中国小儿急救医学最新文献

{"title":"Antiviral therapy of adenovirus pneumonia","authors":"J. Ying, G. Yan","doi":"10.3760/CMA.J.ISSN.1673-4912.2019.12.001","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-4912.2019.12.001","url":null,"abstract":"Adenovirus pneumonia is a common type of pneumonia in immunocompetent and immunocompromised patients, and its prognosis is poor.Antiviral therapy includs ganciclovir, valganciclovir, cidofovir, brincidofovir, ribavirin and so on.Among them, cidofovir and brincidofovir have obvious antiviral activity against adenovirus in vitro and in vivo, but further RCT results are still needed.Therefore, antiviral therapy of adenovirus pneumonia still needs further study. \u0000 \u0000 \u0000Key words: \u0000Adenovirus; Ganciclovir; Cidofovir; Ribavirin","PeriodicalId":68901,"journal":{"name":"中国小儿急救医学","volume":"26 1","pages":"881-884"},"PeriodicalIF":0.0,"publicationDate":"2019-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43725319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metabolomics study on biomarkers of hand,foot and mouth disease","authors":"Wu Jinzhun, Wu Caiming, Zhu Bi-qin, Cheng Guobing, G. Lu, Dai Xiaoshan","doi":"10.3760/CMA.J.ISSN.1673-4912.2019.12.004","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-4912.2019.12.004","url":null,"abstract":"Objective \u0000To investigate potential biomarkers for different types of hand, foot and mouth disease(HFMD). \u0000 \u0000 \u0000Methods \u0000Nuclear magnetic resonance(NMR)-based metabolomics methods were used to analyze the metabolic differences in serum of HFMD and healthy controls.Partial least squares discriminant analysis(PLS-DA)and orthogonal partial least square discriminant analysis(OPLS-DA)were used for analysis of metabolite profiles.Differential statistical analysis was performed by t tests using GraphPad Prism 5 software. \u0000 \u0000 \u0000Results \u0000The levels of lipid, leucine, valine, β-hydroxybutyric acid, acetone, glucose, glycoprotein, glycerol, glycine, choline, trimethylamine oxide and lactate in HFMD increased significantly compared with healthy controls, whereas the levels of acetic acid and creatine decreased significantly.Additionally, the level of acetone further increased in the severe type of HFMD compared with the mild type, whereas the levels of lipid and trimethylamine oxide decreased. \u0000 \u0000 \u0000Conclusion \u0000These statistically significant differences are involved in lipid metabolism, glucose metabolism and protein metabolism in different types of HFMD.Lipid, acetone and trimethylamine oxide can be used as potential biomarkers of HFMD. \u0000 \u0000 \u0000Key words: \u0000Hand, foot and mouth disease; Nuclear magnetic resonance; Biomarker; Metabolomics","PeriodicalId":68901,"journal":{"name":"中国小儿急救医学","volume":"26 1","pages":"895-900"},"PeriodicalIF":0.0,"publicationDate":"2019-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45449453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of clinical prognosis and mutant gene phenotype in children with hemophagocytic lymphohistiocytosis","authors":"Jing Wang, Jian Wang, L. Luo, Q. Cao","doi":"10.3760/CMA.J.ISSN.1673-4912.2019.12.003","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-4912.2019.12.003","url":null,"abstract":"Objective \u0000To investigate the clinical manifestations, prognosis and gene mutation phenotypes of hemophagocytic lymphohistiocytosis(HLH)in children of our hospital. \u0000 \u0000 \u0000Methods \u0000The clinical data of 42 patients with HLH from April 2013 to December 2018, and the genetic data of 8 patients with familial HLH(FHL)were collected retrospectively.The age, clinical manifestation, laboratory examination, prognosis and the characteristics of gene mutation phenotype of patients with HLH and FHL were analyzed emphatically.Furthermore, the clinical manifestations and prognosis of patients with HLH were analyzed according to whether EB virus was infected. \u0000 \u0000 \u0000Results \u0000Among these 42 patients with HLH, the onset age was ranged from 1 month to 13 years old and most of them were younger than 5 years old.The main clinical manifestations included cytopenia, prolonged fever, enlargement of liver and spleen and lymph nodes enlargement and serosal effusion.Laboratory examination showed that lactate dehydrogenas, ferritin, erythrocyte sedimentation rate and triglyceride increased significantly.The survival rate of the group in ferritin exceeding 4 500 μg/L and non-chemotherapy was lower than that of the group of ferritin less than 4 500 μg/L and chemotherapy in clinical prognosis(P<0.05). Ten patients of them survived after chemotherapy, and 2 patients survived for 5 to 6 months after hematopoietic stem cell transplantation in FHL.Patients with EB virus infection were older than those without EB virus infection.They had longer fever duration and higher proportion of lymph nodes enlargement and ferritin