Zigong First People's Hospital

High mortality of pediatric acute respiratory distress syndrome (PARDS) demands new biomarkers. The study aims to clarify the clinical value of miR-192-5p in PARDS and its regulatory role in inflammatory responses. Baseline data and serum samples were collected from healthy children, sepsis children, and sepsis-induced PARDS subjects. The receiver operating characteristic curve (ROC), Kaplan-Meier curve and multivariate Cox regression were used to assess miR-192-5p’s diagnostic and prognostic value for PARDS. The relationship between miR-192-5p and each index was evaluated by correlation analysis. The expression of miR-192-5p, inflammatory factors and ZEB2 in the subjects’ serum and human pulmonary microvascular endothelial cells (HPMECs) were detected by RT-qPCR. The cell viability and secretion of inflammatory factors were evaluated by CCK-8 and ELISA kit. Bioinformatic prediction combined with dual-luciferase reporter assay was used to verify the target genes. miR-192-5p was significantly low-expressed in PARDS patients’ serum. MiR-192-5p was a prognostic protective factor for PARDS, and low miR-192-5p indicated poor prognosis. MiR-192-5p was negatively correlated with TNF-α, IL-6, IL-1β, and APACHE II score. LPS treatment led to reduced HPMECs viability, excessive inflammatory factor production, and down-regulated miR-192-5p expression. Overexpression of miR-192-5p mimic could partially reverse the above phenomena, while knockdown could aggravate the above phenomena. ZEB2 was a downstream target gene of miR-192-5p. miR-192-5p serves as a diagnostic biomarker for PARDS and links to poor prognosis. Downregulation of miR-192-5p may promote LPS-induced inflammatory response and induce HPMECs cell viability by targeting ZEB2, thereby involving in the progression of PARDS.

To investigate the clinical efficacy and safety of pediatric tuina combined with glycerin enema for pediatric intussusception, in order to reduce unnecessary invasive procedures, enhance the safety of intussusception reduction, and conserve medical resources. This was an observational study of routine clinical practice with a non-randomized, single-arm design. A total of 128 children diagnosed with intussusception in Zigong Maternal and Child Health Care Hospital from September 2024 to November 2025 were enrolled as the research subjects, including 58 males and 70 females. All children had an onset time of less than 48 h, and color Doppler ultrasound indicated intussusception accompanied by at least one related clinical symptom (abdominal pain, vomiting, paroxysmal crying, etc.). All children received pediatric tuina combined with glycerin enema via anal administration as the first-line treatment in accordance with the standardized diagnosis and treatment protocol formulated by our hospital. For children with failed reduction after combined treatment, ultrasound-guided hydrostatic enema reduction was further performed; laparoscopic surgery was adopted for those who failed hydrostatic enema reduction. This was a single-arm observational study with no control group. Of the 128 enrolled children, 1 was excluded due to complicated lymph node invagination. Among 127 children who received the initial combined therapy, successful reduction was achieved in 102 cases, with a success rate of 80.3%. Of the 25 failed cases, 23 achieved successful reduction via ultrasound-guided hydrostatic enema (success rate 88.4%), and the remaining 3 underwent successful laparoscopic reduction. Multivariate analysis identified intussusception type, length ≥ 3 cm, and age as independent risk factors for treatment failure, with the predictive model showing good performance (AUC = 0.797). No severe complications were observed during follow-up. Pediatric tuina combined with glycerin enema is feasible and safe for selected children with intussusception. This regimen is easy to perform without additional specialized equipment, helps reduce unnecessary primary enema intervention and avoid overtreatment, and may assist in distinguishing transient from fixed intussusception. Even in cases of failed initial reduction, it may provide favorable conditions for subsequent procedures. As a conservative adjuvant therapy in selected patients, this combined modality shows good clinical application potential and deserves further validation in future large-sample, multicenter controlled studies.

