Accuracy of intrapartum cardiotocography in identifying acidemia at birth by umbilical cord blood gasometry in high-risk pregnancies

SUMMARY OBJECTIVE: The aim of this study was to evaluate the accuracy of intrapartum cardiotocography in identifying acidemia at birth by umbilical cord blood gasometry in high-risk pregnancies. METHODS: This was a retrospective cohort study of singleton high-risk parturients using intrapartum cardiotocography categories I, II, and III. The presence of fetal acidemia at birth was identified by the analysis of umbilical cord arterial blood pH (<7.1). Associations between variables were determined using the chi-square test and Kruskal-Wallis tests. RESULTS: We included 105 cases of cardiotocography category I, 20 cases of cardiotocography category II, and 10 cases of cardiotocography category III. cardiotocography category III had a higher prevalence of cesarean sections compared to cardiotocography category I (90.0 vs. 42.9%, p<0.006). Venous pH was higher in patients with cardiotocography category I compared to cardiotocography category III (7.32 vs. 7.23, p=0.036). Prevalence of neonatal intensive care unit (NICU) admission was lower in neonates of patients with cardiotocography category I compared to cardiotocography category III (3.8 vs. 30.0%, p=0.014). Prevalence of composite adverse outcomes was lower in neonates of patients with cardiotocography category I compared to cardiotocography category II (9.5 vs. 30.0%, p=0.022) and cardiotocography category III (9.5 vs. 60.0%, p=0.0004). cardiotocography categories II and III had low sensitivity (0.05 and 0.00, respectively) and high negative predictive value (NPV) (0.84 and 0.91, respectively) for identifying fetal acidemia at birth. The three categories of intrapartum cardiotocography showed high specificities (96.0, 99.0, and 99.0%, respectively). CONCLUSION: All three categories of intrapartum cardiotocography showed low sensitivity and high specificity for identifying acidemia at birth.

Accuracy of intrapartum cardiotocography in identifying fetal acidemia by umbilical cord blood analysis in low-risk pregnancies

SUMMARY OBJECTIVE: The aim of this study was to evaluate the accuracy of intrapartum cardiotocography in identifying fetal acidemia by umbilical cord blood analysis in low-risk pregnancies. METHODS: This is a retrospective cohort study of low-risk singleton pregnancies in labor after performing intrapartum cardiotocography categories I, II, and III. The presence of fetal acidemia at birth was identified by analyzing the pH of umbilical cord arterial blood (pH<7.1). RESULTS: No significant effect of the cardiotocography category on the arterial (p=0.543) and venous (p=0.770) pH of umbilical cord blood was observed. No significant association was observed between the cardiotocography category and the presence of fetal acidemia (p=0.706), 1-min Apgar score <7 (p=0.260), hospitalization in the neonatal intensive care unit (p=0.605), newborn death within the first 48 h, need for neonatal resuscitation (p=0.637), and adverse perinatal outcomes (p=0.373). Sensitivities of 62, 31, and 6.0%; positive predictive values of 11.0, 16.0, and 10.0%; and negative predictive values of 85, 89.0, and 87.0% were observed for cardiotocography categories I, II, and III, respectively. CONCLUSION: The three categories of intrapartum cardiotocography presented low sensitivities and high negative predictive values to identify fetal acidemia at birth in low-risk pregnancies.

Investigation on the incidence and risk factors of fetomaternal hemorrhage syndrome in pregnant women in Changsha / 中国输血杂志

【Objective】 To investigate the incidence and possible risk factors of FMH among pregnant women in Changsha. 【Methods】 A total of pregnant women (6~42 weeks of gestation) who underwent prenatal examinations in our hospital from June 2019 to December 2020 were enrolled as subjects. In this study, the modified Kleihauer-Betke (K-B) test was used for preliminary screening and flow cytometry was applied to confirme initially positive samples to evaluate the incidence of FMH and estimate fetal blood loss. The logistic regression analysis was used to study the risk factors of FMH. 【Results】 The incidence of FMH in pregnant women was 10.45% (183/1 752), the average volume of fetal blood loss was (2.50±3.87)mL, and 0.11% (2/1 752) of the fetal losed blood > 30 mL. Univariate analysis showed that age, twin pregnancy, pregnancy complicated with uterine fibroids, in vitro fertilization, fetal growth restriction, preeclampsia, and number of pregnancies may be risk factors for FMH. Multivariate analysis showed that twin pregnancy (OR 2.274, 95%CI: 1.135-4.458, P<0.05) and preeclampsia (OR 2.341, 95%CI: 1.082-4.837, P<0.05) were independent risk factors for FMH. 【Conclusion】 Maternal age and various physiological and pathological factors during pregnancy may be associated with the risk of FMH, especially twin pregnancy and pre-eclampsia are independent risk factors for FMH.

