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1.
Chinese Journal of School Health ; (12): 211-214, 2021.
Article in Chinese | WPRIM | ID: wpr-873640

ABSTRACT

Objective@#In order to provide guidance for the prevention and control of epidemic situations in schools, this paper explores the risk perception and prevention behaviors of college students after classes resume in the post-epidemic period of novel coronavirus pneumonia.@*Methods@#By using convenient sampling method, 835 college students who resumed classes were randomly selected from a university in Guizhou. Self-efficacy questionnaire, perceived social support questionnaire and self-designed questionnaire were adiministered.@*Results@#Totally 37.0% of college students believed that the risk of infection was high, 57.4% of college students believed the severity of infection was very high once get infected, meanwhile, 84.3% of them think that keeping away from crowded places was a better preventive behavior, 89.7% of college students often wear masks, 91.4% of college students wash their hands frequently. There was a significant positive correlation between general self-efficacy, perceived social support and preventive behavior (r=0.10-0.65, P<0.01). General self-efficacy and perceived social support play both a partial intermediary role and a chain intermediary role between risk perception and preventive behavior.@*Conclusion@#Risk perception of Novel Coronavirus was moderate among college students, who can take active measures to effectively prevent it. Risk perception could not only directly affect the prevention behavior of college students, but also indirectly affect the prevention behavior of college students through understanding social support and general self-efficacy.

2.
Chinese Critical Care Medicine ; (12): 711-715, 2020.
Article in Chinese | WPRIM | ID: wpr-866886

ABSTRACT

Objective:To investigate the significance of N-terminal pro-brain natriuretic peptide (NT-proBNP) in the early assessment of neonatal cardiac dysfunction in sepsis.Methods:The children diagnosed with neonatal sepsis and common infection neonates admitted to the department of pediatric neonatal intensive care unit (NICU) of Liaocheng People's Hospital from January 2016 to January 2019 were enrolled. Data of clinical sign, laboratory results, bedside echocardiography and survival data were collected, and the differences of clinical indexes were compared among sepsis patients with and without cardiac dysfunction and common infection. The risk factors of sepsis with cardiac dysfunction were analyzed by multivariate Logistic regression, and the early prediction value of NT-proBNP for neonatal septic cardiac dysfunction was evaluated by the receiver operating characteristic (ROC) curve.Results:There were 112 neonates with sepsis (49 with cardiac dysfunction and 63 without cardiac dysfunction) and 67 children with common infection included in the analysis. The onset time of neonates in septic cardiac dysfunction group was significantly earlier than that of septic non-cardiac dysfunction group and common infection group [hours: 52.9 (0, 180.3) vs. 53.9 (0, 183.6), 81.0 (45.6, 202.4), both P < 0.05]. Compared with the general infection group, albumin (ALB), white blood cell count (WBC), left ventricular ejection fraction (LVEF) in septic cardiac dysfunction group significantly decreased, NT-proBNP, hypersensitive C-reactive protein (hs-CRP)/ALB, pulmonary artery systolic pressure (PASP) significantly increased, while right ventricular (RV) and Tei index significantly increased [ALB (g/L): 24.1±3.8 vs. 27.8±3.6, WBC (×10 9/L): 12.7 (3.7, 18.9) vs. 15.4 (9.9, 23.2), LVEF: 0.626±0.123 vs. 0.700±0.021, NT-proBNP (ng/L): 20 230.6 (15 890.0, 35 000.0) vs. 7 324.5 (2 426.5, 13 890.0), hs-CRP/ALB: 0.33 (0.29, 0.81) vs. 0.06 (0.00, 0.21), PASP (mmHg, 1 mmHg = 0.133 kPa): 52.25±14.12 vs. 41.07±27.73, RV (mm): 10.74±2.42 vs. 8.55±1.41, Tei index: 0.52±0.03 vs. 0.30±0.04, all P < 0.05]. NT-proBNP and Tei index in septic cardiac dysfunction group were significantly higher than those in septic non-cardiac dysfunction group [NT-proBNP (ng/L): 20 230.6 (15 890.0, 35 000.0) vs. 13 057.6 (8 946.0, 35 000.0), Tei index: 0.52±0.03 vs. 0.39±0.02, both P < 0.05], and LVEF was significantly lower than that in septic non-cardiac dysfunction group (0.626±0.123 vs. 0.671±0.086, P < 0.05). Multivariate Logistic regression analysis showed that NT-proBNP, Tei index and hs-CRP/ALB were independent risk factors for cardiac dysfunction in sepsis neonates [odds ratio ( OR) and 95% confidence interval (95% CI) were 8.73 (1.54-5.67), 1.97 (1.26-2.87), 1.87 (1.03-3.40) respectively, all P < 0.05]. ROC curve analysis showed that NT-proBNP, Tei index and hs-CRP/ALB had good predictive value for the occurrence of cardiac dysfunction in septic neonates, the area under ROC curve (AUC) was 0.81 (95% CI was 0.84-0.91), 0.78 (95% CI was 0.65-0.79) and 0.77 (95% CI was 0.61-0.77), respectively. The sensitivity and specificity of NT-proBNP were 80.0% and 79.0% respectively with 12 291.5 ng/L as the cut-off value, the sensitivity and specificity of Tei index were 74.0% and 77.0% respectively with 0.45 as the cut-off value, and the sensitivity and specificity of hs-CRP/ALB were 76.0% and 76.3% respectively with 0.10 as the cut-off value. Conclusions:NT-proBNP can be used as a diagnostic marker of early cardiac dysfunction, and for rapid diagnosis of neonatal cardiac dysfunction in sepsis. The application may guide clinicians to use drugs better to improve cardiac function and treatment effect.

