Progress on the role of circRNAs in lung development / 国际儿科学杂志

Many circular RNAs(circRNAs)have been discovered and identified as noncoding RNA in various organisms in a specie-, tissue-, disease-and developmental stage-specific manner, and have been demonstrated to play essential roles in myriad life processes, such as embryo and tissue development, aging, insulin secretion, vascular disease and cancer.The normal development of lung morphology, structure and function is the physiological basis of breath.Accumulating evidences have been demonstrated that circRNAs might be involved in lung development and play important roles in lung development and related diseases like bronchopulmonary dysplasia(BPD).This review will summarize the biological functions of circRNAs and focus particularly on the potential implications of circRNAs in lung development and BPD.

Progress of biomarkers related to neonatal necrotizing enterocolitis / 国际儿科学杂志

Neonatal necrotizing enterocolitis(NEC)is a life-threatening intestinal disease in newborns, and early identification of NEC is a major clinical challenge.Although clinical manifestations, routine laboratory tests and imaging examinations are essential for NEC, more and more studies in recent years based on the understanding of the pathogenesis of NEC have reported that NEC-related biomarkers such as fatty acid-binding proteins, cytokines, and intestinal flora have potential value in its prediction, early diagnosis, severity assessment and prognosis.This review will discuss the biomarkers related to NEC that have been studied in recent years from three aspects: blood, urine and feces, so as to guide clinical application.

Progress of major biomarkers for neonatal brain injury in clinical application / 国际儿科学杂志

With the continuous progress of monitoring and treatment skills, the mortality of neonates has gradually decreased, and the long-term neurodevelopmental outcome has become the primary concern of society and families.During the perinatal period, the developing brain is vulnerable to hypoxia, hemorrhage, infection and inflammation, which may cause varying degrees of brain cell damage.Studies have found that proteins released by damaged brain cells can be detected in the body fluid of neonates, which are related to the occurrence and prognosis of neonatal brain injury.This article mainly reviews the recently reported brain injury biomarkers such as S100B, neuron specific enolase(NSE)and glial fibrillary acidic protein(GFAP)in different biological samples and its clinical predictive value for the occurrence of brain injury and neurodevelopmental prognosis.

Fetal/neonatal atrial flutter at the onset of perinatal period: clinical analysis of 21 cases / 中华围产医学杂志

Objective:To analyze the clinical features, treatment, and outcomes of fetal/neonatal atrial flutter (AFL) at the onset of the perinatal period to improve the management of this condition.Methods:This retrospective study analyzed the clinical data, treatment, and follow-up results of fetal/neonatal AFL cases transferred to Shanghai Children's Medical Center from November 2013 to August 2021. Clinical characteristics, cardioversion procedures, and outcomes were summarized. Descriptive method was used for statistical analysis.Results:A total of 21 fetuses/neonates presenting with AFL in the perinatal period were involved in this study, including 17 males and four females. Ten of them were born at full term, and 11 were preterms. All of the patients were delivered by cesarean section at 32 to 41 gestational weeks [ (36.6±1.9) weeks] with a birth weight of 2 130 to 4 450g [ (3 059±528) g]. Increased fetal heart rate was all detected after 32 weeks of gestation, and three of them were diagnosed with AFL by fetal echocardiography before being born. The heart rate remained elevated in all cases after birth. All were diagnosed as AFL based on an electrocardiogram on the day of birth, which showed a 2 to 6 over one ratio of atrioventricular conduction. Among the six cases of cardiac insufficiency and low blood pressure complicated by dyspnea and cyanosis, the symptoms were relieved in four cases after mask oxygenation and two cases after ventilation. Among the 21 cases, one was converted spontaneously to normal sinus rhythm and the other 20 recovered after medication or electrical cardioversion. Seven cases were initially treated by drug conversion with a success rate of 5/7 and hospitalized for 23 d (13-25 d). There was one with cardiac insufficiency before treatment and three newly developed cardiac insufficiency during treatment among the seven cases. Thirteen cases were offered electrical cardioversion initially, and the success rate of cardioversion was 12/13. There were five cases of cardiac insufficiency before treatment, while no new cases of cardiac insufficiency was reported during treatment. The duration of hospitalization was 11 d (9-14 d). Apart from one case, the rest 20 infants were followed up from one month to eight years old, and no recurrence was reported.Conclusions:For fetal/neonatal AFL with the onset during the perinatal period, the symptoms mainly manifest in late pregnancy. Its diagnosis depends on fetal echocardiography before birth or electrocardiogram after birth, and electrical cardioversion is a fast and effective measure. While the prognosis of perinatal-onset AFL is generally good.

