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Significance of Fractional Exhaled Nitric Oxide Combined with Serum Procalcitonin and C-Reactive Protein in Evaluation of Elderly Asthma

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Journal of Huazhong University of Science and Technology(Medical Sciences) 2013年第2期33卷 185-188页

作者：吴纪珍马利军赵丽敏张晓宇陈献亮况红艳 Department of Respiratory Medicine and intensive care Union the People's Hospital of Henan Province

bronchial asthma is a common chronic airway inflammatory disease. Asthma is associated with high mortality, especially in the elderly patients. Repeated exacerbations cause disease progression. Therefore, identifying the onset of acute elderly asthma as soon as possible and giving the effective treatment is crucial to improve the prognosis. This study was to investigate the significance of fractional exhaled nitric oxide （FeNO） combined with serum procalcitonin （PCT） and C-reactive protein （CRP） in the evaluation of elderly asthma. A total of 120 elderly patients with an acute attack of asthma from July, 2010 to May, 2012 were studied. On presentation, FeNO, serum PCT and CRP concentrations were measured and sputum culture was also performed. The elderly patients were re-evaluated when they had returned to their stable clinical state. The elderly patients were classified into two groups： positive bac- terial culture group （A） and negative bacterial culture group （b）. The results showed that：（1） In patients with an acute exacerbation of asthma, 48 （40%） patients had positive sputum bacterial culture and 72 （60%） had negative sputum bacterial culture. （2） The levels of FeNO in patients with acute exacerbation of asthma were significantly higher than in those with no acute exacerbation state （63.8±24.6 vs. 19±6.5 ppb, P〈0.05）. There was no significant difference in FeNO between group A and group b （P〉0.05）. （3） The levels of PCT and CRP in group A patients with an acute exacerbation of asthma were significantly higher （P〈0.05） than in group b （for PCT： 27.46±9.32 vs. 7.85±3.52 ng/mL; for CRP： 51.25±11.46 vs. 17.11±5.87 mg/L, respectively）. When they had returned to stable clinical state, the levels of PCT and CRP in group A were decreased significantly （P〈0.05）, and those in group b had no significant change （P〉0.05） when compared with the exacerbation group. There were no significant differences in the levels of PCT and CRP between the two groups in non-acute exacerb

关键词： elderly asthma fractional exhaled nitric oxide procalcitonin C-reactive protein bacterial infection

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Neonates need tailored drug formulations

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World Journal of Clinical Pediatrics 2013年第1期2卷 1-5页

作者： Karel Allegaert Department of Development and Regeneration University Hospitals 3000 LeuvenBelgium neonatal intensive care unit University Hospitals Leuven 3000 Leuven Belgium

Drugs are very strong tools used to improve outcome in neonates. Despite this fact and in contrast to tailored perfusion equipment, incubators or ventilators for neonates, we still commonly use drug formulations initially developed for adults. We would like to make the point that drug formulations given to neonates need to be tailored for this age group. besides the obvious need to search for active compounds that take the pathophysiology of the newborn into account, this includes the dosage and formulation. The dosage or concentration should facilitate the administration of low amounts and be flexible since clearance is lower in neonates with additional extensive between-individual variability. Formulations need to be tailored for dosage variability in the low ranges and also to the clinical characteristics of neonates. A specific focus of interest during neonatal drug development therefore is a need to quantify and limit excipient exposure based on the available knowledge of their safety or toxicity. Until such tailored vials and formulations become available, compounding practices for drug formulations in neonates should be evaluated to guarantee the correct dosing, product stability and safety.

关键词： Drug formulation Newborn Excipient Safety Quality control

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Assessment of left-ventricular diastolic function in pediatric intensive-care patients:a review of parameters and indications compared with those for adults

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World Journal of Pediatrics 2021年第1期17卷 21-30页

作者： Morgan Recher Astrid botte Jerome Soquet Jean-benoit baudelet François Godart Stephane Leteurtre ULR 2694-METRICS:évaluation des Technologies de santéet des Pratiques Médicales Univ.LilleCHU Lille59000 LilleFrance Réanimation et Surveillance Continue Pédiatriques Hopital Jeanne de FlandreCHU de Lille59037 Lille CedexFrance Pediatric and neonatal intensive care unit CHU Bordeaux33076 BordeauxFrance Cardiac Surgery unit CHU Lille59000 LilleFrance Congenital and Pediatric Cardiology unit CHU Lille59000 LilleFrance

