窒息新生儿肾功能损害尿NAG和RBP的变化

目的：探讨窒息新生儿肾功能损害尿N-乙酰-β-D氨基葡萄糖苷酶(NAG),尿视黄醇结合蛋白(RBP)的变化。方法：采用对硝基苯酚比色法及ELISA测定窒息足月儿、早产儿和正常足月儿、早产儿生后第1,3,7天尿NAG活性和尿RBP含量。结果：重度窒息足月儿、早产儿生后第3,7天尿NAG水平均明显高于对照组(P0.05)。结论：尿NAG,RBP可作为早期监测肾功能损害的常规方法,尿RBP是一项较尿NAG更敏感的肾功能损害的早期诊断指标。     

低分子肝素钙治疗过敏性紫癜及预防肾损害的作用

Objective To investigate the curative effect of low molecular heparin calcium on Henoch-Schoenlein purpura(HSP) and the preventive effect on Henoch-schonlein purpura nephritis.Methods One hundred and three patients with HSP were enrolled in the study and divided randomly into two groups,heparin group(57 cases) and control group(46 cases).Heparin group received low molecular heparin calcisymptom remission time,the incidence of recurrent skin rash were recorded.The contents of D-dipolymer and the three indicators of early renal damage were detected before and after the treatment.Results The remission times of purpura,joint pain and abdominal pain in heparin group[(15.23±3.14) d,(6.80±1.96) d and(6.68±3.42) d]were significantly shorter than those of control group[(17.11±4.79) d,(8.30±2.67)d,(8.59±4.09) d](P ＜0.05).The incidence of recurrent skin rash in heparin group(14.6%) was significantly lower than that of control group(39.1%)(P＜0.01).Compared to control group,the positive rate of D-dipolymer in heparin group was higher(15.8% vs 37.0%),and the urine levels of mALB,β2-MG and NAG were significantly decreased[(12.22±3.92) mg/L,(5.35±0.51) mg/L,(8.12±.65) U/L vs (14.15±5.17) mg/L,(6.54±2.67) mg/L,(10.04±2.60) U/L]during 3 months after treatment(P＜0.01,P ＜0.05).Conclusion Low molecular heparin can shorten the course of HSP and prevent the development of Henoch-Schonlein purpura nephritis.     

Ursodeoxycholic acid prevention on cholestasis associated with total parenteral nutrition in preterm infants:a randomized trial

Background Preterm infants with long-term parenteral nutrition(PN)therapy are at risk for cholestasis associated with total parenteral nutrition(PNAC).This study examined the safety and efficacy of ursodeoxycholic acid(UDCA)in preventing PNAC in preterm infants.Our research aimed to investigate the prophylactic effect of preventive oral UDCA on PNAC in preterm infants.Methods We compared oral administration of UDCA prophylaxis with no prophylaxis in a randomized,open-label,proof-of-concept trial in preterm neonates with PN therapy.The low-birth-weight preterm infants(<1800 g)who were registered to the neonatal intensive care unit(NICU)within 24 hours after birth were randomized.The main endpoint was the weekly values of direct bilirubin(DB)of neonates during the NICU stay.Results Eventually,a total of 102 preterm neonates from January 2021 to July 2021 were enrolled in this prospective study(42 in the UDCA group and 60 in the control group).Notably,the peak serum level of DB[13.0(12-16)vs.15.2(12.5-19.6)μmol/L,P<0.05]was significantly lower in the UDCA group than that in the control group without prevention.The peak serum level of total bilirubin(101.1±34 vs.116.5±28.7μmol/L,P<0.05)was also significantly lower in the UDCA group than in the control group.Furthermore,the proportion of patients who suffered from neonatal cholestasis(0.0%vs.11.7%,P<0.05)in the UDCA group was significantly lower.Conclusion UDCA prophylaxis is beneficial in preventing PNAC in NICU infants receiving prolonged PN.     

