Pulmonary hypertension due to left heart disease (PH-LHD) is a common yet complex condition characterized by elevated left atrial pressure, leading to postcapillary pulmonary hypertension. It is divided into isolated postcapillary PH and combined postcapillary and precapillary PH based on pulmonary vascular resistance. "Right ventricular failure often develops due to progressive afterload increase, causing worsening heart failure." Diagnosis relies on right heart catheterization, and PH-specific therapies have shown limited efficacy in PH-LHD. Emerging device-based interventions like interatrial shunt device, pulmonary artery denervation, and MitraClip may provide new therapeutic options, but further research is needed for optimal patient selection.

Pneumonia is one of the important causes of death in children. Conventional detection methods such as bacterial culture and polymerase chain reaction (PCR) are very limited for the detection of pathogens. Metagenomic next generation sequencing (mNGS) has shown strong coverage in nucleic acid detection, but its research in lower respiratory tract samples of children with pneumonia is still quite limited, especially in northwest China.

To characterize the pathogenic microbial spectrum in bronchoalveolar lavage fluid (BALF) of pediatric pneumonia patients in Gansu Province, China, using mNGS, and to demonstrate the advantages of mNGS in pediatric pneumonia diagnostics.

A total of 128 pediatric pneumonia patients admitted to Gansu Provincial Maternal and Child Health Hospital (Gansu Central Hospital) between March 1, 2023 and February 5, 2025 were enrolled. BALF data, including bacterial culture, Polymerase chain reaction (PCR), and mNGS results, were collected from each patient for comprehensive analysis.

A total of 128 patients were enrolled in this retrospective study. Out of all patients, 68(53 %) were male and the median age was 3 years. A total of 31 patients had underlying diseases. mNGS demonstrated a significantly higher pathogen detection rate compared to conventional testing. Through mNGS analysis, viruses were identified as the predominant pathogenic microorganisms in children with pneumonia, and the most common infection pattern was a combination of viral and bacterial infections. Additionally, mNGS detected three types of difficult-to-culture bacteria, namely Tropheryma whipplei, Legionella pneumophila, and Mycobacterium tuberculosis complex, in the BALF from pediatric pneumonia patients in this study.

mNGS has shown obvious advantages in the detection of pathogenic microorganisms in children with pneumonia. Its universality helps to identify the pathogen as soon as possible and make up for the shortcomings of conventional testing, which is particularly important for the accurate treatment of patients with unclear infection or no obvious curative effect.

Postacute sequelae of COVID-19 (PASC) are debilitating health conditions affecting over 7% of the US population. Clinical PASC manifestations are variable, but consistently involve dysautonomia and elevated inflammatory biomarkers. Common symptoms include pain, fatigue, cognitive impairment, sensory loss, and orthostatic intolerance. As neuroimmune hyperactivation and reductions in cerebral blood flow are each implicated in PASC pathophysiology, stellate ganglion block (SGB) represents a promising treatment option due to its ability to reset autonomic activity and reperfuse the brain. We sought to retrospectively assess the potential of SGB to treat head and neck pain, cognitive impairment, and fatigue associated with PASC persisting over 12 months.

We reviewed and analyzed case data from 2 middle-aged female patients with painful, longstanding PASC managed with repeat unilateral SGB. Procedures were performed under ultrasound guidance, with 3 mL 0.5% bupivacaine + 12 mg betamethasone as the injectate. Each patient received 2 SGBs, with all procedures being tolerated well. No complications occurred. One patient had a recurrence of migraine pain following the blocks, while the other experienced durable relief. Both patients saw improvements in cognitive function and fatigue postoperatively, which were sustained.

Most literature on SGB for PASC management concerns its ability to reverse sensory loss, rather than relieve chronic pain. This case report provides preliminary evidence supporting the effectiveness of SGB for managing pain and cognitive impairment in PASC. As PASC symptoms with longer durations tend to be less effectively managed with SGB, we speculate that chronicity of the patients' symptoms hampered SGB-mediated pain relief.

