Objective:To evaluate the efficacy of high-flow nasal cannula (HFNC) for assisted weaning from nasal continuous positive airway pressure (NCPAP) in extremely preterm infants (<28 weeks of gestation) with bronchopulmonary dysplasia (BPD).Methods:This multicenter retrospective cohort study enrolled extremely preterm infants with BPD receiving NCPAP beyond one month postnatally at three tertiary hospitals (Fujian Children's Hospital, Fujian Maternity and Child Health Hospital, and Fujian Obstetrics and Gynecology Hospital) from December 2017 to June 2024. After meeting weaning criteria, these infants transitioned to low-flow nasal cannula (LFNC group, n=51) or HFNC (HFNC group, n=60). Primary outcomes were initial weaning success and total NCPAP duration. Secondary outcomes included oxygen therapy duration, time to full enteral feeding, hospital stay, and oxygen therapy at discharge. Safety outcomes encompassed pneumothorax, nasal trauma, new-onset necrotizing enterocolitis, retinopathy of prematurity, sepsis, and grade Ⅲ-Ⅳ intraventricular hemorrhage. Group differences were analyzed using independent t-tests, Wilcoxon rank-sum, and Chi-square tests, with inverse probability of treatment weighting (IPTW) adjusting confounders followed by logistic/linear regression. Results:After IPTW (HFNC group: 54.8 cases; LFNC group: 53.0 cases), no statistically significant differences were observed in baseline demographic and clinical characteristics between groups, including gestational age, birth weight, BPD severity, duration of invasive mechanical ventilation, and duration of antibiotic exposure (all P>0.05). HFNC group demonstrated higher initial weaning success rate [83.2% (45.6/54.8) vs. 61.6% (32.6/53.0), OR=3.087, 95% CI: 1.027-9.281, P=0.044] and a significant reduction of 13.7 days in total NCPAP duration [25.0 (21.0-35.3) vs. 42.0 (29.4-61.0) days, β=－13.700, 95% CI:－21.372 to－6.027, P<0.001]. Secondary outcomes showed no significant differences between HFNC and LFNC groups: oxygen therapy duration [70.0 (51.8-81.9) vs. 68.0 (59.2-83.1) days], time to full enteral feeding [41.0 (31.0-59.0) vs. 45.0 (40.0-61.6) days], hospital stay [87.0 (74.6-98.5) vs. 93.7 (74.0-102.7) days], and oxygen therapy at discharge [16.6% (9.1/54.8) vs. 13.8% (7.3/53.0)] (all P>0.05). Safety outcomes were comparable between HFNC and LFNC groups: pneumothorax [2.8% (1.5/54.8) vs. 5.1% (2.7/53.0)], nasal trauma [3.8% (2.1/54.8) vs. 11.6% (6.2/53.0)], new-onset necrotizing enterocolitis [6.9% (3.8/54.8) vs. 5.5% (2.9/53.0)], and retinopathy of prematurity [14.4% (7.9/54.8) vs. 17.9% (9.5/53.0)] (all P>0.05). Conclusion:HFNC-assisted weaning may improve initial success and reduce NCPAP duration in BPD extremely preterm infants without increasing adverse events versus LFNC.

Objective:To evaluate the efficacy of high-flow nasal cannula (HFNC) for assisted weaning from nasal continuous positive airway pressure (NCPAP) in extremely preterm infants (<28 weeks of gestation) with bronchopulmonary dysplasia (BPD).Methods:This multicenter retrospective cohort study enrolled extremely preterm infants with BPD receiving NCPAP beyond one month postnatally at three tertiary hospitals (Fujian Children's Hospital, Fujian Maternity and Child Health Hospital, and Fujian Obstetrics and Gynecology Hospital) from December 2017 to June 2024. After meeting weaning criteria, these infants transitioned to low-flow nasal cannula (LFNC group, n=51) or HFNC (HFNC group, n=60). Primary outcomes were initial weaning success and total NCPAP duration. Secondary outcomes included oxygen therapy duration, time to full enteral feeding, hospital stay, and oxygen therapy at discharge. Safety outcomes encompassed pneumothorax, nasal trauma, new-onset necrotizing enterocolitis, retinopathy of prematurity, sepsis, and grade Ⅲ-Ⅳ intraventricular hemorrhage. Group differences were analyzed using independent t-tests, Wilcoxon rank-sum, and Chi-square tests, with inverse probability of treatment weighting (IPTW) adjusting confounders followed by logistic/linear regression. Results:After IPTW (HFNC group: 54.8 cases; LFNC group: 53.0 cases), no statistically significant differences were observed in baseline demographic and clinical characteristics between groups, including gestational age, birth weight, BPD severity, duration of invasive mechanical ventilation, and duration of antibiotic exposure (all P>0.05). HFNC group demonstrated higher initial weaning success rate [83.2% (45.6/54.8) vs. 61.6% (32.6/53.0), OR=3.087, 95% CI: 1.027-9.281, P=0.044] and a significant reduction of 13.7 days in total NCPAP duration [25.0 (21.0-35.3) vs. 42.0 (29.4-61.0) days, β=－13.700, 95% CI:－21.372 to－6.027, P<0.001]. Secondary outcomes showed no significant differences between HFNC and LFNC groups: oxygen therapy duration [70.0 (51.8-81.9) vs. 68.0 (59.2-83.1) days], time to full enteral feeding [41.0 (31.0-59.0) vs. 45.0 (40.0-61.6) days], hospital stay [87.0 (74.6-98.5) vs. 93.7 (74.0-102.7) days], and oxygen therapy at discharge [16.6% (9.1/54.8) vs. 13.8% (7.3/53.0)] (all P>0.05). Safety outcomes were comparable between HFNC and LFNC groups: pneumothorax [2.8% (1.5/54.8) vs. 5.1% (2.7/53.0)], nasal trauma [3.8% (2.1/54.8) vs. 11.6% (6.2/53.0)], new-onset necrotizing enterocolitis [6.9% (3.8/54.8) vs. 5.5% (2.9/53.0)], and retinopathy of prematurity [14.4% (7.9/54.8) vs. 17.9% (9.5/53.0)] (all P>0.05). Conclusion:HFNC-assisted weaning may improve initial success and reduce NCPAP duration in BPD extremely preterm infants without increasing adverse events versus LFNC.

