Prediction of Severe Neonatal Hyperbilirubinemia Using Cord Blood Hydrogen Peroxide: A Prospective Study

Background

We hypothesized that cord blood hydrogen peroxide (H₂O₂) could be utilized to predict the severity of neonatal hyperbilirubinemia.

Methods

We prospectively enrolled term or near-term healthy neonates. Cord blood and capillary blood at three days of age were measured for hydrogen peroxide and bilirubin concentrations. For newborns with hyperbilirubinemia, further blood samples were obtained at five and seven days of age. Newborns were divided into severe or less severe hyperbilirubinemic groups (peak bilirubin ≥17 mg/dL or not). The sensitivity, specificity, and negative predictive values were determined.

Results

There were 158 neonates enrolled. The incidence of neonatal hyperbilirubinemia was 30.5% for a concentration ≥15 mg/dl. The rising patterns were similar among bilirubin concentrations and hydrogen peroxide levels during the first few days of life. There was a strong positive correlation between bilirubin concentrations and hydrogen peroxide levels after correlation analysis. The rate of severe hyperbilirubinemia was 13.3%. It revealed that a cord blood hydrogen peroxide signal level of 2500 counts/10 seconds was an appropriate cut-off for predicting severe hyperbilirubinemia. Sensitivity and the negative predictive value were 76.2% and 93.3%, respectively.

Conclusions

Our findings confirm that hydrogen peroxide levels and bilirubin concentrations in cord and neonatal blood are closely related. A cord blood hydrogen peroxide level above 2500 counts/10 seconds associated with a high predictive value for severe hyperbilirubinemia. This method provides information about which neonate should be closely followed after discharge from the nursery.     

金双歧治疗新生儿高胆红素血症的临床疗效研究

目的 探讨微生态制剂金双歧(双歧杆菌乳酸杆菌三联活菌片)对新生儿高胆红素血症的临床疗效,以找出能及早有效地纠正新生儿高胆红素血症,预防新生儿胆红素脑病发生的新方法.方法 通过随机抽样、收集青白江区人民医院2007年3月至2011年3月72例新生儿高胆红素血症患儿的临床资料并进行回顾性分析,将72例新生儿高胆红素血症患儿随机分为治疗组40例和对照组32例.对照组给予常规治疗,治疗组在常规治疗基础上,加用金双歧1片(0.5亿)/次,每天3次,温开水溶碎后喂服或经胃管注入,共7～10d.检测治疗前后两组血清胆红素水平、计算日平均经皮测胆红素下降值、平均住院时间和黄疸消退时间.结果 金双歧辅助治疗新生儿高胆红素血症,治疗后治疗组与对照组血清总胆红素水平分别为(58.21 +4.36) μmol/L和(64.16±5.29) μmol/L(P ＜0.01);治疗组和对照组日平均经皮测胆红素下降值、平均住院时间和黄疸退尽平均时间分别为( 10.35±2.46)、(7.68±1.35)μmol/L;( 6/54±2/59)、(9/05 +3/12)d; (6/38±1/38)、( 8/75±2/68)d;差异均有统计学意义(P＜0.01).结论 应用金双歧治疗新生儿高胆红素血症可迅速降低血胆红素水平,缩短治疗时间,预防胆红素脑病的发生疗效确切、安全,可作为治疗新生儿高胆红素血症的方法之一,值得临床应用推广.     

