Enterocolitis Research Articles

Клінічна симптоматика агангліонозу кишечника та його ускладнень у дітей віком від 3 до 6 років

Clinical symptoms of colonic aganglionosis (CA) in children 3 to 6 years of age are difficult due to its clinical presentation which represents as the complications of this pathology, because of it the classic signs of Hirschsprung’s disease (HD) are partially eliminated or hidden, which makes it difficult for the effective diagnosis of this pathology in these children. Purpose - to study the clinical symptoms of CA and its complications in children 3 to 6 years of age and to determine the significance of clinical symptoms for the verification of HD. Materials and methods. We have done retrospective analysis of the clinical manifestations in 240 children 3 to 6 years of age with HD, considering the extent of CA, the presence of associated malformations and complications. There were 95 (39.58%) patients with the rectal form of CA, 143 (59.59%) with the rectosigmoid form, 2 (0.83%) with the subtotal form. There were no patients with total CA in this age group. There were 192 boys (80.0%), and 48 girls (20.0%). At the age of 3-4 years 71 (29.58%) patients were diagnosed with HD, at the age of 4-5 years - 79 (32.91%), and at the age of 5-6 years - 90 (37.51%) patients. Results. The diagnosis of HD can be of course considered as late for patients from 3 to 6 years of age. We found associated malformations in 45 (18.75%) patients. Associated intestinal malformations were found in 26 (10.83%) patients, of which 19 (7.92%) had malformations that significantly increased the clinical symptoms of CA and its complications: malrotation (n=17 (7.08%)) and internal abdominal hernia (2 (0.83%)). Enterocolitis (EC) was found in 98 (40.83%) patients. The 1st degree of EC was established in 9 (3.75%) children, 2nd degree - in 34 (14.16%) and 3rd degree - in 55 (22.91%) patients. Among these 55 with 3rd degree of EC the critical moment in the progression of the course of EC was toxic megacolon (TM), which occurred in 14 (25.46%). Hypotrophy was established in 18 (7.49%) patients. Anemia of various degrees was diagnosed in 35 (14.58%) children. The acute stage of the course of HD was diagnosed in 98 (40.83%) patients, subacute - in 77 (32.08%) and chronic - in 65 (27.08%) children. The clinical course of HD was correlated with the extent of the colon affected with CA and is closely related to the presence of its complications: EC, anemia and hypotrophy. Conclusions. Clinical symptoms of CA in children aged 3 to 6 years remains typical and informative upon careful evaluation of complaints, medical history, and objective and laboratory results. The severity of the course, associated developmental malformations and late diagnosis are the main reasons for the appearance of severe complications of HD in children 3 to 6 years of age - EC (40.83%), TM (25.46%), hypotrophy (7.49%) and anemia (14.58%). Variants of complications in CA are characteristic and predictable. Comparison of the clinical signs of CA and its complications contribute to the correct assessment of the patient's condition and timely establishment of the correct diagnosis. The research was carried out in accordance with the principles of the Declaration of Helsinki. The research protocol was approved by the Local Ethics Committee of all institutions mentioned in the work. Informed consent of the children’s parents was obtained for the research. No conflict of interests was declared by the authors.

Comparison of clinical results of Transanal Endorectal Pull-Through of the colon with and without laparoscopic assistance in children with Hirschsprung’s disease

