OBJECTIVE: To construct and validate a prognostic prediction model for children with sepsis using the Phoenix sepsis score (PSS). METHODS: A retrospective case series study was conducted to collect clinical data of children with sepsis admitted to the pediatric intensive care unit (PICU) of the Affiliated Hospital of Guizhou Medical University from January 2022 to April 2024. The data included general information, the worst values of laboratory indicators within the first 24 hours of PICU admission, PSS score, pediatric critical illness score (PCIS), and the survival status of the children within 30 days of admission. The statistically significant indicators in univariate Logistic regression analysis were included in multivariate Logistic regression analysis to screen the risk factors affecting the prognosis of children with sepsis and construct a nomogram model. The receiver operator characteristic curve (ROC curve) was drawn to evaluate the predictive performance of the model. The Bootstrap method was used to perform 1 000 repeated sampling internal verification and draw the calibration curve of the model. RESULTS: A total of 199 children with sepsis were included, of which 32 died and 167 survived 30 days after admission. In the univariate Logistic regression analysis, shock, white blood cell count (WBC), international normalized ratio (INR), lactic acid (Lac), PSS score, and PCIS score were identified as statistically significant predictors. These variables were then included in the multivariate Logistic regression analysis, which demonstrated that shock [odds ratio (OR) = 4.258, 95% confidence interval (95%CI) was 1.049-17.288], WBC (OR = 1.124, 95%CI was 1.052-1.210), and PSS score (OR = 1.977, 95%CI was 1.298-3.012) were independent risk factors for mortality in pediatric patients with sepsis (all P < 0.05). A nomogram model was constructed based on these three risk factors, with the model equation as follows: -4.809+1.449×shock+0.682×PSS score+0.117×WBC. The calibration curve results showed that the model's predictions were highly consistent with the actual observations. The ROC curve showed that when the Youden index of the prediction model was 0.792, the sensitivity and specificity were 90.6% and 88.6%, respectively, and the area under the curve (AUC) was 0.957 (95%CI was 0.930-0.984), which was higher than the AUC of shock, WBC, and PSS score alone (0.808, 0.667, 0.908, respectively). CONCLUSIONS Shock, WBC, and PSS score have demonstrated certain predictive value for mortality in children with sepsis. The nomogram model based on the above indicators has important clinical significance for evaluating the prognosis and guiding treatment of children with sepsis.
Humans ; Sepsis/diagnosis* ; Prognosis ; Retrospective Studies ; Logistic Models ; Intensive Care Units, Pediatric ; Nomograms ; Child ; ROC Curve ; Risk Factors ; Male ; Female ; Child, Preschool ; Infant

Objective To analyze the clinical characteristics of pulmonary tuberculosis patients compli-cated with infection of Nocardia farcinica aiming to improve the diagnosis and treatment the disease.Methods The clinical data of 22 cases of pulmonary tuberculosis complicated with Nocardia farcinica infection admitted to Guang-zhou Chest Hospital from June 2020 to December 2023 were collected and the clinical manifestations,imaging,laboratory tests,treatment process,and disease outcomes were retrospectively analyzed.Results Among the 22 patients,there were 13 males and 9 females,aged 20～86 years,with a median age of 52 years.Common clinical manifestations included cough(22/22),sputum(21/22),and underlying diseases(13/22).One case was positive for cerebrospinal fluid culture,and 21 cases were positive for sputum culture.The culture period was 5～26 days,with a median culture period of 18 days.The imaging manifestations were mainly plaques,plaques and cavities,and the lesions were spread in both lungs(17/22)and cavities(11/22).After anti-tuberculosis treatment,the absorption of lung lesions in some patients was poor,and the absorption of the lesions was improved after anti-nocardia treat-ment.8 cases were cured,13 cases were improved and 1 case died.Conclusion The clinical symptoms of pa-tients with pulmonary tuberculosis complicated with Nocardia farcinica were atypical,the culture period of Nocardia was long,and the imaging manifestations were similar to pulmonary tuberculosis,which is prone to misdiagnosis and missed diagnosis.For patients with poor response to anti-tuberculosis treatment and slow lesion absorption,the possi-bility of a concurrent Nocardia infection should be considered.

Objective To investigate the effectiveness of disodium Aidi injection for cancer-related fatigue in nasopharyngeal carcinoma patients of Ⅲ-Ⅳ B stage undergoing radiotherapy and chemotherapy.Methods Eighty nasopharyngeal carcinoma patients of Ⅲ-Ⅳ B stage with fatigue symptoms from December 2011 to May 2012 in our hospital were divided into two groups.All patients received treatment of sequential 3 cycles with platinum-based chemotherapy after concurrent chemoradiation.One group of 40 patients also received intravenous infusion of disodium Aidi injection (experimental group),the other group of 40 patients only received conventional therapy (control group).Brief fatigue inventory (BFI) questionnaires data were collected at baseline,the eighth week and the twentieth week after treatment.The changes of fatigue severity and the occurrence of Ⅲ-Ⅳ degree adverse reactions in the two groups were compared.Results At the eighth week,the improvement in fatigue severity was not significantly different between two groups (x2 =1.758,P =0.32).However,significant improvement in cancer-related fatigue of experimental group was found than that of control group at the twentieth week(x2 =8.12,P =0.005).The Ⅲ-Ⅳ degree adverse reactions of experimental group were significantly lower than that of control group.Conclusion Disodium Aidi injection combined with radiotherapy and chemotherapy can improve the cancer-related fatigue of nasopharyngeal carcinoma patients of Ⅲ-ⅣB stage and it can also reduce the incidence rate of Ⅲ-Ⅳ degree adverse reactions.

