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ABSTRACT: To examine the esophageal function of neonates by high resolution manometry (HRM), and to provide preliminary data for research on the esophageal function of neonates.
Esophageal HRM was performed on neonates using a solid-state pressure measurement system with 36 circumference sensors arranged at intervals of 0.75 cm, and ManoView software was used to analyze esophageal peristalsis pattern.
Esophageal HRM was performed successfully in 11 neonates, and 126 occurrences of complete esophageal peristalsis were recorded. Complete esophageal peristalsis with pressure increase was recorded in some neonates but most neonates showed a different esophageal peristalsis pattern compared with adults. Some neonates had no relaxation of the upper esophageal sphincter (UES) when pharyngeal muscles contracted in swallowing, some neonates had multiple swallowing without esophageal peristalsis and some neonates had relatively low pressure of esophageal peristalsis. Full-term infants could have relatively low UES pressure and esophageal sphincter (LES) pressure but some preterm infants showed relatively high UES pressure and LES pressure. Longitudinal contraction of the whole esophagus and elevation of LES after swallowing were recorded in some neonates.
Esophageal HRM is safe and tolerable for neonates. HRM shows that esophageal peristalsis after swallowing may not occur or may be incomplete in neonates. The esophageal function of neonates has not yet been developed completely, with large individual differences in esophageal peristalsis. Large sample data are needed for further analysis and research on the esophageal function of neonates.
Zhongguo dang dai er ke za zhi = Chinese journal of contemporary pediatrics 08/2012; 14(8):607-11.
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ABSTRACT: Along with the elevation of survival rate of very low birth weight infants (VLBWI), the enteral feeding of VLBWI has become one of the most important factors, which influence the length of stay, short and long-term prognosis. This study aimed to explore safe and effective clinical protocols of VLBWI enteral feeding.
According to different correlative degree of related factors to VLBWI enteral feeding, different scoring system was formulated for the enteral feeding and monitoring proposal of VLBWI. The safety and efficacy of the score system was evaluated.
Forty-eight VLBWIs in group A was not treated with any score system, gestational age (30.0 ± 2.1) weeks, birth weight (1173 ± 170) g; while 48 VLBWIs in group B were guided with the scoring system, gestational age (30.3 ± 1.7) weeks, birth weight (1133 ± 238) g, there was no significant difference between two groups. The incidence of newborn respiratory distress syndrome of group B was significantly higher than that of group A (P = 0.016). The time of umbilical catheterization of group B was longer than that of group A. There was no significant difference in the incidence of other complications between two groups. The beginning milk volume, milk volume on the third, seventh, fourteenth, twenty-first, twenty-eight day of group B were significantly higher than that of group A [5.6 vs. 3.5 ml/(kg·d), P = 0.008, 12.3 vs. 5.7 ml/(kg·d), P = 0.000, 29.1 vs 8.9 ml/(kg·d), P = 0.000, 62.5 vs. 44.6 ml/(kg·d), P = 0.020, 98.1 vs. 71.5 ml/(kg·d), P = 0.005, 128.0 vs. 102.4 ml/(kg·d), P = 0.011]. The time achieving full enteral feeding of group B was shorter than that of group A (26.7 vs 32.9d, P = 0.007). The incidence of necrotizing enterocolitis in group B was lower than that of group A(0/48 vs. 4/48, P = 0.041). There was no significant difference of the total amino acid dosage between two groups. The total dosage of fatty emulsion was less, and the duration of parenteral nutrition was shorter in group B than in group A (50.3 vs. 73.9 g/kg, P = 0.000, 31.5 vs. 37.8 d, P = 0.016). There was no significant difference in length of stay between two groups. VLBWI of group B began to gain weight earlier [5.0 (4.3, 6.0) vs. 5.0 (5.0, 7.0) d, P = 0.028], regained birth weight earlier (9.2 vs. 11.6 d, P = 0.001), and got more weight in the second week (178 vs. 138 g, P = 0.020).
VLBWI guided with the scoring system achieved full enteral feeding faster, and shortened the duration of parenteral nutrition without increasing the incidence of necrotizing enterocolitis.
Zhonghua er ke za zhi. Chinese journal of pediatrics 07/2012; 50(7):543-8.
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ABSTRACT: To study the effect of early protein and energy intake on early growth velocity of premature infants.
