Pharmacogenomics is an emerging tool to improve the efficacy and safety of drug treatment through the DNA analysis in the genes related to drug concentrations (pharmacokinetics) and drug actions (pharmacodynamics). Clinicians need to integrate the genomic data in their benefit-risk assessment and then provide the right drug to the right patient at the right time. This tool can help to prevent an ineffective treatment, select right dose and reduce adverse drug reactions that are common in the current practice under the trial-observation-adjustment model. Pharmacogenomics may have extensive impacts on unique paediatric patients to enhance a better relationship between medical professionals and affected children or their guardians and to improve the drug compliance. Clinicians should embrace the advancements in pharmacogenomics and actively participate in clinical research to identify the ancestor-related alleles and develop the population-specific gene panel. It will allow patients to enjoy more achievements in pharmacogenomics by implementing it in first line clinical practice.

Objective To study the effectiveness of Saccharomyces boulardii combined with phototherapy in the treatment of hyperbilirubinemia in neonates. Methods The neonates with hyperbilirubinemia who were hospitalized from January to December 2018 were enrolled and randomly divided into an observation group (n=61) and a control group (n=63). The neonates in the observation group were treated with phototherapy combined with Saccharomyces boulardii, and those in the control group were treated with phototherapy combined with placebo. Treatment outcomes were compared between the two groups. Fecal samples were collected 72 hours after treatment and 16s rRNA high-throughput sequencing was used to compare the features of gut microbiota between the two groups. Results There was no significant difference in the total serum bilirubin level between the two groups before treatment (P > 0.05). At 24, 48, and 72 hours after treatment, the observation group had a significantly lower level of total serum bilirubin than the control group (P < 0.05). Compared with the control group, the observation group had a significantly lower proportion of neonates requiring phototherapy again[20% (12/61) vs 75% (47/63), P < 0.05]. Compared with the control group, the observation group had a significantly higher abundance of Bacteroides (P < 0.05) and a significantly lower abundance of Escherichia coli and Staphylococcus in the intestine at 72 hours after treatment (P < 0.05). Conclusions In neonates with hyperbilirubinemia, phototherapy combined with Saccharomyces boulardii can effectively reduce bilirubin level and prevent the recurrence of jaundice. Saccharomyces boulardii can favour the treatment outcome by regulating the gut microbiota of neonates.

Objective To investigate the risk factors for hypoglycemia after birth in preterm infants with a gestational age of ≤ 32 weeks. Methods A retrospective analysis was performed for 86 neonates with hypoglycemia and a gestational age of ≤ 32 weeks who were admitted to the neonatal intensive care unit from January 2017 to June 2020 (hypoglycemia group). A total of 172 preterm infants with normal blood glucose who were hospitalized during the same period were randomly enrolled as the control group. Univariate analysis and multivariate logistic regression analysis were used to screen out the risk factors for hypoglycemia in preterm infants. Results There were 515 preterm infants during the study, among whom 86 (16.7%) had hypoglycemia. Compared with the control group, the hypoglycemia group had significantly higher percentages of small for gestational age (SGA), cesarean section, maternal hypertension, and antenatal steroid administration (P < 0.05), but significantly lower birth weight and rate of intravenous glucose use before blood glucose test (P < 0.05). SGA (OR=4.311, 95% CI:1.285-14.462, P < 0.05), maternal hypertension (OR=2.469, 95% CI:1.310-4.652, P < 0.05), and antenatal steroid administration (OR=6.337, 95% CI:1.430-28.095, P < 0.05) were risk factors for hypoglycemia in preterm infants, while intravenous glucose use (OR=0.318, 95% CI:0.171-0.591, P < 0.05) was a protective factor against hypoglycemia in preterm infants. Conclusions SGA, maternal hypertension, and antenatal steroid administration may increase the risk of early hypoglycemia in preterm infants with a gestational age of ≤ 32 weeks, and intravenous glucose use is recommended as soon as possible after birth for preterm infants with a gestational age of ≤ 32 weeks to reduce the incidence rate of hypoglycemia.

