OBJECTIVE To investigate the clinical characteristics of the acute appendicitis children with Streptococ-cus milleri group(SMG)infection and explore the association between SMG infection and severity of acute appen-dicitis.METHODS A retrospective study was conducted for the children with acute appendicitis who were trea-ted in Wuhan Children's Hospital from Jan.2021 to Dec.2023.The distribution of pathogens isolated from the children with acute appendicitis was analyzed.The children with acute appendicitis were divided into the SMG group(with Streptococcus constellatus/Streptococcus anginosus tested positive)and the non-SMG group according to the test result of SMG in abdominal pus specimens.The clinical characteristics and the results of preoperative laboratory tests were observed and compared between the two groups of children.RESULTS A total of 464 children with acute appendicitis were included in the study,715 strains of pathogens were isolated from the submitted pus specimens.Among the isolated gram-positive bacteria,S.constellatus and S.anginosus were dominant,account-ing for 12.31％and 9.37％,respectively.The analysis of drug resistance showed that the drug resistance rates of the S.constellatus and S.anginosus strains to clindamycin and erythromycin were greater than 40％.As com-pared with the non-SMG group,the length of hospital stay was longer in the SMG group[(10.34±3.93)days],the highest body temperature was higher[(37.78±1.24)℃];the percentage of the children with the use of anti-biotics more than 7 days was 87.10％in the SMG group,the appendiceal perforation rate was 75.48％,the inci-dence rate of diffuse peritonitis was 36.77％,remarkably higher than those of the non-SMG group(allP＜0.05).The total white blood cells was[15.10(11.01,19.13)× 109/L]in the SMG group,with the C-reactive pro-tein(CRP)[76.30(29.23,127.75)mg/L],the fibrinogen[5.01(3.82,6.38)g/L],the serum sodion level[135.35(132.48,137.63)mmol/L];there were significant differences in the above indexes between the SMG group and the non-SMG group(P＜0.05).CONCLUSION The SMG infection is closely associated with the severi-ty of acute appendicitis in the children,and the children are usually complicated with the rise of fibrinogen and CRP and tended to have hyponatremia.

OBJECTIVE To investigate the clinical characteristics of the acute appendicitis children with Streptococ-cus milleri group(SMG)infection and explore the association between SMG infection and severity of acute appen-dicitis.METHODS A retrospective study was conducted for the children with acute appendicitis who were trea-ted in Wuhan Children's Hospital from Jan.2021 to Dec.2023.The distribution of pathogens isolated from the children with acute appendicitis was analyzed.The children with acute appendicitis were divided into the SMG group(with Streptococcus constellatus/Streptococcus anginosus tested positive)and the non-SMG group according to the test result of SMG in abdominal pus specimens.The clinical characteristics and the results of preoperative laboratory tests were observed and compared between the two groups of children.RESULTS A total of 464 children with acute appendicitis were included in the study,715 strains of pathogens were isolated from the submitted pus specimens.Among the isolated gram-positive bacteria,S.constellatus and S.anginosus were dominant,account-ing for 12.31％and 9.37％,respectively.The analysis of drug resistance showed that the drug resistance rates of the S.constellatus and S.anginosus strains to clindamycin and erythromycin were greater than 40％.As com-pared with the non-SMG group,the length of hospital stay was longer in the SMG group[(10.34±3.93)days],the highest body temperature was higher[(37.78±1.24)℃];the percentage of the children with the use of anti-biotics more than 7 days was 87.10％in the SMG group,the appendiceal perforation rate was 75.48％,the inci-dence rate of diffuse peritonitis was 36.77％,remarkably higher than those of the non-SMG group(allP＜0.05).The total white blood cells was[15.10(11.01,19.13)× 109/L]in the SMG group,with the C-reactive pro-tein(CRP)[76.30(29.23,127.75)mg/L],the fibrinogen[5.01(3.82,6.38)g/L],the serum sodion level[135.35(132.48,137.63)mmol/L];there were significant differences in the above indexes between the SMG group and the non-SMG group(P＜0.05).CONCLUSION The SMG infection is closely associated with the severi-ty of acute appendicitis in the children,and the children are usually complicated with the rise of fibrinogen and CRP and tended to have hyponatremia.

Health economics evaluation serves as a pivotal tool for decision-makers to identify the most valuable health intervention program under the condition of resource constraints and optimize the resource allocation.In contrast to the health economics evaluation that was conducted abroad,domestic research remains in an explorato-ry phase.This paper undertakes a systematic review of the application progress and existing limitations of health e-conomic evaluation methodologies in the infection prevention and control(IPC)field,aiming to offer insights and references for the standardized and in-depth development of health economic evaluations in the field of infection control,foster the practice of such evaluations in domestic settings,and push forward the sustainable advancement of China's IPC initiatives.

