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Objective:To investigate the risk factors of respiratory distress syndrome (RDS) complicated by pulmonary hemorrhage (PH) in premature infants.Methods:A total of 102 infant patients with RDS whose gestational age was < 37 weeks received treatment in the Department of Neonatology, Kunming Children's Hospital (Children's Hospital Affiliated to Kunming Medical University) from January 2015 to July 2021 and were included in this study. According to the diagnostic criteria of PH, these infant patients were divided into a PH group and a non-PH group. The clinical data of the two groups were compared using a t-test, non-parametric test, or χ2 test. The risk factors of PH were analyzed. The independent risk factors of RDS complicated by PH in premature infants were determined using multivariate logistic regression analysis. Results:A total of 102 premature infants with RDS were collected, including 51 in the PH group and 51 in the non-PH group. The gestational ages at birth were (32.3 ± 3.0) weeks and (31.6 ± 3.0) weeks in the PH and non-PH groups, respectively. There were 36 males (70.6%) and 33 males (64.7%) in the PH and non-PH groups, respectively. There were no significant differences in proportion of males and gestational ages at birth between the two groups (both P > 0.05). The incidence of gestational age < 32 weeks [52.9% (27/51) vs. 31.3% (16/51)], PH and RDS complicated by patent ductus arteriosus [90.5% (38/42) vs. 70.0% (35/50)], and RDS grade 3-4 [80.4% (41/51) vs. 23.5% (12/51)] in the PH group were significantly higher than those in the non-PH group ( χ2 = 5.29, 4.66, 33.03, all P < 0.05). Multivariate logistic regression analysis showed that RDS grade 3-4 was an independent risk factor of RDS complicated by PH ( OR = 9.83, 95% CI: 3.545-27.265, P < 0.05). The proportion of infants with mechanical ventilation time ≥ 7 days in the PH group was significantly higher than that in the non-PH group [56.9% (29/51) vs. 31.4% (16/51), χ2 = 6.72, P < 0.05]. Conclusion:Gestational age < 32 weeks, PH and RDS complicated by patent ductus arteriosus, and RDS grade 3-4 are the risk factors of PH in premature infants with RDS. RDS grade 3-4 is an independent risk factor.
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Objective:To explore the predictive value of amplitude integrated electroencephalography(aEEG)in the neurological prognosis of children with neonatal bacterial meningitis(NBM).Methods:The clinical data and aEEG results from 148 children diagnosed with NBM who completed aEEG examinations in the Department of Neonatology at Kunming Children′s Hospital from January 2018 to December 2019 were retrospectively analyzed.According to whether aEEG is abnormal, the children were divided into aEEG abnormal group and aEEG non-abnormal group.According to the degree of aEEG abnormality, children with aEEG abnormality were divided into aEEG mild abnormal group and aEEG severe abnormal group.The abnormal rate and abnormal characteristics of aEEG were analyzed; The clinical data of two groups were compared.Results:(1)Among the 148 children with NBM, 49 children had abnormal aEEG, 99 children had no abnormality, and the aEEG abnormal rate was 33.1%.The abnormal aEEG was manifested as delayed sleep-wake cycle maturation in 39 (26.3%) cases, abnormal discharge in eight (5.4%) cases, and abnormal background activity in one (0.6%) case.(2)The proportion of children with convulsive seizures and refractory NBM in aEEG abnormal group were significantly higher than those in aEEG non-abnormal group ( P<0.05). In the routine and biochemical abnormal indexes of cerebrospinal fluid, the proportion of protein >3 g/L, cerebrospinal fluid leukocyte>500×10 6/L, cerebrospinal fluid glucose<1.5 mmol/L, positive cerebrospinal fluid culture, positive blood and cerebrospinal fluid culture, abnormal head MRI in aEEG abnormal group significantly increased ( P<0.05); While there was no significant difference regarding blood routine leukocyte abnormality, CRP increase, and positive blood culture ratio between two groups ( P>0.05). (3) 148 cases of NBM children were followed up to 15 months old, 119 (80.4%) cases completed the follow-up, the loss rate was 19.6%, three cases died, and 11 cases had psychomotor retardation.Compared with the children with abnormal aEEG, the prognosis of children with NBM was significantly different, the Spearman rank correlation coefficient r was 0.315 ( P<0.05). COX regression was used to analyze the predictive value of each index for adverse outcomes. Abnormal aEEG was an independent risk factor for adverse outcomes in children with NBM ( OR=7.452, 95% CI 1.605-34.591, P<0.05). Conclusion:The aEEG monitoring of children with NBM, if abnormal, may indicate severe NBM, which is likely to be transformed into refractory NBM or has a poor prognosis.
