OBJECTIVE: To investigate the clinical features and outcome of neonatal acute respiratory distress syndrome (ARDS) in southwest Hubei, China. METHODS: According to the Montreux definition of neonatal ARDS, a retrospective clinical epidemiological investigation was performed on the medical data of neonates with ARDS who were admitted to Department of Neonatology/Pediatrics in 17 level 2 or level 3 hospitals in southwest Hubei from January to December, 2017. RESULTS: A total of 7 150 neonates were admitted to the 17 hospitals in southwest Hubei during 2017 and 66 (0.92%) were diagnosed with ARDS. Among the 66 neonates with ARDS, 23 (35%) had mild ARDS, 28 (42%) had moderate ARDS, and 15 (23%) had severe ARDS. The main primary diseases for neonatal ARDS were perinatal asphyxia in 23 neonates (35%), pneumonia in 18 neonates (27%), sepsis in 12 neonates (18%), and meconium aspiration syndrome in 10 neonates (15%). Among the 66 neonates with ARDS, 10 neonates (15%) were born to the mothers with an age of ≥35 years, 30 neonates (45%) suffered from intrauterine distress, 32 neonates (49%) had a 1-minute Apgar score of 0 to 7 points, 24 neonates (36%) had abnormal fetal heart monitoring results, and 21 neonates (32%) experienced meconium staining of amniotic fluid. Intraventricular hemorrhage was the most common comorbidity (12 neonates), followed by neonatal shock (9 neonates) and patent ductus arteriosus (8 neonates). All 66 neonates with ARDS were treated with mechanical ventilation in addition to the treatment for primary diseases. Among the 66 neonates with ARDS, 10 died, with a mortality rate of 15% (10/66), and 56 neonates were improved or cured, with a survival rate of 85% (56/66). CONCLUSIONS Neonatal ARDS in southwest Hubei is mostly mild or moderate. Perinatal asphyxia and infection may be the main causes of neonatal ARDS in this area. Intraventricular hemorrhage is the most common comorbidity. Neonates with ARDS tend to have a high survival rate after multimodality treatment.
China ; Female ; Humans ; Infant, Newborn ; Meconium Aspiration Syndrome ; Pregnancy ; Respiratory Distress Syndrome, Newborn ; Retrospective Studies

Objective:To evaluate the effect of mirror therapy on lower-limb motor, balance and walking of stroke patients. Methods:Randomized controlled trails (RCTs) about mirror therapy for lower limb function after stroke were recalled in PubMed, Cochrane Library, EMbase, Medline complete, CNKI, Wanfang Data, VIP and CBMdisc. Meta-analysis was conducted using RevMan 5.3 software for eligible RCTs. Results:A total of twelve studies were retrieved, including 590 patients. Mirror therapy improved the scores of Fugl-Meyer Assessment-Lower Extremity (MD = 6.67, 95%CI 5.60 to 7.74; Z = 12.20, P < 0.001), Brunnstrom stages (MD = 0.55, 95%CI 0.28 to 0.82; Z = 3.98, P < 0.001), Berg Balance Scale (MD = 3.45, 95%CI 1.40 to 5.50; Z = 3.30, P = 0.001), mini-BESTest (MD = 1.49, 95%CI 0.65 to 2.33; Z = 3.48, P < 0.001), Brunnel Balance Assessment (MD = 0.66, 95%CI 0.10 to 1.22; Z = 2.32, P = 0.02). However, it was not significant for 10-meter Walking Test (MD = 0.03, 95%CI -0.04 to 0.11; Z = 0.88, P = 0.38) and Timed "Up and Go" Test (MD = -1.43, 95%CI-4.31 to 1.45; Z = 0.97, P = 0.33). Conclusion:Mirror therapy can improve lower extremity motor function after stroke significantly, and somehow for balance. Further research is needed to explore its effects on walking.

OBJECTIVE: To investigate the incidence of neonatal asphyxia and possible contributing factors for the development of severe asphyxia in Hubei Enshi Tujia and Miao Autonomous Prefecture, China. METHODS: A total of 16 hospitals in Hubei Enshi Tujia and Miao Autonomous Prefecture were selected as research centers. A retrospective analysis was performed for the clinical data of 22 294 live births in these 16 hospitals from January to December, 2016 to investigate the incidence rate of neonatal asphyxia and possible contributing factors for the development of severe asphyxia. RESULTS: Of the 22 294 neonates born alive, 733 (3.29%) were diagnosed with neonatal asphyxia, among whom 627 had mild asphyxia and 106 had severe asphyxia. The neonates with low maternal education level, maternal anemia during pregnancy, chorioamnionitis, abnormal amniotic fluid, abnormal umbilical cord, placenta previa, placental abruption, Tujia Minority, preterm birth, and low birth weight had a higher incidence of severe asphyxia (P<0.05). CONCLUSIONS The incidence rate of neonatal asphyxia in Hubei Enshi Tujia and Miao Autonomous Prefecture is higher. Low maternal education level, maternal anemia during pregnancy, chorioamnionitis, abnormal amniotic fluid, abnormal umbilical cord, placenta previa, placental abruption, Tujia Minority, preterm birth, and low birth weight may be related to the development of severe neonatal asphyxia.
Asphyxia Neonatorum ; epidemiology ; China ; Humans ; Incidence ; Infant, Newborn ; Retrospective Studies

