The intestinal microbiota is composed of beneficial bacteria and harmful bacteria in the body as the ecological environment,which is the largest,most complex microecosystem.There is emerging evidence that appropriate colonization process of intestinal microbes contributes to development of intestinal structure and function and maturation of immune system,which determines the risk of intestinal diseases.More and more studies focus on the relationship between intestinal microecology or probiotics and neonatal necrotizing enterocolitis (NEC).This article reviews the composition and function of neonatal intestinal microbiota,the intestinal microflora in the pathogenesis and mechanism of NEC and preventive effects of probiotics on NEC.

Objective To explore the expression of angiopoietin-1 (Ang-1) and lung development in neonatal rat with hy-peroxia-induced bronchopulmonary dysplasia (BPD). Methods A total of forty-eight 1-to 3-day-old neonatal rats were random-ly divided into hyperoxia group and control group with 24 rats in each group, fed in high concentration oxygen (≥95%) or in air respectively. At 1st, 3rd and 7th day after high oxygen exposure, the histological changes in lung tissue were observed by HE stai-ning under a light microscope and the expressions of Ang-1 mRNA and its protein in lung tissue were detected by RT-PCR and Western blot. Results With extended exposure to high concentrations of oxygen, rats in hyperoxia group presented such patho-logic change of lung tissue dysplasia as alveolar simplification, reduction in alveolar number and arrested pulmonary microvas-cular development. At 7th day after high oxygen exposure, Ang-1 mRNA and protein expressions in hyperoxia group were (0.33± 0.18) and (0.20±0.07), significantly lower than those [(0.83±0.46) and (0.57±0.44)] in control group (P<0.05). Conclusions Ang-1 plays an important regulatory role in the pulmonary vascular development and participates in the pathogenesis of BPD.

Objective To discuss the possible molecular mechanisms involved in the protective effects of Biifdobacterium on intestinal tissue of necrotizing enterocolitis (NEC) newborn rats. Methods Seventy-five newborn Sprague-Dawley rats (born within 2 h) were randomly divided into five groups, each group with 15 rats. Group A was the NEC model group, and the rats were fed lipopolysaccharide (LPS) and formula. Group B was the Biifdobacterium treatment group, and the rats were fed LPS and formula and Biifdobacterium micro-capsule. Group C was the artificial feeding control group, and the rats were fed formula. Group D was the Biifdobacterium control group, and the rats were fed formula and Biifdobacterium micro-capsule. Group E was the breastfeeding control group, and the rats were fed rat breast milk by mothers. LPS 30 mg/kg was administered by gavage once per day for 3 days. Bifidobacterium micro-capsules were given as 1×1010 colony forming units/ml by gavage with formula once per day. After fed for 72 h and fasted for 12 h, the five groups of rats were killed by decapitation. Morphological changes in the terminal ileum tissue were observed under a light microscope and intestinal injury was scored. The expression of Toll-like receptor (TLR) 2, TLR4, and nuclear transcription factor (NF)-κB p65 was detected by immunohistochemical methods. Kruskal-Wallis test, analysis of variance, corrected Chi-square test and Fisher's exact test were used for statistics. Results The morbidity of NEC in group A to E was 11/15, 4/15, 3/15, 2/15 and 0/15, respectively;the intestinal injury score in group A to E was 3.37±0.27, 1.53±0.44, 1.75±0.37, 0.92±0.39 and 0.30±0.18, respectively; the expression level of TLR2 in group A to E was 0.35±0.05, 0.30±0.03, 0.32±0.04, 0.30±0.02 and 0.29±0.03, respectively;the expression level of TLR4 in group A to E was 0.48±0.05, 0.34±0.03, 0.36±0.03, 0.37±0.04 and 0.35±0.02, respectively;the expression level of NF-κB p65 in group A to E was 0.43±0.03, 0.29±0.03, 0.35±0.02, 0.32±0.02 and 0.30±0.02, respectively. The differences in NEC morbidity, intestinal injury score, and the expression levels of TLR4, TLR2 and NF-κB p65 among the five groups were all statistically significant (χ2, H or F=23.863, 70.290, 8.803, 38.599 and 75.076, respectively, all P<0.05). The values in the NEC model group were all significantly higher than those in the other four groups (all P<0.05). The morbidity of NEC in the Biifdobacterium treatment group compared with the three control groups was not significantly different (all P > 0.05). The intestinal injury score in the Bifidobacterium treatment group was significantly higher than that in the Bifidobacterium control group and the breastfeeding control group (both P < 0.01), but was not significantly different to that in the artificial feeding control group (P > 0.05). The expression levels of TLR4 and NF-κB p65 in the Biifdobacterium treatment group were significantly lower than those in the artificial feeding control group and the Biifdobacterium control group (all P < 0.05), and were not significantly different to those in the breastfeeding control group (P>0.05). The expression level of TLR2 in the Biifdobacterium treatment group compared with the three control groups was not significantly different (all P > 0.05). Conclusions Biifdobacterium may inhibit pathogenic bacteria or regulate the negative feedback of TLR2 to reduce the expression of TLR2 and TLR4 in intestinal mucosa cells, inhibit the NF-κB pathway, attenuate the inflammatory reaction, and play a role in the prevention and control of NEC.