低分子肝素钙治疗过敏性紫癜及预防肾损害的作用

Objective To investigate the curative effect of low molecular heparin calcium on Henoch-Schoenlein purpura(HSP) and the preventive effect on Henoch-schonlein purpura nephritis.Methods One hundred and three patients with HSP were enrolled in the study and divided randomly into two groups,heparin group(57 cases) and control group(46 cases).Heparin group received low molecular heparin calcisymptom remission time,the incidence of recurrent skin rash were recorded.The contents of D-dipolymer and the three indicators of early renal damage were detected before and after the treatment.Results The remission times of purpura,joint pain and abdominal pain in heparin group[(15.23±3.14) d,(6.80±1.96) d and(6.68±3.42) d]were significantly shorter than those of control group[(17.11±4.79) d,(8.30±2.67)d,(8.59±4.09) d](P ＜0.05).The incidence of recurrent skin rash in heparin group(14.6%) was significantly lower than that of control group(39.1%)(P＜0.01).Compared to control group,the positive rate of D-dipolymer in heparin group was higher(15.8% vs 37.0%),and the urine levels of mALB,β2-MG and NAG were significantly decreased[(12.22±3.92) mg/L,(5.35±0.51) mg/L,(8.12±.65) U/L vs (14.15±5.17) mg/L,(6.54±2.67) mg/L,(10.04±2.60) U/L]during 3 months after treatment(P＜0.01,P ＜0.05).Conclusion Low molecular heparin can shorten the course of HSP and prevent the development of Henoch-Schonlein purpura nephritis.     

低分子肝素钙治疗过敏性紫癜及预防肾损害的作用

Objective To investigate the curative effect of low molecular heparin calcium on Henoch-Schoenlein purpura(HSP) and the preventive effect on Henoch-schonlein purpura nephritis.Methods One hundred and three patients with HSP were enrolled in the study and divided randomly into two groups,heparin group(57 cases) and control group(46 cases).Heparin group received low molecular heparin calcisymptom remission time,the incidence of recurrent skin rash were recorded.The contents of D-dipolymer and the three indicators of early renal damage were detected before and after the treatment.Results The remission times of purpura,joint pain and abdominal pain in heparin group[(15.23±3.14) d,(6.80±1.96) d and(6.68±3.42) d]were significantly shorter than those of control group[(17.11±4.79) d,(8.30±2.67)d,(8.59±4.09) d](P ＜0.05).The incidence of recurrent skin rash in heparin group(14.6%) was significantly lower than that of control group(39.1%)(P＜0.01).Compared to control group,the positive rate of D-dipolymer in heparin group was higher(15.8% vs 37.0%),and the urine levels of mALB,β2-MG and NAG were significantly decreased[(12.22±3.92) mg/L,(5.35±0.51) mg/L,(8.12±.65) U/L vs (14.15±5.17) mg/L,(6.54±2.67) mg/L,(10.04±2.60) U/L]during 3 months after treatment(P＜0.01,P ＜0.05).Conclusion Low molecular heparin can shorten the course of HSP and prevent the development of Henoch-Schonlein purpura nephritis.     

低分子肝素钙治疗过敏性紫癜及预防肾损害的作用

Objective To investigate the curative effect of low molecular heparin calcium on Henoch-Schoenlein purpura(HSP) and the preventive effect on Henoch-schonlein purpura nephritis.Methods One hundred and three patients with HSP were enrolled in the study and divided randomly into two groups,heparin group(57 cases) and control group(46 cases).Heparin group received low molecular heparin calcisymptom remission time,the incidence of recurrent skin rash were recorded.The contents of D-dipolymer and the three indicators of early renal damage were detected before and after the treatment.Results The remission times of purpura,joint pain and abdominal pain in heparin group[(15.23±3.14) d,(6.80±1.96) d and(6.68±3.42) d]were significantly shorter than those of control group[(17.11±4.79) d,(8.30±2.67)d,(8.59±4.09) d](P ＜0.05).The incidence of recurrent skin rash in heparin group(14.6%) was significantly lower than that of control group(39.1%)(P＜0.01).Compared to control group,the positive rate of D-dipolymer in heparin group was higher(15.8% vs 37.0%),and the urine levels of mALB,β2-MG and NAG were significantly decreased[(12.22±3.92) mg/L,(5.35±0.51) mg/L,(8.12±.65) U/L vs (14.15±5.17) mg/L,(6.54±2.67) mg/L,(10.04±2.60) U/L]during 3 months after treatment(P＜0.01,P ＜0.05).Conclusion Low molecular heparin can shorten the course of HSP and prevent the development of Henoch-Schonlein purpura nephritis.     

