首页期刊导航|中华新生儿科杂志（中英文）
期刊信息/Journal information
中华新生儿科杂志（中英文）
中华新生儿科杂志（中英文）

双月刊

1673-6710

xinshenger1122@126.com

010-66181701

100034

北京市西城区西安门大街1号北京大学第一医院妇儿医院

中华新生儿科杂志（中英文）/Journal Chinese Journal of NeonatologyCSTPCDCSCD
查看更多>>国家级医学专业学术类期刊。办刊宗旨是为广大围产新生儿医学工作者提供学术交流园地，提高广大儿科医师、特别是新生儿专业医师的学术水平，更好地进行新生儿保健、提高医疗质量，使新生儿茁壮成长。读者主要为儿科医护人员及新生儿专业医护人员。是目前全国唯一的全国性的新生儿专业的医学杂志。
正式出版
收录年代

    《高危新生儿分类分级管理专家共识（2023）》解读

    宋燕燕陈运彬史源刘卫华...
    129-131页
    查看更多>>摘要：中华医学会儿科学分会新生儿学组与中华儿科杂志编辑委员会联合新生儿科、儿科、儿童保健科、公共卫生、妇产科、妇幼信息等领域的专家制定发表的“高危新生儿分类分级管理专家共识（2023）”，强调从围生期开始对高危新生儿的危险因素进行分类识别和分级管理，实现贯穿围生期-新生儿期-出院后随访的高危新生儿系统化、多学科及多层级的管理模式，同时提出高危新生儿门诊分级建设标准，明确高危新生儿管理专科建设方向，为医疗机构管理高危新生儿的临床医生和护理人员，以及从事相关临床、教学、科研和管理工作的专业人员提供了科学、规范的指导。本文针对该共识的重点内容进行解读。

    高危新生儿分类分级管理共识解读

      原文链接:
    • 万方数据

    早产儿脑损伤监测技术进展

    侯新琳姜莎莎
    132-135页
    查看更多>>摘要：早产儿脑损伤的诊断和动态评估主要包括脑血流动力学监测、脑电图、近红外光谱技术、颅脑超声、磁共振成像等。这些方法在提供全面评估的同时，能尽早发现中枢神经系统异常，为及时有效的治疗提供支持。综合利用这些监测手段、实施多模态的脑损伤监测技术有助于早发现、早诊断、早治疗早产儿脑损伤，改善早产儿的神经发育结局。

