Effect of glucose metabolism disorders on the short-term prognosis in neonates with asphyxia: a multicenter study in Hubei Province, China / 中国当代儿科杂志

OBJECTIVES@#To study the effect of glucose metabolism disorders on the short-term prognosis in neonates with asphyxia.@*METHODS@#A retrospective analysis was performed on the medical data of the neonates with asphyxia who were admitted to 52 hospitals in Hubei Province of China from January to December, 2018 and had blood glucose data within 12 hours after birth. Their blood glucose data at 1, 2, 6, and 12 hours after birth (with an allowable time error of 0.5 hour) were recorded. According to the presence or absence of brain injury and/or death during hospitalization, the neonates were divided into a poor prognosis group with 693 neonates and a good prognosis group with 779 neonates. The two groups were compared in the incidence of glucose metabolism disorders within 12 hours after birth and short-term prognosis.@*RESULTS@#Compared with the good prognosis group, the poor prognosis group had a significantly higher proportion of neonates from secondary hospitals (48.5% vs 42.6%, @*CONCLUSIONS@#Recurrent hyperglycemia in neonates with asphyxia may suggest poor short-term prognosis, and it is necessary to strengthen the early monitoring and management of the nervous system in such neonates.

Autoimmune Hepatitis-related Cirrhosis: Clinical Features and Effectiveness of Immunosuppressive Treatment in Chinese Patients / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The long-term outcomes of patients with autoimmune hepatitis (AIH) given the immunosuppressive treatment are considered to be preferable. However, little is known about the response of AIH patients with cirrhosis to immunosuppressive treatment. We assessed the effects of immunosuppressive therapy in Chinese AIH patients with cirrhosis from a tertiary hospital.</p><p><b>METHODS</b>Patients with a clinical diagnosis of AIH January 2000 and December 2015 were retrospectively reviewed. Two-hundred and fourteen patients who were followed up and satisfied the simplified AIH criteria were included in the study. Among these patients, 87 presented with cirrhosis when initially diagnosed for AIH. Immunosuppressive treatments were employed in 57 AIH patients who did not present with cirrhosis and 39 patients who presented with cirrhosis. Initial responses to immunosuppressive treatment of patients with and without cirrhosis were analyzed. Independent risk factors were assessed for predicting the prognosis of patients. The t-test and Cox regression statistical analysis were used.</p><p><b>RESULTS</b>In total, 96 AIH patients including 39 with cirrhosis and 57 without cirrhosis underwent immunosuppressive therapy. The overall complete remission after initial immunosuppressive treatment was achieved in 81/96 patients (84.4%), whereas 9/96 (9.4%) achieved incomplete response, and 6/96 (6.3%) occurred treatment failure. Compared to noncirrhotic patients, patients who presented with cirrhosis responded to treatment to a comparable extent regarding complete response (noncirrhosis 50/57 [87.7%] vs. cirrhosis 31/39 [79.5%], P = 0.275), incomplete remission (noncirrhosis 4/57 [7.0%] vs. cirrhosis 5/39 [12.8%], P = 0.338), and treatment failure (noncirrhosis 3/57 [5.3%] vs. cirrhosis 3/39 [7.7%], P = 0.629). Importantly, the remission rate was comparable (54/57 [94.7%] and 36/39 [92.3%], P = 0.629) for noncirrhotic and cirrhotic patients after immunosuppressive therapy. Compared to patients who maintained remission (n = 19) after drug withdrawal, patients who experienced relapse (n = 17) had significantly higher levels of serum immunoglobulin G at entry (15.0 ± 6.5 g/L vs. 22.3 ± 5.8 g/L, t = 2.814, P = 0.004). Moreover, cirrhosis at presentation significantly increased the risk of disease exacerbation (hazard ratio [HR]: 4.603; P = 0.002). The treatment of immunosuppressant (HR: 0.058; P = 0.005) and the level of aspartate aminotransferase at presentation (HR: 1.002; P = 0.017) also increased the risk of disease progression.</p><p><b>CONCLUSIONS</b>The efficacy of initial immunosuppressive treatment in AIH patients with cirrhosis is comparable to that in those without cirrhosis. Cirrhotic patients not treated by immunosuppressants have poor long-term outcomes.</p>

