Objective To discuss the etiology,clinical features,diagnosis and treatment of congenital pleural effusion in fetuses and neonates in order to improve the understanding of this disease. Methods Six neonate cases with congenital pleural effusion were retrospectively analyzed in neonates who were admitted to the Department of Neonatolo-gy of the First Affiliated Hospital of Zhengzhou University after birth and the etiology,clinical features,diagnosis and re-lated treatment were analyzed based on literature review. Results Among 6 patients with congenital pleural effusion, chylothorax was found in 3 cases,one of whom had chylothorax,chylous abdominal,21 trisomy syndrome and congenital hypothyroidism,and the etiology of the other 3 cases were unknown. Diagnosis mainly was depended on imaging and la-boratory tests. The number of nucleated cells of hydrothorax or ascites were(1 588 - 13 057)× 106 / L,mainly lympho-cytes. Protein qualitative was( + - + + + ),the chylothorax qualitative test was positive in 3 cases. The liver function showed that the total protein and albumin were decreased in varyig degrees. Conservative or surgical treatment was taken according to the situation of the patients. Among 6 patients,3 cases were cured after treatment,the others gave up treat-ment finally. Conclusions The etiology of congenital pleural effusion was different,and often associated with chromo-somal abnormalities or other malformations,ultrasonography was the main method to diagnose congenital pleural effusion and the patients should be dynamically observed or treated during the antepartum or intrapartum period. If the neonates are found to have pleural effusion in prenatal period early diagnosis and treatment is a best choice.

Objective To explore the traits of improved polyacrylamide gel electrophoresis (PAGE)-ethidium bromide(EB) staining in the detection of genotype polymorphisms.Methods The methods of PAGE-silver staining,agarose gel electrophoresis (AGE)-EB staining and improved PAGE-EB staining in polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) were used to detect the μ-opioid receptor (OPRM1) A118G genotypes in case group (n =167) infants with intracranial hemorrhage (ICH),and control group(n =163) infants without ICH,to conduct a case study analysis.And the application traits of three methods were compared.Results Genotypes of OPRM1 A118G were GG (169 bp),AG (193 bp,169 bp),AA (193 bp).Both the electrophoresis methods of PAGE-silver staining and PAGE-EB could be used to detect the genotypes of OPRM1 A118G clearly in this study.There was no statistically significant difference between the resolutions of DNA fragments (P =0.884).The first method,which had 13 experiment steps,consuming 4-5 hours,involving 12 kinds of chemical reagents,and the pictures were taken with the camera,was complex,with difficult operation,more time consuming; Compared with the first method,the secondmethod was simple,which had 6 test procedures,consuming 2 hours with 8 reagents,and the pictures were taken by using an automatic gel imager.AGE-EB could not be used to detect genotypes of OPRM1 A118G.Conclusions The method of improved PAGE-EB has the advantages of fast,easy operation,and high resolution,which is worthy of wider application.

ObjectiveTo explore the risk factors of obstructive hydrocephalus secondary to intracranial hemorrhage in premature infants.MethodsA total of 304 premature infants were selected who were diagnosed as sever intracranial hemor-rhage (grade III and IV) by cranial bedside ultrasound admitted to our hospital from Jun. 2013 to Sep. 2014. According to wheth-er the obstructive hydrocephalus was followed, all infants were divided into hydrocephalus group (n=59) and non-hydrocephalus group (n=185). The risk factors of obstructive hydrocephalus secondary to intracranial hemorrhage were analyzed and the lateral ventricle size was measured dynamically.ResultsThe univariate analysis showed the factors related with obstructive hydro-cephalus were as follows: gestational age≤32 weeks, birth weight< 1500g, severe asphyxia, cesarean section, RDS, neonatal infection, heart failure, PDA, acidosis, thrombocytopenia, coagulation abnormalities, and intracranial hemorrhage (gradeⅢ orⅣ) (allP<0.05). Multivariate logistic regression analysis showed that acidosis, thrombocytopenia, coagulation abnormalities, gesta-tional age≤ 32 weeks, severe asphyxia, intracranial hemorrhage (gradeⅢ orⅣ) were independent risk factors for obstructive hydrocephalus (OR: 1.76~20.46, allP<0.05). At each time point after birth, the ratio of posterior horn of lateral ventricle was signiifcantly higher in hydrocephalus group than that in non-hydrocephalus group (P<0.05). There were signiifcant differences in the changes of the posterior horn ratio of left or right lateral ventricle with time in hydrocephalus group (P=0.000), increasing at 14 days and reaching the peak at 28 days after birth.ConclusionsThe risk factors for obstructive hydrocephalus secondary to intracranial hemorrhage in neonates are important. Regular and dynamical monitoring of ventricle size by cranial ultrasound is needed in infants with sever intracranial hemorrhage.

