Responsive colorimetric materials exhibit significant potential for application in fields such as smart food packaging and wound monitoring.The functional integration of pH-indicators with material carriers enables br...Responsive colorimetric materials exhibit significant potential for application in fields such as smart food packaging and wound monitoring.The functional integration of pH-indicators with material carriers enables breakthrough applications in nontraditional domains.In this study,we developed a novel material covalently grafted with a pH indicator that exhibited naked-eye pH-responsive color shifts.The covalent grafting of pH-responsive bromothymol blue onto carboxymethyl cellulose(CMC)was confirmed using advanced characterization techniques,including Fourier transform infrared spectroscopy and X-ray photoelectron spectroscopy.The pH-sensitive chromophore was covalently immobilized onto the CMC matrix through esterification,thereby establishing firm chemical conjugation.Moreover,a superior color-changing performance was achieved within several minutes in response to different pH values.The reusability and stability of this material offer distinct advantages over single-use pH test strips.pH-responsive colorimetric materials hold promise for efficient,noninvasive monitoring in intelligent packaging(food freshness),medical diagnostics(wound status,infections),biosensing,and environmental applications.展开更多
Pediatric sepsis is the most common disease in pediatric critical illness,because the main reason for the disease is that children's immune level is not high or the immune system is not perfect,when children's...Pediatric sepsis is the most common disease in pediatric critical illness,because the main reason for the disease is that children's immune level is not high or the immune system is not perfect,when children's lung,abdominal cavity and blood system are infected,it will cause systemic inflammation and immune dysfunction.Early clinical symptoms are mainly irregular and intermittent fever.When the disease develops to severe sepsis,the children will suffer from acute heart failure,oliguria,respiratory alkalosis and even multiple organ failure.The incidence of death is high.It is reported that the incidence rate of sepsis in children can reach 0.3%,and the mortality rate is 50%.High incidence rate,high mortality rate and high treatment cost are the biggest problems in the pediatric field.In the past,the clinical hope of clearing away heat and toxin,promoting blood circulation and removing stasis,strengthening inflammation and other methods in traditional Chinese medicine,but the treatment effect is not ideal.With the improvement of modem medical understanding of sepsis,continuous blood purification therapy is introduced into the treatment of children with severe sepsis.In order to further explore the effect of continuous blood purification in the treatment of children with severe sepsis,the author summarizes the clinical practice experience and relevant literature,hoping to provide reference for relevant medical staff。展开更多
BACKGROUND Disseminated Fusarium is rare in healthy children.Children with hematological tumors may have secondary fungal infections,including Fusarium infections,which are due to tumor bone marrow infiltration or pro...BACKGROUND Disseminated Fusarium is rare in healthy children.Children with hematological tumors may have secondary fungal infections,including Fusarium infections,which are due to tumor bone marrow infiltration or prolonged bone marrow suppression after chemotherapy.Because of the lack of typical clinical manifestations and effective antifungal drugs,early diagnosis and treatment of the disease are difficult,and the prognosis is poor.CASE SUMMARY The patient in this case was a 13-year-old female child with rash and fever as the first symptoms.She had the characteristics of the four stages of skin that are typical of Fusarium infection.She was diagnosed with disseminated Fusarium infection through skin biopsy and blood culture and diagnosed with Fusarium solani infection based on the morphological characteristics of the blood culture.After treatment with liposome amphotericin B combined with voriconazole,the child recovered.CONCLUSION This case highlights that for children with secondary agranulocytosis after receiving chemotherapy for hematological malignancies,once typical abnormal skin damage is found,the possibility of Fusarium infection should be considered,and voriconazole alone or in combination with polyenes may be the most effective anti-Fusarium drugs.Amphotericin B,the traditional drug of disseminated Fusarium disease,has a high mortality rate,and it is not recommended to use it alone.Adequate neutrophil counts are essential for the treatment of disseminated Fusarium bloodstream infection.展开更多
Purpose:This study aimed to analyze the clinical characteristic of different foreign body injuries in children and offer the preventions.Methods:A retrospective study and the demographic information, injury causes, fo...Purpose:This study aimed to analyze the clinical characteristic of different foreign body injuries in children and offer the preventions.Methods:A retrospective study and the demographic information, injury causes, foreign body injury types and other clinical factors were recorded and analyzed.Results:Of the 2999 patients, 1877 (62.6%) were boys and 1122 (37.4%) were girls. The majority (72.8%, n= 2184) of the injuries were found in 1-3 years old children. The most common anatomical site was the respiratory tract (73.4%, n = 2201) followed by the digestive tract (18.6%, n = 558), the genitourinary tract (1.93%, n = 58) and other sites (6.07%, n = 182). There were 60.4% of the in-patients from rural areas and 53.2% of the patients without medical insurance, the rate of cost by medical insurance increased with age. The medians of length of hospital stay and hospitalization cost were four days and 4767.3 CNY respectively. Most of the patients had surgical treatment (90.6%, n = 2717) and 64.9% of them had the complications (n = 1946). The cure rates of the all foreign body injuries types were above 90%, especially in genitourinary tract (98.3%).Conclusion:Different types of the foreign body injuries had dissimilar clinical characteristics. The effective prevention and control measures should be taken according to the variety of high-risk population, incidence season and foreign body injury types.展开更多
