<strong>Background:</strong><span><span><span style="font-family:""><span style="font-family:Verdana;"> Different gestational </span><span style=&q...<strong>Background:</strong><span><span><span style="font-family:""><span style="font-family:Verdana;"> Different gestational </span><span style="font-family:Verdana;">age specific</span> <span style="font-family:Verdana;">birthweight</span><span style="font-family:Verdana;"> reference charts have been produced for different populations and ethnic groups over different </span><span style="font-family:Verdana;">time periods</span><span style="font-family:Verdana;">, mostly based on birthweight data. This study aims to update birthweight references for Hong Kong (HK) Chinese newborns to provide norms for identification of </span><a name="_Hlk11503682"></a><span style="font-family:Verdana;">small and large for gestational age (SGA and LGA) fetuses, and to verify whether there are significant differences compared to previously published local reference charts, as well as to other southern Chinese </span><span style="font-family:Verdana;">and international</span><span style="font-family:Verdana;"> data. </span><b><span style="font-family:Verdana;">Methods:</span></b><span style="font-family:Verdana;"> All singleton Chinese livebirths deliv</span><span style="font-family:Verdana;">ered in United Christian Hospital from 2012 to 2017 were retrospectively included. The smoothed birthweight centiles at each gestation were computed. The birthweight centiles were then compared with other reference charts.</span></span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">Results:</span></b></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;"> A total of 25,508 </span><span style="font-family:Verdana;">livebirths</span><span style="font-family:Verdana;"> between 24 and 42 completed weeks of gestation were enrolled in the final analysis. The mean birthweights of our cohort were largely similar to previous studies at each gestation, but the 10th and 90th centile ranges differed </span><span style="font-family:Verdana;">significantly,</span><span style="font-family:Verdana;"> so that the proportion of babies that would be classified as SGA or LGA varied widely using cut-offs from different studies. </span></span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">Older local studies tend to </span><span style="font-family:Verdana;">under-estimate</span><span style="font-family:Verdana;">, while the international growth charts would </span><span style="font-family:Verdana;">over-estimate</span><span style="font-family:Verdana;"> the proportion of SGA babies. </span><b><span style="font-family:Verdana;">Conclusions:</span></b><span style="font-family:Verdana;"> Updating fetal growth curve references based on local data is essential to establish more precise definitions of SGA and LGA babies in clinical management. The use of international growth charts in our population may not be appropriate and requires further validation.</span></span></span></span>展开更多
Background： Fetal insulin hypothesis was proposed that the association between low birth weight and type 2 diabetes is principally genetically mediated. The aim of this study was to investigate whether common variant...Background： Fetal insulin hypothesis was proposed that the association between low birth weight and type 2 diabetes is principally genetically mediated. The aim of this study was to investigate whether common variants in genes CDKALI, HHEX, ADCY5, SRR, PTPRD that predisposed to type 2 diabetes were also associated with reduced birthweight in Chinese Han population.Methods： Twelve single nucleotide polymorphisms （rs7756992/rs10946398 in CDKAL1, rsl 111875 in HHEA; rs391300 in SRR, rs17584499 in PTPRD. rs1170806/rs9883204/rs4678017/rs9881942/rs7641344/rs6777397/rs6226243 in ADCY5） were genotyped in 1174 unrelated individuals born in Peking Union Medical College Hospital from 1921 to 1954 by TaqMan allelic discrimination assays, of which 645 had normal glucose tolerance, 181 had developed type 2 diabetes and 348 impaired glucose regulation. Associations of these 12 genetic variants with birthweight and glucose metabolism in later life were analyzed.Results： Birthweight was inversely associated with CDKAL 1-rs 10946398 （β = -41 g [95% confidence interval [CI]： -80, 3], P= 0.034）, common variants both associated with increased risk of impaired glucose metabolism and decreased insulin secretion index later in