Células madre mesenquimatosas y sus diferentes usos / Mesenchymal stem cells and their different uses

Introducción: las células madre mesenquimatosas (CMM) se diferencian de diversos tipos celulares para la regeneración de tejidos, esta característica sumada con la versatilidad del antígeno leucocitario humano (HLA) representan una eficaz alternativa para el tratamiento de enfermedades con tejidos deteriorados. Se pueden obtener a partir de médula ósea, cordón umbilical (CU) y sangre fetal. Objetivo: analizar los tipos de diferenciación de las CMM, sus métodos de extracción y su relación con bancos de sangre de cordón umbilical (BSCU), a fin de demostrar la eficacia de las CMM, en patologías que impliquen alteración de algún tejido u órgano. Metodología: se revisaron varias publicaciones en español e inglés en Pubmed, Clinicalkey y Science Direct; desde 2013 hasta 2020. Se usaron los términos sangre fetal, células madre mesenquimatosas, trasplante de Células Madre de Sangre del Cordón Umbilical y bancos de sangre. Con dicha información se redactó un panorama amplio sobre las células mesenquimales y como estas participan en diversas áreas de la salud, con un énfasis importante en sus usos terapéuticos y lo referente a de donde provienen. Conclusión: a través de la pluripotencialidad de las CMM, se han podido emplear en múltiples patologías pues reestablece tejidos o líneas celulares exitosamente. Así mismo, los recursos para su obtención son claves en la tolerancia de los pacientes, por lo cual una gran opción para su obtención es el CU, que actualmente cuenta con bancos exclusivos para esto. (AU)

Introduction: mesenchymal stem cells (MSC) differentiate into multiple cell types for tissue regeneration, this characteristic added with the versatility of human leukocyte antigen (HLA) represent an effective alternative for the treatment of diseases with damaged tissues. They can be obtained from bone marrow, umbilical cord (UC), and fetal blood. Objetive: analyze the types of differentiation of MSC, their extraction methods and their relationship with umbilical cord blood banks (UCBB), in order to demonstrate the efficacy of MSC, in pathologies that involve alteration of a tissue or organ. Methodology: several publications in Spanish and English in Pubmed, Clinicalkey and Science Direct were reviewed; from 2013 to 2020. The terms fetal blood, mesenchymal stem cells, Umbilical Cord Blood Stem Cell transplantation and blood banks were used. With this information, a broad overview of mesenchymal cells and how they participate in various areas of health was drawn up, with an important emphasis on their therapeutic uses and where they come from. Conclusion: through the pluripotentiality of MSC, they have been used in multiple pathologies as it successfully re-establishes tissues or cell lines. Also, the resources for obtaining it are key in the tolerance of patients, which is why a great option for obtaining it is the UC, which currently has exclusive banks for this.

Effect of combined treatment with human umbilical cord blood mononuclear cells and human umbilical cord mesenchymal stem cells on liver function, inflammation grade, and immune function in patients with hepatitis B cirrhosis / 临床肝胆病杂志

ObjectiveTo retrospectively investigate the effect of combined treatment with human umbilical cord blood mononuclear cells (hUCB-MNCs) and human umbilical cord mesenchymal stem cells (hUC-MSCs) on liver function, inflammation grade, and immune function in patients with hepatitis B-related decompensated cirrhosis. Methods 11 patients with liver cirrhosis who were admitted to the Affiliated Hospital of Inner Mongolia Medical University from November 2016 to June 2019 were enrolled in this clinical study and were given infusion of hUCB-MNCs (＞18×109/time) once in the first week and infusion of hUC-MSCs (1×106/kg) once a week in the second, third, and fourth weeks. Reexamination was performed at 4, 8, and 12 weeks after treatment to compare the changes in liver function, blood ammonia, blood coagulation factors, serum levels of cytokines, and lymphocyte subsets after treatment, and the changes in neurological and psychiatric symptoms were observed and recorded. A one-way repeated-measures analysis of variance was used for comparison of continuous data between groups. ResultsAfter the combined treatment with hUCB-MNCs and hUC-MSCs, all 11 patients achieved certain improvements in psychiatric and neurological symptoms after infusion, and liver function parameters and blood coagulation function basically returned to normal (all P＜0.05). At 12 weeks after the combined infusion of cells, blood ammonia level returned to the normal level (P＜0.05), and there were significant reductions in the levels of the inflammatory cytokines interleukin-6 and tumor necrosis factor (F=49497 and 37.071, both P＜0.05) and significant increases in the levels of the anti-inflammatory cytokines transforming growth factor-β and interleukin-10 (F=35.843 and 15.918, both P＜005). There were also significant reductions in the percentages of the cytotoxic cells CD3+CD8+ T and CD19+ B cells (F=52.242 and 89.097, both P＜0.05) and a significant increase in the regulatory T cells CD4+CD25+ (F=17.337, P＜0.05). ConclusionCombined treatment with hUCB-MNCs and hUC-MSCs for liver cirrhosis can optimize liver function, reduce the production of inflammatory cytokines, alleviate liver inflammation and liver cell destruction, and increase regulatory T cells, thereby affecting the body’s immune function.

