Objective To analyze the predictive value of the mortality risk score for severe hand, foot and mouth disease(MRSHFMD) system for the complications and mortality risk of severe hand, foot and mouth disease(HFMD) in children. Methods This study included 354 children with severe HFMD who admitted in the pediatric intensive care unit(PICU) of Hunan Provincial Children′s Hospital from March 2012 to March 2014.The patients were grouped according to whether they had complicated nervous system damage, pulmonary edema, pulmonary hemorrhage and circulatory failure in the course of disease, and the prognosis was grouped according to their 28 d survival.The worst values of white blood cell count, blood glucose, blood lactic acid, N-terminal pro-brain natriuretic peptide, within 24 hours after admission were used to score MRSHFMD.The predictive value of MRSHFMD for nervous system damage, pulmonary edema, pulmonary hemorrhage, circulatory failure, and prognosis were evaluated using the receiver operating characteristic(ROC)curve. Results The blood glucose, white blood cell count, blood lactic acid value, N-terminal pro-brain natriuretic peptide and MRSHFMD score of the children with HFMD complicated with nervous system damage, pulmonary edema, pulmonary hemorrhage and circulatory failure were significantly higher than those in the non-complicated groups(P<0.01). When the cut-off value of MRSHFMD score was 3, the area (95%CI) under the ROC curve were 0.723 (0.643-0.804), 0.870 (0.793-0.946), 0.921 (0.85-0.992), 0.944 (0.867-1.000) and 0.954 (0.000-1.000) of nervous system damage, pulmonary edema, pulmonary hemorrhage, circulation failure and death in children with HFMD, respectively.The specificity and sensitivity of predicting nervous system damage, pulmonary edema, pulmonary hemorrhage, circulatory failure and death were 44.6% and 95.8%; 67.5% and 95.5%; 83.3% and 95.1%; 89.3% and 95.1%; 90.9% and 93.7%, respectively. Conclusion MRSHFMD system is an effective tool to predict HFMD complications of pulmonary hemorrhage, circulatory failure, and death, which is worthy of clinical promotion. Key words: Hand foot and mouth disease; The mortality risk score for severe hand, foot and mouth disease; Children
{"title":"Application of the mortality risk score for severe hand, foot and mouth disease in children with hand, foot and mouth disease in pediatric intensive care unit","authors":"Xiaoxiao He, Xiulan Lu, J. Qiu, Xun Li, Haipeng Yan, Zhenghui Xiao","doi":"10.3760/CMA.J.ISSN.1673-4912.2020.01.008","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-4912.2020.01.008","url":null,"abstract":"Objective \u0000To analyze the predictive value of the mortality risk score for severe hand, foot and mouth disease(MRSHFMD) system for the complications and mortality risk of severe hand, foot and mouth disease(HFMD) in children. \u0000 \u0000 \u0000Methods \u0000This study included 354 children with severe HFMD who admitted in the pediatric intensive care unit(PICU) of Hunan Provincial Children′s Hospital from March 2012 to March 2014.The patients were grouped according to whether they had complicated nervous system damage, pulmonary edema, pulmonary hemorrhage and circulatory failure in the course of disease, and the prognosis was grouped according to their 28 d survival.The worst values of white blood cell count, blood glucose, blood lactic acid, N-terminal pro-brain natriuretic peptide, within 24 hours after admission were used to score MRSHFMD.The predictive value of MRSHFMD for nervous system damage, pulmonary edema, pulmonary hemorrhage, circulatory failure, and prognosis were evaluated using the receiver operating characteristic(ROC)curve. \u0000 \u0000 \u0000Results \u0000The blood glucose, white blood cell count, blood lactic acid value, N-terminal pro-brain natriuretic peptide and MRSHFMD score of the children with HFMD complicated with nervous system damage, pulmonary edema, pulmonary hemorrhage and circulatory failure were significantly higher than those in the non-complicated groups(P<0.01). When the cut-off value of MRSHFMD score was 3, the area (95%CI) under the ROC curve were 0.723 (0.643-0.804), 0.870 (0.793-0.946), 0.921 (0.85-0.992), 0.944 (0.867-1.000) and 0.954 (0.000-1.000) of nervous system damage, pulmonary edema, pulmonary hemorrhage, circulation failure and death in children with