2010—2019年吉林省先天性甲状腺功能减低症筛查现状与发病趋势分析

目的 分析2010—2019年吉林省先天性甲状腺功能减低症的筛查结果,了解吉林省近十年发病趋势,为进一步完善先天性甲状腺功能减低症的预防与干预措施提供依据。方法 收集2010—2019年吉林省先天性甲状腺功能减低症的筛查及确诊资料,采用SPSS 17.0软件对筛查、复查及确诊结果进行统计分析。结果 2010—2019年吉林省共筛查新生儿1 621 860例,筛查率由2010年的62.13%提高到2019年的99.58%,各年度筛查率经χ2趋势检验,差异有统计学意义（χ2 = 210 591.00,P＜0.05）;确诊先天性甲状腺功能减低症384例（1/4 224）,经χ2趋势检验差异有统计学意义（χ2 = 31.744,P＜0.05）;确诊高促甲状腺素血症233例（1/6 961）,经χ2趋势检验差异有统计学意义（χ2 = 136.158,P＜0.05）。结论 吉林省新生儿疾病筛查率呈现稳步提高,先天性甲状腺功能减低症发病率呈逐年增高趋势,应进一步提升筛查、管理、诊断及治疗等相关工作。     

Anatomic study of the pre- and neonatal hip. Physiopathologic considerations on dysplasia and congenital dislocation of the hip

Summary Therapeutic success in dysplasia and congenital dislocation of the hip depends on an early diagnosis. The physiopathology remains very debatable and several concepts are propounded. For a better physiopathologic understanding, the authors have carried out a study of the morphology and development of 22 pre- and neonatal hips. At first, the acetabulum is cartilaginous and distorted by the moving femoral head; this acetabulum is histologicaly affected by the femoral pressure.The pathologic hip is characterized by defective posterior bony coverage of the femoral head by the acetabulum. The acetabulum ossifies during the 3 months following birth, forming a cup-like cavity under the pressure of the femoral head. Therefore, neonatal screening tests such as sonography must take place in the first weeks of life.

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Étude anatomique de la hanche antéet néonatale. Réflexions sur la physiopathologie des dysplasies et luxations congénitales de la hanche

Résumé Le succès du traitement des dysplasies et luxations congénitales de hanche est lié à la précocité du diagnostic. La physiopathologie de ces affections reste discutée et plusieurs conceptions ont pu être proposées. Les auteurs ont réalisé une étude structurale et évolutive de 22 hanches anté et néonatales afin de mieux comprendre cette physiopathologie. Dans les périodes anté- et néonatale, l'acétabulum est cartilagineux, déformable sous l'action d'une tête fémorale en mouvement et il est le siège de remainements histologiques dépendant de la pression exercée par l'épiphyse fémorale. L'ossification de l'acétabulum s'effectue lors du ler trimestre postnatal, construisant la cavité articulaire sous l'effet de la pression de la tête du fémur. Dysplasies et luxations apparaissent comme un défaut de couverture postéro-supérieure de l'épiphyse fémorale par l'acétabulum. Le dépistage d'anomalies, notamment par l'échographie, devra donc être réalisé dans les premières semaines de la vie.

     

新生儿窒息史对儿童神经心理发育五项功能的影响

目的：分析有新生儿窒息史儿童五项神经心理发育测查结果，了解新生儿窒息对小儿神经心理发育的影响。方法：对有新生儿窒息史儿童98例分别于6月、12月、24月进行“小儿五项神经心理发育测查”，同时选择50例无新生儿窒息史、无其它重大疾病史儿童于相同月龄进行相同测量作对照，计算测得月龄与实际月龄的相差百分比平均值作标准化对比分析。结果：轻度窒息组57例与对照组无显著性差异，重度窒息组与对照组有显著性差异。结论：新生儿重度窒息对小儿五项神经心理发育有显著性影响。     

苏州市新生儿黄疸初步调查

本文总结分析了 1995年 8月～ 1996年 7月在我院出生的 15 3例正常新生儿血清总胆红素水平。根据本组结果和全国黄疸调查协作组对血清胆红素 >12 .9mg/dl的新生儿作脑干听力诱发电位无异常发现 ,提示正常新生儿高胆红素血症的诊断标准应作适当调整 ,而高胆红素干预标准亦应相应提高     

