Compound nutrient assisted phototherapy in the treatment of neonatal jaundice: a multicenter clinical study / 国际儿科学杂志

Objective To evaluate the curative effect of compound nutrient assisted phototherapy on neonatal jaundice.Methods Neonatologists at seven hospitals participated in the study.A total of three hundred and twenty full-term newborns with high indirect bilirubin admitted to hospital from September 2017 to January 2018 were selected.One hundred and sixty-six cases in the observation group,and one hundred and fifty-four cases in the control group,all enrolled neonates were given single-sided,conventional intensity phototherapy.Observation group took compound nutrient at the same time.The average gestational age,age,birth weight of two groups before treatment were not significantly different.Serum total biilirubin,indirect bidirubin,liver function (ALT,AST) and phototherapy time were monitored before treatment and 3 days after treatment.Results The serum total bilirubin in the observation group was significantly lower than that of the control group after 3 days of treatment[(196.7 ± 57.2) μmol/L vs (216.5 ± 54.6) μmol/L],(t=3.17,P＜0.01).The indirect bilirubin in the observation group was significantly lower than that of the control group after 3 days of treatment [(176.3 ± 54.3) μmol/L vs (197.2 ± 52.9) μmol/L],(t=3.50,P＜0.01).The time of phototherapy of the children in the observation group was significantly shorter than that of the control group[(19.8 ± 14.4)d vs (22.9 ± 13.3) d],(t =2.00,P ＜ 0.01).Rash,fever,bronze disease,spilled milk,vomiting,abdominal distention,diarrhea,constipation,liver damage etc.were no significant difference the observation group and the control group(P ＞ 0.05).Conclusion Compound nutrients had good efficacy and safety in adjuvant phototherapy for neonatal high indirect bidirubin.

Associated factors of acute kidney injury in critically ill neonates / 中国小儿急救医学

Objective To study the incidence of acute renal injury ( AKI), related clinical risk factors and recent prognosis in critically ill neonates. Methods The study was a retrospective analysis from January 2016 to December 2016 in the neonatal care department of General Hospital of Shenyang Military Region and the First Hospital Affiliated to China Medical University. We collected the perinatal data,clinical data,biochemical indexes and short-term prognosis. Logistic regression analysis was used to identify the risk factors. Results The incidence of AKI in critically ill neonates was 13. 11%(32/244),and the probability of poor prognosis was 62. 50%(20/32). Gestational age,birth weight,1 min and 5 min Apgar score,con-sciousness,mechanical ventilation,blood pH,blood glucose,blood urea nitrogen,white blood cell and red cell distribution width were the related factors for AKI in critically ill neonates. Logistic regression analysis showed that consciousness(OR=4. 542,95%CI 1. 176-17. 539,P=0. 028),mechanical ventilation(OR=0.267,95%CI 0.101-0.705,P = 0.008),5 min Apgar score(OR = 0.750,95% CI 0.605-0.930,P =0. 009),blood urea nitrogen value(OR=1. 074,95%CI 1. 006-1. 146,P=0. 030)were identified as the inde-pendent risk factors of AKI. ConclusionThe incidence of AKI is high in critically ill neonates. Consciousness,mechanical ventilation,5 min Apgar score,blood urea nitrogen value are identified as independent risk factors for AKI.

Homeopathic closed leverage anatomical plate with compression bolt for treatment of displaced intra-articular calcaneal fractures / 中华创伤杂志

