1.Severe viral infection in neonatal intensive care unit
Chinese Pediatric Emergency Medicine 2015;22(4):232-236
There is a lack of knowledge concerning the frequency and significance in patients treated in the NICU because of the confused and difficult techniques in viral testing. Some researches revealed that the incidence of viral infection in the NICU was 5%. We discussed the common viral infections including re-spiratory syncytial virus,enterovirus,rotavirus,cytomegalovirus,herpes simplex virus,rubella virus,parvovir-us and human immunodeficiency virus. Based on the database of the outbreak of viral infections in NICU,we need for more effective outbreak prevention strategies.
2.Breast milk acquired cytomegalovirus infections in premature infants: doubts and challenges
Chinese Pediatric Emergency Medicine 2021;28(2):102-106
Breast feeding is the optimal food for all babies. Human milk can promote the immune system and other immature organs of premature infants, and improve the development and long term outcomes. However, breast milk may carry pathogenic microorganisms especially cytomegalovirus, which can be infected through breast feeding. Infected preterm infants could appear a series of clinical symptoms and may developed a series of adversely long-term prognosis. This paper discussed the research progress about preterm infants acquired the cytomegalovirus by breast feeding after birth and focused on the existing clinical prevention treatment strategies.
3.Study progress of breast milk stem cells
Chinese Journal of Applied Clinical Pediatrics 2016;31(14):1113-1115
The immense potency of bioactive molecules of human breast milk and importance of breastfeeding is known worldwide.Less attention has been paid on the cellular constituents and properties of breast milk.In the past decade,a research has been done by multidimensional approach to investigat the cells human milk.Technological advances have played an important role in this work,which has resulted in the breakthrough discovery of breast milk stem cells with self renewal and multilineage potentials.Regenerative medicine may benefit from utilizing these cells.Breast milk stem cells are transferred to the offspring during breastfeeding.This contributes substantially to infant health.This review summarizes the current knowledge on the potential of breast milk stem cells,with emphasis on their origin,properties and future applications.
4.Discussion on the 2019 Novel Coronavirus susceptible mechanism in children
International Journal of Pediatrics 2021;48(3):191-194
Although children are susceptible to infectious diseases, the cases of children infected with 2019 Novel Coronavirus(2019-nCoV)is relatively low, and the proportion of severe illnesses is even lower.The reason is that the 2019-nCoV cell receptor has low binding capacity in children or the induced intracellular response is low, children’s immune system is immature, lymphocyte depletion and inflammatory factor storms are rare in children, and China′s strict prevention and control measures have kept children away from 2019-nCoV.
5.Clinical characteristics and cardiac hemodynamic changes of patent ductus ateriosus in preterm infants.
Danfang LU ; Yunfeng LIU ; Xiaomei TONG
Chinese Journal of Pediatrics 2015;53(3):187-193
OBJECTIVETo study clinical characteristics and evaluate cardiac hemodynamic changes in premature infants with patent ductus ateriosus (PDA).
METHODOne hundred and five infants born at ≤ 34 weeks' gestational age (GA) and ≤2 000 g birth weight (BW) were prospectively enrolled, including 63 males and 42 females, and the mean GA was (31. 1 ± 1.9) weeks and BW (1 401 ± 314) g. Echocardiography was done to detect hemodynamically significant PDA (hsPDA) and to evaluate left ventricular function at 2, 3, 5 and 7 d respectively after birth. On the basis of clinical symptoms and echocardiographic outcome, all the cases were divided into 3 groups: hsPDA group (n = 34), non-hsPDA (nhsPDA) group (n = 44) and non-PDA (nPDA) group (n = 27) to survey and compare general conditions, DA diameter, shunt direction, left ventricular function and complications.