HFMD, respectively.The specificity and sensitivity of predicting nervous system damage, pulmonary edema, pulmonary hemorrhage, circulatory failure and death were 44.6% and 95.8%; 67.5% and 95.5%; 83.3% and 95.1%; 89.3% and 95.1%; 90.9% and 93.7%, respectively. \u0000 \u0000 \u0000Conclusion \u0000MRSHFMD system is an effective tool to predict HFMD complications of pulmonary hemorrhage, circulatory failure, and death, which is worthy of clinical promotion. \u0000 \u0000 \u0000Key words: \u0000Hand foot and mouth disease; The mortality risk score for severe hand, foot and mouth disease; Children","PeriodicalId":68901,"journal":{"name":"中国小儿急救医学","volume":"27 1","pages":"35-39"},"PeriodicalIF":0.0,"publicationDate":"2020-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47338997","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}
Pub Date : 2019-12-20DOI: 10.3760/CMA.J.ISSN.1673-4912.2019.12.002
Jingyi Shi
{"title":"Is high-frequency ventilation a remedy for acute respiratory distress syndrome in children?","authors":"Jingyi Shi","doi":"10.3760/CMA.J.ISSN.1673-4912.2019.12.002","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-4912.2019.12.002","url":null,"abstract":"","PeriodicalId":68901,"journal":{"name":"中国小儿急救医学","volume":"26 1","pages":"885-888"},"PeriodicalIF":0.0,"publicationDate":"2019-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42535782","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}
Objective To provide basis for early selection of drug intervention or surgical treatment for premature patent ductus arteriosus(PDA) by a dynamic monitoring of serum N-terminal pro-brain natriuretic peptide(NT-proBNP)levels with ultrasonic examination, so as to improve the prognosis of premature infants. Methods A total of 108 premature infants with gestational age less than 32 weeks and body weight less than 1.5 kg, within 24 h of birth were admitted to the Department of NICU, Harbin Children′s Hospital from June 2016 to December 2018.The serum NT-proBNP levels were measured at 3 d, 6 d, 9 d after birth, and echocardiography was performed at the same time.According to the results of echocardiography and clinical symptoms, infants were divided into haemodynamically significant PDA(hsPDA)(n=29), asymptomatic PDA(asPDA)(n=24)and non-PDA as control group(n=55). Among them, the hsPDA group was further divided into drug treatment group(n=21) and surgical treatment group(n=8). The surgical treatment group was those who failed 2 courses of oral ibuprofen treatment or had contraindications to drug treatment.Arterial catheter ligation was used for surgical treatment group on 9 to 21 days after birth.NT-proBNP levels were detected at 24 hours and 3 days after surgery, and echocardiography was performed at the same time.The levels of serum NT-proBNP were compared between the three groups and before and after the treatment, and the ROC curve of NT-proBNP was drawn to analyze its diagnostic value. Results (1) At 3 and 6 days after birth, serum NT-proBNP levels were 8 346 pg/ml and 3 340 pg/ml in the hsPDA group, and 2 536 pg/ml and 1 079 pg/ml in the asPDA group, 1 132 pg/ml and 879 pg/ml in the control group, respectively.The levels of NT-proBNP in the hsPDA group were significantly higher than those in the asPDA group(P 0.05). (2)At 3, 6, and 9 d after birth, serum NT-proBNP levels were 9 000 pg/ml, 8 989 pg/ml, 9 000 pg/ml in the surgical treatment group, and 3 741 pg/ml, 2 544 pg/ml and 1 032 pg/ml in the drug treatment group, respectively.The levels of serum NT-proBNP in the surgical treatment group were significantly higher than those in the drug treatment group (P 0.05). (3)At 3 d after birth, the area under the ROC curve of serum NT-proBNP was 0.91 (95%CI 0.865-0.964), and the sensitivity and specificity of NT-proBNP to diagnose hsPDA at 2 343.5 pg/ml were 93.1% and 73.41.% respectively. Conclusion NT-proBNP level monitoring can be used as a sensitive indicator for early identification of hsPDA, and it has a clinical significance for intervention strategy and intervention time selection. Key words: Patent ductus arteriosus; N-terminal pro-brain natriuretic peptide; Ibuprofen; Preterm
