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第十三届江浙沪儿科学术会议暨2016年浙江省医学会儿科学学术年会

作者： Cong Xiao Ya

Objective:Amplitude integrated electroencephalogram(aEEG) was recorded in preterm infans with risk factors of brain injury to study the predictive value of aEEG in dignosis of brain injury in preterm infants(BIPI).The value of aEEG in predicting neuropsychologic development outcome were evaluated at corrected age of 12 month by analyzing the correlation between aEEG and neurological outcome,so as to conduct the early intervention of brain damage and reduce the morbidity of preterm infants and burden of the family and society Methods:85 preterm infants with risk factors of brain injury and 34 preterm infant without them were included in our *** were recorded during the first 6 *** samples were collected within 24 hours after birth to test the level of urine S100 B *** received brain MRI at 7 to 10 days after *** behavioral neurological assessmen(NBNA) were conducted at 40+3,42 and 44 weeks’ postmenstrual ***’ s Developmental Center of China(CDCC) were conducted at the corrected age of 3,6 andl2 *** development outcome were evaluated at corrected age of 12 month by clinical manifestation、 brian MRI and *** infants were divided into two groups(the group with brain damage and the group without brain damage)according to their *** predictive value of aEEG,brain MRI,unrin S100 B protein and the correlation between the Results of aEEGand NBNA and CDCC were ***:1.108 preterm infants finished the follow up at corrected age of 12 month,among them 30 infants were in the group without brain damage,48 infants were in the group with brain damage,30 were normal *** sensitivity of aEEG was 96.67%,the specificity was 77.08%,the area under the ROC curve was *** sensitivity of unrin S100 B protein was 80%,the specificity was 87.5%,the area under the ROC curve was *** sensitivity of brain MRI was 70%,the specificity was 91.67%,the area under the ROC curve was *** pred

关键词： amplitude integrated encephalopathy preterm infant brain injury neuropsychologic development

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Gut microbiota in preterm infants receiving breast milk or mixed feeding

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World Journal of Clinical Pediatrics 2024年第2期13卷 135-145页

作者： Sandra Gabriela Sánchez-González Bárbara Gabriela Cárdenas-del-Castillo Elvira Garza-González Gerardo R Padilla-Rivas Isaías Rodríguez-Balderrama Consuelo Treviño-Garza Fernando Félix Montes-Tapia Gerardo C Palacios-Saucedo Anthony Gutiérrez-Rodríguez Manuel Enrique de-la-O-Cavazos Department of Pediatrics Hospital Universitario“Dr.JoséEleuterio González”Universidad Autónoma de Nuevo LeónMonterrey 64460Nuevo LeónMéxico Departamento de Bioquímica y Medicina Molecular Universidad Autónoma de Nuevo LeónMonterrey 64460Nuevo LeónMéxico Department of Biochemistry and Molecular Medicine Universidad Autónoma de Nuevo LeónMonterrey 64460Nuevo LeónMéxico Department of Pediatric Surgery Hospital Universitario"Dr.JoséEleuterio González"Monterrey 64460Nuevo LeónMéxico

BACKGROUND preterm birth is the leading cause of mortality in newborns,with very-low-birthweight infants usually experiencing several *** milk is considered the gold standard of nutrition,especially for preterm infants with delayed gut colonization,because it contains beneficial microorganisms,such as Lactobacilli and *** To analyze the gut microbiota of breastfed preterm infants with a birth weight of 1500 g or *** An observational study was performed on preterm infants with up to 36.6 wk of gestation and a birth weight of 1500 g or less,born at the University Hospital ***éEleuterio González at Monterrey,Mexico.A total of 40 preterm neonates were classified into breast milk feeding(BM)and mixed feeding(MF)groups(21 in the BM group and 19 in the MF group),from October 2017 to June *** samples were collected before they were introduced to any feeding *** full enteral feeding was achieved,the composition of the gut microbiota was analyzed using 16S rRNA gene *** variables were compared using Student’s t-test or using the Mann–Whitney U test for nonparametric ***,evenness,equitability,Margalef’s index,Fisher’s alpha,Chao-1 index,and Shannon’s diversity index were also *** No significant differences were observed at the genus level between the *** comparison indicated higher counts of Alphaproteobacteria and Betaproteobacteria in the initial compared to the final sample of the BM group(P<0.011).In addition,higher counts of Gammaproteobacteria were detected in the final than in the initial sample(P=0.040).According to the Margalef index,Fisher’s alpha,and Chao-1 index,a decrease in species richness from the initial to the final sample,regardless of the feeding type,was observed(P<0.050).The four predominant phyla were Bacteroidetes,Actinobacteria,Firmicutes,and Proteobacteria,with Proteobacteria being the most ***,no significant differences were

