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PURPOSE: The purpose of this study was to investigate the duration of breastfeeding among preterm infants within the first 12 months after birth and analyzed factors influencing the duration of exclusive breastfeeding. DESIGN AND METHODS: In this retrospective study, premature infants who were hospitalized in the Neonatal Intensive Care Unit (NICU) premature delivery area of a third-class maternal and child health hospital in Changsha City, Hunan Province, China from October 2020 to January 2021 were selected as the participants for this study. Relevant data of these infants during their hospitalization was obtained from the hospital information system, while the rate of exclusive breastfeeding among preterm infants at a corrected age of 12 months was tracked through telephone follow-up. Univariate analysis of the effects of breastfeeding duration in preterm infants was conducted based on Mann-Whitney U test and Kruskal-Wallis H test. Multiple linear regression was then applied to determine the factors influencing the duration of exclusive breastfeeding in preterm infants. RESULTS: The median and interquartile range of breastfeeding duration for preterm infants in this study was 4.00 (1.00, 6.00) months. Multiple linear regression analysis showed that the duration of exclusive breastfeeding was affected by several factors including how much other family members support breastfeeding, whether the mother returns to work after maternal leave, and whether the infant is a twin (P < 0.05). CONCLUSION: The duration of exclusive breastfeeding among preterm infants needs to be improved by strengthening health education regarding the benefits of breastfeeding for preterm infants. Medical staff should provide guidance, encourage continuous nursing after discharge, and work with the community to implement targeted intervention measures with the goal of increasing the duration of exclusive breastfeeding among premature infants. IMPLICATIONS TO PRACTICE: Because breastfeeding is vitally important for premature infants, we should encourage longer breastfeeding duration for premature infants by increasing family support, removing barriers to workplace breastfeeding, enhancing people's confidence in breastfeeding and providing support to mothers with twins. Hopefully, these measure can promote breastfeeding for premature infants.
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Aleitamento Materno , Recém-Nascido Prematuro , Lactente , Feminino , Criança , Recém-Nascido , Humanos , Estudos Retrospectivos , Mães , Alta do Paciente , Unidades de Terapia Intensiva NeonatalRESUMO
China has classified the Corona Virus Disease 2019(COVID-19) as a statutory category B infectious disease and managed it according to Category B since January 8, 2023.In view that Omicron variant is currently the main epidemic strain in China, in order to guide the treatment of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2) infection in children with the times, refer to the Diagnosis and Treatment Protocol for Novel Coronavirus Infection (Trial 10 th Edition), Expert Consensus on Diagnosis, Treatment and Prevention of Novel Coronavirus Infection in Children (Fourth Edition) and the Diagnosis and Treatment Strategy for Pediatric Related Viral Infections.The Expert Consensus on the Diagnosis, Treatment and Prevention of Novel Coronavirus Infection in Children (Fifth Edition) has been formulated and updated accordingly on related etiology, epidemiology, pathogenic mechanism, clinical manifestations, auxiliary examination, diagnosis and treatment, and added key points for the treatment of COVID-19 related encephalopathy, fulminating myocarditis and other serious complications for clinical reference.
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Coronavirus disease 2019 (COVID-19) is an acute respiratory infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. It is highly contagious and can cause death in severe cases. As reported by the World Health Organization (WHO), as of 6:36 pm Central European Summer Time (CEST), 12 August 2022, there had been 585 950 285 confirmed cases of COVID-19, including 6 425 422 deaths (WHO, 2022).
