Clinical characteristics of ureaplasma urealyticum infection in very low birth weight preterm infants / 中国新生儿科杂志

Objective:To study the clinical characteristics and risk factors of intrauterine Ureaplasma urealyticum (UU) infection in very low birth weight preterm infants.Methods:From March 2019 to February 2022, very low birth weight preterm infants with gestational age 28~32 weeks admitted to our hospital were enrolled in this single-center retrospective study. According to the UU test results of respiratory tract samples obtained within 24 h after admission, the infants were assigned into the UU group (UU-PCR positive) and the non-UU group (UU-PCR negative). SPSS 26.0 statistical software was used to compare the clinical characteristics, laboratory indices, and complications between the two groups. Risk factors of UU infection were calculated.Results:A total of 327 preterm infants were included: 45 in the UU group and 282 in the non-UU group. No significant differences existed in gender, gestational age, birth weight and delivery pattern between the two groups ( P>0.05). Compared with the non-UU group, the UU group had significantly higher incidences of premature rupture of membranes (PROM) and chorioamnionitis, elevated white blood cell and platelet counts, procalcitonin and C-reactive protein levels, total duration of oxygen use and ventilation, bronchopulmonary dysplasia, necrotizing enterocolitis and metabolic osteopathy ( P<0.05). Multivariate logistic regression analysis showed that PROM ( OR=5.444, 95% CI 2.749-10.781, P<0.001) and chorioamnionitis ( OR=2.161, 95% CI 1.048-4.454, P=0.037) were independent risk factors for UU infection. Conclusions:PROM and chorioamnionitis are risk factors for UU infection in very low birth weight preterm infants. For high-risk premature infants, the UU test should be completed as soon as possible after birth.

Correlation between meconium-stained amniotic fluid and intrauterine infection / 中华实用儿科临床杂志

Fetal hypoxia has long been described as the main cause of meconium-stained amniotic fluid (MSAF). However, recent studies have reported the presence of a variety of pathogenic microorganisms in meconium and amniotic fluid, and even more bacterial species in MSAF.Clinical observations also revealed that MSAF was closely related to fetal-neonatal infection and perinatal infection of pregnant women.Shortly after birth, the fetuses with MSAF developed infectious symptoms or showed abnormalities in infection-related laboratory indicators.Therefore, intrauterine infection may be one major cause of MSAF.To further our understanding of the factors leading to MSAF will improve the clinical management and prognosis of infants.

Nursing care of intrauterine infection complicated with septic shock in middle pregnancy for a patient with recurrent spontaneous abortion / 中国实用护理杂志

Objective:To summarize the nursing care experience of intrauterine infection complicated with septic shock in middle pregnancy for a patient with recurrent spontaneous abortion and postpartum hemorrhage during anti shock treatment.Methods:On June 2020, one patient with recurrent spontaneous abortion was admitted to our hospital with intrauterine infection in the second trimester of pregnancy. Close observation of disease changes, formulate personalized emergency plan, respond quickly when the condition changes, cooperate closely and actively rescue, observation and nursing of postoperative hemorrhage, anti-infective therapy timely, psychological nursing and health education. After active rescue and careful nursing, the patient recovered and discharged 8 days after abortion.Results:After active treatment and careful nursing, the patient recovered well and recovered 8 days after operation.Conclusion:For patients with intrauterine infection, especially patients with recurrent spontaneous abortion, close observation , timely initiation of emergency plans, termination of pregnancy effective anti-infection treatment, and psychological nursing and health guidance are essential to ensure the life safety of patients and promote reproductive health.

