De-Zhi Mu

Sichuan University, Chengdu, Sichuan Sheng, China

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Publications (44)2.17 Total impact

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    ABSTRACT: To investigate the research on neonatal jaundice in recent years by co-word analysis and to summarize the hot spots and trend of research in this field in China.
    08/2014; 16(8):820-823.
  • Xin-Tian Hua, Jun Tang, De-Zhi Mu
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    ABSTRACT: To evaluate the effect of oral administration of probiotics on intestinal colonization with drug-resistant bacteria among preterm infants in the neonatal intensive care unit (NICU).
    06/2014; 16(6):606-609.
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    ABSTRACT: To study the effect of β8 expression on transforming growth factor β1(TGF-β1) activation in astrocytes with oxygen glucose deprivation (OGD). Astrocytes were cultured and then subjected to OGD to generate hypoxia-ischemia (HI) model in vitro. Immunocytochemistry was used to detect the expression and distribution of β8 in nomoxia cultured cells. β8 protein expression was quantified by Western blot at 12 hours, 1 day and 2 days after OGD. Astrocytes and luciferase reporter cells (TMLC) were co-cultured. β8 RNA interference system was established to specifically inhibit β8 expression in cultured astrocytes. TGF-β1 activation was then detected in the co-culture system. β8 was mainly located in the cytoplasm and neurites of astrocytes. OGD resulted in increase of β8 protein expression at 12 hours after reoxygenation in astrocytes, which was peaked at 1 day after reoxygenation. TGF-β1 activation was in accordance with β8 expression in astrocyte-TMLC co-culture system after reoxygenation. After the inhibition of β8, TGF-β1 activation was significantly reduced in all time points. The highly expressed β8 plays important roles in the regulation of TGF-β1 activation in neonatal rats with hypoxic-ischemic brain damage.
    Zhongguo dang dai er ke za zhi = Chinese journal of contemporary pediatrics 01/2014; 16(1):73-6.
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    ABSTRACT: To observe the outcomes of hospitalized neonates who were managed with two different antibiotics strategies, namely, the risk factor based antibiotic strategy and the combination antibiotic strategy that is based on risk factors, infection screening and monitoring. A cohort study was performed on a control group of 4 406 cases of neonates hospitalized between January 2010 and May 2011 and an observed group of 4 476 neonates hospitalized between July 2011 and October 2012. The control group adopted the risk factor based antibiotic strategy and the observed group received a combination antibiotic strategy based on risk factors, infection screening and monitoring. The rate of antibiotic use, average length of stay, readmission rate and mortality rate were compared between the two groups. With the change from the risk factor based antibiotic strategy to the combination antibiotic strategy, the total rate of antibiotic use decreased from 79.6% to 50.5% (P<0.01). There were no differences in the average length of stay, readmission rate, and mortality rate between the two groups. The combination antibiotic strategy based on risk factors, infection screening and monitoring can reduce antibiotic use substantially and has no adverse effects on treatment outcomes in hospitalized neonates.
    Zhongguo dang dai er ke za zhi = Chinese journal of contemporary pediatrics 12/2013; 15(12):1089-92.
  • Jin-Hui Li, Jin-Lin Wu, De-Zhi Mu
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    ABSTRACT: Inhaled NO (iNO) has been shown to have beneficial effects on decreasing pulmonary inflammation, increasing function of surfactant and improving lung growth in prematurely born animal models. iNO has been gradually applied in the neonatal intensive care unit since its first use for persistent pulmonary hypertension (PPHN) in the early 1990's. Although many research findings have shown the benefits of iNO for hypoxic respiratory failure (HRF) of preterm infants, there is no certain evidence to support the routine use of iNO in premature infants. According to recent literature, the mechanism of iNO therapy, treatment scheme, iNO effectiveness and safety in premature infants were reviewed in this article, so as to provide bases for the clinical use of this treatment.
    Zhongguo dang dai er ke za zhi = Chinese journal of contemporary pediatrics 12/2013; 15(12):1100-3.
