摘要:目的：觀察小兒反復性肺炎的發生與血微量元素的關系。方法:選擇56例反復性肺炎患兒為觀察組，與60例健康兒童作對照，分別測定血鎘、鉛、銅、鋅、鈣、鎂、鐵含量。結果:56例反復性肺炎患兒血鋅、鐵含量較對照組減低，差異有統計學意義（Plt;0.05）。結論:部分反復性肺炎的發生與血微量元素鋅、鐵缺乏有關。應對反復性肺炎患兒常規行血微量元素檢測，對血微量元素缺乏者應予相應補充治療。Abstract: Objective: To observe the relationship to the occurrence of repeated pneumonia and the microelement in blood. Methods: We chose the 56 infant patients who suffered from repeated pneumonia as the observe group while the 60 health infants as the comprise group, then test the content of cadmium， plumbum， cuprum， zinc， calcium， magnesium and ferrum in blood. Results: The content of zinc and ferrum in the patient’s blood was lower than the comparison group, and the P value was Plt;0.01 and Plt;0.05 respectively, there was obvious differentiation between the two groups. Conclusion: Occurence of part repeated pneumonia is related to the deficiency of the microelements zinc and ferrum in blood. We should detect the common content of microelement to the infant patients who suffer the repeated pneumonia, and give a complement treatment to the microelements’ deficiency infant patients.
Objective?To investigate the role of low-dose heparin added to total nutrient admixture (TNA) solutions in the prevention of catheter related infections (CRIs). Methods?One-hundred three newborn infants with periph-erally inserted central catheter (PICC) were divided into heparin group (n=63) and control group (n=40). The patients in the heparin group received TNA with 0.5 U/ ml heparin. The patients in the control group received TNA without heparin. We retrospectively analyzed the incidence of CRTs in the two groups. Results?We found that the incidence of CRIs was 0 in the heparin group and 12.5% (5/40) in the control group. The incidence of catheter obstruction was 6.3% (4/63) in the heparin group and 20% (8/40) in the control group. The incidence of catheter-tip colonization was 1.58% (1/40) in the heparin group and 17.5% (7/40) in the control group. The incidences of CRIs, catheter obstruction, and catheter-tip colonization were signiicantly lower in the heparin group than those in the control group (Plt;0.05). Conclusion?TNA solutions with 0.5U/ml heparin have decreased catheter obstruction and CRIs.
Bronchopulmonary dysplasia (BPD) and retinopathy of prematurity (ROP) are common and critically important diseases of preterm infants. The common feature of both conditions is altered angiogenesis and pathological changes in the case of incomplete organ development. The interaction of multiple factors leads to abnormal angiogenesis, which not only increases the possibility of comorbidity of BPO and ROP, but also reveals the potential co-pathogenesis between the two. However, the specific mechanism of this angiogenic balance in the occurrence and development of BPD or ROP is still unclear, and there are no animal models to explore the pathogenesis of both diseases. At present, effective prevention measures for BPO and ROP are still lacking, and treatment methods mainly rely on drug therapy and surgery. In the future, more studies should be conducted to find common therapeutic targets for factors affecting angiogenesis, so as to provide better treatment options for BPD and ROP and improve the effectiveness of treatment.
Objective To assess the growth station, the upper respiratory infection frequency and consultation frequency of the geographically defined high risk neonatal population at 1-year-old based on both birthweight and gestational age. Methods All infants admitted in our hospital from May in 2008 to May in 2009 were divided into three groups according to gestational age and birth weight, that were, group 1: born lt;32 completed gestational weeks and weighing ≥1 500 g; group 2: born after 32 completed gestational weeks and weighing lt;1 500 g; and group 3: born lt;32 completed gestational weeks and weighing lt;1 500 g. Information at 12 months corrected age about growth, the upper respiratory infection frequency and consultation frequency was collected. Results The growth rate of weight and head circumference in group 3 were lower than that in group 1, and the length growth rate was lower than that in group 1 and group 2. Infants in group 3 suffered from more airway infections (median: 15.5) than in group 1 (12.5) and group 2 (8.5). Infants in group 3 needed more medical consultations (median: 27.5) than those in group 1(17.5) and group 2 (15.5). Conclusions This study gives estimates for growth outcome, airway infection and consultation frequency at 12 months corrected age for very low birthweight infants (lt;1 500 g) and for very preterm infants (lt;32 completed gestational weeks). Gestational age and birth weight are the same important for predicting infants’ outcome and should therefore be integrated into clinical statistics.
