Objective:To explore the positive role of developmental care measures in promoting the growth and development of premature infants,and analyze their specific effects on improving the sleep duration and quality of prem...Objective:To explore the positive role of developmental care measures in promoting the growth and development of premature infants,and analyze their specific effects on improving the sleep duration and quality of premature infants.Methods:A total of 80 premature infants who met the inclusion criteria were selected by convenient sampling method and divided into an experimental group and a control group,with 40 cases in each group.The experimental group received comprehensive nursing intervention of developmental care during the nursing process;the control group adopted the traditional conventional nursing model.Results:There was no statistically significant difference in various physical indicators between the two groups of premature infants before nursing intervention.After nursing intervention,the scores of intellectual development level,psychomotor development index and various physical indicators of premature infants in the experimental group were significantly higher than those in the control group,and the difference was statistically significant.Conclusion:The implementation of developmental care for premature infants can significantly improve their various developmental indicators,which can not only effectively promote the rapid development of premature infants’mental and physical growth,but also improve their sleep quality.展开更多
Objective:To investigate the dynamic trajectory,predictors,and underlying adaptation mechanisms of family resilience(FR)among Chinese families with preterm infants(PIs)from birth to six months.Methods:Guided by Ecolog...Objective:To investigate the dynamic trajectory,predictors,and underlying adaptation mechanisms of family resilience(FR)among Chinese families with preterm infants(PIs)from birth to six months.Methods:Guided by Ecological Systems Theory,a convergent parallel mixed-methods study was conducted in the Neonatal Intensive Care Unit(NICU)of a tertiary hospital in Fujian Province,China,from June 2023 to June 2024.Quantitative data were collected from 202 caregivers selected by convenience sampling at four time points:at birth(T0),42 days postpartum(T1),3 months postpartum(T2),and 6 months postpartum(T3).Generalized Estimating Equations(GEE)was used to analyze scale score differences across time points and explore factors influencing FR.Qualitative data were collected through semi-structured interviews with 14 caregivers recruited by maximum variation purposive sampling and analyzed using Colaizzi’s phenomenological approach.After conducting separate data analyses,the findings were integrated through side-by-side comparison and joint display.Results:Quantitative results revealed a non-linear,“V”-shaped trajectory of FR,significantly influenced by educational level,conception via assisted reproduction,farming occupation,coping style,psychological resilience,family functioning,and social support.Qualitative findings identified four themes:initial uncertainty and emotional distress,post-discharge anxiety,gradual adaptation,and eventual stabilization.Integrated mixed-methods findings revealed that the initial confusion phase demands a comprehensive response to family needs(T0);the post-discharge bottleneck requires addressing the care capability-needs gap(T1);the role adaptation phase is pivotal for enhancing internal family resources(T2);and the family-work transition necessitates enhanced work-family facilitation(T3).Conclusions:This study systematically identifies the unique“V”-shaped trajectory of FR in Chinese families with PIs and its key influencing factors,and accurately analyzes their dynamic experiences and adaptation across four stages.These findings provide an empirical basis for stage-specific targeted interventions,strongly support the practical advancement of the family-centered care model,and deliver critical guidance for enhancing FR.展开更多
BACKGROUND Cow's milk allergy(CMA)is a common condition in infants,requiring alternative protein sources in their diets.Soya milk has become a popular substitute,especially in developing countries where it is a mo...BACKGROUND Cow's milk allergy(CMA)is a common condition in infants,requiring alternative protein sources in their diets.Soya milk has become a popular substitute,especially in developing countries where it is a more affordable option compared to expensive hypoallergenic feeds for infants with insufficient breast milk supply.However,recent observations have shown an increase in soya cross-allergic reactions among infants with CMA.AIM To determine how often infants diagnosed with CMA also had soya cross-allergy and to examine the symptoms and outcomes of these infants at 2 years of age.METHODS Data from two pediatric centers were analyzed,looking at clinical records of children under 2 years old diagnosed with CMA from August 2015 to July 2023,divided into two four-year periods.RESULTS The records of 432 infants with CMA were analyzed.In the first four-year period from August 2015 to July 2019,142 infants were studied,with 27(19%)found to have soya-protein allergy as well.In the second four-year period,a total of 290 infants were studied,and soya allergy was found in 136 babies(47%).This represents a significant increase(P<0.0001)in cases of soya protein cross-allergy among infants with CMA.The most common symptoms observed were gastroesophageal reflux disorder(39%),followed by failure to thrive,bloody diarrhea,watery diarrhea,and constipation.At 2 years of age,these infants showed significant growth failure compared to infants with CMA only.CONCLUSION In conclusion,this study emphasizes the importance of being cautious when using soy protein in infants with cow's milk protein allergy,especially in areas where cost is a major concern.展开更多
BACKGROUND Premature infant formula is based on milk and contains energy,vitamins,etc.Breast milk is rich in minerals,such as phosphorus and calcium,and proteins.Both can be used for nutritional support in preterm inf...BACKGROUND Premature infant formula is based on milk and contains energy,vitamins,etc.Breast milk is rich in minerals,such as phosphorus and calcium,and proteins.Both can be used for nutritional support in preterm infants with low-birth-weight.However,their effects on the difference in infant growth rate and postpartum depression are still unclear.AIM To explore the effect of early micro-breastfeeding on the growth rate of preterm infants with low-birth-weight and maternal postpartum depression.METHODS Data of 68 preterm infants with low-birth-weight and their mothers admitted to the Department of Neonatology,Suzhou Ninth Hospital Affiliated to Soochow University,between January 2022 and December 2024,were retrospectively collected.The infants were divided into two groups according to the different enteral feeding methods in the early stage:Control group(n=32 cases,premature infant formula feeding)and observation group(n=36 cases,micro-breastfeeding,i.e.,exclusive breastfeeding,no mixed feeding).The baseline data;feeding status;gastrointestinal adverse reactions such as vomiting,gastric retention,and abdominal distension;growth rate(body weight,body length,and head circumference);and adverse events(infection,cholestasis,hyperbilirubinemia,and necrotizing enterocolitis)were compared between the two groups.Moreover,the maternal postpartum depression status of the two groups based of infants based on the Edinburgh postpartum depression scale(EPDS)was compared.RESULTS No significant difference in baseline data was found between the two groups(P>0.05).The onset time of weight gain(6.49±0.53 days vs 7.09±0.61 days,P<0.001),time for complete meconium excretion(6.28±0.92 days vs 8.31±1.17 days,P<0.001),time for recovery to birth weight(8.81±1.40 days vs 10.95±1.64 days,P<0.001),and time to reach full enteral feeding(12.29±2.08 days vs 15.48±2.27 days,P<0.001)were compared between the observation and control groups.The incidence of vomiting,abdominal distension,and gastric retention was significantly lower in the observation group than in the control group,and the difference was significant(P<0.05).The rates of the weight growth(15.88±1.57 g/day vs 14.84±1.51 g/day,P=0.007),head circumference(0.63±0.08 cm/week vs 0.59±0.05 cm/week,P=0.018),and length(0.80±0.12 cm/week vs 0.73±0.14 cm/week,P=0.029)were compared between the observation and control groups.On hospital admission of preterm infants with low-birthweight,the mothers of the two groups did not show a significant difference in the EPDS scores for postpartum depression(P>0.05).Preterm infants with low-birth-weight were hospitalized for 2 weeks,and the EPDS score for maternal postpartum depression was significantly lower in the observation group than in the control group(8.38±1.47 vs 9.49±2.35,P=0.021).CONCLUSION Compared with preterm infant formula feeding,early micro-breastfeeding can more effectively promote the growth rate of preterm infants with low-birth-weight and reduce the gastrointestinal feeding intolerance and related complications,thereby alleviating mothers’concerns about their children and reducing the risk of postpartum depression.展开更多