Clinical data on premature infants with a birth weight of less than 1800 g were collected retrospectively, including records of general status, enteral and parenteral nutrition and growth parameters. These premature infants were divided into two groups according to the timing of amino acid administration: early supplementation (the first 24 hrs of life; EAA group; n=112) and late supplementation (after 24 hrs of life; LAA group; n=52). Protein and energy intake, protein/energy ratio and growth velocity during hospital stay were compared between the two groups. Correlation analysis was used to evaluate the association of early protein and energy intake and protein/energy ratio with growth velocity of infants.
Compared with the LAA group, the EAA group presented lower weight loss (6.3% vs 8.8%), shorter time to return to birth weight (7 days vs 9 days), and higher head circumference growth (0.79 ± 0.25 cm/week vs 0.55 ± 0.25 cm/week) and weight growth velocity(20 ± 3 g/kg•d vs 17 ± 3 g/kg•d) (P<0.05). The correlation analysis indicated that protein and energy intake and protein/energy ratio on the 3rd and 7th days of life were positively correlated with weight growth velocity. The protein and energy intake per week after returning to birth weight was positively correlated with weight growth velocity (r= 0.709, P<0.01). Significant correlations were found between the protein and energy intake and both head circumference and length growth velocity on the 3rd and the 7th days of life.
Early administration of amino acids can reduce weight loss, shorten the time taken to return to birth weight, and increase weight and head circumference growth velocity in premature infants. An appropriate increase in protein intake can improve weight, circumference and length growth velocity.
Zhongguo dang dai er ke za zhi = Chinese journal of contemporary pediatrics 04/2012; 14(4):247-52.
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ABSTRACT: To summarize the clinical characteristics and prognosis of newborn aristolochic acid nephropathy induced by akebia.
Retrospective analysis of clinical manifestations, therapy and prognosis was made upon data of 3 newborn infants with renal function lesion induced by akebia.
Three infants who were fed with Chinese herbal medicines containing akebia trifoliate suffered from acute renal failure, renal glomerular and tubular injury, with symptoms of vomiting, diarrhea, and oliguria. Laboratory tests manifested hyperpotassemia, hyponatremia, elevation of serum creatinine and urea nitrogen, and metabolic acidosis. Renal glomerular lesion was mild, presented with proteinuria and increased serum β(2) microglobin. Renal dysfunction was manifested with alkaline urine, glucosuria, positiveness of urine glucose, ketone and aminoaciduria, and increased urine β(2) microglobin excretion. After symptomatic treatment for 3 to 4 weeks, the renal function of these infants recovered. Proteinuria, aminoaciduria and glucosuria turned negative within 5 to 8 months, 3 months to 1 year, and 9 months to 3 years, respectively. Urine pH decreased to 7.0 after 5.0 - 5.5 years. All cases took citric acid mixtures for 5.5 to 6 years. A 12-years follow-up demonstrated that serum creatinine of 3 cases were within normal range during the first 11 years of life, however recent follow-up showed increased serum creatinine of case 1 and case 2, except for serum creatinine of case 3 remained normal. The estimated glomerular filtration rate (eGFR) of all the 3 cases decreased. Among which, eGFR of case 1 and case 2 were lower than 90 [ml/(min·1.73 m(2))], and decreased 1.1 [ml/(min·1.73 m(2))] and 0.6 [ml/(min·1.73 m(2))] per year during recent six years, respectively. No obvious decrease of eGFR was observed in case 3. Blood gas analysis and urine routine were normal, yet blood and urine β(2) microglobin excretion were still high. Urinary N-acetyl-β-D-glucosaminidase increased again after having returned to normal.
Newborn aristolochic acid nephropathy induced by akebia might induce acute renal failure and renal tubules injury. Renal function could recover after symptomatic treatment in short-term. Nevertheless, glomerular filtration rate presents a slow descending tendency and renal tubules lesion lasted for many years, which requires a long-term follow-up.
Zhonghua er ke za zhi. Chinese journal of pediatrics 11/2011; 49(11):814-7.
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ABSTRACT: To explore the effect of aggressive nutritional support in early life on growth of preterm infants during hospitalization.
Two retrospective cohorts of preterm infants were compared; 81 infants of group A (born between January 1, 2005 and June 30, 2006) and 79 infants of group B (June 1, 2009 and November 30, 2010) with gestational age above 28 weeks and birth weight between 1000 g and 2000 g, transfered to NICU of PUMCH within 12 hours after birth, hospitalized for > or = 2 weeks, who were free of major congenital anomalies and survived to discharge were recruited. The comparison of enteral and parenteral nutrition, growth rate, biochemical indices during hospitalization between these both groups were made.
