Objective:To understand the epidemiological and etiological characteristics of hand-foot-mouth disease (HFMD) in the Nanshan District of Shenzhen City from 2019 to 2022 and to provide a scientific basis for HFMD prevention in the area.Methods:Epidemiological data on HFMD in Shenzhen Nanshan District from 2019 to 2022 in the China Information System for Disease Control and Prevention were analyzed using descriptive research methods.Real-time reverse transcription polymerase chain reaction (RT-PCR) was used to analyze the etiology characteristics of clinical specimens from HFMD patients. The VP1 gene of the dominant pathogen coxsackievirus A6 (CV-A6) was amplified and sequenced. SepMan Pro of DNASTAR software was used for sequence assembly and MegAlign was used for nucleotide homology analysis.Results:A total of 13 195 HFMD cases were reported in Shenzhen Nanshan District from 2019 to 2022, with an average annual incidence rate of 186.18/100, 000. Summer and autumn are the main onset seasons and children under 7 years old were the main population, accounting for 93.1%. The male-to-female ratio is 1.44∶1. A total of 451 clinical HFMD specimens were detected in the laboratory, including 403 positive (87.36%) and 48 negative (10.64%). The main pathogens were CV-A6 (63.03%), coxsackievirus A16 (CV-A16) (27.79%), coxsackievirus A4 (CV-A4) (4.71%), coxsackievirus A10 (CV-A10) (1.99%), Echovirus 11 (Echo-11) (0.25%), and uncertain type accounted for 2.23%, with no detection for enterovirus71 (EV71) type. The nucleotide homology of the 13 CV-A6 strains ranged from 94.0%?99.6%, and the nucleotide homology with the prototype strain Gdula ranged 84.1%?85.8%. The results of phylogenetic tree showed that all 13 CV-A6 strains in Nanshan District were of the D3a genotype.Conclusions:FHFMD in Nanshan District of Shenzhen City in 2019-2022 shows obvious differences in population and time distribution. Therefore, it is necessary to strengthen publicity and education on HFMD prevention and control in the summer and fall seasons and among key populations. CV-A6 and CV-A16 are the dominant strains of HFMD in Nanshan District, Shenzhen in recent years, so the monitoring of the dominant strains should be improved.

Objective:To summarize the situation of dead newborns and their parents after parents gave up treatment, and analyze the reasons and emotional needs of parents who gave up treatment, so as to provide reference for reducing neonatal mortality and negative emotions of parents.Methods:A retrospective study was conducted to collect the data of neonates and mothers who died after giving up treatment reported in Hunan Children′s Hospital from January 2019 to December 2021. The general information, perinatal risk factors, and the incidence of in-hospital diseases were analyzed. Then, semi-structured interviews were conducted with parents of newborns who died after giving up treatment from February to December 2021. Understand why parents give up treatment and their emotional needs.Results:A total of 172 newborns died after giving up were included in the analysis, including 103 males (59.88%) and 74 premature infants (43.02%); Umbilical cord, placenta and amniotic fluid abnormalities were 21 cases (12.21%), 39 cases (22.67%) and 25 cases (14.53%), respectively. Birth asphyxia was 31 cases (18.02%), including severe asphyxia in 18 cases (10.46%); There were 21 (12.21%), 35 (20.35%) and 30 (17.44%) cases of maternal infection in the third trimester, hypertension in pregnancy and diabetes in pregnancy, respectively. The top three causes of death were septicemia (18.02%), congenital malformation (16.86%) and severe pneumonia (10.47%). The main reason why parents give up treatment was that the child′s disease was critical and irreversible, and parents had strong emotional needs for hospice care in their hearts.Conclusions:There are many high risk factors of perinatal death of newborns after giving up treatment. Sepsis is the primary cause of death, and strengthening perinatal health care is fundamental. Parents have a strong demand for hospice care, so it is of practical significance to implement family-centered hospice care model for such special newborns.

Pulmonary hypertension (PH) is an extremely malignant pulmonary vascular disease of unknown etiology. ADAR1 is an RNA editing enzyme that converts adenosine in RNA to inosine, thereby affecting RNA expression. However, the role of ADAR1 in PH development remains unclear. In the present study, we investigated the biological role and molecular mechanism of ADAR1 in PH pulmonary vascular remodeling. Overexpression of ADAR1 aggravated PH progression and promoted the proliferation of pulmonary artery smooth muscle cells (PASMCs). Conversely, inhibition of ADAR1 produced opposite effects. High-throughput whole transcriptome sequencing showed that ADAR1 was an important regulator of circRNAs in PH. CircCDK17 level was significantly lowered in the serum of PH patients. The effects of ADAR1 on cell cycle progression and proliferation were mediated by circCDK17. ADAR1 affects the stability of circCDK17 by mediating A-to-I modification at the A5 and A293 sites of circCDK17 to prevent it from m1A modification. We demonstrate for the first time that ADAR1 contributes to the PH development, at least partially, through m1A modification of circCDK17 and the subsequent PASMCs proliferation. Our study provides a novel therapeutic strategy for treatment of PH and the evidence for circCDK17 as a potential novel marker for the diagnosis of this disease.

