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Objective: To explore the clinical value of extravascular lung water monitoring for rapid recovery in pediatric patients after complete repair of tetralogy of Fallot (TOF). Methods: A total of 43 pediatric patients received complete repair of TOF were studied. The pulse contour cardiac index (PCCI), global end diastolic volume index (GEDI), stroke volume variation (SVV), systemic vascular resistance index (SVRI), global ejection fraction (GEF), maximum of pressure increase in aorta (dPmax), extravascular lung water index (EVWI) and pulmonary vascular permeability index (PVPI) were recorded by pulse-indicated continuous cardiac output (PICCO) monitoring at immediately enter pediatric ICU (PICU) and 6h, 12h, 18h, 24h post-operation. Meanwhile, the heart rate, blood pressure, central venous pressure (CVP), left atrium pressure (LAP) and balance of liquid were monitored; mechanical ventilation time, PICU stay time, re-intubation,re-occlusion of major aortopulmonary collateral arteries (MAPCAs) and other complications were recorded. Based on post-operative mechanical ventilation time, the patients were divided into 2 groups: Rapid recovery (R) group, patients with mechanical ventilation≤24h, n=29 and Delayed recovery (D) group, patients with mechanical ventilation>24h, n=14. Results: Compared with group D, group R had the shorter mechanical ventilation time (14.2±8.0) h vs (86.3±44.5) h and PICU stay time (2.5±1.7) days vs (5.3±3.6) days, both P<0.05; decreased PVPI at immediately enter PICU and 6h, 12h, 18h, 24h post-operation as (4.9±1.3 vs 6.4±1.5),(5.1±1.8 vs 6.5±1.3),(4.8±2.0 vs 6.5±1.6),(4.4±1.1vs 6.9±1.8), (4.4±2.5 vs 6.5±2.2) respectively, all P<0.05; Lower ELWI at 12h and 18h post-operation as(20.9±6.1) ml/kg vs (26.8±5.7) ml/kg and(19.1±5.5) ml/kg vs (26.7±5.5)ml/kg, both P<0.05. Group R had no patient received re-occlusion of MAPCAs after operation, while Group D had 3. No death, no catheter-related complication occurred in either group. Conclusion: MAPCAs may increase extravascular lung water, pulmonary vascular permeability and cause lung perfusion, therefore affect the early recovery of complete repair of pediatric TOF. PICCO monitoring may conduct bedside quantitative observation of lung perfusion, combining with ELWI and PVPI, clinicians may identify and manage MAPCAs as necessity for rapid recovery in relevant patients.
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Objective To understand the degree of psychological distress of breast cancer patients beford chemotherapy, and to analyze the causes and influencing factors. Methods A cross-sectional study was conducted on 95 patients with prechemotherapy for breast cancer from September 2017 to December 2017 using a general data questionnaire and distress management screening measure. Results The score of psychological pain before chemotherapy of breast cancer was (4.92 ±2.23), among which 69 cases with significant psychological pain accounted for 72.63％ (DT score was greater than 4). The main causes of breast cancer patients' psychological distress ranking on the top 10 are: surgical scar, recurrence worry, arm activities difficulty, daily life was disrupted, anxiety, memory loss, housekeeping difficulties, poor communication with her husband, fatigue, change the appearance. Single factor analysis showed that age, family harmony had an effect on psychological pain scores (P＜0.05).It is found that family harmony is the protective factor of paychological pain when age and family relationship are included in multifactor analysis (OR＞1, P＜0.05). Conclusion There is an obvious psychological distress in breast cancer patients before chemotherapy; The age, family harmony of the patient were independent factors related to psychological distress; body symptoms, emotions and family problems are the key issues to focus on before chemotherapy.
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To establish a method for the simultaneous determination of 9 components, namely gardenoside, paeoniflorin, forsythoside A, baicalin, forsythin, glycyrrhizic acid, rhein, honokiol, and magnolol in Xiao'er Chiqiao Qingre granules（XECQ Gra）. Ultra performance liquid chromatography (UPLC) was used on an Acquity UPLC HSS T3 C₁₈ column (2.1 mm×100 mm, 1.8 μm) with 0.1% phosphoric acid acetonitrile (A)-0.1% phosphoric acid solution (B) as mobile phase for gradient elution. The flow rate was 0.3 mL·min⁻¹ ; the column temperature was set at 30 °C, and the determination wavelength was set at 220 nm. All the 9 compounds were well separated, and showed good linear relationship within their concentrations (r>=0.999). The average recoveries were between 95.84%-101.4% and the RSD values were all less than 3.0%. The method is simple, reliable, and accurate, and could be used for the quality control of XECQ Gra.
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Objective To evaluate the diagnostic value of urine Cystatin C(Cys C) for renal function impairment in neonates with hypoxic-ischemic encephalopathy(HIE).Methods The urine Cys C concentration was measured by enzyme linked immunosorbent assay(ELISA) in 47 cases of HIE newborns(25 cases were mild HIE and 22 cases were moderate-severe HIE) within 3 days after their birth.Twenty-three cases without perinatal asphyxia or other factors which could result in renal function impairment were selected as control group.Urine Cys C with urine retinal-bindingprotein(RBP),?2-microglobulin(?2-MG) and fractional sodium excretion(FENa%) were analyzed by kolmogorov-smirno in each group.Results Compared with control group,the concentration of urine Cys C,RBP and the levels of FENa% in HIE newborns were significantly elevated.The levels of urine Cys C in moderate-severe HIE newborns were significantly higher than those in mild HIE newborns(Pa
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Objective To analyze the clinical characteristic and prognosis of Serratia infections in newborn infants and increase awareness of Serratia infections.Methods The clinical manifestations,diagnosis,complications,treatment and prognosis of Serratia infections were analyzed in 4 hospitalized newborn infants in neonatology center from Jul.2008 to Feb.2009.Results Among the 4 cases,blood culture revealed Serratia marcescens in 3 cases(1 case was preterm infant),cerebral spinal fluid culture revealed Serratia liquefacien in the fourth case.The main clinical manifestations were fever,convulsion and poor response,WBC and CRP were much higher,while obvious thrombocytopenia was only found in the preterm infant.Two cases of septicemia infection alone recovered after the treatment of the third-generation cephalosporin for at least 2 weeks,while the other 2 cases of septicemia infection combined with purulent meningitis,included 1 case of preterm infant and 1 case of Serratia liquefacien infection,developed meningoencephalitis and brain abscess confirmed by serial imaging,both of which had poor neurological sequelaes.Conclusions As a opportunistic pathogen,Serratia can cause severe infection in newborns.The patients complicated with meningitis should be followed up and pay more attention to the high incidence of neurological sequelaes.