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Objective:To study the clinical characteristics of neonatal leukemoid reaction (NLR).Methods:The newborns with NLR admitted to the neonatal intensive care unit of the Seventh Medical Center of PLA General Hospital from September 2010 to January 2022 were selected as the observation group, and the newborns without NLR, who were admitted to the Hospital at the same time and matched with gestational age and birth weight of the NLR newborns were selected as the control group at a ratio of 1∶2. The gestational age, birth weight, maternal complications, maximum leukocyte count, percentage of neutrophils, C-reactive protein, hemoglobin, platelet count, disease diagnosis and other relevant information of the newborns were recorded, and SPSS 21.0 statistical software was applied to compare the data of the two groups of newborns.Results:A total of 36 cases were in the observation group and 72 cases in the control group. Naive granulocytes were found in the peripheral blood of all patients in the observation group, and leukocyte count was higher than that of the control group [61.7 (54.2, 90.6)×10 9/L vs. 19.6 (14.2,27.3)×10 9/L], the difference was statistically significant ( P<0.001), but there was no statistically significant difference in the percentage of neutrophils, hemoglobin, platelets, and C-reactive protein between the two groups ( P>0.05). The proportion of vaginal delivery, meconium-stained amniotic fluid, and neonatal sepsis in the observation group were higher than that in the control group [69.4% (25/36) vs. 38.9% (28/72), 19.4% (7/36) vs. 5.6% (4/72), 47.2% (17/36) vs. 8.3% (6/72)], and the proportion of gestational diabetes mellitus, gestational hypertension and prenatal use of glucocorticoid was lower than that in the control group, with statistical significance ( P<0.05). There was no significant difference in the incidence of premature rupture of membranes, neonatal asphyxia, intracranial hemorrhage, pulmonary hemorrhage, bacterial meningitis, and bronchopulmonary dysplasia between the two groups ( P>0.05). Conclusions:Newborns with NLR are frequently complicated with sepsis. Early prevention and treatment of maternal comorbidities and active control of infection are important for the prevention and treatment of NLR.
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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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Objective The aim of present study was to detect methylation rate of CpG unit of brain derived neurotrophic factor (BDNF) promoter and to study the epigenetic mechanism of autism spectrum disorders (ASD).Methods Total of 12 ASD patients and 12 healthy controls were recruited.The methylation rate of CpG unit in BDNF promoter Ⅰ and Ⅳ were detected using Sequenom MassArray method.The methylation model,correlationship,evolutionary relationship of CpG units in BDNF promoter Ⅰ and Ⅳ were detected and compared between ASD patients and healthy controls.Results The methylation rate was identified in 17 and 8 CpG units in BDNF promoter][and BDNF promoter Ⅳ.A close correlation distance was detected in BDNF promoter Ⅰ CpG units 4,7,10,35,and BDNF promoter Ⅳ CpG units 11.12,14.BDNF promoter][CpG units 4,7,10,35,and BDNF promoter Ⅳ CpG units 11.12,14 could be clustered.ASD patients had a significant lower methylation rate in BDNF promoter Ⅰ CpG unit 5.6 and Ⅳ CpG units 3 and 15 compare with healthy controls (P＜0.05).Conclusions The DNA methylation rate in BDNF pronoter Ⅰ CpG unit 5.6 and Ⅳ CpG units 3 and 15 may be used as potential biomarkers of ASD.