Demyelination of the central nervous system often occurs in neurodegenerative diseases， such as multiple sclerosis （MS）. The myelin sheath， a layer of myelin membrane wrapping the axon， plays a role in the rapid conduction and metabolic coupling of impulses for neurons. The exposure of the axon will lead to axonal degeneratio， and further neuronal degeneration， which is the main cause of dysfunction and even disability in patients with demyelinating neurodegenerative diseases. In addition to the demyelination of mature myelin sheath， remyelination disorder is also one of the major reasons leading to the development of the diseases. The myelin sheath is composed of oligodendrocytes （OLs） derived from oligodendrocyte progenitor cells （OPCs） which are differentiated from neural stem cells （NSCs）. The process of myelin regeneration， i.e.， remyelination， is the differentiation of NSCs into OLs. Recent studies have shown that this process is regulated by a variety of genes. MicroRNAs， as important regulators of neurodegenerative diseases， form a complex regulatory network in the process of myelin regeneration. This review summarizes the main molecular pathways of myelin regeneration and microRNAs involved in this process and classifies the mechanisms and targets. This review is expected to provide a theoretical reference for the future research on the treatment of demyelinating diseases by targeting the regulation of microRNAs.

Recent studies found that the intestinal flora is involved in the occurrence and development of CRC.In particular,Ruminococcus shows a decreased abundance in patients with CRC and can affect gastrointestinal health through cross-feeding and promoting butyrate production.Although the research on Ruminococcus is gradually increasing,no unified understanding of its influence on the occurrence and development of CRC has been established.This work summarizes the relationship of Ruminococcus with CRC and its possible anticancer mechanism to provide a theoretical basis for the further exploration of biological prevention and treatment of CRC in the future.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

Objective:To determine the level of epilepsy knowledge of caregivers for children with epilepsy and analyze its influencing factors, and investigate caregivers' educational needs and their acceptance for remote education, in order to provide reference for clinical telenursing education.Methods:From March to September 2022, 221 caregivers of epileptic children in the outpatient department and ward of neurology department of Xuzhou Children's Hospital were recruited by convenient sampling method for cross-sectional investigation. The status of caregivers' knowledge and educational needs were investigated by the general information questionnaire, epilepsy knowledge questionnaire, epilepsy knowledge needs questionnaire and telenursing acceptance questionnaire, and the influencing factors of knowledge level were analyzed by multiple linear regression.Results:The average score of epilepsy knowledge of caregivers was (15.68 ± 6.43) points. The course of disease, taking medicine on time, education background and monthly income of caregivers were the influencing factors of caregivers' knowledge level, and the difference was statistically significant ( P <0.05). 94.12% (208/221)- 96.38% (213/221) of the caregivers had high educational needs, and they had the highest demand for safety guidance during seizures. Caregivers' acceptance of remote education was moderate, ranging from 34.39% (76/221) to 71.95% (159/221). Conclusions:Caregivers' epilepsy knowledge needs to be improved. Medical institutions should formulate education plans according to the different characteristics of caregivers. Caregivers have a high demand for nursing knowledge, and medical staff should increase health education. Before giving health education based on remote nursing platform, we should fully understand the attitude of caregivers to the platform, so that they can master disease knowledge, strengthen their disease management ability, and improve the quality of life of children.

Objective:To investigate the clinical characteristics and prognosis of IL3-IGH fusion gene-positive pediatric acute lymphoblastic leukemia (ALL) with hypereosinophilia as the first presentation.Methods:The clinical data of 1 pediatric IL3-IGH fusion gene-positive ALL patient with hypereosinophilia as the first presentation in January 2021 in Fujian Medical University Union Hospital was retrospectively analyzed and relevant literature was reviewed.Results:This 11-year-old male patient underwent bone marrow examination, and results showed that the proportion of eosinophils was increased; immunophenotyping disclosed that there were about 49.4% abnormal naive B lymphocytes in bone marrow; 43 leukemia fusion genes showed all negative; the whole transcriptome sequencing showed IL3-IGH fusion gene-positive. The patient was finally diagnosed as B-ALL with IL3-IGH fusion gene. According to the Chinese Children Cancer Group (CCCG)-ALL 2020 regimen, eosinophils returned to normal after induction therapy. Bone marrow examination on day 19 of induction showed that the proportion of promyelocytes was 0.005, the proportion of eosinophils was 0.05, and the minimal residual disease (MRD) was 23.02%. Bone marrow examination on day 46 of induction showed remission, and MRD was 0.18%. Consolidation chemotherapy used CAT (cyclophosphamide 1 g/m 2 once; cytarabine 50 mg/m 2, 12 h once, 7 days in total; mercaptopurine 40 mg/m 2, once per night, 7 days in total) regimen. Then the patient was added with lusotinib (75 mg 12 h once) orally and continued to receive high-dose methotrexate (5 g/m 2) regimen chemotherapy for 2 courses, the MRD was 0.20%. Chimeric antigen receptor T-cell (CAR-T) regimen was administered, followed by negative MRD. Conclusions:IL3-IGH fusion gene ALL is more frequently found in males, and more common in older children and young adults. It is prone to organ infiltration damage, and it has a high rate of induction failure and recurrence as well as poor prognosis.

