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Background A simple measurement of central venous pressure (CVP)-mean by the digital monitor display has become increasingly popular. However, the agreement between CVP-mean and CVP-end (a standard method of CVP measurement by analyzing the waveform at end-expiration) is not well determined. This study was designed to identify the relationship between CVP-mean and CVP-end in critically ill patients and to introduce a new parameter of CVP amplitude (ΔCVP= CVPmax - CVPmin) during the respiratory period to identify the agreement/disagreement between CVP-mean and CVP-end.Methods In total, 291 patients were included in the study. CVP-mean and CVP-end were obtained simultaneously from each patient. CVP measurement difference (|CVP-mean - CVP-end|) was defined as the difference between CVP-mean and CVP-end. The ΔCVP was calculated as the difference between the peak (CVPmax) and the nadir value (CVPmin) during the respiratory cycle, which was automatically recorded on the monitor screen. Subjects with |CVP-mean - CVP-end|≥ 2 mmHg were divided into the inconsistent group, while subjects with |CVP-mean - CVP-end| < 2 mmHg were divided into the consistent group.Results ΔCVP was significantly higher in the inconsistent group [7.17(2.77) vs.5.24(2.18), P<0.001] than that in the consistent group. There was a significantly positive relationship between ΔCVP and |CVP-mean - CVP-end| (r=0.283, P <0.0001). Bland-Altman plot showed the bias was -0.61 mmHg with a wide 95% limit of agreement (-3.34, 2.10) of CVP-end and CVP-mean. The area under the receiver operating characteristic curves (AUC) of ΔCVP for predicting |CVP-mean - CVP-end| ≥ 2 mmHg was 0.709. With a high diagnostic specificity, using ΔCVP<3 to detect |CVP-mean - CVP-end| lower than 2mmHg (consistent measurement) resulted in a sensitivity of 22.37% and a specificity of 93.06%. Using ΔCVP>8 to detect |CVP-mean - CVP-end| >8 mmHg (inconsistent measurement) resulted in a sensitivity of 31.94% and a specificity of 91.32%.Conclusions CVP-end and CVP-mean have statistical discrepancies in specific clinical scenarios. ΔCVP during the respiratory period is related to the variation of the two CVP methods. A high ΔCVP indicates a poor agreement between these two methods, whereas a low ΔCVP indicates a good agreement between these two methods.
Subject(s)
Humans , Central Venous Pressure , Respiration , ROC CurveABSTRACT
Aim To explore the effect of parathyroid hormone on osteoporosis in rats after spinal cord injury(SCI)and its mechanism.Methods SD rats were divided into sham operation group(Sham), SCI model group(SCI), SCI+parathyroid hormone group(SCI+PTH)and SCI+PTH+transfected miR-146a irrelevant fragment group(SCI+PTH+NC)and SCI+PTH+transfection miR-146a inhibitor group(SCI+PTH+miR-146a inhibtor), and then given 60 μg·kg-1 PTH(SCI+PTH group), 60 μg·kg-1 PTH and 20 pm miR-146a NC(SCI+PTH+NC group)or 60 μg·kg-1 PTH and 20 pm miR-146a inhibitor(SCI+PTH+miR-146a inhibitor group)by tail vein injection every 3 d for 8 weeks.Rats in Sham group and SCI group were given equal amount of saline in the same way.The behavioral movement scores of rats were recorded by the BBB scoring method 1 d, 7 d, 14 d, 21 d, 28 d, and 56 d after operation; serum calcium(Ca)and alkaline phosphatase(ALP)were measured using the kits; bone mineral density of femur and tibia was measured by a bone mineral density scanner; the morphological changes of rat spinal cord were observed by HE staining; expression of miR-146a was detected by qRT-PCR and protein expression of p-PI3K and p-Akt was detected by Western blot.Results Compared with Sham group, SCI group had decreased BBB score(P<0.05 or P<0.01), serum Ca, femoral and tibial bone mineral density content and expression of miR-146a, p-PI3K and p-Akt, but increased serum ALP(P<0.01).Compared with SCI group, BBB score(P<0.05 or P<0.01), serum Ca, femoral and tibia bone mineral density content, and the expression of miR-146a, p-PI3K and p-Akt( P<0.01)increased, together with decreased serum ALP in SCI+PTH group(P<0.01).Compared with SCI+ PTH group, the above indicators of rats were significantly inhibited in SCI+PTH+miR-146a inhibitor group.Conclusions PTH has certain therapeutic effect on SCI osteoporosis, achieved possibly by regulating miR-146a/PI3K/Akt signaling.