新生儿缺氧缺血性脑病合并心肌损伤血浆N端脑利钠肽前体的变化及与预后的相关性

Objective To investigate the changes of N-terminal pro-brain natriuretic peptide (NT-proBNP) in neonates with hypoxic-ischemic encephalopathy (HIE) complicated by myocardial ischemic injury. Methods Forty neonates with HIE ( 16 cases with concurrent myocardial injury and 24 cases without) were enrolled. Twenty healthy neonates were used as control. Plasma NT-proBNP levels were measured using enzyme immunoassay. Cardiac function was measured by echocardiography. Results ( 1 ) The mean plasma NT-proBNP levels in patients with myocardial injury[(350 ± 56) pmol/L]were significantly higher than those in patients without myocardial injury[(135 ± 37 ) pmol/L]and in the control group [(117 ±23) pmol/L](P ＜0. 05). (2) The NT-proBNP levels in mild,moderate and severe HIE neonates were ( 132 ±34) pmol/L, (247 ±43) pmol/L and (343 ±53) pmol/L. Compared with the control group,the NT-proBNP levels in the neonates with moderate and severe HIE significantly increased. There were significant differences in the NT-proBNP levels among the mild, moderate and severe HIE neonates ( P ＜ 0. 05 ).(3) In patients with myocardial injury,the NT-proBNP levels significantly decreased in the convalescent phase [(250±78) pmol/L]compared with those in the acute phase[(350±56) pmol/L](P ＜0.05). (4) The NT-proBNP levels were significantly related with left ventricular ejection fraction. Conclusion Plasma NT-proBNP levels increase in neonates with HIE complicated with myocardial ischemic injury in the acute phase.Detection of NT-proBNP levels maybe useful in the diagnosis of myocardial ischemic injury and severe HIE.     

低分子肝素钙治疗过敏性紫癜及预防肾损害的作用

Objective To investigate the curative effect of low molecular heparin calcium on Henoch-Schoenlein purpura(HSP) and the preventive effect on Henoch-schonlein purpura nephritis.Methods One hundred and three patients with HSP were enrolled in the study and divided randomly into two groups,heparin group(57 cases) and control group(46 cases).Heparin group received low molecular heparin calcisymptom remission time,the incidence of recurrent skin rash were recorded.The contents of D-dipolymer and the three indicators of early renal damage were detected before and after the treatment.Results The remission times of purpura,joint pain and abdominal pain in heparin group[(15.23±3.14) d,(6.80±1.96) d and(6.68±3.42) d]were significantly shorter than those of control group[(17.11±4.79) d,(8.30±2.67)d,(8.59±4.09) d](P ＜0.05).The incidence of recurrent skin rash in heparin group(14.6%) was significantly lower than that of control group(39.1%)(P＜0.01).Compared to control group,the positive rate of D-dipolymer in heparin group was higher(15.8% vs 37.0%),and the urine levels of mALB,β2-MG and NAG were significantly decreased[(12.22±3.92) mg/L,(5.35±0.51) mg/L,(8.12±.65) U/L vs (14.15±5.17) mg/L,(6.54±2.67) mg/L,(10.04±2.60) U/L]during 3 months after treatment(P＜0.01,P ＜0.05).Conclusion Low molecular heparin can shorten the course of HSP and prevent the development of Henoch-Schonlein purpura nephritis.     

低分子肝素钙治疗过敏性紫癜及预防肾损害的作用

Objective To investigate the curative effect of low molecular heparin calcium on Henoch-Schoenlein purpura(HSP) and the preventive effect on Henoch-schonlein purpura nephritis.Methods One hundred and three patients with HSP were enrolled in the study and divided randomly into two groups,heparin group(57 cases) and control group(46 cases).Heparin group received low molecular heparin calcisymptom remission time,the incidence of recurrent skin rash were recorded.The contents of D-dipolymer and the three indicators of early renal damage were detected before and after the treatment.Results The remission times of purpura,joint pain and abdominal pain in heparin group[(15.23±3.14) d,(6.80±1.96) d and(6.68±3.42) d]were significantly shorter than those of control group[(17.11±4.79) d,(8.30±2.67)d,(8.59±4.09) d](P ＜0.05).The incidence of recurrent skin rash in heparin group(14.6%) was significantly lower than that of control group(39.1%)(P＜0.01).Compared to control group,the positive rate of D-dipolymer in heparin group was higher(15.8% vs 37.0%),and the urine levels of mALB,β2-MG and NAG were significantly decreased[(12.22±3.92) mg/L,(5.35±0.51) mg/L,(8.12±.65) U/L vs (14.15±5.17) mg/L,(6.54±2.67) mg/L,(10.04±2.60) U/L]during 3 months after treatment(P＜0.01,P ＜0.05).Conclusion Low molecular heparin can shorten the course of HSP and prevent the development of Henoch-Schonlein purpura nephritis.     

