Impact of COVID-19 on adverse reactions to subcutaneous specific immunotherapy in children:a retrospective cohort study.

BACKGROUND: COVID-19 is a new infectious disease. To investigate whether severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection increases the adverse reactions of subcutaneous specific immunotherapy (SCIT) in children. METHODS: This study was conducted by collecting relevant data from children who underwent house dust mite SCIT from April 3, 2021, to March 18, 2023, including information on the time of COVID-19 infection, symptoms, and adverse reactions after each allergen injection. A mixed effects model was used to analyze the changes in adverse reactions before and after the COVID-19 infection. RESULTS: Among the records of adverse reactions from 2658 injections in 123 children who underwent SCIT, the overall adverse reaction rate before COVID-19 infection was 39.8% and 30.0% after COVID-19 infection. Compared with pre-infection with COVID-19, the risks of overall adverse reactions, local adverse reactions, and systemic adverse reactions of immunotherapy after COVID-19 infection were reduced (odds ratio [OR] = 0.24, 0.31, and 0.28, all P < 0.05). Among the local adverse reactions, the incidence of the unvaccinated group was the highest (15.3% vs. 7.1%). The incidence of overall and local adverse reactions to SCIT decreased in 2-vaccinated COVID-19 recipients (OR = 0.29-0.31, P < 0.05). CONCLUSIONS: In children, SARS-CoV-2 infection does not increase the incidence of adverse reactions to SCIT. This finding can provide a basis for the implementation of allergen-specific immunotherapy (AIT) during the COVID-19 pandemic.

Stiff gel-protected fiber-shaped supercapacitors based on CNFA/silk composite fiber with superhigh interference-resistant ability as self-powered temperature sensor.

The development of self-powered sensors with interference-resistant detection is a priority area of research for the next generation of wearable electronic devices. Nevertheless, the presence of multiple stimuli in the actual environment will result in crosstalk with the sensor, thereby hindering the ability to obtain an accurate response to a singular stimulus. Here, we present a self-powered sensor composed of silk-based conductive composite fibers (CNFA@ESF), which is capable of energy storage and sensing. The fabricated CNFA@ESF exhibits excellent mechanical performance, as well as flexibility that can withstand various deformations. The CNFA@ESF provides a good areal capacitance (44.44 mF cm-2), high-rate capability, and excellent cycle stability (91 % for 5000 cycles). In addition, CNFA@ESF also shows good sensing performance for multiple signals including strain, temperature, and humidity. It was observed that the assembly of the symmetrical device with a stiff hydrogel surface layer for protection enabled the real-time, interference-free monitoring of temperature signals. Also, the CNFA@ESF can be woven into fabrics and integrated with a solar cell to form a self-powered sensor system, which has been proven to convert and store solar energy to power electronic watches, indicating its huge potential for future wearable electronics.

Augmented reality navigation method based on image segmentation and sensor tracking registration technology.

With the rapid development of modern science and technology, navigation technology provides great convenience for people's life, but the problem of inaccurate localization in complex environments has always been a challenge that navigation technology needs to be solved urgently. To address this challenge, this paper proposes an augmented reality navigation method that combines image segmentation and multi-sensor fusion tracking registration. The method optimizes the image processing process through the GA-OTSU-Canny algorithm and combines high-precision multi-sensor information in order to achieve accurate tracking of positioning and guidance in complex environments. Experimental results show that the GA-OTSU-Canny algorithm has a faster image edge segmentation rate, and the fastest start speed is only 1.8 s, and the fastest intersection selection time is 1.2 s. The navigation system combining the image segmentation and sensor tracking and registration techniques has a highly efficient performance in real-world navigation, and its building recognition rates are all above 99%. The augmented reality navigation system not only improves the navigation accuracy in high-rise and urban canyon environments, but also significantly outperforms traditional navigation solutions in terms of navigation startup time and target building recognition accuracy. In summary, this research not only provides a new framework for the theoretical integration of image processing and multi-sensor data, but also brings innovative technical solutions for the development and application of practical navigation systems.

