1.The influence of coagulation factors in cord blood
Dongbo LAI ; Huiling LIN ; Tiezhen YE ; Huanhuan ZHU ; Yanmei LI ; Liyi JIANG ; Yujiao LEI
International Journal of Pediatrics 2013;(3):310-315
Objective To investigate the influence on levels of coagulation factors in cord blood,included the physiological and pathological status of mater and the newborn.Methods We Detected the levels of F Ⅱ 、FⅤ 、FⅦ 、FⅧ 、FⅨ 、FⅩ 、FⅪ and FⅫ in cord blood by CA-1500 Automatic blood coagulation analyzer and related reagents,group results by impact factors and compared them statistically.Results (1) Factors of newborn:every coagulation factor between the male group and the female group was no statistical difference(P >0.05) ;F Ⅱ,F Ⅴ,FⅨ and FⅪ in the group of premature infant were less active than the normal (P =0.031,0.037,0.000,0.002) ;FⅡ and FⅦ in the group of birth weight >4.0 kg were more active than the normal (P =0.043,0.043) ; FⅧ in the group of cesarean section was less active than the normal (P =0.004) ; FⅧ,FⅨ and FⅪ in the group of twin pregnancy were less active than the normal (P =0.002,0.000,0.028) ;F Ⅱ and F Ⅷ in the group of intrauterine hypoxia were less active than the normal (P =0.032,0.012).(2) Factors of mater:F Ⅱ and FⅨ in the group of≥35-year-old mothers with first delivery were more active than the normal (P =0.009,0.028).Every coagulation factor between the gestational diabetes mellitus (GDM) group and the not GDM group was no statistical difference(P >0.05) ;FⅧ in the group of pregnancy associated with gynecologic diseases was less active than the normal (P =0.043),F Ⅱ,Ⅶ and F Ⅹ were more active than the normal (P =0.032,0.024,0.022).Conclusion Premature birth,cesarean,twins,intrauterine hypoxia,perinatal infection and other factors have greater impact on the levels of FⅡ,FⅧ,FⅨ and FⅪ in cord blood.To prevent hemorrhagic disease of the newborn,we should avoid the factors mentioned above.
2.Preliminary study of levels of coagulation factors in cord blood of neonate
Yujiao LEI ; Huiling LIN ; Tiezhen YE ; Yanmei LI ; Liyi JIANG ; Huanhuan ZHU
Chinese Journal of Laboratory Medicine 2013;36(9):850-853
Objective To study the levels of coagulation factors in cord blood from normal newborns.Methods The study was clinical experimental study.One hundred and thirty-six cord blood samples collected from newborns who were born in Guangzhou Women and Children's Medical Center from November 2011 to January 2012.The levels of eight coagulation factors FⅡ,FV,FVⅡ,FVⅢ,FⅨ,FⅩ,FⅪ and FⅫ in cord blood were detected using CA-1500 Automatic Blood Coagulation Analyzer.Results The levels of eight coagulation factors in cord blood:the 95% reference ranges were 27.04%-49.02%,53.30%-116.40%,27.80%-56.70%,19.16%-113.06%,19.85%-35.65%,24.20%-48.00%,24.40%-42.20% and 9.20%-54.60% respectively.The 99% reference ranges were 23.56%-52.50%,53.30%-116.40%,27.80%-56.70%,4.31%-127.91%,17.35%-38.15%,24.20%-48.00%,24.40%-42.20% and 9.20%-54.60% respectively.Conclusion The study establishes the reference ranges for levels of coagulation factors in cord blood,it will provide experimental basis for diagnosis and differential diagnosis for neonatal congenital or hereditary coagulation factor deficiency.
