Placental pathologies include placental insufficiency,infection,meconium stained,abnormal planting and placental vascular anastomosis,et al.All those can lead to fetal and neonatal hypoxia ischemia or premature birth,which can cause brain damage.

ObjectiveTo study the feasibility, efficacy and safety of laryngeal mask airway (LMA) Supreme (SLMA) in neonatal resuscitation.MethodsSixty neonates, who were born at South Medical University Affiliated Maternal & Child Health Hospital of Shenzhen from June 1, 2012 to June 1, 2013 and requiring positive pressure ventilation after 30 s primary resuscitation post born, with birth weight above 2 000 g or gestational age above 34 weeks, were randomly assigned into two groups: SLMA group (n=30) and LMA Classic (CLMA) group (n=30). The outcome indicators included the curative effect, insertion time and possible adverse reactions of the two kinds of LMA, and the serum bio-markers, heart rate and percutaneous pulse oxygen saturation (SpO2) of all neonates. Independent samplet test, non-parametric test andChi-square test were applied for statistical analysis.ResultsThe insertion time was shorter in SLMA group than in CLMA group [(4.9±1.0) vs (7.6±1.3) s,t=8.98,P<0.05]. And more displacement occurred in CLMA group than in SLMA group [13.3% (4/30) vs 0% (0/30), Fisher exact test,P<0.05]. The successful rate of resuscitation in SLMA group was higher [100.0% (30/30) vs 90.0% (27/30), Fisher's exact test,P<0.05], and both the onset time and the total ventilation time were shorter than those in CLMA group [(12.4±3.7) vs (15.6±3.8) s,t=3.31,P<0.05; (37.3±17.0) vs (48.2±20.1) s,t=2.29,P<0.05]. The heart rate at 1 min after delivery was higher in SLMA group than in CLMA group [(93.5±20.9) vs (74.2±17.8) bpm,t=-3.86,P<0.05], and the same results were shown for SpO2 at 1, 2 and 3 min after birth [(47.1±8.4)% vs (38.7±12.1)%, t=-3.13; (68.1±9.5)% vs (52.8±10.8)%,t=-5.82; (78.3±10.0)% vs (72.1±9.7)%,t=-2.46; allP<0.05]. In the CLMA group, vomit or regurgitation occurred in three neonates, abdominal distension in two cases, aerogastria in seven cases. However, none of the above was reported in the SLMA group. No laryngeal injury was found in any of the subjects.ConclusionSLMA is more potential than CLMA in neonatal resuscitation because of its simplicity, better airtight, less adverse effect, superior efficacy and less requirement for tracheal intubation.

Objective To investigate the dynamic changes and influencing factors of peripheral blood white blood cells (WBC), differential counts (DCs) and platelet (PLT) count in preterm infants to understand the changing characteristics of these blood parameters in preterm infants of different postnatal age, gestational age, and birth weight.Methods Totally 2 849 preterm infants admitted to the Department of Neonatology of Northwest Women's and Children's Hospital from November 30, 2011 to November 30, 2014 were retrospectively analyzed except for those diagnosed with infectious diseases, hematological system diseases, or immunologic diseases.All of the subjects were divided into seven groups based on their postnatal age, three groups based on gestational age and three groups based on birth weight, or male and female groups, respectively.Peripheral blood samples were obtained for determination of WBC, DCs and PLT.Statistical analysis was performed with oneway analysis of variance, t-test and Spearman linear correlation analysis.Results WBC, neutrophil (Ne), lymphocyte (Ly), monocyte (Mo), eosinophil (Eo), basophil (Ba) and PLT counts were significantly different among the seven groups of preterm babies of different postnatal age (F=172.00, 364.90, 34.88, 14.22, 80.82, 168.10 and 86.64, respectively, all P ＜ 0.01).WBC was found to be at the peak value within one day after birth [(18.40±6.87)× 109/L], followed by remarkable decrease in day ＞ 2-≤ 5 [(10.62±4.68)× 109/L], further gradual decrease thereafter, and then being stable in day ＞ 14-≤ 21 and ＞ 21 ≤≤ 30 [(10.54±3.09)× 109/L and (10.27 ± 3.70) × 109/L, respectively].PLT counts showed no significant change within one day after birth and in day ＞ 1-≤ 2 [(240.56± 63.54)× 109/L and (240.85 ± 71.47) × 109/L, respectively], then began to increase in day ＞ 2-≤ 5 [(249.21 ±80.55)× 109/L], peaked in day ＞ 7-≤ 14 [(339.11 ± 121.84)× 109/L], and decreased gently and became stable finally.The changing trends of Ne and Ly were cross and inverted in day ＞ 5-≤ 7.WBC, Ne, Ly, Mo, Eo, Ba and PLT counts of the preterm infants were all correlated with the postnatal age shown by Spearman linear correlation analysis (r=-0.46,-0.60, 0.18,-0.07, 0.33,-0.47 and 0.29, respectively, all P ＜ 0.01).With the increase of gestational age, WBC, Ne, Mo, and PLT counts increased, but Ly and Eo counts decreased.And all of the above showed significant difference (F=81.00, 124.49, 13.34, 18.35, 5.35 and 4.11, respectively, all P ＜ 0.05).While, the WBC, Ne, Mo, Ba and PLT counts showed positive relationship with the increase of birth weight (F=122.12, 133.09, 39.38, 13.77 and 21.24, respectively, all P ＜ 0.05).WBC, Ne and PLT counts of female infants were higher than those of male babies (t=l 6.35, 16.72 and 13.19, respectively, all P ＜ 0.05).Conclusions The peripheral WBC, DCs and PLT counts of preterm infants change dynamically with postnatal age with the remarkable variations on day ＞2-≤ 5 after birth and stable after 14 days of age.WBC, DCs and PLT counts might all be influenced by gestational age, birth weight and gender to some cxtend.