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Limitation of consciousness level in intensive care unit (ICU) patients poses a great challenge to muscle strength assessment. Muscle ultrasound does not require patient cooperation, and can objectively measure significant changes in muscle cross-sectional area, thickness, echo intensity, and pennation angle to identify muscle atrophy early in the ICU. At the same time, muscle ultrasound technology is easy to be grasped by ICU doctors and nurses, and both show great reliability, which has certain significance for identifying patients at high risk of ICU-acquired weakness. In addition, ultrasound quantitative assessment of muscle has great value for predicting patient outcomes. Large-scale studies on the diagnostic value of ultrasound in ICU-acquired weakness are still lacking, and standardized ultrasound assessment scheme requires further discussion.
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Mechanical power of ventilation, currently defined as the energy delivered from the ventilator to the respiratory system over a period of time, has been recognized as a promising indicator to evaluate ventilator-induced lung injury and predict the prognosis of ventilated critically ill patients. Mechanical power can be accurately measured by the geometric method, while simplified equations allow an easy estimation of mechanical power at the bedside. There may exist a safety threshold of mechanical power above which lung injury is inevitable, and the assessment of mechanical power might be helpful to determine whether the extracorporeal respiratory support is needed in patients with acute respiratory distress syndrome. It should be noted that relatively low mechanical power does not exclude the possibility of lung injury. Lung size and inhomogeneity should also be taken into consideration. Problems regarding the safety limits of mechanical power and contribution of each component to lung injury have not been determined yet. Whether mechanical power-directed lung-protective ventilation strategy could improve clinical outcomes also needs further investigation. Therefore, this review discusses the algorithms, clinical relevance, optimization, and future directions of mechanical power in critically ill patients.
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BACKGROUND@#The peripheral perfusion index (PI), as a real-time bedside indicator of peripheral tissue perfusion, may be useful for determining mean arterial pressure (MAP) after early resuscitation of septic shock patients. The aim of this study was to explore the response of PI to norepinephrine (NE)-induced changes in MAP.@*METHODS@#Twenty septic shock patients with pulse-induced contour cardiac output catheter, who had usual MAP under NE infusion after early resuscitation, were enrolled in this prospective, open-label study. Three MAP levels (usual MAP -10 mmHg, usual MAP, and usual MAP +10 mmHg) were obtained by NE titration, and the corresponding global hemodynamic parameters and PI were recorded. The general linear model with repeated measures was used for analysis of variance of related parameters at three MAP levels.@*RESULTS@#With increasing NE infusion, significant changes were found in MAP (F = 502.46, P < 0.001) and central venous pressure (F = 27.45, P < 0.001) during NE titration. However, there was not a significant and consistent change in continuous cardiac output (CO) (F = 0.41, P = 0.720) and PI (F = 0.73, P = 0.482) at different MAP levels. Of the 20 patients enrolled, seven reached the maximum PI value at usual MAP -10 mmHg, three reached the maximum PI value at usual MAP, and ten reached the maximum PI value at usual MAP +10 mmHg. The change in PI was not significantly correlated with the change in CO (r = 0.260, P = 0.269) from usual MAP -10 mmHg to usual MAP. There was also no significant correlation between the change in PI and change in CO (r = 0.084, P = 0.726) from usual MAP to usual MAP +10 mmHg.@*CONCLUSIONS@#Differing MAP levels by NE infusion induced diverse PI responses in septic shock patients, and these PI responses may be independent of the change in CO. PI may have potential applications for MAP optimization based on changes in peripheral tissue perfusion.