3.
Article in Chinese | WPRIM | ID: wpr-864318

ABSTRACT

Objective:To investigate the value of N-terminal pro-brain natriuretic peptide (NT-proBNP) combined with bedside echocardiography in diagnosis and treatment of neonatal sepsis with cardiac dysfunction.Methods:A total of 56 children diagnosed with neonatal sepsis in the Neonatal Intensive Care Unit, Liaocheng People′s Hospital from July 2016 to July 2017 were enrolled and divided into 2 groups, namely, the cardiac dysfunction group (26 cases) and the non-cardiac dysfunction group (30 cases). Children with general infection (45 cases) hospita-lized at the same period were taken as the control group.The clinical characteristics, related laboratory indexes and prognosis were compared among 3 groups.The related factors of neonatal sepsis with cardiac dysfunction were analyzed by the multivariate Logistic regression approach, and the value of related indexes in the early prediction neonatal sepsis with cardiac dysfunction was analyzed by using the receiver operating characteristic curve (ROC). Results:The onset age of sepsis patients with cardiac dysfunction [63.0 h (30.5 h, 185.6 h)] was significantly earlier than that of the patients without cardiac dysfunction [65.0 h (34.5 h, 170.6 h)] and the control group [80.0 h (45.5 h, 202.3 h)] ( P<0.05). The main primary site of the disease was the lung, which was not statistically significant among the 3 groups ( P>0.05). The NT-proBNP level and the high sensitivity-C-reactive protein (hs-CRP)/albumin (ALB) ratio in the cardiac dysfunction group [20 230.6 ng/L (15 890.0 ng/L, 35 000.0 ng/L); 0.33(0.29, 0.81)] were significantly higher than those in the control group [7 324.5 ng/L (2 426.5ng/L, 13 890.0 ng/L); 0.06(0, 0.21)] (all P<0.05). The right ventricular diameter and the Tei index of the cardiac dysfunction group [(8.74±2.42) mm; 0.52±0.03] were significantly higher than those in the control group [(8.55±1.41)mm; 0.30±0.04], while the EF of the cardiac dysfunction group [(62.61±2.56)%] was significantly lower than that in the control group [(70.03±0.35)%] (all P<0.05). The ROC curve analysis showed that NT-proBNP and the Tei index could effectively predict sepsis with cardiac dysfunction.Specifically, NT-proBNP had a cutoff value of 12 291.5 ng/L, with sensitivity of 80%, specificity of 79%, and the area under ROC curve (AUC) of 0.81.The Tei index had a cutoff value of 0.45, with sensitivity of 74%, specificity of 77%, and the AUC of 0.78. Conclusions:NT-proBNP can be used as a marker of early cardiac dysfunction.Its combination with the Tei index of bedside echocardiography can quickly diagnose cardiac dysfunction of children with sepsis, better guide clinicians in drug use, improve cardiac function of patients and enhance the treatment effect.

4.
Acta Pharmaceutica Sinica B ; (6): 1083-1093, 2020.
Article in English | WPRIM | ID: wpr-828822

ABSTRACT

Understanding of the nephrotoxicity induced by drug candidates is vital to drug discovery and development. Herein, an metabolomics method based on air flow-assisted desorption electrospray ionization mass spectrometry imaging (AFADESI-MSI) was established for direct analysis of metabolites in renal tissue sections. This method was subsequently applied to investigate spatially resolved metabolic profile changes in rat kidney after the administration of aristolochic acid I, a known nephrotoxic drug, aimed to discover metabolites associated with nephrotoxicity. As a result, 38 metabolites related to the arginine-creatinine metabolic pathway, the urea cycle, the serine synthesis pathway, metabolism of lipids, choline, histamine, lysine, and adenosine triphosphate were significantly changed in the group treated with aristolochic acid I. These metabolites exhibited a unique distribution in rat kidney and a good spatial match with histopathological renal lesions. This study provides new insights into the mechanisms underlying aristolochic acids nephrotoxicity and demonstrates that AFADESI-MSI-based metabolomics is a promising technique for investigation of the molecular mechanism of drug toxicity.

5.
Article in Chinese | WPRIM | ID: wpr-802975

ABSTRACT

Objective@#To study the application of multiple row spiral CT (MSCT) in the diagnosis of inferior vena cava lesions in Budd Chiari syndrome (BCS) and its clinical value.@*Methods@#Eighty patients with BCS admitted to the Central Hospital of Shan County from May 2017 to May 2018 were divided into two groups by digital grouping method, with 40 cases in each group.The control group was diagnosed by ultrasound, and the study group was diagnosed by multi-slice CT.The pathological changes, tissue contrast of inferior vena cava and hepatic vein and the diagnostic sensitivity, specificity, positive predictive value and negative predictive value of inferior vena cava obstruction were compared between the two groups.@*Results@#The pathological diagnosis rate in the study group was significantly higher than that in the control group(χ2=4.562, 4.695, 4.125, 5.124, all P<0.05). The contrast of inferior vena cava and hepatic vein tissues in the study group was significantly higher than that in the control group (t=12.897, 13.214, all P<0.05). The sensitivity, specificity, positive predictive value and negative predictive value of the diagnosis of inferior vena cava occlusion in the study group were higher than those in the control group (the control group: 91.2%, 98.6%, 97.3%, 80.3%, the study group: 100.0%, 99.5%, 98.2%, 100.0%, χ2=11.897, 10.214, 11.235, 13.564, all P<0.05).@*Conclusion@#The application of MSCT in the diagnosis of BCS-inferior vena cava lesions, can display the lesions comprehensively and intuitive guidance in the treatment of inferior vena cava lesions, has high diagnostic value, it is worthy of popularization and application in clinic.

