Postnatal glucocorticoid has become an important measure for the prevention and treatment of bronchopulmonary dysplasia in preterm infants. Systemic application of glucocorticoids has therapeutical effectiveness but comes with significant side effects. Many studies have shown that nebulized budesonide may help prevent and treat bronchopulmonary dysplasia in preterm infants. However, there are no clear recommendations on the timing, route, dosage, and short- or long-term efficacy. Therefore, this paper reviews the research progress on the application of nebulized budesonide for the prevention and treatment of bronchopulmonary dysplasia in preterm infants.

Objective To compare the efficacy and the effects on cardiac function of heated humidified high-flow nasal cannula(HHHFNC)and nasal continuous positive airway pressure(NCPAP)as initial treatment for preterm infants with neonatal respiratory dis-tress syndrome(NRDS).Methods The preterm infants with NRDS,gestational age＜35 weeks and requiring noninvasive ventilation ad-mitted to Xuzhou Central Hospital from January 2021 to November 2023 were enrolled for a prospective study and were randomly divided into the HHHFNC group and NCPAP group.The initial treatment was performed using HHHFNC and NCPAP respectively.The efficacy,safety and effects on cardiac function were compared.Results 55 cases were enrolled in HHHFNC group,and 53 cases were enrolled in NCPAP group.There were no statistically significant difference between the two groups in the number and total dose of the use of pulmona-ry surfactant,the number of apneas within 24hours of enrollment,the duration of noninvasive ventilation,the cases of noninvasive ventila-tion failure,the age achieving total enteral nutrition,the length and costs of hospitalization(P＞0.05).The incidence of nasal injury in the HHHFNC group was significantly lower than that in the NCPAP group(0 vs 11.3％,P=0.032).There were no statistically signifi-cant difference between the two groups in the pneumothorax,stage Ⅱ-Ⅲ necrotizing enterocolitis,hemodynamically significant patent ductus arteriosus,grade Ⅱ-Ⅳ intraventricular hemorrhage,bronchopulmonary dysplasia,and retinopathy of prematurity requiring treat-ment at the first screening(P＞0.05).There were no statistically significant difference between the two groups in fraction of inspired oxy-gen and arterial partial pressure of carbon dioxide,Plasma B-type natriuretic peptide(183.9±48.5ng/L vs 187.8±51.4ng/L,189.4±50.9ng/L vs 180.2±45.1ng/L)and Tei index of right ventricle(0.38±0.05 vs 0.40±0.06,0.38±0.06 vs 0.39±0.06)at 24±6h and 48±6h after noninvasive ventilation(P＞0.05).Conclusion In the initial treatment for preterm infants(gestational age＜35 weeks)with NRDS who need noninvasive ventilation,the efficacy of HHHFNC was similar to that of NCPAP,and the rate of nasal injury was lower.Other safety indexes and the effects on cardiac function were similar.

Postnatal glucocorticoid has become an important measure for the prevention and treatment of bronchopulmonary dysplasia in preterm infants. Systemic application of glucocorticoids has therapeutical effectiveness but comes with significant side effects. Many studies have shown that nebulized budesonide may help prevent and treat bronchopulmonary dysplasia in preterm infants. However, there are no clear recommendations on the timing, route, dosage, and short- or long-term efficacy. Therefore, this paper reviews the research progress on the application of nebulized budesonide for the prevention and treatment of bronchopulmonary dysplasia in preterm infants.

Objective To compare the efficacy and the effects on cardiac function of heated humidified high-flow nasal cannula(HHHFNC)and nasal continuous positive airway pressure(NCPAP)as initial treatment for preterm infants with neonatal respiratory dis-tress syndrome(NRDS).Methods The preterm infants with NRDS,gestational age＜35 weeks and requiring noninvasive ventilation ad-mitted to Xuzhou Central Hospital from January 2021 to November 2023 were enrolled for a prospective study and were randomly divided into the HHHFNC group and NCPAP group.The initial treatment was performed using HHHFNC and NCPAP respectively.The efficacy,safety and effects on cardiac function were compared.Results 55 cases were enrolled in HHHFNC group,and 53 cases were enrolled in NCPAP group.There were no statistically significant difference between the two groups in the number and total dose of the use of pulmona-ry surfactant,the number of apneas within 24hours of enrollment,the duration of noninvasive ventilation,the cases of noninvasive ventila-tion failure,the age achieving total enteral nutrition,the length and costs of hospitalization(P＞0.05).The incidence of nasal injury in the HHHFNC group was significantly lower than that in the NCPAP group(0 vs 11.3％,P=0.032).There were no statistically signifi-cant difference between the two groups in the pneumothorax,stage Ⅱ-Ⅲ necrotizing enterocolitis,hemodynamically significant patent ductus arteriosus,grade Ⅱ-Ⅳ intraventricular hemorrhage,bronchopulmonary dysplasia,and retinopathy of prematurity requiring treat-ment at the first screening(P＞0.05).There were no statistically significant difference between the two groups in fraction of inspired oxy-gen and arterial partial pressure of carbon dioxide,Plasma B-type natriuretic peptide(183.9±48.5ng/L vs 187.8±51.4ng/L,189.4±50.9ng/L vs 180.2±45.1ng/L)and Tei index of right ventricle(0.38±0.05 vs 0.40±0.06,0.38±0.06 vs 0.39±0.06)at 24±6h and 48±6h after noninvasive ventilation(P＞0.05).Conclusion In the initial treatment for preterm infants(gestational age＜35 weeks)with NRDS who need noninvasive ventilation,the efficacy of HHHFNC was similar to that of NCPAP,and the rate of nasal injury was lower.Other safety indexes and the effects on cardiac function were similar.

