Analysis on Quality Control of Argyreia acuta Lour

[Objectives]To establish a method for caffeic acid content determination and thin-layer chromatography identification of the Zhuang medicine Argyreia acuta Lour.[Methods]Silica gel GF254(thin-layer plate),toluene-formic acid-ethyl acetate(V∶V∶V=5∶1.2∶3)(developing agent)and 365 nm ultraviolet light were used for thin-layer chromatography identification.Under the chromatographic conditions of column of Thermo SCIENTIFIC Hypersil C18(5μm,4.60 mm×250 mm),mobile phase of methanol-0.1%phosphoric acid(23∶77),detection wavelength of 320 nm,column temperature of 30℃,sample size of 10μL and flow rate of 1.0 mL/min,the content of caffeic acid in A.acuta Lour was determined.[Results]Caffeic acid can be detected in thin layer chromatography,with strong specificity and clear spots.When the sample size of caffeic acid is within the range of 0.0151-0.4530μg(R^(2)=0.9999),the content of caffeic acid showed a relatively good linear relationship with the peak area.The average recovery rate of A.acuta Lour was 99.94%(RSD=2.68%),97.56%(RSD=1.57%)and 99.79%(RSD=2.05%),respectively.[Conclusions]This method can effectively identify A.acuta Lour,and can accurately determine the content of caffeic acid in A.acuta Lour.It has characteristics of high accuracy,high precision,good color rendering stability,good reproducibility and fast analysis speed.

The data and characteristics of the human milk banks in China's Mainland

Background Human milk banks (HMB) have been established for over 100 years in North America and Europe.This study aimed to describe and summarize the operation and characteristics of the HMBs in China's Mainland since the first nonprofit HMB operated in 2013.Methods Operation of HMB in China's Mainland is based on the standards and guidelines of the Human Milk Banking Association of North America and some countries in Europe and was modified to meet the needs and circumstances in China such as donation only in the local HMB by medical staff.We reviewed the descriptive data of these 14 HMBs and the clinical characteristics of recipients,the eligible milk donors and the donor milk retrospectively.Results In China's Mainland,from March 2013 to December 2016,14 nonprofit HMBs were developed and operational in public hospitals except one and located in the south,east,north and northwest of China's Mainland.In total,2680 eligible donors donated 4608.2 L of breast milk.The mean age of these donors was 29.4 years with 60.6% receiving college education and 90.6% term delivery.A total of 4678 recipients including preterm infants (n =2990,63.9%),feeding intolerance (n =711,15.2%),maternal illness (n =345,7.4%),serious infection (n =314,6.7%),necrotising enterocolitis (n =244,5.2%),post-surgery (n =38,0.8%) and others (n =36,0.8%).The rate of discarded raw milk was only 4.4% because of hepatitis B and C or cytomegalovirus positivity.Conclusions HMB has been developing rapidly in China's Mainland.Donor human milk was used not only for preterm infants but also for other ill children.But the sustainability of milk banking needs proper management and more financial support by relative health authorities and the government.

Mortality and Morbidity of Extremely Low Birth Weight Infants in the Mainland of China： A Multi-center Study

Background： With the progress ofperinatal medicine and neonatal technology, more and more extremely low birth weight （ELBW） survived all over the world. This study was designed to investigate the short-term ontcomes of ELBW infants during their Neonatal Intensive Care Unit （NICU） stay in the mainland of China. Methods： All infants admitted to 26 NICUs with a birth weight （BW） 〈1000 g were included between January 1,2011 and December 31,2011. All the data were collected retrospectively from clinical records by a prospectively designed questionnaire. The data collected from each NICU transmitted to the main institution where the results were aggregated and analyzed. Categorical variables were performed with Pearson Chi-square test. Binary Logistic regression analysis was used to detect risk factors. Results： A total of 258 ELBW infants were admitted to 26 NICUs, of whom the mean gestational age （GA） was 28.1 ± 2.2 weeks, and the mean BW was 868 ± 97 g. The overall survival rate at discharge was 50.0%. Despite aggressive treatment 60 infants （23.3%） died and another 69 infants （26.7%） died after medical care withdrawal. Furthermore, the survival rate was significantly higher in coastal areas than inland areas （53.6% vs. 35.3%, P = 0.019）. BW 〈750 g and GA 〈28 weeks were the largest risk factors, and being small for gestational age was a protective factor related to mortality. Respiratory distress syndrome was the most common complication. The incidence of patent ductus arteriosus, intraventricular hemorrhage, periventricular leukomalacia, bronchopulmonary dysplasia, retinopathy of prematurity was 26.2%, 33.7%, 6.7%, 48.1%, and 41.4%, respectively. Ventilator associated pneumonia was the most common hospital acquired infection during hospitalization. Conclusions： Our study was the first survey that revealed the present status of ELBW infants in the mainland of China. The mortality and morbidity of ELBW infants remained high as compared to other developed countries.

