The enrichment of plamitic acid at sn-2 position of triglyceride in human milk improves a high efficiency of fatty acid absorption,softer stools and prevention of calcium malabsorption in infants.Meanwhile,it increases early bone mineralization and development,adjusts the composition of the intestinal microflora.It also may lower the extent and severity of intestinal inflammation after injury and modulate early infant crying.

Overnutrition during the early postnatal life,a critical time window for growth and development,may induce metabolic syndrome later in life,including overweight/obesity and insulin resistance.The important target organs of insulin,such as liver,adipose tissue,skeletal muscle,and central nervous systems show insulin resistance.The involved mechanisms include abnormality of insulin signal pathway,increment of free fatty acid and some adipocytokines,oxidative stress,maladjustment of orexigenic and anorexigenic neuron,modifications of the hypothalamic-pituitary-adrenal glucocorticoid axis as well as epigenetic,etc.Hence,overnutrition should be avoided during the early postnatal life,so as to decrease the risk of developing long-term insulin resistance.

Objective To explore the effects of early postnatal nutrition on adult-onset insulin resistance by an artificial nutrition intervention during the critical period. Methods On postnatal day 2, Sprague-Dawley rats were assigned randomly to overnutrition (SL), normonutrition (NL) and undernutrition (LL) via artificially adjusting the number of pups nursed per dam. Litter size was adjusted to 3 pups/dam, 10 pups/dam and 20 pups/dam for the SL, NL and LL groups, respectively. There were eight litters for each group. All the pups were nursed by their natural dams and fed with a standard rodent laboratory chow. The pups were weaned on postnatal day 21 and three male pups from each litter were separated. After that, all male rats were housed three per cage and fed standard chow until 16 weeks old. At 3 and 16 weeks, rats were killed after overnight fasting and blood was collected. Liver, gastrocnemius muscle and perirenal and epididymal fat pads were dissected and weighed to calculate relative mass after normalization for body weight. Physiological parameters, biochemical values and insulin resistance status, including serum insulin level, homeostasis model assessment for insulin resistance (HOMA-IR) index and intraperitoneal glucose tolerance test (IPGTT), were dynamically monitored. Analysis of variance was used for statistical analysis. Results (1) Before weaning, the body weights of SL rats were significantly heavier than NL rats after postnatal day 10, and weights of LL rats were significantly lower than NL rats after postnatal day 7. After weaning, body weights of SL rats still remained heavier and weights of LL rats continued to be lower than NL rats (P<0.05). (2) At 3 weeks, the weights of liver and perirenal and epididymal fat pads in SL rats were significantly heavier than NL rats, whereas LL rats were lower than NL rats (P<0.05). At 16 weeks, the weights of liver, epididymal fat pads and gastrocnemius muscle in SL rats were significantly heavier than NL rats. Meanwhile, the weights of all detected tissues in LL rats were lower than the NL group. The weights of epididymal fat pads after normalization for body weight in the SL group were heavier than the NL group (P<0.05). (3) At 3 weeks, the fasting serum glucose level of the SL group was significantly higher than the NL and LL groups [(7.77±1.10) vs (6.33±1.20) and (5.80±1.51) mmol/L, respectively, F=13.217, P<0.01]. At 16 weeks of age, the serum insulin level in SL rats significantly increased compared to NL and LL rats [(0.31±0.11) vs (0.16±0.08) and (0.14±0.11) ng/ml, respectively, F=5.369, P=0.017]. For HOMA-IR evaluation, the index was significantly lower in LL rats compared to NL and LL rats at 3 weeks of age [(0.09±0.01) vs (0.25±0.01) and (0.31±0.05), respectively, F=25.923, P=0.005]. At 16 weeks, the index was significantly elevated in SL rats compared to NL and LL rats [(1.77±0.53) vs (0.84±0.44) and (0.83±0.67), respectively, F=5.765, P=0.015]. Furthermore, IPGTT was performed in all groups at 14 weeks of age. SL rats had significantly higher serum glucose levels at 60 min and a significantly increased area under the curve when compared to NL and LL rats (all P<0.05). (4) Serum from 16 week old SL rats was found to contain significantly higher levels of albumin, triglycerides and free fatty acids compared to NL rats (all P<0.05). Conclusions Early postnatal overnutrition induces persistent overweight and visceral white adipose accumulation in rats, while early postnatal undernutrition show the opposite effects. Early postnatal overnutrition may lead to adult-onset insulin resistance in rats. Avoiding overnutrition during the early postnatal period, a critical window for growth and development, may prevent or decrease later metabolic risks.