Management of sphenoidal sinus lesions by septal-assisted approach: Surgical skills and advantages / 华中科技大学学报（医学）（英德文版）

The aim of this study was to develop a less invasive trans-septal approach for the endoscopic management of sphenoid sinus lesions. We performed a septal-assisted surgical procedure for endoscopic sphenoidectomy in 38 patients with isolated or combined sphenoidal sinus lesions, including fungal balls, mucoceles, purulent cystic sphenoidal sinusitis, etc. The posterior portion of the nasal septum became flexible after removal of the vomer and the sphenoidal rostrum. The superior portion of the common meatus was expanded to accommodate the endoscope after the septum was repositioned contra-laterally. The lesions were individually managed through the enlarged ostiums while damage to the mucosa of the front sphenoidal wall was avoided. All the procedures were completed successfully without intraoperative complications, and the bony ostiums were identified easily and enlarged accurately. During the follow-up period of 16 weeks to 2 years, no re-atresia or restenosis was observed. The recurrence rate was 0. No postoperative complications were recorded. All the responses from the patients were satisfactory. It was concluded that endoscopic sphenoidectomy assisted by trans-septal approach is a feasible, safe, effective and minimally invasive approach for selected cases with unilateral or bilateral lesions in the sphenoid sinuses.

Correlation analysis of subjective and objective scoring of chronic rhinosinusitis with nasal polyps / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To explore the relationship of of subjective and objective scoring chronic rhinosinusitis with nasal polyps.</p><p><b>METHODS</b>The clinical data of 159 patients with chronic rhinosinusitis were analyzed. SPSS 18.0 software was used to analyze the data. Pearson regression was used to analyze the relationship.</p><p><b>RESULTS</b>The Pearson correlation coefficient r between VAS score (16.380 ± 5.809)and the whole discomfort (5.070 ± 1.361) was 0.710, there were correlation (P < 0.01). The Pearson correlation coefficient r between Lund-Kennedy score (3.724 ± 1.107) and Lund-Mackay score (5.983 ± 2.984) was 0.513, there were correlation (P < 0.01). The Pearson correlation coefficient r between VAS score and Lund-Kennedy score was 0.417, there were correlation (P < 0.05). VAS score had no correlation with Lund-Mackay(r = 0.113, P > 0.05). The whole discomfort had no correlation with Lund-Kennedy score and Lund-Mackay score (r value were 0.309 and 0.022, all P > 0.05).</p><p><b>CONCLUSIONS</b>The subjective and objective score of chronic rhinosinusitis with nasal polyps were contradict sometimes.</p>

Logistic regression analysis on influence factors of chronic sinusitis after endoscopic sinus surgery / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To explore the clinical effect and the influence factors after endoscopic surgery for chronic sinusitis.</p><p><b>METHODS</b>The clinical data of 337 patients with chronic sinusitis treated by endoscopic surgery were analyzed, including gender, age, culture level, course of the disease, the days of hospitalization, medical history, smoking, drinking, early surgery history, allergic rhinitis (AR) history, clinical classification, visual analogue scale (VAS) score, nasal endoscopy score, nasal polyps, CT examination score, side, nasal adhesion and postoperative follow-up compliance. The clinical effect of endoscopic sinus surgery was evaluated 6 months after operation according to the 1997 Haikou standard. SPSS 18.0 software and conducted chi-square test and logistic regression analysis were used to analyze the data.</p><p><b>RESULTS</b>Three hundred and thirty-seven chronic sinusitis patients were followed up after endoscopic surgery. It was found that 298 cases (88.4%) cured, 29 cases (8.6%) improved, 10 cases (3.0%) invalid. The clinical curative effect of the patients with chronic rhinosinusitis without nasal polyp was better than that of the patients with chronic rhinosinusitis with nasal polyp, the difference was statistically significant (χ(2) = 10.932, P < 0.01). After many factors Logistic regression analysis, the most important effect factor in the clinical curative effect were clinical type, AR or not, VAS score, nasal endoscopic examination score, CT examination score, multiple nasal polyp or not, postoperative nasal adhesion or not and postoperative follow-up compliance.</p><p><b>CONCLUSION</b>The clinical effective of endoscopic sinus surgery is influenced by not only surgery itself, but also by clinical classification, whether and not with AR and so on.</p>