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Objective To study the clinical efficacy of LED blue light tube phototherapy in severe hyperbilirubinemia with acute bilirubin encephalopathy (ABE).Method Clinical data of newborns admitted to neonatal department of our hospital between Dec.2013 and Dec.2016 were retrospectively reviewed.Infants with gestational age ≥ 35 weeks who were diagnosed with severe hyperbilirubinemia and ABE were collected and analyzed.From Dec.2013 to Nov.2014,infants treated with common blue light tube were assigned into traditional blue light group (traditional group).From Dec.2014 to Dec.2016,infants treated with LED blue light tube were assigned to LED blue light group (LED group).Total serum bilirubin (TSB) levels and bilirubin induced neurological dysfunction (BIND) scores were analyzed between the two groups.Neuron specific enolase (NSE) levels before and after phototherapy were also compared.Follow-up data for three months after discharge were analyzed.Result Fifty-one infants with severe hyperbilirubinemia and ABE were included,with 24 cases in traditional group and 27 cases in LED group.There were no significant differences in TSB levels and BIND scores between the two groups before phototherapy (P ＞ 0.05).TSB levels at 4 h,24 h and 48 h after phototherapy in LED group were significantly lower than traditional group respectively [(331.3 ±21.8) μmol/L vs.(372.1 ±25.2) μmol/L,(233.6 ± 20.4) μmol/L vs.(269.4 ± 19.8) μmol/L,(184.5 ± 15.2) μmol/L vs.(226.3 ± 22.7) μmol/L,P ＜ 0.05].However,there was no significant difference in TSB levels at 12 h after phototherapy between the two groups (P ＞ 0.05).BIND scores at 4 h after phototherapy in LED group were significantly lower than traditional group [(4.0 ± 0.6) vs.(4.7 ± 0.8),P ＜ 0.05].There were no significant differences in BIND scores at other time points after phototherapy between the two groups (P ＞ 0.05).In both groups,serum NSE levels after phototherapy were lower than before phototherapy.Serum NSE level after phototherapy in the LED group was significantly lower than the traditional group (P ＜ 0.05).Total phototherapy duration of the LED group was significantly shorter than the traditional group (P ＜ 0.05).The incidence of exchange transfusion in LED group was significantly lower than traditional group.The incidence of abnormal brainstem auditory evoked potential in LED group were significantly lower than traditional group at 1 month and 3 months after birth (P ＜ 0.05).The proportion of abnormal cranial MRI between the two groups showed no statistical differences (P ＞ 0.05).Conclusion TSB levels and brain injury indicators should be closely monitored and evaluated in infants with severe hyperbilirubinemia and ABE.Active LED blue light phototherapy can rapidly reduce TSB levels,effectively control the progress of ABE,and reduce the ratio of exchange transfusion.Adverse reactions of LED blue light phototherapy are not observed in this study.
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Objective To explore the risk factors of hyperbilirubinemia in late preterm infants. Methods Clinical data of 211 cases of late preterm infants with hyperbilirubinemia and 246 cases of late preterm infants without hyperbilirubinemia were retro-spectively analyzed between 2011 and 2012. The risk factors of hyperbilirubinemia were filtered. Results Twenty-seven cases of late premature infants with hyperbilirubinemia were severe. Hospital stay less than 3 days, birth asphyxia history, small for gestatio-nal age, head hematoma, delivery injury, hypoalbuminemia, polycythemia, infection, hemolytic disease, feeding intolerance, and fe-tal excretion delay were associated with hyperbilirubinemia (P<0.05). Rural origin, pregnancy-induced hypertension syndrome and premature rupture of membrane were also associated with hyperbilirubinemia (P<0.05). Multivariate logistic regression analysis showed the history of birth asphyxia , fetal excretion delay, hypoalbuminemia, pregnancy-induced hypertension syndrome were risk factors of hyperbilirubinemia in late preterm infants (OR=2.35-4.05). Pregnancy-induced hypertension syndrome and hemolytic dis-ease were risk factors of severe hyperbilirubinemia in late preterm infants (OR=5.74, 73.64). Conclusions Neonatal asphyxia, fetal excretion delay, hypoalbuminemia and pregnancy-induced hypertension syndrome are risk factors of hyperbilirubinemia in late pre-term infants. Strengthening the management of pregnancy-induced hypertension syndrome and the treatment of newborn hemolytic disease can reduce the occurrence of severe hyperbilirubinemia in late preterm infants.