Objective To investigate the effects of caffeine citrate and aminophylline in treatment of primary apnea of premature infants and its related complications. Methods A total of 152 preterm infants who were diagnosed primary apnea within 10 days after birth were randomly divided into caffeine citrate group(n=77) and aminophylline group(n =75). The changes in the time of the apnea disappeared after treating,needing oxygen,non-invasive and invasive mechanical ventilation,and the incidence of bronchopul-monary dysplasia ( BPD ) , necrotizing enterocolitis, retinopathy of prematurity, patent ductus arteriosus (PDA),intercranial hemorrhage(ICH)were compared between the two groups. Results The time of the apnea disappeared after treating[(47. 4 ± 5. 3) h],needing oxygen[(20. 5 ± 7. 6) d],non-invasive mechani-cal ventilation[(8. 7 ± 4. 2) d] and invasive mechanical ventilation[(1. 0 ± 1. 3) d] in the caffeine citrate group were significantly lower than those in the aminophylline group [ ( 54. 8 ± 6. 2 ) h, ( 24. 4 ± 8. 5 ) d, (10.4±5.3)d,(10.4±5.3)d,respectively](P<0.05).TheincidenceofBPD[16.9%(13/77)],PDA [13. 0%(10/77)] and ICH[16. 9%(13/77)] in the caffeine citrate group were significantly lower than those in the aminophylline group[33.3%(25/75),26.7%(20/75),22.7%(17/75),respectively](P <0. 05),but there were no differences between the two group about the incidence of necrotizing enterocolitis [caffeine group 7. 8%(6/77),aminophylline group 9. 3%(7/75)] and retinopathy of prematurity[caffeine group 6. 5%(5/77),aminophylline group 9. 3%(7/75)](P>0. 05). Conclusion The caffeine citrate has a better efficacy in the treating primary apnea of preterm infants than aminophylline. It can also decrease the incidence of BPD,PDA and ICH in premature infants.

Objective Recent studies in neonatal animals have shown that even slightly decreasing in brain or core temperature could ameliorate the damage resulting from hypoxic-ischemia insults. But the influence of hypothermia which had been used after the end of hypoxia-ischemia of the model hypoxia-ischemia brain damage(HIBD)was unknown. This research wanted to investigate whether hypothermia of defferent begin time after HIBD still could protect the brain in neonatal rats. Methods Pericranial temperatures were adjusted to 31 C in neonatal rats immediately or 2h after the end of hypoxia-ischemia(HI),the number of apoptosis cells in HIBD rats' brain had been counted,rat pups' storing food ability had been observed. Results Apoptosis increased obviously when rat pups were 8 days old, while hypothermia reduced apoptosis ,and postponed apoptosis expression in group that 31 C hypothermia was used immediately or 1h after the end of HI,and hypothermia improved the rat pups' storing food ability. This effect was more obviously in the group that hypothermia was used immediately after the HI than in the group that hypothermia was used 1h after the HI. But the protective effect was not clear in the group that hypothermia was used 2 h after the HI. Conclusion Hypothermia which was used within 1h after the end of HI could protect the HIBD neonatal rat pups brain, this effect was more obviously in the hypothermia be used early after the end of HI group than in the hypothermia be used late after the end of HI group.