Expression of virulence genes in Group B Streptococcus isolated from symptomatic pregnant women with term and preterm delivery

Aims@#Maternal vaginal Group B Streptococcus (GBS) colonization is considered a risk factor for preterm delivery and, consequently, neonatal infections. Previous studies have portrayed the important roles of these virulence factors, including hemolytic pigment, hyaluronidase (HylB), serine-rich protein (Srr) and bacterial surface adhesion of GBS (BsaB) in mediating GBS colonization and intrauterine ascending infection, causing preterm delivery. This study aimed to investigate the association between mRNA expression of virulence genes in GBS isolates obtained from symptomatic pregnant women and preterm delivery.@*Methodology and results@#GBS isolates were obtained from high vaginal swabs of 40 symptomatic pregnant women of gestational age of less than 37 weeks. RNA was extracted from these GBS isolates and RT-qPCR was performed to determine the relative mRNA expression of GBS virulence genes, including CylE (encode enzyme required for the biosynthesis of the hemolytic pigment), HylB, Srr-1 and BsaB. Socio-demographic details and obstetric history were not found to be associated with the delivery outcomes of these women. The GBS isolates from symptomatic pregnant women who delivered prematurely showed a higher expression of CylE gene and a trend towards an elevated expression of HylB gene compared to women with term delivery. Meanwhile the expression of both Srr-1 and BsaB genes was similar between symptomatic pregnant women who had term or preterm delivery.@*Conclusion, significance and impact of study@#The results suggest that following vaginal colonization, both CylE and HylB genes are likely to contribute to intrauterine ascending infection and inflammation, leading to preterm delivery in humans. These virulence factors may be targeted for the pre-clinical stages of vaccine development or therapeutic intervention.

Risk factor and hepatitis B virus makers during the first trimester in villi tissues of HBsAg-positive pregnant women / 中华实验和临床病毒学杂志

Objective@#To determine whether intrauterine infection with hepatitis B virus (HBV) occurs in early pregnancy and to characterize associated virulence factors.@*Methods@#Villi tissues and blood samples of 45 HBV surface antigen (HBsAg)-positive pregnant women were collected during the first trimester and HBV DNA loads were quantified by quantitative reverse transcription polymerase chain reaction (qRT-PCR). The expression of GCM1, HBsAg and hepatitis B core antigen (HBcAg) in villi tissues were detected by immunohistochemical method.@*Results@#Data from qRT-PCR showed that HBV DNA was detected in 14 of 45 villi tissues (positive rate of 31.11%), and 24 of 45 blood samples (positive rate of 53.33%), further statistical analysis showed that the positive rates of HBV DNA between blood samples and villi tissues were not significantly different (χ2=4.555, P=0.054). Among them, 12 samples were consistently positive between the villi and blood specimens, and HBsAg, HBeAg, HBeAb, HBV DNA from peripheral blood in these pregnant women were significantly higher than those of the other women (P value was 0.007, 0.004, 0.000, and 0.000 respectively). The multivariate logistic regression analysis showed that blood HBV DNA greater than 106 IU/ml was independently associated with HBV DNA positive in villi, and the HBsAg, HBeAg, villi tissues HBV DNA positive rates of these pregnant women were significantly higher than those of the other pregnant women (all P value were 0.000). Immunohistochemistry results showed that all 45 cases were positive for GCM1 expression in the cell nucleus. Nine cases also had HBsAg expression in the cytoplasm. Only one case was found to express HBV core antigen (HBcAg) in the nucleus.@*Conclusions@#HBV DNA and HBsAg can be detected from villi tissues harvested during the first trimester in HBsAg-positive pregnant women, and the results suggest an early occurrence of intrauterine infection of fetuses with high HBV levels.