Compared to group A, group B was given greater volume of amino acid infusion on the 3(rd) and 7(th) day of life [2.00 (2.00, 2.50) g/kg vs 1.50 (1.50, 2.00) g/kg, 3.00 (2.00, 3.00) g/kg vs 2.00 (1.80, 2.60) g/kg, all P < 0.001], and Consumed more milk and total energy intake on the 3rd day of life [9.41(2.66, 18.74) ml/kg vs 14.47 (4.23, 30.77) ml/kg, P < 0.05, (64.87 ± 16.04) kcal/kg vs (55.62 ± 17.68) kcal/kg, P = 0.001]. Total energy intakes after a week of life were similar between the two groups. More infants received human milk fortifier in group B (62.8% vs 14.3%, P = 0.001). After stratification according to weight, both very low birth weight infants and infants with birth weight between 1500 g and 2000 g in group B grew more rapidly (P < 0.001). The percentage of growth retardation was increased after hospitalization in group A (65.4% vs 40.7%, P < 0.05), there were no statistically significant differences in group B. The mean Z scores at birth were comparable. The mean Z scores by discharge were higher in group B (-1.24 vs -1.54, P < 0.05). Serum albumin, prealbumin and urea values were similar in both groups at birth, but higher in group B after two weeks of life (P < 0.001). Before discharge, Serum albumin, prealbumin, and urea values in group B was higher (P < 0.001).
Improvements in nutritional practices in early life of preterm infants effectively enhanced the growth and improved the nutritional status of preterm infants during hospitalization.
Zhonghua er ke za zhi. Chinese journal of pediatrics 10/2011; 49(10):771-5.
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ABSTRACT: To review the clinical data of enteral feeding of extremely low birth weight infants (ELBWI), and analyze the influencing factors.
From Jan. 2000 to Jan. 2010, data of 31 ELBWI from Peking Union Medical College Hospital were retrospectively collected. ELBWI were assigned to different groups according to the time achieving full enteral feeding, comparison was done between two groups for enteral feeding.
Twenty-four infants were analyzed, their mean gestational age was (29.0 ± 1.8) weeks (26.14 - 34.43 weeks), birth weight (882 ± 67) g (730 - 970 g), there were 11 infants in group A, whose time for achieving full enteral feeding was (27 ± 6)days, there were 13 infants in group B, whose time achieving full enteral feeding was (46 ± 10)days. The ratio of asphyxia (18.2% vs. 61.5%, P = 0.047), duration of umbilical vein catheterization longer than 10 days (18.2% vs. 61.5%, P = 0.047), and duration of mechanical ventilation longer than 14 days (27.3% vs. 76.9%, P = 0.038) in group A was higher than in group B. The milk volume on the 21st and 28th day in group A was much more than that in group B [(88.9 ± 35.4) ml vs. (37.4 ± 34.9) ml, P = 0.002; (121.1 ± 37.4) ml vs. (53.2 ± 33.1) ml, P = 0.000]. There were no significant differences between the two groups in gestational age, birth weight, patent ductus arterious, erythrocytosis, dysglycemia, sepsis, the time to begin enteral feeding, the beginning milk volume, the adding milk volume in the 1st, 2nd week, and the milk volume on the 3rd, 7th, 14th day.
Asphyxia, duration of umbilical vein catheterization, and duration of mechanical ventilation are likely to influence the enteral feeding of ELBWI, ELBWI with successful enteral feeding could show good tolerance in the 3rd week. But individual program should be made for enteral feeding of ELBWI, because enteral feeding could be influenced by multiple factors.
Zhonghua er ke za zhi. Chinese journal of pediatrics 03/2011; 49(3):222-5.
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Dan-Hua Wang
Zhonghua er ke za zhi. Chinese journal of pediatrics 07/2009; 47(7):513-6.
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Cong-Le Zhou,
Yun-Feng Liu,
Jia-Jie Zhang,
Li-Juan Xie,
Zhi-Guang Li, Dan-Hua Wang,
Wei Zhang,
Xiao-Guang Zhou,
Jun-Yi Wang,
Ying Liu,
Yue Li
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ABSTRACT: To understand the value of measuring neonatal cerebral regional oxygen saturation (rSO2) using near infrared spectroscopy (NIRS) in assessing cerebral oxygenation, to establish the normal range of neonatal cerebral rSO2 and to collect data of the changes of cerebral rSO2 under certain disease status.