Importance:Ventilator-associated pneumonia (VAP) is one of the most common complications after cardiac surgery in children with congenital heart disease (CHD).Early prediction of the incidence of VAP is important for ...Importance:Ventilator-associated pneumonia (VAP) is one of the most common complications after cardiac surgery in children with congenital heart disease (CHD).Early prediction of the incidence of VAP is important for clinical prevention and treatment.Objective:To determine the value of serum C-reactive protein (CRP) levels and the Pediatric Risk of Mortality Ⅲ (PRISM Ⅲ) score in predicting the risk of postoperative VAP in pediatric patients with CHD.Methods:We performed a retrospective review of clinical data of 481 pediatric patients with CHD who were admitted to our pediatric intensive care unit.These patients received mechanical ventilation for 48 hours or longer after corrective Surgery.On the basis of their clinical manifestations and laboratory results,patients were separated into two groups of those with VAP and those without VAP.CRP levels were measured and PRISM Ⅲ scores were collected within 12 hours of admission to the pediatric intensive care unit.The Pearson correlation coefficient was used to evaluate the association of CRP levels and the PRISM score with the occurrence of postoperative VAP.A linear regression model was constructed to obtain a joint function and receiver operating curves were used to assess the predictive value.Results:CRP levels and the PRISM Ⅲ score in the VAP group were significantly higher than those in the non-VAP group (P < 0.05).Receiver operating curves suggested that using CRP + the PRISM Ⅲ score to predict the incidence of VAP after congenial heart surgery was more accurate than using either of them alone (CRP + the PRISM Ⅲ score:sensitivity:53.2%,specificity:85.7%).When CRP + the PRISM Ⅲ score was greater than 45.460,patients were more likely to have VAP.Interpretation:Although using CRP levels plus the PRISM Ⅲ score to predict the incidence of VAP after congenial heart surgery is more accurate than using either of them alone,its predictive value is still limited.展开更多
INTRODUCTION Congenital vascular rings （VRs） are a group of rare cardiovascular anomalies that result from abnormal embryonic development of the paired aortic arches or branching pulmonary arteries. Clinical present...INTRODUCTION Congenital vascular rings （VRs） are a group of rare cardiovascular anomalies that result from abnormal embryonic development of the paired aortic arches or branching pulmonary arteries. Clinical presentation of VR depends on its anatomy, degree, and site of compression.展开更多
Background:Hemolytic uremic syndrome (HUS) is a main cause of acute renal failure in children.This study aimed to analyze the clinical characteristics of HUS.Methods:A retrospective analysis was performed in 46 childr...Background:Hemolytic uremic syndrome (HUS) is a main cause of acute renal failure in children.This study aimed to analyze the clinical characteristics of HUS.Methods:A retrospective analysis was performed in 46 children with sporadic HUS.Results:Of the 46 HUS patients,20 (43.5%) were diarrhea-related HUS,and 26 (56.5%) were atypical HUS.Anemia,edema,oliguria,hemoglobinuria and hypertension were the most common manifestations.Thrombocytopenia,hyponatremia,hypocalcemia,hyperkalemia,metabolic acidosis,increased fibrinogen and hypocomplementemia were found in most patients.The age of onset (younger than 2 years or not,P=0.009),the duration of oliguria or anuria (more than one week or not,P=0.005),accompanied with extrarenal complications or not (P=0.005),dialysis and plasma exchange (P=0.04) were associated with the mortality rate.Conclusion:The age of onset younger than 2 years,oliguria/anuria more than 1 week,and associated with extrarenal complications were predictive factors of poor prognosis.展开更多
Background:This study aimed to discribe the experience in supporting children with refractory cardiopulmonary failure with extracorporeal membrane oxygenation(ECMO).Methods:We retrospectively reviewed 12 children with...Background:This study aimed to discribe the experience in supporting children with refractory cardiopulmonary failure with extracorporeal membrane oxygenation(ECMO).Methods:We retrospectively reviewed 12 children with refractory cardiopulmonary failure supported with ECMO from February 2009 to August 2015 in the Pediatric Intensive Care Unit(PICU),Children's Hospital,Zhejiang University School of Medicine.Results:Seven of the 12 patients were weaned successfully from ECMO and dischaged from the hospital,with a survival rate of 58.3%(7/12).Among them,fi ve patients had acute fulminant myocarditis(AFM).Complications during ECMO included hemorrhage,hemolysis,thrombosis,acute kidney injury,and secondary hematogenous infection.During 1-24 month follow-up,the seven surviving patients recovered with normal cardiopulmonary function.Conclusion:ECMO is useful for supporting children with refractory cardiopulmonary failure,especially for treatment of AFM.展开更多
