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 observe the long-term behavioral changes in movement, emotion, and learning and memory of newborn mice with hypoxic ischemic brain damage (HIBD). Methods:A total of 50 ten-day old newborn C57BL/6 mice were divided into control group (n = 20) and HIBD group (n = 30). The left common carotid artery was ligated in HIBD group and stayed in anoxic chamber for 45 minutes. All the mice were tested with suspension test, light/dark box test, elevated plus maze test, object recognition test and Y maze test two months after surgery. Results:There were 19 mice modeled successfully. Compared with the control group, the suspension test scores decreased (t = 2.785, P < 0.05); the time of latency of light/dark box test increased (t = -4.320, P < 0.001), the time and frequency in light box decreased (t > 2.603, P < 0.05); the time in open arm decreased (t = 4.576, P < 0.001) and the time in close arm increased (t = -3.287, P < 0.01) for the elevated plus maze test; the time nearing old object increased (t = -2.116, P < 0.05) and object recognition index decreased (t = 2.823, P < 0.05) for object recognition test; the time in the initial and novel arms decreased (t > 2.191, P < 0.05) for Y maze test in HIBD group. Conclusion:The long-term disorders of behavior may include disabilities of motor, learning and memory, and disorder of anxiety, in newborn mice with HIBD.

Long-term exposure to high altitude affects spatial working memory. Previous studies have focused on the analysis of electroencephalogram (EEG) components in time domain rather than in frequency domain. To explore the influence of long-term high altitude exposure on time dynamic characteristics and neural oscillation process of the spatial working memory, n-back task combined with the technology of event related potential recording was performed on 20 young migrants who grew at low altitude before the age of 18 and moved to high altitude more than three years ago, and 21 young people who had never been to the high altitude. EEG data were recorded, and the time domain and frequency domain analyses were performed. The results showed that the response time was longer and the accuracy rate was lower under the 2-back condition in the high altitude group compared with those in low altitude group. The late positive potential (LPP) amplitude was more negative, P2 amplitude was more positive in the 2-back condition, and the power value of early delta frequency band (1-4 Hz, 160-300 ms) was larger, while the power values of late delta frequency band (1-4 Hz, 450-650 ms) and theta frequency band (4-8 Hz, 450-650 ms) were smaller in the high altitude group compared with those in low altitude group. The results suggested that long-term exposure to high altitude affected the spatial working memory ability of the migrants, which was reflected in the lack of attention resources in the later matching stage, decreased response inhibition ability and information maintenance ability, and thus resulted in impaired spatial working memory.
Altitude ; Brain ; physiopathology ; Electroencephalography ; Humans ; Memory, Short-Term ; Reaction Time ; Spatial Memory ; Transients and Migrants

Objective:To compare the effects of spinal orthosis and exercise training on psychological status and quality of life in patients with adolescent idiopathic scoliosis (AIS). Methods:From July, 2017 to Febrary, 2018, 55 AIS patients aged ten to 16 years were enrolled. According to the individual's choice, they were divided into exercise group (n = 25) and orthosis group (n = 30). The Cobb's angle, apex vertebral rotation (AVR), trunk shift (TS) and apex vertebral translocation (AVT) were measured before, three months and six months after intervention. They were also evaluated with Scoliosis Research Society Patient Questionnaire-22 (SRS-22) before and six months after intervention. Results:Six months after intervention, the scores of function/activity level, pain, self-image/appearance and treatment satisfaction were better in the exercise group than in the orthosis group (t > 2.137, P < 0.05). Three months and six months after intervention, the Cobb's angles reduced significantly in both groups (t > 4.461, P < 0.001); six months after intervention, the Cobb's angle was smaller in the orthosis group than in the exercise group (t = 2.548, P < 0.05). Three months and six months after intervention, TS, AVR and AVT improved in both groups (t > 2.338, P < 0.05); six months after intervention, they were better in the orthosis group than in the exercise group (t > 2.259, P < 0.05). Conclusion:Single exercise training is effective on AIS patients with Cobb's angle between 25° to 40°, especially for psychological status and the quality of life, however, it isn't as better as orthotics treatment for deformity correction.