Nine large hospitals participated in the multicenter randomized clinical trial from Jan 2007 to Apr 2008. Using the NIRS human tissue oximeter (TSAH-100) independently developed in China, the cerebral rSO2 of 223 normal full-term and 95 otherwise healthy preterm neonates without any special disease, was detected at 1, 2 and 3 days after birth, respectively. The cerebral rSO2 of 102 neonates with diseases which may affect the cerebral oxygenation, was also detected during the severe phases. The pulse oxygen saturation (SpO2) measured at the finger tip, and also the arterial oxygen saturation (SaO2) measured by blood gas analysis, which could indicate the oxygen supply of the whole body, were obtained simultaneously. The correlations among cerebral rSO2, pulse SpO2 and arterial SaO2 were analyzed.
(1) The cerebral rSO2 of the normal full-term neonates was (62+/-2)%. Cerebral hypoxia was defined as rSO2 lower than 58%. The cerebral rSO2 of the normal full-terms was steady at 1, 2 and 3 days after birth respectively, without any significant differences among them (F=0.610, P>0.05). The cerebral rSO2 of the neonates with diseases was (55+/-7)%, which was significantly lower than that of the normal full-term neonates (t=15.492, P<0.05). (2) The cerebral rSO2 was positively correlated with the SpO2 (r=0.74, P<0.01) and the SaO2 (r=0.71, P<0.01). (3) Under some special diseases, the changes of cerebral rSO2 was asynchronous with those of the SpO2: (1) For 18 cases under severe cerebral damages or under relatively low hemoglobin concentration, the cerebral rSO2 was significantly low (50%-58%), but the SpO2 was still normal (above 90%). (2) During the recovery of some critically ill neonates, the increase of cerebral rSO2 was lagged as compared with that of pulse SpO2. Especially, during the severe phases of 6 cases with multi-organ failure, the SpO2 and the cerebral rSO2 were both significantly low (55%-80% for SpO2, and 44%-50% for cerebral rSO2); when the diseases were alleviated, although the SpO2 recovered to above 85%, the cerebral rSO2 was still significantly low (around 50%). (3) In 3 cases, during the severe phases of serious hypoxic-ischemic encephalopathy (HIE), the cerebral rSO2 significantly increased to 70%-72%, which was significantly higher than the normal value (62%).
The range of cerebral rSO2 of the normal full-term neonates was (62+/-2)%. Cerebral oxygenation can be externally indicated by the rSO2 noninvasively and continuously measured by NIRS, which was positively correlated with traditional pulse SpO2 and arterial SaO2. In some special diseases, the rSO2 measured by NIRS can be helpful for clinical diagnoses and treatments.
Zhonghua er ke za zhi. Chinese journal of pediatrics 07/2009; 47(7):517-22.
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Dan-hua Wang
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ABSTRACT: Extrauterine growth restriction in preterm infants secondary to suboptimal nutrition is a major problem in neonatal intensive care units (NICUs). This study was designed to investigate the nutritional support and growth of premature infants who were discharged from 10 tertiary NICUs in different areas in China and evaluate the effects of high risk factors on their growth.
Data of 1000 premature infants (100 infants from each hospital) were retrospectively collected, the data included their gestational age, the growth parameters at birth, complications, enteral and parenteral nutritional support strategies, the growth parameters at discharge and length of hospital stay from Jan. 1, 2005 to Jun. 30, 2006. The growth parameters, including body weight, length and head circumference, were evaluated according to growth curve of newborns in China with their gestational age at birth and corrected gestational age on discharge. Growth retardation was defined as less than the 10th percentile of the expected value. The risk factors which might result in growth retardation of premature infants were assessed with logistic regression. P < 0.05 was considered as significant.
