ABSTRACT
Objective@#To explore the characteristics of thrombelastogaphy (TEG) in term neonates, and to evaluate their correlation with traditional coagulation tests.@*Methods@#A total of 52 term neonates were enrolled as neonatal group and 34 adults undergoing elective surgery as adult control group in Jiangmen Central Hospital from January to December 2017.TEG, plasma coagulation test and platelet counts (PLT) were performed and the corresponding ana-lysis was conducted.@*Results@#TEG parameters in term neonates: response time(R)(4.18±1.08)min, clot kinetics(K)(1.21±0.45) min, α angle (Angle)(73.08±5.74)°, maximum amplitude(MA)(65.68±7.13)mm.Compared with adult control group, neonatal group exhibited shorter R and K(t=3.764, P<0.001; t=4.888, P<0.001), higher Angle, MA(t=5.539, P<0.001; t=2.873, P=0.001). In traditional coagulation, compared with adult control group, neonatal group showed longer prothrombin time(PT), activated partial thromboplastin time(APTT), thrombin time(TT) (t=5.449, P<0.001; t=13.134, P<0.001; t=3.575, P=0.001), lower fibrinogen(Fib) (t=4.164, P<0.001), and higher PLT (t=4.230, P<0.001). In addition, K was negatively correlated with Fib(r=-0.374, P=0.004), while Angle and MA were positively correlated with Fib(r=0.354, P=0.007; r=0.630, P<0.001); K was negatively correlated with PLT(r=-0.430, P=0.001), but Angle and MA were positively correlated with PLT (r=0.427, P=0.001; r=0.586, P<0.001); K was positively correlated with APTT(r=0.285, P=0.035), and MA was negatively correlated with APTT(r=-0.324, P=0.017). There was no significant correlation between R and traditional coagulation test.K, MA and Angle were not significantly correlated with PT (all P>0.05), and Angle and APTT were not significantly correlated (all P>0.05).@*Conclusions@#The reference interval of TEG in term neonates is different from adults.And the parameters of TEG in term neonates are partly related to the traditional coagulation tests.
ABSTRACT
Objective To explore the characteristics of thrombelastogaphy( TEG)in term neonates,and to evaluate their correlation with traditional coagulation tests. Methods A total of 52 term neonates were enrolled as neo-natal group and 34 adults undergoing elective surgery as adult control group in Jiangmen Central Hospital from January to December 2017. TEG,plasma coagulation test and platelet counts(PLT)were performed and the corresponding ana-lysis was conducted. Results TEG parameters in term neonates:response time(R)(4. 18 ± 1. 08)min,clot kinetics (K)(1. 21 ± 0. 45)min,α angle( Angle)(73. 08 ± 5. 74)°,maximum amplitude( MA)(65. 68 ± 7. 13)mm. Com-pared with adult control group,neonatal group exhibited shorter R and K(t=3. 764,P<0. 001;t=4. 888,P<0. 001), higher Angle,MA(t=5. 539,P<0. 001;t=2. 873,P=0. 001). In traditional coagulation,compared with adult control group,neonatal group showed longer prothrombin time( PT),activated partial thromboplastin time( APTT),thrombin time(TT)(t=5. 449,P<0. 001;t=13. 134,P<0. 001;t=3. 575,P=0. 001),lower fibrinogen( Fib)(t=4. 164, P<0. 001),and higher PLT(t=4. 230,P<0. 001). In addition,K was negatively correlated with Fib(r= -0. 374, P=0. 004),while Angle and MA were positively correlated with Fib(r=0. 354,P=0. 007;r=0. 630,P<0. 001);K was negatively correlated with PLT(r= -0. 430,P=0. 001),but Angle and MA were positively correlated with PLT (r=0. 427,P=0. 001;r=0. 586,P<0. 001);K was positively correlated with APTT(r=0. 285,P=0. 035),and MA was negatively correlated with APTT(r= -0. 324,P=0. 017). There was no significant correlation between R and tra-ditional coagulation test. K,MA and Angle were not significantly correlated with PT(all P >0. 05),and Angle and APTT were not significantly correlated(all P>0. 05). Conclusions The reference interval of TEG in term neonates is different from adults. And the parameters of TEG in term neonates are partly related to the traditional coagulation tests.
