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1.
Article in Chinese | WPRIM | ID: wpr-909514

ABSTRACT

Objective:To describe the health-promoting lifestyle of caregivers of children with neurodevelopmental disorders and analyze its influencing factors.Methods:A total of 352 caregivers of children with neurodevelopmental disorders in a hospital in Shenzhen were investigated by questionnaire.The main caregivers were investigated with health-promotion lifestyle scale Ⅱ.Generalized linear model was used to analyze the influencing factors of the health promoting lifestyle score of the caregivers by SPSS 20.0 and R 3.6.0 softwares.Results:The total score of health promotion lifestyle for caregivers of children with neurodevelopmental disorders was (127.66±17.87). The standardized score was (62.05±8.96), with the highest standardized score being (69.62±11.04) for the nutrition dimension and the lowest score being (51.67±11.45) for the physical activity dimension.The difference between the groups was statistically significant ( F=62.780, P<0.01). The results of linear regression analysis showed that the education level ( "junior college" vs "primary and junior high school" : β=14.524, t=3.054, P=0.002; "undergraduate and above" vs "primary and junior high school" : β=18.561, t=3.936, P<0.001), care time ( ">3 years" vs " <1 year" : β=-7.156, t=-3.687, P=0.003), and family income ( "10 000-20 000 yuan/ month" vs "<5 000 yuan/month" : β=14.351, t=3.050, P=0.002) were the influencing factors of health promotion lifestyle of caregivers. Conclusion:The life style of caregivers should be paid attention to.It is necessary to help them improve their health-promoting lifestyle through multiform health promotion methods.

2.
Article in English | WPRIM | ID: wpr-916991

ABSTRACT

Background@#Our previously prepared ceftiofur (CEF) hydrochloride oily suspension shows potential wide applications for controlling swine Streptococcus suis infections, while the irrational dose has not been formulated. @*Objectives@#The rational dose regimens of CEF oily suspension against S. suis were systematically studied using a pharmacokinetic-pharmacodynamic model method. @*Methods@#The healthy and infected pigs were intramuscularly administered CEF hydrochloride oily suspension at a single dose of 5 mg/kg, and then the plasma and pulmonary epithelial lining fluid (PELF) were collected at different times. The minimum inhibitory concentration (MIC), minimal bactericidal concentration, mutant prevention concentration (MPC), post-antibiotic effect (PAE), and time-killing curves were determined. Subsequently, the area under the curve by the MIC (AUC 0–24h /MIC) values of desfuroylceftiofur (DFC) in the PELF was obtained by integrating in vivo pharmacokinetic data of the infected pigs and ex vivo pharmacodynamic data using the sigmoid E max (Hill) equation. The dose was calculated based on the AUC 0–24h /MIC values for bacteriostatic action, bactericidal action, and bacterial elimination. @*Results@#The peak concentration, the area under the concentration-time curve, and the time to peak for PELF's DFC were 24.76 ± 0.92 µg/mL, 811.99 ± 54.70 μg·h/mL, and 8.00 h in healthy pigs, and 33.04 ± 0.99 µg/mL, 735.85 ± 26.20 μg·h/mL, and 8.00 h in infected pigs, respectively. The MIC of PELF's DFC against S. suis strain was 0.25 µg/mL. There was strong concentration-dependent activity as determined by MPC, PAE, and the time-killing curves. The AUC 0–24h /MIC values of PELF's DFC for bacteriostatic activity, bactericidal activity, and virtual eradication of bacteria were 6.54 h, 9.69 h, and 11.49 h, respectively. Thus, a dosage regimen of 1.94 mg/kg every 72 h could be sufficient to reach bactericidal activity. @*Conclusions@#A rational dosage regimen was recommended, and it could assist in increasing the treatment effectiveness of CEF hydrochloride oily suspension against S. suis infections.

