BACKGROUND: Delivery room resuscitation assists preterm infants, especially extremely preterm infants (EPI) and extremely low birth weight infants (ELBWI), in breathing support, while it potentially exerts a negative impact on the lungs and outcomes of preterm infants. This study aimed to assess delivery room resuscitation and discharge outcomes of EPI and ELBWI in China. METHODS: The clinical data of EPI (gestational age [GA] <28 weeks) and ELBWI (birth weight [BW] <1000 g), admitted within 72 h of birth in 33 neonatal intensive care units from five provinces and cities in North China between 2017 and 2018, were analyzed. The primary outcomes were delivery room resuscitation and risk factors for delivery room intubation (DRI). The secondary outcomes were survival rates, incidence of bronchopulmonary dysplasia (BPD), and risk factors for BPD. RESULTS: A cohort of 952 preterm infants were enrolled. The incidence of DRI, chest compressions, and administration of epinephrine was 55.9% (532/952), 12.5% (119/952), and 7.0% (67/952), respectively. Multivariate analysis revealed that the risk factors for DRI were GA <28 weeks (odds ratio [OR], 3.147; 95% confidence interval [CI], 2.082-4.755), BW <1000 g (OR, 2.240; 95% CI, 1.606-3.125), and antepartum infection (OR, 1.429; 95% CI, 1.044-1.956). The survival rate was 65.9% (627/952) and was dependent on GA. The rate of BPD was 29.3% (181/627). Multivariate analysis showed that the risk factors for BPD were male (OR, 1.603; 95% CI, 1.061-2.424), DRI (OR, 2.094; 95% CI, 1.328-3.303), respiratory distress syndrome exposed to ≥2 doses of pulmonary surfactants (PS; OR, 2.700; 95% CI, 1.679-4.343), and mechanical ventilation ≥7 days (OR, 4.358; 95% CI, 2.777-6.837). However, a larger BW (OR, 0.998; 95% CI, 0.996-0.999), antenatal steroid (OR, 0.577; 95% CI, 0.379-0.880), and PS use in the delivery room (OR, 0.273; 95% CI, 0.160-0.467) were preventive factors for BPD (all P < 0.05). CONCLUSION Improving delivery room resuscitation and management of respiratory complications are imperative during early management of the health of EPI and ELBWI.
Birth Weight ; Bronchopulmonary Dysplasia ; China/epidemiology* ; Delivery Rooms ; Female ; Gestational Age ; Humans ; Infant ; Infant, Extremely Low Birth Weight ; Infant, Extremely Premature ; Infant, Newborn ; Male ; Pregnancy

Objective: Several COVID-19 patients have overlapping comorbidities. The independent role of each component contributing to the risk of COVID-19 is unknown, and how some non-cardiometabolic comorbidities affect the risk of COVID-19 remains unclear. Methods: A retrospective follow-up design was adopted. A total of 1,160 laboratory-confirmed patients were enrolled from nine provinces in China. Data on comorbidities were obtained from the patients' medical records. Multivariable logistic regression models were used to estimate the odds ratio ( Results: Overall, 158 (13.6%) patients were diagnosed with severe illness and 32 (2.7%) had unfavorable outcomes. Hypertension (2.87, 1.30-6.32), type 2 diabetes (T2DM) (3.57, 2.32-5.49), cardiovascular disease (CVD) (3.78, 1.81-7.89), fatty liver disease (7.53, 1.96-28.96), hyperlipidemia (2.15, 1.26-3.67), other lung diseases (6.00, 3.01-11.96), and electrolyte imbalance (10.40, 3.00-26.10) were independently linked to increased odds of being severely ill. T2DM (6.07, 2.89-12.75), CVD (8.47, 6.03-11.89), and electrolyte imbalance (19.44, 11.47-32.96) were also strong predictors of unfavorable outcomes. Women with comorbidities were more likely to have severe disease on admission (5.46, 3.25-9.19), while men with comorbidities were more likely to have unfavorable treatment outcomes (6.58, 1.46-29.64) within two weeks. Conclusion Besides hypertension, diabetes, and CVD, fatty liver disease, hyperlipidemia, other lung diseases, and electrolyte imbalance were independent risk factors for COVID-19 severity and poor treatment outcome. Women with comorbidities were more likely to have severe disease, while men with comorbidities were more likely to have unfavorable treatment outcomes.
Adult ; Aged ; COVID-19/virology* ; China/epidemiology* ; Comorbidity ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Severity of Illness Index ; Treatment Outcome

BACKGROUNDPopulation-based cancer registry collects the data on cancer incidence and mortality deaths from covered population to describe and survey the epidemics in certain areas. The aim of this study was to estimate the cancer incidence and mortality in Wuwei, Gansu province, Northwestern China from 2003 to 2012. The goal is to better understand cancer distribution and long-term development of cancer prevention and treatment in Wuwei.