Of the 1000 premature infants enrolled in this study, the data of 974 premature infants were finally eligible. The median gestational age of the 974 premature infants was 32.6 (31.0-34.1) weeks and median birth weight was 1732.2 (1447.9-2030.3) g. Three hundred and seventy-eight premature infants were born at < 32 weeks of gestational age and the body weight of 285 premature infants was < 1500 g at birth. The median time for initial enteral feeding was 2.0 (1, 3) days of life, 77.0% of the premature infants were fed with formulas for low birth weight, and 13.6% were fed with human milk mixed with the formulas for low birth weight. For parenteral nutrition, amino acid solutions were administered in 87.3% of premature infants and median time to begin was 2.5 (2, 3) days of life, median duration of administration was 11 (6, 17) days. Lipid emulsions were supplied in 56.9% of premature infants and median time to begin was 3 (2, 5) days of life, median duration of administration was 12 (7, 18) days. During hospital stay, 74.1% of the premature infants achieved recommended diet indexes of 120 kcal/(kg.d) (including both enteral and parenteral intakes) and mean time for achieving was (16.3 +/- 9.4) days of life, 84.1% of the premature infants reached enteral feeding of 100 kcal/(kg x d) and the mean time to achieve was (17.0 +/- 9.4) days of life. The lower the gestational age of premature infants was, the longer the time for achieving these goals was. Mean loss of weight was 7.54% +/- 4.7% of birth weight and the day for regaining to birth weight was (10.92 +/- 5.10) days. The lower the gestational age at birth, the more the loss of weight, and the longer the time for regaining to birth weight. Mean growth velocity after regaining to birth weight during hospital stay was (13.4 +/- 6.0) g/(kg x d). Mean length of hospital stay was (26.4 +/- 12.9) days. Of the 696 singletons, 60.0%, 58.9% and 29.5% of the infants had growth retardation by weight, length and head circumference respectively on discharge, while the morbidity increased by 32.7%, 30.9% and 10.2%, respectively, compared with those at birth.
Morbidity of growth retardation was high among premature infants at birth by weight, length and head circumference. Such growth retardation was further worsened before discharge. Birth weight below the 10th percentile of expected value, later introduction of enteral feeding and lower growth velocity during hospital stay were risk factors for postnatal growth retardation of premature infants. More aggressive nutritional support strategy needs to be considered for improving the nutritional status and development of premature infants in China.
Zhonghua er ke za zhi. Chinese journal of pediatrics 02/2009; 47(1):12-7.
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ABSTRACT: SSS-Octahydroindole-2-carboxylic acid (SSS-Oic) is a key intermediate used in the synthesis of some angiotensin-converting enzyme (ACE) inhibitors. The separation of diastereoisomers and enantiomers of Oic was performed using a pre-column derivatization chiral HPLC method. Phenyl isothiocyanate (PITC) was used as the derivatization reagent. Three PITC derivatives of Oic stereoisomers were separated on an Ultron ES-OVM chiral column (150 mm x 4.6 mm, 5 microm). Derivatization conditions such as reaction temperature, reaction time and derivatization reagent concentration were investigated. The chromatographic conditions for separation of the three PITC-Oic derivatives were optimized. The method was successfully applied in the diastereoisomeric and enantiomeric purity test of SSS-Oic.
Journal of chromatography. A 02/2009; 1216(15):3044-7. · 4.19 Impact Factor
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ABSTRACT: Two trace impurities in the bulk drug lisinopril were detected by means of high-performance liquid chromatography coupled with mass spectrometry (HPLC/MS) with a simple and sensitive method suitable for HPLC/MSn analysis. The fragmentation behavior of lisinopril and the impurities was investigated, and two unknown impurities were elucidated as 2-(6-amino-1-(1-carboxyethylamino)-1-oxohexan-2-ylamino)-4-phenylbutanoic acid and 6-amino-2-(1-carboxy-3-phenylpro-pylamino)-hexanoic acid on the basis of the multi-stage mass spectrometry and exact mass evidence. The proposed structures of the two unknown impurities were further confirmed by nuclear magnetic resonance (NMR) experiments after preparative isolation.
Journal of Zhejiang University SCIENCE B 06/2008; 9(5):385-90. · 1.10 Impact Factor
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ABSTRACT: To study the source of noise in level III NICU in Beijing region, evaluate preliminary intervention measures, and improve the NICU environment by reducing the noise.
Noise measurements were performed in level III NICU of three hospitals (A, B and C) in Beijing region by dosimeter (B&K 2231, Denmark), during loud hours and quiet hours. In addition, the loud hours were divided into shift time, nursing time and operating time. "Quiet hours" represents the intervals among shift, nursing and operating time. The noise inside/outside incubator was recorded, measures to reduce the noise, including putting plastic foam in incubator, covering sheet and blanket outside incubator were taken, and an educational program was implemented for the staff to decrease noise in the NICU environment.
