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Child abuse is a significant public health issue that can affect children's physical and mental health. However, few studies have examined rural Chinese left-behind children. The role of social cohesion of rural Chinese communities in the prevention of child abuse remains understudied. The present study aims to investigate certain factors that could reduce child abuse problems, placing a special focus on the protective role of social cohesion, especially for left-behind rural children. Data were collected from a sample of 1,049 school-aged rural children from the largest middle school in China's Henan Province. It was found that social cohesion directly affected physical abuse and emotional abuse; furthermore, social cohesion was more significantly associated with emotional abuse, whereas sexual abuse was a more significant issue for left-behind children than for those living with their parents. However, the moderating effect of the left-behind status on the association between social cohesion and physical abuse was not significant. Our findings suggest that social cohesion is an important factor for preventing emotional and sexual abuse. Thus, it is necessary to enhance social cohesion in rural Chinese communities with left-behind children to reduce their risk of experiencing child abuse. [ABSTRACT FROM AUTHOR]

Objective: The aim of the study was to compare the effects of APRV and LTV ventilation on pulmonary permeability in severe ARDS. Methods: Mini Bama adult pigs were randomized into the APRV group ( n = 5) and LTV group ( n = 5). A severe ARDS animal model was induced by the whole lung saline lavage. Pigs were ventilated and monitored continuously for 48 h. Results: Compared with the LTV group, CStat was significantly better ( p < 0.05), and the PaO 2 /FiO 2 ratio showed a trend to be higher throughout the period of the experiment in the APRV group. The extravascular lung water index and pulmonary vascular permeability index showed a trend to be lower in the APRV group. APRV also significantly mitigates lung histopathologic injury determined by the lung histopathological injury score ( p < 0.05) and gross pathological changes of lung tissues. The protein contents of occludin ( p < 0.05), claudin-5 ( p < 0.05), E-cadherin ( p < 0.05), and VE-cadherin ( p < 0.05) in the middle lobe of the right lung were higher in the APRV group than in the LTV group; among them, the contents of occludin ( p < 0.05) and E-cadherin ( p < 0.05) of the whole lung were higher in the APRV group. Transmission electron microscopy showed that alveolar-capillary barrier damage was more severe in the middle lobe of lungs in the LTV group. Conclusion: In comparison with LTV, APRV could preserve the alveolar-capillary barrier architecture, mitigate lung histopathologic injury, increase the expression of cell junction protein, improve respiratory system compliance, and showed a trend to reduce extravascular lung water and improve oxygenation. These findings indicated that APRV might lead to more profound beneficial effects on the integrity of the alveolar-capillary barrier architecture and on the expression of biomarkers related to pulmonary permeability., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest, (Copyright © 2022 Cheng, Yang, Ma, Dong, Yang, Wang, Xue, Zhou and Kang.)

Background: To characterize the population of critically ill patients and infections treated with linezolid in the intensive care unit (ICU), and to evaluate the clinical efficacy and safety of linezolid therapy., Methods: This multi-center, observational, real-world study was conducted across 52 hospitals between June 9, 2018, and December 28, 2019. Patients who met the following inclusion criteria were included: (1) admitted to the ICU, (2) of any age group, and (3) having a clinical or laboratory diagnosis of a Gram-positive bacterial infection. Clinical efficacy was categorized as success (cured or improved), failed, or non-evaluable. Adverse events and serious adverse events were recorded during treatment., Results: A total of 366 ICU patients who met the inclusion criteria were evaluated. Linezolid was used as second- and first-line treatment in 232 (63.4%) and 134 (36.6%) patients, respectively. The most common isolated strain was Staphylococcus aureus (methicillin-resistant Staphylococcus aureus: n =37/119, 31.1%; methicillin-susceptible Staphylococcus aureus: n =15/119, 12.6%); this was followed by Enterococci (vancomycin-resistant Enterococci: n =8/119, 6.7%; vancomycin-susceptible Enterococci: n =11/119, 9.2%) and Streptococcus pneumoniae (multidrug-resistant: n =4/119, 3.4%; non-multidrug resistant: n =2/119, 1.7%). The main infection sites where pathogens were detected included the lung ( n =216/366, 59.6%), skin and soft tissue ( n =104/366, 28.4%), and blood ( n =50/366, 13.7%). Clinical success was achieved in 301 (82.2%) patients; 34 (9.3%) were cured and 267 (73.0%) improved; treatment failure and non-evaluable outcomes were observed in 29 (7.9%) in 36 (9.8%) patients, respectively. Linezolid-related adverse events were reported in 8 (2.2%) patients. No treatment-related serious adverse events were reported., Conclusions: Based on real-world results, linezolid was found to be effective and safe in the treatment of Gram-positive bacterial infections in critically ill patients., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2022 The Authors. Published by Elsevier B.V. on behalf of Chinese Medical Association.)