RESULTThe hsPDA group had smaller GA ((30. 5 ± 2. 1) vs. (31. 6 ± 1. 6) weeks, P = 0. 01) and greater proportion of pulmonary surfactant use and mechanical ventilation (2, 3, 5 d of birth) than the nhsPDA and the nPDA group (χ2 = 11. 62, 14. 95, 12. 73, 1:1. 59, P = 0. 00; 0. 00, 0. 01, 0. 01). Univariate and multivariate Logistic regression analysis indicated that the average length of stay (ALOS) was correlated with hsPDA (F =3. 52 and P =0. 03, OR 1. 03 and P =0. 02). The ALOS was longer in the hsPDA group than in the nhsPDA and the nPDA group ((39 ±23)vs. (30 ± 16)and(29 ±13) d, P =0.02, 0.03). There was no significant.difference in rates of mortality/giving-up of treatment among the three groups (5. 9% (2/34)vs. 0 (0/44) and 3. 7% (1/27), χ2 = 5. 26, P = 0. 06). Diastolic blood pressure and mean blood pressure were significantly lower in the hsPDA group than in the other two groups (P all <0. 05) at 2, 3 and 5 days after birth and the pulse pressure was found significantly higher in the hsPDA group than in the nPDA group at 2 d after birth. Univariate and multivariate Logistic regression analysis demonstrated that hsPDA was correlated significantly with neonatal respiratory distress syndrome (NRDS) and bronchopulmonary dysplasia (BPD) (χ2 =7. 34 and 7. 39, P = 0. 02 and 0. 02; OR = 3. 46 and 4. 01, P = 0. 04 and 0. 02). Premature infants with hsPDA had normal left ventricular fractional shortening (FS) and left ventricular ejection fraction (LVEF), although the cardiac output (CO) of left ventricle increased significantly(F = 6. 93, P <0. 01) within seven days of birth. There was no significant difference in cardiac hemodynamic parameters among closed group of hsPDA group, nhsPDA group and nPDA group simutaneously reexamined at 7th day after birth. The CO was extremely significantly different among premature infants who had different GAs and BWs. The lower the GAs and the BWs, the lower the value of CO(F =5. 16 and 14. 87, P all <0. 01). The DA diameter was reduced much more dramatically after ibuprofen treatment than before in hsPDA group(t = 5. 58, P <0. 01).
CONCLUSIONThe GA, PS use and mechanical ventilation were probably associated with hsPDA. The mean blood pressure and diastolic blood pressure were decreased and pulse pressure was increased in preterm infants with hsPDA that correlated significantly with ALOS, NRDS and BPD. In addition, increased CO values were found in hsPDA group. Oral ibuprofen administered to preterm infants for hsPDA at > 24 h of life promoted ductal closure.
Birth Weight ; Bronchopulmonary Dysplasia ; Cardiac Output ; Cyclooxygenase Inhibitors ; therapeutic use ; Ductus Arteriosus, Patent ; physiopathology ; Echocardiography ; Female ; Gestational Age ; Hemodynamics ; Humans ; Ibuprofen ; therapeutic use ; Infant, Newborn ; Infant, Premature ; Infant, Premature, Diseases ; Male ; Pulmonary Surfactants ; Respiration, Artificial ; Respiratory Distress Syndrome, Newborn ; Ventricular Function, Left
6.Multi-factor analysis of umbilical plasma ?-endorphin levels in neonates
Xuefeng ZHANG ; Hui SHENG ; Xiaomei TONG
Chinese Journal of Perinatal Medicine 1998;0(02):-
Objective To study the levels of umbilical plasma ?-endorphin (?-EP) in normal and abnormal pregnancy and the influencing factors. Methods The umbilical plasma ?-EP concentrations of 95 cases were measured by radioimmunoassay. Linear regression was used to find out the influencing factors of ?-EP including: neonatal gestational age, gender, birth weight, mode of delivery, maternal hypertension, maternal diabetes, premature rupture of membranes(PROM) and fetal distress. The subjects were divided into two groups: healthy term newborns and preterm neonates. Results Gestational age, mode of delivery and fetal distress were important factors influencing umbilical blood ?-EP production (P
7.Effect of the family history of cardiovascular disease and diabetes on birth weight and insulin sensitivity in neonates
Xinli WANG ; Yunpu CUI ; Xiaomei TONG
Chinese Journal of Perinatal Medicine 1998;0(03):-
Objective Examining the potential for genetic influences on the association of fetal growth restriction (FGR) with increased occurrence of coronary heart disease, hypertension and diabetes in later life. Methods The study group consisted of 75 neonates of small-for gestation age (SGA) and 244 neonates of adequate for gestational age (AGA), whose mothers did not have diabetes mellitus. Anthropometric measurements were performed at birth. Fasting glucose and insulin levels were measured on the 3rd day after birth. The history of cardiovascular disease and diabetes mellitus was recorded in their parents and grandparents. Results The prevalence of coronary heart disease, hypertension and diabetes mellitus was significantly higher in parents and grandparents of SGA group than that of AGA group (20.0%, 30.7%, 12.0% vs 9.3%, 14.7%, 3.5%,P0.05). Conclusions Genetic factor may promote both FGR and susceptibility to occurrence of coronary heart disease, hypertension and diabetes.
