Objective To analyze the clinical distribution and drug resistance of Pseudomonas aeruginosa (PAE) isolated from the samples to provide the guidance for the clinician′s medication .Methods The VITEC‐2 Compact system automatic bacterial i‐dentification and drug susceptibility analyzer was adopted to identify the isolated bacteria and conduct the drug sensitivity test ,the data were processed by the WHONET 5 .6 software .The PAE detection situation from the submitted specimens ,source and drug resistance were performed the retrospective analysis .Results The detected PAE strains were mainly isolated from the lower respir‐atory tract specimens ,accounting for 85 % of the submitted specimens ;the resistance rate to aztreonam ,amikacin ,ciprofloxacin , meropenem ,piperacillin/tazobactam ,piperacillin ,gentamicin ,cefepime ,ceftazidime ,tobramycin ,imipenem and levofloxacin showed the declining trend year by year .Except the resistant rate of aztreonam was 28 .2% in 2013 ,which of other antibiotics were at about 10% .Conclusion PAE infection is mainly in the respiratory tract ,its rug resistances should be timely and reasonably monitored to provide the basis for clinical medication .

Objective Pleural effusion of patients with tuberculous pleurisy was analyzed by ultra high performance liquid chromatography-mass spectrometry (UPLC-MS).Orthogonal partial least squares discriminant analysis (OPLS-DA) model was established for searching and analyzing the potential metabolic biomarkers to provide new ideas for the early diagnosis of tuberculosis pleurisy.Methods Totally 166 cases of pleural samples were collected from November 2012 to September 2013 in Tianjin Haihe Hospital (tuberculosis pleurisy 83 cases,bacterial pleurisy 31 cases,lung cancer 30 cases and heart failure 22 cases)and metabonomics quantitative analysis was conducted.Quantitative analysis of metabolic methods was enrolled.Orthogonal partial least squares discriminant analysis (OPLS-DA) model was constructed by the pattern recognition method.Based on the OPLS-DA model,potential biomarkers was filtered preliminary by variable importance in the projection (VIP) and VIP confidence interval value.The specific metabolites were determined by applying non-parametric test(Kruskal-Wallis H test)by using SPSS 17.0,and potential metabolic biomarkers were screened.Results The prediction accuracy of OPLS-DA model was 100％ (38/38),which illustrated that the model could verify the tuberculous pleurisy group and the control group accurately.Based on the data of metabolites,46 potential metabolites were finally screened and 5 metabolites were identified with statistically significant differences (P ＜ 0.05).The data of tuberculosis pleurisy group showed a significant increase in 17a,20a-Dihydroxy cholesteryl,phospholipid [20∶4 (8Z,11Z,14z,17Z)] (1 188 670.00),tocotrienols (1 051 760.00) and phospholipid(O-18:0) (434 394.00) compared with the lung cancer group(735 615.00,336 815.00,324 563.00,193 055.00),bacterial pleurisy group (1 678 805.00,598 256.50,699 384.00,343 866.00),and heart failure group(535 842.00,253 503.00,234 503.00,130 185.00) (H =26.787,18.680,26.193,21.024,P ＜0.01),and a significant decrease in L-phenylalanine(245 976.00)compared with the lung cancer group(753 033.50),bacterial pleurisy group (357 278.00),and heart failure group(586 678.00) (H =13.635,P ＜ 0.01).Conclusions The OPLSDA model constructed on the basic of UPLC-MS technology platform can verify the tuberculous pleurisy group and the control group accurately,and the study provides new ideas and methods for identifying features of tuberculous pleurisy markers and early diagnosis.

