Objective:To study the clinical application of jejunal feeding tube (J-tube) for early enteral nutrition after surgical treatment of upper digestive tract malformation in newborns.Methods:From January 2019 to December 2021, newborns with upper digestive tract malformation received stage Ⅰ small bowel resection and anastomosis in our hospital were enrolled in this prospective randomized controlled study. According to different types of postoperative nutritional support, these patients were randomly assigned into J-tube group and control group using block randomization method. The J-tube group were given enteral nutrition vis J-tube within 48-72 h after surgery and the control group were given oral feeding after the recovery of gastrointestinal function. Calories and proteins intake, growth indicators, duration of hospital stay and parenteral nutrition, time needed for full oral feeding and complications were compared between the two groups.Results:A total of 24 patients were in J-tube group and 28 in controlled group. No significant differences existed on the general status between the two groups ( P>0.05). The average daily intake of calories and proteins in j-tube group in the first week after surgery were significantly higher than control group [(108.7±8.3) kcal/(kg·d) vs. (97.9±7.0) kcal/(kg·d), (3.4±0.3) g/(kg·d) vs. (3.1±0.2) g/(kg·d)] ( P<0.05). No significant differences existed in the average daily intake of calories and proteins during the second postoperative week between the two groups ( P>0.05). Compared with control group,J-tube group showed increased growth velocity in head circumference and weight over time ( P<0.05), while the trend over time in length growth was not significant ( P>0.05). No significant differences existed in the duration of hospital stay and parenteral nutrition, time needed for full oral feeding and complications between the two groups ( P>0.05). Conclusions:Enteral nutrition via J-tube 48-72 h after surgery is safe and feasible in the postoperative nutritional management of newborns with upper digestive tract malformation. This strategy may promote physical growth after surgery without increasing the incidences of complications.

The administration of nanoparticles (NPs) first faces the challenges of evading renal filtration and clearance of reticuloendothelial system (RES). After that, NPs infiltrate through the expanded endothelial space and penetrated the dense stroma of tumor microenvironment to tumor cells. As long as possible to prolong the time of NPs remaining in tumor tissue, NPs release active agent and induce pharmacological action. This review provides a comprehensive summary of the physical and chemical properties of NPs and the influence of various biological factors in tumor microenvironment, and discusses how to improve the final efficacy through adjusting the characteristics and structure of NPs. Perspectives and future directions are also provided.

OBJECTIVE: This study was performed to validate the autonomous maximal smile (AMS) as a new reference for evaluating dental and gingival exposure. METHODS: Digital video clips of 100 volunteers showing posed smiles and AMS at different verbal directives were recorded for evaluation a total of three times at 1-week intervals. Lip-teeth relationship width (LTRW) and buccal corridor width (BCW) were measured. LTRW represented the vertical distance between the inferior border of the upper vermilion and the edge of the maxillary central incisors. Intraclass correlation coefficients (ICCs) for reproducibility, and the m-value (minimum number of repeated measurements required for an ICC level over 0.75), were calculated. RESULTS: LTRW and BCW of the AMS were 1.41 and 2.04 mm, respectively, greater than those of the posed smile (p < 0.05), indicating significantly larger dental and gingival exposure in the AMS. The reproducibility of the AMS (0.74 to 0.77) was excellent, and higher than that of the posed smile (0.62 to 0.65), which had fair-to-good reproducibility. Moreover, the m-value of the AMS (0.88 to 1.05) was lower than that of the posed smile (1.59 to 1.85). CONCLUSIONS: Compared to the posed smile, the AMS shows significantly larger LTRW and BCW, with significantly higher reproducibility. The AMS might serve as an adjunctive reference, in addition to the posed smile, in orthodontic and other dentomaxillofacial treatments.
Incisor ; Volunteers

