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Objective:To investigate the human cytomegalovirus(HCMV)infection and hearing impairment in infants with congenital and perinatal diseases of the Bo′ai Hospital in Zhongshan City, and to explore the risk factors of hearing impairment and clinical outcomes.Methods:A total of 243 cases of infants with congenital and perinatal HCMV infection were collected from Bo′ai Hospital from January 2016 to December 2018.Clinical data and brainstem auditory evoked potential(BAEP)results were analyzed retrospectively.Logistic regression analysis was performed to identify the risk factors of hearing impairment.The children with hearing loss were followed up in out-patient.Results:Positive rates of congenital and perinatal HCMV infection in infants were 4.56%(121/2654), 2.76%(74/2686)and 3.15%(85/2701)from 2016 to 2018 in our hospital respectively.In 243 cases, there were 107 cases with normal hearing(44%), 33 cases with suspicious hearing impairment(14%)and 103 cases with hearing impairment(42%). Multivariate logistic regression analysis showed that the age less than 1 month( P=0.034)and CMV-DNA positive( P=0.003)were independent risk factors for hearing impairment.The manifestations of hearing impairment were various.Twenty cases with suspected hearing impairment were not treated with ganciclovir, in which 19 cases BAEP became normal.Sixty-seven cases with hearing impairment were followed up, of whom 47 cases received standardized ganciclovir antiviral therapy: 30 cases returned to normal, and 12 cases improved, and 3 cases showed no significant changes, and 2 cases aggravated.Twenty cases did not received the antiviral therapy: 5 cases returned to normal, and 8 cases improved, and 3 cases showed no significant changes, and 4 cases aggravated. Conclusion:There was a high rate of HCMV infection of congenital and perinatal infants in our hospital.Infected infants have a higher proportion of hearing impairment.Infants less than 1 month and CMV-DNA positive are more likely to suffer from hearing impairment.It can be considered for clinical observation for the cases with slightly elevated hearing threshold.Standardized ganciclovir antiviral therapy has obvious effect on hearing improvement.
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Objective To investigate the epidemiological characteristics and drug sensitivity of non-typhoid salmonella in Zhongshan city.Methods We collected the positive cases of non-typhoid salmonella in children of Zhongshan city from 2013 to 2015.The sex,age,place of residence,onset time and main serum type of these cases were collected.The characteristics of the cases were described by descriptive epidemiologi-cal study.Results From 2013 to 2015,3 040 stool specimens from patients with enteritis were collected and 402 strain of non-typhoid salmonella were separated out. The total detection rate was 13.22%,the annual detection rate were 10.26%,12.21% and 16.76%,respectively.The peak period was from July to August every year.Of the 402 children,240 were male,162 were female,and the ratio was 1.48:1.The minimum age was 1 month,the maximum was 5 years and 8 months,the mean age was 13.62 months.All patients were characterized by diarrhea and fever,including 64 cases of bloody stool and 1 case of sepsis.The most com-mon serotypes were 4,5,12:i:-and 4,12:i:-.The resistant strains were salmonella typhimurium and variety salmonella typhimurium strains.From 2013 to 2015,the resistance rate of ceftriaxone and ceftazidime in non-typhoid salmonella isolates increased linearly (ceftriaxone: 17.35%, 26.23%, 39.01%; ceftazidime:12.24%,17.21%,30.77%).The differences were statistically significant(χ2=30.3,P<0.01;χ2=26.3, P<0.01).Conclusion The positive rate of nontyphoid salmonella increased year by year from 2013 to 2015.The most common serotype was salmonella typhimurium, and the resistant strains were salmonella typhimurium and salmonella typhimurium variety.The resistance rate of non-typhoid salmonella to ceftriaxone and ceftazidime increased year by year,and the highest rate of ceftazidime resistance was in July 2015.Non-typhoid salmonella was more resistant to ceftriaxone than ceftazidime.
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Objective To summarize the clinical characteristics and drug sensitivity of Pseudomonas aeruginosa in children. Methods The data of children with diagnosed Pseudomonas aeruginosa from 2006 to 2016 were retrospectively analysis. Results There were 14 patients who had diagnosis of Pseudomonas aeruginosa, most of whom were infants and toddlers ( 78 . 6%). The common complications were disseminated intravascular coagulation (DIC) and pulmonary hemorrhage. In 14 patients, 7 patients were cured, 4 were died, and 3 were given up treatment by their family because of serious illness. The antimicrobial susceptibility test showed that isolated pseudomonas aeruginosa had good sensitivity to aminoglycosides and quinolones. Conclusion Pseudomonas aeruginosa sepsis is more common in infants and toddlers, with high mortality. For suspected patients, the antibiotic that covers the Pseudomonas aeruginosa should be used in early antibiotic therapy.
