Objective To explore the relationship between levels of vascular endothelial growth factor(VEGF),insulin-like growth factor 1(IGF-1),and transforming growth factor-β1(TGF-β1)in the synovial fluid of children with avascular necrosis of the femoral head(also known as Perthes disease)and the efficacy of postoperative revascularization,aiming to provide a basis for subsequent diagnosis and treatment.Methods A retrospective study was conducted on 262 children with Perthes disease admitted to the Affiliated Hospital of Gansu University of Chinese Medicine from January 2023 to June 2024.Based on postoperative revascularization efficacy,patients were divided into good revascularization group(n=228)and poor revascularization group(n=34).For poor revascularization group,a 1:2 matched case-control design was used to select 68 age-matched children with hip synovitis who underwent hip joint fluid puncture as control group.Additionally,82 children with Perthes disease treated at the hospital from June 2024 to January 2025 were enrolled as a validation cohort for nomogram model verification.The expression levels of VEGF,IGF-1 and TGF-β1 in the synovial fluid of three groups were compared.Confounding biases were controlled through univariate and stratified analyses.Binary logistic regression analysis was used to identify independent factors affecting the revascularization effect.R software was utilized to draw and verify the nomogram model for predicting the postoperative revascularization effect.Results The levels of VEGF,IGF-1 and TGF-β1 in the synovial fluid of children in poor revascularization group were all higher than those in control group and good revascularization group(P<0.05).After three types of reconstructive surgeries,the levels of VEGF,IGF-1 and TGF-β1 in the synovial fluid of children with poor revascularization were all higher than those in children with good revascularization(P<0.05);however,there was no statistically significant difference in the above indicators among different surgical types(P>0.05).Binary logistic regression analysis showed that the levels of VEGF,IGF-1,and TGF-β1 in the synovial fluid were independent risk factors for poor postoperative revascularization in children with Perthes disease.The area under the ROC curve of the nomogram model established accordingly for predicting poor postoperative revascularization in children with Perthes disease was 0.875(95%CI 0.805-0.945),with a sensitivity of 0.874 and a specificity of 0.851.Moreover,the calibration curve and decision curve analysis(DCA)indicated that the model had good clinical applicability.Conclusions The increased levels of VEGF,IGF-1 and TGF-β1 in synovial fluid are associated with poor postoperative revascularization in children with Perthes disease.These three factors are expected to become prognostic indicators for children with Perthes disease.

OBJECTIVETo study the value of bacterial cultures of bronchoalveolar lavage fluids (BALF) in children with pulmonary infection.

METHODSBacterial cultures sampled from both sputum and BALF were performed on 80 hospitalized children with pulmonary infection between June 2008 and February 2011.Culture results between the two samples were compared.

RESULTSIn the 80 children with pulmonary infection, bacterial cultures of BALF showed that Viridans Streptococci were found in 72 cases (90%), Neisseria in 41 cases (51%), Streptococcus pneumoniae in 11 cases (14%), Staphylococcus Aureus in 3 cases (4%) and Escherichia coli in 3 cases (4%). The positive rates of Viridans Streptococci in the bacterial cultures of BALF was not significantly different from the bacterial cultures of sputum, but the positive rate of Streptococcus pneumoniae in the bacterial cultures of BALF was significantly higher than in the bacterial cultures of sputum (4%). Moreover, Escherichia coli were found only by bacterial cultures of BALF.

CONCLUSIONSBacterial cultures of BALF are useful in the identification of pathogenic bacteria for pulmonary infection in children. Due to the samples taken from the lesion regions in bacterial cultures of BALF, the results of may be more reliable.

Bacteria ; isolation & purification ; Bacterial Infections ; microbiology ; Bronchoalveolar Lavage Fluid ; microbiology ; Child, Preschool ; Female ; Humans ; Infant ; Lung Diseases ; microbiology ; Male

Bronchiolitis Obliterans ; diagnosis ; Child ; Humans

Adolescent ; Bronchoscopy ; Child ; Child, Preschool ; Humans ; Infant ; Infant, Newborn ; Respiratory Tract Diseases ; diagnosis