To evaluate the features of carotid web (CW) by ultrasonography.

A total of 66 patients with CW were retrospectively enrolled from January 2018 to June 2019 at Xuanwu Hospital, Capital Medical University. All patients were examined by both ultrasonography and CTA, and were divided into either a<50% stenosis group (54 cases) or a ≥50% stenosis group (12 cases). The ultrasonographic characteristics of CW, including the length, thickness, direction (forward or backward to the flow), acute angle between the web and carotid wall, and thrombus between the web and carotid wall were compared between the two groups. The stenosis degrees of carotid artery were compared between patients with and without ischemic stroke.

Forty-two (42/66, 63.6%) patients were diagnosed with CW by initial CDFI examination, of whom 21 (21/66, 31.8%) were diagnosed with ulcerative plaque and 3 (3/66, 4.5%) were diagnosed with carotid dissection at first but confirmed by second examination. There were no differences in the web length, thickness, direction, or thrombus detected between the two groups (P>0.05). The angle between the web and carotid wall in the<50% stenosis group was significantly smaller than that of the ≥50% stenosis group (median angel 39o vs 73o, P=0.002), and the percentage of patients with an angle≤ 60o in the<50% stenosis group was significantly higher than that of the ≥50% stenosis group (74.1% vs 41.7%, P=0.042). The diameter of the residual carotid artery at CW location in the<50% stenosis group was significantly larger and peak systolic velocity was significantly higher in the<50% stenosis group than in the≥50% stenosis group (P<0.001). The stenosis degrees of carotid artery were not statistically different between patients with and without ischemic stroke (P=0.321).

Ultrasonography can be used to evaluate the characteristics of carotid web in 2D and color mode. When the angle between the CW and carotid wall is large, the carotid artery stenosis ≥ 50% is more likely to happen, but carotid artery stenosis is not the main cause of ischemic stroke.

The aim of the present study was to evaluate the efficiency of sling exercise, therapeuticultrasound, therapeuticultrasound and sling exercise in patients to alleviate pain and improve lumbar function with lumbar disc herniation.

Individuals were selected from a list of patients being followed at the department of Rehabilitation in the third hospital of Hebei Medical University. 30 patients who were diagnosed with lumbar disc herniation were collected, the diagnoses were established upon medical history, physical examination, and results of imaging studies. The patients were randomly divided into three groups: therapeuticultrasound group received 14 sessions of ultrasonic therapy to the lumbar region, Sling exercise group received 14 sessions of sling exercise, and therapeuticultrasound and sling exercise group received therapeuticultrasound and sling exercise therapy 14 sessions of therapeuticultrasound to the lumbar region,7 sessions per week, 2 weeks. The VAS and ODI were compared with the assessment of the patients before and at the end of the therapy.

At the end of treatment, three groups VAS scores (F=3.069, P=0.043) and ODI scores (t=12.676, P<0.001) was lower than that at the beginning of treatment (P<0.05), at the end of treatment the VAS scores (F=59.400, P<0.001) and of the ODI scores (t=12.737, P<0.001) of ultrasonic and sling exercise therapy group was lower than the other group, the difference is significantly.

All three groups could reduce pain and improve lumbar function, and the ultrasonic and sling exercise therapy was most effective for lumbar disc herniation treatment in the three groups.

To analyze the treatment of different types of traumatic cerebral infarction in children, and explore its pathogenesis in combination with literature so as to improve the cure rate and reduce disability rate.

The clinical data of 42 cases of traumatic cerebral infarction in children were retrospectively analyzed in The Hospital of 81^st Group Army PLA from January 2015 to December 2019. The diagnosis of traumatic cerebral infarction in children was made by CT scan and MRI scan. According to different conditions, children with traumatic cerebral infarction were classified, and different treatment strategies were selected. Children with lacunar infarction were treated with calcium antagonists and neurotrophic drugs, supplemented by hyperbaric oxygen and exercise rehabilitation. The children of focal cerebral infarction and complex cerebral infarction treated by junior dehydrant and hormone also included the calcium antagonist and nutritional nerve drugs. The therapeutic regimen perhaps adjusted by the evolution of the disease. The children of extensive cerebral infarction underwent emergency cranial decompression, and was treated by reducing intracranial pressure and preventing complications after operation. The treatment results and recovery were observed.

