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Zhou G.,Xijing Hospital | Feng Z.,Affiliated Bayi Childrens Hospital | Xiong H.,Central Hospital of xiAn | Duan W.,Xijing Hospital | Jin Z.,Xijing Hospital
Journal of Cardiothoracic and Vascular Anesthesia | Year: 2013

Objective: To investigate the clinical effects of a combined ultrafiltration strategy on the surgical treatment of pediatric patients with congenital heart diseases. Design: A prospective, randomized, controlled study. Setting: A single-institution study in an affiliated hospital of a university. Participants: Sixty-five pediatric patients who underwent open heart surgery with cardiopulmonary bypass (CPB) to treat congenital heart disease were enrolled. The participants were randomized into 2 groups: conventional + modified ultrafiltration (MUF) (CM) group and prime + zero-balanced + MUF (PZM) group. Interventions: In the CM group (n = 33), conventional ultrafiltration was performed after removal of the aortic clamp, and MUF was performed after the completion of CPB. In the PZM group (n = 32), ultrafiltration was performed for the circuit prime solution, zero-balance ultrafiltration was performed after removal of the aortic clamp, and MUF was performed after the completion of CPB. Measurements and Main Results: The blood gas parameters and tumor necrosis factor alpha content in the priming solution and perioperative blood samples were analyzed. Postoperative parameters, including mechanical ventilation time, respiratory indices, intensive care unit time, and hospital time, also were recorded. One hospital death occurred in each group. No severe complications occurred in either group. The lactic acid, glucose, and tumor necrosis factor alpha contents in the priming solution and perioperative blood samples were significantly lower in the PZM group compared with the CM group. The respiratory indices were statistically significantly better in the PZM group compared with the CM group in the early postoperative period. No significant differences were found between the 2 groups regarding the postoperative ventilation time, inotropic support, homologous blood transfusion, drainage, intensive care unit time, or postoperative hospital time. Conclusion: The combined use of ultrafiltration of prime solution, zero-balance ultrafiltration, and MUF strategy is associated with a modest improvement in pulmonary function compared with the combination of conventional and MUF strategies in the early postoperative period, but the principal clinical outcomes are similar. © 2013 Elsevier Inc. All rights reserved.


Chai Y.,Affiliated Bayi Childrens Hospital | Yin X.,Affiliated Bayi Childrens Hospital
Acta Medica Mediterranea | Year: 2014

Neonatal hypoxic-ischemic(H/I) brain damage is a serious complication of intrauterine asphyxia during perinatal period, eventually leading to severe long-term neurodevelopmental disability or even death. Survival babies would experience cerebral palsy, epilepsy, mental retardation, cognitive, sensory and motor dysfunctions. However, there has no proven effective treatment available to protect the brain against injury after H/I occurs, because the exact timing of the hypoxic-ischemic event is unknown and we hardly identify the phase of injury or recovery in an individual patient precisely. In recent years, much effort has been made on the understandings of the H/I damages in the brain and underlying mechanisms of neural dysfunction, expecting the intervention of targeted neuroprotection in the newborn stage. We briefly summarize recent findings of the pathogenesis of hypoxic-ischemic injury with an emphasis on the disturbed neurogenesis process in the brain; the potential role of neural regeneration in basic and clinical research, including the endogenous stem cells mobilization and cell transplantation aiming to enhance the brain function.


Yin X.,Affiliated Bayi Childrens Hospital | Meng F.,The No.302 Hospital of PLA | Wang Y.,Affiliated Bayi Childrens Hospital | Wei W.,Affiliated Bayi Childrens Hospital | And 3 more authors.
International Journal of Clinical and Experimental Pathology | Year: 2013