METHODSData were collected from the Wuwei Cancer Registry between 2003 and 2012. In this registry, data from 46 cancer report centers were included in this analysis. Incidence/mortality rates, age-specific incidence/mortality rates, age-standardized incidence/mortality rates, and cumulative incidence/mortality rates were calculated. Totally, 9,836,740 person-years (5,110,342 for males and 4,726,398 for females) had been monitored over this time period. The gender ratio of male/female was 1.08:1. The number of new cancer cases and related deaths was 24,705 and 17,287 from 2003 to 2012, respectively.

RESULTSThe proportion of morphological verification was 74.43%. The incidence of cases identified through death certification only was 1.21%, and the mortality to incidence ratio was 0.70. The average crude incidence was 251.15/100,000 persons (310.61 and 186.87 for males and females per 100,000 persons, respectively). The age-standardized rates by Chinese standard population (ASR-China) and by world standard population (ASR-world) were 207.76 and 245.42 per 100,000 persons, respectively. The crude cancer mortality was 175.74/100,000 persons (228.34 and 118.86 for males and females per 100,000 persons). ASR for China and the world was 149.57 and 175.13/100,000 persons, respectively. The most common cancers and leading causes of cancer-related deaths in Wuwei were as follows: cancers of stomach, esophagus, liver, lung, colorectum, breast, cervix, lymphoma, blood (leukemia), brain, and central nervous system. In Wuwei, during 2003 and 2012, cancer incidence and mortality rates increased by 1.32% and 1.31%/year, respectively. During this time, colorectum cancer incidence and mortality rates increased by 2.69% and 7.54%/year, respectively, in Wuwei. The incidence and mortality of other gastric, esophageal, liver, and lung cancers also all increased.

CONCLUSIONSThe results of this study report a more accurate cancer burden among the population of Wuwei, China. Active research of cancers etiology and effective prevention should be established to reduce the incidence and mortality associated with cancers.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; China ; epidemiology ; Female ; Humans ; Incidence ; Infant ; Infant, Newborn ; Male ; Middle Aged ; Neoplasms ; epidemiology ; mortality ; Registries ; Retrospective Studies ; Time Factors

A novel method was developed for the rapid determination of multi-indicators in corni fructus by means of near infrared (NIR) spectroscopy. Particle swarm optimization (PSO) based least squares support vector machine was investigated to increase the levels of quality control. The calibration models of moisture, extractum, morroniside and loganin were established using the PSO-LS-SVM algorithm. The performance of PSO-LS-SVM models was compared with partial least squares regression (PLSR) and back propagation artificial neural network (BP-ANN). The calibration and validation results of PSO-LS-SVM were superior to both PLS and BP-ANN. For PSO-LS-SVM models, the correlation coefficients (r) of calibrations were all above 0.942. The optimal prediction results were also achieved by PSO-LS-SVM models with the RMSEP (root mean square error of prediction) and RSEP (relative standard errors of prediction) less than 1.176 and 15.5% respectively. The results suggest that PSO-LS-SVM algorithm has a good model performance and high prediction accuracy. NIR has a potential value for rapid determination of multi-indicators in Corni Fructus.
Algorithms ; Calibration ; Cornus ; chemistry ; Drugs, Chinese Herbal ; chemistry ; Fruit ; chemistry ; Least-Squares Analysis ; Models, Theoretical ; Neural Networks (Computer) ; Quality Control ; Spectroscopy, Near-Infrared ; Support Vector Machine

Objective To evaluate the efficacy of ultrasound-guided aspiration with PICC catheter for the patients with malignant tumors.Methods Thirty patients with tumor from January to November 2012 in the General Department who were not able to draw blood directly were phlebotomized under the guidance of Site-Rite 5TM ultrasound,and the effect was analyzed.Results All 30 cases were successfully phlebotomized,with the rate of 100％.Conclusions Ultrasound-guided PICC catheter is a practical,safe and successful method to draw blood,which can improve the success rate and reduce patients' pain due to repeated punctures as well as the incidence of complications.It is a remedy for the traditional venous hemospasia and quite suitable for patients who cannot be phlebotomized successfully during the rescue.

