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Objectives: To identify risk factors associated with early-onset sepsis (EOS) in very preterm infants and develop a nomogram model for predicting the risk of EOS., Methods: A retrospective analysis was conducted on 344 very preterm infants delivered at the First Affiliated Hospital of Zhengzhou University and admitted to the Department of Neonatology between January 2020 and December 2022. These infants were randomly divided into a training set (241 infants) and a validating set (103 infants) in a 7:3 ratio. The training set was further divided into two groups based on the presence or absence of EOS: EOS ( n =64) and non-EOS ( n =177). Multivariate logistic regression analysis was performed to identify risk factors for EOS in the very preterm infants. The nomogram model was developed using R language and validated using the validating set. The discriminative ability, calibration, and clinical utility of the model were assessed using receiver operating characteristic (ROC) curve analysis, calibration curve analysis, and decision curve analysis, respectively., Results: The multivariate logistic regression analysis revealed that gestational age, need for tracheal intubation in the delivery room, meconium-stained amniotic fluid, serum albumin level on the first day of life, and chorioamnionitis were risk factors for EOS in very preterm infants ( P <0.05). The area under the ROC curve for the training set was 0.925 (95% CI : 0.888-0.963), and that for the validating set was 0.796 (95% CI : 0.694-0.898), confirming the model's good discrimination. The Hosmer-Lemeshow goodness-of-fit test suggested that the model was well-fitting ( P =0.621). The calibration curve analysis and decision curve analysis demonstrated that the model had high predictive efficacy and clinical applicability., Conclusions: Gestational age, need for tracheal intubation in the delivery room, meconium-stained amniotic fluid, serum albumin level on the first day of life, and chorioamnionitis are significantly associated with the development of EOS in very preterm infants.The nomogram model for predicting the risk of EOS in very preterm infants, constructed based on these factors, has high predictive efficacy and clinical applicability.

Objectives: To investigate the efficacy of intravitreal anti-vascular endothelial growth factor (anti-VEGF) injection in the treatment of retinopathy of prematurity (ROP) and the risk factors for recurrence., Methods: A retrospective analysis was performed on the medical data of 159 infants with ROP who were born in the First Affiliated Hospital of Zhengzhou University and underwent anti-VEGF treatment from January 2016 to December 2021. According to the presence or absence of recurrence within the follow-up period after initial anti-VEGF treatment, they were divided into a recurrence group with 24 infants and a non-recurrence group with 135 infants. The medical data were compared between the two groups, and a multivariate logistic regression analysis was used to investigate the risk factors for the recurrence of ROP after anti-VEGF treatment., Results: After one-time anti-VEGF treatment, all 159 infants showed regression of plus disease. Recurrence was observed in 24 infants (15.1%) after anti-VEGF treatment, with a mean interval of (8.4±2.6) weeks from treatment to recurrence. The multivariate logistic regression analysis showed that preoperative fundus hemorrhage and prolonged total oxygen supply time were risk factors for the recurrence of ROP ( P <0.05), while gestational hypertension was a protective factor ( P <0.05)., Conclusions: Intravitreal anti-VEGF injection is effective for ROP. Preoperative fundus hemorrhage and long duration of oxygen therapy may increase the risk of ROP recurrence, and further studies are needed to investigate the influence of gestational hypertension on the recurrence of ROP.

Objective: To investigate the prevalence of chronic kidney disease (CKD) among the children with hearing disorder in Hunan province, China., Methods: In this cross-sectional study, the multi-stage cluster sampling method was used to select 1 500 children as subjects. Questionnaire surveys, physical examinations, and laboratory examinations were performed on the spot., Results: Among the 1 500 children, 1 459 with complete data were included in analysis. Among the 1 459 children, 43 had CKD, with a prevalence rate of 2.95%. The <7 years group had a significantly higher prevalence rate than the 7-14 years group [5.8% (35/604) vs 0.9% (8/855); P<0.05]. Among the 43 children with CKD, 31 (72%) had proteinuria, 27 (63%) had hematuria, and 11 (26%) had a decreased glomerular filtration rate. Among the 43 children with CKD, stage 1, 2, 3a, 3b, 4, and 5 CKD accounted for 30% (13 cases), 44% (19 cases), 12% (5 cases), 7% (3 cases), 7% (3 cases), and 0% (0 case) respectively. The prevalence rate of CKD increased with the severity of hearing disorder (P<0.01)., Conclusions: The prevalence rate of CKD is higher among the children with hearing disorder in Hunan province. Most children have early-stage CKD. CKD is commonly seen in preschool children. Severity of hearing disorder is associated with the prevalence of CKD.

Objective: Otoacoustic emissions (OAE) and auditory brainstem responses (ABR) are tests widely used in neonatal hearing screening. This study aimed to investigate the differences and clinical value of distortion product otoacoustic emissions (DPOAE) and ABR in hearing screening of high-risk neonates admitted to a neonatal intensive care unit (NICU)., Methods: DPOAE and ABR were measured with the Smart-OAE analyser and the Smart-EP brain-stem electric response audiometry apparatus, respectively, in 600 high-risk neonates (1,200 ears). The testing results of DPOAE and ABR were compared., Results: Of the 600 neonates (1,200 ears), the incidence of ABR abnormality (78.6%, 943/1,200) was remarkably higher than that of DPOAE abnormality (22.3%, 268/1,200). Two hundred and forty-one ears (20.8%) were negative and 252 (21%) were positive in both DPOAE and ABR tests. A total of 707 ears (58.9%) presented with a discordant result in DPOAE and ABR. The false positive and false negative rates of the DPOAE test were 6.0% (16/268) and 74.1% (691/932) respectively., Conclusions: In high-risk neonates the diagnostic value of DPOAE for identification of hearing loss, when used alone, is limited. The ABR test appears to be more reliable for hearing screening in high-risk neonates. It is suggested that hearing screening for high-risk neonates should be conducted with ABR first, followed by OAE after failure on ABR.

