OBJECTIVE: To construct and validate a prognostic prediction model for children with sepsis using the Phoenix sepsis score (PSS). METHODS: A retrospective case series study was conducted to collect clinical data of children with sepsis admitted to the pediatric intensive care unit (PICU) of the Affiliated Hospital of Guizhou Medical University from January 2022 to April 2024. The data included general information, the worst values of laboratory indicators within the first 24 hours of PICU admission, PSS score, pediatric critical illness score (PCIS), and the survival status of the children within 30 days of admission. The statistically significant indicators in univariate Logistic regression analysis were included in multivariate Logistic regression analysis to screen the risk factors affecting the prognosis of children with sepsis and construct a nomogram model. The receiver operator characteristic curve (ROC curve) was drawn to evaluate the predictive performance of the model. The Bootstrap method was used to perform 1 000 repeated sampling internal verification and draw the calibration curve of the model. RESULTS: A total of 199 children with sepsis were included, of which 32 died and 167 survived 30 days after admission. In the univariate Logistic regression analysis, shock, white blood cell count (WBC), international normalized ratio (INR), lactic acid (Lac), PSS score, and PCIS score were identified as statistically significant predictors. These variables were then included in the multivariate Logistic regression analysis, which demonstrated that shock [odds ratio (OR) = 4.258, 95% confidence interval (95%CI) was 1.049-17.288], WBC (OR = 1.124, 95%CI was 1.052-1.210), and PSS score (OR = 1.977, 95%CI was 1.298-3.012) were independent risk factors for mortality in pediatric patients with sepsis (all P < 0.05). A nomogram model was constructed based on these three risk factors, with the model equation as follows: -4.809+1.449×shock+0.682×PSS score+0.117×WBC. The calibration curve results showed that the model's predictions were highly consistent with the actual observations. The ROC curve showed that when the Youden index of the prediction model was 0.792, the sensitivity and specificity were 90.6% and 88.6%, respectively, and the area under the curve (AUC) was 0.957 (95%CI was 0.930-0.984), which was higher than the AUC of shock, WBC, and PSS score alone (0.808, 0.667, 0.908, respectively). CONCLUSIONS Shock, WBC, and PSS score have demonstrated certain predictive value for mortality in children with sepsis. The nomogram model based on the above indicators has important clinical significance for evaluating the prognosis and guiding treatment of children with sepsis.
Humans ; Sepsis/diagnosis* ; Prognosis ; Retrospective Studies ; Logistic Models ; Intensive Care Units, Pediatric ; Nomograms ; Child ; ROC Curve ; Risk Factors ; Male ; Female ; Child, Preschool ; Infant

OBJECTIVE To explore the medication rule and potential mechanism of anti-aging traditional Chinese medicine health care prescription by using data mining,network pharmacology and molecular docking technology.METHODS By searching the special food information query platform of the State Administration for Market Regulation and Yaozhi.com,the health care prescrip-tions with traditional Chinese medicine as the main component and anti-aging effect were searched.The data mining technology was used to analyze the prescription rules,and the core anti-aging traditional Chinese medicine was selected according to the analysis re-sults.The chemical constituents and corresponding targets of core anti-aging traditional Chinese medicines were obtained by searching TCMSP and other databases;potential targets related to aging from GeneCards and OMIM databases were screened;the intersection tar-gets of core Chinese medicine and aging were obtained.Subsequently,protein-protein interaction(PPI)network analysis,gene ontolo-gy(GO)and Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway enrichment analysis were performed using STRING database and Cytoscape 3.7.2 software.Finally,the affinity of core targets and key components was verified by molecular docking technology.RESULTS A total of 244 kinds of anti-aging traditional Chinese medicine health care prescriptions were screened and included.The prescription drugs were mainly tonic drugs,the drug properties were mostly warm and mild,the drug taste was mainly sweet,the drugs were mainly distributed in the five zang organs,with the kidney meridian being the first target.According to the re-sults of comprehensive data analysis,five core Chinese medicines(Wolfberry,ginseng,American ginseng,Astragalus,Poria)were screened out.A total of 105 active ingredients(corresponding to 219 target genes),1 568 aging-related potential targets,and 137 in-tersection targets were obtained.According to the degree value,12 core targets were screened out,mainly involving cancer pathways,lipids and atherosclerosis,AGE-RAGE and other signaling pathways.The results of molecular docking showed that the key anti-aging components could spontaneously and stably bind to the core targets.CONCLUSION Through data mining,network pharmacology and molecular docking,the prescription rules of anti-aging Chinese medicine health care prescriptions are analyzed,and the anti-ag-ing potential targets and mechanism pathways of five core traditional Chinese medicines are preliminarily revealed,so as to provide ref-erence and theoretical basis for delaying aging and preventing and treating related diseases in the elderly.