Objective To study the effect of bifidobacterium on intestinal tissue of necrotizing enterocolitis (NEC)in newborn rats and its regulation of Wnt/β-Catenin signal pathway.Methods Seventy -five newborn SD rats were randomly divided into 5 groups,and each group had 1 5 rats.Group A was artificial feeding control group;group B was NEC model group;group C was bifidobacterium treatment group;group D was artificial feeding +bifidobacterium control group;group E was rat breast feeding control group.The localization expression of Toll -like re-ceptor 4(TLR4)of ileocecal ileum tissue was detected by immunohistochemical detection,and also the equivalen-tileum tissues were detected for the contents of glycogen synthase kinase -3β(GSK3β)and β-Catenin expression by Wes-tern blot.Comparing the differences of these indicators between the groups,in addition,the data of TLR4,GSK3βandβ-Catenin were analyzed by Bivariate correlations.Results The levels of TLR4 in ileum tissue of 5 groups were 0.36 ±0.03,0.48 ±0.05,0.34 ±0.03,0.37 ±0.04,0.35 ±0.02.The levels of GSK3βin ileum tissue of 5 groups were 0.98 ±0.23,1 .48 ±0.42,0.99 ±0.20,0.56 ±0.1 7,0.60 ±0.1 5.The levels of β-Catenin in ileum tissue of 5 groups were 1 .48 ±0.22,0.64 ±0.55,1 .27 ±0.36,1 .72 ±0.51 ,1 .82 ±0.44.The levels of TLR4 and GSK3βin ileum tissue of group B were significantly increased compared with group E (P <0.05).The levels of β-Catenin sig-nificantly decreased compared with group E (P <0.05).The levels of TLR4 and GSK3βin ileum tissue of group C were significantly decreased compared with group B (P <0.05).The levels of β-Catenin significantly increased com-pared with group B (P <0.05).Negative correlation was observed between the levels of GSK3βand β-Catenin(r =-0.592,P <0.05),while positive correlation was observed between the levels of TLR4 and GSK3β(r =0.295,P <0.05),and negative correlation was observed between the levels of TLR4 and β-Catenin(r =-0.426,P <0.05). Conclusions Bifidobacterium has certain protective effect on the NEC newborn rat intestines,which can reduce the in-cidence of experimental NEC and the severity of intestinal injury.Its effect may be achieved by regulating the Wnt/β-Catenin signal pathway,which decreases the expression of the level of GSK3βand increases the level of repair fac-tor β-Catenin.

