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Objective:To investigate the correlation between preterm infants with brain injury and the proportion of lymphocyte subsets, especially γδ-T cells in the postnatal peripheral blood, and to determine the predictive potential of γδ-T cells in the early peripheral blood in brain injury.Methods:It was a prospective study involving 106 preterm infants with gestational age less than 34 weeks who were delivered in the Department of Neonatology, the Third Affiliated Hospital of Zhengzhou University from January 1, to June 1, 2021.Relative levels of γδ-T , CD4 + T, CD8 + T, CD3 + T and total lymphocyte subsets in peripheral blood collected within the first 24 hours after birth were measured by flow cytometry.Recruited infants were divided into brain injury group (36 cases) and non-brain injury group (70 cases) according to serial cranial ultrasound and magnetic resonance imaging(MRI) at the corrected gestational age of 36-37 weeks.Differences in general conditions and the proportion of lymphocyte subsets between groups were compared by the t-test or Chi- square test.Patients in brain injury group were further divided into intracranial hemorrhage(ICH) group(8 cases), periventricular leukomalacia (PVL) group (6 cases)and diffuse white matter damage (WMD) group(22 cases). The proportion of lymphocyte subsets among the different groups was compared by One- Way ANOVA, followed by the LSD- t test. Results:The proportion of γδ-T cells in postnatal peripheral blood of preterm infants at 24 hours after birth in brain injury group was significantly lower than that of non-brain injury group [(0.09±0.12)% vs.0.15±0.13)%, t=-2.445, P=0.016]. No significant differences in the proportion of the CD4 + and CD8 + T cell subsets were found between them.Both preterm infants in PVL group and WMD group had a significantly lower proportion of γδ-T cells at 24 hours after birth compared to that of the non-brain injury group [(0.03±0.05)%, (0.07±0.09)% and (0.15±0.13)%], respectively, ( t=-2.190, -2.659, all P<0.05). Conclusions:γδ-T cells in early postnatal peripheral blood may be involved in the development of brain injury in preterm infants and they had early predictive value for preterm infants at high risk of brain injury, especially the leukomalacia and diffuse white matter injury.
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Objective@#To investigate the effect of caffeine citrate administering at different time on outcome and neurodevelopment of premature infants.@*Methods@#A total of 113 preterm infants with gestational age less than 32 weeks and birth weight less than 1 500 g who were hospitalized and treated in the neonatal intensive care unit from January 2018 to June 2018 were enrolled.According to the time when caffeine citrate treatment was started, they were divided into early treatment group(≤1 days) with 53 infants and late treatment group(1 to 10 days) with 60 infants.A retrospective analysis was performed for their clinical data.The perinatal conditions, treatment process and clinical outcomes of the two groups were compared and the neurological development was followed up at 12 months old.@*Results@#Compared with the late treatment group, the early treatment group had a significantly shorter durations of mechanical ventilation time, oxygen therapy time, hospitalization days and a significantly lower incidence of bronchopulmonary dysplasia, patent ductus arteriosusand intraventricular hemorrhage or periventricular leukomalacia, and there were significant differences between two groups(P<0.05, respectively). The neonatal behavioral neurological assessment score in the early treatment group was higher than that in the late treatment group at 40 weeks of gestational age, and there was significant difference between two groups(P<0.05). The mental developmental index at 3 months of corrected age, the mental developmental index and psychomotor developmental index at 12 months were significantly better in the early treatment group than those in the late treatment group, and there were significant differences between two groups(P<0.05, respectively).@*Conclusion@#Early use of caffeine citrate can improve the outcome of premature infants and improve the prognosis of nervous system.
