Objective To explore the relationship between the level of Caveolin-1 and high mobility group protein B1(HMGB-1)in cerebrospinal fluid and the severity of sepsis and their predictive value.Methods A total of 102 children with sepsis were selected in a hospital from June 2021 to December 2023.According to neonatal critical case scoring criteria,the children were divided into mild group(n=41)and severe group(n=61).According to the diagnostic criteria of purulent meningitis and the results of cerebrospinal fluid examina-tion,the children were divided into sepsis complicated with purulent meningitis group(n=16)and simple sepsis group(n=86).The clinical data of the children were collected,and the levels of Caveolin-1,HMGB-1 and inflammatory factors[hypersensitive C-reactive protein(hs-CRP),procalcitonin(PCT)and tumor necro-sis factor-α(TNF-α)]in cerebrospinal fluid of the children were detected by enzyme-linked immunosorbent assay.Multivariate Logistic regression analysis was conducted to analyze the factors affecting the severity of sepsis,and the receiver operating characteristic curve was drawn to analyze the diagnostic value of Caveolin-1 and HMGB-1 in the severity of sepsis and the prediction value of purulent meningitis in the children.Results Compared with mild group,cerebrospinal fluid levels of Caveolin-1 and HMGB-1 in severe group were signifi-cantly increased,and the difference was statistically significant(P<0.05).The levels of PCT,hs-CRP and TNF-α in severe group were significantly higher than those in mild group,and the difference was statistically significant(P<0.05).Multivariate Logistic regression analysis showed that PCT,hs-CRP,TNF-α,Caveolin-1 and HMGB-1 levels were all risk factors for the severity of sepsis in children(P<0.05).The combined diag-nosis of Caveolin-1 and HMGB-1 was significantly better than that of Caveolin-1(Z=2.109,P=0.035),HMGB-1(Z=2.099,P=0.036),PCT(Z=2.487,P=0.013),hs-CRP(Z=2.419,P=0.016)and TNF-α(Z=3.441,P=0.001)were diagnosed alone.Compared with simple sepsis group,cerebrospinal fluid Caveo-lin-1 and HMGB-1 levels in sepsis complicated with purulent meningitis group were significantly increased,and the difference was statistically significant(P<0.05).The combined prediction of Caveolin-1 and HMGB-1 was significantly better than that of Caveolin-1(Z=2.621,P=0.009)and HMGB-1(Z=1.997,P=0.046)alone.Conclusion There are significant increases in the levels of Caveolin-1 and HMGB-1 in chil-dren with severe sepsis or sepsis complicated with purulent meningitis.Caveolin-1 and HMGB-1 have a certain clinical value in evaluating the severity of sepsis in children and predicting whether they are complicated with purulent meningitis.

Objective By observing and measuring the relevant data of the buccal branch of the facial nerve,the parotid duct and the facial artery,the positional relationship among the three was analyzed to avoid accidental injury to the buccal branch of the facial nerve and the parotid duct when ligaturing the facial artery during the operation.Methods Forty adult head and neck specimens were dissected to observe the relationship between the buccal branch of the facial nerve and the parotid duct,the course and positional relationship of the facial artery,and the relationship between the buccal branch of the facial nerve and the peripheral vascular network.The relevant diameters were measured with a vernier caliper.Results The buccal branch of the facial nerve was divided into the superior buccal branch and the inferior buccal branch,and there was no direct anastomosis or connecting fiber between the buccal branch of the facial nerve and the parotid duct.The superior buccal branch was relatively thick,and it has a relatively constant position,which was parallel to the parotid duct.The position of the inferior buccal branch was not constant and it ran on or slightly above the plane of angulus oris.The superior buccal branch was located(10.76±5.54)mm from the parotid duct,while the inferior buccal branch was positioned(6.84±4.06)mm away from the parotid duct.The course of the main trunk of the facial artery was relatively fixed.Moreover,if the branch of the facial artery was missing,other branches of the facial artery would extend to replace the missing branch artery.The main trunk of the facial artery had a diameter of(2.34±0.83)mm,and its branches formed anastomoses with the buccal branch of the maxillary artery,creating a vascular network in the parotid and buccal regions.There was a vascular network around the buccal branch of the facial nerve,which was mostly small branches of the facial artery and the superficial temporal artery.Conclusion The buccal branch of the facial nerve exhibits a consistent anatomic relationship with the parotid duct and the facial artery.During the ligation of the facial artery,the parotid duct can serve as a landmark to accurately locate the buccal branch of the facial nerve,thereby significantly reducing the risk of inadvertent injury to the buccal branch of the facial nerve and the parotid duct.