Lack of in-home water service remains a persistent challenge in rural Alaska due to underfunding, high construction and operating costs, extreme cold, and environmental change. Alaska has the highest proportion of households in the U.S. lacking complete plumbing, resulting in self-hauling of water and waste, reuse of limited supplies, and higher rates of water-washed disease than in plumbed homes. During the COVID-19 response, the Alaska Native Tribal Health Consortium (ANTHC) and Silverline LLC developed and installed the Miniature Portable Alternative Sanitation System (Mini-PASS) in 14 unplumbed Alaska Native communities. To evaluate its impact on hand hygiene, water-hauling behaviors, and system use, we conducted seasonal interviews with 147 households. Among 139 households reporting handwashing methods, 63% (n=93) used the in-home handwashing station (HWS) as their primary method. Longer ownership was associated with greater HWS use and increased water hauling. Analysis of 163 interviews from 52 households showed a monthly rise of 0.08 gal/c/d (0.30 L/c/d) in water use following installation. These findings indicate that in-home HWS interventions such as the Mini-PASS improve hand hygiene, reduce wash-basin water reuse, and modestly increase household water use over time. Longitudinal monitoring is critical to assess sustained behavioral and WASH outcomes in unpiped communities.

Langerhans cell histiocytosis (LCH) is a rare, life-threatening condition that predominantly affects children. It is a diagnostically challenging condition due to several different clinical presentations. Presentations of LCH with otological involvement are considered rare. We report a case where LCH presented a six-month-old boy to our tertiary teaching hospital. The patient presented with a unilateral left postauricular soft tissue mass, with an associated left external ear canal lesion and middle ear effusion, which initially had the working diagnosis of mastoiditis. However, further imaging and molecular testing concluded the final diagnosis as LCH with multisystem involvement. When LCH does have otological involvement, it commonly involves the external and the middle ear, which can often be confused with otitis media and otitis externa. This case report highlights that misdiagnosis of LCH can occur due to its broad presentation. The case report also raises the importance that in cases of unilateral postauricular soft tissue masses with destructive findings on cross-sectional imaging and systemic symptoms and signs, LCH must be a differential diagnosis, and biopsy should be considered.

Mycoplasma pneumoniae is a common cause of respiratory tract infections in children, but neurological complications, including encephalitis, are increasingly recognized. Basal ganglia involvement is rare, and a poorly characterized feature of meningoencephalitis, with clinical consequences being inconclusive.

We report two pediatric cases of Mycoplasma pneumoniae-related meningoencephalitis with bilateral basal ganglia lesions seen on MRI. A literature review was conducted using PubMed, Scopus, and Web of Science to identify reports of M. pneumoniae-related meningoencephalitis in children, and related MRI findings.

Both patients (12-year-old male and 14-year-old female) presented with acute meningoencephalitis syndrome and had marked mononuclear pleocytosis. In both patients M. pneumoniae was confirmed with serological assay from serum sample, while in one patient M. pneumoniae was also confirmed by PCR from pharyngeal swab. Both exhibited bilateral basal ganglia lesions, with complete regression observed during follow-up. Treatment with corticosteroids led to full recovery in both cases. After a literature search, a total of 21 patients had basal ganglia involvement reported.

Literature suggests variable MRI findings in pediatric M. pneumoniae encephalitis, with basal ganglia involvement being uncommon and rarely reported, especially among older children. While diagnostic challenges related to extrapulmonary manifestations of the infection persist, basal ganglia involvement could aid in diagnosis, especially in older children presenting with meningoencephalitis along with pronounced pleocytosis when respiratory symptoms are absent or mild.

The rising prevalence of multidrug-resistant (MDR) bacterial infections, coupled with the diminishing efficacy of antibiotics, has reinvigorated interest in bacteriophage (phage) therapy as a promising alternative, leveraging its unique bactericidal mechanisms and precise targeting capabilities. Concurrently, phage display technology has advanced tumor diagnostics and targeted drug delivery through high-throughput peptide screening. This review systematically evaluates the mechanisms, strategies, and clinical progress of phage-based applications in anti-infective and oncological therapies. Clinical evidence highlights its efficacy against respiratory, oral, wound, bloodstream, and urinary tract infections, alongside solid tumors. However, challenges persist, including limited host range, bacterial resistance, immunogenicity, inefficient delivery systems, and regulatory uncertainties. Future efforts should prioritize AI-driven phage optimization, standardized pharmacokinetic assessment, and interdisciplinary collaboration to accelerate clinical translation. Despite current limitations, phage therapy represents a transformative and scalable approach for combating antimicrobial resistance and advancing precision oncology, positioning it as a pivotal tool in addressing global health crises.

Asthma is a chronic respiratory disease influenced by genetic and environmental factors. Emerging evidence highlights epigenetics as a key regulatory mechanism in asthma development.

This research aimed to summarize current evidence on immune-epigenetic mechanisms in asthma and to identify global research hotspots through bibliometric analysis.

A systematic search was conducted in the Web of Science Core Collection(WoSCC) and Scopus databases for studies published between 1980 and July 2025. Following PRISMA guidelines, duplicate removal and quality control were performed. Eligible articles were analyzed using CiteSpace, VOSviewer, and the R bibliometrix package to evaluate publication trends, countries, institutions, authors, journals, co-cited references, and keyword clusters.

