ObjectiveTo investigate the clinical characteristics of children with severe Mycoplasma pneumoniae pneumonia (SMPP) and the correlation with pediatric critical illness score (PICS), and to explore the effect of combined treatment with antibiotics and glucocorticoids.MethodsThe medical records of 120 children with SMPP admitted to our hospital from January 2020 to June 2021 were retrospectively analyzed. Children with a PICS score greater than 80 within 24 h of admission were included in the non-critical group, those with a score of 71–80 were included in the critical group, and those with a score of ≤70 were included in the extremely critical group. The relevant clinical data and examination indicators of the three groups of children were intercepted and compared. Univariate and multifactorial logistic regression analyses were performed to analyze the correlation between clinical characteristics of children with SMPP and PICS. According to the different treatment methods, the children were subdivided into the control group (n = 54) who received antibiotics alone and the comprehensive group (n = 66) who received antibiotics combined with glucocorticoid therapy. The erythrocyte sedimentation rate (ESR), inflammation and immune indexes, symptom relief or disappearance time, hospitalization days, and clinical efficacy were compared between the two groups before and after treatment.ResultWithin 24 h of admission, among the 120 children with SMPP, 79 had PICS >80, 32 had PICS 71–80, and 9 had PICS ≤70. Before discharge, among the 120 children with SMPP, 99 had PICS >80, 17 had PICS 71–80, and 4 had PICS ≤70. Univariate analysis showed that there were no significant differences in gender ratio, ratio of fever duration >10 days, age and WBC among the three groups (p > 0.05), the differences in the ratio of abnormal ECG, the ratio of ≥2 pathogenic infections, the ratio of ≥2 systemic damages, CRP levels, and D-dimer levels were statistically significant when compared among the three groups (p < 0.05). Multivariate Logistic regression analysis showed that the number of Co-systemic damages and the level of D-dimer were negatively correlated with PICS classification (p < 0.05). After medication, ESR, CRP, IL-6, and CD8+ levels decreased and CD4+ and CD4+/CD8+ levels increased in both the control and comprehensive groups, and all changes were significant in the comprehensive group compared with the control group (p < 0.05). The antipyretic time, cough relief time, disappearance time of lung rales and hospitalization days in the comprehensive group were shorter than those in the control group (p < 0.05). The total effective rate of the comprehensive group (95.45%) was better than that of the control group (83.33%) (p < 0.05).ConclusionPICS can effectively reflect the clinical characteristics of children with SMPP. The comprehensive treatment effect of azithromycin combined with glucocorticoid is significantly better than that of azithromycin alone. It can effectively reduce the level of inflammation in children with SMPP, improve the immune function of children, and accelerate clinical recovery. It has promotion value.

Objective To evaluate the association between hematological parameters on the first day of life and bronchopulmonary dysplasia (BPD) in preterm infants. Methods This retrospective study involved all premature infants admitted to our neonatal intensive care unit from January 2017 to June 2022. BPD was diagnosed based on hypoxia exposure for ≥28 days. The neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), platelet count (PLT), mean platelet volume (MPV), and platelet mass index (PMI) were compared between infants with and without BPD. Multivariate analysis was conducted to evaluate the association between hematological parameters and BPD. Results This study involved 124 premature infants (48 with BPD, 76 without BPD). The BPD group had a lower gestational age and lower weight. The NLR, MPV, and PLR were considerably higher and the PLT and MPI were lower in the BPD than non-BPD group. After adjusting for covariates, logistic regression analysis suggested that the NLR, PLT, and PMI were independent risk factors for BPD. Moreover, the receiver operating characteristic curve indicated that the NLR, PLT, and PMI were reliable predictors of BPD. Conclusion Our findings suggest that a higher NLR and a lower PLT and PMI on the first day may increase the risk of BPD.

