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Objective:To explore the risk factors involved in gastritis, gastric intraepithelial neoplasia (GIN) and gastric cancer in Shihezi area.Methods:A total of 7 110 Han nationality patients who underwent gastroscopy at the First Affiliated Hospital of Shihezi University School of Medicine from January 2012 to December 2016 were selected as the research subjects. The data of patients were obtained through medical records and questionnaires. After excluding diseases related to esophagus and duodenum, a total of 4 429 cases were included in the retrospective analysis. Of which, 4 249 were gastritis, 93 were GIN, and 87 were gastric cancer. χ2 test, rank-sum test or Fisher exact probability method were used to analyze the differences of various factors in gastritis, GIN and gastric cancer. Univariate and multivariate logistic regression analysis were used to screen the risk factors for gastritis progression to GIN and gastric cancer. Results:χ2 test and rank sum test showed that there were statistically significant differences in gender, age, history of digestive diseases and distribution of Helicobacter pylori ( HP) infection among the groups of gastritis, GIN and gastric cancer ( P<0.05). The proportion of HP infection decreased gradually with the disease severity. Multivariate logistic regression analysis showed that male ( P<0.001, OR=2.251, 95% CI: 1.461-3.470), elderly ( P<0.001, OR=4.829, 95% CI: 2.241-10.409), a family history of gastric cancer ( P=0.002, OR=3.227, 95% CI: 1.537-6.774) and a history of digestive diseases ( P=0.034, OR=1.644, 95% CI: 1.037-2.607) were independent risk factors for gastritis progression to GIN. Male ( P<0.001, OR=3.254, 95% CI: 2.026-5.225), middle-aged ( P=0.022, OR=2.688, 95% CI: 1.153-6.265) and elderly ( P=0.002, OR=4.734, 95% CI: 1.750-12.807) were independent risk factors for gastritis progression to gastric cancer. In stratified analysis to exclude age and gender, smoking ( P=0.028, OR=4.060, 95% CI: 1.160-14.202) was found to be a risk factor for gastritis progression to GIN in young adults, and obesity ( P=0.032, OR=3.869, 95% CI: 1.121-13.356) was found to be a risk factor for gastritis progression to gastric cancer in women. Conclusion:The degree of HP infection in gastric tissues is negatively correlated with the severity of gastric diseases, suggesting that HP infection may be an early event inducing gastric cancer. Male, the elderly, people with a family history of gastric cancer and a history of digestive diseases, and young smokers in Shihezi are more likely to develop GIN, and male, middle-aged, elderly, and obese women are at increased risk of gastric cancer.
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The incidence of intensive nervous system disease in children is high, and there will be more or less long-term sequelae.In addition, due to age, long-term treatment costs are high, causing a great burden to society.When intensive nervous system disease occurs, the body can show an increase in sympathetic activity and catecholamine, which leads to the occurrence of takotsubo.After the occurrence of takotsubo, it can reduce the supplement of intracranial oxygen, thus aggravate the intensive nervous system disease and aggravate the adverse clinical outcome of children.Sedation and analgesia to reduce sympathetic activity can achieve the purpose of treating intensive nervous system diseases and takotsubo.
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Sedation-analgesia is one of the key components of the treatment of critical ill children in PICU.Although there are many subjective sedation assessment methods, the mechanism of different sedative drugs is diverse, so there isn′t a recognized gold standard for sedation assessment up to now.Based on the results from clinical studies regarding sedation and analgesia in critical ill children at home and abroad, this review mainly summarized the progress of clinical research on sedation and analgesia in critical ill children, focusing on the analysis of the relationship between the assessment methods, such as bispectral index and the entropy, and the prognosis of critical ill children.