3.
Article in Chinese | WPRIM | ID: wpr-908389

ABSTRACT

Objective:To understand the change trend and influencing factors of fecal calprotectin(FC) in very low birth weight(VLBW) infants, and to explore the application value of FC detection in the diagnosis of necrotizing enterocolitis(NEC) in VLBW infants.Methods:VLBW infants hospitalized in the neonatal department at Quanzhou Children′s Hospital from June 2018 to May 2019 were selected as research object for a prospective study.Fecal samples from the 1st, 7th, 14th, 21st, 28th and 35th days after birth and fecal samples from the acute and recovery stages of NEC were collected continuously.The content of FC was determined quantitatively by immunofluorescence assay.Results:(1) The FC level of non NEC VLBW infants from 1 to 35 days after birth was 143.5(47.8, 391.2) μg/g.Univariate analysis showed that the level of FC fluctuated with the postnatal age, the level of FC was the highest at 21 days, and then decreased.The level of FC increased significantly in formula feeding, premature rupture of membranes, neonatal sepsis, feeding intolerance and pregnant mothers without glucocorticoid before delivery( P< 0.05). (2) Multivariate covariance analysis showed that prenatal application of glucocorticoid( F=10.550, P=0.001), premature rupture of membranes( F=13.311, P<0.001), neonatal sepsis( F=8.001, P=0.005), feeding intolerance( F=4.751, P=0.030) and NEC( F=54.566, P<0.001) had significant effects on FC level.After controlling the effects of prenatal corticosteroid, premature rupture of membranes, neonatal sepsis and feeding intolerance, the levels of FC in NEC group and non-NEC group were 3 162.3(1 412.5-7 244.4)μg/g and 141.3(125.9-162.2)μg/g, respectively.In NEC group, the levels of FC in acute stage and recovery stage were 3 166.9(1 745.1, 6 806.4)μg/g and 130.9(97.4, 273.9)μg/g, respectively, with significant difference( t=10.304, P<0.001). While the levels of FC were 2 347.9(1 404.4, 5 893.4)μg/g in the mild NEC and 4 114.7(2 764.5, 9 208.4)μg/g in the moderate or severe NEC, respectively, with no significant difference( t=1.131, P=0.280). Conclusion:The levels of FC fluctuate with postnatal age and it is affected by multiple factors.FC maybe a useful marker for the diagnosis and evaluation of efficacy of NEC in VLBW infants.

4.
Article in Chinese | WPRIM | ID: wpr-882502

ABSTRACT

Objective:To observe the effects of lentivirus-mediated shRNA silencing of PRL-3 gene on the proliferation, migration and invasion of lung cancer A549 cells and regulation of epithelial-mesenchymal transition (EMT) signaling pathway.Methods:Lung cancer A549 cells were transfected with lentiviral interference vector carrying PRL-3 shRNA to build a stable PRL-3-silencing cell line. The cells were divided into blank control group, NC shRNA group (negative control group) and PRL-3 shRNA group (PRL-3 inhibiting RNAi lentivirus group). CCK-8 method, colony formation assay, Transwell and invasion chamber assay were performed to detect the proliferation, migration and invasion ability of A549 cells respectively. The expressions of E-cadherin and Snail mRNA were detected by real-time fluorescent quantitative PCR.Results:The stable PRL-3-silencing cell line was successfully constructed. The knockdown efficiency of PRL-3 gene in the PRL-3 shRNA group reached 83.5%. CCK-8 method detected the proliferation ability of A549 cells, and the results showed the 24 h absorbance ( A) values of A549 cells in the blank control group, NC shRNA group and PRL-3 shRNA group were 0.296±0.008, 0.342±0.007 and 0.292±0.004, with a statistically significant diffe-rence ( F=106.300, P<0.001), and the PRL-3 shRNA group was significantly lower than the NC shRNA group ( P<0.001); at 48, 72, 96 h after transfection, the cell proliferation abilities of the PRL-3 shRNA group were also significantly inhibited. Colony formation assay showed that the numbers of colony formation in the blank control group, NC shRNA group and PRL-3 shRNA group were 166.7± 6.7, 158.0±6.1 and 119.7±1.5 ( F=67.290, P<0.001). The ability of colony formation of the PRL-3 shRNA group was significantly lower than that of the NC shRNA group ( P<0.001). The numbers of migrated cells in the blank control group, NC shRNA group and PRL-3 shRNA group were 100.0±1.9, 98.8±1.9 and 44.6±7.6 ( F=430.300, P<0.001). The migration ability of the PRL-3 shRNA group was significantly lower than that of the NC shRNA group ( P<0.001). The numbers of invaded cells in the three groups were 117.7±4.1, 113.1±6.6 and 55.6±8.4 ( F=247.200, P<0.001). The invasion ability of the PRL-3shRNA group was significantly lower than that of the NC shRNA group ( P<0.001). Real-time fluorescent quantitative PCR detection results showed that after silencing the expression of PRL-3, the relative expression level of E-cadherin mRNA in A549 cells was significantly up-regulated, and the level of Snail mRNA was significantly down-regulated. Conclusion:PRL-3 silencing can inhibit the proliferation, migration and invasion of A549 cells effectively. PRL-3 may affect the invasion of lung cancer cells through the EMT pathway.

