Objective:To compare the clinical effects of using xenogenic bone graft materials with or without collagen components for tooth micro crestal flap-alveolar ridge preservation (MCF-ARP) at molars with severe periodontitis.Methods:This study included patients who visited Department of Periodontology, Peking University School and Hospital of Stomatology from May to November 2023 due to severe periodontitis, requiring tooth extraction and planning for implant-retained prostheses. A total of 24 molars from 24 patients with severe periodontitis were assigned into two groups: the deproteinized bovine bone mineral (DBBM) group and the DBBM with collagen (DBBM-C) group. Twelve affected teeth from 12 patients were included in each group. Both groups underwent minimally invasive tooth extraction and MCF-ARP, with DBBM and DBBM-C implanted in the extraction socket, respectively. Cone beam CT (CBCT) was performed before and 6 months after the surgery for assessing changes of hard tissue. Intraoral scanning was performed before and at 2 weeks, 1 month, 3 months, and 6 months after the surgery for assessing soft tissue contour changes and patterns in both groups.Results:After 6 months of healing, the central bone height increased by (8.35±2.25) mm in the DBBM group and (7.70±2.36) mm in the DBBM-C group. The ridge width at 1 mm apically from the higher bone crest increased by 6.43 (-0.76,7.96) mm in the DBBM group and 6.01 (5.41,7.90) mm in the DBBM-C group. There was no statistically significant difference in the changes of bone height and width between the two groups (all P>0.05). In terms of soft tissue contour changes, although the buccal contour collapses were less in the DBBM-C group, the two groups showed no statistically significant difference (all P>0.05). Conclusions:Within the limitations of this study, it was demonstrated that the clinical effects of MCF-ARP using xenogenic bone graft materials with or without collagen components in molars with severe periodontitis were comparable.

Objective To develop a machine learning(ML)-based prediction model for assessing the therapeutic effects of resveratrol(RES)on the pathological damage of acute pancreatitis(AP),and to optimize RES administration strategies for AP through validation using an animal model.Methods AAn ML-based prediction model was constructed using published data.Interpretability analysis was applied to identify high-efficacy zones within the parameter space of administration dose and frequency,which was followed by rigorous screening to select the optimal dosing strategy that balanced therapeutic efficacy and experimental feasibility.A total of 32 C57BL/6 mice were randomly assigned to 4 groups(n=8 per group),including a control group(Ctrl),an AP model group induced by caerulein(CER)and referred to as CER-AP,a treatment group receiving RES via intraperitoneal injection(RES i.p.),and a treatment group receiving RES via intragastric gavage(RES i.g.).The Ctrl group received intraperitoneal injection of normal saline.The CER-AP and the treatment groups were induced with 10 intraperitoneal injections of CER at 50 μg/kg.RES was administered to the RES i.p.and RES i.g.groups according to the optimal dose and timing predicted by the ML model.Blood and tissue samples were collected 12 hours after the experiment started.Results The gradient boosting decision tree model,optimized via Hyperopt,yielded the best performance,predicting that the optimal dose and administration frequency were 19.992 mg/kg and 3.828 times,respectively.Accordingly,a regimen of 20 mg/kg RES,administered four times,was used in the animal experiments.Compared with the Ctrl group,the CER-AP group exhibited higher pancreatic pathology scores and elevated levels of serum amylase,lipase,pancreatic myeloperoxidase,and trypsin,with all differences reaching statistical significance(all P<0.05).The administration of 20 mg/kg RES via both intraperitoneal injection and intragastric gavage mitigated pancreatic inflammatory cell infiltration and necrosis,improved the overall pathology score,and reduced serum amylase,lipase,and pancreatic myeloperoxidase levels to varying degrees(all P<0.05).Conclusion A regimen of 20 mg/kg RES administered four times effectively alleviates the severity of CER-induced AP.The therapeutic benefits appear to arise from a multi-target regulatory network that simultaneously suppresses inflammatory cascades,mitigates oxidative stress,and reduces apoptosis,thereby reducing pancreatic tissue damage and systemic inflammatory responses.