Association between cord blood IgE and toddler atopic diseases / 中华检验医学杂志

Objective To investigate the correlation between cord blood IgE level and allergic diseases (atopic dermatitis, food allergy, wheezing and allergic rhinitis) in 36 months old children and explore the susceptibility factors of allergy. Methods A cohort study was designed and Cord blood was collected during delivery of 779 women with full term, and the IgE level of the sample was detected by chemiluminescence immunoassay in Department of Laboratory Medicine, International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University School of Medicine between October 1, 2012 and May 31, 2014. 638 children were followed up at the age of 36 months. The incidence of atopic dermatitis, food allergy, wheezing and allergic rhinitis were investigated by questionnaire, and the relationship between cord blood IgE level and allergic diseases in children was analyzed by multiple logistic regression. Results A total of 638 pregnant women and children were included in this study. The age of pregnant women was (29.7± 3.3) years, and the IgE level in cord blood ranged from 0.1 to 8.43 IU/mL.In caesarean women, higher cord blood IgE was associated with increased risk of allergic dermatitis, wheezing and allergic rhinitis in children, OR=1.87, P<0.01;OR=1.86, P=0.01;OR=1.28, P=0.01;OR=1.98, P=0.01. Conclusion During cesarean section, the elevated IgE level of umbilical cord blood is correlated with the incidence of allergic diseases in children.

Efficacy analysis of haploidentical allogeneic hematopoietic stem cell transplantation combined with third-party umbilical cord blood infusion in treatment of high-risk lymphoblastic malignancies / 白血病·淋巴瘤

Objective To evaluate the efficacy of haploidentical allogeneic hematopoietic stem cell transplantation (Haplo-HSCT) combined with third-party umbilical cord blood (UCB) infusion in treatment of high-risk lymphoblastic malignancies. Methods The clinical data of 20 patients with high-risk lymphoblastic malignancies who received Haplo-HSCT from April 2012 to April 2015 in Shanghai General Hospital were retrospectively analyzed, which were compared with the data from 15 patients who underwent matched unrelated donor HSCT (MUD-HSCT) or 14 matched sibling donor HSCT (MSD-HSCT) during the same period. The efficacy of Haplo-HSCT combined with UCB infusion in treatment of high-risk lymphoblastic malignancies was evaluated. The preparative regimen mainly consisted of teniposide, cyclophosphamide and total body irradiation (TBI). Graft versus host disease (GVHD) preparative regimen included cyclosporine and a short term of methotrexate. The patients who received Haplo-HSCT combined with UCB infusion and MUD-HSCT were treated with antithymocyte globulin (ATG). Results After the transplantation, one patient in MUD-HSCT group and one in MSD-HSCT group died within 21 days, and other patients were engrafted successfully. The median time of neutrophil engraftment was 13 days (10-18 d), 12 days (9-16 d) and 12 days (9-14 d) in Haplo-HSCT + UCB group, MUD-HSCT group and MSD-HSCT group, respectively; the median time of platelets engraftment was 11 days (9-18 d), 12 days (10-23 d) and 12 days (9-14 d), respectively. There were 10, 3, 3 cases of grade Ⅱ-Ⅳacute GVHD at day 100 in the three groups, respectively, and there were 6, 4, 3 cases of chronic GVHD in the three groups, respectively. The 2-year cumulative incidence of relapse was 40.6%, 66.2% and 26.7%, respectively. The predicted 2-year overall survival rate was 37.9%, 42.9% and 55.4%, respectively. All these data had no significant difference (all P＞ 0.05). Conclusion The efficacy of Haplo-HSCT combined with UCB infusion is similar to that of MUD-HSCT or MSD-HSCT in treatment of high-risk lymphoblastic malignancies, which should be recommended to the patients with high-risk lymphoblastic malignancies and without matched donors.

