Channel: Special Subject http://journal23.magtechjournal.com/Jwk3_gjyyws EN-US http://journal23.magtechjournal.com/Jwk3_gjyyws/EN/1007-1245/current.shtml http://journal23.magtechjournal.com/Jwk3_gjyyws 1007-1245 http://journal23.magtechjournal.com/Jwk3_gjyyws/EN/10.3760/cma.j.issn.1007-1245.2021.06.012 Objective To explore the perinatal risk factors small for gestational age (SGA) infants whose birth weight <2 500 g versus whose birth weight ≥ 2 500 g by analyzing and evaluating the clinic documents about SGA infants whose birth weight <2 500 g and whose birth weight ≥ 2 500 g. Methods The data of the SGA infants treated at our department were collected. According to their birth weights, the infants were divided into an observation group (n=169), whose birth weight <2 500 g, and a control group (n=48), whose birth weight ≥ 2 500 g. The relevant perinatal information of the pregnant women and the infants were collected. The women's high risk factors during pregnancy were analyzed. The incidence of common diseases and the infection indicators were compared between the two groups. Results The incidence of diabetes, hypertension, multiple gestation, and GBS infection were 33.14% (56/169), 13.02% (22/169), 10.65% (18/169), and 6.51% (11/169) in the women of the observation group, with no statistical differences from those in the control group (all P>0.05). Six women had chronic fetal distress, 6 placental abnormality, 11 premature rupture of membranes, and 69 caesarean birth in the observation group, and 7, 6, 8, and 11 in the control group, with statistical differences (all P<0.05). The birth weight, Apgar score, body length, head circumference, and hospital stay were (2.25±0.16) kg, (9.34±0.64), (46.78±1.79) cm, (32.03±1.21) cm, and (5.03±2.50) d in the infants of the observation group, and were (2.61±0.12) kg, (9.05±0.88), (48.35±0.79) cm, (32.72±0.67) cm, and (3.76±1.35) d in those of the control groups, with statistical differences (all P<0.05). Conclusions Compared with the SGA infants whose birth weight ≥ 2 500 g, the SGA infants whose birth weight < 2 500 g have a higher disease incidence and a poor performance. Therefore, fortifying antenatal health education for pregnant women and lying-in women and ensuring a regular production inspection to discover high-risk pregnant factors are conducive to reducing the birth rate of SGA fetuses and improving neonate quality.]]> http://journal23.magtechjournal.com/Jwk3_gjyyws/EN/10.3760/cma.j.issn.1007-1245.2021.06.013 Objective To explore the change of immune function and the effect of adrenocorticotropic hormone (ACTH) on lymphocyte subsets and serum immunoglobulin levels in children with infantile spasm. Methods Forty cases of infantile spasm treated in department of pediatrics of our hospital from October 2014 to October 2019 were selected as case group, 40 healthy children as normal control group. ACTH was administered for 4 weeks for patients. Flow cytometry was used to measure the percentages of lymphocyte subsets (CD3⁺, CD4⁺, CD8⁺, CD19⁺, and CD20⁺). Immunoturbidimetric assay was used to measure serum levels of immunoglobulin A (IgA), immunoglobulin M (IgM), and immunoglobulin G (IgG) before and after 4 weeks of treatment, and the results were compared with those of the control group. Results The count of CD8⁺ T cells in patients before treatment was significantly lower than that in the control group [(34.36±3.48)% vs.(32.33±3.08)%] (P<0.01); the ratio of CD4⁺ /CD8⁺ T cell was significantly higher than that in the control group (P<0.05). There were no statistically significant differences in the count of CD3⁺ T cells, CD4⁺ T cells, CD19⁺ B cells, CD20⁺ B cells, and the levels of immunoglobulin between patients before treatment and the control group (all P>0.05). After treatment with ACTH, the count of CD8⁺ T cells in patients [(36.34±4.18)%] was obviously higher than that before treatment (P<0.01); the count of CD4⁺ T cells was obviously lower than that before treatment [(41.08±4.66)% vs.(45.54±5.04)%] (P<0.01); the ratio of CD4⁺ /CD8⁺ T cell was obviously lower than that before treatment [(1.11±0.27) vs.(1.45±0.37)] (P<0.01). There were no statistically significant differences in the count of CD3⁺ T cells, CD19⁺ B cells, CD20⁺ B cells, and the levels of immunoglobulin in patients before and after 4 weeks of treatment (all P>0.05). Conclusion Children with infantile spasm have immunological alterations, and ACTH can regulate the immune function in children and control the development of the disease.]]> http://journal23.magtechjournal.com/Jwk3_gjyyws/EN/10.3760/cma.j.issn.1007-1245.2021.06.014 Objective To analyze the changes of serum levels of vascular endothelial growth factor (VEGF) in neonates and premature infants with retinopathy with different gestational age. Methods Sixty cases of premature infants with gestational age under 32 weeks who were born in Weifang Maternal and Child Health Hospital from September 2018 to September 2019 were selected as group A, 60 cases of premature infants with gestational age of 32-36 weeks as group B, 60 cases of term infants as group C, 60 cases of term infants with retinopathy of prematurity (ROP) as group D. All were tested for serum VEGF and the results were compared. Results At the first, third, and fifth weeks after birth, the VEGF levels in group D were (523.42±4.45) ng/L, (456.72±3.28) ng/L及(346.23±2.68) ng/L, respectively, which were higher than those in group A [(487.23±3.56) ng/L, (423.48±2.36) ng/L, (301.34±2.13) ng/L], group B [(435.63±3.24) ng/L, (386.32±2.32) ng/L, (250.92±3.22) ng/L], and group C [(245.21±3.21) ng/L, (245.17±3.30) ng/L, (245.06±3.28) ng/L], and those in group A and group B were higher than those in group C, those in group A were higher than those in group B, with statistically significant differences (all P<0.05). There were no statistically significant differences in VEGF levels between neonates with and without oxygen inhalation in group A and C (all P>0.05). At the first, third, and fifth weeks after birth, the VEGF levels of neonates with oxygen inhalation in group B were (330.42±3.28) ng/L, (265.92±3.28) ng/L, (207.56±2.64) ng/L, respectively, which were lower than those of neonates without oxygen inhalation [(334.35±2.79) ng/L, (301.56±2.56) ng/L, (210.24±2.38) ng/L], with statistically significant differences (all P<0.05). The VEGF levels in children with ROP were significantly higher than those in preterm infants, with statistically significant differences (all P<0.05). Conclusion The level of VEGF in children with ROP is higher than that in premature infants, and the smaller the gestational age of premature infants is, the higher the VEGF level is. The increase of VEGF level in premature infants may increase the risk of ROP.]]