低分子肝素钙治疗过敏性紫癜及预防肾损害的作用

Objective To investigate the curative effect of low molecular heparin calcium on Henoch-Schoenlein purpura(HSP) and the preventive effect on Henoch-schonlein purpura nephritis.Methods One hundred and three patients with HSP were enrolled in the study and divided randomly into two groups,heparin group(57 cases) and control group(46 cases).Heparin group received low molecular heparin calcisymptom remission time,the incidence of recurrent skin rash were recorded.The contents of D-dipolymer and the three indicators of early renal damage were detected before and after the treatment.Results The remission times of purpura,joint pain and abdominal pain in heparin group[(15.23±3.14) d,(6.80±1.96) d and(6.68±3.42) d]were significantly shorter than those of control group[(17.11±4.79) d,(8.30±2.67)d,(8.59±4.09) d](P ＜0.05).The incidence of recurrent skin rash in heparin group(14.6%) was significantly lower than that of control group(39.1%)(P＜0.01).Compared to control group,the positive rate of D-dipolymer in heparin group was higher(15.8% vs 37.0%),and the urine levels of mALB,β2-MG and NAG were significantly decreased[(12.22±3.92) mg/L,(5.35±0.51) mg/L,(8.12±.65) U/L vs (14.15±5.17) mg/L,(6.54±2.67) mg/L,(10.04±2.60) U/L]during 3 months after treatment(P＜0.01,P ＜0.05).Conclusion Low molecular heparin can shorten the course of HSP and prevent the development of Henoch-Schonlein purpura nephritis.     

低分子肝素钙治疗过敏性紫癜及预防肾损害的作用

Objective To investigate the curative effect of low molecular heparin calcium on Henoch-Schoenlein purpura(HSP) and the preventive effect on Henoch-schonlein purpura nephritis.Methods One hundred and three patients with HSP were enrolled in the study and divided randomly into two groups,heparin group(57 cases) and control group(46 cases).Heparin group received low molecular heparin calcisymptom remission time,the incidence of recurrent skin rash were recorded.The contents of D-dipolymer and the three indicators of early renal damage were detected before and after the treatment.Results The remission times of purpura,joint pain and abdominal pain in heparin group[(15.23±3.14) d,(6.80±1.96) d and(6.68±3.42) d]were significantly shorter than those of control group[(17.11±4.79) d,(8.30±2.67)d,(8.59±4.09) d](P ＜0.05).The incidence of recurrent skin rash in heparin group(14.6%) was significantly lower than that of control group(39.1%)(P＜0.01).Compared to control group,the positive rate of D-dipolymer in heparin group was higher(15.8% vs 37.0%),and the urine levels of mALB,β2-MG and NAG were significantly decreased[(12.22±3.92) mg/L,(5.35±0.51) mg/L,(8.12±.65) U/L vs (14.15±5.17) mg/L,(6.54±2.67) mg/L,(10.04±2.60) U/L]during 3 months after treatment(P＜0.01,P ＜0.05).Conclusion Low molecular heparin can shorten the course of HSP and prevent the development of Henoch-Schonlein purpura nephritis.     

低分子肝素钙治疗过敏性紫癜及预防肾损害的作用

Objective To investigate the curative effect of low molecular heparin calcium on Henoch-Schoenlein purpura(HSP) and the preventive effect on Henoch-schonlein purpura nephritis.Methods One hundred and three patients with HSP were enrolled in the study and divided randomly into two groups,heparin group(57 cases) and control group(46 cases).Heparin group received low molecular heparin calcisymptom remission time,the incidence of recurrent skin rash were recorded.The contents of D-dipolymer and the three indicators of early renal damage were detected before and after the treatment.Results The remission times of purpura,joint pain and abdominal pain in heparin group[(15.23±3.14) d,(6.80±1.96) d and(6.68±3.42) d]were significantly shorter than those of control group[(17.11±4.79) d,(8.30±2.67)d,(8.59±4.09) d](P ＜0.05).The incidence of recurrent skin rash in heparin group(14.6%) was significantly lower than that of control group(39.1%)(P＜0.01).Compared to control group,the positive rate of D-dipolymer in heparin group was higher(15.8% vs 37.0%),and the urine levels of mALB,β2-MG and NAG were significantly decreased[(12.22±3.92) mg/L,(5.35±0.51) mg/L,(8.12±.65) U/L vs (14.15±5.17) mg/L,(6.54±2.67) mg/L,(10.04±2.60) U/L]during 3 months after treatment(P＜0.01,P ＜0.05).Conclusion Low molecular heparin can shorten the course of HSP and prevent the development of Henoch-Schonlein purpura nephritis.     