AIM: To provide references for the non-clinical evaluation of therapeutic targets or drugs for retinoblastoma, fluorescently labeled Y79 cells are injected into the vitreous body of BALB/c-nu mice to establish a retinoblastoma model, and the Melphalan treatment group is used as a positive control, which is verified by fluorescence imaging technology.METHODS: BALB/c-nu mice were intravitreous injected with GFP transfected Y79 cells(1.0×107 cell/mL, 3 μL)to establish the model. On the 27th day, the mice were randomly divided into model control group and different doses of Melphalan groups(1, 3, 10 μg/eye groups)according to the fluorescence value of in vivo imaging, with vitreous body single administrated and ocular symptoms observed daily. Slit-lamp examination was performed at 12, 20, 29, 35, 42, 48, 55, 76, and 83 d after modeling. In vivo imaging was performed on 12, 20, 27, 41, 48, 55, 62, 69, 76, and 83 d. At the last treatment, the eyeball, brain and cerebellum tissues were removed for histopathological examination.RESULTS: From the sixth day of modeling, cloud-like substances could be seen in the eyes of the animals, and the cloud-like substances occupied the whole eyeball of the mice in the model control group at the later stage, accompanied by irregular growth of blood vessels. After 27 days of modeling, the fluorescence value was detected in all the animals, and the fluorescence value continued to increase with the extension of modeling time. The fluorescence value of the tumor reached the peak after 69-83 days of modeling. Histological examination showed severe proliferation of intraocular tumor cells in the model control group, and tumor cells were observed in the brain of 1 model animal. In the 10 μg/eye Melphalan group, the fluorescence value was significantly decreased at 17 d after administration. The fluorescence value of the 3 μg/eye Melphalan group was significantly inhibited at 59 d after administration. No tumor cells were found in the brain tissue of animals in all Melphalan groups.CONCLUSION: After vitreous injection of Y79/pCDH-LUC-copGFP cells in BALB/c-nu mice, significant ocular lesions and proliferation of tumor cells were observed in the eyes. Meanwhile, Melphalan intervention significantly inhibited tumor cells in a dose-dependent manner, indicating that the mouse model of retinoblastoma was successfully constructed.

Objective:To investigate the mediating effect of rehabilitation exercise self-efficacy in the relationship between psychological pain and quality of life among postoperative patients with osteoporotic fractures.Methods:A total of 203 patients with osteoporotic fractures who underwent surgical treatment in the Department of Orthopedics of the Affiliated Hospital of Jining Medical University from June 2023 to June 2024 were recruited using convenience sampling. Postoperatively, patients were assessed with the General Information Questionnaire, the Self-Efficacy Rehabilitation Outcome Scale (SER), the Psychological Pain Scale, and the World Health Organization on Quality of Life Brief Scale (WHOQOL-BREF). The mediating role of rehabilitation exercise self-efficacy was tested using the bootstrap method.Results:A total of 210 questionnaires were distributed, with 203 valid responses collected, yielding an effective response rate of 96.67%. The mean scores of rehabilitation exercise self-efficacy, psychological pain, and quality of life were (65.56±8.89), (26.68±5.57), and (85.90±5.59), respectively. Correlation analysis showed that rehabilitation exercise self-efficacy was negatively correlated with psychological pain ( r=-0.562, P<0.01), psychological pain was negatively correlated with quality of life ( r=-0.801, P<0.01), and rehabilitation exercise self-efficacy was positively correlated with quality of life ( r=0.741, P<0.01). Mediation analysis revealed that rehabilitation exercise self-efficacy partially mediated the relationship between psychological pain and quality of life, with an effect size of -0.231 ( P<0.01), accounting for 38.95% of the total effect. Conclusions:Psychological pain not only directly affects the quality of life in postoperative patients with osteoporotic fractures but also indirectly affects it through rehabilitation exercise self-efficacy. Clinical medical staff should adopt targeted interventions to alleviate psychological pain and enhance rehabilitation exercise self-efficacy, thereby improving patients' quality of life.

