ABSTRACT
Objective To study the effects of stored blood with low glucose 6-phosphate dehydrogenase (G6PD) activity for exchange transfusion (ET) in neonate hyperbilirubinemia.Method From January 2017 to December 2018,all neonates receiving ET for neonatal hyperbilirubinemia in neonatology department of our hospital were prospectively enrolled.G6PD activity in stored blood and in these neonates were examined.Their demographic information and other clinical data including post-ET total serum bilirubin (TSB) decrease,post-ET phototherapy duration and total hospital stay duration were collected.Result A total of 99 cases were enrolled,51 cases with normal G6PD and 48 G6PD deficiency.Among normal G6PDneonates,those receiving low G6PD activity blood had less decrease of post-ET TSB [(56.9 ± 8.4) ％ vs.(72.5 ± 14.4) ％],longer hospital stay and longer post-ET phototherapy duration [(6.4 ± 2.3) d vs.(4.9 ± 1.3) d,(70.8 ± 36.2) h vs.(52.3 ± 16.3) h] (P ＜ 0.05) than those receiving normal G6PD blood.Among G6PD deficiency neonates,those receiving low G6PD activity blood had less decrease of post-ET TSB [(58.8 ±6.2)％ vs.(67.3 ± 13.9)％],longer hospital stay and longer post-ET phototherapy duration [(5.5 ± 2.2) d vs.(4.4 ± 1.4) d,(60.6 ± 25.9) h vs.(47.9 ± 27.9) h] (P ＜ 0.05) than those receiving normal G6PD blood.The G6PD activity in stored blood had significant influences on duration of phototherapy (F =7.695,P =0.007),duration of hospital stay (F =12.528,P =0.001) and decrease of post-ET TSB (F =29.025,P ＜ 0.001).Conclusion ET with low G6PD activity stored blood has less favourable effects with less post-ET TSB decrease and prolonged duration of phototherapy and hospital stay.
ABSTRACT
Objective:To analyze the clinical characteristics of neonatal enteroviral meningitis.Methods:A retrospective analysis was conducted on 87 cases with intracranical infection.The cerebrospinal fluid(CSF)samples of these neonates were collected and tested by polymerase chain reaction(PCR) for enterovirus.According to the results, the cases were divided into the positive group(55 cases) and negative group(32 cases). The clinical characteristics of the cases were collected.Results:The time in hospital of the positive group was shorter than the negative group[(9.5±5.2)d vs.(21.8±15.8)d, t=4.295, P<0.001]. The cure rates of the positive group was higher[96.4%(53/55) vs. 81.2%(26/32), χ2=3.872, P=0.049]. There was no death case in the positive group, while there were 3 death cases(9.4%, 3/32)in the negative group.In summer and autumn, the morbidity of the positive group was higher[96.4%(53/55) vs.62.5%(20/32), χ2=17.181, P<0.001]. In two groups, the most predominant clinical presentation was fever[90.9%(50/55) vs. 68.8%(22/32), χ2=6.962, P=0.008]. CSF examination results showed that white blood cells, the proportion of polymorphonuclear cell and CSF protein in the positive group were lower than those in the negative group, while the proportion of mononuclear cell and CSF glucose level in the positive group were higher( P<0.001). Blood and CSF cultures were negative in the positive group.There were 10 cases whose blood cultures and CSF cultures were positive in the negative group.Among them, there were 3 cases infected by group B streptococcus, 6 cases by E. coli, 1 case by Chryseobacterium meningosepticum.The prognoses of the CSF culture positive cases were poor.The abonormal cases detected by cerebral ultrasound, MRI and aEEG were fewer in the positive group( P<0.05). Conclusion:Enterovirus is the common pathogen of nonbacterial meningitis in summer and autumn in our region.The prognosis of enteroviral meningitis is better.Neonates with suspected clinical presentation, such as fever, should undergo PCR test to check CSF for enteroviru.
