ABSTRACT
OBJECTIVE@#To study the value of fecal calprotectin (FC) in the diagnosis of neonatal necrotizing enterocolitis (NEC) through a Meta analysis.@*METHODS@#Web of Science, Cochrane Library, PubMed, Embase, China National Knowledge Infrastructure, Weipu Periodical Database, Wanfang Data, Chinese Biomedical Literature Database were searched for related studies published up to May 2020, with manual search as supplementation. The QUADAS criteria were used to evaluate the quality of the articles included. Meta-DiSc 1.4 and Stata 15.0 software were used to perform the Meta analysis, including the evaluation of specificity, sensitivity, likelihood ratio, and diagnostic odds ratio. The sensitivity analysis and heterogeneity testing were performed, and the summary receiver operating characteristic (SROC) curve and Fagan diagram were plotted.@*RESULTS@#A total of 15 articles were enrolled, involving 1 719 neonates. Among these articles, 4 had low quality, 2 had high quality, and the rest had medium quality. There was high heterogeneity between studies, and there was no threshold effect or publication bias. The random effects model analysis showed that FC had a pooled specificity of 0.80 (95%@*CONCLUSIONS@#FC has high potential and efficiency in the early diagnosis of NEC. FC measurement can be used for the diagnosis of NEC, but it should be combined with clinical manifestations and other related laboratory examinations.
Subject(s)
Humans , Infant, Newborn , China , Enterocolitis, Necrotizing/diagnosis , Feces , Leukocyte L1 Antigen Complex , ROC Curve , Sensitivity and SpecificityABSTRACT
Objective To investigate the changes of thrombomodulin (TM) and P-selectin(P-sel) in neonates with septicemia and to explore their significances in evaluating the patient's condition and prognosis.Methods From Jun.2010 to Mar.2012,56 neonates with septicemia were included in the septicemia group.And 26 healthy neonates were selected as the control group.The neonatal critical illness scores(NCIS) of septicemia were recorded after hospitalization.According to the scores of NCIS,the neonates were divided into extremely critical group(n =13),critical group (n =22),and non-critical group (n =21).Plasma samples of septicemia groups were taken on admission and in the recovery stages.Plasma samples were taken only once in the control group.The plasma TM and P-sel were measured by enzyme-linked immuno sorbent assay.The TM and P-sel levels were compared among different groups.Results The TM levels in extremely critical group,critical group and non-critical group were (25.52 ± 6.57) μg/L,(17.31 ±4.74) μg/L and (13.27 ± 2.83) μg/L,respectively,which were significantly higher than those in the control group [(9.82 ± 2.69) μg/L] (allP'＜ 0.01).The P-sel levels in extremely critical group,critical group and non-critical group were (162.51 ± 52.64) μg/L,(131.10 ± 38.61) μg/L,(78.18 ± 32.15) μg/L,respectively,which were significantly higher than those in the control group [(61.51 ± 21.35) μg/L] (all P ＜ 0.01).The plasma TM and P-sel levels in non-critical group,critical group and extremely critical group were gradually increased (all P ＜ 0.05).The levels of TM and P-sel in the recovery stage were (10.48 ± 3.44) μg/L and (67.52 ± 25.03) μg/L,respectively,which were significantly decreased compared with those before treatment(all P ＜ 0.01).There was no statistically significant difference in TM and P-sel between the Gram negative bacteria infection group and the Gram positive bacteria infection group (all P ＞ 0.05).The prothrombin time and activated partial thromboplastin time in extremely critrcal group were increased than those of other groups (all P ＜ 0.01).The plasma D-dimer levels in non-critical group,critical group and extremely critical group were increased gradually(all P ＜0.01).NCIS was negatively correlated with TM and P-sel(r =-0.428,-0.515,all P ＜ 0.01).Conclusion The detection of TM and P-sel may be helpful in evaluating the severity and prognosis of disease in neonates with septicemia.
ABSTRACT
Objective To provide more objective evidence for clinical differential diagnosis of the neonatal hypoxic-ischemic encephalopathy(HIE) and acute bilirubin encephalopathy(ABE) by reviewing the magnetic resonance imaging differences between them.Methods The MRI findings along with T1WI characteristics in 48 neonates with HIE and in 36 neonates with ABE in two Grade Ⅲ Class A hospitals between Jan.2010 and Jan.2012 were retrospectively reviewed.All of the MRI imaging data were read again by 2 professor neuroradiologist from these hospital by blind method,and the results were analyzed by the SPSS 15.0 statistical analysis software.Results The ABE in the MRI examination exhibited more abnormalities (OR =29.62,95 ％ CI:7.74-113.38),the difference was statistically significant(x2 =34.636,P =0.000) ; Putamen signals changes were more observed clearly in the HIE,and compared with those in ABE patients,the difference was statistically significant (x2 =4.838,P =0.028) ;the performance of the globus pallidus signals changes in ABE neonates were more observed (OR =24.27,95％ CI:7.68-76.68),and compared with those in HIE neonates,the difference was statistically significant (x2 =36.560,P =0.000).Subthalamic signal changes were found most in ABE neonates (OR =16.43,95 ％ CI:3.44-78.442),the difference was statistically significant(x2 =17.921,P =0.000).And the ABE globus pallidus,subthalamic high signal was localized,with a clear boundary,and high signal intensity on HIE diffusion,and edge blur.Conclusions The globus pallidus,subthalamic of neonates with ABE more easily demonstrated high signal,the putamen in neonates with HIE more easily demonstrated high signal;injury induced by ABE is limited,the damage area with clear boundary,HIE damage is more dispersed,the boundary is not clear.