Objective:To investigate the efficacy of radiotherapy in patients with advanced esophageal cancer receiving first-line chemoimmunotherapy.Methods:A retrospective analysis was conducted on the data of 137 patients with Stage Ⅳ esophageal squamous cell carcinoma (ESCC) treated at our hospital from January 2018 to May 2023. These patients were divided into two groups: a group treated with first-line chemoimmunotherapy combined with radiotherapy (chemoimmunotherapy + radiotherapy group, n = 43) and a group treated with only chemoimmunotherapy ( n = 94). Inverse probability of treatment weighting (IPTW) was applied to balance baseline characteristics between the groups. With overall survival (OS) and progression-free survival (PFS) as study endpoints, the survival data were analyzed using the Kaplan-Meier method, the log-rank test, and the Cox regression method. Results:Before calibration, the chemoimmunotherapy + radiotherapy group significantly outperformed the sole chemoimmunotherapy group in median PFS (13.6 months vs. 7.0 months; HR: 0.501, 95% CI: 0.309-0.811, P = 0.005). After calibration using the COX proportional-hazards model for age, gender, Eastern Cooperative Oncology Group (ECOG) performance status, smoking history, T/N/M stage, and tumor location, the chemoimmunotherapy + radiotherapy group still had significant advantages in PFS (14.7 months vs. 7.0 months; HR: 0.441, 95% CI: 0.261-0.745, P = 0.002). IPTW analysis further confirmed this trend (13.9 months vs. 7.0 months; HR: 0.492, 95% CI: 0.304-0.795, P < 0.001). Specifically, the median OS of the chemoimmunotherapy + radiotherapy group demonstrated significant improvement in all analyses: pre-calibration (29.5 months vs. 18.0 months; HR: 0.507, 95% CI: 0.297-0.867, P = 0.013), after calibration using the Cox model (27.5 months vs. 16.7 months; HR: 0.470, 95% CI: 0.266-0.830, P = 0.009), and after calibration using IPTW (29.5 months vs. 16.9 months; HR: 0.448, 95% CI: 0.262-0.764, P < 0.001). Conclusions:The combination of radiotherapy and first-line chemoimmunotherapy can significantly improve survival outcomes of patients with advanced ESCC, suggesting its potential as a standard treatment strategy.

Objective:To observe the effect of hyperthermia combined with iron overload on the regulation of tumor-associated macrophage polarization and the migration ability of CAL-27 cells and explore its mechanism.Methods:Human monocytic leukemia cell THP-1 was induced and polarized into M2 macrophages. M2 tumor-associated macrophages and CAL-27 cells were divided into the control group (no intervention), hyperthermia group (incubated at 42 ℃ for 1 h, and then incubated at 37 ℃ for 24 h), ferric citrate group (added with 2.5 mg/ml ferric citrate, and cultured in an incubator at 37 ℃for 24 h) and hyperthermia + ferric citrate group (added with 2.5 mg/ml ferric citrate for 1 h, cultured in an incubator at 42℃ for 1 h, and then incubated at 37℃ for 24 h). For M2 macrophage groups, the mRNA relative expression levels of surface markers of M1 macrophage polarization including interleukin (IL)-1β, tumor necrosis factor-α(TNF-α), and those of M2 macrophage polarization including IL-10 and transforming growth factor-β(TGF-β) were detected by real-time reverse transcription polymerase chain reaction. The expression levels of IL-1β and IL-10 were detected by ELISA. The expression levels of CD86 (surface marker of M1 macrophage polarization) and CD206 (surface marker of M2 macrophage polarization) were measured by flow cytometry. The expression levels of signal transducer and activator of transcription 3 (STAT3), Toll-like receptor 4 (TLR4), nuclear factor κB (NF-κB) and phosphorylated (p)-NF-κB were detected by Western blot (WB). The migration ability of CAL-27 cells was assessed by scratch assay.Results:Compared with the control group, the expression levels of IL-1βand TNF-α mRNA, and IL-1βand CD86 proteins were up-regulated, whereas those of IL-10 and TGF-β mRNA, and IL-10 and CD206 proteins were down-regulated in the hyperthermia, ferric citrate and hyperthermia + ferric citrate groups, respectively (all P<0.05). In addition, the changes in the hyperthermia+ferric citrate group were significantly larger than those in the hyperthermia and ferric citrate groups (all P<0.05). WB showed that the expression level of STAT3 protein was down-regulated and those of TLR4, NF-κB and p-NF-κB expression were up-regulated in the hyperthermia + ferric citrate group (all P<0.05). Scratch assay showed that the migration ability of CAL-27 cells was inhibited in the hyperthermia, ferric citrate and hyperthermia + ferric citrate groups ( P<0.001), and the changes in the hyperthermia + ferric citrate group were significantly more pronounced than those in the hyperthermia and ferric citrate groups (both P<0.001). Conclusions:Hyperthermia and iron overload can promote the polarization of M1 macrophages and inhibit the polarization of M1 macrophages into M2 macrophages, thereby suppressing the migration of oral squamous cell carcinoma. The mechanism may be related to inhibiting the expression of STAT3 and activating the TLR4/NF-κB signaling pathway.

