Ⅱ型排卵障碍女性使用克罗米芬或来曲唑诱导排卵的AID临床结局及妊娠结局比较

目的 比较Ⅱ型排卵障碍女性使用克罗米芬(CC)方案或来曲唑(LE)方案诱导排卵后供精人工授精(AID)周期的临床结局和妊娠结局.方法 回顾性分析2012年1月至2019年8月578名Ⅱ型排卵障碍妇女在我中心完成的1 253个AID周期的超声监测数据及临床资料.比较单用CC或LE或联合促性腺激素(Gn)诱导排卵的AID周...     

无创检测技术在新生儿血红蛋白检测中的应用

目的 探讨采用Masimo Radical-7脉搏血氧仪检测新生儿无创血红蛋白浓度的准确性,并探讨无创血红蛋白检测技术在新生儿病房中的应用。 方法 选取包钢集团第三职工医院新生儿病房2015年5~10月收治新生儿,在静脉血常规检测血红蛋白数值(tHb)的基础上于采血前采用Masimo Radical-7脉搏血氧仪检测新生儿无创血红蛋白浓度(SpHb)值,将收集的157对有创静脉血tHb与无创SpHb数据进行相关性及一致性的分析。 结果(1)tHb和SpHb测定结果分别为(137.36 ± 20.80) g·L-1和(136.68 ± 21.35) g·L-1,n=157,t=0.758,P=0.449,差异无统计学意义。(2)pearson相关性分析结果显示tHb与SpHb具有较好的相关性(r=0.858,P<0.001)。(3)Bland-Altman研究显示95％一致性的上下限(-21.4~22.8) g·L-1,其中有6个点(3.82％)在95％一致性界限外,151个点(96.18％)位于95％一致性界限内。 结论 采用Masimo Radical-7脉搏血氧仪检测新生儿无创血红蛋白浓度与有创采集的静脉血常规中血红蛋白浓度之间具有较好的相关性和一致性,对于诊断贫血具有良好的应用价值。     

机械通气治疗新生儿呼吸衰竭36例临床观察

目的：观察探讨不同方式的机械通气治疗新生儿呼吸衰竭的临床效果.方法：选取我院36例诊断为呼吸衰竭的新生儿,随机分为观察组和对照组,各18例,观察组采用高频震荡通气（HFOV）,对照组采用常规机械通气（CMV）,观察对比两组治疗效果.结果：观察组总有效率为88.9%;对照组总有效率为61.1%,两组疗效对比差异显著（P＜0.01）.结论：高频震荡通气（HFOV）治疗新生儿呼吸衰竭的临床效果显著,明显优于常规机械通气（CMV）,能迅速升高Pa（O2）,纠正低氧血症,并发症少,安全性更高.     

窒息新生鼠心肌线粒体膜通透性转换孔开放度的变化

目的 观察新生鼠窒息后心肌组织缺血损伤情况以及心肌细胞线粒体膜通透性转换孔(mitochondrial permeability transition pore,MPTP)开放度的变化,以期揭示MPTP开放在窒息后心肌缺氧缺血及再灌注损伤的作用机制.方法 成年SD母鼠妊娠第21天行剖宫产,随机分为正常分娩组及动脉夹闭组,正常分娩组不夹闭子宫动脉,所分娩新生鼠为对照组;以夹闭动脉夹闭组孕鼠子宫动脉方法制作宫内窒息新生大鼠模型,为窒息组,每组各30只,于出生24 h处死新生鼠.以ELISA法检测血清心肌肌钙蛋白Ⅰ(cardiac troponin Ⅰ,cTn Ⅰ),以荧光分光光度法检测MPTP开放度;以TTC染色法检测心肌缺血面积;以HE染色法观察心肌细胞形态变化.结果 HE染色观察发现,窒息组心肌细胞排列紊乱、细胞肿胀、部分细胞溶解.对照组、窒息组新生鼠血清cTn Ⅰ分别为(0.08 ±0.04) μg/L、(0.40±0.29) μg/L,窒息组明显升高,差异有统计学意义(P＜0.01).对照组、窒息组新生鼠TTC染色心肌缺血面积分别为(8.01±3.48)％、(42.50±15.90)％(P ＜0.01).窒息组出现心肌点状坏死,缺血面积增大.对照组、窒息组新生鼠MPTP相对荧光单位分别为118.10±19.10、79.40±10.57 (P＜0.01),窒息组心肌MPTP开放度增大.各组新生大鼠血清cTn Ⅰ值与MPTP开放度呈正相关(r=-0.384,P＜0.01).结论 窒息新生大鼠出现心肌损伤,表现为血清cTn Ⅰ升高、心肌缺血及坏死.窒息后心肌MPTP开放度增大是导致心肌损伤的重要原因.     

Hearing impairment and hypoxia ischaemic encephalopathy: Incidence and associated factors

Objective

To establish the local incidence of hearing loss in newborns with Hypoxic Ischaemic Encephalopathy (HIE) and to identify associated risk factors.

