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Objective:To study the effects of gender on clinical outcomes of extremely low birth weight infants (ELBWI) and to analyze the risk factors of mortality.Methods:From January 2011 to December 2020, ELBWI (birth weight <1 000 g) admitted to the Neonatology Department of our hospital were retrospectively studied. The infants were assigned into the male group and the female group. Incidences of major complications, survival rate and mortality rate were compared between the two groups. The infants were also assigned into survival group and death group according to their clinical outcomes. Binary multivariate unconditional Logistic regression was used to analyze the risk factors of mortality in ELBWI.Results:A total of 637 ELBWI cases were included. 311 cases were in the male group with a survival rate of 57.9% (180/311) and 326 cases were in the female group with a survival rate of 57.4% (187/326). The incidences of neonatal respiratory distress syndrome (RDS), bronchopulmonary dysplasia (BPD), pulmonary hemorrhage and severe intraventricular hemorrhage (IVH) in the male group were significantly higher than the female group ( P<0.05). Significant increases of survival rate existed for both groups year by year ( P<0.01).No significant differences existed in survival rate, mortality rate of infants receiving proactive treatment and mortality rate of infants withdrawing treatment between the two groups ( P>0.05). Multivariate unconditional Logistic regression analysis showed that withdrawing treatment ( P<0.01) and pulmonary hemorrhage ( P<0.05) were associated with increased risks of mortality. Conclusions:Male ELBWI have higher risks of RDS, BPD and severe IVH than female ELBWI. Withdrawing treatment and pulmonary hemorrhage are common risk factors of mortality for both male and female ELBWI.
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Objective:To analyze the risk factors of bronchopulmonary dysplasia(BPD)in very preterm infants(VPI), and to provide scientific basis for the prevention and treatment of BPD in VPI.Methods:A prospective multicenter study was designed to collect the clinical data of VPI in department of neonatology of 28 hospitals in 7 regions from September 2019 to December 2020.According to the continuous oxygen dependence at 28 days after birth, VPI were divided into non BPD group and BPD group, and the risk factors of BPD in VPI were analyzed.Results:A total of 2 514 cases of VPI including 1 364 cases without BPD and 1 150 cases with BPD were enrolled.The incidence of BPD was 45.7%.The smaller the gestational age and weight, the higher the incidence of BPD( P<0.001). Compared with non BPD group, the average birth age, weight and cesarean section rate in BPD group were lower, and the incidence of male infants, small for gestational age and 5-minute apgar score≤7 were higher( P<0.01). In BPD group, the incidences of neonatal respiratory distress syndrome(NRDS), hemodynamically significant patent ductus arteriosus, retinopathy of prematurity, feeding intolerance, extrauterine growth restriction, grade Ⅲ~Ⅳ intracranial hemorrhage, anemia, early-onset and late-onset sepsis, nosocomial infection, parenteral nutrition-associated cholestasis were higher( P<0.05), the use of pulmonary surfactant(PS), postnatal hormone exposure, anemia and blood transfusion were also higher, and the time of invasive and non-invasive mechanical ventilation, oxygen use and total hospital stay were longer( P<0.001). The time of starting enteral nutrition, cumulative fasting days, days of reaching total enteral nutrition, days of continuous parenteral nutrition, days of reaching 110 kcal/(kg·d) total calorie, days of reaching 110 kcal/(kg·d) oral calorie were longer and the breastfeeding rate was lower in BPD group than those in non BPD group( P<0.001). The cumulative doses of amino acid and fat emulsion during the first week of hospitalization were higher in BPD group( P<0.001). Multivariate Logistic regression analysis showed that NRDS, invasive mechanical ventilation, age of reaching total enteral nutrition, anemia and blood transfusion were the independent risk factors for BPD in VPI, and older gestational age was the protective factor for BPD. Conclusion:Strengthening perinatal management, avoiding premature delivery and severe NRDS, shortening the time of invasive mechanical ventilation, paying attention to enteral nutrition management, reaching whole intestinal feeding as soon as possible, and strictly mastering the indications of blood transfusion are very important to reduce the incidence of BPD in VPI.
