Sudden unexpected postnatal collapse in a neonate / 中国当代儿科杂志

A healthy full-term female neonate, aged 3 days and born by vaginal delivery (with a 1-minute Apgar score of 10 and a 5-minute Apgar score of 10), had unexpected cardiac and respiratory arrests in the early morning on day 3 after birth and recovered to spontaneous breathing and heartbeat after a 10-minute resuscitation. The child had poor response and convulsion after resuscitation. Blood gas analysis showed metabolic acidosis, and amplitude-integrated EEG showed a burst-suppression pattern. She was diagnosed with sudden unexpected postnatal collapse but improved after hypothermia and symptomatic/supportive treatment. This article reports the first case of sudden unexpected postnatal collapse in China and summarizes related risk factors, pathophysiological mechanisms, and preventive and treatment measures of this disorder.

Clinical evaluation of Compound Chamomile and Lidocaine Hydrochloride Gel for postoperative hypospadias in children / 中华男科学杂志

Objective@#To evaluate the clinical efficacy of Compound Chamomile and Lidocaine Hydrochloride Gel for postoperative hypospadias in children.@*METHODS@#From January to December 2020, we treated 116 children with distal hypospadias in the Department of Urology, Department of Pediatrics and the Seventh Medical Center of the PLA General Hospital, 58 by primary Snodgrass urethroplasty only (the control group) and the other 58 with Compound Chamomile and Lidocaine Hydrochloride Gel smeared on the penis postoperatively in addition (the trial group). We compared the operation time and postoperative pain score, edema regression and incidence of infection between the two groups, followed by statistical analysis using T test and Chi-square test.@*RESULTS@#All the operations were successfully completed by the same surgeon under general anesthesia. There were no statistically significant differences between the trial and control groups in age (［2.5 ± 0.8］ vs ［2.4 ± 0.6］ yr, P > 0.05) or operation time (［95.6 ± 14.5］ vs ［97.1 ± 15.2］ min, P > 0.05). No incision infection occurred in any of the cases. The pain scores at dressing removal were remarkably lower in the trial than in the control group at 2 hours (1.4 ± 1.0 vs 2.6 ± 1.3, P < 0.05), 24 hours (2.2 ± 1.3 vs 3.9 ± 1.6, P < 0.05), 48 hours (1.2 ± 0.7 vs 1.6 ± 0.9, P < 0.05) and 72 hours after surgery (2.5 ± 0.8 vs 3.7 ± 1.8, P < 0.05). Significantly more cases of edema regression were achieved in the trial than in the control group at 2 weeks postoperatively (35 vs 19, P < 0.05).@*CONCLUSIONS@#Compound Chamomile and Lidocaine Hydrochloride Gel can effectively relieve pain, reduce edema and accelerate edema regression after surgery in children with hypospadias, and therefore deserves wide clinical application.、.

A clinical epidemiological investigation of neonatal acute respiratory distress syndrome in southwest Hubei, China / 中国当代儿科杂志

OBJECTIVE@#To investigate the clinical features and outcome of neonatal acute respiratory distress syndrome (ARDS) in southwest Hubei, China.@*METHODS@#According to the Montreux definition of neonatal ARDS, a retrospective clinical epidemiological investigation was performed on the medical data of neonates with ARDS who were admitted to Department of Neonatology/Pediatrics in 17 level 2 or level 3 hospitals in southwest Hubei from January to December, 2017.@*RESULTS@#A total of 7 150 neonates were admitted to the 17 hospitals in southwest Hubei during 2017 and 66 (0.92%) were diagnosed with ARDS. Among the 66 neonates with ARDS, 23 (35%) had mild ARDS, 28 (42%) had moderate ARDS, and 15 (23%) had severe ARDS. The main primary diseases for neonatal ARDS were perinatal asphyxia in 23 neonates (35%), pneumonia in 18 neonates (27%), sepsis in 12 neonates (18%), and meconium aspiration syndrome in 10 neonates (15%). Among the 66 neonates with ARDS, 10 neonates (15%) were born to the mothers with an age of ≥35 years, 30 neonates (45%) suffered from intrauterine distress, 32 neonates (49%) had a 1-minute Apgar score of 0 to 7 points, 24 neonates (36%) had abnormal fetal heart monitoring results, and 21 neonates (32%) experienced meconium staining of amniotic fluid. Intraventricular hemorrhage was the most common comorbidity (12 neonates), followed by neonatal shock (9 neonates) and patent ductus arteriosus (8 neonates). All 66 neonates with ARDS were treated with mechanical ventilation in addition to the treatment for primary diseases. Among the 66 neonates with ARDS, 10 died, with a mortality rate of 15% (10/66), and 56 neonates were improved or cured, with a survival rate of 85% (56/66).@*CONCLUSIONS@#Neonatal ARDS in southwest Hubei is mostly mild or moderate. Perinatal asphyxia and infection may be the main causes of neonatal ARDS in this area. Intraventricular hemorrhage is the most common comorbidity. Neonates with ARDS tend to have a high survival rate after multimodality treatment.

