CJCP
  中文版
  English Version
 
 
2023 Vol.  25 No.  9
Published: 2023-09-15
COLUMN ON DIAGNOSIS & TREATMENT IN MDT MODE
STANDARD·PROTOCOL·GUIDELINE
CLINICAL RESEARCH
REVIEW
STANDARD·PROTOCOL·GUIDELINE
889 Youth Committee of the Chinese Association Against Epilepsy (CAAE);CAAE Precision Medicines and Adverse Effect Monitoring Committee
Guidelines for the management of adverse effects of anti-seizure medications (2023)
Epilepsy is a prevalent neurological disorder with a complex etiology and an unclear pathogenesis. In order to standardize the management of adverse effects caused by anti-seizure medications (ASMs), the Youth Committee of the Chinese Association Against Epilepsy (CAAE), in collaboration with the CAAE Precision Medicines and Adverse Effect Monitoring Committee, has developed a guideline: guidelines for the management of adverse effects of anti-seizure medications (2023). This guideline addresses 13 clinical questions related to the management of adverse effects of ASMs in the nervous system, cardiovascular system, and fetus. Its primary objective is to provide guidance to medical professionals specializing in pediatric neurology, neurology, and neurosurgery in China, and to facilitate their clinical practice.
2023 Vol. 25 (9): 889-900 [Abstract] ( 3460 ) [HTML 1KB] [PDF 724KB] ( 3337 )
CLINICAL RESEARCH
901 LIN Rong, YANG Qing, WANG Ya-Sen, SHEN Wei, LIN Xin-Zhu, SONG Si-Yu, KONG Juan, WU Fan, YANG Dong, BAI Rui-Miao, LI Zhan-Kui, SONG Shi-Rong, YU Wen-Ting, MAO Jian, ZHANG Yi-Jia, ZHANG Juan, TONG Xiao-Mei
Comparison of the impact of different fat emulsions on clinical outcomes in preterm infants with varying duration of parenteral nutrition: a randomized controlled multicenter study Hot!
Objective To compare the impact of two types of fat emulsion on clinical outcomes in preterm infants with varying duration of parenteral nutrition (PN). Methods Preterm infants meeting the inclusion criteria were randomly assigned to two groups: medium/long-chain triglyceride fat emulsion (referred to as MCT/LCT) group or multi-oil fat emulsion (containing soybean oil, medium-chain triglycerides, olive oil, and fish oil; referred to as SMOF) group. The infants were stratified into groups based on the duration of PN (15-21 days, 22-28 days, and ≥29 days). Clinical characteristics, nutritional status, biochemical indicators, and clinical outcomes were compared between the two groups. Results Compared with the MCT/LCT group, the SMOF group had lower peak levels of triglyceride during the hospital stay in preterm infants with PN of 15-21 days, 22-28 days, and ≥29 days, respectively (P<0.05). Logistic regression trend analysis showed that with a longer duration of PN, the risk of parenteral nutrition-associated cholestasis (PNAC) and bronchopulmonary dysplasia (BPD) significantly increased in the MCT/LCT group (P<0.05), while the risk of brain injury did not significantly change (P>0.05). In the SMOF group, the risks of PNAC and BPD did not significantly change with a longer duration of PN (P>0.05), but the risk of brain injury significantly decreased (P=0.006). Conclusions Compared to MCT/LCT, SMOF have better lipid tolerance. With a longer duration of PN, SMOF does not increase the risks of PNAC and BPD and had a protective effect against brain injury. This suggests that in preterm infants requiring long-term PN, the use of SMOF is superior to MCT/LCT.
