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NLRP3 activation in macrophages promotes acute intestinal injury in neonatal necrotizing enterocolitis

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World Journal of Pediatrics 2024年第2期20卷 153-164页

作者： Bo Shi Cheng-Jie Lyu Zhen-Kai Le Hao-Sen Ji Yi Xiao Yuan-Yuan Zhang Shou-Jiang Huang Lin-Jun Yu Qiang Shu Jin-Fa Tou Deng-Ming Lai Department of neonatal Surgery Children’s HospitalZhejiang University School of MedicineNational Clinical Research Center for Child HealthHangzhou 310052China Department of Pulmonology Children’s HospitalZhejiang University School of MedicineNational Clinical Research Center for Child HealthHangzhou 310052China Department of Thoracic and Cardiovascular Surgery Children’s HospitalZhejiang University School of MedicineNational Clinical Research Center for Child HealthHangzhou 310052China

Background Macrophages are involved in various immune inflammatory disease *** study aimed to investigate the role and mechanism of macrophages in regulating acute intestinal injury in neonatal necrotizing enterocolitis(NEC).Methods CD68,nucleotide-binding oligomerization domain,leucine-rich repeat,and pyrin domain-containing 3(NLRP3),cysteine aspartate-specific protease-1(caspase-1),and interleukin-1β(IL-1β)in paraffin sections of intestinal tissues from NEC and control patients were detected with immunohistochemistry,immunofluorescence,and western *** pet milk,hypoxia and cold stimulation were used to establish a mouse(wild type and Nlrp3^(-/-))model of *** mouse macrophage(RAW 264.7)and rat intestinal epithelial cell-6 lines were also cultured followed by various ***,intestinal epithelial cell injuries,and IL-1β release were *** Compared to the gut“healthy”patients,the intestinal lamina propria of NEC patients had high macrophage infiltration and high NLRP3,caspase-1,and IL-1β ***,in vivo,the survival rate of Nlrp3^(-/-)NEC mice was dramatically improved,the proportion of intestinal macrophages was reduced,and intestinal injury was decreased compared to those of wild-type NEC ***3,caspase-1,and IL-1β derived from macrophages or supernatant from cocultures of macrophages and intestinal epithelial cells also caused intestinal epithelial cell *** Macrophage activation may be essential for NEC ***3/caspase-1/IL-1β cellular signals derived from macrophages may be the underlying mechanism of NEC development,and all these may be therapeutic targets for developing treatments for NEC.

关键词： Caspase-1 Interleukin-1β Macrophage Necrotizing enterocolitis NLRP3

Epidemiological Aspects of Stillbirth and neonatal Deaths in the Delivery Room at the Libreville Mother-Child University Hospital from 2019 to 2022

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Open Journal of Pediatrics 2024年第1期14卷 1-10页

作者： Eliane Kuissi Kamgaing Jacques Albert Bang Ntamack Opheelia Makoyo Komba Raïssa Koumba Maniaga Steeve Minto’o Rogombe Pascal Loulouga Badinga Aude Lembet Mikolo Simon Ategbo Department of neonatal Medicine Jeanne Ebori Foundation Mother-Child University Hospital (JEFMCUH) of Libreville Libreville Gabon Department of Gynaecology and Obstetrics Jeanne Ebori Foundation (JEFMCUH) of Libreville Libreville Gabon Department of Paediatrics University of Health Sciences Libreville Gabon

