Primary repair of esophageal atresia gross type C via thoracoscopic magnetic compression anastomosis: A case report.

BACKGROUND: Esophageal atresia (EA) is a life-threatening congenital malformation in newborns, and the traditional repair approaches pose technical challenges and are extremely invasive. Therefore, surgeons have been actively investigating new minimally invasive techniques to address this issue. Magnetic compression anastomosis has been reported in several studies for its potential in repairing EA. In this paper, the primary repair of EA with magnetic compression anastomosis under thoracoscopy was reported. CASE SUMMARY: A full-term male weighing 3500 g was diagnosed with EA gross type C. The magnetic devices used in this procedure consisted of two magnetic rings and several catheters. Tracheoesophageal fistula ligation and two purse strings were performed. The magnetic compression anastomosis was then completed thoracoscopically. After the primary repair, no additional operation was conducted. A patent anastomosis was observed on the 15th day postoperatively, and the magnets were removed on the 23rd day. No leakage existed when the transoral feeding started. CONCLUSION: Thoracoscopic magnetic compression anastomosis may be a promising minimally invasive approach for repairing EA.

[Association of neonatal blood calcium levels with perinatal factors and neonatal urinary calcium levels measured by an intelligent urine test system].

OBJECTIVE: To study the association of neonatal blood calcium levels with perinatal factors and neonatal urinary calcium levels measured by an intelligent urine test system. METHODS: The medical data of 96 full-term singleton neonates with mild diseases were collected by a cross-sectional survey, who were hospitalized in the Department of Neonatology, The First Affiliated Hospital of Xi'an Jiaotong University, from June to August 2018. Urinary calcium levels measured by an intelligent urine test system, total blood calcium levels, ionized calcium levels, and the mother's calcium and vitamin D supplementation during pregnancy were recorded. RESULTS: Compared with the group without vitamin D supplementation for the mother (17 neonates), the group with vitamin D supplementation for the mother (79 neonates) had significantly higher levels of total blood calcium and ionized calcium (P < 0.05).The group with both vitamin D and calcium supplementation for the mother (68 neonates) had significantly higher levels of ionized calcium than controls (28 neonate) (P=0.05). There was no significant difference in the levels of total blood calcium and ionized calcium between the group with calcium supplementation for the mother (74 neonates) and the group without calcium supplementation for the mother (22 neonates) (P > 0.05). The hypothermia group (5 neonates) had a significantly lower level of total blood calcium than the normal body temperature group (91 neonates) (P < 0.05). There was a significantly positive correlation between the maternal blood total calcium level and the neonatal blood total calcium and ionized calcium levels (r=0.881 and 0.703 respectively; P < 0.05). The neonatal urinary calcium level measured by the intelligent urine test system was significantly correlated with the blood ionized calcium level (r=0.526, P=0.025). CONCLUSIONS: Vitamin D supplementation during pregnancy can increase the blood levels of total calcium and ionized calcium in neonates, and calcium supplementation alone cannot increase the blood levels of total calcium or ionized calcium in neonates. Hypothermia in neonates might cause the reduction in blood calcium levels. The urinary calcium level measured by the intelligent urine test system is positively correlated with the blood level of ionized calcium.

[Sedative effect of intranasal midazolam in neonates undergoing magnetic resonance imaging: a prospective single-blind randomized controlled study].

OBJECTIVE: To compare intranasal midazolam and intramuscular phenobarbital sodium for their sedative effect in neonates undergoing magnetic resonance imaging (MRI). METHODS: A total of 70 neonates who underwent cranial MRI from September 2017 to March 2019 were randomized into an observation group and a control group, with 35 cases in each group. The observation group received intranasal drops of midazolam (0.3 mg/kg), and the control group received intramuscular injection of phenobarbital sodium (10 mg/kg). The sedation status of the neonates was evaluated using the Ramsay Sedation Scale. Meanwhile, the two groups were compared for the success rate of MRI procedure and incidence of adverse reactions. RESULTS: In the observation group, the sedation score was the highest at 20 minutes post administration, then was gradually decreasing, and decreased to the lowest level at 70 minutes post administration. In the control group, the sedation score was the lowest at 10 minutes post administration, then was gradually increasing, and increased to the highest level at 40 minutes and 50 minutes post administration, followed by a gradual decrease. Comparison of the sedation score at each time period suggested that the sedation score was significantly higher in the observation group than in the control group within 40 minutes post administration (P<0.05), while there were no significant differences between the two groups in the sedation score after 40 minutes post administration (P>0.05). The success rate of MRI procedure was significantly higher in the observation group than in the control group (89% vs 69%, P<0.05). There was no significant difference between the two groups in the incidence of adverse reactions (P>0.05). CONCLUSIONS: Intranasal midazolam is superior to intramuscular phenobarbital sodium in the sedative effect in neonates undergoing MRI, with the benefits of being fast, convenient, safe, and effective.