6.
Chinese Critical Care Medicine ; (12): 1395-1400, 2019.
Article in Chinese | WPRIM | ID: wpr-800908

ABSTRACT

Objective@#To explore the safety and efficacy of intravenous nutrition strategy for preterm infants with birth weight < 1 500 g combined with literatures.@*Methods@#The clinical data of 93 preterm infants with very low or extremely low birth weight (< 1 500 g) who were admitted to the neonatal intensive care unit (NICU) of Liaocheng People's Hospital of Shandong Province from October 2012 to December 2018 were retrospectively analyzed. On the basis of active treatment of primary disease and early enteral nutrition, all preterm infants received "all-in-one" intravenous nutrition strategy. The intravenous nutrient solution containing 6% pediatric compound amino acids, 20% fat emulsion, glucose, vitamins, NaCl, KCl, microelements and minerals was transfused uniformly in 20-24 hours. The changes in growth and biochemical indexes of preterm infants before and after intravenous nutrition intervention were observed. The occurrence of intravenous nutritional complications such as parenteral nutrition associated cholestasis (PNAC) and prognosis were recorded. The receiver operating characteristic (ROC) curve was plotted to assess the predictive power of each indicator for extra uterine growth retardation (EUGR).@*Results@#Ninety-three preterm infants were enrolled in the final analysis. The gestational age was (28.75±1.93) weeks and the birth weight was (1 113.28±190.48) g. All the children except 4 non-surviving preterm infants were discharged from hospital. The average hospitalization time was (51.64±15.98) days. In 89 surviving preterm infants, the maximum weight loss percentage was (4.42±3.12)%, and the time to regain birth weight was (6.36±2.60) days. In these surviving preterm infants, the daily average growth rate of weight gain was (19.53±4.64) g/kg, and the weekly average growth of body length and head circumference gain was (1.06±0.34) cm and (0.69±0.22) cm, respectively. The mean duration of intravenous nutrition was (21.56±8.54) days in 89 surviving preterm infants. The body weight, body length and head circumference of these surviving preterm infants were increased significantly at discharge compared with their admission to NICU [body weight (g): 2 191.63±186.00 vs. 1 118.71±188.78, body length (cm): 45.21±1.50 vs. 37.34±2.56, head circumference (cm): 31.04±1.27 vs. 25.96±1.80]. The level of albumin (Alb) was significantly increased (g/L: 27.52±3.77 vs. 25.70±3.88), however the blood urea nitrogen (BUN) level was significantly reduced (mmol/L: 1.65±1.39 vs. 5.11±3.20) with statistical differences (all P < 0.05). In the 89 surviving preterm infants, 79 preterm infants (88.8%) suffered from premature anemia and 48 (53.9%) achieved transfusion criteria. Forty-two preterm infants (47.2%) had glucose metabolism disorder and 38 (42.7%) had electrolyte disturbances. PNAC occurred in 9 preterm infants (10.1%). Thirty-eight preterm infants (42.7%) had EUGR in weight. ROC curve analysis showed that the combination of gestational age, birth weight and time to restore birth weight had a good predictive value for EUGR in very low or extremely low birth weight preterm infants, and the area under the ROC curve (AUC) was 0.902, the sensitivity was 86.4%, and the specificity was 86.8%.@*Conclusions@#The intravenous nutrition strategy for preterm infants with birth weight < 1 500 g is effective and safe. However, intravenous nutrition can cause some complications, such as glucose metabolism disorder, electrolyte disturbances and PNAC, etc. So the process of intravenous nutrition should be closely monitored. To start EN as early as possible and shorten the duration of intravenous nutrition is an important measure for the prevention of PNAC. The combination of gestational age, birth weight and the time to regain birth weight has a good predictive value for EUGR, and intervention can be strengthened early in hospital to avoid EUGR.

7.
Chinese Critical Care Medicine ; (12): 150-154, 2019.
Article in Chinese | WPRIM | ID: wpr-744688

ABSTRACT

Objective? To? explore? the? clinical? significance? of? early? oral? intervention? measures? in? the?prognosis?of?premature?infants.? Methods? 151?preterm?infants?admitted?to?neonatal?intensive?care?unit?(NICU)?of?Liaocheng?People's?Hospital?from?January?2015?to?January?2017?were?enrolled.?Premature?infants?were?divided?into?intervention?group?and?control?group?according?to?random?number?table?method?and?with?the?consent?of?legal?guardian.?Both?groups?received?routine?treatment?of?preterm?infants?after?stable?vital?signs.?The?intervention?group?received?the?oral?massage?method?adopted?by?none-nutritive?sucking,?stimulating?swallowing?function?and?SandraFucile?on?the?basis?of?routine?treatment,?once?a?day?for?14?consecutive?days.?Both?groups?were?followed?up?for?6?months.?The?oral?feeding?ability?of?premature?infants?was?evaluated?by?the?proficiency?(PRO),?rate?of?transfer?(RT),?feeding?process?and??non-nutritive?suction?(NNS).?At?40?weeks?of?postmenstrual?age?(PMA),?neonatal?behavioral?neurological?(NBNA)?was?used?to?assess?neonatal?brain?development;?Infanib?was?used?for?early?motor?development?evaluation?at?3?months?and??6?months?after?birth.? Results? Finally,?151?premature?infants?were?enrolled,?including?78?in?the?intervention?group?and?73?in?the?control?group.?The?time?to?complete?oral?feeding?of?the?intervention?group?was?significantly?shorter?than?that?of?the?control?group?(days:?18.1±3.7?vs.?23.4±5.8,?P?<?0.05).?Compared?with?the?control?group,?at?the?time?of?complete?oral?feeding,?the?PMA?of?the?intervention?group?was?significantly?decreased?(weeks:?33.4±0.9?vs.?35.9±1.9,?P <?0.05),?the?feeding?efficiency?was?significantly?increased?(mL/min:?10.6±5.1?vs.?8.1±4.7,?P?<?0.05),?and?PRO?was?significantly?increased?[(95±8)%?vs.?(72±28)%,?P <?0.05],?and?the?body?weight?was?significantly?decreased?(g:?1?836.0±193.0?vs.?2?000.8±204.5,?P?<?0.05).?The?NNS?scores?of?the?intervention?group?and?the?control?group?were?increased?gradually?with?time?(F?values?were?86.21?and?75.23,?respectively,?both?P?<?0.01),?and?the?NNS?scores?of?the?intervention?group?at??10?days?and?14?days?were?significantly?higher?than?those?of?the?control?group?(52.89±6.26?vs.?46.74±6.24,?73.90±7.01? vs.?63.53±6.80,?both?P?<?0.01).?The?NBNA?scores?of?the?two?groups?were?lower,?but?there?was?no?significant?difference?between?the?intervention?group?and?the?control?group?(32.7±3.6?vs.?32.0±4.1,?P?>?0.05).?Infanib?evaluation?at?3?months?of?age?showed?that?the?proportion?of?normal?children?in?the?intervention?group?was?significantly?higher?than?that?in?the?control?group?[67.95%?(53/78)?vs.?49.31%?(36/73),?P?<?0.05],?and?at?6?months?of?age,?the?proportion?of?normal?children?in?the?intervention?group?was?significantly?higher?than?that?in?the?control?group?[84.62%?(66/78)?vs.?58.90%?(43/73),??P <?0.01].? Conclusion? Early?oral?exercise?intervention?can?shorten?the?transition?time?from?tube?feeding?to?full?oral?feeding?in?NICU?premature?infants?and?improve?the?performance?of?infants?during?feeding.