Introduction: Stillbirths are estimated at 2 million each year, of which more than 40% occur during labour. Our objective was to study the epidemiological aspects of stillbirth and neonatal deaths in the delivery room in our health facility. Patients and methods: Prospective, descriptive and analytical study, conducted at the Jeanne Ebori Foundation Mother-Child University Hospital over 4 years (January 2019-December 2022). All neonatal deaths in the delivery room or foetal death in utero, were included. Results: Among the 18,346 deliveries performed, 512 newborns were declared dead in the delivery room (27.9‰ live births), divided into in utero foetal death (19.0‰) and immediate neonatal death (8.9‰). The mean age was 34.3 weeks of amenorrhea. The rate of preterm birth was 60.4%. The sex ratio was 1.1. The average weight was 2186.6. The main causes were vascular (46.1%), foetal (20.2%), adnexal (17.1%) and asphyxia per partum (16.6%). Foetal causes were more likely to result in IUFD than other causes (OR = 6.4 [2.4 - 15.7], p neonatal mortality are dominated by maternal vascular pathologies. However, the proportion of childbirth-related causes remains worrying. Better monitoring of pregnancy and labour will minimize this prevalence in our hospital.

关键词： Stillbirth neonatal Death Delivery Room Epidemiology Libreville-Gabon

Congenital Hernia of the Diaphragmatic Dome with neonatal Revelation, Experience from the Neonatology and neonatal Intensive Care Unit at the University Hospital Center of Oujda

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Open Journal of Pediatrics 2024年第5期14卷 790-799页

作者： Addou Bebana Anass Ayyad Mohammed Ec-Chebab Sahar Messaoudi Rim Amrani Pediatrics/Residency Mohammed VI University Hospital Oujda Morocco Department of Neonatology and neonatal Intensive Care Unit Mohammed VI University Hospital Medical School Mohammed First University Oujda Morocco The Maternal-Child & Mental Health Research Laboratory Oujda Morocco

Congenital hernia of the diaphragmatic dome (CHDD) is an embryonic malformation in which all or part of the diaphragmatic dome fails to develop properly. In the majority of cases (80% to 90%), this malformation affects the left posterolateral part of the diaphragm, while in 10% to 15% of cases it affects the right. Bilateral cases are extremely rare, accounting for less than 1% of cases. This malformation is estimated to occur at a frequency of around 1 in 3500 births, with a male predominance. The diaphragmatic defect causes the abdominal organs to rise into the thoracic cavity during critical phases of lung development. These anomalies result in bilateral pulmonary hypoplasia, a reduced number of pulmonary vessels, and pulmonary arterial hypertension (PAH). The combination of these anatomical and functional anomalies, in varying degrees, explains the wide variability of symptoms at birth. Diagnosis is usually made prenatally by ultrasound, which enables severe forms of the disease to be detected and appropriate management initiated. The prognosis remains generally grave, with a neonatal mortality rate of between 30% and 60% depending on the study, and around half of all children will have long-term sequelae.

关键词： Congenital Diaphragmatic Hernia Prenatal Diagnosis Pulmonary Hypoplasia Pulmonary Hypertension Medical-Surgical Treatment

Relationship between neonatal respiratory distress syndrome pulmonary ultrasonography and respiratory distress score,oxygenation index,and chest radiography grading

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World Journal of Clinical Cases 2024年第20期12卷 4154-4165页

作者： Hai Yang Li-Jun Gao Jing Lei Qiang Li Liu Cui Xiao-Hua Li Wu-Xuan Yin Sen-Hua Tian neonatal Intensive Care Center Liupanshui Maternal and Child Care Service CenterLiupanshui 553000Guizhou ProvinceChina Ultrasound Function Department Liupanshui Maternal and Child Care Service CenterLiupanshui 553000Guizhou ProvinceChina Medical Imaging Department Liupanshui Maternal and Child Care Service CenterLiupanshui 553000Guizhou ProvinceChina

