Fruit Intake and Alzheimer's Disease: Results from Mendelian Randomization

Alzheimer's disease (AD) is the leading cause of dementia in old age, recognized as a global health priority. To explore causal effects of fresh fruit intake and dried fruit intake on AD liability, this study utilized GWAS from the UK Biobank and FinnGen to conduct Mendelian randomization (MR) analysis, and used inverse variance weighted (IVW), MR-Egger, and weighted median approaches for MR estimates, and visual inspections judged result stability. Results suggested little evidence of a potential causal relationship between fresh fruit intake and AD (OR=0.97, 95%CI=0.50-1.91, P=0.939), while significant, robust causality was indicated between dried fruit intake and AD (OR=4.09, 95%CI=2.07-8.10, P<0.001). Stability evaluations showed no heterogeneity or pleiotropy affecting interpretability and credibility of primary analyses. In conclusion, we strengthened evidence for positive causality from dried fruit intake to AD liability, with causality from fresh fruit intake on AD risk was not demonstrated.

Infestation and distribution of chigger mites on Brown rat (Rattus norvegicus) in Yunnan Province, Southwest China

Chigger mites is a group of arthropods and some of them are vectors of scrub typhus. As a common synanthropic rodent species, the Brown rat (Rattus norvegicus) often harbors lots of ectoparasites including chigger mites. According to some "data mining" strategies, the present study took the advantage of the abundant original data from a long-term field ecological investigation between 2001 and 2015 to make a detailed analysis of chigger mites on R. norvegicus in Yunnan Province, Southwest of China. From 18 of 33 investigated counties, only 1414 chigger mites were collected from 1113 Brown rats with relatively low infestations. The 1414 individual chigger mites were identified as comprising 61 species, 11 genera and 2 subfamilies of the family Trombiculidae with a high species diversity (S=61, H'=3.13). Of 61 mite species, there were four main species, Walchia ewingi, Ascoschoengastia indica, W. koi and A. rattinorvegici, which accounted for 44.41% of the total mites. All the chigger mites were of aggregated distribution among different individuals of R. norvegicus. The Brown rats in the outdoor habitats harbored much more individuals and species of chigger mites with a higher mean abundance (MA=1.46) and mean intensity (MI=12.53) than in the indoor habitats (P<0.05). The overall infestation of the rats was significantly higher in the mountainous landscapes than in the flatland landscapes (P<0.001). The species similarity (C_ss) of the mites on the male and female rats reached 64.44% with sex biased infestations. The male rats harbored more species and individuals of the mites than the female rats. The adult rats harbored more species and individuals of the mites than the juvenile rats. The species abundance distribution of the mites was successfully fitted by Preston's lognormal model with ŝ(R)=15e^{-[0.31(R-1)]2} (α=0.31, R²=0.95). On the basis of fitting the theoretical curve by Preston's model, the total mite species on R. norvegicus was estimated to be 86 species, and 25 rare mite species were missed in the sampling field investigation. The curve tendency of the species-plot relationship indicates that R. norvegicus have a great potential to harbor many species of chigger mites, and more species of the mites would be collected if more rats are sampled.

Expression and localization of the MMP inhibitor RECK in a rat model of COPD: its involvement in the development of COPD

OBJECTIVE

To unravel the potential function of reversion-inducing cysteine-rich protein with Kazal motifs (RECK) as the matrix metalloproteinase (MMP) inhibitor in the development of chronic obstructive pulmonary disease (COPD).

MATERIALS AND METHODS

Twelve specific pathogen-free Sprague Dawley rats were randomly assigned to the control cohort (n = 6) or the COPD cohort (n = 6). COPD model was developed by tobacco smoke exposure. Functional residual capacity (FRC), static lung compliance (Cchord), ratio of forced expiratory volume in 0.1 s to forced vital capacity (FEV0.1/FVC), and peak expiratory flow (PEF) were detected by respiratory function tests. Immunohistochemistry was performed to determine the pathological changes as well as the expression and localization of RECK in pulmonary tissue. RECK expression was further quantified by real-time polymerase chain reaction (PCR) and Western blot assays.

RESULTS

COPD rats had significantly reduced FEV0.1/FVC% and PEF values but increased FRC and Cchord levels, as compared to the control cohort (p < 0.05). Hematoxylin and eosin (HE) staining indicated typical COPD pathological changes, including leukocyte infiltration, airway thickening, alveoli fusion, etc., in the COPD rats. IHC indicated reduced expression of RECK in the COPD cohort, which was mainly expressed on the epithelium and partly expressed on subepithelial cells and inflammatory cells. Real-time PCR and Western blot assays further revealed the significantly lower expression of RECK in lung tissue from the COPD cohort.

