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Newborn screening (NBS) plays a significant role in reducing the risk of birth defects. NBS in China began in the early 1980s. Under the protection of laws and regulations and the leadership of the national health administration, approved screening centers in public hospitals took the responsibility for publicity, screening, diagnosis, treatment, follow-up and management of birth defects. As of 2022, 31 provinces (autonomous regions and municipalities directly under the central government) have carried out NBS for phenylketonuria, congenital hypothyroidism, and hearing loss, 23 provinces have carried out screening for glucose-6-phosphate dehydrogenase (with a screening rate of 89.24%), and 24 provinces have carried out screening for congenital adrenal cortical hyperplasia (91.45% screening rate). Over the past four decades, screening techniques have evolved from bacterial inhibition, fluorescence analysis, and tandem mass spectrometry for the detection of biochemical markers to genetic testing, which has greatly contributed to the expansion of the types of diseases screened for. The combined use of metabolomics and genomics is currently being explored. Effective management and rigorous quality control of NBS are prerequisites for improving the quality and ensuring the accuracy of screening. The Quality Management System for Newborn Screening System Network (QMS-NBS), established by the National Center for Clinical Laboratories, covers all screening centers and related blood collection agencies. The operation of the QMS-NBS allows the quality and performance of screening to be transparent and measurable, ensuring the quality and efficiency of screening. This article provides an overview of the history of NBS, especially the evolution of policies for the NBS in China, the construction of screening institutions, the number of newborns screened, the incidence rates of screened diseases, the changes in screening technology, the expansion of new diseases screened for, and the quality control of NBS. Overall, the progress in NBS in China has not only benefited from the development and standardization at the technological level, but also benefited from the construction of policies, regulations and ethics.
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Infant, Newborn , Humans , Neonatal Screening , Phenylketonurias , Genetic Testing , Congenital Hypothyroidism , ChinaABSTRACT
Objective:To study the clinical features and drug resistance profile of neonatal sepsis caused by different species of Klebsiella.Methods:From January 2009 to December 2018, cryopreserved Klebsiella strains from blood culture of neonatal sepsis cases in NICU of our hospital were reactivated. Molecular identification and antimicrobial susceptibility tests were performed. Clinical features, laboratory tests, drug resistance profile and prognosis of these patients were analyzed retrospectively.Results:A total of 29 strains of Klebsiella were reactivated. Molecular identification assigned 22 cases (75.9%) into Klebsiella pneumoniae (Kpn) group and 7 cases (24.1%) into Klebsiella quasipneumoniae (Kqu) group. Gestational age and birth weight of Kpn group were higher than Kqu group [(33.1±3.2) weeks vs. (30.6±0.9) weeks, (1 847±677) g vs. (1 416±121) g] ( P<0.05). Abdominal distension was more common in Kqu group than Kpn group [42.9% (3/7) vs. 4.5% (1/22), P<0.05]. No significant differences existed in the laboratory tests including white blood cell count, platelet count, hypersensitive C-reactive protein and procalcitonin between the two groups ( P>0.05). Kpn was 100.0% sensitive to Cefazolin-Tazobactam and Amikacinto and less sensitive to Imipenem and Cefperazone-Sulbactam, Meropenem and Ertapenem. Kqu was generally more sensitive than Kpn and the sensitivity of Kqu to Imipenem was 100.0%. No significant differences existed of the prognosis between the two groups ( P>0.05). Conclusions:Kpn is the main pathogen of neonatal Klebsiella sepsis. Kqu sepsis is more common in neonates with smaller gestational age and lower birth weight. Abdominal distention is common presenting symptom in Kpn sepsis and sensitive antibiotics should be used early.
