Correlation of Lipin gene expression with hepatic fat content in rats with intrauterine growth retardation / 中国当代儿科杂志

OBJECTIVES@#To study the correlation of the expression of Lipin1 in visceral adipose tissue and Lipin2 in liver tissue with hepatic fat content in rats with intrauterine growth retardation (IUGR).@*METHODS@#Pregnant rats were given a low-protein (10% protein) diet during pregnancy to establish a model of IUGR in neonatal rats. The pregnant rats in the control group were given a normal-protein (21% protein) diet during pregnancy. The neonatal rats were weighed and liver tissue was collected on day 1 and at weeks 3, 8, and 12 after birth, and visceral adipose tissue was collected at weeks 3, 8, and 12 after birth. The 3.0T 1H-magnetic resonance spectroscopy was used to measure hepatic fat content at weeks 3, 8, and 12 after birth. Real-time PCR was used to measure mRNA expression levels of Lipin2 in liver tissue and Lipin1 in visceral adipose tissue. Western blot was used to measure protein levels of Lipin2 in liver tissue and Lipin1 in visceral adipose tissue. A Pearson correlation analysis was performed to investigate the correlation of mRNA and protein expression of Lipin with hepatic fat content.@*RESULTS@#The IUGR group had significantly higher mRNA and protein expression levels of Lipin1 in visceral adipose tissue than the control group at weeks 3, 8, and 12 after birth (P<0.05). Compared with the control group, the IUGR group had significantly lower mRNA and protein expression levels of Lipin2 in liver tissue on day 1 after birth and significantly higher mRNA and protein expression levels of Lipin2 at weeks 1, 3, 8, and 12 after birth (P<0.05). At week 3 after birth, there was no significant difference in hepatic fat content between the IUGR and control groups (P>0.05), while at weeks 8 and 12 after birth, the IUGR group had a significantly higher hepatic fat content than the control group (P<0.05). The protein and mRNA expression levels of Lipin1 were positively correlated with hepatic fat content (r=0.628 and 0.521 respectively; P<0.05), and the protein and mRNA expression levels of Lipin2 were also positively correlated with hepatic fat content (r=0.601 and 0.524 respectively; P<0.05).@*CONCLUSIONS@#Upregulation of the mRNA and protein expression levels of Lipin1 in visceral adipose tissue and Lipin2 in liver tissue can increase hepatic fat content in rats with IUGR and may be associated with obesity in adulthood.

Risk factors for metabolic bone disease of prematurity in very/extremely low birth weight infants: a multicenter investigation in China / 中国当代儿科杂志

OBJECTIVE@#To investigate the incidence rate and risk factors for metabolic bone disease of prematurity (MBDP) in very low birth weight/extremely low birth weight (VLBW/ELBW) infants.@*METHODS@#The medical data of 61 786 neonates from multiple centers of China between September 1, 2013 and August 31, 2016 were retrospectively investigated, including 504 VLBW/ELBW preterm infants who met the inclusion criteria. Among the 504 infants, 108 infants diagnosed with MBDP were enrolled as the MBDP group and the remaining 396 infants were enrolled as the non-MBDP group. The two groups were compared in terms of general information of mothers and preterm infants, major diseases during hospitalization, nutritional support strategies, and other treatment conditions. The multivariate logistic regression analysis was used to investigate the risk factors for MBDP.@*RESULTS@#The incidence rate of MBDP was 19.4% (88/452) in VLBW preterm infants and 38.5% (20/52) in ELBW preterm infants. The incidence rate of MBDP was 21.7% in preterm infants with a gestational age of < 32 weeks and 45.5% in those with a gestational age of < 28 weeks. The univariate analysis showed that compared with the non-MBDP group, the MBDP group had significantly lower gestational age and birth weight, a significantly longer length of hospital stay, and a significantly higher incidence rate of extrauterine growth retardation (@*CONCLUSIONS@#A lower gestational age, hypocalcemia, extrauterine growth retardation at discharge, and neonatal sepsis may be associated an increased risk of MBDP in VLBW/ELBW preterm infants. It is necessary to strengthen perinatal healthcare, avoid premature delivery, improve the awareness of the prevention and treatment of MBDP among neonatal pediatricians, and adopt positive and reasonable nutrition strategies and comprehensive management measures for preterm infants.

