OBJECTIVE To describe the epidemiology of nosocomial infections in children′s hospital.METHODS We performed a prospective and retrospective analysis to determine the prevalence of nosocomial infection.Data were collected from 2000 to 2007 in hospitalized cases.RESULTS The incidence of nosocomial infections was 3.43%,from then 40.27% were upper respiratory infections,28.94% of gastrointestinal infections,and 17.61%% bronchitis and pneumonia.The incidence had a tendency decreaseing P

Objective To investigate the prevalence of healthcare-associated infection(HAI)in a children's spe-cialty hospital in Guangzhou in 2014.Methods A cross-sectional survey was undertaken to investigate the preva-lence of HAI among all hospitalized patients on September 17,2014.Results A total of 997 patients were investiga-ted,30 patients developed 32 times of HAI,HAI rate and HAI case rate were 3.01% and 3.21% respectively. The main infection sites were upper respiratory tract(n= 11,34.38% );the departments with higher HAI prevalence rates were intensive care unit(ICU,3 .99% )and pediatric internal medicine department(3 .60% );the rate of etio-logical examination in patients with HAI accounted for 93 .33% ,a total of 24 strains of pathogens were isolated,6 of which were virus (25 . 00% ),6 were fungi (25 . 00% ),11 were bacteria (45 . 83% ),and 1 was Chlamydia (4.17% ). The main bacteria were Staphylococcusaureus (n= 3,27.27% )and Staphylococcusepidermidis (n= 3, 27.27% );a total of 451 (45.24% )patients received antimicrobial agents on the investigation day,67.41% of whom received therapeutic use of antimicrobial agents,19.73% received prophylactic use,and 12.86% received both therapeutic and prophylactic use;mono-drug application accounted for 82 .26% ,the percentage of bacterial de-tection among patients with therapeutic antimicrobial use (including combination of therapeutic and prophylactic use)was 82.60% .Conclusion Management of key departments and key sites of HAI should be strengthened in children's specialty hospital,antimicrobial agents should be used rationally,so as to protect the safety of children.

Objective: To study therapeutic effects of simvastatin on vascular endothelial cell dysfunction in patients with coronary heart disease (CHD). Methods: According to LDL-C level, a total of 90 CHD patients were divided into simvastatin 20mg group (n=37, LDL-C≥2.5mmol/L), simvastatin 10mg group (n=35, 1.8mmol/L≤LDL-C<2.5mmol/L) and routine treatment group (n=18, LDL-C<1.8mmol/L). Their course of treatment was 8 weeks. Color Doppler ultrasound diagnostic instrument was used to measure flow-mediated dilation of brachial artery (FMD), and nitrate reductase method was used to measure concentration of nitric oxide (NO) in all CHD patients. Serum concentrations of TC, TG, LDL-C and HDL-C were routinely measured. Results: After treatment of eight weeks, compared with before treatment, there were significant decrease in concentrations of TC, TG and LDL-C (P<0.05 all), and significant increase in HDL-C level (P<0.05 all) in simvastatin 20mg and 10mg group, but there were no significant difference in above-mentioned all indexes between simvastatin 20mg and 10mg groups, P>0.05 all; Compared with routine treatment group, there were significant improvement in FMD [(6.01±0.49)% vs. (9.01±0.39)% vs. (9.01±0.47)%，P<0.01 all] and significant increase in serum NO concentration [(38.97±8.89)μmol/L vs. (47.67±10.89) μmol/L vs. (45.61±9.09) μmol/L，P<0.05 all] in simvastatin 20mg and 10mg group; But there were also no significant difference in serum NO and FMD between simvastatin 20mg and 10mg groups, P>0.05 all. Conclusion: Simvastatin can increase NO concentration and improve vascular endothelial cell dysfunction in CHD patients. Its mechanism may be related with lipid-lowering effect, but independent of its lipid-lowering effect

AIM: To quest the relationship bwteen BDNF and seizures. METHODS: BDNF and other correlative proteins in the hippocampus of audioepileptic rat (P77PMC) have been detected by immunohistochemistry at different stages of seizures including quiet stage, preconvulsive stage, convulsive stage and postconvulsive stage. Wistar rats were served as controls. RESULTS: At quiet stage, the BDNF in the hippocampus of P77PMC were less than that of control group and stepped up after stimulation, trkB in the hippocampus of P77PMC were high at every stages, but PY20 were increased only after stimulation. NPY in the hippocampus of P77PMC were in a low level before seizures. CONCLUSION: The endogenetic BDNF may alter the excitement of P77PMC by adjusting the expression of NPY in hippocampus and activating its receptor trkB.

Objective To investigate the changes of protein and energy intakes and the z-score of weight for age in appropriate for gestational age (AGA) and small for gestational age (SGA) preterm infants with gestational age less than 34 weeks. Methods The data from 314 hospitalized premature infants ( 268 cases of AGA and 46 cases of SGA) during January 2012 to December 2014 were retrospectively collected. The intakes of protein and energy and the changes of weight within 2 weeks after birth were compared. Results Compared with AGA group, the hospital stays, durations of parenteral and enteral nutrition and total enteral nutrition, and time to achieve full dose feeding were signiifcantly longer in SGA group (P?

