1.Nutritional insufficiency and appropriate catch-up growth in extremely preterm infants within 24 months of corrected age: a retrospective cohort study
Xiaoli QU ; Chunjin PENG ; Yixue ZHAO ; Yulan YANG ; Na LUO ; Ping WANG
Chinese Journal of Pediatrics 2026;64(1):68-76
Objective:To assess the status of undernutrition and appropriate catch-up growth in extremely preterm infants within 24 months of corrected age (CA).Methods:A retrospective cohort study was conducted. A total of 422 extremely preterm infants born at Shenzhen Maternity and Child Healthcare Hospital, Women and Children's Medical Center, Southern Medical University from January 2017 to December 2022 and followed up until 24 months of CA were enrolled. The extremely preterm infants were grouped by gestational age at birth (<25, 25-26, 27 weeks), birth weight (<500, 500-749, 750-999,≥1 000 g), weight for gestational age (large for gestational age (LGA), appropriate for gestational age (AGA), small for gestational age (SGA)) and sex. Weight data within 24 months of CA were collected every 3 months. Nutritional insufficiency, growth rate, and achievement of adequate catch-up growth were analyzed during the period from 0 to 24 months of CA. Z-score method was used to analyze data. Fenton 2013 preterm growth charts (Fenton 2013) were used before 40 weeks of corrected gestational age, and World Health Organization child growth standards (2009) fitted Z-scores were applied from 40 weeks of CA. Changes in weight Z-scores of extremely preterm infants from 0 to 24 months of CA were observed and compared, the occurrence of moderate to severe malnutrition and growth retardation was determined, nutritional insufficiency was assessed, and growth rate as well as the achievement of appropriate catch-up growth were analyzed. The Lambda-mu-sigma method combined with the Z-score fitting model was used to fit and analyze the distribution characteristics of weight percentiles in extremely preterm infants. The Chi-square test was used to compare differences among groups.Results:A total of 422 extremely preterm infants were included, with a gestational age at birth of 26.3(25.4, 27.2) weeks and a birth weight of (880±177) g. Among them, 238 were males and 184 were females; 36 cases (8.5%) were LGA, and 16 cases (3.8%) were SGA. During follow-up within 24 month of CA, 89 cases (21.1%) developed moderate to severe malnutrition. When compared separately among different birth weight and gestational age at birth groups, there had both statistically differences in the incidence of moderate to severe malnutrition ( χ2=42.94 and 9.17, both P<0.05). The incidence was the highest in the birth weight of CA<500 g group and the <25 weeks gestational age at birth group, while it was the lowest in the birth weight of CA≥1 000 g group and the 27 weeks gestational age at birth group in their respective groups. Growth retardation occurred in 5.2% (22/422). However, there had statistically differences in the incidence of growth retardation among different birth weight and gestational age at birth groups, in each grouped time interval ( χ2=21.61 and 4.30, both P<0.05). The proportions of rapid growth were relatively high in the 0-3 months and 3-6 months of CA groups, which were 96 cases (27.4%) and 98 cases (26.6%), respectively. Overall, appropriate catch-up growth was achieved in 341 cases (80.8%) from 0 to 24 months of CA. There had statistically differences in the completion rate of appropriate catch-up growth among different birth weight and gestational age at birth groups ( χ2=23.65 and 7.08, both P<0.05). The completion rate was the highest in the birth weight of CA<500 g group and the <25 weeks of gestational age at birth group, while it was the lowest in the birth weight of CA≥1 000 g group and the 27 weeks of gestational age at birth group. Conclusions:The lower the birth weight and gestational age of extremely preterm infants, the higher the incidence of moderate to severe malnutrition and the lower the achievement rate of adequate catch-up growth within 24 months of CA. The period of 0-6 months of CA is the critical window for catch-up in extremely preterm infants.