This case report aimed to introduce a case of persistent diplopia and strabismus and review its clinical manifestations, management, and prognosis, with the aim of helping clinicians gain an in-depth understanding of the surgery for rhegmatogenous retinal detachment. Case report and literature review. We report a case of persistent diplopia and strabismus despite removal of the scleral explant. Clinical materials were reported, and previous reports on the surgery of the rhegmatogenous retinal detachment were reviewed. A 49-year-old woman complained of decreased visual acuity in the eye for 1 week and was admitted to our hospital with rhegmatogenous retinal detachment. Under retrobulbar anesthesia, she underwent vitrectomy and scleral buckling surgery. She developed diplopia on the first postoperative day. The operated eye exhibited esotropia and hypotropia, with restricted abduction and upward gaze. To alleviate the symptoms, surgery was scheduled to remove the scleral buckle at the 20-day postoperative follow-up. Unfortunately, there was no significant improvement in diplopia or ocular motility disorders. Four months after retinal detachment surgery, she underwent silicone oil removal and strabismus surgery. Fortunately, the symptoms of diplopia completely disappeared, and upward movement of the eyes was slightly restricted. The patient was very satisfied with the treatment results. Persistent diplopia and restrictive strabismus resulting from rhegmatogenous retinal detachment surgery represent rare yet serious complications that significantly affect patients' quality of life. Symptoms may persist even after scleral buckle removal. Successful outcomes depend on the accurate identification of residual mechanical constraints, which typically require imaging studies and targeted surgical release.

BackgroundTo compare the application value of conventional single-shot echo planar imaging (SS-EPI), simultaneous multi-slice single-shot echo planar imaging (SMS + SS-EPI), and simultaneous multi-slice segmented readout isotropic acquisition in diffusion weighted imaging (SMS + RESOLVE-ISO DWI) for subacute early small artery occlusive cerebral infarction.MethodsA retrospective analysis was conducted on 60 patients with subacute early small artery occlusive cerebral infarction, who were treated with SS-EPI-ISO DWI, SMS + SS-EPI-ISO DWI, and SMS + RESOLVE-ISO DWI sequence was used for 1.5 mm isovoxel acquisition. Two radiologists independently assessed the image quality, combining multi-planar reconstruction (MPR), 3-Dimensional fluid attenuated inversion recovery (3D-FLAIR), and apparent diffusion coefficient (ADC) images to evaluate the number of infarct lesions. And subjective and objective evaluations of the image quality were conducted. Objective evaluations include contrast, signal-to-noise ratio (SNR), time SNR (tSNR), contrast-to-noise ratio (CNR) and ADC. Friedman’s test was used to analyze image indicators, Weighted Kappa test was employed to assess the consistency of subjective score, and intraclass correlation coefficient (ICC) was used to analyze the consistency of measurement results.ResultsThe scanning times for SS-EPI-ISO DWI, SMS + SS-EPI-ISO DWI, and SMS + RESOLVE-ISO DWI were 3:06, 1:38, and 4:51 min, respectively. The number of infarcted lesions showed that both SS-EPI-ISO DWI and SMS + SS-EPI-ISO DWI detected 129 lesions, while SMS + RESOLVE-ISO DWI detected 123 lesions. Subjective evaluation showed that SMS + RESOLVE-ISO DWI was superior to the other sequences in terms of overall image quality, artifacts, and geometric distortions (p < 0.001). Objective evaluation revealed significant differences in contrast, SNR, and tSNR among the three sequences (p < 0.001), but no significant differences in CNR and ADC values (p > 0.05).ConclusionSMS + SS-EPI-ISO DWI achieves image quality comparable to that of SS-EPI-ISO DWI while shortening the scanning time. Although its suppression effect on artifacts and geometric distortion is not as good as that of the SMS + RESOLVE-ISO DWI sequence, the clarity of lesion display is similar to that of the SS-EPI-ISO DWI sequence. Therefore, it is suitable for the diagnosis of subacute early small artery occlusive cerebral infarction.

