1.Clinical trial of brexpiprazole in the treatment of adults with acute schizophrenia
Shu-Zhe ZHOU ; Liang LI ; Dong YANG ; Jin-Guo ZHAI ; Tao JIANG ; Yu-Zhong SHI ; Bin WU ; Xiang-Ping WU ; Ke-Qing LI ; Tie-Bang LIU ; Jie LI ; Shi-You TANG ; Li-Li WANG ; Xue-Yi WANG ; Yun-Long TAN ; Qi LIU ; Uki MOTOMICHI ; Ming-Ji XIAN ; Hong-Yan ZHANG
The Chinese Journal of Clinical Pharmacology 2024;40(5):654-658
Objective To evaluate the efficacy and safety of brexpiprazole in treating acute schizophrenia.Methods Patients with schizophrenia were randomly divided into treatment group and control group.The treatment group was given brexpiprozole 2-4 mg·d-1 orally and the control group was given aripiprazole 10-20 mg·d-1orally,both were treated for 6 weeks.Clinical efficacy of the two groups,the response rate at endpoint,the changes from baseline to endpoint of Positive and Negative Syndrome Scale(PANSS),Clinical Global Impression-Improvement(CGI-S),Personal and Social Performance scale(PSP),PANSS Positive syndrome subscale,PANSS negative syndrome subscale were compared.The incidence of treatment-related adverse events in two groups were compared.Results There were 184 patients in treatment group and 186 patients in control group.After treatment,the response rates of treatment group and control group were 79.50%(140 cases/184 cases)and 82.40%(150 cases/186 cases),the scores of CGI-I of treatment group and control group were(2.00±1.20)and(1.90±1.01),with no significant difference(all P>0.05).From baseline to Week 6,the mean change of PANSS total score wese(-30.70±16.96)points in treatment group and(-32.20±17.00)points in control group,with no significant difference(P>0.05).The changes of CGI-S scores in treatment group and control group were(-2.00±1.27)and(-1.90±1.22)points,PSP scores were(18.80±14.77)and(19.20±14.55)points,PANSS positive syndrome scores were(-10.30±5.93)and(-10.80±5.81)points,PANSS negative syndrome scores were(-6.80±5.98)and(-7.30±5.15)points,with no significant difference(P>0.05).There was no significant difference in the incidence of treatment-related adverse events between the two group(69.00%vs.64.50%,P>0.05).Conclusion The non-inferiority of Brexpiprazole to aripiprazole was established,with comparable efficacy and acceptability.
2.Progress in delivering biotechnology drugs on microneedles
Han LIU ; Guo-zhong YANG ; Wan-ren DU ; Suo-hui ZHANG ; Ze-quan ZHOU ; Yun-hua GAO
Acta Pharmaceutica Sinica 2024;59(10):2751-2762
As a new transdermal drug delivery system, microneedles can significantly improve skin permeability, enhance drug transdermal delivery, and demonstrate unique advantages in breaking stratum corneum barrier of skin. This feature enables microneedles to demonstrate enormous potential in delivering biotechnology drugs. The traditional delivery method for biotechnology drugs is mainly injection, which brings problems such as pain and skin redness to patients, leading to poor patient compliance. In addition, the production, transportation, and storage of biotechnology drugs require strict low-temperature conditions to maintain their activity and increase cost output. Microneedles, by contrast, have many benefits, providing new avenues and solutions for biomolecular delivery. Accordingly, this review introduced the microneedle drug delivery system for delivery biotechnology drugs, and summarized the research progress of microneedle systems in biotechnology drugs.