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OBJECTIVE@#Poor tissue perfusion/cellular hypoxia may persist despite restoration of the macrocirculation (Macro). This article reviewed the literatures of coherence between hemodynamics and tissue perfusion in circulatory shock.@*DATA SOURCES@#We retrieved information from the PubMed database up to January 2018 using various search terms or/and their combinations, including resuscitation, circulatory shock, septic shock, tissue perfusion, hemodynamic coherence, and microcirculation (Micro).@*STUDY SELECTION@#The data from peer-reviewed journals printed in English on the relationships of tissue perfusion, shock, and resuscitation were included.@*RESULTS@#A binary (coherence/incoherence, coupled/uncoupled, or associated/disassociated) mode is used to describe resuscitation coherence. The phenomenon of resuscitation incoherence (RI) has gained great attention. However, the RI concept requires a more practical, systematic, and comprehensive framework for use in clinical practice. Moreover, we introduce a conceptual framework of RI to evaluate the interrelationship of the Macro, Micro, and cell. The RI is divided into four types (Type 1: Macro-Micro incoherence + impaired cell; Type 2: Macro-Micro incoherence + normal cell; Type 3: Micro-Cell incoherence + normal Micro; and Type 4: both Macro-Micro and Micro-cell incoherence). Furthermore, we propose the concept of dynamic circulation-perfusion coupling to evaluate the relationship of circulation and tissue perfusion during circulatory shock.@*CONCLUSIONS@#The concept of RI and dynamic circulation-perfusion coupling should be considered in the management of circulatory shock. Moreover, these concepts require further studies in clinical practice.
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Objective:@#Poor tissue perfusion/cellular hypoxia may persist despite restoration of the macrocirculation (Macro). This article reviewed the literatures of coherence between hemodynamics and tissue perfusion in circulatory shock.@*Data sources:@#We retrieved information from the PubMed database up to January 2018 using various search terms or/and their combinations, including resuscitation, circulatory shock, septic shock, tissue perfusion, hemodynamic coherence, and microcirculation (Micro).@*Study selection:@#The data from peer-reviewed journals printed in English on the relationships of tissue perfusion, shock, and resuscitation were included.@*Results:@#A binary (coherence/incoherence, coupled/uncoupled, or associated/disassociated) mode is used to describe resuscitation coherence. The phenomenon of resuscitation incoherence (RI) has gained great attention. However, the RI concept requires a more practical, systematic, and comprehensive framework for use in clinical practice. Moreover, we introduce a conceptual framework of RI to evaluate the interrelationship of the Macro, Micro, and cell. The RI is divided into four types (Type 1: Macro-Micro incoherence + impaired cell; Type 2: Macro-Micro incoherence + normal cell; Type 3: Micro-Cell incoherence + normal Micro; and Type 4: both Macro-Micro and Micro-cell incoherence). Furthermore, we propose the concept of dynamic circulation-perfusion coupling to evaluate the relationship of circulation and tissue perfusion during circulatory shock.@*Conclusions:@#The concept of RI and dynamic circulation-perfusion coupling should be considered in the management of circulatory shock. Moreover, these concepts require further studies in clinical practice.
