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@#Abstract: Objective To analyze the clinical features of hemophagocytic syndrome (HPS) associated with Orientia tsutsugamushi disease in children. Methods The case data of patients with scrub typhus in Kunming Children's Hospital from January 1st 2019 to December 31st 2021 was retrospectively analyzed. The patients were divided into the HPS group and the non-HPS group according to whether associated with HPS. The clinical data of the two groups were analyzed using SPSS 25.0. Results Eighty-five cases of scrub typhus in children were collected, 15 cases (17.6%) had HPS. The mean age of patients with HPS was (5.10±3.82) years, included 9 males and 6 female, there was no significant difference in gender and age between the HPS and the non-HPS group (P>0.05). Comparison of the two groups indicted that the incidence of cough, lung rales, edema, and hepatomegaly were significantly increased in the HPS group (P<0.05). The data showed that compared to the non-HPS group, the HPS group showed significant decreases in the levels of hemoglobin (HGB), platelet (PLT), albumin (ALB), fibrinogen (Fib) (P<0.05), and significant decreases in the levels of C-reactive protein (CRP), lactic dehydrogenase (LDH), triglyceride (TG), serum ferritin (SF) (P<0.05). The proportion of CD4+ T lymphocytes, CD4+/CD8+ were significantly decreased (P<0.05); the proportion of CD3+, CD8+ T lymphocytes were significantly increased (P<0.05). The proportion of pulmonary exudation or consolidation in the HPS group was higher than the non-HPS group, which was statistically significant (P<0.05). All the patients with scrub typhus associated with HPS were treated with oral doxycycline, and intravenous immunoglobulin was given in 13 cases (86.7%). There was one case of death and 14 cases discharged from hospital after treatment in HPS group. Conclusion HPS in scrub typhus infected children is a nonnegligible complication. Prolonged fever, lung rales, hepatomegaly，HGB decreased, thrombocytopenia, hyperferritinemia, and abnormal lymphocyte subsets may associate with HPS. It should be alerted to scrub typhus when presenting with HPS in endemic areas. The scrub typhus associated with HPS can be successfully treated with appropriate antibiotic and immunomodulator treatment.
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Objective@#To understand the consumption of nutritional supplements among the residents aged eighteen years and below in Tongzhou District of Beijing,so as to provide reference for supplements exposure assessment and health education.@* Methods@# A hundred people aged 18 years and below were selected from each of the eight neighborhood committees of Tongzhou Town,Tongzhou District,Beijing. The questionnaire for the Nutritional Supplements Guidelines for Chinese Residents Study was used to collect the rate of taking nutritional supplements,influencing factors,types and frequency. @*Results@#The rate of taking nutritional supplements was 44.16%. The rates of taking nutritional supplements in people aged 0-5 years,6-12 years and 13-18 years were 45.56%,42.86% and 41.00%,respectively,without statistically significant difference among them （P>0.05）. The rates of taking nutritional supplements in males and females were 44.82% and 43.49%,without statistically significant difference between them （P>0.05）. The Results of multivariate logistic regression analysis showed that annual per capita household income of more than 50 000 yuan （OR=1.688,95%CI: 1.171-2.435） and parents taking nutritional supplements （OR=4.104,95%CI: 3.023-5.573） were the promoting factors for the intake of nutritional supplements in people aged 18 years and below. The rates of taking calcium,vitamin D and multivitamin were 26.10%,21.56% and 8.31%,respectively. There were 272 （80.00%） people taking 1-2 kinds of supplements,and 200 （58.82%） people taking them daily. @*Conclusions@#In Tongzhou District,44.16% of the population aged 18 years and below takes nutritional supplements,mainly calcium and vitamin D. Family income and whether their parents taking or not are determinants.
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Contrast-induced acute kidney injury (CI-AKI) is a serious complication of diagnostic coronary angiograph and percutaneous coronary intervention (PCI). However, the exact pathophysiological mechanisms underlying CI-AKI development are largely unknown. The present study examined whether urinary semaphorin 3A levels predict the development of CI-AKI in patients undergoing PCI. This study enrolled 168 patients with stable angina undergoing elective PCI. Serial urine samples, obtained at baseline and 2, 6, 12, 24, 36, and 48 h post-PCI were analyzed by semaphorin 3A and neutrophil gelatinase-associated lipocalin (NGAL) ELISA kit. AKI was defined as an increase in serum creatinine beyond 50% according to the RIFLE classification system. Receiver operator characteristic (ROC) curve analyses identified optimal semaphorin 3A and NGAL values for diagnosing CI-AKI. CI-AKI occurred in 20 of 168 patients. There were no significant differences in the baseline clinical characteristics and angiographic findings between non-AKI patients group and AKI patients group. Both urinary semaphorin 3A and NGAL levels significantly increased at 2 and 6 h post-PCI. ROC analysis showed that the cut-off value of 389.5 pg/mg semaphorin 3A at 2 h post-PCI corresponds to 94% sensitivity and 75% specificity and the cut-off value of 94.4 ng/mg NGAL at 2 h post-PCI corresponds to 74% sensitivity and 82% specificity. Logistic regression showed that semaphorin 3A levels at 2 and 6 h post-PCI were the significant predictors of AKI in our cohort. Urinary semaphorin 3A may be a promising early biomarker for predicting CI-AKI in patients undergoing PCI.