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Hemophagocytic lymphohistiocytosis (HLH) is a potentially life-threatening condition in children with sepsis. We herein aimed to identify clinical and laboratory predictors of HLH in children with sepsis. We conducted a retrospective study of 568 children with sepsis admitted to Guangdong Women and Children Hospital from January 2019 to June 2022. HLH, while rare (6.34%), proved to be a highly fatal complication (37.14%) in children with sepsis. Children with HLH had higher levels of aspartate aminotransferase, lactate dehydrogenase, triglycerides, and ferritin than children without HLH; conversely, they displayed decreased levels of neutrophils, hemoglobin, platelets, fibrinogen, and albumin. Additionally, the HLH group showed higher rates of prolonged fever (> 10 days), hepatomegaly, and splenomegaly than the non-HLH group. Our retrospective analysis identified hypofibrinogenemia (OR = 0.440, P = 0.024) as an independent predictor for the development of HLH in patients with sepsis. The optimal cutoff value for fibrinogen was found to be < 2.43 g/L. The area under the curve for diagnosing HLH was 0.80 (95% confidence interval: 0.73–0.87, P < 0.0001), with a sensitivity of 72.41% and specificity of 76.27%. Thus, hypofibrinogenemia emerges as a potentially valuable predictor for HLH in children with sepsis. [ABSTRACT FROM AUTHOR]

Aiming at the ecological footprint model, the traditional trade adjustment method only considered the international trade process at the urban scale, ignoring the trade footprint generated by domestic trade and indirect trade in various products. This paper adopts the urban-scale ecological footprint model based on the macro-trade adjustment method to calculate the trade adjustment coefficient of biological products and the energy trade adjustment coefficient respectively to correct the trade footprint. The results showed that the per capita ecological deficit showed a straight upward trend, from 0.07351 hm2 in 2013 to 0.15472 hm2 in 2018. From 2013 to 2018, the per capita ecological footprint of Guangdong Province was greater than the per capita ecological carrying capacity, and the ecological economic system of Guangdong Province was in an unsustainable state. According to the trade ecological footprint, Guangdong Province was a completely foreign resource and service exporting city, which was consistent with Guangdong Province's own economic development direction; the analysis results of the ecological product trade footprint were more consistent with the current city positioning of biological resource products of each city, and the energy indirect trade footprint. The improved ecological footprint model could more accurately assess the true status of ecological vitality above the urban scale. [ABSTRACT FROM AUTHOR]