Clinical analysis of 40 newborns with head and neck occupying lesions / 中华耳鼻咽喉头颈外科杂志

Objective: To investigate the clinical features, diagnoses and treatments of head and neck occupying lesions in newborns. Methods: All newborns with head and neck occupying lesions admitted to Neonatel Intensive Care Unit of the First Affiliated Hospital of Zhengzhou University form January 2014 to November 2019 were included. There were 23 males and 17 females, admission age was from 2 d-28 d, and the clinical manifestations, examinations, treatments and outcomes were evaluated. Results: Among 40 newborns with head and neck occupying lesions, 22 cases were admitted with dyspnea, 15 cases with masses in oral cavity or head and neck, 2 cases with fever as the first symptom, and 1 case with hoarseness as the first symptom. There were 5 cases with local infection. All cases were examined with local ultrasound and CT or MRI. Nine cases with severe dyspnea were treated with invasive ventilationm, of them 6 cases underwent invasive ventilation for more than 48 hours, 4 cases received tracheal intubation and artificial nose. Diagnostic punctures were performed in 2 cases. Seven cases received conservative treatments. Surgeries were performed in 31 cases, and 25 cases obtained pathologic diagnoses, including 3 cases of soft palate mature teratomas, 1 case of hard palate teratoma, 1 case of granulosa cell tumor, 1 case of lobulated spindle cell tumor in tongue base, 1 case of polyp in right glottis, 1 case of polyp at esophageal entrance, 4 cases of lingual root cysts, 1 case of laryngeal cyst, 2 cases of thyroglossal duct cysts, 2 cases of lymphangiomas, 1 case of lymphangioma with hibernoma, 1 case of tracheal cyst, 1 case of esophageal cyst, 3 cases of left neck abscesses, 1 case of occipital hemangioma, and 1 case of left temporoparietal abscess. Conclusions: The head and neck occupying lesions in the newborn is prone to upper airway obstruction. Imaging examination can assist the diagnosis. Different treatments can be selected according to the natures of occupying lesions.

Prevalence and risk factor analysis of methicillin-resistant Staphylococcus aureus skin colonization in neonatal intensive care unit / 中华实用儿科临床杂志

Objective To analyze the prevalence and risk factor of methicillin-resistant Staphylococcus aureus (MRSA) skin colonization in neonatal intensive care unit (NICU).Methods One thousand six hundred and seventyeight newborns (938 boys and 740 girls) in NICU were selected,with a mean age of (5.9 ±6.4) days,ranging from 1 to 28 days.Nasal swabs were collected by medical cotton and Staphylococcus aureus (SA) was isolated.All of SA was detected and the mecA gene was detected to determine MRSA through PCR method.The rate of MRSA skin colonization was recorded,and the correlation was analyzed between the rate of MRSA skin colonization and some parameters.The rates of MRSA skin colonization of different time points were compared.Results In NICU,the rate of SA and MRSA skin colonization were 21.10％ (354/1678 cases) and 3.69％ (62/1678 cases),respectively.With the prolongation of hospital stay,the rate of MRSA skin colonization increased,in the order of 7 d ＞ 3 d ＞ 1 d,and the differences were statistically significant (P ＜ 0.05).But the rates of MRSA skin colonization had no significant difference between 7 d and 14 d (P ＞ O.05).Logistic regression analysis showed negative correlation between gestational age,weight,and Apgar scores with MRSA skin colonization but positive correlation between surgery or invasive procedures and antibiotics exposure with MRSA skin colonization.Conclusions Newborns in NICU have high rate of MRSA skin colonization.With the prolongation of hospital stay,the rate of MRSA skin colonization has an increase within 7 days.Gestational age,weight,Apgar scores,surgery or invasive procedures and antibiotics exposure are risk factors of newborn MRSA skin colonization.

