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Huang J.,BAYI Childrens Hospital Affiliated to General Hospital of Beijing Military Command | Kong X.,BAYI Childrens Hospital Affiliated to General Hospital of Beijing Military Command
Zhonghua er ke za zhi = Chinese journal of pediatrics | Year: 2016

OBJECTIVE: To observe the effect of intrapartum and postpartum factors on abnormal neurological findings in the extremely preterm infants.METHOD: Clinical data of 62 premature infants (33 of male, 29 of female) were retrospectively analyzed. None of the premature infants had birth defect; their gestational ages were all less than 28 weeks (23(+ 6)-27(+ 6) weeks). They were hospitalized within 12 hours after birth in the neonatal intensive care unit (NICU) of BAYI Children's Hospital from November 2010 to June 2013. The blood gas, birth condition, complications, the mechanical ventilation and the ultrasonic encephalography were recorded. The 62 cases were divided into 2 groups, alive group and died group. Meanwhile, all cases of survial were divided into brain injuries group and normal brain group. Data were analyzed with t-test, Chi square test and Spearman correlation analysis.RESULT: Fifty-six cases were alive, and 6 cases died (3 were during the treatment and 3 were after parents gave up). The average birth weight of brain injuries group was (954 ± 182) g; and that of the normal brain group was (1 071 ± 136) g. There were significant differences between the two groups in gender (χ(2) = 4.314, P = 0.038), gestational age (χ(2) = 11.622, P = 0.001), birth weight (t = 2.728, P = 0.009), which had significant correlation with neurological outcomes. The Spearman correlative coefficients were -0.278, 0.456 and 0.364 respectively. And P values were 0.038, 0.000 and 0.006. The rates of multiple pregnancy, lung hemorrhage and surgical operation in brain injuries group were 45%(9/20), 55%(11/20), 40%(8/20), which were significantly higher than those in normal brain group, 3%(1/36), 17%(6/36), 11%(4/36)(χ(2) = 12.800, 8.936, 4.773, P all < 0.05). These three factors were the high risk factors for adverse neurological outcomes, the odds ratios were 28.64, 6.11 and 5.33 respectively. There was no significant difference in delivery mode, amniotic fluid, maternal infection, asphyxia, necrotizing enterocolitis, patent ductus arteriosus, sepsis, mechanical ventilation, inhaled nitric oxide therapy, blood glucose, blood gas analysis, doses of dopamine between brain injuries group and normal brain group. The birth weight in alive group was (1 029 ± 163) g, which was significantly higher than those in died group (870 ± 144)g (r=0.29, P=0.022). There was no significant difference in other factors between alive group and died group(P all>0.05).CONCLUSION: Gender, gestational age and birth weight may have relation with the neurological outcomes of extremely preterm infants. Multiple pregnancy, pulmonary hemorrhage and surgical operation are the risk factors of brain injuries. Birth weight is related to the survival of extremely preterm infants.


Si Y.,Bayi Childrens Hospital Affiliated to General Hospital of Beijing Military Command | Yang K.,Beijing Military General Hospital | Qin M.,Bayi Childrens Hospital Affiliated to General Hospital of Beijing Military Command | Zhang C.,Bayi Childrens Hospital Affiliated to General Hospital of Beijing Military Command | And 5 more authors.
Pediatric Hematology and Oncology | Year: 2014

The treatment of pediatric severe aplastic anemia (SAA) with allogeneic hematopoietic stem cell transplantation (allo-HSCT), presents major challenges including the risks of graft failure, septic complications, and graft-versus-host disease (GVHD). Additive infusions of human umbilical cord derived mesenchymal stem cell (hUC-MSC) may be administered to improve patient survival. We retrospectively examined 37 pediatric patients with SAA who received allo-HSCT and subsequent infusions of hUC-MSC suspension at a dose of 1.0 × 106/kg. The times and doses of hUC-MSC infusions were increased in patients with severe GVHD. All patients received hUC-MSC infusions. The median time to post-transplantation neutrophil count of greater than 0.5 × 109/L was 14 days (range, 11-20 days) and time to post-transplantation platelet count of greater than 20 × 109/L was 19 days (14-29 days). The overall frequency of acute GVHD (aGVHD) was 45.9% (17/37). These aGVHD episodes occurred at a median time of post-transplantation 47 days (15-83 days). The frequency of chronic GVHD (cGVHD) was 18.9% (7/37); cGVHD developed from aGVHD in 10.8% (4/37) of patients. The GVHD-associated mortality rate was 18.9% (7/37) and aGVHD-specific mortality rate was 8.1% (3/37). The median overall survival time was 35 months (9-67 months) and the three-year overall survival rate was 74.2% (28/37). Seven patients died of GVHD, one patient died of a severe invasive fungal infection, and one patient died of renal failure. In conclusion, post-transplantation hUC-MSC infusions seemed to be safely infused in children with SAA who have previously received allo-HSCT. © 2014 Informa Healthcare USA, Inc.


