ObjectivesOur goal was to evaluate the influence of the interlude between neoadjuvant immunochemotherapy (NAIC) and surgery on both pathologic responses and surgical outcomes in head and neck squamous cell carcinoma (HNSCC).MethodsPatients undergoing surgery for HNSCC following NAIC were retrospectively enrolled and determined based on the time to surgery (TTS). Impact of TTS on major pathologic response (mPR), pathologic complete response (pCR), surgical complication and 3-year disease free survival (DFS) was evaluated.ResultsA total of 356 patients were enrolled. 225 patients (63.2%) achieved a mPR, among whom a pCR was achieved in 104 patients (29.2%). When compared to the TTS<1 week group, patients with a TTS of 1-2 weeks and those with a TTS of 2-3 weeks exhibited comparable rates of pCR and mPR achievement; however, patients who underwent surgery more than 3 weeks after the completion of NAIC had a significantly reduced likelihood of achieving total tumor regression by 16% (95% CI: 1%-23%) and lower probability of major tumor regression by 21% (95% CI: 5%-36%). The TTS >3 weeks group bore an additional 0.67-fold risk of experiencing surgical complications and 1.23-fold increased risk of adverse recurrence or death events compared to TTS <1 cohort.ConclusionA TTS exceeding 3 weeks was independently associated with a diminished likelihood of achieving both pCR and mPR, an increased rate of surgical complications, and a shorter duration of DFS. These findings suggest that the interval between surgery and the completion of NAIC may be optimal when kept within 3 weeks in HNSCC, though this warrants prospective validation.
Background/objectiveImmunodeficiency is a common precipitating factor for Mycoplasma pneumoniae pneumonia (MPP). Vitamins are essential for enhancing immune function and mitigating systemic inflammation. However, the relationship between various vitamins, particularly B vitamins, and MPP in children remains underexplored. This study aims to assess the nutritional status of multiple vitamins in children with MPP and their relationship to the condition.MethodsA retrospective observational study was conducted at Children’s Hospital Affiliated to Zhengzhou University. A total of 135 children diagnosed with MPP with voluntarily requested vitamin profiling were enrolled between October and December 2023. A control group of 199 children, who underwent health check-ups and vitamins assessments, were also included during the same period. Clinical and laboratory data were retrieved from the hospital’s electronic medical record system.ResultsChildren with MPP exhibited significantly lower levels of VA, VD, VB1, VB7, and VC in their peripheral blood compared to the healthy control group. Nutritional analysis revealed higher deficiency rates of these vitamins in the MPP group. Correlation analysis indicated significant negative relationships between VA, VD, VB1, VB7, and VC levels and the percentage of neutrophils. Additionally, VA, VD, VB7, and VC levels were negatively correlated with the percentage of monocytes. Multivariate regression analysis, adjusted for age and neutrophil percentage, showed that VA (OR = 0.986, 95% CI: 0.981-0.992, P < 0.001), VD (OR = 0.807, 95% CI: 0.746-0.874, P < 0.001), VB1 (OR = 0.592, 95% CI: 0.406-0.864, P = 0.007), VB7 (OR = 0.980, 95% CI: 0.972-0.989, P < 0.001), and VC (OR = 0.899, 95% CI: 0.822-0.984, P = 0.021) were independently associated with MPP. Further analysis demonstrated that children with deficiencies in VA, VD, VB1, VB7, and VC had significantly higher odds of having MPP.ConclusionChildren with MPP exhibit significantly lower levels of VA, VD, VB1, VB7, and VC. The incidence of multiple vitamin deficiencies is notably higher in this group compared to healthy children, and a negative correlation exists between vitamin levels and neutrophil percentage. Multivariate regression analysis confirms that VA, VD, VB1, VB7, and VC were identified to be independently associated with MPP.
