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Objective:To explore the application effect of the ternary linkage continuation care model based on cognitive balance theory in patients with rheumatoid arthritis (RA), and to provide a reference for the continuation care model of RA patients.Methods:The convenience sampling method was adopted. A total of 72 RA patients who were treated in Huainan First People's Hospital, Anhui Province from January to December 2020 were selected as the research objects, and they were divided into observation group and control group by random number table method with 36 cases in each group. The control group was given regular discharge guidance and health education, and the observation group was given ternary continuous care based on cognitive balance theory on the basis of the control group. The intervention time was 3 months. The fatigue state, pain catastrophe, exercise self-efficacy and hope index was evaluated by the Bristol Rheumatoid Arthritis Fatigue Multi-Dimensional Questionnaire (BRAF-MDQ), the Pain Catastrophic Scale (PCS), the Self-Efficacy for Exercise Chinese version(SEE-C), and the Herth Hope Index Scale-Chinese version (HHI-C) and the results were compared between the two groups before and after the intervention.Results:There was no significant difference in the score of BRAF-MDQ, PCS, SEE-C, HHI-C before the intervention between the two groups( P>0.05). The scores of physical fatigue, life fatigue, cognitive fatigue and emotional fatigue of BRAF-MDQ in the observation group after the intervention were (10.02 ± 0.85), (6.33 ± 0.58), (3.31 ± 0.48), (4.25 ± 0.56) points, respectively, significantly lower than those in the control group (12.97 ± 1.89), (8.94 ± 0.97), (6.55 ± 0.97), (5.92 ± 0.87) points, and the differences were statistically significant ( t values were 8.54-17.96, all P<0.05). The scores of contemplation, exaggeration, and helplessness of PCS in the observation group after the intervention were (5.66 ± 0.43), (4.12 ± 0.36), (3.31 ± 0.41) points, respectively, which were significantly lower than those in the control group (8.41 ± 0.88), (5.74 ± 0.85), (5.52 ± 0.86) points, and the differences were statistically significant ( t=16.85, 10.53, 13.92, all P<0.05). The scores of SEE-C and HHI-C were (60.22 ± 7.89), (37.48 ± 5.79) points in the observation group after the intervention, which were significantly higher than those in the control group (46.98 ± 5.84), (34.21 ± 4.93) points, and the differences were statistically significant ( t=8.09, 2.58, both P<0.05). Conclusions:The ternary linkage continuation nursing model based on the cognitive balance theory has a significant effect on alleviating the fatigue state and pain catastrophe of RA patients, and helps to improve the patients' hope level and exercise self-efficacy.
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@#Abstract: Nitrobenzene compounds (NBCs) are widely used in the world. It has 40 isomers such as nitrobenzene, dinitrobenzene and nitrotoluene, that are highly toxic and difficult to degrade and can cause harm to human health in different degrees. At pres⁃ ent, there is no unified standard method and occupational exposure limit for the detection of NBCs in the air. In terms of sampling medium, solid adsorption tube is mostly used for trapping vapor state NBCs, and filter membrane and solid adsorption tube are mostly used in series for sampling coexist NBCs in vapor state and aerosol state. In the detection methods, gas chromatography and liquid chromatography are common, and ultraviolet spectrophotometry, Raman spectroscopy, ion migration spectrometry and some other rapid response methods and technologies are also used in the detection of NBCs. In the detection of NBCs by gas chro⁃ matography, capillary column separation is commonly used, and the main detectors are flame ionization detector, electron capture detector and mass spectrometry detector. It is of practical significance to establish a method with high sensitivity, strong practica⁃ bility, convenient operation, and can simultaneously collect and detect a variety of NBCs in different states.
