宫内炎症暴露对早产儿固有免疫应答的影响

目的探讨宫内炎症暴露对早产儿固有免疫应答的影响。方法 2013年6月至2014年6月出生、胎龄35周的早产儿47例纳入本研究。依据胎盘病理检查结果,将早产儿分为宫内炎症阳性组和阴性组。采用Ficoll密度梯度离心法和贴壁黏附法分别获得脐血单个核细胞以及单核细胞。用内毒素(LPS,100 ng/ml)刺激单个核细胞12 h后,流式细胞术(PCR)检测CD14+单核细胞HLA-DR的表达量以及CD3+CD4+/CD3+CD8+的比例。用LPS(100 ng/ml)刺激单核细胞6 h后,Real-Time PCR检测单核细胞IL-1β、IL-6、IL-10、TNF-αm RNA表达量的变化。ELISA检测脐血以及单核细胞培养上清液中IL-1β、IL-6、IL-10和TNF-α水平。结果宫内炎症阳性组脐血血浆IL-6水平高于宫内炎症阴性组,差异有统计学意义(P=0.001)。LPS刺激后,两组单核细胞IL-1β、IL-6、IL-10、TNF-αm RNA表达量及培养上清液中蛋白水平均显著升高,与刺激前比较差异均有统计学意义(P0.05);但两组间比较差异均无统计学意义(P0.05)。LPS刺激后,宫内炎症阳性组CD14+单核细胞HLA-DR表达量显著降低,而宫内炎症阴性组则显著升高,与刺激前比较差异均有统计学意义(P0.05);且阳性组HLA-DR表达量显著低于阴性组(P=0.002)。结论宫内炎症暴露并不影响早产儿脐血单核细胞对LPS的应答反应水平,但可抑制单核细胞激活后主要抗原递呈受体的表达。     

新生儿脐血一氧化氮与妊高征关系的探讨

娃高征是人类妊娠期主要并发症，也是导致婴儿死亡率升高的主要原因，目前其病因不明。研究表明，一氧化氮（nitricoxide，NO）在妊高征发病机理中发挥重要作用‘”。至今有关临床研究报道不多。我们测定了正常孕妇及妊高征患者所分娩新生儿脐血NO水平，以了解它在妊高征中的病理生理意义。一、对象与方法：1．对象：均为我院妇产科的孕妇及其新生儿。妊高征组新生儿26例，其中男14例，女12例，胎龄36～42周，出生体重2．1～3．5kg，母孕期除妊高征外无其它疾病；对照组新生儿30例，为健康孕妇所生，其性别、服龄、出生体重及分娩方式与妊…     

新生儿吸入性汞中毒1例

患儿男,20天,因拒乳、呼吸急促、呻吟收入。查体:神志清,精神反应差。体温37℃,呼吸72次/分,面色发灰,口周发绀,皮肤无黄染及出血点,前囟平,张力不高,颈无抵抗。胸廓对称,三凹征(+),双肺呼吸音粗。心率150次,分,心律齐,心音有力未闻     

儿童汞暴露神经毒分子机制研究进展

汞广泛存在于环境中且有很强的神经毒性,儿童未成熟的神经系统对汞特别敏感,长期低剂量汞暴露可引起儿童神经系统发育障碍,及时找出汞暴露源并消除或减少汞暴露有利于促进儿童健康成长.各种形态的汞中以有机态的甲基汞毒性最强,鱼贝类中的甲基汞是日常生活中有机汞暴露的主要来源.研究表明,甲基汞主要通过扰乱细胞内的钙离子稳态,改变中枢神经系统谷氨酸平衡以及诱导产生氧化应激起神经毒作用.该文就儿童汞暴露的来源、神经毒和神经毒分子机制进行综述,为寻找有效的儿童汞暴露干预措施提供参考.     