茵陈蒿汤外洗联合布拉氏酵母菌散和光疗治疗新生儿高胆红素血症的临床研究

摘要 目的：探讨茵陈蒿汤外洗联合布拉氏酵母菌散和光疗治疗新生儿高胆红素血症的临床效果。方法：选取我院于2019年3月~2020年12月期间收治的新生儿高胆红素血症患儿97例。根据随机数字表法分为A组（48例）和B组（49例）。A组给予光疗治疗,B组在A组基础上采用茵陈蒿汤外洗联合布拉氏酵母菌散治疗。对比两组疗效、光疗总时间、住院总时间、不同时间点总胆红素（TBIL）及间接胆红素（IBIL）水平,分析两组患儿治疗72 h后的肠道菌群状况。结果：B组治疗后的临床总有效率高于A组（P<0.05）。B组的光疗总时间及住院总时间均短于A组（P<0.05）。两组治疗24 h后、治疗48 h后、治疗72 h后TBIL、DBIL水平呈下降趋势,且B组低于A组（P<0.05）。治疗72 h后B组肠道内拟杆菌属丰度高于A组（P<0.05）,但大肠埃希菌属和葡萄球菌属丰度低于A组（P<0.05）。结论：茵陈蒿汤外洗联合布拉氏酵母菌散和光疗治疗新生儿高胆红素血症的疗效显著,可缩短光疗时间和住院时间,有效降低胆红素水平,调节患儿肠道菌群状况。     

Elucidating the interaction of ticlopidine with serum albumin and its role in bilirubin displacement in vitro

Ticlopidine is an anti-platelet drug that functions as a P2Y₁₂ receptor antagonist. The present study provides a detailed characterization of interaction of ticlopidine with a model transport protein, bovine serum albumin (BSA) as well as an assessment of its bilirubin displacing ability using a multi-spectroscopic approach in combination with isothermal titration calorimetry. The value of binding constant determined using ITC studies was found to be 3.03 × 10³ M^?1 with a binding stoichiometry of approximately 1:1. Competitive site marker experiments indicate that ticlopidine binds to Sudlow site I, located in subdomain IIA of BSA. In addition, Circular dichroism and 3D fluorescence spectroscopy indicated structural and conformational changes in BSA on interaction with ticlopidine. Thermodynamic parameters suggested that the reaction was spontaneous, exothermic, entropically driven, and involved hydrophobic interactions. These results were well supported by those obtained through molecular docking studies. Additionally, the effect of ticlopidine on bilirubin and albumin interaction was evaluated using the peroxidase method as well as through fluorescence spectroscopy. Ticlopidine was found to displace bilirubin from serum albumin. Moreover, the binding constant of bilirubin–serum albumin interaction also decreased in presence of ticlopidine. The results indicated that ticlopidine is a competitive displacer of bilirubin in vitro and may contribute to the incidences hyperbilirubinemia associated with the usage of this drug.     

早期光疗对早产儿黄疸的影响

目的：探讨在经皮胆红素监测下早期蓝光干预对早产儿高胆红素血症的防治作用。方法：选择2009年10月-2011年10月我院新生儿科收治的86例出生体重≤2000g,无出生窒息史的早产儿,按住院号单双号分为观察组46例和对照组40例。对照组按照我国2000年制定的新生儿黄疸干预推荐方案的干预标准进行光疗。观察组于出现黄疸和／或经皮胆红素〉85．50μmol／L,但尚未达方案的干预标准就进行光疗,监测经皮胆红素至黄痘消失。经皮胆红素值达187．5μmol／L以上时同时查静脉血监测血清总胆红素。比较2组早产儿经皮胆红素峰值及恢复正常时间。结果：观察组与对照组比较经皮胆红素峰值较低,黄疸持续时间较短,两组比较P均〈0．05,有统计学差异。结论：早产儿在经皮胆红素监测下进行早期蓝光干预有利于降低早产儿胆红素峰值,缩短黄疸持续时间。有效预防早产儿胆红素脑病。     

Yinzhihuang Oral Liquid Ameliorates Hyperbilirubinemia Induced by δ-Aminolevulinic Acid and Novobiocin in Neonatal Rats