Clinical analysis of 7 cases of community-acquired Novel Coronavirus Omicron variant infection in neonates / 中国新生儿科杂志

Objective:To study the clinical characteristics of neonatal community-acquired Novel Coronavirus (COVID-19) Omicron variant infection.Methods:From March 30 to May 15, 2022, the epidemiological characteristics, clinical manifestations and outcomes of neonatal cases of community-acquired COVID-19 Omicron variant infection admitted to the isolation ward of our hospital were analyzed.Results:A total of 7 neonates infected with community-acquired COVID-19 Omicron variant were treated, including 3 males and 4 females. All of them were term infants with clear epidemiological exposure history. The infection was originated from caregivers of close contact (parents or babysitters). The main clinical symptoms was upper respiratory tract infection, including fever (6 cases), nasal congestion (6 cases), cough (5 cases), runny nose (2 cases), poor appetite (2 cases) and diarrhea (1 case). On admission, no abnormalities were found in blood routine examination and C-reactive protein (CRP). All but one case had normal serum amyloid A (SAA). No obvious abnormalities were found on chest X-ray. All patients were isolated in single-patient rooms after admission. They received standard symptomatic treatment and regular nucleic acid tests. The first negative nucleic acid results came on median 17 d(8~26 d) after the onset of the disease. The patients were discharged after two consecutive (24 h apart) nucleic acid tests with CT value ≥35 and continued health-monitor at home. On discharge, 5 patients had nasal congestion and 2 of them had cough. During the follow-up 4~6 weeks after discharge, all patients gradually recovered without positive nucleic acid results.Conclusions:All 7 neonates with community-acquired COVID-19 Omicron variant infection have epidemiological exposure history. The main clinical symptoms are long-lasting upper respiratory tract infections. It takes a relatively long time for the nucleic acid to turn negative, however, the overall short-term prognosis is good.

Progress on association of perinatal depression and neurobehavioral development in offspring / 中华围产医学杂志

Perinatal depression can cause adverse effects not only on maternal physical and mental health, but also abnormalities or damage to the brain structure and function of the offspring, resulting in short- or long-term effects on neurobehavioral development. This review summarizes the progress in this field and elaborates the mechanism from a neuroendocrinology and epigenetics point of view.

Risk prediction of neonatal hyperbilirubinemia / 中国新生儿科杂志

Objective:To study the predictive value of hour-specific total serum bilirubin(TSB) nomogram combined with clinical risk factors in the risk of hyperbilirubinemia.Method:Perinatal clinical data of newborns born in Shanghai Pudong New Area Health Care Hospital for Women and Children, Shanghai Pudong New Area People's Hospital and Shanghai Pudong Hospital from August 2017 to July 2018 were collected in this prospective study. Transcutaneous bilirubin (TcB) was monitored before discharge from hospital. Enrolled neonates were followed up for 28 days. The patients were assigned to neonatal hyperbilirubinemia group (NHB) and non-hyperbilirubinemia group (Non-HB) according to the occurrence of hyperbilirubinemia. The predictive value of models for the risk of hyperbilirubinemia was evaluated by receiver operating characteristic (ROC) curves and Logistic regression analysis.Result:A total of 8 664 newborns were included in this study, with 1 196 cases of hyperbilirubinemia, with an incidence of 13.8%. Logistic regression analysis showed that maternal blood type O, premature rupture of membranes, male gender, gestational age 35~37 weeks, subcutaneous ecchymosis/cranial edema, and breastfeeding were independent risk factors for NHB ( P<0.05). The area under receiver operative characteristic curve (ROC) of predischarge bilirubin risk zone only was 0.874(95% CI 0.861~0.885, P<0.05)and for all independent risk factors was 0.664 (95% CI 0.647~0.680, P<0.05). The area under ROC curve was 0.891 (95% CI 0.880~0.902, P<0.05) by combining predischarge bilirubin risk zone with clinical risk factors. Conclusion:Predischarge bilirubin risk zone combined with clinical risk factors can reasonably predict neonatal hyperbilirubinemia well.

