Objective:To analyze the clinical features and risk factors for renal injury in children with antineutrophil cytoplasmic antibody (ANCA)-positive IgA vasculitis (IgAV).Methods:A case-control study was conducted. Seventy-two ANCA-positive IgAV children hospitalized at the Children′s Hospital of Chongqing Medical University from January 2017 to October 2022 were enrolled as the ANCA-positive group. Propensity score matching (1∶4) using the nearest neighbor was performed with age and gender as covariate, and 288 cases ANCA-negative IgAV children were included as the ANCA-negative group. Patients with renal injury were named ANCA-positive IgAV nephritis (IgAVN) group and ANCA-negative IgAVN group, respectively. The ANCA-positive IgAVN group was further divided into myeloperoxidase (MPO) group and proteinase 3 (PR3) group based on the type of ANCA. Clinical data including manifestations, laboratory tests, renal injury, and prognosis were collected. Comparisons between groups were performed using independent sample t-tests, Mann-Whitney U tests, χ2 tests, or Fisher′s exact tests. Kaplan-Meier curves were used to assess differences in the time to renal injury onset, and multivariate logistic regression was performed to identify independent risk factors for renal injury. Results:Among the 72 ANCA-positive IgAV children (41 males, 31 females, age of 7.7 (5.3, 11.2) years), no significant difference in age or gender was observed compared to the ANCA-negative group (both P>0.05). The ANCA-positive group had higher IgM levels, a higher incidence of recurrent rash, and shorter thrombin time (all P<0.05). Among children with renal injury, the ANCA-positive group showed significant differences in the incidence of hematuria, clinical classification, and grade A prognosis compared to the ANCA-negative group (all P<0.05), but no difference was found in the time to renal involvement onest or renal pathology (all P>0.05). The MPO group had higher rates of microscopic hematuria, gross hematuria, acute renal insufficiency, glomerular sclerosis, and grade B prognosis compared to the ANCA-negative IgAVN group (all P<0.05), with a later onset of renal involvement ( P<0.05). Elevated serum creatinine ( OR=1.08, 95% CI 1.03-1.14) and shortened thrombin time ( OR=0.71, 95% CI 0.55-0.92) were independent risk factors for renal injury in ANCA-positive IgAV children (all P<0.05). Conclusions:Children with ANCA-positive IgAV are more likely to experience recurrent rash. MPO-ANCA-positive IgAVN children have higher risks of hematuria, acute kidney injury and glomerular sclerosis, with later-onset but poorer renal prognosis compared to ANCA-negative IgAVN children. Higher serum creatinine levels and shorter thrombin time may be associated with renal injury in children with ANCA-positive IgAV.

Objective To evaluate the influence of precision symptom management based on Internet plus on patients with corneal ulcer.Methods An intervention team was set up to build an Internet+precise symptom management plan for corneal ulcer patients,and the research involved 120 patients with corneal ulcers in a tertiary A hospital in Chongqing from July to December 2023.The patients were divided into an intervention group(n=60)and a control group(n=60)according to the random number table generated by SPSS.Symptom assessment questionnaires were completed once a day during hospitalization and twice a week after discharge,and visual acuity,quality of life,and self-efficacy were assessed on the day of admission and 4 weeks after discharge.Results A total of 112 patients completed the study.The data of 54 cases in the intervention group and 58 cases in the control group were statistically analyzed.During hospitalization and within 4 weeks after discharge,the reported symptom threshold events in the intervention group were lower than those in the control group(P=0.031,P=0.027),and the visual acuity,quality of life,and self-efficacy of the intervention group patients were better than those of the control group patients at the end of the 4th week,with statistically significant differences(all P＜0.05).Conclusion Symptom management program based on internet plus can alleviate patients'symptom experience,improve patients'visual acuity,quality of life and self-efficacy.

