Non-Invasive Prenatal Testing:Results in 3733 Cases of Twin Pregnancy and Association With Factors Such as Age / 中国医学科学院学报

Objective To explore the clinical significance of non-invasive prenatal testing(NIPT)for fetal chromosomal abnormalities in the cases of twin pregnancy and its relationship with age and other related factors.Methods A total of 3733 women with twin pregnancy of 12-26+6 weeks who voluntarily underwent NIPT in the Ningbo Women and Children's Hospital from January 2018 to December 2022 were selected.The results of NIPT and amniocentesis were compared and all the participants were followed up.The detection rate of chromosomal abnormalities by NIPT was calculated,and its correlations with age,gestational weeks,chorionicity,and pregnancy type were analyzed.Results Among the 3733 cases,71 cases of fetal chromosome abnormality were indicated by NIPT,including 13 cases of trisomy 21,19 cases of trisomy 18,5 cases of trisomy 13,18 cases of sex chromosome abnormality,and 16 cases of chromosome microdeletion/duplication(excluding 21,18,13,and sex chromosomes),among which 34 cases were true positive and 37 cases were false positive.The overall sensitivity,specificity,and positive predictive value(PPV)of NIPT for chromosomal abnormalities in the cases of twin pregnancy were 100%,98.99%,and 47.89%(34/71),respectively.NIPT showed the sensitivity,specificity,and PPV of 100%,99.78%,and 78.38%(29/37)for trisomy 21,18,and 13,100%,99.56%,and 16.67%(3/18)for sex chromosome abnormalities,and 100%,99.62%,and 12.5%(2/16)for chromosome microdeletion/duplication,respectively.In the age group of ≥40 years,the NIPT for chromosomal abnormalities showed the PPV of 66.67%,the sensitivity of 100%,and the misdiagnosis rate of 30%。However,the NIPT for trisomy 21,18,and 13 showed the PPV of 100%,the misdiagnosis rate of 0,and the sensitivity and specificity of 100%.In terms of grouping based on gestational weeks,the NIPT for chromosomal abnormalities showed the highest PPV(51.28%)in the women with twin pregnancy for 14-17+6 weeks,followed by that(50.00%)in the women with twin pregnancy for 22-26+6 weeks;the NIPT for trisomy 21,18,and 13 showed the highest PPV of 94.74% in the gestation group of 14-17+6 weeks,followed by that(83.33%)in the gestation group of 18-21+6 weeks.The rate of dichorionic diamniotic twins was higher in assisted pregnancies than in natural pregnancies,and NIPT showed the same detection efficiency for dichorionic diamniotic twins and monochorionic diamniotic twins and the same detection efficiency for different pregnancy types.Conclusions NIPT has high accuracy in the diagnosis of twin pregnancy and high sensitivity and high specificity for different ages and gestational weeks,especially for trisomy 21,18,and 13.NIPT is suitable for assisted pregnancy and natural pregnancy,and it is of high value in clinical application.However,extensive application needs a large population-based study.

Quality standard improvement study of ginkgo semen decoction pieces / 药学实践杂志

Objective To establish and improve the quality standard of ginkgo semen decoction pieces. Methods The morphological character for 29 batches of ginkgo gemen and 12 batches of stir-fried ginkgo gemen were observed, and the moisture contents were assayed using the method in Chinese Pharmacopoeia 2015 edition, the first supplement. Results The character of ginkgo gemen and stir-fried ginkgo gemen were consistent in different batches. The moisture content of ginkgo gemen was 8.8% to 12.2%, with an average of 10.5%. The moisture content of stir-fried ginkgo gemen was from 5.4% to 12.3%, with an average of 8.9%. Considering that ginkgo semen decoction pieces are stored for a long time, they are prone to the attack of mildew and insects, and the moisture limit is set to be no more than 10.0% in ginkgo gemen and stir-fried ginkgo. Conclusion Compared with the Chinese Pharmacopoeia 2015 edition, the first supplement, the character identification for ginkgo semen decoction pieces was added and the quality standards were improved. The moisture content of ginkgo semen decoction pieces needs to be strictly controlled under 10.0% to prevent mildew and insects.

