Objective To evaluate the effect of phosphocreatine in the treatment of infant with Pneumonia complicated with myocardial injury.Methods Sixty-eight infants with Pneumonia complicated with myocardial injury were randomized into treatment group (n = 36)and control group (n = 32) .The two groups were both treated with combined anti-infection, antiasthmatic and supporting treatments while the treatment group was given additional phosphocreatine.The ECG,recovery of myocardial enzymes, recovery time of major clinical symptoms and syndromes and the period of hospitalization of the two groups were compared.Results Recovery of ECG and myocardial enzymes in the treatment group (94.44％ and 94.44％)were significantly higher than those in the control group(78.13％ and 75.00％ ,respectively) (x2 =3.93 and 5.11 ,respectively,P ＜0.05).Recovery of clinical presentations were more rapid in the treatment group than that in control group (time for cough recovery, [9.5 ± 2.4]d vs.[11.1 ± 2.6]d ;time for rale disappearance, [8.1 ± 1.9]d vs.[10.3 ± 2.4]d) (t =2.63 and t =4.16 respectively ;P ＜0.05 and ＜0.01 respectively).The period of hospitalization was decreased markedly in the treatment group compared with that in the control group([11.5 ±2.2]d vs.[14.3 ±2.8]d) (t = 4.55, P ＜ 0.01) .ConclusionPhosphocreatine has prominent efficacy in the treatment of infantile Pneumonia complicated with myocardial injury.

Objective To evaluate the accuracy of bispectral index (BIS)-guided closed-loop target controlled infusion (TCI) system in comparison with opened-loop manual TCI during anesthesia of biliary tract and pancreas surgeries.Methods Forty adult patients undergoing open surgery of biliary tract or pancreas under total intravenous anesthesia, including 17 males and 23 females, aged 18-75 years, falling into ASA physical status Ⅱ or Ⅲ, were randomly allocated into closed-loop group (group C, n=20) and opened-loop manual group (group M, n=20).In group M, the propofol effect-site concentration was adapted at the discretion of the anesthesiologist to reach and maintain a BIS as close as possible to 42-52.In the closed-loop TCI group, propofol was administered using the closed-loop anesthesia delivery system to reach and maintain atarget BIS of 42-52.The BIS values would be recorded automatically by the system at each second after it began to run.The anesthesia duration, unconsciousness time, endotracheal intubation time, recovery time and endotracheal extubation time were recorded.The total usage of propfol and remifentanil were calculated.The incidence rates of emergence agitation, postoperative nausea and vomiting and intraoperative awareness were recorded.The frequencies of vasoactive drug were recorded.MDAPE, Wobble, GS through BIS values were calculated.Results BIS was maintained within ±10% of target (excellent) for significantly longer time in group C (52.1±10.5)% than that in group M (37.6±5.8)% (P<0.05).BIS was maintained within ±(10%-20%) of target (good) for the same time in both groups.MDAPE in group C (10.1±2.2)% were significantly lower than those in group M (15.3±6.4)% (P<0.05).GS in group C (23.1±8.9)% was significantly lower than that in group M (33.5±15.8)%.The usages of propofol in group C ·kg-1·min-1 were similar to those in group M (0.12±0.03) mg·kg-1·min-1, and the usages of remifentanil in group C (0.12±0.03) μg·kg-1·min-1 were similar to those in group M (0.15±0.05) μg·kg-1·min-1.The frequencies of vasoactive drug were similar in both groups.There was one incidence of emergence agitation in groups M.Postoperative nausea and vomiting and intraoperative awareness didn't occur in both groups.Conclusion The depth of the anesthesia is maitained more appropriately and stable in the closed-loop group than that in manual administration group.

