Résumé
Objective:To summarize the risk factors, clinical manifestations, diagnosis and treatment of limb thrombosis in neonates.Methods:The clinical data of 14 neonates with limb thrombosis were hospitalized in neonatology department at Shengjing Hospital of China Medical University from February 2012 to February 2022 were retrospectively analyzed.Results:All the 14 cases of limb thrombosis were premature infants, with an average gestational age of 29 weeks and 5 days(27 weeks and 3 days to 33 weeks and 1 day), including eight cases of arterial embolism and six cases of venous embolism.Among them, 13(92.9%) cases were diagnosed with infectious diseases such as septicemia or neonatal necrotizing enterocolitis within 48 hours before embolization, and all had a history of peripheral arterial and venous catheterization.During the early stage of embolization, limb artery embolism was characterized by weakened distal artery pulsation, pale skin, gradual cyanosis and even gangrene.Limb venous embolism was manifested as limb swelling, skin congestion and cyanosis, but the arterial pulsation was normal.Fourteen cases were confirmed by vascular ultrasound.All the eight cases with arterial embolization were treated with heparin anticoagulation, five of which were cured, with an effective rate of 62.5%.The average time of heparin use in five cases was 2.5 days(2-3 days). One patient was not effective after 2 days of heparin treatment, and recovered after thrombectomy.Another two cases had distal limb gangrene, and them were treated with heparin for 5 days and 7 days.All of the six cases with venous embolism were cured, of which four cases were treated with heparin for an average of 8.5 days(4-15 days), and the other two cases were cured after general treatment.There were no bleeding events in the 12 infants treated with heparin.Conclusion:Peripheral arterial and venous catheterization during infection of preterm infants is the most common cause of limb thrombosis.The smaller body weight and gestational age, the thinner blood vessels, the higher risk of occurrence.Vascular ultrasound is the most commonly used examination method for neonatal thrombosis, and heparin anticoagulant therapy is the most commonly used treatment measure.When the treatment effect of heparin is not good, other treatment methods should be sought.
Résumé
Objective To analyze changes and trends of the mortality and causes of death in the residents of Minhang District of Shanghai from 1996 to 2015.Methods Crude death rates (CDR) and age-standardized death rates (ADR) were calculated,respectively.Joinpoint regression was used to analyze the trends in the leading causes of death.Permutation test was used to find whether the joinpoints were statistically significant based on P value＜0.05.Results The elderly population in Minhang District accounted for 18.07％ of the total population in 2015,which increased by 73.89％ than it in 1996.The CDRs of all causes for resent 20 years gradually increased with the annual percentage change (APC) of 0.62％ (P＜0.05),but decreased significantly after standardization (APC =-3.73％,P＜0.05).In 2015,the top five causes of death were circulatory disease;neoplasms;respiratory disease;endocrine,nutritional and metabolic diseases;injury and poisoning in the total population,males and females registered in Minhang District.ADRs of circulatory disease,neoplasms,respiratory disease and injury and poisoning decreased to-3.16％,-1.86％,-8.03％ and -4.96 ％,respectively (P＜0.05).ADRs of endocrine,nutritional and metabolic diseases significantly increased during 1996 to 2001 (APC=16.58％,P＜0.05) and thereafter remained stable.Conclusions The issue of population aging in Minhang District is getting worse,and chronic non-communicable diseases and injury and poisoning can be identified as major public health concerns at present.
Résumé
Objective To analyze changes and trends of the mortality and causes of death in the residents of Minhang District of Shanghai from 1996 to 2015.Methods Crude death rates (CDR) and age-standardized death rates (ADR) were calculated,respectively.Joinpoint regression was used to analyze the trends in the leading causes of death.Permutation test was used to find whether the joinpoints were statistically significant based on P value＜0.05.Results The elderly population in Minhang District accounted for 18.07％ of the total population in 2015,which increased by 73.89％ than it in 1996.The CDRs of all causes for resent 20 years gradually increased with the annual percentage change (APC) of 0.62％ (P＜0.05),but decreased significantly after standardization (APC =-3.73％,P＜0.05).In 2015,the top five causes of death were circulatory disease;neoplasms;respiratory disease;endocrine,nutritional and metabolic diseases;injury and poisoning in the total population,males and females registered in Minhang District.ADRs of circulatory disease,neoplasms,respiratory disease and injury and poisoning decreased to-3.16％,-1.86％,-8.03％ and -4.96 ％,respectively (P＜0.05).ADRs of endocrine,nutritional and metabolic diseases significantly increased during 1996 to 2001 (APC=16.58％,P＜0.05) and thereafter remained stable.Conclusions The issue of population aging in Minhang District is getting worse,and chronic non-communicable diseases and injury and poisoning can be identified as major public health concerns at present.