基金financially supported by the National Natural Science Foundation of China(No.52303209)the“Lingyan”Program of Zhejiang Province(No.2024C03076)+1 种基金Zhejiang University K.P.Chao’s High Technology Development Foundationthe generous support provided by the joint research fund from the Shaoxing Institute of Zhejiang University and Shaoxing Maternity and Child Health Care Hospital。
文摘Responsive colorimetric materials exhibit significant potential for application in fields such as smart food packaging and wound monitoring.The functional integration of pH-indicators with material carriers enables breakthrough applications in nontraditional domains.In this study,we developed a novel material covalently grafted with a pH indicator that exhibited naked-eye pH-responsive color shifts.The covalent grafting of pH-responsive bromothymol blue onto carboxymethyl cellulose(CMC)was confirmed using advanced characterization techniques,including Fourier transform infrared spectroscopy and X-ray photoelectron spectroscopy.The pH-sensitive chromophore was covalently immobilized onto the CMC matrix through esterification,thereby establishing firm chemical conjugation.Moreover,a superior color-changing performance was achieved within several minutes in response to different pH values.The reusability and stability of this material offer distinct advantages over single-use pH test strips.pH-responsive colorimetric materials hold promise for efficient,noninvasive monitoring in intelligent packaging(food freshness),medical diagnostics(wound status,infections),biosensing,and environmental applications.
文摘Pediatric sepsis is the most common disease in pediatric critical illness,because the main reason for the disease is that children's immune level is not high or the immune system is not perfect,when children's lung,abdominal cavity and blood system are infected,it will cause systemic inflammation and immune dysfunction.Early clinical symptoms are mainly irregular and intermittent fever.When the disease develops to severe sepsis,the children will suffer from acute heart failure,oliguria,respiratory alkalosis and even multiple organ failure.The incidence of death is high.It is reported that the incidence rate of sepsis in children can reach 0.3%,and the mortality rate is 50%.High incidence rate,high mortality rate and high treatment cost are the biggest problems in the pediatric field.In the past,the clinical hope of clearing away heat and toxin,promoting blood circulation and removing stasis,strengthening inflammation and other methods in traditional Chinese medicine,but the treatment effect is not ideal.With the improvement of modem medical understanding of sepsis,continuous blood purification therapy is introduced into the treatment of children with severe sepsis.In order to further explore the effect of continuous blood purification in the treatment of children with severe sepsis,the author summarizes the clinical practice experience and relevant literature,hoping to provide reference for relevant medical staff。
文摘BACKGROUND Disseminated Fusarium is rare in healthy children.Children with hematological tumors may have secondary fungal infections,including Fusarium infections,which are due to tumor bone marrow infiltration or prolonged bone marrow suppression after chemotherapy.Because of the lack of typical clinical manifestations and effective antifungal drugs,early diagnosis and treatment of the disease are difficult,and the prognosis is poor.CASE SUMMARY The patient in this case was a 13-year-old female child with rash and fever as the first symptoms.She had the characteristics of the four stages of skin that are typical of Fusarium infection.She was diagnosed with disseminated Fusarium infection through skin biopsy and blood culture and diagnosed with Fusarium solani infection based on the morphological characteristics of the blood culture.After treatment with liposome amphotericin B combined with voriconazole,the child recovered.CONCLUSION This case highlights that for children with secondary agranulocytosis after receiving chemotherapy for hematological malignancies,once typical abnormal skin damage is found,the possibility of Fusarium infection should be considered,and voriconazole alone or in combination with polyenes may be the most effective anti-Fusarium drugs.Amphotericin B,the traditional drug of disseminated Fusarium disease,has a high mortality rate,and it is not recommended to use it alone.Adequate neutrophil counts are essential for the treatment of disseminated Fusarium bloodstream infection.
文摘Purpose:This study aimed to analyze the clinical characteristic of different foreign body injuries in children and offer the preventions.Methods:A retrospective study and the demographic information, injury causes, foreign body injury types and other clinical factors were recorded and analyzed.Results:Of the 2999 patients, 1877 (62.6%) were boys and 1122 (37.4%) were girls. The majority (72.8%, n= 2184) of the injuries were found in 1-3 years old children. The most common anatomical site was the respiratory tract (73.4%, n = 2201) followed by the digestive tract (18.6%, n = 558), the genitourinary tract (1.93%, n = 58) and other sites (6.07%, n = 182). There were 60.4% of the in-patients from rural areas and 53.2% of the patients without medical insurance, the rate of cost by medical insurance increased with age. The medians of length of hospital stay and hospitalization cost were four days and 4767.3 CNY respectively. Most of the patients had surgical treatment (90.6%, n = 2717) and 64.9% of them had the complications (n = 1946). The cure rates of the all foreign body injuries types were above 90%, especially in genitourinary tract (98.3%).Conclusion:Different types of the foreign body injuries had dissimilar clinical characteristics. The effective prevention and control measures should be taken according to the variety of high-risk population, incidence season and foreign body injury types.
