Successful treatment of 3 cases of 22-week extremely premature infants / 中国新生儿科杂志

Objective:To review the treatment experience of extremely premature infants (EPIs) with gestational age (GA) <23 weeks.Methods:From January to November 2021, EPIs with GA<23 weeks treated in our hospital was retrospectively analyzed.Results:A total of 3 patients with GA of 22 weeks were reviewed, including 2 boys and 1 girl. Their birth weight (BW) was 450~498 g. The duration of hospitalization was 112~126 d. The treatment included early "gentle" management strategies, respiratory management, anti-infection, patent ductus arteriosus treatment and parenteral + enteral nutrition. All 3 infants were discharged from the hospital without further oxygen therapy. All had satisfying oral feeding with no neurological sequelae on follow-up.Conclusions:Early "gentle" management is the key to successful treatment and good prognosis for EPIs with GA<23w

Observations on the Therapeutic Effect of No-fire Constant Temperature Moxibustion on Cervical Spondylosis / 上海针灸杂志

Objective To investigate the efficacy of no-fire constant temperature moxibustion for cervical spondylosis. Method Sixty outpatients diagnosed with cervical spondylosis were randomized to a treatment group (receiving no-fire constant temperature moxibustion) and a control group (receiving electroacupuncture). Both groups were treated once every other day, 10 days as one course, for two consecutive courses. The symptoms were scored using the Assessment Scale for Cervical Spondylosis in the patients at the enrollment day and after one and two courses of treatment. Result The total efficacy rate was 90.0% in the treatment group and there was a statistically significant difference compared with the control group (P<0.05). Variance analysis of the Assessment Scale for Cervical Spondylosis scores before treatment showed no statistically significant difference between the two groups (F=0.442, P>0.05), indicating comparability. Variance analysis of the Assessment Scale for Cervical Spondylosis scores after one course of treatment still showed no statistically significant difference between the two groups (F=3.674, P=0.06). Variance analysis of the Assessment Scale for Cervical Spondylosis scores after two courses of treatment showed a statistically significant difference between the two groups (F=18.705, P < 0.05). The therapeutic effect of electroacupuncture on cervical spondylosis was better than that of no-fire constant temperature moxibustion. Conclusion No-fire constant temperature moxibustion is convenient to use, safe, effective and highly acceptable to patients. It can be clinically used to treat cervical spondylosis.

Effect of gently caring on clinical outcomes of extremely low birth weight infants / 中国实用护理杂志

Objective To evaluate whether changes in neonatal intensive care have improved outcomes for extremely low birth weight (ELBW) infants in neonatal intensive care unit (NICU). Methods A prospective phase-lag cohort study was performed in a tertiary level NICU. A meticulous nursing strategy based on neonatal individual developmental care assessment program theory and feasible ELBW minimization stimulus was developed. Conventional care was applied in 2013 (period Ⅰ) and gently caring was applied in 2014 (period Ⅱ). The outcomes of ELBW between these 2 periods were compared. Results During these two periods, thirty-seven infants were included in period Ⅰ and 41 infants in period Ⅱ. In periodⅠ46.0%(17/37) of the infants needed oxygen for at least 28 days, but in period Ⅱ it decreased to 24.4%(10/41), there was significant difference (χ2=3.990, P=0.046). The rate of breastfeeding increased from 27.0%(10/37) in periodⅠto 61.0%(25/41) in period Ⅱ, there was significant difference (χ2=9.061, P=0.003). There was no significant difference in the mortality rate and chronic lung disease (P>0.05). The incidence of intracranial hemorrhage decreased from 21.6%(8/37) to 4.9%(2/41), there was significant difference(P=0.041). Conclusions Gently caring may have resulted in less intracranial hemorrhage and improve breastfeeding rate. Parents are satisfied with gentle care and in light of these findings, gentle care deserves further exploration.

