2.Correlation between blood glucose fluctuation and brain damage in neonates with hypoglycemia
Yuan LYU ; Lingling ZHU ; Ling CHEN ; Liting CHEN ; Hao LI ; Huiping LIU ; Guihua SHU
Journal of Clinical Pediatrics 2017;35(9):652-654
Objective To explore the correlation between the fluctuation of blood glucose levels and brain damage in neonates with hypoglycemia. Methods The clinical data of 58 cases of neonatal hypoglycemia diagnosed from September 2013 to August 2016 were analyzed retrospectively. According to the results of neonatal cranial MRI and/or amplitude integrated electroencephalogram (aEEG), the neonates were divided into brain injury group and non-brain injury group. The fluctuation index of blood glucose was compared between two groups, and the correlation between the fluctuation of blood glucose level and brain injury was analyzed. Results In these 58 cases, 13 cases were in brain injury group (8 males and 5 females) and 45 cases were in non-brain injury group (27 males and 18 females). The lowest blood glucose (LBG) value in brain injury group was lower than that in non-brain injury group, while the duration of hypoglycemia, maximum blood glucose fluctuations (LAGE), standard deviation of blood glucose (SDBG), and average blood glucose fluctuations (MAGE) were higher than those in non-brain injury group, and they were all significantly different (P all<0.001). Conclusions Whether the hypoglycemia in newborn could lead to the brain injury or not depends not only on the minimum hypoglycaemia level and duration of hypoglycemia, but also on the indicators of glucose variation, such as LAGE, SDBG and MAGE.
3.The regulatory effects of transforming growth factor beta-activated kinase 1 on microglia pyroptosis in hypoxic-ischemic brain damage
Yuan LYU ; Weiwei HOU ; Xingxing LU ; Guihua SHU ; Lingling ZHU ; Yanyan CAI
Chinese Journal of Neonatology 2022;37(1):65-69
Objective:To study the regulatory effects of transforming growth factor beta-activated kinase 1 (TAK1) on microglia pyroptosis in hypoxic-ischemic brain damage (HIBD).Methods:Primary microglia cells were isolated from fetal mice and randomly assigned into 4 groups: the control group, 5z-7-oxozeaneol (5z-7) group, oxygen-glucose deprivation (OGD) group and OGD+5z-7 group. OGD models of microglia cells were established for the OGD groups and 5z-7 groups received a small molecule TAK1 inhibitor 5z-7. Expression of phosphorylated TAK1(P-TAK1), pyroptosis related proteins including NOD-like receptor pyrin domain containing 3 (NLRP-3), apoptosis-associated speck-like protein containing a CARD (ASC) oligomers, N terminal of Gasdermin D (GSDMD-N) and interleukin 1β (IL-1β) were examined using Western blot at 0 h, 6 h and 24 h after intervention. Lactate dehydrogenase (LDH) test and transmission electron microscope were used for pyroptosis evaluation.Results:(1) Compared with the control group, expressions of all proteins including P-TAK1, NLRP-3, ASC oligomers, GSDMD-N, IL-1β and LDH level showed no significant differences in the OGD group at 0 h ( P>0.05). P-TAK1 levels in OGD group at 6 h and 24 h were lower than the control group and the levels of NLRP-3, ASC oligomers, GSDMD-N, IL-1β and LDH were significantly higher ( P<0.05). Microglia pyroptosis (characterized by disruption of cell membrane, extravasation of cytoplasm and chromatin margin aggregation) was observed under electron microscope. (2) 5z-7 group and OGD+5z-7 group had lower P-TAK1 levels and higher NLRP-3, ASC oligomers, GSDMD-N, IL-1β and LDH levels than the control group and OGD group at 6 h and 24 h. Conclusions:The down-regulation of TAK1 phosphorylation level may promote microglia pyroptosis in HIBD. This regulatory effects is related to the up-regulation of NLRP-3 expression and the oligomerization of ASC.
4.Improved left ventricular endocardial border echo resolution by perfluoropropane-albumin microsphere injection: a multiple center stage Ⅲ clinical study
Xinfang WANG ; Peili GONG ; Mingxing XIE ; Zhaohui WANG ; Yale HE ; Hongwen FEI ; Yuan LIU ; Liang CUI ; Yafeng WU ; Lin XU ; Xianhong SHU ; Cuizhen PAN ; Shizhen LIU ; Guang ZHI ; Xiaoxia WU ; Haiyan NIU ; Yun ZHANG ; Mei ZHANG ; Guihua YAO ; Yanbin SI ; Xiaoyu XIA
Chinese Journal of Ultrasonography 1993;0(04):-
0.05 ). After once injection both observers considered the number of clearly recognized endocardial border segments increased significantly. The number evaluated by observers A increased from 2.68 ? 0.95 to 5.99 ? 0.10 while from 2.82 ? 1.03 to 5.99 ? 0.11 by observers B( P 0.05 ). The average contrast enhancement rate of LV endocardial border was 99.7 %. Perfluoropropane-albumin microsphere injection had no significant effection on vital signs such as blood prssure, heart rate and respiration. Electrocardiogram didn′t change markedly and the variance of the laboratory findings like blood and urine routine examination, hepatic and renal function was in normal range. Only one case( 0.33 %) had slight side-effects who suffered from mild nausea and diarrhea, which suggested the clinical safety of this contrast agent. Conclusions Perfluoropropane-albumin microsphere injection could enhance the resolution of LV endocardial borders and make the judgement of regional myocardial movement easier. It has little side-effects and will be appropriate for clinical use.