The timing of withdrawal from caffeine citrate in very preterm infants / 中国当代儿科杂志

OBJECTIVES@#To study the clinical features and outcome of very preterm infants withdrawn from caffeine citrate at different time points.@*METHODS@#A retrospective analysis was performed on the medical data of the preterm infants with a gestational age of <32 weeks, who were hospitalized in the Division of Neonatology, the Second Xiangya Hospital of Central South University, from January 1, 2016 to November 30, 2020. According to the time of withdrawal from caffeine citrate, the infants who met the study criteria were divided into the group with withdrawal before the last week of hospitalization and the group with withdrawal within the last week of hospitalization. The two groups were compared in terms of clinical features, features of citric caffeine use, length of hospital stay and hospital costs, change in the intensity of respiratory support, and preterm complications.@*RESULTS@#A total of 403 preterm infants were enrolled, with 285 infants in the group with withdrawal before the last week of hospitalization and 118 infants in the group with withdrawal within the last week of hospitalization. There were no significant differences in clinical features between the two groups (@*CONCLUSIONS@#A relatively long course of caffeine citrate treatment is more beneficial to the short-term clinical outcome of very preterm infants.

Relationship between serum adiponectin and bone mineral density in preterm infants / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To examine serum adiponectin level in preterm infants and to evaluate the relationship between serum adiponectin and bone mineral density in preterm infants.</p><p><b>METHODS</b>Seventy-two appropriate-for-gestational-age neonates were classified into three groups according to their gestational ages: early preterm (31-33(+6) weeks, 13 cases), late preterm (34-36(+6) weeks, 16 cases), and full-term (37-42 weeks, 43 cases). Venous blood was collected at one week of their life to measure serum adiponectin concentration. During the period, omnisense ultrasound bone sonometer was applied to measure speed of sound (SOS) of the left tibia.</p><p><b>RESULTS</b>The median of tibia SOS in the early preterm group was significantly lower than in the late preterm and full term groups (P<0.05), and the median of tibia SOS in the late preterm group was lower than in the full-term group (P<0.05). Serum adiponectin level was lowest in the early preterm group, and the full-term group had the highest serum adiponectin level. Serum adiponectin level was positively correlated with tibia SOS in preterm infants (r=0.664, P<0.05). According to the result of multivariate linear stepwise regression analysis, serum adiponectin and birth weight were independent predictor of tibia SOS in preterm infants.</p><p><b>CONCLUSIONS</b>Serum adiponectin level is lower in preterm infants than that in full-term infants. There is a positive correlation between serum adiponectin and bone mineral density in preterm infants.</p>

Relationship between bone turnover markers and bone sound of speed in appropriate-for-gestational-age neonates / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the correlation of gestational age (GA) with carboxyterminal propeptide of type I procollagen (PICP), deoxypyridinoline (DPD), and bone sound of speed (SOS) in appropriate-for-gestational-age (AGA) neonates, as well as the relationship between bone turnover markers and bone SOS.</p><p><b>METHODS</b>Sixty-five AGA neonates were included in the study. The neonates were divided into three groups: preterm infant (GA ≤3 4 weeks, 14 cases), late preterm infant (34 weeks<GA<37 weeks, 13 cases), and full-term infant (GA ≥ 37 weeks, 38 cases). Birth weight and length were measured in all cases, and Ponderal index (PI) was used to estimate their nutritional status. Venous blood was collected within 7 days after birth to measure blood PICP concentration. Urine was collected to measure urinary DPD and creatinine (Cr) levels. Omnisense 7000P ultrasound bone sonometer was applied to measure the SOS of the left tibia in all cases within 7 days after birth.</p><p><b>RESULTS</b>There were significant differences in GA (F=140.199, P<0.001), birth weight (F=47.042, P<0.001), birth length (F=46.877, P<0.001), and PI (F=11.898, P<0.001) between the three groups; the higher the GA, the higher the birth weigh, birth length, and PI. There were significant differences in PICP (F=30.384, P<0.001), DPD/Cr (F=21.761, P<0.001), and SOS (F=20.052, P<0.001) between the three groups; the higher the GA, the lower the PICP and DPD/Cr and the higher the bone SOS. PICP and DPD/Cr were negatively correlated with GA, birth weight and bone SOS (P<0.01), while bone SOS was positively correlated with GA and birth weight (P<0.01), which still held true after adjustment for GA and birth weight.</p><p><b>CONCLUSIONS</b>Among AGA neonates, bone turnover markers are negatively correlated with GA, birth weight and bone SOS. High bone turnover is bad for bone health in AGA neonates.</p>

