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Purpose@#It is well known that congenital diaphragmatic hernia (CDH) in infants impacts pulmonary function rehabilitation after surgery. However, the risk factors of postoperative pulmonary function are still unclear. In this research, we analyzed the potential risk factors of postoperative pulmonary function in CDH patients in order to improve the clinical management of CDH patients. @*Methods@#Thirty-three cases CDH infants followed were enrolled from November 2016 to September 2018. Clinical data were reviewed. Tidal breathing pulmonary function testing was performed after surgery. Correlation between pulmonary function and clinical characteristics was evaluated using multivariate analysis of variance. @*Results@#Pulmonary dysfunction was detected in 87.9% patients (29 of 33). The defect size was found to be significantly larger in patients with obstructed and mixed ventilatory disorders (P = 0.001). Diagnosis of gestational age (GA) was also significantly earlier compared to restrictive ventilatory disorders (P = 0.001). Larger defect size, and earlier prenatal diagnosis of GA were detected in severe obstructive ventilatory disorders (P = 0.007, P = 0.001, retrospectively). @*Conclusion@#Most patients had various degrees of pulmonary dysfunction after surgery. Patients with larger defect size and earlier diagnosis time might be vulnerable to severe obstructive and mixed ventilatory disorders.
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Objective To investigate the influence of opioids drug doses difference on sedation ,analgesia effects and risk of adverse effects in patients undergoing elective orthopedics operation .Methods From January 2015 to January 2017, 120 patients undergoing elective orthopedics operation in Zhoushan Hospital were chosen and randomly divided into 3 groups according to the digital table ,including low dose group (40 patients) with sufentanil of 0.1μg/kg,moderate dose group(40 patients) with sufentanil of 0.15μg/kg,and high dose group(40 patients) with sufentanil of 0.2μg/kg.The VAS score and Ramsay score after operation ,analgesic drugs addition rate ,addition dose and incidence of adverse effects among 3 groups were compared.Results The VAS scores of the moderate dose group and high dose group at 1h,6h and 12h after operation were significantly lower than those of the low dose group (t＝3.5,3.72,4.19,4.33,3.10,2.43,all P＜0.05).There were no statistically significant differences in Ramsay score after operation among 3 groups(F＝1.02,0.47,0.75,0.94,all P＞0.05).The analgesic drugs addition rate and addition dose of the low dose group were 22.50%,(78.28 ±9.54)mg,respectively,which of the moderate dose group were 7.50%,(63.50 ±6.02) mg,respectively,which of the high dose group were 5.00%,(62.74 ±5.88) mg, respectively.The analgesic drugs addition rate and addition dose of moderate dose group and high dose group were significantly lower than those of the low dose group (χ2/F＝7.48,8.33,3.26,3.41,all P＜0.05).The incidence rate of adverse effects in the high dose group was significantly higher than those in the low dose group and moderate dose group(χ2＝8.12,12.96,7.95,12.02,all P ＜0.05).Conclusion Compared with sufentanil of 0.1μg/kg and 0.2μg/kg,the sufentanil of 0.15 μg/kg on patients undergoing elective orthopedics operation has better analgesia effect.
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ObjectiveTo understand the relationship between mycoplasm load in bronchoalveolar lavage lfuid (BALF) with the status of Th1/Th2 immune response in children withMycoplasma pneumoniae pneumonia (MPP).MethodsThe levels of IL-4, IFN, IL-8 , TNF-α in BLAF and total IgE, ECP in serum from 90 children with MPP were measured by ELISA.MP DNA in BALF was detected quantitatively by lfuorescent real-time PCR. Children with MPP (n=90) were divided into two groups of low MP-DNA load (n=24) and high MP-DNA load (n=26) according to the copies of MP DNA in BALF. The cytokines in BALF, and total IgE and ECP in serum were compared between the two groups. The relationship between the levels of cytokines in BLAF and the copies was evaluated.ResultsThe levels of IL-4 and the IL-4/IFN ratio in BALF from the high DNA-load group were signiifcantly higher than that of the low group (t=4.280, 2.076, allP<0.05). The level of IL-4 was signiifcantly correlated with the copies of MP-DNA in BALF from children with MPP (r=0.509,P<0.05). The percentage of total IgE and ECP positive result in serum from the high DNA-load group is higher than that of the low group. (χ2=24.638, 6.392,allP<0.05).Conclusion Infection with high-load MP in children may cause the imbalance of Th1/Th2. And the Th2 cytokines response seems predomi-nant.
