High flow nasal cannula（HFNC）is a novel oxygen therapy developed in recent years，and has been successfully used in pediatric diseases such as bronchiolitis and pneumonia.Although there has been a lack of clinical application guidelines in pediatrics，it has been increasingly applied to the treatment of exacerbations of bronchial asthma.This review focused on efficacy，application timing，complications and parameters adjustment of HFNC in children with asthma exacerbation，so as to further guide the clinical use.

Objective:To investigate the current status of pertussis laboratory diagnosis and confirmed pertussis cases reporting in Shaanxi Province, and evaluate the quality of case reports.Methods:The information of confirmed pertussis cases reported in Shaanxi Province from January to July 2022 was collected through the China Disease Control and Prevention Information System. The laboratory diagnostic methods and pertussis vaccine immunization history of confirmed cases were investigated, and the descriptive epidemiological method was used for statistical description.Results:Of the 164 confirmed cases of pertussis reported from January to July 2022, two were not tested in the laboratory and 162 were tested in the laboratory. The proportions of different detection methods were 1.85% (3/162) of isolation and culture, 31.48% (51/162) of serum antibody IgG, 14.20% (23/162) of serum antibody IgM, 49.38% (80/162) of serum antibody PCR and 3.09% (5/162) of serum antibody IgM+ PCR. Among the 79 serological positive cases, 12 cases (15.19%)had no history of pertussis immunization, and 15 cases (18.99%), 11 cases (13.92%) and 41 cases (51.90%) had the time interval from vaccination to detection of <1 year, 1-3 years and >3 years, respectively. Based on the analysis of laboratory testing methods and vaccination history, 38 cases were misdiagnosed/misreported among 164 cases, with a misdiagnosis or misreported rate of 23.17%. There were 17, 12 and 9 cases of misdiagnosis/misreport in 0-2 years old group, 3-6 years old group and≥7 years old group, and the misdiagnosis or misreported rates were 27.42%(17/62), 26.67%(12/45) and 15.79%(9/57), respectively.Conclusions:The selection of pertussis laboratory testing methods in some medical institutions in Shaanxi Province is incorrect, which leads to a certain proportion of misdiagnosis or misreport, and it is necessary to further strengthen the training and standardization.

Objective:To analyze the bacteria spectrum and antimicrobial resistance profile of bacterial meningitis among children in Baoji.Methods:Based on the acute meningeal and encephalitis syndrome surveillance project, cerebrospinal fluid samples were collected from 774 cases of bacterial meningitis in Baoji Municipal Maternal and Health Hospital from January 2016 to December 2023. Bacterial culture and drug sensitivity test were carried out.Results:A total of 105 positive strains were isolated with the detection rate of 13.57% (105/774). Among them, gram-positive strains accounted for 80.00% (84/105), mainly including Staphylococcus epidermidis, Staphylococcus hominis, and Streptococcus pneumoniae. Gram-negative bacteria accounted for 20.00% (21/105), and the predominant strain was Escherichia coli. Pathogenic bacteria were detected in every month of the year, with two peaks in March and September (26.67%, 28/105). The youngest was infected 20 min after birth, and the oldest was nine years old. There were statistical differences in the detection rates among different age groups (χ 2=35.91, P<0.05). The positive rate in the toddler group was lower than that in the infant group, the pre-school age group and the school age group, respectively (χ 2=15.01, 7.09, and 10.08; all P<0.05). There was no statistical difference between the toddler group and the neonate group (χ 2=1.60, P>0.05). The strains detected in the neonate group accounted for 44.76% (47/105), mainly including Escherichia coli and Staphylococcus epidermidis; the strains in the infant group accounted for 26.67% (28/105), mainly including Streptococcus pneumoniae; the strains in the toddler group accounted for 3.81% (4/105), mainly including Staphylococcus epidermidis; the strains in the pre-school age accounted for 11.43% (12/105), mainly including Staphylococcus epidermidis; the strains in the school age group accounted for 13.33% (14/105), mainly including Streptococcus pneumoniae. The results of drug sensitivity test showed that the resistance rates of Staphylococcus epidermidis to ampicillin/sulbactam, clindamycin, and levofloxacin were 47.06% (8/17), 41.18% (7/17), and 23.53% (4/17), respectively. Staphylococcus epidermidis strains were sensitive to vancomycin and linezolid. All of the Streptococcus pneumoniae strains were resistant to erythromycin and clindamycin, but sensitive to vancomycin and linezolid. The resistance rate of Streptococcus pneumoniae to penicillin was 69.23% (9/13). The resistance rates of Escherichia coli to ampicillin, levofloxacin, ceftriaxone, and cefotaxime were 66.67% (8/12), 41.67% (5/12), 33.33% (4/12), and 41.67% (5/12), respectively, but they were sensitive to ampicillin/sulbactam, cefoperazone/sulbactam, amikacin, and meropenem. Streptococcus agalactis strains were sensitive to penicillin, linezolid, and vancomycin, but resistant to erythromycin, clindamycin, ampicillin, and levofloxacin. Conclusions:The main pathogens causing bacterial meningitis in Baoji city are Staphylococcus epidermidis, Streptococcus pneumoniae, and Escherichia coli. The distribution of bacteria is varied in different age groups. The diagnosis and treatment of bacterial meningitis should be made based on the bacterial spectrum characteristics and the results of antimicrobial resistance profile.