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Objective:To investigate the causes of enteral nutrition interruption in pediatric intensive care unit and its relationship with prognosis.Methods:In this retrospective study, 471 critically ill children admitted to PICU of Shengjing Hospital of China Medical University from January to June 2019 were enrolled.Data were collected to describe the patient cohort(anthropometrics and diagnostic category) and nutrition practices(feeding mode, frequency, duration, and causes of feeding interruptions). The effect of nutritional interruption on the prognosis of children was statistically analyzed.Results:Ninety-four patients(20.0%) had moderate malnutrition at PICU admission, fifty-eight patients(12.3%) had severe malnutrition.The nutritional deterioration rate was 3.8%(18 cases). The average weight loss during hospitalization was -0.14 kg.A total of 181(38.4%) patients had feeding interruption(FI) during hospitalization.There were 362 episodes of FI in total, with a median of two episodes per patient.Median duration of each episode was 14.89 h. The most common cause of FI was feeding intolerance( n=158, 43.6%). There were 270 episodes of FI in children feeded with milk powder.Median energy deficits per episode was -56.53 kcal/kg.There was no significant difference regarding the duration of FI among children with different diseases, different ages and different critical scores.Children with FI had significantly longer length of hospitalization, more hospitalization costs, greater length of mechanical ventilation and greater loss of weight( P<0.05, respectively). Conclusion:Enteral nutrition interruption is very common in PICU, and FI is the main reason.Nutrition interruption will reduce energy intake, which can prolong the period of hospitalization and mechanical ventilation, increase the hospitalization cost and the weight loss.
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Objective:To analyze and summarize the clinical characteristics, diagnosis and treatment, head imaging changes and prognosis of acute necrotizing encephalopathy of childhood (ANEC), aiming to improve the understanding of this disease.Methods:Clinical data of 13 ANEC patients (there were 7 males and 6 females, the median age was 30 months) admitted to the Pediatric Intensive Care Unit (PICU) of Shengjing Hospital, China Medical University from January 2014 to December 2020 were retrospectively analyzed, including clinical manifestations, laboratory examinations, diagnosis and treatment procedures, and head imaging data.Survivors were followed up through telephone.Results:All patients had fever and convulsions before admission, and the median time between fever and consciousness disturbance was 48 hours.The magnetic resonance imaging scans showed symmetrical multifocal brain damages.All 13 patients used glucocorticoid treatment, 10 cases used human immunoglobulin treatment, 8 cases used plasma exchange treatment.A total of 7/13 patients died.Five children were regularly followed up, who presented normal height and weight development and normal immunity.One child had normal motor intelligence with the acceptable Pediatric Overall Performance Category Score, and the remaining 4 children had certain sequelae, mainly manifesting as slow speech speed and limited movement.Conclusions:ANEC mainly occurs in winter and young children with a high mortality.It progresses rapidly, and consciousness disturbance appears soon after fever and convulsion.Survivors usually have sequelae, mostly manifesting as slow speech speed and limited movement, which can be significantly improved after systematic rehabilitation treatment.
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Objective:To investigate the expression of serum uric acid and cystatin C in older adult patients with diastolic heart failure and their correlation with ventricular remodeling.Methods:The clinical data of 173 older adult patients with diastolic heart failure (patient group) and 144 older adult patients who had normal heart function (control group) who received treatment in Liaoning Jinqiu Hospital from January 2018 to January 2020 were retrospectively analyzed. Left ventricular end-diastolic diameter, left ventricular mass index, serum uric acid and cystatin C levels were compared between the two groups. These indices were also compared between patients with different classes of heart failure. Serum uric acid and cystatin C levels were correlated with left ventricular end-diastolic diameter and left ventricular mass index.Results:Left ventricular end-diastolic diameter, left ventricular mass index, and serum uric acid and cystatin C levels in the patient group were (46.82 ± 4.56) mm, (117.45 ± 24.51) g/m 2, (380.23 ± 115.85) μmol/L, (1.41 ± 0.51) mg/L, respectively, which were significantly higher than (45.8 ± 3.96) mm, (111.19 ± 19.30) g/m 2, (333.65 ± 89.02) μmol/L, (1.06 ± 0.34) mg/L, respectively in the control group ( t = 2.10, 2.48, 3.95, 7.02, all P < 0.05). Serum uric acid level in patients with class IV heart failure was (432.48 ± 157.64) μmol/L, which was significantly higher than (355.22 ± 106.56) μmol/L and (379.89 ± 93.43) μmol/L in patients with class II and class III heart failure ( F = 5.18, P < 0.05). Pearson correlation analysis showed that serum uric acid level was positively correlated with left ventricular end-diastolic diameter ( r = 0.17, P < 0.05) and left ventricular mass index ( r = 0.18, P < 0.05) in older adult patients with diastolic heart failure. Conclusion:Serum uric acid plays an important role in the occurrence and development of diastolic heart failure in older adults. Serum uric acid level can help measure the degree of ventricular remodeling to some extent.