Stroke is one of the leading causes of disability and death. Increasing evidence indicates that β-hydroxybutyrate (BHB) exerts beneficial effects in treating stroke, but the underlying mechanism remains largely unknown. In this study, we injected different doses of BHB into the lateral ventricle in middle cerebral artery occlusion (MCAO) model rats and neuronal cells were treated with different doses of BHB followed by oxygen-glucose deprivation (OGD). We found that a moderate dose of BHB enhanced mitochondrial complex I respiratory chain complex I activity, reduced oxidative stress, inhibited mitochondrial apoptosis, improved neurological scores, and reduced infarct volume after ischemia. We further showed that the effects of BHB were achieved by upregulating the dedicated BHB transporter SMCT1 and activating the Erk/CREB/eNOS pathway. These results provide us with a foundation for a novel understanding of the neuroprotective effects of BHB in stroke.

Background: Although neutrophil-to-lymphocyte ratio (NLR) has been extensively studied in several diseases, its role in pediatric sepsis remains unclear. Our study aimed to assess the predictive significance of NLR for severe pediatric sepsis in the pediatric intensive care unit (PICU)., Methods: We retrospectively recruited critically ill children in the PICU with severe pediatric sepsis from January 2019 to January 2020 in West China Hospital of Sichuan University. Univariate and multivariable logistic regression analysis was used to assess the risk factors of severe pediatric sepsis. Receiver operating characteristic (ROC) curves were plotted for the comparison of the prediction significance of NLR., Results: Overall, 202 patients (severe sepsis 45; non-severe sepsis 157) were included. In the severe sepsis group, the levels of NLR (P<0.001), procalcitonin (PCT; P<0.001), and the Pediatric Risk of Mortality score (PRISM III) were higher than those in the nonsevere sepsis group (P<0.001). The PICU stay time (P<0.001), mechanical ventilation length (P=0.004), and hospital stay time (P<0.001) in the severe sepsis patients were noticeably more extended than those in the control patients. The area under the ROC curve (AUC) of NLR was 0.715 (P<0.001), which was higher than that of the PRISM III score (AUC =0.651, P<0.001) and PCT (AUC =0.647, P<0.001). Furthermore, the constructed predictive model of NLR + PCT + PRISM III showed a better prediction significance than they alone (AUC =0.888, P<0.001)., Conclusions: Results indicated that the initial NLR value was a significant biomarker for predicting severe pediatric sepsis. The combined NLR and PCT improved the evaluation for further early identification of severe sepsis in children., Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at http://dx.doi.org/10.21037/tp-21-47). The authors have no conflicts of interest to declare., (2021 Translational Pediatrics. All rights reserved.)

Objectives: It remains unclear whether 3D systems are manoeuvrable in video-assisted thoracic surgery (VATS) for patients with thoracic diseases. The objective of this systematic review and meta-analysis was to evaluate the efficacy and safety of 3D VATS compared with 2D VATS., Methods: A systemic research of the literature was performed using the PubMed, Embase, the Cochrane library, China National Knowledge Infrastructure, Wanfang and CQVIP databases through December 2016. Studies investigating the efficacy and safety of 3D VATS compared with 2D VATS were eligible for our meta-analysis. Odds ratios and mean differences or standard mean differences with 95% confidence intervals (95% CI) as well as a P-value were applied to compare continuous and dichotomous variables, respectively., Results: Seven studies with 1080 patients (525 patients for 3D VATS and 555 patients for 2D VATS) were included. There were significant differences in the 3D group with regard to shorter operation times (standard mean difference = -0.66, 95% CI: -0.98 to - 0.34; P < 0.001), less blood loss (mean difference = -12.12, 95% CI: -19.07 to - 5.16; P < 0.001) and shorter postoperative drainage times (standard mean difference = -0.53, 95% CI: -0.92 to - 0.14; P = 0.008) compared with the 2D group. However, no statistical difference was found for postoperative hospital stay, total postoperative drainage volume, postoperative drainage volume in 24 h, number of lymph nodes dissected and postoperative complications., Conclusions: The results of this systematic review and meta-analysis suggest that 3D VATS might be an acceptable method for treating thoracic diseases in the future., (© The Author 2017. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.)