1.The changes of amplitude-integrated electroencephalogram in full term newborns with hypoxic-ischemic encephalopathy
Lisha BAO ; Fang LIU ; Zhimei GUO ; Zhifang DU
Chinese Pediatric Emergency Medicine 2013;20(1):44-47
Objective To prospectively observe the changes of amplitude-integrated electroencephalogram(aEEG) in neonates with hypoxic-ischemic encephalopathy (HIE).Methods Thirty-five HIE neonates with gestational age of 37 ~ 41 weeks were chosen as HIE group,and all of them were hospitalized in neonatal intensive care unit of Bethune International Peace Hospital from Aug 2011 to Jan 2012.At the same time,40 healthy term neonates were chosen as control group.aEEG monitoring was done within 24 ~ 48 hours after birth with cerebral function monitor (CF3000) and each recording last at least 8 hours.The continuity,sleep-wake cycle,voltage of every aEEG tracing were analyzed.Results (1) The maximal voltage of aEEG tracing in control group was 30 μV,while that in HIE group was 16 μV.The minimal voltage of aEEG tracing in control group was 13 μV,while that in HIE group was 7 μV.The aEEG tracing amplitude both in highest and lowest in HIE group were significantly lower than those in the control group.There were significant differences between them (P < 0.05).(2) There was significant difference of sleep-wake cycling between HIE group and control group[20% (7/35) vs 100% (40/40),x2 =51.064,P < 0.05].While there was also significant difference of the continuity of the amplitude between HIE group and control group[31% (11/35)vs 100% (40/40),x2 =40.336,P <0.05].Conclusion aEEG has some specific changes in neonates with HIE,possiblility it can be used for earlier predicting the occurrence of brain damage after asphyxia and provides good evidence for the early diagnosis and treatment of HIE.
2.Correlation research of delighted thinking on improving negative emotion of depression patients
Rongrong DU ; Wenqin LIU ; Caixia LIN ; Zhifang PAN ; Jingming ZHANG
Chinese Journal of Practical Nursing 2010;26(10):38-40
Objective To investigate the effect of delighted thinking on improving negative emotion of depression patients. Methods 100 depression patients were randomly divided into the observation group and the control group with 50 in each according to admission sequence. Both groups was executed antidepressionant drugs treatment and routine psychiatric care simultaneously. The observation group was given delighted thinking training on the basis of above treatment. The emotional recovery of two groups was observed. Results There was significant difference on facial expression, communication and limbs language after executing delighted thinking training in the observation group. And there was significant difference on scores of Hamilton depression rating scale (HAMD) at discharge. Scores of Nurses' Observation Scale during early, middle and late stage of delighted thinking training greatly improved compared with those before training. Conclusions Delighted thinking contributes to throw off negative thinking pattern of self-denial, stimulate positive passion threshold, improve depressed mood and raise treatment effect for depression patients.