Yinzhihuang oral liquid (YZH) is a traditional Chinese medicine that has been widely used in Asia to prevent and treat neonatal hyperbilirubinemia, but the published preclinical studies on its anti-hyperbilirubinemia effect are conducted in adult animals, partly due to the lack of preclinical neonatal hyperbilirubinemia animal models. In the present study, we tested six reagents to induce hyperbilirubinemia in neonatal rats, and established two appropriate neonatal hyperbilirubinemia rat models by subcutaneous injection of δ-Aminolevulinic acid (ALA, 200 mg/kg) or novobiocin (NOVO, 200 mg/kg). Oral treatment of YZH (80, 160 and 320 mg/kg) significantly decreased serum conjugated bilirubin levels in ALA-treated neonatal rats and serum unconjugated bilirubin levels in NOVO-treated neonatal rats, respectively. Additionally, pre-treatment of YZH also prevented the increase of serum bilirubin levels in both ALA- and NOVO-treated rats. Mechanistically, YZH significantly up-regulated the mRNA expression of genes involved in hepatic bilirubin disposition (organic anion-transporting polypeptide 1b2, Oatp1b2; multidrug resistance-associated protein 2, Mrp2) and bilirubin conjugation (UDP-glucuronosyltransferase 1a1, Ugt1a1). Additionally, YZH up-regulated the mRNA expression of cytochrome P450 1A1 (Cyp1a1), the target gene of aryl hydrocarbon receptor (AhR), and increased the nuclear protein levels of AhR in livers of neonatal rats. YZH and its two active ingredients, namely baicalin (BCL) and 4’-hydroxyacetophenone (4-HT), up-regulated the mRNA expression of AhR target genes (CYP1A1 and UGT1A1) and increased nuclear protein levels of AhR in HepG2 cells. In conclusion, the present study provides two neonatal hyperbilirubinemia animal models and evaluates the anti-hyperbilirubinemia effect and mechanisms of YZH in neonatal animals.     

Spectrofluorimetric determination of bilirubin in serum samples

A new spectrofluorimetric method was developed for determination of trace amount of bilirubin. Using oxytetracycline–Eu³⁺ as a fluorescent probe, in the buffer solution of pH = 7.3, bilirubin can reduce remarkably the fluorescence intensity of the oxytetracycline–Eu³⁺ complex at λ = 612 nm and the reduced fluorescence intensity was in proportion to the concentration of bilirubin. Optimum conditions for the determination of bilirubin were also investigated. The linear range and limit of detection for the determination of bilirubin were 5.0 × 10^?7, 3.0 × 10^?5 and 7.7 × 10^?8 mol L^?1, respectively. This method is simple, practical and relatively free of interference from coexisting substances and can be successfully applied to assess bilirubin in serum samples and compared with the modified Jendrassik–Grof method in clinical analysis. The quenching mechanism of the fluorescence intensity in the system is also discussed. Copyright © 2010 John Wiley & Sons, Ltd.     

金双歧治疗新生儿高胆红素血症237例临床分析

目的探讨微生态制剂金双歧（双歧杆菌乳酸杆菌三联活菌片）对新生儿高胆红素血症的临床疗效。方法对成都军区总医院2009年9月至2013年9月237例新生儿高胆红素血症患儿的临床资料并进行回顾性分析。将237例新生儿高胆红素血症患儿随机分为对照组和治疗组,治疗组在常规治疗基础上,加用金双歧。检测治疗前后两组日平均经皮胆红素下降值及黄疸消退时间。结果治疗组与对照组治疗前血清总胆红素比较差异无统计学意义;治疗第5天治疗组血清总胆红素较对照组低,两组比较差异有统计学意义;治疗组在治疗第5天血清总胆红素下降至145μmol/L时间较对照组低,差异有统计学意义。结论应用金双歧治疗新生儿高胆红素血症可迅速降低血胆红素水平,缩短治疗时间,行之有效,值得临床治疗新生儿高胆红素辅助用药。     

