Objective To summarize the clinical characteristics and analyze prognostic factors of neuroblastoma (NB) in infants (≤12 months) at a single center. Methods A retrospective analysis was conducted on the clinical data of infant patients (≤12 months) diagnosed with NB and treated between January 2014 and December 2022. Clinical features were analyzed, and comparisons between two sample rates were performed using the χ² test. Univariate prognostic analysis was conducted using the log-rank test, and survival outcomes were analyzed using the Kaplan-Meier method. Results A total of 42 infants (≤12 months) with NB were enrolled. Low-risk patients underwent surgical resection alone; intermediate-risk patients received surgery combined with chemotherapy with or without maintenance therapy; high-risk patients were treated with surgery and chemotherapy with or without maintenance therapy or radiotherapy. The 5-year event-free survival (EFS) rate was (92.7±4.9)%, and the 5-year overall survival rate was (95.2±3.6)%. Only two patients died because of tumor recurrence or progression. Univariate analysis identified MYCN amplification and the initial lactate dehydrogenase (LDH) level ≥ five times the upper limit of the normal were significantly associated with poor prognosis (5-year EFS: 33.3% vs. 97.4% and 60.0% vs. 97.3%, P<0.0001 and P=0.0035). Conclusion Infant NB has a favorable overall prognosis. MYCN amplification and markedly elevated initial LDH are associated with poor outcomes.

OBJECTIVE: Xuebijing injection has been recommended as a therapeutic approach for individuals with severe and critical COVID-19. This study aims to explore the correlation of neutrophil to lymphocyte platelet ratio (NLPR) with the severity and prognosis of COVID-19, and the effect of XBJ on the prognosis of patients with COVID-19 in different inflammatory states. METHODS: This was a retrospective study conducted at Wuhan Union Hospital in China. COVID-19 patients admitted between November 1, 2022 and February 1, 2023 were included. In predicting prognosis for individuals with COVID-19, new inflammatory indicators were used, and their prognostic value was assessed by using Cox regression models and receiver operating characteristic curves. Furthermore, a calculation was made to determine the cutoff value for NLPR. Relative risk and Cox regression models were used to examine the effects of Xuebijing injection on prognosis in patient cohorts that had been stratified by the NLPR cutoff. RESULTS: This research included 455 participants with COVID-19, with a mean age of 72 years. Several inflammatory indicators were found to be strongly correlated with prognosis, and NLPR shows the greatest predictive power. Patients with NLPR > 3.29 exhibited a mortality rate of 17.3%, which was 6.2 times higher than in patients with NLPR ≤ 3.29. Importantly, providing Xuebijing injection to patients with NLPR > 3.29 was associated with a lower risk of 60-day all-cause mortality. However, there was no discernible improvement in survival among patients with NLPR ≤ 3.29 who received Xuebijing injection. CONCLUSION NLPR is the most reliable inflammatory marker for predicting prognosis among individuals with COVID-19, and can accurately identify individuals who may benefit from Xuebijing injection. Please cite this article as: Liao M, Zhang LT, Bai LJ, Wang RY, Liu Y, Han J, Liu LH, Qi BL. Xuebijing injection reduces COVID-19 patients mortality as influenced by the neutrophil to lymphocyte platelet ratio. J Integr Med. 2025; 23(3): 282-288.
Humans ; Drugs, Chinese Herbal/administration & dosage* ; Male ; Female ; Retrospective Studies ; Aged ; Neutrophils ; COVID-19 Drug Treatment ; COVID-19/blood* ; Middle Aged ; Prognosis ; Lymphocytes ; Blood Platelets ; Platelet Count ; SARS-CoV-2 ; Aged, 80 and over ; Adult

This study was aimed at identifying the pathogenic bacteria responsible for the death of a young tiger at the Fujian Meihua Mountain South China Tiger Breeding Research Institute.Tissue samples from the lungs,liver,and intestines of the deceased tiger were collected,and the bacteria were cultured inasterile environment.The bacterial strains were characterized according to their morphological and molecular biological properties,including assessment of virulence genes and antibiotic resistance genes,mouse lethality tests,and antibiotic susceptibility evaluations.A predominant bacterial strain isolated from the liver of the deceased tiger was identified as enterotoxigenic Escherichia coli(ETEC)strain Tiger22513F.Phylogenetic analysis of the 16S rRNA gene revealed that the Tiger22513F strain exhibited close genetic similarity to the reference strain ETEC(MF919609.1),with 99.9%nucleotide similarity,and resided on the same evolutionary branch.The Tiger22513F strain contained 11 antibiotic resistance genes(tetA,sul1,sul3,cmlA,floR,blaTEM,blaSHV,blaCMY-2,qnrA,qnrS,and qnrD)along with five virulence genes(VT1,fyuA,tsh,iucD,and ST).Mouse lethality tests indicated significant pathogenicity toward mice,affecting primarily the lungs,liver,and intestines.Antibiotic susceptibility testing demonstrated that this strain exhibited resistance to various classes of beta-lactam antibiotics,as well as quinolones and aminoglycosides.This investigation successfully isolated a multi-drug resistant enterotoxigenic Escherichia coli strain with pronounced pathogenicity from the liver of a deceased tiger;thus providing valuable scientific insights for clinical diagnosis,as well as prevention and control measures,against ETEC infections in South China tigers.

