Neonatal cerebral infarction is an area of damaged cerebral tissue resulting either from disruption to blood flow in a major cerebral artery from thrombosis or embolism or from thrombosis in a major cerebral vein.The pathogenesis is unknown at present,many studies have shown that genetic,mother hypertension,gestational diabetes,smoking,neonatal congenital heart disease,infections,meningitis are the risk factors of neonatal cerebral infarction.

Objective To determine serum soluble interleukin 2 receptor level in patients with posthepatitis B liver cirrhosis.Methods Serum sIL 2R was measured using enzyme linked immunosorbent assay.Results Serum sIL 2R was significantly higher in patients with posthepatitis B cirrhosis than that in controls(P

The purpose of this study was to investigate the clinical efficacy against acute leukemia by transplantation of nonmyeloablative allogeneic peripheral blood stem cells from unrelated donor (URD NAPBSCT). One patient with acute lymphoblastic leukemia received URD NAPBSCT in our hospital. The donor cells were full engafted, and grade Ⅱ skin aGVHD and interstitial pneumonia were developed. The results showed that URD NAPBSCT is an effective new method for the treatment of acute leukemia.

Meconium-stained amniotic fluid is one of the main risk factors for neonatal meconium aspiration syndrome, and can even cause death, which is a dangerous emergency to handle during neonatal resuscitation. Routine intubation and endotracheal suction are not recommended for non-vigorous newborns born through meconium-stained amniotic fluid in the latest international neonatal resuscitation guideline. But it is controversial due to lacking high-level evidence. We review the recent evidence for the rationale for endotracheal suction in non-vigorous neonates born through meconium-stained amniotic fluid.

In this paper,we analyzed 24 international cooperation projects involving human genetic resources from 1999 to 2009 hosted by the Cancer Institute and Hospital,Chinese Academy of Medical Sciences.The analysis concerned the overall situation of the projects,the foreign cooperative units,subject distribution,research content,export planning,actual export and achievement.We also put forward proposals to improve the human genetic resources management.

Objective:To analyze the mortality of extremely preterm infants(EPIs) born at 22 +0-25 +6 weeks of gestation in Tianjin Central Hospital of Obstetrics and Gynecology and then compare it with data from other countries to provide evidence for better healthcare for this population. Methods:Clinical data of EPIs born at 22 +0-25 +6 gestational weeks in our center from January 2011 to December 2017 were retrospectively collected. The enrolled patients were grouped based on their gestational age, birth weight, and admission time in order to analyze the mortality in different groups. According to the inclusion and exclusion criteria, five sets of data regarding the mortality of EPIs born at 22 +0-25 +6 gestational weeks during the same period were retrieved from a multicenter survey involving 15 centers in China, the National Institute of Child Health and Human Development Neonatal Research Network (NICHD-NRN) in the United States, Canadian Neonatal Network TM, Australian and New Zealand Neonatal Network (ANZNN) and Korean Neonatal Network (KNN). The mortality rate among data from different sources was compared using Chi-square test on the condition that the definition of death was the same. Besides, the causes of neonatal death were analyzed. Results:A total of 64 EPIs were enrolled in our center. The total mortality rate was 42.2% (27/64), and were 1/1, 8/10, 50.0%(10/20) and 24.2%(8/33) in EPIs of gestational age of 22 +0-22 +6, 23 +0-23 +6, 24 +0-24 +6 and 25 +0-25 +6 weeks, 5/6, 50.0%(16/32), 25.0%(6/24) and 0/2 in those with birth weight of ≤600 g, >600-≤800 g, >800-≤1 000 g and >1 000 g, respectively. In the 27 death cases in our center, the causes of death were as follows: neonatal respiratory distress syndrome (16 cases, 59.3%), sepsis (two cases, 7.4%), necrotizing enterocolitis (three cases, 11.1%), severe intraventricular hemorrhage (three cases, 11.1%) and others (three cases, 11.1%). The mortality rate was 57.1%(12/21) before 2016(2011-2015), 45.0%(9/20) in 2016 and 26.1%(6/23) in 2017. The total mortality of EPIs in our center was higher than that in Canada [42.2% vs 26.6%(165/621), χ2=7.015, P=0.008], as well as in Australia and New Zealand [42.2% vs 28.2%(140/497), χ2=5.330, P=0.021], while there was no statistically significant difference when compared with that in South Korea [42.2% vs 42.1%(218/518), χ2<0.001, P=0.988]. Conclusions:The mortality of EPIs born at 22 +0-25 +6 gestational weeks is higher in our center when compared with that in some developed countries such as Canada and Australia. Therefore, we should pay more efforts to reduce the mortality of EPIs through quality improvement.

