Objective To investigate the predictive value of serum apurinic/apyrimidinic endonuclease 1/redox factor-1(APE1/Ref-1) and prokineticin 2(PK2) levels for disease severity and coronary artery lesion(CAL) development in children with Kawasaki disease(KD). Methods A total of 137 pediatric KD patients admitted to the Department of Pediatrics, Wuzhong People ' s Hospital/Affiliated Wuzhong People ' s Hospital of Ningxia Medical University, between February2020 and February 2025 were enrolled. Based on echocardiographic findings, patients were stratified into a CAL subgroup(n = 45) and a non-CAL subgroup(n = 92). Serum levels of APE1/Ref-1 and PK2 were measured using ELISA, and clinical data were collected concurrently. Pearson correlation analysis was performed to assess the relationships of APE1/Ref-1 and PK2 with white blood cell count, platelet count, and erythrocyte sedimentation rate. Multivariate logistic regression was used to identify factors independently associated with CAL development in KD patients. The diagnostic performance of APE1/Ref-1 and PK2 for predicting CAL was evaluated using receiver operating characteristic(ROC) curve analysis. Results Serum APE1/Ref-1 levels were significantly higher, while PK2 levels were significantly lower, in the KD group compared with the healthy control group(t/P = 21.279/<0.001, 16.126/<0.001). The CAL subgroup had significantly higher APE1/Ref-1 levels and significantly lower PK2 levels than the non-CAL subgroup(t/P = 11.854/<0.001, 10.820/<0.001). Serum APE1/Ref-1 levels were positively correlated with erythrocyte sedimentation rate, white blood cell count, and platelet count in children with KD,while PK2 levels showed negative correlations with these parameters(r/P = 0.253/0.021, 0.409/<0.001, 0.473/<0.001;-0.241/0.028,-0.386/<0.001,-0.427/<0.001). Intravenous immunoglobulin(IVIG) resistance and high APE1/Ref-1 levels were independent risk factors for CAL in KD children, while high PK2 levels were an independent protective factor [OR(95%CI) =2.784(1.201-6.455), 2.066(1.115-3.832), 0.704(0.560-0.885)]. The area under the curve(AUC) values of APE1/Ref-1,PK2, and their combination for diagnosing CAL in children with KD were 0.799, 0.723, and 0.911, respectively. The combined prediction was superior to either biomarker alone(Z = 2.881, 3.681; both P<0.001). Conclusion Elevated serum APE1/Ref-1 levels and decreased PK2 levels are associated with the occurrence of CAL in children with KD. The combination of these two biomarkers holds significant value for risk assessment of CAL.

Objective To explore the expression levels of C-C chemokine receptor type 5(CCR5) and C-X-C chemokine ligand 11(CXCL11) in children with viral encephalitis and their clinical significance. Methods A total of 133 children with viral encephalitis admitted to the Department of Pediatrics, the 909 th Hospital/Southeast Hospital Affiliated to Xiamen University from May 2021 to May 2024 were recruited as the case group. They were divided into a mild subgroup(n =83) and a severe subgroup(n = 50) according to the modified Pediatric Early Warning Score(PEWS). Based on disease outcome within 3 months after treatment, the patients were further divided into a good outcome subgroup(n = 92) and a poor outcome subgroup(n = 41). During the same period, 133 febrile children without intracranial infection were randomly selected as the control group. Serum CCR5 and CXCL11 levels were detected by enzyme-linked immunosorbent assay. Pearson correlation analysis was used to analyze the association between serum CCR5, CXCL11 levels and PEWS scores. Multivariate logistic regression analysis was used to identify risk factors for poor outcomes. Receiver operating characteristic(ROC) curves were plotted to evaluate and compare the predictive value of serum CCR5 and CXCL11 for poor outcomes. Results Serum CCR5 and CXCL11 levels were significantly higher in the case group than in the control group(t/P = 25.923/<0.001, 15.796/<0.001). Serum CCR5 and CXCL11 levels in the severe subgroup were significantly higher than those in the mild subgroup(t/P = 24.361/<0.001, 14.608/<0.001). The PEWS score in the severe subgroup was significantly higher than that in the mild subgroup(t/P = 16.304/<0.001). Serum CCR5 and CXCL11 levels showed a positive association with PEWS score(r/P = 0.651/<0.001, 0.623/<0.001). Compared with the good outcome subgroup, the poor outcome subgroup had more severe abnormalities on video electroencephalography(VEEG), a higher proportion of severe cases, and significantly elevated serum CCR5 and CXCL11 levels(χ2/t = 14.250/0.001, 8.650/0.003,-19.762/<0.001,-12.649/<0.001). Severe VEEG abnormalities, severe disease condition, elevated CCR5, and elevated CXCL11 were independent risk factors for poor outcomes, with OR values and95% CIs of 3.892(2.244-6.751), 2.921(1.913-4.461), 1.885(1.335-2.659), and 2.030(1.385-2.975), respectively(all P<0.05). The AUCs of serum CCR5, CXCL11, and their combination in predicting poor outcomes were 0.806, 0.795, and 0.902,respectively. The predictive value of the combination was significantly superior to that of either single indicator(Z/P = 2.322/0.016, 2.437/0.011). Conclusion Serum CCR5 and CXCL11 levels are elevated in children with viral encephalitis and are associated with disease severity and outcomes. Early detection of these two indicators can assist in clinically assessing disease severity and predicting the risk of poor outcomes.

