This study characterizes the demographic, epidemiologic, and clinical characteristics of hospitalized infants diagnosed with coronavirus disease 2019 infection between December 8, 2019, and February 6, 2020, in China.

Objective To evaluate the clinical characteristics and pregnant outcomes of gravidae with COVID-19.Methods This study involved nine gravidae with COVID-19 admitted to the Renmin Hospital of Wuhan University from January 22 to February 1, 2020. Their clinical data, including epidemiological history, clinical symptoms, laboratory examinations, chest CT, treatment, delivery mode, and pregnancy outcomes, were analyzed retrospectively. Descriptive analysis was applied in this study.Results (1) Among the nine cases, five were admitted in the third trimester and four in the second trimester. The median incubation period of COVID-19 was 8 (1-14) d. Fever was presented in all cases on admission, and the other commonly seen symptoms were cough (seven cases) and diarrhea (five cases). Other signs and symptoms were also reported, including shortness of breath, myalgia and fatigue (four cases in each), nasal obstruction, pharyngalgia, chest pain, and headache/dizziness (three cases in each), rash (two cases), and chills and expectoration (one case in each). The most common laboratory abnormalities were a decreased number of lymphocytes (seven cases) and elevated C-reactive protein (six cases). Chest CT scans were performed in seven women, and all showed patchy areas or ground-glass opacity in both lungs. Oligohydramnios was detected in only one case at 37+5 weeks, which was 7 d after the diagnosis of COVID-19. (2) All nine cases received empiric antibiotic and antiviral therapy with Chinese medicine as adjuvant treatment. Eight patients required oxygen inhalation, and seven were treated with glucocorticoid. One case received immunotherapy due to worsening conditions. (3) Four of the nine cases had delivered, including three cesarean sections and one spontaneous vaginal preterm birth after premature rupture of membranes, and the mother was transferred to the intensive care unit 2 d after delivery due to acute respiratory distress syndrome. One case was terminated at 26 gestational weeks. Of the four neonates, there were two term and two premature babies, and one preterm babies was small-for-gestational-age. No neonatal asphyxia was observed. Serial real-time quantitative reverse transcription-polymerase chain reaction showed negative results in the detection of 2019-novel coronavirus in all samples obtained from amniotic fluid, umbilical cord blood, neonatal nasopharynx, breast milk, and vagina. Maternal conditions were all stable in all cases, including the four continuing pregnancy, and the terminated ones, except the case mentioned above.Conclusions There is no distinguishable clinical feature between pregnant and non-pregnant COVID-19 patients. Currently, the evidence for vertical transmission of COVID-19 needs further studies with larger size of examples, but pregnancy may deteriorate COVID-19. Given that COVID-19 may have adverse effects on perinatal outcomes, it''s recommended to take positive and effective measures for COVID-19 women in the third trimester.

目的 描述1例重症新型冠状病毒肺炎患者的诊治过程,帮助临床医生更好地认识和管理新型冠状病毒肺炎.方法 回顾性分析1例重症新型冠状病毒肺炎患者的发病、发展、治疗及结局,并复习相关文献.结果 患者病初表现为发热、干咳,后病情进展,出现呼吸困难,胸部CT示双肺渗出影.根据专家组意见,患者接受洛匹那韦/利托那韦、干扰素α-2b和人血丙种球蛋白等治疗,2周后病愈出院.结论 恰当的管理策略可以达到对新型冠状病毒肺炎有效诊疗的目的.

Our aim was to investigate whether SARS-CoV-2 infection raised high risks of late pregnancy complications, and posed health problems in fetuses and neonates. We analyzed the data of COVID-19 pregnant women with COVID-19 during late pregnancy and their neonates. Eleven out of 16 (69%) pregnant women with COVID-19 had ++ or +++ of ketone body in urine. The blood uric acid of pregnant patients was 334 μmol/L (IQR, 269–452). D-dimer and FDP in pregnant patients were 3.32 mg/L (IQR, 2.18–4.21) and 9.6 mg/L (IQR, 5.9–12.4). Results of blood samples collected at birth showed that 16 neonates had leukocytes (15.7 × 109/L (IQR, 13.7–17.2)), neutrophils (11.1 × 109/L (IQR, 9.2–13.2)), CK (401 U/L (IQR, 382–647)), and LDH (445 U/L (IQR, 417–559)). Twenty-four hours after birth, a neonate from COVID-19 woman had fever and positive of SARS-CoV-2 gene. Another woman had strongly positive for SARS-CoV-2 gene (+++) for 4 weeks, and delivered one neonate who had SARS-CoV-2 IgM (46 AU/mL) and IgG (140 AU/mL) on day 1 after birth. In the third trimester, COVID-19 infection in pregnant patients raised high risks of ketonuria, hypercoagulable state, and hyperfibrinolysis, which may lead to severe complications. COVID-19 increased the inflammatory responses of placenta, and fetuses and neonates had potential organ dysregulation and coagulation disorders. There was a potential intrauterine transmission while pregnant women had high titer of SARS-CoV-2, but it is necessary to detect SARS-CoV-2 in the blood cord, placenta, and amniotic fluid to further confirm intrauterine infection of fetuses.

