Humans ; Infant, Newborn ; Mastocytosis, Cutaneous

Objective To assess the role of glutamine in the prevention of necrotiziting enterocolitis (NEC) in preterm infants. Methods Two thousand seven hundred and seventeen preterm infants hospitalized in our NICU from Oct 2007 to Mar 2010 were assigned in either receiving prophylactic use of glutamine (prevention group, n = 1389) or without glutamine supplementation(control group, n = 1328). The incidence of NEC was compared between the two groups. Results There were no significant differences in sex,gestation age, birth weight, neonatal asphyxia, pneumonia, septicemia and cerebral hemorrhage between the two groups (P ＞ 0. 05). Sixty-eight infants occurred NEC in the control group(5. 12%) ,but only 35 infants occurred NEC in the prevention group(2. 52%) (x2 = 12. 590,P ＜0. 01). Conclusion The prophylactic use of glutamine may reduce the incidence of NEC in preterm infants.

Objective To investigate the clinical efficacy and safety of caffeine citrate in the treat-ment of primary apnea in premature infants. Methods A non-randomized controlled trial had been designed in which 96 premature infants would be enrolled form Oct 2013 to Sep 2014 in our hospital. According to the therapeutic strategy,the patients were divided into treatment group(n=51) and control group(n=45). The treatment group was treated with caffeine citrate,and the control group was treated with placebo. The overall response rates and the complication rates in the two groups were compared. Results The effective rate of the treatment group was 80. 4%(41/51),while the control group was 51. 1%(23/45). There was a significant difference between the two groups(χ2 =9. 224,P =0. 002). The incidence of bronchopulmonary dysplasia (7 cases vs. 14 cases),patent ductus arteriosus(7 cases vs. 15 cases),retinopathy of prematurity(4 cases vs. 10 cases),intraventricular hemorrhage(9 cases vs. 20 cases),showed significant differences between the two groups( P<0. 05 ) . Conclusion Caffeine citrate is significantly more effective than placebo in reducing apnea episodes and reduces the rate of bronchopulmonary dysplasia, patent ductus arteriosus, retinopathy of prematurity and intraventricular hemorrhage in premature infants.

Objective To evaluate the effects of inhaled nitric oxide(iNO)combined with oral sil-denafil therapy in the newborn infants with persistent pulmonary hypertension(PPHN).Methods Forty-six neonates with PPHN were devided into group A(n ﹦23)and group B(n ﹦23).The combined treatment of iNO and oral sildenafil was used in group A,and iNO was used in group B.During the therapy,the following factors were monitored:blood gas analysis,systolic blood pressure(SBP),systolic pulmonary artery pressure (SPAP),inspired oxygen fraction (FiO2 ),iNO concentration,iNO duration,ventilation time and hospital stay.The effective rate,mortality and the risk of pneumothorax,intraventricular hemorrhage,pulmonary hem-orrhage,bronchopulmonary dysplasia were compared between the two groups.All patients were treated in the same neonatal unit and received the same standard therapy throughout the study period.Results The effec-tive rates of group A and group B were 87.0%(20 /23)and 78.3%(18 /23)respectively.There was no sig-nificant difference between the two groups(χ2 ﹦0.15,P 〉0.05).The levels of SPAP/SBP decreased signifi-cantly,and the levels of PaO2 /FiO2 rised significantly at baseline 30 min,6 h and after the treatment.But there were no significant differences between the two groups(P 〉0.05).In group A,the iNO concentration stared at ≥15 ×10 -6 for 14 infants,〉15 ×10 -6 for 6 infants,which were lower than those in the group B (χ2 ﹦6.71 ,P 〈0.05).The iNO would be stopped when the concentration reached 40 ×10 -6 without any sign of improvement.Compared to group B,the duration of iNO[(57.3 ±27.8)h vs.(87.7 ±47.0)h],the ven-tilation time[(94.44 ±31 .88)h vs.(123.20 ±47.43)h],and the time of hospital stay[(14.55 ±3.19)d vs.(18.78 ±4.60)d]in group A were shorter(P 〈0.05),whereas the mortality and the incidence of pneu-mothorax,intraventricular hemorrhage,pulmonary hemorrhage and bronchopulmonary dysplasia had not sig-nificantly differences between the two groups.Conclusion The effects of iNO combined with oral sildenafil in the newborn infants with PPHN was same compared to iNO.But it can effectively reduced the iNO concen-tration and shorten the duration of iNO,the ventilation time and the hospital stay without augmentation of risk of mortality,pneumothorax,intraventricular hemorrhage,pulmonary hemorrhage,bronchopulmonary dysplasia in neonatal patients.

