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There has been a growing amount of evidence that a balanced blood component transfusion with roughly equal ratio of units of packed red blood cells, fresh frozen plasma, and platelets leads to better outcomes in massive transfusion resuscitation of trauma victims. Therefore, the great interest of massive transfusion protocol (MTP) with whole blood was aroused. Low titer group O whole blood (LTOWB) is implemented in routine use for civilian prehospital ambulance services in large trauma centers of most European and American countries nowadays. There is a growing body of evidence to date to support that early use of LTOWB in patients with life-threatening bleeding improve their survival. In view of the current situation of whole blood supply in our country, most trauma resuscitation guidelines still recommend balanced component transfusion for MTPs in the early stage of resuscitation. The research and application of LTOWB abroad will be introduced in this article.
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Objective:To investigate the knowledge, attitudes, and practices (KAP) of pulse oximetry among pediatric healthcare providers in China and analyze the factor influencing the KAP.Methods:A self-developed questionnaire was used for an online research on the KAP of 11 849 pediatric healthcare providers from 31 provinces, autonomous regions, and municipalities of China from March 11 to 14, 2022.The factors influencing the KAP of pulse oximetry among pediatric healthcare providers were examined by Logistic regression. Results:The scores of KAP, of pulse oximetry were 5.57±0.96, 11.24±1.25 and 11.19±4.54, respectively.The corresponding scoring rates were 69.61%, 74.95%, and 55.99%, respectively. Logistic regression results showed that the gender and working years of pediatric healthcare providers, the region they were located, and whether their medical institution was equipped with pulse oximeters were the main factors affecting the knowledge score (all P<0.05). Main factors influencing the attitude score of pediatric healthcare providers included their knowledge score, gender, educational background, working years, region, medical institution level, and whether the medical institution was equipped with pulse oximeters (all P<0.05). For the practice score, the main influencing factors were the knowledge score, gender, age, and whether the medi-cal institution was equipped with pulse oximeters (all P<0.05). Conclusions:Chinese pediatric healthcare providers need to further improve their knowledge about and attitudes towards pulse oximetry.Pulse oximeters are evidently under-used.It is urgent to formulate policies or guidelines, strengthen education and training, improve knowledge and attitudes, equip more institutions with pulse oximeters, and popularize their application in medical institutions.
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Objective To analyze the effects of Hual qi huang granules on children with mycoplasma pneumoniae pneumonia.Methods A randomized,multicenter parallel controlled clinical trial was carried out.A total of 3 000 cases of hospitalized children with mycoplasma pneumoniae pneumonia were selected.All of them were given treatment for mycoplasma pneumoniae pneumonia with macrolide antibiotics and symptomatic treatment.They were randomly divided into 2 groups:research group and control group.The children of research group were give oral Huai qi huang granules for three months.According to the classification of pneumonia,these two groups were divided into:lobar pneumonia research group,lobar pneumonia control group,lobular pneumonia research group,lobular pneumonia control group.The hospitalization duration of fever,length of hospital stay,the absorption area of lung inflammation and pneumonia severity sores were observed.The frequency of upper respiratory infections,bronchitis,pneumonia were observed in 3 months after discharge.Results 2 378 cases were investigated.The hospitalization duration of fever,length of hospital stay of research group were significantly shorter than that of in control group (P < 0.001).The children with lobar pneumonia,2 weeks after treatment,the absorption of consolidation of the lobar pneumonia research group is significantly better than lobar pneumonia control group (P <0.001).After two weeks treatment,the pneumonia scores of lobar pneumonia research group is lower than lobar pneumonia control group (P < 0.05).Followup of 3 months after hospital discharge,frequency of upper respiratory infection and bronchitis of research group,were significantly lower than that of control.In addition,appetite increased significantly in research group than control (P < 0.001).There are 21 cases with drug associated adverse reactions (mild diarrhea),including 12 cases of research group,9 cases of control group,and there was no statistical significance (P >0.05).Conclusion Standard treatment combined with oral Huai qi huang granules in the treatment of mycoplasma pneumoniae pneumonia,can significantly shorten hospitalization duration of fever,length of hospital stay and reduce the severity score of pneumonia.Three months oral Huai qi huang granules can significant reduce the frequency of respiratory infections and bronchitis,also can increase patients appetite,and be safe.
