Bronchopulmonary dysplasia (BPD) is a common respiratory disease in preterm infants.Infection, inflammation and oxidative stress are the main pathogenic mechanisms of BPD.Recent studies have shown that the colonization of pulmonary microorganisms begins from the perinatal period and dynamically changed by multiple factors.Respiratory microecology dysbiosis may trigger oxidative stress, inhibit the expression of miR-876-3p, change pulmonary metabolism and weaken local barrier function, thereby leading to the occurrence and progress of BPD.At the same time, abnormal pulmonary development and lung injury also exert impact on respiratory microecology, and the impact even lasts till adulthood.Probiotics have anti-inflammatory, anti-infection and antioxidant effects.Supplementation of probiotics may promote lung development and alleviate lung injury conditions by regulating respiratory microecology.In this article, the establishment and dynamic changes of neonatal respiratory microecology were elaborated, and the role of respiratory microecology in the pathogenesis, prevention and treatment of BPD was explored.

Data of 55 cases of gastric neuroendocrine neoplasms (G-NENS) with diameter ≤12 mm in the First Affiliated Hospital of Zhengzhou University from August 2014 to August 2019 were retrospectively analyzed. According to the methods of endoscopic resection, the patients were divided into two groups: the endoscopic mucosal resection with a cap (EMR-C) group (35 cases) and the endoscopic submucosal dissection (ESD) group (20 cases). The results showed that the success rates of operation, the whole resection rates and the complete resection rates were all 100.0% in the two groups. Compared with the ESD group, the EMR-C group had a shorter median operation time (12.00 min VS 28.35 min, P<0.001), less mean hospitalization costs (21 165.19 yuan VS 28 400.35 yuan, P=0.004), and a similar overall incidence of complications [2.86% (1/35) VS 0, P=1.000]. By March 2020, the recurrence rate of EMR-C group and ESD group were 28.6% (10/35) and 15.0% (3/20), respectively, without significant difference ( P=0.418). It is suggested that for G-NENS with diameter ≤12 mm, without muscular invasion, lymph node metastasis or distant metastasis, EMR-C and ESD are both safe and effective, but EMR-C has more advantages in terms of operation time and hospitalization costs.

Objective:To compare the clinical efficacy of anti-reflux mucosectomy (ARMS) and endoscopic cardial constriction ligation (ECCL) on treatment of gastroesophageal reflux disease.Methods:A retrospective study was conducted on the data of 48 consecutive patients with gastroesophageal reflux disease, who underwent ARMS or ECCL at the First Affiliated Hospital of Zhengzhou University from December 2015 to August 2018. Twenty cases were in the ARMS group and 28 cases in the ECCL group. The short-term and long-term efficacies were compared between the two groups.Results:The success rate of operation was 100.0% in the both groups. The operation time of the ECCL group was significantly shorter than that of the ARMS group (8.43±1.59 min VS 34.05±12.35 min, t=-9.227, P<0.001). After 2 months follow-up, the symptom improvement rate of the ECCL group and the ARMS group was 89.3% (25/28) and 60.0% (12/20), respectively ( χ2=4.128, P=0.042). The GERD Q score of the ECCL group was significantly lower than that of the ARMS group (6.24 ±1.22 VS 7.35±1.79, t=-2.400, P=0.023). One year after operation, there were no significant differences in the symptom improvement rate, GERD Q score, DeMeester score and the time percentage of pH<4 between the two groups ( P>0.05). Conclusion:The long-term clinical effect of ARMS and ECCL is similar, but the short-term clinical effect of ECCL is superior to ARMS.

