Gastrointestinal perforation in extremely low birth weight infants: A single center retrospective study in China.

BACKGROUND: Gastrointestinal perforation in extremely low birth weight infants, characterized by its rapid onset, multiple complications, and critical condition, poses a significant risk of infant mortality. The aim of this study was to investigate the clinical characteristics of pneumoperitoneum in extremely low birth weight infants (ELBWI) and explore the risk factors associated with gastrointestinal perforation in very low birth weight preterm infants. Additionally, we shared our surgical experiences in managing gastrointestinal perforation among extremely low birth weight infants. METHODS: The Department of Neonatology at Chengdu Women and Children's Central Hospital conducted a retrospective study on gastrointestinal perforation in extremely low birth weight infants (birth weight <1000 g) who were admitted between 2014 and 2021. After baseline analysis and comparing it with the control group, we identified the risk factors associated with gastrointestinal perforation in ELBWI by multiple logistic regression analysis. The Kaplan-Meier analysis was performed to assess the adverse effect of gastrointestinal perforation for survival in ELBW infants. Cox multivariate regression analysis was used to evaluate hazard level of different variables for ELBW infants survival. RESULTS: Hemodynamically significant patent ductus arteriosus (hsPDA)(p = 0.043, OR = 2.779) and sepsis (p = 0.014, OR = 2.265) were significant risk factors for gastrointestinal perforation in extremely low birth weight infants. The Cox proportional hazard model revealed that intraventricular hemorrhage (HR = 2.854, p＜0.001) Sepsis (HR = 1.645, p = 0.015) and gastrointestinal perforation (HR = 1.876, p = 0.008) had detrimental effects on the survival of extremely low birth weight infants; conversely, ibuprofen (HR = 0.304, p＜0.001) and blood transfusion (HR = 0.372, p＜0.001) are beneficial factors for their survival. The preoperative indicators of infection in infants with spontaneous intestinal perforation (SIP) were significantly better than those in the necrotizing enterocolitis (NEC) group (p < 0.05). CONCLUSIONS: Gastrointestinal perforation poses a significant threat the survival of extremely low birth weight (ELBW) infants, with hsPDA and sepsis serving as predisposing factors for gastrointestinal perforation. The gastrointestinal perforation caused by various diseases exhibits distinct clinical characteristics, necessitating tailored surgical approaches based on operative conditions.

Heterogeneous Strain Distribution Based Programmable Gated Microchannel for Ultrasensitive and Stable Strain Sensing.

Developing highly sensitive strain sensors requires conduction pathways capable of rapidly switching between disconnection and reconnection in response to strain. Ion channels in living organisms exactly control the channel switch through protein-composed gates, achieving changeable ion currents. Herein, inspired by the gating characteristics of the ion channels, a programmable fluidic strain sensor enhanced by gating ion pathways through heterogeneous strain distribution of discrete micropillars is proposed. During stretching, the contraction and closure of the widthwise gaps between discrete micropillars greatly weaken or even nearly cut off the conduction pathway, resulting in orders of magnitude increase in resistance and thus ultrahigh sensitivity. By adjusting the combination form and structural parameters of the discrete micropillars in the fluidic channel, the sensitivity and strain range can be customized. Thus, a gauge factor of up to 45 300 and a stretch range of 590% are obtained. Benefiting from the fluidic gating mechanism, no mechanical mismatch can be observed at the interface, breaking through the sensing stability issue of flexible sensors. The proposed sensor can be used to detect the full range of human motion, and integrated into a data glove to achieve human-machine interaction.

Effect of soybean protein isolate-pectin composite nanoparticles and hydroxypropyl methyl cellulose on the formation, stabilization and lipidolysis of food-grade emulsions.

The formation and stabilization mechanism as well as digestion characteristics of food-grade emulsions prepared by the SPNPs-HPMC mixed systems (a combination of soybean protein isolate-pectin composite nanoparticles (SPNPs) and hydroxypropyl methylcellulose (HPMC)) were investigated. Then, it was found that the SPNPs-HPMC mixed systems could not only enhance the stability of the emulsion, but also make it have a satisfactory lipidolys is efficiency. During the formation and stabilization of the emulsion, HPMC was adsorbed in the early stage of emulsion formation, while SPNPs needed a longer adsorption time. When the HPMC concentration was 0.25-0.5 wt%, HPMC and SPNPs co-adsorbed on the interface. When the HPMC concentration was 1-2 wt%, HPMC and SPNPs competed to adsorb on the interface, of which the adsorption HPMC was dominant. In vitro simulation of digestion, SPNPs were decomposed into substances with lower interfacial activity, and the structure and activity of HPMC were well maintained, which led them to reconstruct a new interface layer. Thus, the size distribution and surface area of the emulsion droplets were retained in a good state for the lipidolysis process. Therefore, the SPNPs-HPMC mixed systems could both enhance the stability of the emulsion and grant it a satisfactory lipidolysis efficiency.

