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Objective To investigate the diagnostic value of serum high density lipoprotein cholesterol (HDL-C), serum albumin (SA) and C reactive protein ( CRP) levels combined detection of severe acute pancreatitis.Methods 180 cases of acute pancreatitis were selected from January 2012 to January 2015 in Tianjin fifth central hospital,including 87 severe acute pancreatitis ( SAP) and 93 mild acute pancreatitis ( MAP) , and 100 cases of healthy people were selected as control group.The serum levels of HDL-C, SA and CRP were compared among three groups.Results HDL-C and SA in SAP group and MAP group were significantly lower than control group (P<0.05), the level of CRP was significantly higher than that of control group ( P<0.05); HDL-C, SA levels in SAP group were significantly lower than those of MAP group, the CRP level was significantly higher than that of MAP group (P<0.05).Compared to HDL-C and SA, the sensitivity(89.4%), specificity (95%) and accuracy (92%) of CRP were significantly higher (P<0.05).The sensitivity(93.6%)and specificity (95%) and accuracy (94.3%) of combined detection of three markers were significantly higher than the detection results of the three indexes either,the differences were statistically significant (P <0.05).Conclusion The combined detection of serum HDL-C, SA and CRP levels can effectively improve the early diagnosis rate of SAP, and provide reference for clinical diagnosis.
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Objective To observe the concentration changes of plasma cortisol ( Cor ) and adrenocorticotropic hormone( ACTH) in preterm infants with respiratory failure receiving ventilation treatment. Methods The 30 preterm in-fants with respiratory failure requiring mechanical ventilation were selected as the preterm group with respiratory failure, and 32 full term infants with respiratory failure in need of mechanical ventilation were selected as the term infant group with respiratory failure, and 52 preterm infants( preterm control group) and 17 full term infants( term control group) were selected as controls. All the cases were chosen from Neonatal Intensive Care Unit of Anhui Province Children′s Hospital during January to December 2014. The levels of plasma Cor and ACTH were measured and analyzed. Results (1) Cor level:on the 3rd day, the level of plasma Cor in the preterm group with respiratory failure was lower than that in the term group with respiratory failure[262. 50(162. 00-332. 50) nmol/L vs 531. 00(244. 75-644. 00) nmol/L], and higher than those in the preterm control group[199. 50(49. 05-388. 95) nmol/L] and term control group[120. 00(43. 90-191. 00) nmol/L], the differences were statistically significant(all P<0. 05). On the 7th day, the level of plasma Cor in the preterm group with respiratory failure was lower than that in the term group with respiratory failure[128. 00(65. 85-244. 00) nmol/L vs 222. 00 (131. 50-377. 85) nmol/L], the difference was statistically significant(P<0. 05). (2) ACTH level:on the 3rd day, the level of ACTH in the preterm group with respiratory failure was higher than those in the other groups[38. 20(25. 18-76. 65) pmol/L vs 24. 60(19. 03-38. 20) pmol/L vs 22. 30(14. 40-40. 60) pmol/L vs 24. 20(13. 90-45. 65) pmol/L], the differences were statistically significant(P<0. 05). On the 7th day, the concentration of ACTH in the preterm group with respiratory failure was lower than those in the term group with respiratory failure[16. 55(12. 78-31. 80) pmol/L vs 29. 85(18. 23-54. 65) pmol/L], and there were statistical differences(P<0. 05). Conclusions The newborns with respiratory failure were in criti-cal stress, the level of plasma Cor in the preterm infants with respiratory failure was lower than that of the term infants with respiratory failure, while the level of ACTH in the former was higher than that in the latter. And when the stress disap-peared, both of the plasma Cor and ACTH recovered to the normal level.
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Objective To analyse the difference of effects of different tidal volume mechanical ventilation strategies in infants with severe congenital heart disease after curative.Methods Sixty-eight cases were chosen from CICU of Anhui Provincial Children's Hospital during Oct 2010 to Jan 2012.Thirty-two cases in A group were used in ventilation strategy by lower tidal volumes (6 ～ 10 ml/kg),36 cases in B group were used in ventilation strategy by larger tidal volumes (10 ～ 15 ml/kg).The time of mechanical ventilation,duration of ICU stay and postoperative complications were compared between the two groups.Results The time of mechanical ventilation of B group was shorter than that of A group [(8.6 ± 2.5) d vs (11.7 ± 3.2) d],duration of ICU stay of B group was shorter than that of A group [(11.4 ± 4.8) d vs (15.6 ± 5.7) d],there were statistical differences between two groups(P ＜ 0.0l).The incidence rate of ventilator associated pneumonia and pneumothorax were 6.3％ and 3.1％ in A group,which were 5.6％ and 5.6％ in B group,there were no statistical differences between two groups (P ＞ 0.05).Conclusion The effects of mechanical ventilation with larger tidal volumes is better than that with lower tidal volumes in infants with congenital heart disease postoperative therapy.
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Objective To analyze the risk factors and prevention of non-diabetic mother neonatal hypoglycemia,in order to provide evidences for clinical diagnosis and avoid hypoglycemic brain injuries.Methods This was retrospective study using the method of case control.One hundred and eleven cases of non-diabetic mother neonatal hypoglycemia were enrolled in patients group,and 111 controls of normal blood glucose neonate at the same period were enrolled in control group.The risk factors of neonatal hypoglycemia and the results of neural development after hypoglycemia were analyzed.Results The risk factors of neonatal hypoglycemia were low-birth-weight infant(X2=4.066,P=0.044),small for gestation age infant (X2=21.125,P=0.000),congenital heart disease(X2=5.869,P=0.015),day-age≤3 days(X2=6.876,P=0.032),mother with pregnancy-induced hypertension(X2=6.618,P=0.010)or age<25 years old (X2=6.311,P=0.044).Full-term infants might be easier to show up hypogtycemic brain injuries than pre-term infants;the occurrence of hypoglycemic brain injuries correlated with the level of blood glucose and the lasting time of hypoglycemia.Conclusion Monitor blood glucose closely to the infant has risk factors of hypoglycemia,and discover and cure it on time,in order to avoid hypoglycemic brain injuries.