Objective To investigate the value of serum caspase recruitment domain family member 9( CARD9) and nucleotide-binding oligomerization domain-like receptor family member X1( NLRX1) in the diagnosis and prognosis evaluation of viral myocarditis(VMC) in children. Methods A total of 110 children with VMC admitted to the Department of Pediatrics of Yan 'an People 's Hospital from January 2021 to September 2023 were selected as VMC group and 110 healthy children in the same period were selected as healthy control group. VMC children were divided into poor prognosis subgroup(32 cases) and good prognosis subgroup(78 cases) according to 1-year prognosis. The levels of serum CARD9 and NLRX1 were detected by enzyme-linked immunosorbent assay. Multivariate unconditional Logistic regression analysis was used to analyze the relationship between serum CARD9, NLRX1 levels and poor prognosis of VMC in children. ROC curve was used to analyze the diagnostic value and prognostic value of serum CARD9 and NLRX1 levels in children with VMC. Results Compared with the healthy control group, the level of serum CARD9 of the VMC group increased and the level of NLRX1 decreased( t/P=10.679/<0.001,10.203/<0.001); After 1 year of follow-up, the poor prognosis rate of 110 children with VMC was 29.09 %(32/110); compared with the good prognosis subgroup, the level of serum CARD9 increased and the level of NLRX1 decreased in the poor prognosis subgroup( t/P=5.863/<0.001,5.808/<0.001); High-sensitivity C-reactive protein, high creatine kinase isoenzyme MB, high cardiac troponin I and high CARD9 were independent risk factors for poor prognosis of children with VMC, and high NLRX1 was an independent protective factor[OR(95%CI)=3.372(1.421-8.005),1.178(1.002-1.386),3.104(1.420-6.789),1.081(1.030-1.133),0.613(0.397-0.946)];the AUC of serum CARD9, NLRX1 and the two in the diagnosis of VMC in children were 0.848, 0.840 and 0.919, respectively. The combination of the two was superior to their respective predictive values( Z/P=3.855/<0.001,3.884/<0.001); the AUC of serum CARD9, NLRX1 and the two in evaluating the poor prognosis of children with VMC were 0.805, 0.787 and 0.894, respectively. The combination of the two was superior to the value of each alone in evaluating the poor prognosis of children with VMC( Z/P=2.611/0.009,2.737/0.006).Conclusion The increase of serum CARD9 level and the decrease of serum NLRX1 level of children with VMC are closely related to the decrease of prognosis, the combination of serum CARD9 and NLRX1 levels has high value in the diagnosis and prognosis evaluation of children with VMC.

Objective To investigate the relationship between serum microRNA-132(miR-132), phosphatase and tensin homolog(PTEN) levels, and the disease severity and prognosis of children with viral meningitis(VM). Methods A total of 203 children diagnosed with VM at Shanxi Children's Hospital from January 2022 to March 2024 were enrolled in the VM group. The healthy control group consisted of 50 children undergoing health checks during the same period. VM patients were classified into mild(77 cases), moderate(67 cases), and severe(59 cases) VM subgroups according to the Glasgow Coma Scale(GCS) score. Based on 6-month prognosis, the children were further divided into poor and good prognosis subgroups. Serum miR-132 and PTEN levels were detected by real-time quantitative PCR and enzyme-linked immunosorbent assay. The TargetScan database was used to predict the binding site between miR-132 and PTEN. Pearson correlation analysis was performed to evaluate the correlation between serum miR-132 and PTEN levels, and Spearman rank correlation analysis was performed to assess their relationship with GCS scores. Multivariate Logistic regression analysis was used to investigate the association between serum miR-132 and PTEN levels and the prognosis of VM patients. The predictive performance of serum miR-132 and PTEN levels for prognosis was analyzed using ROC curves. Results Compared with the healthy control group, serum miR-132 levels were lower, and PTEN levels were higher in the VM group( t/P=12.097/<0.001,13.517/<0.001). There was a binding site between miR-132 and PTEN at the 3′-untranslated region(1246-1252), and the serum miR-132 level was negatively correlated with PTEN( r/P=-0.656/<0.001). Serum miR-132 levels decreased, and PTEN levels increased in the mild, moderate, and severe VM subgroups( F/P=298.691/<0.001,358.809/<0.001).The GCS score was positively correlated with serum miR-132 levels and negatively correlated with PTEN levels( r/P=0.660/<0.001,-0.695/<0.001). After 6 months of follow-up, the poor prognosis rate was 34.48%(70/203) in the VM group. Seizures and high PTEN levels were independent risk factors for poor prognosis, while high GCS scores and high miR-132 levels were independent protective factors[OR(95%CI)=3.035(1.083-8.506),1.428(1.207-1.689),0.678(0.572-0.802),0.299(0.176-0.509)].The AUC for predicting poor prognosis in VM children using serum miR-132, PTEN, and their combination were 0.836, 0.822, and 0.914, respectively. The combined prediction was superior to either alone( Z/P=2.202/0.028,2.579/0.010). Conclusion Reduced serum miR-132 levels and increased PTEN levels in children with VM are associated with more severe disease and poorer prognosis. The combined use of serum miR-132 and PTEN levels has a high predictive value for the prognosis of VM children.

