1.Progress of treatment for status epilepticus in children
Chan XIA ; Xiaoou SHAN ; Qi CHEN
Chinese Pediatric Emergency Medicine 2010;17(1):69-71
Status epilepticus(SE)is one of the most common medical emergencies in children.There has been some recent understanding of this fife-threatening condition with reference to the definition,forms of ignorable seizure,drug treatment and role of EEG monitoring.This review discusses the current information regarding the definition,diagnosis,treatment of status epilepticus and the latest advance on management of refractory SE in children.
2.Clinical manifestations, neuroimaging features, treatment, and follow-up in four pediatric patients with glutaric aciduria type Ⅰ
Qi LIU ; Chan XIA ; Wei CHEN ; Wanding YE ; Yiping CHEN
Chinese Journal of Clinical Nutrition 2017;25(1):40-46
Objective To investigate the clinical features,magnetic resonance imaging (MRI),treatment,and follow-up of patients with glutaric aciduria type Ⅰ (GA-1).Methods Four pediatric patients with GA-1 diagnosed in our hospital were included in this study.They were treated with special diets and carnitine supplements.MRI and tandem mass spectrometry (MS/MS) were performed,and the mental development indices were measured.Results GA-1 was confirmed 2 months,13 months,4 months,and 7 months after birth.Seizure had been observed before the disease diagnosis in three patients and disappeared after treatment.In all four patients,T2-weighted brain MRI showed frontotemporal atrophy or hypoplasia and enlarged subarachnoid space in the sylvian fissures and anterior to the temporal lobes.Diffusion weighted imaging revealed high-density lesions over both the putamen and globus pallidus.The patients were followed up for 4 to 5 years.Plasma amino acids and acylcamitine profile were monitored every 3-5 months.The mean C5DC level and C5DC/C8 were kept the higher limits of the normal ranges,especially in case 3.During the follow-up,the body weight was at-2 SD-0 and the height at-1 SD-0.Intellectual development test showed that case 1 and case 4 had mildly abnormal intelligence,whereas case 2 and case 3 had extremely severe intellectual disability.Gene test confirmed the presence of gene mutations in all four cases,including IVS10-2A > C homozygous mutation in cases 1,3,and 4 and [IVS10-2A > C] + [c.245G >c(p.Arg82Pro)] hybrid mutation in case 2.Two female children were smoothly enrolled by local kindergarten,while two male children were unable to walk alone due to delayed motor development and spastic paralysis.Conclusions The phenotype of GA-1 patients is not remarkably correlated with its genotype correlation.Newborn screening is essential for identifying GA-1 patients.
3.Pathogens causing healthcare-associated urinary tract infection in intensive care unit patients
Denghui LU ; Xia WAN ; Chan LI ; Julan XUE ; Yongquan DU
Chinese Journal of Infection Control 2015;(1):63-64,72
Objective To understand healthcare-associated urinary tract infection (HA-UTI)and pathogens causing HA-UTI in intensive care unit (ICU)patients,so as to provide scientific basis for the prevention and control of HA-UTI. Methods Targeted surveillance data about HA-UTI in 32 hospitals in 2013 were analyzed.Results A total of 23 680 ICU patients were monitored,157 cases of HA-UTI occurred,HA-UTI rate was 0.66%;the usage rate of urinary tract cathe-ter was 80.83%,catheter-associated UTI was 1.25‰.A total of 162 pathogenic strains were detected,the percentage of fungi,gram-negative bacteria,and gram-positive bacteria was 40.74% (n=66);31.48 % (n=51),and 27.78% (n=45)respectively.Conclusion The main pathogens causing HAI-URI are fungi,comprehensive intervention measures should be taken to control HA-UTI in ICU patients.
4.Importance of data management with statistical analysis set division.
Ling WANG ; Chan-juan LI ; Zhi-wei JIANG ; Jie-lai XIA
Acta Pharmaceutica Sinica 2015;50(11):1464-1469
Testing of hypothesis was affected by statistical analysis set division which was an important data management work before data base lock-in. Objective division of statistical analysis set under blinding was the guarantee of scientific trial conclusion. All the subjects having accepted at least once trial treatment after randomization should be concluded in safety set. Full analysis set should be close to the intention-to-treat as far as possible. Per protocol set division was the most difficult to control in blinded examination because of more subjectivity than the other two. The objectivity of statistical analysis set division must be guaranteed by the accurate raw data, the comprehensive data check and the scientific discussion, all of which were the strict requirement of data management. Proper division of statistical analysis set objectively and scientifically is an important approach to improve the data management quality.
Clinical Trials as Topic
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standards
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Databases, Factual
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Research Design
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standards
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Statistics as Topic
5.Prevention and handling of missing data in clinical trials.