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<p><b>Background</b>Measurement of general microcirculation remains difficult in septic shock patients. The peripheral perfusion index (PI) and sublingual microcirculation monitoring are thought to be possible methods. This study was performed to determine whether assessing microcirculation by PI and a new parameter, proportion of perfusion vessel change rate (△PPV) from sublingual microcirculation monitoring, can be associated with patients' outcome.</p><p><b>Methods</b>A prospective observational study was carried out, including 74 patients with septic shock in a mixed intensive care unit. Systemic hemodynamic variables were obtained at T0 and 6 h after (T6). PI and sublingual microcirculation indicators were obtained using a bedside monitor and a sidestream dark-field device, respectively. The t-test, analysis of variance, Mann-Whitney U-test, Kruskal-Wallis test, receiver operating characteristic curve analysis with the Hanley-McNeil test, survival curves using the Kaplan-Meier method, and the log-rank (Mantel-Cox) test were used to statistical analysis.</p><p><b>Results</b>Systemic hemodynamics and microcirculation data were obtained and analyzed. Patients were divided into two groups based on whether the first 6 h lactate clearance (LC) was ≥20%; PI and △PPV were lower at T6 in the LC <20% group compared with LC ≥20% (PI: 1.52 [0.89, 1.98] vs. 0.79 [0.44, 1,81], Z = -2.514, P = 0.012; △PPV: 5.9 ± 15.2 vs. 17.9 ± 20.0, t = -2.914, P = 0.005). The cutoff values of PI and △PPV were 1.41% and 12.1%, respectively. The cutoff value of the combined indicators was 1.379 according to logistic regression. Area under the curve demonstrated 0.709 (P < 0.05), and the sensitivity and specificity of using combined indicators were 0.622 and 0.757, respectively. Based on the PI and △PPV cutoff, all the participants were divided into the following groups: (1) high PI and high △PPV group, (2) high PI and low △PPV group, (3) low PI and high △PPV group, and (4) low PI and low △PPV group. The highest Sequential Organ Failure Assessment score (14.5 ± 2.9) was in the low PI and low △PPV group (F = 13.7, P < 0.001). Post hoc tests showed significant differences in 28-day survival rates among these four groups (log rank [Mantel-Cox], 20.931; P < 0.05).</p><p><b>Conclusion</b>PI and △PPV in septic shock patients are related to 6 h LC, and combining these two parameters to assess microcirculation can predict organ dysfunction and 28-day mortality in patients with septic shock.</p>
Subject(s)
Aged , Female , Humans , Male , Middle Aged , Hemodynamics , Physiology , Intensive Care Units , Microcirculation , Physiology , Prognosis , Prospective Studies , ROC Curve , Sepsis , Shock, SepticABSTRACT
BACKGROUND: Recent studies have confirmed that SATB1 is related to the occurrence and development of tumors, but its mechanism in tumor metastasis is unclear. OBJECTIVE: To observe the effects of specific interference of SATB1 gene expression on esophageal carcinoma cell line TE-1 stem cell invasion and migration. METHODS: p75NTRpositive cells and p75NTRnegative cells were isolated from human esophageal carcinoma TE-1 cell lines by immunomagnetic beads. The characteristics of p75NTRpositive cells were verified by in vitro proliferation and clone formation experiments. The p75NTRpositive tumor stem cells in logarithmic growth period were taken. In the transfection group, SATB1 gene siRNA was transfected into the cells by Lipofectamine 2000 liposome method. At the same time, the p75NTRpositive cells transfected with empty vector were used as control. After 72 hours of transfection, the expression of SATB1 in the cells was detected by western blot. Cell migration and invasion abilities were detected by Transwell assay. Expressions of matrix metalloproteinase 2/9 at mRNA and protein levels were detected by western blot and semi-quantitative RT-PCR, respectively. RESULTS AND CONCLUSION: Compared with p75NTRnegative cells, the proliferation of p75NTRpositive cells increased significantly after 3, 5, 7 days of culture (P < 0.05). The clone formation rate of p75NTRpositive cells was significantly higher than that of p75NTRnegative cells (P <0.0.5). After 72 hours of transfection, the expression of SATB1 in the transfection group was significantly lower than that in the control group (P < 0.05). The ability of migration and invasion in the transfection group was significantly lower than that in the control group (P < 0.05). Expressions of matrix metalloproteinase 2/9 mRNA and protein in the transfection group were significantly lower than those of the control group (P < 0.05). In conclusion, siRNA interference with SATB1 gene can reduce the invasion and migration ability of TE-1 tumor stem cells in esophageal carcinoma cell line through down-regulating the expression of matrix metalloproteinase 2/9.
