Objective To determine the influencing factors on prognosis of neonatal necrotizing enterocolitis (NEC) in premature infants with a gestational age of 28-32 weeks.Methods Forty-six cases of NEC (Bell stage Ⅱ or Ⅲ) with a gestational age of 28-32 weeks admitted to Bayi Children's Hospital from January,2009 to January,2013 were analyzed retrospectively.Twenty-nine cases were assigned to the cured group and 17 cases were assigned to the poor prognosis group according to prognosis.General conditions,laboratory results,treatment and complications in the two groups were analyzed.The Chi-square test,Fisher's exact test and univariate analysis of variance were used for statistical analysis.Results There were no statistically significant differences regarding gender,average birth weight and mean age of onset between the two groups [average birth weight (1 410.52±281.59) g vs (1 266.47±280.32) g and mean age of onset:(20.79± 10.61) d vs (16.71 ±9.41) d for the cured group versus the poor prognosis group,respectively].There were no difference in changes in white blood cells and platelets between the two groups.There were six cases of positive blood culture in the poor prognosis group and none in the cured group.There were no differences in procedures such as blood transfusion and ibuprofen administration [41.4％ (12/29) vs 11/17 and 6.9％ (2/29) vs 5/17,both P＞0.05,in the cured group versus the poor prognosis group,respectively].There were significant differences in the use of Bifidobacterium between the two groups [69.0％ (20/29) vs 5/17,x2=6.758,P=0.009].Fourteen cases in the cured group and 10 cases in the poor prognosis group underwent surgery,and all 10 cases in the poor prognosis group died.Seven cases underwent repeated surgery,one infant in the cured group and six infants in the poor prognosis group and a significant difference was observed (Fisher's exact,P=0.007).A statistically significant difference in granulocyte colony-stimulating factor (G-CSF) treatment was observed between the two groups,where 15 cases in the cured group and three cases in the poor prognosis group were treated with G-CSF (x2=5.225,P＜0.05).Statistically significant differences in septicemia,patent ductus arteriosus,gastrointestinal perforation,multiple organ failure (MOF),disseminated intravascular coagulopathy (DIC) and septic shock were observed between the two groups [septicemia:44.8％ (13/29) vs 15/17,x2=8.478; patent ductus arteriosus:17.2％ (5/29) vs 9/17,x2=6.451; gastrointestinal perforation:3.4％ (1/29) vs 6/17; MOF:0.0％ (0/29) vs 5/17; DIC:0.0％ (0/29) vs 3/17; septic shock:3.4％ (1/29) vs 6/17,all P＜0.05 in the cured group versus the poor prognosis group,respectively).Conclusions Oral intestinal microbial preparations before the onset of NEC and G-CSF therapy after the onset of NEC may be protective factors in improving the prognosis of NEC,while patent ductus arteriosus,septicemia,gastrointestinal perforation,MOF,DIC and septic shock are risk factors.Emphasis should be placed on the administration of intestinal microbial agents,prevention of infection and treatment of complications.

The cholinesterase(ChE)and lactate dehydrogenase(LDH)activities in blood smears of 37 patients were observed before and 20 minutes after electroacupuncture.Hegu and Zusanli were mainly chosen as the acupuncture points.Karnovsky method was used to demonstrate ChE,activity,and tetrazolium-formazan reaction for LDH activity. Before acupuncture,all formed elements of blood showed both ChE and LDH acti- vities.In red blood cells ChE and LDH activities were localized at the cell membrane, while in white blood cells they were found throughout the cytoplasm as colored granu- les.The granulocytes showed greater ChE and lesser LDH activities than the lymph- ocytes.The platelets also showed greater LDH and ChE activities,especially the former. On the whole,platelets and leucocytes,as compared with erythrocytes,showed greater activities for ChE and LDH. Under microscopic observation,according to the amount and color of granules,the degrees of GhE and LDH activities for each kind of blood formed elements before and after acupuncture were recorded as different markes,such as +、++、+++ and so on.The degrees of GhE or LDH activity in various formed elements of blood were compared by means of statistical tests.After acupuncture,both GhE and LDH activities of all blood formed elements were increased(p