Experimental research on characteristics of temperature field distribution of mild moxibustion and sparrow-pecking moxibustion / 中国针灸

OBJECTIVE@#To explore the temperature field distribution and variation rules during treatment with mild moxibustion and sparrow-pecking moxibustion of TCM.@*METHODS@#Six healthy subjects were selected. Mild moxibustion and sparrow-pecking moxibustion were exerted at Zusanli (ST 36) respectively, for 25 min. Using infrared thermal imaging instrument, the temperature field distribution was measured during moxibustion at Zusanli (ST 36). The simulated thermometer was adopted to measure the temperature field distribution during moxibustion at the imitated cortex. At 20 min of mild moxibustion and sparrow-pecking moxibustion, the temperature field distribution generated by moxibustion was observed at the imitated cortex and Zusanli (ST 36) separately. The temperature values were collected at the sites 0.7, 2.1 and 3.5 cm far from the center of the moxibustion-exerted places successively, and then the characteristics of temperature field distribution and variation rules were compared between different moxibustion methods at the imitated cortex and Zusanli (ST 36).@*RESULTS@#At 20 min of mild moxibustion and sparrow-pecking moxibustion at Zusanli (ST 36), the temperature field distribution focused on the center of moxibustion-exerted site and the temperature was reduced to all directions and illustrated as a curved surface graph, whereas, the temperature field distribution at the imitated cortex was consistent with that at Zusanli (ST 36). With mild moxibustion, the temperature field was distributed uniformly along the longitudinal temperature gradient; whereas, with sparrow-pecking moxibustion, the longitudinal temperature of the temperature field was greatly different, in which, the maximum temperature and the average temperature were higher than those with mild moxibustion respectively and the first time up to the peak value of sparrow-pecking moxibustion was shorter than that with mild moxibustion. The thermal transfer was presented at the non-moxibustion exerted areas during the moxibustion experiment at Zusanli (ST 36).@*CONCLUSION@#A distance feature is presented in the temperature field measured by simulated thermometer and generated under suspension moxibustion at Zusanli (ST 36). The warm stimulation effect of sparrow-pecking moxibustion is much more obvious at the moxibustion-exerted center as compared with mild moxibustion and the area of warm stimulation generated by sparrow-pecking moxibustion is more concentrated as compared with mild moxibustion. The radiation energy produced by suspension moxibustion is scattered and attenuated in skin tissue, resulting in a certain temperature gradient in the temperature field. The warm stimulation generated at skin surface by moxibustion has a warming-dredging effect.

Development and application of a moxibustion instrument with multi-jointed manipulator / 中国针灸

In view of the limitations of the existing moxibustion instruments, i.e. possible accidental injury when using moxibustion instruments, the negative effects of products from moxibustion instruments on treatment efficacy and health of medical staff and patients, a moxibustion instrument with multi-jointed manipulator is designed. This moxibustion instrument could accurately control the temperature, maintain a safe moxibustion distance, automatically process the burning ashes of moxa and selectively handle moxa smoke. The experimental results shows that this instrument could maintain the constant temperature of target acupoint, reduce the risk of empyrosis, and reasonably deal with the products of moxibustion. The purification rate of moxa smoke is 44.9%, which not only ensures the therapeutic effect of moxa smoke, but also reduces the negative effects of high-concentration moxa smoke on the health of medical staff and patients.

