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Objective:To compare the results of clinical diagnosis and severity grading in preterm infants with bronchopulmonary dysplasia (BPD) using three different diagnostic criteria and the consistency of two new diagnostic criteria.Methods:From January to December, 2020, infants with gestational age <32 w admitted to neonatal intensive care unit of our hospital were retrospectively enrolled in this cohort study. The patients were diagnosed and graded according to the 2001, 2018 and 2019 criteria of BPD. Chi-square test was used to compare the differences of BPD diagnostic rate and mortality rate using three criteria and Kappa coefficient test was used to compare the consistency between the two new criteria of 2018 NICHD and 2019 NRN.Results:A total of 231 preterm infants were enrolled, including 130 males (56.3%) and 101 females. 9 patients were dead. According to 2018 NICHD criteria, 97 cases (42.0%) were diagnosed with BPD, including 16 gradeⅠ, 44 grade Ⅱ, 31 grade Ⅲ and 6 grade ⅢA. The remaining 134 cases were not BPD (58.0%). No significant differences existed ( P>0.05) among the diagnostic rates of 2001 criteria (112/231, 48.5%), 2018 criteria (97/231, 42.0%) and 2019 criteria (91/231, 39.4%). For grade Ⅲ BPD, the diagnostic rate of 2001 criteria was significantly higher than the 2018 criteria (including grade Ⅲ and grade ⅢA, 16.0%) and 2019 criteria (6.5%) and the diagnostic rate of 2018 criteria was also significantly higher than 2019 criteria ( P<0.05). No significant differences existed in the overall mortality rate of BPD among three criteria ( P>0.05), however, the case mortality rate of grade Ⅲ BPD of 2001 criteria (3.9%) was significantly lower than 2018 criteria (24.3%) and 2019 criteria (20.0%) ( P<0.05). The 2018 and 2019 criteria were highly consistent in the overall diagnostic rate of BPD (Kappa value = 0.946), the positive consistency rate was 93.8% (95% CI 85.5%~97.5%) and the negative consistency rate was 100.0% (95% CI 96.5%~100.0%). But the consistency of severity grading for BPD was weak (Kappa value = 0.597) between the two criteria. Conclusions:The 2001 NICHD BPD criteria is no longer valid because it tends to overdiagnose severe BPD, thus underestimate the case mortality. The 2018 NICHD criteria is comprehensive and detailed and the 2019 NRN criteria is simple and practical. The two new criteria are highly consistent in the overall diagnosis of BPD, but the consistency of severity grading is weak.
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OBJECTIVE：To analyze the distribution and drug resistance of bloodstream infection pathogens in a Children’s Hospital from Zhengzhou，and to provide reference rational selection of drugs in anti-infective treatment. METHODS：By retrospective analysis，128 318 blood culture specimens were collected from inpatients in the Affiliated Children’s Hospital of Zhengzhou University from Oct. 2014 to Sept. 2019. The positive rate，clinical symptoms and clinical diagnosis of children with bloodstream infection were analyzed statistically. WHONET 5.6 software was used to analyze pathogenic bacteria of positive specimen，the departments and the resistance of pathogens to the main clinical antibiotics. RESULTS：In 128 318 blood culture samples of inpatients，the positive rate was 2.14％ （2 746/128 318）；among 2 746 blood culture positive sample，the main Symptom of childrem with blood stream infection was fever（1 986/2 746）；main clinical diagnosis included sepsis（1 679/2 746）， bronchopneumonia（858/2 746），purulent meningitis（555/2 746）. The main departments included neonatal diagnosis and treatment center （1 090 strains，accounting for 39.69％） [neonatal intensive care unit （279 strains，accounting for 10.16％），neonatal surgery department （223 strains，accounting for 8.12％），neonatal internal medicine department （209 strains，accounting for 7.61％），infant pediatrics department（200 strains，accounting for 7.28％） and premature pediatrics department（179 strains， accounting for 6.52％）]，hematology oncology department （216 strains，accounting for 7.87％），cardio vascular medicine department（206 strains，accounting for 7.50％）. Gram-positive bacteria accounted for 72.80％，Gram-negative bacteria 24.21％， fugus 2.99％. Among Gram-positive bacteria，coagulase negative staphylococcus（1 414 strains）and Staphylococcus aureus（146 strains）were the most common. The resistance rate of the former to penicillin G，oxacillin and erythromycin was more than 80％， and that of the latter to penicillin G and erythromycin was more than 80％. Among Gram-negative bacteria，Klebsiella pneumoniae （183 strains） and Escherichia coli （172 strains） were the most common. The resistance rates of the former to ampicillin， piperacillin，ampicillin/sulbactam and cefazolin were more than 80％，and the latter to ampicillin and tetracycline were more than 80％. Among the fungus，Candida albicans（42 strains）and Candida parapsilosis（22 strains）were the most common，and the resistance rate to common antifungal drugs was less than 10％. CONCLUSIONS：The pathogens of bloodstream infection in the hospital are complex，mainly coagulase negative staphylococcus and K. pneumoniae，and the drug resistance is severe.
