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Objective@#To examine the eating behaviors and associated factors among preschool children from multiple child families, so as to provide a basis for promoting healthy eating habits in this population.@*Methods@#From April to June 2022, a stratified random cluster sampling method was employed to selected 2 647 guardians of preschool children in 11 kindergartens in Tongling City. Parenting style questionnaire, Identification and Management of Feeding Difficulty Questionnaire (IMFeD), Caregiver s Feeding Style Questionnaire (CFSQ) and a self designed questionnaire were administered. Multiple linear regression was performed to analyze the factors influencing eating behaviors among preschool children.@*Results@#In the study, the detection of eating behavior problems among preschool children was 71.4%, and the detection of reduced appetite was the highest (55.6%). The detection rates of anorexia, picky eating, poor eating and improper eating behavior in only child families were higher (60.6%, 41.0%, 32.0%, 19.5%), compared with those in multiple child families (51.7%, 36.4%, 27.2%, 16.6%) ( χ 2=20.05, 5.95, 7.16, 3.92, P < 0.05 ). Among multiple child families, the detection rates of fear of eating and underlying disease were the lowest in 5-<10-year-old group (2.3%, 0.6%) ( χ 2=11.54, 8.51, P <0.05). In multiple child families, the detection rates of picky eating and poor eating habits for the first-born child were higher (42.0%, 32.5%), compared with second born and third born child (34.6%, 25.6%)( χ 2= 6.15, 6.38, P <0.05). The results of multiple linear regression analysis showed that multiplechild families ( β =-1.40), democratic parenting style ( β =-0.07), higher feeding response scores ( β =-0.33) were negatively associated with eating behavior problems among preschool children ( P <0.05). Eating behavior problems among preschool children were positively correlated with less educated mothers [high and junior high school education ( β =0.87), primary school education and below ( β =3.69)], longer average daily screen time ( β =0.10), higher feeding requirements scores ( β =0.64), doting parenting styles ( β =0.21), permissive parenting styles ( β =0.27) and inconsistent parenting styles ( β =0.14)( P <0.05).@*Conclusion@#The detection rate of the eating behaviors problems among preschool children is high in schools. Greater attention should be paid to only child and first born child of multiple child families, and appropriate feeding and parenting styles, so as to promote healthy eating habits among this population.
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Objective:The purpose of this case report is to improve the understanding of pulmonary arteriovenous malformation (PAVM) and its related complications by reviewing case data and literature.Methods:A case of huge PAVM complicated with brain abscess and paradoxical embolization of liver, spleen and kidney is reported, and then we summarize its clinical characteristics, diagnosis and treatment, and review the relevant references.Results:Brain abscess and paradoxical embolization are the most common complications of PAVM. The diagnosis and process of this patient was timely and clear. The patient received interventional embolization for PAVM and achieved good results.Conclusions:PAVM can cause brain abscess and paradoxical embolization. We should be vigilant to avoid missed diagnosis and misdiagnosis.