Among the three hospitals, the average noise of was (62.60 +/- 2.33) dB during the loud time, and (55.80 +/- 2.61) dB during the quiet time, with a difference of 7 dB (P < 0.05). There was a significant decrease of 2.7 - 3.3 dB during shift time with the averages of A hospital (62.3 +/- 1.5) dB, B hospital (65.10 +/- 2.44) dB and C hospital (61.80 +/- 1.91) dB (F = 9.57, P < 0.05 and P < 0.01), separately. There was a significant decrease of 3 dB during nursing time with the averages of A hospital (62.0 +/- 2.4) dB, B hospital (64.90 +/- 1.06) dB (P < 0.01), respectively, and 2.5 - 3.0 dB during treatment time with the averages of A hospital (60.7 +/- 2.2) dB, B hospital (63.30 +/- 1.19) dB (P < 0.05), separately. After educating the staff in hospital A, there was a significant decrease of 4.7 dB from (61.70 +/- 2.12) dB to (56.90 +/- 2.49) dB in the loud time (P < 0.01), no significant difference during quiet time from (55.0 +/- 1.7) dB to (53.90 +/- 0.88) dB (P > 0.05). There was a significant decrease of 10 dB (P < 0.01) between the averages of inside of incubator (58.60 +/- 3.43) dB and outside of incubator (67.10 +/- 1.87) dB; After installing foam material inside incubator with the average of (56.20 +/- 1.83) dB, there was a significant decrease of 2.8 dB (P < 0.01); covering sheet (in front and back) with the averages of (57.00 +/- 1.47) dB and (55.3 +/- 1.3) dB, respectively, and single or double blanket outside incubator (in the front and the back) noise value (54.50 +/- 1.33) dB, (54.10 +/- 1.15) dB and (54.70 +/- 0.63) dB and (54.10 +/- 1.14) dB, separately, there was a decrease of 1 - 4 dB (P < 0.05 and P < 0.01).
The noise in level III NICU in Beijing region is much higher than that allowed by regulations in Europe and the USA. Staff behavior and the acoustical characteristics of the facility determine the level of noise; herein to staff behavior is the main cause. The level of noise can be lowered considerably by simply making the staff aware of the problem. At the same time, covering incubator and installing plastic foam material also significantly decreased the noise, the methods are simple, feasible and should be applied constantly.
Zhonghua er ke za zhi. Chinese journal of pediatrics 02/2008; 46(2):120-3.
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ABSTRACT: Nosocomial infections (NIs) have become a matter of major concern in neonatal intensive care units (NICU). The objectives of this study were to investigate the incidence of nosocomial infections of newborn infants in NICU and to explore the risk factors and strategies of infection control.
The study enrolled 638 hospitalized newborn infants from Apr 2003 to Dec 2004. The clinical data, such as the clinical manifestation, the condition of colonized bacteria, were collected and analyzed by using SPSS software.
There were 88 times of nosocomial infections in 74 newborn infants. The overall incidence of nosocomial infections was 11.6%. The mean duration from admission to first episode of NI was 7.98 +/- 4.58 days. The incidence density was 14.9 per 1000 NICU patient-days. Catheter-correlated hematogenous infection rate was 18 per 1000 umbilical or central line-days; the ventilator-associated nosocomial pneumonia rate was 63.3 per 1000 ventilator days. The smaller the gestational age and the lower the birth weight, the higher the incidences of nosocomial infection. The duration of hospitalization was longer in these infected infants than those non-infected infants. Univariate analysis indicated that gestational age < or = 32 W, the parenteral nutrition, birth weight < or = 1500 g and mechanical ventilation, apnea, small for gestational age infant, central venous catheter (P < 0.05) were risk factors for NIs. Multivariate analysis identified 3 independent risk factions: the parenteral nutrition ([OR] = 7.185 [95% CI, 3.399 - 15.188]), birth weight < or = 1500 g ([OR] = 3.310 [95% CI, 1.100 - 9.963]) and mechanical ventilation ([OR] = 2.527 [95% CI, 1.092 - 5.850]). The most common infection was pneumonia (45.4%). The mortality rate of nosocomial infections was 4.1%. Bacterial surveillance was examined by nasopharyngeal and rectal swab culture immediately on hospital admission and then once a week. The incidence rate of NIs was 24.8% in patients whose nasopharyngeal and rectal swab culture indicated bacterial colonization, and 1.9% in patients without bacterial colonization (chi(2) = 79.7, P < 0.001).
