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Copyright of Chinese Journal of Contemporary Pediatrics is the property of Xiangya Medical Periodical Press and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective To explore the risk factors of postoperative Hirschsprung-associated enterocolitis (HAEC) within 1 year. Methods From January 2011 to June 2021, the relevant clinical data were retrospectively reviewed for 313 children with Hirschsprung's disease (HSCR). They were assigned into two groups of postoperative HAEC (n=47) and no postoperative HAEC (n = 266). The risk factors of postoperative HAEC included patient gender, age of radical operation, microcytic hypochromic anemia, preoperative HAEC history, preoperative colostomy, pathological classification and hypoalbuminemia. Results Patient gender or age of radical operation showed no difference of statistical significance (P>0.05). And microcytic hypochromic anemia [(59.6%,28/47) υς. (35.3%, 94/266)], preoperative HAEC [(44.7%,21/47) vs. (22.6%,60/266)], preoperative colostomy [(23.4%,11/47) vs. (10.2%,27/266)], long segment or total colonic HSCR [(34.0%, 16/47) vs. (16.9%,45/266)] and hypoalbuminemia [(80.9%,38/47) vs. (66.2%, 176/266)] revealed statistically significant differences (P<0.05). Multiple Logistic regression analysis indicated that microcytic hypochromic anemia (OR=2.522,95% CI:1.301-4.887) and preoperative HAEC(OR=2.812,95% CI:1.415-5.589) were correlated with postoperative HAEC. Conclusions Complication of microcytic hypochromic anemia and preoperative HAEC are the risk factors of postoperative HAEC. Focusing upon the risk factors of postoperative HAEC can effectively lower the most serious complications of HSCR after radical operation and improve the quality-of-life of children. [ABSTRACT FROM AUTHOR]

Objective To explore the clinical characteristics of multiple-birth preterm infants with necrotizing enterocolitis (NEC) and examine the effects of multiple births on clinical manifestations and outcomes of NEC infants. Methods In this retrospective study, 234 premature infants with NEC admitted to Shanghai Children's Hospital from July 2014 to June 2021 were included as research objects, among which 79 were multiple premature infants with NEC and 155 were single premature infants with NEC, According to the presence of single/multiple birth, they were divided into two groups of singleton (group A, n = 155) and multiple-birth (group B, n = 79). Twin group of vaginal delivery was divided into primary birth (group C, n = 9 and secondary birth (group D, n = 4) based upon birth order. Twin group was also assigned into two groups of higher birth weight (group E, n = 20) and lower birth weight (group F n = 45. And twin group was divided into two groups of concordant twins (CT, group G, n = 42 and discordant twins (DT, group H, n = 26). The latter group was further divided into DT with higher birth weight (group l, n = 5 and DT with lower birth weight (group J,n= 21). Demographic profiles (birth weight, gestational age & birth mode), clinical data (time of NEC onset, laboratory results & Bell stage), treatment (medical or surgical, intestinal perforation & extent of disease) and outcomes (postoperative complications & in-hospital mortality) were recorded. Results Seventy-nine cases of multiple preterm NEC infants were recruited, including 75 twins and 4 triplets. Seventy-five preterm NEC twins had a mean gestational age of 31. 60 weeks and a mean birth weight of 1 476.51 gram. Bell stage was 1 (n= 35), II (n = 21) and III n = 19 Eighteen cases (24%) underwent operation. As compared with group A, NEC infants in group B had a lower birth weight [1618.77 ± 481.30) g. (1 479.34 ±376.88) g, P = 0.016], higher rates of cesarean delivery [84(54.2%) vs. 65 (82.3%), P < 0.001 ] and assisted reproductive technology [11(7.1%) vs. 21 (26.6%) P < 0.001 ]. However, no differences existed in demographic profiles, clinical manifestations, laboratory results, Bell stage, surgery or outcomes (P > 0.05). There was no significant effect of birth order on demographic profiles, clinical manifestations, laboratory results, Bell stage, surgery or outcomes (P > 0.05) As compared with group E, group F had a lower birth weight [(1677.65 ±458.23) gus. (1382.89±300.81) g,P=0.019], lower WBC count [(12.31 ±4.22) ts. (9.13 plus/minus 4.01) * 109/L P = 0.023], greater intestinal lesion [5(45.4%) ts.0(0.0%), P = 0.002 ] and more postoperative complications [11(100%) 18. 3 (42.9%), P = 0.011 ] No difference existed in demographic profiles, clinical manifestations, other laboratory results, Bell stage, surgery or in-hospital mortality (P > 0.05). As compared with group G, group J had a greater gestational age [(30.95±2.44), (32.71 ±2.30) week, P = 0.027 ] and a higher rate of cesarean delivery [30 (71.4%) ts. 20 (95.2%) P = 0.045) rfloor. However, no differences existed in demographic profiles, clinical manifestations, laboratory results, Bell stage, surgery or outcomes (P > 0.05) Conclusions Multiple-birth NEC infants have no greater severity of Bell stage, more surgery, greater extent of intestinal lesion, more postoperative complications or higher in-hospital mortality. Twins with lower birth weight are prone to greater extent of intestinal lesion and more postoperative complications. However, birth order and discordance of twins have no significant effect on disease severity, surgery or in-hospital mortality. [ABSTRACT FROM AUTHOR]

Objective To investigate the mechanism of autoinducer-2(AI-2) in relieving intestinal injury in neonatal mouse model of necrotizing enterocolitis (NEC). Methods Thirty-six 7-day-old C57BL/6J mice were randomly divided into Control group (fed by mother mice), NEC group (NEC model induced by formula+lipopolysaccharide administration, hypoxia and cold stress), and NEC+AI-2 group (AI-2 solution added to the modeled formula milk), with 12 mice in each group.The body weight and survival rate of each group were recorded during the modeling period.In 3 d after modeling, the mice were euthanized, and the histopathological changes in the terminal ileum were observed using HE staining.The mRNA expression levels of aryl hydrocarbon receptor (AHR), cytochrome P450 1A1(CYP1A1), TNF-α, IL-6 and IL-22 in intestinal tissue were detected with RT-qPCR.The protein levels of AHR and CYP1A1 in intestinal tissues were measured with Western blotting.The contents of TNF-α, IL-6 and IL-22 in intestinal tissues were detected using enzyme-linked immunosorbent assay (ELISA). Results The survival rate of neonatal rats was significantly higher in the NEC+AI-2 group than the NEC group (91.7%vs 66.7%, P < 0.05).The NEC+AI-2 group had obviously lower intestinal pathological injury score (1.33±0.21 vs 2.67±0.33, P < 0.05), increased mRNA and protein levels of AHR and CYP1A1 in intestinal tissues (P < 0.05), decreased expression levels of pro-inflammatory factors TNF-α and IL-6 in intestinal tissues (P < 0.05), while increased expression level of anti-inflammatory factor IL-22(P < 0.05) when compared with the NEC group.Furthermore, the expression and activation of intestinal AHR were negatively correlated with the intestinal pathological injury score (P < 0.001). Conclusion AI-2 alleviates intestinal injury in neonatal mice with NEC by activating AHR to regulate inflammatory response.

