Impact of a nationwide training program for neonatal resuscitation in China / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Seventeen million births occur in China each year. Neonatal mortality is the leading cause of under 5-year-old child deaths, and intrapartum-related injury accounts for much of mental retardation in young children. The Chinese Ministry of Health sought to improve infant and child survival through a nationwide initiative to have at least one person trained in neonatal resuscitation at every birth. The aim of the current study was to evaluate the impact of China Neonatal Resuscitation Program (NRP) on policy and infrastructure changes and its effectiveness in decreasing the incidence of mortality among newborn infants.</p><p><b>METHODS</b>The Chinese NRP incorporated policy change, professional education, and creation of a sustainable health system infrastructure for resuscitation. Multidisciplinary teams from all 31 provinces and municipal states disseminated NRP in a train-the-trainer cascade. The intervention targeted 20 provinces with high neonatal mortality and programs to reduce maternal mortality. Program evaluation data came from 322 representative hospitals in those provinces.</p><p><b>RESULTS</b>Changes in policy permitted midwives to initiate resuscitation and required resuscitation training for licensure. From 2004 through 2009 more than 110,659 professionals received NRP training in the 20 target provinces, with 94% of delivery facilities and 99% of counties reached. Intrapartum-related deaths in the delivery room decreased from 7.5 to 3.4 per 10,000 from 2003 to 2008, and the incidence of Apgar ≤ 7 at 1 minute decreased from 6.3% to 2.9%.</p><p><b>CONCLUSIONS</b>The Chinese NRP achieved policy changes promoting resuscitation, trained large numbers of professionals, and contributed to reduction in delivery room mortality. Improved adherence to the resuscitation algorithm, extension of training to the township level, and coverage of births now occurring outside health facilities can further increase the number of lives saved.</p>

Changes of nerve growth factor in amniotic fluid and correlation with ventriculomegaly / 中国医学科学杂志(英文版)

<p><b>OBJECTIVE</b>To detect the change of nerve growth factor (NGF) level in human amniotic fluid during gestation, and to explore the relationship between this change and fetal ventriculomegaly (VM).</p><p><b>METHODS</b>The studied subjects (collected from 2004 to 2007) were divided into four groups, including the second-trimester pregnancy group (n=113), third-trimester pregnancy group (n=110), fetal cerebral VM group (n=12), and healthy control group (n=12) which matched with the VM group in gestational weeks. The amniotic fluid specimens were obtained during amniocentesis or cesarean section. The NGF levels in amniotic fluid were detected with enzyme-linked immunosorbent assay.</p><p><b>RESULTS</b>A significantly negative correlation was found between gestational age and the NGF level in amniotic fluid (r=−0.6149, P<0.0001). The NGF level in patients with fetal VM was significantly lower than that in healthy controls (33.95±29.24 pg/mL vs. 64.73±16.21 pg/mL, P=0.024).</p><p><b>CONCLUSION</b>NGF levels in amniotic fluid may be a sensitive marker for fetal VM.</p>

Effect of propentofylline on hypoxic-ischaemic brain damage in newborn rat / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Studies showed that propentofylline enhances the action of adenosine and protects hippocampal neuronal damage against transient global cerebral ischaemia. Our study was to investigate the effect of propentofylline on hypoxic-ischaemic brain damage in neonatal rat.</p><p><b>METHODS</b>Seven-day-old Wistar rats were subjected to unilateral common carotid artery ligation and hypoxia in oxygen 8 kPa for two hours at 37 degrees C. Propentofylline (10 mg/kg) was administered intraperitoneally one hour after hypoxia-ischaemia (treated group). Control group rats were received an equivalent volume of saline. The effects of propentofylline were assessed by observing the body mass gain, behavioural alteration and neurohistological changes. The rats were sacrificed at 72 hours after hypoxia-ischaemia, and the brain sections were examined after haematoxylin and eosin staining.</p><p><b>RESULTS</b>The propentofylline-treated rats had better body mass gain and better behavioural response than the paired saline-controls did. In the control group, the rats either lost body mass or had little mass gain after the insult, their average body mass gain was 97.3% at 24 h, 100.3% at 48 h, and 114.1% at 72 h of recovery. In propentofylline-treated group, there was a significant improvement of body mass gain at 24 h (100.2%, P < 0.05) and 48 h (110.3%, P < 0.01) of recovery; the percentage of rats that performed well on behavioural test was significantly higher from 48 h to 72 h of recovery (P < 0.05); the incidence of severe brain damage to the cerebral cortex and dentate gyrus was significantly reduced in propentofylline-treated rats (cortex, 93% - 70.8%, P < 0.01; dentate gyrus 95% - 66.7%, P < 0.01) as compared with control rats.</p><p><b>CONCLUSIONS</b>Administration of propentofylline 1 hour after hypoxia-ischaemia significantly attenuates brain damage in both the cerebral cortex and dentate gyrus, and also improves the body mass gain as well as behavioural disturbance in 7-day-old rats.</p>