5.
Article in Chinese | WPRIM | ID: wpr-756154

ABSTRACT

Objective To study the clinical manifestations and antibiotic sensitivity features of early-and late-onset invasive infections caused by group B Streptococcus (GBS). Methods A total of 96 infants with invasive GBS infections were enrolled prospectively from seven tertiary hospitals of GBS Infection Research Cooperative Group in southwest Fujian, such as Xiamen Maternal and Child Care Hospital, etc., from January 2016 to June 2018. According to the onset time of infection after birth, they were divided into early-onset GBS disease (GBS-EOD) group (<7 d, n=67) and the late-onset GBS disease (GBS-LOD) group (7-89 d, n=29). Clinical manifestations, disease spectrum, complications and outcomes of the two groups were compared. Drug sensitivity test was carried out using disk diffusion test. Chi-square or Fisher's exact test, two independent sample t-test or Mann-Whitney U tests were used for statistical analysis. Results (1) The average ages at onset in GBS-EOD and GBS-LOD groups were (15.8±6.7) h (0.5-142.0 h) and (25.0±8.1) d (9-89 d), respectively. The incidence of tachypnea, pallor, fever and convulsion were noted in 68.7% (46/67) vs 44.8% (13/29), 52.2% (35/67) vs 17.2% (5/29), 23.9% (16/67) vs 65.5% (19/29) and 7.5% (5/67) vs 48.3% (14/29) of GBS-EOD and GBS-LOD groups with χ2 values of 6.282, 10.199, 15.146 and 21.237 (all P<0.05). The main clinical manifestations of GBS-EOD were tachypnea and pallor, while most of the patients in the GBS-LOD group developed fever and convulsions. (2) The incidence of pneumonia, sepsis, meningitis, sepsis complicated by septic joints, pneumonia complicated by sepsis, sepsis complicated by meningitis and pneumonia complicated by sepsis and meningitis were noted in 43.3% (29/67) vs 20.7% (6/29), 9.0% (6/67) vs 17.2% (5/29), 0.0% (0/67) vs 3.4% (1/29), 0.0% (0/67) vs 6.9% (2/29), 31.3% (21/67) vs 13.8% (4/29), 6.0% (4/67) vs 31.0% (9/29) and 10.4% (7/67) vs 6.9% (2/29) of GBS-EOD and GBS-LOD groups. There was a statistically significant difference in the disease spectrum between the two groups (Fisher's exact test, all P<0.001). Compared with the GBS-LOD group, the GBS-EOD group had a higher incidence of pneumonia [85.1% (57/67) vs 41.4% (12/29), χ2=19.116, P<0.001] and a lower incidence of meningitis [16.4% (11/67) vs 41.4% (12/29), χ2=6.922, P=0.009]. Complications such as acute respiratory distress syndrome (ARDS), pulmonary hemorrhage, shock and persistent pulmonary hypertension of the newborn (PPHN) occurred much more in the GBS-EOD group than the GBS-LOD group [28.4% (19/67) vs 6.9% (2/29), 13.4% (9/67) vs 0.0% (0/29), 11.9% (8/67) vs 10.3% (3/29), 4.5% (3/67) vs 0.0% (0/29), χ2=13.683, P<0.001]. (3) Among the 96 patients, 23 (24.0%) had meningitis and 73 (76.0%) developed pneumonia and sepsis. Meningitis resulted in a higher fatality rate [17.4% (4/23) vs 4.1% (3/73), χ2=4.564, P=0.035] and longer average hospital stay [(37.2±12.6) vs (14.1±5.3) d, t=7.831, P<0.001] than pneumonia and sepsis. Seven out of the 19 meningitis survivors developed intracranial complications. (4) The overall fatality rate in this study was 7.3% (7/96) and no significant difference was found between GBS-EOD and GBS-LOD group [7.5% (5/67) vs 6.9% (2/29), χ2=0.010, P=0.982]. Among the 67 GBS-EOD infants, 58 (86.6%) occurred within 24 h and five of them died, but no death was reported in the other nine cases occurred after 24 h. (5) Totally 96 strains of GBS were isolated with 100% sensitivity to penicillin, ampicillin, cefazolin and meropenem, and 97% to vancomycin. Around 79.3%-91.0% of GBS isolates were resistant to clindamycin and erythromycin. Conclusions Clinial features vary greatly in GBS-LOD and GBS-EOD cases. Infants with meningitis have poor prognosis. The drug resistance rate of GBS to erythromycin and clindamycin are relatively high.