70 patients including 60 cases under acupuncture anesthesia and 10 cases under drug anesthesia were observed. Before and 20 minutes after acupuncture the blood samples were taken from the patient ear lobes respectively, and in some patients taken once again 24 hrs after acupuncture. The electroacupuncture point Hegu or Zusanli was mainly adopted. As the method for detection of cell-mediated immunity(CMI) in vitro the improved microtechnique of whole blood for E-rosette (active and nonactive) and lymphocyte transformation tests was used. In performance of active rosetting the total leucocyte count and the differential lymphocyte count were done for calculation of absolute number of active rosette forming cells (RFC). The mean value of increase of active RFC was 12.7?1.43, the decrease was 6.8?1.77 after acupuncture. The increment of the absolute number of active RFC was 175?63.59. However no marked effect on the drug anesthesia group was found. In the lymphocyte transformation assay the increase was 12.7?1.49, the decrease was 7.0?2.19, and the enhancement effect still exhibited 24 hrs after acupuncture. In these tests an increase was mostly found in those with a lower or a usual CMI level; a decrease often found in those with a higher CMI level prior to acupuncture. The increase or decrease level in the results of three kinds of test (active, nonactive RFC and lymphocyte transformation) was similar, the increase range was 12～13%, the decrease range 6～7%. As the former compared with the latter, the promotion was prominent by all means.

OBJECTIVE: To investigate the efficacy and feasibility of harmonic scalpel assisted Han-uvalopalatoparyngoplasty (H-UPPP) for obstructive sleep apnea and hyponea syndrome (OSAHS). METHOD: For each case of 23 patients with OSAHS, the left was operated on with traditional method and the right was operated on with harmonic scalpel. Operative blood loss, the operation time, postoperative pain, the condition of wounds and complications were compared for each case itself. RESULT: The operative blood loss, the operation time, of the right with harmonic scalpel were much less than the left with traditional method,while no difference in postoperative pain, incidence of primary and secondary hemorrhage, the condition of wounds was found. CONCLUSION The application of harmonic scalpel in H-UPPP was safe, efficient and feasible, and would have a nice application prospect during otolaryngology operations.
Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Sleep Apnea, Obstructive ; surgery ; Surgical Instruments ; Treatment Outcome ; Ultrasonic Therapy ; instrumentation

Objective To explore the methods and effectiveness of using nurses as standardized patient ( NSP) in junior nurses′hanging and choking rescue care training. Methods This study selected four nurses as NSPs, based on Huaxi Hospital′s NSP screening criteria. A total of 60 nurses whose psychiatric nursing age were beyond three years were randomly divided into experimental group and control group, with 30 members each. The nurses in the experimental group were treated with NSP method, while the control group was trained in the regular way. After that, the effects of training were evaluated by Dundee Ready Education Environment Measure ( DREEM ) . The theory and clinical skills examination and training satisfaction were surveyed. Results The theory test scores of the two groups after training were significantly higher than those before training (P<0. 05), and the scores of the experimental group was higher than that of the control group, but there was no significant difference (P>0. 05). The total score of DREEM, and the perception of learning, course organizers and academic self-perception score of DREEM of the experimental group were significantly higher than those of the control group (t=7. 086, 9. 443, 10. 462, 8. 620, respectively;P<0. 05). The score of choking rescue skills of the experimental group was significantly higher than that of the control group ( t=2. 759,P<0. 05). But the score of hanging rescue skills of the experimental group was not significantly higher than that of the control group (P>0. 05). There was no significant difference in the satisfaction between the two groups (P>0. 05). Conclusions The application of NSP in hanging and choking rescue care training can improve the teaching environment, increase nurses′choking rescue care skills, but no difference is found in the theory examination and hanging rescue care skills between the two groups.

