Asthma is a chronic inflammatory disease of the airway involving various cellular players. Among the different phenotypes of asthma, neutrophilic asthma is often associated with severe airway inflammation and a notable resistance to corticosteroid treatment. Macrophages, as innate immune cells, play a crucial role in the pathogenesis of neutrophilic asthma. They regulate neutrophil recruitment and activation to promote the progression of airway inflammation. During this process, macrophages also undergo changes in aspects such as efferocytosis. We reviewed the recent research progresses regarding the role of macrophages in the pathogenesis of neutrophilic asthma, aiming to provide valuable insights for future studies in this area.
Humans ; Asthma/pathology* ; Neutrophils/pathology* ; Macrophages/immunology* ; Animals ; Phagocytosis

The etiologies and clinical manifestations of central nervous system diseases in children are complex and diverse.Some patients may have sequelae that will affect the neurological function and quality of life of children for a lifetime.Mesenchymal stem cells are a potentially effective treatment method for nervous system diseases.In recent years，there has been an increasing number of related studies targeting the pediatric population.This article introduced the mechanism of mesenchymal stem cells in the treatment of central nervous system diseases and reviewed the progress of clinical application research in the field of children.

The etiologies and clinical manifestations of central nervous system diseases in children are complex and diverse.Some patients may have sequelae that will affect the neurological function and quality of life of children for a lifetime.Mesenchymal stem cells are a potentially effective treatment method for nervous system diseases.In recent years，there has been an increasing number of related studies targeting the pediatric population.This article introduced the mechanism of mesenchymal stem cells in the treatment of central nervous system diseases and reviewed the progress of clinical application research in the field of children.

Objective:To investigate the clinical features, pathogen composition, and prognosis of septic shock in pediatric intensive care units (PICU) in China.Methods:A multicenter retrospective cohort study. A retrospective analysis was conducted on the clinical data of children with septic shock from 10 hospitals in China between January 2018 and December 2021. The clinical features, pathogen composition, and outcomes were collected. Patients were categorized into malignant tumor and non-malignant tumor groups, as well as survival and mortality groups. T test, Mann Whitney U test or Chi square test were used respectively for comparing clinical characteristics and prognosis between 2 groups. Multiple Logistic regression was used to identify risk factors for mortality. Results:A total of 1 247 children with septic shock were included, with 748 males (59.9%) and the age of 3.1 (0.9, 8.8) years. The in-patient mortality rate was 23.2% (289 cases). The overall pathogen positive rate was 68.2% (851 cases), with 1 229 pathogens identified. Bacterial accounted for 61.4% (754 strains) and virus for 24.8% (305 strains). Among all bacterium, Gram negative bacteria constituted 64.2% (484 strains), with Pseudomonas aeruginosa and Enterobacter being the most common; Gram positive bacteria comprised 35.8% (270 strains), primarily Streptococcus and Staphylococcus species. Influenza virus (86 strains (28.2%)), Epstein-Barr virus (53 strains (17.4%)), and respiratory syncytial virus (46 strains (17.1%)) were the top three viruses. Children with malignant tumors were older and had higher pediatric risk of mortality (PRISM) Ⅲ score, paediatric sequential organ failure assessment (pSOFA) score (7.9 (4.3, 11.8) vs. 2.3 (0.8, 7.5) years old, 22 (16, 26) vs. 16 (10, 24) points, 10 (5, 14) vs. 8 (4, 12) points, Z=11.32, 0.87, 4.00, all P<0.05), and higher pathogen positive rate, and in-hospital mortality (77.7% (240/309) vs. 65.1% (611/938), 29.7% (92/309) vs. 21.0% (197/938), χ2=16.84, 10.04, both P<0.05) compared to the non-tumor group. In the death group, the score of PRISM Ⅲ, pSOFA (16 (22, 29) vs. 14 (10, 20) points, 8 (12, 15) vs. 6 (3, 9) points, Z=4.92, 11.88, both P<0.05) were all higher, and presence of neoplastic disease, positive rate of pathogen and proportion of invasive mechanical ventilation in death group were also all higher than those in survival group (29.7% (87/289) vs. 23.2% (222/958), 77.8% (225/289) vs. 65.4% (626/958), 73.7% (213/289) vs. 50.6% (485/958), χ2=5.72, 16.03, 49.98, all P<0.05). Multiple Logistic regression showed that PRISM Ⅲ, pSOFA, and malignant tumor were the independent risk factors for mortality ( OR=1.04, 1.09, 0.67, 95% CI 1.01-1.05, 1.04-1.12, 0.47-0.94, all P<0.05). Conclusions:Bacterial infection are predominant in pediatric septic shock, but viral infection are also significant. Children with malignancies are more severe and resource consumptive. The overall mortality rate for pediatric septic shock remains high, and mortality are associated with malignant tumor, PRISM Ⅲ and pSOFA scores.

