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Objective:To study the clinical characteristics and imaging features of neonatal ovarian cysts and to analyze treatment and prognosis of ovarian torsion.Methods:From January 2011 to December 2021,neonates with ovarian cysts admitted to the department of neonatology and pediatric surgery of our hospital were retrospectively studied. They were assigned into ovarian torsion group and non-torsion group. Their clinical manifestations, imaging features, pathological results, treatment and prognosis were reviewed and compared.Results:A total of 44 neonates with ovarian cysts were included, all without specific clinical manifestations. 10 neonates were treated with conservative therapy and 34 received surgery. Ovarian torsion were confirmed during surgery in 23 patients. All 34 patients received abdominal ultrasound preoperatively and 31 (91.2%, 31/34) were diagnosed with ovarian cysts. The accuracy rates of ultrasound for cyst location and ovarian torsion were 85.3% (29/34) and 82.6% (19/23),respectively. 30 patients received abdominal CT scan and 23 (76.7%, 23/30) were diagnosed with ovarian cysts. The accuracy rates of CT scan for cyst location and ovarian torsion were 53.3% (16/30) and 47.8% (11/23), respectively. Among the 34 patients treated with surgery, ovarian cyst dissection was performed in 11 patients and cyst resection in 23 patients with torsion necrosis. 24 patients had simple cysts including 15 torsion necrosis (62.5%, 15/24) and 10 had complicated cysts including 8 torsion necrosis(80.0%, 8/10). The average diameter of ovarian cysts was significantly larger in the torsion group [(8.4±1.6) cm] than the non-torsion group [(4.7±1.2) cm] ( P<0.05). Conclusions:Neonatal ovarian cysts are mostly unilateral without specific clinical manifestations. Large, bilateral and complex cysts are prone to torsion necrosis. Abdomen ultrasound has advantages than CT scan for the localization of the ovarian cyst and diagnosis of ovarian torsion. Surgical treatment is necessary after diagnosis.
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Objective To investigate the protective effect of caffeine citrate on white matter damage in 2-day-old neonatal rats induced by postnatal infection.Methods Forty-eight 2-day-old SD rats were randomly divided into the control group (group A,n =16),lipopolysaccharide(LPS) infection group (group B,n =16),and caffeine citrate intervention group (group C,n =16) according to the random table method.The newborn rats of group B and C were continuously injected LPS 0.6 mg/kg intraperitoneally for 5 days from 2 days old,and the newborn rats of group A were continuously injected by an equal volume of 9 g/L saline intraperitoneally.Group C was continuously injected by caffeine citrate 10 mg/kg intraperitoneally for 7 days from 4 days old;equal volume of 9 g/L saline was injected into group A and B for 7 days continuously.At 12 days old,8 rats of each group were sacrificed randomly to evaluate the expression of myelin basic protein(MBP) subcortical white matter by immunohistochemical method.Both sides of hippocampus of the rest 8 rats of each group were taken out in ice surface rapidly.The left hippocampus was used to detect the expression of MBP and Caspase-3 by Western blot method,and the right hippocampus was used to evaluate the MBP and Caspase-3 protein level by quantitative real-time PCR(qPCR) method.Results The mean integral optical density (IOD) of subcortical MBP positive expression in group A,group B and group C were 132.64 ± 1.94,102.43 ± 2.12,114.25 ± 2.04,and the difference was statistically significant among 3 groups (F =22.912,P ＜ 0.05).The relative expression levels of MBP mRNA of 3 groups in hippocampus were 0.79 ± 0.01,0.39 ± 0.03,0.55 ± 0.02,and the difference was statistically significant among 3 groups (F =18.584,P ＜ 0.05).The relative expression levels of MBP protein of 3 groups in hippocampus were 0.64 ± 0.03,0.31 ± 0.03,0.51 ± 0.05,and the difference was statistically significant among 3 groups (F =25.780,P ＜ 0.05).The relative expression levels of Caspase-3 mRNA of 3 groups in hippocampus were 0.34 ± 0.02,0.74 ± 0.03,0.57 ± 0.04,and the difference was statistically significant among 3 groups (F =6.105,P ＜ 0.05).The relative expression of Caspase-3 protein of 3 groups in hippocampus were 0.11 ± 0.03,0.36 ± 0.02,0.23 ± 0.03,and the difference was statistically significant among 3 groups (F =40.541,P ＜ 0.05).Conclusions Caffeine citrate has showed protective effect on white matter damage in neonatal rats of 2 days old induced by postnatal infection.The mechanism may be related to inhibition of inflammatory response and reducing apoptosis.
