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Respiratory complications of propofol, sevoflurane, and dexmedetomidine anesthesia for fiberoptic bronchoscopy in children aged 1 month to 3 years: a randomized trial

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南方医科大学学报 2024年

作者： Amir Shafa Mohammad Montasery Sedighe Shahhosseini Majid Keivanfar Asieh Maghami Mehr Mahtab Ebrahim Babaei Mohammad Jafari Department of Anesthesiology Anesthesiology and critical care Research Center Department of pediatrics Isfahan University of Medical Sciences Department of Statistics Yazd University departments of Obstetrics and Gynecology Shahrekord University of Medical Sciences

Objective To evaluate the effect of propofol, sevoflurane, and dexmedetomidine on respiratory complications in children undergoing fiberoptic bronchoscopy(FOB). Methods This double-blind randomized clinical trial was conducted among 120 children aged 1 month to 3 years undergoing FOB. The patients were randomized into 3 groups(n=40) for anesthesia induction with sevoflurane inhalation, 1 mg/kg propofol, or 1 μg/kg dexmedetomidine before bronchoscopy, and the changes in hemodynamic parameters, sedation level, and respiratory complications during and after the procedure were assessed. Results The patients' heart rate during bronchoscopy was significantly lower and the mean arterial blood pressure significantly higher in dexmedetomidine group than in sevoflurane and propofol groups(P<0.05). Cough during bronchoscopy did not occur in any of the cases in propofol group, while the highest frequency of cough was recorded in dexmedetomidine group. The incidence of laryngospasm in the propofol group(12.5%) was significantly lower than those in sevoflurane and dexmedetomidine groups(30% and 32.5%, respectively)(P<0.05). Conclusion Sevoflurane and propofol are safe and suitable for anesthesia induction in children below 3 years of age undergoing diagnostic FOB and can achieve better sedative effect and lower the incidences of cough and respiratory complications as compared with dexmedetomidine.

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Respiratory complications of propofol,sevoflurane,and dexmedetomidine anesthesia for fiberoptic bronchoscopy in children aged 1 month to 3 years:a randomized trial

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南方医科大学学报 2024年第9期44卷 1631-1636页

作者： Amir Shafa Mohammad Montasery Sedighe Shahhosseini Majid Keivanfar Asieh Maghami Mehr Mahtab Ebrahim Babaei Mohammad Jafari Department of Anesthesiology Anesthesiology and critical care Research Center Department of pediatrics Isfahan University of Medical SciencesIsfahanIran Department of Statistics Yazd UniversityYazdIran departments of Obstetrics and Gynecology Shahrekord University of Medical SciencesShahrekordIran

Objective To evaluate the effect of propofol,sevoflurane,and dexmedetomidine on respiratory complications inchildren undergoing fiberoptic bronchoscopy(FOB).Methods This double-blind randomized clinical trial was conductedamong 120 children aged 1 month to 3 years undergoing *** patients were randomized into 3 groups(n=40)foranesthesia induction with sevoflurane inhalation,1 mg/kg propofol,or 1μg/kg dexmedetomidine before bronchoscopy,andthe changes in hemodynamic parameters,sedation level,and respiratory complications during and after the procedure *** The patients'heart rate during bronchoscopy was significantly lower and the mean arterial blood pressuresignificantly higher in dexmedetomidine group than in sevoflurane and propofol groups(P<0.05).Cough duringbronchoscopy did not occur in any of the cases in propofol group,while the highest frequency of cough was recorded indexmedetomidine *** incidence of laryngospasm in the propofol group(12.5%)was significantly lower than those insevoflurane and dexmedetomidine groups(30%and 32.5%,respectively)(P<0.05).Conclusion Sevoflurane and propofol aresafe and suitable for anesthesia induction in children below 3 years of age undergoing diagnostic FOB and can achieve bettersedative effect and lower the incidences of cough and respiratory complications as compared with dexmedetomidine.

