Objective To understand the epidemiological features of epidemic cerebrospinal meningitis in Quzhou City,and to provide scientific evidence for formulation of relevant prevention and control measures.Methods The descriptive epidemiological method was applied to the analysis of the epidemiological features of epidemic cerebrospinal meningitis in Quzhou city from 1950 to 2006.Results The epidemic cerebrospinal meningitis reported a total of 30 294 cases including 1 455 deaths.The incidence rate of epidemic cerebrospinal meningitis was 28.11/100 000 on average per year,and the fatality rate of epidemic cerebrospinal meningitis was 4.80%.There were cases reported all-year with a higher occurrence in winter and spring and the highest occurrence in March accounting for 42.85% of the total of cases.The cases were mainly in children under 15 years concentrating on those living scatteredly or in nursery,who accounted for 36.60% of the total of cases.Conclusions It is necessary to enhance surveillance and the forecast of epidemic cerebrospinal meningitis,and concerning the change in the epidemic virus groups,to ensure routine preventive vaccination.It is signficant to control the occurrences and epidemics of epidemic cerebrospinal meningitis.

Objective To explore the anatomical basis for the flexor pollicis brevis branch of median nerve transfer to the deep branch of ulnar nerve.Methods Eight fresh upper limb were dissected and observed.The specimen were dissected under the loup.Observed the number of the flexor pollicis brevis branch and measured the distances from pisiform bone to the flexor pollicis brevis branch.Then the transfer operation on the cadaver were imitated.After the anastomosis was completed,the stumps of the nerves were sectioned and stained with HE.The crossing-sectional area and the density of nerve fiber were obtained by Image-Pro Plus version 6.0,then the number of the nerve fiber were calculated.The data analyzed by SPSS 17.0.Results The flexor pollicis brevis branch constantly appear,there were two branches in 2 specimens,one branch in 6 specimens.The flexor pollicis brevis branch could transfer to the deep branch of ulnar nerve by end-to-end surture without tension.The regeneration distances was (37.3 ± 5.76) mm.The crossing-sectional area were (0.0575 ± 0.0086)mm2 and (0.2039 ± 0.0396)mm2,the number were (492.50± 62.62) and (1651.13± 79.01),the density were (8781.4246 ± 1676.2894)/mm2 and (8371.1592 ± 1677.6509)/mm2 in the flexor pollicis brevis branch and the deep branch of ulnar nerve,respectively.There were no significant differences in the density of the nerve fiber between the donor and recipient nerve (P ＜0.05).But there were differences in the crossing-sectional area and number of the nerve fiber(P ＜ 0.05).Conclusion The flexor pollicis brevis branch transfer to the deep branch of ulnar nerve can provide a short regenerating distance,but can supply a part of recipient nerve to reinnervate.

Objective To investigate the status of blood donation in Shanghai streets,understanding the motivation of the donors for blood donation and how many times they had donate their blood.Here,we intend to improve work efficiency in order to better serve the blood donators and to provide a theoretical basis.Methods To gain insight into the understanding and attitude of citizens for blood donation,we analyzed the volunteer blood donors in 387 vehicles and 436 outdoor pre mobilization object by six months,questionnaire in blood collection vehicle or at scene etc.Results The survey specifically reflected the understanding,attitude and motivation of citizens and foreign workers for blood donation in Shanghai.Conclusion There existed many problems such as wrong recognition,diversified motivation among many citizens for blood donation.More publicity and education for the knowledge of blood donation are needed and it plays significant and longlasting role for blood donation.

