Autism spectrum disorder (ASD) is a pervasive neurodevelopmental disorder characterized by impaired social interactions and communication, repetitive, or stereotyped behavior. Docosahexaenoic acid (DHA), an essential polyunsaturated fatty acid, has been demonstrated to exert anti-oxidative stress and anti-inflammatory properties, while also promoting myelin development and neural differentiation and development. However, it remains uncertain whether DHA can ameliorate autistic-like behaviors, and if so, the underlying mechanisms are still unclear. Here, we established a neonatal maternal separation (NMS) rat model and treated it with DHA (80 mg/kg/day, i.p.). The results showed DHA treatment significantly alleviated autism-like behaviors in the NMS rats during their juvenile period. Subsequently, we employed network pharmacology analysis and molecular docking methods to screen potential targets of DHA in ASD therapy. Through Gene Ontology, Kyoto Encyclopedia of Genes and Genomes, and Wikipedia enrichment analysis, we identified anti-oxidative stress, anti-inflammatory and JNK signaling pathway that might be associated with DHA-mediated improvement of autistic-like behaviors. Furthermore, western blotting assays showed DHA significantly downregulated the expression levels of p-JNK and c-JUN, while upregulating the expression levels of NRF2, HO-1, SOD1, and CAT. In addition, enzyme-linked immunosorbent assay results showed DHA effectively reduced the production of pro-inflammatory factors, such as TNF-α, IL-6, and IL-1β. Collectively, our study predicted and validated that DHA exhibits the potential to improve autistic-like behaviors induced by NMS in rats by suppressing JNK activation and inhibiting oxidative stress and inflammatory response. These findings suggest that DHA may be a potential therapeutic agent for the treatment of ASD.

Kawasaki disease (KD) is an acute, self-limited febrile illness occurring in children. In actual clinical situations, unlike complete Kawasaki disease (CKD), incomplete Kawasaki disease (IKD) lacks typical symptoms and is difficult to distinguish from many febrile illnesses, which poses a challenge to accurate diagnosis and misleading the treatment. Therefore, we investigated the independent risk factors for early prediction of IKD in children. In this research, 809 children suffering from IKD were recruited from the Children's Hospital of Chongqing Medical University from 2007 to 2017, as well as 2427 children were related to febrile diseases, divided into the IKD group and the other related febrile disease group. According to the results of univariate analysis, the study population was divided into three age groups to develop group-specific models that demonstrated more effective performance. Finally, the 0–24 months old group obtained eight independent risk factors: CRP, LDH, UA, TP, ALB, RDA, PLT, and HGB, with the ROC curve showing an AUC of 0.862 in the predictive model and 0.88 in the new dataset. Meanwhile, LDH, UA, ALB, PLT, and MCHC were in the 24–60 months old group, among which AUC was 0.83 in the predictive model and 0.82 in the new dataset; the older group obtained LDH, UA, MCHC, and PLT, with an AUC of 0.7 in the predictive model and 0.8 in the new dataset. Particularly, UA is a new independent risk factor of IKD. These findings offer valuable insights into guiding the personalized diagnosis of IKD in pediatric patients.

Increasing evidence suggests that human bocavirus (HBoV) is associated with respiratory symptoms in the absence of other identifiable pathogens and may even precipitate severe lower respiratory tract infections. However, only a few studies of severe human bocavirus infections in pediatric patients have been reported. The aim of the current study was to collect and analyze clinical data from children diagnosed with mild pneumonia and severe pneumonia, with an emphasis on those testing positive for HBoV from June 2009 to June 2019. Among the 799 HBoV-positive children included in the study, approximately 5.88% experienced severe pneumonia. Results revealed no significant differences between co-detection and single detection of HBoV-positive pneumonia in the severe and mild groups, supporting the pathogenicity of HBoV. A higher incidence of severe cases was observed in children lacking Bacillus Calmette–Guérin (BCG) vaccination, or with congenital airway or bronchopulmonary dysplasia (P = 0.046, P = 0.017). Overall, these findings indicate that HBoV can be identified in respiratory samples from children with severe pneumonia, denoting its role as a viral pathogen in hospitalized children with this condition. Preterm birth, wheezing history of previous infection, pulmonary underlying diseases such as airway dysplasia or bronchopulmonary dysplasia, and viremia may be the risk factors for severe pneumonia with HBoV positive.