Objective To investigate the effects of Bushentongluo Decoction on the joint microenvironment in a rat model of knee osteoarthritis(KOA).Methods Eighty Sprague-Dawley(SD) rats were randomly divided into five groups: a normal control group, a model group, and three Bushentongluo Decoction treatment groups(low, medium, and high doses).The KOA model was induced using the Hulth method. Four weeks after modeling, the rats were administered oral gavage for2 weeks. The normal control group and the model group received 10 ml/(kg·d) of physiological saline. The Bushentongluo Decoction treatment groups received Bushentongluo Decoction at the following dosages: 4.42 ml/200 g(high dose), 2.21 ml/200 g(medium dose), and 1.105 ml/200 g(low dose) daily.ELISA was used to measure serum levels of interleukin-6(IL-6),interleukin-1β(IL-1β), and tumor necrosis factor-α(TNF-α).Hematoxylin and Eosin(H&E) staining and toluidine blue staining were performed to observe histopathological changes in the synovium and cartilage of the knee joints. Immunohistochemistry was used to detect protein expression levels of type Ⅲ collagen(Col Ⅲ), ADAMTS4(A Disintegrin and Metalloproteinase with Thrombospondin Motifs 4), and nuclear factor kappa B p65(NF-κB p65) in the knee joint cartilage tissue.Results(1)Compared with the normal control group, the model group exhibited severe cartilage destruction, with significantly higher Krenn scores and Mankin scores(P<0.01).Serum levels of IL-6, IL-1β, and TNF-α were significantly elevated in the model group compared to the normal control group(P<0.01).The protein expression levels of Col Ⅲ were significantly reduced,the protein expression levels of ADAMTS4 and NF-κB p65 in the cartilage tissue were significantly increased in the model group compared to the normal control group(P<0.01).(2) Compared with the model group, the Bushentongluo Decoction treated groups showed reduced cartilage damage, lower Krenn and Mankin scores, decreased serum levels of IL-6, IL-1β, and TNF-α(P<0.05), increased protein expression levels of Col Ⅲ and reduced protein expression levels of ADAMTS4 and NF-κB p65 in the cartilage tissue(P<0.05).The high-dose group exhibited the most significant improvements.Conclusion Bushentongluo Decoction can improve the joint microenvironment and alleviate the symptoms of knee osteoarthritis in rats by reducing inflammation and protecting cartilage from degradation. These findings suggest that Bushentongluo Decoction has potential as a therapeutic agent for KOA.

This article systematically explores the conceptual connotation and physiological functions of lung collaterals within the diagnostic and therapeutic system of lung collateral diseases. It reveals the interconnected structural relationships and synergistic functional coordination among lung qi collaterals, airways, and blood(vessel) collaterals. The study clarifies that lung collaterals represent a structural-functional unity formed through the integration of ancient anatomical observations,clinical practice inferences, and philosophical reflections on qi, yin-yang, and the five elements. Their theoretical connotation is inherently related to the neuro-endocrine-immune network and pulmonary circulation function of modern medicine, laying a theoretical foundation for the systematic construction of the diagnostic and therapeutic system of lung collateral diseases.

This paper reports a case of a patient with cardiovascular-kidney-metabolic(CKM) syndrome and reviews the relevant literature.