单纯性肥胖儿童临床与血脂成分分析

目的对单纯性肥胖儿童临床与血脂成分进行分析,探讨单纯性肥胖儿童血脂代谢紊乱情况及临床意义。方法对50例2.5~16.0岁单纯性肥胖儿童与40例正常同年龄儿童的临床及血脂成分进行分析,应用生化分析仪检测血脂,包括三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)。应用超声诊断仪进行肝脏检查。结果1.单纯性肥胖与对照组儿童年龄与身高无显著差异,而体质量与体质量指数(BMI)、血压(BP)两组间差异均有非常显著意义(P均<0.001)。2.单纯性肥胖儿童血清TC、TG、LDL的浓度明显高于对照组,差异均有显著性(P均<0.001),HDL浓度两组比较其差异无统计学意义(P>0.05)。3.单纯性肥胖18例(36%)儿童肝脏B超示存在脂肪肝。结论单纯性肥胖儿童存在血脂代谢紊乱,血清TC、TG、LDL浓度均明显升高,预防动脉粥样硬化性心血管疾病必须从儿童时期开始。     

单纯性肥胖儿童高脂血症与脂肪肝的关系

为探讨单纯性肥胖儿童伴高脂血症与脂肪肝之间的关系，对４０例肥胖儿（平均年龄９岁）与２３名正常体重儿（平均年龄８．６岁）的血脂和肝功能各项指标进行了比较；并对３０例肥胖儿做了肝脏－Ｂ型超声检查。结果显示，肥胖组血总胆固醇（Ｔ－ｃｈ）、低密度脂蛋白（ＬＤＬ）、载脂蛋白Ｂ１００（Ａｐｏ－Ｂ１００）、丙氨酸转氨酶（ＡＬＴ）、天冬氨酸转氨酶（ＡＳＴ）和碱性磷酸酶（ＡＫＰ）均明显高于正常对照组（Ｐ＜０．０５或Ｐ＜０．０１）；肝脏Ｂ超结果显示１５例异常，９例轻度脂肪肝，６例脂肪肝。提示单纯性肥胖儿伴高脂血症者脂肪肝较常见，为预防脂肪肝发生，应早期治疗儿童肥胖症。     

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目的探讨单纯性肥胖儿童血浆同型半胱氨酸(HCY)、血脂的变化及其与心脑血管疾病的关系,为儿童单纯性肥胖及成年期心脑血管疾病的防治提供新的思路。方法收集2008年12月至2009年12月大连医科大学附属第一医院34例单纯性肥胖患儿及25例同期健康体检儿童,利用彩色多普勒超声探查肝脏形态结构;同时取禁食12h以上的静脉血,检测血浆HCY、血浆总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白(HDL-Ch)、低密度脂蛋白(LDL-Ch)及血浆脂蛋白(α)[LP(α)]。结果肥胖组18例出现肝脏形态改变,对照组中仅1例;肥胖组血浆TC、TG、LDL-Ch明显高于对照组,差异有统计学意义(P均<0.05);HDL-Ch、LP(α)与对照组比较,差异无统计学意义(P>0.05);肥胖组血浆HCY为(10.91±2.57)μmol/L,对照组为(5.13±1.12)μmol/L,前者较后者明显增高(P<0.05);血浆HCY与血脂水平间无明显相关性。结论单纯性肥胖儿童较健康儿童更易患有脂肪肝或脂肪肝倾向,其发生与患儿脂质代谢异常密切相关;单纯性肥胖儿童血浆HCY明显增高,且HCY与血脂水平无相关性,是心脑血管疾病的独立危险...     

