ICAM-1单克隆抗体对新生大鼠缺氧缺血性脑损伤作用的研究

目的探讨细胞间粘附分子-1(ICAM-1)单克隆抗体对新生大鼠缺氧缺血性脑损伤(HIBD)的保护作用。方法48只7 d龄SD大鼠随机分为缺血缺氧组(A组)、ICAM-1单抗治疗组(B组)、生理盐水组(C组)和正常对照组(D组)。其中A组观察到再给氧后2 h,24 h,48 h,72 h和168 h处死,B,C,D组观察到再给氧后48 h处死。应用免疫组织化学法和HE染色观察1CAM-1在不同时间脑组织的表达和脑组织中性粒细胞浸润情况。结果A组再给氧2 h,脑微血管内皮细胞ICAM-1微弱表达,24 h后表达开始增加,48 h达到高峰,同时受损脑组织中性粒细胞浸润也随之增加。B组再给氧48 h后,ICAM-1表达强度及中性粒细胞浸润比同时间点缺氧缺血组明显降低。结论HIBD时ICAM-1的表达与中性粒细胞浸润密切相关,ICAM-1单抗对新生大鼠HIBD具有一定保护作用。     

人类细小病毒B19感染与新生儿高间接胆红素血症

目的探讨人类细小病毒B19(HPVB19)感染与新生儿高间接胆红素血症(新生儿高胆)发生的关系.方法对136例新生儿高胆及123例正常新生儿用聚合酶链反应技术进行血液HPVB19-DNA的检测.结果 136例新生儿高胆的患儿HPVB19-DNA阳性者48例,阳性率35.3%,123例正常新生儿HPVB19-DNA阳性者12例,阳性率9.8%,两组之间阳性率比较有非常显著性差异(χ\+2=23.7,P＜0.005).结论新生儿高胆的发生与HPVB19感染有关.     

Invasive antenatal procedures and requirement for neonatal intensive care unit admission

Neonatal respiratory difficulties are increased following second trimester amniocentesis. In preterm, prolonged rupture of the membranes, respiratory outcome is particularly poor when rupture occurs in the first trimester. It therefore seems likely that first trimester/early amniocentesis (EA) would be associated with severe respiratory problems necessitating a high neonatal intensive care unit (NICU) admission rate. To test that hypothesis, the requirement for admission to the NICU of 278 infants whose mothers had undergone EA, 262 whose mothers had undergone chorion villus sampling (CVS group) and 264 controls whose mothers had undergone no invasive procedures were reviewed as were their diagnoses if they needed admission. There was no significant difference in the mode of delivery, gestational age or gender distribution of the three groups and the median maternal age of the EA and CVS groups was similar. Nineteen EA, eight CVS and five control infants required admission to the NICU (EA versus controls, P < 0.01; EA versus CVS plus controls, P < 0.005). Nine EA, one CVS and four control infants had suffered respiratory problems (EA versus CVS P < 0.05). Logistic regression analysis demonstrated that immaturity and EA were significantly associated with a requirement for NICU admission. We conclude infants whose mothers have undergone EA may be at increased risk for NICU admission, this is partly due to respiratory problems but the association is uncommon. Received: 1 August 1996 / Accepted: 12 December 1996     

Cholestasis in newborn infants with perinatal asphyxia

Abstract Objective : The aim of this study was to characterize the liver involvement in infants who have both neonatal asphyxia and neonatal cholestasis. Methods : We describe four asphyctic newborn infants (three born at term) who developed early (age 3.8 ± 2.1 days) intrahepatic neonatal cholestasis and in whom tests for causes of neonatal liver damage were negative. Results : The clinical picture and course were benign and similar to that of sporadic "idiopathic" neonatal hepatitis. Clinical signs and abnormal liver function tests tended to normalize within the first year of life in all. Conjugated bilirubin became normal at 6 months after the onset of cholestasis, while liver enzymes tended towards normal values thereafter, within 1 year of follow-up. Liver biopsy (taken in one patient) showed a typical picture of giant cell hepatitis; ultrastructure was nonspecific. Significance : Our results suggest that isolated asphyxia should be taken into account as a potential causal factor in term or pre-term asphyctic newborns who develop early "idiopathic" neonatal cholestasis.     

