Objective:To analyze the time to reach full enteral feedings (TFEF) among preterm infants with gestational age (GA)<32 weeks admitted to the neonatal intensive care unit (NICU) of Chinese Neonatal Network (CHNN).Methods:This was a retrospective analysis based on the database from the CHNN 89 participating centers between January 1 st, 2019 and December 31 st, 2022. All 16 155 preterm infants with a GA <32 weeks and a birth weight <1 500 g, admitted to the NICU within 24 h after birth, hospitalization for at least 7 d and achieved full enteral feedings before discharge were included. According to the birth weight, these infants were divided into extremely low birth weight (ELBW) group and very low birth weight (VLBW) group. The practice characteristics of TFEF across different GA, the severity of neonatal admission, the NICU interventions before reaching full enteral feeding, and relevant neonatal diseases were described. Mann-Whitney U tests or Kruskal-Wallis H tests was used for comparison between groups. Results:Among the 16 155 preterm infants with a GA <32 weeks, 8 505 case (52.6%) were male. The TFEF in 3 374 cases of ELBW groups was 32 (22, 46) d, 351 cases (10.4%) with TFEF ≤2 weeks, 1 050 cases (31.1%) with TFEF >2-4 weeks, 964 cases (28.6%) with TFEF >4-6 weeks, and 1 009 cases (29.9%) with TFEF >6 weeks. The TFEF in 12 781 cases of VLBW group was 22 (15, 32) d, 439 cases (3.4%) with TFEF ≤1 week, 2 565 cases (20.1%) with TFEF >1-2 weeks, 5 526 cases (43.2%) with TFEF >2-4 weeks, and 4 251 cases (33.3%) with TFEF >4 weeks. The TFEF was 36(23, 52) d of 625 preterm infants at a GA ≤25 weeks and 20 (13, 28) d of 2 606 preterm infants at a GA 31 weeks. Inborn infants had a shorter TFEF than those outborn infants and the infants with breast-fed achieved shorter than formula and mixed feeding both in ELBW and VLBW groups (all P<0.001). The earlier enteral feeding started, the shorter TFEF will be both in ELBW and VLBW groups (both P<0.001). The TFEF of preterm infants who were treated before full enteral feeding like peripherally inserted central catheters, and blood transfusions and blood product providers were all longer than those who were not treated (all P<0.001). The TFEF of preterm infants with complications like hemodynamically significant patent ductus arteriosus, necrotizing enterocolitis, late onset sepsis, severe retinopathy of prematurity and bronchopulmonary dysplasia were all longer than those without (all P<0.001). Conclusions:The distribution of TFEF in VLBW and ELBW has a large difference. The TFEF of preterm infants varies with different GA, treatment measures and complications. Further quality improvement is required to shorten TFEF.

Objective:To analyze the time to reach full enteral feedings (TFEF) among preterm infants with gestational age (GA)<32 weeks admitted to the neonatal intensive care unit (NICU) of Chinese Neonatal Network (CHNN).Methods:This was a retrospective analysis based on the database from the CHNN 89 participating centers between January 1 st, 2019 and December 31 st, 2022. All 16 155 preterm infants with a GA <32 weeks and a birth weight <1 500 g, admitted to the NICU within 24 h after birth, hospitalization for at least 7 d and achieved full enteral feedings before discharge were included. According to the birth weight, these infants were divided into extremely low birth weight (ELBW) group and very low birth weight (VLBW) group. The practice characteristics of TFEF across different GA, the severity of neonatal admission, the NICU interventions before reaching full enteral feeding, and relevant neonatal diseases were described. Mann-Whitney U tests or Kruskal-Wallis H tests was used for comparison between groups. Results:Among the 16 155 preterm infants with a GA <32 weeks, 8 505 case (52.6%) were male. The TFEF in 3 374 cases of ELBW groups was 32 (22, 46) d, 351 cases (10.4%) with TFEF ≤2 weeks, 1 050 cases (31.1%) with TFEF >2-4 weeks, 964 cases (28.6%) with TFEF >4-6 weeks, and 1 009 cases (29.9%) with TFEF >6 weeks. The TFEF in 12 781 cases of VLBW group was 22 (15, 32) d, 439 cases (3.4%) with TFEF ≤1 week, 2 565 cases (20.1%) with TFEF >1-2 weeks, 5 526 cases (43.2%) with TFEF >2-4 weeks, and 4 251 cases (33.3%) with TFEF >4 weeks. The TFEF was 36(23, 52) d of 625 preterm infants at a GA ≤25 weeks and 20 (13, 28) d of 2 606 preterm infants at a GA 31 weeks. Inborn infants had a shorter TFEF than those outborn infants and the infants with breast-fed achieved shorter than formula and mixed feeding both in ELBW and VLBW groups (all P<0.001). The earlier enteral feeding started, the shorter TFEF will be both in ELBW and VLBW groups (both P<0.001). The TFEF of preterm infants who were treated before full enteral feeding like peripherally inserted central catheters, and blood transfusions and blood product providers were all longer than those who were not treated (all P<0.001). The TFEF of preterm infants with complications like hemodynamically significant patent ductus arteriosus, necrotizing enterocolitis, late onset sepsis, severe retinopathy of prematurity and bronchopulmonary dysplasia were all longer than those without (all P<0.001). Conclusions:The distribution of TFEF in VLBW and ELBW has a large difference. The TFEF of preterm infants varies with different GA, treatment measures and complications. Further quality improvement is required to shorten TFEF.

