Objective:To understand the management of children with pediatric acute liver failure (PALF) in pediatric intensive care unit (PICU).Methods:A retrospective case-control study was conducted. A total of 101 children with PALF hospitalized in PICU of Beijing Children′s Hospital from July 2017 to October 2022 were included. Demographic, clinical management and prognosis data were collected. According to whether PALF was the main diagnosis, the patients were divided into primary diagnosis group and complication group. The primary diagnosis group was subdivided into effective group and ineffective group with routine treatment (except liver transplantation). The intergroup comparisons were performed using independent samples t-test, Mann-Whitney U test, χ2 test or Fisher exact test. Multivariate Logistic regression analysis was employed to identify risk factors associated with prognosis. Results:Among the 101 children with PALF, 58 were male and 43 were female, with an age of 30 (10, 103) months, 60 cases in primary diagnosis group and 41 cases in complication group. There were no significant differences in prothrombin time (PT) and international normalized ratio (INR) between the two groups (both P>0.05), while the total bilirubin, direct bilirubin and blood ammonia were all significantly higher in the primary diagnosis group (all P<0.05). Unoriginal liver failure (25 cases (42%)) and poisoning (13 cases (22%)) were the most common causes of PALF in the primary diagnosis group, while shock (17 cases, 43%) and hemophagocytic syndrome (14 cases (34%)) in the complication group. The mortality rate of the main diagnosis group was significantly lower than that of the complication group (25% (15/60) vs. 61% (25/41), χ2=13.18, P<0.001), as well as the incidence of combined organ function injury, while the amount of plasma used and the ratio of plasma exchange times to PICU hospitalization days were significantly higher (all P<0.05). In the primary diagnosis group, there were 32 cases (53%) in the effective group and 28 cases (47%) in the ineffective group. In the ineffective group, 15 cases (54%) died and 13 cases (46%) were transferred to another site for liver transplantation assessment. The hospitalization time of PICU in the effective group was significantly longer than that in the ineffective group, while the ratio of plasma exchange times to PICU hospitalization days, the average daily hours of continuous renal replacement therapy (CRRT), the rate of CRRT and the average daily plasma dosage in the effective group were all significantly lower than those in the ineffective group (all P<0.05). The worst PT, INR and blood ammonia, and the stage 4 hepatic encephalopathy morbidity and significant bleeding rate in the effective group were all significantly lower than those in the ineffective group (all P<0.05). Multivariate Logistic regression analysis showed that after adjusting for age, sex, total bilirubin, INR and blood ammonia, stage 4 hepatic encephalopathy was the independent risk factor for the failure of routine treatment of PALF ( OR=84.16,95% CI 4.04-1752.37, P=0.004). Conclusions:PT and INR could not specifically represent liver synthetic function in some PICU patients, so current PALF diagnostic criteria for PICU children has limitations. Complicated with stage 4 hepatic encephalopathy was an independent risk factor of the failure of conventional treatment in patients with PALF.

Objective:To understand the management of children with pediatric acute liver failure (PALF) in pediatric intensive care unit (PICU).Methods:A retrospective case-control study was conducted. A total of 101 children with PALF hospitalized in PICU of Beijing Children′s Hospital from July 2017 to October 2022 were included. Demographic, clinical management and prognosis data were collected. According to whether PALF was the main diagnosis, the patients were divided into primary diagnosis group and complication group. The primary diagnosis group was subdivided into effective group and ineffective group with routine treatment (except liver transplantation). The intergroup comparisons were performed using independent samples t-test, Mann-Whitney U test, χ2 test or Fisher exact test. Multivariate Logistic regression analysis was employed to identify risk factors associated with prognosis. Results:Among the 101 children with PALF, 58 were male and 43 were female, with an age of 30 (10, 103) months, 60 cases in primary diagnosis group and 41 cases in complication group. There were no significant differences in prothrombin time (PT) and international normalized ratio (INR) between the two groups (both P>0.05), while the total bilirubin, direct bilirubin and blood ammonia were all significantly higher in the primary diagnosis group (all P<0.05). Unoriginal liver failure (25 cases (42%)) and poisoning (13 cases (22%)) were the most common causes of PALF in the primary diagnosis group, while shock (17 cases, 43%) and hemophagocytic syndrome (14 cases (34%)) in the complication group. The mortality rate of the main diagnosis group was significantly lower than that of the complication group (25% (15/60) vs. 61% (25/41), χ2=13.18, P<0.001), as well as the incidence of combined organ function injury, while the amount of plasma used and the ratio of plasma exchange times to PICU hospitalization days were significantly higher (all P<0.05). In the primary diagnosis group, there were 32 cases (53%) in the effective group and 28 cases (47%) in the ineffective group. In the ineffective group, 15 cases (54%) died and 13 cases (46%) were transferred to another site for liver transplantation assessment. The hospitalization time of PICU in the effective group was significantly longer than that in the ineffective group, while the ratio of plasma exchange times to PICU hospitalization days, the average daily hours of continuous renal replacement therapy (CRRT), the rate of CRRT and the average daily plasma dosage in the effective group were all significantly lower than those in the ineffective group (all P<0.05). The worst PT, INR and blood ammonia, and the stage 4 hepatic encephalopathy morbidity and significant bleeding rate in the effective group were all significantly lower than those in the ineffective group (all P<0.05). Multivariate Logistic regression analysis showed that after adjusting for age, sex, total bilirubin, INR and blood ammonia, stage 4 hepatic encephalopathy was the independent risk factor for the failure of routine treatment of PALF ( OR=84.16,95% CI 4.04-1752.37, P=0.004). Conclusions:PT and INR could not specifically represent liver synthetic function in some PICU patients, so current PALF diagnostic criteria for PICU children has limitations. Complicated with stage 4 hepatic encephalopathy was an independent risk factor of the failure of conventional treatment in patients with PALF.