小剂量多巴胺联用酚妥拉明治疗原发性肾病综合征患儿水肿的临床研究

目的 探讨小剂量多巴胺联用等量酚妥拉明对原发性肾病综合征(PNS)患儿水肿的疗效及安全性.方法 采取回顾性对照研究的方法.在常规综合治疗的基础上,对155例PNS并发水肿患儿(联用治疗组)给予小剂量多巴胺联用等量酚妥拉明治疗,并与128例单用呋塞米患儿(呋塞米治疗组)对照.结果 联用治疗组治疗后尿量、尿钠均高于治疗前,差异有显著性(P＜0.01),而血钾、血钠及尿钾虽高于治疗前,但差异无显著性(P＞0.05).呋塞米治疗组治疗后尿量、尿钾、尿钠均高于治疗前,差异有显著性(P＜0.01),而血钾、血钠均低于治疗前,差异有显著性(P＜0.01).联用治疗组治疗后水肿减轻率、尿量、尿钠、血钾及血钠均高于呋塞米治疗组,差异有显著性(P＜0.01);而尿钾低于呋塞米治疗组,差异有显著性(P＜0.05).治疗后药物不良反应发生率方面,联用治疗组低于呋塞米治疗组,差异有显著性(P＜0.01).结论 小剂量多巴胺联用等量酚妥拉明治疗小儿PNS水肿安全、有效,适用于不同血容量状态的患儿,可替代呋塞米等利尿剂作为一线用药.

Abstract：

Objective To explore the efficacy and safety of low dose dopamine combined with phentolamine in the treatment of primary nephrotic syndrome (PNS) with edema. Methods Retrospective control studies were performed in 155 patients of PNS with edema, who received comprehensive treatment with small dose dopamine combined with phentolamine (group A). Patients treated with furosemide infusion were recruited as control (group B). Results The urinary output, urinary sodium increased after therapy in group A, showing significant differences (P ＜ 0. 01). But urinary potassium excretion, serum sodium and potassium showed no significant difference after therapy in group A. The urinary output, urinary sodium and potassium excretion increased and the serum sodium and potassium decreased after therapy in group B, all showing significant differences between before and after treatment (P ＜0. 01). The edema relief rate,urinary output, urinary sodium excretion, serum sodium and potassium in group A was significantly higher whereas urinary potassium excretion were significantly lower than those of group B(P ＜0. 01). The rate of drug adverse reaction in group A was significantly lower than that of group B. Conclusion Low dose dopamine combined with phentolamine in PNS with edema is safe and effective,which may be a substitute of diuretic like furosemide in the treatment of edema of patients with different blood volume.     

低分子肝素钙治疗过敏性紫癜及预防肾损害的作用

Objective To investigate the curative effect of low molecular heparin calcium on Henoch-Schoenlein purpura(HSP) and the preventive effect on Henoch-schonlein purpura nephritis.Methods One hundred and three patients with HSP were enrolled in the study and divided randomly into two groups,heparin group(57 cases) and control group(46 cases).Heparin group received low molecular heparin calcisymptom remission time,the incidence of recurrent skin rash were recorded.The contents of D-dipolymer and the three indicators of early renal damage were detected before and after the treatment.Results The remission times of purpura,joint pain and abdominal pain in heparin group[(15.23±3.14) d,(6.80±1.96) d and(6.68±3.42) d]were significantly shorter than those of control group[(17.11±4.79) d,(8.30±2.67)d,(8.59±4.09) d](P ＜0.05).The incidence of recurrent skin rash in heparin group(14.6%) was significantly lower than that of control group(39.1%)(P＜0.01).Compared to control group,the positive rate of D-dipolymer in heparin group was higher(15.8% vs 37.0%),and the urine levels of mALB,β2-MG and NAG were significantly decreased[(12.22±3.92) mg/L,(5.35±0.51) mg/L,(8.12±.65) U/L vs (14.15±5.17) mg/L,(6.54±2.67) mg/L,(10.04±2.60) U/L]during 3 months after treatment(P＜0.01,P ＜0.05).Conclusion Low molecular heparin can shorten the course of HSP and prevent the development of Henoch-Schonlein purpura nephritis.     

角质细胞生长因子-1在脓毒症大鼠肾脏的表达及意义

目的 探讨角质细胞生长因子-1(keratinocyte growth factor-1,KGF-1)在脓毒症大鼠肾脏的表达及意义.方法 将80只6周龄健康雄性Wistar大鼠随机分成手术组和假手术组(各40只).用盲肠结扎穿刺法制备脓毒症大鼠模型.两组分别在术后3h、6h、12h、24h和36h留取血液及肾脏标本,HE染色光镜观察大鼠肾脏病理学变化,测定血肌酐(Cr)、尿素氮(BUN)浓度及WBC计数,免疫组织化学SABC染色法检测KGF-1蛋白表达,实时荧光定量PCR法检测KGF-1mRNA的基因相对表达量.结果 与假手术组相比,手术组24h肾损伤最严重,可见肾小管空泡变性,大量中性粒细胞、淋巴细胞及单核细胞浸润、局部有点状出血、坏死;血Cr、BUN术后3h无明显升高,6h后升高,24h达峰值,36h略有下降,差异有统计学意义(P<0.01).KGF-1蛋白及基因表达6h最强,12h有所下降,24h出现第二次表达高峰,36h又有所下降,均明显高于假手术组(P<0.01).KGF-1mRNA与BUN成正相关(r=0.504,P<0.01),与Cr成正相关(r=0.382,P<0.05).结论 KGF-1在正常大鼠肾脏中即有表达,主要集中在髓质肾小管上皮细胞,皮质肾小管也有分布.脓毒症受损肾脏的KGF-1表达显著增强且与肾脏损伤程度呈正相关,推测KGF-1是影响感染后肾脏损伤修复的重要因素之一.