Roberge S.,Laval University | Roberge S.,University of Québec | Lacasse Y.,Laval University | Tapp S.,University of Québec | And 9 more authors.
Journal of Obstetrics and Gynaecology Canada | Year: 2011

Background: Antenatal glucocorticoid (AGC) therapy has been associated with a decrease in respiratory distress syndrome (RDS). While preterm males remain at greater risk of RDS than females, the role of fetal sex in AGC response is not well known. Objectives: To review the available evidence regarding the effect of fetal sex in the prevention of RDS using AGC. Method: We conducted a systematic review and meta-analysis of RCTs to compare the effect of AGC in male and female infants with regard to the rates of RDS, intra-ventricular hemorrhage (IVH) grades III and IV, and neonatal mortality. Random effects with 95% confidence intervals were assessed in both groups and relative risks were compared using mixed regression. Results: From 248 potentially eligible articles, we included eight in the analysis for a total of 1109 male and 968 female infants. Both male and female infants had a significant decrease in the risks, but no difference between the sexes was observed in terms of reduction in RDS (RR 0.50; 95% CI 0.33 to 0.77 for males, and RR 0.57; 95% CI 0.43 to 0.75 for females, P = 0.99), reduction in IVH (P = 0.98), and reduction in neonatal mortality (P = 0.43). In a sub-analysis, use of betamethasone was associated with a significant decrease in the rate of RDS in males (RR 0.29; 95% CI 0.15 to 0.57) but dexamethasone was not (RR 0.78; 95% CI 0.57 to 1.07). Conversely, dexamethasone use was significantly helpful in females (RR 0.51; 95% CI 0.32 to 0.81) but betamethasone was not (RR 0.62; 95% CI 0.38 to 1.00). Conclusion: The effect of AGC for prevention of RDS is similar in females and males. However, futures studies should investigate the type of AGC according to fetal/neonatal sex. © 2011 Society of Obstetricians and Gynaecologists of Canada.


Xu X.,Bayi Childrens Hospital Affiliated to General Hospital of Beijing Military Command | Liu X.,Bayi Childrens Hospital Affiliated to General Hospital of Beijing Military Command | Zhu B.,Bayi Childrens Hospital Affiliated to General Hospital of Beijing Military Command | Ren H.,Bayi Childrens Hospital Affiliated to General Hospital of Beijing Military Command | And 2 more authors.
Zhonghua er ke za zhi. Chinese journal of pediatrics | Year: 2014

OBJECTIVE: To explore the safety and the efficacy of bronchoscopic argon plasma coagulation (APC) combined with CO2 freezing for the treatment of airway granulation hyperplasia after pediatric airway stenting.METHOD: From April 2010 to December 2012, APC combined CO2 cryotherapy was performed for granulation tissue hyperplasia in 8 children after airway stenting, their clinical data, complications and postoperative outcomes and follow-up data were analyzed.RESULT: Five of the 8 cases were male and 3 female, when stenting their age was 2 to 17 months, the average age was (8.63 ± 5.50) months. Granulation tissue hyperplasia appears in the range of bracket covering, common to both ends of the stent. The time from stentinging to find hyperplasia of granulation tissue was 20 days to 19 months. As a result, in 30%-100% of children airway narrowing was found. We applied APC treatment when the bronchoscopy found hyperplasia lesions, then we used CO2 cryotherapy, i.e., freezing was persisted for 1 min twice and more, then the probe was moved until the APC burning area was entirely frozen, dyspnea in children were significantly improved and two cases of atelectasis patients' lung were completely re-expanded. Eight patients had varying degrees of postoperative low to moderate fever, three cases had a small amount of active bleeding after APC treatment, hemostasis was achieved after topical application of endoscopic injection of epinephrine or reptilase bleeding and freezing, no complications occurred with CO2 cryotherapy. According to the efficacy criteria in this article, the result was significantly effective in 6 cases, effective in 1 case, and partially effective in 1 case.CONCLUSION: APC combined with CO2 cryotherapy may be one of the optional methods that rapidly eliminates granulation tissue and remove the airway obstruction, so it can be used in treatment of pediatric airway' benign lesions.