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Objective:To study the differences of clinical features between aggressive posterior retinopathy of prematurity (APROP) and general retinopathy of prematurity (GROP) and to find the risk factors of APROP.Method:From January 2014 to December 2018, newborns with retinopathy of prematurity (ROP) hospitalized in our hospital were retrospectively studied. According to the diagnosis criteria of APROP, the newborns were assigned into GROP group and APROP group. Their clinical data, treatment and perinatal data were collected. SPSS 18.0 was used to compare the differences between the two groups.Result:A total of 127 newborns were included in the study, 107 in the GROP group and 20 in the APROP group. 91.6% (98/107) infants with gestational age (GA) <32 w were in the GROP group and 95.0% (19/20) in the APROP group. 84.1% (90/107) infants with birth weight (BW) <1 500 g were in the GROP group and 90.0% (18/20) in the APROP group. No significant differences existed of GA and BW between the two groups. 53.3% (57/107) infants in the GROP group received ≥2 times of blood transfusion, significantly lower than 85.0% (17/20) in the APROP group ( P<0.05). Mechanical ventilation (MV) was used in 81.3% (87/107) infants in the GROP group with most duration less than 7 days (69.2%, 74/107). MV was used in all infants in the APROP group with most duration longer than 7 days (65.0%, 13/20). The APROP group had significantly longer MV duration than the GROP group ( P<0.05). Some of the GROP group received laser photocoagulation therapy and all had good prognosis. Most of the APROP group received intravitreal injection and some of them combined with laser photocoagulation. The majority of them had favorable prognosis. Conclusion:The APROP group and the GROP group have similar general clinical characteristics. Increased blood transfusion and elongated MV duration may be risk factors for APROP.
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Neonate is undergoing the transition from fetal circulation to adult circulation in the early period after birth, always accompanied by complex hemodynamic changes.Critical illness in neonates can cause a series of hemodynamic changes.In this article, the main parameters for evaluating neonatal hemodynamics, common methods for monitoring neonatal hemodynamics, and hemodynamic monitoring of common neonatal critical illness were described.
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Objective@#To evaluate the consistency of ultrasonic cardiac output monitor (USCOM) and electric impedance (ICON) in cardiac function monitoring in preterm infants compared with echocardiography (ECHO).@*Methods@#All enrolled children were monitored with ECHO, USCOM and ICON on the 2nd and 7th day after birth.Heart rate (HR) and cardiac index (CI) were recorded.@*Results@#On the second day after birth, the CI measured by ECHO was (3.26±0.68) L/(min·m2), the CI measured by USCOM was (3.21±0.66) L/(min·m2), and the CI measured by ICON was (3.67 ±0.69) L/(min·m2), with an average percent error of 27.9% and 42.3%, respectively.On the 7th day after birth, the CI measured by ECHO was (3.53±0.57) L/(min·m2), the CI measured by USCOM was (3.47±0.59) L/(min·m2), and the CI measured by ICON was (3.73±0.67)L/(min·m2), with an average percent error of 25.8% and 28.3%, respectively.@*Conclusion@#Comparing USCOM with ECHO in cardiac output monitoring of preterm infants, the consistency is good at each time point after birth.Compared with ECHO, ICON has poor consistency in early postnatal cardiac index monitoring, but dynamic monitoring has a certain reference value after one week of birth.
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Objective To investigate whether the therapy of combining budesonide with pulmonary surfactant,compared with only surfactant,has an effect on the incidence of bronchopulmonary dysplasia,mortality and other complications in preterm infants.Methods The preterm infants in accordance with the inclusion criteria,who were born during from 12/2016 and 2/2018,were randomly divided into the combination treatment group (treated with the combination of budesonide and pulmonary surfactant) and control group (treated with only surfactant).Ninety eight preterm infants were enrolled this trial,48 of whom are in budesonide group and 50 are in control group.The basic data were not have statistic significant between two groups except for birth weight (P > 0.05).The incidence of bronchopulmonary dysplasia,the mortality and other complication of premature were compared.Results There was a statistic significance in the incidence of bronchopulmonary dysplasia between the budesonide group and control group (42% vs 66%,P<0.05);The severity of bronchopulmonary dysplasia and case fatality rate between two groups have no satistical difference.The complications of preterm infants in two groups also have no statistical difference apart from the incidence of PDA (15% vs 38%,P < 0.05).Conclusion Budesonide combined with pulmonary surfactant can reduce the incidence of bronchopulmonary dysplasia and does not increase mortality and the rate of other complications in preterm infants.
