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【Objective】 To study the effect of perioperative allogeneic blood transfusion on patients with oral squamous cell carcinoma (OSCC) after first-stage free flap transplantation. 【Methods】 A total of 306 OSCC patients who accepted primary repair and reconstruction using free flap admitted to our affiliation from January 2010 to January 2019 were selected as the research objects and retrospectively analyzed. According to their clinical data, they were divided into three groups: no transfusion group (n=98), 1-2 U transfusion group (n=131) and 3 + U transfusion group (n=77), respectively. The incidence of complications including flap infection, blood circulation disorder and hematoma in the three groups were compared. The five-year survival rate of the three groups was calculated by Kaplan-Meier analysis, and the relative risk of death was analyzed by Cox regression. 【Results】 There was no statistically significant difference among the three groups of patients (P>0.05) regarding such baseline data as embracing gender, age, primary location, degree of differentiation, adjuvant radiotherapy and chemotherapy. The complication rate of patients with 3 + U transfusion (25.97%) was significantly higher than that of no transfusion (6.12%) and 1-2 U transfusion (10.86%) (P<0.05); and the five-year survival rate of patients with 3 + U transfusion (51.95%) was significantly lower than that of no transfusion (69.38%) and 1-2 U transfusion (62.60%) (P<0.05). The results of univariate analysis showed that age, adjuvant radiotherapy, degree of tissue differentiation, collateral infiltration, vascular invasion and blood transfusion were all factors influencing the quality of prognosis after repair and reconstruction of first-stage free flap transplantation treating OSCC (P<0.05). The results of multivariate analysis showed that adjuvant chemoradiotherapy was an independent protective factor for the prognosis and survival quality of postoperative OSCC patients (P<0.01); the degree of differentiation, vascular invasion and blood transfusion were independent risk factors for the prognosis and survival quality of postoperative OSCC patients (P<0.05). 【Conclusion】 Perioperative allogeneic transfusion in OSCC patients can increase the risk of postoperative complications and directly affect their prognostic quality. It can be regarded as an important risk factor for OSCC patients.
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Objective@#To evaluate the performance of multiplex polymerase chain reaction-based reverse line blot hybridization (mPCR/RLB) in the detection of pathogens causing neonatal bacterial meningitis and associated drug resistance genes.@*Methods@#Clinical data and cerebrospinal fluid (CSF) samples were collected retrospectively from 80 cases diagnosed with neonatal bacterial meningitis in Beijing Children's Hospital from January 1, 2012 to December 31, 2018. A total of 100 CSF samples were obtained including 80 samples collected after admission (12 before and 68 after antibiotic treatment) and 20 recollected at follow-up. All CSF samples were analyzed by conventional culture, susceptibility test and mPCR/RLB. Differences in the detection of pathogens and drug resistance genes were analyzed by Chi-square test.@*Results@#(1) Among the 80 first-collected CSF samples, mPCR/RLB revealed significantly higher positive rate than conventional culture [26.3% (21/80) vs 7.5% (6/80), χ2=10.025, P=0.002]. No significant difference was showed between the two methods in analyzing the 12 samples collected before antibiotic therapy (9/12 vs 5/12, χ2=1.543, P=0.214), while the positive rate in 68 samples collected after antibiotic intervention detected by mPCR/RLB was obviously higher than that by conventional culture [17.6% (12/68) vs 1.5% (1/68), χ2=13.176, P<0.001]. (2) Conventional culture results of the 20 samples collected during follow-up were all negative, but four were positive using mPCR/RLB, which were also positive previously. Furthermore, the results of both methods in previous detections were identical. (3) According to the conventional culture results, the pathogens were Escherichia coli (three cases), Group B Streptococcus (two cases) and Listeria monocytogenes (one case), while mPCR/RLB detected Escherichia coli (four cases), Group B Streptococcus (five cases), Listeria monocytogenes (four cases), Neisseria meningitidis (four cases), Haemophilus influenzae b (one case), Gram-negative bacteria (one case), Gram-positive bacteria (one case), and Listeria monocytogenes and Haemophilus influenzae b coinfection (one case) in 80 first-collected CSF samples. (4) Antibiotic susceptibility test showed that one Escherichia coli strain produced extended spectrum beta-lactamases. Drug resistance gene detection by mPCR/RLB showed that acrA, acrB, CTX-M (consistent with antibiotic susseptibility test) and TetM genes were positive in three, two, one and one case, respectively.@*Conclusions@#mPCR/RLB is of great clinical value due to its higher detection rate and better accuracy compared with bacterial culture and can also detect drug resistance genes.
