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Intervention at an early threshold for post-hemorrhagic ventricular dilatation in preterm infants: a systematic review and meta-analysis

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World Journal of Pediatrics 2024年第8期20卷 774-786页

作者： Patrick Blundell Lloyd Abood Mallinath Chakraborty Sujoy Banerjee regional neonatal intensive care unit University Hospital of WalesCardiffUK neonatal unit Singleton HospitalSwanseaSA28QAUK Centre for Medical Education School of MedicineCardiff UniversityCardiffUK

Background Very few adequately powered studies exploring early thresholds for intervention in the management of post-hemorrhagic ventricular dilatation(PHVD)in preterm infants have identified consistent neurodevelopmental advantages at 12–30 *** aimed to conduct a meta-analysis on the efficacy and safety of early versus conservative thresholds for intervention,primarily aimed at normalizing cerebrospinal fluid(CSF)pressure,in the management of PHVD in preterm *** Multiple databases were searched for eligible papers,and prospective randomized trials involving preterm infants were *** results are expressed as relative risks(RRs)with 95%confidence intervals(CIs).The main outcome was survival without moderate-to-severe neurodevelopmental impairment at 12–30 *** Ten articles representing seven randomized trials comparing early versus conservative thresholds for interventions were *** trials(n=545 infants)reported no difference in the main outcome between early and conservative groups[RR 0.99(0.71,1.37)].Sensitivity analysis excluding data from a medication trial did not alter the main outcome[RR 1.15(0.95,1.39)].Infants in the early threshold group received significantly more interventions[RR 1.48(1.05,2.09)].Deaths before discharge/during the initial study period[RR 1.04(0.70,1.54)]or a composite of death or shunt insertion[RR 1.04(0.86,1.27)]were comparable between the two *** Early intervention for PHVD,before a clinical or ultrasound threshold is met,leads to additional clinical procedures but does not improve survival without moderate–severe neurodevelopmental impairment at 12–30 *** should be exercised in interpreting these results due to significant variation between the studies.

关键词： Hydrocephalus Intraventricular hemorrhage Lumbar puncture Mortality Neurodevelopment Preterm infants

Weaning preterm infants from continuous positive airway pressure: evidence for best practice

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World Journal of Pediatrics 2015年第3期11卷 212-218页

作者： Hesham Abdel-Hady Basma Shouman Nehad Nasef neonatal intensive care unit Mansoura University Children's HospitalMansouraEgypt

Background:Nasal continuous positive airway pressure(NCPAP)is frequently used in preterm ***,there is no consensus on when and how to wean them from *** sources:Based on recent publications,we have reviewed the criteria of readiness-to-wean and factors affecting weaning success.A special focus is placed on the methods of weaning from NCPAP in preterm ***:Practical points of when and how to wean from NCPAP in preterm infants are *** infants are ready to be weaned from NCPAP when they are stable on a low NCPAP pressure with no(or minimal)oxygen *** used to wean from NCPAP include:sudden weaning of NCPAP,gradual decrease of NCPAP pressure,graded-time-off NCPAP(cycling),weaning to high or low flow nasal cannula,and a combination of these *** best strategy for weaning is yet to be ***-off NCPAP increases the duration of NCPAP and length of hospital stay without beneficial effect on success of *** decrease of NCPAP pressure is more physiological and better tolerated than cycling-off ***:Further studies are needed to reach a consensus regarding the optimal timing and the best method for weaning from NCPAP in preterm infants.

关键词： continuous positive airway pressure preterm infant weaning

Nitric oxide inhalation inhibits inducible nitric oxide synthase but not nitrotyrosine formation and cell apoptosis in rat lungs with meconiuminduced injury

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Acta Pharmacologica Sinica 2005年第9期26卷 1123-1129页

作者： Mei-ping LU Li-zhong DU~2 Wei-zhong GU Xiang-xiang CHEN neonatal intensive care unit,Department of Pediatrics,Children’s Hospital,Zhejiang University School of Medicine,Hangzhou 310003,China Department of Pediatrics Neonatal Intensive Care Unit Children's Hospital Zhejiang University School of Medicine Hangzhou China