background The incidence of diastolic heart failure has increased over *** evaluation of left-ventricular diastolic func-tion is complex,ongoing,and remains poorly performed in pediatric intensive-care *** study aimed to review the literature and to provide an update on the evaluation of left-ventricular diastolic function in adults and children in intensive *** sources We searched data from PubMed/***-two studies were *** pragmatic questions were identified:(1)What is the physiopathology of diastolic dysfunction?(2)Which tools are required to evaluate diastolic func-tion?(3)What are the echocardiographic criteria needed to evaluate diastolic function?(4)When should diastolic function be evaluated in pediatric intensive care?Results Early diastole allows characterization of relaxation,whereas compliance assessments and filling pressures are evalu-ated during late *** evolution of diastolic function differs between adults and *** in adults,decreased compliance occurs at the same time as delayed relaxation in *** function can be evaluated by Doppler *** echocardiographic criteria for ventricular relaxation include the E wave,E/A wave ratio,and isovolumic relaxation *** compliance can be assessed by the E/e'wave ratio,atrial volume,and Ap wave duration during pulmonary vein *** adult intensive-care patients,the E/e'ratio can be used as an index of tolerance for volume expan-sion in septic patients and to adjust the inotropic *** Clinical studies would allow some of these parameters to be validated for use in children in intensive care.

关键词： Diastole Echocardiography Heart failure intensive-care unit Pediatric

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Debakey Type III Aortic Dissection Causing bowel Necrosis: A Case Report

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Journal of Clinical and Nursing Research 2024年第8期8卷 159-162页

作者： Jinhu Kong Jiazheng Li Haiyang Hu Shangyun Pan Hongsheng Liu Clinical Medical College of Jining Medical University Jining 272067Shandong ProvinceChina Department of Cardiac intensive Medicine Affiliated Hospital of Jining Medical UniversityJining 272000Shandong ProvinceChina

Rationale:Aortic dissection is a life-threatening medical emergency associated with high morbidity and *** mesenteric malperfusion increases the surgical risk and mortality in patients with type b aortic *** Debakey type III b patients involving most of the thoracoabdominal aorta,endovascular treatment to improve true lumen perfusion may have limited *** reperfusion on-time is *** concerns:A 38-year-old man was admitted with sudden severe upper abdominal *** CTA of the entire aorta revealed an aortic dissection with an entry tear in the descending aortic arch involving the celiac trunk,superior mesenteric artery,bilateral common iliac arteries and right external iliac artery,with thrombosis in the superior mesenteric ***:The patient was diagnosed with Debakey type III aortic dissection with mesenteric artery *** chest CT showed the entry tear location and involvement of major *** confirmed partial blood flow in the superior mesenteric ***:The patient underwent endovascular aortic stent-graft implantation through the left femoral artery,covering the descending aortic arch and sealing the entry ***,the patient received intensive care,including ventilatory support,CRRT,anti-infection therapy,vasoactive drugs and lumbar cistern ***:Two weeks postoperatively,the patient developed massive black stools,indicative of intestinal obstruction and *** laparotomy revealed ischemic necrosis and rupture of the stomach,small intestine,and *** surgical efforts,the patient’s condition deteriorated,leading to death from severe infection,acid-base imbalance and multiple organ failure.

关键词： Abdominal pain Aortic dissection Arterial embolism Mesenteric artery

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Roles of neutrophil reactive oxygen species(ROS) generation in organ function impairment in sepsis

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Journal of Zhejiang University-Science b(biomedicine & biotechnology) 2022年第6期23卷 437-450页

作者： Jiaqi LU Jingyuan LIU Ang LI intensive care unit Beijing Ditan HospitalCapital Medical UniversityBeijing 100015China

Sepsis is a condition of severe organ failure caused by the maladaptive response of the host to an *** is a severe complication affecting critically ill patients,which can progress to severe sepsis,septic shock,and ultimately *** a vital part of the human innate immune system,neutrophils are essential in resisting pathogen invasion,infection,and immune ***-produced reactive oxygen species(ROS) play a pivotal role in organ dysfunction related to *** recent years,ROS have received a lot of attention as a major cause of sepsis,which can progress to severe sepsis and septic *** paper reviews the existing knowledge on the production mechanism of neutrophil ROS in human organ function impairment because of sepsis.

关键词： Sepsis Neutrophils Oxidative stress Reactive oxygen species(ROS) Organ dysfunction

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MbL2 Gene Polymorphism and the Association with neonatal Sepsis in Egyptian Neonates, a Case Control Study

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Open Journal of Immunology 2016年第3期6卷 111-119页

作者： Ghada El-Saeed Mashaly Amr Mohamed El-Sabbagh Samah Sabry El-Kazzaz Islam Nour Medical Microbiology and Immunology Department Faculty of Medicine Mansoura University Mansoura Egypt neonatal intensive care unit Faculty of Medicine Mansoura University Mansoura Egypt

