Mechanistic role of RND3-regulated IL33/ST2 signaling on cardiomyocyte senescence.

Hyperinflammatory responses are pivotal in the cardiomyocyte senescence pathophysiology, with IL33 serving as a crucial pro-inflammatory mediator. Our previous findings highlighted RND3's suppressive effect on IL33 expression. This study aims to explore the role of RND3 in IL33/ST2 signaling activation and in cardiomyocyte senescence. Intramyocardial injection of exogenous IL33 reduces the ejection fraction and fractional shortening of rats, inducing the appearance of senescence-associated secretory phenotype (SASP) in myocardial tissues. Recombinant IL33 treatment of AC16 cardiomyocytes significantly upregulated expression of SASP factors like IL1α, IL6, and MCP1, and increased the p-p65/p65 ratio and proportions of SA-ß-gal and γH2AX-positive cells. NF-κB inhibitor pyrrolidinedithiocarbamate ammonium (PDTC) and ST2 antibody astegolimab treatments mitigated above effects. RND3 gene knockout H9C2 cardiomyocytes using CRISPR/Cas9 technology upregulated IL33, ST2L, IL1α, IL6, and MCP1 levels, decreased sST2 levels, and increased SA-ß-gal and γH2AX-positive cells. A highly possibility of binding between RND3 and IL33 proteins was showed by molecular docking and co-immunoprecipitation, and loss of RND3 attenuated ubiquitination mediated degradation of IL33; what's more, a panel of ubiquitination regulatory genes closely related to RND3 were screened using qPCR array. In contrast, RND3 overexpression in rats by injection of AAV9-CMV-RND3 particles inhibited IL33, ST2L, IL1α, IL6, and MCP1 expression in cardiac tissues, decreased serum IL33 levels, and increased sST2 levels. These results suggest that RND3 expression in cardiomyocytes modulates cell senescence by inhibiting the IL33/ST2/NF-κB signaling pathway, underscoring its potential as a therapeutic target in cardiovascular senescence.

Effects of flora deficiency on the structure and function of the large intestine.

The significant anatomical changes in large intestine of germ-free (GF) mice provide excellent material for understanding microbe-host crosstalk. We observed significant differences of GF mice in anatomical and physiological involving in enlarged cecum, thinned mucosal layer and enriched water in cecal content. Furthermore, integration analysis of multi-omics data revealed the associations between the structure of large intestinal mesenchymal cells and the thinning of the mucosal layer. Increased Aqp8 expression in GF mice may contribute to enhanced water secretion or altered hydrodynamics in the cecum. In addition, the proportion of epithelial cells, nutrient absorption capacity, immune function and the metabolome of cecum contents of large intestine were also significantly altered. Together, this is the first systematic study of the transcriptome and metabolome of the cecum and colon of GF mice, and these findings contribute to our understanding of the intricate interactions between microbes and the large intestine.

Accommodation and Binocular Vision in Children with Myopic Anisometropia.

Purpose: To assess the differences in accommodation and binocular vision in children with myopic anisometropia and determine the correlation with anisometropia. Method: A total of 110 patients with myopia aged 8-15 years were recruited from June 2021 to February 2022 from the Affiliated Hospital of Xuzhou Medical University. Based on the interocular differences of spherical equivalent refraction, patients were divided into the isometropia (35 children), low anisometropia (LA group, 42 children), and high anisometropia (HA group, 33 children). The variables assessed were refraction, heterophoria, amplitude of accommodation (AMP), accommodative response (AR), gradient AC/A, positive and negative relative accommodation (PRA/NRA), and near stereopsis in the three groups. Pearson's correlation coefficient tests were used to investigate the possible association between each parameter and interocular differences (IODs). Results: Among 110 subjects, there were 49 males and 61 females with a mean age of 11.39 ± 2.28 years. Compared with those in the isometropia group, AMP was lower and near stereopsis was higher in the LA group, and the distance and near heterophoria, PRA, AR, and near stereopsis were higher, and PRA, AMP, and gradient AC/A were lower in the HA group (all P < 0.05). Compared with those in the LA group, the near stereopsis, AR, and the near stereopsis were higher in the HA group, and the gradient AC/A was lower (all P < 0.05). However, no significant differences existed in the negative relative accommodation (P > 0.05). The distance and near heterophoria, AR, AMP, and near stereopsis were observed to be correlated with IODs, respectively (r = -0.259, p = 0.006; r = -0.201, p = 0.036; r = 0.306, p = 0.001; r = -0.315, p = 0.001; r = 0.535, p < 0.001). Conclusion: Our results suggested that with the increase of anisometropia, distance and near heterophoria, AR, AMP, and near stereopsis had a tendency to get worse in children with myopic anisometropia.

