ABSTRACT
【Objective】 To explore the correlation between the severity of jaundice in ABO hemolytic disease of fetus and newborn (HDFN) and multiple indicators, in order to achieve accurate diagnosis, timely treatment, and prevent complications in ABO HDFN. 【Methods】 From March 2020 to February 2023, a total of 283 ABO HDFN in our hospital were classified into mild, moderate and severe groups based on total bilirubin levels. The differences in basic data, relevant laboratory indicators and the agglutination intensity of the three hemolysis tests were analyzed and compared. 【Results】 In the severe group, 75% (12/16) were male infants, which was significantly higher compared to 37.5% (57/152) in the moderate group (P<0.05). The values (mg/dL) of transcutaneous jaundice in the mild, moderate and severe groups were:forehead 9.88±1.93 vs 12.34±2.01 vs 15.56±2.69, face 10.25±2.27 vs 13.28±2.32 vs 15.99±2.86, chest 9.67±2.16 vs 12.51±2.11 vs 15.33±2.36, respectively. The values(µmol/L) of direct bilirubin (DBIL) and indirect bilirubin (IBIL) were 9.87±2.06 vs 11.90±2.59 vs 16.12±4.73, and 159.36±37.55 vs 252.98±30.52 vs 353.76±55.68, respectively, and the differences between the mild, moderate and severe groups were statistically significant (all P<0.05) . The creatine kinase (CK) values(unit/L) of mild, moderate and severe groups were 664.15±498.26 vs 500.51 ±451.63 vs 402.63±224.27, and the difference between the mild group and the other two groups was statistically significant (P<0.05) . There was no statistically significant difference in the agglutination intensity of the three hemolysis tests among HDFN with different severity of jaundice. 【Conclusion】 Clinicians can predict the severity of jaundice in light of gender, transcutaneous jaundice, DBIL, IBIL and CK of ABO HDFN, for further and graded treatment, so as to avoid the sequelae or even life-threatening consequences caused by ABO HDFN.
ABSTRACT
Objective@#To explore the feasibility of application of multi-point puncture immunohistochemical to determine the invasion extent of the epidermis in Kaposiform hemangioendothelioma before surgery and choose the surgical method.@*Methods@#From July 2013 to April 2016, 17 patients with Kaposiform hemangioendothelioma were admitted to the People′s Hospital of Zhengzhou University, including 7 males and 10 females. The first consultation age was 75.60±31.55 days. Preoperative multi-point pathological puncture D2-40, CD31, CD34 immunohistochemical staining was to test the invasion extent of the epidermis in Kaposiform hemangioendothelioma and to determine whether undergo autologous skin grafting. Skin graft survival areas were recorded postoperatively. Platelet values were examined after 1 week, 4 weeks, 12 weeks and 24 weeks.@*Results@#In these 17 cases, 15 cases with epidermis and dermis unaffected was performed in situ grafting. 2 cases with the tumor invasion, superficial skin grafting were repaired. In these 15 cases of in situ grafting, platelet values returned to normal at 1 week after the operations, and platelet values were higher than 100×109/L at 4 weeks, 12 weeks and 24 weeks. Among them, 12 cases of epidermal survival area were greater than 90%, 2 cases were 70%-90%, and 1 cases was about 50%.@*Conclusions@#During the complete resection of Kaposiform hemangioendothelioma, the multi-puncture D2-40, CD31 and CD34 staining are used to determine invasion extent of the tumor to the skin, which can maximize the retention of normal tissue surface, reduce postoperative complications. This is a new multi-disciplinary surgical approach.
ABSTRACT
Objective For the second children diagnosed as ABO hemolytic disease of the newborn(ABO-HDN),we made a comprehensive analysis of the related indicators of prenatal and postpartum,so as to achieve early prevention,early diagnosis and early treatment.Methods Prenatal microcolumn gel assay was used to detect the father and mother's blood type and mother's irregular antibody,mother serum IgG anti A(B)anti-body titer.Microcolumn gel assay was used to detect hemolysis three tests after the production of pregnant women.The results were divided into five groups according to the results of hemolysis three tests:group A[di-rect antiglobulin test(+),free antibodies test(+)and antibody releasing test(+)],group B[direct antiglobu-lin test(-),free antibodies test(+)and antibody releasing test(+)],group C[direct antiglobulin test(+), free antibodies test(-)and antibody releasing test(+)],group D[direct antiglobulin test(-),free antibod-ies test(-)and antibody releasing test(+)]and group E[direct antiglobulin test(+),free antibodies test (-)and antibody releasing test(-)].Total bilirubin,unbound bilirubin,hemoglobin,reticulocyte percentage and lactate dehydrogenase were detected by automatic analyzer.Results ABO-HDN children hemolysis three tests,in the 5 groups,the higher the titer of the mother's IgG anti A(B)antibody,the more serious the child' s condition was,the difference was statistically significant(P<0.05).Reticulocyte percentage and lactate de-hydrogenase in the five groups,the difference was statistically significant(P<0.05).Conclusion A combina-tion of antenatal and postnatal multiple laboratory test parameters is more accurate in predicting the second child ABO-HDN.At the same time,it helps to master the state of the disease and reduce the occurrence of complications and sequelae.