Objective To investigate the targeting of transforming growth factor β1(TGF-β1)expression by Ran-binding protein 9(RANBP9)and its effect on colorectal cancer Colo320 cell apoptosis.Methods Gene expression levels of RANBP9 were analyzed in 625 colon cancer tissues and 20 normal colon tissues in The Cancer Genome Atlas database.The relationship between RANBP9 expression and survival time of patients with colon cancer was analyzed using KMPLOT.The expression of TGF-β1 in normal colon tissues and colon cancer tissues was analyzed using the human protein immunohistochemistry database and the relationship between TGF-β1 expression and the survival of patients with colon cancer was analyzed using the UALCAN database.The relationship between RANBP9 and TGF-β1 was analyzed by dual luciferase experiments.Colo320 cells were transfected with pcDNA3.1-GFP-RANBP9 and control pcDNA3.1-GFP-RANBP9-NC plasmids,respectively,and normal control cells were established without transfection.The cells were cultured and the growth viability of each group of cells was detected by the iazolyl blue tetrazolium bromide method,apoptosis was detected by flow cytometry,the mitochondrial membrane potential was detected by JC-1 staining,and RANBP9 and TGF-β1 protein expression were detected by Western blot.Results RANBP9 expression was significantly reduced in colon cancer tissues.Compared with patients with low RANBP9 expression,patients with high RANBP9 expression had a higher survival curve and significantly higher expression of TGF-β1 in colon cancer tissue.Compared with patients with high TGF-β1 expression,patients with low TGF-β1 expression had a significantly higher survival curve(P＜0.05).RANBP9 targeted the expression of TGF-β1 in colon cancer.Compared with the normal group,cell growth,mitochondrial membrane potential,and TGF-β1 expression were all significantly down-regulated and the apoptosis rate and RANBP9 expression were significantly increased in the experiment group(P＜0.05).Conclusions RANBP9 can target the expression of TGF-β1,promote the growth of Colo320 colon cancer cells,decrease the mitochondrial membrane potential,and induce apoptosis.

Objective:To evaluate the relationship between the Panton-Valentine leukocidin (pvl) strain and clinical characteristics, and to describe the molecular biological characteristics of invasive Staphylococcus aureus ( S. aureus) infected clinical isolates. Methods:The isolates of S. aureus caused by invasive infection were collected in Beijing Children's Hospital Affiliated to Capital Medical University from January 2016 to December 2019, and the clinical data of the corresponding children were collected retrospectively using electronic medical records. Multilocus sequence typing, spa typing and pvl gene were analyzed using the PCR. In addition, the minimum inhibitory concentrations (MIC) of antibiotics of all isolates were detected by the micro-broth dilution method, and the isolates were divided into the pvl+ and pvl- groups according to whether or not the S. aureus isolates carried pvl. The t test and the Mann-Whitney U test were used to compare the clinical symptoms between the pvl+ and pvl- groups. Chi-square test was used to compare the drug susceptibility between the two isolates. Results:A total of 127 cases of invasive S. aureus infection were collected during the study period. The white blood cell count, neutrophil count, and C-reaction protein level in the pvl+ group were significantly higher than those in the pvl- group ( P=0.001, P=0.001, P=0.005). The rate of pvl carrier was 44.9%. Among 57 pvl+ pathogenic strains, 64.9% (37/57) were MRSA. The multidrug resistance rate of pvl- isolates was higher than that of pvl+ isolates (70% vs. 49.12%, P=0.02). Conclusions:In invasive S. aureus infection, pvl+ strain is associated with elevated inflammatory markers in children. the positive rate of pvl is higher in clinical isolates, and the multidrug resistance rate of pvl- S. aureus is higher.