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@#Abstract: Objective - - To establish a pre column derivatization high performance liquid chromatography method for detecting Methods dimethyl sulfate (DMS) in workplace air. DMS in workplace air was collected with mercaptopyridine impregnated （ silicone tube. The derivative of DMS and mercaptopyridine was eluted by mobile phase phase A: water, phase B: acetonitrile, ∶ the volume ratio was 40 60) , and separated with a C18 column, then detected with diode array detector and quantitated by a Results - standard curve. The linear range of DMS was 0.17 40.00 mg/L, with the correlation coefficient of 0.999 95. The detection limit and the lower limit of quantitation were 0.05 and 0.17 mg/L respectively. The minimum detection concentration and minimum quantitation concentration were 0.02 and 0.04 mg/m³, respectively (air sample volume of 4.5 L, 1.0 mL sample - - - solution). The average desorption efficiency was 98.40% 102.00%. The within run and between run relative standard deviations - - were 0.61% 3.92% and 1.71% 6.00%, respectively. The samples could be stored at room temperature for at least 14 days. Conclusion This method can be used to detect DMS in workplace air.
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@#Objective - ，，，，，- - - To establish a gas chromatographic method for the determination of trans 1 1 1 4 4 4 hexafluoro 2 ［ - （）］ Methods - （） butene HFO 1366mzz E in workplace air. HFO 1366mzz E in air was directly collected with aluminum foil ， ， ， composite plastic bag separated by dimethylpolysiloxane capillary column detected by flame ionization detector and Results - （） - 3， quantified with external standard method. The linear range of HFO 1366mzz E was 6.82 68 200.00 mg/m with the 3， correlation coefficient of 0.999 9. The detection limit and the lower limit of quantitation were 0.59 and 1.98 mg/m respectively. - - - The recovery rate was within 95.45% 103.05%. The relative standard deviation of within batch precision and between batch - - ， precision were 2.26% 5.07% and 4.09% 6.82% respectively. The samples can be stored at room temperature for at least seven Conclusion ， ， days. This method is simple to use with a wide linear range low detection limit high accuracy and precision and - （） good sample stability. It can be used for the detection of HFO 1366mzz E in the air of workplace
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@#Objective - - To prepare the GDH 5 air sampling tube for simultaneous collection of eight kinds of chloro nitrobenzene （ ） ， compounds CNBs in the air of workplace and establish a matching determination method using gas chromatography. Methods - - ， Eight kinds of CNBs in vapor and aerosol state were collected by self developed GDH 5 air sampling tube desorbed ， ， ， by toluene separated by polysiloxane gas chromatography column detected by microcell electron capture detector and Results - （ - quantified by external standard method. It was determined that the air sampling tube was assembled by XAD 2 ion ） - ， exchange resin and glass fiber filter membrane. The linear range of CNBs was 0.80 240.00 mg/L and the linear correlation - - coefficients were greater than 0.999 9. The detection limit was 7.87 13.03 μg/L. The minimum detectable concentration was 0.60 3， - 3（ ） 1.33 μg/m and the minimum quantitative concentration was 2.00 4.22 μg/m sample 45.00 L . The average desorption - - （RSD） - ， - RSD efficiency was 101.2% 110.0%. The within run relative standard deviation was 0.8% 4.1% and the between run - Conclusion - was 0.3% 5.8%. The samples could be stored for more than 30 days at room temperature. GDH 5 air sampling tube and its associated determination method can be used for the collection and determination of eight kinds of CNBs in workplace air.