A total of 4,020 unique publications were included. By utilizing data from both the WoSCC and Scopus, research output has risen markedly since 2010, with the United States and China leading in productivity and collaboration. Harvard University and the University of California System emerged as central institutions, while influential authors included Ian M. Adcock, Juan C. Celedón, and Peter J. Barnes. Leading journals, like Clinical Epigenetics and the Journal of Allergy and Clinical Immunology, have seen a steady increase in interdisciplinary research contributions over the years. Through keyword clustering, we identified four major research hotspots: immune and inflammatory mechanisms, epigenetic and regulatory mechanisms, environmental exposures and gene-environment interactions, and epigenetic therapies and biomarkers for precision medicine.

Epigenetic research in asthma is rapidly expanding, with increasing international collaboration. Future efforts should focus on translating mechanistic insights into clinical applications by validating biomarkers, refining patient stratification, and advancing epigenetic-based therapeutic strategies.

Respiratory viral infections pose a major global public health challenge, with pathogens such as influenza viruses, novel coronaviruses, and respiratory syncytial virus exerting serious threats to human health. These infections often progress to severe disease in children, the elderly, and individuals with compromised immunity. Due to their anatomical exposure and relatively weak mucosal defenses, the upper respiratory tract-including the nasal cavity and throat-serves as a primary portal of entry for these pathogens. Such infections can lead to otolaryngological conditions such as anosmia and otitis media, and may further exacerbate illness in susceptible populations. After viral invasion, the host perceives pathogens through pattern recognition receptors (PRRs), rapidly activating the expression and signaling pathways of type I and type III interferons (IFN). This plays a core role in antiviral defense. Notably, viral infection profoundly reshapes the host cell's metabolic network, involving widespread alterations in carbohydrate, lipid, amino acid, and nucleotide metabolism. During this process, key metabolic products are released or generated. These are the products of metabolic reprogramming and important immune regulatory molecules that can directly or indirectly modulate the host's antiviral immune response, particularly the interferon pathway. These findings reveal that viral invasion, host metabolic reprogramming, and interferon-mediated antiviral immunity form a tightly intertwined, and dynamically interact a regulatory network of"virus-metabolism-IFN". This profoundly elucidates the underlying regulatory logic of the metabolic microenvironment in antiviral immunity. Understanding this mechanism offers new perspectives for diagnosis and treatment: targeting metabolic nodes or utilizing metabolic modulators, as well as combined strategies with IFN, and may become novel approaches for the prevention and treatment of upper respiratory viral diseases. This review focuses on the core role of IFN-mediated innate immunity in viral defense and its interactive regulation with metabolic reprogramming. It reviews the progress of studies on how metabolic products regulate the IFN pathway and antiviral responses through various mechanisms, and explores the potential clinical application prospects of metabolic regulation in local immune defense and the prevention and treatment of viral infections.

This study investigated key genes associated with both chronic obstructive pulmonary disease (COPD) and macrophage polarization or mitochondrial dysfunction, and explored their underlying mechanisms through bioinformatics analysis.

Data from GSE151052, GSE106986, and GSE171541 were utilized. Critical module genes linked to mitochondria-related genes (MRGs) and macrophage polarization-related genes (MPRGs) were identified via co-expression networks. Biomarkers for COPD were then screened using differential expression analysis, machine learning, and receiver operating characteristic (ROC) curves. A nomogram was developed to assess COPD risk. Additionally, immune infiltration, molecular regulation, and drug prediction analyses were conducted. Single-cell analysis in GSE171541 identified key cell types involved in COPD.

A series of analyses identified three COPD biomarkers-P2RY1, UBASH3B, and HMCN1-which exhibited strong discriminatory power between COPD and control samples. The nomogram effectively predicted COPD risk. Immune infiltration analysis revealed a strong positive correlation between UBASH3B and immature dendritic cells, while P2RY1 showed a strong negative correlation with eosinophils. Molecular regulation indicated that all three biomarkers were modulated by specific miRNAs and transcription factors. Nickel was identified as a potential drug co-predicted for the biomarkers. Single-cell analysis identified seven key cell types: macrophages, monocytes, T cells, AT2 cells, proliferating cells, endothelial cells, and stromal cells.

Three biomarkers associated with mitochondrial function and macrophage polarization were identified in COPD through bioinformatics analysis. These biomarkers offer potential for enhancing COPD diagnosis and treatment, and provide insights into the molecular mechanisms underlying the disease.