[Effect of cerebral hemodynamic changes on white matter damage in premature infant with patent ductus arteriosus].

OBJECTIVE: To investigate the effect of cerebral hemodynamic changes on white matter damage in premature infant with patent ductus arteriosus(PDA). METHODS: A total of 106 premature infants were enrolled in the study, including 35 PDA infants with hemodynamic changes (hsPDA group), 35 PDA infants without hemodynamic changes (non-hsPDA group) and 36 non-PDA infants (control group). Serum level of neuron-specific enolase (NES) was detected and craniocerebral ultrasound examination was performed on d3, d7 and d14 after birth. The correlation between blood flow rate of PDA and gray scale value of lateral ventricle was analyzed. RESULTS: Gray scale values of lateral ventricle and serum levels of NES in hsPDA group were higher than those in control group on d3, d7 and d14 (P<0.01), but no significant difference was observed between non-hsPDA group and control group (P>0.05). There was a positive correlation between the blood flow rate of PDA and gray scale value of lateral ventricle (r=0.876, P<0.01) in premature infants. CONCLUSION: Patent ductus arteriosus with hemodynamic changes is closely related to white matter damage in premature infants, and early intervention is necessary.

Neuroprotective effect of paracrine extracts derived from human adipose stem cells on white matter injury of neonatal rats / 中国新生儿科杂志

Objective To explore the effect of paracrine extracts derived from human adipose stem cells on white matter injury of neonatal rats and to compare the difference of therapeutive effect between the cerebellum medulla oblongata pool injection and the jugular vein injection.Method A total of 73 three-day-old SD rats were chosen to establish the model of white mater injury.After 24 hours,the 73 rats were randomized into the experimental group (n =46) and the control group (n =27).Then the experimental group was reclassified into ventricular group (n =23) and intravenous group (n =23).In the ventricular group,the paracrine extracts of human adipose stem cells was injected locally into the cerebellum medulla oblongata pool injection,while the extracts was injected into the jugular vein in the intravenous group.The control group was reclassified ventricular control group (n =15) and intravenous control group (n =12),and equivoluminal saline was injected the same way as the experimental group.Frozen sections of the brain tissue from 3 rats of each experimental group one day after injection were stained with fluorescein-conjugated streptavidin to study the distribution of the extracts.The brain tissue of 3 rats from each subgroup 3 days after injection were stained with hematoxylin eosin (HE) to observe the pathomorphological changes.While 7 days later,myelin basic protein (MBP) of white matter which was obtained from 7 rats of each group was detected by immunofluorescence staining.28 days after injection,the remaining rats were assessed by neurobehavior tests.For the rats that died during the experiment,the same number of the rats would be substituted in this study.Result The paracrine extracts were found to transfer to the brain lesion area,and the amount of the extracts was more in the ventricular group.The results of the HE staining showed that the white matter injury was more severe in the ventricular control group,and extensive area of infarction were found in this group.White matter injury was mild in the experimental group,and the structure of the corpus callosum was more complete in the ventricular group.MBP semi-quantitative scores of the ventricular group (0.7 ± 0.3) and intravenous group (1.7 ± 0.3) were lower than those of ventricular control group (3.4 ± 0.4)and intravenous control group(3.3 ±0.3).And the MBP scores of ventricular group was significantly lower than that of intravenous group (P ＜ 0.05).The scores of the neurobehavioral tests of the experimental group were significantly higher than those of the control group,while the scores of the ventricular group were significantly higher than those of the intravenous group (P ＜ 0.05).Conclusion The paracrine extracts derived from adipose stem cells could improve the prognosis of white matter injury,and cerebellum medulla oblongata pool injection showed better curative effect than the jugular vein injection.

