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Objective:To study the clinical characteristics of neonatal leukemoid reaction (NLR).Methods:The newborns with NLR admitted to the neonatal intensive care unit of the Seventh Medical Center of PLA General Hospital from September 2010 to January 2022 were selected as the observation group, and the newborns without NLR, who were admitted to the Hospital at the same time and matched with gestational age and birth weight of the NLR newborns were selected as the control group at a ratio of 1∶2. The gestational age, birth weight, maternal complications, maximum leukocyte count, percentage of neutrophils, C-reactive protein, hemoglobin, platelet count, disease diagnosis and other relevant information of the newborns were recorded, and SPSS 21.0 statistical software was applied to compare the data of the two groups of newborns.Results:A total of 36 cases were in the observation group and 72 cases in the control group. Naive granulocytes were found in the peripheral blood of all patients in the observation group, and leukocyte count was higher than that of the control group [61.7 (54.2, 90.6)×10 9/L vs. 19.6 (14.2,27.3)×10 9/L], the difference was statistically significant ( P<0.001), but there was no statistically significant difference in the percentage of neutrophils, hemoglobin, platelets, and C-reactive protein between the two groups ( P>0.05). The proportion of vaginal delivery, meconium-stained amniotic fluid, and neonatal sepsis in the observation group were higher than that in the control group [69.4% (25/36) vs. 38.9% (28/72), 19.4% (7/36) vs. 5.6% (4/72), 47.2% (17/36) vs. 8.3% (6/72)], and the proportion of gestational diabetes mellitus, gestational hypertension and prenatal use of glucocorticoid was lower than that in the control group, with statistical significance ( P<0.05). There was no significant difference in the incidence of premature rupture of membranes, neonatal asphyxia, intracranial hemorrhage, pulmonary hemorrhage, bacterial meningitis, and bronchopulmonary dysplasia between the two groups ( P>0.05). Conclusions:Newborns with NLR are frequently complicated with sepsis. Early prevention and treatment of maternal comorbidities and active control of infection are important for the prevention and treatment of NLR.
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Objective:To investigate the hemodynamic characteristics and dynamic cerebral autoregulation(dCA) of patients with severe carotid stenosis before carotid endarterectomy(CEA), and to analyze their correlations with hyperperfusion after CEA.Methods:A total of 63 patients with unilateral severe carotid artery atherosclerotic stenosis who underwent CEA were consecutively recruited prospectively in Xuanwu Hospital, Capital Medical University from January 2021 to August 2021. According to postoperative hyperperfusion, patients were divided into hyperperfusion group (13 cases) and non-hyperperfusion group (50 cases). The general clinical data and hemodynamic parameters were compared between the two groups. The dCA was evaluated by the transfer function analysis that measured the fluctuation amplitude of mean cerebral blood flow velocity(CBFV) with blood pressure change, the time difference of phase with blood pressure change, and the correlation between mean CBFV and blood pressure change. The value of dCA for predicting postoperative hyperperfusion was analyzed through the ROC curve and the area under the curve(AUC).Results:①The proportion of hypertension in hyperperfusion group was higher than that in non-hyperperfusion group ( P<0.05). ②The peak systolic velocity (PSV) at the stenosis lesion of the internal carotid artery, the end-diastolic velocity (EDV) at the stenosis lesion of the internal carotid artery and the ratio of PSV at the stenosis lesion of the internal carotid artery to the distal internal carotid artery in the hyperperfusion group were higher than the non-hyperperfusion group.And the PSV of the ipsilateral middle cerebral artery in the hyperperfusion group was lower than the non-hyperperfusion group (all P<0.05). ③In the very low-frequency and low-frequency region, the phase in the hyperperfusion group was lower than that in the non-hyperperfusion group (all P<0.05), while there was no significant difference in the high-frequency regions( P>0.05). In the three regions of very low-frequency, low-frequency and high-frequency, there were no significant differences in the gain and coherence between the two groups(all P>0.05). ④The best cutoff value of phase in the very low-frequency was 33.28 for predicting hyperperfusion after CEA (AUC=0.766, 95% CI=0.629-0.904, P=0.03), with the specificity of 0.700, and sensitivity of 0.846. Conclusions:There are differences in hemodynamics and dCA between the hyperperfusion group and the non-hyperperfusion group after CEA. The impaired preoperative dynamic cerebral autoregulation is an independent predictor of postoperative hyperperfusion.