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Objective The intention of this thesis is to present the nervous system symptoms of rare diseases with a view to raising researchers′awareness of these symptoms,providing one of bases for other relevant researches in the future. Methods Based on the classification in Orphanet database,rare neurological diseases are picked out and put into different groups.The diseases with the same neurological symptoms and signs are in the same group. Then,differences and similarities of the diseases in the same group are analyzed. Results 57 kinds of rare neurological diseases are sorted out from rare diseases list and account for 31.49% of total diseases in the list.These diseases are characterized by aspecific,complex and interlaced neurological abnormalities.Specifically, the above-mentioned neurological abnormalities include 10 kinds of neurological symptoms and signs like peripheral neuropathy,epilepsy,and neuromuscular diseases.Conclusions Rare diseases,in most cases,are featured with complex neurological abnormalities,which presents great challenges for identification and diagnosis.In view of this fact,it is helpful to analyze the connection between rare diseases and their symptoms by adopting the classification in Orphanet database,which is beneficial for promoting identification on neurological symptoms and signs of rare diseases.
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Objective To investigate the pathological features of ovarian tumors in elderly women.Methods We retrospectively analyzed clinical data of 124 elderly patients with ovarian cancer who were admitted to our hospital from January 2015 to December 2017.Results Among the 124 elderly patients with ovarian tumors,there were 6 borderline tumors,19 malignant tumors,and 99 benign tumors.Postmenopausal vaginal bleeding and lower abdominal pain were the main symptoms of ovarian cancer in elderly patients.The incidence of abdominal pain in patients with benign ovarian tumors was significantly higher than in patients with malignant tumors (x2 =5.813,P ＜0.05);the incidence of postmenopausal vaginal bleeding in malignant tumors was significantly higher than in benign tumors(x2=8.123,P ＜0.05);the major pathological type of benign ovarian tumors was mucinous cystadenoma,while serous cystadenoma was the most common type of malignant tumors.Analysis of related factors showed that menopausal age was positively correlated with,and menarche age and number of pregnancies were negatively correlated with ovarian tumors;and there was no correlation with number of abortions.Conclusions Malignant ovarian tumors are common in elderly women.Clinically,attention to risk factors,early detection and diagnosis will help further reduce the malignant transformation rate and improve the quality of life for patients.
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Objective To Discuss early clinical manifestation and early antibiotic selection of neonatal puru-lent meningitis.Methods 83 cases diagnosed as neonatal purulent meningitis in the newborn were choosed as the research object.Retrospective analysis was used.Clinical data according to the complaints of the neonatal hospitalized were collected and analyzed to understand neonatal purulent meningitis early features,and to choose the effective anti-biotics under the undefined etiology circumstances in early stage.Results The early features was fever (51.8%), following with hyper -bilirubinemia of newborn(26.5%),livor(9.6%)and rhinostegnosis(9.6%).Microbiological examination:all cases with Blood cultures and CSF cultures,the result showed pathogenic bacteria testing positive were 15 cases(18.1%),blood culture positive were 11 cases(13.3%).Epidermis staphylococcus aureus was in the lead, followed by E.coli.And CSF cultures positive had only 4 cases(4.8%),E.Coli was in the majority.Etiology clear choosed sensitive antibiotic treatment among the 83 cases.Etiology unknown cases choosed penicillin and ceftriaxone sodium combined treatment for 2 weeks.Treatment effective was 72.3%,not cured or automatic discharge accounted for 27.7%.Conclusion Lumbar puncture should be used timely,in order to avoid missed diagnosis.Early use of penicillin combined ceftriaxone sodium treatment has better effect,and is worth popularizing in the grassroots.
