Objective To observe the difference and clinical significance of expression levels of microRNA-155(miR-155)mRNA and interleukin-6(IL-6)in very preterm neonates with preeclampsia.Methods Twenty-eight cases of very preterm newborns(gestational age<32 weeks and/or body weight<1500 g)from preeclampsia pregnant women admitted to the department of obstetrics of Liaocheng People's Hospital from January to December 2021 were selected as the observation group,and 26 cases of very preterm neonates hospitalized for other reasons during the same period were selected as the control group.Electronic medical record clinical data related to children were collected,and the differences between the two groups were compared,including general conditions of preterm infants and pregnant mothers(gender,gestational age,birth weight,preeclampsia or not),proportion of invasive ventilation,proportion of bronchopulmonary dysplasia(BPD),incidence of acute respiratory distress syndrome(ARDS)and early-onset sepsis,white blood cell count(WBC),neutrophil count(NEUT),and expression of miR-155 mRNA and IL-6 levels in the serum of umbilical arterial blood after birth.Pearson correlation analysis was used to analyze the correlation between miR-155 and IL-6 levels Results The birth body weight of the observation group was significantly lower than that of the control group(kg:1.21±0.22 vs.1.32±0.33,P<0.05),the proportion of invasive ventilation,the proportion of BPD,the incidence of ARDS and sepsis were significantly higher than those in the control group[the proportion of invasive ventilation:75.0%(21/28)vs.57.7%(15/26),the proportion of BPD:35.7%(10/28)vs.11.5%(3/26),incidence of ARDS:100.0%(28/28)vs.84.6%(22/26),incidence of sepsis:71.4%(20/28)vs.53.8%(14/26),all P<0.05],the level of miR-155 mRNA expression and IL-6 were significantly higher than those in the control group[miR-155 mRNA(2-ΔΔCt):0.93±0.18 vs.0.17±0.03,IL-6(ng/L):73.84(33.44,429.00)vs.19.05(9.30,47.20),both P<0.05].Pearson correlation analysis showed that miR-155 and IL-6 levels were significantly positively correlated(r=0.782,P<0.01).With the extension of birth time,both WBC and NEUT gradually decreased in the two groups,and there were statistically significant differences in WBC and NEUT at each time point after birth,with counts significantly lower at 48 hours and 72 hours compared to 24 hours after birth(both P<0.05).The WBC of the observation group at 24,48 and 72 hours after birth was significantly lower than that of the control group(×109/L:7.85±2.44 vs.12.28±6.81 at 24 hours after birth,7.31±3.53 vs.10.98±7.91 at 48 hours after birth,4.97±2.05 vs.7.82±4.65 at 72 hours after birth,all P<0.05),NEUT in observation group was significantly lower than of control group at 24 hours and 48 hours after birth(×109/L:24 hours after birth was 4.13±1.93 vs.7.45±5.67,48 hours after birth was 3.96±2.64 vs.6.89±6.24,both P<0.05).Conclusion The expression level of miR-155 mRNA and IL-6 in very preterm neonates with preeclampsia is significantly up-regulated at the time of birth,and the inflammatory response of the body is disturbed,which has certain value for early assessment of the disease.

Objective:To investigate the value of N-terminal pro-brain natriuretic peptide (NT-proBNP) combined with bedside echocardiography in diagnosis and treatment of neonatal sepsis with cardiac dysfunction.Methods:A total of 56 children diagnosed with neonatal sepsis in the Neonatal Intensive Care Unit, Liaocheng People′s Hospital from July 2016 to July 2017 were enrolled and divided into 2 groups, namely, the cardiac dysfunction group (26 cases) and the non-cardiac dysfunction group (30 cases). Children with general infection (45 cases) hospita-lized at the same period were taken as the control group.The clinical characteristics, related laboratory indexes and prognosis were compared among 3 groups.The related factors of neonatal sepsis with cardiac dysfunction were analyzed by the multivariate Logistic regression approach, and the value of related indexes in the early prediction neonatal sepsis with cardiac dysfunction was analyzed by using the receiver operating characteristic curve (ROC). Results:The onset age of sepsis patients with cardiac dysfunction [63.0 h (30.5 h, 185.6 h)] was significantly earlier than that of the patients without cardiac dysfunction [65.0 h (34.5 h, 170.6 h)] and the control group [80.0 h (45.5 h, 202.3 h)] ( P<0.05). The main primary site of the disease was the lung, which was not statistically significant among the 3 groups ( P>0.05). The NT-proBNP level and the high sensitivity-C-reactive protein (hs-CRP)/albumin (ALB) ratio in the cardiac dysfunction group [20 230.6 ng/L (15 890.0 ng/L, 35 000.0 ng/L); 0.33(0.29, 0.81)] were significantly higher than those in the control group [7 324.5 ng/L (2 426.5ng/L, 13 890.0 ng/L); 0.06(0, 0.21)] (all P<0.05). The right ventricular diameter and the Tei index of the cardiac dysfunction group [(8.74±2.42) mm; 0.52±0.03] were significantly higher than those in the control group [(8.55±1.41)mm; 0.30±0.04], while the EF of the cardiac dysfunction group [(62.61±2.56)%] was significantly lower than that in the control group [(70.03±0.35)%] (all P<0.05). The ROC curve analysis showed that NT-proBNP and the Tei index could effectively predict sepsis with cardiac dysfunction.Specifically, NT-proBNP had a cutoff value of 12 291.5 ng/L, with sensitivity of 80%, specificity of 79%, and the area under ROC curve (AUC) of 0.81.The Tei index had a cutoff value of 0.45, with sensitivity of 74%, specificity of 77%, and the AUC of 0.78. Conclusions:NT-proBNP can be used as a marker of early cardiac dysfunction.Its combination with the Tei index of bedside echocardiography can quickly diagnose cardiac dysfunction of children with sepsis, better guide clinicians in drug use, improve cardiac function of patients and enhance the treatment effect.