The role of montelukast in the prevention and treatment of bronchopulmonary dysplasia in premature infants / 国际儿科学杂志

Bronchopulmonary dysplasia is one of the most common chronic respiratory diseases in premature infants, especially in very low birth weight infants.Lung immaturity, inflammatory injury, oxidative stress and abnormal repair after injury are the important factors.Leukotriene is an inflammatory mediator of 5-lipoxygenase pathway and participates in the occurrence of bronchopulmonary dysplasia.Montelukast, as a leukotriene receptor antagonist, may play a role in the treatment of bronchopulmonary dysplasia through anti-inflammation, anti-oxidation and anti-fibrosis.This article will review the potential mechanism and related clinical researches of montelukast which is used in treating bronchopulmonary dysplasia.

The clinical application of dexmedetomidine in neonates / 国际儿科学杂志

Dexmedetomidine exerts sedative, analgesic and anti-sympathetic effects mainly through activating α2-adrenergic receptors in the presynaptic and posterior membranes.It has little influence on respiratory system as well as hematological dynamics.In addition, it can be administered by nasal instillation with fast effect, minor trauma and proper duration of action.In recent years, it has been gradually used in neonatal anesthesia assistance, sedation and analgesia of mechanical ventilation, auxiliary examination, etc.This article reviews the progress in clinical application of dexmedetomidine in neonates.

Effect of high sn-2 palmitate infant formula on the excretion of fatty acids, calcium and magnesium in infants / 中华临床营养杂志

Objective To explore the effect of high sn-2 palmitate infant formula (HPIF) on stool frequency and consistency,fatty acids,calcium and magnesium contents in infants.Methods A prospective,double-blind,randomized,controlled clinical study was conducted including 94 healthy mature infants of single birth and appropriate for gestational age,born from June 2013 to December 2014.All eligible infants were enrolled within 21 days after birth.All the infant formula fed subjects were divided randomly into two groups as standard infant formula (IF) group and high sn-2 palmitate infant formula (HPIF) group.Breast-fed infants were enrolled as control group (BF group).All infants were followed up until 90 days old.The growth indexes and defecation status of the three groups were monitored dynamically.Meanwhile,stool fatty acid profile and mineral contents were also detected.Results There was no significant difference in head circumference,body length and body weight among the three groups at enrollment,42 days and 90 days old.The stool frequency and mushy stool frequency of HPIF and IF groups were significantly lower than that of BF group at 42 days and 90 days old;formed stool frequency was higher in HPIF and IF groups than in BF group.The fecal palmitic acid level in dry feces was significantly higher in HPIF and IF groups than in BF group [(31.1 ± 9.8),(30.9± 10.7) vs.(10.8± 8.8) mg/g] at 42 days old.At 90 days old,the fecal palmitic acid level in dry feces was significantly lower in HPIF group than in IF group [(24.3± 9.8) vs.(29.9± 7.9) mg/mg],while was significantly higher in both infant formula fed groups than in BF group [(8.9± 8.4) mg/g].The fecal calcium level in dry feces of HPIF and IF groups were significantly higher than that of BF group [(38.3± 14.0),(38.8± 15.5) vs.(21.3± 13.7) mg/g] at 42 days old.At 90 days old,the fecal calcium level in dry feces of HPIF group was significantly lower than that of IF group [(31.1 11.2) vs.(45.9 ± 16.5) mg/g,dry stool] and significantly higher than that of BF group [(21.5 ± 9.9) mg/g].The fecal magnesium level was similar between HPIF and IF groups,and significantly higher than that of BF group at 42 days and 90 days old.The fecal calcium level was positively correlated with the content of fecal palmitic acid among three groups (r =0.43,P＜ 0.01).Conclusions Breast milk is the best food for infants.Compared with standard infant formula,feeding with high sn-2 palmitate infant formula can reduce the fecal excretion of calcium and palmitic acid,making it closer to the level of breast-fed infants.

