Objective:To investigate the features of peripheral blood lymphocyte subsets in children with sepsis and evaluate the value of these cells in combination with multiple indicators in the diagnosis of pediatric sepsis.Methods:A retrospective study was conducted on 86 sepsis children and 83 children with local infection admitted to Hebei Children′s Hospital from October 2022 to October 2024. Baseline clinical data, peripheral blood lymphocyte subsets, and other laboratory indicators were compared between the two groups. The least absolute shrinkage and selection operator (LASSO) regression and multivariate logistic regression were used to evaluate the independent risk factors correlated with the initiation of sepsis. The receiver operating characteristic (ROC) curve was plotted to evaluate the value of each independent risk factor for diagnosing sepsis.Results:The thrombin time, the absolute counts of NK, CD3 + T, CD4 + T, and CD8 + T cells, the levels of IgG and IgM, and the counts of lymphocytes and platelets were lower in the sepsis children than in the children with local infection. However, the prothrombin time (PT), activated partial thromboplastin time, the levels of fibrinogen, direct bilirubin, and C-reactive protein (CRP) were higher in the sepsis group (all P<0.05). The variables screened by LASSO regression were analyzed by the multivariate logistic regression, and the results showed that PT, absolute CD4 + T cell count, and the levels of IgM and CRP were independent risk factors for sepsis. The ROC analysis indicated that the area under the ROC curve (AUC) for PT, absolute CD4 + T cell count, and IgM and CRP levels when used individually in diagnosing sepsis was 0.729, 0.593, 0.605, and 0.795, respectively. The AUC for the four indexes when used in combination for diagnosing sepsis reached 0.822, showing greater superiority over that of the single index. Conclusions:The combined measurement of PT, absolute CD4 + T cell count, and the levels of IgM and CRP can improve the diagnostic efficacy for sepsis in children. Early monitoring of these indexes facilitates the assessment of the condition in children suffering from sepsis.

Objective:To explore the morphological characteristics of the corpus callosum (CC) in patients with unilateral medial temporal lobe epilepsy (mTLE) with hippocampal sclerosis (HS), and their correlation with hippocampal volume and clinical indicators.Methods:This was a cross-sectional study. Clinical (age of onset, disease duration, seizure frequency, seizure duration, etc.) and imaging data of 44 patients mTLE with unilateral HS confirmed by postoperative pathology and 42 healthy controls (HCs) recruited at West China Hospital of Sichuan University from June 2017 to May 2023 were analyzed retrospectively. Among the 44 patients, 19 had left-sided HS and 25 had right-sided HS. All subjects underwent high-resolution 3D T 1WI. Hippocampal volumes were obtained using FreeSurfer. ART was used to measure the morphological parameters of the CC for each participant, including total CC area, volume, perimeter, length, thickness, circularity, and the area of seven CC subregions defined by Witelson: rostrum, genu, body, anterior midbody, posterior midbody, isthmus and splenium. Differences in these metrics between two or three groups were compared using independent samples t-test or one-way ANOVA. Pearson or Spearman correlation analysis was used to observe the correlation between morphological features of the CC and hippocampal volume and other clinical indicators in patients with mTLE with unilateral HS. Results:Compared with HCs, patients with mTLE with unilateral HS had significantly reduced total CC area, CC circularity, as well as the area and thickness of the genu, anterior midbody, posterior midbody, isthmus, splenium, and the area of the rostrum ( P<0.05). Significant differences were observed in the total area, circularity, and subregional areas (genu, rostrum, anterior midbody, posterior midbody, splenium), as well as thickness (genu, anterior midbody, posterior midbody, isthmus) of the CC among mTLE with left-sided HS, mTLE with right-sided HS, and HCs ( P<0.05). When compared to HCs, the total area of the CC, circularity and the areas of the genu, rostrum, anterior midbody, posterior midbody, and splenium, and the thicknesses of the genu, anterior midbody, posterior midbody, and isthmus of the CC were significantly reduced in patients with mTLE with right-sided HS ( P<0.05), and the thicknesses of the midbody and isthmus of the CC were significantly reduced in patients with mTLE with left-sided HS compared to HCs ( P<0.05), and the two-by-two comparison of the rest of the indicators did not show statistically significant differences ( P>0.05). Correlation analysis showed that some morphological abnormalities in the CC in mTLE with unilateral HS patients were significantly correlated with age of onset, disease duration, seizure frequency, seizure duration, and hippocampal volume. Conclusions:mTLE with unilateral HS patients can exhibit morphological abnormalities in the CC, particularly in those with right-sided lesions. These abnormalities are significantly associated with seizure-related factors and hippocampal atrophy.