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Objective To study the heart function,risk factors and associated complications caused by patent ductus arteriosus( PDA)in preterm infants. Methods A retrospective analysis Was conducted at Neonatal Intensive Care Unit of Shenzhen People's Hospital from October 2016 to August 2017 to study the cardiac functions of infants less than 3 days after birth betWeen PDA group and non-PDA group(1: 1 paired study according to gestational age and Weight). MeanWhile their clinical data Were collected by case-control analysis method,to explore the risk factors and complications caused by PDA in preterm infants. Results There Were 50 cases in PDA group,and 50 cases in non-PDA group. The physical data betWeen 2 groups had no statistically significant difference(all P>0. 05). The heart rate (HR),cardiac output(CO)and cardiac output index(CI)in 2 groups Were(148. 36 ± 12. 98)times/min,(0. 52 ± 0. 21)L/min,(0. 44 ± 0. 19)L/( min·m2 )and(142. 52 ± 18. 07)times/min,(3. 48 ± 0. 92)L/min,(2. 99 ± 0. 80)L/(min·m2 ),respectively;the levels of PDA group Were higher than those of the non-PDA group,and the differences Were significant(P﹦0. 021,0. 020,0. 027). Single factor analysis shoWed that PDA in the preterm infants Was significantly associated With asphyxia,premature rupture of membranes and the use of prenatal hormone( P﹦0. 001,0. 009,0. 004). Ventilation time,pneumonia,feeding intolerance,and bronchial pulmonary dysplasia Were asso﹣ciated With PDA in preterm infants(P﹦0. 010,0. 010,0. 000,0. 026). The Logistic regression analysis shoWed that asphyxia Was independent risk factor for PDA in preterm infants(OR﹦7. 280),and prenatal antenatal corticosteroids Was independent protective factor( OR ﹦0. 008). Conclusions In preterm infants With PDA,the HR,CO and CI increase and electronic heart monitoring could identify the hemodynamic changes in preterm infants With PDA. Asphyxia is major high risk factor in PDA in preterm infants,While the use of prenatal antenatal corticosteroids is seen as the pro﹣tective factor. PDA in preterm infants can prolong the ventilation times and increase the pneumonia,feeding intolerance and BPD.
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Objective To analyze the detection rate of neonatal congenital malformation,and to explore the risk factors for neonatal malformation.Methods A total of 29 831 infants born in Shenzhen People's Hospital from January 2011 to December 2015 were analyzed retrospectively,the detection rate of congenital malformations was calculated,381 infants with congenital malformation were selected as malformation group,and 381 healthy infants were selected as healthy control group,and the risk factors of congenital malformation were analyzed.Results A total of 381 infants with congenital malformation were screened out,the incidence rate of congenital malformation being was 12.77‰(381/ 29 831 cases).The incidence rates of multi-finger or multi-toe,cleft lip,congenital heart disease were the high,which were 18.64% (71/381 cases),17.32% (66/381 cases) and 16.80% (64/381 cases),respectively.The multiple Logistic analysis showed that birth children with low weight newborns (< 2 500 g),multiple births,preterm birth (< 37 weeks),pregnancies > 1,low literacy levels of mothers,living in towns,late childbirth (≥ 35 years of age),pregnancy syndrome,viral infection during early pregnancy,medication history during pregnancy,rubella unvaccinated,exposure to harmful substance,smoking and alcohol during pregnancy and paternal smoking,chronic diseases,total 16 items were related risk factors for neonatal congenital malformations (all P < 0.05).Among them,the impact of viral infection during early pregnancy,alcohol,smoking,pregnancy syndrome,exposure to harmful substance,medication history during pregnancy on the incidence of malformations in neonates was relatively serious.Conclusions The incidence rate of congenital malformations among neonates conforms to the present situations in China,which was closely correlated with genetic and environmental factors.Health education targeting pregnant women and the women of childbearing age should be carried cut to reduce the birth of neonatal congenital malformations.