Objective To explore the current status and hotpots of neonatal necrotizing enterocolitis (NEC) at home and abroad through bibliometric analysis. Methods The Chinese and English literature items were retrieved from the journal databases of China National Knowledge Infrastructure (CNKI), PubMed, Wan- fang and Web of Science (WOS). The retrieval period started from January 1, 1990 to June 20, 2023. Statistical analyses and comparisons were performed in terms of time distribution, journal distribution, country distribution and keyword of the included literature. Microsoft Excel and VOS viewer were utilized for integrating search re- sults. Results A total of 12 078 literature items related to NEC were included, including 1 060 Chinese and 11 018 English literature items. Among the English literature items, the United States had published the most literature; Chinese Journal of Pediatric Surgery and Pediatric Research were the journals with the highest num- ber of articles published in NEC journals at home and abroad respectively. In Chinese literature, the frequently appearing keywords were divided into three groups of "necrotizing enterocolitis" "risk factors" and "diagnosis and treatment". In English literature, the frequently appearing keywords were divided into four groups of "necro- tizing enterocolitis", "diagnosis", "neonatal outcome" and "treatment". Domestic and foreign research hotpots were generally consistent. Citation analysis indicated that, in recent 5 years, domestic and foreign researches fo- cused upon three aspects: "clinical value of laboratory parameters in NEC", "etiology of NEC" and "epidemiol- ogy and pathophysiology of NEC". Conclusions With some development prospect, NEC researches have at- tracted widespread attention both at home and abroad, and is a clinical difficulty and resarch hotpot. Chinese scholas should carry ont in-depth research to further improve the quality of NEC research in China. [ABSTRACT FROM AUTHOR]

Objective To summarize the clinical features of intestinal stricture after conservative measures for neonatal necrotizing enterocolitis (NEC) and compare the outcomes of single and multiple stricture groups. Methods From January 2014 to December 2020, retrospective review was performed for the relevant clinical data of 67 neonates operated for post-NEC intestinal strictures. Basic information, NEC onset time, Bell stage, radiographic studies, surgical approach postoperative complications were recorded. Then they were assigned into two groups of single stricture and multiple strictures and the prognosis between two groups were compared. Results Positive rate of preoperative contrast enema was 83.9%.Primary end-to-end anastomosis (n=60) and enterostomy (n=7) were performed at a median of 39 days after NEC with a median weight of 2.53 kg. Multiple strictures were detected in 33 neonates (49.3%) while the remainders had only 1 stricture. There were a total of 123 strictures. Except for 1 stricture spanning small intestine and colon (from terminal ileum to sigmoid colon), 65 strictures were present in small intestine, including terminal ileum (n=37) and colon (n=57)(ascending colon, n=27). Two cases underwent enterostomy later due to disease deterioration and 1 died at Month 2 after discharge. Another child accepted enterostomal closure 12 months later. Complications included intestinal prolapse (n=2) and adhesive intestinal obstruction (n=4). The long-term survival rate of intestinal strictures after conservative measures was 95.5%(64/67). Length of bowel resection (P < 0.001) and operative duration (P=0.008) were significantly longer in multiple-stricture group than those in single-stricture group. However, no significant inter-group difference existed in time to complete enteral feeding (P=0.862) or postoperative complications (P=0.347). Conclusions Despite a low incidence of intestinal strictures after conservative measures for NEC, multiple strictures account for a large proportion. The strictures occur predominantly in terminal ileum and colon. Contrast enema is valuable for preoperative examination. All intestinal segments should be carefully explored intraoperatively. And multiple strictures have no effect upon postoperative recovery and outcomes. [ABSTRACT FROM AUTHOR]

Objective To study the predictive value of hemoglobin (Hb) decrease for the occurrence of necrotizing enterocolitis (NEC) in preterm infants with late-onset sepsis (LOS) . Methods Clinical data of 93 LOS preterm infants were collected for retrospective analysis, among which 16 infants developed NEC while 77 infants did not. Based on the decrease in Hb levels from the most recent Hb measurement before LOS occurrence to the initial Hb levels during LOS, the infants were divided into three groups: no Hb decrease (n=15), mild Hb decrease (Hb decrease <15 g/L; n=35), and severe Hb decrease (Hb decrease ≥15 g/L; n=43). Multivariate logistic regression analysis was conducted to explore the predictive factors for NEC secondary to LOS, and the value of Hb decrease in predicting NEC secondary to LOS was evaluated through receiver operating characteristic curve analysis. Results The incidence of NEC in the severe Hb decrease group, mild Hb decrease group, and no Hb decrease group were 26%, 14%, and 0% (P<0.05), respectively. Multivariate logistic regression analysis revealed that a larger Hb decrease was an independent predictive factor for NEC in LOS preterm infants (OR=1.141, 95%CI: 1.061-1.277, P<0.001). Receiver operating characteristic curve analysis showed that the area under the curve for predicting NEC in preterm infants with LOS using Hb decrease (with a cut-off value of 20 g/L) was 0.803, with sensitivity and specificity of 0.69 and 0.78, respectively. Conclusions Hb decrease can serve as an indicator for prediction of NEC in preterm infants with LOS. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Modern Laboratory Medicine is the property of Journal of Modern Laboratory Medicine Editorial Department and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: To explore the effect of Xuebijing combine with ulinastatin on inflammatory response and myocardial protection of neonatus with necrotizing enterocolitis (NEC). Methods: 120 neonatus with NEC who were admitted to Guangdong Women and Children Hospital from May 2019 to May 2022 were selected. According to the random number table method, they were divided into control group (intravenous infusion of physiological saline before anesthesia induction), ulinastatin group (intravenous infusion of ulinastatin injection before anesthesia induction), Xuebijing group (intravenous infusion of Xuebijing injection before anesthesia induction), and combined group (intravenous infusion of ulinastatin injection and Xuebijing injection before anesthesia induction), with 30 cases of each group. The levels of mean arterial pressure (MAP), heart rate (HR), interleukin-17 (IL-17), C-reactive protein (CRP), tumor necrosis factor -α (TNF-α), cardiac troponin (cTnI), and B-type natriuretic peptide (BNP) were compared of four groups of neonatus, and the mortality and incidence of adverse reactions of four groups were recorded. Results: There was no statistically significant difference of HR between groups before surgery(P>0.05), ulinastatin group and Xuebijing group showed that decreased compared with control group after surgery and 1 d after surgery, and combined group showed that significant decreased after surgery and 1d after surgery compared with ulinastatin group and Xuebijing group(P<0.05). There was no statistically significant difference of MAP between groups before surgery(P>0.05), ulinastatin group and Xuebijing group showed that increased compared with control group after surgery and 1 d after surgery, and combined group showed that significant increased after surgery and 1 d after surgery compared with ulinastatin group and Xuebijing group(P<0.05). The CRP, IL-17, TNF-α of ulinastatin group, Xuebijing group, and combined group after surgery and 1 d after surgery were lower than those of control group at the same time point, and combined group were lower than those of ulinastatin group and Xuebijing group at the same time point(P<0.05). The cTnI and BNP of ulinastatin group, Xuebijing group, and combined group after surgery and 1 d after surgery were lower than those of control group at the same time point, and combined group were lower than those of ulinastatin group and Xuebijing group at the same time point(P<0.05). The mortality of combined group was lower than that of control group, ulinastatin group, and Xuebijing group. There was no statistically significant difference of the incidence of adverse reactions of four groups(P>0.05). Conclusion: Perioperative use of Xuebijing combine with ulinastatin of NEC, which is beneficial for the hemodynamic stability of neonatus, can alleviate the inflammatory response of neonatus, exert myocardial protection effect, and reduce clinical mortality. [ABSTRACT FROM AUTHOR]

