Objective:To investigate the differences in clinical characteristics and antibiotic resistance of neonatal sepsis（NS）caused by different Gram-staining pathogens.Methods:A retrospective study was conducted on confirmed NS cases admitted to the Neonatal Ward of the Pediatric Department at The First Affiliated Hospital of Dali University，from June 1，2014，to May 31，2024.Patients were divided into Gram-positive and Gram-negative groups based on blood or cerebrospinal fluid（CSF）culture results.Clinical characteristics，pathogen distribution，and antibiotic resistance were compared between the two groups.Results:A total of 98 cases were included，with 81 in the Gram-positive group and 17 in the Gram-negative group.Multivariate logistic regression analysis revealed that NS cases with a high neutrophil percentage（ OR=0.933，95% CI：0.899-0.969）or hemorrhagic symptoms/signs（ OR=0.059，95% CI：0.008-0.458）were less likely to have Gram-positive pathogens detected in blood or CSF cultures（ P<0.05）.Common Gram-positive pathogens included Staphylococcus epidermidis with 35 strains（33.65%）and Staphylococcus hominis with 22 strains（21.15%）.The predominant Gram-negative pathogen was Escherichia coli with 14 strains（13.46%）.Gram-positive pathogens exhibited high resistance to oxacillin（91.30%），erythromycin（90.91%），and penicillin G（90.00%），but low resistance to tigecycline（0），linezolid（0），and vancomycin（0）.Gram-negative pathogens showed high resistance to ampicillin（92.31%），cefazolin（90.00%），and ampicillin/sulbactam（75.00%），but low resistance to amikacin（6.25%），latamoxef（0），and ertapenem（0）.The incidence of concurrent purulent meningitis was lower in the Gram-positive group than in the Gram-negative group（9.88% vs.47.06%， χ2=11.628， P<0.05），and there was significant difference. Conclusion:NS cases with high neutrophil percentages or hemorrhagic symptoms/signs are less likely to be caused by Gram-positive pathogens.Staphylococcus epidermidis and Staphylococcus hominis are common Gram-positive pathogens，while Escherichia coli is the predominant Gram-negative pathogen in NS.Both Gram-positive and Gram-negative pathogens exhibit resistance to specific antibiotics.NS caused by Gram-positive pathogens is less likely to be complicated by purulent meningitis compared to those caused by Gram-negative pathogens.

Chronic limb-threatening ischemia(CLTI)is a serious peripheral arterial disease(PAD)characterized by reduced blood flow in the limbs,resulting in tissue damage and dysfunction.Mesenchymal stem cells(MSCs)have become a research hotspot in the field of CLTI treatment in recent years due to their unique regenerative ability and immunomodulatory properties.In the environment of hypoxia and tissue injury,MSCs can promote angiogenesis,reduce inflammation and promote tissue repair by secreting cytokines,cell differentiation and inter-cellular signal transduction,so as to improve the symptoms and prognosis of patients with CLTI,showing a broad clinical application prospect.

Objective:To investigate whether circular RNA VMA21(circVMA21)targeting miR-497-5p/mucin1(MUC1)affecting the expressions of inflammatory factors and apoptosis in lung epithelial cells induced by LPS.Methods:A549 lung epithelial cells were divided into Con group(control),LPS group(LPS injury),LPS+pcDNA group,LPS+pcDNA-circVMA21 group,LPS+anti-miR-NC group,LPS+anti-miR-497-5p group,LPS+pcDNA-circVMA21+miR-NC group,LPS+pcDNA-circVMA21+miR-497-5p group.Expressions of circVMA21 and miR-497-5p were measured by qRT-PCR,expressions of inflammatory factors IL-6,IL-1β and TNF-α were determined by ELISA,flow cytometry was used to monitor cell apoptosis,and Western blot was employed to assay expres-sions of MUC1,TLR4/NF-κB pathway and apoptosis-related activation-cleaved-caspase3 and cleaved-caspase9 protein.The targeting relationships between circVMA21 and miR-497-5p,miR-497-5p and MUC1 were determined by dual luciferase reporter assay.Results:Compared with Con group,expressions of circVMA21 and MUC1 in lung epithelial cells of LPS group were decreased,while expression levels of miR-497-5p,IL-6,IL-1β and TNF-α,apoptosis rate,expressions of apoptotic proteins cleaved-caspase3 and cleaved-caspase9,and TLR4,p-NF-κB p65/NF-κB p65 were increased(P<0.05).Compared with LPS+pcDNA group,expressions of circVMA21 and MUC1 in lung epithelial cells of LPS+pcDNA-circVMA21 group were increased,while expression levels of IL-6,IL-1β and TNF-α,apoptosis rate,expressions of cleaved-caspase3 and cleaved-caspase9,and TLR4,p-NF-κB p65/NF-κB p65 were decreased(P<0.05).circVMA21 was targeted regulating the expression of miR-497-5p.Compared with LPS+anti-miR-NC group,ex-pressions of MUC1 in lung epithelial cells of LPS+anti-miR-497-5p group was increased,while expression levels of IL-6,IL-1β,TNF-α,apoptosis rate,protein cleaved-caspase3 and cleaved-caspase9,and TLR4,p-NF-κB p65/NF-κB p65 were decreased(P<0.05).miR-497-5p was targeted regulating the expression of MUC1.Compared with LPS+pcDNA-circVMA21+miR-NC group,expression of MUC1 in lung epithelial cells of LPS+pcDNA-circVMA21+miR-497-5p group was decreased,while expression levels of IL-6,IL-1β,TNF-α,apoptosis rate,expressions of cleaved-caspase3 and cleaved-caspase9,and TLR4,p-NF-κB p65/NF-κB p65 were increased(P<0.05).Conclusion:circVMA21 may promote expression of MUC1 and inhibit activation of TLR-4/NF-κB pathway by down-regu-lating miR-497-5p,thereby reducing expressions of inflammatory factors and apoptosis of lung epithelial cells induced by LPS.

