STUDY ON THE GROWTH OF CEREBELLUMIN NEWBORN INFANTS

Objective To know the growth of the cerebellum in newborn infants. Methods The centraivermian area (CVA) of the cerebellum was measured by head ultrasonography in 90 newborns including 65full - terms, 14 preterms and 11 small for gestational age infants (SGA). Results The average age of the newborninfants were 4.7d (3~7d). The mean CVA in full-terms was 5.81±0.8cm2, which was significantly greater thanthat in preterms (3.7±1.0cm2), and SGA (5.1±0.8cm2), respectively. However, when corrected for birth weight(BW), the ratio of CVA/BW in term SGA was 2.07, being signoficantly higher than the ratio of 1.72 in normalfull- term newborns. There was no dillerence between male and female infants. Statistically significantrelationships were lound between CVA and BW (r=0.8129, P<0.01) and between CVA and gestational age(r=0.7450, P<0.01). Conclusion The study provide some understanding on the grouth of the cerebellum, and thecerebellar measurement by cranial ultrasound is helpful for the assessment of neurological maturation in newborninfants.

Lipid infusion and intravenous access in newborn infants

The spectacular development of neonatal intensive care since the 1960s allowed a drop in neonatal mortality of very-low-birth-weight （VLBW） infants from 50% to less than 15% in the last decade.

Research Progress on the Etiology,Diagnosis and Treatment of Neonatal Necrotizing Enterocolitis

Necrotizing enterocolitis(NEC)is a leading cause of death from gastrointestinal disease in premature and low-birth-weight infants.Early detection of severely ischemic or necrotic bowel before perforation is rather difficult.New techniques including multi-omics contribute to better understanding its underlying mechanisms and discovering differe categories of biomarkers.Combination of clinical metrics such as seven components of metabolic derangement(CMD)may provide accurate assessment of its severity.Implementation of quality improvement initiatives including breast milk feeding actually lowers its incidence.

Investigation of regurgitation and other symptoms of gastroesophageal reflux in Indonesian infants

AIM:To evaluate the incidence of regurgitation and other symptoms of gastroesophageal reflux in Indonesian infants. METHODS:In a cross-sectional study at the University Outpatient Clinic for vaccination in Jakarta,138 mothers of healthy infants less than 12-mo old were prospectively asked to report the frequency of regurgitation. RESULTS:Whatever the age was,some infants did not regurgitate(from 10% during the first month of life to 67% in 1-year-old infants).Regurgitation of at least once a day was reported in 77% of infants younger than 3 too.Daily regurgitation decreased to 12% in the 9-12 mo old group. Reported peak prevalence was 81%(26/32)during the first month of life.Regurgitation decreased sharply between the 4-6 and 7-9 mo old groups(from 44% to 9%).The longer the regurgitation persisted,the more frequently the mother perceived regurgitation as a problem.Volume and frequency of regurgitation,back arching,irritability,crying and refusal of feeding were the symptoms causing maternal anxiety.The longer the regurgitation persisted,the more frequently the mothers viewed it as a health problem. CONCLUSION:Regurgitation occurs frequently in Indonesian infants,and is a frequent cause of concern to mothers.

The Distribution and Morphological Diversity of GABA-containing Neurons in The Prefrontal Cortex of Human Newborn Baby Infant

The prefrontal cortex of a human full termnewborn infant just after accidental death was studies by mcans of immunocytochemical technique with antibody directedagainst GABA(Immunonuclear Corp.)and ABC kit(Vector)。GABA-containing neurons were found over all layers and all were nonpyramidal cells.The laminar distribution of GABA-containing ne-urons was not even between different layers,density in laye Ⅱ was prominently higher than any other layers,density in layer Ⅲ and layer Ⅳ was higher than that in layer V and Ⅵ.

