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Systemic postnatal corticosteroid use for the prevention of bronchopulmonary dysplasia and its relationship to early neurodevelopment in extremely preterm

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World Journal of Pediatrics 2023年第6期19卷 586-594页

作者： Emilia Esterman Traci-Anne Goyen Pranav Jani Gemma Lowe Jane Baird Rajesh Maheshwari Daphne D’Cruz Melissa Luig Dharmesh Shah department of neonatology Westmead HospitalWestmeadAustralia Faculty of Medicine and Health The University of SydneySydneyAustralia

Background Systemic postnatal corticosteroid use in extremely preterm infants poses a risk of adverse neurodevelopmental *** study explores their use beyond seven days of age with early neurodevelopmental assessments during the fidgety period(9-20 weeks postterm age).Methods This retrospective single-center cohort study included inborn extremely preterm infants from 1 January 2014 to 31 December *** infants,those with congenital or genetic abnormalities,and those who received postnatal cor-ticosteroids for nonrespiratory reasons were *** cohort was dichotomized based on the status of corticosteroid *** neurodevelopmental outcomes were reported using Prechtl's General Movements *** Of the 282 infants,67(23.75%)received *** these,34(50.75%)received them for dependency on invasive ventilation(intermittent positive-pressure ventilation),and the remainder received them for dependency on non-invasive ventilation continuous positive airway pressure(CPAP)or bi-level positive airway pressure(BiPAP).Abnormal or absent fidgety movements were observed in 13% of infants(7/54)who received corticosteroids compared to 2% of infants(3/146)who did *** increased odds for an abnormal general movements assessment from corticosteroid use after adjusting for gestational age[adjusted odds ratio(aOR)=5.5,95% confidence interval(CI)=1.14-26.56]was *** motor optimality scores differed between the two groups[corticosteroid group:25.5(23-26)versus no-corticosteroid group:26(24-28);z=-2.02].A motor optimality score<20 was observed in 14.8% of infants(8/54)in the corticosteroid group compared to 2% of infants(3/146)in the noncorticosteroid *** difference was significant after adjustment for gestational age(aOR 5.96,95%CI 1.28-27.74).Conclusions Abnormal early neurodevelopment was observed in infants who received systemic postnatal *** relationship between these findings and other factors influen

关键词： Corticosteroids Early neurodevelopment General movement assessment Preterm infants

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Analysis of the Current Situation and Influencing Factors of Social Isolation Among the Elderly in the Community

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Proceedings of Anticancer Research 2024年第3期8卷 150-156页

作者： Weiwei Dong Xiaohui Qi Jialiang Wang Dongmei Cui Yanling Li Shaohua Li Physical Examination Center Affiliated Hospital of Hebei UniversityBaoding 071000Hebei ProvinceChina Departement of Respiratory and Critical Care Medicine Affiliated Hospital of Hebei UniversityBaoding 071000Hebei ProvinceChina department of Neurosurgery Affiliated Hospital of Hebei UniversityBaoding 071000Hebei ProvinceChina Departement of Nursing Affiliated Hospital of Hebei UniversityBaoding 071000Hebei ProvinceChina Departement of neonatology Affiliated Hospital of Hebei UniversityBaoding 071000Hebei ProvinceChina

Objective: To investigate the current situation of social isolation among the elderly in the community, and to analyze its influencing factors. Methods: A total of 265 elderly people were selected to conduct the survey using the general information questionnaire and the Chinese version of the social isolation scale for the elderly. Results: The social isolation score of the elderly was (20.15 ± 0.23). Factors such as age, education level, economic status, and social participation ability influenced the social isolation score (P < 0.05). Conclusion: The social isolation of the elderly is more serious, and the social isolation can be alleviated by improving the level of education and the economic situation and strengthening social participation.