关键词： fiberoptic bronchoscopy propofol sevoflurane dexmedetomidine children

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Tissue-resident macrophages exacerbate lung injury after remote sterile damage

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Cellular & Molecular Immunology 2024年第4期21卷 332-348页

作者： Hanhui Zhong Jingjing Ji Jinling Zhuang Ziying Xiong Pengyun Xie Xiaolei Liu Jundi Zheng Wangli Tian Xiaoyang Hong Jing Tang The Department of Anesthesiology Affiliated Hospital of Guangdong Medical UniversityZhanjiangGuangdongChina The Department of critical care Medicine General Hospital of Southern Theater Command of PLAGuangzhouChina The Department of Respiratory Medicine Guangdong Provincial Hospital of Integrated Chinese and Western MedicineFoshanChina pediatric Intensive care Unit Senior Department of Pediatricsthe Seventh Medical Center of PLA General HospitalBeijingChina

Remote organ injury,which is a common secondary complication of sterile tissue damage,is a major cause of poor prognosis and is difficult to ***,we report the critical role of tissue-resident macrophages in lung injury after trauma or stroke through the inflammatory *** found that depleting tissue-resident macrophages rather than disrupting the recruitment of monocyte-derived macrophages attenuated lung injury after trauma or *** findings revealed that the release of circulating alarmins from sites of distant sterile tissue damage triggered an inflammatory response in lung-resident macrophages by binding to receptor for advanced glycation end products(RAGE)on the membrane,which activated epidermal growth factor receptor(EGFR).Mechanistically,ligand-activated RAGE triggered EGFR activation through an interaction,leading to Rab5-mediated RAGE internalization and EGFR phosphorylation,which subsequently recruited and activated P38;this,in turn,promoted RAGE translation and trafficking to the plasma membrane to increase the cellular response to RAGE ligands,consequently exacerbating *** study also showed that the loss of RAGE or EGFR expression by adoptive transfer of macrophages,blocking the function of RAGE with a neutralizing antibody,or pharmacological inhibition of EGFR activation in macrophages could protect against trauma-or stroke-induced remote lung ***,our study revealed that targeting the RAGE-EGFR signaling pathway in tissue-resident macrophages is a potential therapeutic approach for treating secondary complications of sterile damage.

关键词： tissue-resident macrophage RAGE remote sterile damage

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SARS-CoV-2 variants are associated with different clinical courses in children with MIS-C

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World Journal of pediatrics 2024年第2期20卷 143-152页

作者： Andres F.Moreno Rojas Emelia Bainto Helen Harvey Adriana H.Tremoulet Jane C.Burns Kirsten B.Dummer Department of pediatrics Division of Pediatric CardiologyUniversity of California San Diegoand Rady Children’s Hospital3020 Children’s Way MC 5004San DiegoCA 92123USA Kawasaki Disease Research Center La JollaCAUSA Department of pediatrics Division of Pediatric Critical CareUniversity of California San Diegoand Rady Children’s HospitalSan DiegoCAUSA Department of pediatrics University of California San Diegoand Rady Children’s HospitalSan DiegoCAUSA

Background Recent infection with SARS‑CoV-2 in children has been associated with multisystem inflammatory syndrome in children(MIS-C).SARS‑CoV-2 has undergone different *** publications exist about specific variants and their correlation with the severity of *** This was a single-center,retrospective study including all patients admitted with MIS-C at Rady Children’s Hospital-San Diego between May 2020 and March *** epidemiologic data,including viral genomic information,were obtained from public ***,clinical presentation,laboratory values,and outcomes were obtained from electronic medical *** The analysis included 104 pediatric *** MIS-C waves were *** variants in San Diego during the first wave included clades 20A to *** the second wave,there were variants from clades 20A to C,20G,21C(Epsilon),20I(Alpha),and 20J(Gamma).The third wave had Delta strains(clades 21A,21I,and 21J),and the fourth had Omicron variants(clades 21K,21L,and 22C).MIS-C presented with similar symptoms and laboratory findings across all *** patients were admitted to the pediatric intensive care unit(PICU)(74%)and required inotropic support(63%)during the second *** of the patients required mechanical circulatory support,and only two required invasive ventilatory *** was no *** The various strains of SARS-CoV-2 triggered MIS-C with differing severities,with the second wave having a more severe clinical *** the differences in disease severity across variants were due to changes in the virus or other factors remains unknown.

