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Bi-level Nasal Positive Airway Pressure(BiPAP)versus Nasal Continuous Positive Airway Pressure(CPAP)for Preterm Infants with Birth Weight Less Than 1500g and Respiratory Distress Syndrome Following INSURE Treatment:A Two-center Randomized Controlled Trial

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Current Medical Science 2021年第3期41卷 542-547页

作者： Rui PAN Gao-yan CHEN Jing WANG Zhao-xian ZHOU Ping-ying ZHANG Li-wen CHANG Zhi-hui RONG Department of Pediatrics Xicmgyang Central HospitalAffiliated Hospital of Hubei University of Arts and ScienceXiangyang 440021China Department of Neonatology Tongji HospitalHuazhong University of Science and TechnologyWuhan 430030China

The present study aimed to examine the effectiveness of bi-level positive airway pressure(BiPAP)versus continuous positive airway pressure(CPAP)in preterm infants with birth weight less than 1500 g and respiratory distress syndrome(RDS)following intubation-surfactant-extubation(INSURE)treatment.A two-center randomized control trial was *** primary outcome was the reintubation rate of infants within 72 h of age after *** outcomes included bronchopulmonary dysplasia(BPD),necrotizing enterocolitis(NEC),retinopathy of prematurity(ROP)and incidences of adverse *** function at one year of corrected age was also compared between the two *** were 140 cases in the CPAP group and 144 in the BiPAP *** INSURE,the reintubation rates of infants within 72 h of age were 15%and 11.1%in the CPAP group and the BiPAP group,respectively(P>0.05).Neonates in the BiPAP group was on positive airway pressure(PAP)therapy three days less than in the CPAP group(12.6 d and 15.3 d,respectively,P0.05).There was no difference in lung function at one year of age between the two groups(P>0.05).In conclusion,after INSURE,the reintubation rate of infants within 72 h of age was comparable between the BiPAP group and the CPAP *** was superior to CPAP in terms of shorter durations(days)on PAP support and oxygen *** were no differences in the incidences of BPD and ROP,and lung function at one year of age between the two ventilation methods.

关键词： noninvasive ventilator neonate bronchopulmonary dysplasia continuous positive airway pressure

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Mortality, morbidity, and care practices for 1750 very low birth weight infants, 2016-2021

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中华医学杂志(英文版) 2024年第20期137卷 2452页

作者： He Yang Zhang Meng Tang Jun Liu Wanxiu Hu Yong Shi Jing Wang Hua Xiong Tao Zhang Li Ying Junjie Mu Dezhi Department of Neonatology West China Second Hospital Sichuan University Chengdu Sichuan China Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University) Ministry of Education Chengdu Sichuan China

Background: Very low birth weight (VLBW) infants are the key populations in neonatology, wherein morbidity and mortality remain major challenges. The study aimed to analyze the clinical characteristics of VLBW ***: A retrospective cohort study was conducted in West China Second Hospital between January 2016 and December 2021. Neonates with a birth weight of bronchopulmonary dysplasia (BPD), 22.0% (334/1517) had apnea, 11.1% (169/1517) had culture-confirmed sepsis, 8.4% (128/1517) had pulmonary hemorrhage, 7.6% (116/1517) had severe intraventricular hemorrhage (IVH)/periventricular leukomalacia (PVL), 5.7% (87/1517) had necrotizing enterocolitis (NEC), and 2.0% (31/1517) had severe retinopathy of prematurity. The total and in-hospital mortality rates were 9.7% (169/1750) and 3.0% (45/1517), respectively. The top three diagnoses of death among those who had received complete treatment were sepsis, NRDS, and NEC. In 2009-2015, 1146 VLBW were enrolled and 895 infants received complete treatment. The proportions of apnea, IVH, and IVH stage ≥3/PVL, were higher in 2009-2015 compared with those in 2016-2021, while the proportions of NRDS and BPD were characterized by significant increases in 2016-2021. The total and in-hospital mortality rates were 16.7% (191/1146) and 5.6% (50/895) respectively in ***: Among VLBW infants born in 2016-2021, the to

关键词： Morbidity Mortality Very low birth weight bronchopulmonary dysplasia Respiratory distress syndrome Newborn

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Oxygen administration in the care of neonates： a double-edged sword

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Chinese Medical Journal 2010年第20期123卷 2938-2942页

作者： Phyllis A. Dennery University of Pennsylvania School of Medicine Children's Hospital of Philadelphia Philadelphia PA 19072 USA

