ObjectiveTo investigate the role of interleukin （IL）-17A in acute inhalational pneumonia induced by the highly drug-resistant and hypervirulent Staphylococcus aureus strain USA300-R in mice. MethodsAn acute inhalational pneumonia model was established in mice using an aerosolized pulmonary delivery technique. RNA sequencing （RNA-seq） and enzyme-linked immunosorbent assay （ELISA） were employed to examine the expression dynamics of Il17a mRNA and IL-17A protein， respectively， in the lungs of infected mice. Il17a knockout （Il17a^-/-） mice were generated using CRISPR/Cas9 gene editing technology. The survival rate， body weight， bacterial load in lung tissue， and histopathological changes were compared between Il17a^-/- and wild-type （WT） mice following inhalational infection with USA300-R. Results12 hours after USA300-R infection， compared to pre-infection， the expression level of Il17a mRNA in lung tissue and the level of IL-17A protein in bronchoalveolar lavage fluid （BALF） increased by approximately 50-fold （P<0.01） and 6-fold （P<0.001）， respectively. Compared to WT mice， Il17a^-/- mice exhibited approximately 10-fold higher bacterial loads in lung tissue at both 12 and 24 hours post-infection （P<0.001， P<0.05）. However， they showed significantly attenuated lung histopathological injury， reduced alveolar wall thickening， markedly decreased neutrophil infiltration， and an approximately 50% improvement in survival rate （P<0.05）. ConclusionIn acute Staphylococcus aureus USA300-R inhalational pneumonia， IL-17A contributes to bacterial clearance by recruiting neutrophils； however， excessive neutrophil infiltration exacerbates pulmonary inflammation and injury， reduces survival rates， and represents a potential therapeutic target.

Objective To develop a predictive model for guiding blood transfusion decisions in pediatric patients with traumatic brain injury(TBI)by identifying and analyzing key factors that influence blood transfusion requirements.Methods A retrospective analysis was conducted on the clinical data of 1,535 pediatric patients with TBI admitted to four medical institutions from January 1,2015,to December 31,2022.Patients were divided into two groups:those who received red blood cell transfusions during hospitalization and those who did not.Comparative analyses were performed on demographic,clinical,and laboratory data between these two groups.Logistic regression analysis was used to identify risk factors associated with in-hospital blood transfusion,and a predictive model was developed using a nomogram.The performance of this model was evaluated using a receiver operating characteristic(ROC)curve.Results Significant differences were observed between the blood transfusion and non-blood transfusion groups in terms of baseline demographics,clinical indicators,and laboratory test results(all P<0.05).Patients in the blood transfusion group exhibited significantly higher in-hospital mortality,compli-cation rates,use of mechanical ventilation,ICU admission rates,and length of stay compared to those in the non-blood transfusion group(all P<0.05).Multivariate logistic regression analysis identified heart rate,presence of other fractures,treatment methods,hemoglobin(Hb),platelet count(Plt),activated partial thromboplastin time(APTT),and D-dimer levels as independent risk factors for blood transfusion in TBI patients.The area under the ROC curve for the blood transfusion prediction model,based on these independent risk factors,was 0.95(95%CI:0.94～0.97),indicating excellent predictive accuracy.Calibration and decision curves further validated the robust-ness and reliability of the model's predictive capacity.Conclusions Heart rate,presence of other fractures,treatment methods,Hb,Plt count,APTT,and D-dimer levels serve as independent risk factors for blood transfusion in TBI patients.The prediction model developed based on these factors demonstrates excellent predictive performance,thereby guiding clinicians in making informed blood transfusion decisions and enhancing the success rate of patient outcomes.