西宁地区新生儿脐血清补体C3含量检测与分析

本文于１９９３年元月至９月间对新生儿脐血标本２１０例进行了血清补体Ｃ３含量的检测。结果表明，从分析与成熟、性别、出生体重、以及西宁与武汉两地新生儿脐血清补体Ｃ３值比较，得出新生儿脐血清补体Ｃ３值比成人明显低，与新生儿出生体重成正比关系，无性别差异。西宁、武汉两地相比，海拔２２００米比武汉明显高，经协方差分析，Ｆ＝５．３３，Ｐ〈０．０５。     

汞的神经毒性及机制研究进展

环境地儿童健康的影响正日益受到关注,汞对脑的发育以及神经生长因子、胶质细胞、金属硫蛋白、神经递质等有没的影响,本文就此进行综述。     

新生儿脐血维生素K缺乏诱导蛋白与胎龄及地区的关系

目的 探讨新生儿脐血维生素K缺乏诱导蛋白(PIVKA-Ⅱ)水平是否与胎龄及地区有关。方法采集405例足月儿(平均胎龄39.31周,城镇259例,乡村146例)及142例早产儿(平均胎龄35.90周,城镇116例,乡村26例)脐血,用酶联免疫吸附法测定其PIVKA-Ⅱ水平,≥2μg/ml为阳性。结果 不同胎龄新生儿脐血PIVKA-Ⅱ阳性率无显著差异(P>0.05);城镇足月儿脐血PIVKA-Ⅱ阳性率32.82％,显著低于乡村65.75％(P<0.01),而城镇与乡村早产儿脐血PIVKA-Ⅱ阳性率(42.24％,46.15％)无显著差异(P>0.05)。结论新生儿脐血PIVKA-Ⅱ水平与胎龄无关,与地区有关。     

妊娠高血压母亲新生儿脐血S-100蛋白水平与脑血流变化的研究

目的 探讨妊娠高血压母亲新生儿脐血S-100蛋白水平与脑血流变化的关系.方法 我院2006年1月至2007年1月收治的妊娠高血压母亲所生新生儿为观察组,母亲重度子痫前期为重度组,只有高血压或轻度子痫前期为轻度组;无国产期缺氧史的足月儿为对照组.采用ELISA法对所有新生儿脐血S-100蛋白进行检测,同时应用彩色多谱勒超声观察生后24h内双侧大脑中动脉收缩期峰流速(Vs)、舒张末期流速(Vd)及阻力指数(RI).结果 重度组脐血S-100蛋白水平高于轻度组和对照组[(60.1±8.3)μg/L比(37.6±5.0)μg/L和(35.1±3.3)μg/L,P均＜0.01],轻度组和对照组之间差异无统计学意义(P＞0.05).重度组Vs、Vd均低于轻度组和对照组,RI高于对照组,差异有统计学意义(P＞0.05).妊娠高血压母亲新生儿脐血S-100蛋白水平与大脑中动脉血流速度呈负相关(r=-0.257,P＜0.05).结论 妊娠高血压母亲新生儿脐血S-100蛋白水平升高,脑血流速度降低,二者变化有明显相关性.     

妊高症母亲的新生儿脐血NO水平的研究

妊高征是人类妊娠期主要的并发症,也是导致婴儿死亡率上升的主要原因,近年来研究结果表明,一氧化氮的减少在妊高征的发病机理中起着重要作用。我们测定健康孕妇及妊高征孕妇所生新生儿脐带血NO水平,以了解妊高征母亲与其婴儿血NO相关因素。资料与方法一、研究对象:均为我院产科孕妇所生新生儿,妊高征组新生儿28例,男18例,女10例,胎龄在35～42周,出生体重2.0～4.2公斤,其中体重<2500克7例,≥2500克21例。对照组22例,为健康孕妇所生新生儿,性别、胎龄,体重与妊高征组有可比性。二、实验方法:1.标本采集与处理　均于分娩后抽取脐静脉血3ml,室…     