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Objective: To evaluate the short-term efficacy and perioperative safety of catheter-based intervention in patients with pulmonary vein stenosis caused by fibrosing mediastinitis (FM). Methods: It was a case series study. Consecutive patients with pulmonary vein stenosis caused by FM, who underwent percutaneous pulmonary vein angioplasty in Gansu Provincial Hospital from January 2018 to June 2020, were retrospective enrolled. The baseline characteristics, comorbidities, exercise capacity and hemodynamic data before and after treatment were compared, and the procedural related complications were evaluated. Results: A total of 30 patients ((64.3±7.1) years, 15 males) were included. Sixty-three pulmonary vein stenosis were treated by 32 percutaneous pulmonary vein angioplasty procedures. Forty-four stents were implanted in 41 pulmonary veins after balloon angioplasty, and the diameter of implanted stents was (8.3±1.2)mm. Balloon angioplasty was performed on 22 pulmonary vein stenosis, the mean balloon diameter was (4.2±2.1)mm. The pulmonary vein diameter increased from (2.6±1.3) to (6.6±2.6) mm (P<0.001) and the pressure gradient across the pulmonary vein stenotic segment reduced from 19 (12, 29) to 2 (0, 4) mmHg (1 mmHg=0.133 kPa) (P<0.001) immediately post procedure. The pulmonary vein flow grade was significantly improved compared with baseline (P<0.001). The most common operation related complications were lung injury (44.0% (11/25)) and hemoptysis (18.8% (6/32)), which did not need special treatment. During the 2.0 (1.3, 3.2) months follow-up, the WHO functional class was significantly improved (P<0.05), the 6-minute walking distance increased from (254.8±114.5) m to (342.8±72.4)m (P<0.05), the mean pulmonary arterial pressure decreased from (40.9±8.3) mmHg to (35.4±7.7) mmHg (P<0.01), 17 out of 19 patients with refractory pleural effusion experienced total remission during the follow-up period (P<0.001). CT pulmonary venography was repeated in 17 patients. The incidence of in-stent restenosis of pulmonary vein was 24.0% (6/25). Conclusions: Percutaneous pulmonary vein angioplasty is effective for the treatment of pulmonary vein stenosis caused by fibrosing mediastinitis. However, it's not so safe, procedural related complication should be paid attention to and the rate of in-stent restenosis is relative high during the short-term follow-up.
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Humans , Male , Angioplasty, Balloon , Catheters , Mediastinitis , Retrospective Studies , Sclerosis , Stenosis, Pulmonary Vein , Stents , Treatment OutcomeABSTRACT
Objective: To analyze the clinical characteristics, laboratory examination, diagnosis, treatment, and outcome of hereditary factor Ⅹ (FⅩ) deficiency. Methods: Clinical data of 11 patients with congenital FⅩ deficiency were retrospectively analyzed from July 2009 to February 2021. Results: There were 3 males and 8 females. Median age was 39 (5-55) years. The media duration of follow-up was 81.67 (1.87-142.73) months. Of the 11 patients, 10 had bleeding symptoms, 7 had ecchymosis or hemorrhage after skin bump, 7 had nosebleed, 6 had gingival hemorrhage, and 1 had muscle hematoma. Among the female patients, 6 had menorrhagia and 1 experienced bleeding after vaginal delivery. Family history of FⅩ deficiency was found in one case. Eight patients had a history of surgery, and four had postoperative bleeding. Laboratory findings were characterized by significantly prolonged activated partial thromboplastin time, prothrombin time, and decreased FⅩ activity (FⅩ∶C) . Four cases underwent gene mutation analysis and five new mutations were found. Four cases were treated with prothrombin complex concentrates (PCC) and seven cases with fresh frozen plasma (FFP) . One female patient had significantly reduced menstrual volume after PCC prophylactic therapy. One patient received FFP for prophylactic infusion with no bleeding during and after the operation. Conclusion: Most patients with congenital FⅩ deficiency had bleeding symptoms and there was no significant correlation between severity of bleeding symptoms and FⅩ∶C. Prophylaxis should be applied in patients with severe bleeding tendencies. Gene mutation test is significant for screening, diagnosis, and prognosis prediction of congenital FX deficiency.
