影响早产儿贫血的相关因素分析

目的 探讨影响和加重早产儿贫血的因素.方法 选择2012年1月至2013年6月在我院新生儿科住院期间出现贫血的早产儿,按不同胎龄、出生体重、出生时基础血红蛋白（Hb）值、有无机械通气进行分组,分别比较各组贫血出现时间和住院期间Hb最低值.结果 胎龄＜32周、出生体重＜1500 g的早产儿,贫血出现时间分别为（12.9±5.0）天、（12.5±4.1）天,Hb最低值分别为（94.3±14.1）g/L、（90.0±10.3）g/L,随着胎龄和出生体重增加,贫血出现时间延迟,程度减轻（P均＜0.05）.出生时基础Hb值≤145 g/L的早产儿,贫血出现时间为（7.1±1.4）天,Hb平均值为（100.0±9.2）g/L,与出生时基础Hb值＞145 g/L的早产儿比较,贫血时间早（P＜0.05）.需机械通气者贫血出现时间为（10.5±3.4）天,Hb平均值为（88.7±9.5）g/L,与非机械通气组比较,贫血出现时间早,程度重（P＜0.05）.多元线性回归分析显示,胎龄、出生体重和基础Hb值为早产儿贫血出现时间的影响因素,胎龄和基础Hb值是影响最低Hb值的因素.结论 胎龄越小,出生体重越低,贫血出现时间越早,贫血程度越重.基础Hb值越低,贫血出现越早.需机械通气者因病情重,受多种因素影响可加重早产儿贫血.     

极低出生体重儿呼吸道分泌物解脲脲原体阳性与肺部损伤的关系

目的 探讨极低出生体重儿呼吸道分泌物解脲脲原体（UU）阳性与肺部损伤的关系。方法 选择2011年10月至2013年5月我院新生儿重症监护病房收治的极低出生体重儿,采用荧光定量聚合酶链反应法检测入院时呼吸道分泌物UU核酸,根据检测结果分为阳性组和阴性组。比较两组入院时感染标记物、新生儿呼吸窘迫综合征、先天性肺炎发生率的差异,以及住院时间28天以上者支气管肺发育不良发生率。结果 174例极低出生体重儿中,UU阳性69例,阴性105例;UU阳性组新生儿呼吸窘迫综合征发生率（26.1%,18/69）低于阴性组（56.2%,59/105）;先天性肺炎发生率（47.8%,33/69）高于阴性组（31.4%,33/105）;住院28天以上的VLBWI 145例,其中UU阳性56例,阴性89例,两组支气管肺发育不良发生率差异无统计学意义。而对于体重〈1250 g的极低出生体重儿,UU阳性组支气管肺发育不良发生率（74.1%,20/27）高于阴性组（45.0%,18/40）。结论 呼吸道分泌物UU阳性增加了极低出生体重儿先天性肺炎、出生体重〈1250 g的极低出生体重儿支气管肺发育不良的发生风险,是新生儿呼吸窘迫综合征的保护性因素。     

Nuevas curvas poblacionales de crecimiento en recién nacidos extremadamente prematuros españoles

IntroductionMost anthropometric reference data for extremely preterm infants used in Spain are outdated and based on non-Spanish populations, or are derived from small hospital-based samples that failed to include neonates of borderline viability.ObjectivesTo develop gender-specific, population-based curves for birth weight, length, and head circumference in extremely preterm Caucasian infants, using a large contemporary sample size of Spanish singletons.Patients and methodsAnthropometric data from neonates ≤ 28 weeks of gestational age were collected between January 2002 and December 2010 using the Spanish database SEN1500. Gestational age was estimated according to obstetric data (early pregnancy ultrasound). The data were analyzed with the SPSS.20 package, and centile tables were created for males and females using the Cole and Green LMS method.ResultsThis study presents the first population-based growth curves for extremely preterm infants, including those of borderline viability, in Spain. A sexual dimorphism is evident for all of the studied parameters, starting at early gestation.ConclusionsThese new gender-specific and population-based data could be useful for the improvement of growth assessments of extremely preterm infants in our country, for the development of epidemiological studies, for the evaluation of temporal trends, and for clinical or public health interventions seeking to optimize fetal growth.     