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Humanos , COVID-19 , SARS-CoV-2 , Saúde Mental , Estudos de Coortes , Qualidade de Vida , China/epidemiologia , Pessoal de Saúde , Hospitais , PulmãoRESUMO
Monkeypox is a zoonotic disease.Previous studies have shown that children are vulnerable to monkeypox and are also at high risk for severe disease or complications.In order to improve pediatricians′ understanding of monkeypox and achieve early detection, early diagnosis, early treatment and early disposal, the committee composed of more than 40 experts in the related fields of infectious diseases, pediatrics, infection control and public health formulate this expert consensus, on the basis of the latest clinical management and infection prevention and control for monkeypox released by the World Health Organization (WHO), the guidelines for diagnosis and treatment of monkeypox (version 2022) issued by National Health Commission of the People′s Republic of China and other relevant documents.During the development of this consensus, multidisciplinary experts have repeatedly demonstrated the etiology, epidemiology, transmission, clinical manifestations, laboratory examinations, diagnosis and differential diagnosis, treatment, discharge criteria, prevention, case management process and key points of prevention and control about monkeypox.
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Since December 2019, severe acute respiratory syndrome coronavirus 2(SARS-CoV-2) infections have raged globally for more than 2 years.China has always adopted scientific and effective prevention and control measures to achieved some success.However, with the continuous variation of SARS-CoV-2 cases and imported cases from abroad, the prevention and control work has become more difficult and complex.With the variation of the mutant strain, the number of cases in children changed, and some new special symptoms and complications were found, which proposed a new topic for the prevention and treatment of SARS-CoV-2 infection in children in China.Based on the third edition, the present consensus according to the characteristics of the new strain, expounded the etiology, pathology, pathogenesis, and according to the clinical characteristics and experience of children′s cases, and puts forward recommendations on the diagnostic criteria, laboratory examination, treatment, prevention and control of children′s cases for providing reference for further guidance of effective prevention and treatment of SARS-CoV-2 infection in children in China.
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2019 novel coronavirus(2019-nCoV) outbreak is one of the public health emergency of international concern.Since the 2019-nCoV outbreak, China has been adopting strict prevention and control measures, and has achieved remarkable results in the initial stage of prevention and control.However, some imported cases and sporadic regional cases have been found, and even short-term regional epidemics have occurred, indicating that the preventing and control against the epidemic remains grim.With the change of the incidence proportion and the number of cases in children under 18 years old, some new special symptoms and complications have appeared in children patients.In addition, with the occurrence of virus mutation, it has not only attracted attention from all parties, but also proposed a new topic for the prevention and treatment of 2019-nCoV infection in children of China.Based on the second edition, the present consensus further summarizes the clinical characteristics and experience of children′s cases, and puts forward recommendations on the diagnostic criteria, laboratory examination, treatment, prevention and control of children′s cases for providing reference for further guidance of treatment of 2019-nCoV infection in children.
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At present, severe acute respiratory syndrome coronavirus-2(SARS-CoV-2)infection is still rampant worldwide.As of September 10, 2021, there were about 222 million confirmed cases of corona virus disease 2019(COVID-19)and more than 4.6 million deaths worldwide.With the development of COVID-19 vaccines and the gradual vaccination worldwide, the increasing number of cases in children and unvaccinated young people has drawn attention.According to World Health Organization surveillance data, the proportion of COVID-19 infection cases in children gradually increased, and the proportion of cases in the age groups of under 5 years and 5-14 years increased from 1.0% and 2.5% in January 2020 to 2.0% and 8.7% in July 2021, respectively.At present, billions of adults have been vaccinated with various COVID-19 vaccines worldwide, and their protective effects including reducing infection and transmission, reducing severe disease and hospitalization, and reducing death, as well as high safety have been confirmed.Canada, the United States, Europe and other countries have approved the emergency COVID-19 vaccination in children and adolescents aged 12 to 17 years, and China has also approved the phased vaccination of COVID-19 vaccination in children and adolescents aged 3 to 17 years. For smooth advancement and implementation of COVID-19 vaccination in children, academic institutions, including National Clinical Research Center for Respiratory Diseases, National Center for Children′s Health, and The Society of Pediatrics, Chinese Medical Association organized relevant experts to reach this consensus on COVID-19 vaccination in children.