ObjectiveTo explore the chnical application value of ultrafine electronic endoscopy on the diagnosis of pediatric diseases of upper digestive tract.MethodsSeventy-five cases suspected upper gastrointestinal diseases from January 2009 to June 2010 were selected and were divided by systematic sampling method into observation group(47 cases) which was diagnosed with ultrafine electronic endoscopy and control group(28 cases) which was diagnosed by normal endoscopy.The data of diagnosis and compliance of two groups were observed and compared.ResultsCompliance rate of observation group and control group had significant difference[ 100.0％(47/47) vs.67.9％(19/28),P ＜ 0.01 ].The incidence rates of nausea,salivation and restless of observation group [ 8.5％(4/47 ),6.4％(3/47),8.5％(4/47 ) ]were lower than those of control group [39.3％(11/28),28.6％(8/28),50.0％(14/28)](P＜ 0.01 or ＜ 0.05).Correct diagnosis rate of control group was 84.2％ (16/19),while that of observation group was 95.7％ (45/47),but comparison of diagnosis showed no significant difference(P ＞ 0.05).The incidence rates of diaphragmatic spasm,sore throat and slow heartbeat in successful examination cases of control group[21.1％ (4/19),31.6％ (6/19),21.1％ (4/19) ]significant higher than those of observation group [0,2.1％ ( 1/47),2.1％(1/47) ](P ＜ 0.01 or ＜ 0.05 ).ConclusionUltrafine electronic endoscopy can achieve the same accuracy as normal endoscopy,but compared with normal endoscopy,it can improve the compliance of children during the examination and reduce the incidence of postoperative complications.

Objective: To investigate the peripheral blood mucosa-associated constant T cell(MAIT) expression in children with bronchial asthma and its relevance to severity. Methods: Ninety-eight children with bronchial asthma who were treated in Affliated Dongfeng Hospital from May 2016 to May 2019 were selected as the asthma group. Another 60 healthy children who underwent health checkup during the same period were as control group. The levels of MAIT were detected by flow cytometry analyzer using BD FACSAria II flow cytometry, and the lung function was detected by Yage lung function tester. The receiver operating characteristic (ROC) curve was used to evaluate the diagnostic efficacy of peripheral blood MAIT for bronchial asthma. Pearson analysis was used to examine the relationship between MAIT cells and pulmonary function. Results: There were no significant differences in the general data of gender, age, and body mass index between the two groups (P>0.05). The asthma control test (ACT) score, the percentage of first second forced expiratory volume occupied estimated value (FEV₁%), the percentage of first second forced expiratory volume occupied forced vital capacity (FEV₁/FVC), the percentage of peak expiratory flowoccupied estimated value (PEF), and MAIT cells in asthma group were significantly lower than those in control group (P<0.05). Serum MAIT identified bronchial asthma and healthy controls with an area under curve (AUC) of 0.900, with a sensitivity of 82.65%, and a specificity of 85.00%. Serum MAIT identified the mild-sustained group and the healthy control group with an AUC of 0.910, with a sensitivity of 94.64%, and a specificity of 81.67%. Correlation analysis showed that MAIT cells in children with bronchial asthma were significantly positively correlated with pulmonary function indexes such as FEV₁%, FEV₁/FVC and PEF (r=0.159, 0.222, 0.213, P<0.05). Conclusions The peripheral blood MAIT in children with bronchial asthma is significantly reduced, which is related to the levels of lung function indicators. MAIT can be used as one of the indicators for the diagnosis and clinical prognosis of patients with bronchial asthma.