    早产儿脑损伤脑功能脑功能成像

      原文链接:
    • 万方数据

    超早产儿纵向宫外生长迟缓现状调查及预测模型的建立

    黄晓芳冯琪李帅军田秀英...
    136-144页
    查看更多>>摘要：目的 基于新生儿重症监护室（neonatal intensive care unit，NICU）的多中心数据，进行胎龄<28周超早产儿（extremely preterm infants，EPIs）纵向宫外生长迟缓（extrauterine growth restriction，EUGR）现状调查，并建立预测模型。 方法 回顾性研究2017年1月至2018年12月华北地区32个NICU收治的EPIs一般情况、营养支持、住院期间并发症及体重增长情况等临床资料。出院体重Z评分较入院时下降>1定义为纵向EUGR，将EPIs分为纵向EUGR组及非纵向EUGR组，总结EPIs营养支持及体重增长现状。将EPIs按7∶3的比例随机分为训练集和验证集。在训练集中采用单因素和多因素回归分析筛选纵向EUGR的独立危险因素，利用赤池信息准则决定最优Nomogram模型并绘制列线图。对模型进行区分度、校准度和临床决策曲线评价。 结果 共纳入436例EPIs，胎龄（26.9±0.9）周，出生体重（989±171）g，纵向RUGR发生率82.3%（359/436）。最终纳入出生体重Z评分、体重下降程度、体重增长速率、出院前3 d母乳喂养比例≥75%、机械通气≥7 d、母亲完成产前促肺治疗、支气管肺发育不良7个变量构建列线图。训练集和验证集的受试者工作特征曲线下面积分别为 0.870（95%CI 0.820~0.920）和0.879（95%CI 0.815~0.942），提示模型区分度良好。校准曲线提示模型存在较好的拟合度（P>0.05）。临床决策曲线分析表明模型在所有阈值下均有正向获益。 结论 目前EPIs纵向ERGR发生率较高，本研究构建并验证了EPIs出院时纵向EUGR的预测模型，有助于尽早识别纵向EUGR高危的EPIs并进行干预。未来研究有必要扩大样本量和进行前瞻性研究来优化和验证该预测模型。 Objective To study the current status of longitudinal extrauterine growth restriction (EUGR) in extremely preterm infants (EPIs) and to develop a prediction model based on clinical data from multiple NICUs. Methods From January 2017 to December 2018, EPIs admitted to 32 NICUs in North China were retrospectively studied. Their general conditions, nutritional support, complications during hospitalization and weight changes were reviewed. Weight loss between birth and discharge > 1SD was defined as longitudinal EUGR. The EPIs were assigned into longitudinal EUGR group and non-EUGR group and their nutritional support and weight changes were compared. The EPIs were randomly assigned into the training dataset and the validation dataset with a ratio of 7∶3. Univariate Cox regression analysis and multiple regression analysis were used in the training dataset to select the independent predictive factors. The best-fitting Nomogram model predicting longitudinal EUGR was established based on Akaike Information Criterion. The model was evaluated for discrimination efficacy, calibration and clinical decision curve analysis. Results A total of 436 EPIs were included in this study, with a mean gestational age of (26.9±0.9) weeks and a birth weight of (989±171) g. The incidence of longitudinal EUGR was 82.3%(359/436). Seven variables (birth weight Z-score, weight loss, weight growth velocity, the proportion of breast milk ≥75% within 3 d before discharge, invasive mechanical ventilation ≥7 d, maternal antenatal corticosteroids use and bronchopulmonary dysplasia) were selected to establish the prediction model. The area under the receiver operating characteristic curve of the training dataset and the validation dataset were 0.870 (95%CI 0.820-0.920) and 0.879 (95%CI 0.815-0.942), suggesting good discrimination efficacy. The calibration curve indicated a good fit of the model (P>0.05). The decision curve analysis showed positive net benefits at all thresholds. Conclusions Currently, EPIs have a high incidence of longitudinal EUGR. The prediction model is helpful for early identification and intervention for EPIs with higher risks of longitudinal EUGR. It is necessary to expand the sample size and conduct prospective studies to optimize and validate the prediction model in the future.

