Objective:To compare the clinical characteristics of congenital chylothorax in preterm and term infants.Method:From January 2011 to December 2019, the clinical data of infants with congenital chylothorax admitted to our hospital were retrospectively analyzed. The infants were assigned into preterm group (<37 weeks) and term group (≥37 weeks) according to their gestational age. The general information, clinical manifestations, laboratory results, treatment and prognosis of the two groups were compared.Result:A total of 34 infants with congenital chylothorax were included, including 11 premature infants and 23 term infants. No significant differences existed in gender, delivery mode, prenatal diagnosis of pleural effusion, congenital heart disease/chromosome abnormality, birth asphyxia, dyspnea, fetal edema, and location of effusion between the two groups ( P>0.05). Compared with term group, preterm group had significantly fewer leukocytes [3 245(1 007, 7 403)×10 6/L vs. 10 214(6 233,16 458)×10 6/L] and lower protein level [(28.1±7.6) g/L vs. (33.3±6.3) g/L] in the pleural fluid ( P<0.05). No significant differences existed in the proportion of pleural lymphocytes between the two groups ( P>0.05). The proportion of mechanical ventilation (MV) in the preterm group was statistically higher than that the term group [100%(11/11) vs. 65.2%(15/23)], and the duration of MV was statistically longer than the term group [(16(10,25) d) vs. (1(0,11) d)] ( P<0.05). No significant differences existed between the two groups in the application of other treatment options (thoracentesis/drainage, fasting, octreotide and erythromycin pleural injection), time needed for the disappearance of effusion, duration of hospital stay and cure/improvement rate ( P>0.05). Conclusion:Preterm infants may have lower leukocyte count and protein level in the pleural effusion than the term infants. Both preterm and term infants have higher proportion of lymphocytes in the pleural effusion fluid. Although most preterm infants need ventilator support after delivery, most of them achieve complete remission after conservative treatment and the overall prognosis is as good as term infants.

Objective:To study the effects of comprehensive warming intervention strategy on the body temperature of preterm infants (gestational age <32 weeks and birth weight <1 500 g) during inter-hospital transportation.Method:From October 2016 to July 2019, eligible preterm infants transported to our hospital were retrospectively analyzed. From October 2016 to March 2018, preterm infants transported with routine transportation strategy were assigned into the control group. From April 2018 to July 2019, preterm infants transported with the comprehensive warming intervention strategy were assigned into the experiment group. The body temperature, complications and prognosis before and after the transportation to our NICU were compared.Result:A total of 1 194 premature infants with gestational age <32 weeks were included with 630 cases in the control group and 564 cases in the experiment group. No significant differences existed in demographic data of the mothers, infants and the transportation time between the two groups ( P>0.05). The body temperatures before and after transportation in the experimental group were (36.8±0.5)℃ and (36.7±0.5)℃, significantly higher than the control group [(36.0±0.4)℃ and (36.3±0.6)℃] ( P<0.01). The incidences of hypoglycemia and mortality in the experimental group were 3.7% (21/564) and 4.8% (27/564), significantly lower than the control group [8.4% (53/630) and 7.9% (50/630)] ( P<0.05). Conclusion:Comprehensive warming intervention strategy in inter-hospital transport can effectively improve the body temperature of preterm infants before and after transportation, reducing the incidences of hypoglycemia and mortality.

In order to improve the clarity of ECG waveforms and the anti-interference ability of ECG acquisition under abnormal conditions, this study proposes a high-definition ECG recording method based on superimposed averaging algorithm. The results show that the proposed method can more clearly reflect the details of the ECG. Meanwhile, it has a significant inhibitory effect on EMG interference. As a result, the proposed method has a positive significance for improving the anti-interference ability of ECG equipment.
Algorithms ; Electrocardiography

Compared with percutaneous oxygen saturation(SpO 2), cerebral regional tissue oxygen saturation(CrSO 2)reflects the mixed oxygen saturation of brain tissue, and its change is closely correlated with the metabolism of brain tissue after birth.Near-infrared spectroscopy(NIRS)is a non-invasive continuous monitoring technology, which can provide information about changes in blood flow and damage of brain tissue.For now, NIRS has been used as a routine monitoring method in some neonatal intensive care units.Although the current research has not clearly proposed the diagnostic significance of NIRS in neonatal brain injury, current studies have found that detecting changes in CrSO 2 and corresponding interventions in abnormal values can reduce the incidence of brain injury in premature infants.The relationship between CrSO 2 and brain injury and the factors affecting CrSO 2 are still the current research hotspots.This article reviews the factors affecting the changes of CrSO 2 and clinical interventions to maintain its stability.

Diabetes diet management plays an important role in the treatment of diabetes. "Controlling diet" is the most basic and important part of diabetes treatment. Patients with mild diabetes can control blood glucose through diet therapy. Effective diet management assessment can quickly discover the deficiencies of diet self-management in diabetic patients. Artificial intelligence is widely used in the medical field. This article will briefly introduce the role and application progress of artificial intelligence technology in diabetes diet management, including diet recommendation and automatic monitoring.

