OBJECTIVES: To investigate the incidence of extrauterine growth retardation (EUGR) and its risk factors in very preterm infants (VPIs) during hospitalization in China. METHODS: A prospective multicenter study was performed on the medical data of 2 514 VPIs who were hospitalized in the department of neonatology in 28 hospitals from 7 areas of China between September 2019 and December 2020. According to the presence or absence of EUGR based on the evaluation of body weight at the corrected gestational age of 36 weeks or at discharge, the VPIs were classified to two groups: EUGR group (n=1 189) and non-EUGR (n=1 325). The clinical features were compared between the two groups, and the incidence of EUGR and risk factors for EUGR were examined. RESULTS: The incidence of EUGR was 47.30% (1 189/2 514) evaluated by weight. The multivariate logistic regression analysis showed that higher weight growth velocity after regaining birth weight and higher cumulative calorie intake during the first week of hospitalization were protective factors against EUGR (P<0.05), while small-for-gestational-age birth, prolonged time to the initiation of total enteral feeding, prolonged cumulative fasting time, lower breast milk intake before starting human milk fortifiers, prolonged time to the initiation of full fortified feeding, and moderate-to-severe bronchopulmonary dysplasia were risk factors for EUGR (P<0.05). CONCLUSIONS It is crucial to reduce the incidence of EUGR by achieving total enteral feeding as early as possible, strengthening breastfeeding, increasing calorie intake in the first week after birth, improving the velocity of weight gain, and preventing moderate-severe bronchopulmonary dysplasia in VPIs.
Female ; Fetal Growth Retardation ; Gestational Age ; Hospitalization ; Humans ; Incidence ; Infant ; Infant, Newborn ; Infant, Premature ; Infant, Very Low Birth Weight ; Prospective Studies ; Risk Factors

Objective: To investigate the safety, feasibility and short-term efficacy of total laparoscopic loop ileostomy reversal in patients after resection of rectal cancer. Methods: The clinical data of 20 patients who underwent total laparoscopic loop ileoscopic loop ileostomy after radical resection of rectal cancer at Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, or Beijing Chaoyang District Sanhuan Cancer Hospital from October 2019 to June 2020 were collected and retrospectively analyzed. Results: All patients had successfully underwent total laparoscopic ileostomy reversal without conversion to open surgery or discontinued operation. No perioperative related death cases were found. In the whole group, the median operation time was 97 (60-145) minutes and the median intraoperative blood loss was 20 (10-100) milliliters. The median Visual Analogue Scale (VAS) score was 1.9 (1-5) one day after the operation. Nobody needed to use additional analgesic drugs. The median time to grand activities was 25 (16-42) hours, the median time to flatus was 44 (19-51) hours, and the median hospitalization after operation was 6.9 (5-9) days. No patients underwent operation related complications such as operative incision infection, abdominal and pelvic infection, intestinal obstruction, anastomotic leakage, bleeding and so on. Conclusions: Total laparoscopic loop ileostomy reversal appears to be safe, feasible and with promising efficacy for selected patients.
Humans ; Ileostomy ; Retrospective Studies ; Laparoscopy ; Rectal Neoplasms/surgery* ; Anastomotic Leak ; Anastomosis, Surgical

OBJECTIVE: To evaluate the clinical features of preterm infants with a birth weight less than 1 500 g undergoing different intensities of resuscitation. METHODS: A retrospective analysis was performed for the preterm infants with a birth weight less than 1 500 g and a gestational age less than 32 weeks who were treated in the neonatal intensive care unit of 20 hospitals in Jiangsu, China from January 2018 to December 2019. According to the intensity of resuscitation in the delivery room, the infants were divided into three groups:non-tracheal intubation ( RESULTS: Compared with the non-tracheal intubation group, the tracheal intubation and ECPR groups had significantly lower rates of cesarean section and use of antenatal corticosteroid ( CONCLUSIONS For preterm infants with a birth weight less than 1 500 g, the higher intensity of resuscitation in the delivery room is related to lower rate of antenatal corticosteroid therapy, lower gestational age, and lower birth weight. The infants undergoing tracheal intubation or ECRP in the delivery room have an increased incidence rate of adverse clinical outcomes. This suggests that it is important to improve the quality of perinatal management and delivery room resuscitation to improve the prognosis of the infants.
Birth Weight ; Cesarean Section ; China ; Female ; Gestational Age ; Humans ; Infant ; Infant, Newborn ; Infant, Premature ; Pregnancy ; Retrospective Studies

