目的：探讨维生素B2（VB2）联合蓝光照射对新生儿黄疸康复进程及肝脏功能的影响。方法：选取2024年5月—2025年10月收治的150例黄疸患儿，应用随机数字表法分为常规组和试验组，每组75例。常规组接受蓝光照射治疗，试验组在常规组基础上口服VB2治疗。比较两组患儿的氧化应激反应[谷胱甘肽过氧化物酶（GSH-Px），8羟基脱氧鸟苷（8-OHdG）、晚期蛋白氧化产物（AOPP）、超氧阴离子（O2-）]、肝脏微循环[血管性血友病因子（vWF）、可溶性血栓调节蛋白（sTM）、肝动脉阻力指数（HA-RI）、门静脉血流速度（PVV）]、胆红素排泄[总胆红素（TBil）、间接胆红素（IBil）]、肝脏功能[丙氨酸氨基转移酶（ALT）、天门冬氨酸氨基转移酶（AST）]、康复进程[光疗时间、胆红素恢复正常时间、黄疸消退时间、住院康复时间]及治疗安全性。结果：治疗后，试验组的GSH-Px高于常规组，8-OHdG、AOPP、O2-均低于常规组（P＜0.05）；试验组的vWF、sTM、HA-RI均低于常规组，PVV高于常规组（P＜0.05）。试验组的TBil、IBil、ALT、AST分别为（80.52±5.47）μmol/L、（68.52±5.49）μmol/L、（30.25±5.48）U/L、（32.14±5.22）U/L，均低于常规组[（85.19±6.44）μmol/L、（74.37±6.52）μmol/L、（35.29±6.17）U/L、（38.55±6.48）U/L]，差异有统计学意义（P＜0.05）。试验组的光疗时间、胆红素恢复正常时间、黄疸消退时间、住院康复时间分别为（3.05±0.33）d、（4.22±1.39）d、（5.41±1.27）d、（5.12±0.49）d，均低于常规组[（3.68±0.36）d、（5.36±1.45）d、（6.28±1.33）d、（6.51±0.54）d]，差异有统计学意义（P＜0.05）。试验组的不良反应发生率与常规组比较，差异无统计学意义（P＞0.05）。结论：VB2联合蓝光照射可减轻黄疸患儿的氧化应激反应并改善肝脏微循环，对促进胆红素排泄、改善肝脏功能均有积极影响，在促进患儿康复同时未显著增加治疗风险。其安全性较高，可进一步推广。

Objective: To investigate the effects of vitamin B2 (VB2) combined with blue light irradiation on the recovery process and liver function of neonatal jaundice. Method: 150 children with jaundice admitted from May 2024 to October 2025 were selected and randomly divided into a control group and an experimental group using a random number table method, with 75 cases in each group. The conventional group received blue light irradiation treatment, while the experimental group received oral VB2 treatment on the basis of the conventional group. Compare the oxidative stress response of two groups of children [glutathione peroxidase (GSH Px) higher than the control group, 8-hydroxydeoxyguanosine (8-OHdG), advanced protein oxidation products (AOPP), superoxide anion (O2-)], liver microcirculation [von Willebrand factor (vWF), soluble thrombomodulin (sTM), hepatic artery resistance index (HA-RI), portal vein blood flow velocity (PVV)], bilirubin excretion [total bilirubin (TBil), indirect bilirubin (IBil)], liver function [alanine aminotransferase (ALT), aspartate aminotransferase (AST)], rehabilitation process [phototherapy time, bilirubin recovery time to normal, jaundice regression time]. Hospitalization rehabilitation time and treatment safety. Result: After treatment, the GSH Px levels in the experimental group were higher than those in the control group, while 8-OHdG, AOPP, and O2- levels were lower than those in the control group (P<0.05); The vWF, sTM, and HA-RI of the experimental group were lower than those of the control group, while PVV was higher than that of the control group (P<0.05). The TBil, IBil, ALT, and AST of the experimental group were (80.52 ± 5.47) μ mol/L, (68.52 ± 5.49) μ mol/L, (30.25 ± 5.48) U/L, and (32.14 ± 5.22) U/L, respectively, which were lower than those of the conventional group [(85.19 ± 6.44) μ mol/L, (74.37 ± 6.52) μ mol/L, (35.29 ± 6.17) U/L, (38.55 ± 6.48) U/L], and the difference was statistically significant (P<0.05). The phototherapy time, bilirubin recovery time, jaundice resolution time, and hospital rehabilitation time of the experimental group were (3.05 ± 0.33) days, (4.22 ± 1.39) days, (5.41 ± 1.27) days, and (5.12 ± 0.49) days, respectively, which were lower than those of the conventional group [(3.68 ± 0.36) days, (5.36 ± 1.45) days, (6.28 ± 1.33) days, and (6.51 ± 0.54) days], and the difference was statistically significant (P<0.05). The incidence of adverse reactions in the experimental group was not significantly different from that in the control group (P>0.05). Conclusion: VB2 combined with blue light irradiation can alleviate oxidative stress response and improve liver microcirculation in children with jaundice. It has a positive effect on promoting bilirubin excretion and improving liver function, and does not significantly increase treatment risk while promoting the recovery of children. It has high safety and can be further promoted.