Objective:To establish a portable gastrointestinal endoscopy telemedicine platform that enables the real-time transmission of endoscopy audio and video data to the consulting physicians through 5G communication technology, and to evaluate the effectiveness of this platform.Methods:From October 10 to October 20, 2023, 30 cases (16 cases from Sanya, Hainan Province, and 14 cases from Zhanjiang, Guangdong Province) from primary health institutions were selected for portable gastrointestinal endoscopy telemedicine consultations with a tertiary hospital in Shanghai. 5G network transmission parameters were recorded, and the lesion detection rate of the examination side and the consultation side, as well as the quality of the videos and images were compared.Results:The 5G network transmission parameters for telemedicine from Sanya and Zhanjiang to Shanghai included download network speeds of 168.3 Mbps and 160.4 Mbps, upload network speeds of 75.1 Mbps and 72.4 Mbps, and delays of 28 ms and 25 ms, respectively. There was no significant difference in the lesion detection rate [43.3% (13/30) VS 36.7% (11/30), χ2=0.792, P=0.598] between the physicians on the examination side and the consultation side. The endoscopic video quality (2.92±0.59 points VS 2.88±0.64 points, t=0.302, P=0.763) and picture quality (3.10±0.57 points VS 3.05±0.53 points, t=0.424, P=0.622) were compared by two senior endoscopists between the examination side and the consultation side, indicating no significant difference. Conclusion:The utilization of portable gastrointestinal endoscopy for telemedicine based on 5G network technology is effective in enabling telemedicine consultations and providing operational guidance. This approach enhances the procedural skills and diagnostic capabilities of physicians in primary healthcare settings, facilitating the equitable distribution of high-quality medical resources.

Objective To investigate the effect of Dex on neurological function in PD rats through the receptor interacting protein kinase 1(RIPK1)/RIPK3/mixed lineage kinase domain-like pro-tein(MLKL)pathway.Methods After rat PD model was constructed,the PD rats were assigned into PD group,L-,M-and H-Dex groups(intraperitoneal injection of 25,50,and 100 μg/kg Dex,respectively),and Dex+recombinant RIPK1 protein(rRIPK1)group(intraperitoneal injection of 100 μg/kg Dex+8 μg/kg rRIPK1),with 6 animals in each group.Another 6 rats served as sham-operation(Sham)group.The rats from the Sham group and PD group were intragastrically ad-ministered and injected with an equal amount of normal saline solution once a day.After 21 con-secutive days,the rotational behavior was observed of in each group rats.HE staining was per-formed to detect the pathological changes in dopaminergic neurons in the substantia nigra.TUNEL staining was conducted to measure the apoptosis of dopaminergic neurons.ELISA was used to determine the levels of neurotransmitters[DA,HVA,3,4-dihydroxyphenylacetic acid(DOPAC),5-hydroxytrptamine(5-HT)]and inflammatory factors(TNF-α,IL-1β)in the sub-stantia nigra.Western blotting was applied to detect the expression of RIPK1/RIPK3/MLKL pathway related proteins in the substantia nigra tissues.Results Intact and well-arranged mor-phology and structure were observed in the neurons of the Sham group.The PD group presented prominently less neurons,in scattered arrangement,with obviously reduced volume,irregular nu-clear deformation,indicating notably neuronal damage.The severity of neuronal damage was at-tenuated sequentially in the L-Dex,M-Dex,and H-Dex groups,but the damage in the Dex+rRIPK1 group was further worsened.The PD group had significantly larger number of rotations,longer escape latency,higher apoptotic rate,increased TNF-α and IL-1β contents,and elevated lev-els of p-RIPK1/RIPK1(1.07±0.18 vs 0.36±0.11),p-RIPK3/RIPK3(1.32±0.21 vs 0.47±0.14),and p-MLKL/MLKL(0.79±0.11 vs 0.18±0.05),but lower DA,DOPAC,5-HT,and HVA con-tents than the Sham group(P＜0.05).Dex treatment of low,medium and high doses reserved all above changes induced by PD modeling(P＜0.05).The Dex+rRIPK1 group obtained larger num-ber of rotations,longer escape latency,higher apoptotic rate,increased TNF-α and IL-1β contents,and elevated levels of p-RIPK1/RIPK1(0.95±0.17 vs 0.41±0.12),p-RIPK3/RIPK3(1.14±0.20 vs 0.51±0.15),and p-MLKL/MLKL(0.72±0.09 vs 0.24±0.06),but decreased DA,DOPAC,5-HT,and HVA contents when compared with the H-Dex group(P＜0.05).Conclusion Dex protects the neurological function of PD rats by inhibiting the RIPK1/RIPK3/MLKL pathway.