Objective: To evaluate the ability of new injury severity score (NISS), acute physiology and chronic health evaluation II (APACHE II), Glasgow coma scale (GCS), a combination of NISS and GCS, a combination of APACHE II and GCS, a combination of NISS and APACHE II to predict all-cause mortality of patients with severe trauma in mainland China. Methods: This was a multicenter observational cohort study conducted in the ICU of the Chonggang General Hospital, Daping Hospital of the Army Medical University and Affiliated Hospital of Zunyi Medical College from January 2012 to August 2016. The score of NISS, APACHE II, GCS, a combination of NISS and GCS, a combination of APACHE II and GCS, a combination of NISS and APACHE II were calculated based on data from the first 24 hours of ICU admission. Data were processed with Student's t-test, chi-square test, and receiver operating characteristic (ROC) curve of six scoring systems. Calibration was assessed with the Hosmer-Lemeshow test. The primary endpoint was death from any cause during ICU stay. Results: A total of 852 and 238 patients with severe trauma were assigned to the derivation group and validation group, respectively. Area under the ROC curve (AUC) was 0.826 [95% confidence interval (CI)=0.794-0.855)] for NISS, 0.802 (95% CI=0.768-0.832) for APACHE II, 0.808 (95% CI=0.774-0.838) for NGCS, 0.859 (95% CI=0.829 -0.886) for NISS+NGCS, 0.864 (95% CI=0.835-0.890) for APACHE II +NGCS, 0.896 (95% CI=0.869-0.929) for NISS+APACHE II in the derivation cohort. Similarly, the score of NISS+APACHE II was also better than the other five scores in the validation cohort (AUC=0.782; 95% CI=0.725-0.833) and had a good calibration (P=0.41). Conclusions: Taking into account anatomical and physiological parameters completely, the combination of NISS and APACHE II performs better than NISS, APACHE II, NGCS, NISS+NGCS, APACHE II +NGCS for predicting mortality in ICU severe trauma patients. It is needful to develop models that contain various types of accessible predictors (demographic variables, injury cause/mechanism, physiological and anatomical variables, etc.) as comprehensive as possible.

AIM: To analyze the clinical effects of preoperative intravitreal Conbercept combined vitrectomy for proliferative diabetic retinopathy ( PDR) patients.?METHODS:From June 2014 to May 2017, 57 patients (65 eyes) diagnosed with PDR. The patients were divided into two groups according to whether received preoperative intravitreal conbercept: intravitreal group ( 27 cases, 31 eyes), control group (30 cases, 34 eyes). Intravitreal group was treated with 0. 05mg ( 0. 05mL ) conbercept intravitreal injection 3d before vitrectomy, while control group was treated with vitrectomy alone. The overall surgical time, intraoperative bleeding, use of endodiathermy, iatrogenic retinal hole, and silicone oil, postoperative vitreous hemorrhage and the best corrected visual acuity were recorded and analyzed.?RESULTS: The average surgical time of intravitreal group was lower ( P < 0. 05 ), while intraoperative hemorrhage rate, rate of endodiathermy application, iatrogenic hiatal incidence, rate of silicone oil application, incidences of recurrent vitreous hemorrhage of intravitreal group were lower than those of control group ( all P<0. 05 ) . Intravitreal group got better postoperative best corrected visual acuity than control group (P<0. 05).?CONCLUSION: Intravitreal conbercept for proliferative diabetic retinopathy before 25G vitrectomy decreased surgical complications, reduced the surgical time and postoperative vitreous hemorrhage, and improved the potoperative best corrected visual acuity.

