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Sun H.,Zhengzhou Childrens Hospital | Sun H.,Zhengzhou University | Kang W.,Zhengzhou Childrens Hospital | Cheng X.,Zhengzhou University | And 9 more authors.
Neonatology | Year: 2013

Background: Retinopathy of prematurity (ROP) is a gestational age (GA)-related illness that can lead to blindness in premature infants. Timely screening of premature infants could improve visual prognosis. Objective: To evaluate the WINROP algorithm as a method of predicting severe ROP in a Chinese population. Methods: 590 infants with a GA <32 weeks were entered into an online surveillance system (www.winrop.com) that included ROP evaluations and weekly weight measurements from birth to a corrected GA of 40 weeks. If the rate of weight gain decreased to a certain degree, the algorithm signaled an alarm that the infant was at risk for developing sight-threatening ROP. Each infant was categorized as having no, mild, or severe ROP. Results: Among the 590 infants with a GA <32 weeks, an alarm was triggered in 85 infants (14.4%), 50 of which developed severe ROP and were identified in this alarm group. Twenty-seven infants triggered the alarm signal in the first week after birth and 7 infants triggered the alarm at birth. Seven of the infants developed proliferative ROP and the median GA at birth for these infants was 31 weeks. Conclusions: The WINROP system had a sensitivity of 87.5% in a Chinese population for the early identification of infants that developed severe ROP. Postnatal weight gain may help predict ROP in lower birth weight infants. Copyright © 2013 S. Karger AG, Basel. Source

Sun H.,Zhengzhou University | Cheng R.,Nanjing Medical University | Kang W.,Zhengzhou University | Xiong H.,Zhengzhou University | And 6 more authors.
Respiratory Care | Year: 2014

BACKGROUND: Mechanical ventilation and surfactants are the standard treatment of preterm respiratory distress syndrome (RDS). The effects of the primary ventilation model on bronchopulmonary dysplasia (BPD) and long-term neurodevelopment outcomes are controversial. The purpose of this study was to compare the efficacy and safety of high-frequency oscillatory ventilation (HFOV) and synchronized intermittent mandatory ventilation plus pressure support ventilation (SIMV-PSV) in preterm infants with severe RDS. METHODS: A total of 366 eligible preterm infants were randomly assigned to treatment with HFOV (n = 184) or SIMV-PSV (n = 182). Surfactant was applied if PaO2/FIO2 was < 200 mm Hg after 2 hours of ventilation. Primary outcomes were mortality or incidence of BPD. Secondary outcomes were duration of ventilation and hospitalization, surfactant requirements, pneumothorax, retinopathy of prematurity ≥ stage 2, and neurodevelopment at 18 months of corrected age. RESULTS: Survival and complete outcome data were available for 288 infants at 18 months of corrected age. The incidence of death or BPD was significantly higher in the SIMV-PSV group (P =.001). The duration of mechanical ventilation and hospitalization was shorter and the incidence of surfactant requirement and retinopathy of prematurity was lower in the HFOV group (P <.001, P =.002, P =.04, respectively). Moderate or severe neurological disability was less frequent in the HFOV group than in the SIMV-PSV group at 18 months (P =.03). The combination of HFOV and surfactant dramatically reduced negative outcomes in preterm infants with severe RDS. CONCLUSIONS: Initial ventilation with HFOV in preterm infants with severe RDS reduces the incidence of death and BPD, and improves long-term neurodevelopment outcomes. (ClinicalTrials.gov NCT01496508). © 2014 Daedalus Enterprises. Source

Gao J.,Zhengzhou University | Gao J.,Henan Traditional Chinese Medical College | Wang S.,Zhengzhou University | Wang X.,Zhengzhou University | And 3 more authors.
Neurological Sciences | Year: 2011

