摘要:目的：观察小儿反复性肺炎的发生与血微量元素的关系。方法:选择56例反复性肺炎患儿为观察组，与60例健康儿童作对照，分别测定血镉、铅、铜、锌、钙、镁、铁含量。结果:56例反复性肺炎患儿血锌、铁含量较对照组减低，差异有统计学意义（Plt;0.05）。结论:部分反复性肺炎的发生与血微量元素锌、铁缺乏有关。应对反复性肺炎患儿常规行血微量元素检测，对血微量元素缺乏者应予相应补充治疗。Abstract: Objective: To observe the relationship to the occurrence of repeated pneumonia and the microelement in blood. Methods: We chose the 56 infant patients who suffered from repeated pneumonia as the observe group while the 60 health infants as the comprise group, then test the content of cadmium， plumbum， cuprum， zinc， calcium， magnesium and ferrum in blood. Results: The content of zinc and ferrum in the patient’s blood was lower than the comparison group, and the P value was Plt;0.01 and Plt;0.05 respectively, there was obvious differentiation between the two groups. Conclusion: Occurence of part repeated pneumonia is related to the deficiency of the microelements zinc and ferrum in blood. We should detect the common content of microelement to the infant patients who suffer the repeated pneumonia, and give a complement treatment to the microelements’ deficiency infant patients.
Severe psychomotor developmental delay resulting from early postnatal (within 3 months) seizures can be diagnosed as Early-Infantile Developmental and Epileptic encephalopathies (EIDEE). Its primary etiologies include structural, hereditary, metabolic and etc. The main pathogenesis may be related to the inhibition of normal physiological activity of the brain by abnormal electrical activity and the damage of the brain neural network. Ohtahara syndrome and Early Myoclonic Encephalopathy (EME) are typical types of EIDEE. The principle of treatment is to improve the cognitive and developmental function by controlling frequent seizures. When the seizure is difficult to control with drugs, surgical evaluation should be performed as soon as possible, and surgical treatment is the first choice for patients suitable for surgery. The types of surgery can be divided into excision surgery, dissociation surgery, neuromodulation surgery and etc. The current status of surgical treatment of EIDEE was described, and the curative effect of surgical treatment was explored, so as to help clinicians choose appropriate treatment methods.
Objective To systematically review the effect of adjustable fortification on feeding during preterm hospitalization. Methods We searched Cochrane Library, Web of Science, PubMed, China National Knowledge Infrastructure, Wanfang, Chongqing VIP for clinical controlled trials about adjustable fortification in premature infants. The retrieval time limit was from the establishment of each database to September 2022. We selected studies according to inclusion and exclusion criteria, extracted data and assessed their quality, then used RevMan5.3 for analysis. Results A total of 5 randomized controlled studies, 1 historical controlled study and 3 case-control studies were included, including 750 premature infants. Meta-analysis results showed that compared with the standard fortification group, the differences of body weight growth rate [mean difference (MD)=1.61 g/(kg·d), 95% confidence interval (CI) (0.73, 2.49) g/(kg·d), P=0.0003], body length growth rate [MD=0.15 cm/week, 95%CI (0.01, 0.29) cm/week, P=0.04], head circumference growth rate [MD=0.19 cm/week, 95%CI (0.06, 0.31) cm/week, P=0.003], incidence rate of necrotizing enterocolitis [relative risk (RR)=0.23, 95%CI (0.07, 0.75), P=0.01] were statistically significant in the adjustable fortification group. There was no significant difference in the incidence of feeding intolerance between the two groups [RR=0.58, 95%CI (0.31, 1.11), P=0.10]. Conclusion Adjusted fortification has a positive role in promoting the physical development of premature infants without increasing the incidence of feeding intolerance and necrotizing enterocolitis. When the growth of premature infants is poor after using standard fortification, adjustable fortification can be considered. However, due to the lack of included literature, more large sample, high-quality randomized controlled studies are needed in the future to further verify the feeding effect of adjustable fortification on premature infants.
Bronchopulmonary dysplasia (BPD) and retinopathy of prematurity (ROP) are common and critically important diseases of preterm infants. The common feature of both conditions is altered angiogenesis and pathological changes in the case of incomplete organ development. The interaction of multiple factors leads to abnormal angiogenesis, which not only increases the possibility of comorbidity of BPO and ROP, but also reveals the potential co-pathogenesis between the two. However, the specific mechanism of this angiogenic balance in the occurrence and development of BPD or ROP is still unclear, and there are no animal models to explore the pathogenesis of both diseases. At present, effective prevention measures for BPO and ROP are still lacking, and treatment methods mainly rely on drug therapy and surgery. In the future, more studies should be conducted to find common therapeutic targets for factors affecting angiogenesis, so as to provide better treatment options for BPD and ROP and improve the effectiveness of treatment.
