Fetal movement is one of the markers of fetal wellbeing. Decreased fetal movement(DFM)in the third trimester indicates an increased possibility of intrauterine asphyxia/ anoxia. There is a lack of reported data for the correlation of DFM and incidence of neonatal hypoxic - ischemic brain damage(HIBD). DFM is a multi - factorial clinical phenomenon which may be caused by various issues of pregnant women,fetus,and cord. Incidence of negative neonatal outcomes greatly increased in the condition of DFM. Obstetricians and neonatologists should keep close monito-ring to pregnant women with DFM in the third trimester and their newborn infants. Appropriate medical intervention is highly recommended in order to minimize the occurrence of HIBD.

Objective To study the protective effect of paeonol against hypoxic-ischemic brain damage of neonatal rats. Methods 36 neonatal SD rats were randomly divided into normal control group, sham group, HIBD group, and HIBD plus Pae group. The expression of cleaved caspase -3 in the damaged cortex of rats was examined by the immunohistochemical staining and the number of necrotic neurons was counted after hematoxylin-eosin staining. Results The number of the cleaved caspase - 3 positive cells in the damaged cortex of rats in the HIBD plus Pae group was significantly lower than that in the HIBD group( P < 0.05 ). The percentage of necrotic neurons was decreased in the HIBD plus Pae group in comparison with HIBD group( P <0.01). Conclusions Paeonol may take protective effect against hypoxic-ischemic brain damage.

Due to the dysontogenesis of the arterial duct wall and the abnormal secretion of prostaglandin,symptomatic patent ductus arteriosus is thus often presented in preterm infants.In the past,Indomethacin or Ibuprofen (cyclooxygenase inhibitor) was always chosen to be the interventional medication.While in recent years,Acetaminophen (prostaglandin synthetase inhibitor) has become another therapeutic option for symptomatic patent ductus arteriosus with similar efficacy but less adverse events.The latest research of the mechanism,the therapeutic strategy of time,mode,dosage and duration,the efficacy and the adverse events of Acetaminophen were reviewed.

Umbilical venous catheterization (UVC) is associated with many complications, such as displacement of the catheter, infection, exudation, thrombosis, pericardial effusion/pleural effusion, of which central line-associated bloodstream infections has been of long-standing interest. There is currently no optimal method for estimating the depth of UVC insertion. Ultrasound examination can be used to evaluate the position of the end of the tube after catheterization to avoid organ damage and complications caused by displacement and dislocation. However, whilst it is known that there is a correlation between the duration of UVC and central line-associated bloodstream infection, a consensus is yet to be reached regarding the optimal duration of UVC retention. More, high quality evidence through multi-center, prospective randomized controlled study is needed.

Ductus Arteriosus, Patent ; drug therapy ; Humans ; Infant, Newborn ; Infant, Premature ; Natriuretic Peptide, Brain ; therapeutic use ; Peptide Fragments ; therapeutic use

Objective To investigate the changes of cardiac function at pre -and post -treatment in preterm infants with patent ductus arteriosus (PDA)in order to guide drug treatment.Methods Totally 84 preterm infants with PDA admitted to Neonatal Intensive Care Unit of Xuzhou Hospital Affiliated to Medical College of Southeast University from July 201 2 to June 201 4 were divided into 4 groups according to treatment drug:Ibuprofen group (27 cases),Indo-methacin group (24 cases),control group (1 1 cases),and Paracetamol group (22 cases).Patients were also divided into symptomatic PDA group (38 cases)and asymptomatic PDA group (46 cases)according to severity;PDA closed group (69 cases)and PDA unclosed group (1 5 cases)according to sequel.The level of plasma brain natriuretic pep-tide (BNP),cardiac troponin I (cTnI),correct QT intervals dispersion (QTcd)were monitored pre -and post -treat-ment.Data were analyzed by using SPSS 1 9.0 software.Results Three cardiac markers at post -treatment were of no significant difference among 4 treatment drugs.The changes of the cTnI and QTcd at pre -and post -treatment were of no significance.The level of BNP in symptomatic PDA group was significantly higher than that in asymptomatic PDA group at pre -treatment [(378 ±94)ng/L vs (1 47 ±75)ng/L,t =2.584,P =0.01 4].In the symptomatic PDA group,the level of BNP at post -treatment [(1 82 ±81 )ng/L]was significantly decreased than that at per -treatment (t =2.741 ,P =0.009).In the asymptomatic PDA group,there was no significant difference between the pre - and post -treatment [(1 21 ±61 )ng/L]in the level of BNP (t =1 .254,P =0.207).There was no significant difference in the level of BNP at per -treatment between PDA closed group and PDA unclosed group [(274 ±91 )ng/L vs (289 ± 87)ng/L,t =-0.874,P =0.391 ].In PDA closed group,the level of BNP at post -treatment [(1 21 ±74)ng/L] was significantly decreased compared with that at per -treatment (t =3.580,P =0.000).In PDA unclosed group, there was no significant difference between the pre - and post -treatment [(245 ±74)ng/L]in the level of BNP (t =0.854,P =0.392).Conclusion Early medication intervention for symptomatic PDA of preterm infants is benefi-cial for the closure of PDA and for attenuating negative effects on cardiac function of PDA.

