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Objective:To compare the differences in exploratory behaviors between infants with high-risk autism spectrum disorder (HR-ASD) and normal development (TD) infants, and to explore the relationship between exploratory behaviors and the severity of ASD symptoms.Methods:A total of 31 infants aged 6-23 months with HR-ASD in the Pediatric Clinic, the Affiliated Brain Hospital of Nanjing Medical University from January 2019 to August 2020 were retrospectively recruited in the HR-ASD group, and 37 TD infants aged from 6 to 23 months in Nanjing were selected as the TD group.The development level of the 2 groups was evaluated by Gesell development scale, and the depth and breadth of exploratory behaviors were measured in free play.Autism Diagnostic Observation Schedule (ADOS) was used to evaluate the severity of ASD symptoms in HR-ASD group.Differences in exploratory behaviors between the 2 groups were analyzed by the independent sample t-test and Chi- square test. Pearson′ s correlation analysis was performed to explore the correlation between exploratory behaviors and symptom severity in HR-ASD group.Binary Logistic regression analysis was used to explore the discrimination efficiency of sexual behavior in the 2 groups. Results:Compared with TD group, the depth and breadth of exploratory behaviors in HR-ASD group were significantly lower (55.06±25.73 vs.132.78±44.69, 4.42±2.20 vs.8.78±3.28)( t=-8.95, -6.53, all P<0.01), and atypical exploratory behavior and avoidance withdrawal behavior were significantly worse [18 cases(58.06%) vs.6 cases(16.22%), 10 cases(32.26%) vs.3 cases(8.11%)]( χ2=15.30, 6.36, all P<0.05). Significant differences in the frequency and duration of object exploration, environmental exploration and social exploration were detected between HR-ASD group and TD group (3 vs. 0 vs. 0, 45 vs. 0 vs. 0)(all P<0.01). Pearson correlation analysis showed that, the frequency of object exploratory behavior was positively correlated with the dimension of ADOS in HR-AD group ( r=0.40, P<0.05); while the duration of object exploratory behavior, the complexity of object explo-ratory behavior and the depth of exploratory behavior were negatively correlated with CARS score ( r=-0.45, -0.47, -0.42, all P<0.05). The depth of exploratory behavior was negatively correlated with the stereotyped dimension of ADOS ( r=-0.40, P<0.05). Binary Logistic regression analysis showed that the depth of exploratory behavior had a discrimination effect ( P<0.01). Conclusions:The characteristics of exploratory behaviors in HR-ASD infants are abnormal, especially the distinguishing effect on the depth of exploratory behaviors, which can be used as a candidate behavioral index for early screening of ASD.
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Premature delivery is one of the direct factors that affect the early development and safety of infants. Its direct clinical manifestation is the change of uterine contraction intensity and frequency. Uterine Electrohysterography(EHG) signal collected from the abdomen of pregnant women can accurately and effectively reflect the uterine contraction, which has higher clinical application value than invasive monitoring technology such as intrauterine pressure catheter. Therefore, the research of fetal preterm birth recognition algorithm based on EHG is particularly important for perinatal fetal monitoring. We proposed a convolution neural network(CNN) based on EHG fetal preterm birth recognition algorithm, and a deep CNN model was constructed by combining the Gramian angular difference field(GADF) with the transfer learning technology. The structure of the model was optimized using the clinical measured term-preterm EHG database. The classification accuracy of 94.38% and F1 value of 97.11% were achieved. The experimental results showed that the model constructed in this paper has a certain auxiliary diagnostic value for clinical prediction of premature delivery.
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Female , Humans , Infant, Newborn , Pregnancy , Algorithms , Electromyography , Neural Networks, Computer , Premature Birth/diagnosis , Uterine ContractionABSTRACT
Objective:To explore the differences between impaired perspective-taking and executive function in children with attention deficit hyperactivity disorder(ADHD).Methods:From January 2019 to December 2020, according to DSM-5 diagnostic criteria, thirty-two cases of ADHD children aged 6 to 16(ADHD group) and twenty-six cases of typical development children and adolescents matched with age and intelligence (TD Group) were included. The response time and accuracy rate in dilemma stage and probe stage to self-oriented, maternal perspective-taking and other perspective-taking were measured using perspective-shifting task, and the executive function was evaluated by the behavior rating inventory of executive function (BRIEF). Repeated measurement analysis of variance was used to compare the difference of response time and accuracy rate between the two groups. Pearson correlation analysis was used to explore the correlation between the perspective-taking behavior characteristics and the BRIEF total score and subscale scores of ADHD group.Results:The total score and subscale scores of BRIEF scale in ADHD group were significantly higher than those in TD group (all P<0.01). The interaction between group and task type was significant during the task dilemma stage of perspective-shifting task ( F(2, 106)=4.365, P<0.05). Simple effect analysis showed that in other-perspective-taking task, the response time of ADHD group ((2 305.48±464.27)ms) was significantly longer than that of TD group ((1 971.13±462.95)ms) and the difference was statistically significant ( t=2.870, P<0.01). Pearson correlation analysis showed that the response time of ADHD group to other perspective-taking in dilemma stage was positively correlated with working memory, organization and inhibition index in EF ( r=0.401, 0.432, 0.342, all P<0.01). Conclusion:The ability of the perspective taking is closely related to impaired executive function, which seem to share a common neuropsychological basis.