We applied resting-state functional magnetic resonance imaging (rfMRI) combined with graph theory to analyze 90 regions of the infantile small world neural network of the whole brain. We tried to get the following two points clear:① whether the parameters of the node property of the infantile small world neural network are correlated with the level of infantile intelligence development; ② whether the parameters of the infantile small world neural network are correlated with the children's baseline parameters, i.e., the demographic parameters such as gender, age, parents' education level, etc. Twelve cases of healthy infants were included in the investigation (9 males and 3 females with the average age of 33.42±8.42 months.) We then evaluated the level of infantile intelligence of all the cases and graded by Gesell Development Scale Test. We used a Siemens 3.0T Trio imaging system to perform resting-state (rs) EPI scans, and collected the BOLD functional Magnetic Resonance Imaging (fMRI) data. We performed the data processing with Statistical Parametric Mapping 5(SPM5) based on Matlab environment. Furthermore, we got the attributes of the whole brain small world and node attributes of 90 encephalic regions of templates of Anatomatic Automatic Labeling (ALL). At last, we carried out correlation study between the above-mentioned attitudes, intelligence scale parameters and demographic data. The results showed that many node attributes of small world neural network were closely correlated with intelligence scale parameters. Betweeness was mainly centered in thalamus, superior frontal gyrus, and occipital lobe (negative correlation). The r value of superior occipital gyrus associated with the individual and social intelligent scale was -0.729 (P=0.007); degree was mainly centered in amygdaloid nucleus, superior frontal gyrus, and inferior parietal gyrus (positive correlation). The r value of inferior parietal gyrus associated with the gross motor intelligent scale was 0.725 (P=0.008); efficiency was mainly centered in inferior frontal gyrus, inferior parietal gyrus, and insular lobe (positive correlation). The r value of inferior parietal gyrus associated with the language intelligent scale was 0.738 (P=0.006); Anoda cluster coefficient (anodalCp) was centered in frontal lobe, inferior parietal gyrus, and paracentral lobule (positive correlation); Node shortest path length (nlp) was centered in frontal lobe, inferior parietal gyrus, and insular lobe. The distribution of the encephalic regions in the left and right brain was different. However, no statistical significance was found between the correlation of monolithic attributes of small world and intelligence scale. The encephalic regions, in which node attributes of small world were related to other demographic indices, were mainly centered in temporal lobe, cuneus, cingulated gyrus, angular gyrus, and paracentral lobule areas. Most of them belong to the default mode network (DMN). The node attributes of small world neural network are widely related to infantile intelligence level, moreover the distribution is characteristic in different encephalic regions. The distribution of dominant encephalic is in accordance the related functions. The existing correlations reflect the ever changing small world nervous network during infantile development.
ObjectiveTo systematically review the experience of parents caring for preterm infants after discharge from hospital. MethodsWe searched databases including The Cochrane Library, Joanna Briggs Institute Library, PubMed, EMbase, Scopus, ISI Web of Science, PsycINFO, CINAHL, CBM, CNKI and VIP from inception to May 2015, to collect qualitative studies in the experience of parents caring for preterm infants after discharge from hospital. The quality of included studies was evaluated according to JBI Critical Appraisal Tool for qualitative studies in Australia. The results were integrated by integrating methods. ResultsA total of nine studies were included. Thirty-one complete findings were grouped according to their similarities to form seven categories. These categories resulted in two synthesized findings:integration results 1:parents grow in the adaptation of their care giving roles for the preterm infants; integration results 2:they are eager and thankful for support, resource and information in this critical transition period. ConclusionHealth care workers should pay attention to the important influence of premature infants discharged from hospital on their parents. In the adaption period of premature parents, health care workers should give necessary care knowledge skills to guide the parents, to assist them to compete the role of caregivers as soon as possible and promote the healthy growth of premature infants after discharge.
ObjectivesTo evaluate the predicting value of bedside pulmonary ultrasound in bronchopulmonary dysplasia (BPD) in premature infants.MethodsPremature infants with gestational age below 28 weeks or birth weight below 1 500 g admitted to NICU of Chengdu Women and Children’s Central Hospital from June 2018 to June 2019 were included. Pulmonary bedside ultrasound monitoring was performed on the 3rd, 7th, 14th and 28th day after admission, and the characteristic ultrasound images were recorded and scored. BPD were diagnosed by NICHD standard. The clinical data and pulmonary ultrasound data were compared and analyzed. Then diagnostic value of bedside pulmonary ultrasound in BPD of premature infants were analyzed.ResultsA total of 81 children involving 32 BPD and 49 non-BPD were included. The sensitivity (Sen), specificity (Spe) and area under curve (AUC) of receiver operating characteristic (ROC) of the "alveolar-interstitial syndrome" within 3 days after birth and the "fragment sign" on 28 days after birth were 81.25%, 51.02%, 0.66 and 31.25%, 97.96%, 0.65, respectively. The lung ultrasound scores in the BPD group on the 3rd, 7th, 14th, and 28th day after birth were 71.99.%, 68.39%, 0.71; 87.50%, 57.14%, 0.72; 78.13%, 73.47%, 0.76 and 56.25 %, 75.51%, 0.66. Sen, Spe and ROC AUC of comprehensive evaluation of lung ultrasound predicted the occurrence of BPD been 81.25%, 63.27%, and 0.85.ConclusionsThe comprehensive evaluation of combination of "alveolar interstitial syndrome" image characteristics within 3 days after birth, "fragment sign" image characteristics after 28 days, and lung ultrasound score at different times after birth can predict the premature infants with bronchopulmonary dysplasia.