新生儿高胆红素血症与先天性巨细胞病毒感染的相关性研究

目的:探讨新生儿高胆红素血症与巨细胞病毒(HCMV)感染的相关性及临床意义。方法:对170例疑为高胆红素血症新生儿血清标本分别检测HCMV的IgG和IgM及血清总胆红素(TBIL)。排除高胆红素血症新生儿血清标本100例为正常对照。结果:高胆红素血症患者血清HCMV-IgG、IgM阳性率高于正常对照组,两者比较有统计学意义。结论:巨细胞病毒感染与新生儿高胆红素血症相关性大,是引起高胆红素血症的主要病原之一。     

Evaluation of transcutaneous bilirubinometry in preterm infants of gestational age 32-34 weeks

Aims: The aim of this prospective study was to evaluate the accuracy of transcutaneous bilirubinometry using the Minolta Air-Shields JM-103 device in preterm newborns of gestational age 32-34 weeks, and to identify the most appropriate measurement site. Methods: Transcutaneous bilirubin (TcB) measurements were performed over forehead, sternum and abdomen, if total serum bilirubin (TSB) had to be determined on clinical indication in neonates of selected gestational age. TSB levels were measured in a clinical laboratory using direct spectrophotometry. In order to assess transcutaneous bilirubinometry accuracy, differences between TSB and TcB, their CI95%, and correlation coefficients (r) between TcB and TSB were evaluated. Results: The study group consisted of 44 infants, including 6 very low birth weight (VLBW) neonates. The correlations between transcutaneous and laboratory values were found to be significant and close. Minimal differences were observed when measured over sternum. The measurements over forehead had a tendency to underestimate TSB levels. Conclusions: Noninvasive measurement by Minolta JM-103 demonstrated significant accuracy. The authors recommend measurements over sternum or abdomen in premature infants born within 32-34 gestational weeks as a reliable and accurate neonatal hyperbilirubinemia screening test. Transcutaneous bilirubinometry has the potential to reduce the number of blood samplings, thus reducing neonatal pain and discomfort, parental distress and medical care cost.     

Serum bilirubin levels in breast- and formula-fed infants in the first 5 days of life.

A prospective study was conducted in a level II maternity unit to investigate the incidence of hyperbilirubinemia in healthy, term, breast-fed and formula-fed infants. Serum bilirubin levels were determined for 176 breast-red and 164 formula-fed infants in cord blood and on days 1, 2, 3 and 5 after birth. The mean total bilirubin levels were significantly higher on each postnatal day in the breast-fed infants, as was the proportion of infants with peak levels above 12 mg/dl (205 mumol/l; 28% v. 6%). The breast-fed infants also had significantly higher proportional weight losses on each postnatal day than the formula-fed infants. However, there was no correlation between the cumulative weight loss on day 3 and bilirubin levels on the same day with either feeding regimen. None of the infants required an exchange transfusion or prolonged care in hospital for hyperbilirubinemia.     

Evaluation of cord blood immunoglobulin E and its association with maternal factors in a group of Iranian newborns

Allergic disorders are among the most common diseases around the world especially in children. Many factors contribute to the pathogenesis of atopic disorders, but early events during the pregnancy are very important. The aim of this study was to evaluate the level of cord blood immunoglobulin E (CB-IgE) and its association with maternal in a group of Iranian newborns. In a cross-sectional study, 163 pregnant women randomly selected and information about pregnancy and atopy were taken by questionnaire. Blood samples of mothers and matched cord blood were collected and total serum IgE levels were measured by enzyme-linked immunosorbent assay (ELISA) method. To rolling out the possibility of contamination with maternal blood, total IgA was checked for all the cord blood samples. Sixteen percent of mothers had the history of atopic diseases and the mean IgE level was significantly higher in an atopic than nonatopic mothers (241 vs 102, P < 0.001). About 73.9% of cord blood samples, had high IgE level (>0.9 IU/mL). The level of cord blood IgE (CB-IgE) was not significantly different in male and female newborns (2.14 vs 2.15 IU/mL). There was no significant correlation between maternal factors such as age, pregnancy variables, allergens exposure, smoking, and maternal IgE with cord blood IgE. The results of this study showed that CB-IgE is high in a remarkable number of samples; independent of maternal or fetal factors. Further studies need to evaluate the reasons for the high level of IgE in cord blood in our area.     

