纳洛酮在小儿重症肺炎急救中的应用效果观察的临床研究

目的：探索纳洛酮在小儿重症肺炎急救中的效果。方法120例小儿重症肺炎患儿随机分为实验组和对照组，每组60例。所有患儿均给予基础治疗及对症治疗，实验组患儿另给予纳洛酮静脉滴注治疗。观察对比两组患儿的症状及体征消失时间、治愈情况。结果实验组患儿经治疗后，其发热、肝大、气促和心跳过速等症状及体征消失时间较对照组短，差异均具有统计学意义(P<0.05)。实验组有效率95.0%高于对照组81.7%，差异具有统计学意义(P<0.05)。结论纳洛酮治疗小儿重症肺炎可以有效缩短患儿的病程，对最终治愈患儿疾病有显著作用，值得临床应用。     

Neonatal herpes infections in The Netherlands in the period 2006–2011

Objective: To monitor the incidence of neonatal herpes in The Netherlands between 2006 and 2011, as well as the adherence to the rather conservative Dutch prevention policy.

Methods: Questionnaires were sent to all virology laboratories (n?=?44), gynaecology and paediatrics departments of all hospitals in The Netherlands (n?=?89). Questionnaires for the laboratories pertained to rates of proven cases of neonatal herpes; for the gynaecologists and paediatricians it pertained to rates of genital herpes during pregnancy and neonatal herpes, and their policy. For gynaecologists this concerned the risk of herpes simplex virus transmission in case of primary genital herpes during pregnancy or labour; for paediatricians it concerned the diagnostic policy in a neonate suspected of neonatal herpes.

Results: For the period 2006–2011 38 cases of neonatal herpes were reported, yielding an incidence of 4.7 per 100?000 births. The estimated annual number of pregnant women with primary or recurrent genital herpes was 278. Of the responding gynaecologists and paediatricians, only 59% and up to 39%, respectively, reported a policy in accordance with the national guideline.

Conclusions: The incidence of neonatal herpes in The Netherlands seems to have increased in the period 2006–2011. Combined with suboptimal guideline adherence this warrants strategies to improve awareness and subsequent adherence.     

血清前白蛋白动态变化评估重症社区获得性肺炎预后的价值

目的探讨血清前白蛋白评估重症社区获得性肺炎(SCAP)患者预后的临床价值。方法回顾性分析2010年8月至2014年8月西安医学院第一附属医院收治的87例SCAP患者的临床资料,按预后分为治愈组(64例)、死亡组(23例),检测两组患者入院第1天,第5天及观察终点(出院或死亡前最后一次,平均(19.2±5.7)天)血清前白蛋白含量,用统计软件SPSS19.0进行数据分析,定性资料采用χ~2检验,计量资料两两比较采用独立样本t检验,组内不同时间点数据比较采用重复测定方差分析。结果血清前白蛋白在治愈组和死亡组入院第1天比较差异无统计学意义(P0.05),第5天及观察终点比较差异具有统计学意义(P0.01)。并且治愈组血清前白蛋白在第1天,第5天和观察终点逐渐升高,而死亡组血清前白蛋白逐渐下降,同一组不同时间点数据两两比较差异具有统计学意义(P0.01)。结论血清前白蛋白持续低水平提示病情危重,预后不佳。动态观察血清前白蛋白水平对判断SCAP预后有一定的评估价值。     

慢性阻塞性肺炎患者内科治疗方法的临床疗效探究

目的：探究内科治疗方法治疗阻塞性肺炎患者的临床疗效。方法选取我院2014年1月～2015年1月收治的64例患者，随机分成两组，观察组患者用多索茶碱治疗，对照组患者用氨茶碱治疗，均治疗一周后，比较两组患者的有效率，得出结论。结果观察组患者的有效率为（30/32）93.8%，对照组的有效率为（21/32）65.6%，两组患者的差异具有统计学意义（P＜0.05）。结论多索茶碱治疗慢性阻塞性肺炎的临床疗效优于氨茶碱，有明显的临床效果，能够有效降低不良反应的发生，提高治愈率。     

Family nurture intervention alters relationships between preterm infant EEG delta brush characteristics and term age EEG power