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Objective:To investigate the mortality and causes of death in neonates from different medical institutions in Henan province.Methods:A retrospective analysis was performed on the death cases of 62 different medical institutions in 18 cities of Henan province in 2018, in order to compare the differences of neonatal mortality, age of death and the causes of death between maternal and child health care hospitals and general hospitals.Results:(1) A total of 80 780 newborns were admitted to 62 hospitals and 311 neonates died with a mortality rate of 3.85‰.A total of 33 339 newborns were admitted to 24 maternal and child health care hospitals, and 102 neonates died with a mortality rate of 3.06‰.Among them, 54 cases(52.9%) were premature infants and 48 cases(47.1%)were full-term infants.A total of 47 441 newborns were admitted to 38 general hospitals, and 209 neonates died with a mortality rate of 4.41‰.Among them, 111 cases(53.1%) were premature infants and 98 cases (46.9%) were full-term infants.Neonatal mortality in general hospitals was higher than that in maternal and child health care hospitals( P<0.05). (2) Neonatal death mainly occurred within one week after birth, especially within the first day.There were 67 cases of death(65.7%) in 24 maternal and child health care hospitals within the first day, including 34 cases (50.7%) of full-term infants and 33 cases (49.3%)of premature infants.And there were 87 cases of death(41.6%) in 38 general hospitals within the first day, including 50 cases (57.5%) of premature infants and 37 cases (42.5%) of full-term infants.Neonatal mortality within the first day after birth in maternal and child health care hospitals was higher than that in general hospitals( P<0.05). (3) The leading causes of neonatal death were non-infectious pulmonary diseases(128 cases, 41.2%), followed by birth asphyxia(73 cases, 23.5%) and infection(51 cases, 16.4%), but the causes of death in sequence varies from maternal and child health care hospitals and general hospitals.(4) For early death (within one week after birth) in both general hospitals and maternal and child health care hospitals, the main causes were birth asphyxia for full-term neonates, and pulmonary diseases(mainly respiratory distress syndrome)and birth asphyxia for premature infants.For late-stage death (2-4 weeks after birth) of neonates, infection was the leading cause in both term and preterm infants in general hospitals.For maternal and child health hospitals, the main causes of death for full-term infants were infection, and pulmonary diseases (mainly pulmonary hemorrhage and respiratory distress syndrome) for premature infants. Conclusion:There are some differences between maternal and child health care hospitals and general hospitals in neonatal mortality, mortality within the first day after birth, and causes of death.Therefore, it is necessary to strengthen the corresponding software and hardware constructions for newborns in different medical institutions to further reduce the neonatal mortality rate.
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Objective:To investigate the effect of caffeine citrate administering at different time on outcome and neurodevelopment of premature infants.Methods:A total of 113 preterm infants with gestational age less than 32 weeks and birth weight less than 1 500 g who were hospitalized and treated in the neonatal intensive care unit from January 2018 to June 2018 were enrolled.According to the time when caffeine citrate treatment was started, they were divided into early treatment group(≤1 days) with 53 infants and late treatment group(1 to 10 days) with 60 infants.A retrospective analysis was performed for their clinical data.The perinatal conditions, treatment process and clinical outcomes of the two groups were compared and the neurological development was followed up at 12 months old.Results:Compared with the late treatment group, the early treatment group had a significantly shorter durations of mechanical ventilation time, oxygen therapy time, hospitalization days and a significantly lower incidence of bronchopulmonary dysplasia, patent ductus arteriosusand intraventricular hemorrhage or periventricular leukomalacia, and there were significant differences between two groups( P<0.05, respectively). The neonatal behavioral neurological assessment score in the early treatment group was higher than that in the late treatment group at 40 weeks of gestational age, and there was significant difference between two groups( P<0.05). The mental developmental index at 3 months of corrected age, the mental developmental index and psychomotor developmental index at 12 months were significantly better in the early treatment group than those in the late treatment group, and there were significant differences between two groups( P<0.05, respectively). Conclusion:Early use of caffeine citrate can improve the outcome of premature infants and improve the prognosis of nervous system.
