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

Currently, the global malaria epidemic is still severe. China was certified malaria-free by WHO in 2021; however, there is a risk of cross-border importation and secondary transmission of malaria via aircrafts and through land bordering countries in China because of the complex environments in border areas between China and neighboring malaria-endemic countries, notably the explosive growth in the malaria epidemic in Myanmar in China-Myanmar border areas. This article summarizes typical cases of secondary transmission caused by imported malaria across the world, and proposes responses to cross-border importation and secondary transmission of malaria in non-border and border areas of China, in order to effectively reduce the risk of malaria importation and secondary transmission and consolidate the hard earned malaria elimination achievements.

Objective To explore the clinical efficacy of laparoscopy combined with choledochoscopy for exploration common bile duct in treatment of calculus of common bile duct.Methods A retrospective analysis was conducted on clinical data of 102 patients with calculus of common bile duct from January 2022 to April 2024.They were separated into laparoscopic group(n=52,who underwent laparoscopy combined with choledochoscopy for exploration common bile duct)and open group(n=50,who underwent open surgery)according to the different surgical methods used.Perioperative indicators,serum gastrin hormone levels[gastrin and cholecystokinin],liver function[serum total bilirubin and serum total bile acid],and postoperative complications were compared between the two groups.Results There were no statistically significant differences in surgical time and stone clearance rate between the laparoscopic group and the open group(P>0.05),while intraoperative blood loss in laparoscopic group was less than that in open group,the first exhaust time and postoperative hospital stay in the laparoscopic group were shorter than those in open group,the differences were statistically significnat(P<0.05);On the third day after surgery,the serum gastrin levels in both groups were lower than those on the first day before surgery,and the serum cholecystokinin levels were higher than those on the first day before surgery,the differences were statistically significant(P<0.05);On the third day after surgery,the serum gastrin level in the laparoscopic group was higher than that in open group,and the serum cholecystokinin level was lower than that in open group,the differences were statistically significant(P<0.05);Three days after surgery,the levels of serum total bilirubin and serum total bile acid in both groups were lower than those 1 day before surgery,and both indicators in laparoscopic group were lower than those in open group,the differences were statistically significant(P<0.05);The incidence of complications in laparoscopic group was 7.69%,lower than that in open group was 26.00%,,the difference was statistically significant(P<0.05).Conclusion The stone removal effect of laparoscopy combined with choledochoscopy for exploration common bile duct in patients with calculus of common bile duct is comparable to that of open surgery.However,compared with open surgery,this study's surgical procedure is more conducive to the rapid recovery of liver function,reduce the impact on gastrin hormones and the risk of complications,and accelerate the postoperative recovery process.It is worthy of clinical application.

Objective:To evaluate the preventive effects of transcutaneous electrical acupoint stimulation (TEAS) on chronic pain after lumbar spine surgery.Methods:This was a secondary analysis conducted on the studies assessing the effect of TEAS on gastrointestinal function in patients undergoing lumbar spinal surgery. Fifty lumbar spinal stenosis patients of either sex, aged 50-75 yr, with a body mass index of 18.5-28.0 kg/m 2, of American Society of Anesthesiologists Physical Status cassification Ⅰ or Ⅱ, with expected operation time≥3 h, undergoing lumbar spinal surgery under general anesthesia, were enrolled and assigned into 2 groups ( n=25 each) using a random number table method: control group (C group) and TEAS group. In group C, stimulating electrodes were placed at the non-acupoint parts of the limbs, but no electrical stimulation was applied. In group TEAS, the bilateral Neiguan (PC6), Hegu (L14), Zusanli (ST36), Shangjuxu (ST37) and Xiajuxu (ST39) were stimulated with disperse-dense waves at a frequency of 2/100 Hz. The intensity of stimulation was the maximum current that patients could tolerate. The intervention was performed once a day for 30 min per session at 30 min prior to anesthesia induction and on postoperative days 1-7. Telephone follow-ups were conducted at 3, 6 and 12 months after surgery to record the occurrence of postoperative moderate-to-severe lower back pain and leg pain (Numerical Rating Scale score ≥4), and the Oswestry Disability Index (ODI) value and four-item neuropathic pain questionnaire scores. The pain-related medical visits and usage of nonsteroidal anti-inflammatory drugs were also recorded after surgery. Results:Three patients in each group were lost to follow-up. Compared with group C, the incidence of chronic low back pain was significantly decreased at 6-12 months after surgery, the ODI value and four-item neuropathic pain questionnaire scores were decreased at 12 months after surgery ( P<0.05), ODI value difference reached the minimal clinically important difference, the proportion of patients requiring medical visits due to postoperative pain and usage rate of nonsteroidal anti-inflammatory drugs were decreased at 6-12 months after surgery ( P<0.05), and no significant change in the incidence of chronic moderate-to-severe leg pain was found at each time period after surgery in group TEAS( P>0.05). Conclusions:TEAS can prevent the occurrence of chronic lower back pain and improve functional impairment in patients undergoing lumbar spine surgery.

