新生儿微量血胆红素动态监测

目的应用微量胆红素测定仪动态监测新生儿胆红素,确定胆红素的标准范围,以及时治疗生理性黄胆,防止病理性黄胆对新生儿的损害.方法采取新生儿足母趾微量血20微升,在微量胆红素测定仪上测定胆红素,读取结果.结果新生儿胆红素峰值出现在4～6d,正常范围:足月新生儿胆红素24h<6mg/dl,48h<10mg/dl,3～7d<15mg/dl,7d后下降.结论应用微量胆红素测定仪监测新生儿胆红素,结果准确、可靠,能及时反映新生儿血中胆红素的变化,对生理性黄胆超出一定范围给予适时治疗提供重要依据.     

新生儿高胆红素血症蓝光治疗的观察护理

新生儿高胆红素血症采取正确的治疗手段和相应的有效护理措施,能及时有效地降低血清未结合胆红素,减少胆红素性脑病的发生,促进患儿早日康复.     

新生儿高胆红素血症患儿血β2微球蛋白变化及临床意义

目的探讨血β2微球蛋白在新生儿高胆红素血症患儿血中的变化及临床诊疗意义。方法对临床确诊的48例新生儿高胆红素血症患儿进行血β2微球蛋白含量测定,并与正常新生儿进行对比分析。结果新生儿高胆红素血症患儿血β2微球蛋白含量明显增高,且新生儿高胆红素血症患儿血胆红素水平越高,血β2微球蛋白含量亦明显增高,胆红素水平的高低与血β2微球蛋白含量呈明显正相关。结论血β2微球蛋白在新生儿高胆红素血症时明显升高,且与胆红素水平呈正相关,提示临床在治疗新生儿高胆红素血症患儿的同时,应加强肾脏的保护治疗。     

颅脑MRI与脑脊液总胆红素诊断新生儿胆红素脑病的临床分析

目的探讨颅脑MRI与脑脊液总胆红素诊断新生儿胆红素脑病的效果。方法选择48例胆红素脑病新生儿为研究组,48例高胆红素血症新生儿为对照组。观察对比两组新生儿的脑脊液胆红素水平、颅脑MRI信号的改变。结果研究组新生儿脑脊液胆红素水平高于对照组(P 0. 05)。研究组新生儿颅脑T1WI苍白球对称性信号的发生率明显高于对照组(P 0. 05),正常信号低于对照组(P 0. 05)。结论颅脑MRI与脑脊液总胆红素均是诊断新生儿胆红素脑病的可靠手段,其中颅脑MRI具有高清、快速、分辨率高等优势,而T1WI苍白球对称高信号是胆红素脑病新生儿的重要征象,为疾病早期诊断提供了可靠的依据。     

喂养方式与新生儿高胆红素血症的关系

将229例足月健康新生儿(Apgar评分8～10分)按照喂养的方式分为母婴同室和混合喂养两组,观察在两种喂养方式下高胆红素血症的发病率和血清胆红素的水平。结果表明,两组新生儿的高胆红素血症发病率没有显著性差异,母婴同室的高胆红素血症发病率并没有高于混合喂养组,但母婴同室组的血清胆红素水平却明显低于混合组(P<0.02)。尤其在不明原因黄疸的新生儿中,两种喂养方式下的血清胆红素水平有非常显著的差异(P<0.001)。喂养方式在ABO血型不合、G-6-PD缺陷、母HBsAg阳性等因素组的新生儿高胆红素血症的发病率和血清胆红素水平中影响不大。母婴同室可降低新生儿血清胆红素水平,提高新生儿的机体状态。     

神经元特异性烯醇化酶测定对新生儿高未结合胆红素血症的价值

目的　探讨血清神经元特异性烯醇化酶 (NSE)作为诊断新生儿高未结合胆红素血症合并脑组织损害的应用价值。方法　利用静脉血测定了 35例高未结合胆红素血症新生儿和 31例正常新生儿血清NSE水平。结果　高未结合胆红素患儿血清NSE水平明显高于正常对照组 (P <0 0 1) ,与总胆红素水平相关性差。结论　新生儿血清NSE水平升高与高未结合胆红素血症造成的脑细胞损害有关 ,可作为临床监测高未结合胆红素血症新生儿胆红素脑病的一个筛选指标 ,值的推广应用。     