Objective To evaluate the use of oxygen in neonates in the past, present and future Data sources The data are mainly from Pubmed with relevant published articles from the 1940s to the present with some information gathered from web *** selection Studies evaluating the use of oxygen in premature and term infants through history with original milestone articles *** There are still many unknowns about the proper use of oxygen in preterm and term infants but many studies suggest that both liberal use （resulting in a blood oxygen saturation of greater than 94%） as well as restrictive use （resulting in a blood oxygen saturation of less than 80%-85%） are detrimental and have long term consequences on the *** Definitive studies evaluating the appropriate concentration and duration of supplemental oxygen are ongoing and will help in the management of term and preterm infants requiring oxygen.

关键词： supplemental oxygen prematurity retinopathy of prematurity bronchopulmonary dysplasia

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Bosentan Is Associated with a Reduction in Right Ventricular Systolic Pressure N-Terminal Pro-Hormone B-Type Natriuretic Peptide Levels in Young Patients with Pulmonary Hypertension

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Open Journal of Pediatrics 2023年第1期13卷 32-42页

作者： Lily M. Landry Andrew C. Burks Onyekachukwu Osakwe Jarrod D. Knudson Christopher L. Jenks Department of Pediatrics Division of Pediatric Cardiology University of Mississippi Medical Center Jackson USA School of Medicine University of Mississippi Medical Center Jackson USA Department of Pediatrics Division of Pediatric Critical Care University of Mississippi Medical Center Jackson USA

Pulmonary hypertension is a rare and potentially fatal disease in children if left untreated. Emerging therapies, including Bosentan, a dual endothelin receptor antagonist, have shown significant benefits in the adult pulmonary hypertension population;however, few studies have assessed the efficacy and safety of endothelin receptor antagonists in infants and young children. Our study was a single-center retrospective analysis of patients less than two years of age with a confirmed diagnosis of pulmonary hypertension and initiated on Bosentan therapy between 2017 and 2020. Twelve cases met eligibility criteria. Demographic data, laboratory data, echocardiographic, and cardiac catheterization data were analyzed. With treatment, there was a statistically significant decrease in mean right ventricular systolic pressure estimated by the tricuspid regurgitation jet (79 ± 23 mmHg reduced to 52 ± 25 mmHg;p < 0.001) N-terminal pro-hormone B-type natriuretic peptide levels (21,071 reduced to 2,037;p < 0.001). Additionally, improvement and eventual normalization of right ventricular function and septal geometry was seen within the first four months of therapy. Patients who underwent cardiac catheterization after therapy initiation (n = 4) demonstrated hemodynamic improvements;however, only the decrease in diastolic pulmonary artery pressure was statistically significant (p = 0.018). No significant differences in hemoglobin, platelet count, or liver function tests were observed between groups. In conclusion, these data suggest that Bosentan may be an effective and relatively safe treatment option for children less than two years of age with pulmonary hypertension. Further long-term randomized control studies are necessary to validate the potential clinical benefit of utilizing this drug therapy in young children.

关键词： Pulmonary Arterial Hypertension bronchopulmonary dysplasia Endothelial Receptor Antagonist Congenital Heart Disease

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Emerging role of cellular senescence in normal lung development and perinatal lung injury

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Chinese Medical Journal Pulmonary and Critical Care Medicine 2024年第1期2卷 10-16页

作者： Phyllis A.Dennery Hongwei Yao Department of Molecular Biology Cell Biology&BiochemistryDivision of Biology and MedicineBrown UniversityProvidenceRI 02912USA Department of Pediatrics Warren Alpert Medical School of Brown UniversityProvidenceRI 02903USA

Cellular senescence is a status of irreversible growth arrest,which can be triggered by the p53/p21cip1 and p16INK4/Rb pathways via intrinsic and external *** cells are typically enlarged and flattened,and characterized by numerous molecular *** latter consists of increased surfaceome,increased resid-ual lysosomal activity at pH 6.0(manifested by increased activity of senescence-associated beta-galactosidase[SA-𝛽-gal]),senescence-associated mitochondrial dysfunction,cytoplasmic chromatin fragment,nuclear lamin b1 exclusion,telomere-associated foci,and the senescence-associated secretory *** features vary depending on the stressor leading to senescence and the type of *** senescence plays pivotal roles in organismal aging and in the pathogenesis of aging-related ***,senescence can also both promote and inhibit wound healing *** recently report that senescence as a programmed pro-cess contributes to normal lung *** senescence is also observed in Down Syndrome,as well as in premature infants with bronchopulmonary dysplasia and in a hyperoxia-induced rodent model of this ***,this senescence results in neonatal lung *** this review,we briefly discuss the molecular features of *** then focus on the emerging role of senescence in normal lung development and in the pathogenesis of bronchopulmonary dysplasia as well as putative signaling pathways driving ***,we discuss potential therapeutic approaches targeting senescent cells to prevent perinatal lung diseases.

