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Risk factors and machine learning prediction models for bronchopulmonary dysplasia severity in the Chinese population

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World Journal of Pediatrics 2023年第6期19卷 568-576页

作者： Wen He Lan Zhang Rui Feng Wei-Han Fang Yun Cao Si-Qi Sun Peng Shi Jian-Guo Zhou Liang-Feng Tang Xiao-Bo Zhang Yuan-Yuan Qi Department of Respirology Children’s HospitalFudan University399 Wanyuan RoadShanghai 201102China Department of Neonatology Children’s HospitalFudan UniversityShanghaiChina Shanghai Key Laboratory of Intelligent Information Processing School of Management and StatisticsFudan UniversityShanghaiChina Shanghai Pinghe Bilingual School ShanghaiChina Department of Data Management and Statistics Children’s Hospital of Fudan UniversityShanghaiChina Department of Urology Children’s HospitalFudan UniversityShanghaiChina

Background bronchopulmonary dysplasia(BPD)is a common chronic lung disease in extremely preterm *** outcome and clinical burden vary dramatically according to *** some prediction tools for BPD exist,they seldom pay attention to disease severity and are based on populations in developed *** study aimed to develop machine learning prediction models for BPD severity based on selected clinical factors in a Chinese *** In this retrospective,single-center study,we included patients with a gestational age<32 weeks who were diagnosed with BPD in our neonatal intensive care unit from 2016 to *** collected their clinical information during the maternal,birth and early postnatal *** factors were selected through univariable and ordinal logistic regression *** models based on logistic regression(LR),gradient boosting decision tree,XGBoost(XGB)and random forest(RF)models were implemented and assessed by the area under the receiver operating characteristic curve(AUC).Results We ultimately included 471 patients(279 mild,147 moderate,and 45 severe cases).On ordinal logistic regression,gestational diabetes mellitus,initial fraction of inspiration O_(2) value,invasive ventilation,acidosis,hypochloremia,C-reactive protein level,patent ductus arteriosus and Gram-negative respiratory culture were independent risk factors for BPD *** the XGB,LR and RF models(AUC=0.85,0.86 and 0.84,respectively)all had good *** We found risk factors for BPD severity in our population and developed machine learning models based on *** models have good performance and can be used to aid in predicting BPD severity in the Chinese population.

关键词： bronchopulmonary dysplasia Machine learning-Prediction model Preterm

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Factors affecting length of stay according to bronchopulmonary dysplasia severity:a nationwide cohort study in Korea

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World Journal of Pediatrics 2024年第5期20卷 470-480页

作者： Hye Mi Lee Jeongmin Shin Sae Yun Kim So Young Kim Department of Pediatrics College of MedicineThe Catholic University of KoreaSeoulRepublic of Korea Department of Pediatrics Yeouido St.Mary’s HospitalCollege of MedicineThe Catholic University of Korea1063-roYeongdeungpo-guSeoul07345Republic of Korea

Background Longer hospitalizations for preterm infants with bronchopulmonary dysplasia(BPD)delay developmental outcomes,increase the risk for hospital-acquired complications,and exert a substantial socioeconomic *** study aimed to identify factors associated with an extended length of stay(LOS)at different levels of severity of *** A cohort study was conducted using the Korean Neonatal Network registry of very low birth weight infants with BPD between 2013 and 2017 through retrospective *** A total of 4263 infants were diagnosed with *** mild BPD,infants requiring surgical treatment for patent ductus arteriosus needed a longer LOS[eadjustedβcoefficients(adjβ)1.041;95%confidence interval(CI):0.01–0.08]and hydrocephalus(eadjβ1.094;95%CI 0.01–0.17).In moderate BPD,infants administered steroids or with intraventricular hemorrhage required a longer LOS(eadjβ1.041;95%CI 0.00–0.07 and eadjβ1.271;95%CI 0.11–0.38,respectively).In severe BPD,infants with comorbidities required a longer LOS:pulmonary hypertension(eadjβ1.174;95%CI 0.09–0.23),administrated steroid for BPD(eadjβ1.116;95%CI 0.07–0.14),sepsis(eadjβ1.062;95%CI 0.01–0.11),patent ductus arteriosus requiring surgical ligation(eadjβ1.041;95%CI 0.00–0.08),and intraventricular hemorrhage(eadjβ1.016;95%CI 0.05–0.26).Additionally,the higher the clinical risk index score,the longer the LOS needed for infants in all *** The factors affecting LOS differed according to the severity of *** approaches to reducing LOS may be devised using knowledge of the various risk factors affecting LOS by BPD severity.