Objective To study the clinical features,diagnosis,treatment and prognosis of neonatal fulminant myocarditis.Method From January 2016 to August 2016,clinical data of neonates with fulminant myocarditis admitted to the neonatal intense care unit (NICU) were retrospectively collected and analyzed.Result A total of 11 neonates were enrolled,including 6 males and 5 females,and 5 preterms and 6 full term infants.The average gestation age was (37.7 ± 1.6) weeks and their weight on hospital admission was (3 382 ± 675) g.Among the infants,9 got ill in summer and 2 in spring and winter.The onset of illness was within 3 ～ 5 d after birth in 8 cases and 2 ～ 3 weeks in the other 3 cases.The main clinical presentations included fever,anorexia,shortness of breath and lethargy.Various degrees of cardiac dysfunction appeared in all 11 cases,including cardiogenic shock in 10 cases,severe arrhythmias with multiple organ dysfunction in 7 cases,and viral meningitis in 7 cases.10 infants had significantly elevated brain natriuretic peptide (BNP) and troponin Ⅰ,and those with troponin Ⅰ above 20 μg/L had poor prognosis.A comprehensive treatment of limiting liquid volume,high-dose adrenocortical steroids,and IVIG were carried out.Meanwhile,therapy to prevent shock,improve cardiac function,reverse arrhythmia,and mechanical ventilation were used in children with dyspnea.7 cases were cured and 6 patients were followedup for 6 to 12 months.Among the 6 followed-up patients,within 1 ～3 months after discharge,4 cases had normal echocardiogram,and persistently abnormal echocardiogram were found in the other 2 cases and eventually confirmed as dilated cardiomyopathy.4 patients were dead.Conclusion The clinical manifestations of neonatal fulminant myocarditis are unspecific.It's difficult to recognize the early symptoms,missed and delayed diagnosis are common,resulting in high mortality rate.Timely diagnosis and effective treatment can improve the survival rate.

Objective To study the feasibility of non-invasive spatially-resolved near-infrared spectroscopy (SR-NIRS) in clinical bedside monitoring of shock.Methods The central venous blood samples of 25 patients with shock were collected and the central internal jugular central vein oxygenation (ScvO2) level was measured.The self-developed non-invasive SR-NIRS device was used to measure tissue blood oxygen saturation (StO2) surrounding the region of jugular central vein.In addition,the artery oxygen saturation (SaO2) and partial pressure of oxygen (PO2) were also measured using conventional methods.The correlation between StO2 between ScvO2,SaO2 and PO2 was analyzed.Results StO2 levels in shock patients were highly correlated with ScvO2 levels (r=0.84,P＜0.001) and the concordance coefficient of 0.80 was high.Conclusion StO2 value collected from the surrounding region of jugular central vein by SR-NIRS device can be used as an indicator of shock suggesting the potential of noninvasive SR-NIRS for bedside shock monitoring.

Objective:To improve the understanding of adult primary hemophagocytic syndrome (HPS) with aggressive natural killer cell leukemia (ANKL).Methods:The clinicopathological data of one adult patient with suspected primary HPS complicated with ANKL in Huiqiao Medical Center, Nanfang Hospital of Southern Medical University in October 2017 were retrospectively analyzed, and literatures were reviewed.Results:A 21-year-old male patient presented with persistent fever, hemocytopenia, splenomegaly, low fibrinogen, a significant increase in ferritin, hemophagocytes in bone marrow, decreased natural killer (NK) cell activity, and increased soluble CD25. Flow cytometry detection showed that the expression of NK cells was abnormal, and there were familial lysosomal trafficking regulator (LYST) and UNC13D gene defects. He was suspected of primary HPS complicated with ANKL. The patient was given 4 courses of EPOCH+PEG-Asp (etoposide, dexamethasone, vindesine, cyclophosphamide, doxorubicin hydrochloride liposome, pegaspargase) regimen chemotherapy, 20 mg of citalopidine twice a week maintenance therapy and matched unrelated hematopoietic stem cell transplantation. After 35 months of follow-up, he got sustained remission.Conclusions:Even if there are secondary causes of adult HPS, it is necessary to screen out related genes to avoid misdiagnosis. HPS patients with ANKL progress rapidly, and the early mortality is high. EPOCH+ PEG-Asp regimen induction therapy and allogeneic hematopoietic stem cell transplantation should be used as early as possible after diagnosis.