Congenital H-type anovestibuler fistula

The congenital H-type fistula between the anorectum and genital tract besides a normal anus is a rare entity in the spectrum of anorectal anomalies. We described a girl with an anovestibuler H-type fistula and left vulvar abscess. A 40-day-old girl presented symptoms after her parents noted the presence of stool at the vestibulum. On the physical examination, anus was in normal location and size, and had normal sphincter tone. A vestibuler opening was seen in the midline just below of the hymen. A fistulous communication was found between the vestibuler opening and the anus, just above the dentate line. There was a vulvar abscess which had a left lateral vulvar drainage opening 15 mm left lateral to the perineum. After the management of local inflammation and abscess, the patient was operated for primary repair of the fistula. A protective colostomy wasn′t performed prior the operation. A profuse diarrhea started after 5 hours of postoperation. After the diarrhea, a recurrent fistula was occurred on the second postoperative day. A divided sigmoid colostomy was performed. 2 months later, and anterior sagital anorectoplasty was reconstructed and colostomy was closed 1 month later. Various surgical techniques with or without protective colostomy have been described for double termination repair. But there is no consensus regarding surgical management of double termination.

Gastric malignancies in Northern Jordan with special emphasis on descriptive epidemiology

AIM:To study the epidemiology of gastric malignancies in Jordan as a model for Middle East countries where such data is scarce. METHODS:Pertinent epidemiological and clinicopathological data for 201 patients with gastric malignancy in north of Jordan between 1991 and 2001 were analyzed. RESULTS:Male:female ratio was 1.8:1.The mean age was 61.2 years,and 8.5% of the patients were younger than 40 years of age.The overall age-adjusted incidence was 5.82/100 000 population/year.The age specific incidence for males raised from 1.48 in those aged 30-39 years to 72.4 in those aged 70-79 years.Adenocarcinomas, gastric lymphomas,malignant stromal tumors,and carcinoids were found in 87.5%,8%,2.5%,and 2% respectively.There was an average of 10.1-month delay between the initial symptoms and the diagnosis.Only 82 patients underwent“curative”gastrectomy.Among adenocarcinoma groups,Lauren intestinal type was the commonest(72.2%)and the distal third was the most common localization(48.9%).The mean follow up for patients with gastric adenocarcinoma was 25.1 mo(range 1-132mo).The 5-year survival rates for stages Ⅰ(n=15), Ⅱ(n=41),Ⅲ(n=59),and Ⅳ(n=53) were 67.3%,41.3%, 5.7%,and 0% respectively(P=0.0001).The overall 5 year survival was 21.1%. CONCLUSION:Despite low inddence,some epidemiological features of gastric cancer in Jordan mimic those of high- risk areas.Patients are detected and treated after a relatively long delay.No justification in favor of a possible gastric cancer screening effort in Jordan is supported by our study;rather,the need of an earlier diagnosis and subsequent better care.

Gastroesophageal manometry and 24-hour double pH monitoring in neonates with birth asphyxia

INTRODUCTIONBirth asphyxia may lead to disturbances of gastroenteric motility of newborn infants[1.2] . The change of gut pressure and reflux are the major manifestations of the motor disturbance [3-9] . To evaluate the effects of perinatal asphyxia on the gastroenteric motility, gastric and esophageal pressure and double pH were measured in a group of asphyxiated newborns. And. their pathophysiological and anatomical effects on gastroenteric function were discussed.

“AFGP” bundles for an extremely preterm infant who underwent difficult removal of a peripherally inserted central catheter:A case report

BACKGROUND There have been few reports on level 3 difficult removal of peripherally inserted central catheter(PICC)in neonates.Here,we reported a case of an extremely preterm infant who underwent level 3 difficult removal of a PICC.CASE SUMMARY Female baby A,weighing 1070 g at 27^(+1) wk of gestational age,was diagnosed with extremely preterm infant and neonatal respiratory distress syndrome.She underwent PICC insertion twice.The first PICC insertion went well;the second PICC was inserted in the right lower extremity,however,phlebitis occurred on the second day after the placement.On the third day of catheterization,phlebitis was aggravated,while the right leg circumference increased by 2.5 cm.On the fourth day of catheterization,more red swelling was found in the popliteal part,covering an area of about 1.5 cm×4 cm,which was diagnosed as phlebitis level 3;thus,we decided to remove the PICC.During tube removal,the catheter rebounded and could not be pulled out(several conventional methods were performed).Finally,we successfully removed the PICC using a new approach termed“AFGP”.On the 36th day of admission,the baby fully recovered and was discharged.CONCLUSION The“AFGP”bundle approach was effective for an extremely preterm infant,who underwent level 3 difficult removal of a PICC.

