Impact of premature rupture of membranes on neonatal complications in preterm infants with gestational age <37 weeks / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the effect of premature rupture of the membrane (PROM) on neonatal complications in premature infants.</p><p><b>METHODS</b>The registration information of 7684 preterm infants with gestational age <37 weeks were collected from the cooperative units in the task group between January 1, 2014 to December 31, 2014. Specially trained personnel from each cooperative units filled in the unified form in a standardized format to record the gender, gestational age, birth weight, PROM, placental abruption, antenatal corticosteroid, Apgar score, amniotic fluid pollution, and complications of the infants. The data were analyzed comparatively between the cases with PROM and those without (control).</p><p><b>RESULTS</b>The preterm mortality rate was significantly lower but the incidences of ICH, NEC, ROP and BPD were significantly higher in PROM group than in the control group (P<0.05). The 95% confidence interval of the OR value was <1 for mortality, and was >1 for ICH, NEC, ROP and BPD. After adjustment for gestational age, birth weight, gender, mode of delivery, placental abruption, placenta previa, prenatal hormones, gestational diabetes mellitus (GDM), gestational period hypertension and 5-min Apgar score <7, the incidences of NEC, ROP and BPD were significantly different between the two groups (P<0.05) with 95% confidence interval of OR value >1, but the mortality rate and incidence of ICH were not significantly different between the two groups (P>0.05).</p><p><b>CONCLUSION</b>PROM is a risk factor for NEC, ROP and BPD in preterm infants, and adequate intervention of PROM can reduce the incidences of such complications as NEC, ROP and BPD in the infants.</p>

Clinical effect of stem cell transplantation via hepatic artery in the treatment of type II hyperammonemia: a report on 6 cases / 中国当代儿科杂志

This study aimed to investigate the clinical effect of transplantation of CD133⁺ peripheral blood stem cells or umbilical cord mesenchymal stem cells via the hepatic artery in children with type II hyperammonemia and its possible action mechanism. Umbilical cord mesenchymal stem cells were obtained by collecting cord blood (100-150 mL) from healthy fetuses and separating stem cell suspension (5 mL) from the cord blood by hydroxyethyl starch sedimentation. CD133⁺ peripheral blood stem cells were obtained by mobilizing peripheral blood from the fathers of sick children using recombinant human granulocyte colony-stimulating factor for 5 days, collecting mononuclear cells (120 mL), and separating out CD133⁺ cells by sorting. With catheterization and percutaneous puncture, the obtained stem cells were slowly injected into the liver of sick children via the hepatic artery. The changes in clinical symptoms and laboratory indices such as blood ammonia, liver function, and arginine and citrulline concentrations were observed. After stem cell transplantation via the hepatic artery, the 6 children showed significantly decreased blood ammonia levels, and their blood ammonia levels slowly increased 1 to 2 weeks later, but remained below 100 μmol/L, and changes in glutamic-pyruvic transaminase levels were similar to blood ammonia. Plasma citrulline and arginine concentrations increased significantly after transplantation and the increase in citrulline level exceeded the increase in arginine level. An 8 months follow-up visit for one typical patient showed that the weight and height increased after transplantation and sleep was improved without night crying. The child could actively gaze at interesting objects instead of responding indifferently and started to say simple words. With regard to fine motor skills, the child could pinch things with the thumb and middle finger instead of displaying a lack of hand-eye coordination and progress was also made in gross motor skills. Gesell test showed that the child made progress for an average of 3.82 months in all areas. It was concluded that after stem cell transplantation, children with type II hyperammonemia have decreased blood ammonia levels, stable and improved liver function and steadily increased plasma citrulline and arginine concentrations. They display a progressive trend in such aspects as movement, language and environmental adaptability. It is hypothesized that stem cell transplantation via the hepatic artery partially or totally activates, or provides supplementary ornithine carbamoyl transferase, so that plasma citrulline and arginine concentrations increase and urea cycle disorder can be corrected to some extent.