Objective:To study the operational efficiency of township health centers in poverty-lifted and non-poverty counties in Hubei Province in the new era of rural revitalization, so as to provide a reference for further promoting township health centers to make up for their shortcomings and improve their service capabilities.Methods:Data was sourced from databases such as the Health and Health Statistics Annual Report, Health Finance Annual Report of Hubei Province for the year 2022. The number of health technicians, business premises area, actual bed count, and the number of equipment worth more than 10 000 yuan in 1 010 township health centers from 36 poverty-lifted counties and 47 non-poverty counties in Hubei Province were taken as input variables. The number of discharged patients, total outpatient visits, the number of people aged 65 and above receiving health management, and the number of hypertensive and type 2 diabetes patients receiving standardized management were taken as output variables. The number of permanent population, per capita regional GDP, population density, urbanization rate, and local general public budget investment were taken as environmental variables. The three-stage data envelopment analysis(DEA) method was applied to measure the operational efficiency of township health centers in poverty-lifted and non-poverty counties in Hubei Province.Results:Environmental variables had different impacts on the operational efficiency of township health centers in poverty-lifted and non-poverty counties ( P<0.01). After removing the impacts, the comprehensive technical efficiency, pure technical efficiency, and scale efficiency of township health centers in poverty-lifted and non-poverty counties in Hubei Province were 0.894, 0.960, 0.931 and 0.840, 0.919, 0.911, respectively; there were 22 pure technical efficiency township health centers in poverty-lifted counties, accounting for 61.10%, with 13 having a scale efficiency of 1, accounting for 36.00%, and 19 with increasing returns to scale, accounting for 52.78%; there were 22 pure technical efficiency township health centers in non-poverty counties, accounting for 46.80%, with 13 having a scale efficiency of 1, accounting for 27.66%, and 22 with increasing returns to scale, accounting for 46.81%. Conclusions:The operational efficiency of poverty-lifted counties was better than that of non-poverty counties. The main reason for the poor operation efficiency of township health centers in poverty-lifted counties was the low scale efficiency, and the poor operation efficiency of township health centers in non-poverty counties was mainly due to insufficient investment in technology development and scale. It is suggested that township health centers in poverty-lifted counties should seize the strategic opportunity of rural revitalization and expand reasonably. Township health centers in non-poverty counties should innovate development methods while improving the capacity of basic medical services.

Objective:To study the operational efficiency of township health centers in poverty-lifted and non-poverty counties in Hubei Province in the new era of rural revitalization, so as to provide a reference for further promoting township health centers to make up for their shortcomings and improve their service capabilities.Methods:Data was sourced from databases such as the Health and Health Statistics Annual Report, Health Finance Annual Report of Hubei Province for the year 2022. The number of health technicians, business premises area, actual bed count, and the number of equipment worth more than 10 000 yuan in 1 010 township health centers from 36 poverty-lifted counties and 47 non-poverty counties in Hubei Province were taken as input variables. The number of discharged patients, total outpatient visits, the number of people aged 65 and above receiving health management, and the number of hypertensive and type 2 diabetes patients receiving standardized management were taken as output variables. The number of permanent population, per capita regional GDP, population density, urbanization rate, and local general public budget investment were taken as environmental variables. The three-stage data envelopment analysis(DEA) method was applied to measure the operational efficiency of township health centers in poverty-lifted and non-poverty counties in Hubei Province.Results:Environmental variables had different impacts on the operational efficiency of township health centers in poverty-lifted and non-poverty counties ( P<0.01). After removing the impacts, the comprehensive technical efficiency, pure technical efficiency, and scale efficiency of township health centers in poverty-lifted and non-poverty counties in Hubei Province were 0.894, 0.960, 0.931 and 0.840, 0.919, 0.911, respectively; there were 22 pure technical efficiency township health centers in poverty-lifted counties, accounting for 61.10%, with 13 having a scale efficiency of 1, accounting for 36.00%, and 19 with increasing returns to scale, accounting for 52.78%; there were 22 pure technical efficiency township health centers in non-poverty counties, accounting for 46.80%, with 13 having a scale efficiency of 1, accounting for 27.66%, and 22 with increasing returns to scale, accounting for 46.81%. Conclusions:The operational efficiency of poverty-lifted counties was better than that of non-poverty counties. The main reason for the poor operation efficiency of township health centers in poverty-lifted counties was the low scale efficiency, and the poor operation efficiency of township health centers in non-poverty counties was mainly due to insufficient investment in technology development and scale. It is suggested that township health centers in poverty-lifted counties should seize the strategic opportunity of rural revitalization and expand reasonably. Township health centers in non-poverty counties should innovate development methods while improving the capacity of basic medical services.

