Dual X-Ray Image under Neural Network Adopted in Comparison of Efficacy and Safety of Deep Hydrolyzed Protein Milk Powder and Parenteral Nutrition in Intervention of Neonatal Noninfectious Abdominal Distension

Objective. The aim of this study was to explore the application value of double X-ray image based on neural network in comparison of the efficacy and safety of deep-water proteolytic milk powder and parenteral nutrition in the intervention of neonatal noninfectious abdominal distention. Methods. Clinical data of 58 neonates diagnosed with noninfectious abdominal distention were retrospectively analyzed. 2D-3D registration was simplified into two steps by decomposing spatial rigid-body transformation parameters into two planes, including 2D-2D approximate rigid-body registration and single-parameter 2D-3D rigid-body registration. Then, the convolution neural network was used to fit the nonlinear mapping relationship between the residual of X-ray images and the corresponding attitude differences of children, and the residual regression spatial rigid-body transformation parameters of the X-DRR image pairs were obtained. Noninfectious abdominal distention was diagnosed in all neonates, of which 28 neonates were treated with deep hydrolyzed protein milk powder. Another 30 neonates who received parenteral nutrition support were set as control group. All newborns received two weeks of treatment. The total effective rate, birth weight recovery, weight growth rate, intestinal feeding recovery time, and incidence of feeding intolerance were compared between the two groups. Results. Spatial coordinate decomposition using double X-ray can simplify the mapping relationship between spatial coordinate transformation and X-DRR residual image. Compared with the gray level iterative optimization registration algorithm, the registration accuracy and speed were significantly improved. The total effective rate in the treatment group (92.86%) was significantly higher than that in the control group (9%). The recovery time of birth weight, intestinal feeding recovery time, and meconium excretion time were significantly shorter than those in the control group, and the body weight in the treatment group increased faster than that in the control group ( P < 0.05 ). In addition, the incidence of feeding intolerance was 3.57% (1/28) in the treatment group and 36.36% (8/22) in the control group, which was significantly lower than that in the treatment group ( P < 0.05 ). Conclusion. After data training, the network can complete accurate double ray registration in 0.04 s. Deep hydrolyzed protein milk powder had remarkable therapeutic effect on neonates, with no infective abdominal distention, fast recovery, and low incidence of feeding intolerance, which was safe and reliable in clinical application.

Application Effect of Acupoint Massage on Zusanli on Premature Infants with Feeding Intolerance and Their Clinical Symptoms

FI is mainly caused by functional disturbance in premature infants, which greatly poses a threat to their growth and development, so a large number of studies on the clinical features of FI should be conducted to provide theoretical support for treatment. The purpose of the study was to investigate the therapeutic effect of acupoint massage on Zusanli on premature infants with feeding intolerance (FI) and their clinical symptoms. A total of 60 premature infants with FI admitted to our hospital over the past two years were selected as the FI group, and another 60 premature infants without FI were selected as the control group. The birthweight and gestational age of the premature infants in the FI group were significantly lower than those in the control group ( P < 0.001 ), whereas there were no significant differences in general information of the premature infants between the two groups ( P > 0.05 ). Vomiting, abdominal distension, and gastric retention are the main clinical symptoms of premature infants with FI, and acupoint massage on Zusanli combined with routine treatment can effectively improve digestive function, relieve clinical symptoms, and shorten treatment time of premature infants with FI, which is worthy of application and promotion in clinical practice.

