1.Progress of N-terminal pro-brain natriuretic peptide in early diagnosis of bronchopulmonary dysplasia and pulmonary hypertension in premature infants
Chinese Pediatric Emergency Medicine 2024;31(3):206-209
Bronchopulmonary dysplasia(BPD)is a significant complication that greatly impacts the prognosis of preterm infants.The incidence of pulmonary hypertension(PH)in preterms with moderate to severe BPD is relatively high,which further increases the mortality among infants with BPD.Diagnosis of BPD could be made until 36 weeks corrected gestational age,and the clinical manifestations of BPD-PH are also not specific enough for accurate identification.Cardiac catheterization is considered the gold standard for diagnosis,which is an invasive procedure,while echocardiography heavily relies on the experience of operator,limiting early detection of both BPD and BPD-PH.N-terminal pro-brain natriuretic peptide(NT-proBNP),secreted by ventricular myocytes in response to volume or pressure overload,has been widely utilized in assessing cardiac load in cases of congenital heart disease.Recent studies have shown that the blood NT-proBNP levels significantly elevate in infants with BPD within one week after birth and during the development stage of BPD.Additionally,there is a substantial increase in NT-proBNP levels from 28 to 36 weeks corrected gestational age,which has both high sensitivity and high specificity in predicting the occurrence of BPD-PH.Therefore,NT-proBNP is expected to serve as a biomarker for the early prediction of BPD and BPD-PH.This review summarized the biological function,metabolic characteristics,and current research advancements regarding NT-proBNP in BPD and BPD-PH.The aim is to utilize NT-proBNP as an early predictor for BPD and BPD-PH,enabling timely identification of premature infants with high risk factors of these diseases,and facilitating prompt intervention to ultimately enhance prognosis.
2.Measurement and algorithm of healthy life expectancy: a scoping review
Wanqi WANG ; Jinghan QU ; Mengze LIU ; Minrui LI ; Boying ZANG ; Junwen ZHOU ; Houyu ZHAO ; Rui ZHANG ; Yunning LIU ; Lijun WANG ; Xia WAN ; Feng SUN ; Jing WU
Chinese Journal of Epidemiology 2022;43(12):1986-1994
Objective:Healthy life expectancy (HLE), which combines life expectancy with health, is an essential comprehensive measure of life length and quality. This article aimed to systematically review the methods for defining and measuring HLE and describe application studies published, providing a reference for decision makers to select and develop methods suitable for China's conditions to measure HLE.Methods:Seven Chinese and English literature databases were searched up to May 7, 2022, and several related reviews and bibliography were manually retrieved. Systematic reviews and empirical research were included concerning HLE indicators and measurement of HLE. Information including the study area, type of the study, study population, HLE index, measurement method, data sources, and results from application studies published in the last five years were extracted. The evolution of the definition of HLE, the scope of different indicators, the measurement scale of health, and measurement methods, were all collected. Results of the empirical research related to measurement methods of indicators were summarized. The study followed the scoping review framework and was written according to the PRISMA-ScR statement.Results:A total of 84 articles were included, including 13 reviews, 17 original studies related to HLE index definition, ten original studies related to index measurement, and 44 empirical studies conducted in the past five years. There were as many as 20 indicators related to HLE, and each scale had its emphasis. A total of ten methods measuring HLE were identified, which vary in the definition of health, whether using weight, and the data type. The most commonly used indicators in the past five years were disability-free life expectancy and HLE. For the method of HLE calculation, Sullivan's method was mainly used for cross-sectional data, and the multistate life table was mainly used for longitudinal data.Conclusions:There are various definitions and measurement methods of HLE, but none are suitable for all scenarios. To summarize the HLE concept, health evaluation techniques, measurement methods, and application studies published worldwide can provide a reference for the localization of HLE measurement in China.
3.Case 04 (2024): Two cases of neonatal limb arterial thrombosis with thrombolytic therapy
Mengze SUN ; Ying ZHANG ; Laishuan WANG ; Zheng CHEN ; Hua WANG ; Xin DING ; Qiushi WANG ; Haidi HU ; Ana HOU
Chinese Journal of Perinatal Medicine 2024;27(8):688-694
This article reported two cases of axillary artery thrombosis in extremely low/very low birth weight infants following the placement of a local arterial catheter, who hospitalized in Shengjing Hospital of China Medical Universityin in April 2023 and August 2022, respectively. Case 1: Before surgery for necrotizing enterocolitis, an arterial catheter was placed in the left axilla of the infant. On the same day, the infant developed cyanosis of the left upper limb and weakened radial artery pulse. Ultrasound examination confirmed the presence of left axillary artery thrombosis. Despite subcutaneous injection of low molecular weight heparin (LMWH) and plasma infusion, there was no improvement in blood circulation. The infant also exhibited reduced movement in the left upper limb and loss of radial artery pulse. Thrombolytic therapy with recombinant tissue-type plasminogen activator was administered. Six hours after the treatment, the radial artery pulse became palpable. Thrombolysis was then terminated, and anticoagulation with LMWH was supplied for two weeks. At one year and eight months of age, the infant had a weaker left-hand grip strength compared to the right, but the overall functionality was largely preserved. Case 2: The infant developed late-onset sepsis at 17 days old and had an arterial catheter placed in the axilla. Pale left upper limb was observed in the following day, and the brachial and radial artery pulses were absent. Vascular ultrasound indicated the presence of left axillary artery thrombosis. Anticoagulation therapy with subcutaneous injection of LMWH was provided, along with thrombolysis using urokinase. On the sixth day after thrombolysis, an ultrasound examination showed no thrombus-like echoes. At one year and eight months of age, the development and movement of the affected upper limb became normal.