1.Effects of resistance combined with aerobic chrono-exercise on common carotid artery elasticity and hemodynamics in young men.
Miao-Xin JIAO ; Bing-Yi SHEN ; Hai-Bin LIU ; Li-Hong CHEN ; Guang-Rui YANG
Acta Physiologica Sinica 2025;77(4):741-751
The purpose of the present study was to investigate the effects of resistance combined with aerobic chrono-exercise on the common carotid artery elasticity and hemodynamics. 24 healthy young men (21.96±0.43 years old) underwent a single acute resistance combined with aerobic exercise intervention at eight time periods (6, 8, 10, 12, 14, 16, 18, and 20 o'clock). The axial flow velocity and diameter waveforms of the common carotid artery were measured, and the hemodynamics were calculated using the classical hemodynamic theory before exercise, immediately after exercise, 10 min and 20 min after exercise. The results showed that during exercise recovery, systolic and mean pressures decreased more markedly after exercise at 8 o'clock (P < 0.05); At 20 min post-exercise, arterial stiffness index and pressure-strain elastic modulus after exercise at 6 o'clock were reduced compared with the resting state, but were significantly elevated after exercise at 20 o'clock (P < 0.05). Immediately after exercise, the pressure rise was higher after exercise at 6 o'clock and the mean wall shear stress was higher after exercise at 20 o'clock (P < 0.05). These results suggest that resistance combined with aerobic chrono-exercise produces different effects on common carotid artery hemodynamics in young men. A single acute session of resistance combined with aerobic exercise at 8 o'clock is more effective in lowering blood pressure. Exercise at 6 o'clock is beneficial to improve arterial elasticity but is not recommended for young male individuals with cardiovascular disease risks because of the excessive increase in blood pressure immediately after exercise. Exercise at 20 o'clock is more effective in improving wall shear stress but is accompanied by elevated arterial stiffness indices and pressure-strain elastic modulus. These results provide a scientific basis for healthy young men in choosing the time of exercise by exploring the common carotid artery elasticity and hemodynamic-related indices.
Humans
;
Male
;
Young Adult
;
Exercise/physiology*
;
Carotid Artery, Common/physiology*
;
Hemodynamics/physiology*
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Vascular Stiffness/physiology*
;
Elasticity
;
Resistance Training
;
Adult
2.Changing resistance profiles of Haemophilus influenzae and Moraxella catarrhalis isolates in hospitals across China:results from the CHINET Antimicrobial Resistance Surveillance Program,2015-2021
Hui FAN ; Chunhong SHAO ; Jia WANG ; Yang YANG ; Fupin HU ; Demei ZHU ; Yunsheng CHEN ; Qing MENG ; Hong ZHANG ; Chun WANG ; Fang DONG ; Wenqi SONG ; Kaizhen WEN ; Yirong ZHANG ; Chuanqing WANG ; Pan FU ; Chao ZHUO ; Danhong SU ; Jiangwei KE ; Shuping ZHOU ; Hua ZHANG ; Fangfang HU ; Mei KANG ; Chao HE ; Hua YU ; Xiangning HUANG ; Yingchun XU ; Xiaojiang ZHANG ; Wenen LIU ; Yanming LI ; Lei ZHU ; Jinhua MENG ; Shifu WANG ; Bin SHAN ; Yan DU ; Wei JIA ; Gang LI ; Jiao FENG ; Ping GONG ; Miao SONG ; Lianhua WEI ; Xin WANG ; Ruizhong WANG ; Hua FANG ; Sufang GUO ; Yanyan WANG ; Dawen GUO ; Jinying ZHAO ; Lixia ZHANG ; Juan MA ; Han SHEN ; Wanqing ZHOU ; Ruyi GUO ; Yan ZHU ; Jinsong WU ; Yuemei LU ; Yuxing NI ; Jingrong SUN ; Xiaobo MA ; Yanqing ZHENG ; Yunsong YU ; Jie LIN ; Ziyong SUN ; Zhongju CHEN ; Zhidong HU ; Jin LI ; Fengbo ZHANG ; Ping JI ; Yunjian HU ; Xiaoman AI ; Jinju DUAN ; Jianbang KANG ; Xuefei HU ; Xuesong XU ; Chao YAN ; Yi LI ; Shanmei WANG ; Hongqin GU ; Yuanhong XU ; Ying HUANG ; Yunzhuo CHU ; Sufei TIAN ; Jihong LI ; Bixia YU ; Cunshan KOU ; Jilu SHEN ; Wenhui HUANG ; Xiuli YANG ; Likang ZHU ; Lin JIANG ; Wen HE ; Chunlei YUE
Chinese Journal of Infection and Chemotherapy 2025;25(1):30-38