ABSTRACT
Objective To investigate the efficacy of volume target pressure control(VTPC)and synchronized intermittent mandatory ventilation(SIMV)in treating severe neonatal respiratory distress syndrome(NRDS). Methods Fifty - six admitted cases with severe NRDS hospitalized in Jiangmen Central Hospital from October 2012 to March 2015 were randomly divided into 2 groups:28 cases in VTPC group were treated by VTPC and SIMV,and 28 cases in pressure control ventilation(PCV)group were treated by PCV and SIMV. There was no significant difference between 2 groups in terms of gender,gestational age,and birth weight(all P ﹥ 0. 05). Artery blood gas analysis was performed at 6 hours,12 hours,24 hours,and 48 hours respectively after ventilation. The following parameters were observed:the time of invasive mechanical ventilation,duration of oxygen therapy,mortality and the incidence rates of hypocapnia,pneumo-thorax,ventilator associated pneumonia( VAP),grade Ⅲ - Ⅳ periventricular intraventricular hemorrhage( PVH -IVH),periventricular leukomalacia(PVL)and bronchopulmonary dysplasia(BPD). Results No case in 2 groups withdrew from the test. There was no significant difference between 2 groups in terms of the first treatment time and total doses of poractant alfa injection(all P ﹥ 0. 05). The time of invasive mechanical ventilation in VTPC group[(71. 75 ± 9. 82)h]was shorter than that in PVC group[(97. 89 ± 16. 88)h](t = 7. 083,P = 0. 000). Hypocapnia incidence of four blood gas analysis in VTPC group[(19. 64 ± 14. 20)% ]was lower than that in PCV group[(47. 32 ± 18. 43)% ] (t = 6. 294,P = 0. 000). Incidence rates of VAP and PVL in VTPC group were lower than those in PCV group(χ2 =5. 197,P = 0. 023;χ2 = 4. 766,P = 0. 029). However,duration of oxygen therapy,mortality and the incidence rates of pneumothorax,Ⅲ - Ⅳ PVH - IVH and BPD were not significantly different between 2 groups( all P ﹥ 0. 05). Conclusion VTPC + SIMV has a better efficacy than PCV + SIMV in the treatment of NRDS.
ABSTRACT
Objective To investigate the clinic value of procalcitonin( PCT)and c-reactive protein ( CRP)in differential diagnosis for febrile diseases. Methods One hundred and forty patients with febrile diseases in May 2009 to February 2014 in the No. 309th Hospital of People Liberation Army were investigated and analyzed retrospectively. Based on discharge diagnosis,patients were divided into bacterial infection group( n=58),non-bacterial infection group(n=47)and rheumatic diseases group(n=35),another 40 healthy people were served as the control group. Serum PCT and CRP were detected and compared in four groups. One month after backing to normal temperature in all the patients,detected serum PCT and CRP again. Results Serum PCT and CRP level in bacterial infection group,non-bacterial infection group,rheumatic diseases group and control group were(5. 18 ± 1. 92)and(0. 45 ± 0. 22),(0. 34 ± 0. 13)and(0. 16 ± 0. 05)μg/L,(25. 31 ± 4. 24), (1. 94 ± 0. 37 ),( 62. 32 ± 15. 10 ) and( 1. 30 ± 0. 04 ) mg/L respectively. Serum PCT and CRP level in bacterial infection group were significantly higher than that in control group(P﹤0. 01). Even though serum PCT and CRP level in non-bacterial group slightly higher than that of healthy control group,there was no statistical difference(P﹥0. 05). Serum PCT and CRP level in bacterial infection group were significantly higher than that of non-bacterial infection group( P ﹤0. 01 ). Serum CRP level in rheumatic diseases group was significantly higher than that of healthy control group( P﹤0. 01),while PCT level only slightly higher compared with healthy control group(P﹥0. 05). One month after backing to normal temperature in all the patients,serum PCT and CRP level in bacterial infection group reduced significantly compared with that of febrile period( P ﹤0. 01). Serum PCT and CRP level in non-bacterial infection group were no significant change( P﹥0. 05 ),and serum CRP level in rheumatic diseases group reduced significantly( P﹤0. 01 ),while serum PCT were no significant change(P﹥0. 05). Conclusion Serum PCT combined with CRP might be of great importance in the differential diagnosis for febrile diseases.
