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

BACKGROUND: Imprecise interpretation of coronary angiograms was reported and resulted in inappropriate revascularization. Synergy Between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery (SYNTAX) score is a comprehensive system to evaluate the complexity of the overall lesions. We hypothesized that a real-time SYNTAX score feedback from image analysts may rectify the mis-estimation and improve revascularization appropriateness in patients with stable coronary artery disease (CAD). METHODS: In this single-center, historical control study, patients with stable CAD with coronary lesion stenosis ≥50% were consecutively recruited. During the control period, SYNTAX scores were calculated by treating cardiologists. During the intervention period, SYNTAX scores were calculated by image analysts immediately after coronary angiography and were provided to cardiologists in real-time to aid decision-making. The primary outcome was revascularization deemed inappropriate by Chinese appropriate use criteria for coronary revascularization. RESULTS: A total of 3245 patients were enrolled and assigned to the control group (08/2016-03/2017, n = 1525) or the intervention group (03/2017-09/2017, n = 1720). For SYNTAX score tertiles, 17.9% patients were overestimated and 4.3% were underestimated by cardiologists in the control group. After adjustment, inappropriate revascularization significantly decreased in the intervention group compared with the control group (adjusted odds ratio [OR]: 0.83; 95% confidence interval [CI]: 0.73-0.95; P = 0.007). Both inappropriate percutaneous coronary intervention (adjusted OR: 0.82; 95% CI: 0.74-0.92; P < 0.001) and percutaneous coronary intervention utilization (adjusted OR: 0.88; 95% CI: 0.79-0.98; P = 0.016) decreased significantly in the intervention group. There was no significant difference in 1-year adverse cardiac events between the control group and the intervention group. CONCLUSIONS: Real-time SYNTAX score feedback significantly reduced inappropriate coronary revascularization in stable patients with CAD. CLINICAL TRIAL REGISTRATION Nos. NCT03068858 and NCT02880605; https://www.clinicaltrials.gov.

OBJECTIVE: To investigate the down-regulation effect of let-7b-5p on the expression of FTO in acute myeloid leukemia cell line THP-1 and inhibitory effect on THP-1 proliferation via m METHODS: The acute myeloid leukemia cell line THP-1 and the normal human peripheral blood mononuclear cells (PBMNC) were selected as subjects. The expression of let-7b-5p and FTO mRNA in those cells was detected by qPCR, further the expression of FTO protein in those cells was detected by Western blot. And, the luciferase reporter gene assay was used to verify the targeting effect of let-7b-5p on FTO. Finally, THP-1 cells were transfected respectively with let-7b-5p mimic, and PBMNC with let-7b-5p inhibitor, there after the C-MYC mRNA m RESULTS: Compared with PBMNC, the expression of let-7b-5p in THP-1 significantly decreased, while the expression of FTO was significantly increased (P<0.05). After transfection with let-7b-5p mimic combined with FTO 3'-UTR, the luciferase activity of transfected THP-1 cells significantly decreased, but the luciferase activity significantly increased after transfection with mutant 3'-UTR, which was significantly different from the negative control group(blank vector) (P<0.05). Let-7b-5p inhibitor down-regulated c-MYC mRNA m CONCLUSION Human acute myeloid leukemia cell line THP-1 low expresses the let-7b-5p, which regulates c-MYC expression through let-7b-5p-/FTO-/m
Alpha-Ketoglutarate-Dependent Dioxygenase FTO/genetics* ; Cell Line, Tumor ; Cell Proliferation ; Humans ; Leukemia ; Leukocytes, Mononuclear ; MicroRNAs/genetics* ; Signal Transduction ; THP-1 Cells

【Objective】 To study the diagnostic value of computed tomography(CT) in the diagnosis of infantile congenital lung malformation(CLM) . 【Methods】 A total of 76 CLM patients diagnosed in the Third Affiliated Hospital of Guangzhou Medical University from May 2019 to May 2020 were selected. The diagnostic accuracy of preoperative CT and prenatal ultrasound(US) diagnosis of CLM was compared based on the gold standard of pathological results. The preoperative CT findings and differential diagnosis were analyzed. 【Results】 Among the 76 cases of CLM, there were 36 cases of congenital pulmonary airway malformation(CPAM), 26 cases of pulmonary sequestration(PS), 8 cases of congenital lobar emphysema(CLE), and 6 cases of mixed type. There was a moderate agreement between CT and US diagnosis of CLM(Kappa = 0.465, P < 0.05). The accuracy rate of CT diagnosis was 85.5%, which was higher than that of US(69.7%). McNemar test result is P = 0.001, the difference of diagnostic value between CT and US was statistically significant. In terms of CT manifestations, CPAM was mainly characterized by cystic lesions of different sizes. PS showed pulmonary mass with abnormal blood supply artery, mainly from the aortic branch. CLE was characterized by overexpansion of the pulmonary lobes and thinning of the pulmonary blood vessels. 【Conclusions】 In infantile CLM, preoperative CT is an important supplementary examination for prenatal US. Different types of CLM have different manifestations. CT can diagnose and distinguish different types of CLM, which provides an important basis for preoperative clinical evaluation.