Introduction. Techniques of Transanal Endorectal Pull-Through (TEPT) with and without laparoscopic assistance have been widely used in pediatric surgery for correction of Hirschsprung’s disease (HD) in children with. Many clinics in their studies have noted the positive features of this approach compared to classical methods, but the long-term results after such operations in children are still debated. Purpose - to study and compare the clinical results of TEPT with and without laparoscopic assistance in children with HD. Materials and methods. We analyzed the experience of TEPT approach with laparoscopy (n=65 (29.41%)) and without laparoscopic assistance (n=144 (70.59%)) in childreb for correction of HD. For confirmation diagnosis we used the results of general clinical and special procedures (barium enema, anomanometry, histological, determination of acetylcholesterase activity). Results. Overall, among 55 (26.32%) of 209 patients who underwent TEPT, postoperative in long term follow up we found intestinal problems like - moderate stenosis of the colo-anal anastomosis without incontinence 4 (1.91%), constipation 9 (4.31%), partial faecal incontinence 20 (9.57%) and enterocolitis (EC) 22 (10.53%). There was no significant difference in the clinical results of TEPT with laparoscopy and without laparoscopic assistance in our patients. After TEPT without laparoscopic assistance, 6 (4.17%) of 144 patients had constipation, 11 (7.64%) had partial fecal incontinence, and 16 (11.11%) had enterocolitis (EC). And among 65 children after TEPT with laparoscopy, 3 (4.62%) patients were diagnosed with constipation, 9 (13.85%) with partial fecal incontinence and 6 (9.23%) with EC. All children with postoperative intestinal problems were treated conservatively. There was no need for redo surgical interventions in these patients. Conclusions. The technique of TEPT with laparoscopy and without laparoscopic assistance is a modern method of surgical correction of HD, which has significant technical advantages compared to other existing methods. In 26.32% of children with HD who were operated by the TEPT method, persistent intestinal problems continue in the long term follow-up period. The research was carried out in accordance with the principles of the Declaration of Helsinki. The research protocol was approved by the Local Ethics Committee of all institutions mentioned in the work. Informed consent of the children’s parents was obtained for the research. No conflict of interests was declared by the authors.

Pseudomembranous Enteritis Presenting as SAIO Mimicking a Case of Small Bowel Crohn’s

Background: Pseudomembranous colitis (PMC) is a manifestation of severe colonic disease that is usually associated with Clostridium difficile infection but associated small bowel involvement is rare and presentation as obligating enteropathy is even rarer. Aims and Methods: 21 years old medical student residing in south India presented with history of recent onset of vomiting of 2-3 weeks, mild abdominal distention and occasional colic for 1 week and mild degree fever for 2 days. She gives h/o recurrent lower abdominal pain and bloody stools of 9 months for which she underwent upper and lower GI scopes and was diagnosed with Biopsy proven IBD-UC - Montreal L2 with mild to moderate severity and was well controlled with 5 ASA. She was asymptomatic until presentation. Investigations s/o Elevated TC with neutrophilic predominance, CRP ,Anaemia, Hypoalbuminemia ,vit D def. She was started on Iv antibiotics and mesacol along with supportive mediations, Septic workup, AxR, was Wnl. Colonoscopy suggestive of Inflammatory Pancolitis with some whitish exudates in R colon? PMC,UC-EIS 9, UGI scopy s/o D2D3 narrowing with superficial ulcerations, Stools C/s, CD toxins/GDH. Based on this her immunosuppressants were titrated and modified along with treatment for PMC were initiated. She improved and was discharged after 10 days. Biopsy suggestive of UC associated Entropathy with f/s/o Pseudo- membraneous enteritis. along with focal enhanced gastritis with a single periglandular granuloma. CTenterography done after 2 weeks were essentially normal. Currently she is nearly asymptomatic on azathioprine, steroids and metronidazole is doing well. Results:PMC Enterocolitis needs to be thought as a differential of patient presenting with proximal bowel disease with IBD-UC. Though rare can present as a close mimicker of CD. Conclusion: PMC is a rare cause of Obstructive enteropathy. PMC needs to thought as a differential in a patient with proximal bowel involvement in a patient with Ulcerative colitis. Keywords: PMC, Entero Colitis, Abdominal Pain

Стан мікробіоти порожнини товстої кишки дітей, хворих на гострий ентероколіт, які перебувають на природному вигодовуванні, при інфікованості грудного молока