Clinical Features and Biomarkers for Early Prediction of Refractory Mycoplasma Pneumoniae Pneumonia in Children.

Objective: The study aimed to analyze the clinical characteristics of children with RMPP and to explore the biomarkers for the early prediction of RMPP, thus providing references for the clinical diagnosis and treatment of RMPP in children. Methods: Baseline clinical characteristics, clinical symptoms, physical examination, chest imaging, and laboratory indicators between children with RMPP and general refractory mycoplasma pneumoniae pneumonia (GMPP) were compared. Multiple logistic regression analysis was used to determine independent risk factors for RMPP. ROC curves were adopted to analyze the predictive values of biomarkers. Results: The RMPP group had more severe clinical symptoms and manifestations on imaging (including pleural effusion, pulmonary consolidation, and pulmonary atelectasis), a higher incidence of extrapulmonary complications, and a longer duration of hospital stays. Results of multiple logistic regression analysis showed that serum D-dimer (OR = 8.169, P < 0.001), C-reactive protein (CRP) (OR = 1.146, P < 0.001), and lactate dehydrogenase (LDH) (OR = 1.025, P < 0.001) levels were independent risk factors for RMPP. The area under the receiver operating characteristic curve (AUROC) in RMPP prediction was 0.841, 0.870, and 0.893 for serum levels of D-dimer, CRP, and LDH, respectively (P < 0.001), with a cutoff value of 1.47 ng/ml, 39.34 mg/L, and 379 IU/L, respectively. Conclusions: Serum D-dimer, CRP, and LDH levels were related to the severity of mycoplasma pneumoniae pneumonia in children and had potential as biomarkers for the early prediction of RMPP, suggesting great applicative values for the early diagnosis and timely intervention of children with RMPP in clinical practice.

An analysis of risk factors associated with recurrent wheezing in the pediatric population.

BACKGROUND: Recurrent wheezing is a common clinical problem in early childhood, which is associated with significant morbidity. There is no international consensus on the management and prevention of recurrent wheezing; therefore, identifying the risk factors associated with recurrent wheezing is crucial to prevent episodes of wheezing in young children. METHODS: In this retrospective study, we collected the data of 24,737 patients who were admitted to our hospital between 27th April 2012 and 11th September 2019. After screening for patients with wheezing, we identified 8572 patients with a primary diagnosis of pneumonia with wheezing. Patients' clinical data were collected from the hospital medical records. Patients were stratified for age in the groups of < 6 months, 6-12 months, and > 12 months. RESULTS: Among the 8569 pediatric pneumonia patients with wheezing, there were 343 patients with recurrent wheezing. Most enrolled patients were under 6 months of age (45.17%) and had a normal birth weight (86.95%). Winter was the most common onset season for the first episode of wheezing, while spring was the most common season for the second episode of wheezing for those with recurrent wheezing. The univariate and multivariate logistic regression analysis for the risk factor associated with recurrent wheezing showed that male gender, past history of respiratory and cardiovascular diseases, low birth weight, development of severe pneumonia, and PICU admission were significantly associated with recurrent wheezing. CONCLUSION: Male gender, past history of respiratory and cardiovascular diseases, low birth weight, severe pneumonia, and PICU admission are independent risk factors of recurrent wheezing in the pediatric population.

Evaluation of Graphene Oxide as a Thermal Ionization Enhancer for Plutonium in TIMS Measurement.