学龄儿童肥胖相关性脂肪肝及脂代谢紊乱的病例对照研究

目的 研究学龄儿童肥胖与非乙醇性脂肪肝病（nonalcoholic fatty liver disease, NAFLD）及脂肪代谢紊乱等相关因素的关系。方法 采用典型整群抽样方法选取北京市海淀区中等水平的4所小学和4所中学，在知情同意的前提下，从中抽取659名7～18岁肥胖儿童作为肥胖组，603名正常体重儿童作为对照组，进行问卷、身体测量、腹部B超脂肪肝检查及血清总胆固醇（TC）、三酰甘油（TG）、高密度脂蛋白胆固醇（HDL-C）和低密度脂蛋白胆固醇（LDL-C）水平，血清丙氨酸转氨酶（ALT）和天冬氨酸转氨酶（AST）等生化指标检测。超重、肥胖采用中国学龄儿童超重、肥胖BMI筛查标准进行评价；血脂异常的判定标准：静脉血清TC≥5.20 mmol·L-1，TG≥1.70 mmol·L-1，HDL-C≤1.03 mmol·L-1，LDL C≥3.12 mmol·L-1；肝功能异常：静脉血清ALT≥40.0 U·L-1和（或）AST≥45.0 U·L-1；NAFLD诊断依据2003年中华医学会肝脏病学分会脂肪肝和酒精性肝病学组公布的非酒精性脂肪性肝病诊断标准进行。统计方法包括计量资料的描述统计、协方差分析、卡方检验、二分类多因素Logistic回归分析及趋势卡方检验等。结果 肥胖组有3例未行脂肪肝B超检测，肥胖组B超脂肪肝和NAFLD的检出率分别为28.0%（184/656）和10.2%（67/656），对照组脂肪肝和NAFLD的检出率分别为0.3%（2/603）和0.2%（1/603），差异有统计学意义（P<0.01），肥胖组TG、TC、LDL-C水平明显高于对照组，HDL-C水平明显低于对照组（P<0.01）。肥胖同时罹患NAFLD时，血脂异常进一步加重，ALT及AST异常也更明显，以ALT升高为著；随着肥胖的加重，脂肪代谢紊乱及肝功能损害程度逐渐上升。结论 肥胖儿童伴发NAFLD较为普遍，单纯性肥胖对儿童的肝功能和脂肪代谢等均造成危害，并随肥胖程度逐渐加重，对中度以上肥胖儿童建议常规进行腹部B超检查。     

非酒精性脂肪肝病儿童、青少年的肝内脂肪定量评价

目的：量化评估非酒精性脂肪肝病(NAFLD)儿童、青少年肝内脂肪的临床意义。方法：对93例肥胖儿童、青少年进行形体学参数、肝功能、血脂、血糖及胰岛素释放试验和肝脏B超等检查,采用氢质子磁共振波谱定量测定肝内脂肪（IHF）含量,并按传统诊断标准将其分为单纯性肥胖组（31例）、非酒精性脂肪肝病-1组（NAFLD-1,33例）（B超示脂肪肝,但不伴有肝损）和NAFLD-2组（B超示脂肪肝,且伴有肝损,29例）。20例健康儿童、青少年作为正常对照组。观察IHF含量在组间的变化情况,分析IHF含量与各临床生化指标的相关关系以及探寻IHF量化改变的影响因素。结果：正常对照组、单纯性肥胖组、NAFLD-1组和NAFLD-2组IHF含量分别为0.80%（0.4%～1.0%）、2.9%（1.7%～4.3%）、14.0%（7.2%～17.5%）、18.8%（14.0%~29.1%）,组间两两比较差异均有统计学意义（P<0.05）。单因素相关分析表明IHF含量与腰围、臀围、腰臀比、体重指数、收缩压、舒张压、丙氨酸氨基转移酶、门冬氨酸氨基转移酶、γ-谷氨酰转肽酶、空腹甘油三酯、低密度脂蛋白、口服葡萄糖耐量试验（OGTT）2 h血糖、空腹胰岛素、2 h胰岛素和胰岛素抵抗指数呈显著正相关,与高密度脂蛋白呈显著负相关。进一步的多元线性回归分析发现增加的腰围、降低的高密度脂蛋白水平和增高的OGTT 2 h血糖是IHF含量升高的独立危险因素。结论：IHF量化改变非常敏感,早期已增高于单纯性肥胖儿童、青少年,并随NAFLD的发生、发展进程而显著升高。量化的IHF与诸多临床生化指标相关,其中腰围、高密度脂蛋白和OGTT 2 h血糖是IHF含量的独立影响因素。     

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目的探寻肥胖与糖脂代谢异常的相关性及相应靶器官肝脏、心脏损害情况,以早期采取干预措施。方法选择2008年7月至2010年10月沈阳市儿童医院儿保门诊就诊的单纯性肥胖儿童516例为肥胖组,100名体检体重正常儿童为对照组。取空腹静脉血检测空腹血糖(FPG)、甘油三酯(TG)、总胆固醇(TC)、谷丙转氨酶(ALT)、空腹胰岛素(FINS)等指标,计算胰岛素抵抗指数(HOMA-IR)及胰岛β细胞功能值(HOMA-β);对肥胖儿童行口服糖耐量试验(OGTT)和胰岛素释放试验。对所有入组者均进行肝脏和心脏超声检查。结果肥胖组收缩压、舒张压均高于对照组(P<0.05),肥胖组高血压检出率为12.0%(62/516)。肥胖组FBG、FINS、HOMA-IR及HOMA-β均高于对照组(P<0.05);TC、TG、LDL-C均高于对照组,而HDL-C低于对照组,差异均有统计学意义(P<0.05)。轻、中、重度肥胖组脂肪肝发生率差异有统计学意义(P<0.001),且随肥胖程度加重,脂肪肝发生率明显增加(χ2=12.97,P<0.001)。肥胖组心包外脂肪增厚268例,平均厚度(3.372±0.098)mm,与对照组比较差异有统计...     

