1.Clinical characteristics and risk factors of 341 very preterm/very low birth weight infants with bronchopulmonary dysplasia
Pingjiao GU ; Yiheng DAI ; Xuqiang YE ; Jipeng SHI
Journal of Chinese Physician 2023;25(4):565-569
Objective:To investigate clinical characteristics and potential risk factors of very preterm/very low birth weight infants with bronchopulmonary dysplasia (BPD).Methods:A retrospective epidemiological study was performed in 341 neonates with birth weights<1 500 g or gestational age between 23 + 0 to 31 + 6 weeks, who were born in Foshan Women and Children Hospital and were admitted to neonatal intensive care units (NICU) within 24 hours of birth. These neonates were divided into non-BPD group and BPD group. Clinical characteristics and potential risk factors were comparatively analyzed between groups. Risk factors for BPD were identified by binary logistic regression analysis. Results:Among the total of 341 enrolled neonates, including 255 neonates without BPD and 86 neonates with BPD, the total incidence of BPD was 25.2%. The incidences of BPD in the infants with gestational age of <30 weeks, 30-32 weeks, and >32 weeks, as well as birth weight <1 000 g, 1 000-1 499 g, and ≥1 500 g were 43.8%(63/144), 15.1%(22/146), 2.0%(1/51), 80.0%(36/45), 20.2%(41/203), 9.7%(9/93), respectively. The gestational age, birth weight, the proportion of cesarean section, and extubation rate within 7 days were lower in BPD group than those in non-BPD group [(28.5±2.4)weeks vs (30.7±1.8)weeks, (1 087.9±312.8)g vs (1 418.4±247.9)g, 54.6%(47/86) vs 75.7%(193/255), 57.1%(44/77) vs 90.0%(108/120), all P<0.05]. Compared to the non-BPD group, the proportion of Apgar score of ≤7 points 5 minutes after birth [16.3%(14/86) vs 2.4%(6/255)], postnatal endotracheal intubation rate [62.8%(54/86) vs 27.4%(70/255)], volume of red blood cell transfusion ≥3 times [31.4%(27/86) vs 6.3%(16/255)], pulmonary surfactant (PS) utilization [82.6%(71/86) vs 44.7%(114/255)], rate of conventional mechanical ventilation [89.5%(77/86) vs 47.0%(120/255)], combined with hemodynamically significant patent ductus arteriosus (HsPDA) [34.9%(30/86) vs 8.2%(21/255)], diagnosed with neonatal respiratory distress syndrome (NRDS) [94.2%(81/86) vs 5.9%(15/255)], combined with clinically diagnosed sepsis [17.4%(15/86) vs 7.0%(18/255)], combined with ≥3 stage retinopathy of prematurity (ROP) [20.9%(18/86) vs 2.7%(7/255)] and mortality [10.5%(9/86) vs 0.8%(2/255)], length of conventional mechanical ventilation, duration of oxygen consumption, and length of hospital stays were higher in the BPD group (all P<0.05). The results of multivariate logistic regression analysis showed that small gestational age ( OR=1.285, 95% CI: 1.010-1.633), Apgar score ≤7 points within 5 min of birth ( OR=5.712, 95% CI: 1.411-23.115), mechanical ventilation duration ( OR=1.113, 95% CI: 1.043-1.188) and oxygen duration ( OR=1.139, 95% CI: 1.092-1.188) were high risk factors for the development of BPD, while heavier birth weight ( OR=0.996, 95% CI: 0.994-0.998) was protective factor for BPD. Conclusions:The smaller the gestational age and the lower the birth weight, the higher the incidence of BPD, Apgar score≤7 points within 5 min of birth, long conventional mechanical ventilation time, and long duration of oxygen consumption are the risk factors for BPD. Prevention of premature delivery, reduction of asphyxia at birth, reduction of endotracheal intubation and invasive ventilation duration, and reduction of oxygen use time are effective measures to reduce the occurrence of BPD.
2.Serum levels of procalcitonin,interleukin-6 and interleukin-8 in patients with COVID-19 infection at admis-sion and their significance in patient prognosis
Sibo LONG ; Yan CHEN ; Xintong ZHANG ; Yanjun YIN ; Limei YANG ; Maike ZHENG ; Chaohong WANG ; Qing SUN ; Jun YAN ; Yiheng SHI ; Guangli SHI ; Yan ZHAO ; Guirong WANG
The Journal of Practical Medicine 2024;40(4):471-475
Objective To analyze the predictive value of serum levels of procalcitonin(PCT)and cytokines on the prognosis of patients with COVID-19 at admission.Methods From November 2022 to February 2023,patients diagnosed with COVID-19 who were admitted to Beijing Chest Hospital were enrolled.Chemiluminescence was used to detect serum PCT levels,and flow microsphere array was used to detect serum cytokines IL-1β,IL-2,IL-4,IL-5,IL-6,IL-8,IL-10,IL-12p70,IL-17A,IL-17F,IL-22,TNF-α,TNF-β,IFN-γ level.ICU admission,mechanical ventilation and in-hospital death were defined as poor prognosis.After excluding patients with bacterial infection,the relationship between serum PCT and cytokine levels at admission and the prognosis of COVID-19 patients was analyzed.After excluding patients with bacterial infection,the relationship between serum PCT and cytokine levels at admission and the prognosis of COVID-19 patients was analyzed.Results A total of 176 patients with complete data were included,including 134 in the PCT-normal group and 42 in the PCT-elevated group,with a median age of 71.50 years and 71.59%males.Patients in the PCT elevated-group had significantly higher rates of ICU admission(38.41%vs.13.11%,P<0.05),mechanical ventilation(76.92%vs.24.59%,P<0.001)and in-hospital mortality(38.46%vs.6.56%,P<0.001)were significantly higher than those in the PCT-normal group.Serum levels of cytokines IL-6(7.40 pg/mL vs.4.78 pg/mL,P = 0.033 4)and IL-8(10.97 pg/mL vs.5.92 pg/mL,P<0.001)were significantly higher in patients with poor prognosis than in those with good prognosis.The area under the curve for PCT,IL-6,and IL-8 to predict poor prognosis in COVID-19 patients was 0.687,0.660,and 0.746,respectively;sensitivity was 52.78%,55.17%,and 72.41%,respectively;and specificity was 81.58%,74.19%,and 74.19%,respectively,as calculated from the ROC curve.When PCT,IL-6 and IL-8 jointly predict the prognosis of COVID-19 patients,the area under the curve is 0.764,the sensitivity is 70.00%,and the specificity is 80.00%.Conclusion Serum PCT and cytokines IL-6 and IL-8 could be used as predictive markers for poor prognosis in patients with COVID-19.
