ABSTRACT
Objective To study the correlation of bone age and bone mineral density with age, height and weight of short children. Methods Sixty-four short children who were consulted and treated at the author's hospital from January 2016 to October 2018 were selected as research subjects. The general information including age, sex, height and weight of the children were recorded. The ultrasound bone density test was carried out at the same time. The bone mineral density and bone age were evaluated through plain carpal bone radiograph. The relationship between different bone age and bone mineral density value with age, height and weight was analyzed. Results The actual age of the enrolled children was positively correlated with bone mineral density and bone age (boys r=0.658, 0.919, girls r=0.641, 0.906). The height of the enrolled children was positively correlated with bone mineral density and bone age (boy r=0.561, 0.326, girls r=0.586, 0.349). The weight of the enrolled children was positively correlated with bone mineral density and bone age (boys r=0.340, 0.314, girls r=0.395, 0.282). Conclusion The bone age and bone mineral density of short children were positively correlated with their age, height and weight. In clinical diagnosis and treatment, the use of bone age and bone mineral density as a guide can produce more significant effects, which can be used as scientific indicators for the evaluation and prediction of short children.
ABSTRACT
Objective To investigate the effects of sequential pulmonary resuscitation maneuver (RM) with pulmonary protective ventilation on hemodynamics and arterial blood gas in patients with acute respiratory distress syndrome (ARDS) caused by severe chest trauma. Methods Ninety-six ARDS patients caused by severe chest trauma admitted to Dongguan People's Hospital from January 2017 to December 2018 were enrolled, and they were divided into a RM group and a mechanical ventilation group according to different ventilation modes, 48 cases being in each group. The mechanical ventilation group was given low tidal volume ventilation combined with the best positive end-expiratory pressure (PEEP); while the RM group was given sequential lung RM therapy on the basis of treatment in the mechanical ventilation group. The heart rate (HR), mean arterial pressure (MAP), central venous pressure (CVP), cardiac output (CO), cardiac output index (CI), systemic circulation resistance index (SVRI) arterial blood gas were monitored before and after treatment in the two groups, and oxygenation index(PaO2/FiO2) was calculated; The mechanical ventilation time, intensive care unit (ICU) hospitalization time, incidence of ventilator associated pneumonia (VAP), mortality and incidence of adverse reaction were observed between the two groups. Results After treatment, the pH value and arterial partial pressure of carbon dioxide (PaCO2) of the two groups had no significant change; with the prolongation of treatment, the arterial partial pressure of oxygen (PaO2) and arterial blood oxygen saturation (SaO2);PaO2/FiO2 were increased significantly, total carbon dioxide (TCO2) was decreased significantly, after 72 hours of treatment, the degree of change in the RM group were more remarkable greater than those in the mechanical ventilation group [PaO2 (mmHg, 1 mmHg = 0.133 kPa): 91.02±9.03 vs. 80.34±7.66, SaO2: 0.96±0.04 vs. 0.94±0.04, TCO2 (mmol/L): 24.72±2.83 vs. 23.54±2.76, PaO2/FiO2 (mmHg): 238.47±19.83 vs. 185.34±17.37, all P < 0.05]. The ICU hospitalization time and mechanical ventilation time in the RM group were significantly lower than those in the mechanical ventilation group [ICU hospitalization time (days): 22.03±3.39 vs. 26.75±4.04,mechanical ventilation time (days): 13.38±4.04 vs. 19.33±5.02], and the incidence of VAP and mortality in the RM group were significantly lower than those in the mechanical ventilation group[incidence of VAP: 25.00% (12/48) vs. 8.33% (4/48), mortality: 18.75% (9/48) vs. 22.92% (11/48), both P < 0.05]. With the extension of time, CVP, MAP, CO, CI and SVRI in RM group all showed a trend of first decreasing and then increasing, while HR showed a trend of increasing and then decreasing, and the above indicators in 5 minutes after pulmonary re-opening, gradually returned to normal, showing no statistical significances compared with those before treatment [HR (bpm): 97.88±6.22 vs. 98.20±8.37, CVP (mmHg): 6.33±1.35 vs. 6.32±1.36, MAP (mmHg): 94.56±5.96 vs. 95.03±9.82, CO (L/min): 6.34±1.42 vs. 6.40±1.23, CI (L·min-1·s-1):2.08±0.32 vs. 2.17±0.53, SVRI: 2 404.34±31.34 vs. 2 474.34±29.73, all P > 0.05]. No adverse reactions occurred in the two groups. Conclusion Pulmonary protective ventilation sequential lung recruitment maneuver can significantly improve the oxygenation of ARDS caused by severe chest trauma, shorten the durations of mechanical ventilation and hospitalization in ICU, reduce the incidence of VAP, improve pulmonary inflammation, and in the mean time it has no serious adverse effects on hemodynamics.