Bronchopulmonary dysplasia is one of the most common chronic respiratory diseases in premature infants, especially in very low birth weight infants.Lung immaturity, inflammatory injury, oxidative stress and abnormal repair after injury are the important factors.Leukotriene is an inflammatory mediator of 5-lipoxygenase pathway and participates in the occurrence of bronchopulmonary dysplasia.Montelukast, as a leukotriene receptor antagonist, may play a role in the treatment of bronchopulmonary dysplasia through anti-inflammation, anti-oxidation and anti-fibrosis.This article will review the potential mechanism and related clinical researches of montelukast which is used in treating bronchopulmonary dysplasia.

Blood Group Incompatibility ; complications ; Erythroblastosis, Fetal ; etiology ; Humans ; Infant, Newborn ; MNSs Blood-Group System ; immunology ; Male

The perinatal risk factors of transient hypothyroxinemia(TH) in premature very-low-birth-weight infants (VLBWI) was investigated by longitudinally assessing thyroid hormones concentrations during their early life after birth and analyzing the relationship to perinatal factors. The serum TT4 concentration on day 7 was (61.03±24.19)nmol/L and the incidence of TH was 12. 05% (n= 10). Pulmonary surfactant support ( OR = 14.25, 95% CI2. 61-70. 07), ventilation support ( OR = 13. 76,95% CI 2. 55-68. 05) , dopamine support ( OR = 9.45, 95% CI 2. 26-39. 5 ) , and gestational age less than 30 weeks ( OR = 5. 78,95% CI 1. 36-24. 49) were perinatal risk factors for TH of premature VLBWI.

OBJECTIVE:To provide reference for promoting the prior usage of essential medicines and scientifically selecting of antitumor medicines in the national and local drug reimbursement list. METHODS:Entering the Human Resources and Social Se-curity Bureau websites in 10 cities(Beijing,Shanghai,Guangzhou,Nanjing,Wuhan,Xi’an,Chengdu,Shenyang,Jinan and Gui-yang),drug reimbursement list was downloaded to statistically analyze the containing of antitumor medicines(including 24 essential medicines). RESULTS:In antitumor medicines,there were 5 cities with more than 100 varieties,of which Shanghai had 255 vari-eties,which was far more than other cities;the numbers of medicines in class A were near 30 in all the cities except Beijing(67 va-rieties),and the number of class B was highest in Shanghai and lowest in Beijing. All the drug reimbursement lists in 10 cities con-tained 24 antitumor essential medicines,however,the classification was different according to the dosage forms,among which, parts of formulations of cytarabine(injections),doxorubicin(injections),busulfan (often release oral dosage forms),fluorouracil (often release oral dosage forms,injections),cyclophosphamide(often release oral dosage forms,injections),methotrexate(often release oral dosage forms,injections)and cisplatin were classified as class A medicines in all cities;oxaliplatin(injections)and pa-clitaxel (injections) were classified as class B medicines;busulfan,fluorouracil,cyclophosphamide and methotrexate were classi-fied as class B in Shanghai only. CONCLUSIONS:There are some differences in the distribution of antitumor essential medicines in drug reimbursement list in each city,the varieties in developed cities are relatively more,and developing cities are less. It is sug-gested to consider the tumor epidemiology characteristics and economic situations,reasonably select antitumor essential medicines into drug reimbursement list and reasonably adjust the proportion of class A and B to ensure the basic medication and drugs’reim-bursement.

