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 evaluation value of platelet-derived growth factor(PDGF),monocyte chemoattractant-1(MCP-1)and angiopoietin-like protein-4(ANGPTL4)in aqueous humor for therapeutic ef-ficacy and disease progression of anti-vascular endothelial growth factor(VEGF)treatment in neovascular glaucoma(NVG).Methods A total of 220 patients(220 eyes)with NVG in this hospital from January 2020 to January 2024 were selected as the NVG group,and 248(248 eyes)patients who underwent cataract surgery were selected as the control group.According to the Teich classification criteria for iris neovascularization,pa-tients were divided into grade Ⅱ(n=102),grade Ⅲ(n=73),and grade Ⅳ(n=45).According to the thera-peutic effect,they were further divided into the effective group(n=186)and the ineffective group(n=34).The levels of PDGF,MCP-1 and ANGPTL4 were detected by enzyme-linked immunosorbent assay(ELISA),and the influencing factors of ineffective anti-VEGF treatment were analyzed by multivariate Logistic regres-sion.Receiver operating characteristic(ROC)curve was drawn to analyze the predictive value of PDGF,MCP-1 and ANGPTL4 for the effectiveness of anti-VEGF treatment.Results The levels of PDGF,MCP-1 and AN-GPTL4 in the NVG group were higher than those in the control group,and the differences were statistically significant(P＜0.05).The levels of PDGF,MCP-1 and ANGPTL4 in grade Ⅲ patients were higher than those in grade Ⅱ patients,and those in grade Ⅳ patients were higher than those in grade Ⅲ and grade Ⅱ pa-tients,and the differences were statistically significant(P＜0.05).After anti-VEGF treatment,the levels of PDGF,MCP-1 and ANGPTL4 in the effective group decreased more significantly than those in the ineffective group(P＜0.05).Elevated PDGF,MCP-1 and ANGPTL4 were independent risk factors for ineffective anti-VEGF treatment(P＜0.05).The area under the curve(AUC)of aqueous humor PDGF,MCP-1,and AN-GPTL4 alone in predicting the effectiveness of anti-VEGF treatment were 0.812,0.790,and 0.802 respective-ly.The AUC of the combined prediction was 0.948,which was superior to the individual predictions of each(P＜0.05).Conclusion The levels of PDGF,MCP-1 and ANGPTL4 in the aqueous humor of NVG patients gradually increase with the progression of the disease,and the higher levels of these three factors may have re-sistance effect to anti-VEGF therapy.

Objective: To analyze the association between dietary inflammatory index (DII) and gallstone disease among middle-aged and elderly population, so as to provide the evidence for the prevention and control of gallstone disease. Methods: Baseline survey data were collected from the Shanghai Women's Health Study (SWHS) and Shanghai Men's Health Study (SMHS), including demographic information, gallstone disease prevalence and dietary habits. DII was calculated using 29 kinds of food parameters associated with common inflammatory biomarkers and food intake data of residents. A multivariable logistic regression model was used to analyze the association between dietary inflammatory index and gallstone disease. Results: A total of 132 312 individuals were included in the analysis. There were 59 627 males and 72 685 females. Among males, the median age was 53.07 (interquartile range, 9.73) years, 41 544 cases (69.67%) had an educational level of middle school, 4 463 cases (7.48%) had gallstone disease, and DII was -6.46 to 5.59. Among females, the median age was 50.27 (interquartile range, 9.05) years, 47 380 cases (65.19%) had an educational level of middle school, 8 090 cases (11.13%) had gallstone disease, and DII was -6.44 to 4.93. Multivariable logistic regression analysis showed that after adjusting for age, educational level, income level, smoking, alcohol consumption, tea consumption, physical activity and menopausal status (only for females), DII (OR=1.095, 95%CI: 1.002-1.196) was associated with an increased risk of gallston disease among males, but no statistically association was found among females (P>0.05). Conclusion DII might be associated with an increased risk of gallstone disease among middle-aged and elderly population.