Objective To explore the clinical characteristics of neonatal group B streptococcal sepsis (GBS)sepsis in order to provide the guide for early diagnosis and appropriate treatment.Methods A retro-spective review was performed and a total of 33cases of neonatal GBS sepsis were identified in the NICU of Children′s Hospital of Quanzhou from March 2011to October 2014.The perinatal factors,clinical characteris-tics,laboratory finding,treatment and prognosis were analyzed.Results A total of 33cases of neonatal GBS sepsis were identified.The incidence of neonatal GBS sepsis was 2.0‰(33/16448)among all the NICU pa-tients admitted at the same period.All 21cases of early-onset GBS sepsis were term infants,which had 13ca-ses of respiratory distress,11cases of anhelation and 10cases of cyanosis as main initial clinical symptoms. Among 12late-onset cases,8occurred in term infants,10with ardent fever as the main initial clinical symp-toms,6combined with purulent meningitis.All the GBS strains were sensitive to vancomycin,then penicillin combined with meropenem therapy was effective.Of the 33patients,18cured,9discharged with improve-ment,2died,4patients died during hospitalization after being given up because of serious complication,total mortality was 18.2%.Conclusion The clinical manifestations of neonatal GBS sepsis are usually obviously and fatally,and with a high mortality.Antepartum prophylaxis,early diagnosis and timely sensitive antibiotics therapy are vital for reducing the incidence of complications and mortality of neonatal GBS sepsis.

Objective: To explore the effects of sensory integration training on the behaviors and cognition in children with attention deficit hyperactivity sorder (ADHD) . Methods: Fifty-two children with ADHD (experimental group) were undergone sensory integration training for 60 times and their behaviors were evaluated with the Corners Parents Symptom Questionnaire (PSQ), and the cognition function was determined with the Combined Raven's Test (CRT) and Wisconsin Card Sorting Test (WCST) before and after the training. Another 52 healthy volunteers were recruited as controls and given the corresponding tests described above for comparison of the results. Results: The scores of conduct disorder, compulsion, hyperactivity and hyperactivity index in children with ADHD were decreased significantly than those of controls after training [(0.60 ± 0. 34) vs. (0.68 ± 0.35), (0.92±0.57) vs. (1.25±0.70), (0.82±0.29) vs. (1.08±0.44); P<0.05] .Inaddition, the improvement was found in IQ, categories control, and conceptive level as compared with that before the training [such as IQ, (105. 37 ±22.76) vs. (97. 37 ±24.15); P<0.001], whereas the scores of response error, response error percentage, first category and persistent errors were decreased after the training [such as response error, (39.40 ± 22.22) vs. (46.60 ±23.44), P<0.001] . For the experimental subjects, the scores in the first response number and the persistent errors percentage right after the training were higher compared with the controls [(12.03 ±5.08) vs. (10.65±0.84), (50.75 ±18.35) vs. (39.95 ± 15. 34); Ps<0.05] .Conclusion: The sensory integration training can improve the behaviors and cognition in children with ADHD, but it produces fewer effects on some of the executive functions despite clinical symptom relief to a certain extent.