关键词： bronchopulmonary dysplasia Length of stay Very low birth weight

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Phase I trial of human umbilical cord-derived mesenchymal stem cells for treatment of severe bronchopulmonary dysplasia

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Genes & Diseases 2023年第2期10卷 521-530页

作者： Yunqiu Xia Tingyuan Lang Yuqin Niu Xian Wu Ou Zhou Jihong Dai Lei Bao Ke Yang Lin Zou Zhou Fu Gang Geng Department of Dermatology Ministry of Education Key Laboratory of Child Development and DisordersNational Clinical Research Center for Child Health and DisordersChina International Science and Technology Cooperation Base of Child Development and Critical DisordersChildren's Hospital of Chongqing Medical UniversityChongqing 400014China Department of Gynecologic Oncology School of MedicineChongqing University Cancer HospitalChongqing UniversityChongqing 400030China The First Affiliated Hospital School of MedicineShihezi UniversityShiheziXinjiang 832008China Department of Respiratory Medicine West China Second University HospitalSichuan UniversityChengduSichuan 610041China Department of Respiratory Medicine Children's Hospital of Chongqing Medical UniversityChongqing 400014China Department of Neonatology Children's Hospital of Chongqing Medical UniversityChongqing 400014China Chongqing Engineering Technology Research Center of Stem Cell Therapy Children's Hospital of Chongqing Medical UniversityChongqing 400014China Center for Clinical Molecular Medicine Children's Hospital of Chongqing Medical UniversityChongqing 400014China

Severe bronchopulmonary dysplasia(BPD)is a chronic lung disorder that primarily affects premature babies with extremely low birth weight and involves in multiple organ system;no effective pharmacotherapy for this disease exists,and mortality remains *** on the evidence from previous preclinical studies and phase I clinical trials,this study aims to test the safety of intravenous application of a single dose of human umbilical cord-derived mesenchymal stem cells(hUC-MSCs)in patients with severe *** Mesenchymal Stem cells for bronchopulmonary dysplasia Treatment(MSBDT)trial is a single center,open-label,dose-escalation phase I clinical *** BPD patients were enrolled in Children Hospital of Chongqing Medical University,Chongqing,*** first six patients were treated with low-dose hUC-MSCs(1×10^(6) cells/kg)and the next seven patients were treated with high-dose hUC-MSCs(5×10^(6) cells/kg).This study is registered with ***,number *** prespecified infusion-associated adverse events,immediate complication,respiratory or cardiovascular compromise were observed during infusion and 24 h after *** significant changes in safety laboratory values were *** death event occurred in the low-dose group on study day 10,and one death event occurred in the high-dose group on study day 24,while,after review in detail,the two cases are not believed to be infusion-associated *** conclusion,intravenous application of a single dose of hUC-MSCs was tolerated in thirteen patients with severe BPD.

关键词： bronchopulmonary dysplasia Dose escalation Human umbilical cord-derived mesenchymal stem cells Intravenous treatment Phase I trial

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bronchopulmonary dysplasia： pathogenesis, risk factors and early prevention strategies

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Chinese Medical Journal 2010年第20期123卷 2955-2957页

作者： Egbert Herting Department of Child and Adolescent Health University Hospital of Schleswig-Holstein Campus Lubeck Ratzeburger Allee 160 D-23538 Ltibeck Germany

The treatment of infants with established bronchopulmonary dysplasia （BPD） remains a common,frustrating and expensive problem in neonatology, pediatric PlUlmonology, pediatric critical care and general pediatrics.

关键词： bronchopulmonary dysplasia neonates surfactant ventilation

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Characteristics of home oxygen therapy for preterm infants with bronchopulmonary dysplasia in China:results of a multicenter cohort

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World Journal of Pediatrics 2023年第6期19卷 557-567页

作者： Wen-Xing Jiang Yan-Chen Wang Hong-Xia Song Mi Xiao Fan He Si-Yuan Jiang Xin-Yue Gu Jian-Hua Sun Yun Cao Wen-Hao Zhou Shoo Kim Lee Li-Ping Chen Li-Yuan Hu Division of Neonatology Jiangxi Provincial Children’s Hospital1666 Diezihu AvenueHonggutan New AreaNanchang 330038China NHC Key Laboratory of Neonatal Diseases Fudan UniversityChildren’s Hospital of Fudan UniversityShanghai 201102China Division of Neonatology The First Affiliated Hospital of Xi’an Jiaotong UniversityXi’an 710061China Division of Neonatology Children’s Hospital of Fudan University399 Wanyuan RoadMinhang DistrictShanghai 201102China Division of Neonatology Shanghai Children’s Medical CenterShanghai Jiao Tong University School of MedicineShanghai 200127China Maternal-Infants Care Research Centre and Department of Pediatrics Mount Sinai HospitalTorontoON M5G 1X5Canada University of Toronto TorontoON M5T 3M7Canada