早期服用清肝利胆口服液对围产期因素导致新生儿高胆红素血症的影响

目的对于围产期因素导致的高胆红素血症新生儿,早期给予清肝利胆口服液,检测其胆红素指数的变化,观察早期服用清肝利胆口服液对围产期因素导致的新生儿高胆红素血症的影响.方法对围产期因素导致胆红素升高的新生儿,随机分为两组:给药组与对照组.在其发生黄疸的初期(即新生儿胆红素指数达到10mg/dl)时,开始给药(3ml/次,日两次).用药 3天后,比较两组胆红素指数的变化.结果给药组胆红素水平与对照组相比明显下降(P＜0.01).结论在新生儿黄疸的高危期早期给予清肝利胆口服液,可以有效地预防新生儿高胆红素血症发生.     

检测PCT对新生儿高胆红素血症的病因分析和早期诊断的价值

目的探讨血清降钙素原（PCT）在新生儿高胆红素血症时的病因分析和早期诊断的价值,为新生儿高胆红素血症的治疗提供理论指导。方法将158例我院2008年10月～2010年4月新生儿高胆红素血症病例分为感染组和非感染组,检测血清PCT进行回顾性分析。结果在新生儿新生儿高胆红素血症疾病中,由感染引起的新生儿高胆红素血症88.2%患者血清PCT升高。新生儿重症感染引起的新生儿高胆红素血症有发病急、进展快,临床表现不特异等特点,且因新生儿个体差异大,如日龄,胎龄,免疫力及基础疾病不同,临床表现差异较大,因而早期诊断较困难,特别是新生儿败血症的诊断,血培养结果时间较长,且阳性率不高。降钙素原（PCT）是一种降钙素前肽,有报道显示,PCT的升高与细菌感染密切相关。本研究探讨PCT在新生儿高胆红素血症的病因分析和早期诊断的价值。     

新生儿非结合性高胆红素血症遗传学特征及病因相关因素分析研究

目的探讨新生儿非结合性高胆红素血症遗传学特征及病因相关因素。方法 (1)选择2015年12月-2017年12月入院治疗的新生儿非结合性高胆红素血症患者55例,设为观察组;选择同期分娩的正常新生儿55例,设为观察组。对观察组采用突变特异性扩增系统(ARMS)法检测新生儿G6PD基因突变情况及类型,分析新生儿非结合性高胆红素血症的遗传学特征;(2)进行单因素及多因素Logistic回归分析,分析新生儿非结核性高胆红素血症病因相关因素。结果对入组的110例新生儿非结核性高胆红素均完成遗传学检查,PCR结果表明:对于G1338A突变者能扩增出361bp特异性电泳带;对于G1376T突变者则可以扩增出345bp特异性电泳带。对于阴性对照组中经右601bp部位存在对照泳带。观察组55例新生儿中1388突变51例,1376突变4例;单因素结果表明:新生儿非结合性高胆红素血症发生率与性别、体重、宫内窘迫、遗传代谢病及ABO溶血发生率无统计学意义(P0.05);新生儿非结合性高胆红素血症发生率与早产、感染、头皮血肿、围产窒息关系密切(P0.05);多因素Logistic回归分析结果表明:新生儿非结合性高胆红素血症发生率与早产、感染、头皮血肿、围产窒息关系密切(P0.05)。结论新生儿非结合性高胆红素血症患儿常伴有G1388A、G1376T位基因突变的主要类型,并且病因相关因素较多,临床上应根据病因相关因素制定有效的措施进行干预,降低疾病发生率。     

高胆红素血症足月新生儿血清S100BB蛋白的变化及意义

目的分析高胆红素血症新生儿血清S100BB蛋白和新生儿行为神经测定(NeonatalBehavioralNeurologicalAssessment,NBNA)的变化及两者的相关性,探讨高胆红素血症新生儿血清S100BB蛋白的变化及临床意义。方法运用酶联免疫吸附测定法检测42例高胆红素血症新生儿和29例正常新生儿血清中S100BB蛋白浓度,同步测定血清总胆红素(TSB)、白蛋白含量,计算胆红素-白蛋白比值(B/A),并行新生儿NBNA评分。高胆组按TSB≥342μmol/L和171～342μmol/L分为实验组a和实验组b。对照组TSB<85.5μmol/L。结果①两实验组血清S100BB蛋白浓度较对照组均显著升高(P<0.01),两实验组间S100BB蛋白浓度无显著差异(P>0.05)。②两实验组NBNA评分值均明显低于对照组(P<0.01)。两实验组间无显著差异(P>0.05)。③血清S100BB蛋白浓度与NBNA评分显著性负相关(P<0.01)。结论血清S100BB蛋白比TSB、B/A值能更早期预测新生儿胆红素脑病患病风险。     

