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Objective:To measure the predictive value of miR-424 on the risk of sepsis complicated with acute respiratory distress syndrome(ARDS), and to explore its correlation with the prognosis of ARDS children.Methods:A prospective study was conducted.The data of children with sepsis (some complicated with ARDS), who were treated in Henan Provincial People′s Hospital (People′s Hospital, Zhengzhou University) were collected from February 2020 to February 2021.The incidence of ARDS and the fatality rate of ARDS children were recorded.Children were divided into survival group and death group according to whether death or not.The expression of miR-424 in peripheral blood mononuclear cells was detected by quantitative reverse transcription polymerase chain reaction (RT-qPCR). Pearson correlation analysis was made to investigate the relationship between the expression level of miR-424 and Pediatric Critical Illness Score(PCIS), Sequential Organ Failure Assessment(SOFA) score, oxygenation index(P/F ratio), C-reactive protein(CRP), procalcitonin (PCT), interleukin 6 (IL-6) and interleukin 8 (IL-8). The factors affecting the prognosis of ARDS children were analyzed by multivariate Logistic regression.Receiver operating characteristic curve(ROC)was used to assess the accuracy of miR-424 in early diagnosis of sepsis complicated with ARDS, and to measure the predicative value of miR-424 on the risk of death in sepsis patients with ARDS. Results:A total of 121 sepsis patients were included in this study, and 36 cases of them were complicated with ARDS.The expression level of miR-424(0.56±0.17)in the blood of sepsis patients complicated with ARDS was significantly lower than that of sepsis patients without ARDS (0.98±0.26)( t=8.776, P<0.001). The expression of miR-424 was negatively co-rrelated with IL-6( r=-0.627, P<0.01), IL-8 ( r=-0.651, P<0.01) and CRP( r=-0.472, P<0.05)in sepsis patients with ARDS.The expression of miR-424 was positively correlated with PCIS score( r=0.330, P<0.05), P/F ratio ( r=0.592, P<0.001) and albumin ( r=0.496, P<0.05) in sepsis patients with ARDS.The ROC showed that miR-424 [area under curve(AUC)=0.908, 95% CI: 0.856-0.960] could differentiate sepsis patients with ARDS from those without ARDS.Compared with that of the survival group(0.63±0.15), miR-424 of the death group decreased significantly(0.42±0.14)( t=3.890, P<0.05). The decreased miR-424 (AUC=0.845, 95% CI: 0.696-0.995)indicated an increased risk of death in children with ARDS.Multivariate Logistic regression analysis showed that miR-424( OR=0.001, P=0.033)and albumin ( OR=0.553, P=0.040) were independent risk factors for death in ARDS children. Conclusions:miR-424 can help with early diagnosis of sepsis complicated with ARDS, and can be used as a predictor of the prognosis of sepsis children complicated with ARDS.
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Objective:To measure the predictive value of miR-424 on the risk of sepsis complicated with acute respiratory distress syndrome(ARDS), and to explore its correlation with the prognosis of ARDS children.Methods:A prospective study was conducted.The data of children with sepsis (some complicated with ARDS), who were treated in Henan Provincial People′s Hospital (People′s Hospital, Zhengzhou University) were collected from February 2020 to February 2021.The incidence of ARDS and the fatality rate of ARDS children were recorded.Children were divided into survival group and death group according to whether death or not.The expression of miR-424 in peripheral blood mononuclear cells was detected by quantitative reverse transcription polymerase chain reaction (RT-qPCR). Pearson correlation analysis was made to investigate the relationship between the expression level of miR-424 and Pediatric Critical Illness Score(PCIS), Sequential Organ Failure Assessment(SOFA) score, oxygenation index(P/F ratio), C-reactive protein(CRP), procalcitonin (PCT), interleukin 6 (IL-6) and interleukin 8 (IL-8). The factors affecting the prognosis of ARDS children were analyzed by multivariate Logistic regression.Receiver operating characteristic curve(ROC)was used to assess the accuracy of miR-424 in early diagnosis of sepsis complicated with ARDS, and to measure the predicative value of miR-424 on the risk of death in sepsis patients with ARDS. Results:A total of 121 sepsis patients were included in this study, and 36 cases of them were complicated with ARDS.The expression level of miR-424(0.56±0.17)in the blood of sepsis patients complicated with ARDS was significantly lower than that of sepsis patients without ARDS (0.98±0.26)( t=8.776, P<0.001). The expression of miR-424 was negatively co-rrelated with IL-6( r=-0.627, P<0.01), IL-8 ( r=-0.651, P<0.01) and CRP( r=-0.472, P<0.05)in sepsis patients with ARDS.The expression of miR-424 was positively correlated with PCIS score( r=0.330, P<0.05), P/F ratio ( r=0.592, P<0.001) and albumin ( r=0.496, P<0.05) in sepsis patients with ARDS.The ROC showed that miR-424 [area under curve(AUC)=0.908, 95% CI: 0.856-0.960] could differentiate sepsis patients with ARDS from those without ARDS.Compared with that of the survival group(0.63±0.15), miR-424 of the death group decreased significantly(0.42±0.14)( t=3.890, P<0.05). The decreased miR-424 (AUC=0.845, 95% CI: 0.696-0.995)indicated an increased risk of death in children with ARDS.Multivariate Logistic regression analysis showed that miR-424( OR=0.001, P=0.033)and albumin ( OR=0.553, P=0.040) were independent risk factors for death in ARDS children. Conclusions:miR-424 can help with early diagnosis of sepsis complicated with ARDS, and can be used as a predictor of the prognosis of sepsis children complicated with ARDS.