5.Application value of point-of-care lung ultrasound scoring in selecting respiratory support treatment for neonatal infectious pneumonia
Xingchen GAO ; Weiwei HOU ; Yuan LYU ; Kaiting YANG ; Nana PENG ; Guihua SHU
Journal of Clinical Medicine in Practice 2024;28(6):56-59
Objective To investigate the application value of point-of-care lung ultrasound(POC-LUS)scoring in selecting respiratory support treatment modalities for neonatal infectious pneu-monia(NIP).Methods A total of 89 NIP patients were selected as the study subjects and divided into control group(no assisted ventilation)with 46 cases,noninvasive group(noninvasive assisted ventilation)with 28 cases,and invasive group(invasive mechanical ventilation)with 15 cases based on the degree of dyspnea and blood gas analysis results.The POC-LUS scores of the three groups were compared,and the correlations of POC-LUS scores with arterial oxygen partial pressure[pa(O2)]and arterial carbon dioxide partial pressure[pa(CO2)]were analyzed.Receiver operating characteristic(ROC)curves were plotted to assess the predictive efficacy of POC-LUS scores for the need for nonin-vasive assisted ventilation or invasive mechanical ventilation in NIP patients.Results The POC-LUS scores of the noninvasive group and the invasive group were(31.7±7.3)and(42.1±8.0),respec-tively,which were higher than(21.5±7.3)of the control group.Additionally,the score of the inva-sive group was higher than that of the noninvasive group(P<0.05).Correlation analysis revealed a significant negative correlation between POC-LUS scores and pa(O2)(r=-0.802,P<0.05),and a significant positive correlation with pa(CO2)(r=0.807,P<0.05).ROC curve analysis showed that the area under the curve(AUC)of POC-LUS scores for predicting the need for noninvasive assisted ventilation and invasive mechanical ventilation were 0.918(95%CI,0.862 to 0.973)and 0.938(95%CI,0.889 to 0.987),respectively.The sensitivity was 0.767 and 0.933,and the specificity was 0.935 and 0.824,with optimal cutoff values of 29.5 and 31.5,respectively.Conclusion POC-LUS scoring can quantitatively assess the severity of lung lesions in NIP patients and serves as a guiding tool for clinicians in selecting assisted ventilation treatment modalities.
6.Application value of point-of-care lung ultrasound scoring in selecting respiratory support treatment for neonatal infectious pneumonia
Xingchen GAO ; Weiwei HOU ; Yuan LYU ; Kaiting YANG ; Nana PENG ; Guihua SHU
Journal of Clinical Medicine in Practice 2024;28(6):56-59
Objective To investigate the application value of point-of-care lung ultrasound(POC-LUS)scoring in selecting respiratory support treatment modalities for neonatal infectious pneu-monia(NIP).Methods A total of 89 NIP patients were selected as the study subjects and divided into control group(no assisted ventilation)with 46 cases,noninvasive group(noninvasive assisted ventilation)with 28 cases,and invasive group(invasive mechanical ventilation)with 15 cases based on the degree of dyspnea and blood gas analysis results.The POC-LUS scores of the three groups were compared,and the correlations of POC-LUS scores with arterial oxygen partial pressure[pa(O2)]and arterial carbon dioxide partial pressure[pa(CO2)]were analyzed.Receiver operating characteristic(ROC)curves were plotted to assess the predictive efficacy of POC-LUS scores for the need for nonin-vasive assisted ventilation or invasive mechanical ventilation in NIP patients.Results The POC-LUS scores of the noninvasive group and the invasive group were(31.7±7.3)and(42.1±8.0),respec-tively,which were higher than(21.5±7.3)of the control group.Additionally,the score of the inva-sive group was higher than that of the noninvasive group(P<0.05).Correlation analysis revealed a significant negative correlation between POC-LUS scores and pa(O2)(r=-0.802,P<0.05),and a significant positive correlation with pa(CO2)(r=0.807,P<0.05).ROC curve analysis showed that the area under the curve(AUC)of POC-LUS scores for predicting the need for noninvasive assisted ventilation and invasive mechanical ventilation were 0.918(95%CI,0.862 to 0.973)and 0.938(95%CI,0.889 to 0.987),respectively.The sensitivity was 0.767 and 0.933,and the specificity was 0.935 and 0.824,with optimal cutoff values of 29.5 and 31.5,respectively.Conclusion POC-LUS scoring can quantitatively assess the severity of lung lesions in NIP patients and serves as a guiding tool for clinicians in selecting assisted ventilation treatment modalities.