Objective To monitor the changes of resting energy expenditure in ventilated critically ill children,to compare the results of standard equations and indirect calorimetry (IC) in predicting energy expenditure,and to investigate the possible influence factors of the metabolic status of the critically ill children.Methods From September 2012 to September 2013,56 critically ill children on assisted ventilation and fitting the requirements of IC in pediatric intensive care unit of Shanghai Children's Medical Center were enrolled in this prospective study.IC measurements were performed using metabolic cart on day 1,4,7,10 after trachea intubation.General clinical data of these children were recorded.Results 130 IC measurements were performed in the 56 children.The measured resting energy expenditure (MREE) did not exhibit significant differences among day 1,4,7,and 10 (P =0.379).Although there were no significant differences between MREE and energy expenditure predicted with Schofield and WHO equations (P =0.917,P =0.995),the agreement was poor between the measured and predicted values (R2 =0.185,R2 =0.322).The metabolic status of the children on day 1 of ventilation was only correlated with age (P =0.000) and height (P =0.027),not with severity of underlying diseases or clinical outcomes.Conclusions MREE of IC method in ventilated critically ill children did not significantly change over time in this study.A poor agreement was observed between equationpredicted energy expenditure and MREE.IC measurement of resting energy expenditure is recommended for guiding individual nutritional support among critically ill children so as to improve clinical outcome.

Objective To assess the nutritional status of critically ill children and the nutritional intake during their stay in pediatric intensive care unit (PICU),and analyze the correlation factors of nutritional deftciencies.Methods One hundred and twenty-seven patients who met the PICU admission standards with a PICU stay of ＞72 h were recruited from June to October 2012 in Shanghai Children's Medical Center.Anthropometric measurements and all nutrition-related indicators of those patients were recorded from day 1 to day 10.Results 59 of the 127 patients (46.5％) showed malnutrition at admission,in which 49.2％ had severe malnutrition.65 of the 127 patients (51.2％) showed malnutrition at discharge,in which 63.1％ were severely malnourished.Median estimated energy requirements (EER) by American Society for Parenteral and Enteral Nutrition was 376.7 kJ/ (kg · d) [interquartile range,IQR:314.0～376.7 kJ/ (kg · d)],prescribed calories were 237.8 kJ/ (kg· d) [IQR:159.5 ～291.8 kJ/ (ks· d)],and delivered calories were 220.2 kJ/ (kg· d)[IQR:132.3 ～ 279.2 k J/ (kg · d)],showing significant difference (P =0.000).The delivered energy was ＜90％ of EER in 80.7％ of the 1021 recorded days and the prescribed energy was ＜90％ of EER in 74.3％of the 1021 recorded days.The cumulative calory deficiency from day 1 to day 10 in PICU was (933.5 ±745.5) kJ/ (kg · person),and the cumulative protein deficiency was (4.0 ±5.0) g/ (kg · person).83 patients (65.4％) experienced at least one feeding interruption.Altogether 170 times of feeding interruption were recorded,of which 117 (68.8％) could be explained by examination procedures.Conclusions There is a high prevalence of malnutrition in critically ill children at admission into PICU,and their nutritional status deteriorates during hospital stay.Discrepancies between required and delivered energy were mainly attributed to under-prescription,while discrepancies between prescribed and delivered energy were mainly attributed to feeding interruptions.Appropriate care for these children entails early nutritional risk screening and correct nutrition support to avoid nutritional deficiencies.

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OBJECTIVETo describe a HPLC method for assessing betaine in Fufang Guilu granule.

METHODThe content of betainephenaxcyl bromide in Fufang Guilu granule was determined by HPLC. The analytical column was a shim-pack CLC-ODS (6.0 mm x 150 mm) filling a 5 microm stationary phase; The mobile phase consisted of acetonitrile-water(35:65) with 0.1 mol x L(-1) NaClO4; The flow-rate was 1 mL x min (-1); The detector was set at 254 nm.

RESULTThe calibration curve was linear over the range of 0.09-0.585 microg (r = 0.9997). The average recovery of the method was 98.4%, RSD 2.5% (n = 5).

CONCLUSIONThe results showed that this method was reliable and accurate, and can be used for quality control of Fufang Guilu granule.