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We reported a case of neonatal Langerhans cell histiocytosis (LCH) with his clinical manifestations, examinations, diagnosis and treatment. This infant was hospitalized due to the rash and poor response. He was diagnosed as LCH after admission by imaging, skin biopsy and immunohistochemistry. The infant died because his parents refused all possible treatments. At the moment, no effective treatment is available for LCH patients, while the main managements are infection control and necessary supportive care. Pulmonary infections often contribute to the death of LCH patient and can aggravate the situation by stimulating histiocytic hyperplasia.
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Objective To investigate the effects of mycoplasma pneumoniae(MP)infection on the exhaled nitric oxide level and lung function in asthmatic children,analyze the correlation between exhaled nitric oxide level and lung function and to provide reference for the treatment and monitoring of asthmatic children.Methods Sixty-eight children aged from 5 to 13 years old with mild or moderate asthma during June 2011 to January 2013 were collected.MP-IgG antibody,MP-IgM antibody,MP-DNA,total serum IgE,FeNO measurement and spirometry were examined on the next day morning.They were divided into two groups according to the pathogen:ashtma with MP group and ashtma without MP group.Then the levels of nitric oxide level and lung function indicators between the two groups were analyzed.Results The FeNO level in ashtma with MP group was significantly higher(P0.05),but differnces were found in MEF75 and PEF(P<0.05).No correlation was found between FeNO levels and lung function parameters(FVC,FEV1,FEV1/Vcmax,MEF50,MEF25,MEF75 and PEF).Conclusion In asthma children with MP infection,the FeNO level was significantly increased and no correlation was found between FeNO levels and lung function.
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Objective T o investigate the tim e-dependent expression of m etallothionein (M T ) 1A m R N A and M T 2A m R N A in contused skeletal m uscle of rats. Methods A total of 54 Sprague-D aw ley rats w ere used in this study. T he rats w ere divided into tw o parts:control group (n=6) and contusion groups (0.5, 1, 6, 12, 18, 24, 30, and 36 h after contusion, n=6). T otal R N A w as extracted from skeletal m uscle. T he expression levels of M T 1A m R N A and M T 2A m R N A w ere detected by SY B R G reen I real-tim e PC R . Results T he expression trends of the tw o potential m arker genes w ere related to w ound age. In ad-dition to 0.5 h, there w ere significant contrasts betw een the control group and contused group (P<0.05), about the expression levels of M T 1A m R N A and M T 2A m R N A in different phases. A s the extension of w ound age, the relative expression of M T 1A m R N A and M T 2A m R N A at 1 h, 6 h, 12 h and 18 h after contusion dem onstrated upgrade tendency until its expression levels in 18 h peak w ith 239.41±15.20 and 717.42 ±50.76, respectively. W hen tim e extends to 24 h after injury, the expression of above tw o m arks decreased, respectively. T he M T 1A m R N A and M T 2A m R N A expression levels increased at 30 h and then decreased. Conclusion D eterm ination of M T 1A m R N A and M T 2A m R N A levels by real-tim e PC R m ay be useful for the estim ation of w ound age.
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Objective To explore the postmortem stability of nine Housekeeping gene mRNA—β-actin, GAPDH, RPL32, PKG1, SDHA, rRPL13, HPRT, TBP, YWHAZ and the correlation between its relative expression and postmortem interval (PMI) in rat brain tissue and skeletal muscle. Methods 33 healty adult SD rats were randomly divided into 11 groups at 11 postmortem interval(0h, 1h, 3h, 6h, 12h, 24h, 2d, 4d, 8d, 16d, 24d), sacrificed by cervic al dislocation and it's anterior tibial muscle and brain tissue (about 50mg) were extracted, respectively. The total RNA was extracted from organizations and the nine mRNA were detected by Real-time RT-PCR. Proper internal reference was selected by geNorm software. To evaluate the stability of genes by GeNorm, NormFinder and BestKeeper software. Regression analysis by spss software. Results The expression of HPRT is the most stable in both brain and skeletal muscle, suitable for reference gene. The relative expression levels of SDHA, RPL32 and TBP in brain tissue had a certain linear relationship with PMI. While there was no significant correlation between the relative expression of RNA and PMI in skeletal muscle. Conclusion Brain tissue and skeletal muscle could be suitable materials for extracting RNA in advanced stage PMI. The relative expression levels of SDHA, RPL32 and TBP had a certain linear relationship with PMI, which could be auxiliary indices for the estimation of PMI.
