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Objective To study the role of plasma exchange combined with continuous blood purification in the treatment of refractory Kawasaki disease shock syndrome (KDSS). Methods A total of 35 children with KDSS who were hospitalized in the Department of Pediatric Intensive Care Unit, Hunan Children's Hospital, from January 2019 to August 2022 were included as subjects. According to whether plasma exchange combined with continuous veno-venous hemofiltration dialysis was performed, they were divided into a purification group with 12 patients and a conventional group with 23 patients. The two groups were compared in terms of clinical data, laboratory markers, and prognosis. Results Compared with the conventional group, the purification group had significantly shorter time to recovery from shock and length of hospital stay in the pediatric intensive care unit, as well as a significantly lower number of organs involved during the course of the disease (P<0.05). After treatment, the purification group had significant reductions in the levels of interleukin-6, tumor necrosis factor-α, heparin-binding protein, and brain natriuretic peptide (P<0.05), while the conventional group had significant increases in these indices after treatment (P<0.05). After treatment, the children in the purification group tended to have reductions in stroke volume variation, thoracic fluid content, and systemic vascular resistance and an increase in cardiac output over the time of treatment. Conclusions Plasma exchange combined with continuous veno-venous hemofiltration dialysis for the treatment of KDSS can alleviate inflammation, maintain fluid balance inside and outside blood vessels, and shorten the course of disease, the duration of shock and the length of hospital stay in the pediatric intensive care unit. [ABSTRACT FROM AUTHOR]

Objective To study the efficacy and safety of double plasma molecular absorption system (DPMAS) in the treatment of pediatric acute liver failure (PALF). Methods A prospective analysis was performed on the medical data of children with PALF who were hospitalized in the Intensive Care Unit (ICU), Hunan Children's Hospital, from March 2018 to June 2020. The children were randomly divided into two groups: plasma exchange group (PE group) and DPMAS group (n=18 each). The two groups were compared in terms of clinical indices after treatment, laboratory markers before and after treatment, and adverse events after treatment. Results Compared with the PE group, the DPMAS group had a significantly lower number of times of artificial liver support therapy and a significantly shorter duration of ICU stay (P<0.05), while there was no significant difference in the 12-week survival rate between the two groups (P>0.05). There was no significant difference in laboratory markers between the two groups before treatment (P>0.05). After treatment, both groups had reductions in the levels of total bilirubin, interleukin-6, and tumor necrosis factor-α, and the DPMAS group had significantly greater reductions than the PE group (P<0.05). Both groups had a significant reduction in alanine aminotransferase (P<0.05), while there was no significant difference between the two groups (P>0.05). The PE group had a significant increase in albumin, while the DPMAS group had a significant reduction in albumin (P<0.05). The PE group had a significant reduction in prothrombin time, while the DPMAS group had a significant increase in prothrombin time (P<0.05). There was no significant difference between the two groups in the rebound rate of total bilirubin and the overall incidence rate of adverse events after treatment (P>0.05). Conclusions DPMAS is safe and effective in the treatment of PALF and can thus be used as an alternative to artificial liver support therapy. [ABSTRACT FROM AUTHOR]

To assess the efficacy of the "Implementation Details of Air Pollution Prevention and Control Action Plan", the chemical composition of PM2.5 and other pollutants was determined during the winters of 2013–2014 and 2016–2017 at two urban sites in Xiangtan City, Hunan. The concentrations of PM2.5, SO2, and NO2 decreased from 146.0 to 94.5 μg/m3, 75.9 to 33.5 μg/m3, and 80.6 to 55.8 μg/m3, respectively, from winter 2013–2014 to winter 2016–2017. The concentrations of almost all the major chemical components of PM2.5 decreased as well, particularly secondary inorganic aerosols (SIAs). These results indicate that the implementation of the air quality control plan was very effective in improving air quality. Analysis of the data also suggests that SIA formation is likely responsible for high winter PM2.5 pollution and that high relative humidity levels and low wind speed can promote the formation of SIA. A 72-h back trajectory analysis shows that both regional transport and the accumulation of local pollutants under stagnant meteorological conditions promote the occurrence of episodes of high wintertime pollution levels. [ABSTRACT FROM AUTHOR]