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Objective:To study the clinical features and genotypes of neonatal Glanzmann thrombasthenia(NGT).Methods:A male neonate with NGT admitted to the Department of Neonatology of our hospital was retrospectively reviewed. CNKI, Wangfang database, VIP, the Chinese Medical Journal Full Text database, PubMed and Embase database were searched using key words '(neonate OR newborn) AND (Glanzmann thrombasthenia)' both in English and Chinese. The clinical features and genotypes of NGT were summarized and analyzed.Results:A male full-term neonate was admitted to our hospital for mass on the forehead and ecchymosis and petechiae on the body within half an hour after birth. He gradually developed subgaleal hemorrhage and severe anemia. Platelet count, mean platelet volume and coagulation functions were normal. The platelet aggregation test indicated decreased platelet aggregation rate induced by arachidonic acid and adenosine diphosphate. Genetic testing revealed two heterozygous mutations in the patient's ITGA2B gene: NM_000419.4: c.886G>A(p.Gly296Arg) and NM_000419.4: c.2855dup(p.Phe953Valfs*83). A total of 42 literature involving 44 patients (our case included) with NGT were retrieved. 33 cases (75.0%) of NGT showed ecchymosis or petechiae on the first day after birth. For 13 cases with detailed information, 5 cases with severe anemia were given erythrocyte and plasma transfusion and platelet transfusion was given in 1 case. 4 cases had homozygous variants and 4 cases showed compound heterozygous variants. 10 cases had follow-up records, including 2 cases without any bleeding and 8 cases with varying degrees of bleeding during follow-up. No deaths were reported.Conclusions:Neonates with ecchymosis and petechiae in the early postnatal period should be suspected of NGT. Blood transfusion is preferred when the indication for transfusion is met.
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Pear is one of the main fruits with thousands of years of cultivation history in China. There are more than 2000 varieties of pear cultivars around the world, including more than 1200 varieties or cultivars in China (Legrand et al., 2016). Xinjiang Uygur Autonomous Region is an important pear production region in China with 30 of varieties or cultivars. Pyrus sinkiangensis is the most popular variety, which is mainly distributed in Xinjiang (Zhou et al., 2018). Chlorogenic acid (CGA), p-coumaric acid, and arbutin are the main polyphenols in pear fruit, and their levels show great differences among different varieties (Li et al., 2014). CGA is a potential chemo-preventive agent, which possesses many important bioactivities including antioxidant, diabetes attenuating, and anti-obesity (Wang et al., 2021). Therefore, the specific CGA content of a variety is considered the embodiment of the functional nutritional value of pears.
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Chlorogenic Acid , Fruit , Gene Expression Profiling , Pyrus/genetics , TranscriptomeABSTRACT
Objective@#To investigate the clinical efficacy of sequential heated humidified high flow nasal ca-nnula(HHHFNC)after extubation in premature infants with pulmonary hemorrhage.@*Methods@#A total of 52 premature infants with pulmonary hemorrhage were selected, who were randomly (by means of random number table) given nasal intermittent positive pressure ventilation(NIPPV)(27 cases) and HHHFNC (25 cases) as a sequential respiratory su-pport from January 2017 to January 2018 at Suzhou Hospital of Nanjing Medical University were selected.The incidence of the basic conditions of the 2 groups of premature infants [gestational age, birth weight, mechanical ventilation days after pulmonary hemorrhage, high-frequency ventilation, usage of nitric oxide(NO)], blood gas analysis indicators at 1 h before extubation and ventilator parameters including the arterial oxygen partial pressure [pa(O2)], arterial partial pressure of carbon dioxide [pa(CO2)], pH value, positive end-expiratory pressure(PEEP), respiratory rates (RR), peak inspiratory pressure (PIP), fraction of inspiration oxygen (FiO2) were compared.The blood gas analysis after extubation [pa(O2), pa(CO2), pH value] at 1 h, outcome events/complications at the end of treatment (reintubation, uration of oxygen therapy after pulmonary hemorrhage, hospitalization days, bronchial pulmonary hypoplasia, ventilator associated pneumonia, feeding intolerance, neonatal necrotizing enterocolitis, pneumothorax) were also compared.@*Results@#There were no significant differences between the NIPPV group and the HHHFNC group in the following items: gestational age, birth weight, mechanical ventilation days after pulmonary hemorrhage, high-frequency ventilation, usage of NO[(30.5±2.9) weeks vs.(31.6±2.7) weeks, 1 325(818) g vs.1 400(800) g, 5 days vs.4 days, 25.9%(7/27 cases) vs.24.0%(6/25 cases), 7.4%(2/27 cases)vs.0(0/25 cases), all P>0.05]. There were no significant differences between the two groups in blood gas analysis indicators before extubation at 1 h and ventilator parameters [pa(O2), pa(CO2), pH value, PEEP, RR, PIP, FiO2], blood gas analysis [pa(O2), pa(CO2), pH value] after extubation at 1 h (all P>0.05); There were no significant differences between the two groups in reintubation, hospitalization days, bronchial pulmonary hypoplasia, ventilator associated pneumonia, feeding intolerance, neonatal necrotizing enterocolitis, pneumothorax [7.4%(2/27 cases) vs.4.0%(1/25 cases), 43(29) days vs.41(22) days, 40.7%(11/27 cases ) vs.16.0%(4/25 cases), 11.1%(3/27 cases) vs.12.0%(3/25 cases), 37.0%(10/27 cases) vs.32.0%(8/25 cases), 7.4%(2/27 cases ) vs.12.0%(3/25 cases), 7.4%(2/27 cases) vs.12.0%(3/25 cases)] (all P>0.05). The duration of oxygen therapy after pulmonary hemorrhage in the HHHFNC group was shorter than that in the NIPPV group [25(30) days vs.9(22) days, P<0.05].@*Conclusions@#As a sequential respiratory support for preterm infants with pulmonary hemorrhage, HHHFNC has shorter duration of oxygen therapy after pulmonary hemorrhage than that of NIPPV, suggesting that HHHFNC is an ideal non-invasive ventilation treatment.