{"title":"A clinical study on the correlation between N-terminal pro-brain natriuretic peptide and patent ductus arteriosus in premature infants","authors":"Li-li Dong, Ying-qiu Zhang, Xiaoyan Song, Chun-Ming Jiang, Yanyan Wang, Xiao-Fang Zhong","doi":"10.3760/CMA.J.ISSN.1673-4912.2019.12.010","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-4912.2019.12.010","url":null,"abstract":"Objective \u0000To provide basis for early selection of drug intervention or surgical treatment for premature patent ductus arteriosus(PDA) by a dynamic monitoring of serum N-terminal pro-brain natriuretic peptide(NT-proBNP)levels with ultrasonic examination, so as to improve the prognosis of premature infants. \u0000 \u0000 \u0000Methods \u0000A total of 108 premature infants with gestational age less than 32 weeks and body weight less than 1.5 kg, within 24 h of birth were admitted to the Department of NICU, Harbin Children′s Hospital from June 2016 to December 2018.The serum NT-proBNP levels were measured at 3 d, 6 d, 9 d after birth, and echocardiography was performed at the same time.According to the results of echocardiography and clinical symptoms, infants were divided into haemodynamically significant PDA(hsPDA)(n=29), asymptomatic PDA(asPDA)(n=24)and non-PDA as control group(n=55). Among them, the hsPDA group was further divided into drug treatment group(n=21) and surgical treatment group(n=8). The surgical treatment group was those who failed 2 courses of oral ibuprofen treatment or had contraindications to drug treatment.Arterial catheter ligation was used for surgical treatment group on 9 to 21 days after birth.NT-proBNP levels were detected at 24 hours and 3 days after surgery, and echocardiography was performed at the same time.The levels of serum NT-proBNP were compared between the three groups and before and after the treatment, and the ROC curve of NT-proBNP was drawn to analyze its diagnostic value. \u0000 \u0000 \u0000Results \u0000(1) At 3 and 6 days after birth, serum NT-proBNP levels were 8 346 pg/ml and 3 340 pg/ml in the hsPDA group, and 2 536 pg/ml and 1 079 pg/ml in the asPDA group, 1 132 pg/ml and 879 pg/ml in the control group, respectively.The levels of NT-proBNP in the hsPDA group were significantly higher than those in the asPDA group(P 0.05). (2)At 3, 6, and 9 d after birth, serum NT-proBNP levels were 9 000 pg/ml, 8 989 pg/ml, 9 000 pg/ml in the surgical treatment group, and 3 741 pg/ml, 2 544 pg/ml and 1 032 pg/ml in the drug treatment group, respectively.The levels of serum NT-proBNP in the surgical treatment group were significantly higher than those in the drug treatment group (P 0.05). (3)At 3 d after birth, the area under the ROC curve of serum NT-proBNP was 0.91 (95%CI 0.865-0.964), and the sensitivity and specificity of NT-proBNP to diagnose hsPDA at 2 343.5 pg/ml were 93.1% and 73.41.% respectively. \u0000 \u0000 \u0000Conclusion \u0000NT-proBNP level monitoring can be used as a sensitive indicator for early identification of hsPDA, and it has a clinical significance for intervention strategy and intervention time selection. \u0000 \u0000 \u0000Key words: \u0000Patent ductus arteriosus; N-terminal pro-brain natriuretic peptide; Ibuprofen; Preterm","PeriodicalId":68901,"journal":{"name":"中国小儿急救医学","volume":"26 1","pages":"927-931"},"PeriodicalIF":0.0,"publicationDate":"2019-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46752235","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}
Pub Date : 2019-12-20DOI: 10.3760/CMA.J.ISSN.1673-4912.2019.12.005
Hu Shaodong, Yu Liqin, Chen Liming, Wang Shumei, Zhou Zhenhui, Li Qiuping, Feng Zhi-chun
Objective To study the threshold values of lactic acid (Lac)and buffuer excess (BE) when neonatal umbilical arterial blood gas is at pH <7.20. Methods A total of 2 518 pregnant women admitted in Beijing New Century Women and Children′s Hospital from January 2017 to February 2019 were enrolled.The general conditions in perinatal period and labor methods were counted.Umbilical cord arterial blood was immediately collected before the first cry of newborn and was detected on the Abbott I-STAT automatic blood gas analyzer from the United States, and then the umbilical arterial blood gas was measured.We analyzed the perinatal factors affecting umbilical arterial blood gas.We studied the threshold values of Lac and BE for neonal asphyxia by receiver operating characteristic curve. Results (1)Maternal anemia, Streptococcus agalactiae infection, precipitate labour, placenta abnormalities had no