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Objective:To investigate the reference ranges for thyroid function and its influencing factors in preterm infants at 14 d after birth.Methods:This retrospective study involved 514 preterm infants who met the inclusion criteria in Affiliated Hospital of Inner Mongolia Medical University from January 1, 2019 to December 31, 2021. They were divided into three group according to their gestational age [early premature group (26-31 +6 weeks, n=153), middle premature group (32-33 +6 weeks, n=129) and late premature group (34-36 +6 weeks, n=232)] or birth weight (BW) [<1 500 g group ( n=129), 1 500-2 000 g group ( n=120) and ≥2 000 g group ( n=265)]. Venous blood samples were collected from the infants at 14 d after birth and their thyroid function was determined by chemiluminescence immunoassay. The reference values of free triiodothyronine (FT 3), free thyroxine (FT 4) and thyroid stimulating hormone (TSH) were calculated based on the values of 95% confidence intervals ( CI) and expressed as percentiles in the range from P2.5 to P97.5. Mann-Whitney U test or Kruskal-Wallis H test was used to compare those thyroid hormone levels between groups. Spearman correlation analysis was used to study the correlation of gestational age or birth weight with FT 3, FT 4 and TSH levels. The factors influencing the levels of thyroid hormones were analyzed by multiple linear regression. Results:The reference ranges for FT 3, FT 4 and TSH were 1.53-3.72 pg/ml, 0.81-1.91 ng/dl and 1.32-7.80 μIU/ml in the early premature infants, 1.74-4.16 pg/ml, 0.90-2.82 ng/dl and 0.63-7.64 μIU/ml in middle prematures and 2.07-4.88 pg/ml, 1.09-2.27 ng/dl and 1.14-7.06 μIU/ml in late prematures. The reference ranges for the above three indexes were 1.53-4.06 pg/ml, 0.81-1.83 ng/dl and 1.14-7.84 μIU/ml in premature infants with BW<1 500 g, 1.67-3.98 pg/ml, 0.88-2.97 ng/dl and 0.94-7.64 μIU/ml in those whose BW between 1 500 g and 2 000 g and 1.91-4.75 pg/ml, 1.09-2.31 ng/dl and 1.14-6.32 μIU/ml in those whose BW≥2 000 g. Multiple linear regression showed that the level of FT 3 was positively correlated with gestational age ( β=0.119, P<0.05) and birth weight ( β=1.950×10 －4, P<0.05); that of FT 4 was positively correlated with gestational age only ( β=0.031, P<0.05); and TSH level was negatively correlated with birth weight ( β=－4.250×10 －4, P<0.05). Conclusions:Gestational age and birth weight are the factors influencing thyroid function in preterm infants at 14 d after birth. Evaluation of thyroid function with FT 4 and TSH should based on the references ranges of different gestational age and birth weight .
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Bone metabolism biochemical indicators can reflect the state of bone transformation timely, which not only play an essential physiological role in individuals' normal growth and development but also are related to the development of many diseases. This paper reviews the progress on the correlation of serum bone metabolism biochemical indicators during pregnancy and the neonatal period to provide a reference for achieving adequate intrauterine nutritional reserves in the fetus and individualized nutritional guidance in the neonatal period.
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Objective:To study the correlation of bone metabolism biomarkers between newborn twins and their mothers during pregnancy.Methods:From January 1, 2018 to June 30, 2022, newborn twins with mild symptoms admitted to the neonatal department of our hospital were retrospectively reviewed. The clinical data of the twins and their mothers were collected, including bone metabolism biomarkers of the twins within 3 d after birth and their mothers within last month during pregnancy. The twins were assigned into different groups according to gestational age(GA), birth weight(BW), the relationship between BW and GA(appropriate for GA(AGA),small for GA(SGA) and large for GA(LGA), birth season, gender, and the mothers' age, ethnicity, pre-delivery body mass index (BMI), gestational BMI increase, number of births and chorionic properties. The correlations of bone metabolism biomarkers between the twins and their mothers were analyzed.Results:A total of 302 pairs of twins were included. The incidence of insufficient or deficient serum 25-(OH)D 3 was 97.4% among the mothers, and 87.7% among the twins. The levels of blood phosphorus ( r=0.262, P<0.001) and 25-(OH)D 3 ( r=0.239, P=0.002) in mothers were positively correlated with the twin with larger BW. No significant differences existed in 25-(OH)D 3 between genders, AGA,SGA and LGA, birth season, and mothers' age, ethnicity, pre-delivery BMI, gestational BMI increase and chorionic properties( P>0.05). 25-(OH)D 3 in the twins were positively correlated with BW and 25-(OH)D 3 of mothers before delivery ( P<0.05) and negatively correlated with number of births ( P<0.05). Conclusions:In most mothers and their newborn twins, 25-(OH)D 3 are insufficient or deficient. The levels of blood phosphorus and 25-(OH) D 3 are correlated between the newborns and their mothers. The lower the BW of the newborn, the more times the mother give birth and the lower the mother's pre-delivery 25-(OH)D 3 level, the lower the newborn's 25-(OH)D 3 level.
