Melanotic Neuroectodermal Tumor of Infancy: the Use of Immunohistochemical Analysis

The Melanotic Neuroectodermal Tumor of Infancy (MNTI) is an asymptomatic, pigmented neoplasm characterized by a fast and locally aggressive growth along with a rare tissue formation. In the diagnostic process, the use of imaging exams can suggest a local destruction suggestive of malignancy, a sign of bone remodeling and expansion. Therefore, as any early diagnosis minimizes risks and improves the prognosis of treatment for the patient, the aim of this study was, based on a clinical case report, to corroborate the use of histopathological analysis associated with immunohistochemistry. Thus, we conclude that the immunohistochemical exam is of great importance for a better complementation of the MNTI diagnosis process. In addition, it can reveal signs of possible aggressive growth.     

TREX1基因变异致Aicardi-Goutières综合征1例报告

目的 总结TREX 1基因变异致Aicardi-Goutières综合征(AGS)的临床及基因特征.方法 回顾分析1例新生儿期起病的AGS综合征患儿的临床资料.结果 女性患儿于生后第2天起发热、喂养困难、呼吸困难;特殊面容,头型尖、头围小(30 cm)、眼距宽、眼裂窄、鼻梁低平、上唇短小、短下颌,四肢肌张力低,原始反射...     

动静脉同步换血换血量与胆红素水平关系的回归再分析

目的通过对加大样本量的线性回归分析,进一步研究适用于一般临床外周动静脉同步换血应用的反映换血量和总胆红素(TBIL)下降关系的回归方程。方法对75例采用外周动静脉同步换血疗法的高胆红素血症新生儿,按换血前TBIL数值高低依序分为5组,对每换血50 ml/kg进行TBIL值检测和回归分析,并对回归方程参数的95%置信区间进行分析和检验。结果 (1)每增加50 ml/kg换血量,TBIL累积换出率差异有非常显著意义(P0.01);经200 ml/kg换血后TBIL的累积换出率均值为61.5%。(2)换血过程中TBIL浓度(y)与换血量(x)呈线性相关(r值在0.96～0.98之间,P0.001)。(3)分组系列回归方程的斜率(a)与换血前TBIL浓度初始值(y0)也呈高度线性相关,其(r=0.99,P0.001)。(4)各组方程参数回归效果的方差分析检验结果均有非常显著统计学意义(P0.01)。(5)对换血回归方程参数适用区间95%置信度的检验结果有非常显著统计学意义(P0.001)。结论经分别对换血过程TBIL浓度值y与换血量x相关性依模型y=y0-ax以及对方程斜率参数a与换血前TBIL浓度初始值y0相关性依模型a=αy0+β进行的线性回归分析,可建立适用于临床指导换血用量的综合单自变量线性回归方程y=y0-ax=y0-(0.0035 y0-0.081)x。     

新生儿及婴儿发育性髋关节异常早期筛查及早期治疗的探讨

目的通过对新生儿及婴儿发育性髋关节异常的早期筛查,结合临床检查与超声检查诊断的评价,推动新生儿及婴儿发育性髋关节异常的早期诊治。方法对本院出生的1213例新生儿及866例年龄6个月以下婴儿进行临床及超声早期筛查（Graf方法）,以明确诊断,及时治疗。结果新生儿早期疑诊45例,最终确诊5例,婴儿确诊3例,经用Pavlik吊带治疗6例痊愈,1例6个月后行闭合复位石膏固定治疗。结论新生儿期超声检查髋关节不稳定率偏高（Graflla型髋）,发育性髋关节异常的早期筛查,特别是低于6个月的超声检查检出率高,各科医师合作有利于DDH的早期诊治。     

高氧对新生大鼠肺泡Ⅱ型上皮细胞上皮钠通道转运功能的影响

目的 探讨高氧对新生大鼠肺泡Ⅱ型上皮(alveolar epithelial typeⅡ,ATⅡ)细胞钠转运功能的影响.方法 分离提取新生大鼠ATⅡ细胞,随机分成高氧组和对照组,分别在氧浓度为85％和21％的细胞培养箱中原代培养.应用Western blot方法和全细胞膜片钳技术检测高氧暴露后上皮钠通道(epithelial sodium channel,ENaC)蛋白表达变化及高氧对阿米洛利敏感性钠电流的影响.结果 高氧使新生大鼠ATⅡ细胞中β-ENaC和γ-ENaC表达增加[β-ENaC:(1 d:0.43±0.06 vs0.32 ±0.04,P=0.047;2 d:0.73 ±0.06 vs 0.50±0.08,P=0.019;3 d:0.72±0.08 vs 0.52±0.06,P=0.027);γ-ENaC:(1 d:0.64 ±0.05 vs 0.53 ±0.05,P =0.044;2 d:0.76 ±0.03 vs 0.52 ±0.04,P =0.001;3 d:0.77±0.06 vs 0.61 ±0.05,P=0.025)],同时使阿米洛利敏感性钠电流增强(1 d:13.71±2.77 vs 8.92±1.38,P＜0.001;2 d:29.12±11.03 vs 10.41±1.80,P＜0.001),面对α-ENaC表达表现出一定的抑制作用(1 d:0.31 ±0.05 vs 0.46 ±0.05,P =0.025;2 d:0.30 ±0.01 vs 0.38 ±0.02,P =0.002;3 d:0.37 ±0.06vs 0.37 ±0.08,P=0.983).结论 高氧促进了 ATⅡ细胞ENaC钠转运功能,ENaC功能障碍并非高氧暴露后肺水肿发生的主要原因.     