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Severe acute respiratory syndrome coronavirus-2(SARS-CoV-2)infection is still worldwide.As a vulnerable group, severe and dead pediatric cases are also reported.Under this severe epidemic situation, children should be well protected.With the widespread vaccination of SARS-CoV-2 vaccine in adults, the infection rate have decreased.Therefore, SARS-CoV-2 vaccine inoculation for children groups step by step is of great significance to the protection of children and the prevention and control of corona virus disease 2019(COVID-19) as a whole.But the safety of children vaccinated with SARS-CoV-2 vaccine is a main concern of parents.Therefore, in order to ensure the safety of vaccination and the implementation of vaccination work, National Clinical Research Center for Respiratory Diseases, National Center for Children′s Health and the Society of Pediatrics, Chinese Medical Association organized experts to interpret the main issue of parents about SARS-CoV-2 vaccine for children, in order to answer the doubts of parents.
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BackgroundThe dynamic changes of lymphocyte subsets and cytokines profiles of patients with novel coronavirus disease (COVID-19) and their correlation with the disease severity remain unclear. MethodsPeripheral blood samples were longitudinally collected from 40 confirmed COVID-19 patients and examined for lymphocyte subsets by flow cytometry and cytokine profiles by specific immunoassays. ResultsOf the 40 COVID-19 patients enrolled, 13 severe cases showed significant and sustained decreases in lymphocyte counts but increases in neutrophil counts than 27 mild cases. Further analysis demonstrated significant decreases in the counts of T cells, especially CD8 + T cells, as well as increases in IL-6, IL-10, IL-2 and IFN-{gamma} levels in the peripheral blood in the severe cases compared to those in the mild cases. T cell counts and cytokine levels in severe COVID-19 patients who survived the disease gradually recovered at later time points to levels that were comparable to those of the mild cases. Moreover, the neutrophil-to-CD8+ T cell ratio (N8R) were identified as the most powerful prognostic factor affecting the prognosis for severe COVID-19. ConclusionsThe degree of lymphopenia and a proinflammatory cytokine storm is higher in severe COVID-19 patients than in mild cases, and is associated with the disease severity. N8R may serve as a useful prognostic factor for early identification of severe COVID-19 cases. SummaryLymphocyte subsets and cytokine profiles in the peripheral blood of COVID-19 patients were longitudinally characterized. The study revealed the kinetics features of immune parameters associated with the disease severity and identified N8R as a useful prognostic factor for predicting severe COVID-19 cases.
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At the end of December 2019, acute respiratory infectious diseases caused by a new type of coronavirus were prevalent in Wuhan and other cities of China. Different from radiology examinations, the protocols of nuclear medical imaging examinations are complicated, in which more workplaces and staff are needed, resulting more complex management of patients and higher protection requirements. Combined with the characteristics of SPECT and PET imaging procedures, this paper puts forward some suggestions on the protective process of imaging examinations for patients with confirmed or suspected noval coronavirus infec- tion. The main purpose is to protect medical staff from virus infection, effectively reduce the risk of virus transmission during the examination process, and ensure the medical quality and safety.
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At the end of December 2019, acute respiratory infectious diseases caused by a new type of coronavirus were prevalent in Wuhan and other cities of China. Different from radiology examinations, the protocols of nuclear medical imaging examinations are complicated, in which more workplaces and staff are needed, resulting more complex management of patients and higher protection requirements. Combined with the characteristics of SPECT and PET imaging procedures, this paper puts forward some suggestions on the protective process of imaging examinations for patients with confirmed or suspected novel coronavirus infection. The main purpose is to protect medical staff from virus infection, effectively reduce the risk of virus transmission during the examination process, and ensure the medical quality and safety.