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Objective:To evaluate the efficacy and safety of noninvasive high-frequency oscillatory ventilation (nHFOV) as the initial ventilation mode for respiratory distress syndrome (RDS) in premature infants.Methods:From the establishment of the databases [(PubMed, Embase, Cochrane Library, CNKI, Wanfang database, CQVIP and CBM (SinoMed)] to March 1, 2022, literature on randomized controlled trials (RCTs) using nHFOV and nasal continuous positive airway pressure(NCPAP) as the initial ventilation modes for RDS in premature infants were searched. The qualities of the included literature were evaluated according to Cochrane Evaluation Manual. RevMan 5.4 software was used for Meta-analysis.Results:Seven RCTs involving 786 children were included for the final Meta-analysis, with 395 cases in the nHFOV group and 391 cases in the NCPAP group. The results showed that the nHFOV group had lower intubation rates than the NCPAP group ( OR=0.34, 95% CI 0.22~0.51, P<0.001). No significant differences existed in mortality rates and complication rates between the two groups ( P>0.05). Conclusions:nHFOV as the initial treatment for RDS in premature infants may reduce the incidence of early treatment failure without increasing complications.
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Premature infants have immature gastrointestinal function and are prone to various comorbidities after birth, which have a great impact on their near and long-term prognosis.Proper nutritional support is the basis of their survival and treatment plan, of which enteral nutrition is the main tool.However, the management of enteral nutrition varies considerably between neonatal facilities worldwide, and the nutritional management of preterm infants varies between physicians.This review summarized and discussed the existing literature on enteral nutrition in preterm infants, to provide a review of the current status of enteral nutrition support in preterm infants in China and abroad and the factors that currently influence the time to achieve adequate enteral nutrition, aiming to provide a reference for improving clinical practice protocols.
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Objective:To analyze the risk factors of bronchopulmonary dysplasia(BPD)in very preterm infants(VPI), and to provide scientific basis for the prevention and treatment of BPD in VPI.Methods:A prospective multicenter study was designed to collect the clinical data of VPI in department of neonatology of 28 hospitals in 7 regions from September 2019 to December 2020.According to the continuous oxygen dependence at 28 days after birth, VPI were divided into non BPD group and BPD group, and the risk factors of BPD in VPI were analyzed.Results:A total of 2 514 cases of VPI including 1 364 cases without BPD and 1 150 cases with BPD were enrolled.The incidence of BPD was 45.7%.The smaller the gestational age and weight, the higher the incidence of BPD( P<0.001). Compared with non BPD group, the average birth age, weight and cesarean section rate in BPD group were lower, and the incidence of male infants, small for gestational age and 5-minute apgar score≤7 were higher( P<0.01). In BPD group, the incidences of neonatal respiratory distress syndrome(NRDS), hemodynamically significant patent ductus arteriosus, retinopathy of prematurity, feeding intolerance, extrauterine growth restriction, grade Ⅲ~Ⅳ intracranial hemorrhage, anemia, early-onset and late-onset sepsis, nosocomial infection, parenteral nutrition-associated cholestasis were higher( P<0.05), the use of pulmonary surfactant(PS), postnatal hormone exposure, anemia and blood transfusion were also higher, and the time of invasive and non-invasive mechanical ventilation, oxygen use and total hospital stay were longer( P<0.001). The time of starting enteral nutrition, cumulative fasting days, days of reaching total enteral nutrition, days of continuous parenteral nutrition, days of reaching 110 kcal/(kg·d) total calorie, days of reaching 110 kcal/(kg·d) oral calorie were longer and the breastfeeding rate was lower in BPD group than those in non BPD group( P<0.001). The cumulative doses of amino acid and fat emulsion during the first week of hospitalization were higher in BPD group( P<0.001). Multivariate Logistic regression analysis showed that NRDS, invasive mechanical ventilation, age of reaching total enteral nutrition, anemia and blood transfusion were the independent risk factors for BPD in VPI, and older gestational age was the protective factor for BPD. Conclusion:Strengthening perinatal management, avoiding premature delivery and severe NRDS, shortening the time of invasive mechanical ventilation, paying attention to enteral nutrition management, reaching whole intestinal feeding as soon as possible, and strictly mastering the indications of blood transfusion are very important to reduce the incidence of BPD in VPI.