Purpose: Myofibroblastic cancer-associated fibroblasts (myCAFs) are important components of the tumor microenvironment closely associated with tumor stromal remodeling and immunosuppression. This study aimed to explore myCAFs marker gene biomarkers for clinical diagnosis and therapy for patients with bladder cancer (BC). Materials and Methods: BC single-cell RNA sequencing (scRNA-seq) data were obtained from the National Center for Biotechnology Information Sequence Read Archive. Transcriptome and clinical data were downloaded from The Cancer Genome Atlas and the Gene Expression Omnibus databases. Subsequently, univariate Cox and LASSO (Least Absolute Shrinkage and Selection Operator regression) regression analyses were performed to construct a prognostic signature. Immune cell activity was estimated using single-sample gene set enrichment analysis whilst the TIDE (tumor immune dysfunction and exclusion) method was employed to assess patient response to immunotherapy. The chemotherapy response of patients with BC was evaluated using genomics of drug sensitivity in cancer. Furthermore, Immunohistochemistry was used to verify the correlation between MAP1B expression and immunotherapy efficacy. The scRNA-seq data were analyzed to identify myCAFs marker genes. Results: Combined with bulk RNA-sequencing data, we constructed a two-gene (COL6A1 and MAP1B) risk signature. In patients with BC, the signature demonstrated outstanding prognostic value, immune infiltration, and immunotherapy response. This signature served as a crucial guide for the selection of anti-tumor chemotherapy medications. Additionally, immunohistochemistry confirmed that MAP1B expression was significantly correlated with immunotherapy efficacy. Conclusions Our findings revealed a typical prognostic signature based on myCAF marker genes, which offers patients with BC a novel treatment target alongside theoretical justification.

Humans ; Hematopoietic Stem Cell Transplantation ; Transplantation, Autologous ; Lymphoma, Non-Hodgkin/drug therapy* ; Aminopyridines/therapeutic use* ; Antineoplastic Combined Chemotherapy Protocols

