Objective To improve the clinical prognosis of patients by reviewing ten years epidemiology data of acute poisoning inpatients.Methods The epidemiology data of the acute poisoning inpatients from 2006-2015 were retrospectively analyzed.The indexes including age,gender,nationality,geographical distribution,substance of poison,seasons,diagnosis and fee-for-service were collected.Results There were 1 083 patients with acute poisoning in total,624 cases (57.6％) for gas poisoning,213 cases (19.7％) for pesticide poisoning,136 cases (12.6％) for drug poisoning,74 cases (6.8％) for food poisoning and 36 cases for others.The ration of male to female was 0.94:1.The age of 31 to 45 range accounted for the highest proportion.The incidence of poisoning in 2011-2015 was significantly higher than that in 2006-2010 (P ＜0.05).The geographical distribution was also significantly different (P ＜0.05),most of the cases were in Shihezi city,then were Manasi and Sawan counties.Among the 1 083 patients,59％ cases were cured,33.6％ cases were improved after treatment,and the mortality rate was 2.6％.Feefor-service was also significantly increased in the older patients or males,and substance of poisoning dependent.The highest treatment cost was carbon monoxide poisoning,then were pesticide,drugs and food.Conclusions The common causes of poisoning in Shihezi city were carbon monoxide,organophosphorus pesticide,botulism and drugs,more emergency medical service should prevent poisoning and treat these patients.

Objective To explore the effects of delivery classification scale for fetal cardiac disease on the prenatal and postnatal integrated treatment strategies.Methods Delivery classification scale for fetal cardiac disease included:grade Ⅰ,no hemodynamics instability; grade Ⅱ,ducted-dependent lesions,stable hemodynamics anticipated;grade Ⅲ,possibility or likelihood of hemodynamic instability; IMPACT(delivery immediately heart intervention) level,hemodynamic instability is anticipated at separation from placental circulation.During August 2006 to May 2010,a retrospective study of 46 cases of prenatal diagnosis of congenital heart disease and delivery in one cardiac center was taken,in which 33 in grade Ⅰ,9 in grade Ⅱ,4 in grade Ⅲ,and no IMPACT.Results Thirty-nine boys and 7 girls were born at (38.0 ± 1.4) weeks of gestation and had consistent fetal diagnoses of mainly cardiac abnormalities with postnatal screen.Thirteen neonates underwent cardiac intervention within one week after birth with one death,including 2 in grade Ⅰ,7 in grade Ⅱ,4 in grade Ⅲ,of them 1 death.Seven infants including 5 in grade Ⅰ and 2 in grade Ⅱ underwent cardiac intervention with one death.The remaining 26 children in grade Ⅰ had uneventfully outcomes,in which 7 cases of surgical operation,17 cases of interventional therapy,2 cases of spontaneous healing.Conclusion Delivery classification scale for fetal cardiac disease should have some guiding significance for early treatment strategies and could enhance closely integration of prenatal diagnosis and postnatal treatment.The most fetuses in grade Ⅰ need not undergo cardiac interventions in neonatal stage.However,early cardiac intervention for fetuses in grade Ⅱ and Ⅲ should be carried out postnatally with the help of neonatologists.

Objective To summarize primary experiences of integrated fetal diagnosis and postnatal treatment for the transposition of the great arteries (TGA). Methods Five fetus were diagnozed as TGA at(28.4 ±4.4) weeks of gestation via fetal echocardiography. The mean age of the pregnant women was (28.4 ±3.0) years old. Delivers were taken by caesarean at (36.5 ±1.8) weeks of gestation. The body weight of neonates was (2468 ±442) grams. All neonates were transported to the department of neonatology and re-checked by echocardiography. 3 cases were TGA with intact ventricular septum, 2 cases were TGA with ventricular septal defect. Prostaglandin and mechanical ventilation were applied if oxygen saturation was lower. The standard arterial switch procedure was performed under cardiopulmonary bypass with moderate hypothermia. Results The mean age for patients at surgery was (9. 0 ±6. 2) days ( ranged 2-19 days). Three neonates survived, 2 preterm neonates died. One with body weight 1770 g, 2 days after operation was died of sudden heart arrest and failure of resuscitation. Another was treated by mechanical ventilation and prostaglandin after delivery and underwent operation at the second postnatal day, the neonate appeared low cardiac output and high serum lactate postoperatively and died in the third day. Conclusion The integrated fetal diagnosis and postnatal treatment for TGA could prevent severe cyanosis and emergency transportation after parturition. The lack of any link in the cooperation among the multidisciplinary team could affect the benefits for the TGA neonates provided by prenatal diagnosis.