Distribution and drug resistance of pathogens in lower respiratory tract infection in neonates / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the epidemiological characteristics of pathogens and their antimicrobial susceptibility in neonates with lower respiratory tract infection (LRTI).</p><p><b>METHODS</b>Sputum specimens for bacterial cultures were collected from 1173 neonates with LRTL between January 2005 and December 2006. Antibiotic susceptibility tests were performed after bacteria had been identified.</p><p><b>RESULTS</b>A total of 707 pathogenic strains (60.3%) were identified, including 521 (73.7%) Gram-negative bacilli, 106 (15.0%) Gram-positive bacilli, and 80 (11.3%) fungi. E Coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, and enteric bacilli were common cultured Gram-negative bacilli. Most strains of Gram-negative bacilli were susceptible to meropenem, piperacillin/tazobactam, the fourth generation cephalosporin, cebfoperazone/sulbactam and amikacin. Staphylococcus aureus and coagula-negative staphylococci (CNS) were common in the cultured Gram-positive bacilli. Staphylococcus aureus and CNS were susceptible to vancomycin, ciprofloxacin and piperacillin/tazobactam but were resistant to Penicillin.</p><p><b>CONCLUSIONS</b>Gram-negative bacilli predominate the pathogens of LRTI in neonates. E Coli, Klebsiella pneumoniae, and Pseudomonas aeruginosa are major pathogens.</p>

A comparison of auditory brainstem responses and otoacoustic emissions in hearing screening of high-risk neonates / 中国当代儿科杂志

<p><b>OBJECTIVE</b>Otoacoustic emissions (OAE) and auditory brainstem responses (ABR) are tests widely used in neonatal hearing screening. This study aimed to investigate the differences and clinical value of distortion product otoacoustic emissions (DPOAE) and ABR in hearing screening of high-risk neonates admitted to a neonatal intensive care unit (NICU).</p><p><b>METHODS</b>DPOAE and ABR were measured with the Smart-OAE analyser and the Smart-EP brain-stem electric response audiometry apparatus, respectively, in 600 high-risk neonates (1,200 ears). The testing results of DPOAE and ABR were compared.</p><p><b>RESULTS</b>Of the 600 neonates (1,200 ears), the incidence of ABR abnormality (78.6%, 943/1,200) was remarkably higher than that of DPOAE abnormality (22.3%, 268/1,200). Two hundred and forty-one ears (20.8%) were negative and 252 (21%) were positive in both DPOAE and ABR tests. A total of 707 ears (58.9%) presented with a discordant result in DPOAE and ABR. The false positive and false negative rates of the DPOAE test were 6.0% (16/268) and 74.1% (691/932) respectively.</p><p><b>CONCLUSIONS</b>In high-risk neonates the diagnostic value of DPOAE for identification of hearing loss, when used alone, is limited. The ABR test appears to be more reliable for hearing screening in high-risk neonates. It is suggested that hearing screening for high-risk neonates should be conducted with ABR first, followed by OAE after failure on ABR.</p>

Therapeutic Effect of Antenatal Corticosteroids and Postnatal Pulmonary Surfactant on Neonatal Respiratory Distress Syndrome / 实用儿科临床杂志

Objective To explore the prevention and treatment effects of either antenatal corticosteroids (ACS) or postnatal pulmonary surfactant (PS) alone or the combination of both ACS and PS on neonatal respiratory distress syndrome (RDS). Methods One hundred and forty - three cases of RDS admitted to our neonatal intensive care unit ( NICU ) from Jan. 2003 to Jan. 2007 were selected, and divided into 4 groups:group 1 received both ACS and PS (n =36) ;group 2 only received ACS(n =33) ;group 3 only received PS (n =39) ;group 4 didn't receive both ACS and PS (n =35). The clinical parameters like sex,gestational age,birth weight,mode of dellvery,associated maternal risk factors, the Apgar score,the need of resuscitation at the time of delivery and associated perinatal complications of the babies were analyzed.The relation between the 4 groups regarding the different modes of supplemental oxygen use ( nasal prong and head box), continuous positive airway pressure (CPAP) ,the need of mechanical ventilator (MV) ,the mean NICU days to cure from the RDS and finally the treatment outcomes were compared. Results There were no significant differences between the 4 groups with regards to their general features and clinical parameters( P > 0.05 ). There was a significant difference between the groups regarding the mean hour requirement of the supplemental oxygen ( nasal prong and head box), CPAP and MV. Nasal prong : The mean hour for each group was ( 75.81 ± 15.63 ), ( 130.09 ± 27.32 ),(150.67 ±28.59) ,( 174.32 ± 25.92) h,respectively (P=0.041). Head box: The mean hour for each group was (37.16 ±5.51) ,(55.29 ±11.71 ), (62.69 ±12.39 ), ( 100.75 ± 28.10 ) h, respectively ( P = 0.047 ). CPAP: The mean hour for each group was ( 24.33 ± 4.41 ),(27.44 ±4.47), (26.53±3.13 ), (56.50 ± 5.50 ) h, respectively ( P = 0. 005 ). MV: The mean hour for MV use for each group was ( 56.12 ±15.65 ), ( 110.19 ± 21.59 ), ( 127.79 ± 26.36 ), ( 156.61 ± 12.92 ) h, respectively ( P = 0. 009 ). The mean number of days in NICU to recover for each group was ( 15.89 ± 1.29 ), (21.61 ± 2.30 ), ( 28.31 ± 3.40 ), ( 32.73 ± 4.57 ) d, respectively ( P = 0 ). The complete cure rate for each group was 63.89%, 51.52% ,35.90% ,20. 0% ,respectively. It shown a significant difference (P =0. 005 ) among the 4 groups regarding treatment outcomes. Conclusions ACS and PS combined therapy is the most effective therapy for the prevention of RDS,followed by ACS therapy alone,then PS therapy alone,and no ACS/no PS therapy is the least effective.