Macrophage activation syndrome in a newborn of adult-onset Still's disease mother: a case report and literature review / 中国新生儿科杂志

Objective To study the clinical characteristics of neonatal macrophage activation syndrome (MAS) associated with maternal rheumatic diseases and improve the understanding of neonatal MAS.Method Clinical data of MAS in a newborn infant with adult-onset Still's disease (AOSD) mother was retrospectively studied.From the establishment day of databases (CNKI,VIP,Wanfang,Pubmed and Embase) to December 2017,literature were retrieved with key words including "newborn","macrophage activation syndrome" and "hemophagocytic lymphohistiocytosis (HLH) ".Clinical features of infant MAS/HLH with maternal rheumatic diseases were summarized.Result A 27-day-old boy with AOSD mother manifested with fever,watery stools,irritability,prominent enlargement of right parotid gland and right cervical lymphadenitis.The infant was diagnosed with MAS due to coagulopathy,multiple organ dysfunction,hypofibrinogenemia and increased levels of ferritin.Anti-SSA/Ro52kD and stool rotavims antigen were positive.The infant recovered with intravenous immunoglobulin and steroids therapy.Follow-up at 2-year-old were normal.A total of 3 other cases of neonatal MAS/HLH were retrieved.All patients had high fever,hepatosplenomegaly and multiple organ dysfunction,impaired digestive system (abdominal distention,diarrhea and ascites),disseminated intravascular coagulation (2 cases),mental disorders (1 case),complete atrioventricular block (1 case) and severe hypotension (1 case).Laboratory results showed thrombocytopenia,elevated level of hepatic enzyme and serum ferritin in all patients.Targeted panel-based next generation sequencing were all negative for pathogenic gene mutations.After treatments of steroids,intravenous immunoglobulin and chemotherapy,all patients improved and ultimately cured.Conclusion In view of the impacts of the maternal rheumatic diseases on fetus,newborns with early onset high fever and hepatosplenomegaly should be suspected of MAS.Early diagnosis and effective treatment are crucial for clinical improvement.

Neonatal cardiac arrhythmia: a retrospective analysis of 128 cases / 中国新生儿科杂志

Objective To discuss the clinical features,pathogenesis,diagnosis,treatment and therapeutic outcome of neonatal cardiac arrhythmia.Method The clinical data of newborns with arrhythmia admitted from May 2013 to May 2018 were analyzed retrospectively.All cases were grouped into benign and non-benign arrhythmia groups according to the severity of clinical manifestations.The clinical features,pathogenesis,diagnosis,treatment and therapeutic outcome of them were compared.Result There were 128 cases including 89 (69.5％) males,39 (30.5％) females;106 (82.8％) full-term infants,22 (17.2％) premature infants;39 (30.5％) atrial premature contraction,5 (3.9％) atrial tachycardia,10 (7.8％) atrial flutter,36 (28.1％) paroxysmal supraventricular tachycardia,26 (20.3％) ventricular premature contraction,12(9.4％) atrioventricular block;65 cases (50.8％) were benign arrhythmia and 63 cases (49.2％) were non-benign.52 cases (40.6％) showed noncardiac symptoms (including 10 cases of shortness of breath,9 cases of pallor or cyanosis,5 cases of refusal to suck,3 cases of grunting,25 cases with two or more than two kinds of clinical symptoms),and 76 cases (59.4％) were asymptomatic;31 cases (24.2％) were cardiac insufficiency.The three common causes of neonatal cardiac arrhythmia were:32 (25％) cases by infection,20 (15.6％) cases by perinatal asphyxia,19 (14.8％) cases were congenital heart disease;87 (68.0％) cases were mainly treated with primary diseases.41 cases (32.0％) were treated with antiarrhythmic drugs or cardioversion.There was significant difference in gender,noncardiac symptoms,cardiac insufficiency,age of onset,days of hospitalization,cardiac troponin Ⅰ and creatine kinase isoenzyme between the two groups (P ＜ 0.05).Conclusion Neonatal cardiac arrhythmias should be considered and evaluated with shortness of breath,cyanosis or pallor and rejection refusal of milk.High risk factors of neonatal cardiac arrhythmias included infection,perinatal asphyxia and congenital heart disease.Benign and non-benign arrhythmia should be identified.