肝脏B超联合肝功能及Ⅲ型前胶原肽对肥胖儿童非酒精性脂肪肝病的诊断价值

目的评价肝脏B超联合血清指标在儿童非酒精性脂肪肝病(NAFLD)中的诊断价值。方法将269例肥胖儿童按诊断标准分为单纯肥胖儿童组(SOC)和NAFLD组。NAFLD儿童根据有无肝功能受损分成NAFLD-1组(B超示脂肪肝,肝功能正常)和NAFLD-2组(B超示脂肪肝,同时伴肝功能异常);再根据B超影像学结果分成轻度脂肪肝组和中重度脂肪肝组。另设30例健康儿童为对照组。对各组患儿进行身高、体质量、腰围、臀围、肝功能(丙氨酸氨基转移酶ALT、天冬氨酸氨基转移酶AST)、血脂、透明质酸(HA)、Ⅳ型胶原(CⅣ)、层黏蛋白(LN)、Ⅲ型前胶原肽(PCⅢ)、肝脏B超、糖耐量试验及胰岛素释放试验等检查,并比较各组间体质指数(BMI)、腰臀比、血压、血脂、肝功能、血糖、胰岛素、肝纤维化指标、胰岛素抵抗指数。对单纯肥胖组和肥胖伴NAFLD组进行二分类Logistic回归分析,并用ROC曲线下面积评价各血清指标的诊断价值。结果 SOC组与NAFLD-1组间ALT、AST、TG、HA、PCⅢ、空腹胰岛素(FINS)、2 h胰岛素、WBISI差异有统计学意义;NAFLD-1组与NAFLD-2组比ALT、PCⅢ差异有统计学意义。Logistic回归分析,ALT水平的回归系数为0.11,P为0。通过ROC曲线决策分析,ALT、AST、PCⅢ的曲线下面积最大,分别为0.88、0.80、0.70。结论同时检查肝脏B超及血清指标ALT、AST、PCⅢ,不但可反映肝脏的炎症程度,也反映了肝纤维化的程度,是诊断肥胖儿童NAFLD严重分层最有价值的方法。     

肥胖儿童非酒精性脂肪肝炎54例

目的 观察不同程度肥胖儿童非酒精性脂肪肝炎(NASH)的发病状况,探讨其可能的发病机制.方法 体质量指数(BMI)≥23的7～16岁单纯性肥胖儿童123例.按BMI分为3组:BMI≥30组34例,25≤BMI＜30组57例,23≤BMI＜25组32例.分别进行肝脏B超检查,并检测血转氨酶、胆固醇、三酰甘油(TG)及空腹血糖/空腹胰岛素比值(FlGIR).将另24例仅有肥胖而无肝脂肪病变者设为对照组.结果 123例患儿中B超发现肝脂肪病变99例(80.49%),其中符合NASH诊断标准者54例(43.90%).所有患儿中,BMI≥30组脂肪肝炎及FGIR＜7的发生率均显著高于其他2组(Pa ＜0.01).相关分析表明,ALT和AST与BMI分级、血胆固醇、TG、FGIR均有相关性(r=0.413,0.290,0.379,-0.477 Pa ＜0.01;r=0.359,0.349,0.348,-0.369 Pa ＜0,01).NASH患儿与对照组血脂、FGIR、BMI比较差异均有统计学意义(X2=9.84,25.59 Pa ＜0.01;t=5.05P＜0.01).结论 BMI ≥30是肥胖儿童发生NASH的高危因素,且脂代谢紊乱和胰岛素抵抗可能与其发病有关.     