The aim of this study is to analyze factors influencing the development of bronchopulmonary dysplasia(BPD)within 28 d after birth in very-low-birth-weight(VLBW)infants with a gestational age of less than 34 weeks who ...The aim of this study is to analyze factors influencing the development of bronchopulmonary dysplasia(BPD)within 28 d after birth in very-low-birth-weight(VLBW)infants with a gestational age of less than 34 weeks who were receiving early parenteral nutrition.Data were retrospectively collected from infants born between January and December 2021,who were admitted to the neonatal intensive care unit within 24 h of birth,had a gestational age of less than 34 weeks,and were classified as VLBW.The study included 14 cases without BPD and 20 cases with BPD,and it compared clinical data during hospitalization between these two groups.On the 1st day of life,the BPD group had a nitrogen-to-calorie ratio of 105.44±26.67,while the non-BPD group had a ratio of 146.81±37.04.This difference was statistically significant,with a P-value of 0.04,indicating a potential association between the nitrogen-to-calorie ratio and the development of BPD.However,no significant differences were observed in other clinical indicators between the two groups.These findings suggested that a larger sample size was needed to further explore and confirm the correlation between the nitrogen-to-calorie ratio and the risk of developing BPD in this population.展开更多
Background There have been numerous intervention studies focusing on the development of preterm infants,but there has been limited investigation into the home environment as a determinant of developmental outcomes in ...Background There have been numerous intervention studies focusing on the development of preterm infants,but there has been limited investigation into the home environment as a determinant of developmental outcomes in preterm infants.The aspects and extent to which the home environment affects the early(18 months corrected age)neuropsychological development of preterm infants are still unclear.Aims This study aimed to analyse the effect of the home environment on the neuropsychiatric development of preterm infants at 18 months corrected age after discharge from the neonatal intensive care unit(NICU).It also sought to provide a basis for promoting neuropsychiatric development among preterm infants by improving the home environment.Methods In this retrospective cross-sectional study,275 preterm infants born between January 2019 and January 2022 were followed up for systematic management after discharge from the NICU at Shanghai Children's Hospital.The Home Nurture Environment Questionnaire was used to assess the home environment of the infants and analyse its impact on the developmental quotient(evaluated by the Gesell Developmental Scale)and the rate of developmental delays at 18 months corrected age.Results A total of 41.454%of the infants were extremely preterm.The developmental quotient scores at 18 months corrected age were in the middle of the scale.The language domain had the highest rate of developmental delay(46.182%),followed by the adaptive domain(37.091%).Multiple logistic regression analyses showed that compared with infants in supportive home environments,infants with moderate/unsupportive home environments had significantly elevated risks of development delay:2.162-fold for global(odds ratio(OR)2.162,95% confidence interval(Cl)1.274 to 3.665,p=0.004),2.193-fold for fine motor(OR 2.193,95%CI 1.161 to 4.140,p=0.016),2.249-fold for language(0R 2.249,95%CI 1.336 to 3.786,p=0.002)and 2.042-fold for personal-social(OR 2.042,95%CI 1.149 to 3.628,p=0.015).Conclusions A supportive home environment is a crucial protective factor for the neuropsychological development of preterm infants.It is associated with higher developmental quotient scores and protects against neuropsychiatric delays.Incorporating evaluation and continuous improvement of the home environment into the management framework for preterm infants to promote optimal neurodevelopment is essential.展开更多
High-risk infants,from fetal stage to 3-year-old,face severe physical and mental development threats due to biological,psychological,or environmental factors.These threats can lead to developmental delay and cognitive...High-risk infants,from fetal stage to 3-year-old,face severe physical and mental development threats due to biological,psychological,or environmental factors.These threats can lead to developmental delay and cognitive impairment,affecting their future quality of life and social integration.Scientific health management,with nutritional intervention as a key part,is urgently needed.Nutritional intervention,through targeted supplementation and feeding guidance,can optimize their development,avoid nutritional-related deviations,reduce long-term disease risk,and lay a healthy growth foundation.This study analyzes the positive effects of nutritional intervention on high-risk infants’physical growth,neural development,and disease prevention,providing scientific evidence for optimizing clinical follow-up strategies.展开更多
Objective:To understand the current status and influencing factors of family caregiving for infants and toddlers aged 6–36 months in Tianhe District,Guangzhou City,with the aim of better comprehending the physiologic...Objective:To understand the current status and influencing factors of family caregiving for infants and toddlers aged 6–36 months in Tianhe District,Guangzhou City,with the aim of better comprehending the physiological and psychological needs of infants and toddlers,and assisting families in developing effective intervention measures and support strategies.Methods:In November 2024,a random sample of 311 infants and toddlers aged 6–36 months from the permanent resident population in Tianhe District,Guangzhou City,was selected.Caregivers were surveyed using a questionnaire regarding family caregiving practices for infants and toddlers.The Kruskal-Wallis’s test,Mann-Whitney test,and multiple linear regression analysis were employed to examine the influencing factors of family caregiving for infants and toddlers.Results:The findings indicate that the quality of family caregiving is significantly influenced by the educational level of the parents(p<0.001)and the annual household income(p<0.001).Work-family conflict showed a significant negative correlation with the quality of family caregiving(β=-0.239,p<0.001),while family atmosphere demonstrated a significant positive correlation with the quality of family caregiving(β=0.225,p<0.001).Conclusion:In Tianhe District,Guangzhou City,the quality of infant and toddler caregiving is determined by a combination of key factors,including annual household income,parental educational background,work-family conflict,and family atmosphere.These elements collectively form the core determinants of caregiving practices for infants and toddlers.展开更多
BACKGROUND To prevent mother to child transmission(MTCT)of human immunodeficiency virus(HIV),sustained maternal viral load suppression(VLS)and early HIV testing among HIV exposed infants(HEI)is critical.AIM To investi...BACKGROUND To prevent mother to child transmission(MTCT)of human immunodeficiency virus(HIV),sustained maternal viral load suppression(VLS)and early HIV testing among HIV exposed infants(HEI)is critical.AIM To investigate maternal viral load results and infant HIV testing uptake at 6-weeks,and 9-months and 18-months in Rwanda.METHODS Between 2015 and 2022,VLS(<200 copies/mL)was measured among pregnant women living with HIV(WLHIV)from 38-healthcare facilities.Viral loads(VL)were measured at 6-months,12-months and 24-months,respectively.For maternal VL,the unit of analysis was visit-pair,and the pairs were created to define those with VL<200 copies/mL at two consecutive visits as having sustained VLS,persistent viremia(VL≥200 copies/mL at two consecutive visits),viral rebound(VL<200 copies/mL at prior visit only)and newly suppressed(VL<200 copies/mL at subsequent visit only).HEI were considered to have persistent HIV testing if they had all three HIV tests.Poisson regression models with generalized estimating equations were used to estimate the adjusted incidence rate ratio(aIRR)and 95%CI for factors associated with sustained VLS and persistent HIV testing.RESULTS A total of 1145 mother-infant pairs were analyzed.Infant HIV testing uptake at 6-weeks,9-months and 18-months was 1145(100.0%),1089(95.1%),1006(87.9%)respectively.Nine hundred ninety-nine HEI(87.3%)tested for HIV persistently.At 18-months,the incidence of HIV among HEI was 8(0.7%).Of 1145 mothers,1076(94.0%)had≥2 VL results making a total of 2010 visit-pairs(142-single;934-double visit-pairs).The incidence rate of sustained VLS,persistent viremia,viral rebound and new suppression were 91.0%,1.3%,3.6%and 4.0%respectively.Maternal disclosure of HIV status(aIRR=1.08,95%CI:1.02-1.14)was associated with increased likelihood of sustained VLS.Having peer support(aIRR=1.0595%CI:1.01-1.10)was associated with persistent HIV testing among HEI.CONCLUSION Sustained VLS is high among pregnant WLHIV in Rwanda.The low incidence of HIV among HEI may be attributed to high VLS levels.Targeted interventions,including enhanced HIV disclosure and peer support,are crucial for improving sustained VLS and increasing infant HIV testing uptake to reduce MTCT.展开更多
Objective:To explore the application effect of improved“Bird’s nest”nursing in the transport of premature infants.Methods:Collecting 100 cases of premature infants,randomly divided into experimental group and contr...Objective:To explore the application effect of improved“Bird’s nest”nursing in the transport of premature infants.Methods:Collecting 100 cases of premature infants,randomly divided into experimental group and control group,two groups of premature 50 cases each.The control group received the traditional“Bird’s nest”nursing.Experimental group in modified the“bird’s nest”nursing intervention,compared two groups of premature monitoring vital signs during the transfer process,transport after the body development indicators,the time and cure warmers intervention.Results:Compared with control group,experimental group premature temperature fluctuation is small,apnea and fewer times of low body temperature and oxygen saturation is higher,the contrast results with statistical significance(P<0.05).There was no significant difference in physical development,time to get out of the incubator,and cure rate.Conclusion:Modified the“bird’s nest”care in outside the hospital application,help to improve premature transfer process safety,and security for premature success implementation of transshipment is of great significance.展开更多