Objective To establish the quality standard for Shanzhajing Jiangzhi tablet by HPLC .Methods Samples were analyzed on a Agilent Zorbax SB C18 column(250 mm × 4 .6 mm ,5μm) with methanol and 0 .06 mol/L ammonium acetate (85∶15)as mobile phase at the flow rate of 0 .8 ml/min .The wavelength and column temperature were set at 210 nm and 25 ℃ ,respectively .Results The calibration curve showed a good linear relationship within the range of 0 .124-2 .48 μg for oleanolic acid (r=0 .999 7) and 0 .498-9 .96 μg for ursolic acid (r=0 .999 8) .The average recovery ratio of the oleanolic acid and ursolic acid were 96 .9% (RSD=1 .26% ) and 100.4% (RSD=2 .6% ) ,respectively .Conclusion The method was proved to be good at evaluation effectiveness and practicality .

Objective To identify the risk factors for nosocomial sepsis in preterm infants.Methods A case-control study (1 ∶ 2) was conducted in 81 preterm infants with nosocomial sepsis and 162 preterm infants without nosocomial sepsis as age-matched controls (admission time was the most closely) hospitalized in Fujian Maternity and Children Hospital from January 1,2007 to December 31,2011.Data of preterm infants including maternal,delivery and neonatal records were collected.Risk factors for nosocomial sepsis were analyzed using t test,x2 test and multivariate Logistic regression.Results Nosocomial sepsis occurred in 81 preterm infants with an incidence rate of 1.50％ (81/5 392).Univariate analysis showed that the gestational age [(31.8 ±2.4)vs(33.8 ± 1.8)weeks,t=-7.260,P＜0.01] and birth weight [(1 545± 349) vs (2 174±465) g,t=-10.750,P＜0.01] of neonates with nosocomial sepsis were lower than those in the controls.Compared with the controls,the neonates with nosocomial sepsis had higher incidence of small for gestational age [27.2％ (22/81) vs 11.7％ (19/162)],multiple birth [35.8％ (29/81) vs 21.6％ (35/162)],neonatal asphyxia [19.8％(16/81)vs 8.6％(14/162)],admission to neonatal intensive care unit [81.5％(66/81) vs 49.4％ (80/162)],incubator usage [87.7％ (71/81) vs 29.0％ (47/162)],intracranial hemorrhage [27.2％ (22/81)vs 14.2％ (23/162)],noninvasive ventilation [35.8％ (29/81)vs 14.8％ (24/162)],feeding intolerance [64.2％ (52/81) vs 17.9％ (29/162)],using probiotics [65.4％ (53/81) vs 37.0％ (60/162)],duration of parenteral nutrition ＞7 days [77.8％ (63/81) vs 16.0％ (26/162)],combined administration of antibiotics [61.7％(50/81) vs 43.8％(71/162)],duration of antibiotics administration ＞7 days [65.4％(53/81) vs 9.3％ (15/162)],intravenous immunoglobulin [76.5％ (62/81) vs 46.9％ (76/162)] and central vena catheterization [16.0％ (13/81) vs 1.2％ (2/162)] (all P＜0.05).The Logistic regression analysis showed that low birth weight (OR=2.087,95％CI:1.074 4.057),duration of parenteral nutrition ＞7 days (OR=3.075,95％CI:1.158 8.164),feeding intolerance (OR-4.328,95％CI:1.776-10.544) and duration of antibiotic administration ＞7 days (OR=18.443,95％CI:5.084-66.913) were independent risk factors for nosocomial sepsis in preterm infants (all P＜0.05).Conclusions Preterm infants with low birth weight,long duration of parenteral nutrition,long-term antibiotic treatment and feeding intolerance have high risk for nosocomial sepsis.