Expression of p53 in neonatal mice following hypoxia-ischemia and effects of its inhibitor on neonatal brain injury / 中国当代儿科杂志

<p><b>OBJECTIVE</b>p53-induced apoptosis is crucial in the development of hypoxic-ischemia (HI) brain damage and neurodegenerative disorders. Some experimental research has shown that a synthetic inhibitor of p53 can protect neurons against apoptosis. This study aimed to explore the expression of p53 in neonatal mice following HI brain damage and the effect of p53 inhibitor (pifithrin-alpha, PFT-alpha) on brain damage.</p><p><b>METHODS</b>HI was induced in 9-day-old mice pups by ligation of left carotid artery and 10% oxygen exposure for 55 minutes. The pups were sacrificed and the brains were taken out at 3, 8, 24, and 72 hrs post-HI. The brains were sectioned and stained with antibody against p53 and microtubule-associated protein 2 (MAP-2). PFT-alpha was injected intraperitoneally: in experiment 1, immediately after HI with different dosages (1, 2 and 8 mg/kg); in experiment 2, 2 mg/kg at different HI times (1 hr before HI, and immediately and 1 hr after HI). Control animals without HI received injections of 0.5% dimethyl sulfoxide. Brain damage was evaluated by gross morphology scoring at 72 hrs after HI.</p><p><b>RESULTS</b>The number of p53 positive cells in the cortex, hippocampus and striatum of the ipsilateral hemisphere increased significantly and peaked at 3-8 hrs post-HI when compared with those of contralateral hemisphere as well as normal controls. The positive cells distributed mainly in the MAP-2 negative area. Both different dosages and different injection time PFT-alpha treatment did not reduce the extent of brain damage.</p><p><b>CONCLUSIONS</b>The immunoactivity of p53 increased significantly as early as 3 hrs post-HI. The distribution area of p53 expression was consistent with that of brain damage. The p53 inhibitor PFT-alpha has no protective effects against HI brain damage in neonatal mice.</p>

Neuroprotective effect of hypothermia on hypoxic-ischemic brain injury in mice / 中国当代儿科杂志

<p><b>OBJECTIVE</b>The study was to investigate the effect of different temperatures during hypoxia on brain injury in mice of different ages.</p><p><b>METHODS</b>Newborn C57/BL6 mice at 7 days or 21 days of life were subjected to left carotid artery ligation followed by exposure with 10% oxygen. The mice were kept in a incubator with a predetermined, constant temperature, either 34 degrees centigrade (Hypothermia group) or 36 degrees centigrade (Normothermia group). Brain injury was evaluated 7 days after hypoxia-ischemia (HI). Active caspase-3 and apoptosis-inducing factor (AIF) expressions in the brain tissue were detected by immunohistochemistry and Western Blot was used to evaluate the phosphor-Akt (P-Akt) expression in the brain tissue at 24 hrs post-HI.</p><p><b>RESULTS</b>Brain injuries, including the cortex, hippocampus, striatum and thalamus injuries, occurred in the Normothermia group at 7 days post-HI. The brain cortex showed cystic cavitation in the postnatal day (P)7 pups mice and laminar infarct of the brain cortex was observed in P21 mice. In the Hypothermia group, the P7 mice did not present with laminar infarct of the cortex and had lower scores of neuropathological lesions in cortex, hippocampus, striatum and thalamus than P7 mice from the Normothermia group (P < 0.01); the cortex injuries were significantly relieved but the injuries of hippocampus, striatum and thalamus in P21 mice were similar to those from the Normothermia group. Active caspase-3 (7.0 +/- 5.6) and AIF positive cells (3.7 +/- 6.2) in the cortex of P7 mice from the Hypothermia group were significantly lower than those of the Normothermia group (51.5 +/- 23.2 and 31.8 +/- 22.4) at 24 hrs post-HI (P < 0.01). Wetstern Blot showed the P-Akt expression was obviously decreased in the ipsilateral hemisphere to the occlusion compared with that of the contralateral hemisphere after HI in the Normothermia group (P < 0.05), while in the Hypothermia group the P-Akt expression was not significantly different between the two hemispheres.</p><p><b>CONCLUSIONS</b>Hypothermia has protective effects against HI insults. The protection was more pronounced for the immature brain than the mature brain.</p>