2023 Vol. 25 (9): 901-908 [Abstract] ( 2307 ) [HTML 1KB] [PDF 651KB] ( 1298 )
909 Jiangsu Multicenter Study Collaborative Group for Breastmilk Feeding in Neonatal Intensive Care Units
Risk factors for low Apgar score at 1 minute after birth in very low/extremely low birth weight infants: a retrospective multicenter study
Objective To investigate the risk factors for low Apgar score (≤7) at 1 minute after birth in very low/extremely low birth weight infants. Methods Clinical data of very low/extremely low birth weight infants were retrospectively collected from January 2018 to December 2019 in the multicenter clinical database of the Jiangsu Multicenter Study Collaborative Group for Breastmilk Feeding in Neonatal Intensive Care Units. The infants were divided into two groups: low Apgar score group (Apgar score ≤7) and normal Apgar score group (Apgar score >7) based on the Apgar score at 1 minute after birth. Multivariable logistic regression analysis was used to identify factors associated with low Apgar score at 1 minute after birth. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the predictive value of relevant indicators for low Apgar score at 1 minute after birth. Results A total of 1 809 very low/extremely low birth weight infants were included. The incidence of low Apgar score at 1 minute was 52.90% (957/1 809). Multivariable logistic regression analysis showed that older gestational age (OR=0.853, P<0.05) and higher birth weight (OR=0.999, P<0.05) were associated with a lower risk of low Apgar score at 1 minute, while the presence of abnormal amniotic fluid (OR=1.646, P<0.05) and antenatal use of glucocorticoids (OR=0.502, P<0.05) were associated with a higher and lower risk, respectively. ROC curve analysis showed that the combination of gestational age, birth weight, abnormal amniotic fluid, and antenatal use of glucocorticoids had a sensitivity of 0.554 and specificity of 0.680 in predicting low Apgar score at 1 minute. Conclusions Younger gestational age, lower birth weight, and abnormal amniotic fluid increase the risk of low Apgar score at 1 minute after birth in very low/extremely low birth weight infants, while antenatal use of glucocorticoids can reduce this risk.
2023 Vol. 25 (9): 909-914 [Abstract] ( 2271 ) [HTML 1KB] [PDF 602KB] ( 1481 )
915 WEI Xin-Yu, ZHANG Jing, HAO Qing-Fei, DU Yan-Na, CHENG Xiu-Yong
Establishment of a nomogram model for predicting the risk of early-onset sepsis in very preterm infants
Objective To identify risk factors associated with early-onset sepsis (EOS) in very preterm infants and develop a nomogram model for predicting the risk of EOS. Methods A retrospective analysis was conducted on 344 very preterm infants delivered at the First Affiliated Hospital of Zhengzhou University and admitted to the Department of Neonatology between January 2020 and December 2022. These infants were randomly divided into a training set (241 infants) and a validating set (103 infants) in a 7:3 ratio. The training set was further divided into two groups based on the presence or absence of EOS: EOS (n=64) and non-EOS (n=177). Multivariate logistic regression analysis was performed to identify risk factors for EOS in the very preterm infants. The nomogram model was developed using R language and validated using the validating set. The discriminative ability, calibration, and clinical utility of the model were assessed using receiver operating characteristic (ROC) curve analysis, calibration curve analysis, and decision curve analysis, respectively. Results The multivariate logistic regression analysis revealed that gestational age, need for tracheal intubation in the delivery room, meconium-stained amniotic fluid, serum albumin level on the first day of life, and chorioamnionitis were risk factors for EOS in very preterm infants (P<0.05). The area under the ROC curve for the training set was 0.925 (95%CI: 0.888-0.963), and that for the validating set was 0.796 (95%CI: 0.694-0.898), confirming the model's good discrimination. The Hosmer-Lemeshow goodness-of-fit test suggested that the model was well-fitting (P=0.621). The calibration curve analysis and decision curve analysis demonstrated that the model had high predictive efficacy and clinical applicability. Conclusions Gestational age, need for tracheal intubation in the delivery room, meconium-stained amniotic fluid, serum albumin level on the first day of life, and chorioamnionitis are significantly associated with the development of EOS in very preterm infants.The nomogram model for predicting the risk of EOS in very preterm infants, constructed based on these factors, has high predictive efficacy and clinical applicability.
