ABSTRACT
Objective:To study the relationship between white matter injury (WMI) and brain maturity in preterm infants at full-term corrected gestational age (cGA).Methods:A retrospective study was performed in preterm infants [GA≤32 weeks or birth weight (BW) ≤1 500 g] admitted to the neonatal intensive care unit of the First Affiliated Hospital of Xi'an Jiaotong University from January 2017 to August 2018 and the Northwest Women and Children's Hospital from January 2017 to June 2017. The infants received conventional magnetic resonance imaging (MRI) at cGA 37~42 weeks. The infants were assigned into the WMI group and the control group according to the WMI scoring system, including the total maturation scores (TMS) and four sub-item scores.Results:A total of 118 premature infants were enrolled in this study (17 cases in the WMI group and 101 cases in the control group). The GA was (30.3±1.7) weeks, and BW was (1 356±268) g. The proportion of delayed TMS in the WMI group was significantly higher than the control group [58.8%(10/17) vs. 31.7%(32/101), P<0.05]. The TMS of the WMI group were significantly lower than the control group [(10.7±1.8) vs. (11.8±1.5), P<0.05]. The sub-item scores of TMS showed that the myelination [(2.8±0.6) vs. (3.1±0.4), P<0.05] and glial cell migration bands of the WMI group [(1.6±0.4) vs. (2.1±0.6), P=0.004] were significantly lower than the control group and no significant differences existed in cortical folding and involution of germinal matrix tissue scores between the two groups. Conclusions:The brain maturity of preterm infants with WMI is substantially delayed than those without WMI, including delayed myelination and delayed disappearance of glial cell migration bands.
ABSTRACT
Objective To investigate the clinical significance of measuring resting energy expenditure (REE) for guiding an accurate nutritional support in elderly bedridden patients with nasal feeding.Methods The REE of 32 elderly bedridden patients with nasal feeding was assessed by using the Cosmed K4b2 portable telemetric gas analysis system.The waist-hip ratio, serum levels of albumin, transferrin, prealbumin and retinol-binding protein were determined to assess comprehensive nutrition status.The energy intakes were calculated, and the correlation of REE and the difference between the energy intakes and consumption with nutritional index were analyzed.Results The resting energy expendture was lower in the patients with waist-hip ratio≥0.95 than in patients with waist-hip ratio ＜0.95 (t=3.622, P＜0.01).The waist-hip ratio was reduced and serum albumin and transferrin levels were decreased along with the increase of REE in elderly patients (r=-0.55,-0.36 and-0.593, respectively, P=0.001, 0.043, ＜0.001).The difference between the energy intake and expenditure was higher in patients with waist-hip ratio≥0.95 than those with waist-hip ratio＜0.95 (t =5.643, P＜ 0.001).Serum albumin, prealbumin, transferrin and retinol-binding protein levels were increased along with the increase of the difference between the energy intake and expenditure, which showed the positive correlations (r=0.525, 0.409, 0.624, 0.414, respectively,P=0.002, 0.02, ＜0.001, 0.019).Conclusions Precise determination of REE and energy intake guided by REE are the important guarantees for the reasonable nutrition support in the elderly.
ABSTRACT
Objective To investigate the change of the first-phase insulin secretion in impaired glucose regulation and its influencing factors.Methods The investigation was performed in 1024 subjects who were selected by cluster sampling.The body waist circumference (WC) was examined in these subjects.Oral glucose tolerance test was performed,and fasting plasma glucose,fasting insulin as well as 30-,60-,and 120-minute plasma glucose and insulin after glucose intake were also tested.All the 1024 subjects were divided into 5 groups based on the results of oral glucose tolerance test:normal glucose tolerance group,impaired fasting glucose group,impaired glucose tolerance group,impaired fasting glucos/impaired glucose tolerance group,and diabetes mellitus group.First-phase insulin secretion index (the ratio of change in insulin to change in glucose during the first 30 minutes after glucose ingestion was calculated.Results Compared with normal glucose tolerance group (1.96 ± 1.03),the first-phase insulin secretion index significantly decreased in the impaired fasting glucose group (1.79 ±0.91) (P =0.007),the impaired glucose tolerance group (1.81 ± 0.97) (P =0.007),the impaired fasting glucose / impaired glucose tolerance group (1.59 ± 0.85) (P =0.005),and the diabetes mellitus group (1.30 ± 0.60) (P =0.004).Logistic regression analysis showed that WC was the strongest influencing factor of first-phase insulin secretion (β =0.716,P =0.000).Conclusions The firstphase insulin secretion index has already dropped in the stage of impaired glucose regulation.WC can be a useful indicator for evaluating first-phase insulin secretion.