新生儿脐血叶酸含量与生长状况关系的研究

我们用放射免疫检测法(RIA)对60例产妇静脉血和80例新生儿脐静脉血叶酸(FA)含量进行测定,同时测量新生儿的体重和身长,探讨母血与新生儿脐血FA含量之问以及脐血FA含量与新生儿生长状况间的相互关系。结果表明,母血的FA     

Low-level chronic mercury exposure in children and adolescents: Meta-analysis

BACKGROUND: Mercury is a well-known neurotoxin. There are three kinds of mercury exposure: elemental mercury poisoning, inorganic mercury poisoning and organomercury poisoning. Organomercury is the most toxic. Twenty-four hour urine for mercury and blood mercury are the gold standards for diagnosis of mercury poisoning, including low-level chronic mercury exposure. Other tests for mercury level are discussed. The purpose of the present paper was to review recent data on the nature, pathophysiology, pharmacokinetics, diagnostic methods, treatment and the linkage to neurodevelopmental disabilities of mercury exposure in children. METHODS: A literature search was undertaken of MEDLINE (1980-2003), and American Academy of Pediatrics, American Medical Association, American Dental Association, World Health Organization and Center for Disease Control websites. The search string 'mercury' was used in MEDLINE and articles were selected as appropriate by two independent reviewers. All relevant information was reviewed and data were extracted by two independent reviewers. RESULTS: Based on the meta-analysis of the accuracy of hair mercury, hair mercury levels correlated with mercury level in blood (sample size weighted correlation coefficient, r w = 0.61), with 24 h urine ( r w = 0.46) and with cord blood ( r w = 0.64). However, the correlation for hair mercury level with 24 h urine level and blood level was not high enough to replace them in clinical decision-making of individual patient. Epidemiological evidence has shown that low-level mercury poisoning is not a cause of autism (relative risk = 0.49, 95%CI = 0.36-0.66). The risk of neurodevelopmental disabilities from low-level exposure to methylmercury from the regular consumption of fish is still controversial even after combining results from different epidemiological studies worldwide. There is a lack of data in the literature about the effect of chelation therapy in children with neurodevelopmental disabilities. CONCLUSION: Mercury poisoning should be diagnosed only with validated methods. There is no evidence to support the association between mercury poisoning and autism.     

Environmental mercury exposure in children: South China''s experience

BACKGROUND: Environmental mercury levels significantly increased in the past decades following its increase in industrial applications. In spite of an increasing concern on the potential harmful effects of mercury on children, there is no reported data for the Chinese population. The relationship between dietary habit and environmental mercury exposure in Chinese children was studied. METHODS: The hair and blood mercury levels of Chinese children aged above 3 years in 2000 March to September, were studied. Sociodemographic data, dietary habits of the past 6 months, and other risk factors for environmental mercury exposure were collected. Those children with blood mercury levels above the toxic range (i.e. > 45 nmol/L) and their family members were further evaluated and their blood and hair mercury levels were monitored before and after Fishing-Moratorium period (June to August 2000) in South China Sea. RESULTS: Altogether, 137 Chinese children (mean age, 7.2 years) were recruited. The mean hair mercury level was 2.2 p.p.m and the mean blood mercury level was 17.6 nmol/L. There was a strong correlation (r = 0.88) between hair and blood mercury levels in our cohort. Frequency of fish consumption correlated with hair (r = 0.51) and blood (r = 0.54) mercury levels. For those children who consumed fish more than 3 times/week, hair and blood mercury levels were twice as high as those who consumed fish l-3 times/week and threefold of those who never consumed fish. Five children and 12 family members had toxic blood mercury levels. Their blood (P < 0.0001) and hair (P = 0.02) mercury levels dropped significantly after reducing fish consumption during Fishing-Moratorium period. CONCLUSION: Both blood and hair (i.e. Tissue) mercury levels of children in Hong Kong was elevated and correlated with the frequency of fish consumption.     