3.Jianwei Xiaozhang Tablets Improves Precancerous Lesions of Gastric Cancer in Rats via Regulating PI3K-Akt-eNOS Pathway
Hai-Yang HUANG ; Shao-Wen ZHONG ; Yun AN ; Yu-Xin WANG ; Shu-Min ZHU ; Jie GAO ; Xiao-Min LU ; Ming-Guo DONG
Journal of Guangzhou University of Traditional Chinese Medicine 2024;41(3):709-718
Objective To investigate the therapeutic effect and mechanism of Jianwei Xiaozhang Tablets on rats with precancerous lesions of gastric cancer(PLGC).Methods Forty male SD rats were randomly divided into the normal group,the model group,the folic acid group and the Jianwei Xiaozhang Tablets group,with 10 rats in each group.In addition to the normal group,the other three groups of rats were prepared by gavage with Ranitidine Aqueous Solution combined with N-methyl-N'-nitro-N-nitrosoguanidine(MNNG)solution drinking method for the preparation of PLGC model.After successful modeling,drugs were administered accordingly for 7 weeks.The changes in body mass of rats during modeling and drug administration were recorded,the gross view of the stomach was observed and scored pathologically,the coefficients of spleen and liver were determined,the pathological changes in gastric tissue were observed by hematoxylin-eosin(HE)staining,enzyme-linked immunosorbent assay(ELISA)was used to measure serum gastrin(GAS),motilin(MTL)and glucagon(GC),Alisin Blue-Periodic Acid Schiff's(AB-PAS)staining was used to observe the thickness of the mucosal layer of gastric tissues,the expressions of phosphatidylinositol 3-kinase(PI3K),phosphorylated PI3K(p-PI3K),protein kinase B(Akt),phosphorylated Akt(p-Akt),and endothelial-type nitric oxide synthase(eNOS)proteins in gastric tissues were detected by protein immunoblotting(Western Blot),and the expression of vascular endothelial growth factor A(VEGFA)protein in gastric tissues was detected by immunofluorescence staining.Results Compared with the normal group,the body mass of rats in the model group grew slowly during the experimental period,gastric macroscopic pathological scores were significantly increased(P<0.01),splenic coefficient and hepatic coefficient were significantly decreased(P<0.01),the gastric tissues showed cuprocyte hyperplasia and intestinal chemotaxis,gastric tissues'inflammation scores were significantly increased(P<0.01),the serum GAS content was significantly increased(P<0.01),and the MTL,GC contents were significantly reduced(P<0.05),and the thickness of the mucous membrane layer of gastric tissue was significantly reduced(P<0.05),the protein expression levels of PI3K,p-PI3K,Akt,p-Akt and eNOS were reduced(P<0.01),and the protein expression level of VEGFA was reduced(P<0.01);compared with the model group,the above indexes of the Jianwei Xiaozhang Tablets group and the folic acid group were all significantly improved(P<0.05 or P<0.01),among which,the Jianwei Xiaozhang Tablets group had a better improvement effect in the proliferation of cup cells and intestinal chemotaxis in gastric tissues,the content of serum GAS,and the thickness of the mucous layer in gastric tissues.Conclusion The mechanism of the improvement of PLGC in rats by Jianwei Xiaozhang Tablets may be related to the activation of the PI3K-Akt-eNOS pathway,which in turn promotes the angiogenesis and repair of gastric damaged tissues.