摘要:目的: 探討如何提高早產兒存活率和生存質量。 方法 :對我院新生兒病房收治的228例早產兒的臨床資料進行了回顧分析。 結果 :引起早產的母親因素以胎膜早破、妊娠期膽汁淤積綜合征及妊娠合并高血壓綜合征為早產的重要因素,而引起早產兒常見疾病的是新生兒肺炎,高膽紅素血癥及新生兒窒息等。而呼吸衰竭、新生兒休克、多器官衰竭則是引起早產兒預后不良的重要因素。 結論 :早產原因以母體因素為主,故加強孕期保健,積極防治母親的有關并發癥,同時提高新生兒急救水平,早期干預,以提高早產兒的生存質量。Abstract: Objective: To exploere the ways of promoting the survival rate and the quality of life in premature infants. Methods :The clinical data on 228 cases of premature infants treated by neonatal wards were analyzed retrospectivelly. Results : The important factors of premature are cholestasis of pregnancy syndrome, premature rupture of membbranes, and hypertemsion in prefnancy. The commom diseases in premature infants are neonatal pnecemonia, hyperbilirubinemia and asphxia, the major factors in poor prognasis are caused by neonatal shock, multiple organ failure in premature infants. Conclusion :The main reasons of premature is maternal factors. It is important to strengthen the health care during pregnancy, control the complications of mothers actively, at the same time, improve the level of neonatal first aid, intervent early, so as to imprive the quality of life in preterm infants.
Objective
To summarize the clinical characteristics of coarctation of the aorta (CoA) associated with intracardiac anomalies in infants.
Methods
The data from August 2009 to August 2017 of 86 infants who were diagnosed with CoA associated with intracardiac anomalies were analyzed. Preoperative diagnosis, surgical findings and post-operation follow-up were analyzed retrospectively. There were 56 males and 30 females at age of 1–346 (95.1±78.0)d. All the included patients underwent single-stage repair of CoA associated with intracardiac anomalies.
Results
Mean operative time was 279.0±56.4 min, mean cardiopulmonary bypass time was 162.3±51.0 min, and mean aorta cross-clamp time was 74.7±25.2 min. Mean length of ICU stay and ventilation time was 7.4±4.7 days and 101.1±75.4 hours, respectively. The residual transcoarctation gradient before discharge was lower than pre-operative transcoarctation gradient significantly (42.3±17.7 mm Hg vs. 22.1±9.4 mm Hg, P<0.001), and 7 early deaths were observed after surgery. The mean follow-up time of 79 hospital survivors was 31.0±27.4 months. And no late death was found. Transcoarctation gradient of hospital survivors in the last time follow-up was 21.2±11.0 mm Hg. Transcoarctation gradient of 29 patients was higher than 20 mm Hg. However, only 4 patients with significant clinical symptom of lower limbs retardation were recommended for ballon angioplasty consultant. The cumulative recoarctation-free survival in 2-year follow-up was 69.2%.
Conclusions
To avoid early second-stage operations, single-stage repair of CoA associated with intracardiac anomalies is effective and safe, and the outcomes of early to mid term follow-up are satisfactory.
ObjectiveTo explore the influence of paternal serum HBV-DNA load levels and pregnant women's HBsAb on vertical transmission of hepatitis B virus (HBV) from HBsAg positive fathers to infants in order to provide effective methods for paternal-fetal ventrical transmission of HBV prevention.