Thermal ionization mass spectrometry (TIMS) has been extensively employed for the assessment of plutonium (Pu) isotopes in nuclear forensics and environmental monitoring. Recently, great efforts have been made to improve the ionization efficiency (IE) of Pu to achieve better accuracy and precision for trace-level analysis. Herein, the thermal ionization enhancement effect for plutonium of graphene oxide (GO) was investigated and the corresponding mechanism was discussed. The GO layers were homogeneously mounted on the filament's central surface to promote pg-level Pu ion emission. With the excellent structural property of GO, a greatly promoted ionization efficiency of 0.44% for Pu was obtained, and the initial ionization temperature for Pu was remarkably reduced from 1610 to 1390 °C. Average boosts in IE compared to the classical double-filament mode and graphite-loaded single-filament mode were 1640 and 520%, respectively. The analytical accuracy and precision based on the GO-loaded single-filament mode were validated using Pu isotopic certified reference materials. This work demonstrates the excellent property of GO as an ion source additive for Pu ionization, as it provided an interface for the promotion of energy transfer and Pu carbide formation. The operation of GO loading is quite simple and can be finished within 5 min. This rapid filament carburization approach has great potential for improving the measurement precision of trace-level plutonium isotopes and can be applied in nuclear safeguards, nuclear forensics, and environmental monitoring.

ZFX-mediated upregulation of CEBPA-AS1 contributes to acute myeloid leukemia progression through miR-24-3p/CTBP2 axis.

Emerging reports demonstrated that long non-coding RNAs (lncRNAs) play a role in the pathogenesis and metastasis of cancers. However, the biological functions and underlying mechanisms of LncRNA CEBPA-AS1 in acute myeloid leukemia (AML) remain largely elusive. The level of CEBPA-AS1 was examined in AML clinical tissues and cell lines via fluorescence in situ hybridization (FISH) and reverse transcription-quantitative polymerase chain reaction (RT-qPCR). In vivo and in vitro functional tests were applied to identify the pro-oncogenic role of CEBPA-AS1 in AML development. The overexpressed CEBPA-AS1 was linked to poor survival in AML patients. Moreover, the relationships among CEBPA-AS1, Zinc Finger Protein X-Linked (ZFX), and miR-24-3p were predicted by bioinformatics and validated by RNA immunoprecipitation (RIP) and luciferase reporter assays. Our findings unveiled that transcription factor ZFX particularly interacted with the promoter of CEBPA-AS1 and activated CEBPA-AS1 transcription. Downregulation of CEBPA-AS1 inhibited the proliferation and invasion while promoted apoptosis of AML cells in in vitro, as well as in vivo, xenograft tumor growth was modified. However, overexpression of CEBPA-AS1 observed the opposite effects. Furthermore, CEBPA-AS1 acted as a competitive endogenous RNA (ceRNA) of miR-24-3p to attenuate the repressive effects of miR-24-3p on its downstream target CTBP2. Taken together, this study emphasized the pro-oncogenic role of CEBPA-AS1 in AML and illustrated its connections with the upstream transcription factor ZFX and the downstream regulative axis miR-24-3p/CTBP2, providing important insights to the cancerogenic process in AML.

Percutaneous Puncture Embolization for Recurrent Pulmonary Arteriovenous Malformation After Failed Initial Treatment: A Case Report.

BACKGROUND: Transcatheter embolization is a commonly used minimally invasive technique in the treatment of pulmonary arteriovenous malformation (PAVM) with a high probability of post-operative recurrence, and some recurrent cases of PAVM cannot be treated via pulmonary arterial re-embolization. Here, we report the first case, to our knowledge, a 55-year-old female undergoing percutaneous direct puncture embolization for recurrent PAVM with good short-term efficacy. CASE PRESENTATION: The patient was a 55-year-old female presenting to the emergency department of our hospital with acute exacerbation of chest tightness and shortness of breath for 2 hours. The patient was diagnosed with PAVM and undergone embolization half a year ago. DSA-guided embolization was performed through percutaneous puncture approach. After embolization with four spring coils, the blood flow to the PAVMs was stopped and the surgery completed. The patient reported improvement of chest tightness and shortness of breath and was discharged from the hospital 3 days later. CONCLUSION: Our case was unique as a portion of the PAVMs was closely attached to the chest wall and PVP was slightly increased, which made percutaneous puncture embolization possible. Our case can be helpful in the treatment of recurrent PAVM in patients who cannot undergo re-embolization through pulmonary artery.