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Objective:To study the effects of hypertensive disorders of pregnancy (HDP) on the birth weight (BW) differences in twins.Method:From January 2011 to January 2020, twins delivered in our hospital were retrospectively analyzed. The twins born to HDP mothers were the HDP group and those born to healthy mothers were the control group. The maternal and neonatal data of the two groups were collected and the effects of HDP on the BW differences were analyzed.Result:The age of the mothers, the proportion of mothers of older ages and more-than-once delivery in HDP group (418 cases) were significantly higher than the control group (499 cases) [(31.4±5.3) years vs. (30.4±3.8) years, 26.6% (111/418) vs. 12.6% (63/499), 20.6% (86/418) vs. (15.0% (75/499)] ( P<0.05). The gestational age (GA) of newborns in the HDP group (836 cases) was significantly lower than the control group (998 cases) [(35.1±2.2) weeks vs. (36.7±1.2)]( P<0.05). The proportion of twins with GA <34 weeks in the HDP groups was significantly higher than the control group [24.2% (101/418) vs. 3.8% (19/499)] ( P<0.05). Cesarean section was the main delivery mode in both groups. The BW differences of the twins in the HDP group were larger than the control group [22.4% (9.1%, 31.9%) vs. 13.1% (5.8%, 19.6%)]. Significantly more twins in the HDP group showed ≥30% BW difference than the control group [28.7% (120/418) vs. 3.8% (19/499)] ( P<0.05). The incidences of BW discordant in twins (BWDT) in the HDP group was significantly higher than the control group [BWDT≥15%:61.5% (257/418) vs. 38.3% (191/499), BWDT≥20%: 51.4% (215/418) vs. 25.3% (126/499)] ( P<0.05).Among twins with GA of 34~37 weeks, the BW of the bigger infants and the smaller infants in the HDP group were all lower than the control group and the percentage of BW difference was significantly higher than the control group ( P<0.05). Conclusion:HDP may influence the intrauterine growth of the twins, aggravate the BW differences and increase the incidences of BWDT. It is necessary to make better prenatal management of HDP and closely monitor the intrauterine growth of the fetuses.
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Objective:To study the clinical characteristics of hepatic injury following umbilical vein catheterization, so as to improve the safety and use of umbilical vein catheterization in the newborn.Methods:Data of infants undergoing umbilical vein catheterization during hospitalization in the neonatology department of the Third Affiliated Hospital of Guangzhou Medical University from Jan 1st, 2015 to Dec 31st, 2019 were collected retrospectively.The clinical characteristics, diagnoses and treatments of the infants with hepatic injury following umbilical vein catheterization were summarized and analyzed.And the relative literature was reviewed.Results:A total of 1 721 infants underwent umbilical vein catheterization, and seven cases(0.4%)had hepatic injury, including six cases of exudative necrosis in the liver and one case of hepatic hematoma.There was no significant difference in gestational age[(31.12±2.64)weeks vs.(30.62±2.75)weeks]or birth weight[(1 493±525)g vs.(1 374±473)g]between hepatic injury group and non-hepatic injury group( P>0.05). Clinically, it was found that the tip position of umbilical vein catheter was below the diaphragm(between the 9th and 11th thoracic vertebrae)in all seven cases.Except one case with no obvious clinical symptoms, the other six cases had clinical symptoms, mainly manifested as abdominal distension, repeated gastric retention, decreased bowel sounds, and additional with shock and anemia in hepatic hematoma.Blood sample tests showed elevated C-reactive protein, white blood cell count and transaminase.X-ray examination revealed cystic translucent shadow in the liver, and ultrasound and/or computed tomography examination showed the lesion in more detail.After removal of the catheter and administration of antibiotic, the hepatic injury recovered gradually. Conclusion:The hepatic injury following umbilical vein catheterization in neonates is not common.The catheter tip under the diaphragm is the main risk factor.And the diagnosis is dependent on imaging examination.
