Objective To investigate the clinical effect of loading dose of phenobarbital in neonatal hypoxic-ischemic encephalopathy(HIE).Methods Three hundred and fifty-six patients with neonatal HIE were randomly divided into treatment group and control group by systematic sampling,with 178 patients in each group.Two groups were given comprehensive therapy,with or without convalsions,early application of loading dose of phenobarbital in 20 mg/kg intramuscular injection,12 h beck to a maintenance dose 5 mg/(kg·d)in treatment group,while a conventional dose of phenobarbital in 5 mg/(kg·d)was used in control group after convulsion happened.Clinical effect of short-term and long-term were observed.Results The rates of eelampsia,choloplania and total effect was 11.2％(20/178),7.9％(14/178)and 87.1％(155/178)in treatment group,and 68.0％(121/178),50.6％(90/178)and 77.5％(138/178)in control group,there were significant differences between two groups(x2 =6.403,78.459 and 8.308,P ＜ 0.05).DQ score in treatment group was higher than that in control group(P＜ 0.05).The patients in two groups were followed up to age 18 months,the deformity rate in treatment group[7.9％(14/178)]was lower than that in control group[28.1％(50/178)],there was significant difference between two groups(x2 =29.085,P ＜ 0.05).Conclusion Loading dose of phenobarbital is very effective to treat neonatal HIE.

ObjectiveTo study exogenous surfactants disaturated phosphatidyl choline (DSPC) kinetics in full term infants with respiratory distress syndrome(RDS) who were treated with different dose of poractant alfa.MethodsOne hundred and twenty-two full term infants with RDS undergoing mechanical ventilation were divided into group A (80 cases) and group B (42 cases) by simple random method,who received 100 mg/kg or 200 mg/kg poractant alfa mixed with DSPC.Clinical manifestation and respiratory parameters were recorded,and DSPC half-life period and pool size and endogenous DSPC synthesis rate were calculated.ResultsFifty-six infants (70.0％) received a second dose after(25 ± 11) h and 18 infants (22.5％) received a third dose after(41 ± 11 ) h in group A.Twelve infants ( 28.6％ ) received a second dose after (33 ± 8) h and 2 infants (4.8％) received a third dose in group B.DSPC half-life period in group B was longer than that in group A[the fast:(32 ± 19) h vs.(15 ± 15) h;the second:(43 ±32) h vs.(21 ± 13) h],there was significant difference (P＜ 0.01 or ＜ 0.05).DSPC synthesis rate and pool size before the first and second doses had no difference between the two groups.But the oxygenation index at the first and the second dose in group B was less than that in group A,there were significant differences (P ＜ 0.01 or ＜ 0.05).ConclusionPoractant alfa given to full term infants with RDS at a dose of 200 mg/kg results in a longerDSPC half-life period,fewer retreatments,and better oxygenation index values.

The incidence of diabetes mellitus tends to increase, and clinical treatment is extremely challenging. Although drugs exert certain therapeutic effect on reducing blood glucose level, it remains impossible to achieve clinical cure of type 1 diabetes mellitus with a risk of blood glucose fluctuations. Islet cell transplantation is one of the efficacious methods to solve the problem of blood glucose fluctuation caused by insulin injection. However, there are several problems in the clinical practice of islet cell transplantation, including long time use of immunosuppressants in recipients and massive loss of pancreatic islet cells after transplantation, which limit its wide application in clinical practice. Islet cell encapsulation technology can reduce the loss of islet cells and decrease or eliminate the rejection, which is a key link to improve the survival of islet cells. In this article, the development course of islet cell encapsulation technology was briefly reviewed, the challenges in different islet cell encapsulation technologies were analyzed and subsequent research on this technology was projected, aiming to provide reference for promoting the development of islet cell.

Objective To evaluate the efficacy and safety of chloral hydrate combined with dexmedetomidine for sedation during echocardiography in pediatric patients with Williams-Beuren syndrome.Methods Eighteen pediatric patients diagnosed with Williams-Beuren syndrome by genetic testing,aged 5-58 months,scheduled for elective echocardiography under sedation,received oral chloral hydrate 50 mg/kg.Vital signs were measured every 5 min,and sedation was assessed using Ramsay sedation score.When Ramsay sedation score＜4 points 20 min later,intranasal dexmedetomidine 1 μg/kg was given as rescue sedative.Medicine used,vital signs,onset time,moderate and deep sedation duration and emergence time were recorded.Results The success rate of sedation with chloral hydrate alone was 38.9％ and with chloral hydrate and dexmedetomidine 61.1％.The onset time,sedation duration and emergence time were (15.7+1.9) min,(75+26) min and (52+25) min,respectively,in pediatric patients received chloral hydrate alone.The onset time,sedation duration and emergence time were (33.2±3.4) min,(83±49) min and (61±46) min,respectively,in pediatric patients received chloral hydrate and dexmedetomidine.The onset time was significantly prolonged in pediatric patients received chloral hydrate and dexmedetomidine than in pediatric patients received chloral hydrate alone (P＜0.05).Heart rate,respiratory rate and SpO2 were stable during sedation in all pediatric patients,and nausea and mild vomiting were found in 3 pediatric patients received chloral hydrate and in 6 pediatric patients received chloral hydrate and dexmedetomidine,and no other adverse reactions were observed.Conclusion Oral chloral hydrate 50 mg/kg combined with intranasal dexmedetomidine 1 μg/kg provides reliable sedative efficacy and exerts less influence on respiratory and circulatory function with higher safety when used for echocardiography in pediatric patients with Williams-Beuren syndrome.