Congenital disorder of glycosylation type Ⅰg: a case report and literature review / 中国新生儿科杂志

Objective To study the clinical features,diagnosis,genetic characteristics and treatment of congenital disorder of glycosylation type Ⅰg (CDG-Ⅰg) and to raise the awareness of CDG-Ⅰg among the clinicians.Method The data of one child with CDG-Ⅰg admitted to Shanghai Children's Medical Center affiliated to Shanghai Jiaotong University School of Medicine was studied retrospectively.Literatures were retrieved with key words including "congenital glycosylation disorder Ⅰg","ALG12","congenital glycosylation defect Ⅰg","CDG-Ⅰg" and "congenital disorder" in the Chinese knowledge network,VP database,Wanfang database,Biomedicine,PubMed and the Web of Science database from data established until January 2018.We summarized the clinical and genetic characteristics of CDG-Ⅰg.Result An one-day-old male infant admitted to the Hospital due to "poor response with hypoglycemia" manifested with facial deformity,hypotonia,inverted nipples,micropenis and undescended testes.He had intermittent hypoglycemia and recurrent infection,treated with antimicrobials,glucose rehydration and hormone therapy.Serum insulin,growth hormone level,blood and urine metabolic screening were normal.The patient was compound heterozygous for ALG12 mutations,c.432C ＞ A,p.Cys144 * and c.904T ＞ C,p.Tyr302His,each of his parents carried a pathogenic mutation.The patient died in follow-up for unknown reasons.No reported cases of CDG-Ⅰg from China have so far been reported yet.We reviewed the other 8 cases CDG-Ⅰg (4 males and 4 females) born in foreign countries,5 of them with neonatal onset.Common clinical manifestaions include facial deformity,hypotonia,hypogenitalism,coagulopathy,hypoimmunity,recurrent infection,electroyte imbalance etc.The ALG12 gene has 11 mutation sites.Conclusion CDG-Ⅰg is a rare autosomal recessive disorder.Most reported patients had onset in neonatal period.It seems that the association of facial deformity,psychomotor retardation,hypotonia,coagulopathy,male hypogenitalism and hypoglycemia might be a clue to the diagnosis of CDG-Ⅰg.Gene detection of ALG12 can confirm the diagnosis.This disorder has no specific treatment yet.

Vitamin D level in cord blood and neonatal outcomes in a birth cohort study in Shanghai / 临床儿科杂志

Objectives To detect the cord blood vitamin D level in neonates and to determine the association between the cord blood vitamin D level and neonatal outcomes. Methods A total of 223 eligible mother-and-singleton-offspring pairs were recruited. The information of mothers' pregnancy was collected by questionnaires. The weight, length, and head circumference of neonates were measured. The levels of 25(OH)D in cord blood of neonates and in blood of late pregnancy mothers were determined by chemiluminescence immunoassay. Results The median concentration of 25(OH)D in cord blood was 20.7 nmol/L, and 82.1% of neonate had vitamin D deficiency, and 12.1% had severe vitamin D deficiency (0.05). After the variables of sex, gestational age and birth season are controlled, the birth weight and head circumference were significantly different in neonates with different concentrations of 25(OH)D in cord blood (P<0.05). Conclusions The concentration of 25(OH)D in cord blood in term neonates was generally lower. The vitamin D status in neonates was consistet with that in their late pregnancy mothers. Cord blood 25(OH) D levels were associated with neonates' birth weight and head circumference, but it should be confirmed by larger sample size in the future.

Correlation of severe neonatal hyperbilirubinemia and hearing damage / 上海交通大学学报（医学版）

Objective · To investigate the risk factors of hearing damage in child patients with severe neonatal hyperbilirubinemia (NHB) and follow up their prognosis. Methods · Clinical data of 106 newborns with severe NHB in neonatal ward of Shanghai Children's Medical Center from June 2015 to June 2016 were retrospectively analyzed. According to total serum bilirubin (TSB) level, they were divided into three groups, severe NHB group (342.0 μmol/L<TSB peak <427.5 μmol/L), very severe NHB group (TSB peak range 427.5-513.0 μmol/L), and fatal NHB group (TSB peak >513.0 μmol/L). Automatic auditory brainstem response (AABR) was used to evaluate the hearing ability of children in hospital, while those who got abnormal results would undergo diagnostic test of auditory brainstem response (ABR) when 3 months old. Auditory behavioral response of all 106 child patients at 3 and 6 months old were followed up. Results · There were totally 106 cases in three groups, among which 33 cases (33/106, 31.13%) got abnormal results at hearing screening in hospital, 22 cases (22/86, 25.58%) in severe NHB group, 9 cases (9/16, 56.25%) in very severe NHB group, and 2 cases (2/4, 50.00%) in fatal NHB group. The difference between groups was statistically significant (all P<0.05). All 33 patients not passing AABR in hospital came to undergo diagnostic test of ABR through regular education by a specially assigned person when 3 months old. Two children were diagnosed mild hearing damage. One of them was considered being caused by tympanitis. All children had good situation of auditory behavioral response at 3 and 6 months old in follow-up. Conclusion · Severe NHB is one of the high risk factors of hearing damage in neonates. The morbidity of hearing damage was higher with the increase of TSB level. The hearing damage caused by severe NHB might be reversible. It also suggested that the follow-up plan should be improved. The hearing damage caused by severe NHB might have no obvious effect on children in daily life, but long term follow-up of these children is still needed.