ABSTRACT
Objective:To analyze the causes of SARS-CoV-2 nosocomial infection among healthcare workers (HCWs) and explore the effective precaution strategies in Emergency Center.Methods:The data of SARS-CoV-2 infected HCWs from January 5 to March 2, 2020 were retrospectively analyzed and compared under different conditions in Emergency Center of Zhongnan Hospital of Wuhan University.Results:Totally 13 SARS-CoV-2 infected HCWs (12 confirmed cases and 1 suspected case) were included in this study. The overall infection rate was 17.8% (13/73). The infection rates in outpatient/rescue room, isolation observation room and isolationin patient ward were 11.8% (4/34), 20.0% (3/15), 25% (6/24), respectively. The infection rate of physician was 13.0% (3/23), and the infection rate of nurse was 20.0% (10/50). All the infected HCWs had the definite exposure with confirmed or suspected COVID-19 patients. One asymptomatic cases were identified by laboratory findings of SARS-CoV-2 infection screening. There was no new confirmed SARS-CoV-2 infected HCWs after February 5, 2020. All the infected HCWs were cured.Conclusions:Under the epidemic of COVID-19, HCWs of Emergency Center have a high risk of occupational exposure and infection, especially for staffs working in COVID-19 isolation units. Scientific prevention and control management can effectively reduce the risk of SARS-CoV-2 infections and ensure the occupational safety for HCWs in Emergency Center.
ABSTRACT
Objective@#To investigate the effects of neonatal intensive care unit (NICU)-centered regional neonatal transport network (NTN) on the treatment of retinopathy of prematurity (ROP).@*Methods@#A retrospective analysis was conducted to analyze the transfer, treatment and outcomes of 406 preterm infants with ROP who were transferred to the Bayi Children's Hospital Affiliated to the Seventh Medical Center of PLA General Hospital via the NTN from July 2008 to December 2014. Independent sample t-test, Chi-square test and Mann-Whitney nonparametric test were used for statistical analysis.@*Results@#Among the 406 premature infants who were transferred to our hospital because of ROP, there were 257 males and 149 females with the gestational age of (29.5±1.9) weeks (24+5-36 weeks) and the birth weight of (1 234.8± 268.9) g (580-2 400 g). The age at transfer was (48.9±18.5) d (15-78 d) and the transport distance was (216.5±78.6) km (10-625 km). No death was reported during the transportation. Very preterm births and very low birth weight infants (VLBWI) accounted for 88.7% (360 cases) and 82.5% (335 cases), respectively. Lesions occurred in 1, 2 and 3 zones were detected in 98 (24.1%), 286 (70.4%) and 22 (5.4%) cases, respectively. Lesions of stage 1-5 were observed in 51 (12.6%), 156 (38.4%), 183 (45.1%), 12 (3.0%) and 4 (1.0%) cases. There were 186 cases (45.8%) with Plus lesions. A total of 252 cases (62.1%) underwent surgery which were achieving treatment standards, including 165 (65.5%) undergoing laser therapy, 93 (36.9%) receiving anti-vascular endothelial growth factor (VEGF) therapy, 16 (6.4%) having vitrectomy and two (0.8%) having scleral buckling. Eighteen infants were diagnosed with retinal structural abnormalities, among which 16 had retinal detachment before admission (12 in phase 4 and four in phase 5). Two without retinal detachment on admission developed to phase 4 after surgery. The incidence of retinal structural dysplasia was 0.9% (2/236) in infants receiving laser and/or anti-VEGF therapy in our hospital. Compared with the cured patients (n=234), those with retinal structural dysplasia (n=18) had a late transfer time [80 (38-270) vs 50 (19-150) d, Z=3.387, P<0.001].@*Conclusions@#The NICU-centered and regional transfer-based ROP treatment network provides timely and effective treatment for infants with ROP.
ABSTRACT
Trillions of microbes reside in the human body and participate in multiple physiological and pathophysiological processes that affect host health throughout the life cycle. The microbiome is hallmarked by distinctive compositional and functional features across different life periods. Accumulating evidence has shown that microbes residing in the human body may play fundamental roles in infant development and the maturation of the immune system. Gut microbes are thought to be essential for the facilitation of infantile and childhood development and immunity by assisting in breaking down food substances to liberate nutrients, protecting against pathogens, stimulating or modulating the immune system, and exerting control over the hypothalamic-pituitary-adrenal axis. This review aims to summarize the current understanding of the colonization and development of the gut microbiota in early life, highlighting the recent findings regarding the role of intestinal microbes in pediatric diseases. Furthermore, we also discuss the microbiota-mediated therapeutics that can reconfigure bacterial communities to treat dysbiosis.
