Objective:To summarize and analyze the risk factors associated with bronchial mucus plugs (BMPs) in children with Mycoplasma pneumoniae pneumonia (MPP),providing a clinical basis for the indication of bronchoscopy in children with MPP.Methods:A total of 72 children with MPP admitted to the Department of Pediatrics at the Fourth Affiliated Hospital of Nanjing Medical University from December 2022 to December 2024,who underwent bronchoscopy,were selected for this study.According to the presence or absence of BMPs under tracheoscopy,the patients were divided into the mucus plug group and the non-mucus plug group,and their clinical data were analyzed and compared.Results:Among the 72 children with MPP,30 cases (41.7%) were in the mucus plug group,while 42 cases (58.3%) were in the non-mucus plug group.Univariate Logistic regression analysis showed that thermal peak ( OR 2.086,95% CI 1.029-4.299, P=0.041),thermal duration ( OR 1.453,95% CI 1.197-1.763, P < 0.001),thermal duration ≥10 days ( OR 26.154,95% CI 5.316-128.661, P<0.001),combined with pleural effusion ( OR 4.727,95% CI 1.136-19.677, P=0.033),atelectasis ( OR 5.636,95% CI 2.024-15.699, P<0.001),lymphocyte proportion( OR 0.936,95% CI 0.888-0.978, P=0.014),neutrophil proportion( OR 1.048,95% CI 1.005-1.093, P=0.028),lactatedehydrogenase ( OR 1.005,95% CI 1.001-1.009, P = 0.028),D-dimer ( OR 2.203,95% CI 1.133-4.280, P = 0.020),fibrin degradation products ( OR 1.563,95% CI 1.095-2.231, P=0.014),and no heat regression within 72 hours of hormone use ( OR 0.239,95% CI 0.085-0.667, P=0.006) were significant influencing factors for the formation of BMPs in children with MPP.Multivariate Logistic regression analysis showed that thermal duration ≥10 days and atelectasis were independent risk factors for BMPs formation ( P<0.05). Conclusion:For MPP children with thermal duration≥10 days,especially with atelectasis,BMPs may have been formed,and it is recommended to perform bronchoscopy as soon as possible.

Objective:To explore the mediating role of self-perceived aging in the relationship between perceived social support and self-efficacy for exercise in aged patients undergoing surgery for lung cancer and provide a basis for formulating relevant clinical intervention strategies.Methods:Totally 220 aged lung cancer patients who underwent surgery and were hospitalized at the Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, from April to June 2024 were recruited by convenience sampling. Patients completed a demographic questionnaire, the Self-Efficacy for Exercise (SEE) , the Ageing Perceptions Questionnaire (B-APQ) , and the Perceived Social Support Scale (PSSS) . The mediation effect of self-perceived aging between perceived social support and self-efficacy for exercise was analyzed using Model 4 in the SPSS Process macro.Results:A total of 220 questionnaires were distributed, and 207 valid questionnaires were returned, with an effective recovery rate of 94.09%. The total score for B-APQ was (46.93±11.35) , the SEE score was (44.12±12.83) , and the PSSS score was (53.18±13.53) . Perceived social support had a direct effect on self-efficacy for exercise (effect value: 0.278; P<0.01) . Self-perceived aging played a partial mediating role between perceived social support and self-efficacy for exercise, with a mediation effect value of 0.138 ( P<0.01) , accounting for 33.17% of the total effect (0.138/0.416) . Conclusions:Perceived social support directly influences self-efficacy for exercise in aged patients undergoing surgery for lung cancer and also exerts an indirect effect through self-perceived aging. It is recommended that healthcare providers guide these patients to establish a positive perception of aging while focusing on enhancing their social support levels to improve their self-efficacy for exercise and promote recovery.