OBJECTIVE To study the chemical constituents in the root bark of Schisandra sphenanthera and their cytotoxic activ-ities.METHODS The compounds were isolated and purified by silica,Sephadex LH-20 and semi preparative-HPLC and the chem-ical structures were identified by 1 H-NMR,13 C-NMR and MS data analysis.The cytotoxic activities of the compounds were deter-mined by MTT method.RESULTS Twenty lignans were isolated and deduced as:Matairesinol(1),2-Hydroxy-2-(3′,4′-di-hydroxyphenyl)methyl-3-(3″,4″-dimethoxyphenyl)methyl-gamma-butyrolactone(2),(+)-Nortrachelogenin(3),2-Hydroxy-2-(4′-O-β-D-glucopyranosyl-3′-hydroxyphenyl)methyl-3-(3″,4″-dimethoxyphenyl)methyl-γ-butyrolactone(4),Nortracheloside(5),Burselignan(6),(+)-Cycloolivil(7),5-Methoxy-(+)-isolariciresinol(8),(-)-Isolariciresinol 3α-O-β-D-glucopyranoside(9),(+)-9-O-β-D-Glucopyranosyl lyoniresinol(10),(-)-Secoisolariciresinol(11),Licarin A(12),Cedrusin(13),Mataires-inol 4′-O-β-D-glucopyranoside(14),Pregomisin(15),Meso-dihydroguaiaretic acid(16),7S,8R-Erythro-4,9,9′-trihydroxy-3,3′-dimethoxy-8-O-4′-neolignan-7-O-β-D-glucopyranoside(17),Gomisin M2(18),Gomisin M3(19),Pinoresinol(20).Com-pounds 1-3,12,15,16,18 and 19 showed cytotoxic activity against A549,HCT116 and SW620 cell lines with IC50 values ranging from 1.4 to 22.9 μmol·L-1.CONCLUSION Compounds 1-4,6-12,14,17-19 are isolated from the plant for the first time,com-pounds 1-3,12,15,16,18 and 19 exhibit cytotoxic activities.

Objective To explore the effect of microRNA-381-3p(miR-381-3p)/MuRF1 axis on cardiopulmonary injury in hypoxia-induced pulmonary hypertension(HPH)mice and its potential mechanisms.Methods Sixty mice were randomly assigned to four groups:the normal control group(NC),the hypobaric hypoxia-induced pulmonary hypertension(HPH)group,the HPH+agomir control group and the HPH+miR-381-3p agomir analog group(HPH+miR-381-3p agomir),with 15 mice in each group.The HPH mouse model was established using a low-pressure and hypoxic artificial chamber.Three weeks prior to the establishment of the HPH model,miR-381-3p agomir and its corresponding control agomir were prepared by dissolving them in RNA-free phosphate-buffered saline(PBS)according to the experimental requirements.These solutions were administered via tail vein injection at a dose of 10 mg/kg,twice weekly for three consecutive weeks.Right heart function was assessed using echocardiography.Right ventricular systolic pressure(RVSP)was measured via cardiac catheterization.Pulmonary vascular remodeling was evaluated through hematoxylin and eosin(HE)staining.Levels of inflammatory cytokines in bronchoalveolar lavage fluid were quantified using enzyme-linked immunosorbent assay(ELISA).Real-time quantitative fluorescent PCR(RT-qPCR)was employed to analyze the mRNA expression levels of miR-381-3p and MuRF1.Potential targets of miR-381-3p were predicted,and pathway enrichment analysis was conducted.A dual-luciferase reporter gene assay was performed to confirm the direct regulatory effect of miR-381-3p on MuRF1.Results Compared with the NC group,the mRNA expression of miR-381-3p was significantly decreased in both the HPH group and the HPH+agomir control group,whereas the mRNA expression of MuRF1 was significantly increased(P＜0.05).In contrast,compared with the HPH group and the HPH+agomir control group,the mRNA expression of miR-381-3p was significantly increased in the HPH+miR-381-3p agomir group,while the mRNA expression of MuRF1 was significantly decreased(P＜0.05).Additionally,compared with the NC group,RVSP,right ventricular anterior wall thickness(RVAW),right ventricular hypertrophy index(RVHI),right ventricular collagen volume fraction(CVF),distal pulmonary artery wall thickness ratio(WT),pulmonary artery wall area ratio(WA),as well as IL-1β,IL-6 and TNF-α levels in alveolar lavage fluid were significantly increased in the HPH group and the HPH+agomir control group,whereas the right ventricular diameter(RVID)was significantly decreased(P＜0.05).Conversely,compared with the HPH group and the HPH+agomir control group,RVSP,RVAW,RVHI,right ventricular CVF,WT,Wa and RVID were decreased in the HPH+miR-381-3p agomir group,and IL-1β,IL-6,and TNF-α levels of alveolar lavage fluid were significantly decreased(P＜0.05).Furthermore,the downstream target genes of miR-381-3p were predicted in the database,and MuRF1 was a potential target,and the Cytoskeleton in muscle cells ranked first in the significant enrichment of target genes.Compared with WT-MuRF1+mimic control group,the luciferase activity was decreased in the WT-MuRF1+miR-381-3p mimic group(P＜0.05).There was no significant difference in the luciferase activity between the Mut-MuRF1+mimic control group and the Mut-MuRF1+miR-381-3p mimic group.Conclusion Overexpression of miR-381-3p can improve cardiopulmonary injury in HPH mice,and the mechanism may be related to the targeted inhibition of MuRF1 by miR-381-3p.

