Objective To investigate and analyze the association between serum microRNA-141-3p(miR-141-3p)and miR-223-3p levels and neonatal necrotizing enterocolitis.Methods Eighty neonates with necrotizing enterocolitis admitted to our hospital between January 2019 and January 2022 were enrolled as subjects.According to the disease stage,they were divided into the stage Ⅱ group(n=43)and the stage Ⅲ group(n=37).Additionally,80 healthy newborns born during the same period were recruited as the control group.General clinical data were collected and analyzed systematically.The expression levels of miR-141-3p and miR-223-3p were detected using quantitative real-time PCR(qRT-PCR).Spearman's correlation analysis was performed to evaluate the relationship between miR-141-3p,miR-223-3p,and the severity of the disease.Multivariate logistic regression analysis was conducted to assess the impact of miR-141-3p and miR-223-3p on the severity of pediatric illness.Furthermore,a Receiver Operating Characteristic(ROC)curve was plotted to determine the diagnostic value of miR-141-3p and miR-223-3p in predicting the severity of the patient's condition.Results Compared with the control group,the rela-tive expression levels of miR-141-3p and miR-223-3p in the diseased group were significantly decreased(P<0.05).Similarly,compared with the stage Ⅱ group,the relative expression levels of miR-141-3p and miR-223-3p in the stage Ⅲ group were also markedly reduced(P<0.05).Furthermore,miR-141-3p and miR-223-3p exhibited a nega-tive correlation with disease severity(r=-0.489,-0.496,P<0.05).Increased relative expression of miR-141-3p and miR-223-3p was identified as a protective factor influencing disease severity in children(P<0.05).The AUC values for diagnosing the severity of necrotizing enterocolitis using miR-141-3p,miR-223-3p,and their combination were 0.806,0.783,and 0.885,respectively.Combined diagnosis demonstrated significantly better performance than miR-141-3p alone(Z=2.050,P=0.040)or miR-223-3p alone(Z=2.184,P=0.029).Conclusion In neonates with necrotizing enterocolitis,the relative expression levels of serum miR-141-3p and miR-223-3p are significantly decreased,which are closely associated with disease progression and provide potential auxiliary diagnostic value for assessing disease severity.

Objective To investigate and analyze the association between serum microRNA-141-3p(miR-141-3p)and miR-223-3p levels and neonatal necrotizing enterocolitis.Methods Eighty neonates with necrotizing enterocolitis admitted to our hospital between January 2019 and January 2022 were enrolled as subjects.According to the disease stage,they were divided into the stage Ⅱ group(n=43)and the stage Ⅲ group(n=37).Additionally,80 healthy newborns born during the same period were recruited as the control group.General clinical data were collected and analyzed systematically.The expression levels of miR-141-3p and miR-223-3p were detected using quantitative real-time PCR(qRT-PCR).Spearman's correlation analysis was performed to evaluate the relationship between miR-141-3p,miR-223-3p,and the severity of the disease.Multivariate logistic regression analysis was conducted to assess the impact of miR-141-3p and miR-223-3p on the severity of pediatric illness.Furthermore,a Receiver Operating Characteristic(ROC)curve was plotted to determine the diagnostic value of miR-141-3p and miR-223-3p in predicting the severity of the patient's condition.Results Compared with the control group,the rela-tive expression levels of miR-141-3p and miR-223-3p in the diseased group were significantly decreased(P<0.05).Similarly,compared with the stage Ⅱ group,the relative expression levels of miR-141-3p and miR-223-3p in the stage Ⅲ group were also markedly reduced(P<0.05).Furthermore,miR-141-3p and miR-223-3p exhibited a nega-tive correlation with disease severity(r=-0.489,-0.496,P<0.05).Increased relative expression of miR-141-3p and miR-223-3p was identified as a protective factor influencing disease severity in children(P<0.05).The AUC values for diagnosing the severity of necrotizing enterocolitis using miR-141-3p,miR-223-3p,and their combination were 0.806,0.783,and 0.885,respectively.Combined diagnosis demonstrated significantly better performance than miR-141-3p alone(Z=2.050,P=0.040)or miR-223-3p alone(Z=2.184,P=0.029).Conclusion In neonates with necrotizing enterocolitis,the relative expression levels of serum miR-141-3p and miR-223-3p are significantly decreased,which are closely associated with disease progression and provide potential auxiliary diagnostic value for assessing disease severity.

