Humans ; Ankle ; Ankle Joint/surgery* ; Arthritis ; Arthrodesis ; Lower Extremity ; Hemophilia A/complications*

OBJECTIVE: To investigate the current status of antibiotic use for very and extremely low birth weight (VLBW/ELBW) infants in neonatal intensive care units (NICUs) of Hunan Province. METHODS: The use of antibiotics was investigated in multiple level 3 NICUs of Hunan Province for VLBW and ELBW infants born between January, 2017 and December, 2017. RESULTS: The clinical data of 1 442 VLBW/ELBW infants were collected from 24 NICUs in 2017. The median antibiotic use duration was 17 days (range: 0-86 days), accounting for 53.0% of the total length of hospital stay. The highest duration of antibiotic use was up to 91.4% of the total length of hospital stay, with the lowest at 14.6%. In 16 out of 24 NICUs, the antibiotic use duration was accounted for more than 50.0% of the hospitalization days. There were 113 cases with positive bacterial culture grown in blood or cerebrospinal fluid, making the positive rate of overall bacterial culture as 7.84%. The positive rate of bacterial culture in different NICUs was significantly different from 0% to 14.9%. The common isolated bacterial pathogens Klebsiella pneumoniae was 29 cases (25.7%); Escherichia coli 12 cases (10.6%); Staphylococcus aureus 3 cases (2.7%). The most commonly used antibiotics were third-generation of cephalosporins, accounting for 41.00% of the total antibiotics, followed by penicillins, accounting for 32.10%, and followed by carbapenems, accounting for 13.15%. The proportion of antibiotic use time was negatively correlated with birth weight Z-score and the change in weight Z-score between birth and hospital discharge (r=-0.095, -0.151 respectively, P<0.01), positively correlated with death/withdrawal of care (r=0.196, P<0.01). CONCLUSIONS Antibiotics used for VLBW/ELBW infants in NICUs of Hunan Province are obviously prolonged in many NICUs. The proportion of routine use of third-generation of cephalosporins and carbapenems antibiotics is high among the NICUs.
Anti-Bacterial Agents ; Birth Weight ; Humans ; Infant ; Infant, Extremely Low Birth Weight ; Infant, Newborn ; Intensive Care Units, Neonatal ; Surveys and Questionnaires

OBJECTIVETo investigate the current status of the application of H-magnetic resonance spectroscopy (H-MRS) in neonates with hypoxic-ischemic encephalopathy (HIE), and to describe the trend of research in the field.

METHODSPubMed, EMBASE, and Web of Science were searched for English articles published up to January 10, 2018, with the combination of key words and MeSH terms. The articles were screened according to inclusion and exclusion criteria. Excel 2016, Bicomb 2.0, and VOSviewer1.6.6 were used to analyze the key words, to perform a cluster analysis of hot words, and to plot the knowledge map.

RESULTSA total of 66 articles were included, and 27 high-frequency key words were extracted. The results showed that H-MRS was mainly used in four directions of the clinical practice and scientific research on HIE. In clinical practice, H-MRS attracted wide attention as a clinical examination for HIE and a tool for prognostic evaluation; in scientific research, H-MRS was used in animal experiments and studies associated with mild hypothermia therapy.

CONCLUSIONSAs an auxiliary means of magnetic resonance imaging, H-MRS plays an important role in investigating the pathogenesis of neonatal HIE, improving existing therapies, and evaluating the prognosis of neonates with HIE.

Female ; Humans ; Hypoxia-Ischemia, Brain ; diagnosis ; diagnostic imaging ; Infant, Newborn ; Infant, Newborn, Diseases ; diagnosis ; diagnostic imaging ; Magnetic Resonance Imaging ; methods ; Male

Rotator cuff injury is a common shoulder disease,which often results in pain and limited motion of shoulder and reduces the quality of life.There are some limitations for current treatments,which often lead to repair failure or reinjury of rotator cuff.Therefore,a novel repair technique is needed.Biologic repair represents a novel technique in the management of rotator cuff injury,and has the potential to restore the normal histological structure of rotator cuff.Biologic repair involves the application of growth factors and/or cells to promote the regeneration of rotator cuff tendons. This study reviewed the literatures on biologic repair of rotator cuff injury,and presented the research progress.

Background: Disease-modifying therapy is the standard treatment for patients with multiple sclerosis (MS) in remission. The primary objective of the current analysis was to assess the efficacy and safety of two teriflunomide doses (7 mg and 14 mg) in the subgroup of Chinese patients with relapsing MS included in the TOWER study. Methods: TOWER was a multicenter, multinational, randomized, double-blind, parallel-group (three groups), placebo-controlled study. This subgroup analysis includes 148 Chinese patients randomized to receive either teriflunomide 7 mg (n = 51), teriflunomide 14 mg (n = 43), or placebo (n = 54). Results: Of the 148 patients in the intent-to-treat population, adjusted annualized relapse rates were 0.63 (95% confidence interval [CI]: 0.44, 0.92) in the placebo group, 0.48 (95% CI: 0.33, 0.70) in the teriflunomide 7 mg group, and 0.18 (95% CI: 0.09, 0.36) in the teriflunomide 14 mg group; this corresponded to a significant relative risk reduction in the teriflunomide 14 mg group versus placebo (-71.2%, P = 0.0012). Teriflunomide 14 mg also tended to reduce 12-week confirmed disability worsening by 68.1% compared with placebo (hazard ratio: 0.319, P = 0.1194). There were no differences across all treatment groups in the proportion of patients with treatment-emergent adverse events (TEAEs; 72.2% in the placebo group, 74.5% in the teriflunomide 7 mg group, and 69.8% in the teriflunomide 14 mg group); corresponding proportions for serious adverse events were 11.1%, 3.9%, and 11.6%, respectively. The most frequently reported TEAEs with teriflunomide versus placebo were neutropenia, increased alanine aminotransferase, and hair thinning. Conclusions: Teriflunomide was as effective and safe in the Chinese subpopulation as it was in the overall population of patients in the TOWER trial. Teriflunomide has the potential to meet unmet medical needs for MS patients in China. Trial Registration ClinicalTrials.gov, NCT00751881; https://clinicaltrials.gov/ct2/show/NCT00751881?term=NCT00751881&rank=1.
China ; Crotonates ; administration & dosage ; adverse effects ; therapeutic use ; Double-Blind Method ; Drug Administration Schedule ; Humans ; Immunosuppressive Agents ; administration & dosage ; adverse effects ; therapeutic use ; Multicenter Studies as Topic ; Multiple Sclerosis ; drug therapy ; metabolism ; Proportional Hazards Models ; Toluidines ; administration & dosage ; adverse effects ; therapeutic use