2023 Vol. 25 (9): 915-922 [Abstract] ( 2045 ) [HTML 1KB] [PDF 855KB] ( 1610 )
923 ZHANG Yi, DING Chang-Hong, LI Hua, WANG Xiao-Hui, CHEN Chun-Hong, FANG Fang
Electroencephalogram characteristics of 26 children with febrile infection-related epilepsy syndrome
Objective To investigate the electroencephalogram (EEG) characteristics and progression of febrile infection-related epilepsy syndrome (FIRES) in children, aiming to enhance diagnosis and treatment approaches. Methods A retrospective analysis was conducted on 26 children with FIRES between May 2017 and December 2021. Results All 26 children (100%) presented with fever at the onset, followed by frequent convulsions that rapidly progressed into convulsive status. Ventilator support was required for 22 cases (85%). During the acute phase, EEG features demonstrated the disappearance of background activity and physiological sleep cycles in all children. Diffuse slow waves and multifocal slow spike slow waves were observed as abnormal waves during the interictal period. A characteristic pattern of focal low amplitude fast wave initiation was detected in all children during seizure episodes. In the chronic phase, the background EEG activity gradually recovered, and the presence of abnormal waves was relatively limited. The characteristic pattern of focal slow wave rhythm initiation was evident during seizure episodes. Additionally, extreme δ brushes were observed in four cases (15%). Conclusions These findings suggest that EEG manifestations in children with FIRES exhibit distinctive patterns during the acute and chronic stages, providing significant value for early diagnosis and clinical staging. Extreme δ brushes may be one of the distinctive markers of children with FIRES.
2023 Vol. 25 (9): 923-928 [Abstract] ( 2537 ) [HTML 1KB] [PDF 1125KB] ( 1305 )
929 JIN Mei, LIU Jing, LIU Kang, ZHAO Li-Bo, ZHAO Zi-Wei, SUN Su-Zhen
Characteristics of sympathetic skin response in children with Guillain-Barré syndrome
Objective To explore the value of sympathetic skin response (SSR) in the early diagnosis and prognostic evaluation of Guillain-Barre syndrome (GBS) in children. Methods A retrospective analysis was conducted on the clinical data of 25 children with GBS who were diagnosed from October 2018 to November 2022, and 30 children who were diagnosed with Tourette's syndrome during the same period were selected as the control group. The characteristics of SSR were compared between the two groups, and the association of SSR with autonomic dysfunction (AD), disease severity, and prognosis was analyzed. Results The GBS group had a significantly higher abnormal rate of SSR than the control group during the acute phase (P<0.001). SSR combined with early nerve conduction (within 2 weeks after onset) had a sensitivity of 84%, a specificity of 100%, and an accuracy of 93% in the diagnosis of GBS. There were no significant differences in the proportion of AD cases, as well as the Hughes scores during the disease peak, between the abnormal and normal SSR groups (P>0.05). All 7 children with poor short-term prognosis (at 1 month after onset) had abnormal SSR. Conclusions SSR can be used for the early diagnosis of GBS and the monitoring of treatment response in children.
2023 Vol. 25 (9): 929-935 [Abstract] ( 2098 ) [HTML 1KB] [PDF 779KB] ( 1213 )
936 PENG Qin-Ling, WANG Ping, HU Nan
Clinical and neuroelectrophysiological features of botulism in children: an analysis of eight sporadic cases
Objective To study the clinical and neuroelectrophysiological features of botulism in children. Methods A retrospective analysis was conducted on the clinical data of eight children who were diagnosed with botulism in the Department of Neurology, Hunan Children's Hospital, from August 2015 to October 2022. Results All eight children were found to have symmetrical cranial nerve palsy and flaccid paralysis of the extremities, with a descending pattern. Seven children presented with respiratory muscle paralysis. Electrophysiological examinations revealed decreased compound muscle action potential (CMAP) amplitudes in 5 children, increased CMAP amplitudes exceeding 40.0% in 6 children during high-frequency repetitive nerve stimulation, and short duration, low amplitude, and polyphasic motor unit action potentials in 4 children. Conclusions The main clinical features of botulism in children include symmetric, descending flaccid paralysis starting from cranial nerves, with the possibility of respiratory muscle paralysis. Electrophysiological abnormalities associated with it include decreased CMAP amplitudes, increased CMAP amplitudes during high-frequency repetitive nerve stimulation, and short duration, low amplitude, and polyphasic motor unit action potentials.