Subject(s)
Child , Child, Preschool , Humans , Infant , Infant, Newborn , Disease , Dysbiosis , Therapeutics , Gastrointestinal MicrobiomeABSTRACT
Objective To investigate the effects of neonatal intensive care unit (NICU)-centered regional neonatal transport network (NTN) on the treatment of retinopathy of prematurity (ROP). Methods A retrospective analysis was conducted to analyze the transfer, treatment and outcomes of 406 preterm infants with ROP who were transferred to the Bayi Children's Hospital Affiliated to the Seventh Medical Center of PLA General Hospital via the NTN from July 2008 to December 2014. Independent sample t-test, Chi-square test and Mann-Whitney nonparametric test were used for statistical analysis. Results Among the 406 premature infants who were transferred to our hospital because of ROP, there were 257 males and 149 females with the gestational age of (29.5±1.9) weeks (24+5-36 weeks) and the birth weight of (1 234.8± 268.9) g (580-2 400 g). The age at transfer was (48.9±18.5) d (15-78 d) and the transport distance was (216.5±78.6) km (10-625 km). No death was reported during the transportation. Very preterm births and very low birth weight infants (VLBWI) accounted for 88.7% (360 cases) and 82.5% (335 cases), respectively. Lesions occurred in 1, 2 and 3 zones were detected in 98 (24.1%), 286 (70.4%) and 22 (5.4%) cases, respectively. Lesions of stage 1-5 were observed in 51 (12.6%), 156 (38.4%), 183 (45.1%), 12 (3.0%) and 4 (1.0%) cases. There were 186 cases (45.8%) with Plus lesions. A total of 252 cases (62.1%) underwent surgery which were achieving treatment standards, including 165 (65.5%) undergoing laser therapy, 93 (36.9%) receiving anti-vascular endothelial growth factor (VEGF) therapy, 16 (6.4%) having vitrectomy and two (0.8%) having scleral buckling. Eighteen infants were diagnosed with retinal structural abnormalities, among which 16 had retinal detachment before admission (12 in phase 4 and four in phase 5). Two without retinal detachment on admission developed to phase 4 after surgery. The incidence of retinal structural dysplasia was 0.9% (2/236) in infants receiving laser and/or anti-VEGF therapy in our hospital. Compared with the cured patients (n=234), those with retinal structural dysplasia (n=18) had a late transfer time [80 (38-270) vs 50 (19-150) d, Z=3.387, P<0.001]. Conclusions The NICU-centered and regional transfer-based ROP treatment network provides timely and effective treatment for infants with ROP.
ABSTRACT
Objective To identify the epidemiological changes in invasive fungal infection (IFI) in a neonatal intensive care unit (NICU) to provide information for prevention and treatment of IFI.Methods A total of 102 cases who were diagnosed with IFI among 42 187 neonates hospitalized in the NICU of Affiliated BaYi Children's Hospital,Chinese People's Liberation Army General Hospital from January 1,2009 to December 31,2014 were enrolled in this study.Since January 1,2012,the divisions of our NICU were more specific and intravenous fluconazole was administered as a routine preventive measure for high-risk infants.Clinical information of the IFI cases including general features,incidence,distribution of pathogens and drug (Amphotericin B,Fluconazole,Flucytosin,Itraconazole and Voriconazole) sensitivity were analyzed between former period (January 1,2009 to December 31,2011) and latter period (January 1,2012 to December 31,2014) by Chi-square test.Results The total incidence of IFI was 2.42‰ (102/42 187),and among the 102 IFI cases,73.5％ (75/102) were preterm infants and 75.5％ (77/102) were low birth weight infants.The incidence ofIFI in the latter period was lower than that in the former period [1.8‰ (48/26 046) vs 3.3‰ (54/16 141),x2=9.329,P＜0.01].The incidences of IFI in neonates with gestation age ＜28,≥ 28-＜32 and ≥ 32-＜37 weeks in latter period were decreased as compared with those in former period [10.6 ‰ (3/284) vs 76.9 ‰ (9/117),x2=12.569;6.1‰ (13/2 134) vs 21.9‰ (28/1 277),x2=16.868;1.4‰ (12/8 706) vs 1.9‰ (10/5 256),x2=7.165] (all P＜0.01).Altogether 103 pathogen strains were identified from 102 IFI cases as one Candida parapsilosis strain and one Laurent cryptococcus strain were both isolated from one patient.The most prevalent three pathogens were Candida albicans [51.5％ (53/103)],Candidaparapsilosis [24.3％ (25/103)] and Candida glabrata [8.7％ (9/103)].The isolated rates of Candida albicans and Candida glabrata strains in the latter period were higher than those in the former period [63.3％ (31/49) vs 40.7％ (22/54),x2=5.218;18.4％ (9/49) vs 0.0％ (0/54),x2=10.868],while the isolated rate of Candida parapsilosis strain was lower in the latter period than that in the former period [12.2％(6/49) vs 35.2％(19/54),x2=7.355] (all P＜0.05).All pathogen strains were sensitive strains except one Candida krusei strain which was isolated in the former period and was resistant to Fluconazole.Conclusions Premature infants born at lower gestational ages or with low birth weights are still at high-risk of IFI,but the incidence of IFI has declined in recent years.Routine administration of fluconazole in high-risk infants in NICU could prevente IFI without increasing drug resistance.Candida albicans is the predominant pathogen ofIFI.
