Abstract Objective To assess the outcome of patients with cancer-related sepsis requiring continuous renal replacement therapy (CRRT) in a single-center pediatric intensive care unit (PICU). Method Children with sepsis who necessitate CRRT from January 2017 to December 2021 were enrolled. The patients with leukemia/lymphoma or solid tumors were defined as underlying cancer. Multivariate logistic regression analysis was performed to identify the death risk factors in patients with cancer-related sepsis. Results A total of 146 patients were qualified for inclusion. Forty-six (31.5%) patients with cancer-related sepsis and 100 (68.5%) non-cancer-related sepsis. The overall PICU mortality was 28.1% (41/146), and mortality was significantly higher in cancer-related sepsis patients compared with non-cancer patients (41.3% vs. 22.0%, p = 0.016). Need mechanical ventilation, p-SOFA, acute liver failure, higher fluid overload at CRRT initiation, hypoalbuminemia, and high inotropic support were associated with PICU mortality in cancer-related sepsis patients. Moreover, levels of IL-6, total bilirubin, creatinine, blood urea nitrogen, and international normalized ratio were significantly higher in non-survivors than survivors. In multivariate logistic regression analysis, pediatric sequential organ failure assessment (p-SOFA) score (OR:1.805 [95%CI: 1.047-3.113]) and serum albumin level (OR: 0.758 [95%CI: 0.581 -0.988]) were death risk factors in cancer-related sepsis receiving CRRT, and the AUC of combined index of p-SOFA and albumin was 0.852 (95% CI: 0.730-0.974). Conclusion The overall PICU mortality is high in cancer-related sepsis necessitating CRRT. Higher p-SOFA and lower albumin were independent risk factors for PICU mortality. cancerrelated cancer related (CRRT singlecenter single center PICU. . (PICU) 201 202 enrolled leukemialymphoma leukemia lymphoma 14 inclusion Fortysix Forty six 31.5% 315 31 5 (31.5% 10 68.5% 685 68 (68.5% noncancerrelated non 281 28 1 28.1 41/146, 41146 41/146 , 41 (41/146) noncancer 41.3% 413 3 (41.3 vs 220 22 0 22.0% 0.016. 0016 0.016 016 0.016) ventilation pSOFA, pSOFA SOFA, SOFA initiation hypoalbuminemia Moreover IL6, IL6 IL 6, 6 IL-6 bilirubin creatinine nitrogen nonsurvivors survivors (p-SOFA OR1.805 OR1805 OR 1.805 805 (OR:1.80 95%CI 95CI CI 95 [95%CI 1.0473.113 10473113 1.047 3.113 047 113 1.047-3.113] (OR 0758 758 0.75 0581 581 0.58 0.988 0988 988 -0.988] 0852 852 0.85 95% (95 0.7300.974. 07300974 0.730 0.974 730 974 0.730-0.974) (PICU 20 31.5 (31.5 68.5 (68.5 2 28. 4114 41/14 4 (41/146 41.3 (41. 22.0 001 0.01 01 IL- OR1 OR1.80 OR180 1805 1.80 80 (OR:1.8 9 0473 1.0473.11 1047311 1047 1.04 3113 3.11 04 11 1.047-3.113 075 75 0.7 058 58 0.5 0.98 098 98 -0.988 085 85 0.8 (9 7300 0.7300.974 0730097 0730 0.73 0974 0.97 73 97 0.730-0.974 31. (31. 68. (68. 411 41/1 (41/14 41. (41 22. 00 0.0 OR1.8 OR18 180 1.8 8 (OR:1. 1.0473.1 104731 104 1.0 311 3.1 1.047-3.11 07 7 0. 05 0.9 09 -0.98 08 ( 0.7300.97 073009 073 097 0.730-0.97 (31 (68 41/ (41/1 (4 OR1. 18 1. (OR:1 1.0473. 10473 3. 1.047-3.1 -0.9 0.7300.9 07300 0.730-0.9 (3 (6 (41/ 1.0473 1.047-3. -0. 0.7300. 0.730-0. 1.047-3 -0 0.7300 0.730-0 1.047- - 0.730-

