The clinical value of lung ultrasound scores predicting pulmonary surfactant use in premature infants with respiratory distress syndrome / 中国新生儿科杂志

Objective:To study the clinical value of lung ultrasound score (LUSsc) within 2 h after birth for pulmonary surfactant (PS) use in preterm infants with respiratory distress syndrome (RDS).Methods:From July 2019 to May 2021, preterm infants with RDS hospitalized in our hospital and received pulmonary ultrasound within 2 h after birth were prospectively enrolled. 12-area LUSsc was calculated. The infants were assigned into <32 weeks group and 32-36 weeks group according to gestational age (GA). Simple random sampling was carried out in each group with 1/5 as the validation set and the other 4/5 as the training set. The infants were also assigned into PS group and non-PS group according to PS usage within 24 h after birth. Receiver operator characteristic (ROC) curve of LUSsc predicting PS usage was drawn and validated.Results:A total of 857 RDS infants were enrolled, including 313 in <32 weeks group and 544 in 32-36 weeks group. For <32 weeks group, area under curve (AUC) of LUSsc>8.5 predicting PS use was 0.779 (95% CI 0.722-0.837), with 76.4% sensitivity and 81.4% specificity. The accuracy of using LUSsc>8.5 as cut-off predicting actual clinical PS application was 82.3% (Kappa value 0.692, P<0.05, McNemar's test P>0.05).For 32-36 weeks group, AUC of LUSsc>9.5 predicting PS use was 0.785 (95% CI 0.723-0.848), with 71.1% sensitivity and 81.7% specificity. The accuracy of using LUSsc>9.5 as cut-off predicting actual clinical PS application was 92.6% (Kappa value 0.772, P<0.05, McNemar's test P>0.05). Conclusions:LUSsc within 2 h after birth is independent predictor of PS use in preterm infants with RDS. For <32 weeks group, LUSsc>8.5 suggests PS application and for 32-36 weeks group the cut-off is LUSsc>9.5.

A case report of congenital dysplasia caused by the ANK3 gene mutation in the newborn / 中华实用儿科临床杂志

The clinical features, examination findings and gene results of the newborn diagnosed with congenital dysplasia by the ANK3 gene heterozygous mutation in the First Hospital of Jilin University were retrospectively analyzed.A female newborn at 10 minutes presented for postnatal asphyxia and 10 minutes after resuscitation.She had a special appearance, with little spontaneous breathing, no swallowing, extremely low muscular tension, and no primal reflexes.Amplitude integrated electroencephalogram(aEEG) suggested the burst suppression (BS) background activity, BS (+ ), lower boundary at 2 μV, upper boundary at 50 μV, no sleep awakening cycle, no convulsive seizure, and mechanical brush seen in the original electroencephalogram burst.Severe abnormal aEEG was detected.Gene results suggested 2 heterozygous mutations in the ANK3 gene [c.4183(exon33) C >G and c. 8239(exon37) C >T], which have not been previously reported.This case report for the first time reported the clinical phenotype of the ANK3 gene mutation in the newborn with congenital dysplasia.

Reference range of red blood cell parameters of radial artery within 24 hours after birth of premature infants with different gestational ages and genders / 中华检验医学杂志

Objective:To establish the reference range of red blood cell parameters within 24 hours after birth of premature infants with different gestational ages and genders.Methods:According to the inclusion criteria and exclusion criteria, a retrospective analysis was performed in premature infants who were admitted to the neonatal intensive care unit from January 1, 2018 to December 31, 2019. These newborns were delivered in the obstetrics department of our hospital or came from other parts of Jilin Province. All of their radial artery blood were collected within 24 hours after birth. According to the blood examination results, we analyzed reference range of red blood cell parameters of these premature infants.Results:With the increase of gestational age, the number of RBC, HGB, HCT, MCHC gradually increases and the number of MCV, MCH gradually decreases. There are differences in some red blood cell parameters of premature infants with 34 week≤gestational age<37 week between different genders. Compared with boys, the number of RBC, HGB, HCT and MCV in girls were higher. The number of RBC in premature infants with 23 week≤gestational age<28 week and 28 week ≤ gestion age<34 week are 2.58×10 12-5.45×10 12/L and 2.97×10 12-5.86×10 12/L respectively. In the group of premature infants with 34 week ≤gestion age<37 week, the number of RBC in boys is 3.38×10 12-5.83×10 12/L, while the number of RBC in girls is 3.18-5.89×10 12/L. There're no difference in RDW among preterm infants with different gestational ages and genders, which is 14.8%-20.6%. Conclusions:The study established the reference range of red blood cell parameters of 23 w≤gestational age<37 w premature infants within 24 hours after the birth and explored the differences in red blood cell parameters of premature infants with different gestational ages and genders.