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Bronchopulmonary dysplasia(BPD)is a common chronic lung disease during the newborn period.It not only affects the quality of life of the children, but causes complications that have a certain impact on the future growth and development of them.Currently, there is still a lack of specific prevention and treatment measures.MicroRNAs(miRNAs)are a class of endogenous small molecule non-coding RNAs.In recent years, some abnormally-expressed miRNAs have been found to be involved in the pathogenesis of BPD through regulating apoptosis pathway, but the specific pathogenic link and mechanisms are still not clear enough.In this article, the molecular mechanisms of miRNAs involved in apoptosis in the pathogenesis of BPD were reviewed to provide a theoretical basis for exploring new diagnosis and treatment methods for BPD.
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With the continuous advancement and improvement of medical technology, the survival rate of preterm infants has gradually increased. Due to the increasing frequency of mechanical ventilation in the neonatal intensive care unit,acute lung injury (ALI),bronchopulmonary dysplasia (BPD) and other common serious complications are inevitable,which seriously affect the quality of life in children. At present, the etiology and pathogenesis of BPD and ALI are not yet clear,but studies had shown that the two had the same genetic factors, such as tumor necrosis factor-α, Toll-like receptor, pulmonary surfactant protein, mi-croRNA and other genes. This paper reviewed the role of tumor necrosis factor-α, Toll-like receptor in the development of BPD and ALI.
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Objective@#To explore the relationship between serum glial fibrillary acidic protein (GFAP) level and neonatal hypoxic-ischemic encephalopathy (HIE), and to verify whether GFAP combined with craniocerebral magnetic resonance imaging (MRI) can more accurately evaluate the prognosis of HIE.@*Methods@#We selected HIE children who hospitalized in the department of neonatology, the affiliated hospital of Inner Mongolia Medical University from January 2017 to December 2017, and full-term newborns without brain injury who were hospitalized in the same period. Serum samples were taken for GFAP detection on the 1st, 3rd, 7th day after birth of HIE and the 3rd day after birth of full-term newborns without brain injury. All the subjects completed craniocerebral MRI examination and followed up. At the same time, the correlation between GFAP level and the severity of brain MRI was evaluated.@*Results@#⑴ The level of serum GFAP in HIE group on the 3rd day after birth [(5.54±1.30)ng/ml] was significantly higher than that in control group [(3.38±0.31)ng/ml] (P<0.01). ⑵ Comparison of serum GFAP levels in HIE children with different degrees: the serum levels of GFAP in the severe group on the 1st, 3rd and 7th day were as follows: (5.56±1.89)ng/ml, (6.42±1.63)ng/ml, (7.22±1.30)ng/ml; the serum levels of GFAP in moderate group on the 1st, 3rd and 7th day were as follows: (5.07±0.62)ng/ml, (6.73±0.772)ng/ml, (6.25±0.812)ng/ml; the serum levels of GFAP in mild group on the 1st, 3rd and 7th day were as follows: (4.20±0.13)ng/ml, (5.34±0.33)ng/ml, (4.52±0.33)ng/ml; the serum GFAP levels in severe group were higher than those in moderate group and mild group on the 1st, 3rd and 7th day, and those in moderate group were higher than those in mild group (P<0.01). ⑶ Comparison of serum GFAP levels between sequelae group and non-sequelae group: there was no significant difference between sequelae group [(5.22±1.52)ng/ml, (6.48±1.17)ng/ml] and non-sequelae group [(4.47±0.50)ng/ml, (5.75±0.88)ng/ml] on the 1st and 3rd day (P>0.05); there was significant difference between sequelae group [(6.93±1.29)ng/ml] and non-sequelae group [(4.91±0.77)ng/ml] on the 7th day (P<0.01). ⑷ Comparison of serum GFAP levels between abnormal group of MRI and normal group of MRI: the levels of serum GFAP on day 1, 3 and 7 in abnormal craniocerebral MRI group were as follows: (5.25±1.28)ng/ml, (6.66±1.10)ng/ml, (6.64±1.08)ng/ml; the levels of serum GFAP on day 1, 3 and 7 in the normal group of MRI were as follows: (4.26±0.25)ng/ml, (5.41±0.40)ng/ml, (4.62±0.48)ng/ml; the serum levels of GFAP on day 1, 3 and 7 in mild abnormal craniocerebral MRI group were as follows: (4.92±0.9)ng/ml, (6.42±0.47)ng/ml, (5.95±0.58)ng/ml; the levels of serum GFAP on day 1, 3 and 7 in moderate abnormal group of craniocerebral MRI were as follows: (4.49±0.58)ng/ml, (6.24±1.87)ng/ml, (6.11±0.08)ng/ml; the levels of serum GFAP on day 1, 3 and 7 in the severe abnormal group of craniocerebral MRI were as follows: (6.17±1.34)ng/ml, (7.22±0.91)ng/ml, (7.73±1.01)ng/ml. Among the three groups of abnormal group of craniocerebral MRI, there were no significant differences in serum GFAP levels on day 1 and 3 (P>0.05), and there were significant differences on day 7 (P<0.05).@*Conclusions@#It is speculated that the increase of serum GFAP level in HIE newborns is related to the severity and prognosis of the disease, and is positively related to the results of craniocerebral MRI examination.Detecting the changes of serum GFAP in HIE newborns is helpful to determine the severity of the disease and evaluate the prognosis of the children. Combining GFAP with craniocerebral MRI may improve the accuracy of the judgment.