Acute kidney injury (AKI) is a prevalent and serious clinical challenge with limited specific treatments. Phyllanthus urinaria L (PU), a well-regarded herbal medicine, possesses noted anti-inflammatory, antiviral, and antitumor properties. Yet, research into its renal protective effects, particularly for cisplatin-induced AKI, is markedly limited. Our study explores the therapeutic potential of PU against AKI triggered by cisplatin administration. Utilizing an AKI model induced by a substantial dose of cisplatin, we assessed renal function through histological examination (hematoxylin and eosin staining) and biochemical markers, including blood urea nitrogen (BUN) and serum creatinine (Scr). Our results demonstrated that PU may mitigate cisplatin's structural damage to renal tissue. Post-treatment with PU, a significant reduction in pro-inflammatory cytokines interleukin-1β (IL-1β), IL-6, and tumor necrosis factor-α (TNF-α) was observed through quantitative polymerase chain reaction (PCR) analysis. Additionally, the expressions of apoptotic and anti-apoptotic proteins B cell leukemia/lymphoma two (Bcl-2), Bcl2-Associated X protein (Bax), and cleaved-caspase3 evaluated via Western blot and immunofluorescence indicated that PU could inhibit apoptosis in response to cisplatin injury. Oxidative stress markers, such as malondialdehyde (MDA) and superoxide dismutase (SOD), showed decreased MDA levels and elevated SOD activity following PU treatment, suggesting a reduction in oxidative damage. Furthermore, cisplatin-induced downregulation of NRF2 and NQO1 was countered by PU, highlighting its restorative effect on antioxidant pathways as confirmed by Western blot and immunofluorescence. Collectively, our findings endorse PU's protective capability against cisplatin-induced AKI, endorsing its therapeutic potential to counteract cisplatin's nephrotoxicity.

Double outlet left ventricle (DOLV) is a rare congenital cardiac anomaly in which both great arteries originate entirely or predominantly from the morphologic left ventricle. The aim of this study is to explore its clinical presentations and compare the diagnostic accuracy of transthoracic echocardiography (TTE) with computed tomographic angiography (CTA) on DOLV. We took TTE as a first-line examination modality, considering CTA and surgical results as the gold standard. Ten suspected patients with DOLV were identified at the Children's Hospital of Chongqing Medical University from March 2009 to November 2023. The clinical presentations, TTE, CTA, and follow-up data of the children were analyzed retrospectively. All 10 cases (100%) underwent TTE examination, and 7 patients (70%) received CTA examination. Six patients (60%) ultimately underwent surgery and were confirmed to have DOLV. DOLV were initially diagnosed using TTE with a diagnostic accuracy rate of 85.71% after comparisons with CTA and surgery results. Ventricular septal defect (100%) and atrial septal defect (80%) were the common associated abnormality. The clinical manifestation of DOLV was atypical, and TTE has a relatively high diagnostic accuracy for DOLV in pediatrics, making it a very valuable tool for early detection.

Preterm birth is a major global health concern associated with high morbidity and mortality rates, along with long-term neurodevelopmental impairments. Developmental supportive care (DSC) plays a crucial role in optimizing neurodevelopmental outcomes in these vulnerable neonates. This study aimed to develop, validate, and assess the feasibility of a nurse-led developmental intervention package (NLDIP). A Medical Research Council (MRC) framework was used to develop and validate the NLDIP. The NLDIP was designed based on a comprehensive scoping review, expert consultations, and practical feasibility assessments in a neonatal intensive care unit (NICU). Validation was conducted through single-round Delphi technique with expert reviews from different fields. The content validity index value was 0.9 and a dry run was performed to assess compliance and feasibility. The NLDIP was systematically developed and validated, comprising three key components: standard DSC, age-appropriate multisensory stimulation (MSS) during hospitalization, and continued MSS at home. The findings demonstrate that the NLDIP is a valid, feasible, and well-structured intervention which can be effectively implemented by nurses in an integrated way to enhance the neurodevelopmental outcomes of preterm infants.

Small for gestational age (SGA) and twin infants are at increased risk of growth deviations, but postnatal catch-up growth (CUG) patterns across singleton, twin, appropriate for gestational age (AGA), and SGA groups remain unclear. This prospective cohort study (n = 340) investigated the postnatal growth trajectories and physical growth deviations in singleton and twin AGA and SGA infants during the first year of life. The primary findings indicated that SGA infants exhibited rapid CUG in weight and head circumference within the first 6 months, whereas length catch-up required a longer period. Twin SGA infants displayed distinct patterns: faster weight CUG but slower length CUG compared with singleton SGA infants, with gender differences—male SGA twins had lower length z-scores than SGA singletons. The rate of deviation in physical growth of SGA infants improved significantly within the first year of life, with wasting being infrequent. In conclusion, the mechanism underlying SGA is more complex among twins than singletons. Twin SGA infants require prolonged growth monitoring, and regular follow-up is essential to optimize growth outcomes and mitigate long-term risks. This preliminary study offers a foundation for further investigation into the biological and environmental factors driving these differences.