ABSTRACT
Objective To explore the application of continuing nursing model in life of puerperae with preterm infants and evaluate its effects.Methods Based on continuous nursing model of Ahmadi,puerperae's continuing nursing program was constructed.Randomized controlled trail design was used,and totally 110 puerperae in a hospital in Beijing were recruited from August 2016 to March 2017.The experimental group received continuing nursing intervention model,and the control group received routine nursing care.Parenting knowledge and psychological evaluation of the two groups were collected 3 days before discharge,1 month,3 months and 6 months after discharge.Results Ninety-eight puerperae completed the study.In the experimental group,the score of parenting knowledge was higher than that of the control group(P＜0.01),and the total score of mental health assessment and scores of depression and anxiety were lower than those in the control group (P＜0.05).Conclusion Puerperae's continuing nursing program based on the continuous nursing model of Ahmadi improved maternal ability and positive emotion,and promoted quality of life.
ABSTRACT
Objective At present , there is only a small amount of survey scale of caregivers′cognitive level on continuous nursing care for premature infants , which had not been subject to stringent testing of reliability and validity .This paper aims at developing a suitable survey scale of caregivers′cognitive level oncontinuous nursing care for 0-1 year premature infants , and testing its reliability and validity. Methods Convenience sampling method was used and totally 495 caregivers of premature infants of Army General Hospi-tal affiliated BaYi Children hospital from April to August 2016 has been investigated .After we had preliminary content of the question-naire, two-round Delphi consultations were used to identify the draft of the scale , and the reliability and validity were tested . Results Totally 419 valid questionnaires from 495.Questionnaires effective recovery was 84.65%.Critical ratio for each entry was 9.355-23.179 ( P<0.05) , which suggested that entries had good distinction .Coeffi-cient of correlation between scale items and total score was 0.500-0.775(P<0.05), whichindicated highly homogeneity between entries and table.By exploratory factor analysis , 5 entries were removed and 77 entries remained .The final scale of caregivers′cognitive level on continuous nursing care for premature infants included 4 indicators in level one , 15 indicators in level two and 77 indicators in level three .The Cronbach′s alpha was 0.985 for overall questionnaire and 0.848-0.939 for each dimension .The split-half reliability was 0.895 for overall questionnaire and 0.814-0.939 for each dimension .The content validity index was 0.963.The cumulative contribution rate of each dimension was 64.645%-83.236%. Conclusion The scale content was scientific and comprehensive .It can be used to investigate the caregivers′cognitive level on continuous nursing care for 0-1 year pre-mature infants, direct nurses to provide continuous care for premature infants , and evaluate the continuous nursing effect .