OBJECTIVE To evaluate the differences between the sampling methods of peristaltic pump+membrane filtration and rinsing for monitoring the cleaning and disinfection effectiveness of flexible endoscopes,and to pro-vide a reference for selecting an efficient sampling method for monitoring the cleaning and disinfection effectiveness of flexible endoscopes.METHODS A total of 305 cases of monitoring data on the cleaning and disinfection of flexi-ble endoscopes from People's Hospital of Rizhao in Shandong Province from Jan.2021 to Dec.2024 were selected.The results of 93 cases sampled by rinsing from Jan.2021 to Dec.2022 were compared with those of 212 cases sampled by peristaltic pump+membrane filtration from Jan.2023 to Dec.2024.The monitoring capabilities of different sampling methods for flexible endoscopes after cleaning and disinfection were evaluated,and the con-sumable costs of different sampling methods were also calculated.RESULTS The detection rate of pathogenic bac-teria after biological monitoring of the peristaltic pump+membrane filtration sampling method was 25.94％(55/212),which was higher than that of the rinsing sampling method(8.60％,8/93)(P＜0.05).There was no sta-tistically significant difference in the sampling qualification rate between the two methods(P=0.075).There was no statistically significant difference in the qualification rate between manual and mechanical cleaning and dis-infection methods under the same sampling method.However,there was a statistically significant difference in the detection rate of pathogenic bacteria between manual cleaning and disinfection(36.21％)and mechanical cleaning and disinfection(22.08％)under the peristaltic pump+membrane filtration sampling method(P=0.036).The detection rate of pathogenic bacteria of the peristaltic pump+membrane filtration sampling method was higher than that of the rinsing sampling method for both cleaning and disinfection methods(P＜0.05).The consumable cost per endoscope of the peristaltic pump+membrane filtration sampling method was(84.90±2.91)yuan,which was higher than that of the rinsing sampling method(32.24±4.73)yuan(P＜0.001).CONCLUSION Al-though the peristaltic pump+membrane filtration sampling method has higher consumable costs,it can effec-tively improve the detection rate of pathogenic bacteria and enhance the sensitivity of biological monitoring of cleaning and disinfection.

AIM:To explore the clinical significance of stearoyl-CoA desaturase 1(SCD1)in colorectal can-cer and to evaluate the effects and mechanisms of diosgenin glucoside on the proliferation of colorectal cancer cells.METHODS:The expression of SCD1 in colorectal cancer tissues was assessed using qPCR and Western blot,and its cor-relation with clinical features was analyzed.The impact of diosgenin glucoside on the viability of SW620 and HCT116 cells was measured using the CCK-8 assay,and the proliferation was further investigated through cell cloning experiments.Ad-ditionally,the effects of diosgenin glucoside on apoptosis-related genes and SCD1 were evaluated by qPCR and Western blot.Molecular docking was employed to analyze the binding site and binding energy between diosgenin glucoside and SCD1.RESULTS:(1)Both SCD1 mRNA and protein were highly expressed in colorectal cancer tissues,with an 88%positive rate.And SCD1 mRNA expression correlated with cancer type and clinical stage.(2)Diosgenin glucoside de-creased the viability and cloning ability of SW620 and HCT116 cells in a dose-dependent manner.(3)Diosgenin gluco-side upregulated the mRNA and protein expression of pro-apoptotic proteins caspase-3 and Bax in a dose-dependent man-ner,while it downregulated the mRNA and protein expression of the anti-apoptotic protein Bcl-2.(4)Diosgenin glucoside reduced the mRNA and protein expression of SCD1 in a dose-dependent manner and bound to SCD1 via hydrogen and con-jugated bonds with a binding energy of-7.7 kcal/mol.CONCLUSION:(1)SCD1 is closely associated with the type and clinical stage of colorectal cancer.(2)The reduction in viability and proliferation of colorectal cancer cells by diosgenin glucoside may be attributed to its binding to SCD1,which lowers its expression and promotes apoptosis.

