OBJECTIVE: To investigate the expression and possible regulatory mechanism of miR-34a in the lung tissue of neonatal rat model of bronchopulmonary dysplasia (BPD) induced by hyperoxia. METHODS: In the study, 80 newborn SD rats were randomly divided into hyperoxia group (FiO₂=60%) and air group (FiO₂=21%) within 2 hours after birth, 40 rats per group. Lung tissue samples of the SD rats in each group were extracted on the 1st, 7th, 14th and 21st days after birth, and the pathological changes of lung tissue were observed under light microscope after HE staining. The number of radial alveolar counts (RAC) and the mean alveolar diameter (MAD) and the thickness of alveolar septal thickness (AST) were measured to evaluate the development of alveoli. Real-time fluorescence quantitative PCR was used to detect the expression of miR-34a, angiopoietin-1 (Ang-1) and tyrosine kinase receptor-2 (Tie-2) in lung tissue of rats in hyperoxia group and air group at different time points. Enzyme-linked immunosorbent assay (ELISA) was used to detect the proteins expression of Ang-1 and Tie-2 in the lung tissues of the two groups at different time points. RESULTS: The weight of rats in the hyperoxia group on the 7th, 14th and 21st days after birth was significantly lower than that in the air group (P all < 0.05). With the prolongation of oxygen exposure, the number of alveoli decreased, the volume increased, the structure simplified, the alveolar cavity enlarged obviously and the alveolar septum thickened in the hyperoxia group. On the 7th, 14th and 21st days after birth, the RAC in the hyperoxia group was significantly lower than that in the air group (P all < 0.05). Compared with the air group, MAD and AST increased significantly on the 7th, 14th and 21st days after birth in the hyperoxia group, and the difference was statistically significant (P all < 0.05). The expression level of miR-34a in lung tissue of hyperoxia group was significantly higher than that of air group on the 7th, 14th and 21st days after birth, and the difference was statistically significant (P all < 0.05). Compared with the air group at the same time point, the expression levels of Ang-1 and Tie-2 mRNA and protein in the hyperoxia group were lower than those in the air group on the 14th and 21st days after birth (P all < 0.05). CONCLUSION The new BPD model of newborn SD rats can be successfully established by continuous exposure to 60% hyperoxia. The expression of miR-34a was up-regulated in the lung tissue of the new BPD model of neonatal rats. MiR-34a may play an important role in the occurrence and development of BPD by regulating Ang-1/Tie-2 signal pathway.
Animals ; MicroRNAs/metabolism* ; Bronchopulmonary Dysplasia/genetics* ; Hyperoxia/metabolism* ; Rats, Sprague-Dawley ; Animals, Newborn ; Rats ; Angiopoietin-1/genetics* ; Disease Models, Animal ; Receptor, TIE-2/genetics* ; Lung/pathology* ; Male

This report described a neonate with dehydrated hereditary stomatocytosis (DHSt) presented as a PIEZO1 gene variant. The infant was transferred to the neonatal unit due to severe anemia indicated by umbilical artery blood gas analysis. Physical examination revealed generalized pallor with pale gums, nail beds, and conjunctivae, but no hepatosplenomegaly. Laboratory findings showed markedly reduced hemoglobin (82 g/L), elevated reticulocyte count (320.30×10 9/L), and increased reticulocyte percentage (13.27%). Jaundice developed at 18 hours of age, with a peak total serum bilirubin at 137.1 μmol/L (predominantly indirect) by 24 hours, confirming neonatal hyperbilirubinemia. Whole-exome sequencing identified a heterozygous missense variant in PIEZO1 [c.6280C>T (p.Leu2094Phe)], inherited from the asymptomatic father. The infant was diagnosed with DHSt and treated with packed red blood cell transfusion and phototherapy, achieving clinical stabilization prior to discharge. Follow-up at six and seven months showed normalized hematologic parameters. At 11 months, developmental milestones were age-appropriate, though mild anemia persisted (hemoglobin 110 g/L), prompting dietary iron supplementation.