[Influence of acute pancreatitis in pregnancy on pregnancy outcomes and neonates].

OBJECTIVE: To study the influence of acute pancreatitis in pregnancy (APIP) on pregnancy outcomes and neonates. METHODS: A retrospective analysis was performed for 33 APIP patients and 31 neonates born alive. RESULTS: Of the 33 APIP patients, 26 (79%) developed APIP in the late pregnancy. Fourteen (45%) patients had hyperlipidemic APIP, 13 (42%) had biliary APIP, and 4 (13%) had other types of APIP. According to the severity, 22 (67%) were mild APIP, 5 (15%) were moderate APIP, and 6 were severe APIP. None of the 33 APIP patients died. Among the 20 patients with term delivery, 11 underwent termination of pregnancy; among the 10 patients with preterm delivery, 9 underwent termination of pregnancy; two patients experienced intrauterine fetal death, and one experienced abortion during the second trimester. Among the 31 neonates born alive (two of them were twins), 1 (3%) died, 12 (39%) experienced neonatal hyperbilirubinemia, 8 (26%) had neonatal hypoglycemia, 6 (19%) had neonatal respiratory distress syndrome, 5 (16%) experienced infectious diseases, and 2 (6%) experienced intracranial hemorrhage. The hyperlipidemic APIP group had a higher percentage of patients undergoing termination of pregnancy than the biliary APIP and other types of APIP groups (P<0.05). The incidence rate of preterm infants in the moderate APIP was higher than in the mild and severe APIP groups (P<0.05). The mean birth weights of neonates were the lowest in the moderate APIP group. The incidence rates of neonatal respiratory distress syndrome, intracranial hemorrhage, and infectious disease were the lowest in the mild APIP group (P<0.05). CONCLUSIONS: APIP can lead to adverse pregnancy outcomes and neonatal diseases, which are associated with the severity of pancreatitis.

[Monomer conversion effect of post-cure treatment on light-cured composite resin].

PURPOSE: To study the influence of post-cure treatment on the monomer conversion of 3 light-cured composite resins. METHODS: Three kinds of light-cured composite resin: CHARISMA, DenFilTM Flow and nano-hydroxyapatite composite resin were double-side cured for 40 s. The materials without any secondary treatment were used as control group (group A). Group B were lighted in Translux CU light cure case for 5 min. Group C were subjected to post-cure heat treatment for 7.5 min at 140 degrees centigrade and Group D were post heated in 132 degrees centigrade and pressured 0.2 MPa for 6.5 min. Degree of conversion (DC) of all the samples was measured by Fourier transform infrared spectroscopy (FTIR). The data was analyzed using SPSS 13.0 software package. RESULTS: The monomer conversion of light-cured composite resins improved at different degree after post-cure treatment, and group C was the most favorable group(P<0.05). Compared with the control group, group B and C had significant differences (P<0.05) except when the DenFilTM Flow and CHARISMA were lighted for 5 minutes (P>0.05). Among the experimental groups, there was no significant difference between each group of DenFilTM Flow groups, CHARISMA illumination and hot-pressing groups, and n-HA composite resin illumination compared with 140 degrees centigrade groups. CONCLUSIONS: Post-cure treatment can increase the monomer conversion of light-cured composite resin so as to improve material performance, particularly for the heat treatment for 7.5 min at 140 degrees centigrade.

[Bonding performance evaluation between the new nano-hydroxyapatite composite resin and dentin].