Aim: Natural killer (NK) cells, as key regulatory cells, accumulate at the maternal-fetal interface in large numbers. This study explored the effect of miR-30e on regulating the activity and function of peripheral blood NK cells (PB-NK cells) and decidua NK cells (D-NK cells) by targeting PRF1 in immune tolerance of maternal-fetal interface.Methods: Expressions of miR-30e in PB and decidua tissues from 49 patients with recurrent spontaneous abortion and 52 normal pregnant women were measured using PCR. NK cells were isolated from PB and decidua tissues and identified by flow cytometry (FCM). In PB-NK cells and D-NK cells activated by IFN-α, expressions of miR-30e and PRF1 were determined by PCR and Western blot. Negative controls of miR-30e mimics/inhibitors and siRNA against PRF1 were transfected in PB-NK cells and D-NK cells. Expressions of miR-30e and PRF1 were determined and their relationship was verified. Expressions of KIR2DL1, NKp44, IFN-γ, TNF-α, IL-4 and IL-10 were determined by FCM. Cytotoxicity kit was used to identify the cytotoxicity of NK cells. PCR and ELISA were employed to measure expression of VEGF, Ang-2 and PGF in D-NK cells.Results: After activation by IFN-α, D-NK cells and PB-NK cells showed decreased miR-30e expression and increased PRF1 expression in normal non-pregnant women. PRF1 is a target gene of miR-30e and miR-30e negatively regulated PRF1 expression. The treatment of miR-30e mimics elevated KIR2DL1 expression and decreased NKp44 expression in PB-NK or D-NK cells. Moreover, up-regulation of miR-30e expression suppressed cytotoxicity, corresponding to increased expression of IL-4and IL-10 and reduced expression of IFN-γ and TNF-α in PB-NK and D-NK cells, as well as enhanced expression of VEGF, Ang-2 and PGF in D-NK cells. Transfection of miR-30e inhibitors could reverse the tendencies.Conclusion: Up-regulated miR-30e can reduce the cytotoxicity of PB-NK cells and D-NK cells by targeting PRF1, whereby inhibiting Th1 tolerance phenotype and inducing Th2 immunodominance. miR-30e may be contributive to creating a micro-immune tolerance environment of maternal-fetal interface.

High heterogeneity has been reported among cohort studies investigating the association between metformin and pancreatic cancer survival. Immortal time bias may be one importance source of heterogeneity, as it is widely present in previous cohort studies and may severely impair the validity. Our study aimed to examine whether metformin therapy improves pancreatic cancer survival, and to assess the impact of immortal time bias on the effect estimation of metformin in cohort studies. PubMed, EMbase and SciVerse Scopus were searched. Pooled relative risks (RRs) were derived using a random‐effects model. Pooled RR from the six studies without immortal time bias showed no association between metformin and mortality in pancreatic cancer patients (RR 0.93, 95% CI 0.82, 1.05; p = 0.22 and I2 = 75%). In contrast, pooled RR from the nine studies with immortal time bias showed a reduction of 24% in mortality associated with metformin (RR 0.76, 95% CI 0.69, 0.84; p < 0.001 and I2 = 1%). From a meta‐regression model, existence of immortal time bias was associated with a reduction of 18% in the effect estimate of metformin on pancreatic cancer survival (ratio of RR 0.82, 95% CI 0.70, 0.96; p = 0.02). In conclusions, cumulative evidence from cohort studies does not support a beneficial effect of metformin on pancreatic cancer survival. The association between metformin and pancreatic cancer survival has been greatly exaggerated in previous cohort studies due to the wide existence of immortal time bias. More rigorous designs and statistical methods are needed to account for immortal time bias.

In recent decades, much effort has been made in China to reduce the burden of cervical cancer.

