1.The relationship between chest radiographic changes and clinical manifestations in 148 patients with scrub typhus in Guangdong area
Xujing LIANG ; Simin HUANG ; Jianping LI ; Xiannü ZHU ; Yongping LU ; Youpeng CHEN
Chinese Journal of Infectious Diseases 2012;30(6):359-362
Objective To investigate the relationship between chest radiographic changes and clinical manifestations in patients with scrub typhus in Guangdong area.MethodsA total of 148 cases of scrub typhus admitted to First Affiliated Hospital of Ji′nan University,Guangzhou Eighth People′s Hospital and the Second People′s Hospital of Yuebei between 1999 and 2010 was retrospectively reviewed.The patients were divided into two groups based on the findings of the chest X-rays (with or without radiographic abnormalities).Furthermore,the clinical characteristics and prognosis in two groups were compared.The statistical analysis was done using t test,chi-square test or Fisher′s exact test.ResultsChest X-rays showed abnormalities in 66 (44.6%) cases,and the chest X-ray features were diverse.The incidences of cough,severe thrombocytopenia,hypoalbuminemia,shock,acute respiratory failure,jaundice and acute renal failure were all significantly increased in group of patients with chest X-rays abnormalities compared with the other group of patients without chest X-rays abnormalities (χ2 =18.193,6.872,17.138,5.608,4.318,7.982 and 7.932,respectively; all P<0.05).The hospitalization day was longer in patients with chest X-rays abnormalities compared with the patients without chest X-rays abnormalities,but there was no statistical difference [(11.7±7.1)d vs (9.9±5.0)d,t=1.717; P=0.088)],while the mortality was higher(6.1 % vs 0; Fisher′s exact test,P =0.038).Conclusions The clinical manifestations of the patients with scrub typhus are diverse,and the presence of abnormal chest X-rays is shown to be associated with the disease severity.Physicians should have the awareness of scrub typhus to make the diagnosis and treatment properly.
2.Multicenter investigation on sedative and analgesic treatment and management of pediatric intensive care unit in Shandong province
Haiqing WANG ; Meiyun XIN ; Hongfeng ZHU ; Mingying HAN ; Shengying DONG ; Zhaohua ZHANG ; Youpeng JIN
Chinese Pediatric Emergency Medicine 2020;27(4):279-283
Objective:To understand the status of sedation and analgesia treatment and management in pediatric intensive care unit(PICU) in Shandong Province, and to provide the basis for the improvement of sedation and analgesia treatment plan.Methods:This study was a multi-center retrospective study.The PICUs of 6 tertiary hospitals in Shandong Province participated in this study.The data of 1 340 children admitted to these 6 PICUs from January 2016 to December 2018 were collected.The age, gender, the pediatric risk of mortality score Ⅲ at 24 hours after admission, whether they received mechanical ventilation, whether they received sedation and(or) analgesia, whether they were monitored sedation and(or) analgesia, and in-hospital mortality were analyzed.The children were divided into the simple sedation group( n=798), the sedation + analgesia group( n=120) and the non-sedation analgesia group( n=422) according to whether they received sedation and(or) analgesia.The diseases, proportion of mechanical ventilation, incidence of hypotension, average length of stay in PICU and in-hospital mortality were compared among the three groups. Results:The median age of the 1 340 children was (13.3±6.4) months, including 786 males(58.7%). Sedation therapy had been carried out in 6 PICUs, of which 5 PICUs had routine sedation assessment; 4 PICUs had carried out analgesic therapy, of which only 2 had routine pain assessment.A total of 918 children(68.5%)received sedation and(or) analgesia, midazolam was the most commonly used sedative drug, followed by dexmedetomidine, and 526 children(57.3%)were monitored for sedation assessment, the most commonly used assessment method was the Richmond agitation sedation score.One hundred and twenty(9.0%)cases received sedation combined with analgesia, fentanyl was the most commonly used analgesic, and 38 children(31.7%) underwent routine pain assessment.There was no significant difference in age and sex among the three groups.The proportion of surgical diseases and patients received mechanical ventilation(100.0%, 120/120) were the highest in the sedation + analgesia group.The proportion of mechanically ventilated patients was the lowest in the non-sedation analgesia group(11.4%, 48/422). The mean duration of mechanical ventilation in the sedation + analgesia group was slightly shorter than that in the simple sedation group( P>0.05). The incidence of hypotension was highest in the sedation + analgesia group, and lowest in the non-sedation analgesia group[21.7%(26/120) vs.2.1%(9/422), P<0.01]. There was no significant difference in in-hospital mortality and mean PICU stay among three groups. Conclusion:Benzodiazepines are still the main sedative drugs used in PICUs in Shandong Province.In recent years, the usage of dexmedetomidine has gradually increased, but the proportion of analgesic use is very low.At present, analgesic and sedative therapy is mainly used for children after surgery and receiving mechanical ventilation.Although analgesic and sedative therapy does not increase the in-hospital mortality and average length of stay in PICU, it increases the incidence of hypotension.The sedative and analgesic treatment and assessment in the PICU of Shandong Province are still not standardized, mainly reflected in infrequently analgesic treatment and the assessment of sedation and pain, which need to be further improved.