2.Nutritional insufficiency and appropriate catch-up growth in extremely preterm infants within 24 months of corrected age: a retrospective cohort study
Xiaoli QU ; Chunjin PENG ; Yixue ZHAO ; Yulan YANG ; Na LUO ; Ping WANG
Chinese Journal of Pediatrics 2026;64(1):68-76
Objective:To assess the status of undernutrition and appropriate catch-up growth in extremely preterm infants within 24 months of corrected age (CA).Methods:A retrospective cohort study was conducted. A total of 422 extremely preterm infants born at Shenzhen Maternity and Child Healthcare Hospital, Women and Children's Medical Center, Southern Medical University from January 2017 to December 2022 and followed up until 24 months of CA were enrolled. The extremely preterm infants were grouped by gestational age at birth (<25, 25-26, 27 weeks), birth weight (<500, 500-749, 750-999,≥1 000 g), weight for gestational age (large for gestational age (LGA), appropriate for gestational age (AGA), small for gestational age (SGA)) and sex. Weight data within 24 months of CA were collected every 3 months. Nutritional insufficiency, growth rate, and achievement of adequate catch-up growth were analyzed during the period from 0 to 24 months of CA. Z-score method was used to analyze data. Fenton 2013 preterm growth charts (Fenton 2013) were used before 40 weeks of corrected gestational age, and World Health Organization child growth standards (2009) fitted Z-scores were applied from 40 weeks of CA. Changes in weight Z-scores of extremely preterm infants from 0 to 24 months of CA were observed and compared, the occurrence of moderate to severe malnutrition and growth retardation was determined, nutritional insufficiency was assessed, and growth rate as well as the achievement of appropriate catch-up growth were analyzed. The Lambda-mu-sigma method combined with the Z-score fitting model was used to fit and analyze the distribution characteristics of weight percentiles in extremely preterm infants. The Chi-square test was used to compare differences among groups.Results:A total of 422 extremely preterm infants were included, with a gestational age at birth of 26.3(25.4, 27.2) weeks and a birth weight of (880±177) g. Among them, 238 were males and 184 were females; 36 cases (8.5%) were LGA, and 16 cases (3.8%) were SGA. During follow-up within 24 month of CA, 89 cases (21.1%) developed moderate to severe malnutrition. When compared separately among different birth weight and gestational age at birth groups, there had both statistically differences in the incidence of moderate to severe malnutrition ( χ2=42.94 and 9.17, both P<0.05). The incidence was the highest in the birth weight of CA<500 g group and the <25 weeks gestational age at birth group, while it was the lowest in the birth weight of CA≥1 000 g group and the 27 weeks gestational age at birth group in their respective groups. Growth retardation occurred in 5.2% (22/422). However, there had statistically differences in the incidence of growth retardation among different birth weight and gestational age at birth groups, in each grouped time interval ( χ2=21.61 and 4.30, both P<0.05). The proportions of rapid growth were relatively high in the 0-3 months and 3-6 months of CA groups, which were 96 cases (27.4%) and 98 cases (26.6%), respectively. Overall, appropriate catch-up growth was achieved in 341 cases (80.8%) from 0 to 24 months of CA. There had statistically differences in the completion rate of appropriate catch-up growth among different birth weight and gestational age at birth groups ( χ2=23.65 and 7.08, both P<0.05). The completion rate was the highest in the birth weight of CA<500 g group and the <25 weeks of gestational age at birth group, while it was the lowest in the birth weight of CA≥1 000 g group and the 27 weeks of gestational age at birth group. Conclusions:The lower the birth weight and gestational age of extremely preterm infants, the higher the incidence of moderate to severe malnutrition and the lower the achievement rate of adequate catch-up growth within 24 months of CA. The period of 0-6 months of CA is the critical window for catch-up in extremely preterm infants.
