Diagnosis and treatment of five neonatal cerebral venous sinus thrombosis / 中华儿科杂志

Objective@#To summarize the clinical presentations and imaging features of cerebral venous sinus thrombosis (CVST) in 5 newborns.@*Methods@#The clinical data of 5 newborns with CVST admitted to Department of Neonatology of Maternal and Children Hospital of Hubei Province from February 2017 to April 2018 were analyzed retrospectively. The risk factors, clinical presentations, imaging manifestations and treatment of CVST were investigated.@*Results@#Of the 5 full term neonates, 4 were males and 1 female, with 4 aged less than 7 days and 1 more than 7 days; one with the history of maternal gestational diabetes mellitus, one with maternal gestational hypertension. The clinical presentations included seizures (3 cases), fever (3 cases), dehydration (1 cases), lethargy (2 cases), hypoglycemia (2 cases), thrombocytopenia (2 cases). Electroencephalogram (EEG) showed electrical seizures in 3 cases. Magnetic resonance imaging (MRI) and magnetic resonance venography (MRV) showed 4 cases of intracranial hemorrhage, 3 cases of cerebral parenchymal infarction. For the sites of the thrombi, 4 were in the superior sagittal sinus, 3 in straight sinus, 2 in transverse sinus and 1 in sinus confluence. CT showed intracranial hemorrhage in 2 cases and venous sinus dilatation in 2 cases. Doppler ultrasound showed 2 cases of intraventricular hemorrhage and 2 cases of changes of venous sinus blood flow. Three neonates were treated with anticoagulant and thrombolytic therapy, followed by recanalization of the veins and discontinuing of seizures.@*Conclusions@#Seizure is the main clinical presentation of CVST. The main radiologic manifestations are cerebral infarction and hemorrhage. Timely brain MRI and MRV are helpful in the early diagnosis and treatment of CVST.

Diagnosis and therapeutic strategies of parenteral nutrition-associated liver disease in premature infants / 中华实用儿科临床杂志

Parenteral nutrition - associated liver disease (PNALD)or cholestasis (PNAC)is the main compli-cation of prolonged parenteral nutrition in premature infants. It is characterized by cholestatic jaundice,which is defined as direct serum bilirubin of ≥34. 2 μmol/ L with or without liver enzymes abnormalities,rule out other causes. The risk factors contributing to the incidence of PNALD are premature,low birth weight,the duration of parenteral nutrition (PN),components of PN,sepsis,intestinal disease,genetic susceptibility. Although the damage is frequently mild,and resolves after discontinuation of parenteral nutrition,in some cases it progresses into cirrhotic changes. Ursodeoxycholic acid and lipid emulsions based on fish oil with a high content of long - chain polyunsaturated fatty acids ω - 3 has been proposed to be efficacy. But effective preventive and therapeutic strategies for PNALD have not been established yet. In-novative therapeutic strategies needs to be investigated.

Relationship between neonatal asphyxia and blood glucose disorder / 中华围产医学杂志

Objective To study the association between neonatal asphyxia and blood glucose disorder. Methods A total of 134 cases of neonatal asphyxia born in the Maternal and Child Hospital of Hubei Province between January 2013 and January 2015 were included in this study. Blood glucose levels were determined within 30 min after birth and before glucose infusion. The infants were divided into the mild asphyxia group (Apgar score 4 to 7) and severe asphyxia group (Apgar score 0 to 3) according to the Apgar score at 5 min after birth. Statistical analyses were performed using the two-sample t-test and Chi-square test. Results The incidence of asphyxia was 3.2‰(134/41 875). Hypoglycemia was the main blood glucose disorder in the mild asphyxia group [12% (13/112)], and hyperglycemia was the main blood glucose disorder in the severe asphyxia group [32%(7/22)]. The average blood glucose level was higher in the severe asphyxia group than in the mild asphyxia group [(5.8±3.4) vs (5.0±2.3) mmol/L, t=21.979, P=0.001]. In the severe asphyxia group, the incidence of hypoglycemia was higher [18% (4/22) vs 12% (13/112), χ2=7.464, P=0.006] and the average blood glucose level was lower [(1.8±0.7) vs (2.1±0.4) mmol/L, t=5.247, P=0.042],and the incidence of hyperglycemia was also higher [32% (7/22) vs 9% (10/112), χ2=11.679, P=0.001] and the blood glucose level was higher [(11.6±3.8) vs (9.3±2.0) mmol/L, t=1.106, P=0.048]. Conclusion Neonatal asphyxia can lead to blood glucose disorders. The incidence and the severity of these disorders were higher in neonates with severe asphyxia.

Discussion on Financial Crisis Attacks to College and University Libraries and Its Countermeasures / 医学信息学杂志

The paper discusses financial crisis attacks to hardware and software construction in college and university libraries, li-brarians and readers, explores effective countermeasures to confront the influences, including improving the quality of acquisition, mobilizing the enthusiasm of librarians, helping readers to adjust their attitudes, in order to do well in library work.