Objective:To evaluate the preventive effects of transcutaneous electrical acupoint stimulation (TEAS) on chronic pain after lumbar spine surgery.Methods:This was a secondary analysis conducted on the studies assessing the effect of TEAS on gastrointestinal function in patients undergoing lumbar spinal surgery. Fifty lumbar spinal stenosis patients of either sex, aged 50-75 yr, with a body mass index of 18.5-28.0 kg/m 2, of American Society of Anesthesiologists Physical Status cassification Ⅰ or Ⅱ, with expected operation time≥3 h, undergoing lumbar spinal surgery under general anesthesia, were enrolled and assigned into 2 groups ( n=25 each) using a random number table method: control group (C group) and TEAS group. In group C, stimulating electrodes were placed at the non-acupoint parts of the limbs, but no electrical stimulation was applied. In group TEAS, the bilateral Neiguan (PC6), Hegu (L14), Zusanli (ST36), Shangjuxu (ST37) and Xiajuxu (ST39) were stimulated with disperse-dense waves at a frequency of 2/100 Hz. The intensity of stimulation was the maximum current that patients could tolerate. The intervention was performed once a day for 30 min per session at 30 min prior to anesthesia induction and on postoperative days 1-7. Telephone follow-ups were conducted at 3, 6 and 12 months after surgery to record the occurrence of postoperative moderate-to-severe lower back pain and leg pain (Numerical Rating Scale score ≥4), and the Oswestry Disability Index (ODI) value and four-item neuropathic pain questionnaire scores. The pain-related medical visits and usage of nonsteroidal anti-inflammatory drugs were also recorded after surgery. Results:Three patients in each group were lost to follow-up. Compared with group C, the incidence of chronic low back pain was significantly decreased at 6-12 months after surgery, the ODI value and four-item neuropathic pain questionnaire scores were decreased at 12 months after surgery ( P<0.05), ODI value difference reached the minimal clinically important difference, the proportion of patients requiring medical visits due to postoperative pain and usage rate of nonsteroidal anti-inflammatory drugs were decreased at 6-12 months after surgery ( P<0.05), and no significant change in the incidence of chronic moderate-to-severe leg pain was found at each time period after surgery in group TEAS( P>0.05). Conclusions:TEAS can prevent the occurrence of chronic lower back pain and improve functional impairment in patients undergoing lumbar spine surgery.

OBJECTIVE To evaluate the differences between the sampling methods of peristaltic pump+membrane filtration and rinsing for monitoring the cleaning and disinfection effectiveness of flexible endoscopes,and to pro-vide a reference for selecting an efficient sampling method for monitoring the cleaning and disinfection effectiveness of flexible endoscopes.METHODS A total of 305 cases of monitoring data on the cleaning and disinfection of flexi-ble endoscopes from People's Hospital of Rizhao in Shandong Province from Jan.2021 to Dec.2024 were selected.The results of 93 cases sampled by rinsing from Jan.2021 to Dec.2022 were compared with those of 212 cases sampled by peristaltic pump+membrane filtration from Jan.2023 to Dec.2024.The monitoring capabilities of different sampling methods for flexible endoscopes after cleaning and disinfection were evaluated,and the con-sumable costs of different sampling methods were also calculated.RESULTS The detection rate of pathogenic bac-teria after biological monitoring of the peristaltic pump+membrane filtration sampling method was 25.94％(55/212),which was higher than that of the rinsing sampling method(8.60％,8/93)(P＜0.05).There was no sta-tistically significant difference in the sampling qualification rate between the two methods(P=0.075).There was no statistically significant difference in the qualification rate between manual and mechanical cleaning and dis-infection methods under the same sampling method.However,there was a statistically significant difference in the detection rate of pathogenic bacteria between manual cleaning and disinfection(36.21％)and mechanical cleaning and disinfection(22.08％)under the peristaltic pump+membrane filtration sampling method(P=0.036).The detection rate of pathogenic bacteria of the peristaltic pump+membrane filtration sampling method was higher than that of the rinsing sampling method for both cleaning and disinfection methods(P＜0.05).The consumable cost per endoscope of the peristaltic pump+membrane filtration sampling method was(84.90±2.91)yuan,which was higher than that of the rinsing sampling method(32.24±4.73)yuan(P＜0.001).CONCLUSION Al-though the peristaltic pump+membrane filtration sampling method has higher consumable costs,it can effec-tively improve the detection rate of pathogenic bacteria and enhance the sensitivity of biological monitoring of cleaning and disinfection.

