OBJECTIVE: This article evaluates the auditory and speech perception outcomes of sensorneural hearing loss with cerebral white matter abnormalities after cochlear implantation. METHOD: A retrospective analysis was performed on the cochlear implantatees with cerebral white matter abnormalities by using the categories of auditory performance and speech intelligibility rating, and compared with the non-syndrome patients with sensorineural hearing loss. Paired t-test was used for statistical analysis. RESULT: There was statistical difference between normal group and white matter changes group with sensorineural hearing loss after 6 month. No statistical difference was found after 12 month and 24 month. CONCLUSION In the short term, the cochlear implant can be performed safely in patients with white matter changes. After a formal rehabilitation training,no significant difference in auditory or language ability was found between normal group and white matter changes group with sensorineural hearing loss.
Child, Preschool ; Cochlear Implantation ; rehabilitation ; Female ; Follow-Up Studies ; Hearing Loss, Sensorineural ; etiology ; surgery ; Humans ; Leukoencephalopathies ; complications ; Male

Objective To explore the correlation between apparent diffusion coefficient(ADC)and neonatal behavioral neurological assessment(NBNA) of newborns with hypoxic ischemic encephalopathy (HIE),and to evaluate ADC in the early diagnosis of HIE from the imaging perspective. Method One hundred and nine neonates aged 0—7 days with HIE underwent conventional MRI and DWI. According to HIE grading standards, there were 43 neonates in the mild group, 38 in the moderate group, 28 in the severe group, and meanwhile 24 normal neonates with the same ages were selected as the control group. All cases were assessed with NBNA, and ADC values of bilateral frontal white matter, parietal white matter, periventricular white matter, posterior limb of the internal capsule(PLIC), ventral lateral nucleus of thalamus, lenticular nucleus, splenium of the corpus callosum, brainstem were measured. ADC values of different groups were compared by analysis of variance, and the correlations between ADC values of all ROIs and NBNA were analyzed by Pearson correlation. Results Except lenticular nucleus and the brainstem, ADC values of frontal white matter, parietal white matter, periventricular white matter and PLIC, ventral lateral nucleus of thalamus, splenium of the corpus callosum were decreased in the mild, moderate, severe group. In the mild, moderate, and severe group, the ADC values of frontal deep white matter were(1.82± 0.33)× 10-3,(1.77 ± 0.34)× 10-3 and(1.62 ± 0.31)× 10-3 mm2/s,while they were(1.81 ± 0.34)× 10-3,(1.79 ± 0.27)× 10-3 and(1.72 ± 0.31)× 10-3 mm2/s for the parietal deep white matter,(1.27 ± 0.15)× 10-3,(1.23 ± 0.12)× 10-3 and(1.15 ± 0.17)× 10-3 mm2/s for the periventricular white matter,(1.08 ± 0.09)× 10-3,(0.97 ± 0.07)×10-3 and(0.84±0.06)×10-3 mm2/s for the PLIC,(1.13±0.07)×10-3 ,(1.08±0.13)×10-3 and(1.00± 0.13)× 10-3 mm2/s for the ventral lateral nucleus of thalamus,(1.27 ± 0.22)× 10-3,(1.18 ± 0.16)× 10-3 and (1.00 ± 0.23)× 10-3 mm2/s for the splenium of the corpus callosum. There were statistically significant differences between the 3 groups (F=61.27,16.27, 23.26, 72.70, 26.73, 66.09,all P<0.05). In the mild, modreate and severe group, NBNA were(36.8 ± 1.4) in the mild group,(33.5 ± 1.6) in the moderate,and (29.3 ± 2.6) in the severe group. There was positive correlation between ADC values of frontal white matter, parietal white matter, periventricular white matter and PLIC, ventral lateral nucleus of thalamus, splenium of the corpus callosum and NBNA scores(r=0.60,0.49,0.54,0.67,0.56,0.65,all P<0.05). Conclusions There are correlations between ADC values of the related ROIs of HIE and NBNA scores. Combining two aspects might diagnose the brain injury of HIE more accurately and objectively.

