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Objective To evaluate the prophylatic effect of recombinant human erythropoietin (rhEPO) on bronchopulmonary dysplasia (BPD) of preterm infants. Methods One hundred and fifty-five infants who were born at 26-29+6 weeks of gestation in Department of Neonatology, Guangdong Women and Children Hospital from January 1, 2009 to December 31, 2010 were randomly assigned to rhEPO-treated group (n=78) and control group (n=77) on admission. Randomization was stratified according to gestational age (26 or 27 weeks and 28 or 29 weeks). rhEPO-treated group was given the rhEPO at 300 U/kg, but none for the control group. Forty-eight hours after birth, rhEPO was injected subcutaneously every other day, three times a week for 4 weeks. The supportive care was same in the two groups. The outcomes at 36 weeks gestation included:(1) mortality of the infants;(2) incidence and severity of BPD;(3) rates of the complications, such as pneumonia, sepsis, necrotizing enterocolitis (NEC), intraventricular hemorrhage (IVH), patent ductus arteriosus (PDA), and retinopathy of prematurity (ROP) ; and (4) duration of oxygen and ventilation support. Mann-Whitney U, χ2, Fisher's exact or t test were used for statistical analysis. Results The incidence of BPD in rhEPO-treated group was lower than in the control group [18.6%(11/59) vs 36.8%(25/68),χ2=5.107,P=0.030), but there was no difference in the severity of BPD (P>0.05). There was no significant difference in the mortality rate between the two groups [12.8%(10/78)vs 7.8%(6/77), P>0.05]. The duration of the mechanical ventilation and oxygen therapy was shorter in rhEPO-treated group than in the control group [oxygen therapy:166.4(138.9-198.1) h vs 288.9(287.4-312.9)h, U=361.000;mechanical ventilation:80.5(67.7-95.1) h vs 150.4(148.9-151.9) h, U=88.000;both P0.05). Conclusion Prophylatic treatment of rhEPO in preterm infants could decrease the incidence of BPD, and reduce the duration of the mechanical ventilation and oxygen therapy, but without increasing any side effects.
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Objective To explore the effect and its possible mechanism of human umbilical cord mesenchymal stem cells (hUCMSCs) on bacterial growth in bronchoalveolar lavage fluid (BALF) of newborns with ventilator associated pneumonia (VAP).Methods Newborns admitted to neonatal intensive care unit (NICU) in Guangdong Women and Children Hospital Affiliated to Guangzhou Medical University from June 1,2012 to December 31,2012 were reviewed.The inclusion criteria were:(1)Positive BALF culture results.(2) Requirement of mechanical ventilation with tracheal intubation.(3) Diagnosed as ventilator-associated pneumonia.Two pieces of BALF samples of newborn were collected and randornaly divided into experimental and control group.hUCMSCs were added into the experimental group,while the same volume of conditioned medium was added into the control group.Both groups were incubated for six hours in humidified CO2 incubator at 37 ℃,then,bacterial growth was assessed by colony forming unit (CFU) counts.Levels of the antimicrobial peptides (Cathelicidin/LL-37 and human HBD-2) were determined by enzyme-linked immunosorbent assay and Western blot.Paired t-test was used for statistical analysis.Results Among the culture results of 31 newborns,there were Klebsiella pneumoniae (6 cases,19.3％),Stenotrophomonas narrow food aeromonas (6 cases,19.3％),Hemolytic staphylococci (5 cases,16.1％),Escherichia coli (3 cases,9.7％),Bacterial meningitis septicemia Elizabeth Platinum (3 cases,9.7％),Acinetobacter baumannii (3 cases,9.7％),Pseudomonas putida (2 cases,6.4％),Pseudomonas aeruginosa (1 case,3.2％),Staphylococcus aureus (1 case,3.2％) and Enterobacter cloacae (1 ease,3.2％).The CFU counts in experimental group were much less than those in control group [(2.60±0.67) ×104] CFU/ml vs [(1.18±0.32) ×105] CFU/ml,(t=-20.19,P＜0.01).Levels of Cathelicidin/LL-37 and HBD-2 in experimental group were higher than those in control group [Cathelicidin/LL-37:(8.98 ± 3.22) ng/ml vs (3.18 ± 1.57) ng/ml,t =17.79,P ＜ 0.01 ;HBD-2:(379.87±11.74) pg/ml vs (39.89±2.86) pg/ml,t=37.62,P＜0.01].Conclusions hUCMSCs had antimicrobial effect on bacterial growth in BALFs from ventilator associated pneumonia possibly by the secretion of antimicrobial peptides (Cathelicidin/LL-37 and HBD-2).
