Anti-Bacterial Agents ; therapeutic use ; Bacterial Infections ; diagnosis ; therapy ; China ; Communicable Diseases ; diagnosis ; therapy ; Cross Infection ; prevention & control ; therapy ; Granulocyte Colony-Stimulating Factor ; therapeutic use ; Granulocyte-Macrophage Colony-Stimulating Factor ; therapeutic use ; Humans ; Immunoglobulins, Intravenous ; therapeutic use ; Infant, Newborn ; Sepsis ; diagnosis ; therapy

Objective To establish the animal model with stress ulcer(SU) and probe the relationship between the gastric mucosal injury and lasting stress time,the dynamic structural changes of pH of gastric juice.Methods Twenty-four SD young rats were randomly divided into 4 groups:control group,45 min(groupⅠ),90 min(groupⅡ),3 h(groupⅢ)groups under water immersion restraint stress(WRS).The change of gastric mucosal ulcer index(UI),pH of gastric juice were observed.Results Acute gastric mucosal damage was induced by WRS,with the WRS time prolonged,UI increased gradually and pH of gastric juice remarkably decreased in experimental rats.UI was positively rela-ted with stress time(r=0.957 P

Humans ; Facial Injuries/etiology* ; Wound Healing

The ABCD2 score is validated for evaluating short-term stroke risk after transient ischemic attack (TIA); however, whether it is able to predict the long-term risk of vascular outcome remains uncertain. Recently a new tissue-based definition of TIA has been proposed. The ABCD2 scores of 145 TIA patients admitted to our hospital were retrospectively calculated and stratified into two categories: ≤ 3 points (low risk); 4-7 points (moderate-high risk). At a median follow-up of 81 months, new vascular events were recorded. Follow-up data were available in 107 patients. Seventy one patients had a moderate-high ABCD2 score. Sixty six patients experienced a cerebral ischemic event; 8 a myocardial infarction; 7 died of cerebrovascular or cardiovascular cause. Moderate-high ABCD2 score was significantly associated with the further cerebral ischemic events (hazard ratio [HR], 1.755; 95% confidence interval [CI], 1.019 to 3.024) and with the combined endpoint (HR, 1.818; 95% CI, 1.079 to 3.063). Our study shows that the ABCD2 score may also be used to predict long-term vascular outcome after tissue-based definition of TIA. Moderate-high ABCD2 score is associated with an increased general vascular risk in the long-term follow-up after TIA.
Stroke

Child ; Child Welfare ; Education, Medical, Continuing ; Humans ; Pediatrics ; education

ObjectiveTo explore the etiology, comolication a nd causes of death of hospitalized preterm infants. MethodsM aternal and neonatal medical records of 834 hospitalized preterm infants from Ja nuary 1991 to Decembre 2001 were reviewed.ResultsThe statist ics showed that there was an increased tendency of hospitalized preterm infants year by year. Most of them have a definite etiology of prematurity. There were m ore cases hospitalized in winter than in other seasons. 87.6% of preterm infants were associated with different complications. The morbidity of cold injury, pne umonia, recurrent apnea and intracranial hemorrhage declined in last 6 years. Si xty-four babies died, the mortality rate was 7.7%. The smaller the gestational age and birth weight was, the higher the mortality would be. The risk factors of death were birth weight, gestational age, Apgar score at 1 minute after birth, pulmonary hemorrhage and hyaline membrane disease.Conclusion It is important to enforce the perinatal health care and the co-operation of ob stetricians and pediatricians to reduce the complications of prematurity. We sho uld set up a well organized district perinatal transport system, raise the effic iency of rescue management, reduce the mortality and improve the prognosis of pr eterm infants.

OBJECTIVESTo investigate the related perinatal factors in the development of anemia of prematurity by a case-control study.

METHODSThe medical data of 165 preterm infants admitted to the department of neonatology in Peking University Third Hospital from January 2005 to December 2006 were retrospectively reviewed. The infants were classified into two groups: anemia and non-anemia (control). The factors associated with anemia of prematurity were identified.

RESULTSSixty-three preterm infants (38.1%) had anemia. The gestational age (32.5+/-2.0 weeks vs 33.7+/-1.9 weeks) and birth weight (1682.7+/-393.9 g vs 2041.1+/-510.1 g) of the anemia group were significantly lower than those of the control group (P<0.01). The blood loss from laboratory testing (12.4+/-6.5 mL/kg vs 6.6+/-3.6 mL/kg) and the duration of hospital stay (25.6+/-14.2 days vs 14.1+/-8.7 days) of the anemia group were significantly higher than those of the control group (P<0.01). More critically ill patients (33.3%) were noted in the anemia group compared with in the control group (9.8%) (P<0.01). In the anemia group, 44.4% of the mothers had preeclampsia but only 28.4% in the control group (P<0.05). Multiple factor logistic regression analysis revealed that the blood loss from laboratory testing was the only independent high-risk factor for anemia of prematurity. Compared with the preterm infants whose blood loss from laboratory testing was < 5 mL/kg, the OR values of the preterm infants whose blood loss was 5-10, 10-15 and > or = 15 mL/kg was 1.737 (95% CI: 0.699-4.316, P>0.05), 4.141 (95% CI: 1.573-10.905, P<0.01) and 32.267 (95% CI: 8.053-129.287, P<0.01), respectively.