Objective To investigate the clinical value of perinuclear antineutrophil cytoplasmic antibody (p-ANCA) and fecal calprotectin in predicting the severity of ulcerative colitis (UC) in children.Methods One hundred children with UC from March 2014 to March 2019 in Affiliated Dongfeng Hospital,Hubei University of Medicine were selected.According to the endoscopic severity index of ulcerative colitis (UCEIS),the children were divided into remission stage (29 cases);active stage (71cases),among whom 43 cases were mild-moderate,and 28 cases were severe.The serum levels of interleukin-6 (IL-6),procalcitonin (PCT),C-reactive protein (CRP),erythrocyte sedimentation rate (ESR),albumin,platelet,hemoglobin,white blood cell and p-ANCA were detected,and the fecal calprotectin was detected.The clinical value of each index in predicting the severity of UC was determined by receiver operating characteristic (ROC) curve.Results The course of disease,IL-6,PCT,CRP,ESR,p-ANCA and calprotectin in remission stage children were significantly lower than those in active stage children:(3.14 ± 1.25) years vs.(3.73 ± 0.89) years,(10.08 ± 4.40)/μg/L vs.(15.84 ± 3.22) μg/L,(1.02 ± 0.38) μg/Lvs.(1.38 ± 0.43) μg/L,(15.92 ± 6.13) mg/L vs.(24.30 ± 6.06) mg/L,(14.75 ± 6.42) mm/1 h vs.(25.31 ± 6.98) mm/1 h,(17.19 ± 4.76) U vs.(28.01 ± 6.12) U and (504.82 ± 127.46) μg/g vs.(717.04 ± 142.30) μg/g,and there were statistical differences (P＜0.05 or ＜0.01).The IL-6,CRP,ESR,white blood cell,p-ANCA and calprotectin in mild-moderate children were significantly lower than those in sever children:(14.56 ± 2.72) μg/L vs.(17.82 ± 2.93) μg/L,(22.01 ± 5.32) mg/L vs.(27.83 ± 5.46) mg/L,(22.31 ± 4.46) mm/1 h vs.(29.91 ± 7.70) mm/1 h,(7.33 ± 1.33) × 109/L vs.(8.38 ± 1.90) × 109/L,(25.52 ± 5.22) U vs.(31.83 ± 5.44) U and (632.80 ± 82.51) μg/g vs.(846.42 ± 11.10) μg/g,and there were statistical differences (P＜0.01 or ＜:0.05).Pearson correlation analysis result showed that,in active children,the UCEIS had high positive correlation with fecal calprotectin (r =0.707,P＜0.01),mild positive correlation with p-ANCA,ESR,IL-6,CRP and albumin (r =0.660,0.650,0.626,0.592 and 0.486;P＜0.01),and low positive correlation with PCT and white blood cell (r =0.362 and 0.245,P＜0.01 or ＜0.05).ROC curve analysis result showed that the optimal cut-off value of p-ANCA was 23.40 U,and the area under curve (AUC) in diagnosis of active stage UC was maximum (0.923),with a specificity of 93.1％ and a sensitivity of 78.9％;the optimal cut-off value of fecal calprotectin was 732.69 μg/g,and the AUC in diagnosis of active stage UC was maximum (0.937),with a specificity of 93.0％ and a sensitivity of 92.9％.Conclusions Serum p-ANCA is useful for UC disease activity diagnosis in children,while fecal calprotectin is independent predictor of the severe of UC.

Objective:To explore the risk factors of rotavirus enteritis with myocardial injury and the value of establishment of a risk map model.Methods:The clinical data of 247 patients with rotavirus enteritis in Dongfeng Hospital of Hubei University Medicine from January 2017 to December 2018 were retrospectively analyzed. They were divided into the myocardial injury group(158 patients) and the non-myocardial injury group(89 patients) according to the happening of myocardial injury, and the basic information of all patients was retrieved. Independent risk factors for mycotic enteritis with myocardial injury were analyzed by univariate analysisand multiple Logistic regression analysis.A nomogram prediction model was established using R software, and the accuracy and discrimination of the nomogram model were verified.Results:The univariate analysis showed that the age, vomiting, severe dehydration, electrolyte disturbance, acidosis, and abnormal electrocardiogram were the risk factors of rotavirus enteritis with myocardial injury ( P < 0.05). The multivariate Logistic regression analysis showed that the age ranged between 6 months and 1 year ( OR = 1.989, 95% CI 1.123-3.524), vomiting ( OR = 2.509, 95% CI 1.405-4.480), severe dehydration ( OR = 2.782, 95% CI 1.083-7.142), electrolyte disturbance ( OR = 1.655, 95% CI 1.011-3.007) and acidosis ( OR = 2.417, 95% CI 1.348-4.332) were independent risk factors for rotavirus enteritis with myocardial injury ( P < 0.05). The collinear chart prediction model established showed that it had good prediction ability. At the same time, the collinear chart model was verified using Bootstrap internal verification method. The C-index index was 0.736 (95% CI 0.704-0.768) indicated that the column of the line graph model had good accuracy and discrimination. Conclusions:Ages from 6 months to 1 year, vomiting, severe dehydration, electrolyte disturbance, and acidosis are independent risk factors for rotavirus enteritis with myocardial injury. The establishment of a related nomogram predictive model is helpful for clinical personnel to screen high-risk populations and has guiding significance in prevention and treatment measures.

