Objective To explore the predictive value of early variability of levels of multiple inflammatory factors for the prognosis of children with Mycoplasma pneumoniae pneumonia(MPP).Methods A total of 253 MPP children admitted to the hospital from May 2022 to October 2024 were selected as the research sub-jects.Blood samples were collected from all patients at admission and up to 72 h[T0(0-6 h at admission),T1(24 h after admission),T2(48 h after admission),T3(72 h after admission)].Serum inflammatory fac-tors,including C-reactive protein(CRP),interleukin(IL)-2,IL-4,IL-5,IL-6,IL-8,IL-10,IL-17A,IL-1β,γ-in-terferon(IFN-γ),and tumor necrosis factor-α(TNF-α)were measured,and variability was calculated(T1=[(T1-T0)/T0]× 100％,△T2=[(T2-T0)/T0]× 100％,△T3=[(T3-T0)/T0]× 100％).MPP patients were divided into the good prognosis group and poor prognosis according to the prognosis condition.The ser-um inflammatory factor levels and their variability at different time points in the good prognosis group and the poor prognosis group were compared,multivariate Logistic regression was used to analyze the influencing fac-tors of MPP children's prognosis,and receiver operating characteristic(ROC)curve was used to analyze the predictive value of early variability of inflammatory factor levels for MPP children's prognosis.Results After 3 months of follow-up observation,a total of 7 cases were lost to follow-up,and a total of 246 cases were final-ly included for analysis.Among them,58 cases were in the poor prognosis group,and 188 cases were in the good prognosis group.The disease course of the poor prognosis group was longer than that of the good prog-nosis group(P＜0.05),the severity of the disease was more severe than that of the good prognosis group(P＜0.05),and the proportion of affected lung lobes≥2/3 was higher in the poor prognosis group than in the good prognosis group(P＜0.05).IL-6,IL-17A and IL-1β levels at T1-T3 were higher than those at T0(P＜0.0125).The level of IL-6 at T0-T3,IL-1 β level at T2-T3,and IL-17A at T3 in the poor prognosis group were higher than those in the good prognosis group(P＜0.05).IL-6(△T2),IL-17A(△T3),IL-1β(△T2),IL-1β(△T3)in the poor prognosis group were higher than those in the good prognosis group(P＜0.05).The results of the multivariate Logistic regression analysis showed that IL-6(T0),IL-6(T1),IL-6(△T2),IL-1β(△T3),IL-17A(△T3)were the factors influencing the prognosis of children with MPP(P＜0.05).The ROC curve showed that the area under the curve of IL-6(T0),IL-6(T1),IL-6(△T2),IL-1β(△T3),IL-17A(△T3)for predicting the prognosis of children with MPP was all above 0.7.Conclusion The prognosis of MPP patients is related to the phase sensitivity and dynamic remodeling of the inflammatory network.IL-6(T0),IL-6(T1),IL-6(△T2),IL-1β(△T3),IL-17A(△T3)are key prognostic indicators for MPP patients.Dy-namic monitoring of inflammatory factor levels can help intervene in immune imbalances and cytokine storms in a timely manner to improve the prognosis of pediatric patients.

Sodium glucose cotransporter 2 inhibitor (SGLT2i) emerged as a new hypoglycemic agent, which can inhibit glucose reabsorption and thus play a hypoglycemic role. Recent studies have shown that SGLT2i not only lowers blood glucose, but also has a protective effect on the cardiovascular system, which may benefit patients with heart failure.The specific mechanism of action is still not fully elucidated. This paper aims to summarize the latest research results of SGLT2i in the treatment of heart failure, and analyze the possible mechanisms for clinical guidance.

Objective:To investigate the clinical significance and correlation of serum alpha fetoprotein(AFP), alkaline phosphatase (ALP), and protein induced by vitamin K antagonist-Ⅱ(PIVKA-Ⅱ) in patients with primary hepatoculellar carrcinoma (PHC).Methods:A total of 72 patients with PHC who admitted to Dajiangdong Hospital from May 2017 to June 2019 were selected as observation group and they were divided into metastasis group (25 cases) and non-metastasis group (47 cases) according to the presence or absence of lymph node metastasis.Another 72 healthy people who had physical examinations during the same period were selected as the control group.The serum levels of AFP, ALP and PIVKA-Ⅱ were measured in all patients.ROC curves were used to analyze the clinical value of these three indicators in the early diagnosis and prognosis of PHC.The correlation between serum AFP, ALP, PIVKA-Ⅱ levels and clinical stage of PHC was analyzed by Pearson method.Results:The serum levels of AFP, ALP and PIVKA-Ⅱ in the observation group were significantly higher than those in the control group( t=36.64, 24.53, 47.89, P=0.012, 0.005, 0.001). The serum AFP, ALP and PIVKA-Ⅱ levels were higher in the metastasis group than in the non-metastatic group( t=20.98, 38.12, 54.17, P=0.04, 0.001, 0.000). ROC analysis showed that the serum AFP, ALP and PIVKA-Ⅱ had diagnostic value for PHC, and the combined detection had higher diagnostic efficacy ( P=0.021, 0.014, 0.003, 0.001). Compared with single index, the clinical value of three indicators in predicting whether PHC had lymph node metastasis increased significantly( P=0.036, 0.027, 0.018, 0.005). The specificity(89.57%), sensitivity(92.60%), positive predictive value(89.53%) and negative predictive value(83.75%) of the three indicators in detecting PHC increased significantly( P<0.05). Pearson analysis showed positive correlations between serum AFP, ALP, PIVKA-Ⅱ and tumor stage( P<0.05). Conclusion:Serum AFP, ALP and PIVKA-Ⅱ have certain clinical value in the early diagnosis of PHC, and the combination of these three indicators can improve the diagnostic efficacy.