关键词： Community Elderly Social isolation

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Polymorphism analysis of the ABCA3 gene： association with neonatal respiratory distress syndrome in preterm infants

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Chinese Medical Journal 2012年第9期125卷 1594-1598页

作者： JIANG Lin WU Yi-dong XU Xue-feng DU Li-zhong department of neonatology Children's HospitalZhejiang University School of MedicineHangzhouZhejiang 310003China

Background Previous reports indicated that mutations in the adenosine triphosphate （ATP）-binding cassette transporter A3 （ABCA3） cause fatal respiratory failure in term infants, and common ABCA3 gene polymorphisms have been characterized at the population level in Caucasians. But the role of ABCA3 in relation to respiratory distress syndrome （RDS） in newborns has not been evaluated within a Chinese population. The aim of this study was to analyze eight single-nucleotide polymorphisms （SNPs） of the ABCA3 gene, and to assess the ABCA3 gene as a candidate gene for susceptibility to RDS in newborns.Methods Eight SNPs were selected and genotyped in 203 newborns. The data analysis and statistical tests were used for allele frequencies, haplotype and Hardy-Weinberg equilibrium pairwise linkage disequilibrium measures. Results There was a haplotype association with SNP rs313909 and SNP rs170447, but no haplotype association was observed among the newborns with and without RDS （P 〉0.05）. The minor allele frequency （G） of the coding SNP （cSNP） rs323043 （P585P） was significantly increased in preterm infants with RDS.Conclusion There is an association between a synonymous cSNP rs323043 and the development of RDS.

关键词： adenosine triphosphate-binding cassette transporter A3 respiratory distress syndrome single-nucleotide polymorphisms minor allele frequency

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Isolation of the Left Subclavian Artery in D-Transposition of the Great Arteries with Right Aortic Arch

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Congenital Heart Disease 2021年第4期16卷 369-371页

作者： Kotaro Hine Kohei Ogata Keiko Saitou Norio Mizukaki Hiroko Arai Hitoshi Yoda department of neonatology Toho University Omori Medical CenterTokyo143-8541Japan

Abnormal branching of the aorta associated with the right aortic arch(RAA)has been reported as isolation of left subclavian artery(ILSA),isolation of left common carotid artery,isolation of brachiocephalic *** is a rare aortic branch anomaly that originates in the left subclavian artery from the pulmonary artery via ductus *** reports have described ILSA associated with 22q11.2 deletion syndrome and tetralogy of ***,we present a very unusual case of RAA with ILSA associated with D-transposition of the great arteries and inferior vena cava interrupted with azygos continuation.

关键词： Isolated left subclavian artery transposition of the great arteries RAA ILSA

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Evaluation of a complex couplet care intervention in a neonatal intensive care unit:A mixed methods study protocol

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Pediatric Investigation 2024年第2期8卷 139-148页

作者： Michella Bjerregaard Anna Axelin Emma Louise Malchau Carlsen Hans Okkels Birk Ingrid Poulsen Patrick Palisz Thomas Kallemose Anne Brødsgaard department of Paediatric and Adolescent Medicine Copenhagen University Hospital Amager HvidovreHvidovreDenmark department of Public Health Faculty of HealthResearch Unit for Nursing and HealthcareUniversity of AarhusAarhusDenmark department of Nursing Science University of TurkuTurkuFinland department of Clinical Medicine Faculty of Health and Medical ScienceUniversity of CopenhagenCopenhagenDenmark department of Public Health Section of Health Service ResearchUniversity of CopenhagenCopenhagenDenmark department of People and Technology Roskilde UniversityRoskildeDenmark department of Clinical Research Copenhagen University Hospital Amager HvidovreHvidovreDenmark department of Gynaecology and Obstetrics Copenhagen University Hospital Amager HvidovreHvidovreDenmark