Objective? To explore the reasons of hypertensive patients' uncontrolled blood pressure before onset of ischemic stroke so as to provide clinical evidence for stroke prevention. Methods? The phenomenological analysis method in qualitative research was applied. From February to June 2016, 15 hypertensive ischemic stroke patients with hypertensive cerebral infarction and low medication adherence admitted to the department of neurology of three tertiary hospitals in Guangdong province were selected and participated in qualitative interviews. Results? By Colaizzi phenomenological analysis method, the medication misconception of patients were summarized into 4 themes: estimating physical condition by self-feeling, holding the opinion that there was few relation between "whether monitoring blood pressure", "forgetting medication","stopping medication because of various reasons" and cerebral infarction. Conclusions? There are some misunderstandings in the cognition of taking medicine before the onset of hypertensive cerebral infarction. It suggests that we should strengthen blood pressure monitoring and health education of drug compliance in hypertensive patients and hypertensive cerebral infarction patients, so as to improve the effect of primary prevention and secondary prevention of stroke.

Objective To explore the prevalence of diabetes and hyperlipidemia in cerebral infraction patients with hypertension and look into the rates of awareness, treatment and control. Methods Blood pressure, blood glucose and blood lipids were measured in 238 cerebral infraction patients with hypertension. Meanwhile, the rate of awareness, treatment and control of hypertension, diabetes and hyperlipidemia were investigated by questionnaire. Results Among 79.41％of the patients had abnormal blood pressure and cerebral infaction on admission, the rates of awareness , treatment and control of hypertension were 74.79％, 67.23％, 20.59％. 10.11％of them never took antihypertensive drugs in spite of their awareness of hypertension. 32.35％ of the patients were combined with diabetes, the rates of awareness, treatment and control were 79.22％, 62.34％, 12.99％respectively, and among them 21.31％never tookantidiabetic drugs in spite of awareness of diabetes. 81.51％ of the patients were combined with hyperlipidemia, the rates of awareness, treatment and control were 23.20％, 6.70％, 1.55％respectively, and among them 71.11％never took lipid-lowering drugs with awareness of high blood lipid. Conclusions 79.41％ of the incidence of cerebral infraction was related to abnormal blood pressure. 32.35％cerebral infarction patients with hyperlipdemioa are complicated with hypertension diabetes;81.51％are complicated with 28.57％cerebral infraction patients with hypertension were complicated with diabetes and hyperlipidemia as well, but the rate of awareness, treatment and control were relatively low. In order to improve the secondary prevention, we should pay more attention to the stroke risk factors, and help make the individualized medicine-taking plan to improve the control rate.

Objective To test the effect of an APP in the adherence of inhalation medicines for children with asthma,improve the rate of inhalation medicines compliance,self management ability and the quality of life of children with asthma.Methods The research use self-control study.We use Medication Adherence Report Scale for Asthma (MARS-A) to test the adherence of inhalation medicines for children with asthma in outpatient department.After 2 months using the APP,the children with asthma may be re-tested by the MARS-A to compare the differences in medication adherence,asthma knowledge,use method and pulmonary function,etc.Finally,data analysis using paired t test.Results After using the APP,the inhalation medicines adherence rate is increased from 25.78 ％ to 68.75 ％,the awareness rate of patients and their caregivers are increased from 25 ％ to 65 ％,and the APP usage rate is 42.18％,there was significant difference (P＜0.01).Conclusion The APP can effectively improve the adherence of inhalation drugs,standardized medication management,guarantee treatment effect and improve the quality of life of children with asthma.It could also reducing medical costs and improving work efficiency and service quality,thus deserves promotion.