Objective To study the expression levels of serum pyruvate dehydrogenase kinase 4(PDK4) and chitinase 1(CHIT1) in neonatal early-onset sepsis(EOS), and to analyze their prognostic value for EOS. Methods From February 2021 to February 2024,114 EOS children diagnosed and treated in NICU of Shanxi Children's Hospital(Shanxi Maternal and Child Health Hospital) were selected as EOS group. According to the prognosis, they were divided into poor prognosis subgroup(n=31) and good prognosis subgroup(n=83), and 100 healthy newborns in the same period were selected as healthy control group. Serum PDK4 and CHIT1 levels were detected by enzyme-linked immunosorbent assay; Pearson correlation analysis was used to analyze the correlation between serum PDK4, CHIT1 and clinical parameters in children with EOS; Multivariate Logistic regression analysis was used to analyze the factors affecting the prognosis of EOS children; The receiver operating characteristic curve was used to analyze the value of serum PDK4 and CHIT1 in the evaluation of EOS.Results The serum levels of PDK4 and CHIT1 in EOS group were higher than those in healthy control group( t=44.576,38.771,all P<0.001). The levels of procalcitonin, respiratory distress syndrome, necrotizing enterocolitis, shock, serum PDK4 and CHIT1 in EOS children in the poor prognosis subgroup were higher than those in the good prognosis subgroup( t=10.229,42.970,14.742,15.754,20.405,12.158,all P<0.001). Serum PDK4 and CHIT1 were positively correlated with white blood cell count, C-reactive protein and procalcitonin( r=0.667,0.702,0.723,0.766,0.669,0.758,all P<0.001). Procalcitonin, respiratory distress syndrome, necrotizing enterocolitis, shock, serum PDK4 and CHIT1 were risk factors for poor prognosis in children with EOS[OR(95%CI)=1.594(1.252-2.028),1.465(1.214-1.769),1.384(1.088-1.761),1.323(1.124-1.557),1.589(1.258-2.006),1.733(1.249-2.404)].The AUC of serum PDK4, CHIT1 and the combination of the two in predicting the poor prognosis of EOS children were 0.836,0.825 and 0.926, respectively. The combination of the two was superior to their respective predictive values( Z=4.560,4.563,P<0.001).Conclusion The levels of serum PDK4 and CHIT1 in children with EOS are increased, which are related to the severity of the disease. The combination of the two has a high evaluation efficiency for the prognosis of children with EOS.

Objective To compare the clinical efficacy of anterior cervical micro-incision endoscopic surgery and complete areolar approach endoscopic thyroidectomy in treating differentiated thyroid cancer. Methods From February 2022 to February 2023, Clinical data of 102 patients with differentiated thyroid cancer diagnosed and treated by Head and Neck Surgery in Xuzhou Cancer Hospital were collected. They were assigned into anterior cervical group and complete areolar approach group complying with surgical methods, with 51 patients in each group. The anterior cervical group underwent anterior cervical micro-incision endoscopic surgery, while the complete areolar approach group underwent complete areolar approach endoscopic thyroidectomy. Two groups were compared for surgical indicators, trauma stress indicators, coagulation function, thyroid function, pain level, complications, and cosmetic satisfaction. Results The anterior cervical group had unusually larger number of lymph node dissection(t/P=2.589/0.011), longer surgical time(t/P=2.265/0.026), and less intraoperative blood loss than complete areolar approach group(t/P=2.617/0.010). The C-reactive protein(CRP), prostaglandin E2(PGE2), and cortisol(Cor) in both groups unusually increased after surgery(anterior cervical group: t/P=37.105/<0.001,40.582/<0.001,37.955/<0.001;complete areolar approach group: t/P=39.336/<0.001,43.655/<0.001,36.791/<0.001). The postoperative activated partial thromboplastin time(APTT)and prothrombin time(PT) of both groups were prominently shortened, while fibrinogen(FIB) was prominently increased(anterior cervical group: t/P=7.671/0.014,20.546/<0.001,4.447/0.021;complete areolar approach