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@# BACKGROUND:The aim of this study is to investigate the diagnostic and prognostic value of neutrophil CD64 (nCD64) as a novel biomarker in sepsis patients. METHODS: One hundred fifty-one adult patients diagnosed with sepsis and 20 age-matched healthy controls were enrolled in the study. Patients with sepsis were further subdivided into a sepsis group and a septic shock group. nCD64 expression, serum procalcitonin (PCT) level, C-reactive protein (CRP) level, and white blood cell (WBC) count were obtained for each patient, and Sequential Organ Failure Assessment (SOFA) scores were calculated. RESULTS: nCD64 expression was higher in the sepsis group with confirmed infection than in the control group. The receiver operating characteristic (ROC) curve of nCD64 was higher than those of SOFA score, PCT, CRP and WBC for diagnosing infection. The area under the curve (AUC) of nCD64 combined with SOFA score was the highest for all parameters. The AUC of nCD64 for predicting 28-day mortality in sepsis was signifi cantly higher than those of PCT, CRP, and WBC, but slightly lower than that of SOFA score. The AUC of nCD64 or PCT combined with SOFA score was signifi cantly higher than that of any single parameter for predicting 28-day mortality. CONCLUSION: nCD64 expression and SOFA score are valuable parameters for early diagnosis of infection and prognostic evaluation of sepsis patients.
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Background@#Immune disorder is an important feature of patients with out-of-hospital cardiac arrest (OHCA) after the return of spontaneous circulation (ROSC). We investigated the expression of circulatory T helper type (Th) 1, Th2, and Th17 cells to explore the early immune alteration in OHCA patients after ROSC.@*Methods@#During July-September 2016 and March-September 2017, 65 consecutive OHCA patients with ROSC >12 h and 30 healthy individuals were enrolled in this study. Clinical and 28-day survival data were collected. Peripheral blood samples were analyzed to evaluate the expression of Th1/Th2/Th17 cells by flow cytometry from OHCA patients after ROSC on days 1 and 3 and from healthy individuals.@*Results@#Compared with healthy individuals, T lymphocyte counts and Th1 cell counts decreased on days 1 and 3 after ROSC (1464 [1198, 2152] vs. 779 [481, 1140] vs. 581 [324, 1118]/μl, χ = 30.342, P 3 days; patients were divided into survivors (n = 10) and nonsurvivors (n = 18) based on 28-day survival. No significant differences in Th1/Th2/Th17 cell counts, ratios in CD4+ lymphocytes, and Th1/Th2 cell ratio were seen between survivors and nonsurvivors on both days (all P > 0.05). There was no difference over time in both survivors and nonsurvivors (all P > 0.05).@*Conclusion@#Downregulated T lymphocyte counts, including Th1/Th2/Th17 subsets and Th1/Th2 cell ratio imbalance, occur in the early period after ROSC, that may be involved in immune dysfunction in OHCA patients.
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Aged , Female , Humans , Male , Middle Aged , Cardiopulmonary Resuscitation , Out-of-Hospital Cardiac Arrest , Allergy and Immunology , Therapeutics , Th1 Cells , Th17 Cells , Th2 CellsABSTRACT
Objective To study and analyze the effect of quinolones combined with psychological intervention on the patients with urinary tract infection. Methods 100 patients with urinary tract infection in Jiande the first people's hospital from January 2015 to December 2016 were selected as the the study subjects. They were randomly divided into two groups, the control group and the experimental group, 50 cases in each group. The control group were given Ceftezole sodium and other cephalosporins drug treatment, patients in the experimental group were ciprofloxacin treatment, two patients underwent renal protection, treatment for 12 cycles. The therapeutic effects in the experimental group and the control group were compared and analyzed. Results In the experimental group, 47 cases was effective, the effective rate was 94.0％;In the control group, 37 cases was effective, and the effective rate was 74.0％. The effective rate in the experimental group was significantly higher than that in the control group(P<0.05). The adverse reaction rate in the experiment group was 2％(1/50), and 4％(2/50) in the control group, the difference was no statistically significant. Conclusion The combination of quinolones and psychological intervention on the treatment of the patients with urinary tract infection is effective, which can can significantly improve the efficiency of treatment of infection, high safety.
