Evidence-based standardized nutrition protocol can shorten the time to full enteral feeding in very preterm/very low birth weight infants / 中国当代儿科杂志

OBJECTIVES@#To investigate whether evidence-based standardized nutrition protocol can facilitate the establishment of full enteral nutrition and its effect on short-term clinical outcomes in very preterm/very low birth weight infants.@*METHODS@#A retrospective analysis was performed on the medical data of 312 preterm infants with a gestational age of ≤32 weeks or a birth weight of <1 500 g. The standardized nutrition protocol for preterm infants was implemented in May 2020; 160 infants who were treated from May 1, 2019 to April 30, 2020 were enrolled as the control group, and 152 infants who were treated from June 1, 2020 to May 31, 2021 were enrolled as the test group. The two groups were compared in terms of the time to full enteral feeding, the time to the start of enteral feeding, duration of parenteral nutrition, the time to recovery to birth weight, the duration of central venous catheterization, and the incidence rates of common complications in preterm infants.@*RESULTS@#Compared with the control group, the test group had significantly shorter time to full enteral feeding, time to the start of enteral feeding, duration of parenteral nutrition, and duration of central venous catheterization and a significantly lower incidence rate of catheter-related bloodstream infection (P<0.05). There were no significant differences between the two groups in the mortality rate and the incidence rate of common complications in preterm infants including grade II-III necrotizing enterocolitis (P>0.05).@*CONCLUSIONS@#Implementation of the standardized nutrition protocol can facilitate the establishment of full enteral feeding, shorten the duration of parenteral nutrition, and reduce catheter-related bloodstream infection in very preterm/very low birth weight infants, without increasing the risk of necrotizing enterocolitis.

Incidence of late-onset sepsis in very low birth weight and extremely low birth weight infants and risk factors for late-onset sepsis / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the incidence of late-onset sepsis (LOS) in very low birth weight (VLBW) and extremely low birth weight (ELBW) infants in the neonatal intensive care unit (NICU) and the risk factors for LOS.</p><p><b>METHODS</b>A retrospective analysis was performed for the clinical data of all VLBW and ELBW infants who were hospitalized in the NICU between January 2011 and December 2013. According to the presence or absence of LOS, these infants were divided into LOS group and non-LOS group. The incidence and mortality rates of LOS, common pathogenic bacteria, and risk factors for LOS were analyzed.</p><p><b>RESULTS</b>Of the 226 VLBW and ELBW infants, 117 (51.8%) developed LOS, among whom 45 had a confirmed diagnosis of LOS and 72 had a clinical diagnosis of LOS. The LOS group had a significantly higher mortality rate than the non-LOS group [13.7% (16/117) vs 4.6% (5/109); P<0.05]. Bacterial culture found 51 strains of pathogenic bacteria, among which 32 (63%) were Gram-negative bacteria, 16 (31%) were Gram-positive bacteria, and 3 (6%) were fungi. The multivariate logistic regression analysis showed that gestational age, small for gestational age (SGA), duration of parenteral nutrition, peripherally inserted central catheter (PICC) placement, and mechanical ventilation were independent risk factors for LOS in VLBW and ELBW infants (OR=0.84, 1.59, 1.34, 3.11, and 4.55 respectively; P<0.05).</p><p><b>CONCLUSIONS</b>LOS has high incidence and mortality rates in VLBW and ELBW infants. Common pathogenic bacteria of LOS are Gram-negative bacteria. Low gestational age, long duration of parenteral nutrition, SGA, PICC placement, and mechanical ventilation may increase the risk of LOS in VLBW and ELBW infants.</p>

Morphology Manifestation of Bone Marrow Cells in 155 Newly- Diagnosed Patients with POEMS Syndrome / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To investigate the morphological manifestation of bone marrow cells in newly-diagnosed patients with POEMS syndrome.</p><p><b>METHODS</b>The bone marrow cells in 155 patients with POEMS syndrome were classified and counted by OLYMPUS BX51 microscope, and the abnormal morphology of bone marrow cells was observed.</p><p><b>RESULTS</b>The count of plasma cells with normal morphology was 83.9% (130/155), the count of plasma cells with abnormal morphology (< 5 percent) was 12.3% (19/155), the count of plasma cells with obvious abnormal morphology (> 10 percent) was 3.8% (6/155) in patients with POEMS syndrome.</p><p><b>CONCLUSION</b>The morphology of plasma cells in the most patients with the POEMS syndrome are normal, the minor patients of the POEMS syndrome have little abnormal plasma cell morphology, the extremely few patients showed obvious morphological abnormality in the bone marrow plasma cells. The higher proportion of plasma cells, the more easily and more abnormal plasma cells will be found.</p>