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Adolescent , Adult , Child , Child, Preschool , Female , Humans , Male , Middle Aged , Young Adult , Blood Coagulation Factors/therapeutic use , Blood Coagulation Tests , Factor X Deficiency/genetics , Hemorrhage/drug therapy , Plasma , Retrospective StudiesABSTRACT
Objective: To explore the clinical application value of two longitudes three transverses method in the location of the perforator of thoracodorsal artery perforator and deep wound repair. Methods: The retrospectively observational study was conducted. From December 2018 to June 2020, 17 patients with deep wounds who were admitted to the Affiliated Hospital of Zunyi Medical University met the inclusion criteria and were included in this study, including 7 males and 10 females, aged 12 to 72 years. The wound areas of patients after debridement were 7 cm×3 cm to 11 cm×7 cm. Two longitudinal lines were located through the midpoint of the armpit, the posterior superior iliac spine, and the protruding point of the sacroiliac joint, and three transverse lines were located 5, 10, and 15 cm below the midpoint of the armpit between the two longitudinal lines, i.e. two longitudes three transverses method, resulting in two trapezoidal areas. And then the thoracodorsal artery perforators in two trapezoidal areas were explored by the portable Doppler blood flow detector. On this account, a single or lobulated free thoracodorsal artery perforator flap or flap that carrying partial latissimus dorsi muscle, with an area of 7 cm×4 cm to 12 cm×8 cm was designed and harvested to repair the wound. The donor sites were all closed by suturing directly. The number and location of thoracodorsal artery perforators, and the distance from the position where the first perforator (the perforator closest to the axillary apex) exits the muscle to the lateral border of the latissimus dorsi in preoperative localization and intraoperative exploration, the diameter of thoracodorsal artery perforator measured during operation, and the flap types were recorded. The survivals of flaps and appearances of donor sites were followed up. Results: The number and location of thoracodorsal artery perforators located before operation in each patient were consistent with the results of intraoperative exploration. A total of 42 perforators were found in two trapezoidal areas, with 2 or 3 perforators each patient. The perforators were all located in two trapezoid areas, and a stable perforator (the first perforator) was located and detected in the first trapezoidal area. There were averagely 1.47 perforators in the second trapezoidal area. The position where the first perforator exits the muscle was 2.1-3.1 cm away from the lateral border of the latissimus dorsi. The diameters of thoracodorsal artery perforators were 0.4-0.6 mm. In this group, 12 cases were repaired with single thoracodorsal artery perforator flap, 3 cases with lobulated thoracodorsal artery perforator flap, and 2 cases with thoracodorsal artery perforator flap carrying partial latissimus dorsi muscle. The patients were followed up for 6 to 16 months. All the 17 flaps survived with good elasticity, blood circulation, and soft texture. Only linear scar was left in the donor area. Conclusions: The two longitudes three transverses method is helpful to locate the perforator of thoracodorsal artery perforator flap. The method is simple and reliable. The thoracodorsal artery perforator flap designed and harvested based on this method has good clinical effects in repairing deep wound, with minimal donor site damage.
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Adolescent , Adult , Aged , Child , Female , Humans , Male , Middle Aged , Young Adult , Arteries , Perforator Flap , Plastic Surgery Procedures/methods , Retrospective Studies , Skin Transplantation , Soft Tissue Injuries/surgery , Treatment OutcomeABSTRACT
OBJECTIVE@#To investigate the factors affecting the chronicity of childhood primary immune thrombo-cytopenia (ITP) and compare the efficiency of different first-line treatment regimens.@*METHODS@#Children with ITP hospitalized in our hospital from September 2013 to October 2018 were retrospectively analyzed.@*RESULTS@#Three hundred and one children (150 males and 151 females) were included in this study, with a median age of 8 (0.17-17) years old, and 110 (36.5%), 92 (30.6%), and 99 (32.9%) cases were grouped into newly diagnosed, persistent, and chronic ITP, respectively. The median of follow-up was 41.92 (1.07-74.03) months. At the end of the follow-up (October 2019), among the 202 newly diagnosed/persistent ITP children, 79 cases (59 newly diagnosed and 20 persistent ITP) achieved remission within 1 year after initial diagnosis, with a remission rate of 39.3%; 122 cases (50 newly diagnosed and 72 persistent ITP) developed chronic disease, with a chronicity rate of 60.7%; one case underwent splenectomy. In 99 cases with chronic ITP, 5 cases underwent splenectomy. Multivariable logistic regression analysis showed that, the insidious onset of symptoms (OR=3.754, 95%CI: 1.882-7.488, P=0.000) increased the risk of chronicity, while the positive antibody to anti-platelet membrane glycoprotein (OR=0.446, 95%CI: 0.224-0.888, P=0.021) might reduce the risk of chronicity. And no difference was found by the analysis of subtype of anti-platelet membrane glycoprotein (P=0.305). The efficacy of the first-line treatment of intravenous immunoglobulin (IVIG) alone or combined with steroid was better than that of steroid alone (P=0.028, 0.028), however, the efficiency was not significantly different between IVIG alone and combined with steroid (P=0.086).@*CONCLUSION@#Insidious onset of symptoms in pediatric ITP increases the risk of chronicity, while the positive titer of anti-platelet membrane glycoprotein may reduce the risk. In the first-line treatment for the newly diagnosed/persistent children. The efficacy of IVIG alone or combined with steroid is better than that of steroid alone.
