Objective Serious bacterial infection (SBI) remains an important cause of morbidity and mortality in preterm infants. The objective of this study was to evaluate the dynamically increased value of the red cell distribution width (RDW) in the diagnosis of SBI. Methods This retrospective study enrolled 334 preterm infants with birth weight less than 1500 g. The initial RDW and the maximum value of RDW during hospitalization were extracted from the MIMIC-III database (version 1.4). Infants were categorized into four groups according to baseline RDW value and ΔRDW (ΔRDW = RDW at maximum- RDW at baseline). Logistic regression analysis was used to assess the risk of developing SBI in each group. A receiver operating characteristic (ROC) curve analysis was used to evaluate the diagnostic value of RDW at baseline alone, ΔRDW alone, and in combination. Results Infants with increased RDW at baseline (> 17%) and ΔRDW > 2% exhibited the highest risk of developing SBI, whereas the patients with normal RDW level at baseline (≤ 17%) and ΔRDW≤2% (the reference group) had the lowest risk. This association remained unaltered even after adjustment in multivariable models. Basing on ROC curve analysis, the area under the curve predicted by the combination of RDW at baseline and ΔRDW for SBI was 0.81 (95% CI, 0.76–0.87). Sensitivity and specificity were 78.16 and 72.47% respectively. Conclusions We observed that combination of elevated RDW at baseline and dynamic increases during hospitalization is significantly associated with SBI. Therefore, that combination could be a promising independent diagnostic indicator of SBI in newborns.

Objective Knee osteoarthritis is a prevalent degenerative joint disease and seriously affects the athletic abilities of middle-aged and elderly patients. Acupressure is a traditional non-pharmacological intervention that promotes blood circulation and muscle activity. Self-administrated acupressure and exercise can be potential management for knee osteoarthritis. Design It is a randomized and controlled trial for knee osteoarthritis self-treatment. Settings Cangzhou Hospital. Interventions 221 patients with knee osteoarthritis were recruited and randomly divided into 4 groups: control group ( n = 55), exercise group ( n = 56), acupressure group ( n = 55) and exercise & acupressure group ( n = 55). In the first eight weeks, corresponding training courses were provided to different groups of patients. The patients were asked to carry out their own corresponding interventions for 16 weeks. The patient‘s condition was evaluated in the sixteenth week. Main measures The Western Ontario and McMaster Universities global scores of knee osteoarthritis patients were assessed at the 8th and 16th week of our trial. Results Self-administered acupressure and exercise significantly decreased visual analogue scale (3.75 ± 1.89 versus 2.93 ± 1.73, p < 0.05), pain (7.6 ± 2.8 versus 4.8 ± 2.7, p < 0.05), stiffness (3.75 ± 1.89 versus 2.93 ± 1.73, p < 0.05) at the 16th week ( p < 0.05) in patients with knee osteoarthritis compared to other intervention. The combination of acupressure and exercise also improved the range of motion (114.4 ± 11.5 versus 120.4 ± 11.9, p < 0.05) and walk speed (1.48 ± 0.48 versus 1.76 ± 0.50, p < 0.05) of osteoarthritis patients ( p < 0.05). Conclusion Self-administrated exercise and acupressure alleviate the arthritic symptoms (swelling, pain, joint dysfunction and joint deformities) and improve the joint functions, supporting its potential use in the clinical management for osteoarthritis.

Prenatal fever could result in brain function impairments in the offspring. The present study investigated the effect of interleukin-6 (IL-6)-induced maternal fever on the offspring and the involvement of connexin 36 in this process. Pregnant C57BL/6J mice were injected with IL-6 on gestational day 15. The levels of iNOS and COX-2 were measured as an index of neuroinflammation in the brain of newborn pups. Offspring were treated with the connexin 36 (Cx36) inhibitor mefloquine at postnatal day (P)1–P3 or at P40–P42. Rotarod, grip traction, and foot fault tests were carried out to evaluate the motor behavior of adult offspring. Injection of IL-6 led to an elevation of the core temperature in the pregnant dams. Offspring of these dams showed significantly increased COX-2 and iNOS mRNA expression and protein levels in the whole-brain samples and significantly increased Cx36 in the cerebellum. Moreover, offspring of these dams showed motor deficits at an adult age. Neonatal administration of the Cx36 inhibitor mefloquine could prevent these motor deficits. Maternal fever during pregnancy induced by IL-6 injection could lead to neuroinflammation and motor deficits in the offspring. Neonatal inhibition of Cx36 could ameliorate the motor deficits in the offspring, indicating an involvement of Cx36 in the IL-6-induced maternal fever.

Background: Metagenomic next generation sequencing (mNGS) is becoming an increasingly available diagnostic method used to identify a broad range of pathogens. However, the optimal role of mNGS in clinical diagnostic schema remains uncertain, especially in pediatric patients suspected central nervous system (CNS) infection and treated with empirical antibiotic. The purpose of this study was to investigate the usefulness of cerebrospinal fluid (CSF) mNGS in the pediatric patients.Methods: We performed a retrospective review of suspected CNS infection patients who had CSF mNGS test from April 2019 to December 2020. Results and clinical impact of mNGS test were collected. We investigated the usefulness of CSF mNGS in clinical impact and diagnosis. Results: We enrolled 57 pediatric patients with empirical treatment. A total of 39 CNS infection patients were diagnosed, and 27 patients were identified by mNGS that only 2 of 27 were co-identified by CSF culture. In all of the patients, 75.4% (45 cases) had changed (addition or de-escalation) in antimicrobial therapy according to the results of the mNGS test. By each CSF mNGS test as a whole, the positive and negative percent agreement were 69.2% (95% CI: 54.1-84.4%) and 61.1% (95% CI: 36.2-86.1%), respectively, and true negatives of negative mNGS tests were 50% (95% CI: 27.3 – 72.7%).Conclusion: In this study, CSF mNGS test improved the diagnosis of neurologic infections and adjusted antibiotic therapy in the vast majority of cases. Consequently, for patients with empirical treatment, CSF mNGS should be used more in pathogen diagnosis and clinical therapy.