新生儿期的免疫系统发育阶段对维持新生儿健康至关重要,具有独特的免疫调节机制。近年来,人们越来越关注髓源性抑制细胞（MDSCs）在新生儿免疫调节中的作用。MDSCs是一类免疫抑制功能强大的异质性细胞群体,它们能够通过多种机制调节免疫应答。MDSCs在新生儿中的调节作用对防止过度免疫反应和促进免疫耐受至关重要,有助于预防新生儿期炎症性疾病,并对其后续健康产生积极影响。近期研究文献分析展示了MDSCs在新生儿免疫调节中的多种作用机制,包括在特定病理条件下的保护作用、与新生儿期炎症反应的相互作用,以及对长期免疫发展的潜在影响。因此,深入理解MDSCs在新生儿免疫中的角色,不仅有助于揭示其复杂的调节机制,也为制定新的预防和治疗新生儿炎症性疾病的策略提供了新的思路。

The developmental stage of the immune system during the neonatal period is crucial for maintaining neonatal health,characterized by unique immunoregulatory mechanisms．In recent years,increasing attention has been drawn to the role of myeloid-derived suppressor cells（MDSCs）in neonatal immune regulation．MDSCs represents a heterogeneous population of cells with potent immunosuppressive functions,capable of modulating immune responses through various mechanisms．The regulatory role of MDSCs in neonates is vital for preventing excessive immune reactions and promoting immune tolerance,thereby aiding in the prevention of neonatal inflammatory diseases and positively influencing subsequent health outcomes．Analysis of recent research literature reveals multiple mechanisms through which MDSCs contribute to neonatal immune regulation,including protective effects under specific pathological conditions,interactions with neonatal inflammatory responses,and potential impacts on long-term immune development．Therefore,a comprehensive understanding of the role of MDSCs in neonatal immunity not only helps elucidate their intricate regulatory mechanisms but also provides novel insights for developing strategies for the prevention and treatment of neonatal inflammatory diseases．

目的 研究影响新生儿低血糖的相关危险因素。方法 回顾性分析新生儿科570例新生儿的临床资料,其中新生儿低血糖组190例,正常血糖组新生儿380例,采用Logistic回归分析新生儿低血糖相关危险因素。结果 单因素Logistic回归分析显示,新生儿体质量减轻、早产、新生儿呼吸衰竭、新生儿呼吸窘迫、新生儿感染、母亲分娩年龄增大、经产妇、剖宫产、双胎、妊娠期糖尿病、妊娠期高血压疾病是新生儿低血糖发生的危险因素（均P<0.05）;多因素Logistic回归分析显示,早产（OR=2.115,95%CI：1.186~3.772）、剖宫产（OR=6.92,95%CI：4.202~11.397）是新生儿低血糖发生的危险因素（均P<0.05）。结论 早产、剖宫产是新生儿低血糖发生的危险因素,应根据危险因素及时识别和治疗新生儿低血糖,为新生儿提供及时产后护理指导,以降低新生儿低血糖发生率。

