Necrotizing enterocolitis (NEC) is the most common severe gastrointestinal emergency in neonatal period. Searching biomarkers to identify infants at greatest risk of developing NEC might be of importance for early diagnosis, effective treatment and better prognosis of NEC. Biomarkers from stool and urine attract great attention due to non-invasiveness and easy availability of fecal and urinary sampling. This article reviews the latest research progress of non-invasive biomarkers including intestinal fatty acid binding protein, serum amyloid A, complement C3a and C5a in urine;fecal lactoferrin, intestinal bacteria spectrum, fecal calprotectin, S100A12 and high mobility group box-1 protein.

Necrotizing enterocolitis (NEC) is one of the severe gastrointestinal emergencies with high mortality in neo-natal period. Studies suggested that sepsis from NEC were associated with higher mortality in NEC. Therefore, it is important to explore the related factors and prevention measures of NEC and improve the prognosis of children with NEC. In recent years, studies have shown that the risk factors of sepsis in NEC included prematurity, low birth weight, long time of total parenteral nutrition supports and long duration of antibiotic exposure. The main pathogen of sepsis was gram-negative bacilli. Probiotics, glutamine and lactoferrin supplementation may reduce the incidence and severity of NEC, and may help further reduce the risk of gut-derived sepsis.

Objective To investigate the risk factors, pathogens spectrum and antimicrobial susceptibility of neonatal fungal septicemia. Methods Medical records of 23 neonates with fungal septicemia from May 2009 to August 2013 were analyzed retrospectively. Results A total of 36 strains of fungi including 20 strains of Candidaparapsilosis (55.6%) and 11 strains of Candidaalbicans (30.6%) were isolated from 23 patients. Fungal pathogens were susceptible to amphotericin and lfuorouracil, with susceptibility being 69.4%-77.8%. Prematurity, low birth weight, application of broad-spectrum antibiotics and invasive operation might be the risk factors of fungal septicemia. Fifteen cases (65.2%) had good outcomes (survival or partial restoration), while 8 cases (34.8%) had poor outcomes (withdrawing therapy or death). The duration of antifungal therapy in good prognosis group was longer than that in poor prognosis group (t=2.982, P<0.05). No significant difference in indicators of liver and kidney function was observed between before antifungal therapy and within 2 weeks after treatment. Meanwhile, no signiifcant difference of WBC was found between before antifungal therapy and within 2 weeks after treatment. The platelet counts were increased within one week after initial antifungal therapy (P<0.05). Conclusions Candida is the main pathogen of neonatal fungal septicemia and sensitive to amphotericin B. Long enough course of antifungal therapy is necessary to improve the cure rate.

Early-onset neonatal sepsis (EONS) is one of the major causes of mortality in neonates, especially in very low birth weight infants. EONS has no speciifc manifestations, and progresses rapidly and unexpectedly. EONS is often missed diag-nosed or even misdiagnosed due to the absence of ideal diagnostic methods in current clinical practice, and this dilemma leads to the high mortality of EONS. Therefore the accurate diagnosis in the early stage of EONS is very important. This review describes the progress in diagnostic methods of EONS including culture, blood cell counts, molecular biological technique, procalcitonin and C-reactive protein measurements, cytokine proifling and some other novel means. It may provide useful information for early diagnosis of EONS.

Objective To study the analgesic clinical effect of patient self-controlled epidural analgesia(PCEA) in post-thoracotomy pain.Methods Eighty-six patients(ASA statge I or II)underwent thoracotomy with general anesthesia were randomly assigned to two groups after operation,PCEA group:45 cases,muscular injection(MI) group:41 cases.Comparing the effect and the side effect of analgesia between them.Respiratory rate(RR),volume of ventilation(MV) minute and SpO 2 were recorded before and after operation.Results In PCEA group, the scores of analgesic scale was significantly superior than that in MI group(P

Objective: To investigate the risk factors for mortality in neonates with congenital esophageal atresia (CEA) and simple congenital heart disease (CHD) including atrial septal defect (ASD), ventricular septal defect (VSD) and patent ductus arteriosus (PDA). Methods The medical records of neonates with CEA and simple CHD who had surgery in Children’s Hospital of Chongqing Medical University from 1998 to 2013, were analyzed retrospectively. Factors including neonatal demographics, laboratory results and complications after surgery were compared between survivor and non-survivor groups. Results Seventy ifve cases were included in this study and the mortality was 10.67%(8/75). There was no signiifcant difference between non-survivor group (n=8) and survivor group (n=67) in factors such as gestational age, birth weight, age of admission, age at surgery, duration of surgery, full blood examination, serum electrolytes, blood gases, prevalence of septicemia, pneumothorax, and cold lesion syndrome. However, the prevalence of respiratory failure and heart failure in non-survivor group was higher than that in survivor group (75%vs. 9%, P=0.000;50%vs. 1.5%, P=0.000, respectively). Conclusions The poor outcome among neonates with CEA plus simple CHD might be associated with respiratory failure and heart failure.