Highly elastic photothermal nanofibrillated cellulose aerogels for solar-assisted efficient cleanup of viscous oil spill.

Frequent oil spills and illegal industrial pollutant discharge cause ecological and resource damages, so it is necessary to establish efficient adsorption and recovery strategies for oils in wastewater. Herein, inspired by solar-driven viscosity-breaking, we propose a facile approach to fabricate multifunctional nanofibrillated cellulose-based aerogel with high elasticity, excellent photothermal conversion, efficient selective oil adsorption and antibacterial properties. Firstly, copper sulfide (CuS) nanoparticles were in situ deposited on the template of oxidative nanofibrillated cellulose (ONC), aiming at achieving efficient photothermal effect and antibacterial properties. Ethylene glycol diglycidyl ether (EGDE) was employed to establish multiple crosslinking network between CuS@ONC and polyethyleneimine (PEI). A thin hydrophobic PMTS layer deposited on the surface of aerogel via a facile gas-solid reaction ensured stable oil selectivity. The resulting composite aerogel can rapidly adsorb oil under solar self-heating, significantly reducing the adsorption time from 25 to 5 min. Furthermore, it exhibits excellent adsorption capacities for various oils, retaining over 92 % of its initial capacity even after 20 adsorption-desorption cycles, and the antibacterial properties extend its lifespan. This work offers a promising method for constructing multifunctional aerogels for efficient oil-water separation, especially beneficial for high-viscosity and high-melting-point oil cleanup.

Exercise preconditioning promotes myocardial GLUT4 translocation and induces autophagy to alleviate exhaustive exercise-induced myocardial injury in rats.

Exercise preconditioning (EP) is a line of scientific inquiry into the short-term biochemical mediators of cardioprotection in the heart. This study examined the involvement of autophagy induced by energy metabolism in myocardial remodelling by EP and myocardial protection. A total of 120 healthy male Sprague Dawley (SD) rats were randomly divided into six groups. Plasma cTnI, HBFP staining and electrocardiographic indicators were examined in the context of myocardial ischemic/hypoxic injury and protection. Western blotting and fluorescence double labelling were used to investigate the relationship between energy metabolism and autophagy in EP-resistant myocardial injury caused by exhaustive exercise. Compared with those in the C group, the levels of myocardial ischemic/hypoxic injury were significantly increased in the EE group. Compared with those in the EE group, the levels of myocardial ischemic/hypoxic injury were significantly decreased in the EEP + EE and LEP + EE groups. Compared with that in the EE group, the level of GLUT4 in the sarcolemma was significantly increased, and the colocalization of GLUT4 with the sarcolemma was significantly increased in the EEP + EE and LEP + EE groups (P < 0.05). LC3-II and LC3-II/LC3-I levels of the EEP + EE group were significantly elevated compared with those in the EE group (P < 0.05). The levels of p62 were significantly decreased in the EEP + EE and LEP + EE groups compared with the EE group (P < 0.05). EP promotes GLUT4 translocation and induced autophagy to alleviate exhaustive exercise-induced myocardial ischemic/hypoxic injury.

A single-cell atlas of West African lungfish respiratory system reveals evolutionary adaptations to terrestrialization.

The six species of lungfish possess both lungs and gills and are the closest extant relatives of tetrapods. Here, we report a single-cell transcriptome atlas of the West African lungfish (Protopterus annectens). This species manifests the most extreme form of terrestrialization, a life history strategy to survive dry periods that can last for years, characterized by dormancy and reversible adaptive changes of the gills and lungs. Our atlas highlights the cell type diversity of the West African lungfish, including gene expression consistent with phenotype changes of terrestrialization. Comparison with terrestrial tetrapods and ray-finned fishes reveals broad homology between the swim bladder and lung cell types as well as shared and idiosyncratic changes of the external gills of the West African lungfish and the internal gills of Atlantic salmon. The single-cell atlas presented here provides a valuable resource for further exploration of the respiratory system evolution in vertebrates and the diversity of lungfish terrestrialization.

Superior Rate Capability of Small Regenerated Graphite Particles Induced by Homogeneously Distributed Current Density Derived from Cracks and Intrinsic Defects.

