Objective To explore the clinical features of ABO hemolytic disease in newboms,red blood cell glucose-6-phosphate dehydrogenase(G-6-PD) deficiency and the combined. Methods In the study, 160 cases of ABO hemolytic disease in newborn (ABO group) ,219 cases of G-6-PD deficiency(G6PD group) ,52 cases of the combined(ABO + G6PD group). The three groups were analyzed. Results The hemoglobin in the G6PD group ( (159. 7 ± 24.9) g/L) was significantly higher than in the ABO group ((150. 2 ± 23.0) g/L) and ABO + G6PD group( (149. 2 ±22. 8) g/L) (P < 0. 01). TBIL in the G6PD group ( (419. 0 ± 152. 9)μmol/L) was significantly higher than that in the ABO group ( ( 355. 4 ± 113. 2 )μmol/L) ( P < 0. 01). The Jaundice dissipated time in the G6PD group were significantly longer than ABO group ( ( 9.4 ± 2. 3) d vs. ( 8. 2 ± 2. 2 ) d) ( P < 0. 01 ) . In the ABO + G6PD group, the Jaundice dissipated time, time of phototherapy and number of phototherapy was (12. 0 ± 2. 7)d,(43. 2±16. 0)h and (3.5 ± 1. 2) times, which was significantly longer (or more) than those of the ABO group ((8. 1 ±2.2)d,(36. 1 ±15.9)h and (2. 6 ±1. 2)times) and G6PD group( (9.4 ±2. 3)d,(37. 6 ± 17. 3)h and (2. 8 ± 1. 3) times) (P<0. 05). The incidence of the bilirubin encephalopathy, hypocalcemia rate in the G6PD group (16. 0% ,32.9% ) were significantly higher than those in the ABO group(6. 9% and 20.0% ) (P <0. 05 ) . However, the incidence of anemia (23. 3% ) in the G6PD group was significantly lower than that in the ABO group (40. 0% ) and ABO + G6PD group (51.9%) ( P < 0. 01) . Conclusions In the newborns with ABO hemolytic disease and G-6-PD deficiency,the time jaundice appear,the degree of jaundice,bilirubin encephalopathy rate were not significantly different from those in the ABO hemolytic disease and G-6-PD group, but the jaundice persisted longer,and more easily repeated. Compared to the neonatal ABO hemolytic disease, the degree of jaundice, jaundice persisted longer in the G-6-PD deficiency,bilirubin encephalopathy is more likely to occur,whereas the incidence of anemia is much lower.

Restenosis is the major causee which leads to arterial occlusion and graft failure after vascular reconstruction.Thus to clarif the mechanism of restenosis is of great importance to prevent and treat postprocedural restenosis and improve long-term graft patency.Current studies on restenosis focus on elastic recoil,thrombosis,inflammatory reaction,neointimal hyperplasia and vascular remodeling,herein,we reviewed literatures.

Objective To explore relationship between excursion of blood glucose levels and cognitive performance in diabetic patients over aged 60 years.Methods A total of 108 diabetic patients over aged 60 years were recruited in this study and they wore under continuous blood glucose monitoring system (CGMS) for three days to evaluate excursion of their mean blood glucose (MBG) level and its standard deviation (SD).All the participants accepted cognitive function tests during continuous blood glucose monitoring, including mini mental status examination (MMSE), Montreal cognitive assessment (MOCA) and clock drawing test (CDT).Relationship of the SD of blood glucose level and cognitive performance in the three cognitive tests was assessed.Data were analyzed with CGMS software version 3.0.Results The SD reversely correlated with scores of MMSE (r = - 0.324, P ＜ 0.01 ) and CDT ( r =-0.325, P = 0.001 ), but they did not significantly correlate with MOCA scores (r = -0.212, P =0.081 ).Statistically significant difference was observed between the SD and scores of all three cognitive tests adjusted for glycosylated hemoglobin Alc (HbAlc) level (r = -0.387, -0.046 and -0.292, P =0.029, ＜0.001 and ＜ 0.001, respectively).The SD reversely correlated with scores of MMSE, MOCA and CDT adjusted for MBG (r= -0.314, -0.466 and -0.345, P ＜0.01, respectively).Results of multivariate linear regression analysis showed that the SD reversely correlated to scores of MMSE, MOCA and CDT (β = - 0.378, - 0.224 and - 0.346, all P ＜ 0.05).Conclusions Excursion of blood glucose levels can influence their cognitive performance in diabetic patients over aged 60 years, leading to decrease in their overall cognitive function and activities as its excursion large enough.