Objective:To investigate the protective effects of bovine lactoferrin (bLF) supplementation on intestinal mucosal tissue and its influence on of inflammatory factors in the premature rats model of necrotizing enterocolitis(NEC), and to provide the theoretical basis for prevention of NEC by bLF supplementation.Methods:Premature SD rats were randomly divided into 4 groups, 25 cases in each group.Control group: oral feeding; model group : oral feeding with lipopolysaccharides(LPS) gavage + hypoxic stimulation; high dose bLF intervention group: daily bLF (7 g/L) + oral feeding with LPS gavage + hypoxic stimulation; low dose bLF intervention group: daily bLF (2 g/L) + oral feeding with LPS gavage + hypoxic stimulation.Histopathological analysis was performed by HE staining.The expression levels of interleukin-1β(IL-1β)and interleukin-6(IL-6)in intestinal mucosa were detected by enzyme linked immunosorbent assay (ELISA).Results:(1) Morphological observation: the intestinal wall of model group was thin, and there were different degrees of pneumoconiosis and effusion in intestinal cavity.Under the microscopy, it could be observed that the intestinal tissue necrosis was serious, the intestinal villi fell off, glands arranged disorderly, epithelial edema was significant, the lamina propria and submucosa had severely edema and were separated, and there were a large number of inflammatory cells infiltrated.The above-mentioned manifestations were alleviated in the high-dose and low-dose bLF intervention groups, and no significant abnormalities were found in the control group.(2) The expression of IL-1β and IL-6 in intestinal tissue: the tissue concentration of IL-1β and IL-6 in the model group rats [(380.89±20.25) ng/L, (485.12±31.44) ng/L]were significantly higher than those in the control group[(270.69±45.58) ng/L, (212.62±89.46) ng/L]( q =9.785, 14.030, all P<0.01). The expression of IL-1β and IL-6 in mucosal tissue of ileum was significantly inhibited in hypoxic and LPS-stimulated rats fed with bLF(IL-1β: q=9.105, 8.761, all P<0.01; IL-6: q=8.175, 8.996, all P<0.01). There was no significant difference in the expression of IL-1β and IL-6 between high dose bLF(7 g/L) and low dose bLF (2 g/L) inter vention groups (IL-1β: q=-0.084, P>0.05; IL-6: q=-1.140, P>0.05). Conclusion:Enteral bLF supplementation can alleviate the damage of intestinal tissue in NEC model of premature SD rats, inhibit the expression of IL-1β and IL-6 inflammatory factors in intestinal tissue, and have a protective effect on intestinal tissue.

The amplifier is easy to saturation because of polarization voltage in ambulatory ECG acquisition. The traditional way is using analog high-pass filter to eliminate, but the output tends to have a residue. If upgrading high-pass filter cutoff frequency, it will lead to low frequency distortion of ECG signals. In this paper, a Savitzky-Golay (SG) smoothing filter has been designed by combining the single edge point and the polynomial order , which can fit the polarization voltage components of ECG signals, filter useful components and get drift-free ECG signals by using the subtraction algorithm. The results of ECG filtering experiment verify the feasibility of the SG smoothing filter, and show the filtered ECG signal without any losses of useful components.
Algorithms ; Amplifiers, Electronic ; Electrocardiography, Ambulatory ; methods ; Humans ; Signal Processing, Computer-Assisted

Objective To study the clinical features of early-onset Group B streptococcal(GBS) sepsis to improve the management of early-onset GBS sepsis.Method To review the clinical data of 27 cases of early-onset GBS sepsis in the Hospital over the past 5 years (January 2013 to November 2017),and analyze its clinical features,laboratory results,complications,prognosis and perinatal characteristics.Result A total of 27 cases of early-onset GBS sepsis were enrolled within 5 years,accounting for 0.85‰ (27/31 936) of total hospitalized patients over the same period.Among them,6 were premature infants and 21 full-term infants.The time of onset was within 24 hours.In all the cases,except for one full-term infant with fever as the initial symptom,the remainder had dyspnea as the initial symptom,accompanied by poor response and low poor muscle tone.Among them,17 patients required assisted ventilation.One of the full-term infant treated with ECMO within 48 hours after birth because of dyspnea,pulmonary hypertension and persistent hypoxemia,etc.,and improved and discharged;another 10 patients needed hood oxygen supply.5 cases (18.5％,5/27) diagnosed with purulent meningitis.In complete blood count,white blood cells ranged from (0.8～34.2)× 109/L,the minimum platelets counts was 16× 109/L,the maximum CRP was 249 mg/L,and maximum procalcitonin was＞ 100 ng/ml.All blood cultures were sensitive to penicillin.of the 27 patients,2 died despite of medical treatment,and 5 patients died as their parents worried about possible sequelae and discharged against medical advice.Therefore,tlhe total mortality rate was 25.9％ (7/27).All children were administered penicillin after the blood culture results were known,meropenem was subsequently added or replaced with vancomycin according to the clinical progress of the child.The remaining 20 patients recovered and discharged.Conclusion The clinical manifestation of early onset GBS septicemia is critically ill,with early onset,rapid progress,and high mortality.Special attention should be paid to high-risk cases during perinatal period,and early recognition with effective treatment would reduce morbidity and mortality.