Objective To study the clinical significance and cut-off value of white blood cell (WBC) count in the diagnosis of early-onset sepsis (EOS) in neonates. Methods A retrospective analysis was performed on 306 neonates with EOS who were admitted from January 2019 to March 2020. A total of 580 children without infection who were admitted during the same period of time were enrolled as the control group. General status and WBC count were compared between the two groups. The diagnostic value of WBC count was analyzed based on the diagnostic and therapeutic protocol of neonatal sepsis in 2003 (referred to as the 2003 diagnostic and therapeutic protocol) and the expert consensus on the diagnosis and treatment of neonatal sepsis (2019 edition) (referred to as the 2019 expert consensus). Results According to the two different diagnosis and treatment protocols, the statistical analysis showed that WBC count had a relatively positive rate (51.3% and 32.0% respectively) but a relatively high specificity (93.3% and 98.6% respectively). The receiver operating characteristic (ROC) curve analysis showed that the area under the ROC curve of WBC count in the 2003 diagnostic and therapeutic protocol was larger than that in the 2019 expert consensus (P < 0.05). Conclusions The cut-off value of WBC ≥ 25×10⁹/L in the 2003 diagnostic and therapeutic protocol is more reasonable in the diagnosis of EOS.

Objective To systematically evaluate the efficacy and safety of high-flow nasal cannula (HFNC) therapy versus nasal continuous positive airway pressure (nCPAP) in the treatment of respiratory distress syndrome (RDS) in neonates. Methods PubMed, Embase, Cochrane Library, Web of Science, China Biology Medicine disc, Wanfang Database, CNKI, and Weipu Database were searched for the randomized controlled trials (RCTs) of HFNC versus nCPAP in the treatment of neonatal RDS published up to April 1, 2020. RevMan5.3 software was used to perform a Meta analysis of the eligible RCTs. Results A total of 12 RCTs were included, with 2 861 neonates in total, among whom 2 698 neonates (94.30%) had a gestational age of ≥ 28 weeks and 163 (5.70%) had a gestational age of < 28 weeks. For primary respiratory support, the HFNC group had a significantly higher rate of treatment failure than the nCPAP group (RR=1.86, 95% CI:1.53-2.25, P < 0.001), but there were no significant differences between the two groups in the rate of invasive mechanical ventilation (P=0.40) and the rate of use of pulmonary surfactant (P=0.77). For post-extubation respiratory support, there were no significant differences between the two groups in the treatment failure rate, reintubation rate, and total oxygen supply time (P > 0.05). For primary respiratory support and post-extubation respiratory support, the HFNC group had a significantly lower incidence rate of nasal injury than the nCPAP group (P < 0.001), and there were no significant differences between the two groups in the mortality rate and incidence rates of the complications such as air leak syndrome, bronchopulmonary dysplasia, and necrotizing enterocolitis (P > 0.05). Conclusions Based on the current clinical evidence, HFNC has a higher failure rate than nCPAP when used as primary respiratory support for neonates with RDS, and therefore it is not recommended to use HFNC as the primary respiratory support for neonates with RDS. In RDS neonates with a gestational age of ≥ 28 weeks, HFNC can be used as post-extubation respiratory support in the weaning phase.

Objective To study the pharmacokinetic characteristics, clinical effect, and safety of pegylated recombinant human granulocyte colony-stimulating factor (PEG-rhG-CSF) in children with acute lymphoblastic leukemia (ALL). Methods A prospective study was performed on children with ALL who cyclophosphamide, cytarabine, and 6-mercaptopurine were used for consolidation therapy. PEG-rhG-CSF (PEG-rhG-CSF group) or rhG-CSF (rhG-CSF group) was injected after chemotherapy. The plasma concentration of PEG-rhG-CSF was measured, and clinical outcome and safety were observed for both groups. Results A total of 17 children with ALL were enrolled, with 9 children in the PEG-rhG-CSF group and 8 children in the rhG-CSF group. In the PEG-rhG-CSF group, the peak concentration of PEG-rhG-CSF was 348.2 ng/mL (range 114.7-552.0 ng/mL), the time to peak was 48 hours (range 12-72 hours), and the half life was 14.1 hours (range 11.1-18.1 hours). The plasma concentration curve of PEG-rhG-CSF was consistent with the mechanism of neutrophil-mediated clearance. Compared with the rhG-CSF group, the PEG-rhG-CSF group had a significantly shorter median time to absolute neutrophil count (ANC) recovery (P < 0.05). There were no significant differences between the two groups in ANC nadir, incidence rate of febrile neutropenia, duration of grade IV neutropenia, incidence rate of infection, and length of hospital stay. No bone pain or muscle soreness was observed in either group (P > 0.05). Conclusions The pharmacokinetic characteristics of PEG-rhG-CSF in children with ALL receiving consolidation chemotherapy are consistent with the mechanism of neutrophil-mediated clearance, with a short half life and fast recovery of ANC, and there are no significant differences in safety between PEG-rhG-CSF and rhG-CSF.