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Objective To observe the clinical efficacy and safety of GINA regimen and GINA regimen combined with oral Huaiqihuang granule in the treatment of children with bronchial asthma.Methods A ran-domized,single blind,multicenter,parallel controlled clinical trial wascarried out.A total of 1 128 patients with bronchial asthma in children were randomized into two groups.The observation group were treated with GINA regimen combined with oral Huaiqihuang granule.The GINA regimen treatment group was treated by GINA reg-imen.Clinical assessment and C-ACT scores was observed in first month,third month,sixth month after treat-ment.Clinical assessment included the times of upper respiratory tract infection occurrence,bronchitis and pneu-monia,asthmatic attacks,application of emergency medicine,hospitalizations due to asthmatic.Drug adverse effect in the two groups was compared.Results The times of upper respiratory tract infection,bronchitis and pneumonia,asthmatic was significantly decreased(P 0.05).Conclusion The treatment of bronchial asthma in children with GINA regimen combined with oral Huaiqihuang granule can significantly reduce the incidence of respiratory infections and the number of asthmatic attacks dramatically and safely improve clinical curative effect,asthma control.
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Objective To study the different periods of childhood bronchial asthma induced sputum of the percentage change of inflammatory cells,and to explore part of the pathogenesis of asthma in children.Methods 69 children with asthma(the age ≥5 years old) were selected.By clinical symptoms,they were divided into acute exacerbation and clinical remission of 3 months and 6 months.At the same time,in the same groups of hospital pediatric clinic,22 healthy children were chosen as control group.The percentage of neutrophils and eosinophils in induced sputum was detected.Through the comparison,we can explore the correlation between the two kinds of inflammatory cells in different periods of asthma.Results Comparing the percentage of neutrophils among the four groups,acute exacerbation group was compared with clinical remission three months group,clinical remission six months group and the normal control group,acute exacerbation group was higher than the clinical remission group of three months,clinical remission of six months and normal control group [(57.905 ± 11.615)% vs (40.137 ± 11.668)%,(33.825 ± 12.457) %,(23.836 ± 13.585) %,P =0.039,0.000,0.000].The clinical remission of three months and clinical remission six months group were higher than the normal control group(P =0.000,0.032).The clinical remission of three months group and 6 months group had no significant difference (P =0.538).The percentage of eosinophils in acute exacerbation group was higher than the clinical remission of three months group,clinical remission of six months and normal control group [(4.090 ± 1.452) % vs (2.685 ± 1.190) %,(2.151 ± 1.417) %,(1.848 t 0.887) %,P =0.002,0.000,0.000].The clinical remission of three months group and the normal control group had no significant difference (P =0.937).Conclusion Asthma in children induced sputum neutrophil percentage and eosinophil percentage are significantly higher in acute exacerbation.The study shows that neutrophils and eosinophils are involved in the part of the pathogenesis of bronchial asthma in children.
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Objective To explore the levels of neuron-speciifc enolase (NSE) of the cerebrospinal lfuid (CSF) in children with convulsion. Methods Ninety children with convulsion were enrolled. According to the frequency of convulsion attack, the children were divided into brief convulsion group 51 cases and prolonged convulsion group 39 cases, further, based on the etiology, the children were divided into viral encephalitis (VE) group, idiopathic epilepsy (EP) group, and febrile convulsion (FS) group. CSF was collected within 24-48 h convulsion attack. Twenty-three children with elective surgery were selected as a control group. CSF was collected before surgery. The NSE level of CSF were measured by ELISA method and compared among groups. Results The NSE levels of CSF in prolonged convulsion group and brief convulsion group were signiifcantly higher than that in control group, while the NES levels of CSF in prolonged convulsion group were signiifcantly higher than that in brief convulsion group (all P0.05). Conclusions Convulsion contributed to higher NSE levers of CSF, especially in children with prolonged convulsion attack or with VE. The NSE level of CSF can be regarded as an early objective indicator of brain damage after convulsions.
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Anti-endothelial cell antibodies (AECA) are heterogeneous autoimmune antibodies, which target at a group of antigens expressed in endothelial cells. In 1971, AECA was reported by Lindquist and Osterland for the first time. Since then, an increasing number of researches have showed that AECA exists and plays potential pathogenic role in the immune or inlfammation-related diseases, especially in systemic vasculitis. AECA may be a useful sera marker for the diagnosis and prognosis judgment of related autoimmune diseases. In this review, we summarize the recent progress on the relationship between AECA and systemic vasculitis.