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Objective To explore the efficiency and prognosis of hematological malignancies treated by haploidentical hematopoietic stem cell transplantation.Methods 70 patients who received haploidentical hematopoietic stem cell transplantation were analyzed retrospectively.According to tumor burden before transplantation,the patients were divided into three groups,the low tumor burden group,the mediate tumor burden group and the high tumor burden group.And then the effection of the tumor burden to survival was analyzed,and the engraftment,GVHD,infection,conditioning related toxicity,relapse and survival rate were also observed.Results The follow-up was terminated on January 1,2014.Follow-ups were performed for a median of 34.05 (7.4-83.6) months after transplantation.All patients achieved engraftments.The cumulative incidence of GVHD of grades 2-4 was 47.14 ％ (33/70) and that of grades 3-4 was 21.4 ％ (15/70).The chronic extensive GVHD was 20.0 ％ (14/70).The overall survival was 68.6 ％.Transplant-related mortality was 12.8 ％ and the relapse was 18.6 ％.The overall survivals in low tumor burden group,mediate tumor burden group,high tumor burden group were 91.67 ％,72.7 ％,33.3 ％ respectively.By SPSS 20.0,tumor burden was the high risk factor affecting the survival (low tumor group vs high tumor group,mediate tumor group vs high tumor group,low tumor group vs high tumor group,P =0.000,P =0.038,P =0.016).Conclusions Haploidentical hematopoietic stem cell transplantation in hematological malignancies is safe and effective.And for hematological malignancies with poor prognosis disease,it should be accepted the HSCT as soon as possible after remission in order to reduce the recurrence rate of malignancy.
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Objective To evaluate the efficacy of haploidentical hematopoietic stem cell transplantation (HSCT) with supplemental umbilical cord blood (UCB) infusion in treatment of malignant hematological diseases.Method Clinical data of 66 patients with hematological malignancies treated with HSCT in our hospital between January 2010 and May 2013,were retrospectively analyzed.Among them 25 cases received infusion of human UCB before HSCT (experimental group) and other 41 cases had no UCB injection before HSCT (control group).Results There were no differences in age,gender,donor type,disease categories,disease status before transplant between two groups (P ＞ 0.05).There was a significant difference in conditioning regimes between two groups (P ＜ 0.05),but no clinical implication.The infused mononuclear cell (MNC) count in experimental group was higher than that in control group (9.94 ± 2.88 × 108/kg vs.7.80 ±0.82 × 108/kg,P =0.00),while there were no difference in infused CD34 + cell count (5.46 ±3.54 × 106/kg vs.3.54 ± 1.60 × 106/kg,P =0.16).Neutrophil recovery time in experimental group was shorter than that in control group (13.7 ±2.9 d vs.16.6 ±2.9 d,P =0.023).The incidences of grade Ⅲ-Ⅳ acute graft versus host disease (aGVHD,P =0.036),bacterial infection (P =0.001) and fungal infection (P =0.001)and hemorrhagic cystitis (P =0.00)in experimental group were lower than those in control group.There were no significant differences in platelet recovery time(P =0.43),the incidence of grade Ⅰ-Ⅱ aGVHD (P =0.27),implanted syndrome (P =0.24),sinusoidal obstruction syndrome (P =0.57)and viraemia (P =0.31)between two groups.Conclusion HSCT with supplemental infusion of human UCB may alleviate the degree of aGVHD,but the long-term outcome remains to be studied.
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Objective To investigate the association of single nucleotide polymorphisms(SNPs)in regulated upon activation normal T cell expressed and secreted (RANTES) gene C-28G(RANTES C-28G),RANTES A-403G and Eotaxin-3 gene C +77T(Eotaxin-3 C+77T) with asthma in Han ethnic children. Methods The buccal mucosa swabs of 192 Han ethnic children with asthma (asthma group) were collected,and polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) was employed to detect the SNP loci of RANTES A-403G,C-28G and Eotaxin-3 C+77T.Besides,another 192 healthy subjects (aged 18 to 22 years) without sibship with those in asthma group were served as controls.Genotype and genotypic distribution between these two groups were analysed. Results There was no significant differences in genotype and genotypic distribution of SNP loci of RANTES A-403G and RANTES C-28G between asthma group and control group (P>0.05),while there were significant differences in genotypic distribution of Eotaxin-3 C+77T between these two groups.The frequency of Eotaxin-3 C+77T T/T genotype in asthma group was significantly higher than that in control group (32.3% vs 12.5%,OR=3.44,P=0.000). Conclusion Eotaxin-3 C+77T may be the asthma susceptible SNP loci for Han ethnic children,and Eotaxin-3 C+77T T/T is significantly related with the development of childhood asthma