Objective To investigate the role of heme oxygenase-1 ( HO-1 ) and carbon monoxide ( CO) in children with mycoplasma pneumoniae infection. Methods A total of 198 cases with mycoplasma pneumoniae infection under 3 years were enrolled in this study. According to whether with wheezing,all cases were divided into wheezing group( n=58 ) and no wheezing group ( n=140 ) . According to having hypox-emia,wheezing group was divided into mild wheezing group(n=34) and severe wheezing group(n=24). And no wheezing group was set as control group. The serum COHb levels were measured by dual-wavelength spectrophotometry. The serum HO-1 were measured by ELISA. Results The levels of serum HO-1 and COHb% in severe wheezing group were ( 2 734. 10 ± 707. 59 ) ng/L, ( 3. 88 ± 0. 83 )%, and ( 1 130. 03 ± 671. 02) ng/L,(1. 16 ± 0. 63)% in mild wheezing group,and(931. 32 ± 451. 67) ng/L,(1. 04 ± 0. 37)% in no wheezing group,respectively. There were significant differences in serum HO-1 and COHb% between se-vere wheezing group and mild wheezing group(P<0. 01,respectively),and there were no significan differ-ences in serum HO-1 and COHb% between mild wheezing group and no wheezing group( P>0. 05,respec-tively). There was significant positive correlation between serum HO-1 and COHb%(r=0. 875,P<0. 01). Conclusion With mycoplasma pneumoniae infection,the expression of HO-1 and COHb% increase by the wheezing disease progression. HO-1 and CO may participate in the development process of infantile wheezing diseases.

BACKGROUND: Mesenchymal stem cell-based therapy is pursued aggressively with promising preclinical studies and higher future prospect in the treatment of nonhealing wounds. OBJECTIVE: To review the strategies for improving the efficacy of mesenchymal stem cells in the treatment of nonhealing wounds, which are expected to provide theoretical basis for clinical treatment of nonhealing wounds. METHODS: Wanfang, CNKI, PubMed and Web of Science were searched for articles about the application of mesenchymal stem cells in nonhealing wounds from March 2002 to March 2020. The key words were “mesenchymal stem cells, nonhealing wounds (nonhealing chronic wounds), wound repair, tissue regeneration” in Chinese and “mesenchymal stem cells, nonhealing chronic wound, wound repair, tissue regeneration” in English. After excluding outdated and repetitive viewpoints, the retrieved literature was sorted out and a total of 64 articles were included for analysis. RESULTS AND CONCLUSION: (1) The formation mechanism of nonhealing wounds was summarized. (2) The molecular mechanisms of mesenchymal stem cells in the treatment of nonhealing wounds were summarized, such as direct differentiation, paracrine, immunomodulatory, mobilization resident stem cells to participate in wound repair. (3) This paper summarized the improvement of the efficacy of mesenchymal stem cells in the treatment of nonhealing wounds, such as gene modification and pretreatment. (4) This study can provide a theoretical basis for improving the efficacy of mesenchymal stem cells in the treatment of nonhealing wounds.

Objective To investigate the epidemiological characteristics of hand,foot and mouth disease (HFMD) in Hangzhou in 2016,so as to provide evidence for prevention and control of HFMD.Methods The clinical data of HFMD diagnosed in outpatient and inpatient department of Hangzhou Children's Hospital were retrospectively analyzed.At the same time,we investigated their family health and environment,and whether there was any silent infection among family members who were closely contacted with HFMD cases.Results There were 14 600 cases of HFMD diagnosed,including 1 492 hospitalized patients in 2016.The peak of cases occurred from May to July.Of the 1 492 hospitalized cases of HFMD 1 374 were positive for enterovirus,accounting for 92.1％.Of all positive specimens,266 cases were positive for EV-A71,accounting for 19.36％,151 cases were positive for coxsackievirus A16 (CV-A16),accounting for 10.99％,and 957 cases were positive for other enterovirus,accounting for 69.65％.A total of 108 family members who had close contact with 75 EV-A71 positive children were investigated.Among them,31 fecal specimens were positive for EV-A71 nucleic acid,accounting for 28.7％ (31/108).There were 54 cases of children without breastfeeding,accounting for 36％ (54/150),83 children living in rural and suburban areas,accounting for 55.3％ (83/150),87 children with poor health conditions,accounting for 58％ (87/150),112 families had 3 or more family menbers,accounting for 74.7％ (112/150),90 main family caregivers were educated at high school or below,accounting for 60％ (90/150),36 families have kindergarten children in family members and he/she was ill at that time,accounting for 64.3％ (36/56),115 families had no accepted knowledge of HFMD,accounting for 76.7％ (115/150).Conclusions The etiology of HFMD in Hangzhou in 2016 is mainly other enterovirus,and family factors may have certain correlation in the pathogenesis and transmission of HFMD.

