Bioinformatics Analysis Of Key Genes And MicroRNAs In Necrotizing Enterocolitis And Assessment Of The Status Of 95 Neonatal Intensive Care Centers In China

Part ? Bioinformatics analysis of key genes and microRNAs in necrot izing enterocolitisObjectiveBased on GEO database through bioinformatics analysis,differentially expressed genes and microRNAs were screened out.And then protein interaction networks was constructed to predict key genes and pathways in the development of NEC.It is significant to look for potential biomarkers and therapeutic targets of NEC to guide follow-up basic experiments and clinical research.MethodsMRNA and microRNA expression profiles of NEC intestinal tissue samples and intestinal tissue samples of neonatal with non-inflammatory diseases were downloaded from the high-throughput Gene Expression Omnibus GEO2R online analysis website.Differentially expressed genes and microRNAs were screened out separately.For the differentially expressed genes obtained from the screening,the biological function GO and KEGG enrichment analysis were performed using the DAVID database.Protein-Protein interaction network(PPI)was constructed on using STRING database.The Cytoscape and cytoHubba plug-in were applied to analyze and obtain key genes in PPI network.For the differentially expressed miRNAs screened,the three databases including Mirbase,Starbase,and Targetscan,were used to predict the target genes of the differentially expressed miRNAs,and the target genes predicted in the three databases were intersected to screen out common target genes.The differentially expressed genes involved in the cytokines interaction were comprehensively analyzed and crossed,and their potential targets are obtained.Results1?A total of 600 DEGs were obtained,of which 130 genes were up-regulated and 470 were down-regulated.DAVID database showed that DEGs were involved in biological functions such as inflammation,steroid metabolism,neutrophil chemotaxis,cholesterol homeostasis,and other biological pathways such as arachidonic acid epoxidase activity and monooxygenase activity.And cell components mainly included apical plasma membrane,extracellular space,brush border,plasma membrane and so on.Enrichment analysis of KEGG signaling pathway showed that differential genes are mainly involved in fat digestion and absorption,drug metabolism-cytochrome P450 pathway.2?After constructing PPI,10 hub genes were obtained,including IL6?CXCLB?ITGAM?IL1B?TLR2?CDH1?MMP9?PTGS2?CXCL1?APOB.3?A total of 13 differentially expressed miRNAs were obtained,of which 3 were up-regulated and 10 were down-regulated.Using three database target gene prediction sites,11 miRNAs and 15 target genes involved in cytokine regulation were discovered.ConclusionBased on the bioinformatics data of the GEO database,this study analyzed the expression profiles of miRNAs and genes related to necrotizing enterocolitis,and formed a protein-protein interaction network of differentially expressed genes,and discovered the key genes related to necrotizing enterocolitis.MiRNAs and its possible target genes were screened out to provide directions for subsequent functional studies.Part ? Assessment of the status of 95 neonatal intensive care centers in ChinaObjectiveIn order to strengthen the construction and management of critically ill neonatal care centers and effectively reduce neonatal mortality,the former National Health and Family Planning Commission formulated the "Guidelines for the Construction and Management of Critical Neonatal Care Centers"(hereafter referred to as the "Guide")as a guide for the construction of critically ill newborns throughout the country.Guiding documents of the newborn care center.In order to evaluate the current situation of resource allocation and network construction of critical newborn care centers in provinces,cities and counties in China since the issuance of the "Guide",this survey aims to assess the construction and development of critical newborn care centers and treatment systems in typical regions of provinces,cities,and counties.Scientific and efficient suggestions are put forward for further promoting the construction of the critically ill newborn treatment network.Methods1?Through the questionnaire,the link was transferred to the relevant medical institutions.After the completion,the project team collected and organized the data.2?By comparing with the relevant standards of the "Guidelines for the Construction and Management of Critical Neonatal Treatment Centers" promulgated by the National Health Commission,the compliance of facilities,equipment,staffing and technical service projects carried out by neonatal treatment centers at all levels was evaluated subsequently.3?Statistical data was analyzed using IBM SPSS20.0 statistical software.Enumeration data were described by frequency and rate.Chi-square test or Fisher's exact test was used for comparison between groups.P<0.05 was used to determine that the difference was statistically significant.Results1?From the perspective of neonatal center construction and bed settings,there were still 9 hospitals in the provincial centers in the form of wards,with a compliance rate of only 47.1%,and 1 center each at the municipal and county level failed to meet the standards.As for the beds,8 hospitals in provincial centers did not meet the standards,with a compliance rate of only 61.9%,10 municipal centers and 3 county centers did not meet the standards.2?Among the equipment evaluated,the provincial centers had a higher compliance rate,followed by the municipal centers,and the county centers were relatively poor,especially the ventilators?monitors and blood gas analyzers.Provincial centers almost met the standard,except the incubators,bedside ultrasound diagnostic equipment and NO treatment equipment.3?From the perspective of staffing,such as the doctors to beds ratio,the doctors to beds ratio needs to be at least ?0.2,but in provincial rescue centers,the compliance rate was only 61.9%,that is,nearly one-third of the provincial centers failed to meet the standard,while the rate of the ratio in municipal and county level centers was 88.57%and 88.23%,respectively.4?As for technical development projects,most provincial and municipal centers had reached a relatively high level of technology,but there were still some provincial centers that have not carried out sub-hypothermia,peritoneal dialysis and CRRT.Provincial and county centers had not fully carried out the required projects.ConclusionAlthough tremendous progress has been achieved since the release of national Guidelines,neonatal intensive care for newborns in China is facing significant challenges,including deficiency of neonatal beds,staff shortage,insufficient facilities,and regional inequalities.Measures should be taken to strengthen and expand the medical capabilities of NICCs in China.