Bronchiolitis is the main cause of wheezing episodes in infants under 2 years old.Most of them are caused by virus infection.Most of the children with bronchiolitis can recover after clinical treatment, but some of them may have recurrent wheezing or even asthma.There are many risk factors and complicated pathogenesis of recurrent wheezing after bronchiolitis.Risk factors mainly include: susceptible gene, virus type infected in the first wheezing, atopy, exposure to school-age siblings, tobacco exposure, family history of asthma, increased specific IgE, high blood eosinophils count, etc.In this paper, the risk factors of recurrent wheezing after bronchiolitis are introduced as follows.

Objective:To explore the clinical features of Mycoplasma pneumoniae(MP)infection in children, and provide data support for the prevention and control of MP.Methods:In this study , a retrospective analysis was used to collect clinical data with respiratory tract infection from January 2018 to February 2022 in the Shenyang Children′s Hospital, and analyze the distribution characteristics of MP positive rate, season, age, sex.Results:In this study, the positive rate of MP was 17.12% (20 299/118 598), in 2018, 2019, 2020 and 2021 were 22.92% (7 732/33 738), 15.76% (5 736/36 388), 9.81% (1 313/13 379) and 16.60% (4 954/29 849) respectively.The highest positive rates of MP in 2018 and 2019 were 27.72% (1 809/6 527) and 23.45% (1 519/6 478) in summer, respectively, 2020 was spring (19.13%, 216/1 129) and 2021 was autumn (20.09%, 1 665/8 287).The MP positive rates of infancy, early childhood, preschool age and school age were 5.89% (605/10 265), 14.35% (4 639/32 333), 18.51% (10 961/59 203) and 24.37% (4 094/16 798), and MP positive rate increased with age, the difference was statistically significant ( χ2=1 790.971, P<0.05).The positive rate of boys was 14.70% (9 586/65 206), while that of girls was 20.06% (10 713/53 392), the difference was statistically significant ( χ2=594.937, P<0.05). Conclusion:MP can occur all years round, mainly in summer and autumn.Girls are susceptible, especially common in school-age and pre-school children.Prevention and control measures should be taken as soon as possible for susceptible individuals to reduce the infection rate of MP.

Objective To evaluate the clinical value of magnetic resonance imaging in the diagnosis of complex anal fistula. Methods 80 patients with complex anal fistula were selected,and they were randomly divided into observation group(n=40) and control group(n=40) according to the digital table. The control group was treated according to the clinical experience of the physician,after the anus-related examination,combined with intraoperative methylene blue staining guidelines for surgical treatment. The observation group received the magnetic resonance imaging before operation,followed by the same steps as the control group. The number and accuracy of the anorectal fistula were compared between the two groups. The complication rate,the number of reoperation and the recurrence rate were analyzed. Results The number of incisors in the anal fistula in the observation group was (2. 1 ± 0. 2), which was significantly higher than (1.5 ±0.1) in the control group (t=16.971,P<0.05). The accuracy rate of anal mouth in the observation group was 95. 0%,which was significantly higher than 52. 5% in the control group (χ2 =16.529,P<0.05).Thepostoperativehealingtimeoftheobservationgroupwas(12.7±2.1)days,whichwas significantly shorter than (16. 7 ± 2. 5) days of the control group(t =8. 523,P <0. 05). The incidence rate of bleeding,infection,anal leakage and anal fecal in the observation group was 5. 0%,which was significantly lower than 30. 0% in the control group (χ2 =7. 013,P<0. 05). And the rate of reoperation of the observation group was 2. 5%, which was significantly lower than 22. 5% of the control group(χ2 =5. 600,P <0. 05). Conclusion For anal fistula, especially complex anal fistula, magnetic resonance imaging before operation can effectively clear the distribution of fistula, provide effective guidance to surgical treatment, thereby improving the surgical results and reduce surgical complications.