8.
Article in Chinese | WPRIM | ID: wpr-753780

ABSTRACT

Objective To study the application of multiple row spiral CT (MSCT) in the diagnosis of inferior vena cava lesions in Budd Chiari syndrome (BCS) and its clinical value.Methods Eighty patients with BCS admitted to the Central Hospital of Shan County from May 2017 to May 2018 were divided into two groups by digital grouping method,with 40 cases in each group.The control group was diagnosed by ultrasound , and the study group was diagnosed by multi-slice CT.The pathological changes ,tissue contrast of inferior vena cava and hepatic vein and the diagnostic sensitivity,specificity,positive predictive value and negative predictive value of inferior vena cava obstruction were compared between the two groups.Results The pathological diagnosis rate in the study group was significantly higher than that in the control group (χ2 =4.562,4.695,4.125,5.124,all P<0.05).The contrast of inferior vena cava and hepatic vein tissues in the study group was significantly higher than that in the control group ( t=12.897, 13.214, all P <0.05 ).The sensitivity, specificity, positive predictive value and negative predictive value of the diagnosis of inferior vena cava occlusion in the study group were higher than those in the control group (the control group:91.2%,98.6%,97.3%,80.3%,the study group:100.0%,99.5%,98.2%,100.0%,χ2 =11.897,10.214, 11.235,13.564,all P<0.05).Conclusion The application of MSCT in the diagnosis of BCS -inferior vena cava lesions,can display the lesions comprehensively and intuitive guidance in the treatment of inferior vena cava lesions , has high diagnostic value ,it is worthy of popularization and application in clinic.

9.
Chinese Critical Care Medicine ; (12): 1395-1400, 2019.
Article in Chinese | WPRIM | ID: wpr-824212

ABSTRACT

To explore the safety and efficacy of intravenous nutrition strategy for preterm infants with birth weight < 1 500 g combined with literatures. Methods The clinical data of 93 preterm infants with very low or extremely low birth weight (< 1 500 g) who were admitted to the neonatal intensive care unit (NICU) of Liaocheng People's Hospital of Shandong Province from October 2012 to December 2018 were retrospectively analyzed. On the basis of active treatment of primary disease and early enteral nutrition, all preterm infants received "all-in-one" intravenous nutrition strategy. The intravenous nutrient solution containing 6% pediatric compound amino acids, 20% fat emulsion, glucose, vitamins, NaCl, KCl, microelements and minerals was transfused uniformly in 20-24 hours. The changes in growth and biochemical indexes of preterm infants before and after intravenous nutrition intervention were observed. The occurrence of intravenous nutritional complications such as parenteral nutrition associated cholestasis (PNAC) and prognosis were recorded. The receiver operating characteristic (ROC) curve was plotted to assess the predictive power of each indicator for extra uterine growth retardation (EUGR). Results Ninety-three preterm infants were enrolled in the final analysis. The gestational age was (28.75±1.93) weeks and the birth weight was (1 113.28±190.48) g. All the children except 4 non-surviving preterm infants were discharged from hospital. The average hospitalization time was (51.64±15.98) days. In 89 surviving preterm infants, the maximum weight loss percentage was (4.42±3.12)%, and the time to regain birth weight was (6.36±2.60) days. In these surviving preterm infants, the daily average growth rate of weight gain was (19.53±4.64) g/kg, and the weekly average growth of body length and head circumference gain was (1.06±0.34) cm and (0.69±0.22) cm, respectively. The mean duration of intravenous nutrition was (21.56±8.54) days in 89 surviving preterm infants. The body weight, body length and head circumference of these surviving preterm infants were increased significantly at discharge compared with their admission to NICU [body weight (g): 2 191.63±186.00 vs. 1 118.71±188.78, body length (cm): 45.21±1.50 vs. 37.34±2.56, head circumference (cm): 31.04±1.27 vs. 25.96±1.80]. The level of albumin (Alb) was significantly increased (g/L: 27.52±3.77 vs. 25.70±3.88), however the blood urea nitrogen (BUN) level was significantly reduced (mmol/L: 1.65±1.39 vs. 5.11±3.20) with statistical differences (all P < 0.05). In the 89 surviving preterm infants, 79 preterm infants (88.8%) suffered from premature anemia and 48 (53.9%) achieved transfusion criteria. Forty-two preterm infants (47.2%) had glucose metabolism disorder and 38 (42.7%) had electrolyte disturbances. PNAC occurred in 9 preterm infants (10.1%). Thirty-eight preterm infants (42.7%) had EUGR in weight. ROC curve analysis showed that the combination of gestational age, birth weight and time to restore birth weight had a good predictive value for EUGR in very low or extremely low birth weight preterm infants, and the area under the ROC curve (AUC) was 0.902, the sensitivity was 86.4%, and the specificity was 86.8%. Conclusions The intravenous nutrition strategy for preterm infants with birth weight < 1 500 g is effective and safe. However, intravenous nutrition can cause some complications, such as glucose metabolism disorder, electrolyte disturbances and PNAC, etc. So the process of intravenous nutrition should be closely monitored. To start EN as early as possible and shorten the duration of intravenous nutrition is an important measure for the prevention of PNAC. The combination of gestational age, birth weight and the time to regain birth weight has a good predictive value for EUGR, and intervention can be strengthened early in hospital to avoid EUGR.

