胎心率延长减速临床价值分析

胎心监护用于临床以来，对降低围产儿死亡率起到了一定作用。胎心监护可连续动态监测胎心率(FHR)，客观地反映胎儿心动规律及各种因素对胎心的影响，并记录其瞬间变化。1998年1月～2002年5月，我们对1928例正常孕妇进行了胎心监护，现对监护中延长减速(PD)图形的临床意义进行探讨。     

妊娠期高血压疾病患者及新生儿脐血血清表皮生长因子水平检测及意义

目的探讨表皮生长因子（EGF）在妊娠期高血压疾病（HDCP））发生、发展及胎儿、胎盘生长发育过程中的作用。方法采用ELISA法测定65例HDCP患者（HDCP组）、21例正常妊娠妇女（对照组）及其新生儿脐血中EGF水平,分析其与新生儿体质量及胎盘重量的相关性。结果HDCP组母体及脐血中EGF、新生儿体质量及胎盘重量均明显低于对照组（P〈0．05）,并随HDCP病情加重逐渐下降EGF在HDCP组母血及脐血中的水平呈正相关（r=0．123,P〈0．05）,脐血中EGF水平与胎儿体质量及胎盘重量均呈正相关（r=0．326、0．451,P〈0．05）。结论HDCP患者血清及其新生儿脐血中EGF水平均降低,此可能在HDCP发生、发展及胎儿、胎盘生长发育过程中起重要作用。     

新生儿脐血TSH测定规范实验方法及操作程序的探讨

为解决全国性的TSH与肿大率、尿碘等指标间“分离现象”。进行IRMA与ELISA法的选择;当日与过夜洗脱条件的选择;ELISA芬兰试剂盒与澳大利亚试剂盒的选择。以建立新生儿筛查规范的检测方法及操作程序。使TSH指标更客观真实的反映筛查人群碘营养状况,用于IDD防治监测,现将测定新生儿脐血TSH规范实验方法及操作程序报告如下。     

杭州市新生儿脐带血TSH水平分析

用免疫放射法（ＩＲＭＡ）测定杭州市区１４２析新生儿滤纸血ＴＳＨ及４５６例８－１０岁儿意志水碘测定分析。杭州市区新生儿ＴＳＨ值≥５ｍＩＵ／Ｌ者占５２．３％，８－１０岁儿童尿碘值大于１００μｇ／Ｌ占３２．２％，小于１００μｇ／Ｌ者占６８．８％，８－１０岁在校学生甲状腺肿大率１０．０１％－１９．４７％（触诊法）１６．４５％（Ｂ超法）；居民户食用盐碘含量为０．１２ｍｇ／ｋｇ。调查表明杭州市区人群缺碘存在。     

浙江省30市（县）新生儿脐血TSH结果分析

免疫放射法(IRM)纸片新生儿脐血TSH测定,作为监测人群碘缺乏较为敏感且简而易行的方法已被国内外公认,国际控制碘缺乏病理事会(IC-CIDD)提出,新生儿TSH水平可作为一个国家和地区实现消除碘缺乏病(IDD)的进程状况。作为97全国碘缺乏病调查指标之一,作者于1997年3～7月采用PPS法随机抽取30个市(县)的中心医院,共采集有效新生儿脐血纸片930份进行测定,结果报告如下。     

新生儿脐血血气分析在新生儿窒息中的应用价值分析

目的 分析新生儿脐血血气分析在新生儿窒息中的应用价值.方法 对2018年6月-2019年6月期间在我院出生的足月产新生儿进行研究,共计80例,出生后立即采集新生儿的脐动脉血然后进行血气分析,将数据与Apgar评分诊断情况进行对比.结果 可根据评分的情况将其区分成参照组和窒息组,根据数据显示,窒息组的PaO2、pH值较低,PCO2较高(P<0.05);参照组新生儿酸中毒的发生率显著低于窒息组(P<0.05).结论 新生儿脐血血气分析能够对胎儿缺血缺氧的情况进行客观的反映,可以作为新生儿窒息诊断的依据,因而新生儿脐血血气分析的检验方式可以广泛应用于临床,作为诊断新生儿窒息的重要依据.     