CONCLUSIONS

RECK is mainly expressed on airway epithelial cells. COPD rats expressed significantly lower RECK levels, indicating that RECK exhibits a protective function in the development of COPD.

Large Positive Thermal Expansion and Small Band Gap in Double-ReO3-Type Compound NaSbF6

Double-ReO₃-type structure compound NaSbF₆ undergoes a low-temperature rhombohedral to high-temperature cubic phase between 303 and 323 K, as revealed by temperature-dependent X-ray diffractions. Although many double-ReO₃-type fluorides exhibit either low thermal expansion or negative thermal expansion (NTE), NaSbF₆ exhibits positive thermal expansion (PTE) with a large volumetric coefficient of thermal expansion, α_v = 62 ppm/K, in its cubic phase. Raman spectroscopy reveals that the low-frequency transverse vibration of fluorine atoms is stiffened in NaSbF₆, compared with the typical NTE compound CaZrF₆ with the same structure. The related weak contraction associated with the polyhedral rocking would be overcome by the notable elongation of the Na-F bond length on heating, thus leading to the large volumetric PTE. Unlike ScF₃ and CaZrF₆ which are insulators with a wide band gap, a relative small band gap of 3.76 eV was observed in NaSbF₆. The small band gap can be attributed to the hybridization between the Sb 5s and F 2p orbitals.

Continued EGFR-TKIs treatment promotes the survival of elderly patients with acquired resistance to EGFR-TKIs therapy

OBJECTIVE

Continued EGFR-TKIs treatment is still controversial for NSCLC patients with activating EGFR mutations, who acquire resistance to the drug. Of these patients, elderly ones were worth to be investigated to further examine efficacy of continued EGFR-TKIs treatment.

PATIENTS AND METHODS

A total of 232 NSCLC patients (≥ 70-year-old) were recruited from the Chinese People's Liberation Army General Hospital between January 1, 2009, and July 31, 2014. And 44 patients were qualified for further retrospectively investigated, which were divided into dramatic and non-dramatic progression groups based on the characteristics of progression during first-line EGFR-TKIs treatment. And they were also divided into two groups: continued EGFR-TKIs group and discontinued EGFR-TKIs group. Subsequently, progression-free survival (PFS), post-progression survival (PPS), and overall survival (OS) of these groups were investigated by multivariate analysis.

RESULTS

Median OS (28.9 months vs. 23.2 months, p = 0.46) and median PPS (16.9 months vs. 4.4 months, p = 0.216) were both not significantly different between continued EGFR-TKIs groups and discontinued ones. However, when focusing on patients with non-dramatic progression, the median OS (29.0 months vs. 23.2 months, p = 0.039) and median PPS (21.3 months vs. 3.9 months, p = 0.001) were significantly longer in the continued EGFR-TKIs patients than discontinued ones.

DISCUSSION

Continued EGFR-TKIs beyond PD may be a good option for elderly patients with non-dramatic progression. The characteristic of progression after first-line EGFR-TKIs treatment should be taken into account to determine which part of patients is suitable for continued EGFR-TKIs treatment, especially for the speed of progression.

CONCLUSION

Continued EGFR-TKIs treatment promotes the survival of elderly patients with acquired resistance to EGFR-TKIs therapy.

Propofol suppresses invasion and induces apoptosis of osteosarcoma cell in vitro via downregulation of TGF-β1 expression

OBJECTIVE

Osteosarcoma (OS) is the most common malignant tumor of the bone, with a high mortality rate and poor prognosis. Propofol has been proposed to play a role of antitumor in various cancers. However, the functions and mechanisms of propofol in OS is still not clear.

MATERIALS AND METHODS

The different concentrations of propofol were co-incubated with osteosarcoma MG-63 lines for 72 hrs. Cell proliferation, apoptosis, and invasion were detected by MTT assay, Flow cytometry analysis, and Matrigel invasion assay. Western blot was used to detect the TGF-β1 protein levels. MG-63 cells were treated with human recombinant TGF-β1 (rh TGF-β1) to assess the role of TGF-β1 in propofol-induced anti-tumor activity.

RESULTS

Propofol significantly inhibited cell proliferation and invasion and promoted apoptosis of MG-63 lines cells. Propofol also efficiently reduced TGF-β1 expression. Moreover, restoration of TGF-β1 by rhTGF-β1 treatment reversed the effects of propofol on the biological behavior of OS cells.