BackgroundDexmedetomidine (DEX) plus sufentanil (SF) sedation is commonly used after transcatheter closure for simple congenital heart disease (CHD), yet early hemodynamic responses vary. Absolute heart rate (HR) values are not comparable across pediatric ages; an age-standardized HR Z-score may better contextualize baseline HR status.ObjectiveTo evaluate the association between baseline HR Z-score and early postoperative trajectories of rate–pressure product (RPP), HR, and mean arterial pressure (MAP) under a standardized DEX + SF pathway, and to describe safety outcomes.MethodsWe retrospectively studied 96 children (0–16 years) admitted to the PICU after transcatheter closure (June 2023–August 2025). Hemodynamics were recorded at admission (T0), 1 h, 4 h, and 8 h. Longitudinal associations were assessed using linear mixed models including time, HR Z-score, and a time × Z-score interaction, with age as a covariate, with sensitivity analyses.ResultsRPP decreased over time and showed a significant time × HR Z-score interaction, indicating that baseline HR Z-score modified the early postoperative RPP trajectory. The corresponding interaction was significant for HR but not for systolic blood pressure or MAP, consistent with HR-driven differences, while SBP/MAP interactions were not statistically significant in this cohort. Bradycardia occurred in 9/96 patients (9.4%), and no hypotension events were observed.ConclusionBaseline HR Z-score, as an approximate age-standardized index of heart rate, is associated with early postoperative myocardial workload trajectory after transcatheter closure under DEX + SF sedation, primarily via HR reduction, and may help guide monitoring intensity.

ObjectiveThis study aimed to evaluate the oncologic safety of sentinel lymph node biopsy (SLNB) compared with systematic lymph node dissection (LND) in patients with early-stage cervical cancer and to determine whether SLNB alone yields comparable survival outcomes.Data sourcesStudies published up to October 2025 were systematically searched in PubMed, Embase, and Web of Science using relevant keywords, including “sentinel lymph node”, “cervical cancer”, “cervical carcinoma” and “lymphadenectomy.”Study eligibility criteriaComparative cohort studies and single-arm studies involving patients with early-stage cervical cancer undergoing SLNB, with or without LND, and reporting survival outcomes— including cancer-specific survival (CSS), disease-specific survival (DSS), overall survival (OS), progression-free survival (PFS), and disease-free survival (DFS) —were included.Study appraisal and synthesis methodsThe quality of the included studies was assessed using appropriate tools: the Cochrane Risk of Bias 2.0 (RoB 2) tool for randomized controlled trials, the Newcastle–Ottawa Scale (NOS) for observational studies, and the Methodological Index for Non-Randomized Studies (MINORS) for single-arm or non-randomized studies. All meta-analyses were performed using the meta package in R. Hazard ratios (HRs) and risk ratios (RRs) with 95% confidence intervals (CIs) were pooled using fixed- or random-effects models depending on heterogeneity. Sensitivity analyses were conducted via leave-one-out analysis.ResultsThe pooled analysis of six comparative studies revealed no significant difference in cancer-specific survival (HR = 0.93, 95% CI: 0.27–3.20), overall survival (HR = 0.92 (95% CI: 0.65–1.31), disease-free survival (HR = 0.99, 95%CI: 0.00–855.48), or progression-free survival (HR = 0.71, 95% CI: 0.29-1.05) between the SLNB and LND groups. SLNB was associated with a significantly lower risk of postoperative complications (RR = 0.70, P = 0.0406), and did not increase the recurrence rate (RR = 0.96, 95% CI: 0.36-2.53) compared with LND. Six single-arm studies reported 5-year OS and DFS rates of 97% and 94%, respectively, following SLNB alone. The pooled SLNB positivity rate across 13 studies was 8% (95% CI: 5%–12%). Sensitivity analysis confirmed the robustness of the CSS results.ConclusionThis study suggests that SLNB provides oncologic outcomes comparable to LND while reducing surgical morbidity in early-stage cervical cancer. The inclusion of CSS as a validated endpoint reinforces the cancer-specific safety of SLNB, with no significant compromise observed in either OS or PFS. While current evidence is promising, further large-scale prospective trials are needed to refine indications and standardize implementation of SLNB in routine clinical practice.

Cerebral palsy (CP) is the leading cause of childhood motor disability, often requiring intensive, long-term rehabilitation to improve motor function and independence in daily activities. Robot-assisted therapy has emerged as a promising intervention, as it can deliver high-intensity, task-specific, and motivating treatment. However, evidence for its superiority over conventional rehabilitation interventions (CRIs) is inconsistent, and a comprehensive quantitative synthesis is lacking. This protocol details a systematic review and meta-analysis to evaluate the effectiveness of robot-assisted therapy on motor outcomes in children with CP. This protocol has been developed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P) statement. We will conduct a comprehensive search of five electronic databases (PubMed, Embase, Web of Science, CINAHL, and the Cochrane Library) from their inception to June 2025. The review will include randomized controlled trials (RCTs) comparing robot-assisted therapy with CRIs in children with CP. Two independent reviewers will screen titles, abstracts, and full texts and extract relevant data. Primary outcomes will include measures of gross motor function, activities of daily living (ADL), gait, and balance. Secondary outcomes will include upper limb function and quality of life. Where appropriate, we will perform a meta-analysis using a random-effects model in Stata 14.0. We will investigate sources of heterogeneity using subgroup and sensitivity analyses. Publication bias will be assessed with funnel plots and Egger's test. Furthermore, Trial Sequential Analysis will be employed to assess the robustness of the findings and control for risks of random error. The overall quality of evidence will be evaluated using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) framework. PROSPERO CRD420250652267.

