BACKGROUNDThe mechanism of PALLD, PRKCH, AKAP12, PDK4, and CHIT1 proteins in serum diagnosis of neonatal sepsis (NS) was explored.METHODSAnalysis of PALLD, PRKCH, AKAP12, PDK4, and CHIT1 expression in serum from NS patients and their correlations were manifested. Evaluation of the ability of PALLD, PRKCH, AKAP12, PDK4, and CHIT1 to identify NS was manifested. Analysis of the prognostic value of PALLD, PRKCH, AKAP12, PDK4, and CHIT1 was in NS.RESULTSElevated PALLD, PRKCH, AKAP12, PDK4, and CHIT1 were found in serum from NS patients. Serum PALLD, PRKCH, AKAP12, PDK4, and CHIT1 have diagnostic value for NS. Moreover, PALLD could predict the overall survival of NS patients.CONCLUSIONSThis study clarifies elevated PALLD, PRKCH, AKAP12, PDK4, and CHIT1 in NS patients. Meanwhile, PALLD, PRKCH, AKAP12, PDK4, and CHIT1 are available to offer brand-new non-invasive biomarkers for NS's prognosis and diagnosis.

Objective To explore the morbidity and mortality rates for ＜32 weeks gestational age(GA) preterm infants in Bayi Children's Hospital,the Military General Hospital of Beijing,aims to identify clinically applicable strategies for improvement in outcomes of preterm infants.Methods Neonatal data were collected from 1838 infants of very low GA (＜ 32 weeks) who were born at or transferred to Bayi Children's Hospital,the Military General Hospital of Beijing,in 2010-2012.The infants were divided into 7 groups according to GA.The clinical data and complications were analyzed,and the mortality rate during initial hospitalization and major neonatal morbidity such as bronchopulmonary dysplasia (BPD),necrotizing enterocolitis (NEC),severe retinopathy of prematurity (ROP),severe intraventricular hemorrhage(IVH),and sepsis in survivors were assessed.Results From 2010 to 2012,there was a significant decreasing trend in the mortality rate for infants ＜32 weeks GA(6.8％ in 2010,4.0％ in 2011 and 2.7％ in 2012; x2 =12.269,P ＜0.01).The mortality rate were also decreased in each GA group from 2010 to 2012,but there was no significant difference(all P ＞0.05) except 28 week GA infants(P =0.01).The major morbidity rate in survivors of infants ＜ 32 weeks GA was 20.8％ in 2010,18.4％ in 2011 and 15.5 ％ in 2012 (x2 =6.436,P ＜ 0.05).The major morbidity rate in the survivors were also decreased in each GA group from 2010 to 2012,but there was no significant differences(all P ＞ 0.05).Mortality and major morbidity rates in all years were highest in infants at the lowest GAs (GA ＜ 28 weeks) especially in 25 weeks GA infants,and decreased with GA increasing.There was no significant difference in the incidence of moderate and severe BPD,severe NEC,Ⅲ or Ⅳ grade IVH,stage Ⅲ to Ⅴ ROP and sepsis for infants ＜ 32 weeks GA from 2010 to 2012 (all P ＞ 0.05).Conclusions Mortality and major neonatal morbidity in the survivors decreased in infants ＜32 weeks GA between 2010 and 2012.But extremely low GA infants(＜28 week) have high mortality and major morbidity known to be associated with long term adverse consequences.Optimized the management of severe complications can help to improve the outcome of the infants' medicare.

肺出血是新生儿常见急重症,起病急,进展迅速,病死率极高.极低出生体重儿(very low birth weight infant,VLBWI)由于其特殊的发育特点和生理状态,是肺出血发病的高危群体.本研究对本院新生儿重症监护病房2008年10月至2009年9月收治的181例VLBWI中发生肺出血的情况及其高危因素和临床转归进行分析.

目的 分析早产新生儿监护病房(PNICU)内早产儿真菌性败血症的临床特点,为其诊治及预防提供参考依据.方法 对PNICU21例确诊为真菌性败血症早产儿的临床资料进行回顾性分析.结果 21例真菌性败血症患儿均为＜34周早产儿,占同期出院早产儿的1.24%,体质量均＜1800g,其中极低出生体质量儿10例,超低出生体质量儿2例.21例真菌感染前全部接受广谱抗生素治疗及静脉营养,17例有皮质激素暴露,17例曾机械通气,4例留置中心静脉导管(PICC),4例曾外科胸腔闭式引流,2例曾使用抑酸剂.起病最早为生后10d,最晚57d.表现为发热、呼吸暂停、灌注差、惊厥等症状.6例血常规白细胞＜5.0×109/L,14例C反应蛋白明显升高,13例血小板＜100×109/L,血培养近平滑假丝酵母10例,罗伦特隐球菌3例,无名假丝酵母3例,白色假丝酵母菌2例,季也蒙假丝酵母菌、葡萄牙假丝酵母、粉状毕赤酵母各1例,药敏均提示对二性霉素B敏感,氟康唑敏感率为90.48%.脑脊液检查1例白细胞和蛋白均明显增高,培养与血培养一致.CT检查脑组织大片坏死.21例均接受氟康唑抗真菌及对症支持治疗,15例治愈,5例放弃治疗自动出院,1例死亡.结论 PNICU真菌败血症多见于＜34周早产儿,以假丝酵母类最为多见,高危因素包括出生胎龄、体质量、长期应用广谱抗生素、机械通气、皮质激素暴露、外科手术、中心静脉置管等,可伴有白细胞升高或减少、血小板减少、C反应蛋白升高等,氟康唑治疗效果较好.