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The clinical manifestations of neonatal shock are atypical so that the early identification was important.Heart rate variability analysis and pulse oximetry for perfusion index monitoring are great help for early identification of neonatal shock.Much attention should be given to the treatment of neonatal special type of shock in addition to follow the general principles of shock treatment.
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Objective To study the relationship between intrauterine infection and early neonatal sepsis.Method From October 2015 to September 2016,the clinical data of pregnant mothers and their newborns in Shenzhen Longhua District Central Hospital were collected,and data of Shenzhen People's Hospital from January 2016 to June 2016 were collected.100 pairs of pregnant mothers and their newborns with confirmed or suspected intrauterine infection were selected as the observation group,and another 100 pairs without intrauterine infection during the same period as the control group.The ratio of term infants vs.premature infants was 1∶ 1.The complete blood count (CBC),CD64,procalcitonin (PCT) and C-reactive protein (CRP) were measured in peripheral blood of all mothers on the day of delivery.The CBC,CD64,CRP,PCT,blood culture of both umbilical venous blood and peripheral blood in neonates were examined and the pathological examination of placenta was performed.Result The positive rate of placental pathology and umbilical cord blood culture in observation group were significantly higher than that in the control and the positive rate in preterms was higher than the terms in observation group (P < 0.05).No significant differences existed between term and premature newborns on the positive rate of peripheral blood culture (P > 0.05).The positive rate of blood culture from umbilical cord blood was higher than peripheral blood in observation group (P < 0.05),but no significant difference in control group (P > 0.05).The incidence of septicemia in term and premature newborns in observation group was significantly higher than the control group (P< 0.05).The CD64,PCT in mother's peripheral blood and umbilical cord blood,and CRP in mother's blood were all higher than the control group,the differences were statistically significant (P < 0.05),but CRP in umbilical cord blood in both group were similar (P > 0.05).The area under ROC curve of CD64 and PCT in mother's peripheral blood,CD64 and PCT in umbilical cord blood to diagnose early-onset septicemia in newborns was 0.755,0.793,0.852 and 0.811,respectively.Conclusion The risk of neonatal infections is significantly increased because of intrauterine infection.Combination of peripheral and umbilical blood cultures can increase the accuracy of sepsis diagnosis.Both CD64 and PCT in umbilical cord blood and maternal blood can be used as indicators of intrauterine infection with a predictive value in the diagnosis of early-onset neonatal sepsis.
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Bronchopulmonary dysplasia( BPD) is one of the common complications in premature in-fants,especially those with very and extremely low birth weight. Among all the related factors of BPD,the role of patent ductus arteriosus( PDA) and especially its management with the different approaches and tim-ing of interventions have received widespread attention. Research progresses of the relationship between patent ductus arteriosus management and the development of BPD were summarized . On the basis of that,the sug-gestions focusing on lowering the incidence of BPD in very /extremely low birth weight infants are recom-mended.
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Invasive fungal infections(IFI) is significantly increasing in the neonatal intensive care unit recent years.The characteristics of IFI are low diagnosis rate,high mortality and being prone to involve in the nervous system.In this paper,the epidemiology,pathogens,risk factors,diagnosis,treatment and prevention of neonatal IFI are reviewed to improve the understanding of this disease.
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Neurally ajd usted ventilatory assist( NAVA) uses the electrical activity of the diaphragm as a neural trigger to synchronize mechanical ventilatory breaths with the patient′s neural respiratory drive. Some studies have shown that compared with pressure-support ventilation,NAVA can improve patient-venti-lator synchrony while maintaining spontaneous breathing,unload respiratory musculaturei n term adn prte erm i nfants.Further studies are needed to determ ine whether NA VA will have significant impact on the overall outcomes of neonates.
