A survey of high risk factors affecting retinopathy in full-term infants in China

AIM: To investigate the possible relationship between the influencing factors occurring before and during birth in full-term infants and the outcome of retinopathy. METHODS: Totally 816 full-term infants admitted in the neonate intensive unit of Boai Hospital of Zhongshan between 1 May, 2008 and 30 June, 2011 were included in the study. Fundus examination was performed and evaluated individually on them at the age of 48 hours after delivery, 2 weeks and 1 month. Some possible risk factors happening prenatally or during delivery such as pregnant related hypertension, placenta previa, placental abruption etc, as well as some neonatal risk factors such as neonatal asphyxia, hypoxic-ischemic encephalopathy (HIE), low birth weight etc, were recorded and evacuated. Then the effect of the risk factors of full-term infants on retinopathy was studied. RESULTS: The incidence of retinal hemorrhage of full-term infants with prenatal pregnant related hypertension (PRH) of the mother (43.6%) was significantly higher than that of full-term infants without (8.0%). (P<0.001). The incidence of retinal hemorrhage of full-term infants with neonatal asphyxia and /or hypoxic-ischemic encephalopathy (HIE)(29.3%) was significantly higher than that of those without (15.7%), but correlation was not found between the severity of retina hemorrhage and the degree of hypoxic disease. A pale color of optic disc was associated with a low birth weight of full-term infant. Full-term infants with birth weigh-less than 2500g had a significant higher incidence of retinopathy than those with birth weight equal or more than 2500g( P<0.001). CONCLUSION: The main influencing factors which lead to retinopathy of high risk full-term infants are prenatal factors such as PRH, and some neonatal risk factors such as asphyxia, hypoxic-ischemic encephalopathy, and low birth weight.

Change in the body temperature of healthy term infant over the first 72 hours of life

Objective: To determine the range of body temperature in a group of healthy Chinese term neonates over the first 72 hours of life and to assess the influence of body weight, gestational age and route of delivery. Method: All 200 consecutive cases of neonates delivered at our hospital from March to August 2001 were included in this retrospective study. Temperatures were measured immediately after delivery, after 30 minutes, 1 hour, 2 hours, 8 hours and 15 hours and on the 2nd and 3rd day. Axillary temperatures ranging from 36.5 篊 to 37 篊 were regarded as normal. No cases of maternal fever or systemic infection of the newborns were discovered. All infants were discharged in good general condition. Results: The mean rectal temperature at birth was 37.19 篊. The lowest average temperature was reached at 1 hour after delivery (36.54 篊) with a significant difference between natural delivery (36.48 篊) and section (36.59 篊) (P<0.05). Temperature subsequently rose to 36.70 篊 at 8 hours and 36.78 篊 at 15 hours (P<0.05). Hypothermia was seen in 51.8% and hypothermia in 42.5% of the patients. On the 3rd day after delivery, 96% of all temperatures were in the normal range. A significant relation was found between hypothermia and both low birth weight (P<0.001) and low gestational age (P<0.05). Conclusion: The ref-erence range presently used did not include all physiological temperatures in the first 72 hours of life. Considering other factors, such as birth weight, route of delivery, gestational age and body temperature on the 2nd and 3rd day of life, may help to correctly assess the significance of temperatures beyond the reference range.

The Effect of Massage with Oils on the Growth of Term Infants: A Randomized Controlled Trial

