Umbilical vascular catheter rupture: a case report and literature review / 中国新生儿科杂志

Objective:To study the clinical characteristics of neonatal umbilical vascular catheter (UVC) rupture.Methods:A neonate with UVC rupture admitted to Neonatology Department of our hospital was retrospectively reviewed. Literature on this subject were searched in the following databases: Chinese Medical Journal full-text Database, CNKI, Wanfang Database, CQVIP database, PubMed, Web of Science, Embase and Cochrane Library (up until March 15 2022). The causes, treatment and prognosis of neonatal UVC rupture were analyzed.Results:In our case, the UVC was accidentally damaged during the removal of the ligature suture. The UVC was ruptured after a slight force was applied to remove the catheter, resulting in approximately 7 cm of UVC remaining in the body. Trans-umbilical vein intervention was performed and the catheter was successfully removed with a lasso under X-ray guidance. A total of 33 UVC rupture cases were included from 15 articles (no case report in China before). In 16 cases (47.1%), the UVCs were accidentally cut off by knife or scissors when removing the catheter. In 3 cases (8.8%), the UVCs were broken during insertion. The UVC was broken in 1 case (2.9%) during flushing the catheter. The causes of the other 14 cases (41.2%) were unknown. 9 cases (26.5%) had clinical manifestations, including respiratory distress, prominent heart murmur, sepsis and limb ischemia. 20 cases (58.8%) showed no clinical features. No data on the other 5 cases (14.7%). 21 cases (61.8%) received vascular intervention removal, 11 cases (32.4%) received surgical removal, 1 case (2.9%) was removed with tweezers, and 1 case (2.9%) died before UVC was removed. Among the neonates receiving surgical treatment, 1 case died of sepsis on the second day after surgery and 1 case had sequela of limb ischemia. 2 cases had postoperative vasospasm and embolism after vascular intervention with overall good prognosis.Conclusions:The rupture of UVC in neonates is rare and mainly related with knife and scissors injury.

Characteristics of thrombelastography in term neonates and its comparison with traditional coagulation tests / 中华实用儿科临床杂志

Objective@#To explore the characteristics of thrombelastogaphy (TEG) in term neonates, and to evaluate their correlation with traditional coagulation tests.@*Methods@#A total of 52 term neonates were enrolled as neonatal group and 34 adults undergoing elective surgery as adult control group in Jiangmen Central Hospital from January to December 2017.TEG, plasma coagulation test and platelet counts (PLT) were performed and the corresponding ana-lysis was conducted.@*Results@#TEG parameters in term neonates: response time(R)(4.18±1.08)min, clot kinetics(K)(1.21±0.45) min, α angle (Angle)(73.08±5.74)°, maximum amplitude(MA)(65.68±7.13)mm.Compared with adult control group, neonatal group exhibited shorter R and K(t=3.764, P<0.001; t=4.888, P<0.001), higher Angle, MA(t=5.539, P<0.001; t=2.873, P=0.001). In traditional coagulation, compared with adult control group, neonatal group showed longer prothrombin time(PT), activated partial thromboplastin time(APTT), thrombin time(TT) (t=5.449, P<0.001; t=13.134, P<0.001; t=3.575, P=0.001), lower fibrinogen(Fib) (t=4.164, P<0.001), and higher PLT (t=4.230, P<0.001). In addition, K was negatively correlated with Fib(r=-0.374, P=0.004), while Angle and MA were positively correlated with Fib(r=0.354, P=0.007; r=0.630, P<0.001); K was negatively correlated with PLT(r=-0.430, P=0.001), but Angle and MA were positively correlated with PLT (r=0.427, P=0.001; r=0.586, P<0.001); K was positively correlated with APTT(r=0.285, P=0.035), and MA was negatively correlated with APTT(r=-0.324, P=0.017). There was no significant correlation between R and traditional coagulation test.K, MA and Angle were not significantly correlated with PT (all P>0.05), and Angle and APTT were not significantly correlated (all P>0.05).@*Conclusions@#The reference interval of TEG in term neonates is different from adults.And the parameters of TEG in term neonates are partly related to the traditional coagulation tests.

