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ObjectiveTo tentatively understand the status of radioactive contamination in nuclear medicine personnel. MethodsA total of 34 radiation staff engaged in nuclear medicine diagnosis and treatment were selected from two hospitals in Shanghai as the survey subjects.Among the 34 medical staff， 8 were nuclear medicine doctors， 14 were nuclear medicine technicians and 12 were nuclear medicine nurses. After surface contamination monitoring was first carried out to confirm that they had no surface radioactivity contamination， whole body scanning was performed with a whole body counter to determine whether they were internally contaminated with artificial radionuclides. ResultsThe α surface contamination was not detected in the nuclear medical staff. The β surface contamination of the nuclear medicine doctors， technicians and nurses was （13.8±0.8）， （14.1±0.8） and （14.0±0.7） times per second， respectively. There were 2， 2， and 4 nuclear medicine doctors who were contaminated with 18F， 99mTc and 131I， 3， 5， and 2 nuclear medicine technicians who were contaminated with 18F， 99mTc and 131I， and 6， 8， and 5 nuclear medicine nurses who were contaminated with 18F， 99mTc and 131I， respectively. The 18F activity of nuclear medicine technicians was 1 997‒9 401 Bq， and the 99mTc activity of nuclear medicine technicians and nurses was 3 699‒18 692 and 652‒388 22 Bq， respectively. One nuclear medicine nurse had a 99mTc activity of 35 389 Bq. According to the preliminary estimation of 131I internal irradiation dose， the maximum committed effective dose of nuclear medicine doctors， technicians and nurses could reach 0.370， 0.018 and 0.584 mSv， respectively. ConclusionThe nuclear medicine staff are exposed to radioactive contamination， and it is important to monitor and evaluate their internal radiation doses.
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Background Based on numerous epidemiological studies, radionuclide 131I can result in thyroid disease. Objective To study the contamination level of thyroid 131I in 131I treatment associated radiation workers in nuclear medicine departments in Shanghai. Methods Based on a general survey on basic situation of nuclear medicine in Shanghai, the level of internal exposure of radiation workers involved in 131I treatment was assessed with questionnaires and on-site monitoring. A portable γ spectrometer was used for on-site detection, the intake and annual effective dose were estimated according to the measurement results. Physical examination reports were collected for radionuclide positive workers, and chromosome testing was performed. Results There were 579 nuclear medicine workers and 175 were engaged in 131I treatment in Shanghai. 131I was detected in thyroid of 18 workers, with a detection rate of 10.3%. Among them, the detection rates of thyroid 131I in nurses and cleaners were 23% and 25% respectively. The mean measured activity of thyroid 131I was 306.1 Bq and the maximum measured activity was 3716.9 Bq (nurse). The maximum intake was estimated at 37544 Bq and the median was 786.4 Bq. The average annual committed effective dose was 1.22 mSv and the maximum value was 14.87mSv. The chromosomal aberration rates of all detected workers were negative, and all blood indicators were normal except one with low hemoglobin. Conclusion The annual dose of nuclear medical staff engaged in 131I treatment does not exceed the national standard limit, but the internal exposure of nurses and cleaners should not be ignored. On the basis of strengthening protection and decontamination, routine internal exposure monitoring should be carried out.
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Medical imaging technology course has the characteristics of strong professionalism, complicated content to understand, and quickly updated knowledge. In traditional teaching mode, it takes teachers a lot of time to prepare lessons, and the teaching tools are limited like only taking use of blackboard, model and wall maps, which not only makes teaching content boring but also hardly stimulates students' initiative. Teaching reform of medical imaging technology courses from the perspective of "Internet Plus-based teaching and diagnosis reform" involves teaching content, teaching concept, teaching mode, teaching evaluation and experiments, etc., in which computer-aided teaching, flipped classroom, micro-course and high-quality resource-sharing course are used to increase experimental content, reform experimental teaching methods, and create "real-situation" experimental environment as well as other teaching diagnosis and reform measures, aiming to explore a new teaching pattern that meets the development of students majoring in medical imaging technology and the demand for social talents.
