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Objectives To explore the associations between higher antibiotic use rates (AURs) and adverse outcomes in very-low-birthweight (VLBW) infants without culture-proven sepsis or necrotizing enterocolitis (NEC) in a multicenter of China. Methods A prospective cohort study was performed on VLBW infants admitted to 24 neonatal intensive care units from January 1, 2018, to December 31, 2018. AUR was calculated as calendar days of antibiotic therapy divided by total hospital days. The composite primary outcome was defned as mortality or severe morbidity, including any of the following: severe neurologic injury, bronchopulmonary dysplasia (BPD), and stage 3 or higher retinopathy of prematurity. Results A total of 1,034 VLBW infants who received antibiotics without culture-proven sepsis or NEC were included in this study. The overall AUR of eligible VLBW infants was 55%, and the AUR of each eligible VLBW infant ranged from 3 to 100%, with a median of 56% (IQR 33%, 86%). After generalized propensity score and logistic regression analysis of 4 groups of VLBW infants with diferent AUR range, infants in the higher quartile AUR, (Q3, 0.57~0.86) and (Q4, 0.87~1.00), had higher odds of composite primary outcome (adjusted OR: 1.81; 95% CI: 1.23–2.67; adjusted OR 2.37; 95% CI: 1.59–3.54, respectively) and BPD (adjusted OR: 3.09; 95% CI: 1.52–6.57; adjusted OR 3.17; 95% CI: 1.56–6.57, respectively) than those in the lowest AUR (Q1). Conclusions Antibiotic overexposure in VLBW infants without culture-proven sepsis or NEC was associated with increased risk of composite primary outcome and BPD. Rational empirical antibiotic use in VLBW infants is urgently needed in China.
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Aims: With pickled perilla leaves as raw materials, this paper proposed the optimal ethanol extraction conditions and made a profound analysis for extract in the compositions of major active ingredients, nutrients, mineral elements and amino acid to characterize the nutritional and biological properties of pickled perilla leaves, which could aid its finely processing and future application in the development of functional food. Methods: The optimum ethanol extraction process for preparing freeze-dried powder from pickled perilla was studied by means of orthogonal experiments, with the concentration of ethanol, extracting temperature and extracting time as factors. Meanwhile, the contents of the activity components, such as polysaccharide, flavones and rosmarinic acid, as well as the mineral elements and nutritional contents in the freezedried powder were determined according to the methods reported by relevant literatures without or with a few modifications. Results: The optimal extracting conditions as follows: 50ºC of temperature, 60 min of extraction time and 80% of ethanol concentration. Under the optimal extracting conditions, the extraction rate of the freeze-dried powder was 1.71%. Moreover, perilla leaf extract contained rich biological and nutritional ingredients, including 33.39% of flavonoids, 9.24% of polysaccharides, 22.79% of rosmarinic acid, 5.47% of protein, 7.61% of fat, 2354 mg/kg of Ca, 111.4 mg/kg of Fe, 5.045 mg/kg of Zn, 1817 mg/kg of K , 12.66 mg/kg of Mn and nine of essential amino acids. In addition, perilla leaf extract exhibited obvious scavenging effects on the DPPH•, •OH and O2 •. Conclusion: In summary, pickled perilla leaf ethanol extract was rich in biological ingredients as well as a variety of nutrients, and showed antioxidant activities in vitro, thus it is valuable and promising in the development of functional foods in the future.