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At the end of December 2019,acute respiratory infectious diseases caused by a new type of coronavirus were prevalent in Wuhan and other cities of China.Different from radiology examinations,the protocols of nuclear medical imaging examinations are complicated,in which more workplaces and staff are needed,resulting more complex management of patients and higher protection requirements.Combined with the characteristics of SPECT and PET imaging procedures,this paper puts forward some suggestions on the protective process of imaging examinations for patients with confirmed or suspected novel coronavirus infection.The main purpose is to protect medical staff from virus infection,effectively reduce the risk of virus transmission during the examination process,and ensure the medical quality and safety.
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Objective To establish a risk warning model for surgical site infection(SSI), provide support for screening high risk population and finding suspected cases.Methods Clinical data of 5 067 patients who underwent abdominal surgery in 6 domestic hospitals from January 2013 to December 2015 were collected retrospectively, all cases were randomly divided into modeling group and validation group according to a 6:4 ratio, warning model was established by employing logistic regression, the area under the receiver operating characteristic curve (AUC) was used to evaluate discriminant ability of evaluation model, the maximum Youden index was as the optimum cut-off point.Results For the warning model of high-risk patients, AUC was 0.823, sensitivity and specificity were 78.81% and 74.33% respectively, positive predictive value and negative predictive value were 19.67% and 97.78% respectively.For the discriminant model of suspected infection cases, AUC was 0.978, sensitivity and specificity were 93.38% and 95.62% respectively, positive predictive value and negative predictive value were 62.95% and 99.45% respectively.Conclusion The early-warning model established in this study has better discrimination ability, which can provide a reference for the development of early warning and discrimination of healthcare-associated infection information system.
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Objective To observe the changes of serumγ?glutamyl transpeptidase(GGT)levels before and after the patho?gen treatment in patients with subclinical schistosomiasis,and explore its clinical value in the diagnosis and treatment of sub?clinical schistosomiasis. Methods Totally 109 patients with subclinical schistosomiasis,who were found in the endemic inves?tigation of schistosomiasis in Ezhou City,were selected as the investigation subjects,and then they were treated with praziquan?tel. The serum GGT levels of the subjects before and after the treatment were detected and compared. Results Before the treat?ment,the average value of the GGT levels of the 109 patients was(48.1 ± 45.9)IU/L,among which,the GGT levels of 69 cases (63.3%)were normal,and the levels of 40 cases(36.7%)were increased. After the treatment,the average GGT level of the pa?tients was(32.1 ± 23.4)IU/L,which decreased by 33.3%comparing with that before the treatment,and the difference had a statistical significance(U=2.17,P=0.01). The GGT levels of 65 patients decreased in different degrees. Among the 40 pa?tients whose GGT levels had increased before the treatment,the GGT levels of 31 ones returned to the normal. Conclusion The GGT level detection can accurately reflect the liver function in the patients with subclinical schistosomiasis ,and also it has certain clinical application value to judge the liver function damage and recovery of the patients before and after the pathogen treatment.
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Objective To investigate the predictive value of heart rate variability to,and its correlation with ventricular arrhythmias in patients with structural heart disease.Methods 24 hours ambulatory electrocardiogram monitoring was administered during March 2012 and October 2013,and standard deviation of the NN interval (SDNN) in the time-domain analysis and sympathetic/vagal ratio in the frequency domain analysis were collected and retrospectively analyzed in 300 patients.Results The incidence rate of ventricular arrhythmias was higher in patients with structural heart disease in SDNN <100 ms group than in control group [4.1% (3/74) vs.39.5% (45/114),P<0.01].The sympathetic/vagal ratio was significantly higher in group with structural heart disease and ventricular arrhythmia than in control group(19.9 ±2.3 vs.10.1 ±1.7,P<0.01)The time-domain index SDNN was negatively correlated with the frequency domain index (sympathetic/vagal ratio) (r=-0.819,P <0.01).Conclusions SDNN <100ms and the increased sympathetic/vagal ratio can be considered as the predictors of ventricular arrhythmias in patients with structural heart disease.
