ABSTRACT
Objective To explore the clinical characteristics of pleural effusion associated with peripherally inserted central catheters (PICCs) in neonates. Method The clinical data of pleural effusion caused by PICCs in two neonates were retrospectively analyzed. Results Both 2 cases were preterm female infants. Case 1 was delivered at 26+5 weeks, with a birth weight of 800 g. Dyspnea aggravated 8 hours after the PICC placement. Bedside chest radiograph indicated a large amount of pleural effusion on the right side. PICC was removed, puncture and drainage were performed, and pleural effusion was cured after 6 days of closed thoracic drainage. Case 2 was delivered at 29+3 weeks with a birth weight of 1240 g. Three days after placement of PICC, dyspnea became worse. Bedside chest radiograph showed bilateral pleural effusion, which was cured after PICC removal, puncture and drainage. According to the routine and biochemical indexes of pleural effusion, combined with the medical history, case 1 was consistent with the diagnosis of chylothorax and case 2 was considered as fluid exudation. Conclusion Neonatal PICC-associated pleural effusion is rare, but the etiology is varied and progress is rapid. Vigilance and active treatment is needed in clinic.
ABSTRACT
Objective To observe the effect of estrogen on BBB permeability,occludin expression after ischemia-reperfusion in rats,and to make a further investigation on the role of estrogen in cerebral ischemia. Methods Ovariectomized rats were randomly divided into sham-operated group,model group,and estrogen pretreatment group. 4 h,24 h,3 d after ischemia-reperfusion were selected as different observation points,and changes of edema,occluding expression,and blood-brain barrier permeability of the 3 points in time were observed. BBB ultra-structure electron microscope observation was made at 24 h and 3 d after ischemia-reperfusion. Changes in cerebral edema were measured by brain water content percentage;protein expressions were measured by Western blot;and BBB permeability was measured by Evans blue as-say. Results Compared with the sham group,brain tissue water content and EB content in model group both increased 4 h after ischemia-reperfusion (P0. 05). 24 h after ischemia-reperfusion,the occludin expression were weaker than that in the sham surgery group with a significant difference (P0. 05). In estrogen group,there was significant difference in occludin protein expression at 24 h and 3 d after ischemia-reperfusion compared with model group at the same time point (P<0. 05). Conclusion BBB ultrastructure disclose TJ was broke and vesicles within EC was increased and astrocyte cell foot process was swelling in MCAO model,it might be the vasogenic brain edema pathological basis for MCAO. In MCAO animal model,with ischemia-reperfusion time increasing,TJ protein occludin expression significantly decreased,it suggests that occludin plays an important role in the regulation of TJ permeability. Estrogen increases has a very close relationship with occludin ex-pression,and it may be one of the mechanisms of protecting BBB integrity and lessening cerebral edema.