PubMed | BAYI Childrens Hospital Affiliated to General Hospital of Beijing Military Command
Type: Journal Article | Journal: Zhonghua er ke za zhi = Chinese journal of pediatrics | Year: 2016

To observe the effect of intrapartum and postpartum factors on abnormal neurological findings in the extremely preterm infants.Clinical data of 62 premature infants (33 of male, 29 of female) were retrospectively analyzed. None of the premature infants had birth defect; their gestational ages were all less than 28 weeks (23(+ 6)-27(+ 6) weeks). They were hospitalized within 12 hours after birth in the neonatal intensive care unit (NICU) of BAYI Childrens Hospital from November 2010 to June 2013. The blood gas, birth condition, complications, the mechanical ventilation and the ultrasonic encephalography were recorded. The 62 cases were divided into 2 groups, alive group and died group. Meanwhile, all cases of survial were divided into brain injuries group and normal brain group. Data were analyzed with t-test, Chi square test and Spearman correlation analysis.Fifty-six cases were alive, and 6 cases died (3 were during the treatment and 3 were after parents gave up). The average birth weight of brain injuries group was (954 182) g; and that of the normal brain group was (1 071 136) g. There were significant differences between the two groups in gender ((2) = 4.314, P = 0.038), gestational age ((2) = 11.622, P = 0.001), birth weight (t = 2.728, P = 0.009), which had significant correlation with neurological outcomes. The Spearman correlative coefficients were -0.278, 0.456 and 0.364 respectively. And P values were 0.038, 0.000 and 0.006. The rates of multiple pregnancy, lung hemorrhage and surgical operation in brain injuries group were 45%(9/20), 55%(11/20), 40%(8/20), which were significantly higher than those in normal brain group, 3%(1/36), 17%(6/36), 11%(4/36)((2) = 12.800, 8.936, 4.773, P all < 0.05). These three factors were the high risk factors for adverse neurological outcomes, the odds ratios were 28.64, 6.11 and 5.33 respectively. There was no significant difference in delivery mode, amniotic fluid, maternal infection, asphyxia, necrotizing enterocolitis, patent ductus arteriosus, sepsis, mechanical ventilation, inhaled nitric oxide therapy, blood glucose, blood gas analysis, doses of dopamine between brain injuries group and normal brain group. The birth weight in alive group was (1 029 163) g, which was significantly higher than those in died group (870 144)g (r=0.29, P=0.022). There was no significant difference in other factors between alive group and died group(P all>0.05).Gender, gestational age and birth weight may have relation with the neurological outcomes of extremely preterm infants. Multiple pregnancy, pulmonary hemorrhage and surgical operation are the risk factors of brain injuries. Birth weight is related to the survival of extremely preterm infants.


PubMed | Bayi Childrens Hospital Affiliated to General Hospital of Beijing Military Command
Type: Journal Article | Journal: Zhonghua er ke za zhi = Chinese journal of pediatrics | Year: 2014