Objective To investigate the role of Sneathia sanguinegens(S.sanguinegens)in the development of unexplained recurrent spontaneous abortion(URSA).Methods A case-control study was conducted to analyze the vaginal flora characteristics of 65 patients with URSA and 18 healthy controls through 16S rRNA gene sequencing.Toxicity profile of S.sanguinegens on human cervical cancer cells(ME-180),human umbilical vein endothelial cells(HUVEC)and human placental choriocarcinoma cells(JEG-3)was analyzed at the cellular level to assess the mechanism of it in adverse pregnancy outcomes.And S.sanguinegens was used to infect C57BL/6J mice to explore the toxic effect on living organisms.Results The relative abundance of Sneathia was increased in patients with URSA compared with healthy controls.It was positively correlated with the number of miscarriages,and was attributed to S.sanguinegens.We also found that S.sanguinegens damaged ME-180,JEG-3 and HUVEC cells.The degree of cellular damage was related to the level of S.sanguinegens added.Intravenous infection with S.sanguinegens caused inflammatory damage in several organs and extramedullary hematopoiesis in the spleen.Conclusion S.sanguinegens is closely related to URSA and should be emphasized in patients with high vaginal bacterial load.

Objective To evaluate the effects of transcatheter aortic valve replacement(TAVR)on left ventricular reverse remodeling(LVRR)and outcomes in patients with mixed aortic valve disease(MAVD)and predominant aortic stenosis(AS).Methods Patients undergoing TAVR at our center between January 2020 and December 2022 were enrolled consecutively.Propensity score matching(PSM)(1∶1 ratio)was used to reduce selection bias.Transthoracic echocardiography(TTE)was used to monitor left ventricular ejection fraction(LVEF)and other structural parameters over time.The study outcome was a composite of cardiovascular death and rehospitalization due to cardiovascular causes.Linear mixed-effects models and logistic regression were utilized for comparing echocardiographic changes across groups and identifying independent risk factors for no-LVRR,respectively.Results After PSM,126 patients were included.MAVD group exhibited larger structural parameters(left ventricular end-systolic/end-diastolic diameter and volume,left ventricular mass index)and a lower left ventricular ejection fraction(LVEF)(all P＜0.05).However,more pronounced improvements in left ventricular structure and hemodynamics were observed during follow-up.Multivariate logistic regression analysis indicated that the left ventricular mass index(LVMI)was an independent predictor of left ventricular reverse remodeling(LVRR)after TAVR,whereas persistent moderate or greater mitral regurgitation(MR)and paravalvular leak(PVL)significantly reduced the incidence of LVRR.During a median follow-up period of 23 months,a total of 31 endpoint events occurred,and there was no statistically significant difference in long-term prognosis between the two groups(Log-rank P=0.330).Conclusions Compared to patients in the AS group,those in the MAVD group exhibited more severe left ventricular remodeling before TAVR.However,more significant LVRR was observed during postoperative follow-up.Additionally,the long-term prognosis was comparable between the two groups.

Objective To investigate the expression of serum microRNA(miR)-16a and mir-15b in patients with early-onset neonatal sepsis(EONS)and its value in clinical diagnosis and prognosis evaluation.Methods 114 children diagnosed with EONS admitted to the Department of Neonatology,Baoding Hospital of Beijing Children's Hospital Affiliated to Capital Medical University from October 2020 to October 2023 were selected as the EONS group,and 114 healthy newborns in the hospital during the same period were selected as the control group.Follow up was conducted on all EONS patients for a period of 6 months,including 34 cases in the poor prognosis group and 80 cases in the good prognosis group.The relative expression levels of miR-16a and miR-15b were measured within 6h of admission using real-time fluorescence quamtitative PCR(qRT-PCR).ROC curve was applied to analyze the diagnostic and prognostic value of serum miR-16a and miR-15b for EONS.Multivariate Logistic regression was applied to analyze the factors that affected the poor prognosis of EONS.Results Compared with the reference group,the birth weight of children in the EONS group(3.44±0.35kg/m2 vs 3.89±0.40kg/m2)was obviously reduced,and there was a obvious difference(35/114,1/114)in pathological jaundice between the two groups,and the differences were statistically significant(t=9.040,χ2=35.922,all P＜0.05).Compared with the reference group,the serum levels of miR-16a and miR-15b in the EONS group were obviously increased,and the differences was statistically significant(t=7.699,8.606,all P＜0.05).The area under the curve(AUC)of the ROC curve for the combined diagnosis of EONS by serum miR-16a and miR-15b was higher than that of miR-16a and miR-15b alone,and the differences were statistically significant(Z=2.619,2.157,all P<0.05).Compared with the good prognosis group,the poor prognosis group had a obvious decrease in body weight at birth,and a obvious increase in serum levels of miR-16a and miR-15b,and the differences were statistically significant(t=5.434,6.308,all P＜0.05).The AUC of serum miR-16a and miR-15b combined for prognostic evaluation was higher than that of miR-16a and miR-15b evaluated separately,and the differences were statistically significant(Z=2.364,2.073,all P＜0.05).Birth weight,miR-16a,miR-15b expression level was a prognostic factor of EONS(Wald χ2=33.459,16.146,49.797,all P<0.05).Conclusion MiR-16a and miR-15b are highly expressed in the serum of children with EONS,and they have certain diagnostic and prognostic value for EONS.