In 42 cases of traumatic cerebral infarction in children, 35 cases (83.3%) were good recovery, 4 cases (9.5%) were moderate disability, 2 cases (4.8%) were severe disability, 1 case (2.4%) died, and no vegetative state. The good recovery rate of lacunar infarction was 100%, that of focal cerebral infarction was 62.5%, that of mixed cerebral infarction was 60%, and that of extensive cerebral infarction was 50%.

It is of great significance to improve the therapeutic effect and prognosis of children with traumatic cerebral infarction to adopt different treatment schemes for different types of cerebral infarction.

To characterize the patients with supratentorial hypertensive intracerebral hemorrhage (ICH) in the Tibetan Plateau over an altitude of 4000 meters.

A total of 68 cases with supratentorial hypertensive ICH were retrospectively included in Ali Regional People’s Hospital from January 2017 to September 2018. The clinical and laboratory data were collected. A simple linear correlation analysis was applied to analyze the correlation between the amount of bleeding and sex, age, nationality, time from onset , systolic blood pressure (SBP), diastolic blood pressure (DBP), hemoglobin (Hb), serum triglyceride (TG), and cholesterol. According to computed tomography (CT) findings, 68 cases were divided into the basal ganglia ICH group (33 cases) and the lobar ICH group (35 cases). The characteristics between two groups were analyzed using t-test or χ² test.

The data of sex, age, nationality, time from onset, SBP, DBP, Hb, TG, and cholesterol of 68 cases on admission did not show any definitive correlation with the hematoma volumes (P＞0.05). The SBP and DBP of patients in the basal ganglia ICH group were significantly higher than that in the lobar ICH group, respectively [(184.9±28.5) mmHg vs (164.6±24.4) mmHg; (113.0±18.1) mmHg vs (103.0±18.4) mmHg] (t=0.499, 0.486; P=0.002, 0.033).

The relevant factors of hematoma volumes in patients with ICH in plateau area were not yet clear. Diastolic and systolic blood pressure of patients in the basal ganglia ICH group was higher than that in those in lobar ICH group.

To compare the efficacy evaluation of electrospun composite biomaterials and a porcine small intestine submucosa mesh for hernia repair.

A randomized, single-blind, controlled multicenter trial was performed in 3 hospitals in Shanghai. Eligible adult patients with primary unilateral reducible groin hernias were randomly assigned (1∶1) to electrospun composite biomaterials (experimental group) or porcine small intestine submucosa (control group) mesh groups. Patients were treated with the tARB technique and assessed at 1,3 and 6 months after the surgery. The primary endpoint was hernia recurrence. The secondary endpoints were postoperative complications including groin pain and operative site infections.

172 patients were assigned to experimental (n=86) and control (n=86) groups. At 6 months follow-up, postoperative complications occurred in 5 patients (5/86, 5.95%) and 2 (2/86, 2.35%) patients in the control and experimental groups, respectively (P>0.05). There was no significant difference in VAS or SVS score between the two groups.

We demonstrate that electrospun composite biomaterial mesh can be used as a ideal choice for inguinal hernia repair. Electrospun composite biomaterial has the characteristics of low recurrence rate, absorbability and long-term comfort.It can be further applied in clinical practice in the future.

Pancreaticoduodenectomy(PD)remains one of the most complicated hepatobiliary operations. The development of minimally invasive surgery for PD has always been an hot spot. Laparoscopic pancreaticoduodenectomy(LPD) has not been widespread carried out due to its difficulty and long learning curve. LPD accounts for 9% of all PD, according to the National Cancer Data base. Compared with laparoscopic surgery, robotic surgery system has significant advantages in the field of minimally invasive PD, including stereotactic amplified vision, filtering hand tremor and simulating the wrist. The article would review the surgical techniques and notes, which could provide clinical reference for other surgeons.