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Objective:To evaluate the relationship of vitamin D deficiency(VDD) between sepsis and septic shock among critical ill children, and investigate the influence of VDD on etiology and prognosis of sepsis.Methods:The observational cohort studies, involving vitamin D and critically ill children, were searched in Medline, Web of Science, EBSCO host and China National Knowledge Infrastructure, Wanfang Data Knowledge Service Platform.The quality assessment was conducted on the basis of the Newcastle-Ottawa Quality Assessment Scale.Consistent definitions of sepsis and septic shock were applied and standardized data were obtained following the study design.We retrieved the clinical outcomes related to septic shock and serum 25-hydroxyvitamin D 3concentrations and made a meta-analysis for the relation between VDD and clinical outcomes at two cut-offs. Results:In the analysis of collected data including severe VDD as a risk factor for incidence of sepsis and septic shock, the pooled RRwas 1.71(95% CI1.11 to 2.63, P=0.01) and 2.05(95% CI1.35 to 3.10, P<0.001) respectively, which were all higher compared with VDD.And severe VDD was also associated with cv-SOFA score( RR0.68, 95% CI0.45 to 0.91, P<0.001). However, no significant differences in mortality or the duration of vasopressor was found at severe VDD or VDD cut-off levels among septic shock patients. Conclusion:Among pediatric critical illness, severe VDD is more likely related to the incidence for sepsis and septic shock compared with VDD.And comorbidity with severe VDD could increase the cv-SOFA score of septic children.
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Objective:To investigate the characteristics of gut microbiota in children with sepsis and the effects of probiotic intervention.Methods:Thirty-four children with sepsis admitted to the Pediatric Intensive Care Unit of Henan Provincial People′s Hospital were enrolled in this prospective study from May 2019 to July 2020. They were randomly divided into two groups and received conventional treatment (conventional treatment group, n=17) and conventional treatment combined with probiotics (probiotics group, n=17), respectively. Twenty healthy children were selected as healthy control group. The baseline characteristics and sequential organ failure assessment (SOFA) score of all children with sepsis were recorded within 24 h after recruitment. Stool samples were collected 5-7 d after recruitment. High-throughput 16S rRNA gene sequencing was used to detect gut microbiota. Bioinformatic analysis and predictive functional profiling of microbial communities were performed to analyze the differences between groups. Results:The α-diversity and β-diversity indexes showed compared with the healthy control group, the two sepsis groups had lower abundance of gut microbiota, but greater individual differences in bacteria structure. These indexes were improved significantly following probiotic intervention ( P<0.05). At the level of phylum, the proportions of Bacteroidota and Actinobacteriota in the conventional treatment group were the lowest among the three groups, while the proportion of Proteobacteria increased significantly ( P<0.05). At the level of genus, Enterocoddus was the predominant bacterium in the conventional treatment group, while the abundance of Bifidobacterium, Faecalibacterium, Erysipelotrichaceae and Rumimococcus- torques in the probiotics group showed an upward trend ( P<0.05). Differences in the abundance of metabolic pathways, including mitochondrial synthesis, exosomes, mRNA transcription and degradation and cysteine metabolism, could be found between the two sepsis groups. Conclusions:This study revealed that children with sepsis exhibit a dysbiotic microbial community with reduced microbial diversity, declined structural stability, decreased abundance of Bacteroidota and enrichment of Proteobacteria. Probiotic supplementation could elevate the percentage of beneficial symbiotic bacteria and reduce the number of pathogenic bacteria. The differential metabolic pathways might be associated with the mechanism of probiotics in practice.
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Antioxidants are important substances in the body against oxidative stress,which can main-tain the balance of redox substances by reducing the content of reactive oxygen species in cells. Studies have shown that new antioxidants have significant inhibitory effects on the growth of urological neoplasms by inhibiting tumor cell proliferation,inducing apoptosis,disturbing angiogenesis and metastasis of tumor cells. Antioxidants are of great value in the prevention and treatment of urinary system tumors and are expected to become new anti-tumor drugs.
