Objective To explore the effect of single and multiple course dexamethasone on brain development in preterm infants.Met-hods One hundred and eighteen preterm infants delivered after 28-34 weeks′ gestation from Aug.2005 to Mar.2007 in our NICU were enrolled in this study.These infants were divided into 3 groups by antenatalcourses of dexamethasone: control group,single-course group and multi-course group.Supportive treatments were given to all 3 groups.Neonatal behavioral neurological assessment(NBNA) was conducted on expected date of delivery.Mental and psychomotor developmental index was evaluated at 3,6,12 months by using intellectual development table made at Children′s Development Center of China(CDCC).Results The score of NBNA was much higher in single-course group than that in multi-course group and control group(Pa

Objective To explore the prevention and treatment effects of either antenatal corticosteroids (ACS) or postnatal pulmonary surfactant (PS) alone or the combination of both ACS and PS on neonatal respiratory distress syndrome (RDS). Methods One hundred and forty - three cases of RDS admitted to our neonatal intensive care unit ( NICU ) from Jan. 2003 to Jan. 2007 were selected, and divided into 4 groups:group 1 received both ACS and PS (n =36) ;group 2 only received ACS(n =33) ;group 3 only received PS (n =39) ;group 4 didn't receive both ACS and PS (n =35). The clinical parameters like sex,gestational age,birth weight,mode of dellvery,associated maternal risk factors, the Apgar score,the need of resuscitation at the time of delivery and associated perinatal complications of the babies were analyzed.The relation between the 4 groups regarding the different modes of supplemental oxygen use ( nasal prong and head box), continuous positive airway pressure (CPAP) ,the need of mechanical ventilator (MV) ,the mean NICU days to cure from the RDS and finally the treatment outcomes were compared. Results There were no significant differences between the 4 groups with regards to their general features and clinical parameters( P > 0.05 ). There was a significant difference between the groups regarding the mean hour requirement of the supplemental oxygen ( nasal prong and head box), CPAP and MV. Nasal prong : The mean hour for each group was ( 75.81 ± 15.63 ), ( 130.09 ± 27.32 ),(150.67 ±28.59) ,( 174.32 ± 25.92) h,respectively (P=0.041). Head box: The mean hour for each group was (37.16 ±5.51) ,(55.29 ±11.71 ), (62.69 ±12.39 ), ( 100.75 ± 28.10 ) h, respectively ( P = 0.047 ). CPAP: The mean hour for each group was ( 24.33 ± 4.41 ),(27.44 ±4.47), (26.53±3.13 ), (56.50 ± 5.50 ) h, respectively ( P = 0. 005 ). MV: The mean hour for MV use for each group was ( 56.12 ±15.65 ), ( 110.19 ± 21.59 ), ( 127.79 ± 26.36 ), ( 156.61 ± 12.92 ) h, respectively ( P = 0. 009 ). The mean number of days in NICU to recover for each group was ( 15.89 ± 1.29 ), (21.61 ± 2.30 ), ( 28.31 ± 3.40 ), ( 32.73 ± 4.57 ) d, respectively ( P = 0 ). The complete cure rate for each group was 63.89%, 51.52% ,35.90% ,20. 0% ,respectively. It shown a significant difference (P =0. 005 ) among the 4 groups regarding treatment outcomes. Conclusions ACS and PS combined therapy is the most effective therapy for the prevention of RDS,followed by ACS therapy alone,then PS therapy alone,and no ACS/no PS therapy is the least effective.

Objective To analyze the incidence rate and mortality of perinatal asphyxia and effects of new resuscitation technique on asphyxia as well as the risk factors of asphyxia in latest 10 years.Methods A retrospective evaluation was done for all the newborns who were born in the provincial women and children′s health care hospital from 1995 to 2004.The morbidity,mortality and fatality rate were calculated for each observed year and different seasons.The influence of gender,body weight,gestational age as well as polyembryony and mode of delivery on the asphyxia was analyzed.Results The morbidity of mild birth asphyxia was decreased dramatically and maintained at about 1.5% after using new resuscitation technique,however,there were no obvious effects on the sever asphyxia.In the same time,no big influence on fatality rate of birth asphyxia was observed.The incidence rate was highest in April,but the mortality and fatality of asphyxia was highest in July.The incidence of asphyxia was also related with gender,polyembryony,birth weight,prematurity babies and aids to delivery from voginal.Conclusions The incidence of perinatal asphyxia is related with the gender,polyembryony,birth weight and gestation age as well as seasons.New resuscitation technique can reduce the morbidity of mild birth asphyxia,and no effect on the severe asphyxia as well as fatality rate.