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Objective:To investigate the effect of Budesonide (BUD) on pulmonary vascular development and the expression of vascular endothelial growth factor (VEGF) and nucleotide binding oligomerization domain-like receptor protein 3 (NLRP3) in newborn rats with bronchopulmonary dysplasia (BPD) caused by intrauterine infection.Methods:The 15-day-pregnant SD rats were divided into control group and infection group [intraperitoneal injection of 0.35 mg/(kg·d) lipopolysaccharide], and the newborn rats born by the above groups were divided into 3 groups: BUD group (0.5 mg of BUD suspension), normal control group (NC group, equal amount of 9 g/L saline), BPD group (equal amount of 9 g/L saline), with 40 rats in each group, all of them were inhaled twice a day for 14 days.Ten newborn rats were selected at birth, on the 3 rd, 7 th and 14 th day after administration.Pulmonary histopathological changes and radial alveolar counts (RAC) were observed after HE staining, and the thickness of alveolar respiratory membrane was measured; the platelet-endothelial cell adhesion molecule (PECAM-1/CD 31) in lung tissue was detected by immunohistochemistry, and the density of pulmonary microvessels was calculated; the expressions of VEGF, NLRP3 and Caspase-1 were detected by Western blot; and the levels of serum interleukin( IL)-1β and IL-18 were measured by enzyme-linked immunosorbent assay. Results:With the increase of day-old, the lung tissue of newborn rats in NC group was gradually developed and matured, the structure of alveoli was clear, the size was uniform, the count was significantly increased, and no obvious pathological changes were observed.In BPD group, the lung tissue structure was disordered, the alveoli were different in size and few in count, and inflammatory cells were exuded from the alveoli or the alveoli space.Compared with BPD group, the pathological changes of lung tissue in BUD group were significantly reduced.On the 3 rd, 7 th and 14 th day after administration, compared with NC group, the RAC, average integral optical density of CD 31 positive cells, density of pulmonary microvessel and level of VEGF protein in lung tissue of BPD group and BUD group were lower, and the differences were statistically significant (all P<0.05); while the thickness of respiratory membrane, level of NLRP3, Caspase-1 proteins in lung tissue and serum levels of IL-1β, IL-18 were significantly higher, and the differences were statistically significant(all P<0.05). Compared with BPD group, the RAC, average integral optical density of CD 31 positive cells, density of pulmonary microvessel and level of VEGF protein in lung tissue of BPD group and BUD group were significantly higher, and the differences were statistically significant (all P<0.05); while the thickness of respiratory membrane, level of NLRP3, Caspase-1 proteins in lung tissue and serum levels of IL-1β, IL-18 were significantly lower, and the differences were statistically significant (all P<0.05). Conclusions:The occurrence and development of pathological changes of BPD newborn rats caused by intrauterine infection can affect the development of pulmonary vessels through the inflammatory response of lung tissue.BUD can alleviate pathological changes in lung tissues of BPD newborn rats by reducing inflammatory reaction and up-regulating VEGF expression, promoting pulmonary vascular remodeling, and increasing pulmonary microvascular density.
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Objective:To investigate the status of enteral feeding and the incidence of feeding intolerance in premature infants less than 32 weeks of gestation age, as well as the difficulties during enteral feeding.Methods:A retrospective analysis was conducted on preterm infants less than 32 weeks of gestation age admitted to the Neonatal Intensive Care Unit of the Third Affiliated Hospital of Guangzhou Medical University from January to December 2018.The infants were divided into 2 groups: 76 cases in the feeding tolerance group, 45 males (59.2%, 45/76 cases), mean gestational age (29.43±1.42) weeks; 79 cases in the feeding intolerance group, 48 males (60.8%, 48/79 cases), mean gestational age (29.16±1.60) weeks.The incidence of feeding intolerance was explored, and the enteral feeding, growth and main diagnosis as well as treatment during hospitalization between the 2 groups were compared.Results:(1) For preterm infants less than 32 weeks of gestation age, 92.9%(144/155 cases) of infants were given formula milk within 48 hours after birth, and 76.1% (118/155 cases) of infants were given formula milk within 24 hours after birth, the initial milk feeding volume of the 2 groups were [(12.24±4.37) mL/ (kg·d) vs.(11.23±4.88) mL/(kg·d), t= 0.812, P>0.05]. (2) The rate of milk volume increase in the feeding tolerance group and feeding intolerance group were [(8.69±4.30)mL / (kg·d) vs.(4.29±4.02) mL / (kg·d) in week 1; (8.43±0.45) mL / (kg·d) vs.(4.26±2.75) mL / (kg·d) in week 2, t=6.583, t′=13.294, all P<0.05)]. (3) The duration of achieving sufficient enteral feeding in the feeding tolerance and feeding intolerance group premature infant were[(20.55±9.66) d vs.(34.88±15.02) d, t=7.489, P<0.05]. (4) The feeding tolerance group had shorter hospital stay, more weight gain and lower incidence of extrauterine growth retardation than the feeding intolerance group.(5) The incidence of feeding intolerance was 50.9% (79/155 cases) in preterm infants less than 32 weeks of gestation age, delayed meconium excretion, blood transfusion, non-invasive mechanical ventilation, use of hormones, use of antibiotics for more than 2 weeks, bronchopulmonary dysplasia may be associated with feeding intolerance. Conclusion:Enteral feeding is not ideal for preterm infants less than 32 weeks of gestation age, and the incidence of feeding intolerance is high.The feeding plan of medical staff needs to be improved.
