABE group, and the differences were statistically significant( P<0.05). Multivariate Logistic regression analysis showed that high hemoglobin level ( OR=1.032, 95% CI 1.007 to 1.057) and long hospital stay ( OR=1.15, 95% CI 1.007 to 1.312) were independent risk factors for ABE patients.Breastfeeding was a protective factor for ABE patients( OR=0.151, 95% CI 0.028 to 0.821). Conclusion:High hemoglobin value and long hospital stay are independent risk factors for ABE patients, and breast feeding is a protective factor for ABE.

Objective:To assess the efficacy of immunosuppressor on treatment of Henoch-Sch?nlein purpura nephritis(HSPN).Methods:Literatures were searched in PubMed, Cochrane library, Web of Science, Wanfang database, CNKI and CBM database from inception to January 2021.The studies that investigated the effect of immunosuppressor on HSPN outcomes were included.Article screening, data extraction and quality assessment were accomplished by two investigators independently, and statistical analyses were performed by STATA 14.Results:Ten studies were included with 443 cases, of which, 245 cases were in the experimental group while 198 cases were in the control group.The Meta-analysis showed that the experimental group had higher complete remission rate( OR=1.95, 95% CI 1.19-3.22, P=0.009), total remission rate ( OR=2.92, 95% CI 1.74-4.88, P<0.001), proteinuria decreasing level ( SMD=0.35, 95% CI 0.09-0.61, P=0.008), the increasing level of serum albumin ( SMD=1.27, 95% CI 0.43-2.11, P=0.003) and the increasing level of estimated glomerular filtration rate ( SMD=0.48, 95% CI 0.21-0.76, P=0.001), lower relapse rate ( OR=0.19, 95% CI 0.05-0.72, P=0.015) as well as death rate ( OR=0.19, 95% CI 0.04-0.78, P=0.021)than those of the control group. Conclusion:The immunosuppressor could enhance complete remission rate, total remission rate, proteinuria decreasing level, the increasing level of serum albumin and the increasing level of estimated glomerular filtration rate, reduce relapse rate and death rate of HSPN patients.

Henoch-Schonlein purpura (HSP) is a type of systemic leucocytoclastic vasculitis mediated by IgA immune complex deposition, which mainly affects the skin, joints, gastrointestinal tract and small blood vessels in the glomeruli.It is a common systemic vasculitis in children.Due to severe complications of HSP, conventional clinical medicine has limited efficacy in some serious, even life-threatening or organ dysfunction cases, such as advanced renal insufficiency, fatal gastrointestinal bleeding, nervous vasculitis, pulmonal bleeding, etc.As an adjunctive therapy, plasma exchange has led to significant results for this type of HSP.In this paper, the status of plasma exchange in HSP treatment was reviewed.

Objective:To evaluate the characteristics and risk factors for blood transfusion in very low birth weight infants(VLBWI).Methods:Clinical data of one hundred VLBWI, hospitalized from July, 2016 to June, 2019, were studied retrospectively.The infants were divided into two groups according to whether they received blood transfusion.The general information, incidence of diseases and treatment measures were compared between two groups.The risk factors influencing the blood transfusion were analyzed.Results:Of the one hundred VLBWI, sixty-nine cases needed blood transfusion.The first time of blood transfusion ranged from one to four weeks after birth, and average number of transfusions was 6 times.Maternal anemia during pregnancy, birth weight, gestational age, hemoglobin and hematocrit at birth, volume of blood taking within two weeks after birth, duration of hospitalization, duration of paraenteral nutrition, delivery method, need for intubation and neonatal respiratory distress syndrome, apnea, bronchopulmonary dysplasia, patent ductus arteriosus showed significant differences between the two groups( P<0.05). Logistic regression analysis revealed that lower gestation( OR=0.386, 95% CI 0.212-0.704, P=0.002), longer duration of hospital stay( OR=2.177, 95% CI 1.170-4.049, P=0.014), prolonged parenteral nutrition( OR=1.195, 95% CI 1.083-1.319, P<0.001), greater volume of blood taking within two weeks after birth ( OR=1.269, 95% CI 1.083-1.487, P=0.003)and cesarean delivery( OR=5.513, 95% CI 1.056-28.770, P=0.043) were associated with increasing risk of blood transfusion in VLBWI. Conclusion:The gestational age, length of hospital stay, blood intake within two weeks after birth, duration of paraenteral nutrition and delivery method all affected the risk of blood transfusion to varying degrees.

