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Objective To investigate the pathogenic role of neutrophil extracellular traps （NETs） in the pathogenesis and progression of severe Mycoplasma pneumoniae pneumonia （SMPP） in children and to assess their predictive value for SMPP. Methods Children with Mycoplasma pneumoniae pneumonia （MPP） admitted to the Second Hospital of Lanzhou University from October to December 2023 were selected as the study subjects. They were divided into the non-severe group （MPP group， n = 45） and severe group （SMPP group， n = 39）. The levels of NETs in the serum and bronchoalveolar lavage fluid （BALF） of all children were measured using ELISA. Additionally， BALF from both the affected and contralateral sides was collected from children in the SMPP group， and the content of NETs in BALF was determined using ELISA. Results A significant difference was observed in the serum concentration of NETs between MPP and SMPP patients （P < 0.01）. In the SMPP group， the level of NETs in the BALF of the affected lung was significantly higher than those of the contralateral side （P < 0.001）. Serum NETs levels were significantly higher than those in BALF in SMPP group （P < 0.001）. The area under the ROC curve （AUC） for predicting SMPP based on serum NETs levels was 0.892 （95%CI 0.810-0.963， P < 0.001）， with a sensitivity of 0.821 and specificity of 0.875， and a cut-off value of 17.24 ng/mL，respectively. The AUC of the combination of serum NETs with C-reactive protein （CRP） and lactate dehydrogenase （LDH） levels for predicting SMPP was 0.974 （95%CI 0.946-1.000， P < 0.001）， with a sensitivity of 0.923 and specificity of 0.950， respectively. Conclusions Excessive activation of NETs may contribute to the incidence of SMPP and localized lung injury in children with MPP. Monitoring the serum levels of NETs， CRP and LDH can effectively predict the incidence of SMPP. The combination of NETs， CRP， and LDH yields the best predictive performance.

To analyze a case of severe avian influenza A (H5N6) virus infection resulting in severe pneumonia and acute respiratory distress syndrome (ARDS) was admitted to Guilin Municipal Hospital of Traditional Chinese Medicine on July 6, 2023. The clinical data and treatment of this patient were analyzed retrospectively. The initial clinical manifestations of the patient were fever, cough, and expectoration, and the antigen test for influenza A virus was positive. Chest CT showed: double lung texture increased and thickened, and multiple patchy high-density shadows with air-containing bronchial shadows were found in the left lung, especially in the left upper lobe; a few patchy increased-density shadows were also seen in the lower lobe of the right lung, along with left-sided pleural effusion. Metagenomic next-generation metagenomic sequencing (mNGS) of bronchoalveolar lavage fluid was performed to identify the pathogen as influenza A virus H5N6. On the 4th day of admission, the patient's condition rapidly progressed to ARDS, which could not be improved by high-flow oxygen therapy, mechanical ventilation, and prone position ventilation. Subsequently, with the assistance of veno-venous extracorporeal membrane oxygenation (VV-ECMO), the patient's lung function gradually improved. Extracorporeal membrane oxygenation (ECMO) was withdrawn after 25 days, and the patient recovered and was discharged after a hospital stay of 41 days. Patients with severe avian influenza A (H5N6) usually have critical illness and rapid progression, often rapidly progressing to ARDS. When conventional mechanical ventilation cannot correct hypoxemia, VV-ECMO auxiliary treatment should be administered as early as possible. In addition, mNGS can help to quickly identify the diagnosis and differential diagnosis of avian influenza A (H5N6) in the early stage of the disease, particularly suitable for the diagnosis of severe and emergency infections. [ABSTRACT FROM AUTHOR]

Glioblastoma multiforme (GBM) remains refractory to conventional therapy. CD133+ GBM cells have been recently isolated and characterized as chemo-/radio-resistant tumor-initiating cells and are hypothesized to be responsible for post-treatment recurrence. In order to explore the molecular properties of tumorigenic CD133+ GBM cells that resist treatment, we isolated CD133+ GBM cells from tumors that are recurrent and have previously received chemo-/radio-therapy. We found that the purified CD133+ GBM cells sorted from the CD133+ GBM spheres express SOX2 and CD44 and are capable of clonal self-renewal and dividing to produce fast-growing CD133− progeny, which form the major cell population within GBM spheres. Intracranial injection of purified CD133+, not CD133− GBM daughter cells, can lead to the development of YKL-40+ infiltrating tumors that display hypervascularity and pseudopalisading necrosis-like features in mouse brain. The molecular profile of purified CD133+ GBM cells revealed characteristics of neuroectoderm-like cells, expressing both radial glial and neural crest cell developmental genes, and portraying a slow-growing, non-differentiated, polarized/migratory, astrogliogenic, and chondrogenic phenotype. These data suggest that at least a subset of treated and recurrent GBM tumors may be seeded by CD133+ GBM cells with neural and mesenchymal properties. The data also imply that CD133+ GBM cells may be clinically indolent/quiescent prior to undergoing proliferative cell division (PCD) to produce CD133− GBM effector progeny. Identifying intrinsic and extrinsic cues, which promote CD133+ GBM cell self-renewal and PCD to support ongoing tumor regeneration may highlight novel therapeutic strategies to greatly diminish the recurrence rate of GBM.

Improving the platinum (Pt) mass activity for low‐cost electrochemical hydrogen evolution is an important and arduous task. Here, a selective etching‐reducing fluidized bed reactor technique is reported to create Ti vacancies and firmly anchor single Pt atoms on the active {100} facets of titanium carbide (TiC) to increase the Pt utilization efficiency and improve catalytic activity significantly by a synergistic effect between Ti vacancies and Pt atoms. The generated Ti vacancies are negatively charged and stabilize Pt atoms by forming covalent PtC bonds, showing excellent long‐term durability. Pt single atoms (ultralow load of 1.2 µg cm−2) on the defective TiC {100} show remarkable activity (24.9 mV at 10 mA cm−2) and a mass activity (49.69 A mg−1) ≈190 times that of the state‐of‐the‐art PtC catalyst and nearly double the previously reported best values. The developed cation defect engineering exhibits excellent potential for fabricating next‐generation advanced single‐atom catalysts for large‐scale hydrogen evolution at a low cost. [ABSTRACT FROM AUTHOR]