ABSTRACT
Objective To observe the change of serum inflammatory factors such as tumor necrosis factor (TNF)-α, interleukin (IL)-6 before and after blood transfusion, and analyze the possible pathogenesis of transfusion-associated neonatal necrotizing enterocolitis (NEC). Methods One hundred and sixty-two patients who needed blood transfusion in NICU from Janury 2014 to Octorber 2015 were enrolled in this study. Among them, 13 patients had transfusion-ralated neonatal necrotizing enterocolitis (TRNEC, test group A), and 149 patients didn′t have TRNEC (test group B). In the mean time, 45 NEC patients without blood transfusion in 1 292 patients was as control group A, 30 patients who didn′t receive blood treatment and had NEC was as control group B. The levels of TNF-α, IL-6 in four groups were compared. Results The rate of TRNEC was 8.02% (13/162). The rate of NEC was 3.48%(45/1 292), and there was significant difference (χ2=7.79, P<0.01). The levels of serum TNF-α, IL-6 at 24 h and 48 h after blood transfusions in test group A and test group B were increased compared with those in control group B (P<0.01 or<0.05). The levels of serum TNF-α, IL-6 at 24 h and 48 h after blood transfusions in test group A were increased compared with those in test group B and control group A (P<0.01 or<0.05). The levels of serum TNF-α, IL-6 at 24 h and 48 h after blood transfusions in test group B were decreased compared with those in test group A (P<0.05). The levels of serum TNF-α, IL-6 at 24 h and 48 h after NEC in control group A were increased compared with those in control group B (P<0.05). Conclusions The pathogenesis of TRNEC may have connection with the inflammatory factors such as TNF-α, IL-6, which are produced in the processing of handling whole blood and the storage of red cell.
ABSTRACT
Objective To study the protective effect of cessation of enteral feeding on transfusionrelated necrotizing enterocolitis of newborn (TRNEC).Method Newborns who need blood transfusion in our neonatal intensive care unit (NICU) from January 2015 to February 2016 were randomly assigned to the cessative feeding group (fasting for 6 h when blood transfusion) and the feeding group according to the method of random number table.The abdominal perimeter,the level of tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6),and the incidence of NEC within 48 hours after transfusion in these newborns were analyzed and compared.Result A total of 106 newborns with blood transfusion were included in this study,54 in the cessative feeding group and 52 in the feeding group.There were no significant differences between the two groups in gender,gestational age,birth weight,underlying diseases and abdominal perimeter before transfusion (P ＜ 0.05).The incidence of TRNEC in the cessative feeding group was significantly lower (3.7％) than that in the feeding group (17.3％) (P ＜ 0.05).The abdominal perimeters at 6 h and 12 h a fter blood transfusion in the cessative feeding group were both significantly lower than that in the feeding group (P ＜ 0.05).Within 48 h after blood transfusion,the incidence of vomiting,abdominal distention and bloody stools in the cessative feeding group were all significantly lower than that in the feeding group (P ＜0.05).Furthermore,at 6 and 12 h after receiving blood transfusion,the cessative feeding group both showed lower levels of the serum TNF-α and IL-6 than the feeding group (P ＜ 0.05).However,the levels of the serum TNF-α and IL-6 at 6 h after blood transfusion and 12 h after blood transfusion in both groups were all showed no significant differences (P ＞ 0.05).Conclusion Cessation of enteral feeding for 6 h during blood transfusion is a positive protective measure that can reduce the incidence of TRNEC.
ABSTRACT
Objective To analyze the clinical features of severe hand-foot-mouth disease (HFMD)combined with encephalitis.Methods The cases with HFMD in our hospital from September 2009 to September 2010 were divided into two groups including the ordinary case group(n =235) and the encephalitis group (n =88).Clinical manifestations were analysed between the two groups.Results There were significant differences in number of oral ulcers,degree and duration of fever between two groups (P ＜ 0.05).Eighty percent cases of the ordinary group had multiple or dense herpes or ulcers,which was more than that of the encephalitis group.But there were no significant differences in WBC and its classification in peripheral blood between two groups (P ＞ 0.05).There were obvious differences in CK,CK-MB,AST,GLU of blood between two groups (P ＜ 0.05).The contents of protein,glucose and chloride in cerebrospinal fluid have no differences between two groups (P ＞ 0.05),besides the cell count.The cell count in cerebrospinal fluid of cases with enterovirus infected encephalitis was significantly higher than those with CoxA16 infection(P ＜ 0.05).Conclusion The patients with few rash,less oral herpes,ulcers or high levels of CK,CK-MB,GLU should be closely observed to vigilant merger encephalitis.The cases with severe H-FMD have middle or high fever and duration of fever are more than 4 days.The increased cell count in cerebrospinal fluid may imply encephalitis with enterovirus 71 infection.