<abstract><p>Possible complications, such as intestinal obstruction and inflammation of the intestinal tract, can have a detrimental effect on the prognosis after surgery for Hirschsprung disease. The aim of this study was to investigate the potential targets and mechanisms of action of echinacoside to improve the prognosis of Hirschsprung disease. Genes related to the disease were obtained through analysis of the GSE96854 dataset and four databases: OMIM, DisGeNET, Genecard and NCBI. The targets of echinacoside were obtained from three databases: PharmMapper, Drugbank and TargetNet. The intersection of disease genes and drug targets was validated by molecular docking. The valid docked targets were further explored for their expression by using immunohistochemistry. In this study, enrichment analysis was used to explore the mechanistic pathways involved in the genes. Finally, we identified CA1, CA2, CA9, CA12, DNMT1, RIMS2, RPGRIP1L and ZEB2 as the core targets. Except for ZEB2, which is predominantly expressed in brain tissue, the remaining seven genes show tissue specificity and high expression in the gastrointestinal tract. RIMS2 possesses a high mutation phenomenon in pan-cancer, while a validated ceRNA network of eight genes was constructed. The core genes are involved in several signaling pathways, including the one-carbon metabolic process, carbonate dehydratase activity and others. This study may help us to further understand the pharmacological mechanisms of echinacoside and provide new guidance and ideas to guide the treatment of Hirschsprung disease.</p></abstract>

Background: Plastic bronchitis (PB) is a severe disease with rapid progression and high mortality, and its incidence is increasing. This study created and validated a diagnostic and predictive nomogram based on clinical characteristics to improve the diagnosis of PB in clinical practice.Methods: This randomized, controlled, retrospective, observational study evaluated 447 children with severe Mycoplasma pneumoniae pneumonia, including 147 children with PB (intervention group) and 300 without PB (control group). Independent diagnostic predictors of PB were identified by multivariate logistic regression analysis and area under the receiver operating characteristic curve (AUC≥0.70), and a diagnostic model with six independent clinical characteristics was developed. The performance of the nomogram was assessed using the C-index, calibration curves, and decision curve analysis.Results: Fever duration, neutrophil percentage, lactate dehydrogenase, procalcitonin, interleukin-6, and pleural effusion were independent risk factors for PB and were included in the nomogram. The C-index of the nomogram was 0.900 (95% CI: 0.866–0.934), indicating an excellent ability to discriminate between patients with and without PB. The calibration curve showed good agreement between the predicted and actual probability. The net reclassification improvement(NRI) was 0.1803 (95% CI: 0.0039–0.3567; p=0.0451), and the integrated discrimination improvement(IDI) was 0.1755 (95% CI: 0.1004–0.2505; p<0.001). Decision curve analysis(DCA) showed that the nomogram was clinically useful for detecting PB.Conclusions: We constructed and validated a diagnostic and predictive nomogram with six independent risk factors for PB. The proposed nomogram can improve the early diagnosis of this complication in clinical practice.