Review of the endocrine organ-like tumor hypothesis of cancer cachexia in pancreatic ductal adenocarcinoma.

Pancreatic ductal adenocarcinoma (PDAC) is one of the most fatal types of solid tumors, associated with a high prevalence of cachexia (~80%). PDAC-derived cachexia (PDAC-CC) is a systemic disease involving the complex interplay between the tumor and multiple organs. The endocrine organ-like tumor (EOLT) hypothesis may explain the systemic crosstalk underlying the deleterious homeostatic shifts that occur in PDAC-CC. Several studies have reported a markedly heterogeneous collection of cachectic mediators, signaling mechanisms, and metabolic pathways, including exocrine pancreatic insufficiency, hormonal disturbance, pro-inflammatory cytokine storm, digestive and tumor-derived factors, and PDAC progression. The complexities of PDAC-CC necessitate a careful review of recent literature summarizing cachectic mediators, corresponding metabolic functions, and the collateral impacts on wasting organs. The EOLT hypothesis suggests that metabolites, genetic instability, and epigenetic changes (microRNAs) are involved in cachexia development. Both tumors and host tissues can secrete multiple cachectic factors (beyond only inflammatory mediators). Some regulatory molecules, metabolites, and microRNAs are tissue-specific, resulting in insufficient energy production to support tumor/cachexia development. Due to these complexities, changes in a single factor can trigger bi-directional feedback circuits that exacerbate PDAC and result in the development of irreversible cachexia. We provide an integrated review based on 267 papers and 20 clinical trials from PubMed and ClinicalTrials.gov database proposed under the EOLT hypothesis that may provide a fundamental understanding of cachexia development and response to current treatments.

DNAzyme recognition triggered cascade signal amplification for rapid and highly sensitive visual detection of uranyl ions.

This work presents a rapid and highly sensitive colorimetric assay using bifunctional DNA probe decorated agarose microbeads (MBs) coupled with a cascade signal amplification system, including rolling circle amplification (RCA) and the hemin/G-quadruplex-catalyzed colorimetric reaction, for visualized detection of uranyl ions. The DNA probe integrates the UO22+-specific DNAzyme/substrate as the target recognition unit and a DNA primer as the signal conversion unit. The presence of uranyl ions induces the efficient cleavage of the DNA substrates with the catalysis of DNAzyme. Then the conjugated primers are released from MBs, initiating the RCA reaction (the first amplification). The RCA product consists of repetitive G-quadruplexes that can lead to a second amplification by catalyzing the oxidation of ABTS2- with hemin binding, resulting in a coloration that is visible to the naked eye. The whole assay procedure could be finished within 40 min, including recognition of uranyl and DNA cleavage (5 min), the RCA reaction (30 min) and data readout either by eye or using a UV-vis spectrometer (5 min for each sample). In the optimal conditions, concentrations as low as 5 nM uranyl ions could be distinguished by the naked eye. With UV-vis spectrometric measurement, the visible absorbance had a linear relationship with the concentration of uranyl ions with a dynamic range from 1 nM to 50 nM, and a low detection limit of 0.48 nM (i.e. ∼0.12 ppb) was obtained. Excellent selectivity and anti-interference capability in water samples were also certified. This facile visualized assay could be applied in detecting trace-level uranium for on-site environmental analysis.

Cloud point extraction associated with differential pulse voltammetry: preconcentration and determination of trace uranyl in natural water.

