Objective:To investigate the clinical features, pathogen composition, and prognosis of septic shock in pediatric intensive care units (PICU) in China.Methods:A multicenter retrospective cohort study. A retrospective analysis was conducted on the clinical data of children with septic shock from 10 hospitals in China between January 2018 and December 2021. The clinical features, pathogen composition, and outcomes were collected. Patients were categorized into malignant tumor and non-malignant tumor groups, as well as survival and mortality groups. T test, Mann Whitney U test or Chi square test were used respectively for comparing clinical characteristics and prognosis between 2 groups. Multiple Logistic regression was used to identify risk factors for mortality. Results:A total of 1 247 children with septic shock were included, with 748 males (59.9%) and the age of 3.1 (0.9, 8.8) years. The in-patient mortality rate was 23.2% (289 cases). The overall pathogen positive rate was 68.2% (851 cases), with 1 229 pathogens identified. Bacterial accounted for 61.4% (754 strains) and virus for 24.8% (305 strains). Among all bacterium, Gram negative bacteria constituted 64.2% (484 strains), with Pseudomonas aeruginosa and Enterobacter being the most common; Gram positive bacteria comprised 35.8% (270 strains), primarily Streptococcus and Staphylococcus species. Influenza virus (86 strains (28.2%)), Epstein-Barr virus (53 strains (17.4%)), and respiratory syncytial virus (46 strains (17.1%)) were the top three viruses. Children with malignant tumors were older and had higher pediatric risk of mortality (PRISM) Ⅲ score, paediatric sequential organ failure assessment (pSOFA) score (7.9 (4.3, 11.8) vs. 2.3 (0.8, 7.5) years old, 22 (16, 26) vs. 16 (10, 24) points, 10 (5, 14) vs. 8 (4, 12) points, Z=11.32, 0.87, 4.00, all P<0.05), and higher pathogen positive rate, and in-hospital mortality (77.7% (240/309) vs. 65.1% (611/938), 29.7% (92/309) vs. 21.0% (197/938), χ2=16.84, 10.04, both P<0.05) compared to the non-tumor group. In the death group, the score of PRISM Ⅲ, pSOFA (16 (22, 29) vs. 14 (10, 20) points, 8 (12, 15) vs. 6 (3, 9) points, Z=4.92, 11.88, both P<0.05) were all higher, and presence of neoplastic disease, positive rate of pathogen and proportion of invasive mechanical ventilation in death group were also all higher than those in survival group (29.7% (87/289) vs. 23.2% (222/958), 77.8% (225/289) vs. 65.4% (626/958), 73.7% (213/289) vs. 50.6% (485/958), χ2=5.72, 16.03, 49.98, all P<0.05). Multiple Logistic regression showed that PRISM Ⅲ, pSOFA, and malignant tumor were the independent risk factors for mortality ( OR=1.04, 1.09, 0.67, 95% CI 1.01-1.05, 1.04-1.12, 0.47-0.94, all P<0.05). Conclusions:Bacterial infection are predominant in pediatric septic shock, but viral infection are also significant. Children with malignancies are more severe and resource consumptive. The overall mortality rate for pediatric septic shock remains high, and mortality are associated with malignant tumor, PRISM Ⅲ and pSOFA scores.

Dendrobium officinale is a Chinese herbal medicine with the same origin as medicine and food,and it is commonly used in making soup and tonic diet,etc.Dendrobium officinale and its compound preparations are widely used in clinical practice.This article used keywords such as"Dendrobium officinale"and"clinical"to search for relevant literature on clinical research on Dendrobium officinale in CNKI,Wanfang,VIP,PubMed and other databases over the past 10 years.It is found that Dendrobium officinale and its compound preparations were mainly used in the treatment of internal medicine(such as chronic gastritis,diabetes,bronchitis,hypertension,coronary heart disease,etc.),surgery,gynecology,pediatrics,ophthalmology and other diseases,and had good clinical effects.It is a Chinese herbal medicine with the development value.This article provides a comprehensive and systematic summary and analysis of the clinical application of Dendrobium officinale,aiming to provide reference for its rational clinical application and further development and research.