group: t/P=13.323/<0.001,23.695/<0.001,14.533/<0.001). The postoperative triiodothyronine(T3), thyroxine(T4), free triiodothyronine(FT3), and free thyroxine(FT4) in both groups reduced unusually, while thyroid stimulating hormone(TSH) raised higher(anterior cervical group: t/P=96.024/<0.001,27.446/<0.001,64.267/<0.001,54.574/<0.001,30.796/<0.001; complete areolar approach group: t/P=42.866/<0.001,26.519/<0.001,60.782/<0.001,57.527/<0.001, 34.083/<0.001). The pain in both groups on postoperative day 2rd was unusually milder than on postoperative 1st day(anterior cervical group: t/P=32.582/<0.001;complete areolar approach group: t/P=32.566/<0.001). the="" total="" incidence="" of="" postoperative="" complications="" was="" not="" unusually="" different="" between="" two="" p="">0.05). The anterior cervical group had prominently lower Vancouver Scar Scale(VSS) score and Patient And Observer Scar Assessment Scale(POSAS) score than complete areolar approach group one year after surgery( t/P=16.964/<0.001,9.023/<0.001). Conclusion The clinical efficacy of anterior cervical micro-incision endoscopic surgery is comparable to that of complete areolar approach endoscopic thyroidectomy for differentiated thyroid cancer. However, anterior cervical micro-incision endoscopic surgery has more lymph node dissection, longer operation time, less intraoperative bleeding, and higher aesthetic satisfaction.

Objective To study the expression of carnitine palmitoyltransferase 1A(CPT1A) and 3-phosphoinositide dependent protein kinase 1(PDPK1) in prostate cancer and its correlation with epithelial mesenchymal transition(EMT) and its clinical significance. Method: A total of 110 patients with prostate cancer treated in the Department of Urology of Xi'an People 's Hospital(Xi'an Fourth Hospital/Northwest University Affiliated People 's Hospital) from January 2019 to December 2021 were selected. The expression levels of CPT1 A mRNA, PDPK1 mRNA and EMT genes[Twist, E-cadherin( E-cad), N-cadherin( N-cad)]mRNA in tissues were detected by real-time fluorescence quantitative PCR. Pearson correlation was used to study the correlation between CPT1 A mRNA, PDPK1 mRNA and EMT gene; the expression of CPT1 A and PDPK1 protein was detected by immunohistochemistry; the effect of CPT1A and PDPK1 protein expression on the prognosis of prostate cancer was statistically analyzed.Results Compared with the adjacent tissues, the expression of CPT1A mRNA, PDPK1 mRNA, Twist mRNA, N-cad mRNA in cancer tissues was higher, and the expression of E-cad mRNA was lower( t/P=37.485/<0.001,42.555/<0.001,41.666/<0.001,33.161/<0.001,37.382/<0.001); the expression of CPT1A mRNA and PDPK1 mRNA in prostate cancer was positively correlated with the expression of EMT gene Twist mRNA and N-cad mRNA( r=0.722,0.630;0.651,0.643,all P<0.001), and negatively correlated with E-cad mRNA( r=-0.712,-0.730, all P<0.001); the positive rates of CPT1A and PDPK1 protein in prostate cancer tissues were 70.91%(78/110) and 65.45%(72/110), which were higher than those in adjacent tissues 5.45%(6/110) and 6.36%(7/110)( χ2=99.832, 52.011, all P<0.001); the="" positive="" rates="" of="" cpt1="" a="" and="" pdpk1="" protein="" in="" prostate="" cancer="" tissues="" with="" t3="" stage="" gleason="" score="">7 were increased( χ2/P=9.870/0.002,7.405/0.007;13.062/<0.001,12.351/<0.001). The 3-year progression-free survival rates of CPT1A positive group and PDPK1 positive group were 51.28%(40/78) and 48.61%(35/72), respectively, which were lower than 81.25 %(26/32) and 81.58%(31/38) of CPT1A negative group and PDPK1 negative group(Log-rank χ2=7.845,10.980,P=0.005,0.001).CPT1 A positive, PDPK1 positive, T3 a stage and Gleason score > 7 were risk factors affecting the prognosis of prostate cancer[OR(95%CI)=1.326(1.077-1.632),1.301(1.110-1.525),1.324(1.074-1.633),1.370(1.092-1.720)].Conclusion The expression of CPT1 A and PDPK1 in prostate cancer is increased, which is positively correlated with the expression of EMT gene, and is a tumor marker for evaluating the prognosis of prostate cancer.