Low Apgar score is associated with increased risk of death in preterm or full-term infants. However, the use of Apgar score to assess extremely preterm (EP) infants is controversial. In this study, we characterized the distribution of Apgar scores in EP infants with gestational age between 25 and 27 weeks, and investigated the association of Apgar score with survival rate at discharge by analyzing the clinical data of the EP infants discharged between January 2008 and December 2017 from 26 neonatal intensive care units in Guangdong Province, China. A total of 1567 infants with gestational age of 26.84±0.79 weeks and birth weight of 951±169 grams were involved in our study. The Apgar score increased with gestational age from 25 to 27 weeks and with time from birth from 1 to 10 min. The survival rate increased with a higher Apgar score, but no significant difference was found for 1-min Apgar score and the survival rate between infants with 25 or 26 weeks of gestation or 5-min Apgar score in infants with 25 weeks of gestation. The Apgar score is associated with survival of EP infants.

OBJECTIVES: This study explored the clinical efficacy of VitalStim electrical stimulation combined with swallowing function training for patients with dysphagia following an acute stroke. METHODS: Seventy-two patients with dysphagia following an acute stroke were admitted to our hospital and were further divided into two groups using prospective research methods. There were 36 cases in each group according to the random number table method. The control group received conventional medical treatment and swallowing function training while the experimental group received conventional medical treatment and VitalStim electrical stimulation combined with swallowing function training. RESULTS: The overall response rate of the experimental group (94.44%) was higher than that of the control group (77.78%), and the difference was statistically significant (p<0.05). Compared with before treatment, the upward and forward movement speeds of the hyoid bone, anterior movement speed, the grading score of the Kubota drinking water test, Caiteng’s grading score, serum superoxide dismutase, 5-hydroxytryptamine, and norepinephrine levels, Fugl-Meyer Assessment score, and multiple quality of life scores of the two groups showed improvement after treatment. While the standard swallowing assessment score, serum malondialdehyde level, and National Institutes of Health Stroke Scale score decreased, the aforementioned indices showed a significant improvement in the experimental group (p<0.05). CONCLUSION: The results of this study indicate that VitalStim electrical stimulation combined with swallowing function is effective for treating dysphagia following an acute stroke. It can effectively improve swallowing, neurological, and limb motor functions, reduce complications, promote physical recovery, and improve overall quality of life of patients.

Abstract This study investigated the extraction of matrine from Vietnamese sophora root and its in vitro and in vivo inhibitory effects on oral squamous cell carcinoma (OSCC) cells. Matrine was extracted from Vietnamese sophora root using microwave-assisted extraction technology and purified using macroporous adsorption resin. Human OSCC Tca8113 cells were treated with matrine with concentration of 0, 0.5, 1, 2, 4 and 8 g/L. The proliferation and apoptosis of cells were detected. OSCC cells were transplanted in the nude mice, and then the nude mice were treated with normal saline, cyclophosphamide (CTX) (20 mg·kg-1) and matrine (100 mg·kg -1), respectively. The optimized extraction parameters of matrine were obtained. The in vitro experiments showed that, matrine inhibit the proliferation of Tca8113 cells and induced the cell apoptosis. The in vivo experiments found that, the tumor inhibition rate of matrine was basically equivalent to that of CTX. In addition, compared with CTX, matrine had no obvious toxic side effect on the liver and kidney function of nude mice. These results indicate that, matrine has obvious in vitro and in vivo inhibitory effects on OSCC cells, with no obvious toxic side effect on the liver and kidney function.