Objective To assess the effects of different administration timing of prophylactic antibiotics on infections after hip arthroplasty. Methods 535 patients having undergone arthroplasty were divided into two groups: the experiment group (n=273)and the control group (n=262): The former groupwere administered with antibiotics until 24 hours postoperatively and the latter until 72 hours postoperatively. The two groups were compared in terms of postoperative infection rate. Results The infection rates in the experimental groupand the control group were 4.396%and 3..817%, with insignificant differencebetween them. Conclusion For those patients undergoing hip arthroplasty, extended administration of antibiotics after operation (over 48 hours) may not reduce the risk of recent the infection rate.

Objective To explore depression and anxiety in nasopharyngeal carcinoma (NPC) patients in Chaoshan region and investigate their influencing factors. Methods Two hundred and one patients newly diagnosed with NPC were included in this study. The status of depression and anxiety during their hospital stay were evaluated using the self-rating depression scale (SDS) and the self-rating anxiety scale (SAS). Data including sex, age, education, history of smoking, course of disease, sleeping quality and oral pain were also collected and their relationships with depression and anxiety were analyzed as well. Results They had significantly higher mean SAS score (36.41 ± 7.41) and SDS score (48.42 ± 7.19), as compared with the healthy population. Single factor analysis indicated that age, education, history of smoking, course of disease, sleeping quality, and oral pain had significant impact on the scores of SAS and SDS. Multivariate logistics regression analysis indicated that age, education, history of smoking, course of disease, sleeping quality, and oral pain had significant impact on their anxiety and depression. Conclusions Depression and anxiety are common psychological problems in NPC patients. Patients at the middle to elderly age and with low education, history of smoking, bad sleeping quality and oral pain are more susceptible to depression and anxiety.

Objective To explore the characteristics of respiratory tract microbiota and its clinical significance in children with protracted bacterial bronchitis (PBB).Methods Twelve children aged from 5 months to 2 years old with PBB (PBB group) and 12 age-matched tracheomalacia(TM) children (TM group) were included in this study,who were admitted into the Respiratory Department of Shenzhen Children's Hospital.Their bronchoalveolar lavage fluid (BALF) samples were collected.Bacterial DNA was extracted from their BALF samples and the 16S rRNA V3-V4 region was sequenced by using Illumina MiSeq TMII system,and the findings were analyzed by bioinformatics methods.Results Principal component analysis revealed the difference in microbiota composition between 2 groups.Compared with TM group,PBB group exhibited lower microbial diversity:the Shannon indices were also 1.683 ± 0.703 and 2.324 ± 0.142 for PBB group and TM group respectively,and the differences were also significant(all P ＜ 0.05),and the Simpson indices were 0.416 ± 0.216 and 0.191 ± 0.025 for PBB group and TM group,respectively,and the differences were also significant (all P ＜ 0.05).The relative abundance of Actinobacteria was significantly lower in PBB group [(0.215 ± 0.228) ％] than that in TM group [(3.028 ± 0.592) ％] (P ＜ 0.01).The proportions of beneficial genera obviously decreased in PBB group,including Lactococcus [(13.464±7.319)％ in PBB group,and (44.784 ± 5.020)％ in TM group,P ＜0.01],Lactobacillus [(0.153 ±0.076)％ in PBB group,and (0.313 ±0.060)％ in TM group,P＜0.01],andArthrobacter [(0.024 ±0.018)％ in PBB group,and (2.970 ±0.584)％ in TM group,P＜0.01].On the other hand,the relative abundances of opportunistic pathogenic genera increased in PBB group significantly,including Haemophilus [(14.319 ± 29.532) ％ in PBB group,and (0.047 ± 0.127) ％ in TM group,P ＜ 0.Ol],Pseudomonas [(10.406 ± 25.439) ％ in PBB group,and (7.228 ± 0.948) ％ in TM group,P ＜ 0.01],and Escherichia [(0.432 ±0.441)％ in PBB group,and (0.055 ±0.035)％ in TM group,P ＜0.01].Conclusion These findings confirmed the existence of respiratory tract microbiotia dysbiosis in PBB,which probably was one of the pathogenetic mechanisms for PBB.