Abstract：

Objective To investigate the expression and significance of keratinocyte growth factor-1(KGF-1) in the kidneys of septic rats.Methods Eighty male Wistar rats were randomly divided into the sepsis group and sham operation group.Either group was divided into 3-hour,6-hour,12-hour,24-hour and 36-hour subgroups,with 8 rats in each.Sepsis models were established by cecum ligation perforation (CLP).The kidney and blood samples were respectively taken for pathological study.Serum creatinine (Cr) and blood urea nitrogen (BUN) level determination and leukocyte counting were performed.KGF-1 protein was detected by immunohistochemical method and the expression of KGF-1 genes by real time PCR.Results The renal tubules in sepsis group were injured most at 24h after operation,which were infiltrated by considerable neutrophilic granulocytes,leukomonocytes and mononuclear cells,with vacuolar degeneration,focal hemorrhage and necrosis under the light microscopy.Serum Cr and BUN increased from 6h after operation,and reached the peak at 24h after operation in sepsis group,which were significantly different in those of sham operation group (P< 0.01).Compared with sham operation group,the expression of KGF-1 protein and genes of sepsis group increased significantly and reached the peak at 6h after operation.KGF-1mRNA was positively correlated with BUN and Cr (r=0.504,P<0.01;r=0.382,P<0.05).Conclusion KGF-1 was also expressed in normal kidneys,mainly in tubule epithelial cells of renal medulla and also in that of renal cortex.The expression of KGF-1 in sepsis group was obviously higher than that of sham operation group,and was positively correlated with the degree of kidney damage after infection.KGF-1 was speculated to be one of the protective factors affecting the repair of impaired kidneys caused by infection.     

Changes of B cell - activating factor and a proliferation - inducing ligand in serum of children with Henoch -Schonlein purpura nephritis北大核心CSCD

Objective To investigate the changes of B cell - activating factor (BAFF) and a proliferation -inducing ligand (APRIL) in serum of children with Henoch - Schonlein purpura nephritis (HSPN), and to explore their role in the pathogenesis of children HSPN. Methods A total of 28 children with HSPN who were before treatment were selected in Department of Pediatrics Nephrology and Rheumatology,Shengjing Hospital of China Medical University from November 2017 to August 2018. Sixteen children with Henoch - Schonlein purpura were selected as HSP group, and 20 healthy children were selected as healthy control group. Followed the HSPN guideline to cure the patients for 6-8 weeks. The clinical data were collected. Serum levels of BAFF and APRIL were measured by adopting enzyme -linked immunosorbent assay (ELISA). Results (1) Changes of serum BAFF level: the serum levels of BAFF in HSPN children were significantly lower than those in the HSP group and the healthy control group [HSPN group (0. 652 ± 0.360) |jLg/L,HSP group (1.276 ±0.459) |jig/L, healthy control group (1. 285 ± 0. 299) |jLg/L, F = 17. 519,P = 0.000]. Moreover, the serum levels of BAFF in before treatment were significantly lower than those in after treatment [before treatment (0. 652 ± 0. 360) |JLg/L, after treatment (0. 860 ±0. 262) |JLg/L, P < 0. 05). However, there were no significant di-fferences in the serum levels of BAFF between HSP group and healthy control group (P >0.05). (2)Changes of serum APRIL level: the serum levels of APRIL in HSPN and HSP children were both significantly higher than those in healthy control group,but there were no marked differences between the 2 groups [HSPN group (2.285 ±1.015) |JLg/L, HSP group (2.609 ±1.264) |jig/L, healthy control group (1.677 ±0. 118) |JLg/L,F =3. 647,P =0. 016]. There were no significant differences in the serum levels of APRIL between before treatment and after treatment [before treatment (2. 285 ±1.015) |JLg/L, after treatment (2. 042 ± 0. 695) |Jig/L, P > 0. 05]. (3) Pearson correlation analysis results showed that the serum levels of BAFF were negatively correlated with 24 h urinary protein, urinary microalbumin, and urine red blood cell count (r = -0. 587, -0.608, -0.515,all P <0. 05). The serum levels of APRIL were positively correlated with serum IgA(r = 0. 588,P < 0. 05). Conclusions The level of serum BAFF decreased and APRIL increased in children with HSPN, which was related to the degree of renal involvement. It suggests that BAFF and APRIL may be related to the pathogenesis of HSPN in children. © 2019 Chinese Medical Journals Publishing House Co.Ltd. All rights reserved.     