Objective: To explore the relative risks of rotavirus diarrhea after exposure to different levels of atmospheric pressure in children in Guangzhou City, so as to provide reference for improving public awareness of high atmospheric pressure exposure. Methods: The study used the China Notifiable Communicable Diseases Network System and China Meteorological Science Data Sharing Service Network to collect meteorological data and data relating to daily cases of rotavirus diarrhea in children at Guangzhou Women and Children s Medical Center from 2012 to 2020. The association between rotavirus diarrhea and atmospheric pressure was analyzed using distributed lag non linear models (DLNM). The relative risks of different sex and age sub groups exposed to different atmospheric pressures were also evaluated. Results: A total of 18 587 cases of rotavirus diarrhea were reported from 2012 to 2020, among which 11 662 cases (62.7%) were boys, and 12 582 cases (67.7%) were children aged 6 to 24 months old, which represented the highest proportion. The results of the DLNM showed that the relative risk of rotavirus diarrhea was the highest on the day of exposure to extreme high atmospheric pressure ( RR =1.50, 95% CI =1.24-1.82, P <0.05) and the effect could last for 28 days. Risk of rotavirus diarrhea was low for exposure to low pressure within 2 weeks ( P <0.05). During extremely high atmospheric pressure weather, RR was higher in girls ( RR =3.31, 95% CI =1.46-7.49， P <0.05) than that in boys ( RR =1.98, 95% CI =0.96-4.07， P >0.05). Among different age sub groups, RR was the highest in children aged 24 to 60 months after exposure to the highest level of atmospheric pressure exposure ( RR =3.36, 95% CI =1.27-8.89, P <0.05). Conclusion In Guangzhou, exposure to high pressure increases the risk of rotavirus diarrhea in children. In the future, public awareness should be raised regarding the risk after exposure to high atmospheric pressure.

Objective To study the dynamic changes of blood carnitine and acylcarnitine levels in preterm infants during parenteral and enteral nutritional support,and the relationship between carnitine status and nutritional patterns,gestational age (GA) and weight gain.Method From January 2017 to December 2017,preterm infants admitted to the neonatal intensive care unit (NICU) within 24 hours after birth and received parenteral nutrition support were enrolled.They were assigned into 4 groups according to their GA:ultra-premature infants (＜ 28 weeks),very premature infants (28 ～ 31 weeks),mid premature infants (32 ～ 33 weeks) and late premature infants (34 ～ 36 weeks).They were assigned into 2 groups according to their average daily weight gain:＜ 15 g/(kg · d) group and ≥15 g/(kg · d) group.Blood samples were collected and examined as dried-blood spot specimens on filter paper for four times:after born,given total parenteral nutrition,given enteral combined parenteral nutrition,and given total parenteral nutrition.The concentrations of free carnitine and acylcarnitine were detected using liquid chromatographytandem mass spectrometry (LC-MS/MS).SPSS 21.0 statistical software was used for statistical analysis.Result A total of 124 preterm infants and 410 samples were collected.As the infants experienced gradual transition from parenteral nutrition to enteral nutrition,the free carnitine and most acylcarnitines levels were decreasing (C3,C4,C10DC,C12,C12∶1,C12DC,C14,C16,C16∶ 1,C16-OH and C18,P＜0.05).Preterm infants with small GA showed higher levels of C4-OH (P =0.001) and C5 (P =0.001).Preterm infants with lower velocity of weight gain showed lower concentration of C5-OH (P =0.006) in the early postnatal period.Conclusion Free carnitine and acylcarnitine in preterm infants during the early postnatal period are decreasing with the transition from parenteral nutrition to enteral nutrition,indicating that the exogenous nutrition is relatively insufficient.C4-OH and C5 levels are negatively correlated with GA.In addition,lower level of C5-OH may indicate slow weight gain during the early postnatal period.

Objective:To investigate the prognostic factors of differentiated thyroid cancer (DTC) patients with positive thyroglobulin antibody (TgAb) and varying ages after operation and 131I treatment. To explore the value of TgAb level and its change in the prognosis of DTC patients. Methods:Clinical data of 131 TgAb positive DTC patients were retrospectively analyzed. According to age, they were divided into young group(age<55 years, n=95) and elder group (age≥55 years, n=36). According to response, it was divided into excellent response group (110 cases) and non-excellent response group (21 cases). χ2 test and t test were used to compare the clinicopathological features between excellent response group and non-excellent response group. By logistic regression analysis, the independent risk factors affecting the prognosis of patients were analyzed. The receiver operating characteristic curve was used to determine the TgAb value of persistent or recurrent DTC, and the Kaplan-Meier regression curve was used to analyze the time of TgAb becoming negative. P<0.05 was statistically significant. Results:In young patients, the higher serum TgAb level before 131I treatment and the lateral lymph node metastasis were the independent influencing factors of poor prognosis [ OR=0.89(95% CI 0.83-0.95), OR=0.15(95% CI 0.05-0.52); both P<0.05]. In elder group, extraglandular invasion and higher serum TgAb before 131I treatment were associated with poorer prognosis [ OR=0.05(95% CI 0-0.83), OR=0.91(95% CI 0.76-1.13); P<0.05]. The serum TgAb thresholds for predicting DTC persistence/recurrence were 315.5 IU/mL(246.0 IU/mL in the young group and 516.5 IU/mL in the elder group). The mean time TgAb sera turned negative was (26.37±2.22) months [(23.28±2.37) months for young group and (32.64±4.07) months for elder group]. The TgAb decreased >50% in one year of the patients who had a lower probability of disease persistence/recurrence than the group without ( P<0.05). Conclusions:The high level of serum TgAb before 131I treatment and lateral lymph node metastasis were independent factors of poor prognosis in young patients, while in elder patients, extraglandular tumor invasion and the high level of serum TgAb before 131I treatment were independent factors of poor prognosis. The rate of TgAb change one year after treatment may be used as an early marker for predicting the disease status of TgAb positive patients.