Objective:To investigate the association between fasting blood glucose levels and the risk of early vascular aging(EVA).Methods:The basic information, medical history, and laboratory results of 695 individuals who underwent health check-up at the Physical Examination Center of the First People′s Hospital of Changzhou from January 2020 to March 2021 were retrospectively analyzed.Results:A total of 695 healthy individuals were included in the study, among whom there were 249 cases of EVA and 446 cases of non-EVA. Compared to the non-EVA group, the EVA group showed significant differences in age, gender, triglycerides, high density lipoprotein-cholesterol(HDL-C), fasting blood glucose, left brachial-ankle pulse wave velocity(L-baPWV), right brachial-ankle pulse wave velocity(R-baPWV), systolic blood pressure, and diastolic blood pressure(all P<0.01). All participants were divided into three groups( T1, T2, T3) based on fasting blood glucose levels. As fasting blood glucose levels increased, body mass index, total cholesterol, triglycerides, HDL-C, low density lipoprotein-cholesterol, L-baPWV, R-baPWV, systolic blood pressure, diastolic blood pressure, and EVA indicators showed significant differences among the three groups(all P<0.05). Univariate logistic regression analysis showed that age, gender, triglycerides, HDL-C, systolic blood pressure, diastolic blood pressure, and fasting blood glucose levels were significantly associated with the occurrence of EVA(all P<0.05). For the continuous variable of fasting blood glucose, in the regression equations without correction, with preliminary correction, and with full correction of covariates, higher fasting blood glucose levels significantly increased the risk of EVA, with odds ratios( OR) of 2.249, 2.580, and 2.413, respectively(all P<0.001). Compared to the T1 group, the risk of EVA in the T2 group, after no correction, preliminary correction, and full correction of covariates, was 1.881, 2.040, and 1.972, respectively(all P<0.01). The risk of EVA in the T3 group, unadjusted, preliminary adjustment, and full adjustment of covariates, was 3.234, 3.733, and 3.410, respectively(all P<0.001). After adjusting for confounding factors, a linear relationship between fasting blood glucose levels and the occurrence of EVA was observed through smooth curve fitting. Conclusion:Elevated fasting blood glucose may increase the risk of developing EVA.

Objective: The functions of both the central and peripheral autonomic nervous system, indexed by heart rate variability (HRV), are affected by psychology and physiology. This review summarizes the results of studies comparing the evaluation of HRV parameters between individuals with posttraumatic stress disorder (PTSD) and healthy controls. Methods: Eligible studies (n=499) were identified through literature searches of the EMBASE, Medline, PubMed and Web of Science databases. Nineteen studies met our inclusion criteria. A random effects model was used, and standardized mean differences for highfrequency HRV(HF-HRV), low-frequency HRV(LF-HRV) and the root mean square of successive R-R interval differences (RMSSD) were calculated. Results: Significant effects were found for HF-HRV [p<0.0001, Z=4.18; Hedges’g=-1.58, 95% confidence interval (CI) (-2.32, -0.84); k=14] and RMSSD [p<0.00001, Z=4.80; Hedges’g=-1.96, 95% CI (-2.76, -1.16); k=9] relative to healthy controls. Considerable heterogeneity was revealed, but the main effects for HF-HRV and RMSSD were robust in subsequent meta-regression and subgroup analyses. Conclusion Given the relationships among low vagal state, inflammation, and alterations in brain structure and function, including executive function and emotion regulation, reduced HRV may be regarded as an endophenotype in PTSD research.