Diagnostic value of serum NSE, S100B protein and myocardial zymogram in premature infants with intrauterine infection / 中国基层医药

Objective@#To explore the diagnostic value of serum NSE, S100B protein and myocardial zymogram in premature infants with intrauterine infection.@*Methods@#From January 2016 to December 2017, 60 preterm infants with intrauterine infection in the Integrated Chinese and Western Medicine Hospital of Wenzhou were selected in the study.According to whether brain injury occurred, they were divided into brain injury group (28 cases) and non-brain injury group (32 cases). Serum NSE content was detected by chemiluminescence method, serum S100B protein level was detected by enzyme linked immunosorbent assay (ELISA), and serum CK and HBDH levels were detected by automatic biochemical analyzer.The serum levels of NSE, S100B, CK and HBDH were compared between the two groups, the combined diagnostic efficacy of NSE+ S100B protein+ CK+ HBDH was analyzed, the correlation of serum NSE, S100B protein, CK, HBDH with brain injury wasanalyzed.@*Results@#The levels of serum NSE [(2.43±0.54)μg/L] and S 100B [(14.36±3.21)ng/L] in the brain injury group were higher than those in the non-brain injury group [(0.97±0.27)μg/L and (8.10±1.87)ng/L] (t=13.498, 9.370, all P<0.05). The levels of serum CK [(437.64±54.12)U/L] and HBDH [(387.91±56.45)U/L] in the brain injury group were significantly higher than those in the non-brain injury group [(183.54±32.58)U/L and (174.3±26.63)U/L] (t=22.347, 19.126, all P<0.05). The sensitivity and specificity of the combined diagnosis of NSE+ S100B protein and myocardial zymogram were higher than those of each single index.Serum NSE, S100B protein, CK and HBDH were positively correlated with brain injury.@*Conclusion@#The elevation of serum NSE, S100B protein and myocardial zymogram in preterm infants with intrauterine infection after birth has certain clinical significance in judging whether brain injury occurs or not.

Intrauterine infection and fetal cardiovascular system development / 国际儿科学杂志

When the pathogen infects the fetus,the pathogenic microorganism and the infection product are recognized by the corresponding receptor.The fetus innate immune system is passively activated,which produces proinflammatory cytokines,induces cascade reaction of cytokines,and releases a large number of inflammatory factors secreted by the body.Its toxic effect can cause damage to the brain,lung,small intestine and heart and other important organs of the whole body,which seriously threatens the life of the perinatal infants and their subsequent survival quality.It has been found that fetal cardiovascular system is one of the important target organs of intrauterine infection.Cytokines produced by cardiac inflammation and induced by intrauterine infection can damage myocardial cells,affect the proliferation of myocardial cells,and cause damage to cardiac function.Moreover,the persistent influence of infection on fetus leads to fetal vascular remodeling and changes in fetal cardiopulmonary hemodynamics.This article reviews the effects of pathogens of intrauterine infection and fetal cardiac inflammation,cardiac hemodynamics,cardiomyocyte development,gene program of cardiomyocyte and cardiac structure development on fetal cardiovascular system.

Relationship between umbilical cord blood cytokines and intrauterine HBV infection / 中国综合临床

Objective To investigate the relationship between neonatal umbilical cord blood cytokine interferon-γ (IFN-γ),interleukin-4 (IL-4),interleukin-12 (IL-12),interleukin-18 (IL-18) and hepatitis B virus (HBV) intrauterine infection.Methods Seventy-five newborns delivered by HBsAg-positive pregnant women in the First Hospital of Hebei Medical University and the Fifth Hospital of Shijiazhuang from December 2017 to June 2018 were selected as observation group.According to the results of five items of hepatitis B and HBV DNA test in cord blood of newborns,17 of them were positive as intrauterine infection group,and 58 of them were negative as uninfection intrauterine group.Forty-three newborns delivered by healthy pregnant women with negative HBsAg were taken as control group.The levels of cytokines IFN-γ,IL-4,IL-12 and IL-18 in cord blood of neonates were detected by ELISA,Results The levels of IFN-γ,IL-4,IL-12 and IL-18 in the newborns of intrauterine infection group were (409.51 ±51.77),630.51(612.49,647.33),85.60(56.11,133.99),32.41 (23.04,87.53) ng/L.The levels in the uninfected intrauterine Group were (523.87 ± 38.45),573.33 (531.95,598.38),186.53 (77.77,302.66),125.99(63.32,202.73) ng/L.The levels in the control group were (509.39±73.02),565.83 (443.40,620.82),199.89 (128.92,289.30),152.98 (86.76,188.57) ng/L.There were significant differences in IFN-γ,IL-4,IL-12,IL-18 between the intrauterine infection group and the uninfected intrauterine group and the control group (all P＜0.01).There was no significant difference between the uninfected group and the control group (all P＞0.05).Conclusion The decrease of IFN-γ,IL-12,IL-18 and the increase of IL-4 in cord blood of neonates result in the decrease of viral clearance ability and the failure of HBV clearance,which leads to intrauterine infection of neonates with HBV.