Background Home oxygen therapy(HOT)is indicated upon discharge in some preterm infants with severe bronchopulmonary dysplasia(BPD).There is a lack of evidence-based consensus on the indication for HOT among these *** wide variation in the institutional use of HOT exists,little is known about the role of regional social-economic level in the wide variation of *** This was a secondary analysis of Chinese Neonatal Network(CHNN)data from January 1,2019 to December 31,*** at gestational ages<32 weeks,with a birth weight<1500 g,and with moderate or severe BPD who survived to discharge from tertiary hospitals located in 25 provinces were included in this *** with major congenital anomalies and those who were discharged against medical advice were *** Of 1768 preterm infants with BPD,474 infants(26.8%)were discharged to home with *** proportion of HOT use in participating member hospitals varied from 0 to 89%,with five of 52 hospitals’observing proportions of HOT use that were significantly greater than expected,with 14 hospitals with observing proportions significantly less than expected,and with 33 hospitals with appropriate *** noted a negative correlation between different performance groups of HOT and median GDP per capita(P=0.04).Conclusions The use of HOT varied across China and was negatively correlated with the levels of provincial economic levels.A local HOT guideline is needed to address the wide variation in HOT use with respect to different regional economic levels in countries like China.

关键词： bronchopulmonary dysplasia Chinese Neonatal Network Gross domestic product Home oxygen therapy Preterm infants

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Longer duration of initial invasive mechanical ventilation is still a crucial risk factor for moderate‑to‑severe bronchopulmonary dysplasia in very preterm infants:a multicentrer prospective study

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World Journal of Pediatrics 2023年第6期19卷 577-585页

作者： Cong Dou Yong-Hui Yu Qing-Cui Zhuo Jian-Hong Qi Lei Huang Yan-Jie Ding De-Juan Yang Li Li Dan Li Xiao-Kang Wang Yan Wang Xin Qiao Xiang Zhang Bing-Jin Zhang Hai-Yan Jiang Zhong-Liang Li Simmy Reddy Department of Neonatology Maternal and Child Health Care Hospital of Shandong ProvinceShandong UniversityJinan 250014China Department of Neonatology Shandong Provincial Hospital affiliated to Shandong First Medical UniversityHuaiYin DistrictNo.324Jingwu RoadJinan 250021China Department of Neonatology Shandong Provincial HospitalShandong UniversityHuaiYin DistrictNo.324Jingwu RoadJinan 250021China Department of Neonatology Qilu Hospital of Shandong UniversityJinan 250012China Department of Neonatology Shandong Provincial Maternal and Child Health Care HospitalJinan 250014China Department of Neonatology Yantai Yuhuangding HospitalYantai 264000China Department of Neonatology The First Affiliated Hospital of Shandong First Medical UniversityJinan 250014China Department of Neonatology Linyi People’s HospitalLinyi 276000China Department of Neonatology Liaocheng People’s HospitalLiaocheng 252000China Department of Neonatology The Affiliated Taian City Central Hospital of Qingdao UniversityTaian 271000China Department of Neonatology Jinan Maternity and Child Healthcare HospitalJinan 250001China Department of Neonatology Hebei Petro China Central HospitalLangfang 065000China Department of Neonatology Shengli Olifield Central HospitalDongying 257000China Department of Neonatology The Third Hospital of Baogang GroupBaotou 014000China Department of Neonatology W.F.Maternal and Child Health HospitalWeifang 261011China Cheeloo College of Medicine Shandong UniversityJinan 250000China