Objective: To assess the efficacy and safety of the endoscopic anti-reflux mucosectomy for gastroesophageal reflux disease. Methods: Data of 18 patients with gastroesophageal reflux disease who underwent endoscopic anti-reflux mucosectomy at the First Affiliated Hospital of ZhengZhou University from December 2015 to July 2018 were retrospectively studied. The therapeutic effects (improvement of heartburn and reflux symptoms, 24 h esophageal pH monitoring) and complications were analyzed. Results: Anti-reflux mucosectomy was performed successfully in all patients with successful rate of 100%. ESD was performed in 8 cases and EMR in 10 cases.24 h esophageal pH monitoring results showed that the Demeester score, the time percentage of pH < 4, total reflux events and reflux times of pH < 4 with time longer than 5 minutes after treatment were significantly lower than those before treatment (20.16±9.12 VS 74.16±20.03, (2.70±0.88)% VS (6.42±1.37)%, 43.78±19.68 VS 156.56±41.22, 2.89±1.68 VS 9.89±2.95, all P<0.05). No bleeding, perforation or infection was observed after the procedure. During a follow-up period of 3-34 months, symptom relief rate was 89% (16/18). A tightened cardiac was noted in 18 cases and recovery of mucosal damage was found in 16 patients. Conclusion Anti-reflux mucosectomy is safe, effective and easy to operate for gastroesophageal reflux disease.

OBJECTIVE: To evaluate the feasibility of applying intracranial lead reconstruction in deep brain stimulation (DBS) therapy for Parkinsonism. METHODS: We retrospectively collected the clinical data from 27 patients with Parkinson's disease (PD), who received bilateral subthalamic nucleus (STN) DBS therapy between January, 2016 and December, 2017. According to the position of the selected optimal stimulating contact of the implanted leads, the patients were divided into group A with the stimulating contacts of the bilateral leads in the STN, group B with unilateral stimulating contacts in the STN, and group C with bilateral stimulating contacts outside the STN. All the patients were assessed for improvement using Hoehn-Yahr stage, the third part of United Parkinson's Disease Rating Scale (UPDRS Ⅲ), Schwab and England Activities of Daily Living (SE-ADL), and L-dopa equivalent daily dose (LEDD). The consistency between the optimal stimulating contact selected by lead reconstruction and that by standard postoperative programming procedure was also evaluated. RESULTS: The patients in all the 3 groups showed postoperative improvements in Hoehn-Yahr stage, UPDRS Ⅲ score, SE-ADL score, and LEDD in the medication-off state. But at 12 months of the follow-up, such improvements were maintained only in the patients of group A. The optimal stimulating contacts selected by lead reconstruction and standard postoperative programming procedure had a matching rate of up to 77.78% (42/54), and the coordinates of the optimal contacts selected by the two methods showed no significant difference. CONCLUSIONS Intracranial lead reconstruction facilitates the study of the association between the implant site of the leads and the clinical outcome of DBS therapy for PD and allows the precise selection of the optimal contact of the implanted leads in postoperative programming of DBS.
Activities of Daily Living ; Deep Brain Stimulation ; Humans ; Parkinson Disease ; Retrospective Studies ; Treatment Outcome

Objective To compare the long-term efficacy and complications of peroral endoscopic circular myotomy and full-thickness myotomy for patients with achalasia of cardia. Methods A retrospective analysis was performed on the data of 53 patients with achalasia of cardia, who underwent peroral endoscopic myotomy in the First Affiliated Hospital of Zhengzhou University from June 2012 to December 2014 and were followed-up regularly.Twenty-one patients underwent circular myotomy, and the other 32 patients underwent full-thickness myotomy. The postoperative long-term efficacy and gastroesophageal reflux complications of the two groups were compared. Results The effective rate of the circular myotomy group and the full-thickness myotomy group was 90. 5%( 19/21) and 100. 0%( 32/32), respectively ( P＝ 0. 152). There were no significant differences between the two groups on postoperative Eckardt scores, lower esophageal sphincter pressure and 4 s integrated relaxation pressure ( P ＞ 0. 05 ). The incidence of clinically relevant gastroesophageal reflux of full-thickness myotomy group was higher than that of circular myotomy group (40. 6% VS 14. 3%, χ2＝4. 174, P＝0. 041). Conclusion The long-term efficacy of circular myotomy is similar to that of full-thickness myotomy, but the incidence of clinically relevant gastroesophageal reflux is higher in full-thickness myotomy.