Objective To explore the mechanism of modified Sijunzi Decoction in the intervention of premature ovarian failure(POF)rats through PTEN-mediated PI3K/AKT signaling pathway.Methods Totally 50 SPF-grade healthy female SD rats were divided into normal group(10 rats)and model group(40 rats).The model group was injected with cyclophosphamide to establish a POF model,and then randomly divided into model group and TCM low-,medium-and high-dosage group,with 10 rats in each group,TCM low-,medium-and high-dosage group were given modified Sijunzi Decoction 6.3,12.6,25.2 g/kg by gavage,the normal group and model group were given equal volume of normal saline,once a day for 28 days.The general condition and body mass of rats in each group were observed and recorded daily.After administration,the ovarian index was measured,HE staining was used to observe the morphology of ovarian tissue,ELISA was used to detect the contents of serum estradiol(E2)luteinizing hormone(LH),follicle-stimulating hormone(FSH),anti-Müllerian hormone(AMH),gonadotropin-releasing hormone(GnRH)and β-endorphin(β-EP),RT-PCR was used to detect the mRNA expression of PTEN,PI3K and AKT in ovarian tissue,Western blot was used to detect the protein expression of PTEN,PI3K,AKT,p-PI3K and p-AKT,immunohistochemistry was used to detect the positive expression of PTEN,PI3K and AKT.Results Compared with the normal group,the rats in the model group were depressed,the hair fell off,the diet and drinking water were reduced,the stools became thinner,the body mass was reduced(P<0.05),and the ovarian index was reduced(P<0.05),the ovarian tissue structure was disordered,the number of follicles decreased,and the contents of serum LH,FSH and GnRH increased(P<0.05),the contents of E2,AMH and β-EP decreased(P<0.05),the expression of PTEN mRNA and protein decreased(P<0.05),the expressions of PI3K and AKT mRNA and protein increased(P<0.05),and the expressions of p-PI3K and p-AKT protein increased(P<0.05).Compared with the model group,the general condition of rats in each dosage of TCM groups improved significantly,the body mass increased(P<0.05),ovarian index increased(P<0.05),the number of follicles in rat ovarian tissue increased,the contents of LH,FSH and GnRH decreased(P<0.05),the contents of E2,AMH and β-EP increased(P<0.05),the expression of PTEN mRNA and protein increased(P<0.05),the expression of PI3K and AKT mRNA and protein decreased(P<0.05),and the protein expression of p-PI3K and p-AKT decreased(P<0.05).Conclusion Modified Sijunzi Decoction may regulate the PI3K/AKT signaling pathway mediated by PTEN,repair the excessive consumption of follicles in ovarian tissue of POF rats,improve the ovarian function,so as to intervene the process of POF.

