1.Interpretation of "Guidelines for prevention of respiratory syncytial virus infections in mothers and infants (2025 Edition)"
Pengxiang ZHOU ; Wei ZHOU ; Huixia YANG ; Meihua PIAO ; Yangyu ZHAO ; Tongyan HAN
Chinese Journal of Perinatal Medicine 2025;28(12):1029-1034
The "Guidelines for prevention of respiratory syncytial virus (RSV) infection in mothers and infants (2025 Edition)" were developed by the Society of Perinatal Medicine, Chinese Medical Association. This guideline focuses on preventing RSV infections in maternal and neonatal populations, providing 15 evidence-based recommendations addressing eight clinical questions that integrate current best evidence with clinical expertise and patient preferences. The recommendations encompass non-pharmacological prevention, pharmacological prophylaxis, and vaccine strategies. This article provides a comprehensive interpretation of the guidelines, summarizes the current evidence status and practical limitations, and aims to facilitate better understanding and application of the recommendations among healthcare providers, thereby enhancing RSV infection prevention and control for maternal and neonatal populations in China.
2.Short-term safety evaluation of Nirsevimab injection: a prospective study
Pengxiang ZHOU ; Linghui LI ; Wei ZHOU ; Meihua PIAO ; Tongyan HAN
Chinese Journal of Perinatal Medicine 2025;28(12):1057-1061
Objective:To evaluate the short-term safety of Nirsevimab injection for preventing respiratory syncytial virus infections in infants through a physician-nurse-pharmacist collaborative model.Methods:This prospective observational study enrolled infants receiving single-dose Nirsevimab at Peking University Third Hospital from September 2024 to August 2025. A multidisciplinary team comprising pediatricians, nurses, pharmacists, and obstetricians was established to develop standardized protocols for medication management, injection procedures, follow-up processes, and safety assessment forms. Descriptive statistics analyzed on-site observations within 30 minutes post-injection and all adverse events, with causality assessment conducted.Results:Among 331 participants [171 males (51.7%), 160 females (48.3%)], 225 (68.0%) received outpatient injections and 106 (32.0%) inpatient injections. Successful administration was achieved in 330 cases (99.7%), including 207 (62.7%) receiving 50 mg/vial and 123 (37.3%) receiving 100 mg/vial formulations; one child (3 years 11 months, 19.0 kg) received two 100 mg doses. During the 30-minute observation, 11 cases (3.3%) experienced adverse events, all presenting as injection site erythema following 100 mg/vial administration, with no systemic or serious adverse events observed. All symptoms resolved spontaneously within 30 minutes. Multidisciplinary review suggested potential associations with insufficient rewarming time, larger injection volumes, or post-injection compression pressure.Conclusion:Nirsevimab demonstrated favorable short-term safety profiles in Chinese infants following single-dose administration, with feasible multidisciplinary standardized protocols, though larger sample sizes and extended follow-up are warranted for monitoring medium-to-long-term safety and special populations.
3.Predicting value of intestinal fatty acid-binding protein in esophageal varices in patients with hepatitis B cirrhosis
Caijun HAN ; Zhengxie WU ; Yuan HUANG ; Xing JIN ; Meihua PIAO
Chinese Journal of Laboratory Medicine 2025;48(11):1446-1451
Objective:To explore the clinical predicting value of serum intestinal fatty acid-binding protein (I-FABP) in the development of esophageal varices (EV) in patients with chronic hepatitis B cirrhosis.Method:We used case-control study. A retrospective analysis was performed on the clinical data of 169 patients with hepatitis B cirrhosis who were admitted to the Affiliated Hospital of Yanbian University from September 2020 to October 2023. EV diagnosis and grades were based on gastroscopy. Enzyme-linked immunosorbent assay was used to measure the serum level of I-FABP on admission. Spearman correlation analysis was used to investigate the correlation among variables. Contributing factors of EV were evaluated using univariate and multivariate logistic regression analysis. Receiver operating characteristic (ROC) curves were used to evaluate the predictive performance of I-FABP for EV presence.Results:The gastroscopy showed 59 patients without EV. The median of I-FABP in the EV Group was significantly higher than that in the no-EV Group [2.01 (1.39, 2.89) μg/L vs 0.96 (0.77, 1.91) μg/L], and the difference was statistically significant ( Z=5.585, P<0.001). I-FABP showed significant positive correlations between model for end-stage liver disease sore and Von Willebrand Factor Antigen/thrombocyte Ratio ( r=0.523, 0.328, both P<0.001). Multiple logistic regression analysis identified I-FABP as the independent factor contributing to the presence of EV ( OR=1.73, P=0.045). The area under the curve of I-FABP predicting EV was 0.76. The cut-off was 1.46 μg/L. Conclusion:I-FABP is a potential marker for the formation of EV in patients with hepatitis B cirrhosis, and its increased concentration is related to reduced hepatic reserve and portal hypertension.
