ABSTRACT
OBJECTIVES: To investigate the risk factors for bronchopulmonary dysplasia (BPD) in twin preterm infants with a gestational age of <34 weeks, and to provide a basis for early identification of BPD in twin preterm infants in clinical practice. METHODS: A retrospective analysis was performed for the twin preterm infants with a gestational age of <34 weeks who were admitted to 22 hospitals nationwide from January 2018 to December 2020. According to their conditions, they were divided into group A (both twins had BPD), group B (only one twin had BPD), and group C (neither twin had BPD). The risk factors for BPD in twin preterm infants were analyzed. Further analysis was conducted on group B to investigate the postnatal risk factors for BPD within twins. RESULTS: A total of 904 pairs of twins with a gestational age of <34 weeks were included in this study. The multivariate logistic regression analysis showed that compared with group C, birth weight discordance of >25% between the twins was an independent risk factor for BPD in one of the twins (OR=3.370, 95%CI: 1.500-7.568, P<0.05), and high gestational age at birth was a protective factor against BPD (P<0.05). The conditional logistic regression analysis of group B showed that small-for-gestational-age (SGA) birth was an independent risk factor for BPD in individual twins (OR=5.017, 95%CI: 1.040-24.190, P<0.05). CONCLUSIONS: The development of BPD in twin preterm infants is associated with gestational age, birth weight discordance between the twins, and SGA birth.
Subject(s)
Bronchopulmonary Dysplasia , Infant, Premature , Twins , Humans , Bronchopulmonary Dysplasia/etiology , Bronchopulmonary Dysplasia/epidemiology , Risk Factors , Infant, Newborn , Female , Retrospective Studies , Male , Gestational Age , Birth Weight , Logistic ModelsABSTRACT
OBJECTIVES: To investigate the risk factors for necrotizing enterocolitis (NEC) in very preterm infants and establish a nomogram model for predicting the risk of NEC. METHODS: A total of 752 very preterm infants who were hospitalized from January 2015 to December 2021 were enrolled as subjects, among whom 654 were born in 2015-2020 (development set) and 98 were born in 2021 (validation set). According to the presence or absence of NEC, the development set was divided into two groups: NEC (n=77) and non-NEC (n=577). A multivariate logistic regression analysis was used to investigate the independent risk factors for NEC in very preterm infants. R software was used to plot the nomogram model. The nomogram model was then validated by the data of the validation set. The receiver operating characteristic (ROC) curve, the Hosmer-Lemeshow goodness-of-fit test, and the calibration curve were used to evaluate the performance of the nomogram model, and the clinical decision curve was used to assess the clinical practicability of the model. RESULTS: The multivariate logistic regression analysis showed that neonatal asphyxia, sepsis, shock, hypoalbuminemia, severe anemia, and formula feeding were independent risk factors for NEC in very preterm infants (P<0.05). The ROC curve of the development set had an area under the curve (AUC) of 0.833 (95%CI: 0.715-0.952), and the ROC curve of the validation set had an AUC of 0.826 (95%CI: 0.797-0.862), suggesting that the nomogram model had a good discriminatory ability. The calibration curve analysis and the Hosmer-Lemeshow goodness-of-fit test showed good accuracy and consistency between the predicted value of the model and the actual value. CONCLUSIONS: Neonatal asphyxia, sepsis, shock, hypoalbuminemia, severe anemia, and formula feeding are independent risk factors for NEC in very preterm infant. The nomogram model based on the multivariate logistic regression analysis provides a quantitative, simple, and intuitive tool for early assessment of the development of NEC in very preterm infants in clinical practice.
Subject(s)
Enterocolitis, Necrotizing , Hypoalbuminemia , Infant, Newborn, Diseases , Infant, Premature, Diseases , Sepsis , Asphyxia/complications , Child , Enterocolitis, Necrotizing/complications , Enterocolitis, Necrotizing/etiology , Female , Fetal Growth Retardation , Humans , Infant , Infant, Newborn , Infant, Premature , Infant, Premature, Diseases/diagnosis , Infant, Premature, Diseases/etiology , Nomograms , Sepsis/complicationsABSTRACT
OBJECTIVES: To evaluate the accuracy and safety of measurements of transcutaneous carbon dioxide partial pressure (TcPCO2) and transcutaneous oxygen partial pressure (TcPO2) at electrode temperatures lower than the value used in clinical practice in very low birth weight infants. METHODS: A total of 45 very low birth weight infants were enrolled. TcPCO2 and TcPO2 measurements were performed in these infants. Two transcutaneous monitors were placed simultaneously for each subject. One electrode was set and maintained at 42â used in clinical practice for neonates (control group), and the other was successively set at 38â, 39â, 40°C, and 41â (experimental group). The paired t-test was used to compare the measurement results between the groups. A Pearson correlation analysis was used to analyze the correlation between the measurement results of the experimental group and control group, and between the measurement results of experimental group and arterial blood gas parameters. RESULTS: There was no significant difference in TcPCO2 between each experimental subgroup (38-41â) and the control group. TcPCO2 in each experimental subgroup (38-41â) was strongly positively correlated with TcPCO2 in the control group (r>0.9, P<0.05) and arterial carbon dioxide partial pressure (r>0.8, P<0.05). There were significant differences in TcPO2 between each experimental subgroup (38-41â) and the control group (P<0.05), but TcPO2 in each experimental subgroup (38-41â) was positively correlated with TcPO2 in the control group (r=0.493-0.574, P<0.05) and arterial oxygen partial pressure (r=0.324-0.399, P<0.05). No skin injury occurred during transcutaneous measurements at all electrode temperatures. CONCLUSIONS: Lower electrode temperatures (38-41â) can accurately measure blood carbon dioxide partial pressure in very low birth weight infants, and thus can be used to replace the electrode temperature of 42°C. Transcutaneous measurements at the lower electrode temperatures may be helpful for understanding the changing trend of blood oxygen partial pressure.
Subject(s)
Blood Gas Monitoring, Transcutaneous , Carbon Dioxide , Electrodes , Humans , Infant , Infant, Newborn , Infant, Very Low Birth Weight , Oxygen , Partial Pressure , TemperatureABSTRACT
Objective: Comparing the differences about physicochemical properties and in vitro dissolution behavior of active ingredients between ultrafine powder and common powder of Eucommia ulmoides to provide the experimental evidence for the ultrafine powder application and the control of particle size. Methods: Ultrafine powders were produced by using ultra mill. Particle size, cell wall breaking rate, morphology, and dissolution were used to evaluate the effect of particle size on microcharacteristic and dissolution behavior of powders of E. ulmoides. Results: There were significant differences between ultrafine and common powders of microcharacteristic. The extraction rates and dissolution rates of the active ingredients of ultrafine powders were higher than those of common powders. Conclusion: An appropriate degree of superfine grinding can increase the wall-breaking rate and promote the dissolution of active ingredients of E. ulmoides, and the dissolution medium has an obvious influence on the dissolution rates. The application of ultrafine grinding technology to E. ulmoides is feasible.