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Objective To study the survival rate,complications and risk factors affecting clinical outcomes in extremely low birth weight (ELBW) premature infants.Method From January 2008 to December 2017,clinical data of ELBW infants admitted to the department of neonatology of our hospital were collected.The survival rates and the incidences of complications were compared between different subgroups of different birth weight (BW) and discharging date.The risk factors affecting the survival rate of ELBW infants were analysed using multivariate unconditional Logistic regression analysis.Result (1) A total of 438 ELBW infants were enrolled,representing 4.9％ (438/8 910) of all discharged preterm infants,and 2.6％ (438/16 948) of all discharged neonates during the study period.Among them,3 were excluded because of incomplete data and lost of follow-up.The BW was 900 (750,950) g and the gestational age was (28.0±2.1) weeks.The overall survival rate was 81.6％ (209/256) with 179 cases excluded for giving up treatment.(2) From 2008 to 2017,the percentages of ELBW infants among all discharged newborns and all discharged premature infants increased annually (x2 trend=6.818,27.850,P=0.009,＜0.001).(3) No significant differences existed in the survival rates of ELBW infants between 2013-2017 and 2008-2012(P＞0.05).The survival rates of different BW groups (＜700 g,700～799 g,800～899 g,and 900～999 g)increased from 40.0％ (6/15) to 88.5％ (139/157) (x2 trend=32.648,P＜0.001).(4) The main complications in ELBW infants were respiratory distress syndrome 87.5％ (224/256),retinopathy of prematurity 63.1％ (123/195),and bronchopulmonary dysplasia 63.0％ (126/200).(5) Multivariate unconditional logistic regression analysis showed that BW＜900 g (＜700 g∶ OR=10.147,95％CI 2.684～38.360;700～799 g∶ OR=6.978,95％CI 1.647～29.555;800～899 g∶ 0R=4.727,95％CI 1.060～21.082,P＜0.05),and gestational age＜28 weeks (OR=3.529,95％CI 1.601～7.778,P=0.002) were the risk factors for survival rate and antenatal steroids was the protective factor(OR=0.155,95％CI 0.069～0.353,P＜0.001).Conclusion The number of ELBW infants discharged from neonatology department increased annually.The survival rate of ELBW infants was positively correlated with BW.Antenatal steroids may improve the survival rate of ELBW infants.
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Objective To investigate the effect of docosahexaenoic acid (DHA) on the body weight growth and lipid metabolism of neonatal rats during lactation.Methods The specific pathogen free Sprague-Dawley neonatal rats were randomly assigned into 4 groups (high-dose group,medium-dose group,low-dose group and control group) by random number table method.The rats in 3 experiment groups received intragastric administration with DHA 600 mg/kg,300 mg/kg and 100 mg/kg,respectively,while the control group were given 9 g/L saline,totally for 21 days.Body weight was monitored and compared among groups on postnatal day 1,7,14 and 21.And body weight growth rates at each time point were calculated.The serum concentrations of high density lipoprotein cholesterol (HDL-C),low density lipoprotein cholesterol(LDL-C),triglyceride (TG) and total cholesterol were measured and compared at 6-week and 8-week ages.The pathological and histological changes in the heart,the large vessel and the liver were observed at same time.Results The mean body weight of the neonatal rats were significantly different among 4 groups on postnatal day 7,14 and 21 (F =17.334,4.159,6.485,all P ＜ 0.01).Comparisons were made between every 2 groups,the low-dose group was higher than the control group on postnatal day 7 [(21.60 ±0.89) g vs.(18.57 ± 0.76) g] and day 21 [(58.52 ±6.62) g vs.(53.01 ± 11.75) g];the medium-dose group was lower than the control group on postnatal day 7 [(14.23 ±0.49) g vs.(18.57 ±0.76) g] and lower than the low-dose group on postnatal day 21 [(52.47 ±8.18) g vs.(58.52 ±6.62) g];the high-dose group was lower than the low-dose group on postnatal day 7[(16.13 ± 1.02) g vs.(21.6 ±0.89) g],and it was lower than the control group and the low-dose group on postnatal day 14[(31.69 ± 1.77) g vs.(37.60 ± 1.32) g and (36.24 ±0.84) g],and lower than all the other 3 groups on postnatal day 21 [(45.9 ± 13.17) g vs.(53.01 ± 11.75) g,(58.52 ±6.62) g and (52.47 ±8.18) g];all the differences above were statistically significant (all P ＜ 0.05).During the first and the second week after birth,there were significant differences in the mean body weight growth rate among 4 groups (F =8.369,8.331,all P ＜ 0.01),but there was no significant difference during the third week (F =0.603,P ＞ 0.05).Compared with 2 groups,the mean body weight growth rate of the low-dose group was higher than that of the control group in the first week [(184.96 ± 63.16) ％ vs.