Objective To study the intelligence structure and clinical features of children with attention deficit hyperactivity disorder (ADHD) and specific learning disorder (SLD). Methods A retrospective analysis was performed on 88 school-age children with ADHD. According to the presence or absence of SLD, they were divided into two groups:simple ADHD group with 45 children and ADHD+SLD group with 43 children. Intelligence structure and clinical features were compared between the two groups. Results Compared with the simple ADHD group, the ADHD+SLD group had significantly lower verbal intelligence quotient (VIQ), performance intelligence quotient (PIQ), and full intelligence quotient (FIQ) (P < 0.05), significantly lower scores of VIQ factors (including information, similarities, arithmetic, and recitation) (P < 0.05), and significantly lower scores of PIQ factors (including picture completion, picture arrangement, block design, and object assembly) (P < 0.05). The development of SLD was negatively correlated with FIQ, VIQ, and PIQ. It was also negatively correlated with the scores of intelligence structure factors (including information, similarities, arithmetic, recitation, picture completion, picture arrangement, block design, and object assembly) (P < 0.05). Conclusions Children with ADHD and SLD have poorer FIQ, VIQ, and PIQ than those with ADHD alone, which mainly manifests as the weak abilities of most intelligence structure factors. It is necessary to pay attention to the management and intervention of SLD in school-age children with ADHD.

Objective To study the value of amplitude-integrated EEG (aEEG), Full Outline of Unresponsiveness (FOUR), and Glasgow Coma Scale (GCS) in evaluating the prognosis of children with disturbance of consciousness in the pediatric intensive care unit (PICU). Methods A total of 164 children with disturbance of consciousness who were admitted to the PICU of Children's Hospital Affiliated to Soochow University were enrolled as subjects. According to prognosis, they were divided into a poor prognosis group with 111 children and a good prognosis group with 53 children. The results of aEEG monitoring, FOUR score, and GCS score on days 1 and 5 of admission were collected. The association between evaluation methods and prognosis was analyzed. The receiver operating characteristic (ROC) curve was used to evaluate the value of aEEG, FOUR, and GCS in predicting prognosis. Results The children with no improvement or abnormal aggravation of aEEG on day 5 tended to have a poor prognosis. The results of aEEG was positively correlated with prognosis (r=0.689, P < 0.001), and FOUR and GCS were negatively correlated with prognosis (r=-0.655 and -0.554 respectively, P < 0.001). The areas under the ROC curve (AUC) of aEEG, FOUR, and GCS were 0.894, 0.903, and 0.840 respectively, and there was no significant difference in the AUC between the three indices (P > 0.05), while aEEG combined with FOUR had an AUC of 0.945, which was significantly larger than that of each index alone (P < 0.05). Conclusions Both aEEG and FOUR can be used as effective tools to predict the prognosis of children with disturbance of consciousness, and a combination of aEEG and FOUR can improve the predictive value.