Objective:To evaluate the value of sugammadex for ultra-fast-track anesthesia in pediatric patients undergoing surgery for correction of congenital heart disease.Methods:Forty pediatric patients of both sexes, aged 1-6 yr, with American Society of Anesthesiologists physical status Ⅱ, scheduled for elective surgery for correction of congenital heart disease, were enrolled in this study and randomly assigned into sugammadex group (group S) and control group (group C) with a random number table.Sugammadex 4.0 mg/kg was injected intravenously to reverse neuromuscular relaxation in group S and the equal volume of normal saline was administrated in group C when the train-of-four (TOF) count was 0 and post-tetanic count was 1 or 2 during recovery from anesthesia.The recovery time of TOF ratio to 25%, 75% and 90%, the extubation time and the success rate of ultra-fast-track anesthesia were recorded.Results:Compared to group C, sugammadex significantly shortened the recovery time of TOF ratio to 25%, 75% and 90% and the extubation time in group S ( P<0.05); Furthermore, the success rate of ultra-fast-track anesthesia reached 100% in group S compared to 0% in group C. Conclusion:Intravenous administration of sugammadex 4.0 mg/kg significantly shortens the recovery time of neuromuscular relaxation and extubation time and enhances the success rate of ultra-fast-track anesthesia in pediatric patients undergoing surgical correction of congenital heart disease.

Objective:To measure the skin thickness in patients with erysipelas by high-frequency ultrasonography (HF-USG), and to compare the clinical efficacy of systemic antibiotics alone versus their combination with glucocorticoids in the treatment of erysipelas.Methods:Hospitalized patients with erysipelas were enrolled from Zhongda Hospital, Southeast University from January to December in 2021, and randomly divided into the study group and control group according to the order of visits. The study group was treated with systemic cefathiamidine for 7 days followed by oral methylprednisolone at a dose of 0.4 mg·kg -1·d -1, while the control group was treated with cefathiamidine alone. Before and after the treatment for 10 days, the thicknesses of the epidermis-dermis layers and subcutaneous tissues were measured by HF-USG at the sites of the most severe skin lesions on the affected limbs and at the corresponding sites on the healthy limbs, and white blood cell (WBC) counts, neutrophil (NEU) counts, as well as C-reaction protein (CRP) levels were determined. The t test and non-parametric test were used to compare the efficacy between two groups. Results:A total of 23 patients with erysipelas were enrolled. Among the 12 patients in the study group, 8 were males and 4 were females, and their age was 71.4 ± 11.4 years. Among the 11 patients in the control group, 7 were males and 4 were females, and their age was 67.4 ± 11.1 years. Before treatment, the thicknesses of the epidermis-dermis layers (0.33 ± 0.12 cm) and subcutaneous tissues (1.08 ± 0.49 cm) in the study group were not significantly different from those in the control group (0.25 ± 0.09 cm, 0.98 ± 0.46 cm; t = -1.83, -0.49, P = 0.081, 0.626, respectively). After the 10-day treatment, the thicknesses of the epidermis-dermis layers and subcutaneous tissues of the skin lesions on the affected limbs significantly decreased in both groups compared with those before treatment (both P < 0.05), and the decrease in the thicknesses of subcutaneous tissues was significantly stronger in the study group (0.32 ± 0.33 cm) than in the control group (0.10 ± 0.07 cm; t = 2.20, P = 0.039). Before treatment, the WBC counts ([11.16 ± 4.42] × 10 9/L), NEU counts ([8.26 ± 4.16] × 10 9/L) and CRP levels (median [ Q1, Q3]: 72.20 [19.28, 140.50] mg/L) in the study group were not significantly different from those in the control group ([10.10 ± 4.53] × 10 9/L, [7.21 ± 3.00] × 10 9/L, 34.40 [8.00, 74.20] mg/L, respectively; t or Z = 0.60, 0.71, -0.85, P = 0.578, 0.496, 0.196, respectively). After the 10-day treatment, the WBC counts, NEU counts, and CRP levels significantly decreased in both groups compared with those before treatment (all P < 0.05) . Conclusion:The combined treatment with systemic antibiotics and glucocorticoids could effectively alleviate skin inflammation, and more rapidly reduce the thicknesses of inflamed subcutaneous tissues in patients with erysipelas compared with systemic antibiotics alone.