Objective:To investigate the effect of biological maternal sounds on blood gas analysis index, mechanical ventilation time, oxygen therapy time and hospital stay in mechanically ventilated children with severe pneumonia.Methods:This study was a randomized controlled trial. From June 2020 to November 2020, 128 mechanically ventilated children with severe pneumonia in Hunan Children′s Hospital were selected by convenient sampling method and divided into four groups with 32 cases in each group by random number table method. Group A was given routine nursing care, group B was given mother sounds, group C was given mother cardiotone, group D was given biological maternal sounds. Data of blood gas analysis index, mechanical ventilation duration, oxygen therapy duration, hospital stays were collected for comparative analysis.Results:Finally, group A, B, C, and D included 28, 30, 28 and 28 cases, respectively. There was no statistically significant difference in PaO 2 among the four groups on the 1st to 2nd day after intervention ( P>0.05), but PaO 2 on the 3rd to 7th day after intervention were (75.57 ± 12.88), (77.71 ± 15.81), (78.21 ± 14.51), (78.64 ± 17.71), (79.04 ± 11.57) mmHg (1 mmHg=0.133 kPa), (81.71 ± 17.89), (82.93 ± 18.36), (82.68 ± 15.47), (83.25 ± 14.24), (83.77 ± 13.90) mmHg, (80.89 ± 18.78) (82.11 ± 13.34), (82.96 ± 14.20), (83.43 ± 14.37), (83.68 ± 12.64) mmHg, (84.54 ± 18.77), (86.29 ± 10.94), (86.96 ± 10.53), (87.46 ± 12.64), (89.08 ± 12.21) mmHg, with statistically significant differences ( F values were 41.17 - 332.68, all P<0.01). Further pairwise comparison revealed that PaO 2 in group B and group C were higher than those in group A on the 3rd to 7th day after intervention, while those in group D were higher on the 3rd to 7th day after intervention than those in group A, B, and C, with statistically significant differences( t values were 3.35- 4.75, all P<0.01). There was no statistically significant difference in PaCO 2 among the four groups on the 1st to 4th day after intervention ( P>0.05), but PaCO 2 on the 5th to 7th day after intervention was (47.31 ± 2.89), (46.18 ± 2.06), (41.94 ± 2.09) mmHg, (44.73 ± 1.76), (41.38 ± 1.30), (38.33 ± 1.16) mmHg, (44.81 ± 1.24), (41.23 ± 1.89), (38.73 ± 2.55) mmHg, (40.83 ± 1.78), (37.87 ± 1.43), (34.78 ± 2.05) mmHg, with statistically significant differences ( F=29.48, 36.12, 34.52, all P<0.05). Further pairwise comparison revealed that PaCO 2 in group B and group C were lower than those in group A on the 5th to 7th day after intervention, while PaCO 2 in group D were lower than those in groups A, B, and C, with statistically significant differences ( t values were 3.37-4.85, all P<0.01). During the analysis of PaO 2 and PaCO 2 in the four groups at different time points, the interaction effects were not statistically significant ( P>0.05). There was no significant difference in invasive mechanical ventilation duration, non-invasive mechanical ventilation duration and hospital stay among the four groups after intervention ( P>0.05). The oxygen therapy time of the four groups were (8.61 ± 6.40), (6.17 ± 4.80), (6.23 ± 2.75), and (3.75 ± 2.10) days, with statistically significant differences ( F=17.27, P<0.01). Further pairwise comparison revealed that the oxygen therapy time in group B and group C was shorter than that in group A, while group D was significantly shorter than that in groups A, B, and C, with statistically significant differences ( t values were 4.02-4.74, all P<0.01). Conclusions:Biological maternal sounds is superior to maternal sound and mother cardiotone in improve the blood gas analysis index, shorten the oxygen treatment time, which is worthy of clinical promotion in neonatal unaccompanied ward.