Interaction between Maternal Prepregnancy Body Mass Index and Gestational Weight Gain Shapes Infant Growth

ObjectiveTo quantify the combined effect of maternal prepregnancy obesity and maternal gestational weight gain (GWG) on the shape of infant growth throughout the first year of life.MethodsA retrospective cohort of mother–child dyads with children born between January 2007 and May 2012 was identified in a linked electronic medical record. Data were abstracted to define the primary exposures of maternal prepregnancy body mass index (BMI) and GWG, and the primary outcome of infant growth trajectory.ResultsWe included 499 mother–child dyads. The average maternal age was 28.2 years; 55% of mothers were overweight or obese before pregnancy, and 42% of mothers had excess GWG, as defined by the Institute of Medicine. Maternal prepregnancy BMI (P < .001) and the interaction between prepregnancy BMI and maternal GWG (P = .02) showed significant association with infant growth trajectory through the first year of life after controlling for breast-feeding and other covariates, while GWG alone did not reach statistical significance (P = .38). Among infants of mothers with excess GWG, a prepregnancy BMI of 40 kg/m² versus 25 kg/m² resulted in a 13.6% (95% confidence interval 5.8, 21.5; P < .001) increase in 3-month infant weight/length percentile that persisted at 12 months (8.4%, 95% confidence interval 0.2, 16.5; P = .04).ConclusionsThe combined effect of excess maternal GWG and prepregnancy obesity resulted in higher infant birth weight, rapid weight gain in the first 3 months of life, with a sustained weight elevation throughout the first year of life. These findings highlight the importance of the preconception and prenatal periods for pediatric obesity prevention.     

A possible mechanism of low molecular weight protein tyrosine phosphatase (LMW-PTP) activity modulation by glutathione action during human osteoblast differentiation

Objective

Low molecular weight protein tyrosine phosphatases (LMW-PTPs) are a family of enzymes strongly involved in the regulation of cell growth and differentiation. Since there is no information concerning the relationship between osteoblastic differentiation and LMW-PTP expression/activity, we investigated its involvement during human osteoblast-like cells (hFOB 1.19) differentiation. It is known that LMW-PTP is regulated by an elegant redox mechanism, so we also observed how the osteoblastic differentiation affected the reduced glutathione levels.

Design

hFOB 1.19 cells were cultured in DMEM/F12 up to 35 days. The osteoblast phenotype acquisition was monitored by measuring alkaline phosphatase activity and mineralized nodule formation by Von Kossa staining. LMW-PTP activity and expression were measured using the p-nitrophenylphosphate as substrate and Western blotting respectively. Crystal violet assay determined the cell number in each experimental point. Glutathione level was determined by both HPLC and DNTB assays.

Results

LMW-PTP modulation was coincident with the osteoblastic differentiation biomarkers, such as alkaline phosphatase activity and presence of nodules of mineralization in vitro. Likewise LMW-PTP, the reduced glutathione-dependent microenvironment was modulated during osteoblastic differentiation. During this process, LMW-PTP expression/activity, as well as alkaline phosphatase and glutathione increased progressively up to the 21st day (p < 0.001) of culturing, decreasing thereafter.

Conclusions

Our results clearly suggest that LMW-PTP expression/activity was rigorously modulated during osteoblastic differentiation, possibly in response to the redox status of the cells, since it seems to depend on suitable levels of reduced glutathione. In this way, we pointed out LMW-PTP as an important signaling molecule in osteoblast biology and bone formation.     

Periodontal treatment during pregnancy decreases the rate of adverse pregnancy outcome: a controlled clinical trial

Objectives

The aim of this study was to evaluate the effects of non-surgical treatment of periodontal disease during the second trimester of gestation on adverse pregnancy outcomes.

Material and Methods

Pregnant patients during the 1^st and 2^nd trimesters at antenatal care in a Public Health Center were divided into 2 groups: NIG – "no intervention" (n=17) or IG- "intervention" (n=16). IG patients were submitted to a non-surgical periodontal treatment performed by a single periodontist consisting of scaling and root planning (SRP), professional prophylaxis (PROPH) and oral hygiene instruction (OHI). NIG received PROPH and OHI during pregnancy and were referred for treatment after delivery. Periodontal evaluation was performed by a single trained examiner, blinded to periodontal treatment, according to probing depth (PD), clinical attachment level (CAL), plaque index (PI) and sulcular bleeding index (SBI) at baseline and 35 gestational weeks-28 days post-partum. Primary adverse pregnancy outcomes were preterm birth (<37 weeks), low birth weight (<2.5 kg), late abortion (14-24 weeks) or abortion (<14 weeks). The results obtained were statistically evaluated according to OR, unpaired t test and paired t test at 5% significance level.