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Objective:To provide clinical evidence-based prognosis for patients with postpartum HEELP syndrome complicated with acute renal failure. Methods:The clinical question was proposed. Some database was searched to assess the evidence. Results:A total of 4 studies were included,however,the quality of the studies was low. The results of the studies was suitable for our patients. The death of patients with postpartum HEELP syndrome complicated with acute renal failure was attributed to multiple organ failure. The risk factors for poor prognosis was primipara, delivery after twin pregnancy, absence of typical symptoms, rapid clinical progression, high blood pressure, epigastric pain. Early assessment and diagnosis for maternal and infant, positive in intervention and be caution for the DIC and multiple organ failure, using plasmapheresis can improve the prognosis. Conclusion:Patients with postpartum HEELP syndrome complicated with acute renal failure have an acute process and poor prognosis, especially for patients without typical symptoms.
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Objective To study the epidemic characteristics and disease spectrum of Epstein-Barr virus (EBV) infected children in Zhongshan region, Guangdong province. Methods Clinical data from the children with positive EBV-DNA detected by real-time lfuorescent quantitative PCR between 2011 and 2013 was retrospectively analyzed. Results A total of 409 cases were detected with EBV-DNA positive from 3402 cases, with a total positive rate 12%, and the positive rate is 8.1%in 2011, 10.4% in 2012, 19.5% in 2013, there were significant differences among positive rate (χ2=6804.00, P0.05) and different age groups (χ2=136.96, P<0.05). The positive rate of pre-school group is the highest. EBV infection can cause multiple system diseases. The most common disease caused by EBV infection was infectious mononucleosis (61.6%), followed by respiratory tract infection (26.7%), neck lymphadenitis (3.4%), idiopathic thrombocytopenic purpura (2.4%), etc. Among the 409 cases of EBV infection, the concurrent other pathogen speciifc IgM positive cases as MP-IgM positive (n=79), CP-IgM positive (n=47), Parvovirus B19-IgM positive (n=20), HSV-IgM positive (n=11), CMV-IgM positive (n=10), and RV-IgM positive (n=4) were found. Conclusions Infectious mononucleosis is the leading disease in children infected by EBV in Zhongshan region, the annual positive rate is increasing. Multiple pathogen speciifc IgM may be detected positive in children with EBV infection, which should be interpreted in combination with clinical status.
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Objective To investigate hospitalized children's nutritional risk and malnutrition occurrence,and to provide clinical basis for nutrition support.Methods Nutritional risk screening tool STRONGkids was applied to 651 cases of hospitalized children with nutritional risk screening,and through physical measurement to assess children' s nutritional status,at the same time during the patient's diagnosis,the length of time data for analysis was recorded.Results Of 651 cases of hospitalized children,7.07％ (46 cases) were of highly nutritional risk,80.95％ (527 cases) with moderate nutrition risk,and 11.98％ (78 cases) were of low nutrition risk.Malnutrition rate was 22.58％,moderate malnutrition in 111 cases (17.05％),severe malnutrition in 36 cases (5.53％).The first three high risk diseases were congenital heart disease,chronic liver disease and chronic kidney disease(x2 =21.43,P ＜0.01).According to the result of nutrition evaluation concluded with congenital heart disease,chronic kidney disease occurred with severe malnutrition was far higher than other diseases(x2 =16.53,P ＜ 0.05).Children with highly nutritional risk were more likely to have weight loss than the children with relatively low nutritional risk (P ＜ 0.05),and their length of hospital stay were obviously longer than the children with low or moderate nutritional risk (P ＜ 0.05).Conclusions The hospitalized children have high incidence of malnutrition,and different nutritional risks lead to different clinical outcomes.STRONGkids score method helps to evaluate nutritional risk in hospitalized children and detect malnutrition and potential deterioration,which is conducive to early comprehensive nutritional assessment and proper nutritional treatment,thus to improve their clinical outcomes.
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Objective To evaluate the efficacy and safety of composite milk clotting enzyme capsules in children with functional dyspepsia.Methods A multicenter,randomized,open-label clinical trial was carried out in 4Guangzhou hospitals during Feb.2012 to Mar.2013.Children with functional dyspepsia on basis of Rome Ⅲ criteria were enrolled and treated with composite milk clotting enzyme capsules.Total symptom score and drug-related adverse reactions were evaluated after one-week and two-week therapy.The treatment outcome were divided into very effective,fairly effective and ineffective according to the symptom score changes.Superiority test was done for effectiveness of the treatment based on efficacy difference by 10％ regarded as superiority.Results Two hundred and one children were enrolled.One hundred and ninety-six children completed the study as planned.After two-week therapy,better effective rate and total effective rate were 68.88％ and 87.76％,higher than those of one-week therapy (27.04％,76.02％) (U =2.935,P ＜ 0.05).The lower limits of 95 ％ confidence interval of difference in symptoms improve rate,better efficacy rate and symptom score decrease rate between two-week and one-week therapy were more than 10％,and two-week therapy was superior to one-week therapy.No significant drug-related adverse reaction was found during the study.Conclusions Composite milk clotting enzyme capsules can improve functional dyspepsia symptoms significantly.The effectiveness of two-week of treatment is better than that of one-week treatment.No obvious drug-related adverse reaction is observed.