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HBeAg negative serological status and low viral replication levels characterize chronic hepatitis B virus-infected women at reproductive age in Greece: A one-year prospective single center study

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World Journal of Gastroenterology 2005年第31期11卷 4879-4882页

作者： Ioannis S. Elefsiniotis Irene Glynou Ioanna Magaziotou Konstantinos D. Pantazis Nikolaos V. Fotos Hero Brokalaki Helen Kada George Saroglou department of Internal Medicine department of Microbiology department of neonatology

AIM： To evaluate the seroprevalence of hepatitis B surface antigen （HBsAg） in 13 581 women at reproductive age and the hepatitis B e antigen （HBeAg）/anti-HBe status as well as serum hepatitis B virus （HBV）-DNA levels in a subgroup of HBsAg（＋） pregnant women at labor in Greece. METHODS： Serological markers were detected using enzyme immunoassays. Serum HBV-DNA was determined by a sensitive quantitative PCR assay. Statistical analysis of data was based on parametric methodology. RESULTS： Overall, 1.156% of women were HBsAg（＋） and the majority of them （71.3%） were Albanian. The prevalence of HBsAg was 5.1% in Albanian women, 4.2% in Asian women and 1.14% in women from Eastern European countries. The prevalence of HBsAg in African （0.36%） and Greek women （0.29%） was very low. Only 4.45% of HBsAg （＋） women were also HBeAg（＋） whereas the vast majority of them were HBeAg（-）/anti-HBe（＋）. Undetectable levels of viremia （〈200 copies/mL） were observed in 32.26% of pregnant women at labor and 29.03% exhibited extremely low levels of viral replication （〈400 copies/mL）. Only two pregnant women exhibited extremely high serum HBV- DNA levels （〉10 000 000 copies/mL）, whereas 32.26% exhibited HBV-DNA levels between 1 500 and 40 000 copies/mL. CONCLUSION： The overall prevalence of HBsAg is relatively low among women at reproductive age in Greece but is higher enough among specific populations. The HBeAg（-）/anti-HBe（＋） serological status and the extremely low or even undetectable viral replicative status in the majority/of HBsAg（＋） women of our study population, suggestthat only a small proportion of HBsAg（＋） women in Greece exhibit a high risk for vertical transmission of the infection.

关键词： Hepatitis B Reproductive age Verticaltransmission HBeAg HBV-DNA

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Association between innate immunity gene polymorphisms and neonatal sepsis development:a systematic review and meta-analysis

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World Journal of Pediatrics 2022年第10期18卷 654-670页

作者： Tamara Sljivancanin Jakovljevic Jelena Martic Jelena Jacimovic Nadja Nikolic Jelena Milasin Tanja Lazić Mitrović department of neonatology The Obstetrics and Gynecology Clinic“Narodni Front”BelgradeSerbia School of Medicine University of BelgradeBelgradeSerbia department of neonatology Mother and Child Health Care Institute of Serbia“Dr Vukan Cupic”BelgradeSerbia Central Library School of Dental MedicineUniversity of BelgradeBelgradeSerbia department of Human Genetics School of Dental MedicineUniversity of BelgradeBelgradeSerbia

Background The aim of this meta-analysis was to analyze all available data from studies investigating associations between polymorphisms in genes responsible for innate immunity and neonatal sepsis *** A comprehensive literature search,reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses-S guidelines,was performed with no language *** derived using the PICO(population,intervention,comparison and outcomes)strategy,with data on the genotype distribution for innate immunity gene polymorphisms in newborns with and without *** were analyzed using Review *** Cochran–Mantel–Haenszel test was used to calculate odds ratios with 95%confidence *** was tested using the I2 *** From a total of 9428 possibly relevant articles,33 qualified for inclusion in this systematic *** to the STrengthening the REporting of Genetic Association Studies,23 studies were found to be of moderate quality,while 10 were of low *** results showed an association of the mannose-binding lectin(MBL)exon 1 genetic polymorphism with the risk of culture-proven ***-like receptor(TLR)4 rs4986791 genotype distribution suggests its association with the increased risk of culture-proven *** certainty of evidence per GRADE(Grading of Recommendations,Assessment,Development,and Evaluation)varied from very low to *** bias was not *** Out of the 11 investigated single-nucleotide polymorphisms,this meta-analysis found a possible association between the risk for culture-proven sepsis and MBL exon 1 and TLR4 rs4986791 *** is an evident need for larger well-designed,multicentric observational studies investigating inflammatory gene polymorphisms in neonatal sepsis.

