OBJECTIVETo investigate the association between the serum level of brain-derived neurotrophic factor (BDNF) and the severity of asthma in children.

METHODSA total of 60 children with acute exacerbation of asthma were enrolled and divided according to the severity of the disease into mild group (n=18), moderate group (n=25), and severe group (n=17). Sixty healthy children were enrolled as controls. ELISA was used to measure the serum BDNF level in each group and the association between serum BDNF level and the severity of asthma was analyzed.

RESULTSThe asthmatic children at the acute exacerbation and remission stages had significantly higher serum BDNF levels than healthy controls (P<0.05). The serum BDNF level was significantly reduced in the remission stage compared with that in the acute exacerbation stage in asthmatic children (P<0.05). The children with varying degrees of severity at the acute exacerbation stage had different serum BDNF levels: the severe group had the highest serum BDNF level and the mild group had the lowest level (P<0.05).

CONCLUSIONSBDNF may play an important role in the pathogenesis of childhood asthma and is related to the severity of the disease.

Adolescent ; Asthma ; blood ; etiology ; Brain-Derived Neurotrophic Factor ; blood ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Male ; Severity of Illness Index

Objective: To investigate the correlation between skip metastasis of neck lymph node and clinicopathological features in papillary thyroid carcinoma. Methods: Totally 272 papillary thyroid carcinoma patients with lateral lymph node metastases who received surgical procedure at Department of Thyroid Surgery, the First Hospital of the Jilin University from January 2014 to June 2016 were analyzed retrospectively. There were 105 male and 167 female patients, aging from 16 to 73 years with a mean age of (42±8) years. There were 29 patients (10.7%) with skip metastasis. And then the correlation between skip metastasis of neck lymph node and clinicopathological features was analyzed by χ² test and multivariate Logistic regression test. Results: The rate of skip metastasis in all patients was 10.7% (29/272). By summarizing the distribution of the lateral lymph nodes about the patients with skip metastasis, 16 cases metastasized in single level (55.2%), meanwhile 6 in two levels (20.7%) and 7 in three levels (24.1%). Strong correlation between age, tumor location and skip metastasis was found using χ² test (χ² values were 14.056 and 21.362 respectively, both P values were 0.000). Age (>45 years) (OR=4.318, 95% CI: 1.767 to 10.552, P=0.001), microcarcinoma (OR=2.623, 95% CI: 1.013 to 6.795, P=0.047)and the tumor located in the upper of the thyroid (OR=11.982, 95% CI: 2.533 to 56.173, P=0.002) were risk factors to the skip metastasis through multivariable Logistic regression analysis. Conclusions Age >45 years old, microcarcinoma or tumor located in the upper part of the thyroid gland was more likely present with skip metastasis. Skip metastases are often involved in the lateral multi-level. Therefore, confronted patients with one of these risk factors, the occurrence of skip metastasis should be awared when the lateral lymph node was large abnormally. Accordingly, it may be appropriate to extend the indications of fine needle aspiration for lateral lymph node in order to prevent missed diagnosis.

OBJECTIVETo study the effect of obesity on the treatment outcome of asthma predictive index (API)-positive infants and young children with wheezing.

METHODSA total of 208 API-positive infants and young children with wheezing were enrolled. According to the Kaup index, the patients were divided into an obese group (n=93) and a non-obese group (n=115). The patients were given multimodality therapy in an acute episode of wheezing and aerosol inhalation of inhaled corticosteroid (ICS) budesonide suspension in the remission stage. The dose of ICS was adjusted according to clinical control. The patients were treated for 6 months, and were followed up at 2 weeks after treatment and once per month afterwards.

RESULTSAt 2 weeks and 1 month after treatment, the obese group had significantly lower remission rates of clinical symptoms than the non-obese group (35.5%/75.3% vs 53.0%/87.8%; P<0.05). Compared with the non-obese group, the obese group had significantly higher incidence rates of wheezing at 3 and 6 months after treatment and a significantly higher proportion of patients who visited the emergency service or were hospitalized due to wheezing within 6 months (P<0.05).

CONCLUSIONSObesity can inhibit the response to ICS treatment in API-positive infants and young children with wheezing.

Administration, Inhalation ; Adrenal Cortex Hormones ; administration & dosage ; Asthma ; drug therapy ; Child, Preschool ; Female ; Humans ; Infant ; Infant, Newborn ; Male ; Obesity ; complications ; Respiratory Sounds ; drug effects ; Treatment Outcome

OBJECTIVETo investigate the clinical characteristics of different ages of children with acute exacerbation of bronchial asthma.