Background and Aims: Infant massage could potentially benefit both physiological and psychological health. This study aims to determine the effect of massage with oils on the growth of full-term infants, which is given by their mothers. Study Design: This is a double-blind randomized controlled trial which was conducted on full term infants visited in the nine Public Health Centers of Shahrekord, Iran in 2010. Material and Methods: This study included 217 infants. Inclusion criteria for the infants were age scale between 10 to 15 days, full term gestation, birth weight of 2500 grams at least, Apgar score of 7 or above, no resuscitation after the birth, exclusive breastfeeding during the study, medically stable condition without any need for drugs, nulliparous. The infants were randomized into four groups: massage with sunflower oil, massage with sesame oil, massage without oil, and no massage (control group). Massage was given by mothers twice a day for 4 weeks, starting from the 10 - 15th day of life. Weight and height were measured weekly. At last, Repeated Measures Analysis of Covariance was employed to analyze the data. Birth weight (height) as well as mean frequency of breastfeeding during the study was deemed as covariates. Results: The findings showed that the mean of weight and height was significantly different between groups over time, respectively (P = 0.005, P < 0.001). The infants’ mean weight in sunflower oil massage group increased significantly compared with other three groups (P = 0.005). In addition, infants’ height gain in sunflower and sesame oil massage group were significantly higher than message-only and control groups (p < 0.001). Conclusions: Massage with oil, especially sunflower oil is an inexpensive, simple, and effective intervention which improved weight and height gain in selected samples. Further studies are needed to evaluate the serious adverse effects, if any, to notify midwives and health care staff.

Evaluation of the Dietary Reference Intakes for Japanese (2010 Edition): Recommended Protein, Pantothenic acid, Vitamin D, and Iron Intakes for Breast-Fed Infants Aged 6 - 11 Months

Objective: With regard to the 2010 edition of Dietary Reference Intakes for Japanese (DRIs-2010), we investigated whether the DRIs for two age groups, breast-fed infants aged 6-8 and 9-11 months, can be fulfilled for every nutrient in actual dietary practice. Design: We evaluated (1) whether the DRIs for all nutrients can be fulfilled in a formula with energy and protein exceeding their DRIs, (2) whether the DRIs for all nutrients can be fulfilled in a formula prepared in accordance with Japanese government-recommended weaning guidelines, and (3) what kinds of formulas can be prepared if the DRIs for all nutrients are fulfilled without referring to the weaning guidelines. Setting: Simulation of diet menu on the basis of published data in our university and survey of diet menu in a university hospital attached to a national medical school. Subjects: The three types of formulas were planned for ten days. Results: It was impossible to simultaneously fulfil the DRIs for 6 - 8-month-old infants concerning pantothenic acid, vitamin D, and iron and those for 9 - 11-month-old infants concerning these nutrients plus protein. Conclusion: According to the DRIs-2010, the DRI for all nutrients could not be fulfilled in an ingestible formula.

Message of the President elected for the term 2016-2019

It is a great privilege and honour for me to serve again as President of IFToMM for the term 2026- 2029. I thank the delegates and the Chairs of Member Organizations （MOs） for having voted my candidature and for promising support of my actions for future development of IFToMM.

生殖道感染对足月和未足月胎膜早破孕妇宫颈分泌液MMP-2、MMP-9表达及不良母婴结局的影响

目的分析生殖道感染对足月和未足月胎膜早破(PROM)孕妇基质金属蛋白酶-2(MMP-2)、基质金属蛋白酶-9(MMP-9)表达及不良母婴结局的影响。方法招募2021年6月至2023年6月就诊于湖北医药学院附属十堰市太和医院的110例PROM孕妇作为研究对象。根据生殖道感染情况和孕周将其分为未足月胎膜早破(pPROM)感染组(34例)、pPROM非感染组(26例)、足月胎膜早破(tPROM)感染组(34例)、tPROM非感染组(16例)。比较四组一般资料、宫颈分泌液MMP-2和MMP-9表达水平以及不良母婴结局发生情况,采用多因素logistic回归分析PROM孕妇发生不良母婴结局的影响因素。结果四组年龄、孕次、体质量指数、吸烟史、饮酒史比较差异无统计学意义(P>0.05)。四组宫颈分泌液MMP-2、MMP-9表达水平比较差异有统计学意义(P<0.05),其中pPROM感染组宫颈分泌液MMP-2、MMP-9表达水平高于pPROM非感染组和tPROM非感染组,tPROM感染组宫颈分泌液MMP-2、MMP-9表达水平高于tPROM非感染组,差异有统计学意义(P<0.05)。四组绒毛膜羊膜炎及不良母婴结局总发生率比较差异有统计学意义(P<0.05),其中pPROM感染组绒毛膜羊膜炎发生率高于tPROM感染组和tPROM非感染组,不良母婴结局总发生率高于pPROM非感染组和tPROM非感染组,差异有统计学意义(P<0.05)。多因素logistic回归分析结果显示,生殖道感染及较高的宫颈分泌液MMP-2、MMP-9表达水平是PROM孕妇发生不良母婴结局的独立危险因素(P<0.05)。结论生殖道感染可增加足月和未足月PROM孕妇宫颈分泌液MMP-2、MMP-9表达水平,生殖道感染及较高的宫颈分泌液MMP-2、MMP-9表达水平是PROM孕妇发生不良母婴结局的独立危险因素。