Objective : To identify autophagy-related genes involved in pulmonary infection caused by the highly drug-resistant and virulent methicillin-resistant Staphylococcus aureus strain USA300 ( USA300) ，and to explore the underlying molecular mechanisms ， thereby providing potential targets for immunotherapy． Methods: The GSE220943 dataset of a USA300-induced pulmonary infection mouse model was obtained from the GEO database． Differentially expressed genes ( DEGs ) were identified using the DESeq2 package． Autophagy-related genes ( ARGs) were retrieved from the MSigDB and Autophagy databases．Weighted gene co-expression network analysis ( WGCNA) was performed to construct gene co-expression modules．Genes overlapping among DEGs，ARGs，and WGCNA modules were identified as autophagy-related DEGs．Gene Ontology ( GO) enrichment analysis was con- ducted using the clusterProfiler R package，while Kyoto Encyclopedia of Genes and Genomes ( KEGG) pathway en- richment analysis was performed via the Metascape platform．Immune cell infiltration was analyzed using the Immu- CellAI-mouse website．A protein - protein interaction ( PPI) network was constructed using the STRING database， and hub genes were identified through topological analysis in Cytoscape． Receiver operating characteristic curve ( ROC) curves were plotted via the website https: / /www．bioinformatics．com．cn． Finally，key gene expression was validated in mouse lung tissues by real-time quantitative reverse transcription PCR ( RT-qPCR) ． Results: A total of 6 135，4 075，3 680，and 2 342 differentially expressed genes ( DEGs) were identified at 12，24，48，and 96 hours post-infection，respectively．By integrating DEGs，autophagy-related genes ( ARGs) ，and WGCNA mod- ules，19 autophagy-related DEGs were identified． GO and KEGG enrichment analyses indicated that these genes were mainly involved in CD4 + T cell activation and regulation，innate immune responses，and autophagosome mem- brane formation．Immune infiltration analysis revealed that innate immune cells such as neutrophils and dendritic cells predominated during the early phase of infection，while γδ T cells and M2 macrophages became more promi- nent in the later stages．PPI network analysis identified 12 hub autophagy-related genes，among which three upreg- ulated key genes ( Eif2ak2，Ikbke，and Nfkbiz) were further confirmed．The area under the ROC curve for all three genes was 1. 000．RT-qPCR validation demonstrated significantly elevated expression of these three genes in lung tissues at 24 hours post-infection ( all P＜0. 05) ． Conclusion Eif2ak2，Ikbke，and Nfkbiz may be involved in the pulmonary infection caused by USA300 by promoting autophagy and hold promise as potential targets for immuno- therapy．

Objective:To investigate the sleep characteristics and executive function development in children aged 6-12 years with attention deficit hyperactivity disorder(ADHD),and to examine the relationship between them.Methods:A total of 112 children diagnosed with ADHD according to the Diagnostic and Statistical Manual of Mental Disorders,Fourth Edition(DSM-Ⅳ),and 45 age-and gender-matched typically developing children were recruited.Sleep characteristics were assessed with the Chinese version of Children's Sleep Habits Questionnaire(CSHQ)and ActiGraph GT9X Link Three-axis acceleration body dynamometert.Core ADHD symptoms and multi-ple dimensions of executive function were evaluated withthe Swanson,Nolan,and Pelham scale,Fourth Edition(SNAP-Ⅳ)assessment scale,Stroop Color-Word Test(SCWT),Rey-Osterrieth Complex Figure Test(ROCFT),and Trail Making Test(TMT).Results:Compared with controls,children with ADHD showed significantly higher total CSHQ scores,sleep resistance,sleep anxiety,and sleep maintenance time(P＜0.05),and had significantly lower sleep efficiencies measured by ActiGraph GT9X Link(P＜0.05).In the SCWT,children with ADHD re-quired more time in the word interference and color interference tests(P＜0.05).In the ROCFT,the scores of im-mediate details,delayed details,immediate structure,and delayed structure were lower in the children with ADHD(P＜0.05).In the TMT,the number of errors in the digit connection and the time and number of errors in the digit-letter connection were higher in the children with ADHD(P＜0.05).The total CSHQ scores of ADHD children were negatively correlated with the working memory scores and positively correlated with the core symptom scores.Conclusion:Children with ADHD exhibit notable sleep disturbance and underdeveloped executive func-tion.the sleep problems,as measured by CSHQ are associated significantly with deficits in executive function.

Objective To explore the effect of aerobic calisthenics on sleep quality in children with attention-deficit/hyperactivity disorder(ADHD).Methods Forty children with ADHD(aged 9～11 years;mean age 9.83±0.76 years)were recruited from the pediatric outpatient department of some class-3 grade-A hospital in Beijing.They were randomized into an intervention group(n=21)and a control group(n=19).Both groups participated in standard school physical education programs,while the intervention group underwent 60-minute aerobic calisthenics exercise sessions three times weekly for 8 weeks.Before and after the intervention,the sleep condition was measured using the children's sleep habits questionnaire(CSHQ)and the three-axis acceleration recorder.The inter-group differenc-es in sleep dimensions were analyzed using independent samples t-tests,while the intra-group ones were evaluated using paired t-tests.Results(1)Inter-group comparison:Before the experiment,no sig-nificant differences were detected between the two groups in sleep characteristics.After the experi-ment,in comparison with the control group,there was a significant decrease in awakening time,aver-age awakening time,and sleep latency time of the intervention group,but a significant increase in sleep efficiency(P<0.05).Moreover,the total score of CSHQ,as well as the sleep resistance and sleep delay scores,were significantly lower in the intervention group(P<0.05).(2)Intra-group com-parison:In the intervention group,after the experiment,there were significant reductions in awakening time and sleep latency time,and a significant enhancement in sleep efficiency(P<0.05).Moreover,the total score of CSHQ,along with the scores of sleep resistance,sleep delay,and daytime sleepi-ness,decreased significantly(P<0.05).In the control group,the daytime sleepiness score decreased af-ter the experiment(P<0.05).Conclusion An 8-week aerobic calisthenics exercise(60 minutes/session,3 sessions/week)significantly improves overall sleep quality in children with ADHD.Therefore,it is worth application in the clinical practice.

