ObjectiveTo investigate the clinical features, complications, diagnosis and management of congenital hepatic hemangiomas(CHHs).Methods12 neonates of CHH admitted to our hospital in the past 10 years were retrospectively analyzed, and the clinical manifestations, auxiliary examination results, diagnosis and treatment methods, clinical efficacy andprognosis were reviewed.ResultsIn this study, 12 neonates with CHHs were reported. Among them, 8 cases underwent surgical treatment and recovered well postoperatively. 3 cases received routine pharmacological treatment, were gradually recovering. Only one case, presenting with giant CHH and congestive heart failure (CHF) at birth, failed initial pharmacological treatment and underwent percutaneous hepatic hemangioma embolization but died postoperatively.ConclusionLarge CHHs tend to be complicated with refractory congestive heart failure, likely due to tumor size and intra-tumor arteriovenous shunt. Propranolol is effective for CHHs with stable hemodynamics but has a slow onset of action, making it less suitable for cases complicated with CHF. Surgical resection is effective and recommended for large CHHs with stable hemodynamics, while percutaneous hepatic hemangioma embolization is advised for unstable cases.

The protective effects of autophagy-mediated microglial inflammatory regulation on diseases of the central nervous system (CNS) has been a recent field of interest. The canonical signaling pathway activated by Wnt1, the Wnt/β-catenin signaling cascade, also plays a crucial protective role in neurodegenerative diseases. However, the relationship between Wnt1/β-catenin signaling and microglial activation remains unclear. Our study focused on understanding the impact and mechanism of Wnt1 on microglial activation. To simulate neuroinflammatory conditions in vitro, BV2 cells were exposed to 1 μg/mL lipopolysaccharide. CD86- and CD206-positive cells were identified by flow cytometry and immunofluorescence assays. Inflammatory and anti-inflammatory factors were measured using enzyme-linked immunosorbent assays. Autophagy was analyzed by expression of LC3B puncta, LC3, P62, and beclin1 expression. The inflammatory activation suppressed by rhWnt1 was restricted by DKK1, siRNA-β-catenin and siRNA-LKB1, respectively, with concomitant changes in β-catenin expression and phosphorylation of NFκB-p65, LKB1, and AMPK. Although the anti-inflammatory effect of Wnt1/LKB1 pathway was independent of β-catenin, Wnt1/LKB1 regulated β-catenin. The reduced inflammation caused by rhWnt1 is linked to its enhancement of autophagy, a process blocked by siRNA-LKB1 and 3-MA partially. The anti-inflammatory effects of Wnt1 on BV2 cells improved autophagy, a mechanism partly dependent on the β-catenin pathway or the phosphorylation of LKB1. Furthermore, the Wnt1/LKB1 pathway was activated independently of β-catenin and participated in regulating its expression. Our research unveils a previously unknown method through which Wnt1 exerts its anti-inflammatory effects, which may have a potential protective role against CNS diseases.

OBJECTIVES:To investigate the value of weight growth velocity, calculated using the Patel exponential model and the Z-score change method, in predicting the neurological and physical development outcomes of preterm infants with a gestational age of <30 weeks in the long term. METHODS:A retrospective study was conducted involving preterm infants with a gestational age of <30 weeks who were hospitalized and treated in the Department of Neonatology at Tongji Hospital, Huazhong University of Science and Technology, from January 2017 to June 2022, and were followed up at the outpatient service more than 18 months of age. The preterm infants were divided into high and low rate groups based on the two calculation methods, and the two methods were compared regarding their predictive value for neurological and physical development outcomes in the long term. RESULTS:The average age of the last follow-up was (23.0±3.6) months. For neurological development, according to the Patel exponential model, the low rate group exhibited a significantly higher abnormal rate in the fine motor domain compared to the high rate group (P<0.05). Using the Z-score change method, the low rate group had significantly higher abnormal rates in both gross motor and fine motor domains, and significantly lower developmental quotients for gross motor, fine motor, and adaptive behavior domains compared to the high rate group (P<0.05). For physical development, there were no significant differences in body length, body weight, head circumference, or the incidence rate of growth restriction between the low rate and high rate groups identified by either method (P>0.05). CONCLUSIONS:Weight growth velocity calculated using the Z-score change method is more effective in predicting long-term neurological outcomes in preterm infants, while weight growth velocity derived from both methods shows no significant association with long-term physical development outcomes.