Objective To compare the safety and efficacy of 23-Gauge pars plana vitrectomy (PPV) and PPV combined with scleral buckling-PPV (SB-PPV) in proliferative rhegmatogenous retinal detachments with inferior breaks.Methods Retrospectively nonrandomized clinical case study was conducted in 70 patients with proliferative rhegmatogenous retinal detachment associated with inferior breaks between January 2013 and December 2016,including 39 eyes receiving SB-PPV procedures as the SB-PPV group and 31 eyes undergoing PPV procedures as the PPV group.And anatomical success rate for one procedure,lens trauma rate,retinotomy rate,postoperative best corrected visual acuity (BCVA) outcome and intraocular pressure (IOP) were recorded and analyzed.Results The anatomical success rate for one procedure was 92.3％ (36/ 39) in the SB-PPV group and 74.2％ (23/31) in the PPV group,and the difference was statistically significant (P ＜ 0.035).The lens trauma rate was 2.6％ (1/39) in the SB-PPV group and 19.4％ (6/31) in PPV group,with the difference being statistically significant (P ＜0.05).The retinotomy rate was 5.1％ (2/39) in the SB-PPV group and 32.3％ (10/31) in the PPV group,and the difference approached statistically significance (P ＜0.05).There was no significant difference in the postoperative BCVA and IOP between the two groups (both P ＞ 0.05).Conclusion SB-PPV can increase the anatomical success rate for one procedure in patients with rhegmatogenous retinal detachment associated with inferior breaks,and reduce retinotomy rate and lens trauma rate.

OBJECTIVETo explore the relationship between c-kit and platelet-derived growth factor receptor alpha(PDGFRA) gene mutation features and the prognosis of gastrointestinal stromal tumor(GIST).

METHODSClinicopathological, genetic testing and follow-up informations of patients admitted to the Shanxi Tumor Hospital from June 2000 to January 2009 were collected. The survival was calculated and univariate analysis was conducted using the Kaplan-Meier method. Multivariate analysis was conducted by the Cox regression method.

RESULTSThe 5-year disease-free survival rate was 61.5% and the 5-year overall survival rate was 67.4%. The 5-year disease-free survival rates of patients without disease among those with c-kit exon 11 mutation (n=77), c-kit exon 9 mutation(n=4), and PDGFRA exon 18 mutation (n=2) were 63.4%, 14.3% and 100%, and the 5-year overall survival rates were 70.8%, 50.0% and 100%, respectively. In the patients with c-kit exon 11 mutation, the 5-year disease-free survival rates among those with point mutations(n=26), deletion mutations(n=44), and duplication mutations(n=7) were 87.1%, 44.9% and 80.0%, and the 5-year overall survival rates were 88.1%, 57.0% and 100%, respectively. There were significant differences in overall survival among different factors. Multivariate analysis showed that gene mutation was not the independent factor of prognosis(P=0.492).

CONCLUSIONSIn GIST patients undergoing surgery without imatinib treatment, mutated genotype is better than wild type in terms of prognosis. Gene mutation is not the independent factor of prognosis in GIST patients.

DNA Mutational Analysis ; Female ; Follow-Up Studies ; Gastrointestinal Stromal Tumors ; genetics ; surgery ; Humans ; Male ; Middle Aged ; Mutation ; Prognosis ; Proto-Oncogene Proteins c-kit ; genetics ; Receptor, Platelet-Derived Growth Factor alpha ; genetics

Objective To analyze the stem cell re-distribution after intra-coronary infusion (ICI)into arrested and beating hearts in a swine myocardial infarction ( MI ) model using magnetic resonance imaging (MRI). Methods Bone marrow-derived mesenchymal stem cells were obtained from male swine and labeled with iron oxide during culture. One week after MI in female swine, the survivors were randomly divided into 4 groups. Cardiopulmonary bypass was set up to arrest the heart, and then SPIO labeled male stem cells ( 1 × 108 ) were infused through coronary of beating heart ( n = 6) and the arrested heart ( n = 6).Saline was injected in either the beating or arresting heart as respective controls. Three days later, cell distribution was assessed by T2* change with magnetic resonance imaging and Y-chromosome (SRY) was detected with quantitative polymerase chain reaction. Results The reduction of T2* values was significantly different in the hearts, spleens, livers and lung between the transplantation groups and the control groups. Only few transplanted cells were localized in the heart and T2 * values were similar between beating and arrest heart groups [ ( -7.81 ±2.03) ms vs. ( -6.56 ± 1.72)ms, P＞0.05], while T2* value reduction was more significant in the spleen and liver in arrest heart group than in beating heart group [spleen: (-16.72 ±2.83)ms vs. ( -22.18 ±3.98)ms, P＜0.01, liver: ( -2.40±0.44)ms vs.( -5.32 ± 3.40 ) ms, P ＜ 0. 05 ] . T2 * value was similar in kidney among the four groups. qRT-PCR detected SRY gene was similar in the heart, less in the spleen and liver while more in the lung in beating heart group compared to arrested heart group. In vitro Prussian blue stained positively transplanted cells were found in the above organs in transplantation group. Conclusions The majority of stem cells transplanted by ICI would be entrapped by the extracardial organs. Stem cell transplantation via ICI into the arrested heart does not favor more cells retention in the injured myocardium. Further investigation is needed to optimize the approach of stem cell delivery.