Objective:To investigate whether circular RNA VMA21(circVMA21)targeting miR-497-5p/mucin1(MUC1)affecting the expressions of inflammatory factors and apoptosis in lung epithelial cells induced by LPS.Methods:A549 lung epithelial cells were divided into Con group(control),LPS group(LPS injury),LPS+pcDNA group,LPS+pcDNA-circVMA21 group,LPS+anti-miR-NC group,LPS+anti-miR-497-5p group,LPS+pcDNA-circVMA21+miR-NC group,LPS+pcDNA-circVMA21+miR-497-5p group.Expressions of circVMA21 and miR-497-5p were measured by qRT-PCR,expressions of inflammatory factors IL-6,IL-1β and TNF-α were determined by ELISA,flow cytometry was used to monitor cell apoptosis,and Western blot was employed to assay expres-sions of MUC1,TLR4/NF-κB pathway and apoptosis-related activation-cleaved-caspase3 and cleaved-caspase9 protein.The targeting relationships between circVMA21 and miR-497-5p,miR-497-5p and MUC1 were determined by dual luciferase reporter assay.Results:Compared with Con group,expressions of circVMA21 and MUC1 in lung epithelial cells of LPS group were decreased,while expression levels of miR-497-5p,IL-6,IL-1β and TNF-α,apoptosis rate,expressions of apoptotic proteins cleaved-caspase3 and cleaved-caspase9,and TLR4,p-NF-κB p65/NF-κB p65 were increased(P<0.05).Compared with LPS+pcDNA group,expressions of circVMA21 and MUC1 in lung epithelial cells of LPS+pcDNA-circVMA21 group were increased,while expression levels of IL-6,IL-1β and TNF-α,apoptosis rate,expressions of cleaved-caspase3 and cleaved-caspase9,and TLR4,p-NF-κB p65/NF-κB p65 were decreased(P<0.05).circVMA21 was targeted regulating the expression of miR-497-5p.Compared with LPS+anti-miR-NC group,ex-pressions of MUC1 in lung epithelial cells of LPS+anti-miR-497-5p group was increased,while expression levels of IL-6,IL-1β,TNF-α,apoptosis rate,protein cleaved-caspase3 and cleaved-caspase9,and TLR4,p-NF-κB p65/NF-κB p65 were decreased(P<0.05).miR-497-5p was targeted regulating the expression of MUC1.Compared with LPS+pcDNA-circVMA21+miR-NC group,expression of MUC1 in lung epithelial cells of LPS+pcDNA-circVMA21+miR-497-5p group was decreased,while expression levels of IL-6,IL-1β,TNF-α,apoptosis rate,expressions of cleaved-caspase3 and cleaved-caspase9,and TLR4,p-NF-κB p65/NF-κB p65 were increased(P<0.05).Conclusion:circVMA21 may promote expression of MUC1 and inhibit activation of TLR-4/NF-κB pathway by down-regu-lating miR-497-5p,thereby reducing expressions of inflammatory factors and apoptosis of lung epithelial cells induced by LPS.