Objective To study the relevant risk factors of neonatal hypoglycemia．Methods A retrospective analysis was conducted on the clinical data of 570 newborns in neonatal pediatrics,including 190 cases in the neonatal hypoglycemia group and 380 cases in the normal blood glucose group．Logistic regression analysis was used to analyze the risk factors related to neonatal hypoglycemia．Results Single factor Logistic regression analysis showed that neonatal weight loss,premature,neonatal respiratory failure,neonatal respiratory distress,neonatal infection,the mother’s age of delivery,multipara,cesarean section,twins,pregnancy diabetes,pregnancy hypertension were the risk factors for neonatal hypoglycemia,all of which had statistical significance（all P<0.05）．In multivariate Logistic regression analysis,premature（OR=2.115,95% CI：1.186-3.772）and cesarean section（OR=6.92,95% CI：4.202-11.397）were risk factors for neonatal hypoglycemia（both P<0.05）．Conclusions Premature and cesarean section are risk factors for the occurrence of neonatal hypoglycemia in the local area．Timely identification and treatment of neonatal hypoglycemia based on risk factors,providing timely postpartum nursing guidance for newborns,can reduce the occurrence of neonatal hypoglycemia．

目的 分析阿莫西林克拉维酸钾与第三代头孢类抗菌药联合应用于新生儿肺炎患儿的应用效果及其对患儿肠道菌群的影响。方法 选择在2021年2月—2022年11月期间于我院新生儿科接受相关治疗的100例新生儿肺炎患儿,依照简单随机化法将患儿分为研究组（n=50）及参照组（n=50）。给予参照组常规新生儿肺炎治疗,在此基础上给予研究组患者阿莫西林克拉维酸钾与第三代头孢类抗菌药的联合治疗。治疗结束后对比两组患儿的血清因子水平、肠道菌落情况、临床疗效以及不良反应发生情况。结果 治疗前,两组患儿的血清因子水平、肠道内菌群数量比较差异无统计学意义（P>0.05）,治疗后两组患儿的降钙素原（procalcitonin,PCT）、C-反应蛋白（C-reactive protein,CRP）、白细胞计数（white blood cell count,WBC）、肠球菌、肠杆菌、双歧杆菌以及乳酸杆菌水平均有改善（P<0.05）,其中研究组的PCT、CRP、WBC、肠球菌、双歧杆菌以及乳酸杆菌数量低于参照组,而研究组的肠杆菌数量高于参照组;同时研究组的临床有效率（94.00%）与参照组的临床有效率（86.00%）比较差异无统计学意义（P>0.05）;两组患儿的不良反应发生率比较差异无统计学意义（P>0.05）,但其中研究组腹泻的发生率高于参照组（P<0.05）。结论 在对新生儿肺炎患儿进行治疗时采取阿莫西林克拉维酸钾单纯治疗与阿莫西林克拉维酸钾+第三代头孢类抗菌药（头孢他啶）的临床疗效相当,联合用药虽能更为显著地减少患儿机体的细菌数量,改善血清因子水平,但更易发生腹泻的并发症,且为了减少耐药性,应适当采用单独用药。

Objective To analyze the application effect of amoxicillin clavulanate potassium combined with third-generation cephalosporin antibiotics in children with neonatal pneumonia and its impact on the intestinal microbiota．Methods From February 2021 to November 2022,100 newborns with pneumonia who received relevant treatment in the Department of Neonatology at the First People’s Hospital of Shangqiu City were randomly divided into a study group（n=50）and a reference group（n=50）using a simple randomization method．Routine treatment was provided for neonatal pneumonia in the reference group,and on this basis,a combination treatment of amoxicillin,clavulanate potassium,and third-generation cephalosporin antibiotics was applied on the study group patients．After treatment,the serum factor levels,intestinal colony status,clinical efficacy,and incidence of adverse reactions were compared between the two groups of children．Results Before treatment,there were no statistically significant differences in serum factor levels and intestinal microbiota between the two groups of children（P>0.05）．After treatment,the levels of procalcitonin（PCT）,C-reactive protein（CRP）,white blood cell count（WBC）,Enterococcus,Enterobacter,Bifidobacterium,and Lactobacillus in the two groups of children improved（P<0.05）,with the levels of PCT,CRP,WBC,the number of Enterococcus,Bifidobacterium,and Lactobacillus in the study group was lower than that in the reference group,while the number of Enterobacter in the study group was higher．There was no statistically significant difference（P>0.05）in the clinical response rate between the study group（94.00%）and the reference group（86.00%）．There was no statistically significant difference in the incidence of adverse reactions between the two groups of children（P>0.05）,but the incidence of diarrhea in the study group was higher than that in the reference group（P<0.05）．Conclusions The clinical efficacy of amoxicillin clavulanate potassium alone and amoxicillin clavulanate potassium+third-generation cephalosporin antibiotics（ceftazidime）in the treatment of newborns with pneumonia is comparable．Although the combination therapy can significantly reduce the number of bacteria in the body of children and improve serum factor levels,it is more prone to complications of diarrhea．In order to reduce drug resistance,separate medication should be appropriately used．

