[Analysis of risk factors of mortality in infants and toddlers with moderate to severe pediatric acute respiratory distress syndrome].

Objective: To identify the risk factors in mortality of pediatric acute respiratory distress syndrome (PARDS) in pediatric intensive care unit (PICU). Methods: Second analysis of the data collected in the "efficacy of pulmonary surfactant (PS) in the treatment of children with moderate to severe PARDS" program. Retrospective case summary of the risk factors of mortality of children with moderate to severe PARDS who admitted in 14 participating tertiary PICU between December 2016 to December 2021. Differences in general condition, underlying diseases, oxygenation index, and mechanical ventilation were compared after the group was divided by survival at PICU discharge. When comparing between groups, the Mann-Whitney U test was used for measurement data, and the chi-square test was used for counting data. Receiver Operating Characteristic (ROC) curves were used to assess the accuracy of oxygen index (OI) in predicting mortality. Multivariate Logistic regression analysis was used to identify the risk factors for mortality. Results: Among 101 children with moderate to severe PARDS, 63 (62.4%) were males, 38 (37.6%) were females, aged (12±8) months. There were 23 cases in the non-survival group and 78 cases in the survival group. The combined rates of underlying diseases (52.2% (12/23) vs. 29.5% (23/78), χ2=4.04, P=0.045) and immune deficiency (30.4% (7/23) vs. 11.5% (9/78), χ2=4.76, P=0.029) in non-survival patients were significantly higher than those in survival patients, while the use of pulmonary surfactant (PS) was significantly lower (8.7% (2/23) vs. 41.0% (32/78), χ2=8.31, P=0.004). No significant differences existed in age, sex, pediatric critical illness score, etiology of PARDS, mechanical ventilation mode and fluid balance within 72 h (all P>0.05). OI on the first day (11.9(8.3, 17.1) vs.15.5(11.7, 23.0)), the second day (10.1(7.6, 16.6) vs.14.8(9.3, 26.2)) and the third day (9.2(6.6, 16.6) vs. 16.7(11.2, 31.4)) after PARDS identified were all higher in non-survival group compared to survival group (Z=-2.70, -2.52, -3.79 respectively, all P<0.05), and the improvement of OI in non-survival group was worse (0.03(-0.32, 0.31) vs. 0.32(-0.02, 0.56), Z=-2.49, P=0.013). ROC curve analysis showed that the OI on the thind day was more appropriate in predicting in-hospital mortality (area under the curve= 0.76, standard error 0.05,95%CI 0.65-0.87,P<0.001). When OI was set at 11.1, the sensitivity was 78.3% (95%CI 58.1%-90.3%), and the specificity was 60.3% (95%CI 49.2%-70.4%). Multivariate Logistic regression analysis showed that after adjusting for age, sex, pediatric critical illness score and fluid load within 72 h, no use of PS (OR=11.26, 95%CI 2.19-57.95, P=0.004), OI value on the third day (OR=7.93, 95%CI 1.51-41.69, P=0.014), and companied with immunodeficiency (OR=4.72, 95%CI 1.17-19.02, P=0.029) were independent risk factors for mortality in children with PARDS. Conclusions: The mortality of patients with moderate to severe PARDS is high, and immunodeficiency, no use of PS and OI on the third day after PARDS identified are the independent risk factors related to mortality. The OI on the third day after PARDS identified could be used to predict mortality.

[Detection of distortion-product otoacoustic emissions in well-drilling workers].

OBJECTIVE: To understand the value of using distortion product of otoacoustic emissions(DPOAE) in monitoring noise-induced hearing-loss. METHOD: The amplitude and the positive rates of DPOAE were detected in 102 well-drilling workers (195 ears). RESULT: The amplitude and the positive rates of DPOAE declined significantly in noise groups against control. With the increase of working-age the positive rates of DPOAE was decrease. The DPOAE amplitudes and the positive rates of noise group with normal pure tone threshold were obvious lower than that in controls. There were negative relationship between pure tone threshold in high-frequency and the positive rates. CONCLUSION: The DPOAE can reflect the cochlea's function of labors working in noise condition well. Contrast with the pure tone audiometry, DPOAE was more sensitive and more objective.

[Detection of Epstein-Barr virus DNA in fine needle aspiration specimen from cervical lymphnodes with polymerase chain reaction].

OBJECTIVE: For the diagnosis of occult nasopharyngeal carcinoma. METHOD: Epstein-Barr virus in 58 fine needle aspirations from cervical metastatic lymphnodes were detected with polymerase chain reaction. RESULT: The positive reaction was found in 28/35 metastatic carcinoma samples from middle or upside neck. Negative reaction was found in 3 lymphomas, 4 metastatic carcinomas in clavicular superior lymphnodes and 15/16 inflammatory diseases of cervical lymphnodes. The sensibility of this method for the diagnosis of nasopharyngeal carcinoma was 89.3%. The specificity was 86.7%. CONCLUSION: The detection of Epstein-Barr virus in metastatic carcinoma from cervical lymphnodes had some clinical values for the diagnosis of occult nasopharyngeal carcinoma.

Semantic matching of pictures in schizophrenia: a cross-cultural ERP study.

In this study the N400 of schizophrenics was compared with that of control subjects in a picture semantic-matching task. The comparison of N400 difference waveforms (subtraction of event-related potentials of congruent from those of incongruent trials) between control and patients was supplemented by separate analysis for congruent and incongruent trials. The N400 latency was delayed in patients. Also, the amplitude of N400 in the difference waveform was reduced in schizophrenics; however only congruent trials were different for patients (more negative) with respect to controls. This result is consistent with the hypothesis that schizophrenics use context poorly, but inconsistent with simple versions of the idea that associations are generally disinhibited in schizophrenia. Since the amplitudes of N400 and an auditory P300 were not correlated, a general processing deficit does not explain the results. Finally, by using picture matching, a cross-cultural comparison of N400 in schizophrenics from Cuba and China was possible, which indicated that the N400 abnormalities were similar in both groups.