Aim:To investigate the effects of inhaled nitric oxide(NO)on pulmonaryinflammation,apoptosis,peroxidation and protein nitration in a rat model of acutelung injury(ALI)induced by ***:Twenty-four healthy maleSprague-Dawley rats were randomly devided into 3 groups(n=8):meconium-induced ALl with intratracheal instillation of 1 mL/kg saline(Mec/saline group),continuous inhalation of NO at 20 μL/L.(Mec/iNO),and the control group(control).Electromicroscopic examination was used to determine the extent of *** was used to detect DNA fragmentation in pulmonary apoptoticcells,expressed as the apoptosis index(AI).Western blotting was used to detectpulmonary inducible NO synthase(iNOS)***-PCR was used to detectinterleukin(IL)-1β mRNA *** count in bronchoalveolar lavage(BAL),myeloperoxidase(MPO)activity,as well as malondialdehyde(MDA)andnitrotyrosine formation,the markers of toxic NO-superoxide pathway in rat lungparenchyma specimens,were also ***:Expression of iNOS pro-tein and IL- 113 mRNA were increased significantly in the Mec/saline group(bothP<0.01)compared with the control *** cell count,MPO activity,lunginjury score,pulmonary AI,MDA level and nitrotyrosine formation were alsoincreased significantly(all P<0.01).The meconium-induced iNOS protein andIL-1β mRNA expression were inhibited significantly by NO inhalation when com-pared with the Mec/saline group(both P<0.01 ).BAL cell count,MPO activity andlung injury score were also decreased significantly(P<0.01 or P<0,05).However,there were no statistical differences in MDA level,nitrotyrosine formation or pul-monary AI between the Mec/saline and Mec/iNO *** revealed a significant degree of epithelial apoptosis in both the Mec/saline and Mec/iNO ***:Early continuous inhalation of NO20 μL/L may protect the lungs from inflammatory injury,but does not decreaseepithelial apoptosis or lung nitrotyrosine formati

关键词： inhaled nitric oxide meconium acute lung injury nitrotyrosine apoptosis

Prognostic value of circulating tumor cells in esophageal cancer

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World Journal of Gastroenterology 2017年第7期23卷 1310-1318页

作者： Hai-Tao Xu Jing Miao Jian-Wei Liu Lian-Guo Zhang Qing-Guang Zhang Department of Thoracic Surgery Affiliated Hospital of Binzhou Medical University Department of neonatal intensive care unit Binzhou People’s Hospital

AIM To perform a meta-analysis of the related studies to assess whether circulating tumor cells(CTCs) can be used as a prognostic marker of esophageal *** Pub Med, Embase, Cochrane Library and references in relevant studies were searched to assess the prognostic relevance of CTCs in patients with esophageal cancer. The primary outcome assessed was overall survival(OS). The meta-analysis was performed using the random effects model, with hazard ratio(HR), risk ratio(RR) and 95% confidence intervals(95%CIs) as effect *** Nine eligible studies were included involving a total of 911 esophageal cancer patients. Overall analyses revealed that CTCs-positivity predicted disease progression(HR = 2.77, 95%CI: 1.75-4.40, P < 0.0001) and reduced OS(HR = 2.67, 95%CI: 1.99-3.58, P < 0.00001). Further subgroup analyses demonstrated that CTCs-positive patients also had poor OS in different subsets. Moreover, CTCs-positivity was also significantly associated with TNM stage(RR = 1.48, 95%CI: 1.07-2.06, P = 0.02) and T stage(RR = 1.44, 95%CI: 1.13-1.84, P = 0.003) in esophageal *** Detection of CTCs at baseline indicates poor prognosis in patients with esophageal cancer. However, this finding relies on data from observational studies and is potentially subject to selection bias. Prospective trials are warranted.

关键词： Circulating tumor cells Esophageal cancer Prognosis Meta-analysis

Early neonatal complications in pregnant women with gestational diabetes mellitus and the effects of glycemic control on neonatal infection

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World Journal of Diabetes 2023年第9期14卷 1393-1402页

作者： Bei-Bei Wang Mei Xue Department of neonatal intensive care unit Taizhou People’s Hospital of Jiangsu ProvinceTaizhou 225300Jiangsu ProvinceChina

BACKGROUND Gestational diabetes mellitus(GDM)has become increasingly prevalent *** control in pregnant women with GDM has a critical role in neonatal *** To analyze the early neonatal complications in GDM,and examine the effect of blood glucose control level on neonatal *** The clinical data of 236 pregnant women with GDM and 240 healthy pregnant women and newborns during from March 2020 to December 2021 the same period were retrospectively analyzed,and the early complications in newborns in the two groups were *** patients were divided into the conforming glycemic control group(CGC group)and the non-conforming glycemic control group(NCGC group)based on whether glycemic control in the pregnant women with GDM conformed to *** data,immune function,infectionrelated markers,and infection rates in neonates were compared between the two *** The incidence of neonatal complications in the 236 neonates in the GDM group was significantly higher than that in the control group(P0.05).Additionally,the NCGC group had significantly decreased peripheral blood CD3^(+),CD4^(+),CD8^(+)T cell ratios,CD4/CD8 ratios and immunoglobulin G in neonates compared with the CGC group(Pneonatal infection rate was also significantly increased in the NCGC group(Pneonatal complications increased in pregnant women with *** glycemic control decreased neonatal immune function,and increased the incidence of neonatal infections.