The study of exposure levels of dioxin-like compounds in cord blood of newborns in an e-waste dismantling area in Guangdong Province / 中华预防医学杂志

Objective@#To study the pollution status of polybrominated diphenyl ethers (PBDEs), polychlorinated biphenyls (PCB), polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDD/Fs) in cord blood of newborns in an e-waste dismantling area of Guangdong Province.@*Methods@#We recruited 20 eligible mothers and newborns who could meet the inclusion criteria in local hospitals of Guiyu in 2007. The inclusion criteria included directly engaged in dismantling e-waste during pregnancy and within 1 year before pregnancy; living in the e-waste dismantling workshops or the distance between living place and the e-waste dismantling areas was ≤200 m; the father of newborn was directly engaged in electronic waste dismantling for more than 1 year; the frequency of visiting the e-waste dismantling workshop during pregnancy was ≥3 times in a week. Questionnaires and physical examinations were performed on maternal and neonatal, and cord blood was collected from newborns to detect PCDD/Fs, PCB and PBDE. The concentration level of organic pollutants was corrected by the blood lipid content, and the total toxicity equivalent was calculated. The correlation between three compounds was analyzed by Spearman correlation.@*Results@#The mothers of the 20 newborns were (23.45±3.27) years old and lived for more than 5 years. The number of one parent engaged in e-waste dismantling, the mother or father smoking, and parent engaged in e-waste dismantling work were 3, 13, 15 and 19, respectively. The weight of newborns ranged from 2.5 to 3.6 kilogram and the Apgar score was 10 points. No adverse birth outcomes such as preterm birth, malformation or stillbirth were found. The median (maximum, minimum) concentration of PCBs, PCDD/Fs and PBDEs in cord blood were 263.22 (328.29, 244.19), 38.42 (147.49, 12.68), 39.33 (265.11, 14.81) pg/g lipid, respectively. The median (maximum, minimum) of toxic equivalence concentrations of PCDD/Fs and PCB were 3.94 (9.24, 2.69) and 15.95 (26.64, 9.28) pg TEQ/g lipid. PBDE, the proportion of PBDE, PCB and PCDD/Fs in cord blood was 50.41%, 49.25% and 0.34%, respectively. PCBs and PBDEs were positively correlated (r=0.733, P=0.039).@*Conclusion@#The high concentrations of PCDD/Fs, PCB, and PBDE were detected in the e-waste dismantling area. It is recommended that the risk of such substances on the health of local people should be assessed in a timely manner.

Correlation between cord blood vitamin D level and recurrent respiratory tract infection in infants / 中国基层医药

Objective@#To investigate the correlation between cord blood vitamin D level and recurrent respiratory tract infection in infants.@*Methods@#From August 2014 to July 2015, 298 neonates in the Second Hospital of Jiaxing were selected in this study.The serum levels of 25-hydroxyvitamin D[25(OH)D] were measured by enzyme-linked immunosorbent assay(ELISA) in umbilical cord blood of neonates.The incidence of respiratory tract infection in infants was followed up.@*Results@#There were 53.1%(158/298) newborns with vitamin D deficiency(deficiency group), 24.8%(74/298) neonates with inadequate vitamin D(inadequate group), 22.1%(66/298) infants with adequate vitamin D(adequate group). The incidence rates of recurrent respiratory infections in vitamin D deficiency group, inadequate group and adequate group were 29.7%(47/158), 17.6%(13/74), 10.6%(7/66), respectively.The incidence of recurrent respiratory tract infection among the three groups was statistically significantly different(χ2=11.114, P=0.01).@*Conclusion@#Vitamin D nutrition level of neonates has a significant correlation with infants with respiratory tract infection, especially lower respiratory tract infection.Therefore, it is necessary to pay attention to the supplement and detection of vitamin D during pregnancy, so as to reduce the incidence of infant respiratory diseases in the region.

Association between cord blood IgE and toddler atopic diseases / 中华检验医学杂志

Objective@#To investigate the correlation between cord blood IgE level and allergic diseases (atopic dermatitis, food allergy, wheezing and allergic rhinitis) in 36 months old children and explore the susceptibility factors of allergy.@*Methods@#A cohort study was designed and Cord blood was collected during delivery of 779 women with full term, and the IgE level of the sample was detected by chemiluminescence immunoassay in Department of Laboratory Medicine, International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University School of Medicine between October 1, 2012 and May 31, 2014. 638 children were followed up at the age of 36 months. The incidence of atopic dermatitis, food allergy, wheezing and allergic rhinitis were investigated by questionnaire, and the relationship between cord blood IgE level and allergic diseases in children was analyzed by multiple logistic regression.@*Results@#A total of 638 pregnant women and children were included in this study. The age of pregnant women was (29.7±3.3) years, and the IgE level in cord blood ranged from 0.1 to 8.43 IU/mL.In caesarean women, higher cord blood IgE was associated with increased risk of allergic dermatitis, wheezing and allergic rhinitis in children, OR=1.87, P<0.01; OR=1.86, P=0.01; OR=1.28, P=0.01; OR=1.98, P=0.01.@*Conclusion@#During cesarean section, the elevated IgE level of umbilical cord blood is correlated with the incidence of allergic diseases in children.