Background: Malnutrition, a serious public health concern, is influenced by various factors. Objective: The study aims to explore malnutrition issues among infants under five years old in Guéra Province. Methods:...Background: Malnutrition, a serious public health concern, is influenced by various factors. Objective: The study aims to explore malnutrition issues among infants under five years old in Guéra Province. Methods: The study used a cross-sectional design and a two-stage cluster sampling method to select participants. The study population was infants aged between 0 - 24 months. Data collection was done between June 2023 and September 2024;it included anthropometric measurements, blood analyses, and interviews. Anthropometric parameters were calculated using ENA for SMART software. Statistical analyses were performed by R Studio to investigate associations between different characteristics, using logistic regression models to identify risk factors. A p-value less than 0.05 was considered significant. Results: The study included 377 infants in eight villages in Guéra Province, Chad. The sample was predominantly girls (55.3%), with a median age of 16 months. Most infants (94%) were mixed-fed, and only 6% were exclusively breastfed. We found that 7.3% of children were globally malnourished, with higher rates in boys 9.6%. A significant disparity existed between boys and girls in global acute malnutrition (GAM) rates, with boys having a higher prevalence of 17.9%. A substantial proportion of Infants were underweight, with males 27.4%. Stunting was prevalent 20.1%. Several factors were associated with malnutrition, including gender, feeding practices, infectious diseases, and socioeconomic factors. Diarrhea, malaria, limited access to drinking water, and early diet diversification were significantly associated with malnutrition. Conclusion: Targeted interventions are necessary to address these issues and improve the nutritional status of children in the Guéra province.展开更多
Immunoprophylaxis is routinely recommended for infants born to mothers with hepatitis B virus(HBV)infection within the first 12-24 hours.Detection of he-patitis B surface antibody(HBsAb)resulting from hepatitis B immu...Immunoprophylaxis is routinely recommended for infants born to mothers with hepatitis B virus(HBV)infection within the first 12-24 hours.Detection of he-patitis B surface antibody(HBsAb)resulting from hepatitis B immunoglobulin administered at birth may be perceived as a real vaccine response.This makes it difficult to detect HBV infection.For this reason,it is recommended that infants born to hepatitis B surface antigen positive mothers and who received immunop-rophylaxis at birth should have HBsAb testing when they are 9-15 months old.展开更多
BACKGROUND Enhanced recovery after surgery(ERAS)represents an innovative,protocoldriven perioperative care program designed to optimize patient outcomes.However,its application and efficacy in infants and children wit...BACKGROUND Enhanced recovery after surgery(ERAS)represents an innovative,protocoldriven perioperative care program designed to optimize patient outcomes.However,its application and efficacy in infants and children with Hirschsprung disease(HD)remain underexplored.AIM To delve into the impact of ERAS on perioperative recovery and the overall medical experience in HD infants and children.METHODS Thirty-eight infants and children with HD who received the Soave surgical procedure were enrolled in this case-control study.According to age-and sexstratified single-blind randomized tables,20 cases received ERAS treatment(ERAS group)and 18 cases received conventional treatment(control group).The two treatments were then compared in terms of perioperative recovery and medical experience.RESULTS Significant differences were observed in pain scores at awakening(4.2±1.3 vs 5.2±1.2,t=2.516,P=0.017)and pain duration(85.69±7.46 hours vs 67.00±8.56 hours,t=7.139,P<0.001)between the ERAS and control group.The recovery of bowel movement was earlier in the ERAS group than in the control group(borborygmus time:33.63±9.83 hours vs 44.69±16.85 hours,t=2.501,P=0.017;feeding time:36.63±9.55 hours vs 49.36±16.99 hours,t=2.884,P=0.007;anal catheter indwelling time:75.83±13.80 hours vs 93.36±20.65 hours,t=3.104,P=0.004),and fever duration(40.73±14.42 hours vs 52.63±18.69 hours,t=2.211,P=0.034).In the ERAS group,hospital stay was shorter(7.5±0.9 days vs 8.3±1.2 days)and the cost was lower(14203±2381 yuan vs 16847±3558 yuan).During the 1-month follow-up period,of the multiple postoperative complications observed,the occurrence of perianal dermatitis(PFisher=0.016)and defecation dysfunction(PFisher=0.027)were lower in the ERAS group than in the control group.CONCLUSION The ERAS protocol has the potential to profoundly enhance postoperative recovery and significantly elevate the overall comfort and quality of the medical experience,making it an indispensable approach that warrants widespread adoption.Continuous refinement through evidence-based practices is anticipated to further optimize its efficacy.展开更多
BACKGROUND The primary complication associated with gestational diabetes mellitus(GDM)is delivery of an infant that is large for gestational age(LGA).Epidemiological findings have demonstrated that irregular lipid met...BACKGROUND The primary complication associated with gestational diabetes mellitus(GDM)is delivery of an infant that is large for gestational age(LGA).Epidemiological findings have demonstrated that irregular lipid metabolism significantly con-tributes to insulin resistance,a key pathophysiological mechanism in GDM.However,the correlation between various lipid indices and the probability of delivering LGA infants remains inconsistent.AIM To explore the relationships between lipid indices and the possibility of having LGA infants among GDM-affected pregnant females.METHODS Binary logistic regression methods were employed to evaluate the odds ratios and corresponding 95%confidence intervals for LGA according to five lipid indices.Restricted cubic spline models were applied to investigate dose-response relationships.The association between lipid indices and the risk of delivering LGA infants was further investigated among different subgroups.Receiver operating characteristic curves were utilized to assess the diagnostic performance of lipid indices.RESULTS Across crude and adjusted models,females with lipid indices in the upper two tertiles presented a markedly elevated risk of delivering LGA infants compared with the lowest tertile category.Conversely,high-density lipoprotein cholesterol levels demonstrated the contrary trend.Restricted cubic spline analyses revealed linear associations between the five lipid indices,except triglyceride levels,and the prevalence of LGA.The subgroup analysis highlighted that the correlation between lipid indices and the probability of LGA was inconsistent.The five lipid indices presented significant diagnostic efficacy,as indicated by receiver operating characteristic curve areas.CONCLUSION Our research demonstrated that lipid indices were effective predictors of the incidence of LGA infants in GDM-affected pregnancies irrespective of potential confounding factors.展开更多
In the present study, clinical pharmacists monitored the blood concentration of vancomycin in children in the Infant Ward from 2013 to 2014, and the drug dose was adjusted according to its plasma concentration. Moreov...In the present study, clinical pharmacists monitored the blood concentration of vancomycin in children in the Infant Ward from 2013 to 2014, and the drug dose was adjusted according to its plasma concentration. Moreover, we analyzed the plasma concentration of vancomycin in infants in the hospital from 2013 to 2014. Simultaneously, we also discussed the necessity of regular therapeutic drug monitoring of vancomycin in infants, and the important role of clinical pharmacists was further explored. The results showed that it was necessary to routinely monitor the therapeutic drug in infants. Clinical pharmacists performed medication monitoring, which improved the effectiveness of vancomycin and prevented its adverse effects. In addition, it is a new treatment model for the participation of clinical pharmacists in the clinical treatment.展开更多