Objective:To establish a medical reference range of serum iodine in adults with normal thyroid function in Fujian Province.Methods:Permanent residents aged 16 - 60 years old and living in the local area for 5 years and more were selected as survey subjects in three areas with appropriate iodine nutrition in Fujian Province from September 2019 to January 2020. Urine and blood samples were collected to detect urinary iodine, serum iodine and thyroid function indexes [thyroid stimulating hormone (TSH), thyroglobulin (Tg), free triiodothyronine (FT 3), free thyroxine (FT 4), total triiodothyronine (TT 3), total thyroxine (TT 4), thyroid peroxidase antibody (TPOAb) and thyroglobulin antibody (TgAb)] levels. The percentile method was used to establish the 95% medical reference range of serum iodine in adults with normal thyroid function, and Pearson correlation analysis was used to analyze the correlation between serum iodine and thyroid function indexes in adults with normal thyroid function. Results:A total of 149 adults with normal thyroid function were examined, and the median urinary iodine was 119.45 μg/L, which was at the appropriate level (100 - 199 μg/L); serum iodine was (61.35 ± 16.20) μg/L, and the 95% medical reference range of serum iodine in adults with normal thyroid function was preliminarily formulated as 34.36 - 97.17 μg/L. Correlation analysis showed that serum iodine was positively correlated with FT 4 level ( r = 0.17, P = 0.035), but was not correlated with other thyroid function indexes ( P > 0.05). Conclusion:The medical reference range of serum iodine in adults with normal thyroid function in Fujian Province is successfully established, which provides a basis for judgment of individual iodine nutrition in adults.

Objective:To understand the correlation between urinary iodine, salt iodine and thyroid nodules in children aged 8 - 10 years and pregnant women in different regions of Fujian Province, and to explore the influencing factors of thyroid diseases.Methods:A cross-sectional study was conducted in Dongshan County and Pingtan County of Fujian Province from September to November 2019. According to the inclusion criteria, 140 pregnant women and 270 children aged 8 - 10 years were selected in Dongshan County, and 189 pregnant women and 368 children aged 8 - 10 years were selected in Pingtan County. Random urine and edible salt samples were collected to determine iodine content, and iodine nutrition was evaluated in each population. Thyroid was examined by B ultrasound and questionnaire survey of thyroid diseases was carried out. The correlation between urinary iodine, salt iodine and thyroid nodules in children aged 8 - 10 years and pregnant women in different regions was analyzed.Results:There were statistically significant differences in the median urinary iodine among children in different genders (male: 151.30 μg/L, female: 130.30 μg/L) and regions (Dongshan County: 160.30 μg/L, Pingtan County: 129.70 μg/L, P < 0.05); there was no significant difference in the median urinary iodine among children of different ages (8, 9, 10 years old: 141.60, 128.05, 150.30 μg/L, P > 0.05). The median urinary iodine among pregnant women was 119.30 μg/L, and there was no significant difference in median urinary iodine among pregnant women in different stages and regions ( P > 0.05). The medians of salt iodine from children and pregnant women were 20.30 and 23.65 mg/kg, respectively. Urinary iodine in children was positively correlated with salt iodine ( r = 0.13, P < 0.05). However, there was no correlation between urinary iodine and salt iodine in pregnant women ( P > 0.05). The detection rate of thyroid nodules in children was 21.79% (139/638). There was significant difference in the detection rate of thyroid nodules in children of different ages ( P < 0.05). The detection rate of thyroid nodules in pregnant women was 4.26% (14/329). There was no correlation between detection rate of thyroid nodules and urinary iodine or salt iodine in children and pregnant women ( P > 0.05). Thyroid volume of children in the two counties was within the normal range, and there was no correlation between thyroid volume and urinary iodine or salt iodine ( P > 0.05). Conclusions:The iodine nutrition of children in Dongshan County and Pingtan County is suitable (100 - 199 μg/L), while iodine deficiency (< 150 μg/L) exists in pregnant women. Urinary iodine in children is related to salt iodine, and urinary iodine increased with increase of salt iodine. The prevalence of thyroid nodules in children of different ages is different, which requires further study. The detection rate of thyroid nodules in children and pregnant women is not correlated with urinary iodine and salt iodine.

Objective:To deeply understand the real emotional experience and needs of the parents of dying newborns, so as to provide a reference for future neonatal palliative care.Methods:From February to October 2021, purposeful sampling was used to select 15 parents of dying newborns in the Department of Neonatology of Hunan Children's Hospital as the research object. A qualitative research design was conducted, and the semi-structured interview method was used to conduct in-depth interviews with the research subjects, and NVivo 10.0 software was used for data analysis.Results:A total of 3 themes were extracted, namely, the ambivalence when giving up treatment, negative life effects after giving up, needs and expectations.Conclusions:Parents of dying newborns generally have ambivalence when they give up treatment. After giving up, they will show emotions such as sadness and helplessness, self-blame and regret, and depression. Understanding the real emotions and inner needs of the parents of dying newborns helps medical and nursing staff to pay attention to parents' negative psychology and understand their needs, and provide parents with targeted psychological support and other care, so as to help the parents of dying newborns and their families through a special period.