Objective:To evaluate the clinical efficacy and the mid- and long-term follow-up outcomes of transanal anaplasty for treating rectovestibular fistula.Methods:The clinical data of 68 female infants diagnosed with rectovestibular fistula undergoing transanal anoplasty at the Department of Pediatric Surgery, the First Affiliated Hospital of Zhengzhou University from Oct 2014 to Dec 2023 was collected. Postoperative complications, perineal and anal appearances, and defecation function of postoperative children aged 3 years or older were recorded.Results:After surgery 68 children followed-up for 6 months of recent with short-term complications in 6 cases, including 3 cases of incision infection, 2 cases of rectal mucosal prolapse, and 1 case of anal stenosis. Rintala score was (18.65±1.99). Twenty-five children underwent anorectal manometry, no significant differences were observed in the maximal systolic pressure of the anal canal( t=-0.596, P=0.563) and the maximum systolic time( t=-0.183, P=0.854). The resting pressure( t=-3.050, P=0.005), functional length( t=2.696, P=0.012), and positive rate of rectal anal inhibitory reflex( χ2=6.382, P=0.012) of the anal canal were significantly lower than those of the normal group( P<0.05). Conclusions:Transanal anaplasty for the treatment of rectovestibular fistula in girls has a low incidence of complications. It results in a normal perineal body appearance, good anal bowel control, and high quality of life.

Objective:To evaluate the clinical efficacy and the mid- and long-term follow-up outcomes of transanal anaplasty for treating rectovestibular fistula.Methods:The clinical data of 68 female infants diagnosed with rectovestibular fistula undergoing transanal anoplasty at the Department of Pediatric Surgery, the First Affiliated Hospital of Zhengzhou University from Oct 2014 to Dec 2023 was collected. Postoperative complications, perineal and anal appearances, and defecation function of postoperative children aged 3 years or older were recorded.Results:After surgery 68 children followed-up for 6 months of recent with short-term complications in 6 cases, including 3 cases of incision infection, 2 cases of rectal mucosal prolapse, and 1 case of anal stenosis. Rintala score was (18.65±1.99). Twenty-five children underwent anorectal manometry, no significant differences were observed in the maximal systolic pressure of the anal canal( t=-0.596, P=0.563) and the maximum systolic time( t=-0.183, P=0.854). The resting pressure( t=-3.050, P=0.005), functional length( t=2.696, P=0.012), and positive rate of rectal anal inhibitory reflex( χ2=6.382, P=0.012) of the anal canal were significantly lower than those of the normal group( P<0.05). Conclusions:Transanal anaplasty for the treatment of rectovestibular fistula in girls has a low incidence of complications. It results in a normal perineal body appearance, good anal bowel control, and high quality of life.