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Objective@#To investigate the death status and cause of death of newborns in critical care centers at different levels in Henan province.@*Methods@#Retrospective analysis was performed on the death cases at 85 critical neonatal treatment centers in 18 cities of Henan province from January to December 2018, and the similarities and differences in neonatal mortality, age of death and causes of death among cities and county-level critical neonatal care centers were compared.@*Results@#(1) A total of 99 832 neonates were admitted to 85 hospitals, and 318 neonates died, with a mortality rate of 3.19‰.A total of 42 066 neonates were admitted to 21 municipal hospitals, and 194 neonates died, with a mortality rate of 4.6‰.Among them, 109 cases (56.2%) were premature infants (14 cases were of 28 weeks, 70 cases were of 28-34 weeks, 25 cases were of >34-37 weeks), and 85 cases (43.8%) were full-term infants.A total of 57 766 neonates were admitted to 64 county-level hospitals, with 124 deaths and a mortality rate of 2.1‰.Among them, 67 cases (54.0%) were full-term infants, 57 cases (46.0%) were premature infants (9 cases were of 28 weeks, 34 cases were of 28-34 weeks and 14 cases were of >34-37 weeks). The mortality rates at muni-cipal hospital were higher than those at the county-level hospitals, and the difference was statistically significant (χ2=46.589, P<0.05). (2) Neonatal death mainly occurred within 1 week after birth, especially within 1 day after birth.There were 81 deaths (41.8%) in 21 municipal hospitals within 1 day, including 50 premature infants (61.7%) and 31 full-term infants (38.3%). There were 75 deaths (60.5%) in 64 county-level hospitals within 1 day, including 34 premature infants (45.3%) and 41 full-term infants (54.7%). The mortality rate in county-level hospitals was higher than that in the municipal hospital within 1 day, and the difference was statistically significant(χ2=10.621, P< 0.05). (3)The top 5 causes of neonatal death in the municipal and the county-level hospitals were pulmonary diseases (130 cases, 40.8%), birth asphyxia (74 cases, 23.3%), infection (50 cases, 15.7%), congenital malformation (24 cases, 7.5%), and very-early premature/very-low birth weight infants (12 cases, 4.1%). (4)For early (within 1 week after birth) death of full-term infants, the main causes of death in municipal hospitals were lung diseases (mainly neonatal respiratory distress syndrome/acute respiratory distress syndrome), birth asphyxia, infection, congenital malformation.The leading causes of death at county-level hospitals were birth asphyxia, pulmonary diseases and infection.For premature infants who died within 1 week, the main causes of death at the municipal and the county-level hospitals were pulmonary diseases and birth asphyxia.For late-stage (2-4 weeks after birth) death of neonates, whether full-term infants or premature infants, the main cause of death in municipal and county-level hospitals was infection.@*Conclusions@#There are differences in neonatal mortality, mortality within 1 day after birth and the first cause of death at critical neonatal treatment centers at municipal and county-level hospitals.For the early-stage(within 1 week) neonates, the main causes of death in municipal and county-level hospitals are lung diseases (mainly neonatal respiratory distress syndrome/acute respiratory distress syndrome), birth asphyxia and infection.For the late-stage neonates, infection is the main cause of death in the municipal and the county-level hospitals.It is necessary to improve the neonatal care ability of critical neonatal treatment centers at different levels separately in order to reduce neonatal mortality.
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Objective To investigate the death status and cause of death of newborns in critical care centers at different levels in Henan province.Methods Retrospective analysis was performed on the death cases at 85 critical neonatal treatment centers in 18 cities of Henan province from January to December 2018,and the similarities and differences in neonatal mortality,age of death and causes of death among cities and county-level critical neonatal care centers were compared.Results (1) A total of 99 832 neonates were admitted to 85 hospitals,and 318 neonates died,with a mortality rate of 3.19‰.A total of 42 066 neonates were admitted to 21 municipal hospitals,and 194 neonates died,with a mortality rate of 4.6‰.Among them,109 cases (56.2％) were premature infants (14 cases were of 28 weeks,70 cases were of 28-34 weeks,25 cases were of ＞ 34-37 weeks),and 85 cases (43.8 ％) were full-term infants.A total of 57 766 neonates were admitted to 64 county-level hospitals,with 124 deaths and a mortality rate of 2.1％o.Among them,67 cases (54.0％) were full-term infants,57 cases (46.0％) were premature infants (9 cases were of 28 weeks,34 cases were of 28-34 weeks and 14 cases were of ＞ 34-37 weeks).The mortality rates at municipal hospital were higher than those at the county-level hospitals,and the difference was statistically significant (x2 =46.589,P ＜0.05).