To explore the potential mechanism of the rhubarb-Salvia miltiorrhiza herb pair in the intervention of diabetic kidney disease (DKD) by integrating Gene Expression Omnibus (GEO) data mining, network pharmacology, and molecular docking techniques.

Active ingredients and potential targets of rhubarb-Salvia miltiorrhiza were obtained through the Traditional Chinese Medicine Systems Pharmacology (TCMSP) database combining with the Chinese Pharmacopoeia and relevant literature. The glomerular dataset GSE30528 and the tubular dataset GSE30529 related to DKD were retrieved from the GEO database, and differential analysis was performed in the two types of tissues to screen exploratory candidate targets. Protein-protein interaction analysis was performed using the STRING database, and the target network was constructed with Cytoscape software, while GO functional annotation and KEGG pathway enrichment analysis of key targets were conducted via R language. Finally, molecular docking verification was carried out using AutoDock Vina.

From rhubarb-Salvia miltiorrhiza, a total of 90 active ingredients, 150 potential targets, and 3, 592 candidate differential targets for DKD were screened out, yielding a total of 43 intersecting targets. Topological analysis identified the core targets as EGFR, CASP3, ICAM1, KDR, and MAPK1, and the core components as emodin, aloe-emodin, danshensu, and tanshinone ⅡA. Go enrichment involved epithelial cell proliferation and apoptosis, ERK1/2 cascade reaction, and collagen-containing extracellular matrix. KEGG enrichment was mainly observed in PI3K/Akt, MAPK, integrin, and HIF-1 signaling pathway. Molecular docking showed that the binding energies of emodin and tanshinone ⅡA to the core target EGFR were -9.32 and -9.59 kcal/mol, respectively, both exhibiting favorable theoretical binding activity.

The rhubarb-Salvia miltiorrhiza herb pair may participate in the pathological processes associated with DKD through a multi-component, multi-target, and multi-pathway network. The signal networks related to emodin, tanshinone ⅡA, and EGFR can serve as candidate directions for subsequent in-vivo and in-vitro verification.

To explore the influence of dulaglutide combined with dapagliflozin on renal function and fibrosis in patients with type 2 diabetic kidney disease (T2DKD).

This study was a prospective randomized controlled trial. Consecutive patients with T2DKD admitted to our hospital from January 2024 to December 2024 were enrolled and randomly assigned to an observation group and a control group. All patients received basic routine treatment for diabetes. The control group was treated with dapagliflozin monotherapy, while the observation group received additional intervention with dulaglutide injection on the basis of dapagliflozin. Levels of renal function, renal fibrosis markers, and inflammatory factors were measured and compared between the two groups at baseline and 12-month follow-up. Adverse events during treatment were also recorded. Inter-group comparisons were performed using the t-test and Pearson χ² test.

A total of 94 patients with T2DKD were enrolled in this study, with 47 patients in the observation group and 47 in the control group. All the patients completed 12-month standardized treatment. After treatment, the estimated glomerular filtration rate (eGFR) was significantly increased in both groups compared with baseline, and post-treatment eGFR in the observation group was markedly higher than that in the control group (P<0.05). After treatment, the urine albumin-to-creatinine ratio (UACR), serum creatinine (Scr), blood urea nitrogen (BUN), renal fibrosis markers including transforming growth factor-β1 (TGF-β1), connective tissue growth factor (CTGF), kidney injury molecule-1 (KIM-1), as well as inflammatory factors including high-sensitivity C-reactive protein (hs-CRP), interleukin-1β (IL-1β), and tumor necrosis factor-α (TNF-α) were obviously decreased in both groups relative to baseline; moreover, these indicators in the observation group were significantly lower than those in the control group (P<0.05). Glycated hemoglobin (HbA1c) and fasting plasma glucose (FPG) were significantly reduced in both groups after treatment (P<0.05), whereas no statistically significant inter-group differences in HbA1c and FPG were observed after treatment. There was no significant difference in the incidence of adverse events between the two groups during the treatment period.

Dulaglutide combined with dapagliflozin can better preserve renal function, inhibit renal fibrosis, and reduce systemic inflammatory response in patients with T2DKD. Its glucose-lowering efficacy is comparable to dapagliflozin monotherapy, with favorable safety profile.