Diagnostic values of prealbumin and retinol-binding protein for liver damage caused by different degrees of neonatal asphyxia / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the diagnostic values of prealbumin (PAB) and retinol-binding protein (RBP) for liver damage caused by mild or severe asphyxia.</p><p><b>METHODS</b>A retrospective analysis was performed on 185 neonates (including 84 premature infants and 101 full-term infants) with asphyxia. Based on the Apgar score, they were divided into two groups: mild asphyxia group (n=150) and severe asphyxia group (n=35). The levels of PAB, RBP, alanine aminotransferase (ALT), and aspartate aminotransferase (AST) were measured and compared. Their diagnostic values for liver damage were evaluated by ROC curve analysis.</p><p><b>RESULTS</b>The premature infants in the severe asphyxia group had significantly higher AST level and significantly lower levels of PAB and RBP than those in the mild asphyxia group (P<0.05). The full-term infants in the severe asphyxia group had a significantly lower PAB level than those in the mild asphyxia group (P<0.05). After treatment, the PAB level was significantly improved in the premature infants in the severe asphyxia group and in the full-term infants in both mild and severe asphyxia group (P<0.05). The full-term infants in the mild asphyxia groups also showed a significant improvement in AST level (P<0.05). The ROC curve analysis showed that PAB had a good sensitivity and specificity for identifying liver damage caused by mild or severe asphyxia in full-term and preterm infants.</p><p><b>CONCLUSIONS</b>PAB can be used as an indicator of liver damage caused by asphyxia in neonates, and can be used to assess the degree of asphyxia.</p>

Diagnostic value of prealbumin for severe necrotizing enterocolitis / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To study the clinical features of severe neonatal necrotizing enterocolitis (NEC), and to investigate the diagnostic value of prealbumin (PA) in neonates with severe NEC.</p><p><b>METHODS</b>The clinical data and results of routine blood test and blood biochemical test of 40 neonates with NEC (29 neonates with NEC II and 11 with NEC III) were analyzed. The multivariate logistic regression analysis and receiver operating characteristic (ROC) curve were applied to investigate the value of PA in the diagnosis of severe NEC.</p><p><b>RESULTS</b>The multivariate logistic regression analysis showed that PA was an important index for the diagnosis of severe NEC (≥IIB). The ROC analysis showed that in the diagnosis of severe NEC (≥IIB), PA had high sensitivity (0.870) and specificity (0.647).</p><p><b>CONCLUSIONS</b>PA has a good value in the diagnosis of severe NEC.</p>

Role of miRNA-210 in hypoxic-ischemic brain edema in neonatal rats / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the role of miRNA-210 in hypoxic-ischemic brain edema in neonatal rats.</p><p><b>METHODS</b>A total of 80 neonatal rats were randomly divided into control group, normal saline group, miRNA-210 expression inhibition group, and miRNA-210 overexpression group, with 20 rats in each group. Each group was randomly divided into sham-operation group and hypoxia-ischemia (HI) group, with 10 rats in each group. The neonatal rats in the HI group were treated with ligation of the left common carotid artery and then put in a hypoxia cabin with mixed gas of 8% O2 and 92% N2 for 2 hours; those in the sham-operation group were treated with isolation of the left common carotid artery only, without ligation or hypoxia treatment. After HI or sham-operation, the rats in the normal saline group, miRNA-210 expression inhibition group, and miRNA-210 overexpression group were intracranially injected with normal saline (2.5 mg/kg), miRNA-210 inhibitor (2.5 mg/kg), and miRNA-210 mimic (2.5 mg/kg) respectively. No treatment was given to the rats in the control group. The rats were sacrificed three days later, and the left brain tissue was harvested. Fluorescent quantitative PCR was used to measure the expression of miRNA-210; the dry-wet weight method was used to measure the water content of brain tissue; hematoxylin and eosin staining was used to observe the histomorphological changes in the brain.</p><p><b>RESULTS</b>The HI groups showed significant reductions in the expression of miRNA-210 and significant increases in the water content of brain tissue compared with the corresponding sham-operation groups (P<0.05). Compared with the normal saline HI group, the miRNA-210 expression inhibition HI group showed a significant reduction in the expression of miRNA-210 and a significant increase in the water content of brain tissue (P<0.05), and the miRNA-210 overexpression HI group showed a significant increase in the expression of miRNA-210 and a significant reduction in the water content of brain tissue (P<0.05). The results of hematoxylin and eosin staining suggested that the miRNA-210 expression inhibition HI group showed marked edema, and the miRNA-210 overexpression HI group showed a significant improvement in edema.</p><p><b>CONCLUSIONS</b>Neonatal rats show down-regulated expression of miRNA-210 after HI, suggesting that miRNA-210 may be involved in the development and progression of hypoxic-ischemic brain edema in neonatal rats.</p>