关键词： Complications COVID-19 MIS-C SARS-CoV-2 variants

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Outcomes of critically ill children with pre-existing mental health conditions

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pediatric Investigation 2024年第2期8卷 108-116页

作者： Conrad Krawiec Morgan Cash Gary Ceneviva Zizhong Tian Shouhao Zhou Neal J.Thomas Department of pediatrics Pediatric Critical Care MedicinePenn State Hershey Children's HospitalPennsylvaniaUSA Department of Public Health Sciences Division of Biostatistics and BioinformaticsPennsylvania State University College of MedicinePennsylvaniaUSA Department of Public Health_Sciences Pennsylvania State University College of MedicinePennsylvaniaUSA

Importance:critically ill children with pre-existing mental health conditions may have an increased risk of poor health ***:We aimed to evaluate if pre-existing mental health conditions in critically ill pediatric patients would be associated with worse clinical outcomes,compared to children with no documented mental health ***:This retrospective observational cohort study utilized the TriNetX electronic health record database of critically ill subjects aged 12-18 *** were analyzed for demographics,pre-existing conditions,diagnostic,medication,procedural codes,and ***:From a dataset of 102027 critically ill children,we analyzed 1999 subjects(284[14.2%]with a pre-existing mental health condition and 1715[85.8%]with no pre-existing mental health condition).Multivariable analysis demonstrated that death within one year was associated with the presence of pre-existing mental health conditions(odds ratio 8.97[3.48-23.15],Pcritical ***,the confidence interval was wide and hence,the findings are *** studies with a larger sample size may be necessary to evaluate the true long-term impact of children with pre-existing mental health conditions who require critical care services.

关键词： critical care Psychiatry Psychology Public health

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Current situation and prospect for the diagnosis and treatment of pediatric critical rare diseases in China

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pediatric Investigation 2024年第1期8卷 66-71页

作者： Yingchao Liu Suyun Qian pediatric Intensive care Unit Beijing Children’s HospitalCapital Medical UniversityNational Center for Children’s HealthBeijingChina

The onset of critical rare diseases(RDs)in children is rapid and dangerous,accompanied by a high mortality rate,which brings a heavy burden to both families and *** malformations,neuromuscular diseases,metabolic diseases,and heart diseases are the most common types of RDs in children of China,often manifesting with multiple organ *** present,the diagnosis and treatment of critical RDs in children face challenges such as prolonged diagnosis time,a high misdiagnosis rate,limited treatment modalities,and a significant disease ***,with the progress in genetic testing technology,the establishment of multidisciplinary diagnosis and treatment platforms,and the implementation of relevant RD policies in China,children with critical RDs will received enhanced medical services,experience improved prognoses,and reintegrate into social life.

关键词： Children critical Current situation Prospect Rare diseases

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Psychological Impact of the 2022 Round COVID-19 Pandemic on China's College Students

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Journal of Shanghai Jiaotong university(Science) 2024年第1期29卷 141-149页

作者：洪冬羊王金霞张虹洋曹紫阳晏紫君邹琳 School of pediatrics Shanghai Jiao Tong University School of MedicineShanghai 200001China Institute of pediatric Infection Immunityand Critical Care MedicineShanghai Children's HospitalShanghai Jiao Tong University School of MedicineShanghai 200062China Clinical Research Unit Shanghai Children's HospitalShanghai Jiao Tong University School of MedicineShanghai 200062China

In response to the new round of COVID-19 outbreaks since March 2022,universities with high outbreak rates around the country have taken quarantine measures to contain the *** from previous coronavirus outbreaks has shown that people under quarantine are at risk for mental health *** better understand the impacts of this round of COVID-19 quarantine on domestic college students and their responses,we conducted a systematic survey to assess the stress and anxiety,and to evaluate effective measurements in this *** searched relevant documents and literature,and designed a questionnaire from six aspects,including psychological status,epidemic situation,study,daily life,sports,and interpersonal communication,with 51 items in *** sent the questionnaire on the Wenjuanxing Web platform,from April 2 to 8,*** evaluated the mental status according to parts of the Generalized Anxiety Disorder-7(GAD-7)and Depression Anxiety Stress Scales-21(DASS-21),and investigated the influencing risk factors and *** analysis was performed by using the Chi-square test and multi-variable logistic *** total,508 college respondents were recruited in our survey,and the pooled prevalence of mild anxiety(GAD score≥5,or DASS-21 anxiety score≥8)or stress(DASS-21 pressure score≥14)caused by the new round of COVID-19 pandemic quarantine was 19.69%(100/508).The prevalence of the anxiety or stress in college students with COVID-19 quarantine between different genders,regions,and majors was not significantly *** risk factors for the mild anxiety or stress of undergraduates by COVID-19 quarantine included learning efficiency or duration[OR=1.36,95%CI(1.14—1.62),P=0.001],based on the combined analysis of Chi-square test analysis with multi-variable logistic regression ***,the mental well-beings before COVID-19 epidemic quarantine[OR=0.22,95%CI(0.130.36),P<0.0001],more low-intensity exercise[OR=0.36