The recent study by Buturak and colleagues reported that high-sensitivity troponin T rose to a higher levels following uncomplicated elective percutaneous coronary interventions (PCI) in patients without clinical and procedural signs suggestive of myocardial necrosis, and stent post-dilation with non-compliant balloons was one of the factors contributing to the elevation [ [1] Buturak A. Degirmencioglu A. Surgit O. Demir A.R. Karakurt H. Erturk M. et al. Rise of serum troponin levels following uncomplicated elective percutaneous coronary interventions in patients without clinical and procedural signs suggestive of myocardial necrosis. Postepy Kardiol Interwencyjnej. 2016; 12: 41-48 PubMed Google Scholar ]. The results concurred with previous findings that stent post-dilation is associated with a higher risk of death, particularly in acute myocardial infarction (AMI) patients [ [2] Zhang Z.J. Marroquin O.C. Stone R.A. Weissfeld J.L. Mulukutla S.R. Selzer F. et al. Differential effects of post-dilation after stent deployment in patients presenting with and without acute myocardial infarction. Am Heart J. 2010; 160: 979-986.e1 Abstract Full Text Full Text PDF PubMed Scopus (36) Google Scholar ].

The aims of this study were to investigate the impact of weight loss experienced during initial Concurrent Chemoradiotherapy (C-CRT) on survival outcome of patients with stage III Non-Small Cell Lung Cancer (NSCLC). We retrospectively reviewed 98 patients with stage III NSCLC who received C-CRT from January 2007 to December 2010. Patients were treated with systemic chemotherapy regimen of Cisplatin/Docetaxel and concurrent thoracic radiotherapy at a median dose of 66 Gy (range 60 to 70 Gy). Weight loss was defined as weight loss of more than 5% during C-CRT. In 60% of the patients weight loss was observed. In our retrospective clinical study, Kaplan-Meier curves show that patients with weight loss have poorer Progression-Free Survival (PFS) and Overall Survival (OS) (P=0.005, 0.001). Multivariate Cox regression analysis indicated that weight loss could influence the overall survival time of patients in stage III NSCLC, with the hazard ratio of 1.869 (95% CI, 1.175-2.975; P=0.008). Weight loss may be a useful prognostic factor to predict treatment outcome in stage III NSCLC treated with C-CRT.

心脏远程监护对于致命性心律失常可做到迅速识别、及时通知，为及时抢救、挽救患者生命赢得了宝贵的时间。本文介绍心脏远程监护成功抢救电风暴患者一例。

Pediatric patients were recruited to analyze differences in Epstein-Barr virus (EBV) copy numbers and adaptive immune reactions in children with chronic active vs acute EBV infection (CAEBVI vs AEBVI), as well as to examine the relationship between these parameters and the pathogenesis of CAEBVI. Fluorescent qPCR was used to assess EBV-DNA levels, while ELISA, antibody affinity, flow cytometry, and heterophil agglutination (HA) assays were used to evaluate patient EBV-adaptive humoral and cellular immunity. Lastly, ELISPOT was employed to assess interferon (IFN)-gamma secretory functions of EBV-specific cytotoxic T-lymphocytes (CTL) as a marker of subject EBV-specific adaptive cellular immunity. The results indicated that, compared with AEBVI patients or normal children, there was a dramatic elevation in viral copy levels, viral capsid antigen (VCA)-IgA, early antigen (EA)-IgA, and EA-IgG, but a lack of EBV nuclear antigen (EBNA)-IgG and a negative HA in CAEBVI patients (p<0.01). These subjects also had decreased CD4(+), CD8(+) (naive), CD8(+)CD38(+), and effective memory T-lymphocyte levels compared with AEBVI patients (p<0.01), and decreased EBV-specific CTL function compared with normal children (p<0.01). These results suggest that there is a disturbance in EBV antigen availability and in both the adaptive humoral and cellular immune responses in patients with CAEBVI, and that these outcomes may be associated with the chronic active re-infection process itself associated with CAEBVI.

