Life-and-Death Decisions in a Neonatal Intensive Care Unit in Denmark: The Discrete Authority of Origin Stories

In what ways are care and compassion implicated in efforts to establish lives worth living? Drawing on fieldwork in a Danish Neonatal Intensive Care Unit (NICU), in this article we investigate the role of family biographies in conducting life-and-death decisions around premature infants. Guided by a larger literature on citizenship, we view decisions in the NICU as political acts of assigning citizenship. We ask what bodies and biographies can generate and evoke care and compassion among NICU staff and forge entries or exits from the Danish Welfare State. We demonstrate that infants’ origin stories are appointed legitimate forms of suffering in contemporary Danish society and are thus granted an unnoticed form of authority in life-and-death decisions. In this way, we conclude that what comes to constitute a life worth living in the twenty-first-century Danish Welfare State is in fact the worth of the family.     

新生溶血病患儿红细胞上致敏抗体对Rh 血型检测的影响

目的:探讨新生溶血病患儿红细胞致敏抗体对其Rh血型鉴定的影响。方法:采用抗球蛋白法、盐水法、微柱凝胶法(Rh血型测定型)、凝聚胺法和抗血清微柱凝胶法(Ig G型)五种方法对近三年来我院收集的163例新生溶血病患儿红细胞进行Rh血型检测,对五种检测结果不一致的患儿红细胞进行0.2 M 2-巯基乙醇抗体放散,比较放散后五种方法检测结果并验证其准确性。结果:29例直接抗体试验阳性患儿的五种Rh血型检测结果不一致,经0.2 M 2-巯基乙醇抗体放散后检测结果均一致。Rh血型准确性验证表明,红细胞放散测定的Rh血型完全符合临床现象。结论:患儿红细胞的致敏抗体达一定数量后,会影响抗球蛋白法、盐水法、微柱凝胶法(Rh血型测定型)、凝聚胺法和抗血清微柱凝胶法(Ig G型)对Rh血型鉴定,0.2M 2-巯基乙醇抗体放散法是一种正确鉴定新生儿Rh血型的简单可行的方法。     

呼吸窘迫综合征早产儿血清VA、PCT、TNF-α及CRP水平的表达及临床意义

目的:探讨呼吸窘迫综合征(RDS)早产儿血清维生素A(VA)、降钙素原(PCT)、肿瘤坏死因子-α(TNF-α)及C反应蛋白(CRP)水平的表达及临床意义。方法:选取2015年2月～2018年5月期间青岛市妇女儿童医院收治的90例RDS早产儿纳入观察组,根据RDS分级将观察组分为轻度组48例,中重度组42例。另选取同期于本院出生的非RDS早产儿35例作为对照组。根据血清VA水平将125例早产儿分为VA缺乏组(n=72),亚临床VA缺乏组(n=36),正常组(n=17)。比较观察组与对照组、轻度组与中重度组早产儿血清VA、PCT、TNF-α及CRP水平,比较不同血清VA水平早产儿的RDS发病情况,分析观察组早产儿血清VA与PCT、TNF-α及CRP水平的相关性。结果:观察组早产儿血清VA水平明显低于对照组(P0.05),而观察组早产儿血清PCT、TNF-α、CRP明显高于对照组(P0.05)。中重度组早产儿血清VA水平与轻度组比较差异无统计学意义(P0.05),而中重度组早产儿血清PCT、TNF-α、CRP水平明显高于轻度组(P0.05)。随着血清VA水平的升高,RDS发病率逐渐降低,组间比较差异有统计学意义(P0.05)。Pearson相关性分析显示,观察组早产儿血清VA与PCT、TNF-α及CRP水平无显著相关性(P0.05)。结论:RDS早产儿血清VA与PCT、TNF-α及CRP水平均存在明显异常,但四者无明显相关性,血清VA相对较低者更易发生RDS,临床可通过及时干预VA水平以降低RDS的发生风险。     

脂联素在早产儿血清中的表达及其与体格指标、载脂蛋白和骨密度的关系

目的:探讨脂联素在早产儿血清中的表达水平及其与体格指标、载脂蛋白和骨密度的相关性。方法:选择2017年1月至2018年5月期间我院新生儿科住院的早产儿72例作为研究组,另外选择同期我院出生的足月新生儿58例作为对照组。对比两组新生儿的一般资料、脂联素、载脂蛋白和骨密度水平,分析早产儿血清脂联素水平与体格指标、载脂蛋白和骨密度的相关性,同时分析影响血清脂联素水平的危险因素。结果:两组受试新生儿的性别、胸围、低密度脂蛋白(LDL-C)及高密度脂蛋白(HDL-C)之间的差异无统计学意义(P0.05);研究组新生儿的胎龄、体质量指数(BMⅠ)、身长、头围、总胆固醇(TC)及三酰甘油(TG)明显低于对照组(P0.05);与对照组相比,研究组新生儿血清脂联素、载脂蛋白A-Ⅰ(Apo A-Ⅰ)及左胫骨中段超声波在骨骼中的传播速度(SOS)水平明显下降,而载脂蛋白B(Apo B)和Apo B/Apo A-Ⅰ水平均显著升高,且差异均具有统计学意义(P0.05);早产儿血清脂联素水平与胎龄、BMⅠ、头围、TC、TG、Apo A-Ⅰ及SOS呈正相关(P0.05),与Apo B和Apo B/Apo A-Ⅰ水平呈负相关(P0.05);Logistic回归结果显示,胎龄、BMⅠ、Apo B/Apo A-Ⅰ及SOS是早产儿血清脂联素水平的影响因素(P0.05)。结论:早产儿血清脂联素水平低于足月儿,血清脂联素水平与体格指标、载脂蛋白及骨密度密切相关,可能对新生儿的生长发育具有重要的调节作用。     

Acceleration of newborn rats’ development with the use of photobiomodulation and the near possibility of application in human premature babies

Photobiomodulation was explored to find evidence of stimulation during the development of newborn rats. A light chamber device was used, and rat pups were divided into groups after birth. Investigation of the process’ security was performed before the full experiment. Following a protocol of alternating illumination and mother's presence during the first 13 days, we observed that, in the group that received photobiomodulation, the pups opened their eyes faster, indicating earlier achievement of maturity. The rate of weight gain also indicates faster metabolic activity in the group that was photostimulated. This study is the first step toward the use of photobiomodulation for premature newborn human babies.     