Effectiveness and Safety of Moxibustion Robots on Primary Dysmenorrhea: A Randomized Controlled Pilot Trial / 中国结合医学杂志

OBJECTIVE@#To conduct a pilot trial to explore the effectiveness and safety of moxibustion robots in treating primary dysmenorrhea (PD) and evaluate its feasibility in clinic.@*METHODS@#A total of 70 participants with PD were allocated to either moxibustion robot (MR) group (35 cases) or manual moxibustion (MM) group (35 cases) using computer-generated randomization. One acupoint Guanyuan (CV 4) was selected to receive moxa heat stimulation. Two groups of participants were given 3 menstrual cycles of MM and MR treatment respectively (once a day, 5 days a session) and received another 3 menstrual cycles follow-up. The degree of pain was evaluated by short-form McGill pain questionnaire (SF-MPQ) and the symptoms of dysmenorrhea were evaluated by Cox Menstrual Symptom Scale (CMSS). The safety was measured by the occurrence rate of adverse events (AEs), including burns (blisters, red and swollen), itching, bowel changes, menstrual cycle disorder, menorrhagia and fatigue, etc. RESULTS: A total of 62 patients completed the trial, 32 in MR group and 30 in MM group. Compared with baseline, scores of SF-MPQ and CMSS significantly decreased in both groups (P0.05). The total occurrence rate of AEs in MR group was 2.1%, which was significantly lower than MM group (7.2%, P<0.05).@*CONCLUSIONS@#MR has the same effect as MM at SF-MPQ and CMSS in patients with PD. However, MR is safer than MM (Trial registration No. ChiCTR1800018236).

Historical evolution of Salviae Miltiorrhizae Radix et Rhizoma processing methods / 中国中药杂志

China has a long history of Salviae Miltiorrhizae Radix et Rhizoma processing with multiple methods available. The pre-sent study collated and summarized the Salviae Miltiorrhizae Radix et Rhizoma processing methods recorded in 23 related herbal medicine books, all editions of Chinese Pharmacopoeia, the 1988 edition of National Regulations for Processing of Chinese Medicine, and 20 current local processing specifications and standards. The results demonstrated various processing methods of Salviae Miltiorrhizae Radix et Rhizoma, such as removing residual part of stem, plantlet, or soil, smashing, filing, cutting, decocting, washing with wine, soaking in wine, and stir-frying with wine or blood from pig heart, while raw and wine-processed products are mainly used in modern times. Due to the lack of unified standards, the phenomena of multiple methods adopted in one place and different methods in different places have led to uneven quality of Salviae Miltiorrhizae Radix et Rhizoma pieces, even affecting the safety and effectiveness of its clinical medication. This study is expected to provide a reference for the development of Salviae Miltiorrhizae Radix et Rhizoma processing and its rational medication.

AAnalysis of the Status of Career Decision-making and Its Influencing Factors among Nursing Postgraduate Students / 中国实用护理杂志

Objective:To examine the status of career decision-making and its influencing factors among nursing postgraduate students.Methods:From October 2018 to December 2019, 249 nursing postgraduate students from universities were selected by convenience sampling method and were investigated using general information questionnaire, Career Decision-making Difficulties Questionnaire, Professional Identity Scale and Proactive Personality Scale.Results:The score of postgraduate nursing students' career decision-making difficulties was (58.10±8.98). Correlation analysis showed that the score of the career decision-making difficulties was positively correlated with professional identity and proactive personality of nursing postgraduate students ( r=0.187, 0.581, P<0.01). Multiple linear regression analysis showed that gender, whether they had received career counseling and proactive personality scores were influencing factors of career decision-making difficulties which explained 38.0% of the total variation. Conclusions:The career decision-making difficulties of nursing postgraduate students is at a medium level. Educators can reduce the career decision-making difficulties of nursing postgraduate students by conducting career counseling, improving professional identity or enhancing career initiative.