Early Diagnosis of Myocardial Injury in Neonatal Asphyxia / 实用儿科临床杂志

Objective To investigate the clinical value of cardiac troponin Ⅰ(cTnⅠ) and creatinine kinase MB(CK-MB) in early diagnosis of myocardial injury(MCI) in neonatal asphyxia.Methods The serum cTnⅠ and CK-MB in neonates [34 with asphyxia and MCI,38 with asphyxia but no MCI(NMCI)],and 30 cases of normal control(NC) were measured with direct immunoassay chemiluminometric technology and immunoinhibition enzymes-activated assay.Results The cTnⅠ level in NC group had no changes within 10 days after birth,MCI group were significantly higher than those in NMCI and NC groups(all P0.05).The diagnostic sensitivity,specificity and accuracy of cTnⅠ for neonates with MCI were 91%,88% and 89%,respectively;and of CK-MB were 85%,68% and 74%,respectively.Conclusions cTnⅠ and CK-MB can be taken as early diagnostic markers of MCI in neonates with asphyxia,(cTnⅠ) is better than CK-MB.

Effect of Intrauterine Infection and Interuterine Asphyxia to Fetal Rats′ Brain Damage,Cell Apoptosis and Expression of Glial Fibrillary Acidic Protein / 实用儿科临床杂志

Objective To find out the associated effect of intrauterine infection and interuterine asphyxia to fetal rat′s brain damage,cell apoptosis,and expression of glial fibrillary acidic protein(GFAP).Methods Pregnant rats of gestation 18 days were randomly divided into four groups:1.NS plus sham operation,2.intrauterine infection,3.intrauterine asphyxia,4.intrauterine infection plus intrauterine asphyxia.The fetal rats′ brains were taken out 72 h after different disposal and given HE coloration,immunohistochemistry of TUNEL and GFAP,respectively.Results The level of brain cell edema and tissue disorganization of group intrauterine infection plus intrauterine asphyxia were more serious than those of group intrauterine infection or group intrauterine asphyxia.TUNEL and GFAP had the same results:The number of positive cells in group intrauterine infection plus intrauterine asphyxia more than that in group intrauterine infection,and which in group intrauterine asphyxia more than that in group NS plus sham operation.There was significant difference between the first three groups and the group NS plus sham operation(P=0).There was also significant difference between group intrauterine infection plus intrauterine asphyxia and group intrauterine infection or group intrauterine asphyxia(P=0).Conclusions Both intrauterine infection and intrauterine asphyxia may induce premature rat brain damage,the association of intrauterine infection and intrauterine asphyxia may aggravate the degree of fetal rat brain damage,also increase the number of apoptosis cell and the expression of GFAP.

Cytochrome C release and apoptosis in neonatal rat cerebral hypoxia-ischemia / 中华儿科杂志

