ABSTRACT
Objective:To analyze the risk factors of bronchopulmonary dysplasia(BPD)in very preterm infants(VPI), and to provide scientific basis for the prevention and treatment of BPD in VPI.Methods:A prospective multicenter study was designed to collect the clinical data of VPI in department of neonatology of 28 hospitals in 7 regions from September 2019 to December 2020.According to the continuous oxygen dependence at 28 days after birth, VPI were divided into non BPD group and BPD group, and the risk factors of BPD in VPI were analyzed.Results:A total of 2 514 cases of VPI including 1 364 cases without BPD and 1 150 cases with BPD were enrolled.The incidence of BPD was 45.7%.The smaller the gestational age and weight, the higher the incidence of BPD( P<0.001). Compared with non BPD group, the average birth age, weight and cesarean section rate in BPD group were lower, and the incidence of male infants, small for gestational age and 5-minute apgar score≤7 were higher( P<0.01). In BPD group, the incidences of neonatal respiratory distress syndrome(NRDS), hemodynamically significant patent ductus arteriosus, retinopathy of prematurity, feeding intolerance, extrauterine growth restriction, grade Ⅲ~Ⅳ intracranial hemorrhage, anemia, early-onset and late-onset sepsis, nosocomial infection, parenteral nutrition-associated cholestasis were higher( P<0.05), the use of pulmonary surfactant(PS), postnatal hormone exposure, anemia and blood transfusion were also higher, and the time of invasive and non-invasive mechanical ventilation, oxygen use and total hospital stay were longer( P<0.001). The time of starting enteral nutrition, cumulative fasting days, days of reaching total enteral nutrition, days of continuous parenteral nutrition, days of reaching 110 kcal/(kg·d) total calorie, days of reaching 110 kcal/(kg·d) oral calorie were longer and the breastfeeding rate was lower in BPD group than those in non BPD group( P<0.001). The cumulative doses of amino acid and fat emulsion during the first week of hospitalization were higher in BPD group( P<0.001). Multivariate Logistic regression analysis showed that NRDS, invasive mechanical ventilation, age of reaching total enteral nutrition, anemia and blood transfusion were the independent risk factors for BPD in VPI, and older gestational age was the protective factor for BPD. Conclusion:Strengthening perinatal management, avoiding premature delivery and severe NRDS, shortening the time of invasive mechanical ventilation, paying attention to enteral nutrition management, reaching whole intestinal feeding as soon as possible, and strictly mastering the indications of blood transfusion are very important to reduce the incidence of BPD in VPI.
ABSTRACT
Objective: To compare the urinary neutrophil gelatinase-associated lipocalin (NGAL) levels in the acute kidney injury (AKI) and non-AKI premature infants, and to explore the clinical value of NGAL level in the early diagnosis of AKI. Methods: A total of 85 premature infants were divided into AKI group (n=30) and non-AKI group (n=55) according to whether AKI occurred. The levels of urinary NGAL were detected by enzymelinked immunosorbent assay (ELISA) method at 24, 48, 72, 120, and 168 h after birth. The levels of serum creatinine (Scr) of preterm infants were detected by dry chemical method. The receiver operation characteristics (ROC) curve is used to judge the diagnostic value of each indicator. Results: There were no significant differences in gender, gestational ages, body weights at birth, ages at NICU of the premature infants between two groups (P> 0. 05). There were significant differences in the urinary NGAL levels of the premature infants between two groups at different time points (F=62. 710, P<0. 01); the urinary NGAL level was increased at 24 h after birth, reached the highest peak at 72 h afger birth, and decreased from 72 h after birth. The urinary NGAL levels of the premature infants in AKI group were higher than those in non-AKI group at 24, 48, 72 and 120 h after birth (P< 0. 05). There were statistically significant differences in the Scr levels of the pretmature infants between two groups at different time points (F=27. 332, P<0. 05). The Scr levels of the premature infants in AKI group were higher than those in non-AKI group at 48, 72 and 120 h after birth (P<0. 05). The area under ROC curve (AUC) of urinary NGAL level at 24 after birth was significantly greater than that of Scr level (P<0. 01). When the cutoff value of urinary NGAL level was 6. 95 ng middot; dL-1, the sensitivity and specificity of urinary NGAL level in diagnosis of AKI were 0. 900 and 0. 836, respectively. Conclusion: The level of urinary NGAL can effectively predict the AKI in the premature infants.
ABSTRACT
Objective To study the correlation of the level of high-sensitivity C-reactive protein (Hs-CRP) in the acute phase of ischemic stroke and progressive stroke. Methods 101 patients with acute ischemic stroke were collected. Serum Hs-CRP of all patients were measured at 24 hours after admission , the onset of 48 hours, the onset of 72 hours by latex enhanced immune turbidity method. According to their serum Hs-CRP lev-els, the patients were divided into the group of Hs-CRP sustained growth (n = 35) and the group of non Hs-CRP sustained growth (n = 66). The NIHSS scores were assessed on two groups of patients , Logistic regression analysis was made to screen the related factors of Hs-CRP increase and the possible risky factors for progressive ischemic stroke. Results There was a significant difference of serum Hs-CRP level between the two groups (P <0.001). The incidence of progressive stroke in the group of Hs-CRP sustained growth was significantly higher than that in the group of non Hs-CRP sustained growth (χ2 = 32.710, P < 0.001). Logistic regression analysis showed blood glucose , white blood cell count , triglyceride level and NIHSS scores at admission were associated with sustained growth of Hs-CRP and the factors that they included Hs-CRP sustained growth , admission NIHSS scores, diabetes mellitus and pulmonary infection were regarded as independent risk factors. Conclusion The sustained growth of Hs-CRP in the acute phase of ischemic stroke is an independent predictor of progressive stroke.