儿茶酚胺类药物对感染性休克兔胃肠灌注的影响

Objective To assess the effects of dopamine,dobutamine and norepinephrine on the P(g-a)CO2 and superior mesenteric blood flow in septic shock.Methods Rabbit septic shock model was established by challenging with intravenous injection of lipopolysaccharides from Escherichia coil(2 mg/kg).The rabbits with septic shock were randomly assigned to 3 groups-dopamine group(n = 8),dobutamine group(n = 8) and norepinephrine group(n = 8).Apart from volume resuscitation with normal saline solution [20 ml/(kg· h)]，dopamine[5μg/(kg·min)],dobutamine[(5μg/(kg·min)]and norepinephrine [(1μg/(kg·min)]were infused in dopamine group,dobutamine group and norepinephrine group respeclively.Cardiac index(CI) and superior mesenteric blood flow index(SMBFI) were continuously monitored by doppler flowrneter.Gastric mucosal PCO2 was evaluated by gas tonometry every 10 min.Arterial and venous blood gas analyses and lactate levels were measured every 1 h.Results MAP,CI,and SMBFI significandy decreased and P(g-a) CO2 increased after lipopolysaccharides infusion in three groups.After 2-hour treatment,MAP in norepinephrine group[(70 +3) mm Hg]was higher than that of dopamine group[(66±4) mm Hg]and dobutamine group[(65±4) mm Hg](P ＜0.05).SMBFI in norepinephrine group [(18.7±2.9) ml/(kg·min)]was higher than that of dopamine group[(16.2±1.6) ml/(kg·min)]and dobutamine group[(15.8±1.9) ml/(kg·min)](P＜0.05).P(g-a) CO2 in norepinephrine group [(30±6) mm Hg]was lower than that of dobutamine group[(23±5)mm Hg](P＜0.05).Condnsion As an adjuvant therapy of volume resuscitation,norepinephrine is more effective than low dose dopamine and dobutamine in improving splanchnic perfusion.     

呼吸衰竭新生儿肾上腺皮质功能状态分析

Objective To observe the adrenal function in neonates with respiratory failure(neonatal respiratory distress syndrome,pneumonia and severe wet lung),the incidence of adrenal insufficiency,and the relationships between adrenal function and lung diseases.Methods Fifty-five cases of neonates(the preterm group of 33 cases,the term group of 22 cases)were enrolled the study.Serum cortisol values and plasma adrenocorticotropic hormone(ACTH)concentration were detected in the morning.Peak serum cortisol values were detected after 30 minutes low-dose(1 μg/1.73 m2)ACTH stimulation test.Adrenal insufficiency was defined as the peak serum cortisol values ＜ 200 μg/L.Results The mean basal serum cortisol values of the preterm group was significantly higher than that of the term group[(139.2±85.4)μg/L vs(92.1±75.0)μg/L,P=0.0407],and the mean poststimulation increase cortisol level[(122.3±56.4)μg/L vs(198.2±77.9)μg/L,P=0.000 1]and the mean ACTH level[(5.22±2.40)ng/L vs(8.66±5.41)ng/L,P =0.008 4]of the preterm group were significantly lower than that of the term group.The total incidence of adrenal insufficiency in neonates with respiratory failure was 20.0%(11/55),and the incidence of adrenal insufficiency was 21.2%(7/33)in the preterm group and 18.2%(4/22)in the term group.Neonates who had the ventilatory requirements had significantly higher incidence of adrenal insufficiency than neonates who did not have the requirements(29.4% vs 4.8%,P = 0.037).None neonate with adrenal insufficiency died.Conclusion The adrenal and the pituitary function of preterm infants are poor than term infants.The incidence of adrenal insufficiency in neonates with respiratory failure is high,especially in the neonates who have the ventilatory requirements.We do not found relationship between the mortality and adrenal insufficiency.The low-dose ACTH test could be a valuable tool in assessing the function of HPA-axis in neonates with respiratory failure.     