Gastrointestinal neuroendocrine tumors are a group of highly heterogeneous tumors. Their incidences have increased in the Western countries as well as in Asia for years. In recent years, predominant progression has been made in the basic and translational studies on gastrointestinal neuroendocrine tumors. Gastric neuroendocrine neoplasmas are classified as four types: type I( occurs on the basis of autoimmune atrophic gastritis, type II( clinically manifests as multiple endocrine tumor type I( and Zollinger-Ellison syndrome, type III( is sporadic neuroendocrine neoplasmas, and type IIII( is neuroendocrine carcinoma. According to the location of primary tumor, intestinal neuroendocrine neoplasmas are classified as small intestine neuroendocrine neoplasmas and colorectal neuroendocrine neoplasmas. The latest finding shows that familial type I( gastric neuroendocrine neoplasmas exists homozygous missense mutation (c.2107C>T) of ATP4A gene. A number of researches focus on small intestine neuroendocrine neoplasmas recently. The chromosome instability, whole genome low methylation and abnormal expression of microRNA can be found in small intestine neuroendocrine neoplasmas. Part of them presents heterozygous mutations and loss of heterozygosity of CDKN1B gene. A recent study showed the heterozygous mutations of IPMK gene (c.990-993del) in familial small intestinal neuroendocrine neoplasmas. PROX1 and Annexin A1 may be involved in the malignant progression of rectal neuroendocrine neoplasmas via the Wnt pathway. The molecular mechanism of gastrointestinal neuroendocrine carcinoma is significantly different from gastrointestinal neuroendocrine tumors. The expression of mTOR, thymidylate synthase and PD-L1 protein, and gene mutation of BRAF V600E and KRAS have been exclusively found in gastrointestinal neuroendocrine carcinoma. The expression of thymidylate synthase, p27, p16, Gα15, PROX1 and Annexin A1 in gastrointestinal neuroendocrine neoplasmas is associated with the prognosis of these patients. Neurokinin A is a specific peripheral blood tumor biomarker for the prognosis and response to the treatment of patients with small intestinal neuroendocrine neoplasmas. INSL5 can be used as a unique biomarker for rectal neuroendocrine neoplasmas.
Biomarkers, Tumor ; Carcinoma, Neuroendocrine ; Gastrointestinal Neoplasms ; Humans ; Intestine, Small ; Mutation ; Neuroendocrine Tumors ; Prognosis ; Translational Medical Research

OBJECTIVETo explore possible mechanisms of postural tachycardia syndrome (POTS) by comparing plasma intermedin (IMD) during head-up tilt test (HUTT) in children with POTS.

METHODThe study subjects were divided into two groups: POTS group and control group. The POTS group consisted of twenty-nine children (male 14, female 15) with POTS, the mean age (12.4 ±3.1) years old, admitted into Peking University First Hospital from November 2013 to June 2014. The control group consisted of 32 healthy children (male 17, female 15). Their mean age was (11.6±2.2) years old, who were confirmed as healthy by physical examination and HUTT. Finapres Medical System was used to continuously monitor heart rate and blood pressure during HUTT, and electrocadiogram was performed. Supine systolic and diastolic blood pressure, mean arterial pressure (MAP), ΔMAP (standing mean arterial pressure-supine MAP), supine heart rate and ΔHR (standing HR-supine HR) were compared between POTS group and control group. Sandwich immunoluminescence assay was used to test plasma IMD. The plasma IMD level was compared in supine between POTS and control group. The plasma IMD level in supine was compared with HUTT in POTS group.

RESULTNo significant differences were found in age, height, weight, supine systolic and diastolic blood pressure, MAP, ΔMAP and supine heart rate between POTS group and control group (P>0.05). ΔHR in POTS group was significantly higher than that of control group ((48±10) vs. (22±7) beats /min, t=9.797, P<0.05). The plasma IMD level in POTS group was lower than that of control group in supine position ((497±61)×10(-6) vs. (529±58)×10(-6) mg/L, t=2.117, P<0.05). But, it was higher during HUTT than supine IMD in POTS group ((537±57) ×10(-6) vs. (497±61)×10(-6) mg/L, t=-2.464, P<0.05). The plasma delta IMD level (HUTT vs. supine) was positively correlated with delta HR in POTS group (r=0.435, P<0.05).

CONCLUSIONThe excessively high heart rate during HUTT have a positive correlation with plasma IMD, which may play a role in the pathogenesis of POTS in children.

OBJECTIVETo predict the therapeutic efficacy of oral rehydration salts (ORS) by quantifying changes in heart rate during the head-up test (HUT) in children with postural tachycardia syndrome (POTS).

METHODFifty-four children from Peking University First Hospital during July 2005 to September 2013 were enrolled into POTS group. Twenty healthy children were enrolled in this study as the control group. Children with POTS were treated with ORS and successfully followed up. HUT test was done before and at the end of the treatment. POTS children were further divided into responding group and the non-responding group depending on if the symptom scores were reduced by 50% or greater after the treatment. The heart rate, systolic blood pressure (SBP) and diastolic blood pressure (DBP) changes during the HUT test were analyzed between the control group and the POTS patients. A receiver operating characteristic (ROC) curve was used to analyze the predictive value of the increase in heart rates (from the supine to upright) and the maximum upright heart rate in 10 minutes after ORS treatment.

