Early Nursing Intervention in Children with Viral Meningitis

Aim: To explore the effect of a WeChat peer education program in children with severe viral meningitis combined with respiratory failure. Design: Retrospective cohort study. Methods: Patients who had severe viral meningitis combined with respiratory failure, were admitted to the hospital from March 2017 to June 2018, and who received the WeChat-based nursing intervention were included. Patients who received routine nursing were used as controls. The family’s emotional state, self-care ability, and rehabilitation were analyzed. Results: There were 37 patients in the WeChat group (19 boys (51.3%) and 18 girls (48.7%);mean of 5.1 ± 2.4 years of age) and 37 controls (20 boys (54.1%) and 17 girls (45.9%);mean of 5.9 ± 2.4 years of age) (all P > 0.05). After nursing, improvements in the self-assessed anxiety score and self-assessed depression score were better in the WeChat group (anxiety: -29.2% vs. -20.3%, P = 0.015;depression: -25.2% vs. -15.4%, P = 0.009). After nursing, the improvements in the condition management ability scale and condition management difficulty scale scores were better in the WeChat group (ability: +80.5% vs. +44.4%. P = 0.001;difficulty: +58.4% vs. +37.8%, P = 0.003). After nursing, the improvement in the Fugl-Meyer score was better in the WeChat group (+138.0% vs. +53.0%, P Conclusion: Early nursing intervention combined with WeChat peer education can improve the emotional state of children with severe viral meningitis combined with respiratory failure and their caregivers. Impact: Viral meningitis is associated with a good prognosis, but central nervous system complications can be observed. Early intervention is the key to a good prognosis. Internet-based nursing and coaching can improve self-efficacy and care ability in patients with various conditions, as well as improve the emotional state of the children and their caregivers. The research might have an impact on any children’s hospital that deals with viral meningitis.

Early Intervention Facilitates Neuropsychological Development in Children with Autism and Attention Deficit Hyperactivity Disorder

Objective:This study aims to investigate the impact of early intervention on neuropsychological development in children with autism and attention deficit hyperactivity disorder(ADHD),providing effective intervention strategies for clinical practice.Methods:A total of 130 children with autism and ADHD who visited the hospital between June 2023 and June 2024 were selected as study subjects and randomly divided into an intervention group and a control group,with 65 children in each group.The intervention group received a one-year early comprehensive intervention,including behavioral therapy,cognitive training,and family guidance,while the control group only received routine medical care.The neuropsychological development assessment scale was used to evaluate both groups before and after the intervention to compare changes in their neuropsychological development levels.Results:Children in the intervention group showed significant improvements in cognitive function,social skills,language ability,and attention concentration,with an average improvement score of 23.5 points.Children in the control group did not show significant improvements in these areas,with an average improvement score of only 5.8 points.The difference between the two groups was statistically significant(P<0.05).Conclusion:Early comprehensive intervention has a significant promoting effect on the neuropsychological development of children with autism and ADHD.Targeted behavioral therapy,cognitive training,and family guidance can effectively enhance children’s cognitive,social,language,and attention abilities,laying a solid foundation for their future overall development.Therefore,it is recommended to actively promote and apply early intervention strategies in clinical practice.

Study on the Effect of Early Oral Motor Intervention in Preterm Infants in Neonatal Intensive Care Unit

Objective:To study the effective value of introducing the concept of early oral exercise in the process of nursing intervention for preterm infants in the neonatal intensive care unit(NICU).Methods:96 cases of preterm infants diagnosed from January 2022 to August 2022 were selected and randomly divided into two groups:the general practice group(general nursing intervention),and the early practice group(early oral exercise intervention),and the effect of intervention on preterm infants in the two groups was observed.Results:After nursing care,the mean value of the non-nutritive sucking ability assessment(76.54±5.82),the mean value of the intellectual development degree assessment(104.57±8.45),the mean value of the psychomotor development degree assessment(102.33±6.74),and the mean value of behavioral neural reflexes ability assessment(38.71±2.40)in the early practice group were better than that as compared to the general practice group(P<0.05);the mean value of oral feeding start time of preterm infants in the early practice group(35.42±7.63)weeks,the mean value of all oral feeding time(34.12±5.28)weeks,and the mean time of hospital intervention(15.33±4.25)days were lesser than compared to those of the general practice group at 37.4±5.82 weeks,37.46±3.55 weeks,and 20.46±2.91 days,respectively(P<0.05);the rate of adverse reactions in preterm infants in the early practice group significantly lower than that of the general practice group(P<0.05).Conclusion:The introduction of the concept of early oral exercise intervention among NICU nurses improved the feeding effect,sucking ability of preterm infants,and intellectual development.Hence,early oral motor care should be popularized.