Objective To explore the efficacy and safety of systemic mild hypothermia in management of neonates with moderate or severe hypoxic-ischemic encephalopathy (HIE).Methods A retrospective case-control study was conducted on 75 neonates with moderate or severe HIE,who were admitted to the Neonatal Intensive Care Unit of Teaching Hospital of Fujian Medical University (Quanzhou Children's Hospital) from January 1,2011 to May 31,2015.The 75 neonates were divided into two groups,the conventional treatment group (33 cases,control group) and the mild hypothermia treatment group (42 cases,hypothermia group).Sequential management protocol for all subjects was followed,including amplitude-integrated electroencephalogram (aEEG) before treatment,aEEG and brain MRI at one week after birth,neonatal behavioral neurological assessment (NBNA) on the 14th day after birth,and determination of mental and psychomotor development index with Bayley Scales of Infant and Toddler Developmental at 18 months old.Adverse reactions,serious disability cases and deaths during the study were also recorded.Two sample-t test and Chi-square test were as statistical methods.Results There were six death cases in the control group,but on one died in the hypothermia group.In the survivals,The maximum voltage and minimum voltage in the hypothermia group were higher at 7-day old than that before treatment [maximum voltage:(31.3 ±2.4) vs (18.1± 2.2) μ V;minimum voltage:(13.5±2.1) vs (6.1 ±1.5) μ V,t=8.591 and 5.314,both P ＜ 0.05],and also higher than that of control group [(25.2±3.1) and (9.3±3.1) μV,respectively,both P ≤ 0.05].Compared with the control group,there were more babies with normal head MRI [43％(18/42) vs 18％(6/33),x2=4.814,P ≤ 0.05] in the hypothermia group at 7-day old and less cases of severe disability [21％(9/42) vs 45％(15/33),x2=4.902,P ≤ 0.05] and deaths [0％(0/42) vs 18％(6/33),x2=6.098,P ≤ 0.05].Higher NBNA score at 14 day and Bayley developmental index at 18 months were shown in the hypothermia group than in the control (39.4±2.6 vs 35.3 ±2.4,t=3.316;mental development index:96.3± 13.2 vs 84.3 ± 10.6,t=7.893;psychomotor development index:98.2 ±16.8 vs 85.4±13.2,t=8.753,all P ≤ 0.05).The adverse effects of hypothermia treatment included electrolyte imbalance (n=12),abnormal blood glucose level (n=8),hepatic and renal dysfunction (n=7),infections (n=6) and bradycardiac (n=4),and no cold injury syndrome case was reported.However,none of the above had significant difference compared with the control group (P ＞ 0.05).Conclusions Systemic mild hypothermia treatment is effective in reducing mortality rate and major disability rate in neonates with moderate or severe HIE and improves the neuromotor development when babies grow up to 18-month-old.

Objective To dynamically observe the developing process and characteristics of the chronic intra-hepatic hyperplastic nodule to small hepatoma with ultrasound,and to evaluate the value of ultrasound in the diagnosis of small hepatoma.Methods One hundred twenty-two chrome hepatitis cases with HBsAg(+),HBcAb(+)and HBeAg(+)were prospectively examined by two-dimensional ultrasound and three-dimensional reconstruction.Characteristics and diagnostic accuracy of two-dimensional ultrasound and three-dimensional reconstruction were compared with the results of hepatic biopsy.Results Thirty-four of 122 patients developed small hepatoma.The duration between hepatic fibrosis and liver cirrhosis was (6.30±2.31)years,and time of hepatoma changed from liver cirrhosis was (8.01±2.10) years.The intrahepatic hyperplastic nodule,shape of small hepatoma and relationship between tumor and ambient tissue were displayed clearly with three-dimensional ultrasound,and the number of detection with threedimensional ultrasound was much higher than that of two-dimensional ultrasound significantly.Conclusions Dynamic ultrasound examination of the echogenicity change of chronic hepatic lesion caused by HBV is useful for early detection of small intra-hepatic nodule,three-dimensional ultrasound reconstruction may enhance the accuracy in diagnosing small hepatoma.