Objective To investigate the distribution and antimicrobial resistance profiles of clinically isolated Haemophilus influenzae and Moraxella catarrhalis in hospitals across China from 2015 to 2021,and provide evidence for rational use of antimicrobial agents.Methods Data of H.influenzae and M.catarrhalis strains isolated from 2015 to 2021 in CHINET program were collected for analysis,and antimicrobial susceptibility testing was performed by disc diffusion method or automated systems according to the uniform protocol of CHINET.The results were interpreted according to the CLSI breakpoints in 2022.Beta-lactamases was detected by using nitrocefin disk.Results From 2015 to 2021,a total of 43 642 strains of Haemophilus species were isolated,accounting for 2.91%of the total clinical isolates and 4.07%of Gram-negative bacteria in CHINET program.Among the 40 437 strains of H.influenzae,66.89%were isolated from children and 33.11%were isolated from adults.More than 90%of the H.influenzae strains were isolated from respiratory tract specimens.The prevalence of β-lactamase was 53.79%in H.influenzae strains.The H.influenzae strains isolated from children showed higher resistance rate than the strains isolated from adults.Overall,779 strains of H.influenzae did not produce β-lactamase but were resistant to ampicillin(BLNAR).Beta-lactamase-producing strains showed significantly higher resistance rates to these antimicrobial agents than the β-lactamase-nonproducing strains.Of the 16 191 M.catarrhalis strains,80.06%were isolated from children and 19.94%isolated from adults.M.catarrhalis strains were mostly susceptible to both amoxicillin-clavulanic acid and cefuroxime,evidenced by resistance rate lower than 2.0%.Conclusions The emergence of antibiotic-resistant H.influenzae due to β-lactamase production poses a challenge for clinical anti-infective treatment.Therefore,it is very important to implement antibiotic resistance surveillance for H.influenzae and guide rational antibiotic use.All local clinical microbiology laboratories should actively improve antibiotic susceptibility testing and strengthen antibiotic resistance surveillance for H.influenzae.
3.Functional perforator flap: concept and clinical applications.
Hu JIAO ; Mengqing ZANG ; Lu ZHOU ; Shengyang JIN ; Jiadong PAN ; Miao WANG ; Xin WANG ; Yuanbo LIU
Chinese Journal of Reparative and Reconstructive Surgery 2025;39(9):1076-1085
OBJECTIVE:
To review the clinical applications of functional perforator flaps in restoring human body functions.
METHODS:
An extensive literature review was conducted on both domestic and international publications to summarize the clinical use of functional perforator flaps for functional restoration.
RESULTS:
Perforator flaps are among the most commonly used flaps in reconstructive surgery. Beyond providing soft tissue repair, they are increasingly employed to reconstruct diverse bodily functions, leading us to propose the concept of the "functional perforator flap". Although various forms of functional perforator flaps are currently utilized, reports are predominantly scattered case studies, lacking systematic organization. Commonly used functional perforator flaps can be categorized into five types: chimeric perforator flaps, perforator flaps for nerve function restoration, perforator flaps for lymphatic drainage enhancement, flow-through perforator flaps, and perforator flaps for restoring bone and joint motion. These flaps significantly broaden the application scope of perforator flaps, elevating the goal of reconstruction from mere wound repair to achieving repair concurrent with functional reconstruction.
CONCLUSION
The application of various functional perforator flap designs significantly improves wound reconstruction outcomes and represents an effective approach for managing complex defects. Future developments will undoubtedly see more forms of functional perforator flaps reported to meet increasingly sophisticated reconstructive demands.