Objective: To investigate and analysis the effects of cimetidine on inflammatory immune response and intestinal microorganism in mice with necrotizing enterocolitis (NEC). Methods: 36 cases of mice with necrotizing enterocolitis were randomly divided into three groups: model group, cimetidine group 1, and cimetidine group 2, with 12 mice in each group. The model group, cimetidine group 1, and cimetidine group 2 were orally administrated with 0.1 mL of normal saline, 0.1 mL of gastric cimetidine, and 0.2 mL of gastric cimetidine daily. After continuous application for 14 days, the inflammatory immune response and intestinal microbial changes of the mice were observed. Results: The body weight of cimetidine group 1 and cimetidine group 2 on the 7th and 14th day of treatment were significantly higher than that of the model group(P<0.05), and the body weight of cimetidine group 2 were significantly higher than that of cimetidine group 1(P<0.05). At the 14th day of treatment, the content of IL-2 in intestinal tissue of cimetidine group 1 and cimetidine group 2 were lower than that of model group (P<0.05), and the content of IL-10 were higher than that of model group(P<0.05). There were significant difference compared between cimetidine group 2 and cimetidine group 1 (P<0.05). At the 14th day of treatment, the relative expression levels of Bifidobacterium and Lactobacillus in the feces of cimetidine 1 and 2 groups were significantly higher than those of the model group(P<0.05), while the relative expression levels of Escherichia coli were significantly lower than those of the model group (P<0.05). There were significant difference compared between cimetidine 2 and cimetidine 1 groups (P<0.05). The relative expression levels of CaMKIV and CREM proteins in the intestinal tissue of cimetidine 1 and 2 groups were significantly lower than those of the model group on the 14th day of treatment(P<0.05), and cimetidine 2 group also significantly decreased compared with cimetidine 1 group (P<0.05). Conclusion: The application of cimetidine in mice with necrotizing enterocolitis can regulate the balance of inflammatory immune response, promote the recovery of mice weight to normal, and also reduce the relative expression level of CaMKIV and CREM proteins in intestinal tissue, thus improving the intestinal microbial status of mice, which is dose dependent. [ABSTRACT FROM AUTHOR]

Copyright of Chinese Journal of Contemporary Pediatrics is the property of Xiangya Medical Periodical Press and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective To explore the effect of sodium butyrate on brain injury in mice with necrotizing enterocolitis (NEC). Methods A total of 137 3-day-old C57BL/6 mice were randomly divided into Control group (CON group, n=40, without maternal separation), NEC+PBS group (NP group, n=57) and NEC+butyrate group (NB group, n=40). The mice from the NP and NB groups were separated maternally and given either PBS or sodium butyrate by gavage from postnatal day 3 for 7 consecutive days, then a NEC model was established by formula feeding combined with hypoxia and hypothermia for 3 consecutive days. Survival rate, histopathological injury of the intestine, mRNA expression of TNF-α and IL-6 in the brain, and number of activated microglia and astrocytes were observed and detected. Morris water maze and transmission electron microscopy were employed to observe the long-term cognitive impairment and microstructure of myelin, respectively, for the adult mice (4 weeks old). Western blotting was used to measure the protein level of HMGB1 in the intestine and TLR4 as well as NF-κB in the brain. Results Compared with the CON group, the mice of the NP group showed increased mRNA expression of TNF-α(1.51± 0.20 vs 0.67±0.14) and IL-6 (2.03±0.39 vs 1.01±0.17) in the brain (both P < 0.05), raised number of activated microglia (751.00±82.35 vs 284.70±52.01, P < 0.05) and astrocytes (P < 0.05) in the hippocampus, and elevated protein levels of HMGB1 (1.76±0.19 vs 0.73±0.06) in the intestine as well as TLR4 (1.14±0.16 vs 0.81±0.01) and NF-κB (1.21±0.19 vs 0.60±0.15) in the brain (all P < 0.05). In addition, the adult mice in the NP group demonstrated the prolonged escape latency and decreased crossing-platform times, and increased G-ratio (all P < 0.05). After the administration of sodium butyrate, the mRNA expression levels of TNF-α(0.81±0.12 vs 1.51±0.20) and IL-6 (0.93±0.38 vs 2.03±0.39) in the brain were decreased, the activation of microglia was inhibited (468.00±99.59 vs 751.00±82.35), and the number of astrocytes was reduced (all P < 0.05). The decreased expression levels of HMGB1 (1.22±0.11 vs 1.76±0.19) in the intestine and TLR4 (0.88±0.06 vs 1.14±0.16) and NF-κB (0.70±0.19 vs 1.21±0.19) in the brain were also marked in the NB group (all P < 0.05). The adult mice of the NB group showed shortened escape latency, and increased crossing-platform times and myelin thickness (all P < 0.05). Conclusion Sodium butyrate alleviates the neuroinflammation by inhibiting the activation of TLR4-NF-κB signal pathway in the NEC brain, and thus exerts protective effect against NEC-associated brain injury.

Necrotizing enterocolitis (NEC), with the main manifestations of bloody stool, abdominal distension, and vomiting, is one of the leading causes of death in neonates, and early identification and diagnosis are crucial for the prognosis of NEC. The emergence and development of machine learning has provided the potential for early, rapid, and accurate identification of this disease. This article summarizes the algorithms of machine learning recently used in NEC, analyzes the high-risk predictive factors revealed by these algorithms, evaluates the ability and characteristics of machine learning in the etiology, definition, and diagnosis of NEC, and discusses the challenges and prospects for the future application of machine learning in NEC. [ABSTRACT FROM AUTHOR]

Objective: To investigate the predictive value of serum amyloid A (SAA), C-reactive protein (CRP), platelet distribution width (PDW) and neutrophil/lymphocyte ratio (NLR) for the timing of neonatal necrotizing enterocolitis (NEC) surgery.Methods: 70 children with NEC who were admitted to Foshan Maternal and Child Health Hospital from January 2019 to January 2022were selected, and they were divided into surgery group with 35 cases and non-surgery group with 35 cases according to treatment methods. Clinical data of children with NEC were collected, and the levels of serum SAA, CRP, peripheral blood PDW and NLR in the two groups were detected. Univariate and multivariate Logistic regression were used to analyze the influencing factors of neonatal NEC surgery. The predictive value of serum SAA, CRP, peripheral blood PDW and NLR on the timing of neonatal NEC surgery was analyzed by receiver operating characteristic (ROC) curve. Results: The gestational age ≥37 weeks and the proportion of weight ＞2500 g at diagnosis in the surgery group were lower than those in the non-surgery group, the proportion of weight 1500～2500 g at diagnosis, poor mental response, abdominal distension, weak bowel sound and the levels of serum SAA, CRP, peripheral blood PDW and NLR were higher than those in the non-surgery group (all P＜0.05). Multivariate Logistic regression analysis showed that weight＞2500 g at diagnosis was an independent protective factor for neonatal NEC surgery, poor mental response, abdominal distension, weak bowel sound and increased levels of serum SAA, CRP, PDW and NLR were independent risk factors for neonatal NEC surgery (all P＜0.05). ROC curve analysis showed that the area under the curve (AUC) of the combination of serum SAA, CRP, peripheral blood PDW and NLR in predicting the timing of neonatal NEC surgery was greater than that of each indicator alone. Conclusion: The increase levels of serum SAA, CRP, peripheral blood PDW and NLR are closely related to neonatal NEC surgery, and the combined value of these four indicators in predicting the timing of neonatal NEC surgery is higher [ABSTRACT FROM AUTHOR]