Study on the efficacy of early treatment with pirfenidone on the lung function of patients with idiopathic pulmonary fibrosis

BACKGROUND Idiopathic pulmonary fibrosis(IPF)is classified under fibrotic interstitial pneumonia,characterized by a chronic and progressive course.The predominant clinical features of IPF include dyspnea and pulmonary dysfunction.AIM To assess the effects of pirfenidone in the early treatment of IPF on lung function in patients.METHODS A retrospective analysis was performed on 113 patients with IPF who were treated in our hospital from November 2017 to January 2023.These patients were divided into two groups:control group(n=53)and observation group(n=60).In the control group,patients received routine therapy in combination with methylprednisolone tablets,while those in the observation group received routine therapy together with pirfenidone.After applying these distinct treatment approaches to the two groups,we assessed several parameters,including the overall effectiveness of clinical therapy,the occurrence of adverse reactions(e.g.,nausea,vomiting,and anorexia),symptom severity scores,pulmonary function index levels,inflammatory marker levels,and the 6-min walk distance before and after treatment in both groups.RESULTS The observation group exhibited significantly higher rates than the control group after therapy,with a clear distinction(P<0.05).After treatment,the observation group experienced significantly fewer adverse reactions than the control group,with a noticeable difference(P<0.05).When analyzing the symptom severity scores between the two groups of patients after treatment,the observation group had significantly lower scores than the control group,with a distinct difference(P<0.05).When comparing the pulmonary function index levels between the two groups of patients after therapy,the observation group displayed significantly higher levels than the control group,with a noticeable difference(P<0.05).Evaluating the inflammatory marker data(C-reactive protein,interleukin-2[IL-2],and IL-8)between the two groups of patients after therapy,the observation group exhibited significantly lower levels than the control group,with significant disparities(P<0.05).Comparison of the 6-min walking distance data between the two groups of patients after treatment showed that the observation group achieved significantly greater distances than the control group,with a marked difference(P<0.05).CONCLUSION Prompt initiation of pirfenidone treatment in individuals diagnosed with IPF can enhance pulmonary function,elevate inflammatory factor levels,and increase the distance covered in the 6-min walk test.This intervention is conducive to effectively decreasing the occurrence of adverse reactions in patients.

The Evidenced Effects of Early Childhood Interventions to Promote Mental Health and Parenting in the Nordic Countries: A Systematic Review

Thefirst years of life and the family context are key to the promotion and protection of children’s health and well-being,emphasizing the need for interventions aimed to support families with young children.This review aimed to explore the effectiveness of early childhood interventions developed for promoting mental health and parenting among families with young children in the Nordic countries.Six electronic databases were systematically searched,and 20 articles covering 16 studies applying various quantitative and qualitative methods met the study inclusion criteria.The studied interventions were assessed as universal health-promoting interventions and health-promoting interventions with elements of prevention.Outcomes of interest encompassed mental health,related risk and protective factors among the parents and/or the children,or child-parent interaction.The results from studies applying statistical methods show significant improvements in parents’self-efficacy,self-esteem,and parental satisfaction,while few improvements in parents’social support or parental relationship were identified.Improvements in social support and parental relationships were however reported in qualitative studies.Most quantitative studies reporting on parents’mental health problems and stress found a significant decrease,and qualitative studies highlighted experienced positive effects on mental health and well-being.The majority of stu-dies reporting on children’s mental health and/or development as well as strengths and difficulties indicated a statistically significant positive development.No significant changes were however found for existing behavioral problems.The majority of studies examining parenting strategies and/or parent-child interaction found signifi-cant positive changes after the interventions.In sum,althoughfindings are heterogeneous,early childhood inter-ventions show various positive effects on the parenting and mental health of both children and their parents.The fact that different types of initiatives have been developed and implemented can be seen as an advantage,con-sidering the varying needs and expectations of different families.