Objective: To probe into the correlation between chronic liver disease and intestinal barrier function. Methods: 1 491 cases of hospitalized patients were enrolled, of which 741 cases were of chronic liver diseases, including 397 cases of fatty liver diseases, 230 cases of chronic hepatitis, 114 cases of liver cirrhosis, and 750 cases of non-hepatic diseases. All admitted patients’ intestinal barrier function like diamine oxidase (DAO), D-lactate, lipopolysaccharide, and biochemical indicators of liver functions were tested. According to different data, statistical analysis was done using t-test, ANOVA, Dunnett’s test, χ ² test of fourfold table, Pearson’s correlation, and binary logistic regression. Results: The intestinal barrier dysfunction was more likely to occur in the chronic liver disease group than that of non-hepatic disease group [54.15% (379/741) vs. 18.53% (139/750), χ ² = 193.58, P < 0.001]. The correlation analysis between biochemical indicators of liver function and intestinal barrier function in chronic liver disease group showed that alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma glutamyl transferase (GGT), and total bilirubin levels were more susceptible to intestinal barrier dysfunction than those with normal indexes (P < 0.05 ). GGT had stimulated DAO (P < 0.05, OR > 1), D-lactate (P < 0.05, OR > 1), lipopolysaccharide (P < 0.05, OR > 1), ALT and AST. Conclusion Chronic liver disease increases with damage to intestinal barrier function.

Objective To establish a rat model of nonalcoholic fatty liver disease (NAFLD) using high-fat diet,and to dynamically observe the influence of the changes in gut microbiota on the development and progression of NAFLD in rats during and after modeling.Methods Sprague-Dawley rats were given high-fat diet to establish the model of NAFLD,and these rats were randomly divided into high-fat group,antibiotic pretreatment group,antibiotic treatment group,restricted diet group,and control group.The rats were sacrificed in different feeding periods,and 16sRNA fluorescent quantitative PCR was used to analyze the changes in ileocecal microbiota in rats.The liver pathological scores were determined,and enzymatic colorimetry was used to measure blood lipid level in serum and liver homogenate.The sample mean t-test was used for comparison between groups.Results Compared with the high-fat group,the restricted diet group showed the most significant improvements in quality of life and biochemical parameters.In the restricted diet group,the number of probiotics (Bifidobacterium and Lactobacillus) at the end of the ileum gradually increased and tended to increase over the time of intervention,and the most significant difference between this group and the high-fat group occurred at the 10th week (Bifidobacterium:0.91±0.23 vs 0.28±0.12,P ＜ 0.05;Lactobacillus:0.78±0.04 vs 0.21±0.03,P ＜ 0.05),while the number of enterococci decreased.There were no significant differences in enteric bacilli between groups (all P ＞ 0.05).At the 10th week,the liver pathological scores in the control group,antibiotic treatment group,and restricted diet group were 1.13±1.74,4.86±0.86,and 2.94±1.91,respectively,significantly lower than 7.09±2.03 in the high fat group (all P ＜ 0.05).Conclusion Diet structure change and antibiotic intervention can adjust gut microecology,alleviate the lesions of NAFLD,and thus provide new strategies for the prevention and treatment of NAFLD from the perspective of microecology.

Objective To evaluate the application of three dimensional time-of-flight (3D-TOF) MRA in screening intracranial aneurysms in the population of Wenling community. Methods A total of 2 124 patients with suspicious intracranial aneurysm in Wenling community, who received 3D-TOF MRA and three dimensional digital subtraction angiography(3D-DSA) during the period from September 2011 to August 2012, were enrolled in this study. The epidemic data of intracranial aneurysm in Wenling community were analyzed, the effectiveness of 3D-TOF MRA in detecting intracranial aneurysm was assessed, and the consistency between 3D-TOF MRA and 3D-DSA (regarded as the golden standard) in detecting intracranial aneurysm was statistically analyzed. Results The results of 3D-TOF MRA showed that the morbidity of intracranial aneurysm in the population of Wenling community was 6.87% (146/2 124), among which the morbidities in males and females were 48.63% (n=71) and 51.37% (n=75) respectively; the mean age of patients was (41.2±11.6) years old. The accompanying diseases included hypertension, diabetes mellitus, arteriosclerosis and cerebrovascular lesions. 3D-TOF MRA examination revealed 149 intracranial aneurysms, among which misdiagnosis was made in 5 patients and missed diagnosis in 2 patients. The sensitivity, specificity and accuracy of 3D-TOF MRA in diagnosing intracranial aneurysm were 98.63% (144/146), 99.72%(1 773/1 778) and 99.67%(2 117/2 124) respectively. No statistically significant difference in measuring the longitudinal diameter and neck width of intracranial aneurysms existed between 3D-TOF MRA and 3D-DSA examinations (P>0.05). Conclusion In detecting intracranial aneurysm, 3D-TOF MRA carries higher sensitivity, specificity and accuracy, and its non-invasive advantage is more suitable for the screening of intracranial aneurysms.