Objective:To investigate the correlation between levels of fibroblast growth factor-23 (FGF-23) and monocyte chemoattractant protein-1 (MCP-1) and glucocorticoids-induced osteoporosis (GIOP) in children.Methods:From May. 2018 to May. 2022, 80 children with glucocorticoid osteoporosis admitted to our hospital were selected as the study subjects, and the control group was 62 children who received glucocorticoid therapy but had normal bone mass. General data were collected and bone density and bone metabolism were measured, including type 1 collagen carboxy-terminal peptide (CTX-1), type 1 procollagen amino-terminal peptide (PINP), and osteocalcin (OC). The levels of MCP-1and FGF-23 in the serum of the two groups were detected, and univariate and multivariate analysis was performed using prism software to analyze the risk factors affecting GIOP.Results:There was no significant difference in general data between the two groups (both P>0.05). The levels of FGF-23 (264.81±24.61) and MCP-1 (194.16±15.76) in serum of GIOP children were significantly higher than those in the control group (207.97±9.91; 179.00±18.34) ( t=17.13, P < 0.001; t=5.29, P < 0.001) ; Compared with those of the control group (0.88±1.08; 23.98±2.45; 8.36±3.71; 4.56±2.21), bone mineral density (0.44±0.29), PINP (16.29±3.97) and OC (6.74±3.22) levels were decreased, and CTX-1 level was increased (6.62±1.11) ( t=3.58, P<0.05; t=13.40, P<0.05; t=2.78, P<0.05; t=7.25, P<0.05) of the study group. Multivariate Logistic regression model showed that FGF-23 ( OR=1.161, 95% CI: 1.080-1.341, P<0.05), MCP-1 ( OR=1.179, 95% CI: 1.044-1.448, P<0.05) and CTX-1 ( OR=3.018, 95% CI: 1.526-10.510, P<0.05) were independent clinical risk factors for GIOP in children (all P<0.05). PINP ( OR=0.453, 95% CI: 0.169-0.740, P<0.05) was a protective factor affecting GIOP in children. Conclusion:FGF-23 and MCP-1 were independent risk factors for GIOP in children.

目的 探讨新生儿败血症外周血核因子-κB(NF-κB)、中性粒细胞CD11b、簇分化抗原64(CD64)表达及与病情严重程度的关系.方法 选取2017年10月-2020年9月于徐州医科大学附属连云港医院新生儿科收治的100例败血症患儿为新生儿败血症组,依据病情严重程度,分为重症组32例,轻症组68例.另选取同期医院分娩的50名健康新生儿为正常对照组.测定两组研究对象外周血NF-κB、CD11b、CD64水平,采用受试者工作特性曲线(ROC)分析不同NF-κB、CD11b、CD64水平对败血症患儿病情程度的评估价值.结果 新生儿败血症组患儿外周血NF-κB、CD11b、CD64水平均高于正常对照组(P<0.05);重症组患儿外周血NF-κB、CD11b、CD64水平均高于轻症组(P<0.05).ROC曲线分析结果显示,NF-κB、CD11b、CD64水平单独诊断重症新生儿败血症的ROC曲线下面积均低于三项指标联合诊断重症新生儿败血症的ROC曲线下面积;三项指标单独诊断时的截断值分别为:17.65 mg/L、386.27平均荧光强度(Median fluorescence intensity,MFI)和45.92 MFI.结论 NF-κB、CD11b、CD64在重症败血症患儿外周血中均呈较高水平,三项指标联合检测对重症新生儿败血症具有较好的预测价值.

目的:探讨早期间歇蓝光照射联合益生菌、黄疸茵陈颗粒对新生儿黄疸患儿的免疫能力、黄疸指数的影响及其临床疗效.方法:选取我院2017年8月至2020年12月期间诊治的125例新生儿黄疸患儿,采用随机数字表法将所有患儿进行简单随机分组为研究组63例,对照组62例,所有患儿均采用间歇蓝光照射治疗,研究组患者在光疗的基础上联合益生菌、黄疸茵陈颗粒治疗.评估两组患儿的临床效果,计算总有效率.对比观察两组患儿治疗前后的免疫功能水平的变化,主要包括免疫球蛋白A(Immunoglobulin A,IgA)、免疫球蛋白G(Immunoglobulin G,IgG),同时对比两组患儿的超氧化物歧化酶(Superoxide dismutase,SOD)、丙二醛(Malondialdehyde,MDA)、过氧化氢酶(Catalase enzymes,CAT)等过氧化物质水平.对比两组患儿的黄疸指数水平的变化并记录两组患儿的黄疸消退时间、出院时间.结果:经过治疗两组患儿的IgA、IgG及MDA水平均显著升高,患儿的CAT和SOD显著降低,同时治疗后研究组患儿IgA、IgG及MDA水平均明显高于对照组患儿,CAT和SOD水平显著低于对照组,同时研究组治疗后较治疗前的IgA、IgG、CAT、SOD、MDA水平的变化的差异均显著高于对照组,差异均具有统计学意义(P<0.05);经过治疗后两组患儿的黄疸指数均明显降低,治疗后研究组患儿的黄疸指数显著低于对照组患儿,而研究组患儿治疗后黄疸指数水平降低差值也明显高于对照组,差异均具有统计学意义(P<0.05);研究组患儿治疗的总有效率显著高于对照组患儿,不良反应总发生率显著低于对照组,差异均具有统计学意义(P<0.05),差异均具有统计学意义(P<0.05).结论:早期间歇蓝光照射联合益生菌、黄疸茵陈颗粒治疗能够显著改善新生黄疸患儿的免疫功能状态,降低黄疸指数,减少患儿机体氧化应激损伤,促进患儿的恢复,具有较高的临床价值.