Prenatal Exposure to Lead and Chromium is Associated with IL-13 Levels in Umbilical Cord Blood and Severity of Atopic Dermatitis: COCOA Study

There have been few studies investigating the association between atopic dermatitis (AD) and prenatal exposure to heavy metals. We aimed to evaluate whether prenatal exposure to heavy metals is associated with the development or severity of AD in a birth cohort study. A total of 331 subjects were followed from birth for a median duration of 60.0 months. The presence and severity of AD were evaluated at ages 6 and 12 months, and regularly once a year thereafter. The concentrations of lead, mercury, chromium, and cadmium in umbilical cord blood were measured by inductively coupled plasma mass spectrometry. Cord blood mononuclear cells (CBMCs) were isolated and stimulated for analysis of cytokine production using ELISA. Heavy metal levels in cord blood were not associated with the development of AD until 24 months of age. However, a positive correlation was observed between the duration of AD and lead levels in cord blood (p=0.002). AD severity was also positively associated with chromium concentrations in cord blood (p=0.037), while cord blood levels of lead, mercury, and cadmium were not significantly associated with AD severity (p=0.562, p=0.054, and p=0.055, respectively). Interleukin-13 production in CBMCs was positively related with lead and chromium levels in cord blood (p=0.021 and p=0.015, respectively). Prenatal exposure to lead and chromium is associated with the persistence and severity of AD, and the immune reaction toward a Th2 polarization.

The Predictive value of umbilical cord blood regulatory T cells for bronchopulmonary dysplasia in preterm infants / 中国新生儿科杂志

Objective To study the predictive value of umbilical cord blood regulatory T cells (Treg) for bronchopulmonary dysplasia (BPD) in preterm infants. Method From June 2017 to December 2018, premature infants with gestational age less than 32 weeks admitted to NICU of our hospiatal were prospectively selected. The umbilical cord blood was collected at birth to examine the Treg amount. The infants were assigned into BPD group and non-BPD group according to the diagnosis at discharge. The differences of Treg amount between the two groups and different degrees of BPD were analysed. Result A total of 124 premature infants (GA<32 weeks) were admitted, including 41 cases in BPD group (mild, n=18;moderate, n=14; severe, n=9) and 83 cases in the non-BPD group. The BPD group had GA of (29.6 ± 1.1) weeks and birth weight (BW) of (1128 ± 135) g. The non-BPD group had GA of (29.8 ± 1.1) weeks and BW of (1316 ± 180) g. The birth weight, 1min and 5min Apgar scores in BPD group were lower than the non-BPD group (P<0.001). The BPD group had higher incidence of respiratory distress syndrome, longer duration of mechanical ventilation (MV) and oxygen inhalation(P<0.001) than the non-BPD group. The MV duration and oxygen inhalation duration in the severe BPD group were significantly longer than the moderate and mild BPD groups, and the duration in the moderate group was longer than the mild group (P<0.001). The number of Treg in cord blood in the BPD group [(1.43 ± 0.06) × 105 cells/ml] was significantly lower than the non-BPD group [(2.57 ± 0.09) × 105 cells/ml], and the difference was statistically significant (P<0.001). Multivariate Logistic regression analysis showed that a significant decrease in the number of Treg was a risk factor for BPD in premature infants (OR=0.000, 95％CI 0.000 ～ 0.012, P=0.009). The number of Treg in umbilical cord blood was negatively correlated with the severity of BPD. The area under the ROC curve showed that the cut-off value was 1.95 × 105 cells/ml, with Youden index 0.613, sensitivity 85.4％ and specificity 75.9％. Conclusion The number of cord blood Treg cells may be a useful biomarker for predicting BPD in premature infants.