Results

No significant differences were observed between groups at baseline examination. Periodontal treatment resulted in stabilization of CAL and PI (p>0.05) at IG and worsening of all periodontal parameters at NIG (p<0.0001), except for PI. Significant differences in periodontal conditions of IG and NIG were observed at 2nd examination (p<0.001). The rate of adverse pregnancy outcomes was 47.05% in NIG and 6.25% in IG. Periodontal treatment during pregnancy was associated to a decreased risk of developing adverse pregnancy outcomes [OR=13.50; CI: 1.47-123.45; p=0.02].

Conclusions

Periodontal treatment during the second trimester of gestation contributes to decrease adverse pregnancy outcomes.     

牙周龈下螺旋体和早产低体重儿关系的初探

目的初探牙周状况、龈下螺旋体和早产低体重儿(PLWB)发生之间的关系。方法从住院病例库中按严格标准选出PLWB组(49例)和Control组(20例),电话召回填写调查问卷、单盲检查口腔牙周情况(PLI、BI、PD)并计数指数牙(16、21、24、36、41、44)的CAL和龈下螺旋体比例,用统计学软件处理最终数据。结果PLWB组83.7?L>0,Control组55.0%,P<0.05;两组所有指数牙的PD、CAL和龈下螺旋体比例均为PLWB组大于Control组,P<0.05都是下颌牙位。结论PLWB组牙周破坏倾向于比Control组更重;龈下螺旋体或许可以充当一个粗略的PLWB预示指标。     

母体牙周病与新生儿低体质量关系的初步探讨

目的 :探讨母体牙周病与新生儿体质量 (体重 )不足是否有相关性。方法 :调查 2 0 7名产后 4d母亲。新生儿体质量不足 :体质量 <2 50 0 g或者伴有孕期 <37周、胎膜早破等妊娠不良情况 (n =1 0 6)。对照组 :新生儿体质量≥ 2 50 0 g ,正常分娩 (n =1 0 1 )。每位受试者均接受牙周检查并记录临床有关数据。 结果 :LWN组牙周病明显重于对照组 ,经统计学处理P <0 .0 0 1。 2 0 7名母亲牙周袋深度和牙龈指数与新生儿体质量呈负相关 (rGI=- 0 .37,P <0 .0 1 ;rPD=- 0 .1 9,P <0 .0 1 )。结论 :母体牙周病作为新生儿低体质量的危险因素之一尚需进一步研究 ,本调查结果显示母体的牙周病与新生儿低体质量呈低度相关     

Can poly(acrylic) acid molecular weight mixtures improve the compressive fracture strength and elastic modulus of a glass-ionomer restorative?

Objectives

To optimize the compressive fracture strength (σ) and elastic modulus (E) of a glass-ionomer (GI) restorative using poly(acrylic) acid (PAA) weight average molecular weight (M_w) mixtures.

Methods

174 PAA solutions were prepared (four control PAA M_ws at three PAA concentrations (25, 35 and 45%) (n = 12) and six M_w mixtures (Groups A-F at nine blend ratios and three PAA concentrations (n = 162))). The viscosity (η) of each PAA solution was determined using a digital viscometer. The PAA solutions were hand-mixed with a commercial GI restorative powder (Ionofil Molar; Voco, Cuxhaven, Germany) and σ and E were determined using cylindrical (6 mm height, 4 mm diameter) specimens (n = 20) at 24 h. Data were analyzed using analyses of variance (ANOVA) (three-, two- and one-way) and regression analyses at p < 0.05.

Results

The three- and two-way ANOVAs highlighted significant effects of M_w mixture, blend ratio and PAA concentration (all p < 0.0001) on the η, σ and E data. Regression analyses showed significant increases in η, σ and E (p < 0.0001) with increasing M_w from Groups A to F. There was no significant effect of blend ratio on the σ data for Groups A (p = 0.178), D (p = 0.747) and F (p = 0.107) and on the E data (p > 0.083).

Significance

The current approach to improving the mechanical properties of GI restoratives using PAA M_w mixtures is encouraging, however, further manipulation of the GI restorative system by optimizing PAA M_w mixtures, blend ratios and PAA concentrations is required to elicit further improvements in σ and E without impacting upon the η of the PAA solution.