4.Effect of cyclic RNA hsa-circ-0001360 on homocysteine-induced apoptosis of human umbilical vein endothelial cells
Yuanjun KUANG ; Sumei YU ; Yingyi ZHONG ; Xuhong ZHANG ; Shengchao MA ; Anning YANG ; Yinju HAO ; Jiantuan XIONG ; Yun JIAO ; Yideng JIANG
Chinese Journal of Tissue Engineering Research 2024;28(25):4060-4064
BACKGROUND:Increased homocysteine level induces apoptosis of human umbilical vein endothelial cells,but the mechanism remains unclear. OBJECTIVE:To investigate the role of hsa-circ-0001360 in human umbilical vein endothelial cell apoptosis induced by homocysteine. METHODS:In vitro cultured human umbilical vein endothelial cells were divided into control group,homocysteine group,interference control group,interference control + homocysteine group,hsa-circ-0001360 interference group,hsa-circ-0001360 + homocysteine interference group,overexpression control group,overexpression control + homocysteine group,hsa-circ-0001360 overexpression group and hsa-circ-0001360 + homocysteine overexpression group.All groups were treated with 100 μmol/L homocysteine.After 72 hours of intervention,the expressions of apoptosis-related proteins Bax,Bcl-2,and Caspase-3 were detected by western blot assay.The apoptotic rate was detected by flow cytometry.Quantitative real-time PCR was used to detect the expression of hsa-circ-0001360. RESULTS AND CONCLUSION:(1)Compared with the control group,the expression of Caspase-3 and Bax was significantly increased(P<0.01),and the expression of Bcl-2 was significantly decreased(P<0.01),and the apoptotic rate was significantly increased(P<0.01)in the homocysteine group.(2)Compared with control group,the expression of hsa-circ-0001360 was significantly increased in the homocysteine group(P<0.01).(3)The expression of hsa-circ-0001360 was significantly higher in the cytoplasm than that in the nucleus(P<0.01).(4)Compared with the interference control C group and interference control + homocysteine group,the expressions of Caspase-3 and Bax were significantly decreased(P<0.01),while the expression of Bcl-2 was significantly increased(P<0.01);the apoptotic rate was significantly decreased(P<0.01)in sh-hsa-circ-0001360 interference group and sh-hsa-circ-0001360 + homocysteine interference group.(5)Compared with overexpression control group and overexpression control + homocysteine group,the expressions of Caspase-3 and Bax were significantly increased(P<0.01),while the expression of Bcl-2 was significantly decreased(P<0.01);the apoptotic rate was significantly increased(P<0.01)in the hsa-circ-0001360 overexpression group and the hsa-circ-0001360 + homocysteine overexpression group.(6)In conclusion,hsa-circ-0001360 can promote the apoptosis of human umbilical vein endothelial cells induced by homocysteine.
5.Effects of Rosa roxburghii Radix on ulcerative colitis in rats based on pyroptosis and neutrophil extracellular traps
Yi-Ping YAN ; Yun-Zhi CHEN ; Qian LI ; Bo-Yang CHEN ; Zhi-Liang FAN ; Shuai CHEN ; Yi-Hui CHAI ; Zhong QIN
Chinese Traditional Patent Medicine 2024;46(3):780-788
AIM To explore the effects of Rosa roxburghii Radix on ulcerative colitis(UC)in rats based on pyroptosis and neutrophil extracellular traps(NETs).METHODS Rats were randomly divided into the normal group and the model group.The successfully established UC rat models by trinitrobenzene sulfonic acid(TNBS)/ethanol enema were then randomly divided into the model group,the sulfasalazine group(0.3 g/kg)and the low,medium and high dose R.roxburghii Radix groups(2,4,8 g/kg),followed by dosing of corresponding drugs by gavage.21 days later,the rats had their disease activity index(DAI)score calculated;their pathological changes of colon tissue observed by HE staining;their levels of serum interleukin(IL)-18,IL-1β and myeloperoxidase(MPO)detected by ELISA;and their protein expressions of NE,MPO,NLRP3,caspase-1 and GSDMD in colon tissue detected by Western blot and immunohistochemistry.RESULTS Compared with the normal group,the model group displayed increased DAI score(P<0.01),increased serum levels of IL-1β,IL-18 and MPO(P<0.01),and increased protein expressions of NE,MPO,caspase-1,NLRP3 and GSDMD in colon tissue(P<0.01).Compared with the model group,the groups intervened with sulfasalazine,or medium,or high dose R.roxburghii Radix demonstrated with decreased DAI scores(P<0.05,P<0.01),decreased serum levels of IL-1β,IL-18 and MPO(P<0.01),and decreased protein expressions of NE,MPO,caspase-1,NLRP3 and GSDMD in colon tissue(P<0.05,P<0.01).CONCLUSION R.roxburghii Radix may alleviate the inflammatory reaction in a rat model of UC and improve its pathological injury of colon via regulating pyroptosis and NETs.
