Comparison of SpO 2/FiO 2 and ROX index for predicting failure of high-flow nasal cannula therapy in children with acute respiratory failure after congenital heart surgery / 中国小儿急救医学

Objective:To compare the predictive ability of SpO 2/FiO 2(S/F) and ROX index on the failure of high-flow nasal cannula(HFNC)therapy in children with acute respiratory failure after congenital heart disease surgery, and to identify the best cut-off point. Methods:Through a case-control study, the clinical data of 371 children with acute respiratory failure after congenital heart surgery treated with HFNC admitted to Guangzhou Women and Children′s Medical Center from January 2018 to December 2021 were retrospectively analyzed.The primary outcome was the need for re-intubation within 48 h after extubation of invasive ventilation.The ability of S/F and ROX index to predict HFNC failure was compared, and the optimal cut-off point was determined based on the area under the curve (AUC) of receiver operating characteristic curve.Results:A total of 371 children were included, of whom 27 (7.3%) eventually required mechanical ventilation within 48 h. The S/F prediction accuracy was highest after 6 h of HFNC treatment(AUC=0.712, 95% CI 0.599-0.825, P=0.001), and the best cut-off point for S/F was 178 mmHg(1 mmHg=0.133 kPa)(sensitivity 74.9%, specificity 69.6%). Whereas the prediction accuracy of the ROX index was highest after 12 hours of HFNC treatment, the AUC was 0.737(95% CI 0.623-0.851, P=0.002), and the best cut-off point of the ROX index was 5.865(sensitivity 72.4% specificity 66.7%). The difference in AUC between S/F after 6 h of HFNC treatment and ROX after 12 h was not statistically significant ( P=0.444), with higher sensitivity and specificity, and earlier prediction time(6 hours) in the former. Conclusion:Children with acute respiratory failure after congenital heart surgery have a strong predictive ability of S/F after 6 h of HFNC treatment, and the risk of HFNC treatment failure is higher in children with S/F <178 mmHg.

Early and mid-term results of surgical treatment for complete atrioventricular septal defect / 中华胸心血管外科杂志

Objective:To summarize the results of surgical treatment for complete atrioventricular septal defect(CAVSD) in early and middle stages.Methods:147 children with CAVSD in Guangzhou Women and Children’s Medical Center from January 2010 to December 2019 were selected, Males 85, females 62, median age of surgery 5 months(1 months-10 years old), median body mass 5.5 kg(2.4-20.9 kg). Complete atrioventricular septal defect was diagnosed by ultrasonic cardiogram before surgery. All the children underwent atrial ventricular valve formation and underwent simultaneous repair.Outpatient follow-up was planned.Ultrasonic cardiogram and electrocardiogram were performed. SPSS 22 statistical software was used for data analysis.Results:All 147 CAVSD patients underwent one-time surgical correction.Early postoperative death occurred in 7 cases(4.76%). The causes of death were: 3 cases of pulmonary hypertension crisis, 3 cases of severe mitral insufficiency(MI), 1 case of postoperative malignant arrhythmia, and the rest of the children were cured and discharged. Permanent pacemaker was installed in 3 patients due to atrioventricular block(AVB). The follow-up time was 1-10 years old, and 2 patients died in late stage: 1 patient did not seek medical treatment in time due to infection, and 1 patient had unknown cause. Five patients underwent secondary surgery: 4 due to severe mitral/tricuspid insufficiency(MI/TI) and 1 due to delayed AVB. The mid-term follow-up showed 9 cases of severe MI and 4 cases of severe TI. Compared with children with surgical age<3 months and ≥3 months, there were statistically significant differences in postoperative ventilator-assisted ventilation time, severe MI before postoperative discharge and total mortality between the two groups( P<0.05). Mid-term follow-up results showed no difference between the two groups. There were statistically significant differences in surgical age, postoperative CICU stay time and total hospital stay between the children with trisomy 21-syndrome and those without trisomy 21-syndrome( P<0.05), and there was no difference between the two groups in mid-term follow-up results. Residual shunt of 1-3 mm VSD was found in 29 cases, 26 cases were closed during follow-up, and 3 cases had smaller residual shunt. Conclusion:Modified single patch technique treatment of CAVSD has good effect, low mortality and low re-operation rate. But age <3 months group, infant mortality was significantly increased, the duration of postoperative mechanical assisted ventilation was prolonged, and the proportion of early postoperative severe MI was high.Severe MI and TI is easy to occur after CAVSD, which requires long-term follow-up and timely treatment. The children with trisomy 21-syndrome were similar to those with normal chromosome except for longer stay in ICU and total hospital stay.