新生儿引起肝内胆汁淤积是由感染、遗传代谢性疾病、胃肠外营养、基因突变等各种不同病因导致胆汁形成、分泌和排泄障碍。胆汁在体内淤积会影响新生儿的生长发育,严重者出现肝纤维化、肝功能衰竭等不可逆的改变,其发病的机制涉及参与肝脏胆汁酸分泌的各种转运体、肝细胞膜转运蛋白转录和和转录后的调控等。本文归纳总结近年来国内外关于胆汁酸转运体及其转录和转录后的调控,从而为此疾病的防治提供理论依据,为将来降低其发生率和改善预后。

Neonatal intrahepatic cholestasis is caused by infection,genetic metabolic diseases,parenteral nutrition,gene mutation and other different causes leading to bile formation,secretion and excretion disorders．Bile stasis in the body will affect the growth and development of the newborn,and in severe cases,irreversible changes such as liver fibrosis and liver failure will occur．The pathogenesis of bile stasis involves various transporters involved in the secretion of bile acids in the liver,transcription and post transcription regulation of liver cell membrane transporters．In this paper,we summarized the recent studies on bile acid transporters and their transcriptional and post transcriptional regulation at home and abroad,so as to provide a theoretical basis for the prevention and treatment of this disease,and to reduce its incidence and improve its prognosis in the future.

目的 观察父亲参与的早期母婴皮肤接触(SSC)对顺产初产妇的新生儿应激反应及生命体征的影响,为进一步优化“新生儿早期基本保健(EENC)”技术的临床实施建议提供实验依据。方法 使用随机数字表选取2017年2月—2021年5月期间,在深圳市福田区妇幼保健院产科分娩的1 986例顺产初产妇及新生儿作为研究对象。其中638例新生儿(共同参与组)实施了父亲参与的早期SSC,467例新生儿(SSC组)实施了早期母婴SSC,881例新生儿(对照组)实施了常规新生儿处理。观察3组新生儿的唾液皮质醇水平、体温和低温发生率、心率以及啼哭时间的差异,探讨父亲参与的早期母婴SSC在临床实施的可行性。结果 ① 3组新生儿出生30 min、60 min、90 min、180 min时,任意2组唾液皮质醇水平比较,差异均有统计学意义(均P<0.01);出生120 min时,共同参与组与对照组、SSC组与对照组比较,差异均有统计学意义(均P<0.01)。② 3组新生儿出生30 min、60 min时,共同参与组与对照组,SSC组与对照组的体温、低温发生率比较,差异均有统计学意义(均P<0.01);出生90 min时,任意2组体温比较,差异均有统计学意义(均P<0.01),共同参与组与对照组,SSC组与对照组的低温发生率比较,差异均有统计学意义(均P<0.01);出生120 min、180 min时,任意2组的体温与低温发生率比较,差异均有统计学意义(均P<0.01)。③ 3组新生儿出生30 min、60 min、90 min时,共同参与组与对照组,SSC组与对照组的心率比较,差异均有统计学意义(均P<0.01)。出生120 min、180 min时,任意2组比较,差异均有统计学意义(均P<0.01)。④ 3组新生儿出生0～30 min、30～60 min、60～90 min时间段,共同参与组与对照组,SSC组与对照组的啼哭时间比较,差异均有统计学意义(均P<0.01)。出生90～120 min、120～180 min时间段:任意2组的啼哭时间比较,差异均有统计学意义(均P<0.01)。结论 早期母婴SSC和父亲参与的早期母婴SSC均能降低顺产初产妇的新生儿唾液皮质醇水平,维持恒定的体温和心率,减少低温发生率和啼哭时间。相比较而言,父亲参与的早期母婴SSC是一种更科学、更有利于降低新生儿应激反应及维护其生命体征的护理模式。

