脑后部可逆性脑病综合征(PRES)的临床MR诊断

目的：探讨MR对PRES的临床诊断价值。方法应用3.0 T MR对30例PRES患者进行常规扫描，其中19例同时行MRA检查，13例行MRV检查。结果 PRES病变主要累及顶枕叶，双侧基本对称；病变主要位于脑白质内，也可累及其它部位。PRES病变的特点是呈长T 1长T 2信号，边缘不清，无明显占位效应。MRA及MRV均无异常发现。结论 MR对PRES可以作出准确诊断，对临床有重要的指导意义。     

PS联合CPAP治疗新生儿呼吸窘迫综合征临床研究

目的通过研究肺表面活性物质(PS)结合持续气道正压通气(CPAP)治疗新生儿呼吸窘迫综合征(NRDS)的治疗效果,进一步指导NRDS的临床治疗。方法选取于2017年4月-2018年10月间在本院收治的80例确诊为新生儿呼吸窘迫综合征的患儿作为研究对象,随机将患儿分为试验组和对照组,对照组给予持续气道正压通气治疗,试验组在对照组的基础上联合使用PS治疗。结果试验组对于呼吸窘迫缓解的有效率明显高于对照组,在气管插管内滴入PS治疗后试验组的血气情况明显优于对照组,且试验组患儿副作用发生率明显低于对照组,以上指标差异具有统计学意义,P <0.05。结论 PS结合CPAP在新生儿呼吸窘迫综合征的治疗中疗效很好。     

Mode of Delivery and the Survival of Macrosomic Infants in the United States, 1995–1999

ABSTRACT: Background: Although increases in perinatal mortality risk associated with fetal macrosomia are well documented, the optimal route of delivery for fetuses with suspected macrosomia remains controversial. The objective of this investigation was to assess the risk of neonatal death among macrosomic infants delivered vaginally compared with those delivered by cesarean section. Methods: Data were derived from the U.S. 1995–1999 Linked Live Birth‐Infant Death Cohort files and term (37–44 wk), single live births to United States resident mothers selected. A proportional hazards model was used to analyze the risk of neonatal death associated with cesarean delivery among 3 categories of macrosomic infants (infants weighing 4,000–4,499 g; 4,500–4,999 g; and 5,000+ g). Results: After controlling for maternal characteristics and complications, the adjusted hazard ratio for neonatal death associated with cesarean delivery among the 3 categories of macrosomic infants was 1.40, 1.30, and 0.85. Conclusions: Although cesarean delivery may reduce the risk of death for the heaviest infants (5,000+ g), the relative benefit of this intervention for macrosomic infants weighing 4,000–4,999 g remains debatable. Thus, policies in support of prophylactic cesarean delivery for suspected fetal macrosomia may need to be reevaluated. (BIRTH 33:4 December 2006)     

Are hospitals prepared to support newborn survival? – an evaluation of eight first‐referral level hospitals in Kenya*

Objective To assess the availability of resources that support the provision of basic neonatal care in eight first‐referral level (district) hospitals in Kenya. Methods We selected two hospitals each from four of Kenya’s eight provinces with the aim of representing the diversity of this part of the health system in Kenya. We created a checklist of 53 indicator items necessary for providing essential basic care to newborns and assessed their availability at each of the eight hospitals by direct observation, and then compared our observations with the opinions of health workers providing care to newborns on recent availability for some items, using a self‐administered structured questionnaire. Results The hospitals surveyed were often unable to maintain a safe hygienic environment for patients and health care workers; staffing was insufficient and sometimes poorly organised to support the provision of care; some key equipment, laboratory tests, drugs and consumables were not available while patient management guidelines were missing in all sites. Conclusion Hospitals appear relatively poorly prepared to fill their proposed role in ensuring newborn survival. More effective interventions are needed to improve them to meet the special needs of this at‐risk group.     

新生儿出生信息样本分析

目的:了解和探讨新生儿出生信息的分布态势及规律。方法:对本院2006年1~6月间所有新生儿出生信息进行样本分析。结果:半年间分娩的新生儿共1075例,其中死亡19例,双胞胎15例,以1028例单胎活产新生儿的出生体重、胎龄及产妇年龄作为研究样本进行分析,统计数据与传统意义上的正常胎龄和新生儿体重基本相符,胎龄、体重均值均有所提高。结论:孕产妇的健康状况和新生儿的体质均有所改善,随胎龄的增加,新生儿出生体重亦随之增加,并且,目前新生儿的整体统计体重要大于现有的临床指标,因此,应对现有的临床指标进行适当调整,重新确定低出生体重儿和巨大儿的临床指标。     

Neuroimaging and Neurologic Complications after Organ Transplantation

Neurologic complications are common after transplantation and affect 30-60% of transplant recipients. The etiology of most of the posttransplant neurologic disorders is related to the opportunistic infections, both systemic and involving central nervous system (CNS), toxicity of immunosuppressive medications, and the metabolic insult created by the underlying primary disease and the transplant procedure. Neuroimaging studies are one of the key tools in the evaluation and enable early diagnosis of neurologic complications in transplant patients, especially posterior reversible leukoencephalopathy syndrome, central pontine myelinolysis, intracerebral hemorrhage, and fungal and bacterial abscesses. Magnetic resonance imaging (MRI) is the preferred technique, but each of the available neuroimaging techniques offers a unique insight into the pathophysiologic mechanisms underlying neurologic complications of transplantation. The role of neuroimaging in this population includes early detection of calcineurin inhibitor neurotoxicity, opportunistic infections, neoplasia, metabolic disorders, or cerebrovascular diseases. In addition, we can monitor longitudinal progression of disease and treatment response.     

乌司他丁对大鼠胰性脑病保护作用的实验研究

目的 :探讨乌司他丁对大鼠急性出血坏死性胰腺炎时对脑组织损害的保护作用 ,为胰性脑病的治疗提供实验依据。方法 :将 90只SD大鼠随机分为正常对照组 ,急性出血坏死性胰腺炎诱导组和乌司他丁处理组 ,经胰胆管逆行注射 5%牛磺胆酸钠建立大鼠ANP模型 ,12h后处死动物 ,测定血清TNFα水平 ,并检测脑组织含水量、脑微血管内白细胞聚集及附壁现象。结果 :经乌司他丁处理后 ,血清中乌司他丁水平、脑组织含水量、脑组织MDA含量、脑微血管内白细胞聚集及附壁现象显著降低(P <0 .0 1)。结论 :乌司他丁可以减轻急性出血坏死性胰腺炎时脑损害的发生和发展     

不同采血针对新生儿足跟采血成功率的影响

目的：探讨不同采血针在新生儿疾病筛查采血中的采血效果。方法：采用三种采血针分别对2126例（A组）、1786例（B组）、1471例（C组）新生儿进行足跟采血，比较其采血成功率。结果：A、B、C三组之间差异有统计学意义（P〈0．01）。结论：采用7号一次性注射针头采血（C组）可明显提高采血成功率。