Objective To analyze the clinical characteristics of severe retinopathy of prematurity (ROP) in extremely low birth weight infants (ELBWI),and to evaluate the management model of ROP screening of ELBWI and the clinical effects and treatment timing of photocoagulation with intravitreous injection of vascular endothelial growth factor inhibitor (Avastin).Methods Forty-five cases of ELBWI (birth weight ＜ 1000 g) survived finally in our neonatal intensive care unit from July 1,2004 to June 30,2011 were reviewed.ROP screening was regularly performed in 4 ～ 6 weeks postpartum with binocular indirect funduscope by ophthalmologists.Newborns with severe ROP were treated with laser photocoagulation in the fundus.Some newborns that developed aggressive posterior ROP(APROP) were treated with combined intravitreous injection of Avastin and photocoagulation.Results Thirteen of 45 cases (28.89％) had not developed to ROP finally.Six cases (13.33％) developed to stage 1 ～ 2 ROP and then spontaneous recovery during the follow-up period.Twenty-six newborns (57.78％) developed to severe aggressive posterior ROP (APROP) and need to be treated with photocoagulation.All 3 APROP infants (6.67％) were received intravitreous Avastin injection prior to photocoagulation.The visual acuity of all 45 patients (100％) in this study was preserved.Conclusion ELBWI have a higher morbidity of severe ROP.Timely screening and intervention are effective to prevent disease progression.Intravitreous Avastin injection prior to photocoagulation may be necessary to preserve the visual acuity of infants with APROP.Respiratory management is the key for post-operation care.

Objective:To explore the mechanism of follicular helper T (Tfh) cells, i.e. CD4 +CXCR5 +T cells, and the secreted cytokine programmed death factor 1 (PD-1) in the pathogenesis of tuberculosis, and to explore the significance of Tfh cells and PD-1 in the treatment of tuberculosis. Methods:Flow cytometry was used to detect the changes of Tfh cells and PD-1 in mononuclear cells during the treatment cycle of tuberculosis.Results:Before treatments, the ratio of Tfh cells/CD4 +T cells in peripheral blood mononuclear cells in the pulmonary tuberculosis group was 3.37%±0.45%, which was significantly higher than 2.21%±0.47% of the healthy control group ( P<0.01), and significantly higher than 2.39%±0.38% after treatments ( P<0.01). Before treatments, the ratio of CD4 +CXCR5 +PD-1 +T cells/Tfh cells in the peripheral blood of the tuberculosis group was 25.33%±10.08%, which was significantly higher than 8.42%±2.31% of the healthy control group ( P<0.01), and significantly higher than 11.35%±2.65% after treatments ( P<0.01). After treatments, the levels of Tfh cells and PD-1 in the sputum smear-negative group and the sputum smear-negative group were lower than that before treatments, and the difference between the groups was statistically significant (all P<0.05). Conclusions:The levels of Tfh cells and PD-1 in patients with tuberculosis are significantly higher than those in healthy people, and after drug treatment, the levels of both can be reduced. With the prolongation of the treatment cycle, the sputum smear-transforming group and the non-negative group began to show significant differences. In the course of pulmonary tuberculosis, monitoring changes in Tfh cells and PD-1 levels is helpful for the diagnosis of tuberculosis, and has certain guiding significance for its treatment and outcome.

Objective:To determine the value of ultrasonographic measurement of submental soft tissue distance in predicting poor ventilation with laryngeal mask airway (LMA).Methods:A total of 272 American Society of Anesthesiologists physical status Ⅰ or Ⅱ patients, aged 25-78 yr, weighing 40-85 kg, with mechanical ventilation time 30-120 min, scheduled for elective lower limb vascular surgery or lithotripsy under general anesthesia with LMA, were selected.The parameters of submental soft tissue of tongue thickness (TT), distance from skin to the hyoid bone (DSHB), distance from skin to epiglottis midway (DSEM) and distance from skin to anterior commissure of the vocal cords (DSAC) were measured using ultrasonography before operation.The type of LMA was chosen according to the instruction book.The development of failure of LMA placement at the first attempt, air leakage around LMA cuff during mechanical ventilation, peak airway pressure >20 cmH 2O and gastric insufflation detected by ultrasonography were recorded.The development of one or more adverse events mentioned above was considered to be poor ventilation.The patients were divided into normal ventilation group (N group) and poor ventilation group (P group) according to whether poor ventilation occurred.The receiver operating characteristic curve for ultrasonographic measurement of submental soft tissue distance in predicting poor ventilation with LMA was drawn, and the area under the curve (AUC) and 95% confidence interval (CI), sensitivity and specificity and cut-off value were calculated.The risk factors of which P values were less than 0.05 would enter the logistic regression analysis to stratify the risk factors for poor ventilation with LMA. Results:The AUC for TT, DSHB, DSEM and DSAC measured using ultrasonography in predicting poor ventilation with LMA (95%CI) was 0.866 (0.813-0.919), 0.755 (0.683-0.827), 0.835 (0.772-0.899) and 0.705 (0.628-0.782) ( P<0.05 or 0.01), respectively.The results of logistic regression analysis showed that TT≥6.140 cm, DSHB≥1.145 cm, DSEM≥2.175 cm and DSAC≥1.075 cm were risks factor for poor ventilation with LMA. Conclusion:Ultrasonographic measurement of TT, DSHB, DSEM and DSAC can predict the development of poor ventilation with LMA.