Objective: To investigate the mechanism underlying the effect of hyperbaric oxygen (HBO) on hypoxic/ischemic brain damage (HIBD) in a neonatal rat model. Methods: A total of 30 neonatal SD rats aged 7 days were randomly assigned into control group, HIBD group and HBO group (n=10 per group). Following HIBD modeling in neonatal rats, HBO treatment was performed for consecutive 7 days. Immunohistochemistry was done to measure the expression of bone morphogenetic protein-4 (BMP-4) and nestin in the hippocampus. In situ hybridization was employed to detect the mRNA expression of BMP-4 and nestin in the hippocampus. TUNEL staining was done to detect the apoptosis of nerve cells. Results: HIBD was successfully established in the present study. Among three groups, the protein expression of BMP-4 in the hippocampus was the highest in the HBO group, and the smallest in the HIBD group. The BMP-4 expression in the HIBD group was significantly lower than that in the control group. The protein expression of nestin in the hippocampus was the highest in the HBO group, and the smallest in the HIBD group. The nestin protein expression in the hippocampus of HIBD group was significantly lower than that in the control group. The mRNA expression of BMP-4 in the hippocampus was the highest in the HBO group, and the smallest in the HIBD group. The mRNA expression of nestin in the hippocampus was the highest in the HBO group, and the smallest in the HIBD group. The number of apoptotic cells was the largest in the HIBD group, and the number of apoptotic cells in the HBO group was still larger than that in the control group (P<0.01). Conclusion: HBO may promote the neurological recovery in neonatal rats with HIBD, which may be attributed to the increased protein and mRNA expression of BMP-4 and nestin in the hippocampus and the inhibition of neural apoptosis.


Yin X.,Affiliated Bayi Childrens Hospital | Dong L.,Clinical Force | Wei W.,Affiliated Bayi Childrens Hospital | Wang Y.,Affiliated Bayi Childrens Hospital | And 2 more authors.
Experimental and Therapeutic Medicine | Year: 2013

The present study aimed to investigate the influence of mouse nerve growth factor (mNGF) on glial fibrillary acidic protein (GFAP) expression in neonatal rats with hypoxic-ischemic brain damage (HIBD). A total of 60 7-day-old neonatal rats were randomly divided into control, HIBD and mNGF groups (n=20). The rats in the mNGF group were injected intramuscularly with mNGF once a day for 5 days. Each group was randomly divided into a day 7 subgroup and a day 14 subgroup according to the time of sacrifice. After the rats were sacrificed, the expression of GFAP in the hippocampus in the three groups was confirmed by immunohistochemical analysis. The results revealed that the expression level of GFAP in the ischemic side of the hippocampus in the mNGF and HIBD groups was higher compared with that in the control group at days 7 and 14 after surgery, respectively (P<0.01). GFAP-positive cells were mainly distributed in the ischemic side of the hippocampal dentate gyrus (DG) region in the mNGF group while in the HIBD group they were in the ischemic side of the hippocampal CA1 region. Compared with day 7, the expression of GFAP in the ischemic side of the hippocampus in the mNGF group increased at 14 days (P<0.01), but decreased in the HIBD group (P<0.01); however, this was still higher than that in the control group (P<0.01). This study revealed that mNGF increases the expression of GFAP in the hippocampus of neonatal rats with HIBD and therefore may have a role in the repair of HIBD.


Yin X.,Affiliated Bayi Childrens Hospital | Meng F.,Center for Liver Cirrhosis | Qu W.,Affiliated Bayi Childrens Hospital | Fan H.,Affiliated Bayi Childrens Hospital | And 2 more authors.
Experimental and Therapeutic Medicine | Year: 2013

Surfactant protein B (SP-B) deficiency has become increasingly recognized as a cause of severe prolonged respiratory distress. However, little has been reported with regard to the genetic variability of SP-B in Chinese infants with neonatal respiratory distress syndrome (RDS). One case of a Chinese male infant with neonatal RDS was analyzed for clinical manifestation and genetic variability of SP-B. The clinical manifestations, including grunting, intercostal retractions, nasal flaring, cyanosis and tachypnea were discovered in the physical examination. The initial chest X-ray indicated hyperinflation, diffuse opacification and air bronchogram of the lungs. Pathological tests of lung tissue revealed RDS and SP-B deficiency. Atelectasis and pneumonedema were observed in the lobes of the lung. Molecular analysis of genomic DNA revealed a mutation of 121del2 in intron 4 of the SP-B gene. In conclusion, the variant in intron 4 of the SP-B gene was associated with neonatal RDS in a Chinese male infant.

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