Clinical study of submental artery island myocutaneous flap for reconstruction of oral and maxillofacial defects following operation / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To evaluate the outcome and indication of the reconstruction of oral and maxillofacial postoperative defects by submental artery island myocutaneous flaps.</p><p><b>METHODS</b>Sixty eight cases with the reconstruction of oral and maxillofacial defects by submental artery island myocutaneous flaps from January 2006 to May 2010 were analysed retrospectively. Primary lesions included carcinomas originating from tongue (28 cases), palate (13 cases), mouth floor (9 cases), gingiva (4 cases), buccal mucosa (6 cases), lip (3 cases), and other malignant or benign tumors (5 cases). The ages ranged from 25 to 84 years (mean 58 years); 47 males and 21 females. The sizes of skin paddle varied from a minimum of 4 cm × 4 cm to a maximum of 15 cm × 10 cm.</p><p><b>RESULTS</b>Of the 68 flaps, 62 were survival, 4 had partial necrosis but healed with treatments, and 2 failed due to complete necrosis. Appearance and functions of recipient sites were satisfactory. The followed-up time was 3 - 24 months, local recurrence occurred in 5 cases and cervical lymph node metastases were found in 15 patients.</p><p><b>CONCLUSION</b>Submental island flap is reliable for the reconstruction of postoperative defects in early oral cancer without regional lymph node metastasis or in benign tumor.</p>

Evaluation of the articulator function in the hemi-tongue defect patients after radical tongue cancer resection and simultaneous reconstruction with forearm flap or primary close / 中华整形外科杂志

<p><b>OBJECTIVE</b>To explore the effect of the patients' articulator function after reconstruction of hemi-tongue defect with forearm flap (FAP) or prime close (PC).</p><p><b>METHODS</b>36 patients who underwent hemiglossectomy were investigated after radical surgery for TSCC. 20 cases were reconstructed with FAP flaps and 16 with primary closure. The patients' articulator functions were evaluated by articulation tests. VS-9700 was used to analyze the speech character when they pronounce /ji/.</p><p><b>RESULTS</b>1) The speech articulation of patients who underwent hemi-tongue reconstruction with FAF was better than that of patients with PC, and there was significant difference between them (P < 0.05). 2) The first formant (F1) of /i/ of the PC group was lower than that of the control group (P < 0.05). But the second formant (F2) of the PC group was higher than that of the control group (P < 0.05). The first formant (F1) of /i/ of the FAF group was lower than that of the control group (P < 0.05), but there were no significant differences between FAF group and control group in F2 of /i/ (P > 0.05).</p><p><b>CONCLUSIONS</b>Articulator function can be well achieved by forearm flaps reconstruction to hemi-tongue defect patients.</p>

Intraoral submandibular gland excision and how to deal with external maxillary artery / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the feasibility and safety of intraoral submandibular gland excision.</p><p><b>METHODS</b>Analyze the relationship between the external maxillary artery and submandibular gland, and offer a reliable anatomical base for 10 cases of intraoral submandibular gland excision, including 8 cases of chronic sialadenitis, 1 case of pleomorphic adenoma and 1 case of cyst of submandibular gland.</p><p><b>RESULTS</b>The external maxillary artery went across the surface of gland submandibular, and its branches provided nutrition for the gland in most cases. The results of 10 cases intraoral submandibular gland excision were effective and satisfied, without major complications. The average time of operation was 50 minutes and the average hemorrhage of operation was 60 ml.</p><p><b>CONCLUSION</b>Intraoral submandibular gland excision is safe and feasible for chronic sialadenitis and cyst of submandibular gland and some of benign tumor submandibular gland as long as indications strictly controlled and the external maxillary artery well coped with.</p>

Combined repair of large defect caused by radical surgery of advanced tongue cancer with rib-major pectoralis myocutaneous flap carrying costal parietal pleura / 中华外科杂志

<p><b>OBJECTIVE</b>To explore the clinical value and safety of using rib-major pectoralis myocutaneous flap carrying costal parietal pleura in combined repair of large soft and hard tissue defect caused by radical surgery of advanced tongue cancer.</p><p><b>METHODS</b>Six patients with advanced tongue carcinoma involving the floor of mouth and mandible were performed combined radical neck dissection with glossectomy and mandibulectomy, which caused large soft and hard tissue defect. Six rib-major pectoralis myocutaneous flaps carrying costal parietal pleura were transferred for immediate repair of the large defects. The rib flaps were applied for the repair of mandible, and the major pectoralis myocutaneous flaps were applied for the reconstruction of tongue and floor of mouth.</p><p><b>RESULTS</b>Six patients recovered well after operation. Six rib-major pectoralis myocutaneous flaps carrying costal parietal pleura survived well; the wounds of surgical incision of the oral cavity, neck, and chest healed up. The reconstructed tongue and the lower face appearance were satisfactory, the occlusion relationships were normal; the speaking as well as swallowing functions recovered.</p><p><b>CONCLUSIONS</b>It's safe and reliable to use rib-major pectoralis myocutaneous flap carrying costal parietal pleura to repair large soft and hard tissue defect in oral and maxillofacial region. Opening pleural cavity and harvest costal parietal pleura would not influence patients' thoracic movement and breath function and would not cause other complications. It's simple and safe for harvesting the composite flap. Carrying costal parietal pleura assures the sufficient blood supply of rib in the composite flap.</p>