The fluorescence quenching of Ru(bipy)32+: an application for the determination of bilirubin in biological samples

A simple, sensitive and efficient fluorescence method has been established for the quantitative analysis of bilirubin. The fluorometric determination method was based on the kinetic quenching of ruthenium(II) fluorescence. The quenching effect may be due to the complexation reaction of bilirubin with ruthenium(II). Therefore, the effects of ruthenium concentrations and different surfactants have been studied. Under the optimized experimental parameters, the fluorescence intensity decreased proportionally with the bilirubin concentration and linearity was established in the range of 3.3 × 10⁻⁷ to 3.0 × 10⁻⁴ M bilirubin. The detection limit calculated from the calibration graph was found to be 5.2 × 10⁻⁸ M. The relative standard deviation (RSD) of 10 consecutive measurements of 8.0 × 10⁻⁶ M bilirubin was 3.0%, while the recoveries of bilirubin in both human serum and urine samples were obtained in the range 94.0–99.5%. The interference study shows that the developed fluorescence based technique is fast, easy to carry out and shows negligible interference. The developed technique was successfully applied for the analysis of bilirubin in human urine and serum samples. All the experimental results and quality parameters confirmed the sensitivity and reproducibility of the proposed technique for bilirubin determination in human urine and serum samples .     

Association of serum total bilirubin levels with diastolic dysfunction in heart failure with preserved ejection fraction

Background

Left ventricular diastolic dysfunction is one of the main characteristics of heart failure patients with a preserved left ventricular ejection fraction. As bilirubin is regarded as an important endogenous antioxidant molecule, serum total bilirubin levels were compared between heart failure patients with a preserved left ventricular ejection fraction and normal controls in this study. We recruited 327 heart failure patients with a preserved left ventricular ejection fraction and 200 healthy controls. Patients were divided into 4 subgroups by their comprehensive echocardiographic manifestations, 1-mild, 2-moderate, 3-severe (reversible restrictive), 4-severe (fixed restrictive). Total bilirubin levels were compared using stepwise multiple regressions adjusted for selected factors.

Results

After adjusting for gender, age, smoking, systolic blood pressure, diastolic blood pressure, total cholesterol and triglyceride, serum total bilirubin levels were significantly lower in the heart failure group compared with the control group (P < 0.01). Patients in the subgroup (4-severe) showed significantly (P < 0.05) lower levels of total bilirubin when compared with the subgroup (1-mild).

Conclusions

TB level was negatively correlated with left ventricular diastolic dysfunction in heart failure patients with a preserved left ventricular ejection fraction, which might provide a new insight into the complicated mechanisms of heart failure with a preserved left ventricular ejection fraction.     