关键词： Genetic Immunity Innate Neonatal sepsis Polymorphism

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Respiratory management of extremely low birth weight infants: survey of neonatal specialists

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世界儿科杂志:英文版 2016年第3期12卷 314-319页

作者： Sumesh Parat Maroun Jean Mhanna department of Pediatrics Division of NeonatologyCase Western Reserve University School of MedicineMetroHealth Medical CenterClevelandOhioUSA

Background:To investigate strategies used for the management of respiratory distress syndrome(RDS)and bronchopulmonary dysplasia(BPD)in extremely low birth weight(ELBW)***:A survey of neonatal specialists working in US academic institutions with fellowship training ***:Eighty percent(72/89)of the identifi ed academic institutions had at least one physician who responded to the *** respondents,85%(171/201)agreed or strongly agreed to use continuous positive airway pressure(CPAP)initially for the management of RDS,and the majority agreed or strongly agreed to use a fraction of inspired oxygen(FiO2)≥0.4 and a mean airway pressure(MAP)≥10 cm H2O as a criteria for surfactant therapy;and 73%(146/200)sometimes or always used caffeine to prevent *** 25%(50/202)sometimes or almost always used steroids to prevent or treat *** indications to use steroids were 3 or more extubation failures or inability to extubate beyond 8 weeks of ***:Variability in treatment strategies of ELBW is common among neonatal ***,the majority of the respondents agreed or strongly agreed to use early CPAP for the management of RDS,consider a FiO2≥0.4 and a MAP≥10 cm H2O as criteria for surfactant therapy,and sometimes or almost always used caffeine to prevent *** continue to have a role in the management of BPD in infants who are diffi cult to extubate.

关键词： bronchopulmonary dysplasia extremely low birth weight infants respiratory distress syndrome survey

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Neonatal hemorrhage stroke and severe coagulopathy in a late preterm infant after receiving umbilical cord milking:A case report

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World Journal of Clinical Cases 2022年第16期10卷 5365-5372页

作者： Yan Lu Zhi-Qun Zhang department of neonatology Affiliated Hangzhou First People’s HospitalZhejiang University School of MedicineHangzhou 310003Zhejiang ProvinceChina

BACKGROUND Umbilical cord milking(UCM)is an alternative placental transfusion method for delayed umbilical cord clamping in routine obstetric practice,allowing prompt resuscitation of an ***,UCM has been adopted at some tertiary neonatal centers for preterm infants to enhance placental-to-fetal *** is not suggested for babies less than 28 wk of gestational age because it is associated with severe brain *** late preterm or term infants who do not require resuscitation,cord management is recommended to increase iron levels and prevent the development of iron deficiency anemia,which is associated with impaired motor development,behavioral problems,and cognitive *** remain about whether UCM increases the incidence of intraventricular ***,there are very few reports of late preterm infants presenting with neonatal hemorrhage stroke(NHS)and severe coagulopathy after receiving ***,we report a case of a late preterm infant born at 34 wk of *** abruptly deteriorated,exhibiting signs and symptoms of NHS and severe coagulopathy after receiving UCM on the first day of *** SUMMARY A female preterm infant born at 34 wk of gestation received UCM after *** was small for her gestational age and described as vigorous with Apgar scores of 9 and 10 at one minute and five minutes of life,*** hospitalization in the neonatal intensive care unit,she showed hypoglycemia and metabolic *** baby was administered glucose and sodium bicarbonate *** vitamin K1 was also used to prevent vitamin K *** baby developed umbilical cord bleeding and gastric bleeding on day 1 of life;a physical examination showed bilateral conjunctival hemorrhage,and a blood test showed thrombocytopenia,prolonged prothrombin time,prolonged activated partial thromboplastin time,low fibrinogen,raised D-dimer levels and anemia.A subsequent cranial ultrasound and computed tomography scan sho

关键词： Neonatal hemorrhage stroke Umbilical cord milking Coagulopathy Disseminated intravascular coagulation Premature infant Small for gestational age Case report

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Outcomes and risk factors of ventilator-associated pneumonia in neonates

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World Journal of Pediatrics 2017年第4期13卷 328-334页

作者： Anucha Thatrimontrichai Natthaka Rujeerapaiboon Waricha Janjindamai Supaporn Dissaneevate Gunlawadee Maneenil Supika Kritsaneepaiboon Pattama Tanaanantarak Division of neonatology Department of PediatricsFaculty of MedicinePrince of Songkla UniversitySongkhlaThailand department of Radiology Faculty of MedicinePrince of Songkla UniversitySongkhlaThailand