A procedure for the electroanalytical determination of uranyl ions pre-concentrated from natural water by cloud point extraction (CPE) is developed in this study. CPE parameters, such as surfactant concentration, extractant concentration, pH and additive concentration were optimized. After CPE, the solution was diluted for electrochemical determination by differential pulse voltammetry (DPV) with a mercury film electrode (Hg-GCE). The current response of uranyl showed a linear relationship with concentration from 10 nmol L-1 to 1 µmol L-1. The hyphenated method combining CPE and DPV achieved a detection limit of uranyl as low as 0.15 nmol L-1. The presence of some foreign ions interfered greatly with the current response of electrochemical detection. Therefore, the hyphenated technique combining CPE and DPV is important because the CPE step provides selectivity against the co-existing metal ions for electrochemical detection. No interference was seen from the representative foreign metal ions in the CPE-DPV method. The developed method was successfully applied for the determination of uranyl ions in natural water. The average recovery using CPE-DPV in real samples varied from 94.4% to 103.2% and the precision was comparable with that of inductively coupled plasma mass spectrometry (ICP-MS), indicating the good accuracy and precision of the method developed. This hyphenated technique could have greater potential applications for the determination of uranyl ions in aqueous environments.

Flexible, anti-damage, and non-contact sensing electronic skin implanted with MWCNT to block public pathogens contact infection.

If a person comes into contact with pathogens on public facilities, there is a threat of contact (skin/wound) infections. More urgently, there are also reports about COVID-19 coronavirus contact infection, which once again reminds that contact infection is a very easily overlooked disease exposure route. Herein, we propose an innovative implantation strategy to fabricate a multi-walled carbon nanotube/polyvinyl alcohol (MWCNT/PVA, MCP) interpenetrating interface to achieve flexibility, anti-damage, and non-contact sensing electronic skin (E-skin). Interestingly, the MCP E-skin had a fascinating non-contact sensing function, which can respond to the finger approaching 0-20 mm through the spatial weak field. This non-contact sensing can be applied urgently to human-machine interactions in public facilities to block pathogen. The scratches of the fruit knife did not damage the MCP E-skin, and can resist chemical corrosion after hydrophobic treatment. In addition, the MCP E-skin was developed to real-time monitor the respiratory and cough for exercise detection and disease diagnosis. Notably, the MCP E-skin has great potential for emergency applications in times of infectious disease pandemics. Electronic Supplementary Material: Supplementary material (fabrication of MCP E-skin, laser confocal tomography, parameter optimization, mechanical property characterization, finite element simulation, sensing mechanism, signal processing) is available in the online version of this article at 10.1007/s12274-021-3831-z.

Cellulose nanofiber derived carbon aerogel with 3D multiscale pore architecture for high-performance supercapacitors.

Carbon materials are highly promising electrode materials for supercapacitors, due to their hierarchical porous structure and large specific surface area. However, the limited specific capacitance and inferior rate capability significantly prevent their practical application. Herein, 3D interconnected hierarchical porous carbon aerogels (CNFAs) through engineering the pyrolysis chemistry of CNF are developed. The obtained CNFAs effectively improve the carbon yield and suppress the volume shrinkage, as well as have robust mechanical properties. As a supercapacitor electrode, the CNFAs-17% electrode exhibits an ultrahigh capacitance of 440.29 F g-1 at 1 A g-1, significantly superior to most reported biomass-based carbon materials. Moreover, the CNFAs-17% assembled symmetric supercapacitor (SSC) achieves an outstanding rate capability (63.29% at 10 mA cm-2), high areal energy density (0.081 mWh cm-2), and remarkable cycling stability (nearly 100% capacitance retention after 7000 cycles). This work offers a simple, effective strategy towards the preparation of promising electrode materials for high-performance energy storage applications.

Androgen/Androgen Receptor Signaling in Ovarian Cancer: Molecular Regulation and Therapeutic Potentials.

Ovarian cancer (OVCA) arises from three cellular origins, namely surface epithelial cells, germ cells, and stromal cells. More than 85% of OVCAs are EOCs (epithelial ovarian carcinomas), which are the most lethal gynecological malignancies. Cancer stem/progenitor cells (CSPCs) are considered to be cancer promoters due to their capacity for unlimited self-renewal and drug resistance. Androgen receptor (AR) belongs to the nuclear receptor superfamily and can be activated through binding to its ligand androgens. Studies have reported an association between AR expression and EOC carcinogenesis, and AR is suggested to be involved in proliferation, migration/invasion, and stemness. In addition, alternative AR activating signals, including both ligand-dependent and ligand-independent, are involved in OVCA progression. Although some clinical trials have previously been conducted to evaluate the effects of anti-androgens in EOC, no significant results have been reported. In contrast, experimental studies evaluating the effects of anti-androgen or anti-AR reagents in AR-expressing EOC models have demonstrated positive results for suppressing disease progression. Since AR is involved in complex signaling pathways and may be expressed at various levels in OVCA, the aim of this article was to provide an overview of current studies and perspectives regarding the relevance of androgen/AR roles in OVCA.