2023 Vol. 25 (9): 936-940 [Abstract] ( 1940 ) [HTML 1KB] [PDF 759KB] ( 1417 )
941 PENG Zhi-Hui, YAN Hai-Peng, LU Xiu-Lan, ZHANG Xin-Ping, HUANG Jiao-Tian, XIAO Zheng-Hui
Value of complement component 3 in predicting the prognosis of children with sepsis
Objective To investigate changes in complement component 3 (C3) levels in children with sepsis and its correlation with the severity of sepsis and to explore the significance of C3 in predicting mortality in children with sepsis. Methods A retrospective analysis was conducted on 529 children with sepsis who were admitted to the Pediatric Intensive Care Unit in Hunan Children's Hospital between November 2019 and September 2021. The children were categorized into two groups based on their prognosis at day 28 after sepsis diagnosis: the survival group (n=471) and the death group (n=58). Additionally, the children were divided into normal C3 group (n=273) and reduced C3 group (n=256) based on the median C3 level (0.77 g/L) within 24 hours of admission. Clinical data and laboratory markers were compared between the groups, and assess the predictive value of C3 levels in relation to sepsis-related mortality. Results The death group exhibited significantly lower C3 levels compared to the survival group (P<0.05). Multivariate logistic regression analysis revealed that higher pediatric Sequential Organ Failure Assessment (p-SOFA) scores and lower C3 levels were closely associated with sepsis-related mortality (P<0.05). The receiver operating characteristic curve (ROC) analysis demonstrated that combination of p-SOFA scores and C3 levels yielded an area under the ROC curve of 0.852, which was higher than that of each indicator alone (P<0.05). Conclusions C3 can serve as an indicator to assess the severity and prognosis of sepsis in children. The combination of p-SOFA scores and C3 levels holds good predictive value for mortality in children with sepsis.
2023 Vol. 25 (9): 941-946 [Abstract] ( 1982 ) [HTML 1KB] [PDF 587KB] ( 837 )
947 SUN Juan, LI Ming-Xia, DU Tian-Hua, WANG Huai-Li
Clinical characteristics and prognosis of acute pancreatitis in children
Objective To study the clinical characteristics of acute pancreatitis (AP) in children. Methods A retrospective analysis was conducted on the children with AP who were hospitalized in the First Affiliated Hospital of Zhengzhou University from January 2020 to June 2022, and their clinical characteristics were summarized and analyzed. Results A total of 92 children with AP were included, with a male/female ratio of 1:1 and a mean age of (9±4) years. Adolescents (34%, 31/92) and pre-school children (33%, 30/92) were more commonly affected, while infants and toddlers (7%, 6/92) were less commonly affected. The etiology of the disease from most to least was as follows: drug-induced (40%, 37/92), biliary (18%, 17/92), dietary (14%, 13/92), idiopathic (13%, 12/92), trauma-related (9%, 8/92), and infectious (5%, 5/92). Mild, moderate, and severe AP accounted for 68% (63/92), 21% (19/92), and 11% (10/92), respectively. Among all 92 children, 62 (67%) received abdominal ultrasound, with a positive rate of 66% (41/62); 67 (73%) underwent abdominal CT, with a positive rate of 90% (60/67); 20 (22%) underwent magnetic resonance cholangiopancreatography (MRCP), with a positive rate of 95% (19/20). There were significant differences in the levels of D-dimer, procalcitonin, and amylase among children with different degrees of severity of the condition (P<0.05), and there were significant differences in the levels of leukocyte count, hematocrit, blood urea nitrogen, albumin, and blood calcium among children with different etiologies (P<0.05). Of all 92 children, 89 (97%) had a good prognosis. Conclusions The primary cause of pediatric AP is medication-induced, with a predominantce of mild cases. Abdominal CT has a high rate of utilization and positivity in the diagnosis of pediatric AP, while MRCP has the highest specificity among imaging techniques. Laboratory tests aid in determining the severity and etiology of AP. The prognosis of AP is favorable in children.