Early and accurate diagnosis of acute graft-versus-host disease (aGVHD) after allogeneic hematopoietic stem cell transplantation is crucial for the prognosis of patients. This study identified a potential biomarker for the severity of aGVHD after human leukocyte antigen (HLA)-haploidentical peripheral blood hematopoietic stem cell transplantation (haplo-PBSCT). We included 20 healthy subjects and 57 patients who underwent haplo-PBSCT. Of these patients, 22 developed aGVHD after haplo-PBSCT. The results showed that patients with aGVHD had significantly increased levels of Tim-3+/Perforin+/Granzyme B+CD8+ T cells, but significantly decreased Galectin-9. The differences in Galectin-9 and Tim-3+/Granzyme B+CD8+ T cells between grade I-II aGVHD and III-IV aGVHD were also significant. In vitro, the apoptosis of CD8+ T cells from aGVHD patients was significantly increased after Tim-3/Galectin-9 pathway activation, which decreased Granzyme B secretion. As revealed by univariate analysis, the level of Tim-3+CD8+ T cells was a risk factor for severe aGVHD. ROC analysis demonstrated that high levels of Tim-3+CD8+ T cells had a significant diagnostic value for severe aGVHD, with an area under the curve of 0.854 and cut-off value of 14.155%. In conclusion, the binding of Tim-3 with exogenous Galectin-9 can promote apoptosis of CD8+ T cells and affect the secretion of Granzyme B. Tim-3+CD8+ T cells have the potential to serve as immunological markers for assessing the severity of aGVHD after haplo-PBSCT and identifying patients at a higher risk for severe aGVHD.

ABSTRACT Host immunogenetic setting is involved in the regulation of human papillomavirus (HPV) infection and development of condyloma acuminatum (CA). We investigated the correlation of two common single nucleotide polymorphisms (SNPs) (−607C/A and −137G/C) of IL-18 with the susceptibility of CA in a large Chinese cohort. Out of 408 CA patients analyzed, 300 had HPV infection transmitted through sexual contact (SC) and 108 through non-sexual contact (NSC). In addition, 360 healthy volunteers were enrolled as controls. SNPs at positions −607C/A and −137G/C in IL-18 promoter were analyzed. Comparing CA patients to healthy controls, no dominant relevance was found between the IL-18 promoter −607 C/A or −137G/C polymorphisms and the CA disease either identified genotypically (p > 0.05) or by allelically (p > 0.05). However, the IL-18 promoter −137G/C polymorphism genotype and allele frequencies in the NSC CA group, but not between in the SC group, were significantly higher than in the controls. There was no dominant relevance between IL-18-607C/A polymorphism genotype and allele frequencies among SC, NSC CA patients, and controls. Our study demonstrates that polymorphism −137G/C in IL-18 promoter is significantly correlated with risk of CA in NSC patients.

The mortality of patients with mycotic aneurysms is high, especially in East Asia, and infection by Salmonella species is the most common. Our study aimed to improve prognosis of adult mycotic aneurysms with early diagnosis and accurate treatment. Four adult patients with mycotic aneurysm caused by Salmonella were included and analyzed by single-center retrospective analysis. Cases reported in the literature during the past 10 years were also summarized. The average age of the 4 male patients was 61.25 years, while that of the 53 cases reported in the literature was 65.13 years. Hypertension, diabetes, and atherosclerosis were common complications. Most patients presented fever and experienced pain at the corresponding position of the aneurysm. Laboratory examination found an increased number of white blood cells accompanied by an increase in inflammatory markers. Most aneurysms were found in the abdominal aorta, while the rupture of an aneurysm was the most common complication. The mortality rates were 21.43 and 7.14% after open surgery or endovascular aneurysm repair (EVAR) intervention, respectively. The recurrence rates of infection were 0 and 17.85% for both treatments, respectively. The mortality rate of mycotic aneurysm caused by Salmonella infection was high in middle-aged males with hypertension, diabetes, and atherosclerosis. The possibility of a Salmonella-infected aneurysm should be considered in these high-risk groups presenting chills, fever, chest, and back pain. Open surgery was superior to EVAR treatment in the clearance of infected foci and the reduction of postoperative recurrence. The recurrence of postoperative infection can be prevented by intravenous antibiotic therapy for 6 weeks post-surgery.

The polar amino acid, such as aspartic acid (L-Asp) and arginine(L-Arg) are the primary active molecules of the glycoprotein on the organic/inorganic interface of biomineralized tissue. In this study, aspartic acid and arginine were used as the organic template in inducing the nucleation and growth of calcium carbonate. With the analysis of X-ray diffraction we investigated the relationship between amino acid concentration and the precipitation phase crystal structure of calcium carbonate. SEM was employed in the analysis of the morphological characteristic of the precipitation. To interpret the cause of the hierarchic structure was proposed from the view of the small biomolecules polarity that can control over the growth of the crystals and the aggregation of the micro crystals. The conclusion also provides a new material synthesize strategy.