中国小儿急救医学最新文献

{"title":"Correlation analysis of pediatric sepsis and intestinal flora imbalance","authors":"Du Bailu, X. Mo, Yue Tao, Bi-ru Li, Q. Cao","doi":"10.3760/CMA.J.ISSN.1673-4912.2019.09.004","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-4912.2019.09.004","url":null,"abstract":"Objective \u0000To investigate the interaction between the gut microbiota and the sepsis in children by comparing the difference of gut microbiota between septic children and healthy children. \u0000 \u0000 \u0000Methods \u0000Genome was extracted from excrements of 18 cases of sepsis and 6 cases of healthy children.After genomic extraction, the hypervariable region of 16S rDNA gene were amplified and a small fragment library was constructed, and high-throughput sequencing was carried out, then the data of the lower machine was effectively sequenced by biological information processing.We could seek for the species that had changed significantly due to sepsis by comparing the diversity and the differences in the composition of intestinal flora between the two groups. \u0000 \u0000 \u0000Results \u0000The gut microbiome of the sepsis group was distinct from that of the health group.The operational taxonomic units in the sepsis group were significantly reduced compared with healthy group(P=0.001). The gut microbiome of children with sepsis had significantly lower diversity and richness compared with healthy group(P<0.05). A total of 7 species were shown to be differentially abundant between septic patients and healthy controls.The genus Pseudomonadales, Carnobacteriaceae and Granulicatella_elegans were significantly more abundant in the sepsis group; meanwhile the genus Pasteurellaceae, Ruminococcus, Lactobacillus_rogosae and Anaerostipes_butyratucus were less abundant in the sepsis group.In addition, the Granulicatella_elegans was characteristically present in the intestine of children with sepsis(P<0.001). \u0000 \u0000 \u0000Conclusion \u0000The microbial diversity and structure of the gut microbiome in children with sepsis are significantly different from those of healthy children.Our data suggest biomarkers identified in this study might participate in the pathogenesis or development process of sepsis. \u0000 \u0000 \u0000Key words: \u0000Sepsis; Gut microbiota; 16S rDNA; Children","PeriodicalId":68901,"journal":{"name":"中国小儿急救医学","volume":"26 1","pages":"656-661"},"PeriodicalIF":0.0,"publicationDate":"2019-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48761531","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":"Neonatal common lung diseases: lung ultrasound or chest X-ray?","authors":"Jing Liu","doi":"10.3760/CMA.J.ISSN.1673-4912.2019.08.002","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-4912.2019.08.002","url":null,"abstract":"Chest X-ray examination is the traditional methods in the diagnosis of neonatal lung diseases, lung ultrasound (LUS) is the emerging technology in this field.It has confirmed that LUS is more accurate and reliable in diagnosis of lung diseases than X-ray, however, it remains controversy whether or not LUS could replace X-ray as the front-line examination method for neonatal lung diseases.In this paper, we combined the research progress, our clinical application experience and typical cases to elaborate various aspects of the feasibility and necessity of routine use of ultrasound in neonatal wards.We concluded that LUS has many advantages and provides accurate and reliable information, therefore, it might be regularly used in NICUs. \u0000 \u0000 \u0000Key words: \u0000Lung disease; Diagnosis; Differential diagnosis; Lung ultrasound; Chest X-ray; Neonate","PeriodicalId":68901,"journal":{"name":"中国小儿急救医学","volume":"26 1","pages":"565-570"},"PeriodicalIF":0.0,"publicationDate":"2019-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42237810","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":"Cord blood vitamin D levels and its relationship to early-onset sepsis in the very low birth weight infants","authors":"Yongyan Shi, Xuewei Cui, Ziyun Liu, Jun Li, Xindong Xue","doi":"10.3760/CMA.J.ISSN.1673-4912.2019.08.011","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-4912.2019.08.011","url":null,"abstract":"Objective \u0000To investigate the association between serum 25(OH)D levels and the incidence of early-onset sepsis(EOS) in the very low birth weight infants(VLBWI) and the gestational age below 34 weeks. \u0000 \u0000 \u0000Methods \u0000The cord blood of 159 VLBWI were collected between January and December 2017, including 31 clinically diagnosed EOS and 128 non-EOS patients.Serum 25(OH)D 30 ng/ml as vitamin D sufficiency. \u0000 \u0000 \u0000Results \u0000There were no differences in gender, gestational age, birth weight and Apgar score between the EOS group and the non-EOS group(P>0.05). Serum 25(OH)D was(9.08±4.21)ng/ml in the EOS group and(11.91±5.37)ng/ml in the non-EOS group(P=0.007). The rate of severe vitamin D deficiency was 67.7%(21/31)in the EOS group and 41.4%(53/128) in the non-EOS group.The rate of vitamin D deficiency was 32.3%(10/31)in the EOS group and 52.3%(67/128)in the non-EOS group.But there was no difference of vitamin D deficiency distribution in the two groups(P=0.152). The cut-off value of serum 25(OH)D level in predicting EOS was 10.06 ng/ml. \u0000 \u0000 \u0000Conclusion \u0000The incidence of vitamin D deficiency is as high as 95%, calling for urgent attention on vitamin D supplementation in those VLBWI.Low 25(OH)D level(<10 ng/ml)might be predictive of EOS. \u0000 \u0000 \u0000Key words: \u0000Preterm; Very low birth weight infants; Early-onset sepsis; 25-hydroxy-vitamin D","PeriodicalId":68901,"journal":{"name":"中国小儿急救医学","volume":"26 1","pages":"604-607"},"PeriodicalIF":0.0,"publicationDate":"2019-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44637785","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 diagnostic value of lung ultrasound in neonatal infectious pneumonia","authors":"Wenjuan Chen","doi":"10.3760/CMA.J.ISSN.1673-4912.2019.08.003","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-4912.2019.08.003","url":null,"abstract":"The lung ultrasound develops rapidly in recent years.We investigated the ultrasonic diagnostic value of neonatal infectious pneumonia on the basis of our experience in diagnosing adults′ and children′s infectious pneumonia.The result confirms the reliability and effectiveness of lung ultrasound in diagnosing neonatal infectious pneumonia.We believe that the diagnostic performance of lung ultrasound will be improved a lot with the popularization of lung ultrasound, in combination with the supervision of patients′ conditions as well as routine clinical diagnosis and treatment procedures. \u0000 \u0000 \u0000Key words: \u0000Neonates; Infectious pneumonia; Lung ultrasound","PeriodicalId":68901,"journal":{"name":"中国小儿急救医学","volume":"26 1","pages":"571-574"},"PeriodicalIF":0.0,"publicationDate":"2019-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41729284","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 in right ventricular protective ventilatory strategy for acute respiratory distress syndrome","authors":"L. Pei","doi":"10.3760/CMA.J.ISSN.1673-4912.2019.08.013","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-4912.2019.08.013","url":null,"abstract":"Acute respiratory distress syndrome (ARDS) is a devastating clinical syndrome with the condition of dyspnea, characterized by rapidly progressive hypoxemia with noncardiogenic pulmonary edema.Current therapeutic strategies are based on improving oxygenation and pulmonary compliance while minimizing ventilator-induced lung injury.However, many previous studies had found that the leading risk of ARDS patient′s death is circulatory collapse rather than pulmonary injury or hypoxemia.Additionally, acute cardiac dysfunction caused by increased pulmonary vascular resistance is an important cause of circulatory failure.Besides, with the deepening of the studies, the dysfunction of lung and heart in ARDS patients, also known as severe acute cor pulmonale (ACP), has been shown to be associated with the pathophysiological process of the ARDS and could lead to the increase of right ventricular pressure load, which eventually might result in right ventricular failure.Furthermore, the inappropriate mechanical ventilation could also lead to right ventricular failure, and therefore it′s necessary to closely monitor the function of right ventricular in ARDS patients.To conclude, we will introduce the protective ventilation strategy of right ventricular preliminarily in this review. \u0000 \u0000 \u0000Key words: \u0000Acute respiratory distress syndrome; Acute cor pulmonale; Right ventricle; Mechanical ventilation","PeriodicalId":68901,"journal":{"name":"中国小儿急救医学","volume":"26 1","pages":"614-617"},"PeriodicalIF":0.0,"publicationDate":"2019-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45388674","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 29 cases of neonatal atelectasis treated by ultrasound-assisted fiberoptic bronchoscopy and bronchoalveolar lavage","authors":"Ying-jun Wang, Lu Liu, Yubin Dong, Yonggang Luan, Yaqin Cao, N. Huang","doi":"10.3760/CMA.J.ISSN.1673-4912.2019.08.009","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-4912.2019.08.009","url":null,"abstract":"Objective