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Objective Take frizzled class receptor 4(FZD4) as an example for exploring whether the transmembrane receptor protein is a suitable marker for wound age estimation. Methods A total of 78 Sprague-Dawley rats were divided randomly into the control group and the contusion groups of 4h, 8h, 12h, 16h, 20h, 24h, 28h, 32h, 36h, 40h, 44h, and 48h after injury (n=6). Using a drop-ball technique, a contusion was produced in the right lamb of rats. The samples were dissected from injury zones. Then the expression of FZD4 was detected using immunofluorescence, real-time PCR and western blot, respectively. Results FZD4 was located on the membrane of skeletal muscle cells. Compared to the control group, FZD4 mRNA showed a signiifcant increase (over 2-fold) in 8h, 12h, 36h, and 40h after injury by Real-time PCR (P<0.05), and FZD4 protein showed a statistical up-regulation (less than 2-fold) in 8h, 36h, 40h, 44h, and 48h post contusion by western blotting (P<0.05). Conclusion The expression of FZD4 mRNA and protein are both time-dependent during contused skeletal muscle repair. To some degree, FZD4 mRNA was more suitable than corresponding protein for determining wound age.
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Objective T o investigate the relationship betw een the expression of secreted frizzled-related protein 5 (SFR P5) m RNA and the tim e interval after skeletal m uscle injury in rats by real-tim e PC R . Methods A total of ninety SD rats w ere random ly divided into the contusion groups at different tim es including 4 h, 8 h, 12 h, 16 h, 20 h, 24 h, 28 h, 32 h, 36 h, 40 h, 44 h, 48 h after contusion, incision groups at different tim es including 4h and 8h after incision and the control group. T he sam ples w ere taken from the contused zone at different tim e points. T he total RNA w as isolated from the sam ples and re-versely transcribed to analyze the expression levels of SFRP5 m RNA . Results C om pared to the control group, the expression of SFRP5 m RNA in contusion groups w ere dow n-regulated w ithin 48 h after con-tusion and reached the low est level at 20 h, and the expression of SFRP5 m RNA gradually increased from 20 h to 48 h after contusion. T he expression of SFRP5 m RNA in the incised groups w ere signifi-cantly low er than that of the contusion groups at 4 h after injury. A t the tim e of 8 h, the expression levels betw een the contusion and incision groups show ed no statistically significant difference. Conclusion It is suggested that SFRP5 m RNA analysis m ay show regular expression and can be a m arker for estim ation of skeletal m uscle injury age.
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Objective In order to understand which kind of function genes play an important role for es-timating wound age, the variation of difference genes’ mRNA expression were compared after injury. Methods T he mRNA expression levels of seven candidate genes (ICAM-1, NF-κB, MX2, MT1, MT2, sTnI, and Cox6c) were analyzed in contused rat skeletal muscle at different time points using real-time fluorescent quantitative PC R (R T-qPC R ). T he rawC t values were normalized relative to that of RPL32 mRNA , and converted to standard C t values. A t each time point after injury, the standard deviations (SD ) of the standard C t values were calculated by SPSS. Results T he expression trends of the seven genes were all found to be related to wound age, but there were lower variation coefficients and greater reliability of sTnI and Cox6c when compared with other genes. Conclusion T he genes encoding struc-tural proteins or proteins that performbasic functions can be suitable for wound age estimation.
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Objective T o investigate the relation betw een injury tim e and the expression of cytochrom e c oxidase subunitⅥc (COX6C) m R N A in skeletal m uscle of rat after contusion. Methods A total of fifty-four SD rats w ere divided into the control group and the contusion groups (0.5,1,6,12,18, 24, 30, and 36 h after contusion), random ly. T he contusion m odel w as established by free fall drop of gravity ham-m er. A t corresponding tim e point after contusion, the regular histology w as exam ined and expression level of COX6C m R N A w as tested by real-tim e PC R after extraction of total R N A from the tissues. Results T he m ain pathological features of 6 h after injury included edem a and hem orrhage in m yocytes w ith no inflam m atory cells found. A fter 6 hours, the findings included m yocyte degeneration and necro-sis, inflam m atory cells infiltration, and fibrous connective tissue proliferation in the contused zone. T he expression level of COX6C m R N A w as higher than that of the control group w ithin 6 h after contusion. T he expression level w as low er than that of the control group from 6-36 h after contusion. Conclusion T he level of COX6C m R N A expresses in a regular w ay after contusion. It m ay be useful for estim ating w ound age in com bination w ith the results of pathological features.