OBJECTIVE To analyze the clinical characteristics and pathogens for mixed infections in children with pertussis,so as to references for clinical diagnosis and treatment.METHODS A retrospective analysis was conduc-ted on the clinical data of 350 children diagnosed with pertussis and hospitalized in Wuhan Children's Hospital from Jan.2022 to Dec.2023.The clinical characteristics,peak white blood cell count,peak lymphocyte ratio,high-sensitivity C-reactive protein or C-reactive protein,procalcitonin and complications were compared between different age groups,as well as between the single infection group and the mixed infection group.RESULTS Mixed infections were observed in 291 children(83.14％),predominantly viral(63.43％,222/350),with human rhinovirus/enterovirus being the most common(32.57％,114/350).For children aged＜6 months,6 months to＜1 year and 1 to＜3 years,the incidence of family contact history of cough,panting,hasty breathing,respira-tory failure,peak white blood cell count and peak lymphocyte ratio were all higher than those aged 3 to＜6 years and≥6years(all P＜0.05).The incidence of post-cough vomiting was higher in children aged 6 months to＜1 year and 1 to＜3 years compared to other age groups(P＜0.05).The length of hospital stay decreased with in-creasing age(P＜0.05).The proportions of children with paroxysmal spasmodic cough,post-cough cyanosis,post-cough flushing,coughing spells,inspiratory three concave sign,pneumonia and pulmonary phlegm rales all generally decreased with age(all P＜0.05).Nodding respiration was only observed in children aged＜1 year(P＜0.05).The incidence of fever,co-infection with bacteria and Mycoplasma pneumoniae infection was higher in children aged 6 months to＜1 year,1 to＜3 years,3 to＜6 years and ≥ 6 years compared to those aged＜6 months(all P＜0.05).The incidence of fever was higher in the mixed infection group than that in the single in-fection group(P＜0.05).Children in the single infection group had longer hospital stays,higher incidence of par-oxysmal spasmodic cough,nocturnal cough,post-cough flushing,coughing spells,pulmonary phlegm rales and higher peak lymphocyte ratio(all P＜0.05).The incidence of paroxysmal spasmodic cough was higher in the sin-gle infection group for children aged＜3 months(P＜0.05).CONCLUSIONS The younger children with pertussis have a higher proportion of family contact history of cough and are more prone to clinical manifestations such as paroxysmal spasmodic cough,post-cough vomiting,post-cough cyanosis,and pneumonia.They also have higher peak white blood cell counts,peak lymphocyte ratios and longer hospital stays.As children'age increased,the in-cidence of fever,bacterial,and mycoplasma infections also increased.The types of pathogens in mixed infections varies with patients' age and pertussis mixed infections may mask typical clinical symptoms.

BACKGROUND: While emotional distress, encompassing anxiety and depression, has been associated with negative clinical outcomes, its impact across various clinical departments and general hospitals has been less explored. Previous studies with limited sample sizes have examined the effectiveness of specific treatments (e.g., antidepressants) rather than a systemic management strategy for outcome improvement in non-psychiatric inpatients. To enhance the understanding of the importance of addressing mental health care needs among non-psychiatric patients in general hospitals, this study retrospectively investigated the impacts of emotional distress and the effects of early detection and management of depression and anxiety on hospital length of stay (LOS) and rate of long LOS (LLOS, i.e., LOS >30 days) in a large sample of non-psychiatric inpatients. METHODS: This retrospective cohort study included 487,871 inpatients from 20 non-psychiatric departments of a general hospital. They were divided, according to whether they underwent a novel strategy to manage emotional distress which deployed the Huaxi Emotional Distress Index (HEI) for brief screening with grading psychological services (BS-GPS), into BS-GPS ( n = 178,883) and non-BS-GPS ( n = 308,988) cohorts. The LOS and rate of LLOS between the BS-GPS and non-BS-GPS cohorts and between subcohorts with and without clinically significant anxiety and/or depression (CSAD, i.e., HEI score ≥11 on admission to the hospital) in the BS-GPS cohort were compared using univariable analyses, multilevel analyses, and/or propensity score-matched analyses, respectively. RESULTS: The detection rate of CSAD in the BS-GPS cohort varied from 2.64% (95% confidence interval [CI]: 2.49%-2.81%) to 20.50% (95% CI: 19.43%-21.62%) across the 20 departments, with a average rate of 5.36%. Significant differences were observed in both the LOS and LLOS rates between the subcohorts with CSAD (12.7 days, 535/9590) and without CSAD (9.5 days, 3800/169,293) and between the BS-GPS (9.6 days, 4335/178,883) and non-BS-GPS (10.8 days, 11,483/308,988) cohorts. These differences remained significant after controlling for confounders using propensity score-matched comparisons. A multilevel analysis indicated that BS-GPS was negatively associated with both LOS and LLOS after controlling for sociodemographics and the departments of patient discharge and remained negatively associated with LLOS after controlling additionally for the year of patient discharge. CONCLUSION Emotional distress significantly prolonged the LOS and increased the LLOS of non-psychiatric inpatients across most departments and general hospitals. These impacts were moderated by the implementation of BS-GPS. Thus, BS-GPS has the potential as an effective, resource-saving strategy for enhancing mental health care and optimizing medical resources in general hospitals.
Humans ; Retrospective Studies ; Male ; Length of Stay/statistics & numerical data* ; Female ; Middle Aged ; Adult ; Psychological Distress ; Inpatients/psychology* ; Aged ; Anxiety/diagnosis* ; Depression/diagnosis*