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Objective:To investigate the effects of probiotics on the stabilization of blood glucose and its mechanism in children with severe infectious pneumonia.Methods:Eighty children with severe infectious pneumonia admitted to PICU were enrolled in the clinical trial prospectively.They were divided into two groups by random.Forty patients given probiotics were regarded as treatment group,the others not given probiotics were considered to be controlled group,in addition to the regular therapy.Blood glucose,plasma H2 S,D-lactate and acetic acid,propionic acid and butyric acid concentrations in stools were measured respectively at the beginning of the treatment and on day 8 after the treatment.At the same time the changes of blood glucose,fluctuation of them and prognosis were examined.Results:There was no significance in all the parameters of the two groups at the beginning of the treatment (P ＞ 0.05).The levels of plasma H2S and acetic acid,butyric acid in the stools of the probiotics group was (24.6 ± 7.4) μmol/L,(32.8 ± 8.6) μmol/g,(15.2 ± 5.2) μmoL/g on the day 8 respectively;but the concentration of these parameters in the control group was (20.9 ± 7.4) μ mol/L,(28.6 ± 7.9) μmol/g,(12.9 ± 5.0) μmoL/g.Meanwhile the level of D-lactate in patients given probiotics (1.25 ± 0.39) μg/ ml was significantly lower than that the control group (1.45 ± 0.4) μg/ml.The blood glucose (6.1 ± 2.7) mmol/L was lower than than in the other group (7.4 ± 2.7) mmol/L on day 8.And a higher recov ery rate was found in probiotic group.Furthermore,blood glucose and H2S,acetic acid levels expressed negative correlation at 8 day;but positive correlations were found between blood glucose and D-lactate (P ＜ 0.05).Conclusion:Application of probiotics to children with severe infectious pneumonia can moderate the structure of enterobacteria,reinforce the intestinal barrier and elevate the levels of plasma H2S and had positive effects on the stabilization of blood glucose and prognosis.
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Objective To investigate the regulatory effects of probiotics on ghrelin and their pro-tective effects on pulmonary function of children during acute lung injury.Methods Fifty children with acute lung injury were recruited form Henan Provincial People′s Hospital during 2010 to 2013 and randomly divided into two groups.In addition to regular therapy, those who received probiotics treatment were set up as the probiotics treatment group and the others were considered as the control group.Levels of ghrelin, sur-factant protein A( SP-A) , TNF-αand IL-6 in serum samples were measured before and 10 days after the cor-responding treatments.Each patient was analyzed by pulmonary function test and echocardiography.The vol-ume to peak expiratory flow ( VPEF) , ratio of time to reach peak tidal expiratory flow to total expiratory time ( TPTEF/TE) , mean arterial pressure ( MAP) and pulmonary artery pressure ( PAP) were recorded for sta-tistical analysis.Results The levels of SP-A, TNF-αand IL-6 in serum samples from the probiotics treat-ment group were decreased on day 10 as compared with those of the control group [(195.9±54.3) ng/ml vs (245.5±56.4) ng/ml, (382.0±56.4) pg/ml vs (440.7±46.8) pg/ml, (221.5±62.6) pg/ml vs (303.5 ±83.9) pg/ml;P<0.05] .Children from the probiotics treatment group showed higher values of VPEF and TPTEF/TE on day 10 as compared with those without probiotics treatment [(25.3±4.5) ml vs (23.8±4.6) ml, (29.5±4.3) %vs (26.8±4.7) %;P<0.05].Treatment of children with probiotics increased MAP and decreased PAP [(74.5±6.7) mmHg vs (71.9±6.9) mmHg, (25.5±6.4) mmHg vs (29.1±6.2) mmHg] .The levels of ghrelin in patients received probiotics treatment were higher than those of children without probiotics treatment [(329.3 ±49.6) pg/ml vs (296.6 ±48.5) pg/ml].The levels of ghrelin showed negative correlations with the levels of SP-A, TNF-α, IL-6 and PAP on day 10, but positive correla-tions with TPTEF/TE and MAP (P<0.05).Conclusion Use of probiotics to children with acute lung inju-ry could regulate the level of ghrelin, alleviate the inflammation of lungs and improve the recovery of lung function and circulation.Therefore, probiotics treatment had positive effects on the protection of pulmonary function.
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Objective To evaluate the efficacy and safety of ?-asarone injection in infants with asthmatic pneumonia.Methods 142 patients aged from 4 months to 6 years were randomly divided into a treatment group(78 cases) and a control group(64 cases).Two groups were the same basically on the conventional therapy.The treatment group was administrated with ?-asarone injection.Every 0.5mg/kg(maxium dose
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This study is to investigate the clinical effects of intravenous high dose of gamma immunoglobulin(IG) in treatment of Kawasaki disease(KD). A total of 21 children with KD were treated with high dose of gamma IG intravenously.The result showed that it was more effective when adding high dose of gamma IG than aspirin alone( P