[This corrects the article DOI: 10.3389/fped.2025.1453019.].

Abstract Background Bryant-Li-Bhoj’s neurodevelopmental syndrome is an extremely rare neurodevelopmental disorder caused by germline variation of the H3-3A or H3-3B gene. Similar reports have not been found in China, and there are only two similar reports in the world. Case presentation: A female child, full-term cesarean section, had intermittent convulsions and feeding difficulties shortly after birth. She had special facial features such as a small jaw, a narrow forehead, and a narrow palatal arch. The skin of the head and neck was loose and redundant. The muscle tone of the limbs was reduced, the primitive reflex was weakened, and hearing and vision were impaired. Genetic testing revealed a heterozygous missense mutation in the H3-3A gene, c.365C > G ( p.P122R ), which indicated the diagnosis of Bryant-Li-Bhoj neurodevelopmental syndrome type 1. The disease is extremely rare and has not been reported in China. Conclusion: The prognosis and progression of Bryant-Li-Bhoj’s neurodevelopmental syndrome are still unknown. Early genetic testing can help make an early diagnosis and clarify the direction of diagnosis and treatment.

ObjectiveTo establish a nomogram model incorporating markers of echocardiography and N-terminal pro brain natriuretic peptide (NT-proBNP) for predicting adverse outcomes of patent ductus arteriosus (PDAao) in very low birth weight infants and to evaluate the predictive values of the model.MethodsA prospective study was conducted for very low birth weight infants who were admitted from May 2019 to September 2020. An echocardiogram and blood NT-proBNP test were carried out in the first 48 h after birth, and the arterial duct remained open in all patients. Other data collected included clinical symptoms and infant characteristics. A nomogram model was established to predict the risk of PDAao (including severe BPD, IVH, NEC or death). Internal verifications were performed for the nomogram, and the discrimination and calibration of the model were evaluated by the C-index and calibration curve.ResultsEighty-two infants were enrolled and divided into an adverse outcome (AO) group and normal outcome (NO) group with 41 patients in each group. PDA diameter, PDA maximum flow velocity, left atrium diameter/aortic diameter (LA/AO) ratio and NT-proBNP level were independent risk factors for PDAao and were included in the nomogram model. The model presented good discrimination with a C-index of 0.917 (95% CI 0.859–0.975). The calibration curves in showed high consistency and indicated good Correspondence: between the event incidence predicted by the nomogram model and the true incidence of PDAao.ConclusionThe nomogram model incorporating the PDA diameter, PDA maximum flow velocity, LA/AO ratio and NT-proBNP level in the first 48 h could early predict the later occurrence of PDAao in very low birth weight infants.