more than 4 500 μg/L(P values were 0.01, 0.04, 0.03, 0.03 respectively). However, there was no significant difference in survival time between the two groups.Eight patients had mutations in UNC13D(50.00%), PRF1(25.00%), PRKDC(12.50%)and IL2RG(12.50%)genes respectively, and most of the mutations were complex heterozygous mutations(62.50%). All the mutations were originated from their parents. \u0000 \u0000 \u0000Conclusion \u0000HLH is characterized by cytopenia, prolonged fever, enlargement of liver and spleen.HLH is more common in children under 5 years old.The clinical manifestations of HLH with EB virus infection are more severe while the prognosis is not statistically significant.The incidence of FHL is higher.There are more UNC13D gene mutations and complex heterozygous mutations.Children with HLH should be detected and treated with standardized therapy as soon as possible.Hematopoietic stem cell transplantation is a good treatment for HLH, especially for FHL patients. \u0000 \u0000 \u0000Key words: \u0000Hemophagocytic syndrome; Exon sequencing; Gene mutation; EB virus infection; Prognosis","PeriodicalId":68901,"journal":{"name":"中国小儿急救医学","volume":"26 1","pages":"889-894"},"PeriodicalIF":0.0,"publicationDate":"2019-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42476601","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Progress and prospects of biomarkers of bronchopulmonary dysplasia in premature infants","authors":"Yu-qing Pan","doi":"10.3760/CMA.J.ISSN.1673-4912.2019.12.011","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-4912.2019.12.011","url":null,"abstract":"Bronchopulmonary dysplasia(BPD)is one of the most serious lung diseases in premature infants and an important cause of death in preterm infants.The pathophysiological mechanism of BPD is still unclear.The preventive and targeted treatment strategies for this disease are also very limited.However, various biomarkers have been found in blood, alveolar lavage fluid, exhaled gas condensate, and urine.It is used to identify high-risk children with BPD early and to predict the severity and prognosis of the disease. \u0000 \u0000 \u0000Key words: \u0000Biomarker; Bronchopulmonary dysplasia; Premature","PeriodicalId":68901,"journal":{"name":"中国小儿急救医学","volume":"26 1","pages":"932-936"},"PeriodicalIF":0.0,"publicationDate":"2019-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48757003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advances on the mechanism of caffeine in preventing bronchopulmonary dysplasia in preterms","authors":"Jun Li","doi":"10.3760/CMA.J.ISSN.1673-4912.2019.12.013","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-4912.2019.12.013","url":null,"abstract":"Caffeine citrate, as one type of methylxanthine, is often used to treat apnea in premature infants.Recent studies have found that it is not only used for extubation before weaning, shortening the time of mechanical ventilation, preventing apnea and reducing the occurance of intermittent hypoxic episodes, but also exerting lung protection by inhibiting inflammatory reactions, mitigating oxidative stress, improving pulmonary function and pulmonary angiogenesis.Thus, it could effectively reduce the risk of bronchopulmonary dysplasia in premature infants. \u0000 \u0000 \u0000Key words: \u0000Caffeine; Bronchopulmonary dysplasia; Preterm","PeriodicalId":68901,"journal":{"name":"中国小儿急救医学","volume":"26 1","pages":"941-946"},"PeriodicalIF":0.0,"publicationDate":"2019-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46422349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Research on application of intelligent assistant decision-making in the five-level triage of pediatric emergency department","authors":"Xianghui Huang, Deyi Zhuang, Wanting Li","doi":"10.3760/CMA.J.ISSN.1673-4912.2019.12.006","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-4912.2019.12.006","url":null,"abstract":"Objective \u0000To explore the application effect of intelligent assistant decision-making in the five-level triage of pediatric emergency department. \u0000 \u0000 \u0000Methods \u0000The patients treated in the pediatric emergency department of Xiamen Children′s Hospital using the intelligent assistant decision-making system were divided into two groups before and after one month.In March 2018, 17 900 cases were in the traditional group, and in April 2018, 18 590 cases were in the intelligent group.The traditional group conducted manual triage according to the five-level pre-screening and triage standard.The intelligent group conducted triage based on the self-developed intelligent assistant decision-making system.Intelligent assistant decision-making included automatic identification of whether vital signs data was abnormal and automatic provision of basis for triage level to help nurses confirm two major functions.The patients′ information were collected according to the established content, and