Objective:To explore the mediating role of self-perceived aging in the relationship between perceived social support and self-efficacy for exercise in aged patients undergoing surgery for lung cancer and provide a basis for formulating relevant clinical intervention strategies.Methods:Totally 220 aged lung cancer patients who underwent surgery and were hospitalized at the Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, from April to June 2024 were recruited by convenience sampling. Patients completed a demographic questionnaire, the Self-Efficacy for Exercise (SEE) , the Ageing Perceptions Questionnaire (B-APQ) , and the Perceived Social Support Scale (PSSS) . The mediation effect of self-perceived aging between perceived social support and self-efficacy for exercise was analyzed using Model 4 in the SPSS Process macro.Results:A total of 220 questionnaires were distributed, and 207 valid questionnaires were returned, with an effective recovery rate of 94.09%. The total score for B-APQ was (46.93±11.35) , the SEE score was (44.12±12.83) , and the PSSS score was (53.18±13.53) . Perceived social support had a direct effect on self-efficacy for exercise (effect value: 0.278; P<0.01) . Self-perceived aging played a partial mediating role between perceived social support and self-efficacy for exercise, with a mediation effect value of 0.138 ( P<0.01) , accounting for 33.17% of the total effect (0.138/0.416) . Conclusions:Perceived social support directly influences self-efficacy for exercise in aged patients undergoing surgery for lung cancer and also exerts an indirect effect through self-perceived aging. It is recommended that healthcare providers guide these patients to establish a positive perception of aging while focusing on enhancing their social support levels to improve their self-efficacy for exercise and promote recovery.

Objective:To summarize and analyze the risk factors associated with bronchial mucus plugs (BMPs) in children with Mycoplasma pneumoniae pneumonia (MPP),providing a clinical basis for the indication of bronchoscopy in children with MPP.Methods:A total of 72 children with MPP admitted to the Department of Pediatrics at the Fourth Affiliated Hospital of Nanjing Medical University from December 2022 to December 2024,who underwent bronchoscopy,were selected for this study.According to the presence or absence of BMPs under tracheoscopy,the patients were divided into the mucus plug group and the non-mucus plug group,and their clinical data were analyzed and compared.Results:Among the 72 children with MPP,30 cases (41.7%) were in the mucus plug group,while 42 cases (58.3%) were in the non-mucus plug group.Univariate Logistic regression analysis showed that thermal peak ( OR 2.086,95% CI 1.029-4.299, P=0.041),thermal duration ( OR 1.453,95% CI 1.197-1.763, P < 0.001),thermal duration ≥10 days ( OR 26.154,95% CI 5.316-128.661, P<0.001),combined with pleural effusion ( OR 4.727,95% CI 1.136-19.677, P=0.033),atelectasis ( OR 5.636,95% CI 2.024-15.699, P<0.001),lymphocyte proportion( OR 0.936,95% CI 0.888-0.978, P=0.014),neutrophil proportion( OR 1.048,95% CI 1.005-1.093, P=0.028),lactatedehydrogenase ( OR 1.005,95% CI 1.001-1.009, P = 0.028),D-dimer ( OR 2.203,95% CI 1.133-4.280, P = 0.020),fibrin degradation products ( OR 1.563,95% CI 1.095-2.231, P=0.014),and no heat regression within 72 hours of hormone use ( OR 0.239,95% CI 0.085-0.667, P=0.006) were significant influencing factors for the formation of BMPs in children with MPP.Multivariate Logistic regression analysis showed that thermal duration ≥10 days and atelectasis were independent risk factors for BMPs formation ( P<0.05). Conclusion:For MPP children with thermal duration≥10 days,especially with atelectasis,BMPs may have been formed,and it is recommended to perform bronchoscopy as soon as possible.

Hypoxemia is a common complication of pneumonia, asthma, and bronchopulmonary dysplasia in children.Rapid identification of hypoxemia is of great significance for the disposal and management of critical children.Pulse oximetry is recognized by the World Health Organization as the best way to monitor hypoxemia in children, and it can monitor pulse oxygen saturation noninvasively and continuously.Based on the related literature at home and abroad, combined with the clinical needs of pediatrics, the " Expert consensus on clinical application of pulse oximetry in children" is formulated to improve the understanding of pediatricians and nurses on the application in pediatric clinical practice, principle, operation techniques, and limitations of pulse oximetry.