    纵向宫外生长迟缓现状预测模型超早产儿

      原文链接:
    • 万方数据

    加速康复理念联合早期肠液回输在新生儿小肠造瘘术后的临床应用

    刘文跃吴晓霞张晖孙雪...
    145-149页
    查看更多>>摘要：目的 探讨加速康复理念联合早期肠液回输技术在新生儿肠梗阻中高位小肠造瘘术后的应用价值。 方法 本研究为前瞻性病例对照研究，选择2018年12月至2022年12月山西省儿童医院新生儿外科因肠梗阻行中高位小肠造瘘的新生儿为研究对象，术后随机分为加速康复组与传统治疗组。加速康复组术后应用加速康复理念联合早期肠液回输，传统治疗组术后采用常规胃肠减压、不常规镇痛及根据排便量实施肠液回输等传统措施，比较两组患儿术后肠外营养时间、导管留置时间、每日体重增长、住院时间、相关并发症指标及30 d内再入院率。 结果 共纳入42例患儿，加速康复组22例，传统治疗组20例。加速康复组术后肠外营养时间［（22.6±9.4）d比（30.7±11.3）d］、导管留置时间［（5.9±0.8）d比（9.9±2.1）d］、术后住院时间［（26.8±9.8）d比（33.8±11.5）d］均短于传统治疗组，差异有统计学意义（P<0.05）；两组术后每日体重增长比较差异无统计学意义（P>0.05）；加速康复组术后胃肠黏膜出血发生率低于传统治疗组（13.6%比45.0%），差异有统计学意义（P<0.05）；两组喂养不耐受、肠外营养相关性胆汁淤积、中心静脉导管相关血流感染、肠液回输相关并发症发生率、提前关闭造瘘率以及30 d内再入院率比较，差异均无统计学意义（P>0.05）。 结论 加速康复理念联合早期肠液回输在新生儿肠梗阻中高位小肠造瘘术后的应用安全可行，能缩短肠外营养使用时间、置管时间和住院时间，加速患儿术后康复。 Objective To study the clinical value of enhanced recovery after surgery(ERAS) strategy combined with early intestinal fluid reinfusion among neonates receiving jejunostomy due to intestinal obstruction. Methods From December 2018 to December 2022, neonates with intestinal obstruction receiving jejunostomy in the Department of Neonatal Surgery of our hospital were prospectively enrolled. They were randomly assigned into ERAS group and traditional treatment (TT) group after surgery. The ERAS group was treated with ERAS strategy plus early intestinal fluid reinfusion. The TT group was treated with conventional gastrointestinal decompression, analgesia as needed and enteric fluid reinfusion according to the amount of defecation. The postoperative parenteral nutrition (PN) duration (Tpn), central venous catheter (CVC) duration (Tcvc), daily weight gain, duration of postoperative hospital stay (Thos), complications and readmission rate within 30 days were compared between the two groups. Results A total of 22 cases were included in the ERAS group and 20 cases were in the TT group. Tpn [(22.6±9.4) d vs. (30.7±11.3) d], Tcvc [(5.9±0.8) d vs. (9.9±2.1) d] and Thos [(26.8±9.8) d vs. (33.8±11.5) d] in the ERAS group were significantly shorter than the TT group (P<0.05). No significant difference existed in daily weight gain between the two groups (P>0.05). The incidence of postoperative gastrointestinal mucosal bleeding in the ERAS group was significantly lower than the TT group (13.6% vs. 45.0%)(P<0.05). No significant differences existed in the following items between the two groups: feeding intolerance, PN-associated cholestasis, CVC-related bloodstream infection, intestinal fluid reinfusion-related complications, premature closure of fistula and readmission rate within 30 days (allP>0.05). Conclusions The application of ERAS strategy plus early intestinal fluid reinfusion in neonates with enterostomy is safe and feasible, which can reduce the postoperative durations of PN, CVC and hospital stay and accelerate the recovery.