胆红素脑病SD乳鼠模型中脑水通道蛋白-4表达发生变化

神经细胞水肿是胆红素脑病（bilirubin encephalopathy,BE）发生发展过程中的重要病理变化。水通道蛋白-4（aquaporin-4,AQP4）的表达及分布异常与多种疾病所致细胞毒性脑水肿的发生发展具有密切联系。但胆红素脑病中AQP4的表达变化规律及其在病理进展中的作用尚不清楚。采用7日龄SD大鼠小脑延髓池注射胆红素溶液的方法,建立新生大鼠胆红素脑病模型。胆红素脑病模型根据胆红素作用时间的不同,分为12 h、24 h、48 h、72 h和7 d组。采用HE及尼氏染色,检测各新生大鼠脑组织的病理改变;应用透射电镜(TEM),检测胆红素作用24 h后,鼠脑组织超微结构的变化;应用免疫荧光及Western 印迹,检测 AQP4在脑组织中的表达变化。通过上述实验,以探讨AQP4的表达变化与胆红素所致脑损伤的关系。HE及尼氏染色结果显示,随着胆红素沉积时间的延长,神经细胞逐渐肿胀,细胞间隙增大,尼氏小体数量逐渐减少;电镜结果显示,胆红素脑病24 h后神经细胞线粒体出现肿胀;免疫荧光染色显示,24 h组AQP4的表达范围明显增加,其后表达范围逐渐减少,表达强度也随之减弱;Western 印迹结果显示,AQP4表达在不同时间点呈现先增高后降低的趋势,在24 h达到峰值（24 h组1.38 ± 0.11 vs 对照组0.87 ± 0.21, P＜0.05）,在之后的各时间点上,AQP4的表达呈现下降趋势,而72 h组与7 d组AQP4表达均低于48 h组（P＜0.05）,基本恢复到对照组的表达水平（P＞0.05）。上述结果提示,胆红素脑病中胆红素的毒性作用将引起AQP4表达量的改变,AQP4的表达变化与胆红素脑病中细胞毒性脑水肿的发生相关,并且可能在胆红素脑病脑损伤的进展中发挥作用。     

胆红素脑病SD乳鼠模型中脑水通道蛋白-4表达发生变化

神经细胞水肿是胆红素脑病（bilirubin encephalopathy,BE）发生发展过程中的重要病理变化。水通道蛋白-4（aquaporin-4,AQP4）的表达及分布异常与多种疾病所致细胞毒性脑水肿的发生发展具有密切联系。但胆红素脑病中AQP4的表达变化规律及其在病理进展中的作用尚不清楚。采用7日龄SD大鼠小脑延髓池注射胆红素溶液的方法,建立新生大鼠胆红素脑病模型。胆红素脑病模型根据胆红素作用时间的不同,分为12 h、24 h、48 h、72 h和7 d组。采用HE及尼氏染色,检测各新生大鼠脑组织的病理改变;应用透射电镜(TEM),检测胆红素作用24 h后,鼠脑组织超微结构的变化;应用免疫荧光及Western 印迹,检测 AQP4在脑组织中的表达变化。通过上述实验,以探讨AQP4的表达变化与胆红素所致脑损伤的关系。HE及尼氏染色结果显示,随着胆红素沉积时间的延长,神经细胞逐渐肿胀,细胞间隙增大,尼氏小体数量逐渐减少;电镜结果显示,胆红素脑病24 h后神经细胞线粒体出现肿胀;免疫荧光染色显示,24 h组AQP4的表达范围明显增加,其后表达范围逐渐减少,表达强度也随之减弱;Western 印迹结果显示,AQP4表达在不同时间点呈现先增高后降低的趋势,在24 h达到峰值（24 h组1.38 ± 0.11 vs 对照组0.87 ± 0.21, P＜0.05）,在之后的各时间点上,AQP4的表达呈现下降趋势,而72 h组与7 d组AQP4表达均低于48 h组（P＜0.05）,基本恢复到对照组的表达水平（P＞0.05）。上述结果提示,胆红素脑病中胆红素的毒性作用将引起AQP4表达量的改变,AQP4的表达变化与胆红素脑病中细胞毒性脑水肿的发生相关,并且可能在胆红素脑病脑损伤的进展中发挥作用。     

Targeted suppression of heme oxygenase-1 by small interference RNAs inhibits the production of bilirubin in neonatal rat with hyperbilirubinemia

Background  

Excessive accumulation of bilirubin contributes to neonatal hyperbilirubinemia in rats. Heme oxygenase (HO) is one of the rate-limiting enzymes in catabolizing heme to bilirubin. In the present study, we investigated whether suppression of rat HO-1 (rHO-1) expression by small interference RNAs (siRNAs) reduces bilirubin levels in hyperbilirubinemic rats.     

Association of serum bilirubin with contrast-induced nephropathy and future cardiovascular events in patients undergoing coronary intervention

Objectives

Enhanced reactive oxygen species formation within the kidney following the administration of contrast media may play a key role in the development of contrast-induced nephropathy (CIN). Bilirubin has emerged as an important endogenous antioxidant molecule. This study was undertaken to determine whether bilirubin is associated with CIN and future cardiovascular events in patients undergoing coronary intervention.

