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Conjugated hyperbilirubinemia presenting in first fourteen days in term neonates

World Journal of Hepatology 2017年第26期9卷 1108-1114页

作者： Fang Kuan Chiou Christina Ong kong boo phua Fares Chedid Ajmal Kader Gastro-enterology Service Paediatric Medicine KK Women’s and Children’s Hospital Neonatal Medicine Al Jalila Children’s Specialty Hospital Pediatric Gastroenterology Dubai Hospital

AIM To describe the etiology and characteristics of earlyonset conjugated hyperbilirubinemia(ECHB) presenting within 14 d of life in term *** Retrospective review was performed of term infants up to 28-d-old who presented with conjugated hyperbilirubinemia(CHB) at a tertiary center over a 5-year period from January 2010 to December 2014. CHB is defined as conjugated bilirubin(CB) fraction greater than 15% of total bilirubin and CB greater or equal to 25 μmol/L. ECHB is defined as CHB detected within 14 d of life. "Late-onset" CHB(LCHB) is detected at 15-28 d of life and served as the comparison *** Total of 117 patients were recruited: 65 had ECHB, 52had LCHB. Neonates with ECHB were more likely to be clinically unwell(80.0% vs 42.3%, P < 0.001) and associated with non-hepatic causes(73.8% vs 44.2%, P = 0.001) compared to LCHB. Multifactorial liver injury(75.0%) and sepsis(17.3%) were the most common causes of ECHB in clinically unwell infants, majority(87.5%) had resolution of CHB with no progression to chronic liver disease. Inborn errors of metabolism were rare(5.8%) but associated with high mortality(100%) in our series. In the subgroup of clinically well infants(n = 13) with ECHB, biliary atresia(BA) was the most common diagnosis(61.5%), all presented initially with normal stools and decline in total bilirubin but with persistent CHB. CONCLUSION Secondary hepatic injury is the most common reason for ECHB. BA presents with ECHB in well infants without classical symptoms of pale stools and deep jaundice.

关键词： Conjugated hyperbilirubinemia Biliary atresia Cholestasis Direct hyperbilirubinemia Neonatal jaundice

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Cap polyposis: A rare cause of rectal bleeding in children

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World Journal of Gastroenterology 2013年第26期19卷 4185-4191页

作者： Jia Hui Li May Ying Leong kong boo phua Yee Low Ajmal Kader Veena Logarajah Lin Yin Ong Joyce HY Chua Christina Ong Gastroenterology Service Department of Pediatric Medicine KK Women's and Children's Hospital Department of Pathology KK Women's and Children's Hospital Department of Pediatric Surgery KK Hospital

AIM: To evaluate the clinicopathological features and treatment outcomes of cap polyposis in the pediatric population. METHODS: All pediatric patients with histologically proven diagnosis of cap polyposis were identified from our endoscopy and histology database over a 12 year period from 2000-2012 at our tertiary pediatric center, KK Women's and Children's Hospital in Singapore. The case records of these patients were retrospectively reviewed. The demographics, clinical course, laboratory results, endoscopic and histopathological features, treatments, and outcomes were analyzed. The study protocol was approved by the hospital institutional review board. The histological slides were reviewed by a pediatric histopathologist to confirm the diagnosis of cap polyposis. RESULTS: Eleven patients were diagnosed with cap polyposis. The median patient age was 13 years (range 5-17 years); the sample included 7 males and 4 females. All of the patients presented with bloody stools. Seven patients (63%) had constipation, while 4 patients (36%) had diarrhea. All of the patients underwent colonoscopy and polypectomies (excluding 1 patient who refused polypectomy). The macroscopic findings were of polypoid lesions covered by fibrinopurulent exudates with normal intervening mucosa. The rectum was the most common involvement site (n = 9, 82%), followed by the rectosigmoid colon (n = 3, 18%). Five (45%) patients had fewer than 5 polyps, and 6 patients (65%) had multiple polyps. Histological examination of these polyps showed surface ulcerations with a cap of fibrin inflammatory exudate. Four (80%) patients with fewer than 5 polyps had complete resolution of symptoms following the polypectomy. One patient who did not consent to the polypectomy had resolution of symptoms after being treated with sulphasalazine. All 6 patients with multiple polyps experienced recurrence of bloody stools on follow-up (mean = 28 mo). CONCLUSION: Cap polyposis is a rare and underrecognised cause of rectal b

关键词： Cap polyposis Polyps Rectal bleeding Pediatrics Inflammatory bowel disease

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Evaluation of Self Management Behavior of Chronic Kidney Disease Patients

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Journal of Pharmacy and Pharmacology 2017年第4期5卷 179-188页

作者： Sook Hui phua Nur Akmar Taha Kiew Bing Pau Wei Yen kong Faculty of Pharmacy Universiti Kebangsaan Malaysia 43600 UKM Bangi Selangor Malaysia Pharmacy Department Universiti Kebangsaan Malaysia Medical Centre Jalan Yaacob Latif Bandar Tun Razak 56000 Cheras Kuala Lumpur Malaysia Nephrology Unit Medical Department Universiti Kebangsaan Malaysia Medical Centre Jalan Yaacob Latif Bandar Tun Razak 56000 Cheras Kuala Lumpur Malaysia