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Objective To investigate the influence of optimized mode for the hemodynamics short -term training course on the training effectiveness.Methods From 2016 to 2017,an optimized training mode was used in the hemodynam-ics 2-day training course in Peking Union Medical College Hospital,and the training effectiveness was evaluated.The optimized training mode included optimized course structure,opened-on-line answer questions,pre-training and post-training examination.Results A total of 808 clinical doctors participated in the hemodynamic training courses,and 627 participators finished both pre-training and post-training examinations.The percent of the pass of the examination was 44% at the baseline, and the percent of the pass of the examination was 88.2% after the training course.The post-training score was significantly higher than the pre-training score in the subgroup of 627 participators(pair-t-test, pre-training score 55.7±19.3 vs.post-training score 73.7±10.5,difference 18±21,P<0.001).Moreover,there was no relationship between pre-training score and post-training score.Conclusions The optimized mode of the hemody-namics short-term training course can improve the short-term training effectiveness.However,further studies are nee-ded to improve the application of hemodynamics in the clinical practice.
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<p><b>BACKGROUND</b>Electrical impedance tomography (EIT) is a real-time bedside monitoring tool, which can reflect dynamic regional lung ventilation. The aim of the present study was to monitor regional gas distribution in patients with acute respiratory distress syndrome (ARDS) during positive-end-expiratory pressure (PEEP) titration using EIT.</p><p><b>METHODS</b>Eighteen ARDS patients under mechanical ventilation in Department of Critical Care Medicine of Peking Union Medical College Hospital from January to April in 2014 were included in this prospective observational study. After recruitment maneuvers (RMs), decremental PEEP titration was performed from 20 cmH 2 O to 5 cmH 2 O in steps of 3 cmH 2 O every 5-10 min. Regional over-distension and recruitment were monitored with EIT.</p><p><b>RESULTS</b>After RMs, patient with arterial blood oxygen partial pressure (PaO 2) + carbon dioxide partial pressure (PaCO 2 ) >400 mmHg with 100% of fractional inspired oxygen concentration were defined as RM responders. Thirteen ARDS patients was diagnosed as responders whose PaO 2 + PaCO 2 were higher than nonresponders (419 ± 44 mmHg vs. 170 ± 73 mmHg, P < 0.0001). In responders, PEEP mainly increased recruited pixels in dependent regions and over-distended pixels in nondependent regions. PEEP alleviated global inhomogeneity of tidal volume and end-expiratory lung volume. PEEP levels without significant alveolar derecruitment and over-distension were identified individually.</p><p><b>CONCLUSIONS</b>After RMs, PEEP titration significantly affected regional gas distribution in lung, which could be monitored with EIT. EIT has the potential to optimize PEEP titration.</p>
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Aged , Female , Humans , Male , Middle Aged , Electric Impedance , Positive-Pressure Respiration , Respiratory Distress Syndrome , Diagnosis , Tomography , MethodsABSTRACT
OBJECTIVE@#To investigate the prevalence and risk factors of bronchial asthma in the Li ethnic group in Hainan, China.@*METHODS@#This study employed a stratified random sample design using custom-designed questionnaires. Subjects with asthma-like symptoms were first identified by two rounds of surveys and then confirmed by respiratory physicians using pulmonary function test, bronchial dilation test and challenge test. Demographic data, information on family history of asthma, history of allergies, smoking habits, domestic cooking fuel and other potential risk factors were collected. Logistic regression was performed to evaluate risk factors for asthma.@*RESULTS@#The prevalence of asthma in the Li ethnic group was 3.38%, much higher than the national average level in China. Aging, agriculture industry (the rubber industry in particular), rural residence, family history of asthma, history of allergies, cold air, inhalation of dust and irritant gases, smoking, domestic cooking fuel and living environment were associated with increased risk of asthma.@*CONCLUSIONS@#The high prevalence of asthma in the Li ethnic group highlights the importance of asthma prevention and treatment in this population. Risk factors indentified in this study warrant special attention. Elevating public awareness about asthma in local communities will benefit the prevention of the disease.
