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1.
Article in English | WPRIM | ID: wpr-928587

ABSTRACT

Neonatal seizures are the most common clinical manifestations of critically ill neonates and often suggest serious diseases and complicated etiologies. The precise diagnosis of this disease can optimize the use of anti-seizure medication, reduce hospital costs, and improve the long-term neurodevelopmental outcomes. Currently, a few artificial intelligence-assisted diagnosis and treatment systems have been developed for neonatal seizures, but there is still a lack of high-level evidence for the diagnosis and treatment value in the real world. Based on an artificial intelligence-assisted diagnosis and treatment systems that has been developed for neonatal seizures, this study plans to recruit 370 neonates at a high risk of seizures from 6 neonatal intensive care units (NICUs) in China, in order to evaluate the effect of the system on the diagnosis, treatment, and prognosis of neonatal seizures in neonates with different gestational ages in the NICU. In this study, a diagnostic study protocol is used to evaluate the diagnostic value of the system, and a randomized parallel-controlled trial is designed to evaluate the effect of the system on the treatment and prognosis of neonates at a high risk of seizures. This multicenter prospective study will provide high-level evidence for the clinical application of artificial intelligence-assisted diagnosis and treatment systems for neonatal seizures in the real world.


Subject(s)
Artificial Intelligence , Electroencephalography/methods , Epilepsy/diagnosis , Humans , Infant, Newborn , Infant, Newborn, Diseases/diagnosis , Intensive Care Units, Neonatal , Multicenter Studies as Topic , Prospective Studies , Randomized Controlled Trials as Topic , Seizures/drug therapy
2.
Chinese Medical Journal ; (24): 2901-2910, 2021.
Article in English | WPRIM | ID: wpr-921119

ABSTRACT

Recent research efforts have provided compelling evidence of genome-wide DNA methylation alterations in pediatrics. It is currently well established that epigenetic clocks, composed of DNA methylation sites, can estimate the gestational and chronological age of cells and tissues from different ages. Also, extensive research is aimed at their correlation with early life exposure and pediatric diseases. This review aimed to systematically summarize the epigenetic clocks in the pediatric population. Publications were collected from PubMed and Web of Science databases up to Apr 2021. Epigenetic clocks, DNA methylation clocks, epigenetic age acceleration or deceleration, pediatric and the pediatric population were used as search criteria. Here, we first review the currently applicative pediatric epigenetic clocks. We then highlight the interpretation for epigenetic age deviations in the pediatric population and their association with external factors, developmental trajectories, and pediatric diseases. Considering the remaining unknown of pediatric clocks, research strategies into them are also discussed. In all, pediatric epigenetic clocks may act as potent tools to understand development, growth and diseases in early life.


Subject(s)
Aging , Child , DNA Methylation/genetics , Epigenesis, Genetic/genetics , Epigenomics , Humans
3.
Article in Chinese | WPRIM | ID: wpr-879889

ABSTRACT

Coronavirus disease 2019 (COVID-19) has become a worldwide pandemic and can occur at any age, including children. Children with COVID-19 can develop the clinical symptoms of multiple systems, among which symptoms of the nervous system have been reported increasingly, and thus it is particularly important to understand COVID-19-associated neurological damage in children. This article reviews the mechanisms and types of COVID-19-associated neurological damage in children.


Subject(s)
COVID-19 , Child , Humans , Nervous System Diseases , Pandemics , SARS-CoV-2
4.
Article in Chinese | WPRIM | ID: wpr-879853

ABSTRACT

Neural development is regulated by both external environment and internal signals, and in addition to transcription factors, epigenetic modifications also play an important role. By focusing on the genetic mechanism of ATP-dependent chromatin remodeling in children with neurodevelopmental disorders, this article elaborates on the effect of four chromatin remodeling complexes on neurogenesis and the development and maturation of neurons and neuroglial cells and introduces the clinical research advances in neurodevelopmental disorders.


