Dexmedetomidine(DEX) is a new type of highly selective α₂ adrenergic receptor agonist with multiple effects, such as sedation, analgesic, anti-anxiety and inhibition of sympathetic nervous system activity.DEX is usually used as an anesthetic adjuvant and as an sedative and analgesic in PICU, also possessing effects of preventing and treating emergence agitation, counteracting postoperative shivering and organ protection.This paper summarized the clinical application of DEX in pediatric field.

OBJECTIVETo observe the clinical effect of Qidi Yiqi Yangyin Huoxue Recipe (QYYHR) on diabetic nephropathy (DN) at stage III and IV.

METHODSOne hundred type 2 DN patients of qi-yin deficiency with blood-stasis syndrome were randomly divided into two groups, all were treated with basal hypoglycemic treatment but with QYYHR given to the treatment group additionally for 3 months. The symptoms were observed, blood glucose, urinary albumin excretion rate (UAER), blood urea nitrogen (BUN), creatinine (Cr) and hemorheological parameters were detected before and after treatment.

RESULTSThe total effective rate was higher in the treatment group than that in the control group (89.6% vs. 68.1%, P < 0.01), and the improvement of UAER, BUN, Cr and hemorheological parameters was also significantly better in the former than in the latter (P < 0.05).

CONCLUSIONQYYHR has favorable effects on type 2 DN of qi-yin deficiency with blood-stasis syndrome.

Adult ; Aged ; Albuminuria ; urine ; Blood Glucose ; metabolism ; Blood Urea Nitrogen ; Creatinine ; blood ; Diabetes Mellitus, Type 2 ; complications ; Diabetic Nephropathies ; blood ; drug therapy ; etiology ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Hemorheology ; drug effects ; Humans ; Male ; Middle Aged ; Phytotherapy ; Qi ; Treatment Outcome ; Yin Deficiency ; drug therapy

Male infertility microsurgery represents the fastest growing sub-specialty in urology and clinical andrology over the past two decades. The importance of microsurgery for male infertility has risen as a part of the urologist's armamentarium in the medical and surgical management of male infertility. Despite the advances in male infertility microsurgery in China, the lack of standardized and well-organized training programs for male infertility microsurgery remains a serious problem affecting its development. In this article, Zhao and Peng have shared their experience with the learning curve of male infertility microsurgery at the Center for Male Reproductive Medicine and Microsurgery, Weill Medical College of Cornell University, which centers on how to pay attention to the details and basic principles of microsurgery. Male infertility microsurgery is physically, technically and mentally challenging, and must be first learned in the laboratory. Clinical success depends heavily upon appropriate training in a microsurgical laboratory. Good training can significantly reduce operation time and surgical errors as well as improve the quality of outcomes.
Andrology ; education ; Humans ; Infertility, Male ; surgery ; Male ; Microsurgery ; education

AIM: To analyze the treatment of retinal arterial macroaneurysm(RAM)and its efficacy.

METHODS:A total of 26 diagnoses of retinal arterial microaneurysm made in the Fourth People's Hospital of Shenyang between June 2016 and June 2018 were reviewed. Various treatment strategies for different types, and complications, of RAM were utilized, with the clinical, anatomical, and functional outcomes being analyzed retrospectively.

RESULTS: Visual prognosis and its efficacy were due to the scope and location of exudation or heamorrhage, disease duration and treatments employed. Hemorrhagic RAM, edema or hemorrhage affecting the macular region and long disease duration associated with poor prognosis. Vitrectomy with subretinal air tamponade had strong functional and anatomical effects on submacular haemorrhages within 3wk.

CONCLUSION: A suitable, individually adapted treatment of retinal arterial macroaneurysm should be chosen to achieve better prognosis.

Objective: To evaluate the clinical effectiveness of combining electrical stimulation with manual massage in treating women′s myofascial pelvic pain (MPPS). Methods: A total of 93 MPPS patients were recruited and randomly divided into an infrared irradiation group (n=30), an electrical stimulation group (n=31) and a combination group (n=32). Those in the infrared group and the electrical stimulation group were given 30 minutes of infrared irradiation or electrical stimulation daily for 10 days, while the combined group was given a manual massage with electrical stimulation. The response to treatment was evaluated using a visual analogue scale (VAS) to rate discomfort, plus a physical examination, and surface electromyography results using Glazer′s protocol. The treatments′ efficacy and the recurrence of pain were evaluated 1 month after the treatment. Results: The average VAS ratings, resting potentials and their variability of the three groups all improved significantly after the treatment. The average VAS scores of the combined and electrical stimulation groups after the treatment were significantly lower than that of the infrared group. Moreover, the total effective rates of the combined group (96.87%) and the electrical stimulation group (80.65%) were significantly higher than that of the infrared group (56.67%), and the resting potential and variability of the former two groups were also significantly better. All of the above measurements among the combined group after the treatment were significantly better, on average, than in the electrical stimulation group. A month later the recurrence rate in the combined group (6.25%) was significantly lower than in the electrical stimulation group (25.81%) and the infrared group (56.67%). Conclusion Electrical stimulation combined with manual massage is effective in relieving myofascial pelvic pain.

