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Objective To analyze the clinical characteristics of neonatal necrotizing enterocolitis (NEC) and food protein-induced proctocolitis (FPIPC) in neonates with bloody stool as the initial manifestation. Methods We retrospectively analyzed the clinical data of 207 neonates with NEC (n=57; 27.5%) and FPIPC (n=150; 72.5%), who presented with bloody stool as the initial symptom and were treated in the outpatient clinic of our hospital between January 2018 and December 2018. The clinical symptoms and signs, laboratory test results, imaging findings, treatment and prognosis were compared between the two groups. Results The neonates with FPIPC were more likely to have such clinical manifestations as diarrhea, fat globules in the feces and elevated peripheral blood eosinophil count than those with NEC (P < 0.05). The neonates with NEC often had disease onset at a younger age and were more likely to have abdominal distension, vomiting, fever, elevated C-reactive protein, white blood cells in the feces, pneumatosis intestinalis, and portal venous gas than those with FPIPC group (P < 0.05). Conclusion In neonates admitted for bloody stool as the initial symptom, NEC often occurs at a younger age than FPIPC and is associated with a higher incidence of sepsis. The neonates with FPIPC often have more obvious elevation of eosinophil count, which can be accompanied by pneumatosis intestinalis or portal gas accumulation.

Ventilator-associated pneumonia (VAP) is a common complication and cause of death in neonates on mechanical ventilation. However, it is difficult to define the causes of VAP. To understand the causes of VAP, we undertook a prospective study based on the diversity of the microflora in VAP. The experimental group consisted of newborns who suffered from respiratory distress syndrome (RDS) and VAP, while the control group suffered from RDS without VAP. Sputa were collected within 1, 3, and 5 days of ventilation and were divided into six groups. DNA was extracted from the samples, and the 16S rDNA was PCR amplified, separated using denaturing gradient gel electrophoresis (DGGE), cloned and sequenced. The resulting sequences were compared using BLAST. The DGGE pictures were measured, and the richness, Shannon-Wiener index, and cluster maps were analyzed. No differences were found regarding the constituent ratio of any genus between the Non-VAP and VAP group within 1 day after intubation. After 1 to 3 days, the constituent ratios of Klebsiella sp., Acinetobacter sp., and Streptococcus sp. in the VAP group were higher than those in the Non-VAP group, and the ratios of Serratia sp. and Achromobacter sp. were lower. After 3 to 5 days, the ratios of Klebsiella sp., Acinetobacter sp., Serratia sp., and Achromobacter sp. were lower than those in the Non-VAP group. The richness and Shannon-Wiener index of the Non-VAP group were higher than those of the VAP group from 1 to 3 days after intubation, while no differences were found within 1 day and from 3 to 5 days. We conclude that during the first three days of intubation, the microflora diversity in the lower respiratory tract was reduced due to VAP, and the greater constituent ratios of Klebsiella sp., Acinetobacter sp., and Streptococcus sp. in the sputum may be indicators of VAP. [ABSTRACT FROM AUTHOR]

Objective: To explore the effect of prenatal glucocorticoids therapy on hearing screening in premature infants Methods: Data of 693 preterm infants with gestational age of 24-34+6weeks admitted to theJiangxi Maternal and Child Health Hospital within 24 h after birth from June 2022 to June 2023 were retrospectively analyzed. The infants were divided into the DXM group （544 cases） and the non-DXM group （149 cases） based on whether dexamethasone （DXM） was administered prenatally. General data of preterm infants and parturients in two groups were compared, and the effects of different doses and timing of DXM on hearing screening were analyzed. Results: In the terms of preliminary hearing screening. the pass rate of initial hearing screening in DXM group was significantly higher than that in non-DXM group（53.9% vs 35.6%）, with statistical significance（ P <0.05）. Further subgroup analysis showed that the passing rate of preliminary hearing screening in adequate prenatal dose（=4 doses） DXM group（58.1%） was significantly higher than that in insufficient group（48.0%） and excessive group（42.4%）, with statistical significance（ P <0.05）. Administering DXM 48 hours to 7 days before birth resulted in a higher pass rate for initial hearing screening compared to administration <48 hours or >7 days before birth （56.4% vs. 48.6%）, with a statistically significant difference （P < 0.05）. In terms of re-hearing screening, the pass rate of secondary hearing screening was not significantly correlated with DXM treatment（ P >0.05）, but was significantly correlated with gestational age, birth weight, hospital stays, invasive mechanical ventilation, and common neonatal diseases（bronchopulmonary dysplasia, respiratory distress syndrome）（ P <0.05）. Among them, bronchopulmonary dysplasia was an independent risk factor forsecondary hearing screening referral（ P <0.05）. Conclusion: A single course of adequate dexamethasone use within 48 h-7 d of prenatal has a positive effect on the preliminary hearing screening of preterm infants., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright© by the Editorial Department of Journal of Clinical Otorhinolaryngology Head and Neck Surgery.)