Abstract Background: Conjunctival filtering bleb scar formation is the main reason for the failure of glaucoma filtration surgery. Cytoglobin (Cygb) has been reported to play an important role in extracellular matrix (ECM) remodeling, fibrosis and tissue damage repairing. This study aimed to investigate the role of Cygb in anti-scarring during excessive conjunctival wound healing after glaucoma filtration surgery. Methods: Cygb was overexpressed in human tenon fibroblasts (hTFs) by transfecting hTFs with lentiviral particles encoding pLenti6.2-FLAG-Cygb. Changes in the mRNA and protein levels of fibronectin, collagen I, collagen III, TGF-β1, and HIF1α were determined by RT-PCR and western blotting respectively. Results: After Cygb overexpression, hTFs displayed no significant changes in visual appearance and cell counts compared to controls. Whereas, Cygb overexpression significantly decreased the mRNA and protein expression levels of collagen I, collagen III and fibronectin compared with control (p < 0.01). There was also a statistically significant decrease in the mRNA and protein levels of TGF-β1 and HIF-1α in hTFs with overexpressed Cygb compared with control group (p < 0.05). Conclusion: Our study provided evidence that overexpression of Cygb decreased the expression levels of fibronectin, collagen I, collagen III, TGF-β1 and HIF-1α in hTFs. Therefore, therapies targeting Cygb expression in hTFs may pave a new way for clinicians to solve the problem of post-glaucoma surgery scarring.

Abstract Purpose: To investigate the effect of oxymatrine on periodontitis in rats and related mechanism. Methods: Ninety SD rats were divided into control, model, 10, 20 and 40 mg/kg oxymatrine and tinidazole groups. The periodontitis model was established in later 5 groups. The 10, 20 and 40 mg/kg oxymatrine groups were intragastrically administrated with 10, 20 and 40 mg/kg oxymatrine, respectively. The tinidazole group was intragastrically administrated with 100 mg/kg tinidazole. The treatment duration was 4 weeks. The tooth mobility, gingival and plaque indexes, serum inflammatory factor levels and gingival tissue matrix metalloproteinases (MMPs) and tissue inhibitor of metalloproteinase (TIMP) protein levels were detected. Results: After treatment, compared with model group, in 40 mg/kg oxymatrine group the rat general conditions were obviously improved, the tooth mobility, gingival index and plaque index were significantly decreased (P<0.05), the serum tumor necrosis factor-α, interleukin-1β and prostaglandin E2 levels were significantly decreased (P<0.05), the MMP-2 and MMP-9 protein levels were significantly decreased (P<0.05), and the TIMP-2 protein level was significantly increased (P<0.05). Conclusions: Oxymatrine can alleviate the experimental periodontitis in rats. The mechanism may be related to its inhibiting inflammatory factor secretion and regulating MMPs/TIMP protein expression.

JUSTIFICATIVA E OBJETIVOS: Investigar a eficácia clínica, segurança e viabilidade do monitor Narcotrend® para avaliar a profundidade da anestesia em crianças com doença cardíaca congênita (DCC) submetidas à cirurgia cardíaca. MÉTODOS: Foram randomicamente selecionadas 80 crianças submetidas à anestesia geral em cirurgia seletiva. As crianças foram divididas em dois grupos de forma aleatória (n = 40 por grupo). No grupo Narcotrend, a profundidade da anestesia foi monitorada com o Narcotrend. No grupo padrão, a profundidade da anestesia foi controlada de acordo com a experiência clínica. A pressão arterial média (PAM) e a frequência cardíaca (FC) foram determinadas e a dose de fentanil e relaxante muscular e os tempos de recuperação e de extubação foram registrados. RESULTADOS: Em ambos os grupos, os sinais vitais apresentaram-se estáveis durante a cirurgia. No grupo Narcotrend, a PAM e a FC foram mais estáveis, a dose total de fentanil e relaxante muscular significativamente menor e os tempos de recuperação e extubação acentuadamente mais reduzidos em comparação com o grupo padrão. CONCLUSÃO: A aplicação do monitor Narcotrend para medir a profundidade da anestesia foi útil para controlar a profundidade da anestesia em crianças com DCC que receberam anestesia intravenosa total, na qual uma pequena quantidade de narcóticos pode obter a anestesia ideal. Além disso, os tempos de recuperação e extubação foram menores e os efeitos secundários, como sensibilização intraoperatória, puderam ser evitados.