Objective To investigate Helicobacter pylori(Hp)infection and HLA-DQA1 allelic frequency in family members of children with recurrent abdominal pain.Methods One hundred and eighteen family members of 20 children with recurrent abdominal pain were divided into two groups:with and without recurrent abdominal pain.Serum Hp antibody was tested by dot immunogold filtration assay and immunophenotyping was determined by Western blot(immunobiot)technique.Polymerase chain reactionsequence specific primers(PCR-SSP)technique Was applied to identify HLA-DQAi allelic frequencies.Hardy-Weinberg equilibrium test was performed(P>0.05),and Chi-square test was used to compare the frequency of HLA-DQA1 alleles between the groups.Results The Hp seropositive rate in 118 members Was 100%and the Hp immunophenotyping was 96.6%.The prevalence of Hp Ⅰ and Ⅱ type was 55.1%(65/118)and41.5%(49/118).HLA-DQA1*0302 allelic frequency Was significantly higher in subjects with recurrent abdominal pain than that in subjects without one(23%vs.2%,X2=13.277,P=0.000).Conclusion There is immunogenetic difference between familial members with and without recurrent abdominal pain infected by Hp,and HLA-DQA1*0302 may be the associated gene contributing to different clinical outcomes after Hp infections.

Objective:To summarize the experience and early outcomes of transapical mitral valve-in-valve procedure with J-Valve in patients with bioprostheses degeneration.Methods:The clinical data of 29 patients who underwent mitral transcatheter valve-in-valve implantation with J-Valve from April 2020 to March 2021 were retrospectively analyzed. There were male 16 and female 13 patients with average age (72.0±11.6) years. Patients underwent previous mitral valve replacement with bioprostheses of Hancock Ⅱ in 17, Edwards SAV in 7, Edwards Perimount in 3, Balmedic in 1, Mosaic in 1. The size of mitral bioprostheses included 25 # for 8 patients, 27 # for 17 patients, and 29 # for other 4 patients. The operations were performed in the hybrid operation room. Under X-ray fluoroscopy and TEE monitoring, the retro-preseted J-valve was implanted into the mitral bioprosthetic valve via the intercostal space and apical puncture. Results:One patient was converted urgently to mediate sternotomy, and the transcatheter mitral valve was reset after opening left atrium on cardiopulmonary bypass due to the migration of transcatheter valve. twenty eight patients were successfully completed transcatheter mitral valve-in-valve procedure with technical success achieving in 96.6% . Among the 28 patients who successfully were completed valve-in-valve procedure, 1 died and 27 were discharged in well condition. The mean mitral transvalvular gradient was (7.6±2.2)mmHg(1 mmHg=0.133 kPa), no death or other major complications occurred during the follow-up.Conclusion:The application of J-Valve interventional valve in patients with bioprosthesis degeneration can achieve favourable early outcomes, even if the patient was replaced with a small bioprosthesis in the previous operation, the hemodynamic effect was still satisfactory.

Objective:To investigate the safety of inter-hospital referral and the prognosis of neonatal with critical congenital heart disease.Methods:The criticality score, transit distance and time, and the prognosis of 237 newborns with critical congenital heart disease in Guangdong Provincial People′s Hospital from July 2016 to July 2018 were retrospectively analyzed.Results:A total of 237 children were included (162 male and 75 female) with the median age of 6 days and the median body weight of 2.98 kg.The median transit distance was 90 km.The average value of neonatal critical illness score (NCIS) was (86.54±9.05) scores before transport; 136 cases were greater than 90 scores, 84 cases between 70 and 90 scores, 17 cases less than 70 scores; while the average NCIS was (87.05±8.19) scores when arrived at neonatal intensive care unit (NICU), 138 cases were greater than 90 scores, 82 cases between 70 and 90 scores, 17 cases less than 70 scores.There were no significant differences in the scores of critical cases before and after transfer according to the transfer time and distance ( t=0.346, P>0.05). There was no one death occurred during the transfer process.All over, 222 cases were cured and discharged from the hospital after surgery and or medical interventional treatments, 15 cases died after giving up treatment or losing the opportunity for surgery. Conclusions:It is safe and effective of the inter-hospital transport for the rescue of infants with critical congenital heart disease when followed the principles and transport rules and regulations, with trained workers and special equipments.