BACKGROUND Accurate condition assessment is critical for improving the prognosis of neonatal respiratory distress syndrome(RDS),but current assessment methods for RDS pose a cumulative risk of harm to ***,a less harmful method for assessing the health of neonates with RDS is *** To analyze the relationships between pulmonary ultrasonography and respiratory distress scores,oxygenation index,and chest X-ray grade of neonatal RDS to identify predictors of neonatal RDS *** This retrospective study analyzed the medical information of 73 neonates with RDS admitted to the neonatal intensive care unit of Liupanshui Maternal and Child Care Service Center between April and December *** pulmonary ultrasonography score,respiratory distress score,oxygenation index,and chest Xray grade of each newborn before and after treatment were *** correlation analysis was performed to determine the relationships among these values and neonatal RDS *** The pulmonary ultrasonography score,respiratory distress score,oxygenation index,and chest X-ray RDS grade of the neonates were significantly lower after treatment than before treatment(Pneonatal RDS(area under the curve=0.805–1.000,Pneonatal RDS score,oxygenation index,and chest X-ray *** pulmonary ultrasonography score was an effective predictor of neonatal RDS severity.

关键词： neonatal respiratory distress syndrome Pulmonary ultrasonography Ultrasonography score Respiratory distress score Oxygenation index Chest X-ray grading

Protective effect of topiramate on hypoxic-ischemic brain injury in neonatal rat

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Asian Pacific Journal of Tropical Medicine 2014年第6期7卷 496-500页

作者： Hong Jiang Juan-Juan Lei Yi-He Zhang neonatal Department Affiliated Hospital of Yan'an University of Shaanxi Province

Objective:To explore protective effeet of topiramate(TPM) on hypoxic—ischemic brain ***:A total of 360 neonatal rats were seleeted then randomly divided into sham operation group,ischemia and hypoxia group,conventional treatment group and degradation therapy group(n=90).After surgical treatment,sham and ischemic hypoxia group were treat with normal saline:conventional treatment group was received Tl'M solution 100 mg/kg.2 times/d:degradation therapy group received TPM solution 150 mg/kg.2 times/*** 3 d treatment each dosage was reduced 50 mg/*** lowest reduced to 50 mg/*** groups received continuous treatment for 10 *** treatment for 1 d.4 d.7 d.10 d the cercbral edema,neuron-specific enolase(NSE)and γ-aminobutyric acid(GABA) levels and cognitive abilities of four groups were ***:After 1d.4d of treatment,the brain water conlenl and NSE levels in ischemia and hypoxia group,the conventional treatment group and the degradation therapy group were significantly higher than that in sham group(P.the GABA levels in the conventional treatment

关键词： TPM Brain Injury NSE GABA

Foxg1 mRNA overexpression in neonatal rats following hypoxic brain injury

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Neural Regeneration Research 2011年第1期6卷 41-46页

作者： Luquan Li Yi Zheng Guoliang Mo Fang Li Jialin Yu neonatal Diagnosis and Treatment Center Children's Hospital of Chongqing Medical University Chongqing 400014 China

Forkhead box G1 （Foxgl） is expressed during the embryonic stage and in postnatal brain regions sensitive to hypoxia/ischemia injury, such as the hippocampus and cerebral cortex. To date, very little is known about Foxgl expression changes in the brain following hypoxia injury （HI）. The present study measured Foxgl mRNA expression using reverse-transcription polymerase chain reaction on days 3, 7, 14, 28, and 56 following HI to determine self-restorative features in the injured brain. In addition, mRNA expression of other related layer markers, such as Reelin, RORB, Foxpl, Foxp2, ER81, and Otx-1, was detected following HI. Results revealed significantly decreased Foxgl mRNA expression at 3 days after HI, which significantly increased by 56 days. Reelin and Foxp2 mRNA expression were upregulated until 56 days after HI, but Foxpl and ER81 mRNA expression decreased from day 14 to 56 following HI. In addition, Otx-1 and RORI3 mRNA expression decreased from day 3 to 28 after HI. These findings revealed Fxogl mRNA overexpression and varying degrees of restoration in the neonatal rat brain following HI.