早产儿D-二聚体及凝血功能动态变化的临床意义

目的观察不同日龄正常早产儿D-二聚体(DD)、血浆凝血酶原时间(PT)和活化部分凝血时间(APTT)生理水平及其变化的临床意义。方法选取日龄1、5、10d的早产儿各20例及1、5、10d正常足月儿各20例(作对照),检测血浆DD、PT、APTT水平,比较各组间凝血、纤溶活性变化及其日龄变化规律。结果(1)早产儿和足月儿DD在新生儿期较高,尤其是早产儿在生后1周内;DD随日龄增长而降低,早产儿降低较慢。(2)早产儿PT、APTT在第1天与足月儿比较差异有统计学意义(P<0.05),在第5、10天与足月儿比较差异无统计学意义(P>0.05)。(3)早产儿PT、APTT随着日龄增长有下降趋势;足月儿第1天的APTT较长,PT则无明显变化。结论新生儿出生后DD高于正常值,尤其是早产儿DD显著高于正常值,PT及APTT均较高。提示凝血、纤溶活性的增强,对新生儿特别是早产儿临床出现DD高于正常或PT及APTT延长时,应动态观察,诊断DIC要慎重。

足月儿与早产儿血清CK-MB、MYO、BNP、cTnI水平变化及其临床意义

目的探讨足月儿与早产儿血清肌酸激酶同工酶（CK-MB）、肌红蛋白（MYO）、脑钠肽（BNP）和肌钙蛋白I（c Tn I）水平的变化及其临床意义。方法选取2012年9月至2015年10月在南京医科大学附属淮安第一医院分娩的新生儿211例,比较足月儿与早产儿的血清CK-MB、MYO、BNP和c Tn I水平的差异;比较足月儿与早产儿的新生儿窒息和新生儿缺血缺氧性脑病发生率的差异;比较新生儿窒息、新生儿缺血缺氧性脑病与正常新生儿的CK-MB、MYO、BNP和c Tn I水平的差异;分析新生儿CKMB、MYO、BNP和c Tn I水平的相关性。结果足月儿血清中的CK-MB和MYO低于早产儿,差异均具有统计学意义（t值分别为7.057、13.029,均P〈0.05）;足月儿与早产儿血清BNP和c Tn I的差异均无统计学意义（均P〉0.05）。足月儿中新生儿窒息和新生儿缺血缺氧性脑病发生率均低于早产儿,且差异均有统计学意义（χ2值分别为13.642、10.913,均P〈0.05）。新生儿窒息、新生儿缺血缺氧性脑病患儿血清中的CK-MB、MYO、BNP和c Tn I水平均高于正常新生儿,且差异具有统计学意义（t=4.088～21.802,均P〈0.05）。新生儿血清中的CK-MB水平与MYO水平呈正相关（r=0.356,P〈0.001）。结论足月儿血清中的CK-MB、MYO低于早产儿,新生儿窒息和新生儿缺血缺氧性脑病患儿血清中的CK-MB、MYO、BNP和c Tn I水平均高于正常新生儿,而且新生儿血清CK-MB与MYO呈正相关。