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    ABSTRACT: To explore the role and mechanisms of FOXO3a nuclear translocation in neuronal apoptosis after hypoxia-ischemia (HI). One hundred and sixty 10-day-old Sprague-Dawly rats were randomly divided into two groups: HI and sham-operated. The right common carotid artery was ligated followed by hypoxia exposure for 2.5 hours in the HI group. The sham-operated group rats were not subjected to carotid artery ligation or hypoxia treatment. Rat cerebral cortex was collected at 0.5, 2, 4, 8 and 24 hours after hypoxia. Western blot was used to detect expression of total FOXO3a protein, pnuclear and cytoplasmic FOXO3a and Bim. TUNEL staining was used to detect apoptotic cells. The nuclear protein of FOXO3a obviously increased from 0.5 to 24 hours after HI in a time-dependent manner compared with the sham-operated group (P<0.01). On the contrary, cytoplasmic protein evidently decreased from 0.5 to 24 hours in the HI group compared with the sham-operated group (P<0.01). Bim protein increased from 0.5 hour, peaked at 2 hours, started to decline at 4 hours (P<0.01), and returned to baseline level at 8 and 24 hours after HI in the HI group compared with the sham-operated group. TUNEL positive cells started to express at 4 hours, and peaked at 24 hours after HI (P<0.01). However, TUNEL positive cells were rarely found in the sham-operated group. HI induces FOXO3a translocation from cytoplasm to nucleus, and enhances protein expression of its target gene Bim in the neonatal rat brain. The upregulation of Bim expression might be related to neuronal apoptosis.
    Zhongguo dang dai er ke za zhi = Chinese journal of contemporary pediatrics 11/2013; 15(11):1023-1027.
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    ABSTRACT: Inadequate postnatal nutritional support is an important factor contributing to growth failure, which leads to poor neurological outcome. In this study, co-word analysis was used to investigate the research on nutrition of premature infants over the last six years in China, describe the research trend in this field in China, and provide possible directions for future research. A literature search was performed in January 2013 using the CNKI database and the key words "preterm infant" and "nutrition". A total of 772 articles were retrieved. Then high-frequency key words were extracted using Excel 2010 to create a co-occurrence matrix. Finally, a visualized network was built using Ucinet 6.0. The knowledge domain map of research on nutritional support for premature infants in China showed that the major topic of relevant research is still the combination of parenteral nutrition and enteral nutrition, with the goal of maintaining appropriate growth rates in premature infants. Researchers have paid much attention to the adverse effects of parenteral nutrition. Feeding intolerance is still the main problem in nutritional support, especially enteral nutrition, for premature infants. A visualized network of current research on nutrition of premature infants in China has been created, and a knowledge domain map has been drawn to reflect the hot topics in this field of study over the last six years.
    Zhongguo dang dai er ke za zhi = Chinese journal of contemporary pediatrics 10/2013; 15(10):835-840.
