Humans ; Infant, Newborn ; Mastocytosis, Cutaneous

Objective To investigate the effect of calcium acetate in treatment of elderly patients with CAPD in peritoneal dialysis patients with hyperphosphatemia and efficacy.MethodsFrom March 2013 to January 2016,46 elderly patients with CAPD were randomly divided into experimental group and control group.The control group were used calcium 1.5mmol/L Liquor Dialysisintraperitoneus CAPD treatment,and control diet.Besides these treatments,the experimental group were given calcium acetate tablets 668mg/3 times every day after a meal, 2 tablets each time.All patients were detected before treatment and 4,6 and 10 weeks after the serum calcium, phosphorus and calcium and phosphorus in blood iPTH index, calculate the product of calcium and phosphorus,record and statistical analysis.ResultsTwo groups after 4 week of treatment, all outcome measures were decreased;the experimental group blood phosphorus decreased significantly after 6 weeks treatment;it after 10 weeks of treatment, serum calcium(t=5.202),phosphorus(t=7.767),blood iPTH(t=-10.324) and the calcium phosphorus product (t=-4.106) compared with that before treatment,there were statistically significant differences(P<0.01);the control group after 10 weeks of treatment, with all outcome measures there were no significant differences.The experimental group after 10 weeks of treatment,serum calcium(t=-4.055),phosphorus (t=-9.037),blood iPTH(t=9.940) and the calcium phosphorus product(t=-4.211)compared with the control group,the differences were statistically significant(P<0.01).ConclusionCalcium acetate treatment can significantly reduce the blood serum of aged CAPD in peritoneal dialysis patients with high phosphorus,effectively prolong the survival time and improve the quality of life during treatment.

Objective To evaluate the effects of inhaled nitric oxide(iNO)combined with oral sil-denafil therapy in the newborn infants with persistent pulmonary hypertension(PPHN).Methods Forty-six neonates with PPHN were devided into group A(n ﹦23)and group B(n ﹦23).The combined treatment of iNO and oral sildenafil was used in group A,and iNO was used in group B.During the therapy,the following factors were monitored:blood gas analysis,systolic blood pressure(SBP),systolic pulmonary artery pressure (SPAP),inspired oxygen fraction (FiO2 ),iNO concentration,iNO duration,ventilation time and hospital stay.The effective rate,mortality and the risk of pneumothorax,intraventricular hemorrhage,pulmonary hem-orrhage,bronchopulmonary dysplasia were compared between the two groups.All patients were treated in the same neonatal unit and received the same standard therapy throughout the study period.Results The effec-tive rates of group A and group B were 87.0%(20 /23)and 78.3%(18 /23)respectively.There was no sig-nificant difference between the two groups(χ2 ﹦0.15,P 〉0.05).The levels of SPAP/SBP decreased signifi-cantly,and the levels of PaO2 /FiO2 rised significantly at baseline 30 min,6 h and after the treatment.But there were no significant differences between the two groups(P 〉0.05).In group A,the iNO concentration stared at ≥15 ×10 -6 for 14 infants,〉15 ×10 -6 for 6 infants,which were lower than those in the group B (χ2 ﹦6.71 ,P 〈0.05).The iNO would be stopped when the concentration reached 40 ×10 -6 without any sign of improvement.Compared to group B,the duration of iNO[(57.3 ±27.8)h vs.(87.7 ±47.0)h],the ven-tilation time[(94.44 ±31 .88)h vs.(123.20 ±47.43)h],and the time of hospital stay[(14.55 ±3.19)d vs.(18.78 ±4.60)d]in group A were shorter(P 〈0.05),whereas the mortality and the incidence of pneu-mothorax,intraventricular hemorrhage,pulmonary hemorrhage and bronchopulmonary dysplasia had not sig-nificantly differences between the two groups.Conclusion The effects of iNO combined with oral sildenafil in the newborn infants with PPHN was same compared to iNO.But it can effectively reduced the iNO concen-tration and shorten the duration of iNO,the ventilation time and the hospital stay without augmentation of risk of mortality,pneumothorax,intraventricular hemorrhage,pulmonary hemorrhage,bronchopulmonary dysplasia in neonatal patients.

Objective To explore the clinical characteristics of neonatal group B streptococcal sepsis (GBS)sepsis in order to provide the guide for early diagnosis and appropriate treatment.Methods A retro-spective review was performed and a total of 33cases of neonatal GBS sepsis were identified in the NICU of Children′s Hospital of Quanzhou from March 2011to October 2014.The perinatal factors,clinical characteris-tics,laboratory finding,treatment and prognosis were analyzed.Results A total of 33cases of neonatal GBS sepsis were identified.The incidence of neonatal GBS sepsis was 2.0‰(33/16448)among all the NICU pa-tients admitted at the same period.All 21cases of early-onset GBS sepsis were term infants,which had 13ca-ses of respiratory distress,11cases of anhelation and 10cases of cyanosis as main initial clinical symptoms. Among 12late-onset cases,8occurred in term infants,10with ardent fever as the main initial clinical symp-toms,6combined with purulent meningitis.All the GBS strains were sensitive to vancomycin,then penicillin combined with meropenem therapy was effective.Of the 33patients,18cured,9discharged with improve-ment,2died,4patients died during hospitalization after being given up because of serious complication,total mortality was 18.2%.Conclusion The clinical manifestations of neonatal GBS sepsis are usually obviously and fatally,and with a high mortality.Antepartum prophylaxis,early diagnosis and timely sensitive antibiotics therapy are vital for reducing the incidence of complications and mortality of neonatal GBS sepsis.