4.Predicting value of intestinal fatty acid-binding protein in esophageal varices in patients with hepatitis B cirrhosis
Caijun HAN ; Zhengxie WU ; Yuan HUANG ; Xing JIN ; Meihua PIAO
Chinese Journal of Laboratory Medicine 2025;48(11):1446-1451
Objective:To explore the clinical predicting value of serum intestinal fatty acid-binding protein (I-FABP) in the development of esophageal varices (EV) in patients with chronic hepatitis B cirrhosis.Method:We used case-control study. A retrospective analysis was performed on the clinical data of 169 patients with hepatitis B cirrhosis who were admitted to the Affiliated Hospital of Yanbian University from September 2020 to October 2023. EV diagnosis and grades were based on gastroscopy. Enzyme-linked immunosorbent assay was used to measure the serum level of I-FABP on admission. Spearman correlation analysis was used to investigate the correlation among variables. Contributing factors of EV were evaluated using univariate and multivariate logistic regression analysis. Receiver operating characteristic (ROC) curves were used to evaluate the predictive performance of I-FABP for EV presence.Results:The gastroscopy showed 59 patients without EV. The median of I-FABP in the EV Group was significantly higher than that in the no-EV Group [2.01 (1.39, 2.89) μg/L vs 0.96 (0.77, 1.91) μg/L], and the difference was statistically significant ( Z=5.585, P<0.001). I-FABP showed significant positive correlations between model for end-stage liver disease sore and Von Willebrand Factor Antigen/thrombocyte Ratio ( r=0.523, 0.328, both P<0.001). Multiple logistic regression analysis identified I-FABP as the independent factor contributing to the presence of EV ( OR=1.73, P=0.045). The area under the curve of I-FABP predicting EV was 0.76. The cut-off was 1.46 μg/L. Conclusion:I-FABP is a potential marker for the formation of EV in patients with hepatitis B cirrhosis, and its increased concentration is related to reduced hepatic reserve and portal hypertension.
5.Interpretation of "Guidelines for prevention of respiratory syncytial virus infections in mothers and infants (2025 Edition)"
Pengxiang ZHOU ; Wei ZHOU ; Huixia YANG ; Meihua PIAO ; Yangyu ZHAO ; Tongyan HAN
Chinese Journal of Perinatal Medicine 2025;28(12):1029-1034
The "Guidelines for prevention of respiratory syncytial virus (RSV) infection in mothers and infants (2025 Edition)" were developed by the Society of Perinatal Medicine, Chinese Medical Association. This guideline focuses on preventing RSV infections in maternal and neonatal populations, providing 15 evidence-based recommendations addressing eight clinical questions that integrate current best evidence with clinical expertise and patient preferences. The recommendations encompass non-pharmacological prevention, pharmacological prophylaxis, and vaccine strategies. This article provides a comprehensive interpretation of the guidelines, summarizes the current evidence status and practical limitations, and aims to facilitate better understanding and application of the recommendations among healthcare providers, thereby enhancing RSV infection prevention and control for maternal and neonatal populations in China.