    加速康复肠液回输肠造瘘新生儿

      原文链接:
    • 万方数据

    基于机器学习的新生儿坏死性小肠结肠炎预测模型的建立

    李振宇李玲魏佳琦蒋沁蕾...
    150-156页
    查看更多>>摘要：目的 探讨将机器学习方法应用于新生儿坏死性小肠结肠炎（necrotizing enterocolitis，NEC）诊断及严重程度分类的意义。 方法 回顾性分析2015年1月至2021年10月吉林大学第一医院新生儿科疑似NEC并行腹部影像学检查的新生儿临床资料，根据入选患儿（数据集1）是否符合改良Bell分期Ⅱ期以上分为NEC组和非NEC组，用于诊断预测分析；NEC组（数据集2）再根据是否为Bell分期Ⅲ期以上分为外科NEC组和内科NEC组，用于NEC严重程度分析。采用特征选择算法中的极端随机树、弹性网和递归特征消除法对全部变量进行筛选，通过逻辑回归、支持向量机（support vector machine，SVM）、随机森林和光梯度增强机等机器学习分类模型建立NEC诊断和严重程度预测模型。应用受试者工作特征曲线下面积（the area under the receiver operating characteristic curve，AUROC）、敏感度、特异度、阳性预测值和阴性预测值评估模型性能，选出最优模型。 结果 共纳入536例疑似NEC患儿。数据集1包括非NEC组302例、NEC组234例；数据集2包括内科NEC组164例、外科NEC组70例。极端随机树法筛出的变量在两个数据集中预测性能最佳，在NEC诊断分类模型中，SVM模型预测性能最佳，AUROC为0.932（95%CI 0.891~0.973），准确度0.844（95%CI 0.793~0.895），共确定11个预测变量，包括门静脉积气、发病时中性粒细胞百分比、肠腔扩张、发病时单核细胞计数等；在NEC严重程度预测模型中，SVM模型预测性能最佳，AUROC为0.835（95%CI 0.737~0.933），准确度0.787（95%CI 0.703~0.871），共确定25个预测变量，包括发病时日龄、C反应蛋白、中性粒细胞计数等。 结论 利用机器学习中的特征选择算法和SVM分类模型建立的新生儿NEC预测模型有助于NEC的诊断和疾病严重程度分类。 Objective To construct prediction models of necrotizing enterocolitis (NEC) using machine learning (ML) methods. Methods From January 2015 to October 2021, neonates with suspected NEC symptoms receiving abdominal ultrasound examinations in our hospital were retrospectively analyzed. The neonates were assigned into NEC group (modified Bell's staging≥Ⅱ) and non-NEC group for diagnostic prediction analysis (dataset 1). The NEC group was subgrouped into surgical NEC group (staging≥Ⅲ) and conservative NEC group for severity analysis (dataset 2). Feature selection algorithms including extremely randomized trees, elastic net and recursive feature elimination were used to screen all variables. The diagnostic and severity prediction models for NEC were established using logistic regression, support vector machine (SVM), random forest, light gradient boosting machine and other ML methods. The performances of different models were evaluated using area under the receiver operating characteristic curve (AUC), sensitivity, specificity, negative predictive value and positive predictive value. Results A total of 536 neonates were enrolled, including 234 in the NEC group and 302 in the non-NEC group (dataset 1).70 were in the surgical NEC group and 164 in the conservative NEC group (dataset 2). The variables selected by extremely randomized trees showed the best predictive performance in two datasets. For diagnostic prediction models, the SVM model had the best predictive performance, with AUC of 0.932 (95%CI 0.891-0.973) and accuracy of 0.844 (95%CI 0.793-0.895). A total of 11 predictive variables were determined, including portal venous gas, intestinal dilation, neutrophil percentage and absolute monocyte count at the onset of illness. For NEC severity prediction models, the SVM model showed the best predictive performance, with AUC of 0.835 (95%CI 0.737-0.933) and accuracy of 0.787 (95%CI 0.703-0.871). A total of 25 predictive variables were identified, including age of onset, C-reactive protein and absolute neutrophil count at clincial onset. Conclusions NEC prediction model established using feature selection algorithm and SVM classification model in ML is helpful for the diagnosis of NEC and grading of disease severity.