Efficacy and safety of COVID-19 vaccines: a systematic review / 中国当代儿科杂志

OBJECTIVE@#To evaluate systematically the efficacy and safety of COVID-19 vaccines.@*METHODS@#PubMed, Embase, Cochrane Library, Clinicaltrial.gov, CNKI, Wanfang Data, China Biomedical Literature Service System, and China Clinical Trial Registry were searched for randomized controlled trials of COVID-19 vaccines published up to December 31, 2020. The Cochrane bias risk assessment tool was used to assess the quality of studies. A qualitative analysis was performed on the results of clinical trials.@*RESULTS@#Thirteen randomized, blinded, controlled trials, which involved the safety and efficacy of 11 COVID-19 vaccines, were included. In 10 studies, the 28-day seroconversion rate of subjects exceeded 80%. In two 10 000-scale clinical trials, the vaccines were effective in 95% and 70.4% of the subjects, respectively. The seroconversion rate was lower than 60% in only one study. In six studies, the proportion of subjects who had an adverse reaction within 28 days after vaccination was lower than 30%. This proportion was 30%-50% in two studies and > 50% in the other two studies. Most of the adverse reactions were mild to moderate and resolved within 24 hours after vaccination. The most common local adverse reaction was pain or tenderness at the injection site, and the most common systemic adverse reaction was fatigue, fever, or bodily pain. The immune response and incidence of adverse reactions to the vaccines were positively correlated with the dose given to the subjects. The immune response to the vaccines was worse in the elderly than in the younger population. In 6 studies that compared single-dose and double-dose vaccination, 4 studies showed that double-dose vaccination produced a stronger immune response than single-dose vaccination.@*CONCLUSIONS@#Most of the COVID-19 vaccines appear to be effective and safe. Double-dose vaccination is recommended. However, more research is needed to investigate the long-term efficacy and safety of the vaccines and the influence of dose, age, and production process on the protective efficacy.

Research Progress of Metabolomics in Forensic Pathology / 法医学杂志

Metabolomics is an interdisciplinary subject that rose in the post-genomic era, which focuses on quantitative study of the response of living organisms to outside stimulation and pathophysiological changes, as well as multiple dynamic response of the level of in vivo metabolites caused by genetic mutation. It is extensively used in basic research of system biology, materia medica, clinical medicine, etc. In the forensic field, metabolomics mainly focuses on forensic toxicology, but with the generalization of certain techniques, it's foreseeable that metabolomics has a broad research prospect in forensic pathology. This article summarizes the major analysis techniques and methods of metabolomics, describes the research status of metabolomic techniques in the field of forensic pathology application research, including postmortem interval and death cause. Moreover, this article summarizes and discusses the potential applicable areas, in order to provide reference for relative research and application.

Energy Demand and Its Regulatory Mechanism during Folliculogenesis / 中国医学科学院学报

The growth and development of follicles are regulated by genes,hormones and growth factors autocrined and paracrined from granulosa cells,theca cells,and oocytes.Products of glycolysis from granulosa cells such as pyruvate and lactate are one of the main energy sources,which play an important role during folliculogenesis and follicle maturity.Studies on the changes of the products and rate-limiting enzymes during granulosa cells' glycolysis help to clarify the molecular mechanism of energy demand in folliculogenesis and guide the clinical treatment of infertility due to abnormal follicular development.This article reviews recent research advances in the energy demand and regulatory mechanism in different states of folliculogenesis.

Research Progress of CircRNA and Its Application Prospect in Forensic Medicine / 法医学杂志

Circular RNA(circRNA)is a type of noncoding RNA with tissue specificity and high stabil-ity, which forms a closed continuous loop and is abundantly expressed in tissue cells. According to re-cent research, the regulatory function of circRNA elucidating in the occurrence and development of dis-ease shows a potential for diagnosing clinical disease and revealing disease mechanism. This paper re-views the biological characteristics, analysis methods of circRNA and its research progress in clinical ap-plication as biomarker, and outlooks its application in the field of forensic medicine.