OBJECTIVETo evaluate the clinical feasibility of particle impaction bone graft and plate internal fixation for the treatment of proximal femoral bone tumors or tumor disease.

METHODSFrom January 2013 to January 2016 a total of 26 cases of the proximal femur bone tumors or tumor lesions, neither pathological fracture, were retrospectively analyzed, including 12 males and 14 females with an average age of 34.2 years old ranging from 8 to 62 years old. The pathologic result involved fibrous dysplasia in 11 cases, bone isolation bone cyst in 7 cases, giant cell tumors of bone in 3 cases, aneurysm sample bone cyst in 3 cases, non ossifying fibroma in 1 case, benign fibrous histiocytoma in 1 case. No biopsy of the lesion was performed before the operation. Postoperative lesions were sent to pathology. The operation was treated by particle impaction bone graft and plate internal fixation.

RESULTSAll patients were followed up to resume normal life for 8 to 42 months with an average of 25 months. The function assessment referenced to the bone and soft tissue tumor association (MSTS). At the end of the last examination, the positive and lateral X-ray films of the femur showed no low density shadow in the margin of bone graft and bone graft, and the bone healing in the bone graft area was good. No recurrence or metastasis was found in all patients, and no loosening or deformation of the internal fixator occurred. The hip function was well restored and no fracture or deformity progressed in all patients.

CONCLUSIONSThe tumor recurrence in the proximal femur is related to curettage and bone grafting. After the curettage, the residual tumor cells were treated by chemical and physical methods. By this method, the disease can be cured for a long time, and it can reduce the recurrence and resume the function of the hip joint.

OBJECTIVETo investigate the effect of premature rupture of membranes (PROM) on maternal infections and outcome of preterm infants.

METHODSA total of 441 preterm infants and 387 mothers were enrolled as subjects. According to the presence or absence of PROM, the mothers were divided into non-PROM group with 104 mothers, PROM duration <72 hours group with 90 mothers, and PROM duration ≥72 hours group with 193 mothers. The three groups were compared in terms of clinical features of mothers and infants and complications.

RESULTSCompared with the control group and the PROM duration <72 hours group, the PROM duration ≥72 hours group had significantly higher maternal age, incidence rate of umbilical vasculitis, and rate of antibiotic use; the PROM duration ≥72 hours group had a significantly higher incidence rate of moderate-to-severe chorioamnionitis than the control group (P<0.05), while there was no significant difference between the PROM duration ≥72 hours group and the PROM duration <72 hours group (P>0.05). Compared with the control group and the PROM duration <72 hours group, the PROM duration ≥72 hours group had significantly higher incidence rates of pneumonia and intracranial hemorrhage in preterm infants; the PROM duration ≥72 hours group had a significantly higher incidence rate of congenital infection and a significantly longer mean length of hospital stay compared with the control group (P<0.05), while there were no significant differences between the PROM duration ≥72 hours group and the PROM duration <72 hours group (P>0.05). The multivariate analysis showed that PROM duration ≥72 hours was an independent risk factors for pneumonia (OR=2.200, 95%CI: 1.386-3.492) and intracranial hemorrhage (OR=2.331, 95%CI: 1.420-3.827) in preterm infants.

CONCLUSIONSPROM duration ≥72 hours significantly increases the risk of placental infection in mothers and it is an independent risk factor for pneumonia and intracranial hemorrhage in preterm infants.

Adolescent ; Adult ; Chorioamnionitis ; etiology ; Female ; Fetal Membranes, Premature Rupture ; Humans ; Infant, Newborn ; Infant, Premature ; Intracranial Hemorrhages ; etiology ; Logistic Models ; Pregnancy ; Pregnancy Complications, Infectious ; etiology ; Time Factors ; Young Adult

OBJECTIVETo investigate the research on neonatal jaundice in recent years by co-word analysis and to summarize the hot spots and trend of research in this field in China.

METHODSThe CNKI was searched with "neonate" and "jaundice" as the key words to identify the papers published from January 2009 to July 2013 that were in accordance with strict inclusion and exclusion criteria. To reveal the relationship between different high-frequency key words, Microsoft Office Excel 2013 was used for statistical analysis of key words, and Ucinet 6.0 and Netdraw were used for co-occurrence analysis.

RESULTSA total of 2 054 papers were included, and 44 high-frequency key words were extracted. The current hotspots of research on neonatal jaundice in China were displayed, and the relationship between different high-frequency key words was presented.

CONCLUSIONSThere has been in-depth research on clinical manifestations and diagnosis of neonatal jaundice in China, but further research is needed to investigate the etiology, mechanism, and treatment of neonatal jaundice.

Biomedical Research ; Humans ; Infant, Newborn ; Jaundice, Neonatal ; complications ; diagnosis ; therapy