文摘Importance:Ventilator-associated pneumonia (VAP) is one of the most common complications after cardiac surgery in children with congenital heart disease (CHD).Early prediction of the incidence of VAP is important for clinical prevention and treatment.Objective:To determine the value of serum C-reactive protein (CRP) levels and the Pediatric Risk of Mortality Ⅲ (PRISM Ⅲ) score in predicting the risk of postoperative VAP in pediatric patients with CHD.Methods:We performed a retrospective review of clinical data of 481 pediatric patients with CHD who were admitted to our pediatric intensive care unit.These patients received mechanical ventilation for 48 hours or longer after corrective Surgery.On the basis of their clinical manifestations and laboratory results,patients were separated into two groups of those with VAP and those without VAP.CRP levels were measured and PRISM Ⅲ scores were collected within 12 hours of admission to the pediatric intensive care unit.The Pearson correlation coefficient was used to evaluate the association of CRP levels and the PRISM score with the occurrence of postoperative VAP.A linear regression model was constructed to obtain a joint function and receiver operating curves were used to assess the predictive value.Results:CRP levels and the PRISM Ⅲ score in the VAP group were significantly higher than those in the non-VAP group (P < 0.05).Receiver operating curves suggested that using CRP + the PRISM Ⅲ score to predict the incidence of VAP after congenial heart surgery was more accurate than using either of them alone (CRP + the PRISM Ⅲ score:sensitivity:53.2%,specificity:85.7%).When CRP + the PRISM Ⅲ score was greater than 45.460,patients were more likely to have VAP.Interpretation:Although using CRP levels plus the PRISM Ⅲ score to predict the incidence of VAP after congenial heart surgery is more accurate than using either of them alone,its predictive value is still limited.
文摘INTRODUCTION Congenital vascular rings （VRs） are a group of rare cardiovascular anomalies that result from abnormal embryonic development of the paired aortic arches or branching pulmonary arteries. Clinical presentation of VR depends on its anatomy, degree, and site of compression.
基金This study was supported by National Natural Science Foundation of China(81270045 and 30771009)Zhejiang Provincial Natural Science Foundation of China(LY16H160024 and Y206058).
文摘Background:Hemolytic uremic syndrome (HUS) is a main cause of acute renal failure in children.This study aimed to analyze the clinical characteristics of HUS.Methods:A retrospective analysis was performed in 46 children with sporadic HUS.Results:Of the 46 HUS patients,20 (43.5%) were diarrhea-related HUS,and 26 (56.5%) were atypical HUS.Anemia,edema,oliguria,hemoglobinuria and hypertension were the most common manifestations.Thrombocytopenia,hyponatremia,hypocalcemia,hyperkalemia,metabolic acidosis,increased fibrinogen and hypocomplementemia were found in most patients.The age of onset (younger than 2 years or not,P=0.009),the duration of oliguria or anuria (more than one week or not,P=0.005),accompanied with extrarenal complications or not (P=0.005),dialysis and plasma exchange (P=0.04) were associated with the mortality rate.Conclusion:The age of onset younger than 2 years,oliguria/anuria more than 1 week,and associated with extrarenal complications were predictive factors of poor prognosis.
基金This project was supported by Major Project of Science and Technology Department of Zhejiang province,China(no.N20130282)Research Project of Health and Family Planning Commission of Zhejiang province,China(no.2014KYA259)National Natural Science Foundation of China(no.81270045).
文摘Background:This study aimed to discribe the experience in supporting children with refractory cardiopulmonary failure with extracorporeal membrane oxygenation(ECMO).Methods:We retrospectively reviewed 12 children with refractory cardiopulmonary failure supported with ECMO from February 2009 to August 2015 in the Pediatric Intensive Care Unit(PICU),Children's Hospital,Zhejiang University School of Medicine.Results:Seven of the 12 patients were weaned successfully from ECMO and dischaged from the hospital,with a survival rate of 58.3%(7/12).Among them,fi ve patients had acute fulminant myocarditis(AFM).Complications during ECMO included hemorrhage,hemolysis,thrombosis,acute kidney injury,and secondary hematogenous infection.During 1-24 month follow-up,the seven surviving patients recovered with normal cardiopulmonary function.Conclusion:ECMO is useful for supporting children with refractory cardiopulmonary failure,especially for treatment of AFM.
