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Objective To explore the clinical significance of the serum brain?derived neurotrophic factor( BDNF) level in severe neonatal hyperbilirubinemia. Methods One hundred and twenty term and birth weight>2500 g infants admitted to the Neonatal Intensive Care Unit of Bethune nternational Peace Hospital of People Liberation Army were divided into severe hyperbilirubinemia group and control group according to their total bilirubin concentration. Total bilirubin( TBIL) concentration,BDNF and albumin in serum were determined in two groups. In addition, craniocerebral MRI was performed in severe neonatal hyperbilirubinemia before discharge. The correlation of the BDNF, TBIL, B/A, MRI results between severe hyperbilirubinemia group and control group were compared. Results The serum BDNF levels in severe hyperbilirubinemia group was ( 8. 84 ±3. 26) μg/L,significantly higher than that in control group((6. 24±1. 71) μg/L,t=3. 88,P0. 05). The serum BDNF level with craniocerebral MRI abnormal was ( 9. 53 ± 2. 77 ) μg/L, higher than that with craniocerebral MRI abnormal ((7. 81±3. 76) μg/L),but there was no statistical difference between them(t=1. 439,P>0. 05). Conclusion In severe neonatal hyperbilirubinemia, the body can secrete BDNF increasely. BDNF level is positivelycorrelated with B/ A level. As a marker of brain damage,BDNF is sensitive than craniocerebral MRI.
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<p><b>OBJECTIVE</b>To summarize the clinical characteristics of an infant with chronic myelogenous leukemia (CML) and the effects of imatinib on the case.</p><p><b>METHOD</b>The clinical features of an infant with CML, who was treated with imatinib in the Norman Bethune International Peace Hospital at June 2009, were retrospectively analyzed and the reports in literature were reviewed. The 1-year-old boy suffered from recurrent low-degree fever and pallor. He had a moderate anemia, distended abdomen and marked splenomegaly. Bone marrow aspiration revealed CML in chronic phase)CP). The t (9; 22))q34; q11) could be detected and BCR-ABL (p210) was positive. The boy was diagnosed as CML-CP and treated with imatinib 100 mg per day. There were 10 related papers and more than 100 child CML patients were reported as retrieved from CNKI)from its establishment to August 2014) and Wanfang Database)from its establishment to August 2014) when "Child", " Chronic" and "Leukemia" were used as keywords. And there were 30 related papers including 400 cases from PubMed Database (from its establishment to August 2014) and one detailed report of an infant with CML was retrieved when "childhood" and "chronic myeloid leukemia" "imatinib" were used as keywords. The clinical effects of imatinib in infant CML cases were analyzed and summarized based on the literature.</p><p><b>RESULT</b>The boy obtained a complete hematologic response (CHR) at the 6th week of diagnosis, a complete cytogenetic response (CCyR) at the 3rd month and a complete molecular response)CMR) at the 12th month without side effect. This boy grows very well and after a 62-month follow-up, his disease was stable. According to the domestic literature, 5 children CML cases aged 6 -12 years were treated with imatinib without side effects and got complete hematologic response (CHR) after 2-month-therapy. The dose, metabolic characteristics and clinical observation of imatinib can be found in foreign literature and imatinib showed good response with good tolerance in children with CML. Imatinib is regarded as the first line drug for children CML. But it may affect the development of the children.</p><p><b>CONCLUSION</b>The children with CML-CP had a good response to imatinib, but more experience in the treatment of children with CML with iniatinib is needed.</p>
Subject(s)
Humans , Infant , Male , Anemia , Antineoplastic Agents , Therapeutic Uses , Fusion Proteins, bcr-abl , Imatinib Mesylate , Therapeutic Uses , Leukemia, Myelogenous, Chronic, BCR-ABL Positive , Drug Therapy , Remission Induction , Retrospective StudiesABSTRACT
Obgective To explore the risk factors of preterm infants with bronchopulmonary dysplasia(BPD).Methods A prospective cohort study was conducted to analyze the risk factors of preterm infants with BPD.Preterm infants (gestational age ＜ 32 weeks,and admission within 24 h since birth,and survival time more than 28 d since birth) who were sent to the Ward of Extremely Preterm Infants in Bayi Children's Hospital Affiliated to Clinical Medical College in Beijing Military General Hospital of Southern Medical University were enrolled from November 2013 to May 2014.According to the diagnostic criteria of BPD,the subjects were divided into 2 groups(BPD group and non-BPD group).Factors such as maternal information,neonatal basic information,neonatal diseases and treatments were compared between the 2 groups.Risk factors of preterm infants with BPD were analyzed by using t test,Chi-square test,Fisher's exact probability method and Logistic regression analysis.Results (1) A total of 298 cases were enrolled in this study.Among these infants,180 cases were male and 118 cases were female.The gestational age ranged from 25.6 to 31.9 weeks with the average age of (29.9 ± 1.4) weeks and the birth weights ranged from 740 to 2 300 g with the average weight of (1 428.3 ± 289.0) g.There were 19 cases of extremely low birth weight and 175 cases of very low birth weight.Sixty-nine cases of these infants were diagnosed as BPD (43 cases were mild,10 cases were moderate,16 cases were severe) with incidence of 23.2％.(2)The incidence of BPD was negatively related to gestational age and birth weight:the incidence of BPD in preterm infants with gestational age ＜ 28 weeks,28-30 weeks and ≥ 30-32 weeks were 70.4％,41.9％ and 6.2％;the incidence of BPD in preterm infants with birth weight ＜ 1 000 g,1 000-1 500 g and ≥ 1 500-1 800 g were 78.9％,29.5％ and 8.8％.(3) Multivariate Logistic regression found gestational age (OR =4.52),birth weight (OR =3.38),gender (OR =3.04),cytomegalovirus infection (OR =55.27),duration of invasive ventilation ≥ 7 d (OR =3.22),the highest concentration of inspired oxygen ≥400 mL/L (OR =4.14),patent ductus arteriosus(PDA) in need of surgical ligation (OR =7.30),and transfusion of packed red blood cells within 14 d since birth (OR =3.51) were the independent risk factors of BPD (all P ＜ 0.05).(4) Factors such as birth weight (P =0.015),duration of invasive ventilation (P =0.003),duration of inspired oxygen (P =0.000),and PDA in need of surgical ligation or not(P =0.017) were related to the severity of BPD.Conclusions BPD is a multifactorial disease.Taking effective measures to control risk factors is the key for preventing BPD.