CONCLUSIONS

Propofol can effectively inhibit proliferation and invasion and induce apoptosis of OS cells through, at least partly, downregulation of TGF-β1 expression.

Analysis of ectoparasites (chigger mites, gamasid mites, fleas and sucking lice) of the Yunnan red-backed vole (Eothenomys miletus) sampled throughout its range in southwest China

The Yunnan red-backed vole Eothenomys miletus (Rodentia: Cricetidae) is an endemic rodent species and reservoir host of zoonoses in southwest China. Based on a large host sample (2463 voles collected from 39 localities between 2001 and 2013), a general analysis of four categories of ectoparasite (fleas, sucking lice, chigger mites and gamasid mites) on E. miletus across its entire range of distribution was made. This analysis identified a total of 71 895 ectoparasites belonging to 320 species (30 species of flea, 9 of sucking louse, 106 of gamasid mite and 175 of chigger mite) with a high prevalence (87%), mean abundance (29.19) and mean intensity (33.69). Of the 18 vector species of zoonoses found on E. miletus, the flea Ctenophthalmus quadratus (Siphonaptera: Hystrichopsyllidae) and chigger mite Leptotrombidium scutellare (Trombidiformes: Trombiculidae) were the dominant species; these are the main vectors of zoonoses in China. All of the dominant parasite species showed an aggregated distribution pattern. Male voles harboured more species of parasite than females. Chigger mites represented the most abundant species group on voles and their prevalence was positively correlated with mean abundance (r = 0.73; P < 0.05). As a single rodent species, E. miletus has a high potential to harbour abundant ectoparasites with high species diversity and high rates of infestation. The sex of the vole affects ectoparasite infestation.

Propofol suppresses invasion, angiogenesis and survival of EC-1 cells in vitro by regulation of S100A4 expression

OBJECTIVE

Propofol possess anticancer properties in several cancers. In the present study, we investigate the effect of propofol on the human esophageal squamous cell carcinomas (ESCC) EC-1 cells in vitro and its molecular mechanisms of action.

MATERIALS AND METHODS

EC-1 cells were explored to 10-100 μmol/L propofol for 72 h or 100 μmol/L/mL propofol for 24-72 h. EC-1 cells were explored to 100 μmol/L propofol for 24 h, then was transiently transfected into PcDNA3.1-S100A4 cDNA or PcDNA3.1 plasmid for 48 hrs. MTT, TUNEL, ELISA, migration, tube formation and immunoblotting were analized.

RESULTS

Propofol inhibits invasion, angiogenesis, proliferation and induces apoptosis in a dose and time-dependence manner, followed by deseased S100A4 expression by Western blot assay. Pre-transfection of PcDNA3.1-S100A4 cDNA inhibits propofol-induced apoptosis and promotes invasion and angiogenesis in EC-1 cells in vitro.

CONCLUSIONS

Propofol inhibited invasion, angiogenesis and induces apoptosis of human EC-1 cells in vitro through regulation of S100A4 expression. It not only can be an anesthesia agent, but also plays a important role of inhibiting the migration and angiogenesis of ESCC cells in the therapy of ESCC patients.

Impact of age on epicardial and pericoronary adipose tissue volume

OBJECTIVE

The aim of the present study was to investigate the impact of age on epicardial and pericoronary adipose tissue volume.

PATIENTS AND METHODS

Eighty healthy individuals with normal body mass index underwent multi-slice computed tomography (MSCT) with coronary computed tomography angiography, and their scanning images were stored and analysed. Among them, 62 subjects were male, and 18 subjects were female. The patients were grouped by age: 10 subjects were < 35 yrs, 20 were 35-44 yrs, 20 were 45-54 yrs, 20 were 55-64 yrs, and 10 were > 65 yrs. Pericoronary adipose tissue (PCAT), and the volume and the thickness of epicardial adipose tissue (EAT) were measured.

RESULTS

The correlation analysis showed that age was positively correlated to EAT volume. Moreover, spearman correlation analysis showed that the volumes of PCAT in the left main-left anterior descending artery (LM-LAD) and right coronary artery (RCA) gradually increased with increasing age, but not with the left circumflex artery (LCX) and EAT thickness (p > 0.05).

CONCLUSIONS

These findings suggest that the volumes of EAT and the adipose tissue surrounding the LM-LAD and RCA increase with increasing age.

