Dynamic changes and influencing factors of leukocyte and platelet count in preterm infants / 中华围产医学杂志

Objective To investigate the dynamic changes and influencing factors of peripheral blood white blood cells (WBC), differential counts (DCs) and platelet (PLT) count in preterm infants to understand the changing characteristics of these blood parameters in preterm infants of different postnatal age, gestational age, and birth weight.Methods Totally 2 849 preterm infants admitted to the Department of Neonatology of Northwest Women's and Children's Hospital from November 30, 2011 to November 30, 2014 were retrospectively analyzed except for those diagnosed with infectious diseases, hematological system diseases, or immunologic diseases.All of the subjects were divided into seven groups based on their postnatal age, three groups based on gestational age and three groups based on birth weight, or male and female groups, respectively.Peripheral blood samples were obtained for determination of WBC, DCs and PLT.Statistical analysis was performed with oneway analysis of variance, t-test and Spearman linear correlation analysis.Results WBC, neutrophil (Ne), lymphocyte (Ly), monocyte (Mo), eosinophil (Eo), basophil (Ba) and PLT counts were significantly different among the seven groups of preterm babies of different postnatal age (F=172.00, 364.90, 34.88, 14.22, 80.82, 168.10 and 86.64, respectively, all P ＜ 0.01).WBC was found to be at the peak value within one day after birth [(18.40±6.87)× 109/L], followed by remarkable decrease in day ＞ 2-≤ 5 [(10.62±4.68)× 109/L], further gradual decrease thereafter, and then being stable in day ＞ 14-≤ 21 and ＞ 21 ≤≤ 30 [(10.54±3.09)× 109/L and (10.27 ± 3.70) × 109/L, respectively].PLT counts showed no significant change within one day after birth and in day ＞ 1-≤ 2 [(240.56± 63.54)× 109/L and (240.85 ± 71.47) × 109/L, respectively], then began to increase in day ＞ 2-≤ 5 [(249.21 ±80.55)× 109/L], peaked in day ＞ 7-≤ 14 [(339.11 ± 121.84)× 109/L], and decreased gently and became stable finally.The changing trends of Ne and Ly were cross and inverted in day ＞ 5-≤ 7.WBC, Ne, Ly, Mo, Eo, Ba and PLT counts of the preterm infants were all correlated with the postnatal age shown by Spearman linear correlation analysis (r=-0.46,-0.60, 0.18,-0.07, 0.33,-0.47 and 0.29, respectively, all P ＜ 0.01).With the increase of gestational age, WBC, Ne, Mo, and PLT counts increased, but Ly and Eo counts decreased.And all of the above showed significant difference (F=81.00, 124.49, 13.34, 18.35, 5.35 and 4.11, respectively, all P ＜ 0.05).While, the WBC, Ne, Mo, Ba and PLT counts showed positive relationship with the increase of birth weight (F=122.12, 133.09, 39.38, 13.77 and 21.24, respectively, all P ＜ 0.05).WBC, Ne and PLT counts of female infants were higher than those of male babies (t=l 6.35, 16.72 and 13.19, respectively, all P ＜ 0.05).Conclusions The peripheral WBC, DCs and PLT counts of preterm infants change dynamically with postnatal age with the remarkable variations on day ＞2-≤ 5 after birth and stable after 14 days of age.WBC, DCs and PLT counts might all be influenced by gestational age, birth weight and gender to some cxtend.

Expression of PCNA, BCL-2, CD4+, CD8+ in the adenoid tissues from children with secretory otitis media / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the relationship between immune status of adenoids and secretory otitis media (SOM).@*METHOD@#The adenoid tissue samples of 72 cases with SOM and 30 cases with adenoid hypertrophy without SOM were studied by immunohistochemical method.@*RESULT@#The PCNA, BCL-2, CD4+, CD8+ and CD4+ / CD8+ in SOM tissue samples were 30.85 +/- 1.73, 21.27 +/- 1.25, 41.90 +/- 9.07, 20.45 +/- 7.08 and 2.10 +/- 0.17, respectively, which were much more than that of tissue samples without SOM (25.25 +/- 1.75, 14.05 +/- 1.02, 16.30 +/- 8.21, 11.15 +/- 5.71, 1.39 +/- 0.15 respectively) (P < 0.01). The expression of CD4+ in T-lymphocyte was obviously higher than that of CD8+.@*CONCLUSION@#In adenoid tissues of SOM patients, the activity of T-lymphocyte subsets are increased,the adenoids are enlarged and local immunity are enhanced. Therefore,adenoidectomy should be applied in SOM patients as early as possible.

Preliminary practice of the resident physicians in specialized hospital participating in the stan-dardized clinical resident training in general hospital / 中华医学教育探索杂志

The significance for specialized hospital's resident physicians participating in the standardized clinical resident training in general hospital is expounded and its existing prob-lems are pointed out.It is suggested that the administration division should give full play to subjective initiative,coordinate problem solving and improve training quality,and meanwhile speciality hospitals should make an active effort in the application for national subspeciality physician training base.

Dilemma and strategy of clinical teaching of infectious disease in non-affiliated hospitals of university / 中华医学教育探索杂志

With more and more non-affiliated hospitals of universities joining the clinical teaching of infectious diseases,there have been some dilemmas on clinical teaching,such as the shortage of staff,teaching experience,poor lecture art and teaching enthusiasm,textbook lag,the shortage of case teaching abd students'fear of infectious disease etc. Countermeasures such as perfecting the organizational structure,formulating preferential policy,clearing historical mission,increasing students' interest in learning,adding new academic progress,enriching teaching methods,setting up experts'supervision will ensure the effective teaching quality.

The Effect of Injecting?-acceptor Inhibitor on the Miocardial Infarction Prognosis / 医学研究杂志

Objective To investigate the effect of injecting?-acceptor inhibitor on the acute extensive miocardial infarction prognosis. Methods 53 cases patients with acute extensive miocardial infarction were injected Betaloc 5mg, after 3 times, taken Betaloc orally. Betaloc was not applied in another 49 cases patients with acute extensive miocardial infarction.The curative effect was compared between the two groups. Results The efficient or inefficient ratio of the group with Betaloc or the group without Betaloc was 48/53, 5/53 or 36/49, 13/49 respectively. The difference was significant by ?~2 test .Conclusions The patient with acute extensive miocardial infarction can get the extra good by means of early application of ?-acceptor inhibitor except the patient with no-no of the application of Betaloc.