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Objective:To study the early effects of intact-umbilical cord milking (I-UCM) and cut-umbilical cord milking (C-UCM) for the prevention of anemia of prematurity in preterm infants.Method:From January 2019 to October 2019, C-section delivered infants with gestational age <34 weeks were randomly assigned into I-UCM group and C-UCM group. Hematological parameters at different timepoints after birth, iron status, incidence of anemia within 7 d after birth, blood transfusions, transcutaneous bilirubin levels and the total duration of phototherapy were collected and analyzed.Result:A total of 60 cases were enrolled, including 30 in I-UCM group and 30 in C-UCM group. I-UCM group had significant higher levels of hemoglobin (Hb), hematocrit (Hct) and serum iron on admission ( P<0.05). Comparing with C-UCM group, Hb and Hct were significantly higher in I-UCM group at 7 d and 14 d after birth ( P<0.05). Lower prevalence of anemia within 1 week [3.3% (1/30) vs. 33.3% (10/30), P<0.05] and less blood transfusions during hospitalization [13.3% (4/30) vs. 56.7% (17/30)] were noted in I-UCM group. No statistically significant differences existed between the two groups in phototherapy duration and the peak bilirubin levels ( P>0.05). Conclusion:I-UCM can provide more placental transfusion at birth to increase Hb levels and iron storage to prevent and reduce anemia in preterm infants.
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Objective To study the clinical features and risk factors of acute pulmonary reperfusion injury after operation in neonates with severe pulmonary stenosis or pulmonary atresia.Method From February 2014 to February 2018,a retrospective analysis was performed in patients with critical pulmonary stenosis or pulmonary atresia who received percutaneous balloon pulmonary valvuloplasty (PBPV) in the neonatal intensive care unit of our hospital.Clinical characteristics,perioperative cardiac structure,hemodynamic data and biochemical results were collected.The neonates were assigned into injury group if they had acute lung reperfusion injury,and non-injury group if not.The risk factors of acute lung reperfusion injury were analyzed using multi-variate Logistic regression model.Result A total of 32 patients (24 prenatal diagnosis and 8 postnatal diagnosis) with severe pulmonary stenosis or pulmonary atresia with intact ventricular septum were enrolled.The main manifestations were dyspnea and cyanosis.Intravenous prostaglandin E was administered to keep the ductus arteriosus open.The age of operation ranged from 1 to 52 days and the median age was 7.5 days.Postoperative acute lung reperfusion injury occurred in 7 cases (21.9％).Preoperative and intraoperative pulmonary valve annulus diameter,balloon diameter,preoperative hemoglobin,hematocrit and blood albumin were significantly lower in the injury group.The operation duration,total length of hospital stay and postoperative duration were longer than in the non-injury group,the differences were statistically significant (P ＜ 0.05).Multi-variate Logistic regression analysis showed that the diameter of pulmonary valve annulus (OR =5.814,95％CI 1.106 ～30.568),preoperative blood albumin (OR =1.361,95％ CI 1.063 ～ 1.742),and hematocrit (OR =1.173,95％ CI 1.010 ～ 1.363) were risk factors of acute lung reperfusion injury,with statistically significant differences (P ＜ 0.05).Conclusion Acute lung reperfusion injury is one of the common complications after the operation of severe pulmonary stenosis or pulmonary atresia.The severity of pulmonary valve annulus stenosis,preoperative hematocrit and blood albumin level may be the risk factors of postoperative acute lung reperfusion injury.
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Objective To study the differences of clinical manifestations,etiology and hospitalized outcomes of purulent meningitis in preterm and term infants.Method All preterm and term infants with purulent meningitis hospitalized in the Hospital from 2006 to 2015 were enrolled in this study.The data of neonate's condition,maternal condition,clinical manifestations,complications,etiology,treatment and outcomes of the preterm and term infants groups were compared.Result During the study period,44 preterm infants and 118 term infants were included.The time of onset for purulent meningitis of preterm infants group was statistically earlier than that of term infants group [11.2 (3.2,19.8) d vs.14.3 (5.6,23.9) d,P ＜ 0.05].The prognosis of preterm infants group was statistically worse than that of term infants group (P ＜ 0.05).Among them,the incidences of clinical manifestations in preterm infants group compared to term infants group were:fever (54.5％ vs.78.8％),seizure (11.4％ vs.26.3％),lethargy and poor response (59.1％ vs.38.1％),slow weight gain (9.1％ vs.0％),apnea (45.5％ vs.0.8％) and cyanosis (15.9％ vs.4.2％);all the differences between two groups were significant (P ＜ 0.05).The time of onset for purulent meningitis with complications was statistically earlier than those without complications [9.5 (4.1,20.5) d vs.13.8 (5.9,22.0) d,P＜0.05].The duration of treatment for purulent meningitis with complications was longer than that without complications [(42.2 ± 8.8) d vs.(28.7 ± 7.1) d,P ＜ 0.05],and the positive rate of pathogens was also statistically higher than those without complications (73.8％ vs.26.7％,P ＜0.05).Coagulase-negative staphylococcus was the main pathogen for both preterm and term infants group.Klebsiella pneumoniae was more common in preterm infants group than in term infants group (40.0％ vs.10.4％,P ＜0.05).Conclusion Preterm infants with purulent meningitis had early onset time,atypical clinical manifestations,and poor prognosis.The treatment course for purulent meningitis with complications is prolonged.The pathogens for neonatal purulent meningitis have already changed.The detection rate of conditional pathogens is increasing yearly,for which the clinicians should take note seriously.
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Objective:ToexploreinfluenceofBMP9inmyocardiocytesdifferentiationof stem cell Invitro.Methods:TheC3H10T1/2stem cell were transfected with 2.67 ml/L pAdEasy-BMP9 Ad-GFP plasmid for 1 week and 2 weeks .The specific transcription factors of cardiomyocytes were detected in stem cells during differentiation with plasmid transfection by RT-PCR and the specific proteins in cardiomy-ocytes were detected by laser confocal microsopy after 1 week;the change of cells ultramicro structure were detected by electron micro-scope after 2 weeks.Results:Cells volume are increscent obviously,cells trend become unanimous,the connection between cells are compact,refractivity of cells enhance conspicuously after induction for 1 week.The expression of NKx 2.5,GATA-4,MEF2C could be de-tected in C3H10T1/2 stem cells with pAdEasy-BMP9 Ad-GFP plasmid tranfection.Cx43 and cTnT can be detected with plasmid tranfec-tion.Cardiomyocytes ultramicro structure can be detected after induction for 2 weeks.Conclusion:BMP9 makes a very important influ-ence in C3H10T1/2 stem cells targeted differentiation into cardiomyocytes。