Olfactory change pattern after endoscopic sinus surgery in chronic rhinosinusitis with olfactory dysfunction

Objective: To determine the change pattern of olfactory function in chronic rhinosinusitis [CRS] with olfactory dysfunction after endoscopic sinus surgery [ESS], and its association with inspection scores

Study Design: Observational study

Place and Duration of Study: Second Hospital of Shandong University, China, from December 2014 to January 2016

Methodology: Thirty-four CRS with nasal polyps [CRSwNP] patients and 14 CRS without nasal polyps [CRSsNP] patients were evaluated preoperatively by Tand T olfactory test, olfactory VAS test, SNOT-20 score and Lund-Mackay CT score. Outcomes were re-evaluated at 1 month, 3 months and 6 months postoperatively

Results: Both olfactory and SNOT-20 scores showed significant improvement within 6 months in both CRSwNP and CRSsNP groups. Patients with anosmia in Tand T test showed the largest degree of improvement. No significant recovery of olfactory dysfunction was observed at 1 month and 3 months in CRSsNP groups postoperative. In CRSwNP, the olfactory scores were correlated with the CT scores significantly [r=0.649, p<0.001; r=0.625, p<0.001]. However, no correlation was found between the SNOT-20 score and olfactory score preoperatively

Conclusion: Our study has confirmed that the therapeutic effects of ESS on olfactory function last for up to 6 months, particularly in patients with CRSwNP. Although the therapeutic effects plateaued at 3 months postoperatively, the olfactory function continues to recover between 3 and 6 months

Study on the Efficiency of Public Hospitals' Medical Service and Its Influencing Factors in Tianjin / 中国卫生经济

Objective:To analyze the efficiency of 77 public hospitals' medical services and influencing factors in Tianjin.Methods:Using DEA method to measure the hospitals' medical service efficiency,establishing Tobit regression model to analyze the influencing factors of public hospitals medical service efficiency.Results:The overall efficiency of Tianjin public hospitals was low,most hospitals were not reasonable in the size,the significant influencing factors of Tianjin public hospitals' medical service efficiency including the per capita physician outpatient,the proportion of senior technical staffs,hospital gearing ratio,drug-income ratio and average fee per patient.Conclusion:Increasing the per capita physician outpatient and the proportion of senior technical staff could significantly enhance the overall technical efficiency,while decreasing the gearing ratio and the average fee of per patient were also beneficial to improve hospital efficiency.

Study on relationship between bone mineral density and levels of bone metabolism,immune cytokines and estrogen in postmenopausal women / 中国免疫学杂志

Objective:To analyze the change of bone mineral density (BMD) in postmenopausal women,and to study the relationship between BMD and the estrogen,cytokines,and serum levels of bone metabolism.Methods: 135 postmenopausal women were divided into the OP group (n=54),Osteopenia group (n=43) and normal group (n=38) according to the results of lumbar spine bone mineral density (BMD) scan.To detected the concentration of serum estradiol (E2),bone alkaline phosphatase (BALP) and osteocalcin (BGP),tartrate resistant acid phosphatase-5b (TRAP-5b),interleukin-6 (IL-6),tumor necrosis factor alpha (TNF-α),transforming growth factor beta (TGF-β1) and IL-10 of research objects in the three groups.And to analyze the relationship between BMD and the levels of E2,BALP,BGP,TRAP-5b,IL-6,TNF-α,TGF-β1 and IL-10.Results: In the OP group and the Osteopenia group,BMD and the levels of E2,TGF-β1 and IL-10 were obviously lower than that in the normal group (P0.05).The low serum E2 levels and high serum levels of BALP,BGP,TRAP-5b,IL-6 and TNF-α were the independent factors affecting the reduction of BMD (P<0.05).Conclusion: The E2 level in patients with PMOP decreased obviously,which caused the imbalance of bone remodeling and inflammatory reaction,and which was related to the decrease of BMD.