Betaine ; analysis ; Chromatography, High Pressure Liquid ; methods ; Codonopsis ; chemistry ; Drug Combinations ; Drugs, Chinese Herbal ; chemistry ; Lycium ; chemistry ; Plants, Medicinal ; chemistry ; Quality Control ; Reproducibility of Results

In 2013, Shanghai Medical College of Fudan University restarted the enrollment of the undergraduate students in directional pediatrics. To cultivate medical talents in pediatrics, a serious of educational innovations and practices have been carried out guided by competency training, including training a team of teachers with simulated teaching skills and establishing a teaching platform for simulation teaching. Medical students can practice medicine and gain experience through the risk-free simulated scenarios, that is helpful to enhance their confidence in clinical skills and communications and decrease medical errors in their future careers.

Objective:To investigate the antibacterial efficacy of allicin effective component,dially trisulfide(DATS),on the biofilms of Enterococcus faecalis(E.faecalis)in vitro.Methods:60 healthy single root canal permanent teeth were selected.After cleaning and autoclaving,15 teeth without infection were used in the negative control group,45 teeth were contaminated by E.faecalis and incubated for 28 days as the infection models and devided into 3 groups(n=15)as below:DATS group,Calcium hydroxide group and positive(without antibacteria treatment)control group.The minial inhibition concentration(MIC)and minial bactericidal concentrition(MBC)of DATS on E.feacalis were studied with doubling diluting method.At the day 1,2 and 7 of the exprement,the 4 mg of root canal in-ner dentin powder,5 specimens of each group were sespectively transfered into sterile bottle containing 2 mL BHI broth and cultured at 37 ℃ 5％CO2 for 72 h,the turbitity of the upper layer of liquid of the culture was measured.Results:MIC and MBC(μg/mL)of DATS to E.feacalis was 2 560 and 5 120 repsectively.At the first day,turbidity in the DATS group was the lowest(P＜0.05).At the third day,turbidity showed no difference between DATS group and negative control group(P=0.454).At the 7th day,between calcium hydroxide and the negative control group,P＜0.05.Conclusion:DATS may suppress E.faecalis in the biofilm in vitro.

Objective To explore the epidemiological characteristics of mycoplasma pneumoniae (MP) infection in hospitalized children between 2019 and 2022, and to provide a basis for the prevention and treatment of the disease in the clinic. Methods Blood samples of 12 830 children hospitalized for respiratory tract infection in our hospital between January 2019 and December 2022 were collected, and tested for MP infection, then the prevalence of MP infection in different years, seasons, genders and ages was analyzed. Results The total positive rate of MP was 16.55% (2 123 / 12 830). The annual prevalence rate of MP infection decreased from 17.97% in 2019 to 16.48% in 2022, with statistical difference (P<0.05). In terms of gender, the prevalence of MP infection was higher in females at a rate of 19.38% (1 198 / 6 182) compared with a rate of 13.91% (925 / 6 648) in males, with statistical difference (χ²=69.277, P<0.05).The positive rates in summer (19.84%) and autumn (19.57%) were higher than those in spring (12.97%) and winter (12.38%) (P<0.05) In terms of age, the positive rate of MP infection was 9.68% in < 1 age group, 12.95% in 1-3 age group, 18.23% in 4-6 age group and 23.23% in > 6 age group (P<0.05), with the highest positive rate in > 6 age group. The positive rate of MP infection was 15.49% in acute upper respiratory tract infection , 17.28% in acute lower respiratory tract infection , 16.43% in severe pneumonia, and 16.71% in other diseases, with no statistical difference (P>0.05). Conclusion MP is one of the main pathogens of respiratory infections in hospitalized children. Despite the decreasing trend in MP infection rate in hospitalized children between 2019 and 2022, it remains above the norm. MP infection is characterized by a high prevalence in summer and autumn, children >6 years of age, and girls, so effective measures should be taken to guide clinical anti-infection strategies to improve the physical and mental health of children in this region.