PURPOSE: To evaluate the shear bond strength and bonding ability between the new nano-hydroxyapatite composite resin and tooth structure. METHODS: Thirty-six healthy isolated molars were randomly assigned to 3 groups according to the material employed: new nano-hydroxyapatite composite resin, composite resin karisma and glass ionomer cement. After thermal cycling, the data of shear bond strength was recorded, and the type of specimen fracture section was observed under stereo microscope. The data was analyzed statistically by SPSS17.0 software package. RESULTS: The average shear bonding strength of nano-hydroxyapatite composite resin was (11.23±4.6082) N/mm(2), and that of composite resin charisma and glass ionomer cement was (14.49±7.9855) N/mm(2) and(10.08±6.3701) N/mm(2), respectively. No significant difference was found among 3 groups. The bonding fracture mode of each specimen had no significant difference(P>0.05). CONCLUSIONS: As a new dental restorative material, new nano-hydroxyapatite composite resin has superior bonding ability and can be used in clinical therapy. Supported by Natural Science Foundation of Shandong Province (Y2008C159).

[Detection of genetic defect within ABCA3 from newborns with respiratory distress syndrome].

OBJECTIVE: To detect possible relationship between genetic defect within the gene encoding member A3 of the ATP Binding Cassette family (ABCA3) and neonatal respiratory distress syndrome (NRDS), thus to understand the genetic mechanisms of NRDS in Han ethnic group. METHOD: The clinical data of 11 cases with NRDS hospitalized in neonatal intensive care unit was investigated. Blood samples were collected from 11 cases with NRDS and 97 unassociated normal individuals. Polymerase chain reaction (PCR) and DNA direct sequencing were performed to screen all exons and their flanking introns of ABCA3 gene for mutation analysis in 11 cases with NRDS. If a new missense variation was identified, single strand conformation polymorphism analysis was performed in 97 healthy controls. Lung tissue sample from a case who died 12 hours after birth was examined with light microscopy and electron microscopy. RESULT: Three missense genetic variants in exons, which include c. 2169 G > A (p.M723I), c. 1010 T > G (p.V337G), c. 4972 A > G (p.S1658G), one splice junction site variation (Exon 30 + 2 T/G), several unreported polymorphism sites [213 C > T(p.F71F), exon 21 + 34C/T] and reported polymorphism site (p.F353F) were identified on ABCA3 gene coding region in 11 case. The homozygous variation (c.2169G > A), which was in exon 17 and causes an M723I amino acid change, was found in the case who died 13 hours after birth, but not detected in 97 controls, indicating that this variation is indeed a mutation and not a polymorphism. In the case carrying c.2169G > A, ultrastructural examination of the alveolar type II cells with electron microscopy demonstrated abnormally small and dense lamellar body with eccentrically distributed electron dense substance. CONCLUSION: Genetic variants within ABCA3 may be the genetic cause of or a contributor to some unexplained refractory NRDS. Identification of ABCA3 genetic variant in NRDS infants is important to establish appropriate management and evaluation of treatment options, as well as to offer genetic counseling and prenatal diagnosis.

[Study on the fluorescence properties of carbon dots prepared by one step microwave method].

In recent years, more and more researchers pay attention to the synthesis of water-soluble fluorescent carbon dots. Compared with the traditional cadmium-based, silicon-based quantum dots and organic dyes, carbon dots with low toxicity and high stability can be chemically modified and be compatible with a variety of organic, inorganic, and biological molecules, and can be applied in many areas. The fluorescence carbon dots were prepared by one step microwave method using ascorbic acid as raw materials. The carbon dots were characterized by X-ray diffraction (XRD), transmission electron microscopy(TEM), ultraviolet-visible spectrophotometry, fluorescence spectrophotometry, and Fourier transform infrared spectrophotometry (FTIR). The results showed that the carbon dots have approximate spherical morphology, uniform size, good dispersion and non-agglomeration, good fluorescence properties. The carbon dots were rich in carboxyl and hydroxyl groups and had highly hydrophilic nature The emission wavelength of carbon dots depended on the excitation wavelength. Furthermore, these carbon dots also had good fluorescence properties in a wide pH range.