Septic encephalopathy( SE) is defined as diffuse brain dysfunction that related to systemic inflammatory response and without clinical or laboratory evidence of central nervous system infection.SE is one of the most common complications of patients with severe sepsis.Its pathogenesis is very complex and is not yet clear.The clinical manifestations of SE varied and have no specificity, mainly for changes of con-sciousness and mental status.The performance of electroencephalography is more sensitive,and is associated with prognosis.Somatosensory evoked potentials could display the damage of cortical or subcortical path-ways.Brain MRI has a more accurate assessment of the nature and the extent of brain damage.SE is a diag-nosis of exclusion.Before the diagnosis of SE,we need to exclude other encephalitis and encephalopathy.The morbidity and mortality of SE are high.It requires close attention,early detection and timely treatment.

Adult ; Drugs, Chinese Herbal ; therapeutic use ; Endometriosis ; drug therapy ; Female ; Follow-Up Studies ; Humans ; Medicine, Chinese Traditional ; Middle Aged ; Phytotherapy

Aorta, Thoracic ; abnormalities ; Humans ; Infant ; Magnetic Resonance Angiography ; Male ; Pulmonary Artery ; abnormalities ; Recurrence ; Respiratory Insufficiency ; etiology ; Respiratory Sounds ; etiology ; Subclavian Artery ; abnormalities ; Vascular Diseases ; complications ; congenital ; diagnosis ; pathology ; physiopathology

Adolescent ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Male ; Neoplasms ; complications ; Respiratory Distress Syndrome, Adult ; complications ; Risk Factors

Animals ; Bone Marrow Cells ; cytology ; Cells, Cultured ; Culture Media, Conditioned ; Megakaryocytes ; cytology ; Mice ; Mice, Inbred Strains ; Thrombopoietin ; pharmacology

Humans ; Large-Conductance Calcium-Activated Potassium Channels ; TRPC Cation Channels ; Vasodilation

Objective To study the clinical presentations,radiologic features,prognosis,and possible causes of liver injury associated umbilical venous catheter (UVC ).Methods We reviewed database of our NICU from December 2012 to November 2015 and identified preterm infants with liver injury while UVC in place.The gestational age,birth weight,gender,days of UVC in place prior to liver injury, the depth of UVC (cm),UVC tip position,ultrasound findings of liver injury,laboratory tests,treatment and outcomes were collected.Results During study period,322 infants received UVC insertion.Ten cases (3.1 %)of liver injury associated with UVC were diagnosed.Of the ten infants,nine were diagnosed as extravasation of fluid to liver parenchyma,and one was diagnosed as liver hematoma.The mean birth weight was (1184 ±207)g,mean gestational age was (28.5 ±1.7)weeks.The UVC tip was at thoracic (T) vertebrae T 9 to T 11 level,nine UVC tips were below the right diaphragm level.All UVCs were used for total parenteral nutrition before liver injury was diagnosed.Six infants had clinical manifestations,and four infants were free of clinical manifestations.The most prominent clinical signs were abdominal distension (n =5),weak bowel sounds (n =5)and hepatomegaly (n =4).One infant who was diagnosed with liver hematoma also had progressive hemoglobin decline (minimum 34 g/L)and shock.Abdominal ultrasound showed well-limited,irregular,hyperechoic rimmed lesions with heterogeneously hypoechoic centers or anechoic liquid dark space.Extravasation of fluid to liver parenchyma will restorate within one week after the UVC was remove.One baby who was diagnosed as liver hematoma passed away at 9 days of life.Liver ultrasound of eight returned to normal in 52 days to 3.5 months,and one had calcified lesions at 9 months of age.Conclusions Liver injury is an unusual complication of UVC insertion and usage.Proper positioning of the UVC tip may help to avoid this complication.Early recognition,prompt diagnosis with liver ultrasound examination and timely treatment can lead to better outcome in newborns with extravasation of fluid to liver parenchyma.

The central nervous system ( CNS) complications and peripheral nervous system ( PNS) complications are common complications of sepsis. CNS complications include sepsis associated encephalopathy (SAE),septic-metastatic encephalitis (SME),and septic-embolic encephalitis (SEE). Of them,the SAE is the most common complication of CNS complications. PNS complications include critical illness polyneuropathy (CIP) and critical illness myopathy (CIM). CIP and CIM could lead to muscle weakness and dependence on mechanical ventilation of patients with sepsis. Sepsis related neurological complications are closely related to the mortality and prognosis of patients,so early recognition and timely intervention are important.