significant impact on neonatal umbilical artery blood gas.The Lac value in blood gas was higher in the group of premature rupture of fetal membranes and fetal intrauterine distress.The value of BE was lower in the group with premature rupture of fetal membranes and fetal distress (P 3.97 mmol/L, the sensitivity and specificity of the diagnosis of asphyxia were 0.864 and 0.791, respectively.When BE was ≤-6 mmol/L, the diagnostic sensitivity and specificity of asphyxia were 0.613 and 0.756, respectively. Conclusion Neonatal umbilical arterial blood gas is affected by many factors.The effect of accouche on umbilical arterial blood gas is large.When there is asphyxia with pH 3.97 mmol/L and ≤-6 mmol/L, respectively. Key words: Umbilical artery; Blood gas analysis; Lactic acid; Buffuer excess; Newborn
{"title":"Threshold value of lactic acid and buffer excess in umbilical cord arterial blood gas during neonatal asphyxia","authors":"Hu Shaodong, Yu Liqin, Chen Liming, Wang Shumei, Zhou Zhenhui, Li Qiuping, Feng Zhi-chun","doi":"10.3760/CMA.J.ISSN.1673-4912.2019.12.005","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-4912.2019.12.005","url":null,"abstract":"Objective \u0000To study the threshold values of lactic acid (Lac)and buffuer excess (BE) when neonatal umbilical arterial blood gas is at pH <7.20. \u0000 \u0000 \u0000Methods \u0000A total of 2 518 pregnant women admitted in Beijing New Century Women and Children′s Hospital from January 2017 to February 2019 were enrolled.The general conditions in perinatal period and labor methods were counted.Umbilical cord arterial blood was immediately collected before the first cry of newborn and was detected on the Abbott I-STAT automatic blood gas analyzer from the United States, and then the umbilical arterial blood gas was measured.We analyzed the perinatal factors affecting umbilical arterial blood gas.We studied the threshold values of Lac and BE for neonal asphyxia by receiver operating characteristic curve. \u0000 \u0000 \u0000Results \u0000(1)Maternal anemia, Streptococcus agalactiae infection, precipitate labour, placenta abnormalities had no significant impact on neonatal umbilical artery blood gas.The Lac value in blood gas was higher in the group of premature rupture of fetal membranes and fetal intrauterine distress.The value of BE was lower in the group with premature rupture of fetal membranes and fetal distress (P 3.97 mmol/L, the sensitivity and specificity of the diagnosis of asphyxia were 0.864 and 0.791, respectively.When BE was ≤-6 mmol/L, the diagnostic sensitivity and specificity of asphyxia were 0.613 and 0.756, respectively. \u0000 \u0000 \u0000Conclusion \u0000Neonatal umbilical arterial blood gas is affected by many factors.The effect of accouche on umbilical arterial blood gas is large.When there is asphyxia with pH 3.97 mmol/L and ≤-6 mmol/L, respectively. \u0000 \u0000 \u0000Key words: \u0000Umbilical artery; Blood gas analysis; Lactic acid; Buffuer excess; Newborn","PeriodicalId":68901,"journal":{"name":"中国小儿急救医学","volume":"26 1","pages":"901-906"},"PeriodicalIF":0.0,"publicationDate":"2019-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45901684","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}
Pub Date : 2019-12-20DOI: 10.3760/CMA.J.ISSN.1673-4912.2019.12.008
Chen Zekun, Cheng Xiaokang, Hong Shaoxian, Chen Jing-fang, Zheng Weikun
Objective To explore the value of ultrasound in the differential diagnosis of neonatal upper and lower gastrointestinal tract(GIT)perforation. Methods We retrospectively reviewed the ultrasound findings of 42 neonates of surgery-confirmed neonatal GIT perforation in our hospital from January 1, 2015 to December 31, 2018.The accuracy of ultrasound for detecting GIT perforation and the ultrasound features of upper and lower GIT perforation were evaluated. Results (1)Of the 42 neonates with GIT perforation, 1 case didn′t undergo ultrasound, 2 cases were missed, and 1 case was misdiagnosed.Thirty-eight neonates were diagnosed of GIT perforation by ultrasound preoperatively, with a detection rate of 92.7%(38/41). The locations of GIT perforation were identified by ultrasound in 30 cases(78.9%, 30/38), including 11 cases of upper GIT perforation and 19 cases of lower GIT perforation.