A Clinical Epidemiological Investigation Of Respiratory Distress Syndrome In Premature Infants From 14 Hospitals In China And Protective Effect Of Ulinastatin Against Newborn Rat Models Of Hyperoxia-induced Lung Injury

OBJECTIVES.To investigate the morbidity,mortality,characteristics of the complications,high r-isk factors and the effects of antenatal corticosteroids on the morbidity and prognosis of respiratory distress syndrome in inborn preterm neonates.METHODS.Data were collected from 2013 to 2014 for premature with gestational age of<37 and>24 weeks born in Obstetric.The general conditions,perinatal factors,characteristics of the complications and death rates were analysis retrospectively.The morbidity,mortality,characteristics of the complications,high risk factors,effect of antenatal corticosteroids were analysis retrospectively.RESULTS.There were 6017 cases(9.7%)of preterm neonates in 2013 and 7684 cases(10.2%)of preterm neonates in 2014.Of these preterm neonates,16.1%were classified as RDS in 2013 whereas 15.3%in 2014.Morbidities of RDS in premature infants decreased with increasing GA both in 2013 and 2014.The mortality of preterm neonates with RDS was 6.4%in 2013 and 10.5%in 2014,which was higher than those without RDS.Similarly to the trend with GA,morbidities of RDS decreased with the increasing of BW.There were 4409(73.3%)and 6604(85.9%)premature infants hospitalized in 2013 and 2014.The incidence of main complications in preterm neonates with RDS were higher than those without RDS.Logistic regressions showed that male,GA<33 weeks,BW<2500 grams,body length<40cm,neonatal asphyxia were risk factors for RDS.In preterm neonates with GA<33 weeks,male,GA<28 weeks,body length<40cm,neonatal asphyxia were risk factors for RDS.Prenatal dexamethasone was protection factor for RDS.In preterm neonates with GA>33 weeks,neonatal asphyxia,cesarean delivery,placenta previa were risk factors for RDS.2606(43.3%)cases in 2013 and 2879(37.5%)cases in 2014 underwent antenatal dexamethasone therapy.For neonates with GA<33 weeks,the incidence of RDS and severe RDS,the proportion of patients received>2 doses of surfactant were lower in antenatal corticosteroids group compared with non-antenatal corticosteroids group.For preterm neonates with GA>33 weeks,the incidence of RDS were higher in antenatal corticosteroids group compared with non-antenatal corticosteroids group.CONCLUSIONS.The incidence of preterm neonates in China was similar to previous reports in 2013 and 2014.The survival rate in preterm neonates,extreme prematurity and severe/moderate prematurity improved obviously than ever before.The mortality and morbidity of complications of preterm neonates with RDS was higher than those without RDS.Most of the high risk factors of RDS in preterm neonates with GA<33 weeks were related to their immature lung development.Prenatal dexamethasone can effectively reduce the incidence of RDS and improve the prognosis.For preterm neonates with GA>33 weeks,the high risk factors of RDS tended to be related to perinatal factors,the protective effect of dexamethasone was not obviously.Objective In the present study,UTI was administrated to newborn rats and its effect against hyperoxia-induced lung injury was examined.Methods The pups were randomly divided into five groups within 24 hours of birth,hyperoxia(Hyp);hyperoixa plus low-dose UTI(Hyp+UTI-L);hyperoixa plus middle-dose UTI(Hyp+UTI-M);hyperoixa plus high-dose UTI(Hyp+UTI-H,);Normoxia control(Nor,n = 9).10,000 U/kg,50,000 U/kg and 100,000 U/kg of UTI was injected through intraperitoneal every day to Hyp+UTI-L,Hyp+UTI-M and Hyp+UTI-H,respectively,from the 21th day after birth.Pups in Hyp group were administration with the same volume of solvent from the 21th day after birth.Weights of rats were recorded every other day.Lung W/D ratio was calculated,Hematoxylin and eosin staining was conducted for pathological studies,the protein levels of SOD and MDA were assessed using Western blot analysis.Results The results showed that UTI treatment improved obviously the average weight of rats,attenuated the W/D weight ratio,down-regulated the levels of TNF-a and inhibited macrophage infiltration,and dramatically changes were observed in high dose of UTI treatment group.But UTI treatment had no significant effect on the levels of pulmonary SOD and MDA levels.Conclusions These data indicate that UTI may be a potential therapy in the prevention of hyperoxia-induced lung injury in infants.These effects were mediated mainly by its anti-inflammatory properties.