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Objective:To explore the differences and current situation of scientific research background and occupational cognition of enrollees in MD-PhD programs.Methods:A questionnaire survey was conducted among 158 students (40 males and 118 females) who were enrolled in MD-PhD programs in a medical college during 2017 to 2020. SPSS 24.0 and Fisher’s exact test were used for statistical analysis.Results:Over 50% of enrollees in 2019 and 2020 had at least 2-year experience in basic medical research before enrollment. The research background of MD-PhD program enrollees was continuously improving from 2018 to 2020, and Fisher's exact chi-square P value was 0.02. Since 2018, the proportion of enrollees who planned to seek for administrative or education-related jobs in medical institutions had reduced year by year ( P=0.01). Conclusion:In view of the scientific research problems and professional cognitive tendencies of the new students of the MD-PhD programs, certain relevant guidance suggestions are put forward in this study.
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Objective:To investigate and compare the clinical characteristics, pathogen distributions and outcomes of bacterial meningitis in preterm and term infants.Methods:The data of 252 cases of neonatal bacterial meningitis hospitalized in Guangzhou Women and Children′s Medical Center from January 2013 to December 2018 were retrospectively analyzed and divided into two groups according to gestational age: preterm group( n=64)and term group( n=188). The clinical manifestations, laboratory examinations, pathogen distributions and clinical outcomes of the children in two groups were compared. Results:Fever was the most common clinical manifestation in both groups, but the incidences of lethargy, apnea and feeding intolerance in preterm group were significantly higher than those in term group( P<0.05). There was no significant difference in the rate of the first hemogram/cerebrospinal fluid abnormality between two groups( P>0.05). Sepsis, subdural effusion and hydrocephalus were the main complications in both groups.The incidence of complications in premature infants was 60.9%(39/64), which was significantly higher than that in full-term infants(44.7%, 84 /188) , with a statistically significant difference ( P<0.05). Escherichia coli and Streptococcus agalactiae were the most common pathogens in the preterm infants, whereas Klebsiella pneumoniae and Streptococcus agalactiae were the most common pathogens in the term infants.There was no statistical difference in the time of positive bacteria turning negative between two groups, but the course of antibiotics in preterm group was significantly longer than that in term group( P<0.05). The clinical cure/improvement rates in the two groups was about 95%, and the difference between two groups was not statistically significant( P>0.05). Conclusion:Early clinical manifestations of bacterial meningitis in preterm infants are atypical and relatively easy to be missed.The incidence of complications is significantly higher than that of full-term infants, and the duration of antibiotic use is longer.However, the clinical cure/improvement rate of premature infants is not worse than that of full-term infants after reasonable and standardized early treatment.
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【Objective】 To discuss the influence of apheresis platelets donation mode transformation, from walk-in to appointment, on apheresis platelets donation, donor retention and donation service quality. 【Methods】 The comparative research method is used to compare the number of apheresis platelets donors, blood donation units, rate of first-time blood donation, rate of repeated blood donation, conversion rate of fixed whole blood donors and satisfaction rate before and after the transformation of donation model. Questionnaires were randomly distributed to apheresis platelets blood donors before and after the transformation to study the evaluation of appointment mode. 【Results】 In comparison with walk-in mode, the number of blood donors after adopting the appointment mode was 30 193, with 41.93% (8 920/21 273) increase; number of blood donations was 119 143, with 93.66% (57 622/61 521) increase; platelet donation was 212 717 treatment units, with 103.12% (107 990/104 727) increase; rate of repeated blood donation was 53.56% (16 172/30 193), with 15.43% increase; the number of first-time donors was 15 949, with 57.93% (5 850/10 099) increase; the conversion rate of fixed whole-blood donors was 37.86% (6 039/15 949), with 8.84% increasement; the satisfaction of appointment mode reached 99.81%, with significantly improved satisfaction with blood donation environment and waiting time. 【Conclusion】 The appointment mode of apheresis platelet donation has a promoting role in the increase of apheresis platelets donation, the improvement of solid blood donors and the quality of apheresis platelets donation services.
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Objective@#To investigate the prevalence and types of maternal near miss in Hangzhou City from 2015 to 2020, so as to provide insights into early identification and interventions for maternal near miss.@*Methods@#The data of maternal near miss in 5 hospitals of Hangzhou City from 2015 to 2020 were collected from China's National Maternal Near Miss Obstetrics Surveillance System, and the incidence and mortality of maternal near miss, types of pregnancy-related complications/comorbidities and types of critical illness were descriptively analyzed.@*Results@#Totally 230 490 pregnant and lying-in women were recruited in 5 hospitals in Hangzhou City from 2015 to 2020, and there were 182 514 live births, 177 428 women with pregnancy-related complications/comorbidities, and 1 790 cases of maternal near miss with a 0.98% annual incidence rate. The incidence of maternal near miss was high in 2019 (1.18%). The hospital mortality and death index were respectively 3.29/105 and 0.33% among pregnant and lying-in women from 2015 to 2020, and there was no death found among pregnant and lying-in women from 2018 to 2020. The main pregnancy-related complications/comorbidities included anemia (79.33%), obstetric hemorrhagic disorders (69.83%), and gestational hypertension (16.65%). The main critical illness among maternal near miss included coagulation dysfunction (87.23/104), cardiovascular dysfunction (20.44/104), and respiratory dysfunction (9.70/104).@*Conclusions@#The incidence of maternal near miss was high and the hospital mortality appeared a reduction tendency among pregnant and lying-in women in Hangzhou City from 2015 to 2020. Coagulation dysfunction is the primary critical illness among maternal near miss, and the management of anemia and hemorrhagic diseases requires to be improved.