6.Influence of GPRC5A-Regulated ABCB1 Expression on Lung Adenocarcinoma Proliferation
Li YUN ; Cui WEN-WEN ; Yang ZHONG-FA ; Liu WEN-HAO ; Bian MAO-WANG ; Deng JIONG ; Wang TONG
Chinese Medical Sciences Journal 2024;39(1):9-18,中插2
Objective Aberrant expression of ATP binding cassette subfamily B member 1(ABCB1)plays a key role in several cancers.However,influence of G protein coupled receptor family C group 5 type A(GPRC5A)-regulated ABCB1 expression on lung adenocarcinoma proliferation remains unclear.Therefore,this study investigated the effect of GPRC5A regulated ABCB1 expression on the proliferation of lung adenocarcinoma. Methods ABCB1 expressions in lung adenocarcinoma cell lines,human lung adenocarcinoma tissues,and tracheal epithelial cells and lung tissues of GPRC5A knockout mice and wild-type mice were analyzed with RT-PCR,Western blot,or immunohistochemical analysis.Cell counting kit-8 assay was performed to analyze the sensitivity of tracheal epithelial cells from GPRC5A knockout mice to chemotherapeutic agents.Subcutaneous tumor formation assay was performed to confirm whether down-regulation of ABCB 1 could inhibit the proliferation of lung adenocarcinoma in vivo.To verify the potential regulatory relationship between GPRC5A and ABCB1,immunofluorescence and immunoprecipitation assays were performed. Results ABCB1 expression was up-regulated in lung adenocarcinoma cell lines and human lung adenocarcinoma tissues.ABCB1 expression in the tracheal epithelial cells and lung tissues of GPRC5A deficient mice was higher than that in the wild type mice.Tracheal epithelial cells of GPRC5A knockout mice were much more sensitive to tariquidar and doxorubicin than those of GPRC5A wild type mice.Accordingly,28 days after injection of the transplanted cells,the volume and weight of lung tumor in ABCB1 knockout cell-transplanted GPRC5A-/-C57BL/6 mice were significantly smaller than those in wild type cell-transplanted mice(P=0.0043,P=0.0060).Furthermore,immunofluorescence and immunoprecipitation assays showed that GPRC5A regulated ABCB1 expression by direct binding. Conclusion GPRC5A reduces lung adenocarcinoma proliferation via inhibiting ABCB1 expression.The pathway by which GPRC5A regulates ABCB1 expression needs to be investigated.
7.Clinical Observation on the Tiaodu Lijin Acupuncture Combined with Thumb-tack Needling for Subcutaeous Embedding in the Treatment of Lumbar Disc Herniation
Yun-Fei WANG ; Jing YANG ; Wen-Zhong WU
Journal of Guangzhou University of Traditional Chinese Medicine 2024;41(7):1805-1812
Objective To observe the clinical efficacy of Tiaodu Lijin Acupuncture combined with thumb-tack needling for subcutaeous embedding in the treatment of lumbar disc herniation.Methods A total of 98 patients with lumbar disc herniation were randomly divided into observation group and control group,49 cases in each group.The control group was treated with Tiaodu Lijin Acupuncture,and the observation group was treated with thumb-tack needling for subcutaeous embedding on the basis of the control group.Both groups were treated for one month.After one month of treatment,the clinical efficacy of the two groups was evaluated.The changes of Japanese Orthopaedic Association(JOA)score and Visual Analogue Scale(VAS)of pain were observed before and after treatment in the two groups,as well as the activity of lumbar spine and the expressions of ERK protein and ERK mRNA.The levels of β-endorphin(β-EP),neuropeptide Y(NPY),5-hydroxytryptamine(5-HT),substance P(SP),interleukin 6(IL-6),tumor necrosis factor α(TNF-α)and interleukin 1β(IL-1β)were compared between the two groups before and after treatment.The safety of the two groups was evaluated.Results(1)The total effective rate was 93.88%(46/49)in the observation group and 79.59%(39/49)in the control group.The curative effect of the observation group was superior to that of the control group,and the difference was statistically significant(P<0.05).(2)After treatment,the JOA and VAS scores of the two groups were significantly improved(P<0.05),and the improvement of JOA and VAS scores in the observation group was significantly superior to that in the control group,the difference was statistically significant(P<0.05).(3)After treatment,the levels of β-EP,NPY,5-HT and SP in the two groups were significantly improved(P<0.05),and the observation group was significantly superior to the control group in improving the levels of β-EP,NPY,5-HT and SP,the difference was statistically significant(P<0.05).