Analysis on the Application Effect of Abdominal Acupoint Massage on Feeding Intolerance in Premature Infants

Objective. Breast milk is the best food for newly born infants because it is more digestible and can relieve infants’ gastrointestinal burdens. The purpose of this study was to investigate the application effect of abdominal acupoint massage on feeding intolerance in premature infants. Methods. A total of 50 premature infants with feeding intolerance admitted to our hospital from January 2018 to October 2019 were selected and randomly divided into the control group (n = 25) and the experimental group (n = 25). Among them, the premature infants in the control group received routine therapy, while based on the treatment in the control group, the premature infants in the experimental group were treated with abdominal acupoint massage. After that, the incidence of feeding intolerance, MNA nutritional status score, body mass, development state, length of hospital stay, and response rate were all compared between the two groups to analyze the application effect of abdominal acupoint massage on feeding intolerance in premature infants. Results. The incidence of feeding intolerance of the premature infants in the experimental group was significantly lower than that in the control group, with statistically significant differences ( P < 0.05 ); the MNA nutritional status scores of the premature infants in the experimental group were significantly higher than those in the control group, with statistically significant differences ( P < 0.05 ); the body mass and development state of the premature infants in the experimental group were significantly better than those in the control group, with statistically significant differences ( P < 0.05 ); the length of hospital stay of the premature infants in the experimental group was significantly shorter than that in the control group, with statistically significant differences ( P < 0.05 ); the response rate in the experimental group was significantly higher than that in the control group, with statistically significant differences ( P < 0.05 ). Conclusions. Abdominal acupoint massage therapy can significantly reduce the incidence of feeding intolerance, shorten the length of hospital stay, and improve nutritional status, development state, and response rate in premature infants, with obvious therapeutic effect, which is worthy of application and promotion in clinical practice.

Dilemma in diagnosing Metabolic Disorder: A case of Galactokinase Deficiency with an unusual presentation

An infant with metabolic disorder can have vague presentations like repeated chest infections, feeding intolerance and failure to thrive. This may lead to a diagnostic dilemma. Detailed clinical history together with biochemical investigations are must to reach a diagnosis. Galactokinase Deficiency (GKD) has a varied presentation with some features like microcephaly, juvenile cataracts and failure to thrive. We encountered a case of GKD in an infant in which there was an absence of cataracts. Raised Immunoreactive Trypsinogen (IRT) in Newborn Screening was strongly suggestive of Cystic Fibrosis (CF), however Genetic Analysis revealed a heterozygous missense variation in EXON4 of the GALK1 GENE, confirming the diagnosis of GKD. Hence, this case highlights the importance of considering different metabolic disorders as differential diagnoses of one another even in absence of a typical feature of a particular disorder.

Preventive Strategies for Feeding Intolerance in Patients with Severe Traumatic Brain Injury in China: An Online Cross-Sectional Survey

Background The application of preventive strategies for feeding intolerance in severe traumatic brain injury (STBI) patients is discrepant among different hospitals. We aim to investigate the application status of preventive measures of feeding intolerance in China. Method A cross-sectional study was carried out among 996 clinicians and nurses working in intensive care units of 89 hospitals in China (response rate of 89.81%). Data were collected by means of an online survey. Descriptive statistics were used to analyze respondents’ characteristics and questionnaire responses. Results Clinicians and nurses usually applied several methods simultaneously to assess gastrointestinal functions and risk of feeding intolerance among STBI patients, including assessment scales, gastrointestinal symptoms, etc. Furthermore, initiating enteral nutrition (EN) within 24-48 hours (61.45%), < 500 ml initial volume of EN solution (50.00%), using non-nutritional preparations as initial EN formula (65.56%), nasogastric tube EN (91.16%), continuous feeding by pump (72.89%), 30°-45° of head-of-bed elevation during EN (89.46%), monitoring gastric residual volume by syringe (93.67%), assessing gastric residual volume every 4 hours (51.51%), EN solution temperature of 38℃-40℃ (65.46%), prokinetic agents (73.29%), enema (73.59%), probiotics (79.01%), and antacid agents (84.13%), were mostly applied strategies in clinical practice for preventing feeding intolerance among STBI patients. Conclusions The data from the survey showed that medical staffs in China are closely concerned with the gastrointestinal functions of STBI patients and EN delivery protocol, and have a positive attitude towards preventive strategies for feeding intolerance. Meanwhile, there are still many points need to be paid attention to and solved, and researchers, clinicians, nurses and dietitians should strengthen the cooperation to explore more valuable preventive strategies for feeding intolerance in STBI patients.