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Objective:To investigate the attitude of neonatologists toward the treatment of extremely preterm infants (EPIs) in China.Methods:A cross-sectional survey was conducted using a questionnaire designed and posted on Wenjuanxing, a web-based survey platform, from June to July 2021. The respondents were neonatal physicians in various provinces and cities in China. The questionnaire covered the basic information, treatment experience and attitude towards EPIs, and opinions on the current definition of the preterm infant in China. The results were described or analyzed using the Chi-square test.Results:A total of 1 066 valid replies were collected. The respondents included 322 males and 744 females, among whom 78.1% (832/1 066) were assistant director physicians or director physicians, 82.8% (882/1 066) were from tertiary hospitals, and 83.0% (885/1 066) had the experiences of treating EPIs. In terms of the attitude toward the treatment of EPIs, 63.0% (672/1 066) of the respondents suggested that the lower limit of gestational age for EPIs requiring active resuscitation should be defined at 25 gestational weeks or less. Moreover, 57.1% (609/1 066) considered that the current domestic definition of preterm infants as 28 gestational age or above was inappropriate, and 75.2% (458/609) considered that the lower limit defined as preterm infants should be 25 gestational weeks or less. Concerning the treatment experience in EPIs, 54.3% (579/1 066) of the respondents suggested that in their hospital, withdrawing treatment in EPIs was common or very common, and 83.3% (888/1 066) considered that the main reason for withdrawing treatment was family members' concerns about the prognosis. Those who hesitated about treating the EPIs accounted for 71.6% (763/1 066), and 83.9% (640/763) hesitated due to the poor prognosis and possible medical disputes. Moreover, 32.7% (349/1 066) of the respondents or their colleagues had been involved in medical disputes about whether to treat EPIs, and 74.8% (797/1 066) believed that the patients should be the decision-maker on whether to treat EPIs or not.Conclusion:Most neonatal physicians in this survey hold a positive attitude toward the treatment of EPIs and believe that the lower limit of gestational age for preterm infants should be lowered. However, a hesitating attitude to the care of EPIs is still common, and uncertainty about the prognosis of EPIs remains a concern.
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Extremely premature infants with <28 weeks of gestational age are at higher risk of various complications after birth and have higher mortality and disability rate due to the extremely immature organs. In recent years, with the rapid development of the perinatal medical system and related therapeutic technology, extremely preterm infants' short- and long-term prognosis has been significantly improved. Since the new century, with the rapid social and economic development, the number of treated extremely premature infants and its survival rate in China has also significantly increased. However, compared with the developed countries, the gap still exists. Here we outline the current situation of the management of extremely premature infants in China and abroad and the challenges we faced.
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Objective:To understand the profile type of serum Epstein-Barr virus (EBV) antibodies in children with infectious mononucleosis (IM), and to analyze the significance of viral capsid antigen (VCA) IgG antibody affinity in the diagnosis of IM.Methods:Retrospective analysis was performed on the results of the serum anti-EBV antibody profile and plasma EBV nucleic acid test of 150 hospitalized children with IM diagnosed in Beijing Children′s Hospital, Capital Medical University, from May 2016 to May 2019.Anti-EBV antibody profiles, including anti-VCA-IgG, anti-VCA-IgM, anti-early antigen (EA) IgA, anti-EBV nuclear antigen (EBNA) IgG, and anti-VCA-IgG affinity, were detected by enzyme-linked immunosorbent assay (ELISA). Plasma EBV nucleic acids were detected by real-time quantitative PCR.Results:There were mainly two types of anti-EBV antibody profiles in 150 children with IM: (1)130 cases who were positive for anti-VCA-IgM/IgG, negative for anti-EBNA-IgG and positive for anti-VCA-IgG antibodies with low affinity, accounting for 86.7% (130/150 cases), of which 50 cases were positive for anti-early antigen IgA; (2)18 cases who were negative for anti-VCA-IgM, positive for anti-VCA-IgG, negative for anti-EBNA-IgG and positive for anti-VCA-IgG antibody with low affinity, accounting for 12.0% (18/150 cases), of which 5 cases were positive for anti-EA IgA.EBV DNA was measured in 132 children, with a posi-tive rate of 37.9% (50/132 cases).Conclusions:There were several types of serum EBV antibody profiles in children with IM, 12.0% of patients with IM in this study were negative for anti-VCA-IgM, and the diagnosis of IM was confirmed by the affinity of anti-VCA IgG.