0-6个月足月儿和早产儿闪光视觉诱发电位研究

【目的】研究足月儿和早产儿的闪光视觉诱发电位（flash visual evoked potentials,FVEP）特点及临床应用。【方法】应用重庆康华公司的眼多功能检查仪对91名婴儿（足月儿61名,早产儿30名）进行FVEP检测。【结果】获得足月儿和早产儿FVEP波的潜伏期和振幅正常值,及其随月龄的改变而改变的趋势。足月儿0-2、2-4、4-6个月组足月儿P1波潜伏期均值分别为181.77、153.451、32.44 ms,早产儿为213.25、184.22、166.47 ms。组间潜伏期值差异有显著性（P〈0.05）;比较了早产儿与足月儿FVEP各波潜伏期值的差异及矫正月龄后各波潜伏期值差异,足月儿和早产儿的主波P1出波率相对其它波稳定,且早产儿P1波的潜伏期较足月儿延长,矫正月龄后早产儿的P1波潜伏期与足月儿差异无显著性。【结论】以FVEP波的主波P1潜伏期值为参考值对小婴儿的视功能检查具有可行性;在为早产儿作视功能检查时,建议检查矫正月龄后的潜伏期值是否在正常值范围内。

IL-6检测在宫内感染早产儿治疗过程中的应用研究

目的探讨母亲胎盘炎症与宫内感染早产儿血清白细胞介素6(IL-6)的相关性,母亲产前抗生素使用对宫内感染早产儿血清IL-6水平的影响,以及血清IL-6水平变化与早产儿出生后相关感染性疾病的发生和近期预后的关系。方法选取2019年1月至2019年12月在雅安市人民医院产科分娩,胎龄28~36周、单活胎、转入该院新生儿科、符合宫内感染诊断标准而母亲无其他合并症的早产儿为研究对象,将其胎膜胎盘送病理检查,并检测出生时、治疗48 h后早产儿血清IL-6的水平。首先,将宫内感染早产儿根据胎盘病检结果分为无绒毛膜羊膜炎组、绒毛膜羊膜炎Ⅰ期组、绒毛膜羊膜炎Ⅱ期组,探讨母亲胎盘炎症与宫内感染早产儿血清IL-6水平的关系;其次,将宫内感染早产儿按母亲产前使用抗生素疗程分为母亲产前使用抗生素≥3 d组、<3 d组及未使用组,探讨母亲产前抗生素使用对宫内感染早产儿血清IL-6水平的影响;最后,将宫内感染早产儿分别根据其胎龄、病情、IL-6水平及治疗48 h后转归进行分组,比较各组IL-6水平及相关疾病的发生率。结果绒毛膜羊膜炎组早产儿出生时血清IL-6水平高于无绒毛膜羊膜炎组,且在无绒毛膜羊膜炎、绒毛膜羊膜炎Ⅰ期、Ⅱ期的病例中呈依次递增趋势,差异有统计学意义(P<0.05);母亲产前使用抗生素(≥3 d、<3 d)早产儿出生时血清IL-6水平均低于未使用病例,差异有统计学意义(P<0.05);不同胎龄早产儿出生时血清IL-6水平之间比较,差异无统计学意义(P>0.05);早产儿出生时血清IL-6水平在非危重组、危重组及极危重组呈上升趋势,但三组之间差异无统计学意义(P>0.05);病情好转组治疗48 h后血清IL-6水平低于出生时,病情加重组治疗48 h后血清IL-6水平高于出生时,差异有统计学意义(P<0.05);IL-6>7 pg/ml与≤7 pg/ml早产儿PVL、PIVH、ROP、BPD的发生率差异无统计学意义(P>0.05)。结论宫内感染时早产儿静脉血IL-6水平升高,且与胎盘炎症严重程度相关;母亲产前应用抗生素能有效降低宫内感染早产儿血清IL-6水平,且血清IL-6水平与临床治疗效果相关;而宫内感染早产儿出生时IL-6水平和PVL、PIVH、ROP、BPD的发生率没有必然联系,故血清IL-6水平对评价感染严重程度、指导抗生素应用、评估疗效具有一定的参考意义。

