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Objective To determine the clinical features and gene expression of neonatal chronic granulomatous disease(CGD) in newborns,in order to provide the evidence for early diagnosis,treatment and infection prophylaxis and so as to improve prognosis.Methods The clinical data of 6 neonates with CGD who hospitalized in Beijing Children's Hospital,Capital University of Medical Sciences,from Jan.to Dec.2013 were retrospectively analyzed,to summarize their clinical features and gene expression.Results All patients were male,mean age of onset in 6 patients was 19 days old.Six patients were onset with cough and fever,3 cases with skin abscesses.All patients had special lung images and their respiratory burst test were all positive.Six patients were all X-linked recessive heredity with mutation in CYBB gene,4 cases carried missense mutation,1 case carried frameshit mutation,1 case had shear point disappear.All patients were improved during hospitalization with anti-infective therapy including antifungal and antibiotic drugs.After their discharge,the patients were followed up for 1 year,among them 5 patients taking antibiotics according to doctor's advise hadn't got any severe infections or other complications,1 patient did not receive antibiotics according to doctor's advise,caught respiratory infection was occured once per 1-2 months and died of multiple organ failure in 5 months due to severe infection.Conclusions For newborn with respiratory symptoms such as cough and fever,with apparently nodular and massive radiologic infiltrates,CGD cases should be highly suspected.Long term prognosis is good in children with prophylactic medication and they may have a longer infection interval.
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Objective To explore the effect of pulmonary surfactant(PS) in the treatment of neonatal respiratory distress syndrome(NRDS).Methods According to whether using the PS,60 NRDS patients were divided into treatment group and control group.The blood-gas analysis index,oxygen time,mechanical ventilation time,hospitalization time and other indicators were analyzed.Results After 6h treatment,blood pH value (7.41 ± 0.11),PaO2 (69.8 ± 11.9) mm Hg and PaCO2 (48.7 ± 11.1)mm Hg in the treatment group were higher than those of the control group (7.24 ±0.13),(53.3 ±9.8)mm Hg,(59.1 ± 12.7)mm Hg(t =3.35,2.88,3.24,all P ＜0.05).In the treatment group,oxygen time (98.2 ± 29.2) h,the time of mechanical ventilation (77.6 ± 30.4) h and hospitalization time (12.9 ± 1.7)d,were also shorter than those of the control group (143.9 ± 26.5) h,(121.4 ± 22.9) h,(17.6 ±2.1) d (t =4.56,5.32,4.86,all P ＜ 0.05).Conclusion The application of PS in the treatment of NRDS can improve the lung function and lung aeration and reduce the time of mechanical ventilation.
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Objective To analyze the incidence,bacterial spectrum and clinical features of peripherally inserted central catheter-associated bloodstream infection in neonates, and to investigate the effect of infection control strategies on the occurrence of infection,by which it is helpful in choosing effective strategies for clinical practice. Methods Clinical data, results of blood culture and culture of the catheter tip were collected from 72 infants (66 of them were very low birth weight) admitted to NICU from July, 2007 to August, 2008. The incidence of PICC-associated bloodstream infection (PICC-BSI) in the old hospital was compared with that of the new hospital. Results Bacterial colonization was not found. PICC-BSI was found in 15 cases (18. 1%), including 11 cases (13.2%) with definite sepsis and 4 cases (4. 8 %) with clinical sepsis.The incidence of PICC-BSI was 10. 2/1 000 PICC-days as a whole,with 16. 1/1 000 PICC-days in the old hospital and,7. 7/1 000 PICC-days in the new hospital respectively. Eleven organisms were isolated including Coagulase negative staphylococcus (CoNS) (4 strains), Acinetobacter baumannii (3 strains), Klebsiella pneumonia (2 strains), Enterococcus(1 strain), and Candida parapsilosis (1 strain). The incidence of PICC-BSI in the new hospital was lower compared with that of the old hospital. Conclusion Most of the isolated organisms of PICC-BSI are opportunistic and multi-drug resistant pathogen. PICC-BSI can be reduced by the effective infection control strategies in NICU.
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Neonatal necrotizing enterocolitis is the common disease of gastrointestinal tract of neonate.Also it is one of the main reasons of premature death. The pathogenesis of NEC is still unknown. Recently, scientists at home or abroad have done much research on the risk factors, pathogenesis, treatment and precaution of NEC.They try to reduce the morbidity and mortality of NEC by the way of changing feeding patterns, using probiotics,controlling the infection of pathogenic bacteria,using nutrition or cell factors. This passage reviewed the precaution of NEC in passed three years.