Objective: To investigate the differential performance of ultrasound between infantile fibrosarcoma(IFS) and soft tissue hemangioma. Methods: The retrospective study was conducted from January 2012 to January 2019 in Beijing Children′s Hospital, Capital Medical University. A total of 16 patients with IFS were consecutively collected as IFS group, and 26 consecutive patients with soft tissue hemangioma (hemangioma group) were selected for comparison according to the tumor size of IFS. All the final diagnosis got confirmed by pathological analysis. The ultrasonographic features of IFS and hemangioma were compared and analyzed, and after weighting on the basis of the dominance ration (OR), the ultrasonic features with diagnostic value were used to establish the prediction equation. Then, the differential performance of every feature and the prediction equation was evaluated via the ROC analysis. Results: There were differences in the lesion echo, margin and blood flow characteristics between IFS group and hemangioma group (P=0.013, 0.002, 0.005), the area under the ROC (AUC) of applying every ultrasonic feature with diagnostic value for differentiation were 0.695, 0.740, and 0.700, respectively. Benefiting from the employment of the prediction equation, the AUC was improved to 0.887 with a sensitivity of 81.3% and a specificity of 96.2%, which were better than the diagnosis by any single feature (P=0.017, 0.035, 0.003). Conclusions Ultrasound can be utilized to discriminate infantile fibrosarcoma from soft tissue hemangioma. The use of prediction equation can further improve the differential performance with higher clinical value.

【Objective】 To investigate the transfusion effect of 0.5-dose of apheresis platelet in pediatric patients. 【Methods】 A total of 195 children who underwent 0.5-dose platelet transfusion from August 2021 to June 2022 were enrolled, and the platelet count within 24 hours before and after platelet transfusion were recorded. They were grouped by gender, disease type, blood product transfusion history, platelet antibody results, platelet storage time and weight to analyze the effect of platelet transfusion. 【Results】 Among 195 cases, 77.4% (151/195) were effective and 22.6% (44/195) were ineffective after 0.5-dose of platelet transfusion. Platelet transfusion more than three times has significant impact on the effectiveness of platelet transfusion, with platelet transfusion efficiency decreased from 80.8% to 65.9% (P<0.05), and CCI decreased from 11.56±8.94 to 8.52±8.42 (P<0.05). The transfusion effect of the HLA and HPA antibodies positive group was significantly lower than the negative group, with CCI decreased from 11.39±8.87 to 7.82±8.59 (P=0.05). Linear regression analysis showed that the effect of platelet transfusion decreased with the increasing of platelet storage time (P<0.05), and the effect of platelet transfusion decreased in children weighing less than 20 kg compared with those weighing more than 20 kg, with the effective rate decreased from 84.1% to 63.5% (P<0.05). Different gender, disease type and the number of red blood cell transfusions had no significant effect on platelet transfusion. 【Conclusion】 The 0.5-dose platelet transfusion has good therapeutic effect in children below 20 kg. The results of HLA and HPA antibodies and the number of platelet transfusions greatly influence the effect of platelet transfusion in children, and the transfusion effect decreases with the increase of platelet storage time.

Objective To analyze the control status and influencing factors of glycosylated hemoglobin (HbA1c) in children with type 1 diabetes mellitus (T1DM) in Tianjin from 2020 to 2021, and to provide a theoretical basis for controlling blood glucose in children with type 1 diabetes mellitus. Methods A total of 538 children with type 1 diabetes, including 275 males and 263 females, were selected from our hospital from January 2020 to June 2021. All the children were determined according to the level of HbA1c and divided into well-controlled group (HbA1c<7.0%, n=469) and poorly controlled group (HbA1c≥7.0%, n=69), 3ml fasting elbow venous blood was extracted from the two groups, and the levels of HbA1c, FPG, 2hPG, TC and LDL-C were compared between the two groups. Clinical data of the children were collected from the medical record system. The factors affecting the control of HbA1c in children with type 1 diabetes were analyzed by univariate analysis and logistic regression. Results The comparison of general data between the two groups showed no significant difference in age, sex and course of type 1 diabetes mellitus (P<0.05). The levels of HbA1c, FPG, 2hPG, TC and LDL-C in poorly controlled group were significantly higher than those in well controlled group (P<0.05). The blood glucose monitoring <60 times/month (OR=3.017), uncontrolled diet (OR=2.871), obesity (OR=2.623) were independent risk factors for poor control of HbA1c in children with type 1 diabetes (P<0.05). Conclusions Children with type 1 diabetes mellitus have a greater risk of poor control of HbA1c. It is necessary to strengthen publicity and education for parents of children with diabetes, regularly monitor blood glucose and control diet to effectively improve blood glucose control in children.

