Incidence of extrauterine growth retardation and its risk factors in very preterm infants during hospitalization: a multicenter prospective study / 中国当代儿科杂志

OBJECTIVES@#To investigate the incidence of extrauterine growth retardation (EUGR) and its risk factors in very preterm infants (VPIs) during hospitalization in China.@*METHODS@#A prospective multicenter study was performed on the medical data of 2 514 VPIs who were hospitalized in the department of neonatology in 28 hospitals from 7 areas of China between September 2019 and December 2020. According to the presence or absence of EUGR based on the evaluation of body weight at the corrected gestational age of 36 weeks or at discharge, the VPIs were classified to two groups: EUGR group (n=1 189) and non-EUGR (n=1 325). The clinical features were compared between the two groups, and the incidence of EUGR and risk factors for EUGR were examined.@*RESULTS@#The incidence of EUGR was 47.30% (1 189/2 514) evaluated by weight. The multivariate logistic regression analysis showed that higher weight growth velocity after regaining birth weight and higher cumulative calorie intake during the first week of hospitalization were protective factors against EUGR (P<0.05), while small-for-gestational-age birth, prolonged time to the initiation of total enteral feeding, prolonged cumulative fasting time, lower breast milk intake before starting human milk fortifiers, prolonged time to the initiation of full fortified feeding, and moderate-to-severe bronchopulmonary dysplasia were risk factors for EUGR (P<0.05).@*CONCLUSIONS@#It is crucial to reduce the incidence of EUGR by achieving total enteral feeding as early as possible, strengthening breastfeeding, increasing calorie intake in the first week after birth, improving the velocity of weight gain, and preventing moderate-severe bronchopulmonary dysplasia in VPIs.

Retrospective analysis of 35 burn patients in different stages of pregnancy / 中华烧伤杂志

Objective: To summarize the clinical outcomes of burn patients in different stages of pregnancy and explore a rational therapeutic scheme for burns during pregnancy. Methods: A retrospective observational study was conducted. From June 2010 to June 2020, 21 patients who met the inclusion criteria were admitted to the Department of Burns of Wuhan Third Hospital and 14 patients who met the inclusion criteria were admitted to the Department of Burns of the First Affiliated Hospital of Nanchang University. Based on the pregnancy period when patients suffered burns, the 35 patients were divided into early pregnancy group with 18 patients (aged (26±4) years, with 8 (4, 11) weeks of gestation), middle pregnancy group with 10 patients (aged (26±3) years, with 21 (14, 27) weeks of gestation), and late pregnancy group with 7 patients (aged (30±5) years, with 32 (29, 35) weeks of gestation). All the patients received treatment including fluid resuscitation, anti-infection, wound treatment, and multidisciplinary comprehensive managements. The burn-related complications during the treatment, maternal outcomes, fetal outcomes, fetal delivery mode, gestational weeks at delivery, and newborn weight of patients in the 3 groups were recorded. Data were statistically analyzed with one-way analysis of variance, Kruskal-Wallis test, and Fisher's exact probability test. Results: During the treatment, there were 4, 4, and 2 patients who suffered wound infections and 1, 3, and 2 patients who developed shock symptoms, respectively, in early pregnancy group, middle pregnancy group, and late pregnancy group. There were no statistically significant differences in them among the 3 groups (P>0.05). One patient in late pregnancy group developed into multiple organ dysfunction syndrome after debridement. At last, all the pregnant women survived, and no statistically significant difference existed among the 3 groups (P>0.05). In early pregnancy group, middle pregnancy group, and late pregnancy group, the survived fetus cases were 9, 8, and 6, respectively, and the differences between them were not statistically significant (P>0.05). Variables including stillbirth and full-term birth were close in patients in the 3 groups (P>0.05), while the preterm birth and miscarriage in patients in the 3 groups were statistically different (P<0.05 or P<0.01), with the early pregnancy group having the most miscarriage cases and the fewest preterm birth cases. There were no statistically significant differences in fetal delivery mode, gestational weeks at delivery, and newborn weight among the patients with survived fetus in 3 groups (P>0.05). Conclusions: For patients suffering burns during early, middle, and late pregnancy, superior rates of maternal and fetal survival can be achieved after timely and adequate treatments including fluid resuscitation, anti-infection, wound treatment, and multidisciplinary comprehensive managements.