OBJECTIVE: To analyze the correlation between the mutational status of immunoglobulin heavy chain variable (IGHV) gene with the prognosis of patients with Waldenström macroglobulinemia (WM). METHODS: Immunoglobulin heavy chain gene (IGH) clonotypic sequence analysis was carried out to assess the mutational status of IGHV in the blood and/or bone marrow samples from 44 WM patients. The usage characteristics of IGHV-IGHD-IGHJ gene was explored. RESULTS: The most common IGHV subgroup was IGHV3, which was similar to the data from the Institute of Hematology of Chinese Academy of Medical Science. IGHV3-23 (20.45% vs. 15.44%) and IGHV3-74 (11.36% vs. 7.35%) were the main fragments used, which was followed by IGHV4 gene family (15.91% vs. 24.26%). However, no significant correlation was found between the IGHV4 usage and the prognosis of the patients. Should 98% be taken as the cut-off value for the IGHV mutation status, only 5 patients had no IGHV variant, and there was no correlation with the prognosis. Based on the X-tile analysis, 92.6% was re-selected as the cut-off value for the IGHV variant status in such patients. LDH was increased in 26 patients (59.1%) without IGHV variant (P < 0.05), whilst progression-free survival (P < 0.05) and overall survival (P < 0.05) were significantly shorter compared with those with IGHV variants. CONCLUSION The usage characteristics of IGHV-IGHD-IGHJ in our patients was similar to reported by the Institute of Hematology of Chinese Academy of Medical Science, albeit that no correlation was found between the IGHV4 usage and the prognosis of the patients. Furthermore, 98% may not be appropriate for distinguishing the IGHV variant status in WM patients.
Humans ; Immunoglobulin Heavy Chains/genetics* ; Multigene Family ; Mutation ; Waldenstrom Macroglobulinemia/genetics*

【Objective】 To analyze the epidemiological characteristics of pertussis in Shaanxi Province from 2012 to 2021. 【Methods】 We collected the information of pertussis cases in Shaanxi Province from 2012 to 2021 by the China Disease Control and Prevention Information System for analyzing the incidence and distribution characteristics. 【Results】 From 2012 to 2021, a total of 8270 cases of pertussis were reported in Shaanxi Province, with the incidence ranging from 0.21 to 6.20 per 100 000 persons, and for an annual average incidence of 2.17 per 100 000 persons. 44.81% (3 706/8 270) occurred from June to September. The annual average incidence in southern Shaanxi, Guanzhong, and northern Shaanxi was 1.78, 2.47, and 1.46 per 100 000 persons (χ²=289.638, P<0.001). The number of patients (proportions) with pertussis aged 0-1, 1-5, 5-10, and ≥10 years was 3 884 (46.96%), 2 869 (34.69%), 1 408 (17.03%), and 109 (1.32%), respectively. The number of patients (proportion) ≤ 2 months old, 3-5 months old, and ≥ 6 months old was 884 (22.76%),1 608 (41.40%), and 1 392 (35.84%) among pertussis patients under 1 year old. 【Conclusion】 The incidence of pertussis in Shaanxi Province basically showed an increasing trend with higher rates between June and September, higher rates in Guanzhong region of the province, and more patients over 5 years old.

Objective:To investigate the clinical effect of the "Tongluo" technique on gastrocnemius muscle hardness and muscle tone in children with spastic cerebral palsy (SCP) using shear wave elastography (SWE).Methods:Forty children with SCP who were treated at the First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine from January 2020 to June 2021 were selected as the observation group and received the "Tongluo" technique intervention. At the same time, 20 normal children were selected as the control group, without any intervention. Compare the various indicators of the two groups at baseline and after 1.5 and 3 months of treatment, including Young’s modulus value of the medial gastrocnemius muscle at rest, the modified Ashworth scale (MAS) score, and the clinical spasm index (CSI) score. The changes in muscle tone and spasticity of SCP children before and after treatment were compared, and the differences in the Young’s modulus between MAS and CSI levels in SCP children as well as the correlation between MAS, CSI, and Young’s modulus were analyzed.Results:The difference in Young’s modulus values of the control group at baseline, after 1.5 and 3 months of treatment was not statistically significant (all P > 0.05). At baseline, after 1.5 and 3 months of treatment, Young’s modulus value, MAS score, and total CSI score gradually decreased in the observation group, and the differences obtained from pairwise comparisons were statistically significant (all P < 0.01). At the same intervention stage, Young’s modulus value of the observation group was higher than that of the control group, with a statistically significant difference ( P < 0.01). The MAS score results showed that Young’s modulus of the observation group increased with the increase in muscle tone, and there was a positive correlation between Young’s modulus and muscle tone ( P < 0.01), and the difference in Young’s modulus corresponding to different muscle tones was statistically significant ( P < 0.05). The CSI score results showed that the Young’s modulus of the observation group increased with the increase in spasticity degree, and there was a positive correlation between the Young’s modulus and muscle tone ( P < 0.01), and the difference in Young’s modulus corresponding to different spasticity degrees was statistically significant ( P < 0.05). Conclusions:The muscle hardness of children with SCP is higher than that of normal children. The "Tongluo" technique can effectively improve muscle hardness, reduce muscle tone, and effectively improve muscle spasticity in children with SCP. The principle may be related to adjusting the internal structure of muscles to reduce muscle hardness. The results of this study can guide clinical rehabilitation and evaluation.