用IRMA法和ELISA法检测同批新生儿脐血TSH的结果比较

以ＩＲＭＡ和ＥＬＩＳＡ两种方法检测足月产正常新生儿脐血２６４份，结果：９６．２％的样品检测值为ＩＲＭＡ＞ＥＬＩＳＡ，其Ｍ±Ｓｍ分别为７．６４±０．２７ｍＩＵ／Ｌ和４．０７±０．２５ｍＩＵ／Ｌ，（ｕ＝９．７０，Ｐ＜０．０１）；ＴＳＨ值＜５ｍＩＵ／Ｌ的百分率分别为２２．１％和６１．４％，（ｕ＝２．１４，Ｐ＜０．０５）；经配对比较，两法呈现良好的正相关关系，ｒ＝０．７０６（ｔ＝１６．１２，Ｐ＜０．０００５）。根据本实验求得以ＥＬＩＳＡ检测值推算ＩＲＭＡ值的直线回归方程式是：Ｙ＝３．５９９５＋１．０４８０Ｘ。作者认为：用国产ＩＲＭＡ纸片法试剂盒检测新生儿脐血ＴＳＨ时，其上限值可界定在≤９ｍＩＵ／Ｌ。     

云南省新生儿TSH水平调查

云南历史上是碘缺乏病严重流行区,自1995年以来,全省已普及食盐加碘,为了解我省2000年消除碘缺乏病的目标进程,按照“全国碘缺乏病防治监测方案”的要求,对我省30个县新生儿脐血TSH、儿童甲状腺、尿碘及盐碘进行监测,结果如下。1 材料和方法1.1 对象 在全省范围内按PPS抽样方法,确定30个县(市、区)作为抽样单位,在各抽样单位中随机抽取一所小学和一所乡医院,作为本次的“监测点”和新生儿脐带血“采血点”,抽取该小学中的8-10岁儿童40     

双位点酶免法测定新生儿脐血和足血TSH水平的比较

先天性“甲低”是以外周血甲状腺激素水平降低为特征的新生儿内分泌障碍,其特点是外周血中甲状腺激素低于正常水平,而促甲状腺素高于正常水平,新生儿外周血中TSH浓度增高,可作为筛查判断先天性“甲低”的根据。检测新生儿滤纸血斑样品的TSH水平,不仅可筛查先天性甲减的患儿,同时也可监测和评价某一地区碘缺乏病的严重程度和防治效果,ICCIDD推荐的采集血样的方法是婴儿出生后4～8天,用针刺足跟取血进行筛查。但在一些地区由于采集足血会遇到许多困难,因此有些作者用IMRA法测定了新生儿的脐血和足血,尝试     

Early proliferation of umbilical cord blood cells from premature neonates

BACKGROUND AND OBJECTIVE: Human umbilical cord blood (UCB) is an important source of haematopoietic stem cells; however, the behaviour of progenitor cells obtained from premature and full-term neonates is still a controversy subject. Thus, the aim of this study was to evaluate cell cycle parameters and the proliferative capacity of UCB progenitor cells from premature and full-term neonates. MATERIAL AND METHODS: Clonogenic assays were performed with methylcellulose, medium supplemented with recombinant stimulating growth factors and the colonies were scored on the seventh day and the 14th day of culture. A cell cycle study was carried out by DNA analysis using flow cytometry and 30 000 events were acquired; p107 and p130 expressions were analysed by Western blotting. RESULTS: Cultures obtained from UCB of premature neonates showed an early growth of colony-forming unit (CFU)-burst forming unit erythroid/CFU-granulocyte, erythrocyte, macrophage and megakaryocyte (BFU-E/GEMM), and CFU-granulocyte, macrophage (GM) by the seventh day of culture (P < 0.001). Therefore, the number and morphological characteristics of these colonies were comparable with those obtained from full-term neonates, on the 14th day of culture. At the 14th day, a large amount of CFU-GM was detected in the premature group (P < 0.0032). The premature culture on the 14th day showed fibroblasts and was comparable to those of full-term neonates on the 21st day in terms of number and morphology of the colonies. DNA analysis showed that the number of cells in S-phase was also higher in premature samples when compared to full-term neonates, P < 0.0021 (0 h = 12.8 vs. 2.5%; 16 h = 10.5 vs. 5.9%; 20 h = 13.5 vs. 10.3%; 24 h = 13.8 vs. 9.1%; 48 h = 14.0 vs. 5.4%; 72 h = 20.5 vs. 8.9%; 96 h = 13.8 vs. 7.7%). The Western blotting results demonstrated that p107 and p130 cell cycle protein expressions were higher in premature cells than in full-term cells. CONCLUSION: These results suggest that the higher capacity of proliferation and early differentiation of premature UCB might not be related only to the amount of stem/progenitor cells but also to a different timing of cell cycle entry.     