MethodsUsing HBsAg and HBV-DNA as indicators to screen pregnant women and their husbands after gained consent, 121 families with HBVM negative or only HBsAb positive and HBV-DNA negative pregnant women, HBsAg positive husbands and their newborns were selected. In this case-control study, according to neonatal cord blood HBV-DNA detection, 23 newborns with cord blood HBV-DNA positive were selected as cases, 98 newborns as controls.
ResultsThe positive rate of neonatal cord blood HBV-DNA was 19.0% (23/121); and there was dose-response relationship between paternal serum HBV-DNA load levels and neonatal cord blood HBV-DNA positive (trend χ2=60.108, P=0.000). The analysis of ROC curve showed that paternal serum HBV-DNA load level (106 copies/mL) is a better demarcation point to forecast the occurrence of vertical transmission of HBV from HBsAg positive fathers to infants, because there was a better sensitivity and specificity during forecast; and HBsAb negative pregnant women's were statistically significant (χ2=12.399, P=0.000). There was no significant difference at the positive rate of neonatal cord blood HBV-DNA between the case group and control group when paternal serum HBV-DNA load levels exceed 107 copies/mL (P > 0.05).
ConclusionPaternal serum HBV-DNA load levels and HBsAb negative pregnant women are the risk factors of vertical transmission of HBV from HBsAg positive father to infants. Paternal serum HBV-DNA load level (106 copies/mL) is an appropriate index of the occurrence of vertical transmission.
We applied resting-state functional magnetic resonance imaging (rfMRI) combined with graph theory to analyze 90 regions of the infantile small world neural network of the whole brain. We tried to get the following two points clear:① whether the parameters of the node property of the infantile small world neural network are correlated with the level of infantile intelligence development; ② whether the parameters of the infantile small world neural network are correlated with the children's baseline parameters, i.e., the demographic parameters such as gender, age, parents' education level, etc. Twelve cases of healthy infants were included in the investigation (9 males and 3 females with the average age of 33.42±8.42 months.) We then evaluated the level of infantile intelligence of all the cases and graded by Gesell Development Scale Test. We used a Siemens 3.0T Trio imaging system to perform resting-state (rs) EPI scans, and collected the BOLD functional Magnetic Resonance Imaging (fMRI) data. We performed the data processing with Statistical Parametric Mapping 5(SPM5) based on Matlab environment. Furthermore, we got the attributes of the whole brain small world and node attributes of 90 encephalic regions of templates of Anatomatic Automatic Labeling (ALL). At last, we carried out correlation study between the above-mentioned attitudes, intelligence scale parameters and demographic data. The results showed that many node attributes of small world neural network were closely correlated with intelligence scale parameters. Betweeness was mainly centered in thalamus, superior frontal gyrus, and occipital lobe (negative correlation). The r value of superior occipital gyrus associated with the individual and social intelligent scale was -0.729 (P=0.007); degree was mainly centered in amygdaloid nucleus, superior frontal gyrus, and inferior parietal gyrus (positive correlation). The r value of inferior parietal gyrus associated with the gross motor intelligent scale was 0.725 (P=0.008); efficiency was mainly centered in inferior frontal gyrus, inferior parietal gyrus, and insular lobe (positive correlation). The r value of inferior parietal gyrus associated with the language intelligent scale was 0.738 (P=0.006); Anoda cluster coefficient (anodalCp) was centered in frontal lobe, inferior parietal gyrus, and paracentral lobule (positive correlation); Node shortest path length (nlp) was centered in frontal lobe, inferior parietal gyrus, and insular lobe. The distribution of the encephalic regions in the left and right brain was different. However, no statistical significance was found between the correlation of monolithic attributes of small world and intelligence scale. The encephalic regions, in which node attributes of small world were related to other demographic indices, were mainly centered in temporal lobe, cuneus, cingulated gyrus, angular gyrus, and paracentral lobule areas. Most of them belong to the default mode network (DMN). The node attributes of small world neural network are widely related to infantile intelligence level, moreover the distribution is characteristic in different encephalic regions. The distribution of dominant encephalic is in accordance the related functions. The existing correlations reflect the ever changing small world nervous network during infantile development.
