Effect of glucose metabolism disorders on the short-term prognosis in neonates with asphyxia: a multicenter study in Hubei Province, China. / çª’æ¯æ–°ç”Ÿå„¿ç³–ä»£è°¢ç´Šä¹±å¯¹è¿‘æœŸé¢„åŽçš„å½±å“ï¼šä¸€é¡¹æ¹–åŒ—çœå¤šä¸­å¿ƒç ”ç©¶.

OBJECTIVES: To study the effect of glucose metabolism disorders on the short-term prognosis in neonates with asphyxia. METHODS: A retrospective analysis was performed on the medical data of the neonates with asphyxia who were admitted to 52 hospitals in Hubei Province of China from January to December, 2018 and had blood glucose data within 12 hours after birth. Their blood glucose data at 1, 2, 6, and 12 hours after birth (with an allowable time error of 0.5 hour) were recorded. According to the presence or absence of brain injury and/or death during hospitalization, the neonates were divided into a poor prognosis group with 693 neonates and a good prognosis group with 779 neonates. The two groups were compared in the incidence of glucose metabolism disorders within 12 hours after birth and short-term prognosis. RESULTS: Compared with the good prognosis group, the poor prognosis group had a significantly higher proportion of neonates from secondary hospitals (48.5% vs 42.6%, P<0.05) or with severe asphyxia (19.8% vs 8.1%, P<0.05) or hypothermia therapy (4.8% vs 1.5%, P<0.05), as well as a significantly higher incidence rate of disorder of glucose metabolism (18.8% vs 12.5%, P<0.05). Compared with the good prognosis group, the poor prognosis group had a significantly higher incidence rate of disorder of glucose metabolism at 1, 2, and 6 hours after birth (P<0.05). The multivariate logistic regression analysis showed that recurrent hyperglycemia (adjusted odds ratio=2.380, 95% confidence interval: 1.275-4.442, P<0.05) was an independent risk factor for poor prognosis in neonates with asphyxia. CONCLUSIONS: Recurrent hyperglycemia in neonates with asphyxia may suggest poor short-term prognosis, and it is necessary to strengthen the early monitoring and management of the nervous system in such neonates.

Case report: Acinetobacter baumannii septic arthritis in an immunocompetent infant.

Acinetobacter baumannii is a gram-negative coccobacilli, mainly causing nosocomial infections with poor prognosis, especially in patients with prolonged hospitalization or antibiotics administration. A. baumannii pneumonia is the most common clinical form and usually occurs in critically ill patients in the intensive care unit. However, septic arthritis caused by A. baumannii is rarely reported. In this report, we describe a case of A. baumannii septic arthritis combined with incomplete Kawasaki disease in an infant. The child's chief complaint was a 2-week intermittent fever with poor response to antibiotics. Initial physical examination revealed swollen lymph nodes in the neck, pharynx congestion, and the appearance of rashes. Combined with laboratory tests, the diagnosis of incomplete Kawasaki disease was considered. After administration of high-dose intravenous immunoglobulin and corticosteroids, the child's fever improved and periungual desquamation appeared simultaneously. Swelling of the right knee occurred 5 days after the fever improved and imaging tests of MRI and ultrasound suggested the existence of infection. A diagnosis of septic arthritis was established subsequently, and arthroscopy was carried out. A. baumannii was finally identified by metagenomics next-generation sequencing of joint draining fluid for pathogenic microorganisms. Treatment with meropenem was then started. The patient eventually recovered and was discharged from the hospital after 23 days of treatment with meropenem. Although A. baumannii is not a common bacterium of septic arthritis, this rare infection can still occur in infants. Early diagnosis, pathogenic identification, and target antibiotic treatment are important to reduce the occurrence of joint sequelae.

A 3D-QSAR model for the comprehensive bioenrichment and biodegradation effect of benzotriazole ultraviolet stabilisers and application of the model in molecular modification.

Ultraviolet (UV) absorber, a type of light stabiliser, has received considerable attention because of its high bioenrichment ability and low biodegradability. In this study, benzotriazole ultraviolet stabilisers (BUVSs) were used as the research object, and the bioenrichment and biodegradation data of 13 types of BUVS molecules were subjected to dimensionless processing through quartile data transformation. Additionally, a three-dimensional quantitative structure-activity relationship (3D-QSAR) model was constructed for the investigation of the comprehensive effect of molecular bioenrichment and biodegradation of BUVSs, and improved derivative molecules were designed. Furthermore, the validity of the model was predicted using EPI simulation software, and finally, the biodegradability of BUVSs and their bioenrichment and biological effect before and after modification in the food chain and in the aerobic and anaerobic bacteria in sewage were analysed through the molecular docking technology. A total of 10 derivatives with reduced enrichment ability and enhanced degradability were designed using the CoMFA model analysis (reduction: combined effect value, 0.32-20.55%; log BCF, 2.37-17.59%; and log HL, 0.47-16.94%). Molecular docking showed that the bioenrichment ability of two derivative molecules in the four organisms was decreased by 1.87-27.67%, and the biodegradation ability of four derivative molecules in the three sewage bacteria was enhanced by 1.60-33.38% compared with those before modification. The molecular modification method of UV absorbent developed in this study provides a new perspective for further studies on environment-friendly UV absorbent and helps reduce the risks of these emerging pollutants on the environment and human body.