Objective To systematically review the effect of adjustable fortification on feeding during preterm hospitalization. Methods We searched Cochrane Library, Web of Science, PubMed, China National Knowledge Infrastructure, Wanfang, Chongqing VIP for clinical controlled trials about adjustable fortification in premature infants. The retrieval time limit was from the establishment of each database to September 2022. We selected studies according to inclusion and exclusion criteria, extracted data and assessed their quality, then used RevMan5.3 for analysis. Results A total of 5 randomized controlled studies, 1 historical controlled study and 3 case-control studies were included, including 750 premature infants. Meta-analysis results showed that compared with the standard fortification group, the differences of body weight growth rate [mean difference (MD)=1.61 g/(kg·d), 95% confidence interval (CI) (0.73, 2.49) g/(kg·d), P=0.0003], body length growth rate [MD=0.15 cm/week, 95%CI (0.01, 0.29) cm/week, P=0.04], head circumference growth rate [MD=0.19 cm/week, 95%CI (0.06, 0.31) cm/week, P=0.003], incidence rate of necrotizing enterocolitis [relative risk (RR)=0.23, 95%CI (0.07, 0.75), P=0.01] were statistically significant in the adjustable fortification group. There was no significant difference in the incidence of feeding intolerance between the two groups [RR=0.58, 95%CI (0.31, 1.11), P=0.10]. Conclusion Adjusted fortification has a positive role in promoting the physical development of premature infants without increasing the incidence of feeding intolerance and necrotizing enterocolitis. When the growth of premature infants is poor after using standard fortification, adjustable fortification can be considered. However, due to the lack of included literature, more large sample, high-quality randomized controlled studies are needed in the future to further verify the feeding effect of adjustable fortification on premature infants.
ObjectiveTo investigate whether transplantation of islet cells combined with bone marrow mesenchymal stem cell (BMSCs) of the pancreatic subcapsular promoting revascularization of pancreatic islets in rats, so as to reduce the loss of islet cells after transplantation and improve the success rate of islet cell transplantation. MethodsThe model of diabetic rat was established. The BMSCs and islet cells were cultured and identified, then the simple islet cells, simple BMSCs, and combination of islet cells and BMSCs were injected into the pancreatic subcapsular of the islet cell group, BMSCs group, and combination group, respectively. In addition, the same amount of normal saline was injected into the same site as the control group. There were 10 rats in each group. The changes of blood glucose and serum insulin in different time point were detected in each group. The mRNA expressions of angiogenesis factors such as hypoxia inducible factor-1α (HIF-1α), stromal cell derived factor 1α (SDF1α), vascular endothelial growth factor (VEGF), and basic fibroblast growth factor 2 (FGF2) were determined by real-time quantitative PCR. Results① The blood glucose levels of the islet cell group and combination group were lower than those of the control group and the BMSCs group within 15 d after surgery (P<0.05) and decreased to the normal level, which of the combination group could still maintain the normal level until on day 29 (P<0.05), but which of the islet cell group began to increase on day 15 after surgery and was similar to that in the BMSCs group (P>0.05). ② Compared with the control group and the BMSCs group, the insulin levels were higher in the islet cell group and combination group on day 1, 3, 7, 15, and 29 after surgery (P<0.05), especially in the combination group. ③ The expression levels of HIF-1α, SDF1α, VEGF, and FGF2 mRNAs in the combination group were higher than those the other three groups, and the differences were statistically significant (P<0.05). ConclusionsIslet cell transplantation of pancreatic subcapsular could decrease blood glucose level in diabetic rats. Hypoglycemic effect of single islet cell transplantation gradually weakens on day 15 d after surgery. After BMSCs combined with islet cells transplantation, the glycemic effect of rat is stable for a longer time. Expressions of angiogenesis factors of BMSCs combined with islet cells transplantation rat are high, which combined with pathological sections suggests that BMSCs could promote vascular recanalization of islet transplantation.