CONCLUSIONSAnemia of prematurity is associated with gestational age, birth weight, duration of hospital stay, illness severity and maternal preeclampsia. The blood loss from laboratory testing is an independent risk-factor in the development of anemia of prematurity.

Anemia ; etiology ; Birth Weight ; Blood Specimen Collection ; Case-Control Studies ; Female ; Gestational Age ; Humans ; Infant, Newborn ; Infant, Premature, Diseases ; etiology ; Logistic Models ; Male ; Retrospective Studies

Objective • To verify the effectiveness of the intervention program of bowel dysfunction in patients with spinal cord injury (SCI). Methods • Eighty bowel dysfunction patients with SCI in a rehabilitation hospital in Shanghai from Jan. to Dec. 2018 were included. According to the time of admission, the patients were divided into intervention group and control group, with 40 cases in each group. The patients in the control group received the routine nursing, and the patients in the intervention group were provided with the intervention program constructed by this study. The bowel function indexes of the two groups were compared at the time of admission, 4 weeks after intervention and 1 month after discharge. The quality of life in the two groups was compared at the time of admission and 1 day before discharge. Results • After intervention, the defecation frequency, fecal character score, defecation time, abdominal distention, constipation rate and drug dependence rate of the intervention group were lower than those of the control group (all P<0.05), and their total scores of quality of life and the scores in various fields were higher than those of the control group (all P<0.05). The differences in the quality of life between the two groups of patients after intervention and at the time of admission were statistically significant except for the social field (all P<0.05). Conclusion • The intervention program for bowel dysfunction patients with SCI can effectively lead to the recovery of the bowel function, reduce the incidence of bowel complications, and improve the quality of their life.

A boy aged 2 months (born at 36 weeks of gestation) was admitted due to cough and dyspnea. After admission, he was found to have persistent hypertension, proteinuria, and persistent convulsion, and imaging examination showed extensive calcification of the aorta and major branches and stenosis of local lumens of the abdominal aorta and the right renal artery with increased blood flow velocity. The boy was admitted during the neonatal period due to wet lung and pulmonary arterial hypertension and was found to have hypertension and proteinuria. High-throughput whole-exome sequencing was performed and found two compound heterozygous mutations in the ENPP1 gene from his parents, c.130C>T (p.Q44X) and c.1112A>T (p.Y371F). c.130C>T was a nonsense mutation, which could cause partial deletion of protein from 44 amino acids, and was defined as a primary pathogenic mutation. c.1112A>T was a missense mutation which had been reported as a pathogenic mutation associated with idiopathic infantile arterial calcification (IIAC). Therefore, he was diagnosed with IIAC. He was given phosphonate drugs, antihypertensive drugs, anticonvulsion treatment, and respiratory support. Blood pressure was maintained at the upper limit of normal value. There was no deterioration of arterial calcification. It is concluded that IIAC should be considered for infants with persistent hypertension and extensive vascular calcification, and imaging and genetic examinations should be performed as early as possible to make a confirmed diagnosis.
Humans ; Hypertension ; Infant ; Infant, Premature ; Male ; Mutation ; Vascular Calcification

OBJECTIVETo evaluate the clinical features of respiratory diseases of late preterm neonates.

METHODSSix hundred and thirty late preterm infant(gestational age: 34~36+6weeks),4401 cases of term infants and 328 early preterm infants who were born at the obstetrical department of Peking University 3rd Hospital from January 2009 to December 2010 were enrolled. Among them 84 late preterm infants, 135 term infants and 182 early preterm infants developed respiratory diseases. The incidence of respiratory diseases,clinical features and the severity of the diseases were compared among the three groups.

RESULTSThe incidence and mortality rates of respiratory diseases and the percentage of severe cases were significantly higher in the late preterm group than in the term group, but lower than in the early preterm group (P<0.01). The symptoms of respiratory disease occurred earlier in the late preterm group than in the term group, but later than in the early preterm group (P<0.01). The late preterm group had a significantly higher incidence of tachypnea and lower incidence of retraction sign when compared with the term and early preterm groups (P<0.05). The percentages requiring oxygen therapy and mechanical ventilation in the late preterm group were both significantly higher than in the term group, but lower than in the early preterm group (P<0.05). The multiple linear regression analysis showed 11 factors associated with the severity of respiratory diseases: decreased arterial partial pressure of oxygen, hematokrit, pH value and respiratory rate, arterial oxyhemoglobin saturation, systolic arterial pressure, 5 minute Apgar score and gestational age, and increased blood urea nitrogen, heart rate and respiratory rate.

CONCLUSIONSLate preterm infants are more likely to develop respiratory diseases than term infants, and to develop a more severe condition and need a more intensive respiratory support treatment. Tachypnea is a common presentation of dyspnea in late preterm infants and occurs earlier than in term infants but later than in early preterm infants. It may usually indicate a serious condition when dyspnea, abnormal heart rate and blood pressure, and multisystem damages occur in late preterm infants.

Humans ; Incidence ; Infant, Newborn ; Infant, Premature, Diseases ; epidemiology ; mortality ; Prognosis ; Respiratory Tract Diseases ; epidemiology ; mortality ; Retrospective Studies