As spent batteries can be considered as alternative raw sources of electrode materials; the development of regeneration techniques for spent graphite becomes key to realizing economic and environmental sustainability. Herein, the reutilization of small spent graphite particles is domonstrated due to their special structural characteristics, which may directly contribute to the improvement of lithiation kinetics and high-rate charging during long-term cycling. Such intrinsic defects and external cracked channels may be introduced by the aging of intrinsic bulk structure and exfoliation of surface structure. On account of these potential advantages, a carbonized polypyrrole layer on sieved small graphite particles is developed to obtain superior rate performance. The coated amorphous/graphitic layer could repair the exposed edge and basal plane, and significantly facilitate Li ion diffusion during fast charging. Moreover, the enhanced performance may favor the improved homogeneity of current density distribution during fast charging, which is confirmed by a porous electrode model. The regenerated graphite with a disorder/order coating layer could effectively regulate the Li+ transport channel, exhibiting a high specific capacity at high-rate charging (102.7 mAh g-1 at 4 C after 500 cycles) without severe Li plating. This work provides an opportunity to utilize spent graphite in fast-charging batteries.

Association of dual electronic cigarettes and marijuana use with sleep duration among adults from the United States, NHANES 2015-2018.

Electronic cigarette (e-cigarette) use is becoming more widespread, and studies show that they are not absolutely harmless. To investigate the association between the dual use of e-cigarettes and marijuana with sleep duration among adults in the United States, this cross-sectional study used data from 6,573 participants aged 18-64 years from 2015 to 2018 from the National Health and Nutrition Examination Survey database. Chi-square tests and analysis of variance were used for bivariate analyses of binary and continuous variables, respectively. Multinomial logistic regression models were used for univariate and multivariate analyses of e-cigarette use, marijuana use, and sleep duration. Sensitivity analyses were conducted in populations with dual e-cigarette and traditional cigarette use and dual marijuana and traditional cigarette use. People who concurrently use e-cigarettes and marijuana had higher odds of not having the recommended sleep duration than neither users (short sleep duration: odds ratio [OR], 2.34; 95% confidence interval [CI], 1.19-4.61; P = 0.014; long sleep duration: OR, 2.09; 95% CI, 1.53-2.87; P < 0.001) and a shorter sleep duration than e-cigarette only users (OR, 4.24; 95% CI, 1.75-4.60; P < 0.001). Concurrent traditional cigarette and marijuana users had higher odds of long sleep duration than neither users (OR, 1.98; 95% CI, 1.21-3.24; P = 0.0065). Almost half of the people who concurrently use e-cigarettes and marijuana had both short and long sleep durations compared to neither users and short sleep duration compared to e-cigarette only users. Longitudinal randomized controlled trials are needed to explore the joint effect of dual tobacco use on sleep health.

Global optimality analysis and solution of the ℓ0 total variation signal denoising model.

The total variation regularizer is diffusely emerged in statistics, image and signal processing to obtain piecewise constant estimator. The ℓ0 total variation (L0TV) regularized signal denoising model is a nonconvex and discontinuous optimization problem, and it is very difficult to find its global optimal solution. In this paper, we present the global optimality analysis of L0TV signal denoising model, and design an efficient algorithm to pursuit its solution. Firstly, we equivalently rewrite the L0TV denoising model as a partial regularized (PL0R) minimization problem by aid of the structured difference operator. Subsequently, we define a P-stationary point of PL0R, and show that it is a global optimal solution. These theoretical results allow us to find the global optimal solution of the L0TV model. Therefore, an efficient Newton-type algorithm is proposed for the PL0R problem. The algorithm has a considerably low computational complexity in each iteration. Finally, experimental results demonstrate the excellent performance of our approach in comparison with several state-of-the-art methods.

Microbiota-mediated shaping of mouse spleen structure and immune function characterized by scRNA-seq and Stereo-seq.

