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OBJECTIVE: To observe changes in plasma motilin (MOT) level among preterm infants after birth, to investigate the relationship between plasma motilin level and feeding intolerance (FI), and to clarify the possible risk factors. METHODS: A total of 112 preterm infants were divided into feeding tolerance (FT) group (n=59) and FI group (n=53). Their plasma MOT levels were measured by radioimmunoassay on days 1, 4, 7 and 14 of life. The clinical data of FI group were collected and subjected to multivariate logistic regression analysis. RESULTS: Compared with the FT group, the FI group showed significantly lower plasma MOT levels on days 1, 4, 7 and 14 of life (P<0.05), and there was a positive correlation between plasma MOT level and gestational age, age in days, and volume of enteral feeding in the FI group. The lower the gestational age, the longer the FI duration. There was a negative correlation between the plasma MOT level on day 1 of life and the FI duration (r=-0.913, P<0.001). Gestational age and prenatal use of glucocorticoid were protective factors for FI, while fetal distress, placental abnormality and perinatal infection were risk factors for FI. CONCLUSIONS: Change in plasma MOT level may be closely related to the development of FI in preterm infants. Early monitoring of plasma MOT level may be useful for predicting the occurrence of FI.

OBJECTIVE: To determine the frequency distribution and antibiotic resistance of pathogens isolated from the cerebrospinal fluid samples of children with bacterial meningitis (BM) and to provide a basis for the timely and effective treatment of childhood BM. METHODS: Retrospective analysis was performed on pathogens isolated from 5097 cerebrospinal fluid samples collected from children in Kunming Children′s Hospital between January 2008 and June 2012, as well as drug sensitivity test results. Kirby-Bauer antibiotic testing was used to analyze the sensitivity of these pathogens to commonly used antibiotics. RESULTS: A total of 116 pathogen strains were detected from the 5097 cerebrospinal fluid samples, including 77 (66.4%) Gram-positive strains, 30 (25.9%) Gram-negative strains, and 9 (7.8%) fungal strains, with a positive rate of 2.28%. The six most frequently isolated pathogens were Staphylococcus epidermidis (32 strains, 27.6%), Streptococcus pneumoniae (15 strains, 12.9%), Escherichia coli (15 strains, 12.9%), Staphylococcus haemolyticus (9 strains, 7.8%), Cryptococcus neoformans (8 strains, 6.9%) and Staphylococcus aureus (6 strains, 5.2%). Coagulase-negative staphylococci was the predominant pathogen in neonates and young infants with BM, and its sensitivity rates to penicillin, erythromycin and clindamycin were lower than 40%. Streptococcus pneumoniae had a penicillin sensitivity rate of 13.4%, while sensitivity rates to erythromycin and clindamycin reached 60.0%. No Staphylococcus and Streptococcus pneumoniae pathogens resistant to vancomycin were found. Gram-negative bacilli had relatively high sensitivity rates to imipenem, meropenem, cefoperazone/sulbactam and cefepime. CONCLUSIONS: Gram-positive cocci are the predominant pathogens for childhood BM over the past five years. The detected pathogens develop high resistance to commonly used antibiotics. To prevent misdiagnosis, careful attention should be paid to BM caused by Cryptococcus neoformans.

OBJECTIVE: To investigate the effect of montelukast on the expression of sensory neuropeptide (neurokinin-1) receptor (NK1R) in young asthmatic rats with airway remodeling. METHODS: Twenty-four Sprague-Dawley rats were randomly divided into control group (n=8), asthma (n=8), and montelukast groups (n=8). A rat model of asthma was induced by ovalbumin (OVA) inhalation. Normal saline was used instead of sensitizing solution and 1% OVA in the control group. Each rat in the montelukast group was given montelukast (15 mg/kg) by gavage 2 h before OVA inhalation. All rats received their respective treatments for 8 weeks. Immunohistochemistry, real-time PCR and Western blot were used to measure the mRNA and protein expression levels of NK1R in asthmatic airway remolding and to evaluate the effect of montelukast on NK1R expression. RESULTS: The asthma group showed significantly higher mRNA and protein expression levels of NK1R than the control group (P<0.01). The mRNA and protein expression levels of NK1R in the montelukast group were significantly lower than in the asthma group (P<0.05), but significantly higher than in the control group (P<0.01). CONCLUSIONS: Rats with induced asthma have upregulated NK1R expression in the airway, and montelukast can downregulate NK1R expression during airway remodeling.

OBJECTIVE: To investigate the effects of down-regulating Tim-3 gene in the peripheral blood mononuclear cells (PBMCs) of an asthmatic mouse model by short hairpin RNA (shRNA) and to explore the effect of Tim-3 on Th1 and Th17 cell differentiation. METHODS: An asthmatic murine model was established by ovalbumin sensitization and challenge. PBMCs were isolated from asthmatic mice and transfected by shRNA targeting Tim-3 gene. The mRNA and protein expressions of Tim-3 were detected by quantitative PCR and Western blot. Flow cytometry analysis was performed to determine the levels of Th1 and Th17, and ELISA was performed to determine concentrations of IFN-γ, IL-4 and IL-17 in the supernatant. RESULTS: Tim-3 mRNA expression in PBMCs was significantly increased in asthmatic mice. The mRNA and protein expression of Tim-3 decreased significantly in the shRNA group. Compared with the negative groups, Th1 cell levels increased and Th17 cell levels decreased significantly in the asthmatic groups after Tim-3 shRNA interference. In the Tim-3 shRNA interference groups concentrations of IFN-γ increased significantly while IL-17 decreased significantly. CONCLUSIONS: Specific Tim-3 shRNA effectively silences the expression of Tim-3 and change in Tim-3 expression could affect T cell differentiation.

Cerebral palsy (CP) is a permanent disorder in the development of movement and posture in the developing infant brain and is one of the major disabilities that result from extremely preterm birth. Early identification of possible neurodevelopmental injury offers the opportunity to deliver intervention at a very early age and thus prevent severe disability. The assessment of general movements (GMs), has emerged as a reliable and valid predictor of severe neurologic deficits in infants. This method is based on a visual Gestalt perception of the quality of GMs in the preterm and term periods, and postterm up to 5 months. The quality of “fidgety movements” is the most valuable marker for predicting neurologic outcomes.