Objective:To study the risk factors, diagnosis and treatment of transient hyperinsulinemic hypoglycemia (HH) in newborns.Methods:From January 2016 to December 2020, newborns with transient HH (HH group) admitted to our hospital were enrolled in this retrospective nested case-control study. Newborns with similar gestational age (GA) (differences of GA<2 w) without HH were matched with 1∶2 ratio as the non-HH group. Clinical characteristics of the two groups were compared and the risk factors and therapeutic results of HH in newborns were analyzed using SPSS 20.0 statistical software.Results:A total of 39 cases were included in the HH group and 75 cases were matched in the non-HH group. The proportion of small for gestational age (SGA) [51.3%(20/39) vs. 32.0%(24/75)], the amount of amino acids (AA) in intravenous infusion[1.0(0.0,1.0) g/(kg·d) vs. 0.0(0.0,1.0) g/(kg·d)], the incidence of hypoglycemia [(4.3±1.9) times vs. (3.6±1.3) times] and the maximum glucose infusion rate (GIR)[(8.3±2.5) mg/(kg·min) vs. (7.4±1.1) mg/(kg·min)] in the HH group were higher than the non-HH group (all P<0.05). The platelet count in the HH group were lower than the non-HH group [(186.9±60.9)×10 9/L vs. (215.3±61.7)×10 9/L, P<0.05]. SGA ( OR=2.535, 95% CI 1.077~5.971), the amount of intravenous AA ( OR=2.180, 95% CI 1.029~4.619) and the maximum GIR ( OR=1.405, 95% CI 1.088~1.815) were independent risk factors for transient HH. In the HH group, 28/39 cases were treated with Diazoxide or Octreotide and the therapeutic effects were good with few adverse drug reactions (ADR). 37/39 cases were recovered within 28 d of birth and the other 2 cases were recovered at 2.5 m and 3.5 m, respectively. Conclusions:SGA, the amount of intravenous AA and higher GIR are risk factors for transient HH in newborns. Diazoxide or Octreotide are effective with few ADR in the treatment of transient HH. Most patients will recover from transient HH in 2 w to 3 m.

Objective:To study the clinical value of bladder stimulation technique (BST) for clean-catch urine collection in late newborns.Methods:From November 2020 to March 2022, relatively stable late newborns hospitalized in the Department of Neonatology of our hospital were enrolled in the prospective randomized controlled trial. The newborns were assigned into BST group and control group. In BST group, urine was collected using BST (suprapubic tapping alternating with lumbosacral massage for 5 min) 20~30 min after feeding and specimen were collected using urine bag before and after BST. In the control group, urine was collected using urine bag method. The urine collection was considered successful if >1 ml of urine not contaminated by faeces were collected within 60 min. The t-test and χ 2 test were used for data analysis. Results:A total of 231 late newborns were included with 117 cases in BST group and 114 in control group. The rate of successful urine collection in BST group was higher than control group (65.8% vs. 39.4%).The time needed for successful urine collection [(30.2±8.5) min vs. (40.7±12.9) min], the incidences of faeces contamination (2.5% vs. 21.1%) and urine contamination (11.7% vs. 26.7%) in BST group were all significantly lower than control group(all P<0.05). Male and female newborns in BST group had similar success rates of urine collection (65.6% vs. 66.0%). Male newborns in BST group had similar urine contamination rate with control group (9.5% vs. 11.5%) and female newborns in BST group had significantly lower urine contamination rate than control group (14.3% vs. 47.4%, P<0.05). Urine was successfully collected in 71 newborns in BST group with median duration of BST for 81 (61,132) s. No adverse effects were observed except for transient consolable crying. Conclusions:Compared with urine bag collection method, BST improves successful urine collection rates and reduces the time needed for urine collection and urine contamination rates (especially for females).