Characteristics of thrombelastography in term neonates and its comparison With traditional coagulation tests / 中华实用儿科临床杂志

Objective To explore the characteristics of thrombelastogaphy( TEG)in term neonates,and to evaluate their correlation with traditional coagulation tests. Methods A total of 52 term neonates were enrolled as neo-natal group and 34 adults undergoing elective surgery as adult control group in Jiangmen Central Hospital from January to December 2017. TEG,plasma coagulation test and platelet counts(PLT)were performed and the corresponding ana-lysis was conducted. Results TEG parameters in term neonates:response time(R)(4. 18 ± 1. 08)min,clot kinetics (K)(1. 21 ± 0. 45)min,α angle( Angle)(73. 08 ± 5. 74)°,maximum amplitude( MA)(65. 68 ± 7. 13)mm. Com-pared with adult control group,neonatal group exhibited shorter R and K(t=3. 764,P<0. 001;t=4. 888,P<0. 001), higher Angle,MA(t=5. 539,P<0. 001;t=2. 873,P=0. 001). In traditional coagulation,compared with adult control group,neonatal group showed longer prothrombin time( PT),activated partial thromboplastin time( APTT),thrombin time(TT)(t=5. 449,P<0. 001;t=13. 134,P<0. 001;t=3. 575,P=0. 001),lower fibrinogen( Fib)(t=4. 164, P<0. 001),and higher PLT(t=4. 230,P<0. 001). In addition,K was negatively correlated with Fib(r= -0. 374, P=0. 004),while Angle and MA were positively correlated with Fib(r=0. 354,P=0. 007;r=0. 630,P<0. 001);K was negatively correlated with PLT(r= -0. 430,P=0. 001),but Angle and MA were positively correlated with PLT (r=0. 427,P=0. 001;r=0. 586,P<0. 001);K was positively correlated with APTT(r=0. 285,P=0. 035),and MA was negatively correlated with APTT(r= -0. 324,P=0. 017). There was no significant correlation between R and tra-ditional coagulation test. K,MA and Angle were not significantly correlated with PT(all P >0. 05),and Angle and APTT were not significantly correlated(all P>0. 05). Conclusions The reference interval of TEG in term neonates is different from adults. And the parameters of TEG in term neonates are partly related to the traditional coagulation tests.

Efficacy of volume target pressure control and synchronized intermittent mandatory ventilation in treating neo-natal respiratory distress syndrome / 中华实用儿科临床杂志

Objective To investigate the efficacy of volume target pressure control(VTPC)and synchronized intermittent mandatory ventilation(SIMV)in treating severe neonatal respiratory distress syndrome(NRDS). Methods Fifty - six admitted cases with severe NRDS hospitalized in Jiangmen Central Hospital from October 2012 to March 2015 were randomly divided into 2 groups:28 cases in VTPC group were treated by VTPC and SIMV,and 28 cases in pressure control ventilation(PCV)group were treated by PCV and SIMV. There was no significant difference between 2 groups in terms of gender,gestational age,and birth weight(all P ﹥ 0. 05). Artery blood gas analysis was performed at 6 hours,12 hours,24 hours,and 48 hours respectively after ventilation. The following parameters were observed:the time of invasive mechanical ventilation,duration of oxygen therapy,mortality and the incidence rates of hypocapnia,pneumo-thorax,ventilator associated pneumonia( VAP),grade Ⅲ - Ⅳ periventricular intraventricular hemorrhage( PVH -IVH),periventricular leukomalacia(PVL)and bronchopulmonary dysplasia(BPD). Results No case in 2 groups withdrew from the test. There was no significant difference between 2 groups in terms of the first treatment time and total doses of poractant alfa injection(all P ﹥ 0. 05). The time of invasive mechanical ventilation in VTPC group[(71. 75 ± 9. 82)h]was shorter than that in PVC group[(97. 89 ± 16. 88)h](t = 7. 083,P = 0. 000). Hypocapnia incidence of four blood gas analysis in VTPC group[(19. 64 ± 14. 20)% ]was lower than that in PCV group[(47. 32 ± 18. 43)% ] (t = 6. 294,P = 0. 000). Incidence rates of VAP and PVL in VTPC group were lower than those in PCV group(χ2 =5. 197,P = 0. 023;χ2 = 4. 766,P = 0. 029). However,duration of oxygen therapy,mortality and the incidence rates of pneumothorax,Ⅲ - Ⅳ PVH - IVH and BPD were not significantly different between 2 groups( all P ﹥ 0. 05). Conclusion VTPC + SIMV has a better efficacy than PCV + SIMV in the treatment of NRDS.