10.
Chinese Journal of Neonatology ; (6): 196-199, 2018.
Article in Chinese | WPRIM | ID: wpr-699291

ABSTRACT

Objective To study the clinical features,diagnosis,treatment and prognosis of neonatal fulminant myocarditis.Method From January 2016 to August 2016,clinical data of neonates with fulminant myocarditis admitted to the neonatal intense care unit (NICU) were retrospectively collected and analyzed.Result A total of 11 neonates were enrolled,including 6 males and 5 females,and 5 preterms and 6 full term infants.The average gestation age was (37.7 ± 1.6) weeks and their weight on hospital admission was (3 382 ± 675) g.Among the infants,9 got ill in summer and 2 in spring and winter.The onset of illness was within 3 ~ 5 d after birth in 8 cases and 2 ~ 3 weeks in the other 3 cases.The main clinical presentations included fever,anorexia,shortness of breath and lethargy.Various degrees of cardiac dysfunction appeared in all 11 cases,including cardiogenic shock in 10 cases,severe arrhythmias with multiple organ dysfunction in 7 cases,and viral meningitis in 7 cases.10 infants had significantly elevated brain natriuretic peptide (BNP) and troponin Ⅰ,and those with troponin Ⅰ above 20 μg/L had poor prognosis.A comprehensive treatment of limiting liquid volume,high-dose adrenocortical steroids,and IVIG were carried out.Meanwhile,therapy to prevent shock,improve cardiac function,reverse arrhythmia,and mechanical ventilation were used in children with dyspnea.7 cases were cured and 6 patients were followedup for 6 to 12 months.Among the 6 followed-up patients,within 1 ~3 months after discharge,4 cases had normal echocardiogram,and persistently abnormal echocardiogram were found in the other 2 cases and eventually confirmed as dilated cardiomyopathy.4 patients were dead.Conclusion The clinical manifestations of neonatal fulminant myocarditis are unspecific.It's difficult to recognize the early symptoms,missed and delayed diagnosis are common,resulting in high mortality rate.Timely diagnosis and effective treatment can improve the survival rate.

11.
Article in Chinese | WPRIM | ID: wpr-704128

ABSTRACT

Objective To investigate the recovery mechanism of brain function in patients with mo-tor aphasia after cerebral infarction by resting-state functional magnetic resonance imaging (fMRI) functional connectivity. Methods 10 patients with aphasia after cerebral infarction (aphasia group),and 10 patients without aphasia (control group)in the same period were enrolled.Both patients underwent resting-state fMRI examination.Patients with aphasia received a second fMRI examination 1 month later.The SPM8 software and DPARSF software were used to process the data.The back of the left middle frontal gyrus ( LFMG) was se-lected as the seed point for functional connectivity analysis.REST was used for pairing and two-sample t-tests. Results Compared with the control group,the brain regions with increased LMFG-ROI functional connectiv-ity were right insula(MNI:x,y,z:45,12,0,t=7.98),right inferior frontal gyrus (triangular,ankle,island cap) (MNI:x,y,z:42,6,27,t=6.75),right upper temporal gyrus and right middle temporal gyrus( MNI:x, y,z:48,-45,6,t=10.57),right superior border gyrus(MNI:x,y,z:15,-66,60,t=5.59) and right angle gy-rus(MNI:x,y,z:54,-50,12,t=9.55) in the aphasia group (before rehabilitation),and the brain regions with reduced functional connectivity were left posterior cingulate gyrus( MNI:x,y,z:6,-75,9,t=-10.05), and left anterior wedge lobe(MNI:x,y,z:-6,-69,33,t=-9.07).Compared with the control group,the brain regions with enhanced LMFG-ROI functional connectivity in the aphasia group (after rehabilitation 1 month) included head of left caudate nucleus,left middle frontal gyrus and inferior frontal gyrus,left globus pallidus, left central anterior gyrus,central posterior gyrus,left insula; the brain regions with reduced functional con-nectivity were right hippocampus,left cerebellum,right lingual gyrus,posterior left cingulate gyrus,right oc-cipital lobe and right anterior wedge lobe.Compared with aphasia group before rehabilitation,the brain regions with increased LMFG-ROI functional connectivity after rehabilitation 1 month were the left frontal frontal gy-rus(MNI:x,y,z:-51,15,24),t=15.87),left frontal parietal island cover(MNI:x,y,z:-24,-66,42,t=5.20),left central anterior gyrus and central posterior gyrus(MNI:x,y,z:-15,-16,55,t=6.53); and the reduced brain regions were the right superior temporal gyrus and middle temporal gyrus(MNI:x,y,z:57,-18,30,t=-15.21),right insula (MNI:x,y,z:-24,-66,42,t=-5.20)and right superior border gyrus (MNI:x,y,z:15,-66,60,t=-7.69). Conclusion The functional reorganization of the brain regions around the left hemisphere's injury lingual area may be the main mechanism of brain functional plasticity in patients with aphasia after cerebral infarction,and the right hemisphere is also involved in this process.In both the a-cute and chronic phases of motor aphasia,activation of the posterior left cingulate gyrus is reduced.