Subject(s)
Adolescent , Child , Female , Humans , Male , Child, Hospitalized , Immunoglobulins, Intravenous , Purpura, Thrombocytopenic, Idiopathic , Retrospective Studies , SplenectomyABSTRACT
Objective:To explore the epidemiological characteristics of septic shock in children and analyse the risk factors for prognosis.Methods:Retrospective study was conducted to collect the clinical data of 90 children with septic shock admitted to PICU from January 2017 to July 2020.Logistic regression analysis was used to analyze the epidemiological characteristics and risk factors of death of children with septic shock.Results:Among the 90 children with septic shock, 27 patients died, with a fatality rate of 30.0%.The primary infection sites were mainly in lungs and gastrointestinal/abdominal cavity, and the mortality rate of children with septic shock caused by primary gastrointestinal/abdominal infection was higher than that of lungs infection(48.1% vs.23.7%, χ2=6.049, P<0.05), and the time of death was shorter than that of lungs infection[2.1(0.9, 6.5)d vs.8.0(2.2, 13.5)d, H=2.052, P<0.05]. With the prognosis of children as dependent variable, the sex, age, pediatric critical illness score, glasgow coma scale, hypotension, combination with basic diseases, high lactic acidosis as well as severe pneumonia, gastrointestinal function failure, liver failure, acute kidney injury, and stress hyperglycemia were introduced to Logistic regression equation.The results showed that pediatric critical illness score, hypotension, combination with basic diseases, gastrointestinal function failure, liver failure, and acute kidney injury were related to the prognosis of children with septic shock, and hypotension, gastrointestinal function failure and combination with basic diseases were independent risk factors for death in children with septic shock. Conclusion:It is necessary to strengthen early intervention for primary gastrointestinal/abdominal infection, combined with underlying diseases and septic shock in compensatory stage.
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Objective:To investigate the effect of plasma exchange (PE) and continuous blood purification(CRRT) on children with bee sting poisoning and multiple organ dysfunction syndrome (MODS).Methods:From January 2016 to September 2019, 37 children aged 9 months to 11 years with bee sting and MODS were treated with dexamethasone 0.5 mg/kg or methylprednisolone 3 mg-5 mg/kg anti allergic and anti-inflammatory and organ support. Among them, 26 cases were treated with plasma exchange and continuous blood purification (treatment group), and the rest 11 cases were only given conventional treatment, but did not receive blood purification treatment (control group).The critical illness score, liver and kidney functions, myolysis, pulmonary hemorrhage/pulmonary edema, coagulation disorders, shock, hemolysis, gastrointestinal failure and other organ damage, ICU stay time, mechanical ventilation time, organ dysfunction recovery time and clinical outcomes were retrospectively analyzed. In the treatment group, 18 cases started blood purification before 12 h after MODS (early treatment group) and 8 cases started blood purification after 12 h (delayed treatment group).Results:There was no significant difference in age, sex, child critical illness score, onset time and organ function damage between the treatment and control groups ( P>0.05). The cure rate of the treatment group was higher than that of the control group [(25/26 (96.15%) vs 8/11 (72.73%), P=0.036]. There was no significant difference in ICU stay between the control group and the treatment group [(10.03±7.74) d vs (12.01±6.95) d, P>0.05]. Among the 25 survivors in the treatment group, one patient had mild renal function damage and one patient had multiple necrosis of skin, subcutaneous and muscle tissue. Compared with 4 of the 8 survivors in the control group, the residual organ function damage in the treatment group was significantly less than that in the control group [(2/25 (8.00%) vs 4/8 (50.00%), P=0.031)].The recovery of liver function, renal function, myolysis and hemolysis in the treatment group was faster than those in the control group (all P < 0.05). The initiation of blood purification within 12 h after the occurrence of MODS required fewer times of plasma exchange and shorter CRRT time, ICU stay and ventilator time (all P < 0.05). Conclusions:In children with bee sting combined with MODS, plasma exchange and continuous blood purification can achieve better therapeutic effect and better clinical outcome.
