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Background: Acute appendicitis is a common abdominal emergency observed in emergency departments (ED). Distinguishing between uncomplicated and complicated appendicitis is important in determining a treatment strategy. Serum soluble vascular cell adhesion molecule-1 (VCAM-1) is an inflammatory biomarker. We aimed to determine the role of VCAM-1 in predicting complicated appendicitis in children. Methods: Pediatric patients with suspected appendicitis admitted to the ED were enrolled in this prospective study. Pre-surgical serum VCAM-1 was tested in children with acute appendicitis within 72 h of symptoms (from day 1 to day 3). Serum VCAM-1 levels were further analyzed and compared between patients with and without complicated appendicitis. Results: Among the 226 pediatric appendicitis patients, 70 had uncomplicated appendicitis, 138 had complicated appendicitis, and 18 had normal appendices. The mean serum VCAM-1 levels in patients with perforated appendicitis were higher than in those with simple appendicitis (p < 0.001). On day 1 to day 3, the mean VCAM-1 levels in patients with complicated appendicitis were all significantly higher than in those with uncomplicated appendicitis (all p < 0.001). Conclusion: Serum VCAM-1 levels may be helpful in differentiating uncomplicated and complicated appendicitis in children and could predict appendiceal perforation. [ABSTRACT FROM AUTHOR]

Appendicitis is primarily diagnosed based on intraoperative or histopathological findings, and few studies have explored pre-operative markers of a perforated appendix. This study aimed to identify systemic biomarkers to predict pediatric appendicitis at various time points. The study group comprised pediatric patients with clinically suspected appendicitis between 2016 and 2019. Pre-surgical serum interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), intercellular cell-adhesion molecule-1 (ICAM-1), and endothelial selectin (E-selectin) levels were tested from day 1 to day 3 of the disease course. The biomarker values were analyzed and compared between children with normal appendices and appendicitis and those with perforated appendicitis (PA) and non-perforated appendicitis. Among 226 pediatric patients, 106 had non-perforated appendicitis, 102 had PA, and 18 had normal appendices. The levels of all serum proinflammatory biomarkers were elevated in children with acute appendicitis compared with those in children with normal appendices. In addition, the serum IL-6 and TNF-α levels in children with PA were significantly higher, with an elevation in TNF-α levels from days 1 and 2. In addition, serum IL-6 levels increased significantly from days 2 and 3 (both p < 0.05). Serum ICAM-1 and E-selectin levels were elevated in the PA group, with consistently elevated levels within the first three days of admission (all p < 0.05). These results indicate that increased serum levels of proinflammatory biomarkers including IL-6, TNF-α, ICAM-1, and E-selectin could be used as parameters in the prediction and early diagnosis of acute appendicitis, especially in children with PA. [ABSTRACT FROM AUTHOR]

Summary: Exosomes are extracellular vesicles, measuring 40–160 nm in diameter, that are released by many cell types and tissues, including adipose tissue. Exosomes are critical mediators of intercellular communication and their contents are complex and diverse. In recent years, accumulating evidence has proved that multiple adipose tissue‐derived exosomal noncoding RNAs (ncRNAs), including microRNAs (miRNAs), long noncoding RNAs (lncRNAs) and circular RNAs (circRNAs), play pivotal roles in the pathogenesis of diverse metabolic diseases, such as obesity. In this narrative review, we focus on the adipose tissue‐derived exosomal ncRNAs, especially exosomal miRNAs, and their dysregulation in multiple types of metabolic diseases. A deeper understanding of the role of adipose tissue‐derived exosomal ncRNAs may help provide new diagnostic and treatment methods for metabolic diseases. [ABSTRACT FROM AUTHOR]

Objective To investigate how to choose surgical approaches for juvenile nasopharyngeal angiofibroma (JNA) at stages Ⅰ and Ⅱ, and explore the function and limitation of endoscopic surgery. Methods Clinical data of 20 JNA patients undergoing conventional or endoscopic surgeries in the First Affiliated Hospital of the Army Medical University between January 2002 and December 2018 were collected and retrospectively analyzed. Of them, 9 patients (open surgery group) were given conventional open surgeries (including 5 cases of facial degloving approach and 4 cases of transpalatal approach), and the other 11 patients (endoscopy group) were operated with the aid of endoscopy. The choice of surgical methods, intraoperative blood loss, length of hospitalization, incidence of complications and recurrence, and follow-up data were compared between the 2 groups. Results The enrolled patients were all males, at a mean age of 14.6 years, and pathologically diagnosed with NA. The endoscopy group had less intraoperative blood loss (509 vs 1 072 mL), shorter operation time (135 vs 283 min), shorter length of hospital stay (5.5 vs 10.8 d) and lower recurrence rate (0/11 vs 2/9) when compared to the open surgery group. Conclusion Endoscopic surgery is a safe and reliable technique for JNA, with the advantages of milder traumatic injury, less blood loss, lower recurrence, and shorter hospital stay. Endoscopic surgery after embolization is an ideal method for the treatment of small and medium-sized JNA. For the patients with higher stages of JNA, nasal endoscopy combined with external nasal approach may be considered.