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Acute kidney injury(AKI)is a syndrome with many different causes and can occur at different stages throughout critical illness.Renal Doppler ultrasonography is the most appropriate imaging test in the evaluation of AKI and has the highest level of recommendation: (1)assessment of intrinsic causes of AKI, (2)distinguishing acute from chronic kidney diseases, (3)detection of the causes of obstruction.The resistive index in patients with AKI will be reviewed with attention to its use for predicting the development and prognosis of AKI.Meanwhile, combined application of cardiopulmonary ultrasound and evaluation of hemodynamics are helpful to evaluate the etiology, supervision and guiding treatment of AKI.
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Objective:To evaluate the diagnostic and therapeutic value of bedside severe ultrasound in children with shock.Methods:Children who were diagnosed shock in the PICU of Shengjing Hospital of China Medical University from May 1, 2019 to April 31, 2020 were included in this study.Rapid ultrasound in shock (RUSH) exam was used to evaluate the morphology and function of heart, lung and abdomen of children with shock, so as to assist the diagnosis and treatment of shock.Results:Twenty-six children with shock were evaluated immediately according to the RUSH exam when they were admitted to hospital.Eight cases were diagnosed as septic shock, six cases as cardiogenic shock, six cases as hypovolemic shock and six cases as mixed shock.The left ventricular ejection fraction (LVEF) of children with cardiogenic shock was (26.5±8.24)%, and the width of inferior vena cava was greater than 10 mm.After the shock was corrected, LVEF increased to (32.17±26.11)%.However, the LVEF of children with septic shock was (73.25±1.28)% at admission and (50.12±31.41)% at shock correction.Nine cases (34.6%) found more B-lines in the lungs after fluid resuscitation for one hour in 26 children with shock.Among them, about 50% of the children with cardiogenic shock found more B-lines in their lungs one hour after fluid resuscitation, and 11 cases(57.9%) of the surviving children showed more B-lines after shock correction, but only six children could hear blisters after physical examination.Conclusion:According to RUSH exam, we can evaluate the volume status, cardiac function, volume responsiveness and focus on infection in children with shock, distinguish the type of shock earlier and more accurately, assist in guiding fluid resuscitation, and facilitate accurate and individualized fluid management and treatment of patients.
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OBJECTIVE@#To explore the mechanism by which ginsenoside 20(S)-Rg3 upregulates the expression of tumor suppressor von Hippel-Lindau (VHL) gene in ovarian cancer cells.@*METHODS@#Ovarian cancer cell line SKOV3 treated with 20(S)-Rg3 were examined for mRNA and protein levels of VHL, DNMT1, DNMT3A and DNMT3B by real-time PCR and Western blotting, respectively. The changes in VHL mRNA expression in SKOV3 cells in response to treatment with 5-Aza-CdR, a DNA methyltransferase inhibitor, were detected using real-time PCR. VHL gene promoter methylation was examined with methylation-specific PCR and VHL expression levels were determined with real-time PCR and Western blotting in non-treated or 20(S)-Rg3-treated SKOV3 cells and in 20(S)-Rg3-treated DNMT3A-overexpressing SKOV3 cells. VHL and DNMT3A protein levels were detected by immunohistochemistry in subcutaneous SKOV3 cell xenografts in nude mice.@*RESULTS@#Treatment of SKOV3 cells with 20(S)-Rg3 significantly upregulated VHL and downregulated DNMT3A expressions at both the mRNA and protein levels (@*CONCLUSIONS@#Ginsenoside 20(S)-Rg3 upregulates VHL expression in ovarian cancer cells by suppressing DNMT3A-mediated DNA methylation.