Objective:To investigate the predictive role of dynamic changes of plasma biomarkers in patients with viral and mycoplasma community-acquired pneumonia (CAP).Methods:From January 2020 to June 2020, 141 patients with viral and mycoplasma CAP in People's Hospital of Ningxia Hui Autonomous Region were enrolled. Pneumonia severity index (PSI) scores [grade Ⅰ-Ⅱ(PSI score ≤ 70), grade Ⅲ (PSI score 71-90) and grade Ⅳ-Ⅴ(PSI score ≥ 91)], serum amyloid A (SAA), hypersensitive C-reactive protein (hs-CRP), procalcitonin (PCT), erythrocyte sedimentation rate (ESR) and white blood cell (WBC) on the 1 day after admission were compared between the different pathogens (viral and mycoplasma) or different disease severity. The change in level of SAA, hs-CRP on the third day (Δ 3 d = 1 d-3 d) were compared among different disease outcome groups (patients were divided into improved group, stable group and exacerbation group based on PSI scores or lung CT images on the third day). The change in the level of SAA, hs-CRP on the seventh day (Δ 7 d = 1 d-7 d) were compared among different disease prognosis groups (patients were divided into survival group and death group based on 28-day survival data). The receiver operating characteristic curve (ROC) were drawn to evaluate the value of SAA in the evaluation of disease and prediction prognosis. Results:The level of SAA in mycoplasma group (43 cases) was significantly higher than that in virus group (98 cases) on the 1 day after admission. There were no significant differences in other plasma biomarkers between the two groups. The more severe the illness, the higher the SAA level on the 1 day after admission. The trends of other plasma biomarkers in the two groups were consistent with SAA. The levels of SAA in the patients with exacerbation of the virus group and mycoplasma group (12 cases, 9 cases) were significantly higher than those of the improved group (57 cases, 26 cases) and the stable group (29 cases, 8 cases). SAA increased gradually in the exacerbation group, decreased gradually in the improved group, and slightly increased in the stable group. ΔSAA 3 d were differences among three groups. The change trend of hs-CPR was consistent with SAA. The level of SAA in the death group was higher than that in the survival group on the seventh day. SAA increased in the death group and decreased in survival group with time from hospital admission. There were differences according to ΔSAA 7 d between death group and survival group. The change trend of hs-CPR was consistent with SAA. ROC curve showed that the value of SAA was better than hs-CRP in assessing the severity of patients on admission day, and the area under ROC curve (AUC) was respectively 0.777 [95% confidence interval (95% CI) was 0.669-0.886], 0.729 (95% CI was 0.628-0.830). The value of ΔSAA 3 d was better than SAA on the third day predicting disease trends, and AUC was respectively 0.979 (95% CI was 0.921-1.000), 0.850 (95% CI was 0.660-1.000). hs-CRP on the third day and Δhs-CRP 3 d had no predictive value. Both SAA on the seventh day and ΔSAA 7 d have predictive value for prognosis. AUC was respectively 0.954 (95% CI was 0.898-0.993) and 0.890 (95% CI was 0.689-1.000). SAA on the seventh day and ΔSAA 7 d were better than hs-CRP on the seventh day. Δhs-CRP 7 d have no predictive value. Conclusions:SAA is a sensitive and valuable indicator for CAP patients with viruses and mycoplasma. Dynamic monitoring of SAA can evaluate the patient's progression, prognosis, and assist diagnosis and treatment.

Objective:To explore the application effect of "Internet +" hospital-family-school care model for school-age children with epilepsy.Methods:Using the convenient sampling method, a total of 80 school-age children with epilepsy who were treated in Xuzhou Children's Hospital from January to December 2020 were selected as the research objects. According to the random number table method, they were divided into the observation group and the control group, with 40 cases in each group. The control group was given routine continuous care, while the observation group implemented the "Internet +" hospital-family-school care model on the basis of the control group. Before the intervention and 3 and 6 months after the intervention, the self-made drug compliance questionnaire and Quality Childhood Epilepsy Questionnaire (QOLCE) were used to investigate the medication compliance and quality of life of children in the two groups. A self-made parent satisfaction questionnaire was used to investigate satisfaction of parents before the intervention and 6 months after the intervention.Results:After 3 and 6 months of intervention, medication compliance and scores of five aspects in QOLCE of the observation group were all higher than those of the control group, and the differences were statistically significant ( P<0.05) . After 6 months of intervention, the parents' satisfaction was higher than that of the control group, and the differences were statistically significant ( P<0.05) . Conclusions:The "Internet +" hospital-family-school care model can improve the medication compliance and quality of life of children and satisfaction of their parents with care and achieve a smooth transition from the hospital to the family and school, which is worthy of clinical promotion.