Objective:To investigate the clinical efficacy of anal dimple anorectoplasty on female infants with congenital anal atresia combined rectal vestibular fistula.Methods:Clinical data of 69 female infants with congenital anal atresia combined rectal vestibular fistula admitted to Department of Pediatric Surgery, the First Affiliated Hospital of Zhengzhou University from July 2012 to July 2022 were retrospectively analyzed.They were divided into 2 groups according to the surgical methods: 34 cases of anal dimple anorectoplasty(group A) and 35 cases of anterior sagittal anorectoplasty(group B). The operation time, length of stay, short-term complications, long-term complications and bowel function (determined by the Rintala score at 6 months postoperatively) of the two groups were compared.The difference in the incidence of postoperative complications between groups was compared by Chi- square test, and the remaining differences between groups were compared by the paired t-test. Results:The operative time [(80.18±9.29) min vs.(103.85±8.26) min] and postoperative hospital stay[(6.10±1.52) d vs.(7.63±2.40) d] in group A were significantly shorter than those of group B ( t=11.40, 2.62; all P<0.05). The Rintala total score at 6 months postoperatively in group A was significantly higher than that of group B[(19.36±0.93) points vs.(18.76±0.44) points]( t=3.20, P<0.05). There were no significant differences in the incidences of short-term [(4/34, 11.8%) vs.(7/35, 20.0%)] and long-term complications [(2/34, 5.9%) vs.(4/35, 11.4%)]between group A and group B ( χ2=0.75, 0.75; all P>0.05). Conclusions:Anal dimple anorectoplasty for female infants with congenital anal atresia combined rectal vestibular fistula is safe and effective.

Objective:To evaluate endoscopic retrograde appendicitis therapy in treatment of children with acute uncomplicated appendicitis.Methods:Sixty children patients were admitted at the Affiliated Hospital of Zhengzhou University from Oct 2019 to Jun 2021 and were divided into ERAT group ( n=30) and LA group ( n=30). Results:All operations were successfully performed . ERAT children started oral feeding earlier [(6.8±2.0) h vs. (12.3±2.0) h, t=-10.636, P<0.001], postoperative hospital stay was shorter [(3.2±1.3) d vs. (5.0±1.3) d, t=-5.360, P<0.001]. After 14 months follow up, the recurrence rate in the ERAT group was 6%. The complication rate of LA was 10%. Conclusion:ERAT is a safe and effective therapy in treating children with acute uncomplicated appendicitis with low,acceptable recurrence rate.

Objective: To evaluate the intervention effects of response to heatwave in communities of four cities, China. Methods: Baseline survey on heatwave and climate change related knowledge, attitude and practice (KAP) was conducted in the pilot communities in Harbin, Nanjing, Shenzhen and Chongqing, using face-to-face questionnaire interview in November, 2011 to November, 2013. Finally, 1 604 residents were interviewed. Intervention measures were implemented in summers of 2013 and 2014, including delivering early warning information of heatwave health risk and launching health education and promotion. The second survey was conducted in same communities using the same questionnaire and sampling method as baseline survey in November, 2014, and 1 640 residents were interviewed. The Chi-square test was used to compare the demographic characteristics and KAP of community residents between before and after intervention, and the factors that affected the intervention effect were selected by logistic multiple stepwise regression model. Results: The age of the residents interviewed before and after intervention was (46.4 ± 15.5) years and (45.0 ± 15.9) years, respectively. Overall, the residents' awareness rates of heatwave before and after intervention were 70.5% (1 131/1 604) and 82.9% (1 359/1 640) (χ²=69.40, P<0.001). The rate of residents who had wished to receive early warning information increased 6.3% (χ²=41.11, P<0.001), which reached 94.6% (1 551/1 604) after intervention from 88.3% (1 416/1 604) in baseline survey. Both heatwave health risk early warning and health education had big impacts to residents. There were 92.7% (1 105 residents) among the 1 192 residents who had received the early warning information arrange work and rest time according to the early warning information and 93.0% (1 231 residents) among the 1 323 residents who knew about health education activities being conducted in community thought that the community health education activities had made active role in protecting health from heatwaves. After a series of intervention, male had a effect on attitude about hot wave than female in Nanjing and Chongqing, OR (95%CI) were 1.48(1.02-2.16) and 1.45 (1.18-2.05) , respectively; compared with subjects below primary school education, people with college degree or above had higer KAP in all cities (ORs range from 1.18 to 2.05), P<0.05; regular physical exercise (ORs range from 1.39 to 2.70) also had profound impacts on KAP in all cities (P<0.05). Conclusion s Early warning and health education were effective measures to enhance residents' response capacity to climate change.