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Objective@#To analyze the epidemiological characteristics, clinical manifestations and imaging charac-teristics of 76 cases with neonatal cerebral infarction, in order to provide evidence for the diagnosis, treatment and prognosis for neonal cerebral infarction.@*Method@#Newborns with cerebral infarction admitted into the Neonatal Center, Beijing Children′s Hospital, Capital Medical University from January 2007 to December 2017 were enrolled.According to neurological sequelae, the participants were divided into good prognosis group and poor prognosis group for retrospective analysis, and their cranial magnetic resonance imaging(MRI) changes and mental development were followed up.@*Results@#The incidence of convulsion was the highest in 76 cases (73.7%, 56/76 cases), among which unilateral limb twitching was characteristic in 39.2% (22/56 cases). Clinical physical examination showed no significant positive signs in 13.2%(10/76 cases) of the patients, but middle cerebral artery involvement accounted for 80.3% (61/76 cases), and there was no abnormal discharge of electroencephalogram in 29.2% (19/65 cases) of the patients.Among 41 children (29.3%) received follow-up, 12 cases had neurological sequelae, and 15 cases (36.6%) received anticoa-gulant therapy.The median area of original damage of T2 sequence cerebral infarction was 10.3%, the median area of diffusion weighted image damage was 2.0%, and the median area of damage of T2 sequence was 1.0%.The median ratio of craniocerebral lesion damage was 8.4%.The ratios of poor prognosis were 14.9%, 4.8%, 0.5% and 14.4%, respectively.@*Conclusions@#Neonatal convulsion is the most common manifestation of neonatal cerebral infarction.Unilateral limb clonus is characteristic.The larger the infarct involvement area and the larger the intracranial lesion change area through reexamination, the poorer prognosis of the children.Early anticoagulant therapy could not improve the prognosis of neonatal cerebral infarction.
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Objective To analyze the epidemiological characteristics,clinical manifestations and imaging characteristics of 76 cases with neonatal cerebral infarction,in order to provide evidence for the diagnosis,treatment and prognosis for neonal cerebral infarction.Method Newborns with cerebral infarction admitted into the Neonatal Center,Beijing Children's Hospital,Capital Medical University from January 2007 to December 2017 were enrolled.According to neurological sequelae,the participants were divided into good prognosis group and poor prognosis group for retrospective analysis,and their cranial magnetic resonance imaging (MRI) changes and mental development were followed up.Results The incidence of convulsion was the highest in 76 cases (73.7 ％,56/76 cases),among which unilateral limb twitching was characteristic in 39.2％ (22/56 cases).Clinical physical examination showed no significant positive signs in 13.2％ (10/76 cases) of the patients,but middle cerebral artery involvement accounted for 80.3％ (61/76 cases),and there was no abnormal discharge of electroencephalogram in 29.2％ (19/65 cases) of the patients.Among 41 children (29.3 ％) received follow-up,12 cases had neurological sequelae,and 15 cases (36.6％) received anticoagulant therapy.The median area of original damage of T2 sequence cerebral infarction was 10.3％,the median area of diffusion weighted image damage was 2.0％,and the median area of damage of T2 sequence was 1.0％.The median ratio of craniocerebral lesion damage was 8.4％.The ratios of poor prognosis were 14.9％,4.8％,0.5％ and 14.4％,respectively.Conclusions Neonatal convulsion is the most common manifestation of neonatal cerebral infarction.Unilateral limb clonus is characteristic.The larger the infarct involvement area and the larger the intracranial lesion change area through reexamination,the poorer prognosis of the children.Early anticoagulant therapy could not improve the prognosis of neonatal cerebral infarction.
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The umbilical vein catheterization is one of the most common interventions in neonates.Central line-associated bloodstream infections is a frequent complication of umbilical vein catheterization.It may lead to increased morbidity and mortality by 7% to 11%.At present, published literature on umbilical vein catheter-related bloodstream infections is limited in China.Our better knowledge of its epidemiology, risk factors and preventive measures could help to improve clinical practice and guide future research.