Pulmonary tuberculosis (PTB) remains a significant public health challenge in underdeveloped regions of western China. A critical, yet underutilized, approach to strengthening grassroots control lies in township-level Perspective. This study takes Zigong City, a prototypical prefectural-level city in Southwestern China, as a case study to elucidate the fine-scale spatiotemporal patterns, potential influencing factors, and future trends of PTB. The findings are intended to provide a transferable model for similar regions across Southwest China. Utilizing township-level PTB case data from Zigong City (2005–2023), we performed an in-depth spatiotemporal investigation. Joinpoint regression was used to assess temporal trends. Spatial autocorrelation, spatiotemporal scan statistics, and emerging hot spot analysis were employed to identify high-risk clusters. The Spatial Durbin Model (SDM) was used to examine the associations and spatial spillover effects of environmental and socioeconomic variables. A Seasonal Autoregressive Integrated Moving Average (SARIMA) model was developed to forecast incidence. A total of 31,729 PTB cases were notified. The overall incidence showed a significant declining trend (Average Annual Percent Change: -2.54%). Spatiotemporal analysis not only identified one most likely and twelve secondary clusters but also revealed a consistent annual peak in incidence during March and April. Eight townships in eastern Zigong were consistently classified as persistent high-risk hot spots. According to the SDM, particulate matter with a diameter less than 2.5 μm (PM₂.₅), ozone (O₃), precipitation, and relative humidity showed positive associations with local PTB risk. Conversely, negative associations were observed for higher gross domestic product (GDP) per capita, population density, night-time light (NTL), normalized difference vegetation index (NDVI), temperature, and sunshine duration. The SARIMA model projected a continued decline under the current trend, with incidence falling to 39.91 per 100,000 by 2030. The analysis of Zigong City from 2005 to 2023 reveals that while PTB incidence is declining overall, it exhibits distinct spatiotemporal heterogeneity, characterized by persistent clustering in eastern townships and a consistent spring peak. Key environmental variables such as PM₂.₅, O₃, precipitation, and relative humidity were positively associated with PTB risk, whereas higher socioeconomic indicators and favorable natural conditions were associated with lower risk. The SARIMA model further forecasts a continued decline under current conditions, with incidence expected to fall to 39.91 per 100,000 by 2030. These findings underscore the importance of integrated, spatially-targeted interventions that address both environmental and socioeconomic determinants. By leveraging township-level spatiotemporal analysis and predictive modeling, this study provides an evidence-based and scalable framework to guide TB elimination efforts in southwestern China and other comparable settings.

The use of covered stents in hemodialysis vascular access has increased in recent years. The most frequently reported mode of stent failure is edge restenosis, whereas edge collapse is extremely rare and has seldom been described. We report the case of a 48-year-old man who initially underwent placement of a covered stent in the cephalic arch, followed 1 year later by deployment of a second stent for edge stenosis. Two months thereafter, collapse of the distal edge of the second stent resulted in thrombosis of the arteriovenous fistula. Although surgical thrombectomy combined with percutaneous transluminal angioplasty (PTA) temporarily restored the stent configuration, recurrent collapse was observed 2 days later. To address this, a limited skin incision was made near the distal edge of the stent, and under ultrasound guidance, the collapsed edge was sutured and fixed to the surrounding subcutaneous tissue to prevent further infolding. This approach achieved durable results, with follow-up examinations at 2 and 6 months showing no recurrence of collapse, preserved stent patency, and stable fistula function with reduced tension. This case highlights the potential role and effectiveness of surgical fixation in managing the rare complication of stent edge collapse in hemodialysis access.