Effects of L-Arg on expression of PI3K and PKB in liver among low-birth-weight newborn rats / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To measure the expression of phosphatidylinositol 3-kinase (PI3K) and protein kinase B (PKB) in liver tissue among low-birth-weight newborn rats treated with L-arginine (L-Arg) in early life, and to investigate the effect of L-Arg on insulin resistance.</p><p><b>METHODS</b>Eighteen pregnant rats were randomly divided into three groups: control, model and intervention (n=6 each). The control group was fed with normal protein feed (protein content=21%) during pregnancy to establish a normal-birth-weight newborn rat model, and the model and intervention groups were fed with low-protein feed (protein content=10%) during pregnancy to establish a low-birth-weight newborn rat model. Newborn rats from the three pregnant rat groups were also assigned to control, model and intervention groups. During 21 days of lactation, maternal rats in the control and model groups were fed with normal protein feed and normal drinking water, while maternal rats in the intervention group were fed with normal protein feed and drinking water rich in L-Arg (200 mg/kg·d). After ablactation, the three groups of newborn rats were fed with normal protein feed and normal drinking water. Liver tissue samples were collected from these newborn rats at 1, 3 and 8 weeks after birth. Protein expression of PI3K and PKB in liver tissue was measured by Western blot.</p><p><b>RESULTS</b>At 1 week after birth, the newborn rats in the intervention group had significantly higher protein expression of PI3K than in the model group (P=0.045), but there was no significant difference when compared with the control group (P=0.503). At 8 weeks after birth, the newborn rats in the intervention group had significantly higher protein expression of PKB than the model group (P=0.039), but there was no significant difference when compared with the control group (P>0.05).</p><p><b>CONCLUSIONS</b>A supplement of L-Arg in early life can boost protein synthesis, increase protein expression of PI3K and PKB in liver tissue, promote insulin signaling and reduce insulin resistance.</p>

Diseases in the Neonatal period among preterm infants: an epidemiological investigation / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To explore diseases in the neonatal period among hospitalized preterm infants.</p><p><b>METHODS</b>The clinical data of 961 preterm infants who were hospitalized in three hospitals in Changsha in 2008 were retrospectively reviewed.</p><p><b>RESULTS</b>The most common neonatal disease was respiratory system diseases (73.8%), followed by infectious diseases (39.4%) and nervous system diseases (38.3%). With the increase of gestational age and birth weight, the incidence of circulatory system diseases showed no statistically significant differences (all P>0.05), while the incidences of other diseases, such as respiratory system diseases, neonatal infections, nervous system diseases, and the desirable outcome of the preterm infants became significantly different (all P<0.05). Increased birth weight and gestational age were the protective factors while neonatal asphyxia, hyperbilirubinemia and neonatal scleredema were the risk factors for the outcome of preterm infants.</p><p><b>CONCLUSIONS</b>The common neonatal diseases for preterm infants are respiratory system diseases, neonatal infections, and nervous system diseases. The incidence of the common diseases is reduced with the increasing gestational age and birth weight. Interventions should be carefully planned based on the protective factors (increased birth weight and gestational age) and risk factors (neonatal asphyxia, hyperbilirubinemia and scleredema) of the outcomes of these diseases.</p>

