Sepsis is a life-threatening organ dysfunction caused by a dysregulated host response to infection，characterized by high mortality rate.The pathological mechanisms of sepsis-induced organ failure are highly complex，including multiple processes such as abnormal immune responses，hemodynamic alterations，and severe endothelial dysfunction.Chromogranin A（Cg A），an acidic glycoprotein belonging to the granin family，serves as a precursor for various bioactive peptides，and is involved in diverse physiological processes，including inflammatory regulation，tissue repair，vascular function modulation，and glucose/lipid metabolism.Recent studies have revealed that Cg A and its derived peptides not only participate in the pathological progression of sepsis，but also exhibit significant correlations with the severity of organ injury. Consequently，Cg A has garnered attention for its potential role in the clinical diagnosis and prognostic evaluation of sepsis.This article provides a comprehensive review of the structure and functions of Cg A，as well as current research advances and clinical applications in sepsis.

Exosomes are a kind of nanovesicles with a wide range of chemical components，which are enriched in a variety of bioactive molecules，such as lipids，proteins，nucleic acids，etc. Exosomes carry biologically active molecules that transmit different messages between cells，and play a role in human physiological and pathological processes. Compared with synthetic carriers such as liposomes and nanoparticles，by virtue of their natural endogenous attributes and cell-specific targeting capabilities，exosomes have broad application prospects in the fields of early disease diagnosis marker screening and targeted therapy drug carriers. This article reviews the role of exosomes in common children's diseases and their research progress，providing new ideas for pediatric clinicians to explore disease diagnosis and treatment.

Objective:To explore the application effect of 5E nursing guided by empowerment theory in patients undergoing liver cancer resection.Methods:Using the purposive sampling method, a total of 88 patients who underwent liver cancer resection surgery in Zhumadian Central Hospital from July 2020 to July 2022 were selected as the research objects. They were divided into the control group ( n=44) and the observation group ( n=44) by the random number table method. The control group was given 5E nursing, while the observation group was given 5E nursing guided by empowerment theory. The improvement of gastrointestinal function between the two groups was compared by the first anal defecation time, the first anal exhaust time and the recovery time of bowel sound. Visual Analogue Scale (VAS) was used to evaluate postoperative pain, General Self-Efficacy Scale (GSES) was used to evaluate self-efficacy, and hope level was assessed by Herth Hope Index (HHI). After treatment, the compliance and occurrence of digestive tract discomfort were compared between the two groups. Results:The first anal defecation time, first anal exhaust time and bowel sound recovery time in observation group were less than those in control group ( P<0.05). Postoperative pain score of observation group was lower than that of control group 48 hours after operation ( P<0.05). After nursing, the GSES, HHI and compliance scores of the observation group were higher than those of the control group ( P<0.05), and the incidence of gastrointestinal discomfort symptoms in the observation group was lower than that in the control group ( P<0.05) . Conclusions:The 5E nursing guided by empowerment theory can effectively improve the compliance, self-efficacy and hope level of liver cancer resection patients, reduce pain, promote postoperative recovery and reduce the incidence of gastrointestinal discomfort symptoms.

Objective To investigate whether microtubule disassembly plays an important role in the pathogenesis of the opening of mitochondria permeability transition pore (MPTP) in hypoxic cardiomyocytes and the decrease of its activity, resulting in its hypoxic injury. Methods Neonatal rat cardiomyocytes in primary culture were randomized as normoxia group (A), hypoxic group (B), normoxia treated with microtubule destabilizing agent (Colchicine) group (C), hypoxia treated with microtubule stabilizing agent (Taxol) group (D). At 0.5, 1, 3, 6, 12 h after treatment, polymeric tubulin was detected by immunofluorescence and Western blotting, mitochondria permeability transition pore (MPTP) open by coloading with calcein AM and cobalt chloride, and the activity of cells by measuring the mitochondrial-dependent reduction of MTT to formazan. Results Early microtubule disassembly, MPTP open and activity decrease of cardiomyocytes in both groups B and C were observed at 0.5 h after treatment. These phenomena all became more and more significant with the prolongation of treatment. However, microtubule disassembly, MPTP open and activity decrease of cardiomyocytes of group D were significantly lower than those of group B. Conclusion Microtubule disassembly happened at 0.5 h after hypoxic treatment. Microtubule stabling agent Taxol and destabilizing agent Colchicine can regulate microtubule integrity efficiently. The microtubule damage plays an important role in the hypoxic injury of cardiomyocytes.

Objective To investigate the protective effect of glycine (Gly) on hypoxic injury to murine cardiomyocytes and the mechanisms. Methods The survival rate of cardiomyocyte survival was detected by trypan blue exclusion and lactate dehydrogenase (LDH) with an ultraviolet spectrophotometer. Ca 2+ changes in the cardiomyocytes were detected by laser confocal microscopy. Results Glycine markedly improved the survival rate of cardiomyocytes and decreased the release of LDH in cardiomyocytes after hypoxia. The protective effect was in a dose-dependent manner. Glycine could also block calcium overload after hypoxia. Conclusion Glycine has the protective effect on cardiomyocytes through the improvement of survival rate, decrease of LDH release, and blockage of calcium overload after hypoxia.