人窦房结的神经发育

本文用14例不同发育阶段的胚胎,以及新生儿与成人各2例的窦房结,以Faworsky法银染,光镜观察。8周胚在腔房交界处的前内侧,出现局限性增厚,该区致密,细胞较小,尚未包绕窦房结动脉;至12周时,该区称为窦房结,已见少量纤细的神经纤维。16～22周胚胎的窦房结切面呈椭圆形,窦房结动脉位于中央,已能分出三个区。中央网状区内,神经节与神经纤维丰富,心外膜下神经节较少。神经细胞为多极神经元,胞体大小不一,核质比例为幼稚形细胞状态。24～32周的胚胎心外膜下神经节数量逐渐增多,可以分出深、浅两组;结内神经节则逐渐减少。此阶段结外节已多于结内节。38周胚胎与新生儿的窦房结神经配布,与24～32周胚胎阶段相似,只是更趋于成熟,接近成年人窦房结的神经分布特点。     

Die Aktivierung der Sulfonamidelimination bei reifen und unreifen Neugeborenen durch Complamin ®

Zusammenfassung Bei reifen und unreifen Neugeborenen wurde am Beispiel des Sulfasomidins die Beeinflussung der Elimination von Sulfonamiden durch Complamin untersucht.Nach dreitägiger Complamingabe verringerte sich die Eliminationshalbwertszeit um 27,5% (Mittelwert von 23 Kindern). Bei einer Kontrollgruppe von 13 Kindern zeigte sich dagegen keine Veränderung.Complamin führt also bei Neugeborenen zu einer Aktivierung der Sulfonamidelimination, die in dieser Altersgruppe normalerweise verlangsamt ist.

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Summary In mature and premature new borns the influence of Complamin on the elimination of sulfonamides was investigated in the example of Sulfasomidin.After 3 days application of Complamin the elimination half time was 27,5% shorter than initially (average of 23 children). A controll group (13 children) showed no alteration. Complamin in new borns induced an activation of sulfonamid elimination, which is normally retarded in this age.

     

16383例围产儿出生缺陷调查报告及干预措施研究

回顾性调查了开封市区医院1997年元月～2001年12月5年间住院分娩围产儿出生缺陷发生情况，结果发现，5年间出生缺陷平均发生率10．62‰，前5位顺住依次是：中枢神经系统，颌面五官系统，消化系统，心血管系统，骨骼肌肉系统。出生缺陷的发生与出生季节、围产儿性别、产母居住地没有关系，而与孕母年龄关系很大，35岁以上孕妇出生缺陷发生率大大增加。加强宣传和普及优生科学知识，积极开展优生技术和方法，开展产前筛查和产前诊断技术，提高人口素质，降低出生缺陷发生率。     

Prevalence of serologic markers of the hepatitis B virus in pregnant women of Bamako, Mali

A prospective study of the serological markers of hepatitis B virus (HBV) including hepatitis B virus surface antigen (HBsAg) and hepatitis B surface antibody (anti HBs) was conducted over 5 years in Bamako. The aims of this study were to assess the prevalence of HBsAg in pregnant women and to determine the risk of HBV infection for this population. The study involved 829 pregnant women for whom blood samples were collected after the first quarter of pregnancy. HBsAg and anti HBs were detected in all cases by radioimmunoassay. The prevalence of HBsAg and anti HBs in pregnant women was respectively 15.5% and 16.9%. This prevalence of HBsAg, higher than in the general population, points to the fact that pregnant women are a high risk group for hepatitis B infection. In addition, scarification and tattooing practices increase significantly the risk of infection by hepatitis B virus (OR = 2.03; 1.07 < OR < 3.82; chi 2 = 5.62; p: 1%). Thus, we can presumably conclude that infants and new borns in such conditions are largely exposed to hepatitis B virus infection, even though hepatitis B core antibody and hepatitis B e antigen were not investigated for technical reasons. In conclusion, the authors believe that infants and new borns must be systematically immunised against hepatitis B virus infection in Bamako.     

