Perinatal transmission of hepatitis B virus.

Transmission of hepatitis B virus from carrier mothers to their infants seems most likely to occur during birth. Both cord blood and breast milk have been found to be positive (in 35% and 72% of cases respectively) for hepatitis B surface antigen (HBsAg), but they do not appear to play an important role in transmission. To control this problem high-risk women should be tested during pregnancy for HBsAg. The infants of infected women should be given several doses of hepatitis B immunoglobulin starting at birth. In less developed regions, where hepatitis B is endemic, administration of the immunoglobulin in combination with vaccine, or even the vaccine alone, may be preferable in order to provide infants with lasting protection.     

Perinatal asphyxia and outcome of very low birthweight infants

Seventy-eight very low birthweight (VLBW) infants (whose birthweights were 1500 g or less) were admitted to the Neonatal Special Care Unit in 1977. Seventy-two of them required treatment in the intensive care area; these represented 40% of admissions to that area of the Unit. The mortality rate was 20% for infants weighing 1001 g to 1500 g, and 52% for those weighing 501 g to 1000 g. An Apgar score of 0 to 3 at two minutes and five minutes was reported in 34% and 19% of VLBW infants respectively. Although there was no difference in birthweight between the groups with a high or low Apgar score, the mortality rate of infants with a five-minute Apgar score of 0 to 3 was 79% compared to 22% in those with a score of 4 to 10. Over 50% of the infants developed hyaline membrane disease regardless of Apgar score. However, in the infants with a five-minute Apgar score of 0 to 3, the severity of respiratory insufficiency was increased as indicated by increased requirement for high inspired oxygen, and the need for intermittent positive pressure ventilation. The duration of stay in the neonatal intensive care area, and the total length of hospital stay of the 49 VLBW survivors were shorter in the group with higher two-minute and five-minute Apgar scores. Long-term morbidity cannot yet be ascertained. It is likely that prevention, or prompt detection, and appropriate management of perinatal asphyxia would produce a further decline in mortality as well as morbidity for VLBW infants.     

围产期人类免疫缺陷病毒感染的母婴传播及防治

围产期人类免疫缺陷病毒感染的母婴传播及防治杭爱国据世界卫生组织（ＷＨＯ）１９９６年统计,世界上已有１８００万成人和１５０万儿童感染人类免疫缺陷病毒（ＨＩＶ）［１］。中国预防医学科学院估计,中国ＨＩＶ的实际感染人数１９９５年末已增至１０万名［２］。对艾...     

C反应蛋白在评估新生儿早发感染诊断中的价值

目的评估新生儿早发感染中C反应蛋白的诊断价值。方法前瞻性、观察性研究,将110例怀疑早发感染的住院新生儿随机分为感染组44例和非感染组66例,比较两组间CRP水平、血常规结果。结果感染组与非感染组在白细胞计数异常、中性细胞绝对计数异常、血小板计数异常构成比及白细胞计数、中性分类、中性细胞绝对计数、血小板计数水平比较差异均无统计学意义,而感染组CRP水平明显升高,与非感染组比较,Z=-4.858,P=0.000,两组之间差异有统计学意义;CRP在新生儿早发感染诊断的AUC为0.758（0.664～0.853）,CRP≥10mg/L时,敏感度40.9%、特异度93.9%。结论新生儿早发感染中CRP具有一定诊断价值,特异度较高,但敏感度较低。     

儿童眶部绿色瘤CT诊断(附2例报告并文献复习)

目的 提高对儿童眶部绿色瘤CT表现的认识，探讨其CT诊断价值。方法 分析两例骨髓涂片证实为急性粒细胞性白血病患的眶部绿色瘤CT表现。结果 眶部绿色瘤的CT表现有以下特点：沿眶侧壁生长的多发梭形软组织密度肿物，中等度强化，常同时累及双眶，骨质破坏轻，可伴有放射状骨膜反应。结论 眶部CT扫描是眶部绿色瘤早期诊断的主要手段。     

Perinatal risk factors in preterm infants with moderate-to-profound hearing deficits