RESULTPOTS children were 6-17 (11.3 ± 3.0) years old and the control group children were 10-12 (11.0 ± 0.8) years old. The changes of the heart rate during the HUT was different between the POTS patients and the controls ((41 ± 10) vs. (20 ± 7) beats/min, t = -10.441, P = 0.000) . There was no significant difference between the two groups in the maximum upright heart rate in 10 minutes during the HUT ( (117 ± 12) vs. (114 ± 8) beats/min, t = -1.322, P = 0.192) . The symptom scores were reduced compared with those before treatment ((3.2 ± 1.8) vs. (5.7 ± 2.0), t = 10.958, P < 0.001) and the heart rate changes from supine to upright were decreased in 30 patients ((33 ± 11) vs. (41 ± 11) beats/min, t = 2.956, P = 0.006). Compared with the non-responding group (28 cases), the heart rate change during the HUT test was great in the responding group (26 cases) before treatment ((46 ± 10) vs. (37 ± 9) beats/min, t = -3.582, P = 0.001), and the maximum upright heart rate in 10 minutes was also high in the responding group ( (122 ± 12) vs. (113 ± 10) beats/min, t = -2.693, P = 0.010). The ROC curve showed that ORS for children with POTS would be predicted to be effective when the pre-treatment increase of heart rate was 41 beats/min (sensitivity 72% and specificity 70%), or when the maximum upright heart rate in 10 minutes was 123 beats/min before treatment (sensitivity 48% specificity 56%). When the two indices were used together, sensitivity was 84% and specificity was 56%.

CONCLUSIONThe changes in heart rate during the HUT was useful in predicting the response to ORS in children with POTS.

Blood Pressure ; Child ; Fluid Therapy ; Heart Rate ; Humans ; Postural Orthostatic Tachycardia Syndrome ; physiopathology ; therapy ; Predictive Value of Tests ; ROC Curve ; Salts ; Sensitivity and Specificity ; Treatment Outcome

Objective To compare the therapeutic effect of Midodrine hydrochloride plus oral rehydration salts,Metoprolol plus oral rehydration salts and simple oral rehydration salts on children with postural tachycardia syn-drome(POTS). Methods One hundred and ninety - two children with POTS were divided into Midodrine hydrochlo-ride plus oral rehydration salts group(84 cases),Metoprolol plus oral rehydration salts group(54 cases)and oral rehy-dration salts group(54 cases). The patients were followed up at the outpatient department after 3 - months treatment. Short - term effect was analyzed by reevaluating the symptom scores,repeating upright test and studying the side effects of the drugs. All the children were followed - up by telephone,mainly investigating on the syndrome recurrence and symptom - free survival by Kaplan - Meier analysis. The follow - up time was 3 to 122(42. 7 ± 24. 3)months. Results Short - term effect showed that the symptom scores were decreased after treatment(t = 21. 536,P ﹤ 0. 001). Head -up test showed that delta heart rate was decreased. The effective rates in the Midodrine hydrochloride plus oral rehydra-tion salts group and the Metoprolol plus oral rehydration salts group were significantly higher than those of the simple oral rehydration salts group(χ2 = 10. 905,P = 0. 004). But no statistical difference was found between the Midodrine hydrochloride plus oral rehydration salts group and the Metoprolol plus oral rehydration salts group(χ2 = 0. 042,P =0. 837). Long - term effect by Kaplan - Meier curve showed that the therapeutic effect of Midodrine hydrochloride plus oral rehydration salts group was significantly higher than any of the other two groups(χ2 = 13. 299,P ﹤ 0. 01),but no statistical difference was found between the Metoprolol plus oral rehydration salts group and the simple oral rehydration salts group(χ2 = 0. 150,P = 0. 699). Conclusions In terms of the short - term result,the effective rates in the Mido-drine hydrochloride plus oral rehydration salts group and the Metoprolol plus oral rehydration salts group were signifi-cantly higher than those of the simple oral rehydration salts group. The therapeutic effect of the Midodrine hydrochloride plus oral rehydration salts was superior to that of the Metoprolol plus oral rehydration salts and the simple oral rehydra-tion salts for POTS children by the long - term follow - up study.