life. After adjusting for sex, gestational weeks, parity and maternal age, the risk allele of CDKAL1-rs7756992 was associated with reduced birthweight （β = 36 g [95% CI： -72, -0.2], P = 0.048）. The risk allele in SRR showed a trend toward a reduction ofbirthweight （P =0.085）. Conclusions： This study identified the association between type 2 diabetes risk variants in CDKAL 1 and birthweight in Chinese Hart individuals, and the carrier of risk allele within SRR had the trend of reduced birthweight. This demonstrates that there is a clear overlap between the genetics of type 2 diabetes and fetal growth, which proposes that lower birth weight and type 2 diabetes may be two phenotypes of one genotype.展开更多
目的:评估富含IgM免疫球蛋白辅助治疗极低出生体重儿院内感染败血症的临床和实验室参数。方法:选取2015年2月至2016年2月入住本院共53例院内感染败血症的极低出生体重儿为研究对象,将所有患儿分为治疗组28例,对照组25例,治疗组患儿在传...目的:评估富含IgM免疫球蛋白辅助治疗极低出生体重儿院内感染败血症的临床和实验室参数。方法:选取2015年2月至2016年2月入住本院共53例院内感染败血症的极低出生体重儿为研究对象,将所有患儿分为治疗组28例,对照组25例,治疗组患儿在传统抗生素治疗方案的基础上,进行连续3 d,每日4 h内静注富含IgM免疫球蛋白5 m L/kg,对照组患儿则只进行传统抗生素治疗方案,观察对比两组治疗前后的临床及实验室参数。结果:两组患儿于治疗前在C-反应蛋白、体温、白细胞计数、未成熟白细胞占总白细胞比值等方面比较,差异无统计学意义,观察治疗后两组患儿上述参数相比治疗前明显改善且治疗组优于对照组,差异具有统计学意义(P<0.05);两组患儿治疗结束总有效率分别为82.1%、64.0%,治疗组明显优于对照组,差异具有统计学意义(P<0.05);治疗组与对照组治疗中均出现低血糖、消化道出血、贫血、呼吸暂停、休克等并发症,且并发症发病率分别为28.6%、44.0%,治疗组显著低于对照组,差异具有统计学意义(P<0.05)。结论:富含IgM免疫球蛋白可以用于极低出生体重儿院内感染败血症的辅助治疗。展开更多
文摘<strong>Background:</strong><span><span><span style="font-family:""><span style="font-family:Verdana;"> Different gestational </span><span style="font-family:Verdana;">age specific</span> <span style="font-family:Verdana;">birthweight</span><span style="font-family:Verdana;"> reference charts have been produced for different populations and ethnic groups over different </span><span style="font-family:Verdana;">time periods</span><span style="font-family:Verdana;">, mostly based on birthweight data. This study aims to update birthweight references for Hong Kong (HK) Chinese newborns to provide norms for identification of </span><a name="_Hlk11503682"></a><span style="font-family:Verdana;">small and large for gestational age (SGA and LGA) fetuses, and to verify whether there are significant differences compared to previously published local reference charts, as well as to other southern Chinese </span><span style="font-family:Verdana;">and international</span><span style="font-family:Verdana;"> data. </span><b><span style="font-family:Verdana;">Methods:</span></b><span style="font-family:Verdana;"> All singleton Chinese livebirths deliv</span><span style="font-family:Verdana;">ered in United Christian Hospital from 2012 to 2017 were retrospectively included. The smoothed birthweight centiles at each gestation were computed. The birthweight centiles were then compared with other reference charts.</span></span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">Results:</span></b></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;"> A total of 25,508 </span><span style="font-family:Verdana;">livebirths</span><span style="font-family:Verdana;"> between 24 and 42 completed weeks of gestation were enrolled in the final analysis. The mean birthweights of our cohort were largely similar to previous studies at each gestation, but the 10th and 90th centile ranges differed </span><span style="font-family:Verdana;">significantly,</span><span style="font-family:Verdana;"> so that the proportion of babies that would be classified as SGA or LGA varied widely using cut-offs from different studies. </span></span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">Older local studies tend to </span><span style="font-family:Verdana;">under-estimate</span><span style="font-family:Verdana;">, while the international growth charts would </span><span style="font-family:Verdana;">over-estimate</span><span style="font-family:Verdana;"> the proportion of SGA babies. </span><b><span style="font-family:Verdana;">Conclusions:</span></b><span style="font-family:Verdana;"> Updating fetal growth curve references based on local data is essential to establish more precise definitions of SGA and LGA babies in clinical management. The use of international growth charts in our population may not be appropriate and requires further validation.</span></span></span></span>
基金Source of Support： This study was supported by grants from the Natural Sciences Foundation of Beijing （No. 5072042）, National Natural Science Foundation of China （No. 81170736）, National Key Program of Clinical Science. Conflict of Interest： None declared.