关键词： Senescence Normal lung development bronchopulmonary dysplasia Down syndrome Senolytics

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KL-6和Clara细胞蛋白作为早产儿支气管肺发育不良预测指标的比较(英文)

KL-6和Clara细胞蛋白作为早产儿支气管肺发育不良预测指标的比较(...

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2014年浙江省医学会儿科学分会学术年会暨儿内科疾病诊治新进展国家级继续教育学习班

作者： Ke-Yi Wang Xian-Mei Huang Hui Lu Zhi-Qun Zhang Department of Central Laboratory Hangzhou First People's Hospital Department of Pediatrics Hangzhou First People's Hospital Division of Neonatology Department of PediatricsHangzhou First People's Hospital

Background:Circulating Krebs von den Lungen-6/mucin 1(KL-6/MUC1) and Clara cell secretory protein(CC16) are specific indicators of pulmonary injury involving the alveolar epithelium and ***:To evaluate the predictive characteristics of KL-6 and CC16 for bronchopulmonary dysplasia(BPD) in preterm infants,either independently or in combination,as well as to determine their reference *** design:This prospective cohort study was performed from 2011 to 2013 with preterm neonates of gestational age ≤32 weeks and birth weight ≤1500 *** KL-6 and CC16 levels were determined 7 and 14 days after ***:Seventy-three preterm infants were *** was identified in 24 of these infants(Gestational age:29.2 ± 1.7 weeks).After adjusting for potential confounders,serum KL-6 concentrations were found to be elevated in BPD infants at both time points relative to non-BPD infants,while serum CC16 concentrations were lower at 14 *** both 7 d and 14 d of life the predictive power of KL-6 levels exceeded that of CC16(area under receiver operating characteristic curve:at 7 d,0.91 cf.0.73,P = 0.02;at 14 d,0.95 cf.0.85,P = 0.05).The combination of these markers enhanced the sensitivity ***:Serum KL-6 level at 14 days of life in preterm infants predict the occurrence of *** serum levels of both KL-6 and CC16 together further enhanced the prediction *** biological markers could help the clinician plan early therapeutic interventions to minimize or avoid BPD in preterm infants.

关键词： Premature infants bronchopulmonary dysplasia Clara cell secretory protein KL-6 Mechanical ventilation

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早产儿支气管肺发育不良和红细胞输注间的关系(英文)

早产儿支气管肺发育不良和红细胞输注间的关系(英文)

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2014年浙江省医学会儿科学分会学术年会暨儿内科疾病诊治新进展国家级继续教育学习班

作者：张志群 Xian-Mei HUANG Hui LU Division of Neonatology Department of PediatricsHangzhou First People's Hospital Department of Pediatrics Hangzhou First People's Hospital

Background:Anemia of prematurity(AOP) and transfusion of packed red blood cells(PRBCs) are both common in preterm *** transfusion is used for the treatment of AOP to increase the oxygen carrying capacity of *** transfusion has been shown to result in higher rates of organ ***:To determine whether PRBC transfusion for AOP was associated with an incidence of bronchopulmonary dysplasia(BPD) in *** Design:This retrospective study was performed on all live-born neonates with birth weights ≤ 1,500 g or gestational age(GA) ≤ 32 weeks admitted from 2008 to *** who received PRBC transfusion and those who did not receive PRBC transfusion were compared for incidence of BPD and other ***:Of 209 patients,119 received PRBC transfusion before diagnosed BPD(group 1) and 90 did not receive PRBC or PRBC transfusion after diagnosed BPD(group 2).The incidence of BPD was higher in group 1 than group 2(37.8 vs.2.2%,p < 0.00001);after adjusting for significant risk factors,the adjusted odds ratio for BPD was 9.541(95% CI 2.031,44.806),p = ***:This study shows an association between PRBC transfusion and increased incidence of BPD in preterm infants.

关键词： prematurity bronchopulmonary dysplasia transfusion red blood cells anemia of prematurity

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