Curative effect on three non-invasive modes of mechanical ventilation in treatment of neonatal respiratory distress syndrome / 实用医学杂志

Objective To investigate the curative effect on non-invasive CPAP and SIMV and BiPAP mechanical ventilation in treatment of NRDS. Methods A retrospective study was initiated on clinical data of 162 neonates, who were hospitalized from March 2010 to March 2014 in Jiangmen Central Hospital and underwent the above three modes of non-invasive mechanical ventilation treatment. All cases met the setting standard, and their curative effects were contrasted. Results 53 cases were treated by non-invasive CPAP, 60 cases were operated by non-invasive SIMV, 49 cases were done by non-invasive BiPAP. Among the three groups, the comparison on sex ratio,gestational age of birth and birth weight showed no difference (P > 0.05). The number of effective cases in three groups was 38, 53 and 44 respectively, and the number of invalid cases was 15, 7 and 5 respectively. Among three groups, the curative effect was significant (P > 0.05), curative effect of non-invasive SIMV group showed no difference (P > 0.05) compared with that of non-invasive BiPAP group, curative effect of non-invasive SIMV group and non-invasive BiPAP group was better than that of non-invasive CPAP group (P > 0.05). Conclusion Curative effects of non-invasive SIMV and non-invasive BiPAP for NRDS showed no difference. However, their curative effect is better than that of non-invasive CPAP, which indicates that they can be better choices.

Preventive effect of Fluconazole prophylaxis on invasive fungous infections of premature infants / 中华实用儿科临床杂志

Objective To explore the preventive effect of Fluconazole on invasive fungous infections in premature infants.Methods Two hundred and thirty-four cases of preterm infants hospitalized in Jiangmen Central Hospital from Feb.2008 to Oct.2013 were analyzed by retrospective study.The subjects were divided into 3 groups based on whether Fluconazole was used and it was used orally or intravenously for the prevention of invasive fungous infections in premature infants.The Fluconazole prophylaxis was not given to group A,whereas oral Fluconazole prophylaxis [6 mg/(kg · times),every other day] and intravenous Fluconazole prophylaxis [3 mg/ (kg · times),once every 3 days] were applied in group B and group C.The incidence of invasive fungous infections and the clinical effects of Fluconazole on the 3 groups were evaluated and compared.Results The number of cases analyzed in the study were 53,115 and 66 cases in group A,group B and group C,respectively.There were no significant differences between the 3 groups in terms of gender,gestational age,birth weights,length of hospitalization,intravenous nutrition,and number of peripherally inserted central catheter,antibiotics and invasive mechanical ventilation use days (all P ＞ 0.05).The incidences of invasive fungal infections were 11.32％ (6/53 cases),6.96％ (8/115 cases) and 0 in group A,group B and group C,respectively.The prophylaxis effects between the 3 groups were significantly different (x2 =7.078,P =0.029).Group A and group B were not significantly different (x2 =0.905,P =0.342),but group C was better than group A and group B,and the differences were significant (P =0.007,0.028).Conclusions Prevention of invasive fungous infections by intravenous Fluconazole has good curative effects,and which can be used as the first choice.