Use of antenatal corticosteroids among infants with gestational age at 24 to 31 weeks in 57 neonatal intensive care units of China: a cross-sectional study

Background:Antenatal corticosteroids(ACS)can significantly improve the outcomes of preterm infants.This study aimed to describe the ACS use rates among preterm infants admitted to Chinese neonatal intensive care units(NICU)and to explore perinatal factors associated with ACS use,using the largest contemporary cohort of very preterm infants in China.Methods:This cross-sectional study enrolled all infants born at 24^(+0)to 31^(+6)weeks and admitted to 57 NICUs of the Chinese Neonatal Network from January 1st,2019 to December 30th,2019.The ACS administration was defined as at least one dose of dexamethasone and betamethasone given before delivery.Multiple logistic regressions were applied to determine the association between perinatal factors and ACS usage.Results:A total of 7828 infants were enrolled,among which 6103(78.0%)infants received ACS.ACS use rates increased with increasing gestational age(GA),from 177/259(68.3%)at 24 to 25 weeks’gestation to 3120/3960(78.8%)at 30 to 31 weeks’gestation.Among infants exposed to ACS,2999 of 6103(49.1%)infants received a single complete course,and 33.4%(2039/6103)infants received a partial course.ACS use rates varied from 30.2%to 100%among different hospitals.Multivariate regression showed that increasing GA,born in hospital(inborn),increasing maternal age,maternal hypertension and premature rupture of membranes were associated with higher likelihood to receive ACS.Conclusions:The use rate of ACS remained low for infants at 24 to 31 weeks’gestation admitted to Chinese NICUs,with fewer infants receiving a complete course.The use rates varied significantly among different hospitals.Efforts are urgently needed to propose improvement measures and thus improve the usage of ACS.

Mechanism of peripheral blood mononuclear cell invasion by HBV on artificial immunization in newborns

OBJECTIVE: To study the effect and mechanism of the peripheral blood mononuclear cell (PBMC) invasion by HBV on artificial immunization in newborns. METHODS: Fifty-two newborns of HBsAg positive mothers were immunized with HBIG (hepatitis B immunoglobulin) and HBVac (hepatitis B vaccine) and were followed up for 7 months. The newborns' HBV-DNA in serum and in the PBMCs was detected with nested-PCR; anti-HBs was tested with solid phase radioimmunoassay (SP-RIA). PBMCs isolated from newborn peripheral blood were incubated in the presence of PHA or purified HBsAg. Interleukin-2 (IL-2) level in culture supernatants of activated cells was detected by ELISA. RESULTS: The failure rate of immunization was higher in infants with positive HBV-DNA in PBMCs than those with negative HBV-DNA (P

Epidemiology of respiratory distress and the illness severity in late preterm or term infants： a prospective multi-center study