Objective:To investigate the knowledge, attitudes, and practices (KAP) of pulse oximetry among pediatric healthcare providers in China and analyze the factor influencing the KAP.Methods:A self-developed questionnaire was used for an online research on the KAP of 11 849 pediatric healthcare providers from 31 provinces, autonomous regions, and municipalities of China from March 11 to 14, 2022.The factors influencing the KAP of pulse oximetry among pediatric healthcare providers were examined by Logistic regression. Results:The scores of KAP, of pulse oximetry were 5.57±0.96, 11.24±1.25 and 11.19±4.54, respectively.The corresponding scoring rates were 69.61%, 74.95%, and 55.99%, respectively. Logistic regression results showed that the gender and working years of pediatric healthcare providers, the region they were located, and whether their medical institution was equipped with pulse oximeters were the main factors affecting the knowledge score (all P<0.05). Main factors influencing the attitude score of pediatric healthcare providers included their knowledge score, gender, educational background, working years, region, medical institution level, and whether the medical institution was equipped with pulse oximeters (all P<0.05). For the practice score, the main influencing factors were the knowledge score, gender, age, and whether the medi-cal institution was equipped with pulse oximeters (all P<0.05). Conclusions:Chinese pediatric healthcare providers need to further improve their knowledge about and attitudes towards pulse oximetry.Pulse oximeters are evidently under-used.It is urgent to formulate policies or guidelines, strengthen education and training, improve knowledge and attitudes, equip more institutions with pulse oximeters, and popularize their application in medical institutions.

Objective To investigate the effect of Brahma-related gene 1 (Brg1) on mucus hypersecretion in the airway of asthmatic mice and explore the mechanism. Methods Female C57bl/6 mice aged 6-8 weeks were randomized into wild-type control group, wild-type asthma group, Brg1-/-group with Brg1 gene knockdown in type II alveolar epithelial cells, and Brg1-/-+asthma group (n=10). The mice in asthma group and Brg1-/-+asthma group were sensitized with ovalbumin (OVA) to establish asthmatic models. PAS staining was used to determine the number of goblet cells and mucus secretion in the airway. Real-time PCR was used to detect the expression of MUC5AC mRNA in the lung tissues. The levels of mucin MUC5AC and interleukin-13 (IL-13) in the bronchoalveolar lavage fluid (BALF) were detected with ELISA and immunohistochemistry, and the expressions of STAT6 and p-STAT6 in the lung tissue were detected using Western blotting. Results Compared with the control mice, wild-type asthmatic mice showed obvious mucus hypersecretion and increased MUC5AC mRNA in the airway with significantly increased IL-13 and MUC5AC levels in the BALF and activation of p-STAT6 in the lung tissues (P<0.05). In the transgenic mice with Brg1 gene knockdown, airway mucus secretion and MUC5AC mRNA expression was significantly reduced following OVA challenge compared with those in the wild-type asthmatic mice; IL-13 and MUC5AC levels in the BALF and p-STAT6 expression in the lung tissues were also significantly decreased in the transgenic mice (P<0.05). Conclusion Brg1 gene knockdown in type II alveolar epithelial cells alleviates OVA-induced airway mucus hypersecretion and reduces the expression of MUC5AC in C57bl/6 mice possibly by inhibiting STAT6 activation, suggesting the role of Brg1 in promoting asthmatic airway mucus hypersecretion.