Malaria in Gabon. Transplacental passage and dynamics of development of fluorescent antimalarial antibodies with age

In permanent malaria transmission area (Gabon), fluorescent malarial antibodies have been studied among a population of mothers new borns and children from 1 to 15 years old. A lack of transplacental transfer of antibodies among african pairs "cord-mother" is noticed and in negative correlation with total mother IgG level. The antibodies rapidly increase from 1-2 years old still 9. Chimioprophylaxis does'nt modified for a long time the development of the FAT malarial antibodies.     

The influence of the muscles of facial expression on the development of the midface and the nose in cleft lip and palate patients. A reflection of functional anatomy, facial esthetics and physiology of the nose.

The further improvement of well-established techniques in primary and secondary cleft surgery requires a detailed and interdisciplinary knowledge and observation of anatomical, functional and developmental problems. An investigation into the macroscopic and microscopic anatomy of the perinasal and perioral muscles and parts of the human nasal septum, as well as into the pathomorphology of ancient skulls with untreated clefts is presented. On this basis an interpretation of clinical findings in untreated newborns compared with surgically treated CLP-patients has been undertaken. The 3D-CT, superimposing photography and coloured experimental settings of nasal airflow complete the visualisation of the anatomical and functional findings.     

藏医与现代解剖学对骨数目的统计差异的分析

根据传统藏医论著,把颅骨、躯干骨、四肢骨三部分与现代解剖学进行了分析对比,按藏医理论,人体有３６０块骨,与现代医学的统计相差１５４块。其主要差异在椎骨、胸骨、肋软骨、牙和指、趾甲、造成差异的主要原因：一是藏医骨的概念与现代医学有不同之处,二是对某些骨,藏医是从形态上计数的;三是藏对某些骨从新生儿及胚胎发生学进行计数。     

Stellate cells differentiate successively in the cat sensorimotor cortex during early postnatal ontogeny

Golgi and Golgi-Kopsch techniques were used to investigate maturation of stellate and pyramidal cells and development of stellate-pyramidal connections in kittens of the following ages: 2, 7, 14, 21, 28 and 34 days. By two weeks, stellate cells in layer V have become mature. Layer III stellate cells with vertical axon ramifications are differentiated by 2–3 weeks of life and in 3-week-olds the horizontal spread of axon collaterals amounts to 1300 μm. Layer II stellate cells which are poorly developed in newborns acquire the greatest number of collaterals and a complex axon branching pattern by 4 weeks of age.     

Iron hydroxide polymaltose--cause of persistent iron deficiency anemia at delivery

Ironhydroxide polymaltose (IPC) preparations were used to treat four pregnant women with iron deficiency anemia. Despite patient compliance for sufficient length of time, hemoglobin failed to rise. By the time this was noticed, pregnancy was well advanced and delivery was only few weeks away. Patients were switched over to ferrous fumarate/succinate/parenteral iron. Although hemoglobin increased, women were still iron deficient at the time of delivery. Besides exposing women to hazards of iron deficiency at the time of delivery, their new borns are exposed to the risks intrauterine growth retardation and its consequences in childhood and later life. It would be advisable to avoid the use IPC preparations in patients with iron deficiency anemia, especially pregnant women.     

Genetic epidemiology of cystic fibrosis in Saguenay-Lac-St-Jean (Quebec, Canada)

Cystic fibrosis (CF) is an autosomal recessive disorder with a prevalence at birth estimated at 1/2000-1/2500 livebirths in Caucasian populations. Some 127 CF individuals are known in Saguenay-Lac-St-Jean (SLSJ), a geographically isolated region of Quebec. The prevalence at birth was estimated at 1/902 live borns, and the carrier rate was estimated at 1/15 inhabitants in the SLSJ region. The mean inbreeding coefficient was only slightly elevated in the CF group compared with three control groups, and was due to remote consanguinity. The mean kinship coefficient was 2.4 times higher in the CF group than in the control groups. In SLSJ region, the places of origin of the CF individuals and their parents did not show a clustered nonuniform distribution. Endogamy was not higher in the CF group than in control groups.