Disease Management ; Ductus Arteriosus, Patent ; therapy ; Humans ; Infant, Newborn ; Infant, Premature ; Infant, Premature, Diseases ; therapy

Objective To explore the clinical features of drug abuse mother’ s infants and evaluate the effect of corresponding therapeutics.Methods The clinical data of 54 cases of drug abuse mother’s infants were analyzed. Result During 12 years from 1990 to 2002,54 cases of drug abuse mother’ s infants were treated in our department. In 54 cases,premature was found in 28 cases,LBW in 32 cases,neonatal asphyxia 14 cases, NRDS 12 cases,intracranial hemorrhage 8 cases,congenital anomaly 2 cases. Infants born to addicted mothers have many health problems in the neonatal period Infants born to mothers drug abusing more than 2 years were significantly less mature and lighter than those born to mothers drug abusing less than 2 years( P

Nosocomial infection (NI), a major cause of morbidity and mortality in neonates, is the common challenges faced by health workers worldwide. This paper was to review the epidemiology, major challenges, prevention and control mea-sures of NI in neonatal intensive care unit. The present situation of NI in China and the corresponding countermeasures are also discussed.

Objective To investigate the effects of recombinate mouse granulocyte-macrophage-colony-stimulating factor(GM-CSF) alone with mesenchymal stem cells(MSCs) on injured lung of rots after exposure to hyperoxia. Method Mouse MSCs were separated, cultured, amplificated, identified and labeled with 4', 6-diamidino-2-phenylindole(DAPI). Thirty-two 3-day-old Sprague Dawley(SD) rats from four litters were randomly divided(random number) into four groups, namely hypemxia exposured + GM-CSF + MSCs group(group A), hyperoxia exposured + GM-CSF group( group B), hyperoxia exposured + MSCs group( group C) and hypemxia exposured group(group D). All rats were placed in a closed Plexiglas chamber with a minimal flow in and out, providing six to seven exchanges of the chamber volume per hour and maintaining O_2 levels above 95%. Seven days lair,all of them were taken out of the chamber. Rats in group A were treated with 5 x 10~4 MSCs intraperitoneally alone with 9 μg/kg GM-CSF subcutaneously, rats in group B received 9 μg/kg GM-CSF subcutaneously, rats of group C were treated with 5 x 10~4 MSCs intraperitonealiy and rats of group D were administrated with phosphatebuffered solution(PBS). Three days latter, all animals were sacrificed by an injection of 120 mg/kg sodium pentobarbital, perfused with cold 0.9% NaCl, and the left lungs were removed. The upper lobe of them were grinded to make tissue homogenates used for ELASA, and the lower lobes of them were made into frozen sections for fluorescence microscope. The right lungs were fixed in situ for 2 hours by intratracheal instillation of 10% neutral formalin and then were still fixed for additional 24 hours. Sagittal sections of paraffin-embedded middle lobe and upper lobe of left hmg tissue were used for Immunohistochemistry and histological study respectively, Immunohistochemistry was used to detect the expression of telomerase reverse transcrip tase(TERT) grade. Results Among 4groups, there were significantly differences in radical alveolar counts(RAC), TNF-α and IL-β1 in tissue homogenates( P < 0. 01 ). Compared with group D, increase in RAC and the decrease in both TNF-α and IL-β1 were found in other groups, and furthermore there were obvious differences in those changes between group A and group B as well as between group A and group C. There were significant differences in TERT(P<0.01) among four groups. The TERT grade in group A and group B were increased more markedly. DAPI-positive cells were found in group A and group C with significantly differences(6.23 ± 1.88, 5.10 ± 0.91, t = 1.53, P<0.05).Conclusions The protective effects of GM-CSF/MSCs on injuried lungs of new born rats after exposure to hyperoxia may be associated with the increase in the proliferation of stem cells improving the local micro-environment of lung tissue. This protective effects against lung injury induced by hyperoxia exposure may be attributed to the synergism between GM-CSF and MSCs.

OBJECTIVE:To evaluate the prophylactic use of antibiotics in perioperative period in our hospital. METHODS:The prophylactic use of antibiotics in 841 patients in our hospital in the first 3 months was analyzed statistically. RESULTS:841 patients have used antibiotics,and 74.04% of those patients with typeⅠ incision operation used antibiotics for 3 to 7 days. Cephalosporins and Fluoroquinolones were predominantly used for prophylactic purpose. Irrational use of antibiotics was seen in 714 cases. CONCLUSION:The prophylactic use of antibiotics in our hospital is far from rational,thus it is necessary to put "Guideline on Clinical Use of Antimicrobials" into practice.

