Risk factors and outcomes of acute kidney injury in ventilated newborns.

Purpose: This study aimed to investigate the occurrence and risk factors of acute kidney injury (AKI) in ventilated newborns.Methods: In total, 139 newborns receiving mechanical ventilation (MV) were reviewed in this retrospective study. The demographic and clinical data were collected. Then, the independent risk factors for AKI were evaluated using univariate and multivariate logistic regression analyses.Results: The incidence rate of AKI was 15.11% (21/139) in ventilated newborns. Univariate analysis showed significant differences in gestational age, birth weight, Apagar scores, the highest oxygen concentration, serum creatinine levels at admission and 48 h after MV, history of asphyxia, urine output at 48 h after MV, invasive MV, noninvasive MV, and outcomes between AKI and non-AKI groups (all p < .05). The lower gestational age (odd ratio (OR): 1.194, 95% confidence interval (CI): 1.013-1.407, p = .035), the increased use of invasive mechanical ventilation (IMV) (OR: 4.790, 95% CI: 1.115-20.575, p = .035), and lower birth weight (OR: 0.377, 95% CI: 0.178-0.801, p = .011) were independent risk factors for the occurrence of AKI. Additionally, higher stage of AKI was significantly associated with poor prognosis of AKI (p = .018).Conclusion: In this retrospective study, it was found that lower gestational age, birth weight, and increased use of IMV were independent risk factors for AKI in ventilated newborns. The poor prognosis might be indicated by the higher AKI stage.

[Influence of electroacupuncture stimulation of delivery-facilitating acupoints with different stimulating parameters on serum endocrine hormones of late-stage pregnant rats].

OBJECTIVE: To observe the influence of electroacupuncture (EA) stimulation of "Hegu" (LI 4) and "Sanyinjiao"(SP 6; a classical delivery-facilitating acupoint recipe) at different parameters on endocrine hormone levels of late-stage pregnant rats, so as to find the better stimulation parameters for delivery facilitation. METHODS: Ninety-six female Wistar rats were randomly divided into eight groups: normal control (normal), pregnancy (model), EA-15 Hz, EA-30 Hz, EA-50 Hz, EA-2 Hz/ 15 Hz, EA-2 Hz/30 Hz and EA-2 Hz/50 Hz, with 12 rats in each group except EA-30 Hz group (n = 10). EA stimulation (0.2 to 0. 3 mA) was delivered to bilateral LI 4 for 20 min and then bilateral SP 6 for 5 min (25 min). The contents of serum estradiol (E2), progesterone (P) and prostaglandin E2 (PGE2) were detected by ELISA. RESULTS: Compared with the normal group, serum E2, P and PGE2 contents were significantly increased in the pregnancy model group (P<0.01), and E2/ P level was downregulated mildly (P>0.05). Compared with the model group, the contents of serum E2 in the EA-15 Hz, EA-30 Hz, EA-50 Hz, EA-2 Hz/15 Hz and EA-2 Hz/50 Hz groups, serum PGE2 contents in the EA-15 Hz, EA-30 Hz and EA-2 Hz/50 Hz groups, and E2/P levels in the EA-15 Hz, EA-30 Hz, EA-50 Hz and EA-2 Hz/50 Hz groups were significantly increased (P<0.01, P<0.05), whereas serum P contents in the EA-15 Hz, EA-30 Hz, EA-50 Hz and EA-2 Hz/50 Hz groups were significantly down-regulated (P<0. 01, P<0. 05). The effects of EA-2 Hz/50 Hz group were significantly superior to those of EA-2 Hz/15 Hz and EA-2 Hz/ 30 Hz groups in raising serum E2 and E2/P levels (P<0.05, P<0.01). No significant differences were found among the EA-15 Hz, EA-30 Hz, EA-50 Hz and EA-2 Hz/50 Hz groups in raising serum E2, PGE2 and E2/P levels, and among the EA-30 Hz, EA-50 Hz and EA-2 Hz/50 Hz groups in lowering serum P levels (P>0. 05). It displayed that the effects of EA at 15 Hz, 30 Hz and 2 Hz/50 Hz on the abovementioned 4 indexes were relatively better. CONCLUSION: EA of LI 4 and SP 6 at 15 Hz, 30 Hz and 2 Hz/ 50 Hz can effectively up-regulate serum E2, PGE2 and E2/P levels and down-regulate serum P content in pregnancy rats, which may contribute to its effect in promoting labor.

[Effect of the optimized traditional acupuncture prescription for accouchement on cervical ripening in late-stage pregnant rats].

OBJECTIVE: To observe the mechanism of the optimized traditional acupuncture prescription for accouchement on cervical ripening based on the molecular biology by observing related indices of cervical ripening in late-stage pregnant rats. METHODS: Twenty initial pregnant Wistar rats were randomly divided into an electroacupuncture (EA) group (n = 10) and a model group (n = 10), and other 10 non-pregnancy female rats with same lot were selected as a blank control group. EA group was treated with the optimized traditional acupuncture prescription for accouchement on the 20th day of pregnant, which performed EA at bilateral "Hegu" (LI 4) for 20 min and then at bilateral "Sanyinjiao" (SP 6) for 5 min with 2 Hz/50 Hz sparse-dense wave, while the other groups without acupuncture intervention. The contents of matrix metalloproteinase 9 (MMP-9) and interleukin 8 (IL-8) in cervix tissue were detected by ELISA method. RESULTS: Compared with the blank control group, the contents of MMP-9 and IL-8 in the model group were increased significantly (both P < 0.01). Compared with the model group, the contents of MMP-9 and IL-8 in the EA group were increased significantly (P < or = 0.05). CONCLUSION: Optimized traditional acupuncture prescription for accouchement can increase the contents of MMP-9 and IL-8 in cervix tissue of late-stage pregnant rats so as to promote cervical ripening, and the mechanism of EA in promoting cervical ripening is explained from the perspective of molecular biology.

[Clinical observation on penetration needling combined with electroacupuncture for treatment of post-stroke shoulder-hand syndrome].

OBJECTIVE: To probe a method for increasing clinical therapeutic effect of poststroke shoulder-hand syndrome. METHODS: Eighty cases of poststroke shoulder-hand syndrome were randomly divided into a treatment group and a control group, 40 cases in each group. The treatment group were treated by penetration needling combined with electroacupuncture, and the control group with routine acupuncture combined with electroacupuncture, once daily, 5 sessions each week, for 4 weeks. Changes of clinical symptoms, articular mobility and pain score were observed. RESULTS: The therapeutic effect in the treatment group was significantly better than that in the control group (P < 0.05). CONCLUSION: Penetration needling combined with electroacupuncture, or routine acupuncture combined with electroacupuncture can effectively alleviate pain, improve motion function and reduce edema, but the penetration needling is better than the routine acupuncture for treatment of poststroke shoulder-hand syndrome.