Objective:To analyze the short-term effect of targeted drugs on quality of life in patients with radioactive iodine-refractory differentiated thyroid cancer (RAIR-DTC).Methods:From February 2020 to April 2022, 19 RAIR-DTC patients (10 males, 9 females; age (54.5±14.5) years) who received targeted drugs therapy (sorafenib, lenvatinib or anlotinib) in Tianjin Medical University General Hospital were prospectively enrolled. The thyroglobulin (Tg) levels prior and 1, 3, 6 months post the targeted treatment, and the adverse events were measured and recorded. Response evaluation criteria in solid tumors (RECIST) 1.1 version was used to evaluate the treatment response. The quality of life based on five-level EuroQol five-dimensional questionnaire (EQ-5D-5L) was monitored prior and 3 months post the targeted treatment, and the prevalence rates of mobility, self-care, usual activities, pain/discomfort, and anxiety/depression were analyzed, and the scores of health assessment were assessed. Paired t test, Kruskal-Wallis rank sum test and χ2 test were used to analyze data. Results:The prevalence rates of mobility (8/19), self-care (6/19), usual activities (10/19), pain/discomfort (10/19), and anxiety/depression (12/19) in 3 months post treatment were higher than those prior treatment (1/19, 1/19, 1/19, 2/19, 2/19; χ2 values: 4.38-11.31, all P<0.05). The score of health assessment prior treatment was (84.37±6.25), which was higher than that at 3 months post treatment (71.63±9.14; t=5.02, P=0.001). After targeted treatment, 10 patients were with skin toxicity, 8 patients were with hypertension, 8 patients were with weight loss, 7 patients were with diarrhea, 6 patients were with fatigue, 5 patients were with hepatic dysfunction, 2 patients were with proteinuria, 2 patients were with muscle pain and 1 patient was with oral ulcer. Of 19 patients, 17 insisted on continuing treatment, and the other two stopped treatment. The Tg levels at 1, 3 and 6 months post treatment were 56.26(44.60, 210.50), 53.36(41.25, 203.07) and 54.35(34.71, 223.52) mg/L, respectively, which were lower than the level prior treatment with no significant difference (110.16(49.63, 294.50) mg/L; H=2.42, P=0.490). After 3 months of targeted treatment, the progression-free survival (PFS) rate was 16/17, including 7 patients with partial response (PR), 9 patients with stable disease (SD), and 1 patient with progression of disease (PD). After 6 months of targeted treatment, the PFS rate was 10/17, including 5 patients with PR, 5 patients with SD, and 7 patients with PD. Conclusion:After 3-6 months of targeted treatment, the tumor markers of most patients are decreased with metastases improved, but the adverse events of targeted drugs have a great impact on quality of life in patients with RAIR-DTC.

Objective　To investigate the characteristics of video electroencephalogram （VEEG） in patients with dorsolateral frontal lobe epilepsy in order to improve the clinical diagnosis rate. Methods　Retrospective collection of VEEG in the Department of Neurology，the Sixth Affiliated Hospital of Xinjiang Medical University from October 2017 to October 2019，15 patients with dorsolateral frontal lobe epilepsy who had clinical attacks were analyzed. Results　All 15 patients with dorsolateral frontal lobe epilepsy had clinical seizures. Among them，10 were mainly with Simple Motor （SM） symptoms，and 5 were with SM and Complex Motor （CM） symptoms，such as chewing，Rhythmic tapping and "grasping" motions of upper limbs，"humming" sounds in the mouth，shaking his head repeatedly and so on. VEEG interictal period showed that epileptiform discharge was limited to 7 cases in frontal lobe，5 cases in ipsilateral temporal region and 3 cases in central region. VEEG onset period showed that 8 cases started with full conduction voltage drop，low amplitude fast activity in frontal region，and 7 cases started with θ or δ wave activity in frontal region. Conclusion　Dorsolateral frontal lobe epilepsy has special manifestations in clinical manifestations and EEG interictal or seizure stages，which need to attract clinical attention.