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Objective To explore the changes of IL-17 and neutrophils,eosinophils percentage in the induced phlegm from the children with different severity bronchial asthma.Methods Forty children with acute asthma were divided into two groups according to the severity of asthma:medium or severe group(n =16) and light group( n =24 ).Twenty normal children were chosen in the same stage as control group.The IL-17 content and the percentage of neutrophils and eosinophils were compared.Results The contents of IL-17 in the medium or severe group,light group and control group were(1.096 ±0.664) ng/L,(0.474 ±0.240) ng/L and(0.227 ±0.360 ) ng/L respectively.The percentage of neutrophils were ( 55.359 ± 12.486 ) %,( 44.476 ± 17.708 ) % and ( 36.493 ± 12.470 ) % respectively.The percentage of eosinophils were ( 1.252 ± 2.025 ) %,(4.107 ± 3.234) %and (1.409 ± 3.480) % respectively.There were significant differences in three groups ( P < 0.05 ).There was significant positive correlation between IL-17 content and percentage of neutrophils in the medium or severe group( r =0.740,P =0.049 ).There was negative correlation in the light group ( r =- 0.764,P =0.000 ).Conclusion There was different among IL-17 content and percentage of neutrophils,eosinophils in children of different groups.The study showed that IL-17 was involved in the potential pathogenesis of asthma.
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Objective To investigate the role of peripheral blood lymphocyte apoptosis through Fas/ Fas ligand pathway in the development of viral myocarditis. Methods Twenty-five viral myocarditis (VMC) and 25 healthy children were chosen for study. The apoptosis percentage in peripheral blood iymphocytes was quantitatively examined, flow cytometry with Annexin V/PI double parameter was used. And the expressions of Fas and Fasl protein in peripheral blood lymphocytes were analyzed with flow cytometry. Results The percentage of apoptosis in peripheral blood lymphocytes in children with VMC [(0. 6976 ± 0. 1109)%] was significantly higher than that of healthy children [(0. 1288 ± 0. 1069) %] (t = 18.459, P < 0.001). Moreover, the apoptosis cell percentage showed a significant positive correlation with the serum levels of myocardium enzyme (creatine kinase-MB, lactate dehydrogenase, creatine kinase, hydroxybutyrate dehydrogenase)(r =0. 817 ,P <0. 01 ;r =0. 785 ,P <0.01 ;r =0. 726 ,P <0. 01 ;r =0. 712 ,P <0. 01). The expression of Fas and Fasl protein in VMC patients(2. 8804 ± 0. 3020,4. 4496 ± 0. 4836) were higher than those of health children(2. 1300 ±0. 6200,0. 1238 ±0. 0384) ,which had significant difference(t = 17. 321 ,P <0. 001 ;t' =44. 577, P < 0. 001). The apoptosis percentage of peripheral blood lymphocytes in children with VMC showed a significant positive correlation with the Fas and Fasl protein expression in peripheral blood lymphocytes(r =0. 972, P < 0. 01; r = 0. 958, P < 0. 01). Conclusion Apoptosis percentage of peripheral blood lymphocytes increases among children with VMC, probably because immune response decreased or it is related with the degree of myocardium damaged. Fas and Fasl play an important role in apoptosis of peripheral blood lymphocytes in children with VMC.
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ObjectiveTo explore the association between HLA -A gene and anaphylactoid purpura(AP) in children of Mongolia in Inner Mongolia. To find correlated genes and study part of pathogenesis and the method of prevention and cure of AP. MethodsThe method of case control was adopted and selected 56 children with AP as case group and 66 health children as control group in Mongolia,who had resided in Inner Mongolia three generations without consanguinity, history of mixed, marriages, other medical history , and family history of immunity,led into polymerase chain reaction sequence specific oligonucleotide probes technique, analyzed the type of HLA-A gene. The compare of gene frenquency made with logistic regression after χ2 or Fisher test. ResultsThe gene frenquency of HLA- A * 11 ( 16. 1% ) allele in case group compared to that of control group( 9. 1% ) ,Wald of HLA-A * 11 gene was 3. 954 ,P =0. 047, the difference had statistical significance. B = 0. 844 > 0, OR = 2. 325 > 1, it helped development of the disease,which 95%confident interval was 1. 012-5.340,which did not include 1 ,EF =0. 342 >0. ConclusionHLA-A * 11 allele may be the susceptible gene of AP in children of Mongolia in Inner Mongolia.