关键词： Foxgl mRNA hypoxia injury neonatal rats cerebral cortex

Gastrodin protects neonatal rat brain against hypoxic-ischemic encephalopathy Acute therapeutic drug effects

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Neural Regeneration Research 2008年第2期3卷 196-199页

作者： Yanjun Niu Zhengyong Jin Department of neonatal Diseases Affiliated Hospital of Yanbian University Yanji 133000 Jilin Province China

BACKGROUND： Pharmacological experiments have demonstrated that gastrodin has a protective effect on neonatal rat brain subjected to hypoxia-ischemia; however, the underlying mechanism has not been fully elucidated. OBJECTIVE： The aim of this study was to investigate the acute therapeutic effects of gastrodin by observing prostaglandin B2 and 6-keto-prostaglandin F 1 a in brain tissue of neonatal rats that received gastrodin injections immediately after hypoxia-ischemia. DESIGN： Single-factor design. SETTING： Department of Pediatrics, Affiliated Hospital of Yanbian University. MATERIALS： This study was performed in the Laboratory of the Department of Pediatrics, Affiliated Hospital of Yanbian University （key laboratory of provincial Health Department） from April to December 2003. Fifty-five Wistar rats of either gender, aged 7 days, were provided by the Laboratory Animal Center of Affiliated Hospital of Yanbian University. The rats were randomly divided into normal control （n =10）, model （n = 15）, gastrodin-treated （n = 15）, and Danshen-treated （n = 15） groups. The protocol was performed in accordance with guidelines from the Institute of Health Sciences for the use and care of animals. The following reagents were. used： Gastrodin （Sancai Medicine Group Co., Ltd., Zhongshan, Guangdong Province, China; component： gastrodin）, Danshen （Conba Stock Company, Jinhua, Zhengjiang Province, China; component： salvia miltiorrhiza）, and reagent kits for ^125I-prostaglandin B2 and ^125I-6-prostaglandin F l a （Research and Development Center for Science and Technology, General Hospital of Chinese PLA）. METHODS： Rats in the normal control group received no treatment. Rats in the remaining 3 groups were anesthetized, followed by ligation of the left common carotid artery. One hour later, the rats were placed in a closed hypoxic box and allowed to inhale 8% oxygen-air （2.0 3.0 L/min） for 2 hours to develop hypoxic-ischemic encephalopathy. Immediately after lesion, rats in the

关键词： rat model neonatal hypoxia-ischemia prostaglandin B2 6-keto-prostaglandin F 1α

Delivery room resuscitation intensity and associated neonatal outcomes of 24^(+0)-31^(+6) weeks'preterm infants in China:a retrospective cross-sectional study

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World Journal of Pediatrics 2024年第1期20卷 64-72页

作者： Si-Lu Wang Chun Chen Xin-Yue Gu Zhao-Qing Yin Le Su Si-Yuan Jiang Yun Cao Li-Zhong Du Jian-Hua Sun Jiang-Qin Liu Chuan-Zhong Yang Department of Neonatology Shanghai Key Laboratory of Maternal Fetal MedicineShanghai Institute of Maternal-Fetal Medicine and Gynecologic OncologyShanghai First Maternity and Infant HospitalSchool of MedicineTongji UniversityNo.2699Gaoke Western RoadPudong DistrictShanghai 201204China Department of Neonatology Affiliated Shenzhen Maternity and Child Healthcare HospitalSouthern Medical UniversityNo.2004Hongli RoadFutian DistrictShenzhen 518028China NHC Key Laboratory of neonatal Diseases Fudan UniversityChildren's Hospital of Fudan UniversityShanghaiChina Department of Neonatology People's Hospital of DehongKunming Medical UniversityDehongChina Department of Neonatology Children's Hospital of Fudan UniversityShanghaiChina Department of Neonatology Children's HospitalZhejiang University School of MedicineHangzhouChina Department of Neonatology Shanghai Children's Medical CenterSchool of MedicineShanghai Jiao Tong UniversityShanghaiChina