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BACKGROUND:A series of studies have found that mesenchymal stem cells play an important role in the prevention and cure of acute lung injury in adult animals. OBJECTIVE:To further validate the effects of human umbilical cord mesenchymal stem cells on endotoxin-induced acute lung injury in newborn rats. METHODS:Total y 120 newborn rats aged 7 days were randomly assigned to three groups. Intraperitoneal injection of 3 mg/kg endotoxin was done to establish neonatal rat model of acute lung injury in the model and stem cellgroup. Rats in the normal saline group were intraperitoneal y injected with 0.1 mL normal saline. After 30 minutes of modeling, the rats in the stem cellgroup were subjected to intraperitoneal injection of 0.1 mL human umbilical cord mesenchymal stem cells (1×106). The same volume of normal saline was administered in the normal saline and model groups. Lung tissue and blood specimens from newborn rats were taken at 6 hours, 1 day, 2 days, 4 days, and 7 days after treatment to observe lung pathological changes and detect levels of serum tumor necrosis factor-alpha and interleukin-10 as wel as myeloperoxidase activity in the lung tissue. RESULTS AND CONCLUSION:The lung hematoxylin-eosin staining and myeloperoxidase activity indicated acute lung injury in the model group. At 4 and 7 days after modeling, the severity of lung injury in the stem cellgroup was lighter than that in the model group. Compared with the model group, the interleukin-10 level was significantly increased in the stem cellgroup, while the level of tumor necrosis factor-alpha was significantly reduced (P<0.05). These findings suggest that human umbilical cord mesenchymal stem cells transplanted into newborn rats with acute lung injury can reduce lung inflammation, and the main mechanism may be that human umbilical cord mesenchymal stem cells can balance anti-inflammatory and pro-inflammatory factors and reduce lung injury through immune regulation.
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Objective To investigate the time and risk factors for spontaneous closure of patent ductus arteriosus (PDA) in preterm infants. Methods One hundred and seventy-seven preterm infants with arterial ductus unclosed were divided into three groups according to their gestational age as 28-31+6 weeks group (n=44),32-34+6 weeks group (n=59) and 35-36+6 weeks group (n=74).PDA was diagnosed by echocardiography in time of ≤12 h,-24 h,-48 h,-72 h,-96 h,-120 h,-144 h and >144 but ≤168 h after birth.The parameters of cardiac function included peak flow rate of aorta valve orifice,peak flow rate of pulmonary artery valve orifice,cardiac output,stroke volume,ejection fraction,the ratio of early (E) and late (A) diastolic velocities of mitral and tricuspid valves.The risk factors of arterial ductus spontaneous closure were determined by Logistic regression analysis.Results The cumulative spontaneous closure rates of preterm infants in three groups were 95.5%,100.0% and 100.0% within 168 h after birth respectively. There were significant differences of cumulative spontaneous closure rate in different time among three groups (x2 =4.23,7.45,12.46,7.14,4.75,6.47,3.89 and 3.89 respectively,P<0.05).After spontaneous closure of PDA during 12-24 h, peak flow rate of pulmonary artery valve orifice increased [(0.69±0.12) cm/s vs (0.65±0.12) cm/s,t=2.37,P=0.02],peak flow rate of aorta valve orifice [(0.65±0.11) cm/s vs (0.69±0.12) cm/s,t=2.51,P=0.02] and ejection fraction [(63.00±8.50) % vs (66.00±8.50) %,t=2.34,P=0.02] decreased.Logistic regression analysis showed that,the risk factors of preterm infants with arterial ductus unclosed within 24 hours after birth were gestation age (OR =1,825,95%CI:1.239-2.689),1 min Apgar score 0-3 (OR=1.946,95%CI:1.572-3.527) and early onset sepsis (OR=3.215,95%CI:1.245-5.463) ; gestation age (OR=3.270,95%CI:1.852-5.774),twins (OR=3.634,95%CI:1.489-8.871),1 min Apgar score 0-3 (OR=3.752,95%CI:2.156-5.436),Ⅲ-Ⅳ stage of respiratory distress syndrome (OR=2.897,95%CI:1.764-5.348) and early onset sepsis (OR=3.172,95%CI:2.134-6.437) were the risk factors of preterm infants with arterial ductus unclosed during 24-48 hours after birth; and gestational age (OR=2.471,95%CI:1.087-5.613),1 min Apgar score 0-3 (OR=2.985,95%CI: 1.469-5.736), Ⅲ-Ⅳ stage of respiratory distress syndrome (OR =3.645,95% CI:1.879-6.282),fluid volume excess (OR =4.135,95%CI:2.146-7.428) and early onset sepsis (OR=3.246,95%CI:2.146-4.526) for those with arterial ductus unclosed during 48-72 hours after birth. Conclusions The spontaneous closure rate of arterial ductus in the newborn infants whose gestational age over 28 weeks was above 90% in the first week after birth.There was no difference of left ventricular pump function between before and after the spontaneous closure.Reducing the incidence of premature birth,twins,severe asphyxia,severe respiratory distress syndrome, fluid excess and early onset sepsis might improve the spontaneous closure of arterial ductus.