Background:Ventilator-associated pneumonia (VAP) in neonates has been associated with high mortality and poor *** study aimed to compare the incidence,risk factors,and outcomes of VAP and nonVAP conditions in ***:We performed a prospective cohort study in a neonatal intensive care unit (NICU) in Thailand from January 2014 to December *** neonatal patients who were ventilated more than 48 hours were ***:There were 128 enrolled *** median (inter quartile range) gestational age and birthweight were 35 (30.2,37.8) weeks and 2380 (1323.8,3020.0) *** were 17 VAP patients (19 episodes) and 111 non-VAP *** VAP rate was 13.3% or 10.1 per 1000 ventilator *** to the multivariate analysis,a birthweight less than 750 g [adjusted odds ratio (aOR)=10.75,95% confidence interval (CI)=2.35-49.16;P=0.002] and sedative medication use (aOR=4.00,95% CI=1.23-12.50;P=0.021)were independent risk factors for *** with the non-VAP group,the median difference in the VAP group yielded a significantly longer duration of NICU stay (18 days,P=0.001),total length of hospital stay (16 days,P=0.002) and higher hospital costs ($5113,P=0.001).The inhospital mortality rate in the VAP and non-VAP groups was 17.6% and 15.3% (P=0.73),***:A neonatal birthweight less than 750 g and sedative medication use were independent risk factors for *** VAP patients experienced a longer duration of both NICU and hospital stay,and incurred higher hospitalization costs.

关键词： mechanical ventilation newborn risk factor sedatives ventilator-associated pneumonia

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Systemic changes and adverse effects induced by retinopathy of prematurity screening

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International Journal of Ophthalmology(English edition) 2016年第8期9卷 1148-1155页

作者： Jing-Bo Jiang Zhi-Wei Zhang Jia-Wen Zhang Yan-Li Wang Chuan Nie Xian-Qiong Luo department of neonatology Guangdong Province Women and Children's Hospital department of Pediatric Cardiology Guangdong Cardiovascular Institute Guangdong General HospitalGuangdong Academy of Medical Sciences

AIM: To estimate the potential systemic events during and after retinopathy of prematurity (ROP) screening. ' METHODS: A prospective and descriptive designed study was conducted to detect the physiologic and pathological changes 24h before, during, and 72h after ROP screening. Control blood pressure (BP), saturation, pulse rate, and body temperature were routinely taken at various time internals before and after screening. Adverse effects pertain to cardiovascular system, respiratory system, gastric system, urinary system and nervous system were retrospect 0-72h after ROP screening at a 24-hour interval. RESULTS: Totally 1254 prematurity babies receiving ROP screening during Jan. 1st 2013 to Dec. 31th 2013 were enrolled in our survey. Compared to control vital sign data taken before the examination, there was a fluctuation in the diastolic BP with the increased 3.03 mm Hg (P=0.04) after 3 doses of mydriatic drops. Immediately after the examination, there was a further 12.64 mm Hg (P<0.01) increase in systolic BP and a 7.24 mm Hg (P<0.01) in diastolic BP. The mean pulse rate during examination was 22.4 bpm (P<0.01) higher than the 133.3 +/- 9.0 bpm control level. The oxygen saturation shared an average drop of 5% (P<0.01) during screening. In prematurity with postconceptional age less than 31wk, the incidence of apnea (23.5%), necrotizing enterocolitis (NEC) (8.7%), gastric residual (25.4%) and upper digestive tract hemorrhage (6.4%) also demonstrated a significant rise (P<0.01). CONCLUSION: In our study sample, ROP screening was associated with NEC, gastric residual and upper digestive tract hemorrhage. These gastrointestinal side effects, along with breath activity pattern change and vital signs indicators fluctuation, may be results of additional stress responses.