Objective To evaluate the efficacy and safety of 13-cis retinoid acid (13-CRA) and all trans retinoid acid (ATAR) redifferentiation therapy in patients with poorly differentiated thyroid cancer. Methods A single-center, randomized, double-blind, parallel controlled clinical trial was preformed. All patients were randomized into three groups. 78 cases were enrolled in each group. The patients were treated by 13-CRA in A group, by ATRA in B group, and by placebo in control group. The induced effects of retinoid acid (RA) and 131I treatment efficacies were defined as primary outcome of efficacy. Results After RA induction therapy, the effective rates in A, B, and control groups were 59.72%, 52.86% and 7.69%, respectively, with statistically significant difference among 3 groups (P<0.05). Compared with control group, A and B groups revealed significant induced efficacies (P<0.017), but there was no significant difference between A group and B group. After 131I treatment, the effective rates in A, B, and control group were 70.83%, 64.29%, and 28.21% respectively, with statistically significant difference (P<0.05). Compared with control group, the effective rates of 131I treatment in A and B groups were significantly raised (P<0.017), but there was no significant difference between A group and B group. The damage of skins and mucous membranes such as desquamation, dry skin, dry lips, dry eyes, etc occurred mostly in A group. The symptoms of nervous system such as headache, dizziness, etc occurred mostly in B group. Conclusions The induced differentiation of 13-CRA or ATRA is an effective method for the treatment of poorly differentiated thyroid carcinoma.

Objective To investigate the value of ADC and FA of diffusion tensor imaging(DTI)and T2 value of T2 mapping for assessing lumbar intervertebral disc degeneration.Methods 12 cases of healthy volunteers(8 males and 4 females),28 cases of patients with chronic low back pain(15 males and 13 females,19-70 years old)were performed lumbar spine MRI,DTI and T2 mapping to obtain ADC,FA and T2 value.Intervertebral discs were classified according to the Pfirrmann grading.The correlations of different degeneration grade with ADC,FA and T2 value were analyzed.The diagnostic value of ADC,FA and T2 values of lumbar intervertebral disc degeneration were compared. Results Both ADC value and T2 value were significantly negative correlated with lumbar intervertebral disc degeneratic Pfirrminn grading(r=-0.779,r=-0.708,P<0.001).FA value were positively correlated with Pfirrminn grading(r=0.474,P<0.001), the correlation was not closely.Conclusion DTI and T2 mapping can be effectively used to quantitatively evaluate the degeneration degree of lumbar intervertebral disc,the diagnostic value of ADC was the highest,followed by T2 ,and FA was the worst.

Objective To study the effect of hepatitis E virus Open Reading Frame 3 protein on the proliferation and cell cycle of Chang liver cells (CCL13).Methods The pDsRed-Monomer-N1-ORF3 recombinant plasmid was transfected into CCL13 cells via lipofectamine 2 000 reagent,then assayed cell proliferation by MTT assay;Flow cytometric was used to detect cell cycle after dying with PI;and the cell cycle proteins expression were detected by western-blotting.Results pDsRed-Monomer-N1-ORF3 recombinant plasmid was successfully transfected into CCL13 cells,Expression of ORF3 can inhibit the proliferation activity of CCL13 cells from the 3rd day (P ＜ 0.01),and prevent the cell cycle in G0/G1 phase;Western Blot showed expression of cell cycle proteins cyclin D1 and cyclin E1 were decreased in ORF3 group compared with the control group;However,the expression of cyclin A2 and cyclin B1 had no significantly difference in three groups.Conclusions HEV-ORF3 can inhibits the proliferation activity of CCL13 cells by inhibition expression of cell cycle proteins cyclin D1 and cyclin E1.

Objective To explore the abnormal karyotype characteristics of myelodysplastic syndrome (MDS)patients and their correlation with clinical prognosis.Methods Analyzed the karyotypes of 281 MDS patients by use of G-banding tech-nique.Results Through analysis of the karyotypes of 281 MDS patients,found that the percentage of abnormal karyotypes was 48.75% (137/281),among 137 patients with abnormal karyotypes,43.07% (59 cases)presented with numerical aber-ration,31.39% (43 cases)with structural aberration,and 25.54% (35 cases)with both numerical and structural abnormali-ties.As for MDS subtypes,the occurrence rate of abnormal karyotype was 63.41% (26/41)in RAEB-2,58.73% (37/63)in RAEB-1,39.2% (49/125)in RCMD,15.38% (2/13)in RAS and 22.58% (7/31)in RA.The rates of abnormal karyotype in RAEB-1 and RAEB-2 were significantly higher than that in RA and RAS(P<0.01),and in RCMD (P <0.05).The fre-quent abnormal karyotypes were as follows:+8,-7/7q-,-20/20q-,complex karyotypes chromosomal translocation,i(17),-Y and +21.The follow-up study of 159 MDS patients indicated that the median survival time was 39 months for 68 patients with normal karyotypes and 21 months for 91 patients with abnormal karyotypes,the former was significantly prolonged than the latter (P < 0.05).As far as the leukemia transition rate was concerned,the patients with aberrant karyotypes (35.5%)were significantly higher than that with normal karyotypes (10.3%)(P < 0.01),among them,the cases with complex karyotypes and-7/7q-more easily transit into leukemia.Conclusion MDS was one kind of clonal hematological ma-lignancy with high heterogeneity.Chromosomal karyotype test plays an important role in the correct diagnosis,typing and prognosis evaluation of MDS.