Objective To observe the proliferation ability of cocultured dendritic cells(DCs)loaded with tumor antigen and cytokine-induced killer cells( CIKs)and its killing effect on hepatocarcinoma cells HepG2. Methods The antigen of hepatocarcinoma cells HepG2 was prepared by repeated freezing and thawing of liquid nitrogen. Peripheral blood mononuclear cells(PBMNCs)were isolated from healthy donors by blood cell separator,then DCs and CIKs were induced. Ag-DCs were obtained by impinging DCs with tumor antigens. CIKs were divided into three groups:the first group was CIKs alone,the second group was mixed in the propor-tion of DCs : CIKs = 1 : 5,and the third group was mixed in the proportion of Ag-DCs : CIKs = 1 : 5. The three groups of cells were recorded as CIK group,DC-CIK group and Ag-DC-CIK group. The proliferation and cell phenotype of the three groups of cells were observed and the killing effects on hepatocarcinoma cells HepG2 were detected by methyl thiazolyl tetrazolium(MTT)assay. Results The proliferation multiples of the three groups of cells were gradually increased with the prolongation of culture time,and the proliferation rates of Ag-DC-CIK on the 9th day(61. 32 ± 1. 72),the 12th day(190. 83 ± 3. 53)and the 15th day(399. 09 ± 5. 60) were significantly higher than those of CIK group(22. 47 ± 2. 07,55. 91 ± 1. 81,83. 20 ± 2. 34)and DC-CIK group(40. 26 ±2. 49,125. 03 ±4. 16,251. 55 ±3. 25),and the difference between the three group was statisti-cally significant(F =185. 78,P =0. 033;F = 297. 35,P = 0. 018;F = 455. 37,P < 0. 001),in addition,the differences between each two groups were statistically significant(all P <0. 05). The cytotoxicity of Ag-DC-CIK to HepG2 cells at the effective target ratios of 5 : 1(31. 71％ ±0. 29％ ),10 : 1(42. 43％ ±1. 86％ )and 20 : 1 (57. 69％ ±1. 11％ )were significantly higher than those of CIK group(12. 11％ ±1. 14％ ,21. 30％ ±0. 52％ , 30. 71％ ±1. 26％ )and DC-CIK group(20. 06％ ± 0. 67％ ,29. 89％ ± 1. 37％ ,39. 11％ ± 0. 92％ ),and the difference between the three group was statistically significant(F =159. 64,P =0. 037;F =199. 36,P =0. 025;F =302. 08,P <0. 001),in addition,the differences between each two groups were statistically significant(all P <0. 05). On the 15th day of cell culture,the flow cytometry analysis showed that all the three groups were expressed CD3 + CD8 + ,CD3 + CD56 + double positive cells,the contents of CD3 + CD8 + 、CD3 + CD56 + double positive cells in the Ag-DC-CIK group(88. 12％ ± 1. 24％ ,61. 35％ ± 2. 63％ )were significantly higher than those in the CIK group(54. 37％ ± 3. 08％ ,18. 22％ ± 1. 83％ )and DC-CIK group(69. 80％ ± 1. 46％ , 39. 51％ ±2. 17％ ),and the difference between the three group was statistically significant(F = 414. 32,P <0. 001;F =378. 60,P <0. 001),in addition,the differences between each two groups were statistically signifi-cant(all P <0. 001). Conclusion The proliferation ability and killing effect of Ag-DC-CIK that obtained from antigen-pulsed DCs co-cultured with CIKs are significantly higher than those of CIKs and DC-CIKs.

Objective To investigate the effects of early essential newborn care (EENC) on body temperature and short-term clinical outcomes of vaginally born preterm infants at 1 h after birth. Methods This was a prospective case-control study. A total of 97 premature infants, who were born vaginally between 34-37 weeks in the Obstetrics Department of General Hospital of Ningxia Medical University from January 1 to December 31, 2017 and admitted to the neonatal intensive care unit were enrolled as intervention group. Another 103 premature infants, who were born vaginally in the Obstetrics Department of Yinchuan Maternal and Child Health Hospital at the same period were enrolled as control group. EENC-based treatment and management were implemented to infants in the intervention group, such as thorough drying immediately, 30 min skin-to-skin contact immediately and delayed cord clamping after birth, etc., while those in the control group were managed based on routine protocol. Chi-square test was used to compare the incidence of hypothermia, hypoglycemia and hypoxemia between the two groups at 1 h after birth. The general condition and the time of colostrum secretion were compared by two independent sample t-test. Multivariate logistic regression was used to analyze the risk factors of hypothermia. Results At last, 96 participants in the intervention group and 102 in the control group were analyzed. Compared with the control group, the intervention group showed lower incidence of hypothermia [17.7% (17/96) vs 37.3% (38/102), χ2=9.418, P=0.002], hypoglycemia [9.4% (9/96) vs 19.6% (20/102), χ2=4.142, P=0.042] and hypoxemia [14.6% (14/96) vs 28.4% (29/102), χ2=5.578, P=0.018] at 1 h after birth and earlier colostrum secretion [(18.3±2.4) vs (31.4±3.5) min, t=32.463, P<0.001]. Multivariate logistic regression analysis showed that birth weight <2 500 g ( OR=2.483, 95% CI : 1.731-3.234, P=0.025), gestational age<36 weeks (OR=1.899, 95%CI : 1.325-2.472, P=0.012), room temperature between 22-24℃in the delivery ward (OR=2.465, 95% CI: 1.279-4.754, P=0.007), no-skin contact (OR=2.958, 95%CI: 1.435-4.481, P=0.023) and rapid and simple drying ( OR=2.467, 95% CI : 1.285-4.736, P=0.006) were the risk factors for hypothermia in premature infants. Conclusions EENC can reduce the incidence of hypothermia, hypoglycemia and hypoxemia in premature infants at 1 h after birth and may be helpful for early colostrum secretion.