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Objective:To analyze the clinical and gene mutation characteristics of congenital disorder of glycosylation (CDG) caused by compound heterozygous mutation of the COG6 gene ( COG6-CDG). Methods:This study retrospectively analyzed the clinical data and genetic test results of a patient with COG6-CDG in Bayi Children's Hospital, the Seventh Affiliated Medical Center of Chinese PLA General Hospital, in August 2019. Literature was retrieved with keywords including COG6, COG6-CDG, congenital disorders of glycosylation typeⅡL and congenital disorders of glycosylationⅡL in China National Knowledge Infrastructure, Wanfang Database, VIP Database, PubMed, and Web of Science Database from the establishment to July 2020, to summarize the clinical and genetic characteristics of COG6-CDG. Results:(1) Case report: The 59-day-old baby boy, with a gestational age of 27 +5 weeks and birth weight of 1 180 g, presented with multi-system involvement on admission, including unidentified progressive hepatosplenomegaly with jaundice and ascites, persistent thrombocytopenia, microcephaly, hypotonia, hypohidrosis, hyperkeratosis, and recurrent hyperthermia, infection, and hypoglycemia, as well as dysfunctions of the heart, gastrointestinal tract, lungs, kidneys, ocular fundus, and the coagulation system. Despite given ventilator-assisted ventilation, anti-infection therapy, abdominal puncture and drainage, and blood transfusion, the patient still had an aggravated condition and eventually died of multiple organ failures 192 d after birth. Genetic analysis showed that the nuclear family carried compound heterozygous mutations in the COG6 gene (NM_020751.2), including missense mutations of c.662C>T(p.T221M) in exon 7 and c.443T>C(p.I148T) in exon 5, which were both novel mutations and originated from the mother and father, respectively. (2) Literature review: Eight related papers were retrieved, including 20 cases. The main manifestations were various degrees of nervous system abnormalities and growth retardation, complicated by abnormalities of the liver, heart, gastrointestinal tract, blood, immunity, teeth, and bones. All the reported cases suffered from mental and growth retardation, and nine deaths were reported. A total of 11 COG6 gene mutations were identified, and most of them were c.1167-24A>G splicing mutations in a deep intron (seven cases), followed by c.1646G>T (four cases) and c.511C>T (three cases). Conclusions:COG6-CDG commonly manifests as multi-system and multi-organ dysfunctions with poor prognosis. Gene detection is conducive to the accurate diagnosis of COG6-CDG. Our case carries compound heterozygous mutations of c.662C>T(p.T221M) and c.443T>C(p.I148T), which are unreported novel mutations.
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Acute lung injury(ALI)/acute respiratory distress syndrome(ARDS)is one of the most common clinical critical illnesses in ICU.The basic pathological features of this disease are uncontrolled inflammation, destruction of the alveolar-capillary barrier and diffuse alveolar and interstitial edema.In severe cases, patients may develop significant pulmonary fibrosis.Based on the pathological changes, repairing damaged alveolar-capillary membrane and reducing fibrosis seem to be the key to the treatments of ALI/ARDS.Vascular endothelial growth factor(VEGF) is known to be the main regulator of endothelial cell proliferation and differentiation.Previous studies have suggested that VEGF plays an important role in the inflammatory reactions and pathological manifestations of ALI/ARDS, but the results are complex.This review mainly focused on the expression changes of VEGF in ALI/ ARDS and the effects and mechanisms of regulating VEGF signaling.
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Objective:To discuss the correlation between the immune instability of Th17/Treg and the pathogenesis of the Henoch-Schonlein purpura(HSP)with Mpcoplasma pneumoniae(MP)infection.Methods:From June 2018 to December 2019, children who had been diagnosed as HSP in the Department of Pediatrics at Qinhuangdao First Hospital and Qinhuangdao Maternal and Child Health Care Hospital, as well as in-patients with MP infection and outpatients, who had health check-up were collected.The subjects were divided into HSP group(41 cases), MP group(25 cases), HSP-MP group(19 cases) and control group(20 cases) according to the diagnosis of HSP and MP infection.The percentage of Th17 and Treg cells in peripheral venous blood of four groups were determined by flow cytometry, and the levels of interleukin(IL)-17, IL-6 and transforming growth factor-β(TGF-β)in peripheral venous serum of four groups were detected by ELISA.Results:There were no statistically significant differences regarding age and gender distribution among four groups( P>0.05). The percentages of Th17 cells, IL-17 and IL-6 levels in peripheral blood of the HSP-MP group was significantly higher than those in the other three groups( P<0.05), which in HSP group and MP group were higher than that in control group( P<0.05). There was no statistical difference between HSP group and MP group( P>0.05). The percentage of Treg cells in peripheral blood was significantly lower in HSP-MP group than those in the other three groups( P<0.05), which in the HSP group and MP group were lower than those in control group( P<0.05). There was no statistical difference between HSP group and MP group( P>0.05). There were no statistically significant differences of TGF-β among the four groups( P>0.05). Conclusion:High levels of IL-17 and IL-6 may be an important factor causing severe Th17/Treg immune disorders in children with HSP combined with MP infection, which may play an important role in the pathogenesis of HSP combined with MP infection.