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Animals , Cell Line, Tumor , DNA Methylation , Female , Gene Expression , Ginsenosides/pharmacology , Humans , Mice , Mice, Nude , Ovarian Neoplasms/genetics , Promoter Regions, Genetic , Von Hippel-Lindau Tumor Suppressor Protein/geneticsABSTRACT
Septic shock refers to sepsis combined with severe circulatory disorders and cell metabolism disorders, with high incidence, high fatality rate, and dangerous condition.It is one of the leading cause of death in children in pediatric intensive care units.Therefore, early diagnosis and effective treatment of septic shock are very important.Among them, fluid resuscitation is an important part of treatment.However, the research in recent years has a lot of controversy about subsequent fluid balance management issues.This review summarized fluid balance therapy, focusing on the large dose of fluid resuscitation on the prognosis of children with septic shock, aiming to provide a reference for the future improvement of fluid therapy for children with sepsis.
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Objective:To explore the clinical significance of thrombelastography (TEG) and conventional coagulation tests (CCTs) in the diagnosis of trauma-induced coagulopathy(TIC) and the risk factors for TIC.Methods:Traumatic patients hospitalized in PICU at Shengjing Hospital of China Medical University from December 1, 2017 to January 31, 2019 were divided into three groups according to injury severity score(ISS): non-severe group(≤16 points), severe group (17-25 points) and extremely severe group(>25 points). All patients received 2.5 mL of venous blood at admission/after 6 h, 12 h, 24 h, and 48 h injury to detect TEG and CCTs.The prevalence, time of onset, recovery time of coagulation function and risk factors for TIC were summarized.Results:A total of 64 cases were collected, including 18 non-critical cases, 28 critical cases and 18 extremely critical cases.TEG and CCTs were used to diagnose TIC in nine cases(14.1%)and four cases(6.3%), respectively.TIC could be diagnosed by TEG at 6 hours after trauma, and 12 hours for CCTs.TEG was used to diagnose four cases of hypercoagulability.Univariate analysis showed that female, blood transfusion, transfusion, shock, multiple organ dysfunction syndrome, mechanical ventilation, hypothermia, low age, low glasgow coma scale (GCS) and high ISS were all risk factors for TIC.Logistics regression analysis found that children with high-risk factors such as girl, hypothermia, shock and mechanical ventilation were 4.333, 17.889, 10.208, and 4.479 times more likely to develop TIC than those without high-risk factors.For every 1 score increase in the ISS score, the risk of TIC increased by 1.147.As the age increased by 1 year, GCS increased by 1 point, and the risk of TIC decreased by 0.765 and 0.817, respectively, which were protective factors for TIC.Conclusion:TEG and CCTs are consistent in the diagnosis of TIC, but TEG is more sensitive at an earlier stage and can detect hypercoagulability.Female, shock, hypothermia, low age, high ISS, and low GCS are risk factors for TIC.
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The gastrointestinal tract is the most vulnerable organ to infection, trauma, shock and other stress states.The incidence of gastrointestinal failure is high, which seriously affects the prognosis of critically ill children, but it lacks clear diagnostic indicators for clinical application.The intestinal blood supply mainly comes from superior mesenteric artery, so the blood perfusion of superior mesenteric artery can reflect the intestinal circulation.Based on the latest progress of gastrointestinal failure all over the world, and the extensive application of near infrared spectroscopy in brain and gastrointestinal tract, this study puts forward a powerful clinical index for the diagnosis of gastrointestinal failure-mesenteric local tissue oxygen saturation.
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In recent years, the incidence of deep vein thrombosis(DVT) in children is on the rise.If the embolus falls off, it will cause complications such as pulmonary embolism, which may cause disability and death.Therefore, early prevention and timely treatment of DVT are important to improve survival rate.Due to the complexity and particularity of children′s conditions and the lack of large-scale trials and statistics, there is no uniform standards at home and abroad.This article combined some current clinical advances to provide a reference for the prevention, diagnosis and treatment of DVT.