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Objective To explore the effects of hydrogen sulfide (H2S) on hyperoxia-induced lung injury in neonatal rats.Methods Eighty full-term Sprague-Dawley rats within 12 hours after birth were randomly divided into control group,hyperoxia group,sodium hydrosulfide (NaHS) + hyperoxia group (NaHS 90 μmol/kg injected intraperitoneally) and propargylglycine (PPG) +hyperoxia group (PPG 50 mg/kg injected intraperitoneally).Except for the control group,the other three groups were exposed to 95％ O2 for seven days.Pulmonary histopathology was observed after HE staining,numeration of leukocyte and albumin in bronchoalveolar lavage fluid (BALF) were processed by optical microscope and Lowry methods.The plasma H2S concentration,activity of cystathionine-γ-lyase (CSE) and contents of malondialdehyde (MDA) in lung tissues were also detected.Analysis of variance and LSD-t test were used for statistics.Results (1) Compared with the control group,alveolar hemorrhage,interstitial edema,inflammatory cell infiltration were observed in the hyperoxia group.The number of white blood cells,neutrophils and albumin content in BALF increased in the hyperoxia group [(130.2± 15.3) × 107/L vs (15.1 ±2.5) × 107/L; (64.6± 12.4) × 107/L vs (2.1 ±0.5) × 107/L; (934.6± 106.4) mg/L vs (254.3±50.7) mg/L,respectively.LSD-t=-14.65,5.78 and 2.97,all P＜0.01],but the plasma H2S concentration and the activity of CSE in lung tissue decreased [(112.6± 20.4) μmol/Lvs (182.3±15.7) μ mol/L,LSD-t=-9.90; (3.4±0.4) μmol/ (min·g) vs (6.8± 1.4) μ mol/ (min · g),LSD-t=-4.59; both P＜0.01].However,the contents of MDA increased [(1.7± 0.3) nmol/ml vs (0.9±0.1) nmol/ml,LSD-t=3.03,P＜0.01].(2) Compared with the hyperoxia group,inflammatory exudation and structural disorder of lung tissue were alleviated in the NaHS+hyperoxia group.White blood cells [(56.3± 11.6) × 107/L],neutrophils [(34.8±7.8) × 107/L] and albumin content [(753.8± 89.6) mg/L] in BALF decreased significantly (LSD-t=-9.66,-11.81 and-5.78,P＜0.01).The plasma H2S concentration [(235.7±32.7) μ mol/L] and the activity ofCSE [(5.8± 1.1) μ mol/(min · g)] increased significantly (LSD-t=11.34 and 5.98,P＜0.01) in the NaHS+hyperoxia group.(3) Compared with the hyperoxia group,inflammatory exudation and structural disorder of lung tissue were more severe in PPG+ hyperoxia group.White blood cells,neutrophils and albumin content in BALF increased significantly (LSD-t=5.52,6.37 and 8.23,P＜0.01),the plasma H2S concentration and the activity of CSE decreased (LSD-t=-4.29 and-3.97,P＜0.01),the contents of MDA increased (LSD-t=3.02,P＜0.01).Conclusions H2S is involved in the pathophysiological process of hyperoxia-induced lung injury in neonatal rats.Exogenous H2S can alleviate the pulmonary injury by inhibiting inflammatory reaction and oxidative stress.
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Objective To observe the dynamic changes in plasma coagulation indexes in the rabbit's amniotic fluid embolism. Method The experimental amniotic embolism model was established by injecting the amniotic fluid or placental extract-amniotic fluid through the rabbit's marginal vein of the ear. Blood samples were taken from the heart before and after infusion. Fibrinogen (FIB), prothrombin time (PT), thrombin time (TT), and activated partial thromboplastin time (APTT) were measured with coagulation analyzer. Results As compared with the sham operation group, FIB decrease significantly after infusion with amniotic fluid and placenta! extract mixed with amniotic fluid (P
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The pathological changes of pulmonary fat emdoiksm were studied in ratsby means of an intravenous injection with autosnbcutaneous fat.The resultsshowed that most fat ernboli appeared in pulmonary arterioles and capillariesafter 24 hours.By 4 days,large number of sudan Ⅲ-positive emboli were seenthroughout the lungs.The inflammatory cellular infiltration including the histoc-ytes,macrophages,polymorphonuclear leucocytes and occasional eosinophils,pulmonary edema and focal hemorrhage were observed.After 7 days,most fatemboli disappeared.No fat embolism in other organs was found.
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To study the pathological process and renal patho morphology of crush syndromed.The rabbit model of crush injury crush syndrome was established.Transmission electron microscopy(TEM),biochemistry,radioimmunoassay and immuohistochemistry were employed.The results demonstrated that the serum K + and BUN increased,The serum CO 2CP decreased after crush injury.The degeneration and necrosis of the epithelial cells of the renal tubule and myoglobin casts in the renal tubules were observed in crush syndrome,the serum K + increase was absent.Our results may be regarded as criteria for the diagnosis of the crush injury crush syndrome.The serum K + increase was the cause of death in early stage after crush injury.