Predatory bacteriophages have evolved a vast array of depolymerases for bacteria capture and deprotection. These depolymerases are enzymes responsible for degrading diverse bacterial surface carbohydrates. They are exploited as antibiofilm agents and antimicrobial adjuvants while rarely inducing bacterial resistance, making them an invaluable asset in the era of antibiotic resistance. Numerous depolymerases have been investigated preclinically, with evidence indicating that depolymerases with appropriate dose regimens can safely and effectively combat different multidrug-resistant pathogens in animal infection models. Additionally, some formulation approaches have been developed for improved stability and activity of depolymerases. However, depolymerase formulation is limited to liquid dosage form and remains in its infancy, posing a significant hurdle to their clinical translation, compounded by challenges in their applicability and manufacturing. Future development must address these obstacles for clinical utility. Here, after unravelling the history, diversity, and therapeutic use of depolymerases, we summarized the preclinical efficacy and existing formulation findings of recombinant depolymerases. Finally, the challenges and perspectives of depolymerases as therapeutics for humans were assessed to provide insights for their further development.

Objective:To investigate the clinicopathological features,differential diagnosis,treatment and prognosis of Burkitt-like lymphoma with 11q aberration (BLL-11q).Methods:The clinical manifestations,histological morphology,immunophenotype and molecular genetic changes of 2 cases of BLL-11q admitted to the department of pathology of The First People's Hospital of Lianyungang in 2020 and 2021 were analyzed retrospectively,and the relevant literatures were reviewed.Results:Patients were found with right neck masses inadvertently and grew rapidly. They presented with localized disease with Ann Arbor stages IA and IIA. Microscopically, the normal structure of the lymph node disappeared and was replaced by a diffuse proliferation of lymphocytes, with consistent morphology and medium size. And the presence of "star-sky" phenomenon was obvious, the morphological characteristics were similar to Burkitt lymphoma. Immunophenotypically, tumor cells were diffusely positive for CD20, CD79α, PAX5, CD10 and Bcl-6, partly moderately positive for C-MYC and MUM-1, however, CD3, Bcl-2, CD30 and TDT were negative,Ki-67 positive index was more than 95%, and EBER was negative. FISH detection showed that MYC, Bcl-2, and Bcl-6 were negative. Both cases had the 11q23.3 gain and 11q24.3 loss. Both patients were treated with chemotherapy and followed up for 10-22 months,and achieved complete remission and disease-free survival.Conclusion:BLL-11q is a rare germinal center B-cell lymphoma with abnormal long arm of chromosome 11 and lack of MYC gene rearrangement. It should be distinguished from Burkitt lymphoma, diffuse large B-cell lymphoma, B-lymphoblastic lymphoma, large B-cell lymphoma with IRF4 rearrangement and high-grade B-cell lymphoma. On the basis of morphology and immunophenotype, the diagnosis depends on genetic detection. There may be a better prognosis.

Objective:To explore the effect of hyperbaric oxygen (HBO) therapy on the healing of the skin flap, the vascular endothelial growth factor (VEGF) and hypoxia inducing factor-1α (HIF-1α) after modified radical mastectomy.Methods:A total of 132 patients with breast cancer admitted in the Department of Breast Surgery of Heping Hospital Affiliated to Changzhi Medical College from January 2017 to June 2019 were selected as the research subjects and randomly divided into control group ( n=66) and observation group ( n=66). The control group was given the modified radical mastectomy, while the observation group was additionally given hyperbaric oxygen therapy. The postoperative healing condition of incision flap, including healing time, drainage volume, and pain score, was compared between two groups. And the serum VEGF and HIF-1α levels of patients in the two groups were compared before and after the treatment. Besides, postoperative complications were also observed. Results:The healing time of the skin flap in the observation group with HBO [(10.43±0.96) d] was significantly shorter than that in the control group [(13.81±1.15) d]. The drainage volume of the observation group was (274.01±13.10) ml, and the visual analogue scale (VAS) were (4.02±0.34) and (2.84±0.30) on the first and the third day after the operation respectively. The healing condition and VAS scores of the observation group were both better than those in the control group, and all the differences were statistically significant ( P<0.05). Serum VEGF and HIF-1α levels in the observation group were (809.67±40.22) pg/ml and (243.71±22.84) pg/ml respectively, which were significantly improved compared with those before the treatment and those of the control group, and all the differences were statistically significant ( P<0.05). The incidence of postoperative complications in the observation group (3.03%) was lower than that of the control group (10.61%). Conclusion:The hyperbaric oxygen therapy has a significant clinical effect on the patient after the modified radical mastectomy. It can accelerate skin flap healing, relieve patients’ pain, and promote prognosis by reducing HIF-1α level and increasing VEGF content.