足月新生儿脐血血清游离卡尼汀浓度及相关因素研究

目的了解足月新生儿脐血血清游离卡尼汀浓度及其相关影响因素。方法收集2004年11月至2005年2月出生的足月新生儿89例,男46例,女43例。平均胎龄(39.4±0.9)周,出生体重(3427.2±414.4)g,身长(49.8±2.5)cm,头围(34.8±1.4)cm,Apgar评分为8~10分。平产50例,剖宫产39例。于出生后即采集脐血2ml,用高效液相(HPLC)法测定脐血血清中卡尼汀浓度。结果89例正常新生儿平均脐血血清卡尼汀浓度为(52.2±22.9)μmol/L。其中男性组为(49.3±18.7)μmol/L,女性组为(55.3±26.5)μmol/L,两者之间差异无显著性(P=0.216);平产组为(52.4±24.5)μmol/L,剖宫产组为(51.9±20.9)μmol/L,两者之间差异无显著性(P=0.924)。根据新生儿出生体重分为<3000g(11例)、3000~3999g(68例)和≥4000g(10例)3组,其血清卡尼汀平均值分别为(61.5±26.2)μmol/L、(52.0±23.1)μmol/L和(42.8±12.3)μmol/L。脐血卡尼汀浓度与出生体重呈负相关(r=-0.239,P=0.026);与孕母年龄、新生儿胎龄、身长和头围无相关性。结论本组足月新生儿脐血血清卡尼汀浓度为(52.2±22.9)μmol/L,与新生儿出生体重呈负相关,与孕母年龄、新生儿胎龄、身长、头围、性别和分娩方式无相关性。     

Umbilical Cord Stricture and Intrauterine Fetal Death

Umbilical cord stricture is an uncommon but distinctive condition associated with intrauterine fetal death. Although cases have been reported periodically since the last century, there has been considerable speculation as to whether the condition is real or a postmortem artifact. In the present study, 25 cases reported since 1925 are reviewed and 8 new cases are described. Clinically, a decrease in fetal movements is usually the only symptom during the second or third trimester of pregnancy and fetal death occurs soon after. The women's age, health, and previous history have shown no link with this condition, but a higher incidence is noted in twin pregnancies. Morphologically, most infants are macerated and an extremely narrow segment of umbilical cord is usually seen at the fetal end and rarely at the placental end or in multiple sites along the cord. Absence of Wharton's jelly, stenosis, or obliteration of cord vessels at the narrow segment and intravascular cord thrombosis are the major pathological features. The findings of this study support the view that the condition can cause fetal death and alerts both pathologists and clinicians to the important features identifying this cause of perinatal wastage.     

新生儿脐血脂联素水平及与其他相关激素间关系研究

目的探讨新生儿脐血脂联素水平及与脐血瘦素、胰岛素、甲状腺激素、生长激素间的关系。方法采用放射免疫法检测78例正常足月新生儿脐血脂联素、瘦素、胰岛素、甲状腺激素、生长激素水平,所有新生儿分为小于胎龄儿(SGA)13例、适于胎龄儿(AGA)53例、大于胎龄儿(LGA)12例,并计算体重指数=体重(kg)/身长2(cm2)评估新生儿营养状态。结果新生儿脐血脂联素水平为(24.58±4.26)μg/ml,与体重指数呈正相关(r=0.367,P<0.05);SGA组脐血脂联素为(19.95±4.70)μg/ml,AGA组(24.81±4.15)μg/ml,LGA组(26.57±4.29)μg/ml,3者间差异显著(F=8.871,P<0.05);新生儿不同性别、分娩方式间脂联素水平差异无显著性(t=1.314,0.713,P均>0.05);脐血脂联素与瘦素、胰岛素、FT3、FT4呈正相关(r=0.298~0.453,P均<0.05);与TSH呈负相关(r=-0.487,P<0.05);与生长激素、TT3、TT4无相关性(r=0.072、0.182、0.211,P>0.05)。结论新生儿脐血脂联素水平为(24.58±4.26)μg/ml,在一定程度上反映了胎儿的营养状态,它可能与瘦素、胰岛素、甲状腺激素一起共同调节胎儿的生长发育,它们可以作为评估胎儿体重与生长发育的临床指标。     