Background:Families with an infant in need of intensive care most often experience a harmful separation after *** is due to a division of medical specialties into neonatal care and maternal ***,a couplet care intervention is implemented for mother-infant dyads in a neonatal intensive care *** study protocol provides a comprehensive evaluation of the *** aim is to evaluate the effect and implementation of a complex couplet care intervention to promote zero separation between mother and ***:The couplet care intervention is a family-centered model of care,where treatment-requiring mother-infant dyads will be admitted together and receive couplet care by neonatal *** study adheres to the framework of the Medical Research Council and will use a mixed methods embedded design comprising a quasi-experimental trial and a qualitative process ***,a health economic evaluation will be conducted to assess the cost-effectiveness of this complex couplet care ***:Separation of mother-infant dyads after birth has an adverse impact on family health and *** study protocol evaluates a complex couplet care *** this study,a first step is taken to help bridge the gap between current practices and a new care model to prevent the separation of mothers and their infants.

关键词： Complex interventions Couplet care Family-centered care neonatology Zero separation

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Simplified lung ultrasound method to predict the respiratory support needs of neonates whose mothers had pregnancy complications: a diagnostic accuracy study

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Reproductive and Developmental Medicine 2023年第3期7卷 149-155页

作者： Xin-Ao Lin Xue-Feng Wang Xiao-Bo Fan Guan-Nan Xi Ji-Mei Wang department of neonatology Obstetrics and Gynecology Hospital of Fudan UniversityShanghai 200090China

Objective:Some pregnancy complications are associated with respiratory problems in *** identification and implementation of respiratory support are needed for these *** study aimed to(1)use lung ultrasound(LU)for predicting the respiratory support requirements of infants and(2)simplify the examination method to facilitate its clinical ***:Neonates underwent LU examinations within 1 hour of *** infants were divided into a pregnancy complication(PC)group and a control group according to their mothers'clinical *** primary outcome measure was the need for respiratory *** models were established based on the differences in LU patterns between the two *** predictive value of the models was compared with that of the LU score(LUS)system,which has been widely used in other *** models were established by analyzing the predictive effects of LU patterns in different parts of the *** reliability was tested using the receiver operating characteristic curve ***:PC and control groups had 29 and 117 neonates,respectively;a total of 22 neonates required respiratory *** PC and control groups showed differences in respiratory support requirements,A-lines,and coalesced *** percentages of A-lines and coalesced B-lines were associated with respiratory support *** optimal cutoff values for the percentages of the A-lines and coalesced B-lines were 55.7%and 24.5%,*** effects were obtained by calculating the percentage of coalesced B-lines in four areas(R3,R4,L3,and L4).These methods were judged as more visual and convenient than LUS ***:The percentages of A-line and coalesced B-lines on LU images can be used to predict the respiratory support needs of neonates whose mothers had pregnancy *** four areas(R3,R4,L3,and L4)had similar predictive values.

关键词： Lung ultrasound Respiratory support Pregnancy complications

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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： Xu-fang LI Ting-ting CHENG Rui-lian GUAN Hong LIANG Wei-neng LU Jing-hua ZHANG Mei-yi LIU Xin YU Jun LIANG Li SUN Lian ZHANG department of neonatology Guangzhou Women and Children k Medical Center Guangzhou 510010 China

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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Acupuncture in Preterm Babies during Minor Painful Procedures

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Journal of Traditional Chinese Medicine 2011年第4期31卷 308-310页

作者： Ayse Ecevit Deniz Anuk Ince Aylin Tarcan Mehmet Tugrul Cabioglu Abdullah Kurt department of Pediatrics Division of Neonatology Baskent University Faculty of Medicine Acupuncture Treatment Unit Department of Physiology Baskent University Faculty of Medicine

Objective: To evaluate analgesic effects of acupuncture in preterm neonates during minor painful procedures. Methods: Ten preterm neonates requiring heel prick for blood gas analysis were enrolled in the study, which had a crossover design. Oxygen saturation, systolic and diastolic blood pressure, respiratory rate, heart rate, and crying duration were recorded before and after heel prick. Babies were given expressed breast milk before each procedure. Patients were randomly assigned to receive acupuncture or not, and the groups were crossed over on the following day, so that patients who had received acupuncture received only breast milk, and the previous breast milk only group received both acupuncture and breast milk. The neonatal infant pain scale (NIPS) was used for pain evaluation. Results: Crying duration and NIPS pain scores during heel prick were lower in the neonates who had received acupuncture. Conclusion: Acupuncture is an effective method for the treatment of pain in neonates.

