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

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