8.Study on hypocarbia in newborns during mechanical ventilation
Xiaomei TONG ; Yanmei CHANG ; Xinli WANG
Chinese Journal of Perinatal Medicine 2003;0(06):-
Objective To explore the causes and adverse effects of hypocarbia in newborns during mechanical ventilation. Methods Two hundred and forty-six newborns received assisted ventilation from Jan. 1994 to Dec. 2003 were retrospectively reviewed. Results The morbidity of hypocarbia was 14. 2%. It is common in preterm infants and the onset time of which were (31. 6?26. 9) hours after mechanical ventilation. The common primary disease was respiratory distress syndrome (RDS) (22. 6%). The mortality (32. 9%) and incidence of intracranial hemorrhage (20%) in hypocarbia cases were higher than those of the control group (7. 1 % and 5. 7%) (P
9.Influence of maternal glucose metabolism during pregnancy and family history of diabetes on insulin sensitivity in infants and toddlers
Taoran FU ; Xuemei WANG ; Xinli WANG ; Xiaomei TONG
Chinese Journal of Perinatal Medicine 2010;13(6):450-455
Objective To explore the related factors of insulin sensitivity in infants and toddlers. Methods From January 2006 to May 2008, 246 infants and 120 toddlers who had regular physical check-ups at the Children Healthcare Center of Third Hospital of Peking University were selected in this retrospective study. The homeostasis model assessment insulin resistance index (HOMA-IR), insulin action index(IAI), fasting glucose-to-insulin ratio (FGIR) and HOMA-β cell function (HOMA-β) were measured with the homeostasis model analysis. According to different glucose metabolic situation of the pregnant mothers and diabetes family history, the infants and toddlers were divided into different groups. The above indicators were compared among groups.Results In infants with maternal diabetes, the levels of HOMA-IR and HOMA-β were 3.24 (2.76-4.12) and 164. 00 (114. 44-192.85), higher than those born to mothers without abnomal glucose metabolism [1.51 (0. 86-2.50) and 67.07 (41.83-106.22)], while the levels of IAI and FGIR were lower[-7.18(-7.41-7.02) and 7.31(5.82-8.55) vs -6.41(-6.92-5.85) and 14.84(9.49-24. 79)] (Z=3. 76,3. 35,3. 76 and 3.71, P<0. 017). Compared with infants of maternal impaired glucose tolerance,the level of HOMA-IR was higher (Z= 3.19, P<0.017) in infants with maternal diabetes,the level of IAI was lower(Z= 3. 19, P<0. 017). No significant difference of insulin sensitivity were observed between infants with and without maternal impaired glucose tolerance (P>0. 017). The level of HOMA-IR was higher in infants and toddlers with diabetes in first-degree relatives [infants: 3.24(2. 73-4. 13) vs 1.41(0.84-2.50) ; toddlers: 3.98(2.62-4.80) vs 1.70(0.92-3.04); P<0. 017], while the levels of IAI and FGIR were lower [infants: IAI, -7. 18(-7.42-- 7.00) vs - 6.34 ( - 6.91- 5.82); FGIR, 7.31 (5.40-7.48) vs 14.87 (9.53-25.17); toddlers: IAI,-7.38(-7.57-6.97) vs -6.54(-7.11-5.92); FGIR, 6.17(6.04-8.00) vs 12.65(8.33-21.53), P<0. 017], and the level of HOMA-β was higher just in the infants [164.00(137.82-198.00) vs 67.06(40.40-106.83), P<0. 017]. No significant difference was observed in infants with second-degree relatives diabetes and without diabetic family history group (P>0. 017). Conclusions Maternal diabetes and diabetic family history in first-degree relatives were significantly related to the decrease of insulin sensitivity in infants and toddlers.
10.Application of neurally adjusted ventilatory assist in pediatrics
Tongyan HAN ; Naishun TSOI ; Xiaomei TONG ; Meihua PIAO
Chinese Journal of Applied Clinical Pediatrics 2014;29(12):943-945
During the treatment of pediatric critical cases,the mechanical ventilation support is one of the most important factors.Neonatologists are trying to find a better mode of ventilation support.Neurally adjusted ventilatory assist (NAVA) is a new mode of mechanical ventilation controlled by diaphragmatic electrical signals.Because the mechanism of ventilation support is different from the conventional ventilators,NAVA provides a different effect of respiratory support varying with the needs of the newborn.Pediatric studies had been review to provide more information of NAVA to pediatrics.