Effect on sex hormone functional of extracts of Herba Epimedii/Fructus Ligustri Lucidi in osteoporosis rats / 中国免疫学杂志

Objective:To explore the effect on sex hormone functional of extracts of Herba Epimedii /Fructus Ligustri Lucidi in osteoporosis rats.Methods:50 cases of 3 months Wistar rats were rando mly divided into normal group ,model group,extract low dose group(extract-L),extract middle dose group(extract-M),extract high dose group(extract-H),10 cases in each group,in addition to the normal group,other 4 groups were bulided OP model by filling and feeding retinoic acid for 15 d,then normal group and model group were filling physiological saline;extract-L,extract-M,extract-H were respectively feeding extracts of Herba Epimedii /Fructus Ligustri Lucidi at 50 mg/kg,100 mg/kg,200 mg/kg,both for 3 weeks.Measured the bone mineral density (BMD),observed the femoral pathology change of left femur with hematoxylin and eosin ( HE ) staining, measured trabecular bone tissue morphology related parameters ,analyzed the hormone receptor protein expression with immunohistochemistry .Results:The BMD of the whole femur ,femur head,and femur neck in normal group were all significantly higher than that of model group ,the BMD of the whole femur ,femur head, and femur neck in extract-M and extract-H group were all significantly higher than that of model group ,the BMD of the whole femur in extract-L group was significantly higher than that of model group ,the differences were statistically significant (P<0.05 or P<0.01).The bone trabecular number had significantly increased ,integrity,continuity improved significantly ,bone histomorphometry such as Tb.Ar, Tb.Th,and Tb.N in model group were decreased ,and Tb.Sp was increased,extract-M and extract-H group had remarkable effect on each index ,while extract-L group only had a remarkable effect on Tb .Ar and Tb.Th ( P<0.05 or P<0.01 ) , compared with model group.The expression of AR , ER in normal groups were significantly higher than that of model group , the expression of AR , ER in extract-H group was significantly higher than that of model group , the differences were statistically significant ( P<0.05 or P<0.01 ) . Conclusion:This study demonstrated that the combination with TFE and TIFL had potential protective effects on osteoporosis rats induced by retinoic acid .The combination with TFE and TIFL is able to increase BMD ,reverse pathological changes of bone tissue ,co-ordinate hormones of the hypothalamic-pituitary-gonadal axis ,and upregulate the expression of sex hormone receptors .

Clinical research advances of apatinib in the treatment of malignancies / 中国肿瘤临床

Antitumor drugs that target the signaling of vascular endothelial growth factor and its receptors have attracted increasing attention with the development of antiangiogenic targeted therapy. Apatinib is a second-generation vascular endothelial growth factor receptor-2 inhibitor and a potent antiangiogenic agent. Apatinib is one of the recent oral molecular targeted anti tumor drugs. Clinical studies have indicated that apatinib exhibits high bioavailability and a tolerable safety profile. A series of large-scale randomized and controlled clinical trials before and after the release of the drug in the market have demonstrated encouraging objective response rate and survival benefit across a broad range of malignancies, including non-small cell lung cancer, breast cancer, and gastric cancer. Apa-tinib was approved and launched in China in 2014 as a subsequent-line treatment for patients with advanced gastric cancer. Apatinib is currently undergoing phase II/III clinical trials for the treatment of numerous cancer types, such as gastric carcinoma, lung cancer, he-patocellular carcinoma, esophageal cancer, and colorectal cancer. These clinical trials are conducted to determine the antitumor activi-ty of apatinib when administrated alone or in combination with other therapies. This review summarizes the latest research progress of apatinib, including antitumor mechanisms, clinical effects on different tumor types, safety profile and adverse effects, drug interac-tions, as well as drug resistance and biomarkers. This article presents a deeper understanding of the clinical application of apatinib in anti tumor treatment, and provides reference for future clinical practice in therapeutic options for cancer patients.