Актуальність. Проблема гострого ентероколіту є надзвичайно актуальною внаслідок їх знач­ного поширення й порівняно низької ефективності етіотропного та патогенетичного лікування. Метою дослідження було вивчення таксономічного складу і популяційного рівня мікробіоти вмісту порожнини товстої кишки дітей, хворих на гострий ентероколіт, при природному вигодовуванні молоком, інфікованим Staphylococcus aureus, а також розкрити механізми колонізації досліджуваного біотопу мікроорганізмами. Матеріали та методи. Бактеріологічному й мікологічному дослідженню підлягав вміст порожнини товстої кишки 53 дітей віком від одного до шести місяців, хворих на ентероколіт, які перебували на грудному вигодовуванні інфікованим молоком, контрольну групу становили 35 зразків вмісту порожнини товстої кишки здорових дітей, також досліджувалось грудне молоко матерів-годувальниць обох груп. Результати. Дослідження грудного молока показали, що в 49 (92,45 %) пробах виділено та ідентифіковано Staphylococcus aureus, а в 4 (7,55 %) — Staphylococcus epidermidis (3,0–7,0 lg КУО/мл (М ± m = (4,37 ± 0,38) lg КУО/мл)). S.аureus та S.еpidermidis виділяли зі зразків випорожнень усіх хворих дітей у 2,92 раза частіше, ніж у практично здорових дітей. На фоні вигодовування дитини інфікованим молоком із досліджуваного біотопу елімінують еубактерії, пептокок, а E.coli Hly+, протеї, цитробактер і стафілококи контамінують порожнину товстої кишки. Популяційний рівень Bifidobacterium знижується на 43,03 % (на 3 порядки), Lactobacillus — на 32,24 % (на 2 порядки). Спостерігається заселення товстої кишки E.coli Hly+ у 16,48 %, протеями — у 22,53 %, цитробактерами — у 3,77 %, пептококами — у 15,09 %, пептострептококами — у 55,42 % і стафілококами — у 91,43 %. Висновки. Доведено, що сформований дисбактеріоз товстокишкового мікробіоценозу в дітей грудного віку, хворих на гострий ентероколіт, характеризується зменшенням кількості біфідобактерій і лактобактерій та зростанням кількості й значення в мікробіоценозі грамнегативних умовно-патогенних ентеробактерій, бактероїдів та грампозитивних умовно-патогенних бактерій роду Staphylococcus, Peptostreptococcus і Peptococcus.

Methicillin-Resistant Staphylococcus aureus -Associated Diarrhea in a Critically Ill Burn Patient

Described in surgical patients after antibiotic use in the 1950s and 1960s, Staphylococcus aureus ( S. aureus ) enterocolitis is a rare form of nosocomial diarrhea. However, S. aureus is not routinely tested like Clostridium difficile ( C. difficile ). We report a case of methicillin-resistant S. aureus (MRSA) enterocolitis found on stool culture in a 22-week pregnant female with a previously negative nasal MRSA culture, and a total burn surface area greater than 60%. She also developed necrotizing MRSA pneumonia and bacteremia. After starting broad-spectrum antibiotic for the necrotizing pneumonia with subsequent acute respiratory distress syndrome, the patient exhibited large voluminous diarrhea that tested positive for MRSA and negative for C. difficile in the stool culture. Similar to other reports of high-volume diarrhea, the diarrhea resolved quickly with enteral vancomycin. S. aureus should be considered along with C. difficile during the workup of nosocomial diarrhea, especially with exposure to broad-spectrum antibiotics in the critically ill patient. J Med Cases. 2021;12(7):257-261 doi: https://doi.org/10.14740/jmc3690

Immunoglobulin G4 Related-Disease: A Rare Presentation With Secondary Hypereosinophilic Syndrome and Eosinophilic Ascites