Subject(s)
Adolescent , Adult , Child , Child, Preschool , Female , Humans , Male , Middle Aged , Young Adult , Asian People , Asthma , Epidemiology , China , Epidemiology , Dust , Environmental Exposure , Ethnicity , Logistic Models , Prevalence , Respiratory Function Tests , Risk Factors , SmokingABSTRACT
Background Both functional and morphological changes in amblyopic development are known to occur at various levels in the central visual pathway.However,whether the retina is involved or not during amblyopic progression remains controversial.Objective This study was designed to compare the thicknesses of the fovea and retinal nerve fiber layer (RNFL) of the normal fellow eye of amblyopic eye using optical coherence tomography (OCT) in children with myopic anisometropia.Methods Twenty-two patients with unilateral myopic anisometropic amblyopia were included as the anisometropia amblyopia group.Ten unilateral myopic anisometropic amblyopia subjects received treatment and recovered were used as the amblyopic cure group,and 11 individuals with simple myopic anisometropia without amblyopia were enrolled as the control group.OCT was performed on both eyes of all the subjects with informed consent.Fovea retinal thickness and RNFL thickness from the superior,inferior,nasal and temporal quadrants in the peripapillary region were evaluated.The measurement parameters were bilaterally compared in all the individuals by paired t test.The multiple regression model was used to analyze the correlation of retinal thickness with amblyopia patients.This study was approved by the Ethic Committee of this hospital.Written informed consent was obtain from each subject prior to the eye examination.Results Fovea retinal thickness increased in the amblyopic eyes compared with the fellow eyes,showing a statistically significant difference between them (P =0.001).However,no significant differences were found in the fovea retinal thickness between both eyes in the amblyopic cure group and simple myopic anisometropia without amblyopia group (P =0.778,0.943).Among the anisometropia amblyopia group,amblyopia cure group and simple myopic anisometropia without amblyopia group,the RNFL thicknesses of the temporal quadrant was significantly thicker in the higher myopic lateral eyes than those of the fellow eyes (P＜0.001,P =0.003,P =0.046).However,the differences in the superior,inferior,nasal and the average RNFL thickness were not statistically significant between the two eyes (P＞0.05).A negative correlation was found between the inferior retinal thickness with age (r=-0.559,P=0.016).Conclusions The fovea may be affected in unilateral myopic anisometropic amblyopia.There is no significant difference in the RNFL thickness between simple myopic eye and unilateral myopic anisometropia amblyopic eye.Improvement in amblyopia is coming along with the reduction of the thickness of the fovea.
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<p><b>OBJECTIVE</b>To investigate the prevalence of malignant tumor and its influencing factor among rubber workers in Hainan Province of China, and to study the high incidence of cancer and type of work.</p><p><b>METHODS</b>A retrospective cohort study on registered workers over 1 working age among partial rubber factories in Hainan Province in the period from 2005 to 2010.</p><p><b>RESULT</b>There was a remarkable difference in the incidence between nature exposed rubber group and non-exposed group (χ(2) = 52.13,P < 0.01). Occupational exposure induced a high risk in malignant tumors (OR = 2.47, P < 0.05). The incidence of tumor may be associated with occupational exposure: the longer occupational exposure time, the higher was the incidence of tumor (χ(2) = 11.40, P < 0.05).</p><p><b>CONCLUSIONS</b>The occupational exposure in rubber workers can induce a high incidence of malignant tumor.</p>
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Female , Humans , Male , China , Epidemiology , Neoplasms , Epidemiology , Occupational Exposure , Prevalence , Risk Factors , RubberABSTRACT