Técnica quirúrgica vascular integral avanzada (VIVA) aplicada en pacientes con placenta previa anormalmente adherida con feto in situ / Advanced integral vascular surgical technique (AIVS) applied in patients with placenta previa adhered abnormally with in situ fetus

Resumen OBJETIVO: Describir la técnica quirúrgica vascular integral avanzada (VIVA) aplicada en pacientes con placenta previa anormalmente adherida, con feto in situ. MATERIALES Y MÉTODOS: Estudio prospectivo y descriptivo de serie de casos efectuado en pacientes atendidas en el Hospital de Especialidades del Niño y la Mujer de Querétaro, y en el Hospital Materno Celaya, entre enero y junio de 2017, con placenta previa anormalmente adherida en quienes se practicó la técnica quirúrgica vascular integral avanzada. Los datos se analizaron con estadística descriptiva y medidas de tendencia central. Parámetros de estudio: edad materna, edad gestacional al momento de la interrupción del embarazo, tiempo y sangrado quirúrgico estimado, concentración de hemoglobina y hematocrito pre y posquirúrgicos; pacientes que requirieron "biocirugía", ingreso a unidad de cuidados intensivos obstétricos y tiempo de estancia intrahospitalaria. Variables perinatales: Capurro al nacimiento, peso del neonato, calificación de Apgar y gasometría del cordón umbilical. RESULTADOS: Se registraron 16 pacientes, todas se intervinieron en un solo procedimiento quirúrgico, sin necesidad de reintervención, con sangrado quirúrgico promedio objetivado con hemoglobina pre y posquirúrgica, sin indicación de ingreso a la unidad de cuidados intensivos obstétricos, con adecuada evolución posquirúrgica y sin morbilidad neonatal asociada. CONCLUSIÓN: La técnica quirúrgica vascular integral avanzada (VIVA) es un procedimiento seguro, accesible, asequible y disponible; debe integrarse un equipo médico-quirúrgico adecuadamente organizado.

Abstract OBJECTIVE: To describe the advanced integral vascular surgical technique (AIVS) applied in patients with placenta previa adhered abnormally with in situ fetus. MATERIALS AND METHODS: Prospective and descriptive study presenting a series of cases, carried out in patients with abnormally attached placenta previa to whom the advanced integral vascular surgical technique was applied, attended at the Hospital of Specialties of the Child and the Woman of Querétaro, and Hospital Maternal Celaya, between January and June 2017. Using descriptive statistics of central tendency, maternal variables were analyzed such as: maternal age, gestational age at the time of the interruption of the obstetric event, time and estimated surgical bleeding, hemoglobin concentration and pre and post hematocrit postsurgical patients who required "biosurgery", admission to obstetric intensive care unit and intrahospital stay; perinatal variables: Capurro at birth, neonatal weight, Apgar score and umbilical cord blood gas. RESULTS: 16 patients were registered. All the patients were operated on in a single surgical event, with no need for reoperation, with average surgical bleeding objectified with pre- and postoperative hemoglobin, without indication of admission to the Obstetric Intensive Care Unit, with adequate postoperative evolution and perinatal outcomes without associated neonatal morbidity. CONCLUSION: The advanced integral vascular surgical technique (AIVS) is a safe, accessible, affordable and available technique, having to integrate a properly organized medical surgical team.

Extensive screening and study of deafness genes from the newborn cord blood / 中国新生儿科杂志

Objective To study the mutation rate of hereditary deafness genes found in the newborn babies and to explore the feasibility of routine screening of congenital deafness for the newborns.Method The cord blood were taken to tcst four common deafness genes using gene chip technology in newborn infants born in our Hospital from May 2015 to May 2017 and screening of hearing was performed 48 hours after birth.x2 test was used to analyze the results of gene screening and the hearing screening data obtained after 42 days.Result A total of 2 615 newborns were enrolled in the study and 2 455 cases passed the hearing screening test 48 hours after birth (the passing rate was 93.9％).143 cases passed the hearing screening after 42 days with the passing rate of 99.3％.The mutation of deafness gene from the newborn's cord blood was detected in 107 cases with the rate of 4.1％.96 of 107 infants with deafness gene mutations passed the hearing screening (89.7％).While in infants without this mutation,2 502 cases passed the hearing screening (99.8％,2 502/2 508).The rate of hearing defects in children with deafness gene mutation was significantly higher than those without this gene mutation,and the difference was statistically significant (x2 =160.199,P ＜0.001).Of the 107 cases,the most common mutation was GJB2 (49 cases,45.8％),followed by SLC26A4 (37 cases,34.6％) and mtDNA 12SrRNA (13 cases,12.1％),while the GJB3 was the least (8 cases,7.5％).6 cases were diagnosed the neonate hearing loss at 3 months in 17 newborns who failed to pass repeat screening test 42 days after birth.Among them,hearing loss was caused by the mutation in 5 cases.Conclusion The main mutated genes in children with deafness were GJB2 and SLC26A4 in this study.The combination of hearing screening of newborns and gene test is clinically feasible.The deafness genes in the normal hearing carriers can be detected in time.It is of great advantage for early intervention and treament of the infants early.