    坏死性小肠结肠炎机器学习特征选择算法新生儿

      原文链接:
    • 万方数据

    新生儿难治性脓毒性休克早期预测指标分析

    钟隽镌莫镜张静林颖仪...
    157-161页
    查看更多>>摘要：目的 探讨新生儿难治性脓毒性休克的早期预测指标。 方法 选择2020年7月至2021年12月广东省妇幼保健院新生儿重症监护病房收治的脓毒性休克新生儿进行回顾性分析，根据病程中的最高脓毒性休克评分（septic shock scores，SSS）分为难治组和非难治组，比较两组患儿围生期情况、诊断脓毒性休克时的实验室检查结果及血流动力学参数，并进行多因素logistic回归分析得出独立危险因素，并对独立危险因素进行受试者工作特征曲线分析，得出截断值作为脓毒性休克发生不良预后的早期预测指标。 结果 共纳入130例患儿，难治组54例，非难治组76例。与非难治组相比，难治组患儿诊断脓毒性休克时的pH、BE值、每搏指数、心输出量、心脏指数明显降低（P<0.05），平均动脉压与心脏指数比值（mean arterial pressure to cardiac index ratio，MAP/CI）［（12.7±5.2）比（8.8±2.9）］、SSS［床边式SSS：1（0，3）分比0（0，0）分；计算式SSS：4.4（1.3，19.2）分比1.3（1.2，1.4）分；改良版计算式SSS：16.7（3.4，20.6）分比2.6（1.8，4.0）分］明显升高（P<0.05）。多因素logistic回归分析显示，MAP/CI高是新生儿难治性脓毒性休克的独立危险因素，曲线下面积0.734，最佳截断值为11.6，敏感度62%，特异度87%，阳性预测值79%，阴性预测值77%；改良版计算式SSS高是新生儿脓毒性休克死亡的独立危险因素，曲线下面积0.845，最佳截断值为5.8，敏感度83%，特异度72%，阳性预测值21%，阴性预测值97%。 结论 MAP/CI升高（≥11.6）、改良版计算式SSS升高（≥5.8）可分别作为新生儿难治性脓毒性休克诊断及预测死亡的早期指标。 Objective To study the early predictors of refractory septic shock (RSS) in neonates. Methods From July 2020 to December 2021, clinical data of neonates with septic shock admitted to the Neonatal Department of our hospital were retrospectively reviewed. According to the maximum septic shock score (SSS) during clinical course, the neonates were assigned into RSS group and non-RSS group. Perinatal data, laboratory results and hemodynamic parameters at diagnosis were compared between the two groups. Multiple logistic regression analysis was used to identify independent risk factors of RSS and septic shock-related death. Receiver operating characteristic (ROC) curve was constructed to evaluate the early predictors of poor prognosis. Results A total of 130 neonates were enrolled, including 54 in RSS group and 76 in non-RSS group. Compared with the non-RSS group, the RSS group had significantly lower pH, base excess (BE), stroke volume index (SVI), cardiac output (CO) and cardiac index (CI).Meanwhile, the RSS group had significantly higher mean arterial pressure (MAP) to CI ratio (MAP/CI) and SSS [including bedside SSS (bSSS), computed SSS (cSSS) and modified version of cSSS (mcSSS)] (all P<0.05). Multiple logistic regression analysis showed that increased MAP/CI was an independent predictor of RSS. The cut-off value of MAP/CI was 11.6 [sensitivity 62%, specificity 87%, positive predictive value (PPV) 79% and negative predictive value (NPV) 77%], with an area under the curve (AUC) of 0.734. Increased mcSSS was an independent predictor of septic shock-related death. The cut-off value of mcSSS was 5.8 (sensitivity 83%, specificity 72%, PPV 21% and NPV 97%), with an AUC of 0.845. Conclusions Increased MAP/CI (≥11.6) and mcSSS (≥5.8) may be early predictors of RSS and septic shock-related death in neonates.

