Neurochemical Studies on the Cerebellar Hypoplasia of Gunn Rat (Hereditary Hyperbilirubinemic Rat)

The cerebellar hypoplasia induced by hereditary hyperbilirubinemia in the Gunn rat was analyzed neurochemically and immunohistochemically. The antiserum against myelin basic protein was used to visualize the arborization of the fibers in the cerebellum. Arborization was very scarce in the affected lobes of the homozygous (jj) cerebellum. Na,K-ATPase activity did not show significant differences between the jj and the control (Jj) cerebellum. The concentration of norepinephrine in the jj cerebellum was about 1.5 times that of the control. However, the activation ratio of the Na,K-ATPase by norepinephrine and other catecholamines such as dopamine and isoproterenol was about twice as high as the basal activity, and no significant difference was observed between the jj and the Jj cerebella. The glutamic acid decarboxylase activity of the jj cerebellum did not differ significantly from that of the control.     

Early predictive value of cord blood bilirubin and dynamic monitoring of transcutaneous bilirubin for hyperbilirubinemia of newborns

ObjectiveTo study the early predictive value of cord blood bilirubin and dynamic monitoring of transcutaneous bilirubin for hyperbilirubinemia of newborns.Methods389 newborns delivered from June 2014 to December 2015 were enrolled as the research subjects; detailed records were made about the general data of newborns and mothers, and after cord blood bilirubin being graded, the incidence of hyperbilirubinemia was counted, and the prediction efficiency of cord blood bilirubin was analyzed by receiver operator characteristic (ROC) curve. At the same time, the transcutaneous bilirubin was detected continuously when the neonate was born and 24 h, 48 h and 72 h after birth, and the relativity between transcutaneous bilirubin at 72 h and serum bilirubin was analyzed.ResultsNo significant difference was found in the hyperbilirubinemia group and the non-hyperbilirubinemia group concerning general data of the newborns and their mothers. With the concentration of cord blood bilirubin increased, the incidence of hyperbilirubinemia also increased; separate prediction of hyperbilirubinemia by cord blood bilirubin showed a sensitivity and specificity of 71.4% and 65.6% respectively, and they need further dynamic monitoring. The daily mean of transcutaneous bilirubin in hyperbilirubinemia group was significantly higher than that in non-hyperbilirubinemia group at 24 h, 48 h and 72 h, and the measurement value of transcutaneous bilirubin at 72 h had a high correlation with serum bilirubin. When transcutaneous bilirubin value is higher than 18, the incidence of hyperbilirubinemia should be considered.ConclusionsThe increase of cord blood bilirubin effectively predict the occurrence of neonatal hyperbilirubinemia. There is a good correlation between levels of transcutaneous bilirubin and serum bilirubin. Moreover, combined detection of transcutaneous bilirubin and cord blood bilirubin can significantly improve the prediction accuracy of hyperbilirubinemia.     

Phototherapy increases DNA damage in lymphocytes of hyperbilirubinemic neonates

Phototherapy is commonly used in the treatment of hyperbilirubinemia in newborns. No serious side effects related to phototherapy have been observed, but concerns regarding its potential to damage DNA have been expressed, based on animal or cell-culture studies. The aim of this study was to investigate, in neonates with hyperbilirubinemia, the possible relation between phototherapy and DNA damage. The study included 33 full-term newborns with non-physiological jaundice and 14 healthy newborns with physiological jaundice as controls. Phototherapy was performed with an array of six fluorescent lamps producing radiation with wavelengths of 480–520 nm at 12 μW/cm²/nm. DNA damage in lymphocytes was determined by use of the alkaline comet assay. The DNA damage increased significantly with the duration of phototherapy, as shown by measurements at 24, 48, and 72 h (P < 0.001). These findings indicate that phototherapy, widely used in neonatology units, increases DNA damage in newborns. It remains to be seen whether the genotoxic effect observed in the present study can cause any long-term health effect in phototherapy-treated infants in later life.     