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Objective To observe the effects of fecal microbiota transplantation on intestinal microbiota and brain function in sepsis rats. Methods Sixty male Sprague Dawley (SD) rats were divided into sham operation group, model group and fecal microbiota transplantation (FMT) group by random number table, each group 20 rats. The rat model of sepsis was established by injection of lipopolysaccharide (LPS) 10 mg/kg in tail vein. FMT group received nasogastric infusion of feces from healthy donor. Fecal samples were collected on the 6th day after the modeling to detect the levels of intestinal microbiota composition; the brain function was also evaluated by electroencephalogram (EEG), and the proportion of each waveform in EEG was calculated. After sacrifice of rats in different groups, the brain tissues were taken, the levels of protein expression and positive cells of Iba-1 in brain tissue were detected by Western Blot and immunohistochemistry method. Results ① Intestinal flora analysis showed that: the diversity index and Chaol index of the intestinal microbiota in model group were significantly lower than that in sham operation group (observed species:282±40 vs. 473±37, Chao1 index: 730±21 vs. 837±27, both P < 0.05); compared with the model group, the diversity index and Chaol index in FMT group were obviously higher (observed species: 461±20 vs. 282±40, Chao1 index:840±16 vs. 730±21, both P < 0.05). At phylum, family, genus level analysis showed that the proportion of Firmicutes phylum and Fusobacterium were obviously lower than those of sham operation group [Firmicutes phylum (22.12±1.34)% vs. (78.01±1.23)%, Fusobacterium: (2.03±0.17)% vs. (5.03±0.19)%, both P < 0.05], and the proportions of Proteobacteria, Bacteroidetes phyla and Acidaminococcaceae, Fusobacteriaceae, Enterbacteriacecae, Alistipes were markedly higher in model group [Proteobacteria: (70.21±2.35)% vs. (19.45±2.17)%, Bacteroidetes phyla: (4.12±0.19)% vs. (2.50±0.64)%, Acidaminococcaceae: (12.51±0.87)% vs. (1.01±0.12)%, Fusobacteriaceae: (13.62±1.27)% vs. (2.31±0.19)%, Enterbacteriacecae: (18.24±2.13)% vs. (4.15±1.51)%, Alistipes: (4.53±0.27)% vs. (1.47±0.33)%, all P < 0.05]; compared with the model group, the proportion of Firmicutes phylum and Faecalibacterium in FMT group were significantly higher [Firmicutes phylum: (72.14±2.31)% vs. (22.12±1.34)%, Faecalibacterium: (5.01±0.27)% vs. (2.03±0.17)%, both P < 0.05], and Proteobacteria, Bacteroidetes phyla and Acidaminococcaceae, Fusobacteriaceae, Enterbacteriacecae in FMT group were obviously lower [Proteobacteria: (14.23±1.98)% vs. (70.21±2.35)%, Bacteroidetes phyla: (3.15±0.18)% vs. (4.12±0.19)%, Acidaminococcaceae: (0.91±0.11)% vs. (12.51±0.87)%, Fusobacteriaceae: (1.25±0.15)% vs. (13.62±1.27)%, Enterbacteriacecae: (3.50±0.21)% vs. (18.24±2.13)%, all P < 0.05]. ② EEG analysis showed that the percentages of δ wave in EEG in model group was significantly higher after modeling than that in sham operation group [(16.86±0.50)% vs. (10.67±0.65)%, P < 0.05]; the ratios of δ wave in EEG was significantly lower in FMT group than that in the model group [(12.87±0.60)% vs. (17.35±0.41)%, P <0.05]. The incidence of abnormal EEG in sham operation group was 0, the incidence of abnormal EEG in model group was significantly increased [the ratios of δpredominant wave, θpredominant wave, low-voltage were 66.7% (6/9), 66.7% (6/9), 77.8% (7/9) respectively], the ratios of above abnormal waves in EEG in FMT group were obviously lower than those in model group [the ratios of above abnormal waves in FMT group were respectively 9.1% (1/11), 9.1% (1/11), 18.2%(2/11)]. ③ Western Blot analysis showed that the protein expression of Iba-1 in cortex in model group obviously was higher than that in sham operation group (Iba-1/β-actin: 1.39±0.16 vs. 0.67±0.18, P < 0.05); the expression of Iba-1 in cortex tissue of FMT group was markedly lower than that in model group (Iba-1/β-actin: 0.51±0.14 vs. 1.39±0.16, P < 0.05). ④ Immunohistochemistry of Iba-1 in cortex analysis showed that there were no Iba-1 positive cells in the cortex in sham operation group; Iba-1 positive cells were found in the cortex in model group; the number of Iba-1 positive cells in FMT group was less than that in model group. Conclusion FMT can improve the construction of intestinal microbiota, and ameliorate the brain dysfunction in SAE.