3.Herbal Textual Research on Arcae Concha in Famous Classical Formulas
Yiqin ZHANG ; Yixue ZHUANG ; Yinan LU ; Yanning CHEN ; Yichong CHEN ; Shuiyu XU ; Zhilai ZHAN ; Chengzi YANG
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(2):208-218
In this paper, the name, origin, producing area, harvesting, processing and functional indications of Arcae Concha were systematically combed and verified by consulting the ancient and modern literature, in order to provide a basis for the development of famous classical formulas containing Arcae Concha. Arcae Concha was first recorded in the name of Han in Bencao Shiyi, but later, due to the influence of LI Shizhen's error of combining Han item with Kuiha in the Ming dynasty, there were aliases such as Kuilu and Fulao, and Yizong Bidu began to include Walengzi as its correct name and has been used ever since. The textual descriptions and illustrations of the medicinal materials of Arcae Concha contained in the materia medica of the past generations were consistent with the modern Arca inflata, A. subcrenata and A. granosa. In ancient times, there were medicinal records of two parts of shell and meat, but now the shell is used as medicine, and the meat is mostly edible. In ancient times, Zhejiang, Shandong, Guangdong and Guangxi were the main producing areas, and Zhejiang was the best. It is now believed that A. inflata is mostly distributed in the northern part of the Huanghai Sea, A. granosa is mostly distributed in the coastal areas south of Shandong Peninsula in China, and A. subcrenata is widely distributed in the coastal areas of China. Its quality is better in a complete, white, no residual meat and sand. In ancient times, there was no clear harvesting period, and the processing was mainly based on vinegar quenching after calcination or powdering of calcined shell, but now the harvesting period is autumn and winter. After harvesting, it is directly washed and crushed for raw use or processed by calcined method. The records of the medicinal materials in the past dynasties on the properties of Arcae Concha were mainly warm, sweet, salty and mild, and it is now believed that Arcae Concha is salty in taste and mild in nature. In ancient times, it was believed that Arcae Concha were mainly used for coldness in the heart and abdomen, coldness in the waist and spine, benefiting the five internal organs, strengthening the stomach. Nowadays, it is believed that Arcae Concha can eliminate phlegm and remove blood stasis, soften the hardness and dissipate the lumps, produce acid and relieve pain. It can be used in the treatment of stubborn phlegm, gall tumor, scrofula and other symptoms. In conclusion, it is suggested that for the famous classical formulas containing Arcae Concha, the corresponding methods should be selected according to the processing requirements of the drug in the formulas, while those without processing requirements can be determined according to the functional position of the products.
4.Mechanism of inhibitory effect of total flavonoids from Taraxacum mongolicum on obesity in mice by regulating intestinal flora
Yixue GAO ; Lin GUO ; Linyan LANG ; Jing WU ; Haoyang WANG ; Jing YANG ; Mingsan MIAO ; Zhanzhan LI
China Pharmacy 2025;36(3):293-299
OBJECTIVE To investigate the mechanism of the inhibitory effect of total flavonoids from Taraxacum mongolicum on high-fat diet-induced obesity in mice through modulation of intestinal flora.METHODS Twenty-four C57BL/6J mice were randomly divided into blank group,model group and T.mongolicum total flavonoid group,with 8 mice in each group.Except for the blank group,the other 2 groups were given a high-fat diet,while T mongolicum total flavonoid group was given T.mongolicum total flavonoid[400 mg/(kg·d)]intragastrically,once a day,for 8 consecutive weeks.During the experiment,the food intake of each group of mice was recorded.After the last medication,the body mass,fat weight,blood lipid level and pathological changes of liver and epididymal fat in mice were evaluated to observe the effect of T.mongolicum total flavonoid on the treatment of obesity in mice.The changes in abundance and structure of intestinal flora in mice were detected by amplicon sequencing;the effects of T.mongolicum total flavonoids on fat metabolism related genes were analyzed by qPCR.RESULTS Compared with model group,the body weight of mice in T.mongolicum total flavonoids group was decreased significantly(P<0.05);the levels of total lipid cholesterol,triglycerides,and LDL cholesterol were all decreased significantly(P<0.01),and the level of HDL cholesterol was increased significantly(P<0.01);the fat indexes of inguinal white adipose tissue and epididymal white adipose tissue were significantly reduced(P<0.05);significant improvement in hepatocellular steatosis and adipose cytopathy were significantly improved;mRNA expressions of COX7A1 and COX8B were significantly upregulated(P<0.05).The results of bacterial colony detection showed that compared with the model group,there was a rising trend in the diversity of the bacterial colony in T.mongolicum total flavonoids group,and the Sobs index characterization and β diversity were increased significantly(P<0.05).Relative abundances of Blautia,norank_f_Ruminococcaceae,Bilophila,Alistipes,classified_f_Ruminococcaceae,Parabacteroides,norank_f_Desulfovibrionaceae,Anaerotruncus were significantly up-regulated(P<0.05),while those of Faecalibaculum,Erysipelatoclostridium,GCA-900066575,Tuzzerella,Lactobacillus,norank_f_norank_o_RF39,achnospiraceae_FCS020_group were significantly down-regulated(P<0.05).CONCLUSIONS T.mongolicum total flavonoids can reduce body mass,fat weight and blood lipid levels,and repair the pathological damage to liver and epididymal fat in obese mice,which is related to improving intestinal flora disorders caused by high-fat diet.