人类细小病毒B19感染与新生儿高间接胆红素血症

目的探讨人类细小病毒B19(HPVB19)感染与新生儿高间接胆红素血症(新生儿高胆)发生的关系.方法对136例新生儿高胆及123例正常新生儿用聚合酶链反应技术进行血液HPVB19-DNA的检测.结果 136例新生儿高胆的患儿HPVB19-DNA阳性者48例,阳性率35.3%,123例正常新生儿HPVB19-DNA阳性者12例,阳性率9.8%,两组之间阳性率比较有非常显著性差异(χ\+2=23.7,P＜0.005).结论新生儿高胆的发生与HPVB19感染有关.     

窒息新生儿胆囊排空功能的研究

观察窒息对新生儿胆囊排空功能的影响。方法用B超检测窒息新生儿107例及正常对照组 新生儿219例胆囊排空前后胆囊的长径、直径,计算出胆囊排空前后最大纵断面积近似值(长径×直径)的均 数、各指标胆囊排空前后差值及胆囊排空率;并用统计学方法比较以上各指标。结果窒息组的各差值及胆囊 排空率均小于正常对照组,而最大纵断面积近似值却大于正常对照组(P均＜0.01)。结论窒息可使新生儿 胆囊排空功能明显减弱,使新生儿胆囊扩张。     

高压氧治疗促进HIBD新生大鼠内源性神经干细胞的迁移与分化

目的：该研究探讨了高压氧（HBO）对缺氧缺血性脑损伤（HIBD） 新生大鼠内源性神经干细胞（NSCs）的迁移与分化的影响。方法：7 日龄 Sprague-Dawley 新生大鼠随机分为对照组,模型组及HBO组。采用 Rice-Vannucci 方法制成 HIBD 模型。造模后 3 h 内行HBO 治疗。分别于 HBO治疗后 7 d、14 d、 28 d,采用 BrdU/DCX,BrdU/β-tubulin,BrdU/GFAP和BrdU/O4免疫荧光双标法,用共聚焦显微镜动态检测侧脑室室管膜下区（subventricular zone, SVZ）与大脑皮层内源性 NSCs的迁移与分化。结果：治疗后7 d,HBO 组损伤侧SVZ 区 BrdU+DCX+细胞数（84±21 个/mm2）增加,多于对照组（39±14 个/mm2）与模型组（68±17 个/mm2）（P<0.05）;治疗后14 d,SVZ区BrdU+DCX+ 细胞数减少,而皮层区BrdU+DCX+ 细胞数增加,HBO组明显多于对照组(P<0.01）;治疗后28 d,各组大脑皮层BrdU+DCX+ 细胞数减少,大脑皮层出现BrdU+β-tubulin+,BrdU+GFAP+,BrdU+O4+细胞。HBO组BrdU+β-tubulin+与BrdU+O4+细胞数显著高于对照组与模型组（P<0.05）。结论：高压氧可促进 HIBD 新生大鼠内源性NSCs迁移到大脑皮层并分化为成熟的神经细胞。［中国当代儿科杂志,2009,11（9）：749-752］     

An experimental model of neonatal normocapnic hypoxia and resuscitation in Landrace/Large White piglets

Objective: The aim of this study is to describe and evaluate an experimental model of neonatal normocapnic hypoxia and resuscitation. Methods: Ten male Landrace/Large White neonatal piglets were studied. Following anaesthesia and intubation, the animals were mechanically ventilated. Surgical procedures included catheterization of the right internal jugular vein and the carotid artery. After stabilization with 21% O₂, normocapnic hypoxia was induced by decreasing the inspired O₂ to 6–8%. When piglets developed bradycardia (heart rate < 60 beats/min), reoxygenation was initiated by administering 21% O₂. Arterial blood samples were taken during baseline, hypoxia and reoxygenation in order to measure interleukine-6 and interleukine-8. Results: Nine out of ten animals were successfully resuscitated (one of these required chest compressions and a dose of adrenaline) and one died despite resuscitation efforts. After returning to baseline haemodynamic values, euthanasia was performed using thiopental overdose. Conclusions: Haemodynamic fluctuations at baseline, during normocapnic hypoxia and reoxygenation in Landrace/Large White piglets are comparable to that in human neonates, making the breed a favorable model of human neonatal hypoxia investigation.     

Neonatal outcome in discordant eutrophic twins: twin growth.

OBJECTIVE: To compare maternal characteristics and neonatal outcome in discordant twin gestations (DT) and concordant twin gestation (CT). METHOD: Maternal and neonatal data base of live twins >25 weeks' gestation (N=351 pairs) were reviewed for antepartum complications, labor beginning, mode of delivery, neonatal complications, malformations and perinatal mortality. The chi-squared analysis and Student t-tests were used to analyze the differences between discordant and concordant premature and term twin pairs, and appropriate for gestational age (AGA) twins, separately. RESULTS: DT occurred in 15.1% of all twin pregnancies. In preterm and term DT there were significantly more elective cesareans. Growth discordance among preterm and term eutrophic twins was not connected with increased neonatal death or other complications, except higher incidence of early neurological signs in term DT. CONCLUSION: We strongly believed that prematurity and not discordant growth of eutrophic twins has important influence on neonatal outcome.