Transplantation of human neural precursor cells in the treatment of children with pervasive developmental disorder / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To assess the efficiency and safety of human neural progenitor cells (hNPCs) transplantation in the treatment of pervasive developmental disorder (PDD) in children.</p><p><b>METHODS</b>Twenty-two children with PDD were treated, including 13 children with Rett syndrome and 9 children with autism. They accepted hNPCs transplantation voluntarily. hNPCs derived from aborted fetal tissue were injected into the lateral ventricle of the patients under supersonic guidance. All patients were assessed according to the Autism Behavior Checklist before operation, at one and six months post operation, and one year later.</p><p><b>RESULTS</b>No delayed complications resulting from this therapy were observed. The clinical symptoms of 17 patients, including 8 patients with autism and 9 patients with Rett syndrome, improved in varying degrees. The assessment results of the Autism Behavior Checklist for children with autism showed that compared with pre-operative function, social communication scores were significantly reduced at six months after transplantation, and total scores and social communication and language scores were also significantly reduced 1 year after transplantation (P<0.05).</p><p><b>CONCLUSIONS</b>These results suggest that hNPCs transplantation is effective and safe for treatment of PPD in children. It deserves a further study.</p>

Treatment of cerebral palsy with transplantation of human neural progenitor cells / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To study the clinical efficacy of transplantation of human neural progenitor cells (hNPCs) in the treatment of severe cerebral palsy (CP) in children.</p><p><b>METHODS</b>Forty-five children with CP were voluntarily accepted transplantation of hNPCs. The cells obtained from the forebrain of 10 to 12-week-fetus were cultured and amplified into hNPCs. Then the hNPCs were injected into the cerebral ventricle of the patients with the supersonic guidance.</p><p><b>RESULTS</b>Dyssomnia, irritability and muscular tension were improved in one patient 3 days after transplantation. The clinical improvements were observed in the majority of the patients 1 month after transplantation. The therapeutic effects slowed down 3 to 6 months after transplantation. One year after transplantation the gross and fine motor skills and the congnition ability in the transplantation group were considerably surpassed to those in the control group. No delayed severe complications were observed after transplantation. No tumorigenesis was noted 5 years after transplantation.</p><p><b>CONCLUSIONS</b>The transplantation of hNPCs as a novel therapy is effective and safe for severe CP. Many investigations are needed to evaluate the effect of the therapy.</p>

Clinical application of bone marrow mesenchymal stem cell transplantation in children with severe mental retardation / 中华神经医学杂志

Objective To observe the clinical efficacy of transplantation with autologous bone marrow mesenchymal stem cells (MSCs) in the treatment of children with severe mental retardation (MR). Methods Fifty children with severe MR (2-6 years old), admitted to our hospital from May 2008 to December 2009, were chosen; self-control observation on the mental and motor developments of these children in the same length of time periods was performed 6 months before and 6 months after the autologous bone marrow MSCs transplantation. Meanwhile, the improvements of each patient were followed up and analyzed 1, 3 and 6 months after the transplantation. Results Two patients failed in the culture of bone marrow MSCs; 6 patients failed in follow-up; the other 42 were observed completely.Significant improvement was noted in 25 patients after the transplantation with an effective rate reaching 59.5%; gradual mental and motor improvements appeared in these 25 patients 1 month after the transplantation, and lasted till the 6th month of transplantation. The average scores of mental improvement were (4.67±4.20) in 6 months before transplantation, and (17.12±13.05) in 6 months after transplantation (t=6.816, P=0.000). The average times having gross motor improvement 6 months before and 6 months after transplantation were (1.019±0.78) and (1.15±0.91), respectively (t=1.610, P＞0.05); the average times having fine motor improvement were (0.89±0.79) and (3.40±3.16) months in 6 months before and 6months after transplantation (t=5.030, P＜0.05); the average times having language improvement were (0.99±0.95) and (3.23±3.30) months in 6 months before and 6 months after transplantation (t=4.000, P＜0.05); the average times having personal-social behavior progress were (1.03±0.81) and (2.95±3.68)months in 6 months before and 6 months after transplantation (t=3.509, P＜0.05); the average times having adaptive behavior progress were (0.88±1.22) and (1.19±1.48) months in 6 months before and 6 months after transplantation (t=1.322, P＞0.05). Conclusion Autologous bone marrow MSCs transplantation can improve the intellectual development in a short time, mainly in the fine motor, language and personal-social behavior, in children with severe MR. Bone marrow MSCs transplantation for severe MR is safe and effective in a short-term.