Objective:To investigate the risk factors for mortality in neonates with necrotizing enterocolitis (NEC).Methods:This retrospective cohort study included patients diagnosed with NEC at stage Ⅱ-Ⅲ (Bell's criteria) and admitted to the Neonatology Department of Guangzhou Women and Children's Medical Center Affiliated to Guangzhou Medical University from January 2017 to December 2022. According to the outcomes, these patients were divided into the mortality and survival groups. Perinatal conditions, clinical manifestations, disease status during hospitalization, and blood routine parameters at different time points after birth were compared between the two groups to analyze the risk factors for mortality of NEC. Statistical analysis was performed using independent-sample t-test, Mann-Whitney U test, Chi-square test (or Fisher's exact test), and multivariate logistic regression analysis. Results:(1) A total of 118 NEC cases were included, with 100 in the survival group and 18 in the mortality group. (2) The gestational age and birth weight were significantly lower in the mortality group than in the survival group [(28.9±4.2) weeks vs. (33.7±3.9) weeks, t=4.78; 940 g (685-1 275 g) vs. 1 830 g (1 352-2 368 g), Z=4.18; both P<0.05]. The incidence of neonatal asphyxia was higher in the mortality group [9/18 vs. 18% (18/100), χ2=7.13, P<0.05]. (3) Compared with the survival group, the mortality group had higher proportions of patients who were at NEC stage Ⅲ, accepted surgery, were treated with vasoactive drugs, had undergone invasive mechanical ventilation, or had metabolic acidosis, hyperlactatemia, shock, or hematochezia [17/18 vs. 24% (24/100), χ2=33.39; 17/18 vs. 31% (31/100), χ2=22.88; 16/18 vs. 22% (22/100), χ2=31.26; 16/18 vs. 39% (39/100), χ2=15.26; 18/18 vs. 28% (28/100), χ2=30.29; 16/18 vs. 20% (20/100), χ2=34.15; 17/18 vs. 21% (21/100), χ2=37.69; 9/18 vs. 82% (82/100), χ2=7.13; all P<0.05]. (4) The proportions of patients who developed late-onset sepsis, hemodynamically- significant patent ductus arteriosus, respiratory distress syndrome, or pulmonary hemorrhage were significantly higher in the mortality group than in the survival group [15/18 vs. 33% (33/100), χ2=16.01; 9/18 vs. 21% (21/100), χ2=5.32; 15/18 vs. 39% (39/100), χ2=12.08; 7/18 vs. 7% (7/100), χ2=11.94; all P<0.05]. (5) Within 24 h of birth, the levels of red blood cells and platelets were lower in the mortality group than in the survival group [4.1×1012/L (3.8×10 12/L-4.6×10 12/L) vs. 4.6×10 12/L (4.0×10 12/L-4.9×10 12/L), Z=2.04; (199.9±68.6)×10 9/L vs. (239.8±72.6)×10 9/L, t=2.16; both P<0.05]; at 6-8 d after birth, the levels of red blood cells, hemoglobin (Hb) and hematocrit (HCT) were lower in the mortality group than in the survival group [(3.2±0.5)×10 12/L vs. (3.9±0.8)×10 12/L, t=3.30; (111.2±19.2) vs. (138.1±28.3) g/L, t=3.51; (33.0±5.4)% vs. (40.9±8.1)%, t=3.61; all P<0.05]; at the diagnosis of NEC, red blood cell count, Hb level, HCT, and platelet count were lower in the mortality group than in the survival group [(3.3±1.0)×10 12/L vs. (3.8±0.8)×10 12/L, t=2.47; (102.8±28.8) vs. (124.4±26.3) g/L, t=3.59; 31.0% (25.9%-38.4%) vs. 37.2% (31.5%-43.7%), Z=2.62; 87.0×10 9/L (50.2×10 9/L-157.0×10 9/L) vs. 228.0×10 9/L (130.0×10 9/L-414.7×10 9/L), Z=3.78; all P<0.05], while mean platelet volume (MPV), platelet distribution width, and the differences in hemoglobin (ΔHb) and hematocrit (ΔHCT) between the first 24 h after birth and 6-8 d after birth were significantly higher in the mortality group than in the survival group [13.1 fl (11.4-13.6 fl) vs. 11.6 fl (10.7-12.4 fl), Z=3.26; 19.6% (13.9%-25.2%) vs. 14.8% (12.0%-18.6%), Z=2.76; 35.5 g/L (28.3-57.3 g/L) vs. 27.0 g/L (8.0-42.5 g/L), Z=2.20;11.5% (9.4%-16.3%) vs. 6.3% (2.2%-11.2%), Z=2.85; all P<0.05]. (6) Late-onset sepsis ( OR=5.568, 95% CI: 1.201-25.816), hyperlactatemia ( OR=6.702, 95% CI: 1.193-37.651), shock ( OR=10.616, 95% CI: 1.157-97.406) and MPV elevation at the diagnosis of NEC ( OR=2.769, 95% CI: 1.468-5.223) were independent risk factors, while gestational age ( OR=0.836, 95% CI: 0.708-0.986), and HCT at 6-8 d after birth ( OR=0.848, 95% CI: 0.759-0.947) were protecting fctors for death in NEC. Conclusions:Preterm infants with smaller gestational age are more prone to mortality of NEC. Early identification and management of late-onset sepsis, shock, and hyperlactatemia may reduce the risk of mortality in NEC.