microRNA(miRNA)is a 22nt long sin-gle-stranded non-coding RNA that is involved in a variety of physiological and pathological processes.Bronchial asthma is a heterogeneous disease,and airway inflammation is one of the important mecha-nisms of its pathogenesis.Asthma can be classified into different types based on the different immune mechanisms involved in its pathogenesis,and the mechanism of airway inflammation also varies be-tween different types of asthma.This article reviews the research progress of miRNA in asthma airway inflammation and endotype,and explores the pathogenesis and treatment prospects of miRNA in asthma airway inflammation and endotype.

BACKGROUND:Studies have found that glucagon-like peptide-1 and its analogues have a significant neuroprotective effect,and some drugs have been applied to the clinical stage Ⅲ study of Alzheimer's disease.However,the mechanism of its neuroprotective effect is still unclear,which needs to be further explored and clarified. OBJECTIVE:To screen out the genes related to the pathogenesis of Alzheimer's disease and the related targets of semaglutide for the treatment of Alzheimer's disease based on bioinformatics and network pharmacology analyses,to identify the potential target genes by comprehensive analysis of the two and to verify them at the cellular level. METHODS:Using DisGeNET database,differentially expressed genes between Alzheimer's disease patients and healthy population were screened out.The chemical structure formula and two-dimensional structure diagram of semaglutide were obtained using PubChem online database.GO/KEGG enrichment analysis was performed using DAVID online database.A protein-protein interaction network was constructed by using the STRING database.The HPA database was used to determine the distribution characteristics of the target proteins in various human tissues.Finally,western blot was used to detect relevant protein expression in HT22 cells after semaglutide intervention. RESULTS AND CONCLUSION:With the dataset in DisGeNET database,3 374 differentially expressed genes between Alzheimer's disease patients and healthy people were obtained,and meanwhile,101 target genes of semaglutide potential drugs were obtained.There were 23 intersection genes between them.Ten key genes were identified based on the protein-protein interaction network,which were silent information regulator 1(SIRT1),CASP9,CCND1,CASP1,KEAP1,DLG4,CASP4,GRB2,GRIA1,and EDNRA.The results of GO gene functional annotation analysis of key genes showed that the positive regulatory activity of cysteine endopeptidase,the positive regulation of proteolysis,and the positive regulation of cysteine endopeptidase involved the cytoplasmic part of the apoptotic activity process;AMPA glutamate receptor complex,inflammatory complex,CARD domain binding,cysteine endopeptidase activity,and cysteine endopeptidase activity were involved in the apoptotic process.The results of KEGG signaling pathway analysis indicated that colorectal cancer,non-small cell carcinoma,and endometrial carcinoma were related to immune infiltration,inflammation and autophagic apoptosis.In addition,according to the association ranking of key genes and their distribution in different tissues of HPA online database,SIRT1 was identified as the most significant differential gene.The expression level of SIRT1 protein was significantly down-regulated in HT22 cells after β-amyloid protein 1-42 treatment,but it could be significantly increased after being treated with semaglutide.To conclude,SIRT1 may be a target gene for semaglutide in the treatment of Alzheimer's disease.

Objective:To analyze the clinical features of severe refractory mycoplasma pneumoniae pneumonia (SRMPP) in children, and explore its risk factors complicated with extrapulmonary organ dysfunction.Methods:The clinical data of children with SRMPP who were admitted to the Department of Critical Care Medicine of Shanghai Children's Hospital from July 2017 to June 2019 were retrospectively summarized. The patients were divided into two groups according to the occurrence of extrapulmonary organ dysfunction: the extrapulmonary organ dysfunction group and the respiratory dysfunction group. The differences of clinical features and laboratory indexes between the two groups were compared, and the risk factors of extrapulmonary organ dysfunction were screened out by logistic regression analysis.Results:A total of 107 cases with SRMPP were admitted to the Pediatric Intensive Care Unit during the past two years, and there were 44 cases (41.1%) complicated with pleural effusion, 17 cases (15.9%) with plastic bronchitis, 104 cases (97.2%) with positive results for macrolide resistance genes (2063, 2064), with an in-hospital mortality rate of 2.8% (3/107). Among 107 children with SRMPP, there were 51 cases (47.7%) with extrapulmonary organ dysfunction, 43 cases (40.2%) with cardiovascular dysfunction, 13 cases (12.1%) with coagulation dysfunction, 11 cases (10.3%) with gastrointestinal dysfunction, 4 cases (3.7%) with renal dysfunction, 4 cases (3.7%) with brain dysfunction, 3 cases (2.8%) with liver dysfunction, and 16 cases (15.0%) with multiple organ dysfunction. Compared with the respiratory dysfunction group, the incidence of capillary leak syndrome was higher (52.9% vs. 17.9%, P < 0.001), the capillary leak index was increased [11.71 (4.63, 27.07) vs. 5.78 (2.07, 15.71), P =0.019], serum albumin was decreased [(32.2 ± 5.6)g/L vs. (34.7 ± 6.7)g/L, P=0. 041], and prothrombin time was prolonged significantly [12.7 (11.7, 13.8)s vs. 12.0 (11.4, 13.0)s, P=0. 009]. Logistic regression analysis showed that capillary leak syndrome ( OR=0. 278, 95% CI 0.102-0.759, P=0. 013) and prolonged prothrombin time ( OR=1. 443, 95% CI 1.018-2.046, P=0. 039) were independent risk factors for SRMPP complicated with extrapulmonary organ dysfunction. Conclusions:Approximately 50% of children with SRMPP have dysfunction of extrapulmonary organs, such as circulation, coagulation and gastrointestinal disorders. Capillary leak syndrome and prolonged prothrombin time are independent risk factors for SRMPP complicated with extrapulmonary organ dysfunction.