早产儿血清炎性因子与生长发育指标的关系及对新生儿呼吸窘迫综合征的预测研究

摘要 目的：分析早产儿血清炎性因子与生长发育指标的关系及对新生儿呼吸窘迫综合征（RDS）的预测效能。方法：选择2018年1月至2020年10月在我院出生的98例早产儿作为研究对象,根据是否并发RDS,分为RDS组（58例）和非RDS组（40例）。检测两组血清白细胞介素-1β（IL-1β）、IL-6、IL-8、肿瘤坏死因子-α（TNF-α）、降钙素原（PCT）水平,记录生长发育指标,通过Pearson相关性分析早产儿血清炎性因子与生长发育指标的关系,使用受试者工作特征曲线（ROC）分析血清炎性因子对新生儿呼吸窘迫综合征的预测效能。结果：RDS组血清IL-1β、IL-6、IL-8、TNF-α、PCT水平均高于非RDS组（P＜0.05）;RDS组胎龄、出生体重均小于非RDS组（P＜0.05）;经Pearson相关性分析,早产儿血清IL-1β、IL-6、IL-8、TNF-α、PCT水平均与胎龄、出生体重呈负相关（P＜0.05）;经多因素Logistic回归分析,IL-1β、IL-6、IL-8、TNF-α、PCT均是早产儿并发新生儿呼吸窘迫综合征的独立危险因素（P＜0.05）;经ROC曲线分析,IL-1β、IL-6、IL-8、TNF-α联合PCT预测早产儿并发新生儿呼吸窘迫综合征的AUC为0.910。结论：早产儿血清IL-1β、IL-6、IL-8、TNF-α均与胎龄及出生体重密切相关,这些炎性因子联合预测RDS发生的效能较好,值得临床予以重视应用。     

Increased maternal leptin levels may be an indicator of subclinical hypothyroidism in a newborn

BackgroundSeveral factors may influence newborn thyroid-stimulating hormone (TSH) concentrations and cause subclinical hypothyroidism in a newborn. A sufficient level of leptin signalling is needed for the normal production of TSH and thyroid hormones by the thyroid gland. Our study aimed to investigate the correlation between maternal serum leptin concentration during the third trimester of pregnancy and newborn screening-TSH levels.MethodsThis prospective cross-sectional study was conducted in obstetrics and gynaecology clinics of a state hospital between June and August 2013. Maternal venous blood samples were collected from 270 healthy pregnant women in the third trimester just before delivery. Measurements of maternal fT3, fT4, TSH, anti-thyroid peroxidase (TPO), and anti-thyroglobulin (anti-Tg) antibodies from serum samples were performed by chemiluminescence immunoassay. Maternal serum leptin levels were determined by ELISA. Dried capillary blood spots were used to measure newborn TSH levels.ResultsSubjects were divided into two groups according to the neonatal TSH levels using a cut-point of 5.5 mIU/L. Median maternal serum leptin levels were significantly higher in newborns whose TSH levels were higher than >5.5 mIU/L [13.2 μg/L (1.3 - 46.5) vs 19.7 μg/L (2.4 - 48.5), p<0.05]. Serum leptin levels showed a negative correlation with maternal fT4 (r=0.32, p<0.05), fT3 (r=0.23, p<0.05), and a positive correlation with BMI (r=0.30, p<0.05).ConclusionsOur results suggest that high leptin levels in the third trimester of pregnancy influence maternal thyroid functions and might cause an increase in newborn TSH levels. Detection of high maternal serum leptin levels may be a reason for subclinical hypothyroidism.     

Relationship Between Male Size and Newborn Size in the Seaweed Pipefish, Syngnathus Schlegeli

Relationships between male size, number, and weight of newborn were determined in the seaweed pipefish, Syngnathus schlegeli, with paternal care of embryos in the brood pouch. While the number of newborn increased linearly with the increase in male size, the pouch volume increased exponentially with the male size. This resulted in embryo density in the pouch negatively correlating with the male size. Newborn dry weight was negatively correlated with the embryo density in the pouch. Thus, larger males were considered to brood embryos at lower densities and give birth to heavier newborn. Neither paternal size nor embryo density seemed to have an effect upon developmental stage and total length of the newborn. Substantial weight loss of embryos during incubation indicated that paternal nutritional contribution to embryos is insignificant; therefore, the tendency of larger males to produce heavier newborn may not relate to allocation of paternal nourishment. Because egg weight increased with the female size, larger males are considered to receive the eggs of larger females and give birth to heavier newborn that developed from heavier eggs. Lower embryo density in larger males is attributable to the larger size of the heavier eggs. Assuming the pouch to be a cylindrical tube and the egg to be a sphere, geometrical calculations revealed that the relationship between the volumetric fraction of the pouch used by eggs (i.e. functional volume) and the male size was negatively quadric and had a peak. Increase in egg diameter increased the male size at which the functional volume of the pouch is maximized. Thus it appears that the size relationship of mates in pipefish is related to effective use of the pouch space.