Humans
;
Perforator Flap/blood supply*
;
Plastic Surgery Procedures/methods*
;
Soft Tissue Injuries/surgery*
;
Skin Transplantation/methods*
;
Wound Healing
4.Changing resistance profiles of Haemophilus influenzae and Moraxella catarrhalis isolates in hospitals across China:results from the CHINET Antimicrobial Resistance Surveillance Program,2015-2021
Hui FAN ; Chunhong SHAO ; Jia WANG ; Yang YANG ; Fupin HU ; Demei ZHU ; Yunsheng CHEN ; Qing MENG ; Hong ZHANG ; Chun WANG ; Fang DONG ; Wenqi SONG ; Kaizhen WEN ; Yirong ZHANG ; Chuanqing WANG ; Pan FU ; Chao ZHUO ; Danhong SU ; Jiangwei KE ; Shuping ZHOU ; Hua ZHANG ; Fangfang HU ; Mei KANG ; Chao HE ; Hua YU ; Xiangning HUANG ; Yingchun XU ; Xiaojiang ZHANG ; Wenen LIU ; Yanming LI ; Lei ZHU ; Jinhua MENG ; Shifu WANG ; Bin SHAN ; Yan DU ; Wei JIA ; Gang LI ; Jiao FENG ; Ping GONG ; Miao SONG ; Lianhua WEI ; Xin WANG ; Ruizhong WANG ; Hua FANG ; Sufang GUO ; Yanyan WANG ; Dawen GUO ; Jinying ZHAO ; Lixia ZHANG ; Juan MA ; Han SHEN ; Wanqing ZHOU ; Ruyi GUO ; Yan ZHU ; Jinsong WU ; Yuemei LU ; Yuxing NI ; Jingrong SUN ; Xiaobo MA ; Yanqing ZHENG ; Yunsong YU ; Jie LIN ; Ziyong SUN ; Zhongju CHEN ; Zhidong HU ; Jin LI ; Fengbo ZHANG ; Ping JI ; Yunjian HU ; Xiaoman AI ; Jinju DUAN ; Jianbang KANG ; Xuefei HU ; Xuesong XU ; Chao YAN ; Yi LI ; Shanmei WANG ; Hongqin GU ; Yuanhong XU ; Ying HUANG ; Yunzhuo CHU ; Sufei TIAN ; Jihong LI ; Bixia YU ; Cunshan KOU ; Jilu SHEN ; Wenhui HUANG ; Xiuli YANG ; Likang ZHU ; Lin JIANG ; Wen HE ; Chunlei YUE
Chinese Journal of Infection and Chemotherapy 2025;25(1):30-38
Objective To investigate the distribution and antimicrobial resistance profiles of clinically isolated Haemophilus influenzae and Moraxella catarrhalis in hospitals across China from 2015 to 2021,and provide evidence for rational use of antimicrobial agents.Methods Data of H.influenzae and M.catarrhalis strains isolated from 2015 to 2021 in CHINET program were collected for analysis,and antimicrobial susceptibility testing was performed by disc diffusion method or automated systems according to the uniform protocol of CHINET.The results were interpreted according to the CLSI breakpoints in 2022.Beta-lactamases was detected by using nitrocefin disk.Results From 2015 to 2021,a total of 43 642 strains of Haemophilus species were isolated,accounting for 2.91%of the total clinical isolates and 4.07%of Gram-negative bacteria in CHINET program.Among the 40 437 strains of H.influenzae,66.89%were isolated from children and 33.11%were isolated from adults.More than 90%of the H.influenzae strains were isolated from respiratory tract specimens.The prevalence of β-lactamase was 53.79%in H.influenzae strains.The H.influenzae strains isolated from children showed higher resistance rate than the strains isolated from adults.Overall,779 strains of H.influenzae did not produce β-lactamase but were resistant to ampicillin(BLNAR).Beta-lactamase-producing strains showed significantly higher resistance rates to these antimicrobial agents than the β-lactamase-nonproducing strains.Of the 16 191 M.catarrhalis strains,80.06%were isolated from children and 19.94%isolated from adults.M.catarrhalis strains were mostly susceptible to both amoxicillin-clavulanic acid and cefuroxime,evidenced by resistance rate lower than 2.0%.Conclusions The emergence of antibiotic-resistant H.influenzae due to β-lactamase production poses a challenge for clinical anti-infective treatment.Therefore,it is very important to implement antibiotic resistance surveillance for H.influenzae and guide rational antibiotic use.All local clinical microbiology laboratories should actively improve antibiotic susceptibility testing and strengthen antibiotic resistance surveillance for H.influenzae.