Correlation of severe neonatal hyperbilirubinemia and hearing damage / 上海交通大学学报（医学版）

Objective · To investigate the risk factors of hearing damage in child patients with severe neonatal hyperbilirubinemia (NHB) and follow up their prognosis. Methods · Clinical data of 106 newborns with severe NHB in neonatal ward of Shanghai Children's Medical Center from June 2015 to June 2016 were retrospectively analyzed. According to total serum bilirubin (TSB) level, they were divided into three groups, severe NHB group (342.0 μmol/L<TSB peak <427.5 μmol/L), very severe NHB group (TSB peak range 427.5-513.0 μmol/L), and fatal NHB group (TSB peak >513.0 μmol/L). Automatic auditory brainstem response (AABR) was used to evaluate the hearing ability of children in hospital, while those who got abnormal results would undergo diagnostic test of auditory brainstem response (ABR) when 3 months old. Auditory behavioral response of all 106 child patients at 3 and 6 months old were followed up. Results · There were totally 106 cases in three groups, among which 33 cases (33/106, 31.13%) got abnormal results at hearing screening in hospital, 22 cases (22/86, 25.58%) in severe NHB group, 9 cases (9/16, 56.25%) in very severe NHB group, and 2 cases (2/4, 50.00%) in fatal NHB group. The difference between groups was statistically significant (all P<0.05). All 33 patients not passing AABR in hospital came to undergo diagnostic test of ABR through regular education by a specially assigned person when 3 months old. Two children were diagnosed mild hearing damage. One of them was considered being caused by tympanitis. All children had good situation of auditory behavioral response at 3 and 6 months old in follow-up. Conclusion · Severe NHB is one of the high risk factors of hearing damage in neonates. The morbidity of hearing damage was higher with the increase of TSB level. The hearing damage caused by severe NHB might be reversible. It also suggested that the follow-up plan should be improved. The hearing damage caused by severe NHB might have no obvious effect on children in daily life, but long term follow-up of these children is still needed.

Effects of early postnatal nutrition on adult-onset insulin resistance in Sprague-Dawley rats / 中华围产医学杂志