关键词： Gestational diabetes mellitus Early neonatal complications Glycemic control neonatal infection

Non-immune hydrops fetalis:Two case reports

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World Journal of Clinical Cases 2021年第22期9卷 6531-6537页

作者： Marianna Maranto Valentina Cigna Emanuela Orlandi Gaspare Cucinella Clelia Lo Verso Vincenzo Duca Francesco Picciotto Fetal Medicine and Prenatal Diagnosis unit Villa Sofia Cervello HospitalsPalermo 90146Italy Health Promotion Maternal and Infant Care UnitInternal Medicine and Medical Specialties“G.D’Alessandro”University of PalermoPalermo 90100Italy Neonatology and neonatal intensive care unit Civico Di Cristina Benfratelli HospitalPalermo 90100Italy Neonatology and neonatal intensive care unit Ingrassia HospitalPalermo 90100Italy

BACKGROUND Fetal hydrops is a serious condition difficult to manage,often with a poor prognosis,and it is characterized by the collection of fluid in the extravascular *** 1968,the most frequent cause was the maternal-fetal Rh ***,90%of the cases are non-immune hydrops *** fetal anatomic and functional disorders can cause non-immune hydrops fetalis and the pathogenesis is incompletely *** varies from viral infections to heart disease,chromosomal abnormalities,hematological and autoimmune *** SUMMARY A 38-year-old pregnant woman has neck lymphoadenomegaly,fever,cough,tonsillar plaques at 14 wk of amenorrhea and a rash with widespread *** 27.5 wk a fetal ultrasound shows signs of severe anemia and *** is performed with confirmation of severe fetal anemia and subsequent fetal *** karyotype is 46,XX,array-comparative genome hybridization(CGH)negative,and infectious tests are not *** the following days there is a progressive improvement of the indirect signs of fetal *** 33.6 wk,for relapse of severe fetal anemia,further fetal transfusions are necessary and an urgent cesarean section is *** the day 12 of life,for the detection of anemia,the newborn is subjected to transfusion of concentrated red blood cells and begins treatment with *** there is a normalization of blood chemistry values and the baby does not need new transfusions.A 29-year-old pregnant woman,with Sjogren's syndrome and positive Anti-Ro/SSA antibodies,is subjected to serial fetal ecocardio for branch *** 26.5 wk there is a finding of fetal *** disease tests on amniotic fluid are negative as well as quantitative fluorescent polymerase chain reaction,Array *** cordocentesis Hb is 1.3 mmol/L,consequently fetal transfusion is *** in this case,due to continuous episodes of relapse of fetal anemia with consequent transfusions,at 2

关键词： Cordocentesis Fetal anemia Fetal transfusion Hydrops fetalis Preterm cesarean section Case report

Treating aplasia cutis congenita in a newborn with the combination of ionic silver dressing and moist exposed burn ointment: A case report

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World Journal of Clinical Cases 2019年第17期7卷 2611-2616页

作者： Guo-Feng Lei Jun-Ping Zhang Xiao-Bing Wang Xiao-Li You Jin-Ya Gao Xiao-Mei Li Mei-Ling Chen Xiu-Qin Ning Jiang-Li Sun Department of neonatal intensive care unit Sanmenxia Central HospitalSanmenxia 472000Henan ProvinceChina Department of intensive care unit Sanmenxia Central HospitalSanmenxia 472000Henan ProvinceChina Reproductive endocrine center Sanmenxia Central HospitalSanmenxia 472000Henan ProvinceChina

BACKGROUND Aplasia cutis congenita (ACC) in newborns is a condition in which congenital defects or hypoplasia is present in part of the epidermis,dermis and even subcutaneous tissue (including muscle and bones).First reported by Cordon in 1767,ACC is a rare disease with a low incidence of 1/100000 to 3/***,there are 500 cases reported *** can be accompanied by other *** onset mechanism of the disease remains unknown but is thought to be correlated to factors such as genetics,narrow uterus,foetal skin and amniotic membrane adhesion,use of teratogenic drugs in early pregnancy and viral *** SUMMARY In August 2018,we treated a newborn with ACC on the left lower limbs using a combination of ionic silver dressing and moist exposed burn ointment (MEBO) and achieved a satisfactory treatment *** skin defects were observed on the external genitals and on areas from the left foot to 3/4 of the upper left *** tissue and blood vessels were observed in the regions with skin *** following treatments were ***,the wound was rinsed with 0.9% sodium chloride solution followed by disinfection with povidone-iodine *** then MEBO was applied to the wound at a thickness of approximately 1 *** applying ionic silver dressing,the wound was covered with sterile *** wound dressing was replaced every 2-3 *** the 4-mo follow-up,the treatment outcome was *** was minimal scar tissue formation,and limb function was not *** The combination of ionic silver dressing and MEBO to ACC is helpful.