6.
Article in Chinese | WPRIM | ID: wpr-756117

ABSTRACT

Objective To analyze the role of intestinal fatty acid-binding protein (I-FABP) expression in a neonatal rat model of necrotizing enterocolitis (NEC).Methods A total of 24 newborn rats were randomly divided into two groups:control group (n=6) and NEC group (n=18).Rats in the NEC group were fed with formula and experienced hypoxia,reoxygenation,cold stress and sequentially Lipopolysaccharide (10 mg/kg) lavage for three consecutive days to establish NEC model,after which were respectively sacrificed on day 1,2 and 3 (six for each day).Those in the control group were all sacrificed on day 3.Ileocecal tissues were collected for morphological and histological analysis.I-FABP expression was detected using Western blot and immunohistochemistry (IHC).One-way analysis of variance,LSD-t test,Kruskal-Wallis H test,Mann-Whitney U test and Pearson's correlation analysis were used for statistical analysis.Results The NEC model (intestinal pathological score ≥ 2) was established successfully without causing death.Compared with the control group,the NEC group showed less body weight gain [M (P25-P75):1.00 (0.48-1.35) vs 1.74 (1.62-1.86),1.25 (0.75-1.40) vs 2.61 (2.53-2.99),1.35 (0.88-1.48) vs 3.60 (3.48-3.73);Z=-2.898,-2.903,-2.892;all P<0.05] and higher intestinal pathological scores [(2 (2-3),3 (2-3),4 (3-4) vs 0 (0-1);all P<0.05] on day 1,2 and 3.The intestinal pathological score on day 3 was significantly higher than that on day 2 and day 1 (both P<0.05).Expression of I-FABP and the number of I-FABP positive enterocytes in the NEC model group were increased compared with those in the control group [Western blot:0.179 (0.179-0.186),0.231 (0.211-0.245),0.202 (0.192-0.225) vs 0.091 (0.086-0.093);IHC:59 (55-60),80 (83-86),80 (84-88) vs 44 (39-47);all P<0.05].Moreover,the expression of I-FABP protein and the number of I-FABP positive enterocytes on day 2 and day 3 were significantly higher than those on day 1 (all P<0.05).I-FABP expression was positively associated with intestinal pathological score (Western blot:r=0.932,95%CI:0.872-0.969;IHC:r=0.709,95%CI:0.484-0.872).Conclusions I-FABP is an efficient marker for NEC and correlates with the severity of intestinal injury.

7.
Article in Chinese | WPRIM | ID: wpr-753592

ABSTRACT

Objective To investigate the utilization of antibacterial drugs in the old community-acquired pneumonia (CAP) with chronic obstructive pulmonary disease(COPD) in our hospital.To analyze the rational application of antibacterial drugs,thus to provide a powerful reference for clinical diagnosis and treatment.Methods From June 2011 to June 2013,100 patients with COPD and CAP were selected in Xiaolan People's Hospital.The average age was (76.95 ±6.57) years old,including 62 males and 38 females.The utilization of antibacterial drugs was investigated by retrospective study in the patients.Results In the course of treatment,the rate of using the antibacterial drugs in 100 patients was 100%,concerning 13 varieties of 5 major categories,including β-lactam (including β-lactam/β-lactamase inhibitors),quinolones,carbapenems,macrolides,aminoglycosides.The largest frequency was piperacillin/sulbactam,up to 92.Ceftezole,cefotian and azithromycin were less than 0.9 for DUI in DDDS ordering 10 drugs,it showed that the frequency was insufficient or the dosage was too small.For example,insufficient frequency of cephalosporin once a day and small dosage of azithromycin 0.25g once a day.Combination with two kinds of antimicrobial drugs was common,it was relatively rational between the combination of drugs,usually cephalosporins + quinolones,β-lactam/β-lactamase inhibitors + quinolones,β-lactam/β-lactamase inhibitors + macrolides.Conclusion The etiology of 100 elderly patients with COPD and CAP in our hospital is mainly Gram-negative bacteria.The anti-infection treatment is mainly cefdiazine and piperacillin/sulbactam,and the combined drug was mainly quinolones.The drug regimen and treatment course are reasonable,there is a high prognosis in the patients.

8.
Chinese Journal of Neonatology ; (6): 385-389, 2019.
Article in Chinese | WPRIM | ID: wpr-753041

ABSTRACT

Objective To study the expression of intestinal intestinal fatty acid-binding protein (I-FABP) and its clinical significance in an experimental model of necrotizing enterocolitis (NEC) in neonatal rats. Method Twenty-four neonatal Sprague-Dawley (SD) rats were randomly assigned into 4 groups at 48 h after birth (6 rats in each group):group A (control group), group B (NEC group-1), group C (NEC group-2), and group D (NEC group-3). The neonatal rats were fed by the mother rats in the same cage within 48 h after birth. After 48 h, the NEC group received artificial feeding, hypoxia, cold stimulation and lipopolysaccharide (LPS) gavage (10 mg/kg). NEC group-1, 2 and 3 were sacrificed on an empty stomach at 1, 2 and 3 d after the modeling. The control group was sacrificed on an empty stomach 3 d after the modeling without special treatment. Intestinal tissue were obtained from each rats. The histological changes of ileal tissues were studied using hematoxylin-eosin (HE) staining. The expressions of intestinal I-FABP were detected using RT-PCR and ELISA methods. Result Compared with the control group, body weight of rats in NEC group-1, 2 and 3 were lower, and pathology scores in these three groups were higher (P<0.05). The levels of intestinal I-FABP mRNA in NEC group-1, NEC group-2 and NEC group-3 were 2.69±0.27, 2.12±0.09, 3.18± 0.22, respectively. The protein expression levels were 363.7 ± 11.4, 321.7 ± 45.8, 432.3 ± 50.3, respectively. The mRNA and protein levels were all significantly higher than the control group (mRNA: 1.00 ± 0.02, protein: 134.2 ± 24.0, P<0.05). Conclusion I-FABP was a useful marker for ischemic injury to the intestine. These findings may contribute to a better diagnosis of NEC in newborns.