This report described a neonate with dehydrated hereditary stomatocytosis (DHSt) presented as a PIEZO1 gene variant. The infant was transferred to the neonatal unit due to severe anemia indicated by umbilical artery blood gas analysis. Physical examination revealed generalized pallor with pale gums, nail beds, and conjunctivae, but no hepatosplenomegaly. Laboratory findings showed markedly reduced hemoglobin (82 g/L), elevated reticulocyte count (320.30×10 9/L), and increased reticulocyte percentage (13.27%). Jaundice developed at 18 hours of age, with a peak total serum bilirubin at 137.1 μmol/L (predominantly indirect) by 24 hours, confirming neonatal hyperbilirubinemia. Whole-exome sequencing identified a heterozygous missense variant in PIEZO1 [c.6280C>T (p.Leu2094Phe)], inherited from the asymptomatic father. The infant was diagnosed with DHSt and treated with packed red blood cell transfusion and phototherapy, achieving clinical stabilization prior to discharge. Follow-up at six and seven months showed normalized hematologic parameters. At 11 months, developmental milestones were age-appropriate, though mild anemia persisted (hemoglobin 110 g/L), prompting dietary iron supplementation.

Objective:To investigate the expression of microRNA-34a (miR-34a)and tumor necrosis factor-α (TNF-α) in lung injury induced by lipopolysaccharides (LPS) in neonatal rats with acute respiratory distress syndrome (ARDS). The expression of mirna-34a and tumor necrosis factor-α (TNF-α) in lung injury induced by lipopolysaccharides (LPS) was determined by tumor necrosis factor.Methods:A total of 80 7-day-old newborn SD rats were randomly(random number) divided into two groups, 40 in each group, NARDS animal models were established by intraperitoneal injection of 4 mg/kg LPS solution for 3,6,12 and 24 hours respectively. Normal control group was established by intraperitoneal injection of 4 mL/kg isotonic Nacl solution. The wet/dry weight ratio of lung was measured to observe the changes of lung histopathology. The expression of miR-34a in lung tissues and cells was detected by quantitative real-time PCR (qrt-PCR).Results:the wet/dry weight of lung in the experimental group was significantly higher than that in the control group. Hematoxylin-eosin (HE) staining showed diffuse changes in lung tissue, thickening of alveolar septum, partial alveolar fusion and decreased number of alveoli in experimental group. The expression levels of miR-34a and TNF-α in the experimental group were higher than those in the control group at each time point.Conclusions:It is speculated that miR-34a can promote the release of more inflammatory factors by positively regulating the expression of TNF-α, thus affecting the occurrence and development of lung injury. The expression of miR-34a positively correlated with TNF-α. miR-34a may affect the regulation mechanism of lung injury by mediating the expression of TNF-α through some signal pathway or inflammatory reaction, it provides a new therapeutic target for the treatment of neonatal acute respiratory distress syndrome (NARDS).

Objective:To evaluate the clinical efficacy of non-invasive high-frequency oscillatory ventilation (nHFOV) and nasal continuous positive airway pressure ventilation (nCPAP) as transitional breathing modes after evacuation from invasive ventilation in neonatal respiratory distress syndrome (NRDS).Methods:A randomized controlled trial was conducted using PubMed, Cochrane Library, Embase, China National Knowledge Infrastructure (CNKI), Wanfang, and VIP databases to search for all published literature before July 2022 on the treatment of NRDS with nHFOV and/or nCPAP after invasive ventilation and weaning. We compared the success rates of the evacuation , as well as the incidence of pneumothorax, bronchopulmonary dysplasia, and intraventricular hemorrhage between the nHFOV group and the nCPAP group in newborns who underwent invasive ventilation with NRDS.Results:A total of 7 randomized controlled studies were included, including 598 newborns diagnosed with NRDS who underwent tracheal intubation mechanical ventilation. The success rates of evacuating invasive ventilators for children in the nHFOV and nCPAP groups included in the article were calculated. The success rates of evacuating invasive ventilators for children in the two groups were 88.5%(231/261) and 66.5%(171/257), respectively. Compared with the nCPAP group, the success rate of evacuating invasive ventilators for children with NRDS in the nHFOV group was higher ( OR=3.93, 95% CI: 2.47-6.23, P<0.001). However, there was no statistically significant difference in the incidence of bronchopulmonary dysplasia, intraventricular hemorrhage, and pneumothorax between the two groups after weaning (all P>0.05). Conclusions:After weaning NRDS patients with invasive ventilation, nHFOV has a higher success rate in weaning compared to nCPAP, which is worthy of clinical application.