Objective:To investigate the features of peripheral blood lymphocyte subsets in children with sepsis and evaluate the value of these cells in combination with multiple indicators in the diagnosis of pediatric sepsis.Methods:A retrospective study was conducted on 86 sepsis children and 83 children with local infection admitted to Hebei Children′s Hospital from October 2022 to October 2024. Baseline clinical data, peripheral blood lymphocyte subsets, and other laboratory indicators were compared between the two groups. The least absolute shrinkage and selection operator (LASSO) regression and multivariate logistic regression were used to evaluate the independent risk factors correlated with the initiation of sepsis. The receiver operating characteristic (ROC) curve was plotted to evaluate the value of each independent risk factor for diagnosing sepsis.Results:The thrombin time, the absolute counts of NK, CD3 + T, CD4 + T, and CD8 + T cells, the levels of IgG and IgM, and the counts of lymphocytes and platelets were lower in the sepsis children than in the children with local infection. However, the prothrombin time (PT), activated partial thromboplastin time, the levels of fibrinogen, direct bilirubin, and C-reactive protein (CRP) were higher in the sepsis group (all P<0.05). The variables screened by LASSO regression were analyzed by the multivariate logistic regression, and the results showed that PT, absolute CD4 + T cell count, and the levels of IgM and CRP were independent risk factors for sepsis. The ROC analysis indicated that the area under the ROC curve (AUC) for PT, absolute CD4 + T cell count, and IgM and CRP levels when used individually in diagnosing sepsis was 0.729, 0.593, 0.605, and 0.795, respectively. The AUC for the four indexes when used in combination for diagnosing sepsis reached 0.822, showing greater superiority over that of the single index. Conclusions:The combined measurement of PT, absolute CD4 + T cell count, and the levels of IgM and CRP can improve the diagnostic efficacy for sepsis in children. Early monitoring of these indexes facilitates the assessment of the condition in children suffering from sepsis.

Objective:To explore the morphological characteristics of the corpus callosum (CC) in patients with unilateral medial temporal lobe epilepsy (mTLE) with hippocampal sclerosis (HS), and their correlation with hippocampal volume and clinical indicators.Methods:This was a cross-sectional study. Clinical (age of onset, disease duration, seizure frequency, seizure duration, etc.) and imaging data of 44 patients mTLE with unilateral HS confirmed by postoperative pathology and 42 healthy controls (HCs) recruited at West China Hospital of Sichuan University from June 2017 to May 2023 were analyzed retrospectively. Among the 44 patients, 19 had left-sided HS and 25 had right-sided HS. All subjects underwent high-resolution 3D T 1WI. Hippocampal volumes were obtained using FreeSurfer. ART was used to measure the morphological parameters of the CC for each participant, including total CC area, volume, perimeter, length, thickness, circularity, and the area of seven CC subregions defined by Witelson: rostrum, genu, body, anterior midbody, posterior midbody, isthmus and splenium. Differences in these metrics between two or three groups were compared using independent samples t-test or one-way ANOVA. Pearson or Spearman correlation analysis was used to observe the correlation between morphological features of the CC and hippocampal volume and other clinical indicators in patients with mTLE with unilateral HS. Results:Compared with HCs, patients with mTLE with unilateral HS had significantly reduced total CC area, CC circularity, as well as the area and thickness of the genu, anterior midbody, posterior midbody, isthmus, splenium, and the area of the rostrum ( P<0.05). Significant differences were observed in the total area, circularity, and subregional areas (genu, rostrum, anterior midbody, posterior midbody, splenium), as well as thickness (genu, anterior midbody, posterior midbody, isthmus) of the CC among mTLE with left-sided HS, mTLE with right-sided HS, and HCs ( P<0.05). When compared to HCs, the total area of the CC, circularity and the areas of the genu, rostrum, anterior midbody, posterior midbody, and splenium, and the thicknesses of the genu, anterior midbody, posterior midbody, and isthmus of the CC were significantly reduced in patients with mTLE with right-sided HS ( P<0.05), and the thicknesses of the midbody and isthmus of the CC were significantly reduced in patients with mTLE with left-sided HS compared to HCs ( P<0.05), and the two-by-two comparison of the rest of the indicators did not show statistically significant differences ( P>0.05). Correlation analysis showed that some morphological abnormalities in the CC in mTLE with unilateral HS patients were significantly correlated with age of onset, disease duration, seizure frequency, seizure duration, and hippocampal volume. Conclusions:mTLE with unilateral HS patients can exhibit morphological abnormalities in the CC, particularly in those with right-sided lesions. These abnormalities are significantly associated with seizure-related factors and hippocampal atrophy.