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Objective:Based on a cross-sectional survey about the status of analgesia and sedation nursing behavior of PICU nurses in Northeast China and Inner Mongolia, to analyze the influencing factors and to provide reference for further constructing standardized training programs and developing standardized for analgesia and sedation nursing process.Methods:The self-designed questionnaire was made for investigation from 435 PICU nurses in 18 hospitals in Northeast China and Inner Mongolia.Results:The average questionnaire score of the analgesia and sedation nursing behavior of PICU nurses was(70.54±13.63)in Northeast China and Inner Mongolia.The behavioral scores were different in each group between different age, nursing age, PICU nursing age, educational background, professional title, and whether was the intensive care unit nurse, whether trained in analgesia and sedation, whether have experience in caring children with analgesia and sedation, and the differences were all statistically significant( P<0.05). The main factors influencing the analgesia and sedation behavior of PICU nurses were whether have received training in analgesia and sedation, whether have experience in caring children with analgesia and sedation treatment and their attitude score to analgesia and sedation. Conclusion:There is still much space for development in analgesia and sedation nursing behavior of PICU nurses in Northeast China and Inner Mongolia.The more analgesia and sedation training PICU nurses take participate in, the more experience and positive attitudes they have in nursing children with analgesia and sedation, their clinical nursing practice ability could become more stronger.
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Objective@#To investigate the occurrence and risk factors of deep venous thrombosis (DVT) in adult burn patients.@*Methods@#The clinical data of 1 219 adult burn patients admitted to the Department of Burns of Zhengzhou First People′s Hospital from January 1, 2015 to August 31, 2016, conforming to the study criteria, were analyzed retrospectively by the method of case-control study, including 811 males and 408 females, aged 18-102 years. According to whether DVT occurred during hospitalization or not, the patients were divided into group DVT (n=12) and non-DVT group (n=1 207). The incidence of DVT, the diagnosis time of DVT, affected limbs, and DVT classification were counted and recorded. The gender, age, total burn area, D-dimer, lower limb burn, full-thickness burn, femoral vein indwelling central venous catheter (CVC) , inhalation injury, sepsis/infection shock, surgical operation, and infusion of concentrated red blood cells of patients between the two groups were compared with chi-square test, and then the indicators with statistically significant differences between the two groups were processed by multivariate binary logistic regression analysis to screen the independent risk factors of DVT in the adult burn patients.@*Results@#(1) The incidence of DVT of adult burn patients was 0.98% (12/1 219), and DVT was diagnosed 24-138 days after injury, with a median of 61.5 days. DVT occurred in the right lower limb of 2 patients, left lower limb of 8 patients, and bilateral lower limbs of 2 patients, and DVT classification included 6 cases of mixed type and 6 cases of peripheral type. (2) There were no statistically significant differences in gender, age, and full-thickness burn of patients between the two groups ( χ2=1.524, 0.021, 3.115, P>0.05). There were statistically significant differences in total burn area, lower limb burn, inhalation injury, sepsis/infection shock, D-dimer, femoral vein indwelling CVC, surgical operation, and infusion of concentrated red blood cells among patients between the two groups (χ2=17.975, 6.206, 3.987, 8.875, 5.447, 15.124, 10.735, 14.031, P<0.05 or P<0.01). (3) Total burn area, D-dimer, and femoral vein indwelling CVC were independent risk factors for DVT in adult burn patients (odds ratio=10.927, 4.762, 9.394, 95% confidence interval=3.078-38.789, 1.197-18.934, 2.631-33.540, P<0.05 or P<0.01).@*Conclusions@#The incidence of DVT in adult burn patients is relatively low, and the diagnosis time of DVT is 3 weeks after burn, with DVT classification of mixed type and peripheral type. The total burn area, femoral vein indwelling CVC, and D-dimer are independent risk factors for predicting DVT in adult burn patients.
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Intestinal dysfunction can be induced under infection,trauma or stress. The intestinal mu＿cosal barrier injury is a common pathophysiological process in critically ill patients. The bowel is one of the earliest and most severely affected organ under severe infection and tissue hypoxia＿ischemia. Intestinal dam＿age leads to a large number of bacterial flora shift,resulting in intestinal infection,intestinal endotoxemia and intestinal sepsis. In recent years, gastrointestinal barrier function has attracted people′s attention, which is closely related to the prognosis of critically ill patients. This article described the normal intestinal barrier function,the effects of trauma and stress on intestinal barrier function, bacterial group migration, and the effects of endotoxin translocation on the body and its prevention and treatment.