Hemangioendothelioma ; Humans ; Infant, Newborn ; Kasabach-Merritt Syndrome ; Sarcoma, Kaposi

Magnesium ion (Mg²⁺ ) plays an important role in maintaining the life and health of the body.In preterm infants, the protective effect of prenatal Mg²⁺ supplementation on the nervous system of preterm infants has been widely recognized.Researchers begin to pay attention to the effects of serum Mg²⁺ level on the development of nervous system and effects of prenatal exposure to Mg²⁺ on the non-nervous system in preterm infants.The effects of Mg²⁺ on the development of neural and non-neural system in preterm infants were summarized.

Objective: To analyze the risk factors of adverse neurodevelopmental prognostic in very /extremely low birth weight infants (VLBWI/ELBWI). Methods: The 24 hours VLBWI/ELBWI admitted to the neonatal intensive care unit between January 2016 and October 2016 were enrolled.These infants were followed up and neurodevelopmental evaluation was performed at a corrected age of 12 months by using the Bayley Scales of Infant Development Ⅱ (BSID-Ⅱ). According to the neurodevelopmental outcomes, they were divided into normal and abnormal neurodeve-lopment groups.The data of prenatal, intrapartum and postpartum periods in the two groups were compared.Potential risk factors of neurodevelopmental impairment were analyzed with Logistic stepwise regression. Results: A total of 167 VLBWI/ELBWI were enrolled, among which 14 cases died during hospitalization or after giving up treatment.At the corrected age of 12 months, 140(91.5%) infants completed follow-up and 13(8.5%) were lost to follow-up.Among 140 infants who completed neurodevelopmental evaluation at the corrected age of 12 months, there were 86 males, 54 females, and in which 28 cases had extremely low birth weight, 112 cases with very low birth weight, with gestational age of (30.4±2.2) weeks (25.3-36.0 weeks). There were one hundred and twenty-five cases with normal neurodevelopmental outcomes and 15 cases with abnormal neurodevelopmental outcomes.The results of univariate analysis showed that birth weight<1 000 g, exposure to antenatal steroids, N -terminal brain natriuretic peptide (NT-proBNP) ≥35 000 ng/L and bronchopulmonary dysplasia (BPD) in the two groups were statistically significant(P<0.05). Logistic stepwise regression showed that NT-proBNP level≥35 000 ng/L may independently predict neurodevelopmental impairment among VLBWI/ELBWI (OR=22.774, 95%CI: 3.079-168.425, P=0.002). Exposure to antenatal steroids may be a protective factor for neurodevelopmental impairment (OR=0.125, 95%CI: 0.020-0.782, P=0.026). Conclusions Plasma NT-proBNP level ≥35 000 ng/L may independently predict neurodevelopmental impairment among VLBWI/ELBWI.Antenatal corticosteroids may be the protective factor of poor neurodevelopmental outcomes.