Ganciclovir therapy for congenital cytomegalovirus infection in newborn infants: a meta analysis / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To evaluate the efficacy and safety of ganciclovir therapy for congenital cytomegalovirus (CMV) infection in newborn infants.</p><p><b>METHODS</b>The randomized controlled trials (RCTs) and quasi-RCTs on ganciclovir therapy for congenital CMV were reviewed in the following electronic databases: PubMed (January 1988 to January 2009), EMbase (January 1988 to January 2009), the Cochrane library (Issue 3, 2003 and Issue 1, 2009), the Chinese Journals Full-text Database (January 1994 to January 2009), the Chinese Biological Medical Disc (January 1994 to January 2009) and the Chinese Medical Current Contents (January 1994 to January 2009). Quality assessment, data extraction, and meta analysis were performed.</p><p><b>RESULTS</b>Ten papers were included. Meta analysis showed that the ganciclovir therapy increased the improvement rate (91.4% vs 34.0%; p<0.01) and led CMV infection indexes to become negative in more patients (87.6% vs 15.3%; p<0.01) and decreased incidence of hearing disturbance (4.7% vs 37.2%; p<0.01) as compared with the non-ganciclovir therapy control group. The incidence of the ganciclovir-therapy-related side effects was low.</p><p><b>CONCLUSIONS</b>Ganciclovir treatment may increase the improvement rate and the rate of CMV infection indexes becoming negative, and decrease incidence of hearing disturbance, with few side effects, in newborn infants with CMV infection. However the supporting evidence is not strong due to few trials and more high-quality research is needed.</p>

Comparison of therapeutic effect of different doses of ganciclovir for neonatal congenital cytomegalovirus infection / 中国当代儿科杂志

<p><b>OBJECTIVE</b>Ganciclovir is a first-line drug for treatment of cytomegalovirus (CMV) infection. However, some ganciclovir treatment-related side-effects can be found. This study aimed to compare the efficacy and side effects of relatively low and high doses of ganciclovir in the treatment of neonatal congenital CMV infection.</p><p><b>METHODS</b>One hundred and sixty-seven neonates with congenital CMV infection were randomly assigned to high-dose (n=79) and low-dose ganciclovir groups (n=88). The high-dose ganciclovir group was injected with ganciclovir of 7.5 mg/kg in the inducement phase and of 10 mg/kg in the maintaining phase. The low-dose ganciclovir group was injected with ganciclovir of 5 mg/kg in the inducement and the maintaining phases. The efficacy and side effects were observed in the two groups.</p><p><b>RESULTS</b>After treatment the clinical symptoms and signs were obviously improved in both groups. CMV-IgM became negative in 93.8% of neonates in the high-dose ganciclovir group and 93.1% of neonates in the low-dose ganciclovir group (P>0.05). CMV-DNA became negative in 80.8% of neonates in the high-dose ganciclovir group and in 86.7% in the low-dose ganciclovir group (P>0.05). The low-dose ganciclovir group had lower incidence of side effects than the high-dose ganciclovir group: vomiting 2.3% vs 11.4%; anemia 8.0% vs 20.3%; reduction of neutrophilic granulocytes 5.7% vs 16.5%; increase in platelet count 8.0% vs 18.9% (P<0.05).</p><p><b>CONCLUSIONS</b>Low-dose ganciclovir has the same clinical efficacy to high-dose ganciclovir for treatment of neonatal congenital CMV infection, but fewer side effects occur in the low-dose group.</p>

Perinatal birth defects in 5 years in Changsha / 中南大学学报(医学版)

OBJECTIVE@#To investigate and analyze the occurrence of 64,101 perinatal birth defects from 2000 to 2004, to determine the tendency of the incidence rate of birth defects and perinatal mortality, and to explore feasible and effective intervention strategy.@*METHODS@#We investigated 64,101 perinatal infants who were born in 13 hospitals in Changsha from January 2000 to December 2004. The incidence rate of all birth defects, mortality of perinatal infants, the incidence rate of various kinds of birth defects, and the component rate of birth defects were analyzed.@*RESULTS@#Altogether 1,050 neonate birth defects were found, with the incidence rate of 1.638%. The incidence rate of birth defects was increasing year-by-year in 2000 compared with that in 2002, 2003 and 2004, with significant differences (all P values<0.05): the incidence rate of birth defects in 2001 compared with that in 2002, 2003 and 2004, also with significant differences (P<0.05). Eight hundred seventy nine perinatal infants died, and the mortality was 1.371%. The mortality perinatal of infants increased in 2001 compared with that in 2002 and in 2003, with significant differences (P<0.05). The top 5 birth defects with the highest incidence were congenital heart disease, polydactly, auricle malformation, cheiloschisis, and palatoschisis, congenital hydrocephal in turn. The incidences of congenital heart disease and hydrocephal increased significantly. One hundred seventy seven fetuses were performed induced labor because of fetal defects from 2003.@*CONCLUSION@#We must pay attention to the increasing tendency of birth defect incidence and perinatal mortality. Strengthening environmental protection and antenatal care can decrease the birth defect incidence. Performing antenatal examination and neonatal screening regularly can discover the birth defects in time. When severe birth defects occur, the induced labor should be performed.