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Objective To explore the perinatal risk factors and clinical characteristics of complications of early term neonates.Methods Data of 5 468 live term newborns and their mothers hospitalized in the Third Affiliated Hospital of Zhengzhou University from January 2013 to December 2013 were analyzed.Background information,morbidity and complications of the mothers were compared among early,full and late term groups (n=l 933,3 013,412,respectively).And background information and incidence of complications were also investigated among neonates of early,full and late term groups (n=2 033,3 023,412,respectively),and neonates born between 37-37+6 (n=695) and 38-38+6 weeks (n=1 338).One-way analysis of variance,LSD-t test,logistic regression analysis,Chi-square or Fisher exact test,Pearson Chi-square test,corrected Chi-square test were used for statistical analysis.Results 1.Comparison among the early,full and late term group showed that higher proportions of elder gravida [21.1％(407/1 933),10.5％(317/3 013),6.8％(28/412),x2=127.690],multipara [43.7％(844/1 933),23.1％(697/3 013),15.0％(62/412),x2=287.765],scarred uterus [27.9％(539/1 933),8.9％(267/3013),1.5％(6/412),x2=396.521],higher incidence of cesarean section [75.2％(1 453/1 933),56.2％(1 693/3 013),54.1％(223/412),x2=196.348],hypertensive disorder complicating pregnancy [9.2％(178/1 933),3.5％(105/3 013),2.9％(12/412),x2=79.915],multiple pregnancy[5.1％(99/1 933),0.3％(9/3 013),0.0％(0/412),x2=147.860],gravidity＞1[63.1％(1 220/1 933),47.3％(1 425/3 013),39.6％(163/412),x2=147.668],premature rupture of fetal membranes[20.6％(398/l 933),14.2％(428/3 013),10.2％(42/412),x2=47.217],abnormal amniotic fluid[17.8％(344/1 933),12.3％(370/3 013),11.2％(46/412),x2=32.777],gestational diabetes mellitus[11.5％(223/1 933),5.9％(178/3 013),5.1％(21/412),x2=56.169],abnormal presentation [9.5％(184/1 933),5.1％(155/3 013),2.9％(12/412),x2=43.511],abnormal placenta [7.6％(146/1 933),3.1％(92/3 013),2.7％(11/412),x2=57.739],hysteromyoma[4.9％(94/1 933),2.3％(68/3 013),0.7％(3/412),x2=35.062] in the early term group than in the full and late term group,respectively (all P＜0.016).Multivariate logistic analysis showed that multiple pregnancy (OR=21.736,95％CI:10.785-43.806),scarred uterus (OR=3.302,95％CI:2.679-4.071) and hypertensive disorder complicating pregnancy(OR=2.658,95％CI:2.040-3.465) were the leading three perinatal risk factors for early term delivery.2.The incidence of the following neonatal conditions were different among early,full and late term infants (all P＜0.05):hyperbilirubinemia [12.5％(255/2 033),3.9％(119/3 023),4.9％(20/412),x2=138.343],infectious diseases [4.3％(88/2 033),2.0％(59/3 023),1.7％(7/412),x2=27.122],asphyxia[3.0％(60/2 033,1.4％(42/3 023),1.0％(4/412),x2=17.795],brain damage [2.3％(46/2 033),0.5％(15/3,023),10.％(4/412)],respiratory distress syndrome [1.1％(23/2 033),0.2％(7/3 023),0.0％(0/412)],feeding problems [2.0％(41/2 033),0.3％(10/3 023),1.0％ (4/412)],surgical diseases[2.0％(41/2 033),0.9％(28/3 023),1.5％(6/412),x2=0.709],intracranial hemorrhage [1.9％(39/2 033),0.9％(26/3 023),0.5％(2/412),x2=13.263],wet lung [0.9％(19/2 033),0.4％(11/3 023),0.5％(2/412)].Incidences of the above complications in the early term infants were all higher than in the full term infants,but when compared with the later term infants,only that of hyperbilirubinemia and infectious diseases was higher (all P＜0.016).Incidence of admission ot NICU [24.5％(170/695) vs 11.5％(153/1 338),x2=57.729],hyperbilirubinemia [19.0％(132/695) vs 9.2％(123/1 338),x2=40.046],infectious