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Objective To discuss the influence of pudendal nerve block anesthesia on pain degree and labor course when presentation at different positions during the second stage of labor,in order to find the better anesthesia timing and method to reduce pain,shorten labor,increase maternal comfort to a maximum extent and provide the best service for the maternal.Methods 200 cases of primiparas with fullterm and single-birth were selected and numbered randomly,patients with odd numbers were set to the observation group,patients with even numbers were set to the control group,100 cases in each group.In the observation group,when the presentation reached S+1,1％ lidocaine was used to perform pudendal nerve block anesthesia.In the control group,the pudendal nerve block anesthesia was performed before perineal incision.Results The pain intensity,time of the second labor stage,perineum damage degree between the two groups were statistically different.The observation group with Ⅱ-grade level,Ⅲ-grade level pain were 32 cases less than that of the control group.The perineum incision later crack number in the observation group was 24 cases less than that of the control group.The number of delivery within 1 hour in the second labor process in the observation group was 21 cases more than that in the control group.Conclusions Implementation of bilateral pudendal nerve block anesthesia in the second stage of labor when the presentation reaches S+1 can alleviate childbirth pain,shorten the second stage of labor,reduce the degree of perineal trauma.
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Objective To determine the risk factors for imipenem-resistant Pseudomonas aeruginosa (IRPA) infections in neonatal intensive care unit (NICU).Methods One hundred and eighty-eight Pseudomonas aeruginosa infected children (confirmed by pathogenic examination) in the NICU of Maternal and Child Health Hospital of Guangdong from January 1,2008 to December 31,2011,were chosen as the objects of study,and were divided into two groups.The first group included 73 children that had been isolated with IRPA strains(IRPA group),and the second group included 115 children that only had imipenem-sensitive Pseudo monas aeruginosa (ISPA) strains (ISPA group).Chi-square test or t-test was applied.The risk factors were investigated by univariate or multivariate Logistic regression analysis.Results Data from univariate analysis showed that the gestational age and birth weight of neonates were lower than those in ISPA group [(34.0±3.5) weeks vs (35.6±2.8)weeks,t=3.413,P＜0.01; (1848.1±276.4) g vs (2110.7±345.6) g,t=5.472,P＜0.01].There were more neonates with gestational age ≤ 32 weeks [67.1％ (49/73) vs 45.2 ％ (52/115)],birth weight ＜1500 g [73.9％ (54/73) vs 33.0％(38/115)],small for gestational age [68.5％ (50/73) vs 29.6％ (34/115)],receiving imipenem [72.6％ (53/73) vs 27.0％ (31/115)] or the third generation cephalosporins [65.8％ (48/73) vs 33.0％ (38/115)] two weeks before the isolation of Pseudomonas aeruginosa,and mechanical ventilation [78.1％ (57/73) vs 61.7 ％ (71/115)],deep vein catheterization [83.6％(61/73) vs 65.2％(75/115)] in the IRPA group than in the ISPA group (all P＜0.05 or 0.01).The multivariate Logistic regression analysis revealed that imipenem treatment within two weeks before the isolation of Pseudomonas aeruginosa (OR=6.409; 95％ CI:1.926-21.333,P =0.002) was an independent risk factor.Conclusions IRPA infection in NICU hospitalized infants is strongly related to their gestational age and birth weight.History of imipenem administration could be an independent risk factor.
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Objective To investigate the relationship between Helicobacter pylori (H. pylori) infection and concentration of reactive oxygen species (ROS) in AGS cells. Methods AGS cells were cultured with either Hp11638 (CagA~+ , VacA~+ ) extract or Hp11638 mutant (CagA~+ , VacA~-) extract for 48 hours, then the cells and supernatants were collected. The concentration of ROS in AGS cells was measured by flow cytometry. The eytochrome C reduction was detected by spectrophotometer at 550 nm. Results The ROS levels in the AGS cells were correlated with two H. pylori strains in a concentration- and time-dependent manner. The ROS levels in AGS cells treated with Hp11638 extract in different concentrations or times were correspondingly higher than those treated with Hp11638 mutant extract. Similar results were found in examination of cytochrome C reduction. Conclusion The elevation of ROS in AGS cells is related to effects of H. pylori proteins, and the VaeA protein involves in the process.