5.Inflammatory and Immunomodulatory Effects of Tripterygium wilfordii Multiglycoside in Mouse Models of Psoriasis Keratinocytes.
Shuo ZHANG ; Hong-Jin LI ; Chun-Mei YANG ; Liu LIU ; Xiao-Ying SUN ; Jiao WANG ; Si-Ting CHEN ; Yi LU ; Man-Qi HU ; Ge YAN ; Ya-Qiong ZHOU ; Xiao MIAO ; Xin LI ; Bin LI
Chinese journal of integrative medicine 2024;30(3):222-229
OBJECTIVE:
To determine the role of Tripterygium wilfordii multiglycoside (TGW) in the treatment of psoriatic dermatitis from a cellular immunological perspective.
METHODS:
Mouse models of psoriatic dermatitis were established by imiquimod (IMQ). Twelve male BALB/c mice were assigned to IMQ or IMQ+TGW groups according to a random number table. Histopathological changes in vivo were assessed by hematoxylin and eosin staining. Ratios of immune cells and cytokines in mice, as well as PAM212 cell proliferation in vitro were assessed by flow cytometry. Pro-inflammatory cytokine expression was determined using reverse transcription quantitative polymerase chain reaction.
RESULTS:
TGW significantly ameliorated the severity of IMQ-induced psoriasis-like mouse skin lesions and restrained the activation of CD45+ cells, neutrophils and T lymphocytes (all P<0.01). Moreover, TGW significantly attenuated keratinocytes (KCs) proliferation and downregulated the mRNA levels of inflammatory cytokines including interleukin (IL)-17A, IL-23, tumor necrosis factor α, and chemokine (C-X-C motif) ligand 1 (P<0.01 or P<0.05). Furthermore, it reduced the number of γ δ T17 cells in skin lesion of mice and draining lymph nodes (P<0.01).
CONCLUSIONS
TGW improved psoriasis-like inflammation by inhibiting KCs proliferation, as well as the associated immune cells and cytokine expression. It inhibited IL-17 secretion from γ δ T cells, which improved the immune-inflammatory microenvironment of psoriasis.
Male
;
Animals
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Mice
;
Tripterygium
;
Psoriasis/drug therapy*
;
Keratinocytes
;
Skin Diseases/metabolism*
;
Cytokines/metabolism*
;
Imiquimod/metabolism*
;
Dermatitis/pathology*
;
Disease Models, Animal
;
Mice, Inbred BALB C
;
Skin/metabolism*
6.Secondary metabolites from endophytic fungi Candida sp.of Berberis atrocarpa
Ming-Zhuo GUO ; Shu-Fang MA ; Shi-Miao WANG ; Ya-Ping FENG ; Yan OUYANG ; Ke-Jian PANG ; Zi-Wei JIAO ; Xin-Zhou YANG
Chinese Traditional Patent Medicine 2024;46(9):3000-3005
AIM To study the secondary metabolites from the endophytic fungi Candida sp.of Berberis atrocarpa Schneid.METHODS The ethyl acetate fraction and petroleum ether fraction from the secondary metabolites of Candida sp.fermentation extract were separated and purified by silica gel,Sephadex LH-20 and preparative liquid chromatography,then the structures of obtained compounds were identified by physicochemical properties and spectral data.RESULTS Eighteen compounds were isolated and identified as 1-phenyl-1,2-ethanediol(1),4-hydroxyphenethyl alcohol(2),4-hydroxybenzoic acid(3),4-hydroxyphenylacetic acid(4),3-hydroxyphenylacetic acid(5),3-methylsulfinyl propionic acid(6),phenylacetic acid(7),(S)-N-nitroso-1-amino-p-hydroxy phenylethanol(8),2-phenylacetamide(9),p-hydroxybenzaldehyde(10),ethyl 2-(4-hydroxyphenyl)acetate(11),dibutyl phthalate(12),5,5'-dimethoxybiphenyl-2,2'-diol(13),3-indolealdehyde(14),N-acetyl-L-phenylalanine(15),9-hydroxy-10E,12Z-octadecadienoic acid(16),9-hydroxy-10E,12E-octadecadienoic acid(17),(6E)-5-methylene-6-tetradecenoic acid(18).CONCLUSION Compounds 1,3-8 and 10-18 are isolated from Candida sp for the first time.
