Introduction. The incidence rate of necrotizing enterocolitis is 2.4:1000 of newborns. The number of complications reaches 51-68%, and mortality rate varies from 4 to 80%. The aim of the study was to present current data of Russian and foreign experimental studies related to necrotizing enterocolitis in children. Results. Currently, infants with low and very low body weight constitute the most proportion of patients with enterocolitis; the development of the disease in this cohort of patients has its distinctive features. In this regard, the issues of pathogenesis, the impact of risk factors and methods of prevention of the pathological process remain underinvestigated. Experimental models were used to study the features of the toll-interleukin 1 receptor domain containing adapter protein (TIRAP), the etiology of Toll-like receptor 4 expression, and the reasons for the increased levels of inflammatory mediators. The mechanism of intestinal-brain reciprocal communication was confirmed. The role of the bacterial flora and effectiveness of the antibacterial drug effect on this flora was also determined. Biomarkers of enterocolitis, such as an epidermal growth factor, interleukins, claudins 2, 3, 4, were detected using experimental modeling. Various options for disease prevention ranging from ischemic preconditioning to probiotics application and breastfeeding were analyzed, the latter ones having beneficial ability to form natural defenses in newborns. Conclusions. Thus, necrotizing enterocolitis is a severe systemic disease. Experimental modeling allows analyzing the most complex, unsolved problems and introducing novel knowledge into clinical practice.

The aim of the study is to present modern methods of diagnosis and treatment of necrotizing enterocolitis (NEC) in newborns.According to Russian and foreign literature, up to 7.2% of newborns with NEC are admitted to intensive care units. The overall mortality rate in enterocolitis remains at the level of 15%, and in the surgical stages of the disease ranges from 26 to 31%.It is known that the transferred hypoxia and asphyxia lead to vascular disorders. In addition, colonization of the intestine by pathogenic flora takes the leading place in the progression of the process.In order to diagnose NEC, an overview X-ray of the abdominal organs is performed, which reveals such typical changes as: pneumatosis intestinalis, pneumoperitoneum, gastric dilatation, and the presence of a static bowel loop. Ultrasound examination of the abdominal organs confirms enterocolitis in 90% of cases. If necessary, instrumental examination findings are assessed in dynamics. Quantitative changes in the parameters of procalcitonin, calprotectin, cathelicidin, alkaline phosphadase are detected with the help of laboratory diagnostics. It is noted that TGF-1, FXIII factors, thymic index (TI), proteins (FABP2, claudin-2, GFAP) parameters vary at different stages of the disease.Researchers highlight the importance of NEC prevention, a special role is given to breastfeeding. Treatment of necrotizing enterocolitis depends on the stage of the disease and the severity of symptoms, and consists of conservative therapy and surgical correction. The timeliness and necessity of prescribing antibiotics is being actively discussed. Most surgeons emphasize the therapeutic and diagnostic role of laparocentesis; the imposition of preventive intestinal stomas is considered the operation of choice. The medical periodical publications present the experience of using laparoscopy in newborns with the surgical stage of NEC. In addition to the generally accepted methods of treatment, researchers suggest options aimed at improving the clinical outcome of disease correction (vacuum therapy, the introduction of an "oxygen cocktail").

This paper describes the professional activities and merits of the pediatric surgeon Vyacheslav V. Parshikov in celebration of his 75th anniversary.