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Objective:To investigate the changes of quadriceps femoris thickness with the length of stay in intensive care unit (ICU) in patients with sepsis, and to evaluate the diagnostic value of muscle changes in mortality.Methods:A prospective study was conducted, and 92 patients with sepsis who were admitted to the ICU of the Affiliated Hospital of Jining Medical College from January 2020 to December 2021 were enrolled. The thickness of quadriceps femoris [including the quadriceps femoris muscle thickness at the midpoint of the anterior superior iliac spine and the upper edge of the patella (M-QMLT), and at the middle and lower 1/3 of the patella (T-QMLT)] measured by ultrasound 1 day (D1), 3 days (D3), and 7 days (D7) after admission to the ICU were collected. The atrophy rate of quadriceps femoris was calculated 3 and 7 days after admission to the ICU compared with 1 day [(D3-D1)/D1 and (D7-D1)/D1, (TD3-TD1)/TD1 and (TD7-TD1)/TD1, respectively]. The demographic information, underlying diseases, vital signs when admission to the ICU and in-hospital mortality of all patients were recorded, and the differences of the above indicators between the two groupswere compared. Multivariate Logistic regression was used to analyze the influence of quadriceps femoris muscle thickness and atrophy rate on in-hospital mortality of septic patients. The receiver operator characteristic curve (ROC curve) was drawn to analyze the predictive value of quadriceps femoris muscle thickness and atrophy rate on in-hospital mortality of septic patients.Results:A total of 92 patients with severe sepsis were included, of which 41 patients died in hospital, 51 patients discharged. The in-hospital mortality was 44.6%. The muscle thickness of quadriceps femoris in severe septic patients decreased with the prolongation of ICU stay, and there was no significant difference between the two groups at the first and third day of ICU admission. The muscle thickness of quadriceps femoris at different measuring positions in the survival group was significantly greater than those in the death group 7 days after admission to the ICU [M-QMLT D7 (cm): 0.50±0.26 vs. 0.39±0.19, T-QMLT D7 (cm): 0.58±0.29 vs. 0.45±0.21, both P < 0.05]. The atrophy rate of quadriceps femoris muscle thickness at different measuring positions 3 and 7 days after admission to ICU in the survival group was significantly lower than those in the death group [(D3-D1)/D1: (8.33±3.44)% vs. (9.74±3.91)%, (D7-D1)/D1: (12.21±4.76)% vs. (19.80±6.15)%, (TD3-TD1)/TD1: (7.83±4.26)% vs. (10.51±4.75)%, (TD7-TD1)/TD1: (11.10±5.46)% vs. (20.22±6.05)%, all P < 0.05]. Multivariate Logistic regression analysis showed that M-QMLT D7, T-QMLT D7, (D3-D1)/D1, (D7-D1)/D1, (TD3-TD1)/TD1, (TD7-TD1)/TD1 were independent risk factors for in-hospital mortality (all P < 0.05). The results were stable after adjusting for confounding factors. ROC curve analysis showed that (TD7-TD1)/TD1 [area under the ROC curve (AUC) was 0.853, 95% confidence interval (95% CI) was 0.773-0.934] was superior to (D7-D1)/D1, T-QMLT D7, M-QMLT D7, (TD3-TD1)/TD1 and (D3-D1)/D1 [AUC was 0.821 (0.725-0.917), 0.692 (0.582-0.802), 0.683 (0.573-0.794), 0.680 (0.569-0.791), 0.622 (0.502-0.742)]. Conclusions:For septic patients in ICU, bedside ultrasound monitoring of quadriceps femoris muscle thickness and atrophy rate has a certain predictive value for in-hospital mortality, and a certain guiding significance in clinical treatment and predicting the prognosis of sepsis.
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Objective:To explore the value of lactic acid (Lac), procalcitonin (PCT), sequential organ failure assessment (SOFA) score and acute physiology and chronic health evaluationⅡ (APACHEⅡ) score in assessing the severity and predicting the prognosis in sepsis shock.Methods:A retrospectively study was conducted. Patients with septic shock hospitalized in the department of critical care medicine of the Affiliated Hospital of Jining Medical University from April 2015 to June 2019 were enrrolled. The patient's gender, age, body mass index (BMI), infection site, organ dysfunction status; Lac, PCT, C-reactive protein (CRP), heart rate and body temperature immediately after admission to the intensive care unit (ICU); APACHEⅡ and SOFA scores within 24 hours, and 28-day prognosis were collected. According to the 28-day prognosis, the patients with septic shock were divided into the survival group and the death group, and the differences in the indicators between the groups were compared. Multivariate Logistic regression analysis was used to screen the risk factors