Objective:To evaluate the association between methylenetetrahydrofolate reductase ( MTHFR) A1298C polymorphism and the risk of non-syndromic cleft lip with or without cleft palate (NSCL/P). Methods:Embase, Web of Science, MEDLINE, PubMed, Cochrane Central Register of Controlled Trials (Central), Cumulative Index to Nursing and Allied Health Literature (CINAHL), ClinicalTrials.gov, China Biomedical Literature Database (CBLD), VIP Database, China National Knowledge Infrastructure (CNKI), Wanfang Database, and Yiigle were searched up to February 28, 2023. The search formula was "nonsyndromic cleft lip and/or cleft palate OR nonsyndromic cleft lip with or without palate OR NSCL/P" AND "5,10-methylenetetrahydrofolate reductase OR methylenetetrahydrofolate reductase OR MTHFR" AND " A1298C OR 1298A>C OR rs1801131 OR polymorphism". Taking NSCL/P patients and control groups as the research objects, we collected and described the research on MTHFR A1298C gene polymorphism and NSCL/P susceptibility under five genetic models (allelic model, homozygous comparison model, heterozygous comparison model, dominant comparison model, and recessive comparison model). Literature screening and quality evaluation were conducted based on inclusion and exclusion criteria, and meta-analysis was performed using Review Manager 5.3 software. Subgroup analysis was carried out according to race, control source, and genotyping method. Results:A total of 24 studies meeting the inclusion criteria were included, involving 8 841 cases, with 3 761 in the NSCL/P group and 5 080 in the control group. In five genetic models, there was no association between MTHFR A1298C polymorphism and the risk of NSCL/P (allele model: OR=1.07, 95% CI: 1.00-1.15, I 2=49%, P=0.06; homozygous comparison model: OR=1.06, 95% CI: 0.90-1.26, I 2=23%, P=0.48; heterozygous comparison model: OR=1.05, 95% CI: 0.95-1.15, I 2=59%, P=0.36; dominant comparison model: OR=1.04, 95% CI: 0.95-1.14, I 2 =58%, P=0.34; recessive comparison model: OR=1.04, 95% CI: 0.89-1.23, I 2=22%, P=0.60). Only in the allele genetic model was there a significant association between MTHFR A1298C polymorphism and the risk of NSCL/P in the Asian population ( OR=1.15, 95% CI: 1.01-1.31, I 2=62%, P=0.04). There was no association between MTHFR A1298C polymorphism and the risk of NSCL/P in other races or any genetic model. In the heterozygous comparison genetic model, when the control group cases were hospital-based, there was an association between MTHFR A1298C polymorphism and the risk of NSCL/P in the population ( OR=1.15, 95% CI: 1.02-1.30, I 2=69%, P=0.03). Regardless of the genotyping method used, there was no association between MTHFR A1298C polymorphism and the risk of NSCL/P. All funnel plots were symmetrical, indicating no significant publication bias in this meta-analysis. Sensitivity analysis showed that no single study would reverse the overall results. Conclusions:MTHFR A1298C polymorphism is not associated with NSCL/P susceptibility in the general population. However, in Asians, MTHFR A1298C polymorphism is significantly associated with an increased risk of NSCL/P.