BACKGROUND AND OBJECTIVES: To investigate the clinic effectiveness, safety and feasibility of Narcotrend® monitor for evaluation of depth of anesthesia in congenital heart disease (CHD) infants undergoing cardiac surgery. METHODS: A total of 80 infants receiving general anesthesia in selective surgery were randomly selected. Infants were assigned into two groups (n = 40 per group). In the Narcotrend group, the depth of anesthesia was monitored with the Narcotrend monitor. In the standard group, the depth of anesthesia was controlled according to the experience. The mean arterial pressure (MAP) and heart rate (HR) were determined, as well as the dose of fentanyl, muscle relaxant, recovery time and extubation time were recorded. RESULTS: In both groups, vital signs were stable during the surgery. When compared with the standard group, the MAP and HR were more stable, the total dose of fentanyl and muscle relaxant were significantly reduced and the recovery time and extubation time were markedly shortened in the Narcotrend group. CONCLUSION: The application of Narcotrend monitor was beneficial to the control of the depth of anesthesia in CHD infants receiving total intravenous anesthesia, in which small amount of narcotics can achieve optimal anesthesia. Moreover, the recovery time and extubation time are reduced and the harmful consequence such as intraoperative awareness can be avoided.

JUSTIFICATIVA Y OBJETIVOS: Investigar la eficacia clínica, la seguridad y la viabilidad del monitor Narcotrend® para evaluar la profundidad de la anestesia en niños con enfermedad cardíaca congénita (ECC) sometidos a la cirugía cardíaca. MÉTODOS: Un total de 80 niños sometidos a la anestesia general en cirugía selectiva fueron seleccionados aleatoriamente. Los niños fueron divididos en dos grupos de forma aleatoria (N = 40 por grupo). En el grupo Narcotrend, la profundidad de la anestesia se monitorizó con el monitor Narcotrend. En el grupo estándar, la profundidad de la anestesia fue controlada de acuerdo con la experiencia. Se midieron la presión arterial promedio (PAP) y la frecuencia cardíaca (FC). Fueron registrados también la dosis de fentanilo y de relajante muscular junto con los tiempos de recuperación y de desentubación. RESULTADOS: En los dos grupos, los signos vitales se mantuvieron estables durante la cirugía. En el grupo Narcotrend, la PAP y la FC fueron más estables, la dosis total de fentanilo y de relajante muscular significativamente menor y los tiempos de recuperación y desentubación ostensiblemente más reducidos en comparación con el grupo estándar. CONCLUSIONES: La aplicación del monitor Narcotrend para medir la profundidad de la anestesia fue útil en el control de la profundidad de la anestesia en niños con ECC que reciben anestesia intravenosa total, en donde una pequeña cantidad de narcóticos puede alcanzar la anestesia ideal. Además, los tiempos de recuperación y desentubación fueron menores, y el efecto secundario, como la sensibilización intraoperatoria, pudo ser evitado.

OBJECTIVE: To estimate influenza-associated mortality in urban China. METHODS: Influenza-associated excess mortality for the period 2003-2008 was estimated in three cities in temperate northern China and five cities in the subtropical south of the country. The estimates were derived from models based on negative binomial regressions, vital statistics and the results of weekly influenza virus surveillance. FINDINGS: Annual influenza-associated excess mortality, for all causes, was 18.0 (range: 10.9-32.7) deaths per 100000 population in the northern cities and 11.3 (range: 7.3-17.8) deaths per 100000 in the southern cities. Excess mortality for respiratory and circulatory disease was 12.4 (range: 7.4-22.2) and 8.8 (range: 5.5-13.6) deaths per 100000 people in the northern and southern cities, respectively. Most (86%) deaths occurred among people aged >65 years. Influenza-associated excess mortality was higher in B-virus-dominant seasons than in seasons when A(H3N2) or A(H1N1) predominated, and more than half of all influenza-associated mortality was associated with influenza B virus. CONCLUSION: Between 2003 and 2008, seasonal influenza, particularly that caused by the influenza B virus, was associated with substantial mortality in three cities in the temperate north of China and five cities in the subtropical south of the country.