Influence of human cytomegalovirus infection on cell cycle and replication licensing factor Cdt1 in human embryonic lung fibroblastic cells / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To study the influence of human cytomegalovirus (HCMV) infection on cell cycle and the expression of replication licensing factor Cdt1 in human embryonic lung fibroblastic (HEL) cells and to explore the pathogenesis of HCMV infection.</p><p><b>METHODS</b>HEL cells were synchronized in the G0/G1 phase by the serum starvation method. The synchronized HEL cells were infected with HCMV, and those that were not subjected to HCMV infection were used as the control group. The HEL cells were harvested at 12, 24, 48, 72 and 96 hrs of HCMV infection. The cell cycle of HEL cells was detected by the flow cytometry. The expression of Cdt1 mRNA in HEL cells was determined by reverse transcription-polymerase chain reaction (RT-PCR).</p><p><b>RESULTS</b>The cells in the G1 phase in the control group was significantly more than in the HCMV-infected group 12 and 24 hrs after infection (P < 0.01). The expression of Cdt1 mRNA in the HCMV-infected group was significantly lower 12 and 24 hrs after infection but increased significantly 48 hrs after infection compared with the control group (P < 0.05). The expression of Cdt1 mRNA reached a peak at 12 hrs of infection in the control group, but at 48 hrs of infection in the HCMV-infected group, which markedly lagged behind the control group.</p><p><b>CONCLUSIONS</b>HCMV infection arrests the cell cycle of HEL cells at the G1 phase. HCMV infection makes Cdt1 expression delay. HCMV infection can interfere cell cycle of HEL cells possibly through affecting the expression of Cdt1.</p>

Effects of birth asphyxia or intrauterine distress on renal functions in newborns in the first week of life / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the renal function in newborns with birth asphyxia or intrauterine distress in the first week of life.</p><p><b>METHODS</b>Sixty full-term newborns born between June 2002 and February 2003 were assigned into three groups: Control group (healthy newborns), Intrauterine distress group (Apgar score > 7), and Birth asphyxia group without intrauterine distress (12 mild asphyxia and 8 severe asphyxia) (n=20 each). Urinary levels of alpha1-microglobulin (alpha1-MG), beta2-microglobulin (beta2-MG) and albumin (Alb) were detected by radioimmunoassay at 0-2, 3-4 and 6-7 days after birth.</p><p><b>RESULTS</b>The urinary levels of alpha1-MG, beta2-MG and Alb in the Asphyxia group were significantly higher than those in the Control group at all time points (P < 0.05), peaking at 3-4 days after birth. Statistically significant differences were found between the severely and mildly asphyxiated newborns for the urinary levels of alpha1-MG, beta2-MG and Alb at all time points (P < 0.05). There were no significant differences in the urinary levels of alpha1-MG, beta2-MG and Alb between the Intrauterine distress and the Control groups at each time point.</p><p><b>CONCLUSIONS</b>Birth asphyxia may lead to renal glomerular and tubular impairments and it is speculated that the most serious impairment occurs at the 3rd and 4th days of life. The severity of renal impairments is associated with the degree of asphyxia. The renal function of the newborn appears to be normal following intrauterine distress.</p>

Effects of neonatal recurrent seizures on gamma-aminobutyric acid B1 receptor expression in the rat brain / 中国当代儿科杂志