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The clinical pharmaceutical care in Japan is patient-centered and professional .Their policies of pharmaceutical service fee encourage clinical pharmaceutical care development , and embody values of pharmacists as well .The pharmaceutical service management in Japan indicates its attention on practical outcomes , serving as a useful reference for China in both service mode and management policies .
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OBJECTIVE:To explore optimization method and effect of clinical pharmacists on anticoagulants therapy plan for cancer patient with venous thromboembolism(VTE). METHODS:Clinical pharmacists participated in the whole process of antico-agulant therapy for one case of breast cancer complicated with VTE. Clinical pharmacists suggested patient to initially take low mo-lecular weight heparin sodium 0.6 ml,sc,qd;and then take Warfarin sodium tablet 3 mg,po,qd;initial plan and oral dosage form plan superimposed and alternated,and pharmaceutical care and medication education were also provided for the patient. RESULTS:Physicians adopted clinical pharmacist's suggestions,and the patient received anticoagulant therapy for 27 days and paclitaxel che-motherapy once. Coagulation function INR was 2.71;the patient didn't felt discomfort and then discharged from hospital. CON-CLUSIONS:The participation of clinical pharmacists in the optimization of individualized anticoagulant therapy and pharmaceutical care is able to promote rational drug use,prevent severe ADR in the clinic,guarantee the safety of drug use and improve medica-tion compliance.
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Objective To observe the clinical efficacy of acupuncture plus medicine and function training in treating post-stroke shoulder-hand syndrome. Method Sixty patients with post-stroke shoulder-hand syndrome were randomized into a treatment group of 30 cases and a control group of 30 cases. The treatment group was intervened by acupuncture plus medicine and functional training, while the control group was only by functional training. Before and after intervention, the hand swelling degree, Visual Analogue Scale (VAS), shoulder joint motion scale, Fugl-Meyer Assessment (FMA) scale were used to measure the swelling and pain of hand, motion of shoulder, and motor function of upper limb. Result After intervention, the swelling and pain of hand, motion range of shoulder and motor function of upper limb were significantly improved in both groups (P<0.01), and the improvements in the treatment group were more significant than that in the control group (P<0.05). Conclusion Acupuncture plus medicine and function training can enhance the efficacy in treating post-stroke shoulder-hand syndrome, superior to pure function training.
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ObjectiveTo investigate the effects of acupuncture on neuromuscular block of vecuronium and analgesia under general anesthesia.MethodsNinety ASA Ⅰ or Ⅱ patients,aged 29-80 yr,weighing 50-80kg,scheduled for laparoscopic chotecystectomy,were randomly divided into 3 groups (n =30 each):acupuncture at acupoints combined with general anesthesia group (group A),acupuncture at non-acupoints combined with general anesthesia group (group B) and general anesthesia group (group C).Bilateral Hegu (LI4),Neiguan (PC6),Zusanli (ST36),yanglingquan (GB34),and Quchi (LI11) acupoints were selected in group A.In group B,the points adopted were the midpoints between the meridians in which the acupoints were selected in group A and the adjacent meridians on the lateral side,at the level of selected meridian points correspondingly.Electric stimulation was started from 15-30 min before anesthesia induction and continued until the end of operation.Anesthesia was induced with iv injection of fentanyl,propofol and vecuronium and maintained with intermittent iv boluses of fentanyl and vecuronium.All the patients received patient-controlled intravenous analgesia after operation.The effect time,onset time,clinical duration and recovery index of vecuronium,consumption of anesthetics during operation,and consumption of fentanyl for postoperative analgesia and postoperative adverse reactions were recorded.Results Compared with group C,the elinical duration was significantly prolonged,the consumption of anesthetics during operation and consumption of fentanyl for postoperative analgesia were significantly reduced,and the incidence of nausea was significantly decreased ( P ＜ 0.05 ),while no significant changed was found in the effect time,onset time,and recovery index in group A ( P ＞ 0.05).Compared with group B,the amount of fentanyl consumed during and after operation was significantly reduced in group A ( P ＜ 0.05 ).ConclusionAcupuncture can prolong the clinical duration of vecuronium,and enhance the analgesic efficacy during and after operation under general anesthesia.
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Pharmacy intravenous admixture service was built in accordance with the Australian criteria for intravenous drug admixture and managed in light of the ideas contained in the Accreditation Standards for Hospital released by the US Joint Commission International. Cytoxic drugs, total parenter-al nutrition solutions and intravenous infusions were centrally admixted in the service. Aseptic operation was stressed in the admixture of intravenous drugs while the appropriateness of drug use and the rationality of drug formulations were stressed in the review of doctors' orders. In practice, priority was given to environment and equipment management, qualification and certification of personnel and continuous education, the process was standardized, regulations for standard post operation and the rational use of drugs were formulated, and criteria for assessing doctors' orders were established All this has led to satisfactory results.