关键词： COVID-19 psychological investigation college students anxiety stress

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Chemical components in cultivated Cordyceps sinensis and their effects on fibrosis

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Chinese Herbal Medicines 2024年第1期16卷 162-167页

作者： Zhonghua Dong Xiao Sun Department of Clinical Pharmacy The First Affiliated Hospital of Shandong First Medical University&Shandong Provincial Qianfoshan HospitalShandong Engineering and Technology Research Center for Pediatric Drug DevelopmentShandong Medicine and Health Key Laboratory of Clinical PharmacyJinan 250014China Department of Emergency Medicine Qilu Hospital of Shandong UniversityJinan 250012China Shandong Provincial Clinical Research Center for Emergency and critical care Medicine Institute of Emergency and Critical Care Medicine of Shandong UniversityChest Pain CenterQilu Hospital of Shandong UniversityJinan 250012China Key Laboratory of Emergency and critical care Medicine of Shandong Province Key Laboratory of Cardiopulmonary-Cerebral Resuscitation Research of Shandong ProvinceShandong Provincial Engineering Laboratory for Emergency and Critical Care MedicineShandong Key Laboratory:Magnetic Field-free Medicine&Functional ImagingQilu Hospital of Shandong UniversityJinan 250012China NMPA Key Laboratory for Clinical Research and Evaluation of Innovative Drug Qilu Hospital of Shandong UniversityJinan 250012China

Objective:Cultivated Cordyceps sinensis powder has been used as clinical drug and healthy food to nourish the lung and kidney,which solves the problem of serious shortage of wild *** study aims to explore the chemical components and compared their anti-fibrotic effects in cultivated ***:Nucleosides,sterols and polysaccharides were separated and purified from cultivated ***,and analyzed by high performance liquid chromatography,gas chromatography-mass spectrometry and chemical chromogenic methods,*** high glucose-induced rat mesangial cell models,fibronectin and type 1 collagen were used as evaluation ***:There were 10 kinds of nucleosides and one sterol in cultivated *** contents of nucleosides,sterols and polysaccharides in the cultivated *** were close to 2%,0.55%and 4.4%,***,nucleoside,sterol and polysaccharide components exhibited varying degrees of antifibrotic *** nucleoside components and sterol components inhibited the expression of extracellular matrix more effectively in the three main ***:Cultivated *** remains the similar compounds with the wild ***,and nucleosides and sterols may be the main active substances that contribute to its anti-fibrotic *** project of this study may provide valuable information on further optimization of more effective remedies with few side effects based on cultivated ***.

关键词： anti-fibrotic effects cultivated Cordyceps sinensis ergosterol nucleosides polysaccharides

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PCDH17 restricts dendritic spine morphogenesis by regulating ROCK2-dependent control of the actin cytoskeleton,modulating emotional behavior

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Zoological Research 2024年第3期45卷 535-550页

作者： Laidong Yu Fangfang Zeng Mengshu Fan Kexuan Zhang Jingjing Duan Yalu Tan Panlin Liao Jin Wen Chenyu Wang Meilin Wang Jialong Yuan Xinxin Pang Yan Huang Yangzhou Zhang Jia-Da Li Zhuohua Zhang Zhonghua Hu Hunan Key Laboratory of Molecular Precision Medicine Department of Critical Care MedicineXiangya HospitalCentral South UniversityChangshaHunan 410008China Center for Medical Genetics and Hunan Key Laboratory of Medical Genetics School of Life SciencesCentral South UniversityChangshaHunan 410008China National Clinical Research Center for Geriatric Disorders Xiangya HospitalCentral South UniversityChangshaHunan 410008China Hunan Provincial Clinical Research Center for critical care Medicine Xiangya HospitalCentral South UniversityChangshaHunan 410008China Hunan Key Laboratory of Animal Models for Human Diseases School of Life SciencesCentral South UniversityChangshaHunan 410008China MOE Key Lab of Rare pediatric Diseases School of Life SciencesCentral South UniversityChangshaHunan 410008China Department of Neurosciences University of South China Medical SchoolHengyangHunan 421001China

