Risk factors in patent ductus arteriosus in preterm infants and their effect on early cardiac function / 中华实用儿科临床杂志

Objective To study the heart function,risk factors and associated complications caused by patent ductus arteriosus( PDA)in preterm infants. Methods A retrospective analysis Was conducted at Neonatal Intensive Care Unit of Shenzhen People＇s Hospital from October 2016 to August 2017 to study the cardiac functions of infants less than 3 days after birth betWeen PDA group and non－PDA group(1: 1 paired study according to gestational age and Weight). MeanWhile their clinical data Were collected by case－control analysis method,to explore the risk factors and complications caused by PDA in preterm infants. Results There Were 50 cases in PDA group,and 50 cases in non－PDA group. The physical data betWeen 2 groups had no statistically significant difference(all P＞0. 05). The heart rate (HR),cardiac output(CO)and cardiac output index(CI)in 2 groups Were(148. 36 ± 12. 98)times／min,(0. 52 ± 0. 21)L／min,(0. 44 ± 0. 19)L／( min·m2 )and(142. 52 ± 18. 07)times／min,(3. 48 ± 0. 92)L／min,(2. 99 ± 0. 80)L／(min·m2 ),respectively;the levels of PDA group Were higher than those of the non－PDA group,and the differences Were significant(P﹦0. 021,0. 020,0. 027). Single factor analysis shoWed that PDA in the preterm infants Was significantly associated With asphyxia,premature rupture of membranes and the use of prenatal hormone( P﹦0. 001,0. 009,0. 004). Ventilation time,pneumonia,feeding intolerance,and bronchial pulmonary dysplasia Were asso﹣ciated With PDA in preterm infants(P﹦0. 010,0. 010,0. 000,0. 026). The Logistic regression analysis shoWed that asphyxia Was independent risk factor for PDA in preterm infants(OR﹦7. 280),and prenatal antenatal corticosteroids Was independent protective factor( OR ﹦0. 008). Conclusions In preterm infants With PDA,the HR,CO and CI increase and electronic heart monitoring could identify the hemodynamic changes in preterm infants With PDA. Asphyxia is major high risk factor in PDA in preterm infants,While the use of prenatal antenatal corticosteroids is seen as the pro﹣tective factor. PDA in preterm infants can prolong the ventilation times and increase the pneumonia,feeding intolerance and BPD.

Research progress on co-infection of community-acquired pneumonia in hospitalized children / 国际儿科学杂志

Community acquired pneumonia ( CAP) is the most common respiratory infectious disease in hospitalized children. With the development of etiology detection technology, the detection rate of CAP pathogens has rose significantly, and meanwhile the co-infections of multiple pathogens have been paid more at-tention gradually. The combinations of co-infection agents are in a diverse way. There is not a unified under-standing about the impact on the severity of disease. The mechanism of co-infection and risk factors remain un-clear. These have brought great difficulties for clinical diagnosis and treatment. This review provides an over-view of the current situation, pathogen combination, age and seasonal characteristics, clinical features, the impact on the severity of disease, risk factors, treatment and so on in CAP hospitalized children with co-infec-tion.

The relationship between the onset of cerebral infarction in anterior and posterior circulation and the"three high" risk factors in Guangzhou communities / 实用医学杂志

Objective To investigate the relationship between the onset of cerebral infarction in anterior and posterior circulation and the "three high" risk factors in Guangzhou communities. Methods From Jan. 2014 to Jan.2016,367 patients from Guangzhou communities were diagnosed with new cerebral infarction by head diffu-sion weighted imaging(DWI).The data were divided into two groups of anterior and posterior circulation,and uni-variate and multivariate methods were used to analyze the relationship between the "three high" and other risk factors and the onset of cerebral infarction in anterior and posterior circulation.The data of anterior circulation cere-bral infarction were further divided into two subgroups of lacunar and non-lacunar infarction,and the same statisti-cal methods were employed to analyze differences of risk factors between the two subgroups. Results The frequen-cies of hypertension(P = 0.040)and large atherosclerotic infarction(P = 0.012)were significantly higher,and the serum high-density lipoprotein(HDL)level(P = 0.045)was significantly lower in posterior circulation than those in anterior circulation,respectively;and the onset of posterior circulation cerebral infarction was more associ-ated with the incidence of hypertension(OR = 1.767,P = 0.035)and the decrease of HDL(OR = 0.380,P =0.021). In anterior circulation,the levels of systolic blood pressure(SBP)(P = 0.011)and diastolic blood pres-sure(DBP)(P=0.000),as well as the frequency of large atherosclerotic infarction(P=0.000)in non-lacunar infarction subgroup were significantly higher than those in lacunar infarction subgroup respectively,and the onset of non-lacunar infarction was more closely related to increased SBP levels(OR=1.045,P=0.001). Conclusions Among the"three high"risk factors,the onset of posterior circulation cerebral infarction is more closely related to the incidence of hypertension and the decrease of HDL.In anterior circulation,and the onset of non-lacunar infarc-tion is more closely related to the increased levels of DBP and SBP,especially to the elevated levels of SBP.

Characteristics of bloodborne occupational exposure among health care workers in a tertiary infectious diseases hospital for five consecutive years / 中国感染控制杂志

Objective To evaluate the correlation between occupational exposure and work intensity of health care workers(HCWs)in an infectious diseases hospital for 5 consecutive years,and provide reference for occupational precaution.Methods Occupational exposures cases reported between January 2010 and December 2014 were ana-lyzed retrospectively,occupation types,exposure routes,and exposure sources were analyzed.Results A total of 228 cases of occupational exposure were reported,nurses and doctors were the major exposure population(75.44%and 19.30% respectively);occupational exposure mainly occurred during the infusion process(52.19%);hepatitis B was the main exposure source (71 .05%),followed by human immunodeficiency virus (10.09%).The Pearson correlation coefficient between the occupational exposure rate of doctors and the ratio of doctors to patients was-0.849 (P <0.05),and for nurses,the correlation coefficient was -0.823 (P <0.05 ).Conclusion Nurses are high risk population of occupational exposures,occupational exposure is most likely to occur during transfusion process,occupational exposure of doctors and nurses has a strong correlation with the work intensity.