Application of intravenous umbilical cord blood mononuclear cells in treatment of end stage heart failure / 中华老年心脑血管病杂志

Objective To assess the safety and efficacy of intravenous umbilical cord blood mononuclear cells in treatment of end stage heart failure (HF).Methods Twenty-one end stage HF patients with cardiac function Ⅳaccording to NYHA were treated with intravenous umbilical cord blood mononuclear cells.Their cardiac function was assessed,their NT-proBNP,LVEF,LVEDD were measured before and after treatment for 1 month,3 months and 6 months.Results Umbilical cord blood mononuclear cells were effective for 20 patients and ineffective for 1 patient who died within 30 days after treatment.The rate of improved cardiac function Ⅱ and Ⅲ was significantly higher while the serum NT-proBNP level was significantly lower after treatment for 1 month and 3 months (90.5％,95.2％ vs 0％,P＜0.05;3045.3±103.8 ng/L,3367.5±111.4 ng/L vs 5312.1±121.9 ng/L,P＜0.05).Conclusion Intravenous umbilical cord blood mononuclear cells are safe for end stage HF patients,alleviate their symptoms,improve their cardiac function and quality of life with no significant side effect.

Epidemiological study of antibody to pertussis toxin IgG in newborns in Shunyi District of Beijing in 2016 / 中华围产医学杂志

Objective To investigate the levels of antibody to pertussis toxin (PT) IgG in newborns in Shunyi Women and Children's Hospital of Beijing Children's Hospital in 2016.Methods A total of 419 newborns were enrolled in this study.Umbilical cord blood sample was collected from each subject and detected by enzyme-linked immunosorbent assay to measure the concentration of PT-IgG.Besides,all newborns were followed up to January 31,2017.Chi-square test was used for statistical analysis.Results The detectable rate of umbilical cord blood samples for PT-IgG accounted for 30.1％ (126/419).The median antibody level was ＜ 5 U/ml,and the 90th and the 95th percentile were 14.3 and 24.0 U/ml,respectively.No cases of pertussis occurred at the end of follow-up.Conclusions The newborns born in Shunyi Women and Children's Hospital of Beijing Children's Hospital are generally lack of protective PT antibody.

Umbilical cord blood pluripotent stem cell immune education treatment for juvenile type 1 diabetes / 中国医师杂志

Type 1 diabetes is a autoimmune disease that occurs under the influence of both genetic predisposition and environmental factors,mediated mainly by T lymphocytes with various kinds of other involved immune cells.The autoimmune attacks eventually lead to the islet beta cell destruction and insulin insufficiency.Multiple fundamental studies and clinical trials have revealed that umbilical cord blood pluripotent stem cells have the potential to help restore immune balance,induce immune tolerance,stop the autoimmune attacks against beta cells,and promote beta cell regeneration in type 1 diabetes mellitus (T1DM),by means of cell to cell contact and soluble cytokine secretion.For the past few years,the National Clinical Research Center for Metabolic Diseases of Second Xiangya Hospital has been leading the research on stem cell education therapy and has performed the therapy for 35 juvenile type 1 diabetes patients from China and foreign countries,introducing a novel treatment for T1DM.

Evaluación de umbrales mínimos de celularidad en unidades de sangre de cordon umbilical en el Instituto Nacional Materno Perinatal del Perú / Evaluation of minimum thresholds of cellularity in units of umbilical cord blood at Instituto Nacional Materno Perinatal in Peru

RESUMEN Con el objetivo de evaluar criterios mínimos de celularidad de las unidades de sangre de cordón umbilical (USCU) según los estándares NETCORD en el Instituto Nacional Materno Perinatal de Lima, Perú, se realizó un estudio transversal que incluyó 100 USCU; se determinó el volumen, el recuento de células nucleadas totales (CNT) por hematología y el número de células CD34+ totales, así como también la viabilidad celular, por citometría de flujo. Se encontró que el 56% de las USCU no cumplen los umbrales mínimos de celularidad para ser criopreservadas en un banco de sangre de cordón umbilical. Se encontró, además, que las USCU de recién nacidos de mayor peso y de sexo femenino presentan mayor volumen y recuentos de células. En conclusión, es necesario considerar estas variables para optimizar la colecta de las USCU y obtener mayores recuentos de células que permita almacenar unidades de alta calidad en un futuro banco de sangre de cordón umbilical en Perú.