Objective:To study the operational efficiency of township health centers in poverty-lifted and non-poverty counties in Hubei Province in the new era of rural revitalization, so as to provide a reference for further promoting township health centers to make up for their shortcomings and improve their service capabilities.Methods:Data was sourced from databases such as the Health and Health Statistics Annual Report, Health Finance Annual Report of Hubei Province for the year 2022. The number of health technicians, business premises area, actual bed count, and the number of equipment worth more than 10 000 yuan in 1 010 township health centers from 36 poverty-lifted counties and 47 non-poverty counties in Hubei Province were taken as input variables. The number of discharged patients, total outpatient visits, the number of people aged 65 and above receiving health management, and the number of hypertensive and type 2 diabetes patients receiving standardized management were taken as output variables. The number of permanent population, per capita regional GDP, population density, urbanization rate, and local general public budget investment were taken as environmental variables. The three-stage data envelopment analysis(DEA) method was applied to measure the operational efficiency of township health centers in poverty-lifted and non-poverty counties in Hubei Province.Results:Environmental variables had different impacts on the operational efficiency of township health centers in poverty-lifted and non-poverty counties ( P<0.01). After removing the impacts, the comprehensive technical efficiency, pure technical efficiency, and scale efficiency of township health centers in poverty-lifted and non-poverty counties in Hubei Province were 0.894, 0.960, 0.931 and 0.840, 0.919, 0.911, respectively; there were 22 pure technical efficiency township health centers in poverty-lifted counties, accounting for 61.10%, with 13 having a scale efficiency of 1, accounting for 36.00%, and 19 with increasing returns to scale, accounting for 52.78%; there were 22 pure technical efficiency township health centers in non-poverty counties, accounting for 46.80%, with 13 having a scale efficiency of 1, accounting for 27.66%, and 22 with increasing returns to scale, accounting for 46.81%. Conclusions:The operational efficiency of poverty-lifted counties was better than that of non-poverty counties. The main reason for the poor operation efficiency of township health centers in poverty-lifted counties was the low scale efficiency, and the poor operation efficiency of township health centers in non-poverty counties was mainly due to insufficient investment in technology development and scale. It is suggested that township health centers in poverty-lifted counties should seize the strategic opportunity of rural revitalization and expand reasonably. Township health centers in non-poverty counties should innovate development methods while improving the capacity of basic medical services.

Objective:To study the operational efficiency of township health centers in poverty-lifted and non-poverty counties in Hubei Province in the new era of rural revitalization, so as to provide a reference for further promoting township health centers to make up for their shortcomings and improve their service capabilities.Methods:Data was sourced from databases such as the Health and Health Statistics Annual Report, Health Finance Annual Report of Hubei Province for the year 2022. The number of health technicians, business premises area, actual bed count, and the number of equipment worth more than 10 000 yuan in 1 010 township health centers from 36 poverty-lifted counties and 47 non-poverty counties in Hubei Province were taken as input variables. The number of discharged patients, total outpatient visits, the number of people aged 65 and above receiving health management, and the number of hypertensive and type 2 diabetes patients receiving standardized management were taken as output variables. The number of permanent population, per capita regional GDP, population density, urbanization rate, and local general public budget investment were taken as environmental variables. The three-stage data envelopment analysis(DEA) method was applied to measure the operational efficiency of township health centers in poverty-lifted and non-poverty counties in Hubei Province.Results:Environmental variables had different impacts on the operational efficiency of township health centers in poverty-lifted and non-poverty counties ( P<0.01). After removing the impacts, the comprehensive technical efficiency, pure technical efficiency, and scale efficiency of township health centers in poverty-lifted and non-poverty counties in Hubei Province were 0.894, 0.960, 0.931 and 0.840, 0.919, 0.911, respectively; there were 22 pure technical efficiency township health centers in poverty-lifted counties, accounting for 61.10%, with 13 having a scale efficiency of 1, accounting for 36.00%, and 19 with increasing returns to scale, accounting for 52.78%; there were 22 pure technical efficiency township health centers in non-poverty counties, accounting for 46.80%, with 13 having a scale efficiency of 1, accounting for 27.66%, and 22 with increasing returns to scale, accounting for 46.81%. Conclusions:The operational efficiency of poverty-lifted counties was better than that of non-poverty counties. The main reason for the poor operation efficiency of township health centers in poverty-lifted counties was the low scale efficiency, and the poor operation efficiency of township health centers in non-poverty counties was mainly due to insufficient investment in technology development and scale. It is suggested that township health centers in poverty-lifted counties should seize the strategic opportunity of rural revitalization and expand reasonably. Township health centers in non-poverty counties should innovate development methods while improving the capacity of basic medical services.

