ObjectiveTo study the serum levels of melanoma deficiency factor 2(AIM2) and prokinetin 2(PK2) in Kawasaki disease(KD) children and their relationship with disease severity and predictive value in coronary artery injury.MethodsOne hundred and forty-eight KD children diagnosed and treated in the Emergency department/cardiology department of Shanghai Children's Hospital from January 2020 to December 2022 were selected as the KD group, divided into coronary artery injury(CAL) subgroup(41 cases) and non-CAL subgroup(107 cases). According to the severity of CAL condition, 18 cases were divided into mild CAL group, 13 cases were divided into moderate CAL group; 10 cases in the severe CAL group. 60 healthy children who underwent physical examination at the same time were selected as the healthy control group. Enzyme linked immunosorbent assay was used to detect serum levels of AIM2 and PK2. Logistic regression and receiver operating characteristic curve were conducted to analyze the value of serum AIM2 and PK2 in CAL in children with KD.ResultsThe serum AIM2 level in the KD group was higher than that in the healthy control group, while the serum PK2 level was lower than that in the healthy control group(t/P=38.274/<0.001, 28.934/<0.001). Compared with the non-CAL subgroup, the CAL subgroup had higher fever time, C-reactive protein, and serum AIM2, while the serum PK2 was lower(t/P=6.774/<0.001,17.365/<0.001,26.703/<0.001,19.502/<0.001).The serum AIM2 of KD group children was positively correlated with fever time and C-reactive protein(r=0.689, 0.713, all P<0.001); Serum PK2 was negatively correlated with fever time and C-reactive protein(r=-0.762,-0.689, all P<0.001). The serum AIM2 levels in the mild CAL group, moderate CAL group, and severe CAL group increased sequentially, while the serum PK2 levels decreased sequentially(F/P=158.710/<0.001, 60.081/<0.001). Long fever duration, high C-reactive protein, and high serum AIM2 were independent risk factors affecting the occurrence of CAL in children with KD, while serum PK2 was a protective factor[OR(95%CI)=1.387(1.124-1.710),1.573(1.241-1.994),1.338(1.057-1.692),0.773(0.619-0.964)]. The area under the curve of serum AIM2 and PK2 combined prediction for the occurrence of CAL in KD children was 0.928(0.884-0.958), which was larger than that of serum AIM2. PK2 single detection was 0.852(0.819-0.887) and 0.858(0.811-0.892)(Z/P=4.616/<0.001, 4.602/<0.001).ConclusionThe increase of serum AIM2 and decrease of PK2 patients are related with disease severity in KD. The combination of serum AIM2 and PK2 has a high evaluation value for the occurrence of CAL in KD patients.

ObjectiveTo study the value of peripheral blood myxovirus resistance-A(MxA) and chitinase 3-like protein 1(YKL-40) levels in evaluating the condition and clinical outcome of respiratory syncytial virus(RSV) pneumonia in children.MethodsFrom January 2022 to January 2024,120 children with RSV pneumonia [divided into severe pneumonia group(n=40) and non-severe pneumonia group(n=80)] were diagnosed and treated in the Department of Pediatrics of Yulin First Hospital(Second Affiliated Hospital of Yan 'an University), and 60 healthy children(healthy control group) were studied. The data of gender, age, course of disease, arterial partial pressure of oxygen(PaO2), arterial partial pressure of carbon dioxide(PaCO2), heart rate, blood routine indexes and inflammatory factor levels(IL-6, CRP, TNF-α) were collected. The CURB-65 score of the severity of RSV pneumonia in children was evaluated. The levels of MxA and YKL-40 in peripheral blood were detected by enzyme-linked immunosorbent assay. The clinical outcome of children with RSV pneumonia was evaluated. The levels of MxA and YKL-40 in children with RSV pneumonia were compared with those in the control group. Pearson correlation analysis was used to analyze the correlation between MxA and YKL-40 and inflammatory factors and CURB-65 score. Multivariate logistic regression analysis was used to analyze the factors affecting the clinical outcome of children. The receiver operating curve was used to evaluate the predictive efficacy of MxA and YKL-40 on clinical outcome.ResultsThe levels of MxA and YKL-40 in severe pneumonia group were higher than those in non-severe pneumonia group and control group(F=116.970,48.810,P<0.001). The levels of MxA and YKL-40 in peripheral blood of children with RSV pneumonia were positively correlated with IL-6, CRP, TNF-α and CURB-65 scores(r=0.631,0.564,0.631,0.712,0.675,0.581,0.689,0.741,all P<0.001). High levels of MxA, YKL-40 and elevated CURB-65 scores were independent risk factors for adverse outcomes in children with RSV pneumonia[OR(95%CI)=2.013(1.463-2.979),1.865(1.132-2.358),1.477(1.813-3.005),all P<0.01].The area under the curve(AUC) of MxA combined with YKL-40 for adverse outcomes in children with RSV pneumonia(AUC = 0.861) was higher than that of MxA and YKL-40 alone(AUC=0.727,0.745)(Z=5.136,4.384,all P<0.001).ConclusionThe levels of MxA and YKL-40 in children with RSV pneumonia are increased, which are related to the inflammatory response and the severity of the disease. They are independent indicators for evaluating the clinical outcome of children with RSV pneumonia. The combined detection of MxA and YKL-40 has a high predictive efficiency for the occurrence of adverse outcomes in children with RSV pneumonia.