Analysis of In-hospital Neonatal Death in the Tertiary Neonatal Intensive Care Unit in China： A Multicenter Retrospective Study

Background：Globally,the proportion of child deaths that occur in the neonatal period remains a high level of 37-41%.Differences of cause in neonate death exist in different regions as well as in different economic development countries.The specific aim of this study was to investigate the causes,characteristics,and differences of death in neonates during hospitalization in the tertiary Neonatal Intensive Care Unit （NICU） of China.Methods：All the dead neonates admitted to 26 NICUs were included between January 1,2011,and December 31,2011.All the data were collected retrospectively from clinical records by a designed questionnaire.Data collected from each NICU were delivered to the leading institution where the results were analyzed.Results：A total of 744 newborns died during the l-year survey,accounting for 1.2% of all the neonates admitted to 26 NICUs and 37.6% of all the deaths in children under 5 years of age in these hospitals.Preterm neonate death accounted for 59.3% of all the death.The leading causes of death in preterm and term infants were pulmonary disease and infection,respectively.In early neonate period,pulmonary diseases （56.5%） occupied the largest proportion ofpreterm deaths while infection （27%） and neurologic diseases （22%） were the two main causes of term deaths.In late neonate period,infection was the leading cause of both preterm and term neonate deaths.About two-thirds of neonate death occurred after medical care withdrawal.Of the cases who might survive if receiving continuing treatment,parents＇ concern about the long-term outcomes was the main reason of medical care withdrawal.Conclusions：Neonate death still accounts for a high proportion of all the deaths in children under 5 years of age.Our study showed the majority of neonate death occurred in preterm infants.Cause of death varied with the age of death and gestational age.Accurate and prompt evaluation of the long-term outcomes should be carried out to guide the critical decision.

Implementing comprehensive genetic carrier screening in China―Harnessing the power of genomic medicine for the effective prevention/management of birth defects and rare genetic diseases in China

Carrier screening had been demonstrated as a powerful practice in preventing selected severe genetic disorders. This practice is expanding its scope and impact in the era of next-generation sequencing. Empirical and theoretical data support the utility of expanded carrier screening. The authors propose a comprehensive carrier screening program as a main component of the first-tier measure in preventing severe genetic disorders and birth defects in China. We discussed the key principles and important aspects to ensure the success of such a program. The authors believe this program will play a pivotal role in our endeavor for a healthier nation.

Causes of severe neonatal hyperbilirubinemia: a multicenter study of three regions in China

Background Available evidence suggests that our country bear great burden of severe hyperbilirubinemia.However,the causes have not been explored recently in different regions of China to guide necessary clinical and public health interventions.Methods This was a prospective,observational study conducted from March 1,2018,to February 28,2019.Four hospitals in three regions of China participated in the survey.Data from infants with a gestational age≥35 weeks,birth weight>2000 g,and total serum bilirubin(TSB)level≥17 mg/dL(342μmol/L)were prospectively collected.Results A total of 783 cases were reported.Causes were identified in 259 cases.The major causes were ABO incompatibility(n=101),glucose-6-phosphate dehydrogenase deficiency(n=76),and intracranial hemorrhage(n=70).All infants with glucose-6-phosphate dehydrogenase deficiency were from the central south region.Those from the central south region had much higher peak total bilirubin levels[mean,404μmol/L;standard deviation(SD),75μmol/L]than those from the other regions(mean,373μmol/L;SD,35μmol/L)(P<0.001).Conclusions ABO incompatibility was the leading cause in the east and northwest regions,but cases in the central south region were mainly caused by both ABO incompatibility and glucose-6-phosphate dehydrogenase deficiency,and infants in this region had a much higher peak total bilirubin level.Intracranial hemorrhage may be another common cause.More thorough assessments and rigorous bilirubin follow-up strategies are needed in the central south region.

Population-based frequency of surfactant dysfunction mutations in a native Chinese cohort

Background: Rare mutations in surfactant-associatedgenes contribute to neonatal respiratory distress syndrome.The frequency of mutations in these genes in the Chinesepopulation is unknown.Methods: We obtained blood spots from the GuangxiNeonatal Screening Center in Nanning, China thatincluded Han (n=443) and Zhuang (n=313) ethnic groups.We resequenced all exons of the surfactant proteins-B(SFTPB), -C (SFTPC), and the ATP-binding cassettemember A3 (ABCA3) genes and compared the frequenciesof 5 common and all rare variants.Results: We found minor differences in thefrequencies of the common variants in the Han andZhuang cohorts. We did not find any rare mutations inSFTPB or SFTPC, but we found three ABCA3 mutationsin the Han [minor allele frequency (MAF)=0.003] and 7 inthe Zhuang (MAF=0.011) cohorts (P=0.10). The ABCA3mutations were unique to each cohort;five were novel.The collapsed carrier rate of rare ABCA3 mutations inthe Han and Zhuang populations combined was 1.3%,which is signifi cantly lower than that in the United States(P<0.001).Conclusions: The population-based frequency ofmutations in ABCA3 in south China newborns is signifi cantlylower than that in United States. The contribution of theserare ABCA3 mutations to disease burden in the south Chinapopulation is still unknown.

Next-generation sequencing based molecular testing is an equalizer for diagnostic service of rare genetic disorders in China

The traditional approach of clinical genetic practice,known as the phenotype-first approach,usually starts with a thorough review of electronic medical records of the patient and a complete evaluation of patient's clinical presentation,as well as a survey of family history.Often more than one experienced clinical geneticists will order a variety of additional laboratory or imaging tests to obtain relevant information in order to reach a reasonable clinical diagnosis.Finally,molecular testing often helps to confirm the clinical diagnosis.This practice requires the availability of electronic medical records,well trained clinical geneticists who are able to perform relevant clinical evaluation,order appropriate tests and understand the molecular reports.These critical components of clinical genetics are mostly lacking in China today,1 as a consequence,most of patients with genetic condition do not receive a proper evaluation by clinical geneticists,only a small percent of patients received a clinical diagnosis and the majority remains undiagnosed for life.