Allogeneic cord blood red blood cells: assessing cord blood unit fractionation and validation

BackgroundFor neonates and preterm infants, in whom a transfusion dose is low, the use of red blood cells (RBC) from cord blood appears to be feasible. Standardisation of fractionation and identification and assessment of quality control parameters for such RBC are still lacking.Materials and methodsWe describe the process used to obtain RBC from cord blood for transfusion purposes, including quality controls to evaluate fractionation performance and the effects of storage. The cord RBC, to which SAG-M was added, were sampled on the day of fractionation, and 7 and 14 days (end of storage) later in order to measure the complete blood count, biochemical parameters and residual white blood cells. We also assessed microbial contamination.ResultsData relative to 279 cord blood units were evaluated. The median gestational age at collection was 40 weeks (interquartile range [IQR] 39.1–40.7) and the median volume was 90 mL (IQR 81–103). Units were subjected to automated fractionation with Compomat, and packed RBC were suspended in SAG-M solution. The median volume of the SAG-M-suspended units was 31 mL (IQR 24.0–38.1) and the median haematocrit was 54.2% (IQR 49.4–59.5). The median volume after leukoreduction was 22 mL (IQR 17–28), with the volume decrease being similar in units leukoreduced before (n=75) or after (n=204) storage. The haematocrit of leukoreduced units was higher than that of buffy coat-depleted units. Storage at 2–6 °C for 14 days was accompanied by an increase of potassium levels and percentage of haemolysis. Microbial cultures were positive for 2.9% of the collected units.DiscussionFractionation of whole cord blood can provide RBC concentrates with similar baseline characteristics as units from adults. The transfusion dose and quality of the units appear safe and suitable for clinical use in neonates, with a satisfactory haematocrit and residual white blood cell content, despite a very variable collection volume.     

Mid-trimester fetal blood-derived adherent cells share characteristics similar to mesenchymal stem cells but full-term umbilical cord blood does not

Stem cell transplantation is a promising treatment for many conditions. Although stem cells can be isolated from many tissues, blood is the ideal source of these cells due to the ease of collection. Mesenchymal stem cells (MSCs) have been paid increased attention because of their powerful proliferation and pluripotent differentiating ability. But whether MSCs reside in blood (newborn umbilical cord blood and fetal or adult peripheral blood) is also debatable. The present study showed that MSC-like cells could be isolated and expanded from 16-26 weeks fetal blood but were not acquired efficiently from full-term infants' umbilical cord blood (UCB). Adherent cells separated from postnatal UCB were heterogeneous in cell morphology. Their proliferation capacity was limited and they were mainly CD45+, which indicated their haematopoietic derivation. On the contrary, MSC-like cells shared a similar phenotype to bone marrow MSCs. They were CD34- CD45- CD44+ CD71+ CD90+ CD105+. They could be induced to differentiate into osteogenic, adipogenic and neural lineage cells. Single cell clones also showed similar phenotype and differentiation ability. Our results suggest that early fetal blood is rich in MSCs but term UCB is not.     