Objective To explore the therapeutic effect and security of caffeine citrate in preventing primary apnea of preterm infants by observing the clinical effect, adverse reaction and prognosis of caffeine citrate preventing the primary apnea. Methods A total of 132 preterm infants admitted to neonatal department of Tianjin Central Hospital of Obstetrics and Gynecology were selected during January 2015 to July 2016. They were randomly divided into two groups, one was the caffeine group, and the other was the control group. The infants of caffenine group were intravenous injected caffeine citrate 24 hours after birth, with the first dose 20 mg/kg, and the maintain dose 5 mg/kg every 24 hours, until the corrected gestational age was 34 weeks. The infants of control group were not given methylxanthine drugs. Data were compared between two groups including the incidence of apena after 48 hours of giving drugs, the period of using nasal continuous positive airway pressure (n-CPAP) or ventilator, the incidence of feeding intolerance, tachycardia, patent ductus arteriosus (PDA), intracranial hemorrhage (HIE), necrotizing enterocolitis (NEC),and bronchopulmonary dysplasia (BPD), weight growth rate and the length of hospitalization. Results There were significantly lower incidence of apnea after 48 hours, the period of using nasal continuous positive airway pressure or ventilator, incidence of patent ductus arteriosus and intracranial hemorrhage and the duration of hospitalization in caffeine group than those in control group (P < 0.05). There were no statistically significant differences in the incidence of feeding intolerence, bradycardia, NEC, BPD and the weight growth rate between the two groups (P>0.05). Conclusion The preterm infants given caffeine could reduce the incidence of the primary apnea, improve the prognosis of the preterm infants, and no significant adverse reaction.

Objective To investigate the effects of human milk fortifier(HMF)addition at different time points on the growth,development and the incidence of complications in very low birth weight(VLBW)infants.Methods A total of 93 VLBW infants admitted into Neonatal Intensive Care Unit of Tianjin Central Hospital of Obste-trics and Gynecology from January to September 2015 with more than 80％of total milk intake during hospitalization,excluding those who had severe asphyxia or abandoned treatment and died,were collected.The included cases were divided into 2 groups by using completely randomized grouping method,early fortification group(n=48)and delayed fortification group(n=45)adding HMF with the enteral intake of 50 mL/(kg·d)and 100 mL/(kg·d),respectively.The outcomes included growth development and the incidence of complications during hospitalization.Then,t test and chi-square test of independent samples were used for statistical analysis.Results There was significant difference in the weight growth rate between the 2 groups,and the growth rate of early fortification group and delayed fortification group were(15.4±2.4)g/(kg·d)and(13.6±2.3)g/(kg·d),respectively(t=3.043,P=0.004).There was no significant difference in height growth rate,head circumference growth rate,weight at 34 weeks postmenstrual age,time of recovering birth weight and parenteral nutrition,hospitalization duration,body weight,body length,head circumference at discharge and the incidence of extrauterine growth retardation between the 2 groups(all P>0.05).There was no statistical difference in incidence of feeding intolerance,necrotizing enterocolitis,nosocomial infection,retinopathy of prematurity,bronchopulmonary dysplasia between the 2 groups(all P>0.05).Conclusions HMF with enteral intake of 50 mL/(kg·d)contributes to weight gain rate in VLBW infants during hospitalization,but not to the increase in the incidence of complications.

