Association between the ratio of dietary vitamin A to body weight and hypertension in children / 中国学校卫生

Objective@#To explore the relationship between the ratio of dietary vitamin A (VitA) to body weight and hypertension among children, so as to provide a reference for blood pressure control through dietary nutritional interventions and childhood hypertension prevention.@*Methods@#Utilizing the baseline survey and followup sample data from the Healthy Children Cohort established in urban and rural areas of Chongqing from 2014 to 2019, structured quantitative dietary questionnaire and selfdesigned questionnaire were used to investigate the information of dietary intake and socioeconomic characteristics of 15 279 children, as well as blood pressure, height, weight measurement. The ratio of dietary VitA to body weight was divided into four groups based on quartiles [≤P25(Q1), >P25~P50(Q2), >P50~P75(Q3), >P75(Q4)]. Generalized linear regression models and Logistic regression models were used to analyze the correlation between ratio of dietary VitA to body weight with blood pressure levels and prevalence of hypertension.@*Results@#The results of the 2014 baseline survey indicated that, after adjusting for confounding factors such as demographic indicators and nutritional intake, significant differences were observed in systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP) among different groups categorized by the ratio of dietary VitA to body weight (F=157.57, 44.71, 95.92, P<0.01). The baseline ratio of dietary VitA to body weight in children exhibited a negative correlation with DBP, SBP and MAP at baseline and in 2019[baseline: β(95%CI)=-0.65(-0.89--0.42), -0.22(-0.42--0.01), -0.36(-0.56--0.16); 2019: β(95%CI)=-0.77(-1.34--0.19), -0.62(-1.21--0.02), -0.77(-1.34--0.19), P＜0.05]. Compared to Q1 group, the risk of hypertension decreased among children in Q4 at baseline and followup in 2019 [OR(95%CI)=0.63(0.49-0.81), 0.18(0.08-0.42), P<0.01].@*Conclusions@#The ratio of dietary VitA to body weight is significantly negatively correlated with blood pressure levels among children, and dietary VitA deficiency is an independent risk factor for hypertension among children. Measures should be taken to actively adjust childrens dietary nutrition and reduce the risk of childhood hypertension.

[Preliminary analysis on the treatment of ventilator-associated pneumonia caused by pandrug-resistant Acinetobacter baumannii].

OBJECTIVE: To analyze the clinical features of pandrug-resistant Acinetobacter baumannii (PDR-Ab) in the Chinese PLA General Hospital and compare the efficacies of different antibiotic treatments in aged patients with ventilator-associative pneumonia (VAP) caused by PDR-Ab. METHODS: Data were collected from all isolated PDR-Ab strains in our hospital from April 2009 to April 2010. The clinical features, treatment, and outcomes were retrospectively reviewed. RESULTS: PDR-Ab was found to be the dominant pathogen in 42 of 126 aged VAP patients. Cefoperazone/sulbactam plus minocycline showed good efficacy in 20 patients with PDR-Ab VAP, showing a clinical cure rate of 65% (13/20) and a bacterial eradication rate of 40% (8/20). Another 22 patients were treated with other antimicrobial drugs, achieving a clinical cure rate of 22.7% (5/22) and a bacterial eradication rate of 13.6% (3/22). The factors influencing bacterial clearance were prolonged length of hospital stay and mechanical ventilation prior to positive culture (all P<0.01). CONCLUSION: Cefoperazone/sulbactam plus minocycline can be an effective treatment for VAP caused by PDR-Ab.

[Comparison of SmartCare and spontaneous breathing trials for weaning old patients with chronic obstructive pulmonary diseases].

OBJECTIVE: To compare the outcome of the SmartCare and spontaneous breathing trials (SBT) for weaning old patients with chronic obstructive pulmonary diseases (COPD). METHODS: Thirty-eight COPD patients were enrolled in Department of Respiratory Medicine on the South Building, General Hospital of People's Liberation Army from January, 2003 to April, 2005. They mechanically ventilated for at least 3 d (age: 70 - 91 year, average: 83.3 +/- 4.3), randomly assigned to receive SmartCare (SC group, n = 13) or SBT (SBT group, n = 25). All patients were considered clinically and biologically stable, and therefore ready to be weaned from mechanical ventilation. In SC group, patients were ventilated with an inspiratory pressure (IPAP) support adjusted to achieve pH value > or = 7.35, saturation of oxygen in arterial blood (SaO2) > or = 90%, respiratory frequency (RR) > or = 10 and < or = 30 breaths/min, and fraction of inspired oxygen (FiO2) < or = 45%. In SBT group, the patients were placed in a weaning protocol utilizing increasing duration of spontaneous breathing. The following data were recorded at weaning: the acute physiology and chronic health evaluation II (APACHE II) score, arterial blood gases under mechanical ventilation, serum calcium, magnesium, and phosphorus, the days of ventilation before weaning and the duration of weaning. The patients of both groups were considered as successfully weaned when they were able to tolerate at least 48 consecutive hours of spontaneous breathing. Failure was defined in a patient who died during the weaning process or who still needed mechanical ventilation after at least 40 consecutive days of weaning. RESULTS: No significant differences were found between the groups at the onset of weaning from mechanical ventilation regarding APACHE II, serum albumin, calcium, magnesium, phosphorus, partial pressure of carbon dioxide in arterial blood (PaCO2), and the days of mechanical ventilation (t = 0.834, 0.696, 1.384, 0.682, 0.467, 0.816, 0.384, all P > 0.05). The pH value of the SBT group (7.45 +/- 0.05) was higher than the SC group (7.40 +/- 0.04, t = 3.263, P < 0.05). Although patients in the SC group spent less time in weaning than those in the SBT group, the difference was not significant [(8.54 +/- 2.09), (13.32 +/- 2.19) d for the SC and SBT groups, respectively, t = 1.320, P = 0.251]. The 7-d weaning success rate was greater in the SC group than the SBT group (77%, 40%, chi(2) = 4.677, P = 0.031). No significant difference was found in 14-d weaning success rate (77%, 64% in the SC and SBT groups, chi(2) = 0.661, P = 0.416). Fewer arterial blood analyses were performed in the SC group (3.5 +/- 3.1, 6.6 +/- 3.7, t = 2.710, P = 0.011). CONCLUSION: The SmartCare is better than SBT in weaning patients with COPD within 7 days.