Anatomical information for intercostobrachial nerve preservation in axillary lymph node dissection for breast cancer

This study aimed to provide additional anatomical information for axillary lymph node dissection (ALND) through in vivo anatomy studies of intercostobrachial nerve (ICBN) preservation in order to provide theoretical and practical experience for clinicians. A total of 156 patients with breast cancer underwent ALND at the Department of Gynecology of Baotou Tumor Hospital between June 2009 and March 2010. The origin, destination, main source, length, branch type, and direction of ICBN in axilla were observed, as well as its relationship with adjacent major blood vessels and nerves within the axilla. There were 120 cases of single trunk, 23 cases of double trunks, 9 cases of multiple trunks, and 4 cases without trunks in 156 patients with ICBN preservation. The transverse diameter at the origin of the ICBN was 1.89 ± 0.44 mm with a length of 94.45 ± 12.08 mm; the distances were 77.19 ± 21.04 mm, 29.34 ± 6.73 mm, 90.04 ± 13.13 mm, and 28.63 ± 13.01 mm from origin to the inferior margin at the midpoint of the clavicle, inferior margin of the axillary vein, the bottom of axilla, and branch point, respectively. The identification, dissection, and preservation of ICBN was simple and easy in a modified radical mastectomy for breast cancer and breast-conserving surgery, which only took 10-20 min, but effectively reduced the incidence of post-mastectomy pain syndrome and significantly improved the quality of life for patients after surgery.

Overweight, obesity and thyroid cancer risk: a meta-analysis of cohort studies

OBJECTIVE

This meta-analysis examined the relationship between excess body weight or body mass index (BMI) and risk of thyroid cancer.

METHODS

PubMed(®), MEDLINE(®), EMBASE™ and Academic Search™ Premier databases were searched to identify cohort studies examining the effect of being overweight or obese on the risk of thyroid cancer.

RESULTS

The inclusion criteria were met by seven cohort studies (total number of thyroid cancer cases, 5154). The pooled relative risk (RR) of thyroid cancer was 1.13 (95% confidence interval [CI] 1.04, 1.22) for overweight. Obesity was also linked with increased thyroid cancer risk in males and females, the strength of the association increasing with increasing BMI. The combined RR of thyroid cancer was 1.18 (95% CI 1.11, 1.25) for excess body weight (overweight and obesity combined). Being overweight was associated with a significant increase in thyroid cancer risk among non-Asians, but not among Asians. Overweight, obesity and excess body weight were all associated with papillary thyroid carcinoma risk.

CONCLUSIONS

The association between overweight/obesity/excess body weight and thyroid cancer risk was confirmed.

Abundances and host relationships of chigger mites in Yunnan Province, China

This paper reports on ectoparasitic chigger mites found on small mammals in Yunnan Province, southwest China. Data were accumulated from 19 investigation sites (counties) between 2001 and 2009. A total of 10 222 small mammal hosts were captured and identified; these represented 62 species, 34 genera and 11 families in five orders. From the body surfaces of these 10 222 hosts, a total of 92 990 chigger mites were collected and identified microscopically. These represented 224 species, 22 genera and three subfamilies in the family Trombiculidae (Trombidiformes). Small mammals were commonly found to be infested by chigger mites and most host species harboured several species of mite. The species diversity of chigger mites in Yunnan was much higher than diversities reported previously in other provinces of China and in other countries. A single species of rodent, Eothenomys miletus (Rodentia: Cricetidae), carried 111 species of chigger mite, thus demonstrating the highest species diversity and heaviest mite infestation of all recorded hosts. This diversity is exceptional compared with that of other ectoparasites. Of the total 224 mite species, 21 species accounted for 82.2% of all mites counted. Two species acting as major vectors for scrub typhus (tsutsugamushi disease), Leptotrombidium scutellare and Leptotrombidium deliense, were identified as the dominant mite species in this sample. In addition to these two major vectors, 12 potential or suspected vector species were found. Most species of chigger mite had a wide range of hosts and low host specificity. For example, L. scutellare parasitized 30 species of host. The low host specificity of chigger mites may increase their probability of encountering humans, as well as their transmission of scrub typhus among different hosts. Hierarchical clustering analysis showed that similarities between different chigger mite communities on the 18 main species of small mammal host did not accord with the taxonomic affinity of the hosts. This suggests that the distribution of chigger mites may be strongly influenced by the environment in which hosts live.

