Research progress on moderate and deep sedation during wound dressing change in pediatric burn patients / 中华烧伤杂志

Moderate and deep sedation can effectively relieve or eliminate the pain and body discomfort during wound dressing change in pediatric burn patients, relieve anxiety, agitation, and even delirium of the children, reduce the metabolic rate of the children, make them in a quiet, comfortable, and cooperative state, which is conducive to the smooth completion of dressing change. This paper summarized the three aspects of moderate and deep sedation in pediatric burn patients, including the overview, main points of implementation, and effects, and further introduced the moderate and deep sedation medication regimens for different routes of administration, as well as the content of evaluation and monitoring. Suggestions on the prevention and management of related complications and the management of moderate and deep sedation implementation procedures were put forward, in order to provide references for the development of moderate and deep sedation for wound dressing change in pediatric burn patients in China.

Application effects of feedforward control theory in the rollover bed treatment of mass patients with burn-explosion combined injury / 中华烧伤杂志

Objective: To explore the application effects of feedforward control theory in the rollover bed treatment of mass patients with burn-explosion combined injury. Methods: A retrospective observational research was conducted. From June 13 to 14, 2020, 15 patients with severe burn-explosion combined injury caused by liquefied natural gas tank car explosion and conforming to the inclusion criteria were admitted to the Second Affiliated Hospital of Zhejiang University School of Medicine. There were 13 males and 2 females, aged 33-92 (66±17) years. All the patients were treated with rollover bed from 48 h post admission, and the feedforward control theory was introduced, including establishing a special feedforward control management team for rollover bed, clarifying the duties of the medical staff in the rollover bed treatment of patients, implementing the cooperation strategy of multidisciplinary physician, training and examining for 80 nurses in the temporarily organized nurse team in the form of "rollover bed workshop", and formulating the checklist and valuation list of rollover bed treatment for continuous quality control. The frequency and the total number of turning over, and successful rate of one-time posture change with the rollover bed of patients within 30 days of admission were recorded, the occurrences of adverse events caused by improper operation for the rollover bed during the treatment were observed, including respiratory and cardiac arrests, treatment interruption, unplanned extubation, bed falling, and skin graft displacement. The lowest levels of arterial partial pressure of oxygen (PaO2) and arterial partial pressure of carbon dioxide (PaCO2), the number of patients with oxygenation index>300 mmHg (1 mmHg=0.133 kPa), and the occurrence of acute respiratory distress syndrome (ARDS) of patients within 2 days of admission and on the 30th day of admission were recorded. Results: Within 30 days of admission, the patients were turned over with the rollover bed for 2 to 6 times each day, with a total of 1 320 turning over operations, the successful rate of one-time posture change reached 99.9% (1 319/1 320), and no adverse event occurred. Within 2 days of admission, the lowest levels of PaO2 and PaCO2 of the patients were (100±19) and (42±4) mmHg, respectively, and the number of patients with mild, moderate, and severe ARDS were 10, 2, and 3, respectively, and none of the patients had oxygenation index>300 mmHg. On the 30th day of admission, the lowest levels of PaO2 and PaCO2 of the patients were (135±28) and (37±8) mmHg, respectively, 3 patients developed moderate ARDS, 1 patient developed severe ARDS, and 11 patients had oxygenation index>300 mmHg. Conclusions: The introduction of feedforward control theory in the treatment of rollover bed of mass patients with burn-explosion combined injury can ensure safe and successful completion of turning over with the rollover bed, promote the repair of burn wound, and improve respiratory function, and therefore improve the treatment quality of patients.

Abnormal processing characteristics to basic emotional faces in the early phase in children with autism spectrum disorder / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To explore the recognition ability and abnormal processing characteristics to basic emotional faces in the early phase in children with autism spectrum disorders (ASD).</p><p><b>METHODS</b>Photos of Chinese static faces with four basic emotions (fearful, happy, angry and sad) were used as stimulus. Twenty-five ASD children and twenty-two age- and gender-matched typical developed children (normal controls) were asked to match the emotional faces with words. Event-related potential (ERP) data were recorded concurrently.</p><p><b>RESULTS</b>N170 latencies for total emotion and fearful face in the left temporal region were faster than in the right one in normal controls (P<0.05), but the results were not noted in ASD children. Further, N170 latencies in the left temporal region of ASD children were slower than normal controls for total emotion, fearful and happy faces (P<0.05), and their N170 latencies in the right temporal region were prone to slower than normal controls for angry and fearful faces.</p><p><b>CONCLUSIONS</b>The holistic perception speed of emotional faces in the early cognitive processing phase in ASD children is slower than normal controls. The lateralized response in the early phase of recognizing emotional faces may be aberrant in children with ASD.</p>

Association between intelligence development and facial expression recognition ability in children with autism spectrum disorder / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the features of intelligence development, facial expression recognition ability, and the association between them in children with autism spectrum disorder (ASD).</p><p><b>METHODS</b>A total of 27 ASD children aged 6-16 years (ASD group, full intelligence quotient >70) and age- and gender-matched normally developed children (control group) were enrolled. Wechsler Intelligence Scale for Children Fourth Edition and Chinese Static Facial Expression Photos were used for intelligence evaluation and facial expression recognition test.</p><p><b>RESULTS</b>Compared with the control group, the ASD group had significantly lower scores of full intelligence quotient, verbal comprehension index, perceptual reasoning index (PRI), processing speed index（PSI), and working memory index (WMI) (P<0.05). The ASD group also had a significantly lower overall accuracy rate of facial expression recognition and significantly lower accuracy rates of the recognition of happy, angry, sad, and frightened expressions than the control group (P<0.05). In the ASD group, the overall accuracy rate of facial expression recognition and the accuracy rates of the recognition of happy and frightened expressions were positively correlated with PRI (r=0.415, 0.455, and 0.393 respectively; P<0.05). The accuracy rate of the recognition of angry expression was positively correlated with WMI (r=0.397; P<0.05).</p><p><b>CONCLUSIONS</b>ASD children have delayed intelligence development compared with normally developed children and impaired expression recognition ability. Perceptual reasoning and working memory abilities are positively correlated with expression recognition ability, which suggests that insufficient perceptual reasoning and working memory abilities may be important factors affecting facial expression recognition ability in ASD children.</p>

Event-related potential of working memory on emotional faces in children with autism spectrum disorder / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the characteristics of working memory ability on emotional faces and related event-related potential (ERP) in children with autism spectrum disorder (ASD).</p><p><b>METHODS</b>The Chinese Facial Affective Picture System was used as test material, and the event-related potential system was used to record the electroencephalographic data when 16 ASD children aged 6-12 years (ASD group) and 14 normal children matched for age (control group) were completing the facial emotion delayed match-to-sample task. The characteristics of P3b component were analyzed for both groups.</p><p><b>RESULTS</b>Compared with the control group, the ASD group had a significantly longer reaction time (1 527 ms vs 1 060 ms; P<0.05) and a significantly lower accuracy rate (76% vs 88%; P<0.01) in the facial emotion delayed match-to-sample task. There was a difference in the amplitude of P3b component during the encoding stage between the two groups. In the ASD group, the P3b component on the left side electrode had a higher amplitude than that on the right side electrode (P<0.05), while the control group had no such characteristics.</p><p><b>CONCLUSIONS</b>There is a difference in P3b component during the encoding stage between school-aged ASD children and normal children. In ASD children, working memory on emotional faces may depend more on the related neural pathway in the left hemisphere.</p>