Objective:To explore the application and treatment efficacy of less invasive surfactant administration (LISA) and nasal high-frequency oscillation ventilation (nHFOV) in very low and extremely low birth weight preterm infants with neonatal respiratory distress syndrome (NRDS).Methods:A total of 85 very low and extremely low birth weight preterm infants with gestational age ranging between 27-32 weeks who were diagnosed with NRDS in the Second Affiliated Hospital of Zhengzhou University from July 2018 to October 2019 were enrolled.After being stratified by gestational age of >27-29 weeks, >29-30 weeks, >30-31 weeks, >31-32 weeks, the neonates were divided into the LISA group (40 cases) and the intubation-surfactant-extubation (INSURE) group (45 cases) by the random envelope method.The LISA group was subdivided into the continuous positive airway pressure (CPAP) group (25 cases) and the nHFOV group (15 cases) by the same method.The patients in the INSURE group were infused with pulmonary surfactant (PS) through the endotracheal tube under positive airway pressure, and then treated with CPAP after extubation.The patients in the LISA group were first treated with CPAP and injected with PS through the gastric tube.After removing the gastric tube, the patients in the CPAP group were given CPAP-assisted ventilation, while the patients in the nHFOV group were given nHFOV-assisted ventilation or mechanical ventilation if nHFOV-assisted ventilation failed.The feasibility of LISA technology and nHFOV was observed, and the adverse reactions, mechanical ventilation, oxygen duration, hospital stay and the incidence of NRDS complications in different groups of the patients were compared.Results:(1) The mechanical ventilation rate (5.0% vs.22.2%), the incidence of broncho-pulmonary dysplasia (BPD) (20.0% vs.42.2%) and the incidence of periventricular leukomalacia (PVL) (12.5% vs.42.2%) in the LISA group were significantly lower than those in the INSURE group (all P<0.05). There were no statistically significant differences in total oxygen duration, hospitalization duration, intraventricular he-morrhage (IVH), retinopathy of prematurity (ROP), and necrotizing enterocolitis (NEC) between the LISA group and the INSURE group (all P>0.05). (2) There was no significant difference in adverse reactions between the LISA group and the INSURE group as well as between the CPAP group and the nHFOV group (all P>0.05). (3) The younger the gestational age at birth, the higher the incidence of NRDS complications.Patients in the LISA group had a lower incidence of NPDS complications than patients of the same gestational age in the INSURE group, but the diffe-rence was not statistically significant (all P>0.05). (4) There was no significant difference in the mechanical ventilation rate and the incidence of BPD, IVH, PVL, NEC and ROP complications between the CPAP group and the nHFOV group (all P>0.05). Conclusions:In the treatment of very low and extremely low birth weight preterm infants with NRDS at the gestational age of 27-32 weeks, LISA technology is a safe and effective PS delivery method, which can reduce the mechanical ventilation rate and the incidence of BPD and PVL.The nHFOV can be used as an initial model for respiratory support of NRDS preterm infants with very low and ultra-low birth weight.LISA combined with nHFOV is applicable to the treatment of preterm infants with NRDS.

Objective: To determine the association between physical health fitness with Chinese reading ability of schoolaged children, so as to provide evidence for improving children s reading ability. Methods: A questionnaire survey was conducted among 1 923 school aged children in grades 2-6 in a primary school in Wuhan, Hubei Province, China. The questionnaire included basic demographic information and Dyslexia Checklist for Chinese Children and the Pupil Rating Scale Revised Screening. At the same time, participants underwent physical fitness tests which included an assessment of height, weight, and lung capacity, as well as a 50 meter run, sit forward bend, one minute skipping rope task, sit ups, and a 50 × 8 round trip. Results: A total of 59 children were identified with dyslexia. Normal children achieved higher scores than children with dyslexia in the total physical health score, as well as the one minute skipping rope score, one minute sit up score, and sitting forward score ( P <0.05). Multiple linear regression analyses showed that the reading ability of girls was higher than that of boys ( β =-3.04, P <0.01), and the children who regularly participated in more intense physical activity and who had higher fitness scores had a higher reading ability ( β =-1.68, -0.08, P <0.01). Children s reading ability increased significantly with parental educational level( P <0.05). Conclusion Gender, parents education level, physical exercise intensity, and children s physical fitness were identified as influencing factors of school age children s reading ability. A positive correlation was found between children s physical health level and reading ability.

