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Objective To study the value of lung ultrasonography (LUS) in the diagnosis of pneumothorax in critically ill neonates.Method The neonates admitted to our NICU and suspected to have pneumothorax were prospectively enrolled from June 2017 to December 2018.All eligible infants received both LUS examination and chest X-ray.The characteristics of LUS imaging was analyzed based on the chest X-ray which was used as the golden standard for the diagnosis of pneumothorax.The sensitivity,specificity,positive predictive value and negative predictive value of LUS is computed.The duration of LUS and chest X-ray were compared.The outcome and complications were also observed.Result Fifty neonates with suspected pneumothorax were collected.Among them,pneumothorax was confirmed with chest X-ray in 31 neonates (62.0%).Ultrasound signs of pneumothorax included absence of lung sliding (100%),absence of B lines (100%),stratosphere sign (100%) were observed in all of the 31 neonates.Presence of lung point was also observed in 90.3% of the patients.The sensitivity,specificity,positive predictive value,negative predictive value and X-ray coincidence rate of LUS in the diagnosis of pneumothorax were 100%.LUS and chest X-ray examination took (5.6 ±5.1) min and (20.1 ± 12.2) min,respectively,the difference was statistically significant (P < 0.05).All 31 infants with pneumothorax survived.15 infants underwent closed thoracic drainage after emergency thoracic puncture or aspiration assisted by LUS.No postoperative complications occurred.Conclusion LUS showed high accuracy,sensitivity and specificity in detecting pneumothorax in critically ill neonates.It is simple to operate and can guide clinical rescue more promptly and quickly.
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Objective To investigate the optimal initial concentration of microRNA22 agomir in epilepsy model induced by lithium chloride-pilocarpine after single injection of lateral ventricle.Methods 36 rats with acute temporal lobe epilepsy were randomly divided into 6 groups:the control group and the other five groups were the experimental group.All epilepsy rats were selected for right lateral ventricle injection.The control group was given negative control reagent,while the experimental group were given 0.1 mmol/L,2.5 mmol/L,5 mmol/L,10 mmol/L,20 mmol/L different concentrations of miRNA22agomir reagent.6 rats in each group were randomly selected for acute phase experiment after 3 days of administration.The expression of P2X7 in hippocampus of epilepsy rats was determined by Western blot and quantitative real-time polymerase chain reaction (qRT-PCR).Results Compared with control group,the protein and mRNA expression of P2X7 reduced in all of the model group.The protein and mRNA expression level of P2X7 protein in hippocampus of rats injected with 2.5 mmol/L,5 mmol/L and 10 mmol/L in each experimental group were significantly lower than that in the other two groups (P < 0.05).Moreover,the protein and mRNA expression level of P2X7 were the lowest at 2.5 mmol/L injection and 10 mmol/L,and there was no significant difference between the two groups (P > 0.05).Conclusions The optimal onset concentration for unilateral lateral ventricle injection miRNA22 agomir treatment of temporal lobe epilepsy is 2.5 mmol/L.
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Objective To explore whether the lung ultrasound( LUS) score can be used to assess and predict the criticality of neonates with pulmonary disease at an early stage . Methods T he new borns born in the obstetrics department of Affiliated Hospital of Jining M edical University from April to October 2018 were transferred to the neonatal intensive care unit due to respiratory distress . T he children underwent LUS examination and scoring at 2 hours after birth . T he correlation analysis were performed between LUS score and neonatal critical illness score ( NCIS ) ,NCIS +single index ,respectively . And the ROC curve was used to analyze the value of LUS score in predicting neonatal criticality . Results ①T he LUS score of non‐critical neonates was significantly lower than that of critically ill newborns , the difference was statistically significant ( P =0 .005) ; LUS score was an independent risk factor for critical neonates ( OR=1 .71 ,95%CI :1 .059-2 .765 , P = 0 .028 ) . ② T he correlation coefficient between LUS score and NCIS was -0 .48 ( P =0 .002) . T he correlation coefficient between the LUS score and the NCIS + single index was -0 .44 ( P=0 .005) . ③T he area under the ROC curve of LUS score predicting neonatal criticality was 0 .88 ( 95%CI :0 .725-0 .965 , P <0 .000 1) ,the optimal diagnostic threshold was 6 points with sensitivity of 80% and specificity of 100% . Conclusions The LUS score at a postnatal age of 2 hours after birth can early assess and predict the criticality of neonates with pulmonary disease . And the LUS score greater than 6 has the highest diagnostic value .
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Objective@#To explore whether the lung ultrasound(LUS) score can be used to assess and predict the criticality of neonates with pulmonary disease at an early stage.@*Methods@#The newborns born in the obstetrics department of Affiliated Hospital of Jining Medical University from April to October 2018 were transferred to the neonatal intensive care unit due to respiratory distress. The children underwent LUS examination and scoring at 2 hours after birth. The correlation analysis were performed between LUS score and neonatal critical illness score (NCIS ), NCIS+ single index, respectively. And the ROC curve was used to analyze the value of LUS score in predicting neonatal criticality.@*Results@#①The LUS score of non-critical neonates was significantly lower than that of critically ill newborns, the difference was statistically significant (P=0.005); LUS score was an independent risk factor for critical neonates (OR=1.71, 95% CI: 1.059-2.765, P=0.028). ②The correlation coefficient between LUS score and NCIS was -0.48 (P=0.002). The correlation coefficient between the LUS score and the NCIS+ single index was -0.44 (P=0.005). ③The area under the ROC curve of LUS score predicting neonatal criticality was 0.88 (95% CI: 0.725-0.965, P<0.000 1), the optimal diagnostic threshold was 6 points with sensitivity of 80% and specificity of 100%.@*Conclusions@#The LUS score at a postnatal age of 2 hours after birth can early assess and predict the criticality of neonates with pulmonary disease. And the LUS score greater than 6 has the highest diagnostic value.