9.
Chinese Journal of Neonatology ; (6): 334-337, 2019.
Article in Chinese | WPRIM | ID: wpr-753031

ABSTRACT

Objective To study the clinical effects of continuous blood purification (CBP) in the treatment of newborns with severe sepsis and multiple organ dysfunction syndrome (MODS). Method From May 2013 to November 2018, the clinical data of infants with severe sepsis and MODS receiving CBP in the neonatal department of our hospital were retrospectively analysed. Changes of blood pressure, arterial partial pressure of oxygen/inhaled oxygen concentration (PaO2/FiO2), pH, serum potassium, sodium, urea nitrogen, creatinine, urine volume and maintenance dose of adrenaline at different time points before and after CBP were analysed. Result According to the inclusion and exclusion criteria, a total of 8 newborns with sepsis and MODS were enrolled in the study. One patient had the complication of perforated colon, and the other one had acute renal failure. The number of affected organs in these infants was 3~5. Six cases began CBP treatment within 1~5 days after admission, and the other two cases began CBP treatment on the 38th and 47th days after admission. The average treatment duration was (58.6±25.9) h. The effective rate of CBP in the treatment of severe sepsis with MODS was 75.0%(6/8). Blood pressure was increased at 6 h, 12 h, 24 h and 48 h after treatment and at the end of treatment. PaO2/FiO2 and blood pH were increased. The urine volume was increased at 24 h and 48 h after treatment and at the end of treatment (P<0.05). Serum potassium, urea nitrogen and creatinine were significantly decreased (P<0.05). The maintenance dose of adrenaline was also decreased significantly at 12 h after CBP (P<0.05), and withdrawn at 48 h after treatment. Only one case experienced membrane blockage during CBP. Dialysis was continued after the replacement of filtration membrane. No other complications existed. Conclusion CBP is effective in the treatment of neonatal severe sepsis with MODS. It can improve the circulation and renal function.

10.
Article in Chinese | WPRIM | ID: wpr-752916

ABSTRACT

Objective To explore the value of amplitude integrated electroencephalography (aEEG) in cerebral function monitoring in preterm infants younger than 30 weeks of gestation. Methods A total of 165 cases of preterm infants younger than 30 weeks of gestation were prospectively enrolled in the study from September 2015 to February 2017,including 20 preterm infants with severe brain injury ( severe brain injury group) and 145 with non-severe brain injury ( non-severe brain injury group). Five aspects of each tracing, such as continuity(Co),sleep-wake cycling( Cy),amplitude of the lower border(LB),bandwidth( B) and total maturation scores,were evaluated and compared between two groups by applying a preterm infants aEEG scoring system. The neuromotor development of preterm infants survivors was assessed by using the 0 to 6 years old children′s neurological and psychological development scale of China Capital Institute of Pediatrics. Clinical data were collected and compared with the results of aEEG. Results The scores for Co,Cy,LB,B as well as total maturation scores of preterm infants with severe brain injury at different gestational age were lower than those of infants with non-severe brain injury at the same gestational age. The differences were sta-tistically significant (all P<0. 05). There were no statistical differences in Co,Cy,LB,B scores and total maturation scores between each gestational ages in severe brain injury group (all P>0. 05). Scores for Co, Cy,B and total maturation scores progressively increased with advancing gestational age in non-severe brain injury group( all P <0. 05),but there were no statistical differences between each gestational ages in LB scores(all P>0. 05). Follow-up results of 16 cases with severe brain injury:15 cases of DQ≤69,1 case of DQ 70-84,and no cases of DQ≥85; 130 cases of non-severe brain injury group:78 case of DQ≥85,42 cases of DQ 70-84,10 cases of DQ≤69. By chi-square analysis and Spearman rank correlation analysis,the results of aEEG total maturation scores were correlated with outcome of these preterm infants younger than 30 weeks of gestation ( r =0. 702,P <0. 05). Conclusion aEEG can provide important information of the status of cerebral function in preterm infants younger than 30 weeks of gestation and help to predict their outcome.

11.
Article in English | WPRIM | ID: wpr-758947

ABSTRACT

Misuse and abuse of veterinary antimicrobial agents have led to an alarming increase in bacterial resistance, clinical treatment failure, and drug residues. To address these problems, consistent and appropriate dosage regimens for veterinary antimicrobial agents are needed. Pharmacokinetics/Pharmacodynamics (PK/PD) models have been widely used to establish rational dosage regimens for veterinary antimicrobial agents that can achieve effective prevention and treatment of bacterial diseases and avoid the development of bacterial resistance. This review introduces building methods for PK/PD models and describes current PK/PD research progress toward rational dosage regimens for veterinary antimicrobial agents. Finally, the challenges and prospects of PK/PD models in the design of dosage regimens for veterinary antimicrobial agents are reviewed. This review will help to increase awareness of PK/PD modeling among veterinarians and hopefully promote its development and future use.