Objective To investigate the diagnostic value of lactate dehydrogenase (LDH) isoenzymes in children with refractory mycoplasma pneumoniae pneumonia (RMPP). Methods One hundred and forty-seven children with mycoplasma pneumoniae pneumonia (MPP) in Children′s Medical Center, Dongfeng Hospital Affiliated to Hubei University of Medicine from July 2016 to July 2018 were selected. Among them, RMPP was in 54 cases (RMPP group), and non-RMPP was in 93 cases (non-RMPP group). The white blood cell count (WBC), C- reactive protein (CRP), erythrocyte sedimentation rate (ESR), aspartate aminotransferase (AST), alanine aminotransferase (ALT) and creatine kinase (CK) were detected; meanwhile, the serum levels of total LDH and LDH isoenzymes (LDH1, LDH2, LDH3, LDH4 and LDH5) were measured by radioimmunoassay. Results The ESR, AST, ALT, LDH1, LDH2, LDH4, LDH5 and total LDH in RMPP group were significantly higher than those in non-RMPP group:(23.15 ± 3.62) mm/h vs. (19.45 ± 3.04) mm/h, (37.20 ± 6.82) U/L vs. (31.49 ± 4.70) U/L, (35.48 ± 5.72) U/L vs. (27.31 ± 7.22) U/L, (89.77 ± 5.26) U/L vs. (85.01 ± 7.65) U/L, (154.60 ± 22.30) U/L vs. (133.17 ± 32.82) U/L, (61.51 ± 10.09) U/L vs. (47.74 ± 11.22) U/L, (78.99 ± 12.86) U/L vs. (64.98 ± 7.14) U/L and (511.49 ± 38.90) U/L vs. (450.19 ± 47.63) U/L, and there were statistical differences (P＜0.05); there were no statistical differences in WBC, CRP, CK and LDH3 between 2 groups (P＞0.05). Logistic regression analysis result showed that the ESR, AST, ALT, LDH1, LDH4 and LDH5 were the risk factors of RMPP ( OR=0.618, 0.735, 0.785, 0.769, 0.866, 0.880; 95% CI 0.430 to 0.888, 0.596 to 0.906, 0.665 to 0.926, 0.646 to 0.917, 0.781 to 0.961, 0.803 to 0.965; P<0.01). Receiver operating characteristic curve analysis result showed that the area under curve (AUC) of RMPP predicted by LDH5 was the largest (0.857), and then by LDH4 (0.819). The critical values were 70.74 and 53.14 U/L respectively; the AUC of RMPP predicted by LDH4 combined with LDH5 was 0.914, and the critical values was 130.10 U/L, with a sensitivity of 83.3% and a specificity of 92.5% , 95% CI 0.856 to 0.954. Conclusions Serum levels of LDH4 and LDH5 are significantly increased in children with RMPP. LDH4 combine with LDH5 detection might be useful in predicting the occurrence of RMPP.