<p><b>OBJECTIVE</b>To study the relation of cytochrome C release from mitochondria to cytosol and neuronal apoptosis after cerebral hypoxia-ischemia (HI) in neonatal rats.</p><p><b>METHODS</b>Hypoxia-ischemia was induced in 7-day-old rat pups by ligation of left carotid artery and 7.7% oxygen was inhaled for 55 min. The pups were sacrificed and the brains were taken out at different recovery time. Some of the brains were homogenized and cellular fraction of mitochondria and cytosol was isolated with different speed centrifugation. The cellular fraction was used for Western blotting. Some of the brains were sectioned and stained with antibody against cytochrome C and TUNEL as well as double labeling with different combinations.</p><p><b>RESULTS</b>Western blots showed that cytochrome C in mitochondria was not reduced significantly at 1 h, but reduced markedly at 14 h in ipsilateral hemisphere post-HI. However, the immunoreactivity of cytochrome C in cytosol was increased markedly at 1 h post-HI and reached peak at 14 h post-HI. The number of cytochrome C positive cells in the cortex was increased significantly at 1 h (8.4 +/- 1.8/visual field) compared to normal control (1.5 +/- 0.8/visual field) (P < 0.01) and reached peak at 14 h (29.0 +/- 5.2/visual field) post-HI. The number of TUNEL positive cells increased significantly at 1 h post-HI (14 +/- 3/visual field) compared to normal control (1.5 +/- 0.8/visual field) (P < 0.01) and reached peak at 24 h (286 +/- 86/visual field). The double labeling of cytochrome C and active caspase-3 showed that they colocalized well at 3 h after HI. Furthermore, the positive cells showed nuclei condensation. There were more active caspase-3 positive cells at late recovery (24 h and on) after HI. The double labeling of cytochrome C and TUNEL showed only part of Positive cells colocalized. The cells with cytochrome C strong staining showed TUNEL negative or weakly positive. The cells with TUNEL strong staining showed weakly cytochrome C staining.</p><p><b>CONCLUSION</b>Cytochrome C release is one of the early biochemical changes of neuronal apoptosis after hypoxia-ischemia in neonatal rat brain.</p>

Effect of Intrauterine Asphyxia on Expression of Tissue-Type Plasminogen Activator in Fetal Rat′s Brain / 实用儿科临床杂志

0.05),but there were significant difference between the two groups from 12 hours to 48 hours after operation(all P

Changes of Cytokines Measurement in Serum and Cerebrospinal Fluid in Asphyxia Ne onates and Its Relationship with Prognostic / 实用儿科临床杂志

Objective To study the dynamic changes of cytokines including tumor necrosis factor-alpha (TNF-?),interleukin-6 (IL-6),IL-8 in serum and cerebrospinal fluid (CSF) of asphyxia neonates,and to analyze the relationship between cytokines levels and severity of brain damage and neurological outcome. Methods The concentrations of TNF-?,IL-6,IL-8 in serum and CSF were measured by radioimmunoassay in 63 asphyxia neonates. Neurological development was evaluated at 12 months by children′s developmental scale of china.Results The serum concentrations of TNF-?, IL-6,IL-8 were significantly higher in asphyxiated neonates than those in the controls,and they were correlated with the degree of encephalopathy. The level of serum TNF-? was hig-(hest) at the first day and IL-6 was highest at the third day. There was no marked dynamic changes within 5 days in serum IL-8 level. The concentrations of TNF-?,IL-8 in CSF were higher at the first and the third day.The dynamic changes of IL-6 in CSF were similar in serum and they were positively correlated. The serum concentration of IL-6 in severe brain injury group was much higher than those of normal and mild group.The CSF concentration of IL-6 in severe brain injury group was much higher than that of normal group. The CSF concentration of IL-8 in severe brain injury group was much higher than those of the normal and mild group. Conclusions The concentrations of TNF-?,IL-6 and IL-8 are increased both in serum and CSF in asphyxiated neonates which are correlated with severity of hypoxic-ischemic encephalopathy. Cytokine-mediated inflammatory reactions may participate in the mechanism of hypoxic-ischemic brain injury after asphyxiaion.The concentration of IL-6 in serum and IL-6, IL-8 in CSF are correlated with the neurological outcome.

Neuroprotective effect and mechanisms of hypothermia in neonatal rat cerebral hypoxic-ischemic damages / 中华儿科杂志