OBJECTIVE To analyze the clinical characteristics and pathogens for mixed infections in children with pertussis,so as to references for clinical diagnosis and treatment.METHODS A retrospective analysis was conduc-ted on the clinical data of 350 children diagnosed with pertussis and hospitalized in Wuhan Children's Hospital from Jan.2022 to Dec.2023.The clinical characteristics,peak white blood cell count,peak lymphocyte ratio,high-sensitivity C-reactive protein or C-reactive protein,procalcitonin and complications were compared between different age groups,as well as between the single infection group and the mixed infection group.RESULTS Mixed infections were observed in 291 children(83.14％),predominantly viral(63.43％,222/350),with human rhinovirus/enterovirus being the most common(32.57％,114/350).For children aged＜6 months,6 months to＜1 year and 1 to＜3 years,the incidence of family contact history of cough,panting,hasty breathing,respira-tory failure,peak white blood cell count and peak lymphocyte ratio were all higher than those aged 3 to＜6 years and≥6years(all P＜0.05).The incidence of post-cough vomiting was higher in children aged 6 months to＜1 year and 1 to＜3 years compared to other age groups(P＜0.05).The length of hospital stay decreased with in-creasing age(P＜0.05).The proportions of children with paroxysmal spasmodic cough,post-cough cyanosis,post-cough flushing,coughing spells,inspiratory three concave sign,pneumonia and pulmonary phlegm rales all generally decreased with age(all P＜0.05).Nodding respiration was only observed in children aged＜1 year(P＜0.05).The incidence of fever,co-infection with bacteria and Mycoplasma pneumoniae infection was higher in children aged 6 months to＜1 year,1 to＜3 years,3 to＜6 years and ≥ 6 years compared to those aged＜6 months(all P＜0.05).The incidence of fever was higher in the mixed infection group than that in the single in-fection group(P＜0.05).Children in the single infection group had longer hospital stays,higher incidence of par-oxysmal spasmodic cough,nocturnal cough,post-cough flushing,coughing spells,pulmonary phlegm rales and higher peak lymphocyte ratio(all P＜0.05).The incidence of paroxysmal spasmodic cough was higher in the sin-gle infection group for children aged＜3 months(P＜0.05).CONCLUSIONS The younger children with pertussis have a higher proportion of family contact history of cough and are more prone to clinical manifestations such as paroxysmal spasmodic cough,post-cough vomiting,post-cough cyanosis,and pneumonia.They also have higher peak white blood cell counts,peak lymphocyte ratios and longer hospital stays.As children'age increased,the in-cidence of fever,bacterial,and mycoplasma infections also increased.The types of pathogens in mixed infections varies with patients' age and pertussis mixed infections may mask typical clinical symptoms.

Health economics evaluation serves as a pivotal tool for decision-makers to identify the most valuable health intervention program under the condition of resource constraints and optimize the resource allocation.In contrast to the health economics evaluation that was conducted abroad,domestic research remains in an explorato-ry phase.This paper undertakes a systematic review of the application progress and existing limitations of health e-conomic evaluation methodologies in the infection prevention and control(IPC)field,aiming to offer insights and references for the standardized and in-depth development of health economic evaluations in the field of infection control,foster the practice of such evaluations in domestic settings,and push forward the sustainable advancement of China's IPC initiatives.