Objective To study the incidence of complications and the influence on early postnatal growth and development in very low birth weight infant(VLBWI) fed by breast milk.Methods From January 1, 2010 to December 31, 2013, 351 VLBWIs, who were appropriate for gestational age and hospitalized in Neonatal Intensive Care Unit of Tianjin Central Hospital of Obstetrics and Gynecology, were included in this study after exclusion of those with small for gestational age, large for gestational age, severe perinatal asphyxia at birth, withdrawing treatment or death, and mixed feeding infants.The group of formula-fed infants (FFI) were 168 VLBWI admitted between January 1, 2010 to December 31, 2011 and the group of breast milk-fed infants (BFI) were 183 VLBWI admitted between January 1, 2012 to December 31, 2013.For BFIs, we added human milk fortifier when oral intake reached 100 ml/kg.All subjects were followed up to 40 weeks of corrected gestational age.We compared the incidence of complications and infantile growth and development from birth to 30 days old between the two groups.Independent sample t-test and Chi-square test were applied for statistical analysis.Results The incidence of feeding intolerance in FFIs was higher than that of the BFIs [27.4％ (46/168) vs 15.3％ (28/183)], so was the incidence of necrotizing enterocolitis [14.9％ (25/168) vs 5.5％ (10/183)] (x2=7.683 and 8.651, both P ＜ 0.05).The incidence of nosocomial infection, retinopathy of prematurity and bronchopulmonary dysplasia in FFI and BFI were 34.5％ (58/168) vs 33.3％ (61/183), 15.5％ (26/168) vs 10.4％ (19/183), and 11.3％ (19/168) vs 9.3％ (17/183), but none of them showed significant difference between the two groups (x2=0.055, 2.033 and 0.388, all P ＞ 0.05).Significant difference was neither found in weight gain from birth to 30 days old [(304± 137) vs (308± 123) g], height growth [(2.6± 1.1) vs (2.7± 1.2) cm] and head circumference growth [(2.5± 1.0) vs (2.4±0.9) cm] between the FFIs and BFIs (t=0.106, 0.614 and 0.485, all P ＞ 0.05).Conclusion Breast feeding is beneficial to VLBWI in decreasing the incidence of feeding intolerance and necrotizing enterocolitis without adverse effect on their early postnatal growth and development.

Objective To understand the whole situation of neonatal resuscitation in high risk deliveries.Methods Totally,3 420 neonates born from high risk pregnant mothers in Tianjin Central Obstetrics and Gynecology Hospital from September 2013 to November 2014 were recruited and divided into four groups according the needs of resuscitation,including no resuscitation group (Group A),initial resuscitation group (Group B),initial resuscitation plus bag-and-mask or T-piece ventilation (positive pressure ventilation group,Group C),tracheal intubation and/or external chest compression and/or epinephrine administation (tracheal intubation group,Group D).Variance analysis,Chi-square test and Logistic regression analysis were applied to compare the differences of clinical conditions among these groups and to analyze risk factors of tracheal intubation requirement for extensive resuscitation.Results Among the 3 420 newborns,2 360(69.0％) were assigned to Group A,565 (16.5％) to Group B,408 (11.9％) to Group C and 87 (2.5％) to Group D.Statistical differences were shown in the gestational age [(35.5 ± 4.1),(33.0 ± 4.3) and (32.1 ± 4.8) weeks],birth weight [(2 593.8 ± 663.6),(2 063.3 ± 973.9) and (1 839.0 ± 977.9) g],and the incidence of multiple births [66(11.7％),65(15.9％) and 23(26.4％)],abruptio placentae [15(2.7％),35(8.6％) and 9(10.3％)],umbilical cord prolapse [0(0.0％),2(0.5％),and 10(11.5％)],abnormal fetal heart rate in labor [28(5.0％),45(11.0％) and 46(52.9％)],prolonged labor [36(6.4％),35(8.6％),and 20(23.0％)],meconium stained liquor [32(5.7％),0(0.0％),and 8(9.2％)],and congenital anomaly [8(1.4％),12(2.9％) and 7(8.0％)] among Group B,C and D (F or x2=233.188,105.050,14.535,19.934,91.434,149.366,26.525,28.602 and 13.765,all P ≤ 0.05).Multiple regression analysis revealed that gestational age ≤ 28 weeks (OR=1.290,95％ CI:1.167-1.425),abnormal fetal heart rate in labor (OR=1.350,95％CI:1.184-6.862) and meconium stained liquor (OR=1.397,95％CI:1.051-6.825) were independent risk factors for endotracheal intubation requirement (all P ≤ 0.05).Conclusions More newborns born from high risk mothers may need resuscitation,especially for those in small gestational age,with abnormal fetal heart rate during labor and meconium-stained liquor,thus close monitoring and management are necessary.