儿童青少年单纯性肥胖60例临床分析

目的 探讨儿童青少年肥胖的并发症及其危害性及早期干预的重要性.方法 60例单纯性肥胖儿童青少年全部进行空腹肝功能、血脂、皮质醇、血糖、胰岛索及餐后血精和胰岛素测定,并行骨龄摄片、肝脏B超检查,对其临床资料进行分析.结果 60例单纯性肥胖儿童青少年临床症状不明显,但并发高血压、血脂紊乱、糖代谢异常、脂肪肝甚至肝功能损害的发生率分别为5.0%、15.0%、58.3%、71.6%和30.0%,其中糖耐量异常及2型糖尿病各1例.结论 肥胖儿童青少年易并发高血压、血脂紊乱、糖代谢异常、脂肪肝甚至肝功能损害,尤其糖代谢异常及脂肪肝的发生率极高,儿童肥胖不容忽视,应予早期预防及干预.     

52例肥胖和超重儿童糖耐量及胰岛素释放试验分析

目的 了解肥胖和超重儿童糖代谢及胰岛细胞功能状况。方法 对52例单纯性肥胖与超重儿童进行口服糖耐量试验,并测定其血糖及胰岛素水平。计算胰岛素抵抗指数(IR),胰岛素敏感指数(IS),服糖后30min胰岛素增加值与血糖增加值的比值。并查甘油三酯、肝脏B超。体重指数(BMI)与IR之间、不同BMI组之间、糖耐量减低组与对照组之间进行比较。结果 发现糖尿病1例(1．9％),IGT者5例(9．6％)。IR≥2．8为胰岛素抵抗,占76．9％。BMI与IR之间无相关关系。不同BMI组之间IR、IS、服糖后30min胰岛素增加值与血糖增加值的比值差异均无统计学意义。糖耐量减低组与对照组之间IR、IS差异无统计学意义,服糖后30min胰岛素增加值与血糖增加值的比值之间差异有统计学意义。甘油三酯升高19例(37％),脂肪肝16例(53％)。结论 肥胖与超重儿童普遍存在胰岛素抵抗和敏感性下降,其与BMI程度无关。肥胖伴糖耐量减低儿童除胰岛素抵抗外存在明显的B细胞功能减退。许多肥胖和超重儿童同时存在脂代谢紊乱。     

Short-term effects of blood transfusion on blood volume and resting peripheral blood flow in preterm infants

The effects of blood transfusion on cardiac output and blood pressure are variable, but resting peripheral blood flow (RPBF) may be a sensitive indicator of changes in blood volume. The purpose of this investigation was to study the effects of red cell transfusion on blood volume (Evans blue), blood pressure, RPBF in the leg (strain-gauge plethysmography) and blood viscosity (cone-plate viscometer) in preterm infants during the first week after birth. Fourteen infants with mean ± SD birth weight of 1658 ± 429 g, gestational age 33 ± 3 weeks and postnatal age 64 ± 40 h received 18 ±4 ml/kg of packed red cells (red cells 11±2 ml/kg, plasma 7± 1 ml/kg) because their hematocrit was less than 0.45 l/l. Mean blood volume before transfusion was 88±15 ml/kg. The increase in blood volume (9 ±4 ml/kg) measured 4 to 6 h after transfusion was smaller than the transfused volume (18 ± 4 ml/kg), due to a shift of plasma to the extravascular space. The plasma shift increased with increasing pretransfusion blood volume ( r = 0.70; p = 0.007). Red cell transfusion caused an increase in RPBF by 25% ( p <0.01), whereas systolic blood pressure (BP) increased by only 12%. Peripheral resistance (R = BP/RPBF) decreased by 9% (p<0.01). Blood viscosity (±) increased by 21'% ( p <0.001) and vascular hindrance (R/±) decreased by 24% ( p < 0.001), indicating vasodilatation of limb arteries. The increase in RPBF and the decrease in hindrance were particularly pronounced in infants with high pretransfusion blood volume. We conclude that the increase in blood volume after transfusion is not proportional to the transfused volume and that RPBF increases more than systolic blood pressure with increasing blood volume. The increase in RPBF can be explained by vasodilatation of limb arteries and by increased blood pressure.     

Paediatric packs for neonatal blood transfusions

ABSTRACT. This study demonstrates that the use of paediatric packs of semi packed Group 0 red cells for neonatal transfusion can result in substantial savings of fresh whole blood donations. A comparison of blood usage patterns at National Women's Hospital in 1978 and 1980 revealed that despite a doubling of blood usage per infant, the total number of blood donors to which a baby was exposed increased by only 26%. Paediatric packs of blood are easily prepared, reduce blood bank requirements for fresh blood, and decrease the exposure of infants to multiple donors. Quality control data on paediatric packs are presented and alternative neonatal blood programmes discussed. Donors for a neonatal blood transfusion programme should probably be cytomegalic virus antibody negative.     