<p><b>OBJECTIVE</b>Recent studies suggest that hypothermia may be a potential treatment for perinatal hypoxic-ischemic (HI) brain damage. But the mechanisms of this effect are not well known. In the present study, the protective effect of systemic hypothermia as well as effect on apoptosis and associated biochemical events were investigated on neonatal rats with HI brain damage.</p><p><b>METHODS</b>Seven-day-old Wistar rats were subjected to left carotid artery ligation and hypoxia was persisted for 60 min. Immediately at the end of hypoxia, the animals were maintained either at 36 degrees C or 30 degrees C for 10 h at random. Caspase-2, 3 activity in brain homogenate was detected with Western blotting at 24 h post-HI (n = 8 for each group). Immunoactivity of microtubule-associated protein-2 (MAP-2), active caspase-3, apoptosis inducing factor (AIF) and oligonucleotide hairpin probe staining were detected at 72 h post-HI. The infarct volume, neuronal loss in CA(1) sector of hippocampus as well as brain injury scoring were calculated according to MAP-2 staining and hematoxylin and eosin staining.</p><p><b>RESULTS</b>Caspase-2, 3 activities were much higher in the normothermia group [(27.7 +/- 14.7), (94.9 +/- 53.1) pmol/(min.mg protein)] at 24 h post-HI than those of hypothermia [(7.9 +/- 3.4), (21.1 +/- 18.7) pmol/(min.mg protein)] and normal control groups [(7.6 +/- 0.7), (12.9 +/- 0.5) pmol/(min x mg protein)] (P < 0.01). The activities were not significantly different between hypothermia group and normal control group. Western blotting showed that caspase-3 activation process was blocked by hypothermia. The number of active caspase-3 and AIF positive cells in the cortex of ipsilateral hemisphere was much higher in the normothermia group (median: 148.5; 22/field) than that of hypothermia group (median: 48.5; 9/field) (P < 0.05). The number of apoptotic cells as judged by oligonucleotide hairpin probe labeling was much higher in normothermia group (median: 144/field) than that of hypothermia group (median: 133/field) (P < 0.05). The brain injury scoring, infarct volume and neuronal loss in CA(1) area of hippocampus were much less in the hypothermia group [10.4 +/- 2.9; 40.5 +/- 34.8)mm(3); 25.7 +/- 11.5] than that of normothermia group [14.2 +/- 3.5; (73.9 +/- 22.4) mm(3); 37.4 +/- 10.6, P < 0.05].</p><p><b>CONCLUSIONS</b>Systemic hypothermia for 10 h after hypoxia-ischemia seemed to be effective in reducing brain damage and the mechanism is associated with alteration of apoptotic pathway.</p>

Relationship between Placental Vascular Anastomosis and Physical Development and Morbidity of Disease in Twin Neonates / 实用儿科临床杂志

Objective To investigate the relationship of placental vascular anastomosis and physical development and morbidity of the disease in twin neonates.Methods Fourteen pairs of twin neonates deliveried from Sep.2005 to Aug.2009 were enrolled in Newborn Intensive Care Unit,the Third Affiliated Hospital of Zhengzhou University.These twins were divided into 2 groups according the conditions of placental vascular anastomosis:significant placental vascular anastomosis group(group A) and no significant vascula anastomosis group(group B).Birth weight,head circumference,length,the morbidity of disease were all investigated in 2 groups.Clinic follow-up included neonatal behavioral neurological assessment(NBNA) and children′s development center of China(CDCC).The correlation of neonates placental vascular anastomosis between twin neonates were compared.Results There were statistically significant differences between group A and group B in birth weight,head circumference and body length(t=6.070,5.237,5.784,Pa

Infection,Inflammatory Response and Neonatal Brain Damage / 实用儿科临床杂志

Infection and inflammatory response can induce the brain damage in neonate,but the mechanism involved in it has not been elucidated completely.Proposed mechanisms include inflammatory response,cytokine and free radical-mediated injury,and excitatory amino acids-induced injury.The activation of microglia and selective vulnerability of immature oligodendrocyte play an important role in the whole process.Recent researches show that the fetal inflammatory response and complex gene regulation are also involved in the infection-induced brain damage.

Influence of Preterm Premature Rupture of Membranes on Neurological Development of Preterm Infants / 实用儿科临床杂志

Objective To investigate the influence of preterm premature rupture of membranes (PPROM) on neurological development of preterm infants.Methods The preterm infants were classified into 2 groups( PPROM group and control group).The neonatal behavioral neurological assessment (NBNA) and CDCC of infants in two groups were measured and compared after retrieved:gestational age 40 weeks,3 months and 6 months.Results Psycho-moter developmental index(PDI) of PPROM group after retrieved gestational age 3,6 months was significantly lower than that of control group(Pa

Influence of Single and Multiple Course Dexamethasone on Brain Development of Preterm Infants / 实用儿科临床杂志