Objective: To investigate the diagnostic and predictable value of the levels of serum Trx (S-Trx), urinary Trx (U-Trx) and S-Trx/U-Trx ratio in acute pyelonephritis of children. Methods: A total of 120 children with urinary tract infection were divided into APN group (67 cases) and non-APN group (53 cases).In addition, 67 children with APN were assigned to severe group (23 cases)and non-severe group (44 cases). The leves of serum C-reactive protein(CRP), precalcitonin(PCT), cystatin C (CysC), Trx (S-Trx) and urinary β₂-microglobulin(β₂-MG), neutrophill gelatinase-related apolipoprotein (NGAL), Trx (U-Trx) were collected. Besides, the ratio of S-Trx/U-Trx was also counted. The diagnostic and predictable value of each index were determined by receiver operating characteristic (ROC). Results: Serum PCT, S-Trx, urinary β₂-MG, NGAL, U-Trx was markedly increased and S-Trx/U-Trx ratio was obviously decreased in the APN group compared to that of the non-APN group (P<0.05). Moreover, S-Trx, urinary NGAL, U-Trx was significantly increased and S-Trx/U-Trx ratio was significantly decreased in the severe group compared to that of the non-severe group (P<0.05). Both in APN group or severe APN group, S-Trx and U-Trx displayed significantly positive correlation (P<0.05). The results from ROC demonstrated that AUC were 0.960, and optimal cut-off value were 16.17 μg/L of U-Trx diagnostic APN in children, with a specificity and sensitivity of 94.34% and 92.54%, respectively. The optimal cut-off value was 1.29.AUC of S-Trx/U-Trx 0.960 predicted the severe of APN in children, with a specificity and sensitivity of 81.82% and 82.61%, respectively. Conclusions U-Trx is useful for diagnostic APN in children, S-Trx/U-Trx is an independent predictor of the severe APN.

Objective:To evaluate the efficacy and safety of Xiao′er Huangjin Zhike Granules in the treatment of cough caused by acute bronchitis in children, which is defined in TCM terms as a syndrome of phlegm-heat obstructing the lung.Methods:This was a block-randomized, double-blind, placebo-controlled, multicenter clinical trial.From January 2022 to September 2023, 359 children aged 3 to 7 years old diagnosed as acute bronchitis (lung-obstructing phlegm-heat syndrome) were enrolled from 21 participating hospitals and randomly assigned to the experimental group and placebo group in a 3︰1 ratio, and respectively treated with Xiao′er Huangjin Zhike Granules and its matching placebo.Cough resolution/general resolution rate after 7 days of treatment was used as the primary efficacy outcome for both groups.Results:(1)On the seventh day of treatment, the rate of cough disappearance/basically disappearance in the experimental group and placebo group were 73.95% and 57.61% retrospectively, which had statistically significance ( P=0.001).(2)After 7 days of treatment, the median duration of cough disappearance/basic disappearance were 5 days and 6 days in the two groups , with a statistically significant difference ( P=0.006).The area under the curve of cough symptom severity time was 7.20 ± 3.79 in the experimental group and 8.20±4.42 in the placebo group.The difference between the two groups was statistically significant ( P=0.039).(3) After 7 days of treatment, the difference between TCM syndrome score and baseline was -16.0 (-20.0, -15.0) points in the experimental group and -15.0 (-18.0, -12.0) points in the placebo group, with significant difference between the two groups ( P=0.004).In the experimental group, the clinical control rate, the markedly effective rate, the effective rate and the ineffective rate were 49.04%, 28.35%, 16.48% and 6.13% severally; and in the placebo group, the clinical control rate, the markedly effective rate, the effective rate and the ineffective rate were 38.04%, 26.09%, 29.35%, and 6.52% separately, which had statistically significant ( P=0.014).(4) There was no significant difference in the incidence of adverse events or adverse reactions during the trial between both groups.Moreover, while adverse reactions in the form of vomiting and diarrhea were occasionally reported, no serious drug-related adverse event or adverse reaction was reported.(5)The tested drug provided good treatment compliance, showing no statistically significant difference from the placebo in terms of compliance rate. Conclusions:Based on the above findings, it can be concluded that Xiao′er Huangjin Zhike Granules provides good safety, efficacy, and treatment compliance in the treatment of cough caused by acute bronchitis, and lung-obstructing phlegm-heat syndrome, in children.