Background The severity of respiratory distress was associated with neonatal prognosis. This study aimed to explore the clinical characteristics, therapeutic interventions and short-term outcomes of late preterm or term infants who required respiratory support, and compare the usage of different illness severity assessment tools.Methods Seven neonatal intensive care units in tertiary hospitals were recruited. From November 2008 to October 2009, neonates born at ≥34 weeks＇ gestational age, admitted at 〈72 hours of age, requiring continuous positive airway pressure （CPAP） or mechanical ventilation for respiratory support were enrolled. Clinical data including demographic variables, underlying disease, complications, therapeutic interventions and short-term outcomes were collected. All infants were divided into three groups by Acute care of at-risk newborns （ACoRN） Respiratory Score 〈5, 5-8, and 〉8.Results During the study period, 503 newborn late preterm or term infants required respiratory support. The mean gestational age was （36.8±2.2） weeks, mean birth weight was （2734.5±603.5） g. The majority of the neonates were male （69.4%）, late preterm （63.3%）, delivered by cesarean section （74.8%）, admitted in the first day of life （89.3%） and outborn （born at other hospitals, 76.9%）. Of the cesarean section, 51.1% were performed electively. Infants in the severe group were more mature, had the highest rate of elective cesarean section, Apgar score 〈7 at 5 minutes and resuscitated with intubation, the in-hospital mortality increased significantly. In total, 58.1% of the patients were supported with mechanical ventilation and 17.3% received high frequency oscillation. Adjunctive therapies were commonly needed.Higher rate of infants in severe group needed mechanical ventilation or high frequency oscillation, volume expansion,bicarbonate infusion or vasopressors therapy （P 〈0.05）. The incidence of complications was also increased significantly in severe group （P 〈0.05）. The in-hospital mortality in the severe group was significantly higher than other two groups （P〈0.05）. ACoRN Respiratory Score was correlated with Score for Neonatal Acute Physiology-Version Ⅱ （SNAP-Ⅱ） （P〈0.01）. High gestational age, high SNAP-Ⅱ score and oxygenation index （OI）, and Apgar score at 5 minutes 〈5 were independent risks for death.Conclusions Neonatal respiratory distress is still a common cause of hospitalization in China. Illness severity assessment is important for the management. ACoRN Respiratory Score which correlated with SNAP-Ⅱ score is easy to use and may be helpful in facilitating the caregivers in local hospital to identify the early signs and make the transfer decision promptly.

Transphyseal separation of the distal humerus in newborns

Obstetric traumatic separation of the distal humeral epiphysis is a very uncommon injury, which pre- sents a diagnostic challenge. These case serials reviewed the functional outcomes of 5 patients who had sustained a fracture-separation of the distal humeral epiphysis at birth. The diagnosis was made at a mean time of 40.8 h after delivery. All the patients were treated with gentle close manipulation, reduction under fluoroscopy and above-elbow cast application. After discharge, the patients were fol- lowed up for a mean of 30 months. Clinico-radiological results were excellent in four patients. One case necessitated closed reduction and percutaneous K-wire fixation at one week follow-up due to failed reduction. Cubitusvarus deformity was the only complication noted in I case. Good functional outcome can be expected in newborns with fracture-separation of the distal humeral epiphysis wherein the physis is anatomically reduced.

Effect of Combined Acupuncture and Rehabilitation on High-risk Infants with Perinatal Brain Injuries

Objective： To investigate the effect of combined acupuncture and rehabilitation on intelligence and motor development of high risk infants with perinatal brain injuries. Methods： Ninety-seven survived cases in the neonatal intensive care unit （NICU） were allocated into a treatment group of 53 cases and a control group of 44 cases following the consent of the parents. Cases in the treatment group were treated by combined acupuncture and rehabilitation; whereas cases in the control group were treated by conventional child care methods. Systemic follow-up has been made for 2 years. Then the infants＇ intelligence was evaluated respectively in the 6th, 12th and 34th months. Results： Compared with the control group, the mental development indexes （MDI） and physical development indexes （PDI） in the treatment group were increased by 14.96 and 9.82 respectively. There was a significant difference （χ2=8.1659, P〈0.01 ） in the abnormal intelligence rates between the treatment group （15.1%） and the control group （40.9%,）. Conclusion： Combined acupuncture and rehabilitation can effectively improve the mental and physical development of high-risk infants with perinatal brain injuries. Additionally, this therapy can decrease the disability rates and increase the infants＇ quality of life.

Critical Review of Massage Therapy Employed for Newborns

Objective： To evaluate the outcomes of current studies regarding the beneficial effects of infant massage therapy. Method： Firstly, some common knowledge related to massage is provided. Subsequently, research-based evidence on massage effects in neonatal unit has been examined, particularly on premature babies and newborns with jaundice. Result and Conclusion： the practice of massage therapy promotes the development of preterm babies and the treatment of neonates with jaundice generally safe, however the methodology employed in reviewed studies is of certain limitations, such as a lack of RCT with large sample size, inadequate follow-up period.