The standardization of acupuncture and moxibustion in Canada is increasingly flouring nowadays:on one hand,acupuncture industry in legislated provinces is in the charge of direct administrative departments and associations of acu-moxi; on the other hand,according to the local situations,relevant regulations have been made,which are concentrated on two aspects-technical and administrative standards.Undoubtedly,Canadian Alliance of Regulatory Bodies for TCM Practitioners and Acupuncturist (CARB),united by each provincial TCM/Acupuncture Administration,is the first step to issue federal standards and establish federal level management institution.However,now the releasing of a fundamental regulatory file is in need of active corporation and publicity from each province and association.Therefore,it shows that the body of standardization in Canada is still not relatively perfect.Through introducing and analyzing the relevant information,the author expects that the readers can know the current development of acupuncture and moxibustion standardization in Canada.

Objective:To explore the clinical features and prognosis of urachal carcinoma.Methods:The clinical data of 35 patients with urachal carcinoma admitted to the First Affiliated Hospital of Zhengzhou University from August 2011 to November 2019 were analyzed retrospectively. There were 23 males and 12 females, with a male to female ratio of 1.92∶1. The average age was (52.1±13.9) years old, and the median age was 55 years old. There were 8 patients with a history of smoking and 3 patients with a history of drinking. There were 5 cases of hypertension, 5 cases of diabetes, 2 cases of coronary heart disease, and 1 case of cerebral infarction. The first symptoms were hematuria in 25 cases, lower abdominal pain in 4 cases, abdominal mass in 2 cases, umbilical discharge in 1 case, and asymptomatic in 4 cases.Preoperative CT examination showed that the tumor was located on the top wall of the bladder in 24 cases and the front wall of the bladder in 11 cases. There were 25 solid tumors and 10 cystic tumors. The maximum diameter of the tumor was 1.5 to 11.0 cm, and the median maximum diameter of the tumor was 4.0 cm. Preoperative cystoscopy detected masses on the anterior or top wall of the bladder and urachal carcinoma was suspected in 35 cases. All 35 cases underwent enlarged partial cystectomy (conventional resection of the umbilical part), and 3 cases underwent pelvic lymph node dissection at the same time. Among them, 19 cases underwent open surgery, 14 cases underwent laparoscopic surgery, and 2 cases underwent Da Vinci robot assisted laparoscopic surgery.Results:According to Mayo staging, there were 10 cases of stage Ⅰ, 18 cases of stage Ⅱ, 1 case of stage Ⅲ, and 6 cases of stage Ⅳ. The overall follow-up rate was 91.4% (32/35), and the median follow-up time was 41 (3-103) months. The 1-year survival rate was 82.5%, the 3-year survival rate was 59.3%, and the 5-year survival rate was 53.9%. Univariate analysis showed that age ( P=0.033), maximum tumor diameter ( P=0.011), lymph node metastasis ( P=0.002), distant metastasis ( P=0.011), pathological grade ( P=0.001), Mayo staging ( P=0.026) were ralated prognostic factors (all P<0.05). Cox multivariate analysis showed that the pathologically poor differentiation ( HR=1.640, 95% CI 1.112-2.418, P=0.013), and the largest tumor diameter ≥4cm were ( HR=5.000, 95% CI 1.099-22.755, P=0.037). Independent factors affecting patient prognosis. Conclusions:Urachal carcinoma is a malignant bladder tumor with insidient onset. Most of the first diagnosis symptoms are hematuria. When diagnosed, most patients are in the middle and late stages of clinical grading, and the prognosis is poor.Pathological grade and maximum tumor diameter are independent factors that affect the prognosis of patients with urachal carcinoma. The higher was the pathological grade, and the larger was the maximum tumor diameter, the worse was the prognosis.