Serum zinc and copper levels in the maternal blood and cord blood of neonates

Estimation of serum zinc and copper in the maternal blood and cord blood of neonates was carried out to correlate the trace metals in the neonates and their mothers in relation to gestational age and birth weight. Sixty-five healthy neonates, both term and preterm and their mothers were selected. This cross sectional study was done at Azimpur Maternity Centre, Dhaka Medical College Hospital and Chemistry Division, Atomic Energy Centre, Dhaka, Bangladesh from July 1997 to June 1998. The estimation of trace metals was carried out by Atomic Absorption Spectrophotometry (AAS). The mean serum zinc levels in the maternal blood and cord blood were 0.47 ± 0.24 μg/ml and 0.85 ± 0.33 μg/ml respectively and the mean copper levels in the maternal blood and cord blood were 1.37 ± 0.62 μg/ml and 0.31 ± 0.32 μg/ml respectively. Cord blood zinc level was significantly higher and cord blood copper level was significantly lower than the corresponding maternal blood levels. There was no significant correlation between gestational age and serum zinc levels in the cord or maternal blood. But significant inverse correlation was found between gestational age and serum levels of copper in the maternal and cord blood.     

ABPM vs office blood pressure to define blood pressure control in treated hypertensive paediatric renal transplant recipients

While 24-h ambulatory blood pressure monitoring (ABPM) is an established tool for monitoring antihypertensive therapy in adults, data in children are scarce. We retrospectively analysed whether office blood pressure (BP) is reliable for the diagnosis of BP control in 26 treated hypertensive paediatric renal transplants. Controlled office BP was defined as the mean of three replicate systolic and diastolic BP recordings less than or equal to the 95th age-, sex- and height-matched percentile on the three-outpatient visits closest to ABPM. Controlled ABPM was defined as systolic and diastolic daytime BP < or =95th distribution adjusted height- and sex-related percentile of the adapted ABPM reference. Eight recipients (30%) with controlled office BP were in fact categorized as having non-controlled BP by ABPM criteria. Overall, when office BP and ABPM were compared using the Bland and Altman method, the 95% limits of agreement between office and daytime values ranged from -12.6 to 34.1 mmHg for systolic and -23.9 to 31.7 mmHg for diastolic BP, and the mean difference was 10.7 and 3.9 mmHg respectively. Office readings miss a substantial number of recipients who are hypertensive by ABPM criteria. Undertreatment of hypertension could be avoided if ABPM is applied as an adjunct to office readings.     

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目的调查四川省藏族儿童青少年肥胖指标体重指数(BMI)、腰围(WC)、腰臀比(WHR)、腰围身高比(WhtR)与血压、血脂,并对其相关性进行分析。方法采用多阶段、分层、整群随机抽样的方法,选取2007年10月调查的四川省阿坝自治州松潘县藏族儿童青少年818名资料完整者进行数据分析。测量计算BMI、WC、WHR、WhtR,并分别检测收缩压(SBP)、舒张压(DBP)、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白(HDL-C)以及低密度脂蛋白(LDL-C)的血清浓度,并进行相关性分析。结果女童超重肥胖率(12.78%)高于男童(3.30%),男童和女童超重肥胖组的血压、血脂与同性别BMI正常组相比差异有统计学意义。对血压、血脂与年龄、肥胖指标进行不同性别单因素相关性分析显示,男童和女童的BMI和WC均与SBP、DBP呈正相关。血脂四项与肥胖指标有不同程度的相关性。结论四川省藏族儿童青少年的BMI、WC、WHR、WhtR和血压、血脂存在不同程度的性别、年龄差异,尤其体现在16～17岁年龄组。监测儿童青少年期的BMI、WC和WhtR对于血压和血脂的控制和维持具有重要意义。     

Autologous blood transfusions

Due to enormous risks of transfusion-transmitted diseases in allogenic blood transfusions, including dreaded AIDS, there has been constant endeavour to look for a safer alternative. Autologous transfusion which is transfusion of blood/component donated by intended recipient, has proved to be a safe and viable alternative. Initially tried in 1874 in the form of blood salvage, the process has become popular since 1971 with better PVC containers and storage facilities. Due to ignorance and lack of interest the procedure in still unpopular in India. It is very useful for preventing complications of allogenic transfusion and in rare blood group or patients for whom it is difficult to find compatible blood. Since 1980s the procedure is being widely used. Maximally used category is preoperative donation. Strict protocols regarding selection, storage and labelling are essential. There has been tenfold increase in the preoperative autologous donations in many centres. Isovolemic hemodilution and blood salvage are also being used. The procedure has also been used for preteenage and paediatric ages successfully. 1 to 5 units can be collected from single donor. Now the popularity of the procedure has increased due to awareness and interest.     