Objective:To explore the risk factors of recurrent wheezing in infants after bronchiolitis, and to study the influence of different risk factors on recurrent wheezing, so as to provide strategies for clinical treatment and prevention.Methods:Four hundred and ninety-two patients with bronchiolitis in Department of Respiratory Pediatrics, Shengjing Hospital of China Medical University from January 2016 to December 2018 were selected and divided into wheezing group(147 cases)and non wheezing group(345 cases)according to the recurrence of wheezing after bronchiolitis.The data of the selected cases were collected, the risk factors were analyzed and the incidence of recurrent wheezing in patients with different risk factors for bronchiolitis was calculated.Results:In this study, 492 children with bronchiolitis were included, 147 cases(29.9%)had recurrent wheezing.There were significant differences in breastfeeding, artificial feeding, history of eczema, positive allergens reported by parents, family history of asthma, parents suffering from allergic disease, smoke exposure and severe illness between wheezing group and non wheezing group( P<0.05). Logistic regression analysis showed that the risk factors of wheezing after bronchiolitis were severe illness, positive allergens reported by parents, parents suffering from allergic disease, smoke exposure( P<0.05). Patients with one of these risk factors for bronchiolitis had a 16.7%~48.3% chance of recurrent wheezing.Patients with two of these risk factors for bronchiolitis had a 33.3%~100% chance of recurrent wheezing.Patients with three of these risk factors for bronchiolitis had a 50%~100% chance of recurrent wheezing.Patients with bronchiolitis with all four risk factors had a recurrent wheezing rate of 100%. Conclusion:The recurrent wheezing rate of infants with bronchiolitis was at a high level.The risk factors of wheezing after bronchiolitis were severe illness, positive allergen reported by parents, parents suffering from allergic disease and smoke exposure.The more risk factors, the higher probability of wheezing after bronchiolitis.

This study was aimed to observe the effect of Yue-Ju Bao-He (YJBH) pill and simvastatin on the reversal of myocardial fibrosis induced by atherosclerosis (AS).ApoE-/-mice were fed on high fat diet to establish models of atherosclerotic plaque and myocardial fibrosis.YJBH pill and simvastatin were used alone or in combination as interventions.Control groups of high fat diet as well as normal diet were observed.Serum lipid and vascular angiotensin Ⅱ (Ang Ⅱ),matrix metalloproteinase-1 (MMP-1) were measured by Elisa.Quantitative analysis of collagen volume fraction (CVF) was conducted by myocardial tissue Masson staining.High-throughput transcriptome sequencing analysis was also adapted to detect differentially expressed genes in myocardial tissues of each group.The results showed that compared with single usage,YJBH pill combined with simvastatin can effectively reduce the total cholesterol (TC),triglyceride (TG),low density lipoprotein (LDL-C) and Ang Ⅱ,increase high density lipoprotein (HDL-C),MMP-1,while Masson staining CVF value was also significantly decreased.Compared with the control group of normal diet,the analysis results from high-throughput transcriptome sequencing analysis showed that difference of gene expression of YJBH pill combined with simvastatin group was mainly in fatty acid metabolism,extend and degradation related pathways,and compared with the model group,the difference of gene expression was mainly in primary immunodeficiency and intestinal immune network IgA production pathways.It was concluded that the combined therapy of YJBH pill and simvastatin can effectively reverse the AS induced myocardial fibrosis.Its mechanism is related to the regulation of immune inflammatory reaction.

OBJECTIVETo observe the effects of electroacupuncture (EA) on postoperative cognitive dysfunction (POCD) and AngⅡ/AT1R in the hippocampus in D-galactose-induced aging rats which received hepalobectomy, and to explore the possible mechanism of EA on POCD.

METHODSEighty male Sprague-Dawley rats were randomly divided into a young control group (10 rats), a D-Galactose-induced aged (Da) group (10 rats), a Da+hepatolobectomy group (30 rats) and an EA group (30 rats). The rats in the Da+hepatolobectomy group and EA group were further randomly divided into a 1 d subgroup, 3 d subgroup and a 7 d subgroup, 10 rats in each subgroup. The rats in the EA group were treated with EA at "Baihui" (GV 20) and "Dazhui" (GV 14) with continuous wave (15 Hz in frequency and 1 mA in intensity), and rats in each subgroup were treated for 1 d, 3 d and 7 d, respectively. The rats in the remaining groups were treated with immobilization, once a day. The Y-maze was used to observe the behavior change of rats, and ELISA was applied to measure the level of hippocampal AngⅡ, and RT-PCR and immunohistochemistry method were performed to detect AT1R mRNA expressions and AT1R positive expression in the hippocampus.