山东地区新生儿脐血HLA-A、HLA-B等位基因多态性研究

目的研究山东地区新生儿脐血人类白细胞抗原（HLA—A、HLA—B）等位基因的分布特征．探讨国人用山东脐血供者进行造血干细胞移植的可能性。方法应用PCR—SS0方法对山东地区5844例无血缘关系的汉族健康新生儿脐血进行HLA—A、HLA—B等位基因分布调查。结果检出20种HLA—A等位基因,频率较高的为A＊02（0．3041）、A＊11（0．1443）、A＊24（0．1434）、A＊30（0．0975）和A＊33（0．0859）,较低的为A＊34（0．0006）、A＊25（0．0005）、A＊66（0．0005）、A＊74（0．0004）和A＊36（0．0001）。检出46种HLA—B等位基因．频率较高的为B＊13（0．1348）、B＊51（0．0713）、B＊62（0．0712）、B＊61（0．0676）和B＊60（0．0642）,较低的为B＊77（0．0001）．B＊76（0．0002）．B＊47（0．0003）,B＊42（0．0003）和B＊72（0．0004）。结论山东新生儿脐血HLAI类基因具有多态性,能代表山东汉族人群HLA的分布特征,反映北方汉族HLA的分布规律;国人（尤其是北方汉族人）在山东脐血库中最容易找到HLAI类等位基因相合的异基因脐血供者。     

Age‐related changes in blood pressure and heart rates of patients with Parkinson's disease

This study evaluated yearly changes in systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rates (HR) for patients with Parkinson's disease (PD). Data were collected for the last 10 years from medical records of 28 PD patients and 30 non‐PD patients with other neurological disorders. Age‐related changes in each group were analyzed by year using mean values of SBP, DBP, and HR obtained at their bi‐monthly visits. In results, PD patients had a gradual decrease in SBP with longer disease duration, and mean SBP significantly decreased from Year 7–11 compared to the mean values for Year 1 (p < .001 or p < .01). In non‐PD patients, mean SBP significantly increased from Year 4–11 compared to the mean values for Year 1 (p < .001 or p < .01). This is the first study to report age‐related changes of BP in individual patients with PD over 10 years.     

饮食组成与血脂、脂质过氧化物和冠心病关系的比较研究

目的 :探讨饮食结构与血脂、脂质过氧化物和冠心病的关系。方法 :以 6 5名经理和 6 7名一般工人为研究对象 ,进行膳食和饮食生活行为调查。结果 :经理组人均每日热能和蛋白质摄入量达到我国营养学会建议的每日摄入量的 111%和 145% ,脂肪占热能的 38.7% ,动物性食物平均每日 350克以上 ,谷类食物及蔬菜水果摄入量较少 ,而工人组基本保持了我国传统膳食模式。经理组血清 TC、TG、L DL- C和 L PO水平明显高于工人组 (P<0 .0 0 1,0 .0 1,0 .0 5,0 .0 0 1) ,而 HDL- C明显低于工人组 (P<0 .0 1)。经多元逐步回归分析 ,饮食中脂肪的摄入量和热能比与 TC、TG、LDL- C和 LPO呈明显正相关 ;脂肪、动物性食物与 HDL- C,谷类食物与 TC、TG、LDL- C和 L PO呈负相关。结论 :长期食用脂肪过多 ,谷类食物和蔬菜水果比重过低的饮食 ,能促使血脂升高 ,脂质过氧化作用增强 ,发生冠心病的危险性增加     

Allogeneic cord blood transfusions prevent fetal haemoglobin depletion in preterm neonates. Results of the CB-TrIP study

Repeated red blood cell (RBC) transfusions in preterm neonates are associated with poor outcome and increased risk for prematurity-associated diseases. RBC transfusions cause the progressive replacement of fetal haemoglobin (HbF) by adult haemoglobin (HbA). We monitored HbF levels in 25 preterm neonates until 36 weeks of post-menstrual age (PMA); patients received RBC units from allogeneic cord blood (cord-RBCs) or from adult donors (adult-RBCs), depending on whether cord-RBCs were available. Primary outcome was HbF level at PMA of 32 weeks. Twenty-three neonates survived until this age: 14 received no transfusions, two only cord-RBCs, three only adult-RBCs and four both RBC types. HbF levels in neonates transfused with cord-RBCs were significantly higher than in neonates receiving adult-RBCs (P < 0·0001) or both RBC types (P < 0·0001). Superimposable results were obtained at PMA of 36 weeks. Every adult-RBCs transfusion increased the risk for an HbF in the lowest quartile by about 10-fold, whereas this effect was not evident if combined adult- and cord-RBCs were evaluated. Overall, these data show that transfusing cord-RBCs can limit the HbF depletion caused by conventional RBC transfusions. Transfusing cord blood warrants investigation in randomised trials as a strategy to mitigate the severity of retinopathy of prematurity (NCT03764813).     