Objective To compare the treatment of displaced intra-articular calcaneal fractures by homeopathic closed leverage anatomical plate with compression bolt through small posterior lateral approach vs.traditional open reduction and internal fixation.Methods A retrospective case control study was made on 98 cases of displaced intra-articular calcaneal fractures admitted from September 2012 to May 2015.According to the random number table,the subjects were assigned to homeopathic closed leverage anatomical plating with compression bolt through small posterior lateral approach (experiment group,58 cases,66 sides) and open reduction and internal fixation through L-shape approach (control group,40 cases,45 sides).Experiment group consisted of 50 male and eight females cases aging from 27-56 years (mean,41.9 years),and the Sanders classification was 40 cases of type Ⅱ,24 type Ⅲ and two type Ⅳ.Control group consisted of 36 male and four female cases aging from 25-58 years (mean,43.7 years),and the Sanders classification was 25 cases of type Ⅱ,18 type Ⅱ and two type Ⅳ.Operation time,bone reduction,postoperative Bohler's angle,width of the calcaneum,and incision healing were recorded.Functional outcomes were evaluated with Maryland hindfoot scoring system at last follow-up.Results Operation time was (52.6 ± 11.2) min in experiment group,significantly shorter than that in control group [(86.4 ± 14.1) min] (P ＜ 0.01).All cases were followed up from 18-50 months (mean,30.8 months).Reduction of the calcaneal posterior facet in 53 sides (80％) was graded as nearly anatomical in experiment group,and 38 sides (84％) in control group (P ＞ 0.05).Postoperative Bohler's angle was (28.0 ± 6.2) ° in experiment group,and (26.8 ± 7.0) ° in control group (P ＞ 0.05).Width of the calcaneum was (31.3 ±3.6)mm in experiment group and (34.9 ± 4.0)mm in control group (P ＜ 0.01).All cases presented satisfactory shape of the calcaneus without lateral-side impact syndrome.No case had wound infection and incision-edge necrosis in experimental group,while two cases of superficial wound infection and three cases of incision-edge necrosis were found in control group (P ＜ 0.01).At last follow-up,Maryland hindfoot score was (87.1 ± 7.6)points in experiment group and (84.9 ± 9.1)points in control group (P ＞ 0.05).Conclusion Homeopathic percutaneous leverage and anatomical plate with compression bolt through small posterior lateral approach is an effective method for treatment of displaced intra-articular calcaneal fractures,for it has advantages of minimal invasion,less operation time,good reduction and function,and less wound complications.

Dynamic expression of E2F1 in lung of premature rats with hyperoxia-induced chronic lung disease and its significance / 中南大学学报(医学版)

OBJECTIVE@#To determine the dynamic expression of E2F1 in lung of premature rats with hyperoxia-induced chronic lung disease and the relation between E2F1 and pulmonary fibrosis.@*METHODS@#Premature Wistar rats at 21 days gestation were randomly and equally divided into a hyperoxia group and a room air group. The hyperoxia group was continuously exposed to hyperoxia (90%) while the air group in room air. Lung tissues in the 2 groups were obtained at 3, 7 and 14 days after exposing to either room air or hyperoxia. The changes of pulmonary histopathology at different time points were observed by hematoxylin and eosin staining; the severity of pulmonary fibrosis was evaluated; and the expression of E2F1 in lung tissue was detected by immunohistochemistry and Western blot.@*RESULTS@#After 3 days of hyperoxia, no significant interstitial fibrosis was observed; while after 7 days in the hyperoxia group, interstitial fibrosis was observed. These changes became more obvious after 14 days of prolonged hyperoxia exposure. No significant difference in the expressions of E2F1 protein was found between the hyperoxia group and the room air group 3 days postnatally (P>0.05). The expression of E2F1 in the hyperoxia group significantly increased 7 days and 14 days postnatally (P<0.05, P<0.01).@*CONCLUSION@#Abnormality of E2F1 expression is involved in the pathological process of the proliferation of lung fibroblasts in hyperoxia-induced chronic lung disease neonatal rats, and it plays an important role in lung fibrosis.

The dynamic study of total antioxidative capacity and malondialdehyde in the liver of newborn rats induced by hyperoxia / 中国小儿急救医学

Objective To determine the levels of total antioxidative capacity(TAOC) and malondialdehyde(MDA) in liver exposed to hyperoxia,and to explore whether oxygen inhalation could cause liver injury in newborn rats.Methods Sixty-four newborn rats which were less than 12-hour-old were enrolled in this study.The rats were randomly divided into hyperoxia group(FiO2=0.85,n=32) and control group(air,n=32).Eight rats in each group were randomly sacrificed to obtain liver tissues at 1d,3d,7d and 14d.The TAOC of liver homogenates was detected by chemical colorimetry,and the MDA level of liver homogenates was measured by thiobarbituric acid test.Results In the hyperoxia group,TAOC in liver increased on the 1st day[(3.60±0.28)U/mg prot vs(3.39±0.19)U/mg prot,P<0.05];TAOC began to decreased on the 3rd day,and significantly lower than that of control group on the 14th day [(3.10±0.15)U/mg prot vs (3.56±0.14)U/mg prot,P<0.01].In the hyperoxia group,the MDA level increased on the 3rd day[(3.58±0.11)nmol/mg prot vs(2.82±0.14)nmol/mg prot,P<0.01],and reached a peak on the 7th day[(3.58 ±0.11)nmol/mg prot vs(2.82±0.14)nmol/mg prot,P<0.01],then decreased but still remained higher than control group on the 14th day [(2.92±0.18)nmol/mg prot vs(2.77 ±0.09)nmol/mg prot,P<0.01].Conclusion Too more MDA in liver and TAOC decrease may cause liver injury in newborn rats exposed to hyperoxia.With the oxygen inhalation time prolonging,the liver injury aggravation.