Breast cancer is the leading cause of malignancy-related mortality in women worldwide. The more accurate prediction of lymph node metastasis and evaluation of personalized prognosis of breast cancer patients could provide evidence and reference for individualized comprehensive treatment and clinical decision-making. Nomogram is statistical calculation model developed to generate individualized prediction of a certain clinical event through the factors associated with it. Currently breast cancer related nomogram models is most commonly used in the prediction of non-sentinel lymph node status in patients with sentinel lymph node-positive breast cancer, sentinel lymph node metastasis in clinical node-negative breast cancer and prognosis evaluation of breast cancer. This article reviewed the recent advances in breast cancer related nomograms according to the above mentioned three aspects, and evaluated respectively the predictive factors, accuracy, characteristics and clinical application potential.

Objective To evaluate the effectiveness of maternal prenatal education on promoting breastfeeding rate for preterm infants in neonatal intensive care unit (NICU).Methods Gravidas who were admitted to Peking University First Hospital for any risk of preterm delivery from November 2013 to December 2014 and preterm infants admitted to the NICU (length of stay ≥ 5 d) of the same hospital during the same period were involved.All the gravidas received prenatal education and completed questionnaires.Two hundred and ninety-five preterm infants who met the inclusion criteria were divided into two groups including education group (n=125) and non-education group (n=170) according to whether their mothers received prenatal education or not.Conditions of the preterm infants during hospitalization and after discharge and breastfeeding rates were comparatively analyzed between the two groups.T test,Chi-test and Wilcoxon rank-sum test were used for statistical analysis.Results (1) There were 380 gravidas received questionnaires.Among them,346 (91.1％)completed the questionnaires and were recruited in this study.Only 31.8％ (110/346) of these gravidas were active in learning more about breastfeeding and 46.2％ (160/346) of them lacked confidence in breastfeeding after the appearance of preterm delivery signs.There were significant improvements in their attitudes towards considering breastfeeding seriously and discussing with their family,confidence in breastfeeding,the importance of colostrum and how to breastfeed a preterm infant in hospital after maternal prenatal education (all P＜0.001).Prenatal education was thought to be helpful in 77.5％ (268/346) of the gravidas.(2) The two groups of preterm infants showed good homogeneities in gestational age,gender,birth weight and other basal conditions as well as in incidences of in-hospital complications and conditions after discharge (all P＞0.05).Proportions of breast milk intake (breast milk intake over total dairy intake) in preterm infants were higher in education group than those in non-education group within 5 d after birth [0.0 (0.0-16.5)％ vs 0.0 (0.0-2.5)％,Z=-3.422],＞5-≤ 7 d [33.7 (0.0-82.8)％ vs 0.0 (0.0-50.3)％,Z=-3.070],＞7-≤ 14 d [75.2(23.5-96.4)％ vs 47.6(0.0-92.2)％,Z=-2.345] and during hospitalization [58.4 (21.0-78.8)％ vs 31.9 (0.0-71.7)％,Z=-3.902] (all P＜0.05).Breastfeeding rates were higher in education group than those in non-education group at the age of 5 d [47.2％(59/125) vs 27.1％ (46/170),x2=12.747],7 d [70.4％ (88/125) vs 51.2％ (87/170),x2=11.031],three months [83.3％(65/78) vs 56.1％ (60/107),x2=15.297] and six months [64.5％ (49/76) vs 49.1％ (53/108),x2=4.282] (all P＜0.05).Exclusive breastfeeding rates in the first,third and sixth months after birth were higher in education group [45.7％(53/116),42.3％ (33/78) and 36.9％ (28/76)] than those in non-education group [21.3％ (32/150),28.0％ (30/107)and 22.2％ (24/108)] (22=17.847,4.091 and 4.703,all P＜0.05),respectively.Conclusions Most gravidas with risk factors of preterm delivery have no confidence on breastfeeding.Prenatal maternal education is an effective and feasible intervention to improve breastfeeding rate for preterm infants in NICU from early hospitalization till six months after birth.