In 1984, according to the criteria of the classifieation for congenital hand deformity which wasput out by the International Hand Surgery Committee, we had made an investigation for congenitalhand deformity among 318066 newborns in Shanghai. It was found that the inctdence of a congenitalhand malformation was 0. 0808 percent among the total newborns. The congenital malformation ofthe thumb was 37. 74 percent of all deformities of the hand. According to the statistical analysis, we ...
ObjectivesUsing systematic literature review to analyze the effects of levetiracetam (LEV) on neonatal safety during early pregnancy.MethodsThe scope of the literature must be English literature, published from 1997 to 2018. Meta-analysis was performed by random effects models.ResultsSeven literatures were included. A total of 672 cases exposed to LEV in treatment group and 772 234 cases in control groups were selected for meta-analysis. There was no significant difference in neonatal malignancy between treatment group and control group［OR=1.05, 95% CI (0.54, 2.02), P=0.37］. Further, we evaluated the effect of LEV monotherapy and polytherapy on neonatal safety, a total of 464 monotherapy cases and 632 polytherapy cases respectively were selected for meta-analysis. The results showed that there was no significant difference between these two therapies in neonatal malignancy ［OR=0.54, 95% CI(0.31, 0.96), P=0.32］.ConclusionsAs the papers we included, levetiracetam in the treatment of epilepsy during pregnancy is relatively safe for newborn.
ObjectiveTo evaluate the quality of Chinese guidelines of newborns so as to provide references for the formulation of relevant guidelines for newborns in the future.MethodsCBM, VIP, WanFang Data, CNKI and Medlive databases were systematically searched to collect clinical practice guidelines in neonatal field in China from January 1st, 2000 to June 28th, 2020. Four researchers independently screened literature, extracted data, used AGREEⅡ to evaluate the methodological quality of the guidelines, used RIGHT to evaluate the reporting quality of the guidelines, and analyzed the score and reporting rate of items in each field.ResultsA total of 35 guidelines were included, and the quantity of publications increased annually. The AGREEⅡ score showed that guidelines published after 2017 were rated higher in all areas than that prior to 2017, with clarity scoring highest (82.9%) and editorial independence scoring lowest (15.4%). The RIGHT score showed that guidelines published after 2017 had higher reporting rates in most areas than that prior to 2017. The highest proportion of reported areas was basic information (75.6% vs. 65.0%). Areas with the lowest reporting ratios in the guidelines prior to 2017 were review and quality assurance (0%), while after 2017 were other areas (4.4%).ConclusionsNeonatal guidelines in China have developed rapidly and the quality of the guideline still requires improvement.
ObjectiveTo summarize our experience of critical congenital heart diseases treatment system for the newborn and to report its surgical results.MethodsWe reviewed the clinical data of 97 neonates with congenital heart diseases who admitted to pediatric cardiac center from January 2019 to August 2020 in our hospital. The patients were divided into a prenatal and postnatal diagnosis and treatment integration group (integrated group, n=41), and a postnatal diagnosis and rapid admission by green channel group (non-integrated group, n=56).ResultsThe age of admission in the integrated group was younger than that in the non-integrated group (3.0 d vs. 11.0 d, P<0.001), and the weight was lighter (3.3±0.4 kg vs. 3.6±0.6 kg, P=0.006), operation age was younger (13.0 d vs. 17.5 d, P=0.004), proportion of palliative surgery was smaller (2.4% vs. 8.9%, P=0.396), time for ventilator assistance was longer (153.0 h vs. 65.0 h, P=0.020), hospital mortality was lower (0.0% vs. 7.1%, P=0.135). There was no significant difference in the follow-up (11.0 months vs. 12 months, P=1.000), out-of-hospital mortality (2.4% vs. 1.8%, P=1.000) and total mortality (2.4% vs. 8.9%, P=0.396) between the two groups.ConclusionPrenatal and postnatal diagnosis and treatment integration can significantly shorten the diagnosis and the hospitalization interval of newborn, that surgical intervention could be performed timely. It can reduce the risk of death before surgery but need longer time for recovery after surgery. Patients with postnatal diagnosis and admitted hospital through green channel also can get perfect results if surgical intervention is performed timely.