足月儿与早产儿排尿方式的比较研究

目的 探讨足月儿与早产儿出生后排尿方式的不同.方法 选取2010年3月至5月人住郑州大学第一附属医院新生儿室的出生后3～7d足月儿12例与早产儿14例作为研究对象,足月儿孕(38.3±1.1)周,体重(3.1±0.4)kg,早产儿孕(32.5±1.6)周,体重(1.7±0.4)kg.观察新生儿在12 h内(上午9点至晚上9点)的自由排尿情况,记录每次排尿量、残余尿量、排尿时的意识状态(清醒/睡眠)、排尿次数及排尿时间等参数,同时记录饮奶量、液体输入量及摄入时间,液体摄人量按标准进行.每次排尿量等于排尿后尿垫重量减去排尿前尿垫重量,残余尿量由超声检测仪测得.共观察记录了220例次.结果 每次排尿量、残余尿量、排尿次数、排尿时意识清醒状态百分比在足月儿分别为(19.8±10.9)ml、(1.55±1.01)ml、(7.2±1.9)次、(43.5±26.8)%,而在早产儿则分别为(11.1±7.5)ml、(1.82±0.88)ml、(9.6±2.5)次、(24.7±19.1)%.二组数据相比,早产儿的每次排尿量及排尿时意识清醒状态百分比小于足月儿,残余尿量及排尿次数大于足月儿,均具有统计学差异(P＜0.05).结论 足月儿与早产儿排尿方式明显不同,提示足月儿膀胱功能的发育优于早产儿,早产儿膀胱功能及其受控制的神经系统发育较足月儿明显延迟.

Abstract：

Objective To study the voiding patterns of term and preterm newborns.Methods Between March 2010 and May 2010,26 hospitalized newborns aged 3 to 7 days at this center were recruited in this study.In these patients,12 were term newborns,with an average gestational age of (38.3 ± 1.1 ) weeks,weight of (3.1 ± 0.4) kg,14 were preterm newborns with an average gestational age of (32.5 ± 1.6) weeks,and weight of (1.7 ± 0.4) kg.The voiding volumes (VV),post-void residual volumes (PRV),state of consciousness at voiding,voiding time (VT),voiding frequency (VF)in 12 hours as well as the volume of milk and liquid fed in the same time frame were recorded and analyzed retrospectively.Results In the term newborns,the VV and consciousness voiding rate were significantly higher compared with the preterm newborns [VV and consciousness voiding rate,( 19.8 ±10.9) ml (43.5 ± 26.8%) vs (11.1 ± 7.5) ml (24.7 ± 19.1 %),P＜0.05].However,the PRV and VF were significant lower in term newborns [PRV and VF,(1.55 ± 1.01 ) ml (7.2 ± 1.9) times vs (1.82 ± 0.88) ml (9.6 ± 2.5) times,P＜0.05].Conclusions Incomplete voiding pattern exists in term and preterm newborns.The better urodynamic parameters of the term newborns indicate the term newborns have better mature bladder function than preterm newborns.     

Changes and significance of type 2 innate lymphoid cells and their related factors in bronchopulmonary dysplasia北大核心CSCD

Objective To investigate the changes and significance of type 2 innate lymphoid cells (ILC2), interleukin-33 (IL-33), interleukin-25 (IL-25), thymic stromal lymphopoietin (TSLP), interleukin-5 (IL-5), and interleukin-13 (IL-13) in peripheral blood of preterm infants with bronchopulmonary dysplasia (BPD). Methods A total of 76 preterm infants with a gestational age of <32 weeks and a length of hospital stay of ≥14 days who were admitted to the Department of Pediatrics of the Affiliated Hospital of Jiangsu University from September 2020 to December 2021 were enrolled. According to the diagnostic criteria for BPD, they were divided into a BPD group with 30 infants and a non-BPD group with 46 infants. The two groups were compared in terms of the percentage of ILC2 and the levels of IL-33, IL-25, TSLP, IL-5, and IL-13 in peripheral blood on days 1, 7, and 14 after birth. Results The BPD group had significantly lower birth weight and gestational age than the non-BPD group (P<0.05). On days 7 and 14 after birth, the BPD group had significantly higher levels of ILC2, IL-33, TSLP, and IL-5 than the non-BPD group (P<0.05), and these indices had an area under the curve of >0.7 in predicting the devolpment of BPD (P<0.05). Multivariate logistic regression analysis showed that after adjusting for gestational age and birth weight, peripheral blood IL-33, TSLP and IL-5 on days 7 and 14 after birth were closely related to the devolpment of BPD (P<0.05). Conclusions Early innate immune activation and upregulated expression of related factors may be observed in preterm infants with BPD. ILC2, IL-33, TSLP, and IL-5 may be used as biological indicators for early diagnosis of BPD. © 2023 Xiangya Hospital of CSU. All rights reserved.