Objective To explore the value of amplitude integrated electroencephalography (aEEG) in cerebral function monitoring in preterm infants younger than 30 weeks of gestation. Methods A total of 165 cases of preterm infants younger than 30 weeks of gestation were prospectively enrolled in the study from September 2015 to February 2017,including 20 preterm infants with severe brain injury ( severe brain injury group) and 145 with non-severe brain injury ( non-severe brain injury group). Five aspects of each tracing, such as continuity(Co),sleep-wake cycling( Cy),amplitude of the lower border(LB),bandwidth( B) and total maturation scores,were evaluated and compared between two groups by applying a preterm infants aEEG scoring system. The neuromotor development of preterm infants survivors was assessed by using the 0 to 6 years old children′s neurological and psychological development scale of China Capital Institute of Pediatrics. Clinical data were collected and compared with the results of aEEG. Results The scores for Co,Cy,LB,B as well as total maturation scores of preterm infants with severe brain injury at different gestational age were lower than those of infants with non-severe brain injury at the same gestational age. The differences were sta-tistically significant (all P<0. 05). There were no statistical differences in Co,Cy,LB,B scores and total maturation scores between each gestational ages in severe brain injury group (all P>0. 05). Scores for Co, Cy,B and total maturation scores progressively increased with advancing gestational age in non-severe brain injury group( all P <0. 05),but there were no statistical differences between each gestational ages in LB scores(all P>0. 05). Follow-up results of 16 cases with severe brain injury:15 cases of DQ≤69,1 case of DQ 70－84,and no cases of DQ≥85; 130 cases of non-severe brain injury group:78 case of DQ≥85,42 cases of DQ 70－84,10 cases of DQ≤69. By chi-square analysis and Spearman rank correlation analysis,the results of aEEG total maturation scores were correlated with outcome of these preterm infants younger than 30 weeks of gestation ( r ＝0. 702,P <0. 05). Conclusion aEEG can provide important information of the status of cerebral function in preterm infants younger than 30 weeks of gestation and help to predict their outcome.

Objective To explore the value of amplitude integrated electroencephalography ( aEEG) in diagnosis and prognosis in neonates with acute hypoglycemic brain injury. Methods A total of 47 cases of neonatal hypoglycemic brain injury were prospectively enrolled in the study from January 2011 to July 2015. The aEEG traces were classified according to background activity ( normal,moderate,or severely abnormal) , presence of seizures and sleep-wake cycling ( SWC) . The neuromotor development of survivors with neonatal hypoglycemic brain injury was assessed by using the 0-6 years old children′s neurological and psychological development scale of China Capital Institute of Pediatrics. Clinical data were collected and compared with the result of aEEG. Results The characteristic of aEEG tracings in 47 infants showed continuous normal voltage (CNV)(n=9),discontinuous voltage(DC)(n=29),continuous low voltage(CLV)(n=3),burst-suppres-sion(BS)(n=6);mature sleep-wake cycling(SWC)(n=9),immature SWC(n=17),no SWC (n=21);39 infants(83. 0%) had electrical seizures:single seizure(n=11),repetitive seizures(n=20),and status ep-ilepticus (SE)(n=8). aEEG of 23 infants who had poor outcome showed CLV(n=3),BS/SE(n=4),BS/repetitive seizures( n =2 ) , DC/SE ( n =4 ) , DC/repetitive seizures ( n =10 ) . By chi-square analysis and Spearman rank correlation analysis,the results of aEEG classification,background pattern and SWC were cor-related with outcome of these infants with hypoglycemic brain injury. Conclusion Amplitude integrated electroencephalography can provide important information of the status of cerebral function in neonates with acute hypoglycemic brain injury and help to predict their outcome.