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Objective:To explore the relationship between the neural development of preterm infants and gut microbiota.Methods:66 premature infants who were hospitalized in the Neonatology Department of Hunan Children′s Hospital from September 2018 to September 2019 were included in the study. Their fecal samples and clinical data from the first admission were collected. According to the neurodevelopment, the patients were divided into normal neurodevelopment group and neurodysplasia group. The bacterial DNA of fecal samples was extracted by 16S rDNA high-throughput sequencing technology and bioinformatics analysis was conducted to compare the composition and diversity of gut microbiota between the two groups.Results:(1) The Shannon index of gut microbiota in normal neurodevelopmental group and neurodysplastic group was 0.89(0.41, 1.51) and 1.01(0.47, 1.31), respectively. There was no significant difference in diversity index between the two groups ( P>0.05). (2) Bifidobacterium, veronica and negativites in the gut microbiota of the normal neurodevelopmental group were significantly higher (all P<0.05), and streptococcus in the gut microbiota of the dysplastic group were significantly higher ( P<0.05). The gut microbiota of the two groups were mainly enterococcus and escherichia shigella. Conclusions:At the genus level, enterococcus and escherichia are the dominant flora of early gut microbiota in preterm infants. Gut microbiota is related to the neural development of preterm infants. The increased abundance of streptococcus, and the decreased abundance of bifidobacterium, veronicus, and negativites may be risk factors for neurodysplasia of preterm infants. The diversity of gut microbiota in early preterm infants may not be significantly related to neural development.
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Objective:To study the clinical characteristics of neonatal sepsis caused by raoultella ornithinolytica.Methods:From January 2010 to December 2020, clinical data of seven cases of neonates with raoultella ornithinolytica sepsis in the Department of Neonatology of our hospital were analyzed. Literature published from the establishment of the databases to December 31, 2020 were searched and reviewed on this topic. The databases included PubMed, Web of Science, Embase database, Wanfang Database, CNKI, National Science and Technology Library and Chinese Science Paper Online.Results:Among the 7 cases admitted to our hospital, 6 male and 1 female, 6 premature and 1 full-term small-for-gestational-age (SGA), 6 patients presented with lethargy, 5 patients had fever and 3 showed dyspnea. 4 patients had necrotizing enterocolitis (NEC), 1 congenital intestinal malrotation, 1 congenital jejunal atresia, 1 intestinal adhesion and stricture. 4 patients had history of surgery. Leucocytosis was found in 3 cases and leukopenia in 1 case. Thrombocytopenia and increased inflammatory indicators were found in all cases. All 7 patients recovered and were discharged. 4 articles on 4 newborn cases (3 males, 1 female including two premature infants) were found for literature review. 3 cases had skin flushing, 3 cases showed dyspnea, 2 cases had fever and 1 case presented with lethargy. 1 case received surgery for congenital heart disease. Leucocytosis was found in 2 cases, leukopenia in 1 case, thrombocytopenia in 2 cases and elevated inflammatory indicators in 3 cases. 1 patient died due to septic shock and the other three recovered and were discharged.Conclusions:Raoultella ornithinolytica neonatal sepsis may occur in infants with intestinal comorbidities, history of invasive procedures, premature birth or full-term SGA and congenital malformations. Most anti-infective therapies are effective. However, if the patient had septic shock, the prognosis is poor.
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Objective:To study the protective effect of polygalasaponin F (PGSF) on isoproterenol (ISO)-induced myocardial ischemia (MI) injury in neonatal rats and its possible mechanism.Methods:Fifty newborn Sprague Dawley (SD) rats were randomly divided into control group, model group, low, medium and high dose PGSF groups (5, 10, 50 mg/kg), with 10 rats in each group. The rats in the control group were treated with normal saline; Myocardial ischemia (MI) model was established in model group by subcutaneous injection of isoproterenol (ISO, 85 mg/kg, once a day); The MI model was established in rats of low, medium and high dose PGSF group after intraperitoneal injection of 5, 10 and 50 mg/kg PGSF for 7 days. The cardiac function of rats in each group was evaluated by echocardiography; pathological changes of myocardial tissue of rats in each group were observed by hematoxylin and eosin (HE) staining; The serum activities of troponin I (cTnI), creatine kinase isoenzyme (CK-MB), myoglobin (Mb) and lactate dehydrogenase (LDH) of rats in each group were detected by enzyme linked immunosorbent assay (ELISA); the content of malondialdehyde (MDA) and active oxygen species (ROS) in myocardial tissue were detected ; the expression of nuclear proliferation antigen (Ki67) and caspase-3 protein in myocardial tissue was detected by immunohistochemical staining; The expression of protein kinase B (AKT) and nuclear factor erythroid 2-related factor 2 (Nrf2) protein in myocardium was detected by Western blot.Results:In the model group, the myocardial structure was disordered, the cells were congested and swollen, and there were a lot of inflammatory cells infiltrating and large necrotic foci. The left ventricular wall thickness (LVWT), left ventricular ejection fraction (LVEF), fractional shortening (FS), heart rate (HR) and expression of Ki67 positive protein in the model group were lower than those in the control group (all P<0.05), while the left ventricular end systolic volume (LVESV), activities of cTnI, CK-MB, Mb, LDH in serum, content of ROS and MDA in myocardial tissue and caspase-3 positive protein in the model group were higher than those in the control group (all P<0.05). Compared with the model group, the degree of myocardial pathological changes in neonatal rats of the low, medium and high dose PGSF groups gradually decreased. Compared with model group, the LVWT, LVEF, FS, HR and expression of Ki67 positive protein increased in low, medium and high dose PGSF groups (all P<0.05), while the LVESV, activities of cTnI, CK-MB, Mb and LDH in serum, content of ROS and MDA in myocardial tissue and the expression of caspase-3 positive protein decreased (all P<0.05); Western blot results showed that the relative expression of phosphorylated(p)-AKT/AKT, p-Nrf2/Nrf2 protein in myocardium of model group was lower than that of control group (all P<0.05); The relative expression of p-AKT/AKT, p-Nrf2/Nrf2 protein in myocardium of low, medium and high dose PGSF groups were higher than that in the model group (all P<0.05). Conclusions:PGSF has protective effect on MI injury in neonatal rats, and its mechanism may be related to anti-apoptosis and anti-oxidative stress.