Subject(s)
Child , Chromatin , Chromatin Assembly and Disassembly , Humans , Neurodevelopmental Disorders/genetics , Neurogenesis , Transcription Factors/genetics
5.
Article in Chinese | WPRIM | ID: wpr-828718

ABSTRACT

This article reports the clinical and genetic features of two cases of cerebral creatine deficiency syndrome I (CCDSI) caused by SLC6A8 gene mutations. Both children were boys. Boy 1 (aged 2 years and 10 months) and Boy 2 (aged 8 years and 11 months) had the clinical manifestations of delayed mental and motor development, and convulsion. Their older brothers had the same symptoms. The mother of the boy 1 had mild intellectual disability. The genetic analysis showed two novel homozygous mutations, c.200G>A(p.Gly67Asp) and c.626_627delCT(p.Pro209Argfs*87), in the SLC6A8 gene on the X chromosome, both of which came from their mothers. These two novel mutations were rated as possible pathogenic mutations and were not reported in the literature before. This study expands the mutation spectrum of the SLC6A8 gene and has great significance in the diagnosis of boys with delayed development, and epilepsy.


Subject(s)
Child , Child, Preschool , Creatine , Epilepsy , Genetic Testing , Humans , Male , Mutation , Nerve Tissue Proteins , Genetics , Plasma Membrane Neurotransmitter Transport Proteins , Genetics , Syndrome
6.
Article in Chinese | WPRIM | ID: wpr-817872

ABSTRACT

Simulation-based medicine education(SBME)refers to the clinical teaching method of using medical simulation equipment or simulator design to simulate clinical scenes,replacing the actual content of real medical scenes in an interactive way and the actual patient. Simulation is particularly important in pediatric resident training,and a large amount of evidencebased evidence confirms that simulation training used in resident training ensures patients' safety and improves patients' outcomes. The paper mainly expounds the application principle,theoretical basis,main content and the method of establishing the simulation center in the training of pediatric resident in simulated medical education,intending to promote the further development of simulation training in the training of domestic pediatric resident.

7.
Article in Chinese | WPRIM | ID: wpr-733027

ABSTRACT

Until recently,the common treatment for phenylketonuria (PKU) was a phenylalanine (Phe)-restricted diet.Increasing evidence of suboptimal outcomes was observed in diet-treated individuals.The observation of clinically significant reductions in blood Phe levels in a subset of patients with PKU following oral administration of tetrahydrobiopterin(BH4),a cofactor of phenylalanine hydroxylase.Clinical studies suggest that treatment with BH4 provides better Phe control and increases dietary Phe tolerance,allowing significant relaxation or even discontinuation of dietary Phe restriction.The current knowledge on this novel pharmacologic approach to the treatment of PKU will be discussed.

8.
Article in Chinese | WPRIM | ID: wpr-345671

ABSTRACT

Congenital malformation is one of the most frequent causes of infant death in western countries and major cities in China. Though genetic screening of newborns remains a hot issue and concern, the mortality rate associated with birth defects has not been significantly reduced over the past 20 years. Many genetic diseases manifest symptoms during the first 28 days of life, but full clinical symptoms might not be evident in newborns. Moreover, genetic aberrations is highly heterogeneous. These complicated factors lead to the establishment of diagnosis based on nonspecific or obscure symptoms. Recently developed array comparative genomic hybridization (CGH) and next generation sequencing (NGS) techniques with efficient high-resolution allow to screening of the entire genome for DNA copy number variants and sequencing respectively. These new and powerful tools can shorten the differential diagnosis process and quicken to movement towards targeted treatment and genetic and prognostic counseling.


Subject(s)
Comparative Genomic Hybridization , Congenital Abnormalities , Diagnosis , Genetics , DNA Copy Number Variations , Humans , Infant, Newborn , Sequence Analysis, DNA
9.
Article in Chinese | WPRIM | ID: wpr-241489

ABSTRACT

<p><b>OBJECTIVE</b>To study the effect of selective moderate head cooling therapy on maximum length sequences brainstem auditory evoked potential (MLS-BAEP) in newborn piglets with hypoxic-ischemic brain damage.</p><p><b>METHODS</b>Sixteen newborn piglets aged 5-7 day old were randomly divided into three groups: normothermic control (n=4), HI (n=6) and mild hypothermia-treated (n=6). HI was induced through temporary occlusion of both carotid arteries, followed by mechanical ventilation with low concentration of oxygen (FiO2=0.06) for 30 minutes. Mild hypothermia was induced by equipment via circulating water. MLS-BAER was recorded before HI and at 12 hours, 24 hours, 36 hours, 48 hours, 60 hours, 72 hours, 4 days, 7 days, 10 days, 13 days and 15 days after HI.</p><p><b>RESULTS</b>Compared with the normothermic control group, all latencies and intervals tended to increase significantly at 72 hours in the HI group and reached peak values on day 7. From day 10, all latencies and intervals tended to decrease, but apart from wave I latency, still differed significantly from those of the normothermic control group. MLS-BAER variables did not reach normal values until day 15. Ⅲ latency, Ⅰ-Ⅲ interval and Ⅰ-Ⅴ interval were significantly reduced in the hypothermia-treated group between 60 and 7 days after HI compared with the HI group (P<0.05). V latency and Ⅲ-Ⅴ interval in the hypothermia-treated group were also reduced compared with the HI group between 72 hours and 7 days after HI (P<0.05).</p><p><b>CONCLUSIONS</b>Both peripheral and central auditory systems are disturbed by HI, which shows as a significant increase in MLS-BAER variables (all latencies and intervals) in newborn piglets. Involvement in central brainstem auditory system reaches a peak on day 7 after injury. MLS-BAER variables still cannot reach to normal values until day 15. Selective moderate head cooling therapy can significantly reduce brainstem damage induced by HI.</p>


