1.Analysis of colonization rate and molecular characteristics of Staphylococcus aureus on tracheotomy wounds at early postoperational stage in neonates
Jie YU ; Enxia TIAN ; Xiying XIANG ; Xing ZHU ; Juan DU ; Kaihu YAO ; Jie ZHANG ; Mingyan HEI
Chinese Journal of Pediatrics 2025;63(4):399-404
Objective:To analyze the colonization rate and molecular types of Staphylococcus aureus (SA) on the tracheotomy wounds of neonates at early postoperative stage in neonatal intensive care unit (NICU). Methods:This was a case series study. Patients who were admitted and underwent tracheotomy in NICU of Beijing Children′s Hospital, Capital Medical University from January 1 st 2020 to December 31 st 2023 were enrolled. Swabs on the skin around the incision or on the nasal mucosa were collected and cultured at 24, 72 and 168 h after operation. Coagulase test and Staphytect Plus kits were used for SA identification. The nuc gene amplification and molecular types of SA were assessed by PCR. The patients were divided into SA colonization group and non-colonization group based on the presence or absence of SA colonization, and into infection group and non-infection group based on the presence or absence of infection. Demographic data, hospitalization information, colonization and infection status of SA were collected from the digital medical record system of the hospital. Differences between groups were analyzed using the independent sample t test or Fisher exact test. Results:Totally 19 patients were enrolled, among whom 13 were male. The gestation age was 39.0 (38.1, 40.0) weeks, and the birth weight was 3 150 (2 600, 3 400) g. Tracheotomy was done at 8.2 (4.1, 19.6) days after diagnosis and indication confirmed. Corrected gestational age of patients on the operation day was 43.6 (42.2, 45.4) weeks. The NICU stay time was (34.0±3.1) days. SA colonization was confirmed around the incision of 8 patients. Out of the 18 strains of colonized bacteria, 10 were methicillin-resistant Staphylococcus aureus (MRSA). The most common molecular type of MRSA was ST59-SCCmec Ⅳ-t437 strain (8 strains). A total of 10 patients presented typical clinical manifestations of bacterial infection at the lungs, 3 patients in the blood stream and 2 patients in the central nervous system. Among 10 patients with bacterial infection, 3 patients were MRSA positive by boby fluid culture and affected by the ST59-SCCmec Ⅳ-t437 strain. The infection rate was different between patients with or without SA colonization on the tracheotomy incision (7/8 vs. 3/11, P=0.020). Conclusions:The colonization rate and infection rate are high on the tracheotomy incision in neonates. The major type is MRSA, and the most common molecular strain is ST59-SCCmec Ⅳ-t437 .
2.Clinical evaluation of instantly generated inhaled nitric oxide in the treatment of neonatal pulmonary hypertension
Changyang MA ; Juan DU ; Lu CHEN ; Xiying XIANG ; Mingyan HEI ; Zixin YANG
Chinese Journal of Pediatrics 2025;63(11):1234-1239
Objective:To explore the efficacy and safety of instantly generated inhaled nitric oxide (iNO) for treating neonatal pulmonary hypertension (PH) complicated with severe hypoxic respiratory failure.Methods:This single-center, single-arm, prospective study included 32 neonates with PH complicated with hypoxic respiratory failure who were hospitalized in the neonatal intensive care unit (NICU) of Beijing Children′s Hospital Affiliated to Capital Medical University from March 2023 to March 2025 and received immediate iNO generation therapy. The demographic data, maternal pregnancy, mechanical ventilation parameters, arterial blood gas indexes, other hospitalization data and safety indexes of iNO treatment were collected. The time point for starting iNO treatment was set as 0 h, and the observation time points were 1, 6, 12, 24, 48 h after treatment and when iNO treatment was stopped. The positive reaction of iNO treatment was defined as the decrease of oxygenation index (OI)>10% or the increase of arterial partial pressure of oxygen (PaO 2)>10% after treatment. The OI, mechanical ventilation parameters, arterial blood gas index changes and treatment positive reaction ratio were analyzed to evaluate the effectiveness of iNO treatment, and the nitrogen dioxide concentration, methemoglobin (MetHb) concentration and other indicators were analyzed to evaluate the safety of iNO treatment. Paired t test or Wilcoxon signed rank sum test was used to compare