<p><b>OBJECTIVE</b>This study investigated the effects of flurothyl-induced neonatal recurrent seizures on gamma-aminobutyric acid B1 receptor (GABAB1R) expression in neonatal and adult rat brain, and explored the possible relationship between the alterations of GABAB1R in mature brain and the changes of spatial memory and seizure susceptibility in adult rats.</p><p><b>METHODS</b>Forty-eight postnatal day (P) 7 Sprague-Dawley rats were randomly assigned into two groups: Control and Seizure group (n=24 each). Seizures were induced by inhalant flurothyl daily for six consecutive days in rat pups from the Seizure group. Twelve rats selected randomly in each group were sacrificed on the 7th day after the last seizure for detecting the expressions of GABAB1R mRNA and protein in cerebral cortex and hippocampus by reverse transcription-polymerase chain reaction (RT-PCR) and immuno-histochemistry method. The spatial memory was tested by using the Morris water maze task during P61 to P64 and the seizure threshold was measured at P75 following intraperitoneal injection of pentylenetetrazol ( PTZ ) in the remaining rats. The rats were then sacrificed for detecting the expressions of GABAB1R mRNA and protein in cerebral cortex and hippocampus.</p><p><b>RESULTS</b>The expressions of GABAB1R mRNA and protein in the cerebral cortex on the 7th day after the last seizure and at P75 decreased significantly in the Seizure group when compared with the Control group (P < 0.05). The GABAB1R protein expression in the dentate gyrus on the 7th day after the last seizure in the Seizure group was significantly lower than that in the Control group (P < 0.05), but the GABAB1R mRNA expression in the hippocampus was not different from that in the Control group. There were no significant differences in the expressions of GABAB1R mRNA and protein in the hippocampus between the two groups at P75. The escape latencies in water maze of the rats in the Seizure group at P64 were significantly longer than those in the Control group (98,533.8 +/- 27,205.4 ms vs 46,723.3 +/- 40,666.5 ms; P <0.05). There were no differences in the seizure threshold between the two groups.</p><p><b>CONCLUSIONS</b>The expressions of GABAB1R mRNA and protein in the cerebral cortex and hippocampus of neonatal rats with recurrent seizures decreased significantly, suggesting the changes of GABAB1R may be related to acute brain injury following neonatal recurrent seizures and the memory deficit in adult rats caused by neonatal recurrent seizures.</p>

Influence of Hearing Disorder on Newborns with Hyperbilirubinemia / 实用儿科临床杂志

Objective To investigate the incidence of hearing disorder and analyse the high-risk factors with hearing injury in newborns with hyperbilirubinemia.Methods The newborns with hyperbilirubinemia who admitted to the department of neonate,were received the distortion product otoacoustic emission(DPOAE)test when they recovered from hyperbilirubinemia;those babies who didn′t pass the first test received screening again in 42 days after birth.Those babies who didn′t pass the second test received auditory brain stem response(ABR)test.Results Fifty-eight(33.2%)newborns didn′t pass the first DPOAE test among 235 newborns with hyperbilirubinemia;11(18.9%)infants didn′t pass the second DPOAE test among 58 infants;5 infants failed to pass the ABR test,the ratio of hea-ring disorder in newborns with hyperbilirubinemia was 2.13%;18(9.9%)newborns didn′t pass the first DPOAE test among 182 normal newborns,and those infants all passed the second DPOAE test.Conclusions Hyperbilirubinemia is high-risk population of hearing disorder.The congenital cytomegalovirus infection,neonatal septicemia and hemolytic disease of newborn are the high risk factors responsible for hearing disorder.All high risk newborns should recieve hearing examination regularly.

Relationships between Low Birth Weight and Insulin Resistance and Adult Cardiovascular Disease / 实用儿科临床杂志

The nutritional status in early life have been gradually recognized that it can change the status of development and metabolism of adults.Epidemiological evidence and animal model study have found that low birth weight is the risk factors of adult metabolic syndrome and cardiovascular disease.Insulin resistance is a common pathophysiological basis.Renin-angiotensin system and insulin signaling systems interact to promote the development of insulin resistance.