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Objective To study the threshold values of lactic acid ( Lac) and buffuer excess ( BE) when neonatal umbilical arterial blood gas is at pH <7. 20. Methods A total of 2 518 pregnant women admitted in Beijing New Century Women and Children′s Hospital from January 2017 to February 2019 were enrolled. The general conditions in perinatal period and labor methods were counted. Umbilical cord arterial blood was immediately collected before the first cry of newborn and was detected on the Abbott I-STAT auto-matic blood gas analyzer from the United States,and then the umbilical arterial blood gas was measured. We analyzed the perinatal factors affecting umbilical arterial blood gas. We studied the threshold values of Lac and BE for neonal asphyxia by receiver operating characteristic curve. Results (1)Maternal anemia,Strep-tococcus agalactiae infection,precipitate labour,placenta abnormalities had no significant impact on neonatal umbilical artery blood gas. The Lac value in blood gas was higher in the group of premature rupture of fetal membranes and fetal intrauterine distress. The value of BE was lower in the group with premature rupture of fetal membranes and fetal distress ( P <0. 05 ). The Lac value in cesarean section group was the lowest [(1. 79 ± 1. 25) mmol/L],while that in midwifery group was the highest[(4. 45 ± 1. 58) mmol/L]. pH value was the lowest (7. 25 ± 0. 07) in the midwifery group and the highest (7. 31 ± 0. 06) in the cesarean section group. The value of BE was the lowest in the midwifery group[ －(5. 66 ± 2. 52) mmol/L],and the highest in the cesarean section group[ －(2. 99 ± 2. 28) mmol/L],with statistically significant differences among the three groups (P<0. 05). (2) Multiple linear regression analysis showed that fetal delivery mode, fetal intrauterine distress,premature rupture of membranes,and gestational diabetes were the factors affecting Lac level in umbilical artery blood gas of newborns. Methods of delivery,intrauterine distress,premature rup-ture of membranes and placental abnormalities were the factors that affected the BE value of umbilical artery blood gas in newborns. (3) A total of 199 cases with pH value <7. 2 were diagnosed as asphyxia,and the receiver operating characteristic curve of Lac and BE values of neonatal umbilical artery blood gas for the diagnosis of asphyxia was drawn. When Lac was >3. 97 mmol/L,the sensitivity and specificity of the diag-nosis of asphyxia were 0. 864 and 0. 791,respectively. When BE was≤－6 mmol/L,the diagnostic sensitivi-ty and specificity of asphyxia were 0. 613 and 0. 756,respectively. Conclusion Neonatal umbilical arterial blood gas is affected by many factors. The effect of accouche on umbilical arterial blood gas is large. When there is asphyxia with pH <7. 2,the cut points of Lac and BE are >3. 97 mmol/L and ≤ －6 mmol/L, respectively.
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Objective@#To study the threshold values of lactic acid (Lac)and buffuer excess (BE) when neonatal umbilical arterial blood gas is at pH <7.20.@*Methods@#A total of 2 518 pregnant women admitted in Beijing New Century Women and Children′s Hospital from January 2017 to February 2019 were enrolled.The general conditions in perinatal period and labor methods were counted.Umbilical cord arterial blood was immediately collected before the first cry of newborn and was detected on the Abbott I-STAT automatic blood gas analyzer from the United States, and then the umbilical arterial blood gas was measured.We analyzed the perinatal factors affecting umbilical arterial blood gas.We studied the threshold values of Lac and BE for neonal asphyxia by receiver operating characteristic curve.@*Results@#(1)Maternal anemia, Streptococcus agalactiae infection, precipitate labour, placenta abnormalities had no significant impact on neonatal umbilical artery blood gas.The Lac value in blood gas was higher in the group of premature rupture of fetal membranes and fetal intrauterine distress.The value of BE was lower in the group with premature rupture of fetal membranes and fetal distress (P<0.05). The Lac value in cesarean section group was the lowest[(1.79±1.25) mmol/L], while that in midwifery group was the highest[(4.45±1.58) mmol/L]. pH value was the lowest (7.25±0.07) in the midwifery group and the highest (7.31±0.06) in the cesarean section group.The value of BE was the lowest in the midwifery group[-(5.66±2.52) mmol/L], and the highest in the cesarean section group[-(2.99±2.28) mmol/L], with statistically significant differences among the three groups (P<0.05). (2) Multiple linear regression analysis showed that fetal delivery mode, fetal intrauterine distress, premature rupture of membranes, and gestational diabetes were the factors affecting Lac level in umbilical artery blood gas of newborns.Methods of delivery, intrauterine distress, premature rupture of membranes and placental abnormalities were the factors that affected the BE value of umbilical artery blood gas in newborns.(3) A total of 199 cases with pH value <7.2 were diagnosed as asphyxia, and the receiver operating characteristic curve of Lac and BE values of neonatal umbilical artery blood gas for the diagnosis of asphyxia was drawn.When Lac was >3.97 mmol/L, the sensitivity and specificity of the diagnosis of asphyxia were 0.864 and 0.791, respectively.When BE was ≤-6 mmol/L, the diagnostic sensitivity and specificity of asphyxia were 0.613 and 0.756, respectively.@*Conclusion@#Neonatal umbilical arterial blood gas is affected by many factors.The effect of accouche on umbilical arterial blood gas is large.When there is asphyxia with pH <7.2, the cut points of Lac and BE are >3.97 mmol/L and ≤-6 mmol/L, respectively.
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Here,we reported a case of term infant with unilateral congenital microphthalmia (CM).Physical examination conducted on 2 d after birth showed that the left eye was barely open and the eye socket was deeper than the right.Meanwhile,the cornea of the left eye was not completely exposed and the light reflex could not be elicited.Ophthalmology consultation,ultrasound and CT scan were conducted,and CM was finally diagnosed since the infant was found to have a small eyeball and shortened axial length,accompanying by pathological changes in the lens,vitreous body and retina.This case suggested that detailed physical examination should be carried out,especially for the eyes,including orbit and eyelid,presence or absence of secretion or concealed eyeball,together with medical imaging techniques technology,to ensure an early detection and diagnosis of CM in neonates.
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Objective To study the system of streptococcal C5a peptidase (ScpB) and the specif-ic antibody levels in serum, lung, vagina and recta after subcutaneous and intranasal immunization with dif-ferent doses of C5a peptide. Methods Recombinant protein C5a peptide was expressed in E. coli strain BL21 and purified by affinity chromatography. The expressed product was identified by SDS-PAGE and pep-tide mass fingerprinting (PMF). BALB/c mice were subcutaneously and intranasally injected with different doses of ScpB. Antibody titer was tested by ELISA. Opsonophagocytosis assay was used to test the function of antibody. Results ScpB protein was successfully expressed and purified. The probability based mouse score of ScpB was 175 by PMF analysis. ELISA data showed that both subcutaneous and intranasal immtmi-zation could elicit significantly higher levels of IgG in immunized mice serum than that of control group (P ＜0.01), 30 μg group waa better than 5 μg and 10 μg group. Intranasal immunization could elicit higher lev-els of IgA in lung, vagina and rectum (P ＜0.001) while system immunization could not. Opsenophagocyto-sis tests indicated that anti-serum of ScpB had opsenophagocytic activity than that of control (P ＜ 0. 05).Conclusion The results demonstrated that intranasal immunization with ScpB could induce significantly higher levels of lgG and IgA, and its anti-serum had better opsenic activity.