Diagnosis of pneumothorax in critically ill adults

The diagnosis of pneumothorax is established from the patients' history, physical examination and, where possible, by radiological investigations. Adult respiratory distress syndrome, pneumonia, and trauma are important predictors of pneumothorax, as are various practical procedures including mechanical ventilation, central line insertion, and surgical procedures in the thorax, head, and neck and abdomen. Examination should include an inspection of the ventilator observations and chest drainage systems as well as the patient's cardiovascular and respiratory systems.Radiological diagnosis is normally confined to plain frontal radiographs in the critically ill patient, although lateral images and computed tomography are also important. Situations are described where an abnormal lucency or an apparent lung edge may be confused with a pneumothorax. These may arise from outside the thoracic cavity or from lung abnormalities or abdominal viscera inside the chest.     

Venous graft repair following brachial artery thrombosis in a neonate

A case of venous graft repair to recover blood flow of a newborn's upper extremity, is described. Eventhough this complication remains uncommon, we emphasize on to avoid brachial artery for vascular monitorization and to perform microsurgical revision as elective procedure if conservative therapy is unsuccessful. Accepted: 4 February 1997     

新生儿窒息513例临床分析

目的 探讨新生儿窒息的相关因素及预防措施。方法 对1995年1月～2004年12月哈尔滨二四二医院住院分娩发生的新生儿窒息513例临床资料进行分析。结果 新生儿窒息与胎儿窘迫高度相关。脐带因素、产程异常、胎盘功能不全是新生儿窒息的主要产科原因。结论 新生儿窒息是胎儿窘迫产程中缺氧在出生后的表现和继续。应以预防为主：要重视产前检查，对高危妊娠进行系统管理，指导胎动计数，加强产程监护，综合判断后选择最佳分娩方式。一旦发生，及时进行复苏术。     

Effects of REM sleep deprivation on cholinergic receptor sensitivity and passive avoidance behavior in clomipramine model of depression

This study investigated the effects of REM (rapid eye movement) sleep deprivation (RSD) on the activity of central cholinergic receptors and passive avoidance retention in rats treated neonatally with clomipramine. Male rat pups treated with clomipramine (15 mg/kg, s.c.) twice daily from postnatal day 5 to 21 were subjected to RSD procedure at three months of age, for 4 days consecutively. In the post-RSD phase, RSD-control rats showed a significantly enhanced cholinomimetic-induced hypothermia and an improved retention in passive avoidance task. However, these measures were not significantly different in RSD-experimental group as compared to rats treated neonatally with saline. These results suggest that RSD reverses the sensitivity of central cholinergic receptors in rats given clomipramine neonatally, and this mechanism may be involved in mediating the antidepressant effects of RSD treatment in clomipramine model of depression.     

CGRP对缺氧缺血新生鼠脑细胞内游离Ca2+的影响

目的探讨降钙素基因相关肽(CGRP)对缺氧缺血新生鼠脑细胞内游离Ca2+的影响及对脑损伤的保护作用.方法 7日龄SD大鼠制成HIE模型.⑴药物治疗组于模型后即给CGRP 3μg*kg-1*d-1,腹腔内注射,共3d;⑵生理盐水组每天给予同剂量生理盐水腹腔内注射;⑶正常对照组(假手术组).各组于3d后断头取脑,采用钙荧光指标剂Fura-2AM法测定脑细胞胞浆游离钙浓度[(Ca2+)].结果生理盐水组脑细胞内钙含量最高,(129.47±17.21nmol/L)与正常对照组(93.72±24.16nmol/L)比较有显著差异P＜0.01,而药物治疗组(103.35±12.46nmol/L)与正常对照组比较无显著差异.结论 CGRP能阻止新生鼠缺氧缺血脑损伤后细胞钙内流,降低细胞膜对Ca2+通透性可能是CGRP对脑缺氧缺血保护作用的重要机制.     

广州市产科资源对新生儿窒息的影响

目的 :探讨广州市产科资源对新生儿窒息及重度窒息发生率的影响 ,总结进一步降低新生儿窒息发生率及重度窒息发生率的行政干预措施。方法 :对全市各产科医院的分娩量、产、儿科床位、 MICU、 NICU、产床数、产、儿科技术人才及设备资源等变量进行分层聚类分析 ,将特征相似的产、儿科资源合并 ,最终选择代表产科资源特征的 5类变量 ,将所有产科医院进行样品聚类。结果 :将 14 4所产科医院分 6类 ,描述各类医院特征 ,其中新生儿窒息及重度窒息发生率均最高的一类共 6所产科医院 ,其医院规模最小、技术力量不足、助产技术服务需求低。而新生儿窒息及重度窒息发生率均最低的一类共 6 3所产科医院 ,其产科资源与新生儿窒息发生率高的一组相似。结论 :要进一步降低广州市新生儿窒息发生率 ,可对重点医院进行技术指导 ,进行必要的医疗资源调整及投入。