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Objective To investigate the association between serum 25(OH) D levels and the inci-dence of early-onset sepsis(EOS) in the very low birth weight infants(VLBWI) and the gestational age be-low 34 weeks. Methods The cord blood of 159 VLBWI were collected between January and December 2017,including 31 clinically diagnosed EOS and 128 non-EOS patients. Serum 25(OH)D<10 ng/ml was de-fined as severe vitamin D deficiency,25(OH)D 10 to 20 ng/ml as vitamin D deficiency,25(OH)D 20 to 30 ng/ml as vitamin D insufficiency and 25(OH)D >30 ng/ml as vitamin D sufficiency. Results There were no differences in gender,gestational age,birth weight and Apgar score between the EOS group and the non-EOS group(P>0. 05). Serum 25(OH) D was(9. 08 ± 4. 21) ng/ml in the EOS group and(11. 91 ± 5. 37) ng/ml in the non-EOS group(P＝0. 007). The rate of severe vitamin D deficiency was 67. 7%(21/31)in the EOS group and 41. 4%(53/128) in the non-EOS group. The rate of vitamin D deficiency was 32. 3%(10/31)in the EOS group and 52. 3%(67/128)in the non-EOS group. But there was no difference of vitamin D deficiency distribution in the two groups(P＝0. 152). The cut-off value of serum 25(OH)D level in predic-ting EOS was 10. 06 ng/ml. Conclusion The incidence of vitamin D deficiency is as high as 95%,calling for urgent attention on vitamin D supplementation in those VLBWI. Low 25(OH)D level( <10 ng/ml)might be predictive of EOS.
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Neonatal tracheal intubation is not only an important anesthesiologist's skill of neonatal anesthesia,but also a necessary skill for a neonatologist.In the process of neonatal resuscitation and anaesthetic induction of tracheal intubation,it is important to complete the tracheal intubation and control the airway rapidly.Before neonatal tracheal intubation,it is an important task for the neonatologist and anesthesiologist to select the suitable anesthetic drugs and reasonable compatibility,and to make the vital signs stable during intubation in order to reduce adverse events.This paper reviews the types and compatibility of anaesthetic drug for neonatal intubation in recent year,in order to provide reference for clinical selection.
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Objective To investigate the changes in cognitive function in patients with early Parkinson's disease (PD) in a 5-year follow-up.Methods A total of 181 PD and 173 normal participants were recruited between January 2009 and January 2012 at the Department of Neurology,the Second Hospital of Jiaxing City.Regression analysis was used to evaluate the risk factors of cognitive impairment,and changes in subdomains of the Montreal Cognitive Assessment (MoCA) were compared annually with baseline data.Results Baseline clinical data were similar between the two groups.The level of cognitive impairment was positively correlated to the age of onset and the Hamilton Anxiety Scale (H AMD) (t =3.326,P＜ 0.05;t =5.211,P＜0.01),and negatively correlated to education level (t=-2.505,P＜0.05).There were no statistical differences in the first (26.5 ± 2.6),second (26.3±3.2) and third year (25.9±2.9) in the total scores of MoCA,which significantly increased in the forth (24.4 ± 2.3,P＜0.05) and fifth (24.1 ± 1.2,P＜0.05) year compared with baseline levels (26.7±2.9).However,in the control group,differences between any two years in total scores were not statistically significant (all P＞0.05).Seven subdomains of MoCA were attenuated,and four of them were significant different between the groups,including delayed recall,attention,abstraction task and orientation after the forth year of follow-up (all P ＜ 0.05).Meanwhile,visuospatial execution capacity was attenuated before the third year,and then rose markedly (P＜0.05).In the control group,the between-year differences of seven subdomains were not statistically significant (all P＞0.05).Conclusions Cognitive function of PD patients decreases significantly in some domains,such as delayed recall,attention,abstraction task and orientation after a five-year followup.