> http://journal23.magtechjournal.com/Jwk3_gjyyws/EN/10.3760/cma.j.issn.1007-1245.2021.06.015 Objective To analyze the impact of traditional Chinese medical massage on PEF and C-ACT score in children with bronchial asthma. Methods Eighty-eight children with bronchial asthma who were admitted to our hospital from July 2018 to July 2020 were selected and were grouped with the method of single-blind random sampling (44 cases in each group). The patients in the control group received conventional western medicine treatment, and the patients in the experimental group received traditional Chinese medical massage therapy on the basis of the control group. The clinical efficacy, disappearance time of clinical symptoms, PEF, C-ACT score, and serum inflammatory factors of the two groups were compared. Results The total effective rate in the experimental group [95.45% (42/44)] was higher than that in the control group [70.45% (31/44)] (P<0.05), the disappearance time of wheezing rale, gurgling with sputum, cough, and gasp in the experimental group were shorter than those in the control group, the PEF and C-ACT score of the experimental group after treatment for 14 d were higher than those of the control group, the levels of serum IL-6, CRP, and TNF-a of the experimental group after treatment for 14 d were lower than those of the control group, with statistically significant differences (all P<0.001). Conclusion Traditional Chinese medical massage could effectively improve the pulmonary symptoms of children with bronchial asthma and inhibit the release of inflammatory mediators, which presented obvious curative effect and was worth learning.]]> http://journal23.magtechjournal.com/Jwk3_gjyyws/EN/10.3760/cma.j.issn.1007-1245.2021.06.016 http://journal23.magtechjournal.com/Jwk3_gjyyws/EN/10.3760/cma.j.issn.1007-1245.2021.06.017 Objective To investigate the safety of neonatal peripheral arteriovenous synchronous blood exchange. Methods A simulation device predicting the change in blood volume of children before peripheral arteriovenous synchronous exchange transfusion in neonates was designed. Before the simulation device started, two bags of normal saline were used for pre-flush of the tubes of blood transfusion sets of the two infusion pumps, and then connecting three bags of normal saline, turning on the two infusion pumps at the same time, running for 0.5 to 1 hour; three bags of normal saline were weighed with the electronic scale before and after turning on the infusion pumps, the difference in flow velocity between the artery and vein ends was calculated, and the change in blood volume of children was estimated. According to the calculation results, another peripheral venous infusion compensation path was opened during the exchange transfusion to compensate blood volume loss during the exchange transfusion. From January 2018 to December 2018, 13 children who underwent routine peripheral arteriovenous synchronous blood exchange were set as the control group; from January 2019 to December 2019, 11 children were set as the observation group, the blood volume change of children was estimated by the simulation device before peripheral arteriovenous synchronous blood exchange. Results The blood purging effect was ideal in both groups, but MAP, HR, RR, and SpO₂ in the control group showed significant fluctuations after 45 min of blood exchange (all P<0.05), indicating that there was a certain degree of blood volume change in the group. Compared with the control group, the above vital signs in the observation group were continuously stable, and none of the children in the observation group presented hemorrhagic shock and circulatory congestion, indicating that the hemodynamics of the children in the group were stable during blood exchange, and their blood volume did not change significantly. Conclusion The device can accurately predict the difference in blood flow velocity between the artery and vein ends and the change in the blood volume of children, ensure that the blood volume of the children is stable during blood exchange, and improve the safety of exchange transfusion in neonates.]]> http://journal23.magtechjournal.com/Jwk3_gjyyws/EN/10.3760/cma.j.issn.1007-1245.2021.06.018 Objective To probe into parental stress and its influencing factors in parents of children with acute lymphoblastic leukemia. Method A questionnaire survey was conducted among the parents of 180 children with acute lymphoblastic leukemia in 3 general hospitals of Henan province from February 2019 to August 2019 with general information questionnaire, Parenting Stress Scale, Perceived Social Support Scale, Simplified Coping Style Questionnaire, and Rosenberg Self-esteem Scale. Results The score of parenting stress was (103.12±16.48). Multivariate linear regression analysis results showed that treatment duration, immunophenotyping, monthly income, the number of children, participation in fundraising, and gender of children were the influencing factors of parenting stress, which could explain 63.4% of the total variation. The parenting stress in parents of children with acute lymphoblastic leukemia was negatively correlated with positive coping style, the total score and scores of all dimensions of social support, self-esteem of children, and was positively correlated with negative coping style (all P<0.05). Conclusion Parenting stress was higher in parents of children with acute lymphoblastic leukemia. Nursing staff should pay attention to the psychological intervention of the parents of children with acute lymphoblastic leukemia, guide them to adopt positive coping style, in order to reduce their parenting stress.]]>