Adult ; Humans ; Male ; Multiple Myeloma ; pathology ; Neoplasm Invasiveness

Objective To analyze clinicopathological characteristics and the potential risk-related factors of female breast hyperplasia in different age groups.Method From Jan 2015 to Dec 2016,patients diagnosed with breast hyperplasia in 12 hospitals were evaluated.All patients completed the self-designed questionnaires on women'health,including basic demographic information,clinic examination information,radiologic information and pathologic results.The patients were divided into a young group (＜ 45 years old) and an elderly group (from 45 to 75 years old).Results There were 3 684 cases of breast hyperplasia,including 2 291 cases in young group and 1 393 cases in elder group,respectively Clinically breast pain type were most commonly observed in both young and older groups (50.3％ vs.42.7％,P ＜ 0.001).While pathological research based on biopsy showed that breast adenopathy were the most common changes in both groups (67.9％ vs.61.7％,P ＜0.001).More breast cancer cases were identified in elder group than that in young group,especially in clinically lump type patients (9.4％ vs.4.2％,P ＜ 0.001).Compared with elder group,patients in young group have different distribution characteristics regarding to fertility factors,lifestyle factors and psychology scale including anxiety and depression.Conclusion Distributions of clinicopathological characteristics and risk factors of female breast hyperplasia differ across different age groups.

Objective To investigate the effects of magnesium sulfate and magnesium L-sulfonate on the neurobehavioral response and the expression of induced nitric oxide synthase (iNOS) in neurons after acute cerebral ischemia in rats. Methods One hundred and twelve male Sprague-Dawley ( SD) rats were double-blinded randomly divided into sham-operated group, middle cerebral artery occlusion ( MCAO ) group,MgSO4 treatment group,L-MgT treatment group. Each group was further divided into 6 h,12 h and 24 h subgroups according to the different detection time points. Rat MCAO models were produced following the Longa's method. And the Longa score,limb-placing test,rotarod test,and sticky tape test were performed to evaluate the neurological damage,autonomous movement and coordinate perception in the 24 h subgroup. At the end of the experiment,2,3,5-triphenyltetrazolium chloride ( TTC) was used to evaluate the area of cerebral infarction at 24 h reperfusion. Immunohistochemical staining was employed to determine the altera-tions in iNOS expression in neurons 6 h,12 h and 24 h after reperfusion. Results In behavioral evaluation:Longa score:Normal performance was observed in sham-operated group. Compared with the MCAO group,the scores of MgSO4 treatment group(1. 71±0. 18) and L-MgT treatment group(1. 14±0. 14) were decreased (t=0. 548,3. 873,all P<0. 05),and the score of L-MgT treatment group was lower than that of the MgSO4 group(t=2. 828,P<0. 05). Limb symmetry score:There was no statistically significant difference between MgSO4 group and MCAO group,but there was a statistically significant difference between L-MgT group and MCAO group (t=7. 071,P<0. 05). The roding experiment:The time of MgSO4 group and the L-MgT group were significantly different from that of the MCAO group (t=9. 588,20. 776,P<0. 05),and the time of the L-MgT group was significantly higher than that of the MgSO4 group (t=4. 983,P<0. 05). The right limb strip removal experiment: The time of MgSO4 group and L-MgT group were statistically different from that of MCAO group (t=6. 135,5. 825,P<0. 05),and the time of L-MgT group was increased compared with that of MgSO4 group(t=4. 507,P<0. 05). TTC test:No infarction was formed in the sham group. Compared with MCAO group ((36. 82±1. 35)%),the cerebral infarction volume of MgSO4 group ((17. 39±1. 72)%) and L-MgT group ((10. 81 ± 1. 35)%) significantly decreased, with statistically significant differences ( t=8. 874,11. 105,P<0. 05). Compared with MgSO4 group,cerebral infarction volume in L-MgT group was sig-nificantly reduced,with statistical significance (t=2. 593,P<0. 05). HE staining:There was no statistically significant difference in cell morphology between MgSO4 group and MCAO group at each time point,but the cell morphology of L-MgT group was intact compared with that of MCAO group. INOS staining at 24 h:There was no statistically significant difference in the positive cell density between the MgSO4 group and the MCAO group,but the L-MgT group (cortex:(196. 7±8. 1);striatum:(153. 3±3. 8)) positive cell density was lower than that of the MCAO group (cortex:(375. 0±6. 7),striatum:(358. 3±4. 5)),and the difference was sta-tistically significant (t=11. 113,36. 231,P<0. 05). Conclusion L-MgT may have a significantly protective effect on MCAO rats,and its mechanism may be related to the level of iNOS in neurons.