Objective By observing and measuring the relevant data of the buccal branch of the facial nerve,the parotid duct and the facial artery,the positional relationship among the three was analyzed to avoid accidental injury to the buccal branch of the facial nerve and the parotid duct when ligaturing the facial artery during the operation.Methods Forty adult head and neck specimens were dissected to observe the relationship between the buccal branch of the facial nerve and the parotid duct,the course and positional relationship of the facial artery,and the relationship between the buccal branch of the facial nerve and the peripheral vascular network.The relevant diameters were measured with a vernier caliper.Results The buccal branch of the facial nerve was divided into the superior buccal branch and the inferior buccal branch,and there was no direct anastomosis or connecting fiber between the buccal branch of the facial nerve and the parotid duct.The superior buccal branch was relatively thick,and it has a relatively constant position,which was parallel to the parotid duct.The position of the inferior buccal branch was not constant and it ran on or slightly above the plane of angulus oris.The superior buccal branch was located(10.76±5.54)mm from the parotid duct,while the inferior buccal branch was positioned(6.84±4.06)mm away from the parotid duct.The course of the main trunk of the facial artery was relatively fixed.Moreover,if the branch of the facial artery was missing,other branches of the facial artery would extend to replace the missing branch artery.The main trunk of the facial artery had a diameter of(2.34±0.83)mm,and its branches formed anastomoses with the buccal branch of the maxillary artery,creating a vascular network in the parotid and buccal regions.There was a vascular network around the buccal branch of the facial nerve,which was mostly small branches of the facial artery and the superficial temporal artery.Conclusion The buccal branch of the facial nerve exhibits a consistent anatomic relationship with the parotid duct and the facial artery.During the ligation of the facial artery,the parotid duct can serve as a landmark to accurately locate the buccal branch of the facial nerve,thereby significantly reducing the risk of inadvertent injury to the buccal branch of the facial nerve and the parotid duct.

Objective To evaluate the effects of transcatheter aortic valve replacement(TAVR)on left ventricular reverse remodeling(LVRR)and outcomes in patients with mixed aortic valve disease(MAVD)and predominant aortic stenosis(AS).Methods Patients undergoing TAVR at our center between January 2020 and December 2022 were enrolled consecutively.Propensity score matching(PSM)(1∶1 ratio)was used to reduce selection bias.Transthoracic echocardiography(TTE)was used to monitor left ventricular ejection fraction(LVEF)and other structural parameters over time.The study outcome was a composite of cardiovascular death and rehospitalization due to cardiovascular causes.Linear mixed-effects models and logistic regression were utilized for comparing echocardiographic changes across groups and identifying independent risk factors for no-LVRR,respectively.Results After PSM,126 patients were included.MAVD group exhibited larger structural parameters(left ventricular end-systolic/end-diastolic diameter and volume,left ventricular mass index)and a lower left ventricular ejection fraction(LVEF)(all P＜0.05).However,more pronounced improvements in left ventricular structure and hemodynamics were observed during follow-up.Multivariate logistic regression analysis indicated that the left ventricular mass index(LVMI)was an independent predictor of left ventricular reverse remodeling(LVRR)after TAVR,whereas persistent moderate or greater mitral regurgitation(MR)and paravalvular leak(PVL)significantly reduced the incidence of LVRR.During a median follow-up period of 23 months,a total of 31 endpoint events occurred,and there was no statistically significant difference in long-term prognosis between the two groups(Log-rank P=0.330).Conclusions Compared to patients in the AS group,those in the MAVD group exhibited more severe left ventricular remodeling before TAVR.However,more significant LVRR was observed during postoperative follow-up.Additionally,the long-term prognosis was comparable between the two groups.