Diabetic kidney disease (DKD), as the leading cause of end-stage renal disease, involves complex pathophysiological mechanisms. In recent years, macrophage-mediated immune metabolic dysregulation has been identified as a critical driver of DKD progression, where the phenotypic switching between M1 and M2 macrophages is governed by specific metabolic reprogramming (glycolysis versus oxidative phosphorylation). Nuclear factor erythroid 2-related factor 2 (Nrf2), a core transcription factor for cellular antioxidant response, not only regulates redox homeostasis but also influences macrophage polarization, thereby exerting renoprotective effects. However, the precise molecular mechanisms by which Nrf2 modulates macrophage metabolic reprogramming to affect polarization within the DKD microenvironment remain elusive. This review aims to systematically elucidate the molecular mechanisms of Nrf2 in regulating metabolic reprogramming and polarization of macrophage in DKD, providing new insights and potential therapeutic targets for the precision treatment of DKD.

Volume status assessment plays a central role in the clinical management of hemodialysis patients, and its accuracy directly affects patients′ prognosis and survival rate. In recent years, relevant research on artificial intelligence models in this field has demonstrated application potential. Precise assessment of volume status can be achieved by analyzing multi-dimensional clinical data, providing a basis for personalized treatment. This paper reviews the application of artificial intelligence and its combination with traditional volume assessment methods in volume evaluation for hemodialysis patients, and discusses their advantages, limitations, and development directions.

Patients on maintenance hemodialysis are in a state of persistent low-grade microinflammation. The accumulation of pro-inflammatory cytokines and middle-large molecular uremic toxins is closely associated with cardiovascular events, protein-energy wasting, and deteriorated quality of life. Conventional hemodialysis has limited capacity to remove middle-large molecular inflammatory mediators, and may even aggravate inflammatory responses due to bioincompatibility. Based on adsorption mechanism, hemoperfusion combined with conventional dialysis can eliminate uremic toxins such as β-microglobulin and inflammatory mediators including interleukin-6 and tumor necrosis factor-α, and to some extent regulate immune cell activation and ameliorate the imbalance of immune cell subsets. This article reviews the pathological basis of microinflammation in maintenance hemodialysis patients, as well as the mechanism, combined modalities, and clinical research progress of hemoperfusion, so as to provide references for the optimization of blood purification strategies.

Chronic kidney disease-associated pruritus (CKD-aP) is a common yet long-overlooked complication among patients with end-stage renal disease. CKD-aP can significantly affect patients′ quality of life, sleep, and mood, reduce dialysis adherence, and is closely associated with an increased risk of mortality. In recent years, with deeper understanding of its pathogenesis and advances in the research and development of therapeutic drugs, CKD-aP has been redefined from a conventional accompanying "symptom" to an independent clinical disorder requiring active identification and systematic intervention. This article systematically reviewed CKD-aP from the perspectives of epidemiology, pathogenesis, diagnostic procedures, assessment scales, stratified management strategies, and advances in pharmaceutical research. It focuses on introducing the characteristics and clinical application value of various pruritus assessment tools as well as their applications in the research and development of κ-opioid receptor agonists, and discusses stratified management regimens based on pruritus severity. The aim is to improve clinicians′ ability to identify and standardly manage CKD-aP and improve patients′ prognosis.

Chronic hyperglycemia serves as the core initiating trigger of diabetic kidney disease (DKD). Through the interactive regulation and cascade amplification of multiple pathways including disordered glucose and lipid metabolism, abnormal renal hemodynamics, oxidative stress, chronic low-grade inflammation, and excessive activation of the lectin pathway in the complement system, it continuously damages the structure and function of podocytes, subsequently induces glomerulosclerosis and renal tubulointerstitial fibrosis, and mediates the onset and progressive deterioration of DKD. As one of the three major activation pathways of the complement system, the lectin pathway was discovered most recently, and research interest in it has been rising year by year. Characterized by its ability to initiate activation without antibodies, this pathway acts as a critical mediator linking innate immune defense and inflammatory responses, and plays a central role in the pathophysiological processes of DKD. This paper reviews the mechanisms and research progress of the core components of the lectin pathway of the complement system in DKD, discussing their feasibility as therapeutic targets for providing new insights for basic research, clinical prevention and treatment of DKD.