Objective To investigate the nutritional status of children with cerebral palsy (CP) and the clinical effectiveness of Subjective Global Nutritional Assessment (SGNA) in nutritional assessment of hospitalized children with CP. Methods A total of 208 children with CP, aged 1-5 years, who were hospitalized from April to October 2019 were enrolled as subjects. SGNA was used to investigate nutritional status, and the Z-score method recommended by the World Health Organization was used as a reference standard to validate the clinical effectiveness of SGNA. Results The detection rate of malnutrition in children with CP was 42.3% by SGNA and 39.4% by the Z-score method (P > 0.05). The application of SGNA showed high consistency between different evaluators (κ=0.621, P < 0.001). With the Z-score method as the reference standard, SGNA had a sensitivity of 80.5%, a specificity of 82.5%, a positive predictive value of 75.0%, and a negative predictive value of 86.7%, and high consistency was observed between the two evaluation methods (κ=0.622, P < 0.001). SGNA was moderately consistent with weight-for-age Z-score and height-for-age Z-score (κ=0.495 and 0.478 respectively, P < 0.001) and was poorly consistent with weight-for-height Z-score (κ=0.197, P < 0.05). Conclusions There is a relatively high incidence rate of malnutrition in children with CP. SGNA can be used as a tool to assess the nutritional status of children with CP.

Objective To study the clinical features of neuroblastoma (NB) and the factors influencing survival rate. Methods A total of 44 children with NB who were admitted from April 2016 to February 2020 were enrolled as research subjects. A retrospective analysis was performed on their medical data and follow-up data. Results The common clinical symptoms of these 44 children were fever (10/44, 23%), mass (9/44, 20%), abdominal pain (8/44, 18%), cough (7/44, 16%), pale complexion (3/44, 7%), claudication (2/44, 5%), and abnormal activity (2/44, 5%). According to the INSS stage, 2 children (4%) had stage I NB, 5 children (11%) had stage II NB, 5 children (11%) had stage III NB, and 32 children (73%) had stage IV NB. The mean follow-up time was (15.3±1.5) months, with a recurrence rate of 20% and an overall survival rate of 82%. Among the 44 children, 29 (66%) achieved event-free survival and 7 (16%) had survival with tumor. The univariate analysis showed that a pathological type of NB and an increase in serum neuron-specific enolase (NSE) decreased the overall survival rate of children with NB (P < 0.05). Conclusions The clinical symptoms of children with NB are not specific at the first visit. Fever, abdominal pain, and mass are common symptoms, and there is a high proportion of children in the advanced stage. The pathological type of NB and an increase in serum NSE may be associated with a reduction in the overall survival rate of children with NB.

Objective To investigate the respiratory pathogens and clinical features in children with acute exacerbation of bronchial asthma. Methods Nasopharyngeal swabs were collected from 225 children with acute exacerbation of bronchial asthma, aged < 14 years, who attended the outpatient service or were hospitalized from August 2017 to August 2019. Quantitative real-time PCR was used to detect 12 pathogens, i.e., respiratory syncytial virus (RSV), human rhinovirus (HRV), influenza virus A (IFVA), influenza virus B (IFVB), parainfluenza virus types 1-3 (PIV1-3), human metapneumovirus (HMPV), adenovirus (ADV), Bordetella pertussis (BP), Chlamydia pneumoniae (CP), and Mycoplasma pneumoniae (MP). Results The overall detection rate of virus was 46.2% (104/225), and 7 kinds of viruses were detected, i.e., HRV (19.6%, 44/225), ADV (16.0%, 36/225), IFVB (5.8%, 13/225), RSV (4.9%, 11/225), IFVA (3.6%, 8/225), PIV3 (1.8%, 4/225), and HMPV (0.4%, 1/225). Of all pathogens, BP had the highest detection rate of 28.4% (64/225), and the detection rates of MP and CP were 16.4% (37/225) and 0.4% (1/225), respectively. The mild exacerbation group had a higher detection rate of BP than the severe exacerbation group (P < 0.05), while the severe exacerbation group had significantly higher detection rates of RSV and MP than the mild exacerbation group (P < 0.05). There were significant differences in the proportion of children with paroxysmal cough, spasmodic cough, fever, lung rales and abnormal lung imaging findings among the simple BP infection, simple virus infection and simple MP infection groups (P < 0.05). Conclusions BP, HRV, and MP are common respiratory pathogens detected in children with acute exacerbation of bronchial asthma, and respiratory virus infection is an important pathogen of acute exacerbation of asthma in children. Acute exacerbation of asthma caused by different pathogens has different clinical features and severities.