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Objective To study the effect of long‐acting nitrate on cardiac function and expression of AngⅡreceptor (ATR)subtypes in kidneys of chronic heart failure (CHF)rats after myocardial infarction .Methods Ninety male Wistar rats aged 10 weeks were randomly divided into control group (group A ,n=9) ,sham operation group (group B ,n=8) ,HF model group (group C ,n=9) , low Elantan dose group (group D ,n=9) ,high Elantan dose group (group E ,n=9) ,olmesartan group (group F ,n=9) ,and combined high Elantan dose and olmesartan group (group G ,n=8) .A HF model was established by ligating the left anterior descending artery .The animals received gastric drugs for 6 weeks .Their cardiac function was assyed by ultrasound echocardiography and expressions of AT1 R and AT2 R were detected by RT‐PCR and Western blot ,respectively .Results The PRA and AngⅡexpression levels were significantly higher ,the AT1 R expression level was significantly higher and the AT2 R expression level was significantly lower in group C than in group B (P<0 .01 ,P<0 .05) .The PRA and AngⅡexpression levels were significantly lower ,the AT1 R expression level was significantly lower and the AT2 R expression level was significantly higher in groups E‐G than in group C (P<0 .05 ,P<0 .01) .The receptor expression levels were much higher in group G than in group F (P<0 .05) .Conclusion Long‐term use of long‐acting nitrate can effectively improve cardiac function and protect renal function .
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Objective To determine the pathogenic bacteria distribution and drug resistance in children with sepsis. Methods From 2002 to 2011, a ten consecutive years of monitoring of pathogenic bacteria distribution, drug resistance in pediatric patients with sepsis were conducted. Results From 2002 to 2011, 2 493 strains of pathogenic bacteria were detected in 68 419 specimens of blood culture. The positive rate was 3.64%. Among them, 1 913 strains (76.73%) were the gram-positive bacteria (G+bacteria), 562 strains (22.54%) were gram-negative bacteria (G-bacteria) and 18 strains (0.72%) were fungi. From 2002 to 2006, 959 strains (4.73%) of pathogenic bacteria were detected in 20 287 specimens of blood culture. Among them, the G+bacteria was 731 strains (76.23%), G-bacteria was 228 strains (23.77%). From 2007 to 2011, 1 534 strains (4.73%) of pathogenic bacteria were detected in 48 132 specimens of blood culture, G+ bacteria was 1 182 strains (77.05%), G-bacteria was 334 strains (21.77%), fungi was 18 strains (1.17%). The positive rate of blood culture, the pathogenic bacteria distributions of G+, G-, and fungi were signiifcantly different between the ifrst and the second 5 years (P<0.01). The positive rate of G+bacteria tended to increase and the positive rate of G-bacteria tended to decrease. Com-paring between the ifrst and second 5 years, the positive rate of coagulase-negative staphylococci, Klebsiella, Alcaligenes, fungi tended to increas, and the positive rate of Staphylococcus aureus, Enterococcus, Pseudomonas, Salmonella tended to decrease. The distribution of pathogens in different age groups of children with sepsis also were signiifcantly difference (P<0.001). Over the 10 years, G+positive bacteria were highly resistant to penicillin and erythromycin, but not resistant to Vancomycin. ESBLs positive E. coli strains and Klebsiella Trevisan became highly resistant to antibiotics. Salmonella was sensitive to commonly used antibiotics. Conclusions Coagulase negative staphylococcus was the most common pathogenic bacteria in children with sepsis in the last 10 years, multiple pathogenic bacteria also show a growing trend in drug resis-tance.