OBJECTIVE: To screen for differentially expressed circular RNAs (circRNAs) in the serum of preterm infants with intraventricular hemorrhage (IVH) and explore the competitive endogenous RNA (ceRNA) mechanism of circRNAs in IVH in these infants. METHODS: Fifty preterm infants (gestational age of 28 to 34 weeks) admitted in our department between January, 2019 and January, 2020 were enrolled in this study, including 25 with a MRI diagnosis of IVH and 25 without IVH. Serum samples were collected from 3 randomly selected infants from each group for profiling differentially expressed circRNAs using circRNA array technique. Gene ontology (GO) and pathway analyses were performed to reveal the function of the identified circRNAs. The circRNA-miRNA-mRNA network was constructed to identify the co-expression network of hsa_circ_ 0087893. RESULTS: A total of 121 differentially expressed circRNAs were identified in the infants with IVH, including 62 up-regulated and 59 down-regulated circRNAs. GO and pathway analyses showed that these circRNAs were involved in multiple biological processes and pathways, including cell proliferation, activation and death, DNA damage and repair, retinol metabolism, sphingolipid metabolism, cell adhesion molecules. Among these circRNAs, hsa_circ_0087893 was found to have significant down-regulation in IVH group and co-express with 41 miRNAs and 15 mRNAs (such as miR-214-3p, miR-761, miR-183-5p, AKR1B1, KRT34, PPP2CB, and HPRT1). CONCLUSION The circRNA hsa_circ_0087893 may function as a ceRNA and play an important role in the occurrence and progression of IVH in preterm infants.
Infant, Newborn ; Infant ; Humans ; RNA, Circular ; Infant, Premature ; MicroRNAs ; RNA, Messenger ; Cerebral Hemorrhage/genetics* ; Aldehyde Reductase

Objective To simulate and analyze the CT examination doses to typical patients based on Chinese reference human phantom, and to develop an online software for assessing the organ absorbed dose and effective dose to the examinees undergoing CT examination in order to provide a tool for rapid assessment of radiation dose from CT examination. Methods Based on the Monte Carlo simulation, a GE LightSpeed 16 CT scanner was modeled. The organ doses to Chinese adult male, female and 1 year-old child male from single axial scan were calculated based on the Chinese reference phantoms and an organ dose database was established. A web-based CT dose assessment software was developed to read the data from the organ dose database according to the CT scanning parameters entered by the user and to calculate the organ absorbed dose and effective dose rapidly. Results A new CT dose assessment software was developed, which can be used to assess organ doses to Chinese adult male, female and 1-year-old male for different CT scanner, voltage, current, collimator width and other CT parameters. The organ doses calculated in this work were compared with simulation data in two relevant studies. Dose differences for the organs completely included in the scan range were small, with relative differences less than 15％ and 25％, respectively. Conclusions The CT dose assessment software provides a powerful tool for the simple and rapid assessment of radiation dose to the examinees undergoing CT examinations.

Objective: To explore the influence of early essential newborn care(EENC) on the development of omphalitis in preterm infants following normal delivery. Methods: A total of 184 preterm infants, admitted to General Hospital of Ningxia Medical University from January 2017 to December 2017, were retrospectively collected as EENC group. During the same period, 161 preterm infants who were born in Yinchuan Maternal and Child Health Hospital were included in the control group. Preterm infants in EENC group were managed based on the clinical practice guideline of "Early Essential Newborn Care", while those in the control group underwent routine care after birth. The incidence of omphalitis between the two groups were compared using independent-samples t test and Chi-square test. Influencing factors of omphalitis were analyzed using univariate analysis and multivariate logistic regression analysis. Results: The incidence of mild omphalitis was lower [5.4% (10/184) vs 11.8% (19/161), χ²=4.520, P<0.05], and the separation and drying up time of cord stump were both earlier in the EENC group than those in the control group [(5.5±1.5) vs (8.2±1.2) d, t=4.169; (2.6±1.4) vs (3.2±1.4) d, t=4.513; both P<0.05]. Logistic regression analysis showed that gestational age≤34 weeks (OR=1.885, 95%CI: 1.109-6.757, P=0.032), early umbilical cord clamping (OR=3.615, 95%CI: 1.372-9.381, P=0.001) and bandaging of the umbilical stump (OR=1.921, 95%CI: 1.257-11.893, P=0.035) were independent risk factors of omphalitis in preterm infants. Conclusions Umbilical cord treatment based on EENC could reduce the incidence of omphalitis by avoiding its risk factors in preterm infants following normal delivery.