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Objectives To investigate the incidence of brain injuri in premature infants in ten hospitals of seven large cities in China sponsored by the Subspecialty Group of Neonatology of Pediatric Society, China Medical Association. Methods All premature infants with gestational age less than 37 weeks in ten hospitals were given routine cranial ultrasound within three days of birth, and then repeated every 3-7 days till the discharge from the hospital during January 2005 to August 2006. Results Incidence of intraventricular hemorrhage (IVH) and severe IVH were 10.8% (406/3 768) and 2.4% (92/3 768) with 22.6% (92/406) for grade 1, 54.7% (222/406) for grade 2, 17.2% (70/406) for grade 3 and 5.4% (22/406) for grade 4 in nine hospitals; incidence of periventricular leukomalacia (PVL) and cystic PVL were 2.3% (112/4 933) and 0.3% (16/4 933) with 85.7% (96/112) for grade 1, 12.5% (14/112) for grade 2, and 1.8% (2/112) for grade 3 including all ten hospitals, respectively. Risk factors associated with increased severity of IVH were vaginal delivery (OR = 1.874, 95% CI = 1.172 - 2.997, P < 0.01), perinatal asphyxia (OR = 1.598, 95% CI = 1.077 - 2.372, P < 0.05), mechanical ventilation (OR = 3.988, 95% CI= 2.448 -6.948, P< 0.01), and amniotic fluid contamination (OR = 2.192, 95% CI = 1.054 - 4.544, P< 0.05). Risk factors that might result in the development of cystic PVL were vaginal delivery (OR = 1.400, 95% CI = 1.186 - 1.652, P < 0.001) and mechanical ventilation (OR = 3.000, 95% CI = 1.015 - 8.864, P < 0.05). Conclusions These data reflect basically the prevalence of brain injuriy in premature infants in major cities of China. However, more than 60% of population lives in the rural area, further multicenter investigation including the rural area is expected to be undertaken in future.
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Forty-three children with congenital hypothyroidism(CH)underwent 99mTc thyroid scintigraphy, after being followed up by receiving levothyroxine till 2 to 3 years of age. The results showed that thyroid agenesia happened in 37 cases( 86.05% ) while entopic gland in 6 cases (13.95% ). Thyroid scintigraphy with 99mTc is an informative procedure in determining etiology and treatment schedules for children with CH.
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Objective To investigate the features and influence factors of cardiac function in preterm infants.Methods One hundred and eleven preterm infants were divided into three groups according to the gestational age which was 28-31+6,32-33+6 and 34-36+6 weeks respectively.Fifty term-birth infants at gestational age of 37-41+6 weeks were taken as control group.The cardiac function was examined by SonoSite 180 PLUS color Doppler ultrasonic diagnostic apparatus.The parameters of cardiac function included heart rate,peak flow rate of aorta valve orifice (AV),peak flow rate of pulmonary artery valve orifice (PV),cardiac output (CO),stroke volume (SV),left ventricular end diastolic volume (LVEDV),left ventricular end systolic volume (LVESV),the ratio of early (E) and late (A) diastolic velocities of mitral and tricuspid valves (MVE/A,TVE/A).Within one week after delivery,the cardiac function was examined,and the cardiac function of preterm infants with different gestational age were compared.Another 162 preterm infants were divided into four groups according to the time at examination as 12 h-,24 h-,72 h-and 1 week-28 d.The influence factors of cardiac function were determined by multi-factor linear regression analysis.Results The AV,PV,CO,LVEDV,LVESV and SV increased with the increasing of gestational age.MVE/A (1.13±0.17,1.14±0.18,1.13±0.18) and TVE/A (0.90±0.16,0.90±0.13,0.90±0.15) of 28-31+6,32-33+6 and 34-36+6 weeks group were higher than those of control group (1.28±0.17 and 1.04±0.20),respectively (P<0.05).PV of 72 h-group and 1 week-28 d group were higher than that of 12 h-group [(79.60±11.22) cm/s and (78.86±13.64) cm/s vs (72.61±8.56) cm/s](P<0.05).The heart rate of 1 week-28 d group was higher than that of other three groups (P<0.05).Both CO and SV were positively related to body weight and gestational age (r=0.55 and 0.36,0.61and 0.52,respectively,P<0.05).Conclusions The left ventricular pump function increases with the increasing of gestational age,while the diastolic function of left and right ventricle of preterm infants does not change significantly in the first month of life.The PV of preterm infants significantly increases 72 h after delivery.The body weight and gestational age are important influence factors of cardiac function in preterm infants.