the observation indexes at different treatment times. Friedman test was used to compare the concentration of nitrogen dioxide and MetHb at multiple treatment times. Receiver operating characteristic (ROC) curve was used to analyze the best cut-off value of OI related indexes to distinguish the treatment outcome of iNO. Results:Among 32 neonates, 18 (56%) were males and 14 (44%) were females, the gestational age was 38 (35, 39) weeks, the birth weight was 3.1 (2.3, 3.4) kg, and the age of enrollment was 3 (2, 8) days. The OI and the mean airway pressure at 48 h after treatment were both lower than those at 0 h ((10.4±2.0 vs. 22.6±2.5, 13.0 (12.0, 14.0) vs. 14.0 (13.0, 16.0) cmH 2O, 1 cmH 2O=0.098 kPa, both P<0.05). The fraction of inspired oxygen at 24 and 48 h after treatment were both lower than those at 0 h (both P<0.05). The PaO 2 at 6, 12, 24 and 48 h after treatment were all higher than those at 0 h (all P<0.05). The proportion of positive reactions to iNO treatment was 20 neonates (63%), 22 neonates (69%), 23 neonates (72%), 23 neonates (72%) and 26 neonates (8%) at 1, 6, 12, 24, 48 h after treatment, respectively. No occurrence of methemoglobinemia, excessive nitrogen dioxide concentration, or device related adverse events were observed. Out of 32 neonates, a total of 24 neonates (75%) were cured or improved and discharged according to medical advice, while 8 neonates (25%) died in the hospital. The best cut-off value of OI at 0 h and the decline range of OI at 12 h to distinguish the outcome of hospitalization were 24.8 and 22.2%, respectively. Conclusion:It was effective and safe to use instantly generated iNO to treat neonatal PH with severe hypoxic respiratory failure.
3.Analysis of colonization rate and molecular characteristics of Staphylococcus aureus on tracheotomy wounds at early postoperational stage in neonates
Jie YU ; Enxia TIAN ; Xiying XIANG ; Xing ZHU ; Juan DU ; Kaihu YAO ; Jie ZHANG ; Mingyan HEI
Chinese Journal of Pediatrics 2025;63(4):399-404
Objective:To analyze the colonization rate and molecular types of Staphylococcus aureus (SA) on the tracheotomy wounds of neonates at early postoperative stage in neonatal intensive care unit (NICU). Methods:This was a case series study. Patients who were admitted and underwent tracheotomy in NICU of Beijing Children′s Hospital, Capital Medical University from January 1 st 2020 to December 31 st 2023 were enrolled. Swabs on the skin around the incision or on the nasal mucosa were collected and cultured at 24, 72 and 168 h after operation. Coagulase test and Staphytect Plus kits were used for SA identification. The nuc gene amplification and molecular types of SA were assessed by PCR. The patients were divided into SA colonization group and non-colonization group based on the presence or absence of SA colonization, and into infection group and non-infection group based on the presence or absence of infection. Demographic data, hospitalization information, colonization and infection status of SA were collected from the digital medical record system of the hospital. Differences between groups were analyzed using the independent sample t test or Fisher exact test. Results:Totally 19 patients were enrolled, among whom 13 were male. The gestation age was 39.0 (38.1, 40.0) weeks, and the birth weight was 3 150 (2 600, 3 400) g. Tracheotomy was done at 8.2(4.1, 19.6) days after diagnosis and indication confirmed. Corrected gestational age of patients on the operation day was 43.6 (42.2, 45.4) weeks. The NICU stay time was (34.0±3.1) days. SA colonization was confirmed around the incision of 8 patients. Out of the 18 strains of colonized bacteria, 10 were methicillin-resistant Staphylococcus aureus (MRSA). The most common molecular type of MRSA was ST59-SCCmec Ⅳ-t437 strain (8 strains). A total of 10 patients presented typical clinical manifestations of bacterial infection at the lungs, 3 patients in the blood stream and 2 patients in the central nervous system. Among 10 patients with bacterial infection, 3 patients were MRSA positive by boby fluid culture and affected by the ST59-SCCmec Ⅳ-t437 strain. The infection rate was different between patients with or without SA colonization on the tracheotomy incision (7/8 vs. 3/11, P=0.020). Conclusions:The colonization rate and infection rate were high on the tracheotomy incision in neonates. The major type was MRSA, and the most common molecular strain was ST59-SCCmec Ⅳ-t437 .