5.Corneal wound healing mechanism after infrared laser irradiation
Yixue YIN ; Luguang JIAO ; Jiarui WANG ; Congling ZHOU ; Zaifu YANG
Recent Advances in Ophthalmology 2024;44(5):350-354
Objective To explore the corneal wound healing mechanism after 3.74 μm infrared laser irradiation.Methods Twenty-seven C57BL/6J mice(six to eight weeks old)were randomly divided into a normal group(3 mice)and an experimental group(24 mice).Mice in the normal group were not subjected to any treatment.The corneas of mice in the experimental group were damaged by infrared laser at a wavelength of 3.74 μm.The spot diameter was 2 mm,the exposure duration 0.8 s,and the radiant exposure 23.2 J·cm-2.Pathological sectioning of corneas was performed at 3 h,6 h,12 h,1 d,3 d,7 d,14 d,and 21 d after laser irradiation in the experimental group,with 3 mice at each time point.It was the same for mice in the normal group.Immunohistochemical staining was conducted to examine neutrophil elastase,CD68,CD163 and thrombomodulin-positive cells and identify neovascularization.Results Neutrophil elastase,CD68,CD163,and thrombomodulin-positive cells were not detected in the corneal stroma of mice in the normal group.Neutrophil elastase-positive cells were detected in the damaged corneal periphery of mice in the experimental group at 3 h,migrated to the damaged area at 12 h,peaked at 1 d,and then decreased gradually with time,but still existed slightly at 21 d after laser irradiation.CD68-positive cells were detected in the damaged corneal periphery of mice in the experimental group at 12 h and in the damaged area at 1 d through 21 d after laser irradiation.CD163-positive cells were found in the damaged corneal periphery of mice in the experimental group at 7 d and in the damaged area at 14 d and 21 d after laser irradiation.Throm-bomodulin-positive cells were found in the damaged area of the corneal stroma at 14 d and 21 d after laser irradiation.Con-clusion During the wound healing process after 3.74 μm infrared laser-induced full-thickness corneal injury in mice,a large number of inflammatory cells migrate from the damaged corneal periphery or limbus to the damaged area.Neutrophils and M1 macrophages infiltrate in the early stage,while M2 macrophages are involved in the later stage,accompanied by neovascularization.