12.
Article in Chinese | WPRIM | ID: wpr-700610

ABSTRACT

Objective To understand the utilization of spare time among medical college freshmen at different academic levels and to explore the factors that affect undergraduates' utilization of spare time and their solutions.Methods The questionnaire is designed by myself,including after-school time planning,arrangement purpose,arrangement content and time allocation,etc.392 freshmen with three different educational levels were selected by cluster sampling.The questionnaires were issued and recovered in anonymous way.Data was recorded and collated by EpiData software,and descriptive analysis and chisquare test was used by SPSS 19.0.Results There are basic or frequent arrangements in spare time for 40.5% (155 people) of medical students.For 61.5% (236 people) of medical students,relaxation is the purpose in arranging their activity in spare time.Medical students who surf the Internet,read books and sleep in spare time account for 28.7% (110 people),28.5% (109 people) and 22.3% (85 people) respectively.60.5% (232 people) of medical students chat and play games on the Internet.There are significant differences among the three groups of different academic levels in the purposes of arrangements,activity contents,internet surfing time and attitude of part-time job (P<0.05).Conclusion There are deficiencies in the utilization of spare time among medical college freshmen,and different academic levels are probably one of the influential factors that affect college students' utilization of spare time.

13.
Article in Chinese | WPRIM | ID: wpr-709836

ABSTRACT

Objective To evaluate the cardioprotection induced by combination of dexmedetomidine and limb ischemic preconditioning in the patients undergoing coronary artery bypass grafting (CABG) with cardiopulmonary bypass (CPB).Methods Eighty American Society of Anesthesiologists physical starus Ⅱ or Ⅲ patients of both sexes,aged 52-64 yr,weighing 51-78 kg,with New York Heart Association Ⅱ or Ⅲ,scheduled for elective CABG with CPB,were divided into 4 groups (n =20 each) using a random number table method:control group (group C),limb ischemic preconditioning group (group L),dexmedetomidine group (group D) and dexmedetomidine plus limb ischemic preconditioning group (group DL).Limb ischemic preconditioning was induced by 3 cycles of 5-min unilateral lower limb ischemia followed by 5-min reperfusion starting from 30 min before aortic clamping in L and DL groups.Dexmedetomidine was injected via the central vein in a loading dose of 1 μg/kg after induction of anesthesia,followed by an infusion of 0.4 μg · kg-1 · h-1 until the end of operation in D and DL groups.Venous blood samples were obtained immediately before aortic clamping,at the end of CPB and at the end of operation for determination of plasma concentrations of cardiac troponin Ⅰ (cTnI) by enzyme-linked immunosorbent assay.Myocardial tissues were obtained from the right auricle immediately before aortic clamping and at the end of CPB for determination of the expression of Bcl-2 and Bax (by immunohistochemistry) and apoptosis index (AI) (using TUNEL).The restoration of spontaneous heart beat was recorded.Bcl-2/Bax ratio was calculated.Results Compared with group C,the plasma cTnI concentrations were significantly decreased,the Bcl-2 expression was up-regulated,the Bcl-2/Bax ratio was increased,Bax expression was down-regulated,and AI was decreased in the other three groups (P<0.05).Compared with L and D groups,the plasma cT-nI concentrations were significantly decreased,the Bcl-2 expression was up-regulated,the Bcl-2/Bax ratio was increased,Bax expression was down-regulated,and AI was decreased in group DL (P<0.05).The rate of restoration of spontaneous heart beat was significantly increased in group DL as compared with the other three groups (P<0.05).Conclusion Combination of dexmedetomidine and limb ischemic preconditioning can mitigate myocardial injury,it provides better efficacy than either alone,and the mechanism is related to inhibiting cell apoptosis in the patients undergoing CABG with CPB.

14.
Article in Chinese | WPRIM | ID: wpr-709748

ABSTRACT

Objective To investigate the effect of intrathecal dexmedetomidine pretreatment on my-ocardial ischemia-reperfusion (I∕R) injury in rats. Methods Forty-five adult Sprague-Dawley rats of both sexes, weighing 200-250 g, in which intrathecal catheters were successfully placed without complications, were divided into 3 groups (n= 15 each) using a random number table: sham operation group (group S), group I∕R and intrathecal dexmedetomidine pretreatment group ( group DEX). Myocardial I∕R injury was produced by occlusion of the left anterior descending branch of the coronary artery for 30 min followed by 120 min reperfusion. Dexmedetomidine 1 μg∕kg (diluted to 10 μl in normal saline) was intrathecally injec-ted at 30 min before ischemia in group DEX. The equal volume of normal saline was given in group I∕R. Blood samples were collected from the cardiac apex at the end of reperfusion for measurement of plasma nor-epinephrine (NE) and cardiac troponin I ( cTnI) concentrations. Then all the rats were sacrificed, and myocardial tissues were obtained for determination of myocardical infarct size, and the spinal cord was isola-ted to detect the expression of c-fos in the spinal dorsal horn by Western blot. Results Compared with group S, the myocardical infarct size, plasma NE and cTnI concentrations were significnatly increased, and the expression of c-fos in the spinal dorsal horn was up-regulated in I∕R and DEX groups (P<0. 05). Compared with group I∕R, the myocardical infarct size, plasma NE and cTnI concentrations were signific-natly decreased, and the expression of c-fos in the spinal dorsal horn was down-regulated in group DEX (P<0. 05). Conclusion Intrathecal dexmedetomidine pretreatment can reduce myocardial I∕R injury in rats, and the mechanims may be related to decreasing plasma NE levels and inhibiting c-fos expression in the spinal dorsal horn.