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    ABSTRACT: To investigate the effect of different operation time to percutaneous balloon pulmonic valvuloplasty (PBPV) to critical pulmonary valve stenosis (CPS). Twenty-one infants (age ≤ 60 days at operating day) suffered from CPS, diagnosed by fetal echocardiogram and confirmed by echocardiography after birth, were enrolled in this case-control-study with written informed consent during April 2007 to December 2011. Of the 21 cases, 7 had prenatal diagnosis in our prenatal diagnosis center (prenatal group, Pre) and 14 were referred from other hospitals, who were divided into postpartum group A (Post A, referred within 28 days after birth) and postpartum group B (Post B, referred 29 to 60 days after birth). To Pre-group, the integrative interventional protocol was cautiously made by the consultative specialists, including intrauterine diagnosis, perinatal care and urgent PBPV soon after birth. To Post-group, emergency PBPV was preformed after the referral. Tei index of right ventricular and pressure-gradient (PG) between right ventricular and pulmonary artery were measured before and at different time points one year after PBPV. The values of SpO2 in Pre-group ranged from 82%-92% (86.57% ± 5.34%) under the state of continuous intravenous infusion of alprostadil. PBPV was successfully preformed within 3-6 days after birth. The values of SpO2 increased to 97.33% ± 1.15% post procedure. The values of PG pre- and post- procedure were (86.34 ± 11.77) mm Hg and (31.43 ± 8.46) mm Hg respectively. Preoperative RV Tei-index was 0.68 ± 0.05, it decreased rapidly after procedure, and recovered to normal one month after procedure. Only one case showed restenosis seven months after procedure and repeated PBPV. Fourteen referral cases (6 cases in Post A group and 8 cases in Post B group, accompanied in 1 and 3 cases with heart failure), the values of SpO2 ranged from 83%-91% under state of continuous intravenous infusion of alprostadil. And the operating time was 10-57 days after birth. The values of SpO2 recovered to normal post procedure, and heart failure alleviated. Increased preoperative RV pressure obviously decreased significantly post-procedure. And increased Tei-index declined gradually, at one-year follow-up, the value of Tei-index in Post A group recovered to normal, whereas that of Post B was (0.51 ± 0.06), compared to Pre and Post A groups, the difference was significant (P < 0.05) . One case showed restenosis nine months after procedure and repeated PBPV was performed. The hypoxic exposure durations were (4.43 ± 0.68) , (16.33 ± 4.46) , (41.25 ± 9.19) , respectively, and the difference among the three groups was significant (P < 0.05). To the fetuses with definite prenatal diagnosis of critical pulmonary valve stenosis, preoperative general condition can be adjusted to more suitable for emergency operation. Early PBPV can achieve shorter hypoxic exposure and better recovery of right ventricular function post procedure. Perinatal integrated intervention for CPS can significantly improve the prognosis and quality of life in this patient population.
    Zhonghua er ke za zhi. Chinese journal of pediatrics 08/2013; 51(8):584-9.
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    ABSTRACT: To investigate the clinical value of mycobacterial DNA microarray technology for diagnosis of childhood tuberculosis. 120 clinical specimens were collected from hospitalized child patients. Acid-fast staining, mycobacterial culture and DNA microarray assays were performed using these clinical specimens. The results of DNA microarray assays were compared with the results of acid-fast staining and mycobacterial culture. The sensitivity of DNA microarray assays for specimens from children with tuberculosis was 24.3% (17/70), of acid-fast staining 17.1% (12/70), of mycobacterial culture 20.0% (14/70), and the specificity of the three methods was all 100.0% (50/50). The difference between results of DNA microarray assays and that of acid-fast staining or mycobacterial culture was not significant. DNA microarray assay has reference value for the diagnosis of childhood tuberculosis. It provides a new way for the diagnosis of childhood tuberculosis.
    Sichuan da xue xue bao. Yi xue ban = Journal of Sichuan University. Medical science edition 05/2013; 44(3):429-31.
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    ABSTRACT: To investigate the activity of protein kinase B (Akt) and its downstream protein, glycogen synthase kinase-3beta (GSK-3beta) under hypoxia-ischemia (HI), and the possible regulation for axonal density. Postnatal day 10 SD rats were suffered the right common carotid artery ligation and 8% mixture of oxygen and nitrogen hypoxia 2.5 h to produce HI model. The expression of total and phosphorylated Akt and GSK-3beta was detected by western blot after HI. After pretreatment of Akt inhibitor, wortmannin or LY294002, Western blot detect the expression of total and phosphorylated of Akt, GSK-3beta at 4 h and 24 h after HI. After pretreatment of wortmannin, axonal density was determined by Bielschowsky silver impregnation, and histological injury was evaluated by hematoxylin and eosin (HE) staining. The expression of total Akt and GSK-3beta remained unchanged after HI. p-Akt protein significantly decreased at 0.5 h, increased at 2 h and reached the highest at 4 h, returned to baseline at 8 h, declined at 24 and 48 h after HI, and finally returned to baseline again at 72 h compared with that of sham controls, p-GSK-3beta protein decreased at 0. 5 h, increased at 2 h, reached the highest at 4 h, returned to baseline at 8 and decreased at 24 h, reached the lowest at 48 h, and returned to baseline at 72 h. Wortmannin or LY294002 intervention didn't change the expression of total Akt and GSK-3beta, while decrease the p-Akt and p-GSK-3beta expression. HI cause decreased axonal density, and the histological injury of brain. Wortmannin pretreatment could aggravate the histological injury and decrease axonal density after HI. The Akt pathway is involved in axonal density and histological brain injury after HI in neonatal rat.