Methods

Totally, 544 consecutive patients received coronary intervention were enrolled. All patients were followed up for at least 3 years or until the occurrence of a major event. The primary endpoint was CIN, defined as a rise in serum creatinine (SCr) of 0.5 mg/dl or a 25% increase from the baseline value within 48 hours after the procedure. The secondary endpoint was the combined occurrence of major adverse cardiovascular events (MACE), including death, nonfatal myocardial infarction, and ischemic stroke.

Results

Overall, CIN occurred in 85 (15.6%) patients. All patients were stratified into 3 groups (low/normal/high) according to the serum bilirubin levels. In a multivariate logistic analysis, the odds ratio for CIN with low-bilirubin levels relative to high-bilirubin levels was 11.82 (95% CI, 3.25–43.03). By Cox regression analysis, serum bilirubin levels was an independent predictor of MACE in patients undergoing coronary intervention (low vs. high hazard ratio 2.26; 95% CI, 1.05–4.90).

Conclusions

CIN is a serious complication of coronary intervention. Higher serum bilirubin concentrations were associated with lower risk of CIN and fewer cardiovascular events. The development of interventions that promote bilirubin levels may be a potential target to reduce CIN and future MACE in patients undergoing coronary intervention.     

柴胡解毒汤对人肝星状细胞LX-2增殖及凋亡的影响

目的:观察柴胡解毒汤含药血清对人肝星状细胞LX-2增殖、凋亡情况的影响,探究其抗肝纤维化作用的可能机制。方法:将Wistar大鼠分为实验组与对照组,分别以柴胡解毒汤、生理盐水灌胃5天后取血制备大鼠含药血清与正常血清。同时复苏人肝星状细胞LX-2后进行细胞培养和细胞传代。当肝星状细胞数量达到预定值时,将肝星状细胞分为对照组和药物组。观察LX-2细胞在与含药血清孵育24 h、36 h、48 h、72 h后,用CCK-8比色法测定细胞的增殖抑制率。用流式细胞术(Annexin V-FITC,PI染色法)检测细胞凋亡的概况。结果:柴胡解毒汤含药血清在给药24 h后可抑制LX-2细胞的增殖,36 h、48 h、72 h的增殖抑制率分别为0.37%、0.46%、0.44%,并可诱导LX-2细胞发生凋亡,48 h、72 h凋亡概率分别为(9.80±0.95)%、(36.40±5.09)%,差异具有统计学意义(P0.05)。结论:柴胡解毒汤具有抑制LX-2细胞增殖、诱导LX-2细胞发生凋亡的能力,这可能是柴胡解毒汤抗纤维化作用的机制之一。     

金双歧预防早期新生儿高胆红素血症的 临床观察

目的评估益生菌在足月新生儿高胆红素血症中的预防作用及患儿不良反应的发生情况。方法选取成都市妇女儿童中心医院2017年1月至2017年6月产科出生的健康足月儿320例,随机分为预防组(160例)和对照组(160例)。预防组给予益生菌(金双歧)治疗,0.5 g/次,2次/d,连续口服5 d,对照组不做处理。全部新生儿均为母乳喂养,并在生后5 d内检测经皮胆红素平均值,记录临床结果。比较新生儿每天经皮胆红素平均值,需要光疗的比例,不良反应发生情况等一系列临床指标。结果第4、5天预防组新生儿经皮胆红素平均值明显低于对照组,差异有统计学意义(P0.05)。预防组与对照组相比,光疗比例明显降低,差异有统计学意义(P0.05)。两组新生儿发生腹泻和呕吐的情况差异无统计学意义。结论益生菌可以显著降低健康足月新生儿经皮胆红素值,降低需要光疗的比例,安全性较高。