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Objective To prospectively observe the changes of amplitude-integrated electroencephalogram(aEEG) in neonates with hypoxic-ischemic encephalopathy (HIE).Methods Thirty-five HIE neonates with gestational age of 37 ～ 41 weeks were chosen as HIE group,and all of them were hospitalized in neonatal intensive care unit of Bethune International Peace Hospital from Aug 2011 to Jan 2012.At the same time,40 healthy term neonates were chosen as control group.aEEG monitoring was done within 24 ～ 48 hours after birth with cerebral function monitor (CF3000) and each recording last at least 8 hours.The continuity,sleep-wake cycle,voltage of every aEEG tracing were analyzed.Results (1) The maximal voltage of aEEG tracing in control group was 30 μV,while that in HIE group was 16 μV.The minimal voltage of aEEG tracing in control group was 13 μV,while that in HIE group was 7 μV.The aEEG tracing amplitude both in highest and lowest in HIE group were significantly lower than those in the control group.There were significant differences between them (P ＜ 0.05).(2) There was significant difference of sleep-wake cycling between HIE group and control group[20％ (7/35) vs 100％ (40/40),x2 =51.064,P ＜ 0.05].While there was also significant difference of the continuity of the amplitude between HIE group and control group[31％ (11/35)vs 100％ (40/40),x2 =40.336,P ＜0.05].Conclusion aEEG has some specific changes in neonates with HIE,possiblility it can be used for earlier predicting the occurrence of brain damage after asphyxia and provides good evidence for the early diagnosis and treatment of HIE.
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Objectives To investigate the clinical characteristics of hypoglycemic brain damage, and to assess the ifndings of amplitude-integrated electroencephalography (aEEG) and its predictive value in hypoglycemic brain damage. Methods Twenty-four neonates diagnosed with hypoglycaemia were selected. 12-hour continuous aEEG recordings were performed on the day when hypoglycaemia was diagnosed and second aEEG tracings was performed on the same day or the day after. The variability of aEEG background, appearance of sleep-wake cycling, bandwidth span and amplitude of lower border were analysed and compared with the results of brain MRI. Results Different degrees of epileptic seizures were found in neonates with severe hypoglycemic brain damage and were persisted after the blood sugar was corrected. aEEG in hypoglycemic brain damage was characterized by calyptriform or jagged epileptiform activity, disappearance of the sleep-wake cycle, but little impact on amplitude of lower border and bandwidth span. The recovery of sleep-wake cycle was a sign of brain function recovery. The aEEG and MRI had a good consistency in monitoring the hypoglycemic brain damage. Conclusions aEEG have signiifcant changes in hypoglycemic brain damage and can be used to monitor dynamically hypo-glycemic brain damage.
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Objective To study the clinic value of brain edema detected by ultrasound examination in high risk term infants. Meth-ods The study group included 140 term infants who were found having brain edema in cranial ultrasound examinations. 152 term infants with normal ultrasound scan were selected as a control group. The risk factors of brain edema were collected, and univariate analysis and multivariate logistic regression analysis were performed. Results (1) There was no difference of incidence of brain edema between the infants with or without maternal ill historys, fetal distress or hypoalbuminemia, with P > 0.05. (2) In the univariate regression model, as-phyxia,hypoxic -ischemic encephalopathy (HIE) ,ventilation and metabolic acidosis were associated with an increased risk of brain ede-ma. In the multivariate logistic regression model, HIE was associated with a greater risk of brain edema and ventilation was possibly asso-ciated with brain edema. Conclusion Brain edema detected by ultrasound examination in high risk term infants has close relationship with HIE. It suggest that there is a consistency between ultrasound results and clinic situation. The detection of brain edema by ultrasound can assist doctor in clinic practice.
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Objective To investigate a way of early diagnosis for pancreatic cancer. Methods The clinical data of 135 patients with were retrospected and 28cases in them were analyzed. Results 124 patients were for surgical resection, 11 patients were in traditional Chinese medicine ,suiting the remedy to the case ,sustaining, et al. Apart from some patients were relivend, prognosis of all patients were worse , patient,s condition of most cases had promptly worsend. living time was 3-6 monthes, 11.5 monthes averagely. Conclusion Taking early stage diagnosis seriously was key to solve pacretic cancer.