1. To assess the subtypes of Mycoplasma pneumoniae (M. pneumoniae) circulated in Henan Province, China during the years 2019–2023 and the proportion changed with time. We were also interested in macrolide resistance (MR) mutation of M. pneumoniae. 2. To see if there is a correlation between the subtypes of M. pneumoniae and clinical characteristics. We conducted multi-locus variable-number tandem repeat analysis (MLVA) typing, multi-locus sequence typing (MLST), and MR mutation test in the 23S rRNA from 417 M. pneumoniae clinical isolates. Our study showed there were two major MLVA types: 4572 and 3562. In general, the main MLST types were 3 and 14. The results of MR mutations showed that 97.4
Background Autism spectrum disorder (ASD) shows a marked male bias. Vitamin A (VA) and serotonin (5-hydroxytryptamine [5-HT]), both crucial in neurodevelopment and frequently dysregulated in ASD, yet their collective contribution to the observed sexual dimorphism remain unclear in large multi-center studies. Methods From 13 Chinese cities, we recruited 1,219 ASD and 1,215 typically developing (TD) children with an age range of 2–7 years old. Core symptoms were assessed using the Childhood Autism Rating Scale (CARS), Autism Behavior Checklist (ABC), and Social Responsiveness Scale (SRS). Neurodevelopment was assessed with the Children Neuropsychological and Behavior Scale-Revised 2016 (CNBS-R2016). Serum VA and 5-HT were measured by high-performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS). Results Among VA-deficient (VAD) boys, peripheral blood 5-HT concentration were higher in ASD than TD children. Within the male ASD chidlren, the VAD subgroup showed elevated 5-HT levels compared to the VA-normal (VAN) subgroup. In high 5-HT boys, serum VA was lower in ASD than in TD chidlren. Severity-stratified analysis among VAD boys revealed higher 5-HT in severe versus mild-to-moderate ASD. Notably, in severe ASD cases, VAD boys exhibited higher 5-HT than VAN boys, and high 5-HT boys had lower VA than low 5-HT peers. VA and 5-HT interactively influenced ABC, CARS, and autistic mannerisms subdomain scores, along with the general quotient, fine motor, and adaptive behavior domain in boys with ASD. Conclusion The correlation between VA and 5-HT in ASD children exhibits significant sexual dimorphism. Specifically, among boys with ASD, VA and 5-HT interact to modulate both core symptoms and neurodevelopmental outcomes.
Background:Fulminant myocarditis (FM) in children can progress rapidly to cardiogenic shock, with high risk of mortality. Early recognition of prognostic markers is critical to guide timely escalation of circulatory support. This multicenter study sought to characterize clinical features and identify early predictors of in-hospital mortality in pediatric FM. Methods:We conducted a retrospective cohort study of patients <18 years with FM admitted to eight ECMO-capable pediatric intensive care units between January 2018 and August 2023. Clinical, biochemical, electrocardiographic, and echocardiographic variables were analyzed. Logistic regression was used to identify predictors of mortality, and receiver operating characteristic (ROC) curves were generated to assess discriminatory performance. Results:A total of 187 children were included; 157 (84.0%) required ECMO. In-hospital mortality was 16.6% (31/187). Univariate analysis identified elevated CK-MB, higher peak lactate, and ventricular tachycardia as associated with mortality. In multivariate analysis, peak lactate (AUC 0.791) and CK-MB (AUC 0.774) remained independent predictors. A combined model of peak lactate and ventricular tachycardia demonstrated moderate discrimination (AUC 0.772), whereas a composite model incorporating CK-MB, peak lactate, and ventricular tachycardia achieved the best predictive performance (AUC 0.815). Elevated lactate measured 12 h after initiation of extracorporeal membrane oxygenation or intensive conventional therapy further increased mortality risk (OR 1.219, 95% CI 1.004-1.481). Conclusion:Peak lactate, CK-MB, and ventricular tachycardia are early independent predictors of in-hospital mortality in pediatric FM. Persistent hyperlactatemia within 12 h of advanced support provides additional prognostic value and may assist clinicians in early risk stratification.