OBJECTIVE: To assess the activities of biapenem against multidrug-resistant and extensively drug-resistant Mycobacterium tuberculosis. METHODS: Biapenem/clavulanate (BP/CL) was evaluated for in vitro activity against Mycobacterium tuberculosis (Mtb) multidrug-resistant (MDR) isolates, extensively drug-resistant (XDR) isolates, and the H37RV strain. BP/CL activity against the H37Rv strain was assessed in liquid cultures, in macrophages, and in mice.. RESULTS: BP/CL exhibited activity against MDR and XDR Mtb isolates in liquid cultures. BP/CL treatment significantly reduced the number of colony forming units (CFU) of Mtb within macrophages compared with control untreated infected macrophages. Notably, BP/CL synergized in pairwise combinations with protionamide, aminosalicylate, and capreomycin to achieve a fractional inhibitory concentration for each pairing of 0.375 in vitro. In a mouse tuberculosis infection model, the efficacy of a cocktail of levofloxacin + pyrazinamide + protionamide + aminosalicylate against Mtb increased when the cocktail was combined with BP/CL, achieving efficacy similar to that of the positive control treatment (isoniazid + rifampin + pyrazinamide) after 2 months of treatment. CONCLUSION BP/CL may provide a new option to clinically treat MDR tuberculosis.
Animals ; Anti-Infective Agents ; pharmacology ; therapeutic use ; Cell Line ; Drug Evaluation, Preclinical ; Macrophages ; Mice ; Mycobacterium tuberculosis ; drug effects ; Thienamycins ; pharmacology ; therapeutic use ; Tuberculosis, Multidrug-Resistant ; drug therapy

BACKGROUNDLaparoscopic resection (LAP) for small bowel gastrointestinal stromal tumors (GISTs) is not as common as for stomach. This study aimed to evaluate the safety and efficacy of LAP for small bowel GISTs with systematic review and meta-analysis.

METHODSThe Web of Science, Cochrane Library, Embase, and PubMed databases before December 2016 were comprehensively searched to retrieve comparative trials of LAP and conventional open resection (OPEN) for GISTs of small bowel with a relevance of review object. These researches reported intraoperative and postoperative clinical course (operation time, blood loss, time to first flatus and oral intake, hospital stay, morbidity, and mortality), oncologic outcomes, and long-term survival status.

RESULTSSix studies involving 391 patients were identified. Compared to OPEN, LAP had associated with a shorter operation time (weighted mean difference [WMD] = -27.97 min, 95% confidence interval [CI]: -49.40--6.54, P < 0.01); less intraoperative blood loss (WMD = -0.72 ml; 95% CI: -1.30--0.13, P = 0.02); earlier time to flatus (WMD = -0.83 day; 95% CI: -1.44--0.22, P < 0.01); earlier time to restart oral intake (WMD = -1.95 days; 95% CI: -3.31--0.60, P < 0.01); shorter hospital stay (WMD = -3.00 days; 95% CI: -4.87--1.13, P < 0.01); and a decrease in overall complications (risk ratio = 0.56, 95% CI: 0.33-0.97, P = 0.04). In addition, the tumor recurrence and long-term survival rate showed that there was no significant difference between the two groups of patients.

CONCLUSIONSLAP for small bowel GISTs is a safe and feasible procedure with shorter operation time, less blood loss, less overall complications, and quicker recovery. Besides, tumor recurrence and the long-term survival rate are similar to open approach. Because of the limitations of this study, methodologically high-quality studies are needed for certain appraisal.

Radical retropubic prostatectomy (RRP) has been one of the most effective treatments for prostate cancer.This study is designed to identify the related predictive risk factors for complications in patients following RRP.Between 2000 and 2012 in Department of Urology,Fudan University Shanghai Cancer Center,421 cases undergoing RRP for localized prostate cancer by one surgeon were included in this retrospective analysis.We reviewed various risk factors that were correlated with perioperative complications,including patient characteristics [age,body mass index (BMI),co-morbidities],clinical findings (preoperative PSA level,Gleason score,clinical stage,pathological grade),and surgeon's own clinical practice.Charlson comorbidity index (CCI) was used to explain comorbidities.The total rate of perioperative complications was 23.2％ (98/421).There were 45/421 (10.7％),28/421 (6.6％),24/421 (5.7％) and 1/421 (0.2％) in grade Ⅰ,Ⅱ,Ⅲ,Ⅳ respectively,and 323/421 (76.8％) cases had none of these complications.Statistical analysis of multiple potential risk factors revealed that BMI ＞30 (P=0.014),Charlson score ≥1 (P＜0.001) and surgical experience (P=0.0252) were predictors of perioperative complications.Age,PSA level,Gleason score,TNM stage,operation time,blood loss,and blood transfusion were not correlated with perioperative complications (P＞0.05).It was concluded that patients' own factors and surgeons' technical factors are related with an increased risk of development of perioperative complications following radical prostatectomy.Knowing these predictors can both favor risk stratification of patients undergoing RRP and help surgeons make treatment decisions.

China ; Humans ; Organ Transplantation ; legislation & jurisprudence