Periodontitis is a widespread disease worldwide, with the primary cause of tissue loss being an immune inflammatory response mediated by bacteria. Increasing evidence has revealed a significant correlation between mitochondrial dysfunction and the occurrence and progression of periodontitis. This paper provides a review of current research on the role of mitochondrial dysfunction in the occurrence and development of periodontitis and related therapies from the perspectives of oxidative stress, inflammatory responses, and the regulation of mitochondrial homeostasis. Mitochondria are the main source and target of cellular reactive oxygen species. Mitochondrial dysfunction can generate large amounts of reactive oxygen species, exacerbating local oxidative stress in periodontal tissues and causing cell toxicity and tissue damage. Mitochondria are also the center of cellular inflammatory responses, and the positive feedback loop of inflammation induced by mitochondrial dysfunction may explain the persistent and unresolved nature of periodontitis. Biomaterials loaded with pharmacological agents show potential in restoring mitochondrial function, controlling the development of periodontitis, and promoting periodontal tissue regeneration. However, the key sites of mitochondrial dysfunction in the occurrence and development of periodontitis are not yet fully understood, and the improvement of mitochondrial function in periodontal therapy is still in the experimental stage. Future research efforts should focus on the effect of mitochondrial dysfunction on periodontal cells and explore its specific mechanism in the occurrence and progression of periodontitis in order to provide new insights into the treatment of periodontitis.

An epidemiological investigation was carried out on a local cluster of outbreak caused by imported cases of Coronavirus Disease 2019 (COVID-19) in rural areas of Chengdu in December 2020, to find out the source of infection and the chain of transmission. According to
COVID-19 ; Disease Outbreaks ; Epidemics ; Humans ; Quarantine ; SARS-CoV-2

Objective:To analyze the viral nucleic acid and cytokines in 12 children with 2019-nCoV infection.Methods:Clinical and laboratory data of the children diagnosed with 2019-nCoV infection in Guangzhou Women and Children′s Medical Center from January to April 2020 were retrospectively analyzed. Throat and anal swabs were collected on alternate days for the detection of 2019-nCoV nucleic acid by fluorescence quantitative PCR. Flow cytometry was used to detect serum cytokines including IFN-γ, IL-1β, IL-2, IL-4, IL-5, IL-6, IL-8, IL-10, IL-12p70, IL-17A, IL-17F, IL-22, TNF-α and TNF-β during the early (both throat and anal swab tests were positive), the intermediate (throat swab test was negative, while anal swab test remained positive), and the convalescence (both throat and anal swab tests were negative) stages of infection.Results:A total of 12 children were enrolled in this study. The male-to-female ratio was 5∶1. The average age was (7.0±4.3) years. There were two asymptomatic, five mild and five common cases. No severe or critical cases were involved. Initially, throat and anal swab nucleic acid tests were simultaneously positive in nine children newly diagnosed in our hospital and the median time of viral shedding in throat swab was longer than that in throat swab [32 (4.5, 45.0) d vs 3 (2, 9) d, Z=11.0, P=0.010]. The median difference of viral shedding time between anal swab and pharyngeal swab was 25.5 (1.5, 42.8) d. The overall levels of serum cytokines IL-17A, IL -4 and IL-5 in different stages of the disease (early, intermediate and convalescence stage) were statistically different ( Z or F, P values were 8.33, 0.016; 5.36, 0.010 and 6.56, 0.004, respectively), and a significant increase was observed in the intermediate stage of infection. IL-17F, IL-2 and IL-22 were all increased during the infection, but there was no significant statistical difference among the three stages ( P>0.05). Conclusions:It was noted that intestinal viral shedding needed a longer time. Although the infectivity has not been determined, higher requirements have been put forward for disease prevention and control. Cytokines secreted by Th2 and Th17 cells were involved in the immune response in children with non-severe 2019-nCoV infection. Monitoring viral shedding and cytokine changes in pediatric patients would be conducive to disease assessment.

Objective: To investigate the clinical manifestations, diagnosis, and treatment of H1N1 influenza A-associated encephalopathy (IAE) in children. Methods: The clinical manifestations, laboratory tests, cranial magnetic resonance imaging (MRI), electroencephalography (EEG) examinations and treatments of seven children with H1N1 IAE hospitalized in Guangzhou Women and Children′s Medical Center from December 2018 to January 2019 were retrospectively analyzed. Results: Five of the seven children with H1N1 IAE were female. The age at admission was 4 years and 5 months (range 7 months-9 years). Neurological symptoms occurred simultaneously or early (0-3 days) after the flu-like symptom appeared. The main clinical manifestations of neurological symptoms were seizures (repeated seizures in five cases and status convulsion in two cases, including one case of unexpected fever and repeated seizures in a nine-year old girl) accompanied with altered consciousness (drowsiness in five cases and coma in two cases). Cranial MRI in three cases displayed multifocal lesions, mainly in the bilateral thalamus, brainstem and cerebellar hemisphere. MRI also showed reversible splenial lesion in the corpus callusumin in three cases. EEG tracings were characterized by diffuse slow wave activity in four cases, and status epilepticus was monitored in one case. All the 7 cases were treated with oral oseltamivir. Three cases were treated with pulsed methylprednisolone and intravenous immunoglobulin. One case was treated with intravenous immunoglobulin alone and all the patients received oral oseltamivir. All the patients survived, with three patients had minor neurological sequelae at discharge. Conclusions The main clinical manifestations of H1N1 IAE are seizures and altered consciousness. Cranial MRI combined with EEG is helpful for early diagnosis. Intravenous immunoglobulin and (or) methylprednisolone should be considered for severe cases.