Epidemiological prediction of the distribution of insects of medical significance: comparative distributions of fleas and sucking lice on the rat host Rattus norvegicus in Yunnan Province, China

Determining the distribution patterns of ectoparasites is important for predicting the spread of vector-borne diseases. A simple epidemiological model was used to compare the distributions of two different taxa of ectoparasitic insects, sucking lice (Insecta: Siphonaptera) and fleas (Insecta: Anoplura), on the same rodent host, Rattus norvegicus Berkenhout (Rodentia: Muridae), in Yunnan Province, China. Correlations between mean abundance and prevalence were determined. Both fleas and sucking lice were aggregated on their hosts, and sucking lice showed a higher degree of aggregation than fleas. The prevalence of both fleas and sucking lice increased with log-transformed mean abundance and a highly linear correlation and modelling efficiency of predicted prevalence against observed prevalence were obtained. The results demonstrate that prevalence can be explained simply by mean abundance.

Resveratrol reduces endothelial progenitor cells senescence through augmentation of telomerase activity by Akt-dependent mechanisms

BACKGROUND AND PURPOSE

Recent studies have shown that resveratrol increased endothelial progenitor cells (EPCs) numbers and functional activity. However, the mechanisms remain to be determined. Previous studies have demonstrated that increased EPC numbers and activity were associated with the inhibition of EPC senescence, which involves activation of telomerase. Therefore, we investigated whether resveratrol inhibits the onset of EPC senescence through telomerase activation, leading to potentiation of cellular activity.

EXPERIMENTAL APPROACH

After prolonged in vitro cultivation, EPCs were incubated with or without resveratrol. The senescence of EPCs were determined by acidic beta-galactosidase staining. The bromo-deoxyuridine incorporation assay or a modified Boyden chamber assay were employed to assess proliferative or migratory capacity, respectively. To further examine the underlying mechanisms of these effects, we measured telomerase activity and the phosphorylation of Akt by western blotting.

KEY RESULTS

Resveratrol dose dependently prevented the onset of EPCs senescence and increased the proliferation and migration of EPCs. The effect of resveratrol on senescence could not be abolished by eNOS inhibitor or by an oestrogenic receptor antagonist. Resveratrol significantly increased telomerase activity and Akt phosphorylation. Pre-treatment with the PI3K inhibitor, LY294002, significantly attenuated resveratrol-induced telomerase activity.

CONCLUSIONS AND IMPLICATIONS

Resveratrol delayed the onset of EPC senescence and this effect was accompanied by activation of telomerase through the PI3K-Akt signalling pathway. The inhibition of EPCs senescence by resveratrol might protect EPCs against dysfunction induced by pathological factors in vivo and improve EPC functional activities in a way that may be important for cell therapy.

High frequency occurrence of 1-OPRD variant of PRNP gene in gastric cancer cell lines and Chinese population with gastric cancer

The prion protein gene PRNP encodes PrPc and PrPsc, causing a number of neurological disorders. Approximately 10-15% of human prion disease is inherited and more than 20 pathogenic mutations have been found. Most of the genetic alterations are point mutations, with the exception of genetic insertions of one to nine extra octapeptide repeats occurring in the important octapeptide-coding region. Our previous work showed that PrPc was overexpressed in gastric cancer. We wondered whether mutations of PrPc existed in human gastric cancer. DNA sequencing and gel electrophoresis were used to determine the possible mutation of PrPc in patients and cell lines of gastric cancer. We found that 1-OPRD (one octapeptide-repeat deletion) homozygosity or heterozygosity exists in several gastric cancer cell lines, e.g. MKN28 and KatoIII are homozygous for 1-OPRD, and SGC7901 and BGC-823 are heterozygous for 1-OPRD. The mutation frequency in tissues of gastric cancer cases is significantly higher than that in the common population (p<0.05). All positive cases in gastric cancer were found to be heterozygous for 1-OPRD. Further study of the variant may be helpful in understanding the mechanisms of occurrence and development of clinical gastric carcinoma as well as the biology of the mysterious gene PRNP.