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<p><b>OBJECTIVE</b>Epinephrine is the primary drug administered during cardiopulmonary resuscitation (CPR) to reverse cardiac arrest. The evidence for the use of adrenaline in out-of-hospital cardiac arrest (OHCA) and in-hospital resuscitation is inconclusive. We conducted a systematic review on the clinical efficacy of adrenaline in adult OHCA patients to evaluate whether epinephrine provides any overall benefit for patients.</p><p><b>DATA SOURCES</b>The EMBASE and PubMed databases were searched with the key words "epinephrine," "cardiac arrest," and variations of these terms.</p><p><b>STUDY SELECTION</b>Data from clinical randomized trials, meta-analyses, guidelines, and recent reviews were selected for review.</p><p><b>RESULTS</b>Sudden cardiac arrest causes 544,000 deaths in China each year, with survival occurring in <1% of cases (compared with 12% in the United States). The American Heart Association recommends the use of epinephrine in patients with cardiac arrest, as part of advanced cardiac life support. There is a clear evidence of an association between epinephrine and increased return of spontaneous circulation (ROSC). However, there are conflicting results regarding long-term survival and functional recovery, particularly neurological outcome, after CPR. There is currently insufficient evidence to support or reject epinephrine administration during resuscitation. We believe that epinephrine may have a role in resuscitation, as administration of epinephrine during CPR increases the probability of restoring cardiac activity with pulses, which is an essential intermediate step toward long-term survival.</p><p><b>CONCLUSIONS</b>The administration of adrenaline was associated with improved short-term survival (ROSC). However, it appears that the use of adrenaline is associated with no benefit on survival to hospital discharge or survival with favorable neurological outcome after OHCA, and it may have a harmful effect. Larger placebo-controlled, double-blind, randomized control trials are required to definitively establish the effect of epinephrine.</p>
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Objective To compare the clinical efficacy and safety between transurethral plasma kinetic enucleation of prostate(TUPKEP) and transurethral resection of prostate(TURP) on benign prostatic hyperplasia(BPH). Methods One hundred and forty two BPH patients were divided into two groups:TUPKEP group (72 cases) and TURP group (70 cases). Seventy two cases aged 52-90 years[mean age (70. 5±7.6) years] with prostate weight of 27-126 g [mean weight (75. 6±10. 3)g] underwent TUPKEP, and seventy cases aged 51-87 years[mean age (70. 2±6. 8) years] with prostate weight of 25-118 g[mean weight (73.8±9.9)g] underwent TURP. There were no significant differences in age, weight of the prostate, international prostate symptom score(IPSS), residual urine volume(RUV) ,maximum urinary flow rate (Qmax) and quality of life (QOL) scores between the two groups before operation (t=0. 2873, 1.0612, 1. 0832,0. 9522,0. 0000, 1. 0774;P=0. 7743,0. 2904, 0. 2806,0. 3426,1. 0000,0. 2832). The operative time, intraoperative blood loss, the preserved time of installing catheter, hospitalization time, postoperative morbidity rate and efficacy were compared between the two groups. Results The operation success rates were 100. 0% (72/72) in TUPKEP group and 98.6% (69/70) in TURP group. The average operation time were (46.2±6.4)min and (58. 4±9. 6)min (t±8. 9404, P=0.0000), and the mean intraoperative blood loss were (105.9± 12.2)ml and (148.6±14.3) ml(t=19. 1608, P=0.0000) in TUPKEP and TURP groups respectively. The mean preserved time of installing catheter were (3. 5±1.0)d and (5.0±1.0)d(t= 8. 9364, P=0. 0000), and the average hospitalization time were (5.1±1.9) d and (7.0±2.6) d (t= 4. 9819,P=0.0000)in the two groups, respectively. In TUPKEP group, there was one case of temporary urinary incontinence, two cases of secondary prostate hemorrhage and one case of external orifice stricture of urethra, with a complication rate of 5.56%. In TURP group, there were two cases of transurethral resection syndrome (TURS), one case of urinary extravasation, two cases of temporary urinary incontinence, three cases of secondary prostate hemorrhage and two cases of external orifice stricture of urethra, with a complication rate of 14.29% . Compared with preoperation, Qmax was obviously increased and IPSS,RUV, QOL scores were decreased after follow- up for 3 months, but there were no significant differences in these parameters between the two conditions(t=1. 1131,0. 2543,1. 2959,0. 7252;P=0. 2676,0. 7996,0. 1971,0. 4696). Canclusions TUPKEP and TURP have similar efficacy in the treatment of BPH, but TUPKEP is a method with shorter operation time, less blood loss, lower postoperative complication rate and more safety than TURP.
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OBJECTIVE: To analyze the literatures on grand mal epilepsy caused by levocarnitine,explore the causes of seizures, the clinical features and treatment measures in order to provide guidance for rational use of drug. METHODS: Included studies retrieved from CNKI and VIP in china journal of medicine from 1999～2009.Based on a grand mal epilepsy case caused by levocarnitine for Injection in our hospital, cases of grand mal epilepsy caused by levocarnitine reported in literatures were analyzed comprehensively. RESULTS: The clinical information of grand mal epilepsy cases reported in our hospital and literatures were analyzed as well as past medical history, usage and dosage, onset time, treatment method and efficacy. All patients were in the process of irrigation of Levocarnitine showed the typical clinical manifestations of grand mal epilepsy, after active treatment were both mitigation. CONCLUSION: The adverse reaction that grand mal epilepsy is caused by levocarnitine is rare,and pathogenesis is not clear but clinicians should pay attention to it.