6.Short-term safety evaluation of Nirsevimab injection: a prospective study
Pengxiang ZHOU ; Linghui LI ; Wei ZHOU ; Meihua PIAO ; Tongyan HAN
Chinese Journal of Perinatal Medicine 2025;28(12):1057-1061
Objective:To evaluate the short-term safety of Nirsevimab injection for preventing respiratory syncytial virus infections in infants through a physician-nurse-pharmacist collaborative model.Methods:This prospective observational study enrolled infants receiving single-dose Nirsevimab at Peking University Third Hospital from September 2024 to August 2025. A multidisciplinary team comprising pediatricians, nurses, pharmacists, and obstetricians was established to develop standardized protocols for medication management, injection procedures, follow-up processes, and safety assessment forms. Descriptive statistics analyzed on-site observations within 30 minutes post-injection and all adverse events, with causality assessment conducted.Results:Among 331 participants [171 males (51.7%), 160 females (48.3%)], 225 (68.0%) received outpatient injections and 106 (32.0%) inpatient injections. Successful administration was achieved in 330 cases (99.7%), including 207 (62.7%) receiving 50 mg/vial and 123 (37.3%) receiving 100 mg/vial formulations; one child (3 years 11 months, 19.0 kg) received two 100 mg doses. During the 30-minute observation, 11 cases (3.3%) experienced adverse events, all presenting as injection site erythema following 100 mg/vial administration, with no systemic or serious adverse events observed. All symptoms resolved spontaneously within 30 minutes. Multidisciplinary review suggested potential associations with insufficient rewarming time, larger injection volumes, or post-injection compression pressure.Conclusion:Nirsevimab demonstrated favorable short-term safety profiles in Chinese infants following single-dose administration, with feasible multidisciplinary standardized protocols, though larger sample sizes and extended follow-up are warranted for monitoring medium-to-long-term safety and special populations.
7.Value of intestinal fatty acid binding protein in predicting the development and progression of acute-on-chronic liver failure
Caijun HAN ; Meihua PIAO ; Yuan HUANG ; Zhengxie WU ; Xing JIN ; Guangyi LI
Journal of Clinical Hepatology 2024;40(8):1633-1638
Objective To investigate the value of intestinal fatty acid binding protein(I-FABP)in predicting the development and progression of acute-on-chronic liver failure(ACLF).Methods A retrospective analysis was performed for the clinical data of 168 patients with decompensated liver cirrhosis who were admitted to The Affiliated Hospital of Yanbian University from September 2020 to March 2023.The conditions of the patients with ACLF on admission were observed,and the patients were followed up for 6 months to identify new-onset ACLF cases.ELISA was used to measure the serum level of I-FABP on admission.The Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups,and the Kruskal-Wallis H rank sum test was used for comparison between multiple groups;the chi-square test was used for comparison of categorical data between groups;the Jonckheere-Terpstra test was used for trend analysis.The Spearman correlation analysis was used to investigate the correlation between two variables,and the multivariate Cox regression analysis was used to investigate the influencing factors for new-onset ACLF during follow-up.The Kaplan-Meier curve was used to analyze the onset of ACLF in different groups,and the log-rank test was used for the analysis of such differences.The receiver operating characteristic(ROC)curve and the area under the ROC curve(AUC)were used to investigate the performance of I-FABP in predicting the development and progression of ACLF.Results Among the 168 patients enrolled in this study,there were 43 patients with ACLF and 125 patients without ACLF,among whom 19 developed ACLF during follow-up.The patients with ACLF on admission had a significantly higher level of I-FABP than those without ACLF(Z=4.359,P<0.001).The patients with new-onset ACLF had a significantly higher level of I-FABP than those without new-onset ACLF(Z=3.414,P<0.001).The level of I-FABP increased with the increase in ACLF severity grade(H=17.385,P<0.001,Ptrend<0.001).The multivariate Cox regression analysis showed that I-FABP was independently associated with new-onset ACLF during follow-up(hazard ratio=2.138,95%confidence interval[CI]:1.297-3.525,P=0.003),and the tertile of I-FABP showed a good discriminatory ability(χ2=12.16,P<0.001).The ROC curve showed that I-FABP had a good performance in predicting the development and progression of ACLF,with an area under the ROC curve of 0.854(95%CI:0.791-0.903)and 0.747(95%CI:0.661-0.820),respectively,and an optimal cut-off value of 2.07 μg/L and 1.86 μg/L,respectively.Conclusion I-FABP can be used as a biomarker to predict the development and progression of ACLF,and it may help to identify high-risk patients and improve clinical management.