Objective To investigate the effect of pretreatment with U75302,antagonist of leukotriene B4 receptor 1 (BLT1),on cisplatin induced acute kidney injury in mice and its immunoregulatory mechanism.Methods Healthy C57BL/6 mice were randomized into four subgroups:1.healthy control group;2.cisplatin group;3.U75302 control group;4.cisplatin + U75302 group,n=6.Group 2 and 4 received intraperitoneal injection of cisplatin (20 mg/kg) on day 0,group 3 and 4received intraperitoneal injection of U75302 (5 μg/mouse) on day 0 and day 2.Mice were sacrificed on the 3rd day and blood and kidney were collected.Renal function and histological changes were estimated,the infiltration of immune cells were determined by flow cytometry,the level of peroxidase (MPO) in kidney were determined by colorimetry,relative expression of TNF-α,IL-1β,CXCL1,CXCL2 were detected by Real-time PCR.Results Compared with healthy control group,levels of BUN,Scr were higher in cisplatin group with serious tubular structural damage.There were more neutrophils,macrophages,CD4+ T lymphocytes,CD8+ T lymphocytes in kidneys of cisplatin group,the level of MPO and relative expression of TNF-α,IL-1β,CXCL1,CXCL2 were also higher in cisplatin group.Compared with cisplatin group,lower BUN [(17.75±1.80) mmol/L vs (42.6±6.66) mmol/L,P ＜0.05],Scr were found in cisplatin+ U75302 group with less tubular structural damage.Meanwhile,U75302 reduced infiltration of neutrophils [(146±13)×103/g vs (296±66) ×103/g,P ＜ 0.05],macrophages [(245± 13)× 103/g vs (420±78)× 103/g,P ＜ 0.05] in the kidney.Levels of MPO [(1.756±0.283) U/g vs (3.308±0.577) U/g,P＜0.05] and relative expression of TNF-α,IL-1β,CXCL1,CXCL2 were also lower.Conclusions BLT1 antagonist U75302 protects mice against AKI induced by cisplatin,and the mechanism is associated with reduced infiltration of inflammatory cells in kidney and the inhibition of kidney inflammation.

OBJECTIVETo investigate the chemical constituents from Lamiophlomis rotata and the bioactivities of 8-epideoxyloganic acid.

METHODThe constituents were isolated by using a combination of various chromatographic techniques including column chromatography over ployamide, silica gel and Sephadex LH-20. Structures of the isolates were identified by spectroscopic data analysis. Bioactivities were screened by using models in vivo.

RESULTFive constituents were isolated. 8-epideoxyloganic acid was isolated for the first time in L. rotata and also in lamioplomis genus. 8-epideoxyloganic acid could significantly inhibit aectic acid-induced twisting times and slower the time of homeostatsis, also inhibit xylene-induced ear edema in mice.

CONCLUSION8-epideoxyloganic acid possesses bioactivities of analgesia, homeostasis and anti-inflammatory.

Analgesics ; pharmacology ; Animals ; Anti-Inflammatory Agents ; pharmacology ; Female ; Lamiaceae ; chemistry ; Male ; Mice ; Pyrans ; isolation & purification ; pharmacology

BACKGROUND:Constructing animaI model of intervertebraI disc degeneration which more faithfully mimics the pathologic hallmarks of human intervertebral disc degeneration can be a beneficial assistance for further intervertebraI disc degeneration therapy.However,there is not an accepted optimal model for intervertebral disc degeneration study OBJECTIVE:To compare the rabbit model of degenerative intervertebral disc constructed by anulus puncture and anulus incision.METHODS:Totally 32 New Zealand white rabbits were randomly divided into the anulus puncture group and annulus incision group.Intervertebral disc of L_(3-6) 6was exposed by extro-peritoneal approach,and the discs were injured by puncturing the anulus or cutting the anulus The deep and direction were controlled.Pathological change of intervertebral disc was checked with MRI and histopathological examination at weeks 2,4,12,and 20 after operation.RESULTS AND CONCLUSION:At week 4 after operation.the area of nucleus gelatinosus was deflated with enlarged anulus fibrosus,T_2-weighted image(T_2WI)declined,blurred,and the height of intervertebral space was also decreased,the grade of T2 value in the anulus puncture group was lower than that of the annulus incision group(P＜0 05):with time prolonged,T2 scores increased,and the intervertebraI space narrowed.which reached a peak at week 20 after operation.The differences had no significance.The histological sections demonstrated that the cell content in nucleus pulposus was increased gradually.The rabbit model of intervertebraI disc degeneration can be successfully constructed by the methods of anulus puncture and annulus incision.The degeneration of incision modelis more severe than that of puncture model.Anulus puncture method can faithfully mimic intervertebral disc degeneration after damage in human being.