Objective:To explore the effect of hyperbaric oxygen (HBO) therapy on the healing of the skin flap, the vascular endothelial growth factor (VEGF) and hypoxia inducing factor-1α (HIF-1α) after modified radical mastectomy.Methods:A total of 132 patients with breast cancer admitted in the Department of Breast Surgery of Heping Hospital Affiliated to Changzhi Medical College from January 2017 to June 2019 were selected as the research subjects and randomly divided into control group ( n=66) and observation group ( n=66). The control group was given the modified radical mastectomy, while the observation group was additionally given hyperbaric oxygen therapy. The postoperative healing condition of incision flap, including healing time, drainage volume, and pain score, was compared between two groups. And the serum VEGF and HIF-1α levels of patients in the two groups were compared before and after the treatment. Besides, postoperative complications were also observed. Results:The healing time of the skin flap in the observation group with HBO [(10.43±0.96) d] was significantly shorter than that in the control group [(13.81±1.15) d]. The drainage volume of the observation group was (274.01±13.10) ml, and the visual analogue scale (VAS) were (4.02±0.34) and (2.84±0.30) on the first and the third day after the operation respectively. The healing condition and VAS scores of the observation group were both better than those in the control group, and all the differences were statistically significant ( P<0.05). Serum VEGF and HIF-1α levels in the observation group were (809.67±40.22) pg/ml and (243.71±22.84) pg/ml respectively, which were significantly improved compared with those before the treatment and those of the control group, and all the differences were statistically significant ( P<0.05). The incidence of postoperative complications in the observation group (3.03%) was lower than that of the control group (10.61%). Conclusion:The hyperbaric oxygen therapy has a significant clinical effect on the patient after the modified radical mastectomy. It can accelerate skin flap healing, relieve patients’ pain, and promote prognosis by reducing HIF-1α level and increasing VEGF content.

Electrogenerated chemiluminescence (electrochemiluminescence, ECL) generates species at electrode surfaces, which undergoes electron-transfer reactions and forms excited states to emit light. It has be-come a very powerful analytical technique and has been widely used in such as clinical testing, bio-warfare agent detection, and pharmaceutical analysis. This review focuses on the current trends of molecular recognition-based biosensing methods for pharmaceutical analysis since 2010. It introduces a background of ECL and presents the recent ECL developments in ECL immunoassay (ECLIA), im-munosensors, enzyme-based biosensors, aptamer-based biosensors, and molecularly imprinted poly-mers (MIP)-based sensors. At last, the future perspective for these analytical methods is briefly discussed.