Effect of cerebral hemodynamic changes on white matter damage in premature infant with patent ductus arteriosus / 浙江大学学报·医学版

OBJECTIVE@#To investigate the effect of cerebral hemodynamic changes on white matter damage in premature infant with patent ductus arteriosus(PDA).@*METHODS@#A total of 106 premature infants were enrolled in the study, including 35 PDA infants with hemodynamic changes (hsPDA group), 35 PDA infants without hemodynamic changes (non-hsPDA group) and 36 non-PDA infants (control group). Serum level of neuron-specific enolase (NES) was detected and craniocerebral ultrasound examination was performed on d3, d7 and d14 after birth. The correlation between blood flow rate of PDA and gray scale value of lateral ventricle was analyzed.@*RESULTS@#Gray scale values of lateral ventricle and serum levels of NES in hsPDA group were higher than those in control group on d3, d7 and d14 (P0.05). There was a positive correlation between the blood flow rate of PDA and gray scale value of lateral ventricle (r=0.876, P<0.01) in premature infants.@*CONCLUSION@#Patent ductus arteriosus with hemodynamic changes is closely related to white matter damage in premature infants, and early intervention is necessary.

Early Intervention of Selective Head Sub-hypothermia in Full Term Infant with Severe Asphyxia / 中国基层医药

ObjectiveTo study the curative effect of early intervention on selective head sub-hypothermia in full term infant with severe asphyxia.MethodsForty two full term infant with severe asphyxia were randomly divided into treatment(n =22) and control ( n =20) group,all patients were treated according to three supportive therapy and three heteropathy after resuscitation,and meanwhile the treament group combined with selective head sub-hypothermia.In the 2 groups,heart and breath oxygen saturation,blood sugar were measurded within 72 hours after treatment,and the Chinese 20-item neonate nerve behaviors were evaluated 28 days after birth.Test were conducted with the Bayley infant development scale in 2 months after birth.ResultsAfter 72 hours of treatment,the heart rate of treatment group reduced and showed significant difference from that of contol group and restored to normal.There were no significant differences in breath,blood pressure(BP),degree of blood ozygen saturation,blood sugar between the 2 groups.After 28 days of birth,scores of neonate nerve behaviors were ( 37 ± 3) in treatment group and (31 ± 3) in control group,respectively ;which showed significant difference ( P ＜ 0.01 ).In the 2nd months of birth,scores of Bayley infant development scale were (91 ± 3 ) in treatment group and ( 86 ± 4 ) in control group,respectively,which showed significant difference(P ＜ 0.05 ).ConclusionSelective head sub-hypothermia was convenient and safe,and had reliable curative effect by relieving or prenventing sequel and raising quality of life.

Lung protective strategies of ventilation in hyaline membrane disease of neonates / 中国基层医药

Objective To explore the protective ventilation strategies in hyaline membmne disease(HMD) of neonates,in order to decrease the incidence of ventilator-associated lung injury(VAU).Methods 68 newborn infants,diagnosed as of neonatal hyaline membrane disease and needed ventilator support,were recruited from the neonatal intensive care unit from 2003 to 2005.Infant with HMD were divided into the conventional ventilation practice group (the control group) and protective ventilation strategies group (the experimental group).The ventilator settinns,artery blood gas analysis,ventilator-associated lung injury and other clinical data were analyzed and compared.Results The incidence of ventilator-associated lung injury in the experimental group wag significantly lower than that in the cntrol group(2.94% VS 17.6%,P＜0.05).PaCO2 in experimental group was significantly higher than that in control group.The mortality in the experimental group was significantly lower than that in control group.Condusion The protective ventilation strategies can decrease the incidence of ventilator-associated lung injury in neonatal HMD.the protective ventilation strategies can decrease the mortality in neonatal HMD.

Effects of permissive hypercapnia on inhibiting inflammatory mediators into plasma in respiratory distress syndrome of neonates / 中国医师进修杂志

Objective To observe the changes in inflammatory mediators in plasma in respiratory distress syndrome(RDS) of neonates received lung protective ventilation treatment. Methods Sixty newborn infants,diagnosed as RDS of neonatal and needed ventilator support, were recruited from the intensive care unit from May 2003 to May 2006. Infant with RDS were randomly divided into two groups. Both had 30 newborn infants. The infants in the experimental groups received lung protective ventilation treatment tidal volume:5-8 ml/kg,positive end-expiratory pressure (PEEP):0.51~0.98 kPa, and the control groups received large tidal volume ventilation (tidal volume:10-15 ml/kg,PEEP:0-0.29 kPa). The contents of TNF-?, interleukin-6 in plasma were measured. Results After those two therapies, the contents of tumor necrosis factor-?(TNF-?), interleukin-6 in plasma decreased obviously, especially after receiving lung protective ventilation treatment. Conclusions There are statistical differences in the amount of inflammatory mediators released between the experimental group under lung protective ventilation treatment and the control group received large tidal volume ventilation,and better effects are seen in RDS infants under lung protective ventilation treatment .