ObjectiveTo investigate the role and possible mechanism of action of rhubarb decoction （RD） retention enema in improving inflammatory damage of brain tissue in a rat model of mild hepatic encephalopathy （MHE）. MethodsA total of 60 male Sprague-Dawley rats were divided into blank group （CON group with 6 rats） and chronic liver cirrhosis modeling group with 54 rats using the complete randomization method. After 12 weeks， 40 rats with successful modeling which were confirmed to meet the requirements for MHE model by the Morris water maze test were randomly divided into model group （MOD group）， lactulose group （LT group）， low-dose RD group （RD1 group）， middle-dose RD group （RD2 group）， and high-dose RD group （RD3 group）， with 8 rats in each group. The rats in the CON group and the MOD group were given retention enema with 2 mL of normal saline once a day； the rats in the LT group were given retention enema with 2 mL of lactulose at a dose of 22.5% once a day； the rats in the RD1， RD2， and RD3 groups were given retention enema with 2 mL RD at a dose of 2.5， 5.0， and 7.5 g/kg， respectively， once a day. After 10 days of treatment， the Morris water maze test was performed to analyze the spatial learning and memory abilities of rats. The rats were analyzed from the following aspects： behavioral status； the serum levels of alanine aminotransferase （ALT）， aspartate aminotransferase （AST）， interleukin-1β （IL-1β）， interleukin-6 （IL-6）， and tumor necrosis factor-α （TNF-α） and the level of blood ammonia； pathological changes of liver tissue and brain tissue； the mRNA and protein expression levels of phosphatidylinositol 3-kinase （PI3K）， protein kinase B （AKT）， and mammalian target of rapamycin （mTOR） in brain tissue. A one-way analysis of variance was used for comparison of continuous data between multiple groups， and the least significant difference t-test was used for further comparison between two groups. ResultsCompared with the MOD group， the RD1， RD2， and RD3 groups had a significantly shorter escape latency （all P<0.01）， significant reductions in the levels of ALT， AST， IL-1β， IL-6， TNF-α， and blood ammonia （all P<0.05）， significant alleviation of the degeneration， necrosis， and inflammation of hepatocytes and brain cells， and significant reductions in the mRNA and protein expression levels of PI3K， AKT， and mTOR in brain tissue （all P<0.05）， and the RD3 group had a better treatment outcome than the RD1 and RD2 groups. ConclusionRetention enema with RD can improve cognitive function and inflammatory damage of brain tissue in MHE rats， possibly by regulating the PI3K/AKT/mTOR signaling pathway.

Objective To prepare desalted Aconiti Lateralis Radix Praeparata(Danfupian)standard decoction for HPLC content determination and fingerprint analysis.Methods 15 batches of Danfupian standard decoction were prepared,and the transfer rate of monoester alkaloids was calculated by detecting their content.The transfer rates of monoester alkaloids of 15 batches of Danfupian standard decoction were calculated.The fingerprints of Danfupian standard decoction were established by HPLC,and the similarity values of fingerprints were calculated.Results According to the measurement of 15 batches of Danfupian standard decoction,the average transfer rate of monoester alkaloids was 78.03%with a rage from 56.93%to 94.06%.Besides,9 common peaks were determined and 3 peaks were calibrated.Moreover,the similarity was over 0.95 between fingerprints of standard decoction and the control fingerprint of the 15 batches of Danfupian standard decoction.Conclusion This study establishes an HPLC content determination and fingerprint analysis method of Danfupian standard decoction,which can provide reference for the quality control of the TCM granules of Danfupian.