Effects of homocysteine on number and activity of endothelial progenitor cells from peripheral blood

The aim of this study is to investigate whether homocysteine (Hcy) has influences on endothelial progenitor cells (EPCs) number and activity. Total mononuclear cells (MNCs) were isolated from peripheral blood by Ficoll density gradient centrifugation, and then the cells were plated on fibronectin-coated culture dishes. After 7 d cultured, attached cells were stimulated with Hcy (to make a series of final concentrations: 10, 50, 100 and 200 micromol/l) or vehicle control for the respective time points (6, 12, 24 and 48 h). EPCs were characterized as adherent cells double positive for DiLDL uptake and lectin binding by direct fluorescent staining under a laser scanning confocal microscope. EPCs proliferation, migration and in vitro vasculogenesis activity were assayed with 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay, modified Boyden chamber assay and in vitro vasculogenesis kit, respectively. EPCs adhesion assay was performed by replating those on fibronectin-coated dishes, and then adherent cells were counted. Incubation of isolated human MNCs with Hcy dose and time dependently decreased the number of EPCs, maximum at 200 micromol/l, 24 h (approximately 50% reduction, P < 0.01). In addition, Hcy dose and time dependently impaired EPC proliferative, migratory, adhesive and in vitro vasculogenesis capacity. In conclusion, hyperHcy may induce the reduction of EPCs with decreased functional activity.

Effects of somatostatin, octreotide and pitressin plus nitroglycerine on systemic and portal haemodynamics in the control of acute variceal bleeding

To examine the haemodynamic effects of somatostatin (SS) and octreotide (OC) versus pitressin plus nitroglycerine (PN) in the control of variceal bleeding, 224 patients with acute oesophageal and gastric variceal haemorrhage were randomly divided into three groups and treated with SS, OC and PN; they also had their Doppler ultrasound parameters measured before, during and after treatment. The success rates of bleeding control in the SS (80.9%, 86.8% and 89.7%, p<0.001) and OC (75.3%, 80.8% and 84.9%, p<0.01) groups were significantly higher than in the PN group (51.8%, 59.0% and 65.1%) at 24, 48 and 72 hours respectively, and the average duration of SS (12.7 + 6.8 h) and OC (13.8 + 8.0 h) was significantly lower than that of PN (24.6 + 15.4 h, p<0.001). Side-effects of SS (7.4%) and OC (8.2%) were less than those of PN (41.0%, p<0.001 and p<0.01). The diameter of portal vein (PVD), velocity of portal vein (PVV), volume of portal blood flow (PVF) and hepatic artery pulsatility index (HA-PI) in all three groups decreased significantly during initial treatment, but recovered when treatment was stopped. Heart rate and cardiac output decreased significantly in patients treated with SS and OC; mean arterial pressure was unchanged. However, heart rate and mean arterial pressure increased, and cardiac output decreased, with PN. Somatostatin and octreotide were more effective than pitressin plus nitroglycerine in patients with acute variceal haemorrhage, with fewer side-effects, and may decrease PVF and portal vein pressure through reduction of cardiac output and dilatation of the visceral blood vessels.

Single-stage laryngotracheal reconstruction: the Great Ormond Street experience and guidelines for patient selection

OBJECTIVES

To review all patients undergoing single-stage laryngotracheal reconstruction and to determine guidelines to predict successful outcomes and prevent the necessity of tracheotomy following laryngotracheal reconstruction.

DESIGN

Chart review.

SETTING

Tertiary care children's hospital.

PATIENTS

A retrospective chart review was performed at our institution involving all patients who underwent single-stage laryngotracheal reconstruction from 1993 through 1996. A total of 28 patients were reviewed.

RESULTS

Based on this chart review, a statistically higher incidence of extubation complications (P = .045), ie, bleeding, reintubation, or subcutaneous emphysema, occurred in children who weighed less than 4 kg. Although not statistically significant (P>.99), the relative risks of failure, defined as tracheotomy dependent or significant airway compromise following single-stage laryngotracheal reconstruction, were 3.43 if the child's weight was less than 4 kg at the time of surgery and 2.31 if the gestational age was less than 30 weeks at the time of surgery. Length of time for intubation did not appear to have any effect on outcome.

CONCLUSIONS

Patients' gestational age and weight at the time of surgery appear to have the most impact on successful outcome. Children weighing more than 4 kg and those with gestational age of greater than 30 weeks appear to have a greater chance at successful extubation and eventual patent airway. Duration of intubation following single-stage laryngotracheal reconstruction does not appear to affect outcome.

Alpha-tocopherol concentrations in human milk from mothers of preterm and full-term infants in China

alpha-Tocopherol content in breast milk of 28 mothers who delivered preterm infants (preterm milk) and 43 mothers who delivered full-term infants (term milk) were measured. alpha-Tocopherol concentration in preterm milk did not differ significantly from that of term milk in the first 12 days of lactation (P > 0.05). There is a higher alpha-tocopherol concentration in the early colostrum, however, it decreases with the lactational days significantly. The investigation suggests that early breast-feeding would be beneficial to the improvement of vitamin E intake in neonates during the early life.