Copyright of Chinese Journal of Contemporary Pediatrics is the property of Xiangya Medical Periodical Press and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective To investigate the effects of hypoxia inducible factor-1α (HIF-1α) on the brain injury of necrotizing enterocolitis (NEC) mice. Methods Eighty-one C57BL/6 mice aged 5 d were randomly divided into 4 groups: Control group (CON, n=15, breastfed, in cages with their mothers), NEC group (n=24, fed in an incubator, with formula milk+hypoxia+oral lipopolysaccharide to induce NEC mouse model), DMOG group (n=19, given HIF-1α stabilizer DMOG on the base of NEC model), and 2ME2 group (n=23, given HIF-1α inhibitor 2ME2 on the base of NEC model). The mortality of mice was recorded during modeling. All mice were sacrificed in 4 d after modeling, and the intestinal pathological features of mice were observed by HE staining. Western blotting and immunohistochemical assay were performed respectively to detect the expression of HIF-1α protein in brain tissue and the numbers of activated microglia, astrocytes and oligodendrocytes in the hippocampus. The mRNA levels of inflammatory cytokines IL-1β and TNF-α were determined by RT-qPCR in brain tissue. Results As compared with the CON group, the mice of the NEC group showed intestinal tract damage, increased activated microglia (0.80±0.75 vs 4.00±0.63, P < 0.05) and astrocytes (P < 0.05) in the hippocampus, decreased number of oligodendrocytes (64.40±7.26 vs 45.60±2.80, P < 0.05), and higher levels of TNF-α, IL-1β and HIF-1α (P < 0.05). After intraperitoneal injection of HIF-1α stabilizer DMOG, the survival rate of mice in the DMOG group was increased (66.67% vs 84.21%, P < 0.05), and the intestinal injury was reduced. The activation of microglia (4.00±0.63 vs 1.60±0.49, P < 0.05) and astrocytes (P < 0.05) was inhibited, while the number of oligodendrocytes was elevated (45.60±2.80 vs 56.00±5.22, P < 0.05), and the expression of TNF-α and IL-1β was down-regulated (P < 0.05). However, intraperitoneal injection of HIF-1α inhibitor 2ME2 resulted in opposite outcomes. Conclusion HIF-1α is protectively up-regulated in the brain of NEC mice, and its stable and high expression reduces the neuroinflammation in the brain of NEC mice, exerting a protective effect on the brain.

Objective To establish a mouse model of necrotizing enterocolitis and detect the key protein molecules in serum of neonatal rats with early NEC, so as to preliminatively determine whether necrotizing enterocolitis is involved in early neonatal necrotizing enterocolitis. Methods The NEC mouse model was established and randomly divided into the experimental group and control group with 12 newborn rats in each group. The neonatal rats in the experimental group were induced into NEC animal models. Blood samples were extracted and the concentrations of IL-18, Gasdermin D and Caspase-1 in serum of all rats were detected by Elisa kit. The concentration of target protein in serum of the two groups was compared, α = 0.05. Results The concentrations of Gasdermin D and Caspase-1 in serum of rats in the two groups were significantly different, with P values of 0.017 and < 0.001, respectively. It could be considered that the concentrations of Gasdermin D and caspase-1 in serum of rats in the experimental group were higher than those in the control group. There was no significant difference in serum IL-18 concentration between the two groups （P = 0.755）. Conclusion Gasdermin D mediated pyroptosis may be involved in the pathogenesis of early NEC. [ABSTRACT FROM AUTHOR]

Copyright of Chinese Journal of Contemporary Pediatrics is the property of Xiangya Medical Periodical Press and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Chinese Journal of Contemporary Pediatrics is the property of Xiangya Medical Periodical Press and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective To investigate the effect of necrotizing enterocolitis (NEC) at different severities on brain injury in neonatal mice. Methods Sixty 5-day old C57BL/6 mice were randomly divided into control group (CON group, n=20) and NEC group (n=40). The CON group was breeding with female mice and breast-fed. The NEC group was fed in an incubator, and induced by formula gavage feeding+hypoxia+oral lipopolysaccharide (LPS) to establish the model of NEC. In 4 d after NEC modeling, all pups were sacrificed by cervical decapitation. Their body weight was measured and general conditions were observed. HE staining was used to observe the pathological changes of intestinal tissue. NEC group was divided into mild NEC subgroup and severe NEC subgroup according to the intestinal injury score of ileocecus. Nissl staining was employed to further observe the pathological changes of the corresponding brain tissue. The correlation between the severity of intestinal injury and the number of nerve cells was analyzed with Pearson analysis. The mRNA levels of the inflammatory factors interleukin-1β (IL-1β), IL-6 and tumor necrosis factor-α (TNF-α) in brain tissues were measured with quantitative real-time PCR (RT-qPCR). Enzyme-linked immunosorbent assay (ELISA) was adopted to detect the protein contents of IL-1β, IL-6 and TNF-α in brain tissues. Immunofluorescence assay was conducted to detect the number of activated microglia and astrocytes in the hippocampus. Results Compared with CON group, the NEC group had decreased activities and lower body weight (3.84±1.25 vs 1.76±0.26 g, P < 0.05), and serious intestinal damage. The number of nerve cells in the hippocampus were significantly reduced in the NEC group than the CON group (P < 0.05), so was in the severe NEC subgroup than that the mild NEC subgroup (P < 0.05). Correlation analysis showed that the pathological changes of brain were negatively correlated with the severity of intestinal injury (r=- 0.943, P < 0.001). When compared with the CON group, the mRNA and protein levels of IL-1β, IL-6 and TNF-α in brain tissues were significantly elevated (P < 0.05), and the numbers of activated microglia and astrocytes were also significantly increased in the NEC group (P < 0.05), especially in the severe NEC subgroup (P < 0.05). Conclusion NEC can lead to acute brain injury in neonatal mice, and the severity of damage is related to the severity of intestinal injury, which may be related to the increase of neuroinflammation.

Objective To investigate the risk factors for necrotizing enterocolitis (NEC) in very preterm infants and establish a nomogram model for predicting the risk of NEC. Methods A total of 752 very preterm infants who were hospitalized from January 2015 to December 2021 were enrolled as subjects, among whom 654 were born in 2015-2020 (development set) and 98 were born in 2021 (validation set). According to the presence or absence of NEC, the development set was divided into two groups: NEC (n=77) and non-NEC (n=577). A multivariate logistic regression analysis was used to investigate the independent risk factors for NEC in very preterm infants. R software was used to plot the nomogram model. The nomogram model was then validated by the data of the validation set. The receiver operating characteristic (ROC) curve, the Hosmer-Lemeshow goodness-of-fit test, and the calibration curve were used to evaluate the performance of the nomogram model, and the clinical decision curve was used to assess the clinical practicability of the model. Results The multivariate logistic regression analysis showed that neonatal asphyxia, sepsis, shock, hypoalbuminemia, severe anemia, and formula feeding were independent risk factors for NEC in very preterm infants (P<0.05). The ROC curve of the development set had an area under the curve (AUC) of 0.833 (95%CI: 0.7150.952), and the ROC curve of the validation set had an AUC of 0.826 (95%CI: 0.797-0.862), suggesting that the nomogram model had a good discriminatory ability. The calibration curve analysis and the Hosmer-Lemeshow goodness-of-fit test showed good accuracy and consistency between the predicted value of the model and the actual value. Conclusions Neonatal asphyxia, sepsis, shock, hypoalbuminemia, severe anemia, and formula feeding are independent risk factors for NEC in very preterm infant. The nomogram model based on the multivariate logistic regression analysis provides a quantitative, simple, and intuitive tool for early assessment of the development of NEC in very preterm infants in clinical practice. [ABSTRACT FROM AUTHOR]