婴幼儿全身强直-阵挛癫痫发作间期SPECT与长程EEG的对比研究

目的通过对全身强直-阵挛性癫痫婴幼儿发作间期单光子发射计算机断层成像术(single-photon emission computedtomography,SPECT)与长程脑电图的对比研究,评价SPECT与EEG在癫痫灶定位诊断的价值。方法对100例3岁内全身强直-阵挛癫痫患儿进行癫痫发作类型的确诊和神经系统检查、发作间期SPECT显像、长程EEG与影像学检查。结果发作间期SPECT异常76例(76%),高灌注43例(56.6%)、低灌注30例(39.5%)、高-低灌注3例(3.9%);异常灌注灶125个:颞叶51个(40.8%)、额叶18个、顶叶21个、枕叶8个、底节区16个、丘脑2个、小脑9个。长程监测脑电图异常84例(84%),痫样放电76例(90.5%),弥漫性异常62例(82.8%)和局灶性异常22例(26.2%)。CT/MRI异常27例(27%)。SPECT异常灌注灶与EEG的致痫灶相符者13例(19.7%),相近者30例(45.5%),不相符者23例(34.8%)。结论婴幼儿全身强直-阵挛性癫痫发作间期SPECT显像的特点以高灌注灶为主,颞叶异常灌注灶数明显高于其他各叶。长程EEG表现痫样放电以广泛性多见。SPECT的异常灌注灶与EEG的致痫灶的相关性较低。临床上应当结合SPECT、长程脑电图等检查结果进行综合分析,以提高致痫灶定位的准确性。

早产儿脐血GM-CSF与生后24h内外周血细胞的分析

目的 测定早产儿、足月儿脐血GM -CSF的浓度及外周血细胞计数 ,探讨脐血GM -CSF的浓度与生后 2 4h内外周血细胞的关系。方法 5 4例早产儿、13例足月儿出生时采脐血 ,用ELISA法测定GM -CSF的浓度 ,生后 2 4h内检测外周血细胞 ,应用SPSS统计软件包进行分析。结果 早产儿组及足月儿组脐血GM -CSF的浓度与外周血细胞计数无明显差异 ;孕妇的高危因素和早产儿并发症不影响脐血GM -CSF的浓度 ;早产儿脐血GM -CSF的浓度与白细胞计数呈正相关 ;与中性粒细胞淋巴细胞、中值细胞、红细胞和血小板均无相关性。结论 早产儿与足月儿外周血白细胞数量和脐血GM -CSF的浓度无明显差异 ;早产儿脐血GM -CSF的浓度与生后2

浅析TD-LTE系统网络时间同步

本文首先描述了在移动通信中的网络时间同步相关研究的情况,包括同步策略及TD-LTE网络时间同步的技术要求。分析了TD-LTE毫微微基站网络时间同步的方式。简要讨论了基于光回传网的时间同步技术,重点讨论了基于网络收听时间同步技术和协同接收技术。