Early pirfenidone treatment enhances lung function in idiopathic pulmonary fibrosis patients

This editorial comments on the study by Lei et al investigating the efficacy of early treatment with pirfenidone on the lung function of patients with idiopathic pulmonary fibrosis(IPF)published.This study evaluates the efficacy of early treatment with pirfenidone on lung function in patients with IPF.The early and advanced stages of IPF are defined,highlighting the drug's benefits.While prior research indicates pirfenidone's effectiveness in advanced IPF,this study focuses on its advantages in early stages.The study emphasizes the importance of computed tomography imaging alongside biochemical data and lung function tests for a comprehensive analysis of symptom relief.Results show that early intervention with pirfenidone significantly reduces disease progression and preserves lung function,underscoring its potential as a critical treatment strategy in early IPF.

Early versus delayed intervention in necrotizing acute pancreatitis complicated by persistent organ failure

Background:Current guidelines for the treatment of patients with necrotizing acute pancreatitis(NAP)recommend that invasive intervention for pancreatic necrosis should be deferred to 4 or more weeks from disease onset to allow necrotic collections becoming“walled-off”.However,for patients showing signs of clinical deterioration,especially those with persistent organ failure(POF),it is controversial whether this delayed approach should always be adopted.In this study,we aimed to assess the impact of differently timed intervention on clinical outcomes in a group of NAP patients complicated by POF.Methods:All NAP patients admitted to our hospital from January 2013 to December 2017 were screened for potential inclusion.They were divided into two groups based on the timing of initial interven-tion(within 4 weeks and beyond 4 weeks).All the data were extracted from a prospectively collected database.Results:Overall,131 patients were included for analysis.Among them,100(76.3%)patients were in-tervened within 4 weeks and 31(23.7%)underwent delayed interventions.As for organ failure prior to intervention,the incidences of respiratory failure,renal failure and cardiovascular failure were not signifi-cantly different between the two groups(P>0.05).The mortality was not significantly different between the two groups(35.0%vs.32.3%,P=0.83).The incidences of new-onset multiple organ failure(8.0%vs.6.5%,P=1.00),gastrointestinal fistula(29.0%vs.12.9%,P=0.10)and bleeding(35.0%vs.35.5%,P=1.00),and length of ICU(30.0 vs.22.0 days,P=0.61)and hospital stay(42.5 vs.40.0 days,P=0.96)were com-parable between the two groups.Conclusion:Intervention within 4 weeks did not worsen the clinical outcomes in NAP patients compli-cated by POF.

Efficacy of early intervention of motor relearning program on post-stroke hemiplemia:A randomized controlled observation