Objective To explore the effect of aerobic calisthenics on sleep quality in children with attention-deficit/hyperactivity disorder(ADHD).Methods Forty children with ADHD(aged 9～11 years;mean age 9.83±0.76 years)were recruited from the pediatric outpatient department of some class-3 grade-A hospital in Beijing.They were randomized into an intervention group(n=21)and a control group(n=19).Both groups participated in standard school physical education programs,while the intervention group underwent 60-minute aerobic calisthenics exercise sessions three times weekly for 8 weeks.Before and after the intervention,the sleep condition was measured using the children's sleep habits questionnaire(CSHQ)and the three-axis acceleration recorder.The inter-group differenc-es in sleep dimensions were analyzed using independent samples t-tests,while the intra-group ones were evaluated using paired t-tests.Results(1)Inter-group comparison:Before the experiment,no sig-nificant differences were detected between the two groups in sleep characteristics.After the experi-ment,in comparison with the control group,there was a significant decrease in awakening time,aver-age awakening time,and sleep latency time of the intervention group,but a significant increase in sleep efficiency(P<0.05).Moreover,the total score of CSHQ,as well as the sleep resistance and sleep delay scores,were significantly lower in the intervention group(P<0.05).(2)Intra-group com-parison:In the intervention group,after the experiment,there were significant reductions in awakening time and sleep latency time,and a significant enhancement in sleep efficiency(P<0.05).Moreover,the total score of CSHQ,along with the scores of sleep resistance,sleep delay,and daytime sleepi-ness,decreased significantly(P<0.05).In the control group,the daytime sleepiness score decreased af-ter the experiment(P<0.05).Conclusion An 8-week aerobic calisthenics exercise(60 minutes/session,3 sessions/week)significantly improves overall sleep quality in children with ADHD.Therefore,it is worth application in the clinical practice.

Objective:To investigate the sleep characteristics and executive function development in children aged 6-12 years with attention deficit hyperactivity disorder(ADHD),and to examine the relationship between them.Methods:A total of 112 children diagnosed with ADHD according to the Diagnostic and Statistical Manual of Mental Disorders,Fourth Edition(DSM-Ⅳ),and 45 age-and gender-matched typically developing children were recruited.Sleep characteristics were assessed with the Chinese version of Children's Sleep Habits Questionnaire(CSHQ)and ActiGraph GT9X Link Three-axis acceleration body dynamometert.Core ADHD symptoms and multi-ple dimensions of executive function were evaluated withthe Swanson,Nolan,and Pelham scale,Fourth Edition(SNAP-Ⅳ)assessment scale,Stroop Color-Word Test(SCWT),Rey-Osterrieth Complex Figure Test(ROCFT),and Trail Making Test(TMT).Results:Compared with controls,children with ADHD showed significantly higher total CSHQ scores,sleep resistance,sleep anxiety,and sleep maintenance time(P＜0.05),and had significantly lower sleep efficiencies measured by ActiGraph GT9X Link(P＜0.05).In the SCWT,children with ADHD re-quired more time in the word interference and color interference tests(P＜0.05).In the ROCFT,the scores of im-mediate details,delayed details,immediate structure,and delayed structure were lower in the children with ADHD(P＜0.05).In the TMT,the number of errors in the digit connection and the time and number of errors in the digit-letter connection were higher in the children with ADHD(P＜0.05).The total CSHQ scores of ADHD children were negatively correlated with the working memory scores and positively correlated with the core symptom scores.Conclusion:Children with ADHD exhibit notable sleep disturbance and underdeveloped executive func-tion.the sleep problems,as measured by CSHQ are associated significantly with deficits in executive function.