Observation of Curative Effect of Tazobactam Sodium/Piperacillin Sodium for Injection on Neonatal Infections / 中国药房

OBJECTIVE:To observe the curative effect of tazobactam sodium/piperacillin sodium for injection on the Neonatal infections.METHODS:140neonatal infections cases were randomly divided into treatment group and control group:the treated group were treated with tazobactam sodium/piperacillin sodium for injection100～200mg/(kg?d);while the con?trol group were treated with penicillin-G100000～200000IU/(kg?d).The course of therapy for both groups were5d～10d.RESULTS:The effective rates of the treatment group and the control group were91.43%,52.86%(P

Recent smell loss is the best predictor of COVID-19: a preregistered, cross-sectional study

BackgroundCOVID-19 has heterogeneous manifestations, though one of the most common symptoms is a sudden loss of smell (anosmia or hyposmia). We investigated whether olfactory loss is a reliable predictor of COVID-19. MethodsThis preregistered, cross-sectional study used a crowdsourced questionnaire in 23 languages to assess symptoms in individuals self-reporting recent respiratory illness. We quantified changes in chemosensory abilities during the course of the respiratory illness using 0-100 visual analog scales (VAS) for participants reporting a positive (C19+; n=4148) or negative (C19-; n=546) COVID-19 laboratory test outcome. Logistic regression models identified singular and cumulative predictors of COVID-19 status and post-COVID-19 olfactory recovery. ResultsBoth C19+ and C19-groups exhibited smell loss, but it was significantly larger in C19+ participants (mean{+/-}SD, C19+: -82.5{+/-}27.2 points; C19-: -59.8{+/-}37.7). Smell loss during illness was the best predictor of COVID-19 in both single and cumulative feature models (ROC AUC=0.72), with additional features providing negligible model improvement. VAS ratings of smell loss were more predictive than binary chemosensory yes/no-questions or other cardinal symptoms, such as fever or cough. Olfactory recovery within 40 days was reported for [~]50% of participants and was best predicted by time since illness onset. ConclusionsAs smell loss is the best predictor of COVID-19, we developed the ODoR-19 tool, a 0-10 scale to screen for recent olfactory loss. Numeric ratings [≤]2 indicate high odds of symptomatic COVID-19 (4

More than just smell - COVID-19 is associated with severe impairment of smell, taste, and chemesthesis

Recent anecdotal and scientific reports have provided evidence of a link between COVID-19 and chemosensory impairments such as anosmia. However, these reports have downplayed or failed to distinguish potential effects on taste, ignored chemesthesis, generally lacked quantitative measurements, were mostly restricted to data from single countries. Here, we report the development, implementation and initial results of a multi-lingual, international questionnaire to assess self-reported quantity and quality of perception in three distinct chemosensory modalities (smell, taste, and chemesthesis) before and during COVID-19. In the first 11 days after questionnaire launch, 4039 participants (2913 women, 1118 men, 8 other, ages 19-79) reported a COVID-19 diagnosis either via laboratory tests or clinical assessment. Importantly, smell, taste and chemesthetic function were each significantly reduced compared to their status before the disease. Difference scores (maximum possible change {+/-}100) revealed a mean reduction of smell (-79.7 {+/-} 28.7, mean {+/-} SD), taste (-69.0 {+/-} 32.6), and chemesthetic (-37.3 {+/-} 36.2) function during COVID-19. Qualitative changes in olfactory ability (parosmia and phantosmia) were relatively rare and correlated with smell loss. Importantly, perceived nasal obstruction did not account for smell loss. Furthermore, chemosensory impairments were similar between participants in the laboratory test and clinical assessment groups. These results show that COVID-19-associated chemosensory impairment is not limited to smell, but also affects taste and chemesthesis. The multimodal impact of COVID-19 and lack of perceived nasal obstruction suggest that SARS-CoV-2 infection may disrupt sensory-neural mechanisms.