Systemic immune-inflammation index combined with pediatric appendicitis score in assessing the severity and prognosis for paediatric appendicitis

BACKGROUND Pediatric appendicitis is a common cause of abdominal pain in children and is recognized as a significant surgical emergency.A prompt and accurate diagnosis is essential to prevent complications such as perforation and peritonitis.AIM To investigate the predictive value of the systemic immune-inflammation index(SII)combined with the pediatric appendicitis score(PAS)for the assessment of disease severity and surgical outcomes in children aged 5 years and older with appendicitis.METHODS Clinical data of 104 children diagnosed with acute appendicitis were analyzed.The participants were categorized into the acute appendicitis group and chronic appendicitis group based on disease presentation and further stratified into the good prognosis group and poor prognosis group based on prognosis.The SII and PAS were measured,and a joint model using the combined SII and PAS was constructed to predict disease severity and surgical outcomes.RESULTS Significant differences were observed in the SII and PAS parameters between the acute appendicitis group and chronic appendicitis group.Correlation analysis showed associations among the SII,PAS,and disease severity,with the combined SII and PAS model demonstrating significant predictive value for assessing disease severity[aera under the curve(AUC)=0.914]and predicting surgical outcomes(AUC=0.857)in children aged 5 years and older with appendicitis.CONCLUSION The study findings support the potential of integrating the SII with the PAS for assessing disease severity and predicting surgical outcomes in pediatric appendicitis,indicating the clinical utility of the combined SII and PAS model in guiding clinical decision-making and optimizing surgical management strategies for pediatric patients with appendicitis.

Diagnostic significance of serum levels of serum amyloid A,procalcitonin,and high-mobility group box 1 in identifying necrotising enterocolitis in newborns

BACKGROUND Necrotising enterocolitis(NEC)is a critical gastrointestinal emergency affecting premature and low-birth-weight neonates.Serum amyloid A(SAA),procalcitonin(PCT),and high-mobility group box 1(HMGB1)have emerged as potential biomarkers for NEC due to their roles in inflammatory response,tissue damage,and immune regulation.AIM To evaluate the diagnostic value of SAA,PCT,and HMGB1 in the context of NEC in newborns.METHODS The study retrospectively analysed the clinical data of 48 newborns diagnosed with NEC and 50 healthy newborns admitted to the hospital.Clinical,radiological,and laboratory findings,including serum SAA,PCT,and HMGB1 Levels,were collected,and specific detection methods were used.The diagnostic value of the biomarkers was evaluated through statistical analysis,which was performed using chi-square test,t-test,correlation analysis,and receiver operating characteristic(ROC)analysis.RESULTS The study demonstrated significantly elevated levels of serum SAA,PCT,and HMGB1 Levels in newborns diagnosed with NEC compared with healthy controls.The correlation analysis indicated strong positive correlations among serum SAA,PCT,and HMGB1 Levels and the presence of NEC.ROC analysis revealed promising sensitivity and specificity for serum SAA,PCT,and HMGB1 Levels as potential diagnostic markers.The combined model of the three biomarkers demonstrating an extremely high area under the curve(0.908).CONCLUSION The diagnostic value of serum SAA,PCT,and HMGB1 Levels in NEC was highlighted.These biomarkers potentially improve the early detection,risk stratification,and clinical management of critical conditions.The findings suggest that these biomarkers may aid in timely intervention and the enhancement of outcomes for neonates affected by NEC.

Echinacoside and Cistanche tubulosa(Schenk) R. wight have male reproductive protection effect by targeting hypothalamic and rogen receptor

OBJECTIVE Cistanche deserticola Y.C.Ma is an official plant that grows in arid or semi-arid areas.Our early work demonstrated that Cistanche extracts protect against sperm damage in mice under bisphenol A induced reproductive damage.Echinacoside(ECH) is one of the major active components.The present study investigated the mechanisms behind the possible protective effects of ECH against oligoasthenospermia in rat and identified the interaction between ECH and AR.METH.ODS The distribution of ECH was assayed by HPLC,the quantity and quality of sperm was evaluated and hormone levels were determined by radioimmunosorbent assay.The levels of androgen receptor(AR) and key steroidogenic-related genes were reduced as determined by Western blotting and qPCR analysis.The interaction between ECH and AR were evaluated by fluorescence localization assay,indirect ELISA and molecular docking.RESULTS ECH significantly increased the quantity of sperm and secretions of luteinizing hormone and testosterone.ECH was distributed to the hypothalamus but not in the testes.ECH combined with hypothalamic AR in the pocket of Met-894 and Val-713 to inhibit transfer of AR from the cytoplasm to nuclei in the hypothalamus.While negative feedback of sex hormone regula.tion was inhibited,positive feedback was stimulated to increase the secretion of luteinizing hormone and testosterone subsequently enhancing the quantity of sperm.C.militaris significantly alleviated the BPA-induced reproductive damage by increasing testicular superoxide dismutase(SOD),glutathione peroxidase(GSH-PX) and glutathione(GSH);as well as by reducing serum malondialdehyde(MDA).C.militaris not only obviously enhanced the levels of serumLH and T,but it also improved the sperm count and motility compared to the BPA-treated group.CONCLUSION C.militaris and ECH protect the BPA induced reproductive damage.ECH blocks AR activity in the hypothalamus to increase the quantity of sperm and protect against oligoasthenospermia in rats.

Cistanchetubulosa(Schenk)R.Wight amelioratesbisphenol A-induced testicular and sperm toxicity in rats through steroidogenesis and redox pathways

OBJECTIVE Bisphenol A(BPA)is a commonly used phenolic environmental estrogen that impacts male reproductive system.Cistanchetubulosa(CT)is a traditional Chinese medicine used to boost male sexual activity.It has been proved for increasing the expression of steroidogenic enzyme and remarkable antioxidant activity.This study aimed to investigate the mechanisms behind the possible protective effects of CT against BPA-induced testicular and sperm toxicity in rats.METHODS CT was identified by 5.8sgene sequencing.The major compositions(echinacosideand acteoside)of CT were quantified by HPLC method.CT(200or 400mg·kg-1)or VE(positive control,300mg·kg-1)and BPA(200mg·kg-1)were administered orally(one time per day)to adult male ratsfor 6weeks.The sperm parameters were observed by dark-field microscope;serum hormone levels(FSH,LH and T)were tested by radio immunosorbent;LDH-x activity,redox balance status(content of MDA,GSH,H2O2 and OH-,and activity of SOD)were evaluated using commercial kits;the expression of the key steroidogenic enzymes were evaluated by qRT-PCR,heat map,immunofluorescence and Western blotting.RESULTS The CT treatment reversed BPA-induced abnormal in sperm characteristics,testicular structure and LDH-x activity,as well as normalized serum testosterone.CT increased both mRNA and protein expressions of key steroidogenic enzymes including StAR,CYP11A1,3β-HSD,17β-HSD and CYP17A1,suggesting that CT enhanced sex hormone synthesis.Moreover,the remarkable antioxidant effect of CT contributed to its protection against BPA-induced testicular toxicity,which was evidenced by the normalization of testicular,redox markers(MDA,H2O2,OH-and GSH contents,and SOD activity)after CT treatment.CONCLUSION CT effectively attenuated BPA-induced poor sperm quality and testicular toxicity in rats through steroidogenesis and redox pathways.