Mycoplasma pneumoniae infection can cause coagulation dysfunction and thrombosis, involving organ including deep vein, lung and brain, etc.Central venous catheterization is the most important risk factor for deep venous thrombosis.Lung consolidation more than 2/3 is a high risk of pulmonary embolismin mycoplasma pneumoniae pneumonia.Elevated blood D-dimer over 5 mg/L is an independent risk factor for predicting thrombus.Color Doppler ultrasound and CT angiography(CTA) are the main methods to determine thrombosis.Deep venous thrombosis or pulmonary embolism should be treated with individualized anticoagulant and thrombolytic therapy.

Adult ; Antibodies, Viral/isolation & purification* ; COVID-19/virology* ; Feces/chemistry* ; Female ; Humans ; Intestines/virology* ; Male ; RNA, Ribosomal, 16S/genetics* ; RNA, Viral/isolation & purification* ; SARS-CoV-2/pathogenicity*

Liver is the most common location for hematogenous spread of solid tumors. Clinically acute hepatic failure ( ALF) secondary to either a solid organ tumor or a hematologic malignancy is rare,but with a poor prognosis and high mortality. The time between the onset of symptoms and ALF was relatively rapid. Malignancy is one of the causes of pediatric acute liver failure (PALF). Common clinical symptoms were jaundice,haemorrhage,and hepatic encephalopathy. It is lack of specific clinical features and difficult to diagnose in early phase. Delayed diagnosis and treatment contribute to poor prognosis. How to combine the treatment of primary tumors and liver protection is critical issue to clinician. The effective therapy for patients with PALF is liver transplantation. In recent years,the development of artificial liver support is to provide a facilitating recovery chance and to prolong the window of opportunity for liver transplantation.

Objective: To investigate the incidence and prognosis of hypophosphatemia in critically ill children treated with continuous blood purification (CBP). Methods: The medical records of the critically ill patients, who were treated with CBP, admitted to pediatric intensive care unit (PICU) of Shanghai Children's Hospital from May 2014 to April 2017 were retrospectively analyzed. The serum phosphorus levels were tested before CBP, at 48-72 h during CBP, at the end of CBP and on the next day after CBP finished. Phosphorus supplement was given to the children with severe hypophosphatemia. Results: A total of 85 patients met the inclusion criteria. The serum phosphorus levels at the 4 indicated time points were (1.4±0.5), (0.7±0.3), (0.8±0.3), (0.9±0.4) mmol/L, respectively (F=45.21, P<0.05). Among the children, 66 cases (78%) had hypophosphatemia during CBP. The incidences of moderate and severe hypophosphatemia were 32 (48%) and 9 (14%), respectively. There were 41 patients with CBP replacement rates of (35-49) ml/(kg·h), while 44 patients with CBP replacement rates of 50-70 ml/(kg·h). There were significant differences at 48-72 h during CBP, the end of CBP and on the next day after CBP ((0.8±0.4) vs. (0.5±0.2), (1.0±0.3) vs. (0.6±0.2), and (1.1±0.4) vs. (0.8±0.2) mmol/L; t=7.672, 4.060, 14.440, P<0.05). Atotal of 9 cases were treated with sodium glycerophosphate. Among the 85 children, 24 (28%) patients died while 61 (72%) survived. There were no significant differences between the two groups in serum phosphorus levels at the indicated time points ((1.4±0.5) vs. (1.4±0.5), (0.7±0.3) vs. (0.7±0.3), (0.7±0.3) vs. (0.8±0.3), and (1.0±0.3) vs. (0.9±0.3) mmol/L, respectively, P>0.05). Conclusions Hypophosphatemia is prone to occur during CBP, which probably related to the replacement rate. There was no significant relationship between hypophosphatemia and mortality in critically ill children after giving phosphorus supplementation.