BACKGROUND： Previous studies believed that the effect of rehabilitation training within 6 months after stroke （early rehabilitation training） is usually unsatisfactory. The rehabilitation training when acute stroke is stabilized may be better for the recovery of limb function. OBJECTIVE： To observe the effects of the rehabilitation training of motor relearning program plus Bobath technique on the motor function of limbs, nerve function and activities of daily life （ADL） in patients with acute stroke hemiplegia. DESIGN： A randomized controlled observation SETTING： Department of Neurology, Yaan People＇s Hospital PARTICIPANTS： A total of 150 patients with acute post-stroke hemiplegia were selected from the Department of Neurology, Yaan People＇s Hospital from March 2000 to October 2002. The patients were all accorded with the diagnostic standards about stroke set by the Fifth National Academic Meeting for Cerebrovascular Disease （1996）, confirmed by CT and MRI, and they were all informed with the interventions and the items of evaluation. The enrolled patients were randomly divided into training group （n=78） and control group （n=72） at admission. METHODS ： ① Interventions： All the patients were given routine treatments for stroke, including managin blood pressure, maintaining the balance of hydrolyte and electrolure, reducing intracranial pressure by dehydration, and venous injection of citicoline, besides those in the training group received rehabilitation training by motor relearning program and Bobath technique. The rehabilitation training began after the vital signs became stable within 24 hours to 3 days after attack for the patients with cerebral infarction and 48 hours to 5 days after at- tack for those with cerebral hemorrhage respectively, three times a day in the morning, at noon and in the evening respectively, 30 minutes for each time, they were trained for 1 month. Lying position： The patients should keep the anti-spasm posture in the supine position, contralateral and ipsilateral lying positions, and the postures should be changed regularly; The patients should exercise each joint passively; turn the body over and move actively; They should also performed the bringing training, and the weight loading training for the affected upper limb. Sitting position： The patients should finish the conversion from a lying position to a sitting one independently. Standing position： The patients should finish the conversion from a sitting position to a standing one independently; They also took weight loading training for the affected lower limb. The walking training should be performed when the affected lower limb could support 2/3 of body mass. Walking training： In a standing position supported by the affected lower limb, the unaffected one stepped in small range forward and backward; Each process of balancing and controlling standing position was trained by supporting the body mass by the affected lower limb; In swinging position, the independent movement of the ipsilateral knee joint was trained in alternation of flexion and extension. ② Evaluation of limb function, ADL and nerve function： The motor function of the affected limb was evaluated with the Fugl-Meyer assessment （FMA）, the total score of the motor function of upper and lower limbs was 100 points, the higher the score, the better the limb function. ADL were assessed with the modified Barthel index （MBI）, the total score was 100 points, the higher the score, the better the independence and the smaller the dependence. The severities of neurological deficit were assessed with neurological deficit score （NDS）, the total score ranged 0-45 points, the higher the score, the severer the neurological deficit. ③ Statistical analysis： The ttest was applied to compare the differences of the measurement data. MAIN OUTCOME MEASURES： The changes of nerve function, motor function and ADL in patients with post-stroke hemiplegia after motor relearning program training were observed. RESULTS： All the 150 patients with post-stroke hemiplegia were involved in the analysis of results. ① The scores of NDS, FMA and MBI before intervention in the training group were （25±9）, （23±23）, （20±16） points, which were close to those in the control group [（24±8）, （24±21）, （24±20） points, P 〉 0.05]. ② The NDS score after intervention in the training group was obviously lower than that in the control group [（10±7）, （18±9） points, t=4.07, P 〈 0.01], but the FMA and MBI scores were markedly higher than those in the control group [（72±28）, （80±24） points; （43±28）, （40±24） points, t=3.99, 6.50, P 〈 0.01]. CONCLUSION ： The comprehensive rehabilitation of motor relearning program plus Bobath technique at early period can remarkably improve the motor function of the affected limbs, nerve function and ADL in patients with post-stroke hemiplegia.

PreEMPT (Preterm Infant Early Intervention for Movement and Participation Trial): The Feasibility of a Novel, Participation-Focused Early Physiotherapy Intervention Supported by Telehealth in Regional Australia—A Protocol

Background: Early intervention is beneficial for improving preterm infant motor and cognitive outcomes in early childhood;however, little is known about whether early intervention can influence a preterm infant’s participation. Additionally, many studies investigating the impact of early intervention for preterm infants have been conducted in large metropolitan centres, leaving preterm infants who reside in regional areas underrepresented in the literature to date. Consequentially, it is not yet known whether there are service delivery models, such as using telehealth as an adjunct to face-to-face intervention, that might cater to the needs of preterm infants residing outside metropolitan centres. PreEMPT (Preterm infant Early intervention for Movement and Participation Trial) is a novel early physiotherapy intervention that has been designed to use a participation goal-directed intervention approach via a mixture of face-to-face clinic sessions and telehealth sessions to improve the motor and participation outcomes of preterm born infants. Methods: This study aims to evaluate the feasibility of PreEMPT using an assessor-blinded, randomised controlled trial to compare PreEMPT to Usual Physiotherapy Care (UPC) for preterm infants residing in a regional Australian hospital catchment area. Twenty-six preterm infants (≤34 + 6 weeks gestational age) will be recruited prior to term corrected age from the special care nursery of a regional hospital. Following informed consent and baseline assessments, infants will be randomly allocated to receive either PreEMPT, a novel participation-focused early physiotherapy intervention delivered weekly for 14 forty-five-minute sessions alternating face-to-face sessions with telehealth into the infant’s home, or UPC, two - three physiotherapy sessions in the 4-month intervention period. Outcome measures relating to infant neuromotor development, motor performance, general development, and parental mental health and well-being will be assessed at 4-, 6- and 8-months corrected age. Feasibility will be evaluated by acceptability (parental satisfaction), demand and practicality (recruitment rate and telehealth session implementation), implementation (attendance at assessment and treatment sessions), and limited efficacy testing (comparing outcomes listed above for infants in PreEMPT and UPC). Discussion: This study will be the first of its kind to use the participation of preterm infants in meaningful life situations as the foundation for intervention delivered via alternating face-to-face clinic sessions with telehealth into the home. The feasibility of this approach will be evaluated and used to inform future iterations of research about PreEMPT’s efficacy for improving preterm infant motor and participation outcomes.