Objective:To analyze the risk factors of bronchopulmonary dysplasia(BPD)in very preterm infants(VPI), and to provide scientific basis for the prevention and treatment of BPD in VPI.Methods:A prospective multicenter study was designed to collect the clinical data of VPI in department of neonatology of 28 hospitals in 7 regions from September 2019 to December 2020.According to the continuous oxygen dependence at 28 days after birth, VPI were divided into non BPD group and BPD group, and the risk factors of BPD in VPI were analyzed.Results:A total of 2 514 cases of VPI including 1 364 cases without BPD and 1 150 cases with BPD were enrolled.The incidence of BPD was 45.7%.The smaller the gestational age and weight, the higher the incidence of BPD( P<0.001). Compared with non BPD group, the average birth age, weight and cesarean section rate in BPD group were lower, and the incidence of male infants, small for gestational age and 5-minute apgar score≤7 were higher( P<0.01). In BPD group, the incidences of neonatal respiratory distress syndrome(NRDS), hemodynamically significant patent ductus arteriosus, retinopathy of prematurity, feeding intolerance, extrauterine growth restriction, grade Ⅲ~Ⅳ intracranial hemorrhage, anemia, early-onset and late-onset sepsis, nosocomial infection, parenteral nutrition-associated cholestasis were higher( P<0.05), the use of pulmonary surfactant(PS), postnatal hormone exposure, anemia and blood transfusion were also higher, and the time of invasive and non-invasive mechanical ventilation, oxygen use and total hospital stay were longer( P<0.001). The time of starting enteral nutrition, cumulative fasting days, days of reaching total enteral nutrition, days of continuous parenteral nutrition, days of reaching 110 kcal/(kg·d) total calorie, days of reaching 110 kcal/(kg·d) oral calorie were longer and the breastfeeding rate was lower in BPD group than those in non BPD group( P<0.001). The cumulative doses of amino acid and fat emulsion during the first week of hospitalization were higher in BPD group( P<0.001). Multivariate Logistic regression analysis showed that NRDS, invasive mechanical ventilation, age of reaching total enteral nutrition, anemia and blood transfusion were the independent risk factors for BPD in VPI, and older gestational age was the protective factor for BPD. Conclusion:Strengthening perinatal management, avoiding premature delivery and severe NRDS, shortening the time of invasive mechanical ventilation, paying attention to enteral nutrition management, reaching whole intestinal feeding as soon as possible, and strictly mastering the indications of blood transfusion are very important to reduce the incidence of BPD in VPI.

Background:Trichohepatoenteric syndrome (THES) is a rare autosomal recessive genetic disease caused by pathogenic mutations in TTC37 or SKIV2L gene. The presentation is variable, including intractable diarrhea, woolly hair abnormality, immune dysfunction, intrauterine growth restriction (IUGR), facial dysmorphism, and sometimes liver and skin abnormalities. Although four Chinese children affected with THES syndrome 1 have been described in Singapore, Taiwan (China) and Malaysia, to our knowledge, this is the first report of a patient with THES in Mainland China, harboring classical platelets features, clinical course, and novel mutations in TTC37 gene.Case Description:The male infant had symmetrical IUGR, and was born at 37+1 weeks with a birth weight of 1,480 g. He presented with feeding difficulties and vomiting from the 12th day after birth during the stay in neonatal intensive care unit, and had excessive diarrhea from the 21st day after birth. From the 35th day after birth, even slightly hypotonic oral rehydration solution caused watery stools. The blood glucose level was lower than 3.3 mmol/L even when the glucose infusion rate was up to 14 mg/kg/min on the parenteral alone, which has not been reported in previous literature. Normal α-granules were observed occasionally in THES platelets. Whole-exome sequencing analysis identified compound heterozygous mutations (c.4130C > G: p.S1377X) and (Exon11-13 del) in the TTC37 gene, which had been inherited from his father and mother, respectively. To our knowledge, the above mutations have not been described in any database or previous literature. Total parenteral nutrition was employed as mainstay of therapy, and hydrocortisone (1 mg/kg/dose, every 4 hours) was used to maintain blood glucose levels. The patient's final prognosis was poor after discharged from the hospital.Conclusions:This case presented with mild platelet abnormality and intractable hypoglycemia, which extends the known mutation and phenotype of THES. The clinical features of Chinese patient are consistent with other ethnicity. Molecular diagnosis is useful for patients with unexplained intractable diarrhea, which puts an end to a long diagnostic odyssey.

患儿,男,生后18 d,因"反复抽搐16 d"于2020年9月就诊于华中科技大学同济医学院附属同济医院新生儿科门诊.患儿系第1胎第1产,因"脐带绕颈3周"剖宫产娩出,出生体质量3.2 kg,围产期无窒息缺氧史.母亲孕期无特殊病史.家族中无类似病史.患儿生后第3天无明显诱因出现抽搐,仅表现为四肢抖动,持续数秒后缓解,2～3 h发作1次(均为吃奶时发现).