ObjectiveTo investigate the effects of serum levels of leptin, tumor necrosis factor-α(TNF-α) and interleukin-6(IL-6) on lung function and asthma control in children with obese asthma.MethodsA prospective study was conducted on 103 children with obese asthma from September 2020 to August 2023 in our hospital as study group, 103 non-obese children with asthma from the same period as non-obese asthma group, and 103 healthy children who underwent physical examination as a healthy control group. The levels of serum leptin, TNF-α, and IL-6 were compared among the three groups, the relationship was analyzed between serum leptin, TNF-α, and IL-6 levels and lung function in obese children with asthma, and their predictive value for asthma control was evaluated.ResultsThe levels of serum leptin, TNF-α, and IL-6 in the study group > non-obese asthma group > healthy control group(F/P=21.723<0.001、104.516/<0.001、62.026/<0.001). the="" levels="" of="" serum="" and="" il-6="" in="" children="" with="" severe="" asthma="">children with moderate asthma > children with mild asthma(F/P=23.660/<0.001、33.615/<0.001、26.434/<0.001). 4="" 27="" 31="" 45="" after="" weeks="" of="" cases="" were="" completely="" included="" in="" the="" complete="" control="" partially="" partial="" and="" not="" uncontrolled="" .="" there="" was="" no="" significant="" difference="" bmi="" among="" three="" p="">0.05). There was a significant difference in the severity of the disease among the three subgroups(χ2/P=23.441/<0.001). FVC, FEV1, and PEF showed a gradual downward trend in the complete controlled subgroup, partially controlled subgroup, and uncontrolled subgroup(F/P=23.083/<0.001、22.823/<0.001、34.771/<0.001), while the levels of serum leptin, TNF-α, and IL-6 showed a gradual upward trend in the complete controlled subgroup, partially controlled subgroup, and uncontrolled subgroup(F/P=38.883/<0.001、122.302/<0.001、29.940/<0.001). The levels of serum leptin, TNF-α, and IL-6 were negatively correlated with FVC, FEV1, and PEF(r=-0.622、-0.640、-0.603,-0.662、-0.609、-0.594,-0.703、-0.625、-0.619,P均<0.001). The AUC of serum leptin, TNF-α, and IL-6 for predicting asthma control was 0.734, 0.778, and 0.767, which was significantly better than the predictive value of each indicator alone(Z=3.712, 3.065, 3.214, all P<0.001).ConclusionSerum leptin, TNF-α, and IL-6 are abnormally elevated in obese children with asthma, and are closely related to the severity of the disease and lung function. Combined detection can reliably predict the control of asthma.

