Explore the vast range of titles available.

Matrix metalloproteinase-9 (MMP-9) belongs to the MMP family and has been widely investigated. Excessive MMP-9 expression can enhance extracellular matrix degradation and promote plaque instability. Studies have demonstrated that MMP-9 levels are higher in vulnerable plaques than in stable plaques. Additionally, several human studies have demonstrated that MMP-9 may be a predictor of atherosclerotic plaque instability and a risk factor for future adverse cardiovascular and cerebrovascular events. MMP-9 deficiency or blocking MMP-9 expression can inhibit plaque inflammation and prevent atherosclerotic plaque instability. All of these results suggest that MMP-9 may be a useful predictive biomarker for vulnerable atherosclerotic plaques, as well as a therapeutic target for preventing atherosclerotic plaque instability. In this review, we describe the structure, function, and regulation of MMP-9. We also discuss the role of MMP-9 in predicting and preventing atherosclerotic plaque instability.

Objectives. Neonates with pneumonia often also have sepsis, and the identifying sepsis from pneumonia may be a challenge for clinicians. However, there are no available data regarding the clinical value C-reactive protein-to-albumin ratio (CAR) in identifying sepsis in neonates with pneumonia. The aim of this study was to evaluate the clinical value of CAR in identifying sepsis in neonates with pneumonia. Methods. 847 neonates with pneumonia were included in this study, of which 511 neonates were diagnosed with sepsis. Neonates were divided into the sepsis group and the nonsepsis group. All neonates underwent extensive and necessary clinical and laboratory tests. CAR was calculated as serum C-reactive protein (ng/ml)/albumin (mg/ml). All statistical analyses were performed using the statistical package SPSS 24.0, as appropriate. Results. Compared with the nonsepsis group, neonates with sepsis have a higher CAR (P<0.001). Further analysis showed that the prevalence of neonates with sepsis increased significantly from 41.0% in the low CAR group (CAR≤0.024×10−3) to 80.0% in the high CAR group (CAR>0.024×10−3) (P<0.001). Correlation analysis showed that there was a strong positive correlation between CAR and PCT (r=0.452, P<0.001), nSOFA (r=0.267, P<0.001), and the prolonged length of hospital stay (r=0.311, P<0.001). Multiple logistic regression showed that CAR was an independent risk factor for the presence of sepsis in neonates with pneumonia. Receiver operating characteristic curve analysis revealed that CAR had adequate discriminatory power in predicting sepsis in neonates with pneumonia (area under curve AUC=0.76, 95% CI 0.73-0.79, P<0.001). Conclusions. CAR can be used as a new marker to identify sepsis in neonates with pneumonia.

Neutrophil extracellular traps (NETs) are characterized as extracellular DNA fibers comprised of histone and cytoplasmic granule proteins. NETs were first described as a form of innate response against pathogen invasion, which can capture pathogens, degrade bacterial toxic factors, and kill bacteria. Additionally, NETs also provide a scaffold for protein and cell binding. Protein binding to NETs further activate the coagulation system which participates in thrombosis. In addition, NETs also can damage the tissues due to the proteins they carry. Many studies have suggested that the excessive formation of NETs may contribute to a range of diseases, including thrombosis, atherosclerosis, autoimmune diseases, and sepsis. In this review, we describe the structure and components of NETs, models of NET formation, and detection methods. We also discuss the molecular mechanism of NET formation and their disease relevance. Modulation of NET formation may provide a new route for the prevention and treatment of releated human diseases.

Neonates with pneumonia (NWP) may experience unidentified life-threatening sepsis, yet distinguishing NWP from neonates with sepsis (NWS) based solely on clinical presentation remains challenging. This study aimed to evaluate the diagnostic utility of the C-reactive protein to platelet ratio (CPR) in distinguishing neonatal late-onset sepsis (LOS) among NWPs. From February 2016 to March 2022, a total of 1385 NWPs aged over 3 days were included. Of these, 174 neonates with confirmed positive blood cultures were categorized into the sepsis cohort, while the remainder formed the pneumonia cohort. All clinical data were retrospectively extracted from electronic medical records. CPR was calculated as the ratio of C-reactive protein levels to platelet count. Independent risk factors (IRFs) for neonatal LOS were identified through multivariate logistic regression. The diagnostic performance of CPR in identifying LOS among NWPs was analyzed using receiver operating characteristic (ROC) curve metrics. Statistical analyses were conducted using SPSS version 24.0 and MedCalc version 15.2.2. Neonates with NWS demonstrated significantly higher CPR compared to those with NWP alone. Further analysis revealed a notably increased incidence of sepsis among neonates exhibiting elevated CPR levels relative to those with lower values. Correlation analysis identified a direct association between CPR and elevated procalcitonin, creatinine, and urea nitrogen levels, as well as prolonged hospitalization. Multiple logistic regression analysis identified CPR as an IRF for late-onset NWS. ROC curve analysis demonstrated that CPR outperformed CRP and platelet count individually in diagnosing NWS, with a diagnostic sensitivity of 54% and specificity of 85%. CPR serves as an effective initial diagnostic marker with superior accuracy in distinguishing delayed NWS from NWP compared to CRP and platelet count alone.