Objective To evaluate the value of fecal high mobility group box-1 (HMGB 1 ) in early diagnosis and prediction of the severity of neonatal necrotizing enterocolitis (NEC). Methods From July 2013 to June 2015 , the neonates who had distention, vomit, or gross blood in stool and were suspected of NEC were recruited as NEC group while hospitalized children without abdominal distension, vomiting, bloody diarrhea, or other gastrointestinal symptoms were recruited as the control group. Stool samples were collected on day 1 , 3 , 5 and 7 after admission. The level of HMGB 1 was measured by enzyme linked immunosorbent assay (ELISA). Results In the end, there were 46 cases in NEC group and 15 cases in control group. In NEC group, 29 cases were conifrmed of stageⅠof NEC by abdominal radiograph within 24 h after hospitalized, all of them were deteriorated to stageⅡphase in 4 days, and 10 cases were deteriorated to stageⅢ. Seventeen cases were conifrmed of stageⅡby abdominal radiograph within 24 h after hospitalized, 7 cases were deteriorated to stageⅢ. In 17 stageⅢcases, 11 cases received surgical treatment and 6 cases gave up. Eight cases survived and 3 died after surgery. The levels of HMGB 1 in NEC group on day 1 , 3 , 5 and 7 after hospitalized were higher than those in control group (P

Objective To explore whether the neurons induced from mesenchymal stem cells(MSCs) have synapse function or not.Methods Passage 4-5 MSCs in good shape was induced by Salvia miltiorrhiza with optimized protocol for several times,and then the observation under inverted phase contrast microscope,immunofluorocytochemistry and the measurement of neurophysiological function were carried out.Ca2+ influx and synapse function were detected with laser-scanning confocal microscopy(LSCM),taking 50 mmol/L KCl as stimuli to evoke action potential.Results The cells that had been induced for 5 h at 4th time from MSCs,looked like neurons and displayed that the processes stretched out to form complex net.Immunofluorocytochemistry presented that the rate of TUJ-1 expression was(96.7?2.8)% and that of synaptophysin was(96.2?2.1)%.When the neuron-like cells were stimulated by high concentration of KCl,intracellular Ca2+ influx enhanced quickly.When the neuron-like cells were stimulated by high KCl solution for the first time,SynaptoRed-C2 anchored onto the membrane,and after the second excitation,the fluorescence intensity decreased quickly.Conclusion The neuron-like cells derived from MSCs that are induced by salvia miltiorrhiza with optimized protocol have synapse function.

Objective To explore the distribution and differentiation of bone mesenchymal stem cells (MSCs) in the brain of neonatal rats with hypoxic ischemic encephalopathy (HIE). Methods MSCs were isolated and purified by adhering to the culture glassware wall and prelabeled with bromodeoxyuridine (BrdU) for 72 h before transplantation. The model of HIE was established. At 24 h after hypoxic ischemia, approximate 4?10 6 cells were injected into the brain of neonatal rats with HIE through the right side bregma. The Nestin, neuron specific enolase (NSE) and glial fibrillary acid protein (GFAP) were detected by immunofluorochemistry at 4 weeks after injection. Results Majority of MSCs were distributed in the cortex, hippocampus of the lesioned hemisphere. The number of MSCs was (2781?254) in the left hemisphere, but (4708?281) in the right hemisphere. There was significant difference (t=18.70, P0.05). The expression ratio of NSE was (3.79?0.95)% in the left hemisphere, but (5.69?1.48)% in the right hemisphere (t=3.404, P0.05). Conclusion MSCs are mainly distributed in the lesioned hemisphere and can differentiate into neuronal-like cells, express the mark of neural stem cells, neurons and neuroglial cells at 28 d after intracortical transplantation.

Objective To assess the clinical efficacy of acupuncture at the sphenopalatine ganglion for the treatment of patients with moderate to severe allergic rhinitis.Methods 42 cases of moderate to severe allergic rhinitis patients in Otorhinolaryngology clinic of Tongren Hospital between August 2012 to November 2013 were randomized into a treatment group and a control group. The treatment group was treated by acupuncturing sphenopalatine ganglion, once per week, altogether 4 times. The control group was treated by acupuncturingFengchi(GB20),Baihui(GV20),Yingxiang(GV29),Shangxing(GV23),Taiyang(EX-HN5), Quchi(LI11) andZusanli (ST36) was used in the control group, 3 times per week for 4 weeks. The changes of the Total Nasal Symptoms Score (TNSS) and the Total Non-Nasal Symptom Score (TNNSS) were evaluated before and after treatment. The Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) was used to evaluate the quality of life.Results One week after treatment, the scores of TNSS, TNNSS and RQLQ in both groups were significantly improved than before the treatment (treatment group: 5.0[4.0, 6.0]vs. 9.0[7.0, 10.0], 1.0[1.0, 1.5]vs. 3.0[3.0, 3.0], 44.0[35.5, 50.0]vs. 60.0[53.5,75.0]; control group: 6.0[5.5, 8.0]vs. 10.0[8.5, 10.1], 2.0[2.0, 3.0]vs. 3.00[3.0, 3.0], 50.0[45.5, 58.0]vs.43.0[27.0, 48.0]; allP<0.01); the scores of TNSS, TNNSS and RQLQ 1 week after treatment in the treatment group were significantly improved than those in the control group. The scores of TNSS(2.0[1.0, 3.0]vs. 3.0[2.0, 4.5]), TNNSS(1.0[0.0, 1.0]vs.2.0[2.0, 3.0]) and RQLQ(24.0[19.0, 29.0]vs. 43.0[27.0, 48.5])4 week after treatment in the treatment group were significantly improved than those in the control group(allP<0.01).Conclusions Acupuncture at the sphenopalatine ganglion could relieve the symptoms and improve the quality of life in patients with moderate to severe allergic rhinitis, and show more rapid and persistent therapeutic effect. It may be superior to the common acupuncture.