8.Perinatal characteristics and early postnatal circulatory function changes in the larger fetus in twin pregnancy with selective intrauterine growth restriction
Yahui ZHANG ; Dan WANG ; Yunfeng LIU ; Shi SHI ; Meihua PIAO
Chinese Journal of Perinatal Medicine 2024;27(3):188-195
Objective:To explore the perinatal characteristics and early postnatal circulatory function of the larger fetus in monochorionic diamniotic twin pregnancy complicated with selective intrauterine growth restriction (sIUGR).Methods:From February 2018 to August 2022, a total of 91 larger fetuses of the sIUGR pregnancies who were hospitalized in the neonatal intensive care unit of Peking University Third Hospital were retrospectively included. The perinatal factors, clinical monitoring indicators, and echocardiographic data of the larger twins in pregnancies with three types of sIUGR were compared using one-way analysis of variance and LSD test, Kruskal-Wallis H test, Chi-square test, and Bonferroni correction. Results:The gestational age, birth weight, and placental weight were (30.6±1.5) weeks, (1 503.9±286.4) g, and (548±120) g in the type Ⅱ sIUGR larger twins and were (30.5±2.3) weeks, (1 523.5±424.4) g, and (560±109) g in type Ⅲ, which were all smaller, lower, and lighter than those in the type Ⅰ[(33.0±1.7) weeks, (2 022.1±372.3) g, and (630±131) g, respectively] (LSD test, all P<0.05). Compared with type Ⅰ sIUGR larger twins, type Ⅱ and Ⅲ sIUGR larger twins had longer hospital stay [36.0 d (27.0-43.0 d) and 32.0 d (15.0-47.0 d) vs. 17.0 d (9.5-22.0 d)], higher proportion of preterm births due to fetal distress [63.6% (21/33) and 75.0% (15/20) vs. 31.6% (12/38), χ2=7.30 and 9.93] (Bonferroni correction, all P<0.017); Compared with type Ⅰ sIUGR larger twins, type Ⅱ sIUGR larger twins had higher proportion of postnatal use of vasoactive drugs [45.5% (15/33) vs. 18.4% (7/38), χ2=6.04, P=0.014]. The interventricular septum thickness was larger in the type Ⅲ sIUGR larger twins than those in the type Ⅰ and Ⅱ twins [(4.4±1.4) vs. (3.8±0.9) and (3.3±0.9) mm]; the thickness of left ventricular free wall was the largest in the type Ⅲ larger twins, followed by those in the type Ⅰ and type Ⅱ [(4.6±1.3) vs. (3.1±0.7) vs. (2.7±0.6) mm]; the left ventricular end-diastolic diameter, right ventricular outflow tract diameter, right ventricular anteroposterior diameter, and pulmonary artery diameter in type Ⅰ larger twins were increased comparing with those in type Ⅱ and Ⅲ [left ventricular end-diastolic diameter: (15.0±2.1) vs. (13.4±2.3) and (12.3±3.2) mm; right ventricular outflow tract diameter: (8.7±1.4) vs. (7.3±1.4) and (7.1±0.8) mm; right ventricular anteroposterior diameter: (7.1±1.5) vs. (6.5±0.9) and (6.4±1.0) mm; pulmonary artery diameter: (6.8±1.1) vs. (6.3±0.9) and (6.3±0.8) mm] (LSD test, all P<0.05). Conclusion:The larger fetuses of type Ⅱ and Ⅲ sIUGR pregnancies had smaller gestational age and lighter birth weight who are more prone to have fetal distress, so it is necessary to strengthen dynamic monitoring and circulatory support for such neonates during the perinatal period and early postnatal period. The thickening of the left ventricular wall and interventricular septum in the early postnatal period of type Ⅲ larger fetuses may lead to the decrease of ventricular diastolic function reserve, thereby the evaluation and monitoring of the myocardial diastolic function of these neonates in the early postnatal period are critical.