<p><b>OBJECTIVE</b>To study the risk factors of bronchial asthma of Li nationality in Hainan.</p><p><b>METHODS</b>A total of 13 050 subjects of Li nationality were selected by random unequal ratio stratified cluster sampling method from southern, central and western part of Hainan and investigated with Hainan Epidemiological Asthma Survey Questionnaire of Li Nationality. There were 441 cases of bronchial asthma, and 1296 cases of control that were sampled by random number table method. The logistic regression method was used to analyze risk factors.</p><p><b>RESULTS</b>The asthma prevalence of Li nationality in Hainan was 3.38%(441/13 050). The main risk factors of asthma were family asthma (OR = 4.323, 95%CI = 3.259 - 5.735), hypersensitiveness (OR = 7.775, 95%CI = 5.686 - 10.632), smoking (OR = 1.494, 95%CI = 1.174 - 1.902), cooking fuels and living environment. Cold air change (OR = 1.604, 95%CI = 1.286 - 2.001) and respirable dust or irritant gas (OR = 2.123, 95%CI = 1.702 - 2.648) were the important incentives.</p><p><b>CONCLUSION</b>The main risk factors of asthma among Li nationality were family asthma, hypersensitiveness, smoking, cooking fuels by means of fuel oil, hay or wood, living environment by means of couch grass room and human-livestock mix live, cold air change, respirable dust or irritant gas.</p>
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Adult , Child , Female , Humans , Male , Asian People , Asthma , Epidemiology , China , Epidemiology , Ethnicity , Prevalence , Risk FactorsABSTRACT
<p><b>OBJECTIVE</b>To describe the impact of the global economic crisis on the nutritional status of children in China during and after the crisis.</p><p><b>METHODS</b>Data from 1990 to 2010 were sourced from the National Food and Nutrition Surveillance System. Approximately 16 000 children under 5 years old were selected using a stratified random cluster method from 40 surveillance sites. Anthropometric and hemoglobin measurements for children under 5 were conducted. Nutritional status was determined according to WHO child growth standards.</p><p><b>RESULTS</b>Prevalence of underweight and stunting in children under 5 had a downward trend. Underweight prevalence was close to normal (less than 5%), with prevalence of stunting 12.6% in 2009 and 12.1% in 2010 in rural areas. Prevalence of stunting in infants under 6 months and 6-12 months old in poorer rural areas increased from 5.7%-9.1% and 6.7%-12.5%, respectively, in 2008-2009. This trend also continued post-crisis in 2010. Prevalence of stunting in children left behind by mothers was 20%-30% higher than in children the same age in general and poorer rural areas. Prevalence of anemia in children did not change in rural areas, but prevalence of anemia in all age groups increased in poorer rural areas, especially in children under 24 months old. Level reached 30%-40% in 2009, and fluctuated in 2010.</p><p><b>CONCLUSION</b>The nutritional status of children under 5 was comparatively stable during and after the global economic crisis, attributable to the Chinese government's policy response. The nutritional status in poorer rural areas fluctuated in response to the economic crisis and, thus, relevant action and intervention must be taken immediately to help the most vulnerable population in poorer rural areas. A proper national nutritional strategy for children under 2 years old, including nutrition supplementation for pregnant women and in-home fortification for complementary feeding, should be initiated.</p>
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Child, Preschool , Female , Humans , Infant , Male , Pregnancy , Aging , Anemia , Economics , Epidemiology , Child Development , Physiology , Child Nutrition Disorders , Economics , Epidemiology , China , Epidemiology , Economic Recession , Infant Nutrition Disorders , Economics , Epidemiology , Nutritional Status , Physiology , Population Surveillance , Poverty , Prevalence , Rural Population , Thinness , Time FactorsABSTRACT