METHODSThe clinical data of 118 children with an acute exacerbation of bronchial asthma between June 2012 and June 2015 were retrospectively analyzed. These patients were classified into infant group (<3 years old), preschool group (3-6 years old), and school-age group (6-14 years old) to compare their clinical characteristics.

RESULTSThe infant group had the highest rate of pneumonia, the highest rate of hospital use of antibacterial agents, the highest hospital costs, and the longest length of hospital stay, followed by the preschool group and the school-age group (P<0.05). For the maintenance treatment of asthma, the rate of use of inhaled corticosteroids was highest in the school-age group (70%), followed by the preschool group (50% )and the infant group (38%) (P<0.05).

CONCLUSIONSThe clinical characteristics vary between different ages of children with acute exacerbation of bronchial asthma: the children less than 3 years old have a higher rate of pneumonia, a higher rate of use of antibacterial agents, higher hospital costs, a longer length of hospital stay, and a lower rate of standard treatment.

Acute Disease ; Adolescent ; Age Factors ; Asthma ; complications ; drug therapy ; Child ; Child, Preschool ; Female ; Humans ; Length of Stay ; Male ; Retrospective Studies

Objective:In oder to investigate the effect of Chuanmingshen violaceum polysaccharides ( CVP) and Solfated Chua-nmingshen violaceum polysaccharides ( SCVP) on immunosuppression induced by cyclophosphamide ( CY) in mice.Methods: CY were used to induce immunosuppression in mice;Spleen and thymus indexes were used to evaluate the immune organs indexes;the [3-(4, 5-dimethylthiazol-2-yl)-2,5-diphenyltet-razolium bromide,MTT] method was used to detect the proliferation of spleen lymphocytes of each group;the concentrations of IFN-γand IL-2 were assayed by ELISA kit.Results: SCVP and CVP could resist immunosuppression by promoting lymphocyte proliferation, increasing the contents of IFN-γ and IL-2, promoting immune organs development in immunosuppressive mice induced by CY.Conclusion:SCVP and CVP exhibited the potential to used as immunopotentiator.

Objective:To evaluate the predictive value of systemic immune inflammation index (SII) for short-term prognosis in patients with sepsis complicated with acute kidney injury who received continuous renal replacement therapy (CRRT) .Methods:From Feb. 2018 to Jan. 2022, 90 patients with sepsis complicated with acute kidney injury who received CRRT in Hangzhou Cancer Hospital were included as the research objects. According to the survival of patients within 90 days, they were grouped into a survival group of 60 cases and a death group of 30 cases. The clinical baseline data such as age, sequential organ failure assessment (SOFA) score, acute physiological function and chronic health status scoring system II (APACHE II), albumin (ALB) were recorded. Automatic blood cell analyzer was applied to detect lymphocyte count, platelet count and neutrophil count in peripheral venous blood of patients with sepsis complicated with acute kidney injury who received CRRT, and the SII was calculated; Pearson correlation analysis was performed to analyze the correlation between SII and clinical baseline data in dead patients with sepsis complicated with acute kidney injury receiving CRRT; ROC curve was drawn to analyze and compare the predictive value of SII, SOFA score and APACHEII for death in patients with sepsis complicated with acute kidney injury receiving CRRT; Kaplan-Meier curve was performed to describe the changes in patient survival; multivariate Cox regression analysis was performed to analyze the factors affecting 90-day death in patients with sepsis complicated with acute kidney injury receiving CRRT.Results:SII (2636.74), C-reactive protein (CRP) [ (92.45±29.74) mg/L], SOFA score (12.83±3.24) and APACHEII (28.30±7.51) in the death group were higher than those in the survival group [341.92, (50.24±16.13) mg/L, 10.00±3.12, 25.13±6.87], and ALB [ (2.50±0.53) g/dl] was lower than that in the survival group [ (2.79±0.61) g/dl] ( P<0.05). SII was significantly positively correlated with CRP, SOFA score and APACHEII, and significantly negatively correlated with ALB in patients with sepsis complicated with acute kidney injury who received CRRT ( P<0.05). The areas under the curve (AUC) of SII, SOFA score, and APACHEII for predicting death in patients with sepsis complicated with acute kidney injury who received CRRT were 0.936, 0.827, and 0.736, respectively, and AUC of SII prediction was greater than that of SOFA score and APACHEII ( P<0.05). The 90-day survival rate of patients with sepsis complicated with acute kidney injury who received CRRT in the high SII group (23/46, 50.00%) was lower than that in the low SII group (37/44, 84.09%) ( P<0.05). SII was an independent risk factor for death within 90 days in patients with sepsis complicated with acute kidney injury who received CRRT ( P<0.05) . Conclusion:SII can better predict the 90-day mortality risk of patients with sepsis complicated with acute kidney injury receiving CRRT, and assist clinical assessment of short-term prognosis.