There is uncertain result with regard to the use of inhalation or instillation steroids to prevent bronchopulmonary dysplasia in preterm infants. This meta-analysis was designed to evaluate the efficacy and safety of ...There is uncertain result with regard to the use of inhalation or instillation steroids to prevent bronchopulmonary dysplasia in preterm infants. This meta-analysis was designed to evaluate the efficacy and safety of early airway administration (within 2 days after birth) of corticosteroids and pulmonary surfactant (PS) for preventing bronchopulmonary dysplasia (BPD) in premature infants with neonatal respiratory distress syndrome (NRDS). The related studies were retrieved in PubMed, EMBASE, the Cochrane Library, Clinical Trial, CNKI, Wanfang and VIP Database from inception to August 2018. Two reviewers independently screened the studies to ensure that all patients with diagnosis of NRDS were enrolled to studies within 1 day after birth, assessed the quality of included studies by GRADEpro system and extracted the data for review. The meta-analysis was performed by RevMan 5.2 software. A subgroup analysis about inhaled corticosteroid (ICS) delivery method was made between ICS inhalation subgroup [inhalation of ICS by nebulizer or metered dose inhaler (MDI)] and ICS intratracheal instillation subgroup (PS used as a vehicle). Eight randomized controlled trials were enrolled in the meta-analysis, 5 trials of which stated the randomized method, grouping and blinded method, and the follow-up procedures were reported. GRADEpro system showed high quality of 4 trials (5 articles), and the rest 4 trials had moderate quality. Meta-analysis showed that the incidence of BPD was decreased in ICS group, the relative risk (RR) was 0.56 (95% CI: 0.42-0.76), and similar trends were found in ICS inhalation subgroup and ICS intratracheal instillation subgroup, with the corresponding RR being 0.58 (95% CI: 0.41-0.82) and 0.47 (95% CI: 0.24-0.95) respectively. ICS could also significantly reduce the mortality risk as compared with placebo control group (RR: 0.67;95% CI: 0.45-0.99), with RR of ICS inhalation subgroup and ICS intratracheal instillation subgroup being 0.81 (95% CI: 0.34-1.94) and 0.64 (95% CI: 0.41-0.99) respectively. Moreover, the percentage of infants using PS more than one time was lower in ICS group than in the placebo control group, with the RR and 95% CI being 0.55 (95% CI: 0.45-0.67), and that in ICS intratracheal instillation subgroup lower than in ICS inhalation subgroup (RR: 0.56;95% CI: 0.45-0.69, and RR: 0.35;95% CI:0.08-1.52 respectively). There was no significant difference in the incidence of infection or retinopathy of prematurity and neuro-motor system impairment between ICS group and placebo control group, with the corresponding RR being 0.95 (95% CI:0.59-1.52), 0.92 (95% CI: 0.62-1.38) and 1.13 (95% CI: 0.92-1.39), respectively. It was concluded that early administration of ICS and PS is an effective and safe option for preterm infants with NRDS in preventing BPD and reducing mortality, decreasing the additional PS usage, especially for the ICS intratracheal instillation subgroup. Furthermore, the appropriate dose and duration of ICS, combined use of inhalation or instillation of ICS with PS and the long-term safety of airway administration of corticosteroids need to be assessed in large trials.展开更多
AIM: To report the visual outcomes and refractive status in premature infants with and without retinopathy of prematurity(ROP) who were or not treated. METHODS: The clinical records of all premature infants with or wi...AIM: To report the visual outcomes and refractive status in premature infants with and without retinopathy of prematurity(ROP) who were or not treated. METHODS: The clinical records of all premature infants with or without ROP and with or without treatment between 2007 and 2017 were retrospectively reviewed. Basic demographic data, serial changes in ROP incidence, treatment and outcomes, and the refractive states were analyzed. Correlations among myopia and astigmatism progression, birth weight, gestational age, and treatment methods were also analyzed.RESULTS: A total of 562 screened premature infants(all Chinese, 1124 eyes), were recruited with a 378:184 maleto-female ratio. Birth weight did not directly influence ROP incidence. The overall ROP incidence was 16.55%(93/562 cases). The incidences in boys and girls were 16.14%(33/378 cases) and 17.39%(32/184 cases), respectively, and this difference was not significant. However, all infants with serious ROP(stage IV and V) were male. Myopia combined with astigmatism was common in premature infants with and without ROP(30.99%, 172/555 cases), and myopic refraction(including myopia and myopia combined with astigmatism) was more common in premature infants with ROP(48.84%, 42/86 cases). In the >8.00 diopter group, there were significantly more ROP infants than without ROP. Myopic refraction(including myopia and myopia combined with astigmatism) was most common in infants with ROP after treatment(63.63%, 7/11 cases). CONCLUSION: The refractive state is different between premature infants and mature infants. Those treated for ROP had a higher chance of developing myopia, astigmatism, and higher diopter.展开更多
AIM:To assess the safety and utility of capsule endoscopy(CE)for children who are unable to swallow the capsule endoscope.METHODS:The medical records of all of the children who underwent CE between 2010 and 2012 were ...AIM:To assess the safety and utility of capsule endoscopy(CE)for children who are unable to swallow the capsule endoscope.METHODS:The medical records of all of the children who underwent CE between 2010 and 2012 were retrospectively reviewed.The patients were divided into 2groups:group A included patients who were unable to swallow the capsule endoscope,and group B included patients who were able to swallow it.For the patients who were unable to swallow the capsule endoscope,it was placed in the duodenum endoscopically.The small bowel transit time,endoscopic diagnosis and complications of the 2 groups were compared.RESULTS:During the study period,28 CE procedures were performed in 26 patients.Group A included 11patients with a median age of 2 years(range 10 mo-9years),and group B included 15 patients with a median age of 12 years(range 8 years-16 years).The lightest child in the study weighed 7.9 kg.The detection rates did not differ between the 2 groups.The median small bowel transit time was 401 min(range 264-734 min)in group A and 227 min(range 56-512 min)in group B(P=0.0078).No serious complications,including capsule retention,occurred.No significant mucosal trauma occurred in the pharynx,esophagus,stomach or duodenum when the capsule was introduced using an endoscope.CONCLUSION:CE is a safe and useful procedure for infants and young children who are unable to swallow the capsule endoscope.展开更多
The epidemiologic characteristics of 631 infant pertussis cases 〈 12 months, which accounted for 57.42% of the total cases, were analyzed by descriptive epidemiology in Tianjin, between 2010 and 2015. The incidence o...The epidemiologic characteristics of 631 infant pertussis cases 〈 12 months, which accounted for 57.42% of the total cases, were analyzed by descriptive epidemiology in Tianjin, between 2010 and 2015. The incidence of infants was 104.66/100,000, which was 118 times higher than in other age groups （P 〈 0.001）. The primary type of pertussis simultaneously presented in households was adult-to-infant （70.51%）. The parents were identified as the source of infection in 80.18% of cases for infants. The positive rate of placental antibody transfer was 31.06% and 3.13% for 3-month-old infants. Infants presented the highest age-specific pertussis incidence. The most important reason was parents were the important sources of infection, and secondly the lower level of antibodies in neonates and the rapid waning of maternal antibody titer.展开更多
A randomized,double-blind,placebo-controlled multicenter trial was conducted in healthy Chinese infants to assess the efficacy and safety of a hexavalent live human-bovine reassortant rotavirus vaccine(HRV)against rot...A randomized,double-blind,placebo-controlled multicenter trial was conducted in healthy Chinese infants to assess the efficacy and safety of a hexavalent live human-bovine reassortant rotavirus vaccine(HRV)against rotavirus gastroenteritis(RVGE).A total of 6400 participants aged 6-12 weeks were enrolled and randomly assigned to either HRV(n?3200)or placebo(n?3200)group.All the subjects received three oral doses of vaccine four weeks apart.The vaccine efficacy(VE)against RVGE caused by rotavirus serotypes contained in HRV was evaluated from 14 days after three doses of administration up until the end of the second rotavirus season.VE against severe RVGE,VE against RVGE hospitalization caused by serotypes contained in HRV,and VE against RVGE,severe RVGE,and RVGE hospitalization caused by natural infection of any serotype of rotavirus were also investigated.All adverse events(AEs)were collected for 30 days after each dose.Serious AEs(SAEs)and intussusception cases were collected during the entire study.Our data showed that VE against RVGE caused by serotypes contained in HRV was 69.21%(95%CI:53.31-79.69).VE against severe RVGE and RVGE hospitalization caused by serotypes contained in HRV were 91.36%(95%CI:78.45-96.53)and 89.21%(95%CI:64.51-96.72)respectively.VE against RVGE,severe RVGE,and RVGE hospitalization caused by natural infection of any serotype of rotavirus were 62.88%(95%CI:49.11-72.92),85.51%(95%CI:72.74-92.30)and 83.68%(95%CI:61.34-93.11).Incidences of AEs from the first dose to one month post the third dose in HRV and placebo groups were comparable.There was no significant difference in incidences of SAEs in HRV and placebo groups.This study shows that this hexavalent reassortant rotavirus vaccine is an effective,well-tolerated,and safe vaccine for Chinese infants.展开更多
文摘Objective:To explore the positive role of developmental care measures in promoting the growth and development of premature infants,and analyze their specific effects on improving the sleep duration and quality of premature infants.Methods:A total of 80 premature infants who met the inclusion criteria were selected by convenient sampling method and divided into an experimental group and a control group,with 40 cases in each group.The experimental group received comprehensive nursing intervention of developmental care during the nursing process;the control group adopted the traditional conventional nursing model.Results:There was no statistically significant difference in various physical indicators between the two groups of premature infants before nursing intervention.After nursing intervention,the scores of intellectual development level,psychomotor development index and various physical indicators of premature infants in the experimental group were significantly higher than those in the control group,and the difference was statistically significant.Conclusion:The implementation of developmental care for premature infants can significantly improve their various developmental indicators,which can not only effectively promote the rapid development of premature infants’mental and physical growth,but also improve their sleep quality.