Lysophosphatidic acid (LPA) has anti-inflammatory and protective effects in sepsis, yet clinical evidence on its correlation with sepsis progression and outcomes is limited. This study aimed to evaluate the association of plasma LPA levels with sepsis development, severity, and mortality. A total of 42 sepsis patients and 29 controls with common infections were included. Among the sepsis patients, 15 succumbed during hospitalization. Plasma LPA levels were measured, and clinical data were retrospectively analyzed. Plasma LPA was significantly lower in sepsis patients compared to controls, and further reduced in non-survivors. Notably, correlation analyses suggested that LPA levels were negatively correlated with neutrophil count, procalcitonin, interleukin-6, and Sequential Organ Failure Assessment (SOFA) score. Multivariate regression analysis identified LPA as an independent risk factor for sepsis onset and in-hospital mortality. Receiver operating characteristic (ROC) curve analysis revealed that LPA had a high diagnostic accuracy for sepsis (area under the ROC curve [AUC] = 0.92, 95% CI = 0.86-0.99, P < 0.001) and was a strong predictor of in-hospital mortality (AUC = 0.86, 95% CI = 0.76-0.97, P < 0.001). Reduced plasma LPA levels in sepsis patients are inversely correlated with infection/inflammation markers and SOFA scores. Together, these results suggest that LPA may serve as a potential diagnostic and prognostic biomarker for sepsis, supporting its potential as a complementary tool to enhance early risk stratification and guide bedside clinical decision-making.

Background/objectiveImmunodeficiency is a common precipitating factor for Mycoplasma pneumoniae pneumonia (MPP). Vitamins are essential for enhancing immune function and mitigating systemic inflammation. However, the relationship between various vitamins, particularly B vitamins, and MPP in children remains underexplored. This study aims to assess the nutritional status of multiple vitamins in children with MPP and their relationship to the condition.MethodsA retrospective observational study was conducted at Children’s Hospital Affiliated to Zhengzhou University. A total of 135 children diagnosed with MPP with voluntarily requested vitamin profiling were enrolled between October and December 2023. A control group of 199 children, who underwent health check-ups and vitamins assessments, were also included during the same period. Clinical and laboratory data were retrieved from the hospital’s electronic medical record system.ResultsChildren with MPP exhibited significantly lower levels of VA, VD, VB1, VB7, and VC in their peripheral blood compared to the healthy control group. Nutritional analysis revealed higher deficiency rates of these vitamins in the MPP group. Correlation analysis indicated significant negative relationships between VA, VD, VB1, VB7, and VC levels and the percentage of neutrophils. Additionally, VA, VD, VB7, and VC levels were negatively correlated with the percentage of monocytes. Multivariate regression analysis, adjusted for age and neutrophil percentage, showed that VA (OR = 0.986, 95% CI: 0.981-0.992, P < 0.001), VD (OR = 0.807, 95% CI: 0.746-0.874, P < 0.001), VB1 (OR = 0.592, 95% CI: 0.406-0.864, P = 0.007), VB7 (OR = 0.980, 95% CI: 0.972-0.989, P < 0.001), and VC (OR = 0.899, 95% CI: 0.822-0.984, P = 0.021) were independently associated with MPP. Further analysis demonstrated that children with deficiencies in VA, VD, VB1, VB7, and VC had significantly higher odds of having MPP.ConclusionChildren with MPP exhibit significantly lower levels of VA, VD, VB1, VB7, and VC. The incidence of multiple vitamin deficiencies is notably higher in this group compared to healthy children, and a negative correlation exists between vitamin levels and neutrophil percentage. Multivariate regression analysis confirms that VA, VD, VB1, VB7, and VC were identified to be independently associated with MPP.

The relationship between vitamin C nutritional status and inflammation has garnered increasing attention, but studies in younger populations are limited. This study aimed to investigate the association between serum vitamin C and high-sensitivity C-reactive protein (hs-CRP) levels in children and adolescents. A cross-sectional analysis was conducted using data from the National Health and Nutrition Examination Survey (NHANES). The demographic data of 1766 participants aged 6–19 years were analyzed using t-tests and chi-square tests. The relationship between serum vitamin C and hs-CRP levels was analyzed using logistic regression, trend tests, and smooth curve fitting. Subgroup analyses and interaction tests were performed to assess the stability of the relationship across different populations. Our findings indicated a negative correlation between serum vitamin C and hs-CRP levels. In the fully adjusted model, each unit increase in serum vitamin C was associated with a reduction of 0.84 mg/L in hs-CRP levels (β = -0.84, 95% confidence interval [CI]: -1.34, -0.35). The hs-CRP levels in the vitamin C saturating group were 3.04 mg/L lower than those in the deficiency group (β = -3.04, 95% CI: -4.99, -1.08). This correlation was more significant in males, individuals with a family income to poverty ratio of ≤ 1.3, and those with a body mass index of ≥ 30 kg/m 2 . Serum vitamin C levels were negatively correlated with hs-CRP levels in American children and adolescents aged 6–19 years. Males, individuals from low-income families, and those who are overweight derived greater benefits from higher serum vitamin C concentrations.