(4)After treatment,the levels of IL-6,IL-1β and TNF-α in the two groups were significantly improved(P<0.05),and the levels of IL-6,IL-1β and TNF-α in the observation group were significantly superior to those in the control group(P<0.05).(5)After treatment,the lumbar flexion and extension activities of the two groups were significantly improved(P<0.05),and the improvement of lumbar flexion and extension activities in the observation group was significantly superior to that in the control group,the difference was statistically significant(P<0.05).(6)After treatment,the expressions of ERK protein and the level of ERK mRNA in the two groups were significantly improved(P<0.05),and the observation group was significantly superior to the control group in improving the expressions of ERK protein and the level of ERK mRNA,the difference was statistically significant(P<0.05).(7)The incidence of adverse reactions in the observation group was 8.16%(4/49),while the control group was 4.08%(2/49).There was no significant difference between the observation group and the control group(P>0.05).Conclusion Tiaodu Lijin Acupuncture combined with thumb-tack needling for subcutaeous embedding exerts certain effect in the treatment of lumbar disc herniation.It can significantly improve the pain symptoms of patients,reduce the levels of serum pain mediators and inflammatory factors,and improve lumbar function.The mechanism may be related to the inhibition of ERK signaling pathway.
8.Effect of flavokawain B downregulates androgen receptor on the proliferation and migration in triple-negative breast cancer
Zhong-Yun YANG ; Ting WU ; Xue-Sen LI
Medical Journal of Chinese People's Liberation Army 2024;49(8):930-938
Objective To investigate how flavokawain B(FKB)affects the proliferation and migration of triple-negative breast cancer(TNBC)cells by downregulating the androgen receptor(AR).Methods The expression of AR in breast cancer and normal tissues was analyzed using the GEPIA2 database.Expression of estrogen receptor(ER),human epidermal growth factor receptor 2(HER2),progesterone receptor(PR),and AR was detected in six breast cancer cell lines(SUM159PT,MCF-7,T47D,BT474,Hs-578T,and MDB-MA-231)by Western blotting.The effect of FKB(0,10,20,30,40,50,60 μmoL/L)treatment of 24,48,and 72 h on the proliferative activity of SUM159PT breast cancer cells was assessed using the CCK-8 assay under normal or androgen deprivation conditions.The mRNA and protein of AR expression was measured by qRT-PCR and Western blotting after 30 μmoL/L FKB treatment of SUM159PT cells for 0,4 and 8 h.SUM159PT cells were set as control group(treatment with 0.1%DMSO),dihydrotestosterone(DHT)group(treatment with 10 nmol/L DHT),FKB group(treatment with 15 μmol/L FKB),DHT+FKB group(treatment with 10 nmol/L DHT and 15 μmol/L FKB),AR antagonist enzalutamide(ENZA)group(treatment with 40 μmol/L ENZA),and DHT+ENZA group(treatment with 10 nmol/L DHT and 40 μmol/L ENZA)under androgen deprivation conditions.Cell proliferation,migration,and colony formation abilities in the above groups were determined using the CCK-8 method,Transwell assay,and clone formation test.Western blotting was also used to detect the expression levels of EMT-related proteins(N-cadherin,Occludin,Vimentin)and AR protein.Results AR mRNA expression level was significantly higher in breast cancer tissue than in normal breast tissue(P<0.05).AR was expressed at comparable levels in five different breast cancer cell lines(SUM159PT,MCF-7,T47D,BT474,and Hs-578T)in addition to MDB-MA-231.FKB can downregulate AR mRNA and protein levels(P<0.05).Western blotting results showed that DHT could upregulate AR protein levels in SUM159PT cells,but FKB could prevent the DHT-induced upregulation of AR protein levels(P<0.05).FKB and ENZA decreased SUM159PT cell proliferation and migration and DHT-mediated cell proliferation and migration(P<0.05).FKB and ENZA can reduce N-cadherin and Vimentin protein levels and counteract DHT-induced increases in N-cadherin and Vimentin protein levels(P<0.05).In addition,FKB may increase Occludin expression and counteract the DHT-induced decrease in Occludin protein expression(P<0.05).Conclusion Flavokawain B could inhibit the proliferation,migration,and clonogenic ability of TNBC cells by regulating AR expression.