ObjectiveTo investigate the relationship between serum levels of cytotoxic T-lymphocyte antigen-4(CTLA4) and S100 calcium-binding protein A12( S100A12) and the condition and prognosis of children with primary nephrotic syndrome(PNS).MethodsA total of 129 children with PNS admitted to the Department of Pediatrics, Affiliated Hospital of Xuzhou Medical University from June 2019 to June 2021 were retrospectively selected as the PNS group. According to different conditions, the children were divided into simple PNS subgroup(69 cases) and nephritis PNS subgroup(60 cases); According to the prognosis of 3 years after treatment, the children were divided into poor prognosis subgroup(23 cases) and good prognosis subgroup(104 cases).108 healthy children were selected as healthy control group. The levels of serum CTLA4 and S100A12 were detected by enzyme-linked immunosorbent assay. Pearson method was used to analyze the correlation between serum CTLA4, S100A12 levels and serum Alb levels, renal function indexes in children with PNS. Multivariate Logistic regression analysis was used to analyze the influencing factors of poor prognosis in children with PNS. The receiver operating characteristic(ROC) curve was used to evaluate the predictive value of serum CTLA4 and S100A12 levels for poor prognosis in children with PNS.ResultsThe serum CTLA4 level in the PNS group was lower than that in the healthy control group, and the serum S100A12 level was higher than that in the healthy control group(t/P=22.138/<0.001,17.374/<0.001); The levels of serum S100A12, BUN, SCr and 24 h urine protein in the nephritis PNS subgroup were higher than those in the simple PNS subgroup, and the levels of serum CTLA4 and Alb were lower than those in the simple PNS subgroup(t/P = 11.092/<0.001,7.832/<0.001,7.379/<0.001,8.090/<0.001,14.359/<0.001,7.455/<0.001); Pearson correlation analysis showed that serum CTLA4 level in children with PNS was positively correlated with Alb level, and negatively correlated with BUN, SCr and 24 h urine protein level(r/P=0.464/0.001,-0.365/0.012,-0.328/0.019,-0.507/<0.001). Serum S100A12 level was positively correlated with BUN, SCr and 24 h urine protein level, and negatively correlated with Alb level(r/P=0.286/0.031, 0.307/0.023, 0.427/0.003,-0.338/0.009). The proportion of nephritis PNS, BUN, SCr, 24 h urine protein and S100A12 levels in the poor prognosis subgroup were higher than those in the good prognosis subgroup, and the levels of serum Alb and CTLA4 were lower than those in the good prognosis subgroup(χ2/t/P=10.841/0.001, 6.397/<0.001, 2.644/0.009, 11.690/<0.001, 6.834/<0.001, 5.558/<0.001, 3.874/<0.001); Nephritic PNS and high S100A12 were independent risk factors for poor prognosis in children with PNS[OR( 95 % CI) = 2.236( 1.211-4.131), 1.887( 1.114-3.197)], and high CTLA4 was an independent protective factor[OR( 95 % CI) = 0.439( 0.221-0.877)]; The AUC of serum CTLA4, S100A12 levels and the combination of the two in predicting the poor prognosis of children with PNS were 0.754,0.731 and 0.959, respectively. The AUC of the combination of the two was greater than that of the single prediction(Z/P = 3.866/<0.001, 3.033/<0.001).ConclusionThe decrease of serum CTLA4 level and the increase of S100A12 level in children with PNS are related to the aggravation of PNS and poor prognosis, which can be used as a marker for the prognosis of PNS.

Objective To investigate the relationship between the expression of microRNA-497-5p(miR-497-5p) and forkhead box P4(FOXP4) in papillary thyroid carcinoma(PTC) tissues and their association with pathological parameters and prognosis. Methods A total of 153 PTC patients treated in the Breast and Thyroid Surgery Department of Shangluo Central Hospital from January 2017 to August 2019 were selected for this study. Quantitative real-time PCR was used to detect miR-497-5p and FOXP4 mRNA expression in PTC and adjacent non-cancerous tissues. The correlation between miR-497-5p and FOXP4 mRNA levels was analyzed using Pearson correlation. Kaplan-Meier survival analysis assessed the impact of miR-497-5p and FOXP4 expression on patient prognosis, while Cox regression was used to identify factors affecting PTC prognosis. Results The miR-497-5p expression was significantly lower, while FOXP4 mRNA expression was significantly higher in PTC tissues compared to adjacent non-cancerous tissues(t/P=35.062/<0.001,38.007/<0.001). A binding site was identified in the 3′-untranslated region of FOXP4 for miR-497-5p. Pearson correlation showed a negative correlation between miR-497-5p and FOXP4 mRNA levels in PTC tissues(r/P=-0.664/<0.001). miR-497-5p levels were significantly lower, and FOXP4 mRNA levels higher in stages Ⅲ-IVB and in cases with lymph node metastasis compared to stages I-II and cases without lymph node metastasis(t/P=3.013/0.003,2.834/0.005,3.027/0.003,2.872/0.005). The five-year survival rate was 84.31%(129/153) among all PTC patients, with a significantly higher survival rate in the high miR-497-5p group(96.00%, 72/75) compared to the low miR-497-5p group(73.08%, 57/78)(Log-rank χ2=15.118,P<0.001). Conversely, the high FOXP4 mRNA group had a lower five-year survival rate(71.23%, 52/73) compared to the low FOXP4 mRNA group(96.25%, 77/80)(Log-rank χ2=18.128,P<0.001). Advanced TNM stage(Ⅲ-IVB), lymph node metastasis, and elevated FOXP4 mRNA were independent risk factors for poor prognosis in PTC patients [HR(95%CI)=3.835(1.373-10.715), 3.061(1.106-8.472), and 4.841(1.601-14.633)], while elevated miR-497-5p was an independent protective factor [HR(95%CI)=0.193(0.056-0.666)]. Conclusion Low expression of miR-497-5p and high expression of FOXP4 mRNA in PTC tissues are associated with unfavorable pathological parameters and poor prognosis.