Subject(s)
Anti-Infective Agents , Bacterial Infections , Drug Residues , Humans , Treatment Failure , Veterinarians
12.
Article in Chinese | WPRIM | ID: wpr-801491

ABSTRACT

Objective@#To investigate the utilization of antibacterial drugs in the old community-acquired pneumonia (CAP) with chronic obstructive pulmonary disease(COPD) in our hospital.To analyze the rational application of antibacterial drugs, thus to provide a powerful reference for clinical diagnosis and treatment.@*Methods@#From June 2011 to June 2013, 100 patients with COPD and CAP were selected in Xiaolan People's Hospital.The average age was (76.95±6.57) years old, including 62 males and 38 females.The utilization of antibacterial drugs was investigated by retrospective study in the patients.@*Results@#In the course of treatment, the rate of using the antibacterial drugs in 100 patients was 100%, concerning 13 varieties of 5 major categories, including β-lactam (including β-lactam/β-lactamase inhibitors), quinolones, carbapenems, macrolides, aminoglycosides.The largest frequency was piperacillin/sulbactam, up to 92.Ceftezole, cefotian and azithromycin were less than 0.9 for DUI in DDDS ordering 10 drugs, it showed that the frequency was insufficient or the dosage was too small.For example, insufficient frequency of cephalosporin once a day and small dosage of azithromycin 0.25g once a day.Combination with two kinds of antimicrobial drugs was common, it was relatively rational between the combination of drugs, usually cephalosporins+ quinolones, β-lactam/β-lactamase inhibitors+ quinolones, β-lactam/β-lactamase inhibitors+ macrolides.@*Conclusion@#The etiology of 100 elderly patients with COPD and CAP in our hospital is mainly Gram-negative bacteria.The anti-infection treatment is mainly cefdiazine and piperacillin/sulbactam, and the combined drug was mainly quinolones.The drug regimen and treatment course are reasonable, there is a high prognosis in the patients.

13.
Chinese Journal of Oncology ; (12): 949-952, 2019.
Article in Chinese | WPRIM | ID: wpr-800455

ABSTRACT

Lung cancer is the most frequently diagnosed cancer and the most common cause of cancer mortality in China. Non-small cell lung cancer (NSCLC) accounts for about 85% of lung cancers. The mutation rate of epidermal growth factor receptor (EGFR) gene is relatively high, accounts for 32%~38% of all NSCLC. During the last decade, the application of EGFR specific tyrosine kinase inhibitors (TKI) significantly improved prognosis of NSCLC patients with sensitive EGFR mutations. Thus, the research and development of third generation EGFR-TKI have entered the period of rapid development. The fourth generation EGFR-TKI which targeting EGFR C797S has even begun clinical development in China. This review will discuss the clinical research and drug review of EGFR-TKI from the perspective of drug review.

14.
Chinese Journal of Neonatology ; (6): 437-441, 2018.
Article in Chinese | WPRIM | ID: wpr-699325

ABSTRACT

Objective To study the clinical value of transcutaneous O2 (TcPO2) and transcutaneous CO2 (TcPCO2) monitoring among infants with respiratory failure.Method From August 2017 to February 2018,neonates with respiratory failure treated with nasal continuous positive airway pressure (NCPAP) or mechanical ventilation (MV) in the neonatal department were prospectively enrolled.At four time points of 30 min,6 h,24 h after respiratory support and before discharged,TcPO2 and TcPCO2 were compared with PaO2 and PaCO2 using the correlation and consistency analysis methods.Result A total of 368 paired samples from 92 infants were collected.The correlations of TcPCO2 and PaCO2 at 30 min,6 h,24 h and before discharged were strong (r =0.790,95 % CI 0.656 ~ 0.884;r =0.827,95 % CI 0.710 ~ 0.908;r =0.901,95 % CI 0.867 ~ 0.932;r =0.905,95 % CI0.830 ~ 0.954,P < 0.05).The correlations of TcPO2 and PaO2 at 30 min,6 h,24 h were weak (r =0.629,95% CI 0.461 ~ 0.767;r =0.638,95% CI 0.465 ~ 0.793;r =0.739,95 % CI 0.619 ~ 0.831),but strong before discharged (r =0.886,95 % CI 0.818 ~ 0.934).Conclusion When tissue well perfused,TcPCO2 is an accurate,continuous and noninvasive marker to evaluate the PaCO2 of neonates with respiratory failure.But TcPO2 cannot reflect PaO2 accurately,and the combination of other index of oxygenation should be used.