新生儿缺氧缺血性脑病心肌酶谱测定的临床意义

目的：观察新生儿缺氧缺血性脑病（ＨＩＥ）心肌酶活性化及心脏受损的情况,方法：采用连续监测法等方法检测了１１０例新生儿ＨＩＥ与４５例正常新生儿脐血心肌酶谱测定值比较。结果：血清心肌酶谱ＨＩＥ新生儿组明显高于新生儿正常对照组（Ｐ〈０．０１）,而重度ＨＩＥ组显高于轻、中度ＨＩＥ组（Ｐ〈０．０１）。结论：新生儿ＨＩＥ做心肌产谱测定是诊断其心肌损害、损害程度和估计预后的临床指标之一,有助于临床早期预测新生儿ＨＩＥ心肌损害有给予早期治疗。     

Maternal colonization and early-onset neonatal bacterial sepsis in the Gambia,West Africa: a genomic analysis of vertical transmission

ObjectivesTo define bacterial aetiology of neonatal sepsis and estimate the prevalence of neonatal infection from maternal genital tract bacterial carriage among mother-newborn pairs.MethodsWe carried out a cross-sectional study of newborns with clinical sepsis admitted to three hospitals in the Gambia neonatal wards. Neonatal blood cultures and maternal genital swabs were obtained at recruitment. We used whole-genome sequencing to explore vertical transmission for neonates with microbiologically confirmed bloodstream infection by comparing phenotypically-matched paired neonatal blood cultures and maternal genital tract bacterial isolates.ResultsWe enrolled 203 maternal-newborn pairs. Two-thirds (67%; 137/203) of neonates presented with early-onset sepsis (days 0–6 after birth) of which 26% (36/137) were because of a clinically-significant bacterial pathogen. Blood culture isolates from newborns with early-onset sepsis because of Staphylococcus aureus (n = 5), Klebsiella pneumonia (n = 2), and Enterococcus faecalis (n = 1), phenotypically matched their maternal genital tract isolates. Pairwise single-nucleotide variants comparisons showed differences of 12 to 52 single-nucleotide variants only between maternal and newborn S. aureus isolates, presumably representing vertical transmission with a transmission rate of 14% (5/36).ConclusionsWe found a low prevalence of vertical transmission of maternal genital tract colonization in maternal-newborn pairs for early-onset neonatal sepsis in the West African context. Identifying infection acquisition pathways among newborns is essential to prioritize preventive interventions, which could be targeted at the mother or infection control in the hospital environment, depending on the major pathways of transmission.     

Age-related differences in sensitivity to organophosphorus pesticides

Organophosphorus (OP) pesticides are used extensively throughout the world to control undesirable pest species. The primary mechanism of action for OP insecticides is inhibition of acetylcholinesterase (AChE), an enzyme dynamically involved in cholinergic neurotransmission. Extensive inhibition of AChE leads to accumulation of acetylcholine in the synapse, disruption of normal impulse flow and subsequent signs of toxicity, including autonomic dysfunction, involuntary movements, muscle fasciculations and a host of others. It is generally believed that young individuals are more sensitive to the neurotoxic effects of these agents relative to adults. Essentially all studies addressing age-related differences in sensitivity to these toxicants have examined responses to acute exposures, however, using acute toxicity (lethality) as the endpoint. As the biochemical mechanism of toxicity for this class of toxicants (inhibition of AChE) is well known and considering that low level, repeated exposures are of great concern to the general public, we propose that evidence of neurochemical alterations, especially when exposures occur during development and maturation, is a more relevant endpoint of toxicity than lethality for estimating susceptibility. This report briefly summarizes previous and ongoing work in our laboratory which examines the relative sensitivity to these toxicants between young and adult rats.     

Povidone-iodine in umbilical cord care interferes with neonatal screening for hypothyroidism

Out of 1346 newborns screened for congenital hypothyroidism, 31 non-hypothyroid infants were summoned because of a thyroid stimulating hormone (TSH) level above 10 U/ml. False-positive TSH levels were significantly more frequent in the babies treated with povidone-iodine (4.6%) than in those treated with either alcohol or triple dye (0.7%).Conclusion Iodine containing solutions should be avoided in umbilical cord care of the newborn