3.Prospective study of risk factors for preterm infants with bronchopulmonary dysplasia
Yanli REN ; Xiangyong KONG ; Zhifang DU ; Zhichun FENG
Chinese Journal of Applied Clinical Pediatrics 2015;30(10):757-760
Obgective To explore the risk factors of preterm infants with bronchopulmonary dysplasia(BPD).Methods A prospective cohort study was conducted to analyze the risk factors of preterm infants with BPD.Preterm infants (gestational age < 32 weeks,and admission within 24 h since birth,and survival time more than 28 d since birth) who were sent to the Ward of Extremely Preterm Infants in Bayi Children's Hospital Affiliated to Clinical Medical College in Beijing Military General Hospital of Southern Medical University were enrolled from November 2013 to May 2014.According to the diagnostic criteria of BPD,the subjects were divided into 2 groups(BPD group and non-BPD group).Factors such as maternal information,neonatal basic information,neonatal diseases and treatments were compared between the 2 groups.Risk factors of preterm infants with BPD were analyzed by using t test,Chi-square test,Fisher's exact probability method and Logistic regression analysis.Results (1) A total of 298 cases were enrolled in this study.Among these infants,180 cases were male and 118 cases were female.The gestational age ranged from 25.6 to 31.9 weeks with the average age of (29.9 ± 1.4) weeks and the birth weights ranged from 740 to 2 300 g with the average weight of (1 428.3 ± 289.0) g.There were 19 cases of extremely low birth weight and 175 cases of very low birth weight.Sixty-nine cases of these infants were diagnosed as BPD (43 cases were mild,10 cases were moderate,16 cases were severe) with incidence of 23.2%.(2)The incidence of BPD was negatively related to gestational age and birth weight:the incidence of BPD in preterm infants with gestational age < 28 weeks,28-30 weeks and ≥ 30-32 weeks were 70.4%,41.9% and 6.2%;the incidence of BPD in preterm infants with birth weight < 1 000 g,1 000-1 500 g and ≥ 1 500-1 800 g were 78.9%,29.5% and 8.8%.(3) Multivariate Logistic regression found gestational age (OR =4.52),birth weight (OR =3.38),gender (OR =3.04),cytomegalovirus infection (OR =55.27),duration of invasive ventilation ≥ 7 d (OR =3.22),the highest concentration of inspired oxygen ≥400 mL/L (OR =4.14),patent ductus arteriosus(PDA) in need of surgical ligation (OR =7.30),and transfusion of packed red blood cells within 14 d since birth (OR =3.51) were the independent risk factors of BPD (all P < 0.05).(4) Factors such as birth weight (P =0.015),duration of invasive ventilation (P =0.003),duration of inspired oxygen (P =0.000),and PDA in need of surgical ligation or not(P =0.017) were related to the severity of BPD.Conclusions BPD is a multifactorial disease.Taking effective measures to control risk factors is the key for preventing BPD.
5.Diagnosis for pancreatic cancer:an analysis of 135 cases
Zhifang DU ; Bingtai ZHANG ; Jiwen ZHANG ; Junmao ZHANG
Cancer Research and Clinic 2005;0(S1):-
Objective To investigate a way of early diagnosis for pancreatic cancer. Methods The clinical data of 135 patients with were retrospected and 28cases in them were analyzed. Results 124 patients were for surgical resection, 11 patients were in traditional Chinese medicine ,suiting the remedy to the case ,sustaining, et al. Apart from some patients were relivend, prognosis of all patients were worse , patient,s condition of most cases had promptly worsend. living time was 3-6 monthes, 11.5 monthes averagely. Conclusion Taking early stage diagnosis seriously was key to solve pacretic cancer.
6.Imatinib is effective in a 12-month-old boy with chronic myelogenous leukemia: case report and literature review.
Yuxia PAN ; Shupeng WEN ; Jinman TIAN ; Zhaoxia LYU ; Zhifang DU ; Lin YAN
Chinese Journal of Pediatrics 2015;53(3):194-197
OBJECTIVETo summarize the clinical characteristics of an infant with chronic myelogenous leukemia (CML) and the effects of imatinib on the case.
METHODThe clinical features of an infant with CML, who was treated with imatinib in the Norman Bethune International Peace Hospital at June 2009, were retrospectively analyzed and the reports in literature were reviewed. The 1-year-old boy suffered from recurrent low-degree fever and pallor. He had a moderate anemia, distended abdomen and marked splenomegaly. Bone marrow aspiration revealed CML in chronic phase)CP). The t (9; 22))q34; q11) could be detected and BCR-ABL (p210) was positive. The boy was diagnosed as CML-CP and treated with imatinib 100 mg per day. There were 10 related papers and more than 100 child CML patients were reported as retrieved from CNKI)from its establishment to August 2014) and Wanfang Database)from its establishment to August 2014) when "Child", " Chronic" and "Leukemia" were used as keywords. And there were 30 related papers including 400 cases from PubMed Database (from its establishment to August 2014) and one detailed report of an infant with CML was retrieved when "childhood" and "chronic myeloid leukemia" "imatinib" were used as keywords. The clinical effects of imatinib in infant CML cases were analyzed and summarized based on the literature.