To explore the safety and the efficacy of bronchoscopic argon plasma coagulation (APC) combined with CO2 freezing for the treatment of airway granulation hyperplasia after pediatric airway stenting.From April 2010 to December 2012, APC combined CO2 cryotherapy was performed for granulation tissue hyperplasia in 8 children after airway stenting, their clinical data, complications and postoperative outcomes and follow-up data were analyzed.Five of the 8 cases were male and 3 female, when stenting their age was 2 to 17 months, the average age was (8.63 5.50) months. Granulation tissue hyperplasia appears in the range of bracket covering, common to both ends of the stent. The time from stentinging to find hyperplasia of granulation tissue was 20 days to 19 months. As a result, in 30%-100% of children airway narrowing was found. We applied APC treatment when the bronchoscopy found hyperplasia lesions, then we used CO2 cryotherapy, i.e., freezing was persisted for 1 min twice and more, then the probe was moved until the APC burning area was entirely frozen, dyspnea in children were significantly improved and two cases of atelectasis patients lung were completely re-expanded. Eight patients had varying degrees of postoperative low to moderate fever, three cases had a small amount of active bleeding after APC treatment, hemostasis was achieved after topical application of endoscopic injection of epinephrine or reptilase bleeding and freezing, no complications occurred with CO2 cryotherapy. According to the efficacy criteria in this article, the result was significantly effective in 6 cases, effective in 1 case, and partially effective in 1 case.APC combined with CO2 cryotherapy may be one of the optional methods that rapidly eliminates granulation tissue and remove the airway obstruction, so it can be used in treatment of pediatric airway benign lesions.


PubMed | Bayi Childrens Hospital Affiliated to General Hospital of Beijing Military Command
Type: Journal Article | Journal: Pediatric hematology and oncology | Year: 2014

The treatment of pediatric severe aplastic anemia (SAA) with allogeneic hematopoietic stem cell transplantation (allo-HSCT), presents major challenges including the risks of graft failure, septic complications, and graft-versus-host disease (GVHD). Additive infusions of human umbilical cord derived mesenchymal stem cell (hUC-MSC) may be administered to improve patient survival. We retrospectively examined 37 pediatric patients with SAA who received allo-HSCT and subsequent infusions of hUC-MSC suspension at a dose of 1.010(6)/kg. The times and doses of hUC-MSC infusions were increased in patients with severe GVHD. All patients received hUC-MSC infusions. The median time to post-transplantation neutrophil count of greater than 0.510(9)/L was 14days (range, 11-20days) and time to post-transplantation platelet count of greater than 2010(9)/L was 19days (14-29days). The overall frequency of acute GVHD (aGVHD) was 45.9% (17/37). These aGVHD episodes occurred at a median time of post-transplantation 47days (15-83days). The frequency of chronic GVHD (cGVHD) was 18.9% (7/37); cGVHD developed from aGVHD in 10.8% (4/37) of patients. The GVHD-associated mortality rate was 18.9% (7/37) and aGVHD-specific mortality rate was 8.1% (3/37). The median overall survival time was 35months (9-67months) and the three-year overall survival rate was 74.2% (28/37). Seven patients died of GVHD, one patient died of a severe invasive fungal infection, and one patient died of renal failure. In conclusion, post-transplantation hUC-MSC infusions seemed to be safely infused in children with SAA who have previously received allo-HSCT.


PubMed | Yangzhou University, Bayi Childrens Hospital Affiliated to General Hospital of Beijing Military Command and Chongqing Medical University
Type: Journal Article | Journal: Biomedical reports | Year: 2015

Due to their capacity to self-replicate or produce specific differentiated cell types, neural stem cells (NSCs) and bone marrow derived-mesenchymal stem cells (BMSCs) are potential sources for cell transplantation therapies, particularly for neural injury. However, the interaction between NSCs and BMSCs during differentiation has not yet been defined. The interaction is believed to improve the effectiveness and efficiency of cell therapy. In the present study, human NSCs and BMSCs were cultured and the Transwell co-culture system was used to observe the interplay between NSCs and BMSCs during differentiation. The results revealed that NSCs promoted BMSCs to differentiate into neurons and NSCs; whereas, BMSCs did not affect the differentiation of NSCs. Simultaneously, co-culture increased the concentration of brain-derived neurotrophic factor (BDNF) and nerve growth factor (NGF), which are secreted by NSCs and BMSCs. The present findings suggest that co-culture of NSCs and BMSCs can promote the differentiation and this process may be modulated by BDNF and NGF.