3.Pharmacy construction and management of Yanqing Winter (Paralympic)Olympic Village Polyclinic for 2022 Beijing Winter (Paralympic)Olympic Games basedon 4M1Emethod
Xin YE ; Xiangyi SHI ; Shanshan XU ; Nan WANG ; Yannan ZANG ; Zhen LI ; Shuang LIU ; Yiheng YANG ; Rongsheng ZHAO
China Pharmacy 2022;33(20):2433-2437
The pharmacy of Y anqing Winter (Paralympic)Olympic Village Polyclinic of 2022 Beijing Winter (Paralympic) Olympic Games will be comprehensively managed from five aspects of man ,machine,material,method and environment by adopting the 4M1E management method of quality management tool . In terms of man ,constantly enhanced training and daily health monitoring have been insisted ;in terms of machine ,drug information entry and drug information management have been improved and maintained ;in terms of drugs ,on the basis of drug management ,the management of drugs banned by the World Anti -Doping Agency,class Ⅱ psychotropic drugs and narcotic drugs have been strengthened ;in terms of regulations and environment ,strict pharmacy workflow and management system have been established ,and epidemic prevention closed -loop management requirements have been strictly implemented . From the pre -opening of Yanqing Winter (Paralympic)Olympic Village on January 23,2022 to the official closing of the Village on March 16,2022,the clinic pharmacy dispensed a total of 156 prescriptions(105 prescriptions during the Winter Olympic Games ,51 prescriptions during the Winter Paralympic Games ),including 18 prescriptions from the National (Regional) Olympic Committee and the National (Regional) Paralympic Games team doctors ,2 prescriptions containing stimulants that do not need to be exempted from treatment,1 prescription for narcotics ,and 37 prescriptions for athletes(23.7%). Ibuprofen tablets ,Diclofenac diethylamine emulsion,Loratadine tablets and other drugs are widely used . The application of 4M1E management method enables the clinic pharmacy to provide perfect and high -quality pharmaceutical services for large -scale events while doing well in epidemic prevention and control .
4.Interpretation of Novel Coronavirus Infection :Expert Consensus on Guidance and Prevention Strategies for Hospi tal Pharmacists and the Pharmacy Workforce
Rongsheng ZHAO ; Yiheng YANG ; Li YANG ; Zijian LI ; Fang LIU ; Zhenyu REN ; Wei LIU ; Zhanmiao YI ; Yingqiu YING ; Xiaoxiao LI ; Yingying YAN ; Huibo LI ; Shujie DONG ; Weilong SHI ; Xiaohan XU ; Pengxiang ZHOU ; Zaiwei SONG ; Siqian ZHENG ; Ying LIU ; Shen ZHOU ; Suodi ZHAI
China Pharmacy 2020;31(4):385-389
OBJECTIVE:To provid e reference for pharmaceutical workers to better understand Novel Coronavirus Infection : Expert Consensus on Guidance and Prevention Strategies for Hospital Pharmacists and the Pharmacy Workforce (hereinafter referred to as “expert consensus ”),and to apply and practice in specific work ,so as to give full play to the role of pharmacists to help fight the epidemic.METHODS :The background of the formulation and revision of the expert consensus were introduced ,and its main contents and viewpoints were interpreted. RESULTS & CONCLUSIONS :The text of expert consensus is divided into 8 parts,mainly including disease diagnosis and treatment [SARS-CoV- 2 infection related background ,clinical manifestations and diagnosis, treatment],hospital pharmacy (prevention and control strategy ,work guidance ),drug and facility support management(key drug/facility/equipment support ,management and use of the drug in special circumstances ),information sources and related resources ,etc.,which comprehensively and detailedly provide information ,guidance and strategies for coronavirus SARS-CoV-2 infection prevention and control to play the role of pharmacists in hospital pharmacy well ,do well in the protection of staff in different pharmaceutical posts ,drug security work in response to epidemic situation ,and develop pharmaceutical care. So far,the understanding of SARS-CoV- 2 in the pharmaceutical industry is relatively limited. Based on the accumulated experience and progress in epidemic prevention and control ,the expert consensus will be updated and improved continuously ,so as to provide guidance and help for hospital pharmaceutical personnel.