6.Construction of a carbon dioxide laser-induced mouse corneal injury model and observation of corneal wound healing
Congling ZHOU ; Luguang JIAO ; Jiarui WANG ; Yixue YIN ; Zukang NIE ; Mengqi QIU ; Li ZHONG ; Zaifu YANG
Recent Advances in Ophthalmology 2024;44(10):769-773
Objective To construct a carbon dioxide(CO2)laser-induced corneal injury model in mice and observe the process of corneal wound healing.Methods Twenty eyes of ten C57BL/6J mice were divided into 4 groups.The cen-tral corneas in each group were irradiated by CO2 laser with a wavelength of 10.6 μm,spot diameter of 2 mm and power of 0.94 W.The exposure doses were 3.0 J·cm-2,4.5 J·cm-2,7.5 J·cm-2 and 10.5 J·cm-2,with corresponding expo-sure durations of 0.10 s,0.15 s,0.25 s and 0.35 s.Corneal injury severity was assessed using a slit lamp microscope,opti-cal coherence tomography and histopathological evaluation at 1 day after the exposure to determine the proper exposure dose for constructing a corneal injury model.Subsequently,the corneal injury model was constructed and the same meth-ods were used to monitor wound healing before,and 0 hours to 6 months after the exposure.Results No obvious corne-al injury was observed at an exposure dose of 3.0 J·cm-2.At an exposure dose of 4.5 J·cm-2,an off-white injury area appeared on the central cornea with loss of epithelium and endothelium.At an exposure dose of 7.5 J·cm-2 or 10.5 J·cm-2,the injury area became porcelain white,the cornea was thickened,and the iris was seen adhering to the margin of the cornea.Therefore,4.5 J·cm-2 CO2 laser was selected to construct a corneal injury model.At this exposure dose,the cornea swelled and thickened rapidly after injury,reached the maximum thickness 1 day after the exposure,and then grad-ually recovered,returning to normal by 14 days after the exposure.In the early stage(0 hours to 3 days after the expo-sure),the cornea showed shedding of injured epithelium and endothelium,migration of new epithelium and endothelium,and infiltration and regression of inflammatory cells.At the late stage(7 days to 6 months after the exposure),the cornea gradually returned to a normal physiological state,but some of the injured cornea exhibited stromal hyperplasia.Conclu-sion A CO2 laser with an exposure dose of 4.5 J·cm-2 can be used to construct a corneal injury model in mice.The a-cute phase of corneal injury primarily occurs within 3 days after the exposure.The cornea tends to restore its original physi-ological structure,but the corneal transparency cannot return to a normal state.
7.Qualitative and quantitative determination of a new impurity from beclomethasone propionate inhalation aerasol
Cong DAI ; Heng TIAN ; Chunmin WU ; Yixue YANG ; Qihua BEI ; Quanhong YAN
China Pharmacist 2024;28(11):416-423
Objective To establish a method to qualitatively identify and quantitatively determine a new impurity from beclomethasone propionate inhalation aerasol.Methods Ultra-performance liquid chromatography-Q-exactive orbitrap-mass spectrometry(UPLC-QE-MS)technology and Discovery Studio software were used to identify and predict the toxicity of a new impurity in beclomethasone propionate inhalation aerasol,and the content of this new impurity was determined by UPLC.Results The new impurity in beclomethasone propionate inhalation aerasol was polybutylene terephthalate(PBT)cyclic dimer.Discovery Studio software predicted that PBT dimer had potential developmental toxicity,with no mutagenicity,no ocular and skin irritancy and no rodent carcinogenicity.The content range of PBT dimer in 9 batches of beclomethasone propionate inhalation aerasol was 20.5-116.6 pg per bottle.Conclusion This study can realize the rapid identification and toxicity prediction of the new impurity in the preparation,and provide a theoretical basis for the quality control of the preparation by determining their content.
8.Herbal Textual Research on Bruceae Fructus in Famous Classical Formulas
Shuiyu XU ; Yixue ZHUANG ; Yiqin ZHANG ; Yichong CHEN ; Yanning CHEN ; Zhilai ZHAN ; Chengzi YANG
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(7):11-19
Through consulting the ancient herbal books and modern literature, this paper has carried out the textual research on the name, origin, place of origin, harvesting and processing, and other contents of Bruceae Fructus, combed its ancient and modern medicinal history, so as to provide reference for the development of famous classical formulas containing Bruceae Fructus. Through the herbal textual research, It can be verified that, since the Qing dynasty, Bruceae Fructus has been recorded in the materia medica, most of the materia medica in previous dynasties took Bruceae Fructus as its proper name, and Laoyadan, Kushenzi and Yadanzi as the aliases. The main origin of Bruceae Fructus is Brucea javanica, its medicinal part is the fruit, which is harvested from August to October every year, the fruit can be harvested when it is ripe. Bruceae Fructus was first distributed in Fujian, Guangdong and Guangxi, and gradually expanded to the south of China with the change of time. The traditional processing method of Bruceae Fructus is mainly to remove the shell and kernel, and remove the oil by frosting. The 2020 edition of Chinese Pharmacopoeia stipulates that its processing method is to remove the shell and impurities. Based on the research results, it is suggested that the dried mature fruit of B. javanica should be selected for the development of famous classical formulas containing this herb, and the raw products can be used if the original formula does not specify the processing requirements.