Herpes zoster (HZ) and its complications remain one of the major public health problems threatening human health. Four HZ vaccines are currently licensed for commercial use worldwide, while novel HZ vaccine candidates based on diverse technological platforms are in different stages of development. Enhancing public understanding of the effectiveness and safety of HZ vaccines is particularly crucial for increasing vaccine coverage and reducing vaccine hesitancy. This article introduces the overview of licensed HZ vaccines with a focus on elucidating the effectiveness and safety of HZ vaccines in immunocompetent and immunocompromised populations, in order to provide a scientific basis for the deployment of HZ vaccination.

Objective:To explore the effectiveness of immersive virtual reality (VR)-guided core stability-assisted training in improving the balance of ischemic stroke survivors.Methods:Sixty-six hemiplegic ischemic stroke survivors were randomly divided into a conventional rehabilitation training group (CON) of 32 and an immersive VR-guided core stability-assisted training group (VR-TOT) of 34. In addition to basic internal medical treatment, the CON group underwent conventional rehabilitation therapy, while the VR-TOT group received VR-guided core stability-assisted training. Before and after 4 weeks of the treatments, the subjects′ balance was evaluated using the Fugl-Meyer balance scale. A three-dimensional force platform was used to collect the sway amplitude, sway speed, peripheral area and total trajectory length of the center of pressure COP of the bilateral plantar in the left-right and anterior-posterior directions while the subjects stood with the eyes open and closed.Results:After the treatments, the average Fugl-Meyer balance scores of both groups had improved significantly. In the eyes-open condition, after the treatment, there was a significant decrease in the average COP sway amplitude in the anteroposterior direction on the hemiplegic side among the CON group, as well as in both the mediolateral and anteroposterior directions on both sides in the VR-TOT group. The sway velocity in the anteroposterior direction on the hemiplegic side had decreased significantly in both groups, and the sway velocity in both the mediolateral and anteroposterior directions on the non-hemiplegic side had also decreased significantly. In the CON group the peripheral area on the non-hemiplegic side had decreased and the total trajectory length had shortened significantly. In the VR-TOT group there were significant decreases in the peripheral area on both sides and in the total trajectory length on both sides. Comparing the two groups after treatment, the peripheral area on the hemiplegic side in the VR-TOT group was significantly smaller. In the eyes-closed condition, the sway amplitude of the COP on the hemiplegic side in the anteroposterior direction and on the non-hemiplegic side in both the mediolateral and anteroposterior directions had decreased significantly in the VR-TOT group after the treatment. The average sway velocity had decreased significantly in the anteroposterior direction on the non-hemiplegic side in the CON group. In the VR-TOT group this was observed in the anteroposterior direction on the hemiplegic side and in both the mediolateral and anteroposterior directions on the healthy side. In the CON group the average peripheral area of the COP on the hemiplegic side had decreased, and the total trajectory length had shortened, both significantly. In the VR-TOT group, the peripheral area on the non-hemiplegic side had decreased significantly as well.Conclusions:Core stability-assisted training based on immersive virtual reality can effectively improve the balance of ischemic stroke survivors. It shows promise for clinical application.

Objective:To develop a treatment-related quality of life scale for Chinese patients with multiple myeloma (MM) and to test its reliability and validity.Methods:The initial scale was constructed through a literature search, Delphi expert correspondence, and cognitive testing. This study conducted a preliminary survey of 379 patients with MM and a formal survey of 865 patients from the hematology departments of 155 hospitals nationwide from February 2024 to March 2024. The final scale was obtained after conducting item analysis and reliability and validity tests on the initial scale.Results:The constructed scale contains 36 items covering six domains: physiological, psychological, social, treatment side effects, general health, and others. In the preliminary survey, the Cronbach’s alpha coefficient of each item ranged from 0.597 to 0.939, and the test-retest reliability was 0.747 ( P<0.001). Exploratory factor analysis extracted eight common factors with a cumulative variance contribution of 60.058%. In the formal survey, the Cronbach’s alpha coefficient of each item ranged from 0.484 to 0.930, and the test-retest reliability was 0.835 ( P<0.001). Confirmatory factor analysis revealed a comparative fit index of 0.750, a root-mean-square error of approximation of 0.090, and a root-mean-square residual of 0.067. Conclusion:The treatment-related quality of life scale for Chinese patients with MM designed in this study exhibited good reliability and validity, reflecting the impact of treatment on the quality of life of patients. This scale can provide a reference to clinicians for assessing the disease status of patients.