The rotator cuff injury is a kind of chronic tendon disease related to overuse injury. The main clinical manifestations of this disease include shoulder pain and dysfunction，which seriously affects people 's life quality and work capability. Although previous studies have shown that inflammation and de- generation of collagen matrix are closely related to the occurrence and development of this disease，the pathogenesis of the disease is still unclear. In this study，the authors review the pathologic mechanisms of rotator cuff injuries from aspects of oxidative stress，inflammation，macrophage and non-coding RNA so as to provide a reference for subsequent research and treatment.

Objective:To predict the pathogens of bloodstream infection (BSI) in hematopoietic stem cell transplantation (HSCT) patients by plasma microbial cell-free DNA (mcfDNA) sequencing with and without additional amplification.Methods:A total of 978 HSCT patients were enrolled in Peking University People′s Hospital from March to July 2021, and the 7 428 blood samples were prospectively collected from pretransplant conditioning period to 4 months after transplantation. The plasma samples were separated and then cryopreserved. According to blood culture results and whether there were plasma samples before BSI onset, twenty-eight HSCT patients with positive blood culture (39 plasma samples within 1-8 days before BSI onset) and 9 HSCT patients with negative blood culture (9 plasma samples) were filtered. The 39 samples were performed with mcfDNA additional and non-additional amplification sequencing, and the 9 samples were only performed with additional amplification sequencing. With the blood culture results as the gold standard, the consistency between the sequencing and the blood culture results was observed. Student t test and Wilcoxon test were used for statistical analysis. Results:Without additional amplification sequencing, only 7 samples sequencing results were consistent with the blood culture results, and the total pathogen detection rate was 17.95% (7/39). The rates within 3 days and 4-8 days were 23.81% (5/21) and 2/18, respectively. The main pathogenic type detected was gram-negative bacteria (5/7). With additional amplification sequencing, the total pathogen detection rate was 59.26% (16/27) and the rate within 3 days was 8/13. The number of gram-positive bacteria detected was elevated (13/16) and the number of additional microorganisms in additional amplification sequencing was increased significantly ( P=0.001 0), compared with non-additional amplification sequencing. Moreover, additional sequencing analysis of 9 samples from patients with negative culture result showed that no pathogen was detected in six samples, and the common Torque teno virus in HSCT patients was detected in only three samples. Conclusion:The pathogen detection rate of plasma mcfDNA additional amplification sequencing was better than that of non-additional amplification sequencing in HSCT patients before BSI onset, especially in the first three days, which has the potential to predict BSI pathogens.

Objective:Investigate the characteristics of hospitalized patients infected with parvovirus B19 (B19V) and the potential impact of B19V on disease progression and clinical outcomes in patients.Methods:The subjects of this observational retrospective study were 62 hospitalized patients who tested positive for B19V among 3 129 inpatients who visited Peking University People′s Hospital between April 1, 2022, and August 31, 2023, and underwent metagenomic next-generation sequencing (mNGS) for pathogens. Patient data regarding pathogen detection, clinical characteristics, and outcomes were collected, along with other laboratory test results, to assess hospitalization duration, incidence of mixed infections during hospitalization, and clinical outcomes within 30 days. The chi-square test was utilized to analyze differences in patient mortality rates and other relevant factors.Results:B19V infection waspobserved in patients with hematological disorders and solid organ transplant recipients (79.03%, 49/62). Additionally, B19V frequently coexists with other pathogens (40/62), with the highest rates of mixed infections involving human herpesvirus 6, cytomegalovirus, and Epstein-Barr virus, having 20, 9, and 8 cases respectively. The most common site of B19V detection is peripheral blood (χ 2=0.000 3, P<0.001), although it can also be detected in other bodily fluid samples. The 30 day mortality rate among B19V infected patients was 19.35% (12/62) 10 out of 12 deceased patients had concurrent mixed infections with other pathogens. Moreover, patients with mixed B19V infections exhibited a higher mortality rate compared to those with B19V infection alone (χ 2=4.546, P=0.033). Comparative analysis of 24 patients who underwent multiple mNGS tests revealed that patients with chronic B19V infection (12 cases) had a higher mortality rate compared to those with transient B19V infection (12 cases) (χ 2=12, P<0.001). Conclusions:Parvovirus B19 (B19V) infection is more commonly observed in patients with hematological disorders and solid organ transplant recipients, often coexisting with other pathogens. The mortality rate within 30 days of B19V infection is elevated, particularly when accompanied by concurrent mixed infections with other pathogens. Moreover, patients with chronic and persistent B19V infection face an increased risk of mortality.