Objective To investigate the effect of Brahma-related gene 1 (Brg1) on mucus hypersecretion in the airway of asthmatic mice and explore the mechanism. Methods Female C57bl/6 mice aged 6-8 weeks were randomized into wild-type control group, wild-type asthma group, Brg1-/-group with Brg1 gene knockdown in type II alveolar epithelial cells, and Brg1-/-+asthma group (n=10). The mice in asthma group and Brg1-/-+asthma group were sensitized with ovalbumin (OVA) to establish asthmatic models. PAS staining was used to determine the number of goblet cells and mucus secretion in the airway. Real-time PCR was used to detect the expression of MUC5AC mRNA in the lung tissues. The levels of mucin MUC5AC and interleukin-13 (IL-13) in the bronchoalveolar lavage fluid (BALF) were detected with ELISA and immunohistochemistry, and the expressions of STAT6 and p-STAT6 in the lung tissue were detected using Western blotting. Results Compared with the control mice, wild-type asthmatic mice showed obvious mucus hypersecretion and increased MUC5AC mRNA in the airway with significantly increased IL-13 and MUC5AC levels in the BALF and activation of p-STAT6 in the lung tissues (P<0.05). In the transgenic mice with Brg1 gene knockdown, airway mucus secretion and MUC5AC mRNA expression was significantly reduced following OVA challenge compared with those in the wild-type asthmatic mice; IL-13 and MUC5AC levels in the BALF and p-STAT6 expression in the lung tissues were also significantly decreased in the transgenic mice (P<0.05). Conclusion Brg1 gene knockdown in type II alveolar epithelial cells alleviates OVA-induced airway mucus hypersecretion and reduces the expression of MUC5AC in C57bl/6 mice possibly by inhibiting STAT6 activation, suggesting the role of Brg1 in promoting asthmatic airway mucus hypersecretion.

To investigate the effect of jianpi-jiedu (JPJD) prescription-contained serum on colorectal cancer SW48 cell proliferation and the underlying mechanisms.
 Methods: Crude extract from JPJD was made by water extract method and the main components of crude extract from JPJD were analyzed by ultra-performance liquid phase high resolution time of flight mass spectrometry (UPLC-Q-TOF/MS). The low, medium, and high-concentration of JPJD-contained serum were prepared by the serum pharmacological method. The effect of serum containing JPJD on SW48 cell proliferation was determined by MTT assay. The cell cycle was detected by flow cytometric method. The protein levels of mammalian target of rapamycin (mTOR), phospho-mTOR, P-P53, and -P21, and the mRNA level of mTOR were examined by Western blot and RT-PCR, respectively.
 Results: Seven compounds including calycosin-7-glucoside, astragaloside, ginsenoside-Re, ginsenoside-Rb1, glycyrrhizinic acid, apigenin, atractylenolide-II were identified. MTT assays demonstrated that the SW48 cell proliferation was inhibited by medium and high concentration of JPJD-contained serum and the percentages of cells at G1 phase in SW48 cell cultured in the medium and high concentration of JPJD serum group were significantly higher than those in the control group (P<0.05). Meanwhile, the levels of mTOR mRNA and phospho-mTOR protein in the medium and high concentration of JPJD serum groups were substantially lower than those in the control group (P<0.05). Conversely, the expressions of phospho-P53 and P21 protein were significantly increased in the medium and high concentration of JPJD serum group compared with those in the control group.
 Conclusion: JPJD prescription-contained serum can inhibit SW48 cell proliferation, which may be related to mTOR-P53-P21 signaling pathways.
Animals ; Apigenin ; Blotting, Western ; Cell Cycle ; Cell Division ; Cell Proliferation ; drug effects ; genetics ; Colorectal Neoplasms ; Cyclin-Dependent Kinase Inhibitor p21 ; drug effects ; Drugs, Chinese Herbal ; pharmacology ; Flow Cytometry ; Ginsenosides ; Glycyrrhizic Acid ; Humans ; Lactones ; Phosphorylation ; genetics ; RNA, Messenger ; Saponins ; Sesquiterpenes ; Signal Transduction ; TOR Serine-Threonine Kinases ; drug effects ; Triterpenes ; Tumor Suppressor Protein p53 ; drug effects

hTe morbidity and mortality of lung cancer rank the ifrst place among all the malignant tumor. Accord-ing to the histopathological characteristics, lung cancer is divided into non-small cell lung cancer (NSCLC) and small cell lung cancer. Only 20% patients diagnosed with NSCLC have the chance for surgery while their 5-yr overall survival is about 30%-60%. hTe therapeutic outcome of surgery alone is not satisfying. Adjuvant chemotherapy atfer surgical resection in stage II-IIIa lung cancer showed effcacy in many randomized clinical trials, but its role in stage I disease remains controversial. hTe choice of appropriate chemotherapy candidates, the selection of chemotherapy regimens and the research progress on bio-marker are mainly discussed in this review.