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Article in Chinese | WPRIM | ID: wpr-807800

ABSTRACT

Objective@#To investigate the effect of hypertensive disorder complicating pregnancy (HDCP) on the mortality and early complications of premature infants.@*Methods@#The general clinical data of preterm infants with gestational age 24-36+ 6 weeks were collected from the cooperative units in the task group from January 1, 2013 to December 31, 2014.According to the severity of HDCP, the infants were divided into 4 groups: HDCP group, preeclampsia group, eclampsia group and non HDCP group, the mortality and major complications of preterm infants were compared, and the influencing factors were analyzed.@*Results@#The mortality rate of preterm in the HDCP group was significantly higher than that of non HDCP group, and there was statistical significance (χ2=9.970, P=0.019). Eclampsia had a highest fatality rate (4.8%) in the early stage, compared with non HDCP group (2.2%), and the difference was statistically significant.Comparison of HDCP group (1.8%) and eclampsia group (3.2%) suggested that there was no statistically significant difference.The incidence of respiratory distress syndrome (RDS) in preterm in HDCP group was significantly higher than that of non HDCP group, and there was statistical significance (χ2=13.241, P=0.004). Eclampsia group showed the highest incidence (35.4%), compared with non HDCP group (16.2%), the difference was statistically significant, but compared with HDCP group (19.9%), preeclampsia group (17.1%), there was no significant diffe-rence.The incidence of bronchopulmonary dysplasia (BPD) in preterm in HDCP group was significantly higher than that of non HDCP group (χ2=9.592, P=0.022), the highest incidence showed up in eclampsia group (9.7%), compared with non HDCP group (2.0%) and HDCP group (1.7%), the difference was statistically significant.But there was no statistically significant difference, compared with preeclampsia group.As the degree of HDCP aggravated, the incidence of BPD gradually rose.There was no significant impact on necrotizing enterocolitis (NEC), retinopathy of prematurity (ROP), intraventricular hemorrhage (IVH) and sepsis of HDCP (χ2=7.054, 7.214, 0.358, 3.852; P=0.070, 0.065, 0.949, 0.278). Considering the overall outcome of the child, that was, whether the child died or survived, he had at least one complication, and HDCP had an effect on it (χ2=15.697, P=0.001), so the incidence increased while the degree of HDCP rose gradually.After adjusting gestational age, birth weight, sex, way of delivery, placental abruption and front placenta, prenatal hormonal, gestational diabetes, neonatal asphyxia and other factors, the results displayed that HDCP was the factor leading to the death of premature baby (OR=2.159, 95%CI: 1.093-4.266), and comparison between preeclampsia and eclampsia showed no statistical difference (P=0.714, 0.389); HDCP had no significant influence on RDS, BDP, ICH, NEC, ROP and sepsis.@*Conclusions@#HDCP leads to increased risk of premature death, but also leads to the increased incidence of RDS and BPD, but it had no obvious effect on NEC, ROP, IVH, sepsis and other complications.

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Chinese Pharmacological Bulletin ; (12): 1285-1290, 2017.
Article in Chinese | WPRIM | ID: wpr-614198

ABSTRACT

Aim To examine the influence of tetramethylpyrazine on learning and memory function of hypoxic hypoxia rats, and the expression of gamma aminobutyric acid(GABA) receptor and forkhead box P2(FOXP2) in hippocampus of rats.Methods A total of 120 Sprague Dawley rats were randomly divided into low hypoxic hypoxia and high hypoxic hypoxia groups, then according to different time points every group was divided into 1 d, 3 d, 7 d 15 d, 30 d group, with 12 rats per each group.Experiment group and the control group were treated with tetramethylpyrazine and 0.9% normal saline, respectively.The hypoxic hypoxia environment was achieved by putting the rats in a hypobaric chamber at a simulated altitude of 5 500 meters for different days.The capabilities of learning and memory of rats were detected by Morris water maze test.The expression of GABA receptor and FOXP2 protein in hippocampus of rat was determined by Western blot.Results ① Morris water maze test showed that the total distance of rats in the simulated hypobaric hypoxia control group was longer than that in the tetramethylpyrazine group(P0.05);however,GABAB1 receptor and FOXP2 protein rose from the third day(P<0.05).The expression of GABAAα1 receptor and FOXP2 protein expression were correlated to total distance of Morris water maze in the control group(r=-0.738, P<0.05;r=-0.693, P<0.05), and the expression of GABAB1 receptor was correlated with FOXP2 protein level(r=0.834, P<0.05).Conclusion The simulated high-altitude hypobaric hypoxia can decrease the learning and memory abilities of rats, which may be ameliorated by tetramethylpyrazine intervention, and this effect might be related to the increase of GABAB1R receptor and FOXP2 expression in hippocampus of rats.