The gut-kidney axis is a core pathway mediating signal communication between the gut and the kidney, and the gut microbiota acts as a key regulatory node of the gut-kidney axis by regulating bile acid metabolism. Bile acid metabolism not only participates in various pathophysiological processes such as glucose and lipid metabolism, intestinal microecological balance, and inflammatory immune regulation, but also affects renal function through gut-kidney axis-mediated signaling pathways, and is involved in the progression of dyslipidemia, atherosclerosis, chronic kidney disease (CKD), etc. CKD can induce gut-kidney axis imbalance, resulting in intestinal microbiota disturbance and abnormal bile acid profiles. The disrupted bile acid profiles can promote CKD progression through mechanisms such as accelerating renal fibrosis, interfering with lipid metabolism, and triggering micro-inflammation. At present, relevant evidence is mostly derived from animal experiments and clinical observational association studies, and the causal regulatory relationship between bile acid metabolism and CKD remains to be further verified.

To explore the application effect of comprehensive intervention measures combined with photodynamic therapy on children with condyloma acuminatum (CA).

Clinical data of 30 children with CA who received aminolaevulinic acid-photodynamic therapy (ALA-PDT) at the Department of Dermatology and Venereology, Beijing Ditan Hospital, Capital Medical University from January 2018 to December 2024 were analyzed, retrospectively. Based on conventional PDT, a series of comprehensive intervention measures such as targeted psychological intervention, full-process pain management, postoperative wound skin management, and health knowledge education were implemented for CA children and their families. After the treatment was completed, regular follow-up were conducted for 6 months to collect statistics on the treatment efficacy, treatment compliance, and related adverse reactions of the children.

Among the 30 children with CA, 18 cases were boys and 12 cases were girls, aged from 2 to 14 years old [(6.3±2.4) years old], the disease duration was 1 to 6 months [(4.2±1.2) months], the diameter of the lesions was 0.2 to 1.8 cm [(1.22±0.10) cm], and the number of lesions was 1 to 8 [(4.43±0.8)]; 20 cases (66.67%) had lesions involving the external genitalia, 8 cases (26.67%) involved the perianal, and 2 cases (6.66%) had external genitalia and perianal lesions. After PDT combined with comprehensive interventions, 22 cases (73.33%) were cured, 7 cases (23.33%) were markedly effective, and 1 case (3.33%) was ineffective. The total treatment effective rate was 96.67% (29/30). No case recurred during the follow-up for 6 months. All children completed the full course of treatment, and 25 cases (83.33%) were fully compliant, 5 cases (16.67%) were partially compliant. No serious systemic adverse reactions occurred during the treatment, and local adverse reactions were all mild to moderate, and may occur concomitantly on the same child. A total of 11 children (36.67%) had at least one local adverse reaction, 6 cases (20.00%) had pain, 6 cases (20.00%) had local erythema, 2 cases had blister erosion (6.67%), 1 case had itching with burning sensation (3.33%), and 3 cases had pigmentation (10.00%); All adverse reactions were completely relieved after local symptomatic treatment and did not affect the ALA-PDT treatment process.

After the comprehensive intervention measures combined with ALA-PDT, CA children showed good treatment compliance, and the adverse reactions can be effectively alleviated.

To investigate the role and potential mechanisms of oropharyngeal microbiota dysbiosis in the development and progression of post-coronavirus disease 2019 (COVID-19) pulmonary fibrosis (PCPF).

A cross-sectional case-control study was conducted, enrolling recovered patients who had been hospitalized for COVID-19 in Xuanwu Hospital Capital Medical University, from December 2022 to May 2023, and had completed a 2-year follow-up after discharge. According to high-resolution computed tomography findings during follow-up, patients were classified into fibrosis group and non-fibrosis group. The α-diversity of the oropharyngeal microbiota between the two groups were compared by Mann-Whitney U test; β-diversity was assessed by non-metric multidimensional scaling (NMDS) and principal coordinates analysis (PCoA). Differences in taxonomic abundance at the phylum, genus and species levels were analyzed by Benjamini-Hochberg method with false discovery rate (FDR) correction. Spearman’s rank correlation was applied to evaluate the associations between microbial taxa and clinical symptoms as well as exercise capacity.