Objective This study aims to evaluate the changes of Cdk5 expression at the time of 3 hours to 10 days after moderate brain injury by blunt force impact in a rat model,and to demonstrate its forensic significance.Methods To establish a rat model of blunt focal brain contusion,and to observe the changes of Cdk5 expression in brain tissue at different timepoints after brain injury by immunohistochemistry and Western blot.Results A low expression level of Cdk5 was observed in the brain tissue of both normal and sham control groups.The expression of Cdk5 increased after 3 and 6 hours,remarkably increased at 12 hours,and reached the maximal level at 24 hours after focal brain injury.The Cdk5 level gradually decreased 3 days,5 days,7 days,and 10 days and reached the normal level 7 and 10 days after the injury,with no statistical difference (P＞0.05) compared with the normal and sham control groups.Conclusion The expression of Cdk5 increased in the peripheral area of contusion tissue after blunt brain injury in rats,showing single peak change,and dropped to normal level with the time extension.The change of Cdk5 expression may provide a new reference index for the prediction of early brain contusion.

Objective: To analyze the performance of the 5 Global Fund Malaria Programmes in China from 2003 to 2013. Methods: All of the proposals, summaries, progress reports, survey reports, Monitoring& Evaluation reports, and performance rating reports of the 5 Global Fund Malaria Programmes in China and the epidemic data of program areas were collected for statistical analysis from 2012 to 2014. Symposiums were held with relevant experts from national and provincial Centers for Disease Control and Prevention, program managers and staffs from national and provincial Global Fund Malaria Programme offices. The completion of the relevant programme indicators (including the general grant information such as program areas, beneficiaries and funding; the implementation of malaria control measures; the performance of malaria control measures; the malaria incidence in the program areas; the prevalence of malaria parasites; and program management and performance evaluation) were analyzed, and the results: of the symposiums were summarized. Results The implementation period of the 5 Global Fund Malaria Programs were as follows: Round 1 from 2003 to 2008, Round 5 from 2006 to 2010, Round 6 from 2007 to 2012, Round 10 from 2012 to 2013, and National Strategy Application (NSA) from 2010 to 2012. Under the support of all the Global Fund Malaria Programs, a total of 11 936 726 fever cases received microscopic tests, 1 485 915 confirmed and suspected malaria cases were treated, 1 579 773 Long Lasting Insecticide-treated Nets were distributed, 3 414 633 regular nets were treated by insecticide, 40 298 284 primary and middle school students received health education on malaria control. Compared with the baseline value, the completion rates of each indicator increased after the implementation of the programs. The growth value ranged from 12.83% to 83.11%, among which the biggest growth was the value of the indicator'Percentage of households with at least one LLIN/ITN in target areas’, and it increased from 9.2% (baseline value of 2006) to 92.31% (value of 2012). The malaria incidence in program areas has dropped significantly year by year, the annual reported malaria incidence in Yunnan and Hainan provinces decreased from 1 950/100 000, 3 850/100 000 in 2002 to 3.31/100 000, 0.15/100 000 in 2012, the P. falciparum malaria incidence in target counties in Hainan province decreased from 90.6/100 000 in 2002 to 0/100 000 in 2012. As from the implementation of NSA grant in 2010 to 2012, the annual reported malaria incidence in 92% of the 75 Type 1 counties was less than 1 per 10 000, 60.00% of Type 1 counties and 98.69% of the 687 Type 2 counties reported zero locally transmitted malaria cases. The Global Fund Secretariat had conducted a total of 37 performance evaluations, of which 9 have been rated as A1, 4 rated as A2, 19 rated as B1 and 5 rated as B1. Conclusions The Global Fund Malaria Program in China has been closely integrated with the goal and task of National Malaria Control Program, reducing malaria burden in target areas, and pushing Chinese malaria control efforts to move from control to elimination.

