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

Recent advances in vital pulp therapy(VPT)research,coupled with the widespread use of biomaterials,have led to an in-crease in the application of VPT.The indications for VPT are continually expanding,particularly for fully developed permanent teeth.Currently,one-way membrane decompression is being investigated as a possible treatment to preserve vital pulp in cases of irreversible pulpitis.This technology involves creating an access point in the pulp cavity and using the one-way membrane to prevent microorganisms from invading the pulp tissue.Additionally,it helps alleviate the high pressure in the pulp cavity caused by inflammation,thereby en-hancing blood circulation within the pulp.This improvement is crucial for establishing a foundation for future vital pulp preservation treatments.A case of irreversible pulpitis caused by caries was reported,in which the dental pulp was preserved using the one-way membrane decompression.The results of a ten-month clinical follow-up indicate a positive outcome.

Objective Constructing a transitional care program for critically ill children in the ICU and exploring the effects of its application on the relocation stress and caregiving abilities of parents of children to improve their caregiving experience.Methods Convenience sampling method was used to select 150 children and their families transferred from PICU to the general ward of a tertiary pediatric hospital in Shanghai from January to September 2023 as research subjects.Subjects enrolled from June to September 2023 were selected as an experimental group,and were applied with the ICU transitional care program for critically ill children.Those enrolled from January to April 2023 were selected as a control group,and received routine ICU transitional care.Family Relocation Stress Scale and Family Caregiver Task Inventory were used to evaluate children's families at 24h before,24h after,and 72h after children's transition from ICU.The incidence of unplanned readmission to ICU within 48h and adverse events were compared between 2 groups of children.Results Eventually 74 pairs in the experimental group and 75 pairs in the control group completed the study.The Family Caregiver Task Inventory scores in the experimental group were lower than that in the control group(P=0.046).Generalized estimation equation showed that,there were significant differences on the intervention effect,the time effect,and the interaction effect of the Family Relocation Stress Scale scores in 2 groups(P＜0.05).Conclusion The ICU transitional care program for critically ill children constructed in this study can effectively improve the level of migration stress and caregiving ability of parents of critically ill children,and optimize the quality of transitional care for critically ill children.

Recent advances in vital pulp therapy(VPT)research,coupled with the widespread use of biomaterials,have led to an in-crease in the application of VPT.The indications for VPT are continually expanding,particularly for fully developed permanent teeth.Currently,one-way membrane decompression is being investigated as a possible treatment to preserve vital pulp in cases of irreversible pulpitis.This technology involves creating an access point in the pulp cavity and using the one-way membrane to prevent microorganisms from invading the pulp tissue.Additionally,it helps alleviate the high pressure in the pulp cavity caused by inflammation,thereby en-hancing blood circulation within the pulp.This improvement is crucial for establishing a foundation for future vital pulp preservation treatments.A case of irreversible pulpitis caused by caries was reported,in which the dental pulp was preserved using the one-way membrane decompression.The results of a ten-month clinical follow-up indicate a positive outcome.

Objective Constructing a transitional care program for critically ill children in the ICU and exploring the effects of its application on the relocation stress and caregiving abilities of parents of children to improve their caregiving experience.Methods Convenience sampling method was used to select 150 children and their families transferred from PICU to the general ward of a tertiary pediatric hospital in Shanghai from January to September 2023 as research subjects.Subjects enrolled from June to September 2023 were selected as an experimental group,and were applied with the ICU transitional care program for critically ill children.Those enrolled from January to April 2023 were selected as a control group,and received routine ICU transitional care.Family Relocation Stress Scale and Family Caregiver Task Inventory were used to evaluate children's families at 24h before,24h after,and 72h after children's transition from ICU.The incidence of unplanned readmission to ICU within 48h and adverse events were compared between 2 groups of children.Results Eventually 74 pairs in the experimental group and 75 pairs in the control group completed the study.The Family Caregiver Task Inventory scores in the experimental group were lower than that in the control group(P=0.046).Generalized estimation equation showed that,there were significant differences on the intervention effect,the time effect,and the interaction effect of the Family Relocation Stress Scale scores in 2 groups(P＜0.05).Conclusion The ICU transitional care program for critically ill children constructed in this study can effectively improve the level of migration stress and caregiving ability of parents of critically ill children,and optimize the quality of transitional care for critically ill children.

OBJECTIVE: To explore the effect of intense pulsed laser (IPL) on anti-aging and its mechanism. METHODS: Rat skin was continuously irradiated ex vivo by IPL at certain wavelengths with different energy densities. The rats were irradiated twice with an interval of 2 weeks. We measured superoxide dismutase (SOD) activity, malondialdehyde (MDA) content, hydroproline (Hyp) content, and the level of apoptosis-related gene B-cell lymphoma-2 (Bcl-2) and Bcl-2 associated X protein (Bax) in the IPL treatment groups, and then compared with those in the model groups and the control group. RESULTS: SOD activity and Hyp content in the IPL treatment groups were higher than those in the model groups, and MDA content in the IPL treatment group was lower than that in the model group (P<0.05). IPL irradiation increased Bcl-2 protein content in rat skin cells, but had no effect on Bax protein expression. CONCLUSION IPL is effective to improve the appearance of aging skin. Its mechanism may relate to maintaining the balance of oxidation and anti-oxidation, restoring oxidase activity, and regulating the death of skin cells by increasing Bcl-2 expression.
Animals ; Female ; Lasers ; Proline ; metabolism ; Proto-Oncogene Proteins c-bcl-2 ; metabolism ; Rats ; Skin ; enzymology ; metabolism ; Skin Aging ; radiation effects ; Superoxide Dismutase ; metabolism ; bcl-2-Associated X Protein ; metabolism