This article reported two cases of axillary artery thrombosis in extremely low/very low birth weight infants following the placement of a local arterial catheter, who hospitalized in Shengjing Hospital of China Medical Universityin in April 2023 and August 2022, respectively. Case 1: Before surgery for necrotizing enterocolitis, an arterial catheter was placed in the left axilla of the infant. On the same day, the infant developed cyanosis of the left upper limb and weakened radial artery pulse. Ultrasound examination confirmed the presence of left axillary artery thrombosis. Despite subcutaneous injection of low molecular weight heparin (LMWH) and plasma infusion, there was no improvement in blood circulation. The infant also exhibited reduced movement in the left upper limb and loss of radial artery pulse. Thrombolytic therapy with recombinant tissue-type plasminogen activator was administered. Six hours after the treatment, the radial artery pulse became palpable. Thrombolysis was then terminated, and anticoagulation with LMWH was supplied for two weeks. At one year and eight months of age, the infant had a weaker left-hand grip strength compared to the right, but the overall functionality was largely preserved. Case 2: The infant developed late-onset sepsis at 17 days old and had an arterial catheter placed in the axilla. Pale left upper limb was observed in the following day, and the brachial and radial artery pulses were absent. Vascular ultrasound indicated the presence of left axillary artery thrombosis. Anticoagulation therapy with subcutaneous injection of LMWH was provided, along with thrombolysis using urokinase. On the sixth day after thrombolysis, an ultrasound examination showed no thrombus-like echoes. At one year and eight months of age, the development and movement of the affected upper limb became normal.

Over the past two decades,therapeutic hypothermia has been the most important treatment for moderate to severe neonatal hypoxic-ischemic encephalopathy (HIE).However,due to the lack of uniformity in the grading assessment methods for HIE and the willingness of clinicians to actively treat,therapeutic hypothermia is now being increasingly implemented in infants with mild HIE.At the same time,owing to the insufficient knowledge regarding the effectiveness and safety of treatment beyond the established indications,concerns about this situation have been arisen.The ongoing large-scale multi-center randomized controlled trial may change this situation in the future.

Objective:To investigate the predictive value of the expression of CD14+CD277+monocyte macrophage and pro-grammed death receptor-1(PD-1)on T cells in clinical outcome of children with acute respiratory distress syndrome(ARDS).Meth-ods:The clinical data of 130 children with ARDS in 3201 hospital from April 2014 to March 2020 were respectively analyzed.After 28 days of treatment,the children were divided into survival group and death group according to their survival status.The levels of PD-1 on CD14+CD277+monocyte macrophages and T cells in survival group and death group were compared.The independent risk factors af-fecting the outcome of the children and the value of PD-1 levels on CD14+CD277+monocyte-macrophages and T cells in predicting the death of the children were analyzed.Results:The proportion of CD14+CD277+monocyte-macrophages and MFI in the death group were higher than those in the survival group(P<0.05).Multivariate Logistic regression analysis showed that gestational age,Apgar score at 5 min after birth,hypoalbuminemia,CD14+CD277+monocyte macrophage and PD-1 on T cells were independent risk factors for death(P<0.05).The area under the ROC curve of CD14+CD277+monocyte macrophage was 0.777(95%CI:0.698～0.855,P=0.000),the cut-off value was 0.105%,the corresponding sensitivity was 81.96%,and the specificity was 55.67%.The area under ROC curve of PD-1 on T cells was 0.756(95%CI:0.674～0.838,P=0.000),and the cutoff value for predicting death was 114 MFI.The sensitivity and specificity were 80.45%and 58.23%.Conclusion:The level of PD-1 on CD14+CD277+monocyte-macrophages and T cells is relat-ed to the prognosis of neonates with ARDS,and its higher level indicates poor prognosis and a higher risk of death.

The Chinese Neonatal Network(CHNN) was established in 2018 with the mission of establishing a national collaboration platform, conducting high-quality and collaborative research, and ultimately improving the quality of neonatal-perinatal care and health in China.At present, 112 hospitals across the country have joined CHNN.CHNN has established a national standardized cohort of very premature infants/very low birth weight infants with >10 000 enrollments each year, has been leading data-driven collaborative quality improvement initiatives, conducting multicenter clinical studies, and performing multi-level training programs.Guided by the principles of collaboration and sharing, data-driven, continuous improvement, and international integration, CHNN has become an important platform for clinical and research collaboration in neonatal medicine in China.