Objective To investigate the clinical efficacy and safety of caffeine citrate in the treat-ment of primary apnea in premature infants. Methods A non-randomized controlled trial had been designed in which 96 premature infants would be enrolled form Oct 2013 to Sep 2014 in our hospital. According to the therapeutic strategy,the patients were divided into treatment group(n=51) and control group(n=45). The treatment group was treated with caffeine citrate,and the control group was treated with placebo. The overall response rates and the complication rates in the two groups were compared. Results The effective rate of the treatment group was 80. 4%(41/51),while the control group was 51. 1%(23/45). There was a significant difference between the two groups(χ2 =9. 224,P =0. 002). The incidence of bronchopulmonary dysplasia (7 cases vs. 14 cases),patent ductus arteriosus(7 cases vs. 15 cases),retinopathy of prematurity(4 cases vs. 10 cases),intraventricular hemorrhage(9 cases vs. 20 cases),showed significant differences between the two groups( P<0. 05 ) . Conclusion Caffeine citrate is significantly more effective than placebo in reducing apnea episodes and reduces the rate of bronchopulmonary dysplasia, patent ductus arteriosus, retinopathy of prematurity and intraventricular hemorrhage in premature infants.

To explore the clinical efficacy of Herba Saxifragae cream (HS), a compound of traditional Chinese herbal medicine, on chronic eczema.

Objective: To evaluate the changes of left and right ventricular function in patients after percutaneous pulmonary valve implantation (PPVI). Methods: A total of 8 patients with successful PPVI in our hospital from 2014-05-27 to 2015-03-25 were studied. The patients received pre-operative evaluation including clinical symptoms, plasma BNP levels, ECG, chest X-ray, echocardiography, CT and MRI examinations. Post-operative follow-up study was conducted at 6 months after PPVI to compare the ventricular functional changes. Results: The average age in 8 patients was 14-42 (25.4±8.1) years including 7 with tetralogy of Fallot correction and 1 with pulmonary stenosis plasty for 24 years. Echocardiography found that 3 patients with mid to large pulmonary regurgitation and 5 with large regurgitation. Compared with pre-operation, at 6 months after PPIV, all patients had decreased right ventricular end-diastolic diameter (RVEDD) as (44.0±4.8) mm vs (33.6±7.1) mm, right ventricular end-diastolic volume index (RVEDVI) (150.1±25.7) ml/m2 vs (111.4±39.1) ml/m2, RVESVI (107.8±21.5) ml/m2 vs (80.7±22.2) ml/m2 and right ventricular cardiac output (RV-CO) (6.8±1.3) L/min vs (4.9±0.8) L/min, but right ventricular ejection fraction (RVEF) was similar (40.5±6.2) % vs (39.5±9.9) %, P>0.05; while
increased LVEDD (42.9±4.4) mm vs (46.1±3.0) mm, P<0.05, but LVEDVI (61.8±15.0) ml/m2 vs (72.4±17.6) ml/m2, LVESVI (47.8±12.4) ml/m2 vs (41.0±10.4) ml/m2, LVEF (50.9±5.5) % vs (52.8±6.7) % and LV-CO (3.7±1.0) L/min vs (4.2±1.0) L/min were similar, allP>0.05. Conclusion: PPVI may decrease right ventricular preload, improve its reverse remodeling and maintain systolic function at normal level in relevant patients; while the impacts on left ventricular function and geometry should be further studied.

The extremely premature infants have different degrees of immature organ development, abnormal intestinal flora establishment and low immune function, and are prone to necrotizing enterocolitis, late-onset sepsis and other complications.Probiotics can improve intestinal flora, and regulate cell metabolic activity and immune function.Probiotics can be used to prevent necrotizing enterocolitis, and late-onset sepsis and so on.However, the possible harm of probiotics to extremely premature infants should not be ignored.This review summarized the effects of probiotics on extremely premature infants.

Objective To explore the prognosis and management of atrial fibrillation (AF) in patients with atrial septal defect(ASD) accompanied by AF after transcatheter closure of ASD. Methods During the period from July 2010 to May 2013, a total of 24 patients with ASD accompanied by AF were admitted to authors’ hospital to receive transcatheter closure of ASD. Electrocardiogram (ECG), chest X-ray film and transthoracic echocardiography (TTE) were performed before and one day after the operation. Follow-up information was obtained through telephone or at out-patient clinic interview. Results Successful occlusion of ASD was obtained in all patients, and in no patient the AF rhythm turned to sinus rhythm after the procedure. In one patient preoperative AF turned to postoperative atrial flutter, and AF recurred in one case who had received transcatheter ablation of AF before the procedure. One female patient developed gastric bleeding during the course of orally taking warfarin, and she died of cerebral infarction at three days after ceasing the use of warfarin. Of the 24 patients, no anticoagulant drug was used in 5 (20.8%), oral administration of aspirin was given in 7 (29.2%), and oral medication of warfarin was employed only in 11 (45.8%). Conclusion The spontaneous conversion rate of AF is very low in patients with ASD complicated by AF after transcatheter closure of ASD. Postoperative medication of anticoagulation should be strictly standardized and carefully managed.