4.Clinical research progress on the application of anti-vascular endothelial growth factors in the treatment of retinopathy of prematurity
Keyue LI ; Juan DU ; Mingyan HEI
Chinese Journal of Applied Clinical Pediatrics 2025;40(7):548-553
Retinopathy of prematurity (ROP) is a retinal vascular proliferative disease affecting premature and low birth weight infants, and it is a serious eye disease that can lead to blindness in children.The classic treatment for ROP is retinal laser photocoagulation.In recent years, with the attention paid to anti-vascular endothelial growth factor (VEGF) drug therapy, increasing evidence supports the efficacy of intravitreal injection of anti-VEGF drugs in the treatment of ROP.In this article, the mechanism of action, development progress, efficacy and safety of anti-VEGF drugs for ROP are reviewed.
5.Clinical research progress on the application of anti-vascular endothelial growth factors in the treatment of retinopathy of prematurity
Keyue LI ; Juan DU ; Mingyan HEI
Chinese Journal of Applied Clinical Pediatrics 2025;40(7):548-553
Retinopathy of prematurity (ROP) is a retinal vascular proliferative disease affecting premature and low birth weight infants, and it is a serious eye disease that can lead to blindness in children.The classic treatment for ROP is retinal laser photocoagulation.In recent years, with the attention paid to anti-vascular endothelial growth factor (VEGF) drug therapy, increasing evidence supports the efficacy of intravitreal injection of anti-VEGF drugs in the treatment of ROP.In this article, the mechanism of action, development progress, efficacy and safety of anti-VEGF drugs for ROP are reviewed.
6.Analysis of colonization rate and molecular characteristics of Staphylococcus aureus on tracheotomy wounds at early postoperational stage in neonates
Jie YU ; Enxia TIAN ; Xiying XIANG ; Xing ZHU ; Juan DU ; Kaihu YAO ; Jie ZHANG ; Mingyan HEI
Chinese Journal of Pediatrics 2025;63(4):399-404
Objective:To analyze the colonization rate and molecular types of Staphylococcus aureus (SA) on the tracheotomy wounds of neonates at early postoperative stage in neonatal intensive care unit (NICU). Methods:This was a case series study. Patients who were admitted and underwent tracheotomy in NICU of Beijing Children′s Hospital, Capital Medical University from January 1 st 2020 to December 31 st 2023 were enrolled. Swabs on the skin around the incision or on the nasal mucosa were collected and cultured at 24, 72 and 168 h after operation. Coagulase test and Staphytect Plus kits were used for SA identification. The nuc gene amplification and molecular types of SA were assessed by PCR. The patients were divided into SA colonization group and non-colonization group based on the presence or absence of SA colonization, and into infection group and non-infection group based on the presence or absence of infection. Demographic data, hospitalization information, colonization and infection status of SA were collected from the digital medical record system of the hospital. Differences between groups were analyzed using the independent sample t test or Fisher exact test. Results:Totally 19 patients were enrolled, among whom 13 were male. The gestation age was 39.0 (38.1, 40.0) weeks, and the birth weight was 3 150 (2 600, 3 400) g. Tracheotomy was done at 8.2(4.1, 19.6) days after diagnosis and indication confirmed. Corrected gestational age of patients on the operation day was 43.6 (42.2, 45.4) weeks. The NICU stay time was (34.0±3.1) days. SA colonization was confirmed around the incision of 8 patients. Out of the 18 strains of colonized bacteria, 10 were methicillin-resistant Staphylococcus aureus (MRSA). The most common molecular type of MRSA was ST59-SCCmec Ⅳ-t437 strain (8 strains). A total of 10 patients presented typical clinical manifestations of bacterial infection at the lungs, 3 patients in the blood stream and 2 patients in the central nervous system. Among 10 patients with bacterial infection, 3 patients were MRSA positive by boby fluid culture and affected by the ST59-SCCmec Ⅳ-t437 strain. The infection rate was different between patients with or without SA colonization on the tracheotomy incision (7/8 vs. 3/11, P=0.020). Conclusions:The colonization rate and infection rate were high on the tracheotomy incision in neonates. The major type was MRSA, and the most common molecular strain was ST59-SCCmec Ⅳ-t437 .