目的:探讨Schaaf-Yang综合征的临床特点与基因特征，并与Prader-Willi综合征进行比较分析。方法:对华中科技大学附属同济医院收治的一例Schaaf-Yang综合征患儿临床资料进行回顾性分析并检索相关文献。该病例为14 d女婴，因"自主呼吸弱及喂养困难14 d"就诊，患儿生后即出现反应差、呼吸及吸吮吞咽困难、额部高、耳位低、躯干部瘦小、左脚发育异常、双手握持困难、肌张力低下。生后14 d转诊途中因窒息缺氧死亡。结果:基因检测显示患儿15号染色体黑色素瘤抗原样基因2(melanoma antigen-like gene 2，MAGEL2)c.C1912T：pQ638X杂合变异，家系验证该突变为新生突变。文献复习国内外已报道的由MAGEL2基因突变所致的Schaaf-Yang综合征病例150余例，其中国内病例15例。结论:国内外病例MAGEL2基因突变均以c.1996dupC突变频率最高，该突变的患儿有更高频率的关节挛缩、进食困难和呼吸功能障碍等表现，以及更严重的智力障碍及发育迟缓。Schaaf-Yang综合征与Prader-Willi综合征临床表现相似，多有重叠。对于新生儿期存在呼吸窘迫、肌张力低下、喂养困难的病例，需注意与Prader-Willi综合征相鉴别，避免漏诊误诊。

Intrauterine infection induces inflammation-mediated microglial activation and brain injury. This study aimed to explore the regulatory mechanism of Wnt family member 1 (Wnt1) in intrauterine infection-mediated microglial polarization. The cell counting kit-8 (CCK-8) assay was used to determine the viability of microglia, and cytokine expression levels were determined using enzyme linked immunosorbent assay (ELISA) kits and real-time quantitative PCR (RT-qPCR). The number of CD206+ and CD16/32+ cells was determined by flow cytometry. Wnt1 expression was analyzed using western blotting and immunofluorescence. Moreover, an in vivo assay was performed to verify the role of WNT1 in inflammation-sensitized brain injury in newborn mice. Lipopolysaccharide (LPS) exposure resulted in a decrease in microglial cell viability while increasing the expression levels of inflammatory cytokines (TNF-α, IL-6, and IL-1β), simultaneously promoting M1-type microglial conversion. However, these effects were rescued by overexpression of Wnt1, which was expressed less in microglia exposed to LPS in vitro and in vivo. Here, we found that Wnt1 activated the LKB1-AMPK pathway, and the inhibition of LKB1 attenuated the rescue effects of Wnt1. In addition, LPS exposure reduced the autophagy of microglia, and Wnt1 overexpression enhanced the autophagy, but this effect was reversed by treatment with an LKB1 inhibitor. Wnt1 activated LKB1 to suppress inflammation-mediated activation of microglia, promote M2-type microglia conversion via the AMPK pathway, and alleviate inflammation-sensitized neonatal brain injuries. This provides a potential avenue for the treatment of neonatal brain injuries.

OBJECTIVES:To investigate the incidence of extrauterine growth retardation (EUGR) and its risk factors in very preterm infants (VPIs) during hospitalization in China. METHODS:A prospective multicenter study was performed on the medical data of 2 514 VPIs who were hospitalized in the department of neonatology in 28 hospitals from 7 areas of China between September 2019 and December 2020. According to the presence or absence of EUGR based on the evaluation of body weight at the corrected gestational age of 36 weeks or at discharge, the VPIs were classified to two groups: EUGR group (n=1 189) and non-EUGR (n=1 325). The clinical features were compared between the two groups, and the incidence of EUGR and risk factors for EUGR were examined. RESULTS:The incidence of EUGR was 47.30% (1 189/2 514) evaluated by weight. The multivariate logistic regression analysis showed that higher weight growth velocity after regaining birth weight and higher cumulative calorie intake during the first week of hospitalization were protective factors against EUGR (P<0.05), while small-for-gestational-age birth, prolonged time to the initiation of total enteral feeding, prolonged cumulative fasting time, lower breast milk intake before starting human milk fortifiers, prolonged time to the initiation of full fortified feeding, and moderate-to-severe bronchopulmonary dysplasia were risk factors for EUGR (P<0.05). CONCLUSIONS:It is crucial to reduce the incidence of EUGR by achieving total enteral feeding as early as possible, strengthening breastfeeding, increasing calorie intake in the first week after birth, improving the velocity of weight gain, and preventing moderate-severe bronchopulmonary dysplasia in VPIs.