The subgranular zone (SGZ) and subventricular zone (SVZ) are developmental remnants of the germinal regions of the brain, hence they retain the ability to generate neuronal progenitor cells in adult life. Neurogenesis in adult brain has an adaptive function because newly produced neurons can integrate into and modify existing neuronal circuits. In contrast to the SGZ and SVZ, other brain regions have a lower capacity to produce new neurons, and this usually occurs via parenchymal and periventricular cell genesis. Compared to neurogenesis, gliogenesis occurs more prevalently in the adult mammalian brain. Under certain circumstances, interaction occurs between neurogenesis and gliogenesis, facilitating glial cells to transform into neuronal lineage. Therefore, modulating the balance between neurogenesis and gliogenesis may present a new perspective for neurorestoration, especially in diseases associated with altered neurogenesis and/or gliogenesis, cell loss, or disturbed homeostasis of cellular constitution. The present review discusses important neuroanatomical features of adult neurogenesis and gliogenesis, aiming to explore how these processes could be modulated toward functional repair of the adult brain.
Adult* ; Aging ; Brain ; Constitution and Bylaws ; Homeostasis ; Humans ; Lateral Ventricles ; Neurogenesis* ; Neuroglia ; Neurons ; Stem Cells

Objective: To know the drug resistance of Acinetobacter baumannii (AB) in wound of children with traffic injury and its relationship with antibiotic use. Methods: Wound exudate of 226 children with traffic injury admitted to our unit from January 2010 to December 2015 were collected. API bacteria identification panels and fully automatic microbiological identification system were used to identify pathogens. Kirby-Bauer paper disk diffusion method was used to detect the drug resistance of pathogens to 18 antibiotics including amoxycillin/clavulanic acid, piperacillin/tazobactam, and imipenem. The detection situation of pathogen of children′s wounds and drug resistance of detected AB to 18 antibiotics in each year were collected. Forty-six AB positive children (2 children excluded) were divided into imipenem-resistant group (IR, n=19) and non imipenem-resistant group (NIR, n=25) according to whether AB was 100% resistant to imipenem. Drug resistance of AB in wounds of children to 18 antibiotics in two groups was compared. The antibiotic use of AB positive children was collected, and the antibiotic use intensity of children in two groups was compared. Data were processed with Fisher′s exact test, independent sample t test, and corrected t test. Results: (1) The detection rates of pathogen in wounds of children in 2010-2015 were 95.6% (43/45), 89.8% (53/59), 81.3% (148/182), 81.1% (107/132), 81.6% (120/147), and 77.5% (62/80), respectively, showing a trend of decreasing year by year. A total of 665 strains and 75 pathogens were detected, and the top 5 pathogens with detection rate from high to low were AB, Pseudomonas aeruginosa, Enterobacter cloacae, Staphylococcus epidermidis, and Escherichia coli, respectively. (2) Drug resistance rates of AB to amoxycillin/clavulanic acid, cefazolin, aztreonam, and piperacillin were all 100%, while AB was 100% sensitive to polymyxin, and the total drug resistance rates of AB to the other 13 antibiotics were all above 50%. The drug resistance rate of AB in wounds of children to piperacillin was higher than that to piperacillin/tazobactam in 2010-2015. (3) Except for imipenem, amoxycillin/clavulanic acid, cefazolin, aztreonam, piperacillin, and polymyxin, the drug resistance rates of AB in wounds of children in group IR to the other 12 antibiotics were higher than those in group NIR (with P values below 0.01). Besides, AB strains in wounds of children in group IR were completely resistant to at least 3 kinds of antibiotics including carbapenems, aminoglycosides, and quinolones, so that they were multidrug-resistant AB. (4) A total of 32 antibiotics were used in 46 AB positive children, and the 10-top-used antibiotics with use intensity from high to low were cefoperazone/sulbactam, piperacillin/tazobactam, cefazolin, imipenem, ceftizoxime, amoxycillin/clavulanate, ceftazidime, cefepime, amoxycillin/sulbactam, and cefmetazole, respectively. (5) Twenty-one antibiotics were not included in the comparison because of their small amount of usage. For the other 11 antibiotics, only the use intensity of metronidazole of children in two groups was statistically different (t=-3.104, P<0.05). There was no statistically significant difference in total antibiotic use of children in two groups (t=0.368, P>0.05). Conclusions AB is one of the main pathogens in wounds of children with traffic injury, with high drug resistant rate. The high intensity of antibiotic use may lead to its drug resistance. In this study, the top-used antibiotics were in accord with AB resistant drugs, indicating a lack of normative use of antibiotics.