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Objective To explore the relationship between serum glial fibrillary acidic protein (GFAP) level and neonatal hypoxic-ischemic encephalopathy (HIE),and to verify whether GFAP combined with craniocerebral magnetic resonance imaging (MRI) can more accurately evaluate the prognosis of HIE.Methods We selected HIE children who hospitalized in the department of neonatology,the affiliated hospital of Inner Mongolia Medical University from January 2017 to December 2017,and full-term newborns without brain injury who were hospitalized in the same period.Serum samples were taken for GFAP detection on the 1st,3rd,7th day after birth of HIE and the 3rd day after birth of full-term newborns without brain injury.All the subjects completed craniocerebral MRI examination and followed up.At the same time,the correlation between GFAP level and the severity of brain MRI was evaluated.Results (1) The level of serum GFAP in HIE group on the 3rd day after birth [(5.54 ± 1.30)ng/ml] was significantly higher than that in control group [(3.38 ± 0.31) ng/ml] (P ＜ 0.01).(2) Comparison of serum GFAP levels in HIE children with different degrees:the serum levels of GFAP in the severe group on the 1st,3rd and 7th day were as follows:(5.56 ± 1.89) ng/ml,(6.42 ± 1.63) ng/ml,(7.22 ± 1.30) ng/ml;the serum levels of GFAP in moderate group on the 1st,3rd and 7th day were as follows:(5.07 ±0.62)ng/ml,(6.73 ±0.772) ng/ml,(6.25 ±0.812)ng/ml;the serum levels of GFAP in mild group on the 1st,3rd and 7th day were as follows:(4.20 ±-0.13) ng/ml,(5.34 ±0.33) ng/ml,(4.52 ±0.33) ng/ml;the serum GFAP levels in severe group were higher than those in moderate group and mild group on the 1st,3rd and 7th day,and those in moderate group were higher than those in mild group (P ＜ 0.01).(3) Comparison of serum GFAP levels between sequelae group and non-sequelae group:there was no significant difference between sequelae group [(5.22 ± 1.52) ng/ml,(6.48 ± 1.17) ng/ml] and non-sequelae group [(4.47 ± 0.50)ng/ml,(5.75 ±0.88) ng/ml] on the 1st and 3rd day (P ＞0.05);there was significant difference between sequelae group [(6.93 ± 1.29) ng/ml] and non-sequelae group [(4.91 ± 0.77) ng/ml] on the 7th day (P ＜0.01).(4) Comparison of serum GFAP levels between abnormal group of MRI and normal group of MRI:the levels of serum GFAP on day 1,3 and 7 in abnormal craniocerebral MRI group were as follows:(5.25 ± 1.28) ng/ml,(6.66 ± 1.10) ng/ml,(6.64 ± 1.08) ng/ml;the levels of serum GFAP on day 1,3 and7 in the normal group of MRI were as follows:(4.26 ±0.25)ng/ml,(5.41 ±0.40) ng,/ml,(4.62 ±0.48) ng/ml;the serum levels of GFAP on day 1,3 and 7 in mild abnormal craniocerebral MRI group were as follows:(4.92 ±0.9)ng/ml,(6.42 ±0.47)ng/ml,(5.95 ±0.58)ng/ml;the levels of serum GFAP on day 1,3 and 7 in moderate abnormal group of craniocerebral MRI were as follows:(4.49 ± 0.58) ng/ml,(6.24 ± 1.87) ng/ml,(6.11 ± 0.08) ng/ml;the levels of serum GFAP on day 1,3 and 7 in the severe abnormal group of craniocerebral MRI were as follows:(6.17 ± 1.34) ng/ml,(7.22 ± 0.91) ng/ml,(7.73 ± 1.01)ng/ml.Among the three groups of abnormal group of craniocerebral MRI,there were no significant differences in serum GFAP levels on day 1 and 3 (P ＞ 0.05),and there were significant differences on day 7 (P ＜ 0.05).Conclusions It is speculated that the increase of serum GFAP level in HIE newborns is related to the severity and prognosis of the disease,and is positively related to the results of craniocerebral MRI examination.Detecting the changes of serum GFAP in HIE newborns is helpful to determine the severity of the disease and evaluate the prognosis of the children.Combining GFAP with craniocerebral MRI may improve the accuracy of the judgment.