CDX2 and gastrointestinal neoplasms / 国际肿瘤学杂志

Caudal type homeobox transcription factor 2 (CDX2) is an enteric-specific nuclear transcription factor, which is mainly expressed in the small intestine and colorectum and not expressed in normal gastric mucosa. CDX2 is involved in the occurrence, development, invasion and metastasis of gastrointestinal tumors, and its expression state is related to the clinicopathological characteristics and prognosis of patients with gastrointestinal tumors. It is expected to provide a new idea for the diagnosis and treatment of gastrointestinal tumors by further studying the mechanism of CDX2 involvement in tumor genesis and development and its relationship with clinicopathological features and prognosis.

Correlation between cardio-vocal syndrome and pulmonary arterial hypertension in infants with congenital heart disease / 中华胸心血管外科杂志

Objective To discuss the relationship between cardio-vocal syndrome and pulmonary arterial hypertension in infants with congenital heart disease(CHD).Methods Based on the electronic bronchoscopy results,257 less than one-year-old infants with congenital heart disease were selected and divided into vocal cord paralysis positive group (31 cases) and negative group(226 cases).Factors including age,sex,body weight,pulmonary arterial hypertension degree and PA/AO value were compared between the two groups.The risk factors of left vocal cord paralysis were analyzed using logistic regression method.Results There were no significant differences in age and weight between left vocal cord paralysis positive group and negative group(P ＞0.05).While incidence of pulmonary arterial hypertension and PA/AO value of the positive group were significantly higher than those of the negative group (P ＜ 0.01).The incidence of left vocal cord paralysis in no,mild-moderate and severe pulmonary arterial hypertension groups were 1.39％,10.6％ and 22.0％ (P ＜ 0.05) respectively.Left vocal cord paralysis was positively correlated with the degree of pulmonary arterial hypertension (r =0.179,P ＜ 0.01) and PA/AO value (r =0.169,P ＜ 0.01).Pulmonary arterial hypertension was an independent risk factor of left vocal cord paralysis (P =0.005,OR =1.689).Conclusion Left vocal cord paralysis was significantly correlated with pulmonary arterial hypertension and pulmonary artery dilatation.So pulmonary arterial hypertension should be one of the possible causes of cardio-vocal syndrome in infants with CHD.

Effect of energy-enriched formula for catch-up growth in malnourished infants after congenital heart disease surgery / 中华临床营养杂志

Objective To investigate the efficacy and safety of enriched-calorie formula in post-operative infants with congenital heart disease and malnutrition.Methods All malnourished infants less than 6 months diagnosed congenital heart disease: ventricular septal defect and had undergone surgery in Guangzhou Women and Children`s Medical Center from December 1,2014 to May 30,2015 were included in this study.All cases were randomly divided into intervention group(energy-enriched formula,intervention group)and control group(standard formula,control group)for enteral nutrition intervention and observed for 3 months.Body mass,body length,upper arm circumference,blood prealbumin(PA),retinol binding protein(RBP),and B-terminal pro-brain natriuretic peptide(NT-proBNP)were measured before and after ICU,after discharge,and 1 month and 3 months after operation.Results Fifty-one cases were in intervention group and 50 cases in control group,respectively.There were no significant differences in body mass,body length,arm circumference,PA,RBP,mean enteral nutrition starting time,mechanical ventilation time,length of ICU stay,hospitalization time,and average fluid intake between the two groups(all P>0.05).The average caloric intake in intervention group was significantly higher than in control group [(437.24±6.68)kJ vs.(312.43±86.22)kJ,P=0.001].There was no significant difference in NT-proBNP,PA,and RBP at different time points between the two groups(all P>0.05).The improvement of nutrition in intervention group was significantly higher than that in control group at 1 month(25.0％vs.4.9％,P=0.011)and 3 months(64.1％vs.15.7％,P<0.001)after operation.Body mass increased in intervention group [(0.067±0.348)kg] compared with that in control group,and decreased [(0.125±0.425)kg] in control group(P=0.015).Body weight[(5.46±1.36)kg vs.(4.80±1.01)kg,P=0.008],weight for age Z score(WAZ)(-2.79±1.28 vs.-3.75±1.27,P<0.001),and height for weight Z score(WHZ)(-2.47±1.43 vs.-3.62±1.77,P=0.001)one month after surgery were significantly higher than those before operation.Body weight [(6.78±1.42)kg vs.(5.72±1.01)kg,P<0.001] arm circumference [(12.80±1.17)cm vs.(12.00±0.90)cm,P<0.001],WAZ(-1.60±1.17 vs.-3.10±1.40,P<0.001),height for age Z score(HAZ)(-1.41±1.63 vs.-2.10±1.41,P=0.034),and WHZ(-0.86±1.31 vs.-2.59±2.13,P<0.001)of the two groups at 3 months postoperative were significantly higher than those before operation,and the growth rate of intervention group was faster than control group.There were no significant adverse reactions in both groups.Conclusion Calorie-enriched formula powder can help malnourished infants to catch up after congenital heart disease surgery.