Gut microbes exhibit complex interactions with their hosts and shape an organism's immune system throughout its lifespan. As the largest secondary lymphoid organ, the spleen has a wide range of immunological functions. To explore the role of microbiota in regulating and shaping the spleen, we employ scRNA-seq and Stereo-seq technologies based on germ-free (GF) mice to detect differences in tissue size, anatomical structure, cell types, functions, and spatial molecular characteristics. We identify 18 cell types, 9 subtypes of T cells, and 7 subtypes of B cells. Gene differential expression analysis reveals that the absence of microorganisms results in alterations in erythropoiesis within the red pulp region and congenital immune deficiency in the white pulp region. Stereo-seq results demonstrate a clear hierarchy of immune cells in the spleen, including marginal zone (MZ) macrophages, MZ B cells, follicular B cells and T cells, distributed in a well-defined pattern from outside to inside. However, this hierarchical structure is disturbed in GF mice. Ccr7 and Cxcl13 chemokines are specifically expressed in the spatial locations of T cells and B cells, respectively. We speculate that the microbiota may mediate the structural composition or partitioning of spleen immune cells by modulating the expression levels of chemokines.

The enormous repetitive Antarctic krill genome reveals environmental adaptations and population insights.

Antarctic krill (Euphausia superba) is Earth's most abundant wild animal, and its enormous biomass is vital to the Southern Ocean ecosystem. Here, we report a 48.01-Gb chromosome-level Antarctic krill genome, whose large genome size appears to have resulted from inter-genic transposable element expansions. Our assembly reveals the molecular architecture of the Antarctic krill circadian clock and uncovers expanded gene families associated with molting and energy metabolism, providing insights into adaptations to the cold and highly seasonal Antarctic environment. Population-level genome re-sequencing from four geographical sites around the Antarctic continent reveals no clear population structure but highlights natural selection associated with environmental variables. An apparent drastic reduction in krill population size 10 mya and a subsequent rebound 100 thousand years ago coincides with climate change events. Our findings uncover the genomic basis of Antarctic krill adaptations to the Southern Ocean and provide valuable resources for future Antarctic research.

Perfluoroalkyl substance exposure is associated with asthma and innate immune cell count in US adolescents stratified by sex.

Exposure to perfluoroalkyl substances (PFAS) may be harmful to humans; however, previous studies have been inconsistent regarding the potential for PFAS-induced immunosuppresion. This study explored the relationship between PFAS exposure and risks of asthma, wheezing, and immunosuppression in 12-19 year-olds using the National Health and Nutrition Examination Survey (NHANES) data. Logistic regression models were used to reveal associations between serum PFAS levels and risks of asthma, wheezing, asthma attack, and emergency department visits. Pearson's correlation was used to determine the relationship between serum PFAS levels and leukocyte count. Data were also stratified by sex. We found that medium-low levels of serum perfluorooctane sulfonate (PFOS) (6.90-12.40 ng/mL) and serum perfluorooctanoic acid (PFOA) (2.43-3.60 ng/mL) were negatively related, respectively, to current asthma and wheezing in boys, and to wheezing in girls. Meanwhile, boys with medium-high levels (1.50-3.00 ng/mL) of serum perfluorohexanesulfonate (PFHxS) had a high risk of wheezing. Among asthmatic participants, both medium-high levels (3.75-5.07 ng/mL) of serum PFOA and high levels (> 3.92 ng/mL) of PFHxS correlated with asthma attacks in boys; likewise, medium-low levels (0.70-0.99 ng/mL) of serum PFNA correlated with asthma attacks in girls. Also, PFOA and PFNA levels were weakly positively correlated with basophil count, whereas PFOS levels were weakly negatively correlated with eosinophils in asthmatic boys, indicating that basophils may be important in the immune response to PFAS exposure among asthmatics.

Exercise preconditioning improves electrocardiographic signs of myocardial ischemic/hypoxic injury and malignant arrhythmias occurring after exhaustive exercise in rats.

Exercise preconditioning (EP) has a good myocardial protective effect. This study explored whether EP improves electrocardiographic (ECG) signs of myocardial ischemic/hypoxic injury and the occurrence of malignant arrhythmia after exhaustive exercise. A total of 120 male SD rats were randomly divided into the control group (group C), early exercise preconditioning group (group EEP), late exercise preconditioning group (group LEP), exhaustive exercise group (group EE), early exercise preconditioning + exhaustive exercise group (group EEP + EE) and late exercise preconditioning + exhaustive exercise group (group LEP + EE). Changes in heart rate (HR), ST segment, T wave and QT corrected (QTc) intervals on ECG; hematoxylin-basic fuchsin-picric acid (HBFP) staining; and cTnI levels were used to study myocardial injury and the protective effect of EP. Compared with those in group C, the levels of plasma markers of myocardial injury, HBFP staining and ECG in group EE were significantly increased (P < 0.05). Compared with those in group EE, the levels of plasma markers of myocardial injury, HBFP staining and ECG in group EEP + EE and group LEP + EE were significantly decreased (P < 0.05). The results suggested that EP improved ECG signs of myocardial ischemic/hypoxic injury and malignant arrhythmias that occur after exhaustive exercise. The ST segment and T wave could also serve as indexes for evaluating exhaustive exercise-induced myocardial ischemia/hypoxia.