Autism spectrum disorder (ASD) involves neuroimmune dysregulation and synaptic pruning defects. This study aimed to investigate the role of triggering receptor expressed on myeloid cells 2 (TREM2) in ASD pathogenesis and its link to retinoic acid (RA)/retinoic acid receptor α (RARα) signaling. Prefrontal cortex–specific knockdown of TREM2 in rats induced core ASD-like behaviors (e.g., social deficits), microglial hyperactivation, aberrant synaptic pruning, reduced serum soluble TREM2 (sTREM2) levels, and disrupted RA/RARα signaling. Oral RA supplementation (6 mg/[kg·day]) reversed these neuroimmune abnormalities and behavioral impairments. In vitro studies demonstrated that TREM2 knockdown and RA supplementation induced RARα-level alterations consistent with in vivo observations. These findings indicated that TREM2 deficiency was a key factor in the pathophysiology of ASD, mediated by the RA/RARα signaling pathway. Furthermore, serum sTREM2 might serve as a potential diagnostic biomarker for ASD. Collectively, these findings underscore the pivotal role of TREM2 in ASD pathogenesis and provide novel perspectives for diagnostic and therapeutic strategies.

Necrotizing enterocolitis (NEC) is a devastating gastrointestinal disorder that frequently affects premature infants, and its pathogenesis is closely related to macrophage polarization. This study investigated the effects of succinate, a metabolite of the intestinal flora, on macrophage polarization in NEC. Succinate aggravated intestinal injury caused by NEC and inhibited the proliferation of damaged mouse monocyte‒macrophage leukemia cells (RAW264.7 cells). It was confirmed by multiple methods that succinate intervention promotes the polarization of intestinal macrophages toward the M1 phenotype in neonatal NEC. This polarization was characterized by a significant upregulation of inducible nitric oxide synthase (iNOS) protein levels and iNOS mRNA expression, along with a marked suppression of arginase 1 (ARG1) protein levels and Arg1 mRNA expression. Moreover, immunofluorescence analysis revealed that in the NEC intestine, the coexpression of the M1 macrophage marker F4/80⁺/CD86⁺ was significantly increased, whereas the coexpression of the M2 macrophage marker F4/80⁺/CD206⁺ was significantly decreased. Mechanistic studies revealed that succinate upregulated the expression levels of phosphorylated protein kinase B (p-AKT) and hypoxia-inducible factor 1 alpha (HIF1a) by activating the PI3K/AKT signaling pathway through its specific receptor succinate receptor 1 (SUCNR1). Further experiments revealed that the expression of polarization-related markers in M1-type macrophages was significantly suppressed after treatment with the SUCNR1-neutralizing antibody or the PI3K inhibitor LY294002. These findings suggest that succinate may activate the phosphatidylinositol 3-kinase/protein kinase B (PI3K/AKT) signaling pathway via SUCNR1 to promote the polarization of NEC macrophages toward the M1 phenotype, thereby accelerating NEC progression.

Monteggia fractures represent relatively infrequent injuries in the pediatric population, accounting for approximately 2% of all forearm fractures. However, the rate of missed diagnoses ranges from 30% to 50%, leading to the development of chronic Monteggia fractures in children. Chronic Monteggia fractures frequently result in elbow deformities and functional limitations, significantly impacting the patients' quality of life. The classification systems and treatment approaches for this condition are complex, and therapeutic strategies remain a subject of considerable debate. This review comprehensively examines the definition, incidence, etiology, classification, pathophysiological characteristics, diagnosis, treatment strategies, and prognosis of chronic Monteggia fractures in children. The aim of this study is to provide a reference for further research into the management of this challenging pediatric orthopedic condition.

The study of cells aids in comprehending the pathophysiology of diseases. However, obtaining a large number of primary cells in a short period is challenging, and they senesce and die after repeated passages. Therefore, establishing immortalized cell lines is necessary for conducting cellular experiments. Researchers commonly use antibiotics to screen immortalized cell models upon construction. However, due to the low transfection rate of the immortalized genes, a significant number of nonimmortalized cells are killed. The connections between the cells act as a web that floats when many cells die. As a result, successfully transfected immortalized cells are lifted and carried away, leading to only a small number of immortalized cells surviving. The surviving cells survive in the absence of other cell-secreted factors. However, their proliferative ability is limited, which makes obtaining immortalized cell lines a time-consuming process. This study aimed to shorten the time required to obtain immortalized cell lines by constructing immortalized Schwann cells and improving the traditional screening method. The immortalized gene transfectants were first cultured, passaged, and then screened. A comparison with the traditional screening method demonstrated the feasibility and advantages of the improved method.