Confined Chemical Transitions for Direct Extraction of Conductive Cellulose Nanofibers with Graphitized Carbon Shell at Low Temperature and Pressure.

Cellulose is the most abundant renewable natural polymer on earth, but it does not conduct electricity, which limits its application expansion. The existing methods of making cellulose conductive are combined with another conductive material or high-temperature/high-pressure carbonization of the cellulose itself, while in the traditional method of sulfuric acid hydrolysis to extract nanocellulose, it is usually believed that a too high temperature will destroy cellulose and lead to experimental failure. Now, based on a new research perspective, by controlling the continuous reaction process and isolating oxygen, we directly extracted intrinsically conductive cellulose nanofiber (CNF) from biomass, where the confined range molecular chains of CNF were converted to highly graphitized carbon at only 90 °C and atmospheric pressure, while large-scale twisted graphene films can be synthesized bottom-up from CNFene suspensions, called CNFene (cellulose nanofiber-graphene). The conductivity of the best CNFene can be as high as 1.099 S/cm, and the generality of this synthetic route has been verified from multiple biomass cellulose sources. By comparing the conventional high-pressure hydrothermal and high-temperature pyrolysis methods, this study avoided the dangerous high-pressure environment and saved 86.16% in energy. These findings break through the conventional notion that nanocellulose cannot conduct electricity by itself and are expected to extend the application potential of pure nanocellulose to energy storage, catalysis, and sensing.

Versatile nanocellulose-based nanohybrids: A promising-new class for active packaging applications.

The food packaging industry is rapidly growing as a consequence of the development of nanotechnology and changing consumers' preferences for food quality and safety. In today's globalization of markets, active packaging has achieved many advantages with the capability to absorb or release substances for prolonging the food shelf life over the traditional one. Therefore, it is critical to developing multifunctional active packaging materials from biodegradable polymers with active agents to decrease environmental challenges. This review article addresses the recent advances in nanocelluloses (NCs)- baseds nanohybrids with new function features in packaging, focusing on the various synthesis methods of NCs-based nanohybrids, and their reinforcing effects as active agents on food packaging properties. The applications of NCs-based nanohybrids as antioxidants, antimicrobial agents, and UV blocker absorbers for prolonging food shelf-life are also reviewed. Overall, these advantages make the CNs-based nanohybrids with versatile properties promising in food and packaging industries, which will impact more readership with concern for future research.

Age-specific risk factors of severe pneumonia among pediatric patients hospitalized with community-acquired pneumonia.