Objective:To evaluate the association between methylenetetrahydrofolate reductase ( MTHFR) A1298C polymorphism and the risk of non-syndromic cleft lip with or without cleft palate (NSCL/P). Methods:Embase, Web of Science, MEDLINE, PubMed, Cochrane Central Register of Controlled Trials (Central), Cumulative Index to Nursing and Allied Health Literature (CINAHL), ClinicalTrials.gov, China Biomedical Literature Database (CBLD), VIP Database, China National Knowledge Infrastructure (CNKI), Wanfang Database, and Yiigle were searched up to February 28, 2023. The search formula was "nonsyndromic cleft lip and/or cleft palate OR nonsyndromic cleft lip with or without palate OR NSCL/P" AND "5,10-methylenetetrahydrofolate reductase OR methylenetetrahydrofolate reductase OR MTHFR" AND " A1298C OR 1298A>C OR rs1801131 OR polymorphism". Taking NSCL/P patients and control groups as the research objects, we collected and described the research on MTHFR A1298C gene polymorphism and NSCL/P susceptibility under five genetic models (allelic model, homozygous comparison model, heterozygous comparison model, dominant comparison model, and recessive comparison model). Literature screening and quality evaluation were conducted based on inclusion and exclusion criteria, and meta-analysis was performed using Review Manager 5.3 software. Subgroup analysis was carried out according to race, control source, and genotyping method. Results:A total of 24 studies meeting the inclusion criteria were included, involving 8 841 cases, with 3 761 in the NSCL/P group and 5 080 in the control group. In five genetic models, there was no association between MTHFR A1298C polymorphism and the risk of NSCL/P (allele model: OR=1.07, 95% CI: 1.00-1.15, I 2=49%, P=0.06; homozygous comparison model: OR=1.06, 95% CI: 0.90-1.26, I 2=23%, P=0.48; heterozygous comparison model: OR=1.05, 95% CI: 0.95-1.15, I 2=59%, P=0.36; dominant comparison model: OR=1.04, 95% CI: 0.95-1.14, I 2 =58%, P=0.34; recessive comparison model: OR=1.04, 95% CI: 0.89-1.23, I 2=22%, P=0.60). Only in the allele genetic model was there a significant association between MTHFR A1298C polymorphism and the risk of NSCL/P in the Asian population ( OR=1.15, 95% CI: 1.01-1.31, I 2=62%, P=0.04). There was no association between MTHFR A1298C polymorphism and the risk of NSCL/P in other races or any genetic model. In the heterozygous comparison genetic model, when the control group cases were hospital-based, there was an association between MTHFR A1298C polymorphism and the risk of NSCL/P in the population ( OR=1.15, 95% CI: 1.02-1.30, I 2=69%, P=0.03). Regardless of the genotyping method used, there was no association between MTHFR A1298C polymorphism and the risk of NSCL/P. All funnel plots were symmetrical, indicating no significant publication bias in this meta-analysis. Sensitivity analysis showed that no single study would reverse the overall results. Conclusions:MTHFR A1298C polymorphism is not associated with NSCL/P susceptibility in the general population. However, in Asians, MTHFR A1298C polymorphism is significantly associated with an increased risk of NSCL/P.

Objective:To evaluate the efficacy and safety of early intratracheal drops of budesonide combined with pulmonary surfactant in the prevention of bronchopulmonary dysplasia(BPD).Methods:Embase, PubMed, Cochrane Library, CNKI and Wanfang database were searched from the establishment of library construction to February 2022.Literature selection, quality assessment and data extraction were conducted according to the inclusion and exclusion criteria, and Meta-analysis was performed on the included literature using Rev Man 5.3 software.Results:Nine randomised controlled studies were included in this study, with a total of 884 children, including 433 in the experimental group and 451 in the control group.The results showed that there was a statistically significant difference in the incidence of BPD between the two groups[ OR=0.40, 95% CI(0.29, 0.53), P<0.001], and there was no statistically significant difference in the morbidity between the two groups[ OR=0.65, 95% CI(0.34, 1.22), P=0.18]. The risks of retinopathy of prematurity[ OR=0.42, 95% CI(0.54, 1.28), P=0.40], patent ductus arteriosus[ OR=0.79, 95% CI(0.57, 1.10), P=0.17], intracranial hemorrhage[ OR=1.09, 95% CI(0.77, 1.53), P=0.63], necrotizing enterocolitis[ OR=0.89, 95% CI(0.55, 1.44), P=0.64], and neonatal septicemia[ OR=0.73, 95% CI(0.49, 1.08), P=0.11] occurred in the experimental group had no statistically significant differences compared to the control group (all P>0.05). Conclusion:Early postnatal intratracheal drops of budesonide combined with pulmonary surfactant can significantly reduce the incidence of BPD, and has no significant effect on mortality or short-term complications.

Objective:To evaluate the efficacy and safety of noninvasive high-frequency oscillatory ventilation (nHFOV) as the initial ventilation mode for respiratory distress syndrome (RDS) in premature infants.Methods:From the establishment of the databases [(PubMed, Embase, Cochrane Library, CNKI, Wanfang database, CQVIP and CBM (SinoMed)] to March 1, 2022, literature on randomized controlled trials (RCTs) using nHFOV and nasal continuous positive airway pressure(NCPAP) as the initial ventilation modes for RDS in premature infants were searched. The qualities of the included literature were evaluated according to Cochrane Evaluation Manual. RevMan 5.4 software was used for Meta-analysis.Results:Seven RCTs involving 786 children were included for the final Meta-analysis, with 395 cases in the nHFOV group and 391 cases in the NCPAP group. The results showed that the nHFOV group had lower intubation rates than the NCPAP group ( OR=0.34, 95% CI 0.22~0.51, P<0.001). No significant differences existed in mortality rates and complication rates between the two groups ( P>0.05). Conclusions:nHFOV as the initial treatment for RDS in premature infants may reduce the incidence of early treatment failure without increasing complications.