3. Significance of bacteria detection with filter paper method on diagnosis of diabetic foot wound infection
Xinhua ZOU ; Youpeng ZHU ; Guoqiang REN ; Gongchi LI ; Jing ZHANG ; Lijun ZOU ; Zibo FENG ; Binghui LI
Chinese Journal of Burns 2017;33(2):83-88
Objective:
To evaluate the significance of bacteria detection with filter paper method on diagnosis of diabetic foot wound infection.
Methods:
Eighteen patients with diabetic foot ulcer conforming to the study criteria were hospitalized in Liyuan Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology from July 2014 to July 2015. Diabetic foot ulcer wounds were classified according to the University of Texas diabetic foot classification (hereinafter referred to as Texas grade) system, and general condition of patients with wounds in different Texas grade was compared. Exudate and tissue of wounds were obtained, and filter paper method and biopsy method were adopted to detect the bacteria of wounds of patients respectively. Filter paper method was regarded as the evaluation method, and biopsy method was regarded as the control method. The relevance, difference, and consistency of the detection results of two methods were tested. Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of filter paper method in bacteria detection were calculated. Receiver operating characteristic (ROC) curve was drawn based on the specificity and sensitivity of filter paper method in bacteria detection of 18 patients to predict the detection effect of the method. Data were processed with one-way analysis of variance and Fisher's exact test. In patients tested positive for bacteria by biopsy method, the correlation between bacteria number detected by biopsy method and that by filter paper method was analyzed with Pearson correlation analysis.
Results:
(1) There were no statistically significant differences among patients with wounds in Texas grade 1, 2, and 3 in age, duration of diabetes, duration of wound, wound area, ankle brachial index, glycosylated hemoglobin, fasting blood sugar, blood platelet count, erythrocyte sedimentation rate, C-reactive protein, aspartate aminotransferase, serum creatinine, and urea nitrogen (with
4. Multicenter investigation of extracorporeal membrane oxygenation application in pediatric intensive care unit in China
Gangfeng YAN ; Xiaodi CAI ; Chengbin ZHOU ; Xiaoyang HONG ; Ying WANG ; Chenmei ZHANG ; Zihao YANG ; Yucai ZHANG ; Yun CUI ; Yanqin CUI ; Yibing CHENG ; Suyun QIAN ; Pengfei ZHANG ; Youpeng JIN ; Xiaodong ZHU ; Hong GAO ; Zipu LI ; Xiulan LU ; Hongjun MIAO ; Qiuyue ZHANG ; Yumei LI ; Weiguo YANG ; Chunyi LIU ; Bo LI ; Ying LI ; Zhenjiang BO ; Jianping CHU ; Xu WANG ; Guoping LU
Chinese Journal of Pediatrics 2018;56(12):929-932
Objective:
To survey the conduction and evaluate the effectiveness of extracorporeal membrane oxygenation (ECMO) therapy in pediatric intensive care unit (PICU) in China mainland.
Methods:
In a questionnaire-based survey, we retrospectively reviewed the application of ECMO in children's hospital and general hospital in China mainland to summarize and analyze the categories of diseases and prognosis of children treated with ECMO therapy.