ABSTRACT A cross-sectional study that included 100 units of umbilical cord blood (UCB) was conducted to evaluate the minimum criteria of cellularity in UCB units, according to NetCord standards at Instituto Nacional Materno Perinatal in Lima, Peru. The volume, total count of nucleated cells by hematological tests and total number of CD34+ as well as cell viability by flow cytometry were determined. The study revealed that 56% of UCB units do not fulfill the minimum criteria of cellularity to be cryopreserved in an umbilical cord blood bank. Furthermore, the UCB units of newborns who weighed more and were female had a higher volume and cell count. In conclusion, these variables must undoubtedly be considered to optimize the collection of UCB units and obtain greater cell counts that enable the storage of high-quality units in a future umbilical cord blood bank in Peru.

Insulin and glucagon levels of umbilical cord blood in appropriate for gestational age - preterm infants with or without postnatal hypoglycemia

PURPOSE: To determine whether serum insulin and glucagon levels of umbilical cord blood correlate with subsequent postnatal hypoglycemia in appropriate for gestational age (AGA) - preterm infants at different gestational ages (GAs). METHODS: The serum insulin and glucagon levels of umbilical cord blood were measured using magnetic bead based multiplex immunoassay in 69 AGA - premature infants, stratified according to GA: GA 23-30 weeks, early preterm (EP, n=31); GA 31-34 weeks, late preterm (LP, n=38). Postnatal hypoglycemia was defined as a capillary glucose level <40 mg/dL within the first 60 minutes of life, regardless of GA. RESULTS: The capillary glucose concentration in EP infants (65.5±21.2 mg/dL) was significantly higher than that of LP infants (55.9±17.3 mg/dL) (P=0.043). The serum glucagon level in EP infants (44.3±28.7 pg/mL) was significantly higher than that in LP infants (28.1±13.6 pg/mL) (P=0.006). There was not a significant difference in serum insulin level between EP and LP infants (372.7±254.2 pg/mL vs. 372.4±209.1 pg/mL, P=0.996). There was a significant difference in the serum glucagon level between infants with and without hypoglycemia (27.7±8.9 mg/dL vs. 36.8±24.6 mg/dL, P=0.036), but not in the serum insulin level (451.9±256.9 pg/mL vs. 357.4±222.2 pg/mL, P=0.211). Postnatal glucose concentration within the first 60 minutes of life had a significant positive correlation with serum glucagon levels (r=0.256, P=0.034), but not with serum insulin levels (r=-0.020, P=0.867). CONCLUSION: Lower glucagon levels of cord blood were seen in premature infants with higher GA, which might contribute to the occurrence of postnatal hypoglycemia.

Insulin and glucagon levels of umbilical cord blood in appropriate for gestational age - preterm infants with or without postnatal hypoglycemia

PURPOSE: To determine whether serum insulin and glucagon levels of umbilical cord blood correlate with subsequent postnatal hypoglycemia in appropriate for gestational age (AGA) - preterm infants at different gestational ages (GAs). METHODS: The serum insulin and glucagon levels of umbilical cord blood were measured using magnetic bead based multiplex immunoassay in 69 AGA - premature infants, stratified according to GA: GA 23-30 weeks, early preterm (EP, n=31); GA 31-34 weeks, late preterm (LP, n=38). Postnatal hypoglycemia was defined as a capillary glucose level <40 mg/dL within the first 60 minutes of life, regardless of GA. RESULTS: The capillary glucose concentration in EP infants (65.5±21.2 mg/dL) was significantly higher than that of LP infants (55.9±17.3 mg/dL) (P=0.043). The serum glucagon level in EP infants (44.3±28.7 pg/mL) was significantly higher than that in LP infants (28.1±13.6 pg/mL) (P=0.006). There was not a significant difference in serum insulin level between EP and LP infants (372.7±254.2 pg/mL vs. 372.4±209.1 pg/mL, P=0.996). There was a significant difference in the serum glucagon level between infants with and without hypoglycemia (27.7±8.9 mg/dL vs. 36.8±24.6 mg/dL, P=0.036), but not in the serum insulin level (451.9±256.9 pg/mL vs. 357.4±222.2 pg/mL, P=0.211). Postnatal glucose concentration within the first 60 minutes of life had a significant positive correlation with serum glucagon levels (r=0.256, P=0.034), but not with serum insulin levels (r=-0.020, P=0.867). CONCLUSION: Lower glucagon levels of cord blood were seen in premature infants with higher GA, which might contribute to the occurrence of postnatal hypoglycemia.