Case Analysis of Participation of Clinical Pharmacists in Anti-infective Treatment for a Case of Septic Shock Induced by Intrauterine Infection / 中国药房

OBJECTIVE: To explore the role of clinical pharmacists in anti-infective treatment for the patient with septic shock induced by intrauterine infection. METHODS: Clinical pharmacists participated in anti-infective treatment for a patient with septic shock induced by intrauterine infection, and assisted physicians to formulate empirical anti-infective treatment, determine that Escherichia coli was pathogenic bacteria and analyze the causes of fluctuations in body temperature. According to the patient's disease condition and results of assistant examination, clinical pharmacists suggested using Imipenem and cilastatin sodium for injection 1. 0 g, ivgtt, q6 h, stopping Teicoplanin for injection, de-escalation using Cefoxitin sodium for injection 2. 0 g, ivgtt, q8 h for anti-infective treatment, with oral sequential therapy. RESULTS: Physicians adopted most advice of pharmacists. After 30 d anti-infective and symptomatic treatment, the patients symptoms were better than before, and discharged from the hospital. CONCLUSIONS: Clinical pharmacists participate in formulating individual anti-infective treatment regimen, so as to promote the rational use of antibiotics and improve the response rate and success rate of treatment.

The relationship between inositol phosphatase-1 and cognitive impairment induced by hippocampal neuritis in intrauterine infected mice / 中华实用儿科临床杂志

Objective To investigate the relationship between cognitive impairment and SH2 domain-containing inositol phosphatase-1 (SHIP-1) induced by hippocampal neuritis in intrauterine infected mice.Methods Thirty C57BL/6 female mice and 15 male mice were caged in a ratio of 2 ∶ 1.After that,the pregnant mice were divided into 2 groups.A mice model of intrauterine infection was established that intrauterine infection group (lipopolysaccharides,LPS group) induced by LPS at the concentration of 350 μg/kg and control group treated with same volume of saline (9 g/L).At 3 days postpartum,15 mice in each group were killed for hippocampus,and the protein levels of SHIP-1,nuclear factor-κB(NF-κB) p65 and phosphorus NF-κB(NF-κBp) in the hippocampus of the newborn mice were detected by Western blott,while the levels of interleukin 1β (IL-1β) and tumor necrosis factor (TNF-α)were detected by using enzyme linked immunosoobent assay.When the remaining mice were 8 weeks old(10 in each group),Morris water maze experiments were performed respectively,which the mice were tested for evaluating learning and memory function by positioning navigation and space exploration experiments.Results The expression of SHIP-1 was significantly increased in control group (0.677 ± 0.074) compared with LPS group (0.317 ± 0.095,t =2.984,P =0.041),while the levels of NF-κB p65,and NF-κBp,were significantly lower in control group (0.630 ± 0.109,0.352 ± 0.084) than LPS group(0.630 ± 0.109,0.352 ± 0.084) (t =3.516,5.161,P =0.025,0.007).Moreover,LPS significantly enhanced the expression of IL-1β and TNF-α [(5.875 ± 0.349) pg/mg,(14.256 ± 0.784)pg/mg] compared with control group[(1.621 ± 0.151) pg/mg,(3.984 ± 0.255) pg/mg],and the differences were significant(t =11.190,12.460,P=0.000,0.000).By the average Escape Latency tests for6 days,LPS group [at 1-6 days (58.286±1.418) s,(56.036 ±2.252) s,(55.071 ±1.856) s,(50.071 ±3.251) s,(52.893 ±2.372) s,(46.929 ±3.761) s] markedly impaired the learning capacity compared with the control group[(53.679 ±2.413) s,(47.571 ±3.529) s,(54.071 ±2.777) s,(47.250 ±2.864) s,(45.107 ±3.447) s,(42.393 ±3.463) s],and the difference was significant (F =4.466,P =0.001).Concurrently,in probe trains LPS group increased the time of in zone southeast latency to first [(44.080 ± 6.313) s] compared with the control group [(25.900 ± 6.033) s],while shortened the period of in zone platform duration and in zone SE duration [(0.000 ± 0.040) s,(4.000 ± 1.693) s],decreased the times of in zone SE frequency and in zone platform frequency[(0.100 ±0.100) times,(1.000 ±0.394)times] compared with the control group [(0.400 ± 0.202) s,(14.360 ± 5.000) s,(0.600 ± 0.267) times,(3.400 ±0.763) times] (t=2.082,1.746,1.962,2.794,1.756,P=0.026,0.049,0.033,0.006,0.048).Conclusion The expression of SHIP-1 in hippocampus of newborn mice with intrauterine infection is decreased,and the inhibitory effect of SHIP-1 on the expression of downstream pro-inflammatory cytokines NF-κB,inflammatory cytokines IL-1β and TNF-α is decreased,along with cognitive impairments.