Sepsis is a systemic inflammatory response caused by infection and is a major cause of neonatal death. This study explored the miR-455-5p in neonatal sepsis, and further investigated the diagnostic and prognostic value of miR-455-5p in neonatal sepsis (NS). The levels of serum miR-455-5p in 88 healthy controls and 90 NS patients were examined by quantitative real-time polymerase chain reaction (qRT-PCR). Pearson correlation coefficient was used to evaluate the correlation between miR-455-5p and clinical features. Receiver operating characteristic (ROC) curve analysis was performed for the diagnostic evaluation on miR-455-5p. The prognostic value of miR-455-5p in NS was analyzed by Kaplan-Meier survival curve and multivariate Cox regression. The expression of serum miR-455-5p in NS patients was highly expressed in comparison to healthy controls (P < 0.001), and the level of miR-455-5p was positively correlated with white blood cell count (WBC) and other clinical characteristics (P < 0.01). The AUC value of ROC curve was 0.895, suggesting that miR-455-5p had diagnostic value for NS. Survival analysis illustrated that patient with high miR-455-5p expression had poor prognosis (log rank P = 0.015), and miR-455-5p may be a potential prognostic marker for NS (HR = 3.454, 95% CI = 1.165-10.234, P = 0.025). The expression of miR-455-5p had the ability to distinguish NS from healthy people, and highly expressed miR-455-5p was associated with poor prognosis in NS patients.

Mycoplasma pneumoniae pneumonia (MPP) is an acute respiratory tract infection caused by Mycoplasma pneumoniae. It is characterized by severe symptoms, long course of disease, many intrapulmonary complications, and poor therapeutic effect. In recent years, the incidence of Mycoplasma infection have been gradually rising trend, and the children’s own immune system development is not mature, cases differences, children with mild can only show the upper respiratory tract infection, and critically ill children can lead to lung infection and even lead to multiple organ dysfunction, affect life and health of children. Soluble triggering receptors expressed on myeloid cell-1 (sTREM-1) is a subtype secreted by myeloid cell trigger receptor-1, which is released into blood in large amounts when the body is infected, and is a newly discovered inflammatory indicator in recent years. CXC chemokine 16 (CXCL-16) can recruit lymphocytes by chemotaxis through binding to its receptor CXCR6 to participate in the body’s immune regulation. The purpose of this study was to investigate serum sTREM-1 and CXCL-16 levels in children with MPP and to analyze their correlation with the disease and diagnostic value. The results showed that the serum levels of sTREM-1 and CXCL-16 were increased in children with Mycoplasma. Serum levels of sTREM-1 and CXCL-16 were positively correlated with the severity of the disease. sTREM-1 combined with CXCL-16 has an important value in the diagnosis of children with MPP.

AIM To evaluate the association between hematological parameters on the first day and bronchopulmonary dysplasia (BPD) in preterm infants and to help with early warning, identification, and intervention in the development of BPD. METHODS This is a retrospective study of all premature infants admitted to neonatal intensive care From January 2017 to June 2022, BPD was diagnosed as hypoxia exposure over 28 days, and levels of neutrophil-to-lymphocyte ratio(NLR), platelet-to-lymphocyte ratio༈PLR༉, Platelet count༈PLT༉, Mean platelet volume༈MPV༉and Platelet mass index༈PMI༉ were determined in all groups. Multivariate analysis was conducted to evaluate the independence of the association between the hematological parameters on the first day and the risk of BPD. RESULTS In our research 76 cases of non-BPD and 48 cases of BPD were used as controls. Compared with the non-BPD group, NLR levels were considerably higher in the BPD group, nevertheless, PLT and MPI were lower than those of non-BPD. Logistic regression analysis suggested that NLR、PLT and PMI were independent risk factors for BPD(OR: 1.15; 95% CI: 1.04–1.28; P < 0.05; OR: 0.65; 95% CI: 0.47–0.89; P < 0.05; OR: 0.90; 95% CI: 0.81-1; P < 0.05). CONCLUSION Our findings suggest that hematologic parameters on the first day are different who will develop BPD. A higher NLR and a lower PLT, PMI on the first day may increase the risk of BPD.