A Study on the Effective Measure Exploration for Higher Learning Institutes to Promote the International Communication of Traditional Chinese Medical Culture / 世界科学技术-中医药现代化

Traditional Chinese Medicine (TCM) is the gem of Chinese culture,while TCM culture the root and driving force for its development.Higher learning institutes,one of whose main missions is innovating and inheriting culture,are playing the unique roles in promoting world-wide recognition of TCM culture through international cooperation due to the abundant resources in TCM academy,talent,clinical study and international education.Taking Jiangxi University of Traditional Chinese Medicine as an example,this paper has made constructive exploration and study on how to promote the international communication of TCM culture to allow the international community for better understanding and the application of TCM based on the analysis of current situation and experience summarization with literature investigation and case study.Effective measures that have been put forward include establishing TCM experiencing center,promoting the construction of Confucius Institute,proactively building TCM library,improving the standardization of TCM translation,optimizing approaches of TCM international communication,and speeding up the cultivation of TCM international communication talents.

Clinical effect of flupentixol and melitracen tablets combined with macrogol 4000 powders on ;treatment of irritable bowel syndrome with constipation in elderly patients / 中国医师进修杂志

Objective To investigate the clinical effect of flupentixol and melitracen tablets combined with macrogol 4000 powders on treatment of irritable bowel syndrome with constipation (IBS-C) in elderly patients. Methods Fifty paients aged from 65 to 95 years with IBS-C were randomly divided into 2 groups: control group (23 patients) and treatment group (27 patients). The patients in treatment group received flupentixol and melitracen tablets (1 tablets, once a day) combined with macrogol 4000 powders (1 bag/time, 2 times a day) , while the patients in control group received macrogol 4000 powders alone. The treatment period was 4 weeks. The curative effect, the scores of self-rating depression scale (SDS) and self-rating anxiety scale (SAS) and adverse reaction were compared between two groups. Results At the improvement of depressive symptoms, the effective rate in treatment group and control group was 88.9%(24/27) and 39.1%(9/23), and there was significant difference (P<0.01). At the improvement of anxiety symptoms, the effective rate in treatment group and control group was 74.1%(20/27) and 26.1%(6/23), and there was significant difference (P<0.01). The total effective rate in treatment group and control group was 88.9%(24/27) and 65.2%(15/24), and there was significant difference (P<0.05). Conclusions Flupentixol and melitracen tablets combined with macrogol 4000 powders on treatment of aged IBS-C patients have more distinguished therapeutic effect in improving constipation symptoms, stools times, anxiety and depression.

Values of C-reactive protein, percentage of neutrophils and mean platelet volume in early diagnosis of neonatal sepsis / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To study the clinical values of C-reactive protein (CRP), the percentage of neutrophils, and mean platelet volume (MPV) in the diagnosis of neonatal sepsis.</p><p><b>METHODS</b>A total of 315 neonates who were confirmed to have sepsis between January 2010 and May 2014 were divided into two groups: proven sepsis (with a positive blood culture; n=207) and clinical sepsis (with a clinical diagnosis; n=108). Within the same period, 132 hospitalized neonates with noninfectious diseases were enrolled as the control group. Serum CRP level, percentage of neutrophils, and MPV were measured. The receiver operating characteristic (ROC) curves were drawn to evaluate the values of the three parameters in the diagnosis of neonatal sepsis.</p><p><b>RESULTS</b>Serum CRP level, percentage of neutrophils, and MPV were significantly higher in the two sepsis groups than in the control group (P<0.05). The optimal cut-off point of CRP for the diagnosis of sepsis was 8.5 mg/L, with the sensitivity and specificity of 74.6% and 92.0%, respectively. The optimal cut-off point of the percentage of neutrophils for the diagnosis of sepsis was 0.53, with the sensitivity and specificity of 64.4% and 83.3%, respectively. The optimal cut-off point of MPV for the diagnosis of sepsis was 11.4 fL, with the sensitivity and specificity of 40.5% and 88.4%, respectively.</p><p><b>CONCLUSIONS</b>The diagnostic accuracy of CRP for neonatal sepsis is superior to those of the percentage of neutrophils and MPV. The measurements of the percentage of neutrophils and MPV hold promise for the early diagnosis of neonatal sepsis.</p>