Immunoglobulin G4 related-disease (IgG4-RD) is a multisystemic immune-mediated fibroinflammatory disease, with a strong predilection for salivary and lacrimal glands, pancreas, biliary tree, lungs, kidneys, aorta, and retroperitoneum. In the case of pancreatic involvement, it manifests as autoimmune pancreatitis. Patients with IgG4-RD usually have mild to moderate eosinophilia in the peripheral blood, however, they may present a secondary hypereosinophilic syndrome (HES). Although there are cases described with severe eosinophilia (> 5,000/µL), the 2019 American College of Rheumatology/European League Against Rheumatism classification criteria for IgG4-RD considers peripheral eosinophilia above 3,000/µL as an exclusion criterion, although stating that assessment for the presence of exclusion criteria should be individualized depending on a patient’s clinical scenario. Here, we describe the clinical case of a 30-year-old woman who presented with chronic diarrhea and abdominal pain. The diagnostic workup revealed eosinophilic ascites, severe peripheral blood eosinophilia (> 5,000/µL), IgG4 elevation (> 2 × upper normal limit), and also diffuse swelling in the body and pancreatic tail (computed tomography (CT) scan). There was a prompt response to corticosteroid therapy with clinical resolution and continued remission under therapy. The patient was diagnosed with IgG4-RD with secondary HES, explaining the gastrointestinal tract and peritoneum damage in the form of enterocolitis and ascites. Exclusion of alternative diagnosis was made. J Med Cases. 2021;12(3):107-111 doi: https://doi.org/10.14740/jmc3634

Influence of premature rupture of membranes on the early prognosis of extremely premature infants

OBJECTIVE To study the influence of premature rupture of membranes (PROM) on the early prognosis of extremely premature infants, and to provide a basis for the management of extremely premature infants and prenatal consultation. METHODS A total of 179 extremely premature singleton infants who were born from 2017 to 2019 were enrolled. According to the presence or absence of PROM, they were divided into two groups: PROM group (n=69) and non-PROM group (n=110). A statistical analysis was performed for maternal data and early prognostic indicators. RESULTS Compared with the non-PROM group, the PROM group had significantly higher incidence rates of earlyonset sepsis and necrotizing enterocolitis (NEC) (P < 0.05) and significantly lower rate of use of pulmonary surfactant and incidence rate of hemodynamically significant patent ductus arteriosus (P < 0.05). The multivariate logistic regression analysis showed that chorioamnionitis was an independent risk factor for early-onset sepsis and NEC (OR=11.062 and 9.437 respectively, P < 0.05), and PROM was an independent protective factor against the use of pulmonary surfactant (OR=0.363, P < 0.05). CONCLUSIONS PROM increases the incidence rates of early-onset sepsis and NEC in extremely premature infants and does not increase the incidence rates of other adverse outcomes. For pregnant women with PROM at the risk of extremely preterm delivery, prevention of miscarriage and chorioamnionitis is recommended to prolong gestational weeks, reduce the incidence rate of infection, and thus improve the outcome of extremely premature infants.

Why so many published studies and so little progress in necrotizing enterocolitis?

Why so many published studies and so little progress in necrotizing enterocolitis?

COVID-19 ve Anne Sütü ile Beslenme

Aralık 2019’da Çin’den başlayarak tüm dünyaya yayılan COVID-19 enfeksiyonu doğumdan itibaren yaşamın her evresini etkileyen bir enfeksiyondur. Küçük çocukların çoğunda asemptomatik ya da hafif şiddette seyrettiği bildirilen COVID-19 enfeksiyonuna yakalanan gebe ve çocuk sayısı giderek artmaktadır. Olağanüstü koşullarda sağlığın korunması ve sürdürülmesinde anne sütü ile beslenme çok önemlidir. Anne sütünün hem anne hem de bebek için kısa ve uzun vadede pek çok olumlu etkisi olduğu bilinmektedir. Yenidoğan gereksinimlerine göre düzenlenebilen eşsiz besleyici özelliği yanı sıra anne sütü içinde bulunan biyoaktif maddeler, büyüme ve gelişmeyi etkileyen hormon ve büyüme faktörleri, immün sistemi düzenleyen faktörler ve antienflamatuvar maddeler bebeği enfeksiyonlardan korumaktadır. Ayrıca maternal enfeksiyonda 7 gün içinde anne sütünde saptanan antikorlar da bebekte enfeksiyon riskini azaltmaktadır. Bu sayede anne sütü ile beslenen bebeklerde otitis media, alt solunum yolu enfeksiyonları, gastroenterit ve prematüre bebeklerde nekrotizan enterokolit nadir görülmektedir. Bu zamana kadar yapılan çalışmalarda anne sütünden bebeğe COVID-19 enfeksiyonu bulaştığı bildirilmemiştir. DSÖ anne sütünün yararlarını, formül sütle beslenmenin zararlarını da hesaba katarak COVID-19 enfekte annelerin maske ve el hijyenine dikkat ederek ten temasını ve anne sütüyle beslenmeyi önermektedir. Sağlık personelleri bu önerilerin rehberliğinde emzirmeyi başlatma ve sürdürme konusunda anne-bebek çiftine destek olmalıdır.