ObjectiveFamily Nurture Intervention (FNI) facilitates mother/infant emotional connection, improves neurodevelopmental outcomes and increases electroencephalogram (EEG) power at term age. Here we explored whether delta brushes (DB), early EEG bursts that shape brain development, are altered by FNI and mediate later effects of FNI on EEG.MethodsWe assessed DB characteristics in EEG data from a randomized controlled trial comparing infants with standard care (SC, n = 31) versus SC + FNI (n = 33) at ~35 and ~40 weeks GA.ResultsCompared to SC infants, FNI infant DB amplitude increased more from ~35 to ~40 weeks, and FNI infants had longer duration DBs. DB parameters (rate, amplitude, brush frequency) at ~35 weeks were correlated with power at ~40 weeks, but only in SC infants. FNI effects on DB parameters do not mediate FNI effects on EEG power or coherence at term.ConclusionsDBs are related to subsequent brain activity and FNI alters DB parameters. However, FNI’s effects on electrocortical activity at term age are not dependent on its earlier effects on DBs.SignificanceWhile early DBs can have important effects on later brain activity in preterm infants, facilitating emotional connection with FNI may allow brain maturation to be less dependent on early bursts.     

Congenital Bronchial Stenosis Presenting as Neonatal Respiratory Distress: A Case Report

BackgroundNeonatal respiratory distress has a broad differential that includes cardiac, pulmonary, anatomic, and infectious etiologies. Congenital stenotic lesions of the trachea and bronchus are rare and can occur anywhere along the tracheobronchial tree. Patients with tracheobronchial stenosis typically present in the neonatal period with respiratory distress.Case ReportWe present a case of a 10-day-old term female who presented to the emergency department (ED) with tachypnea and increased work of breathing. She was found to have congenital bronchial stenosis of her right mainstem bronchus. She was stabilized in the ED and remained in the neonatal intensive care unit until successful slide tracheoplasty was performed.Why Should an Emergency Physician Be Aware of This?Congenital bronchial stenosis is a rare etiology of respiratory distress in a neonate. Anatomic lower airway abnormalities are an important cause of neonatal tachypnea and must remain on the differential. In addition to respiratory stabilization with noninvasive or invasive support, evaluation should be directed at determining the location and anatomic characteristics of the area of stenosis.     

Empirical antibiotic usage and bacterial superinfections in patients with COVID-19 in Japan: A nationwide survey by the Japanese Respiratory Society

An internet questionnaire survey for investigating empirical antibiotic usage and bacterial superinfections in patients with coronavirus disease-2019 (COVID-19) in Japan was conducted among the chief physicians of respiratory disease departments of 715 Japanese Respiratory Society-certified hospitals using Google Forms between January 28, 2021 and February 28, 2021. Responses to the questionnaire survey were obtained from 198 of 715 hospitals (27.6%). The survey revealed that the complication incidences of community-acquired pneumonia; hospital-acquired pneumonia, including ventilator-associated pneumonia; and sepsis were 2.86, 5.59, and 0.99%, respectively, among patients with moderate/severe and critical COVID-19. Bacterial co-infection and secondary infection rarely affected patients with COVID-19 in Japan, and the isolated pathogens were not specific to these patients. Moreover, the anti-inflammatory effects of macrolides for COVID-19 were not observed in several studies. These results might be useful in clinical practice for COVID-19.     

多院区综合医院应对新冠肺炎救治策略研究

大型多院区综合医院一般都具有较强的空间集中性、人口密集性和影响辐射性,在新发重大传染病暴发的情况下,大型多院区综合性医院必然成为新发重大传染病救治的前沿部门和关键环节,其救治策略直接对新发重大传染病的最后结果造成很大的影响。以泰州市某三甲多院区综合医院救治新冠肺炎为例,总结出多院区综合医院"集中患者、集中专家、集中资源和集中救治"的管理策略,供相关单位参考借鉴。     

新型冠状病毒肺炎流行期间大学生压力状况及影响因素

目的 了解新型冠状病毒肺炎流行期间大学生压力状况及影响因素，为减轻其压力负荷提供依据。方法 采用压力负荷量表（Stress Overload Scale, SOS）和社会支持量表 (Social Support Rate Score，SSRS)通过便利抽样的方法对466名浙江省某高校大学生进行调查，采用t检验、方差分析、相关分析和多元回归分析进行统计学处理。结果 调查对象的SOS得分（70.35±10.21）分，SSRS得分（33.14±6.18）分，两者呈负相关（r = - 0.672，P＜0.01）。多因素分析显示，社会支持、是否来自疫情严重地区、是否贫困生、是否大四年级共同影响大学生的压力负荷（F = 26.438，P＜0.001）。结论 新冠肺炎流行期间大学生的压力负荷较大，要针对重点人群及时开展有助于改善大学生身心健康的干预措施，舒缓压力负荷。