OBJECTIVE To explore the medication rule and potential mechanism of anti-aging traditional Chinese medicine health care prescription by using data mining,network pharmacology and molecular docking technology.METHODS By searching the special food information query platform of the State Administration for Market Regulation and Yaozhi.com,the health care prescrip-tions with traditional Chinese medicine as the main component and anti-aging effect were searched.The data mining technology was used to analyze the prescription rules,and the core anti-aging traditional Chinese medicine was selected according to the analysis re-sults.The chemical constituents and corresponding targets of core anti-aging traditional Chinese medicines were obtained by searching TCMSP and other databases;potential targets related to aging from GeneCards and OMIM databases were screened;the intersection tar-gets of core Chinese medicine and aging were obtained.Subsequently,protein-protein interaction(PPI)network analysis,gene ontolo-gy(GO)and Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway enrichment analysis were performed using STRING database and Cytoscape 3.7.2 software.Finally,the affinity of core targets and key components was verified by molecular docking technology.RESULTS A total of 244 kinds of anti-aging traditional Chinese medicine health care prescriptions were screened and included.The prescription drugs were mainly tonic drugs,the drug properties were mostly warm and mild,the drug taste was mainly sweet,the drugs were mainly distributed in the five zang organs,with the kidney meridian being the first target.According to the re-sults of comprehensive data analysis,five core Chinese medicines(Wolfberry,ginseng,American ginseng,Astragalus,Poria)were screened out.A total of 105 active ingredients(corresponding to 219 target genes),1 568 aging-related potential targets,and 137 in-tersection targets were obtained.According to the degree value,12 core targets were screened out,mainly involving cancer pathways,lipids and atherosclerosis,AGE-RAGE and other signaling pathways.The results of molecular docking showed that the key anti-aging components could spontaneously and stably bind to the core targets.CONCLUSION Through data mining,network pharmacology and molecular docking,the prescription rules of anti-aging Chinese medicine health care prescriptions are analyzed,and the anti-ag-ing potential targets and mechanism pathways of five core traditional Chinese medicines are preliminarily revealed,so as to provide ref-erence and theoretical basis for delaying aging and preventing and treating related diseases in the elderly.

Objective:To explore the lung protective effect of nebulized inhalation of lidocaine (NL) on elderly patients undergoing hip fracture surgery.Methods:A prospective study was conducted on 80 elderly patients who underwent hip fracture surgery at the Huizhou Sixth People′s Hospital from September 2020 to December 2021. They were randomly divided into an NL group and a control group with 40 patients in each group. Within 30 minutes before the start of anesthesia, the NL group was given 2% lidocaine 10 ml oxygen driven nebulization inhalation, while the control group was given equal volume sterile injection water nebulization inhalation. All patients underwent general anesthesia with laryngeal mask intubation and iliac fascia space block. A randomized, double-blind, and controlled clinical study was conducted. The average values of intraoperative peak airway pressure (P peak), plateau airway pressure (P plat), and lung dynamic compliance (C dyn) were compared between two groups of patients; We compared the changes in arterial partial pressure of CO 2 (PaCO 2), alveolar arterial oxygen differential pressure (A-aDO 2), respiratory index (RI), and oxygen index (OI) between the two groups of patients and before and after surgery; The clinical pulmonary infection score (CPIS) and lung ultrasound score (LUS) were also compared between two groups of patients on the first day before surgery, the second day after surgery, and the seventh day after surgery. Resultsl:There was no statistically significant difference in the average values of P peak, P plat, and C dyn between the two groups during surgery (all P>0.05). After surgery, A-aDO 2 and RI in both groups increased compared to before surgery, while OI decreased compared to before surgery (all P<0.05); After surgery, A-aDO 2 and RI in the NL group decreased compared to the control group, while OI increased compared to the control group (all P<0.05); There was no statistically significant difference in PaCO 2 between the two groups before and after skin incision (all P>0.05). Compared with the 1st day before surgery, the CPIS and LUS in both groups were significantly increased on the 2nd and 7th day after surgery (all P<0.05); Compared with the second day after surgery, the CPIS and LUS of both groups of patients were significantly reduced on the seventh day after surgery (all P<0.05); On the second day after surgery, the CPIS and LUS in the NL group were significantly lower than those in the control group (all P<0.05); On the 7th day after surgery, the LUS of the NL group was significantly lower than that of the control group ( P<0.05); There was no statistically significant difference in CPIS scores between the two groups ( P>0.05). Conclusions:Nebulized inhalation of lidocaine can reduce lung function damage in elderly patients undergoing hip fracture surgery, and has a certain lung protective effect.