Objective:To discuss the diagnosis and treatment of urothelial carcinoma of the prostate.Methods:The clinical data of 25 patients with prostate urothelial carcinoma from January 2011 to November 2019 were retrospectively analyzed.Among the 25 patients, the age of onset was 39 to 85 years old, with an average of (63.4±11.2) years old, 13 patient presented with gross hematuria, 9 patients presented with dysuria, and 3 presented with bladder irritation. The PSA of 25 patients was within the normal range (less than 4 ng/ml). 17 cases of pelvic MRI showed abnormal signals in the bladder and prostate area, 3 cases indicated that prostate cancer had invaded the bladder, and 14 cases considered bladder cancer Invasion of the prostate suggests a cauliflower-like abnormal signal in the bladder area. 6 of this 14 patients have a history of bladder cancer. All 25 patients underwent surgical treatment, and 14 underwent transurethral diagnostic resection, of which 6 cases accepted radical cystectomy later. One patient underwent radical cystectomy combined with pelvic lymph node dissection 15 days after the first operation.9 cases received radical cystectomy.2 cases undergoing transurethral palliative resection due to multiple metastases before the operation.Results:The postoperative pathological diagnosis of 25 cases were all prostate urothelial carcinoma, 13 cases were accompanied by bladder urothelial carcinoma, secondary prostate urothelial carcinoma, and 12 cases were primary prostate urothelial carcinoma. After the operation, 13 patients were further treated. Among the patients with secondary prostate urothelial carcinoma, 7 patients received bladder perfusion, 2 patients received GC chemotherapy, 1 patient received local pelvic radiotherapy.25 patients were followed up for 2 to 36 months with an average of (21.5±10.1) months. Among them, lymph node metastasis were seen in 17/25 patients. lymph node metastasis were found in 7/25 before surgery, and 1/25 found lymph node metastasis during surgery. Among the patients with distant metastases afterwards, multiple metastases throughout the body (4/14), lung metastases only (6/14), and bone metastases only (4/14), the 1-year survival rate was 88% (22/25), the 2-year survival rate was 40% (10/25), and the 3-year survival rate was 28% (7/25).Conclusions:The diagnosis depends on histopathological examination. Early diagnosis may help improve prognosis. The first choice is a comprehensive treatment based on radical surgery.

Objective To investigate the effect of prostaglandin E: (PGE1) on recovery of early renal graft functions after transplantation. Methods One hundred and seven patients after renal transplantation were allocated in the treated group, and treated by conventional treatment with injection of 10 μg prostaglandin E1 additionally twice a day for 14 days. And eighty-eight patients who received conventional treatment alone after renal transplantation at the corresponding period were allocated in the control group. Indexes of the two groups, including incidence of delayed graft function and acute rejection reaction, volume of urine, serum certaintie (SCr), endogenous certainties clearance rate (CCr), the blood flow resistance in graft as well as blood viscosity (BV), and platelet aggregation rate (PAR), were determined. Results The urinary volume and endogenous certainties clearance rate of the treated group were significantly higher, but the level of SCr, incidence of renal function recovery retardation, BV, PAR and blood flow resistance in graft were significantly lower than these of the control group (P<0.05). The difference of incidence of acute rejection reaction between the two groups was insignificant (P>0.05). Conclusion Prostaglandin E1 can improve blood microcirculation and decrease the incidence of renal function recovery retardation. These effects are helpful for recovery of renal function after renal transplantation.