Objective:To study the ultrasonographic characteristics of embryos/fetuses with normal or abnormal central nervous system (CNS) from 7 to 13 +6 weeks of gestation using high resolution two-dimensional ultrasound combined with HD-live silhouette technology and provide a reference for early diagnosis of CNS abnormalities. Methods:Eighty normal embryos/fetuses during 7-13 +6 weeks and 41 fetuses with CNS malformations in early pregnancy during 11-13 +6 weeks were selected to observe the ultrasonographic features of embryos/fetuses with normal or abnormal CNS using transvaginal high resolution two-dimensional ultrasound and HD-live silhouette technology. Descriptive analysis was performed on the results. Results:From seven weeks of gestational age, high resolution two-dimensional ultrasound combined with HD-live silhouette technology can clearly and stereoscopically show the prosencephalon, mesencephalon and rhombencephalon. The rhombencephalon changed the most in the brain development of embryos. At nine weeks of gestation, cleared structures of pons curvature, the fourth ventricle and cisterna magna were observed. The developing cerebellum and the original Blake pouch cyst were seen at 10 weeks of gestation. From 11 to 13 +6 weeks, the most remarkable change was the choroid plexus of the fourth ventricle changed from perpendicular to parallel to the long axis of the neural tube. Of the 41 fetuses with CNS malformation, 16 (39.0%) were exencephaly, 11 (26.8%) were holoprosencephaly, five (12.2%) were encephalocele, four (9.7%) were anencephaly, three (7.3%) were fourth ventricle dilatation, and two (4.9%) were open spina bifida. Conclusions:High resolution two-dimensional ultrasound combined with HD-live silhouette technology can clearly and stereoscopically display the morphological changes in embryonic embryos/fetuses with development of normal CNS at 7-13 +6 weeks, which is helpful to better understand the origin of CNS embryonic abnormalities and provide diagnostic clues for the early detection of CNS abnormalities.

OBJECTIVESince 1986, the reference of birth weight for gestational age has not been updated. The aim of this study was to set up Chinese neonatal network to investigate the current situation of birth weight in China, especially preterm birth weight, to develop the new reference for birth weight for gestational age and birth weight curve.

METHODA nationwide neonatology network was established in China. This survey was carried out in 63 hospitals of 23 provinces, municipalities and autonomous regions. We continuously collected the information of live births in participating hospitals during the study period of 2011-2014. Data describing birth weight and gestational age were collected prospectively. Newborn's birth weight was measured by electronic scale within 2 hours after birth when baby was undressed. The evaluation of gestational age was based on the combination of mother's last menstrual period, ultrasound in first trimester and gestational age estimation by gestational age scoring system.

STATISTICAL ANALYSISthe growth curve was drawn by using LMSP method, which was conducted in GAMLSS 1.9-4 software package in R software 2.11.1.

RESULTA total of 159 334 newborn infants were enrolled in this study. There were 84 447 male and 74 907 female. The mean birth weight was (3 232 ± 555) g, the mean birth weight of male newborn was (3 271 ± 576) g, the mean weight of female newborn was (3 188 ± 528) g. The test of the variables' distribution suggested that the distribution of gestational age and birth weight did not fit the normal distribution, the optimal distribution for them was BCT distribution. The Q-Q plot test and worm plot test suggested that this curve fitted the distribution optimally. The male and female neonatal birth weight curve was developed using the same method.

CONCLUSIONUsing GAMLSS method to establish nationwide neonatal birth weight curve, and the first time to update the birth weight reference in recent 28 years.