Objective To investigate the analgesic and anti-inflammatory effects of diuretic mixture and its bacteriostasis effect in vitro,and to provide scientific basis for clinical application.Methods Ear swelling test induced by xylene,twisting reaction test induced by acetic acid,capillary permeability increase in abdominal cavity of mice induced by acetic acid,and pain test induced by formalin were used to observe the analgesic and anti-inflammatory effects of diuretic mixture at high,middle and low doses (crude drug 18.0,9.0,and 4.5 g/kg).Bacteriostatic activities of diuretic mixture were tested by K-B paper disc diffusion method.Results Diuretic mixture alleviated ear edema in mouse model at high dose (P ＜ 0.01).Diuretic mixture at high,middle,and low dose could effectively decrease the twisting reaction (P ＜ 0.01),inhibit capillary permeability (P ＜ 0.05 or 0.01),and ease the ache degree of mice induced by formalin in the first phase (P ＜ 0.01),but there was no significant difference in the degree of pain intensity of phase Ⅱ.The inhibitory rates of diuretic mixture on Staphylococcus aureus and Escherichia coli were 95.04％ and 37.44％,respectively.Conclusion Diuretic mixture has significant effects on analgesia and anti-inflammation and against S.aureus and E.coli in vitro.

Background: Disruption of tight junctions between intestinal epithelial cells followed by loss of barrier function is crucial for the pathogenesis and progression of a variety of gastrointestinal disorders.Aims: To investigate the protective effect of ulinastatin on hydrogen peroxide (H2O2)-induced intestinal epithelial barrier disruption.Methods: Model of intestinal epithelial monolayer barrier was established with Caco-2 cells in vitro,and then divided into four groups: blank control group (without any intervention),H2O2 group (500 μmol/L H2O2),low-dose (500 U/mL) and high-dose (3 000 U/mL) ulinastatin groups (ulinastatin + H2O2).Level of malondialdehyde (MDA) and activity of superoxide dismutase (SOD) were detected;transepithelial electrical resistance (TEER) and flux of sodium fluorescein were measured to assess the barrier function;expression and localization of two tight junction proteins,ZO-1 and occludin were evaluated by Western blotting and immunofluorescence;ultrastructure of tight junctions was observed by transmission electron microscopy (TEM).Results: Compared with the blank control group,treatment of Caco-2 cell monolayers with H2O2 resulted in increase in level of MDA,flux of sodium fluorescein and decrease in activity of SOD,TEER and expressions of ZO-1 and occludin (P all ＜0.05).TEM and immunofluorescence showed that the brusher border of Caco-2 cells in H2O2 group was destroyed,the cell-cell junction was vague and the localization of ZO-1 and occludin was discontinuous and the fluorescence intensity was extremely low.While in ulinastatin groups,especially the high-dose group,all the indices above-mentioned were significantly improved (P all ＜0.05).Conclusions: Ulinastatin protects intestinal epithelial monolayer barrier against H2O2-induced disruption at least partially by its antioxidant activity and modulating expression and localization of tight junction proteins.

