OBJECTIVE: To analyze the phenotype and genotype of a neonate with Osteo-oto-hepato-enteric syndrome (O2HE) and review the literature. METHODS: A female neonate diagnosed with O2HE syndrome on December 13, 2024 at the First Affiliated Hospital of Zhengzhou University was selected as the study subject, and her clinical characteristics were analyzed, and pathogenic variants were explored by whole exome sequencing (WES). This study was approved by the Medical Ethics Committee of the Hospital (Ethics No.: 2025-KY-1038). RESULTS: The proband, a female infant, was delivered by Cesarean section at 36⁺¹ weeks of gestation. Five days after birth, she had developed severe diarrhea, mild cholestasis, sensorineural hearing loss, and growth retardation. WES revealed that she has harbored novel compound heterozygous variants c.512delA (p.Lys171Serfs*64) and c.698C>A (p.Thr233Asn) of the UNC45A gene, which were inherited from her mother and father, respectively. A total of 8 English papers were retrieved, which involved 16 patients from 14 families. Combined with our case, the 17 patients included 13 (76.5%) females and 4 (23.5%) males. Four patients (23.5%) had consanguineous parents. One case was excluded from further genetic analysis due to co-morbidity with other genetic variants. The primary clinical features included diarrhea (87.5%), cholestasis (81.3%), sensorineural hearing loss (31.3%), bone fragility (37.5%), and developmental delay (50.0%). Bi-allelic compound heterozygous mutations were identified in 12 patients (75.0%), and homozygous variants in 4 (25.0%). These included missense, nonsense, frameshift and deletional variants. The c.710T>C (p.Leu237Pro) variant was identified for 5 times, 3 of which were in homozygote forms. CONCLUSION O2HE syndrome should be suspected in cases with diarrhea, cholestasis, and hearing abnormalities during early postnatal period. Genetic testing facilitate early identification, genetic diagnosis and treatment.
Humans ; Female ; Infant, Newborn ; Male ; Mutation ; Hearing Loss, Sensorineural/genetics* ; Diarrhea, Infantile/genetics* ; Exome Sequencing ; Phenotype ; Fetal Growth Retardation ; Hair Diseases ; Facies

Background: Hepatocellular carcinoma (HCC) is a leading cause of cancer mortality, characterized by poor prognosis due to its high proliferative and invasive potential. Tumor metabolic reprogramming, particularly involving glucose metabolism, is essential for tumor survival. This study investigates the role of the Hippo pathway effector transcriptional co-activator with PDZ-binding motif (TAZ) in regulating gluconeogenesis and promoting tumorigenesis in HCC. Methods: TAZ expression in HCC was analyzed using The Cancer Genome Atlas data and validated in clinical samples and cell lines. TAZ was overexpressed or silenced in HCC cell lines to evaluate its effects on cell proliferation, apoptosis, migration, and invasion. The expression and prognostic relevance of the gluconeogenesis-related genes phosphoenolpyruvate carboxykinase 1 (PCK1) and glucose-6-phosphatase (G6PC) were examined, along with their correlation with TAZ expression. Tumor growth was assessed in nude mice. Interactions between TAZ and the glucocorticoid receptor (GR) were investigated using co-immunoprecipitation, immunofluorescence, and chromatin immunoprecipitation assays. Results: TAZ was significantly upregulated in HCC tissues and cell lines. TAZ overexpression enhanced proliferation, reduced apoptosis, and promoted migration and invasion. In contrast, PCK1 and G6PC were downregulated in HCC and showed a negative correlation with TAZ expression. Conclusion TAZ modulates gluconeogenesis and accelerates tumor growth, whereas its knockdown attenuates tumor progression. TAZ interacts with GR, suppressing its transcriptional activity on gluconeogenic gene promoters.