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Objective To approach a semi-quantitative diagnostic criteria of neonatal hypoxic-ischemic encephalopathy(HIE) by comprehensive scoring, including history, clinical manifestation and laboratory data,which can be used for early diagnosis,severity grading and the institution of therapy.Methods We analyzed history, clinical manifestation and some parameters of laboratory data,and established criteria for scoring and grading,and compared this grading with the grading determined by clinical data and follow-up,which brought forward a semi-quantitative diagnostic criteria, and applied this criteria to other 41 patients with HIE to test its reliability.Results The grading criteria were established as the following:if total score ≥20.0,the patient was graded as severe one;total score between 10.5-19.5, moderate one; between 5.5-10.0,mild one;≤5.0,non-HIE one. The scoring system was used in other 41 patients with HIE,the specificity and sensitivity were 100% and 96 .9%,97.2% and 100%,100% and 100%, respectively.Conclusions For severe HIE cases who are not permitted to receive compated tomography(CT) examination or no CT can be used, this scoring system can be used to diagnoze HIE and grade the severity. This method is simple and easy to perform.Both specificity and sensitivity are high for diagnosis and severity judgment of HIE.
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Objective To determine the origin of cord serum leptin and its relationship with neonatal anthropometry. Methods Sixty five women and their babies took part in this prospective cohort study. Blood was taken from the women just before delivery and from the umbilical cord of their babies at delivery. Serum leptin was measured by radio immunoassay. Neonatal anthropometric measurements were recorded within 48 hours after delivery. Linear regression analysis was used to explore the relationship between serum leptin concentrations and anthropometric measures and multiple regression analysis then applied to determine which variables remained independently associated with leptin. Results The leptin concentration ( ?s )in maternal serum was (19.93?7.21) ng/mL and in cord blood was (10.50?3.45) ng/mL. Cord leptin levels correlated with placental weight, neonatal birthweight, skinfold thickness and ponderal index but not with maternal leptin levels. The correlation with Placental weight and neonatal birthweight remained significant after multiple regression analysis. Conclusions Relatively big serum leptin concentration gradient between mother and umbilical vessels indicates that placenta might play an important role in leptin production. We hypothesize that leptin might play an important role during pregnancy and fetal development.
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BACKGROUND: Heart transplantation is considerated for a selected certain group of complicated congenital heart disease in neonates because corrective surgery is very difficult and has high mortality. Precise planning of transplantation is necessary to adequately fit the donor heart to the recipient. MATERIAL AND METHOD: We have performed 4 neonatal pig heart transplantations to test the technical feasibility. Experiment 1: The transplantation was performed using the same technique as the adult heart transplantation. Experiment 2: The transplantation for hypoplastic left heart syndrome was simulated as we reconstructed the whole aortic arch with donor aorta. Experiment 3: The heart transplantation was done with radical pulmonary artery reconstruction. Experiment 4: The experiment was performed for a long term survival. RESULT: Preoperative planning was very important for adequate fitting. All animals could be weaned from cardiopulmonary bypass, however, two animals died due to bleeding at pulmonary artery and left atrium. CONCLUSION: We concluded that the neonatal heart transplantation can be applied in some complicated Further using animal model is mandatory.
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Adult , Animals , Humans , Infant, Newborn , Animal Experimentation , Aorta , Aorta, Thoracic , Cardiopulmonary Bypass , Heart Atria , Heart Defects, Congenital , Heart Transplantation , Heart , Hemorrhage , Hypoplastic Left Heart Syndrome , Models, Animal , Mortality , Pulmonary Artery , Tissue DonorsABSTRACT
Objective To explore the early diagnostic value of the expression level of plasma N-terminal pro-B-type natriuretic peptide(NT-proBNP)for heart failure(HF)in neonates.Methods Thirty-five neonates who were clinic diagnoses as HF newborns and 20 cases of non-HF newborns(control group)were selected,on the 2nd,the 7th day after birth,plasma NT-proBNP and CK-MB levels were measured with electrochemiluminescence method and mass method.All data were analyzed by SPSS 16.0 software.Results Compared with the control group,CK-MB and NT-proBNP were higher in the HF group before treatment(P0.05).Compared with before treatment,CK-MB and NT-proBNP were significantly lower in the HF group(P0.05),NT-proBNP level was lower in the control group(P