As a newly discovered type of oxygen-carrying protein,neuroglobin(Ngb) is mainly presented in neurons in the form of monomers,which is closely related to oxygen supply in brain tissues.Neuronal apoptosis and necrosis caused by central nervous system injury aggravate the degrees of cerebral ischemia and hypoxia,and further induce the Ngb high expression,thus exerting a significant neuroprotective effect.As oxygen receptor and oxygen-carrying protein,Ngb can exert endogenous neuroprotective effects under hypoxic conditions and reduce the degree of hypoxic-ischemic brain damage.In this paper,we summarize the structure and function of Ngb,and explore the expression changes and mechanism of Ngb in various types of central nervous system injury.

The brain -derived neurotrophic factor (BDNF)plays an important role in the development and function of the nervous system.BDNF controls the neuronal survival,differentiation,growth of dendrites and axons,for-mation of synapse,neuronal plasticity and the basic process of learning and memory through a variety of ways,the dys-regulation of which is probably the important molecular mechanism responsible for the onset of autism spectrum disor-der.The research advance on preclinical research and clinical research between BDNF and autism spectrum disorder is reviewed in this paper.

To investigate influence of butylphthalide injection on serum neuron specific enolase, C-reactive protein and fatty acid binding protein levels in patients with cerebral vasospasm following aneurysmal subarachnoid hemorrhage.Methods Ninety patients with cerebral vasospasm were admitted to The First Affiliated Hospital of Fujian Medical University, then the patients were divided into two groups: The control group (45 patients) was treated with nimodipine and triple-H therapy after surgery;in addition to nimodipine and triple-H therapy, butylphthalide injection was administered to the experimental group(45 patients).Transcranial doppler(TCD)was used for the evaluating cerebral artery blood flow velocity, and the serum neuron specific enolase(NSE), C-reactive protein(CRP) and fatty acid binding protein(FABP) levels in patients with cerebral vasospasm were measured. Results The experimental group improved significantly more than the control group, a significant decrease in cerebral blood flow velocity of the middle cerebral artery in the experimental group as measured by TCD (P<0.05).The serum levels of NSE, CRP and FABP in the patients in the experimental group decreased more significantly (P<0.05).And the incidence of cerebral infarction in experimental group was lower than that in control group (P<0.05).Conclusion The serum levels of NSE, CRP and FABP in the patients with cerebral vasospasm following aneurysmal subarachnoid hemorrhage could be significantly reduced by administration of butylphthalide injection, which also could improve cerebral blood supply.Therefore, administration of butylphthalide injection is an effective treatment for cerebral vasospasm.

Objective To investigate the changes of perioperative blood glucose in patients with ruptured intracranial aneurysms under keyhole clipping and their prognostic influence factors.Methods Totally, 147 patients with ruptured intracranial aneurysms, admitted to our hospital from July 2010 to July 2012, were selected.The changes of serum glucose on admission and at non-fasting state every day at the hospital, random blood sugar before operation and one day after the operation were analyzed;modified Rankin scale (mRS) was performed to evaluate short-term prognosis of the patients 14 day after the operation;Logistic regression analysis was used to analyze the prognostic influence factors of ruptured intracranial aneurysms under keyhole clipping.Results In the 147 patients with ruptured intracranial aneurysms, 57 (38.8％) had preoperative increased blood glucose and 99 (67.3％) had postoperative increased blood glucose;77 patients had ratio of postoperative/preoperative blood glucose＜1.2, 38 had ratio=1.2-1.5, and 32 had ratio ≥ 1.5.Seventy-eight patients had a good prognosis, while 69 patients gained a poor prognosis.As compared with the good prognosis group, the poor prognosis group had significantly larger percentage of patients with age elder than 60 or with postoperative blood glucose＞7.0 mmol/L, higher Hunt-Hess scale scores and ratio of postoperative/preoperative blood glucose, with significant differences (P＜0.05);multi-factor unconditional Logistic regression analysis indicated that age, postoperative and preoperative blood glucose ratio, postoperative blood glucose and Hunt-Hess scale scores were the independent factors of prognosis.Conclusion In patients with age＞60, Hunt-Hess scale Ⅳ or Ⅴ, postoperative blood glucose＞7.0 mmol/L and postoperative/preoperative blood glucose ratio ≥ 1.5, poor prognosis can be predictive.