(2)A common sonographic finding of GIT perforation in 38 cases was pneumoperitoneum, which appeared as an echogenic line with posterior reverberation artifact under diaphragm or anterior to hepatic/splenic surface and a "stratosphere" sign in M-mode sonography.Free gas changed position when the patient′s position was changed, and didn′t change due to respiratory change.Besides, free gas dispersed with compression on abdomen, and gathered without compression.(3)Upper GIT perforation was showed that poor filling of the stomach cavity, and the abdominal free gas sharply increased.Lower GIT perforation was characterized by collapsed bowel, blurred and interrupted intestinal wall structure, and more accompanied with intestinal obstruction.(4)There was no significant difference of detection rate between ultrasound and X-ray in diagnosing GIT perforation[92.7%(38/41)vs.83.3%(35/42)](P>0.05), whereas ultrasound more sensitive for a very small amount of free gas in the early stage of perforation.(5)Helicobacter pylori infection was found in two cases of GIT perforation. Conclusion Ultrasound can be used for differential diagnosis of upper and lower GIT perforation, and could be recommended as the first choice for detecting GIT perforation in neonatal patients. Key words: Ultrasound; Upper gastrointestinal tract perforation; Lower gastrointestinal tract perforation; Intestinal obstruction
{"title":"The value of ultrasound in diagnosis of neonatal upper and lower gastrointestinal perforation","authors":"Chen Zekun, Cheng Xiaokang, Hong Shaoxian, Chen Jing-fang, Zheng Weikun","doi":"10.3760/CMA.J.ISSN.1673-4912.2019.12.008","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-4912.2019.12.008","url":null,"abstract":"Objective \u0000To explore the value of ultrasound in the differential diagnosis of neonatal upper and lower gastrointestinal tract(GIT)perforation. \u0000 \u0000 \u0000Methods \u0000We retrospectively reviewed the ultrasound findings of 42 neonates of surgery-confirmed neonatal GIT perforation in our hospital from January 1, 2015 to December 31, 2018.The accuracy of ultrasound for detecting GIT perforation and the ultrasound features of upper and lower GIT perforation were evaluated. \u0000 \u0000 \u0000Results \u0000(1)Of the 42 neonates with GIT perforation, 1 case didn′t undergo ultrasound, 2 cases were missed, and 1 case was misdiagnosed.Thirty-eight neonates were diagnosed of GIT perforation by ultrasound preoperatively, with a detection rate of 92.7%(38/41). The locations of GIT perforation were identified by ultrasound in 30 cases(78.9%, 30/38), including 11 cases of upper GIT perforation and 19 cases of lower GIT perforation.(2)A common sonographic finding of GIT perforation in 38 cases was pneumoperitoneum, which appeared as an echogenic line with posterior reverberation artifact under diaphragm or anterior to hepatic/splenic surface and a \"stratosphere\" sign in M-mode sonography.Free gas changed position when the patient′s position was changed, and didn′t change due to respiratory change.Besides, free gas dispersed with compression on abdomen, and gathered without compression.(3)Upper GIT perforation was showed that poor filling of the stomach cavity, and the abdominal free gas sharply increased.Lower GIT perforation was characterized by collapsed bowel, blurred and interrupted intestinal wall structure, and more accompanied with intestinal obstruction.(4)There was no significant difference of detection rate between ultrasound and X-ray in diagnosing GIT perforation[92.7%(38/41)vs.83.3%(35/42)](P>0.05), whereas ultrasound more sensitive for a very small amount of free gas in the early stage of perforation.(5)Helicobacter pylori infection was found in two cases of GIT perforation. \u0000 \u0000 \u0000Conclusion \u0000Ultrasound can be used for differential diagnosis of upper and lower GIT perforation, and could be recommended as the first choice for detecting GIT perforation in neonatal patients. \u0000 \u0000 \u0000Key words: \u0000Ultrasound; Upper gastrointestinal tract perforation; Lower gastrointestinal tract perforation; Intestinal obstruction","PeriodicalId":68901,"journal":{"name":"中国小儿急救医学","volume":"26 1","pages":"917-921"},"PeriodicalIF":0.0,"publicationDate":"2019-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41460310","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}
Pub Date : 2019-12-20DOI: 10.3760/CMA.J.ISSN.1673-4912.2019.12.012