[Objective]To summarize Professor LI Xinmin's clinical experience in treating childhood epilepsy by utilizing the method of strengthening the essence,removing phlegm,regulating Qi and awakening the mind.[Methods]By learning from the teacher,recording and organizing typical medical cases,the clinical experience of Professor LI in treating childhood epilepsy by using the method of"strengthening the essence,removing phlegm,regulating Qi and awakening the mind"was summarized and concluded from the aspects of etiology,pathogenesis,treatment methods and prescriptions,etc.A verified case was attached for corroboration.[Results]Professor LI believes that childhood epilepsy is based on the root cause of deficiency of the essential Qi and the manifestation of phlegm and Qi.He proposes that the disorder of Qi movement and the obstruction of the spirit with phlegm are the key to its pathogenesis,and clinically advocates the application of the method of strengthening the essence,removing phlegm,regulating Qi and awakening the mind.According to the characteristics of different epilepsy syndromes and combined with the classification of modern medicine,he summarizes and puts forward the following viewpoints:"treating generalized tonic-clonic seizures by strengthening the spleen,regulating Qi,eliminating phlegm and calming the wind""treating pediatric psychomotor epilepsy with the method of regulating Qi and eliminating phlegm""treating pediatric abdominal epilepsy by strengthening the spleen,removing phlegm,regulating Qi and harmonizing the middle""differentiating and treating pediatric epilepsy absence seizures from the perspectives of the liver and spleen".The attached verified case was an epileptic absence seizure,the syndrome differentiation belonged to the evil depression,and Shaoyang meridians and the gallbladder meridian Qi reversal,and the treatment adopted the law of evacuating the Shaoyang Qi and calming the nerves;the prescription was modified from Chaihu and Longgu Muli Decoction.[Conclusion]Professor LI's use of the method of strengthening the essence,removing phlegm,regulating Qi and awakening the mind in the treatment of childhood epilepsy has demonstrated certain clinical efficacy and possesses certain practical value,which is worthy of learning and reference.

Objective:To explore the distribution characteristics and drug resistance of pathogenic bacteria in neonatal infectious diseases in Meizhou city from 2019 to 2023, and to guide the use of clinical antibacterial drugs.Methods:A retrospective analysis was conducted on the bacterial culture and drug sensitivity results of neonates with bacterial infectious diseases diagnosed and treated in Meizhou People's Hospital from January 2019 to December 2023. The distribution characteristics of pathogenic bacteria were observed, and the resistance of common pathogenic bacteria to antibacterial drugs was analyzed.Results:A total of 660 strains of pathogenic bacteria were collected, of which 434 isonates (65.76%) came from sputum, 111 isonates (16.82%) came from blood and 73 isonates (11.06%)came from umbilical secretions or other secretions.Gram-negative bacteria accounted for 55.45%(366/660), mainly Escherichia coli and Klebsiella pneumoniae. Gram-positive bacteria accounted for 42.42%(280/660), mainly Staphylococcus aureus and Streptococcus agalactiae. A total of 216 strains of multidrug-resistant bacteria were found, and the top three were extended spectrum beta-lactamases (ESBLs)-producing Escherichia coli, methicillin-resistant Staphylococcus aureus and ESBLs-producing Klebsiella pneumoniae.The resistance rates of Escherichia coli and Klebsiella pneumoniae to cefuroxime and cefotaxime were higher, and the resistance rates to ceftazidime, piperacillin-tazobactam and carbapenems were lower. The resistance rate of Staphylococcus aureus to penicillin was 91.61%. Streptococcus agalactiae was sensitive to penicillin, and both of them were sensitive to linezolid and vancomycin. Conclusions:The main pathogens of neonatal bacterial infection are Escherichia coli, Staphylococcus aureus, Klebsiella pneumoniae, and Streptococcus agalactiae. The proportion of multidrug-resistant bacteria is high, mainly producing ESBLs bacteria. Antibiotics should be rationally selected according to the distribution and drug resistance of pathogens.

Objective:To compare the effectiveness of video laryngoscopy and traditional direct laryngoscopy in neonatal endotracheal intubation teaching.Methods:A total of 52 undergraduate clinical interns in the Department of Neonatology at the First Clinical School of Medicine of Zhengzhou University in June 2024 were selected.The participants were randomly divided into a video laryngoscopy group and a traditional direct laryngoscopy group.After the training，skill assessments were conducted.And a questionnaire was used to evaluate whether there were differences in terms of teaching arrangement, teaching methods, classroom interaction, and teachers' attitudes.Results:The skill assessment score of the video laryngoscope group was (72.85 ± 3.36) points, significantly higher than that of the direct laryngoscope group[(65.81 ± 2.80) points], with a statistically significant difference ( P<0.05). The glottis recognition rate in the video laryngoscope group (88.46%) was higher than that in the direct laryngoscope group (61.54%) ( P<0.05).The intubation success rate in the video laryngoscope group (69.23%) was also higher than that in the direct laryngoscope group (38.7%) ( P<0.05). The results of the teaching satisfaction survey questionnaire showed that the satisfaction ratio for teaching methods in the video laryngoscope group was higher than that in the direct laryngoscope group ( P<0.05), while there were no statistically significant differences between the two groups in terms of teaching arrangements, classroom interaction, assessment and evaluation methods, and teacher attitudes ( P>0.05). Conclusion:Using video laryngoscopy for teaching helps interns better master neonatal tracheal intubation skills and is worth promoting.