Objective To investigate the role of Sneathia sanguinegens(S.sanguinegens)in the development of unexplained recurrent spontaneous abortion(URSA).Methods A case-control study was conducted to analyze the vaginal flora characteristics of 65 patients with URSA and 18 healthy controls through 16S rRNA gene sequencing.Toxicity profile of S.sanguinegens on human cervical cancer cells(ME-180),human umbilical vein endothelial cells(HUVEC)and human placental choriocarcinoma cells(JEG-3)was analyzed at the cellular level to assess the mechanism of it in adverse pregnancy outcomes.And S.sanguinegens was used to infect C57BL/6J mice to explore the toxic effect on living organisms.Results The relative abundance of Sneathia was increased in patients with URSA compared with healthy controls.It was positively correlated with the number of miscarriages,and was attributed to S.sanguinegens.We also found that S.sanguinegens damaged ME-180,JEG-3 and HUVEC cells.The degree of cellular damage was related to the level of S.sanguinegens added.Intravenous infection with S.sanguinegens caused inflammatory damage in several organs and extramedullary hematopoiesis in the spleen.Conclusion S.sanguinegens is closely related to URSA and should be emphasized in patients with high vaginal bacterial load.

Objective To investigate the expression of serum microRNA(miR)-16a and mir-15b in patients with early-onset neonatal sepsis(EONS)and its value in clinical diagnosis and prognosis evaluation.Methods 114 children diagnosed with EONS admitted to the Department of Neonatology,Baoding Hospital of Beijing Children's Hospital Affiliated to Capital Medical University from October 2020 to October 2023 were selected as the EONS group,and 114 healthy newborns in the hospital during the same period were selected as the control group.Follow up was conducted on all EONS patients for a period of 6 months,including 34 cases in the poor prognosis group and 80 cases in the good prognosis group.The relative expression levels of miR-16a and miR-15b were measured within 6h of admission using real-time fluorescence quamtitative PCR(qRT-PCR).ROC curve was applied to analyze the diagnostic and prognostic value of serum miR-16a and miR-15b for EONS.Multivariate Logistic regression was applied to analyze the factors that affected the poor prognosis of EONS.Results Compared with the reference group,the birth weight of children in the EONS group(3.44±0.35kg/m2 vs 3.89±0.40kg/m2)was obviously reduced,and there was a obvious difference(35/114,1/114)in pathological jaundice between the two groups,and the differences were statistically significant(t=9.040,χ2=35.922,all P＜0.05).Compared with the reference group,the serum levels of miR-16a and miR-15b in the EONS group were obviously increased,and the differences was statistically significant(t=7.699,8.606,all P＜0.05).The area under the curve(AUC)of the ROC curve for the combined diagnosis of EONS by serum miR-16a and miR-15b was higher than that of miR-16a and miR-15b alone,and the differences were statistically significant(Z=2.619,2.157,all P<0.05).Compared with the good prognosis group,the poor prognosis group had a obvious decrease in body weight at birth,and a obvious increase in serum levels of miR-16a and miR-15b,and the differences were statistically significant(t=5.434,6.308,all P＜0.05).The AUC of serum miR-16a and miR-15b combined for prognostic evaluation was higher than that of miR-16a and miR-15b evaluated separately,and the differences were statistically significant(Z=2.364,2.073,all P＜0.05).Birth weight,miR-16a,miR-15b expression level was a prognostic factor of EONS(Wald χ2=33.459,16.146,49.797,all P<0.05).Conclusion MiR-16a and miR-15b are highly expressed in the serum of children with EONS,and they have certain diagnostic and prognostic value for EONS.

Objective To investigate the differential expression of miR-124-3p in peripheral blood and clinical sig-nificance of patients with β-thalassemia.Methods Peripheral blood samples were collected from 33 patients with β-thalassemia and 30 healthy controls in Ningde Municipal Hospital Affiliated to Ningde Normal University from June 2021 to August 2022.The expression level of miR-124-3p was detected.Luciferase reporter gene was used to verify the interaction between miR-124-3p and ERF 3'UTR.The correlation between differential expression of miR-124-3p and β-thalassemia was analyzed and the clinical diagnostic value of miR-124-3p for β-thalassemia was eval-uated.Results Compared with healthy control individuals,the expression of miR-124-3p was significantly up-reg-ulated in patients with β-thalassemia(P＜0.001).The genotype of miR-124-3p high expression group was 84.2%β0(16/19),the genotype of low expression group was 55.6%β+(10/18).ROC curve analysis showed that miR-124-3p had predictive efficacy for β-thalassemia(AUC:0.842).Luciferase reporter gene analysis showed that ERF gene was the regulatory target of miR-124-3p.Conclusions The differential expression of miR-124-3p in patients with β-thalassemia is closely related to the genotype and clinical severity of thalassemia,and ERF is negatively reg-ulated by miR-124-3p.miR-124-3p may be an effective diagnostic biomarker for β-thalassemia.