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Peritoneal dialysis is the most common form of renal replacement therapy in neonates.Due to its technical simplicity and compliance with neonatal physiological characteristics, peritoneal dialysis, especially acute peritoneal dialysis(APD), has been paid increasing attention in clinical practice in recent years.APD in neonates can be effective in treating critical diseases such as renal failure and metabolic disturbances.Despite the increasingly extensive application of APD, existing clinical practice shows a relatively high rate of complications and mortality in APD neonates.In this article, the application, prognosis and related factors of APD in neonates were reviewed.
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Extremely premature infants(EPI), especially those under 25 weeks of gestational age, are difficult to manage clinically and have high mortality and disability rates.It is difficult to solve the bottleneck problem fundamentally in the treatment of EPI.Artificial placenta is a fascinating alternative therapy for neonatal lung failure and is expected to maintain the normal development of EPI after delivery.This article briefly introduces the research history, current situation, difficulties to be overcome and future prospects of artificial placenta.
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Objective@#To analyze the effects of the degree and location of intracranial vertebral artery(VA) lesions on the hemodynamic parameters of extracranial VA.@*Methods@#A total of 275 consecutive patients who were diagnosed as posterior circulation ischemic stroke or transient ischemic attack (TIA) with unilateral intracranial VA stenosis or occlusion in the Department of Neurology and Neurosurgery of Capital Medical University Xuanwu Hospital from January 2015 to December 2017 were enrolled. All patients were examined by head and neck vascular ultrasound, CT angiography (CTA) and/or digital subtraction angiography (DSA) within one week. According to the results of DSA or CTA, the patients were divided into mild stenosis group(53 patients), moderate stenosis group(62 patients), severe stenosis group(58 patients) and occlusion group(102 patients). The inner diameter (D), peak systolic velocity (PSV), end diastolic velocity (EDV), and resistance index (RI) of the extracranial segment (V2 segment) of the VA were recorded and analyzed.@*Results@#The PSV and EDV in the severe stenosis group and the occlusion group were significantly lower than those in the mild stenosis group and the moderate stenosis group (P=0.000), and the PSV and EDV in the occlusion group were significantly lower than those in the severe stenosis group[ (31±10) cm/s vs (46±12)cm/s, (5±4)cm/s vs (15±7)cm/s; all P=0.000], RI was significantly higher than the other three groups (0.85±0.12, 0.70±0.10, 0.66±0.07, 0.64±0.06, respectively; all P=0.000); RI in the severe stenosis group were not significantly different from those in the mild to moderate stenosis groups (P=0.044, 0.223). There were no significant differences in the inner diameter, PSV, EDV and RI between the subgroups in the severe stenosis group before or after the PICA (posterior inferior cerebellar artery)(P=0.130, 0.322, 0.865, 0.227). However, the EDV decreased and RI increased in the occlusive subgroup before the PICA when compared the subgroup after the PICA (all P=0.000).@*Conclusions@#The location and degree of intracranial VA lesions directly affect the changes of blood flow velocity and vascular resistance of extracranial VA, and the changes of low-speed and high-resistance hemodynamics of extracranial VA may indicate the existence of occlusive lesions in intracranial VA.