4,6-α-glucosyltransferases (4,6-α-GTs), which converts amylose into α(1-6) bonds-containing α-glucan, possesses great application potential in enzymatic synthesis of dietary fiber. Primers were designed according to the conserved motifs existing in the amino acid sequence of 4,6-α-GTs, and used to amplify a putative GTFB-Like 4,6-α-GTs gene (named as gtf16) from the genomic DNA of Lactobacillus. The gtf16 gene was cloned into the plasmid pET15b, expressed in Escherichia coli BL21(DE3), followed by purification and characterization. The optimum pH and the optimum temperature of the purified enzyme were 5.0 and 40 °C, respectively. The biotransformation product of this enzyme was systematically characterized by thin-layer chromatography, NMR spectroscopy, and hydrolysis reaction. The Gtf16-catalyzed product shows a similar structure to that of the isomalto/malto-polysaccharide (IMMP), which is the amylose-derived product catalyzed by GtfB from Lactobacillus reuteri 121. Moreover, The Gtf16-catalyzed product contains up to 75% of α(1-6) bonds and has an average molecular weight of 23 793 Da. Furthermore, the content of the anti-digestive components was 88.22% upon hydrolysis with digestive enzymes.
Bacterial Proteins/genetics* ; Glucans ; Glucosyltransferases/genetics* ; Lactobacillus fermentum/enzymology*

Objective To evaluate the treatment effects of middle and proximal phalangeal fractures with lateral fixation of mini-titanium plate.Methods From December 2011 to April 2015,56 patients (64 phalanges) suffered from closed middle and proximal phalangeal fractures were treated with lateral fixation of mini-titanium plate.There were 48 males and 8 females,aged from 17 to 65 years (average,36.3 years).Fractures included 25 cases of middle phalangeal fracture and 39 cases of proximal phalangeal fracture.According to site of fracture,12 cases were middle phalangeal condyle fractur,7 cases were middle phalangeal shaft fracture,6 cases were middle phalangeal base fracture,10 cases were proximal phalangeal condyle fracture,22 cases were proximal phalangeaal shaft fracture and 7 cases were proximal phalangeal base fracture.According to the type of fracture,13 cases were transverse,9 cases were short oblique,11 cases were long oblique,6 cases were spiral and 25 cases were comminuted fracture.All phalangeal fractures were exposed by lateral approach,in which the lateral band and oblique fibers of proximal phalanx were excised to fully expose proximal phalangeal fracture.After the reduction,the fractures were fixed with mini-titanium plate laterally.The Disabilities of the Arm,Shoulder and Hand (DASH)and the bilateral fingers total active motion (TAM) were employed to evaluate the functions.All patients took X ray during follow-up.Results All 56 patients were followed up from 9 to 47 months,average (14 ± 6) months.Phalangeal fractures were healed from 7 to 14 weeks,average (8.8 ± 2.4) weeks without loss of fixation or malunion.At final follow-up,DASH score were from 1.7 to 7.5,with an average of 4.8 ± 2.2.TAM of the fingers was excellent (＞ 90％ TAM of the contralateral side) in 33/64 (51.5％) cases,good (75％-90％ TAM of the contralateral side) in 30/64 (46.9％) cas es,fair (50％-75％ TAM of the contralateral side) 1/64 (1.6％) cases.Conclusion Lateral approach fully exposes middle and proximal phalangeal fractures and less interferes with the extensor mechanism.Lateral fixation with mini-titanium plate could provide stability and allow early motion.This technique may be an optional choice in clinical practice.