[Clinical features of severe meconium aspiration syndrome (MAS) and early predicting factors for severe MAS in neonates with meconium-stained amniotic fluid]. / èƒŽç²ªæ±¡æŸ“ç¾Šæ°´æ–°ç”Ÿå„¿å‘ç”Ÿé‡åº¦èƒŽç²ªå¸å ¥ç»¼åˆå¾çš„ä¸´åºŠç‰¹å¾åŠé¢„è­¦å› ç´ åˆ†æž.

OBJECTIVES: To study the clinical features of severe meconium aspiration syndrome (MAS) and early predicting factors for the development of severe MAS in neonates with meconium-stained amniotic fluid (MSAF). METHODS: A total of 295 neonates who were hospitalized due to Ⅲ° MSAF from January 2018 to December 2019 were enrolled as subjects. The neonates were classified to a non-MAS group (n=199), a mild/moderate MAS group (n=77), and a severe MAS group (n=19). A retrospective analysis was performed for general clinical data, blood gas parameters, infection indicators, and perinatal clinical data of the mother. The respiratory support regimens after birth were compared among the three groups. The receiver operating characteristic (ROC) curve and multivariate logistic regression analysis were used to investigate predicting factors for the development of severe MAS in neonates with MSAF. RESULTS: Among the 295 neonates with MSAF, 32.5% (96/295) experienced MAS, among whom 20% (19/96) had severe MAS. Compared with the mild/moderate MAS group and the non-MAS group, the severe MAS group had a significantly lower 5-minute Apgar score (P<0.05) and a significantly higher blood lactate level in the umbilical artery (P<0.05). Compared with the non-MAS group, the severe MAS group had a significantly higher level of interleukin-6 (IL-6) in peripheral blood at 1 hour after birth (P<0.017). In the severe MAS group, 79% (15/19) of the neonates were born inactive, among whom 13 underwent meconium suctioning, and 100% of the neonates started to receive mechanical ventilation within 24 hours. Peripheral blood IL-6 >39.02 pg/mL and white blood cell count (WBC) >30.345×109/L at 1 hour after birth were early predicting indicators for severe MAS in neonates with MSAF (P<0.05). CONCLUSIONS: Meconium suctioning cannot completely prevent the onset of severe MAS in neonates with MSAF. The neonates with severe MAS may develop severe respiratory distress and require mechanical ventilation early after birth. Close monitoring of blood lactate in the umbilical artery and peripheral blood IL-6 and WBC at 1 hour after birth may help with early prediction of the development and severity of MAS.

Clinical features and prognosis of severe meconium aspiration syndrome with acute respiratory distress syndrome. / é‡åº¦èƒŽç²ªå¸å ¥ç»¼åˆå¾å¹¶å‘æ€¥æ€§å‘¼å¸çª˜è¿«ç»¼åˆå¾ä¸´åºŠç‰¹å¾åŠè½¬å½’åˆ†æž.

OBJECTIVES: To study the clinical features and prognosis of neonates with severe meconium aspiration syndrome (MAS) and acute respiratory distress syndrome (ARDS). METHODS: A retrospective analysis was performed on the medical data of 60 neonates with severe MAS who were admitted from January 2017 to December 2019. According to the presence or absence of ARDS, they were divided into two groups: ARDS (n=45) and non-ARDS (n=15). Clinical features and prognosis were compared between the two groups. RESULTS: Among the 60 neonates with severe MAS, 45 (75%) developed ARDS. Arterial blood gas analysis showed that the ARDS group had a significantly higher median oxygenation index within 1 hour after birth than the non-ARDS group (4.7 vs 2.1, P<0.05), while there was no significant difference between the two groups in white blood cell count, C-reactive protein (CRP), and interleukin-6 (IL-6) on admission and the peak values of procalcitonin, CRP, and IL-6 during hospitalization (P>0.05). The ARDS group had a significantly higher incidence rate of shock than the non-ARDS group (84% vs 47%, P<0.05). There was no significant difference between the two groups in the incidence rates of persistent pulmonary hypertension, pneumothorax, pulmonary hemorrhage, hypoxic-ischemic encephalopathy, intracranial hemorrhage, and disseminated intravascular coagulation (P>0.05). The ARDS group required a longer median duration of mechanical ventilation than the non-ARDS group (53 hours vs 3 hours, P<0.05). In the ARDS group, 43 neonates (96%) were cured and 2 neonates (4%) died. In the non-ARDS group, all 15 neonates (100%) were cured. CONCLUSIONS: Neonates with severe MAS and ARDS tend to develop respiratory distress earlier, require a longer duration of mechanical ventilation, and have a higher incidence rate of shock. During the management of children with severe MAS, it is recommended to closely monitor oxygenation index, give timely diagnosis and treatment of ARDS, evaluate tissue perfusion, and actively prevent and treat shock. Citation.

