Risk factors of hypoglycemia in late preterm infants / 中国新生儿科杂志

Objective:To study the risk factors of hypoglycemia in late preterm infants.Methods:From January 2019 to December 2021, late premature infants admitted to NICU of our hospital were retrospectively studied. The infants with hypoglycemia were assigned into the hypoglycemia group and infants with same gestational age and normoglycemia were assigned into the control group in a 1∶1 ratio. The perinatal and maternal data of the two groups were compared. Multivariate logistic regression analysis was used to determine the risk factors of hypoglycemia in late premature infants.Results:A total of 366 cases each were included in the hypoglycemia group and the control group. No significant difference existed in birth weight between the two groups ( P>0.05). Multivariate logistic regression analysis showed that antenatal corticosteroid ( OR=1.567, 95% CI 1.127-2.180), cesarean section ( OR=2.013, 95% CI 1.376-2.944), twin birth ( OR=2.241, 95% CI 1.479-3.396) and infant of a diabetic mother ( OR=1.635, 95% CI 1.131-2.365) were the risk factors of hypoglycemia in late preterm infants ( P<0.05). Conclusions:Antenatal corticosteroid, cesarean section, twin birth and infant of a diabetic mother are independent risk factors for hypoglycemia in late preterm infants.

Research progress of Wnt pathway regulating NSCs in the repair of spinal cord injuries / 国际外科学杂志

Spinal cord injuries is an extremely serious central nervous system injury. The clinical prognosis is very poor. Patients are often associated with lifelong disabilities or paralysis. Regulating NSCs to repair spinal cord injuries is unanimously considered to be a very potential option for the treatment of this type of disease. China has a large population and a large number of patients with spinal cord injuries. Actively regulating spinal cord NSCs is of great significance for the regeneration and repair of spinal cord injuries. Endogenous NSCs avoid many disadvantages of exogenous stem cell transplantation, and have a broader prospect in the treatment of spinal cord injuries. The Wnt signaling pathway plays a very important role in the differentiation of NSCs and the development of the nervous system. However, the molecular mechanism of the proliferation and differentiation of NSCs during regeneration and repair after spinal cord injuries is still not fully understood. This article mainly describes the research progress of Wnt pathway regulating NSCs in the regeneration and repair of spinal cord injuries.

Risk factors for the failure of the INSURE strategy in premature infants with respiratory distress syndrome / 中华实用儿科临床杂志

Objective To analyze the risk factors for the failure of the intubate-surfactant-extubate to continuous positive airway pressure (INSURE) strategy in preterm infants with respiratory distress syndrome (RDS).Methods Premature infants with gestation age ＜ 34 weeks and hospitalized between August 2016 and November 2018 in Department of Neonatology,Xiamen Maternal and Child Health Hospital were eligible for this descriptive study,and were classified into 2 groups:INSURE success group (281 cases),and INSURE failure group (70 cases),according to whether the infants need to be re-intubated and have invasive ventilator therapy within 72 hours after birth.The clinic information of premature infants in different groups were analyzed.Results The failure rate of INSURE strategy was 19.9％ (70/35I cases).Compared with the success group,the premature infants in failure group had smaller gestational age [31.9 (30.0,32.6) weeks] and lower 1 minute Apgar score (8.0 ± 1.9) scores (Z =10.533,t =2.354,all P ＜0.05).The incidence of male infants (74.3％),patent ductus arteriosus (PDA) (12.9％ without PDA,26.8％ ＜0.25 cm,28.3％ ≥ 0.25 cm) and maternal placental abruption was higher (21.4％),and radiological grade (grade 1 was 2.5％,grade 2 was 16.1％,grade 3 was 30.3％,and grade 4 was 66.7％) was more severe (x2 =41.169,P ＜ 0.05).The use rate of antepartum glucocorticoid (28.3 ％ without use,24.9％ for partial treatment and 14.4％ for full treatment) was lower (x2 =7.315,P ＜ 0.05).Logistic regression analysis showed that no use of antepartum glucocorticoid (OR =0.634,95％ CI:0.423-0.951,P =0.027),placental abruption (OR =2.203,95％ CI:1.024-4.738,P =0.043),male infants (OR =2.475,95 ％ CI:1.259-4.867,P =0.009),low gestational age (OR =0.835,95％ CI:0.707-0.986,P =0.033),severe radiological grade (OR =2.829,95 ％ CI:1.886-4.245,P =0.000),and PDA (OR =1.550,95 ％ CI:1.040-2.311,P =0.032) were the risk factors for INSURE failure.Conclusions Placental abruption,male infants,lower gestational age,severe RDS grading,and PDA are risk factors for the failure of the INSURE strategy in preterm infants with respiratory distress syndrome.Antepartum glucocorticoid treatment can improve success rate of INSURE treatment.

Risk factors for the failure of the INSURE strategy in premature infants with respiratory distress syndrome / 中华实用儿科临床杂志

Objective@#To analyze the risk factors for the failure of the intubate-surfactant-extubate to continuous positive airway pressure(INSURE) strategy in preterm infants with respiratory distress syndrome(RDS).@*Methods@#Premature infants with gestation age<34 weeks and hospitalized between August 2016 and November 2018 in Department of Neonatology, Xiamen Maternal and Child Health Hospital were eligible for this descriptive study, and were classified into 2 groups: INSURE success group (281 cases), and INSURE failure group(70 cases), according to whether the infants need to be re-intubated and have invasive ventilator therapy within 72 hours after birth.The clinic information of premature infants in different groups were analyzed.@*Results@#The failure rate of INSURE strategy was 19.9%(70/35I cases). Compared with the success group, the premature infants in failure group had smaller gestational age[31.9(30.0, 32.6)weeks] and lower 1 minute Apgar score(8.0±1.9) scores (Z=10.533, t=2.354, all P<0.05). The incidence of male infants (74.3%), patent ductus arteriosus(PDA) (12.9% without PDA, 26.8% <0.25 cm, 28.3% ≥0.25 cm) and maternal placental abruption was higher (21.4%), and radiological grade (grade 1 was 2.5%, grade 2 was 16.1%, grade 3 was 30.3%, and grade 4 was 66.7%) was more severe (χ2=41.169, P<0.05). The use rate of antepartum glucocorticoid (28.3% without use, 24.9% for partial treatment and 14.4% for full treatment) was lower (χ2=7.315, P<0.05). Logistic regression analysis showed that no use of antepartum glucocorticoid(OR=0.634, 95%CI: 0.423-0.951, P=0.027), placental abruption(OR=2.203, 95%CI: 1.024-4.738, P=0.043), male infants(OR=2.475, 95%CI: 1.259-4.867, P=0.009), low gestational age(OR=0.835, 95%CI: 0.707-0.986, P=0.033), severe radiological grade(OR=2.829, 95%CI: 1.886-4.245, P=0.000), and PDA(OR=1.550, 95%CI: 1.040-2.311, P=0.032)were the risk factors for INSURE failure.@*Conclusions@#Placental abruption, male infants, lower gestational age, severe RDS grading, and PDA are risk factors for the failure of the INSURE strategy in preterm infants with respiratory distress syndrome.Antepartum glucocorticoid treatment can improve success rate of INSURE treatment.