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Objective To explore the effective measures to reduce the incidence of nosocomial infection through the implementation of continuous quality improvement measures in the neonatal intensive care unit (NICU). Methods One hundred and twenty-two premature infants hospitalized in NICU of the Affiliated Hospital of Inner Mongolia Medical University after continuous quality improvement from January 2018 to November 2018 were selected prospectively as the experimental group, and 125 premature infants using routine nursing management mode from March 2017 to December 2017 were selected as the control group. The occurrence of bloodstream infection in two groups was observed. Results The incidence of bloodstream infection in the experimental group [7.4%(9/122)] was significantly lower than that in the control group [17.6%(22/125)], and the difference was statistically significant (P＝0.015). Compared with the control group, the experimental group had statistically significant differences in implementation rate of hand hygiene, average days of peripherally insterted central catheter indwelling, and antibiotic use rate and average days (P < 0.01). Conclusions The incidence of bloodstream infections in NICU can be effectively controlled through strict continuous quality improvement measures.
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Objective To study the correlation between polymorphisms of surfactant protein A1 rs1059047 and rs1136450 and respiratory distress syndrome (RDS) in Mongolian premature infants in Inner Mongolia.Methods Totally 50 Mongolian RDS premature infants in our ward were recruited as the case group (33 males and 17 females),and another 50 Mongolian non-RDS premature infants with same ethnicity,same sex and gestational age were served as the control group (29 males and 21 females).Single nucleotide polymorphisms of SP-A1 rs1059047 and,rs1136450 and allele haploids (6A,6A2,and 6A3) were detected by polymerase chain reaction-single strand conformation polymorphism gene detection technology and were compared between the case and control groups.Results Threegenotypes,CC,TT,CT were detected in the case and control groups at rs1059047,all ofwhich were mainly TT genotype.There was no significant difference in genotype frequency between the two groups (x2=1.429,P ＞ 0.05).Two genotypes,CG and GG,were detected in the case and control groups at rsl 136450,and CG was the dominant genotype.There was no significant difference in genotype frequency between the two groups (x2=1.624,P＞0.05).The distribution frequency of SP-A1 allele haploids (6A,6A2,6A3) in the case group was 36％,68％ and 42％,respectively,and 62％,46％ and 50％ in the control group,respectively.There was no significant differencein the frequency of allele haploid 6A3 between the two groups (x2=0.502,P＞0.05);but there was a significantly difference in the frequency of allele haploids (6A,6A2) between the two groups (x2=6.763,4.937,P＜0.05).Conclusions The alleles and allele fiequency of SP-A1 (rs1059047,rs1136450) were not associated with RDS in Mongolian premature infants.However,SP-A1 allele haploid 6A2 is the susceptible gene for RDS in Mongolian premature infants,and haploid 6A is the protective gene.
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Objective To study the correlation between pulmonary surfactant protein C exon5 area's gene polymorphism and the premature infants with respiratory distress syndrome (RDS) among Mongolian and Han ethnic in Inner Mongolia District. Methods Fifty unrelated Mongolian RDS premature infants (28 weeks ≤ gestational age <37 weeks) were recruited as study group (31 male and 19 female), and another 50 unrelated Han ethnic RDS premature infants (28 weeks ≤ gestational age<37 weeks) were enrolled at the same time, as control group (27 male and 23 female).Polymerase chain reaction was used for gene polymorphism analysis and gene detection technology was employed to determine the sequence of SP-C gene exon5 area, respectively. At last, the difference in genotype frequency of SP-C gene exon 5 area C. 715G>A(S186 N) was compared between two groups. Results There were three genotypes could be checked out from SP-C gene exon 5 area C. 715G>A(S 186N)locus; namely GG,AA,AG types, and in study group, genotype frequencies of these three genotypes were 28％, 62％ and 10％, respectively, and G allele frequency was 33％, and A allele frequency was 67％. Genotype frequencies in control group were 78％, 10％ and 12％, respectively, and G allele frequency was 84％, A allele frequency was 16％. The A allele genotype frequency in study group at SP-C exon 5 area C. 715G>A(S186N) significantly higher than that in control group. There was statistically significant difference in alleles variations between two groups (χ2 = 53.300, P＜ 0.05). Conclusions SP-C exon 5 area C. 715G>A(S 186N)locus polymorphism related to Inner Mongolia Mongolian premature RDS. Individuals carrying SP-C exon 5 area C. 715G>A (S186N) A alleles have higher risk of suffering from RDS.
