| Chapter 1Built the neonatal retinal database based on information platformObjective We built the neonatal retinal database to facilitate the extraction,summari-zation and integration of the data.We built the database to do research of neonatal ocular diseases to find the etiology and prognosis of diseases.Methods Using the theory of software engineering methodology and the implementa-tion of the three layer structure,select the Micro-soft.NET platform framework based on the use of Microsoft Visual Studio C#2005 development tools for development.Using Microsoft SQL Server 2005 database as back-end database management plat-form,data management is reacted..Results We placed all of the information of file such as patients' medical record,lab value,imaging manifestations,results of neonatal retinal screen into the database,and got the integrated medical record,which is convenient for consulting and manage-ment.Every time we input the information we want,the database could output all of the informations.We brought into the user management of follow-ups and could col-lecting all of the contents by this.Conclusion Estabilishment of database for neonatal retinal database provided us a more convenient and prompt platform for the research of neonatal ocular diseases.Chapter 2 Investigate retinal hemorrhage in the newbornObjective Analysis of neonatal fundus examination results,explore the importance of early retinal screening,explore the related factors impacting neonatal retinal hemor-rhage(RH),the degree of bleeding and bleeding location.Methods Data collection from database.All the full-term infants with gestational ag-es more than 37 weeks and Apgar scores of nine or above were included in this study.Infants with severe systemic diseases or any other eye diseases were excluded.Eye examinations were performed with RetCam? within one week of birth for all infants.Maternal,obstetric,and neonatal parameters were compared between newborns with RH and controls.Using SPSS 19.0,we conducted univariate logistic regressions comparing differences in the maternal,obstetric,and neonatal factors between new-borns.For factors with p-values lower than 0.1,we then performed another multino-mial logistic regression to remove interfering confounds,and factors with p-values lower than 0.05 were considered statistically significant.Results RH is the most frequent retinal disease of the newborn.Of the 1199 neonates,294 had RH(24.5%),and in all studies,SVD and cephalhematoma were positively associated with RH at birth,and a negative correlation was found between caesarean birth history and RH.Of the 3054 neonates,408(13.36%)were classified as Degree ?RH,610(19.97%)were classified as Degree ? RH,and 184(6.03%)were classified as Degree ? RH.SVD,prolonged duration of second stage of labor,advanced ma-ternal age,and neonatal intracranial hemorrhage were potential risk factors for aggra-vation of the degree of RH in full-term infants.Of the 1311 newborns,18 had macu-lar hemorrhage(1.4%),SVD and maternal anemia were positively related to RH in the study.Conclusion Neonatal retinal screening is so important for early stage diagnosis of children ocular diseases.The Retcam? system can be the main tool for neonatal fun-dus screening.SVD is not only a factor influencing neonatal RH,but also a risk factor for increasing severity of RH and affecting macular hemorrhage.Cephalhematoma is a potential risk factor for RH in full-term neonates.SVD,prolonged duration of sec-ond stage of labor,advanced maternal age,and neonatal intracranial hemorrhage can aggravate the severity of neonatal RH.Maternal anemia is more likely to lead to macular hemorrhage in the newborn. |
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