7.Protective effects of HMS5552 on pancreatic β cell injury in diabetic rats
Ke-xin ZHOU ; Meng-jiao WANG ; Yu-zheng LÜ ; Miao-miao LIU ; Shou-min XI
The Chinese Journal of Clinical Pharmacology 2024;40(21):3108-3112
Objective To investigate the protective effect of HMS5552 on pancreatic islet β-cell injury in diabetic rats and study the mechanism.Methods A total of 40 SD rats were fed with high-sugar and high-fat diet for 8 weeks combined with intraperitoneal injection of streptozotocin(STZ)to induce type 2 diabetic rat models.The successful model rats were divided into model group(0.9%NaCl by gavage)and experimental group(30 mg·kg-1 HMS5552 by gavage).The other 20 normal rats served as the normal group(0.9%NaCl was given by gavage).Hematoxylin-eosin(HE)staining was used to detect the pathological changes of pancreatic islets.The INS-1 cells were divided into blank group(normal cultured),model group(high-sugar and high-fat culture medium)and experimental-L,-M,-H groups(high-sugar and high-fat culture medium+0.3,3.0 and 30.0 μmol·L-1 HMS5552).The viability of INS-1 cells was detected by cell counting kit-8(CCK-8)method,the apoptosis of INS-1 cells was detected by Annexin V/PI method,the mRNA expression level of B cell lymphocytoma 2(Bcl-2)was detected by real-time fluorescence quantitative polymerase chain reaction(RT-qPCR)method;the expression level of phosphoinositide 3-kinase/protein kinase B(PI3K/AKT)pathway and apoptosis protein was detected by western blotting.Results HE staining showed that the pathological damage of pancreas in the experimental group rats was significantly less than that in the model group.The cell viability of the blank group,model group and experimental-L,-M,-H groups were(99.67±2.40)%,(48.18±4.18)%,(61.74±4.78)%,(70.74±6.36)%and(78.30±4.68)%,respectively;apoptosis rates were(10.40±4.66)%,(48.60±3.27)%,(35.90±4.45)%,(28.07±5.35)%and(18.30±3.04)%,respectively;the relative expression levels of Bcl-2 mRNA were 1.00±0.03,0.32±0.04,0.59±0.05,0.62±0.04 and 0.72±0.12,respectively;phosphorylated PI3K(p-PI3K)/PI3K ratios were 1.00±0.00,0.34±0.05,0.46±0.02,0.64±0.01 and 0.81±0.01,respectively;phosphorylated AKT(p-AKT)/AKT ratios were 1.00±0.00,0.28±0.12,0.63±0.02,0.74±0.06 and 0.87±0.09,respectively.The above indexes in the model group compared with the blank group,the differences between the above indexes of the experimental-L,-M,-H groups and the model group were statistically significant(P<0.05,P<0.01).Conclusion HMS5552 can improve glucose metabolism in diabetic rats and protect pancreatic β-cells by regulating the expression of PI3K/AKT signaling pathway.