OBJECTIVE: To establish a method for determination of strychnine and brucine in formaldehyde fixed tissue by LC-MS/MS analysis. METHODS: The samples were pretreated with solid phase extraction using SCX cartridges and separated on SB-C18 column with mobile phase 0.1% formic acid : 0.1% formic acid-acetonitrile (75:25). Electrospray ionization (ESI) source was utilized and operated in positive ion mode. Multiple reactions monitoring (MRM) mode was applied. External standard method was applied for quantitation. RESULTS: The chromatographic separation of strychnine and brucine in formaldehyde fixed nephritic and hepatic tissues resulted successfully. The standard curve was linear in the range of 0.002-2.0 microg/g for strychnine and brucine in formaldehyde fixed tissues, and the correlation coefficient was more than 0.996. The limits of detection (LOD) of strychnine and brucine in nephritic tissues were 0.06ng/g and 0.03 ng/g, respectively. The LOD of both chemicals were 0.3 ng/g in hepatic tissues. The extraction recovery rate was more than 74.5%. The precision of intra-day and inter-day were both less than 8.2%. CONCLUSION Strychnine and brucine can be sensitive to be determined in formaldehyde fixed tissue by LC-MS/MS analysis. It can be applied in the forensic toxicological analysis.
Chromatography, Liquid/methods* ; Forensic Toxicology ; Formaldehyde/chemistry* ; Formates ; Kidney/metabolism* ; Limit of Detection ; Liver/metabolism* ; Mass Spectrometry ; Molecular Structure ; Reproducibility of Results ; Spectrometry, Mass, Electrospray Ionization/methods* ; Strychnine/chemistry* ; Tandem Mass Spectrometry ; Tissue Distribution

OBJECTIVETo examine the urinary level of tissue factor (uTF) and its procoagulant activity (PCA) in patients with diabetes mellitus, and explore the relationship between uTF and renal damage in diabetes mellitus.

METHODSEighty-six patients with type 2 diabetes mellitus were divided into 3 groups according to urine albumin excretion (UACR), namely normal albuminuria group, microalbuminuria group and macroalbuminuria group. The levels of uTF, PCA, blood urea nitrogen (BUN), serum creatinine (CRE), serum cystatin C (CYSC), glycohemoglobin A1c (HbA1c), and high-sensitivity C-reactive protein (hs-CRP) were measured in all the patients and 21 healthy controls.

RESULTSCompared with normal control, the diabetic patients showed significantly increased levels of uTF and PCA. The urinary TF-PCA was positively correlated to BUN, CYSC, CRE, UACR, fasting glucose and hs-CRP, but not to uTF; only hs-CRP, UACR were positively correlated to uTF.

CONCLUSIONuTF is probably implicated in the development and progression of diabetic nephropathy.

Adult ; Albuminuria ; urine ; Blood Coagulation ; Case-Control Studies ; Creatinine ; urine ; Diabetes Mellitus, Type 2 ; physiopathology ; urine ; Female ; Humans ; Male ; Middle Aged ; Thromboplastin ; urine

Objective To analyze unsafely factors of elderly alimentary tract hemorrhage patients,strengthen nursing safety, assure nursing quality, improve patients' satisfaction and avoid adverse events happen to our bestMethods 223 elderly alimentary tract hemorrhage patients were collected from January to December in 2009, and safety factors, corresponding precaution have been made meanwhile.Days in hospital, recurrence of bleeding and passing rate of basic nursing and satisfaction rate of patients and incident of safety problems were compared with those 201 peering patients collected in 2008.Results Of all the physical factors, "suffering chronic disease in elderly patients" is most and accounts for 85.4%.Of all the psychological factors, "low economical status" is most and accounts for 54%. "Less communication between nurses and patients and inadequate instruction" is most (67%) of environmental and nurse staff factors.Average days in hospital were reduced in 2009 than in 2008 [(9.3 ±0.35)d vs(11.5 ±0.50)d, t =52.887, P ＜0.01].Passing rate,satisfaction rate were improved and bleeding recurrence rate were decreased, compared with those in 2008 (P ＜0.05).Conclusions It will gain better nursing efficacy through analyzing security issue carefully, finding out the disadvantage factor influencing patients' security and adopting effectve nursing safety control strategy.