Results:
By December 31, 2017, a total of 23 hospitals using ECMO, including 22 tertiary referral hospitals and 1 secondary hospital, among which 16 were children′s hospitals and 7 were general hospitals. Thirty-seven ECMO equipment was available. A total of 518 patients treated with ECMO, within whom 323 (62.4%) successfully weaned from ECMO and 262 (50.6%) survived to discharge. Among 375 pediatric patients, 233 (62.1%) were successfully weaned from ECMO and 186 (49.6%) survived to discharge. Among 143 newborn patients, 90 (62.9%) successfully weaned from ECMO, 76 (53.1%) survived to discharge. ECMO was applied in veno-arterial (VA) mode to 501 (96.7%) patients, veno-venous (VV) mode to 14 (2.7%) patients, and VV-VA conversion mode to 3 (0.6%) patients. Sixty-nine patients required extracorporeal cardiopulmonary resuscitation (ECPR), including 20 newborn patients (29.0%) and 38 pediatric patients (71.0%), who were all with cardiovascular disease. Neonatal respiratory distress syndrome (26/61), persistent pulmonary hypertension of the newborn (PPHN) (12/61), and meconium aspiration syndrome (MAS) (11/61) are the most common pulmonary diseases in newborn patients; among whom, infants with PPHN had highest survival rate (10/12), followed by MAS (9/11). Among newborn patients with cardiovascular diseases, those who admitted were after surgery for congenital cardiac disease were the most common (54/82), while those with septic shock had the highest survival rate (2/3). In pediatric pulmonary diseases, acute respiratory distress syndrome was the most common (42/93), while plastic bronchitis was with the highest survival rate (4/4), followed by viral pneumonia (13/16). Among pediatric cardiovascular diseases, congenital cardiac defect was the most common (124/282), while fulminant myocarditis had the highest survival rate (54/77).
Conclusion
The application of ECMO as a rescue therapy for children with severe cardiopulmonary failure has dramatically developed in China mainland.
5.Optimization and simulation of maneuverability and stability of electric wheelchair based on three degrees of freedom model
Changjian ZHU ; Shaoqi ZHENG ; Zhibing GONG ; Xu KE ; Youpeng ZHAO
Chinese Journal of Rehabilitation Theory and Practice 2023;29(4):381-389
ObjectiveTo propose a three-degree-of-freedom model of electric wheelchair, to optimize the steering stability of the wheelchair. MethodsBased on the two degrees of freedom vehicle model and considering the influence of body inertia and lateral wind, the wheelchair roll angle was introduced to establish the three degrees of freedom steering model of wheelchair. The lateral velocity, centroid sideslip angle, yaw rate and body roll angle response of the motor angular velocity input under different working conditions were simulated and analyzed respectively. Taking KS2 electric wheelchair as an example, the wheelchair steering experiment was designed to verify the rationality and feasibility of the model, and the optimization effect of the model algorithm on the wheelchair handling and stability. ResultsThe maneuverability and stability of the electric wheelchair with three degrees of freedom model algorithm were significantly improved, and the response curve was smoother. The smaller the |VL-VR|/t was, the better the handling stability was when the left and right motors of the wheelchair had the same steering direction. When |VL-VR|/t was the same, the steering maneuverability was better on the reverse rotation of the motor, but the handling stability also decreased. ConclusionThe simulation analysis is in good agreement with the experimental results, which verifies that the model is reasonable and feasible. The model algorithm can better optimize the handling stability of electric wheelchairs, and can be generally applied to study and analyze the handling stability of different wheelchairs when they turn.
6. Epidemiological characteristics of acute paraquat poisoning in children in southwest Shandong and related factors of pulmonary interstitial fibrosis
Mengxiao SHEN ; Jinlong LIU ; Lei HAN ; Xuemei SUN ; Shengying DONG ; Chengjun LIU ; Baohai SHI ; Hongfeng ZHU ; Liping CHEN ; Tong CHEN ; Liwen LI ; Bo LI ; Zhaohua ZHANG ; Youpeng JIN
Chinese Pediatric Emergency Medicine 2020;27(1):30-34
Objective:
To analyze the epidemiological characteristics of acute paraquat(PQ)poisoning in children in southwest Shandong, and the risk factors for pulmonary interstitial fibrosis.
Methods:
This retrospective study was performed on the clinical data of children with acute PQ poisoning admitted from January 2013 to December 2017 in 12 hospitals in southwest Shandong.All participants were divided into pulmonary interstitial fibrosis group and no pulmonary interstitial fibrosis group on the basis of the chest CT 14 days after poisoning.The epidemiological characteristics and risk factors of pulmonary interstitial fibrosis were analyzed.
Results:
During the study period, a total of 307 children with acute PQ poisoning were admitted to 12 hospitals, of which 61 (19.87%) were suffering from acute PQ poisoning.Forty-nine cases with complete clinical data were analyzed, including 26 male and 23 female patients poisoned by oral.The age distribution ranged from 8 months to 14 years.Poisoning mainly occured from July to September of each year.The mortality of acute PQ poisoning was 8.2%(4/49), and the incidence of pulmonary interstitial fibrosis in survival patients was 44.4%(20/45). Statistical differences (