关键词： Aplasia cutis congenita Newborns Ionic silver dressing Moist exposed burn ointment

Hemodynamic management in brain dead donors

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World Journal of Transplantation 2021年第10期11卷 410-420页

作者： Chiara Lazzeri Manuela Bonizzoli Cristiana Guetti Giorgio Enzo Fulceri Adriano Peris intensive care unit and regional ECMO Referral Centre Azienda Ospedaliero Universitaria CareggiFlorence 50134Italy

Donor management is the key in the complex donation process,since up to 20%of organs of brain death donors(DBD)are lost due to hemodynamic *** challenge is made more difficult due to the lack of strong recommendations on therapies for hemodynamic management in DBDs and more importantly to the epidemiologic changes in these donors who are becoming older and with more comorbidities(marginal donors).In the present manuscript we aimed at summarizing the available evidence on therapeutic strategies for hemodynamic management(focusing on vasoactive drugs)and monitoring(therapeutic goals).Evidence on management in elderly DBDs is also *** management continues critical care but with different and specific therapeutic goals since the number of donor goals met is related to the number of organs retrieved and *** monitoring of selected parameters(possibly including serial echocardiography)is the clinical tool able to guarantee the achievement and maintaining of therapeutic *** worldwide differences,norepinephrine is the vasoactive of choice in most countries but,whenever higher doses(>0.2 mcg/kg/min)are needed,a second vasoactive drug(vasopressin)is *** therapy(desmopressin,corticosteroid and thyroid hormone)are suggested in all DBDs independently of hemodynamic *** the single patient,therapeutic regimen(imprimis vasoactive drugs)should be chosen also according to the potential organs retrievable(*** vs liver and kidneys).

关键词： Brain-dead donors Hemodynamic Management Vasoactive drugs Hormanal therapy Echocardiography

Hyperbaric oxygen treatment promotes neural stem cell proliferation in the subventricular zone of neonatal rats with hypoxic-ischemic brain damage

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Neural Regeneration Research 2013年第13期8卷 1220-1227页

作者： Zhichun Feng Jing Liu Rong Ju Department of Neonatology & neonatal intensive care unit Bayi Children's Hospital Affiliated to General Hospital of Beijing Military Command Department of Neonatology Chengdu Women's & Children's Central Hospital

Hyperbaric oxygen therapy for the treatment of neonatal hypoxic-ischemic brain damage has been used clinically for many years, but its effectiveness remains controversial. In addition, the mechanism of this potential neuroprotective effect remains unclear. This study aimed to investigate the influence of hyperbaric oxygen on the proliferation of neural stem cells in the subventricular zone of neonatal Sprague-Dawley rats （7 days old） subjected to hypoxic-ischemic brain damage. Six hours after modeling, rats were treated with hyperbaric oxygen once daily for 7 days. Immunohistochemistry revealed that the number of 5-bromo-2＇-deoxyuridine positive and nestin positive cells in the subventricular zone of neonatal rats increased at day 3 after hypoxic-ischemic brain damage and peaked at day 5. After hyperbaric oxygen treatment, the number of 5-bromo-2＇- deoxyuddine positive and nestin positive cells began to increase at day 1, and was significantly higher than that in normal rats and model rats until day 21. Hematoxylin-eosin staining showed that hyperbaric oxygen treatment could attenuate pathological changes to brain tissue in neonatal rats, and reduce the number of degenerating and necrotic nerve cells. Our experimental findings indicate that hyperbaric oxygen treatment enhances the proliferation of neural stem cells in the subventricular zone of neonatal rats with hypoxic-ischemic brain damage, and has therapeutic potential for promoting neurological recovery following brain injury.

关键词： neural regeneration brain injury neonatal hypoxic-ischemic encephalopathy hypoxic-ischemicbrain damage hyperbaric oxygen neural stem cells neurons proliferation subventricular zone neonatal rats nestin grants-supported paper neuroregeneration