Objective:To analyze the clinical features and risk factors for renal injury in children with antineutrophil cytoplasmic antibody (ANCA)-positive IgA vasculitis (IgAV).Methods:A case-control study was conducted. Seventy-two ANCA-positive IgAV children hospitalized at the Children′s Hospital of Chongqing Medical University from January 2017 to October 2022 were enrolled as the ANCA-positive group. Propensity score matching (1∶4) using the nearest neighbor was performed with age and gender as covariate, and 288 cases ANCA-negative IgAV children were included as the ANCA-negative group. Patients with renal injury were named ANCA-positive IgAV nephritis (IgAVN) group and ANCA-negative IgAVN group, respectively. The ANCA-positive IgAVN group was further divided into myeloperoxidase (MPO) group and proteinase 3 (PR3) group based on the type of ANCA. Clinical data including manifestations, laboratory tests, renal injury, and prognosis were collected. Comparisons between groups were performed using independent sample t-tests, Mann-Whitney U tests, χ2 tests, or Fisher′s exact tests. Kaplan-Meier curves were used to assess differences in the time to renal injury onset, and multivariate logistic regression was performed to identify independent risk factors for renal injury. Results:Among the 72 ANCA-positive IgAV children (41 males, 31 females, age of 7.7 (5.3, 11.2) years), no significant difference in age or gender was observed compared to the ANCA-negative group (both P>0.05). The ANCA-positive group had higher IgM levels, a higher incidence of recurrent rash, and shorter thrombin time (all P<0.05). Among children with renal injury, the ANCA-positive group showed significant differences in the incidence of hematuria, clinical classification, and grade A prognosis compared to the ANCA-negative group (all P<0.05), but no difference was found in the time to renal involvement onest or renal pathology (all P>0.05). The MPO group had higher rates of microscopic hematuria, gross hematuria, acute renal insufficiency, glomerular sclerosis, and grade B prognosis compared to the ANCA-negative IgAVN group (all P<0.05), with a later onset of renal involvement ( P<0.05). Elevated serum creatinine ( OR=1.08, 95% CI 1.03-1.14) and shortened thrombin time ( OR=0.71, 95% CI 0.55-0.92) were independent risk factors for renal injury in ANCA-positive IgAV children (all P<0.05). Conclusions:Children with ANCA-positive IgAV are more likely to experience recurrent rash. MPO-ANCA-positive IgAVN children have higher risks of hematuria, acute kidney injury and glomerular sclerosis, with later-onset but poorer renal prognosis compared to ANCA-negative IgAVN children. Higher serum creatinine levels and shorter thrombin time may be associated with renal injury in children with ANCA-positive IgAV.

Objective To evaluate the influence of precision symptom management based on Internet plus on patients with corneal ulcer.Methods An intervention team was set up to build an Internet+precise symptom management plan for corneal ulcer patients,and the research involved 120 patients with corneal ulcers in a tertiary A hospital in Chongqing from July to December 2023.The patients were divided into an intervention group(n=60)and a control group(n=60)according to the random number table generated by SPSS.Symptom assessment questionnaires were completed once a day during hospitalization and twice a week after discharge,and visual acuity,quality of life,and self-efficacy were assessed on the day of admission and 4 weeks after discharge.Results A total of 112 patients completed the study.The data of 54 cases in the intervention group and 58 cases in the control group were statistically analyzed.During hospitalization and within 4 weeks after discharge,the reported symptom threshold events in the intervention group were lower than those in the control group(P=0.031,P=0.027),and the visual acuity,quality of life,and self-efficacy of the intervention group patients were better than those of the control group patients at the end of the 4th week,with statistically significant differences(all P＜0.05).Conclusion Symptom management program based on internet plus can alleviate patients'symptom experience,improve patients'visual acuity,quality of life and self-efficacy.

Objective:To explore the potential relationship between sugar metabolism,acid production and cariogenicity of Prevotella denticola.Methods:Morphological features of Prevotella denticola were observed and respectively cultured under incubation conditions with and without sugar and at different pH values.The growth characteristics of Prevotella denticola were detected by UV-Vis spectro-photometer and pH meter,the organic acid content in the culture supernatants of the cultures was detected by HPLC.Dentin slices were divided into control group,phosphoric acid group and the Prevotella denticola group and cultured in the corresponding mediu for 1 and 2 weeks respectively,the degree of demineralization of the samples was examined SEM and VHM.Results:Prevotella denticola fermen-ted sucrose and glucose,produced acids with its final pH values as low as 4.7,Succinic acid and acetic acid were its main metabolites.Prevotella denticola was moderately acid-tolerant.Furthermore,Prevotella denticola was able to cause dentin demineralization,and the Vickers hardness value of dentin samples in the Prevotella denticola group was significantly decreased compared with the control group(P＜0.05).Conclusion:The cariogenic capacity of Prevotella denticola may be related to its sugar metabolism and acid production.