the system would automatically identify and present according to the corresponding triage basis to determine the triage level.The two groups of children were compared and analyzed in terms of disease distribution, triage level, triage accuracy.The clinical application effect of the emergency pediatric pre-check triage system was evaluated. \u0000 \u0000 \u0000Results \u0000There was no significant difference in disease distribution between the two groups.The top three were respiratory diseases, infectious diseases and digestive diseases.In the comparison of waiting time between the two groups, the waiting time of grade Ⅲ, Ⅳ and Ⅴ patients in the intelligent group was shorter than that in the traditional group, the difference was statistically significant (P<0.05). The consistency of triage grade in the intelligent group was higher than that in the traditional group.The family satisfaction of children in the intelligent group of Ⅲ, Ⅳ, and Ⅴ grade was higher than that in the traditional group. \u0000 \u0000 \u0000Conclusion \u0000The application of intelligent assistant decision-making could improve the efficiency and accuracy of the pre-examination of the nurses, ensure the effectiveness of the triage and the safety of the children, and improve the satisfaction of family members. \u0000 \u0000 \u0000Key words: \u0000Pediatric emergency; Pre-examination triage; Assisted decision","PeriodicalId":68901,"journal":{"name":"中国小儿急救医学","volume":"26 1","pages":"907-911"},"PeriodicalIF":0.0,"publicationDate":"2019-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42598529","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The clinical application and significance of TcpCO2 after weaning of machanical ventilation in very or extreme low birth weight infants","authors":"Tingting Wang","doi":"10.3760/CMA.J.ISSN.1673-4912.2019.12.009","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-4912.2019.12.009","url":null,"abstract":"Objective \u0000To analysis the transcutaneous carbon dioxide pressure(TcpCO2)in very low birth weight infant (VLBW) and extremely low birth weight infant (ELBW) after the time of tube drawing, and further guidance the management of premature ventilator breathing. \u0000 \u0000 \u0000Methods \u0000Premature infants with gestational age less than 32 weeks, birth weight below 1 500 g, hospitalized from March 2016 to December 2018 in our hospital, who needed early mechanical ventilation due to respiratory distress within 24 hours after birth and intended to be withdrawn were enrolled.Fifty-five infants in the observation group were monitored by TcpCO2 and blood gas was collected at 1 h, 6 h, 12 h, 24 h, 48 h, and 72 h after weaning; 55 infants in the control group were collected arterial blood gas only.When TcpCO2 monitoring and PaCO2 indicated hypercapnia, clinical intervention was actively given.The value of blood gas PaCO2 in the two groups and the TcpCO2 value of the observation group were recorded at different time points (1 h, 6 h, 12 h, 24 h, 48 h, 72 h) after weaning, and the failure of weaning was recorded in both group. \u0000 \u0000 \u0000Results \u0000There was no significant difference in the general information (gender, gestational age, birth weight, and whether prenatal maternal glucocorticoids) between the two groups (P>0.05). There were no significant differences in mechanical ventilation time, noninvasive ventilation mode and time between the two groups(P>0.05). The failure rate of withdrawal within 24 h and 72 h was lower in the observation group than the control group[3.6% (2/55) vs.14.0% (8/55), 7.3% (4/55) vs. 21.0% (12/55)], the difference was statistically significant (P 0.05). The values of TcpCO2 and PaCO2 had no significant difference in the observation group at the same time point (P>0.05), and there was a correlation between them(r=0.761, P<0.05). \u0000 \u0000 \u0000Conclusion \u0000VLBW and ELBW undergoing mechanical ventilation are given continuous TcpCO2 monitorings after weaning, which not only has the characteristics of continuous and non-invasive monitoring, but also help to identify hypercapnia early and give symptomatic treatment, and reduce the incidence of weaning failure.And it proves a good correlation between TcpCO2 and PaCO2. \u0000 \u0000 \u0000Key words: \u0000Transcutaneous carbon dioxide pressure; Partial pressure of carbon dioxide; Extubation withdrawal; Very low birth weight infant; Extremely low birth weight infant","PeriodicalId":68901,"journal":{"name":"中国小儿急救医学","volume":"26 1","pages":"922-926"},"PeriodicalIF":0.0,"publicationDate":"2019-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44471731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Study on the influencing factors of vitamin D level in infants","authors":"Chen-yang Wang","doi":"10.3760/CMA.J.ISSN.1673-4912.2019.11.009","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-4912.2019.11.009","url":null,"abstract":"Vitamin