A multicenter survey of antibiotic use in very and extremely low birth weight infants in Hunan Province / 中国当代儿科杂志

OBJECTIVE@#To investigate the current status of antibiotic use for very and extremely low birth weight (VLBW/ELBW) infants in neonatal intensive care units (NICUs) of Hunan Province.@*METHODS@#The use of antibiotics was investigated in multiple level 3 NICUs of Hunan Province for VLBW and ELBW infants born between January, 2017 and December, 2017.@*RESULTS@#The clinical data of 1 442 VLBW/ELBW infants were collected from 24 NICUs in 2017. The median antibiotic use duration was 17 days (range: 0-86 days), accounting for 53.0% of the total length of hospital stay. The highest duration of antibiotic use was up to 91.4% of the total length of hospital stay, with the lowest at 14.6%. In 16 out of 24 NICUs, the antibiotic use duration was accounted for more than 50.0% of the hospitalization days. There were 113 cases with positive bacterial culture grown in blood or cerebrospinal fluid, making the positive rate of overall bacterial culture as 7.84%. The positive rate of bacterial culture in different NICUs was significantly different from 0% to 14.9%. The common isolated bacterial pathogens Klebsiella pneumoniae was 29 cases (25.7%); Escherichia coli 12 cases (10.6%); Staphylococcus aureus 3 cases (2.7%). The most commonly used antibiotics were third-generation of cephalosporins, accounting for 41.00% of the total antibiotics, followed by penicillins, accounting for 32.10%, and followed by carbapenems, accounting for 13.15%. The proportion of antibiotic use time was negatively correlated with birth weight Z-score and the change in weight Z-score between birth and hospital discharge (r=-0.095, -0.151 respectively, P<0.01), positively correlated with death/withdrawal of care (r=0.196, P<0.01).@*CONCLUSIONS@#Antibiotics used for VLBW/ELBW infants in NICUs of Hunan Province are obviously prolonged in many NICUs. The proportion of routine use of third-generation of cephalosporins and carbapenems antibiotics is high among the NICUs.

Clinical observation on the disease course of chronic renal failure intervened by qudu granule / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To observe the disease course of chronic renal failure (CRF) intervened by Qudu Granule (QG) and to explore its possible mechanism.</p><p><b>METHODS</b>Totally 166 phase 3 and 4 chronic kidney disease (CKD) patients of Pi-Shen deficiency and phlegm-turbidity obstruction syndrome were randomly assigned to two groups, the experimental group (83 cases, completed in 77 cases) and the control group (83 cases, completed in 75 cases). Based on the routine treatment, patients in the experimental group orally took QG, while those in the control group orally took niaoduqing granule (NG), 5 g each time, 3 times a day in both groups. The total therapeutic course was over 12 months for all. The changes of serum creatinine (SCr) were observed in the two groups. The reciprocal of SCr was taken as the vertical coordinate, and the course of disease (months) as the horizontal coordinate. The oblique rate and the return coefficient (value b) were compared between the two groups. Meanwhile, the changes of blood pressure, 24-h urinary protein quantitative amount, plasma albumin (Alb), and hemoglobin (Hb) were also observed.</p><p><b>RESULTS</b>The average treatment time was longer in the experimental group [(42.8 +/- 18.5) months] than in the control group [(34.2 +/- 12.7) months, P < 0.01]. In the experimental group 35 patients didn't reach the endpoint at the 48th month, accounting for 45.45%, while 24 patients didn't reach the endpoint in the control group, accounting for 32.00%, showing statistical difference (P < 0.01). The b value was -0.00258 +/- 0.00132 in the experimental group and -0.00386 +/- 0.00167 in the control group. The absolute value of the slope rate was obviously smaller in the experimental group than in the control group (P < 0.01). The 48-month blood pressure was obviously lower in the experimental group than in the control group. The 24-h urinary protein at the 12th, 24th, 36th, and 48th month were obviously lower in the experimental group than in the control group at the same time point (P < 0.05). The plasma Alb was obviously higher in the experimental group than in the control group at the same time point with statistical difference (P < 0.05). There was no statistical difference in the Hb level between the two groups at each time point (P > 0.05).</p><p><b>CONCLUSIONS</b>The course of CRF could be postponed by QG. Its mechanisms might possibly be correlated with lowering blood pressure, reducing the excretion of urinary protein, and increasing plasma Alb.</p>

Hypoglycemic effects of sodium metavanadate in diabetic mice and its effect on glucose phosphorylation / 中华预防医学杂志

<p><b>OBJECTIVE</b>To investigate the effects of sodium metavanadate (SMV) on blood sugar and glucose phosphorylation in mice, and to discuss the possible mechanism of its hypoglycemic effects.</p><p><b>METHODS</b>Diabetic mice (D) and control mice (V) were randomly allocated to drink SMV (0.2 mg/ml) (CV and DV groups) or NaCl (80 mmol/L) (C and V groups) respectively. The study lasted for 5 weeks. Liver glucokinase, muscle hexokinase, blood glucose and insulin were assayed at the end of each week.</p><p><b>RESULTS</b>Blood glucose was higher in the diabetic groups before the administration of SMV, and the blood glucose level of group DV decreased from (18.77 +/- 1.28) to (8.94 +/- 0.94) mmol/L (P < 0.01) after oral administration of SMV for one week. While liver glucokinase increased from (1.29 +/- 0.64) to (15.36 +/- 1.57) mIU/min/mg protein and muscle hexokinase increased from (1.93 +/- 0.50) to (18.62 +/- 1.71) mIU/min/mg protein (P < 0.01) respectively. There was no continuous change of these parameters during the later weeks. No significant change of serum insulin was observed in the diabetic mice. There was a remarkable negative correlation of blood glucose level with liver glucokinase and muscle hexokinase levels.</p><p><b>CONCLUSION</b>The hypoglycemic effects of SMV was independent of insulin level. In consideration of the close relations of the activities of liver glucokinase and muscle hexokinase with diabetes, and the improving of impaired glucose phosphorylation in diabetic mice by oral sodium metavanadate, which might be the mechanism of hypoglycemic effects of SMV.</p>

Echocardiographic and Electrocardiographic Analysis of Coronary Artery Lesions in Kawasaki Disease / 实用儿科临床杂志

Objective To investigate the diagnostic value of combination of echocardiography with electrocardiography for coronary artery lesions(CAL) in Kawasaki disease(KD).Methods Seventy eight children with KD received echocardiographic and electrocardiographic examination.Seventy eight cases were divided into 3 groups according to the results of echocardiogram.Results CAL was discovered in 45 cases and 32 cases with coronary artery dilation,the other 13 cases with coronary artery aneurysm among them.Abnormal electrocardiogram was found in 16 cases.ratio of abnormal electrocardiogram was higher in CAL group than that in normal coronary artery group(P