15.
Article in Chinese | WPRIM | ID: wpr-697194

ABSTRACT

Objective To study the value of SALT method in disaster assistance. Methods A total of 84 internship nurses from 2015 to 2017 were randomly divided into group SLAT and group START and accepted different classification methods training, then checked under the scene of simulated mass casualty events (car accident and earthquake) and the results of the examination were compared. Results The triage time of the SALT group was (8.00±1.36) min, (23.14±1.95) min,less than (10.05±1.34) min, (25.07±2.22) min in the START group in the car accident scene and the earthquake scene and the differences were statistically significant (t=-6.94,-4.23, P<0.05). The accuracy of different classifications under the same scene were compared and there was no statistical significance in the difference(P>0.05). The accuracy of the triage in the car accident scene were better than earthquake scenes of the both SALT and START classifications and differences were statistically significant ( χ2=10.49, 10.54,P<0.05). The consistency of the SALT classification and the START classification was better (Kappa=0.526, P<0.01). Conclusions The SALT method has the advantages of simple, easy to master, accurate and reliable. It is consistent with the traditional START method, but the time of classification is shorter and recommended to be used in the teaching of disaster medicine and the rescue of real disasters.

16.
Article in Chinese | WPRIM | ID: wpr-696489

ABSTRACT

Objective To explore the clinical characteristics of human bocavirus (HBoV) infection in the children with severe lower respiratory tract infection.Methods The clinical data of the hospitalized children with sputum HBoV-positive were analyzed retrospectively,who were hospitalized at the Pediatric Intensive Care Unit of Children's Hospital Affiliated to Capital Institute of Pediatrics from September 1,2016 to March 31,2017.Results A total of 17 children were included in the study.The ratio of male to female was 15 ∶ 2.The diagnostic age ranged from 4 months to 4 years and 10 months old.82.4% (14/17 cases) of the patients were infants less than 2 years old.Autumn and winter were high-occurrence seasons.Pediatric Critical Illness Scores(PCIS) were 68-88 scores(median 82 scores).PCIS was less than 70 scores in 1 case,and between 70 scores and 80 scores in 7 cases,and more than 80 scores in 9 cases.The main clinical manifestations were respiratory system involvement,including dyspnea in 17 cases (100%),fever in 14 cases (82.4%),cough in 16 cases (94.1%),wheezing in 13 cases (76.5%),and moist rales in 13 cases (76.5%).The main abnormal chest radiological findings showed patchy shadows in 7 cases (41.2%) and consolidation in 6 cases (35.3%).The oxygenation index was 73.9-296.0 mmHg(1 mmHg =0.133 kPa),and median was 176 mmHg.The oxygenation index was between 100-200 mmHg in 7 cases(41.2%),and less than 100 mmHg in 2 cases(11.7%).Type Ⅰ respiratory failure occurred in 11 cases (64.7%),while type Ⅱ respiratory failure occurred in 6 cases (35.3 %).All of the patients need respiratory support with mechanical ventilation.Among them,6 patients (35.3%) were treated by non-invasive ventilation and their ventilation time were 25-128 h(median 65 h),while 11 patients (64.7%) were treated by invasive ventilation and their ventilation time was 42-178 h(median 70 h).Other organ or system dysfunction is mild.The length of hospital stay ranged from 3 days to 13 days.The cure rate was 100%.Conclusions HBoV infection in the children with severe lower respiratory tract infection is common in infants under 2 years old,with acute onset and rapid recovery.The obvious clinical symptoms are fever,cough,wheezing and dyspnea.Although respiratory failure is common,other organ or system dysfunction is mild,which may bring about a good prognosis.

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Article in Chinese | WPRIM | ID: wpr-662398

ABSTRACT

Objective To explore the value of amplitude integrated electroencephalography ( aEEG) in diagnosis and prognosis in neonates with acute hypoglycemic brain injury. Methods A total of 47 cases of neonatal hypoglycemic brain injury were prospectively enrolled in the study from January 2011 to July 2015. The aEEG traces were classified according to background activity ( normal,moderate,or severely abnormal) , presence of seizures and sleep-wake cycling ( SWC) . The neuromotor development of survivors with neonatal hypoglycemic brain injury was assessed by using the 0-6 years old children′s neurological and psychological development scale of China Capital Institute of Pediatrics. Clinical data were collected and compared with the result of aEEG. Results The characteristic of aEEG tracings in 47 infants showed continuous normal voltage (CNV)(n=9),discontinuous voltage(DC)(n=29),continuous low voltage(CLV)(n=3),burst-suppres-sion(BS)(n=6);mature sleep-wake cycling(SWC)(n=9),immature SWC(n=17),no SWC (n=21);39 infants(83. 0%) had electrical seizures:single seizure(n=11),repetitive seizures(n=20),and status ep-ilepticus (SE)(n=8). aEEG of 23 infants who had poor outcome showed CLV(n=3),BS/SE(n=4),BS/repetitive seizures( n =2 ) , DC/SE ( n =4 ) , DC/repetitive seizures ( n =10 ) . By chi-square analysis and Spearman rank correlation analysis,the results of aEEG classification,background pattern and SWC were cor-related with outcome of these infants with hypoglycemic brain injury. Conclusion Amplitude integrated electroencephalography can provide important information of the status of cerebral function in neonates with acute hypoglycemic brain injury and help to predict their outcome.

