Objective To investigate the changes and clinical significance of serum soluble intercellular ad-hesion molecule-1(sICAM-1),vascular endothelial growth factor(VEGF)and soluble across a membrane protein(sFas)in acute leukemia.Methods A total of patients with acute leukemia admitted to the People's Hospital of Anyue County from May 2020 to May 2022 were selected as the observation group,and 65 healthy people who underwent physical examination in the hospital during the same period were selected as the control group.All patients were treated with chemotherapy after admission,and followed up by telephone and outpa-tient for 1 year.The levels of serum sICAM-1,VEGF and sFas were compared between the two groups,and the levels of serum sICAM-1,VEGF and sFas were compared between the patients with different efficacy and different prognosis.The receiver operating characteristic(ROC)curve was established to evaluate the predic-tive value of related indicators for the efficacy and prognosis of acute leukemia.Results Compared with con-trol group,the levels of serum sICAM 1,VEGF,sFas in the observation group were increased(P＜0.05).Compared with the non-complete remission(CR)patients,the serum VEGF level in CR patients was signifi-cantly increased(P＜0.05).Compared with the good prognosis patients,the levels of serum sICAM-1,VEGF and sFas in the poor prognosis patients were increased(P＜0.05).ROC curve analysis showed that the area under the curve(AUC)of VEGF in evaluating the efficacy of acute leukemia was 0.778.The AUC for evalua-ting the prognosis of acute leukemia with sICAM-1,VEGF,and sFas alone and in combination were 0.793,0.729,0.666,and 0.889,respectively.Conclusion The levels of serum sICAM-1,VEGF and sFas are in-creased in patients with acute leukemia.The combination of sICAM-1,VEGF and sFas has certain clinical ref-erence value in evaluating the efficacy and prognosis of acute leukemia.

Objective To investigate the prognostic factors of pediatric acute respiratory distress syndrome(pARDS),according to pARDS criteria from the 2015 Pediatric Acute Lung Injury Consensus Con-ference.Methods Clinical data of 69 cases with pARDS in PICU of Beijing Children′s Hospital affiliated to Capital Medical University from January 2009 to December 2015 were retrospectively analyzed. Results Among the 69 cases of pARDS,there were 13 cases with mild ARDS,19 cases with moderate ARDS and 37 cases with severe ARDS. Seventeen pARDS were dead in PICU,including 2 mild pARDS,3 moderate pARDS and 12 severe pARDS,and 14 pARDS of them were female,3 pARDS were male.Gender and chron-ic complication were related to the outcomes of pARDS,and the difference was significant(P<0.05).The mortality of pARDS with chronic complication was up to 69.23%.Duration of mechanical ventilation was related to PICU hospital stay and total length of hospital stay(correlation:0.324,0.181,P<0.01).Duration of mechanical ventilation was also related to weight(correlation 0.491,P<0.01),and weight was a protec-tive factor.Conclusion pARDS is one of the most critical diseases in PICU with low morbidity and high mortality,the mortality of pARDS in this study is 24.64%.Female or chronic co-morbidities pARDS may have poor prognosis.Duration of mechanical ventilation determines the PICU length of stay and total hospital length of stay,and weight is the protective factor of the duration of mechanical ventilation.

Objective:To summarize the clinical characteristics and prognosis of severe infant botulism and evaluate the therapeutic effect of botulinum antitoxin in the pediatric intensive care unit (PICU).Methods:The clinical data of 8 cases diagnosed with infantile botulism were retrospectively analyzed in the PICU of Beijing Children′s Hospital from October 2019 to August 2023. Data of basic demographic information, clinical manifestations, laboratory tests, treatment and prognosis of each child were collected and analyzed using descriptive statistical methods.Results:Eight laboratory-confirmed cases of infant botulism were included in this study, all of which were male infants with an age of 6.0 (3.3,6.8) months. Three of the children were from Inner Mongolia Autonomous Region, 2 of them were from Hebei, and the other 3 were from Beijing, Shandong and Xinjiang Uyghur Autonomous Region, respectively. All the patients were previously healthy. In 4 of these cases, the possible cause was the ingestion of either honey and its products or sealed pickled food by the mother or child before the onset of the disease. The first symptom was poor milk intake (4 cases), followed by shallow shortness of breath (7 cases), limb weakness (7 cases) and so on. The typical signs were bilateral dilated pupils (8 cases) and decreased limb muscle strength (8 cases). The main subtype was type B (7 cases), and only 1 case was classified as type A. Six of the children were treated with antitoxin therapy for a duration of 24 (19, 49) d. Seven of them had invasive mechanical ventilation. All the patients survived upon discharge with a follow-up period of 29 d to 3 years and 8 months. Six patients had fully recovered, and 2 recently discharged patients were gradually recovering.Conclusions:For infants with suspected contact or ingestion of botulinum and presented with bilateral pupillary paralysis, muscle weakness and clear consciousness, the stool should be collected for diagnostic testing using a mouse bioassay as soon as possible. Type B was the most common type. The antitoxin treatment was effectiveness and the prognosis was well.