Food protein-induced enterocolitis syndrome (FPIES) is a type of non-immunoglobulin E (IgE)-mediated food allergy. However, in addition to vomiting and diarrhea, IgE-mediated skin or respiratory symptoms may be comorbidities in some patients with FPIES. We described four unusual cases of neonates with FPIES, whose clinical presentations were variable and misleading. All patients experienced vomiting, diarrhea or other gastrointestinal symptoms, and three of them developed IgE-mediated food allergy. Case 1 was admitted to the hospital with convulsions and then developed severe sepsis and necrotizing enterocolitis (NEC)-like appearance. Case 2 was wrongly diagnosed with Stevens-Johnson syndrome due to a severe extravasation rash of the skin and mucous membranes and a systemic inflammatory response. There was unexplained cholestasis in case 3, which might be attributed to food allergy. Asymptomatic elevation of C-reactive protein was the only hint at early-stage FPIES in case 4. Moreover, there were increased serum food-specific IgG values in three of the above cases. After eliminating the offending food, all of the above clinical manifestations rapidly improved in the four cases; thus, we believe that the most correct diagnosis in the described four cases was FPIES. This case report series should further draw clinicians' attention to FPIES with variable and atypical symptoms. The usefulness of IgG levels in identifying the presence of FPIES is uncertain.

目的 评估治疗前血小板减少对口服布洛芬治疗早产儿血流动力学紊乱的动脉导管未闭(hsPDA)疗效及并发症的影响.方法 选取2016年5月—2019年4月本院收治并经超声心动图确诊的hsPDA早产儿,给予口服布洛芬(首剂10 mg/kg,第二、三剂5 mg/kg,每日1次,共3 d)一个疗程;治疗前采血,根据血小板计数的情况将入选早产儿分为中度减少组(50～99×109/L)、轻度减少组(100～149×109/L)和正常组(≥150×109/L)三组,疗程结束后复查超声心动图,评估患儿药物疗效及并发症如喂养不耐受、新生儿颅内出血(IVH)、坏死性小肠结肠炎(NEC)及肾损伤等发生情况.结果 共纳入符合标准早产儿203例,中度减少组、轻度减少组及正常组分别为14例、38例和151例,三组患儿一般资料差异无统计学意义(P>0.05).口服布洛芬后三组分别有5例(35.7％)、23例(60.5％)和103例(68.2％)患儿PDA关闭,组间关闭率差异有统计学意义(P<0.05).三组早产儿喂养不耐受、NEC、IVH及肾损伤等并发症发生率之间的差异无统计学意义(P>0.05).结论 早产儿hsPDA治疗前合并血小板减少症降低了口服布洛芬的疗效,但不影响hsPDA相关并发症如喂养不耐受、NEC、IVH及肾损伤的发生率.