Objective: To analyze the neurodevelopmental outcome and its risk factors in infants with CHD at 18 months of age. Methods: Eighteen-month-old infants with CHD at the follow-up clinic of our hospital were selected. The Bayley scales of infant development(BSID) were used to evaluate the levels of mental development(MDI) and psychomotor development(PDI). The clinical features during hospitalization were reviewed, and the risk factors of MDI and PDI were analyzed. Results: A total of 116 children with CHD underwent BSID evaluation at 18 months of age. Both the MDI(95.38±22.98) and PDI(87.84±22.57) of the cohort were significantly lower than the average value of the normal population(P<0.05). In infants with cyanotic CHD, the MDI was higher(β=17.218). The longer the length was of the hospital stay, the lower the PDI(β=-0.577). In patients undergoing cardiopulmonary bypass surgery, the PDI was higher(β=11.956). Compared to infants with relatively normal behavior, the PDI of infants with mild behavioral problems was lower(β=-10.605). Conclusion Children with CHD who underwent cardiac surgery have delayed neurodevelopmental outcomes compared with those of healthy children. The outcomes of infants with cyanotic CHD or undergoing cardiopulmonary bypass surgery was better than others. Long hospital stays and mild behavioral problems were risk factors for poor neurodevelopmental outcomes.

Objective: To investigate the risk factors of postoperative acute kidney injury (AKI) in patients aged between 40 and 50 years old undergoing cardiac valvular surgery and the impact on outcome. Methods: The clinical data of 286 patients aged between 40 and 50 years old undergoing cardiac valve surgery in Guangdong Provincial People′s Hospital from January 2012 to December 2016 were analyzed retrospectively. Preoperative coronary angiography was performed in all patients. All patients enrolled were divided into AKI group and non-AKI group according to the existence or not of postoperative AKI. Patients with AKI were further divided into AKI stage 1, stage 2, and stage 3 groups according to KDIGO guideline. Demographic characteristics, preoperative clinical data including serum creatinine, estimated glomerular filtration rate, hemoglobin, uric acid, urinary protein, presence or absence of chronic kidney disease, left ventricular ejection fraction, pulmonary artery pressure, New York Heart Association (NYHA) functional classification, preoperative co-morbidity (hypertension, diabetes, anemia, cerebrovascular disease, peripheral artery disease), preoperative medication(vasoactive drugs, diuretic, renin-angiotensin system inhibitor (RASI), surgical data (contrast dosage in coronary angiography, type of cardiac valve surgery) were recorded and analyzed in this retrospective study. The risk factors for postoperative AKI and its impact on clinical outcomes (mortality, hospitalization expenses and Intensive Care Unit stay duration) were evaluated. Logistic regression analysis was used to determine the risk factors for postoperative AKI and the adjusted variables with P<0.2 were selected for the multivariate logistic regression analysis to define the independent determinants for AKI. Results: AKI was defined in 106 out of 286 enrolled patients, including 96 patients with AKI stage 1, 10 patients with AKI stage 2 and no patients with AKI stage 3. The proportion of coexisting cerebrovascular diseases was higher in AKI group than in non-AKI group (9(8.49%) and 5(2.78%), χ²=4.677, P=0.031), while there was no difference among other baseline data between the two groups. Multivariate logistic regression analysis showed that preoperative complications of cerebral vascular disease was an independent risk factor of postoperative AKI (OR=3.578, 95%CI 1.139-11.242, P=0.029). Five out of 106 AKI patients died during hospitalization while there was only 1 patient died among 180 patients without AKI. Patients with AKI after cardiac valve operation experienced higher mortality than patients without AKI (χ²=5.625, P=0.028). Further analysis showed that there was no difference in hospitalization mortality between patients with AKI stage 2 and stage (χ²=0.686, P=0.408) while the hospitalization mortality in patients with AKI stage 2 was higher than those without AKI (χ²=8.113, P=0.004). The hospitalization expenses in patients with AKI were 10.38(8.59,12.54) ×10⁴ RMB, significantly higher than that in patients without AKI (9.72(8.03,11.93) ×10⁴ RMB)(P=0.043). There was no difference in hospitalization expenses between patients with AKI stage 1 and without AKI (P=0.635). The hospitalization expenses in patients with AKI stage 2 was higher than those without AKI (P=0.023). Intensive Care Unit stay duration in patients with AKI was 3(1,4) days, significantly higher than those without AKI (P=0.044). There was no difference in Intensive Care Unit stay duration in patients with AKI stage 1 and without AKI (P=0.978), while Intensive Care Unit stay duration in patients with AKI stage 2 was significantly longer than those without AKI (P=0.006). Conclusions Preoperative complications of cerebral vascular disease is an independent risk factor of postoperative AKI. Non-senile patients with AKI after cardiac valvular surgery is associated with a higher proportion of mortality, hospitalization expenses and Intensive Care Unit stay duration as compared patients without postoperative AKI.