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Objective:To explore the scheme of assigning rational scores to the Modified Pediatric Nutritional Risk Screening Tool for children with cerebral palsy(CP) at different Gross Motor Function Classification System(GMFCS) levels.Methods:The clinical data of 360 children with CP hospitalized in the Department of Children′s Rehabilitation, the Third Affiliated Hospital of Zhengzhou University from January to October 2019 were analyzed retrospectively.All the CP children at different GMFCS levels who met the inclusion criteria were subject to nutrition screening and assessment by using the Modified Pediatric Nutritional Risk Screening Tool and the Subjective Global Nutritional Assessment(SGNA) scale.The distribution of malnutrition rates assessed by the SGNA scale among the children at different GMFCS levels was examined.Data between groups were compared by the χ2 test.Children at different GMFCS levels were divided into different subgroups according to the statistical difference.Then, 0 or 1 score was assigned to the Modified Pediatric Nutritional Risk Screening Tool in different subgroups, and different combinations were formed.The nutritional risk screening results of different combinations were evaluated by using the SGNA scale assessment results as a reference. Results:In children with CP, the risk detection rate and incidence rate of malnutrition were 58.1%(209/360) and 36.9%(133/360), respectively.There was no significant difference in the incidence rate of malnutrition between GMFCS Ⅱ and GMFCS Ⅲ, as well as between GMFCS Ⅳ and GMFCS Ⅴ(all P>0.05). Therefore, children with CP were divided into 3 subgroups, namely, group Ⅰ, group Ⅱ to Ⅲ, and group Ⅳ to Ⅴ.Different CP disease scores were given to the Modified Pediatric Nutritional Risk Screening Tool in 3 subgroups, forming 3 different protocols[protocol 1 (0, 0, 1 point); protocol 2(0, 1, 1 point); current protocol (1, 1, 1 point)]. Taking the SGNA scale assessment results as a reference, the sensitivity of protocol 1, protocol 2 and current protocol were 85.7%, 92.5%, and 93.2% respectively.The specificity protocol 1, protocol 2 and current protocol were 81.1%, 78.0%, and 62.6%, respectively.And the Youden indexes of above three protocols were 0.668, 0.705, and 0.558, respectively.The Youden index of protocol 2 was relatively high. Conclusions:The Modified Pediatric Nutritional Risk Screening Tool can effectively identify the risk of malnutrition in children with CP.The scheme of assigning 0 points to children with GMFCS grade Ⅰ and 1 point to children with GMFCS grade Ⅱ to Ⅴ is more reasonable.
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Objective:To compare the effect of different methods of sputum aspiration in children with bronchopneumonia and explore the appropriate sputum aspiration methods for children with bronchopneumonia.Methods:This study was a randomized controlled trial. The convenience sampling method was used to select 165 children with bronchopneumonia treated in the Third Affiliated Hospital of Zhengzhou University from October 8, 2020 to September 30, 2021 as the research objects. They were divided into group A, group B and group C by random number table method, with 55 cases in each group. Group A used sputum aspirating tube to aspirate sputum through mouth and nose, group B used olive head to aspirate sputum through nose, and group C used both sputum aspirating tube to aspirate sputum through mouth and olive head through nose. The sputum aspirating effect, respiratory mucosal injury rate and satisfaction degree of children′s parents were compared among the three groups.Results:Finally, there were 53 cases in group A, 54 cases in group B and 53 cases in group C. The total effective rate of sputum aspiration was 96.21%(584/607) in group C, which was higher than that in group A 94.32% (581/616) and in group B 74.12% (464/626), the difference was statistically significant ( χ2=194.62, P<0.01), pairwise comparison among the three groups showed statistical difference ( χ2=95.95, 11.32, 132.16, all P<0.017). The respiratory mucosal injury rate was 1.12% (7/626) in group B, which was lower than that in group C 3.13% (19/607) and in group A 10.39% (64/616), the difference was statistically significant ( χ2=63.53, P<0.01), pairwise comparison among the three groups showed statistical difference ( χ2=49.52, 25.47, 6.04, all P<0.017). The satisfaction degree of children′s parents in group C was 98.11% (52/53), which was higher than that in group B 90.74% (49/54) and in group A 81.13% (43/53), the difference was statistically significant ( χ2=8.54, P<0.05). There was no statistically significant difference in the satisfaction degree of children′s parents between group A and group B, and between group B and group C( P>0.017). There was statistically significant difference in the satisfaction degree of children′s parents between group A and group C ( χ2=8.22, P<0.017). Conclusions:The combination of oral suction tube and nasal suction with olive head can improve the sputum aspirating effect of children with bronchopneumonia and the satisfaction degree of their parents, with a low rate of respiratory mucosal injury and high safety, which is worthy of clinical reference.
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Objective To verify the clinical effect of Qinghuang powder in chronic myelogenous leukemia(CML). Methods 86 CML patients treated with Qinghuang powder, in which 28 cases also partially received herbal medicine (activating blood circulation to dissipate blood stasis). Results 62 cases had complete remission (72.1%), 14 cases partial remission (16.3 %), advance 8 cases(9.3 %), inefficiency 2 cases (2.3 %), and the total efficiency was 97.7 %. The symptom were improved after a week when patients had taken medicines. 44 cases have hepatomegalia, among them 39 cases have diminished or became normal compared to untreated. 70 cases have splenoparectasis, among them 60 cases became normal, 9 cases diminished, and 1 case had no change after treatment. It took 15.5 days in average when spleen began to diminish, and took 62.9 days to become smallest. The WBC began to decrease at 10.4 day and took 54.8 days in average became normal. The major side effect was digestive tract symptom, followed by skin pigmentation and skin excessive cornification. It could be avoided by low dosage. Conclusion Qinghuang powder could not only induce CML to CR, but also improve the clinical symptom of CML and eliminate the infiltration of leukemia cells. It has little influence to Hb and Plt.
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ObjectiveTo explore the expression and significance of ER, PR,C-erbB-2,CylinDl, Rb in different precancerous lesions of breast. MethodsThe expressions of ER, PR, C-erbB-2, CylinD1, Rb in breast normal tissue,hyperplasia, atypical hyperplasia and early-stage breast cancer were examined by immunohistochemical technique. ResultsThe expressions of ER and PR were increasing time trend in the different precancerous lesions, and were related to the breast proliferative degree; the positive expression rates of ER and PR in atypical hyperplasia were 63.2% and 68. 4% respectively,significantly higher than those in normal breast tissue(31.3% and 37. 5% respectively) and in hyperplasia(37. 1% and 42.9% respectively). The positive expression rates of CylinD1 and C-erbB-2 were increasing time trend in the different precancerous lesions. The negative expression rate of Rb was the highest in early-stage breast cancer,and it was zero in normal breast tissue and hyperplasia. ConclusionThe five tumor markers are important factors in breast carcinogenesis, and the overexpression of ER, PR, C-erbB-2, CylinD1 and Rb protein low-expression may be one of the causes of breast neoplasms.