Objectives We aimed to evaluate the risk factors for moderate-to-severe bronchopulmonary dysplasia(BPD)and focus on discussing its relationship with the duration of initial invasive mechanical ventilation(IMV)in very preterm neonates less than 32 weeks of gestational age(GA).Methods We performed a prospective cohort study involving infants born at 23–31 weeks of GA who were admitted to 47 different neonatal intensive care unit(NICU)hospitals in China from January 2018 to December *** data were obtained from the Sina-northern Neonatal Network(SNN)*** We identified 6538 very preterm infants,of whom 49.5%(3236/6538)received initial IMV support,and 12.6%(823/6538)were diagnosed with moderate-to-severe BPD *** median duration of initial IMV in the moderateto-severe BPD group was 26(17–41)days,while in the no or mild BPD group,it was 6(3–10)*** incidence rate of moderate-to-severe BPD and the median duration of initial IMV were quite different across different *** logistic regression analysis showed that the onset of moderate-to-severe BPD was significantly associated with the duration of initial IMV[adjusted odds ratio(AOR):1.97;95%confidence interval(CI):1.10–2.67],late-onset neonatal sepsis(LONS),and patent ductus arteriosus(PDA).Conclusion In this multicenter cohort study,the duration of initial IMV was still relatively long in very premature infants,and the longer duration of initial IMV accounts for the increased risk of moderate-to-severe BPD.

关键词： bronchopulmonary dysplasia Invasive mechanical ventilation Multicenter cohort-Preterm infants Prospective

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Risk of asthma in preterm infants with bronchopulmonary dysplasia: a systematic review and meta‑analysis

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World Journal of Pediatrics 2023年第6期19卷 549-556页

作者： Tong Sun Hai-Yang Yu Miao Yang Yi-Fan Song Jian-Hua Fu Department of Pediatrics Shengjing Hospital of China Medical UniversitySanhao StreetHeping DistrictShenyangChina Department of Neurology Shengjing Hospital of China Medical UniversityShenyangChina

Background This study aimed to systematically review and meta-analyze the available literature on the association between preterm infant bronchopulmonary dysplasia(BPD)and pre-adulthood *** Studies examining the association between BPD and asthma in children and adolescents were systematically reviewed,and a meta-analysis was *** searched Scopus,Embase,Web of Science,PubMed,and Cochrane Library from the database inception to March 26,*** pooled odds ratio(OR)estimate was used in our meta-analysis to calculate the correlation between BPD and the probability of developing asthma before *** 12.0 was used to conduct the statistical *** The correlation between asthma and BPD in preterm newborns was examined in nine *** used a random effect model to pool the OR *** results indicated a marked increase in the risk of subsequent asthma in preterm infants with BPD[OR=1.73,95% confidence interval(CI)=1.43-2.09].Moreover,there was no obvious heterogeneity across the studies(P=0.617,I^(2)=0%).The pooled OR remained stable and ranged from 1.65(95%CI=1.35-2.01)to 1.78(95%CI=1.43-2.21).Regarding publication bias,the funnel plot for asthma risk did not reveal any noticeable *** further performed Begg’s and Egger’s tests to quantitatively evaluate publication *** was no evidence of a publication bias for asthma risk(P>|Z|=0.602 for Begg’s test,and P>|t|=0.991 for Egger’s test).Conclusions Our findings indicate that preterm infants with BPD have a much higher risk of developing asthma in the future(OR=1.73,95%CI=1.43-2.09).Preterm infants with BPD may benefit from long-term follow-up.

关键词： Asthma bronchopulmonary dysplasia Preterm infants

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Successful treatment of pulmonary hypertension in a neonate with bronchopulmonary dysplasia: A case report and literature review

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World Journal of Clinical Cases 2022年第32期10卷 11898-11907页

作者： Jiao Li Jing Zhao Xiao-Yan Yang Jing Shi Hai-Ting Liu Department of Pediatrics West China Second University HospitalSichuan UniversityChengdu 610041Sichuan ProvinceChina Neonatal Ward West China Second University HospitalSichuan UniversityChengdu 610066Sichuan ProvinceChina

BACKGROUND Pulmonary hypertension(PH)is a severe complication of bronchopulmonary dysplasia(BPD)in premature neonates and is closely related to ***,there is no effective and safe treatment for PH due to BPD in *** treatment for cases of BPD-associated PH with Tadalafil combined with bosentan is *** case may make a significant contribution to the literature because PH is difficult to manage as a serious complication of BPD in preterm *** is high,especially when it is complicated by heart *** SUMMARY An extremely premature neonate with a gestational age of 26+5 wk and birth weight of 0.83 kg was diagnosed with BPD associated with PH;oral sildenafil did not improve the *** infant experienced sudden cardiac arrest and serious heart failure with severe *** a series of treatments,including cardiopulmonary resuscitation,mechanical ventilation,and inhaled nitric oxide(iNO),the respiratory and circulatory status improved but the pulmonary artery pressure remained *** oral sildenafil was replaced with oral tadalafil and bosentan;pulmonary artery pressure improved,and the infant recovered at our *** 2 years of follow-up,she is in good condition,without any cardiovascular *** INO can effectively improve the respiratory and circulatory status of infants with PH associated with premature BPD.B-type natriuretic peptide should be routinely measured during hospitalization to evaluate the risk and prognosis of BPD-associated PH in preterm *** combined with bosentan for the treatment of PH associated with premature BPD was better than sildenafil in this *** studies are needed to explore the efficacy and safety of different vasodilators in the treatment of PH associated with premature BPD.