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Objective:To compare the characteristics and differences of intestinal flora in premature infants with late-onset sepsis (LOS) and pneumonia by high-throughput sequencing technology, and to investigate the relationship between intestinal flora and LOS.Methods:Through the case-control method, premature infants with late-onset sepsis who were hospitalized in the neonatal department of Hunan Children′s Hospital from August 2018 to October 2019 were selected as the case group ( n=8). At the same time, premature infants diagnosed with pneumonia were selected as the control group ( n=8). The fecal samples of 16 premature infants were collected for the first time, and the DNA was extracted. The DNA of the target region was amplified by polymerase chain reaction(PCR). High-throughput sequencing was performed using NovaSeq 6000 platform to analyze the composition and diversity of intestinal flora between the two groups. Results:(1) Alpha diversity analysis showed that there was no significant difference in the richness and diversity of intestinal flora between the two groups(all P>0.05). (2) The intestinal flora in premature infants of LOS group and control group were dominated by Firmicutes and Proteobacteria, and facultative anaerobes such as Enterococcus and Escherichia-Shigella were the dominant flora at the genus level. Metastas statistical analysis showed that there was no statistically significant difference in flora composition between the two groups at the phylum level ( P>0.05). (3) Metastas statistical analysis was carried out at the level of class, order, family, genus, and species. The relative abundance of actinomycetes, digestive streptococcaceae and Clostridium in LOS group was higher than that in pneumonia group, and the difference was statistically significant (all P<0.05). (4) The relative abundance of Staphylococcus in the LOS group was significantly greater than that in the control group, but Metastas statistical analysis showed that there was no statistically significant difference in the relative abundance of staphylococcus between the two groups ( P>0.05). (5) Among the 8 cases of LOS, 3 premature infants had positive blood cultures, namely Streptococcus agalactiae, Streptococcus mitis, and Enterococcus faecalis. Enterococcus faecalis belongs to the genus Enterococcus, and Enterococcus belongs to the dominant genus in the LOS group. Conclusions:Different site infections have effects on intestinal microecology of premature infants. There were differences in intestinal flora composition between premature infants with LOS and premature infants with pneumonia.
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Objective:To study the risk factors of metabolic bone disease (MBD) associated fracture in very low birth weight premature infants.Methods:From January 2012 to December 2019, premature infants (gestational age <32 weeks, birth weight <1 500 g) were admitted to our hospital and followed-up regularly for 1.5 years (once every month within first 6 months, then once every 3 months). The infants were assigned into two groups according to X-ray diagnosis: the fracture group and the non-fracture group. The clinical data of the two groups were compared and the risk factors of fracture were analyzed.Results:A total of 62 preterm infants with MBD were included in this study, including 11 in the fracture group and 51 in the non-fracture group. The risk factors of MBD associated fracture included intrauterine growth restriction (IUGR), birth weight <1 000 g, gestational age, respiratory support duration and total parenteral nutrition (TPN) duration ( P<0.05). Logistic regression analysis showed that IUGR ( P<0.05, OR=2.159, 95% CI 1.536~2.759) and TPN duration ( P<0.05, OR=1.143, 95% CI 1.042~1.270) were independent risk factors for fracture. Serum alkaline phosphatase (ALP) in the fracture group was significantly higher than the non-fracture group and 25(OH)VitD was significantly lower than the non-fracture group ( P<0.05). Conclusions:IUGR and TPN duration are risk factors for MBD associated fracture in preterm infants. As biochemical markers of bone metabolism, ALP and 25(OH)VitD levels have clinical value predicting MBD associated fracture.