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Objective To investigate the value of thrombomodulin (TM), thrombin-antithrombin complex (TAT), α2 plasmin inhibitor-plasmin complex (PIC) and tissue plasminogen activator-inhibitor complex (t-PAIC) in the diagnosis and prognosis of neonatal disseminated intravascular coagulation (DIC). Methods Eighty-seven DIC neonates (the observation group) were included and divided into the survival group (66 cases) and the death group (21 cases) based on their outcomes at discharge. And 50 healthy newborns born in the same period were selected as the control group. The clinical data of neonates were collected, and risk factors of neonatal DIC were analyzed by Logistic regression. The differences of TM, TAT, PIC and t-PAIC levels in different groups were analyzed. The receiver operating characteristic (ROC) curve was used to analyze values of TM, TAT, PIC and t-PAIC in the diagnosis and prognosis of neonatal DIC. Results The incidence of low Apgar score, birth asphyxia, IVH, sepsis and maternal pregnancy induced hypertension syndrome (PIH) were higher in the observation group than those in the control group (P＜0.05). Multivariate Logistic regression analysis showed that low Apgar score, birth asphyxia, sepsis and PIH were independent risk factors for neonatal DIC. TM, TAT, PIC and t-PAIC levels were higher in the observation group than those in the control group (P＜0.05). ROC curve showed that the combined diagnosis value of TM, TAT, PIC and t-PAIC was better than that of single diagnosis of neonatal DIC. TM and TAT levels were higher in the death group than those in the survival group (P＜0.05), and there were no significant differences in PIC and t-PAIC levels between the two groups. Multivariate Logistic regression analysis showed that elevated TAT level was an independent risk factor for neonatal DIC prognosis. ROC curve showed that when TAT was 21.72 µg/L, the area under the curve for predicting neonatal DIC prognosis was 0.772 (95%CI: 0.666-0.878), and the sensitivity and specificity were 76.2% and 71.2%, respectively. Conclusion The combined application of TM, TAT, PIC and t-PAIC has important clinical value in diagnosis and prognosis evaluation of neonatal DIC. [ABSTRACT FROM AUTHOR]

Malrotation and midgut volvulus are surgical emergencies that commonly occur within the first month of life. The classic symptom is acute bilious vomiting, while nonspecific symptoms such as recurrent abdominal pain may be present in older children. Malrotation can be associated with duodenal obstruction caused by an abnormal peritoneal fibrous band or congenital anomalies, such as an annular pancreas or a preduodenal portal vein. Volvulus can lead to bowel ischemia and a life-threatening condition, thus prompt and accurate diagnosis is crucial. Diagnosis can be made through upper gastrointestinal series, ultrasonography, and CT, with ultrasonography being preferred as a screening tool due to its rapid and accurate diagnosis, without radiation exposure, in children. This pictorial essay discusses the key imaging findings and diagnostic approaches for malrotation and midgut volvulus, as well as diagnostic pitfalls based on actual cases. [ABSTRACT FROM AUTHOR]

Objective To investigate the effect of mitophagy-NOD-like receptor heat protein domain associated protein 3 (NLRP3) inflammasome pathway on cerebral ischemic injury in neonatal rats. Methods Forty-two 7-day SD rats were divided into the sham group, the cerebral ischemia-reperfusion injury (CIRI) group, the CIRI+dimethyl sulfoxide (DMSO) group, the CIRI+Mdivi-1 group, the CIRI+MCC950 group and the CIRI+Ac-YVAD-CMK group (7 rats in each group). Except for the sham group, the neonatal rat model of hypoxic-ischemic brain injury was established by unilateral common carotid artery occlusion. Neurological symptom score was performed by Londa method. Cell morphology in CA1 region of hippocampus was observed by hematoxylin-eosin (HE) staining. Ultrastructure of hippocampal neurons was observed by transmission electron microscopy, and related proteins of mitochondrial autophagy and NLRP3 inflammasome pathway were detected by Western blot assay. Results Compared with the CIRI+DMSO group, the CIRI+Mdivi-1 group had higher scores of neurobehavioral disorders, fewer synapses and more swollen mitochondria (all P＜0.05). Compared with the CIRI+Mdivi-1 group, the neurobehavioral disorder score and the number of synapses increased, and the number of swollen mitochondria decreased in the CIRI+MCC950 group and the CIRI+Ac-YVAD-cmk group (all P＜0.05). Compared with the CIRI+DMSO group, the protein expressions of PINK1, Parkin and LC3 Ⅱ/Ⅰ were down-regulated in the CIRI+ Mdivi-1 group, and the protein expressions of TOMM20, P62, NLRP3, caspase-1 and caspase-8 were up-regulated (P＜ 0.05). Compared with the CIRI+Mdivi-1 group, the protein expressions of PINK1, Parkin, LC3 Ⅱ/Ⅰ were up-regulated in the CIRI+MCC950 group and the CIRI+Ac-YVAD-cmk group (P＜0.05). The expression levels of NLRP3, caspase-1 and caspase-8 proteins were down-regulated in the CIRI+MCC950 group, and caspase-1 and caspase-8 proteins decreased in the CIRI+Ac-YVAD-cmk group (P＜0.05). Conclusion Activation of mitochondrial autophagy or inhibition of NLRP3 inflammasome activation have protective effects on cerebral ischemic injury in neonatal rats. [ABSTRACT FROM AUTHOR]

Background In the diagnosis of neonatal pneumonia, the possibility of iatrogenic injury caused by magnetic resonance imaging (MRI) may be lower than that by widely used X-ray and even computed tomography scan. However, there are few studies on the application of MRI in the diagnosis of neonatal pneumonia. Objective To explore the feasibility of using MRI for the diagnosis of neonatal pneumonia in primary care based analyzing the application of SS_TSE and modified abdominal T2WI sequences at 1.5 Tesla for the diagnosis of this illness. Methods Nineteen neonates diagnosed with pneumonia by MRI were selected from Wuchuan People's Hospital from January to November 2020. Six parameters under SS_TSE and modified abdominal T2WI sequences including subjective MR score, signal intensity of the lesion (SI lesion) , lung signal intensity (SI lung) , lung noise (SD lung) , calculated image signal-to-noise ratio (SNR) and lesion signal intensity ratio (SIR) were statistically analyzed. Results The values of these six parameters of SS_TSE sequence were 2.2 (2.0, 2.8) , (505.0±102.5) , (243.5±32.0) , (21.8±6.7) , (12.0±3.1) , and 2.1 (2.0, 2.2) , respectively. And The values of subjective score, SI lesion, SI lung, SD lung, SNR and SIR of T2WI sequence were 2.7 (2.0, 3.3) , (293.1±129.6) , (99.7±40.3) , (19.0±7.6) , (5.6±2.3) , and 3.1 (2.6, 3.2) , respectively. Based on the combination of SS_TSE and T2WI images, the diagnoses for all cases were made. Conclusion The brightness of the lesions in SS_TSE sequence is higher, with better objective definition of the images. T2WI sequence has higher subjective definition, and the signal of the lesions was markedly different from the background, which is helpful to observe the border of the lesions. SS_TSE and T2WI sequences are complementary in the diagnosis of neonatal pneumonia. In a word, it is feasible to apply MRI for the diagnosis of neonatal pneumonia at 1.5 Tesla to reduce the possibility of iatrogenic injury.