ABSTRACT
Resistin is a recently discovered polypeptide hormone.Studies have shown that resistin is closely associated with atherosclerosis by promoting inflammatory response and adhesion of vascular endothelial cells,transformation from macrophages to foam cells,vascular smooth muscle cell proliferation and migration,increasing plaque instability,as well as promoting carbohydrate and lipid metabolism disorders,etc.Resistin can promote the occurrence and development of ischemic cerebrovascular disease.It may become a potential biological marker and intervention target.
ABSTRACT
Objective To assess the ability of ABCD3-Ⅰ score in evaluating the early risk of cerebral infarction after transient ischemic attack ( TIA ).Methods A total of 107 TIA patients were evaluated according to ABCD2,ABCD3 and ABCD3-Ⅰ criteria.The occurrences of cerebral infarction within 2 days and 7 days were observed.Results The AUCRoc of ABCD2,ABCD3 and ABCD3-Ⅰ were 0.61,0.66 and 0.71 in predicting the risk of cerebral infarction within 2 days,and were 0.62,0.68 and 0.74 in predicting within 7 days,respectively.Among 107 patients with TIA,13 evolved into cerebral infarction within 2 days,accounting for 12.1％,and 24 within 7 days,accounting for 22.4％.According to ABCD3-Ⅰ criteria,17 patients were of low risk scored 0-3 ; 54 patients were of medium risk scored 4-7 ; and 36 patients were of high risk scored 8-13.The different incidence of cerebral infarction after TIA was related to ABCD3-Ⅰ score:the higher the score was,the higher incidence was.Except for age factor,every score item of ABCD3-Ⅰ display obvious influence to the occurrence of cerebral infarction within 2 days and 7 days after TIA (P ＜ 0.05 ).Conclusion ABCD3-Ⅰ criteria could more effectively predict the occurrence of early risk of cerebral infarction after TIA,which could be used in regular clinical practice for assistance in TIA risk stratification and treatment.
ABSTRACT
In recent years,two important component proteins of the calcium release-activated calcium channel (CRAC) were identified fromDrosophila cells by RNA interference technique,including the calcitum sensor stromal interaction molecule 1 (STIM1) on the endoplasmic reticulum and the CRAC channel protein Orail on the cell membrane.Studies have shown that STIM 1 and Orail have regulatory effects on vascular smooth muscle cells,platelets,vascular endothelial cells and other cells.They play important roles in the aspects of vascular smooth muscle cell phenotypic modulation,hemostasis,thrombosis,and neovascularization.It shows that they both may be closely associated with ischemic cerebrovascular disease.This article reviews the advances in research on STIM1 and Orail proteins in ischemic cerebrovascular disease in order to investigate the possibility of STIM1/Orai1 as a new target in the prevention andtreatment of ischemic cerebrovascular
ABSTRACT
Objective To study the correlation of the changes of routine coagulation index and D-dimmer(D-D) with postpartum hemorrhage. Methods 37 patients with postpartum hemorrhage were divided into 2 groups ac-cording to the quantity of bleeding(group 1,27 patients, postpartum hemorrhage 500 ～ 800ml; group 2,10 patients, postpartum hemorrhage more than g00ml) and 30 patients with normal deliveries as control. Routine congulation in-dex, activated partial thromboplastin time(APIT) ,prothrombin time(PT) ,thrombin time(13") ,fibrinogen(Fg) and D-D were detected during the end of delivery and 48 hours after delivery. Results Compare with control group at the end of the delivery in group 1 ,the D-D was remarkably increased (P<0.05) ,but there was no significant difference of the routine coagulation index compared with control group (P > 0.05), in group 2, the D-D, PT, APTT were in-creased, whereas the Fg was decreased (P < 0.05). 48 hours after delivery, compared with control group,the D-D was significantly higher(P < 0.05), whereas the routine coagulation index had no significant difference (P > 0.05). The lowering of D-D, increase of Fg were higher in group 2 than those in group 1 (P < 0.05). Conclusion It has impor-tant clinical significance to timely monitor routine coagulation index and D-D at the end of delivery and after delivery for understanding the coagulation function of parturient and preventing disseminated intravascular coagulation.
ABSTRACT
Objective To explore the correlation between brain natriuretic peptide (BNP) and cerebral vasospasm (CVS) following subarachnoid hemorrhage (SAH) and hyponatremia. Methods Plasma BNP levels and serum natrium were assessed at 4 different time periods (1 to 3 days, 4 to 6 days, 7 to 9 days, and 10 to 12 days after SAH) in 30 patients with SAH. Correlation analysis was carried out between plasma BNP and blood sodium level. Plasma BNP levels were compared according to patients with or without CVS, and with or without symptom. The plasma BNP levels of 18 healthy controls were measured meanwhile.Results Plasma BNP levels in SAH patients were significantly elevated compared with control subjects ( P