Arsenic removal performance and mechanism from water on iron hydroxide nanopetalines.

Human health has been seriously endangered by arsenic pollution in drinking water. In this paper, iron hydroxide nanopetalines were synthesized through a precipitation method using KBH4 and their performance and mechanism of As(V) and As(III) removal were investigated. The prepared material was characterized by SEM-EDX, XRD, BET, zeta potential and FTIR analyses. Batch experiments indicated that the iron hydroxide nanopetalines exhibited more excellent performance for As(V) and As(III) removal than ferrihydrite. The adsorption processes were very fast in the first stage, followed a relatively slower adsorption rate and reached equilibria after 24 h, and the reaction could be fitted best by the pseudo-second order model, followed by the Elovich model. The adsorption isotherm data followed to the Freundlich model, and the maximal adsorption capacities of As(V) and As(III) calculated by the Langmuir model were 217.76 and 91.74 mg/g at pH 4.0, respectively, whereas these values were 187.84 and 147.06 mg/g at pH 8.0, respectively. Thermodynamic studies indicated that the adsorption process was endothermic and spontaneous. The removal efficiencies of As(V) and As(III) were significantly affected by the solution pH and presence of PO43- and citrate. The reusability experiments showed that more than 67% of the removal efficiency of As(V) could be easily recovered after four cycles. The SEM and XRD analyses indicated that the surface morphology and crystal structure before and after arsenic removal were stable. Based on the analyses of FTIR, XRD and XPS, the predominant adsorption mechanism was the formation of inner-sphere surface complexes by the surface hydroxyl exchange reactions of Fe-OH groups with arsenic species. This research provides a new strategy for the development of arsenic immobilization materials and the results confirm that iron hydroxide nanopetalines could be considered as a promising material for removing arsenic from As-contaminated water for their highly efficient performance and stability.

Robust Multiscale Electron/Ion Transport and Enhanced Structural Stability in SiOx Semi-Solid Anolytes Enabled by Trifunctional Artificial Interfaces for High-Performance Li-Ion Slurry Flow Batteries.

SiOx suspension is regarded as an attractive anolyte for high-energy-density Li-ion slurry flow batteries. However, the poor electronic conductivity and non-negligible volume variation of SiOx greatly hinder its practical applications. Herein, these issues are successfully addressed by rationally designing a trifunctional interface with mixed electron/ion and hard/soft modulated properties on SiOx surface via H-bonding interactions. The interface comprises a lithiated polymer layer (LiPN) interfused with functionalized single-walled carbon nanotubes. Carbon nanotubes work as electrical tentacles to enhance the multiscale electron conduction. The LiPN layer with transferable Li-ions facilitates ion transport. In addition, the LiPN layer employs lithiated rigid polyacrylic acid as a framework to provide mechanical support and soft nafion as a buffer to accommodate volume change, which maintains the structural integrity of SiOx . Hence, SiOx @LiPN/S anolytes exhibit significantly improved rate and cycle performances. Specially, the interface enables the anolytes to load more active particles (30 wt%) or less conductive additives (0.4 wt%). The semi-solid pouch cells based on high-active-content anolytes with stable cyclability are first demonstrated and the flow cell using low-conductive-content anolytes displays a high volumetric capacity of 207 Ah L-1 . This strategy paves a novel approach for optimizing semi-solid electrodes for high-performance Li-ion slurry flow batteries.

Solution to dynamic economic dispatch with prohibited operating zones via MILP.

Dynamic economic dispatch (DED) problem considering prohibited operating zones (POZ), ramp rate constraints, transmission losses and spinning reserve constraints is a complicated non-linear problem which is difficult to solve efficiently. In this paper, a mixed integer linear programming (MILP) method is proposed to solve such a DED problem. Firstly, a novel MILP formulation for DED problem without considering the transmission losses, denoted by MILP-1, is presented by using perspective cut reformulation technique. When the transmission losses are considered, the quadratic terms in the transmission losses are replaced by their first order Taylor expansions, and then an MILP formulation for DED considering the transmission losses, denoted by MILP-2, is obtained. Based on MILP-1 and MILP-2, an MILP-iteration algorithm is proposed to solve the complicated DED problem. The effectiveness of the MILP formulation and MILP iteration algorithm are assessed by several cases and the simulation results show that both of them can solve to competitive solutions in a short time.