Objective To investigate the electro-clinical features of epilepsy with eye closure sensitivity (ECS).Methods The electroencephalograph database was searched using ECS during half a year period from January to June 2017 in Xijing Hospital.The duration of the follow-up was one year.Results Fifty-one patients diagnosed as epilepsy with ECS were investigated.Patients were classified into four epilepsy syndromes:33 with eyelid myoclonia with absences (EMA);13 with juvenile myoclonia epilepsy (JME);two with epilepsy with generalized tonic-clonic seizure on awakening and three with idiopathic occipital lobe epilepsy (IOE).The duration of the epileptiform discharges (EDs) triggered by eye closure (ECL) lasted more than five seconds in four patients with EMA and one patient with IOE.The EDs triggered by ECL were more frequent (85.2± 11.4 vs 37.5± 12.6,t=12.399,P=0.000) and lasting longer ((4.3± 1.9) s vs (2.3±0.8) s,t=3.585,P=0.001) in EMA than in JME.Conclusions ECS is common in EMA.The frequency and duration of the EDs triggered by ECL are helpful for identifying EMA and JME.

Mutations or inactivation of parkin, an E3 ubiquitin ligase, are associated with familial form or sporadic Parkinson's disease (PD), respectively, which manifested with the selective vulnerability of neuronal cells in substantia nigra (SN) and striatum (STR) regions. However, the underlying molecular mechanism linking parkin with the etiology of PD remains elusive. Here we report that p62, a critical regulator for protein quality control, inclusion body formation, selective autophagy and diverse signaling pathways, is a new substrate of parkin. P62 levels were increased in the SN and STR regions, but not in other brain regions in parkin knockout mice. Parkin directly interacts with and ubiquitinates p62 at the K13 to promote proteasomal degradation of p62 even in the absence of ATG5. Pathogenic mutations, knockdown of parkin or mutation of p62 at K13 prevented the degradation of p62. We further showed that parkin deficiency mice have pronounced loss of tyrosine hydroxylase positive neurons and have worse performance in motor test when treated with 6-hydroxydopamine hydrochloride in aged mice. These results suggest that, in addition to their critical role in regulating autophagy, p62 are subjected to parkin mediated proteasomal degradation and implicate that the dysregulation of parkin/p62 axis may involve in the selective vulnerability of neuronal cells during the onset of PD pathogenesis.
Adaptor Proteins, Signal Transducing ; chemistry ; metabolism ; Animals ; HEK293 Cells ; Heat-Shock Proteins ; chemistry ; metabolism ; Humans ; Lysine ; metabolism ; Mice ; Neurons ; metabolism ; pathology ; Oxidopamine ; pharmacology ; Parkinson Disease ; metabolism ; pathology ; Proteasome Endopeptidase Complex ; metabolism ; Protein Stability ; Proteolysis ; drug effects ; Sequestosome-1 Protein ; Ubiquitin-Protein Ligases ; metabolism ; Ubiquitination ; drug effects