关键词： retinopathy of prematurity prematurity screening apnea necrotizing enterocolitis stress response mydriatic drops

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Newborns' sleep-wake cycle development on amplitude integrated electroencephalography

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世界儿科杂志:英文版 2016年第3期12卷 327-334页

作者： Xu-Fang Li Yan-Xia Zhou Lian Zhang department of neonatology Guangzhou Women and Children's Medical CenterGuangzhouChina department of Electro-neurophysiology Guangzhou Women and Children's Medical CenterGuangzhouChina

Background:To observe the development of neonatal sleep among healthy infants of different conceptional age(CA)by analyzing the amplitude-integrated electroencephalography(aEEG)of their sleep-wake cycles(SWC).Methods:Bedside aEEG monitoring was carried out for healthy newborns from 32 to 46 weeks CA between September 1,2011 and August 30,*** each aEEG tracing,mean duration of every complete SWC,number of SWC repetition within 12 hours,mean duration of each narrow and broadband of SWC,mean voltage of the upper edge and lower edge of SWC,mean bandwidth of SWC were counted and *** of the correlations between voltages or bandwidth of SWC and CA was performed to assess the developmental changes of central nervous system of newborns with different ***:The SWC of different CA on aEEG showed clearly identifiable trend after 32 weeks of *** occurrence of SWC gradually increases from preterm to post-term infants;term infants had longer SWC *** voltage of upper edge of the broadband decreased at 39 weeks,while the lower edge voltage increases and the bandwidth of broadband declined along with the growing *** upper edge of the narrowband dropped while the lower edge rised gradually,especially in preterm *** width of the narrowband narrowed down while CA ***:The SWC on aEEG of 32-46 weeks infants showed a continuous,dynamic and developmental *** appearance of SWC and the narrowing bandwidth of narrowband is the main indicator to identify the CA-dependent SWC from the preterm to the late preterm *** lower edge of the broadband identifi es the term to post-term period.

关键词： amplitude-integrated electroencephalography conceptional age development newborn sleep-wake cycle

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Current status of neonatal acute respiratory disorders： a one-year prospective survey from a Chinese neonatal network

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Chinese Medical Journal 2010年第20期123卷 2769-2775页

作者： QIAN Li-ling LIU Cui-qing GUO Yun-xia JIANG Ye-jun NI Li-ming XIA Shi-wen LIU Xiao-hong ZHUANG Wan-zhu XIAO Zhi-hui WANG San-nan ZHOU Xiao-yu SUN Bo department of neonatology Children's Hospital of Fudan University Shanghai 201102 China department of neonatology Children's Hospital of Hebei Province Shijiazhuang Hebei 050031 China department of neonatology Xi'an Children's Hospital Xi'an Shaanxi 710002 China department of neonatology Shaoxing Maternity Hospital Shaoxing Zhejiang 312000 China department of neonatology Provincial Maternity Hospital Xi'an Shaanxi 710003 China department of neonatology Provincial Maternity HospitalWuhanHubei 430070China department of Intensive Care Shenzhen Children's HospitalShenzhenGuangdong 518026China department of neonatology Quanzhou Women and Children's HospitalQuanzhouFujian 362000China department of neonatology Children's Hospital of Suzhou UniversitySuzhouJiangsu 215003China department of neonatology Suzhou Women and Children's Health CenterSuzhouJiangsu 215002China department of neonatology Nanjing Children's Hospital of Nanjing Medical UniversityNanjingJiangsu 210008China department of neonatology Children's Hospital of Fudan UniversityShanghai 201102China

Background We conducted a prospective, multicenter investigation of incidence, management and outcome of neonatal acute respiratory disorders （NARD）, and evaluated related perinatal risk factors and efficacy of respiratory therapies in neonatal intensive care units （NICUs） in a Chinese neonatal *** Data were prospectively collected in 2004-2005 from infants with NARD defined as presence of respiratory distress and oxygen requirement during the first 3 days of *** A total of 2677 NARD was classified （20.5% of NICU admissions）. There were 711 （5.44%） with respiratory distress syndrome （RDS）, 589 （4.51%） pulmonary infection, 409 （3.13%） meconium aspiration syndrome, 658 （5.03%）aspiration of amniotic fluid and 239 （1.83%） transient tachypnoea. Meconium aspiration syndrome had the highest rate with fetal distress, transient tachypnoea from cesarean section, and RDS with maternal disorders. Assisted mechanical ventilation was applied in 53.4% of NARD, and in above five disorders with 84.7%, 52.3%, 39.8%, 24.5%, and 53.6%,respectively. Corresponding mortality in these disorders was 31.4%, 13.6%, 17.8%, 4.1% and 5.0%, *** was provided to 33.9% of RDS. In all RDS infants, the survival rate was 78.8% if receiving surfactant, and 63.4% if not （P 〈0.001）.Conclusions This study provided NICU admission-based incidence and mortality of NARD, reflecting efficiency of advanced respiratory therapies, which should be a reference for current development of respiratory support in NICU at provincial and sub-provincial levels, justifying efforts in upgrading standard of care in emerging regions through a collaborative manner.