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Objective To explore the relationship between plasm level of vascular endothelial growth factor (VEGF) and children Anaphylactoid purpura(AP).Methods The concentrations of VEGF in serum were detected with enzyme-linked immunosorhent assay in twenty four children with AP,twenty four children with APN in acute phase and twenty four healthy children.Results The concentrations of VEGF in patients with APN in acute phase,AP and normal control was (244.56±51.12)μg/L,(155.71±50.48)μg/L and (54.91±40.07)μg/L,respectively.Plasma levels of VEGF in children with APN and AP were significantly higher than those in normal control,statistically significant difference was observed (F=95.789,P=0.000<0.01).Conclusion The concentrations of VEGF in serum increases markedly in acute phase of AP,those in APN is higher than in AP.It indicated that VEGF involved in the occurrence and development of AP vaseulitis,and may reflect the extent of pathogenetic condition.
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Transcription factors T-bet/GATA3 are one of the most fascinating areas of immunology today.Rencently,information has been accumulated to clarity T-bet/GATA3 roles in etiology and progression of certain diseases.This review focuses on the relationship between T-bet/GATA3 and diseases.
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<p><b>OBJECTIVE</b>To analyze the genetic susceptibility of HLA-DQA1 allele to anaphylactoid purpura(AP)and its association with the clinical features in juvenile Hans residing in Inner Mongolia.</p><p><b>METHODS</b>Seventy children with AP and ninety normal controls of Hans in Inner Mongolia were subjected to HLA-DQA1 genotyping with the use of polymerase chain reaction-sequence specific primer (PCR-SSP) technique.</p><p><b>RESULTS</b>(1) The gene frequency of HLA-DQA1*0301 of AP group (33.4%) was significantly higher than that (10.6%) of control group (chi square=21.899, P<0.01). On the other hand, the gene frequencies of HLA-DQA1*0302 were 6.7% and 19% in the AP group and the control group respectively; a significant difference between them was seen (chi square=9.786, P<0.01); (2)The gene frequencies of both DQA1*0301 and DQA1*0302 in the cutaneous purpura simplex cases and the controls were not significantly different (P>0.05). The gene frequencies of DQA1*0301 of the cutaneous purpura cases associated with gastrointestinal, joint and renal impairment were 26.7%, 28.5% and 29.3% respectively, which were higher than that of the control group (10.6%); the differences were statistically significant (P<0.01, 0.01, 0.01; respectively). The gene frequencies of HLA-DQA1*0302(3.9%, 5.7% and 9.6%) for the cutaneous purpura cases associated with gastrointestinal, joint and renal impairment were significantly lower than that (19%) of the controls except renal impairment(P<0.01, 0.01, respectively).</p><p><b>CONCLUSION</b>The allele of HLA-DQA1*0301 was probably a susceptible gene while HLA-DQA1*0302 was the protective one in AP of the children who were Han inhabitants in Inner Mongolia. The results of this study also revealed that patients with the allele of HLA-DQA1*0301 tended to involve gastrointestinal, joint and renal impairment.</p>
Subject(s)
Adolescent , Child , Child, Preschool , Female , Humans , Male , Asian People , Genetics , China , Gastrointestinal Diseases , Genetics , Gene Frequency , Genetic Predisposition to Disease , HLA-DQ Antigens , Genetics , HLA-DQ alpha-Chains , Joint Diseases , Genetics , IgA Vasculitis , Genetics , Renal Insufficiency , GeneticsABSTRACT
Objective To analyse the genetic susceptibility of HLA DQA1 allele to anaphylactoid purpura with involved joints (APIJ),gastrointestestine (APIG) and kidney (APIK) in juvenile Han inhabited in Inner Mongolia.Method There were 45 children with APIJ,39 with APIG and 32 with APIK and 90 normal children controls,all of which were proved to be no sibship and no rheumatic diseases and family history.Of them,HLA DQA1 allelic types were analysed by polymerase chain reaction sequence specific primer (PCR SSP) technique.Results Gene frequencies of HLA DQA10301 in APIJ,APIG and APIK groups (28 5%,24 9% and 25%,respectively) were significantly higher than those of control group (10 6%),and the difference had statistical significance( ? 2=12 008,7 639 and 6 882; P =0 001,0 006 and 0 009;RR=3 83,3 09 and 3 11;EF=0 36,0 295 and 0 297,respectively).In contrast,HLA DQA10302 allelic frequencies in APIJ,APIG and APIK groups (5 7%?3 9% and 6 5%,respectively) were significantly lower than those in control grorp (19%) respectively,and the difference had statistical significance ( ? 2=8 352,10 633 and 5 557; P =0 004,0 002 and 0 018;RR=0 24?0 159 and 0 272;PF=1 09?1 80 and 0 92,respectively).Conclusion The allele of HLA DQA10301 may be a susceptible gene for the Han children with APIJ,APIG and APIK in Inner Mongolia,while HLA DQA10302 gene may be the protective one.