Observations on the Therapeutic Effect of Combined Moxibustion and Medicine on the Clinical Remission Stage of Bronchial Asthma / 上海针灸杂志

Objective To investigate the clinical efficacy of gentle moxibustion plus oral Gushen Dingchuan pills in treating the clinical remission stage of bronchial asthma.Methods Ninety patients with bronchial asthma in the clinical remission stage were randomized to groups A,B and C,30 cases each.group A received moxa-stick gentle moxibustion;group B,oral administration of Gushen Dingchuan pills;group C,moxa-stick gentle moxibustion plus oral administration of Gushen Dingchuan pills.The course of treatment was three months in all the three groups.The TCM symptom score and the Asthma Control Test (ACT) score were recorded and serum immunoglobulin E (IgE) content was measured in the two groups before and after treatment.The clinical therapeutic effects were compared between the groups.Results The total efficacy rate was 76.7％ in group A,80.0％ in group B and 93.3％ in group C.there was a statistically significant difference in the total efficacy rate between group C and group A or B (P＜0.05).There were statistically significant pre-/post-treatment differences in the TCM symptom score,the ACT score and serum IgE content in all the three groups (P＜0.01).There were statistically significant post-treatment differences in the TCM symptom score,the ACT score and serum IgE content between between group C and group A or B (P＜0.01,P＜0.05).Conclusion Gentle moxibustion plus oral Gushen Dingchuan pills can improve immunologic function in patients with bronchial asthma in the clinical remission stage.

Observations on the Therapeutic Effect of Gentle Moxibustion on Old Interphalangeal Collateral Ligament Injury / 上海针灸杂志

ObjectiveTo investigate the clinical efficacy of gentle moxibustion in treating old interphalangeal collateral ligament injury.MethodSixty patients were randomly allocated to two groups. The treatment group of 30 patients received gentle moxibustion 20-30 min once daily for two consecutive courses of treatment. The control group of 30 patients received TDP irradiation 20-30 min once daily for two consecutive courses of treatment.ResultThe excellent rate and the total excellent rate were 56.7% and 83.3%, respectively, in the treatment group and 36.7% and 76.7%, respectively, in the control group; there were statistically significant differences between the two groups (P<0.01).ConclusionGentle moxibustion has a marked therapeutic effect on old interphalangeal collateral ligament injury.

The influence of sleep deprivation and obesity on DNA damage in female Zucker rats

OBJECTIVE: The aim of this study was to evaluate overall genetic damage induced by total sleep deprivation in obese, female Zucker rats of differing ages. METHOD: Lean and obese Zucker rats at 3, 6, and 15 months old were randomly distributed into two groups for each age group: home-cage control and sleep-deprived (N = 5/group). The sleep-deprived groups were deprived sleep by gentle handling for 6 hours, whereas the home-cage control group was allowed to remain undisturbed in their home-cage. At the end of the sleep deprivation period, or after an equivalent amount of time for the home-cage control groups, the rats were brought to an adjacent room and decapitated. The blood, brain, and liver tissue were collected and stored individually to evaluate DNA damage. RESULTS: Significant genetic damage was observed only in 15-month-old rats. Genetic damage was present in the liver cells from sleep-deprived obese rats compared with lean rats in the same condition. Sleep deprivation was associated with genetic damage in brain cells regardless of obesity status. DNA damage was observed in the peripheral blood cells regardless of sleep condition or obesity status. CONCLUSION: Taken together, these results suggest that obesity was associated with genetic damage in liver cells, whereas sleep deprivation was associated with DNA damage in brain cells. These results also indicate that there is no synergistic effect of these noxious conditions on the overall level of genetic damage. In addition, the level of DNA damage was significantly higher in 15-month-old rats compared to younger rats.