ABSTRACT
Objective To explore and build a real, objective, comprehensive clinical nursing individual performance indicators architecture model,and check the rationality and validity for prize distribution by clinical application. Methods The methods included that discuss new ideas of nursing performance management by multi- disciplinary experts,developed clinical personal nursing staff performance evaluation program,worded out indicators and methods for the clinical assessment of individual nurses and nurse managers respectively,then applied research in the pilot departments and hospital step by step. Results A personal performance evaluation framework model was constructed, which include clinical nurses and nursing managers. Experimental results show that the nursing staff in this regard performance program have a high degree of recognition, 98.82% (1 741/1 762) nursing staff understanding of the purpose and significance, 97.15%(1 712/1 762) nurses think the performance model structure is reasonable. After the implementation of the performance program, the outstanding rate of personal performance appraisal of nurses was 93% (1 639/1 762). Conclusions The application of scientific performance appraisal programs can play a positive role in helping improve the quality of clinical care, and promote the stable development of the care team.
ABSTRACT
Objective To compare the clinical effect of montelukast sodium and ketotifen in the treatment of children with cough variant asthma,thus to provide theoretical basis for clinical treatment.Methods 61 children with cough variant asthma were randomly divided into control group and observation group according to the digital table method,31 cases in each group.Patients of two groups were all given antispasmodic and antitussive.The control group was given ketotifen tablets drug therapy,1mg/time,2 times/d,and the observation group was treated with montelukast chewable tablets,5mg/time,1 time /d.After 8 weeks of treatment,the clinical effects were compared between the two groups.Results The total effective rate of the observation group (96.77%)was higher than that of the control group (77.42%),and the difference was statistically significant (χ2 =16.65,P <0.05).The clinical symptoms improved time of the observation group was (5.78 ±1.36)d,which was shorter than (8.45 ±2.24)d of the control group,the difference was statistically significant (t =2.71,P <0.05).The recurrence rate of the observation group (6.45%) was lower than the control group (16.13%),the difference was statistically significant (χ2 =4.67,P <0.05 ). Recurrence time of the observation group was better than that of the control group,the difference was statistically significant (t =7.98,P <0.05 ).Conclusion The curative effect of montelukast special chewing tablets in the treatment of children with bronchial asthma is obviously superior to ketotifen,has less adverse reactions.It was worthy of clinical application.
ABSTRACT
Objective To explore mechnism and effect of fentanyl on proliferation of gastric cancer SGC-7901 cell.Methods Gastric cancer SGC-7901 cell was cultured with fentanyl of 0 (negative control), 0.5, 5 and 50 nmol/L, MTT method was used to detect the effect of fentanyl on SGC-7901 viability.The effect of fentanyl on SGC-7901 cell cycle was measured by flow cytometry.The level of cell related protein,cell cycle protein cyclin D1, Bcl-2.Results Compared with control group, fentanyl (0.5, 5, 50 nmol/L) could inhibit SGC-7901 cell viability, and the inhibitory rate was highest at 48 h.0.5, 5, 50 nmol/L fentanyl made cell cycle arrested in G1 phase.Compared with control group, fentanyl can significantly inhibit cyclinD1 and Bcl-2 expression with drug concentration increasing(P<0.05).Conclusion These results suggeste fentanyl inhibit proliferation of gastric cancer SGC-7901 cell.
ABSTRACT
<p><b>OBJECTIVE</b>To investigate the therapeutic effect of soft tissue expansion combined with follicular unit extraction( FUE) for burn cicatricial bald.</p><p><b>METHODS</b>48 patients with burn cicatricial bald (> 25 cm2) were treated in three stages. The expanders were implanted on the first stage. After expansion for 8 weeks, the expanders were taken out and local flaps were transferred. One year later, follicular unit extraction( FUE) was applied on the bald area.</p><p><b>RESULTS</b>48 cases were followed up for 5 years with satisfactory cosmetic results. The VAS assessment of satisfaction on hair appearance after three-staged surgery was 8.2 ± 2.1.</p><p><b>CONCLUSIONS</b>Soft tissue expansion combined with FUE has a reliable effect for burn cicatricial bald.</p>
Subject(s)
Female , Humans , Male , Alopecia , General Surgery , Burns , General Surgery , Hair , Transplantation , Hair Follicle , Transplantation , Surgical Flaps , Transplantation , Tissue Expansion , Methods , Tissue Expansion DevicesABSTRACT
OBJECTIVE@#To investigate characteristics of molecular etiology of children with profound sensorineural hearing loss in Hubei province, and to provide reference for deafness treatment and genetic counseling.@*METHOD@#Three hundred and six children with profound sensorineural hearing loss in Hubei province were enrolled, their genomic DNA were extracted from peripheral blood and a deafness gene test chip was used to screen nine hot spot mutation in the GJB2, GJB3, SLC26A4, and mitochondria 12SrRNA gene. All patients with SLC26A4 gene mutation were given temporal bone CT scan.@*RESULT@#One hundred and thirty-two (43.14%) out of 306 children were found carrying at least one pathogenic gene mutation. The mutation rates of GJB2, SLC26A4 and mitochondria DNA 12SrRNA gene were 29.41% (90/306), 13.72% (42/306) and 0.65% (2/306), respectively. None out of 306 children was detected GJB3 gene mutation. Thirty-six patients carrying SLC26A4 gene mutation were detected enlarged vestibular aqueduct by CT scan.@*CONCLUSION@#Mutations of GJB2 and SLC26A4 gene are two major pathogenic gene for genetic hearing loss in children. 235delC mutation is the main mutation type, followed by IVS7-2A> G mutation type. The screening of SLC26A4 gene common mutations contribute to the diagnosis of enlarged vestibular aqueduct syndrome.