This study was aimed to investigate the research on pharmacological effects, relevant ideas and methods of Guangdong native heat-clearing and toxin-removing herbs. Literatures on pharmacological effects of Guangdong native heat-clearing and toxin-removing herbs were collected, summarized and analyzed. The results showed that most Guangdong native heat-clearing and toxin-removing herbs had obvious effects of anti-microbial, anti-bacterial endotoxin, anti-inflammatory, and antipyretic effect. It also had obvious antivenomous and analgesia effect. Based on research ideas and methods of Guangdong native heat-clearing and toxin-removing herbs, we clarified the confusion species as soon as possible, and adhered to the whole animal experiments in combination with in vitro experiments and computer molecular docking simulations for the complementation of each other. It was concluded that the study on pharmacological effects of Guangdongnative heat-clearing and toxin-removing herbs provided strong support in its clinical application. Ideas and methods provided in this article was the main way to explain pharmacological effects of Guangdong native heat-clearing and toxin-removing herbs.

Objective To explore the potential influence of a high-fat meal on systemic inflammation and fibrinolytic dysfunction in normocholesterolemic patients with essential hypertension(EH).Methods Plasma concentrations of lipids profiles,high-sensitivity C-reactive protein(hsCRP),plasminogen activator inhibitor type 1(PAI-1)and tissue plasminogen activator(t-PA)antigens in fasting state(F)and at 4 hours after a single high-fat meal(P)were measured in 54 EH patients and 30 healthy controls(Con).Results Postprandial triglyceride concentrations increased significantly in both hypertensive patients and healthy controls(P

OBJECTIVETo investigate gene diagnosis of occult micrometastasis in the mediastinal lymph node in patients with non-small cell lung carcinoma (NSCLC) and to evaluate its prognostic significance.

METHODSWith mRNA expression of mucoid1 (MUC1) gene examined by RT-PCR, 168 mediastinal lymph nodes taken from 37 pN(0) (negative lymph nodes) NSCLC patients (stage Ia approximately IIb) made up the experiment group. Thrity negative lymph nodes from 14 benign lesions and 30 positive lymph nodes from 15 NSCLC patients served as control. The survival difference between MUC1 mRNA-negative and MUC1 mRNA-positive groups was compared by the chi(2) test.

RESULTSUC1 mRNA was not identified in the negative-control group (specificity = 100%), but it was identified in 26 of 30 positive-control samples (sensitivity = 86.7%). MUC1 mRNA was identified in 16 (9.5%) of the experiment group from 12 patients whose TNM stage was up-regulated to stage IIIa. The 3-year survival rate (58.3%) of MUC1 mRNA positive group patients with occult micrometastasis in mediastinal lymph node was lower than the 88.0% of MUC1 mRNA negative group (P < 0.05).

CONCLUSIONOccult micrometastasis in the mediastinal lymph node in NSCLC patients can be diagnosed by MUC1 mRNA expression through RT-PCR. Poor prognosis in some pN(0) NSCLC patients may be associated with nodal occult micrometastasis.

Adult ; Aged ; Carcinoma, Non-Small-Cell Lung ; diagnosis ; secondary ; Female ; Genetic Markers ; genetics ; Humans ; Lung Neoplasms ; diagnosis ; pathology ; Lymphatic Metastasis ; diagnosis ; Male ; Middle Aged ; Mucin-1 ; analysis ; genetics ; Prognosis ; RNA, Messenger ; analysis

Objective: Our aims were to measure DNA content in primary lung cancer and to study the relationship between the DNA content and TNM stage, histological differentiation of tumor cell, cellular proliferation, and apoptosis. Methods: The DNA content and cellular proliferation were analyzed using flow cytometry. Tumor cell apoptosis was detected by using TUNEL method. Results: (1) The DNA index (DI) distribution ranged from 0.829 to 2.514. There were 41 cases (77.4%) of DNA aneuploid. The distribution of DI and DNA aneuploid was independent of histological subtypes（P>0.05）.(2) With the increase of TNM stage, the DI and the rate of DNA aneuploid increased（P<0.05）.(3) There was relationship between DI and histological differentiation of tumor cell. The DI was higher in tumors of poor differentiation than those in tumors of moderate and good differentiation（P<0.05 and P<0.01）. (4) The cellular proliferation index of aneuploid tumors was significantly higher than that of diploid tumors(P<0.01), while apoptosis index of aneuploid tumors was significantly lower than that of diploid tumors (P<0.01). Conclusion: Correlations exist between DNA content and TNM stage, hiological differentiation, cellular proliferation, and apoptosis.