ABSTRACT
Objective To investigate the effects of anesthesia on neurodevelopment of preschool children. Methods A total of 445 children, scheduled to undergo surgery in the Fourth Medical Center of Chinese PLA General Hospital from 1st May 2017 to 1st May 2018, were enrolled and, according to different test purpose, grouped as follows: (1) 120 children (GA group) who underwent surgery before Denver Developmental Screening Test (DDST) were matched to 325 unexposed children (Non-GA group). Meanwhile, 168 children (Naive group) were measured as blank control. (2) According to the number of anesthesia that children had undergone, those in GA group were assigned to three subgroups: single, twice and multiple groups. (3) Subgroup analyses was performed based on the time of cumulative duration of anesthesia exposures (less than 3 and greater than or equal to 3h). Data were collected with a questionnaire to evaluate the children's physical development, DDST results were recorded, and the effects were evaluated of the number of anesthesia and the time of cumulative duration of anesthesia exposures on the DDST results. Results For the children aged 0 to 6 yr, the DDST positive rates in Naive, Non-GA and GA groups were 6.0%, 6.5% and 12.5%, respectively. No significant difference existed in DDST positive rate between Naive group and Non-GA group (P=0.825). Compared with Non-GA group, the DDST positive rate increased in GA group (6.5% vs. 12.5%) with significant difference (P=0.038). Compared among the four domains of DDST separately, statistical difference was found only in terms of personal-social, those in GA group showed poor performance than in Non-GA group (P=0.025). For the children aged less than 3 yr, the DDST positive rates in GA group and Non-GA group were 18.6% and 3.9%, respectively, showing significant differences (P=0.019), but no statistical difference was found on DDST positive rate among the three groups of children aged 3 to 6 yr (P>0.05). In GA group, there was no increase in odds of early developmental vulnerability with increasing frequency of anesthesia exposure (P=0.784). However, the DDST positive rate was significantly higher with longer cumulative duration of anesthesia exposure (≥3h) than that of <3h (18.7% vs. 2.2%, P=0.008). Conclusions Exposure to anesthesia is an increased risk for the later neurodevelopment of preschool children, especially before 3 years old. The time of cumulative duration of anesthesia may be positively correlated to the children's neurodevelopment disabilities.
ABSTRACT
To investigate the growth and maturation of megakaryocyte progenitors in patients with chronic idiopathic thrombocytopenic purpura (CITP), plasma clot culture and GPIIIa monoclonal antibody and ABC immuno- histochemical kit were used to assay CFU-Meg and BFU-Meg, and the area and diameter of GPIIIa(+) cells were determined by image analyzer in 33 CITP cases. It was found that CFU-Meg and BFU-Meg were 39.27 +/- 21.44 and 5.62 +/- 3.93 per 2 x 10(5) MNC, respectively, in CITP patients, there were no significant differences with those in control group. While the area of GPIIIa(+) cells was (134.90 +/- 6.08) micro m(2) and diameter was (12.89 +/- 3.66) micro m, those were lower than those in control group. In patients with normal number of megakaryocytes on marrow smears, CFU-Meg and BFU-Meg were 19.43 +/- 7.28 and 4.67 +/- 1.53, respectively, the values were lower as compared to control group. The positive correlation was showed between the total megakaryocytic colonies and the number of megakaryocytes on marrow smears, r = 0.6503, and there was no correlation with blood platelet counts and course of disease. The results suggest that there was a maturation disturbance of megakaryocyte progenitor in CITP patients and lower proliferative potential in patients with normal megakaryocyte counts on marrow smears.