To investigate the neuroprotective function of BDNF on hypoxic- cultured neurons in vitro.The embryonic cerebral cortical neurons of rat were cultured in vitro in hypoxic and non-hypoxic environments and were observed under transmission electron microscope. MTT colorimetry was used to detect the viability of the neurons. Both DAPI colorated measurement and TUNEL methods were used to calculate the percentages of neuron apoptosis. Three groups were designed and compared: Group A - normal control; Group B - exposed to hypoxia; Group C-BDNF intervened (with different dosages and durations) and exposed to hypoxia.The ultrastructural alterations of the hypoxic cultured neurons indicated that hypoxia induced necrosis, apoptosis or both. The neurons were most sensitive to hypoxia at the initial 10 hours. At six hours after hypoxic cultures, Group C had significant greater livability of neurons and less percentages of neuron apoptosis than Group B (P<0.05).Hypoxia damages embryonic cerebral cortical neurons of rat in vitro. Extrinsic BDNF plays a neuroprotective role against hypoxic-induced neurotoxicity in vitro.
Background: N-terminal brain natriuretic peptide precursor (NT-proBNP) and brain natriuretic peptide (BNP) are mainly produced and secreted in the heart. In 2008, the European Heart Association recommended that serum BNP/NT-proBNP levels should be included in one of the diagnostic criteria of heart failure. Serum NT-proBNP is more stable than BNP, and the detection results are less affected by objective factors, so it is widely used. At present, NT-proBNP has long been beyond the scope of heart failure markers, and has a wide range of clinical value in the evaluation and prediction of some serious diseases. This study prospectively studied the predictive value of serum NT-proBNP in pediatric intensive care unit (PICU).Methods: This was a prospective study involving 375 children in the PICU. The patients were divided into three groups: non-risk, low-risk, and high-risk groups. Serum NT-proBNP levels and the 28-day mortality rate were analyzed.Results: The serum NT-proBNP levels and the mortality of the high-risk group was significantly higher than those of the low- and non-risk groups (P<0.01 in both cases). Receiver operating characteristic curve (ROC curve) analysis showed that the area under the curve was 0.705 (P<0.001, sensitivity =0.643, specificity =0.692). Death multivariate binary logistic regression analysis indicated that NT-proBNP was not an independent factor for 28-day mortality.Conclusions: Serum NT-proBNP was significantly correlated with the severity of illness for critically ill patients in PICU. Although high levels of NT-proBNP indicated greater severity, this was not an independent risk factor affecting the prognosis of patients.
Background Augmentation of androgen/androgen receptor (AR) pathway may influence chronic hepatitis B (CHB) more likely in males. AR activity is modulated by a polymorphic CAG repeat sequence in AR exon 1. This study aimed to investigate the relationship between serum testosterone levels, CAG repeat numbers and hepatitis B virus (HBV)-related acute liver failure (ALF). Methods Three hundred and seventy eight male CHB patients with ALF and 441 asymptomatic HBV carriers (AsCs) were recruited. AR CAG repeats numbers were analyzed. The serum testosterone levels of AsCs, ALFs and patients with hepatitis B flare groups, and sequential serum samples, were assessed quantitatively. Results The median CAG repeat (M-CAG) frequency was significantly higher in ALF patients than AsCs (P<0.001). Patients with M-CAG alleles (P<0.001, OR 3.0, 95% CI 2.1–4.2) had the highest risk for ALF. Serum testosterone levels were significantly higher (P<0.001) at hepatitis flare point (8.2±3.0 ng/mL) than inactive phase (6.4±2.0 ng/mL). CHB (8.30±2.71 ng/mL, P = 7.6×10−6) and ALF group (2.61±1.83 ng/mL, P = 1.7×10−17) had significantly different levels of testosterone in comparison with AsCs group (6.56±2.36 ng/mL). The serum testosterone levels sharply decreased from hepatitis flare phase to liver failure phase, and tended to be normal at the recovery phase. Male AsCs with M-CAG alleles had significantly lower serum testosterone levels (P<0.05). Conclusions There was a serum testosterone fluctuation during hepatitis B flare and HBV-related ALF, and the median CAG repeats in AR gene exon 1 were associated with lower serum testosterone levels in asymptomatic HBV carriers and an increased susceptibility to HBV-related ALF.
Objectives: To estimate the prevalence, management, and outcomes of pediatric severe sepsis in the main PICUs in Southwest China. Design: A prospective, observational, and multicenter study. Setting: Eight PICUs in Southwest China with 19 (13–24) beds and 1,322 (1,066–1,452) annual admissions each. Patients: A total of 10,598 patients (29 d to 18 yr old) were consecutively admitted between September 1, 2016, and August 31, 2017. All patients were screened and evaluated for severe sepsis or septic shock. Of them, 10,353 patients were excluded due to incomplete data or not meeting the consensus criteria for severe sepsis or septic shock; 245 patients were included with complete data. Interventions: None. Measurements and Main Results: Finally, 245 patients who were diagnosed with severe sepsis or septic shock were included in the study, with an incidence rate of 2.3%. Of them, 64.0% of the enrolled patients were male with 80.8% being less than 5 years old and 60.8% being from rural areas. The respiratory system was the most common organ system in which dysfunction was observed (76.7%) as well as the most frequently infected site (37.6%). The primary therapies were antibiotics (99.0%), immunoglobulin (88.3%), mechanical ventilation (78.4%), vasoactive infusions (59.6%), and corticosteroids (46.1%). Among the 188 patients who had respiratory dysfunction, 173(92%) required mechanical ventilation and 39 (20.7%) met the criteria for pediatric acute respiratory distress syndrome. Seven of the patients with pediatric acute respiratory distress syndrome died (7/39, 17.9%). The median durations for mechanical ventilation and vasoactive medications were 123.5 hours (35.25–226.00 hr) and 2 days (1–5 d), respectively. Eighty-six percent of patients had multiple organ dysfunction syndrome at the point at which severe sepsis was recognized, and 31% had underlying conditions. The hospital mortality rate was 18.8%. Conclusions: This report is the first to present the prevalence, treatment, and outcomes of pediatric severe sepsis in the main PICU centers in Southwest China. The mortality rate remains high; therefore, improved clinical management and implementation of large-scale clinical trials are necessary to improve early diagnoses and treatment.