Mannose binding lectin (MbL) is an important component of innate immunity particularly in neonates whose adaptive immunity is not fully developed. Polymorphism in MbL2 gene promoter and exon1 determines MbL serum level and function. The aim of this study was to investigate the frequency of different MbL2 genotypes in neonatal sepsis among patients of neonatal intensive care unit (NICU). Two hundred and forty-five neonates were enrolled in this study (127 infected and 118 uninfected controls). Multiplex PCR and double amplification refractory mutation system (dARMS) were used for typing of MbL2 exon1 and promoter respectively. Klebsiella species were the most frequently isolated organisms (22.8%). There is no statistical significance difference in the distribution of different expression genotypes between infected group and controls (P = 0.11). However, prevalence of low MbL2 expression genotypes (XA/O and O/O) was higher in infected patients compared to control group (patients 25.2% and controls 15.3%). Low and medium MbL2 expression genotypes were mostly associated with Gram-negative bacterial infections (18.9% and 22.8%) respectively. A statistically significant association of Gram-negative bacterial infections with low MbL2 expression genotypes was found (P = 0.02). Higher frequency of Ab and bb genotypes was observed (31.5% and 7.9%) in patients group compared to control, but without statistical significant difference.

关键词： Mannose binding Lectin (MbL) neonatal Sepsis Gene Polymorphism Multiplex PCR Geneotype Haplotype

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Liver transplantation for hepatitis b virus-related cirrhosis with acute-on-chronic liver failure and grade 3-4 hepatic encephalopathy: Survival and quality of life

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中华医学杂志(英文版) 2024年第17期137卷 2024 Apr 17页

作者： Shi Shaohua Zhang Minghui Chen Xuliang Wang Zhuoyi Ding Songming Chen Zhitao Yang Yu Zheng Shusen Department of Hepatobiliary and Pancreatic Surgery Shulan (Hangzhou) Hospital Affiliated to Zhejiang Shuren University Shulan International Medical College Hangzhou Zhejiang China Department of General Surgery The Sixth People’s Hospital of Zhengzhou City Zhengzhou Henan China Department of intensive care unit Shulan (Hangzhou) Hospital Affiliated to Zhejiang Shuren University Shulan International Medical College Hangzhou Zhejiang China

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The scoring system for patients with severe sepsis after orthotopic liver transplantation

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Hepatobiliary & Pancreatic Diseases International 2006年第3期5卷 364-367页

作者： Shun-Wei Huang, Xiang-Dong Guan, Xiao-Shun He, Juan Chen and bin Ouyang Department of Surgical intensive care unit ,and Department of Transplantation Surgery,First Affiliated Hospital, Sun Yat- Sen University, Guangzhou 510800, China Department of Surgical intensive care unit First Affiliated Hospital Sun Yat-Sen University Guangzhou 510800 China. huangshunwei@***

bACKGROUND: because of the complicated pathological features after liver transplantation, severe sepsis is difficult to treat and often leads to death. This study was undertaken to analyze the role of orthotopic liver transplantation (OLT) in patients with severe sepsis and to evaluate the effect of the scoring system. METHODS: Fifty-six patients conformed to the inclusion criteria. They were divided into two groups: non-OLT group (group A) and OLT group (group b). besides the general data of the patients, the surveillance of blood lactate, the number of failed organs, acute physiology and chronic health evaluationⅡ(APACHEⅡ) and mutiple organ dysfunction score (MODS) were evaluated at the 1st, 3rd and 7th day after OLT. RESULTS: The mortality during hospitalization was 30% in the non-OLT group and 57.6% in the other group. The level of blood lactate at the 1st day of OLT increased more significantly in the OLT group than in the non-OLT group (Pbut higher than that in the non-OLT group in the seven days after OLT. The number of failed organs in the OLT group was greater than that in the non-OLT group (Pbut the continuous MODS in the OLT group was higher than that in the non-OLT group (Pber of failed organs. CONCLUSIONS: The persistently higher level of blood lactate during 7 days may be a dependent risk factor. Immunosuppression may be another risk factor for OLT patients. The mortality of OLT in patients with severe sepsis in 28 days is almost double that in non-OLT patients. The MODS score is better than the APACHEⅡscore in the assessment of organ failure in OLT patients with severe sepsis. The standard scoring system could be improved or a new scoring system that includes the blood lactate score should be established for liver transplantation.

