ABSTRACT
BackgroundWe aimed to identify clinical features of coronavirus disease 2019 (COVID-19) in children and evaluate the role of procalcitonin in early differential diagnosis. MethodsA retrospective analysis was performed on all suspected pediatric cases. Results39 (50.6%) of 77 suspected cases were comfirmed, 4 (5.2%) of them had viral coinfection. Compared with non-COVID-19 group (n=33), COVID-19 confirmed group (n=39) had fewer fever(OR[95% CI]0.467[0.314-0.694]; P=.000) and symptoms of acute respiratory infection (0.533[0.36-0.788]; P=.001), more asymptomatic (13.568[1.895-96.729]; P=.000), and more family cluster infections (5.077[2.224-11.591]; P=.000), while computed tomography had more positive findings of viral pneumonia (1.822[1.143-2.906]; P=.008). Age (6.9[3.6-10.5] vs 5[2.1-7.6]; P=. 088) and gender were statistically insignificant. Procalcitonin (0.05[0.029-0.076] vs 0.103[0.053-0.21]; P= 000) of COVID-19 alone group (n=35) was significantly reduced. While compared with coinfection group (n=4), procalcitonin (0.05[0.029-0.076] vs 0.144[0.109-2.26]; P=.010) was also reduced. The area under curve of model is 0.834 ([95% CI][0.741-0.926]; P=.000). Procalcitonin as a differential indicator of COVID-19 alone, its area under curve is 0.809 ([0.710-0.909]; P=.000). The optimal cut-off value is 0.1 ng/mL, the sensitivity, specificity, positive and negative predictive value of differentiating are 65.9%, 78.6%, 82.9%, and 59.2%, respectively. ConclusionsAsymptoms or mild symptoms, positive computed tomography findings and family cluster infection are the main clinical features of COVID-19 in children. With good performance, procalcitonin can provide an important basis for differentiating COVID-19 alone and other viral infection or viral coinfection.
ABSTRACT
Objective To compare the myocardial protection effects of cold blood cardioplegia and cold crystalloid cardioplegia in patients undergoing valve replacement surgery.Methods One hundred adult patients with cardiac function Ⅱ～Ⅲ class undergoing primary elective valve replacement surgery due to rheumatic heart disease were retrospectively analyzed.For patients with cardiac arrest,cold blood cardioplegia was applied to 50 cases(Group B),and cold crystalloid cardioplegia to the others(group C).The process of heart resuscitation,the postoperative need of dopamine,the blood pressure and heart rate,the postoperative level of serum myocardial enzyme,the intensive care unit(ICU) stay after operation were collected and statistically analyzed.All the cardioplegic solution was perfused in a similar manner and topical cooling was employed simultaneously.Results There were less cases in group B than in group C who needed isoprenaline for cardiac resuscitation after clamp removal(P0.05).Conclusion The cold blood cardioplegia and cold crystalloid cardioplegia have similar myocardial protection effects on rheumatic heart disease patients with cardiac function Ⅱ～Ⅲ class undergoing valve replacement surgery.
ABSTRACT
Objective: To explore the effect of initial lower PO_2 controlled reperfusion on cyanotic hypoxic immature myocardium protective during post-ischemia reperfusion. Methods: 24 hypoxic neonatal rabbits were randomized into 3 groups (8 in each group). Group I (initial lower PO_2 controlled reperfusion), group II (normal PO_2 controlled reperfusion), group III (high PO_2 reperfusion group). Using isolate heart Langendorff ischemia-reperfusion model, the myocardial protection results were observed and the mechanism were discussed from molecular biological and ultrastructural view. Results: Compared with high PO_2 reperfusion group and normal PO_2 reperfusion group, the products of oxygen free radical were lowered at the end of reperfusion in initial lower PO_2 controlled reperfusion group. ATP content was increased, myocardial contractility was elevated, coronary sinus flow was raised, the degree of myocardium edema was reduced, and ultrastructure alteration was lessened significantly. Conclusion: Initial lower PO_2 controlled reperfusion reduces oxygen free radical injury, enhances myocardial energy metabolism, lessens myocytic structure destruction and improves postischemic function recovery of cyanotic myocardium.
