Objective To examine the relationship between gender and intraventricular hemorrhage (IVH) in very low birth weight infants (VLBWI) and extremely low birth weight infants (ELBWI).Methods From January 1,1999 to December 31,2012,data on VLBWI and ELBWI,who were admitted to the neonatal intensive care unit of Yuying Children's Hospital within 14 d after birth,were retrospectively collected.The Chi-square test and t test were used to compare neonatal outcomes between male and female infants.The Logistic model was used to analyze the risk factors for IVH.Results A total of 1 008 cases were enrolled,including 615 males and 393 females,895 VLBWI and 113 ELBWI.The incidence of IVH was 15.1％ (152/1 008) and the incidence of severe IVH was 8.4％ (85/1 008).Compared with females,males had a higher total incidence of IVH [17.2％ (106/615) vs 11.7％ (46/393),x2=5.728,P＜0.05] and severe IVH [9.8％ (60/615) vs 6.4％ (25/393),x2=3.896,P＜0.05].These differences were also seen in VLBWI with a birth weight of 1 250 to 1 499 g [IVH:13.7％ (47/344) vs 7.8％ (17/217),x2=4.473,P=0.034; severe IVH:7.6％ (26/344) vs 2.8％ (6/217),x2=5.684,P=0.017].Logistic regression analysis showed that the risk factors for IVH were as follows:gestational age ＜28 weeks (aOR=2.012,95％CI:1.288-3.143,P＜0.05),neonatal respiratory distress syndrome (aOR=l.584,95％CI:1.007-2.492,P＜0.05),invasive mechanical ventilation (aOR=2.743,95％CI:1.826-4.121,P＜0.05),electrolyte disturbance (aOR=2.128,95％CI:1.092-4.149,P＜0.05) and periventricular leukomalacia (aOR=2.901,95％CI:1.312-6.416,P＜0.05),but not male sex (aOR=1.351,95％CI:0.917-1.991,P=0.128).The risk factors for severe IVH were gestational age ＜28 weeks (aOR=2.200,95％CI:1.305-3.708,P＜0.05),invasive mechanical ventilation (aOR=4.714,95％CI:2.809-7.911,P＜0.05) and electrolyte disturbance (aOR=2.232,95％CI:1.047 4.759,P＜0.05),but not male sex (aOR=1.361,95％CI:0.823 2.252,P=0.247).Conclusions Male VLBWI and ELBWI have a higher incidence of IVH and severe IVH,but male sex is not a risk factor for IVH or severe IVH.

Objective To analyze the influencing factors for intraventricular hemorrhage in the very low birth weight infants (VLBWI) and extremely low birth weight infants(ELBWI).Methods The clinical data of all VLBWI and ELBWI in the Second Hospital of Wenzhou Medical College from Jan.1,1999 to Dec.31,2011 were retrospectively collected.They were divided into the intraventricular hemorrhage (IVH) group and non-IVH group,which included mild and severe IVH in IVH group,and then the differences of perinatal factors were analyzed in the different groups.The severity of IVH was graded based on Papile classification,and SPSS 16.0 statistical software was used for the data processing and analysis.Results A total of 925 cases were collected,and the incidence rate of IVH was 12.6％ (117/925 cases),in which the severe IVH accounted for 58.4％ (66/113 cases).Factors like maternal hypertension,maternal age ≥ 30 years,gestational age,birth weight,male,small for gestational age,severe asphyxia,placental abnormalities (including placental abruption,placenta praevia,placenta adhesion,small placenta,aging of placenta),pneumonia,neonatal respiratory distress syndrome,pulmonary hemorrhage,invasive mechanical ventilation,using pulmonary surfactant (PS),chronic lung disease (CLD),necrotizing enterocolitis (NEC) were significantly different between 2 study groups (all P ＜ 0.05).Logistic regression analysis identified that gestational age ＜ 28 weeks (AOR 2.583 ; 95 ％ CI:1.357-4.916,P =0.004),maternal age ≥ 30 years (A OR 1.638 ; 95 ％ CI:1.061-2.530,P =0.026),invasive mechanical ventilation (AOR 2.098 ;95 ％ CI:1.262-3.488,P =0.004),NEC (A OR 3.064 ;95 ％ CI:1.391-6.750,P =0.005),using PS(AOR 1.794;95％ CI:1.057-3.045,P =0.030),pulmonary hemorrhage(AOR 3.372;95％ CI:1.138-9.989,P =0.028),subarachnoid hemorrhage (SAH) (AOR 4.936 ;95 ％ CI:1.717-14.184,P =0.003),periventricular leukomalacia(PVL) (AOR 3.157 ;95％ CI:1.294-7.701,P =0.012),hypoxic-ischemic brain damage (HIBD)(AOR 3.777;95％ CI:1.637-8.716,P =0.002) increased the risks of IVH.Invasive mechanical ventilation increased the risk of severe IVH(AOR 4.333 ;95％ CI:1.861-10.088,P =0.001).Conclusions Anong infants with birth weight ＜ 1 500 g,many prenatal,perinatal and postnatal factors are associated with incidence of IVH.Gestational age ＜ 28 weeks,maternal age ≥ 30 years,invasive mechanical ventilation,NEC,exogenous PS,pulmonary hemorrhage,SAH,PVL and HIBD are risk factors for IVH.Cranial ultrasound plays a key role in the early recognition of IVH.