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Objective:To investigate the correlation between nutritional status and nosocomial infection in elderly patients with acute leukemia.Methods:A total of 202 elderly patients with acute leukemia hospitalized in the Department of Hematology of the First Affiliated Hospital of Anhui Medical University from June 2015 to December 2017 were randomly included as research objects.The nutritional status of patients was assessed by the Patient-Generated Subjective Global Assessment(PG-SGA), and the blood routine and biochemical indexes were compared among patients with different nutritional conditions.The correlations between clinical characteristics and PG-SGA score and between nutritional status and nosocomial infection were analyzed.Univariate analysis and multivariate Logistic regression analysis were used to evaluate the related factors for the nosocomial infection.Results:The hemoglobin and albumin were higher in patients with PG-SGA score of 0-8[(97.02±2.86)g/L and (39.78±0.50)g/L, respectively]than in patients with PG-SGA score ≥ 9[(83.02±3.28)g/L and (37.71±0.71)g/L]( P=0.003, 0.016). And C-reactive protein(CRP)was lower in patients with PG-SGA score of 0-8[(33.98±5.34)mg/L]than in patients with PG-SGA score ≥ 9[(58.82±8.36)mg/L]( P=0.015). There were significant differences in PG-SGA scores among patients with different age, disease stage, disease type and gastrointestinal reaction( t=-6.562, 3.292, 2.869 and 2.268, P=0.000, 0.001, 0.006 and 0.041). The PG-SGA score was positively correlated with the incidence of nosocomial infection( r=0.544, P=0.000). Logistic regression analysis showed that PG-SGA score was an independent risk factor( OR=2.11, 95% CI: 1.66-2.71, P=0.000). And albumin was a protective factor( OR=0.86, 95% CI: 0.77-0.93, P=0.000)for the nosocomial infection in elderly patients with acute leukemia. Conclusions:The nutritional status is closely related to the occurrence of nosocomial infection in elderly patients with acute leukemia.Elderly acute leukemia patients with malnutrition should be given adequate nutritional support as soon as possible to improve their nutritional status and improve prognosis.
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Objective:To summarize the experience of five hospitals in Guangdong Province on successfully transporting retained passengers by chartered flights during the outbreak of the COVID-19.Methods:We retrospectively evaluated the operation and management, cabin arrangement, isolation requirements, and personnel protection in the aspect of epidemic prevention and control.Results:In 11 charter missions, over one thousand "healthy" passengers with potential risk of infections were transported back to China. The medical delivery team and flight crew were kept free of infection, passengers maintained zero cluster infections and no unexpected adverse events during the air transport.Conclusions:Our results indicate how to carry passengers in a scientific and orderly way is crucial for avoiding the transmission risks of the epidemic of COVID-19 among working staffers and passengers during air transportation.