diseases[6.2％(43/695) vs 3.4％(45/1 338),x2=8.807],brain damage[4.0％(28/695) vs 1.3％(18/1 338),x2=14.828],and NRDS[2.0％(14/695) vs 0.5％(9/1 338),x2=7.329],feeding problems [3.2％(22/695) vs 1.5％(20/1 338),x2=6.271],intracranial hemorrhage [3.2％(22/695) vs 1.3％(17/1 338),x2=8.684],wet lung [1.7％(12/695) vs 0.5％(7/1 338),x2=7.049] of the early term infants born at 37-37+6 weeks were all higher than those born at 38-38+6 weeks(all P＜0.05).Conclusions Multiple pregnancy,scarred uterus and hypertensive disorder of pregnancy are the three leading perinatal risk factors of early term delivery.The incidence of neonatal complications among early term infants are higher than those among full term infants,and early term infants are more likely to stay in NICU.We should take preventive measures to decrease the rate of early term delivery and improve the follow-up management of early term infants.
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ObjectiveTo investigate the effects of caffeine citrate (CC) on the neuronal proliferation and apoptosis and long-term learning ability in neonatal rats with hypoxia-ischemic brain damage (HIBD).MethodsForty-eight 7-day-old Sprague-Dawley neonatal rats were randomly divided into 3 groups: sham operation group (n=16), HIBD group (n=16), HIBD + caffeine citrate group (CC group,n=16). Rats in HIBD and CC groups received ligation of left common carotid artery followed by 2 hours of hypoxia to establish HIBD model. Rats in CC group were injected intraperitoneally with CC (20 mg/kg) before and at 0 min, 24 h, 48 h, and 72 h after hypoxia-ischemic (HI), and rats in the other two groups were injected intraperitoneally with an equal volume of normal saline at the corresponding time. Meanwhile, from postnatal day 10, each rat was injected intraperitoneally with 5-bromo-2’-de-oxyuridine (BrdU) (50 mg/kg) for 5 consecutive times, once every 12 h. On postnatal day 12, BrdU in the hippocampal dentate gyrus and cleaved caspase-3 in the hippocampal CA1 area were detected by immunohistochemistry, and neuronal apoptosis in hippocampal CA1 area were detected by TUNEL staining. On postnatal day 28, long-term learning and memory ability of rats was tested by Y maze.ResultsThere was signiifcant difference in the number of BrdU-positive cells in brain tissues of rats among three groups (F=101.38,P<0.01). The BrdU-positive cells in HIBD group and CC group were signiifcantly more than those in sham operation group (P<0.05). There was signiifcant difference in the number of cleaved caspase-3-positive cells in hippocampal CA1 area among three groups (F=379.77,P<0.01). The cleaved caspase-3-positive cells in CC group were signiif-cantly fewer than those in HIBD group but signiifcantly more than those in sham operation group (P<0.05). The TUNEL-pos-itive cells in hippocampal CA1 area were signiifcantly different among three groups (F=505.92,P<0.01) which was most in HIBD group and fewest in sham operation group and signiifcant difference was found through multiple comparison (P<0.05). The total learning number of avoiding electric shock tested by Y maze was signiifcantly different among three groups (F=32.05, P<0.01) which was most in HIBD group. Correct response rate was significantly different among three groups (F=24.99, P<0.01) which was lowest in HIBD group.ConclusionsCaffeine citrate can improve the ability of long-term learning and memory in neonatal rats with hypoxia-ischemic brain damage, the mechanism of which may be related to reducing the neuronal apoptosis after hypoxia ischemia.