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Objective:To evaluate the value of sugammadex for ultra-fast-track anesthesia in pediatric patients undergoing surgery for correction of congenital heart disease.Methods:Forty pediatric patients of both sexes, aged 1-6 yr, with American Society of Anesthesiologists physical status Ⅱ, scheduled for elective surgery for correction of congenital heart disease, were enrolled in this study and randomly assigned into sugammadex group (group S) and control group (group C) with a random number table.Sugammadex 4.0 mg/kg was injected intravenously to reverse neuromuscular relaxation in group S and the equal volume of normal saline was administrated in group C when the train-of-four (TOF) count was 0 and post-tetanic count was 1 or 2 during recovery from anesthesia.The recovery time of TOF ratio to 25%, 75% and 90%, the extubation time and the success rate of ultra-fast-track anesthesia were recorded.Results:Compared to group C, sugammadex significantly shortened the recovery time of TOF ratio to 25%, 75% and 90% and the extubation time in group S ( P<0.05); Furthermore, the success rate of ultra-fast-track anesthesia reached 100% in group S compared to 0% in group C. Conclusion:Intravenous administration of sugammadex 4.0 mg/kg significantly shortens the recovery time of neuromuscular relaxation and extubation time and enhances the success rate of ultra-fast-track anesthesia in pediatric patients undergoing surgical correction of congenital heart disease.
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This research explored the synergistic effects and the mechanism of parthenolide (PTL) and vorinostat (suberoylanilide hydroxamic acid, SAHA) on the proliferation of A549 non-small cell lung cancer cells. The combination effect of PTL and SAHA was detected by cell counting kit-8 (CCK-8) and colony formation assays. Scratch test was performed to detect cell migration. Annexin V-fluorescein isothiocyanate isomer/propidium iodide (FITC/PI) flow cytometry and Western blot analyses were used to determine cell apoptosis and its mechanism. The results showed that combination of PTL and SAHA inhibited the proliferation and migration of A549 with a synergistic effect compared to the single-drug groups. The combination of PTL and SAHA had synergistic effect to induce cell apoptosis by regulating p53 and c-myc pathways, and affected the expression levels of poly ADP-ribose polymerase (PARP), cysteinyl aspartate specific proteinase (caspase)-9, and caspase-3. Taken together, this study shows that combination of PTL and SAHA has synergistic effect, induces cell apoptosis and inhibits A549 proliferation, which is likely to be a novel strategy for the treatment of non-small cell lung cancer.
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This research investigated the effect of parthenolide on the proliferation and migration of human breast cancer cells and explored the molecular mechanism of that effect. Surface plasmon resonance and fluorescence resonance energy transfer melting were used to detect the binding and stabilizing ability of PTL and G-quadruplex. MTT assays were used to determine the effect of PTL on the proliferation of MCF-7 breast cancer cells. A wound healing assay was performed to detect the migration of MCF-7. The results indicate that PTL shows good binding and stabilizing activities with c-myc G-quadruplex with a KD = 13.1 μmol·L-1. PTL inhibited the proliferation of MCF-7 cells with an IC50 of 21.3 μmol·L-1 (24 h), 14.5 μmol·L-1 (48 h) and 9.1 μmol·L-1 (72 h). PTL inhibited MCF-7 breast cancer cell proliferation and migration and down-regulated the transcription and expression level of c-myc by targeting G-quadruplex.