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Objective To investigate the efficacy and safety of MatrixRIB fixation system in the treatment of severe rib fractures.Methods A total of 131 patients with severe rib fractures undergoing open reduction and internal fixation using MatrixRIB fixation system in our department were enrolled.Data including demographics,injury characteristics,surgical procedure details and postoperative recovery were collected.The operation experiences were summarized,and complications,postoperative and follow-up data were analyzed.Results Totally 637 (637/891)rib fractures were fixed.No internal fixation disorder was found,but 1 case had displacement after internal fixation.The majority of patients were extubated immediately after surgery.The mean time of pressure-support ventilation after surgery was 47.6(7 143)hours.The chest instability and pain were improved in all patients after surgery.At 3 to 6 months after treatment,70 patients(70/102)returned to work,and 87 patients(87/89)recovered previous normal life.Conclusions MatrixRIB fixation system is easy to operate in the treatment of severe rib fractures and has good clinical outcomes with few complications.Patients' pain is significantly relieved with satisfactory rehabilitation.
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OBJECTIVE@#To investigate the antitumor activity of decoction and study its liver and kidney toxicity and its effect on the immune system in a tumor-bearing mouse model.@*METHODS@#Hepatoma H22 tumor-bearing mouse models were randomized into model group, cyclophosphamide (CTX) group, and low-, moderate-, and high-dose decoction groups (JW-L, JW-M, and JW-H groups, respectively). The antitumor activity of decoction was assessed by calculating the tumor inhibition rate and pathological observation of the tumor tissues. Immunohistochemistry was used to detect the expressions of Bax, Bcl-2, Bax/Bcl-2 and caspase-3 in the tumors. The liver and kidney toxicity of decoction was analyzed by evaluating the biochemical indicators of liver and kidney functions. The immune function of the tumor-bearing mice were assessed by calculating the immune organ index, testing peripheral blood routines, and detection of serum IL-2 and TNF-α levels using enzyme-linked immunosorbent assay.@*RESULTS@#Compared with that in the model group, the tumor mass in CTX, JW-M and JW-H groups were all significantly reduced ( < 0.05) with cell rupture and necrosis in the tumors. Immunohistochemistry revealed obviously up-regulated expressions of Bax and caspase-3 and down- regulated expression of Bcl-2 protein with an increased Bax/Bcl-2 ratio in CTX, JW-M and JW-H groups. Treatment with decoction significantly reduced Cr, BUN, AST and ALT levels, improved the immune organ index, increased peripheral blood leukocytes, erythrocytes and hemoglobin levels, and up-regulated the levels of TNF-α and IL-2 in the tumor-bearing mice. These changes were especially significant in JW-H group when compared with the parameters in the model group ( < 0.01).@*CONCLUSIONS@# decoction has a strong anti-tumor activity and can improve the liver and kidney functions of tumor-bearing mice. Its anti-tumor effect may be attributed to the up-regulation of Bax, caspase-3, TNF-α and IL-2 levels and the down-regulation of Bcl-2 expression as well as the enhancement of the non-specific immune function.