Objective To investigate the incidence of systemic reactions (SR) to subcutaneous immunotherapy (SCIT) for bronchial asthma and/or allergic rhinitis in children and their risk factors. Methods A retrospective analysis was performed on 198 children with bronchial and/or allergic rhinitis. According to the presence or absence of SR and local reactions (LR) during SCIT, the patients were divided into two groups:SR (with SR and LR, n=31) and control (without SR or LR, n=142). A multivariate logistic regression analysis was used to determine the risk factors associated with SR. Results Among the 198 patients who received 8 157 injections of SCIT, 25 (12.6%) experienced SR (31 times, 0.38%), including grade I SR (18 times, 58%), grade II SR (10 times, 32%), grade III SR (3 times, 10%), and no grade IV SR. The multivariate logistic regression analysis showed that multiple sensitization with both food and inhaled allergens, specific IgE to dust mites (grade 6), total IgE (grade 6), and a history of LR were independent risk factors for SR (P < 0.05). Conclusions SCIT is a safe treatment for bronchial asthma and/or allergic rhinitis in children, with a low incidence of SR. Children with multiple sensitization with both food and inhaled allergens, a hypersensitive state (specific IgE to dust mites, grade 6; total IgE, grade 6), and a history of LR have an increased risk of SR to SCIT.

Objective To observe the incidence of malnutrition and nutritional risk in children with pneumonia on mechanical ventilation in the pediatric intensive care unit (PICU), and to explore the nutritional support effect of short-peptide enteral nutrition formula. Methods A total of 68 children with severe pneumonia who were hospitalized in the PICU from October 2017 to October 2018 and required mechanical ventilation were enrolled for a prospective randomized controlled study. The children were randomly divided into a control group and an experimental group. Through the nasogastric feeding tube, the experimental group received the short-peptide enteral nutrition formula, and the control group received the intact-protein enteral nutrition formula. The weight-for-age Z score, STRONGkids nutritional risk score, and pediatric critical illness score of the two groups were evaluated. The serum levels of total protein, albumin, and prealbumin (PA) on admission and before discharge were measured. The gastrointestinal tolerance and clinical outcome indicators of the two groups were observed. Results Among the 68 mechanically ventilated children, 26 (38%) had malnutrition, including moderate malnutrition (10 cases, 15%) and severe malnutrition (16 cases, 24%); 10 cases (15%) had malnutrition at discharge. Sixty-three children (93%) had nutritional risk, including moderate nutritional risk in 21 cases and high nutritional risk in 42 cases. The moderate and high nutritional risk rates of the critical and extreme critical groups were significantly higher than those of the non-critical group (P < 0.05). Compared with the control group, the experimental group had significantly shorter duration of mechanical ventilation and total length of hospital stay, significantly higher serum PA level and weight growth rate, and significantly better gastrointestinal tolerance (P < 0.05). There were no significant differences in the incidence of ventilator-associated pneumonia and disease outcome between the two groups (P > 0.05). Conclusions The detection rates of malnutrition and nutritional risk in children with pneumonia on mechanical ventilation are relatively high. Short-peptide enteral nutrition formula can help improve their treatment outcome and are more suitable for nutritional support in critically ill children on mechanical ventilation.