    脓毒性休克难治性休克平均动脉压与心脏指数比值脓毒性休克评分新生儿

      原文链接:
    • 万方数据

    经连续性肾脏替代治疗的10例新生儿高氨血症临床分析

    黄俊姿刘志勇许景林张伟峰...
    162-167页
    查看更多>>摘要：目的 探讨新生儿高氨血症患儿的临床转归、遗传病因，以及应用连续性肾脏替代治疗（continuous renal replacement therapy，CRRT）的效果和安全性。 方法 选择2016年9月至2023年6月在泉州市妇幼保健院·儿童医院新生儿重症监护室住院行CRRT的高氨血症新生儿资料进行回顾性分析，收集患儿围产期情况、临床表现、实验室结果、基因检测结果、治疗过程及结局，根据出院时是否存活分为存活组和死亡组，应用SPSS 22.0统计软件分析两组患儿临床特点的差异。 结果 共纳入10例患儿，男8例，女2例；胎龄39.3（38.2，39.8）周，出生体重3 300（3 050，3 583）g；发病日龄2.0（2.0，4.3）d；主要临床表现为抽搐、昏迷，血氨最高586~1 250 μmol/L。患儿行CRRT日龄3.0（2.0，8.3）d，CRRT转流时间20.5（16.5，42.8）h。CRRT前昏迷时间 10.0（3.5，12.8）h，总昏迷时间20.5（12.5，29.0）h；CRRT后6 h内每小时血氨下降（52.6±22.2）μmol/L。最终诊断鸟氨酸氨甲酰基转移酶缺陷症5例，甲基丙二酸血症2例，丙酸血症、肉碱酰基肉碱转位酶缺陷症、暂时性高氨血症各1例。存活6例；出院时共死亡4例，包括2例家长放弃治疗后死亡的患儿。死亡组CRRT前昏迷时间和总昏迷时间长于存活组，差异有统计学意义（P<0.05）。 结论 先天性代谢缺陷是新生儿高氨血症最常见的病因，及时行CRRT可安全有效地降低血氨，并可能改善临床结局。 Objective To study clinical outcomes, genetic etiology, efficacy and safety of continuous renal replacement therapy (CRRT) for neonatal hyperammonemia. Methods From September 2016 to June 2023, neonates with hyperammonemia receiving CRRT in NICU of our hospital were retrospectively analyzed. Their perinatal conditions, clinical manifestations, laboratory results, genetic tests, treatments and outcomes were collected. The patients were assigned into survival group and death group according to their conditions at discharge. SPSS 22.0 statistical software was used to analyze the differences between the two groups. Results A total of 10 patients were enrolled, including 8 males and 2 females. The gestational age was 39.3(38.2,39.8)weeks and birth weight 3 300(3 050, 3 583) g. The age of onset was 2.0(2.0, 4.3) d. The main clinical manifestations included seizures, coma and high blood ammonia level (up to 586-1 250 μmol/L). The patients received CRRT at 3.0(2.0, 8.3) d of age and CRRT lasted for 20.5(16.5, 42.8) h. Before CRRT, average time of coma was 10.0(3.5, 12.8) h and the total duration of coma was 20.5(12.5, 29.0) h. After CRRT, blood ammonia decreased (52.6±22.2) μmol/L every hour for 6 h. The genetic tests showed ornithine transcarbamylase deficiency in 5 cases, methylmalonic acidemia in 2 cases, propionic acidemia in 1 case, carnitine acylcarnitine translocase deficiency in 1 case and transient hyperammonemia in 1 case. 6 patients survived. 4 patients died at discharge, including 2 withdrawal treatment. The duration of coma before CRRT and the total duration of coma in the death group were significantly longer than the survival group (P<0.05). Conclusions Inborn metabolic error are common causes of neonatal hyperammonemia. Timely CRRT can safely and effectively reduce blood ammonia levels and may improve clinical outcomes.