    Sichuan da xue xue bao. Yi xue ban = Journal of Sichuan University. Medical science edition 03/2013; 44(2):274-9.
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    ABSTRACT: To examine brainstem auditory evoked potential (BAEP) in preterm infants after perinatal hypoxia within 3 days and 1 month after birth. BAEP was studied in 42 preterm infants after perinatal hypoxia within 3 days and 1 month after birth, and was compared with those in preterm without any major perinatal problems. The latencies of wave V and the interpeak intervals of III-V and I-V in BAEP of hypoxia preterm infants differed significantly from those in the control with 3 days after birth. One month later, the latencies of wave and the interpeak intervals in BAEP of hypoxia infants were improved, and there were no significant differences between two groups. Central auditory function in preterm infants will be damaged by perinatal hypoxia, which must be taken into account even the damage could be improved in 1 month after birth.
    Sichuan da xue xue bao. Yi xue ban = Journal of Sichuan University. Medical science edition 03/2013; 44(2):284-6.
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    ABSTRACT: To investigate the pharmacokinetics of aminophylline in very low birth weight infant. This study investigated 104 very low birth weight infants using aminophylline 5 mg/kg treating apnea who were hospitalized in our department during 2011-2012. The blood concentration of aminophylline was measured in 30 min before, 8 h and 5 d after first time loading dose, and was counterchecked every week before aminophylline withdrawal. The pharmacokinetic parameters of aminophylline were calculated and population pharmacokinetic model was established by MW/Pharm3.6 statistical analysis. The average birth weight of these 104 very low birth weight infants was (1.15 +/- 0.23) kg, average gestational age was (31.19 +/- 2.50) weeks. The results of aminophylline pharmacokinetics showed: the plasma clearance was (17.88 +/- 5.61) mL/(kg x h), the apparent volume of distribution was (0.93 +/- 0.18) L/kg, the half life time was (28.6 +/- 7.59) h. The aminophylline plasma clearance was related to creatinine clearance, gestational age and days of age after birth (related coefficient was 0.68, 0.62, 0.56 respectively, P < 0.05),the apparent volume of distribution was related to birth weight (related coefficient was 0.82, P < 0.05). The population pharmacokinetics model established can predict the concentration-time curve of the patients. The pharmacokinetics of aminophylline in very low birth weight infant was quite different from adult, which suggest blood concentration monitoring and dose adjustment for the clinical use of aminophylline in low birth weight infants.
    Sichuan da xue xue bao. Yi xue ban = Journal of Sichuan University. Medical science edition 03/2013; 44(2):291-4.
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    ABSTRACT: To study the pathogens, drug sensitivity and risk factors for ventilator-associated pneumonia (VAP) in neonates. Retrospective analysis was performed on the clinical data of 401 neonates who were admitted to the neonatal intensive care unit and received mechanical ventilation for 48 hours or longer from January 2008 to February 2012. Eighty-five of the 401 neonates suffered VAP. The main pathogens for VAP were Gram-negative bacteria (97%), including Klebsiella pneumoniae (51%), Acinetobacter baumannii (17%) and Escherichia coli (12%) as the three most frequent ones. The drug sensitivity test showed that these pathogens developed resistance to amoxicillin, amoxicillin/clavulanic acid, piperacillin, ceftazidime, cefazolin, and cefotaxime, with a susceptibility rate of below 15%, and demonstrated decreased sensitivity to imipenem and meropenem, with a susceptibility rate of below 75%. The independent risk factors for neonatal VAP included birth weight (OR=1.399, P<0.05), duration of mechanical ventilation (OR=1.966, P<0.01), length of hospital stay (OR=1.812, P<0.01), times of tracheal intubation (OR=2.056, P<0.01), and 1 min Apgar score (OR=2.146, P<0.01). The incidence of neonatal VAP is influenced by many factors. The main pathogens for neonatal VAP are Gramnegative bacteria and antibacterial agents should be properly used according to drug sensitivity test results. Comprehensive prevention and control measures should be taken to reduce the incidence of VAP.