Objective To study the incidence rate of non-thyroidal illness syndrome (NTIS) in critically ill children with or without sepsis and the association of NTIS with interleukin-6 (IL-6) and interleukin-10 (IL-10). Methods A retrospective analysis was performed on the medical data of 97 children with sepsis (sepsis group) and 80 non-sepsis children with bacterial infection (non-sepsis group). The correlations of IL-6 and IL-10 with the thyroid function parameters triiodothyronine (T3), thyroxine (T4), and thyroid stimulating hormone (TSH) were analyzed. Results There were no significant differences in age and sex between the sepsis and non-sepsis groups (P > 0.05). Compared with the non-sepsis group, the sepsis group had a significantly higher Sequential Organ Failure Assessment score, a significantly longer length of hospital stay, and a significantly higher rate of use of ventilator (P < 0.05). As for inflammation markers, the sepsis group had significantly higher levels of C-reactive protein, procalcitonin, and IL-6 than the non-sepsis group (P < 0.05). As for thyroid function parameters, the sepsis group had significantly lower levels of T3, T4, free T3, free T4, and TSH than the non-sepsis group (P < 0.05). Compared with the non-sepsis group, the sepsis group had significantly higher incidence rates of NTIS, low T3 and T4, and low TSH (P < 0.001). The correlation analysis revealed that IL-6 level was not correlated with T3, T4, and TSH levels in children with or without sepsis (P > 0.05), but the pooled analysis of the two groups showed that IL-6 level was negatively correlated with T3 and T4 levels (P < 0.001). Conclusions Children with sepsis have a higher incidence rate of NTIS than those without sepsis. The high level of IL-6 may be associated with the development of NTIS.

Objective To study the association between maternal Th1/Th2 immune level at different pregnancy stages and cow's milk protein allergy (CMPA) in infants. Methods The healthy women with a singleton pregnancy, as well as their offspring, who attended Yidu Central Hospital of Weifang and Qingzhou Traditional Chinese Medicine Hospital from July 2016 to December 2018 were enrolled. The maternal levels of interleukin-2 (IL-2), interferon gamma (IFN-γ), interleukin-4 (IL-4), and interleukin-10 (IL-10) at the second and third trimesters of pregnancy were measured. A CMPA questionnaire survey was conducted within one year after birth. Food avoidance and cow's milk oral challenge tests were performed in infants suspected of CMPA. The 48 infants who met the diagnostic criteria for CMPA were included in the observation group, and the remaining 977 normal infants were included in the control group. A univariate analysis was performed on the infants with CMPA. A Poisson regression analysis was used to determine the association between maternal Th1/Th2 immune factors at different pregnancy stages and CMPA. Results The detection rate of CMPA was 4.68%. The clinical manifestations included the symptoms of the digestive system, skin, and respiratory system and other symptoms. The univariate analysis showed that compared with the control group, the observation group had significantly higher incidence rates of maternal food allergy and maternal history of allergic diseases (P < 0.05) and a significantly lower breastfeeding rate (P < 0.05). The observation group had significantly lower maternal levels of IL-2 (second and third trimesters) and IFN-γ (third trimester) than the control group (P < 0.05). Maternal low IFN-γ at the third trimester and maternal low IL-2 at the second and third trimesters were significantly associated with CMPA in infants (P < 0.05). After correction of the factors of breastfeeding, maternal food allergy, and maternal history of allergic diseases, it was found that maternal low IL-2 and IFN-γ at the third trimester were still significantly associated with CMPA in infants (P < 0.05). Conclusions The maternal decrease in Th1 level at the third trimester of pregnancy may lead to the change in fetal immunity and thus increase the risk of CMPA in offspring.

No abstract available

Objective To investigate the role of microglial pyroptosis in hypoxic-ischemic brain damage. Methods An oxygen-glucose deprivation/reoxygenation (OGD/R) model of rat microglial cells were cultured in vitro. Western blot was used to measure the expression of the pyroptosis-related proteins caspase-1, interleukin-1β (IL-1β), and N-terminal gasdermin D (GSDMD-N) at 0, 1, 3, 6, 12, and 24 hours after OGD/R. After the microglial cells were transfected with lentivirus-mediated silenced gasdermin D (GSDMD), immunofluorescence assay and Western blot were used to measure the transfection rate of GSDMD. Microglial cell lines were divided into three groups:normal control, negative control, and LV-sh_GSDMD (lentivirus-mediated GSDMD silencing). CCK-8 assay and LDH kit were used to observe the effect of GSDMD silencing on the viability and toxicity of microglial cells at 24 hours after OGD/R. Western blot was used to observe the effect of GSDMD silencing on the levels of caspase-1, GSDMD-N, and IL-1β in the microglial cells at 24 hours after OGD/R. Results The expression levels of the pyroptosis-related proteins caspase-1, GSDMD-N, and IL-1β in microglial cells were upregulated since 0 hour after OGD/R and reached the peak levels at 24 hours. A microglial cell model of lentivirus-mediated GSDMD silencing was successfully constructed. At 24 hours after OGD/R, compared with the normal control group, the GSDMD silencing group had a significant increase in the cell viability and a significant reduction in the cytotoxicity (P < 0.05), as well as significant reductions in the protein expression levels of caspase-1, GSDMD-N, and IL-1β in microglial cells (P < 0.05). Conclusions Lentivirus silencing of the key substrate protein for pyroptosis GSDMD can alleviate hypoxic-ischemic brain damage, suggesting that microglial pyroptosis aggravates hypoxic-ischemic brain damage.