of 28-day death in patients with septic shock; receiver operating characteristic curve (ROC curve) was used to analyze the value of Lac, PCT, SOFA, APACHEⅡ, and age in predicting the 28-day prognosis of patients with septic shock.Results:A total of 303 septic shock patients were enrolled, of which 124 cases survived and 179 died on the 28th day, and the 28-day mortality was 59.08%. ① Compared with the survival group, patients in the death group were older (years old: 66.58±15.22 vs. 61.15±15.68), APACHEⅡ, SOFA, proportion of lung infections, Lac increased [APACHEⅡ score: 22.79±7.62 vs. 17.98±6.88, SOFA score: 9.42±3.51 vs. 5.65±1.59, proportion of lung infections: 53.63% (96/179) vs. 39.52% (49/124), Lac (mmol/L): 5.10±3.72 vs. 3.71±2.56], oxygenation index (PaO 2/FiO 2) and ICU body temperature decreased [PaO 2/FiO 2 (mmHg, 1 mmHg = 0.133 kPa): 198.94±80.15 vs. 220.68±72.06, ICU body temperature (℃): 37.47±1.08 vs. 37.80±1.14], and the differences were statistically significant (all P < 0.05).②Multivariate Logistic regression analysis results: after adjusted for potential confounding factors, APACHEⅡ, PCT, Lac, age and SOFA were independent risk factors for death in patients with septic shock [APACHEⅡ: odds ratio ( OR) =1.05, 95% confidence interval (95% CI) was 1.01-1.10, P = 0.039; PCT: OR = 0.99, 95% CI was 0.98-1.00, P =0.012; Lac: OR = 1.23, 95% CI was 1.08-1.40, P = 0.002; age: OR = 1.03, 95% CI was 1.01-1.05, P =0.009; SOFA score: OR =1.88, 95% CI was 1.59-2.22, P < 0.001]. ③ROC curve analysis showed that APACHEⅡ, Lac, age and SOFA could predict the prognosis of patients with septic shock [APACHEⅡ: the area under the ROC curve (AUC) = 0.682 4, 95% CI was 0.621 7-0.743 1, P = 0.000; when the best cut-off value was 18.500, its sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio and negative likelihood ratio were 72.63%, 54.84%, 69.89%, 58.12%, 1.608 1 and 0.499 2, respectively. Lac: AUC = 0.604 5, 95% CI was 0.540 8-0.668 2, P = 0.002; when the best cut-off value was 3.550 mmol/L, the sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio and negative likelihood ratio were 50.84%, 73.39%, 73.39%, 50.94%, 1.910 3 and 0.669 9, respectively. Age: AUC = 0.599 1, 95% CI was 0.535 4-0.662 7, P = 0.003; when the best cut-off value was 72.500 years old, the sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio and negative likelihood ratio were 42.46%, 75.00%, 71.03%, 47.45%, 1.698 3 and 0.767 2, respectively. SOFA: AUC =0.822 3, 95% CI was 0.776 7-0.867 9, P = 0.000; when the best cut-off value was 7.500, its sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio and negative likelihood ratio were 68.72%, 87.90%, 89.13%, 66.06%, 5.680 4, 0.355 9 respectively]. The combined prediction had a good sensitivity (72.63%) and specificity (84.86%), and AUC (0.876 5) was higher than that of a single variable, suggested that the multivariate combination was more accurate in predicting the short-term outcome of septic shock. Conclusion:Lac, PCT, SOFA score, APACHEⅡ score and age were independent risk factors for death in patients with septic shock, and the accuracy of Lac, SOFA score, APACHEⅡ score and age in predicting short-term prognosis of septic shock was better than that of single variable, and the diagnostic value was higher.
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Objective@#To understand the cognitive and management status of breast cancer patients with expectant nausea and vomiting in breast cancer patients, and to provide reference for taking targeted measures to improve the symptoms of nausea and vomiting.@*Methods@#From March to May 2018, 10 breast surgical nurses were selected by the purpose sampling method. The phenomenological research methods in qualitative research were used to interview them. The Colaizzi data analysis principle was used to analyze the data and refine the theme.@*Results@#A total of five themes were extracted: nurses generally knew the impact of nausea and vomiting on patients; lack of knowledge about the expected nausea and vomiting of chemotherapy; nausea and vomiting has not been evaluated as an independent symptom; there is still no targeted, systematic management Measures; lack of attention is a major obstacle to the management of nausea and vomiting in patients.@*Conclusion@#Nurses should strengthen the knowledge of chemotherapy-predicted nausea and vomiting in breast cancer patients, and effectively evaluate patients with nausea and vomiting. Nursing managers should formulate corresponding standardized interventions to improve patients' nausea and vomiting according to the existing problems. Improve the quality of life of patients.