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With the progress and development of perinatal medicine,the survival rate of preterm infant has been increased significantly. Early complications of premature infants could be effectively con-trolled,but some surviving premature infants left cerebral palsy,motor development retardation,visual impair-ment and other neurodevelopmental disorders,which seriously affected the quality of life.As a part of the neonatal physical examination,Peabody developmental motor scale plays an increasingly important role in understanding the early intelligence development,behavioral capacity,and neurological development of newborns.This paper reviewed the application of the Peabody developmental motor scale in the assessment of neurodevelopmental disorders in premature infants.
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Objective To analyze the risk factors of neonatal hypoglycemia, and provide evidence for prevention of neonatal hypoglycemia. Methods The clinical data of 120 neonates with hypoglycemia (case group) and 120 neonates without hypoglycemia (control group) were retrospectively analyzed. The risk factors of hypoglycemia were analyzed by multivariate Logistic regression analysis. Results The neonates of low birth weight, small gestational age, premature, pregnant woman with gestational diabetes mellitus,neonatal asphyxia and erythrocytosis in case group were significantly more than those in control group(35 cases vs.13 cases,21 cases vs.6 cases,31 cases vs.11 cases,13 cases vs. 4 cases,27 cases vs.15 cases and 15 cases vs.3 cases),and there were statistical differences(P<0.01 or<0.05).The multivariate Logistic regression analysis result showed that premature,low birth weights, small gestational age, pregnant woman with gestational diabetes mellitus, neonatal asphyxia and erythrocytosis were the risk factors of neonatal hypoglycemia(OR=3.451,3.389,4.030,3.523,2.032 and 5.571;95% CI 1.642-7.253,1.687-6.807,1.564-10.384,1.114-11.139,1.019-4.052 and 1.569 - 19.785; P<0.01 or <0.05). Conclusions The premature, low birth weights, small for gestational age,pregnant woman with gestational diabetes mellitus,neonatal asphyxia and erythrocytosis are the risk factors of neonatal hypoglycemia. Newborns with hypoglycemia risk factors should be regularly tested for blood glucose,and doctors should take immediate actions to correct hypoglycemia in order to avoid hypoglycemia brain damage.
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Objective To summarize the causes,related factors and outcome of extremely premature infants and extremely low birth weight infants.Methods One hundred and three cases of extremely premature infants and extremely low birth weight infants were admired to First Affiliated Hospital of Inner Mongolia Medical University between January 2009 and December 2015.The study was performed to analyze the clinical data of the 103 cases,included history of pregnancy,birth situation,treatment and prognosis.Results In these 103 cases,67 infants survived,36 infants died.The survival rate was 65.0％ (67/103).The extremely premature infants and extremely low birth weight infants were mainly associated with pregnancy-induced hypertension,infection,premature rupture of membranes.Factors that could affect the outcome of these cases included gestational age,sex,birth weight,pulmonary hemorrhage,bronchopulmonary dysplasia and necrotizing enterocolitis(P ＜0.05).The survival infants with long-term hospitalization often complicated with anemia.The top four causes of the death mostly were pulmonary hemorrhage,pneumonia,neonatal respiratory distress syndrome,and necrotizing enterocolitis.Conclusion In order to reduce the incidence of extremely premature infants and extremely low birth weight infants,improve the survival rate and infants quality of life,we should monitor the high-risk pregnant women closely during pregnancy period,prevent and treat all kinds of complications and prevent the occurrence of nosocomial infection.