8.Protective effects of HMS5552 on pancreatic β cell injury in diabetic rats
Ke-xin ZHOU ; Meng-jiao WANG ; Yu-zheng LÜ ; Miao-miao LIU ; Shou-min XI
The Chinese Journal of Clinical Pharmacology 2024;40(21):3108-3112
Objective To investigate the protective effect of HMS5552 on pancreatic islet β-cell injury in diabetic rats and study the mechanism.Methods A total of 40 SD rats were fed with high-sugar and high-fat diet for 8 weeks combined with intraperitoneal injection of streptozotocin(STZ)to induce type 2 diabetic rat models.The successful model rats were divided into model group(0.9%NaCl by gavage)and experimental group(30 mg·kg-1 HMS5552 by gavage).The other 20 normal rats served as the normal group(0.9%NaCl was given by gavage).Hematoxylin-eosin(HE)staining was used to detect the pathological changes of pancreatic islets.The INS-1 cells were divided into blank group(normal cultured),model group(high-sugar and high-fat culture medium)and experimental-L,-M,-H groups(high-sugar and high-fat culture medium+0.3,3.0 and 30.0 μmol·L-1 HMS5552).The viability of INS-1 cells was detected by cell counting kit-8(CCK-8)method,the apoptosis of INS-1 cells was detected by Annexin V/PI method,the mRNA expression level of B cell lymphocytoma 2(Bcl-2)was detected by real-time fluorescence quantitative polymerase chain reaction(RT-qPCR)method;the expression level of phosphoinositide 3-kinase/protein kinase B(PI3K/AKT)pathway and apoptosis protein was detected by western blotting.Results HE staining showed that the pathological damage of pancreas in the experimental group rats was significantly less than that in the model group.The cell viability of the blank group,model group and experimental-L,-M,-H groups were(99.67±2.40)%,(48.18±4.18)%,(61.74±4.78)%,(70.74±6.36)%and(78.30±4.68)%,respectively;apoptosis rates were(10.40±4.66)%,(48.60±3.27)%,(35.90±4.45)%,(28.07±5.35)%and(18.30±3.04)%,respectively;the relative expression levels of Bcl-2 mRNA were 1.00±0.03,0.32±0.04,0.59±0.05,0.62±0.04 and 0.72±0.12,respectively;phosphorylated PI3K(p-PI3K)/PI3K ratios were 1.00±0.00,0.34±0.05,0.46±0.02,0.64±0.01 and 0.81±0.01,respectively;phosphorylated AKT(p-AKT)/AKT ratios were 1.00±0.00,0.28±0.12,0.63±0.02,0.74±0.06 and 0.87±0.09,respectively.The above indexes in the model group compared with the blank group,the differences between the above indexes of the experimental-L,-M,-H groups and the model group were statistically significant(P<0.05,P<0.01).Conclusion HMS5552 can improve glucose metabolism in diabetic rats and protect pancreatic β-cells by regulating the expression of PI3K/AKT signaling pathway.
9.Neonatal Exposure to Propofol Interferes with the Proliferation and Differentiation of Hippocampal Neural Stem Cells and the Neurocognitive Function of Rats in Adulthood via the Akt/p27 Signaling Pathway.
Hui Hui MIAO ; Wen Bo LIU ; Xin Hao JIAO ; Ke Jie SHAO ; Ying Xuan YUAN ; Sha SHA ; Qi Qi ZHANG ; Jing YAN ; Yin Ying SUN ; Cheng Hua ZHOU ; Yu Qing WU
Biomedical and Environmental Sciences 2022;35(4):283-295
Objective:
Neonatal exposure to propofol has been reported to cause neurotoxicity and neurocognitive decline in adulthood; however, the underlying mechanism has not been established.
Methods:
SD rats were exposed to propofol on postnatal day 7 (PND-7). Double-immunofluorescence staining was used to assess neurogenesis in the hippocampal dentate gyrus (DG). The expression of p-Akt and p27 were measured by western blotting. The Morris water maze, novel object recognition test, and object location test were used to evaluate neurocognitive function 2-month-old rats.
Results:
Phosphorylation of Akt was inhibited, while p27 expression was enhanced after neonatal exposure to propofol. Propofol also inhibited proliferation of neural stem cells (NSCs) and decreased differentiation to neurons and astroglia. Moreover, the neurocognitive function in 2-month-old rats was weakened. Of significance, intra-hippocampal injection of the Akt activator, SC79, attenuated the inhibition of p-AKT and increase of p27 expression. SC79 also rescued the propofol-induced inhibition of NSC proliferation and differentiation. The propofol-induced neurocognition deficit was also partially reversed by SC79.