Y. Fei, Xu Li, Liu Huixian
Neonatal asphyxia is a clinical disease in which newborns are unable to establish regular and effective respiration after birth due to various factors, resulting in hypoxia, acidosis and hypercapnia.Severe cases can cause damage to the nervous system of children, mental retardation, cerebral palsy, and even death.The quality assessment of systemic exercise(general movements, GMs)is a simple, non-invasive and easy to implement technique for early diagnosis of neurodevelopmental disorders in children.Although GMs quality assessment has been widely used in the assessment of nervous system injury after asphyxia resuscitation at home and abroad, there has not been a systematic introduction to its pathogenesis, specific manifestations and the correlation between them.Therefore, this paper systematically reviewed the above problems combined with the latest research at home and abroad, in order to provide help for clinical work. Key words: Asphyxia; General movements; Quality assessment; Nervous system injury; Neonate
{"title":"Application of whole body exercise quality assessment in prognosis evaluation of asphyxia children","authors":"Y. Fei, Xu Li, Liu Huixian","doi":"10.3760/CMA.J.ISSN.1673-4912.2019.12.012","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-4912.2019.12.012","url":null,"abstract":"Neonatal asphyxia is a clinical disease in which newborns are unable to establish regular and effective respiration after birth due to various factors, resulting in hypoxia, acidosis and hypercapnia.Severe cases can cause damage to the nervous system of children, mental retardation, cerebral palsy, and even death.The quality assessment of systemic exercise(general movements, GMs)is a simple, non-invasive and easy to implement technique for early diagnosis of neurodevelopmental disorders in children.Although GMs quality assessment has been widely used in the assessment of nervous system injury after asphyxia resuscitation at home and abroad, there has not been a systematic introduction to its pathogenesis, specific manifestations and the correlation between them.Therefore, this paper systematically reviewed the above problems combined with the latest research at home and abroad, in order to provide help for clinical work. \u0000 \u0000 \u0000Key words: \u0000Asphyxia; General movements; Quality assessment; Nervous system injury; Neonate","PeriodicalId":68901,"journal":{"name":"中国小儿急救医学","volume":"26 1","pages":"937-940"},"PeriodicalIF":0.0,"publicationDate":"2019-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45301832","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":"Fifteen cases of central nervous system injury induced by vietnamese sophora root poisoning in children and literature review","authors":"Xiaoli Li, Xiao-li Zhang, L. Gan, T. Jia, Qiliang Guo","doi":"10.3760/CMA.J.ISSN.1673-4912.2019.12.015","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-4912.2019.12.015","url":null,"abstract":"目的 \u0000探讨山豆根中毒致儿童中枢神经系统损害的临床特点、治疗及转归，进行相关文献复习，提高临床医生对该病的认识。 \u0000 \u0000 \u0000方法 \u0000收集2014年6月至2019年6月郑州大学第三附属医院儿科收治的15例山豆根中毒致儿童中枢神经系统损害患儿的临床资料，总结其临床特点、头颅MRI结果、治疗方案及预后。 \u0000 \u0000 \u0000结果 \u000015例山豆根中毒患儿，其中男9例，女6例，年龄3～12岁，8例以消化道症状(恶心、呕吐)起病，7例以神经系统症状(头晕、头痛)起病，所有患儿均出现不同程度的言语不清、失语、视物不清、四肢无力、走路不稳、抽搐及意识障碍等神经系统症状和体征。15例患儿均行头颅MRI检查，2例正常，13例均发现小脑齿状核病变，其中4例合并基底节区病变，1例合并额叶皮层下、脑干及双侧颞叶深部病变。予洗胃、补液利尿、促进代谢、营养神经等治疗后，14例患儿均临床治愈出院，1例遗留肌张力障碍。 \u0000 \u0000 \u0000结论 \u0000山豆根中毒多因超剂量服用，致神经系统损害多累及小脑齿状核及基底节区，行头颅MRI检查可尽早明确诊断，大部分患儿预后良好，一旦出现全身肌张力障碍，临床药物治疗效果不佳，预后不良。","PeriodicalId":68901,"journal":{"name":"中国小儿急救医学","volume":"26 1","pages":"952-954"},"PeriodicalIF":0.0,"publicationDate":"2019-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48542505","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}