2023 Vol. 25 (9): 947-952 [Abstract] ( 2233 ) [HTML 1KB] [PDF 548KB] ( 1739 )
953 LIU Xuan-Cheng, GU Ming-Xiao, SUN Meng, JIANG Qian-Nan
Clinical characteristics and pathogens of infancy lower respiratory tract infections in infants with bronchopulmonary dysplasia
Objective To study the clinical characteristics and pathogen features of infants with bronchopulmonary dysplasia (BPD) who were readmitted during infancy due to lower respiratory tract infections. Methods A retrospective analysis was conducted on 128 preterm infants with BPD who were admitted for lower respiratory tract infections in Qingdao Women and Children's Hospital from January 2020 to December 2022. An equal number of non-BPD preterm infants admitted during the same period were selected as controls. General information, clinical characteristics, lung function parameters, and respiratory pathogen results were compared between the two groups. Results Compared with the non-BPD group, the BPD group had a lower gestational age and birth weight, were more likely to experience shortness of breath, wheezing, and cyanosis, and had a longer duration of wheezing relief (P<0.05). Compared with the non-BPD group, the BPD group had lower lung function parameters, including tidal volume per kilogram of body weight, ratio of time to peak tidal expiratory flow to total expiratory time, ratio of volume at peak tidal expiratory flow to expiratory tidal volume, tidal expiratory flow at 25%, 50%, and 75% of tidal volume, and increased respiratory rate (P<0.05). The detection rates of gram-negative bacteria, such as Klebsiella pneumoniae and Acinetobacter baumannii, were higher in the BPD group than in the non-BPD group (P<0.05). Conclusions Infants with BPD who develop infancy lower respiratory tract infections require closer attention to the clinical characteristics such as shortness of breath, wheezing, and cyanosis. Lung function is characterized by obstructive changes and small airway dysfunction. Gram-negative bacteria, including Klebsiella pneumoniae and Acinetobacter baumannii, are more likely to be detected as respiratory pathogens.
2023 Vol. 25 (9): 953-958 [Abstract] ( 2050 ) [HTML 1KB] [PDF 533KB] ( 1115 )
959 LUO Ming-Xin, HUA Shan, WEI Wen
Clinical efficacy of omalizumab for treatment of moderate or severe allergic asthma in children with serum immunoglobulin E levels >1 500 IU/mL: a prospective study
Objective To evaluate the clinical efficacy of omalizumab in the treatment of moderate or severe allergic asthma in children with serum total immunoglobulin E (IgE) levels >1 500 IU/mL. Methods A total of 95 children with moderate or severe allergic asthma, who were treated at the Department of Respiratory Medicine in Anhui Provincial Children's Hospital from December 2020 to May 2022, were enrolled. Based on their serum total IgE levels and whether they received omalizumab treatment, they were divided into a control group (IgE >1 500 IU/mL, no omalizumab treatment), a normal treatment group (IgE levels between 30 and 1 500 IU/mL, omalizumab treatment), and an ultra-high IgE treatment group (IgE >1 500 IU/mL, omalizumab treatment). The differences in clinical characteristics, Childhood Asthma Control Test (C-ACT) scores before and after treatment, the proportion of acute attacks, IgE levels, pulmonary function indicators, and fractional exhaled nitric oxide (FeNO) concentrations were analyzed among the three groups. Results At the 8th week of treatment, the normal treatment group and the ultra-high IgE treatment group had higher C-ACT scores, forced expiratory volume in first second (FEV1) as a percentage of predicted value (FEV1%pred), FEV1/forced vital capacity (FVC) ratio (FEV1/FVC), and peak expiratory flow (PEF) as a percentage of predicted value (PEF%pred), as well as a lower proportion of acute attacks and FeNO concentration compared to the control group (P<0.05). There were no statistically significant differences in the comparison of various indicators between the ultra-high IgE treatment group and the normal treatment group (P>0.05). At the 16th week of treatment, the normal treatment group and the ultra-high IgE treatment group had higher C-ACT scores and pulmonary function indicators including FEV1%pred, FEV1/FVC, PEF%pred, and forced expiratory flow at 25% vital capacity (FEF25) as a percentage of predicted value (FEF25%pred) compared to the control group (P<0.05). The proportion of acute attacks and FeNO concentration in the ultra-high IgE treatment group were lower than those in the control group (P<0.05). There were no statistically significant differences in the comparison of various indicators between the ultra-high IgE treatment group and the normal treatment group (P>0.05). Conclusions Omalizumab therapy has a certain clinical efficacy in children with moderate or severe allergic asthma and serum total IgE levels >1 500 IU/mL, with no significant difference in efficacy compared to children with serum total IgE levels between 30 and 1 500 IU/mL.
