Effects of cord blood element levels on neurodevelopment of preterm and full-term children: A cohort study / 环境与职业医学

Background Essential and non-essential elements have an important impact on the development of the central nervous system during fetal development. Due to their less developed brain, preterm infants are more sensitive to element exposure, and are high-risk groups of neurodevelopmental abnormalities. However, it is not clear whether the effects of element exposure in utero on postpartum neurodevelopment are different between full-term infants and preterm infants. Objective To evaluate the effects of element exposure levels during pregnancy on neurodevelopment of children aged 6-24 months (of corrected age), and compare the effects between preterm and full-term children. Methods A prospective study design was adopted and this study was conducted based on the Maoming Birth Cohort Study (MBCS) in Maoming City, Guangdong Province. Twenty elements in cord blood of 197 preterm infants and 297 full-term infants were measured, including 11 essential trace elements [vanadium (V), chromium (Cr), manganese (Mn), cobalt (Co), nickel (Ni), copper (Cu), zinc (Zn), selenium (Se), strontium (Sr), tin (Sn), and iron (Fe)], and 9 non-essential trace elements [aluminum (Al), arsenic (As), thallium (Tl), lead (Pb), uranium (U), cerium (Ce), antimony (Sb), cadmium (Cd), and yttrium (Y)]. The neurodevelopment of the children at 6, 12, and 24 months were evaluated by the Ages and Stages Questionnaires-the Third Edition (ASQ-3). A generalized estimating equation (GEE) model was adopted to evaluate the associations between elements and neurodevelopment in full-term and preterm children separately. Results The positive rates of 10 elements (Mn, Cu, Zn, Se, Sr, Fe, Sb, Tl, Pb, and As) in cord blood were greater than 80%. Among the preterm birth children, the results of GEE analysis showed that after adjusting for the covariates, for each increase of interquartile range (IQR) in ln-transformed concentration, As was associated with problems/delay in the communication and problem-solving sub-scales, with the adjusted odds ratios (OR) and 95% confidence intervals (CI) of 1.36 (1.03-1.80) and 1.55 (1.10-2.20), respectively; the adjusted OR (95%CI) of problems/delay in the fine motor and problem-solving sub-scales were 1.44 (1.00-2.07) and 1.76 (1.09-2.84) for Sb, respectively; the adjusted OR (95%CI) of problems/delay in the communication sub-scale was 1.37 (1.09-1.74) for Se. No statistically significant associations between umbilical cord blood element concentrations and neurodevelopment indicators were observed among full-term children. The results of stratified analysis by sex showed that the associations between umbilical cord blood element concentrations and neurodevelopment problems/delay were only significant among female preterm children. Conclusion Exposures to As, Se, and Sb during pregnancy may increase the risk of neurodevelopment problems/delay in preterm children aged 6-24 months, and female seem to be more vulnerable.

Energy supply nutrients and mineral composition analysis in breast milk in Lanzhou urban / 中华临床营养杂志

Objective To analyze the energy supply nutrients (protein,fat and lactose) and mineral elements (calcium,copper,iron,zinc,magnesium,sodium,potassium) supplied in breast milk from the resident of Lanzhou,and investigate the problems of those energy supply nutrients and mineral elements in breast milk of this population so that to provide basis for breast feeding.Methods Breast milk from 1 215 mothers whose babies were fed totally by the breast milk and grew well was collected and assayed for the contents of protein,fat,lactose,calcium,copper,iron,zinc,magnesium,sodium and potassium in Lanzhou region.The optimal range for breast feeding was set by normal distribution method.The results were compared with the breast milk from other internal region in order to clarify the contents difference.Results The prevalence of mother-milk-fed in this region was 48.5％.The normal ranges (unit:g/100 g) of fat,lactose and protein were 1.57-5.11,6.58-7.16 and 0.79-1.35,and the normal ranges of calcium,copper,iron,zinc,magnesium,sodium and potassium were 5.25-7.83 mmol/L,5.66-8.28 mmol/L,0.14-0.3 mmol/L,15-64.48 μmol/L,0.98-1.62 mmol/L,1.92-18.82 mmol/L,7.95～ 17.31 mmol/L in the high quality breast milk.Compared with the other internal region,the normal ranges of the protein,fat and lactose in Lanzhou were lower.The contents of protein,fat,lactose,calories,calcium,copper,zinc and sodium in the breast milk from the whole investigated population were significantly lower compared with breast milk of high quality (P＜0.01).Conclusion The quality of breast milk in Lanzhou is not so good.The contents of various nutrients in breast milk should be improved to a proper level by appropriate ways so that to improve the growth and development of the baby.

The study and use of Episiotomy Evaluation Form in the restrictive use of episiotomy / 中国实用护理杂志

Objective To be good for the different working age midwives to carry out the same evaluation of the pregnant woman,we build and use the Episiotomy Evaluation Form for reducing the rate of episiotomy with ensuring the safety of mother and baby.Methods Consult relevant literature,combine clinical practice,discuss,report to the hospital ethics committee many times and at last it was made after approval.The details included:perineal lesions,perineum elasticity,perineal length,maternal coordination,gestational age,age,fetal distress degree,amniotic fluid situation,the weight of fetus estimated,the second time of labor and so on,to score by 0,1,3,5,20.A total of 600 patients with low risk of natural childbirth were randomly divided into observation group and control group according to method of random number table with 300 cases each.The observation group was graded according to the perineal incision evaluation and we operated according to its use method.The control group was judged according to the experience of midwife and subjective cognition.At last compared the effects on the mother and baby.Results The rates of lateral episiotomy and Ⅰ degree laceration were 15.00％ (45/300) and 63.00％ (189/300) in the observation group and 48.33％ (145/300) and 21.67％ (65/300) in the control group,respectively.The difference between the two groups was statistically significant (x2=16.238,21.507,P ＜ 0.05).There was no statistical difference in the perineal intact rate,median perineal incision rate,perineal Ⅱ degree laceration rate,severe perineal laceration,second stage of labor,postpartum hemorrhage 2 hours,neonatal asphyxia rate,incidence of neonatal birth injury (brachial plexus injury,clavicle fracture,etc.) and pelvic floor muscle strength of 42 days after delivery between the two groups (P ＞ 0.05).Conclusions By using the episiotomy evaluation form,we can improve the accuracy and homogeneity of the midwife's assessment about the episiotomy which is benefit to reduce rate of episiotomy.It is worth promoting in clinical practice but we should ensure the safety of maternal and child.