Aim: To observe the effect of EGCG in combination with gemcitabine on PANC-1 human pancreatic cancer cells and to explore whether EGCG could enhance pancreatic cancer cell sensitivity to chemotherapeutic drugs by inhibiting beta-catenin mRNA and protein through Wnt/beta-catenin pathway. METHODS: Cultured PANC-1 cells were divided into control group, EGCG group, gemcitabine group (JX), and EGCG and gemcitabine group. Cells apoptosis was detected by flow cytometry. beta-catenin expression was measured by RTqPCR and Western blot. Results: JX + EGCG group had the strongest apoptosis, followed by EGCG group, JX group, and control group. beta-catenin mRNA expression of JX + EGCG group was significantly lower than that of control group (P < 0.05). beta-catenin protein expression of JX + EGCG group was significantly lower than that of control group (P < 0.01). Conclusion: Combination of EGCG and Gemcitabine had a synergistic effect on inducing PANC-1 apoptosis, possibly by inhibiting beta-catenin mRNA and protein through Wnt/beta-catenin pathway.

冠状动脉综合征(冠脉综合征)包括急性心肌梗死、不稳定型心绞痛等一组危重心血管疾病,其主要病理基础为冠脉内皮下不稳定斑块破裂、出血及血栓形成.冠脉综合征患者心电图常呈缺血性T波改变,可分为ST段抬高和非ST段抬高两大类.前者主要为ST段抬高型心肌梗死,大多有坏死性Q波;后者包括不稳定型心绞痛和非ST段抬高型心肌梗死,表现为ST段下移和缺血性T波.2006年3月～2012年8月,本院收治心电图呈缺血性T波的非冠状动脉综合征12例.现报告如下.

Objective To distinguish two mechanisms of resting myocardial ischemia-coronary artery spasm and other causes,and determine the incidence of each mechanism in different coronary atherosclerosis(AS)populations with a remote heart monitoring system.Methods All the patients who underwent the coronary arteriography or Computed Tomography of coronary arteriography(CTA),as well as Holter or iHolter,were enrolled in the remote heart monitoring center from January 2009 to December 2010.All patients′ records and reports of the Holter and iHolter were reviewed,and all analyses were performed with the statistical software program SPSS version 16.0.Results The incidence of resting myocardial ischemia was more than 21.3% in patients diagnosed with coronary artery disease by coronary arteriography or CTA,while the incidence was more than 58.3%(P0.05) in patients who only showed mild stenosis in CTA or with negative coronary arteriography.Analyzing the etiologies of the resting myocardial ischemia,coronary artery spasm accounted for more than 73.3%,while the other causes only accounted for less than 26.7%(P0.05).Conclusions Coronary arteriography can be used to distinguish the two mechanisms of resting myocardial ischemia.And coronary artery spasm is the chief mechanism of resting myocardial ischemia.Resting myocardial ischemia can easily happen in the patients only showing mild stenosis in CTA or with negative coronary arteriography.It is very important to monitor resting myocardial ischemia with the remote heart monitoring system.

Objective To establish and evaluate the judge model of Sub-health Self-rating Scale(SSS). Methods Through cluster sampling,6205 effective samples were obtained.Feasibility,reliability and validity analysis were conducted.The clinical sub-health reference parameters,including original score,transformed score and T score,were worked out by percentile method,according to the prevalence rate of sub-health.One thousand valid questionnaires by random sampling were collected to evaluate the consistency between expert judge model and score judge model.The triadic judge model of sub-health by logistic regression was conducted for analysis with fit index χ2 and Nagelkerke R2. Results(1) The feasibility was sufficient with acceptance rate and finish rate of 89.03% and 99.67%,respectively.According to internal consistency analysis,the Cronbach′s alpha indexes of the total scale and the dimensions of body,mood,and society were 0.942,0.915,0.856,and 0.850,respectively,ranging between 0.88-0.72.Split-half reliability of the total scale and the dimensions of body,mood,and society were 0.938,0.933,0.890,and 0.881,respectively,ranging from 0.73 to 0.90.According to validity analysis,there were 10 factors extracted by exploratory factor analysis as 1-order factor(Varimax,FI) with cumulative proportion of 56.63%;and 2 factors as of 2-order factor(Promax,FII) with cumulative proportion of 56.55%.FI included 6 factors of physiological dimension,while FII included 4 factors of psychological and social relationship dimensions,which suggested obviously negative relationship between psychological and social factors.According to confirmatory factor analysis,GFI,CFI,AGFI,NFI,IFI and TLI were 0.86,0.96,0.85,0.055,0.961,0.963 and 0.961,respectively.In content validity,there was significant correlation between each item and factor(r ranged 0.51-0.88).There was also significant correlation between each factor and its own domain(r ranged 0.52-0.89).There was significant correlation between subscale and total scale(r ranged 0.77-0.93).(2) There was significant consistency between expert judge model and score judge model(K>0.70). Conclusion The scale is of better feasibility,reliability and validity and can be used in practice.This study initially established the judge model,which had good prediction rate and interpreting ability.To some extent,the model can be a judging standard of sub-health.