9.Establishment and validation of a nomograph model for prediction of bronchopulmonary dysplasia in very low birth weight infants born earlier than 32 weeks
Hui WU ; Xue AO ; Fengdong WANG ; Lin ZENG ; Meihua PIAO ; Xiaomei TONG ; Tongyan HAN
Chinese Journal of Perinatal Medicine 2023;26(5):366-374
Objective:To investigate the risk factors of bronchopulmonary dysplasia (BPD) in very low birth weight (VLBW) infants with gestational age ≤32 weeks within 28 days after birth and to establish and validate the nomogram model for BPD prediction.Methods:We retrospectively chose VLBW infants with gestational age ≤32 weeks who survived to postmenstrual age (PMA) 36 weeks and were admitted to the neonatal intensive care unit of Peking University Third Hospital from January 2016 to April 2020 as the training cohort. BPD was diagnosed in accordance with the 2018 criteria. The clinical data of these infants were collected, and the risk factors of BPD were analyzed by Chi-square test, Mann-Whitney U test, and multivariate logistic regression, and a nomogram model was established. The area under the curve (AUC) of the receiver operating characteristic (ROC) curve was used to assess the predictive performance. Decision curve analysis (DCA) was constructed for differentiation evaluation, and the calibration chart and Hosmer-Lemeshow goodness of fit test were used for the calibration evaluation. Bootstrap was used for internal validation. VLBW infants with gestational age ≤32 weeks survived to PMA 36 weeks and admitted to Hebei Chengde Maternal and Child Health Hospital from October 2017 to February 2022 were included as the validation cohort. ROC curve and calibration plot were conducted in the validation cohort for external validation. Results:Of the 467 premature infants included in the training cohort, 104 were in the BPD group; of the 101 patients in the external validation cohort, 16 were in the BPD group. Multivariate logistic regression analysis showed that low birth weight ( OR=0.03, 95% CI: 0.01-0.13), nosocomial pneumonia ( OR=2.40, 95% CI: 1.41-4.09), late-onset sepsis ( OR=2.18, 95% CI: 1.18-4.02), and prolonged duration of endotracheal intubation ( OR=1.61, 95% CI: 1.26-2.04) were risk factors for BPD in these groups of infants (all P<0.05). According to the multivariate logistic regression analysis results, a nomogram model for predicting BPD risk was established. The AUC of the training cohort was 0.827 (95% CI: 0.783-0.872), and the ideal cut-off value for predicted probability was 0.206, with a sensitivity of 0.788 (95% CI: 0.697-0.862) and specificity of 0.744 (95% CI: 0.696-0.788). The AUC of the validation cohort was 0.951 (95% CI:0.904-0.999). Taking the prediction probability of 0.206 as the high-risk threshold, the sensitivity and specificity corresponding to this value were 0.812 (95% CI: 0.537-0.950) and 0.882 (95% CI: 0.790-0.939). The Hosmer-Lemeshow goodness-of-fit test in the training and validation cohort showed a good fit ( P>0.05). DCA results showed a high net benefit of clinical intervention in very preterm infants when the threshold probability was 5%~80% for the training cohort. Conclusion:Low birth weight, nosocomial pneumonia, late-onset sepsis, and prolonged tracheal intubation duration are risk factors for BPD. The established nomogram model has a certain value in predicting the risk of BPD in VLBW less than 32 weeks.
10.Neonatal Resuscitation Program in China: achievements and prospects
Meihua PIAO ; Tongyan HAN ; Tao XU
Chinese Journal of Perinatal Medicine 2023;26(11):886-889
With the efforts of Professor Yan Renying, the "Mother of Chinese Perinatal Health Care", the Society of Perinatal Medicine of Chinese Medical Association was established on April 24,1988. In order to reduce the mortality and disability rate associated with neonatal asphyxia, many efforts have been initiated to promote the "Neonatal Resuscitation Program in China" by the Society of Perinatal Medicine in 2004. This article summarizes the implementation strategy, projects, and achievements of the program, and makes prospects for the future.

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