7.Analysis of colonization rate and molecular characteristics of Staphylococcus aureus on tracheotomy wounds at early postoperational stage in neonates
Jie YU ; Enxia TIAN ; Xiying XIANG ; Xing ZHU ; Juan DU ; Kaihu YAO ; Jie ZHANG ; Mingyan HEI
Chinese Journal of Pediatrics 2025;63(4):399-404
Objective:To analyze the colonization rate and molecular types of Staphylococcus aureus (SA) on the tracheotomy wounds of neonates at early postoperative stage in neonatal intensive care unit (NICU). Methods:This was a case series study. Patients who were admitted and underwent tracheotomy in NICU of Beijing Children′s Hospital, Capital Medical University from January 1 st 2020 to December 31 st 2023 were enrolled. Swabs on the skin around the incision or on the nasal mucosa were collected and cultured at 24, 72 and 168 h after operation. Coagulase test and Staphytect Plus kits were used for SA identification. The nuc gene amplification and molecular types of SA were assessed by PCR. The patients were divided into SA colonization group and non-colonization group based on the presence or absence of SA colonization, and into infection group and non-infection group based on the presence or absence of infection. Demographic data, hospitalization information, colonization and infection status of SA were collected from the digital medical record system of the hospital. Differences between groups were analyzed using the independent sample t test or Fisher exact test. Results:Totally 19 patients were enrolled, among whom 13 were male. The gestation age was 39.0 (38.1, 40.0) weeks, and the birth weight was 3 150 (2 600, 3 400) g. Tracheotomy was done at 8.2 (4.1, 19.6) days after diagnosis and indication confirmed. Corrected gestational age of patients on the operation day was 43.6 (42.2, 45.4) weeks. The NICU stay time was (34.0±3.1) days. SA colonization was confirmed around the incision of 8 patients. Out of the 18 strains of colonized bacteria, 10 were methicillin-resistant Staphylococcus aureus (MRSA). The most common molecular type of MRSA was ST59-SCCmec Ⅳ-t437 strain (8 strains). A total of 10 patients presented typical clinical manifestations of bacterial infection at the lungs, 3 patients in the blood stream and 2 patients in the central nervous system. Among 10 patients with bacterial infection, 3 patients were MRSA positive by boby fluid culture and affected by the ST59-SCCmec Ⅳ-t437 strain. The infection rate was different between patients with or without SA colonization on the tracheotomy incision (7/8 vs. 3/11, P=0.020). Conclusions:The colonization rate and infection rate are high on the tracheotomy incision in neonates. The major type is MRSA, and the most common molecular strain is ST59-SCCmec Ⅳ-t437 .