Objective To construct a vector of recombinant adeno-associated virus(AAV) containing the fusion gene hTRX-PR39,and explore the role of fusion gene hTRX-PR39 as a target gene in the treatment of cerebral ischemic disease.Methods The constructed fusion gene hTRX-PR39 was inserted into the EcoRI-BamHI site of vector plasmid pSSCMV,and the vector of hTRX-PR39 recombinant AAV was constructed.The recombinant AAV stock was packaged.Renal embryo 293 cells were co-transfected with the recombinant AAV vector of plasmid pSSCMV/hTRX-PR39,packaging plasmid pAAV/Ad and helper adenovirus plasmid pFG140.Recombinant AAV was produced by homologous recombination of the 3 plasmids in renal embryo 293 cells and its titer was measured by quantitative dot blot hybridization.Results The vector of hTRX-PR39 recombinant AAV was successfully constructed.High titer of recombinant AAV was obtained by homologous recombination in renal embryo 293 cells(3.46×1012-3.46×1013PFU/mL).Conclusion The recombinant AAV vector encoding the gene hTRX-PR39 was successfully constructed in this study by molecular cloning and in vitro recombination techniques,laying the foundation for further research into genetic therapy of cerebral ischemic disease.

目的 探讨心脏远程监护仪手动记录的临床意义.方法 回顾分析6例心血管病患者应用心脏远程监护仪手动记录模式发送的心电图.结果 心电图分别显示窦性心律不齐、窦性停搏、心房扑动、频发室性早搏、ST-T改变、A型预激波.结论 应用心脏远程监护仪手动记录模式对于诊断突发性心律失常和心肌缺血具有重要的临床意义.

Objective To study clinical significance of cardiac remote monitoring system.Methods 1 315 users were girded on cardiac remote monitoring apparatus using the mode of automatically and quietly warning,and monitor on realtime.After the apparatus was picked off,the electrocardiogram date storing in it were imported into computer through Universal Serial Bus and analyzed retrospectively.Results In 1 181 users for diagnosis,977 cases occurring electrocardiogram abnormity were discovered and diagnosed definitely.In the records of electrocardiogram by automatically warning,69 cases of malignant arrhythmia and obvious ST-T change were discovered,and they or their family numbers were informed immediately,or were taken relevant preventive,or cure in time.In 87 users for surgical wardship,4 cases of exceptional cardiogram were discovered through the records of electrocardiogram by automatically warning and the advice was given immediately to pause the operation.In 26 cases of pacemaker followup,5 cases of malignant arrhythmia because of palpitation,2 cases of ST-T change because of chest stuffiness or suffocation and 1 case of apperceive holdback because of dizziness were discovered.For the latter,some parameters of his pacemaker were modulated in time.In 47 users for cadre health care,4 cases of exceptional cardiogram was discovered through the record of electrocardiogram by automatically warning and corresponding measure was brought into effect urgently.Conclusion It had a better applied significance using cardiac remote monitoring apparatus in diagnosis,surgical wardship,pacemaker followup,cadre health care,and so on.

Objective To construct cDNA substractive library from kidney-yin deficiency patients with IgA nephropathy by suppression subtractive hybridization (SSH). Method Total RNAs from normal and disease patients were isolated using Trizol BD. cDNA was produced by SMART RT-PCR. SSH was used to obtain genes associated with kidney-yin deficiency of IgA nephropathy by comparing blood cDNA of patients with kidney-yin deficiency of IgA nephropathy (as Tester or Driver) with normal blood cDNA (as Tester or Driver). After RsaⅠ enzyme digestion, Tester cDNA was divided into two groups for the ligation with the specific adaptor l and adaptor 2. Tester cDNAs were hybridized with Driver cDNA twice and then nested PCR twice. The PCR product was ligated with Uplasmid vectors, transformed into E.coli TOP10 and screened through the blue-white screening system. Positive recombinant clones were confirmed by PCR. Result cDNA subtractive library was successfully produced. 325 clones were obtained from the forward subtractive library and 306 clones were obtained from the reverse subtractive library. Conclusion SSH can be used for the rapid isolation of differentially expressed cDNA. The cDNA subtractive library may be used for cloning the genes involving kidney-yin deficiency in patient with IgA nephropathy.