Clinical analysis of otogenic extracranial and intracranial complications / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To study the clinical feature and treatment of extracranial and intracranial complications caused by otitis media.@*METHOD@#Three hundred and twenty patients of acute and chronic otitis media were admitted to our department between 2005 and 2014. Among them, 34 patients were diagnosed with extracranial and intracranial complications. The clinical features and treatment outcome were retrospectively studied. Of the 34 patients associated with complications, 25 had a single complication,8 had two complications and 1 had three complications. Complications included labyrinthitis in 14 cases, facial paralysis in 11, postauricular subperiosteal abscess in 6, Bezold abscess in 1, thrombophlebitis of sigmoid sinus in 2, otitis meningitis in land otogenic brain abscess in 8.@*RESULT@#Thirty-three patients were cured or improved and 1 patient died.@*CONCLUSION@#Due to the widespread use of antibiotics, the clinical manifestations of extracranial and intracranial complications of otitis media become more hidden and atypical. The surgery is the primary treatment method.

Study of the individualized health management of senile mental disorders / 中华老年医学杂志

Objective To evaluate the effect of the individualized health management on senile mental disorders.Methods 421 patients with senile mental disorders were randomized into two groups:the intervention group (n =213) received routine antipsychotic drugs treatment,health education and individual health management,and the control group(n=208) received only population health education and routine drug antipsychiatric treatment.Results The Brief Psychiatric Rating Scale (BPRS) scores in two group were significantly higher after treatment than before treatment (all P＜0.01).The BPRS score in each period after treatment were significantly higher in intervention group than in control group (all P＜0.01).The mini mental state examination (MMSE) score in two treatment groups were significantly higher after treatment than before treatment (all P＜0.01).The MMSE score in each period after treatment were significantly higher in intervention group than in control group (all P＜0.05).Conclusions The individualized health management in senile mental disorders is not only feasible,but also effective.

Comparative study of three different methods for penile reconstruction / 中华整形外科杂志

<p><b>OBJECTIVE</b>To compare the effect of three methods for penile reconstruction.</p><p><b>METHODS</b>From Sept. 2000 to Dec. 2012, penile reconstruction was performed in 48 cases with free scapular flap transplantation, or pedicled superficial circumflex iliac artery skin flap, or anterolateral thigh skin flap pedicled with lateral circumflex femoral artery. The flaps were 12.0-14.5 cm in length, 10-12 cm in width and the urethra perimeter was about 2-3 cm.</p><p><b>RESULTS</b>Free scapular flaps were used in 21 cases, with flap failure in 3 cases due to insufficient blood supply. Malleable penile prosthesis was implanted in 11 cases, which was exposed in 3 cases. Groin skin flaps were used in 21 cases, with flap failure in 8 cases due to insufficient blood supply. Malleable penile prostheses were implanted in 7 cases, which was exposed in 3 cases. Anterolateral thigh skin flaps were used in 6 cases, with flap failure in 2 cases due to necrosis and infection. No prosthesis was implanted in this group. All the failure cases underwent secondary reconstruction with successful results. 37 cases were followed up for 1-6 years, avevage 2.5 years. 26 cases were satisfied with the results of appearance and function.</p><p><b>CONCLUSIONS</b>Among these three methods, the free scapular flap is most recommended for its high survival rate, low complication rate and high patient satisfaction.</p>

Acoustic radiation force impulse elastography in differential diagnosis of breast masses / 中华超声影像学杂志

ObjectiveTo explore the application value of acoustic radiation force impulse(ARFI) in the differential diagnosis of breast lesions.Methods Eighty six patients with 107 lesions were performed ARFI elastography.The stiffness of the masses in virtual touch tissue image(VTI) were scored.The pathological diagnosis as the gold standard,drawed the ROC curve to find the cut off point of area ratio to predict breast cancer.Shear wave velocity(SWV) within the breast masses were measured using virtual touch tissue quantification(VTQ) technique.ResultsThe elastography hardness score higher than grade 4 was mainly distributed in the malignancies compared to benign lesions( P ＜0.01).1.53 as the cut-off point of area ratio,sensitivity and specificity of diagnosing breast cancer were 95.7 ％,92.5 ％.SWV of malignant group higher than benign group,the difference was statistically significant (P ＜ 0.001 ).Conclusions Hardness score in VTI imaging,area ratio of benign and malignant lesions,SWV within the breast masses can help the differential diagnosis of breast lesions.