Objective: This study used electroencephalography to explore the behavioral and electrophysiological effects of task interruption on performance. Background: Task interruption is known to harm work performance, especially on working memory-related tasks. However, most studies pay little attention to cognitive processes by exploring brain activity and ignore the cumulative effect of sequential interruptions. Method: Thirty-four healthy participants performed a spatial 2-back in three conditions: (1) interruptions with simple math questions, (2) suspensions with prolonged fixation cross, and (3) a pure 2-back. The measured outcomes comprise performance data, ERP amplitudes, EEG power, and subjective workload. Results: Work performance decreased in the resumption trials, and cumulative interruptions had a more destructive effect on performance. EEG results showed that the P2 and P3 amplitudes induced by the 2-back task significantly increased after interruptions; theta and alpha power increased after interruptions. The P3 amplitude and alpha power induced by interruptions were significantly higher than that induced by suspensions. Conclusion: Behavioral data revealed the disruptive effect of interruptions on postinterruption performance and the cumulative effect of interruptions on accuracy. Changes in ERP amplitudes and EEG power indicate the mechanisms of attention reallocation and working memory during interruptions. Larger P3 amplitudes and alpha power after interruptions than after suspensions suggested the inhibition of irrelevant information. These results may support the memory for goals model and improve the understanding of the effects of interruption on working memory. Application: Focusing upon the mechanisms at play during the interruption process can support interruption management to ensure work safety and efficiency. [ABSTRACT FROM AUTHOR]

Background: Acute infectious diarrhea is a common cause of hospitalization in children. Hence, early identification of acute bacterial gastroenteritis with suspected sepsis in pediatric emergency departments (EDs) is important. This study aimed to describe the clinical spectrum and initial characteristics of children who were presented to a pediatric ED with acute infectious diarrhea and suspected sepsis. Methods: Between April 2020 to March 2021, children with clinical diagnoses of acute bacterial colitis and suspected sepsis who were admitted to the pediatric ED were prospectively enrolled. The following data were obtained and compared between different age groups of children: including demographics, presentation, laboratory tests, culture results, treatment modalities, complications, and short-term outcomes. Results: A total of 105 patients (70 males and 35 females; mean age: 3.75 ± 3.52 years) were enrolled in this study. Of them, 89 (84.8%) patients were <6 years of age, and 80 (76.2%) patients required hospitalization for a duration of 4.7 ± 2.08 days. C-reactive protein (CRP) and procalcitonin (PCT) levels were significantly higher in the admission (both p < 0.001) and anti-biotic treatment groups (both p < 0.001). Salmonella enteritidis was the most common organism cultured from the stool and blood samples (39 of 91 (38.5%) and 2 of 105 (1.9%), respectively). Conclusions: The primary causative organism of acute infectious diarrhea identified in this study was S. enteritidis. Age and elevated serum CRP or PCT levels could be important factors in the decisions of emergency physicians regarding hospitalization and antibiotic therapies for pediatric acute infectious diarrhea. [ABSTRACT FROM AUTHOR]

Ventral anterior homeobox 2 (VAX2) gene is a key regulating factor for the development of the ventral region of the eye, and has recently attracted much attention from the cancer treatment field. Our study aimed to explore the effect of VAX2 on papillary thyroid carcinoma (PTC).

Background. Immunoglobulin E (IgE) is the most important promoter of allergic inflammation. However, there are few systematic studies on IgE in age range, genders, disease spectrum, and time regularity. Aim. To screen the common allergens, allergen spectrum, and IgE difference between type 2 inflammatory allergic diseases and other allergic diseases in Weifang, China. Methods. A retrospective study was performed by estimating patients’ clinical data suffering from allergic diseases (urticaria, pollinosis, allergic rhinitis, atopic dermatitis, and bronchial asthma) between May 2019 and April 2020 using an allergen detection kit of Macro-Union Pharmaceutical. Results. 732 of the 1367 patients showed different antigen positive, and the positive rate was 53.5%. The most common allergens were dust mites, mixed fungi, Artemisia pollen, cat/dog dander, and cockroaches. There were 27.0% (369/1367) of the patients with single positive allergen-specific IgE (sIgE), 26.5% (363/1367) with multiple-positive IgE. The total immunoglobulin E (tIgE) levels varied with gender, age, and type of disease. There was a difference in the distribution of allergens between children and adults. A positive correlation between the serum-specific IgE and the corresponding local inhaled allergen density was observed. Conclusions. In this study, we found that type 2 inflammatory allergic diseases have higher serum IgE and a higher probability of inhaled sIgE positive. According to age, gender, and condition, serological IgE detection of allergens provides new insight into the early diagnosis and prevention of allergic diseases.