Cerebellar Hypoplasia in the Gunn Rat with Hereditary Hyperbilirubinemia: Immunohistochemical and Neurochemical Studies

Immunohistochemical reactions were conducted, using the antibodies against GFA and S-100 proteins on sections of cerebellum from the homozygous (jj) and the heterozygous (Jj) Gunn rats. Hypertrophy of the fibrous astrocytes was observed but hyperplasia of the glial cells was not. Although the molecular layer was very thin, the Bergmann fibre appeared normal. Among the free amino acids in the cerebellum from the jj rat, glutamate concentration decreased to two-thirds of the control level. The protein profile of the cerebellum from the jj rat obtained by SDS-polyacrylamide gel electrophoresis revealed that the amount of P400 protein that is characteristic of Purkinje cells decreased considerably and there were also some changes of the other unidentified proteins. By two-dimensional electrophoresis, it was observed that in the supernatant from the jj rat cerebellum one protein spot diminished and in the particulate fraction from the jj rat one spot was enormously increased. The activity of 2',3'-cyclic nucleotide 3'-phosphohydrolase (CNPase) in the cerebellum from the jj rat did not differ significantly from that of the control; however, activities of choline acetyltransferase and acetylcholinesterase of the jj rat were about twice as high as those of the control. 2-Deoxyglucose incorporation was maximum in the granular layer from both the jj and the Jj rat cerebella. However, the incorporation in the jj cerebellum was not higher than in the Jj control and even lower in some parts of the jj cerebellum than in the control Jj cerebellum.     

高通量二代测序 对感染性新生儿高胆红素血症病原菌的分析

摘要：目的 探讨高通量二代测序技术在筛选感染性新生儿高胆红素血症病原菌中的应用价值。方法 运用高通量二代测序技术筛选22例感染性新生儿高胆红素血症患者的病原菌,同时进行传统细菌培养鉴定,比较二者的区别。结果 高通量二代测序技术检测病原菌阳性率为100.00%,传统细菌培养检测阳性率为0.00%。高通量二代测序技术筛选出的感染性新生儿高胆红素血症主要病原菌为Anoxybacillus kestanbolensis、Geobacillus vulcani、Klebsiella oxytoca和Acinetobacter guillouiae。结论 高通量二代测序技术具有高通量、高特异性、高准确度和快速等特点,适合临床患者病原菌的检测。     

微生态制剂（培菲康）治疗新生儿高胆红素血症临床疗效评价

目的评价微生态制剂（培菲康）治疗新生儿高胆红素血症的临床疗效。方法110例在福建医科大学附属第一医院儿科住院治疗的新生儿高胆红素血症患儿分为治疗组和对照组;对照组65例给予肝酶诱导剂、光疗等综合治疗;治疗组45例在综合治疗基础上加用培菲康治疗。治疗前后检测患儿血清总胆红素和间接胆红素含量。采用SPSS11.0软件包进行统计学分析,α=0.05为显著性检验标准。结果时间-效应分析显示培菲康治疗组和对照组血清总胆红素下降值及95%CI（μmol/L）分别为142.6（126.7～158.4）、74.1（66.9～81.3）,血清间接胆红素下降值及95%CI（μmol/L）为115.7（103.3～128.1）、62.6（53.7～71.7）,差异有显著性（P〈0.05）;多元Cox回归分析显示患儿年龄、体重、孕周、入院前病程、入院血清总胆红素值/间接胆红素值及应用培菲康治疗为影响高胆红素血症患儿血清总胆红素/间接胆红素下降的主要因素;治疗组和对照组治愈例数（治愈率）分别为37例（82.2%）、8例（17.8%）,好转例数（好转率）分别为47例（72.3%）、10例（27.7%）,χ^2=1.448,P=0.229。2组均未见明显不良反应发生。结论应用培菲康治疗新生儿高胆红素,可促进胆红素分解和排泄,减少肠肝循环,减少肠道重吸收未结合胆红素,是治疗新生儿高胆红素血症一种可靠、安全的药物。     