Objective To investigate the effects of estrogen signaling on T-cell recruitment and polarization in acutely injured skeletal muscle.Methods One hundred C57BL/6 male mice,one hundred and eighty C57BL/6 female mice were selected.Twenty-five female mice were ovariectomized(OVX)and 10 male mice were taken as the sham-operated(sham).Then,cardiotoxin(CTX)induced tibialis anterior(TA)injury for preparing mice myoinjury model.Subcutaneous injection of 17β-estradiol(E2)or estrogen receptor antagonist 4-hydroxytamoxifen(4-OHT)was performed.A total of 140 mice(70 males and 70 females)were divided into four group including:PBS-male,CTX-male,PBS-female,and CTX-female.Serum estradiol(E2)levels were measured by ELISA,and muscle injury models were validated via HE staining.Subsequently,20 male and 20 female mice were selected for immunofluorescence(IF)and Real-time PCR to assess estrogen receptors(ER)expression in injured muscle tissue.Further,10 male and 40 female mice were allocated into five experimental groups,including CTX,CTX+E2,CTX+4-OHT,CTX+OVX,CTX+sham.HE staining and IF were performed to evaluate inflammatory infiltration in the injured muscle.Additionally,50 female mice were divided into CTX and CTX+OVX groups,and IF combined with flow cytometry were used to analyze T-cell phenotypes and muscle fiber regeneration in the injured muscle.Results In vivo,serum E2 and myofiber ERβ increased post-injury in mice of both sexes,significantly higher in females.Compared to the control group,E2 alleviated inflammation,OVX exacerbated inflammation,increased CD4+T-cell infiltration,elevated T helper 1 cell(Th1)response,decreased regulatory T cells(Tregs),impaired regeneration.In vitro,IFN-γ/LPS significantly upregulated ERβ in myotubes.Conclusion Estrogen signaling critically regulates muscle inflammation.Estrogen deficiency(OVX)delays repair of skeletal muscle by promoting Th1 response and suppressing Tregs function.

Objective To investigate the relationship between serum T cell immunoglobulin mucin mole-cule-3(TIM-3)and netrin-1(NTN-1)levels and the risk of recurrence of B-cell acute lymphoblastic leukemia(B-ALL).Methods A total of 60 children with B-ALL were selected from January 1,2021 to January 1,2023.According to the expression of fusion gene,the children were divided into fusion gene positive group(26 ca-ses)and fusion gene negative group(34 cases).The blood routine,inflammatory factor levels,TIM-3 and its ligand galectin-9(Gal-9),NTN-1 and its downstream protein phosphorylated protein kinase B(pAKT)and protein kinase B(AKT)levels were compared between the negative fusion gene group and the positive fusion gene group at admission.The patients were followed up for 1 year and the recurrence of B-ALL was counted.The difference of serum TIM-3 and NTN-1 levels between the children with recurrence and those without re-currence was compared,and the correlation between the levels of TIM-3 and NTN-1 and recurrence was ana-lyzed.Results Compared with before treatment,the levels of TIM-3 and Gal-9 in both groups decreased after treatment,and the differences were statistically significant(P＜0.05).Compared with before treatment,the levels of TIM-3 and Gal-9 in both groups were decreased after treatment,and the differences were statistically significant(P＜0.05).The levels of NTN-1 and pAKT in fusion gene positive group were significantly higher than those in fusion gene negative group,with statistical significance(P＜0.05),but there was no statistical significance in AKT comparison(P＞0.05).In the follow-up period,there were 9 cases(34.61％)of recur-rence in the fusion gene positive group and 2 cases(5.88％)in the fusion gene negative group.The recurrence rate in the fusion gene positive group was higher than that in the fusion gene negative group,and the differ-ence was statistically significant(P＜0.05).The levels of TIM-3 and NTN-1 in recurrent children were sig-nificantly higher than those in non-recurrent children,and the difference was statistically significant(P＜0.05).Multiple Logistic regression analysis showed that TIM-3 and NTN-1 were independent risk factors af-fecting the prognosis of children(P＜0.05).Serum TIM-3 and NTN-1 levels were positively correlated with the risk of recurrence of B-ALL(r=0.445,0.437,P＜0.05).Conclusion The levels of TIM-3 and NTN-1 are different in different types of B-ALL,which can reflect the risk of recurrence of B-ALL,and it is recom-mended to pay close attention to them.