3.Clinical study on the early prediction of death for serum markers in infants with hemophagocytic syndrome
Dongbo LAI ; Jiayi WANG ; Yuhong ZHAO ; Wenying ZHANG ; Mingqi ZHAO ; Tiezhen YE
Chinese Pediatric Emergency Medicine 2013;20(2):144-148
Objective To investigate the association with death for serum parameters at the time of diagnosis and its value in predicting the death in infants with hemophagocytic syndrome (HPS).Methods A retrospective case-control study was conducted on 108 children with HPS who were admitted to our center between July 2005 and July 2012.For each patient,demographic,laboratory data and outcome information were collected.The patients were divided into death and surviving groups based on the follow-up results.The relation between serum markers and death was examined using the COX proportional hazards model and decision tree.Results Of 108 infants with HPS,33 died corresponding to a fatality rate of 30.6% and 90.3% of deaths occurred within 8 weeks after diagnosis.Following features were significantly associated with death:white blood cells (WBC) <5 x 109/L (HR =9.08,95% CI 3.07 ~ 26.87),hemoglobin <80 g/L (HR =6.15,95% CI 1.68 ~ 22.49),albumin < 28 g/L (HR =4.63,95% CI 1.12 ~ 7.39),serum ferritin > 1 100 μg/L (HR =3.05,95% CI 1.28 ~ 16.75),trigeminal ganglion ≥4 mmol/L (HR =2.88,95% CI 1.51 ~ 8.60),and prothromin time ≥ 16 s (HR =3.60,95 % CI 1.28 ~ 7.24),and fever for more than 2 weeks (HR =5.39,95% CI 1.97 ~ 14.66).Decision tree demonstrated that the probability of death was as high as 100% for infants with WBC <5 x 109/L and hemoglobin < 80 g/L.The odds of dying was still 66.7% for infants who had WBC≥5 × 109/L but reported trigeminal ganglion ≥4 mmol/L after having fever for more than 2 weeks.Conclusion The first 8 weeks after the onset of HPS is the critical period of treatment.There are several easily available serum predictors of early mortality in HPS infants,particularly the WBC and hemoglobin level,which may help guide treatment decisions.
4.The application and significance of gene scanning in the clonality analysis of Ig/TCR gene rearrangements in new cases of acute lymphocytic leukemia
Huiling LIN ; Yanmei LI ; Tiezhen YE ; Yan LI ; Huanhuan ZHU ; Liyi JIANG
Chinese Journal of Laboratory Medicine 2013;(3):228-232
Objective To study the role of gene Scanning in the clonality analysis of Ig/TCR gene remrangement in children with newly diagnosed acute lymphoblastic leukemia (ALL),and the relationship between the clinical characteristics of ALL and the type of Ig/TCR gene rearrangement.Methods The research was the clinical experimental study.Selected 86 cases of children with ALL who were diagnosed and treated in Department of Hematology-oncology of Guangzhou Women and Children's Medical Center,and All cases were confirmed by bone marrow cell morphology and flow cytometric immunophenotyping.Used multiplex PCR to detecte Ig/TCR gene rearrangements in children with newly diagnosed ALL.Applied gene scanning to analyze the clonality of Ig/TCR gene rearrangement.Results There were 83 cases detected 1 or more than 1 types of Ig/TCR gene rearrangements in 86 cases (96.5%),with 2.52 types each case.There were 56 cases detected at least one monoclonal Ig/TCR gene rearrangement in 61 cases analyzed by gene scanning (91.8%).The detectable rate for lgH,Igκ,TCRγ and TCRδ were 27.91%,27.91%,19.77% and 24.42% respectively in 172 of Ig/TCR gene rearrangement.Monoclonal,oligoclonal and polyclonal composition was 58.1%,30.8% and 11.1% respectively,the monoclonal as the main component.There was no significant difference between the types and clonality of Ig/TCR gene rearrangement and the clinical characteristics of children with newly diagnosed ALL (P > 0.05).Conclusions Gene scanning can analyze clonality of the Ig/TCR gene rearrangement conveniently and rapidly,thus,it can be possible to select the stable targets for quantitative detection of minimal residual disease minimal residual disease.There is no significant difference between the types and clonality of Ig/TCR gene rearrangement and clinical characteristics of children with newly diagnosed.