Objective:To explore the value of the neutrophil-to-lymphocyte ratio（NLR）in early prediction of retinopathy of prematurity（ROP）.Methods:The medical records of 325 preterm infants with a gestational age <32 weeks who were admitted to the Neonatology Department of the First Affiliated Hospital of Zhengzhou University from January 1,2019 to December 31,2019 were retrospectively reviewed.The complete blood cell results at 7-10 days of age were collected，including white blood cell，neutrophil，lymphocyte，monocyte，and platelet counts.The NLR，lymphocyte-to-monocyte ratio（LMR），and platelet-to-lymphocyte ratio（PLR）were calculated.Logistic regression analysis was used to assess the risk factors associated with ROP.The receiver operating characteristic curve was performed to evaluate the value of NLR in the early prediction of ROP.Results:A total of 325 infants were involved,including 110（33.8%）with ROP and 215（61.2%）without ROP.The gestational age，birth weight，platelet count，lymphocyte count，and LMR were significantly lower in the ROP group（ P<0.05），whereas the neutrophil count and NLR were found to be significantly higher（ P<0.05）.Multivariate Logistic regression analysis revealed that small gestational age，low birth weight,and high NLR were major risk factors for the development of ROP.The sensitivity and specificity of NLR in early predicting ROP were 90.1% and 74.4%，respectively. Conclusion:The NLR at the first week after birth can serve as a simple method for early prediction of the development of ROP.

[Objective]To summarize Professor LI Xinmin's clinical experience in treating childhood epilepsy by utilizing the method of strengthening the essence,removing phlegm,regulating Qi and awakening the mind.[Methods]By learning from the teacher,recording and organizing typical medical cases,the clinical experience of Professor LI in treating childhood epilepsy by using the method of"strengthening the essence,removing phlegm,regulating Qi and awakening the mind"was summarized and concluded from the aspects of etiology,pathogenesis,treatment methods and prescriptions,etc.A verified case was attached for corroboration.[Results]Professor LI believes that childhood epilepsy is based on the root cause of deficiency of the essential Qi and the manifestation of phlegm and Qi.He proposes that the disorder of Qi movement and the obstruction of the spirit with phlegm are the key to its pathogenesis,and clinically advocates the application of the method of strengthening the essence,removing phlegm,regulating Qi and awakening the mind.According to the characteristics of different epilepsy syndromes and combined with the classification of modern medicine,he summarizes and puts forward the following viewpoints:"treating generalized tonic-clonic seizures by strengthening the spleen,regulating Qi,eliminating phlegm and calming the wind""treating pediatric psychomotor epilepsy with the method of regulating Qi and eliminating phlegm""treating pediatric abdominal epilepsy by strengthening the spleen,removing phlegm,regulating Qi and harmonizing the middle""differentiating and treating pediatric epilepsy absence seizures from the perspectives of the liver and spleen".The attached verified case was an epileptic absence seizure,the syndrome differentiation belonged to the evil depression,and Shaoyang meridians and the gallbladder meridian Qi reversal,and the treatment adopted the law of evacuating the Shaoyang Qi and calming the nerves;the prescription was modified from Chaihu and Longgu Muli Decoction.[Conclusion]Professor LI's use of the method of strengthening the essence,removing phlegm,regulating Qi and awakening the mind in the treatment of childhood epilepsy has demonstrated certain clinical efficacy and possesses certain practical value,which is worthy of learning and reference.