To investigate the effect of electroacupuncture on cell proliferation and differentiation in young rat hippocampus, postnatal day-14 rats were assigned randomly to control, ketamine anesthesia, nonacupoint, or acupoint electroacupuncture groups. Electroacupuncture was applied at bilateral acupoints (Quchi, Waiguan, Huantiao, and Zusanli) 30 min daily for 7 successive days. The proliferation and neuronal differentiation of proliferated surviving cells in the dentate gyrus were evaluated at 4 weeks after last stimulation. The stimulatory effect of electroacupuncture on cell proliferation had a long-lasting effect, as indicated by the increased phosphor-histone H3-positive cells. The number of proliferated and survival cells, indicated by BrdU labeling, was highest in the electroacupuncture group. The number of newly differentiated neurons, as indicated by BrdU/NeuN double labeling, was significantly higher in the electroacupuncture group than in any of the other groups. This finding provides a theoretical basis for the clinical application of acupuncture to cerebral injury rehabilitation in children. © Springer-Verlag 2010. Source

Sun H.,Zhengzhou University | Xu F.,Zhengzhou University | Xiong H.,Zhengzhou Childrens Hospital | Kang W.,Zhengzhou Childrens Hospital | And 10 more authors.
Lung | Year: 2013

Background: The purpose of this study was to compare the risk factors, clinical characteristics, and complications of respiratory distress syndrome (RDS) in infants delivered very preterm, late preterm, and term in order to help optimize the management of RDS in neonates. Methods: A retrospective study was conducted on neonates admitted to the NICU between January 2006 and December 2010. The enrolled infants with RDS were categorized as very preterm (<320/7 weeks gestation), moderately preterm (32 0/7-336/7 weeks), late preterm (340/7-36 6/7 weeks), and term (370/7-420/7 weeks). The rates, potential risk factors, clinical characteristics, and complications of RDS of these four groups were comparatively analyzed. Results: There was an increasing trend in incidence of RDS among the NICU admissions annually. Caesarean section without labor was significantly associated with RDS in term and late preterm infants (P < 0.001). Rates of requirements for ventilator and pulmonary surfactant were similar in very preterm and term infants but significantly lower in late preterm infants (P < 0.001). The oxygenation index value was not substantially lower in late preterm and term infants compared to very preterm infants, and the arterial oxygenation efficiency was improved slowly (P < 0.001). Incidence of pneumonia and occurrence of pneumothorax were significantly higher in term infants (P < 0.001). Conclusions: Term infants with RDS showed an association of RDS with caesarean section without labor and lung infection. These infants also showed slower improvement of oxygenation after surfactant administration and mechanical ventilation, and they experienced a high rate of pneumothorax complication, which was also noticed in late preterm neonates. © 2013 Springer Science+Business Media New York. Source

Huo K.,Zhengzhou University | Zhang Z.,Zhengzhou University | Zhao D.,Zhengzhou University | Li H.,Zhengzhou University | And 7 more authors.
Endocrine Journal | Year: 2011

Neurodevelopment in children with congenital hypothyroidism who receive early treatment is generally good. However, subtle neurological deficits still exist in some patients. The aim of this investigation was to evaluate factors that may influence neurodevelopmental outcome in congenital hypothyroidism patients. The developmental quotient (DQ) of 155 children with congenital hypothyroidism was evaluated at 24 months of age, using Gesell Developmental Schedules (GDS), and compared with that of 310 healthy controls. Mean DQ scores in congenital hypothyroidism patients were 7.5 points lower for adaptive behavior than in control patients (p < 0.01). Patients with severe congenital hypothyroidism had the lowest DQ scores compared with two other congenital hypothyroidism subgroups and controls (p < 0.01). Children with congenital hypothyroidism who also had a low level of serum T4 at diagnosis or exhibited a longer thyroid stimulating hormone (TSH) normalization time had lower adaptive behavior scores (p < 0.0003). Bivariate correlation and multiple regression analyses found that the severity of congenital hypothyroidism and parental socioeconomic status correlated with DQ scores. TSH normalization time was negatively related to adaptive behavior scores (p < 0.01). Neurodevelopmental deficits in children with congenital hypothyroidism correlate with the severity of congenital hypothyroidism, TSH normalization time, and parental socioeconomic status. © The Japan Endocrine Society. Source

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