Objective To summarize the experience of open heart operation on neonates with critical and complex congenital heart diseases and evaluate the methods of perioperative management. Methods From May 2001 to January 2003, 12 patients of neonates with congenital heart diseases underwent emergency operation. Their operating ages ranged from 6 to 30 days, the body weights were 2.8 to 4.5 kg. Their diagnoses included D-transposition of the great arteries in 4 cases, ventricular septal defect with atrial septal defect in 5 cases, complete atrioventricular septal defect, obstructed supracardiac total anomalous pulmonary venous drainage and cardiac rhabdomyomas in 1 case respectively. 12 cases were operated under moderate or deep hypothermic cardiopulmonary bypass. Results All cases were observed in ICU for 2-11 days and discharged 7-19 days after operation. The postoperative complications included low cardiac output, mediastinal infection, respiratory distress syndrome, systemic capillary leak syndrome and acute renal failure. All cases were cured and the follow-up (from 6 months to 2 years) showed satisfactory outcome. Conclusion A particular cardiopulmonary bypass and proper perioperative management is very important to ensure the successful outcome. Peritoneal dialysis is an effective and safe method for treating acute renal failure after cardiac operation in neonates.
Objective To investigate the incidence of retinopathy of prematuri ty (ROP) in the area of Shanghai, and to provide the preliminary data for the ev aluation of present criteria for ROP screening. Methods Record s of 289 prematur e infants who had undergone ROP screening from the four NICU in Shanghai between February 2004 and January 2005 were analyzed. Screening criteria included prete rm infants or low birth weight (LBW) infants with BW of 2000g or less. The first examination starts at 4 to 6 weeks chronologic age or 32 weeks post conceptual age. Results In the 289 screened infants, 19 had developed acu te ROP. There we re 3 threshold ROP, 7 prethreshold ROP and 9 developed ROP less than prethreshol d. The incidence of ROP was 6.6%. According to the British recommended guideline s（BWle;1500 g or GAle;31 weeks）, only 119 out of 289 needed screening and one ca se of stage 1 ROP was missed; the incidence of ROP was 15.1% (18/119). When lowered sc reening criteria to the American guidelines（BWle;1500g or GAle;28 weeks）, t here were only 83 infants needed screening, and we missed 2 stage 1 and 1 prethreshold ROP and the incidence of ROP was 19.3% (16/83). Conclusions The i ncidence of ROP i s 6.6% according to our study. It is lower than other reports and it has somethi ng to do with our present screening guideline. Further epidemiological data are needed to modify the guideline accordingly.
Objective To investigate the method and conditions of isolation，proliferation of multipotent mesenchymal stem cells（MSCs）from human umbilical cord blood in vitro, and to induce osteogenic and adipogenic differentiation directly for identification. Methods Human umbilical cord blood was collected in asepsis condition, isolated by density gradient centrifugation,or sedimented red cell with methylcellulose, and then the same centrifugation was done, or obtained by negative immunodepletion of CD34+. These isolated mononuclear cells were used to carry on plastic adherent culture. To obtain single cellderived colonies, these cells were proliferated clonally in medium which consists of L-DMEM orMesencultTM medium and 10% fetal calf serum（FCS） respectively, then their differentiation potentiality to osteoblasts and lipoblasts was tested. Results The mononuclear cells isolated by sedimented and centrifugated way cultured in MesencultTM medium and 10%FCS were most available. These adhesive cells could become obviously short rodshape or shuttle-shape cells after 5-7 days.The colonies form well in 3rdpassage cells. The mononuclear cells obtained by onlycentrifugalized in density gradient were hard to form colony, isolated by immunomagnetic beads were hard to culture. The surface antigens of these colonies cells presented CD29, CD59, CD71 but not CD34,CD45 and HLADR etc. The colony cells differentiating into osteoblasts that produce mineralized matrices, stained by alizarin red, and differentiating into adipocytes that accumulate lipid vacuoles, stained by oil red. Conclusion MSCs can be isolated from human umbilical cord blood and proliferate it in vitro. The way that mononuclear cells are sedimented red cell by methylcellulose and cultured by MesencultTM medium and 10% FCS is the valid method of isolation. Proliferation colonies cells present matrix cell immunophenotypes, and candifferentiate into osteoblasts and adipocytes.
ObjectiveTo explore the incidence, treatment and prognosis of neonatal respiratory failure (NRF). MethodsThe clinical data of 421 neonates with NRF treated between January 2011 and December 2013 were retrospectively analyzed. ResultsThe incidence and the mortality of NRF was 4.8% and 14.5%, respectively. The main primary disease of NRF was neonatal respiratory distress syndrome (36.1%) and aspiration pneumonia (29.0%). Mechanical ventilation was the main treatment for NRF (77.2%). Premature (χ2=12.216, P<0.001), low birth weight (χ2=8.932, P=0.003) and the neonatal asphyxia (χ2=6.199, P=0.013) were closely related to the prognosis of NRF, which were the risk factors of the death of NRF. ConclusionNRF is a disease with high incidence and high mortality; make effective prevention and treatment measures are important to improve the success rate of therapy for NRF.
ObjectiveTo systematically review the economics evaluation studies on the early screening or diagnosis of primary immunodeficiency diseases (PID). MethodsWeb of Science, CRD, PubMed, The Cochrane Library, CNKI and WanFang Data databases were electronically searched to collect the economics evaluation studies on the early screening or diagnosis of PID from inception to July 1st, 2022. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies, then, a descriptive systematic review was performed. ResultsA total of 10 studies focusing on SCID were included. The results showed that under a relatively high threshold, the early screening and diagnosis of SCID were cost-effective, which can reduce severe infections in patients and treatment costs while improving patient’s survival. ConclusionCurrent evidence shows that early diagnosis of PID can reduce costs and improve benefits. Due to limited quality and quantity of the included studies, more high quality studies are needed to verify above conclusion.
目的:探讨引起早产的原因和影响预后的因素。方法:对我院126例早产进行回顾性分析。结果:早产发生率为5.0%,胎膜早破(PROM)、妊娠高血压综合征(PIH)是引起早产的主要因素。剖宫产与阴道分娩对早产儿结局无明显差异。破膜时间12h内和12h以上两组间宫内感染发生率差异无统计学意义。结论:早产儿预后与早产病因相关。不同分娩方式对新生儿结局没有影响。