To evaluate the efficacy and safety of bronchoalveolar lavage(BAL) in the treatment of neonatal atelectasis with fiberoptic bronchoscopy under ultrasound monitoring. Methods From June 2018 to December 2018, 29 children were diagnosed as atelectasis by lung ultrasound.After conventional mechanical vibration and sputum ineffective, BAL was treated with fiberoptic bronchoscopy.All patients before operation were monitored by ultrasound to find the lung segment where the atelectasis was located.0.9% NaCl solution was injected by fibrobronchoscope(1~2 ml/kg), and then sucked to ensure the recovery rate of the lavage fluid was more than 50%.After each lavage, ultrasound was immediately used to monitor the recovery of atelectasis to determine whether or not to continue the lavage.One course of treatment could be continuously performed BAL 1 to 3 times a day, 1 course per day, and up to 3 courses of lavage.We analyzed the efficacy, adverse reactions and complications of BAL in the treatment of neonatal atelectasis under ultrasound monitoring. Results Twenty-nine patients underwent BAL treatment with fiberoptic bronchoscopy, 25 cases (86.2%) were cured, 3 cases (10.3%) were effective, and 1 case (3.4%) was ineffective.All children had stable vital signs during treatment.Among them, 11 cases (37.9%) had transient hypoxemia, 3 cases (10.3%) had tracheal mucosal injury, and 2 cases (6.9%) had hoarseness.There were no serious complications such as pulmonary hemorrhage, pneumothorax, and cardiac arrest. Conclusion BAL treatment of atelectasis under lung ultrasound monitoring has obvious effect, easy to operate, no radiation, no obvious adverse reactions and complications, which is worthy of clinical application. Key words: Lung ultrasound; Fiberoptic bronchoscopy; Bronchoalveolar lavage; Neonate; Atelectasis","PeriodicalId":68901,"journal":{"name":"中国小儿急救医学","volume":"26 1","pages":"596-599"},"PeriodicalIF":0.0,"publicationDate":"2019-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47389364","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":"Ultrasound differential diagnosis of hepatic hilar cystic lesions in neonates and infants","authors":"Yanchun Cui, Xiaoman Wang","doi":"10.3760/CMA.J.ISSN.1673-4912.2019.08.010","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-4912.2019.08.010","url":null,"abstract":"Objective \u0000To explore the value of ultrasound in differential diagnosis of hepatic hilar cyst in neonates and infants. \u0000 \u0000 \u0000Methods \u0000The ultrasonographic characteristics of 93 children with hilar cysts under 6 months of age admitted to the General Surgery Department of Beijing Children′s Hospital.Affiliated to Capital Medical University from January 2014 to December 2018 were retrospectively analyzed.According to the surgical results, they were divided into two groups: cystic biliary atresia (CBA) group and congenital choledochal cyst (CC) group, 21 cases in the CBA group and 72 cases in the CC group.The size of cyst in hepatic portal area, the shape of gallbladder in empty stomach, the expansion of intrahepatic and extrahepatic bile ducts, the deposition of biliary sludge and the communication between cyst and intrahepatic bile duct were observed by ultrasound. \u0000 \u0000 \u0000Results \u0000The cyst volume of CBA group was 0.4(0.1, 1.3)cm3, and that of CC group was 18.3(5.4, 50.3)cm3.The cyst volume of CBA group was significantly smaller than that of CC group (P<0.01); 19 cases had abnormal gallbladder morphology in CBA group and 4 cases in CC group (P<0.01); 1 case had biliary sludge in hilar cyst in CBA group and 51 cases had biliary sludge in cyst in CC group (P<0.01); no intrahepatic bile duct dilatation was observed in CBA group, and 54 cases had intrahepatic bile duct dilatation in CC group (P<0.01); no cyst communicated with intrahepatic bile duct in CBA group, and all cysts communicated with intrahepatic bile duct in CC group (P<0.01). \u0000 \u0000 \u0000Conclusion \u0000Gallbladder shape, cyst size, biliary sludge deposition, intrahepatic bile duct dilatation and the communication between cyst and intrahepatic bile duct can be used as sonographic features to differentiate CBA from CC. \u0000 \u0000 \u0000Key words: \u0000Ultrasound; Cystic biliary atresia; Choledochal cyst","PeriodicalId":68901,"journal":{"name":"中国小儿急救医学","volume":"26 1","pages":"600-603"},"PeriodicalIF":0.0,"publicationDate":"2019-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47192569","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":"Ultrasonic diagnosis of neonatal