Necrotizing enterocolitis (NEC) is one of the most common gastrointestinal diseases in neonatal intensive care units, characterized by rapid progression and a high mortality rate. Local intestinal ischemia and hypoxia are significant contributors to NEC. Feeding intolerance (FI), which refers to a range of gastrointestinal manifestations arising from the inability to tolerate enteral nutrition, is one of the most common clinical issues in neonates, and preventing and treating FI is crucial for improving neonatal survival rates. Near-infrared spectroscopy is a clinical tool that can be used at the bedside to monitor regional oxygen saturation. It is non-invasive, reliable, and sustainable, and its feasibility and safety in assessing intestinal blood circulation have been validated. Early identification of intestinal ischemia and differentiation of FI from precursor symptoms of NEC, as well as predicting the occurrence of NEC, are extremely important for reducing intestinal injury and adverse long-term outcomes. In recent years, there has been new research progress related to the monitoring of intestinal tissue oxygen saturation and cerebral oxygen saturation for the early identification of FI and precursor symptoms of NEC, and this article provides a review of these developments.

Copyright of Chinese Journal of Contemporary Pediatrics is the property of Xiangya Medical Periodical Press and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Chinese Journal of Contemporary Pediatrics is the property of Xiangya Medical Periodical Press and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective To explore the risk factors and early clinical characteristics of neonatal necrotizing enterocolitis (NEC), so as to improve the early warning of NEC and early intervention, so as to improve the prognosis of NEC. Methods A total of 95 children diagnosed with NEC in our NICU from November 22, 2017 to November 22, 2020 were collected, and 95 non-NEC children in the same period were selected as the control group according to the 1:1 matching ratio. The univariate variables were screened by χ2 test, and then multivariate Logistic regression analysis was performed. The count data were analyzed by t test and rank sum test, and the rank data were analyzed by Spearman rank correlation test, α= 0.05. Results It suggested that premature birth, low birth weight, infection and mechanical ventilation were independent risk factors for NEC, and abdominal distention and gastric retention were the main clinical manifestations in the early stage. There was no significant correlation between leukocytes and neutrophils and the severity of NEC, while C-Reactive Protein and procalcitonin were positively correlated with the severity of NEC. Lymphocytes and platelets were negatively correlated with the severity of the disease, (P < 0.05). Abdominal orthostatic X-ray had no obvious specificity for the early diagnosis of NEC. Conclusion When the children have the premature birth, low birth weight, infection and mechanical ventilation risk factors, abdominal distension and poor feeding performance, accompanied by the increase of C-reactive protein and procalcitonin, it is necessary to be alert to the occurrence of NEC, and dynamic abdominal orthostatic X-ray and abdominal ultrasound can be performed to improve the early diagnosis rate. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Modern Laboratory Medicine is the property of Journal of Modern Laboratory Medicine Editorial Department and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: To investigate the effects of erythropoietin（EPO） combined with glutamine on gastrointestinal hormones,fecal bacteria and serum tumor necrosis factor-α（TNF-α), interleukin-6（IL-6） and intestinal fatty acid binding protein（i-FABP） levels in premature infants with necrotizing enterocolitis（NEC). Methods: 120 cases of NEC premature infants in Shandong Maternal and Child Health Hospital Affiliated to Shandong University and Affiliated Hospital of Xuzhou Medical University from December 2016 to December 2019 were selected, and they were randomly divided into EPO group（EPO treatment), glutamine group（glutamine treatment） and combination group（EPO combined with glutamine treatment), 40 cases in each group. The curative effect, gastrointestinal hormones,fecal bacterial indicators and serum i-FABP, TNF-α, IL-6 levels of the three groups were compared, and the incidence rate of adverse reactions and mortality of the three groups were recorded. Results: The total effective rate of the combination group was higher than that of the glutamine group and EPO group（P<0.05). After treatment, the TNF-α, IL-6 and i-FABP levels in the three groups were lower than those before treatment, and those in the combination group were lower than those in the glutamine group and EPO group（P<0.05). After treatment, the gastrin（MTL） and motilin（GAS） levels in the three groups were higher than those before treatment, and those in the combination group were higher than those in the glutamine group and EPO group（P<0.05). After treatment, the total number of bacteria,bacilli and cocci in the three groups were higher than those before treatment, and those in the combination group were higher than those in the glutamine group and EPO group（P<0.05). The incidence rate of adverse reactions and mortality in combination group were lower than those in glutamine group and EPO group（P<0.05). Conclusion: EPO combined with glutamine in the treatment of NEC premature infants can effectively improve gastrointestinal function, regulate intestinal flora, improve serum inflammatory factors and i-FABP levels,reduce the incidence of adverse reactions and case fatality, with a significant efficacy. [ABSTRACT FROM AUTHOR]

To observe the pathogenic bacteria distribution and drug resistance in neonatal necrotizing enterocolitis（NEC）, and to analyze the influencing factors of the incidence of NEC children. Methods: 50 NEC children who were treated in our hospital from August 2016 to September 2020 were selected（NEC group）, and 100 cases of healthy newborns received in our hospital during the same period as the control group, the pathogenic bacteria distribution and drug resistance in NEC children were observed, and the influencing factors of the incidence of NEC children were analyzed. Results: A total of 63 strains of pathogenic bacteria were isolated from 50 cases of NEC children. There were 38 strains of Gram-negative bacteria, accounting for 60.32%, 23 strains of Gram-positive bacteria, accounting for 36.51%, and 2 strains of fungi, accounting for 3.17%. Escherichia coli and Klebsiella pneumoniae were all less sensitive to ofloxacin, cefoperazone, ceftazidime, cefazolin, amoxicillin, ampicillin, ciprofloxacin and ceftriaxone, and they had highly sensitive to imipenem/cestastatin, piperacillin/tazobactam, meropenem and polymyxin. Univariate analysis showed that the incidence of NEC was associated with neonatal weight, breast-feeding, prenatal use of glucocorticoids, gestational diabetes mellitus, gestational hypertension, neonatal Apgar score, whether combined with pulmonary infection and combined with sepsis（P<0.050. Multivariate logistic regression analysis showed that breast-feeding was the protective factor of the incidence of NEC, and combined with sepsis, gestational diabetes mellitus, neonatal weight, combined with pulmonary infection and neonatal Apgar score were the risk factors of the incidence of NEC（P<0.05), Conclusion: Gram negative bacteria are the main pathogens of NEC. At the same time, there are many factors that affect the incidence of the incidence of NEC, so targeted intervention or treatment measures should be developed in combination with relevant influencing factors to reduce the risk of the incidence of NEC. [ABSTRACT FROM AUTHOR]

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Objective Through retrospective analysis of the neonates with colon perforation caused by necrotizing enterocolitis. to explore the best choice of surgical methods. Methods Neonates with colon perforation caused by necrotizing enterocolitis from May 1.2018 to May 1.2020 were selected as the research objects, and they were divided into resection group (control group. n=21) and repair group (observation group.-26). The curative effect and clinical outcome were analyzed by SPSS20, 0 soft ware. Results The emergency operation time of the observation group was significantly shorter than that of the control group. while the inflammatory recovery time and the ostomy closure time of the observation group were longer than those of the control group: There were no statistically significant differences in mechanical ventilation time, feeding time, parenteral nutrition time-hospital stay time and postoperative complications between the two groups (P-0, 04.0. 01.-0.01). Conclusion Both methods can be used as the treatment of colonic perforation caused by necrotizing enterocolitis in neonates. The choice of surgical methods de pends on the state of the newborn at the time of surgery. Enteroplasty is an option for neonates with poor basic conditions and un stable hemodynamics, while enterotomy is an option for neonates with stable vital signs. [ABSTRACT FROM AUTHOR]