PubMed | Bayi Childrens Hospital Affiliated to General Hospital of Beijing Military Command
Type: Journal Article | Journal: Zhonghua er ke za zhi = Chinese journal of pediatrics | Year: 2014

To investigate the clinical application, indication, timing and prognosis of blood purification (artificial liver, BP) in treatment of acute liver failure in children.Artificial liver was used to treat 30 cases of pediatric acute liver failure (PALF), who were hospitalized in pediatric intensive care unit of Bayi Childrens Hospital Affiliated to Beijing Military Command General Hospital, during March 2010 to July 2013. Simple plasma exchange (PE) mode was used for PALF without complications, while PE combined with continuous veno-venous hemodiafiltration (CVVHDF) mode was used for PALF with cerebral edema and/or hepatorenal syndrome and/or serious abnormality of electrolyte and acid-base balance.Sixteen cases survived and restored hepatic function, with a survival rate of 53.3%. Single PE therapy could significantly decrease total bilirubin (TBIL) from (293.96 214.52) mol/L to (155.64 140.97) mol/L (P = 0.033), increase prothrombin time activity (PTA) from (34.50 18.34) % to (60.50 33.97) % (P = 0.013), while it did not significantly influence ammonia from (156.43 67.23) mol/L to (124.03 62.58) mol/L (P = 0.156) and alanine transarninase (ALT) from (752.53 1 291.84) U/L to (132.00 98.57) U/L (P = 0.066). PE + CVVHDF therapy could significantly ameliorate TBIL from (326.90 233.85) mol/L to (157.53 125.31) mol/L (P = 0.033), ALT from (1 476.64 1 728.18) U/L to (169.38 207.18) U/L (P = 0.019), ammonia from (215.83 83.92) mol/L to (141.25 63.09) mol/L (P = 0.022) and PTA from (36.68 23.13)% to (71.75 50.50) % (P = 0.044). Prothrombin time (PT) from (29.71 17.75)s to (16.27 6.38)s (P = 0.008) , ALT from (1 574.11 1 775.96) U/L to (145.81 113.89 ) U/L (P = 0.003) , TBIL from (233.16 219.70) mol/L to (75.19 86.07) mol/L (P = 0.012) , ammonia from (182.75 90.07) mol/L to (101.81 37.14) mol/L (P = 0.002) and PTA from (38.38 20.39)% to (83.13 41.68)% (P = 0.001) in survived cases significantly ameliorated after BP therapy. TBIL from (394.04 192.80) mol/L to (249.34 113.97) mol/L (P = 0.023) in died cases declined significantly after BP therapy, while alteration of PT, ALT, ammonia , and PTA had no statistical significance (P > 0.10) after BP therapy.PE + CVVHDF therapy could significantly ameliorate not only TBIL and PTA but also ammonia and ALT compared with single PE therapy. The decline of only an index like TBIL or ALT after BP therapy could not improve the prognosis. The inconsistency between serum bilirubin and ALT levels was an important factor that suggested poor prognosis of ALF, and it might increase survival rate to use BP therapy before that inconsistency emerged.


Xu X.,Bayi Childrens Hospital Affiliated to General Hospital of Beijing Military Command
Zhonghua er ke za zhi. Chinese journal of pediatrics | Year: 2013

To explore the diagnostic and therapeutic methods for perioperative children with congenital heart disease (CHD) with airway stenosis in pediatric intensive care unit (PICU). Fiberoptic bronchoscopy was used for the diagnosis of 100 CHD cases in PICU who were clinically considered to have possible airway malformation because of complicated difficult-to-control lung infection, atelectasis and failure with the ventilator after surgery from January 2010 to October 2011. Cases who were confirmed to have severe airway stenosis by bronchoscopy and weaning from the ventilator after surgery were treated with balloon expandable stents into the desired position in the bronchoscopy. There were 73 cases (73%) of CHD patients with airway abnormalities, including 31 cases of severe stenosis (31%), moderate stenosis in 29 cases (29%), mild stenosis in 13 cases (13%). Nine of the 10 children in whom the mechanical ventilation was hard to be stopped after surgery because of severe airway stenosis were weaned from mechanical ventilation successfully by fiberoptic bronchoscopy, while one case died from primary disease with severe sepsis after the placement of bronchial stents. CHD children with difficult-to-control lung infection, atelectasis and failure with ventilator after surgery are often complicated with airway abnormalities. The therapeutic bronchoscopy with airway stent can be used for cases with weaning from the ventilator because of severe airway stenosis.

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