OBJECTIVESince 1986, the reference of birth weight for gestational age has not been updated. The aim of this study was to set up Chinese neonatal network to investigate the current situation of birth weight in China, especially preterm birth weight, to develop the new reference for birth weight for gestational age and birth weight curve.

METHODA nationwide neonatology network was established in China. This survey was carried out in 63 hospitals of 23 provinces, municipalities and autonomous regions. We continuously collected the information of live births in participating hospitals during the study period of 2011-2014. Data describing birth weight and gestational age were collected prospectively. Newborn's birth weight was measured by electronic scale within 2 hours after birth when baby was undressed. The evaluation of gestational age was based on the combination of mother's last menstrual period, ultrasound in first trimester and gestational age estimation by gestational age scoring system.

STATISTICAL ANALYSISthe growth curve was drawn by using LMSP method, which was conducted in GAMLSS 1.9-4 software package in R software 2.11.1.

RESULTA total of 159 334 newborn infants were enrolled in this study. There were 84 447 male and 74 907 female. The mean birth weight was (3 232 ± 555) g, the mean birth weight of male newborn was (3 271 ± 576) g, the mean weight of female newborn was (3 188 ± 528) g. The test of the variables' distribution suggested that the distribution of gestational age and birth weight did not fit the normal distribution, the optimal distribution for them was BCT distribution. The Q-Q plot test and worm plot test suggested that this curve fitted the distribution optimally. The male and female neonatal birth weight curve was developed using the same method.

CONCLUSIONUsing GAMLSS method to establish nationwide neonatal birth weight curve, and the first time to update the birth weight reference in recent 28 years.

Objective:To analyze the risk factors of bronchopulmonary dysplasia(BPD)in very preterm infants(VPI), and to provide scientific basis for the prevention and treatment of BPD in VPI.Methods:A prospective multicenter study was designed to collect the clinical data of VPI in department of neonatology of 28 hospitals in 7 regions from September 2019 to December 2020.According to the continuous oxygen dependence at 28 days after birth, VPI were divided into non BPD group and BPD group, and the risk factors of BPD in VPI were analyzed.Results:A total of 2 514 cases of VPI including 1 364 cases without BPD and 1 150 cases with BPD were enrolled.The incidence of BPD was 45.7%.The smaller the gestational age and weight, the higher the incidence of BPD( P<0.001). Compared with non BPD group, the average birth age, weight and cesarean section rate in BPD group were lower, and the incidence of male infants, small for gestational age and 5-minute apgar score≤7 were higher( P<0.01). In BPD group, the incidences of neonatal respiratory distress syndrome(NRDS), hemodynamically significant patent ductus arteriosus, retinopathy of prematurity, feeding intolerance, extrauterine growth restriction, grade Ⅲ~Ⅳ intracranial hemorrhage, anemia, early-onset and late-onset sepsis, nosocomial infection, parenteral nutrition-associated cholestasis were higher( P<0.05), the use of pulmonary surfactant(PS), postnatal hormone exposure, anemia and blood transfusion were also higher, and the time of invasive and non-invasive mechanical ventilation, oxygen use and total hospital stay were longer( P<0.001). The time of starting enteral nutrition, cumulative fasting days, days of reaching total enteral nutrition, days of continuous parenteral nutrition, days of reaching 110 kcal/(kg·d) total calorie, days of reaching 110 kcal/(kg·d) oral calorie were longer and the breastfeeding rate was lower in BPD group than those in non BPD group( P<0.001). The cumulative doses of amino acid and fat emulsion during the first week of hospitalization were higher in BPD group( P<0.001). Multivariate Logistic regression analysis showed that NRDS, invasive mechanical ventilation, age of reaching total enteral nutrition, anemia and blood transfusion were the independent risk factors for BPD in VPI, and older gestational age was the protective factor for BPD. Conclusion:Strengthening perinatal management, avoiding premature delivery and severe NRDS, shortening the time of invasive mechanical ventilation, paying attention to enteral nutrition management, reaching whole intestinal feeding as soon as possible, and strictly mastering the indications of blood transfusion are very important to reduce the incidence of BPD in VPI.