Objective To study the expression of p35 and p25 in rat after focal cerebral contusion and to provide experimental data for estimating brain injury time. Methods Fifty adult male SD rats were randomly divided into 0 h, 6 h, 12 h, 24 h, 3 d, 5 d, 7 d, 10 d after focal cerebral contusion, control and sham-operated groups (5 rats each group). The focal cerebral contusion rat model was established. The expression of p35 and p25 protein of the damage peripheral zone in brain were detected by HEstain-ing, immunohistochemistry and western blotting at different injury time. Results Alarge number of p35 protein and a small amount of p25 protein were expressed in control group and sham-operated group. After focal cerebral contusion, p35 presented unimodal change with time and p25 presented bimodal changes with time. Conclusion Expression of p35 and p25 showed different regularity with good time correlation, which could help to estimate the brain injury time.

Objective To determine the key interventions transferring from the control to elimination of malaria in China so as to provide the basic information for achieving malaria elimination. Methods Based on the data collected from the document entitled of The National Annual Report on Schistosomiasis,Malaria and Echinococcosis,published by the National Institute of Parasitic Diseases of Chinese Center for Disease Control and Prevention,the malaria incidence and intervention data were se?lected only in the typical endemic provinces during the period of 2004-2010. The correlation between the incidence and interven?tions in the target provinces was analyzed based on the Panel Data Regression Model,and the key interventions were deter?mined. Results Four provinces namely Anhui,Yunnan,Hainan and Henan were targeted with 87.56%of the national malaria figures from 2004 to 2010. When Y was given as vivax malaria incidence,X1 as the log of the number of historical cases receiving radical treatment in the pre?transmission stage(RTPT)(F=14.53,P<0.01,R2=0.72),X2 as the log of risk population receiv?ing RTPR(F=15.90,P<0.01,R2=0.71)and X3 as the number of technicians trained in microscopy(F=11.53,P<0.01,R2=0.61),three space?fixed effect models were established respectively,and X1,X2,as well as X3 had negative effects on Y value. When Y was given as falciparum malaria incidence,X1 as the accumulated technicians trained in microscopy(F=11.06,P<0.01,R2=0.87),X2 as the log of technicians trained in entomology(F=15.28,P<0.01,R2=0.89),two two?way(space and time)fixed effect models were established respectively,and both X1 and X2 had negative effects on Y value. Conclusion RTPT among historical patients and at?risk populations as well as microscopy training influences the variation of vivax malaria inci? dence,while the significant interventions of microscopy training and vector control training indicate that the integrated measures with strengthened capacity in diagnosis and vector control are of importance in the control of falciparum malaria transmission.

To identify the prevalence and the distribution of ticks infected with spotted fever group rickettsiae (SFGR) in Xunke Area of Heilongjiang Province ,China ,partial outer membrane protein A gene (ompA) and citrate synthase gene (gltA) specific fragments were assessed using the PCR method .The positive products were sequenced .Result showed that the pres-ence of SFGR was 14 of 60 in detection Dermacentor silvarum cases ,while the overall positive rate was 23 .33% .Its nucleotide sequence of ompA showed 99 .3% and 99 .18% similarity with nucleotide sequence of Rickettsia sp .JL-02 and Rickettsia rao-ultii respectively .And the evolutionary positions of SFGR species were similar with Rickettsiamontana and Rickettsiamassili-ae .It's concluded that the nature focus of tick-borne spotted fever did exist in the area of Xunke Area of Heilongjiang Province , China .

OBJECTIVE: To observe the protective effect of thermoplastic mask on radiation dermatitis for patients with laryngeal cancer. METHOD: Seventy-three patients with laryngeal cancer was recruited in the research and were divided into two group. The test group (38 patients) was treated with opening-window on thermoplastic mask to protect the skin exposure to the radiotherapy. The control group (35 patients) was treated with intact thermoplastic mask. The rate of radio-dermatitis and pain in the skin exposure to the radiotherapy were assessed. RESULT: The radio-dermatitis and pain of the skin exposure to the radiotherapy in the test group was significantly lower than the control group (P < 0.05). CONCLUSION The opening-window on thermoplastic mask can decrease the radio-dermatitis for patients with laryngeal cancer.
Adult ; Aged ; Female ; Humans ; Laryngeal Neoplasms ; radiotherapy ; Male ; Masks ; Middle Aged ; Radiation Oncology ; methods ; Radiodermatitis ; prevention & control