(141.02 ± 72.07) ％],but which was lower than that of the control group in the second week [(72.60 ± 35.37) ％ vs.(103.20 ± 40.11) ％];the medium-dose group was lower than the low-dose group at the first week [(116.78 ± 51.59) ％ vs.(184.96 ± 63.16)％],but higher than the low-dose group and lower than the control group at the second week[(139.93 ± 67.4) ％ vs.(72.60 ± 35.37) ％ and (103.20 ± 40.11) ％];the high-dose group was lower than the low-dose group in the first week [(137.33 ± 34.42) ％ vs.(184.96 ± 63.16) ％] and lower than that of the medium-dose group in the second week [(98.22 ± 65.86) ％ vs.(139.93 ± 67.4) ％];all these differences were statistically significant (all P ＜ 0.05).At 6 weeks of age,the mean serum concentrations of total cholesterol,TG and LDL-C were not significandy different (F =1.899,1.450,2.581,all P ＞ 0.05) among 4 groups,but the mean concentration of HDL-C was statistically different (F =7.801,P ＜ 0.01).In detail,the mean concentration of HDL-C in medium-dose group was higher than that of the control group,the low-dose group and the high dose group [(1.66 ± 0.08) mmol/L vs.(0.97 ± 0.16) mmol/L,(1.20 ± 0.09) mmol/L and (0.82 ± 0.09) mmol/L,all P ＜ 0.05],and which in the high-dose group was lower than that in the low-dose group (P ＜ 0.05).At 8-week age,the mean serum concentrations of HDL-C,LDL-C and total cholesterol were not significantly different among 4 groups (F =0.935,0.300,1.299,all P ＞ 0.05),but the mean concentration of TG was significantly different (F =2.875,P ＜ 0.05).The mean concentration of TG in the medium-dose group was lower than that in the control group [(0.98 ± 0.11) mmol/L vs.(1.36 ± 0.09) mmol/L,P ＜ 0.05].There were 5 (15.62％) neonatal rats in the high-dose group which were found to have adipose tissue accumulation around the large vessel walls and the heart and were confirmed by histological examination.The liver cells in these rats were found to have mild fatty changes.No similar changes were found in the other groups.Conclusions Neonatal rats supplemented with DHA during lactation can affect their body weight growth and lipid metabolism.Supplemented with high dose may bring risks,while moderate dose may bring benefits.
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Objective To analyze the correlative factors of neonatal deaths in neonatology department to improve the treatment level and reduce the death rate of the hospitalized newborn patients.Method The medical records and death review data of the infants who died in the neonatology department of the Hospital from 2009 to 2015 were retrospectively reviewed.They were assigned to three groups according to the therapeutic measures before their death,including comfort care group,do not resuscitate (DNR) group and active treatment group.Gestational age,birth weight,postnatal age at death and the direct cause of death were compared between groups by x2 test.Result A total of 337 infants were enrolled in this study.There were 112 cases (33.2％) in the comfort care group,73 cases (21.7％) in the DNR group and 152 cases (45.1％) in the active treatment group.Compared to the proportion of the different group during 2009-2012,the proportion of the comfort care group during 2013-2015 significantly increased(38.9％ vs.27.2％,P =0.023),and the proportion of the active treatment group significantly decreased (38.3％ vs.52.5％,P =0.009),while the proportion of the DNR group showed no significant difference (22.9％ vs.20.4％,P =0.580).The proportion of the comfort care group was significantly higher in the group of neonates who died in early neonatal period than that in the late neonatal period and post-neonatal period (42.9％ vs.9.3％,P ＜0.001),while the proportion of the active treatment group and DNR group decreased(17.9％ vs.30.9％,P =0.009;39.2％ vs.59.8％,P =0.001).The proportion the comfort care group increased with the decrcasing gestational age and birth weight (P =0.001 and 0.002).Of the 34 term infants,the top two principle causes of death were severe asphyxia (4.1.1％,14.cases) and congenital defects (32.4％,11 cases).Of the 303 preterm infants,the top three direct causes of death were neonatal respiratory distress syndrome (31.4％,95 cases),neonatal pulmonary hemorrhage (22.4％,68 cases) and congenital defects (6.3％,19 cases).Conclusion The proportion of comfort care and DNR was higher than the proportion of active treatment before the newborns' death and it was relative to gestational age and birth weight.Preterm infants were the predominant population of the infant deaths in the neonatology department.Neonatal respiratory distress syndrome was the principle cause of death in preterm infants,and severe asphyxia was the main cause of death in term infants.
