Clinical effect of different maintenance doses of caffeine citrate in the treatment of preterm infants requiring assisted ventilation: a pilot multicenter study. / ä¸åŒç»´æŒå‰‚é‡æž¸æ©¼é ¸å’–å•¡å› å¯¹è¾ åŠ©é€šæ°”æ—©äº§å„¿çš„ç–—æ•ˆè¯„ä¼°ï¼šä¸€é¡¹åˆæ­¥å¤šä¸­å¿ƒç ”ç©¶.

OBJECTIVES: To explore the optimal maintenance dose of caffeine citrate for preterm infants requiring assisted ventilation and caffeine citrate treatment. METHODS: A retrospective analysis was performed on the medical data of 566 preterm infants (gestational age ≤34 weeks) who were treated and required assisted ventilation and caffeine citrate treatment in the neonatal intensive care unit of 30 tertiary hospitals in Jiangsu Province of China between January 1 and December 31, 2019. The 405 preterm infants receiving high-dose (10 mg/kg per day) caffeine citrate after a loading dose of 20 mg/kg within 24 hours after birth were enrolled as the high-dose group. The 161 preterm infants receiving low-dose (5 mg/kg per day) caffeine citrate were enrolled as the low-dose group. RESULTS: Compared with the low-dose group, the high-dose group had significant reductions in the need for high-concentration oxygen during assisted ventilation (P=0.044), the duration of oxygen inhalation after weaning from noninvasive ventilation (P<0.01), total oxygen inhalation time during hospitalization (P<0.01), the proportion of preterm infants requiring noninvasive ventilation again (P<0.01), the rate of use of pulmonary surfactant and budesonide (P<0.05), and the incidence rates of apnea and bronchopulmonary dysplasia (P<0.01), but the high-dose group had a significantly increased incidence rate of feeding intolerance (P=0.032). There were no significant differences between the two groups in the body weight change, the incidence rates of retinopathy of prematurity, intraventricular hemorrhage or necrotizing enterocolitis, the mortality rate, and the duration of caffeine use (P>0.05). CONCLUSIONS: This pilot multicenter study shows that the high maintenance dose (10 mg/kg per day) is generally beneficial to preterm infants in China and does not increase the incidence rate of common adverse reactions. For the risk of feeding intolerance, further research is needed to eliminate the interference of confounding factors as far as possible.

The impact of nutritional quality and gut bacteria on the fitness of Bactrocera minax (Diptera: Tephritidae).

To examine how nutritional quality and resident gut bacteria interplay in improving the fitness of an oligophagous fruit fly, Bactrocera minax, artificial sucrose diets and full diets (sucrose, tryptone and yeast extract) were fed to flies with and without antibiotic supplementation. Furthermore, Klebsiella oxytoca and Citrobacter freundii were supplemented to sucrose-only diets. Flies were maintained in the laboratory and the fitness parameters, male and female longevity, number of copulations and female fecundity, were recorded. Full diet without bacterial depletion significantly increased fecundity and copulation. In the absence of gut bacteria, flies fed with full diets had significantly decreased mean fecundity and copulation rate. Flies that were fed with sucrose diet had a very low copulation rate and produced no eggs. Diet type and the presence of bacteria did not have any effect on the average longevity of male and female flies. Bacterial supplementation in sucrose diets did not improve any of the measured parameters. The results demonstrate that gut bacteria interact with diet to influence mating and reproduction in B. minax. Symbiotic bacteria significantly and positively impact reproduction in B. minax; however, their impact can only be fully realized when the flies are fed with a nutritionally complete diet.