Role of biological protective dressing in microskin grafting in rabbit / 中华烧伤杂志

<p><b>OBJECTIVE</b>To study the effect of biological protective dressing made from porcine peritoneum in covering wounds with microskin grafts.</p><p><b>METHODS</b>Twenty New Zealand rabbits were divided into ten couples according to the random number table. Rabbits in each couple underwent surgery at the same time. A piece of full-thickness skin of 5 cm in diameter was removed symmetrically from the left and right sides of the back of each rabbit, thus forming two wounds with full-thickness skin defect. One fifth of one piece of skin of one rabbit was cut into tiny pieces of 0.2-0.5 mm in size (microskin). Then the microskin pieces were spread on the two wounds of the donor rabbit with the microskin/wound area ratio 1:10. The two wounds of each rabbit covered with microskin were divided into two groups according to the random number table. One wound was covered with biological protective dressing prepared with porcine peritoneum as experiment group, and the other was covered with the rest allograft in full size obtained from the other rabbit of each couple as control group. The general condition of wound was observed at post operation week (POW) 1-4. Wound healing rate was calculated at POW 3 and 4. Wound healing time was recorded. Specimens were harvested from wounds for histological observation at POW 1-4. Data were processed with paired t test.</p><p><b>RESULTS</b>(1) At POW 1, the biological protective dressings were found to attach firmly to the wounds in experiment group without obvious inflammatory response; the allografts survived well on the wounds in control group. At POW 2, the coverings attached well to the wounds of both groups, but became drier and darker as compared with those at POW 1. At POW 3, some wounds of the two groups healed when the coverings desiccated and separated. At POW 4, all the wounds of both groups healed without obvious difference in appearance. (2) The wound healing rates of the experiment and control groups were respectively (92.8 ± 6.2)% and (91.3 ± 7.3)% (t = 0.54, P > 0.05) at POW 3 and (98.1 ± 2.3)% and (97.0 ± 4.6)% (t = 0.38, P > 0.05) at POW 4. (3) The wound healing time was (25.0 ± 3.9) d in experiment group and (24.8 ± 2.3) d in control group. The difference between them was not statistically significant (t = 0.82, P > 0.05). (4) Histological observation showed that wounds of the two groups were all infiltrated by inflammatory cells, and new blood vessels were observed at POW 1 and 2. The survived microskin proliferated under the coverings. At POW 3 and 4, the coverings on the wounds of two groups were gradually degenerated and became necrotic and separated from the wound beds, while the wounds underneath were re-epithelialized.</p><p><b>CONCLUSIONS</b>The effect of biological protective dressing in covering wounds grafted with microskin is as good as that of the allograft, as they both help the auto-microskin proliferate and repair the wound. It could be considered to be new biological material for clinical application.</p>

Diagnosis of the deep partial-thickness burn wound of Skh-1 mouse with Optical Coherence Tomography / 中华烧伤杂志

<p><b>OBJECTIVE</b>To evaluate the application value of Optical Coherence Tomography (OCT) in the diagnosis of the depth of burn wound.</p><p><b>METHODS</b>Deep partial-thickness scald models of Skh-1 mice were reproduced using self-made steam scald appliance. The scald wounds were scanned with OCT 3 hours, or 3 and 8 days after injury respectively. Scanned wound tissue was harvested for histological examination right after each episode of OCT imaging. Normal skin of mice was scanned and examined with the above-mentioned methods at the same time.</p><p><b>RESULTS</b>Compared with those of the normal skin, collagen in the dermis was denatured after steam scald, and it was imaged as vanishing or reduction in birefringence in OCT detection. The structure change intensity was related to the pathological process of the wounds and consistent with the corresponding histological results.</p><p><b>CONCLUSIONS</b>OCT is a noninvasive technique. It can be used to diagnose the depth of burn wound in real time.</p>

Clinical observation on treatment of multiple bone metastatic tumor of mammary cancer by combination therapy of 89Sr and Chinese herbal medicine / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To compare the clinical curative effects between 89Sr and its combination with the Guliu recipe (GLR, a Chinese herbal medicine) in treating multiple bone metastatic tumor of mammary cancer (MBM-MC).</p><p><b>METHODS</b>By adopting the random sampling and grouping method, 89Sr alone (Sr) and 89Sr combined with CHM (Sr-GLR) were used in treating 86 and 40 patients with MBM-MC respectively. The efficacy of therapy were appraised according to the degree of ostalgia relieving and quality of life (QOF) in patients, and the effect of treatment on focal bone metabolism and bone marrow hematopoietic function were compared.</p><p><b>RESULTS</b>The effective rate of Sr and Sr-GLR in relieving ostalgia was 83.72% and 95.00%, respectively (P > 0.05), the QOF improving and stabilizing rate of them 80.23% and 95.00% (P < 0.05), the effective rate on focal bone metabolism 59.30% and 52.50% (P > 0.05) and their hemo-toxicity 28.00% and 30.00% (P > 0.05).</p><p><b>CONCLUSION</b>Sr-GLR is a combination therapy in treating MBM-MC with good effect, it could raise the patient's QOF, enhance the ostalgia relieving effect without increasing the hemo-toxicity of treatment.</p>