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Objective@#To study the threshold values of lactic acid (Lac)and buffuer excess (BE) when neonatal umbilical arterial blood gas is at pH <7.20.@*Methods@#A total of 2 518 pregnant women admitted in Beijing New Century Women and Children′s Hospital from January 2017 to February 2019 were enrolled.The general conditions in perinatal period and labor methods were counted.Umbilical cord arterial blood was immediately collected before the first cry of newborn and was detected on the Abbott I-STAT automatic blood gas analyzer from the United States, and then the umbilical arterial blood gas was measured.We analyzed the perinatal factors affecting umbilical arterial blood gas.We studied the threshold values of Lac and BE for neonal asphyxia by receiver operating characteristic curve.@*Results@#(1)Maternal anemia, Streptococcus agalactiae infection, precipitate labour, placenta abnormalities had no significant impact on neonatal umbilical artery blood gas.The Lac value in blood gas was higher in the group of premature rupture of fetal membranes and fetal intrauterine distress.The value of BE was lower in the group with premature rupture of fetal membranes and fetal distress (P<0.05). The Lac value in cesarean section group was the lowest[(1.79±1.25) mmol/L], while that in midwifery group was the highest[(4.45±1.58) mmol/L]. pH value was the lowest (7.25±0.07) in the midwifery group and the highest (7.31±0.06) in the cesarean section group.The value of BE was the lowest in the midwifery group[-(5.66±2.52) mmol/L], and the highest in the cesarean section group[-(2.99±2.28) mmol/L], with statistically significant differences among the three groups (P<0.05). (2) Multiple linear regression analysis showed that fetal delivery mode, fetal intrauterine distress, premature rupture of membranes, and gestational diabetes were the factors affecting Lac level in umbilical artery blood gas of newborns.Methods of delivery, intrauterine distress, premature rupture of membranes and placental abnormalities were the factors that affected the BE value of umbilical artery blood gas in newborns.(3) A total of 199 cases with pH value <7.2 were diagnosed as asphyxia, and the receiver operating characteristic curve of Lac and BE values of neonatal umbilical artery blood gas for the diagnosis of asphyxia was drawn.When Lac was >3.97 mmol/L, the sensitivity and specificity of the diagnosis of asphyxia were 0.864 and 0.791, respectively.When BE was ≤-6 mmol/L, the diagnostic sensitivity and specificity of asphyxia were 0.613 and 0.756, respectively.@*Conclusion@#Neonatal umbilical arterial blood gas is affected by many factors.The effect of accouche on umbilical arterial blood gas is large.When there is asphyxia with pH <7.2, the cut points of Lac and BE are >3.97 mmol/L and ≤-6 mmol/L, respectively.
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Based on the data obtained from the questionnaire survey and personal in-depth interviews, this study preliminarily formulated the "selection guidelines for the doctoral application review system of Capital Medical University" (draft). In addition, through Delphi method and chi-square test, the author formulated the "selection guidelines for the doctoral application review system of Capital Medical University". The guide contained four primary indicators of scientific literacy, academic ability, scientific research ability and personality quality and 27 secondary indicators. The respondents generally believed that quality, ability and moral character were the core contents of the doctoral selection guide. The doctoral advisors attached great importance to the personality quality of the applicants while having high requirements on the quality and ability. Meanwhile, the doctoral advisors also had high requirements on the scientific research ability of doctoral students in professional degrees.
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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.
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Objective To analyze the effects of the degree and location of intracranial vertebral artery (VA) lesions on the hemodynamic parameters of extracranial VA.Methods A total of 275 consecutive patients who were diagnosed as posterior circulation ischemic stroke or transient ischemic attack (TIA) with unilateral intracranial VA stenosis or occlusion in the Department of Neurology and Neurosurgery of Capital Medical University Xuanwu Hospital from January 2015 to December 2017 were enrolled.All patients were examined by head and neck vascular ultrasound,CT angiography (CTA) and/or digital subtraction angiography (DSA) within one week.According to the results of DSA or CTA,the patients were divided into mild stenosis group (53 patients),moderate stenosis group (62 patients),severe stenosis group (58patients) and occlusion group(102 patients).The inner diameter (D),peak systolic velocity (PSV),end diastolic velocity (EDV),and resistance index (RI) of the extracranial segment (V2 segment) of the VA were recorded and analyzed.Results The PSV and EDV in the severe stenosis group and the occlusion group were significantly lower than those in the mild stenosis group and the moderate stenosis group (P =0.000),and the PSV and EDV in the occlusion group were significantly lower than those in the severe stenosis group[(31 ± 10) cm/s vs (46 ± 12)cm/s,(5 ± 4)cm/s vs (15 ± 7)cm/s;all P =0.000],RI was significantly higher than the other three groups (0.85 ± 0.12,0.70 ± 0.10,0.66 ± 0.07,0.64 ± 0.06,respectively;all P =0.000);RI in the severe stenosis group were not significantly different from those in the mild to moderate stenosis groups (P =0.044,0.223).There were no significant differences in the inner diameter,PSV,EDV and RI between the subgroups in the severe stenosis group before or after the PICA (posterior inferior cerebellar artery) (P =0.130,0.322,0.865,0.227).However,the EDV decreased and RI increased in the occlusive subgroup before the PICA when compared the subgroup after the PICA (all P =0.000).Conclusions The location and degree of intracranial VA lesions directly affect the changes of blood flow velocity and vascular resistance of extracranial VA,and the changes of low-speed and high-resistance hemodynamics of extracranial VA may indicate the existence of occlusive lesions in intracranial VA.