OBJECTIVEProgressive pseudorheumatoid dysplasia (PPD) (MIM#208230) is a rare autosomal recessive disease of cartilage homeostasis characterized by axial and peripheral skeletal dysplasia. Analysis of WISP3 (Wnt1-inducible signaling pathway protein 3, MIM#603400) gene mutation can confirm the clinical and radiographic diagnosis for PPD. This study aimed to recognize PPD based on clinical manifestations and imaging characteristics of bones, and to investigate the mutations of WISP3 gene in three patients with PPD.

METHODThree male patients (9 - 16 years old) from three unrelated Chinese families, who presented with joint pain, swelling, deformities and motion limitation, were referred to this study. PPD was diagnosed on the basis of the clinical manifestations, imaging characteristics of bones and laboratory evaluation. All five exons and their exon/intron boundaries of the WISP3 gene were amplified by polymerase chain reaction (PCR) from the peripheral blood DNA of three PPD family members, and mutation analysis was performed by bidirectional DNA sequencing.

RESULT(1) Three patients were diagnosed as PPD by characteristic evidences: all patients presented with non-inflammatory multiple joints swelling and stiffness including joints in hand and feet as they age. Radiographs showed platyspondyly, ovoid or wedged anterior end-plate of vertebral bodies, coxa vara, widened epiphyses or metaphyses including capital femoral, metacarpophalangeal, interphalangeal joints and metatarsals. Normal laboratory values were found for the erythrocyte sedimentation rate and C-reactive protein, rheumatoid factors, antinuclear antibodies etc. (2) The three different mutations of WISP3 gene were identified in three patients with PPD, including two small insert mutations (c.624_625insA, c.866_867insA), one was deletion mutation (c.729_735delGAGAAAA). The types of mutation of two alleles in three patients were c.624_625insA/c.729_735delGAGAAAA, c.624_625insA/c.866_867insA and c.866_867 insA/c.866_867insA, respectively. These mutations were found in exon 4 and exon 5 of WISP3 gene, accounting for 50%(3/6) respectively. All three different mutations were novel variations, and none of 3 novel variations was found in the 50 controls.

CONCLUSIONThe characteristic evidences of PPD were non-inflammatory multiple enlarged joints (including hand and feet), limited movement, normal laboratory values such as rheumatoid factors. It is essential for making diagnosis to carefully examine the entire skeleton including spine. The characteristics of bone imaging are platyspondyly, widened epiphyses or metaphyses including large and small joints and narrow joint spaces. Three different novel variations of WISP3 gene were identified in three PPD patients, they are c.624_625insA, c.866_867insA and c.729_735delGAGAAAA. Each of novel mutations is insert or deletion mutation.

Adolescent ; Arthropathy, Neurogenic ; diagnosis ; genetics ; CCN Intercellular Signaling Proteins ; Child ; Humans ; INDEL Mutation ; Insulin-Like Growth Factor Binding Proteins ; genetics ; Joint Diseases ; congenital ; Male ; Molecular Sequence Data

Objective To assess the prevalence,demographic characteristics,risk factors and protective factors on major depression disorder(MDD)among the affected people in the epicenter,7 months after the 2008-earthquake in Wenchuan,China.Methods Stratified multistage cluster randomization was conducted to choose 14 503 subjects aged 15 years or over in the city of Dujiangyan,Beichuan county and Qingchuan county,Sichuan province.We used the general health questionnaire(GHQ-12)as the screening instrument,and the structured clinical interview for DSM-Ⅳ-TR axis Ⅰ disorder-patient edition(SCID-Ⅰ/P)as the tool for diagnosis.Results There were 180 persons diagnosed as MDD with other 13 asymptomatic ones.The point prevalence of MDD was 1.27% and the lifetime prevalence was 1.36%.Risk factors were including:being female(OR=1.56,95%CI:1.136～ 2.143,P＜0.05),co-morbidity with somatic diseases(OR=4.02,95%CI:2.75-5.90,P＜0.05),wounded in the earthquake(OR=3.29,95%CI:1.92-5.65,P＜0.05),property loss up to 10 000-20 000 Yuan(OR=2.09,95%CI:1.18-3.69,P＜0.05),property loss up to＞20 000 Yuan(OR=2.54,95%CI:1.38-4.68,P＜0.05),death or missing of family members(OR=3.79,95%CI:2.08-6.89,P＜0.05)and in middle-age(OR=2.31,95%CI:1.38-3.86,P＜0.05)etc.Having had a job seemed to be a protective factor(OR=0.60,95%CI:0.43-0.83,P＜0.05).Conclusion Major depressive disorder appeared to be a common psychiatric disease in these quake-stricken areas,that causing serious problems.Sustained follow-up and care provided to the affected people in these areas were of extreme importance.