Objective To study the effectiveness of family-integrated-care (FICare) for preterm infants with moderate to severe bronchopuhnonary dysplasia (BPD) in neonatal intensive care unit (NICU).Method Preterm infants with moderate to severe BPD in Hunan Children's Hospital from January 2015 to March 2016 were selected as the objects.These infants were assigned into two groups (FICare group and control group) in the base of whether the parents agreed to implement FICare.If the infant was enrolled into FICare group,the parents need to spend 3 hours in ward every day,and participate in nursing services under the guidance of nurses.The nursing services included bathing,cuddling,skin care,breast-feeding,and so on.If the infant was enrolled into control group,these nursing services were implemented by nurses.Oxygen exposure time,breast-feeding rate,time of begin oral feeding,time of total oral feeding,weight growth rate during hospitalization,weight of discharge,length of stay,readmission rate within 30 days,the rate of parents that mastered basic care knowledge and skills when discharge from hospital,the rate of satisfaction,and the rate of follow-up within 30 days of the two groups were compared.Result There were 106 cases in our study,54 in the FICare group and 52 in the control group.Compare the FICare group and the control group,there were statistical differences between two groups in the follow aspects (all P ＜ 0.05):oxygen exposure time [(57.1 ±20.9) d vs.(71.4 ±32.6) d],breast-feeding rate (77.8％ vs.44.2％),time of total oral feeding [(46.1 4 19.6) d vs.(59.4 ± 30.2) d,length of stay [(65.8 ± 18.4) d vs.(84.3 ±35.0) d],the rate of parents that mastered basic care knowledge and skills when discharge from hospital (96.3％ vs.82.7％),the rate of satisfaction (94.4％ vs.84.6％),the rate of follow-up within 30 days (92.6％ vs.73.1％).Conclusion FICare could significantly reduce oxygen exposure time of preterm infants with moderate to severe BPD,could improve the level of parents mastered basic care knowledge and skills of preterm infants,especially in critically ill preterm children,and could shorten length of stay of them.FICare is beneficial to the healthy growth of premature infants with BPD.

Medical improvement increases successful rescue rate of premature infants.Under the bio-medico-humain management concept, in addition to the enhancement of medical devices and improvement of medical skills, professionals started to pay attention to a more scientific and better humanity caring model in neonatal intensive care unit (NICU). Family integrated care (FICare/FIC) is a synthesized management model of NICU, in which, parents of preterm infants are integrated into the NICU team by allowing parents to enter the NICU, nursing and caring of their own hospitalized infants under the supervision of well trained education nurses.Now, the background of FICare, the implementation method of FICare, the influence of FICare to breastfeeding and prognosis of preterm infants and the influence of FICare to the medical burden will be introduced.

The umbilical vein catheterization is one of the most common interventions in neonates.Central line-associated bloodstream infections is a frequent complication of umbilical vein catheterization.It may lead to increased morbidity and mortality by 7% to 11%.At present, published literature on umbilical vein catheter-related bloodstream infections is limited in China.Our better knowledge of its epidemiology, risk factors and preventive measures could help to improve clinical practice and guide future research.

OBJECTIVE: To determine the effect of Tanshinone IIA (TanIIA) on the phosphory-lated NMDA receptor 1 at Serine 897 site (phospho-NR1 S897) and intracellular free calcium concentration ([Ca(2+)](i)) in neonatal SD rats with hypoxic ischemic brain damage (HIBD), and to explore the neuroprotective mechanism of TanIIA in HIBD. METHODS: Neonatal SD rats were randomly divided into a normal control, and an HIBD and TanIIA+HIBD group. Rice-Vannucci method was used for HIBD animal model. Time points were: 3, 6, 12, and 24 h after HIBD (n=10 in each group at each time point). TanIIA was intraperitoneally given at 1 μg/g every 12 h. Fura-2AM was used to mark the fluorescent calcium probe and [Ca(2+)](i) was measured by a Hitachi F-4500 Fluorescence Spectrophometer. Fluorescent immunohisotichemical study was used for the expression of phospho-NR1 S897. RESULTS: (1) Compared with the normal control group, both the [Ca(2+)](i) absolute number and ipsi-/contra-lateral ratio were increased at each time point with statistical significance (P<0.05). Compared with the HIBD group, the [Ca(2+)](i) in the HIBD+ TanIIA group was decreased at each time point. At 24 h after HIBD, the ipsi-/contra-lateral ratio of HIBD+ TanIIA group was 24.9% less than that of HIBD group with statistical significance (P<0.05). (2) In the normal control group, abundant phospho-NR1 S897 positive cells were nicely distributed in the cortex. Compared with the normal control group, at each time point, both the absolute number of phospho-NR1 S897 positive cells and the fluorescent intensity of phospho-NR1 S897 in the ipsilateral cortex of the HIBD group were decreased with statistical significance (P<0.05). Compared with the HIBD group, both the absolute number of phospho-NR1 S897 positive cells and the fluorescent intensity of phospho-NR1 S897 in the ipsilateral cortex of HIBD+ TanIIA were increased. There was significant difference at 3 and 12 h after the HIBD (P<0.05). CONCLUSION TanIIA reduced the HIBD-caused down-regulation of phospho-NR1 S897 and the HIBD-caused [Ca(2+)](i) elevation in the cortex. The neuroprotective effect of TanIIA may be related to influencing NMDA receptor expression and decreasing intracellular free calcium aggregation.
Abietanes ; pharmacology ; therapeutic use ; Animals ; Animals, Newborn ; Calcium ; metabolism ; Female ; Hypoxia-Ischemia, Brain ; drug therapy ; metabolism ; Male ; Neuroprotective Agents ; pharmacology ; therapeutic use ; Phosphorylation ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Receptors, N-Methyl-D-Aspartate ; genetics ; metabolism