ABSTRACT
Objective: The study aimed to analyse the detection rates of the triple-lumen double-balloon catheter technique and conventional esophagography in diagnosing H-type tracheoesophageal fistula (H-TEF) in neonates. Methods: The data of 8 neonates diagnosed with H-TEF by surgery in the researchers' hospital between January 2015 and January 2022 were collected. We compared the detection (true positive) rates of H-TEF by the triple-lumen double-balloon catheter technique, conventional esophagography, and multidetector row spiral CT. Results: Before surgery, conventional esophagography was applied in all 8 cases, of which the H-TEF diagnosis was confirmed in 5 cases and TEF was suspected in 3 cases. The triple-lumen double-balloon catheter technique was employed in 5 cases, of which 4 were confirmed with H-TEF and 1 was suspected with TEF. Multidetector row spiral CT was performed in 4 cases, and 1 case was confirmed with H-TEF, while no fistula was observed in the other 3 cases. The triple-lumen double-balloon catheter technique yielded a 100% detection rate, while conventional esophagography revealed a 62.5% rate and multidetector row spiral CT showed a 25% rate. By comparative analysis, the true positive rates (TPRs) of the triple-lumen double-balloon catheter technique and conventional esophagography were not significantly different (P=0.118). No significant differences were recorded in TPRs between conventional esophagography and multidetector row spiral CT (P=0.221). However, the triple-lumen double-balloon catheter technique had a significantly higher TPR than multidetector row spiral CT (P=0.118). Conclusion: To diagnose congenital H-TEF in neonates, conventional esophagography is a highly valuable yet inconsistently reliable method and the diagnostic value of CT is relatively limited. The triple-lumen double-balloon catheter technique boasts a significantly valuable application for H-TEF diagnosis. Being simple, economical, and effective, it barely requires state-of-the-art facilities, and no complications have occurred during its clinical practice. These advantages justify a possible wider application of the triple-lumen double-balloon catheter technique in clinical practice.
ABSTRACT
Neonatal hypoxic-ischemic encephalopathy (HIE) is a complex condition that remains the leading cause of mortality and morbidity among infants. Polysaccharide has been reported to possess diverse biological activities, however, the neuro-protective activity of polysaccharide isolated from Lycium ruthenicum remains unknown so far. However, the role of Lycium ruthenicum polysaccharide 3 (LRP3) in HIE has not been evaluated. Herein, we investigated the effect of LRP3 on oxygen-glucose deprivation/reoxygenation (OGD/R)-induced primary cortical neurons. Our results demonstrated that LRP3 significantly improved the cell viability of OGD/R-induced cortical neurons. The OGD/R-caused increase in ROS production and decrease in the activities of anti-oxidative enzymes including catalase (CAT), superoxide dismutase (SOD) and glutathione peroxidase (GPx) were mitigated by LRP3. Besides, the caspase-3 activity in OGD/R-induced cortical neurons was markedly decreased after LRP3 treatment. The increased bax expression and decreased bcl-2 expression caused by OGD/R stimulation were alleviated by pretreatment with LRP3. In addition, LRP3 significantly induced the expressions of nuclear factor erythroid 2-related factor (Nrf2) and heme oxygenase-1 (HO-1) in OGD/R-induced cortical neurons. However, inhibition of Nrf2/HO-1 signaling pathway through transfection with siRNA targeting Nrf2 reversed the protective effects of LRP3. In conclusion, LRP3 exerts a neuroprotective effect against OGD/R-induced neuronal injury in rat primary cortical neurons.