To review the clinical characteristics, short-term outcomes, and risk factors of patients with infective endocarditis(IE) who underwent surgical treatment at a single center, and to summarize treatment experience.

Objective:To study the clinical characteristics of ureaplasma urealyticum (UU) infection in preterm infants with gestational age <34 weeks.Methods:From January 2017 to December 2021, premature infants with gestational age <34 weeks admitted to neonatal department of our hospital were enrolled in this prospective cohort study. UU-DNA from respiratory tract samples were examined using quantitative fluorescence polymerase chain reaction method. The infants were assigned into UU (+) group and UU (-) group. Perinatal factors and clinical characteristics were compared between the two groups.Results:A total of 182 preterm infants were enrolled, including 59 cases (32.4%) in UU (+) group and 123 (67.6%) in UU (-) group. UU (+) group had significantly lower gestational age and birth weight and significantly higher incidences of vaginal delivery, premature rupture of membranes (PROM) >18 h and maternal chorioamnionitis than UU (-) group ( P<0.05). Compared with UU (-) group, UU (+) group had significantly higher leucocyte count, neutrophil count and interleukin-6 at 1, 24 and 72 h after birth ( P<0.05). No significant differences existed in C-reactive protein and procalcitonin between the two groups at each time point ( P>0.05). In UU (+) group, the incidences of intrauterine pulmonary infection and bronchopulmonary dysplasia (BPD) were higher and the incidence of respiratory distress syndrome was lower than UU (-) group ( P<0.05). No significant differences existed in the incidences of intraventricular hemorrhage, periventricular leukomalacia, feeding intolerance, necrotizing enterocolitis, retinopathy of prematurity between the two groups ( P>0.0 5). UU (+) group had significantly longer duration of oxygen therapy than UU (-) group ( P<0.05). No significant differences existed in the duration of invasive mechanical ventilation and hospital stay between the two groups ( P>0.05). Conclusions:Preterm infants <34 weeks with positive UU in respiratory tract secretions have higher incidences of vaginal delivery, PROM>18 h and maternal chorioamnionitis. Leukocyte and neutrophil count and interleukin -6 are higher in these infants. They need prolonged oxygen therapy and have increased risks of intrauterine pulmonary infection and BPD.

Objective To investigate the changes of plasma cortisol and adrenocorticotrophic hormone(ACTH)levels in prema-ture neonates with the infectious diseases.Methods Ninety premature neonates in the neonatal department of our hospital were di-vided into the control group(30 cases),mild infection group(30 cases)and severe infection group(30 cases).The radioimmunoassay was adopted to detect the serum cortisol and ACTH levels on 1,3,7 d after birth in all subjects and the corresponding comparison was conducted.Results The cortisol levels on 1,3,7 d in the mild infection group were (193.04 ±39.48),(151.12 ±35.62 ), (128.37±27.47)ng/mL respectively,the level on 1 d was higher than that on 3,7 d (P <0.05),and the 3 d was higher than that on 7 d (P <0.05).The cortisol level on 1,3,7 d in the severe infection group were (99.43±50.17),(96.52 ±44.69),(131.13 ± 42.73)ng/mL respectively,and the level on 1,3 d was significantly lower than that on 7 d (P <0.05).Conclusion The relative ad-renocortical insufficiency exists in premature neonates with the early stage of severe infection and is manifested by the decline of plasma cortisol level,which could recover to the normal level on 7 d,but the plasma ACTH level has no relation with infection.