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Objective:To evaluate the monitoring value of amplitude-integrated electroencephalography (aEEG) in brain injury among neonates with severe hyperbilirubinemia.Methods:This study retrospectively recruited 223 full-term infants with severe hyperbilirubinemia who underwent aEEG in the Department of Neonatology of Guangzhou Women and Children Medical Center from October 2018 to June 2020. Differences in serum bilirubin level and the incidence of acute bilirubin encephalopathy (ABE) between the normal group ( n=180) and abnormal aEEG group ( n=43) were compared. The monitoring value of aEEG in ABE, and its association with brain stem auditory evoked potential (BAEP) and MRI were studied. Two-independent sample t-test, Mann-Whitney U test and Chi-square test were used for comparing the differences between groups. Goodman-Kruskal Gamma was used for correlation analysis. Results:The total serum bilirubin level [(536.2±154.6) vs (422.1±103.0) μmol/L, t=-5.109, P<0.001] and the incidence of ABE [62.8% (27/43) vs 9.4% (17/180), χ2=62.366, P<0.001] in the abnormal aEEG group were significantly higher than those in the normal aEEG group. The sensitivity and specificity of aEEG in the diagnosis of ABE were 61.3% and 91.1%, respectively. With the progression of ABE from warning period to spasmodic stage, more severe voltage suppression (Gamma=0.847, P=0.003), more disordered sleep-wake cycles (Gamma=0.941, P<0.001) and a more frequent epileptic discharge (Gamma=0.976, P<0.001) were observed. Out of the 223 cases, 148 underwent BAEP. The abnormal rate of aEEG in abnormal BAEP group was significantly higher than that in normal BAEP group [32.7% (33/101) vs 6.4% (3/47), χ2=12.040, P=0.001]. The incidence of abnormal voltage in severe abnormal BAEP group was significantly higher than that in mild abnormal BAEP group [20.6% (7/34) vs 2.6% (1/38), χ2=5.858, P=0.016]. The incidence of epileptic discharge in severe abnormal BAEP group was significantly higher than that in mild abnormal BAEP group [32.4% (11/34) vs 2.6% (1/38), χ2=11.413, P=0.001] and moderate abnormal BAEP group [32.4% (11/34) vs 3.5% (1/29), χ2=8.480, P=0.004]. Among the 223 cases, 108 received MRI examination. The incidence of epileptic discharge in the cases with bilirubin brain injury image was significantly higher than those with normal MRI images [28.6% (10/35) vs 2.6% (1/39), χ2=9.864, P=0.002] and those with other abnormal images [28.6% (10/35) vs 2.9% (1/34), χ2=8.451, P=0.004]. Conclusions:aEEG monitoring is helpful in the diagnosis of ABE and can reflect disease severity. Severe hyperbilirubinemia-induced brain injury in neonates mainly manifests as increased and more frequent epileptic discharge on aEEG. There is a correlation between aEEG monitoring with BAEP and MRI findings.
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Objective To study the clinical features,diagnosis,treatment and genetic characteristics of chronic granulomatosis disease (CGD) in neonates,and to improve the understanding of CGD.Method Clinical manifestations and treatments of one patient with CGD and aspergillus infection in our hospital were analyzed.Key words including "infant","newborn","chronic granulomatous disease","lung abscess",and "aspergillus infection"were searched in Chinese medical databases,PubMed and Embase until 2018 September.The clinical features and genetic mutations of CGD reported in literature were summarized.Result The patient in our hospital was a full-term male infant naturally delivered with birth weight of 3 400 g.The onset of the disease was on the 19th day after birth,and the initial clinical manifestations included fever,cough,and then pulmonary abscess,diarrhea,recurrent skin infection,and aspergillus infection.Anti-infection and symptom-alleviating treatments were not effective,and weight gain was poor.Laboratory examination indicated bacterial and fungal infection.The neutrophil respiratory burst test was positive and indicated CGD.Hetero-zygotic frameshift mutation [c.1599-1602delAGTTt (p.V534Sfs* 12)] of CYBB gene 13 exon was detected and the diagnosis of CGD was confirmed.The mother carried the heterozygous mutation and the father didn't.Antifungal therapy was continued after the children got better and discharged from hospital.The patient was followed up until 3-month-old and his condition was stable.Our literature review revealed 28 reports including 108 cases of CGD infants,including 79 male cases (73.1％) and 21 female cases (19.4％).Most of the CGD infants (79/108,73.1％) had the onset within 2 weeks of life.The main clinical features included pneumonia/pulmonary abscess/pleural effusion (87.0％),diarrhea (58.3％),perianal abscess (35.2％),skin infection (53.7％),aspergillus infection (41.7％),and tuberculosis infection (26.9％).75 cases had positive neutrophil respiratory burst test (69.4％),and 95 cases were diagnosed using genetic tests (88.0％).Over 300 loci of the CYBB gene mutation had been reported contributing to the disease.28 cases had abnormal family history (25.9％),19 cases received hematopoietic stem cell transplantation (17.6％),41 cases had clinical improvement (38.0％),and 35 cases died (32.4％).Conclusion CGD is rare in neonatal period.The main clinical manifestations included recurrent infection with pathogens like aspergillus,tuberculosis and others.CGD can be diagnosed based on recurrent multiple bacterial or fungal infections,neutrophil respiratory burst test and gene tests.CGD should be considered among children with recurrent infections at early life stage,especially those with poor maternal history or positive family history.