9.Anti-inflammatory Effect of 25-OH Vitamin D in Neonatal Infectious Pneumonia by Modulating the TGF-β-mediated YAP/TAZ Nuclear Translocation
Yang LIU ; Yun SHI ; Linping ZHONG ; Gaoyang QIN
Journal of Modern Laboratory Medicine 2024;39(4):28-33,39
Objective To investigate the anti-inflammatory effect of 25-OH vitamin D(25-OH-VD)on neonatal infectious pneumonia(NIP)and its mechanism.Methods A total of 65 children with NIP admitted to Chengdu Women and Children's Central Hospital from January 2022 to January 2023 were selected.According to the severity of the disease,they were divided into mild group(n=34)and severe group(n=31),and 60 healthy neonates in the same period were selected as the control group.Serum 25-OH-VD,interleukin-2(IL-2),interferon-γ(IFN-γ),tumor necrosis factor-α(TNF-α)and IL-1β levels were measured by ELISA.The expressions of vitamin D receptor(VDR),transforming growth factor-β(TGF-β)/nuolea Yes-associated protein(n-YAP)and nuclear transcriptional coactivator PDZ-binding motif(n-TAZ)pathway related proteins in peripheral blood mononuclear cells were detected by Western blot.NIP in vitro models were established by lipopolysaccharide(LPS)stimulation of human lung epithelial cells,which were divided into control group,LPS group and LPS+VD group.Cell viability was detected by CCK-8 assay.The mRNA expressions of recombinant cytochrome P450 27B1(CYP27B1)and VDR in each group were detected by qRT-PCR.The number of YAP positive nuclei in each group was detected by immunocytochemistry.The nuclear translocation of YAP/TAZ complex in each group was detected by immunofluorescence.The expression of inflammatory factor-related proteins in each group was detected by Western blot.Results Compared with the control group,the serum levels of IL-2(1.91±0.18 μ g/L,2.63±0.27 μg/L vs 1.05±0.12 μg/L),IFN-γ(1.73±0.13 μg/L,2.18±0.19 μg/L vs 1.03±0.07 μg/L),TNF-α(1.79±0.08 μg/L,2.38±0.13 μg/L vs 0.97±0.04 μg/L),IL-1 β(2.18±0.07 μg/L,2.59±0.11μg/L vs 0.96±0.02 μg/L),TGF-β(1.67±0.21,2.43±0.42 vs 1.02±0.04),n-YAP(2.08±0.11,4.23±0.37 vs 0.99±0.02)and n-TAZ(2.47±0.42,4.21±0.58 vs 1.03±0.05)proteins of the children in the mild and severe groups were gradually increased,but the content of 25-OH-VD(12.57±2.21 μg/L,7.85±2.03 μg/L vs 16.76±1.02 μg/L)and the expression of VDR(0.73±0.09,0.51±0.06 vs 1.03±0.08)proteins were gradually decreased,and the differences were significant(F=18.983~56.782,all P<0.001).Cell experiment results showed that cellular survival rate was lower at 12 h(76.23%±0.73%vs 116.72%±2.14%),24 h(57.23%±0.94%vs 125.76%±1.67%)and 48 h(41.23%±0.56%vs 138.56%±1.35%)in the LPS group compared with the control group(t=10.342,26.562,37.821),but the rate of cytosolic n-YAP positivity(47.35±3.47 vs 12.46±1.34),the rate of nuclear translocation of the YAP/TAZ complex(2.56%±0.32%vs 1.01%±0.06%)(t=46.362,26.921),the protein expression levels of IL-2(2.03±0.09vs 1.03±0.08),IFN-γ(2.07±0.21 vs 1.02±0.04),TNF-α(2.18±0.11 vs 0.99±0.02)and IL-1β(3.17±0.42 vs 1.03±0.05)were