In the past four decades, the worldwide neonatal collaborative network has been gradually formed, which has solved many practical problems in neonatal clinical medicine.The Neonatal Collaboration Network has led the way in conducting many of the most important trials and has built an exhaustive database.At the same time, more and more networks are making quality improvement in their work and establishing full partnerships among networks, which are contributing to the advancement of neonatal medicine and improving neonatal outcomes.In the foreseeable future, the establishment of more neonatal collaborative networks and increased connections will be critical to the advancement of neonatal medicine.

Objective:To explore the needs of parents of hospitalized neonates with the challenges of implementing family-centered care during the Covid-19 pandemic.Methods:Using a method of phenomenological interviewing and Colaizzi′s method of data analysis, the information of 18 parents of admitted infants of Children′s Hospital of Fudan University from January 1 to 20, 2022 were collected and analyzed.Results:In the post-epidemic era, 5 themes of needs for parents of hospitalized neonates during family-centered care were identified: closeness to babies; emotional support; training about feeding; accommodation services; financial support.Conclusions:In the post-epidemic era, experiencing worry, anxiety, uncertainty, helplessness, loss and other negative psychological experience, the parents of hospitalized neonates have many unsatisfied needs. Hospital administrators need to focus on the needs of parents for family-centered nursing care, and actively explore effective coping strategies.

This paper reports a case of neonatal lupus syndrome manifested by metabolic disease. A male neonate was admitted to the Children's Hospital of Soochow University due to poor response and vomiting for 1 day. Based on the clinical symptoms, including the patterned skin and a full anterior fontanelle, and a result of leukocytosis, neonatal sepsis was considered. Lysinuric protein intolerance was not excluded from the genetic metabolic disorders screening. The patient was positive for lupus-related autoantibodies and antinuclear antibodies, which were also found in his mother and elder sister. He had no functional variant of the SCL7A7 gene, a gene related to lysinuric protein intolerance, thereby the diagnosis of neonatal lupus syndrome manifested by metabolic disorders was confirmed. After treatment with methylprednisolone, the patient recovered well with no specific change in blood genetic metabolism at re-examination. Monthly follow-up after discharge found decreased antibody titers.

Objective:To study the clinical features and molecular diagnosis of neonates with Beckwith-Wiedemann syndrome (BWS).Methods:From January 2016 to December 2020, infants admitted to the Department of Neonatology of Children's Hospital of Fudan University with BWS diagnosed during the neonatal period were reviewed. Their clinical data including clinical features, molecular testing results and comorbidities of other congenital diseases were analyzed.Results:A total of 16 BWS neonates (9 males and 7 females) were included, with average gestational age of 34~39 weeks and average birth weight of 2 412~4 275 g. Macroglossia (9/16) and omphalocele (8/16) were the main clinical features. Birth weight >2 SD of the mean (12/16) was the common secondary feature. According to the European BWS diagnostic scoring criteria, 10 infants with a ≥4 score were clinically diagnosed with BWS. 5 infants with a 2~4 score and 1 infant with a 1 score (whose twin brother had a 4 score) were clinically suspected BWS.13 infants received molecular testing. 6 infants with clinical diagnosis and 5 infants with suspected diagnosis were confirmed to have reduced methylation signal in imprint control region 2 and 2 of the clinically diagnosed infants had increased methylation signal in imprint control region 1. 5 infants had atrial septal defect and brain injury were also seen in 5 infants. Abnormal thyroid function, abnormal umbilical cord morphology and abnormal umbilical blood vessels were seen in 4 infants, respectively.Conclusions:The combination of the clinical features and molecular testing can establish the diagnosis of BWS as early as during the neonatal period. Due to the high risk of comorbidities, abdominal ultrasonography, cardiac ultrasonography, cranial MRI and thyroid function tests are necessary after the diagnosis of BWS.

Humans ; Infant, Newborn ; Intensive Care Units, Neonatal ; Logistic Models ; Phenotype ; Risk Factors

Developmental oligodendrocyte lineages are regulated by internal and external factors during the processes of stereotyping, specialization, proliferation, migration, differentiation, maturation, myelination and myelin remodeling in demyelinating diseases. In recent years, the mechanisms of epigenetics in these processes have been studied extensively, including DNA methylation, histone modification, non-coding RNA and chromatin remodeling; these mechanisms provide potential new targets for treatment of myelin formation disorders or myelin-destructive diseases such as multiple sclerosis, periventricular leukomalacia and encephalomyelitis in preterm infants. This article reviews recent research advance in epigenetics in the development and regeneration of oligodendrocyte lineages.