pneumothorax","authors":"L. Luo","doi":"10.3760/CMA.J.ISSN.1673-4912.2019.08.004","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-4912.2019.08.004","url":null,"abstract":"Neonatal pneumothorax is one of the common acute and severe diseases in newborns.Neonatal pneumothorax is of acute onset, fast progress, and can be life-threatening if not handled timely.Therefore, early and accurate diagnosis of pneumothorax and timely intervention are important.Lung ultrasound has a unique advantage in the diagnosis of pulmonary diseases, real-time convenience, high sensitivity and specificity.It is the frontier medical technology that can visually evaluate pneumothorax. \u0000 \u0000 \u0000Key words: \u0000Neonate; Pneumothorax; Lung ultrasound","PeriodicalId":68901,"journal":{"name":"中国小儿急救医学","volume":"26 1","pages":"575-578"},"PeriodicalIF":0.0,"publicationDate":"2019-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44723087","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":"Effects of different concentration oxygen on the lung development of neonatal rats","authors":"Yanli Sun, Wanjie Huang, Xinyi Zhao, Xin Tong","doi":"10.3760/CMA.J.ISSN.1673-4912.2019.08.012","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-4912.2019.08.012","url":null,"abstract":"Objective \u0000To investigate the effects of different concentration hyperoxic exposure on the lung development of neonatal rats for providing theoretical basis for the preparation of bronchopulmonary dysplasia model. \u0000 \u0000 \u0000Methods \u0000A total of 128 newborn rats were randomly and equally assigned to one of the following four groups: group A(FiO2>0.9, n=32), group B (FiO2=0.6, n=32), group C(FiO2=0.4, n=32) and the air group(21% O2, n=32). Lung tissue were collected at day 3, 7, 14 and 21 for histological analysis.Body weights were recorded, pulmonary morphology and radical alveoli count(RAC), mean alveolar diameter(MAD), alveolar septal thickness(AST) were carried out. \u0000 \u0000 \u0000Results \u0000Compared with the air group of the same time, the body weight of group A significantly decreased at 3 d(P 0.05). HE staining showed that the alveolar cavity significantly increased, alveolar structure was simplified and the alveolar spacing was thickened in different degrees in group A and group B. Furthermore, the reduction in the number of alveoli was more obvious and the alveolar septum was thicker in group A. The change of alveoli in group C was obviously weaker than group A and group B. The RAC of group A and group B were significantly lower than those in the air group(P<0.05). The RAC of group C was slightly lower than those in the air group, and had statistical significance at 14 d(P<0.05). The MAD and AST of group A and group B were significantly higher than those in the air group at 7 d (P<0.05). The MAD and AST of group C decreased slightly over time, and had statistical significance at 21 d(P<0.05). \u0000 \u0000 \u0000Conclusion \u0000Different concentrations of oxygen can have an impact on alveolar development.Severe alveolar dysplasia can be seen after continuous inhalation of more than 60% oxygen concentration.It provides a model basis for the study of the pathogenesis of bronchopulmonary dysplasia. \u0000 \u0000 \u0000Key words: \u0000Oxygen inhalation therapy; Bronchopulmonary dysplasia; Lung development; Rat","PeriodicalId":68901,"journal":{"name":"中国小儿急救医学","volume":"26 1","pages":"608-613"},"PeriodicalIF":0.0,"publicationDate":"2019-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42649923","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 in the application of pulmonary surfactant instillation via fine catheter technology","authors":"Mengyue Huo, H. Mei","doi":"10.3760/CMA.J.ISSN.1673-4912.2019.08.014","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-4912.2019.08.014","url":null,"abstract":"With the improvement of the treatment of neonatal respiratory distress syndrome, minimally invasive pulmonary surfactant(PS)therapy is gradually considered to be a more ideal drug delivery method for PS because of its simpler operation and less airway damage, and it is a part of the lung protective strategy for premature infants.Therefore, this article reviewed the administration methods, advantages, research status and future problems of minimally invasive PS treatment technology. \u0000 \u0000 \u0000Key words: \u0000Respiratory distress syndrome; Neonates; Minimally invasive; Pulmonary surfactant therapy","PeriodicalId":68901,"journal":{"name":"中国小儿急救医学","volume":"26 1","pages":"618-622"},"PeriodicalIF":0.0,"publicationDate":"2019-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49116530","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}