Objective To prospectively assess the nutritional status in the patients with alimentary tract malignancy,and to elucidate the factors related to malnutrition.Methods The nutritional status of 328 patients with newly diagnosed alimentary tract malignancy was assessed using subjective global assessment(SGA)and serum levels of prealbumin and albumin.And the factors influencing the nutritional status of the patients with alimentary tract malignancy in different locations were analyzed.Results The prevalence of malnutrition was 64.43% in all,75.81% in colon cancer,63.24% in esophageal cancer,62.40% in gastric cancer and 60.27% in rectal cancer.The changes of nutritional status mainly manifested weight loss with the incidence of 67.39%,serum prealbumin level under 200 g/L with the incidence of 24.1% and serum albumin level less than 35 g/L with the incidence of 31.70%.And there was significant difference in weight loss and serum levels of prealbumin and albumin among the patients with different nutritional status(P=0.000).The factors that influence the nutritional status of the patients with alimentary tract malignancy include the location and TNM staging of tumors,and the age,appetite and digestive symptoms of the patients.Conclusion The patients with alimentary tract malignancy are susceptible to malnutrition due to the multiple factors such as the tumor location and metabolic impacts of tumor on host.Nutritional screening,assessment and early intervention should be emphasized in the inpatients with alimentary tract malignancy.

Objective:To analyze the characteristics of hospital infection of hematological disease, so as to provide reference for clinical therapy. Methods: Bacterial strains and antimicrobial resistance of pa-tients with hospital infection in Department of Hematology, Peking University Third Hospital from Jan. 2011 to Dec. 2013 were identified and analyzed retrospectively. The specimens were from their blood, urine, sputum, throat swabs and etc. Results:Among the total of 168 isolates of bacteria,the majority of the bacteria strains were from sputum (42. 9%);114(67. 9%) bacteria strains were gram negative and 54(32. 1%) bacteria strains were gram positive;the pathogen testing showed that 20. 8% were Pseudo-monas aeruginosa,18. 5% Escherichia coli,17. 9% Staphylococcus aureus, 9. 5% Klebsiellar pneumonia, 5. 9% Staphylococcus epidermis and 27. 4% other bacteria ;The gram negative bacilli to cefepime, ami-kacin and carbapenems showed the lowest antimicrobial resistance rates, and S. aureus showed the lowest antimicrobial resistance rates to vancomycin and linezolid. Conclusion:Patients with hemopathy are the main population of hospital infections, the gram negative bacteria are the most common pathogens. It is very important to promptly know the change in distribution of the pathogens in order to rationally select antibiotics and reduce the incidence of bacterial infections.

Objective To compare the effects of different doses of amino acids and fat emulsions in parenteral nutrition on the incidence of complications and prognosis in very low birth weight infants (VLBWI). Methods The clinical data of 328 VLBWI who received nutrition support therapy for at least 5 days starting in 72 h after birth during January 2005 to December 2014 , were retrospectively analyzed. According to the dosage in parenteral nutrition, patients were divided into low-dose group and high-dose group. The incidence of complications and prognosis between two groups were compared. Results There were 204 cases in low-dose group and 124 cases in high-dose group. Compared with the low-dose group, the incidence of complications was lower in high-dose group during hospitalization and the incidence of intracranial hemorrhage was reduced most;the incidence of developmental retardation was lower at discharge;the overall incidence of metabolic complications of parenteral nutrition was higher, among which the incidence of high blood glucose, electrolyte disturbance and cholestasis were increased and the incidence of hypoglycemia was lower, and the differences were all statistically signiifcant (P??0 . 05 ). Conclutsions VLBWI can tolerate early aggressive parenteral nutrition which can reduce the incidence of extrauterine growth retardation and premature complications.