ABSTRACT
The clinical data of 5 cases of chylous ascites in preterm infants admitted in NICU of Peking Union Hospital from 2001 to 2021 were retrospectively analyzed. There were 3 boys and 2 girls with the gestational age of 29 +1 weeks, and birth weight of (1 122±323) g. No peritoneal effusion was found on prenatal ultrasound examination. All the five cases diagnosed with chylous ascites after the initiation of enteral nutrition on d4 to d10. All cases were resolved by conservative treatment, including fasting with total parenteral nutrition for 3 wks. The parenteral nutrition strategy was specified by high protein concentration (4 g·kg -1·d -1) and low lipid emulsion (2.0-2.5 g·kg -1·d -1). Formula containing 50% medium chain triglyceride or human milk was fed sequentially, and no feeding intolerance or abdominal distension were observed. All patients were discharged stable and followed up for 3-5 years,and no recurrence occurred. The PubMed and Wanfang database were searched for cases of chylous ascites in preterm infants, and 7 cases were reported in literature. Six cases were diagnosed by antenatal ultrasound between 21 and 23 weeks of gestational age. Three cases underwent radionuclide lymphoscintigraphy, and 2 of them demonstrated peritoneal lymphatic fistula or lymphatic dilatation. Five cases were treated with fasting plus intravenous infusion of octreotide. Three infants who failed to respond to conservative treatment underwent surgical treatment. Four cases were complicated with sepsis and needed intravenous antibiotic treatment.
ABSTRACT
Objective To summarize the clinical features and possible impacts of Goodpasture's syndrome in pregnancy on the pulmonary and kidney of the newborn and the mothers. Methods One patient diagnosed Goodpasture's syndrome in pregnancy hospitalized in Peking Union Medical College Hospital on August 23 in 2011 delivered a neonate with bullae of lung. And literatures including 8 cases of pregnancy complicated by Goodpasture's syndrome worldwide through Medline were reviewed. Results (1) Case report:one 31-year-old women presented with acute renal failure at 30+6 weeks of gestation and delivered a male infant with birth weight 1 900 g by caesarean section at 31+1 weeks of gestation. Diagnosis was confirmed as Goodpasture's syndrome with anti-glomerular basement membrane(GBM) antibodies in serum and renal biopsy after delivery. Then she was treated with methylprednisolone, cyclophosphamide, plasmapheresis and dialysis. The neonate showed the lung bullae in the right middle lobe and bilateral intraventricular hemorrhage but renal function was transient normal with anti-GBM as 113.1 EU/ml. The baby was treated by glucocorticoid for two months and clinical symptoms were improved. Anti-GBM antibodies and chest CT showed normal. After been followed up for two years, the baby was normal. (2) Literatures review:the main manifestations of Goodpasture's syndrome in pregnancy were malignant hypertension and renal failure but respiratory symptoms were not obvious. Treated with plasmapheresis, hematodialysis and glucocorticoid maybe have good effects. Most cases had premature delivery. Neonatal anti-GBM antibodies coming from mothers could result to cerebral, renal and pulmonary injury which could be treated by glucocorticoid. Conclusions The Clinical features of pregnancy complicating the Goodpasture's syndrome are malignant hypertension and renal failure. Diagnosis was depended on positive anti-GBM antibodies and renal pathological changes and treatment were depended on plasmapheresis, hematodialysis and glucocorticoid. Neonatal cerebral, renal and pulmonary injury resulting from anti-GBM antibodies coming from mothers should be followed up, and glucocorticoid should be taken if necessary.
ABSTRACT
Objective: To ascertain the factors and levels in the orthogonal design by drawing the extraction amount time curve of total alkaloid of Rhizoma Coptidis in different solvents. Methods:The extraction amount time curve of total alkaloid was plotted with the extraction amount of total alkaloid as a marker. The orthogonal design was used to select the optimum extraction process according to the contents of total alkaloid and berberine, and extract yield. Results:The extraction amound of total alkaloid related to volume and kinds of solvent and extraction time. The optimum exttraction process was as follows: adding 50% alcohol into meterials and refluxing and extracting for 3 times, 120 min every time. Conclusion:The investigation on the relation between total alkaloid extraction amount and time is of an instructive significance in orthogonal design. The optimum extraction process of Rhizoma Coptidis will provide an experimental basis for industrial production.