OBJECTIVETo investigate the role of spd1672 gene in the infection process of Streptococcus pneumoniae.

METHODSBALB/c mice were intraperitoneally infected by a spd1672 knockout strain and a D39 wild-type strain of S. pneumoniae, and the survival time of mice and blood bacterial counts were recorded. The adhesion and invasion ability of S. pneumoniae strains were assessed in A549 cells. Bactericidal assays were carried out to determine the resistance of spd1672 knockout strains and D39 wild strains, and the serum levels of inflammatory cytokines were detected in the infected mice.

RESULTSThe mice infected with spd1672 knockout strains showed a significantly longer median survival time, a higher survival rate, and a lower blood bacterial load than the wild strain-infected mice (P<0.05). Having a similar cell adhesion ability to the wild-type strain (P>0.05), the spd1672 knockout strain showed significantly lower cell invasion ability than the wild-type strain (P<0.05). The spd1672 knockout strain also had a reduced resistance to whole blood cells, and thw mice infected with spd1672 knockout strain exhibit lower levels of serum inflammatory cytokines than those infected with the wild-type strain.

CONCLUSIONSpd1672 gene is importantly related to the virulence of S. pneumoniae and plays important roles in modulating bacterial invasion, resistance to whole blood cells and proinflammatory responses.

Animals ; Bacterial Proteins ; genetics ; Cell Line, Tumor ; Gene Knockout Techniques ; Humans ; Mice ; Mice, Inbred BALB C ; Streptococcus pneumoniae ; genetics ; pathogenicity ; Virulence

OBJECTIVETo analyze the clinical characteristics of negative pressure pulmonary edema (NPPE).

METHODA retrospective investigation of the clinical manifestation, imageology, clinical course and outcome of 4 children with NPPE seen between June 2012 and July 2013 in a children's hospital. The causation of the airway obstruction was also explored.

RESULTAll the 4 cases were boys, the range of age was 40 days to 9 years. They had no history of respiratory and circulatory system disease. In 3 cases the disease had a sudden onset after the obstruction of airway, and in one the onset occurred 1.5 hours after removing the airway foreign body. All these cases presented with tachypnea, dyspnea, and cyanosis, none had fever. Three cases had coarse rales. Chest radiography was performed in 3 cases and CT scan was performed in 1 case, in all of them both lungs displayed diffuse ground-glass-like change and patchy consolidative infiltrates. Three cases were admitted to the ICU, duration of mechanical ventilation was less than 24 hours in 2 cases and 39 hours in one. Oxygen was given by mask to the remaining one in emergency department, whose symptoms were obviously improved in 10 hours. None was treated with diuretics, glucocorticoids or inotropic agents. Chest radiographs were taken within 24 hours of treatment in 2 cases and 24-48 hours in the other 2; almost all the pulmonary infiltrates were resolved. All the 4 cases were cured. The causes of airway obstruction were airway foreign bodies in two cases, laryngospasm in one and laryngomalacia in the other.

CONCLUSIONNPPE is a life-threatening emergency, which is manifested by rapid onset of respiratory distress rapidly (usually in several minutes, but might be hours later) after relief of the airway obstruction, with findings of pulmonary edema in chest radiograph. The symptoms resolve rapidly by oxygen therapy timely with or without mechanical ventilation. In children with airway obstruction, NPPE should be considered.