Proper regulation of synapse formation and elimination is critical for establishing mature neuronal circuits and maintaining brain *** abnormalities,such as defects in the density and morphology of postsynaptic dendritic spines,underlie the pathology of various neuropsychiatric *** 17(PCDH17)is associated with major mood disorders,including bipolar disorder and ***,the molecular mechanisms by which PCDH17 regulates spine number,morphology,and behavior remain *** this study,we found that PCDH17 functions at postsynaptic sites,restricting the number and size of dendritic spines in excitatory *** overexpression of PCDH17 in the ventral hippocampal CA1 results in spine loss and anxiety-and depression-like behaviors in ***,PCDH17 interacts with actin-relevant proteins and regulates actin filament(F-actin)***,PCDH17 binds to ROCK2,increasing its expression and subsequently enhancing the activity of downstream targets such as LIMK1 and the phosphorylation of cofilin serine-3(Ser3).Inhibition of ROCK2 activity with belumosudil(KD025)ameliorates the defective F-actin organization and spine structure induced by PCDH17 overexpression,suggesting that ROCK2 mediates the effects of PCDH17 on F-actin content and spine ***,these findings reveal a novel mechanism by which PCDH17 regulates synapse development and behavior,providing pathological insights into the neurobiological basis of mood disorders.

关键词： Synapse development Dendritic spine Mood disorder Actin cytoskeleton Animal behavior

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Multi-omics integration reveals potential stage-specific druggable targets in T-cell acute lymphoblastic leukemia

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Genes & Diseases 2024年第5期11卷 374-389页

作者： Zijun Yan Jie Xia Ziyang Cao Hongyang Zhang Jinxia Wang Tienan Feng Yi Shu Lin Zou Clinical Research Unit Shanghai Children’s HospitalSchool of MedicineShanghai Jiao Tong UniversityShanghai 200062China Institute of pediatric Infection Immunityand Critical Care MedicineShanghai Jiao Tong University School of MedicineShanghai 200062China Center for Clinical Molecular Laboratory Medicine of Children’s Hospital of Chongqing Medical University Chongqing 400014China Clinical Research Institute Shanghai Jiao Tong University School of MedicineShanghai 200025China Bioinformatics and BioMedical Bigdata Mining Laboratory School of Big HealthGuizhou Medical UniversityGuiyangGuizhou 554300China

T-cell acute lymphoblastic leukemia(T-ALL),a heterogeneous hematological malignancy,is caused by the developmental arrest of normal T-cell *** development of targeted therapeutic regimens is impeded by poor knowledge of the stage-specific aberrances in this *** this study,we performed multi-omics integration analysis,which included mRNA expression,chromatin accessibility,and gene-dependency database analyses,to identify potential stage-specific druggable targets and repositioned drugs for this *** multi-omics integration helped identify 29 potential pathological genes for *** genes exhibited tissue-specific expression profiles and were enriched in the cell cycle,hematopoietic stem cell differentiation,and the AMPK signaling *** these,four known druggable targets(CDK6,TUBA1A,TUBB,and TYMS)showed dysregulated and stage-specific expression in malignant T cells and may serve as stage-specific targets in *** TUBA1A expression level was higher in the early T cell precursor(ETP)-ALL cells,while TUBB and TYMS were mainly highly expressed in malignant T cells arrested at the CD4 and CD8 double-positive or single-positive ***6 exhibited a U-shaped expression pattern in malignant T cells along the naıve to maturation ***,mebendazole and gemcitabine,which target TUBA1A and TYMS,respectively,exerted stage-specific inhibitory effects on T-ALL cell lines,indicating their potential stage-specific antileukemic role in ***,our findings might aid in identifying potential stage-specific druggable targets and are promising for achieving more precise therapeutic strategies for T-ALL.

关键词： Multi-omics Stage-specific druggable targets Targeted therapeutic strategies T-cell acute lymphoblastic leukemia Drug repositioning

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