Case Report: Two Cases of Pulmonary Artery Dissection in Young Infants.

Pulmonary artery dissection (PAD) is a rare disease. This article reports the treatment of PAD in young infants for the first time. Both cases of the infants were treated with surgery. Different surgical methods achieve different results, which provide ideas for treating PAD in young infants.

A pulmonary artery dissection in infant.

Figure l shows echocardiography, A is the mixed echo mass from pulmonary artery to bifurcation and in left pulmonary artery, with a size of about 31.9mmx15.7mm; B is the CDFI image in the mass, showing a few spot like blood flow signals in the mass.

Effects of AlN Coating Layer on High Temperature Characteristics of Langasite SAW Sensors.

High temperature characteristics of langasite surface acoustic wave (SAW) devices coated with an AlN thin film have been investigated in this work. The AlN films were deposited on the prepared SAW devices by mid-frequency magnetron sputtering. The SAW devices coated with AlN films were measured from room temperature to 600 °C. The results show that the SAW devices can work up to 600 °C. The AlN coating layer can protect and improve the performance of the SAW devices at high temperature. The SAW velocity increases with increasing AlN coating layer thickness. The temperature coefficients of frequency (TCF) of the prepared SAW devices decrease with increasing thickness of AlN coating layers, while the electromechanical coupling coefficient (K²) of the SAW devices increases with increasing AlN film thickness. The K² of the SAW devices increases by about 20% from room temperature to 600 °C. The results suggest that AlN coating layer can not only protect the SAW devices from environmental contamination, but also improve the K² of the SAW devices.

The Characterization of Surface Acoustic Wave Devices Based on AlN-Metal Structures.

We report in this paper on the study of surface acoustic wave (SAW) resonators based on an AlN/titanium alloy (TC4) structure. The AlN/TC4 structure with different thicknesses of AlN films was simulated, and the acoustic propagating modes were discussed. Based on the simulation results, interdigital transducers with a periodic length of 24 µm were patterned by lift-off photolithography techniques on the AlN films/TC4 structure, while the AlN film thickness was in the range 1.5-3.5 µm. The device performances in terms of quality factor (Q-factor) and electromechanical coupling coefficient (k²) were determined from the measure S11 parameters. The Q-factor and k² were strongly dependent not only on the normalized AlN film thickness but also on the full-width at half-maximum (FWHM) of AlN (002) peak. The dispersion curve of the SAW phase velocity was analyzed, and the experimental results showed a good agreement with simulations. The temperature behaviors of the devices were also presented and discussed. The prepared SAW resonators based on AlN/TC4 structure have potential applications in integrated micromechanical sensing systems.

High-Temperature SAW Wireless Strain Sensor with Langasite.

Two Surface acoustic wave (SAW) resonators were fabricated on langasite substrates with Euler angle of (0°, 138.5°, 117°) and (0°, 138.5°, 27°). A dipole antenna was bonded to the prepared SAW resonator to form a wireless sensor. The characteristics of the SAW sensors were measured by wireless frequency domain interrogation methods from 20 °C to 600 °C. Different temperature behaviors of the sensors were observed. Strain sensing was achieved using a cantilever configuration. The sensors were measured under applied strain from 20 °C to 500 °C. The shift of the resonance frequency contributed merely by strain is extracted from the combined effects of temperature and strain. Both the strain factors of the two SAW sensors increase with rising ambient temperature, and the SAW sensor deposited on (0°, 138.5°, 117°) cut is more sensitive to applied strain. The measurement errors of the two sensors are also discussed. The relative errors of the two sensors are between 0.63% and 2.09%. Even at 500 °C, the hysteresis errors of the two sensors are less than 5%.

[Comparison of clinical features between gastroesophageal reflux diseases with atypical and typical symptoms].