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Objective:To investigate the effect of specialized continuous blood purification team (SCT) in the treatment of septic shock in children.Methods:The clinical data of 68 children with septic shock treated with continuous blood purification (CBP) from January 2012 to June 2019 were retrospectively analyzed.Choosing the date of SCT established(January 1, 2017) as the bound, the children were divided into the control group (before the establishment of SCT) and the observation group (after the establishment of SCT) according to whether the CBP was implemented by SCT.The CBP implementation rate, CBP time to get on the machine, the incidence of CBP-related adverse events and the prognosis of the two groups were compared.Results:There were no significant differences between two groups about baseline data such as gender, age and pediatric critical illness score( P>0.05). The CBP implementation rate of the observation group was higher than that in control group (96.7% vs.73.7%, P<0.05), and the CBP time to get on the machine was shorter than that in control group[(1.93±0.65)h vs.(6.25±2.38) h, P<0.01]. The overall incidence of CBP-related adverse events was lower than that in control group (18.7% vs.66.2%, P<0.01), and the 28 d survival was higher than that in control group(83.3% vs.60.5%, P<0.05). Conclusion:SCT can significantly improve the implementation rate and efficiency of CBP treatment in children with septic shock, reducing the incidence of CBP-related adverse events, and improving the survival rate.
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Objective:To explore the serum levels of inflammatory cytokines and prognosis in severe acute infection children with glucose-6-phosphate dehydrogenase(G6PD) deficiency.Methods:A total number of 160 children with severe acute infections admitted to PICU of Guangxi Zhuang Autonomous Region Maternal and Child Health Hospital from June 2014 to December 2017 were selected as subjects in this study, including 80 children with G6PD deficiency(observation group) and 80 children without G6PD deficiency(control group). The changes of TNF-α, IL-6, IL-10 and CRP were dynamically monitored at 0-hour, 12-hour and 24-hour after admision, and the occurrences of sepsis, multiple organ dysfunction syndrome(MODS) were prospectively analyzed.Results:The levels of serum cytokines and CRP in the observation group were significantly higher than those in the control group at admission[TNF-α: (65.57±19.09) pg/ml vs.(46.53±20.34) pg/ml; IL-6: (98.90±29.02) pg/ml vs.(89.89±25.54) pg/ml; IL-10: (87.66±21.84) pg/ml vs.(76.34±19.01) pg/ml; CRP: (60.18±22.24) mg/L vs.(41.43±19.51) mg/L, respectively], and the differences between two groups were statistically significant( P<0.05). The levels of cytokines and CRP in the observation group were higher than those in the control group at 12 h and 24 h after treatment( P<0.01). Compared with the control group, the incidences of sepsis(82.50% vs 67.50%) and MODS(73.75% vs 58.75%) in the observation group increased, and the recovery rate(81.25% vs 92.50%) decreased, with statistical significance between two groups( P<0.05). Conclusion:Children with G6PD deficiency need to be paid more attention to inflammation, sepsis, MODS and the difficulty of treatment when they are infected.The potential mechanism may be related to oxidative stress.
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Objective:To investigate the clinical significance of inflammatory factors in bacterial infection children with glucose-6-phosphate dehydrogenase (G6PD) deficiency in PICU.Methods:A prospective cohort study was carried out from June 2014 to December 2017. 77 bacterial infection children with pediatric critical illness score less than 80 who were admitted to the PICU, were recruit in the study.The patient diagnosed as other basic diseases,with history of high-dose glucocorticoid use, discharged or died within 24 hours were excluded.The recruited patients were divided into G6PD deficiency group (observation group with 36 cases) and non-G6PD deficiency group (control group with 41 cases) according to the presence or absence of G6PD deficiency.Blood samples were taken at admission, 12 hand 24 h after hospitalization to detect the concentrations of tumor necrosis factor (TNF-α), interleukin 6 (IL-6), interleukin 10 (IL-10) andC-reactive protein (CRP). T test, χ2 test and Fisher exact test were used to analyze the changes of the above inflammatory factors, complications, prognosis, PICU stay time and hospitalization costs. Results:The levels of inflammatory factors in the observation group were significantly higher than those in the control group at admission, 12 and 24 hours after hospitalization, the differences were statistically significant (all P< 0.05). There was no statistically significant difference in thechangerate of inflammatory factors between the two groups during treatment; The PICU stay time of observation group was longer [(7.98 ± 6.55) vs (5.01 ± 6.21)] and the hospitalization cost (yuan) was higher [(36 634.09 ± 11 876.67) vs (31 571.42 ± 10 245.80)], P<0.05; Compared to the control group, the incidence ofsevere sepsis, septic shock, MODS increased significantly, and the curative rate decreasedsignificantly in observation group( P<0.05). Conclusions:G6PD-deficient children with bacterial infections had serious inflammatory reactions with poor prognosis and higher hospitalization costs and were susceptible to the occurrence of severe sepsis, septic shock and MODS.