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Animals , Antineoplastic Agents, Phytogenic , Pharmacology , Carcinoma, Hepatocellular , Drug Therapy , Allergy and Immunology , Metabolism , Pathology , Drugs, Chinese Herbal , Pharmacology , Kidney , Liver , Pathology , Liver Neoplasms , Drug Therapy , Allergy and Immunology , Metabolism , Pathology , Mice , Necrosis , Neoplasm Proteins , Metabolism , Random Allocation , Up-RegulationABSTRACT
Objective@#To investigate the epidemiology and clinical features of pulmonary hemorrhage in children at pediatric intensive care unit(PICU).@*Methods@#A retrospective cohort case analysis was performed in order to investigate the incidence, primary disease, clinical manifestations and clinical characteristics of pulmonary hemorrhage in children at PICU of Shengjing Hospital of China Medical University from January 2008 to September 2017.@*Results@#Among the 73 cases, 39 cases were male (53.4%) and 34 cases were female(46.6%), and the average age was 31(5, 72)months.The conditions of 14 cases(19.2%) were improved and discharged, 17(23.3%) cases died during the hospitalization period, and 42 cases gave up treatment halfway.The primary causes of pulmonary hemorrhage included severe heart failure in 17 patients (23.3%), acute respiratory distress syndrome (ARDS) in 12 patients (16.4%), severe sepsis in 10 patients (13.7%), hematological diseases in 10 patients (13.7%), intracranial hemorrhage occurred in 5 patients (6.8%), cardiac arrest in 5 patients (6.8%), coagulation dysfunction in 5 patients(6.8%), renal disease in 3 patients(4.2%) and other diseases in 6 patients(8.3%). The symptoms of all cases (73 cases) of pulmonary hemorrhage included dyspnea, moist rales and decreased blood oxygen saturation.Nasal bleeding or coffee ground like material drawn out from nasal stomach tube could be found in 32 cases(43.8%, 32/73 cases), 36 cases(49.3%, 36/73 cases)were complicated by shock and 9 cases (12.3%, 9/73 cases) were combined with convulsions, and 47 cases (64.4%, 47/73 cases) were given cardiopulmonary resuscitation.The positive end expiratory pressure in ARDS group was(10.2±2.4) cmH2O(1 cmH2O=0.098 kPa), which was higher than that in other groups (F=4.59, P<0.01). The oxygen concentration in acute respiratory distress syndrome group was(0.9±0.1)% , which was higher than that in other groups (F=3.16, P<0.01). International normalization ratio was 1.9±0.7 in severe sepsis group, which was higher than that in other groups (F=2.96, P<0.01). Blood platelets in hematological disease group was (52.0±46.8)×109/L, which was lower than that in other groups (F=8.23, P<0.01) and hemoglobin in hematological disease group was (81.6±15.6) g/L, which was lower than that in other groups (F=5.48, P<0.01). Chest X-ray examinations showed decreased lung permeability, multiple exudative lesions in 61 cases and increased bronchovascular shadows in 5 cases.@*Conclusions@#Pulmonary hemorrhage may be a complication of many diseases. Severe heart failure, ARDS, severe sepsis and hematological diseases are the first four primary causes of pulmonary hemorrhage at PICU. Different causes of pulmonary hemorrhage manifest different characteristics.If the symptom of a patient shows heart rate increase, dyspnea, moist rales and blood oxygen saturation decreased with bleeding tendency and pulmonary infiltration by chest X-ray, he can be suspected of pulmonary hemorrhage.
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Objective@#To analyze epidemiological characteristics of influenza-like illness outbreaks in mainland China during 2017-2018 surveillance season, and to provide scientific evidence for developing influenza prevention and control strategies.@*Methods@#We collected the data on reported influenza outbreaks in 2017-2018 surveillance season from China Influenza Surveillance Information System and China Public Health Emergency Management Information System and analyzed the data of laboratory-confirmed influenza-like illness outbreaks by descriptive epidemiological methods.@*Results@#During the surveillance season, a total of 2 398 influenza-like illness outbreaks (with 10 or more incidences in an outbreak) in mainland China were reported, involving 87 084 patients, of which 2 323 were influenza outbreaks, involving 85 531 patients. The reported influenza-like illness outbreaks occurred most frequently from November 2017 to January 2018 in both the southern and northern regions and the highest peaks were in December 2017. During the period 1 850 influenza-like illness outbreaks (77.15%) were reported in the southern region, and 548 influenza-like illness outbreaks (22.85%) were reported in the northern region. The most of the outbreaks occurred in primary, secondary schools and nursery care schools, with a total of 2 210 reports (92.16%). And the majority of the outbreaks involved 10-29 incident cases. The dominant isolated virus strains for the outbreaks were influenza B (1 505 outbreaks, 62.76% of all the outbreaks).@*Conclusion@#Seasonality of influenza outbreaks were observed in mainland China during 2017-2018 surveillance season and the reported influenza outbreaks were most frequently occurred in autumn-winter season and in southern China. Primary, secondary schools and nursery care schools are high-risk places for outbreaks, and the dominant isolated virus strains for the outbreaks were influenza B.