Value of Tau protein and resistin in early prediction of premature brain damage induced by intrauterine infection / 临床儿科杂志

Objective To explore the value of plasma Tau protein and resistin in early prediction of brain injury in premature infants caused by intrauterine infection. Method A total of 47 premature infants in NICU with early-onset sepsis were selected as infection group from January 2017 to October. According to the cranial MRI, the infection group was further divided into brain injury group (22 cases) and non-brain injury group (25 cases). In addition, 12 normal preterm infants were selected as the control group. Enzyme linked immunosorbent assay (ELISA) was used to detect plasma Tau protein and resistin levels on the first, third and seventh day after birth in three groups. Results The Tau protein in the brain injury group increased significantly on the first day, and then gradually decreased, while it was higher than that in the non-brain injury group and the control group at all time points, and there were statistical differences (P<0.05). At different time points, there was no difference in the level of Tau protein between the non-brain injury group and the control group (P>0.05). The level of resistin in the brain injury group increased significantly on the first day until the third day, and significantly decreased in the seventh day, and it was higher than that in the non-brain injury group and the control group at all time points, and there were statistical differences (P<0.05). Resistin increased on the first day, then gradually decreased, and returned to normal on the seventh day in the non-brain injury group. Conclusion Detection of plasma Tau protein and resistin levels within 3 days after birth may be helpful for early prediction of brain damage in premature infants with intrauterine infection.

A case-control study on risk factors for intrauterine HBV infection / 重庆医学

Objective To explore the risk factors for hepatitis B virus (HBV) intrauterine infection to provide a scientific ev idence for itsprevention.Methods Three hundred and twelve pregnant women of HBsAg positive screened from April 2013 to May 2015 served as the research subjects and were followed up until 6 months after birth.The infantile mothers of HBsAg and/or HBV DNA positive were selected as the intrauterine infection case group,while other mothers served as the control group.The Logistic regression analysis was adopted to analyze the risk factors for intrauterine HBV infection.The questionnaire survey method was used to collect the basic data and time-resolved immunofluorescence assay was used to detect HBsAg.PCR was adopted to measure level of HBV DNA and automatic biochemistry analyzer was used to measure the hepatic functional parameters including ALT,AST,triglyceride and cholesterol.Results The single factor analysis results indicated that HBeAg,HBV DNA,contamination of amniotic fluid and sexual behavior during pregnancy were related to HBV intrauterine infection(P＜0.05).The multiple variate Logistic regression results showed that positive HBeAg(OR=2.76,95 ％ CI=1.19-7.94),positive HBV DNA(OR=9.62,95 ％ CI=2.58-35.33),and sexual behaviors during pregnancy (OR =1.53,95 ％ CI =1.07-6.40) were the risk factors for intrauterine HBV infection.Conclusion Pregnant women with positive HBeAg,positive HBV DNA and sexual behavior during pregnancy may be the high risk factors for neonatal intrauterine HBV infection.