Giant vascular malformations invading the skull:A case report

BACKGROUND Vascular malformations(VMs)arise as a result of errors in the process of angiogenesis and are usually present at birth,but may not become apparent until after birth.However,giant VMs of the head and face are uncommon,with few reported cases,and the prognosis for their surgical intervention is unclear.CASE SUMMARY A 12-year-old girl was admitted to the hospital with findings of an enlarged right temporal scalp.After admission,computed tomography(CT)angiography of cerebral ateries showed a right occlusal gap and a right temporal artery venous malformation.Furthermore,cerebral angiography showed a right temporal lobe VM with multiple vessels supplying blood.The patient underwent surgery to remove the malformed vessels and the eroded skull.Two hours after the surgery,the patient's right pupil was dilated,and an urgent CT scan of the skull showed a right subdural haematoma under the incision,which was urgently removed by a second operation.After surgery,we gave continuous antibiotic anti-infection treatment,and the patient recovered well and was discharged two weeks later.CONCLUSION Surgical removal of giant haemangiomas is risky and adequate preoperative(including interventional embolisation)and intraoperative preparations should be made.

Factors influencing parent satisfaction with preventive health services for the early detection of speech and language delay in preschool children

The aim of this study was to identify parent and child characteristics which could influence parent satisfaction with preventive health services designed to detect preschool children with speech and language (SL) delay. This study was conducted on 101 children aged 18 to 36 months who participated in an organized SL delay early detection program. Validated instruments were used to assess children’s and parents’ characteristics. Satisfaction was evaluated using the client satisfaction questionnaire for the three activities of the program: 1) a public information session about SL development, 2) parent training sessions for parents concerned by their child SL development, and 3) a child’s SL assessment. Multiple logistic regressions were used to identify all independent factors (p < 0.05) associated with satisfaction and to estimate the odds ratios (OR) for satisfaction. Economically disadvantaged parents were less prone to participate in the first two activities of the early detection program. Older parents were more satisfied with the public information session (OR = 1.33 for 1 year increment;p = 0.001). Distressed parents were less satisfied with both the parent training sessions (OR = 0.28;p = 0.009) and the SL assessment (OR = 0.43;p = 0.046). Parents whose child had health problems at birth were less satisfied with the public information session (OR = 0.14, p = 0.03) and the SL assessment (OR = 0.33, p = 0.036). There is a need to better adapt the delivery of preventive services for the early detection of SL delay, especially for disadvantaged and distressed parents and for those whose child had suffered from health problems at birth.

Early intervention improves clinical responses to seasonal allergic rhinitis by stimulation in sphenopalatine ganglion(Xinwu acupoint)

OBJECTIVE:To examine the efficacy of early intervention(4 weeks before pollen dispersal)with sphenopalatine ganglion(Xinwu acupoint)stimulation in patients with allergies after the onset of seasonal allergic rhinitis(SAR).METHODS:This is a prospective,randomized and unblinded half-open study.Forty-one SAR volunteers were randomly assigned to either the sphenopalatine ganglion(SPG)acupuncture plus supplementary acupuncture(SPG group)or the sham-SPG acupuncture plus supplementary acupuncture(SA group)stimulation 4 weeks before the onset of allergy season.The changes of the total nasal symptom score(TNSS)and the Rhinoconjunctivitis Quality of Life Questionnaire(RQLQ)scores were measured on the first week in the onset of allergy season.RESULTS:Four patients dropped out due to local hematoma and pain in the SPG and SA groups.The remaining 37 patients continued through to the end of the trial.After early intervention 4 weeks before the onset of allergy season,the sneezing,nasal congestion and itchiness scores in the first week of onset time were significantly lower in the SPG group than in the SA group patients(P<0.001).The RQLQ score obtained at the onset of symptoms indicated that symptoms were more significantly ameliorated in the SPG group than in the SA group(P<0.001).CONCLUSIONS:The results of this study confirmed that early intervention by sphenopalatine ganglion(Xinwu acupoint)stimulation can effectively improve the symptoms and the quality of SAR patients'daily lives.