文摘Objective:To investigate the dynamic trajectory,predictors,and underlying adaptation mechanisms of family resilience(FR)among Chinese families with preterm infants(PIs)from birth to six months.Methods:Guided by Ecological Systems Theory,a convergent parallel mixed-methods study was conducted in the Neonatal Intensive Care Unit(NICU)of a tertiary hospital in Fujian Province,China,from June 2023 to June 2024.Quantitative data were collected from 202 caregivers selected by convenience sampling at four time points:at birth(T0),42 days postpartum(T1),3 months postpartum(T2),and 6 months postpartum(T3).Generalized Estimating Equations(GEE)was used to analyze scale score differences across time points and explore factors influencing FR.Qualitative data were collected through semi-structured interviews with 14 caregivers recruited by maximum variation purposive sampling and analyzed using Colaizzi’s phenomenological approach.After conducting separate data analyses,the findings were integrated through side-by-side comparison and joint display.Results:Quantitative results revealed a non-linear,“V”-shaped trajectory of FR,significantly influenced by educational level,conception via assisted reproduction,farming occupation,coping style,psychological resilience,family functioning,and social support.Qualitative findings identified four themes:initial uncertainty and emotional distress,post-discharge anxiety,gradual adaptation,and eventual stabilization.Integrated mixed-methods findings revealed that the initial confusion phase demands a comprehensive response to family needs(T0);the post-discharge bottleneck requires addressing the care capability-needs gap(T1);the role adaptation phase is pivotal for enhancing internal family resources(T2);and the family-work transition necessitates enhanced work-family facilitation(T3).Conclusions:This study systematically identifies the unique“V”-shaped trajectory of FR in Chinese families with PIs and its key influencing factors,and accurately analyzes their dynamic experiences and adaptation across four stages.These findings provide an empirical basis for stage-specific targeted interventions,strongly support the practical advancement of the family-centered care model,and deliver critical guidance for enhancing FR.
文摘BACKGROUND Cow's milk allergy(CMA)is a common condition in infants,requiring alternative protein sources in their diets.Soya milk has become a popular substitute,especially in developing countries where it is a more affordable option compared to expensive hypoallergenic feeds for infants with insufficient breast milk supply.However,recent observations have shown an increase in soya cross-allergic reactions among infants with CMA.AIM To determine how often infants diagnosed with CMA also had soya cross-allergy and to examine the symptoms and outcomes of these infants at 2 years of age.METHODS Data from two pediatric centers were analyzed,looking at clinical records of children under 2 years old diagnosed with CMA from August 2015 to July 2023,divided into two four-year periods.RESULTS The records of 432 infants with CMA were analyzed.In the first four-year period from August 2015 to July 2019,142 infants were studied,with 27(19%)found to have soya-protein allergy as well.In the second four-year period,a total of 290 infants were studied,and soya allergy was found in 136 babies(47%).This represents a significant increase(P<0.0001)in cases of soya protein cross-allergy among infants with CMA.The most common symptoms observed were gastroesophageal reflux disorder(39%),followed by failure to thrive,bloody diarrhea,watery diarrhea,and constipation.At 2 years of age,these infants showed significant growth failure compared to infants with CMA only.CONCLUSION In conclusion,this study emphasizes the importance of being cautious when using soy protein in infants with cow's milk protein allergy,especially in areas where cost is a major concern.
文摘BACKGROUND Premature infant formula is based on milk and contains energy,vitamins,etc.Breast milk is rich in minerals,such as phosphorus and calcium,and proteins.Both can be used for nutritional support in preterm infants with low-birth-weight.However,their effects on the difference in infant growth rate and postpartum depression are still unclear.AIM To explore the effect of early micro-breastfeeding on the growth rate of preterm infants with low-birth-weight and maternal postpartum depression.METHODS Data of 68 preterm infants with low-birth-weight and their mothers admitted to the Department of Neonatology,Suzhou Ninth Hospital Affiliated to Soochow University,between January 2022 and December 2024,were retrospectively collected.The infants were divided into two groups according to the different enteral feeding methods in the early stage:Control group(n=32 cases,premature infant formula feeding)and observation group(n=36 cases,micro-breastfeeding,i.e.,exclusive breastfeeding,no mixed feeding).The baseline data;feeding status;gastrointestinal adverse reactions such as vomiting,gastric retention,and abdominal distension;growth rate(body weight,body length,and head circumference);and adverse events(infection,cholestasis,hyperbilirubinemia,and necrotizing enterocolitis)were compared between the two groups.Moreover,the maternal postpartum depression status of the two groups based of infants based on the Edinburgh postpartum depression scale(EPDS)was compared.RESULTS No significant difference in baseline data was found between the two groups(P>0.05).The onset time of weight gain(6.49±0.53 days vs 7.09±0.61 days,P<0.001),time for complete meconium excretion(6.28±0.92 days vs 8.31±1.17 days,P<0.001),time for recovery to birth weight(8.81±1.40 days vs 10.95±1.64 days,P<0.001),and time to reach full enteral feeding(12.29±2.08 days vs 15.48±2.27 days,P<0.001)were compared between the observation and control groups.The incidence of vomiting,abdominal distension,and gastric retention was significantly lower in the observation group than in the control group,and the difference was significant(P<0.05).The rates of the weight growth(15.88±1.57 g/day vs 14.84±1.51 g/day,P=0.007),head circumference(0.63±0.08 cm/week vs 0.59±0.05 cm/week,P=0.018),and length(0.80±0.12 cm/week vs 0.73±0.14 cm/week,P=0.029)were compared between the observation and control groups.On hospital admission of preterm infants with low-birthweight,the mothers of the two groups did not show a significant difference in the EPDS scores for postpartum depression(P>0.05).Preterm infants with low-birth-weight were hospitalized for 2 weeks,and the EPDS score for maternal postpartum depression was significantly lower in the observation group than in the control group(8.38±1.47 vs 9.49±2.35,P=0.021).CONCLUSION Compared with preterm infant formula feeding,early micro-breastfeeding can more effectively promote the growth rate of preterm infants with low-birth-weight and reduce the gastrointestinal feeding intolerance and related complications,thereby alleviating mothers’concerns about their children and reducing the risk of postpartum depression.
基金Science and Technology Program Project of Jiangxi Provincial Health Commission(Grant No.202210200).