Epithelial-mesenchymal transition (EMT ) is known to be involved in airway remodeling and fibrosis of bronchial asthma. However, the molecular mechanisms leading to EMT have yet to be fully clarified. The current study was designed to reveal the potential mechanism of microRNA-21 (miR-21) and poly (ADP-ribose) polymerase-1 (PARP-1) affecting EMT through the PI3K/AKT signaling pathway. Human bronchial epithelial cells (16HBE cells) were transfected with miR-21 mimics/inhibitors and PARP-1 plasmid/small interfering RNA (siRNA). A dual luciferase reporter assay and biotin-labeled RNA pull-down experiments were conducted to verify the targeting relationship between miR-21 mimics and PARP-1. The migration ability of 16HBE cells was evaluated by Transwell assay. Quantitative real-time polymerase chain reaction and Western blotting experiments were applied to determine the expression of Snail, ZEB1, E-cadherin, N-cadherin, Vimentin, and PARP-1. The effects of the PI3K inhibitor LY294002 on the migration of 16HBE cells and EMT were investigated. Overexpression of miR-21 mimics induced migration and EMT of 16HBE cells, which was significantly inhibited by overexpression of PARP-1. Our findings showed that PARP-1 was a direct target of miR-21, and that miR-21 targeted PARP-1 to promote migration and EMT of 16HBE cells through the PI3K/AKT signaling pathway. Using LY294002 to block PI3K/AKT signaling pathway resulted in a significant reduction in the migration and EMT of 16HBE cells. These results suggest that miR-21 promotes EMT and migration of HBE cells by targeting PARP-1. Additionally, the PI3K/AKT signaling pathway might be involved in this mechanism, which could indicate its usefulness as a therapeutic target for asthma.

Objective To explore the relationship between renal volume and function in the preterm and term newborns at different gestational ages.Methods This study was conducted at the First Affiliated Hospital of Zhengzhou University from October 2016 to March 2018.A total of 626 newborns with different gestational ages were included and the renal volume was determined by ultrasonography.Blood samples were taken for laboratory tests to detect renal function including urea,creatinine,uric acid and estimated glomerular filtration rate.Results A total of 352 preterm and 274 full term newborns were enrolled at birth.The mean gestational age of the neonates was (36.0 ± 3.5) weeks and the mean birth weight was (2.59 ±0.77) kg.The mean renal volume of the preterm infants was (19.57 ±4.30) cm3 and estimated glomerular filtration was (21.68 ± 5.99) mL/(min · 1.73 m2);the mean renal volume of the term infants was(23.03 ± 3.80) cm3 and estimated glomerular filtration was(46.60 ± 10.21) mL/(min · 1.73 m2).The renal volume and estimated glomerular filtration of term infants was significantly greater compared to the preterm infants (t =12.96,33.10,all P ＜ 0.001).The renal volume was highly linear positively correlated with gestational age,birth weight and birth length (r =0.546,0.605,0.592,all P ＜ 0.001).The renal volume was highly linear positively correlated with estimated glomerular filtration(r =0.396,P ＜ 0.001).The renal volume was negatively correlated with urea,creatinine and uric acid(r =-0.210,-0.280,-0.176,all P ＜ 0.001).Conclusions The renal volume increases with gestational age and birth weight in neonates.Estimated glomerular filtration increases with renal volume in neonates.The preterm infants have immaturity kidney size and poor development so that they need special medical care.