Objective To develop a predictive model for guiding blood transfusion decisions in pediatric patients with traumatic brain injury(TBI)by identifying and analyzing key factors that influence blood transfusion requirements.Methods A retrospective analysis was conducted on the clinical data of 1,535 pediatric patients with TBI admitted to four medical institutions from January 1,2015,to December 31,2022.Patients were divided into two groups:those who received red blood cell transfusions during hospitalization and those who did not.Comparative analyses were performed on demographic,clinical,and laboratory data between these two groups.Logistic regression analysis was used to identify risk factors associated with in-hospital blood transfusion,and a predictive model was developed using a nomogram.The performance of this model was evaluated using a receiver operating characteristic(ROC)curve.Results Significant differences were observed between the blood transfusion and non-blood transfusion groups in terms of baseline demographics,clinical indicators,and laboratory test results(all P<0.05).Patients in the blood transfusion group exhibited significantly higher in-hospital mortality,compli-cation rates,use of mechanical ventilation,ICU admission rates,and length of stay compared to those in the non-blood transfusion group(all P<0.05).Multivariate logistic regression analysis identified heart rate,presence of other fractures,treatment methods,hemoglobin(Hb),platelet count(Plt),activated partial thromboplastin time(APTT),and D-dimer levels as independent risk factors for blood transfusion in TBI patients.The area under the ROC curve for the blood transfusion prediction model,based on these independent risk factors,was 0.95(95%CI:0.94～0.97),indicating excellent predictive accuracy.Calibration and decision curves further validated the robust-ness and reliability of the model's predictive capacity.Conclusions Heart rate,presence of other fractures,treatment methods,Hb,Plt count,APTT,and D-dimer levels serve as independent risk factors for blood transfusion in TBI patients.The prediction model developed based on these factors demonstrates excellent predictive performance,thereby guiding clinicians in making informed blood transfusion decisions and enhancing the success rate of patient outcomes.

ObjectiveTo explore the characteristics of fine motor skills of school-age children with attention deficit hyperactivity disorder (ADHD) in different sexes. MethodsFrom April, 2021 to April, 2023, 66 ADHD children from grades one to four in Beijing Haidian Wanquan Primary School were screened by psychiatrists, and other 69 ADHD children were recruited from hospitals and patient groups of WeChat, accounting to 135 ADHD children. Meanwhile, a total of 135 typically developed (TD) children matched with sex and age (< 0.5 year) were recruited from the same primary school as controls. They were assessed with Movement Assessment Battery for Children (MABC-2) four subtests of manual dexterit. ResultsAfter controlling age, the subtest scores and the total score of fine motor of MABC-2 were less in ADHD boys and girls than in the TD boys and girls (P < 0.05). The main effect of sex was significant on the subtest scores and the total score of fine motor for ADHD children (F > 5.133, P < 0.05), and they were less in the boy than in the girls (P < 0.05). ConclusionThe development of fine motor delays in school-aged ADHD children, especially for the boys.

Objective To observe the electromyography characteristics of children's handwriting with attention deficit hyperactivity disorder(ADHD),and explore its electrophysiological mechanism,so as to provide an objective basis for developing non-pharmacological treatment for such children.Methods Between September 2021 and April 2022,29 ADHD children were recruited from an ordinary public primary school and the psychiatric clinic of a class-3 grade-A hospital in Beijing.Among them,25 were boys and 4 were girls,with an average age of 8.21±1.78 years.Meanwhile,23 male and 5 fe-male healthy counterparts were selected with the age gap no more than 6 months.The Delsys wireless surface EMG system was used to collect the electromyographic signals of the abductor pollicis breve,the first dorsal interosseous muscle,the flexor radial carpi motor and the extensor finger muscles dur-ing their writing tasks such as tracing trajectories,writing Arabic numerals 0-9,26 small and capital English letters,Chinese characters one to ten and"Yong".The percentage of the averaged electromyog-raphy(AEMG)of a muscle in the sum value of all measured muscles,and the coefficient of differ-ence were selected to evaluate the muscle contribution rate and the consistency of exertion,respective-ly.Moreover,the independent sample t-test was employed to compare the two different groups with the significance set at α=0.05.Results There was a significant difference in the muscle contribution of abductor pollicis breve and first dorsal interosseous muscles when writing Arabic numerals and that of abductor pollicis breve muscles when writing Chinese characters between ADHD children(27.29%,25.58%and 27.53%)and their healthy counterparts(42.87%,19.96%and 37.13%)(P<0.05).Most muscle differentiation coefficients of ADHD children were higher than 100%,with that of the domi-nant hand radial wrist flexor muscle reaching 270%in the trajectory tracing task.Conclusion Accord-ing to the characteristics of EMG signals,school-age ADHD children show an immature writing pat-tern,including poor stability of writing-related muscles,insufficient control of small finger muscle groups,poor control of hand coordination,and insufficient muscle inhibition of non-dominant hand.It is recommended to conduct the electromyoelectric assessment of handwriting movements in ADHD chil-dren,so as to carry out targeted intervention at an early stage.