蒙脱石散联合达克宁散治疗婴幼儿红臀的疗效观察

目的：观察蒙脱石散联合达克宁散治疗婴幼儿尿布皮炎的效果。方法：将176例尿布皮炎患儿按照随机数字表法分为试验组96例和对照组80例,常规处理局部后,试验组采用蒙脱石散联合达克宁散混合剂外涂皮损部位;对照组采用0.02%高锰酸钾溶液泡浴臀部,再用棉布吸干水分后局部外涂金霉素软膏,比较两组治疗效果。结果：对照组总有效率为85.00%,试验组总有效率为97.92%,两组比较差异有统计学意义（X2=15.6382,P〈0.01）。结论：应用蒙脱石散联合达克宁散治疗婴幼儿红臀疗效显著,且操作简单,使用方便,节省时间,可提高护士的工作效率,又能缩短住院天数,免除了患者的经济负担,具有可用性和实用性,临床上值得推广。     

认真实施“一法一例” 抓好母婴保健工作

沈阳市人大、市政府高度重视《中华人民共和国母婴保健法》和《辽宁省母婴保健条例》的贯彻实施，认真抓好宣传工作，建立起一支高素质的执法队伍，加强监督执法的力度，清理整顿了母婴保健技术服务市场，使该市的妇幼卫生工作向法制化管理迈出了一大步     

气管插管冲洗抢救婴幼儿重症肺炎痰堵20例临床分析

目的:探讨气管插管冲洗在抢救婴幼儿重症肺炎痰堵的治疗效果。方法:在治疗肺炎的基础上,对痰液黏稠,痰堵致呼吸困难的20例婴幼儿重症肺炎行气管插管冲洗、吸痰,开通气道,解除呼吸道阻塞。结果:20例患儿中痊愈19例,1例因就诊时间过晚,插管成功后因多脏器功能衰竭而死亡。结论:气管插管冲洗可迅速开通气道,解除呼吸道痰堵,清理上、下呼吸道分泌物,是改善通气功能,纠正呼吸衰竭和进行辅助呼吸的有效方法。     

The effect of electronic job aid assisted one‐to‐one counselling to support exclusive breastfeeding among 0–5‐month‐old infants in rural Bangladesh

Exclusive breastfeeding (EBF) for the first 6 months has established benefits, yet had slow improvements globally. Little is known about electronic job aid‐assisted counselling to support EBF. As a secondary outcome of a cluster randomized controlled trial in Bangladesh, we assessed the effect of electronic job aid‐supported nutrition counselling and practical demonstration on EBF. We randomized pregnant women to one of five study arms in the trial and followed mother–child dyads until 2 years of age. Community health workers (CHWs) provided breastfeeding counselling with or without prenatal and complementary nutrient supplements in all four intervention arms. The comparison arm continued with the usual practice where mothers could receive nutrition counselling at routine antenatal and postnatal care, and during careseeking for childhood illnesses. We assessed breastfeeding indicators at birth and monthly until the child was 6 months old, in both intervention and comparison arms. To evaluate the effect of nutrition counselling on breastfeeding, we combined all four intervention arms and compared them with the comparison arm. Intervention newborns had half the risk (relative risk [RR]: 0.54, 95% confidence interval [CI]: 0.39, 0.76) of receiving prelacteal feeds than those in the comparison arm. EBF declined steeply in the comparison arm after 3 months of age. EBF was 16% higher in the intervention than the comparison arm at 4 months (RR: 1.16, 95% CI: 1.08, 1.23) and 22% higher at 5 months of age (RR: 1.22, 95% CI: 1.12, 1.33). Maternal background and household characteristics did not modify the intervention effect, and we observed no difference in EBF among caesarean versus vaginal births. Breastfeeding counselling and practical demonstration using an electronic job aid by CHWs are promising interventions to improve EBF and are scalable into existing community‐based programmes.