关键词： orthotopic liver transplantation systemic inflammatory response syndrome severe sepsis blood lactate acute physiology and chronic healthevaluationⅡ mutiple organ dysfunction score

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围产期护理缺失量表的汉化及信效度检验

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International Journal of Nursing Sciences 2024年第1期11卷 106-112页

作者：丁胜兰王鑫王清霞沈涓谢惠莉付秀娟廖露茜陈娇娇朱莲黄静杨思源黄秀华张轶岚 birth Room Chengdu Women’s and Children’s Central HospitalSchool of MedicineUniversity of Electronic Science and Technology of ChinaChengduChina Department of Nursing Chengdu Women’s and Children’s Central HospitalSchool of MedicineUniversity of Electronic Science and Technology of ChinaChengduChina Department of Medical Imaging The First Affiliated Hospital of Chongqing Medical UniversityChongqingChina School of Health in Social Science University of EdinburghEdinburghUnited Kingdom School of Nursing Peking UniversityBeijingChina Department of Nursing The First Affiliated Hospital of Chongqing Medical UniversityChongqingChina Surgery intensive care unit Chengdu Women’s and Children’s Central HospitalSchool of MedicineUniversity of Electronic Science and Technology of ChinaChengduChina

目的翻译围产期护理缺失量表,并对其进行信度和效度检验,为国内开展围产期护理缺失的量性研究提供可靠的测评工具。方法采用美国矫形外科医师学会循证医学委员会推荐的跨文化调试量表指南对英文版围产期护理缺失量表进行翻译、回译-文... 详细信息

目的翻译围产期护理缺失量表,并对其进行信度和效度检验,为国内开展围产期护理缺失的量性研究提供可靠的测评工具。方法采用美国矫形外科医师学会循证医学委员会推荐的跨文化调试量表指南对英文版围产期护理缺失量表进行翻译、回译-文化调适及内容验证,形成中文版围产期护理缺失量表,并通过横断面研究验证其信效度。于2023年2月至4月采用便利抽样法,选取西南地区14所不同级别医院491名助产士进行问卷调查。采用项目分析检验中文版量表条目的鉴别度,采用探索性和验证性因子分析评价量表的结构效度,采用内容效度指数和Cronbach'sa系数评价内容效度和信度。结果围产期护理缺失.量表包括A、b两部分。中文版围产期护理缺失量表A部分的项目-总量表相关系数为0.641 -0.866, b部分为0.644~0.819(Pb部分的量表水平内容效度指数均为0.95,条目水平内容效度指数为0.86~1.00。探索性因子分析分别提取了A部分(必要性护理、基本护理和产后护理)和b部分(沟通、人力资源和物质资源)各3个因子,占总方差的70.186%和71.984%。量表A、b部分的Cronbach's a系数分别为0.968、0.940。结论中文版围产期护理缺失量表具有良好的信度和效度,可作为国内评价围产期护理缺失情况和相关原因的工具。未来需要进行更大样本量的研究,以验证该工具在中国本土的适用性。

关键词：助产士护理缺失围产期护理信度调查及问卷效度

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Chest CT features of children infected by b.1.617.2 (Delta) variant of COVID‑19

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World Journal of Pediatrics 2022年第1期18卷 37-42页

作者： Qi-Rui Cheng Ming-Xing Fan Jing Hao Xiao-Chen Hu Xu-Hua Ge Zhi-Liang Hu Zhuo Li Pediatric intensive care unit Children’s Hospital of Nanjing Medical UniversityNo 72 Guanzhou RoadNanjingChina Nanjing Infectious Disease Center The Second Hospital of NanjingNanjing University of Chinese MedicineNanjingChina

background This study aimed to explore the imaging characteristics,diversity and changing trend in CT scans of pediatric patients infected with Delta-variant strain by studying imaging features of children infected with Delta and comparing the results to those of children with original *** A retrospective,comparative analysis of initial chest CT manifestations between 63 pediatric patients infected with Delta variant in 2021 and 23 pediatric patients with COVID-19 in 2020 was *** imaging features were *** addition,the changing trend in imaging features of COVID-19 Delta-variant cases were explored by evaluating the initial and follow-up CT *** Among 63 children with Delta-variant COVID-19 in 2021,34(53.9%)showed positive chest CT presentation;and their CT score(1.10±1.41)was signifcantly lower than that in 2020(2.56±3.5)(P=0.0073).Lesion distribution:lung lesions of Delta cases appear mainly in the lower lungs on both *** children had single lobe involvement(18 cases,52.9%),14(41.2%)in the right lung alone,and 14(41.2%)in both lungs.A majority of Delta cases displayed initially ground glass(23 cases,67.6%)and nodular shadows(13 cases,38.2%)in the frst CT scan,with few extrapulmonary *** 34 children with abnormal chest CT for the frst time have a total of 92 chest CT *** children showed a statistically signifcant diference between the 0-3 day group and the 4-7 day group(P=0.0392)and a signifcant diference between the 4-7 day group and the more than 8 days group(P=0.0003).Conclusions The early manifestations of COVID-19 in children with abnormal imaging are mostly small subpleural nodular ground glass *** changes on the Delta-variant COVID-19 chest CT were milder than the original *** lesions reached a peak on CT in 4-7 days and quickly improved and absorbed after a *** CT re-examination can achieve a good prognosis.

关键词： b.1.617.2(Delta)variant Children Coronavirus disease 2019(COVID-19) Chest computed tomography(CT)

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