AIM: To study the role of nitric oxide ( NO ) and γ-aminobutyric acid ( GABA) in the formation of amblyopia by establishing 2 different types of amblyopic models.METHODS:A total of 18 aged 3-week kittens were randomly divided into monocular deprivation, strabismus and normal groups. All types of amblyopia were developed in the experimental eyes that were detected by P-VEP 12wk later. The cats were killed and the immunocytochemistry staining method were applied to observe under the light microscope the changes of distribution and positive cells areas of NO and GABA across the amblyopic retinal, compared to that from the normal cats of identical age.
RESULTS: The P-VEP showed that the amplitude of wave P1 was lower (P<0. 05) and the P1 latent time was longer ( P<0. 05 ) in two types of amblyopic cats than those in the normal cats. Compared to the normal cats, the NO and GABA positive cells areas were obviously reduced ( P<0. 05 ) across the retina in the amblyopic cats. But no significant difference was found between two kinds of amblyopic cats.
CONCLUSION:The NO and GABA play an important role in the formation of amblyopia in the level of retinal.

Objective To assess the effect of radical laparoscopy-assisted gastrectomy (LG) for patients with chronic obstructive pulmonary disease (COPD). Methods Clinical data of 340 gastric cancer patients with COPD undergoing radical gastrectomy with lymphadenectomy at Southwest Hospital, Third Military Medical University between January 2010 and October 2013 were analyzed retrospectively. The clinical outcomes for the 262 patients with COPD who underwent LG (LG group) were compared with those of 78 patients with COPD who underwent open gastrectomy (OG group). During LG, pneumoperitoneum was maintained at an insuffiation pressure of 8 mmHg to 10 mmHg. The primary endpoint was postoperative pulmonary complication (PPC). To predict factors related to PPC, univariate and multivariate logistic analyses were carried out. Results Intraoperative blood loss was significantly less in the LG group [(131.2±14.7) ml] than in the OG group [(246.7±49.0) ml;t=-13.445, P=0.000], but operation time was significantly longer [(220.4±19.1) min vs. (194.2±31.5) min;t=6.877, P=0.000]. The findings showed PPC to be significantly less frequent in the LG group(5.3%,14/262) than in the OG group (15.4%, 12/78)( X2=8.581, P=0.003). The severity of COPD was independent risk factor for PPC(P=0.031, HR=1.456, 95%CI:1.306-1.789). No independent predictor of PPCs was found in type of operative approach (open vs laparoscopic; P=0.126). Conclusion The LG procedure with insuffiation pressure of pneumoperitoneum is tolerated for gastric cancer patients with mild or moderate COPD.

Objective To assess the effect of radical laparoscopy-assisted gastrectomy (LG) for patients with chronic obstructive pulmonary disease (COPD). Methods Clinical data of 340 gastric cancer patients with COPD undergoing radical gastrectomy with lymphadenectomy at Southwest Hospital, Third Military Medical University between January 2010 and October 2013 were analyzed retrospectively. The clinical outcomes for the 262 patients with COPD who underwent LG (LG group) were compared with those of 78 patients with COPD who underwent open gastrectomy (OG group). During LG, pneumoperitoneum was maintained at an insuffiation pressure of 8 mmHg to 10 mmHg. The primary endpoint was postoperative pulmonary complication (PPC). To predict factors related to PPC, univariate and multivariate logistic analyses were carried out. Results Intraoperative blood loss was significantly less in the LG group [(131.2±14.7) ml] than in the OG group [(246.7±49.0) ml;t=-13.445, P=0.000], but operation time was significantly longer [(220.4±19.1) min vs. (194.2±31.5) min;t=6.877, P=0.000]. The findings showed PPC to be significantly less frequent in the LG group(5.3%,14/262) than in the OG group (15.4%, 12/78)( X2=8.581, P=0.003). The severity of COPD was independent risk factor for PPC(P=0.031, HR=1.456, 95%CI:1.306-1.789). No independent predictor of PPCs was found in type of operative approach (open vs laparoscopic; P=0.126). Conclusion The LG procedure with insuffiation pressure of pneumoperitoneum is tolerated for gastric cancer patients with mild or moderate COPD.