Prediction of pre-eclampsia complicated by fetal growth restriction and its perinatal outcome based on an artificial neural network model.

Objective: Pre-eclampsia (PE) complicated by fetal growth restriction (FGR) increases both perinatal mortality and the incidence of preterm birth and neonatal asphyxia. Because ultrasound measurements are bone markers, soft tissues, such as fetal fat and muscle, are ignored, and the selection of section surface and the influence of fetal position can lead to estimation errors. The early detection of FGR is not easy, resulting in a relative delay in intervention. It is assumed that FGR complicated with PE can be predicted by laboratory and clinical indicators. The present study adopts an artificial neural network (ANN) to assess the effect and predictive value of changes in maternal peripheral blood parameters and clinical indicators on the perinatal outcomes in patients with PE complicated by FGR. Methods: This study used a retrospective case-control approach. The correlation between maternal peripheral blood parameters and perinatal outcomes in pregnant patients with PE complicated by FGR was retrospectively analyzed, and an ANN was constructed to assess the value of the changes in maternal blood parameters in predicting the occurrence of PE complicated by FGR and adverse perinatal outcomes. Results: A total of 15 factors-maternal age, pre-pregnancy body mass index, inflammatory markers (neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio), coagulation parameters (prothrombin time and thrombin time), lipid parameters (high-density lipoprotein, low-density lipoprotein, and triglyceride counts), platelet parameters (mean platelet volume and plateletcrit), uric acid, lactate dehydrogenase, and total bile acids-were correlated with PE complicated by FGR. A total of six ANNs were constructed with the adoption of these parameters. The accuracy, sensitivity, and specificity of predicting the occurrence of the following diseases and adverse outcomes were respectively as follows: 84.3%, 97.7%, and 78% for PE complicated by FGR; 76.3%, 97.3%, and 68% for provider-initiated preterm births,; 81.9%, 97.2%, and 51% for predicting the severity of FGR; 80.3%, 92.9%, and 79% for premature rupture of membranes; 80.1%, 92.3%, and 79% for postpartum hemorrhage; and 77.6%, 92.3%, and 76% for fetal distress. Conclusion: An ANN model based on maternal peripheral blood parameters has a good predictive value for the occurrence of PE complicated by FGR and its adverse perinatal outcomes, such as the severity of FGR and preterm births in these patients.

Prognostic Value of High-Sensitivity C-Reactive Protein, Procalcitonin and Pancreatic Stone Protein in Pediatric Sepsis.

BACKGROUND To investigate the prognostic value of procalcitonin (PCT), high-sensitivity C-reactive protein (hs-CRP), and pancreatic stone protein (PSP) in children with sepsis. MATERIAL AND METHODS A total of 214 patients with sepsis during hospitalization were enrolled. Serum levels of PCT, hs-CRP, and PSP were measured on day 1 of hospitalization and the survival rates of children were recorded after a follow-up of 28 days. Pearson's correlation analysis was conducted to test the association of PCT, hs-CRP, and PSP with pediatric critical illness score (PCIS). Logistic regression models were used to analyze the risk factors contributing to patients' death. The AUC was used to determine the value of PCT, hs-CRP, and PSP in the prognosis of patients with sepsis. RESULTS The expression of PCT, hs-CRP, and PSP in the dying patients was higher than in the surviving patients (p<0.001). Pearson's correlation analysis showed that serum PCT, hs-CRP, and PSP levels were negatively correlated with PCIS (p<0.001). Multivariate logistic regression revealed that PCT, hs-CRP, and PSP were independent risk factors for the prognosis of patients with sepsis (p<0.001). ROC analysis showed the AUC values of PCT, hs-CRP, and PSP were 0.83 (95% CI, 0.77-0.88), 0.76 (95% CI, 0.70-0.82), and 0.73 (95% CI, 0.67-0.79), respectively. The combined AUC value of PCT, hs-CRP, and PSP, was 0.92 (95% CI, 0.87-0.95), which was significantly increased compared with PCT, hs-CRP, or PSP (p<0.001). CONCLUSIONS The combination of serum PCT, hs-CRP, and PSP represents a promising biomarker of risk, and is a useful clinical tool for risk stratification of children with sepsis.

[Changes in serum levels of resistin and visfatin in pediatric patients with acute Kawasaki disease following intravenous immune globulin treatment].