Antipyretic-analgesics are currently one of the most prescribed drugs in children.The clinical application of antipyretic-analgesics for children in our country still have irrational phenomenon, which affects the therapeutic effect and even poses hidden dangers to the safety of children.In this paper, suggestions were put forward from the indications, dosage form/route, dosage suitability, pathophysiological characteristics of children with individual differences and drug interactions in the symptomatic treatment of febrile children, so as to provide reference for the general pharmacists when conducting prescription review.

Objective:The purpose of this study was to investigate the relationship between genotypes and clinical phenotypes of primary distal renal tubular acidosis (dRTA) in children.Methods:Clinical information, genetic testing information and follow-up data (until March 2021) of children with dRTA from Children′s Hospital of Chongqing Medical University (from January 2010 to December 2020) were analyzed retrospectively. According to different pathogenic genes, patients were divided into SLC4A1 gene and ATP6V0A4+ATP6V1B1 gene groups. Age at onset, clinical manifestations and laboratory findings were compared. Self-comparisons of height standard deviation score (HtSDS), weight standard deviation score (WtSDS), blood pH and serum potassium before and after treatment were tested. T-test, Fisher′s exact test and rank sum test were used to analyze among groups. Results:Among 27 children with dRTA (16 boys and 11 girls), the age of onset was 33.4 (10.0, 36.0) months.There were 22 patients (81%) with SLC4A1 gene variation, 3 patients (11%) with ATP6V1B1 gene variation and 2 patients (8%) with ATP6V0A4 gene variation. Totally 22 patients (81%) with renal calcium deposition, 19 patients (70%) hypokalemia, 18 patients (67%) short stature, 16 patients (59%) malnutrition, 16 patients (59%) rickets, and 15 patients (56%) polydipsia and polyuria. Noteworthily, the genotyping results indicated that the age at onset in SLC4A1 gene group was older than that in ATP6V0A4+ATP6V1B1 gene group, with a statistically significant difference (27.3 (12.0, 36.0) vs. 8.2 (2.5, 15.0) months, H=6.33, P=0.012). However, there were no significant differences in clinical manifestations or laboratory test results (all P>0.05). Furthermore, the course of disease was 3.9 (1.3, 6.0) years and the follow-up period was 3.1 (1.0, 4.5) years in 27 patients. In addition, there were no significant differences in recovery rate of clinical manifestations and last laboratory findings between SLC4A1 gene group and ATP6V0A4+ATP6V1B1 gene group (all P>0.05). HtSDS and WtSDS of those patients significantly increased after treatment (-3.2±1.9 vs. -2.1±1.1, -2.5±1.5 vs. 0±1.9, t=-2.94, -5.44, both P<0.01). Serum K + and blood pH were restored eventually ((3.2±0.5) vs. (4.0±0.5) mmol/L, 7.27±0.07 vs. 7.37±0.07, t=-4.92, -5.25, both P<0.01). Totally 14 patients had normalized serum potassium, 12 patients had normalized blood pH, but only 4 patients had normalized serum bicarbonate concentration and normal base excess. Conclusions:The age of onset of patients who had SLC4A1 gene mutation was older than that of patients with ATP6V0A4 gene and ATP6V1B1 gene mutations. However, there was no obvious correlation between the condition and prognosis of the dRTA patients and pathogenic genes. Early diagnosis, early treatment, regular follow-up and timely adjustment of the dosage of medication can significantly improve the prognosis of dRTA in children. Serum bicarbonate concentration and actual base excess might not be the necessory indicators to assess clinical recovery.