Objective:To determine the equilibrium solubility and n-octanol/water partition coefficients (Papp)of cinnamon acid and cinnamaldehyde. Methods:The equilibrium solubility of cinnamon acid and cinnamaldehyde in different solutions was determined by HPLC,and their n-octanol/water partition coefficients were determined by a shaking flask method combined with HPLC-DAD. Results:When the pH of solution was 7.8,the equilibrium solubility of cinnamon acid was the largest,while that of cinnamaldehyde was the largest in pH 6.8 solution. The scopes of lgPappof cinnamon acid and cinnamaldehyde in different buffer solutions(pH 1.2-7.8) were -1.04-2.27 and 0.29-1.67, respectively, while those in n-octanol/water solvent were 0.85 and 1.26, respectively. Conclusion:The method is simple,accurate and fast to predicate the absorption of chemical components. In gastrointestinal physiological environment,cinnamaldehyde has good absorption, while cinnamon acid is with poor absorption in stomach and with better absorption in intestinal.

Background: Disruption of tight junctions between intestinal epithelial cells followed by loss of barrier function is crucial for the pathogenesis and progression of a variety of gastrointestinal disorders.Aims: To investigate the protective effect of ulinastatin on hydrogen peroxide (H2O2)-induced intestinal epithelial barrier disruption.Methods: Model of intestinal epithelial monolayer barrier was established with Caco-2 cells in vitro,and then divided into four groups: blank control group (without any intervention),H2O2 group (500 μmol/L H2O2),low-dose (500 U/mL) and high-dose (3 000 U/mL) ulinastatin groups (ulinastatin + H2O2).Level of malondialdehyde (MDA) and activity of superoxide dismutase (SOD) were detected;transepithelial electrical resistance (TEER) and flux of sodium fluorescein were measured to assess the barrier function;expression and localization of two tight junction proteins,ZO-1 and occludin were evaluated by Western blotting and immunofluorescence;ultrastructure of tight junctions was observed by transmission electron microscopy (TEM).Results: Compared with the blank control group,treatment of Caco-2 cell monolayers with H2O2 resulted in increase in level of MDA,flux of sodium fluorescein and decrease in activity of SOD,TEER and expressions of ZO-1 and occludin (P all ＜0.05).TEM and immunofluorescence showed that the brusher border of Caco-2 cells in H2O2 group was destroyed,the cell-cell junction was vague and the localization of ZO-1 and occludin was discontinuous and the fluorescence intensity was extremely low.While in ulinastatin groups,especially the high-dose group,all the indices above-mentioned were significantly improved (P all ＜0.05).Conclusions: Ulinastatin protects intestinal epithelial monolayer barrier against H2O2-induced disruption at least partially by its antioxidant activity and modulating expression and localization of tight junction proteins.

Objective To establish a method of sperm DNA extraction in mixed stain by using DNase-Ⅰ purificationcombined with alkaline lysis method in forensic science.Methods 79 mixed stain samples of criminal cases were collected.Sperm DNA was extracted using the purification of DNase-Ⅰ binding alkaline lysis method.16 STR loci were genotyped with fluorescent multiplex amplification system.The typing results were compared with that of extracted using two-step differential extraction procedure.Results Of all 79 mixed stain samples,64 samples were genotyped successfully by using DNase-Ⅰ purification combined with alkaline lysis method while 57 samples were genotyped successfully with two-step differential extraction procedure.There was significant difference between two methods(P=0.039).The purification of DNase-Ⅰ binding alkaline lysis method had a higher success rate and lower cost than that of two-step differential extraction procedure.Conclusion Purification of DNase-Ⅰ binding alkaline lysis method can increase the typing success rate of the mixed stain samples.The method is simple,rapid and easy to be automated,and suitable for forensic identification test.

BACKGROUNDTo elucidate the characteristics and metastastic pattern of skipping mediastinal lymph node metastasis (skipping N2) in non-small cell lung cancer (NSCLC), and investigate reasonable extent of lymph node dissection.

METHODSFrom 1990 to 1998, lobectomy combined with systematic mediastinal lymph node dissection was performed in 109 patients with NSCLC. A retrospective study was carried out to elucidate the characteristics of skipping N2 disease and to compare the difference between skipping N2 and non-skipping N2 diseases.

RESULTSTwenty-one patients (19%) had skipping N2 diseases. Of the skipping N2 group, 18 cases (86%) were adenocarcinoma. Skipping N2 disease was more common in T1 and T2 group than that in T3 and T4 group (P < 0.01). All skipping N2 diseases only involved one nodal station, and most of them were regional mediastinal nodal metastasis. Skipping N2 from upper lobe tumors mainly involved superior tracheobronchial or subaortic lymph nodes, and skipping N2 from lower lobe tumors involved subcarinal lymph nodes.

CONCLUSIONSSkipping N2 disease presents certain clinical characteristics and metastastic pattern, and mediastinal nodal dissection might be modified according to the pattern.