影响脐血造血干细胞移植供体品质的相关因素分析

目的探讨影响脐血产品质量的供体相关因素,建立选择脐血移植供体的最优化标准。方法脐血采集自2000年6月至2006年12月在广州市妇婴医院足月分娩的产妇,分析脐血的总有核细胞数(TNC)、CD+34细胞数和总集落数(CFUs)与脐血供体相关因素(新生儿性别和体重、产妇年龄、孕周、分娩方式、胎粪污染、采集体积)的关系。结果TNC与CD+34细胞数、总集落数三者两两间均有相关性,TNC与CD3+4细胞数相关性最好。TNC与新生儿体重、采集体积、产妇年龄有相关关系;阴道分娩、孕周(40周和女性新生儿组TNC数分别高于剖宫产、36~40孕周和男性组。CD+34细胞数和总集落数与采集体积有相关关系,与新生儿体重、产妇年龄无相关关系。CD3+4细胞数受分娩方式的影响(阴道分娩高于剖宫产),不同新生儿性别及孕周间差异无统计学意义。阴道分娩和男性组总集落数分别高于剖宫产和女性组,两组孕周间总集落数差异无统计学意义。采集体积与新生儿体重有关,与产妇年龄、分娩方式、新生儿性别、孕周无关。胎粪污染时TNC较高,CD+34细胞数、总集落数均无影响。结论孕周和新生儿体重指标增加到标准化的脐血采集前供体选择标准,将有利于获得更好的脐血采集质量、提高库存脐血的有效性。     

Cord blood transplant: Current and future issues

Cord blood as the source of hematopoietic stem cells has several advantages over bone marrow cells for transplant purpose. It is readily available, and causes no physical harm or inconveniences to the donor in the processing of harvesting cells. Waiting time between initiating the search and the time to transplant from an unrelated donor is much shorter with cord blood than with unrelated donor bone marrow. The incidence of graft-versus-host diseases is much less. Because of these advantages, cord blood has been increasingly used as the source of stem cells. As of this writing, more than 200 cord blood transplants have been done in patients with hematological malignancies, solid tumors, hematological diseases, immunodeficiency syndromes, and metabolic diseases. One of the limitations inherent in the cord blood is its limited number of hematopoietic stem cells. Thus it has been primarily used for pediatric patients, though more recently, adult patients also have been transplanted with cord blood as people have become more experienced in harvesting cord blood thus yielding a large number of stem cells in a given specimen. Efforts have been made to amplify stem cellsin vitro following harvesting cord blood stem cells, so that adult recipients also would routinely benefit from this resource. Cord blood lymphocytes are functionally “naive”, do not generate vigorous mixed lymphocyte culture reactivities. The low incidence of graft-versus-host disease in the recipients of cord blood is due to this particular property. It is highly desirable that the world wide cord blood registry, similar to the international bone marrow registry would be instituted, but there are logistic, ethical and financial problems that need to be resolved. Cord blood is one of the best stem cell sources, and its application is quite wide.     

The influence of blood transfusion on brain blood flow autoregulation among stable preterm infants

Prior to and 24 h following blood transfusion serial determinations of both cerebral artery flow velocity waveforms and mean arterial blood pressure have been used to reconstruct the autoregulatory curve and its upper blood pressure limit among five stable preterm infants. Prior to transfusion the autoregulatory range of cerebral blood flow (CBF) was narrow due to a relatively low-set upper blood pressure limit. At 24 h after transfusion each individual has been re-examined. Following correction of anemia both a significant reduction of CBF velocities as well as a concomitant rise of the Pulsatility Index (PI) occurred over the entire range of blood pressures indicating a reduction of CBF after transfusion. In addition a right-sided shift of the upper limit towards higher mean blood pressures occurred after transfusion and resulted in an extension of the autoregulatory plateau of CBF. These favourable effects of blood transfusion ameliorating autoregulation of brain blood flow particularly at higher blood pressures might well bear important therapeutic perspectives in our effort to prevent intracranial haemorrhage among sick preterm infants.