Objective:To study clinical outcomes, genetic etiology, efficacy and safety of continuous renal replacement therapy (CRRT) for neonatal hyperammonemia.Methods:From September 2016 to June 2023, neonates with hyperammonemia receiving CRRT in NICU of our hospital were retrospectively analyzed. Their perinatal conditions, clinical manifestations, laboratory results, genetic tests, treatments and outcomes were collected. The patients were assigned into survival group and death group according to their conditions at discharge. SPSS 22.0 statistical software was used to analyze the differences between the two groups.Results:A total of 10 patients were enrolled, including 8 males and 2 females. The gestational age was 39.3(38.2,39.8)weeks and birth weight 3 300(3 050, 3 583) g. The age of onset was 2.0(2.0, 4.3) d. The main clinical manifestations included seizures, coma and high blood ammonia level (up to 586-1 250 μmol/L). The patients received CRRT at 3.0(2.0, 8.3) d of age and CRRT lasted for 20.5(16.5, 42.8) h. Before CRRT, average time of coma was 10.0(3.5, 12.8) h and the total duration of coma was 20.5(12.5, 29.0) h. After CRRT, blood ammonia decreased (52.6±22.2) μmol/L every hour for 6 h. The genetic tests showed ornithine transcarbamylase deficiency in 5 cases, methylmalonic acidemia in 2 cases, propionic acidemia in 1 case, carnitine acylcarnitine translocase deficiency in 1 case and transient hyperammonemia in 1 case. 6 patients survived. 4 patients died at discharge, including 2 withdrawal treatment. The duration of coma before CRRT and the total duration of coma in the death group were significantly longer than the survival group ( P<0.05). Conclusions:Inborn metabolic error are common causes of neonatal hyperammonemia. Timely CRRT can safely and effectively reduce blood ammonia levels and may improve clinical outcomes.

Objective To observe the effect of treating infantile anaphylactoid purpura with self-made Huoxue Huayu decoction. Methods 68 cases with infantile anaphylactoid purpura ,were randomly recruited into a control group and a treatment group, with 34 cases in each group. The control group was taken Cetirizine, Prednisone, Rutin and Vitamin C orally. The treatment group was treated with self-made Huoxue Huayu decoction on the basis of treatment in the control group. Results The total effective rate of the control group and the treatment group was 82.35% and 94.12% respectively. As compared with the effective rate in the control group, the treatment group showed significant improvement. Conclusion It was effective to treat infantile anaphylaetoid purpura with Huoxue Huayu decoction.

Objective To observe the clinical effects of treating infantile viral myocarditis with Huangqi Injection united Vitamin C. Methods 60 patients with infantile viral myocarditis were randomly recruited into a control group and a treatment group, with 30 patients in each group. Both groups were given comprehensive therapies including rest, anti-infection, myocardium nourishment, etc. The treatment group was additionally treated with Huangqi Injection united Vitamin C on the basis of comprehensive therapies. Results The total effective rate of the control group and the treatment groups was 70.00% 96.67% respectively, the difference showing statistic significance (P<0.05) . Conclusion It was effective to treat infantile viral myocarditis with Huangqi Injection united Vitamin C.

Objective To observe curative effect of treating senile Chronic Congestive Heart Failum(CCHF)with Shenmai Inj.plus Potassium Magnesium Asparaginate.Methods 91 patients with senile CCHF were randomly recruited into a treatment group and a control group.The control group was treated with Digoxin,Hydrochiorothiazide,Spironolacmne,Captopril,and Metoprolol taken orally.The treatment group was treated with Shenmai Injection plus Potassmm Jagrnesium Aspartate besides treatments of the control group.Both groups were ordered to rest in bed and take low-salt diet and treated for one course of 14 days.Results The total effective rate of the control group was 80.0%and the total effective rate of the treatment group was 95.7%(P＜0.05).The left veiltricular ejection fraction of the treatment group was improved obviously.As compared with the control group,the treatment group has significant difference(P＜0.01).Conclusion n was safety and effective to treat senile CCHF with Shenmai Inj.plus Potassium Magnesium Asparaginate in addition to lessen digitalis toxic effect and prevent arrhythmia.