Intrauterine infection and neonatal pulmonary outcomes / 中国小儿急救医学

There is no consensus about the relationships between chorioamnionitis and 3 pulmonary outcomes of concern for preterm infants:respiratory distress syndrome,pneumonia/sepsis,and bronchopulmonary dysplasia.Intrauterine infection increases the risk of neonatal infection including sepsis/pneumonia,also increases the incidence of bronchopulmonary dysplasia,but may reduce the incidence and severity of respiratory distress syndrome.In recent years,translational research with various animal models has been helpful to answer basic questions about the effect of antenatal inflammation on maturation and development of the fetal lung and immune system.Although the mechanisms are not entirely clear,chorioamnionitis predisposes infants to premature birth,neonatal sepsis,and other adverse outcomes.In this article,we reviewed the relationship of intrauterine infection and neonatal pulmonary morbidity.

Congenital Cytomegalovirus Infection in Monozygotic Twins with Twin-to-twin Transfusion Syndrome.

Background: Symptoms of congenital cytomegalovirus infection remains unclear. Case characteristics: Extremely low birth weight twins with twin-to-twin transfusion syndrome were infected with cytomegalovirus congenitally.Observation: The donor showed neuronal impairment, whereas the recipient showed hepatic dysfunction. Message: Intrauterine hemodynamics may be important in pathophysiology of congenital cytomegalovirus infection.

Protective effects of activated protein C on neurovascular unit in a rat model of intrauterine infection-induced neonatal white matter injury / 华中科技大学学报（医学）（英德文版）

Activated protein C (APC), a natural anticoagulant, has been reported to exert direct vasculoprotective, neural protective, anti-inflammatory, and proneurogenic activities in the central nervous system. This study was aimed to explore the neuroprotective effects and potential mechanisms of APC on the neurovascular unit of neonatal rats with intrauterine infection-induced white matter injury. Intraperitoneal injection of 300 μg/kg lipopolysaccharide (LPS) was administered consecutively to pregnant Sprague-Dawley rats at embryonic days 19 and 20 to establish the rat model of intrauterine infection- induced white matter injury. Control rats were injected with an equivalent amount of sterile saline on the same time. APC at the dosage of 0.2 mg/kg was intraperitoneally injected to neonatal rats immediately after birth. Brain tissues were collected at postnatal day 7 and stained with hematoxylin and eosin (H&E). Immunohistochemistry was used to evaluate myelin basic protein (MBP) expression in the periventricular white matter region. Blood-brain barrier (BBB) permeability and brain water content were measured using Evens Blue dye and wet/dry weight method. Double immunofluorescence staining and real-time quantitative PCR were performed to detect microglial activation and the expression of protease activated receptor 1 (PAR1). Typical pathological changes of white matter injury were observed in rat brains exposed to LPS, and MBP expression in the periventricular region was significantly decreased. BBB was disrupted and the brain water content was increased. Microglia were largely activated and the mRNA and protein levels of PAR1 were elevated. APC administration ameliorated the pathological lesions of the white matter and increased MBP expression. BBB permeability and brain water content were reduced. Microglia activation was inhibited and the PAR1 mRNA and protein expression levels were both down-regulated. Our results suggested that APC exerted neuroprotective effects on multiple components of the neurovascular unit in neonatal rats with intrauterine infection- induced white matter injury, and the underlying mechanisms might involve decreased expression of PAR1.