ObjectiveTo study the phenotype of children with KCNQ2 gene related epilepsy.MethodsForty epilepsy children who were detected with KCNQ2 gene variants were enrolled. Their genotype and phenotype were analyzed.ResultsThirty-six KCNQ2 variants were identified. Twenty variants were novel. Twelve patients had inherited variants, and 28 patients had de novo variants. The age of seizure onset was from one day to 9 months. 80.0% patients had their seizure onset in neonates (32/40). Multiple seizure types were observed. Focal seizure was observed in 38 patients (95.0%). Epileptic spasm was observed in 10 patients (25.0%). Myoclonic seizure was observed in 4 patients. Tonic spasm seizure was observed in 3 patients. In all patients, seizures manifested in clusters. In 28 patients with de novo KCNQ2 variants, 24 had development delay (85.7%), the other 4 patients had normal development. In 12 patients with inherited KCNQ2 variants, one had development delay, the other 11 patients had normal development (91.7%). The most common interictal EEG changes were local epilepsy discharges (31/40). The MRI of brain was abnormal in 14 patients with de novo KCNQ2 variants and developmental delay. The agenesis of corpus callosum was identified in 10 patient (25.0%). Enlargement of subarachnoid spaces in the frontal and temporal region was identified in 11 patients (27.5%). Cortial dysplasia in the bilateral frontal and temporal region was identified in 2 patients. Sulus deepening was identified in 4 patients. Enlargement of bilateral lateral ventricle was identified in 3 patients. In 40 patients with KCNQ2 variants, 3 were diagnosed as benign familial neonatal epilepsy (BFNE), 2 were diagnosed as benign familial neonatal-infantile epilepsy (BFNIE), 3 were benign familial infantile epilepsy (BFIE), 3 were benign infantile epilepsy (BIE), 5 were benign neonatal epilepsy (BNE), 3 wer Ohtahara syndrome (OS), 9 were West syndrome (WS), 12 were unclassified early infantile epileptic encephalopathy (EIEE), one was epilepsy with autism. Sodium channel blockers oxcarbazepine was the most effective among antiepileptic drugs, with a effective rate of 90.9%.ConclusionsMost KCNQ2 variants are missense variants. De novo variants are more common in patients with KCNQ2 variants. The clinical features of patients with KCNQ2 variants including that mainly with seizure onset in neonate, the main seizure type is focal seizures, seizures occur in clusters. Patients with de novo KCNQ2 variants often had developmental delay, and about half of them had frontal and temporal lobe dysplasia and agenesis of corpus callosum. Sodium channel blockers are effective agents for epilepsy patients with KCNQ2 variants.
ObjectiveTo sum up experiences of precaution and provide evidence to prevent such accidents in the future via analyzing the nosocomial infection in newborn babies who were infected by rotavirus. MethodsWe investigated and monitored the 8 cases of nosocomial infection occurred between July 7th and July 14th, 2012 by epidemiologic and environmental hygienic methods, and analyzed the existing risk factors and took measures to control. ResultsThere were 8 nosocomial infected cases among the 45 newborn babies who were hospitalized. The infection rate was 17.8% and the accident lasted for 7 days. The distribution of space, time and population was clustered. Environment and hands were the main media to spread the virus. ConclusionThe accident was a suspected nosocomial infection caused by rotavirus in the hospital. It can be controlled effectively through intensive cleaning and sterilizing, isolated touching, and improving the medical staff's compliance and accuracy rate of hand sanitation.
