Severe hemolytic disease of the newborn caused by JKb antibody: Two case reports and literature review.

BACKGROUND: JKb antibody rarely causes severe hemolytic disease in the newborn except in 1 case, required blood exchange transfusion but later died of intractable seizure and renal failure. Here we describe 2 cases of JKb-induced severe neonatal jaundice requiring blood exchange transfusion with good neurological outcome. CASE PRESENTATION: Two female Chinese, ethnic Han, term infants with severe jaundice were transferred to us at the age of 5- and 4-day with a total bilirubin of 30.9 and 25.9 mg/dL while reticulocyte counts were 3.2% and 2.2%, respectively. Both infants were not the firstborn to their corresponding mothers. Direct and indirect Coombs' tests were positive, and JKb antibody titers were 1:64 (+) for both mothers. Phototherapy was immediately administered, and a blood exchange transfusion was performed within 5 hours of admission. Magnet resonance image showed no evidence of bilirubin-induced brain damage, and no abnormal neurological finding was detected at 6 months of life. CONCLUSION: JKb antibody-induced hemolytic disease of the newborn usually leads to a benign course, but severe jaundice requiring blood exchange transfusion may occur. Our cases suggest good outcomes can be achieved in this minor blood group-induced hemolytic disease of the newborn if identified and managed early enough.

[Litter decomposition and nutrient dynamics at different succession stages of typical mixed broadleaved-Korean pine forest in Xiaoxing' an Mountains, China].

Taking the mixed leaf litters in broadleaved-Korean pine forests at different succession stages (secondary birch forest, selective cutting forest, and original mixed forest) and the leaf litters of the dominant tree species (Betula costata, Tilia amurensis, and Pinus koraiensis) in these forests in Xiaoxing' an Mountains, China as test objects, this paper studied their remaining rates and nutrient dynamics in October 2006-November 2008 by using decomposition bag method. For all test leaf litters, their remaining rate had an exponential relationship with time. The annual decomposition constant (k) ranged from 0.137 to 0.328, and the time for decomposing 50% (t50%) and 95% (t95%) was 2.340-4.989 years and 9.360-21.796 years, respectively. No significant differences were observed in the decomposition rates of the leaf litters among the forests, but the k value of the mixed leaf litters was decreased in the order of original mixed forest > selective cutting forest > secondary birch forest, while that of the dominant tree species leaf litters had no obvious pattern. During decomposition, the elements C, P, and K in leaf litters released continuously, and the release pattern of C followed linear function, while that of P and K followed a function of higher degree. Element N presented different levels of accumulation, but had no clear pattern.