Objective:To evaluate the role of spinal Rac1 signaling pathway in the maintenance of bone cancer pain (BCP) in rats.Methods:Sixty-four clean-grade adult female Sprague-Dawley rats, aged 8-10 weeks, weighing 180-200 g, were divided into 4 groups using a random number table method: sham operation group (group S, n=8), BCP group ( n=40), BCP plus normal saline group (group BCP+ Veh, n=8), and BCP plus NSC23766 group (group BCP+ NSC, n=8). BCP was induced by injecting Walker 256 mammary gland cancer cell suspension 5 μl (1×10 5 cells/μl) into the bone marrow of the right tibia of rats in BCP, BCP+ Veh and BCP+ NSC groups, while the equal volume of inactivated tumor cells were injected in group S. On 9-11 days after BCP, specific Rac1 inhibitor NSC23766 (5 μg/5 μl) was intrathecally injected once a day in group BCP+ NSC, and the equal volume of normal saline (5 μl) was given once a day in group BCP+ Veh.The mechanical paw withdrawal threshold (MWT) was measured at 1 day before BCP (T 0) and 3, 5, 7, 14 and 21 days after BCP (T 1-5). Eight rats in each group were sacrificed after measurement of MWT at each time point in BCP group or after the last measurement of MWT in S, BCP+ Veh and BCP+ NSC groups, and the lumbar segment (L 4-6) of the spinal cord was removed for determination of the expression of Rac1 signaling pathway-related proteins Rac1, GTP-Rac1, PAK1 and p-PAK1 using Western blot. Results:Compared with group S, MWT was significantly decreased at T 3-5 in BCP, BCP+ Veh and BCP+ NSC groups, and the expression of GTP-Rac1 and p-PAK1 was up-regulated at T 3-5 in group BCP ( P<0.05). Compared with group BCP+ Veh, MWT was significantly increased at T 4, 5, and the expression of GTP-Rac1 and p-PAK1 was down-regulated in group BCP+ NSC ( P<0.05). Conclusion:Spinal Rac1 signaling pathway is involved in the maintenance of BCP in rats.

Objective:To explore the differences in clinical indicators of different pathological types of children with hematuria as the main manifestation, and to establish a BP neural network prediction model based on clinical data.Methods:The clinical data and renal pathological results of children who were referred to Children′s Hospital of Chongqing Medical University from June 2003 to December 2018 for evaluation of hematuria as the main manifestation were collected, the significant differences in these clinical indicators were analyzed, and a BP neural network model for predicting renal pathology in children with hematuria as the main manifestation was established.Results:A total of 438 cases were enrolled in this study, including 232 males and 206 females, with the onset age of (7.00±3.15) years old.According to different clinical manifestations, the children were divided into microscopic hematuria group(179 cases), gross hematuria group(81 cases), microscopic hematuria and proteinuria group (44 cases), and gross hematuria and proteinuria group(134 cases). There were significant differences in sex ratio, onset age, course of disease, inducement, Addis count of urinary red cells, 24-hour proteinuria, blood urea nitrogen, serum creatinine, serum albumin and serum IgA levels among different clinical manifestations (all P< 0.05). Pathological grouping indicated that there were significant differences in sex ratio, onset age, course of disease, family history, Addis count of urinary red cells, 24-hour proteinuria, blood urea nitrogen, serum creatinine, serum albumin, serum IgA and C 3 levels among different pathological groups (all P< 0.05). The BP neural network prediction model was then constructed based on the above indicators, and the accuracy of the prediction model was measured to be 61.19% by using the leave one out method. Conclusions:By comparing the differences of various indicators under different clinical manifestations and pathological types, a BP neural network prediction model for renal pathology in children with hematuria as the main manifestation is established.The model can accurately predict renal pathology with the help of related indicators, and provides a basis for determining the time of kidney biopsy.

Objective To explore the feeling of parents of children with strabismus. Methods A semi-structured interview was conducted among 20 parents of children with strabismus. The data were analyzed based on Colaizzi phenomenotogical research methods. Result The parents' feeling was classified into 4 themes:negative emotional experience, parent-child relationship disorder, social communication disorders, and lack of support system. Conclusion According to the parents' real experience and feelings, medical staffs should pay attention to parents' psychological conditions, giving them necessary knowledge and psychological nursing so as to reduce the parents' psychological tension, improve the quality of life and promote the recovery after surgery.