OBJECTIVE: To study the differences between gastroesophageal reflux disease (GERD) with atypical symptoms (a-GERD) and typical symptoms (t-GERD). METHODS: 30 patients of suspected a-GERD were recruited and examined with upper gastrointestinal endoscopy, high-resolution manometry (HRM), 24 h esophageal multichannel intra-luminal impedance monitoring with pH sensor (MII-pH) and proton pump inhibitor (PPI) trials. The results were compared with those of 33 cases of GERD with typical symptoms. RESULTS: Among the 30 patients of suspected GERD, 24 were confirmed with a-GERD. One third of those patients were over sixty-years old, significantly higher than those with typical GERD (P < 0.05). No significant differences in prevalence of esophageal mucosa breakage and esophageal manometry readings were found between the two groups (P > 0.05). The a-GERD patients had higher data readings in 24 h esophageal MCII-pH monitoring than the t-GERD patients (P < 0.05). Supine type of GER and mixed reflux were predominately seen in the a-GERD patients, while upright type of GER was predominate seen in the t-GERD patients. The response rate of PPI in the a-GERD patients was significantly lower than that in the t-GERD patients when a course of standard dosage of PPI was given (45.8% vs. 78.8%, P < 0.01). But there was no significant difference in PPI response between these two groups when a second course with double standard dosage of PPI combined with pro-motility agents were given (72.7% vs. 88.0%, P < 0.05). CONCLUSION: Compared with patients of t-GERD, older onset age, more severe degree of acid reflux are presented in patients of a-GERD. a-GERD should be considered when it is hard to explain the symptoms of upper part of the chest in clinical practice. 24 h esophageal MII-pH monitoring and/or diagnostic therapy with double standard dosage of PPI helps make a correct diagnosis.

[Clinical features, quality of life and psychological health of patients with irritable bowel syndrome and functional dyspepsia].

OBJECTIVE: To investigate severity of gastrointestinal symptoms, quality of life, and mental health status of patients with irritable bowel syndrome (IBS) and functional dyspepsia (FD). METHODS: IBS patients were enrolled consecutively at the Outpatient Department of Gastroenterology, West China Hospital, Sichuan University from September 2012 to May 2013. The participants were divided into two groups according to their appearance with FD. Ten healthy volunteers served as normal controls. A questionnaire survey was undertaken to measure scores of gastrointestinal symptom rating scale (GSRS), Chinese IBS-quality of life (ChIBS-QOL), Hamilton Anxiety Scale (HAMA), Hamilton Depression Scale (HAMD) and medical conditions. RESULTS: Twenty-five (41.7%) IBS patients were overlapped with FD (IBS-FD). The IBS-FD patients had significantly higher scores of GSRS than IBS patients and healthy volunteers (P < 0.05). The IBS-FD patients saw doctors more frequently than IBS patients (P < 0.05). Neither anxiety nor depression were observed in healthy volunteers. The IBS patients were more likely to present mild anxiety and depression, while the IBS-FD patients were more likely to present moderate to severe anxiety and depression. The IBS-FD patients had significantly higher prevalence of anxiety and depression than IBS patients (80.0% vs. 51.4%, 76.0% vs. 48.6% respectively, P < 0.05). Scores of GSRS, ChIBS-QOL and prevalence of anxiety and depression were the highest in the IBS-FD patients with constipation (IBS-C-FD, P < 0.05). CONCLUSION: IBS-FD patients especially those with constipation suffer more gastrointestinal discomforts, and are more likely to suffer from anxiety and depression and poor quality of life compared with those with IBS only.

[The tests for anti-TB and adenosine deaminase in ascites for distinguishing between tuberculous ascites and carcinous ascites].

OBJECTIVE: To evaluate the tests for anti-TB and adenosine deaminase (ADA) in ascites in an attempt to distinguish between tuberculous ascites and carcinous ascites. METHODS: DIGFA was used to test anti-TB and Martineck's method was used to determine the level of ADA in 35 cases of tuberculous ascites and 31 cases of carcinous ascites. RESULTS: The levels of anti-TB and ADA in ascites were significantly higher in tuberculous ascites than those in carcinous ascites (P < 0.01). When the level of ADA was higher than 45 U/L, the sensitivity, specificity and accuracy in the diagnosis of tuberculous ascites were 100%, 97.1% and 98.5%, respectively. When the result of anti-TB test was positive, the sensitivity, specificity and accuracy in the diagnosis of tuberculous ascites were 93.5%, 94.3% and 95.38%, respectively. CONCLUSION: The tests for anti-TB and ADA in ascites are of important clinical value to differential diagnosis in an attempt to distinguish between tuberculous ascites and carcinous ascites.