    Zhongguo dang dai er ke za zhi = Chinese journal of contemporary pediatrics 01/2013; 15(1):14-8.
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    ABSTRACT: BACKGROUND: Preterm birth is a major cause of neonatal mortality and morbidity. While advances in medical care have improved the survival of preterm infants, neurodevelopmental problems persist in this population. This article aims to review factors associated with their neurodevelopmental outcomes. DATA SOURCES: English language studies of neurodevelopmental outcomes in preterm infants were retrieved from PubMed. A total of 100 related publications were included. RESULTS: Early gestational age and birth weight are the most significant predictors of poor long-term neurological outcome. Structural changes of the brain, infection, male gender and neonatal intensive care unit course are also important factors affecting eventual outcome. Other complex biological and socio-economic factors, which extend from prenatal through postnatal periods, up through and including adulthood, also affect the trajectory of brain development in preterm infants. CONCLUSIONS: Neurodevelopmental problems continue to affect the preterm population. There is a critical need for collaboration among geneticists, obstetricians, pediatricians, and neuroimaging and rehabilitation experts to determine early predictive factors and neuroprotective therapies to properly treat or prevent poor neurodevelopmental outcomes in these infants.
    World Journal of Pediatrics 11/2012; 8(4):293-300. · 1.08 Impact Factor
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    ABSTRACT: To study risk factors for severe hand, foot and mouth disease (HFMD) complicated by heart and lung failure and treatment experience. A total of 198 children with severe HFMD between March and August in 2011 were enrolled. Univariate analysis and logistic regression model were used to analyze the risk factors severe HFMD complicated by heart and lung failure. The effects of combination therapy with immunoglobulin+dexamethasone+ribavirin were observed. Univariate analysis indicated that HFMD patients with heart and lung failure had higher proportions of consciousness, tachypnoea, abnormal hemodynamics, increased troponin and EV71 infection than HFMD patients without heart and lung failure (P<0.05).Multivariate logistic regression analysis indicated that tachypnoea, abnormal hemodynamics and EV71 infection were the main risk factors for heart and lung failure. Compared with combination therapy with dexamethasone+ribavirin, combination therapy with immunoglobulin+dexamethasone+ribavirin was more effective for preventing hemodynamic changes in children with severe HFMD (P<0.01). Compared with HFMD patients with heart and lung failure, the effect of the combination therapy with immunoglobulin+dexamethasone+ribavirin was better in HFMD patients without heart and lung failure (P<0.01). The main risk factors for heart and lung failure in children with severe HFMD include tachypnoea, abnormal hemodynamics and EV71 infection. Early combination therapy with immunoglobulin+dexamethasone+ribavirin can reduce the incidence of heart and lung failure in children with severe HFMD.
    Zhongguo dang dai er ke za zhi = Chinese journal of contemporary pediatrics 08/2012; 14(8):589-92.
  • Min Li, Ying Xiong, De-Zhi Mu, Hua Wang
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    ABSTRACT: This study examined changes to pro-inflammatory cytokine IFN-γ and chemokine IP-10 in the arterial blood of premature infants before and after mechanical ventilation, with the aim of exploring possible mechanisms of ventilation-induced lung injury. Twenty-three neonates requiring mechanical ventilation were enrolled in this study. Arterial blood samples were collected for measuring IFN-γ and IP-10 levels using ELISA before and 4 hours after mechanical ventilation. Blood IFN-γ and IP-10 increased significantly from 59 ± 40 pg/mL and 130 ± 67 pg/mL respectively before mechanical ventilation to 105 ± 54 pg/mL and 220 ± 80 pg/mL respectively after 4 hours of mechanical ventilation (P<0.01). Serum IFN-γ and IP-10 levels increase after mechanical ventilation, suggesting that both may participate in the immune-inflammatory process of ventilation-induced lung injury.