Objective To explore the effect of single and multiple course dexamethasone on brain development in preterm infants.Met-hods One hundred and eighteen preterm infants delivered after 28-34 weeks′ gestation from Aug.2005 to Mar.2007 in our NICU were enrolled in this study.These infants were divided into 3 groups by antenatalcourses of dexamethasone: control group,single-course group and multi-course group.Supportive treatments were given to all 3 groups.Neonatal behavioral neurological assessment(NBNA) was conducted on expected date of delivery.Mental and psychomotor developmental index was evaluated at 3,6,12 months by using intellectual development table made at Children′s Development Center of China(CDCC).Results The score of NBNA was much higher in single-course group than that in multi-course group and control group(Pa

Variance of Perinatal Asphyxia in Latest 10 Years and Analysis of Mortality and Risk Factors of Perinatal Asphyxia / 实用儿科临床杂志

Objective To analyze the incidence rate and mortality of perinatal asphyxia and effects of new resuscitation technique on asphyxia as well as the risk factors of asphyxia in latest 10 years.Methods A retrospective evaluation was done for all the newborns who were born in the provincial women and children′s health care hospital from 1995 to 2004.The morbidity,mortality and fatality rate were calculated for each observed year and different seasons.The influence of gender,body weight,gestational age as well as polyembryony and mode of delivery on the asphyxia was analyzed.Results The morbidity of mild birth asphyxia was decreased dramatically and maintained at about 1.5% after using new resuscitation technique,however,there were no obvious effects on the sever asphyxia.In the same time,no big influence on fatality rate of birth asphyxia was observed.The incidence rate was highest in April,but the mortality and fatality of asphyxia was highest in July.The incidence of asphyxia was also related with gender,polyembryony,birth weight,prematurity babies and aids to delivery from voginal.Conclusions The incidence of perinatal asphyxia is related with the gender,polyembryony,birth weight and gestation age as well as seasons.New resuscitation technique can reduce the morbidity of mild birth asphyxia,and no effect on the severe asphyxia as well as fatality rate.

Effect of Subhypothermia and Erythropoietin Combined Treatment on Neonatal Hypoxic-Ischemic Brain Damage / 实用儿科临床杂志

Objective To explore the effect of systemic subhypothermia and erythropoietin combined treatment on neonatal hypoxic-ischemic brain damage(HIBD).Methods Sixty-five asphyxiated newborns enrolled in this study were divided randomly into combination group(n=16),hypothermia group(n=24)and conventional group(n=25).Subhypothermia was adepted in hypotheria group as well as conventional therapy.Subhypotheria and erythropoietin were both applied in combination group excepy for conventional therapy.The short-term effect was evaluated by neonatal neurological score as well as neonatal behavioral neurological assessment(NBNA)on postnatal days of 7,14 and 28,and the long-term effect was evaluated by using intellectual development table made by Children's Development Center of China(CDCC)at 3 and 6 month of age.Results The neonatal neurological score in combination group at 24,48,72 and 80 h were lower than that of 0 and 12 h.NBNA evaluation was much higher on 14 d and 28 d in combination group and hypothermia group than that in conventional group(Pa0.05).Conclusions Combination therapy with systemic subhypothermia and erythropoietin exerts obvious short and longer-time neuroprotective effect on HIBD,but there are no differences compared with hypothermia alone.

Neuroprotective Effect of Recombinant Human Erythyropoietin Theraphy for Neonatal Hypoxic-Ischemic Encephalopathy / 实用儿科临床杂志

Objective To evaluate the neuroprotective effect and safety of neonatal hypoxic-ischemic encephalopathy(HIE)treated with recombinant human erythropoietin(rhEPO).Methods Fifty-three neonates with HIE were randomly divided into rhEPO treated group(n=29) with the dosage of 300 U/(kg?time),three times a week for 2 weeks and control group(n=24)without rhEPO.All supportive measures were same between 2 groups.Neurological scoring was evaluated at d3,d5 and d7 Neonatal behavioral neurological assessment(NBNA) was evaluated at d7,d14 and d28.The neurodevelopment quote was evaluated at age of 3 and 6 months.Blood pressure,liver and renal function,blood electrolytes and blood hemoglobin,platelet and reticular red blood cell count were monitored before and after treatment in all infants.Results The neurological scoring between two groups had no difference at d3.The significant difference was found at d7(P0.05).Conclusions Teraphy with rhEPO on neonatal HIE infants can promote neurological recovery,and there is no serious side effect with rhEPO treatment.