The perinatal histories of 16 preterm infants with confirmed moderate-to-profound hearing loss were examined to determine the perinatal factors that might have been associated with their abnormal auditory development. Of the 11 factors that were examined, eight factors occurred significantly more frequently in hearing-impaired infants when they were compared with 226 preterm infants who were cared for in the same intensive care unit in 1984. However, when the histories of the 16 infants with hearing loss were compared with those of 16 infants with normal hearing, who were matched according to gestational age, birthweight percentile and sex, there were no differences. The prevalence of aminoglycoside therapy was high in both groups of infants, but the mean duration of therapy in the infants with a hearing deficit was significantly longer (15 days compared with eight days; P less than 0.025). These observations suggest that younger, smaller, preterm infants with a complicated perinatal course and prolonged aminoglycoside therapy are at higher risk of auditory handicap. We recommend that the early identification of preterm infants with a hearing deficit should be achieved by recording brainstem auditory-evoked responses just before discharge from the intensive care unit.     

新生儿高胆红素血症围产因素1∶2病例对照及Logistic回归分析

目的采用流行病学的研究方法,从群体角度进一步探讨围产因素与新生儿高胆红素血症的关系.方法对100例我院产科婴儿室健康足月新生儿采用经皮测胆红素测定诊断为新生儿高胆红素血症的患儿进行1∶2病例对照研究.收集40个围产因素,进行单因素和多因素条件Logistic回归分析.结果孕周、血G6-PD值、羊水混浊度3个变量最终进入回归模型.结论多种围产因素尤其是孕周、母血G6-PD值、羊水混浊度与新生儿高胆红素血症发生密切相关,加强围产保健,对预防新生儿高胆红素血症有积极意义.     

幽门螺杆菌粪便抗原诊断方法的系统评价

目的评价幽门螺杆菌(Hp)粪便抗原诊断Hp感染的价值。方法电子检索以中国生物医学文献数据库、中国生物医学期刊文献数据库、中国学术期刊全文数据库与中文科技期刊全文数据库为主进行文献检索,再根据已发表文献中的参考文献追溯进行手工检索。发表时间截止至2004年3月1日。按确定的纳入标准筛选文献,对纳入的文献进行质量评价,运用Coehrane协作网诊断与筛查小组推荐的SROC曲线法,以敏感性、特异性、准确性、阳性预测值、阴性预测值及似然比等指标行Meta分析。结果19篇文献、3123例符合纳入标准。Hp粪便抗原诊断Hp感染的敏感度及特异度为94％和93％。结论Hp粪便抗原诊断Hp感染简便、无创、准确度高。     

婴儿巨细胞病毒感染25例临床分析

目的: 探讨婴儿巨细胞病毒(cytomegalovirus,CMV)感染的临床特点、检测手段及治疗。方法: 对25例经酶免疫斑点技术确诊为CMV感染的婴儿的临床资料进行分析。结果: 支气管肺炎11例(44%),中枢神经系统损害11例(44%),高胆红素血症8例(32%),所有病例均给予更昔洛韦(ganciclovir,GCV)治疗,支气管肺炎治愈8例,好转3例;中枢神经系统损害治愈1例,好转9例,未愈1例;高胆红素血症治愈2例,好转6例。结论: 婴儿CMV感染以支气管肺炎、中枢神经系统损害和高胆红素血症为多见,血清特异性CMV-IgM抗体阳性为CMV感染的实验室诊断依据,GCV是治疗婴儿CMV感染的首选药物。     

Brain damage in asphyxiated newborn infants: early diagnosis. A follow-up study]

Cranial computerized tomographic (CT) scan and serum creatine phosphokinase-BB(CPK-BB) determination were done in 85 asphyxiated newborn infants, in some of them, long-term follow-up study including neurodevelopmental assessment and CT scan were also carried out. The types of early brain damage after perinatal asphyxia included intraparenchymal hemorrhage (IPH), periventricular-intraventricular hemorrhage (PV-IVH), subarachnoid hemorrhage (SAH) and brain edema (BE). Serum CPK-BB levels were elevated within 24 hours after the events of asphyxia, and correlated to the severity of brain damage. These findings were helpful in the early diagnosis of brain damage and estimating its severity and prognosis. The types and severity of brain damage were obviously related to prognosis. The prognosis of infants after SAH and BE were better than those of infants with PV-IVH, and infants with IPH showed the poor results. Follow-up CT scans were performed in 30 infants with brain damage. Abnormal changes included ventricular sulcus dilation, leukomalacia, cyst formation (pseudocyst) and porencephalic cavitation (porencephaly).