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Objective To explore the relationship between serum albumin (ALB) combined with red blood cell distribution width (RDW) in progression and prognosis of children with heart failure. Method A total of 144 children with heart failure were divided into light, medium, and heavy group according to the modified ROSS score; another aspect, they also were divided into survival group and death group. ALB, RDW, and modified ROSS score were measured to assess the relationship between the factors and the death by logistic regression analysis. Results There are 73 boys and 71 girls. The cases of mild, moderate, and severe group were 78, 39, and 27, respectively. Age and gender difference in three groups were not statistically significant (P>0.05). The ratio of high RDW was 54.86% (79/144), the ratio of low serum ALB was 33.33% (48/144). Chi-square analysis indicated that a severer status of the disease correlated with a lower ALB level (P <0.05) and a higher RDW. The analysis of rank correlation indicating the degree of heart failure was negatively correlated with the related trends of ALB and RDW (P<0.05). Logistic regression analysis indicating a higher risk of death of the disease correlated with a lower ALB level (P<0.05, OR=0.839)and a higher modified ROSS score(P<0.05,OR=1.324).Conclusions The ALB,RDW,and the modified ROSS score are closely related to the severity in heart failure children. The ALB and the modified ROSS score have important clinical prognostic significance in evaluating the prognosis.
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Objective To observe the effect of nystatin via gastrointestinal tract on the incidence of invasive fungal infections (IFI) and the prognosis of patients with mechanical ventilation in ICU.Methods A total of 118 critical ill patients admitted to ICU needing mechanical ventilation were enrolled.The patients were divided into two groups by random digits table method.Patients in study group (57 cases) were administered nystatin 1 000 kU three times a day via the gastric tube;and patients in control group (61cases) were given gastrointestinal prokinetic drug as placebo three times a day.The specimens were collected on admission,the third,the sixth,the ninth day after admission,the strain distribution was observed,and the corrected colonization index (CCI) of all patients were calculated.The incidence of candidemia and 28-day mortality as well as the duration of stay in ICU and hospital was also recorded.Results A total of 860 strains were isolated from 118 patients.Of which Candida albicans accounted for 56.9％ (489/860).The most frequently colonized body sites was oropharyngeal site [35.9％(309/860)].CCI on the sixth,the ninth day after admission in study group was lower than that in control group (0.18 ±0.09 vs.0.40 ±0.16 and 0.10 ± 0.02 vs.0.45 ± 0.13),28-day mortality in study group was lower than that in control group [17.5％(10/57) vs.34.4％(21/61)],the duration of stay in ICU in study group was shorter than that in control group [(9.45 ± 3.36) d vs.(11.78 ± 6.21) d],and there were significant differences (P ＜ 0.05).There were no significant differences in the incidence of candidemia and the duration of stay in hospital (P ＞0.05).Conclusion Nystatin may reduce the colonization of Candida albicans and is associated with shorter ICU day.
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Objective To explore the relationship of red blood cell distribution width (RDW) with severity and prognosis in children with sepsis. Methods The RDW, clinical features and prognosis of 494 sepsis children were retrospectively ana-lyzed. Results The RDW was increased in 305 sepsis children (61.74%) among whom 49.30%in sepsis group, 60.27%in sever sepsis group and 83.46%in septic shock group. The difference was signiifcant (P<0.001). The mortality of RDW increased children among three groups was 1.89%, 20.45%, 67.57%, and it was signiifcantly different (P<0.001). The rates of increased RDW was 56.15%in 374 survived cases and 79.17%in 120 died cases, and the difference was signiifcant (P<0.001). Pediatric critical illness score (PCIS) was negatively correlated with RDW (P<0.001), while mortality was positively correlated with RDW (P<0.001). Conclusions The rate of increased RDW is high in children with severe sepsis and septic shock and the level of RDW is closely related to the prognosis of patients.
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Objective To explore the changes of blood gas, plasma fibrinogen and D-dimmer levels in neonates with severe hyaline membrane disease (HMD). Methods Forty - three neonates with severe HMD(treated by mechanical ventilation) ,26 neonates with mild HMD( without treated by mechanical venti-lation) and 31 controls were studied. The blood gas,plasma fibrinogen and D-dimmer levels were measured. Results Compared with other two groups, the levels of blood pH, PaO2 and FBG decreased significantly in neonates with severe HMD (P<0.01). The levels of PaCO2 and D-dimmer increased significantly (P<0.01). The blood pH was negatively correlated with plasma D-dimmer level,but it was positively correlated with plasma FBG level in neonates with severe HMD. Conclusion There are coagulation abnormalities in neonates with severe HMD. Hypoxemia and acidosis have close relationship with the coagulation abnormali-ties.