Total of 83 patients were enrolled, 43 cases in fibrosis group and 40 cases in non-fibrosis group. During the 2-year follow-up, patients in fibrosis group had more respiratory symptoms and anxiety. Patients in fibrosis group showed significantly higher scores than non-fibrosis group in mMRC scale (U=676.0, P=0.008), BCSS score (U=625.0, P=0.029), CAT score (t=2.127, P=0.036), CET score (U=538.5, P=0.002) and Hamilton Anxiety Rating Scale score (U=634.0, P=0.039); The 6-minute walking distance of patients in fibrosis group was shorter (U=598.5, P=0.017), all with significant differences. Microbiome analysis revealed significantly elevated α-diversity of oropharyngeal microbiota in fibrosis group (Chao1 index: U=580.5, P=0.010; Shannon index: U=557.0, P=0.005; Simpson index: U=513.0, P=0.001; Faith’s phylogenetic diversity: U=579.0, P=0.010; Simpson’s evenness index: U=577.0, P=0.010; Heip’s evenness index: U=529.0, P=0.035), with significant differences. β-diversity analysis showed distinct separation of microbial community structure between the two groups. Taxonomic analysis demonstrated that the relative abundances of potential pro-inflammatory taxa, including Prevotella (U=358.0, P<0.001), Veillonella (U=418.0, P<0.001) and Streptococcus (U=538.0, P=0.003), were significantly increased in fibrosis group, whereas Neisseria (U=226.0, P<0.001) was significantly decreased. Correlation analysis indicated that the abundance of Streptococcus parasanguinis was positively associated with mMRC (r=0.24, P=0.04) and CAT (r=0.27, P=0.02). In contrast, Fusobacterium periodonticum abundance was negatively correlated with CAT (r=－0.30, P<0.01) and Warrick score (r=－0.26, P=0.02), but positively correlated with 6MWD (r=0.26, P=0.02). Furthermore, Veillonella rogosae and Streptococcus infantis were both significantly and negatively correlated with Warrick score (r=－0.30, P<0.01; r=－0.28, P=0.01).

Patients with post-COVID-19 pulmonary fibrosis exhibited persistent oropharyngeal microbial dysbiosis, which is closely associated with clinical symptoms and functional impairment. The oropharyngeal microbiome might serve as a potential non-invasive biomarker for risk assessment and a novel therapeutic target for post-COVID-19 pulmonary fibrosis.

To investigate the independent predictive factors for diagnosis of tuberculous meningitis (TBM) based on regional characteristics in Qinghai, China, and to construct and validate a diagnostic prediction model.

The clinical data of 931 patients with infectious meningitis, including 739 cases with TBM and 192 cases with non-tuberculous infectious meningitis (non-TBM) treated at Qinghai Provincial Fourth People’s Hospital from January 2019 to January 2024 were collected, retrospectively. They were divided into a training set (651 cases, including 522 cases of TBM and 129 cases of non-TBM) and a validation set (280 cases, including 217 cases of TBM and 63 cases of non-TBM) with a ratio of 7∶3. The influencing factors of TBM diagnosis were screened by Lasso regression and multivariate Logistic regression, and a nomogram prediction model was constructed. The diagnostic efficiency of five machine learning models (decision tree, Logistic regression, random forest, support vector machine and extreme gradient boosting) were evaluated and compared by the receiver operating characteristic (ROC) curve.