Objective: To investigate the epidemiological characteristics of pathogens and their antimicrobial susceptibility in neonates with lower respiratory tract infection (LRTI)., Methods: Sputum specimens for bacterial cultures were collected from 1173 neonates with LRTL between January 2005 and December 2006. Antibiotic susceptibility tests were performed after bacteria had been identified., Results: A total of 707 pathogenic strains (60.3%) were identified, including 521 (73.7%) Gram-negative bacilli, 106 (15.0%) Gram-positive bacilli, and 80 (11.3%) fungi. E Coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, and enteric bacilli were common cultured Gram-negative bacilli. Most strains of Gram-negative bacilli were susceptible to meropenem, piperacillin/tazobactam, the fourth generation cephalosporin, cebfoperazone/sulbactam and amikacin. Staphylococcus aureus and coagula-negative staphylococci (CNS) were common in the cultured Gram-positive bacilli. Staphylococcus aureus and CNS were susceptible to vancomycin, ciprofloxacin and piperacillin/tazobactam but were resistant to Penicillin., Conclusions: Gram-negative bacilli predominate the pathogens of LRTI in neonates. E Coli, Klebsiella pneumoniae, and Pseudomonas aeruginosa are major pathogens.

Objective: The study was to investigate the effect of different temperatures during hypoxia on brain injury in mice of different ages., Methods: Newborn C57/BL6 mice at 7 days or 21 days of life were subjected to left carotid artery ligation followed by exposure with 10% oxygen. The mice were kept in a incubator with a predetermined, constant temperature, either 34 degrees centigrade (Hypothermia group) or 36 degrees centigrade (Normothermia group). Brain injury was evaluated 7 days after hypoxia-ischemia (HI). Active caspase-3 and apoptosis-inducing factor (AIF) expressions in the brain tissue were detected by immunohistochemistry and Western Blot was used to evaluate the phosphor-Akt (P-Akt) expression in the brain tissue at 24 hrs post-HI., Results: Brain injuries, including the cortex, hippocampus, striatum and thalamus injuries, occurred in the Normothermia group at 7 days post-HI. The brain cortex showed cystic cavitation in the postnatal day (P)7 pups mice and laminar infarct of the brain cortex was observed in P21 mice. In the Hypothermia group, the P7 mice did not present with laminar infarct of the cortex and had lower scores of neuropathological lesions in cortex, hippocampus, striatum and thalamus than P7 mice from the Normothermia group (P < 0.01); the cortex injuries were significantly relieved but the injuries of hippocampus, striatum and thalamus in P21 mice were similar to those from the Normothermia group. Active caspase-3 (7.0 +/- 5.6) and AIF positive cells (3.7 +/- 6.2) in the cortex of P7 mice from the Hypothermia group were significantly lower than those of the Normothermia group (51.5 +/- 23.2 and 31.8 +/- 22.4) at 24 hrs post-HI (P < 0.01). Wetstern Blot showed the P-Akt expression was obviously decreased in the ipsilateral hemisphere to the occlusion compared with that of the contralateral hemisphere after HI in the Normothermia group (P < 0.05), while in the Hypothermia group the P-Akt expression was not significantly different between the two hemispheres., Conclusions: Hypothermia has protective effects against HI insults. The protection was more pronounced for the immature brain than the mature brain.

Objective: p53-induced apoptosis is crucial in the development of hypoxic-ischemia (HI) brain damage and neurodegenerative disorders. Some experimental research has shown that a synthetic inhibitor of p53 can protect neurons against apoptosis. This study aimed to explore the expression of p53 in neonatal mice following HI brain damage and the effect of p53 inhibitor (pifithrin-alpha, PFT-alpha) on brain damage., Methods: HI was induced in 9-day-old mice pups by ligation of left carotid artery and 10% oxygen exposure for 55 minutes. The pups were sacrificed and the brains were taken out at 3, 8, 24, and 72 hrs post-HI. The brains were sectioned and stained with antibody against p53 and microtubule-associated protein 2 (MAP-2). PFT-alpha was injected intraperitoneally: in experiment 1, immediately after HI with different dosages (1, 2 and 8 mg/kg); in experiment 2, 2 mg/kg at different HI times (1 hr before HI, and immediately and 1 hr after HI). Control animals without HI received injections of 0.5% dimethyl sulfoxide. Brain damage was evaluated by gross morphology scoring at 72 hrs after HI., Results: The number of p53 positive cells in the cortex, hippocampus and striatum of the ipsilateral hemisphere increased significantly and peaked at 3-8 hrs post-HI when compared with those of contralateral hemisphere as well as normal controls. The positive cells distributed mainly in the MAP-2 negative area. Both different dosages and different injection time PFT-alpha treatment did not reduce the extent of brain damage., Conclusions: The immunoactivity of p53 increased significantly as early as 3 hrs post-HI. The distribution area of p53 expression was consistent with that of brain damage. The p53 inhibitor PFT-alpha has no protective effects against HI brain damage in neonatal mice.