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

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 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

Objective: To investigate the application value of thrombelastography(TEG) in coagulation monitoring for ACS patients.Methods: Totally 255 ACS patients were selected with coagulation monitoring by TEG.The patients were divided into none ST-segment elevation myocardial infarction (NSTEMI) group and ST-segment elevation myocardial infarction (STEMI) group.The clotting characteristics in different types of ACS patients were compared and analyzed.Results: The ACS patients had higher intensity of thrombosis (MA) and Angle value.D-dimer and MA were significantly different between NSTEMI group and STEMI group(P＜0.01).The drug utilization in STEMI group was closer to the requirements of the guidelines.Conclusion: TEG shows high application value in coagulation monitoring for ACS patients.MA value and Angle value are more sensitive in evaluating hypercoaguable state.

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.

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.

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.

ObjectiveTo investigate the effects of long-term oxygen exposure on the pulmonary microvascular development and the expression of Ephrin-B2 of lungt issue in neonatal mice.MethodsForty-eight 2-day-old Kunming mice were randomly divided into hyperoxia group and air group, with 24 mice in each group. Mice in hyperoxia group were exposed to 70% oxygen to establish a model of bronchopulmonary dysplasia (BPD). Six mice from each group were sacrificed at 3, 7, 14 and 21 days of age, and lung tissue was collected for further test. The lung sections were stained with hematoxylin and eosin for histological evaluation, radial alveolar counts (RAC) and microvessel density (MVD) measurement by CD34 immunohistochemistry. Location and expression of Ephrin-B2 in lung tissue were measured by immunohistochemistry. Ephrin-B2 mRNA and protein levels were detected by fluorescent quantitative reverse transcriptase-polymerase chain reaction and Western blot, respectively. Two independent samplest-test was used for statistical analysis. Results(1) Pathological changes: The pathology of lung tissue in hyperoxia group showed typical BPD-like changes with advancing postnatal age, presenting mainly with simplified alveolar development and decreased microvessel number. Compared with the air group, RAC and MVD were significantly decreased in 14-day-old mice (6.067±0.432 vs 6.950±0.243,t=4.365,P<0.05; 4.133±0.476 vs 4.867±0.472,t=2.680,P<0.01) and 21-day-old mice in the hyperoxia group (8.050±0.362 vs 9.817±0.487,t=7.127,P<0.05; 4.333±0.532 vs 6.017±0.937,t=3.828,P<0.01). (2) Location and expression of Ephrin-B2: Ephrin-B2 was mainly expressed in alveolar epithelial cells, and weakly expressed in alveolar septum. Compared with the air group, the average optical density of Ephrin-B2 was significantly decreased in 7-day-old (0.146±0.013 vs 0.153±0.009), 14-day-old (0.140±0.007 vs 0.161±0.006) and 21-day-old mice in the hyperoxia group (0.138±0.008 vs 0.166±0.009)(t=-2.049,-9.442 and-10.087, allP<0.05). (3) Ephrin-B2 mRNA and protein levels: The Ephrin-B2 mRNA levels in 14-day-old (0.65±0.14 vs 1.05±0.16,t=4.609,P<0.01) and 21-day-old mice (0.57±0.09 vs 1.13±0.18,t=6.816,P<0.01) were significantly lower in hyperoxia group than in the air group. The Ephrin-B2 protein levels were also significantly lower in hyperoxia group than in the air group in 21-day-old mice (0.13±0.03 vs 0.29±0.08,t=4.587,P=0.000).ConclusionsOxygen-induced BPD model mice have simplified alveolar development, reduced MVD and decreased expression of Ephrin-B2 in lung tissue, which may play an important role in the pathogenesis of BPD.

Objective To study the role of deferoxamine(DFO)on regulating hypoxia-inducible factor 1α(HIF-1α)expression after hypoxia-ischemia brain damage(HIBD)in neonatal rats,to explore the therapeutic strategy for HIBD. Methods Postnatal day 10 SD rats were divided into four groups: hypoxia-ischemia(HI)group,DFO-treated group,normal saline(NS)-treated group,and sham operation group. HIBD model was established by the ligation of right common carotid artery following the inhalation of nitrogen-oxygen mixtures containing 92% nitrogen and 8% oxygen. DFO-treated group and NS-treated group were treated by intraperitoneal injection of DFO or NS respectively. The brains were collected at 4 h,8 h,and 24 h after hypoxia. HIF-1α protein expression was detected by Western blot analysis,and HIF-1α mRNA expression was detected by using RT-PCR at each time point. Results The synthetic level of HIF-1α protein increased significantly at 4 h,peaked at 8 h,and decreased at 24 h after HI in HI group,as well as NS-treated group. However,in DFO-treated group HIF-1α protein was peaked at 4 h,maintained higher level at 8 h and 24 h after HI. The level of HIF-1α protein was much higher in HI and DFO-treated groups than those in sham controls(P ＜ 0.05). The synthetic level of HIF-1α protein were higher in DFO-treated groups than those in HI groups at each time point(P ＜ 0.05). HIF-1α mRNA expression was higher in DFO-treated groups than those in HI groups at each time point. Conclusions DFO upregulate HIF-1α protein and mRNA expression in neonatal rats with HIBD. The peak of HIF-1α protein expression are also more advanced and lasted longer after DFO-treatment.

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.