Expression and effect of basic fibroblast growth factor on human cataract lens epithelial cells

OBJECTIVE: To detect the expression of basic fibroblast growth factor (bFGF) in human ocular tissues, and to assess the effect of bFGF on the proliferation of human cataract lens epithelial cells (LECs) and its correlation with age. METHODS: Enucleated eyes were subjected to immunostaining for bFGF protein. Human cataract LECs were cultured in vitro, and treated with bFGF for 48 hr. Proliferation was estimated by the positive area ratio of proliferating cell nuclear antigen (PCNA) in immunohistochemistry. RESULTS: bFGF protein was found in various human ocular tissues. bFGF stimulated human cataract LEC proliferation, and there was an age-related decrease in responsiveness of human cataract LECs to bFGF (P

全国0～6岁儿童听力筛查诊断培训班调查结果

本文重点介绍了对参加全国0～6岁儿童听力筛查诊断培训班学员的调查结果。95.65%的学员对培训班表示满意;78.46%和75.36%的学员认为培训内容实用和合理;94.20%的学员回答单位领导对新生儿听力筛查工作持肯定、支持态度;88.41%学员还希望参加该项目的提高班学习,另外,学员们还提出了许多宝贵的建议。在做好后勤工作保证学员安心学习的同时,完善教学内容和教学模式,不断提高教学质量,是今后的重点课题。

Klebsiella pneumoniae: epidemiology and analysis of risk factors for infections caused by resistant strains

OBJECTIVE: To analyze the epidemiology of hospital and community-acquired infections caused by Klebsiella pneumoniae (K. pneumoniae) and risk factors for infections caused by resistant strains. METHODS: A retrospective observational study was performed to analyze the relationship between antimicrobial use and bacterial resistance. RESULTS: A K. pneumoniae infection was diagnosed in 0.47% of patients (169 of 36 179) admitted to the hospital between 1 March 1999 and 31 August 2000. Of the 169 isolates, 166 (98.2%) were resistant to at least one antimicrobial and 91.1% (154/169) to two or more antibiotics. 98% were resistant to ampicillin, 77% to piperacillin, 64% to cephalothin, 60% to ampicillin/sulbactam, 59% to cefoperazone, 57% to cefazolin, 55% to cefuroxime, 51% to TMP-SMZ, 51% to tobramycin, 50% to gentamicin, 49% to aztreonam, cefetaxime and ceftriaxone respectively, 47% to ceftazidime, 47% to cefepime, 46% to ciprofloxacin, 46% to ticarcillin/clavulanate, 44% to amikacin, 38% to cefoxitin, 22% to piperacillin/tazobactam, while all strains were tested susceptible to imipenem. CONCLUSIONS: Prior receipt of amtimicrobial therapy was significantly associated with infection caused by a resistant organism and most strains were resistant to multiple antibiotics.

Impact of a nationwide training program for neonatal resuscitation in China

Background Seventeen million births occur in China each year. Neonatal mortality is the leading cause of under 5-year-old child deaths, and intrapartum-related injury accounts for much of mental retardation in young children. The Chinese Ministry of Health sought to improve infant and child survival through a nationwide initiative to have at least one person trained in neonatal resuscitation at every birth. The aim of the current study was to evaluate the impact of China Neonatal Resuscitation Program （NRP） on policy and infrastructure changes and its effectiveness in decreasing the incidence of mortality among newborn infants. Methods The Chinese NRP incorporated policy change, professional education, and creation of a sustainable health system infrastructure for resuscitation. Multidisciplinary teams from all 31 provinces and municipal states disseminated NRP in a train-the-trainer cascade. The intervention targeted 20 provinces with high neonatal mortality and programs to reduce maternal mortality. Program evaluation data came from 322 representative hospitals in those provinces. Results Changes in policy permitted midwives to initiate resuscitation and required resuscitation training for licensure. From 2004 through 2009 more than 110 659 professionals received NRP training in the 20 target provinces, with 94% of delivery facilities and 99% of counties reached. Intrapartum-related deaths in the delivery room decreased from 7.5 to 3.4 per 10 000 from 2003 to 2008, and the incidence of Apgar 〈7 at 1 minute decreased from 6.3% to 2.9%. Conclusions The Chinese NRP achieved policy changes promoting resuscitation, trained large numbers of professionals, and contributed to reduction in delivery room mortality. Improved adherence to the resuscitation algorithm, extension of training to the township level, and coverage of births now occurring outside health facilities can further increase the number of lives saved.