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Objective To explore the clinical features and risk factors of poor prognosis in neonatal necrotizing enterocolitis(NEC).Methods A retrospective study was carried out in the infants with NEC admitted to 6 cooperative hospitals in Guangdong Province between January 2005 and December 2014.The clinical features and risk factors of poor prognosis in preterm and full-term infants diagnosed NEC,early onset and late onset NEC were analyzed.Results A total of 449 cases who met the criteria were admitted during the study time.The mortality was 23.6％ (106/449 cases),of which the preterm group was 24.6％ (58/238 cases) while the full-term group was 22.7％ (48/211 cases),the early onset group was 22.1％ (45/204 cases) while the late onset group was 24.3％ (57/235 cases).The median number of NEC onset in preterm group was 11 d after birth while the number of the full-term group was 6 d.Full-term infants who diagnosed NEC were more likely to manifest themselves as abdominal distension (52.1％ vs.42.0％,x2 =4.597,P =0.032),vomiting(36.5％ vs.17.2％,x2 =21.428,P =0.000) and bloody stool(30.3％ vs.21.4％,x2 =4.653,P =0.031);but in the onset of NEC,preterm infants more likely to have feeding intolerance (21.0％ vs.12.8％,x2=5.309,P =0.021).The early onset group of full-term NEC was much common in twins or multiplets(9.4％ vs.1.1％,x2 =6.226,P =0.013),which rate of surgical therapy was much higher (41.0％ vs.27.0％,P =0.036) and the breast-feeding rate before NEC was lower than the late onset group(14.5％ vs.32.6％,x2 =9.500,P =0.002),the differences were statistically significant.The gestational age and birth weight were bigger in the early onset group of preterm NEC[(33.8 ±2.5) weeks vs.(32.2 ±2.8) weeks,t =4.261,P =0.000;(2.1 ±0.5) kg vs.(1.7 ± 0.5) kg,t =4.735,P =0.000)],but length of stay was shorter than the late onset group (18.0 d vs.26.5 d,P =0.000).Logistic regression analysis showed that the risk factors of poor prognosis of full-term NEC were shock,peritonitis and sepsis;while risk factors of poor prognosis of preterm NEC were small for gestational age infant,pulmonary hemorrhage,shock,intestinal perforation and sepsis;the risk factors of poor prognosis of the early onset group of full-term NEC was shock;while those of the late onset group were shock and peritonitis;the risk factors of poor prognosis in the early onset group of preterm NEC were shock and sepsis,while those in the late onset group were pulmonary hemorrhage,shock,intestinal perforation and sepsis.Conclusions Compared to the preterm NEC,the onset time of full-term NEC was earlier and the clinical manifestations were more typical.Early identification and management of shock,peritonitis,intestinal perforation,sepsis and pulmonary hemorrhage can reduce the risk of poor prognosis of neonate NEC.
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Objective To study the relationship between serum neutrophil gelatinase-associated lipocalin (NGAL),kerbs von lungren 6 antigen (KL-6) and bronchopulmonary dysplasia (BPD) in preterm infants.Method From Jan.2015 to Dec.2015,preterm infants admitted to NICU of Guangzhou Women and Childrem's Medical Center with gestational age less than 32 weeks and birth weight less than 1 500 g were enrolled.The serum levels of procalcitonin (PCT),NGAL and KL-6 protein were detected at 24 h,7 d and 14 d after birth.At the 28 d after birth,according to the presence of BPD or not,the infants were assigned into BPD group and non-BPD group.The differences of the serum levels of PCT,NGAL and KL-6 between the two groups were compared.Result A total of 55 cases were included in the study (BPD group 20 cases,non-BPD group 35 cases).No significant differences existed in gender,birth weight and gestational age between the two groups (P ＞ 0.05).The incidence of respiratory distress syndrome were siginificantly higher in the BPD group (P ＜ 0.05) and the duration of mechanical ventilation and oxygen therapy were siginifantly longer in the BPD group (P ＜ 0.05).No significant difference between the two groups in the level of PCT at 24 h after birth (P ＞ 0.05).The levels of serum PCT at 7 d and 14 d after birth in BPD group were significantly higher than non-BPD group [7 d:(1.5 ± 1.7) ng/ml vs.(0.4 ± 0.2)ng/ml,14 d:(0.8 ± 0.7) ng/ml vs.(0.2 ± 0.1) ng/ml] (P ＜ 0.001).The levels of serum NGAL at 24 h,7 d and 14 d were significantly higher than non-BPD group [24 h:(1.6 ± 0.3) pg/ml vs.(0.8 ±0.2) pg/ml,7 d:(2.3 ±0.5) pg/ml vs.(0.7 ±0.2) pg/ml,14 d:(2.5 ±0.3) pg/ml vs.(0.8 ±0.2)pg/ml] (P ＜0.001).The levels of serum NGAL at 7 d and 14 d after birth in BPD group were significantly higher than 24 h in BPD group (P ＜ 0.05).No significant difference between KL-6 at 24 h after birth in BPD group and non-BPD group (P ＞0.05).The levels of serum KL-6 at 7 d and 14 d after birth in BPD group were significantly higher than non-BPD group [7 d:(1.2 ± 0.2) ng/ml vs.(0.8 ± 0.1) ng/ml,14 d:(1.3 ±0.2) ng/ml vs.(0.8 ±0.9) ng/ml] (P ＜0.001).The level of serum KL-6 at 7 d and 14 d after birth in BPD group were significantly higher than 24 h in BPD group (P ＜ 0.05).Conclusion Respiratory distress syndrome and prolonged mechanical ventilation were risk factors of BPD.The rising of serum NGAL and KL-6 early after birth might be involved in the development of BPD,which had predictive value of BPD.