Objective:To explore the carrier status of group B streptococci (GBS) in pregnant women of Mongolian and Han nationality and the neonatal GBS infection in order to identify the high risk factors of GBS infection in Mongolian and Han newborns in this area.Methods:Totally 7289 pregnant women and their newborns born alive were tested for GBS in the Affiliated Hospital of Inner Mongolia Medical University from June 2017 to June 2020, and their newborns were cultured for GBS, and the venous blood of newborns delivered by GBS positive women were detected for anti-GBS capsular polysaccharide antibody level, in order to determine the high risk factors of neonatal GBS infection.Results:Among the 7289 pregnant women, 3136 were Mongolian pregnant women (2599 full-term delivery and 537 premature delivery) and 4153 were Han pregnant women (3541 full-term delivery and 612 premature delivery). The results of GBS test showed that the GBS carrier rate was 8.19% in the Mongolian preterm delivery group, 4.35% in the Mongolian term group, 11.93% in the Han preterm group, and 5.76% in the Han term group, indicating that the carrier rate of GBS in the preterm group was significantly higher than that in the term group, regardless of Mongolian and Han nationality ( P < 0.05). Further comparing the GBS carrier rate of Mongolian and Han pregnant women, the GBS carrier rate of Mongolian pregnant women was significantly lower than that of Han pregnant women regardless of the premature delivery group and term group ( P < 0.05). (2) A total of 434 newborns were born by GBS positive parturients. The positive rates of GBS in Mongolian premature infants, Mongolian full-term infants, Han premature infants and Han full-term infants were 29.55%, 14.16%, 31.51% and 17.65%, respectively, suggesting that the positive rate of GBS in premature infants was significantly higher than that in full-term infants, regardless of Mongolian and Han nationality ( P<0.05). Further comparing the positive rate of GBS in Mongolian and Han newborns, there was no significant difference in the positive rate of GBS between Mongolian newborns and Han newborns, no matter the premature delivery group and the full-term group. (3) This study compared the incidence of early-onset GBS septicemia in Mongolian and Han newborns. The results showed that the incidence of early-onset GBS septicemia in Mongolian premature infants was 23.08%, and none in full-term infants. The incidence of early-onset GBS septicemia in Han premature infants was 26.09%. The incidence of early-onset GBS septicemia in term infants was 5.56%. The incidence of neonatal GBS septicemia in the preterm group was significantly higher than that in the term group, regardless of Mongolian and Han nationality. By further comparing the incidence of GBS septicemia in Mongolian and Han newborns, there was no significant difference in the positive rate of GBS between Mongolian newborns and Han newborns regardless of the premature delivery group and the term group. (4) In both Mongolian and Han nationality, the level of anti-GBS capsular polysaccharide antibody in premature infants was significantly lower than that in term infants ( P < 0.05). (5) Regardless of the Mongolian and Han nationality, compared with GBS negative group, GBS positive rate was higher in pregnant women aged≥35 years old, with history of menstruation, miscarriage, vaginitis, floating population, and those who had not undergone pre-pregnancy examination,,which were the high risk factors for GBS-positive pregnant women during pregnancy. (6) In both Mongolian and Han nationality, the incidence of chorioamnionitis, puerperal infection, premature delivery and premature rupture of membranes in the GBS positive group was higher than that in the GBS negative group, and the incidence of fetal distress and neonatal asphyxia in the GBS positive group was also higher than that in the GBS negative group. Conclusions:The carrier rate of GBS in Mongolian pregnant women is lower than that in Han pregnant women, and positive GBS during pregnancy will increase the incidence of adverse maternal and fetal outcomes such as chorioamnionitis, puerperal infection, premature delivery, premature rupture of membranes, fetal distress, neonatal asphyxia and neonatal early-onset GBS septicemia. The high risk factors are maternal age ≥ 35 years old, history of menstruation, abortion, vaginitis, floating population, and infection without pre-pregnancy examination. We should attach great importance to the perinatal high risk factors and formulate corresponding intervention measures accordingly, and make rational use of antibiotics for prenatal prevention, so as to further reduce the incidence of early-onset GBS septicemia in newborns.