Objective: To investigate the relationship between serum amyloid A (SAA), C-reactive protein (CRP) and silent information regulator 1 (SIRT1) levels and the progression of neonatal necrotizing enterocolitis and their diagnostic value. Methods: 100 cases of necrotizing enterocolitis treated in the neonatal department of Wuhan Children's Hospital affiliated to Tongji Medical College of Huazhong University of Science and Technology from March 2017 to October 2018 were selected as the observation group. Another 100 healthy newborns born in Wuhan Children's Hospital affiliated to Tongji Medical College of Huazhong University of Science and Technology were selected as the control group. The serum SAA, CRP and SIRT1 levels were measured in each group. Serum SAA, CRP and SIRT1 levels were compared among children with different corrected Bell stages. Spearman correlation analysis was used to observe the correlation between serum SAA, CRP and SIRT1 levels and corrected Bell staging in children in the group. The receiver operating characteristic (ROC) curve was used to evaluate the diagnostic value of three indexes for necrotizing enterocolitis. Results: Compared with the control group, serum SAA and CRP levels were significantly increased in the observation group, while SIRT1 levels were significantly decreased(P<0.05). Comparison of the serum SAA, CRP and SIRT1 levels cin children with different corrected Bell stages showed statistically significant differences by one-way analysis of variance (P<0.05). The serum SAA and CRP levels of the children with corrected Bell stage I, II and III increased in turn, and the serum SIRT1 level of the children with corrected Bell stage I, II and III decreased in turn (all P<0.05). Corrected Bell staging was positively correlated with serum SAA and CRP levels(P＜0.05). Corrected Bell staging was neg-atively correlated with serum SIRT1 level (P＜0.05). The area under curve (AUC) value, sensitivity, specificity and Youden index of the combined detection of three indexes were higher than those of the three indexes alone. Conclusion: The serum SAA and CRP levels in newborns with necrotizing enterocolitis are increased, while the SIRT1 level is decreased, which are related to the progression of neonatal necrotizing enterocolitis. The combined value of the three indexes in the diagnosis of necrotizing enterocolitis is relatively high. [ABSTRACT FROM AUTHOR]

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Objective To summarize the clinical features and management of intestinal stricture following neonatal necrotizing enterocolitis (NEC). Methods We retrospectively analyzed the clinical data of 79 infants with intestinal stricture following NEC treated in our hospital between April, 2014 and June, 2018. Of the 79 infants, 20 were diagnosed to have Bell stage I NEC, 52 were in Bell stage Ⅱ and 7 in Bell stage Ⅲ. All the infants underwent preoperative X-Ray examination, 73 had gastrointestinal contrast study and 69 had rectal mucosal biopsy. Results In these infants, the clinical signs of intestinal stricture occurred at a mean of 46.5 d following NEC. Among the 73 infants receiving gastrointestinal contrast study, 58 were found to have intestinal stenosis and 6 had fetal colon. Rectal mucosal biopsy in 69 infants revealed Hirschsprung disease in 3 cases. Intraoperative exploration showed that intestinal stenosis occurred mostly in the ascending colon, transverse colon and descending colon, and multiple stenosis was detected in 32 cases. Surgical resection of stricture and primary end-to-end anastomosis were performed in 71 cases, and the remaining 8 cases underwent staged surgeries. In the 73 cases with complete follow-up data, 3 had postoperative adhesions, and 2 of them received conservative treatment and the other underwent a second operation. Eight infants were hospitalized for 1 to 3 times for malnutrition and dehydration due to repeated diarrhea, and eventually recovered and were discharged smoothly; all the other infants had uneventful recovery without stricture recurrence. Conclusion Intestinal stenosis following NEC occurs most frequently in the colon, and some cases may have multiple strictures. Gastrointestinal contrast study is the primary option for examination. Surgical resection of the stricture and primary end-to-end anastomosis can achieve good therapeutic effect with favorable prognoses in the patients.

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Copyright of Journal of Modern Laboratory Medicine is the property of Journal of Modern Laboratory Medicine Editorial Department and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Chinese Journal of Contemporary Pediatrics is the property of Xiangya Medical Periodical Press and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Chinese Journal of Contemporary Pediatrics is the property of Xiangya Medical Periodical Press and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objectives: To study the effect of gut microbiota on hematopoiesis in a neonatal rat model of necrotizing enterocolitis (NEC)., Methods: Neonatal Sprague-Dawley rats were randomly divided into a control group and a model group (NEC group), with 6 rats in each group. Formula milk combined with hypoxia and cold stimulation was used to establish a neonatal rat model of NEC. Hematoxylin and eosin staining was used to observe the pathological changes of intestinal tissue and hematopoiesis-related organs. Routine blood tests were conducted for each group. Immunohistochemistry was used to observe the changes in specific cells in hematopoiesis-related organs. Flow cytometry was used to measure the changes in specific cells in bone marrow. 16S rDNA sequencing was used to observe the composition and abundance of gut microbiota., Results: Compared with the control group, the NEC group had intestinal congestion and necrosis, damage, atrophy, and shedding of intestinal villi, and a significant increase in NEC histological score. Compared with the control group, the NEC group had significantly lower numbers of peripheral blood leukocytes and lymphocytes ( P <0.05), nucleated cells in the spleen, thymus, and bone marrow, and small cell aggregates with basophilic nuclei in the liver ( P <0.05). The NEC group had significant reductions in CD71 + erythroid progenitor cells in the liver, CD45 + lymphocytes in the spleen and bone marrow, CD3 + T lymphocytes in thymus, and the proportion of CD45 + CD3 - CD43 + SSC hi neutrophils in bone marrow ( P <0.05). There was a significant difference in the composition of gut microbiota between the NEC and control groups, and the NEC group had a significant reduction in the abundance of Ligilactobacillus and a significant increase in the abundance of Escherichia - Shigella ( P <0.05), which replaced Ligilactobacillus and became the dominant flora., Conclusions: Multi-lineage hematopoietic disorder may be observed in a neonatal rat model of NEC, which may be associated with gut microbiota dysbiosis and abnormal multiplication of the pathogenic bacteria Escherichia - Shigella .