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Objective To investigate the requirements of hospitalized patients on humanized nursing in the ward of whole-process humanistic care mode and provide scientific references for continuous improvement of nursing quality.Methods A total of 408 patients from 2 wards of whole-process humanistic care mode.Patients were applied the self-designed questionnaire in combination with interview to understand the patients’ requirements of humanized nursing.Survey was carried out before the inpatients were discharged from the hospital adopting the “Evaluation Table of Patients’ Satisfaction Degree about the Nursing Service” produced and researched by our hospital independently.Results After carrying out the whole-process humanistic care service mode,the inpatients’ overall satisfaction degree and satisfaction rate with humanistic care were respectively 98.2%,97.5%.Conclusions Carrying out the quality care demonstration project and enhancing the concept of humanistic care can promote each other.Carrying out the inpatients’ care needs survey in the ward of whole-process humanistic care mode,integrating humanistic into every aspect of clinical nursing,are the crux of deepening high-quality nursing care as well as a new subject that clinical nurses should confront conscientiously.
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Objective: To investigate the psychosocial characteristics and mind-physique status of pa-tients with gynecological malignant tumors. Methods: Clinical psycho-rating scale [life event scale (LES) and symptom checklist-90 (SCL-90)] was applied to test life events and mind-physique status of 60 cases of pa-tients with gynecological malignant tumor. The results were compared with those of 40 female patients with benign tumors and 40 normal females. Results: The frequency and tension value of total life events and those of negative life events in the malignant cancer group were much higher than those in the benign tumor group and normal group (P<0.05) and no remarkable differences were found in the frequency of positive life events among the three groups. The frequencies of total life events and negative life events were higher in the be-nign tumor group than those in the normal group (P<0.05) but there were no significant differences in the fre-quency of positive life events, total tension value or positive tension value among the three groups. No signifi-cant differences were found in the indices of SCL-90, positive scores and scorns of other factors among the three groups (P>0.05). The scores of somatization, obsession, interpersonal relationship sensitivity, anxiety, hostility, phobia, and paranoia were higher in the malignant tumor group than in the benign tumor group and normal group (P<0.05). The average positive scores and the depression scores in the benign tumor group were higher than those in the normal group (P<0.05), but there was no statistical significance in other indices between the benign tumor group and the normal group (P>0.05). Conclusion: Negative psychosocial factors are closely correlated with the occurrence and growth of gynecological malignant tumors. Active psychological intervention should be performed as eady as possible.
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Objective To establish an early,simple and rapid colloidal gold strip method for the detection of IgM against hantavirus nucleocapsid protein in patients with hemorrhagic fever with renal syndrome(HFRS).Methods Purified recombinant Hantavirus nucleoprotein(rNP)was labeled by colloidal gold particles and then sprayed and fixed on fiberglass membrane as the combination pad.Anti-Human IgM(μ-chain specific)antibody produced in goat was fixed in the detection area,and mouse antihantavirus antibody was fixed in the quality control area.Both of them were on nitrocellous membrane strip in tandem.Together with a specimen pad ahead.The conbination pad and the nitrocellous membrane were assembled into a test strip.The colloidal gold strip assay was compared with ELISA for evaluation of specificity and sensitivity.Results The colloidal gold strip tests showed positive in the serum samples from 50 cases of HFRS which was clinically diagnosed and then verified by ELISA within 10-15 minutes.Whereas 30 serum samples of healthy donors have tested negative.Conclusions Our new colloidal gold immunochromatographic test strip method was well concordant with the ELISA assay,but the former was more raoid and simole.It could be used primary medical services.
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Objective:To determine the CD 30 expression in patients with hemorrhagic fever with renal syndrome(HFRS).Methods:The double immunofluorescence technique and flow cytometry were used.Results:There is no significant difference among the three groups of HFRS patients on the CD + 4CD - 30 T lymphocyte subset.While the CD + 4CD + 30 T cells increase and the difference between severe group and mild-moderate group is very significant(P