Perinatal outcomes of 658 twins / 中华全科医师杂志

Objective To investigate perinatal outcomes of twin pregnancy.Methods Perinatal outcomes of 658 pregnancies with twins hospitalized and born at Beijing Obstetrics and Gynecology Hospital during 2002 to 2005 were retrospective analyzed to compare the influence of type of twin,delivery mode, gestational week,birth time interval between twins,as well as specific complications of twin pregnancies on their outcomes.Results Pefinatal fatality of monzygous twins was 53.69 per thousand(16/298),higher than that of dizygous twins(27.11 per thousand,9/332),with U=2.35,P0.05.Perinatal fatality was higher in twins with different development (birth weight).Perinatal fatality in dizygous twins(12.5 percent,2/16)was lower than that in monozygous ones(14.3 percent,6/42),and that in twins with different development(birth weight)(0.6 percent, 2/316)was lower than that with same development(1.2 percent,3/256),with ?~2=16.944,P

Mutation analysis of fibroblast growth factor receptor 3 gene in an achondroplasia family / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To clarify the patients' pathogenic mechanism in an achondroplasia family not according with the genetic law of autosomal dominant inheritance disease at gene level.</p><p><b>METHODS</b>Genomic DNA from peripheral blood of all members in this family was used for amplification of the exon 10 of fibroblast growth factor receptor 3(FGFR3) gene by PCR; mutation was detected by DNA sequencing and identified by restriction endonuclease MaeIII.</p><p><b>RESULTS</b>A new mutation of A to T at nucleotide 1180 was found in patients but not in unaffected members.</p><p><b>CONCLUSION</b>Combined with pedigree analysis, it was summarized that achondroplasia patients in this family might result from this new mutation.</p>

Clinical observation on treatment of postpartum hemorrhage by xuesaitong soft capsule / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To observe the effect of Xuesaitong (XST) soft capsule in treating postpartum hemorrhage.</p><p><b>METHODS</b>Sixty pregnant women were randomly divided into the treated group (A) and the control group (B), 30 cases in each, they were treated with XST and placebo respectively for 7 days to observe the changes of hemorrhagic conditions.</p><p><b>RESULTS</b>After delivery, the hemoglobin, RBC count, hematocrit and cardiac index were lower at 3rd day than those before delivery in both groups (P < 0.05 or P < 0.01), reticulocyte count lowered insignificantly as compared with that before delivery in group A but significantly in control group B; the bleeding time shortened significantly in group A (P < 0.05) but unchanged in group B; significant change of blood viscosity only found in group B (P < 0.05). The amount of bleeding 30 min, 1 hr, 2 hrs and 24 hrs after delivery in group A was all lower than that in group B respectively (P < 0.01 or P < 0.05). Involution of uterus in group A at 2nd, 4th and 7th day after delivery was all better than that in group B respectively (P < 0.05).</p><p><b>CONCLUSION</b>XST has definite effect in decreasing postpartum hemorrhage, it also shows effects in promoting involution of uterus, reducing lochia and accelerating recovery of parturients.</p>