文摘Background： Fetal insulin hypothesis was proposed that the association between low birth weight and type 2 diabetes is principally genetically mediated. The aim of this study was to investigate whether common variants in genes CDKALI, HHEX, ADCY5, SRR, PTPRD that predisposed to type 2 diabetes were also associated with reduced birthweight in Chinese Han population.Methods： Twelve single nucleotide polymorphisms （rs7756992/rs10946398 in CDKAL1, rsl 111875 in HHEA; rs391300 in SRR, rs17584499 in PTPRD. rs1170806/rs9883204/rs4678017/rs9881942/rs7641344/rs6777397/rs6226243 in ADCY5） were genotyped in 1174 unrelated individuals born in Peking Union Medical College Hospital from 1921 to 1954 by TaqMan allelic discrimination assays, of which 645 had normal glucose tolerance, 181 had developed type 2 diabetes and 348 impaired glucose regulation. Associations of these 12 genetic variants with birthweight and glucose metabolism in later life were analyzed.Results： Birthweight was inversely associated with CDKAL 1-rs 10946398 （β = -41 g [95% confidence interval [CI]： -80, 3], P= 0.034）, common variants both associated with increased risk of impaired glucose metabolism and decreased insulin secretion index later in life. After adjusting for sex, gestational weeks, parity and maternal age, the risk allele of CDKAL1-rs7756992 was associated with reduced birthweight （β = 36 g [95% CI： -72, -0.2], P = 0.048）. The risk allele in SRR showed a trend toward a reduction ofbirthweight （P =0.085）. Conclusions： This study identified the association between type 2 diabetes risk variants in CDKAL 1 and birthweight in Chinese Hart individuals, and the carrier of risk allele within SRR had the trend of reduced birthweight. This demonstrates that there is a clear overlap between the genetics of type 2 diabetes and fetal growth, which proposes that lower birth weight and type 2 diabetes may be two phenotypes of one genotype.
文摘目的:评估富含IgM免疫球蛋白辅助治疗极低出生体重儿院内感染败血症的临床和实验室参数。方法:选取2015年2月至2016年2月入住本院共53例院内感染败血症的极低出生体重儿为研究对象,将所有患儿分为治疗组28例,对照组25例,治疗组患儿在传统抗生素治疗方案的基础上,进行连续3 d,每日4 h内静注富含IgM免疫球蛋白5 m L/kg,对照组患儿则只进行传统抗生素治疗方案,观察对比两组治疗前后的临床及实验室参数。结果:两组患儿于治疗前在C-反应蛋白、体温、白细胞计数、未成熟白细胞占总白细胞比值等方面比较,差异无统计学意义,观察治疗后两组患儿上述参数相比治疗前明显改善且治疗组优于对照组,差异具有统计学意义(P<0.05);两组患儿治疗结束总有效率分别为82.1%、64.0%,治疗组明显优于对照组,差异具有统计学意义(P<0.05);治疗组与对照组治疗中均出现低血糖、消化道出血、贫血、呼吸暂停、休克等并发症,且并发症发病率分别为28.6%、44.0%,治疗组显著低于对照组,差异具有统计学意义(P<0.05)。结论:富含IgM免疫球蛋白可以用于极低出生体重儿院内感染败血症的辅助治疗。