It is important to identify the high risk factors for nosocomial infections in newborn infants in NICU. Reducing the duration of the parenteral nutrition and the virulence manipulation as far as possible and getting the message of individual bacterial colonization in NICU may be conducive to decrease of the incidence of nosocomial infections and provide reference for rational clinical drug administration.
Zhonghua er ke za zhi. Chinese journal of pediatrics 06/2007; 45(6):437-41.
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ABSTRACT: Glutamine, proposed to be conditionally essential for critically ill patients, is not added routinely to parenteral amino acid formulations for premature infants and is provided in only small quantities by the enteral route when enteral feeding is low. Parenteral feeding is the basic way of nutrition in the first days of life of premature infants. In this study, we evaluated the effects of glutamine supplemented parenteral nutrition for premature infants on growth and development, feeding toleration, and infective episodes.
From December 2002 to July 2006, 53 premature infants were given either standard or glutamine supplemented parenteral nutrition for more than 2 weeks. Twenty-eight infants were in glutamine supplemented group, whose gestational age (31.4 +/- 2.0) weeks, birth weight range (1386 +/- 251) g; twenty-five infants were in control group, gestational age (31.1 +/- 1.7) weeks, with birth weight range (1346 +/- 199) g. There were no differences between the two groups. Various growth and biochemical indices were monitored throughout the duration of hospital stay. Data between groups were analyzed with Student's t test. Nonparametric data were analyzed using a Chi-square test. A two-tailed P value < 0.05 was considered statistically significant.
The level of serum albumin was lower in the glutamine groups on the second week (3.0 vs 3.2 g/dl, P = 0.028), and blood urea nitrogen was higher in glutamine groups on the fourth week (8.1 vs 4.9 mg/dl, P = 0.014), but normal. Glutamine group infants took fewer days to regain birth weight (8.1 vs 10.4 days, P = 0.017), required fewer days on parenteral nutrition (24.8 vs 30.8 days, P = 0.035), with shorter stays in hospital (32.1 vs 38.6 days, P = 0.047). Episodes of hospital acquired infection in glutamine supplemented infants were lower than that in control group (0.96 vs 1.84 times, P = 0.000).
Parenteral glutamine supplementation in premature infants can shorten days on parenteral nutrition and length of stay in hospital, and decrease hospital acquired infection episodes.
Chinese medical journal 01/2007; 120(2):140-4. · 0.86 Impact Factor
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ABSTRACT: During the routine impurity profile of lisinopril bulk drug by HPLC (high-performance liquid chromatography), a potential impurity was detected. Using multidimensional NMR (nuclear magnetic resonance) technique, the trace-level impurity was unambiguously identified to be 2-(-2-oxo-azocan-3-ylamino)-4-phenyl-butyric acid after isolation from lisinopril bulk drug by semi-preparative HPLC. Formation of the impurity was also discussed. To our knowledge, this is a novel impurity and not reported elsewhere.
Journal of Zhejiang University SCIENCE B 05/2006; 7(4):310-3. · 1.10 Impact Factor
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ABSTRACT: The study aimed to investigate the clinical characteristics of enteral feeding in very low birthweight infants (VLBWI), to determine the risk factors associated with feeding intolerance, and to analysis the beneficial factors in order to improve gut motility and maturation.
The study was carried out in 38 VLBWI, birthweight (1,314 +/- 180) g, in the NICU of authors' department. They were divided into feeding tolerance and intolerance groups, and earlier enteral feeding and later groups. Comparison was made between two groups about the associate factors.
The incidence of feeding intolerance was 55 per cent. There was a significant difference in two groups about the clinical factors (gestational age, birth weight, the age of the first feeding, time of full enteral feeding and the hospitalized days). The significant risk factors associated with feeding intolerance were the smaller gestational age, umbilical catheterization, theophylline therapy, and delay of the time when the first feed was commenced.
If vital signs are stable, trophic feeding in VLBWI should be commenced as soon as possible during the first 6 days of life. Early trophic feeding, slowly increase the feeding volume, carefully fast, and moving bowel were suggested and will improve feeding tolerance and gastrointestinal maturation.
Zhonghua er ke za zhi. Chinese journal of pediatrics 03/2003; 41(2):87-90.
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Zhonghua er ke za zhi. Chinese journal of pediatrics 03/2003; 41(2):139-40.
