ObjectiveTo evaluate the efficacy and safety of oropharyngeal administration of colostrum (OAC) in preterm infants.MethodsWe searched Embase, MEDLINE, Cochrane Central Register of Controlled Trials (CENTRAL), Cumulative Index to Nursing and Allied Health Literature (CINAHL), and the website of the clinical trials, search time was from the establishment of the databases or websites up to 1 February 2022. Preterm infants with gestational age (GA) ≤ 32 weeks or birth weight (BW) ≤ 1500 g were taken as the participants, collect randomized controlled trials (RCTs) of comparing OAC and placebo or no intervention in preterm infants. Two researchers independently screened the literature, extracted the data, and evaluated the quality of the literature, and we adopted Review Manager 5.3 software for meta-analysis.ResultsIn total, 11 RCTs (n = 1,173) were included in the review. A meta-analysis showed significant difference in the incidence of necrotizing enterocolitis [NEC; p = 0.009, relative ratio (RR) = 0.51, 95% confidence interval (CI) = 0.31–0.84], late-onset sepsis (LOS; p = 0.02, RR = 0.75, 95% CI = 0.59–0.95), ventilator-associated pneumonia (VAP; p = 0.03, RR = 0.48, 95% CI = 0.24–0.95), the time to reach full enteral feeds (p < 0.00001, mean difference (MD) = −3.40, 95% CI = −3.87 to −2.92), duration of hospital stay (p < 0.00001, MD = −10.00, 95% CI = −11.36 to −8.64), and the rate of weight gain (kg.d; p < 0.00001, MD = 2.63, 95% CI = 2.10–3.16) between the colostrum group and control group. Meanwhile, researchers found no significant difference between the colostrum group and control group in the incidence of bronchopulmonary dysplasia (BPD; p = 0.17, RR = 0.83, 95% CI = 0.64–1.08), intraventricular hemorrhage (IVH; grade ≥3; p = 0.05, RR = 0.44, 95% CI = 0.19–1.01), periventricular leukomalacia (PVL; p = 0.67, RR = 0.70, 95% CI = 0.14–3.49), retinopathy of prematurity (ROP; p = 0.29, RR = 1.25, 95% CI = 0.82–1.89), and patent ductus arteriosus (PDA; p = 0.17, RR = 1.22, 95% CI = 0.92–1.62).ConclusionOropharyngeal administration of colostrum can reduce the incidence of NEC, LOS, and VAP in preterm infants, shortening the time to reach full enteral feeds, and duration of hospital stay, and increasing the rate of weight gain (kg.d). Therefore, OAC can be used as part of routine care for preterm infants.
High-viscosity linear polysiloxane-based magnetorheological fluid features its excellent suspension stability. Few reports could be found for magnetorheological energy absorbers using such highly viscous but highly stable magnetorheological fluids as the controlled medium. This study presents a design strategy for the high-viscosity linear polysiloxane-based magnetorheological fluid-based magnetorheological energy absorber with multi-stage radial flow mode. The design strategy is based on the Herschel-Bulkley flow model incorporating minor losses proposed in our prior work. The optimal geometrical parameters were obtained by gradually reducing the number of unknown variables. By analyzing the effect of thicknesses of baffle and outer cylinder and number of coil turns on magnetic circuit, the distribution of magnetic flux in the effective region of magnetorheological valve was optimized. Furthermore, a magnetorheological energy absorber was fabricated and tested using a high-speed drop tower facility with a 600 kg mass. The maximum nominal impact velocity was 4.2 m/s, and the applied current varied discretely from 0, 1, 2, to 3 A. Comparison of our Herschel-Bulkley flow model with measured data was conducted via analysis of peak force, dynamic range, and maximum displacement that indicate the performance of magnetorheological energy absorber. The results validated the effectiveness of the design strategy for the high-viscosity linear polysiloxane-based magnetorheological fluid-based magnetorheological energy absorber.
Hypoxemia and hypercarbia resulting from a lack of surfactant is considered to be the primary mechanism underlying neonatal respiratory distress syndrome (NRDS). Surfactant replacement therapy may mitigate the symptoms of the disease by decreasing the surface tension of alveoli and facilitating inflation. However, surfactant serves an additional role in immunological processes. Therefore, it may be hypothesized that mechanisms of NRDS involving surfactant exert additional functions to promoting alveolar inflation. Using peripheral blood obtained from mature infants with and without NRDS, in tandem with mRNA sequencing (mRNA-seq) analysis, the present study identified that, while cell cycle regulation and alveolar surfactants serve a role in deterring the further onset of NRDS, innate and pathogen-induced responses of the immune system are among the most important factors in the pathology. The present study illustrated the regulatory importance of these immune pathways in response to alterations in the expression of gene families, particularly in perpetual lung injury leading to NRDS. Notably, data collected from the mRNA-seq analysis revealed similar mechanisms between NRDS and acute respiratory distress syndrome, a clinical phenotype precipitated by the manifestation of a severe form of lung injury due to numerous lung insults, implying that similar therapies may be applied to treat these two diseases.
Aim: To study the relationship between rs1059057 polymorphism of pulmonary surfactant protein A1 (SP-A1) and respiratory distress syndrome (RDS) in Mongolian very premature infants.Methods: Applying the strategy of case-control study, 120 Mongolian RDS very premature infants (58 males and 62 females) in the western part of Inner Mongolia were selected as the case group, and 120 subjects of non-RDS very premature infants (56 males and 64 females) with the same nationality, same sex and similar gestational age were used as the control group. The single nucleotide polymorphism (SNP) site rs1059057 of SP-A1 was genotyped using polymerase chain reaction-single strand conformational polymorphism (PCR-SSCP).Results: Two genotypes, A/G and A/A, were detected at the SP-A1 rs1059057 locus in the western part of Inner Mongolia. In the case group, the frequencies of two genotypes were 53 and 47%, and the frequencies of A allele and G allele were 73 and 27%, respectively. In the control group, the frequencies of the two genotypes were 42 and 58%, and the frequencies of A allele and G allele were 79 and 21%, respectively. There was no significant difference in the genotype frequency of SP-A1 (rs1059057) locus between the case group and the control group (X 2 = 3.275, P > 0.05), and no significant difference in allele frequency between the case group and the control group (X 2 = 2.255, P > 0.05). Conclusion:The genotypes and allele frequencies of SP-A1 (rs1059057) locus were not associated with the incidence of RDS in Mongolian very premature infants in western Inner Mongolia.
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