目的 探讨1044例早产儿动脉导管未闭(PDA)的发生率、危险因素及相关并发症的发生情况.方法 选择2016年5月-2019年4月华中科技大学同济医学院附属同济医院新生儿科收治的早产儿(胎龄<34周)作为研究对象,根据生后一周内超声心动图结果分为PDA组(249例)和对照组(795例),收集两组早产儿的临床资料进行病例对照研究,对PDA发生的相关因素进行单因素分析,并建立二元Logistic回归模型,分析PDA的危险因素及相关并发症的发生情况.结果 胎龄小于34周早产儿PDA发生率为23.9％.且胎龄和出生体重越小,PDA发生率越高.单因素分析结果显示,胎龄、出生体重、窒息、妊娠高血压、产前糖皮质激素使用、胎膜早破与PDA的发生有关(P<0.05).多因素二元Logistic回归分析显示,胎龄小(OR=1.40,95％CI:1.24～1.59)、窒息(OR=1.82,95％CI:1.21～2.75)是PDA发生的独立危险因素;胎膜早破(OR=0.63,95％CI:0.45～0.88)、产前糖皮质激素使用(OR=0.52,95％CI:0.36～0.76)是PDA的独立保护因素.PDA组患儿有创及无创呼吸机应用、肺炎、早产儿支气管肺发育不良(BPD)、喂养不耐受、Bell分期Ⅱ期以上坏死性小肠结肠炎(NEC)、颅内出血(IVH)、早产儿视网膜病变(ROP)及肾损伤的发生率高于对照组,差异有统计学意义,两组患儿在脑室周围白质软化(PVL)的发生率之间的差异无统计学意义.结论 早产儿胎龄和出生体重越小,PDA发生率越高;胎龄小和窒息是早产儿PDA的高危因素之一,而产前激素使用和胎膜早破是其保护因素.早产儿PDA可引起呼吸机应用时间延长,增加肺炎、BPD、喂养不耐受、NEC、IVH、ROP及肾损伤的发生率.

目的 分析新型冠状病毒疫情期间分娩的产妇的心理问题及其婴儿健康结局,为合理制定新型冠状病毒肺炎(COVID-19)确诊或疑似孕产妇及其新生儿管理提供参考.方法 对2020年1月至2020年4月湖北疫情爆发期间分娩的产妇,在产后30 d以问卷形式调查其心理健康状况,同时对其分娩的婴儿的生长发育等情况进行检测,分析疫情期间产妇的心理状况及其婴儿的健康状况.结果 本研究共入组45名产妇,其中确诊或疑似COVID-19产妇28例,非感染产妇17例.45名产妇中,出现抑郁、焦虑、失眠症状的人数分别为14人(31.1％)、21人(46.7％)、15人(33.3％).疫情期间,产妇文化程度及婴儿出生后住院等是影响产妇心理健康的重要因素(P<0.05),产妇是否确诊或疑似COVID-19、妊娠胎次对产妇心理健康的影响不显著(P>0.05).婴儿分住院组20人和居家组27人,两组婴儿的出生情况比较无显著差异,住院组婴儿多次、多部位新冠核酸检测均为阴性.满月后随访结果显示,除居家组血红蛋白明显高于住院组且差异有统计学意义,两组婴儿的日平均体重增长及其余血检结果均无显著差异.结论 产妇文化程度与心理健康状况有关,高中学历的产妇更容易受到疫情因素的影响.婴儿住院严重影响产妇的心理健康状况.对于确诊或疑似COVID-19孕产妇,分娩前后做好感染防控措施,对其足月健康新生儿可选择居家隔离,或短期住院核酸检测阴性后即可出院.