OBJECTIVE: To determine serum levels of resistin and visfatin in the patients with acute Kawasaki disease before and after intravenous immune globulin (IVIG) treatment. METHODS: A total of 50 children with acute Kawasaki disease were treated with IVIG for 48 hours between January 2011 and January 2013. As controls, 30 healthy children and 30 children with acute infectious diseases were included. Serum levels of resistin and visfatin were measured by ELISA both before and after the treatment. RESULTS: The baseline serum levels of resistin and visfatin were significantly higher in patients with acute Kawasaki disease than in the two control groups of subjects (i.e., healthy children and patients with acute infectious diseases; P<0.05). In the 50 patients with Kawasaki disease, 38 were not responding and 12 were responding. Serum resistin levels before treatment were significantly higher in non-responders than those in responders (P<0.05). A significant decrease in serum levels of resistin after treatment was observed in IVIG responders (P<0.05). Serum visfatin levels were not significantly different between IVIG responders and non-responders (P>0.05). Additionally, serum resistin and visfatin levels were not significantly different between acute Kawasaki disease patients with and without coronary artery lesions. CONCLUSIONS: Resistin and visfatin may play important roles in the development of Kawasaki disease and serum resistin may be used as a novel outcome indicator of the IVIG treatment.

[Epidemiological analysis of childhood asthma in Yichang City, China].

OBJECTIVE: To study the prevalence, epidemiological characteristics, and risk factors for childhood asthma in Yichang City, China and to collect evidence for the early diagnosis and preventive treatment of asthma. METHODS: Preliminary screening questionnaires were distributed to more than 90% of children in 5 kindergartens, 10 primary and secondary schools, and 5 communities in Yichang City to detect children with suspected asthma. These surveyed children were selected by cluster random sampling. A further questionnaire survey was conducted for suspected cases. Meanwhile, a similar number of sex- and age-matched non-asthmatic children were selected for the case-control study. Information from returned questionnaires was entered into a database for statistical analysis. RESULTS: A total of 11 000 questionnaires were distributed, and 10 456 (95.1%) questionnaires were returned. The prevalence rate of asthma among children in Yichang was 3.47%, significantly higher in boys than in girls (P<0.05). A total of 107 out of 363 children with asthma had a history of drug allergy, and 152 cases had a family history of allergy. The majority of asthmatic children had irregular onset-prone seasons and hours. Respiratory tract infections were the most common trigger of asthma attacks, accounting for 93.1% of all onsets; family history of allergy, history of early use of antibiotics, history of housing renovation, and history of passive smoking were the major risk factors for asthma. CONCLUSIONS: Prevention of respiratory tract infections may reduce the frequency of asthma attacks; reducing the use of antibiotics during early childhood, decreasing the frequency of housing renovation, and advocating for smoking cessation among parents have preventive effects on asthma.

[Clinical significance of pulmonary function test in patients with chronic rhinosinusitis with nasal polyps].

OBJECTIVE: To investigate the incidence and severity of pulmonary function impairment in patients with chronic rhinosinusitis with nasal polyps (CRSwNP). METHODS: In this prospective study, fifty-six patients with bilateral CRSwNP who were scheduled for functional endoscopic sinus surgery during a period from March to June 2010 in the Department of Otolaryngology of Qilu Hospital, were recruited in this study. Routine medical and rhinological examinations such as nasal endoscopy, sinus CT scan, and skin prick tests (SPT) for common inhalant and food allergens, and cytological examination of the paraffin-embedded NP tissues were performed together with a full assessment of the pulmonary functions. RESULTS: Based on the pulmonary function tests, the rate of patients showing bronchial hyperresponsiveness (BHR), asthma, and abnormal pulmonery functions were 37.5%, 44.6%, and 53.6%. In patients who did not have a history of lower airway symptoms, the rate of abnormal pulmonary functions was 50.0%, the rate of BHR was 43.2%. There was an increased rate of BHR, asthma and abnormal pulmonary functions in patients with a higher polyp grading score or Lund Mackay CT scan score (polyp grading score: χ(2) were 8.077, 3.989 and 7.445, P < 0.01 or < 0.05. CT scan score: χ(2) were 3.863, 5.380 and 4.309; 4.293, 4.293 and 4.572; 10.572, 13.504 and 13.295, P < 0.01 or < 0.05). The rate of BHR and asthma in patients with positive SPT were higher (P < 0.05). In patients with eosinophils hyperplasia in nasal polyps, the rate of BHR, asthma and abnormal pulmonary functions were higher (χ(2) were 4.065, 5.217 and 3.376, P < 0.05 or P < 0.01). CONCLUSIONS: There is a high risk of developing lower airway diseases in patients with CRSwNP.

Aluminium complexes of bidentate N,O- and N,N-ligands derived from oxidative functionalization of amido phosphines: synthesis, structure and reactivity.