Objective To explore the testis development and epididymis in the preterm and term newborns so as to provide the scientific evidence for early clinical diagnosing early.Methods From October 2016 to March 2018,456 hospitalized neonates at Department of Neonatology,the First Affiliated Hospital of Zhengzhou University were recruited within 7 days at birth in this study.In these patients,224 cases were preterm newborns and 232 cases were term newborns.These gestational ages of newborns at birth were (36.18 ± 3.13) weeks (27-41 +6 weeks) and weighted (2.66 ± 0.67) kg(0.90-3.82 kg).The size of the testis and epididymis were measured by ultrasonography.Results The mean testicular volume of the preterm was (0.24 ± 0.07) mL.The mean length of epididymal head,thickness of epididymal head and body and tail of the preterm newborns were (4.17 ±0.59) mm,(2.58 ±0.39) mm,(1.78 ± 0.26) mm,(1.91 ± 0.24) mm,respectively.The mean testicular volume of the term newborns was (0.38 ± 0.13) mL,the mean length of epididymal head,thickness of epididymal head and body and tail of the term newborns were (4.49 ± 0.45) mm,(2.78 ± 0.34) mm,(1.95 ± 0.20) mm,(1.99 ± 0.16) mm,respectively.The mean testicular volume,length of epididymal head,thickness of epididymal head and body and tail of the preterm newborns were significantly lower compared with the term newborns (t =12.810,8.261,6.819,8.058,3.591,all P ＜0.001).The mean testicular volume of the newborns were highly linear positively correlated with gestational age,birth weight and birth length (r =0.538,0.591,0.533,all P ＜ 0.001).In the preterm newborns at postmenstrual age (PMA) of 37 weeks,the mean testicular volume,length of epididymal head,thickness of epididymal head and body and tail of the preterm newborns had no significant difference between the 2 groups (t =1.561,0.863,0.282,1.732,1.147,all P ＞ 0.05).Conclusions The testicular volume,the length of epididymal head,thickness of epididymal head and body increase with gestational age,birth weight and birth length in early neonates.The growth of reproductive system in the preterm newborns at PMA 37 weeks catch-up with term newborns.If this catch-up growth was incomplete at PMA 37 weeks,special attention should be given to monitor underlying diseases.

Objective:To explore the effect of dyslipidemia on the clinical outcome of intracytoplasmic sperm injection-embryo transfer (ICSI-ET) in infertility patients receiving donor eggs.Methods:A total of 118 patients were selected to receive egg donors and ICSI-ET at the First Affiliated Hospital of Nanjing Medical University between April 2007 and December 2020. According to the levels of triacylglycerol, serum cholesterol, high density lipoprotein (HDL), and low density lipoprotein, they were divided into dyslipidemia group (35 cases) and normal blood lipids group (83 cases). The influence of body mass index (BMI) and age was adjusted by 1∶1 propensity score matching, and the general condition and clinical outcome of the two groups were analyzed retrospectively. Finally, the relationship between lipid composition and clinical outcome was analyzed according to patients′ age and BMI.Results:(1) Comparing the pre-matching dyslipidemia group with the normal blood lipids group, the BMI of the dyslipidemia group was significantly higher than that of the normal blood lipids group [(23.5±2.4) vs (22.4±2.7) kg/m 2], and the embryo implantation rate was significantly lower than that of the normal blood lipids group [13.6% (8/59) vs 27.3% (36/132)], the differences were statistically significant (both P<0.05). (2) There were no significant differences in years of infertility, number of pregnancies, number of abortions, number of transplanted embryos, protocol of endometrial preparation, endometrial thickness on transplantation day and high quality embryo rate between the two groups, through propensity score matching (all P>0.05). The biochemical pregnancy rate [28.6% (10/35)], embryo implantation rate [13.6% (8/59)] and live birth rate [20.0% (7/35)] in dyslipidemia group were significantly lower than those in the normal blood lipids group ( P<0.05). The clinical pregnancy rate was lower than that of the normal blood lipids group ( P>0.05). (3) The results of stratified analysis showed that the level of HDL in the clinically non-pregnant group was significantly lower than that in the pregnant group in patients ≤ 35 years old [(1.5±0.3) vs (1.8±0.5) mmol/L; P<0.05]. In the overweight recipient patients, the level of HDL of the clinically non-pregnant group was lower than that of the pregnant group ( P>0.05). Conclusions:Dyslipidemia significantly reduces the biochemical pregnancy rate, embryo implantation rate and live birth rate in patients with receiving donor eggs. Especially in patients aged ≤35 years old, the reduction of HDL is closely related to adverse pregnancy outcomes.