ObjectiveTo systematically review the efficacy and safety of ibuprofen for premature infants with patent ductus arteriosus. MethodsDatabases including PubMed, Ovid-EMbase, The Cochrane Library (Issue 11, 2014), CNKI, WanFang Data and VIP were searched to collect randomized controlled trials (RCTs) and quasi-RCTs about ibuprofen for premature infants with patent ductus arteriosus from inception to December 2014. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then meta-analysis was conducted by RevMan 5.3 software. ResultsA total of 37 RCTs, involving 2 370 patients were included. The results of meta-analysis showed that, compared with the placebo/blank group, ibuprofen could increase the closure rate of PDA (LBWI:RR=1.93, 95%CI 1.25 to 2.99，P=0.003; VLBW:RR=1.23, 95%CI 1.02 to 1.48, P=0.03; ELBWI:RR=2.86, 95%CI 1.51 to 5.41, P=0.001) and decrease the incidence of sepsis (VLBW:RR=0.21, 95%CI 0.07 to 0.64，P=0.006); Compared with the indometacin groups, ibuprofen could decrease the incidence of the increase of serum creatinine (LBWI:RR=0.11, 95%CI 0.04 to 0.37, P=0.000 2), NEC (LBWI, RR=0.52, 95%CI 0.29 to 0.95, P=0.03) and oliguria (LBWI: RR=0.30, 95%CI 0.16 to 0.56, P=0.000 2; VLBW:RR=1.40, 95%CI 1.03 to 1.92, P=0.03); Compared with the intravenous ibuprofen, Oral ibuprofen could increase the closure rate of PDA (VLBW: RR=1.35, 95%CI 1.12 to 1.62, P=0.002; ELBWI, RR=1.42, 95%CI 1.07 to 1.87, P=0.01). ConclusionCurrent evidence shows that there is not indeterminate between ibuprofen and paracetamol groups. Compared with other general drugs, ibuprofen has an advantage over curing PDA and obviously reduces side effects. Due to the limited quality and quantity of included studies, more high quality studies are needed to verify the above conclusion.
Objective To explore the risk factors of premature infants death. Methods The medical records of hospitalized premature infants admitted to West China Second University Hospital of Sichuan University between January 2015 and December 2022 were collected. Premature infants were divided into the death group and the non-death group (control group) based on discharge diagnosis of death. Parturient and premature infants related information were collected, and the disease classification and diagnosis of premature infants were analyzed. Results A total of 13 739 premature infants were included, with 53 deaths and a mortality rate of 3.85‰ (53/13 739). The ages of death were 1-49 days, and the median age of death was (9.68±9.35) days. According to the matching method, 212 premature infants were ultimately included. Among them, there were 53 premature infants in the death group and 159 premature infants in the control group. Compared with the control group, premature infants in the death group had lower gestational age, birth weight, lower 1-minute Apgar scores, lower 5-minute Apgar scores and shorter hospital stay (P<0.05), and received more delivery interventions (P<0.05). There was no statistically significant difference in other indicators between the two groups of premature infants (P>0.05). A total of 212 parturient were included. Among them, there were 53 parturients in the death group and 159 parturients in the control group. The use rate of prenatal corticosteroids in the control group was higher than that in the death group (55.35% vs. 54.72%). There was no statistically significant difference in other related factors between the two groups of parturient (P>0.05). The results of logistic regression analysis showed that longer hospital stay [odds ratio (OR)=0.891, 95% confidence interval (CI) (0.842, 0.943), P<0.001], prenatal use of corticosteroids [OR=0.255, 95%CI (0.104, 0.628), P=0.003] reduced the risk of premature infant death. However, tracheal intubation [OR=10.738, 95%CI (2.893, 39.833), P<0.001] increased the risk of premature infant death. Conclusions Clinicians should pay attention to prenatal examination of newborns and pay attention to evaluation of newborn status. Obstetricians and neonatologists should make joint plans for women with high risk factors for preterm delivery. During the hospitalization, after the diagnosis is clear, standardized treatment should be carried out in strict accordance with the guidelines for systemic diseases and expert consensus.
A case of a 4-month-old child with an aortopulmonary fenestration weighing 6.6 kg who underwent successful transthoracic minimally invasive occlusion in our hospital was reported in this article. The child was transferred from the intensive care unit (ICU) to the general ward 1 day after surgery and discharged 5 days later. Compared with conventional ligation or repair of extracorporeal circulation for the aortopulmonary fenestration, the transthoracic minimally invasive occlusion is characterized by less trauma and faster recovery. However, it requires strict surgical indications and is not suitable for all patients with aortopulmonary fenestration.