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Objective To determine the content and distribution of manganese in rural drinking water in Guangxi province, and to provide scientific evidence for improving drinking water quality and safety. Methods The monitoring results of manganese in rural drinking water in Guangxi from 2014 to 2019 were evaluated according to GB 5749-2006 Sanitary Standards for Drinking Water. Results 47 637 samples were analyzed during 2014-2019.Manganese detection rate was 28.46 %, with the range from 0.05 to 2.71 mg/L, and the qualified rate was 99.46%.The difference of manganese compliance rate in different years was statistically significant (χ2=25.049, P < 0.01), and the rate increased with the increase of year (χ2 =17.498, P < 0.01).The compliance rate in dry seasons was higher than that in wet seasons(χ2=5.871, P < 0.05).The qualified rate of manganese was statistically different between the water samples collected from centralized and scattered supply sources (χ2=90.983, P < 0.01).The qualified rate of manganese in large centralized water supply was higher than that in small centralized water supply (χ2=10.294, P < 0.01).The geographic distribution of the qualified manganese rate was in the following order:center>west>north>south>east.(χ2=103.908, P < 0.01). Conclusion There are high and low concentrations of water manganese in rural areas of Guangxi.While most areas showed low manganese in drinking water, some areas dispayed a local point distribution of high water manganese.
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To explore the optimal therapy time for the treatment of severe coronavirus disease 2019(COVID-19)by traditional Chinese medicine(TCM)and its influence on the therapeutic effect and prognosis. The clinical data,laboratory findings,and outcomes of 64 patients with severe COVID-19 treated with TCM and western medicine in Chongqing from January 20,2020, to March 11,2020 were retrospectively analyzed.Patients were divided into early intervention group[TCM was initiated within 3 days (including day 3) after the first diagnosis of severe type/critical type COVID-19]and late intervention group[TCM was initiated after 7 days (including day 7) after the first diagnosis of severe type /critical type COVID-19].The changes in clinical parameters during the course of disease were compared between the two groups. On day 14,the oxygenation index was 292.5(252.0,351.0)mmHg in the early intervention group,which was significantly higher than that in the late intervention group [246.0(170.0,292.5)mmHg](=0.005).The length of hospital stay [(18.56±1.11)d (24.87±1.64)d,=0.001],duration of ICU stay [(14.12±0.91)d (20.00±1.53)d,=0.000] and time to negativity [(16.77±1.04)d (22.48±1.66)d,=0.001] in the early intervention group were significantly shorter than those in the late intervention group.The intubation rate(7.3%)in the early intervention group was significantly lower than that in the late intervention group(30.4%)(=0.028). Early TCM therapy within three days after a diagnosis of severe COVID-19 can shorten the length of hospital stay,duration of ICU stay,and time to negativity and decrease intubation rate.
Subject(s)
Humans , Betacoronavirus , Coronavirus Infections , Drug Therapy , Medicine, Chinese Traditional , Pandemics , Pneumonia, Viral , Drug Therapy , Prognosis , Retrospective StudiesABSTRACT
OBJECTIVE@#To study the effect of early continuous blood purification (CBP) on the prognosis of children with septic shock.@*METHODS@#A prospective analysis was performed for the children with septic shock who did not reach the 6-hour initial recovery target and/or had a fluid overload of >10%. According to the treatment time of CBP, they were divided into an early group with 30 children and a conventional group with 28 children. The two groups were compared in terms of the start time of CBP and 28-day mortality rate, as well as the related indexes in the children who were cured.@*RESULTS@#The early group had a significantly earlier start time of CBP than the conventional group (P0.05). The children who were cured in the early group had significantly shorter correction time of lactic acid, urine volume, and fluid overload than those in the conventional group (P10%, early CBP treatment can quickly control the disease, shorten the course of disease, and accelerate immune reconstruction.