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Objective To study the composition of gut microbiome in neonates with severe bilinebinemia (serum total bilirubin ＞ 342 μmol/L),and to explore the relationship between gut microbiome and bilirubin brain injury.Methods A prospective study was conducted.The neonates with serum total bilirubin ＞ 342 μmol/L from September 2016 to March 2017 in Guangzhou Women and Children's Medical Center,Guangzhou Medical University,were enrolled in the study and 16S rDNA sequence analysis technology was used to detect the composition of gut microbiome in all subjects.According to the results of brain magnetic resonance imaging (MRI),brain stem auditory evoked potential (BAEP) and clinical manifestations,the subjects were divided into the brain injury group (26 cases) and no brain injury group (28 cases).The differences of the composition of gut microbiome between the 2 groups were compared,and the levels of unconjugated bilirubin in serum and cerebrospinal fluid were also compared.Results The level of unconjugated bilirubin in serum of the brain injury group was (463.51 ± 110.62) μmol/L,but in no brain injury group was(364.18 ±63.13) μmol/L,and there was significant difference between the 2 groups(t =4.090,P =0.000 1).The level of unconjugated bilirubin in the cerebrospinal fluid of the brain injury group was (9.53 ± 2.68) μmol/L,but in no brain injury group was (6.94 ± 2.31) μmol/L,and there was significant difference between the 2 groups (t =3.812,P =0.000 3).There was no correlation between the level of unconjugated bilirubin in the cerebrospinal fluid and serum between the 2 groups(r =0.137,0.081,all P ＞0.05).The abundance of gut microbiome in the brain injury group was lower than that in no brain injury group in genus level,among which Fusobacterium,Catabacter,Succinivibrio,Clostridium and Bacteroides were significantly different (all P ＜ 0.05).Conclusions The occurrence of bilirubin brain injury depends on the level of unconjugated bilirubin in serum cerebrospinal fluid,but it may be more directly dependent on the level of bilirubin in the cerebrospinal fluid.The diversity of gut microbiome in neonates with bilirubin brain injury was significantly lower than that in no brain injury group.The level of unconjugated bilirubin in cerebrospinal fluid may be related to the different blood-brain barrier permeability caused by different composition of gut microbiome.
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Objective To investigate the efficacy and safety of mesenchymalstem cells (MSCs)in improving the renal transplantation functional recovery of donation after citizens death (DCD)derived renal donors.Methods A retrospective analysis of 97 cases of DCD renal transplantation was performed in our center from July 2011 to December 2016.Among them,50 cases were treated with MSCs (the treatment group) and 47 cases without MSCs (the control group).In the treatment group,the umbilical cord stem cell suspension (50 mL,approximately 1 106/kg weight) was infused before vascular patency and 1 week,2 weeks,and 3 weeks after renal transplantation.Postoperative renal function within 3 months of recovery,delayed graft function (DGF) incidence and duration,the incidence of pulmonary infection,acute rejection and surgical complications were analyzed.Resuts The incidence rate of DGF and duration in the treatment group were 16.0％ and (14.42 ± 3.95) days,and those in the control group were 27.7％ and (17.85 ± 6.25) days respectively,and there were statistically significant difference.The incidence of acute rejection in the treatment group and the control group was 12.0 and 21.3％ respectively with the difference being statistically significant.The incidence rate of pulmonary infection in the treatment group and control group was 10％ and 12.7％respectively with the different being not statistically significant.Comparison of eGFR at 1st,1st month and 3rd month after operation showed that the eGFR in the control group was statistically significantly lower than that in the treatment group at 1st and 3rd month,but there was no significant difference in eGFR at 1st week between the two groups.There was no significant difference in the surgical complications between the two groups.Conclusion In the treatment group,the incidence rate of DGF was lower,and DGF duration was shorter than in the control group.The acute rejection rate in the control group increased significantly,but there was no significant difference in pulmonary infection and surgical complications between two groups.The recovery trend of renal function in the treatment group was better than that in the control group.