8.Clinical evaluation of instantly generated inhaled nitric oxide in the treatment of neonatal pulmonary hypertension
Changyang MA ; Juan DU ; Lu CHEN ; Xiying XIANG ; Mingyan HEI ; Zixin YANG
Chinese Journal of Pediatrics 2025;63(11):1234-1239
Objective:To explore the efficacy and safety of instantly generated inhaled nitric oxide (iNO) for treating neonatal pulmonary hypertension (PH) complicated with severe hypoxic respiratory failure.Methods:This single-center, single-arm, prospective study included 32 neonates with PH complicated with hypoxic respiratory failure who were hospitalized in the neonatal intensive care unit (NICU) of Beijing Children′s Hospital Affiliated to Capital Medical University from March 2023 to March 2025 and received immediate iNO generation therapy. The demographic data, maternal pregnancy, mechanical ventilation parameters, arterial blood gas indexes, other hospitalization data and safety indexes of iNO treatment were collected. The time point for starting iNO treatment was set as 0 h, and the observation time points were 1, 6, 12, 24, 48 h after treatment and when iNO treatment was stopped. The positive reaction of iNO treatment was defined as the decrease of oxygenation index (OI)>10% or the increase of arterial partial pressure of oxygen (PaO 2)>10% after treatment. The OI, mechanical ventilation parameters, arterial blood gas index changes and treatment positive reaction ratio were analyzed to evaluate the effectiveness of iNO treatment, and the nitrogen dioxide concentration, methemoglobin (MetHb) concentration and other indicators were analyzed to evaluate the safety of iNO treatment. Paired t test or Wilcoxon signed rank sum test was used to compare the observation indexes at different treatment times. Friedman test was used to compare the concentration of nitrogen dioxide and MetHb at multiple treatment times. Receiver operating characteristic (ROC) curve was used to analyze the best cut-off value of OI related indexes to distinguish the treatment outcome of iNO. Results:Among 32 neonates, 18 (56%) were males and 14 (44%) were females, the gestational age was 38 (35, 39) weeks, the birth weight was 3.1 (2.3, 3.4) kg, and the age of enrollment was 3 (2, 8) days. The OI and the mean airway pressure at 48 h after treatment were both lower than those at 0 h ((10.4±2.0 vs. 22.6±2.5, 13.0 (12.0, 14.0) vs. 14.0 (13.0, 16.0) cmH 2O, 1 cmH 2O=0.098 kPa, both P<0.05). The fraction of inspired oxygen at 24 and 48 h after treatment were both lower than those at 0 h (both P<0.05). The PaO 2 at 6, 12, 24 and 48 h after treatment were all higher than those at 0 h (all P<0.05). The proportion of positive reactions to iNO treatment was 20 neonates (63%), 22 neonates (69%), 23 neonates (72%), 23 neonates (72%) and 26 neonates (8%) at 1, 6, 12, 24, 48 h after treatment, respectively. No occurrence of methemoglobinemia, excessive nitrogen dioxide concentration, or device related adverse events were observed. Out of 32 neonates, a total of 24 neonates (75%) were cured or improved and discharged according to medical advice, while 8 neonates (25%) died in the hospital. The best cut-off value of OI at 0 h and the decline range of OI at 12 h to distinguish the outcome of hospitalization were 24.8 and 22.2%, respectively. Conclusion:It was effective and safe to use instantly generated iNO to treat neonatal PH with severe hypoxic respiratory failure.
9.Development of a national health standard:Guideline for pediatric transfusion
Rong HUANG ; Qingnan HE ; Mingyan HEI ; Minghua YANG ; Xiaofan ZHU ; Jun LU ; Xiaojun XU ; Tian-Ming YUAN ; Rong ZHANG ; Xu WANG ; Jinping LIU ; Jing WANG ; Zhili SHAO ; Mingyi ZHAO ; Jia GUO ; Xiny-In WU ; Jiarui CHEN ; Qirong CHEN ; Rong GUI ; Yongjian GUO
Chinese Journal of Blood Transfusion 2024;37(7):839-844
Children and adults differ significantly in physiology,biochemistry and immune function,which leads to sig-nificant differences in blood transfusion strategies between children and adults.To guide the clinical transfusion practice of pediatric patients and improve the prognosis of children,the National Health Commission organized the formulation and re-lease of the health industry standard Guideline for Pediatric Transfusion(WS/T 795-2022).This paper will briefly introduce some concepts that help understand of the Standard and the preparation process of the Standard,and explain and interpret the preparation of the"scope","general provisions"and"factors to consider"of the Standard,hoping to contribute to the understanding and implementation of the Standard.
10.Role of enriched environment in the model of maternal separation
Jicheng LI ; Min JIANG ; Mingyan HEI
Chinese Journal of Child Health Care 2024;32(2):164-168
Early life stress in humans can affect the normal development of individual neural networks, ultimately leading to diseases such as anxiety, depression, and autism in such children. The maternal separation model is commonly used to study the effects of early adverse experiences in human infants. Studies have shown that maternal separation in mice can lead to anxiety, depression, and impairments in spatial learning and memory in young mice during adulthood. However, enriched environmental interventions have been found to ameliorate the negative outcomes of early life stress by exerting a range of beneficial effects. This article provides an overview of the positive effects of enriched environmental interventions on mice in the maternal separation model.

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