OBJETIVO: Calcular la mortalidad asociada a la gripe en la China urbana. MÉTODOS: Se calculó el exceso de mortalidad asociado a la gripe durante el periodo comprendido entre 2003 y 2008 en tres ciudades del norte de China con clima templado y en cinco ciudades del sur del país con clima subtropical. Los cálculos se obtuvieron de modelos basados en regresiones binomiales negativas, estadísticas vitales y de los resultados de la vigilancia semanal del virus de la gripe. RESULTADOS: El exceso de mortalidad anual asociado a la gripe, por todas las causas, fue de 18,0 (rango: 10,9-32,7) muertes por cada 100000 habitantes en las ciudades del norte y de 11,3 (rango: 7,3-17,8) muertes por cada 100000 habitantes en las ciudades del sur. La mayor parte de este exceso de mortalidad - 12,4 (rango: 7,4-22,2) y 8,8 (rango: 5,5-13,6) muertes por cada 100000 habitantes en las ciudades del norte y del sur, respectivamente - se atribuyeron a una enfermedad respiratoria y/o circulatoria. La mayoría de las muertes (el 86%) ocurrió en personas con una edad >65 años. El exceso de mortalidad asociado a la gripe fue superior en épocas con un virus B dominante que en épocas en las que predominaron los virus A(H3N2) o A(H1N1). Más de la mitad de la mortalidad total asociada a la gripe se asoció al virus B de la gripe. CONCLUSIÓN: Entre 2003 y 2008, la gripe estacional, particularmente la causada por el virus B de la gripe, estuvo asociada a la mortalidad sustancial en tres ciudades de China con clima templado y en cinco ciudades del sur del país con clima subtropical.

OBJECTIF: Estimer la mortalité associée à la grippe en Chine urbaine. MÉTHODES: La mortalité excessive associée à la grippe pour la période 2003-2008 a été évaluée dans trois villes de la zone tempérée du nord de la Chine et dans cinq villes de la zone subtropicale du pays. Les estimations ont été établies sur des modèles basés sur des régressions binomiales négatives, des statistiques vitales et les résultats de la surveillance hebdomadaire de la grippe. RÉSULTATS: La mortalité annuelle excessive associée à la grippe, dans tous les cas, a été de 18 (plage: 10,9-32,7) décès pour une population de 100 000 personnes dans les villes du nord et de 11,3 (plage: 7,3-17,8) décès pour une population de 100 000 personnes dans les villes du sud. La plus grande partie de cette mortalité excessive - respectivement 12,4 (plage: 7,4-22,2) et 8,8 (plage: 5,5-13,6) décès pour une population de 100 000 personnes dans les villes du nord et du sud - a été attribuée à des maladies respiratoires et/ou circulatoires. La plupart des décès (86%) sont survenus chez des personnes de >65 ans. La mortalité excessive associée à la grippe a été plus élevée lors des saisons où prédominait le virus B plutôt que lors de celles où prédominaient les virus A(H3N2) ou A(H1N1) et plus de la moitié de l'ensemble de la mortalité associée à la grippe a été associée au virus B de la grippe. CONCLUSION: De 2003 à 2008, la grippe saisonnière, surtout celle provoquée par le virus B, a été associée à une mortalité substantielle dans trois villes du nord tempéré de Chine et dans cinq villes du sud subtropical du pays.

The purpose of this study was to investigate whether treatment with electroacupuncture (EA) inhibited mitochondria-dependent apoptosis in annulus fibrosis (AF) cells in a rat model of cervical intervertebral disc degradation induced by unbalanced dynamic and static forces. Forty Sprague-Dawley rats were used in this study, of which 30 underwent surgery to induce cervical intervertebral disc degradation, 10 rats received EA at acupoints Dazhui (DU 14) and Shousanli (LI 10). TUNEL staining was measured to assess apoptosis in AF cells, immunohistochemistry was used to examine Bcl-2 and Bax expression, colorimetric assays were used to determine caspase 9 and caspase 3 activities and RT-PCR and western blotting were used to assess the mRNA and protein expression of Crk and ERK2. Treatment with EA reduced the number of AF-positive cells in TUNEL staining, increased Bcl-2-positive cells and decreased Bax-positive cells in immunohistochemical staining, significantly inhibited the activation of caspases-9 and -3, and enhanced the mRNA and protein expression of Crk and ERK2. Our data show that EA inhibits AF cell apoptosis via the mitochondria-dependent pathway and up-regulates Crk and ERK2 expression. These results suggest that treatment with may be a good alternative therapy for preventing cervical spondylosis.