Cytokeratin 8: a sensitive and specific marker for monitoring intestinal recovery after necrotizing enterocolitis

BACKGROUND: Necrotizing enterocolitis (NEC) is one of the leading causes of morbidity and mortality in preterm neonates. Diagnosing and monitoring disease progression or recovery, however, are based on nonspecific clinical, radiographic, or laboratory findings that can be difficult to interpret. Cytokeratin 8 (K8) is an insoluble component of intermediate filaments found within enterocytes. The aim of this project was to develop and test a modified enzyme-linked immunosorbent assay (ELISA) to detect the K8 protein in the …

Predicting “Sepsis Ruled In” in Very Low Birth Weight NICU patients: A 3-NICU collaboration

Background: Signs of late-onset septicemia (LOS) and necrotizing enterocolitis (NEC) overlap with normal variations in preterm neonatal physiology, and about 10-20 sepsis evaluations are performed and antibiotics given for each case of proven LOS or NEC. Early diagnosis is important for improving outcomes, but unnecessary antibiotics increase multiple morbidities. Objective: To develop a model for accurate prediction of LOS or NEC using clinical variables and signs at the time of LOS/NEC evaluation. Methods: Records of consecutive very low birth weight (VLBW) infant admissions at 3 NICUs were reviewed, excluding those that died within 3 days of birth or were admitted after 28d. For infants with F0B31 blood culture for suspected LOS/NEC, the first positive workup was evaluated and if all workups were negative, the first negative was evaluated. A positive LOS/NEC evaluation was defined as a positive blood culture or radiographic diagnosis of NEC and F0B3 5d of antibiotics given, and sepsis ruled out (SRO) was …

Retinopathy of Prematurity and Mother’s Own Milk

Purpose Mothers’ own milk (MOM) feedings reduce the risk of multiple potentially preventable morbidities of prematurity in very low birthweight (VLBW: 1500 g birthweight) infants, including necrotizing enterocolitis, late onset sepsis, bronchopulmonary dysplasia and neurodevelopmental problems. Although bioactive components in MOM suggest a favorable impact on retinopathy of prematurity (ROP), this relationship remains undetermined. There is a lack of consensus in the literature regarding the protective effect associated with MOM. Objective This study compared dose of MOM received by VLBW infants who did and did not require treatment …

Analysis of All Preterm Infants Receiving Delayed Cord Clamping versus Immediate Clamping after Introducing a Delayed Cord Clamping Protocol

Background: Delayed Cord Clamping (DCC) has been recommended by multiple medical bodies, including the American Congress of Obstetricians and Gynecologists, especially due to its benefits in preterm neonates, and is being adopted in many practices. Previous studies have shown benefits such as decreased blood transfusions, improved thermoregulation, decreased rates of intraventricular hemorrhage and necrotizing enterocolitis, however recent studies have found no improved morbidity or mortality. Goal: To evaluate whether there was an effect of delayed cord clamping on short term neonatal …

Sprue-like Intestinal Disease Induced by Checkpoint Inhibitor Immunotherapy

In recent years, immune checkpoint inhibitors have been increasingly used in cancer treatment with significant improvements in overall survival. A downside of these agents has been the emergence of novel intestinal diseases as reflected by development of diarrhea, sometimes severe, in at least 10%. In some, an immune-mediated enterocolitis may often develop. This may be severe, difficult to manage and result in a fatal outcome. Less well appreciated, however, are other less commonly detected forms of colitis, such as collagenous colitis, along with small bowel changes, specifically, sprue-like intestinal disease, apparently occurring as an independent inflammatory process. Taken together, these are likely to represent different pathological phenotypic expressions of treatment toxicity in the intestinal tract following management of cancer with checkpoint inhibitors.