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Journal of Practical Radiology ; (12): 385-388, 2017.
Article in Chinese | WPRIM | ID: wpr-509701

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Objective To discuss specific CT signs of primary trachea,bronchus mucoepidermoid carcinoma.Methods A retro-spective analysis was made on CT features,clinical manifestations and relevant pathology materials of 10 cases of trachea,bronchus mucoepidermoid carcinoma that had been proved by pathological examinations.Results (1)Sites:1 case was in the trachea,1 case in the bronchus,3 cases in lobar bronchus,5 cases in segmental bronchus and they were all central types.(2)Form and size:2 cases were lobular,7 cases were oval or round,1 case was irregular.The maximum diameters of the tumor were 10-39 mm (averagely 25 mm).(3)Edge:8 cases had smooth edge,2 cases had rough edge with infiltration of adjacent pulmonary parenchyma.(4)Densi-ty:6 cases with uneven density,3 cases with even density.The density of 4 cases were higher than that of chest wall muscle,4 cases were similar to chest wall muscle and 1 case lower than chest wall muscle.Calcification can be seen in 4 tumors.(5 )Enhancement features:9 cases underwent CT enhancement scanning,8 cases had mild enhancement and 1 case with light enhancement.(6)Pe-ripheral conditions:all cases showed trachea or bronchus stenosis and blocking,5 cases with obstructive pneumonia,2 cases with obstructive atelectasis,3 cases with far-end bronchus obstructive mucous embolism,1 case with obstructive emphysema,there was no evident swelling in mediastinum or hilar lymph nodes,1 case with multiple pulmonary bulla and pneumothorax in the left lung. Conclusion Primary mucoepidermoid carcinoma of trachea and bronchus is mostly central type,low potential malignancy.CT mani-festations are as follows,occurred in the trachea or bronchus,oval or lobulated masses with smooth edge,slight enhancement,gen-erally with calcification,but few showed invasive growth .

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Chinese Journal of Immunology ; (12): 52-57, 2017.
Article in Chinese | WPRIM | ID: wpr-508370

ABSTRACT

Objective:To explore the anti-inflammatory therapeutic effect and possible immunoregulatory mechanism of Buyang Huanwu Decoction (BYHWD) on the development of experimental autoimmune encephalomyelitis (EAE). Methods:Female C57BL/6 mice were immunized subcutaneously with myelin oligodendrocyte glycoprotein peptides ( MOG35-55 ) ,and randomly divided into saline group,BYHWD group,with 13 mice in each group. At the 3th day,25 ml/kg of saline was orally given to each mouse of saline group,50 g/kg ig of crude BYHWD was orally given to each mouse in BYHWD group for 25 days. Clinical score and body mass were recorded every day. Inflammatory cell infiltrations of spinal cord were observed by HE staining Myelin staining observes the demyelination situa-tion. And the expression of ROCKⅡ in spleen was detected by immunofluorescence staining. The subtypes of CD4+ T cells were analyzed by flow cytometry. Western blot was used to detect the expression of TLR4,Myd88,NF-κB,COX-2,ROCKⅡ in spinal cord and ROCKⅡ in brain. Results: The neurologicalscore significantly decreased in EAE mouse of BYHWD group compared with the saline group (P<0. 001) . BYHWD inhibited the inflammatory cell infiltration and demyelination in the nervous centralis(P<0. 05). The treatment of BYHWD effectively reduced the increased the proportion of CD25+(P<0. 05),IL-10+(P<0. 05),TGF-β+(P<0. 01), IFN-γ+( P<0. 05 ) CD4+T cells , and inhibited the expression of peripheral and central ROCKⅡ( P<0. 05 ) ;BYHWD reduced the expression of TLR4,MyD88,NF-κB,COX-2 in spinal cord (P<0. 05). Conclusion:BYHWD can exert anti-inflammatory and immune regulation effect by the inhibition of ROCKⅡ/TLR4/ NF-κB signaling pathway and regulation of the proportion of peripheral T cell sub-sets.

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Article in Chinese | WPRIM | ID: wpr-507465

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AIM:To explore the therapeutic effect of Buyang-Huanwu decoction (BYHWD) on experimental au-toimmune encephalomyelitis ( EAE) and its immunoregulatory effect on monocyte-macrophages .METHODS: Chronic EAE was induced by myelin oligodendrocyte glycoprotein peptide fragment 35-55 ( MOG35-55 ) in the female C57BL/6 mice, which were randomly divided into saline group and BYHWD group .On day 3 after immunization , the mice in BYHWD group were orally administrated with BYHWD , while normal saline was given to the control mice .The clinical score and body mass were recorded every other day .At day 17 after immunization , the mice were sacrificed and spinal cords were obtained for HE staining and myelin staining .The M1 and M2 macrophage phenotypes of splenic cells were detected by flow cytometry and immunofluorescence staining .The protein expression of iNOS , TNF-α, arginase and IL-10 in the spinal cord macro-phages was determined by Western blotting .RESULTS:BYHWD delayed the onset of EAE , reduced the clinical scores of EAE, inhibited the inflammatory cell infiltration and demyelination in the spinal cord , and promoted the conversion of M 1 macrophages into M2 phenotype in the spinal cord and spleen .CONCLUSION:BYHWD intervention attenuates the be-havioral and pathological changes in the EAE mice , and its mechanism may be related to the macrophage conversion .

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Herald of Medicine ; (12): 109-113, 2017.
Article in Chinese | WPRIM | ID: wpr-506689

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Objective To develop transparency measurement scale on medicine use information in primary health care facilities. Methods The dimensions and items of scale were determined through literature review and expert consultation. The scale was used to investigate 100 primary health care facilities in eastern, central and western regions. Correlation coefficient analysis, Cronbach's coefficient, and exploratory factor analysis were used to select items. Five dimensions and 20 items were selected for the final scale. Cronbach's coefficient was used to evaluate the reliability of the formal scale. Factor analysis was used for construct validity evaluation. Results Dimensions were measured, including service processes, organization and regulation for pharmacy administration, patients informing and education, medicine catalogue, and the economic burden of patients. The scale had good reliability since overall Cronbach coefficient was 0. 844. Factor analysis extracted five common factors, total explaining 89. 69% of the cumulative variance, and the item distribution in five common factors was completely consistent with formal scale, indicating good construct validity. Conclusion This scale had good reliability and validity as a measurement tool to evaluate the transparency level of primary health care facilities in China.

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