目的:探讨症状性动脉导管未闭(sPDA)与非症状性动脉导管未闭(nsPDA)经药物干预后关闭率及相关并发症的发生率,以便进一步指导临床应用.方法:回顾性分析同济医院新生儿科2016年5月至2019年4月收治的胎龄＜34周并于生后1周末行超声心动图诊断为动脉导管未闭(PDA)的早产儿252例,根据是否符合sPDA诊断标准,分为sPDA组(94例)和nsPDA组(158例),nsPDA组分为nsPDA-1组(92例)和nsPDA-2组(66例).sPDA组所有患儿和nsPDA-1组患儿在住院期间均接受了口服布洛芬治疗;nsPDA-2组患儿在住院期间未接受布洛芬治疗.三组患儿于治疗结束后或出院前均复查超声心动图.收集患儿资料,分析三组早产儿动脉导管关闭率和PDA相关并发症的发生情况.结果:sPDA组患儿胎龄、出生体质量均小于nsPDA-1组和nsPDA-2组(P＜0.05),而nsPDA-1组和nsPDA-2组胎龄和出生体质量比较差异均无统计学意义(P＞0.05).口服布洛芬治疗后sPDA组与nsPDA-1组分别有52例和81例患儿动脉导管关闭,关闭率为55.3％和88.0％,而nsPDA-2组有54例早产儿动脉导管自然关闭,关闭率为81.8％,sPDA组动脉导管关闭率低于nsPDA-1组和nsPDA-2组(P＜0.05),而nsPDA-1组和nsPDA-2组关闭率比较差异无统计学意义(P＞0.05).sPDA组肺炎、早产儿支气管肺发育不良(BPD)、喂养不耐受、坏死性小肠结肠炎(NEC)及颅内出血(IVH)的发生率高于nsPDA-1组和nsPDA-2组(P＜0.05),而nsPDA-1组和nsPDA-2组上述并发症发生率比较差异无统计学意义(P＞0.05).sPDA组和nsPDA-1组的肾损伤发生率比较差异无统计学意义(P＞0.05),但均高于nsPDA-2(P＜0.05).结论:早产儿胎龄越小、出生体质量越低,出现sPDA可能性越大;sPDA早产儿1周后口服布洛芬关闭PDA的疗效较nsPDA早产儿差,并较后者更容易出现早产儿相关并发症(肺炎、BPD、喂养不耐受、NEC及IVH).

目的 对极低出生体质量早产儿经母乳获得性巨细胞病毒(CMV)感染的临床特征以及随访情况进行分析.方法 收集2018年1月至2019年1月我院新生儿科80例极低出生体质量早产儿的临床资料,分析极低出生体质量早产儿母乳获得性巨细胞病毒感染的发病率、临床特征以及随访至早产儿半岁.结果 80例极低出生体质量早产儿中经母乳获得性巨细胞病毒感染20例,感染率为25.00％;感染组出生时体质量、出生时胎龄、母乳CMV阳性率、血小板及中性粒细胞均低于非感染组(P＜0.05),而谷丙转氨酶(ALT)、天冬氨酸转氨酶(AST)、总胆红素(TBIL)水平明显高于非感染组(P＜0.05);感染组早产儿中血小板减少症所占百分比均明显高于非感染组(P＜0.05);多因素Logistic回归分析结果显示,出生时胎龄＜28周、母乳CMV阳性可能是极低出生体质量早产儿CMV感染的危险因素(P=0.025、0.039);随访早产儿半岁时,感染组早产儿的体质量、身长均低于非感染组(P＜0.05),而两组早产儿预后情况比较,差异无统计学意义(P＞0.05).结论 母乳CMV阳性喂养早产儿会增加转氨酶增加、血小板与中性粒细胞减少症的发生率,早产儿出生6个月时预后较好.

产单核李斯特菌易感染孕妇、新生儿等免疫力低下的人群,临床表现缺乏特异性,极易致死胎或早产,应引起医护人员高度重视.头孢类抗生素作为孕妇细菌感染的常用药物,对李斯特菌感染无效.青霉素及氨基糖甙类抗生素仍是一线首选用药.早期治疗能明显改善孕妇及患儿预后.临床上应注意鉴别诊断,给予合适的抗感染治疗.本文报道了2例围生期母子共患李斯特菌病的临床情况和诊治过程.

患儿男,因"生后呻吟、吐沫3 h"入住华中科技大学同济医学院附属同济医院儿科.患儿系第6胎第2产,胎龄34+1周,因其母"胎膜早破6 h,瘢痕子宫,妊娠期糖尿病,脐带绕颈1周"剖宫产出生.患儿Apgar评分1 min 8分、5 min 9分,出生体重2140 g.父母非近亲结婚,有一胞兄,体健.母亲36岁,患地中海贫血(基因型不详),人工流产4次,此次孕期产检未发现其他异常.入院查体:体温36.2℃,心率146次/min,呼吸48次/min,血压59/33 mmHg(1 mmHg=0.133 kPa),轻度吸气三凹征,双肺少许湿啰音,心脏、腹部、神经系统无明显异常,四肢末梢青紫.无腭裂、小下颌畸形、泌尿生殖系统畸形.