Zhi-wei JIANG ; Chan-juan LI ; Ling WANG ; Jie-lai XIA
Acta Pharmaceutica Sinica 2015;50(11):1402-1407
Missing data is a common but unavoidable issue in clinical trials. It not only lowers the trial power, but brings the bias to the trial results. Therefore, on one hand, the missing data handling methods are employed in data analysis. On the other hand, it is vital to prevent the missing data in the trials. Prevention of missing data should take the first place. From the perspective of data, firstly, some measures should be taken at the stages of protocol design, data collection and data check to enhance the patients' compliance and reduce the unnecessary missing data. Secondly, the causes of confirmed missing data in the trials should be notified and recorded in detail, which are very important to determine the mechanism of missing data and choose the suitable missing data handling methods, e.g., last observation carried forward (LOCF); multiple imputation (MI); mixed-effect model repeated measure (MMRM), etc.
Clinical Trials as Topic
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Data Collection
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methods
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standards
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Humans
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Models, Theoretical
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Research Design
6.Primary keratinizing squamous cell carcinoma of the gallbladder: report of a case.
Wen-mang XU ; Xia LI ; Qi-chan HU ; Shu-ling SONG ; Li WANG ; Yuan-yuan WANG
Chinese Journal of Pathology 2012;41(12):853-854
Aged
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Carcinoma, Squamous Cell
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pathology
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surgery
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Cholecystectomy
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Gallbladder Neoplasms
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pathology
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surgery
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Humans
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Male
7.Evaluation of intravenous immunoglobulin in the treatment of severe EV71 infection in children
Suhua LI ; Yiping CHEN ; Hongjiao WANG ; Xuexia CHEN ; Hailong LIN ; Chan XIA
Chinese Journal of Primary Medicine and Pharmacy 2013;20(17):2569-2571
Objective To evaluate the efficacy of intravenous immunoglobulin (IVIG) in the treatment of severe EV71 infection in children.Methods The clinical data of children with severe EV71 infection,who admitted in our hospital from January 2010 to November 2012 were retrospectively analyzed.According to the time of admission and treatment principles,the patients were divided into the 2010 group and the 2012 group.The patients of the 2010 group routinely received IVIG treatment,but patients in the 2012 group received IVIG treatment in serious condition.The obvious effective rate,effective rate,ineffective rate,the incidence rate of critically ill and mortality of the two groups were compared.Results There were no significant differences in the obvious effective rate (86.0% and 85.2%),effective rate (9.6% and 11.8%),ineffective rate (4.4% and 3.0%),the incidence rate of critically ill (4.0% and 2.2%) between the two groups (x2 =0.011,1.269,1.657,3.304,all P > 0.05).The mortality of the 2010 group (2.8%) was higher than that of the 2012 group (0.6%)(x2 =8.213,P <0.05).Conclusion IVIG has no effect on patients with severe EV71 infection,and is not recommended.
8.Study on the feasibility and safety of measles vaccination in women of childbearing age
Chan XIA ; Zhengwang WEN ; Qi LIU ; Lei DONG ; Haifan QIU ; Yiping CHEN
Chinese Journal of Infectious Diseases 2016;34(4):227-231
Objective To study the feasibility and safety of measles vaccination in women of childbearing age and to understand the influence of measles vaccination on the fetal transmission measles antibody level of the infants.Methods From January 1,2012 to December 31,2012,600 women of childbearing age were included in this study.The measles IgG antibody was detected,then all participants were randomized according to the IgG level.The measles IgG antibody of participants in non-vaccinated group was detected predelivery in hospital by enzyme linked-immunosorbent assay (ELISA).That of participants in vaccinated group was detected 3 months after vaccination with measles mumps rubella combined vaccine and predelivery by ELISA.And measles nuclear protein fragment gene (measles virus nucleoprotein,MVN) in the blood was detected by reverse transcription polymerase chain reaction (RT PCR).A total of 368 participants gave birth within 2 years after vaccination,and 357 infants 8 months after birth were healthy.In non-vaccinated group,8 infants were diagnosed with measles within 8 months after birth.Finally,349 8-month infants were enrolled in the study,including 52 whose mothers in high antibody without vaccination group,65 whose mothers in high antibody with vaccination group,110 whose mothers in low antibody without vaccination group and 122 whose mothers in low antibody with vaccination group.The measles IgG antibody levels in the blood of all the 8-month infants were detected.Data were analyzed using t test,one-way ANOVA (Newman-Keuls was used for comparison between groups) and Pearson analysis.Results The measles IgG antibody level of expectant women in high antibody without vaccination group was significantly lower compared to that in high antibody with vaccination group ([268.5±74.9] IU/mL vs [578.3t208.1] IU/mL,Q=15.57,P<0.01).That in low antibody without vaccination group was also significantly lower than low antibody with vaccination group ([169.4+42.3] IU/mL vs [584.7+195.8] IU/mL,Q=29.54,P<0.01).The results of MVN RT-PCR after 3 months of vaccination showed no positive bands in all blood samples.Two of the expectant women in high antibody without vaccination group and one in low antibody without vaccination group were positive for MVN bands.Among 8-month infants,the levels of antibody in high antibody without vaccination group and high antibody with vaccination group were (106.3 ± 36.8) IU/mL and (291.8±86.5) IU/mL,respectively,which was statistically different (t=23.33,P<0.01).Those in low antibody without vaccination group and low antibody with vaccination group were (87.1 ± 26.4) IU/mL and (274.0±72.5) IU/mL,respectively,which was statistically different (t =33.27,P<0.01).The measles antibody level of expectant women was positively correlated with their 8-month infants (r=0.652,P<0.01).All 8 infants who were diagnosed with measles were delivered by women without vaccination,and the measles infection rate of infants was significantly different between women with and without vaccination (P=0.002).Condusion It is feasible for women of childbearing age to receive measles vaccination,which can increase the measles IgG antibody level of both expectant women and their infants.