The Effect of Early Intervention and Rehabilitation in the Expression of Aquaporin-4; and Ultrastructure Changes on Rat's Offspring's Damaged Brain Caused by Intrauterine Infection

OBJECTIVE: To study the effect of early intervention and rehabilitation in the expression of aquaporin-4 and ultrastructure changes on cerebral palsy pups model induced by intrauterine infection. METHODS: 20 pregnant Wistar rats were consecutively injected with lipopolysaccharide intraperitoneally. 60 Pups born from lipopolysaccharide group were randomly divided into intervention group (n=30) and non-intervention group (n=30); intervention group further divided into early intervention and rehabilitation group (n=10), acupuncture group (n=10) and consolidate group (n=10). Another 5 pregnant rats were injected with normal saline intraperitoneally; 30 pups born from the normal saline group were taken as control group. The intervention group received early intervention, rehabilitation and acupuncture treatment. The motor functions of all pups were assessed via suspension test and modified BBB locomotor score. Aquaporin-4 expression in brain tissue was studied through immunohistochemical and western-blot analysis. Ultrastructure changes in damaged brain and control group were studied electron-microscopically. RESULTS: The scores of suspension test and modified BBB locomotor test were significantly higher in the control group than the intervention and non intervention group (p<0.01); higher in the intervention group than the non-intervention group (p<0.01). The expression of Aquaporin-4 was lower in intervention and non intervention group than in the control group (p<0.01); also lower in non-intervention group than the intervention group (p<0.01). Marked changes were observed in ultrastructure of cortex and hippocampus CAI in brain damaged group. CONCLUSION: Early intervention and rehabilitation training can improve the motor function in offspring with brain injury and reduce the expression of aquaporin-4 in damaged brain.

Intrauterine infection and neonatal brain damage / 临床儿科杂志

Intrauterine infection is an important risk factor for neonatal brain damage and neurological dysfunction. Viruses, bacteria, and protozoa can cause intrauterine infection which results in neonatal brain damage. The inlfammatory response is an important pathogenic factor for neonatal brain damage caused by intrauterine infection. Intrauterine infection in different periods of pregnancy might cause different types of brain damage in neonates. Clinicians should pay attention to the prevention of intrauterine infection during pregnancy. It is necessary to further strengthen the clinical and basic research to explore effective interventions for neonatal brain damage caused by intrauterine infection.

Relationship between cytokine levels in serum and cerebrospinal fluid and brain injury in preterm infant with ;intrauterine infection / 中华实用儿科临床杂志

Objective To evaluate the relationship between the cytokine levels in the serum and cerebrospinal fluid and the brain injury in preterm infants. Methods From August of 2012 to August of 2013,51 preterm infants were included and 46 infants were survived. All of them were born at the Maternal and Child Hospital of Hubei Pro-vince,with GA≤32 weeks and high risk factors of intrauterine infection and suffering from early onset sepsis. Ac-cording to the screening findings of cerebral ultrasound and/or MRI,the infants were divided into normal group(n=28) and abnormal groups(n=18) with intracranial hemorrhage or white matter damage. The levels of interleukin(IL)-6,IL-1β and tumor necrosis factor-α( TNF-α) in the serum within 12 hours after birth and in cerebrospinal fluid within 72 hours after birth were investigated. The differences in cytokines between two groups were compared with t-test and Chi-square test,and high risk factors of brain injury were analyzed by Logistic regression models. Results The ab-normal group had higher incidence of clinical maternal chorioamnionitis[44. 44%(8/18 cases) vs 14. 29%(4/28 ca-ses),χ2=5.168,P=0.038] and higher white blood cell count[(11.51±9.03)×109/L vs(6.95±5.64)×109/L,t=-2. 107,P=0. 041]. In the abnormal group,the levels of serum IL-6 [(44. 83±16. 31) ng/L],and IL-6,IL-1βand TNF-αin cerebrospinal fluid [(51. 85±15. 65) ng/L,(11. 95±2. 58) ng/L and(193. 11±67. 25) ng/L] were higher than those in the normal group[(36.83±8.76) ng/L,(42.56±12.89) ng/L,(10.26±2.91) ng/L and(160.56± 29. 02) ng/L,respectively] with the statistical difference(t=-2. 687,-2. 250,0. 269,-2. 243,P=0. 010,0. 029,0. 044, 0. 030). Maternal chorioamnionitis,higher serum TNF-αand cerebrospinal fluid IL-6 were high risk factors for brain in-jury(P=0. 014,0. 031,0. 047). Conclusion Increased systemic and cerebrospinal fluid cytokine levels are possibly re-lated to the preterm brain injury when intrauterine infection occurred.