Investigation into relationship between recurrence of allergic purpura and urine IgG / 中国医师进修杂志

Objective To investigate the relationship between urine IgG of the first hospitalized children suffered allergic purpura and recurrence within one year. Methods Used immunoturbidimetry to determine acute-stage and convalescent urine IgG of 43 children suffered allergic purpura in the first hospitalized and no recurrence within one year (no recurrence group), and of 29 children suffered allergic purpura and recurrence within one year (recurrence group), and of 28 hospitalized children suffered primary nephrotic syndrome during the corresponding time period before hormonal therapy (nephrotie syndrome group), and of 30 children done medical examination in out-patient clinic (control group), then analyzed.Results There was no significant difference of the urine IgG level in acute-stage between no recurrence group [(1.391± 0.743) g/L] and recurrence group [(1.474 ±0.658) g/L](P>0.05), while they were all lower than that in recurrence group [(2.808 ± 0.683) g/L] (P < 0.01). The level of convalescent urine IgG in nephrotic syndrome group [(0.202 ± 0.154) g/L] was obviously higher than that in no recurrence group [(0.115 ±0.103) g/L] and control group [(0.109 ±0.098) g/L](P<0.05). Conclusion Urine IgG is a significant index to judge the activity and recurrence and prognosis of pedo-allergie purpura.

Effect of Ca~(2+) channel blocker on the levels of myocardial calcineurin A?mRNA in right ventricle and plasma NO,nitric oxide synthase and endothelin-1 in rats with chronic hypoxia / 中国医师杂志

Objective Many studies showed that Ca~(2+) channel blocker could prevent and treat right ventricular hypertrophy(RVH) induced by chronic hypoxia.To further identify the mechanism,we investigated the effect of Ca~(2+) channel blocker on the levels of myocardial calcineurin A?mRNA(CnA?)in RV and plasma nitric oxide(NO),NO synthase and endothelin-1(ET-1) in rats with chronic hypoxia.Methods 30 rats were divided into three groups by randomized block design: treatment group with Amlodipine Besylate ablets [(30 mg?kg~(-1)?d~(-1)),administered via gavage],chronic hypoxia group,and control group.The rats in treatment group and chronic hypoxia group were exposed to normobaric chronic hypoxia [(10.0?0.5)% O_2 ] for 21 days.On the 21st day of experiment,all rats were sacrificed and the hearts were collected for measuring the weight.Blood samples were also drawn from the ventricles for measuring plasma NO,iNOS and ET-1 levels.CnA?mRNA levels in RV were measured by RT-PCR.Results ⑴The RV/(LV+S)、RV/BW ratios were significantly higher in chronic hypoxia group than those of control group and treatment group(P

The Effect of N-acetylcysteine on ICAM-1 Expression and Apoptosis in Neonatal Rats Brain after Hypoxic and Ischemic Brain Damage / 中国医师杂志

Objective To explore the effect of N-acetylcysteine (NAC) on intercellular adhesion molecule-1(ICAM-1) expression and apoptosis in neonatal rats brain after hypoxic and ischemic brain damage (HIBD). Methods Ninety 7-day old SD rats were divided into sham operative group, HIBD group and NAC treatment group, each group containing 30 animals. ICAM-1 expression and the apoptotic rate of brain cells were measureed at 6h, 12h, 24h, 48h and 7days after model establishment by immunohistochemistry and TUNEL, respectively. Results Compared with sham operative group and NAC treatment group, the number of ICAM-1 expression cells and apoptotic cells in the brain tissue significantly increased in HIBD group. Conclusion NAC could inhibit ICAM-1 expression and cell apoptosis in the brain with HIBD, and had the preventive effect on hypoxic and ischemic brain damage in neonatal rats.

Blockade of L-type Ca~(2+) channels suppresses activation of calcineurin and development of right ventricle cardiac hypertrophy induced by chronic hypoxia / 中国病理生理杂志

AIM: To study the role of calcineurin in the progression of right ventricle cardiac hypertrophy in the chronic hypoxia rats and examine the effect of Ca 2+ channel blockers on the activation of calcineurin. METHODS: Sixty rats were divided into three groups: treatment group with amlodipine besylate ablets, chronic hypoxia group, normal control group with normal oxygen. The rats in treatment group and chronic hypoxia group were exposed to normobaric chronic hypoxia(10?0 5)% O 2 for 21 days. All hearts were removed immediately after dissection for further investigation. RESULTS: (1)The RV/(LV+S),RV/BW were significantly higher in hypoxia group than that of control group and treatment group( P