The sensitivity of tree growth to precipitation regulates their responses to drought, and is a crucial metric for predicting ecosystem dynamics and vulnerability. Sensitivity may be changing with continuing climate change, yet a comprehensive assessment of its change is still lacking. We utilized tree ring measurements from 3,044 sites, climate data and CO2 concentrations obtained from monitoring stations, combined with dynamic global vegetation models to investigate spatiotemporal changes in the sensitivity over the past century. We observed an increasing sensitivity since around 1950. This increased sensitivity was particularly pronounced in arid biomes due to the combined effect of increased precipitation and elevated CO2. While elevated CO2 reduced the sensitivity of the humid regions, the intensified water pressure caused by decreased precipitation still increased the sensitivity. Our findings suggest an escalating vulnerability of tree growth to precipitation change, which may increase the risk of tree mortality under future intensified drought. Plain Language Summary The sensitivity of tree growth to precipitation strongly regulates global vegetation dynamics and their responses to climate change, yet changes in sensitivity remain poorly understood. Here, we defined a sensitivity of tree radial growth to precipitation, and found that most tree species showed an increased sensitivity in the second half of the 20th century. This increased sensitivity in arid biomes could be attributed to increasing precipitation, while the increased sensitivity in humid biomes was caused by decreasing precipitation. Although elevated atmospheric CO2 have generally increased sensitivity in arid biomes and decreased it in humid biomes, these contrasting influences were ultimately overshadowed by changes in precipitation, resulting in an overall increased sensitivity across both arid and humid biomes. Key Points The sensitivity of tree growth to precipitation is increasing since around 1950, both at the arid and humid biomes This increased sensitivity is particularly pronounced in arid biomes due to the combined effect of increased precipitation and elevated CO2 Although elevated CO2 reduce the sensitivity in humid biomes, the decreased precipitation still lead to an increased sensitivity

The neutrophil–lymphocyte ratio (NLR) is an emerging risk factor of sepsis that is receiving increasing attention. However, the relationship between NLR and the presence of sepsis in neonates is poorly studied. Here, we retrospectively recruited 1480 neonates and collected and analyzed relevant clinical and laboratory data. According to the International Pediatric Sepsis Consensus, 737 neonates were diagnosed with sepsis, and 555 neonates were suspected for having infection. Neonates with hyperbilirubinemia (n=188) served as controls. Neonates with sepsis had significantly elevated neutrophil counts and NLR (P<0.001). The proportion of neonates with sepsis increased significantly from 41.6% when NLR<0.91 to 66.2% when NLR>1.88 group (P<0.001). Multiple logistic regression analysis showed that NLR was an independent risk factor for the presence of neonatal sepsis. Receiver operating characteristic (ROC) curve analysis showed that the optimal cut-off value NLR for predicting the presence of neonatal sepsis was 1.62 (area under curve AUC=0.63, 95% CI 0.60–0.66, P<0.001). In conclusion, our data suggest that elevated NLR levels are associated with a higher neonatal sepsis risk.

Background. Neonatal sepsis is an extremely dangerous and fatal disease among neonates, and its timely diagnosis is critical to treatment. This research is aimed at evaluating the clinical significance of the lymphocyte-to-C-reactive protein ratio (LCR) as an early sepsis indicator in neonates with suspected sepsis. Methods. Between January 2016 and December 2021, 1269 neonates suspected of developing sepsis were included in this research. Among them, sepsis was diagnosed in 819 neonates, with 448 severe cases, as per the International Pediatric Sepsis Consensus. Data related to clinical and laboratory tests were obtained via electronic medical records. LCR was calculated as total lymphocyte (109 cells/L)/C-reactive protein (mg/L). Multivariate logistic regression analysis was employed to evaluate the effectiveness of LCR as an independent indicator for determining sepsis in susceptible sepsis neonates. Receiver operating characteristic (ROC) curve analysis was conducted for investigating the diagnostic significance of LCR in sepsis. When suitable, the statistical tool SPSS 24.0 was used for statistical analyses. Results. LCR decreased significantly in the control, mild, and severe sepsis groups. Further analyses exhibited that there was a substantially greater incidence of sepsis in neonates in the low-LCR group (LCR≤3.94) as opposed to the higher LCR group (LCR>3.94) (77.6% vs. 51.4%, p<0.001). Correlation analysis indicated a substantial negative association of LCR with procalcitonin (r=−0.519, p<0.001) and hospital stay duration (r=−0.258, p<0.001). Multiple logistic regression analysis depicted LCR as an independent indicator for identifying sepsis and severe cases of this disease. ROC curve analysis indicated the optimal cutoff value of LCR in identifying sepsis to be 2.10, with 88% sensitivity and 55% specificity. Conclusions. LCR has proven to be a potentially strong biomarker capable of identifying sepsis in a timely manner in neonates suspected to have the disease.