(2) Neonatal death mainly occurred within 1 week after birth,especially within 1 day after birth.There were 81 deaths (41.8％) in 21 municipal hospitals within 1 day,including 50 premature infants (61.7％) and 31 full-term infants (38.3％).There were 75 deaths (60.5％) in 64 county-level hospitals within 1 day,including 34 premature infants (45.3％) and 41 full-term infants (54.7％).The mortality rate in county-level hospitals was higher than that in the municipal hospital within 1 day,and the difference was statistically significant(x2 =10.621,P ＜ 0.05).(3) The top 5 causes of neonatal death in the municipal and the county-level hospitals were pulmonary diseases (130 cases,40.8％),birth asphyxia (74 cases,23.3％),infection (50 cases,15.7％),congenital malformation (24 cases,7.5％),and very-early premature/very-low birth weight infants (12 cases,4.1％).(4)For early (within 1 week after birth) death of full-term infants,the main causes of death in municipal hospitals were lung diseases (mainly neonatal respiratory distress syndrome/acute respiratory distress syndrome),birth asphyxia,infection,congenital malformation.The leading causes of death at county-level hospitals were birth asphyxia,pulmonary diseases and infection.For premature infants who died within 1 week,the main causes of death at the municipal and the county-level hospitals were pulmonary diseases and birth asphyxia.For late-stage (2-4 weeks after birth) death of neonates,whether full-term infants or premature infants,the main cause of death in municipal and county-level hospitals was infection.Conclusions There are differences in neonatal mortality,mortality within 1 day after birth and the first cause of death at critical neonatal treatment centers at municipal and county-level hospitals.For the early-stage (within 1 week) neonates,the main causes of death in municipal and county-level hospitals are lung diseases (mainly neonatal respiratory distress syndrome/acute respiratory distress syndrome),birth asphyxia and infection.For the late-stage neonates,infection is the main cause of death in the municipal and the county-level hospitals.It is necessary to improve the neonatal care ability of critical neonatal treatment centers at different levels separately in order to reduce neonatal mortality.
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Objective:To establish the quality standard for Naoxin Luotong pills. Methods:Astragali radix, bombyx batryticatus and scorpio were identified under a microscope. Peach kernel, astragali radix, paeoniae radix alba, rheum, paeonia suffruticosa and salvia miltiorrhiza were identified by TLC. The content of total ferulic acid was determined by HPLC with a Sapphire C18 column (250 mm × 4. 6 mm,5 μm). The mobile phase was acetonitrile-0. 1% phosphoric acid(12 ∶88)and the detection wavelength was 316 nm. The column temperature was 35℃ and the flow rate was 1. 0 ml·min-1 . Results:The microscopic characteristics of astragali radix, bombyx batryticatus and scorpio were obvious to be observed easily. The TLC spots of peach kernel, astragali radix, paeoniae radix al-ba, rheum, paeonia suffruticosa and salvia miltiorrhiza were clear and specific. Ferulic acid had a good linear relationship within the range of 5. 1-81. 6μg·ml-1(r=0. 999 9), and the average recovery was 103. 30% with RSD of 1. 96% (n= 9). Conclusion:The standard can be used for the quality control of Naoxin Luotong pills.
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Objective To investigate the relationship of Toll-like receptors (TLRs) 2 and 4 with the occurrence of chloasma.Methods Peripheral blood samples were collected from 40 patients with chloasma and 40 healthy human controls,and skin samples were also collected from the lesions of 10 of the patients and normal skin of 10 of the healthy controls.Real time (RT)-PCR was performed to measure the mRNA expressions of TLR2 and TLR4 in skin lesions and blood samples.An immunohistochemical test was conducted to observe the expressions of TLR2 and TLR4 in skin lesions.Statistical analysis was carried out by t test.Results The expressions of TLR2 and TLR4 mRNAs were both significantly higher in skin lesions of the patients than in normal skin of the controls (9.72 ± 2.93 vs.5.10 ± 2.69,t =3.67,P＜ 0.01; 9.52 ± 2.88 vs.4.77 ± 1.90,t =4.36,P＜ 0.01),while no significant difference was found in the mRNA expressions of TLR2 or TLR4 in peripheral blood between the patients and controls (both P ＞ 0.05).As the immunohistochemical test revealed,TLR2 was absent in both the epidermis and vascular endothelial cells in 6 normal control skin samples,weakly expressed in the basal layer of the epidermis but absent in vascular endothelial cells in 4 normal skin samples,and no TLR4 expression was observed in either the epidermis or vascular endothelial cells in these control skin samples.Among the 10 skin samples from chloasma lesions,3 showed TLR2 expression in the whole epidermis,7 in both basal cell layer and prickle cell layer but not in vascular endothelial cells in the superficial dermal layer,all showed strong TLR4 expression in the basal cell layer and weak TLR4 expression in the prickle cell layer,and 3 exhibited TLR4 expression in vascular endothelial cells in the superficial dermal layer.Conclusion TLR-mediated immune responses in local skin might be related to the occurrence of chloasma.