Clinical analysis of 52 cases of 21-hydroxylase-deficient congenital adrenal hyperplasia / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To gain more insight into congenital adrenal hyperplasia (CAH) by analyzing the clinical data of children with 21-hydroxylase-deficient CAH.</p><p><b>METHODS</b>The clinical data of 52 children with 21-hydroxylase-deficient CAH were collected. Based on the disease severity and the presence of salt-losing manifestations, the children were classified into three groups: masculine type (n=15), salt-losing type (n=28), and atypical type (n=9). The clinical data of children with different types of CAH were analyzed and compared.</p><p><b>RESULTS</b>The male-to-female ratio of the 52 cases was 1.6:1; the age of onset was less than 1 month after birth in 41 cases; 4 cases had a positive family history. Clitoral hypertrophy was the most common symptom in children with masculine CAH (87%). Pigmentation (89%), feeding difficulties and growth retardation (61%) were the most common symptoms in children with salt-losing CAH. Pigmentation (78%) was the most common symptom in children with atypical CAH. The three groups of children had different degrees of changes in the levels of adrenocorticotrophic hormone, cortisol, testosterone, and estradiol. Such changes were most pronounced in children with salt-losing CAH and were often accompanied by hyponatremia, hyperkalemia, and metabolic acidosis. After treatment with hydrocortisone and/or 9-alpha fluorohydrocortisone, cortical hormone levels improved in all the children, and the levels of cortisol, testosterone, estradiol, and electrolytes improved significantly after treatment in children with salt-losing CAH (P<0.05). In 22 patients who were followed up, 9 were re-hospitalized due to infection, and 8 developed sexual precocity.</p><p><b>CONCLUSIONS</b>Different types of CAH have different clinical symptoms. It is important that hormone replacement should be initiated as early as possible to improve prognosis.</p>

Renovascular morphological changes in a rabbit model of hydronephrosis / 华中科技大学学报（医学）（英德文版）

Obstructive nephropathy ultimately leads to end-stage renal failure. Renovascular lesions are involved in various nephropathies, and most renal diseases have an ischemic component that underlies the resulting renal fibrosis. The aim of this study was to investigate whether morphological changes occur in the renal vasculature in hydronephrosis and the possible mechanisms involved. A model of complete unilateral ureteral obstruction (CUUO) was used. Experimental animals were divided into five groups: a normal control group (N) and groups of animals at 1st week (O1), 2nd week (O2), 4th week (O4) and 8th week (O8) after CUUO. Blood pressure was measured, renal arterial trees and glomeruli were assessed quantitatively, and renovascular three-dimensional reconstruction was performed on all groups. Glomerular ultrastructural changes were examined by transmission electron microscopy. The results showed that the systolic blood pressure was significantly increased in the obstructed groups (O1, O2, O4 and O8). Three-dimensional reconstruction showed sparse arterial trees in the O8 group, and a tortuous and sometimes ruptured glomerular basement membrane was found in the O4 and O8 groups. Furthermore, epithelial media thickness and media/lumen ratio were increased, lumen diameters were decreased, and the cross-sectional area of the media was unaltered in the segmental renal artery, interlobar artery and afferent arterioles, respectively. In conclusion, renal arterial trees and glomeruli were dramatically altered following CUUO and the changes may be partially ascribed to vascular remodeling. Elucidation of the molecular mechanisms of renovascular morphological alterations will enable the development of potential therapeutic approaches for hydronephrosis.