高胆红素血症新生儿肠道菌群特点与苯巴比妥治疗效果的相关性

摘要 目的：探讨与分析高胆红素血症新生儿肠道菌群特点与苯巴比妥治疗效果的相关性。方法：选择2020年6月到2022年6月在本院诊治的565例高胆红素血症新生儿作为研究对象,所有患儿都给予苯巴比妥治疗,检测新生儿肠道菌群与血清α-谷胱甘肽-s-转移酶（α-GST）、肌酸激酶同工酶（CK-MB）、胆红素含量,判定患儿的治疗效果并进行相关性分析。结果：565例患儿治疗7 d后,有效490例（有效组）,有效率为86.7 %。有效组的血清胆红素、经皮胆红素含量都明显低于无效组（P<0.05）。有效组的血清α-GST、CK-MB含量都明显低于无效组（P<0.05）。有效组的肠球菌属、埃希氏菌属、链球菌属相对丰度均低于无效组,拟杆菌属相对丰度明显高于无效组（P<0.05）。在565例患儿中,Spearsman分析显示苯巴比妥治疗效果有效与肠球菌属、埃希氏菌属、链球菌属、拟杆菌属相对丰度都呈现相关性（P<0.05）。结论：苯巴比妥治疗新生儿高胆红素血症的效果有待提高,通过胆红素、α-GST、CK-MB、肠道菌群检测能有效判定患儿的治疗效果,同时肠道菌群与治疗效果存在相关性。     

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。     

酪酸梭菌活菌散预防新生儿高胆红素血症临床观察

目的观察酪酸梭菌活菌散(商品名:宝乐安)预防新生儿高胆红素血症的临床疗效。方法将产科分娩的正常足月新生儿212例,随机分为2组,预防组106例,对照组106例,2组均在生后半小时内开始喂奶。预防组喂服酪酸梭菌活菌散500 mg/次,3次/d,用至黄疸消退,观察黄疸变化情况及不良反应。结果出生后48 h内胎便转黄率预防组为56.6%,对照组为26.4%;生后7 d内皮肤巩膜黄染达高峰预防组为58.5%,对照组为43.3%;高胆红素血症发生率预防组为7.5%,对照组为22.6%;出生后7 d内血清胆红素达高峰率预防组为62.3%,对照组为47.1%。以上各指标2组间差异均具有统计学意义(P0.01或0.05)。结论酪酸梭菌活菌散预防新生儿高胆红素血症安全有效,值得临床推广应用。     

不同病情高胆红素血症新生儿血清AST、IGF-1、NSE、CysC水平的表达及临床意义

摘要 目的：研究不同病情高胆红素血症新生儿血清谷草转氨酶（AST）、胰岛素样生长因子-1（IGF-1）、神经元特异性烯纯化酶（NSE）、胱抑素C（CysC）水平的表达及临床意义。方法：将我院从2017年1月～2018年12月收治的高胆红素血症新生儿316例作为研究组。按其病情分成轻度组152例、中度组105例以及重度组59例,另取同期健康新生儿100例作为对照组。比较四组新生儿血清AST、IGF-1、NSE、CysC、总胆红素（TSB）水平,分析上述各项指标的关系。此外,比较对照组与研究组的基线资料,分析新生儿高胆红素血症发病的影响因素。结果：轻度组、中度组、重度组血清AST、IGF-1、NSE、CysC、TSB水平均高于对照组,且中度组、重度组上述指标高于轻度组,重度组上述指标高于中度组（P＜0.05）。经Pearson相关性分析可得：高胆红素血症新生儿TSB水平与血清AST、IGF-1、NSE、CysC水平均呈正相关（P＜0.05）。研究组和对照组在母婴血型不合、产前使用催产素、围生期疾病以及TSB、AST、IGF-1、NSE、CysC方面对比差异均有统计学意义（P＜0.05）。经多因素Logistic回归分析可得：新生儿高胆红素血症发病的影响因素为产前使用催产素、围生期疾病以及TSB、AST、IGF-1、NSE、CysC（P＜0.05）。结论：随着高胆红素血症新生儿病情的加剧,血清AST、IGF-1、NSE、CysC水平均逐渐升高且均与血清TSB水平呈正相关,临床工作中可能通过联合检测上述血清学指标辅助评估高胆红素血症新生儿病情,且以上指标水平的升高会增加新生儿高胆红素血症的发病风险。