Relationship between short chain fatty acids in faeces and digestive diseases in neonates

With the deepening of study of neonatal intestinal flora metabolomics, the relationship between short-chain fatty acids(SCFA)and neonatal digestive diseases has become the focus of domestic and foreign scholars.Short-chain fatty acids have an important impact on the occurrence and development of digestive diseases such as neonatal necrotizing enterocolitis by inhibiting the immune response, suppressing allergic and inflammatory reactions and affecting intestinal mucosal innate immune function and mucosal development, which providing research ideas for the diagnosis and treatment of such diseases. Key words: Intestinal flora; Short-chain fatty acids; Neonatal necrotizing enterocolitis; Enteral nutrition

Effects of probiotics on apoptosis and proliferation of intestinal epithelial cells in rats with necrotizing enterocolitis

Objective To study the effect of compound Lactobacillus acidophilus on the apoptosis of intestinal epithelial cells and expression of proliferating cell nuclear antigen (PCNA) in rats with necrotizing enterocolitis, so as to provide some theoretical reference for the application of compound Lactobacillus acidophilus in the prevention and treatment of necrotizing enterocolitis(NEC) for newborn infants. Methods Thirty-six 48-hour old newborn SD rats were randomly divided into normal group, model group and intervention group, with 12 rats in each group.The NEC model was established by hypoxia and cold stimulation for 3 days, and the intervention group was given the compound Lactobacillus acidophilus at the same time; after the model was established, all the rats were sacrificed after 12 hours of fasting and their intestinal tissues were excised by terminal-deoxynucleoitidyl transferase mediated nick end labeling (TUNEL) method to determine the condition of apoptosis and to detect expression of the PCNA gene in the intestinal tissues by fluorescent quantitative PCR. Results (1) The apoptosis rates of the intestinal tissues: in the model group, the normal group and the intervention group were (88.33±2.77)%, (4.75±0.75)% and (44.41±4.81)%, respectively, and the differences had statistical significance(all P<0.05). (2) The PCNA expression in the intestinal tissue by real-time PCR in the model group, normal group and intervention group were (9.28±3.26)×10-4, (15.35±1.91)×10-4 and (12.09±3.06)×10-4, respectively, and the differences had statistical significance(all P<0.05). Conclusions The apoptosis rate of intestinal epithelial cells increases and PCNA expression decreases when NEC occurs.Compound Lactobacillus acidophilus can reduce apoptosis, promote intestinal epithelial cell proliferation, and thus help to reduce the risk and severity of NEC in neonatal rats. Key words: Neonatal necrotizing enterocolitis; Apoptosis; Proliferating cell nuclear antigen; Compound Lactobacillus acidophilus

Resistive Index Value of Superior Mesenteric Artery In Preterm Infants With Necrotizing Enterocolitis

Aims: to find out the comparison of RI values of superior mesenteric artery inpremature infants with NEC and without NEC.Material and methods: This study was an observational analytic study, with acase-control study design, where the sampling method was using consecutive samplingin the NICU Room, Anturium and Radiology Department Dr. Hasan Sadikin GeneralHospital Bandung from September to October 2019. Data processing uses unpairedT-test.Results: The total sample was 22 subjects, consisting of 11 with positive NEC and11 negative NEC, with an average gestational age of 31.36 weeks and an average birthweight of 1490.45 grams. In the positive NEC group, the average RI value was 0.90and in the negative NEC group, the average RI value was 0.70. Statistical test resultswith unpaired T-test showed that there was a statistically significant increase in thevalue of superior mesenteric artery RI in premature infants with NEC compared topremature infants without NEC with a p-value = 0.0001 (p-value < 0.05).Conclusion: There was an increase in the value of superior mesenteric artery RIin premature infants with NEC compared to premature infants without NEC with avalue of p = 0.0001 (p-value <0.05).Key words: Necrotizing Enterocolitis–Superior Mesenteric Artery–Ultrasonography

