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Cardiovascular dysfunction is common in severe sepsis.Although functional alteration is often described,the elevated serum levels of cardiac proteins and autopsy findings of myocardial immune cell infiltration,edema,and damaged mitochondria suggest that structural changes to the heart during severe sepsis may occur and may contribute to cardiac dysfunction.Myocardial functions may be improved by pretreatment with plateletactivating factor,cyclo-sporin A,glutamine,caffeine,simvastatin,or caspase inhibitors.We explored the advance on structural change of the heart during severe sepsis in order to deepen the understanding of these changes.
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Objective To study the clinical characteristics of neonates with Listeriosis sepsis and explore the nursing experience. Methods The clinical data of 22 cases with neonatal Listeriosis sepsis were retrospectively analyzed.Results Twenty-two neonates developed Listeria monocytogenes sepsis 0.5 h~5 d after birth with 13 cases of low birth weight. The stay was 2~77 d,10 were discharged after recovery,7 were discharged after signature of their families due to improvements and 5 died of meningitis and septicemia.Conclusion Timely and accurate collection of samples should be done for laboratory examinations.Close observation of the diseases,attaching importance to infant feeding and implementation of infant developmental nursing are all critical for the improvement of cure rate.
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Objective To investigate the situation of oxygen supplement and the incidence and clinical characteristics of long-term oxygen inhalation newborns in neonatal intensive care unit(NICU).Methods The records of oxygen supplement and the related clinical data of 12 155 neonates admitted in our NICU from Oct 2009 to May 2011 were collected and retrospectively analyzed.The results were compared with the data from a survey on 19 hospitals in China which reported by other authors.Results In 12 155 newborns,4 951 were full term,7 204 were preterm.One hundred and two patients (0.84％,102/12 155 ) accepted oxygen for more than 28 days.Among them,88 were preterm,14 were full term,with the average gestational age (31.16 ±3.70) weeks,the average birth weight (1.60 ±0.68) kg and the mean oxygen supplement period (40.60 ± 12.25) d.Finally,98 were cured or improved,4 died.The incidence of bronchopulmonary dysplasia (BPD) in 7 204 preterm infants was 1.22％ ( 88/7 204) according to the standard of continuous oxygen supply more than 28 days after birth.The incidence of BPD in preterm infants less than 32 weeks was 4.92％ (68/1 381 ) according to the standard of continuous oxygen supply more than 28 days after birth,while the rate was only 2.10％ (29/1 381 ) according to the standard of continuous oxygen supply more than 36 weeks postmenstrual age.The rates of BPD according to the two different standards were significantly different ( x2 =16.251,P ＜0.001 ).There were significant differences in the rate of supply oxygen( x2 =119.99) and supply oxygen time( F =109.27 ) among different gestational age groups in overall the 5 499 neonates ( P ＜0.001 ),but no significant differences in the average time of oxygen supply and mechanical ventilation among different gestational age groups in infants with long-term oxygen dependence ( P ＞ 0.05 ).There were significant differences in rates of pulmonary surfactant therapy,heart failure,retinopathy of prematurity,congenital heart disease,other congenital malformation and mortality among different gestational age groups in long-term oxygen dependence infants (x2 =8.789,13.538,23.176,7.778,8.842,8.246,P ＜ 0.05 ).As compared with the data from 19 hospitals,the corrected rate of long-term oxygen supplement in preterm infants in our hospital was obviously lower[0.99％ (71/7204) vsl.54％ (190/12 351),P ＜0.001].Conclusion Theincidence of BPD in our NICU is low.Lower gestational age,immature lung and secondary lung injury may be the mainly cause of neonatal long-term oxygen dependence,but some factors such as congenital heart disease,congenital malformations should be considered in more mature infants.The most appropriate standard for BPD still remains to be discussed.
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Objective To study the role of deferoxamine(DFO)on regulating hypoxia-inducible factor 1α(HIF-1α)expression after hypoxia-ischemia brain damage(HIBD)in neonatal rats,to explore the therapeutic strategy for HIBD. Methods Postnatal day 10 SD rats were divided into four groups: hypoxia-ischemia(HI)group,DFO-treated group,normal saline(NS)-treated group,and sham operation group. HIBD model was established by the ligation of right common carotid artery following the inhalation of nitrogen-oxygen mixtures containing 92% nitrogen and 8% oxygen. DFO-treated group and NS-treated group were treated by intraperitoneal injection of DFO or NS respectively. The brains were collected at 4 h,8 h,and 24 h after hypoxia. HIF-1α protein expression was detected by Western blot analysis,and HIF-1α mRNA expression was detected by using RT-PCR at each time point. Results The synthetic level of HIF-1α protein increased significantly at 4 h,peaked at 8 h,and decreased at 24 h after HI in HI group,as well as NS-treated group. However,in DFO-treated group HIF-1α protein was peaked at 4 h,maintained higher level at 8 h and 24 h after HI. The level of HIF-1α protein was much higher in HI and DFO-treated groups than those in sham controls(P ＜ 0.05). The synthetic level of HIF-1α protein were higher in DFO-treated groups than those in HI groups at each time point(P ＜ 0.05). HIF-1α mRNA expression was higher in DFO-treated groups than those in HI groups at each time point. Conclusions DFO upregulate HIF-1α protein and mRNA expression in neonatal rats with HIBD. The peak of HIF-1α protein expression are also more advanced and lasted longer after DFO-treatment.