Objective:To explore the effects of tensile force on vascular lumen formation in three-dimensional printed tissue.Methods:The experimental research method was used. Human umbilical vein endothelial cells (HUVECs) were extracted from discarded umbilical cord tissue of 3 healthy women (aged 22 to 35 years) who gave birth in the Department of Gynaecology and Obstetrics of Suzhou Ruihua Orthopaedic Hospital from September 2020 to May 2021. Human skin fibroblasts (HSFs) were extracted from discarded normal skin tissue of 10 male patients (aged 20 to 45 years) who underwent wound repair in the Department of Hand Surgery of Suzhou Ruihua Orthopaedic Hospital from September 2020 to September 2022. After identification of the two kinds of cells, the 4 th to 6 th passage of cells were taken for the follow-up experiments. HUVECs and HSFs were used as seed cells, and polycaprolactone, gelatin, hyaluronic acid, and fibrin were used as scaffold materials, and the three-dimensional printed vascularized tissue was created by three-dimensional bioprinting technology. The printed tissue with polycaprolactone scaffold of 6 and 10 mm spacing, and without polycaprolactone scaffold were set as 6 mm spacing polycaprolactone group, 10 mm spacing polycaprolactone group, and non-polycaprolactone group, respectively. After 4 days of culture, the printed tissue in 10 mm spacing polycaprolactone group was selected to detect the cell survival by cell viability detection kit, and the cell survival rate was calculated. After 14 days of culture, the printed tissue in three groups were taken, and the shape change of tissue was observed by naked eyes; immunofluorescence staining was performed to observe the arrangement of filamentous actin, and lumen diameter, total length, and number of branches of vessel in the tissue. The tissue with micro-spring structure in the above-mentioned three groups was designed, printed, and cultured for 9 days, and the tensile force applied in the printed tissue was measured according to the force-displacement curve. The number of samples was all 3 in the above experiments. Data were statistically analyzed with one-way analysis of variance and Tukey test. Results:After 4 days of culture, the cell survival rate in printed tissue in 10 mm spacing polycaprolactone group was (91.3±2.2)%. After 14 days of culture, the shape change of printed tissue in non-polycaprolactone group was not obvious, while the shape changes of printed tissue in 6 mm spacing polycaprolactone group and 10 mm spacing polycaprolactone group were obvious. After 14 days of culture, the arrangement of filamentous actin in the printed tissue in non-polycaprolactone group had no specific direction, while the arrangement of filamentous actin in the printed tissue in 6 mm spacing polycaprolactone group and 10 mm spacing polycaprolactone group had a specific direction. After 14 days of culture, The vascular lumen diameters of the printed tissue in 6 mm spacing polycaprolactone group and 10 mm spacing polycaprolactone group were (6.0±1.3) and (10.8±1.3) μm, respectively, which were significantly larger than 0 μm in non-polycaprolactone group ( P<0.05), and the vascular lumen diameter of printed tissue in 10 mm spacing polycaprolactone group was significantly larger than that in 6 mm spacing polycaprolactone group ( P<0.05); the total length and number of branches of blood vessel in the printed tissue in 6 mm spacing polycaprolactone group and 10 mm spacing polycaprolactone group were significantly shorter or less than those in non-polycaprolactone group ( P<0.05), and the total length and number of branches of blood vessel in the printed tissue in 10 mm spacing polycaprolactone group were significantly shorter or less than those in 6 mm spacing polycaprolactone group. After 9 days of culture, the tensile forces applied in the printed tissue in 6 mm spacing polycaprolactone group and 10 mm spacing polycaprolactone group were (2 340±59) and (4 284±538) μN, respectively, which were significantly higher than 0 μN in non-polycaprolactone group ( P<0.05), and the tensile force applied in the printed tissue in 10 mm spacing polycaprolactone group was significantly higher than that in 6 mm spacing polycaprolactone group ( P<0.05). Conclusions:The three-dimensional printed scaffold structure can exert different tensile force in the printed tissue, and the vascular lumen diameter of the printed tissue can be regulated by adjusting the tensile force.

Objective:To investigate the clinical features and prognosis of B-cell acute lymphoblastic leukemia (B-ALL) children with intrachromosomal amplification of chromosome 21 (iAMP21).Methods:The data of 233 children diagnosed with B-ALL who received chemotherapy according to Chinese Children Cancer Group (CCCG) - acute lymphoblastic leukemia -2015 (CCCG-ALL-2015) protocol in the Affiliated Union Hospital of Fujian Medical University from January 2019 to December 2020 were retrospectively analyzed. These patients were divided into iAMP21 group and non-iAMP21 group according to whether iAMP21 was positive in the bone marrow fluid of children before chemotherapy based on ETV6-RUNX1 probe fluorescence in situ hybridization. Children in iAMP21 group received CCCG-ALL-2015 intermediate-risk group regimen induction chemotherapy, while children in non-iAMP21 group received different intensities of chemotherapy according to the clinical risk classification. The clinicopathological characteristics of patients were compared in both groups, the therapeutic efficacy and prognosis of B-ALL children with iAMP21 was analyzed.Results:iAMP21 was found in 5 (2.1%) of 233 B-ALL children. The median hemoglobin concentration in iAMP21 group was higher than that in non-iAMP21 group [99 g/L (71-148 g/L) vs. 74 g/L (30-156 g/L); U = 268.50, P = 0.043]; there were 4 cases (80%) with bone pain in iAMP21 group (5 cases) and 53 cases (23.2%) with bone pain in non-iAMP21 group (228 cases),and the difference in the osteoarticular pain incidence of both groups was statistically significant ( χ2 = 8.53, P = 0.017). There were no significant differences in the proportion of patients with different gender, age, white blood cell counts, platelet counts, hepatosplenomegaly between the two groups (all P > 0.05). Among 5 children with iAMP21, 1 patient was detected with high CRLF2 expression and 1 patient with IKZF1 1-8 exon loss of heterozygosity. The above mentioned two children with iAMP21, whose minimal residual disease (MRD) were still positive after consolidation therapy, and then they received chimeric antigen receptor T-cell treatment and hematopoietic stem cell transplantation. MRD of the other 3 children with iAMP21 turned negative after induction therapy. Up to the last follow-up in October 2021, 5 patients with iAMP21 had disease-free survival. Conclusions:The incidence of B-ALL children with iAMP21 is about 2%. These patients are prone to osteoarticular pain and have relatively mild anemia. The curative effect of some children is still poor after active treatment,which needs to be further clarified with more samples.