    Zhongguo dang dai er ke za zhi = Chinese journal of contemporary pediatrics 07/2012; 14(7):496-8.
  • Hua Wang, Ying Xiong, De-Zhi Mu
    Zhongguo dang dai er ke za zhi = Chinese journal of contemporary pediatrics 06/2012; 14(6):466-7.
  • Tao Xiong, Jun Tang, De-Zhi Mu
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    ABSTRACT: Blue light has been widely used for the treatment of neonatal hyperbilirubinemia since the 1950s. Neonatal phototherapy can decrease plasma unconjugated bilirubin level, thus preventing bilirubin encephalopathy, and greatly reduces the exchange transfusion rate. Generally, it is accepted that the side effects of neonatal phototherapy are not serious and seem to be well controlled, however recent research has provided new evidence. The short-term side effects of phototherapy include interference with maternal-infant interaction, imbalance of thermal environment and water loss, electrolyte disturbance, bronze baby syndrome and circadian rhythm disorder. In addition, phototherapy may be associated with some long-term side effects such as melanocytic nevi and skin cancer, allergic diseases, patent ductus arteriosus and retinal damage. Therefore, it is necessary to develop evidence-based guidelines, new light devices and alternative agents, as well as individualized treatments, to minimize the side effects of phototherapy.
    Zhongguo dang dai er ke za zhi = Chinese journal of contemporary pediatrics 05/2012; 14(5):396-400.
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    ABSTRACT: To investigate nasal carriage of community-acquired Staphylococcus aureus and its drug sensitivities in healthy children in Chengdu. Nasal swabs were collected from healthy children from primary schools and kindergartens in Chengdu in two stages (2005-2007 and 2008-2010). All specimens were cultivated. Once S. aureus was identified, drug susceptibility tests (disk diffusion method) were performed with penicillin, erythromycin, clindamycin, ceftazidime and vancomycin. 430 S. aureus were identified from 2373 specimens, with a positive rate of 18.12%. Resistant to penicillin was found in 90% of tests. The isolated S. aureus was also resistant (6.28%) to methicillin-resistant Staphylococcus aureus (MRSA). The first stage identified higher rate of MRSA than the second stage (4.28% versus 9.25%, P = 0.037). Isolates from children living in cities were more likely to be resistant to cefoxitin than isolates from children living in countryside (14.74% versus 2.56%, P = 0.006) in the second stage. We did not find vancomycin-resistant S. aureus. Nasal carriage of S. aureus among healthy children in Chengdu is common and the nasal carried S. aureus is highly resistant to commonly used antibiotics.
    Sichuan da xue xue bao. Yi xue ban = Journal of Sichuan University. Medical science edition 05/2012; 43(3):391-4.
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    ABSTRACT: To investigate the risk factors related to post-asphyxial multiple organ dysfunction (PA-MOD) in neonates. A total of 397 neonates with birth asphyxia were enrolled from January 2009 to December 2010.The patients were divided into PA-MOD group (n=179) and non-PA-MOD group (n=218). The risk factors of PA-MOD were retrospectively studied. Multivariate logistic regression analysis showed that severe asphyxia, fetal distress, abnormal labor, and decreased amniotic fluid were the risk factors for PA-MOD among the neonates. Spearman rank correlation analysis showed that the number of the involved organs increased along with the increase of age at admission (P<0.05) and with the decrease of gestational age and birth weight (P<0.05). The efforts should be made to enhance perinatal care for neonates, especially for preterm infants and low-birh-weight infants, to decrease the incidence of MOD.
    Zhongguo dang dai er ke za zhi = Chinese journal of contemporary pediatrics 12/2011; 13(12):940-3.