Background. Cholestasis is a common but serious clinical condition in preterm neonates. The current management for preterm neonatal cholestasis has limitations. The aim of this study was to determine effects of Bifidobacterium supplementation on the prevention and alleviation of cholestasis in preterm infants with very low birth weight. Methods. Preterm neonates with very low birth weight were enrolled in the Children’s Hospital of Soochow University between December 2012 and December 2017. The patients were randomly assigned into Bifidobacterium and control groups, and effects of Bifidobacterium supplementation on the outcomes were compared between the two groups. Results. There was no significant difference in the baseline characteristics in the two groups. Notably, the proportion of cases with neonatal cholestasis was significantly lower, with fewer neonatal cholestasis-associated complications in the Bifidobacterium group compared with the control group (6% versus 22%, P<0.01). Furthermore, the Bifidobacterium group exhibited less severe cholestasis and better improvement of the liver function than the control group as evidenced by the biochemical tests (P<0.05). Finally, comparison of the other outcomes revealed that significant shorter duration of hospitalization (14.45±2.13 versus 16.12±2.22 days, P<0.01), fewer days to reach the full enteral feeding (9.2±2.11 versus 12±5.67 days, P<0.01), shorter duration of meconium passage (5.0±3.6 versus 6.6±3.38 days, P<0.05), lower proportion of cases on fasting and duration of fasting (0.8% versus 5.6%, P<0.05 and 3.0±1.6 versus 5.6±2.38 days, P<0.01, respectively), and shorter duration of weight gain to normal (4.77±2.49 versus 6.87±2.71 days, P<0.01) in the Bifidobacterium group versus the control group. Conclusions. Bifidobacterium supplementation has significantly preventive and other beneficial effects on the management of cholestasis in preterm infants with very low birth weight. Its long-term safety and effectiveness will need further investigation. This trial is registered with the Chinese Clinical Trial Registry (Registration No. ChiCTR1900022296).

ObjectiveWe aimed to use molecular biomarkers and clinical data and echocardiograms that were collected during admission to predict bronchopulmonary dysplasia (BPD) in preterm infants with gestational age ≤32 weeks.MethodsEighty-two patients (40 with BPD, BPD group and 42 healthy as controls, non-BPD group) admitted to the Department of Neonatology of the Children's Hospital of Soochow University between October 1, 2018, and February 29, 2020, were enrolled in this study at the tertiary hospital. Basic clinical data on the perinatal period, echocardiographic measurements, and molecular biomarkers (N-terminal-pro-B-brain natriuretic peptide, NT-proBNP) were collected. We used multiple logistic regression analysis to establish an early predictive model for detecting BPD development in preterm infants of gestational age ≤32 weeks. We also used a receiver operating characteristic curve to assess the sensitivity and specificity of the model.ResultsNo significant differences were found between the BPD and non-BPD groups in terms of sex, birth weight, gestational age, incidence of asphyxia, maternal age, gravidity, parity, mode of delivery, premature rupture of membranes &gt;18 h, use of prenatal hormones, placental abruption, gestational diabetes mellitus, amniotic fluid contamination, prenatal infections, and maternal diseases. The use of caffeine, albumin, gamma globulin; ventilation; days of FiO2 ≥ 40%; oxygen inhalation time; red blood cell suspension infusion volume (ml/kg); and proportion of infants who received total enteral nutrition (120 kcal/kg.d) ≥24 d after birth were higher in the BPD group than in the non-BPD group. The levels of hemoglobin, hematocrit, and albumin in the BPD group were significantly lower than those in the non-BPD group. The total calorie intake was significantly lower in the BPD group on the 3rd, 7th, and 14th day after birth than in the non-BPD group (P &lt; 0.05). The incidence rates of patent ductus arteriosus (PDA), pulmonary hypertension, and tricuspid regurgitation were significantly higher in the BPD group than in the non-BPD group (P &lt; 0.05). The serum level of NT-proBNP 24 h after birth was significantly higher in the BPD group than in the non-BPD group (P &lt; 0.05). Serum NT-proBNP levels were significantly higher in infants with severe BPD than in those with mild or moderate BPD (P &lt; 0.05).ConclusionAs there were various risk factors for BPD, a combining clinical data, molecular biomarkers, and echocardiogram measurements can be valuable in predicting the BPD. The tricuspid regurgitation flow rate (m/s), NT-proBNP (pg/ml), ventilator-associated pneumonia, days of FiO2 ≥ 40% (d), red blood cell suspension infusion volume (ml/kg), and proportion of infants who received total enteral nutrition (120 kcal/kg.d) ≥24 d after birth were the most practical factors considered for designing an appropriate model for predicting the risk of BPD.

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Background: Genetic characteristics of CYP2J2 in different populations may be helpful to explore inter-ethnic variability in drug response and disease susceptibility. There is no information about the genetic profile of CYP2J2 in the Chinese Uygur population.Methods: We used PCR and direct sequencing to investigate the whole CYP2J2 in 100 unrelated healthy individuals of Chinese Uygur populations. Chi-square test was used to compare genotyping data of CYP2J2 in the Chinese Uygur population with other races. The SIFT and PolyPhen-2 online tools were used to predict the protein function of the novel non-synonymous mutations in CYP2J2. The CADD software was used to predict pathogenicity for mutations.Results: We detected twenty-eight polymorphisms in the CYP2J2, including five new mutations, three alleles (*1, *7 and *8), and three genotypes (*1/*1, *1/*7 and *1/*8) of CYP2J2 in Chinese Uyghur population. The allele frequencies of CYP2E1*1, *7 and *8 were 96%, 3.45%, and 0.5%, respectively. Interethnic comparison found that *1 was significantly higher than Taiwanese and African-Americans; and*7 was relatively lower when compared with Taiwanese and African-Americans (p < 0.05). Furthermore, the protein prediction results revealed that the five non-synonymous mutations could influence the protein structure and function.Conclusion: The observations of this study give rise to useful information on CYP2J2 polymorphisms in Chinese Uygur individuals. We hope the results will indicate important clinical implications for the use of medications metabolized by CYP2J2.