Barriers and motivators to blood and cord blood donations in young African-American women

The primary aim of this study was to assess potential barriers and motivators to blood and cord blood donation among African-American women. A telephone survey of African-American women, ages 18-30 years, in the St. Louis metropolitan area was performed. The survey was administered by trained telemarketing personnel using a Computer-Assisted Direct Interview (CADI) system. One hundred sixty-two women were surveyed. Common barriers to blood donation were inconvenience of donor sites (19%), fear of needles (16%), and too much time required to donate (15%). Potential motivators were increasing awareness of need for blood (43%), increasing the number of convenient donor locations (19%), and encouragement by spiritual leaders to have blood drives at their church (17%). Lack of awareness was the only identified barrier to cord blood donation. Most women surveyed (88%) indicated that they definitely or probably would donate cord blood. Strategies to increase the proportion of African-American blood and cord blood donations may include educating potential donors about the process and benefits of donation to particular patient populations and engaging church leadership in supporting blood and cord blood donations.     

Westernized food habits and concentrations of serum lipids in the Japanese

To investigate the association of westernized food habits and concentrations of serum lipids in the Japanese, we studied 1200 healthy Japanese living in Hiroshima prefecture and 1483 ethnic Japanese from Hiroshima prefecture living in the Hawaii Islands and Los Angeles. The nutritional assessments were made by the same dietitians. No major difference was observed in the total energy intake between the Japanese and the Japanese-Americans in both males and females. However, the intake of animal fat and simple carbohydrates (especially fructose) were markedly greater, and that of complex carbohydrates lower, in the Japanese-Americans compared with the Japanese. The mean serum cholesterol (CH), LDL-CH and serum triglyceride (TG) levels were significantly higher in the Japanese-Americans in both sexes. The mean HDL-CH concentration was similar between the two groups in males, but it was approximately 7 mg/dl higher in Japanese-American females. Using the 75 percentile values of CH and TG in the Japanese in Hiroshima, the frequency of WHO types IIa and IIb hyperlipidemia was about twice as high in the Japanese-Americans. These results suggest that westernized food habits in the Japanese include qualitative changes in animal fat, simple carbohydrate and complex carbohydrate diet rather than an increase in the total energy intake. These changes are associated with marked increases in the concentrations of serum CH and TG and increased prevalence of types IIa and IIb hyperlipidemia.     

Thrombopoietin levels in cord blood plasma and amniotic fluid in fetuses with alloimmune thrombocytopenia and healthy controls

To extend our knowledge of the kinetics of fetal thrombopoietin (TPO), we studied TPO levels in cord blood plasma and amniotic fluid collected from 15 fetuses considered to be at risk of fetomaternal alloimmune thrombocytopenia and also from 10 healthy controls at caesarean delivery. In the plasma of all 25 fetuses and newborn infants studied, TPO was detected above the lower limit of detection (7 pg/ml) and correlated inversely with platelet counts (r = -0.53, P = 0.006). At term, TPO detected in amniotic fluid was at significantly lower levels (7 pg/ml; range 0-22 pg/ml) than simultaneously obtained cord plasma TPO (114 pg/ml; range 43-201 pg/ml; P < 0.001). There was no correlation between levels of TPO in amniotic fluid and cord plasma or platelet counts. In the serial samples collected from the five fetuses with HPA-1a alloimmunization before 37 weeks' gestation, the TPO levels in amniotic fluid were significantly higher than at term (P = 0.013): from 22 to 28 weeks' gestation, 42 pg/ml (30-78 pg/ml); from 32 weeks', 24 pg/ml (17-33 pg/ml); at term, 8 pg/ml (4-13 pg/ml), correlating inversely with gestational age (r = -0.81, P = 0.003). Thus, TPO is present in amniotic fluid at levels apparently inversely related to gestational age. Whether these high levels seen early in pregnancy are normal or are associated with the HPA-1 alloimmunization remains to be shown.