Multistep nucleation visualized during solid-state crystallization.

Mechanisms of nucleation have been debated for more than a century, despite successes of classical nucleation theory. The nucleation process has been recently argued as involving a nonclassical mechanism (the "two-step" mechanism) in which an intermediate step occurs before the formation of a nascent ordered phase. However, a thorough understanding of this mechanism, in terms of both microscopic kinetics and thermodynamics, remains experimentally challenging. Here, in situ observations using transmission electron microscopy on a solid-state nucleation case indicate that early-stage crystallization can follow the non-classical pathway, yet proceed via a more complex manner in which multiple metastable states precede the emergence of a stable nucleus. The intermediate steps were sequentially isolated as spinodal decomposition of amorphous precursor, mass transport and structural oscillations between crystalline and amorphous states. Our experimental and theoretical analyses support the idea that the energetic favorability is the driving force for the observed sequence of events. Due to the broad applicability of solid-state crystallization, the findings of this study offer new insights into modern nucleation theory and a potential avenue for materials design.

Effect of allergic rhinitis on sleep in children and the risk factors of an indoor environment.

PURPOSE: Allergic rhinitis (AR) is an independent risk factor for sleep disorders in children, including abnormal sleep behaviors. We investigated the occurrence of abnormal sleep behaviors in children with AR to determine indoor environmental risk factors affecting sleep. METHODS: This case-control study collected the sleep status and characteristics of the indoor environment of children aged 3-14 years with and without AR using a questionnaire. The differences between the two groups were compared using the Mann-Whitney U test, chi-square test, and Fisher's exact test. The indoor environmental factors affecting sleep behavior were analyzed using logistic regression analysis. RESULTS: Children with AR (n=427) had a higher probability of snoring (8.7 % vs. 2.9 %; P < 0.001), mouth breathing (14.1 % vs. 5.2 %; P < 0.001), restless sleep (6.6 % vs. 4.1 %; P = 0.047), sleep talking (3.3 % vs. 1.1 %; P = 0.003), and hyperhidrosis (16.4 % vs. 8.5 %; P < 0.001) than those without AR (n=1046). Emulsion wall paint (odds ratio (OR) = 2.779; 95 % confidence interval (CI), 1.332-5.796; P = 0.006) and tobacco exposure in early infancy (OR = 2.065; 95 % CI 1.079-3.950; P = 0.029) were associated with hyperhidrosis. CONCLUSION: Children with AR are more likely to have abnormal sleep behaviors than those without, including snoring, mouth breathing, restless sleep, sleep talking, and hyperhidrosis. Emulsion paint wall and tobacco smoke exposure in early infancy had a twofold higher risk of hyperhidrosis during sleep.

Association of Mycoplasma pneumoniae coinfection with adenovirus pneumonia severity in children.

Between the winter of 2018 and the end of 2019, there has been an epidemic of adenovirus infection in southern China, including Zhejiang Province. The number of children suffering from adenovirus pneumonia (AP) has significantly increased. AP can be accompanied by Mycoplasma pneumoniae in children. This study aimed to investigate the association of M. pneumoniae and identify the risk factors for coinfection on hospitalized patients with AP. The patients were classified into two groups by etiologic analysis (single AP and AP with M. pneumoniae coinfection groups). The clinical manifestations, clinical medication, and laboratory and imaging findings of the two groups were compared and analyzed. The coinfection group (n = 125) had a significantly longer duration of fever than the single AP group (n = 171; P = 0.03). Shortness of breath (P = 0.023) and pulmonary imaging findings, such as pulmonary consolidation, atelectasis, pleural effusion, and multilobe lesions (P < 0.05), were more common in the coinfection group. The patients with coinfection had more severe symptoms, significantly longer hospitalization time and an increased proportion of using glucocorticoids and/or immunoglobulin needing oxygen inhalation (P < 0.05). The incidence of AP with M. pneumoniae coinfection is high. The prolonged fever duration and pulmonary imaging findings could be used as prediction factors to predict M. pneumoniae coinfection in children with AP. Patients with AP coinfected with MP may easily develop severe illness. Hence, a reasonable change in the treatment is necessary.