D is a necessary fat-soluble vitamin in the body.It is found that not only does vitamin D deficiency associate with infant nutritional rickets, but it can also affect the functions of nervous, respiratory, immune, cardiovascular, endocrine, skin, kidney, and other function of systems.This paper made an overview of factors influencing infant vitamin D levels, including season of birth, sunshine time, eating habits, feeding patterns and prenatal vitamin D supplement dose.Among the above, as the vitamin D deficiency of infants and young children in plateau areas is quite special, thus it is emphasized in this review, in order for prevention and treatment of vitamin D deficiency. \u0000 \u0000 \u0000Key words: \u0000Plateau region; Infant; Vitamin D; Influencing factors","PeriodicalId":68901,"journal":{"name":"中国小儿急救医学","volume":"26 1","pages":"846-851"},"PeriodicalIF":0.0,"publicationDate":"2019-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48791749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retrospective analysis of 173 cases of oral poisoning in children","authors":"Yupin Li, Jie Ma, Yang Yang, Xun Jiang, Baoxi Wang","doi":"10.3760/CMA.J.ISSN.1673-4912.2019.11.005","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-4912.2019.11.005","url":null,"abstract":"Objective \u0000To analyze and discuss the social factors and clinical characteristics of oral poisoning in children, so as to provide reference for preventing and treating children poisoning. \u0000 \u0000 \u0000Methods \u0000The clinical data of 173 pediatric patients with oral poisoning diagnosed and treated in Department of Pediatrics, the Fourth Military Medical University in Tangdu Hospital from January to December 2017 were retrospectively analyzed. \u0000 \u0000 \u0000Results \u0000Pesticide and insecticide poisoning topped the list(68 cases, 39.31%)and the clinical manifestations of different poisons were varied.Geographically, the urban and rural distribution was mainly rural(118 cases, 68.21%), among which 103 cases(87.29%)were left-behind children in rural areas.Within one year, the number of urban children fluctuated slightly, with a small peak in March and the number of rural children fluctuated greatly, with a large peak in July.In addition, urban children were mainly poisoned by oral internal medicine(34 cases, 61.82%), while rural children were mainly poisoned by oral pesticide and insecticide(64 cases, 54.24%). The gender distribution was mainly male(101 cases, 58.38%), with the highest incidence in early childhood(97 cases, 56.07%). The main reasons for taking poison included children′s misadministration(123 cases, 71.10%), parents′ accidental feeding(24 cases, 13.87%), and elder children′s self-administration due to emotional factors(26 cases, 15.03%). The treatment methods were gastric lavage, emetic stimulation and enema according to the type and time of poisoning of administration, and timely use of specific antidote and symptomatic treatment was also the key to treatment. \u0000 \u0000 \u0000Conclusion \u0000The situation is more serious in rural areas of oral poisoning in children, especially for left-behind children in rural areas, who are at the highest incidence in early childhood.Oral pesticides, insecticides and oral drugs are the most prominent, and misadministration is the main reason.Family poison management should be strengthened for prevention, and treatment should vary according to the type and time of taking poison. \u0000 \u0000 \u0000Key words: \u0000Children; Oral; Poison; Poisoning","PeriodicalId":68901,"journal":{"name":"中国小儿急救医学","volume":"26 1","pages":"825-829"},"PeriodicalIF":0.0,"publicationDate":"2019-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45463907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Extracorporeal membrane oxygenation in the treatment of severe pertussis in infants: a case report and literature review","authors":"Chengxiang Kong, P. Jin, Chun-yi Liu, Jin-ji Xu, Yong Luo, H. Xie, Gang Zhou","doi":"10.3760/CMA.J.ISSN.1673-4912.2019.11.013","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-4912.2019.11.013","url":null,"abstract":"目的 \u0000探讨体外膜肺氧合(extracoporeal membrane oxygenation，ECMO)支持治疗婴儿重症百日咳的有效性。 \u0000 \u0000 \u0000方法 \u0000回顾报道2018年深圳市宝安区妇幼保健院PICU收治的1例确诊重症百日咳2月龄患儿接受ECMO治疗情况，文献复习重症百日咳及ECMO治疗现状，结合病例总结ECMO支持治疗重症百日咳的经验。 \u0000 \u0000 \u0000结果 \u0000未接种百日咳疫苗的2月龄男婴，接触感染病例后发病，并发高白细胞血症、重症肺炎、百日咳脑病、急性呼吸窘迫综合征、心力衰竭及休克等。常规治疗措施无效，出现顽固性低氧血症、严重二氧化碳潴留、循环功能衰竭等表现，实施VA-ECMO支持治疗，联合\"肺休息\"策略、俯卧位通气、限制性液体管理、肺复张等综合性治疗方案，最终成功救治。 \u0000 \u0000 \u0000结论 \u0000动态监测白细胞有助于判断病情及预后。重症百日咳合并高白细胞血症患儿的粒细胞与淋巴细胞比例发生倒置提示病情危重。重症百日咳患儿一旦常规治疗无效，出现继发性器官功能障碍，危及生命时，ECMO不失为\"挽救性\"支持治疗手段。","PeriodicalId":68901,"journal":{"name":"中国小儿急救医学","volume":"26 1","pages":"867-870"},"PeriodicalIF":0.0,"publicationDate":"2019-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47026616","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}