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OBJECTIVE:To systematically evaluate therapeutic efficacies of perioperative application of single-dose and multipie-dose of antibiotics for preventing surgical site infection after closed fractures patients receive incision and internal fixation,and to provide evidence-based reference.METHODS:Retrieved from PubMed,EMBase,CBM,Cochrane Library,CBM,CJFD,VIP and Wanfang database,RCTs about perioperative application of single-dose (trial group) and multiple-dose (control group) of antibiotics for preventing surgical site infection after closed fractures patients receive incision and internal fixation were collected.Meta-analysis was performed using Rev Man 5.3 statistical software after literature screening,data extraction and quality evaluation by improved Jadad.RESULTS:Finally 8 clinical studies were included,involving 3 457 patients.The results of Meta-analysis showed that there was no statistical significance in the rate of surgical site infection [OR=1.02,95％ CI(0.63,1.66),P=0.94)].Cefazolin stadies were included in subgroup analysis according to drug use,and results of Meta-analysis showed that there was no statistical significance in the rate of surgical site infection[OR=1.33,95％CI(0.55,3.20),P=0.52].CONCLUSIONS:Prophylactic application of single-dose of antibiotics is recommended for preventing surgical site infection after closed fractures patients receive incision and internal fixation.
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Objective To investigate the early MRI performance and the evolution of premature infants who developed into periventficular leucomalacia (PVL) eventually.Methods Twelve premature infants diagnosed as PVL by MRI in the department of neonatology in Shengjing Hospital of China Medical University from Jan 2010 to Dec 2013 were selected,all of the cases underwent conventional MRI and diffusion-weighted imaging (DWI) examination twice,the first examinations were finished in 2 to 7 days (mean 5.5 d) after birth and the second examinations were taken in 17 to 23 days(mean 20.3 d).Results The first examination showed:all cases performed high signal intensity of periventricular matter,including 6 diffuse and symmetrical,3 linear and 3 clustered high signal.However,only 5 of the 12 cases showed slightly high signal on T1 weighted image with low signal on T2 weighted image on conventional MRI,the other 7 cases showed no change;for the reexamination:foci of different numbers and sizes showed up in all cases,with the performance of low signal on T1 weighted image,high signal on T2 weighted image and low signal on DWI correspondingly.Conclusion DWI is superior to conventional MRI in finding and forecasting PVL;diffuse white matter damage have more probability to develop into PVL,severe local white matter damage such as multi-clustered and linear damage also can develop into PVL.
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OBJECTIVE:To provide reference for the establishment of more rational preparation model of total nutrient admixture(TNA).METHODS:The problems existing in the preparation of TNA were discussed and the reasons were ana?lyzed.RESULTS&CONCLUSION:Improvement in TNA formulation,personalized medication;Proper selection of form of medication,dosage and preparation method;The quality control and consultation by the nutritional support group members;Monitoring of the patients,and appropriate adjustment of TNA prescription ratios all can help to improve the quality of TNA and promote its wide use in clinic.
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@#ObjectiveTo survey 0—6 years old disabled children in Guiyang.Methods4 999 children aged 0—6 years old chosen randomly from 9 145 children of 12 blocks were investigated with the disability sampling survey criteria of 1987.ResultsThe rate of disabled children in Guiyang was 1.58%, and was not significantly different compared with that of whole country (1.36%) and other three areas including Siping City (P>0.05),but significantly higher than that of other six districts including Heping district of Tianjin municipality (P<0.05). All kinds of disability found by this survey were separately intellectual disability (0.92%),comprehensive disability (0.28%),limb disability (0.24%),vision disability (0.10%),psychiatric disability (0.03%),and hearing disability (0.02%). Rates of intellectual and vision disabilities were significantly higher than that of whole country ( P>0.05).ConclusionSome diseases are directly relative to occurrence of disability. The poor income of the children family,lower education of his parents and not gotten preschool education were risk factors of disability. The institution based rehabilitation and community based rehabilitation are main rehabilitation forms to disabled children.