Objective To study the predictive value of general movements(GMs) quality assessment technique(writhing movements)on the motor development outcome of high-risk infants, so as to provide a reference basis for clinical diagnosis and treatment. Methods A retrospective analysis was made on the high-risk infants who were hospitalized in the Neonatal Department of the Affiliated Hospital of Inner Mongolia Medical University from January 1, 2017 to December 31, 2018, and the GMs quality assessment was finished and followed up to 12-month-old among high-risk infants.The clinical diagnostic criteria for patients with cerebral palsy and Peabody Development Motor Scales-2(PDMS-2)were used to evaluate the motor development outcome of 12-month-old high-risk infants.Furthermore, the predictive value of GMs writhing movements on the motor development outcome of high-risk infants were evaluated. Results The predictive validity of writhing movements phase[cramped synchronized(CS)+ poor repertoire(PR)]for motor retardation and cerebral palsy in high-risk infants who met the inclusion criteria were as follows: the sensitivity, specificity, positive predictive value, negative predictive value were 94.44%, 23.03%, 11.04%, 97.62% and 100%, 21.88%, 2.60%, 100%, respectively.The predictive sensitivity and negative predictive value of writhing movements PR for motor retardation and cerebral palsy were 92.31%, 100%; 98.18%, 100% respectively.The predictive sensitivity, specificity and negative predictive value of writhing movements CS for motor retardation and cerebral palsy were 100%, 95.81%, 100% and 100%, 95.31% and 100%, respectively. Conclusion GMs quality assessment(writhing movements)has high reliability in predicting the motor development outcome of high-risk infants, especially cramped-synchronized has significant value in early screening of children with motor retardation and cerebral palsy. Key words: General movements quality assessment; Writhing movements; Motor development outcome; Predictive validity; High-risk infants
{"title":"Further discussion of general movements quality assessment(writhing movements) in early prediction validity of motor developmental outcome of high-risk infants","authors":"Wenxin Wei, Fei-fei Yan, Xiaomei Cao, Chun-zhi Liu, Chunli Liu, Lifeng Zhang, Xiaoli Wang","doi":"10.3760/CMA.J.ISSN.1673-4912.2019.12.007","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-4912.2019.12.007","url":null,"abstract":"Objective \u0000To study the predictive value of general movements(GMs) quality assessment technique(writhing movements)on the motor development outcome of high-risk infants, so as to provide a reference basis for clinical diagnosis and treatment. \u0000 \u0000 \u0000Methods \u0000A retrospective analysis was made on the high-risk infants who were hospitalized in the Neonatal Department of the Affiliated Hospital of Inner Mongolia Medical University from January 1, 2017 to December 31, 2018, and the GMs quality assessment was finished and followed up to 12-month-old among high-risk infants.The clinical diagnostic criteria for patients with cerebral palsy and Peabody Development Motor Scales-2(PDMS-2)were used to evaluate the motor development outcome of 12-month-old high-risk infants.Furthermore, the predictive value of GMs writhing movements on the motor development outcome of high-risk infants were evaluated. \u0000 \u0000 \u0000Results \u0000The predictive validity of writhing movements phase[cramped synchronized(CS)+ poor repertoire(PR)]for motor retardation and cerebral palsy in high-risk infants who met the inclusion criteria were as follows: the sensitivity, specificity, positive predictive value, negative predictive value were 94.44%, 23.03%, 11.04%, 97.62% and 100%, 21.88%, 2.60%, 100%, respectively.The predictive sensitivity and negative predictive value of writhing movements PR for motor retardation and cerebral palsy were 92.31%, 100%; 98.18%, 100% respectively.The predictive sensitivity, specificity and negative predictive value of writhing movements CS for motor retardation and cerebral palsy were 100%, 95.81%, 100% and 100%, 95.31% and 100%, respectively. \u0000 \u0000 \u0000Conclusion \u0000GMs quality assessment(writhing movements)has high reliability in predicting the motor development outcome of high-risk infants, especially cramped-synchronized has significant value in early screening of children with motor retardation and cerebral palsy. \u0000 \u0000 \u0000Key words: \u0000General movements quality assessment; Writhing movements; Motor development outcome; Predictive validity; High-risk infants","PeriodicalId":68901,"journal":{"name":"中国小儿急救医学","volume":"26 1","pages":"912-916"},"PeriodicalIF":0.0,"publicationDate":"2019-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43999795","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}
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