Abstract: Since early December 2019, patients with unknown pneumonia have been found in Wuhan City, Hubei Province, China. The pathogen in these cases was quickly identified as a new type of coronavirus. The World Health Organization named it 2019 novel coronavirus (2019-nCoV), and the disease caused by the pathogen was called 2019 Coronavirus Disease (COVID-19), which was characterized by higher pathogenicity, transmission of human to human. So it has rapidly spread to more than 190 countries all over the world. With the sudden outbreak of COVID-19, preventing the spread of COVID-19 is the primary problem. Despite fewer children than adults have been affected by the COVID-19, Pediatric Intensive Care Unit (PICU), as a ward for critically ill patients, is also confronted with high risk of 2019-nCoV infection. It is necessary for PICU managers to thoroughly carry out scientific and effective department management and carefully execute of infection control measures to prevent the transmission. According to recommendations for the COVID-19 prevention and control, the relevant guidelines and the authors' work experience, this paper proposes and optimizes the strategic plan for the management of COVID-19 outbreak in PICU, and emphasizes that department managers should conduct comprehensive risk assessments, manage the pediatric patients and healthcare workers meticulously, strengthen the implementation of infection control measures, and use risk management and process control to effectively manage the department as well as to protect the safety of both the patients and the staff.
Objective To provide an overview of the integration of nursing care services for patients with acute leukemia in the past, present and future. Data sources Published literature as indexed in Medline, relevant guideline documents, textbooks and clinical experience. Conclusion Patients with acute leukemia have significant nursing care demands that are frequently unmet by routine oncology treatment. The initial introduction of expert nursing care into routine oncology treatment boosts patient-centered results in people with advanced solid tumors, according to research. Recent data suggest that patients with hematologic malignancies who have undergone transplantation of stem cells have similarly improved, and further trials are being conducted to assess nursing care treatments in patients with acute leukemia. Nursing practice implications Nurses are essential in the management of patients with acute leukemia both in and out of the hospital. As a result, having a basic understanding of these illnesses is critical. In the management of oncologic crises, early symptom identification is crucial.
Objective To investigate the nutrition nursing care and skills on patients injured in an earthquake. Methods 1934 cases of patients injured in an earthquake in our hospital had been given continuous nutrition evaluation,diagnosis,plan,implement and detection,and also modify nutrition plan and measures in time in the course of individual nutrition nursing. Results After reasonable nutrition nursing,there were 6 cases weight loss,3 cases malnutrition,1 case infection,1 case urinary tract infection and other 1923 cases nutrition status well and no complication. Conclusion Scientific and reasonable nutrition nursing care and skills can affect the patients' outcome,promote wound repair,reduce complication,disability rate and mortality of patients.
OBJECTIVE To analyze the results of targeted surveillance of nosocomial infections in Jiangxi and evaluate the changing trends of the results of the targeted surveillance.METHODS The targeted surveillance was carried out for three types of nosocomial infections in member hospitals of monitoring network from 2009 to 2011,including the surgical site infections(SSIs),neonatal nosocomial infections,and ventilator-associated pneumonia(VAP).RESULTS The total incidence of SSIs was 0.61%,while the incidence of type Ⅲ incision infections was the highest(2.58%),there was no significant change in the infection rate among three types of incision surgeries;the incidence of neonatal nosocomial infections was 3.79%,and was highest(7.38%) in the neonates who born at the weight between 1501 g and 2500 g,there was no significant change during the 3 years of surveillance;the incidence of VAP and the daily infection rates were 10.01% and 22.58‰,respectively,the incidence was dropped.CONCLUSION The incidence of neonatal infection,SSIs,and VAP are relatively high,thus it is necessary to strengthen the surveillance and the intervention.
OBJECTIVE To investigate the influencing factors and pathogens distribution of ventilator-associated pneumonia(VAP) in pediatrics ICU(PICU),and provide reference for preventing and controlling VAP.METHODS All cases with mechanical ventilation(MV) duration over 48 hours in PICU from Jan 2008 to Dec 2008 were studied by means of the methods of target surveillance.The risk factors of VAP were analyzed by Logistic regression.RESULTS Totally 33 VAP cases among 132 patients were collected,which the incidence was 25.0%.15 strains of pathogens were isolated,which were mainly Gram-negative pathogens(75%).Logistic regression analysis showed the independent factors were the pneumonia before MV(OR=0.07,P0.001),duration of MV over 5 days(OR=4.58,P0.05),reintubation(OR=3.68,P0.05) and surgery(OR=3.74,P0.05).CONCLUSION Patients in PICU are the high risk group of VAP,the monitroring and control of VAP should be enhanced.
'/%3e%3cuse xlink:href='%23a' transform='rotate(23.036 .093 25.536)'/%3e%3cuse xlink:href='%23a' transform='rotate(45.87 1.273 16.18)'/%3e%3cuse xlink:href='%23a' transform='rotate(69.945 .996 12.078)'/%3e%3cuse xlink:href='%23a' transform='rotate(20.66 -19.689 31.932)'/%3e%3c/svg%3e)