α7 nicotinic acetylcholine receptor(α7nAChR)is widely expressed in the central nervous system and immune system,and plays a neuro-immunoregulatory role.On the one hand,α7nAChR is involved in the transmission of neurotransmitters,the conduction of excitatory signals and the maintenance of synaptic plasticity,which is of great significance for maintaining the normal and stable neurocognitive function.On the other hand,as an important part of the cholinergic anti-inflammatory pathway,α7nAChR is involved in the regulation of physiological and pathological processes such as inflammatory response,oxidative stress,apoptosis and autophagy in the central system,and plays an immunomodulatory and neuroprotective role,thus being potential target for improving perioperative neurocognitive function.This article reviews the biological characteristics of α7nAChR and its effect on perioperative neurocognitive function,in order to provide ideas and methods for clinical improvement of perioperative neurocognitive function in surgical patients.

BACKGROUNDA generally accepted guideline ("41 rules") published by the International Consensus Group for Hematology Review (ICGHR) can not be suitable for all the laboratories because the facility type, laboratory requirements, sample volume, review rate, turn around time, instrument model and characters etc. are quite different from each other, which may cause a higher workload for microscopy review or lead to false or misleading results. Therefore, we decided to develop the personalized review criteria for 4 series of hematology analyzers in the same hospital, and describe all the implement procedures in detail.

METHODSThe total 1770 blood samples were collected from Peking Union Medical College Hospital. Referring to the suggested criteria by international consensus group for hematology review ("41 rules"), the personalized review criteria for 4 series of hematology analyzers including Siemens Advia 2120, Sysmex XE-2100, Sysmex XT-1800i and Sysmex XS-800i were established and validated by adjusting the rules in order to reduce the false positive rate and keep the false negative acceptable by clinical.

RESULTSUsing the "41 rules", high review rates of 37.94%, 35.56%, 33.44% and 37.94% were got respectively in Siemens Advia 2120, Sysmex XE-2100, Sysmex XT-1800i and Sysmex XS-800i. Three false positive rules mainly were observed in all of 4 analyzers: white blood cell < 3 × 10(9)/L or >30 × 10(9)/L, platelet < 100 × 10(9)/L or > 1000 × 10(9)/L and immature granulocyte. Specialized rules were observed in different series of analyzers, atypical/variant lymphs flag were found mainly in Sysmex XE-2100, Aniso-RBC were found mainly in Sysmex XT-1800i, flag of "immature granulocyte" mainly in Sysmex XS-800i, Micro-RBC, Macro-RBC and Aniso-RBC mainly in Siemens Advia 2120. Rules of immature granulocyte, blast, and NRBC flag would be mainly triggered by hematology malignant tumor. We could not delete these rules due to the risk of false negative of serious disease, other rules were deleted or revised. After continually optimizing to the rules, we finalized the criteria suitable for Siemens Advia 2120, Sysmex XE-2100, Sysmex XT-1800i and Sysmex XS-800i in our laboratory. The false negative rates were 2.94%, 2.86%, 3.10% and 2.78%, the review rates were 31.07%, 30.00%, 30.01% and 30.09%, and there was no hematology malignant tumor missed. Validated by 547 samples, the false negative rates of our optimized rules were 0.37%, 0.55%, 0.55%, and 0.91% respectively.

CONCLUSIONThe criteria can be based on the criteria established by International Consensus Group for Hematology Review but must be optimized according to the different requirements.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; China ; Female ; Hematologic Tests ; standards ; Hospitals ; standards ; Humans ; Male ; Middle Aged ; Young Adult