关键词： Gut microbiota Human milk preterm infant Proteobacteria Very low birth weight 16S rRNA

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Ursodeoxycholic acid prevention on cholestasis associated with total parenteral nutrition in preterm infants:a randomized trial

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World Journal of Pediatrics 2022年第2期18卷 100-108页

作者： Si-Ying Liu Li-Wen Chang Jing Wang Min Xie Lei-Lei Chen Wei Liu Department of Pediatrics Tongji HospitalTongji Medical CollegeHuazhong University of Science and Technology1095 Jiefang AvenueWuhan 430030HubeiChina

Background preterm infants with long-term parenteral nutrition(PN)therapy are at risk for cholestasis associated with total parenteral nutrition(PNAC).This study examined the safety and efficacy of ursodeoxycholic acid(UDCA)in preventing PNAC in preterm *** research aimed to investigate the prophylactic effect of preventive oral UDCA on PNAC in preterm *** We compared oral administration of UDCA prophylaxis with no prophylaxis in a randomized,open-label,proof-of-concept trial in preterm neonates with PN *** low-birth-weight preterm infants(preterm neonates from January 2021 to July 2021 were enrolled in this prospective study(42 in the UDCA group and 60 in the control group).Notably,the peak serum level of DB[13.0(12-16)vs.15.2(12.5-19.6)μmol/L,Pinfants receiving prolonged PN.

关键词： Cholestasis Parenteral nutrition preterm infant Ursodeoxycholic acid

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Predictors of readiness for discharge in mothers of preterm infants: The role of stress, self-efficacy and perceived social support

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Asian pacific Journal of Reproduction 2022年第6期11卷 269-275页

作者： Sedighe Valipour Fatemeh Estebsari Maliheh Nasiri Parvaneh Vasli Department of Community Health Nursing School of Nursing and MidwiferyShahid Beheshti University of Medical SciencesTehranIran Department of Basic Sciences School of Nursing and MidwiferyShahid Beheshti University of Medical SciencesTehranIran

Objective:To determine the predictive role of stress,self-efficacy,and perceived social support on readiness for discharge in mothers of preterm ***:The present cross-sectional,descriptive-analytical study was conducted on 120 mothers of preterm infants admitted to hospitals affiliated to Lorestan University of Medical Sciences,Iran in *** were selected by a convenience sampling method and based on inclusion *** collection tools included the demographic questionnaire of mothers and infants,parent perceptions of their child's hospital discharge,parental stressor scale:neonatal intensive care unit,perceived maternal parenting,and multidimensional scale of perceived social *** were analyzed using Pearson correlation and stepwise regression at the significance level of ***:infant behavior and appearance,situational belief,and family support achieved the highest mean score from parents'stress,self-efficacy,and perceived social support dimensions,*** was a significant relationship between stress,self-efficacy,and perceived social support with readiness for discharge in mothers of preterm infants(Ppreterm infants rose by 0.35 and 0.43,respectively,for a unit increase in the scores of self-efficacy and perceived social ***:Stress,self-efficacy,and perceived social support can be considered as predictors of readiness for discharge in mothers of preterm *** is suggested that nurses in neonatal intensive care units provide a better platform for the readiness for discharge in mothers of preterm infants by reducing stressors and increasing maternal self-efficacy and social support.

关键词： Patient discharge Stress Social support Self-efficacy preterm infant Mother

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Weaning preterm infants from continuous positive airway pressure: evidence for best practice

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World Journal of Pediatrics 2015年第3期11卷 212-218页

作者： Hesham Abdel-Hady Basma Shouman Nehad Nasef Neonatal Intensive Care Unit Mansoura University Children's HospitalMansouraEgypt

Background:Nasal continuous positive airway pressure(NCPAP)is frequently used in preterm ***,there is no consensus on when and how to wean them from *** sources:Based on recent publications,we have reviewed the criteria of readiness-to-wean and factors affecting weaning success.A special focus is placed on the methods of weaning from NCPAP in preterm ***:Practical points of when and how to wean from NCPAP in preterm infants are *** infants are ready to be weaned from NCPAP when they are stable on a low NCPAP pressure with no(or minimal)oxygen *** used to wean from NCPAP include:sudden weaning of NCPAP,gradual decrease of NCPAP pressure,graded-time-off NCPAP(cycling),weaning to high or low flow nasal cannula,and a combination of these *** best strategy for weaning is yet to be ***-off NCPAP increases the duration of NCPAP and length of hospital stay without beneficial effect on success of *** decrease of NCPAP pressure is more physiological and better tolerated than cycling-off ***:Further studies are needed to reach a consensus regarding the optimal timing and the best method for weaning from NCPAP in preterm infants.