<p><b>OBJECTIVE</b>To understand the status and problems of complementary feeding and to explore the strategy of improving complementary feeding for infants and young children in China.</p><p><b>METHOD</b>Data of urban and rural children were selected from the China Food and Nutrition Surveillance System (CFNSS) dataset to describe the status of complementary feeding and growth of children. Logistic Regression was used to analyze the relationship between child growth and the complementary feeding pattern.</p><p><b>RESULTS</b>Applications of foods that come from animals, vegetable/fruit and dairy product in complementary feeding were negatively correlated to the prevalence of stunting and underweight. Attributable risk (AR) of no application of vegetable/fruit in complementary feeding to stunting was 30.2%, to underweight 35.4%; AR of no application of foods from animal products in complementary feeding to stunting was 28.2%, to underweight 11.7%; and the AR of no application of diary products in complementary feeding to stunting was 27.4%, to underweight was 15.9%.</p><p><b>CONCLUSION</b>Complementary feeding contributed to the improvement of infants and young children growth in China. There is an urgent need to develop health education in the public on infants and young children complementary feeding, in the mean time, it is pressing to pay attention and take actions to develop and promote affordable, acceptable, and accessible fortified complementary food in rural areas of China.</p>
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Child, Preschool , Humans , Infant , Child Development , China , Dairy Products , Fruit , Infant Nutritional Physiological Phenomena , Meat , Nutrition Surveys , VegetablesABSTRACT
Objective To study the technique and clinical significance of percutaneous biopsy of transplanted liver guided by CT.Methods 19 transplanted liver were undergone 25 times of percutaneous biopsy and the pathomorphologic changes were demonstrated by HE staining.Results The successful rate of the percutaneous biopsy was 100% for all the 25 times of this procedure,including acute rejection on 9 episodes,preservation perfusion retrauma in 6,bile duct strictures in 4,drug-induced injury in 4,chronic rejection in 1 and acute hepatic necrosis in 1.Conclusions CT-guided percutaneous biopsy is an important method for diagnosing transplanted liver injury and providing great value for distinguishment of the causes for transplanted liver injury.(J Intervent Radiol,2007,16:855-857)
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<p><b>OBJECTIVE</b>To explore the possibility that the free latissimus dorsi musculo-cutaneous flap to repair the forearm leg wound.</p><p><b>METHODS</b>To design latissimus dorsi musculo-cutaneous flap which is foundation on T form thoracodorsal artery stalk. To set the short arm into the receiver artery break and anastomos them. It is not only reassure the blood of free musculo-cutaneous flap, but also reconstruct the continuation of the receiver main artery.</p><p><b>RESULTS</b>In 16 patients, 15 patients success completely, 1 patient main success. The blood supply of receiver is adequate.</p><p><b>CONCLUSIONS</b>The free T form thoracodorsal artery stalk musculo-cutaneous flap free grafting is a good method to repair the skin and soft tissues defection of forearm and leg.</p>
Subject(s)
Humans , Anastomosis, Surgical , Methods , Arteries , Forearm , Free Tissue Flaps , Transplantation , Leg , Lower Extremity , Plastic Surgery Procedures , Skin , Superficial Back Muscles , Transplantation , Wound HealingABSTRACT
<p><b>OBJECTIVE</b>To estimate the benefits of reductions in underweight and Vitamin A deficiency for child survival in China that might be expected as a result of lowering the prevalence of these conditions.</p><p><b>METHODS</b>Profiles, a process of nutrition policy analysis was used to quantify the functional consequences of malnutrition in terms of child survival.</p><p><b>RESULTS</b>Underweight: The actual reduction in underweight between 1992 and 2001 (from 15.7% to the current 10.1%) resulted in saving of 176,000 child lives. As estimated, without improvements, 612,000 children will die due to underweight between 2001 and 2010, 281,000 (46%) of them living in western provinces. Reducing underweight prevalence from 10.1% to 8% could overall save 62,000 lives. The reduction of underweight prevalence in the west alone might save 56,000 lives. Vitamin A in China as a whole, vitamin A deficiency accounts, as estimated, for 7.5% of deaths of children 6-59 months old, representing 206,000 deaths over the past ten years. Halving the prevalence over the period would save 49,000 child lives. The higher prevalence and higher mortality rates in western provinces mean that even with only 28% of the Chinese population, over half of child deaths there are related to vitamin A.</p>