Conclusion
Taken together, these results suggest that neurogenesis is hindered by neonatal propofol exposure. Specifically, neonatal propofol exposure was shown to suppress the proliferation and differentiation of NSCs by inhibiting Akt/p27 signaling pathway.
Animals
;
Cell Proliferation
;
Hippocampus/metabolism*
;
Neural Stem Cells
;
Propofol/toxicity*
;
Proto-Oncogene Proteins c-akt/metabolism*
;
Rats
;
Rats, Sprague-Dawley
;
Signal Transduction
10.Effect and influence factors of cardiopulmonary resuscitation in children with congenital heart disease in pediatric intensive care unit.
Gang LIU ; Jian Ping CHU ; Jian Li CHEN ; Su Yun QIAN ; Dan Qun JIN ; Xiu Lan LU ; Mei Xian XU ; Yi Bing CHENG ; Zheng Yun SUN ; Hong Jun MIAO ; Jun LI ; Sheng Ying DONG ; Xin DING ; Ying WANG ; Qing CHEN ; Yuan Yuan DUAN ; Jiao Tian HUANG ; Yan Mei GUO ; Xiao Na SHI ; Jun SU ; Yi YIN ; Xiao Wei XIN ; Shao Dong ZHAO ; Zi Xuan LOU ; Jing Hui JIANG ; Jian Sheng ZENG
Chinese Journal of Pediatrics 2022;60(3):197-202
Objective: To investigate the prognostic factors of children with congenital heart disease (CHD) who had undergone cardiopulmonary resuscitation (CPR) in pediatric intensive care unit (PICU) in China. Methods: From November 2017 to October 2018, this retrospective multi-center study was conducted in 11 hospitals in China. It contained data from 281 cases who had undergone CPR and all of the subjects were divided into CHD group and non-CHD group. The general condition, duration of CPR, epinephrine doses during resuscitation, recovery of spontaneous circulation (ROSC), discharge survival rate and pediatric cerebral performance category in viable children at discharge were compared. According to whether malignant arrhythmia is the direct cause of cardiopulmonary arrest or not, children in CHD and non-CHD groups were divided into 2 subgroups: arrhythmia and non-arrhythmia, and the ROSC and survival rate to discharge were compared. Data in both groups were analyzed by t-test, chi-square analysis or ANOVA, and logistic regression were used to analyze the prognostic factors for ROSC and survival to discharge after cardiac arrest (CA). Results: The incidence of CA in PICU was 3.2% (372/11 588), and the implementation rate of CPR was 75.5% (281/372). There were 144 males and 137 females with median age of 32.8 (5.6, 42.7) months in all 281 CPA cases who received CPR. CHD group had 56 cases while non-CHD had 225 cases, with the percentage of 19.9% (56/281) and 80.1% (225/281) respectively. The proportion of female in CHD group was 60.7% (34/56) which was higher than that in non-CHD group (45.8%, 103/225) (χ2=4.00, P=0.045). There were no differences in ROSC and rate of survival to discharge between the two groups (P>0.05). The ROSC rate of children with arthythmid in CHD group was 70.0% (28/40), higher than 6/16 for non-arrhythmic children (χ2=5.06, P=0.024). At discharge, the pediatric cerebral performance category scores (1-3 scores) of CHD and non-CHD child were 50.9% (26/51) and 44.9% (92/205) respectively. Logistic regression analysis indicated that the independent prognostic factors of ROSC and survival to discharge in children with CHD were CPR duration (odds ratio (OR)=0.95, 0.97; 95%CI: 0.92~0.97, 0.95~0.99; both P<0.05) and epinephrine dosage (OR=0.87 and 0.79, 95%CI: 0.76-1.00 and 0.69-0.89, respectively; both P<0.05). Conclusions: There is no difference between CHD and non-CHD children in ROSC and survival rate of survival to discharge was low. The epinephrine dosage and the duration of CPR are related to the ROSC and survival to discharge of children with CHD.
Cardiopulmonary Resuscitation
;
Child
;
Child, Preschool
;
Female
;
Heart Arrest/therapy*
;
Heart Defects, Congenital/therapy*
;
Humans
;
Intensive Care Units, Pediatric
;
Male
;
Retrospective Studies

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