关键词： continuous positive airway pressure preterm infant weaning

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Effects of Different Surfactant Administrations on Cerebral Autoregulation in preterm infants with Respiratory Distress Syndrome

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Journal of Huazhong University of Science and Technology(Medical Sciences) 2016年第6期36卷 801-805页

作者：李旭芳程婷婷关瑞莲梁红卢伟能张敬华刘美仪余欣梁俊孙黎张炼 Department of Neonatology Guangzhou Women and Children's Medical Center

To treat respiratory distress syndrome,surfactant is currently delivered via less invasive surfactant administration（LISA） or INtubation SURfactant Extubation（INSURE）.The aim of this study was to compare the effect of the two delivery methods of surfactant on cerebral *** infrared spectroscopy monitoring was carried out to detect cerebral oxygen saturation（Sc O2）,and the mean arterial blood pressure（MABP） was simultaneously *** 44 preterm infants included,the surfactant was administrated to 22 via LISA and 22 via *** clinical characteristics,treatments and outcomes of the infants showed no significant differences between the two *** correlation coefficient of Sc O2 and MABP（rSc O2-MABP） 5 min before administration was similar in the two *** surfactant administration,rSc O2-MABP increased in both groups（0.44±0.10 to 0.54±0.12 in LISA,0.45±0.11 to 0.69±0.09 in INSURE）.In the first and second 5 min after instillation,rSc O2-MABP was not significantly different from baseline in the LISA group,but increased in the first 5 min after instillation（0.59±0.13,P=0.000 compared with the baseline in the same group） and recovered in the second 5 min after instillation（0.48±0.10,P=0.321） in the INSURE *** were significant differences in the change rates of rSc O2-MABP between the two groups during and after surfactant *** results suggest that cerebral autoregulation may be affected transiently by surfactant *** effect duration of LISA is shorter than that of INSURE（〈5 min in LISA vs.5–10 min in INSURE）.

关键词： preterm infant respiratory distress syndrome surfactant cerebral autoreguiation pulmonary surfactant

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Reliability and validity of the Chinese version of the Readiness for Hospital Discharge Scale-Parent Form in parents of preterm infants

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International Journal of Nursing Sciences 2017年第2期4卷 88-93页

作者： Yongfeng Chen Jinbing Bai The People's Hospital of Guangxi Zhuang Autonomous Region NanningChina Nell Hodgson Woodruff School of Nursing Emory UniversityAtlantaGAUnited States

Background: The Readiness for Hospital Discharge Scale (RHDS)-Parent Form shows satisfactory reli-ability and validity to assess the readiness of parents to take care of their children discharged from hospitals in Western countries. However, the reliability and validity of this instrument has not been evaluated in Chinese ***: Evaluate the psychometric features of the RHDS-Parent Form among Chinese parents of preterm infants. Methods: The RHDS-Parent Form was translated into a Chinese version following an international in-strument translation guideline. A total of 168 parents with preterm infants were recruited from the neonatal intensive care units of two tertiary-level hospitals in China. The internal consistency of this measure was assessed using the Cronbach's a coefficient;confirmatory factor analysis was conducted to evaluate the construct validity;and Pearson correlation coefficient was used to report the convergent validity. Results: The Chinese version of RHDS (C-RHDS)-Parent Form included 22 items with 4 subscales, ac-counting for 56.71% of the total variance. The C-RHDS-Parent Form and its subscales showed good reliability (Cronbach's a values 0.78-0.92). This measure and its subscales showed positive correlations with the score of Quality of Discharge Teaching Scale. Conclusion: The factor structure of C-RHDS-Parent Form is partially consistent with the original English version. Future studies are needed to explore the factors within this measure before it is widely used in Chinese clinical care settings.

关键词： Parent preterm infant Neonatal intensive care units Readiness for hospital discharge Scale-Parent Form Psychometric property Instrument translation

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Application of prolonging small feeding volumes early in life to prevent of necrotizing enterocolitis in very low birth weight preterm infants

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International Journal of Nursing Sciences 2016年第1期3卷 45-49页

作者： Qiu-fang Li Hua Wang Dan Liu Yi Tang Xin-fen Xu Women's Hospital School of Medicine Zhejiang University HangzhouChina