血清神经胶质原纤维酸性蛋白和泛素羧基末端水解酶-L1与足月儿缺氧缺血性脑病的关系

目的探讨血清神经胶质原纤维酸性蛋白(GFAP)、泛素羧基末端水解酶-L1(UCH-L1)与足月儿缺氧缺血性脑病(HIE)病情严重程度的关系。方法选择2019年2月至2020年2月延安大学附属医院新生儿科收治的46例HIE足月儿为观察对象,根据病情程度分为轻度HIE组(n=13)、中度HIE组(n=21)和重度HIE组(n=12);另选择同期在本院出生且无窒息及神经系统症状的30例足月儿为对照组。轻度HIE组患儿给予常规的三支持治疗(1.维持良好的通气功能;2.维持脑和全身良好的血流灌注;3.维持血糖在正常范围)和三对症治疗(1.控制惊厥;2.降低颅内压;3.消除脑干症状);中、重度HIE患儿除了给予常规的三支持和三对症治疗外,同时于出生后6~72 h期间给予头部亚低温治疗,维持肛温在34~35℃。各组受试者均于出生第1、3、7天采集外周静脉血1.5~2.0 mL,置于干燥促凝管中,凝血后以3200 r·min^(-1)离心5 min,取血清-70℃保存,采用酶联免疫吸附法检测血清GFAP、UCH-L1水平,比较各组受试者出生第1、3、7天血清GFAP、UCH-L1水平差异,并观察血清GFAP、UCH-L1水平与足月儿HIE病情严重程度的关系。结果出生第3天,轻度HIE组患儿血清GFAP水平显著高于对照组(P<0.05)。出生第1、3、7天,中度HIE组、重度HIE组患儿血清GFAP、UCH-L1水平均显著高于对照组(P<0.05)。中度HIE组患儿出生第1、3、7天的血清UCH-L1水平及出生第7天的血清GFAP水平显著高于轻度HIE组,重度HIE组患儿出生第1、3、7天的血清GFAP、UCH-L1水平均显著高于轻度HIE组(P<0.05)。重度HIE组患儿出生第1、7天的血清UCH-L1水平及出生第1、3、7天的血清GFAP水平均显著高于中度HIE组(P<0.05)。中度HIE组、重度HIE组患儿出生第1、7天的血清GFAP水平显著高于出生第3天(P<0.05)。Spearman相关性分析显示,出生第1、3、7天,血清GFAP水平与HIE患儿的病情严重程度均呈正相关(r=0.740、0.526、0.902,P<0.05),血清UCH-L1水平与HIE患儿严重程度亦呈正相关(r=0.733、0.807、0.799,P<0.05)。结论出生1周内,足月HIE患儿血清GFAP、UCH-L1水平与病情严重程度呈正相关,早期检测血清GFAP、UCH-L1水平对早期发现HIE并进行干预具有一定的指导意义。

Kangaroo Care (Skin-to-Skin) for Clustered Pain Procedures: Case Study

Background: Pain management for term newborns undergoing clustered painful procedures has not been tested. Kangaroo Care (chest-to-chest, skin-to-skin position of infant on mother) effectively reduces pain of single procedures, but its effect on pain from clustered procedures is not known. Aim: The aim was to test Kangaroo Care’s effect on pain in one term infant who received clustered painful procedures while determining feasibility of the Kangaroo Care intervention. Design, Setting, and Participant: A case study design was used with one healthy term newborn who received two heel sticks and one injection in one session in the mother’s postpartum room. Method: Heart rate and oxygen saturation (recorded from Massimo Pulse Oximeter every 30 seconds), crying time (total seconds of crying on videotape) and behavioral state (using Anderson Behavioral State Scoring system every 30 seconds) were measured before (5 minutes), during (10.5 minutes) and after (30 minutes) the three clustered painful procedures in a newborn who was in Kangaroo Care during all observations. One staff nurse administered the clustered procedures. Results: Heart rate increased sequentially with each heelstick, oxygen saturation remained unchanged, sleep predominated, and crying was minimal throughout the procedures. Conclusion: Kangaroo Care appeared to reduce pain from clustered painful procedures and can be further tested.