Macrophages play critical roles in renal fibrosis. However, macrophages exhibit ontogenic and functional heterogeneities, and which population of macrophages contributes to renal fibrosis and the underlying mechanisms remain unclear. In this study, we genetically targeted Notch signaling by disrupting the transcription factor recombination signal binding protein-Jκ (RBP-J), to reveal its role in regulation of macrophages during the unilateral ureteral obstruction (UUO)-induced murine renal fibrosis. Myeloid-specific disruption of RBP-J attenuated renal fibrosis with reduced extracellular matrix deposition and myofibroblast activation, as well as attenuated epithelial-mesenchymal transition, likely owing to the reduced expression of TGF-β. Meanwhile, RBP-J deletion significantly hampered macrophage infiltration and activation in fibrotic kidney, although their proliferation appeared unaltered. By using macrophage clearance experiment, we found that kidney resident macrophages made negligible contribution, but bone marrow (BM)-derived macrophages played a major role in renal fibrogenesis. Further mechanistic analyses showed that Notch blockade reduced monocyte emigration from BM by down-regulating CCR2 expression. Finally, we found that myeloid-specific Notch activation aggravated renal fibrosis, which was mediated by CCR2 macrophages infiltration. In summary, our data have unveiled that myeloid-specific targeting of Notch could ameliorate renal fibrosis by regulating BM-derived macrophages recruitment and activation, providing a novel strategy for intervention of this disease.

Objective: To investigate the prognostic factors of multi-drug resistant organism (MDRO) infection in patients with infected pancreatic necrosis(IPN). Methods: A retrospective study was performed to assess the MDRO in IPN patients. The clinical data of 104 IPN patients admitted to the Department of Pancreatic and Biliary Surgery, the First Affiliated Hospital of Harbin Medical University from June 2013 to January 2019 were analyzed. Fifty-six patients were allocated in the MDRO group and 48 patients in the non-MDRO group depended on drug sensitivity test. There were 37 males and 19 females in the MDRO group with age of 40 (23) years. The duration time was 3(5) days between onset and admission. In the non-MDRO group, 34 males and 14 females were included with age of (42±14) years. The duration time was 3(4) days between onset and admission. Normally distributed quantitative variables was represented by ±s, non-normally distributed quantitative variables was represented by M(Q_R). Wilcoxon rank-sum test and χ² test were used to analyze the data. Univariate and multivariable Logistic regression analytic model were used to figure out the risk factors associated with MDRO infection. Results: The mean duration of hospital stay was 29.5(31.8) days and hospitalization expenses were CNY 166 991(270 692), which were much higher than those in non-MDRO group (16.5(15.7) days, CNY 56 789(62 354)) (W=1 889, 2 019, both P<0.01). Gram-negative isolates(67.2%, 80/119) were commonly detected in IPN patients.Acinetobacter baumannii was the most common MDRO(27.0%,20/74). Initial use of carbapenem(OR=2.22, 95%CI: 1.02-4.96, P=0.047) and open necrosectomy(OR=10.00, 95%CI: 3.14-44.77, P<0.01) were the potential risk factors for MDRO-induced infections in IPN. Furthermore, the Logistic regression analysis revealed that open necrosectomy was the independent variable for MDRO infections(OR=9.42, 95%CI: 2.92-42.42, P<0.01). Conclusion Open necrosectomy is the independent risk factor for the infection of MDRO.