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Objective To explore effect of different postures for PICC intubation through basilic vein in very low birth weight infants. Methods Eighty infants from Oct. 2013 to Sep. 2014 with PICC via basilic vein were set as the control group in which traditional method of preventing catheter displacement was applied, another 80 cases from Oct. 2014 to Sep. 2015 were divided to the observation group. And improved method was applied in the experiment group besides the traditional method. The ectopic occurrence rates of the two groups were compared. Result The ectopic rate of PICC catheters in the observation group was significantly lower than that of the control group (P<0.05). Conclusion When the catheter tip reaches the shoulder of the very low birth weight infants, the method of raising their upper limbs slightly to the head can reduce the ectopic incidence of catheters and thereby improve the success rate of PICC intubation.
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Objective To study the relationship between exon gene polymorphism of pulmonary surfactant pro-tein B(SP -B)and the susceptibility and severity,prognosis of respiratory distress syndrome (RDS).Methods To detect the gene sequence of SP -B exon by adopting the gene sequencing technology,and samples were 80 prematures of very low birth weight in Southern Han Chinese,who were divided into 2 groups,the RDS and the non RDS,and the difference of genotype in SP -B exon in 2 groups was compared.Results There was no significant difference between 2 pretem groups in the aspects of the gestational age,sex,birth weight and delivery mode etc(all P >0.05).Fifty -nine prematures of very low birth weight had exons heterogenesis,and there were 2 types of mutations,V1 :Exon2:c.[5A >C]+[5A >C]or c.[5A >C]+[=];V2:Exon5:c.[428C >T]+[428C >T]or c.[428C >T]+[=].There were 20 cases of type V1 ,1 8 cases of type V2,3 cases of type V1 +V2 in 45 cases of RDS,and there were 1 2 cases of type V1 ,9 cases of type V2,no case of type V1 +V2 in the non RDS group.Comparing the incidence of V1 and V2 in 2 groups,there were all significant differences(χ2 =3.73,5.02;all P 0.05).Conclusion Gene polymorphism of SP -B exon are risk factors for premature of very low birth weight in southern Han Chinese in RDS.
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Objective To study the influence of postnatal high protein feeding on learning and memory abilities of preterm rats.Methods After weaning,the SD offspring were divided into 6 groups randomly according random digits table:preterm standard protein group (group A),term standard protein group (group B),preterm low protein group (group C),term low protein group (group D),preterm high protein group (group E),and term high protein group (group F),with 34 rats in each group.Starting from 22 days of age,the standard protein group,low-protein group and the high-protein group were respectively fed with a standard protein diet (containing 18％ protein),low-protein diet (containing 8％ protein) and a high-protein diet (containing 30％ protein) until the end of experiment.Within each group,the rats were respectively tested in 6 weeks and 8 weeks.Morris water maze task was performed to assess the learning and memory abilities of the premature rats.Results 1.Directional navigation experiments:(1) At the age of 6 weeks,the escape latencies to find the platform were shortened with increased training times for full-term rats.The escape latencies of the premature rats did not change significantly on the third and fourth day of the experiment.(2) At the age of 8 weeks,the escape latencies to find the platform were shortened with increased training time for all of the rats.2.Probe trial test:(1)At the age of 6 weeks,premature rats spent significantly less time in target quadrant than full-time rats.And the percent age of traveled distance in target quadrant of premature rats was significantly less than full term rats (P ＜ 0.05).(2) At the age of 8 weeks,group E [(68.48 ± 20.65) s] spent significantly greater time in target quadrant than group A and group C [group A(52.41 ± 11.24) s,group C (49.54 ± 11.04) s].And the percent age of traveled distance in target quadrant of group E [(36.56 ± 10.44) ％] were significantly higher than group A and group C [group A (29.83 ± 8.33) ％,group C (26.97 ± 5.41) ％] (P ＜ 0.05).(3) At the age of 8 weeks,group E spent time in target quadrant and the percent of traveled distance in target quadrant [(68.48 ± 20.65) s,(36.56 ±10.44)％] were higher than group F [(61.29 ± 16.27) s,(35.71 ±6.61)％],but there was no significant difference (P ＞ 0.05).Conclusions In the early growth and development process of the brain,premature birth may seriously affect early brain functions in rats,and the learning and cognitive abilities of the premature rats are worse than full-term rats.In the subsequent process of growth and development,after a long time of high protein nutritional intake,the learning and cognitive abilities of the premature rats can be restored and they can catch up with full-term rats.