Acute Disease ; Airway Obstruction ; complications ; Child ; Child, Preschool ; Foreign Bodies ; complications ; Humans ; Infant ; Intensive Care Units ; Intubation, Intratracheal ; methods ; Laryngismus ; complications ; Larynx ; Lung ; diagnostic imaging ; pathology ; Male ; Oxygen Inhalation Therapy ; Positive-Pressure Respiration ; methods ; Pulmonary Edema ; diagnosis ; etiology ; therapy ; Radiography, Thoracic ; Retrospective Studies ; Tomography, X-Ray Computed

Objective To investigate the hemoglobin (Hb) levels during pregnancy and Hb changes from early pregnancy and association with birth weight on infants.Methods Mothers of Zhuang Nationality who participated in the pregnancy care program and delivered at the Pingguo County Hospital from May 2013 to May 2015 were included in this study.Retrospective analysis was applied to collect data of health care and pregnancy outcomes.Multiple regression analysis and unconditional logistic regression model were used for data analysis.Results The mean birth weight appeared as (313 5.92± 435.84) grams.The Hb levels at early pregnancy showed significantly positive association with birth weight.Results from our study demonstrated that when Hb levels increased +1 g/dl at early pregnancy,birth weight would increase 17.61(95％CI:0.60-34.67) grams,in the adjusted model.The Hb levels at late pregnancy were significantly inversely associated with birth weight.Our findings suggested that when Hb levels increased + 1 g/di at late pregnancy,birth weight would reduce 19.61(95％ CI:-37.53--1.70) grams in the adjusted model.Changes in Hb from early pregnancy stages were significantly inversely associated with birth weight after adjusting for confounders and Hb levels in the early pregnancy stages.The results also indicated that when Hb levels increased a + 1 g/dl from early to late pregnancy,the birth weight would decrease 32.63 g(95％ CI:-48.93--16.32).Compared to the non-anemia group,the anemia group showed significantly increase of small-for-gestational-age (SGA)(OR=1.58,95％CI:1.08-2.32) in early pregnancy.Compared to women under the most reduction status,women with the least reduction had a significantly increase of SGA (OR=1.87,95％CI:1.24-2.81) among their infants.With the magnitude of reduction on Hb concentration during pregnancy,the risk of delivering babies with SGA showed a gradual trends of increase.Conclusion Hb levels at early pregnancy were positively associated with birth weight,but the changes of Hb were inversely associated with birth weight at late pregnancy,in women of Zhuang Nationality.Anemia in early pregnancy and the low amplitude of decreased Hb concentration during pregnancy were both risk factors for newborns under less gestational ages.

Objective To investigate the risk factors for post-traumatic hydrocephalus ( PTH) after traumatic brain injury ( TBI ) . Methods A retrospective case control analysis was made on the clinical data of 794 patients with acute TBI admitted to Shenzhen Second People's Hospital between January 2007 and January 2017. There were 639 males and 155 females, aged 1-90 years [(40. 5 ± 18. 6)years]. All patients were followed up for 1 years, and the patients were divided into PTH group (n=46) and non-PTH group (n=748) according to their prognosis. The following information including Glasgow coma score ( GCS ) on admission, pupil reflex, midline shift and cistern compression, subarachnoid hemorrhage ( SAH ) , operation method, decompressive craniectomy, hydrocephalus after operation, intracranial infection, timing of cranioplasty were analyzed using univariate analysis and Logistic regression. Results PTH occurred in 46 patients (5. 8％). Univariate analysis showed that GCS, midline shift, decompressive craniectomy, subdural effusion, timing of cranioplasty and SAH were significantly related to PTH (P<0. 05 or 0. 01). Logistic regression identified low GCS (OR=3. 778), decompressive craniectomy (OR=2. 508), subdural effusion (OR=2. 269), timing of cranioplasty (≥3 months)(OR=10. 478) and SAH (OR=23. 391) as the independent risk factors for PTH (P<0. 05 or 0. 01). Conclusion PTH is a common serious complication of traumatic brain injury, affected by low GCS, decompressive craniectomy, subdural effusion, delayed cranioplasty and SAH.