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Objective To compare the efficacy of less invasive surfactant administration (LISA) and intubation-surfactant-extubation to CPAP (INSURE) techniques in premature infants with respiratory distress syndrome (RDS).Method From January 2016 to January 2017,premature infants with RDS admitted to our hospital were prospectively and randomly assigned into the LISA group and the INSURE group.A 6F suction tube was used to drip pulmonary surfactant (PS) into the trachea with non-invasive respiratory support in the LISA group.INSURE technique and endotracheal intubation with surfactant administration were used in the INSURE group.The following indicators were examined:the time needed for intubation,the change of percutaneous oxygen partial pressure and the incidence of bradycardia during administration,regurgitation after administration,oxygen therapy duration,mechanical ventilation duration,re-administration of PS and apnea.Secondary indicators included the incidences of pneumothorax,pulmonary hemorrhage,neonatal necrotizing enterocolitis (NEC),intraventricular hemorrhage (IVH),bronchopulmonary dysplasia (BPD),preterm retinopathy (ROP),and periventricular leukomalacia (PVL).Result A total of 145 cases were included including 76 in LISA group and 69 in INSURE group.The gestational age was 27~34 weeks.The birth weight was (1 650±480) g.No statistically significant differences existed between the two groups on the time needed for intubation,the change of percutaneous oxygen partial pressure,mechanical ventilation duration,oxygen therapy duration,the incidence of bradycardia,re-administration of PS,apnea and other complications (P>0.05).Statistically significant differences existed in the incidence of regurgitation (46.1% in LISA group vs.29.0% in INSURE group),mechanical ventilation within 72 hours (13.2% in LISA group vs.27.5% in INSURE group) and the incidence of BPD (6.6% in LISA group vs.17.4% in INSURE group) (P<0.05).Conclusion Compared with INSURE,LISA technique is effective for the treatment of RDS and reduce invasive ventilation duration and the occurrence of BPD.
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Objective To study the relationship between the lung ultrasonography and the chest X-ray and to study the value of lung ultrasonography score (LUS) in evaluating the effect of pulmonary surfactant (PS) on respiratory distress syndrome (RDS) of newborn.Method Preterm infants admitted to the neonatal intensive care unit of our Hospital from January 2016 to December 2017 and diagnosed with RDS were prospectively studied.LUS examinations were performed prior to,and within the first 6~12 hours after surfactant administration,chest X-rays were also performed at the same time so as to evaluate the effects of surfactant replacement therapy and the correlation between the lung ultrasonography and the chest X-rays.Lung ultrasonography findings at a total of six sites,with three sites in each lung were scored based on the presence of normal finding,the amount of B-lines and subpleural consolidations.Result A total of 45 preterm infants with RDS were enrolled.The cases of X-ray grades Ⅰ,Ⅱ,Ⅲ and Ⅳ before PS administration were 5 cases,21 cases,12 cases and 7 cases respectively.The scores of LUS 0~6,7~12,13~ 18 were 5 cases,37 cases and 3 cases respectively,and the median of LUS was 10 points.Chest X-ray grades Ⅰ,Ⅱ,Ⅲ and Ⅳ within 6~12 hours after PS administration were 18 cases,17 cases,8 cases and 2 cases respectively.LUS of 0~6,7~12,13~18 were 21 cases,20 cases and 4 cases respectively.The median of LUS after PS was 7 points.LUS after PS application was significantly lower than that before PS application (P<0.001).The LUS was positively correlated with the grades of X-ray before and after surfactant administration (before surfactant administration r =0.688,P<0.001,after surfactant administration r =0.777,P<0.001).Conclusion LUS is positively correlated with the grade of chest X-ray and might enable an early detection of the surfactant replacement therapy effects in RDS.Further studies are necessary to define the role of LUS in this field.
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Objective To explore the association of IL-10-592A/C polymorphism with the susceptibility to respiratory syncytial virus(RSV) bronchiolitis and disease severity,and to explore the impact of IL10-592A/C polymorphism upon total serum IL-10 levels in children with RSV bronchiolitis. Methods One hundred children (patients group) admitted to hospital with RSV bronchiolitis and 100 healthy children (control group) were recruited. PCR restriction length fragment polymorphism assay was used to detect the single nucleotide polymorphisms of IL-10-592A/C. Total serum IL-10 levels in patients group were assayed with ELISA. Results The genotype frequency of IL-10-592A/C were AA 44% ,AC 38% ,CC 18% in patients group ,and AA 41% ,AC 42% ,CC 17% in the control group,it showed no significant difference between two groups (χ2= 0. 33, P > 0. 05) . The frequency of each allele were A 63%, C 37 % in patient group, and A 64% ,C 36% in the control group,there was no significant difference in allele frequency between two groups (χ2=0. 43 ,P >0. 05) . There was no significant difference in total serum IL-10 levels between different genotype of IL-10-592A/C (F = 0. 87, P > 0. 05) . The differences in genotype frequency of IL-10-592A/C were not significant between mild and moderate to severe cases (χ2= 2. 67, P > 0. 05) . Conclusion IL-10-592A/C gene polymorphisms do not correlated with RSV bronchiolitis.