关键词： epidemiology mortality neonate respiratory disorder respiratory therapy

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Perinatal risk factors for pulmonary hemorrhage in extremely low-birth-weight infants

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World Journal of Pediatrics 2020年第3期16卷 299-304页

作者： Ting-Ting Wang Ming Zhou Xue-Feng Hu Jiang-Qin Liu department of neonatology Shanghai First Maternity and Infant HospitalTongji University School of Medicine#2699Gaoke western RoadPudong DistrictShanghai 201204China

Background Pulmonary hemorrhage (PH) is a life-threatening respiratory complication of extremely low-birth-weight infants (ELBWIs).However,the risk factors for PH are ***,the purpose of this study was to analyze the perinatal risk factors and short-term outcomes of PH in *** This was a retrospective cohort study of live born infants who had birth weights that were less than 1000 g,lived for at least 12 hours,and did not have major congenital anomalies.A logistic regression model was established to analyze the risk factors associated with *** There were 168 ELBWIs born during this period.A total of 160 infants were included,and 30 infants were diagnosed with *** factors including gestational age,small for gestational age,intubation in the delivery room,surfactant in the delivery room,repeated use of surfactant,higher FiO2 during the first day,invasive ventilation during the first day and early onset sepsis (EOS) were associated with the occurrence of PH by univariate *** the logistic regression model,EOS was found to be an independent risk factor for *** mortality and intraventricular hemorrhage rate of the group of ELBWIs with PH were significantly higher than those of the group of ELBWIs without *** rates of periventricular leukomalacia,moderate-to-severe bronchopulmonary dysplasia and severe retinopathy of prematurity,and the duration of the hospital stay were not significantly different between the PH and no-PH *** Although PH did not extend hospital stay or increase the risk of bronchopulmonary dysplasia,it increased the mortality and intraventricular hemorrhage rate in *** was the independent risk factor for PH in ELBWIs.

关键词： Early-onset sepsis Extremely low-birth-weight Pulmonary hemorrhage Risk factor

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Effects of fentanyl and sucrose on pain in retinopathy examinations with pain scale,near-infrared spectroscopy,and ultrasonography:a randomized trial

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World Journal of Pediatrics 2023年第9期19卷 873-882页

作者： Nursu Kara Didem Arman Zeynep Seymen Adem Gül Serdar Cömert department of Pediatrics Division of NeonatologyUniversity of Health Sciences Istanbul Research and Training HospitalIstanbulTurkey department of Opthalmology University of Health Sciences Istanbul Research and Training HospitalIstanbulTurkey

Background This study aimed to compare the efficacy of intravenous,intranasal fentanyl and oral sucrose in reducing the pain response during retinopathy of prematurity examinations using premature infant pain profile(PIPP)*** The study included 42 infants who underwent retinopathy screening *** infants were divided into three groups:oral sucrose,intranasal fentanyl,and intravenous *** signs(heart rate,arterial oxygen saturation,and mean arterial pressure)were *** PIPP was used to determine pain *** oxygenation and middle cerebral artery blood flow were evaluated using near-infrared spectroscopy and Doppler ultrasonography,*** data obtained were compared between *** There was no significant difference between the three groups regarding postconceptional and postnatal ages or birth weights and weight at the time of *** babies had moderate pain during the *** correlation was observed between analgesia method and pain scores(P=0.159).In all three groups,heart rate and mean arterial pressure increased,whereas oxygen saturation decreased during the exam compared with pre-examination ***,heart rate(HR),mean arterial pressure(MAP)and arterial oxygen saturation(sPO2)values did not differ between groups(HR,P=0.150;MAP,P=0.245;sPO2,P=0.140).The cerebral oxygenation(rSO2)values between the three groups were found to be similar[rSO2:P=0.545,P=0.247,P=0.803;fractional tissue oxygen extraction(FTOE):P=0.553,P=0.278].Regarding cerebral blood flow values,we also did not find any difference between the three groups[mean blood flow velocity(Vmean):P=0.569,P=0.975;maximum flow velocity(Vmax):P=0.820,P=0.997].Conclusions Intravenous and intranasal fentanyl and oral sucrose were not superior to each other in preventing pain during the examination for retinopathy of prematurity(ROP).Sucrose may be a good alternative for pain control during ROP *** findings suggest

关键词： Analgesia Cerebral blood flow Cerebral oxygenation Neonate Retinopathy of prematurity

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