Inflammation is involved in the development of various acute and chronic diseases in the body. Sustained inflammatory responses are key driving factors for diseases such as cancer， neurodegenerative diseases， cardiovascular diseases， metabolic syndrome， inflammatory bowel disease， and arthritis. Therefore， finding anti-inflammatory drugs is crucial for the prevention and treatment of various diseases. In recent years， there has been increasing attention to finding natural drugs with minimal toxic side effects. Lonicerae Japonicae Flos and Lonicerae Flos， as traditional Chinese medicines potent in clearing heat and removing toxins， have strong biological activity and multiple pharmacological effects. They are widely distributed in the plant world and have significant medicinal value. With the continuous advancement of the research on Lonicerae Japonicae Flos and Lonicerae Flos， they have been widely used in the medical field and possess great development potential. Currently， research mainly focuses on the anti-inflammatory mechanisms of Lonicerae Japonicae Flos and Lonicerae Flos， while systematic summaries of their anti-inflammatory active ingredients are rare. Therefore， this paper focuses on the differential analysis of the anti-inflammatory active components of Lonicerae Japonicae Flos and Lonicerae Flos. In addition， it reviewed the possible mechanisms by which extracts and active ingredients of Lonicerae Japonicae Flos and Lonicerae Flos may exert anti-inflammatory effects through various pathways， such as influencing the release of cellular inflammatory factors， regulating inflammatory signaling pathways such as nuclear factor-κB （NF-κB）， mitogen-activated protein kinase （MAPK）， signal transducer and activator of transcription 3 （STAT3）， MAPK/extracellular signal-regulated kinase （ERK）/c-Jun N-terminal kinase （JNK）， phosphatidylinositol 3-kinase （PI3K）/protein kinase B （Akt）/NF-κB， and Janus kinase （JAK）/signal transducer and activator of transcription （STAT） signaling pathways， increasing antioxidant stress capacity， enhancing immune defense capabilities， and improving intestinal microbiota， aiming to provide a theoretical basis for the rational clinical application of Lonicerae Japonicae Flos and Lonicerae Flos.

Objective To explore the applicability,safety and effectiveness of hepatic arterial infusion chemotherapy(HAIC)combined with sintilimab and bevacizumab in the patients with intermediate and ad-vanced hepatocellular carcinoma(HCC)failed by lenvatinib treatment.Methods A total of 62 patients with intermediate and advanced liver cancer failed by lenvatinib treatment in this hospital from February 2023 to February 2024 were selected as the study subjects and divided into the HAIC group(n=13),HAIC+targeted therapy group(n=18)and HAIC+combined therapy group(n=31)according to different treatment regi-mens.The HAIC group only received the HAIC treatment,the HAIC+targeted therapy group adopted the HAIC+lenvatinib combined treatment and the HAIC+combined treatment group received the HAIC+sintil-imab and bevacizumab combined treatment.The objective remission rate(ORR),disease control rate(DCR),median progression-free survival time(mPFS),median overall survival time(mOS),carcinoembryonic antigen(CEA),vascular endothelial growth factor(VEGF),carbohydrate antigen 125(CA125)levels after treatment were observed in 3 groups,and the treatment related adverse reactions were recorded.The Kaplan-Meier method was used for conducting the survival analysis.Results According to RECIST1.1 criteria,ORR of the HAIC+combined treatment group was higher than that of the HAIC group and HAIC+targeted therapy group(35.5％vs.23.1％vs.22.2％),DCR was lower than that of the other two groups(83.8％vs.92.3％vs.88.9％),but the differences were not statistically significant and the differences were not statistically sig-nificant(P＞0.05).mOS of the HAIC+combined treatment group was longer than that of the HAIC group and HAIC+targeted therapy group[18.1(95％CI:13.3-22.9)months vs.12.6(95％CI:9.0-16.2)months vs.15.9(95％CI:11.5-20.3)months].mPFS in the HAIC+combined treatment group was longer than that in the the HAIC group and HAIC+targeted therapy group[12.0(95％CI:9.4-14.6)months vs.9.7(95％CI:2.2-17.2)months vs.10.1(95％CI:8.3-11.9)months],and the differences were not statistically sig-nificant(P＞0.05).The levels of CEA,VEGF and CA125 after treatment in 3 groups were decreased com-pared with before treatment,moreover the levels in the HAIC+combined treatment group was the lowest(P＜0.05).There was no statistically significant difference in the incidence rate of adverse reactions among the three groups(P＞0.05).Conclusion The HAIC combined with immunotherapy regimen is effective in the pa-tients with intermediate and advanced HCC failed by lenvatinib treatment,moreover which has high safety.

China has classified the Corona Virus Disease 2019(COVID-19) as a statutory category B infectious disease and managed it according to Category B since January 8, 2023.In view that Omicron variant is currently the main epidemic strain in China, in order to guide the treatment of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2) infection in children with the times, refer to the Diagnosis and Treatment Protocol for Novel Coronavirus Infection (Trial 10 th Edition), Expert Consensus on Diagnosis, Treatment and Prevention of Novel Coronavirus Infection in Children (Fourth Edition) and the Diagnosis and Treatment Strategy for Pediatric Related Viral Infections.The Expert Consensus on the Diagnosis, Treatment and Prevention of Novel Coronavirus Infection in Children (Fifth Edition) has been formulated and updated accordingly on related etiology, epidemiology, pathogenic mechanism, clinical manifestations, auxiliary examination, diagnosis and treatment, and added key points for the treatment of COVID-19 related encephalopathy, fulminating myocarditis and other serious complications for clinical reference.