Objectives To investigate the serum uric acid level and its related factors in obese children. Methods Obese children were selected from all pupils (ages 7-14) of 3 primary schools. Age-and sex-matched children with normal body mass index (BMI) were chosen as normal controls. Fasting venous blood samples were collected to detect uric acid (UA), glucose (GLU), total cholesterol (CHOL), triacylglycerol (TG), high-density lipoprotein cholesterol (HDL-C) and low-density lipopro-tein cholesterol (LDL-C). Results Sixty-eight (2.2%) obese children (57 boys and 11 girls) were detected from 3 000 children. Compared with 136 normal controls, the blood pressure (BP), levels of UA, CHOL, TG and LDL-C, and waist circumference (WC) were higher while HDL-C was lower in obese children (P<0.05). The detection rate of hyperuricemia in obese children (35.3%) were signiifcantly higher than that in normal controls (5.9%) (P<0.05). UA was positively related with WC, BMI, BP and TG, negatively related with HDL-C. Conclusions Obesity can lead to higher serum UA, higher BP and abnormal lipid metabolism. The level of serum UA was correlated with BP and abnormal lipid metabolism.

Objective To observe on the clinical effect and the influence of the level of plasma vascular endothelial growth factor (VEGF), vascular endothelial growth factor receptor (VEGFR) and basic fibroblast growth factor (bFGF) in acute leukemia before and after treatment by thalidomide combined with chemotherapy. Methods Thirty-six cases of acute leukemia patients were randomly divided into experimental group and control group by 18 cases each. Each group was treated with conventional chemotherapy in the standard-dose, meanwhile in the experimental group additional thalidomide 100 mg/day were taken orally. Before treatment and 8 weeks after treatment, plasma were collected for the detection of VEGF, VEGFR and bFGF content by double antibody sandwich enzyme-linked immunosorbent assay (ELISA).Results The ratio of experimental group and control group, were 88.9 % (16/18), 77.8 % (14/18)respectively and the difference was statistically significant (x2 =4.103, P ＜0.05). The level of plasma VEGF (389.78+249.94 pg/ml, 318.54±125.78 pg/ml) of experimental group and control group before treatment was statistically significant (t = 3.141, t =3.024, P ＜0.01) compared with healthy group [(132.91±26.66) pg/ml] respectively. The level of plasma VEGF of those groups after treatment [(211.74+36.72) pg/ml, (288.02±31.77) pg/ml] was statistically significant (t =2.413, t =2.324, P ＜0.05) compared with healthy group respectively. The difference of the level of plasma VEGF of experimental group and control group before treatment was not statistically significant (t =1.384, P ＞0.05). The difference of the level of plasma VEGF of experimental group and control group after treatment was statistically significant(t =2.793,P ＜0.05). The level of plasma VEGFR [(2490.75+1695.9) pg/ml, (2322.78+1105.87) pg/ml] of experimental group and control group before treatment was statistically significant (t =2.914, t =2.783, P ＜0.01) compared with healthy group [(1134.98+378.45) pg/ml] respectively. The level of plasma VEGFR of those groups after treatment [(1359.71± 390.24) pg/ml, (1753.89±337.04) pg/ml] was statistically significant(t =2.572, t =2.447, P ＜0.05) compared with healthy group respectively. The difference of the level of plasma VEGFR of experimental group and control group before treatment was not statistically significant (t =1.276, P ＞0.05). The difference of the level of plasma VEGFR of experimental group and control group after treatment was statistically significant (t = 2.486, P ＜0.05). The level of plasma bFGF [(2.43±0.27) ng/ml, (2.41±0.33) ng/ml] of experimental group and control group before treatment was statistically significant(t =4.982, t =4.171, P ＜0.05) compared with healthy group (1.83±0.44) ng/ml respectively; the level of plasma bFGF of those groups after treatment [(2.09±0.17) ng/ml,(2.11±0.31) ng/ml] was statistically significant (t =3.011, t =2.773, P ＜0.05) compared with healthy group respectively. The difference of the level of plasma bFGF of experimental group and control group before treatment was not statistically significant (t =0.953, P ＞0.05). The difference of the level of plasma bFGF of experimental group and control group after treatment was not statistically significant (t =1.282, P ＞0.05).Conclusion The remission rate could be improved by thalidomide combined with chemotherapy in acute leukemia, which could be an effective treatment by anti-angiogenesis and inhibiting the growth and infiltration of acute leukemia cells.