Non-coding RNAs:a promising target for early metastasis intervention

Metastases account for the overwhelming majority of cancer-associated deaths.The dissemination of cancer cells from the primary tumor to distant organs involves a complex process known as the invasion-metastasis cascade.The underlying biological mechanisms of metastasis,however,remain largely elusive.Recently,the discovery and characterization of non-coding RNAs(ncRNAs)have revealed the diversity of their regulatory roles,especially as key contributors throughout the metastatic cascade.Here,we review recent progress in how three major types of ncRNAs(microRNAs,long non-coding RNAs,and circular RNAs)are involved in the multistep procedure of metastasis.We further examine interactions among the three ncRNAs as well as current progress in their regulatory mechanisms.We also propose the prevention of metastasis in the early stages of cancer progression and discuss current translational studies using ncRNAs as targets for metastasis diagnosis and treatments.These studies provide insights into developing more effective strategies to target metastatic relapse.

Neurodevelopmental Outcomes of Extremely Premature Infants with Extremely Low and Very Low Birth Weight at Three Years of Age: A Retrospective Study

Introduction: The purpose of this retrospective study is to identify medical conditions impacting neurodevelopmental outcomes of extremely low birth weight and very low birth weight preterm infants at three years of age. Methods: Infants born in Banner Diamond Children’s University Medical Center, receiving services in the Newborn Intensive Care Unit, and attending Neonatal Developmental Follow-Up Clinic were identified. Participants received developmental assessment and follow-up from August 2012 through December 2018. Relevant clinical conditions during initial hospital stay and up to three years of age were obtained by reviewing medical and developmental records. Bayley Scales of Infant Toddler Development (Bayley III) was used to evaluate skill development at 6, 9, 12, 18, 24, 30, 36 months. Results: Data analysis did not reveal significant p-values;it did demonstrate that some predictor variables impact neurodevelopmental outcomes in cognitive, language and motor skill development. Conclusion: This retrospective study reports significant association between birth weight and low cognitive scores. Correlations were also found between gestational age and Total Language, and the longer an infant stayed in the NICU, the poorer the Total Language Scaled Scores at 8 to 12 months, 15 to 18 months, and 24 to 36 months. Birth weight was found to be the greatest predictor of poor motor scores.

Understanding Autism Spectrum Disorder(ASD)Unraveling the Mysteries(A Short Review)

Autism Spectrum Disorder(ASD)is a multifaceted neurodevelopmental condition characterized by a spectrum of symptoms and behaviors,challenging to fully comprehend due to its variability.This article provides an overview of ASD,including its characteristics,prevalence,diagnosis,and causes.The prevalence of ASD has been on the rise,with improved awareness and diagnostic tools.While genetics and environmental factors play a role,the exact causes remain elusive.Early intervention and various therapies are crucial for improving outcomes,although there is no cure.Ongoing research aims to uncover the complexities of ASD and develop effective treatments.Embracing diversity and fostering inclusion is essential for supporting individuals with ASD.As we continue to unravel the mysteries of ASD,we move closer to a more understanding and inclusive society.This article explores the role of Transcranial Magnetic Stimulation(TMS)in the treatment of Autism Spectrum Disorder(ASD).TMS,a non-invasive neurostimulation technique,is gaining attention as a potential therapy to address specific aspects of ASD.

The characteristics of liver injury induced by Amanita and clinical value of α-amanitin detection

Background:Amanita poisoning as a foodborne disease has raised concerning mortality issues.Reducing the interval between mushroom ingestion and medical intervention could greatly influence the outcomes of Amanita poisoning patients,while treatment is highly dependent on a confirmed diagnosis.To this end,we developed an early detection-guided intervention strategy by optimizing diagnostic process with performingα-amanitin detection,and further explored whether this strategy influenced the progression of Amanita poisoning.Methods:This study was a retrospective analysis of 25 Amanita poisoning patients.Thirteen patients in the detection group were diagnosed mainly based onα-amanitin detection,and 12 patients were diagnosed essentially on the basis of mushroom consumption history,typical clinical patterns and mushroom identification(conventional group).Amanita poisoning patients received uniform therapy,in which plasmapheresis was executed once confirming the diagnosis of Amanita poisoning.We compared the demographic baseline,clinical and laboratory data,treatment and outcomes between the two groups,and further explored the predictive value ofα-amanitin concentration in serum.Results:Liver injury induced by Amanita appeared worst at the fourth day and alanine aminotransferase(ALT)rose higher than aspartate aminotransferase(AST).The mortality rate was 7.7%(1/13)in the detection group and 50.0%(6/12)in the conventional group(P=0.030),since patients in the detection group arrived hospital much earlier and received plasmapheresis at the early stage of disease.The early detection-guided intervention helped alleviate liver impairment caused by Amanita and decreased the peak AST as well as ALT.However,the predictive value ofα-amanitin concentration in serum was still considered limited.Conclusions:In the management of mushroom poisoning,consideration should be given to the rapid detection ofα-amanitin in suspected Amanita poisoning patients and the immediate initiation of medical treatment upon a positive toxin screening result.

