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??Premature infants often suffer from chronic respiratory diseases and need supplementary oxygen at home after being discharged??and there exists increased rehospitalization?? more frequent cough and wheezing symptoms?? and abnormal lung function reflecting airway obstruction?? hyper-responsiveness and air-trapping. Also?? the neurological problems are more common in preterm survivors with bronchopulmonary dysplasia ??BPD?? compared to those without BPD. Severe BPD could be a predictor for poor neurodevelopmental outcome in certain type of patients.     

Cost-effectiveness of bariatric surgery: Should it be universally available?

This paper is the first to conduct cost-effectiveness analyses of bariatric surgery comparing obese patients with obesity-related diseases to obese people without comorbidities across different BMI categories, using the meta-analysis results of surgery outcomes for our effectiveness inputs. We find that surgery treatment is in general cost-effective for people whose BMI is greater than 35 kg/m(2) with or without obesity-related comorbidities, and it is even cost-saving for super obese (BMI ≥ 50 kg/m(2)) with obesity-related comorbidities. Our results also suggest that surgery can be cost-effective for the mildly obese (BMI ≥ 30 kg/m(2)). The bottom line is that bariatric surgery should be universally available to all classes of obese people.     

Communication with parents concerning withholding or withdrawing of life-sustaining interventions in neonatology

The nature and content of the conversations between the healthcare team and the parents concerning withholding or withdrawing of life-sustaining interventions for neonates vary greatly. These depend upon the status of the infant; for some neonates, death may be imminent, while other infants may be relatively stable, yet with a potential risk for surviving with severe disability. Healthcare providers also need to communicate with prospective parents before the birth of premature infants or neonates with uncertain outcomes. Many authors recommend that parents of fragile neonates receive detailed information about the potential outcomes of their children and the choices they have provided in an unbiased and empathetic manner. However, the exact manner this is to be achieved in clinical practice remains unclear.     

The value of pulmonary artery acceleration time in evaluating pulmonary vascular disease in preterm infants with bronchopulmonary dysplasia

Objectives

Early screening and dynamic monitoring of pulmonary vascular disease (PVD) in bronchopulmonary dysplasia (BPD) high-risk infants is of great clinical significance. Pulmonary artery acceleration time (PAAT) is a reliable and non-invasive method for assessing PVD in children over 1 year, but to date, few studies have used PAAT to assess pulmonary hemodynamics of preterm infants, especially those with BPD. Through dynamic monitoring the main hemodynamic indicators reflected PVD after birth, this study aimed to assess the value of PAAT in evaluating early PVD in BPD infants.

Methods

All 81 preterm infants at risk of BPD were divided into BPD and non-BPD groups according to whether BPD occurred. Clinical characteristics, PAAT, right ventricular ejection time (RVET) and other main hemodynamic indicators at four different time points after birth were studied and compared.

Results

PAAT and PAAT/RVET increased gradually within 72 h after birth in the BPD group (p < .05), but the curve tended to be flat over time after 72 h (p > .05). At PMA32 and 36 weeks, the PAAT (49.7 ± 4.8 vs. 54.8 ± 5.7, p = .001; 50.0 ± 5.3 vs. 57.0 ± 5.3, p = .001) and PAAT/RVET (.33 ± .04 vs. .35 ± .03, p = .001; .34 ± .03 vs. .37 ± .04, p = .001) in BPD group were significantly lower than those in the non-BPD group.

Conclusions

PAAT and PAAT/RVET in the BPD group infants showed different change patterns compared to non-BPD group infants. PAAT can be used as a noninvasive and reliable screening method for screening and dynamic monitoring of PVD in BPD high-risk infants.     

Correlation between secretin-enhanced MRCP findings and histopathologic severity of chronic pancreatitis in a cat model

Background/objectivesTo evaluate the usefulness of secretin-enhanced magnetic resonance cholangiopancreatography (S-MRCP) in chronic pancreatitis (CP), we compared the severity of disease determined histopathologically with that indicated by S-MRCP imaging parameters in an induced CP cat model.Materials and methodsAn experimental group of randomly chosen cats (n = 24) underwent ligation of the pancreatic duct to induce CP, and cats in a similarly chosen control group (n = 8) were sham-operated. MRCP was performed prior to secretin stimulation, and 5 and 15 min afterward, noting in particular the pancreatic duct caliber change (PDC) and the increasing degree of fluid volume (IDFV). Histopathological changes were observed in pancreatic samples processed for hematoxylin–eosin and Sirius red staining, and CP was classified as normal, minimal, moderate, or advanced. Correlations were investigated between these groups and the PDC at 5 min and the IDFV at 15 min.ResultsBetween cats with minimal CP and the controls, the differences in mean IDFV and PDC were not significant although diseased cats showed a downward trend in both parameters. However, compared with the control group both the mean IDFV and PDC were significantly lower in cats with moderate (IDFV, P = 0.001; PDC, P = 0.013) or advanced (IDFV, P = 0.013; PDC, P = 0.001) CP.ConclusionThe S-MRCP parameters IDFV and PDC correlated with the histopathological severity of induced CP. S-MRCP could be used to evaluate the severity of CP, although it is somewhat insensitive for depicting very early disease.     

边缘性人格障碍与焦虑症在诱发电位中的特征性分析

目的:比较边缘性人格障碍(borderlinepersonalitydisorder,BPD)和焦虑症(anxietyneurosis,AN)在诱发电位中的特点。方法:收集27例BPD患者、34例AN患者及52名正常成人对照(NC组),应用美国仪器以及光、声、触刺激,完成视觉诱发电位(VEP)、听觉诱发电位(AEP)和体感诱发电位(SEP)检查。结果:BPD组和AN组及NC组在潜伏期VEP/P1、P2、P3,AEP/P1、N2,波幅VEP/N1-P2、P2-N2、P2、P3,AEP/P2、P3,SEP/P2-N2P2、P3上有差异显著性(P<0.05～0.01)。与NC相比,BPD组潜伏期VEP/P1、P2,AEP/P1、N2前移,波幅VEP/N1-P2、P3,AEP/P3SEP/P2、P3增高,但波幅VEP/P2-N2、P2,AEP/P2降低。与NC相比AN组潜伏期VEP/P1、P3,AEP/N2前移;波幅VEP/P2-N2、P2AEP/P2、SEP/P2-N2、P3降低。BPD组与AN组相比,在潜伏期VEP/P2犤BPD组(161±12)ms,AN组(173±17)ms,P<0.01犦以及波幅VEP/N1-P2、AEP/P3犤BPD组(3.4±1.0)μV,AN组(2.1±1.1)μV,P<0.05犦、SEP/P2-N2、P2犤BPD组(9.9±2.8)μV,AN组(5.0±2.0)μV,P<0.05犦、P3上两者有显著性意义,BPD组前移于AN组,波幅增高。结论:在一些指标上,BPD患者前移于AN患者,波幅增高,但这是否为BPD和AN患者的特点需进一步跟随踪随访。