Renovascular morphological changes in a rabbit model of hydronephrosis / 华中科技大学学报（医学）（英德文版）

Obstructive nephropathy ultimately leads to end-stage renal failure. Renovascular lesions are involved in various nephropathies, and most renal diseases have an ischemic component that underlies the resulting renal fibrosis. The aim of this study was to investigate whether morphological changes occur in the renal vasculature in hydronephrosis and the possible mechanisms involved. A model of complete unilateral ureteral obstruction (CUUO) was used. Experimental animals were divided into five groups: a normal control group (N) and groups of animals at 1st week (O1), 2nd week (O2), 4th week (O4) and 8th week (O8) after CUUO. Blood pressure was measured, renal arterial trees and glomeruli were assessed quantitatively, and renovascular three-dimensional reconstruction was performed on all groups. Glomerular ultrastructural changes were examined by transmission electron microscopy. The results showed that the systolic blood pressure was significantly increased in the obstructed groups (O1, O2, O4 and O8). Three-dimensional reconstruction showed sparse arterial trees in the O8 group, and a tortuous and sometimes ruptured glomerular basement membrane was found in the O4 and O8 groups. Furthermore, epithelial media thickness and media/lumen ratio were increased, lumen diameters were decreased, and the cross-sectional area of the media was unaltered in the segmental renal artery, interlobar artery and afferent arterioles, respectively. In conclusion, renal arterial trees and glomeruli were dramatically altered following CUUO and the changes may be partially ascribed to vascular remodeling. Elucidation of the molecular mechanisms of renovascular morphological alterations will enable the development of potential therapeutic approaches for hydronephrosis.

Bioinformatic analysis of target gene prediction and related signaling pathways of miRNA-126* / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To bioinformatically predict and analyze target genes of miRNA-126(*), with the aim of providing certain basis for related research about target genes and regulatory mechanism in the future.</p><p><b>METHODS</b>The miRNA chip technology was applied to measure expression levels of miRNA-126(*) in 3 time points (embryo 16, 19 and 21 days) of fetal lung development. Then the target genes of miRNA-126(*) were screened through miRGen2.0 database. Subsequent bioinformatic analysis of these target genes was performed by Gene Ontology analysis and Kyoto Encyclopedia of Genes and Genomes Pathway analysis (KEGG Pathway analysis).</p><p><b>RESULTS</b>miRNA-126(*) manifested continuously upregulated expression with the lung development (from embryo 16 to 21 days). There were 422 predicted target genes in total, and the gene set mainly located in glucuronosyltransferase activity, transferase activity (GO molecular function), multicellular organismal development, developmental process (GO biology process) and intracellular part (GO cellular component). The KEGG Pathway analysis demonstrated that the gene set mostly located in RNA degradation (signal transduction pathway) and prion diseases (disease pathway).</p><p><b>CONCLUSIONS</b>The results suggest that miRNA-126(*) plays a certain role in fetal lung development and provide a basis for lung development research in the future.</p>

Prediction of hsa-miR-26a target genes and application in lung development / 中华实用儿科临床杂志

Objective The bioinformatics software and database were involved in prediction of the target genes of hsa-miR-26a,so as to lay foundation and provide theoretical basis for the further studies of hsa-miR-26a biological function in fetal lung development.Methods All literature of miR-26a were searched in PubMed and Google ; miRBase database was used to obtain the sequence of hsa-miR-26a and to analyze its conservation.The target genes of miR-26a were predicted using miRNA target gene database miRGen2.0.TargetScans and PicTar were used to predict target genes of hsa-miR-26a.The intersection of the 2 results and validated targets from DIANA LAB-TarBase 6.0 datebase was analyzed by gene ontology and pathway analysis.Results Hsa-miR-26a had been reported in cancer,cell differentiation,organ development,the immune system as well as involved in other biological process;hsa-miR-26a was highly conservative among different species.The functions of these target genes were enriched in translation regulation,the protein modification,the regulation of celluar proliferation,apoptosis and differentiation process,kinase activity regulation,target genes exist in all of the cell components,including cell membrane,cytoplasm and nucleus.The Wnt signaling pathway,mitogen-activated protein kinase signaling pathway,transforming growth factor-β signaling pathway,the pathway of tumor p53 signaling pathways,cell cycle and adherens junction pathways were significantly enriched and prostate cancer,small cell lung cancer,colorectal cancer,renal cell cancer and glioma were mainly involved (all P ＜ 0.05).Conclusions The target genes of hsa-miR-26a are enriched in multiple biological process.The prediction and bioinformatic analysis of miR-26a target genes lay the foundation for the further study in fetal lung development.