Objective To study the effect of mogroside VI (MVI) on acute liver injury induced by sepsis in mice and its possible mechanisms. Methods A total of 60 male C57BL/6 mice were randomly divided into five groups:sham-operation, model, low-dose MVI (25 mg/kg), high-dose MVI (100 mg/kg), peroxisome proliferator-activated receptor gamma coactivator-1 alpha (PGC-1α) inhibitor (100 mg/kg MVI+30 mg/kg PGC-1α inhibitor SR-18292), with 12 mice in each group. Cecal ligation and puncture were performed to establish a mouse model of sepsis. The drugs were given by intraperitoneal injection after the model was established, once a day for 3 consecutive days. ELISA was used to measure the serum levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST). Colorimetry was used to measure the levels of malondialdehyde (MDA), superoxide dismutase (SOD), and glutathione peroxidase (GSH-Px) in liver tissue. Hematoxylin-eosin staining was used to observe liver histopathological changes. Liver mitochondrial respiratory function was measured, and mitochondrial respiratory control rate was calculated. RT-PCR was used to measure the copy number of mitochondrial DNA (mtDNA) in liver tissue and the mRNA expression levels of PGC-1α, nuclear respiratory factor-1 (NRF-1), and mitochondrial transcription factor A (TFAM) in liver tissue. Western blot was used to measure the protein expression levels of PGC-1α, NRF-1, and TFAM in liver tissue. Results Compared with the sham-operation group, the model group had significant increases in the serum levels of ALT and AST and the content of MDA in liver tissue (P < 0.05) and significant reductions in the activities of GSH-Px and SOD in liver tissue (P < 0.05). The model group had also severe liver histopathological injury and significant reductions in the mitochondrial respiratory control rate, the copy number of mtDNA, and the mRNA and protein expression levels of PGC-1α, NRF-1, and TFAM in liver tissue (P < 0.05). Compared with the model group, the high-dose group had significant reductions in the serum levels of ALT and AST and the content of MDA in liver tissue (P < 0.05), significant increases in the activities of GSH-Px and SOD in liver tissue (P < 0.05), significant improvement in liver histopathological injury, and significant increases in the mitochondrial respiratory control rate, the copy number of mtDNA, and the mRNA and protein expression levels of PGC-1α, NRF-1, and TFAM in liver tissue (P < 0.05). There were no significant differences in the above indicators between the low-dose and model groups (P > 0.05). The PGC-1α inhibitor SR-18292 significantly inhibited the intervention effect of high-dose MVI (P < 0.05). Conclusions MVI can effectively alleviate acute liver injury caused by sepsis in mice, possibly by enhancing mitochondrial biosynthesis mediated by PGC-1α.

The microbiome in neonates is affected by many factors such as mode of birth and feeding pattern, and homeostasis or disorder of microbiome is associated with various neonatal diseases. Preterm infants have a gestational age of < 37 weeks at birth, with immature development and different colonization of bacteria from full-term infants. The research on the characteristics of microbiome and their association with diseases in preterm infants can provide new ideas for the treatment of neonatal diseases. This article reviews the characteristics of intrauterine microbiome, dermal microbiome, oral microbiome, stomach microbiome, intestinal microbiome, and environmental microbiome and their association with common diseases in preterm infants.