Objective To explore the variation and clinical significance of growth hormone(GH) and insulin like growth factor-Ⅰ(IGF-Ⅰ) in children with critical disease.Methods One hundred and twenty-two cases were recruited into the study,among which 42 cases were sepsis in paediatric intensive care unit (sepsis group),20 cases had finished the cardiopulmonary bypass surgery without infection (surgery group).Sixty healthy children served as control group.Serum levels of GH and IGF-Ⅰ were deteced with immunochemiluminometric assay.Results The serum levels of GH were (6.71 ± 6.62) ng/ml in sepsis group,(8.86 ±8.06) ng/ml in surgery group,(3.87 ± 3.31) ng/ml in control group.Compared with the control group,the serum levels of GH in sepsis group and surgery group were increased significantly (P ＜ 0.05).There was no significant difference between sepsis group and surgery group.The serum IGF-Ⅰ levels were (63.72 ±54.17) ng/ml in sepsis group,(119.06 ± 102.12) ng/ml in surgery group and(154.22 ± 107.10) ng/ml in control group separately.The serum IGF-Ⅰ level of sepsis group was significantly decreased compared to the other two groups (P ＜ 0.05).There was no significant difference between surgery group and control group (P ＞0.05).In sepsis group,compared with those who died,the GH of the survival showed no significant difference,IGF-Ⅰ was significantly increased.(P ＜ 0.05).Conclusion GH playes a positive effect in patients with critical disease.IGF-Ⅰ decreases greatly in patients with serious infection.It suggests that IGF-Ⅰ could be a sensitive marker for reflecting whether there is serious infection.The sharply decreasing of IGF-Ⅰ may predict a bad outcome.

Objective To explore the causes,management and prevention of major blood vessel injury during urological laparoscopic surgery.Methods Six cases of major blood vessel injuries happened in 1700 laparoscopic surgeries from January 2007 to July 2011.All of the cases were males.Patient age was (53 ± 14) years.There were 4 extraperitoneal and 2 transperitoneal procedures including 3 adrenalectomies,1 radical cystectomy,1 radical prostatectomy and 1 radical nephrectomy.There were lacerations in 3 cases of vena cava,2 cases of external iliac vein and one case of renal vein.The length of laceration was (0.68 ±0.29) cm and blood lost was (114 ++ 79) ml.Results Five of the patients were managed with laparoscopic techniques by suction compressing bleeding sites,dissecting related vessels,adding extra trocar and repairing laceration by suturing in four cases and clipping bleeding site in one case.The bleeding control management lasted (21.0 ± 5.6) min.One laparoscopic adrenalectomty for the treatment of pheochromocytoma converted to open surgery because of increasing blood pressure.All the patients were followed up for (4 ± 2) months.No more related complication occurred.Conclusions Lymph node dissection,local adhesion and energy source are the main causes for blood vascular injuries.This kind of injuries may occur at any stages during a laparoscopic surgery and laparoscopic repairing is safe and feasible.

OBJECTIVE: To explore the genetic basis for a child featuring global developmental disorder with epilepsy. METHODS: A child who had presented at Guangzhou Women and Children's Medical Center in July 2022 was selected as the study subject. Clinical data was collected. Potential variant was detected by whole exome sequencing (WES). Candidate variant was validated by Sanger sequencing and bioinformatic analysis. RESULTS: The child, a three-year-old ethnic Zhuang Chinese girl, had presented with global developmental disorder and epilepsy, for which rehabilitation therapy was ineffective. Genetic testing revealed that she has harbored a homozygous c.821T>C (p.Leu274Pro) missense variant of the PIGW gene, for which both of her parents and sister were heterozygous carriers. Based on the guidelines from the American College of Medical Genetics and Genomics (ACMG), the variant was classified as variant of uncertain significance. CONCLUSION The homozygous c.821T>C (p.Leu274Pro) variant of the PIGW gene probably underlay the onset of disease in this child. Above finding has enriched the mutational spectrum of the PIGW gene.
Child, Preschool ; Female ; Humans ; Computational Biology ; Developmental Disabilities ; Epilepsy/genetics* ; Genetic Testing ; Homozygote

Objective:To find out how newly recruited nurses feel about the use of scenario simulation teaching in communication skill training, and to provide references and lessons for improving and perfecting the training of newly recruited nurses.Methods:Purposive sampling method was used to select 10 nurses who were newly recruited to a tertiary grade A hospital in Shanghai in July 2023 for semi-structured interviews. Colaizzi's 7-step analysis method was used to collate and analyze the data and develop themes.Results:Three themes were extracted from the feelings of newly recruited nurses about scenario simulation teaching, which were the improvement of learning ability, the cultivation of clinical comprehensive ability, and the improvement of communication and teamwork ability.Conclusions:Scenario simulation teaching can improve the clinical communication ability of newly recruited nurses and enhance their learning ability and comprehensive clinical ability. This study designed a scenario simulation teaching program oriented and targeted to highlight communication ability, which further proved its positive significance. However, attention needs to be paid to the construction of clinical teaching team, evaluation system, and feedback mechanism for targeted improvement to enhance the teaching effect.