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Article in Chinese | WPRIM | ID: wpr-659959

ABSTRACT

Objective To explore the value of amplitude integrated electroencephalography ( aEEG) in diagnosis and prognosis in neonates with acute hypoglycemic brain injury. Methods A total of 47 cases of neonatal hypoglycemic brain injury were prospectively enrolled in the study from January 2011 to July 2015. The aEEG traces were classified according to background activity ( normal,moderate,or severely abnormal) , presence of seizures and sleep-wake cycling ( SWC) . The neuromotor development of survivors with neonatal hypoglycemic brain injury was assessed by using the 0-6 years old children′s neurological and psychological development scale of China Capital Institute of Pediatrics. Clinical data were collected and compared with the result of aEEG. Results The characteristic of aEEG tracings in 47 infants showed continuous normal voltage (CNV)(n=9),discontinuous voltage(DC)(n=29),continuous low voltage(CLV)(n=3),burst-suppres-sion(BS)(n=6);mature sleep-wake cycling(SWC)(n=9),immature SWC(n=17),no SWC (n=21);39 infants(83. 0%) had electrical seizures:single seizure(n=11),repetitive seizures(n=20),and status ep-ilepticus (SE)(n=8). aEEG of 23 infants who had poor outcome showed CLV(n=3),BS/SE(n=4),BS/repetitive seizures( n =2 ) , DC/SE ( n =4 ) , DC/repetitive seizures ( n =10 ) . By chi-square analysis and Spearman rank correlation analysis,the results of aEEG classification,background pattern and SWC were cor-related with outcome of these infants with hypoglycemic brain injury. Conclusion Amplitude integrated electroencephalography can provide important information of the status of cerebral function in neonates with acute hypoglycemic brain injury and help to predict their outcome.

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Clinical Medicine of China ; (12): 701-704, 2017.
Article in Chinese | WPRIM | ID: wpr-612141

ABSTRACT

Objective To study the effect of temporary closure of venous pressure clamp on blood coagulation during duct rinsing in heparin free dialysis.Methods One hundred and forty cases of heparin free dialysis were divided into the control group and observation group according to the singular times dialysis and dual time dialysis,the control group (74 cases with singular times heparin free dialysis) and observation group (66 cases with dual times heparin free dialysis).The rinsing operation of the control group was consistent with the routine dialysis process.In the observation group,the venous pressure clamp was closed before the start of rinsing,and then the venous pressure clamp was opened at the end of this process.The times of alarm,blood pump suspension period,incidence rate and degree of blood coagulation were compared between the two groups to assess the degree of comfort and compliance of all patients during the process.Results The differences between the two groups in terms of times of alarm and blood pump suspension period were statistically significant ((5.7±1.8) times vs.0 times,(9.1±4.0) s vs.0s,P=0.001),the incidence rate of blood coagulation,the degree of blood coagulation above degree Ⅱ and the rate of operation completion ahead of time in the two groups were detected ((70.3% (52/74) vs.7.6% (5/66),21.6% (16/74) vs.0,8.1% (6/74) vs.0).The difference of blood coagulation degree between the two groups was statistically significant (Z=-9.185,P=0.000).Patients in the observation group had a higher grade of comfort degree((4.8±1.0) points vs.(4.2±0.63) points,P=0.001).Conclusion In the operation of heparin free dialysis,the temporary closure of venous pressure clamp can reduce the incidence rate of interruption,prolong the service life of the filter,ensures the dialysis time and treatment effect,and improve the patients' degree of comfort.

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Article in Chinese | WPRIM | ID: wpr-620634

ABSTRACT

Objective To explore the assessment and intervention categorized for patients with permanent colostomy′s continue nursing problem based on the Omaha system. Methods Developing permanent colostomy′s continue nursing problem assessment form in the framework of Omaha system, using this assessment form to evaluate 46 patients′continue nursing problem and choose appropriate interventions. Results A total of 46 patients on the day of discharge had a total of 260 continue nursing problems. There were 5.7 nursing problems averagely for every patient. Incidence of more than 50%of the nursing problems had personal care, role change, mental health, sleep and rest, digestion- hydration and social; potential continue nursing problems was 90. There were 1.97 nursing problems averagely for every patient. The main potential continue nursing problems were two, respectively was colostomy complications and colostomy surrounding skin complications. Continue nursing intervention had a total of 727. There were 15.8 continue nursing interventions averagely for every patient. The most frequent interventions were for physiological and psychosocial domain. Conclusions Omaha Question Classification System can fully assess permanent colostomy′s continue nursing problem andset corresponding nursing intervention strategiesaccording to Omaha intervention system. More attention should be paid to psychosocial and health-related behavior problem. The most frequent interventions were health education, guidance, counseling and monitoring.

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