Treatment of newborns with severe injured brain with transplantation of human neural precursor cells / 中华儿科杂志

<p><b>OBJECTIVE</b>To analyze the therapeutic effect of human neural precursor cells transplantation in treatment of neonates with severe brain injury.</p><p><b>METHOD</b>The transplantation was performed on 6 newborns, one of them was diagnosed as extremely severe carbon monoxide poisoning at 5(th) day after birth; one of them was diagnosed as severe hypoglycemia; the others had asphyxia at birth with Apgar scores from 1 to 3 and were diagnosed as severe neonatal asphyxia, severe hypoxic ischemic encephalopathy according to images, electroencephalogram, biochemical examination and clinical manifestation. With the approval of hospital ethics committee and informed consent of the family members, the newborns received human neural precursor cells transplantation at the 4(th) to 20(th) day after birth. With the agreement of a pregnant woman, forebrain cells were obtained from the forebrain of her 12-week old fetus after spontaneous abortion. The cells from the fetal brain were amplified into human neural precursor cells in vitro and were injected into the cerebral ventricle of the patients.</p><p><b>RESULT</b>On the 2(nd) day after transplantation, sucking and swallowing reflexes gradually appeared in all the patients, muscular tension was also improved, and convulsion stopped. NBNA scoring in 3 of the patients reached normal level on the 28(th) day after birth. The 6 patients were followed up for 12 months. Four patients were normal in psychomotor development and scores of each scale reached normal level. Two patients have cerebral palsy.</p><p><b>CONCLUSION</b>hNPCs transplantation is safe and effective in treatment of severe neonatal brain injury. More clinical trials and further observation are needed.</p>

The hyposensitization of oval cell to antiproliferative effect of transforming growth factor β1 by hepatitis B virus X gene / 中华外科杂志

<p><b>OBJECTIVE</b>To determine whether hepatitis B virus X (HBX) protein expression affect the oval cells' response to anti-proliferative effect of transforming growth factor β1 (TGFβ1) in oval cells.</p><p><b>METHODS</b>Real-time PCR, Western blot analysis were performed to detect the expression of TGFβRII in HBX-transfected oval cells named HBX-EGFP-LE/6, and EGFP-LE/6, LE/6 control cells. In addition, exogenous TGFβ1 was added into all three oval cell lines, MTT assay was preformed to clarify different responses to the anti-proliferative effect of TGFβ1.</p><p><b>RESULTS</b>The TGFβRII mRNA levels in LE/6 and EGFP-LE/6 cells were (10.2 ± 1.8) and (8.8 ± 0.9) folds of those in HBX-EGFP-LE/6 cells, the difference was significant (P < 0.05). HBX protein expression also reduced the protein levels of TGFβRII in HBX-EGFP-LE/6 oval cells, compared to the control cells. The MTT results exhibited that, after TGFβ1 addition, proliferative inhibition rate in the HBX-EGFP-LE/6 cells was 18.1% ± 1.5% while those in control cells were 42.2% ± 2.8% and 41.9% ± 5.0%, the difference was significant (P < 0.01).</p><p><b>CONCLUSION</b>HBX protein expression affects TGFβRII transcriptional activity and protein synthesis, and insensitive oval cells to anti-proliferative effect of TGFβ1.</p>

Collection of Peripheral Blood Stem Cells from Low-Weight Infants with Osteopetrosis and Its Clinical Signi-ficance / 实用儿科临床杂志

Objective To explore the safety of collection of peripheral blood stem cells(PBSCs) from low-weight infants with osteopetrosis(OP) and its clinical significance. Methods One case of low-weight infants with OP received PBSCs collection using a continuous-flow blood cell separator,and the safety of collection process was observed.The amount of monocyte cell(MNC) and CD34+ cell were noted and its clinical significance was analyzed.Results Low-weight infants with OP could tolerate collection process,the number of collection MNC and CD34+ cells were 10.06?108/kg,2.74?106/kg.Conclusion Adequate PBSCs can be collected from OP who need not be mobilized,thus can offer backup for graft failure.PBSCs collection from low-weight infants is safe.