CKD （chronic kidney disease） is a progressive disease. If it is left untreated, it can eventually result in end stage renal failure and necessitate dialysis or kidney transplantation. There is no cure for CKD; instead a great deal of self management over time is essential. The purpose is to evaluate self management behaviour of patients at different stages of CKD. A total of 300 CKD patients were recruited in this cross sectional study from March to July 2015 at nephrology clinic of a tertiary care setting using convenience sampling. Self management behaviour score was determined using in Partners in Health scale and was then compared at different stages of CKD. Demographic and clinical factors contributing to self management behaviour were determined. Results： There was a significant difference in age （p 〈 0.001）, gender （p 〈 0.001）, education level （p 〈 0.001）, marital status （p 〈 0.001）, duration of illness （p 〈 0.001） and number of co-morbidities （p 〈 0.001） among CKD stages. A significant difference in self management behaviour mean score was found among CKD stages （p 〈 0.001）. Post hoc analysis showed self management behaviour mean score for Stage Ⅰ （mean ± SD： 77.81 ± 9.41） was significantly higher than Stage Ⅳ （mean ± SD： 70.53 ± 13.91） and Stage Ⅴ （mean ± SD： 69.54 ± 12.31）. Self management behaviour mean score for Stage Ⅱ （mean ± SD： 78.46 ± 10.01） was significantly higher than Stage Ⅳ and Stage Ⅴ. Multiple linear regression revealed education level （p 〈 0.001） and number of co-morbidities （p = 0.01） as significant predictors of self management behaviour. It can be concluded that special attention should be focused on patients at late stage of CKD, especially those with diabetic nephropathy; low education level and multiple co-morbidities to improve self management behaviour.

关键词： Self management behaviour chronic kidney disease predictors demographic factors clinical factors.

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逆行穿刺路径下血管腔内治疗股腘动脉长段闭塞性病变

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介入放射学杂志 2017年第12期26卷 1078-1082页

作者：柴伟刘汝海张执全李凤山雷豹袁俊建孔德帅沧州市中心医院普通外一科河北061001

目的探讨逆行穿刺路径下血管腔内治疗股腘动脉长段闭塞性病变的临床应用价值。方法回顾性分析2009年6月至2017年1月收治的46例复杂股腘动脉长段闭塞性病变患者临床资料,其中男27例,女19例,平均年龄(69±8)岁;Rutherford分级3级32例,4级8... 详细信息

目的探讨逆行穿刺路径下血管腔内治疗股腘动脉长段闭塞性病变的临床应用价值。方法回顾性分析2009年6月至2017年1月收治的46例复杂股腘动脉长段闭塞性病变患者临床资料,其中男27例,女19例,平均年龄(69±8)岁;Rutherford分级3级32例,4级8例,5级6例;CTA显示病变平均长度(17±5)cm。结果 46例患者手术技术成功率为100%。小切口显露并穿刺动脉平均用时(5.2±2.3)min,7例使用4 F动脉鞘管,39例无鞘操作;41例导丝顺利通过股腘动脉闭塞段进入近端真腔,5例以顺逆行双向内膜下血管成形术(SAFARI)技术建立导丝工作轨道。术后第3日踝-肱指数(ABI)均值为(0.71±0.12),与术前(0.33±0.11)相比差异有显著统计学意义(t=12.483,P<0.001)。总体手术相关并发症发生率为23.9%(11/46),远端动脉穿刺并发症发生率为4.3%(2/46),围手术期无死亡患者。43例(93.5%)患者获随访3~24个月,术后3、6、12个月CTA复查支架一期通畅率分别为91.3%(4/46)、78.3%(10/46)、58.7%(19/46),1年保肢率为95.7%(44/46)。结论逆行穿刺路径下血管腔内治疗复杂股腘动脉长段闭塞性病变操作简单,安全有效,具有一定的临床应用价值。

关键词：动脉硬化闭塞症逆行穿刺技术介入治疗

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图书网上采购电子商务浅议

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科技情报开发与经济 2005年第4期15卷 62-64页

作者：孔春苗汕头大学图书馆

指出图书网上采购电子商务的应用目前还处于早期应用阶段,在分析其应用的成效和阻滞因素的基础上,探讨了进一步发展图书网上采购应采取的措施。

关键词：电子商务图书采访网上采购网上书店

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夏播小黑麦生育期品质变化规律研究

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黑龙江农业科学 2015年第8期 126-129页

作者：韩微波张月学尚晨孔晓蕾田春霞张海玲李佶恺黑龙江省农业科学院草业研究所黑龙江哈尔滨150086

为保持和提高小黑麦优良品质,选择10个小黑麦品系,研究其在孕穗期、抽穗期和开花期品质和产量的变化规律。结果表明,小黑麦不同生育期的粗蛋白质含量不同,随生育时期不断变化逐渐降低,孕穗期最高,开花期时最低。不同生育期粗纤维含量不... 详细信息

为保持和提高小黑麦优良品质,选择10个小黑麦品系,研究其在孕穗期、抽穗期和开花期品质和产量的变化规律。结果表明,小黑麦不同生育期的粗蛋白质含量不同,随生育时期不断变化逐渐降低,孕穗期最高,开花期时最低。不同生育期粗纤维含量不同,抽穗期粗纤维含量最低。不同生育期粗脂肪含量不同,随生育时期不断变化逐渐升高,孕穗期最低,开花期时最高。不同生育期产量不同,在抽穗期产量达到最高。建议夏播小黑麦在孕穗期和抽穗期之间刈割,做到产量和品质兼顾。综合鲜草产量和营养物质产量表现,小黑麦品系黑6-2表现最优。

关键词：小黑麦生育期品质变化

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