RESULTThe boy obtained a complete hematologic response (CHR) at the 6th week of diagnosis, a complete cytogenetic response (CCyR) at the 3rd month and a complete molecular response)CMR) at the 12th month without side effect. This boy grows very well and after a 62-month follow-up, his disease was stable. According to the domestic literature, 5 children CML cases aged 6 -12 years were treated with imatinib without side effects and got complete hematologic response (CHR) after 2-month-therapy. The dose, metabolic characteristics and clinical observation of imatinib can be found in foreign literature and imatinib showed good response with good tolerance in children with CML. Imatinib is regarded as the first line drug for children CML. But it may affect the development of the children.
CONCLUSIONThe children with CML-CP had a good response to imatinib, but more experience in the treatment of children with CML with iniatinib is needed.
Anemia ; Antineoplastic Agents ; therapeutic use ; Fusion Proteins, bcr-abl ; Humans ; Imatinib Mesylate ; therapeutic use ; Infant ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; drug therapy ; Male ; Remission Induction ; Retrospective Studies
7.Characteristics of amplitude integrated EEG in neonates with hypoglycemic brain damage
Zhimei GUO ; Fang LIU ; Chunfeng ZHOU ; Lisha BAO ; Shaoguang LV ; Zhifang DU
Journal of Clinical Pediatrics 2013;(11):1019-1023
Objectives To investigate the clinical characteristics of hypoglycemic brain damage, and to assess the ifndings of amplitude-integrated electroencephalography (aEEG) and its predictive value in hypoglycemic brain damage. Methods Twenty-four neonates diagnosed with hypoglycaemia were selected. 12-hour continuous aEEG recordings were performed on the day when hypoglycaemia was diagnosed and second aEEG tracings was performed on the same day or the day after. The variability of aEEG background, appearance of sleep-wake cycling, bandwidth span and amplitude of lower border were analysed and compared with the results of brain MRI. Results Different degrees of epileptic seizures were found in neonates with severe hypoglycemic brain damage and were persisted after the blood sugar was corrected. aEEG in hypoglycemic brain damage was characterized by calyptriform or jagged epileptiform activity, disappearance of the sleep-wake cycle, but little impact on amplitude of lower border and bandwidth span. The recovery of sleep-wake cycle was a sign of brain function recovery. The aEEG and MRI had a good consistency in monitoring the hypoglycemic brain damage. Conclusions aEEG have signiifcant changes in hypoglycemic brain damage and can be used to monitor dynamically hypo-glycemic brain damage.
8.Change and significance of serum brain-derived neurotrophic factor level in neonatal hyperbilirubinemia
Zhifang DU ; Suyan YANG ; Fang LIU ; Zhaoxia LUY ; Chunfeng ZHOU ; Zhimei GUO
Clinical Medicine of China 2016;32(7):654-656
Objective To explore the clinical significance of the serum brain?derived neurotrophic factor( BDNF) level in severe neonatal hyperbilirubinemia. Methods One hundred and twenty term and birth weight>2500 g infants admitted to the Neonatal Intensive Care Unit of Bethune nternational Peace Hospital of People Liberation Army were divided into severe hyperbilirubinemia group and control group according to their total bilirubin concentration. Total bilirubin( TBIL) concentration,BDNF and albumin in serum were determined in two groups. In addition, craniocerebral MRI was performed in severe neonatal hyperbilirubinemia before discharge. The correlation of the BDNF, TBIL, B/A, MRI results between severe hyperbilirubinemia group and control group were compared. Results The serum BDNF levels in severe hyperbilirubinemia group was ( 8. 84 ±3. 26) μg/L,significantly higher than that in control group((6. 24±1. 71) μg/L,t=3. 88,P<0. 05). In severe hyperbilirubinemia group,BDNF level was positively correlated with B/A level(r=0. 429,P<0. 05),but there was no correlation between BDNF and total bilirubin level(r=0. 278,P>0. 05). The serum BDNF level with craniocerebral MRI abnormal was ( 9. 53 ± 2. 77 ) μg/L, higher than that with craniocerebral MRI abnormal ((7. 81±3. 76) μg/L),but there was no statistical difference between them(t=1. 439,P>0. 05). Conclusion In severe neonatal hyperbilirubinemia, the body can secrete BDNF increasely. BDNF level is positivelycorrelated with B/ A level. As a marker of brain damage,BDNF is sensitive than craniocerebral MRI.