Objective To assess the effectiveness of intravenous immunoglobulin G (IVIG) in reducing the need for exchange transfusion in neonates with proven haemolytic disease due to Rh and/or ABO incompatibility. To evaluate the effectiveness of IVIG in reducing the duration of phototherapy and hospital stay. Methods We electronically searched CENTRAL, MEDLINE (1966 to May 2008), EMBASE (1992 to May 2008), CBMdisc (November 1979 to May 2008), and also checked the reference lists of all papers identified. According to the Cochrane Handbook for Systematic Reviews of interventions, randomized controlled trials comparing IVIG and phototherapy with phototherapy alone in neonates with Rh and/or ABO incompatibility were identified and analyzed. Results Six RCTs were included. The meta-analysis showed that, IVIG can significantly decrease the requirements of exchange transfusion (RR=0.27, 95%CI 0.18 to 0.42), the duration of hospitalization (WMD= –1.11, 95%CI –1.60 to –0.63) and the duration of phototherapy (WMD= –0.82, 95%CI –1.16 to –0.47). Conclusions Intravenous immunoglobulin (IVIG) is recommended for treating hemolytic disease of the newborn because it is effective in decreasing the requirements of exchange transfusion, the duration of hospitalization and phototherapy. Well designed studies with large sample in multi-center are required for further proving.
In October 2020, the American Heart Association issued the 2020 edition of guidelines for cardiopulmonary resuscitation and cardiovascular first aid, which comprehensively revised cardiopulmonary resuscitation and emergency cardiovascular care guidelines related to adults, children, newborns, resuscitation education science and treatment system. According to the latest edition of International Liaison Committee on Resuscitation’s classes of recommendation and levels of evidence, relevant suggestions are put forward. This article interprets the main updated and revised content, including children’s basic and advanced life support and neonatal resuscitation, in order to better guide emergency personnel and improve the quality of cardiopulmonary resuscitation and cardiovascular first aid.
Objective To investigate the role of low-dose heparin added to total nutrient admixture (TNA) solutions in the prevention of catheter related infections (CRIs). Methods One-hundred three newborn infants with periph-erally inserted central catheter (PICC) were divided into heparin group (n=63) and control group (n=40). The patients in the heparin group received TNA with 0.5 U/ ml heparin. The patients in the control group received TNA without heparin. We retrospectively analyzed the incidence of CRTs in the two groups. Results We found that the incidence of CRIs was 0 in the heparin group and 12.5% (5/40) in the control group. The incidence of catheter obstruction was 6.3% (4/63) in the heparin group and 20% (8/40) in the control group. The incidence of catheter-tip colonization was 1.58% (1/40) in the heparin group and 17.5% (7/40) in the control group. The incidences of CRIs, catheter obstruction, and catheter-tip colonization were signiicantly lower in the heparin group than those in the control group (Plt;0.05). Conclusion TNA solutions with 0.5U/ml heparin have decreased catheter obstruction and CRIs.
目的 评价不同复苏方法和不同药物、氧疗、物理疗法等对新生儿窒息复苏和复苏后的预防措施的有效性和安全性.方法 计算机检索Cochrane Library(2004年第3期),MEDLINE(1966～2002年) 关于新生儿窒息复苏时不同复苏方法、氧气的应用、以及不同药物、剂量、给药途径治疗和预防新生儿窒息的系统评价、随机和半随机对照试验.结果 正压通气时使用100%氧气和应用室内空气的复苏效果并无差异.胎粪污染羊水(MSAF)与较高的新生儿缺血缺氧性脑病(HIE)的发生率有关,而气管内有胎粪者无论稀稠均与胎粪吸入综合征发生率无关.窒息复苏后预防性给予亚低温疗法、抗惊厥药、纳洛酮、多巴胺等在降低新生儿病死率,继发HIE的严重程度等方面与对照组相比无显著差异.应用肺表面活性物质(PS)预防和治疗新生儿呼吸窘迫综合征(RDS),可减少死亡率和并发症.结论 应用PS预防和治疗RDS可明显减少新生儿死亡率,且胎龄lt;32周的早产儿预防用药比治疗用药效果更好;目前尚无充分证据证明窒息复苏后预防性给予亚低温疗法、抗惊厥药、纳洛酮、多巴胺等治疗的有效性.