关键词： acupuncture neonatal pain non-pharmacological treatment

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The Epigenetic Switches for Neural Development and Psychiatric Disorders

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Journal of Genetics and Genomics 2013年第7期40卷 339-346页

作者： Jingwen Lv Yongjuan Xin Wenhao Zhou Zilong Qiu department of neonatology Children's Hospital of Fudan University Institute of Neuroscience Shanghai Institute of Biological SciencesChinese Academy of Sciences

The most remarkable feature of the nervous system is that the development and functions of the brain are largely reshaped by postnatal experiences, in joint with genetic landscapes. The nature vs. nurture argument reminds us that both genetic and epigenetic information is indispensable for the normal function of the brain. The epigenetic regulatory mechanisms in the central nervous system have been revealed over last a decade. Moreover, the mutations of epigenetic modulator genes have been shown to be implicated in neuropsychiatric disorders, such as autism spectrum disorders. The epigenetic study has initiated in the neuroscience field for a relative short period of time. In this review, we will summarize recent discoveries about epigenetic regulation on neural development, synaptic plasticity, learning and memory, as well as neuropsychiatric disorders. Although the comprehensive view of how epigenetic regulation contributes to the function of the brain is still not completed, the notion that brain, the most complicated organ of organisms, is profoundly shaped by epigenetic switches is widely accepted.

关键词： DNA methylation Adult neurogenesis Neural plasticity Learning and memory Autism Depression

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No relationship between mode of delivery and neonatal mortality and neurodevelopment in very low birth weight infants aged two years

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World Journal of Pediatrics 2014年第3期10卷 227-231页

作者： Jia-Jun Zhu Ying-Ying Bao Guo-Lian Zhang Li-Xin Ma Ming-Yuan Wu department of neonatology Women's HospitalZhejiang University School of MedicineHangzhou 310006China

Background:To compare neonatal mortality and neurodevelopmental outcomes at two years of age in very low birth weight infants(≤1500 g)born by cesarean with those by vaginal ***:In this retrospective,case-control study,we evaluated neonatal mortality,medical conditions and neurodevelopmental outcomes at two years of corrected age in 710 very low birth weight(VLBW)infants born between January 2005 and December *** the 710 infants,351 were born by the cesarean and 359/710 by vaginal ***:There were no significant differences in neonatal mortality between the cesarean delivery group and vaginal delivery group[56/351(15.9%)vs.71/359(19.8%),P=0.20].VLBW infants delivered by the cesarean procedure had a higher incidence of respiratory distress syndrome than those born by the vaginal route[221/351(63.0%)vs.178/359(49.6%),P<0.001].There were no differences in other neonatal morbidities,including intraventricular hemorrhage[126/351(35.9%)vs.134/359(37.3%),P=0.69],bronchopulmonary dysplasia[39/351(11%)vs.31/359(8.6%),P=0.38]and necrotising enterocolitis[40/351(11.4%)vs.32/359(8.9%),P=0.32]between the two *** incidence of poor neurodevelopment after cesarean delivery was similar to that after vaginal delivery[105/351(29.9)vs.104/359(29.0%),P=0.78].Conclusions:In neither neurodevelopment nor neonatal mortality did cesarean birth offered significant advantages to VLBW ***,the operation might be associated with an increased risk of respiratory distress syndrome for VLBW *** mode of delivery of VLBW infants should be largely based on obstetric indications and maternal considerations rather than perceived better outcomes for the neonate.

关键词： cesarean delivery neonatal mortality neurodevelopment outcomes vaginal delivery very low birth weight

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