Correlation between Transcutaneous Bilirubinemia and Blood Bilirubinemia in Screening Term Newborn for Neonatal Jaundice at the Essos Hospital Centre (EHC), Yaoundé, Cameroon

Background: Early and non-invasive diagnosis of neonatal hyperbilirubinemia remains critical in dark skinned babies of low resource settings. Objective: To assess correlation/agreement between transcutaneous bilirubin (Tcb) and serum bilirubin (Tsb) values in full term neonates with jaundice. Methodology: An analytical cross-sectional study was conducted at the neonatology unit of the Essos Hospital Centre (EHC) from January to June 2019. All full-term neonates aged 0 to 7 days with suspected jaundice who did not receive phototherapy were eligible for the study. The enrolled neonates in the study were assessed clinically, then with the MBJ20 transcutaneous bilirubinometer (TcB). The MBJ20 transcutaneous bilirubinometer highest measurement over the forehead and the sternum were compared to TsB. Data were entered and then analysed with the CsPro7.2 and R (version 3.6.0) software. Correlation was captured by Bland & Alman plots and Concordance Correlation Coefficient (CCC) estimates. The Pearson correlation coefficient and Student test for paired data were used for descriptions purposes, and the significance level was 5%. Results: We recruited 88 neonates. The sex ratio of the babies included was 1.25 favouring males. Median Post-natal age was 3 days with 62% aged 72 hours or more. The mean TcB corresponding to the maximum average between frontal and sternal measurement was 153 mg/dl ± 48 and the average Tsb was 123.80 mg/dl ± 50.48. A good linear correlation was found between TcB and total serum bilirubin level r = 0.86 [0.80;0.91]. Positive correlation was noted between both (forehead and sternum) TcB measurements sites, namely r = 0.78 and r = 0.86. The Bland & Altman plot measured the bias at -29.68 mg/l (confidence interval at 95%, 21.14 - 80.50). The CCC estimate was 0.2 varying from -0.22 to 0.76 according to TcB measurement threshold and post-natal age. The ROC area under the curve value for a threshold < 100 mg/l equals 90% proving to be a good predictor for this threshold. Conclusion: A good linear correlation was found despite a poor agreement between TcB and Tsb. TcB method systematically overestimated the value of TsB.

足月儿缺氧缺血性脑病血清IGF-1 S-100B和GFAP水平检测及其临床意义

目的:观察足月儿缺氧缺血性脑病(HIE)血清胰岛素样生长因子-1(IGF-1)、S100B蛋白(S-100B)和胶质纤维酸性蛋白(GFAP)水平检测及其临床意义。方法:选取2018年1月至2021年1月我院收治的106例足月HIE患儿为研究对象,设为观察组,并选取30例健康足月新生儿作为对照组,并根据治疗后好转情况分为存活组(n=91)和死亡组(n=15),检测血清IGF-1、S-100B和GFAP水平,采用ROC曲线分析血清IGF-1、S-100B和GFAP水平对HIE的诊断价值和对HIE预后的预测价值。结果:观察组血清IGF-1水平低于对照组,S-100B、GFAP水平高于对照组(P<0.05);ROC曲线分析显示,血清IGF-1、S-100B、GFAP水平并联诊断HIE的敏感度为93.40%,AUC为0.886,高于单独检测(P<0.05)。存活组血清IGF-1高于死亡组,S-100B和GFAP水平低于死亡组(P<0.05);ROC曲线分析显示,血清IGF-1、S-100B、GFAP水平并联预测HIE预后的敏感度为91.50%,AUC为0.864,高于单独检测(P<0.05)。结论:足月HIE患儿血清IGF-1水平呈低表达,S-100B、GFAP水平呈高表达,对HIE的早期诊断及预后评价具有重要应用价值。