Objective:To detect the genes of common genetic diseases in newborns with the high-throughput sequencing technology based on target gene capture, to study the incidence rate of such diseases, the carrying rate and variant types of pathogenic mutations related to such diseases, and to explore the application value of the high-throughput sequencing technology in screening genetic diseases of newborns.Methods:The heel blood of 1 793 newborns born in Guangdong province from June 2019 to April 2020 were collected, and the exon regions of 138 common genetic disease-related genes in neonates were detected using the high-throughput sequencing technology based on target gene capture.The pathogenicity of the mutations was interpreted according to the " Classification Criteria and Guidelines for Genetic Variation(2017)" , in which known disease and probable disease were considered as positive mutations.The positive mutations were verified by Sanger sequencing technology, and the test results were analyzed with statistical methods.Results:Among the 1 793 newborns, 978 were male and 815 were female.A total of 158 positive cases were screened(8.81%), and 11 positive diseases were detected.Among the positive diseases, there were 41 cases(2.29%)of autosomal recessive deafness type 1A, 40 cases(2.23%)of Gilbert syndrome or Crigler-Najjar syndrome, and 33 cases(1.84%)of glucose-6-phosphate dehydrogenase deficiency(1.84%), 19 cases(1.06%)of familial hypercho-lesterolemia, 18 cases(1.00%) of sodium taurocholate cotransporter peptide deficiency disease, 2 cases(0.11%)of mitochondrial non-syndromic deafness, 2 cases(0.11%)of Citrin deficiency, 1 case(0.06%)of holocarboxylase synthase deficiency, 1 case(0.06%)of β-thalassemia and 1 case(0.06%)of metachromatic leukodystrophies.Of all studied cases, 972 carried one or more positive mutations, involving 85 kinds of diseases in total.The diseases with a high carrying rate were Gilbert syndrome or Crigler-Najjar syndrome(359 cases, 20.02%), autosomal recessive deafness type 1A(302 cases, 16.84%), and sodium taurocholate cotransport peptide deficiency disease(291 cases, 16.22%). The high-frequency mutation sites were UGT1A1 gene c. 211G> A, GJB2 gene c .109G> A and SLC10A1 gene c. 800C> T. Conclusions:The common genetic diseases detected in neonates from Guangdong province are autosomal recessive deafness type 1A, Gilbert syndrome or Crigler-Najjar syndrome, glucose-6-phosphate dehydrogenase deficiency, familial hypercholesterolemia, and sodium taurocholate cotransport peptide deficiency.There are high-frequency carrying mutation sites in the population.Preliminary genetic screening of common neonatal genetic diseases can accumulate data and experience for the development of newborn genetic screening.

Objective To investigate the image features,categories,and clinical significances of Pneumoconiosis Ⅲ with large shadow.Methods The research is based on the analysis of image features of 168 pneumoconiosis Ⅲ patients who are directly diagnosed by qualified medical professionals in our institution.These image features are large shadows bigger than 2 cm×1 cm which can be observed by high kilovolt chest radiographs,DR chest radiography and chest CT scan.Results Large shadows bigger than 2 ×1 cm show noticeable imaging characteristics,like distribution of superior and middle lung regions (95.2％),irregular shapes (97.6％),splayed or sausage like changes on both sides perpendicular with ribs (89.2％),small shadows of pneumoconiosis (98.8％),and convergence of large shadow to hilum or mediastinal (53.6％).CT scan is significantly better than DR radiography on detection rate of focal emphysema,focal cavities and swollen lymph node of mediastinal.Conclusion Combining the image features of high kilovolt chest radiographs,DR chest radiographs and CT scan are the main methods to identify the shadows,and thus direct diagnose pneumoconiosis Ⅲ;CT scan plays an important role in differential diagnosis.

Renal replacement therapy and perioperative management have difficulties in hemophilia patients with end-stage renal disease. The paper summarized the diagnosis and treatment experience of six hemophilia patients complicated with end-stage renal disease from January 1, 2000 to March 31, 2023 in Peking Union Medical College Hospital. Among 6 patients treated with peritoneal dialysis, 3 were treated with hemodialysis or continuous venous-venous hemodialysis. Altogether 11 dialysis access procedures were conducted successfully, and no serious bleeding or thrombotic events. In further conjunction with literature review, the paper summarized the key points of dialysis access appliance relevant to such patients, to provide reference for renal replacement treatment paths.

Objective To investigate the image features,categories,and clinical significances of Pneumoconiosis Ⅲ with large shadow.Methods The research is based on the analysis of image features of 168 pneumoconiosis Ⅲ patients who are directly diagnosed by qualified medical professionals in our institution.These image features are large shadows bigger than 2 cm×1 cm which can be observed by high kilovolt chest radiographs,DR chest radiography and chest CT scan.Results Large shadows bigger than 2 ×1 cm show noticeable imaging characteristics,like distribution of superior and middle lung regions (95.2％),irregular shapes (97.6％),splayed or sausage like changes on both sides perpendicular with ribs (89.2％),small shadows of pneumoconiosis (98.8％),and convergence of large shadow to hilum or mediastinal (53.6％).CT scan is significantly better than DR radiography on detection rate of focal emphysema,focal cavities and swollen lymph node of mediastinal.Conclusion Combining the image features of high kilovolt chest radiographs,DR chest radiographs and CT scan are the main methods to identify the shadows,and thus direct diagnose pneumoconiosis Ⅲ;CT scan plays an important role in differential diagnosis.