Objective To investigate the clinical manifestations, diagnosis, and treatment of H1N1 influenza A‐associated encephalopathy (IAE) in children. Methods The clinical manifestations, laboratory tests, cranial magnetic resonance imaging (MRI), electroencephalography (EEG) examinations and treatments of seven children with H1N1 IAE hospitalized in Guangzhou Women and Children′s Medical Center from December 2018 to January 2019 were retrospectively analyzed. Results Five of the seven children with H1N1 IAE were female. The age at admission was 4 years and 5 months (range 7 months-9 years). Neurological symptoms occurred simultaneously or early (0-3 days) after the flu‐like symptom appeared. The main clinical manifestations of neurological symptoms were seizures (repeated seizures in five cases and status convulsion in two cases, including one case of unexpected fever and repeated seizures in a nine‐year old girl) accompanied with altered consciousness (drowsiness in five cases and coma in two cases). Cranial MRI in three cases displayed multifocal lesions, mainly in the bilateral thalamus, brainstem and cerebellar hemisphere. MRI also showed reversible splenial lesion in the corpus callusumin in three cases. EEG tracings were characterized by diffuse slow wave activity in four cases, and status epilepticus was monitored in one case. All the 7 cases were treated with oral oseltamivir. Three cases were treated with pulsed methylprednisolone and intravenous immunoglobulin. One case was treated with intravenous immunoglobulin alone and all the patients received oral oseltamivir. All the patients survived, with three patients had minor neurological sequelae at discharge. Conclusions The main clinical manifestations of H1N1 IAE are seizures and altered consciousness. Cranial MRI combined with EEG is helpful for early diagnosis. Intravenous immunoglobulin and (or) methylprednisolone should be considered for severe cases.

Objective: To explore the influences of comprehensive nursing intervention on the caregivers of severely burned children. Methods: Eighty severely burned children, admitted to our department from November 2016 to November 2017 and conforming to the study criteria, were included in this study. They were divided into comprehensive group and control group according to the random number table, with 40 children in each group. One caregiver for each child was included in the same group. Children and caregivers in control group had routine nursing care while children and caregivers in comprehensive group had comprehensive nursing care on the base of routine nursing care, including comprehensive psychological nursing of children and caregivers, guidance of rehabilitation for caregivers throughout the entire recovery process, individualized propaganda and education for caregivers on account of disease of children, perfecting social support system, sustained attention of children during follow-up. Anxiety self-rating scale and social support rating scale were used to assess the levels of anxiety and social support of caregivers of children in the two groups at the time of admission (before intervention) and the second month after discharge (the third time follow-up, after intervention). On the day of discharge, the nursing service satisfaction questionnaire of our department was used to evaluate the nursing service satisfaction of caregivers of children. Data were processed with chi-square test and independent sample t test. Results: (1) Before intervention, the anxiety and social support scores of caregivers of children in control group were respectively (64.5±3.8) and (40.4±2.5) points, similar to (63.5±4.9) and (40.5±2.6) points in comprehensive group (t=0.988, 0.177, P>0.05). After intervention, the anxiety score [(47.2±1.9) points] of caregivers of children in comprehensive group was significantly lower than that of control group [(57.6±4.3) points, t=13.917, P<0.01], and the social support score [(45.3±1.9) points] was significantly higher than (35.9±2.1) points in control group (t=-21.282, P<0.01). After intervention, scores of objective support, subjective support, and social support utilization in the social support evaluation rating of caregivers of children in comprehensive group were significantly higher than those in control group (t=12.678, -11.079, -10.031, P<0.01). (2) At the time of discharge, scores of clinical care, propaganda and education content and form in the nursing service satisfaction questionnaire of caregivers of children in comprehensive group were significantly higher than those of control group (t=-14.757, -15.627, -33.221, P<0.01). Conclusions Comprehensive nursing intervention method can effectively reduce the anxiety of the caregivers of severely burned children, help them to make better use of social support system, and improve the satisfaction of caregivers in nursing services.