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Objective@#To observe serum levels of periostin, ECP, IgE in the antibiotic enterprise workers, and study the role of periostin, ECP, IgE in the development of allergic inflammation.@*Methods@#90 cases with asthma or rhinitis were enrolled as disease group, another 117 workers exposed to 7-ACA、6-APA dust without suffering from allergic illness, are chosen as group of dust exposed, and 192 healthy workers who didn’t contact dust were chosen as control group. Questionnaires were used to learn their basic information.Lung function was determined with a portable spirometer.The expression levels of periostin、ECP and IgE in serum were measured by enzyme-linked immuno sorbent assay.@*Results@#The exposure group and disease group had significantly lower forced vital capacity (FVC) , forced expiratory volume in 1 second (FEVl.0) , and FEVl.0/FVC ratio than the control group (P<0.05) . The disease group had significantly higher eosinophil than the control group (P<0.05) . Compared with the control group, the exposure group, the disease group, asthma subgroup, rhinitis subgroup of serum periostin and IgE increased, the differences are statistically significant (P<0.05) . Serum levels of ECP in the workers of asthma subgroup were significantly higher than that in control group (P<0.05) . Serum expression levels of periostin were positively correlated with IgE, ECP in workers (P<0.001) , serum levels of periostin were negatively correlated with FEV1.0 in workers (P<0.05) . Multiple logistics regression analysis found that exposure to 7-ACA or 6-APA (OR=3.09, 95%CI: 1.83-5.21) , age>47years (OR=2.53, 95%CI: 1.22-5.26) , higher ECP (OR=1.04, 95%CI: 1.01-1.06) were risk factors for increased serum periostin level.@*Conclusion@#Occupational exposure to 7-ACA or 6-APA can result in higher serum periostin level, exposure to 7-ACA or 6-APA, age>47 years, higher ECP are risk factors for increased serum periostin level.
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Objective To study the clinical features of congenital glucose-galactose malabsorption (CGGM),and to improve the understanding of CGGM.Method Clinical manifestations and treatment process of one patient with CGGM in our hospital were retrospectively analyzed.From 1966 to 2016 May,Chinese medical database and PUBMED were searched using Malabsorption syndrome,dehydration,hypernatremia , diarrhea , newborn , carbohydrate metabolism ,andglucose/galactose malabsorption as key words.The clinical features of CGGM reported in literatures were summarized.Result The patient in our hospital was a full-term female infant naturally delivered.The onset of the disease was on the 9th day after birth,and the clinical manifestations included severe diarrhea,severe dehydration,hypernatremia,metabolic acidosis and malnutrition.After intravenous infusion and symptomatic treatment,dehydration,hypernatremia and metabolic acidosis were corrected.However,there was no improvement of diarrhea characterized with watery and acidic stools,and neither was weight gain.Glucose loading test was negative,and fructose loading test was positive.Diarrhea was improved markedly using diagnostic carbohydrate-free formula,so CGGM was diagnosed clinically.SLC5A1 homozygous IVS7-2 A ＞ G mutation was detected which confirmed the diagnosis of CGGM.With carbohydrate-free formula feeding,the body weight of the infant was increased.Followed up for 2 months now,her body length and body weight were at P25 and P22 on growth curve respectively,and no obvious neurological sequela was observed.Our literature review revealed 7 reports including 48 cases of CGGM children.Literature review showed that:most children with CGGM (79.2％) had the onset within 7 days of life;main clinical features included diarrhea (100％),dehydration (100％),and malnutrition (54.2％);22.9％ of patients with carbohydrate-free formula and 27.1％ with fructose matrix formula were fed well;no death was detected,77.1％ had normal weight gain,and 91.7％ had normal development of the nervous system.Conclusion CGGM is rare.The symptoms include severe watery and acidic stools with onset during neonatal period.CGGM is associated with severe complications such as hypertonic dehydration and hypernatremia.The diagnosis is established based upon typical clinical manifestations,sugar loading test and SLC5A1 gene detection.Carbohydrate-free formula feeding is effective.