Objective To analyze the literatures about artificial intelligence in cancer research in Web of Science (WOS) core collection database in 2010-2019 and summarize research hot spots and development trends. Methods Through bibliometrics methods and CiteSpace information visualization software, we applied the visual analysis of relevant literature on artificial intelligence in the field of cancer research retrieved from the Web of Science core collection database from 2010 to 2019. Results The number of published articles about artificial intelligence in the field of cancer research had been increasing year by year. The United States ranked first in the number of published articles in this field, the number of citations and cooperation capabilities. Although the number of published articles in China ranked the second, the number of citations was low. The hot spots of artificial intelligence in cancer research were mainly breast cancer and lung cancer. Machine learning, neural network and other methods were used to build models, which were used in basic cancer research, clinical diagnosis, treatment and prognosis prediction. The research frontiers were the methodological research of artificial intelligence, the research on the occurrence and classification of cancer and the research of protein in this field. Conclusion It will effectively promote the development of artificial intelligence in cancer research in China by learning the hot spots and cutting-edge technologies of international research, focusing on international cooperation and cooperation among national institutions and strengthening cross-disciplinary research.

Abstract Children were vulnerable groups in major public health emergencies. In 2020, the coronavirus disease 2019 (COVID-19) pandemic was widespread in the world. The mental health of school age children has become a worldwide concern. Herein, we conducted this review to evaluate the impact of COVID-19 on the mental health of general children and special children with a high risk of psychological problems, focusing on the prevalence of anxiety, depression, and post traumatic stress disorder among school age children in different countries and regions during the COVID-19 epidemic. Considering the susceptibility between individuals and the accessibility of social resources, we further explored the child, family, and social related factors affecting the mental health of school age children. Finally, some suggestions on the construction of children s mental health service system in major public health emergencies were put forward at the national, school family community, and individual levels. Building a safe and reliable child mental health protection network required the joint efforts of all sectors of society.

Objective: To examine the changes of depressive and anxiety symptoms in school aged children during home confinement and to identify possible influence of learning and lifestyle behaviors on mental health changes. Methods: The population of this study were obtained from the "Tongji Mental Health Cohort". Two primary schools in Wuhan were selected through cluster sampling and students in grade 2-5 were surveyed. This study was divided into two stages. In the first stage (T1=during home learning), a total of 2 588 valid questionnaires were collected. In the second phase (T2=during school learning), 2 424 children were followed up successfully. Combining the results of the depression and anxiety symptoms of the two surveys of children respectively to classify the children s psychological outcomes. Association between home learning and lifestyle behaviors with the change of psychological symptoms in school aged children were estimated by disordered multi classification Logistic regression. Results: The prevalence of depressive and anxiety symptoms were 28.9% and 21.0% in school aged children at T1, 35.6% and 30.6% at T2, respectively. The aggravation and persistence of depressive and anxiety symptoms in children were partly related to their home learning and lifestyle behaviors. Concentration in class（ OR=0.63，95%CI =0.45-0.89）, frequent interaction with teachers ( OR =0.74, 95% CI = 0.57- 0.95 ), participation in physical exercise at home ( OR =0.60, 95% CI =0.41-0.87) was negatively associated with depressive symptoms in children. Time spent on playing video games ( OR =1.15, 95% CI =1.06-1.24) and fear of infection with coronavirus disease 2019 ( OR =1.83, 95% CI =1.39-2.42) were positively associated with anxiety in children. Boys（ OR=0.70， 0.63 ） were more likely to suffer from depression and anxiety symptoms than girls. Conclusion The prevalence of depressive and anxiety symptoms among school aged children increased when they went back to school after home confinement, suggesting more attention are needed for mental health intervention among school aged children.