2023 Vol. 25 (9): 959-965 [Abstract] ( 1971 ) [HTML 1KB] [PDF 562KB] ( 1303 )
966 XU Long-Wei, CAO Feng, TONG Rui-Fang, WANG Chen-Yu, ZHANG Ying-Hui
Relationship between coronavirus disease 2019 vaccination and the risk of immune thrombocytopenia
Objective To study the relationship between coronavirus disease 2019 (COVID-19) vaccination and the risk of immune thrombocytopenia (ITP). Methods A retrospective analysis was conducted on children aged 3-17 years with newly diagnosed ITP who were hospitalized in Children's Hospital Affiliated to Zhengzhou University from November 2021 to December 2022. Clinical data and COVID-19 vaccination status were compared among three groups: ITP patients vaccinated within 12 weeks before onset, vaccinated more than 12 weeks before onset, and unvaccinated. Changes in serum immunoglobulin and complement levels were analyzed among five groups: ITP patients vaccinated <4 weeks before onset, 4-<8 weeks before onset, 8-<12 weeks before onset, ≥12 weeks before onset, and unvaccinated. A case-control design was used to estimate the risk of ITP: 387 children aged 3-17 years with fractures hospitalized during the same period in the emergency department of the hospital were selected as the control group, and the exposure to COVID-19 vaccination within 12, 8, and 4 weeks before onset in ITP children was compared to estimate the risk of ITP. Results Among 129 ITP children, there were no statistically significant differences in age, gender, rate of preceding infections, absolute platelet count at initial diagnosis, absolute lymphocyte count at initial diagnosis, bleeding score, positive anti-nuclear antibody rate, absolute platelet count after 4 days of treatment, recurrence rate, and proportion of patients with disease duration ≥3 months among the three groups vaccinated within 12 weeks before onset, vaccinated more than 12 weeks before onset, and unvaccinated (P>0.05). There was a statistically significant difference in serum immunoglobulin G, immunoglobulin A, and complement component 3 levels among the groups vaccinated <4 weeks, 4-<8 weeks, 8-<12 weeks, and ≥12 weeks before onset, and unvaccinated (P<0.05). The risk estimation results showed that COVID-19 vaccination within 12 weeks, 8 weeks, and 4 weeks before onset did not increase the risk of ITP (P>0.05). Conclusions COVID-19 vaccination does not increase the risk of ITP.
2023 Vol. 25 (9): 966-970 [Abstract] ( 1962 ) [HTML 1KB] [PDF 562KB] ( 1300 )
971 ZHANG Hai-Xia, DONG Jie, HUANG Jiao-Tian, ZHANG Ke-Yuan, LU Xiu-Lan, ZHAO Xin, XIAO Chang-Qiong
Drug treatment efficacy in 32 children with streptococcal toxic shock syndrome
Objective To study the efficacy of different drug treatment regimens in children with streptococcal toxic shock syndrome (STSS). Methods Clinical data of children diagnosed with STSS confirmed by bacterial culture and treated in Hunan Children's Hospital and Chenzhou First People's Hospital from January 2009 to April 2023 were retrospectively collected. The efficacy of different drug treatment regimens was analyzed. The children were divided into four groups based on the treatment regimens: standard group (regimens containing penicillin), Group A (carbapenem + glycopeptides/linezolid), Group B (carbapenems, broad-spectrum antibiotics, glycopeptides/linezolid used alone or in combination, excluding the regimens in Group A), and Group C (macrolides/not receiving antimicrobial drugs). Results A total of 32 cases of STSS were included. Antimicrobial susceptibility testing showed that all strains were sensitive to beta-lactam antibiotics such as ampicillin and vancomycin, while resistant to clindamycin, erythromycin, and tetracycline. There was a statistically significant difference in the efficacy rate among the four groups (P<0.05). The standard group exhibited the highest efficacy rate (100%), while the efficacy rates for Group A, Group B, and Group C were 40%, 40%, and 0%, respectively. Conclusions The use of antimicrobial regimens containing penicillin can improve the therapeutic efficacy of STSS in children.