9.Content study of N-nitroso impurities in 5 types of β-blockers
Heng TIAN ; Yixue YANG ; Cong DAI ; Yaxiong LIU ; Quanhong YAN
China Pharmacy 2024;35(8):936-941
OBJECTIVE To determine the contents of N-nitroso impurities in raw materials/formulations of propranolol, metoprolol, atenolol, esmolol and bisoprolol, and clarify the attention threshold. METHODS Ultra-high performance liquid chromatography-quadrupole/electrostatic field orbitrap high-resolution mass spectrometry(UPLC-Q/Orbitrap HRMS)was adopted. An ACE Excel 3 C18-AR column was used for the separation and a mixture of 0.2% formic acid solution with 0.01 mol/L ammonium acetate and methanol was employed as the mobile phase by gradient elution, at a flow rate of 0.60 mL/min. The column temperature was set at 40 ℃ , and the sample size was 5 μL. The heated electrospray ionization source was employed in the positive full mass spectra-selected ion monitoring mode. The contents of N-nitroso impurities in raw materials/formulations of 15 batches of β-blockers from 10 manufacturers were determined by this method. Discovery Studio software was applied to predict the toxicity of the impurities and estimate the attention threshold. RESULTS Among 5 kinds of β-blockers, the linear ranges of N-nitroso propranolol, N-nitroso metoprolol, N-nitroso atenolol, N-nitroso esmolol and N-nitroso bisoprolol were 1.01-503.38, 1.02-508.38, 0.97-483.63, 1.11-554.27 and 1.05-523.92 ng/mL, respectively (r>0.999). The limits of quantitation were 1.04, 0.25, 0.05, 0.55 and 1.05 ng/mL, and the limits of detection were 0.52, 0.08, 0.02, 0.17 and 0.52 ng/mL, respectively. RSDs of precision, reproducibility, recovery, stability and durability tests were all lower than 7.5% (n=6 or n=5). Among the 15 batches of samples, except for 1 batch, N-nitroso propranolol (1.07-8.91 ng/mg), N-nitroso metoprolol (1.43-3.37 ng/mg), N-nitroso atenolol (1.33 ng/mg), N-nitroso esmolol (0.19 ng/mg) and N-nitroso bisoprolol (1.27 ng/mg) were detected in all other batches. According to predictions, the above 5 impurities had varying degrees of reproductive toxicity, mutagenicity and carcinogenicity, with attention thresholds of 1.0, 0.4, 4.3, 0.2 and 46.7 ng/mg, respectively. CONCLUSIONS The established method is simple, rapid, sensitive and specific, the estimated attention thresholds are clear, which can be used for the control of N-nitroso impurities in various β-blockers.
10.Results and discussion on various laboratories proficiency-testing for assays of bismuth potassium citrate capsules by complexometric titration
YANG Yixue ; HUANG Dan ; WANG Yeru ; WU Fengru ; LIU Yitao ; BEI Qihua ; YAN Quanhong ; XIANG Xinhua
Drug Standards of China 2024;25(1):030-034
Objective: To design the proficiency testing (PT) project (No. NIFDC-PT-183) for assays of bismuth potassium citrate capsules and organize to assess the proficiency of complexometric titration in laboratories, and provide some technical analyses and advices.
Methods: Two groups of samples with different concentration were prepared. The uniformity was evaluated with one-way analysis of variance and the stability was confirmed with t-test, whose results all conformed the requirements. The samples with three combinations were randomly distributed to 279 laboratories. The determination was performed according to the assays of bismuth potassium citrate capsules in Volume Ⅱ of the Chinese Pharmacopoeia 2015. The median value and normalized interquartile range (NIQR) of robust statistical analysis was adopted and Z-scores were used to evaluate the results from each of laboratories.
Results: Among 279 laboratories, 240 laboratories results were satisfactory, 23 were questionable, and the other 16 were unsatisfied. The satisfaction rate was 86.0%.
Conclusion: The overall capacity of national laboratories for assays of bismuth potassium citrate capsules is good while a portion of participants require further improvement.

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