文摘The aim of this study is to analyze factors influencing the development of bronchopulmonary dysplasia(BPD)within 28 d after birth in very-low-birth-weight(VLBW)infants with a gestational age of less than 34 weeks who were receiving early parenteral nutrition.Data were retrospectively collected from infants born between January and December 2021,who were admitted to the neonatal intensive care unit within 24 h of birth,had a gestational age of less than 34 weeks,and were classified as VLBW.The study included 14 cases without BPD and 20 cases with BPD,and it compared clinical data during hospitalization between these two groups.On the 1st day of life,the BPD group had a nitrogen-to-calorie ratio of 105.44±26.67,while the non-BPD group had a ratio of 146.81±37.04.This difference was statistically significant,with a P-value of 0.04,indicating a potential association between the nitrogen-to-calorie ratio and the development of BPD.However,no significant differences were observed in other clinical indicators between the two groups.These findings suggested that a larger sample size was needed to further explore and confirm the correlation between the nitrogen-to-calorie ratio and the risk of developing BPD in this population.
基金funded by Shanghai Municipal Health and Wellness Commission Health Industry Clinical Research Special Project(202140299).
文摘Background There have been numerous intervention studies focusing on the development of preterm infants,but there has been limited investigation into the home environment as a determinant of developmental outcomes in preterm infants.The aspects and extent to which the home environment affects the early(18 months corrected age)neuropsychological development of preterm infants are still unclear.Aims This study aimed to analyse the effect of the home environment on the neuropsychiatric development of preterm infants at 18 months corrected age after discharge from the neonatal intensive care unit(NICU).It also sought to provide a basis for promoting neuropsychiatric development among preterm infants by improving the home environment.Methods In this retrospective cross-sectional study,275 preterm infants born between January 2019 and January 2022 were followed up for systematic management after discharge from the NICU at Shanghai Children's Hospital.The Home Nurture Environment Questionnaire was used to assess the home environment of the infants and analyse its impact on the developmental quotient(evaluated by the Gesell Developmental Scale)and the rate of developmental delays at 18 months corrected age.Results A total of 41.454%of the infants were extremely preterm.The developmental quotient scores at 18 months corrected age were in the middle of the scale.The language domain had the highest rate of developmental delay(46.182%),followed by the adaptive domain(37.091%).Multiple logistic regression analyses showed that compared with infants in supportive home environments,infants with moderate/unsupportive home environments had significantly elevated risks of development delay:2.162-fold for global(odds ratio(OR)2.162,95% confidence interval(Cl)1.274 to 3.665,p=0.004),2.193-fold for fine motor(OR 2.193,95%CI 1.161 to 4.140,p=0.016),2.249-fold for language(0R 2.249,95%CI 1.336 to 3.786,p=0.002)and 2.042-fold for personal-social(OR 2.042,95%CI 1.149 to 3.628,p=0.015).Conclusions A supportive home environment is a crucial protective factor for the neuropsychological development of preterm infants.It is associated with higher developmental quotient scores and protects against neuropsychiatric delays.Incorporating evaluation and continuous improvement of the home environment into the management framework for preterm infants to promote optimal neurodevelopment is essential.
文摘High-risk infants,from fetal stage to 3-year-old,face severe physical and mental development threats due to biological,psychological,or environmental factors.These threats can lead to developmental delay and cognitive impairment,affecting their future quality of life and social integration.Scientific health management,with nutritional intervention as a key part,is urgently needed.Nutritional intervention,through targeted supplementation and feeding guidance,can optimize their development,avoid nutritional-related deviations,reduce long-term disease risk,and lay a healthy growth foundation.This study analyzes the positive effects of nutritional intervention on high-risk infants’physical growth,neural development,and disease prevention,providing scientific evidence for optimizing clinical follow-up strategies.
基金Undergraduate Innovation and Entrepreneurship Training Program,Guangzhou Xinhua University(Project No.:2413092083)。
文摘Objective:To understand the current status and influencing factors of family caregiving for infants and toddlers aged 6–36 months in Tianhe District,Guangzhou City,with the aim of better comprehending the physiological and psychological needs of infants and toddlers,and assisting families in developing effective intervention measures and support strategies.Methods:In November 2024,a random sample of 311 infants and toddlers aged 6–36 months from the permanent resident population in Tianhe District,Guangzhou City,was selected.Caregivers were surveyed using a questionnaire regarding family caregiving practices for infants and toddlers.The Kruskal-Wallis’s test,Mann-Whitney test,and multiple linear regression analysis were employed to examine the influencing factors of family caregiving for infants and toddlers.Results:The findings indicate that the quality of family caregiving is significantly influenced by the educational level of the parents(p<0.001)and the annual household income(p<0.001).Work-family conflict showed a significant negative correlation with the quality of family caregiving(β=-0.239,p<0.001),while family atmosphere demonstrated a significant positive correlation with the quality of family caregiving(β=0.225,p<0.001).Conclusion:In Tianhe District,Guangzhou City,the quality of infant and toddler caregiving is determined by a combination of key factors,including annual household income,parental educational background,work-family conflict,and family atmosphere.These elements collectively form the core determinants of caregiving practices for infants and toddlers.
文摘BACKGROUND To prevent mother to child transmission(MTCT)of human immunodeficiency virus(HIV),sustained maternal viral load suppression(VLS)and early HIV testing among HIV exposed infants(HEI)is critical.AIM To investigate maternal viral load results and infant HIV testing uptake at 6-weeks,and 9-months and 18-months in Rwanda.METHODS Between 2015 and 2022,VLS(<200 copies/mL)was measured among pregnant women living with HIV(WLHIV)from 38-healthcare facilities.Viral loads(VL)were measured at 6-months,12-months and 24-months,respectively.For maternal VL,the unit of analysis was visit-pair,and the pairs were created to define those with VL<200 copies/mL at two consecutive visits as having sustained VLS,persistent viremia(VL≥200 copies/mL at two consecutive visits),viral rebound(VL<200 copies/mL at prior visit only)and newly suppressed(VL<200 copies/mL at subsequent visit only).HEI were considered to have persistent HIV testing if they had all three HIV tests.Poisson regression models with generalized estimating equations were used to estimate the adjusted incidence rate ratio(aIRR)and 95%CI for factors associated with sustained VLS and persistent HIV testing.RESULTS A total of 1145 mother-infant pairs were analyzed.Infant HIV testing uptake at 6-weeks,9-months and 18-months was 1145(100.0%),1089(95.1%),1006(87.9%)respectively.Nine hundred ninety-nine HEI(87.3%)tested for HIV persistently.At 18-months,the incidence of HIV among HEI was 8(0.7%).Of 1145 mothers,1076(94.0%)had≥2 VL results making a total of 2010 visit-pairs(142-single;934-double visit-pairs).The incidence rate of sustained VLS,persistent viremia,viral rebound and new suppression were 91.0%,1.3%,3.6%and 4.0%respectively.Maternal disclosure of HIV status(aIRR=1.08,95%CI:1.02-1.14)was associated with increased likelihood of sustained VLS.Having peer support(aIRR=1.0595%CI:1.01-1.10)was associated with persistent HIV testing among HEI.CONCLUSION Sustained VLS is high among pregnant WLHIV in Rwanda.The low incidence of HIV among HEI may be attributed to high VLS levels.Targeted interventions,including enhanced HIV disclosure and peer support,are crucial for improving sustained VLS and increasing infant HIV testing uptake to reduce MTCT.
基金Health Commission of Guangxi Zhuang Autonomous Region,Self-Financing Scientific Research Subject(Project No.:Z20210327)。
文摘Objective:To explore the application effect of improved“Bird’s nest”nursing in the transport of premature infants.Methods:Collecting 100 cases of premature infants,randomly divided into experimental group and control group,two groups of premature 50 cases each.The control group received the traditional“Bird’s nest”nursing.Experimental group in modified the“bird’s nest”nursing intervention,compared two groups of premature monitoring vital signs during the transfer process,transport after the body development indicators,the time and cure warmers intervention.Results:Compared with control group,experimental group premature temperature fluctuation is small,apnea and fewer times of low body temperature and oxygen saturation is higher,the contrast results with statistical significance(P<0.05).There was no significant difference in physical development,time to get out of the incubator,and cure rate.Conclusion:Modified the“bird’s nest”care in outside the hospital application,help to improve premature transfer process safety,and security for premature success implementation of transshipment is of great significance.