Usage and efficacy of timolol maleate eye drops in treatment of superficial infantile hemangioma / 中南大学学报(医学版)

Objective:To determine drug dose and usage of timolol maleate eye drops in the treatment of superficial infantile hemangioma.Methods:A total of 250 superficial hemangioma infants were recruited and assigned into 5 groups (n=50 for each group):an external application group and 4 exterior coating groups (2,4,6,8 times per day).We evaluated the therapeutic effect of different methods for drug application (external application or exterior coating) and the frequency for drug administration on superficial infantile hemangioma.Results:The external application group (twice a day and 0.5 hour per time) showed better effect than that in the exterior coating group with twice a day (P＜0.001).The difference in therapeutic effect between the exterior coating group with 6 times a day and exterior coating group with twice a day or with 3 times a day was significant (P＜0.001).The differences in drug efficacy were not found among the exterior coating group with 6 times a day,the exterior coating group with 8 times a day,or the external application group with twice a day (All P＞0.05).Conclusion:Drug dose may affect the therapeutic effect oftimolol maleate eye drops in superficial hemangioma infants,and exterior coating with 6 times a day may achieve the best curative effect.

Survey on changes in the proportion for facial aesthetics / 中南大学学报(医学版)

To explore the proportion for facial aesthetics that may be recognized by the potential group who will do plastic surgery in the future. 
 Methods: We measured the celebrity photos, who were born before 1980 recognizable by the people over 40 years old or by high school students. The proportions for facial aesthetics recognizable by these two generations were obtained and compared. 
 Results: Compared the new generation of male celebrities with the older generation of male celebrities, the difference was statistically significant by the independent samples t test (t=-2.502, P0.05). Compared the new generation of female celebrities with the older generation of female celebrities, the difference was statistically significant by the independent samples t test. The ratios between inter-canthic diameter and eyeslit breadth, mouth breadth and eyeslit breadth, stirnhohe and 1/3 of the physiognomic facial height, nasal height and 1/3 of the physiognomic facial height were significantly different (P0.05).
 Conclusion: The young new generation loves more larger eyeslit breadth for men, while a larger eyeslit breadth, smaller bizygomatic breadth and sharper chin for women.

Endovascular treatment for venous malformations with three-point anhydrous ethanol injection / 中南大学学报(医学版)

OBJECTIVE@#To explore the safe method with anhydrous ethanol injection in the treatment of venous malformation.
@*METHODS@#A total of 96 patients with venous malformation were conducted anhydrous ethanol injection for 245 times through percutaneous puncture by three-point method. The complications were observed. In animal experiment, according to the different concentrations of anhydrous ethanol injection, rats were divided into an anhydrous ethanol group, a 75% ethanol group, a 50% ethanol group and a 25% ethanol group (n=5 in each group), and the damage of vessels after ethanol injection was observed.
@*RESULTS@#The successful rate for three-point ethanol injection was 88%. The incidence for both skin ulcer and numbness was 0.9% without severe complications in lung and heart. In the animal experiments, the entire vessel wall including outer membrane was damaged in the anhydrous ethanol group. Part of vessel walls, including the inner membrane and muscle layer, were damaged in both the 75% ethanol group and the 50% ethanol group. However, there was no damage in the vessels in the 25% ethanol group.
@*CONCLUSION@#With the decrease in ethanol concentration, the vascular damage is decreased and eventually disappeared. Three-point anhydrous ethanol injection is safe and effective.

The levels and correlation analysis of trace elements in maternal blood, breast milk and infant blood / 中国医师杂志

Objective To investigate the correlation of trace elements in maternal blood,breast milk and infant blood.Methods Atomic absorption spectrographic method was used to measure blood and milk trace elements [calcium (Ca),ferrum (Fe),zinc (Zn),magnesium (Mg),copper(Cu)] of maternal of natural delivery and infant in 250 cases,then to analyze the correlation of trace elements in maternal blood,breast milk and infant blood in postpartum 42 days.Results There were statistically significant differences in trace elements between the maternal blood,breast milk and infant blood (P ＜ 0.05).There was a positive correlation of Ca,and Fe between maternal blood and infant blood [Ca (r =0.221,P =0.047),Fe (r =0.107,P =0.043)];Fe had a positive correlation between breast milk and infant blood (r =0.139 P =0.035);There was a positive correlation of the trace elements between maternal blood and milk,but no correlation in Mg.Conclusions There was the gradient of trace elements in maternal blood and breast milk in postpartum 42 days.It can keep breast milk in a certain percentage of trace element and contribute to absorption of trace elements and growth and development in infant.The regular determination of trace elements during pregnancy and postpartum in women and their infant can direct a balanced diet and advocate breastfeeding.It can also prevent the lack of calcium,iron,zinc and other trace elements in infant.