AIM:To investigate the difference of non - invasive tearfilm break - up time (NIBUT) by Keratograph 5M beforeand after forced eye opening in healthy individuals.METHODS: Prospective case self - control study. Fortynormal volunteers (79 eyes ) were enrolled. Tear filmimages were captured, non-invasive first tear film breakuptime(NIBUTf ), non- invasive average tear film breakuptime (NIBUTav ) and dry eye level were measured byKeratograph 5M automatically before and after forced eyeopening in each subject. For the first time, we checkedthe left eye after the right eye, and the second timechecked the right eye after the left eye.RESULTS: The average of NIBUTf and NIBUTav were9 18士5. 52s, 11. 74 士5. 59s respectively and percentage ofevery level of dry eye were 43% , 37% , 20% respectivelybefore forced eye opening. The average of NIBUTf andNIBUTav were 8. 91士5. 54s, 11. 76士5. 58s and percentage ofdry eye at different levels were 35% , 48% , 16%respectively after forced eye opening. There was nosignificant difference on NIBUT and dry eye level byOculus keratograph 5M in normal subjects (t = 0. 37, P =0 72; t = -0. 038, P = 0. 97; Z = -0. 42, P = 0. 68).CONCLUSION: There is no influence on NIBUT and dryeye level by detected Keratograph 5M before and afterforced eye opening in healthy subjects.

Objective To observe the effects of acupuncture in acupoints at different meridians on 5-HT, DA, NE in the peripheral serum of insomnia rats; To explore the mechanism of action of acupuncture for the treatment of insomnia. Methods Sixty SD rats were randomly divided into blank group, model group, Baihui+Shenmen group, Baihui+Sanyinjiao group, and Baihui+non-acupoint group, with 12 rats in each group. Injection of PCPA suspension of rats was used to establish insomnia model. Each acupuncture group received corresponding acupoints, 30 min each time, for 7 days. The levels of 5-HT, DA and NE in serum were measured by ELISA. Results Compared with the blank group, the levels of 5-HT, DA and NE in the model group were significantly higher than those in the blank group (P<0.01). Compared with the model group, the contents of DA and NE in the acupuncture groups were significantly lower than those in the model group (P<0.05, P<0.01), and the 5-HT in Baihui+Sanyinjiao group was significantly lower than those in the model group (P<0.05). Among all acupuncture groups, overall efficacy of Baihui+Shenmen group was better than Baihui+Sanyinjiao group and Baihui+non-acupoint group. Conclusion Acupuncture can improve sleep structure in rats may be related to serum monoamine neurotransmitters. Acupuncture in acupoints at different meridians may be one of the influencing factors of acupoint compatibility effects.

AIM: To explore correlation,consistency and comfort between traditional tear film examination methods and Oculus Keratograph.METHODS: A retrospective study.Totally 101 cases (101 eyes) were diagnosed myopia and then accepted LASEK (laser epithelial keratomileusis).Non-invasive tear film break-up time(NIBUT),lower tear meniscus height(LTMH) were measured with Oculus Keratograph,fluorescein tear film break-up time(fl-BUT) and Schimer Ⅰ test (SⅠt) were performed on all cases.The correlations analysis between NIBUT and fl-BUT,LTMH and SⅠt were performed by Spearman rank correlation,consistency check between NIBUT and fl-BUT by Bland-Altman analysis.Visual analogue scale(VAS) was applied on evaluating the comfort of two kinds of examination methods.RESULTS: LTMH and SⅠt showed positive correlation (rs=0.346,P=0.001).NIBUT and fl-BUT showed positive correlation (rs=0.393,P=0.001),95% consistency limits range-9.62 to 14.18 in Bland-Altman Figure.There was significant difference between VAS of NIBUT and VAS of fl-BUT(z=-2.324,P=0.020).There was significant difference between VAS of LTMH and VAS of SⅠt (z=-8.845,P=0.001).CONCLUSION: Oculus Keratograph can objectively measure NIBUT and LTMH,and was more comfortable than traditional tear film examination methods.It can effectively assess tear film function before corneal refractive surgery.

OBJECTIVETo explore the effects of obesity on the peak level of luteinizing hormone (LH) in the gonadotropin-releasing hormone (GnRH) agonist test and obesity-related hormones in girls with central precocious puberty (CPP).

METHODSThree hundred and thirty-three girls with CPP who underwent the GnRH agonist test between 2012 and 2014 were classified into three groups: normal weight (n=123), overweight (n=108), and obesity (n=102), according to body mass index (BMI). The sexual development indices were compared between the three groups. Twenty girls were randomly selected from each group for evaluation of the serum levels of leptin, sex hormone binding globulin (SHBG), neurokinin B, and kisspeptin. The correlation of BMI with the levels of various hormones was assessed using Pearson correlation analysis.

RESULTSThere was no significant difference in mean age at diagnosis between the three groups; however, the bone age was significantly higher in the overweight and obesity groups than in the normal weight group (P<0.05). The peak level of LH in the GnRH agonist test and SHBG level in the normal weight group were significantly higher than those in the overweight and the obesity groups, while the serum levels of leptin and neurokinin B were significantly lower in the normal weight group than in the overweight and the obesity groups (P<0.05). BMI was negatively correlated with the peak level of LH in the GnRH agonist test and SHBG level (P<0.05), and positively correlated with the levels of leptin and neurokinin B (P<0.05).

CONCLUSIONSThe effects of BMI on the result of the GnRH agonist test and levels of obesity-related hormones should be taken into account in girls with precocious puberty.

Body Mass Index ; Child ; Female ; Gonadotropin-Releasing Hormone ; agonists ; Humans ; Leptin ; blood ; Luteinizing Hormone ; blood ; Neurokinin B ; blood ; Obesity ; blood ; Puberty, Precocious ; blood ; Sex Hormone-Binding Globulin ; analysis