Objective To explore the clinical efficacy of laparoscopy combined with choledochoscopy for exploration common bile duct in treatment of calculus of common bile duct.Methods A retrospective analysis was conducted on clinical data of 102 patients with calculus of common bile duct from January 2022 to April 2024.They were separated into laparoscopic group(n=52,who underwent laparoscopy combined with choledochoscopy for exploration common bile duct)and open group(n=50,who underwent open surgery)according to the different surgical methods used.Perioperative indicators,serum gastrin hormone levels[gastrin and cholecystokinin],liver function[serum total bilirubin and serum total bile acid],and postoperative complications were compared between the two groups.Results There were no statistically significant differences in surgical time and stone clearance rate between the laparoscopic group and the open group(P>0.05),while intraoperative blood loss in laparoscopic group was less than that in open group,the first exhaust time and postoperative hospital stay in the laparoscopic group were shorter than those in open group,the differences were statistically significnat(P<0.05);On the third day after surgery,the serum gastrin levels in both groups were lower than those on the first day before surgery,and the serum cholecystokinin levels were higher than those on the first day before surgery,the differences were statistically significant(P<0.05);On the third day after surgery,the serum gastrin level in the laparoscopic group was higher than that in open group,and the serum cholecystokinin level was lower than that in open group,the differences were statistically significant(P<0.05);Three days after surgery,the levels of serum total bilirubin and serum total bile acid in both groups were lower than those 1 day before surgery,and both indicators in laparoscopic group were lower than those in open group,the differences were statistically significant(P<0.05);The incidence of complications in laparoscopic group was 7.69%,lower than that in open group was 26.00%,,the difference was statistically significant(P<0.05).Conclusion The stone removal effect of laparoscopy combined with choledochoscopy for exploration common bile duct in patients with calculus of common bile duct is comparable to that of open surgery.However,compared with open surgery,this study's surgical procedure is more conducive to the rapid recovery of liver function,reduce the impact on gastrin hormones and the risk of complications,and accelerate the postoperative recovery process.It is worthy of clinical application.

AIM:To explore the clinical significance of stearoyl-CoA desaturase 1(SCD1)in colorectal can-cer and to evaluate the effects and mechanisms of diosgenin glucoside on the proliferation of colorectal cancer cells.METHODS:The expression of SCD1 in colorectal cancer tissues was assessed using qPCR and Western blot,and its cor-relation with clinical features was analyzed.The impact of diosgenin glucoside on the viability of SW620 and HCT116 cells was measured using the CCK-8 assay,and the proliferation was further investigated through cell cloning experiments.Ad-ditionally,the effects of diosgenin glucoside on apoptosis-related genes and SCD1 were evaluated by qPCR and Western blot.Molecular docking was employed to analyze the binding site and binding energy between diosgenin glucoside and SCD1.RESULTS:(1)Both SCD1 mRNA and protein were highly expressed in colorectal cancer tissues,with an 88%positive rate.And SCD1 mRNA expression correlated with cancer type and clinical stage.(2)Diosgenin glucoside de-creased the viability and cloning ability of SW620 and HCT116 cells in a dose-dependent manner.(3)Diosgenin gluco-side upregulated the mRNA and protein expression of pro-apoptotic proteins caspase-3 and Bax in a dose-dependent man-ner,while it downregulated the mRNA and protein expression of the anti-apoptotic protein Bcl-2.(4)Diosgenin glucoside reduced the mRNA and protein expression of SCD1 in a dose-dependent manner and bound to SCD1 via hydrogen and con-jugated bonds with a binding energy of-7.7 kcal/mol.CONCLUSION:(1)SCD1 is closely associated with the type and clinical stage of colorectal cancer.(2)The reduction in viability and proliferation of colorectal cancer cells by diosgenin glucoside may be attributed to its binding to SCD1,which lowers its expression and promotes apoptosis.