Effects of in utero exposure to inflammation on innate immune response in preterm infants / 临床儿科杂志

Objective To explore the effect of in utero exposure to inlfammation on innate immune response in preterm infants. Methods Forty-seven premature infants with gestational age<35 weeks were recruited in this study. According to his-tological evidence of placental infection, all neonates were divided into intrauterine inlfammation positive group and negative group. Mononuclear cells and monocytes were isolated from umbilical cord blood, and were cultured in vitro in the presence or absence of LPS (100 ng/ml). The levels of interleukin 1β(IL-1β), interleukin 6 (IL-6), tumor necrosis factor alpha (TNF-α) and interleukin 10 (IL-10) in cord blood plasma and monocyte cultural supernatants were measured by ELISA respectively. The level of IL-1β, TNF-α, IL-6 and IL-10 mRNA were detected by Real-time PCR. Expression of HLA-DR on surface of CD14+monocytes and ratio of CD3+CD4+/CD3+CD8+T was analyzed by lfow cytometry. Results (1) The level of cord plasma IL-6 in intrauterine inlfammation positive group was signiifcantly higher than in negative group. (P=0.02). (2) After stimulation of LPS, levels of IL-1β, IL-6, TNF-α, IL-10 in supernatants were increased signiifcantly, in consistence with their mRNA expression (P<0.05) in both groups. (3) Expression of HLA-DR on surface of monocytes was signiifcantly decreased after stimulation with LPS in intrauterine inlfammation positive group (P=0.012), but was signiifcantly increased in negative group (P=0.0305). Con-clusions In utero exposure to inlfammation does not suppress the response of monocytes to LPS in preterm neonates, but impairs the antigen presenting function in monocytes.

Intrauterine vertical transmission of HBV via pathway of peripheral blood mono-nuclear cells / 中国免疫学杂志

Objective:To study the HBV infection in peripheral blood mononuclear cells in mediating the role of mother -to-child transmission of hepatitis B virus.Methods: The peripheral blood mononuclear cells ( PBMCs ) in maternal and cord blood mononuclear cells ( CBMCs ) in newborns were conventionally isolated by Ficoll-Hypaque medium.The loads of HBV-DNA in peripheral blood of maternal and cord blood of newborns were both detected by PCR .Results:The clinical data showed that the positive detection rates of HBV-DNA in serum and PBMCs of pregnant women with HBeAg (+) were 100.00%( 25/25 ) and 72.00%( 18/25),and the positive detection rates of HBV-DNA in the neonatal umbilical cord blood serum and CBMCs were 60.00%(15/25) and 44.00%(11/25),respectively.There were significantly difference between HBeAg (+) and HBeAg(-) in the pregnant women (P<0.05 ).The positive detection rates of HBV-DNA in neonatal umbilical cord blood serum and CBMCs were higher in the group with high HBV loads (more than 106copies/ml) in PBMCs than those of low HBV loading group (102-103copies/ml).The significantly difference was explored between the two groups.Conclusion: Mononuclear cells can not only be infected by HBV , but also play a critical role in the intrauterine vertical transmission of HBV via the pathway transmitted from PBMCs in pregnant women to CBMCs in newborns.