Laparoscopic pyeloplasty in the treatment of severe neonatal hydronephrosis / 中华实用儿科临床杂志

Objective To explore the feasibility and safety of laparoscopic pyeloplasty in the treatment of neonatal renal pelvis ureteraljunction obstruction(PUJO),and to analyze its preliminary experience.Methods From Jun.2009 to Apr.2012,11 neonates(9 boys and 2 girls) were recruited in this study.They were all detected by prenatal ultrasound and renal pelvis anteroposterior diameter was more than 3 cm.One week after birth,emission computed tomography(ECT) showed that split function of hydronephrotic kidneys were lower than 40％.All patients underwent laparoscopic dismembered pyeloplasty.Results All successful underwent laparoscopic dismembered pyeloplasty,no conversion to open surgery or additional Trocar,no intraoperative complications.The mean time of operation was 80 min,and blood loss was less than 10 mL,the mean postoperative hospital stay was 9 days.All patients were followed up for 6 to 36 months with ultrasound and ECT.The thickness of renal parenchyma increased,and 8 kidneys turned almost normal,the other's renal pelvis anteroposterior diameter was about 1.5 cm,renal pelvis anteroposterior was significantly reduced,and the scar was not obvious.Conclusions Laparoscopic ureteroplasty in the treatment of neonatal hydronephrosis is safe and feasible,and it is worthy of application in a large scale.Qperators need mastering laparoscopic suture technology,and then apply the technique from older children to neonates gradually.

Measurement of brain regional oxygen saturation in neonates in China: a multicenter randomized clinical trial / 中华儿科杂志

<p><b>OBJECTIVES</b>To understand the value of measuring neonatal cerebral regional oxygen saturation (rSO2) using near infrared spectroscopy (NIRS) in assessing cerebral oxygenation, to establish the normal range of neonatal cerebral rSO2 and to collect data of the changes of cerebral rSO2 under certain disease status.</p><p><b>METHODS</b>Nine large hospitals participated in the multicenter randomized clinical trial from Jan 2007 to Apr 2008. Using the NIRS human tissue oximeter (TSAH-100) independently developed in China, the cerebral rSO2 of 223 normal full-term and 95 otherwise healthy preterm neonates without any special disease, was detected at 1, 2 and 3 days after birth, respectively. The cerebral rSO2 of 102 neonates with diseases which may affect the cerebral oxygenation, was also detected during the severe phases. The pulse oxygen saturation (SpO2) measured at the finger tip, and also the arterial oxygen saturation (SaO2) measured by blood gas analysis, which could indicate the oxygen supply of the whole body, were obtained simultaneously. The correlations among cerebral rSO2, pulse SpO2 and arterial SaO2 were analyzed.</p><p><b>RESULTS</b>(1) The cerebral rSO2 of the normal full-term neonates was (62+/-2)%. Cerebral hypoxia was defined as rSO2 lower than 58%. The cerebral rSO2 of the normal full-terms was steady at 1, 2 and 3 days after birth respectively, without any significant differences among them (F=0.610, P>0.05). The cerebral rSO2 of the neonates with diseases was (55+/-7)%, which was significantly lower than that of the normal full-term neonates (t=15.492, P<0.05). (2) The cerebral rSO2 was positively correlated with the SpO2 (r=0.74, P<0.01) and the SaO2 (r=0.71, P<0.01). (3) Under some special diseases, the changes of cerebral rSO2 was asynchronous with those of the SpO2: (1) For 18 cases under severe cerebral damages or under relatively low hemoglobin concentration, the cerebral rSO2 was significantly low (50%-58%), but the SpO2 was still normal (above 90%). (2) During the recovery of some critically ill neonates, the increase of cerebral rSO2 was lagged as compared with that of pulse SpO2. Especially, during the severe phases of 6 cases with multi-organ failure, the SpO2 and the cerebral rSO2 were both significantly low (55%-80% for SpO2, and 44%-50% for cerebral rSO2); when the diseases were alleviated, although the SpO2 recovered to above 85%, the cerebral rSO2 was still significantly low (around 50%). (3) In 3 cases, during the severe phases of serious hypoxic-ischemic encephalopathy (HIE), the cerebral rSO2 significantly increased to 70%-72%, which was significantly higher than the normal value (62%).</p><p><b>CONCLUSIONS</b>The range of cerebral rSO2 of the normal full-term neonates was (62+/-2)%. Cerebral oxygenation can be externally indicated by the rSO2 noninvasively and continuously measured by NIRS, which was positively correlated with traditional pulse SpO2 and arterial SaO2. In some special diseases, the rSO2 measured by NIRS can be helpful for clinical diagnoses and treatments.</p>