Objective:To study the effects of prolonging small feeding volumes early in life on the incidence of necrotizing enterocolitis(NEC)in very low birth weight(VLBW)preterm ***:A total of 128 VLBW infants who could not be breastfed were assigned into the experimental group(63 cases)and the control group(65 cases)using a random number *** experiment group was fed 12 mL/(kg·d)on day 1 which was increased to 24 mL/(kg·d)for the first 10 study *** control group was fed 12 mL/(kg·d)for the first 14e48 ***,the feeding volume increased by 24-36 mL/(kg·d)up to 140e160 mL/(kg·d)and maintained until the 10th day after *** incidence of feeding intolerance and NEC,duration of hospitalization,time to full enteral feedings,incidence of intrahepatic cholestasis,and the levels of gastrin and motilin in serum were ***:The incidence of feeding intolerance was significantly lower in the experimental group compared with the control group(15.87% vs.33.84%).There was a significant reduction in the incidence of NEC between the experimental and control groups(7.9% vs.16% in the control group).Conclusion:A protocol that prolongs small feeding volumes early in life can reduce the incidence and severity of NEC,but still warrants further study.

关键词： infant formula Necrotizing enterocolitis preterm infant Prolonging small feeding volumes Very low birth weight infant

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Neonatal Nutrition and Later Outcomes of Very Low Birth Weight and preterm infants <32 Gestational Age at a Tertiary Care Hospital of Portugal

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Open Journal of Pediatrics 2015年第3期5卷 190-198页

作者： Conceicao Costa Teresa Torres Andreia Teles Departments of Pediatrics—Centro Hospitalar Vila Nova de Gaia/Espinho Vila Nova de GaiaPortugal epartments of Pediatrics Neonatology Unit—Centro Hospitalar Vila Nova de Gaia/EspinhoVila Nova de GaiaPortugal

Premature infants, especially those born with less than 1500 g, often exhibit slow overall growth. Lack of early nutritional support is an important element. The present authors describe parenteral nutritional practices in a tertiary hospital and evaluate postnatal growth of preterm infants under 32 weeks of gestational age or with a birth weight < 1500 g. For population study, we examined 431 newborn files. Their median gestational age was 29.7 weeks. Of them, 25.4% were small for gestational age (SGA). 77.5% received parenteral nutrition (PN), 54.5% of which was provided on the first day. The average time was 14.7 days. The average weight gain by the 30th day was 425 g. At discharge, 37% were rd month 20% had their weight under P3, decreasing to 10% by the 12th month. Children who initiated PN in the first 24 hours of life had significantly better weight on the 30th day of their life (p th month of corrected age (p = 0.038). And they had better Body Mass Index (BMI) in the 3rd (p = 0.012) and 12th (p = 0.023) months. Despite better feeding practices, there is still significant failure in post natal growth. Early introduction of PN was associated with an improved weight gain, which suggests that nutrition that included amino acids may be critical during the first 24 hours of life.

关键词： Growth Parenteral Nutrition preterm infant Very Low Birth Weight

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Comparison in executive function in Chinese preterm and full-term infants at eight months

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Frontiers of Medicine 2018年第2期12卷 164-173页

作者： Yao Feng Hong Zhou Yan Zhang Anthony Perkins Yan Wang Jing Sun Department of Child Adolescent and Women's Health School of Public Health Peking University Beoing 100191 China Menzies Health Institute Queensland Griffith University Gold Coast Queensland QLD 4222 Australia School of Medicine Griffith University Gold Coast Queensland QLD 4222 Australia

Executive function （EF） is increasingly recognized as being responsible for adverse developmental outcomes in preterm-born infants. Several perinatal factors may lead to poor EF development in infancy, and the deficits in EF can be identified in infants as young as eight months. A prospective cohort study was designed to study the EF in Chinese preterm infants and examine the relationship between EF in preterm infants and maternal factors during perinatal period. A total of 88 preterm infants and 88 full-term infants were followed from birth to eight months （corrected age）. Cup Task and Planning Test was applied to assess the EF of infants, and the Bayley Scale of infant Development （BSID-III） was used to evaluate cognitive （MDI） and motor abilities （PDI） of infants. In comparison with full-term infants, the preterm infants performed more poorly on all measures of EF including working memory, inhibition to prepotent responses, inhibition to distraction, and planning, and the differences remained after controlling the MDI and PDI. Anemia and selenium deficiency in mothers during pregnancy contributed to the differences in EF performance. However, maternal depression, hypertension, and diabetes during pregnancy were not related to the EF deficits in preterm infants. Future research should focus on the prevention of anemia and selenium deficiency during pregnancy and whether supplementing selenium in mothers during pregnancy can prevent further deterioration and the development of adverse outcomes of their offspring.

关键词： executive function (EF) preterm infant working memory inhibition to prepotent response inhibition to distraction planning

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