BACKGROUND: Risk factors that predispose the development of severe community-acquired pneumonia (CAP) among pediatric CAP patients of different age ranges are yet to be identified. METHODS: We retrospectively analyzed pediatric in-patients (< 6 years old) diagnosed with CAP in our hospital. We subdivided patients into four age groups (< 6 months, 6 months-1 year, 1-2 years, and 2-6 years). Their medical records, including demographic information, clinical features, laboratory findings, and chest radiographic reports, were reviewed and collected for further analysis. Univariate logistic regression analysis and stepwise regression analysis were applied to identify risk factors associated with severe CAP and ICU admission for overall patients and age-stratified subgroups. RESULTS: A total of 20,174 cases were initially included. Among them, 3309 (16.40%) cases were identified as severe CAP, and 2824 (14.00%) cases required ICU admission. Potential risk factors for severe CAP and ICU admission identified by univariate analysis included younger age, rural residency, premature birth, low birth weight (LBW), formula feeding, congenital heart disease (CHD), history of pneumonia or neonatal jaundice, patients with other health issues, certain symptoms (manifesting wheezing, dyspnea, cyanosis, but have no cough or fever), abnormal laboratory findings (abnormal levels of white blood cells, albumin, and C-reactive protein and RSV infection), and chest X-ray (odds ratio [OR] > 1 for all). CHD, low albumin, proteinuria, abnormal chest x-ray were independent risks factors across different age groups, whereas birth or feeding history, history of pneumonia, cyanosis or dyspnea on admission, and RSV infection were independent risk factors for only younger kids (< 1 year), and wheezing was an independent risk factor only for older children (2-5 years old). CONCLUSIONS: Risk factors predicting disease severity among children hospitalized with CAP vary with age. Risk factor stratification of pediatric CAP based on age-specific risk factors can better guide clinical practice. TRIAL REGISTRATION: This study has been registered in China, with the registration number being ChiCTR2000033019 .

Risk factors associated with wheezing in severe pediatric community-acquired pneumonia: a retrospective study.

BACKGROUND: Wheezing is a common clinical manifestation in children with pneumonia. However, the risk factors associated with the development of wheezing pneumonia and its clinical features are not fully characterized, especially in children with severe pneumonia. METHODS: We retrospectively recruited 1434 pediatric patients diagnosed with severe pneumonia between April 2012 and September 2019 in Fujian Maternity and Child Health Hospital. The medical records regarding demographic information, clinical manifestations, radiographic/laboratory findings, and complications were collected. Based on the presence or absence of wheezing symptoms and signs, subjects were divided into wheezing cohort (n=684) and non-wheezing cohort (n=750), and their clinical data were compared. Multivariate cox regression analysis was performed to identify independent risk factors of wheezing. RESULTS: Demographic features including gender, weigh, onset season, birth weight, full-term birth or not, history of pneumonia were significantly associated with the occurrence of wheezing in severe CAP (P<0.05). Specifically, male gender, onset seasons in autumn/winter, and absence of a history of pneumonia were identified as independent risk factors of wheezing in multivariate analysis (P<0.05). As for clinical features, wheezing cohort differed from the non-wheezing one in terms of clinical manifestation (higher incidence of cough and breathless, but lower incidence of fever), laboratory finding (higher levels of red blood cells, hemoglobin, and albumin and lower levels of total or indirect bilirubin and creatine), pathogen detection (higher incidence of respiratory syncytial viral infection), and clinical complications (lesser risk of sepsis and hydrothorax) (P<0.05). CONCLUSIONS: Severe CAP with wheezing is a special clinical entity of severe pneumonia in children, which has specific risk factors and differ from non-wheezing pneumonia in terms of clinical features and etiologic pathogens.

The relationships between LncRNA NNT-AS1, CRP, PCT and their interactions and the refractory mycoplasma pneumoniae pneumonia in children.

To investigate the relationships between LncRNA NNT-AS1, CRP, PCT and their interactions and the refractory mycoplasma pneumoniae pneumonia (RMPP) in children. Serum levels of LncRNA NNT-AS1 of RMPP and non-RMPP (NRMPP) patients were detected by real-time PCR, and were analyzed together with serum c-reactive protein (CRP) and procalcitonin (PCT). Correlations between LncRNA NNT-AS1 and CRP and PCT were analyzed by Pearson correlation test. The ROC curve was used to analyze the potential of LncRNA NNT-AS1, CRP and PCT as biomarkers for predicting RMPP. Logistic regression crossover model and the Excel compiled by Andersson et al. were used to analyze the interactions among the biomarkers. We found that LncRNA NNT-AS1, CRP and PCT were all highly expressed in patients with RMPP. LncRNA NNT-AS1 could positively correlate with the expressions of CRP and PCT, and jointly promote the occurrence of RMPP. The combined diagnosis of LncRNA NNT-AS1, CRP and PCT could predict the occurrence of RMPP.