妊娠期高血压综合征对其新生儿脐血脂联素水平的影响及其与血脂的关系

目的 探讨妊娠高血压综合征(PIH)对PIH新生儿脐血脂联素水平的影响及其与血脂之间的关系.方法 将PIH孕妇所生新生儿60例分为妊娠期高血压组(23例)、子痫前期轻度组(22例)、子痫前期重度组(15例);取本院健康母亲所生新生儿40例为健康对照组.均采用放射免疫分析法(RIA)测定各组新生儿脐血脂联素水平,全自动生化分析仪测定其脐血血脂6项,并分析脂联素与血脂6项的相关性.结果 1.PIH孕妇所生新生儿脐血脂联素水平低于健康对照组,且随PIH程度的加重呈进行性下降,组间比较有显著性差异(Pa＜0.05).2.PIH孕妇所生新生儿脐血三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白(LDL)水平均高于健康对照组,且随母亲PIH程度的加重呈进行性升高,但组间比较无显著性差异(F=0.270,0.687,0.474 Pa＞0.05);高密度脂蛋白(HDL)、载脂蛋白A(apoA)水平均低于健康对照组,随母亲PIH程度的加重呈进行性的下降,但组间比较无显著性差异(F＝1.773、1.831 Pa＞0.05);脂蛋白(LPA)组间比较无显著性差异(F＝1.490 P＞0.05).3.PIH孕妇所生新生儿脐血脂联素水平与TG、TC、HDL、 LDL、apoA、LPA水平均无相关性(r＝-0.072,-0.089,0.053,-0.043,0.051,0.081 Pa＞0.05).结论 PIH时宫内的不良环境使胎儿内分泌代谢、脂代谢发生改变,且随母亲PIH程度的加重而加重,推测PIH母亲所生新生儿以后可能发生冠心病、动脉粥样硬化的危险性较健康儿童增加.     

Obstetric Care in Diabetic Pregnancy

ABSTRACT. In diabetic pregnancy near-normalization of maternal blood glucose levels improves the perinatal outcome. Strict metabolic control can be achieved by self-monitoring of blood glucose in ambulant praxis. The obstetric supervision may now therefore be organized on an out-patient basis aiming at early recognition of pregnancy complications such as preeclampsia and deviation in fetal growth. For uncomplicated and well-controlled diabetes without vascular complications the obstetric care should be individualized and routine programmes for obstetric surveillance, such as fetal heart rate monitoring and determination of fetal maturity, are usually not necessary. Special attention should, however, be paid to patients with poor metabolic control or vascular complications, particularly in the presence of disturbances of intra-uterine growth.     

The blood flow velocity waveform in the fetal descending aorta: its relationship to fetal behavioural states in normal pregnancy at 37-38 weeks

In 13 normal pregnancies, the relationship between the blood flow velocity waveform at the lower thoracic level of the fetal descending aorta and fetal behavioural states at 37-38 weeks of gestation was studied. The pulsatility index (PI), as a measure of peripheral vascular resistance, was significantly lower during state 2F compared to state 1F according to the classification by Nijhuis et al. (Nijhuis, J.G. et al. (1982) Early Hum. Dev., 6, 177-195), suggesting an increased perfusion of the fetal skeletal musculature to meet the energy demand needed for the raised muscular activity during state 2F; A significant inverse relationship (P less than 0.001) was established between PI and FHR in state 2F; this was mainly determined by a significant rise in end-diastolic flow velocity (P less than 0.02). Both the behavioural state and FHR should be taken into account when evaluating flow velocity waveforms in the fetal descending aorta during the latter weeks of pregnancy.