The effect of different modes of microneedling technique on random flap survival in rats.

OBJECTIVE: The investigation and practice of physical therapy in flap surgery are still scare. The purpose of this study is to evaluate the impact of different microneedling interventions on survival of random pattern flaps in rats, attempting to determine the optimal microneedling protocols for improvement of flap survival. METHODS: Eighty male Sprague-Dawley rats were randomly divided into four groups, with 20 in each group (group A, B, C, and D). A 3 cm × 9 cm rectangular random flap as the McFarlane flap was adopted in each group. In groups A and B, microneedling treatment was performed before and after surgery, respectively. While animals in group C were received both pre- and postoperative microneedling treatment. Group D was used as a control group, which was only exposed to surgery. Flap survival, flap blood flow, number of capillary formations, the expressions of CD31, CD34, HIF-1α, and vascular endothelial growth factor (VEGF) were detected in each group and compared. RESULTS: On the 7th day postoperatively, significant improvements with microneedling treatment were found in flap survival rate (p = 0.007), blood flow (p = 0.024), the expression levels of CD34 (p = 0.005), and the VEGF (p < 0.01). Furthermore, the VEGF expression level was significantly higher in group B when compared with the other three groups (all p < 0.01). However, there was no significant difference in the number of new blood vessels and other immunohistochemical indicators among the four groups (all p > 0.05). CONCLUSION: Microneedling treatment especially postoperative intervention can significantly improve the survival of random flaps in rats.

Use of Neonatal Lung Ultrasound for the Early Detection of Pneumothorax.

OBJECTIVE: Pneumothorax (PTX) can be diagnosed using lung ultrasonography (LUS) in adult patients, but there are only a few reports of LUS in PTX diagnosis in neonates. The aim of the study was to assess the diagnostic accuracy for PTX. STUDY DESIGN: This was a retrospective review study performed in our neonatal intensive care unit (level III) between June 2015 and June 2018. All eligible patients underwent an LUS scan before undergoing a chest X-ray (CXR), which was considered the reference standard. When a diagnosis of PTX was inconsistent between LUS and CXR, a chest computed tomography (CT) scan or chest drain was considered the gold standard. RESULTS: Among 86 infants included in the study, 30 (34.9%) were diagnosed with PTX. In these 30 infants, 35 PTXs were detected by bedside LUS (five bilateral PTXs). Moreover, 11 infants with 14 PTXs were diagnosed only by LUS and were missed by CXR. Out of these 11 infants, 7 underwent a CT scan, whereas the remaining 4 underwent thoracentesis that confirmed PTX diagnosis. CONCLUSION: In neonates with PTX, LUS was more sensitive and specific for the early detection of PTX compared with CXR.

Fabrication and characterization of bit-patterned media beyond 1.5 Tbit/in2.

We fabricated bit-patterned media (BPM) at densities as high as 3.3 Tbit/in(2) using a process consisting of high-resolution electron-beam lithography followed directly by magnetic film deposition. By avoiding pattern transfer processes such as etching and liftoff that inherently reduce pattern fidelity, the resolution of the final pattern was kept close to that of the lithographic step. Magnetic force microscopy (MFM) showed magnetic isolation of the patterned bits at 1.9 Tbit/in(2), which was close to the resolution limit of the MFM. The method presented will enable studies on magnetic bits packed at ultra-high densities, and can be combined with other scalable patterning methods such as templated self-assembly and nanoimprint lithography for high-volume manufacturing.