Copyright of Nursing of Integrated Traditional Chinese & Western Medicine is the property of Journal of Clinical Nursing in Practice (Editorial Board, Shanghai Jiao Tong University Press) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: To explore clinical value of abdominal ultrasonography in the diagnosis of neonatal necrotizing enterocolitis (NEC). Methods: A total of 116 patients with NEC in our hospital from January 2009 to December 2016 were selected as the objects of this study. According to the modified Bell-NEC classification criteria,the patients were divided into diagnosis group (n=50) and suspected group(n=66). According to clinical outcome, the patients were divided into operation group (n=37) and medical cure group (n=79). The results of abdominal ultrasound and X-ray examination were compared between the diagnosis group and the suspected group, and he results of abdominal ultrasound and X-ray examination were compared between the operation group and the medical cure group. Results: In the diagnosis group and the suspected group, the detection rate of abdominal ultrasound on abdominal wall gas and portal venous gas were higher than those of X-ray examination (P<0.05). Abdominal ultrasound also revealed bowel slow peristalsis, loss of peristalsis and seroperitoneum. The detection rate of abdominal ultrasound on bowel wall thickening, intestinal dilatation and seroperitoneum in medical cure group were lower than those in operation group (P<0.05). The detection rate of X-ray film on intestinal dilatation in medical cure group was lower than that in operation group (P<0.05). Conclusion: Abdominal ultrasonography can improve the detection rate of NEC, and has a better predictive effect on the clinical outcome of NEC. [ABSTRACT FROM AUTHOR]

Objectives: To investigate the clinical characteristics and risk factors for early-onset necrotizing enterocolitis (NEC) in preterm infants with very/extremely low birth weight (VLBW/ELBW)., Methods: A retrospective analysis was performed on the medical data of 194 VLBW/ELBW preterm infants with NEC who were admitted to Children's Hospital Affiliated to Zhengzhou University from January 2014 to December 2021. These infants were divided into early-onset group (onset in the first two weeks of life; n =62) and late-onset group (onset two weeks after birth; n =132) based on their onset time. The two groups were compared in terms of perinatal conditions, clinical characteristics, laboratory examination results, and clinical outcomes. Sixty-two non-NEC infants with similar gestational age and birth weight who were hospitalized at the same period as these NEC preterm infants were selected as the control group. The risk factors for the development of early-onset NEC were identified using multivariate logistic regression analysis., Results: Compared with the late-onset group, the early-onset group had significantly higher proportions of infants with 1-minute Apgar score ≤3, stage III NEC, surgical intervention, grade ≥3 intraventricular hemorrhage, apnea, and fever or hypothermia ( P <0.05). The multivariate logistic regression analysis showed that feeding intolerance, blood culture-positive early-onset sepsis, severe anemia, and hemodynamically significant patent ductus arteriosus were independent risk factors for the development of early-onset NEC in VLBW/ELBW preterm infants ( P <0.05)., Conclusions: VLBW/ELBW preterm infants with early-onset NEC have more severe conditions compared with those with late-onset NEC. Neonates with feeding intolerance, blood culture-positive early-onset sepsis, severe anemia, or hemodynamically significant patent ductus arteriosus have a higher risk of early-onset NEC.

Objectives: To study the clinical value of intestinal regional oxygen saturation (rSO 2 ) and C-reactive protein (CRP) in the diagnosis of necrotizing enterocolitis (NEC) in preterm infants., Methods: A prospective observational study was conducted among the preterm infants who were hospitalized in Children's Hospital Affiliated to Anhui Medical University, from October 2020 to December 2021, with 22 infants in the NEC group and 35 infants in the non-NEC group. Intestinal rSO 2 was monitored 24 hours after a confirmed diagnosis of NEC in the NEC group, and serum CRP levels were measured before anti-infection therapy. In the non-NEC group, intestinal rSO 2 monitoring and serum CRP level measurement were performed at the corrospording time points. The two groups were compared in terms of intestinal rSO 2 and serum CRP level. The receiver operating characteristic (ROC) curve was used to analyze the value of intestinal rSO 2 alone, serum CRP alone, and intestinal rSO 2 combined with CRP in the diagnosis of NEC in preterm infants., Results: Compared with the non-NEC group, the NEC group had a significantly lower level of intestinal rSO 2 ( P <0.05) and a higher serum CRP level ( P <0.05). The ROC curve analysis showed that intestinal rSO 2 had an optimal cut-off value of 50.75% in the diagnosis of NEC in preterm infants, with a sensitivity of 81.8%, a specificity of 85.7%, and an area under the ROC curve (AUC) of 89.4%; CRP had an optimal cut-off value of 12.05 mg/L in the diagnosis of NEC in preterm infant, with a sensitivity of 72.7%, a specificity of 74.3%, and an AUC of 74.8%; intestinal rSO 2 combined with CRP had a sensitivity of 90.9%, a specificity of 77.1%, and an AUC of 91.9% in the diagnosis of NEC. The AUC of intestinal rSO 2 alone in the diagnosis NEC was higher than that of CRP ( P <0.05). There was no significant difference in the AUC between intestinal rSO 2 alone and intestinal rSO 2 combined with CRP ( P >0.05)., Conclusions: The value of intestinal rSO 2 in the diagnosis NEC is higher than that of CRP, and is equivalent to that of the combination of intestinal rSO 2 and CRP in preterm infants.

Calibrin-Z is a new type of safe and pollution-free adsorbent which was developed by an organization of United States. Chicken were inoculated with clostridium welchii through mouth, the different concentrations of Calibrin-Z was added in their feedstuff, and the intestinal morphology, pathological changes at their different ages were detected to explore the control effect of this reagent on the necrotic enteritis, immune organ index and the immunity levels. The results showed that Calibrin-Z could improve the immune response, decrease the damage to the intestinal mucosa and obviously inhibit the effect of necrotizing enteritis occurrence. The anti-disease mechanism of Calibrin- Z might be associated with the adsorption of clostridium welchii toxin. It would provide an effective method to control the chicken necrotizing enteritis without using antibiotic drugs, which had very importantly practical significance. [ABSTRACT FROM AUTHOR]

Objectives: To systematically evaluate the risk factors for necrotizing enterocolitis (NEC) in preterm infants., Methods: PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure, and Wanfang Data were searched for case-control studies and cohort studies on the risk factors for NEC in preterm infants published up to December 2021. RevMan 5.3 software was used to perform the Meta analysis., Results: A total of 38 studies were included (28 case-control studies and 10 cohort studies). The Meta analysis showed that maternal gestational diabetes ( OR =2.96, P <0.001), intrahepatic cholestasis during pregnancy ( OR =2.53, P <0.001), preeclampsia ( OR =1.73, P =0.020), history of neonatal asphyxia ( OR =2.13, P <0.001), low gestational age ( OR =1.23, P =0.010), sepsis ( OR =5.32, P <0.001), patent ductus arteriosus ( OR =1.57, P =0.001), congenital heart disease ( OR =3.78, P <0.001), mechanical ventilation ( OR =2.23, P =0.020), history of antibiotic use ( OR =1.07, P <0.001), use of vasopressors ( OR =2.34, P =0.040), and fasting ( OR =1.08, P <0.001) were risk factors for NEC in preterm infants, while cesarean section ( OR =0.73, P =0.004), use of pulmonary surfactant ( OR =0.43, P =0.008), and breastfeeding ( OR =0.24, P =0.020) were protective factors against NEC., Conclusions: Maternal gestational diabetes, intrahepatic cholestasis during pregnancy, preeclampsia, low gestational age, fasting, sepsis, patent ductus arteriosus, congenital heart disease, and histories of asphyxia, mechanical ventilation, antibiotic use, and use of vasopressors may increase the risk of NEC in preterm infants, while cesarean section, use of pulmonary surfactant, and breastfeeding may decrease the risk of NEC in preterm infants.