Gentle handling temporarily increases c-Fos in the substantia nigra pars compacta

Dopaminergic neurotransmission is involved in the regulation of sleep. In particular, the nigrostriatal pathway is an important center of sleep regulation. We hypothesized that dopaminergic neurons located in substantia nigra pars compacta (SNpc) could be activated by gentle handling, a method to obtain sleep deprivation (SD). Adult male C57/BL6J mice (N = 5/group) were distributed into non-SD (NSD) or SD groups. SD animals were subjected to SD once for 1 or 3 h by gentle handling. Two experiments were performed. The first determined the activation of SNpc neurons after SD, and the second examined the same parameters after pharmacologically induced dopaminergic depletion using intraperitoneal reserpine (2 mg/kg). After 1 or 3 h, SD and NSD mice were subjected to motor evaluation using the open field test. Immediately after the behavioral test, the mice were perfused intracardially to fix the brain and for immunohistochemical analysis of c-Fos protein expression within the SNpc. The open field test indicated that SD for 1 or 3 h did not modify motor behavior. However, c-Fos protein expression was increased after 1 h of SD compared with the NSD and 3-h SD groups. These immunohistochemistry data indicate that these periods of SD are not able to produce dopaminergic supersensitivity. Nevertheless, the increased expression of c-Fos within the SNpc suggests that dopaminergic nigral activation was triggered by SD earlier than motor responsiveness. Dopamine-depleted mice (experiment 2) exhibited a similar increase of c-Fos expression compared to control animals indicating that dopamine neurons are still activated in the 1-h SD group despite the exhaustion of dopamine. This finding suggests that this range (2-5-fold) of neuronal activation may serve as a marker of SD.

A Study on the Effects of Early Surfactant Replacement and Gentle Ventilation in the Treatment of Respiratory Distress Syndrome / 소아과

PURPOSE: Recently, early surfactant replacement and tidal volume based gentle ventilation has been a fundamental treatment of respiratory distress syndrome (RDS). The aims of this study were to survey the changes in ventilator care duration and rate of complication in RDS groups. METHODS: We performed a retrospective study of 255 newborn infants less than 1, 500 g admitted to the neonatal intensive care unit (NICU) and discharged from January 1999 to December 2003. 141 of 255 newborn infants were RDS groups that required invasive management, such as endotracheal intubation, surfactant replacement and assisted ventilation. We analyzed epidemiologic data to study the changes in ventilator care duration and outcome of RDS groups. RESULTS: Of 141 RDS groups, 135 were mild to moderate RDS groups and only 6 were severe RDS groups. 24 (17.8%) of 135 mild to moderate RDS groups and 3 (50%) of 6 severe RDS groups were antenatal no use of maternal dexamethasone. 127 (90.1%) of 141 RDS groups underwent replacement of surfactant during 3 hours after birth. 121 (85.9%) weaned within 48 hours. CONCLUSION: Our study shows a decreased frequency of severe RDS by a antenatal use of maternal dexamethasone and decreased duration of ventilator care by early surfactant replacement and gentle ventilation.

Development of Periventricular Leukomalacia and Severe Intraventricular Hemorrhage in Very Low Birth Weight Newborns and Relationship with Ventilator Care (Study of Ventilator Care as a Risk Factor of PVL and PV-IVH) / 소아과

PURPOSE: It has been suggested that changes in cerebral blood flow by ventilator care could be a risk factor in periventricular leukomalacia (PVL) and severe periventricular-intraventricular hemorrhage (PV-IVH). The study aims to assess the relationship between perinatal clinical events, including ventilator care, and the development of PVL and severe PV-IVH; especially, whether ventilator care could be causers of PVL and severe PV-IVH as an individual risk factor. METHODS: Among 255 very low birth weight infants who survived in the Fatima neonatal intensive care unit from January 1999 to December 2003, 15 infants with PVL and eight infants with severe PV-IVH were classified as a study group, while 231 infants were enrolled as a control group. The analysis was performed retrospectively with medical records. RESULTS: Twenty four infants were diagnosed with PVL or severe PV-IVH. Asphyxia, recurrent apnea, sepsis, acidosis and ventilator care were significantly increased in the PVL goup. Asphyxia, recurrent apnea, RDS, acidosis and ventilator care were significantly increased in the severe PV-IVH group. CONCLUSION: Infants with PVL or severe PV-IVH may have multiple perinatal risk factors including asphyxia, recurrent apnea, sepsis, acidosis, RDS and ventilator care. Because most patients with ventilator care have multiple perinatal risk factors, ventilator care does not cause PVL and severe PV- IVH independently. Therefore, incidences of PVL and severe PV-IVH can be decreased by not only gentle ventilation, but also more professional antenatal care.