OBJECTIVE To assess the skills and key points with frontal ostium in Draf IIa endoscopic frontal sinus surgery.METHODS We retrospectively reviewed 607 cases of patients who underwent endoscopic sinus surgery between September, 2004 and December, 2007, 84 cases(147 sides)of patients who underwent Draf IIa endoscopic frontal sinus surgery.The period of follow-up were 7 to 40 months.RESULTS All of 84 cases(147 sides) of patients, frontal ostium drainage was restored in 58 cases(102 sides, 69%), improved in 16 cases(28 sides, 19 percent), invalid in 10 cases(17 sides, 12%).CONCLUSION Endoscopic sinus surgery is an effective way for the treatment of chronic frontal sinusitis.Draf IIa endoscopic frontal sinus surgery is an easy and useful technique to restore the drainage of frontal ostium.

Objective To analyze the clinical characteristics of Klebsiella pneumoniae infection in preterm infants. Methods Clinical data of 75 preterm infants infected with Klebsiella pneumoniae treated in BaYi Children's Hospital from February 6,2008 to February 10,2010 were retrospectively analyzed.The difference of auxiliary examination between early-onset and late-onset infection group were compared by two independent samples t test.Spearman correlation analysis and non-conditional Logistic regression analysis were used to analyze the high risk factors and the prognostic factors of Klebsiella pneumoniae infection in preterm infants. Results The incidence of Klebsiella pneumoniae infection was 2.8％ (75/2721) in preterm infants,and the mortality rate was 9.3％ (7/75). There were 71 cases of Klebsiella pneumoniae sepsis and 4 cases of Klebsiella pneumoniae pneumonia.Among 75 cases,63 cases were early-onset infection (onset age≤72 h) and 12 were late-onset infection (onset age＞72 h).All patients presented with poor response,heart rate during quiet sleep ＞ 160/min and low oxygen saturation.The mean corpuscular volume and mean corpuscular hemoglobin concentration in early-onset Klebsiella pneunoniae infection cases were higher than those in late-onset neonates [(128.87±24.60) fl vs (113.72±13.54) fl,t=-2.07,P＜0.05and (38.11±2.15) pg vs (36.98±1.05) pg,t=-2.76,P＜0.05].Low birth weight and caesarean section were associated with early-onset Klebsiella pneumoniae sepsis (r=0.250 and -0.240,P＜0.05). The prognosis of Klebsiella pneumoniae infection was associated with hospital stay and duration of premature rupture of membranes (r=0.368 and 0.318,P＜0.05). Conclusions There were no specific clinical manifestations for Klebsiella pneumoniae infection in preterm infants.Preterm infants with low birth weight,long duration of premature rupture of membranes,delivered by caesarean section and received invasive operation are likely to develop Klebsiella pneumoniae infection.

Objective To analyze the clinical characteristics and coagulation parameters of the infants with placental abruption . Methods Analysis was made on clinical and laboratory indexes of the hospitalized children of the NICU of Bayi Clinical Medical College of South Medical University ,enrolled from August 2012 to January 2013 ,including 60 infants with placental abruption as observation group and 60 infants without placental abruption as the control group .Results From clinical manifestations and lab date ,significant differences were found in gestational age ,polyembryony ,premature rupture of membrane ,birth weight ,intrauterine growth retardation ,motherhood gestational hypertension ,mother gestational diabetes mellitus ,asphyxia ,APTT ,D-dimer on admis-sion between the observation group and control group (P<0 .05) .Conclusion Placental abruption is the result of placental insuffi-ciency ,which may cause coagulation disorder and thus show the pathological state of high condensation in infants .

Extracorporeal membrane oxygenation(ECMO) is a kind of extra life support technique that can support cardiac and pulmonary function in a relatively long time.With the application of nitric oxide,pulmonary surfactant and high frequency ventilation,the use of ECMO in neonatal respiratory failure decreased.Although received these treatment,there are some newborn with respiratory failure still required ECMO at last.On this paper,the application of ECMO in neonatal respiratory failure from foreign medical institute was introduced,and compared with the domestic situation,in order to improve the application of ECMO in neonatal respiratory failure.

Neonatal hyperinsulinism/hyperammonemia syndrome is a genetic disease result from glutamate dehydrogenase gene mutations.The clinical manifestations are hypoglycemia,hyperinsulinemia and mild hyperammonemia.Hypoglycemia may occur quickly due to eating protein.It is a rare neonatal disease that was easily ignored or delayed diagnosis and treatment causing serious sequelae of nervous system.This review summarized pathogenesis,clinical manifestation and diagnosis of the disease.