Objective: To investigate the effect of hypertensive disorder complicating pregnancy (HDCP) on the mortality and early complications of premature infants. Methods: The general clinical data of preterm infants with gestational age 24-36^{+ 6} weeks were collected from the cooperative units in the task group from January 1, 2013 to December 31, 2014.According to the severity of HDCP, the infants were divided into 4 groups: HDCP group, preeclampsia group, eclampsia group and non HDCP group, the mortality and major complications of preterm infants were compared, and the influencing factors were analyzed. Results: The mortality rate of preterm in the HDCP group was significantly higher than that of non HDCP group, and there was statistical significance (χ²=9.970, P=0.019). Eclampsia had a highest fatality rate (4.8%) in the early stage, compared with non HDCP group (2.2%), and the difference was statistically significant.Comparison of HDCP group (1.8%) and eclampsia group (3.2%) suggested that there was no statistically significant difference.The incidence of respiratory distress syndrome (RDS) in preterm in HDCP group was significantly higher than that of non HDCP group, and there was statistical significance (χ²=13.241, P=0.004). Eclampsia group showed the highest incidence (35.4%), compared with non HDCP group (16.2%), the difference was statistically significant, but compared with HDCP group (19.9%), preeclampsia group (17.1%), there was no significant diffe-rence.The incidence of bronchopulmonary dysplasia (BPD) in preterm in HDCP group was significantly higher than that of non HDCP group (χ²=9.592, P=0.022), the highest incidence showed up in eclampsia group (9.7%), compared with non HDCP group (2.0%) and HDCP group (1.7%), the difference was statistically significant.But there was no statistically significant difference, compared with preeclampsia group.As the degree of HDCP aggravated, the incidence of BPD gradually rose.There was no significant impact on necrotizing enterocolitis (NEC), retinopathy of prematurity (ROP), intraventricular hemorrhage (IVH) and sepsis of HDCP (χ²=7.054, 7.214, 0.358, 3.852; P=0.070, 0.065, 0.949, 0.278). Considering the overall outcome of the child, that was, whether the child died or survived, he had at least one complication, and HDCP had an effect on it (χ²=15.697, P=0.001), so the incidence increased while the degree of HDCP rose gradually.After adjusting gestational age, birth weight, sex, way of delivery, placental abruption and front placenta, prenatal hormonal, gestational diabetes, neonatal asphyxia and other factors, the results displayed that HDCP was the factor leading to the death of premature baby (OR=2.159, 95%CI: 1.093-4.266), and comparison between preeclampsia and eclampsia showed no statistical difference (P=0.714, 0.389); HDCP had no significant influence on RDS, BDP, ICH, NEC, ROP and sepsis. Conclusions HDCP leads to increased risk of premature death, but also leads to the increased incidence of RDS and BPD, but it had no obvious effect on NEC, ROP, IVH, sepsis and other complications.

Objective To evaluate the effects and mechanisms of bovine lactoferrin(bLF)on cell viability,proliferation,and the protective roles in intestinal epithelial cell-6(IEC-6)treated by lipopolysaccharide(LPS).Methods The rat jejunum epithelial cell lines IEC-6 were cultured in vitro.The effects of bLF on cell viability and proliferation in IEC-6 cells were detected by 3-(4,5-dimethyl-2-thiazolyl)-2,5-diphenyl-2-H-tetrazolium bromide(MTT)assay and 5-Bromo-deoxyuridine(Brdu)assay,respectively.Inflammatory cytokines and their mRNA of interleukin-1β(IL-1β),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)and interleukin-8(IL-8)were analyzed by real-time PCR and enzyme-linked immunosorbent assay(ELISA).Western blot was used to measure the levels of mitogen-activated protein kinase(MAPK)activation and nuclear factor kappa β(NF-κB)nuclear translocation.Results Dose dependent effects of bLF on cell viability and proliferation were observed in IEC-6 cells in vitro(F=3.825,5.861,all P<0.05),especially in a dose of 100 mg/L,and bLF significantly stimulated cell viability and proliferation compared with non-treatment group(q=5.240,3.765,all P<0.05).The mRNA levels of IL-1β,IL-6 and TNF-α were decreased by co-stimulation of bLF and LPS compared with the LPS treatments alone in IEC-6 cells in vitro(q=14.28,10.12,16.45,all P<0.001).The secretion of IL-6 and TNF-α was also decreased by co-stimulation of bLF and LPS(q=15.06,6.74,all P<0.01).In vitro,bLF treatment at dose of 100 mg/L could inhibit the activation of MAPK/NF-κB signal pathway induced by LPS(q=12.96,18.54,all P<0.001).Conclusion In vitro,bLF can promote IEC-6 viability and proliferation,and have anti-inflammatory effects via inhibited activation of MAPK/NF-κB nuclear translocation.