Neuroblastoma (NB) is an extracranial solid malignancy in childhood. More and more studies have demonstrated that circRNAs are essential regulators of various tumors. This study conducted to explore the role and mechanism of circular RNA CUT-like homeobox 1 (circCUX1) in NB. The levels of circCUX1, miR-338-3p and plant homeodomain finger protein 20 (PHF20) were detected by qRT-PCR or Western blot. Cell proliferation and apoptosis were evaluated by colony formation assay, flow cytometry and Western blot analysis. Cell migration and invasion were examined via transwell assay. Glycolysis was expressed by measuring the extracellular acidification rate (ECAR). The interaction among circCUX1, miR-338-3p and PHF20 were validated by dual-luciferase reporter assay and RNA Immunoprecipitation assay. Besides, xenograft experiment was performed to assess tumor growth in vivo. circCUX1 and PHF20 were up-regulated, while miR-338-3p was down-regulated in NB tissues and cells. Knockdown of circCUX1 suppressed the progression and glycolysis of NB cells. circCUX1 triggered NB progression and glycolysis by regulating miR-338-3p. Additionally, down-regulation of miR-338-3p promoted NB progression and glycolysis via targeting PHF20. Moreover, circCUX1 sponged miR-338-3p to regulate PHF20 expression. Furthermore, circCUX1 silencing hindered tumor growth in vivo. circCUX1 depletion suppressed tumor progression and glycolysis in NB by regulating miR-338-3p/PHF20 axis, suggesting a potential biomarker for NB treatment.

目的:分析和比较不同量表用于机械通气新生儿急性疼痛评估的价值.方法:使用总结性、回顾性研究方法,研究时间为2017年3月份到2018年7月份,选择在医院NICU接受机械通气诊治的新生儿56例作为研究对象,所有新生儿都给予高频震荡通气治疗,急性疼痛采用新生儿疼痛/激惹与镇静量表、新生儿急性疼痛评估量表进行评估与分析,记录评估效果.结果:新生儿疼痛/激惹与镇静量表的总体Cronbachα系数为0.698分,最高评分为基础行为状态,最低评分为心率增快.新生儿急性疼痛评估量表的内部一致性总体Cronbachα系数为0.822,最高评分为胎龄,最低评分为SaO2.新生儿疼痛/激惹与镇静量表的护理人员一致性组内相关系数(ICC)为0.992,新生儿急性疼痛评估量表的护理人员一致性组内相关系数ICC为0.987.以新生儿疼痛/激惹与镇静量表作为效标,新生儿急性疼痛评估量表的效标关联效度Spearman相关系数为r=0.855,P=0.007.12名护理人员对新生儿急性疼痛评估量表的选择率为66.7％,对新生儿疼痛/激惹与镇静量表的选择率为33.3％.结论:新生儿疼痛/激惹与镇静量表和新生儿急性疼痛评估量表在机械通气新生儿急性疼痛评估中都有很好的信度与一致性,其中新生儿急性疼痛评估量表的可行性和临床实用性更好.

目的 观察暖箱遮光对早产儿喂养不耐受的护理效果.方法 随机选取我院2016年3月～2017年8月65例早产儿为本次实验研究对象,将患儿随机分为A组、B组、C组,三组患儿均给予早产儿常规管理,65例早产儿即A组21例,B组21例,C组23例,比较三组早产儿的护理效果.结果 B组、C组早产儿给予暖箱遮光护理后每日进奶量、胃潴留量、体重增加量均明显优于A组,B组、C组早产儿皮肤磨损、心率加快等不良反应发生率明显低于A组,A组早产儿各项数据与B组、C组差异明显具有统计学意义(P<0.05).结论 对于早产儿给予暖箱遮光护理可明显降低其喂养不耐受,有效提高早产儿胃排空能力,促进肠道蠕动,临床护理效果好.

Objective To investigate children paroxysmal supraventricular tachycardia occurs first aid and nursing.Methods 28 patients with paroxysmal supraventricular tachycardia in children admit ed to hospital after giving a positive rescue, rapid, accurate treatment, intensive care. Results 28 patients with paroxysmal supraventricular tachycardia in children al were discharged, average length of stay was three days. Conclusion Timely,accurate and ef ective medication,active,careful care,can reduce the occurrence of paroxysmal supraventricular tachycardia in children with heart failure and other complications,and to promote their recovery and reduce the length of hospital stay.

目的:探讨小儿传染性单核细胞增多症的护理措施。方法:对18例传染性单核细胞增多症患儿实施精心的基础护理、对症治疗、心理护理和出院指导。结果:18例患儿全部痊愈出院,平均住院14d。结论:及时、有效、积极、精心的护理,可减少传染性单核细胞增多症患儿并发症的发生,促进疾病恢复,减少住院日。

经皮肾活检术(PRB)是诊断肾脏疾病的重要方法之一,由于该检查为侵入性操作,且肾脏组织血流丰富,术后容易发生出血、疼痛、感染、尿潴留、肾周血肿等并发症,为此,我们于2007年1月开始将循证护理运用于肾活检术后患儿的护理实践中,有效提高了其信后的舒适度,减少了并发症的发生,取得满意效果.