0.05),but there were significant difference between the two groups from 12 hours to 48 hours after operation(all P

Objective To find out the associated effect of intrauterine infection and interuterine asphyxia to fetal rat′s brain damage,cell apoptosis,and expression of glial fibrillary acidic protein(GFAP).Methods Pregnant rats of gestation 18 days were randomly divided into four groups:1.NS plus sham operation,2.intrauterine infection,3.intrauterine asphyxia,4.intrauterine infection plus intrauterine asphyxia.The fetal rats′ brains were taken out 72 h after different disposal and given HE coloration,immunohistochemistry of TUNEL and GFAP,respectively.Results The level of brain cell edema and tissue disorganization of group intrauterine infection plus intrauterine asphyxia were more serious than those of group intrauterine infection or group intrauterine asphyxia.TUNEL and GFAP had the same results:The number of positive cells in group intrauterine infection plus intrauterine asphyxia more than that in group intrauterine infection,and which in group intrauterine asphyxia more than that in group NS plus sham operation.There was significant difference between the first three groups and the group NS plus sham operation(P=0).There was also significant difference between group intrauterine infection plus intrauterine asphyxia and group intrauterine infection or group intrauterine asphyxia(P=0).Conclusions Both intrauterine infection and intrauterine asphyxia may induce premature rat brain damage,the association of intrauterine infection and intrauterine asphyxia may aggravate the degree of fetal rat brain damage,also increase the number of apoptosis cell and the expression of GFAP.

Infection and inflammatory response can induce the brain damage in neonate,but the mechanism involved in it has not been elucidated completely.Proposed mechanisms include inflammatory response,cytokine and free radical-mediated injury,and excitatory amino acids-induced injury.The activation of microglia and selective vulnerability of immature oligodendrocyte play an important role in the whole process.Recent researches show that the fetal inflammatory response and complex gene regulation are also involved in the infection-induced brain damage.

Objective To investigate the relationship of placental vascular anastomosis and physical development and morbidity of the disease in twin neonates.Methods Fourteen pairs of twin neonates deliveried from Sep.2005 to Aug.2009 were enrolled in Newborn Intensive Care Unit,the Third Affiliated Hospital of Zhengzhou University.These twins were divided into 2 groups according the conditions of placental vascular anastomosis:significant placental vascular anastomosis group(group A) and no significant vascula anastomosis group(group B).Birth weight,head circumference,length,the morbidity of disease were all investigated in 2 groups.Clinic follow-up included neonatal behavioral neurological assessment(NBNA) and children′s development center of China(CDCC).The correlation of neonates placental vascular anastomosis between twin neonates were compared.Results There were statistically significant differences between group A and group B in birth weight,head circumference and body length(t=6.070,5.237,5.784,Pa

Equipment Failure ; Female ; Heart Ventricles ; pathology ; surgery ; Humans ; Middle Aged ; Pacemaker, Artificial

Objective To investigate the influence of preterm premature rupture of membranes (PPROM) on neurological development of preterm infants.Methods The preterm infants were classified into 2 groups( PPROM group and control group).The neonatal behavioral neurological assessment (NBNA) and CDCC of infants in two groups were measured and compared after retrieved:gestational age 40 weeks,3 months and 6 months.Results Psycho-moter developmental index(PDI) of PPROM group after retrieved gestational age 3,6 months was significantly lower than that of control group(Pa

Objective To evaluate the neuroprotective effect and safety of neonatal hypoxic-ischemic encephalopathy(HIE)treated with recombinant human erythropoietin(rhEPO).Methods Fifty-three neonates with HIE were randomly divided into rhEPO treated group(n=29) with the dosage of 300 U/(kg?time),three times a week for 2 weeks and control group(n=24)without rhEPO.All supportive measures were same between 2 groups.Neurological scoring was evaluated at d3,d5 and d7 Neonatal behavioral neurological assessment(NBNA) was evaluated at d7,d14 and d28.The neurodevelopment quote was evaluated at age of 3 and 6 months.Blood pressure,liver and renal function,blood electrolytes and blood hemoglobin,platelet and reticular red blood cell count were monitored before and after treatment in all infants.Results The neurological scoring between two groups had no difference at d3.The significant difference was found at d7(P0.05).Conclusions Teraphy with rhEPO on neonatal HIE infants can promote neurological recovery,and there is no serious side effect with rhEPO treatment.