Objective:To understand the self-management needs of outpatient adolescent children with epilepsy, so as d to provide a theoretical basis for building a care model for children with epilepsy.Methods:Using the purposive sampling method, a total of 10 adolescent children with epilepsy who were treated in neurology clinic of a Class Ⅲ Grade A hospital affiliated to a medical university in Jiangsu Province were selected as the research objects from June 1 to December 31, 2020. Using qualitative research design, the semi-structured interview method was used to conduct in-depth interviews with the research objects. Data analysis was performed using Nvivo 10.0 software.Results:Through data analysis of the self-management needs of outpatient adolescent children with epilepsy, three themes were extracted, namely information needs, psychological support needs and social support needs.Conclusions:According to the analysis of the self-management needs of adolescent children with epilepsy in outpatient clinics, medical staff should focus on meeting the information needs of children, support children's psychological needs, strengthen social support, pay attention to the role of families and schools, adapt to the new situation, expand service areas and build suitable models of self-management care in adolescent children with epilepsy.

Objective:To determine the application effect of the "full chain" information-based health management model in the home care of children with bronchial asthma.Methods:Sixty children with bronchial asthma who were hospitalized in the Respiratory Department of Xuzhou Children's Hospital from January to June 2020 were selected and divided into a control group and an observation group according to a random number table with 30 cases in each group. The control group received routine nursing care, and the observation group implemented a "full-chain" informatized health management on the basis of the control group.The intervention time was 6 months. The condition control, medication compliance, self-management and airway function were observed and compared between the two groups.Results:After 6 months of intervention, the frequency of attacks, emergency cases, the medication compliance, the maximum expiratory flow rate, symptom days and peak expiratory flow days were 6.67%(2/30), 3.33%(1/30), 93.33%(28/30), (1.83±0.23) L, (163.00±6.74) d, (168.00±3.78) d in the observation group, and 26.67%(8/30), 20.00%(6/30), 66.67%(20/30), (1.67±0.24) L, (144.00±5.88) d, (157.00±4.08) d in the control group. The differences were statistically significant (χ 2 values were 4.320, 4.043, 6.667, t values were 2.636, 11.635, 10.833, P<0.05). There was no significant difference in the ratio of forced expiratory volume and forced expiratory volume in forced vital capacity in the first second after 6 months of intervention between the two groups ( P>0.05). Conclusions:"Full chain" information health management can reduce the number of attacks and emergency visits of children with asthma, effectively improve medication compliance, thus improving airway function and improving the quality of life of children.

Objective: To investigate the clinical effect and safety of dasatinib combined with Chinese Children's Leukemia Group-acute lymphoblastic leukemia (CCLG-ALL) 2008 protocol in treatment of childhood Philadelphia chromosome-positive (Ph⁺) acute lymphoblastic leukemia (ALL). Methods: The clinical data of 22 patients with Ph⁺ ALL who were newly diagnosed at the age of less than 15 years old in Fujian Medical University Union Hospital from January 2014 to December 2018 were retrospectively analyzed. All patients were treated with dasatinib combined with CCLG-ALL2008 protocol (high-risk group). The patients were assigned to two groups according to different starting times of oral dasatinib: the dasatinib-induced group (starting from day 15 of induction chemotherapy) and the dasatinib-consolidated group (starting with early consolidated chemotherapy). The early treatment response and 5-year event-free survival (EFS) rate were compared between the two groups. Results: The differences of clinical characteristics and early efficacy of chemotherapy before treatment of dasatinib between the two groups were not statistically significant (both P > 0.05). The complete remission (CR) rate on day 33 of induction chemotherapy was higher in the dasatinib-induced group than that in the dasatinib-consolidated group [100% (10/10) vs. 75% (9/12)], but the difference was not statistically significant (χ ²= 2.895, P= 0.221). The rate of minimal residual disease (MRD) turned negative (<0.01%) on day 33 of induction chemotherapy in the dasatinib-induced group was significantly higher than that in the dasatinib-consolidated group [70% (7/10) vs. 17% (2/12)], and the difference was statistically significant (χ ²= 6.418, P= 0.027). The 3-year EFS rate was higher in the dasatinib-induced group than that in the dasatinib-consolidated group (88.9% vs. 63.5%), but the difference was not statistically significant (P= 0.163). The incidence of grade 3-4 infection in the dashatinib-induced group was lower than that in the dasatinib-consolidated group, and the difference was statistically significant [60% (6/10) vs. 100% (12/12), P= 0.029]. the other grade 3-4 adverse reactions related to the chemotherapy drugs mainly included hematological toxicity, diarrhea, abnormal liver function, edema and pleural effusion, but there was no significant difference between the two groups (all P > 0.05). Conclusions Dasatinib combined with CCLG-ALL2008 protocol in the treatment of children with Ph⁺ ALL has good efficacy and safety. Furthermore, the early use of dasatinib on day 15 of induction chemotherapy can enable patients to achieve deeper remission earlier and improve long-term efficacy.