Effect of bovine lactoferrin supplementation on intestinal inflammatory factor expression in premature rats model of necrotizing enterocolitis

Objective To investigate the protective effects of bovine lactoferrin (bLF) supplementation on intestinal mucosal tissue and its influence on of inflammatory factors in the premature rats model of necrotizing enterocolitis(NEC), and to provide the theoretical basis for prevention of NEC by bLF supplementation. Methods Premature SD rats were randomly divided into 4 groups, 25 cases in each group.Control group: oral feeding; model group : oral feeding with lipopolysaccharides(LPS) gavage + hypoxic stimulation; high dose bLF intervention group: daily bLF (7 g/L) + oral feeding with LPS gavage + hypoxic stimulation; low dose bLF intervention group: daily bLF (2 g/L) + oral feeding with LPS gavage + hypoxic stimulation.Histopathological analysis was performed by HE staining.The expression levels of interleukin-1β(IL-1β)and interleukin-6(IL-6)in intestinal mucosa were detected by enzyme linked immunosorbent assay (ELISA). Results (1) Morphological observation: the intestinal wall of model group was thin, and there were different degrees of pneumoconiosis and effusion in intestinal cavity.Under the microscopy, it could be observed that the intestinal tissue necrosis was serious, the intestinal villi fell off, glands arranged disorderly, epithelial edema was significant, the lamina propria and submucosa had severely edema and were separated, and there were a large number of inflammatory cells infiltrated.The above-mentioned manifestations were alleviated in the high-dose and low-dose bLF intervention groups, and no significant abnormalities were found in the control group.(2) The expression of IL-1β and IL-6 in intestinal tissue: the tissue concentration of IL-1β and IL-6 in the model group rats [(380.89±20.25) ng/L, (485.12±31.44) ng/L]were significantly higher than those in the control group[(270.69±45.58) ng/L, (212.62±89.46) ng/L](q =9.785, 14.030, all P 0.05; IL-6: q=-1.140, P>0.05). Conclusion Enteral bLF supplementation can alleviate the damage of intestinal tissue in NEC model of premature SD rats, inhibit the expression of IL-1β and IL-6 inflammatory factors in intestinal tissue, and have a protective effect on intestinal tissue. Key words: Bovine lactoferrin; Necrotizing enterocolitis; Interleukin-1β; Interleukin-6

Progress on the protection of lactoferrin to intestinal mucosa barrier

Lactoferrin, a multifunctional glycoprotein found in milk and other external secretions, can regulate intestinal microecology, and promote the maturation of the intestinal immune system as well as the growth and differentiation of intestinal cells.The intestinal mucosa barrier includes normal intestinal flora, intestinal epithelium layer and intestinal immune system.Its function is mainly to prevent the intestinal bacteria and endotoxin from translocating.Recently, many studies have found that damage to the intestinal mucosal barrier is related to the occurrence of necrotizing enterocolitis.This article reviews the relationship between the intestinal mucosal barrier and necrotizing enterocolitis, and the progress of lactoferrin in preventing necrotizing enterocolitis by regulating the intestinal mucosal barrier. Key words: Lactoferrin; Necrotizing enterocolitis; Intestinal barrier

Progress in the pathogenesis of neonatal necrotizing enterocolitis

Neonatal necrotizing enterocolitis(NEC)is one of common gastrointestinal critical diseases in the neonatal medical center, with high morbidity and mortality.The pathophysiological mechanism of the NEC is still unclear so far.Thus, the treatment of NEC is currently mainly limited to the symptomatic treatment in clinic.In the recent years, the studies on the pathogenesis of NEC have been increasing.This artical clarified the pathogenesis of NEC in six aspects: the pathogeny of intestinal immune function, gut microbiome, oxidative stress reaction, breastfeeding, blood transfusion and inflammatory mediators, to provide a new detection in prevention, diagnosis and treatment of NEC. Key words: Neonatal necrotizing enterocolitis; Pathogenesis