Objective To explore the effects of early postnatal nutrition on adult-onset insulin resistance by an artificial nutrition intervention during the critical period. Methods On postnatal day 2, Sprague-Dawley rats were assigned randomly to overnutrition (SL), normonutrition (NL) and undernutrition (LL) via artificially adjusting the number of pups nursed per dam. Litter size was adjusted to 3 pups/dam, 10 pups/dam and 20 pups/dam for the SL, NL and LL groups, respectively. There were eight litters for each group. All the pups were nursed by their natural dams and fed with a standard rodent laboratory chow. The pups were weaned on postnatal day 21 and three male pups from each litter were separated. After that, all male rats were housed three per cage and fed standard chow until 16 weeks old. At 3 and 16 weeks, rats were killed after overnight fasting and blood was collected. Liver, gastrocnemius muscle and perirenal and epididymal fat pads were dissected and weighed to calculate relative mass after normalization for body weight. Physiological parameters, biochemical values and insulin resistance status, including serum insulin level, homeostasis model assessment for insulin resistance (HOMA-IR) index and intraperitoneal glucose tolerance test (IPGTT), were dynamically monitored. Analysis of variance was used for statistical analysis. Results (1) Before weaning, the body weights of SL rats were significantly heavier than NL rats after postnatal day 10, and weights of LL rats were significantly lower than NL rats after postnatal day 7. After weaning, body weights of SL rats still remained heavier and weights of LL rats continued to be lower than NL rats (P<0.05). (2) At 3 weeks, the weights of liver and perirenal and epididymal fat pads in SL rats were significantly heavier than NL rats, whereas LL rats were lower than NL rats (P<0.05). At 16 weeks, the weights of liver, epididymal fat pads and gastrocnemius muscle in SL rats were significantly heavier than NL rats. Meanwhile, the weights of all detected tissues in LL rats were lower than the NL group. The weights of epididymal fat pads after normalization for body weight in the SL group were heavier than the NL group (P<0.05). (3) At 3 weeks, the fasting serum glucose level of the SL group was significantly higher than the NL and LL groups [(7.77±1.10) vs (6.33±1.20) and (5.80±1.51) mmol/L, respectively, F=13.217, P<0.01]. At 16 weeks of age, the serum insulin level in SL rats significantly increased compared to NL and LL rats [(0.31±0.11) vs (0.16±0.08) and (0.14±0.11) ng/ml, respectively, F=5.369, P=0.017]. For HOMA-IR evaluation, the index was significantly lower in LL rats compared to NL and LL rats at 3 weeks of age [(0.09±0.01) vs (0.25±0.01) and (0.31±0.05), respectively, F=25.923, P=0.005]. At 16 weeks, the index was significantly elevated in SL rats compared to NL and LL rats [(1.77±0.53) vs (0.84±0.44) and (0.83±0.67), respectively, F=5.765, P=0.015]. Furthermore, IPGTT was performed in all groups at 14 weeks of age. SL rats had significantly higher serum glucose levels at 60 min and a significantly increased area under the curve when compared to NL and LL rats (all P<0.05). (4) Serum from 16 week old SL rats was found to contain significantly higher levels of albumin, triglycerides and free fatty acids compared to NL rats (all P<0.05). Conclusions Early postnatal overnutrition induces persistent overweight and visceral white adipose accumulation in rats, while early postnatal undernutrition show the opposite effects. Early postnatal overnutrition may lead to adult-onset insulin resistance in rats. Avoiding overnutrition during the early postnatal period, a critical window for growth and development, may prevent or decrease later metabolic risks.

The relationship between the doses in parenteral nutrition and short term outcomes in very low birth weight ;infants / 临床儿科杂志

Objective To compare the effects of different doses of amino acids and fat emulsions in parenteral nutrition on the incidence of complications and prognosis in very low birth weight infants (VLBWI). Methods The clinical data of 328 VLBWI who received nutrition support therapy for at least 5 days starting in 72 h after birth during January 2005 to December 2014 , were retrospectively analyzed. According to the dosage in parenteral nutrition, patients were divided into low-dose group and high-dose group. The incidence of complications and prognosis between two groups were compared. Results There were 204 cases in low-dose group and 124 cases in high-dose group. Compared with the low-dose group, the incidence of complications was lower in high-dose group during hospitalization and the incidence of intracranial hemorrhage was reduced most;the incidence of developmental retardation was lower at discharge;the overall incidence of metabolic complications of parenteral nutrition was higher, among which the incidence of high blood glucose, electrolyte disturbance and cholestasis were increased and the incidence of hypoglycemia was lower, and the differences were all statistically signiifcant (P??0 . 05 ). Conclutsions VLBWI can tolerate early aggressive parenteral nutrition which can reduce the incidence of extrauterine growth retardation and premature complications.

Early postnatal overnutrition results in insulin resistance in adulthood / 中华内分泌代谢杂志

Overnutrition during the early postnatal life,a critical time window for growth and development,may induce metabolic syndrome later in life,including overweight/obesity and insulin resistance.The important target organs of insulin,such as liver,adipose tissue,skeletal muscle,and central nervous systems show insulin resistance.The involved mechanisms include abnormality of insulin signal pathway,increment of free fatty acid and some adipocytokines,oxidative stress,maladjustment of orexigenic and anorexigenic neuron,modifications of the hypothalamic-pituitary-adrenal glucocorticoid axis as well as epigenetic,etc.Hence,overnutrition should be avoided during the early postnatal life,so as to decrease the risk of developing long-term insulin resistance.

The physiological function of plamitic acid content at sn-2 position of triglyceride in human milk / 国际儿科学杂志

The enrichment of plamitic acid at sn-2 position of triglyceride in human milk improves a high efficiency of fatty acid absorption,softer stools and prevention of calcium malabsorption in infants.Meanwhile,it increases early bone mineralization and development,adjusts the composition of the intestinal microflora.It also may lower the extent and severity of intestinal inflammation after injury and modulate early infant crying.