Objective:To explore the distribution characteristics and drug resistance of pathogenic bacteria in neonatal infectious diseases in Meizhou city from 2019 to 2023, and to guide the use of clinical antibacterial drugs.Methods:A retrospective analysis was conducted on the bacterial culture and drug sensitivity results of neonates with bacterial infectious diseases diagnosed and treated in Meizhou People's Hospital from January 2019 to December 2023. The distribution characteristics of pathogenic bacteria were observed, and the resistance of common pathogenic bacteria to antibacterial drugs was analyzed.Results:A total of 660 strains of pathogenic bacteria were collected, of which 434 isonates (65.76%) came from sputum, 111 isonates (16.82%) came from blood and 73 isonates (11.06%)came from umbilical secretions or other secretions.Gram-negative bacteria accounted for 55.45%(366/660), mainly Escherichia coli and Klebsiella pneumoniae. Gram-positive bacteria accounted for 42.42%(280/660), mainly Staphylococcus aureus and Streptococcus agalactiae. A total of 216 strains of multidrug-resistant bacteria were found, and the top three were extended spectrum beta-lactamases (ESBLs)-producing Escherichia coli, methicillin-resistant Staphylococcus aureus and ESBLs-producing Klebsiella pneumoniae.The resistance rates of Escherichia coli and Klebsiella pneumoniae to cefuroxime and cefotaxime were higher, and the resistance rates to ceftazidime, piperacillin-tazobactam and carbapenems were lower. The resistance rate of Staphylococcus aureus to penicillin was 91.61%. Streptococcus agalactiae was sensitive to penicillin, and both of them were sensitive to linezolid and vancomycin. Conclusions:The main pathogens of neonatal bacterial infection are Escherichia coli, Staphylococcus aureus, Klebsiella pneumoniae, and Streptococcus agalactiae. The proportion of multidrug-resistant bacteria is high, mainly producing ESBLs bacteria. Antibiotics should be rationally selected according to the distribution and drug resistance of pathogens.

Objective:To compare the effectiveness of video laryngoscopy and traditional direct laryngoscopy in neonatal endotracheal intubation teaching.Methods:A total of 52 undergraduate clinical interns in the Department of Neonatology at the First Clinical School of Medicine of Zhengzhou University in June 2024 were selected.The participants were randomly divided into a video laryngoscopy group and a traditional direct laryngoscopy group.After the training，skill assessments were conducted.And a questionnaire was used to evaluate whether there were differences in terms of teaching arrangement, teaching methods, classroom interaction, and teachers' attitudes.Results:The skill assessment score of the video laryngoscope group was (72.85 ± 3.36) points, significantly higher than that of the direct laryngoscope group[(65.81 ± 2.80) points], with a statistically significant difference ( P<0.05). The glottis recognition rate in the video laryngoscope group (88.46%) was higher than that in the direct laryngoscope group (61.54%) ( P<0.05).The intubation success rate in the video laryngoscope group (69.23%) was also higher than that in the direct laryngoscope group (38.7%) ( P<0.05). The results of the teaching satisfaction survey questionnaire showed that the satisfaction ratio for teaching methods in the video laryngoscope group was higher than that in the direct laryngoscope group ( P<0.05), while there were no statistically significant differences between the two groups in terms of teaching arrangements, classroom interaction, assessment and evaluation methods, and teacher attitudes ( P>0.05). Conclusion:Using video laryngoscopy for teaching helps interns better master neonatal tracheal intubation skills and is worth promoting.

Objective:To explore the value of the neutrophil-to-lymphocyte ratio（NLR）in early prediction of retinopathy of prematurity（ROP）.Methods:The medical records of 325 preterm infants with a gestational age <32 weeks who were admitted to the Neonatology Department of the First Affiliated Hospital of Zhengzhou University from January 1,2019 to December 31,2019 were retrospectively reviewed.The complete blood cell results at 7-10 days of age were collected，including white blood cell，neutrophil，lymphocyte，monocyte，and platelet counts.The NLR，lymphocyte-to-monocyte ratio（LMR），and platelet-to-lymphocyte ratio（PLR）were calculated.Logistic regression analysis was used to assess the risk factors associated with ROP.The receiver operating characteristic curve was performed to evaluate the value of NLR in the early prediction of ROP.Results:A total of 325 infants were involved,including 110（33.8%）with ROP and 215（61.2%）without ROP.The gestational age，birth weight，platelet count，lymphocyte count，and LMR were significantly lower in the ROP group（ P<0.05），whereas the neutrophil count and NLR were found to be significantly higher（ P<0.05）.Multivariate Logistic regression analysis revealed that small gestational age，low birth weight,and high NLR were major risk factors for the development of ROP.The sensitivity and specificity of NLR in early predicting ROP were 90.1% and 74.4%，respectively. Conclusion:The NLR at the first week after birth can serve as a simple method for early prediction of the development of ROP.