Subject(s)
Animals , Animals, Newborn , Evoked Potentials, Auditory, Brain Stem , Hypothermia, Induced , Hypoxia, Brain , Therapeutics , Swine
10.
Chinese Journal of Pediatrics ; (12): 648-654, 2011.
Article in Chinese | WPRIM | ID: wpr-276977

ABSTRACT

<p><b>OBJECTIVE</b>To study the characteristics of amplitude integrated electroencephalography (aEEG) in preterm infants and changes of maturation with gestational age.</p><p><b>METHODS</b>aEEG monitoring was done within 3 days of age with domestically produced digital aEEG set (CFM3000). Duration of each recording was at least 4 hours. The continuity, sleep-wake cycle, voltage and bandwidth of all aEEG tracing were analyzed.</p><p><b>RESULTS</b>The percent of continuity background increased from 30% of 28 weeks to 85.7% of 36 weeks (χ(2) = 28.2, P = 0.026); the percent of mature sleep-wake cycle increased from 10% of 28 weeks to 100% of 36 weeks (χ(2) = 192.4, P < 0.01). Low bound voltage increased with gestational age, from (6.8 ± 1.7) µV (28 w) to 9.7 - 10.1 µV (35 - 36 w) (F = 11.4, P < 0.01). Bandwidth of the narrow band decreases gradually with gestational age, from 1.45 cm (28 w) to (0.86 ± 0.24) cm (36 w) (F = 8.731, P < 0.01). The correlation coefficient for continuity, sleep-wake cycle, low bound voltage and bandwidth of narrow band, and total scores were 0.32, 0.81, 0.38, 0.55 and 0.78 respectively (P < 0.05).</p><p><b>CONCLUSION</b>The older the gestational age of infants at birth, the more mature the aEEG pattern, manifested as increased continuity and sleep-wake cycle, the higher low bound voltage and more narrowed bandwidth with increased gestational age.</p>


Subject(s)
Age Factors , Electroencephalography , Female , Humans , Infant, Newborn , Infant, Premature , Physiology , Male
11.
Article in Chinese | WPRIM | ID: wpr-347905

ABSTRACT

<p><b>OBJECTIVE</b>To study the proliferation and differentiation of neural stem cells in the subventricular zone (SVZ) in neonatal rats after bilateral common arteries occlusion.</p><p><b>METHODS</b>Ninety-six 3-day-old Sparuge-Dawley rats were randomly divided into two groups: ischemia and control. Rats in the ischemia group were subjected to bilateral common arteries occlusion and the rats in the control group were sham-operated. All rats were administrated with 5-bromodeoxyuridine (BrdU) (50 mg/kg) via intraperitoneal injection. Rats were sacrificed and their brains were removed 1, 4, 7, 10, 14 and 35 days after ischemia. Using brain paraffin sections and immunofluorescence assays, the number of newborn cells in the SVZ was counted. Newborn neural stem cells and oligodendrocytes in the SVZ were observed, and then double marked with BrdU and nestin or osmium tetroxide (O4).</p><p><b>RESULTS</b>The number of BrdU+ cells (neural stem cells) in the SVZ in the ischemia group was greater than in the control group 4, 7, 10 and 14 days after ischemia, and reached a peak at 4 days after ischemia (253.1+/- 49.3 vs 133.5+/- 17.7; P< 0.01). By 35 days after ischemia, the number of BrdU+/O4+ cells (oligodendrocytes) in the corpus callosum (56.0+/- 7.2 vs 17.0+/- 6.4; P< 0.01), the septal nuclei (45.0+/- 11.9 vs 20.5+/- 5.0; P< 0.01), the striatum (34.5+/- 4.2 vs 14.5+/- 5.8; P< 0.01) and the olfactory bulb (46.5+/- 6.6 vs 23.5+/- 8.4; P< 0.01) in the ischemia group increased significantly as compared to the control group (P< 0.01).</p><p><b>CONCLUSIONS</b>Brain ischemia can activate the proliferation of neural stem cells in the SVZ and promote neural stem cells differentiation into oligodendrocytes. The immature brain may have the capacity for self-repair after ischemic brain injury.</p>