Cytokine responses in infants infected with respiratory syncytial virus

Introduction: Variability in severity of Respiratory Syncytial Virus (RSV) infection is reportedly due to differences in inflammatory response. Objective: To characterize the cytokine response in RSV+ infants aged 0 - 36 months and to relate their responses to disease severity. Methods: Nasopharyngeal aspirations (NPAs) were analyzed for RSV and IL-1β, IL-2, IL-4, IL-5, IL-6, IL-10, IL-12, IL-1RA, IL-4R, IFN-γ, sTNFR1, sTNFR2, and TNF-α. Clinical data were collected from the medical records. Results: We included 331 infants of whom 214 were RSV+. In comparison to RSV- infants, they had significantly higher levels of TNF-α, IL-6, IL-1β, and IFN-γ (p α, IL-6, and IL-1β. sTNFR1/2 were significantly increased in RSV+ infants. Hospitalized patients had significantly higher levels of TNF-α, sTNFR2, and IL-10 (p < 0.05) than non-hospitalized patients. The cytokine response could not be related to disease severity. We found no evidence of a skewed Th1/Th2 immune profile. Conclusion: In acute RSV disease, infected infants’ NPAs contain a significant amount of pro-inflammatory cytokines. Whether this response is beneficial or deleterious remains unanswered. Interpersonal variations in cytokine responses might be linked to an inherited tendency to variations in disease severity.

An Improved Numerical Simulation Mode of Nonlinear Wave with Consideration of High Order Terms

SUN Da-peng BAO Wei-bin, WU Hao and LI Yu-cheng （ In this paper the 0-1 combined BEM is adopted to subdivide the computational domain boundary, and to discretize the Green＇s integral expression based on Laplace equation. The FEM is used to subdivide the wave surface and deduce the surface equation which satisfies the nonlinear boundary conditions on the surface. The equations with potential function and wave surface height as an unknown quantity by application of Taylor expansion approach can be solved by iteration within the time step. In m-time iteration within the computational process of time step （n-1）At to nat, the results of the previous iteration are taken as the initial value of the two-order unknown terms in the present iteration. Thus, an improved tracking mode of nonlinear wave surface is estabIished, and numerical results of wave tank test indicate that this mode is improved obviously and is more precise than the previous numerical model which ignored the two-order unknown terms of wave surface location and velocity potential function in comparison with the theoretical values.

Ionic Disorders Observed in Infants with Severe Wasting at the Yalgado Ouedraogo Teaching Hospital and the Charles de Gaulle Pediatric Teaching Hospital in Ouagadougou, Burkina Faso

Introduction: A higher risk of death is associated with wasting in children if it is not treated properly. The objective of this study was to investigate the ionic disorders observed in infants suffering from severe wasting at Yalgado Ouedraogo Teaching Hospital (YO-TH) and at Charles de Gaulle Pediatric Teaching Hospital (CDG-PTH) in Ouagadougou (Burkina Faso). Methods: This was a retrospective study with a descriptive and analytical aim over the period from January 1, 2016 to December 31, 2020. Results: It concerned infants aged 6 to 24 months hospitalized at YO-TH and at CDG-PTH from Ouagadougou. We included 271 infants. The mean age of the infants was 14.48 ± 5.44 months with 42.07% which was in the age range of [12 - 18] months. On admission to the hospital, the children had an average weight, height and BMI of 6.22 ± 1.32 kg, 0.73 ± 0.07 m and 11.67 ± 1.53 kg/m2. In urban areas 56.46% of children and the main reasons for consultation were fever (88.19%), vomiting (52.80%) and diarrhea (50.20%). Electrolyte disturbances in emaciated infants affected all 8 parameters of the blood ionogram. However, the major disorders were 65.68% hyponatremia, 55.35% hypobicarbonatemia, 41.33% hypoprotidemia and 32.47% hypokalemia in infants aged 6 to 24 months. We found an association between diarrhea and residence with hypokalemia (p = 0.0000) and hypochloremia (p = 0.010), respectively. Conclusion: Severe acute wasting in infants 6 to 24 months of age remains a concern in the hospital setting. The frequency of biochemical disturbances is also high.