A series of amido phosphinoxide and amido phosphinimine ligands that are electronic variations of monoanionic N,O- and N,N-ketiminates have been prepared and employed to examine the coordination chemistry of aluminium. Oxidation of the previously established N-(2-diphenylphosphinophenyl)-2,6-dialkylaniline in the presence of H(2)O(2) or organic azides RN(3) (R = 2,6-C(6)H(3)(i)Pr(2), SiMe(3)) led to phosphinoxides (H[NO] 1a-b) and phosphinimines (H[NN] 1c-d), respectively. Alkane elimination reactions of these protio-ligand precursors with trialkylaluminium in toluene or pentane solutions afforded cleanly the corresponding organoaluminium complexes, including dimethyl 2a-d, diethyl 3a-d and diisobutyl derivatives 4a-b and 4d. Solution NMR studies revealed Cs symmetry for these organoaluminium species, in which the α-hydrogen atoms are all diastereotopic. The correlation between the steric congestion of these molecules and the degree of resolution of the multiplet signals corresponding to the diastereotopic α-hydrogen atoms observed by the (1)H NMR spectroscopy is of particular interest. Dichloroaluminium complexes 5c-d were prepared in high yields by protonolysis of MeAlCl(2) with 1c-d. Single-crystal X-ray diffraction analyses of 2c-d, 3a, 3d, 4a, and 4d elucidated a mononuclear, distorted tetrahedral core for all of these aluminium species. Interestingly, complexes 2c-d are active initiators for catalytic ring-opening oligomerization of ε-caprolactone, whereas 2a-b are rather inactive, highlighting the significance of the steric hindrance imposed by the amido phosphinimine ligands, as compared to that imposed by the phosphinoxide counterparts.

Determination of Hg and Pb in fuels by inductively coupled plasma mass spectrometry using flow injection chemical vapor generation.

An isotope dilution inductively coupled plasma mass spectrometry (ICP-MS) method has been developed for the determination of Hg and Pb in fuels using flow injection vapor generation (VG) as the sample introduction system. A simple and inexpensive in-situ nebulizer/vapor generator was employed in this study. An emulsion containing 10% v/v fuel, 2% m/v Triton X-100 and 1.0% m/v tartaric acid was injected into VG-ICP-MS system for the determination of Hg and Pb. Sodium borohydride was used for vapor generation. Since the sensitivities of Hg and Pb in emulsion and those in aqueous solution are quite different, isotope dilution and standard addition methods were used for the determination of Hg and Pb in selected fuel samples. The influences of vapor generation conditions and emulsion preparation on the ion signals are reported. This method has been applied for the determination of Hg and Pb in various fuel samples such as diesel, gasoline and engine oil obtained locally. The analytical results obtained by isotope dilution and standard addition methods were in good agreement with each other and also with those of digested samples analyzed by pneumatic nebulization ICP-MS. Under the optimum operating conditions, the detection limits obtained were 0.02 and 0.03 ng mL(-1) for Hg and Pb, respectively, in prepared emulsified solutions, corresponding to 0.2 and 0.3 ng mL(-1) of Hg and Pb, respectively, in the original fuel samples.

Slurry sampling flow injection chemical vapor generation inductively coupled plasma mass spectrometry for the determination of As, Cd, and Hg in cereals.

A slurry sampling inductively coupled plasma mass spectrometry (ICP-MS) method has been developed for the determination of As, Cd, and Hg in cereals using flow injection chemical vapor generation (VG) as the sample introduction system. A slurry containing 6% m/v flour, 0.7% m/v thiourea, 0.4 microg mL(-1) Co(II), and 2.5% v/v HCl was injected into a VG-ICP-MS system for the determination of As, Cd, and Hg without dissolution and mineralization. Because the sensitivities of the elements studied in the slurry and that of aqueous solution were quite different, a standard addition method and an isotope dilution method were used for the determination of As, Cd, and Hg in selected cereal samples. The influences of vapor generation conditions and slurry preparation on the ion signals were reported. The effectiveness of the vapor generation sample introduction technique in alleviating various spectral interferences in ICP-MS analysis has been demonstrated. This method has been applied for the determination of As, Cd, and Hg in NIST SRM 1567a Wheat Flour reference material, NIST SRM 1568a Rice Flour reference material, and cereal samples obtained from local market. The As, Cd, and Hg analysis results of the reference materials agreed with the certified values. The method detection limits estimated from standard addition curves were about 0.10, 0.16, and 0.07 ng g(-1) for As, Cd, and Hg, respectively, in the original cereal samples.