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Objective To explore the relationships of insulin-like growth factor 1 (IGF-1) and insulin-like growth factor binding protein 3 (IGFBP-3) with growth of very low birth weight (VLBW) infants in the early postnatal stage. Methods According to the individual gestational age and birth weight, 32 cases of VLBW infants were divided into small for gestational age (SGA) group and appropriate for gestational age (AGA) group. After birth, all the infants were given the same nutritional intake. The body weight, body length, head circumference and body mass index (BMI) were monitored at different time points (d0, d7, d14 and d28 after birth). Serum IGF-1 and IGFBP-3 levels were measured by radiommunoassay, and IGF-1/IGFBP-3 molar ratio was calculated. Results There was no signiifcant difference of body weight, body length, head circumference and BMI between two groups at d0, d7, d14 after birth. Body weight and BMI in SGA group were less than those in AGA group at d28 after birth (P<0.05). The levels of IGF-1, IGFBP-3 and IGF-1/IGFBP-3 in SGA group and IGF-1/IGFBP-3 in AGA group did not change with age after birth. The levels of IGF-1 and IGFBP-3 were increased in AGA group after birth. The level of IGF-1 in AGA group at d14 and d28 after birth was higher than that in AGA group at d0 after birth (P<0.05). The level of IGFBP-3 in AGA group at d28 after birth was higher than that in AGA group at d0 after birth (P<0.05). The levels of IGF-1 and IGFBP-3 in SGA group at d28 after birth were lower than those in AGA group at d28 after birth (P<0.05). Conclusions Serum IGF-1 and IGFBP-3 levels in SGA group are lower than those in AGA group. Low levels of IGF-1 and IGFBP-3 may result in growth retardation.
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Objective To explore the effect of Vitamin K1(Vit K1), fresh frozen plasma (plasma) andcryoprecipitate on prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen original(Fbg), thrombin time (TT) of newborns with different gestational ages. Methods The serum of 1,134 newbornsfrom The Third Affiliated Hospital of Guangzhou Medical University was collected from February 2009 to September2012. All newborns had been divided into four groups (according to the gestational age of 28-31+6 weeks, 32-33+6weeks, 34-36+6 weeks and gestational age≥37 weeks).The effect of various interventions (Vit K1, Vit K1+plasmaand Vit K1+cryoprecipitate) on PT, APTT, Fbg, and TT had been recorded. Results (1)The PT and APTT ofeach group with the interventions of Vit k1 were significantly improved (P < 0.05). (2)The PT, APTT, Fbg and TTof each group with the interventions of Vit k1 combined with plasma were significantly improved (P < 0.05). (3)ThePT, APTT and Fbg of each group with the interventions of Vit k1 combined with cryoprecipitate were significantlyimproved (P < 0.05). (4)With Vit k1 combined with plasma, PT and APTT were mostly improved and Fbg wasimproved mostly with Vit k1 combined with cryoprecipitate. Conclusion Vitamin K1, fresh frozen plasma andcryoprecipitate can effectively improvedin the coagulation index of newborns with different gestational ages.