Objective To observe the effect of father's participation in early maternal skin to skin contact (SSC) on primiparas' neonatal stress response and vital signs, so as to provide experimental basis for further optimizing the clinical implementation of “early essential newborn care (EENC)” technology. Methods The random number table was used to select 1 986 primiparas with their newborns who gave birth in Shenzhen Futian District Maternity and Child Healthcare Hospital from February 2017 to may 2021. Among them, 638 newborns (co-participation group) implemented early SSC with father participation, 467 newborns (SSC group) implemented early maternal and infant SSC, 881 newborns (control group) were treated with routine neonatal treatment. To observe the differences of salivary cortisol level, mean body temperature, incidence of hypothermia, heart rate and crying time among the newborns of three groups and to explore the feasibility of early mother and infant SSC with father participation in clinical implementation. Results ①There were significant differences in newborn salivary cortisol levels between any two groups at 30 min, 60 min, 90 min and 180 min after birth (all P<0.01). At 120 min after birth, there were significant differences between the co-participation group and the control group, SSC group and the control group (all P<0.01). ②At 30 min and 60 min after birth, there were significant differences in body temperature and the incidence of hypothermia between the co-participation group and the control group, SSC group and the control group (all P<0.01). At 90 min after birth, there were significant differences in body temperature between any two groups (all P<0.01). There were significant differences in the incidence of hypothermia between the co-participation group and the control group, SSC group and the control group (all P<0.01). There were significant differences in body temperature and the incidence of hypothermia between any two groups at 120 min and 180 min (all P<0.01). ③At 30 min, 60 min and 90 min after birth, there were significant differences in heart rate between the co-participation group and the control group, SSC group and the control group (all P<0.01). At 120 min and 180 min after birth, there were significant differences between any two groups (all P<0.01). ④There were significant differences in the crying time of newborns in the three groups at 0-30 min, 30-60 min and 60-90 min, between the co-participation group and the control group, and between the SSC group and control group (all P<0.01). There were significant differences in crying time between any two groups at 90-120 min and 120-180 min after birth (all P<0.01). Conclusions Early maternal and infant SSC and early maternal and infant SSC participated by father could reduce the salivary cortisol level of primipara newborn, maintain constant body temperature and heart rate,also reduce the incidence of hypothermia and crying time. In comparison, the early maternal and infant SSC with father participation was a more scientific and conducive nursing model to reduce neonatal stress response and maintain their vital signs.

目的 探讨新生儿坏死性小肠结肠炎(NEC)炎症损伤与肠道微生态-LPS-TLR4通路之间的关系。方法 本研究收集2019年3月1日—2021年1月31日在中山市人民医院新生儿监护室确诊为NEC新生儿11例为实验组,随机选取30 例同期在新生儿科病房住院喂养顺利,排除NEC及败血症诊断的新生儿为对照组。采集2组新生儿的粪便标本,进行Real-time PCR表达谱分析2组粪便肠道菌群;取2组外周静脉血检测外周血单核细胞Toll样受体4(TLR4)和血清PCT、CRP、IL-6、SAA等指标,对比2组肠道菌群、外周血单核细胞TLR4和炎症指标水平,通过统计学分析组间差异。结果 本研究结果提示实验组变形菌门占82%(9/11),厚壁菌门占9%(1/11),放线菌门占9%(1/11),对照组变形菌门占20%(6/30),厚壁菌门占73%(22/30),放线菌门占7%(2/30),2组患儿的粪便肠道菌群分布有差异(χ²=11.521,P<0.05);实验组患儿外周血单核细胞TLR4水平高于对照组,组间差异有统计学意义(P<0.001);实验组患儿血清PCT、CRP、IL-6和SAA等炎症指标高于对照组,组间差异有统计学意义(P<0.001)。结论 NEC患儿的肠道菌群以变形菌门为主,伴外周血单核细胞TLR4和外周血炎症指标升高。可见,肠道微生态-LPS-TLR4通路可能与新生儿坏死性小肠结肠炎炎症损伤相关,具体的机制仍需进一步深入研究。