Effect of ventricle injection of Nogo-A antibody on neuronal regeneration following hypoxic-ischemic brain damage in the neonatal rat / 中国当代儿科杂志

<p><b>OBJECTIVE</b>Nogo-A antibody IN-1 can neutralize Nogo-A, a neurite growth inhibitory protein, promoting axonal regeneration following lesions of the central nervous system (CNS) in adult rats. This study aimed to examine the effect of ventricle injection of Nogo-A antibody on neuronal regeneration in neonatal rats following hypoxic-ischemic brain damage (HIBD).</p><p><b>METHODS</b>A model of neonatal HIBD was prepared by the ligation of the left common carotid artery, followed by 8% hypoxia exposure. Forty HIBD rats were randomly given a ventricle injection of 10 microL Nogo-A antibody IN-1 (IN-1 group) or 10 microL artificial cerebrospinal fluid (artificial CSF group) (n=20 each). Another 20 neonatal rats were sham-operated, without hypoxia-ischemia, and were used as the controls. The levels of Nogo-A and GAP-43 protein in the brain were measured by immunohistochemistry.</p><p><b>RESULTS</b>The number of immunohistory positive cells of Nogo-A in the brain in the IN-1 group (28.61+/-1.70) was obviously less than that in the artificial CSF (39.52 +/-1.40) and the sham-operated groups (32.78 +/- 1.87) (both P < 0.01). There were significant differences in the Nogo-A protein expression between the artificial CSF and the sham-operated groups (P < 0.01). The GAP-43 protein expression in the IN-1 group (31.14 +/- 1.88) was noticeably higher than that in the artificial CSF group (27.73 +/- 1.43 ) (P < 0.01). Both the IN-1 and the artificial CSF groups showed lower GAP-43 protein levels than the sham-operated groups (33.64 +/- 1.24) (both P < 0.01).</p><p><b>CONCLUSIONS</b>Nogo-A antibody can reduce the expression of Nogo-A protein in the brain and thus promote neuronal regeneration in neonatal rats following HIBD. An increased GAP-43 protein expression in the brain after Nogo-A antibody administration shows an enhanced neuronal regeneration in the neonatal rats following HIBD.</p>

Transfusion Transmitted Virus Hepatitis in Neonates and Curative Effects of Genciclovir / 实用儿科临床杂志

Objective To investigate the pathogenicity of transfusion transmitted virus (TTV) infection and assess the effect of genciclovir on TTV.Methods Serum TTV-DNA from 968 neonates was detected by a nested polymerase chain reaction technique and electropherosis. Alanine aminotrans ferase (ALT) and direct bilirubin (DB) were assayed in neonates with positive TTV-DNA.Genciclovir[10 mg/(kg?d)]was used to treat neonates with TTV-induced hepatitis.Results Among 968 neonates, 38 had positive TTV-DNA (4.0%). All neonates with positive TTV-DNA had normal serum levels of ALT and DB [(24.8?12.0) U/L and (17.6?6.8) ?mo l/L] 3 days after birth;But an elevated ALT and DB level [(95.5?16.4) U/L and (58.2?10.4) ?mol/L] occurred in 15 of them 2 weeks after birth,and were diagnosed as TTV-induced hepatitis.These patients had hypersomnia,jaundice and anorexia. Serum ALT and DB levels recovered to normal range one week after genciclovir therapy in 11 patients,so did the other 4 patients after 2 weeks therapy with genciclovir. Serum TTV-DNAs in all patients became negative 2 weeks after genciclovir therapy.Conclusion TTV infection exists in the neonates, and may be one of important causes of neonatal hepatitis.genciclovir might have a good anti-TTV effect.