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Objective To understand the cognitive and management status of breast cancer patients with expectant nausea and vomiting in breast cancer patients, and to provide reference for taking targeted measures to improve the symptoms of nausea and vomiting. Methods From March to May 2018, 10 breast surgical nurses were selected by the purpose sampling method. The phenomenological research methods in qualitative research were used to interview them. The Colaizzi data analysis principle was used to analyze the data and refine the theme. Results A total of five themes were extracted: nurses generally knew the impact of nausea and vomiting on patients; lack of knowledge about the expected nausea and vomiting of chemotherapy; nausea and vomiting has not been evaluated as an independent symptom; there is still no targeted, systematic management Measures; lack of attention is a major obstacle to the management of nausea and vomiting in patients. Conclusion Nurses should strengthen the knowledge of chemotherapy-predicted nausea and vomiting in breast cancer patients, and effectively evaluate patients with nausea and vomiting. Nursing managers should formulate corresponding standardized interventions to improve patients' nausea and vomiting according to the existing problems. Improve the quality of life of patients.
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Baicalein is a kind of flavonoids. Long term use of flavonoids can reduce blood pressure by releasing physiological NO to keep the vascular endothelial function of hypertensive animals and reduce mysocardial ischemia injury. The purpose of this study is to explore the effect of baicalein on myocardial I/R damage and explore its mechanism of action, so as to provide experimental evidence for treatment. The results show that baicalein has a significant improvement in I/R damage, mainly in reducing myocardial infarction rate, reducing the release of myocardial isozyme LDH and CK, reducing the level of oxidative stress and reducing the apoptosis of cardiac myocytes. In the baicalein group, the myocardial ischemia state of isolated rat hearts was improved. Among them, myocardial infarction rate in low and middle concentration group was significantly decreased [P<0.05 or P<0.01], and there was no significant change in high concentration group [P>0.05]. The apoptosis rate of cardiac myocytes in the isolated group of baicalein was significantly decreased [P<0.01]. The role of baicalein in the cardiovascular system needs further test and clinical research
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Objective To determine the value of procalcitonin (PCT) as an early marker of postoperative infection after cardiac surgery with cardiopulmonary bypass (CPB).Methods A retrospective study was conducted. Patients with systemic inflammatory response syndrome (SIRS) after cardiac surgery with CPB admitted to intensive care unit (ICU) of Peking Union Medical College Hospital from November 2014 to January 2017 were enrolled. The cardiac surgery types and intraoperative conditions, the treatments in ICU, postoperative 28-day mortality and hospital mortality of the patients; the levels of plasma PCT measured at ICU admission, postoperative 1, 3, and 5 days were collected. According to whether patients with postoperative infection or not, they were divided into infection group and non-infection group. Receiver operating characteristic curve (ROC) was used to analyze the predictive value of plasma PCT levels at different time points in patients with infection.Results Eighty-two patients were included in this study, 25 (30.5％) had microbiological evidence of pneumonia. The levels of plasma PCT were increased with a peak 1 day after cardiac surgery in all patients, then significantly decreased 5 days after operation. Compared with patients without infection, the levels of plasma PCT were significantly increased in patients with infection at immediate and 1, 3, 5 days post operation in ICU [μg/L: 10.0 (6.0, 64.5) vs. 5.0 (1.0, 10.0), 31.0 (10.0, 116.2) vs. 5.0 (1.0, 10.0), 34.7 (10.0, 60.4) vs. 2.9 (0.7, 9.3), 15.8 (7.7, 29.4) vs. 0.7 (0.5, 2.6), allP < 0.01]. The area under the ROC curve (AUC) of the plasma PCT levels at ICU admission, and 1, 3, 5 days thereafter to predict infection for critically ill patients with SIRS after CPB was 0.77, 0.82, 0.86, and 0.91, respectively (allP < 0.01), cut-off values were 6.8, 9.4, 9.2 and 3.9μg/L, with the sensitivities of 76.0％, 84.0％, 79.2％, and 88.0％, and the specificities of 66.7％, 68.4％, 75.4％, and 78.9％, respectively.Conclusions In the presence of SIRS, elevated plasma PCT levels correlated with evidence of infection in early stage post operation in the ICU patients after cardiac surgery with use of CPB. The level of plasma PCT exceeded the cut-off value in different time points, suggesting infection, and it is helpful to predict the occurrence of infection early after operation.
