The Impact of the COVID-19 Outbreak on the Medical Treatment of Chinese Children with Chronic Kidney Disease (CKD)：A Multicenter Cross-section Study in the Context of a Public Health Emergency of International Concern

ObjectiveTo investigate the impact of the COVID-19 outbreak on the medical advice seeking of Chinese children with chronic kidney disease (CKD). Materials and MethodsAn anonymous online questionnaire survey was conducted in 17 pediatric nephropathy diagnosis and treatment centers in China. The questions collected basic information on the patients and their parents and data on changes in the approach to medical treatment and their needs in the context of the outbreak etc. This is a Multicenter Cross-section Study. ResultsA total of 735 valid questionnaires were collected. 555 patients (75.5%) and their parents said that the outbreak had a significant influence on their medical treatment: 264 patients (47.6%) said that it would be delayed by 2 to 4 weeks and 199 patients (35.9%) by 4 to 8 weeks. 510 patients (84.16%) hoped to get in touch with specialists through online consultation, and 528 patients (84.5%) hoped that online consultation could be implemented and that medication could be delivered to them.. A total of 458 patients (62.3%) said that their greatest concern was that the CKD would be aggravated or that they would experience a relapse; only 203 patients were infected by 2019-nCoV. A total of 313 patients (42.5%) experienced anxiety and thus required the intervention of psychologists. ConclusionThe COVID-19 outbreak has affected the medical treatment of children with CKD. Online consultation, medication delivery and psychological counselling are the greatest needs reported by patients and their families and could especially provide solutions for the management of low income children with CKD in remote rural areas in the context of the COVID-19 epidemic. Strengths and limitations of this studyThe study is a Multicenter Cross-section Study in the Context of a Public Health Emergency of International Concern. The study can well explore the impact of COVID-19 outbreak on the medical treatment of CKD children in China and the needs of current patients. The study explored ways to meet the medical needs of CKD children in the context of a public health emergency of international concern, which provides a method support for all countries in the world experiencing COVID-19 outbreak. The study is an exploration of the coping strategies for CKD management in China. The limitations of this study is that it is quite simple and descriptive, and many studies need to be further carried out.

Sympathetic nervous system level and ambulatory blood pressure in children with primary nephrotic syndrome / 中南大学学报(医学版)

OBJECTIVE@#To explore the change in ambulatory blood pressure monitoring (ABPM) value and the sympathetic nervous system (SNS) level in children with primary nephrotic syndrome(PNS) and their relationship.@*METHODS@#ABPM and casual blood pressure(CBP) were tested in 114 children with PNS and 12 normal children as a control group. The 24-h urine noradrenaline(NA), adrenaline(A) and dopamine(DA) content were detected through high-performance liquid chromatography with electrochemical luminescence and the correlation with ABP was analyzed.@*RESULTS@#Among 114 children with PNS, 101 had elevated blood pressure (88.6%), 45 showed high incidence of masked hypertension (39.5%), and 80 non-dipper blood pressure (70.2%). Systolic blood pressure level and blood pressure load were greater than diastolic blood pressure. NA, A, and DA levels of the PNS group were significantly higher than those of the control group, while those of the elevated blood pressure group were significantly higher than those of the normal blood pressure group in PNS children. SNS levels were positively correlated with blood pressure levels and blood pressure load, and negatively correlated with night BP decreasing rates.@*CONCLUSION@#Children with PNS have high incidence of hypertension with large proportion of masked hypertension and non-dipper blood pressure. Severe masked hypertension classification should be set up. In PNS children, SNS activity is elevated that might evaluate the blood pressure level and decrease blood pressure circadian rhythm.

Distribution and Resistance of AmpC Enzyme Producing Gram-negative Bacilli / 中华医院感染学杂志

OBJECTIVE To study the isolation,distributive characteristics and drug resistance of AmpC enzyme producing Gram-negative bacilli in nosocomial infection of two years and provide the evidence for treatment. METHODS A total of 528 strains of Gram-negative bacilli collected from daily specimens were identified with Bio-Fosun-Ⅰ,and AmpC enzyme was screened by cefoxitin disk and then corroborated by EDTA disk method. All data were analyzed statistically. RESULTS Among 528 strains collected,136 (25.75%) were AmpC enzyme producing strains,the respective percentage of Pseudomonas aerugionsa,Echerichia coli,Enterobacter cloacae,Klebsiella pneumoniae and Citrobacter was 32.35%,28.67%,18.38%,8.09% and 5.15%,respectively. Most strains (38.9%) were detected in ICU. The common infection sites were lungs. The resistance rate of AmpC enzyme producing strains to the first,second and third-generations cephalosporins was 71.3-99.5%. The susceptive rate of AmpC enzyme producing strains to imipenem,cefepine,amikacin and piperacillin/tazobactant were low. CONCLUSIONS For effective supervision and control of AmpC enzyme producing Gram-negative bacilli in nosocomial infection,detection of AmpC enzyme shoud be paid much attention by clinical microbiology laboratory.