A Study on the Risk Factors of Periventricular Leukomalacia in Combined Use with Gentle Ventilation and High-Frequency Ventilation

PURPOSE: It is suggested that persistent hypocarbia caused by ventilator therapy could be a risk factor in PVL. The study is aimed to discover whether for preventing hypocarbia with combined use of gentle ventilation and high frequency ventilation, other factors would be causers of PVL. METHODS: Among 45 infants who were born and survived through ventilator treatment in the Fatima neonatal intensive care unit for four years from April 1996 to June 1999, 15 infants with PVL were classified as a study group and 30 without PVL as control group. The analysis was performed retrospectively with medical records. Ventilator treatment was based on the combined use of ventilation by means of the flow interruptor type of Infant Star . The aggressive weaning was performed when the clinical state, chest X-ray and arterial blood gas analysis became stabilized. RESULTS: Among 15 cases with PVL : 9 cases(60.0%) with fetal distress, 1 case(6.6%) with placenta previa, 1 case(6.6%) with placenta abruptio. In the relationship between PaCO2 variance on arterial blood gas analysis and PVL, the highest average of PaCO2 is 44.9 +/- 7.8 mmHg in the study group and 45.0 +/- 10.5 mmHg in the control group, which means there was not statistically significant difference. The PaCO2 concentration lower than 25 mmHg for three days appeared in one case in the study group. CONCLUSIONS: In cases of preventing hypocarbia by combined use of ventilation, it is suggested that the birth history and weaning method is important as risk factor of PVL.

A case of water birth / 대한산부인과학회잡지

Recently, water birth - labor and/or delivery under warm water - is acceptable and natural to many foreign countries as a method of gentle birth. Although some limitations after water birth were reported, a recent international conference explored many of the issuses and indicated the potential scale and the advantages for its inclusion among the options for labor and delivery under water. We experienced a case of water birth who underwent labor and delivery under water. She delivered normal healthy female baby without conventional episiotomy. No obstetrical ans fetal complications were observed during entire procedure of water birth. So, we report this case with brief review of the literatures.

A Study on the Effect of the Combined Use of Gentle Ventilation and High-requency ntilation on the Incidence of Chronic Lung Disease

PURPOSE: This study was conducted to determine the correlation between the incidence of chronic lung disease and the combined use of gentle ventilation and high-frequency ventilation. METHODS: The subject group consisted of 63 very low birthweight infants of less than 1500gm who were born and survived through ventilator treatment in the Fatima neonatal intensive care unit for four years from January 1995 to December 1998. The analysis was performed retrospectively with medical records. Ventilator treatment was based on the combined use of gentle ventilation and high-frequency ventilation by means of the flow interruptor type of Infant star. High- frequency ventilation was carried out for 24 hours after surfactant replacement, when PaCO2 exceeded 60mmHg, or if the period of gentle ventilation exceeded one week. When the results of arterial blood gas analysis and the state of the body became stable, the aggressive weaning was performed. RESULTS: For 49(77.8%) of 63 infants, the weaning was possible within seven days. The other 14 infants(22.2%) needed ventilator treatment for more than seven days. The mean duration of ventilator treatment was 12.3 days. The causes of weaning failure included sepsis, patent ductus arteriosus, chronic lung disease, and intraventricular hemorrhage. Two infants who had received ventialtor treatment for more than two weeks were found to have incidence of chronic lung disease. CONCLUSION: It is suggested that the combined use of gentle ventilation and high-frequency ventilation can help reduce pulmonary damage, and it will be important to shorten the period of ventilator treatment.