Objective:To study the efficacy and safety of oral acetaminophen or high-dose ibuprofen as rescue treatment after failure of conservative management in very preterm infants (VPIs) with haemodynamically significant patent ductus arteriosus (hsPDA).Methods:From May 2020 to November 2022, VPIs with hsPDA (gestational age<32 weeks and age 4~6 d) admitted to NICU of our hospital were prospectively enrolled. The rescue treatment was initiated if hsPDA still exist after 3~4 d of conservative management. The infants were randomly assigned into acetaminophen group (oral acetaminophen 15 mg/kg, once every 6 h for 3 d) and high-dose ibuprofen group (oral ibuprofen 20 mg/kg for the first dose, 10 mg/kg each dose after 24 h and 48 h). Before and after rescue treatment, the following were recorded: echocardiography, complete blood count, biochemistry, B-type natriuretic peptide (BNP), fecal occult blood test (FOBT) and transcranial Doppler ultrasound. Urine output and complications were also examined. SPSS 20.0 was used for statistical analysis.Results:A total of 36 cases were in the acetaminophen group and 37 in the high-dose ibuprofen group. The two groups showed similar efficacy as rescue treatment [80.6% (29/36) vs. 78.4% (29/37), P>0.05]. No significant differences existed in the incidences of upper gastrointestinal bleeding, positive FOBT, oliguria, stage Ⅱ-Ⅲ necrotizing enterocolitis and stage Ⅲ-Ⅳ intraventricular hemorrhage between the two groups ( P>0.05). After rescue treatment, the serum cystatin C in high-dose ibuprofen group was higher [(1.72±0.29) mg/L vs. (1.58±0.26) mg/L] and 24-hours urine output was lower [(3.1±1.0) ml/(kg·h) vs. (3.7±0.7) ml/(kg·h)] than the acetaminophen group (all P<0.05). No significant differences existed in serum creatinine, platelet count, BNP, alanine aminotransferase and total serum bilirubin between the two groups ( P>0.05). Conclusions:After failure of early conservative management in VPIs with hsPDA, when initiated within 7-10 d after birth, rescue treatment with oral acetaminophen or high-dose ibuprofen has a similar efficacy of 80%, and both drugs are safe. Oral high-dose ibuprofen may have a greater effect on renal function than acetaminophen.

Objective: To understand the prevalence, awareness, treatment and control of hypertension in elderly residents in Hebei province. Methods: Elderly residents aged ≥60 were selected though multistage clustering sampling during August to December, 2015. Design based methods were adopted to analyze the prevalence, awareness, treatment and control of hypertension in local residents of Hebei. Results: A total of 2 501 elderly adults were included in the study. The overall prevalence rate of hypertension was 63.7% (58.3% in males, 69.0% in females), the awareness rate of hypertension was 42.4% (35.7% in males, 48.0% in females), the treatment rate was 38.2% (32.0% in males, 43.3% in females), and the control rate was 9.0% (8.1% in males, 9.7% in females). The results of multivariate analysis indicated that age, sex, degree of education, BMI and central obesity were the factors influencing the prevalence, awareness, treatment and control of hypertension in elderly population in Hebei. Conclusions The prevalence of hypertension was high, but the rates of awareness, treatment and control of hypertension were low in elderly residents in Hebei. The influences of overweight, obesity and central obesity on hypertension were significant in the elderly. It is necessary to standard the management of hypertension and reduce the risk factors for hypertension in elderly population to improve the control of hypertension.

Objective To investigate the role of r-aminobutyric acid B receptor in the development of liver fibrosis.Methods Thirty-two Sprague-Dawley (SD) rats were divided into four groups including a control group,a model group,a baclofen group,and a CGP35348 group.Liver fibrosis was then induced by carbon tetrachloride (CCl4).Baclofen and CGP35348 treatment were carried out after the formation of liver fibrosis,followed by complete extraction of the eyeball to obtain blood sample to test liver function.Liver tissue specimens were cut and stored for histological staining,histochemistry,real-time polymerase chain-reaction (RT-PCR),and western blot analysis.Results Histological staining indicated that the degree of liver fibrosis was more severe in the CGP35348 group than in the baclofen group (P＜0.001).The levels of alanine transaminase (ALT),aspartate aminotransferase (AST),gamma-glutamyl transferase (GGT),total bilirubin (TBil),and direct bilirubin (DBil) were significantly lower in the baclofen group than in the CGP35348 group (P＜0.01).The levels of ALT,AST,GGT,TBil,and DBil were significantly higher in the CGP35348 group than in the model group (P＜0.05).Immunofluorescence results show that the hepatic cell migration was inhibited in the baclofen group.Western blot results showed that the expression levels of α-SMA protein were significantly lowered in the baclofen group when compared to that of the CGP35348 group and model group (P＜0.01).Conclusion GABAB receptor might play a role in the liver protection by inhibition of migration of hepatic cells in liver fibrosis.Further studies into the mechanism behind this function are further needed and may be a potential source of future anti-fibrotic treatment.