PURPOSE: Studies suggest that regular use of metformin may decrease cancer mortality. We investigated the association between diabetes medication use and cancer survival. MATERIALS AND METHODS: The current study includes 633 breast, 890 colorectal, 824 lung, and 543 gastric cancer cases identified from participants of two population-based cohort studies in Shanghai. Information on diabetes medication use was obtained by linking to electronic medical records. The associations between diabetes medication use (metformin, sulfonylureas, and insulin) and overall and cancer-specific survival were evaluated using time-dependent Cox proportional hazards models. RESULTS: After adjustment for clinical characteristics and treatment factors, use of metformin was associated with better overall survival among colorectal cancer patients (hazards ratio [HR], 0.55; 95% confidence interval [CI], 0.34 to 0.88) and for all four types of cancer combined (HR, 0.75; 95% CI, 0.57 to 0.98). Ever use of insulin was associated with worse survival for all cancer types combined (HR, 1.89; 95% CI, 1.57 to 2.29) and for the four cancer types individually. Similar associations were seen for diabetic patients. Sulfonylureas use was associated with worse overall survival for breast or gastric cancer (HR, 2.87; 95% CI, 1.22 to 6.80 and HR, 2.05; 95% CI, 1.09 to 3.84, respectively) among diabetic patients. Similar association patterns were observed between diabetes medication use and cancer-specific survival. CONCLUSION: Metformin was associated with improved survival among colorectal cancer cases, while insulin use was associated with worse survival among patients of four major cancers. Further investigation on the topic is needed given the potential translational impact of these findings.
Breast ; Cohort Studies ; Colorectal Neoplasms ; Electronic Health Records ; Humans ; Insulin ; Lung ; Metformin ; Mortality ; Proportional Hazards Models ; Stomach Neoplasms

Objective To study the therapeutic effect of IGF?1R inhibitor TAE226 on malignant pleural effusion ( MPE) in nude mice. Methods Human lung carcinoma A549 cells were injected into the pleural cavity of nude mice to establish MPE model. The mice were randomly divided into model group and treatment group, and were orally administered with distilled water and TAE226 ( 20 mg/kg ) in the same volume, respectively. The volume of pleural effusion and tumor weight of the two groups were observed. HE staining was used to reveal the histological changes and enzyme?linked immunosorbent assay ( ELISA) was used to detect the IGF?1R protein expression. IGF?1R mRNA level in the tumor tissue was determined by RT?PCR. Microvessel density (MVD) and cell proliferation index (PI) were assessed by immunohistochemical analysis. The protein expression levels of IGF?1R, p?IGF?1R, PI3K and p?PI3K in the tumor tissue were determined by Western blotting. Results The volumes of pleural effusion were ( 241. 4 ± 89. 7 ) μl and (121.7±78.8) μl in the model and treatment groups, respectively (P<0.05). The tumor weight of treatment group was (316.7±186.3) mg, significantly lower than that of the model group (671.4±281.4) mg (P<0.05) . RT?PCR analysis showed that IGF?1R mRNA level was 0. 914 ± 0. 029 in the treatment group, significantly lower than that of the model group (1.152±0.037, P<0.01). The ELISA data revealed that IGF?1R protein expression level of the model group was significantly higher than that of the treatment group [(41.0±4.7) μg/L vs. (24.0±3.1) μg/L, P<0.01]. Immunohistochemical analysis showed that there were significant differences between MVD and PI in the model and treatment groups [ MVD, 34. 75 ± 3. 49 vs. 22.25±3.63;PI, (75.25±7.15)% vs. (45.75±5.12)%;P<0.01 for both). Western blot data showed that IGF?1R and PI3K protein expression levels were not significantly different between the model and treatment groups (1.03±0.33 vs. 0.98±0.37 and 1.05±0.28 vs. 0.98±0.19), respectively (P>0.05), but p?IGF?1R and p?PI3K protein expression levels had significant differences between the two groups (1.08±0.10 vs. 0.51± 0.08 and 1.12±0.09 vs. 0.86±0.09), respectively (P<0.01 for both). Conclusions The IGF?1R inhibitor can effectively inhibit the formation of malignant pleural effusion. Its mechanism may be related to the suppression of tumor cell proliferation, invasion and angiogenesis through inhibition of PI3K signaling. TAE226 treatment may be a potential therapeutic regimen of treating malignant pleural effusion.