文摘Background: Malnutrition, a serious public health concern, is influenced by various factors. Objective: The study aims to explore malnutrition issues among infants under five years old in Guéra Province. Methods: The study used a cross-sectional design and a two-stage cluster sampling method to select participants. The study population was infants aged between 0 - 24 months. Data collection was done between June 2023 and September 2024;it included anthropometric measurements, blood analyses, and interviews. Anthropometric parameters were calculated using ENA for SMART software. Statistical analyses were performed by R Studio to investigate associations between different characteristics, using logistic regression models to identify risk factors. A p-value less than 0.05 was considered significant. Results: The study included 377 infants in eight villages in Guéra Province, Chad. The sample was predominantly girls (55.3%), with a median age of 16 months. Most infants (94%) were mixed-fed, and only 6% were exclusively breastfed. We found that 7.3% of children were globally malnourished, with higher rates in boys 9.6%. A significant disparity existed between boys and girls in global acute malnutrition (GAM) rates, with boys having a higher prevalence of 17.9%. A substantial proportion of Infants were underweight, with males 27.4%. Stunting was prevalent 20.1%. Several factors were associated with malnutrition, including gender, feeding practices, infectious diseases, and socioeconomic factors. Diarrhea, malaria, limited access to drinking water, and early diet diversification were significantly associated with malnutrition. Conclusion: Targeted interventions are necessary to address these issues and improve the nutritional status of children in the Guéra province.
文摘Immunoprophylaxis is routinely recommended for infants born to mothers with hepatitis B virus(HBV)infection within the first 12-24 hours.Detection of he-patitis B surface antibody(HBsAb)resulting from hepatitis B immunoglobulin administered at birth may be perceived as a real vaccine response.This makes it difficult to detect HBV infection.For this reason,it is recommended that infants born to hepatitis B surface antigen positive mothers and who received immunop-rophylaxis at birth should have HBsAb testing when they are 9-15 months old.
基金Supported by the Project of Mianyang Central Hospital,School of Medicine,University of Electronic Science and Technology of China,No.2021YJ005the Science&Technology Department of Sichuan Province,China,No.2019YJ0701。
文摘BACKGROUND Enhanced recovery after surgery(ERAS)represents an innovative,protocoldriven perioperative care program designed to optimize patient outcomes.However,its application and efficacy in infants and children with Hirschsprung disease(HD)remain underexplored.AIM To delve into the impact of ERAS on perioperative recovery and the overall medical experience in HD infants and children.METHODS Thirty-eight infants and children with HD who received the Soave surgical procedure were enrolled in this case-control study.According to age-and sexstratified single-blind randomized tables,20 cases received ERAS treatment(ERAS group)and 18 cases received conventional treatment(control group).The two treatments were then compared in terms of perioperative recovery and medical experience.RESULTS Significant differences were observed in pain scores at awakening(4.2±1.3 vs 5.2±1.2,t=2.516,P=0.017)and pain duration(85.69±7.46 hours vs 67.00±8.56 hours,t=7.139,P<0.001)between the ERAS and control group.The recovery of bowel movement was earlier in the ERAS group than in the control group(borborygmus time:33.63±9.83 hours vs 44.69±16.85 hours,t=2.501,P=0.017;feeding time:36.63±9.55 hours vs 49.36±16.99 hours,t=2.884,P=0.007;anal catheter indwelling time:75.83±13.80 hours vs 93.36±20.65 hours,t=3.104,P=0.004),and fever duration(40.73±14.42 hours vs 52.63±18.69 hours,t=2.211,P=0.034).In the ERAS group,hospital stay was shorter(7.5±0.9 days vs 8.3±1.2 days)and the cost was lower(14203±2381 yuan vs 16847±3558 yuan).During the 1-month follow-up period,of the multiple postoperative complications observed,the occurrence of perianal dermatitis(PFisher=0.016)and defecation dysfunction(PFisher=0.027)were lower in the ERAS group than in the control group.CONCLUSION The ERAS protocol has the potential to profoundly enhance postoperative recovery and significantly elevate the overall comfort and quality of the medical experience,making it an indispensable approach that warrants widespread adoption.Continuous refinement through evidence-based practices is anticipated to further optimize its efficacy.
基金Supported by Nanjing Medical Science and Technique Development Foundation,No.YKK23151the Opening Foundation of Key Laboratory,No.JSHD202313+3 种基金Yingke Xinchuang Research Foundation of Jiangsu Blood Transfusion Association,No.JSYK2024006the Jiangsu Province Capability Improvement Project through Science,Technology and Education,No.ZDXYS202210Open Project of the State Key Laboratory of Reproductive Medicine of Nanjing Medical University,No.SKLRM-K202107the Jiangsu Provincial Maternal and Child Health Research Program,No.F202040.
文摘BACKGROUND The primary complication associated with gestational diabetes mellitus(GDM)is delivery of an infant that is large for gestational age(LGA).Epidemiological findings have demonstrated that irregular lipid metabolism significantly con-tributes to insulin resistance,a key pathophysiological mechanism in GDM.However,the correlation between various lipid indices and the probability of delivering LGA infants remains inconsistent.AIM To explore the relationships between lipid indices and the possibility of having LGA infants among GDM-affected pregnant females.METHODS Binary logistic regression methods were employed to evaluate the odds ratios and corresponding 95%confidence intervals for LGA according to five lipid indices.Restricted cubic spline models were applied to investigate dose-response relationships.The association between lipid indices and the risk of delivering LGA infants was further investigated among different subgroups.Receiver operating characteristic curves were utilized to assess the diagnostic performance of lipid indices.RESULTS Across crude and adjusted models,females with lipid indices in the upper two tertiles presented a markedly elevated risk of delivering LGA infants compared with the lowest tertile category.Conversely,high-density lipoprotein cholesterol levels demonstrated the contrary trend.Restricted cubic spline analyses revealed linear associations between the five lipid indices,except triglyceride levels,and the prevalence of LGA.The subgroup analysis highlighted that the correlation between lipid indices and the probability of LGA was inconsistent.The five lipid indices presented significant diagnostic efficacy,as indicated by receiver operating characteristic curve areas.CONCLUSION Our research demonstrated that lipid indices were effective predictors of the incidence of LGA infants in GDM-affected pregnancies irrespective of potential confounding factors.
基金Shanghai Outstanding Young University Teachers Research and Special Funds(Grant No.ZZjdyx13089)Science and Technology Commission of Shanghai Municipality Grants(Grant No.12DZ1930404)
文摘In the present study, clinical pharmacists monitored the blood concentration of vancomycin in children in the Infant Ward from 2013 to 2014, and the drug dose was adjusted according to its plasma concentration. Moreover, we analyzed the plasma concentration of vancomycin in infants in the hospital from 2013 to 2014. Simultaneously, we also discussed the necessity of regular therapeutic drug monitoring of vancomycin in infants, and the important role of clinical pharmacists was further explored. The results showed that it was necessary to routinely monitor the therapeutic drug in infants. Clinical pharmacists performed medication monitoring, which improved the effectiveness of vancomycin and prevented its adverse effects. In addition, it is a new treatment model for the participation of clinical pharmacists in the clinical treatment.