Background The aim of this study was to review current delivery room(DR)resuscitation intensity in Chinese tertiary neonatal intensive care units and to investigate the association between DR resuscitation intensity and short-term outcomes in preterm infants born at 24+0_31+6 weeks gestation age(GA).Methods This was a retrospective cross-sectional *** source population was infants born at 24+0_31+6 weeks'GA who were enrolled in the Chinese neonatal Network 2019 *** infants were categorized into five groups:(1)regular care;(2)oxygen supplementation and/or continuous positive airway pressure(O2/CPAP);(3)mask ventilation;(4)endotracheal intubation;and(5)cardiopulmonary resuscitation(CPR).The association between DR resuscitation and shortterm outcomes was evaluated by inverse propensity score-weighted logistic *** Of 7939 infants included in this cohort,2419(30.5%)received regular care,1994(25.1%)received O,/CPAP,1436(18.1%)received mask ventilation,1769(22.3%)received endotracheal intubation,and 321(4.0%)received CPR in the *** maternal age and maternal hypertension correlated with a higher need for resuscitation,and antenatal steroid use tended to be associated with a lower need for resuscitation(P<0.001).Severe brain impairment increased significantly with increasing amounts of resuscitation in DR after adjusting for perinatal *** strategies vary widely between centers,with over 50%of preterm infants in eight centers requiring higher intensity *** Increased intensity of DR interventions was associated with increased mortality and morbidities in very preterm infants in *** is wide variation in resuscitative approaches across delivery centers,and ongoing quality improvement to standardize resuscitation practices is needed.

关键词： Cardiopulmonary resuscitation Delivery room Endotracheal intubation neonatal resuscitation Preterm

Survey on surgical treatment of neonatal necrotizing enterocolitis in China 2022

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World Journal of Pediatric Surgery 2023年第4期6卷 231-237页

作者： Jiafang Gao Dengming Lai Jinfa Tou Department of neonatal Surgery Children's HospitalZhejiang University School of MedicineHangzhouChina neonatal Surgery Group of the Pediatric Surgery Branch Chinese Medical AssociationBeijingChina

Objective The aim of this study was to identify the state of surgical treatment of neonatal necrotizing enterocolitis(NEC)in *** A total of 246 delegates(88.0%senior surgeons)completed a survey sent by the neonatal Surgery Group of the Pediatric Surgery Branch of the Chinese Medical Association in *** centers were eliminated due to lack of *** Generally,38.2% of surgeons work in centers where more than 20 cases of surgical NEC are treated per year.A total of 81.3% of surgeons reported the use of ultrasonography;the most used biomarkers were white blood cell count(95.9%),C-reactive protein(93.8%),and procalcitonin(76.3%).Most surgeons(80.9%)used a combination of two(67.2%)antibiotics or single(29.5%)antibiotic for a treatment period of 7-14 days,and most used antibiotics were carbapenems(73.9%),penicillin and cephalosporins(56.0%).Patients are issued the fasting order for 5-7 days by nearly half surgeons(49.8%)for conservative treatment.70.1% of surgeons deemed that the most difficult decision was to evaluate the optimal timing of *** surgeons(76.3%)performed diagnostic aspiration of peritoneal *** was performed for the diagnosis and/or treatment of NEC by 40.2% of surgeons.A total of 53.5% of surgeons reported being able to identify localized intestinal necrosis *** relied the most on pneumoperitoneum(94.2%)and failure of conservative treatment(88.8%)to evaluate the surgical *** laparotomy,surgical treatments vary according to NEC *** are fasted for 5–7 days by 55.2% of surgeons *** surgeons(91.7%)followed up with patients with NEC after discharge for up to 5 years(53.8%).Conclusions The most difficult aspect of surgical NEC is evaluating the timing of surgery,and surgeons in the children’s specialized hospitals are *** treatment of NEC totalis is controversial,and the indications for laparoscopy need to be further *** multicenter

关键词： Surgery treatment centers