Objective To investigate the effects of tonsillectomy and adenoidectomy on the body's immune function of preschool children.Methods Using paired comparison method,40 preschool children with OSAHS[aver-age age (4.5 ±1.2)years]were selected.The peripheral venous blood's white blood cells,neutrophils,lymphocytes, monocytes,immune active cells(total T lymphocytes and total B lymphocytes),immunoglobulin(IgA,IgG,IgM)and the content of C3 and C4 levels in the different periods (after 1 month,3 months )before and after tonsillectomy and adenoidectomy were detected.And the immune parameters of 20 healthy children with matched age were selected as control group,the analysis comparison was conducted.Results In preoperative and postoperative 1 month,3 months compared with the control group,the above immune parameters had no statistically significant differences (t =0.332, 0.212,0.336,0.415,0.579,1.295,0.874,1.143,1.296,1.058,1.261,all P >0.05).At postoperative 1 month, the immune active cells(total T lymphocytes and total B lymphocytes),immunoglobulin (IgA,IgG,IgM)and the content of C3 and C4 levels declined slightly compared with preoperation,but within the normal range,back to normal at postoperative 3 months.Conclusion Tonsillectomy and adenoidectomy will not suppress the development of preschool children's immune systems,and the resection is feasible.

Objective To investigate ablation characteristics of PVC/VT originating from left ventricle anterior papillary muscles.Methods This study included 10 patients of PVC/VT originating from left ventricle anterior papillary muscles from January 2015 to June 2016 in Beijing Anzhen Hospital.Electrophysiological mapping and radiofrequency ablation were completed using three-dimensional anatomical mapping system combined with three-dimensional intracardiac ultrasound technology.ECG and abaltion target diagram characteristics as well as the special anatomy were explored.Results All the 10 patients were successfully ablated and followed up for 12 months.One patient had recurrence within 12 months and no complications were recorded.The target sites localized at the tip (n =1),middle portion(n =4)or the base (n =5) of the LV-APM.Among 7 patients,the target sites were located at the anterior septal papillary muscle and in 3 patients were located in the free papillary muscle.9 patients were successfully ablated via anterograde trans-septal catheterization after the failure of retrograde approach.Premature QRS wave time were 152.80 ± 11.72 ms and 6 patients presented sharp potential at the targets during PVC/VT.Conclusions PVC/VT originating from left ventricle anterior papillary muscles have similar ECG and diagram characteristics that is different from which originating from left anterior fascicle.It is recommended to get the target via transseptalpuncure approach.Ablation target could be clearly positioned by three-dimensional intracardiac ultrasound technology.

Objective To evaluate the potential risk of schistosomiasis transmission in the area along the Yangtze River in Yangzhou City,so as to provide evidences for establishing a post?transmission surveillance system for schistosomiasis in marsh?land regions. Methods The water infectivity,floating boatmen and fishermen infection,reservoir host infection and wild feces contamination were investigated in five districts/counties along the Yangtze River in Yangzhou City,including Guangling,Hanji?ang,Jiangdu,Yizheng and Development Zone,and the transmission factors and risky characteristics were assessed after inter?ruption of schistosomiasis transmission in marshland regions. Results A total of 15 key water regions were identified in the area along the Yangtze River in Yangzhou City in 2015. A total of 1 500 sentinel mice were placed,after breeding,their overall sur?vival rate was 99.33%;1 490 were dissected,with no schistosome infection. Of the 5 576 floating boatmen and fishermen exam?ined,no schistosome infection was observed,and among the 3 566 domestic animals(including 171 cattle,1 895 sheep and 1 500 pigs),no infections were detected. During the period between January and March,2016,there were 3 200 mouse traps placed on 8 marshlands,and 62 wild mice were captured from 6 marshlands,with a capture rate of 1.94%,and no schistosome?infected wild mice were seen. In addition,there were 35 pieces of fresh wild feces captured from 7 marshlands,including 11 pieces of bovine feces(31.43%),17 pieces of sheep feces(48.57%),2 pieces of dog feces(5.71%)and 5 pieces of other feces (14.29%),and no infections were detected. Conclusions There is a low risk of schistosomiasis transmission in the area along the Yangtze River in Yangzhou City. However,the contamination of feces from bovine and sheep that are freely pastured on marshlands is a big threat to schistosomiasis control.