The general demographic data and biochemical parameters between patients in training set and validation set were without significant differences (all P>0.05); the baseline characteristics between patients in TBM group and non-TBM group across both the training set and validation set were also without significant differences (all P>0.05). By Lasso dimensionality reduction screening of predictive variables and multivariate regression analysis, a total of 6 independent predictors for TBM were identified: consciousness disorder (OR=2.988, 95%CI: 1.242-7.555, P=0.017), gamma interferon release assay (IGRA) (OR=4.279, 95%CI: 2.074-9.120, P<0.001), CSF monocyte ratio≥50% (OR=4.061, 95%CI: 1.88-9.174, P<0.001), magnetic resonance imaging (MRI) suggesting tuberculoma (OR=7.080, 95%CI: 2.019-34.77, P=0.006), MRI suggesting cranial base meningeal enhancement (OR=3.022, 95%CI: 1.429-6.519, P=0.004) and computerized tomography (CT) showing pulmonary lesions (blood disseminated tuberculosis: OR=46.140, 95%CI: 8.765-856.9, P<0.001). AUC of the Logistic regression model in training set and validation set were both 0.948 (95%CI: 0.927-0.969, 0.920-0.975), with sensitivities of 87.16% and 85.71%, and specificities of 89.92% and 90.48%. The Extreme Gradient Boosting (XGB) model performed the best in diagnosing TBM (AUC=0.954).

The Logistic regression model based on clinical and imaging features exhibits excellent diagnostic accuracy for TBM and is suitable for clinical application.

To investigate the expression profile of novel immunomodulatory factor interleukin (IL)-41 in pediatric patients with Mycoplasma pneumoniae pneumonia (MPP), and to analyze its correlation with disease severity, diagnostic efficacy and value for predicting severe progression.

Total of 32 children with MPP under 18 years old, admitted to Beijing Friendship Hospital, Capital Medical University and Hebei Yiling Hospital throughout 2024 were enrolled for retrospective cohort study, including 17 cases of mild disease (mild group) and 15 cases of severe disease (severe group), while 8 healthy children undergoing physical examinations were selected as the control group. Serum IL-41 level was detected in enrolled children by enzyme-linked immunosorbent assay (ELISA), and parameters such as gender, age, C-reactive protein (CRP), procalcitoninand (PCT) and IL-6 levels were compared, respectively. The diagnostic efficacy of these markers for severe MPP was evaluated by receiver operating characteristic (ROC) curve, the relationships between serum IL-41 level and clinical indicators were analyzed by correlation heatmaps.

Among the 32 enrolled ediatric patients with MPP, there were 11 males (34.4%) and 21 females (65.6%), with a mean age of (8.60±2.89) years old. There was no statistically significant difference in age between mild group and severe group [(9.06±3.45) years old vs. (8.07±2.09) years old] (t=0.393, P=0.697). IL-41 level of MPP children in mild group was significantly higher than that of healthy control group [(182.191±65.364) pg/ml vs. (137.628±2.914) pg/ml], with significant difference (t=2.805, P=0.013). But there were no significant difference of IL-41 level between severe group and healthy control group, or between mild group and severe group (all P>0.05). The area under the ROC curve (AUC) for diagnostic differentiation between mild group and severe group by individual biomarkers IL-41, CRP and IL-6 were 0.652, 0.590 and 0.522, respectively, all showing suboptimal performance. However, the three idicators combined AUC significantly improved to 0.768 (95%CI: 0.598-0.938, P=0.013), with the sensitivity and specificity of 93.8% and 57.1%, respectively. In mild group, the IL-41/CRP ratio [24.47 (7.4, 41.1)] and IL-41/IL-6 ratio [26.88 (9.1, 34.6)] were significantly higher than those of severe group [10.81 (1.3, 18.9) and 9.85 (1.7, 15.1)], with significant differences (Z=－3.946 and －1.957, both P<0.001). Spearman correlation analysis demonstrated a significant positive correlation between serum IL-41 and IL-6 levels of patients with MPP (r=0.64, P=0.020).

Serum IL-41 level is significantly elevated in children with mild MPP, which was elevated but without significance in severe MPP cases, suggesting that IL-41 may exert a protective effect against severe disease as an anti-inflammatory factor. Combined detection of IL-41, CRP and IL-6 enhances the diagnostic accuracy for severe MPP, and dynamic monitoring of IL-41 level may aid in disease progression assessment of patients with MPP.