    高氨血症连续性肾脏替代治疗新生儿先天性代谢缺陷遗传病

      原文链接:
    • 万方数据

    血小板源性生长因子BB调控缺氧诱导因子1α表达在缺氧性肺动脉高压新生大鼠肺血管重塑中的机制研究

    杨延青巴依尔才次克郭鑫王乐...
    168-176页
    查看更多>>摘要：目的 探讨血小板源性生长因子BB（platelet-derived growth factor-BB，PDGF-BB）是否通过调控缺氧诱导因子1α（hypoxia induced factor-1 alpha，HIF-1α）表达促进肺动脉平滑肌细胞增殖以及参与缺氧性肺动脉高压（hypoxic pulmonary hypertension，HPH）的肺血管重塑。 方法 160只Wistar新生大鼠按随机数字表法分为常氧组、HPH组、常氧+PDGF-BB组、HPH+PDGF-BB组、HPH+PDGF-BB抑制剂（STI571）组，每组各32只，每组再分为第3、7、14、21天4个亚组，每组8只。PDGF-BB组经尾静脉注射载有PDGF-BB的腺病毒、HPH+STI571组给予STI571灌胃；缺氧建立新生大鼠HPH模型，建模后第3、7、14、21天检测平均右心室收缩压（right ventricular systolic pressure，RVSP），苏木素-伊红染色观察肺小动脉形态变化及检测肺血管重塑指标，免疫组化测定各组PDGF-BB、HIF-1α及增殖相关蛋白核蛋白Ki67在肺血管中的表达部位和表达水平，实时荧光定量聚合酶链反应检测肺组织中PDGF-BB、HIF-1α及Ki67的mRNA水平。 结果 各时间点HPH组RVSP均高于常氧组（P<0.05），HPH+PDGF-BB组RVSP均高于HPH组（P<0.05），HPH+STI571组RVSP均低于HPH+PDGF-BB组与HPH组（P<0.05）；建模后第3天HPH+PDGF-BB组发生肺血管重塑，第7天常氧+PDGF-BB组和HPH组发生肺血管重塑，HPH+STI571组肺血管重塑出现较晚且程度较其他缺氧组轻；第3、7、21天HPH+PDGF-BB组PDGF-BB、HIF-1α、Ki67蛋白及mRNA表达水平均高于其他组（P<0.05），各时间点HPH+STI571组PDGF-BB、HIF-1α、Ki67蛋白及mRNA表达水平均低于HPH+PDGF-BB组和HPH组（P<0.05）。 结论 PDGF-BB通过上调HIF-1α表达水平促进肺动脉平滑肌细胞增殖、加重肺血管重塑，从而提高HPH新生大鼠肺动脉压力。 Methods A total of 160 Wistar neonatal rats were assigned into normoxia group, HPH group, normoxia+PDGF-BB group, HPH+PDGF-BB group and HPH+PDGF-BB inhibitor (STI571) group using random number table method (32 rats in each group), each group was further assigned into 4 subgroups on d3, d7, d14 and d21 (8 rats in each subgroup). HPH model was established using nitrogen-oxygen mixture with an oxygen concentration of 10%±0.5%. PDGF-BB groups were injected with adenovirus encoding PDGF-BB in the tail vein. HPH+STI571 group was given STI571 intragastrically. On d3, d7, d14 and d21 after modeling, mean right ventricular systolic pressure (RVSP) was examined. Morphological changes of small pulmonary arteries were observed using HE staining and indicators of pulmonary vascular remodeling calculated. Immunohistochemistry was used to determine the protein levels of PDGF-BB, HIF-1α and proliferation-associated protein nuclear protein Ki67 in the pulmonary vasculature of each group. RT-qPCR was used to determine the mRNA levels of PDGF-BB, HIF-1α and Ki67 in lung tissue. Results At all time points, RVSP was higher in the HPH group than the normoxia group (P<0.05), higher in the HPH+PDGF-BB group than the HPH group (P<0.05), and lower in the HPH+STI571 group than both the HPH+PDGF-BB group and the HPH group (P<0.05). On d3 after modeling, pulmonary vascular remodeling occurred in the HPH+PDGF-BB group on d7, pulmonary vascular remodeling occurred in the PDGF-BB group and the HPH group. Pulmonary vascular remodeling appeared later and to a lesser extent in the HPH+STI571 group than the other hypoxic groups. On d3, d7 and d21 after modeling, protein and mRNA levels of PDGF-BB, HIF-1α and Ki67 in the HPH+PDGF-BB group were higher than the other groups (P<0.05). The protein and mRNA expression levels of PDGF-BB, HIF-1α and Ki67 in the HPH+STI571 group were lower than the HPH+PDGF-BB group and the HPH group at all timepoints (P<0.05). Conclusions PDGF-BB up-regulates HIF-1α expression, participates in PASMC proliferation, exacerbates pulmonary vascular remodeling and increases pulmonary artery pressure in neonatal rats with HPH. Obiective To study the roles of platelet-derived growth factor-BB (PDGF-BB) in hypoxic pulmonary hypertension (HPH) and the mechanisms of regulating hypoxia-inducible factor-1α (HIF-1α) expression, promoting the proliferation of pulmonary arterial smooth muscle cells (PASMC) and participating in the remodeling of pulmonary vessels.

    血小板源性生长因子BB缺氧诱导因子1α肺动脉高压血管重塑新生大鼠

      原文链接:
    • 万方数据

    新生儿德朗热综合征1例

    牛旭旭杨冬张莉姜莎莎...
    177-178页
    查看更多>>摘要：本文报道1例新生儿德朗热综合征，患儿宫内发育迟缓，生后发现连眉、耳廓畸形、无外耳道，短鼻、鼻孔前倾，长人中，唇薄而红、小头、小手等多发畸形，全外显子检测提示NIPBL基因c.7373-7374del移码变异，家长放弃治疗后于生后1个月死亡。

    德朗热综合征新生儿NIPBL基因

      原文链接:
    • 万方数据

    新生儿中央轴空病1例

    宁岩冯惠李美霞
    178-179页
    查看更多>>摘要：本文报道1例中央轴空病早产儿，生后即出现关节挛缩、肌张力异常、双侧足内翻、髋关节脱位等，基因检测发现RYR1基因错义变异，予运动功能康复训练，1岁时行跟腱松解手术，3岁9月龄时体格生长发育、语言和智力正常，粗大运动能力稍落后于同龄儿。

    中央轴空病新生儿关节挛缩

      原文链接:
    • 万方数据