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Objective:To explore the risk factors of hypomagnesemia in elderly patients with sepsis and the influence of hypomagnesemia on the prognosis of elderly patients with sepsis.Methods:In this retrospective study, 249 elderly patients with sepsis or septic shock were recruited between January 2018 and January 2021 from the Department of Geriatrics and the Department of Emergency Medicine, General Hospital of Tianjin Medical University, and relevant clinical data were collected.The Logistic regression analysis model was used to identify the relationship between risk factors and hypomagnesemia in patients with sepsis.The prognosis criteria such as hospitalization time in intensive care unit(ICU), 28-day mortality rate, mechanical ventilation time, double infection rate, shock reversal time, etc., were compared between the hypomagnesemia group and the normal magnesium group.Results:Among the 249 elderly patients with sepsis, 187 had normal blood magnesium, 43 had low blood magnesium and 19 had high blood magnesium, accounting for 75.10%, 17.27% and 7.63%, respectively.Compared with the normal blood magnesium group, elderly sepsis patients with hypomagnesemia had a longer hospitalization time in ICU[(16.21±3.68)d vs.(13.86±3.58)d, t=-4.845, P=0.036], and a significantly prolonged mechanical ventilation time[11(3, 18)d vs.3(1, 6)d, Z=-1.782, P=0.033]. There was no significant difference in mortality and double infection rate between the two groups(both P>0.05). The sequential organ failure assessment(SOFA)score of elderly sepsis patients in the low magnesium group was significantly higher than that in the normal magnesium group[(5.69±1.28)scores vs.(3.09±0.68)scores, t=-0.322, P=0.008], but there was no significant difference in acute physiology and chronic health evaluation(APACHE) Ⅱ score between the two groups( P>0.05). Multivariate Logistic regression analysis showed that high SOFA score( OR=1.111, 95% CI: 1.025-1.758, P=0.001)was an independent risk factor for hypomagnesemia. Conclusions:A high SOFA score is an independent risk factor for hypomagnesemia in elderly sepsis patients, and the clinical prognosis of elderly sepsis patients with hypomagnesemia is poor.
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Objective To investigate the cognitive dificiency characteristics and the neuro electrophysiological mechanism of sleep disordered breathing(SDB) in school-age children.Methods20 cases of SDB children and 20 cases of normal group at 6-8 years old participated in the continue performance test(CPT-AX).The amplitude and latency of N2,P3 of event related potentials(ERPs) were measured and analysed at Fz leads,and the behavioral results were recorded at the same time.ResultsThere were no significant differences between SDB group and normal group in behavioral correct number (36.10±4.69 vs 35.05±3.49),the reaction time ((523.77±68.73)ms vs (496.59±78.65)ms) and false alarm number (1.0 (0.25,3.75) vs 0.5 (0.00,3.00))(all P>0.05).The SDB group showed significant increase in Go-P3 amplitudes compared with the normal group((10.25±6.46)μV vs (6.56±4.63)μV,P<0.05).The Go-P3 latency in SDB group was significantly prolonged than that in the normal group((438.80±59.72)ms vs (406±36.30)ms,P<0.05),and the Nogo-N2 amplitude in SDB group significantly decreased compared with the normal group ((-12.46±4.75)μV vs (-15.50±3.82)μV,P<0.05).ConclusionThe children aged 6 to 8 years old with sleep disordered breathing consume more resources and time to complete the attention process,like a compensatory response.And during the monitoring process there is a resource shortage that results in obvious defect in process of inhibition.
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Objectives To study the roles of Th17 cells in peripheral blood and the serum level of IL-17 in children with acute respiratory syncytial virus (RSV) bronchiolitis. Methods A total of 28 children with RSV bronchiolitis were selected as bronchiolitis group, among whom twelve cases were assigned into severe group and sixteen cases were assigned into mild group according to the severity of illness. Twelve cases with acute asthma were selected as asthma group. Ten children without recent infection waiting for surgery were chosen as controls. The percentage of Th17 cells in peripheral blood was measured by lfow cytometry. The serum level of IL-17 was detected by ELISA. The association of severity of illness with the percentage of Th17 cells and the level of IL-17 was studied in children with acute RSV bronchiolitis. Results The serum level of IL-17 and the percentage of Th17 cells were signiifcantly higher in the severe bronchiolitis group than those in the control group and mild bronchiolitis group (P0.05). Conclusions The percentage of Th17 cells and serum level of IL-17 are increased in children with acute RSV bronchiolitis, and may be involved in the pathogenesis of RSV bronchiolitis. (J Clin Pediatr,2013,31(9):850-853)
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Objective To investigate the effects of leukotriene in children with respiratory syncytial (RSV)viral bronchiolitis.Methods The blood and sputum levels of Ieukotriene were detected in 33 cases diagnosed RSV bronchiolitis and 12 cases which were diagnosed pneumonia without RSV infection.Thirty-three cases of bronchiolitis were devided into mild-moderate group(n =22)and severe group(n =11)according to the lowell score.Results The blood and sputum levels of leukotriene in mild-moderate group,severe group,and pneumonia group were(76.96 ± 28.19)pg/ml,(103.53 ± 16.85)pg/ml,(18.14.± 7.49)pg/ml;(31.83 ± 19.14)pg/ml,(67.11 ± 15.11)pg/ml,(6.81 ± 2.90)pg/ml in acute period,and(36.04 ±16.38)pg/ml,(52.27 ± 17.03)pg/m l,(18.14 ± 7.49)pg/ml of serum in recovery period.There were significant differences among three groups(F =48.09,P ＜ 0.001 ; F =15.50,P ＜ 0.001 ; F =44.43,P ＜0.001).After treatment,the blood levels of leukotriene were significantly decreased,but were still higher than that of pneumonia group(P ＜ 0.05).Conclusion The blood and sputum levels of leukotriene increase in children with RSV bronchiolitis,which is related with the severity of bronchiolitis.