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Objective To determine the value of procalcitonin (PCT) as an early marker of postoperative infection after cardiac surgery with cardiopulmonary bypass (CPB).Methods A retrospective study was conducted. Patients with systemic inflammatory response syndrome (SIRS) after cardiac surgery with CPB admitted to intensive care unit (ICU) of Peking Union Medical College Hospital from November 2014 to January 2017 were enrolled. The cardiac surgery types and intraoperative conditions, the treatments in ICU, postoperative 28-day mortality and hospital mortality of the patients; the levels of plasma PCT measured at ICU admission, postoperative 1, 3, and 5 days were collected. According to whether patients with postoperative infection or not, they were divided into infection group and non-infection group. Receiver operating characteristic curve (ROC) was used to analyze the predictive value of plasma PCT levels at different time points in patients with infection.Results Eighty-two patients were included in this study, 25 (30.5％) had microbiological evidence of pneumonia. The levels of plasma PCT were increased with a peak 1 day after cardiac surgery in all patients, then significantly decreased 5 days after operation. Compared with patients without infection, the levels of plasma PCT were significantly increased in patients with infection at immediate and 1, 3, 5 days post operation in ICU [μg/L: 10.0 (6.0, 64.5) vs. 5.0 (1.0, 10.0), 31.0 (10.0, 116.2) vs. 5.0 (1.0, 10.0), 34.7 (10.0, 60.4) vs. 2.9 (0.7, 9.3), 15.8 (7.7, 29.4) vs. 0.7 (0.5, 2.6), allP < 0.01]. The area under the ROC curve (AUC) of the plasma PCT levels at ICU admission, and 1, 3, 5 days thereafter to predict infection for critically ill patients with SIRS after CPB was 0.77, 0.82, 0.86, and 0.91, respectively (allP < 0.01), cut-off values were 6.8, 9.4, 9.2 and 3.9μg/L, with the sensitivities of 76.0％, 84.0％, 79.2％, and 88.0％, and the specificities of 66.7％, 68.4％, 75.4％, and 78.9％, respectively.Conclusions In the presence of SIRS, elevated plasma PCT levels correlated with evidence of infection in early stage post operation in the ICU patients after cardiac surgery with use of CPB. The level of plasma PCT exceeded the cut-off value in different time points, suggesting infection, and it is helpful to predict the occurrence of infection early after operation.
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Objective To establish the UPLC fingerprint of Shuanghuanglian powder-injection. Methods Acquity UPLCTM BEH C18 Column (2.1 mm × 50 mm, 1.7 μm) was established;mobile phase was acetonitrile and 0.1%formic acid with gradient elution;the flow rate was 0.3 mL/min;the column temperature was 40 ℃. Characteristic spectrum cluster of 13 batches of Shuanghuanglian powder-injection were analyzed, and Chinese Medicine Chromatographic Fingerprint Evaluation System (2004 A) was used to evaluate their quality. Results UPLC fingerprint common mode of 13 batches of Shuanghuanglian powder-injection was established. There were total 16 common spectrum peaks in the reference for comparison, and three main peaks were identified with better separation. The 13 batchs had good consistency, and the process was stable. Conclusion The method is rapid, efficient and can be used for full control of the quality of Shuanghuanglian powder-injection.
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OBJECTIVE:To establish a GC-MS method to identify the volatile constituents in Radix Isatidis.METHODS:The method of wet distillation was applied to extracting volatile oil from Radix Isatidis,the chromatographic column was OV-1,and the flow rate was 1.0mL?min-1,EI ion source was used by MS.The volatile constituents in Radix Isatidis were identified and analyzed by NIS107 system.RESULTS:22 chromatographic peaks were separated,19 chemical compounds were identified,representing 90.51% of total amount,hexadecanoic acid had highest content,accounting for 38.52% of total amount.CONCLUSION:This experiment has provided initial usable data for comprehensive utilization of Radix Isatidis.