Home-based Early Intervention on Auditory and Speech Development in Mandarin-speaking Deaf Infants and Toddlers with Chronological Aged 7-24 Months

Background：Early auditory and speech development in home-based early intervention of infants and toddlers with hearing loss younger than 2 years are still spare in China.This study aimed to observe the development of auditory and speech in deaf infants and toddlers who were fitted with hearing aids and/or received cochlear implantation between the chronological ages of 7-24 months,and analyze the effect of chronological age and recovery time on auditory and speech development in the course of home-based early intervention.Methods：This longitudinal study included 55 hearing impaired children with severe and profound binaural deafness,who were divided into Group A （7-12 months）,Group B （13-18 months） and Group C （19-24 months） based on the chronological age.Categories auditory performance （CAP） and speech intelligibility rating scale （SIR） were used to evaluate auditory and speech development at baseline and 3,6,9,12,18,and 24 months of habilitation.Descriptive statistics were used to describe demographic features and were analyzed by repeated measures analysis of variance.Results：With 24 months of hearing intervention,78% of the patients were able to understand common phrases and conversation without lip-reading,96% of the patients were intelligible to a listener.In three groups,children showed the rapid growth of trend features in each period of habilitation.CAP and SIR scores have developed rapidly within 24 months after fitted auxiliary device in Group A,which performed much better auditory and speech abilities than Group B （P 〈 0.05） and Group C （P 〈 0.05）.Group B achieved better results than Group C,whereas no significant differences were observed between Group B and Group C （P 〉 0.05）.Conclusions：The data suggested the early hearing intervention and home-based habilitation benefit auditory and speech development.Chronological age and recovery time may be major factors for aural verbal outcomes in hearing impaired children.The development of auditory and speech in hearing impaired children may be relatively crucial in the first year＆#39;s habilitation after fitted with the auxiliary device.

Early therapeutic interventions of traditional Chinese medicine in COVID-19 patients:A retrospective cohort study

Objective:To observe the early interventions of traditional Chinese Medicine(TCM)on the conversion time of nucleic acid in patients with coronavirus disease 2019(COVID-19),and find possible underlying mechanisms of action.Methods:A retrospective cohort study was conducted on 300 confirmed COVID-19 patients who were treated with TCM,at a designated hospital in China.The patients were categorized into three groups:TCM1,TCM2 and TCM3,who respectively received TCM interventions within 7,8–14,and greater than15 days of hospitalization.Different indicators such as the conversion time of pharyngeal swab nucleic acid,the conversion time of fecal nucleic acid,length of hospital stay,and inflammatory markers(leukocyte count,and lymphocyte count and percentage)were analyzed to observe the impact of early TCM interventions on these groups.Results:The median conversion times of pharyngeal swab nucleic acid in the three groups were 5.5,7 and16 d(P<0.001),with TCM1 and TCM2 being statistically different from TCM3(P<0.01).TCM1(P<0.05)and TCM3(P<0.01)were statistically different from TCM2.The median conversion times of fecal nucleic acid in the three groups were 7,9 and 17 d(P<0.001).Conversion times of fecal nucleic acid in TCM1 were statistically different from TCM3 and TCM2(P<0.01).The median lengths of hospital stay in the three groups were 13,16 and 21 d(P<0.001).TCM1 and TCM2 were statistically different from TCM3(P<0.01);TCM1 and TCM3 were statistically different from TCM2(P<0.01).Both leucocyte and lymphocyte counts increased gradually with an increase in the length of hospital stay in TCM1 group patients,with a statistically significant difference observed at each time point in the group(P<0.001).Statistically significant differences in lymphocyte count and percentage in TCM2(P<0.001),and in leucocyte count(P=0.043)and lymphocyte count(P=0.038)in TCM3 were observed.The comparison among the three groups showed a statistically significant difference in lymphocyte percentage on the third day of admission(P=0.044).Conclusion:In this study,it was observed that in COVID-19 patients treated with a combination of Chinese and Western medicines,TCM intervention earlier in the hospital stay correlated with faster conversion time of pharyngeal swab and fecal nucleic acid,as well as shorter length of hospital stay,thus helping promote faster recovery of the patient.The underlying mechanism of action may be related to improving inflammation in patients with COVID-19.