up-regulated(t=28.341,26.713,31.235,47.823),with significant differences(all P<0.001),while there was no significant difference in the mRNA expression of CYP27B1 and VDR(t=0.872,0.786,all P>0.05).Compared with the LPS group,the cell survival rate at 12h(85.23%±0.36%),24h(79.82%±0.63%)and 48h(76.28%±0.72%)and the mRNA expression of CYP27B1(4.42±0.14)and VDR(5.13±0.56)were elevated in the LPS+VD group,while the nucleus n-YAP positivity(24.41±3.23),nuclear translocation of the YAP/TAZ complex(1.47%±0.26%),IL-2(1.21±0.06),IFN-γ(1.13±0.42),TNF-α(1.03±0.37)and IL-1β(1.61±0.58)protein levels were down-regulated,and the differences were significant(t=7.263,19.892,23.145,27.872,26.982,14.762,13.623,18.273,25.314,27.873,22.134,all P<0.0 1).Conclusion The serum 25-OH-VD level is related to the severity of NIP.Exogenous VD supplementation may play an anti-inflammatory role in reducing NIP injury by regulating the TGF-β-mediated YAP/TAZ nuclear translocation mechanism.
10.Risk factors for bronchopulmonary dysplasia in twin preterm infants:a multicenter study
Yu-Wei FAN ; Yi-Jia ZHANG ; He-Mei WEN ; Hong YAN ; Wei SHEN ; Yue-Qin DING ; Yun-Feng LONG ; Zhi-Gang ZHANG ; Gui-Fang LI ; Hong JIANG ; Hong-Ping RAO ; Jian-Wu QIU ; Xian WEI ; Ya-Yu ZHANG ; Ji-Bin ZENG ; Chang-Liang ZHAO ; Wei-Peng XU ; Fan WANG ; Li YUAN ; Xiu-Fang YANG ; Wei LI ; Ni-Yang LIN ; Qian CHEN ; Chang-Shun XIA ; Xin-Qi ZHONG ; Qi-Liang CUI
Chinese Journal of Contemporary Pediatrics 2024;26(6):611-618
Objective To investigate the risk factors for bronchopulmonary dysplasia(BPD)in twin preterm infants with a gestational age of<34 weeks,and to provide a basis for early identification of BPD in twin preterm infants in clinical practice.Methods A retrospective analysis was performed for the twin preterm infants with a gestational age of<34 weeks who were admitted to 22 hospitals nationwide from January 2018 to December 2020.According to their conditions,they were divided into group A(both twins had BPD),group B(only one twin had BPD),and group C(neither twin had BPD).The risk factors for BPD in twin preterm infants were analyzed.Further analysis was conducted on group B to investigate the postnatal risk factors for BPD within twins.Results A total of 904 pairs of twins with a gestational age of<34 weeks were included in this study.The multivariate logistic regression analysis showed that compared with group C,birth weight discordance of>25%between the twins was an independent risk factor for BPD in one of the twins(OR=3.370,95%CI:1.500-7.568,P<0.05),and high gestational age at birth was a protective factor against BPD(P<0.05).The conditional logistic regression analysis of group B showed that small-for-gestational-age(SGA)birth was an independent risk factor for BPD in individual twins(OR=5.017,95%CI:1.040-24.190,P<0.05).Conclusions The development of BPD in twin preterm infants is associated with gestational age,birth weight discordance between the twins,and SGA birth.

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