Objective:The iodine excretion of adult individuals was calculated by two creatinine correction methods of urinary iodine, and the significance and value of the methods to measure individual iodine nutrition levels were assessed to provide a reference basis for further epidemiological investigation and study of iodine deficiency disorders.Methods:Healthy adults aged 18 - 59 years from Fujian Province were recruited and their 24 h urine, fasting urine, and morning spot urine (8:00 - 12:30) were collected and the corresponding urinary iodine and creatinine concentrations were measured. The estimated 24 h urinary iodine excretion was calculated using two different creatinine correction and creatinine estimation formulas were compared with the measured 24 h urinary iodine excretion.Results:There were no significant differences in measured 24 h urinary iodine excretion value, estimated 24 h urinary iodine excretion value 1 of fasting urine and morning spot urine, and estimated 24 h urinary iodine excretion 2 of fasting urine and morning spot urine between genders (μg/d: 195.5 vs 190.9, 190.0 vs 181.7, 160.2 vs 144.2, 174.8 vs 179.2, 148.3 vs 131.5); there were no significant differences in measured 24 h urinary iodine excretion and fasting urinary estimated 24 h urinary iodine excretion 1, estimated 24 h urinary iodine excretion 2 ( P > 0.05), and there were significant differences in measured 24 h urinary iodine excretion and morning spot urinary estimated 24 h urinary iodine excretion 1, estimated 24 h urinary iodine excretion 2 ( P < 0.01). And there were significant linear correlations between measured 24 h urinary iodine excretion and estimated 24 h urinary iodine excretion 1 of fasting urine and morning spot urine, estimated 24 h urinary iodine excretion 2 of fasting urine and morning spot urine ( r = 0.772, 0.266, 0.828, 0.391, P < 0.01). Conclusions:It is feasible to estimate 24 h urinary iodine excretion in adults with creatinine-corrected fasting urinary iodine concentration. Creatinine-corrected fasting urinary iodine concentration can be used as an individual iodine nutrition level evaluation index, but whether it is applicable to children and pregnant women remains to be further studied.

According to the state's relevant policies on the development of hospice care, hospice care has become a social concern, and it is currently one of the key areas of medical development in China. This article elaborates on the current status and necessity of the development of children's hospice care, summarizes the application effects of family-centered child hospice care in the quality of life of children, the degree of grief of family members and the relationship between doctors and patients, and puts forward corresponding suggestions. This article aims at speeding up the standardized construction of the family-centered hospice care model in our country, and promote the development of children's hospice care in our country.

Objective:To investigate the iodine nutritional status among children aged from 8 - 10 and pregnant women in Xiamen City before and after adjustment of salt iodine concentration, and scientifically evaluate the suitability of the new standard iodized salt adjustment policy for Xiamen City.Methods:In the pre-adjustment period (2011) and the post-adjustment period (2018), cross-sectional research methods and stratified cluster sampling methods were adopted in six districts of Xiamen City. The salt samples of residents and pregnant women, urine samples of children aged from 8 - 10 and pregnant women were collected to determine the iodine level; thyroid of children aged from 8 - 10 was examined. Changes in salt iodine, urine iodine and goiter prevalence before and after adjusting iodine content of salt were compared.Results:The median of salt iodine in residents after the adjustment (23.5 mg/kg) was significantly lower than that of before (28.9 mg/kg, Z = - 10.512, P < 0.05), the median of salt iodine in pregnant women after the adjustment (23.7 mg/kg) was significantly lower than that of before (29.2 mg/kg, Z = - 12.622, P < 0.05); the consumption rate of qualified iodized salt in residents after the adjustment (95.7%, 1 196/1 250) was significantly lower than that of before (97.1%, 1 608/1 656; χ 2 = 4.250, P < 0.05); before and after adjustment of salt iodine concentration, the consumption rate of qualified iodized salt in pregnant women was 94.7% (124/131) and 95.9% (579/604), respectively. No significant difference was found when comparing the consumption rate of qualified iodized salt in pregnant women (χ 2 = 0.015, P > 0.05). There was significant difference in median urinary iodine (from 204.2 to 183.9 μg/L, detected in 652, 1 250 urine samples, respectively) of children aged 8 - 10 years ( Z = - 3.583, P < 0.05); the difference of iodine nutritional status in pregnant women before and after adjustment of salt iodine concentration(130.2, 130.8 μg/L, detected in 132, 604 urine samples, respectively) was not significant ( Z = - 1.715, P > 0.05). The thyroid goiter rate of children aged 8 - 10 years had reduced from 1.1% (14/1 239) to 0.2% (2/1 253), the difference was statistically significant (χ 2 = 9.195, P < 0.05). Conclusions:As a whole, the measure of control and prevention of iodine deficiency disorders through iodized salt is implemented well in Xiamen City. After adjustment of salt iodine concentration, the iodine status of children aged from 8 to 10 is adequate, but the pregnant women has showed iodine deficiency.