Objective: To investigate the expression and role of programmed death ligand-1 (PD-L1) in a mouse model of necrotizing enterocolitis (NEC)., Methods: A total of 20 wild-type C 57 BL /6 J mice were randomly assigned to the control and the model groups. Mice in the control group were breastfed, while mice in the model group were given lipopolysaccharide, formula feeding, hypoxia, and cold stimulation for NEC induction. Then, the intestines of the mice were collected in order to assess the pathological changes through HE staining, to examine PD-L1 expression and localization with immunofluorescence co-localization, and to evaluate intestinal PD-L1 expression with Western blot. Peripheral blood was collected for flow cytometry to examine leukocyte subpopulations and their PD-L1 expression. On the other hand, 14 PD-L 1 (+/+) mice and 14 PD-L 1 (-/-) mice were randomly divided into their respective genotype control groups and model groups. The same induction method as was already mentioned was adopted for the model groups. The intestines of the mice were collected for HE staining to evaluate the pathological change and peripheral blood was collected to examine the expression of inflammatory factors., Results: The NEC mouse model was successfully constructed. PD-L1 was widely expressed in enterocytes and inflammatory cells in the mouse intestines and in T cells, monocytes, and neutrophils in peripheral blood. The expression of PD-L1 in NEC mouse intestines increased in comparison with that of the control group. In the peripheral blood of NEC mice, the proportion of T cells and monocytes and their PD-L1 expression showed no significant changes compared with those of the control group, while the proportion of neutrophils and their PD-L1 expression increased by about 140% and 150%, respectively, in comparison with those of the control group ( P <0.05). According to the results of the PD-L 1 gene mouse experiment, the control groups of PD-L 1 (+/+) mice and PD-L 1 (-/-) mice showed no significant difference in their intestinal conditions and serum inflammatory factor levels, while the PD-L 1 (-/-) NEC mouse had worse intestinal pathological changes and increased mean pathological scores compared with those of PD-L 1 (+/+) NEC mouse ( P <0.05). In addition, serum interleukin (IL)-10 in PD-L 1 (-/-) NEC mouse decreased by about 44% compared with that of PD-L 1 (+/+) NEC mice, and chemokine (C-X-C motif) ligand 1/IL-6/IL-1β all increased by more than 25% (all P <0.05)., Conclusion: PD-L1 is widely expressed in inflammatory cells and enterocytes in mice. Knocking out PD-L 1 aggravates the degree of NEC inflammation and intestinal pathological changes. PD-L1 plays a protective role by reducing inflammation in the pathogenesis of NEC, the mechanism of which may be related to the regulation of neutrophils/enterocytes., (Copyright© by Editorial Board of Journal of Sichuan University (Medical Sciences).)

Objectives: To systematically evaluate the effect of prophylactic use of hydrolyzed protein formula on gastrointestinal diseases and physical development in preterm infants., Methods: A computerized search was performed in the databases including China National Knowledge Infrastructure, Wanfang Data, Weipu, PubMed, Embase, and the Cochrane Library to identify randomized controlled trials of the effect of prophylactic use of hydrolyzed protein formula on gastrointestinal diseases and physical growth in preterm infants. RevMan 5.3 software was used to perform a Meta analysis for the included studies., Results: A total of 7 randomized controlled studies were included. The results of Meta analysis showed that compared with the whole protein formula, the prophylactic use of hydrolyzed protein formula could reduce the risk of neonatal necrotizing enterocolitis ( RR =0.40, P =0.04) and feeding intolerance ( RR =0.40, P =0.005), and had no significant effect on the growth of weight, length and head circumference ( P >0.05)., Conclusions: Compared with the whole protein formula, the prophylactic use of hydrolyzed protein formula in preterm infants may reduce the occurrence of necrotizing enterocolitis and feeding intolerance, and can meet the nutrient requirement of physical development. However, the evidence is limited, and the results of this study cannot support the routine prophylactic use of hydrolyzed protein formula in preterm infants.

Objectives: To investigate the risk factors for necrotizing enterocolitis (NEC) in preterm infants, and to establish a scoring model that can predict the development and guide the prevention of NEC., Methods: A retrospective analysis was performed on the medical data of preterm infants who were admitted to the Department of Neonatology,Bethune First Hospital of Jilin University, from January 2011 to December 2020. These infants were divided into two groups: NEC (298 infants with Bell II stage or above) and non-NEC (300 infants). Univariate and multivariate analyses were performed to identify the factors influencing the development of NEC. A nomogram for predicting the risk of NEC was established based on the factors. The receiver operator characteristic (ROC) curve and the index of concordance (C-index) were used to evaluate the predictive performance of the nomogram., Results: The multivariate logistic regression analysis showed that grade ≥2 intracranial hemorrhage, peripherally inserted central catheterization, breast milk fortifier, transfusion of red cell suspension, hematocrit >49.65%, mean corpuscular volume >114.35 fL, and mean platelet volume >10.95 fL were independent risk factors for NEC ( P <0.05), while the use of pulmonary surfactant, the use of probiotics, and the platelet distribution width >11.8 fL were protective factors against NEC ( P <0.05). The nomogram showed good accuracy in predicting the risk of NEC, with a bootstrap-corrected C-index of 0.844. The nomogram had an optimal cutoff value of 171.02 in predicting the presence or absence of NEC, with a sensitivity of 74.7% and a specificity of 80.5%., Conclusions: The prediction nomogram for the risk of NEC has a certain clinical value in early prediction, targeted prevention, and early intervention of NEC.

A male infant, whose weight was 1 120 g at 28 +2 weeks of gestational age, was admitted to Neonatal Intensive Care Unit of West China Second Hospital of Sichuan University at 20 min after preterm birth. Blood transfusion was performed for anemia (hemoglobin 81 g/L) on day 30 of hospitalization, and feeding was continued during the transfusion. Eight hours after blood transfusion, the patient's manifestations included abdominal distension and stiff to palpation, bowel sound weakening, currant jelly stool, poor responsiveness, and apnea. The clinical diagnosis was necrotizing enterocolitis. Abdominal X-ray showed that the abdominal bowel was significantly dilated and inflated. The patient was immediately treated with fasting, gastrointestinal decompression, enema, and anti-infection treatment. After 40 days in hospital, the patient recovered and was discharged.

Objective: To investigate the protective effect of L. reuteri DSM17938 strain against oxidative stress in a neonatal mouse model of necrotizing enterocolitis (NEC) and explore the possible mechanism., Methods: Ninety-six 10-day-old neonatal C57BL/6J mice were equally randomized into control group, NEC group, and NEC+ L. reuteri group. The pathological changes of the ileocecal intestinal tissue were evaluated with HE staining and double-blind pathological scoring. The mRNA and protein expressions of tumor necrosis factor-α (TNF-α) and interleukin-1β (IL-1β) in the intestinal tissues were detected using quantitative real-time PCR and ELISA, respectively. Colorimetric assays were used to determine the activity of superoxide dismutase (SOD) and its inhibition rate, malondialdehyde (MDA), glutathione (GSH), oxidized glutathione (GSSG), and GSSG/ GSH ratio., Results: Compared with those in the control group, the neonatal mice in NEC group showed significant weight loss ( P < 0.05), obvious intestinal injury, increased pathological scores ( P < 0.05), increased expressions of TNF-α and IL-1β mRNA and proteins ( P < 0.05), decreased SOD activity and inhibition rate, decreased GSH, and significantly increased MDA, GSSG, and GSSG/GSH ratios ( P < 0.05). Treatment with L. reuteri obviously decreased the pathological scores, expressions of TNF-α and IL-1β ( P < 0.05), MDA, GSSG, and GSSG/GSH ratio ( P < 0.05), and significantly increased SOD activity, its inhibition rate, and GSH level in the mice with NEC, but the survival rate was not significantly different between NEC and L. reuteri -treated groups ( P > 0.05)., Conclusions: L. reuteri DSM17938 can offer protection against NEC in mice by reducing oxidative stress and increasing antioxidant capacity of the intestinal tissue to suppress intestinal inflammations.