Relationship between intubation rate and continuous positive airway pressure therapy in the prehospital setting

BACKGROUND: To determine whether the prehospital use of continuous positive airway pressure(CPAP) therapy is associated with a reduced rate of endotracheal intubation in patients with an acute respiratory disorder brought to the emergency department(ED).METHODS: We reviewed medical records of patients with acute respiratory distress who had been treated with CPAP in the Mobile Intensive Care Unit(MICU) from January 2010 to December 2011. These records were compared with those of patients who received standardized care without CPAP in the MICU from January 2004 to December 2004. Categorical variables were summarized as frequencies and compared between groups using Fisher's exact test or the Chi-square test. Continuous variables were summarized as medians(interquartile range), and comparison between the groups was made using Wilcoxon's rank-sum test. The relationship between CPAP and intubation rate was determined using multivariable logistic regression analysis of propensity scores. The results were presented as odds ratio(OR), 95% confidence interval(CI), and P value for test effect. The adequacy of the model was calibrated using Hosmer and Lemeshow's goodness-of-fit test. P<0.05 was considered statistically significant.RESULTS: The records of 785 patients were reviewed. Of the 215 patients treated with CPAP in the MICU, 13% were intubated after admission. In contrast, of the 570 patients who did not receive CPAP, 28% were intubated after ED admission. Unadjusted logistic regression analysis showed that patients who had been treated with CPAP were less likely to be intubated than those without CPAP treatment(OR=0.37, 95% CI, 0.24–0.57, P<0.0001). With propensity scores adjusted, multivariate logistic regression analysis showed that CPAP treatment was associated with a 62% reduction of intubation(OR=0.384, 95%CI, 0.25–0.60, P≤0.0001).CONCLUSIONS: In patients with acute respiratory disorder, there was a relationship between CPAP therapy and the decreased intubation rate. CPAP therapy was feasible in prehospital management of patients with respiratory distress.

Early intervention promotes intellectual development of premature infants:a preliminary report

Objective To evaluate the effect of early intervention on the intellectual development of the premature infants Methods Premature infants at gestational age of 28-36 9 weeks were randomly divided into two groups: intervention and conventional care groups Normal newborn infants during the same period were included in the control group (routine care) Up to March 1996, 156 cases were over the age 1 5-2 years (corrected age), 52 in the intervention group, 51 in the conventional care group and 53 in the normal control group Parents were taught to carry out the 0-2 year intervention program, which included motor, cognitive, speech development and social behavior Every three months, height, weight and head circumference were measured At the age of one and a half and two years, all infants in the three groups received infant development tests of Child Development Center of China (CDCC) scale The examiner did not know which infant had received intervention Results There was no significant difference in biological factors among the two premature groups and in cultural and social factors among the three groups Intelligence tests at the age of one and a half and two years showed that the average mental development index (MDI) in the intervention group was 13 8 and 14 6 higher than those in the conventional care group and the differences were significant The psychomotor development index (PDI) was 5 2 and 4 7 higher but the differences were not significant The MDI and PDI in the intervention group and normal control were quite close, but at two years, the MDI and PDI in the intervention group were 5 7 and 7 3 higher than those in the normal control and the differences were significant (P<0 05) Compared with the normal control, the MDI in conventional care group at one and a half and two years of age were 11 5 and 8 9 lower The difference was very significant There were four cases of mental retardation, whose mental development index (MDI) was less then 70 in the conventional care group, but none in the intervention group Conclusions Early intervention can promote intellectual development of the premature infants and may be beneficial to the prevention of mental retardation Early and intensive intervention can produce better results Bringing parent's initiative into full play through deepening their understanding of the importance of early intervention is the key to success