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Objective To investigate the relative factors of the neonates that were abandoned in hospital less than 24 hours,then the level of the local neonates medical service and the neonatal remedy skills and the life quality could be improved.Methods The clinical data of 379 cases of hospitalized neonates less than 24 hours from 2007 to 2011 were analyzed retrospectively.The correlation factors of the neonates abandoned in hospital less than 24 hours(122 cases) and hospitalized more than 24 hours (244 cases) were analyzed by single and multiple factor regression analysis.Results (1) There were 379 neonates who were in hospital less than 24 hours,among them,122 neonates were gave up the treatments.The differences of the gestational age and weight among abandon group,hospital referral group,improve group and uncured group were significant(P ＜0.01).(2) The numbers of neonates abandoned in hospital less than 24 hours were different significantly from 2007 to 2011 (P ＜0.05) and tendency was decreased year by year(chi-square trend test x2 =6.115,P =0.013).The uncured group was increased year by year (P ＜ 0.05).The hospital referral group,improved group were fluctuation,but no descend or rise tendency(P ＞0.05).(3) The differences of the gestational age,birth weight,uterine-incision delivery,intrapartum asphyxia,intrauterine distress,birth hospital,family income less than twenty thousand yuan every year,father's culture level,diagnosed premature,very low birth weight infant,low birth weight infant,respiratory distress syndrome and brain injuries were significant between neonates in hospital less than 24 hours and more than 24 hours(P ＜ 0.05).The differences of the male,intrapartum high risk factors,mother's morbid state and miscarriage were not significant(P ＞0.05).(4) The uterine-incision delivery,intrapartum asphyxia,birth in the county and below county hospital,family income less than twenty thousand yuan every year and diagnosed respiratory distress syndrome were correlation to the abandon treatment in 24 hours.There were no correlation to the gave up treatment in 24 hours to the rest of the factors.Conclusion We should set up the systemic gravid detection system,avoid premature birth and respiratory distress syndrome,add the hardware configuration and medical personnel to the neonate department,improve the professional technology level,perfect social security system mechanism,decrease the hospital discharge rate of the hospitalization less than 24 hours,improve the level of the local neonatal treatment technology and the quality of population.
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Objective To investigate the dedifferentiation of epidermal cells into their progenitor stem cells induced by basic fibroblasts growth factors(bFGF) in vitro.Methods HEKa cells obtained from Cascade were found flattening and formation of cell-to-cell contacts after 6 to 7 passages,which resembled differentiated epidermal cells in vivo.To examine the effect of growth factors on the cell proliferative alterations,bFGF(100 ng/ml) was added into the culture medium for different periods(6,12,24,48,or 72 h),then the cell proliferation was measured by MTT assay.Phenotypic changes and the cell-fate determination of HEKa cells after bFGF treatment were detected by immunocytochemical assays,flow cytometry and RT-PCR analysis.HEK cells with no intervention treatment were used as a control.Results MTT assay proved that the optimal culture condition to induce the dedifferentiation of epidermal cells into their progenitors was to culture HEKa cells for 36 to 48 h when the addition of bFGF was 100 ng/ml.After treatment with bFGF for 48 h,clusters of round-shaped cells appeared around differentiated epidermal cells,and expanded progressively thereafter.These cells were smaller in shape and with larger nuclear/cytoplasm ratio,and had not only clonogenicity but also ability to form a cutaneous ridge-like structure.Immunohistochemical staining revealed that the expression levels of ?1 integrin,CK19 and CK14 were up-regulated,while the expression of CK10 was significant down-regulated after bFGF treatment.Flow cytometry indicated that there were more CK19-positive and CK14-positive cells in the treatment group than in the control(74.77% vs 15.74%,and 87.14% vs 67.26%respectively),but much lesser CK10-positive cells(4.56% vs 98.56%).Additionally,the mRNA expression levels of ?1 integrin,CK19 and CK14 were up-regulated after bFGF treatment,but that of CK10 was down-regulated.Conclusion bFGF can reverse the differentiated process of epidermal cells and induce them to produce immature,stem-like cells,which can proliferate and be used in the wound repair and regeneration of skin tissues.