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Objective To investigate the dynamic change and correlation of the pulmonary ventilative function, mechanic and cardiac function in the term infants. Methods Twenty hundred term infants were divided into A 、B 、C and D groups by age which was 0 ~ 24 h, ~ 72 h, ~ 1 w and 28 d respectively. The lung ventilative and mechanical function were measured respectively by using techniques of tidal breathing flow-volume loop(TBFVL)and the single occlusion. The Master screen Paed-lung function devices of Germanic JAEGER Co. was be used in this study. The parameter of pulmonary function including minute volume(MV) ,tidal volume (TV), respiratory system compliance(Crs) and respiratory system resistance (Rrs). The cardiac function were measured by using SonoSite 180 PLUS color Doppler ultrasonic diagnostic apparatus. The main parameter of cardiac function including cardiac output(CO) and stroke volume(SV). Results The TV of A, B ,C and D group were 20. 2 ± 3.78,21. 1 ± 3.71,22. 3 ± 4. 48 and 23. 9 ±4.90 (ml)respectively, the TV of C and D group were higher than that of A group, and the TV of D group was higher than that of B group (P < 0. 05).There were no significantly difference of Crs, Rrs among A, B, C and D group(P > 0. 05). The CO of A,B,C and D group were 0.93 ±0. 23,0.93 ±0.23,1.02 ±0.21 and 1.08 ±0.27 (L/min) ,the CO of D group was higher than that of A and B groups (P < 0. 05). The CO was negative correlation with Rrs (r = - 0. 16,P < 0. 05) and positive correlation with MV、 TV、 Crs (r was 0. 50、 0. 54、0. 13 respectively, P < 0. 05).Conclusion The lung ventilative function is mature gradually with increasing age. The cardiac output has been obviously improved for postnatal 1 week in the term infants. The pulmonary ventilative function and mechanic parameter are important effective factors of cardiac function.
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BACKGROUND: The relationship between cellular morphosis and function is undetachable, but there is little investigation about ultrastructure of human umbilical cord mesenchymal stem cells (hUCMSCs).OBJECTIVE: To study the relationship between the functions of hUCMSCs and their ultrastructure obtained by atomic force microscope (AFM). METHODS: hUCMSCs were isolated, cultured, expanded after enzyme digestion. P3 cells were observed under AFM. Immunophenotype and cell cycle were analyzed by flow cytometry, as well as induction of the adipogenic, osteogenic differentiation of hUCMSCs were identified using Oil red O staining and alkaline phosphatase staining. RESULTS AND CONCLUSION: hUCMSCs at passage 3 were strongly positive for CD44 and CD29, weakly positive for CD106, but negative for hematopoietic marker CD34. Cells in G_0/G_1 phase accounted for 80%. Proliferation index was 19.9%. Following adipogenic induction, alkaline phosphatase staining demonstrated brown cytoplasm in cube and polygonal cells. AFM showed hUCMSCs were spindle shape, obvious cytoskeletal filament that connected into nets, which fit for the strong capacities for proliferation, migration and differentiation.