ABSTRACT
Objective To explore the preventive effect of Fluconazole on invasive fungous infections in premature infants.Methods Two hundred and thirty-four cases of preterm infants hospitalized in Jiangmen Central Hospital from Feb.2008 to Oct.2013 were analyzed by retrospective study.The subjects were divided into 3 groups based on whether Fluconazole was used and it was used orally or intravenously for the prevention of invasive fungous infections in premature infants.The Fluconazole prophylaxis was not given to group A,whereas oral Fluconazole prophylaxis [6 mg/(kg · times),every other day] and intravenous Fluconazole prophylaxis [3 mg/ (kg · times),once every 3 days] were applied in group B and group C.The incidence of invasive fungous infections and the clinical effects of Fluconazole on the 3 groups were evaluated and compared.Results The number of cases analyzed in the study were 53,115 and 66 cases in group A,group B and group C,respectively.There were no significant differences between the 3 groups in terms of gender,gestational age,birth weights,length of hospitalization,intravenous nutrition,and number of peripherally inserted central catheter,antibiotics and invasive mechanical ventilation use days (all P ＞ 0.05).The incidences of invasive fungal infections were 11.32％ (6/53 cases),6.96％ (8/115 cases) and 0 in group A,group B and group C,respectively.The prophylaxis effects between the 3 groups were significantly different (x2 =7.078,P =0.029).Group A and group B were not significantly different (x2 =0.905,P =0.342),but group C was better than group A and group B,and the differences were significant (P =0.007,0.028).Conclusions Prevention of invasive fungous infections by intravenous Fluconazole has good curative effects,and which can be used as the first choice.
ABSTRACT
Objective To investigate the change of HR,RR and arterial blood gas in the treatment of BiPAP ventilation in patients with acute pulmonary.Methods Fifty eight patients with acute pulmonary edema were randomized into two groups.The control group(n =29)were given conventional general treatment only,but treatment group(n =29)were given BiPAP ventilation besides conventional treatment.4 h later,heart rate (HR),respiratory rate(RR),SaO2,pH,PaO2 and PaCO2 were compared between the two groups.Hospitalization duration and incidence of invasive mechanical ventilation were recorded after discharge.Results Compared with pre-treatment,HR,RR,SaO2 and PaO2 in treatment group were improved significantly(HR 124 ± 12 beat/min vs 83 ±6 beat/min,t =5.372,P ＜0.01)(RR 37 ±5 beat/min vs 19 ± 8 beat/min,t =4.285,P ＜0.01)(SaO2 81.4％ ±5.4％ vs94.1％ ±4.2％,t=2.731,P＜0.05)(PaO2 53.2±5.4 mm Hg vs 89.1 ±8.5 mm Hg,t=5.763,P ＜0.O1).And these four indicators were also improved in control group after treatment,(HR 123 ± 10 beat/min vs 95 ± 8 beat/min,t =t =3.459,P ＜ 0.01)(RR 36 ± 7 beat/min vs 24 ± 6 beat/min,t =3.127,P ＜0.01)(SaO2 81.8％ ±5.7％ vs 88.3 ±4.5％％,t =2.314,P ＜0.05)(PaO2 53.5 ±4.6 mm Hg vs 72.8 ±9.5 mm Hg,t =3.756,P ＜0.01).HR,RR,SaO2 and PaO2 in treatment group were more significantly improved than that of control group(P ＜ 0.01 or P ＜ 0.05).Hospitalization duration in treatment group was significantly shorter than that of control group(9 d vs 15 d,t =3.763,P ＜ 0.01).The incidence of invasive ventilation were lower than that of control group too(but P ＞ 0.05.Conclusion These results suggested that BiPAP ventilation can regulate HR RR and blood gas value to accetable levels,shorten hoptipitalization duration and reduce the incidence of invasive ventilation.It is proved to be an effective therapeutic technique in the treatment of acute pulmonary edema patients.
ABSTRACT
Objective To explore the effects of low-dose mifepristone on human granulosa cells and the molecular mechanism of its inhibiting or delaying ovulation.Methods Phase contrast microscopy and electron microscopy were conducted to observe the morphological and biochemical change of granulosa cells exposed to various doses of mifepristone for 24 hours(the final concentrations of mifepristone were respectively 2.5?mol/L,5?mol/L and 10?mol/L,Non-mifepristone as the control group).Immunocytochemistry was performed to detect the protein expressions of Bcl-2 and Bax in granulosa cells exposed to various doses of mifepristone for 24 hours.The mRNA levels of Bcl-2 and Bax in granulosa cells were detected by RT-PCR.Results Granulosa cells treated with various doses of mifepristone presented typical morphological characteristics of apoptosis such as condensation of chromatin and cytosolic,and shrink of cells.The expression of Bcl-2 protein might be down-regulated,while the expression of Bax might be up-regulated by mifepristone.The histological score(HSCORE) of Bcl-2 protein in granulosa cells,which were incubated with various doses of mifepristone(2.5?mol/L,5?mol/L,10?mol/L) for 24 hours,were respectively 2.15?0.16,1.88?0.13 and 1.64?0.16 respectively,Compared with the HSCORE of the control group(2.51?0.16),the difference was significant(P0.05).Conclusion Mifepristone could induce human granulosa cells apoptosis.The Bcl-2 protein and Bax protein may be involved in the apoptosis of granulosa cells induced by mifepristone.