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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.
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Child , Child, Preschool , Humans , Infant , Infant, Newborn , Disease , Dysbiosis , Therapeutics , Gastrointestinal MicrobiomeABSTRACT
Objective Taking the Digestive Medical Coordinated Development Center of Beijing Municipal Administration of Hospitals (hereinafter referred to as the "Digestive Medical Coordinated Development Center") as an example ,this paper aims to ex-plore the idea of building a collaborative development system of medical disciplines dominated by advantageous disciplines .Methods Summarizing the construction experience of the Digestive Medical Coordinated Development Center to illustrate the significance ,identify existed challenges and construction pathways of the center .Results The Digestive Medical Coordinated Development Center has built a series of public service platforms for its member institutions ,and improved the system and incentive mechanism to gather the develop-ment synergy of the center .Conclusions Based on the advantages of the collectivized management of Beijing Municipal Administration of Hospital ,the Digestive Medical Coordinated Development Center advances synchronously in the dimensions of scientific research , medical treatment ,information construction and talent ,as well as formed its own development characteristics and accumulated valuable experience for the construction of discipline collaboration center of municipal hospitals .
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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.
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Objective To analyze and compare the intracranial and extracranial color doppler and hemodynamic parameters of severe intracranial vertebral artery stenosis (SIVAS) with different Mori classifications. Methods From January 2017 to June 2018,a total of 122 consecutive in-patients of symptomatic unilateral SI VAS were enrolled retrospectively in Xuanwu Hospital, Capital Medical University. Tliey were divided into Mori A,B,and C groups according to the criteria of Mori classifications by CT Angiography or DSA images. Characteristics of color doppler flow imaging (C D F I) in vertebral stenosis segment and blood flow parameters of spectrum doppler, including peak systolic velocity (PSV), end-diastolic velocity (E D V),mean flow velocity (M F V),resistance index (R I) and pulsatility index (PI) in both the stenosis segment and the proximal stenosis segment were detected and compared. Results Among 122 cases (122 branches),46 cases (46 branches) were Mori A type,55 cases (55 branches) were Mori B type and 21(21 branches) were Mori C type. There were no significant differences among different Mori types in ages,gender,lesion side,cerebrovascular disease risk factors such as hypertension,diabetes,hyperlipidemia and smoking and the incidence rate of posterior circulation infarction (all P > 0. 05). The average lesion length of Mori C group (16.0 ± 6.3 mm) was significant longer than that of Mori B group (7.0 ± 1.6 mm) and Mori A group (3.4 ± 0.8mm). The differences were statistically significant (F= 145. 297, P 0. 017). About 74. 1% (15) of Mori type C did not meet the hemodynamics criteria for severe stenosis. Conclusions Mori C type lesions of SIVAS differ from Mori A and B lesions in the local color imaging features, intracranial and extracranial hemodynamic parameters. Blood flow in Mori C type lesions can be manifested with low-velocity and high-resistance in extracranial segment and discontinuity in intracranial segment.
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Based on the data obtained from the questionnaire survey and personal in-depth interviews,this study preliminarily formulated the "selection guidelines for the doctoral application review system of Capital Medical University"(draft).In addition,through Delphi method and chi-square test,the author formulated the "selection guidelines for the doctoral application review system of Capital Medical University".The guide contained four primary indicators of scientific literacy,academic ability,scientific research ability and personality quality and 27 secondary indicators.The respondents generally believed that quality,ability and moral character were the core contents of the doctoral selection guide.The doctoral advisors attached great importance to the personality quality of the applicants while having high requirements on the quality and ability.Meanwhile,the doctoral advisors also had high requirements on the scientific research ability of doctoral students in professional degrees.