9.The features of solitary pulmonary nodules of adenocarcinoma on 18F-FDG PET/CT
Cong-xia, CHEN ; Wen-chan, LI ; Fu-geng, LIU ; Zhi-ming, YAO ; Wan-ying, QU
Chinese Journal of Nuclear Medicine 2011;31(6):382-385
ObjectiveTo study the imaging characteristics of SPN of adenocarcinoma (ASPNs) on 18F-FDG PET/CT.MethodsThe morphological and metabolic features of 35 ASPNs on FDG PET/CT were retrospectively reviewed.SUVmax (SUV) was measured and ΔSUVmax was calculated according to ΔSUVmax =(SUVmax on delay imaging - SUVmax on early imaging)/SUVmax on early imaging × 100%.Statistical analysis was performed by software SPSS 11.5 using t-test,analysis of variance and Fisher exact test.Results( 1 ) Fifteen ASPNs (42.86%,15/35) presented as nodular pattern on FDG PET imaging,while 20 (57.14%,20/35) as lamellar,cloudy or ill-defined patterns.The SUVmax of these ASPNs followed a descending order of nodular,lamellar,cloudy and ill:defined on both early and delay imaging (F =30.696 and 24.758,both P<0.001).(2)There were 54.29% (19/35) ASPNs with SUVmax ≥2.5 and 45.71% (16/35) ASPNs with SUVmax <2.5.(3) Of 35 ASPNs,24(68.57% ) were solid nodules and 11(31.43%) were ground glass nodules with SUVmax =4.54 ±2.69 and 1.30±0.87,respectively (t =-5.234,P <O.001 ).(4) The SUVmax of ASPNs on delay FDG imaging (4.22 ±3.52) was significantly higher than that on early imaging (3.49 ±2.72) (t =-4.021,P <0.001 ).However,SUVmax was dependent on SUVmax on the early imaging:when SUVmax ≥2.5,ΔSUVmax was positive in 94.74% (18/19) of ASPNs; while SUVmax <2.5,ΔSUVmax was positive in 56.25% (9/16) of ASPNs (P =0.013).(5) Of 31 ASPNs with cell differentiation data,there were 10/17 well-differentiated ASPNs and 13/14 poorly-differentiated ASPNs with positive ΔSUVmax ( P =0.045 ).The average SUVmax of well-differentiated ASPNs was significantly lower than that of poorly-differentiated ASPNs ( 1.70 ± 1.51 vs 4.91 ± 2.69,t =- 3.951,P < 0.001 ).Conclusions The morphological and metabolic features of ASPNs are diversified.It is common for ASPN to present with SUVmax < 2.5.ΔSUVmax may be helpful for differentiating malignant from benign SPNs.
10.Longitudinal study of early neural development in premature infants with different gestational age and birth weight
Shuyuan YAN ; Zhenyu LIU ; Hongyan QIAN ; Xiaoni KUANG ; Zhong YU ; Lin TAN ; Chan XIA
Journal of Clinical Pediatrics 2017;35(6):425-429
Objective To investigate the trend of early neural development in premature infants. Methods At the age of 12 months and 24 months, Bayley Scales of Infant Development were used to assess the mental development index (MDI) and the psychomotor development index (PDI) in preterm (corrected age) and full-term infants. Results At 12 months, there was no significant difference in corrected age PDI scores among different gestational age groups (<32 , 32–33+6 and 34–36+6 weeks) (P=0.820). The actual age MDI and PDI scores of full-term infants and premature infants in 34~36+6 weeks group were significantly higher than those of premature infants in <32 and 32-33+6 weeks groups, and the PDI score of full-term infants was significantly higher than that of premature infants in 34-36+6 weeks group (P<0.05). There was no significant difference in actual age PDI scores among different birth weight groups (P=0.166). The actual age MDI and PDI of full-term infants and premature infants in birth weight≥2500 g group were significantly higher than those of premature infants in <1500 g, 1500~1999 g and 2000~2499 g groups (P<0.05). At 24 months, the actual age MDI scores of full-term infants were significantly higher than those of premature infants in different gestational age and birth weight groups (P<0.05). The actual age MDI curve of premature infants in birth weight <1500g group showed a downward trend, while the actual age PDI curve showed a significant upward trend. Conclusion The neurodevelopment of preterm infants at the corrected age of 12 and 24 months reaches the level of full-term infants.