Twenty Newcastle disease virus (NDV) strains were isolated from chickens and geese in the field outbreaks during 2005 and 2006 in some regions of Jiangsu and Guangxi province. Assessment of the virulence by MDT and ICPI, RT-PCR and sequence analysis of fusion protein gene were used to compare the properties of NDV isolates. The results indicated that MDT and ICPI of the isolates were 45.3h - 58.2h and 1.61 - 2.00 respectively, which confirmed that the all NDV isolates were highly virulent. And their hemagglutinin were not resistant to heat and belonged to fast pattern of elution. The results of nucleotide sequencing and phylogentic analysis of fusion protein gene showed that the twenty strains shared homology from 79.7% to 100% among themselves, from 78.1% to 83.4% and from 80.2% to 90.1% with NDV LaSota, F48E8, respectively. The putative amino acid sequences of fusion protein at the cleavage sites of all the isolates were 112R-R-Q-R/K-R-F117, with the motif characteristics of the virulent NDV strain, which was in accordant with the results of assessment of the pathogenicity. The phylogentic tree based on sequences of fusion protein gene variable regions (47-420nt) revealed that the 18 strains belonged to sub-genotype VIId and the others belonged to an old genotype III of NDV, revealing that subgenotype VIId virus was responsible for the NDV outbreaks in some regions of Jiangsu and Guangxi promince recently.
Amino Acid Motifs ; Amino Acid Sequence ; Animals ; Base Sequence ; Chickens ; virology ; China ; epidemiology ; Disease Outbreaks ; Geese ; virology ; Molecular Epidemiology ; Newcastle Disease ; epidemiology ; genetics ; Newcastle disease virus ; genetics ; pathogenicity ; Phylogeny ; Poultry Diseases ; epidemiology ; genetics ; virology ; Reverse Transcriptase Polymerase Chain Reaction ; Viral Fusion Proteins ; genetics

Objective To understand the epidemiological characteristics of age distribution of measles and related policies on measles vaccines (live; MV) in infants through analyzing the antibody levels of comparison in maternal-infant pairs. Transition of immunity in infants was also studied to provide theoretic basis for measles immunization strategy and to reduce the incidence of month-old infants. Methods In cities of Ningbo, Harbin, and Jinan from Zhejiang, Heilongiiang and Shandong provinces, data was collected from 2004 to 2007 and analyzed regarding the epidemic situation of measles. Studies on maternal-transferred measles antibody were carried our sero-epidemiologically. Results Most of the measles cases were found among babies younger than 12 months,and the incidence of < 1 year olds had been increasing.The distribution was dominated by 5-8 month olds in infant measles cases. The positive rate and GRMT of measles antibody in newborns were 89.3 percent and 738.93. The positive rate of the measles antibody and GMRT of the 6-month infant were 6.9 % and 6.89, while 6.7 % and 3.69 in 8-month infant. There wasa declining trend of the positive rate of the measles antibody during the newborns to 8-month infant. The positive rate and GRMT of measles antibody in mothers were 84.3 percent and 516.94. Mother's measles antibodies mainly to be at low and moderate level, which accounted for 50.4 percent and 30.3 percent respectively, the correlation coefficient between mother and infant was 0. 840. Conclusion Maternal-transferred measles antibody decreased as the growth of infants. The positive rates of measles antibody were quite low in 6-month and 8-month olds which were the age range that needs most attention.