Subject(s)
Animals , Animals, Newborn , Brain Ischemia , Therapeutics , Bromodeoxyuridine , Metabolism , Cell Differentiation , Cell Proliferation , Cerebral Ventricles , Female , Male , Neurogenesis , Rats , Rats, Sprague-Dawley , Stem Cell Transplantation
12.
Article in Chinese | WPRIM | ID: wpr-683306

ABSTRACT

Objective To determine the effect of mild hypothermia on neonatal piglet cardiac hemodynamic function after hypoxia-ischemia (HI).Method Twenty five 7-day-old piglets were used for hypoxic ischemic brain damage (HIBD) model by the method of temporary occlusion of the bilateral carotid arteries and followed by mechanical ventilation with low concentration of oxygen (FiO_2=6%) for 30 minutes.The piglets were randomly divided into three groups:group A (normothermia with body temperature to 39℃,n=9),group B (body temperature to 36℃for 72 hours,n=8),and group C (body temperature to 34℃for 72 hours,n=8).Mild hypothermia was initiated at 4 hours after HI,the systolic and diastole function were evaluated by Doppler echocardiography at pre-HI,post-Hi 4 hours and post-HI 72 hours.Results There were no significant differences in left ventrieular ejection time/left ventrieular ejection time (LPEP/LVEF),right ventricular ejection acceleration time/right ventricular ejection time (RACT/RVET) and CO at post-HI with hypothermia 72 hours in three groups,but the heart rate decreased in B and group C group.Compared with nonnothermia,mild hypothermia treatment showed no significant differences in MAP,LPEP/LVET,RACT/RVET,CO,SV at post-HI with hypothermia 72 hours.Conclusions Body temperature decreased by 3~5℃for 72 hours will not aggravate hemodynamic abnormity.

13.
Chinese Journal of Pediatrics ; (12): 460-462, 2003.
Article in Chinese | WPRIM | ID: wpr-276891

ABSTRACT

<p><b>OBJECTIVE</b>To study the effects of hypothermia on cardiac function in neonates after birth asphyxia.</p><p><b>METHODS</b>Fifty term newborns with Apgar score < 5 at 5 minutes were randomly divided into no cooling group (normothermia group, NG; rectal temperature = 36.5 degrees C +/- 0.5 degrees C, n = 27) and cooling group (hypothermia group, HG; rectal temperature = 34.5 degrees C +/- 0.3 degrees C, nasopharyngeal temperature = 34.0 degrees C +/- 0.5 degrees C, n = 23). The selective head cooling was applied to maintain nasopharyngeal temperature at 34 degrees C for 72 h in hypothermia group. Systolic and diastolic function was detected at the end of treatment by echocardiogram.</p><p><b>RESULTS</b>(1) The heart rate was obviously decreased during the hypothermia treatment, and there was a significant difference between HG and NG [(103 +/- 15) bpm vs. (126 +/- 14) bpm, P < 0.05]. No cardiac arrhythmia and hypotension were found in all neonates. (2) There were no significant differences on the ejection fraction, stroke volume and cardiac output of left ventricle between the two groups (P > 0.05). No significant difference was found in the numbers of left and right ventricular diastolic dysfunction, pulmonary hypertension between the two groups (P > 0.05). (3) The level of cardiac troponin T (cTnT) in plasma was (0.47 +/- 0.15) ng/ml in HG, and (0.35 +/- 0.21) ng/ml in NG, and there was no significant difference between the two groups (P > 0.05).</p><p><b>CONCLUSION</b>No significant cardiac dysfunction complication caused by the hypothermia treatment was found in term neonates after birth asphyxia.</p>


Subject(s)
Asphyxia Neonatorum , Electrocardiography , Heart , Heart Function Tests , Humans , Hypothermia, Induced , Methods , Infant, Newborn , Monitoring, Physiologic , Troponin , Blood
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