Subject(s)
Adolescent , Child , Child, Preschool , Female , Humans , Infant , Male , China , Connexin 26 , Connexins , Genetics , DNA Mutational Analysis , Deafness , Genetics , Genetic Testing , Membrane Transport Proteins , Genetics , Mutation , Oligonucleotide Array Sequence Analysis , Sulfate TransportersABSTRACT
Objective To investigate the risk factors of gallbladder neoplastic polyps,to determine the proper surgical indications,and to understand more about the clinical characteristics of gallbladder adenoma.Methods The clinical data of 748 patients diagnosed to have polypoid lesion of gallbladder (PLG) and underwent cholecystectomy from January 1998 to December 2012 in the Second Affiliated Hospital of Zhejiang University School of Medicine were retrospectively reviewed.Results Among 748 patients,340 had abdominal symptoms.Postoperative histopathology showed non-neoplastic polyps (n =659),gallbladder adenoma (n =68),gallbladder cancer (n =15) and no polyps (n =6).The mean diameters of the nonneoplastic lesions and the neoplastic polyps were (9.38 ± 3.44) mm and (14.55 ± 5.71) mm,respectively (P ＜ 0.01).The average age of the patients with non-neoplastic lesions was (44.14 ± 11.42) years and (47.39 ± 12.82) years in those with neoplastic polyps (P ＜ 0.05).The proportion of solitary PLG was 41.4％ (253/611) and 59.59％ (47/79) for the non-neoplastic lesions and the neoplastic polyps respec tively (P ＜ 0.01).The size of PLG (13.34 ± 4.18 mm vs.20.07 ± 8.19 mm,P ＜ 0.05) and the age of the patient (45.78 ± 11.66 years vs.54.13 ± 15.82 years,P ＜0.05) between the gallbladder adenoma and gallbladder cancer groups were significantly different.Gallbladder adenoma or dysplasia was identified in 66.7％ (10/15) of gal1bladder cancer specimens.Conclusions Patients with PLG and with abdominal symptoms,large size (≥ 10 mm),old age (≥50 y) and solitary polyp are indications for cholecystectomy.Gallbladder adenoma may develop to gallbladder cancer within 10 years.
ABSTRACT
OBJECTIVE@#To investigate the character of 80 Hz auditory steady-state evoked potentials in auditory neuropathy (AN) patients and the correlation between it and ABR.@*METHOD@#The 80 Hz auditory steady-state evoked potentials and ABR to 95 dBnHL (1000 Hz) tone-pip stimuli were recorded from the scalp in patients with AN and normal subjects. The difference of the waveforms between AN ears and normal ears was compared.@*RESULT@#In 85.4% AN ears the 80 Hz auditory steady-state evoked potentials and ABR were simultaneously present. Their amplitudes were low or extremely low. The I and III waves of ABR were absent. The 80 Hz auditory steady-state evoked potentials and ABR were simultaneously absent, in 14.6% AN ears, but were present in all normal ears.@*CONCLUSION@#The 80 Hz auditory steady-state evoked potentials and the V wave of ABR may come from the same brainstem sources.