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The occurrence of stillbirth influences the pregnant women,their husbands,and spousal relationship,and it is easy to produce complex grief.The nursing measures for complex grief are still existing ethical dilemma,including the ethical dilemma of meeting with stillbirth,the ethical issue of the afterward disposal of stillbirth and ethical dilemma of fetal autopsy.This paper stated the ethical reflection of clinical nursing of stillbirth from the perspective of the legal ethical attribute of the remains of stillbirth,the attribution and disposal of the remains of stillbirth,ethical thinking on cultural beliefs,whether to hold a farewell ceremony for fetus and the grief care of the spouse and families of stillbirth maternal.
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Objective To compare the various partial Fourier reconstruction algorithms in MRI image processing and their advantages and disadvantages for improving algorithm .Methods Based on the conjugate symmetry in k‐space data in the partial Fourier reconstruction algorithm theory ,the 1 .5T medical magnetic resonance equipment was utilized ,the k‐space data were collect‐ed ,in reconstruction ,only 55% -80% of full data were utilized to simulate the partial collection pattern and reconstruct the images by using the several algorithms of zero filling ,conjugate synthesis ,Homodyne detection and POCS .Results The results presented that the ringing artifact was most obvious in the conjugate filling pattern and the POCS algorithm had the best effect for eliminating the ringing artifact .Conclusion The POCS algorithm repeatedly uses the weighted iteration with low frequency phase positions , which eliminates artifact ,meanwhile causes the lose of high frequency image details ,moreover the time consuming is longer ;the Ho‐modyne algorithm can keep a good balance between maintaining the image details and diminishing ringing .If the Sinc function serves as a weighting function for conducting phase unwrapping ,the image quality may be further improved .
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Objective To investigate the common pathogens of neonatal bacterial meningitis in the past 5 years,and to evaluate the brain injury in the acute phase through amplitude-integrated electroencephalogram (aEEG),brainstem auditory evoked potential (BAEP) and brain MRI.Methods Sixty children were selected from the past 5 years who were treated in Department of Neonatology,Guangzhou Women and Children's Medical Center in March 2011 to March 2015 as the objects of study.According to the results of etiological culture,the children were divided into streptococcus lactis group (14 cases),escherichia coli group (10 cases),other positive bacteria group (11cases) and culture-negative group (25 cases).The results of aEEG,BAEP and brain MRI of brain injury in the acute phase of these 4 groups were compared.Results Twenty-nine cases of the 60 patients (48.3％) showed positive blood culture,and 14 cases (23.3％) showed positive cerebrospinal fluid (CSF) culture.Streptococcus lactics and escherichia coli were found to be the most common pathogens that caused neonatal bacterial meningitis.By evaluating the cerebral function in the acute phase of 57 cases,it was found that aEEG total abnormal rate was 61.4％,escherichia coli group abnormal rate was 80.0％,while moderate to severe damage seemed to be the most remarkable feature.The abnormal rate was of statistical significance between escherichia coli group and culture-negative group (x2 =3.941,P =0.047).Forty-eight cases manifested potential anomaly evoked by brainstem auditory,with the total abnormal rate as 84.2％.A significant increase in the ratio of severe hearing loss was found in children with bacterial meningitis which was caused by escherichia coli and streptococcus agalactiae.The abnormal rate was of statistical significance between escherichia coli group and culture-negative group (x2 =4.399,P =0.036),and hearing damage caused by escherichia coli was more serious than that in other bacteria group.Of these 57 cases,MRI total abnormal rate was 77.2％,with hydrocephalus as the most common complication.Of the 44 abnormal cases,16 cases showed hydrocephalus,6 cases of which were from the escherichia coli group.The second most common complication was subdural effusion.And another 5 cases showed cerebral softening,3 cases of which were from the escherichia coli group.The data suggested that escherichia coli meningitis easily combined hydrocephalus and brain softening.Conclusions The main pathogens of neonatal bacterial meningitis is streptococcus agalactiae and escherichia coli.The brain injury in neonatal bacterial meningitis caused by escherichia coli is more serious than those caused by other pathogens.