2023 Vol. 25 (9): 971-975 [Abstract] ( 2064 ) [HTML 1KB] [PDF 561KB] ( 1422 )
976 ZHONG Ying-Yan, LI Yu-Ting, CHEN Ru-Meng, CONG En-Zhao, XU Yi-Feng
Childhood trauma and adolescent game addiction: the mediating effects of self-control
Objective To investigate the association between childhood trauma and game addiction in adolescents, as well as the mediating effect of self-control. Methods A cross-sectional study was conducted using cluster random sampling. The participants were 2 664 adolescents from a senior high school in Henan Province. The research tools included a demographic data questionnaire, Childhood Trauma Questionnaire-Short Form, Self-Control Scale, and Game Addiction Scale for Adolescents. The Bootstrap method was used to test the parallel mediating effect, with the five dimensions of self-control as mediators. Results The prevalence of game addiction among the adolescents was 17.68% (471/2 664). There was a positive correlation between childhood trauma and game addiction scores (P<0.01), and a negative correlation between childhood trauma scores and each dimension of self-control (P<0.01). Moreover, all five dimensions of self-control were negatively correlated with game addiction scores (P<0.01) and acted as parallel mediators between childhood trauma and game addiction. The mediating effects of restraint from entertainment (accounting for 15.6% of the total effect) and resistance to temptation (accounting for 10.6% of the total effect) were stronger. Conclusions Childhood trauma may increase the risk of game addiction by impairing adolescents' self-control abilities. The reduction of childhood trauma can cultivate self-control in adolescents and prevent the occurrence of game addiction.
2023 Vol. 25 (9): 976-981 [Abstract] ( 2161 ) [HTML 1KB] [PDF 606KB] ( 1616 )
REVIEW
982 LIANG Guo-Bao, LIN Xin-Zhu
Recent research on inhaled nitric oxide in preterm infants with a gestational age of <34 weeks
Nitric oxide is a messenger molecule for vasodilation of vascular smooth muscle cells, and inhaled nitric oxide (iNO) can dilate pulmonary blood vessels and reduce pulmonary vascular resistance, thereby reducing pulmonary artery pressure, but with no influence on systemic circulation pressure. Guidelines in China and overseas recommend the use of iNO in full-term infants and late preterm infants, and it has been proved that it has a marked effect on persistent pulmonary hypertension and hypoxic respiratory failure in such infants. However, recent studies have shown that there is an increase in the off-label use of iNO in preterm infants with a gestational age of <34 weeks. This article reviews the research progress on the efficacy, safety, timing, dose, and withdrawal mode of iNO and its combination with vasoactive drugs in the treatment of preterm infants with a gestational age of <34 weeks in China and overseas, so as to provide a reference for clinical application.
2023 Vol. 25 (9): 982-988 [Abstract] ( 2276 ) [HTML 1KB] [PDF 551KB] ( 1642 )
COLUMN ON DIAGNOSIS & TREATMENT IN MDT MODE
989 WANG Zi-Ming, DENG Ying-Ping, SHI Yuan-Mei, WANG Lai-Shuan, SUN Song, XIE Xin-Bao, ZHAO Lu, WANG Hong-Sheng, LI Zhi-Hua
A rare case of neonatal-onset hepatic sinusoidal obstruction syndrome
A male infant, aged 1 month and 14 days, was admitted to the hospital due to abdominal distension lasting for 2 weeks and worsening for 3 days. The infant had a history of omphalitis. Physical examination revealed severe abdominal distension, prominent abdominal wall veins, hepatosplenomegaly, and massive ascites. There was a slight elevation in liver transaminase levels. Liver ultrasound and CT scans demonstrated the absence of visualization of the intrahepatic segment of the portal vein and the left, middle, and right veins of the liver, indicating occlusion of these vessels, along with surrounding fibrous hyperplasia. The clinical diagnosis was hepatic sinusoidal obstruction syndrome resulting from omphalitis. A large amount of bloody ascites developed after 12 days of hospitalization, resulting in hypovolemic shock and respiratory failure. The infant passed away following the family's decision to discontinue treatment. This article focuses on the diagnostic approach and multidisciplinary management of neonatal-onset hepatic sinusoidal obstruction syndrome, as well as provides insights into the differential diagnosis of hepatomegaly and ascites.
2023 Vol. 25 (9): 989-994 [Abstract] ( 2058 ) [HTML 1KB] [PDF 542KB] ( 1026 )
995
2023 Vol. 25 (9): 995-995 [Abstract] ( 1150 ) [HTML 1KB] [PDF 231KB] ( 930 )
CJCP
About Journal
Editors members
Contact Us

 
Copyright © 2004-2005 Chinese Journal Of Contemporary Pediatrics All rights reserved.
Addr: 87 Xiangya Road, Changsha, Hunan, 410008, PRC
Tel: 0731-84327402 Fax: 0731-84327922 E-mail: cjcp1999@csu.edu.cn