Meihong Gu

Background: Neonatal hypoglycemia is more prevalent and can cause severe neurological sequelae. The objective of this study was to assess the patterns of neuroradiologic changes in neonatal hypoglycemia. Methods: A retrospective cohort study was conducted on 66 neonatal hypoglycemia patients, and the magnetic resonance imaging (MRI) and clinical records were reviewed. Results: Magnetic resonance imaging showed evidences of abnormality in 54.54% (36 of 66) of hypoglycemic infants. The most common abnormal findings were located on the parietal and occipital lobes of the brains. The number of days with hypoglycemia was significantly higher for abnormal MRI infants ( P < .001), and prolonged/recurrent hypoglycemia was remarkably distinguished for abnormal MRI infants ( P < .001). Patients with abnormal MRI findings did not have a lower blood glucose than infants without abnormal MRI findings ( P > .05), but the lowest blood glucose was significantly lower for the patients with seizures ( P < .01). Conclusions: The pattern of bilateral occipital cortical injury is the most common abnormality for neonatal hypoglycemia. The number of days with hypoglycemia, not the lower blood glucose, was significantly related to abnormal MRI infants.

OBJECTIVE: To determine the risk factors and outcomes of retinopathy of prematurity (ROP) in infants with a birth weight of 1,501-2,000 g. MATERIALS AND METHODS: Clinical characteristics and risk factors were compared and nonconditional logistic regression analysis was performed to determine independent predictors for ROP. RESULTS: There were 54 (9.8%) cases of ROP in 553 patients with a birth weight of 1,501-2,000 g. The most common classification of ROP was in stage 1 (50/54, 92.6%; stages 2 and 3 ROP: 2 infants each). By logistic regression analysis, the following factors independently predicted ROP: gestational age at birth ≤ 34 weeks [odds ratio (OR): 9.01; 95% confidence interval (CI): 1.18-68.70], septicemia (OR: 2.88; 95% CI: 1.30-6.36) and perinatal asphyxia (OR: 5.74; 95% CI: 2.35-14.01). CONCLUSION: ROP occurred commonly among infants with a birth weight of 1,501-2,000 g. The risk factors were gestational age at birth ≤ 34 weeks, septicemia and perinatal asphyxia.

OBJECTIVE: To investigate the factors involved in the development of retinopathy of prematurity (ROP), and to provide the preliminary data for the evaluation of current criteria for ROP screening. METHOD: Premature infants with birth body weight (BBW) ≤ 2000 g or gestational age (GA) ≤ 34 weeks in the two hospitals in Zhejiang between March 2005 and November 2008 were recruited and examined by indirect ophthalmoscopy. The records were analyzed. RESULT: One thousand two hundred and twenty-five premature infants were included. Of them, 713 were male and 512 female. There were 179 twins and 21 triplets in the premature infants. The incidence of ROP was 10.8% (132 in 1225 patients). There were 12 cases (0.98%) to the point of pre threshold ROP. 4 cases (0.3%) developed threshold ROP. Only one case developed pre threshold ROP of low risk among 65 cases without history of oxygen treatment (1.5%). The percentage has significant difference compared to that of cases with history of oxygen (χ(2) = 5.115, P < 0.01).Between ROP and Non-ROP groups, there was significant difference in BBW(F = 26.39, P < 0.001), gestational age (F = 19.73, P < 0.001), but there was no significant difference in sex (χ(2) = 0.279, P > 0.05) or twins and triplets (χ(2) = 3.449, P > 0.05). The incidence of ROP among premature infants with BBW ≤ 1000 g was more than three times of that with BBW > 1000 g, and the incidence of ROP among premature infants with GA ≤ 28 weeks was about 2.5 times of that with GA > 28 weeks. Logistic regression analysis indicated that less BBW or shorter GA or undulation of blood oxygen concentration was a significant risk factor involved in the development of ROP (r = 0.57, P < 0.05). All ROP patients were cured. CONCLUSION: Less BBW, shorter GA and undulation of blood oxygen concentration are the important risk factors for the development of ROP. Premature infants with BBW ≤ 1000 g or GA ≤ 28 weeks, who had oxygen history, should be given very special attention in the ROP screening. The current criteria for ROP screening should be narrowed. In general, the ROP screening has lowered the incidence of blindness among children by investigating and treating ROP timely.

Nonalcoholic fatty liver disease (NAFLD) is closely related to metabolic syndrome (MetS). Bone morphogenetic protein 9 (BMP9) is an essential factor in glucose, lipid and energy metabolism. This study aims to investigate whether BMP9 can serve as a serological marker for the severity of NAFLD or MetS. Blood samples, clinical data and FibroTouch test were collected from consecutively recruited 263 individuals in Shanghai East hospital. All the participants were divided into three groups: the healthy controls, nonalcoholic fatty liver (NAFL) group and nonalcoholic steatohepatitis (NASH) at-risk group according to the results of FibroTouch test and liver function. Serum BMP9 levels were measured by enzyme-linked immunosorbent assay. Serum BMP9 levels were positively correlated with transaminase, triglyceride, fasting plasma glucose, glycated hemoglobin (HbA1c) and uric acid while it showed a downward trend as the increasing number of MetS components. Furthermore, it differentiated NASH at-risk (58.13 ± 2.82 ng/L) from the other groups: healthy control (70.32 ± 3.70 ng/L) and NAFL (64.34 ± 4.76 ng/L) (p < 0.0001). Controlled attenuation parameter of liver fat and liver stiffness measurement were negatively correlated with BMP9 levels, while high-density lipoprotein levels were positively correlated. The risk of developing NAFLD increased along with elevated serum BMP9 and BMI, and a significantly higher risk was observed in men compared to women. BMP9 should be considered a protective factor for the onset and development of NAFLD, as well as a promising biomarker for the severity of the NAFLD and MetS.

AIM: To evaluate the effect of reducing the use of antibiotics in the treatment of infant bacterial dacryocystitis after probing of the lacrimal duct. METHODS: A total of 542 cases of children under one year old and accepting nasolacrimal duct probing treatment were divided into two groups, which were treated with topical and oral antibiotics, respectively. Conjunctival sac secretions were used as a control index of bacterial infection, whereas the disappearance of epiphora symptoms and lacrimal passage patency were used as cure indexes. The χ (2) test was used to compare enumeration and measurement data, and a statistical significance was set at P<0.05. The therapeutic effect on the two groups of postoperative patients was investigated. RESULTS: In the two study groups, no significant differences in gender, age and postoperative control of lacrimal sac infection were observed. The cure rates after three probing operations also showed no significant difference. CONCLUSION: After probing of the lacrimal passage, results of this study confirmed that postoperative medication without oral antibiotics but an ophthalmic dosage of antibiotics was a simple and effective treatment method.