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ObjectiveTo explore the control factor of pulmonary microvascular endothelial cells in pulmonary hemorrhage with the RhoA-Rock pathway inhibitors.MethodsHuman pulmonary rnicrovascular endothelial cells were conventionally cultured,and were divided into four groups:control group,inhibitor group,hypoxia group and hypoxia group with inhibitor.As different fluorescein lsothiocyanate-phalloidin and filamentous actin (F-actin) in cytoplasm combined,it issued red fluorescence.We observed the dynamic changes of F-actin by laser scanning confocal microscope in hypoxia human pulmonary microvascular endothelial cells and recorded the value of fluorescence.ResultsThe mean fluorescence intensity of F-actin of hypoxia group in 1 h,12h and 24 h was (64.3 ±5.5)％,(60.3±4.2)％,and (47.8 ±4.6)％ as compared with the control group;the ratio of hypoxia group with inhibitor was (66.2 ±3.2)％,(67.1 ±6.2)％,and (72.5 ± 6.1 ) ％ as compared with the control group.The mean fluorescence intensity of F-actin decreased obviously after 1 h hypoxia treated to cells,decreasing to (64.3 ± 5.5 ) ％ of the control group (P ＜0.05 ) ;to 24 h,decreasing to (47.8 ±4.6) ％ of the control group(P ＜0.05).The mean fluorescence intensity of F-actin decreased to (66.2 ± 3.2) ％ of the control group after 1 h hypoxia treated in inhibitor group,which was more than 1 h in the hypoxic group.F-actin decreased obviously to (72.5 ± 6.1 ) ％ of the control group after 24 h hypoxia treated in inhibitor group.There was significant difference comparing with the hypoxia group after 24 h hypoxia(P ＜0.05).The mean fluorescence intensity of F-actin of inhibitor group without anoxic was invariant comparing with the control group(P ＞0.05).Cortex-like structure disappeared and the stress fibers arranged disorderly after hypoxia.Actin depolymedzated and broke gradually with the extension of hypoxia time.If to be hypoxic after pretreated with RhoA-Rock pathway inhibitor,cortex-like structure by the composition of pednuclear F-actin reappeared,distribution and arrangement of stress fibers in the cytoplasm tended to rule.ConclusionThe RhoA-Rock pathway mediates the damage on F-actin of pulmonary microvascular endothelial cells after hypoxia.Interfering with the RhoA-Rock pathway inhibitors can provide a new direction for the treatment of neonatal pulmonary hemorrhage.
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Objective To test the attachment quality of autism children between 2～6 years with attach-ment Q-Sort,and to understand the difference from normal children. Methods Use the AQS to test the parents of 167 normal children and 55 autism children,which can evaluate the children' attachment types. Results The rate of security attachment in normal children was 68.3% ,and the rate of unsure attachment was 31.7%. The rate of security attachment in autism children was 29.1% ,and the rate of unsure attachment was 70.9% ;and the rates of security attachment in normal and autism children were different significantly(X2=26.16, P<0.01). Attachment quality was not associated with sex both in normal and autism children and neither age was. Conclusions Most of the normal children have the security attachment,and the autism children have the unsure attachment. Neither age nor sex is associated with attachment quality both normal children and autism children.
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The article explored the cause of recovery failure by adopting advanced simu-lation system(ECS) in the teaching of ‘recoveing of neonatal asphyxia’and put forward some improvement methods and counter measures.Marking full use of the advantages of ECS,designing the training course with specifit roles and objectives,paying attention to the guidance of organiza-tion and exchange as well as the training of cooperative team are the key to improve the skills of neonatal asphyxia recovery in obstetrical pediatric and the teaching quality.
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OBJECTIVE:To investigate the efficacy and mechanism of ademetionine for treating hyper-unconjugated bilirubinemia in neonate rats.METHODS:The model of hyper-unconjugated bilirubinemia was established in 95 neonate SD rats by subcutaneously injection of phenylhydrazine hydrochloride,then the rats were randomly assigned to model control group(treated with normal saline),therapeutic control group(phenobarbital/nikethamide)and the therapeutic group(s-adenosyl-1-methionine)q.d for 7 days all by intraperitoneal injection.Blood samples were taken at different time for the analysis of the hepatic BUGT activity and serum bilirubin.RESULTS:In therapeutic control group compared with the model control group,the serum unconjugated bilirubin was lower,and the hepatic BUGT activity of therapeutic was higher(P
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Objective To discuss the diagnosis and management options of fetal nuchal cystic hygroma(NCH). Methods Ten cases of fetal nuchal cystic hygroma from Mar 1996 to Mar 2003 were retrospectively analyzed. The sonographic images, fetal karyotype examination after amniocentesis, TORCH results and pathology were reviewed. Results The sonogram detected a large cystic mass around the posterior of the neck. The smallest one was 5.3 cm?4.8 cm?4.0 cm in size and the biggest 12.6 cm?6.6 cm?4.0 cm. The nuchal ligament could be seen inside the mass. Four cases complicated with pleural effusions and 4 with pleural effusions, ascites and skin edema. One case was deliveried in full term and the other 9 cases were induced (including 4 fetal death). Seven cases were examined for TORCH of amniotic fluid among which only one TOX PCR positive. The karyotype examination was performed in 6 cases. The results were 45XO(3 cases), 45XO/46XX (60:40) and 45XX,-21,-22,+t(21;22). The only alive baby is 46XX. Conclusions Ultrasound and invasive amniocentesis to detect the fetal karyotype have an important role in early diagnosis and management of nuchal cystic hygroma. Nuchal cystic hygromas are associated with Turner’s syndrome and other chromosomal abnormalities.