9.Value of hepatobiliary scintigraphy combined with total bile acid and γ-glutamyltransferase detection in etiological diagnosis of the persistent jaundice in infants
Yongshuai QI ; Li DU ; Xiaohua CHI ; Feng LIU ; Zhifang DENG ; Guiping LI
Chinese Journal of Applied Clinical Pediatrics 2014;29(19):1459-1462
Objective To investigate the value of hepatobiliary scintigraphy combined with total bile acid (TBA) and γ-glutamyhransferase(γ-GT) detection in the differential diagnosis of persistent jaundice induced by infantile hepatitis syndrome(IHS) and congenital extrahepatic biliary atresia(EHBA).Methods A retrospective analysis of 60 infants with persistent jaundice undertaking 99Tcm-diethylacetanilide iminodiacetic acid (EHIDA) hepatobiliary scintigraphy was done in Nanfang Hospital by single photon emission computed tomography(SPECT).Meanwhile,these infants' sera were collected and separately detected by AU5431 automatic biochemical assay;the sensitivity,specificity and accuracy of hepatobiliary scintigraphy with TBA and γ-GT were evaluated.Results The sensitivity to 99Tcm-EHIDA hepatobiliary scintigraphy in the diagnosis of IHS and EHBA were 100.00% (17/17 cases) and 67.57% (25/37 cases),the specificity was 67.57% (25/37 cases) and 100.00% (17/17 cases),and the accuracy was 77.78% (42/54cases) and 77.78% (42/54 cases),respectively.The levels of TBA and γ-GT were higher in infants with EHBA than those with IHS(U =209.0,19.5,all P <0.05),and ROC curve analysis indicated that TBA in the IHS group and γ-GT in EHBA group had some diagnostic value[area under curve (AUC) =0.736,0.968,respectively].99Tcm-EHIDA hepatobiliary scintigraphy combined with TBA and γ-GT analysis suggested when intestinal non-radioactive imaging was shown,TBA was 98.5 μmol/L and γ-GT was 298 U/L,the sensitivity,specificity and accuracy of diagnosis of EHBA were 100.00.00% (17/17 cases),100.00% (37/37 cases) and 100.00% (54/54 cases) in a serial test.Conclusions Hepatobiliary scintigraphy combined with TBA and γ-GT examination can effectively identify EHBA and IHS earlier,noninvasively and safely,which have important role in further treatment in infants with persistent jaundice.
10.Relationship of the dietary sodium substitution with low sodium and high potassium salt with the blood pressure among middle aged and elderly people: a randomized controlled study
Zhifang LI ; Hui YANG ; Yangfeng WU ; Elliott PAUL ; Shuangsheng DU ; Xiangxian FENG
Chinese Journal of Geriatrics 2014;33(4):365-367
Objective To explore the effects of low-sodium salt on blood pressure and to find out an economical,effective and easy-to-implement method to reduce the blood pressure.Methods This study was a randomized controlled study based on family unit.The participation families were recommended by local newspaper reporters and each family included at least 2 family members over 50 years old,who composed the objects of the study.The intervention group received two-month salt substitution intervention (with low sodium and high potassium) for free,while the control group received no intervention.Results The decrement of systolic blood pressure in intervention group was (4.7±10.9)mmHg,while the systolic blood pressure in control group was decreased by (2.6± 10.3)mmHg.The decline range of blood pressure was higher in the intervention group than in the control group,and there was a statistical significance in the difference (t=2.19,P<0.05).Conclusions Salt substitution (with low sodium and high potassium) is an economical,effective and easy-to-implement method to reduce the blood pressure.Therefore,it is recommended to promote salt substitution (with low sodium and high potassium) in the crowd.