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Objective To analyze the correlation of the mutations of exon 4 of pulmonary surfactant protein (SP)-B and SP-C with respiratory distress syndrome (RDS) in Mongolian premature infants. Methods Fifty cases of hospitalized genetically unrelated Mongolian premature infants with RDS ( 31 males, 19 females) were recruited as RDS group. In the same period, 50 cases ( 27 males, 23 females) of non RDS genetically unrelated premature infants of same ethnicity were choose as the control group. PCR and gene detection were used to detect exon 4 of SP-B and SP-C genes. The differences of the genovariation and genotype frequency of 1580 locus in exon 4 in SP-B, and of c. 571 C?>?A (T 138 N) locus in exon 4 in SP-C were compared between two groups. Results The genovariation of 1580 locus in exon 4 in SP-B was detected in 14 cases (with aberration rate of 28%) in RDS group and in 11 cases (with aberration rate of 22%) in control group, and the difference is not signiifcant between two groups (χ2=0 . 480 , P?>?0 . 05 ). The genotype frequency of CC, TT and CT gene in 1580 locus were 16%, 72%, and 12%respectively in RDS group;and 10%, 78%, and 12%respectively in control group. Meanwhile, the C and T gene frequency was 22% and 78% respectively in RDS group, and 16% and 84% in control group. There was no significant difference in genotype frequency between two groups (χ2=1 . 170 , P?>?0 . 05 ). The genovariation of c. 571 C?>?A (T 138 N) locus in exon 4 in SP-C was detected in 41 cases (with aberration rate of 82%) in RDS group and in 6 cases (with aberration rate of 12%) in control group, and the difference is signiifcant between the two groups (χ2=49 . 177 , P??A (T 138 N) locus were 18%, 50%, and 32%respectively in RDS group;and 88%, 8%, and 4%in control group. Meanwhile, the C and A gene frequency was 34%and 66%respectively in RDS group, and 90%and 10%in control group. There was a signiifcant difference in A gene frequency between the two groups (χ2=66 . 553 , P??A (T 138 N) locus in exon 4 in SP-C gene were in a higher risk of RDS. The mutation of 1580 locus in exon 4 in SP-B had no correlation with Mongolian premature RDS.
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Objective To study the association between the SP-B gene 1580 position polymorphisms and neonatal respiratory distress syndrome (NRDS) in the Mongol nationality from Inner Mongolia.To observe the frequency distribution of polymorphisms of SP-B gene 1580 position in the Mongol nationality newborns from Inner Mongolia.Methods The genotypes of SP-B gene 1580 position were detected by using polymerase chain reaction-restriction fragmnent length polymorphism assay and gene sequencing in 323 Mongol nationality newborns including the case group and the control group.The SP-B 1580C/T allele frequencies of the Mongol nationality newborns were compared with those of Han nationality from Wuhan city,German Caucasian,American Caucasian and Japanese.Results In the case group,the frequencies of TT,TC,CC at SP-B gene 1580 position were 19.9％,37.1％ and 43.0％,respectively;the frequency of the T allele was 38.4％ and C allele was 61.6％.In the control group,the frequencies of TT,TC,CC at SP-B gene 1580 position were 25.2％,39.7％ and 35.1％,respectively;the frequency of the T allele was 47.0％ and C allele was 53.0％.There were no significant differences between the case group and the control group (x2 =2.299,P =0.317).The allele frequencies of SP-B 1580 of the Mongol nationality newborns were significantly different from those of German-Caucasian and American-Caucasian (P ＜ 0.05),but were similar to those of Han nationality from Wuhan city and Japanese (P ＞ 0.05).Conclusions SP-B 1580C/T gene polymorphism in the Mongol nationality newborns displays no significant correlation with sex,birth weight or gestational age.There is no obvious correlation between SP-B gene 1580 position polymorphisms,allele frequency and the Mongol nationality NRDS.There is heterogeneity in the frequencies of polymorphisms of SP-B 1580 among different ethnic genes.
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Objective To study the correlation between the surfactant protein C ( SP-C) gene mutation in exon 5 area and respiratory distress syndrome(RDS) in premature infants. Methods From January 2013 to January 2015, nonconsanguineous premature infants [28 weeks ≤gestational age(GA) A heterozygous mutations were detected in 17 cases among 60 patients in the RDS group. The mutation frequency was 28. 3% . SP-C gene exon 5 region c. 715G > A heterozygous mutations were detected in 8 cases among 60 patients in the control group. The mutation frequency was 13. 3% . The mutation frequency in the RDS group was statistically significantly higher than the control group (χ2 = 4. 093,P =0. 043) . In RDS group, c. 715G > A heterozygous mutation had no significant correlation with RDS grades, oxygen therapy, pulmonary surfactant dose nor treatment outcome (P > 0. 05). Conclusions A correlation may be existed between SP-C gene exon 5 area c. 715G > A heterozygous mutation and RDS in premature infants.