关键词： Premature bronchopulmonary dysplasia Pulmonary hypertension Treatment Case report

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bronchopulmonary dysplasia in Premature Infants with Very Low Birth Weight: A Single Centre Retrospective Study in China

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Open Journal of Pediatrics 2016年第4期6卷 295-307页

作者： Li Shen Tao Bo Senlin Luo Ruolin Zhang Jian Li Division of Neonatology Children’s Medical Center The Second Xiangya Hospital Central South University Changsha China Department of Neonatology The Maternal and Child Health Hospital of Hunan Province Changsha China

To investigate bronchopulmonary dysplasia (BPD) and its treatment with dexamethasone (DEX) in premature infants with birth weight (BW) < 1500 g. We retrospectively reviewed the records of preterm infants admitted to the Division of Neonatology, the Second Xiangya Hospital, Central South University between September 2011 and December 2014. Patients were excluded if they needed oxygen therapy but were lost to follow-up at ≤36 weeks post-menstrual age (PMA) or <56 days after birth, or they had severe congenital anomalies. The incidence of BPD was 18% (37/212). Gestational age (GA) was <32 weeks in all BPD patients. GA, BW, and Apgar scores were lower and hospitalization duration and pulmonary surfactant (PS) use were higher in the BPD group than in the non-BPD group (P < 0.05). Risk factors for BPD included neonatal respiratory distress syndrome, neonatal pneumonia, positive sputum culture, pulmonary hemorrhage, respiratory failure. Multivariate logistic regression revealed that GA (odds ratio [OR]: 0.479, P = 0.004) and neonatal respiratory distress syndrome (OR: 6.146, P = 0.043) were independent risk factors for BPD. DEX was administered to 26 patients after the diagnosis of BPD. After one and two weeks of DEX treatment, the oxygen requirement had significantly reduced compared to the week prior to treatment (P < 0.05), while during treatment, the weight gain rate and weight gain efficiency slower significantly than that during either of the two preceding weeks (P < 0.001). These results suggest that low GA was the most important risk factor for BPD, DEX reduced oxygen dependency but decreased weight gain.

关键词： bronchopulmonary dysplasia Very Low Birth Weight Infants Oxygen Therapy Dexamethasone Weight Gain

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Association of Surfactant Protein B Gene Polymorphisms (C/A-18, C/T1580, Intron 4 and A/G9306) and Haplotypes with bronchopulmonary dysplasia in Chinese Han Population

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Journal of Huazhong University of Science and Technology(Medical Sciences) 2013年第3期33卷 323-328页

作者：蔡保欢常立文李文斌刘伟王席娟莫璐霞赵玲霞徐洪涛杨慧 Department of Pediatrics Tongji HospitalTongji Medical CollegeHuazhong University of Science and Technology

Summary： This study aimed to investigate the association between surfactant protein B （SP-B） pol- ymorphisms and bronchopulmonary dysplasia （BPD） in Chinese Han infants. We performed a case- control study including 86 infants with BPD and 156 matched controls. Genotyping was performed by sequence specific primer-polymerase chain reaction （PCR） and haplotypes were reconstructed by the fastPHASE software. The results showed that significant differences were detected in the geno- type distribution of C/A-18 and intron 4 polymorphisms of SP-B gene between cases and controls. No significant differences were detected in fhe genotype distribution of C/T1580 or A/G9306 be- tween the two groups. Haplotype analysis revealed that the frequency of A-del-C-A haplotype was higher in case group （0.12 to 0.05, P=0.003）, whereas the frequency of C-inv-C-A haplotype was higher in control group （0.19 to 0.05, P=0.000）. In addition, a significant difference was observed in the frequency of C-inv-T-A haplotype between the two groups. It was concluded that the polymor- phisms of SP-B intron 4 and C/A-18 could be associated with BPD in Chinese Han infants, and the del allele of intron 4 and A allele of C/A-18 might be used as markers of susceptibility in the disease. Haplotype analysis indicated that the gene-gene interactions would play an important part in deter- mining susceptibility to BPD.

关键词： bronchopulmonary dysplasia surfactant protein B polymorphism

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