Objective To investigate the relationship between intestinal flora-LPS-TLR4 pathway and the inflammatory injury of neonatal necrotizing enterocolitis (NEC). Methods Eleven neonates with NEC from March, 2019 to January, 2021 were enrolled as the experimental group, and 30 neonates without NEC and septicemia who were admitted in the department of neonatology in the same period were included as the control group. Faecal flora from the two groups were collected and analyzed by Real-time PCR. Toll-like receptor 4 (TLR4) and serum PCT, CRP, IL-6, SAA in peripheral blood were measured. The intestinal flora, the expression of TLR4 in peripheral blood leukocytes and inflammatory markers were compared between two groups. Results It showed that the ratio of Proteobacteria was 82% (9/11), Firmicutes was 9% (1/11), Actinobacteria was 9% (1/11) in the experimental group. In the control group, the ratio of Proteobacteria was 20% (6/30), Firmicutes was 73% (22/30), Actinobacteria was 7% (2/30). There was a significant difference in the distribution of faecal flora between the two groups (χ² = 11.521, P<0.05), and the level of TLR4 in peripheral blood of the experimental group was significantly higher than that of the control group (P＜0.001). The levels of serum PCT, CRP, IL-6 and SAA in the experimental group were significantly higher than those in the control group (P＜0.001). Conclusions The main intestinal flora of neonates with NEC is Proteobacteria, with elevated TLR4 expression and inflammatory markers in peripheral blood. Therefore, the intestinal flora-LPS-TLR4 pathway may be associated with inflammatory injury in neonatal necrotizing enterocolitis.The specific mechanism still needs further study.

目的 总结新生儿红斑狼疮(NLE)的临床特征和预后,提高对NLE的认识。方法 回顾分析2015年1月—2020年12月在广州市妇女儿童医疗中心住院诊治的19例NLE的临床资料,并进行文献复习。结果 收集19例新生儿红斑狼疮,男10例,女9例。皮肤受累者19例;心血管系统受累者7例,其中心电生理异常7例:Ⅲ度房室传导阻滞(AVB)2例,交界性心律1例,Ⅱ度AVB 2例,完全性左束支传导阻滞(CLBBB)1例,T波低平1例;扩张型心肌病(DCM)1例;房间隔缺损1例。血液系统受累者3例;消化系统受累者7例。患儿抗SSA或抗SSB阳性18人,抗核抗体阳性18人,dsDNA阳性2人,抗RNP阳性3人。孕母产前诊断系统性红斑狼疮4例,干燥综合征8例,未分化结缔组织病1例,无任何临床症状6例(有无诊断疾病),其中10例予糖皮质激素治疗。随访时间5月~62月,随访18例。心血管系统受累者的预后差异大,2例Ⅲ度AVB予心脏起搏器治疗,1例交界性心律者建议安装起搏器。1例CLBBB并DCM者的内科治疗效果差。2例Ⅱ度AVB 者无明显临床症状。T波低平者复查为正常。随访中未发现患儿及其母亲有新发自身免疫性疾病。结论 新生儿红斑狼疮临床表现以心血管系统受累为突出特征,其房室结外病变需引起关注。患儿和其母亲的长期随访非常重要。

Objective To summarize the clinical features and prognosis characteristics of neonatal lupus erythematosus (NLE).Methods The clinical data of 19 cases of NLE who were hospitalized in Guangzhou Women and Children's Medical Center from January 2015 to December 2020 were retrospectively analyzed,and the literature was reviewed.Results A total of 19 cases of neonatal lupus erythematosus were enrolled,10 males and 9 females.There were 19 cases of cutaneous lesions; 7 cases of cardiac system involvement,including 7 cases of electrophysiological abnormalities: 2 cases of third-degree atrioventricular block (AVB),1 case of junctional heart rhythm,2 cases of second-degree AVB,1 case of complete left bundle branch block (CLBBB),1 case of low T-wave.Dilated cardiomyopathy(DCM)was found in 1 case,and atrial septal defect was found in 1 case.There were 3 cases of blood system abnormalities and 7 cases of digestive system problems.Eighteen children were positive for anti-SSA or anti-SSB test,18 were positive for ANA,2 were positive for dsDNA,and 3 were positive for anti-RNP.Four cases of mother was prenatal diagnosed with systemic lupus erythematosus,8 cases of Sjgren's syndrome,1 case of undifferentiated connective tissue disease,and 6 cases without any clinical symptoms,among them,10 cases were treated with glucocorticoids.The follow-up time varied from 5 months to 62 months,and 18 cases were followed up.The prognosis of patients with cardiac system involvement varied greatly.Two patients with third-degree AVB were treated with pacemaker,and 1 patient with junctional rhythm was recommended to install pacemaker.The patient with CLBBB and DCM had poor outcome with medical treatment.Two patients with second-degree AVB had no clinical symptoms,and the low T-wave one returned to normal.During the follow-up,no new autoimmune diseases were found in the children and their mothers.Conclusions The clinical manifestations of neonatal lupus erythematosus are prominently characterized by involvement of the cardiovascular system,and the extranodal lesion need to be paid attention to.Long-term follow-up of children and their mothers is critically important.