RESULTSThe number of rat initiative avoidance in the Da group was significantly less than that in the young control group (<0.05), and the mRNA expression and positive percentage of AT1R in the hippocampus in the Da group were significantly higher than those in the young control group (both<0.01). Compared with the Da group, the number of rat initiative avoidance in each subgroup of Da+hepatolobectomy group and EA group were significantly reduced (all<0.01), and the expression of AngⅡ, AT1R mRNA and AT1R positive cells percentage in the hippocampus were significantly increased (<0.05,<0.01). The number of rat initiative avoidance in each subgroup of EA group was higher than that in the subgroup of Da+hepatolobectomy group (<0.05,<0.01); and the expression of AngⅡ, AT1R mRNA, and AT1R positive percentage in the EA group were significantly less than that in the Da+hepatolobectomy group (<0.05,<0.01).

CONCLUSIONSEA at "Baihui" (GV 20) and "Dazhui" (GV 14) could improve POCD in D-galactose-induced aging rats which received hepalobectomy, and it is likely to be related with the inhibition of AngⅡ, AT1R positive expression and AT1R mRNA in the hippocampus.

Objective: To investigate the effect of hypertensive disorder complicating pregnancy (HDCP) on the mortality and early complications of premature infants. Methods: The general clinical data of preterm infants with gestational age 24-36^{+ 6} weeks were collected from the cooperative units in the task group from January 1, 2013 to December 31, 2014.According to the severity of HDCP, the infants were divided into 4 groups: HDCP group, preeclampsia group, eclampsia group and non HDCP group, the mortality and major complications of preterm infants were compared, and the influencing factors were analyzed. Results: The mortality rate of preterm in the HDCP group was significantly higher than that of non HDCP group, and there was statistical significance (χ²=9.970, P=0.019). Eclampsia had a highest fatality rate (4.8%) in the early stage, compared with non HDCP group (2.2%), and the difference was statistically significant.Comparison of HDCP group (1.8%) and eclampsia group (3.2%) suggested that there was no statistically significant difference.The incidence of respiratory distress syndrome (RDS) in preterm in HDCP group was significantly higher than that of non HDCP group, and there was statistical significance (χ²=13.241, P=0.004). Eclampsia group showed the highest incidence (35.4%), compared with non HDCP group (16.2%), the difference was statistically significant, but compared with HDCP group (19.9%), preeclampsia group (17.1%), there was no significant diffe-rence.The incidence of bronchopulmonary dysplasia (BPD) in preterm in HDCP group was significantly higher than that of non HDCP group (χ²=9.592, P=0.022), the highest incidence showed up in eclampsia group (9.7%), compared with non HDCP group (2.0%) and HDCP group (1.7%), the difference was statistically significant.But there was no statistically significant difference, compared with preeclampsia group.As the degree of HDCP aggravated, the incidence of BPD gradually rose.There was no significant impact on necrotizing enterocolitis (NEC), retinopathy of prematurity (ROP), intraventricular hemorrhage (IVH) and sepsis of HDCP (χ²=7.054, 7.214, 0.358, 3.852; P=0.070, 0.065, 0.949, 0.278). Considering the overall outcome of the child, that was, whether the child died or survived, he had at least one complication, and HDCP had an effect on it (χ²=15.697, P=0.001), so the incidence increased while the degree of HDCP rose gradually.After adjusting gestational age, birth weight, sex, way of delivery, placental abruption and front placenta, prenatal hormonal, gestational diabetes, neonatal asphyxia and other factors, the results displayed that HDCP was the factor leading to the death of premature baby (OR=2.159, 95%CI: 1.093-4.266), and comparison between preeclampsia and eclampsia showed no statistical difference (P=0.714, 0.389); HDCP had no significant influence on RDS, BDP, ICH, NEC, ROP and sepsis. Conclusions HDCP leads to increased risk of premature death, but also leads to the increased incidence of RDS and BPD, but it had no obvious effect on NEC, ROP, IVH, sepsis and other complications.