ABSTRACT
Objective To study the pulmonary surfactant (PS) on prevention of neonatal respiratory distress syndrome (NRDS) in neonates delivered via caesarean section. Methods From selective cesarean section infants (gestational age 34-38+6 W), 80 cases whose test tube oscillation tests were negative and amniotic fluid pulmonary surfactant associated protein A (SP-A) concentrations were lower than <10μg/L, and were randomly divided into PS prevention group and control group, with 40 cases in each group. PS prevention group within 1 h of birth were administrated poractant alfa injection by endotracheal tube (dose 100 mg/kg), but the control group was not given special treatment, leaving only the observation. The incidence of NRDS, treatment status and clinical progression were compared between two groups. Results The incidence of NRDS in control group was 82.5%(33/40), in PS prevention group was 37.5%(15/40), and there was significant difference (P<0.05). The degree of NRDS in control group was more severe. The incidence rate of persistent pulmonary hypertension of the new-born (PPHN), pulmonary air leak, patent ductus arteriosus and oxygenation index above 25 mmHg (1 mmHg=0.133 kPa) in control group were significantly higher than those in PS prevention group (P<0.05). The time of mechanical ventilation, the time of oxygen inhalation, ratio of arterial partial pressure of oxygen (PaO2) before mechanical ventilation to fraction of inspired oxygen (FiO2), and costs of hospitalization in control group were significantly higher than those in PS prevention group (P<0.05). Conclusions PS prevention can reduce the incidence of NRDS of neonates delivered by elective caesarean section, can alleviate the symptoms of NRDS, shorten length of stay and reduce the cost of hospitalization.
ABSTRACT
Objective To evaluate the effect of Saccharomyces boulardii (SB) administration on very-low-birth-weight (VLBW) infants.Methods One hundred and ninety-eight preterm infants were prospectively randomized into observation group (105 cases) and control group (93 cases) based on the symptomatic and supportive treatment.When uncompletely stomach intestine nutrition fed,the patients of observation group took SB (50 mg/kg),the patients of control group took equivalent placebo.The times of defecation and diarrhea,the rate of neonatal necrotizing enterocolitis,hospital onset of infection (septicemia,pulmonary infection),fungal infection,the time of intravenous nutrition and length of stay were compared.Results The general data in two groups had no significant difference (P ＞ 0.05).The times of defecation,time of intravenous nutrition and length of stay in two groups had significant difference [(1.8 ± 0.4) times/d vs.(3.4 ± 0.5) times/d,(30.21 ± 3.43) d vs.(40.47 ± 4.35) d,(33.5 ± 6.8) d vs.(45.4 ± 9.3) d] (P ＜ 0.05).The rate of diarrhea,neonatal necrotizing enterocolitis,septicemia and pyemia in two groups had significant difference [14.3％ (15/105) vs.25.8％ (24/93),11.4％ (12/105) vs.19.4％ (18/93),19.0％ (20/105) vs.29.0％ (27/93)] (P ＜ 0.05).The rate of pulmonary infection and fungal infection between two groups had no significant difference(P＞ 0.05).Conclusion SB administration on VLBW infants can reduce the infection,promote enteral feeding,shorter hospital stay,and has a certain significance on the family and the community.
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Objective To investigate the serum levels of certain vitamins and trace elements in infant and children with pneumonia.Methods Totally 120 pediatric patients with pneumonia who were treated in our hospital were enrolled in the study.Meanwhile,60 age-matched healthy children were randomly selected as the control group.The serum vitamin A level was analyzed using high-performance liquid chromatography.The serum 25-hydroxy vitamin D level was analyzed using enzyme linked immunosorbent assay.The serum zinc,calcium,magnesium,and iron contents were detected using atomic absorption spectrometry.The differences of serum levels of vitamins and trace elements as well as the ratios of vitamins and trace elements deficiency were compared between these two groups.Results The rates of iron,zinc,and vitamin A deficiencies were 35.36％,37.09％,and 46.59％,respectively,in pediatric patients with pneumonia,which were significantly higher than those in the control group ( 18.76％,x2 =4.32; 20.08％,x2 =4.15 ; 25.08％,x2 =5.81 ; all P ＜0.05).There were no significant differences in the rates of calcium,magnesium,and vitamin D deficiencies between these two groups ( all P ＞ 0.05 ).The serum zinc [ ( 16.07 ± 3.56) vs.(23.24 ± 4.05) μmol/L,t =15.82,P ＜ 0.05 ],iron [ ( 19.89 ± 4.79) vs.(25.13 ± 5.07 ) μmol/L,t =6.65,P ＜ 0.05 ],and vitamin A levels [ ( 365.76 ±35.37 ) vs.(451.09 ± 32.16) μg/L,t =2.14,P ＜ 0.05 ] in the pneumonia group were significantly lower than those in the control group.The serum levels of calcium,magnesium,and 25-hydroxy vitamin D showed no significant difference between these two groups ( all P ＞ 0.05 ).Conclusion Zinc,iron,and/or vitamin A deficiencies are common among infant and children with pneumonia.
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Fifty children with refractory idiopathic thrombocytopenic purpura (RITP) were treated with rituximab (n =26) or vincristine (n =24).The response rate,adverse reaction and recurrence rate in two groups were compared.The CD19 +/CD20 + B cells in peripheral blood were detected by flow cytometry in 26 patients before and after RITP treatment.The response rates of rituximab group was significantly higher than that of vincristine group ( 69.2％ vs. 37.5％,x2 =9.74,P ＜ 0.01 ). There was no significant difference in the rate of adverse reaction between two groups ( 11.5％ vs.8.3％,x2 =0.62,P ＞ 0.05 ).The recurrence rate of rituximab group ( 22.2％ ) was significantly lower than that of vincristine group (55.6％,x2 =7.24,P ＜ 0.05 ).In rituximab group the platelet count after treatment was significantly higher than that before treatment ( t =12.48,P ＜0.01 ),and the ratio of CD19 +/CD20 + B cells decreased significantly after treatment compare to that before treatment ( t =6.71,P ＜0.05 ).Rituximab is effective in treatment of refractory idiopathic thrombocytopenic purpura in children,which may be associated with decreased B cells in peripheral bloos.