Objective:To explore the clinicopathological characteristics and prognostic factors of bladder squamous cell carcinoma (SqCC)and bladder adenocarcinoma.Methods:A retrospective analysis of the clinical data of 107 patients with nonurothelial carcinoma of the bladder admitted to the First Affiliated Hospital of Zhengzhou University from October 2011 to January 2019 was performed. Among the 107 patients, 78 were males and 29 were females(ratio 2.69∶1), and the median age of onset was 62.0 years. According to histological types, patients were divided into SqCC group, urachal adenocarcinoma group and non-urachal adenocarcinoma group. There were 55 cases in the SqCC group, including 40 males and 15 females. Their mean age was 69.0(58.0, 75.0) years. 14 cases had the history of smoking. The clinic manifestation included hematuria in 35 cases, bladder irritation in 13 cases, dysuria in 2 cases and pain in 5 cases .Tumors located at the anterior and posterior walls in 18 cases, at the lateral wall in 27 cases, at the triangular area in 8 cases and at the apical wall in 2 cases. The average diameter of tumor was 4.5(3.0, 6.0) cm. 37 cases suffered with single tumor and 18 cases suffered with multiple tumors. The surgical method was radical cystectomy in 38 cases, partial cystectomy in 4 cases, TURBT in 9 cases, interventional surgery in 2 cases, and no operation in 2 cases. There were 20 cases in the urachal adenocarcinoma group, including 14 males and 6 females; age 53.5(43.5, 57.8) years; 6 cases with a history of smoking. The clinic manifestation included hematuria in 16 cases, bladder irritation in 1 case, pain in 2 cases and asymptomatic in 1 case. Tumors located at anterior and posterior walls in 4 cases and at apical wall in 16. The average diameter of tumor was 3.0(2.0, 4.8) cm. Single tumor was present in 18 cases, multiple tumors were present in 2 cases. The surgical method was partial cystectomy in 16 cases, radical cystectomy in 1 case, TURBT in 1 case and no operation in 2 cases. There were 32 cases in the non-urachal adenocarcinoma group, including 24 males and 8 females. Their mean age was 55.0(46.3, 70.8) years.11 cases had a history of smoking. The clinic manifestation included hematuria in 16 cases, bladder irritation in 3 cases, dysuria in one case and pain in 7 cases. Tumor located at anterior and posterior walls in 17 cases, at lateral wall in 7 cases, at triangular area in 5 cases and at apical wall in 3 cases. The average diameter of tumor was 3.6(2.0, 4.5) cm. 23 cases suffered with single tumor, 9 cases suffered with multiple tumors.The surgical method was radical cystectomy in 11 cases, partial cystectomy in 9 cases, TURBT in 9 cases , and no operation in 3 cases. The preoperative data of the three groups of tissue types were compared, the differences of age of onset, tumor diameter, tumor location, reason for treatment, operation method ( P<0.05)among the 3 groups were statistically significant. The clinicopathological characteristics and prognosis of the 3 groups of tissue types were compared, and the Cox proportional regression risk model was used to analyze the clinical factors affecting the prognosis. Results:91 patients were followed up, the overall follow-up rate was 85.1%, the median follow-up time was 26(7, 48) months. The 3-year and 5-year overall survival rates were 54.1% and 42.2%, respectively. In the SqCC group, 11 cases received chemotherapy; 3 cases received postoperative radiotherapy; 12 cases received postoperative perfusion.10 cases had recurrence; 17 cases had lymph node metastasis; 19 cases had distant metastasis; 5 cases were pT x in pT stage, 36 cases were pT 1-pT 2, 14 cases were pT 3-pT 4. 19 cases had unknown tumor differentiation, 4 cases had well differentiated, 24 cases had moderately differentiated and 8 cases had poorly differentiated. In the urachal adenocarcinoma group, 7 cases received chemotherapy, 3 cases had recurrence, 2 cases had lymph node metastasis, 2 cases had distant metastasis; 1 case was pT x in pT stage, 16 cases were pT 1-pT 2, 3 cases were pT 3-pT 4. 9 cases had unknown tumor differentiation, 3 cases had well differentiated, and 5 cases had moderately differentiated, 3 cases had poorly differentiated. In the urachal adenocarcinoma group, 3 cases received chemotherapy, 1 case received postradiotherapy, 11 cases received postoperative perfusion; 10 cases had recurrence. 5 cases had lymph node metastasis, 4 cases had distant metastasis, 6 cases were pT x, 21 cases were pT 1-pT 2 and 5 cases were pT 3-pT 4. 14 cases had unknown tumor differentiation, 8 cases had moderately differentiated and 10 cases had poorly differentiated.The postoperative general data of the three groups of tissue types were compared. There was statistically significant difference between whether there was postoperative perfusion and whether there was distant metastasis (all P<0.05). The univariate analysis results showed gender, age, surgical method, lymph node metastasis, distant metastasis, pT staging, tumor differentiation and histological type were risk factors that affect the prognosis(all P<0.05). Cox multivariate analysis showed that women ( HR=2.604, P=0.032) and distant metastases ( HR=2.571, P=0.026) were independent risk factors affecting the prognosis of patients. Conclusions:SqCC and adenocarcinoma are clinically rare and have poor prognosis. They often present with hematuria. Surgical treatment is the first choice. Radical cystectomy is the first choice for SqCC and non-urachal adenocarcinoma, and extended partial cystectomy is the first choice for urachal adenocarcinoma. Female and distant metastasis are independent risk factors affecting the prognosis of patients.