Preparation and Stability of Tetrandrine Liposomes / 中国药房

OBJECTIVE: To draw a comparison between the two preparative technologies of tetrandrine liposomes. METHODS: Tetrandrine liposomes were prepared with ammonium sulfate transmembrane gradient method and film dispersion method respectively. Leaking ratio,particle size,and content of phospholipid of liposomes were selected as the parameters to indicate the stability of liposomes,and the entrapment efficiency was taken as quality index to compare the two preparation technologies. RESULTS: Tetrandrine liposomes prepared with ammonium sulfate transmembrane gradient technology achieved high entrapment efficiency of 81.1% and good stability,while those prepared by film dispersion method had an entrapment efficiency of only 32.9% with poor stability. CONCLUSION: Ammonium sulfate transmembrane gradient method is feasible and superior to the film dispersion method in the preparation of tetrandrine liposome.

Effects of Levocarnitine on myocardial ischemia in rats / 医学研究生学报

Objective:To study the effect of Levocarnitine preconditionon on the myocardial ultrastructure of ischemic rats and the long last calcium channel. Methods: We randomly divided 30 rats into a control group, a Levocarnitine group and a Dihydrochloride group. After the establishment of ischemic models, we observed the ultrastructure of the ischemic myocardium with optical and transmission electron microscopes, and detected the influx of calcium in the long last calcium channel with the patch clamp. Results: Levocarnitine protected the ultrastructure of ischemic myocardium and inhibited the influx of calcium in the long last calcium channel. Conclusion: Levocarnitine can reduce the severity and extent of ischemia-induced damage to the myocardium, protect mitochondria, stabilize its oxidation, inhibit the long last calcium channel of ischemic ventricular myocytes and lessen the injury induced by calcium overload.

Determination of Phospholipid Content in 5-FUR Prodrug Liposome / 中国药房

OBJECTIVE: To determine the concentration of phospholipid in 5-FUR prodrug liposome. METHODS: The sample was fragmented by ethanol and extracted by chloroform. The concentration of phospholipid in 5-FUR prodrug liposome was determined by ammonium ferrothiocyarate spectrophometry at a wavelength 488 nm. RESULTS: The linear range of phospholipid was 0.01～0.10 mg?mL-1(r=0.999 6, n=3) with an average recovery rate of 99.66% (RSD=3.17%). CONCLUSION: This method is simple, convenient and sensitive, and it can be used for the quality control of 5-FUR prodrug liposome.

Preparation of tetrandrine-doxorubicin complex liposomes and its release property in vitro / 中草药

Objective Selecting doxorubicin and tetrandrine as model drug to prepare complex liposomes, study the methods of preparation, and research its release property in vitro. Methods The formulation of tetrandrine-doxorubicin complex liposomes was optimized by three different kinds of methods. And the optimum formula was selected through the orthogonal test according to the entrapment efficiency. Results Tetrandrine-doxorubicin complex liposomes were prepared by (NH4)2SO4-gradient method combined with pH gradient method. One optimum recipe was founded that tetrandrine-doxorubicin complex liposomes/ egg phosphatidyl choline was 1∶20, egg phosphatidyl choline/cholesterol was 3∶1, pH value was 7.6, incubation temperature was 50 ℃, concentration of (NH4)2SO4 was 250 mmol/L. The doxorubicin completely released within 24 h, and the tetrandrine released within 16 h. Conclusion Tetrandrine-doxorubicin complex liposomes have high entrapment efficiency with fine-looking, which is better for the further studies

The Application of Humanistic Service Managing Mode in the Management of NICU / 中国医学伦理学

Objective: To explore the application and clinical effects of humanistic service management in the management of NICU.Method: Humanistic service,management and education are conducted among neonate patients,their family members,nursing staff,and nursing students in NICU,and the outcome clinical effects are investigated.Result: The application of humanistic service dramatically increases the positivity,activeness,creativity,and cohesiveness of nursing staff,improves their overall quality,helps to establish a harmonious relationship between nurses,nursing students,and neonate patients' family members,enhances the satisfaction degree of neonate patients' family members and the nursing standard in NICU,and promotes the general improvement of hospital nursing service.Conclusion: The application of humanistic service in NICU initiates nursing service,improves hospital nursing standard,promotes the general development of NICU nursing,thus deserves to be further extended and applied.