Objective To explore the risk factors of premature infants death. Methods The medical records of hospitalized premature infants admitted to West China Second University Hospital of Sichuan University between January 2015 and December 2022 were collected. Premature infants were divided into the death group and the non-death group (control group) based on discharge diagnosis of death. Parturient and premature infants related information were collected, and the disease classification and diagnosis of premature infants were analyzed. Results A total of 13 739 premature infants were included, with 53 deaths and a mortality rate of 3.85‰ (53/13 739). The ages of death were 1-49 days, and the median age of death was (9.68±9.35) days. According to the matching method, 212 premature infants were ultimately included. Among them, there were 53 premature infants in the death group and 159 premature infants in the control group. Compared with the control group, premature infants in the death group had lower gestational age, birth weight, lower 1-minute Apgar scores, lower 5-minute Apgar scores and shorter hospital stay (P<0.05), and received more delivery interventions (P<0.05). There was no statistically significant difference in other indicators between the two groups of premature infants (P>0.05). A total of 212 parturient were included. Among them, there were 53 parturients in the death group and 159 parturients in the control group. The use rate of prenatal corticosteroids in the control group was higher than that in the death group (55.35% vs. 54.72%). There was no statistically significant difference in other related factors between the two groups of parturient (P>0.05). The results of logistic regression analysis showed that longer hospital stay [odds ratio (OR)=0.891, 95% confidence interval (CI) (0.842, 0.943), P<0.001], prenatal use of corticosteroids [OR=0.255, 95%CI (0.104, 0.628), P=0.003] reduced the risk of premature infant death. However, tracheal intubation [OR=10.738, 95%CI (2.893, 39.833), P<0.001] increased the risk of premature infant death. Conclusions Clinicians should pay attention to prenatal examination of newborns and pay attention to evaluation of newborn status. Obstetricians and neonatologists should make joint plans for women with high risk factors for preterm delivery. During the hospitalization, after the diagnosis is clear, standardized treatment should be carried out in strict accordance with the guidelines for systemic diseases and expert consensus.
ObjectiveTo systematically review the efficacy and safety of ibuprofen for premature infants with patent ductus arteriosus.
MethodsDatabases including PubMed, Ovid-EMbase, The Cochrane Library (Issue 11, 2014), CNKI, WanFang Data and VIP were searched to collect randomized controlled trials (RCTs) and quasi-RCTs about ibuprofen for premature infants with patent ductus arteriosus from inception to December 2014. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then meta-analysis was conducted by RevMan 5.3 software.
ResultsA total of 37 RCTs, involving 2 370 patients were included. The results of meta-analysis showed that, compared with the placebo/blank group, ibuprofen could increase the closure rate of PDA (LBWI:RR=1.93, 95%CI 1.25 to 2.99，P=0.003; VLBW:RR=1.23, 95%CI 1.02 to 1.48, P=0.03; ELBWI:RR=2.86, 95%CI 1.51 to 5.41, P=0.001) and decrease the incidence of sepsis (VLBW:RR=0.21, 95%CI 0.07 to 0.64，P=0.006); Compared with the indometacin groups, ibuprofen could decrease the incidence of the increase of serum creatinine (LBWI:RR=0.11, 95%CI 0.04 to 0.37, P=0.000 2), NEC (LBWI, RR=0.52, 95%CI 0.29 to 0.95, P=0.03) and oliguria (LBWI: RR=0.30, 95%CI 0.16 to 0.56, P=0.000 2; VLBW:RR=1.40, 95%CI 1.03 to 1.92, P=0.03); Compared with the intravenous ibuprofen, Oral ibuprofen could increase the closure rate of PDA (VLBW: RR=1.35, 95%CI 1.12 to 1.62, P=0.002; ELBWI, RR=1.42, 95%CI 1.07 to 1.87, P=0.01).
ConclusionCurrent evidence shows that there is not indeterminate between ibuprofen and paracetamol groups. Compared with other general drugs, ibuprofen has an advantage over curing PDA and obviously reduces side effects. Due to the limited quality and quantity of included studies, more high quality studies are needed to verify the above conclusion.