文摘There is uncertain result with regard to the use of inhalation or instillation steroids to prevent bronchopulmonary dysplasia in preterm infants. This meta-analysis was designed to evaluate the efficacy and safety of early airway administration (within 2 days after birth) of corticosteroids and pulmonary surfactant (PS) for preventing bronchopulmonary dysplasia (BPD) in premature infants with neonatal respiratory distress syndrome (NRDS). The related studies were retrieved in PubMed, EMBASE, the Cochrane Library, Clinical Trial, CNKI, Wanfang and VIP Database from inception to August 2018. Two reviewers independently screened the studies to ensure that all patients with diagnosis of NRDS were enrolled to studies within 1 day after birth, assessed the quality of included studies by GRADEpro system and extracted the data for review. The meta-analysis was performed by RevMan 5.2 software. A subgroup analysis about inhaled corticosteroid (ICS) delivery method was made between ICS inhalation subgroup [inhalation of ICS by nebulizer or metered dose inhaler (MDI)] and ICS intratracheal instillation subgroup (PS used as a vehicle). Eight randomized controlled trials were enrolled in the meta-analysis, 5 trials of which stated the randomized method, grouping and blinded method, and the follow-up procedures were reported. GRADEpro system showed high quality of 4 trials (5 articles), and the rest 4 trials had moderate quality. Meta-analysis showed that the incidence of BPD was decreased in ICS group, the relative risk (RR) was 0.56 (95% CI: 0.42-0.76), and similar trends were found in ICS inhalation subgroup and ICS intratracheal instillation subgroup, with the corresponding RR being 0.58 (95% CI: 0.41-0.82) and 0.47 (95% CI: 0.24-0.95) respectively. ICS could also significantly reduce the mortality risk as compared with placebo control group (RR: 0.67;95% CI: 0.45-0.99), with RR of ICS inhalation subgroup and ICS intratracheal instillation subgroup being 0.81 (95% CI: 0.34-1.94) and 0.64 (95% CI: 0.41-0.99) respectively. Moreover, the percentage of infants using PS more than one time was lower in ICS group than in the placebo control group, with the RR and 95% CI being 0.55 (95% CI: 0.45-0.67), and that in ICS intratracheal instillation subgroup lower than in ICS inhalation subgroup (RR: 0.56;95% CI: 0.45-0.69, and RR: 0.35;95% CI:0.08-1.52 respectively). There was no significant difference in the incidence of infection or retinopathy of prematurity and neuro-motor system impairment between ICS group and placebo control group, with the corresponding RR being 0.95 (95% CI:0.59-1.52), 0.92 (95% CI: 0.62-1.38) and 1.13 (95% CI: 0.92-1.39), respectively. It was concluded that early administration of ICS and PS is an effective and safe option for preterm infants with NRDS in preventing BPD and reducing mortality, decreasing the additional PS usage, especially for the ICS intratracheal instillation subgroup. Furthermore, the appropriate dose and duration of ICS, combined use of inhalation or instillation of ICS with PS and the long-term safety of airway administration of corticosteroids need to be assessed in large trials.
基金Supported by Health and Family Planning Commission of Jiangxi Province(No.20131080)
文摘AIM: To report the visual outcomes and refractive status in premature infants with and without retinopathy of prematurity(ROP) who were or not treated. METHODS: The clinical records of all premature infants with or without ROP and with or without treatment between 2007 and 2017 were retrospectively reviewed. Basic demographic data, serial changes in ROP incidence, treatment and outcomes, and the refractive states were analyzed. Correlations among myopia and astigmatism progression, birth weight, gestational age, and treatment methods were also analyzed.RESULTS: A total of 562 screened premature infants(all Chinese, 1124 eyes), were recruited with a 378:184 maleto-female ratio. Birth weight did not directly influence ROP incidence. The overall ROP incidence was 16.55%(93/562 cases). The incidences in boys and girls were 16.14%(33/378 cases) and 17.39%(32/184 cases), respectively, and this difference was not significant. However, all infants with serious ROP(stage IV and V) were male. Myopia combined with astigmatism was common in premature infants with and without ROP(30.99%, 172/555 cases), and myopic refraction(including myopia and myopia combined with astigmatism) was more common in premature infants with ROP(48.84%, 42/86 cases). In the >8.00 diopter group, there were significantly more ROP infants than without ROP. Myopic refraction(including myopia and myopia combined with astigmatism) was most common in infants with ROP after treatment(63.63%, 7/11 cases). CONCLUSION: The refractive state is different between premature infants and mature infants. Those treated for ROP had a higher chance of developing myopia, astigmatism, and higher diopter.
文摘AIM:To assess the safety and utility of capsule endoscopy(CE)for children who are unable to swallow the capsule endoscope.METHODS:The medical records of all of the children who underwent CE between 2010 and 2012 were retrospectively reviewed.The patients were divided into 2groups:group A included patients who were unable to swallow the capsule endoscope,and group B included patients who were able to swallow it.For the patients who were unable to swallow the capsule endoscope,it was placed in the duodenum endoscopically.The small bowel transit time,endoscopic diagnosis and complications of the 2 groups were compared.RESULTS:During the study period,28 CE procedures were performed in 26 patients.Group A included 11patients with a median age of 2 years(range 10 mo-9years),and group B included 15 patients with a median age of 12 years(range 8 years-16 years).The lightest child in the study weighed 7.9 kg.The detection rates did not differ between the 2 groups.The median small bowel transit time was 401 min(range 264-734 min)in group A and 227 min(range 56-512 min)in group B(P=0.0078).No serious complications,including capsule retention,occurred.No significant mucosal trauma occurred in the pharynx,esophagus,stomach or duodenum when the capsule was introduced using an endoscope.CONCLUSION:CE is a safe and useful procedure for infants and young children who are unable to swallow the capsule endoscope.
基金supported by the Research Fund of Tianjin Health and Family Planning Commission 2015KY18Science and Technology Major Project of Chinese Preventive Medicine Association Q2017A1225
文摘The epidemiologic characteristics of 631 infant pertussis cases 〈 12 months, which accounted for 57.42% of the total cases, were analyzed by descriptive epidemiology in Tianjin, between 2010 and 2015. The incidence of infants was 104.66/100,000, which was 118 times higher than in other age groups （P 〈 0.001）. The primary type of pertussis simultaneously presented in households was adult-to-infant （70.51%）. The parents were identified as the source of infection in 80.18% of cases for infants. The positive rate of placental antibody transfer was 31.06% and 3.13% for 3-month-old infants. Infants presented the highest age-specific pertussis incidence. The most important reason was parents were the important sources of infection, and secondly the lower level of antibodies in neonates and the rapid waning of maternal antibody titer.
基金supported by National Health Commission of the People’s Republic of China (grant number:2019ZX09302059)sponsored and funded by Wuhan Institute of Biological Products Co.,Ltd.,Hubei,China
文摘A randomized,double-blind,placebo-controlled multicenter trial was conducted in healthy Chinese infants to assess the efficacy and safety of a hexavalent live human-bovine reassortant rotavirus vaccine(HRV)against rotavirus gastroenteritis(RVGE).A total of 6400 participants aged 6-12 weeks were enrolled and randomly assigned to either HRV(n?3200)or placebo(n?3200)group.All the subjects received three oral doses of vaccine four weeks apart.The vaccine efficacy(VE)against RVGE caused by rotavirus serotypes contained in HRV was evaluated from 14 days after three doses of administration up until the end of the second rotavirus season.VE against severe RVGE,VE against RVGE hospitalization caused by serotypes contained in HRV,and VE against RVGE,severe RVGE,and RVGE hospitalization caused by natural infection of any serotype of rotavirus were also investigated.All adverse events(AEs)were collected for 30 days after each dose.Serious AEs(SAEs)and intussusception cases were collected during the entire study.Our data showed that VE against RVGE caused by serotypes contained in HRV was 69.21%(95%CI:53.31-79.69).VE against severe RVGE and RVGE hospitalization caused by serotypes contained in HRV were 91.36%(95%CI:78.45-96.53)and 89.21%(95%CI:64.51-96.72)respectively.VE against RVGE,severe RVGE,and RVGE hospitalization caused by natural infection of any serotype of rotavirus were 62.88%(95%CI:49.11-72.92),85.51%(95%CI:72.74-92.30)and 83.68%(95%CI:61.34-93.11).Incidences of AEs from the first dose to one month post the third dose in HRV and placebo groups were comparable.There was no significant difference in incidences of SAEs in HRV and placebo groups.This study shows that this hexavalent reassortant rotavirus vaccine is an effective,well-tolerated,and safe vaccine for Chinese infants.