Recently,phosphatase and tensin homolog deleted on chromosome 10 (PTEN) is suggested as a new agent in the fighting against fibrogenesis.In tumor,DJ-1 is identified as a negative regulator of PTEN.But the expression of DJ-1 and the regulation of PTEN in fibrosis are unclear.Renal fibrosis was induced in 5/6 subtotal nephrectomy rat model.Human proximal tubular epithelial cells (HKC) were treated with transforming growth factor-beta 1 (TGF-β1),or transfected with DJ-1 or PTEN.Confocal microscope was used to investigate the localization of DJ-1 and PTEN.The selective phosphoinositide-3 kinase (PI3K) inhibitor,LY294002,was administered to inhibit PI3K pathway.The DJ-1 and PTEN expression,markers of epithelial-mesenchymal transition (EMT) and Akt phosphorylation were measured by RT-PCR,Western blotting or immunocytochemistry.In vitro,after HKC cells were stimulated with 10 ng/mL TGF-β1 for 72 h,the expression of DJ-1 was increased,and that of PTEN was decreased.In vivo,the same results were identified in 5/6-nephrectomized rats.In normal HKC cells,most of DJ-1 protein localized in cytoplasm,and little in nucleus.TGF-β1 upregulated DJ-1 expression in both cytoplasma and nuclei.In contrary,TGF-β1 emptied cytoplasmic PTEN protein into nucleus.Overexpression of D J-1 decreased the expression of PTEN,promoted the activation of Akt and the expression of vimentin,and also led to the loss of cytoplasmic PTEN.Contrarily,overexpression of PTEN protected HKC cells from TGF-β1-induced EMT.In conclusion,DJ-1 is upregulated in renal fibrosis and DJ-1 mediates EMT by suppressing cytoplasmic PTEN expression and Akt activation.

Recently, phosphatase and tensin homolog deleted on chromosome 10 (PTEN) is suggested as a new agent in the fighting against fibrogenesis. In tumor, DJ-1 is identified as a negative regulator of PTEN. But the expression of DJ-1 and the regulation of PTEN in fibrosis are unclear. Renal fibrosis was induced in 5/6 subtotal nephrectomy rat model. Human proximal tubular epithelial cells (HKC) were treated with transforming growth factor-beta 1 (TGF-β1), or transfected with DJ-1 or PTEN. Confocal microscope was used to investigate the localization of DJ-1 and PTEN. The selective phosphoinositide-3 kinase (PI3K) inhibitor, LY294002, was administered to inhibit PI3K pathway. The DJ-1 and PTEN expression, markers of epithelial-mesenchymal transition (EMT) and Akt phosphorylation were measured by RT-PCR, Western blotting or immunocytochemistry. In vitro, after HKC cells were stimulated with 10 ng/mL TGF-β1 for 72 h, the expression of DJ-1 was increased, and that of PTEN was decreased. In vivo, the same results were identified in 5/6-nephrectomized rats. In normal HKC cells, most of DJ-1 protein localized in cytoplasm, and little in nucleus. TGF-β1 upregulated DJ-1 expression in both cytoplasma and nuclei. In contrary, TGF-β1 emptied cytoplasmic PTEN protein into nucleus. Overexpression of DJ-1 decreased the expression of PTEN, promoted the activation of Akt and the expression of vimentin, and also led to the loss of cytoplasmic PTEN. Contrarily, overexpression of PTEN protected HKC cells from TGF-β1-induced EMT. In conclusion, DJ-1 is upregulated in renal fibrosis and DJ-1 mediates EMT by suppressing cytoplasmic PTEN expression and Akt activation.

Objective To investigate the inhibitory effects of overexpression of PTEN on renal epithelial-mesenchymal trans-differentiation induced by TGF-β1,and the signaling transduction mechanism.Methods HKC cells were transfected with GFP-PTEN via lipofectAMINE2000.The efficiency of transfection was detected by fluorescence microscope.The expression of PTEN protein and mRNA in the translected cells was detected by Western blot and RT-PCR respectively.The experiment was divided into four groups:normal group,TGF-β1 stimulation group,GFP-PTEN+TGF-β1 group and empty vector+TGF-β1 group.The expression of E-cadherin,a-SMA,Akt and p-Akt was detected by Western blot.Results Most ceils transfected with GFP-PTEN expressed GFP.The expression of PTEN protein and mRNA was strongly increased when HKC cells were transfected with GFP-PTEN(all P<0.05).In both TGF-β1 stimulation group and empty vector+TGF-β1 group,the expression level of E-cadherin was lower(all P<0.05),while that of p-Akt and a-SMA was higher than in normal group(both P<0.05).The expression level of p-Akt and a-SMA in GFP-PTEN+TGF-β1 group was Iower(both P<0.05),while that of E-cadherin was higher than in TGF-β1 stimulation group and empty vector+TGF-β1 group(both P<0.05).The expression of Akt was similar in the four groups.Conclusion Overexpression of PTEN can inhibit renal epithelial-mesenehymal trans-differentiation induced by TGF-β1 through suppressing the activation of PI3K/Akt signal pathway.

d by AGE-BSA may be mediated via the activation of PKC signal transduction pathway.