目的 探究肺表面活性物质联合高频振荡通气治疗新生儿呼吸窘迫综合征的有效性及安全性。方法 选取我院新生儿科2016年2月—2018年7月收治的120例呼吸窘迫综合征新生患儿作为研究对象,随机将其分为常规组和试验组,每组各60例。常规组实施肺表面活性物质联合常频振荡通气治疗,试验组采取肺表面活性物质联合高频振荡通气治疗,比较两组治疗前后的肺氧合功能和并发症发生情况。结果 PaO₂、OI、a/A PO₂等指标在治疗前两组差异无统计学意义(P＞0.05),治疗后试验组均要优于常规组,差异有统计学意义(P＜0.05);常规组的并发症发生率为35.0%(21/60),试验组的并发症发生率为18.3%(11/60),试验组低于常规组,差异有统计学意义(P＜0.05)。结论 新生儿呼吸窘迫综合征采用肺表面活性物质联合高频振荡通气治疗效果显著,并发症少,安全性高。

目的 分析神经营养类药物单唾液酸四己糖神经节苷脂(monosialotetrahexosylganglioside,GM1)与胞磷胆碱(citicoline)联合使用在新生儿缺血缺氧性脑病(neonatal hypoxic-ischemic encephalopathy,NHIE)的临床疗效并探讨其可能的作用机制。方法 收集2014年1月—2017年6月在广州市第一人民医院新生儿病房住院的54例新生儿缺血缺氧性脑病患儿的临床资料,将收集到的患儿随机分为2组,对照组27例,治疗组27例。治疗组与对照组的治疗的不同在于前者予以单唾液酸四己糖神经节苷脂GM1联合胞磷胆碱治疗,而对照组仅用单唾液酸四己糖神经节苷脂GM1,无用胞磷胆碱。治疗三个疗程后,比较2组用药前后的临床表现、神经功能评分及MRI变化情况。结果 治疗组中临床总有效24例(88.9%);对照组中总有效17例(63.0%)(P<0.05);经过三个疗程后2组的神经功能评分均有上升,且治疗组的效果更明显(P<0.05);MRI检查示2组较用药前病灶范围减少,水肿减轻,治疗组改善更明显(P<0.05)。即经过三个疗程治疗后,两组患儿病情均有好转,且治疗组疗效更明显。结论 神经营养类药物GM1联合胞磷胆碱通过修复、重构神经元、改善其代谢等促进受损的神经功能的恢复,在新生儿缺血缺氧性脑病的应用中具有良好的疗效。

Objective To analysis the clinical therapeutic effect of monosialotetrahexosylganglioside and citicolineon neonatal hypoxic-ischemic encephalopathy, and explore its possible mechanism.Methods A total of 54 newborn with hypoxicischemic encephalopathy were enrolled from January 2015 to June 2017 in Guangzhou First People's Hospital, and they were divided into control group and treatment group according to the treatment methods, with 27 cases in the control group and 27 cases in the treatment group. Both groups were treated with conventional treatment, the control group added gangliosides, and the treatment group used ganglioside and citicoline. The clinical effects, neurological score and MRI were observed in the two groups.Results The total effective rate was 88.9% in the treatment group,which was higher than 73.0% in the control group (P<0.05). There was no significant difference on neurological score between the two groups before treatment (P>0.05). After treatment, the neurological scores of the two groups were significantly improved, and the score of the treatment group was higher than that of the control group (P<0.05). MRI examinations found that the lesions were significantly improved in the two groups after treatments, and the effect of the treatment group was higher than that of the control group (P<0.05).Conclusion Monosialotetrahexosylganglioside combined with citicolineinthe in treatment of newborn with hypoxicischemic encephalopathy has good effects through repairing and rebuilding the neurons, improving the metabolism to promote the recovery of neurological functions.