Objective: To observe the intestinal viral shedding time in patients with hand, food and mouth disease (HFMD) induced by coxsackievirus A6 (CA6). Method: Throat swab specimens and stool specimens of HFMD children were collected from those admitted to Hangzhou Children′s Hospital between May and October 2015, while fluorescence quantitative PCR was used to detect the viral load.Eeighteen cases of HFMD children were followed up, who were confirmed as CA6 infection via laboratory tests.Stool specimen was collected every 4-7 days, and fluorescence PCR was used for virus nucleic acid detection until the stool viral nucleic acids of infected children turned to be negative.The intestinal virus shedding time of CA6-infected HFMD was compared with the intestinal virus shedding time of 65 children with enterovirus 71 (EV71) infection and 44 children with coxsackievirus A16 (CA16) infection of the previous studies (from May to September 2012). Result: The median stool viral load was 25×10⁵ copies/ml (55×10⁴ copies/mL, 9×10⁶ copies/ml) in CA6-infected children.The numbers of stool virus nucleic acid turning negative were 0 case, 4 cases, 9 cases, 3 cases and 2 cases in 18 children at 1st, 2nd, 3rd, 4th, 5th weeks. At 5th week, the stool virus nucleic acid of children in CA6 group all turned to be negative.The positive rates of stool virus nucleic acid in EV71 group and CA16 group at the 5th week, however, were 31% and 27% respectively.There were statistically significant differences in distribution of positive rate of stool virus nucleic acid between CA6 infected children with EV71 and CA16 infected children (χ²=13.894, 10.698, P<0.05). Conclusion The longest intestinal virus shedding time for CA6-infected HFMD children was 5 weeks, which is obviously shorter than that of EV71- infected children and CA16-infected children.

Humans ; Norepinephrine ; Bacterial Infections/drug therapy* ; Immunity, Innate

Bacterial infection is the main cause of infectious diseases in children. Antibacterials play an important role in anti infection treatment of children. At present, the treatment of antimicrobial drugs in children is facing a severe situation of bacterial resistance. In January 2020, a children′s specialized hospital carried out the practice of precise management of antibiotics in combination with key performance indicators. Through the multi sectoral linkage of management and technology, eight key performance indicators and assessment methods were set up from three levels of antibiotic use, bacterial resistance and hospital infection, to standardize the clinical application of antibiotics and continue to promote the rational use of antibiotics. This practice had improved the performance indicators of antibacterial management. Among them, the use intensity of antibacterial drugs for inpatients decreased from 40.07 DDD in 2019 to 29.00 DDD in 2021, the use rate of antibacterial drugs for inpatients decreased from 81.32% to 64.40%, the percentage of antibacterial drug expenses in total drug expenses decreased from 35.41% to 26.82%, the use proportion of non restricted antibacterial drugs in antibacterial drugs increased from 71.30% to 82.21%, and the drug resistance rate of Salmonella to β-Lactam/enzyme inhibitors decreased from 4.84% to 0.03%, and the incidence of hospital infection decreased from 1.16% to 0.96%. The precise management of antibiotics in combination with key performance indicators improved the level of rational use of antibiotics, effectively curbed bacterial resistance, achieved phased results, so as to provide a reference for the scientific management of antibiotics in children′s hospitals.

Objective To investigate the positive detection and epidemic characteristics of enter ovirus(EV),the pathogen of hand-foot-mouth disease(HFMD),in Hangzhou,and to provide scientific basis for formulating prevention and control strategies of HFMD in the future.Methods From January 2016 to December 2022,14 259 positive cases of enterovirus universal nucleic acid detected in Hangzhou Children's Hospital were collected and analyzed retrospectively by age,gender,detection time and other factors.Results The average positive detection rate of EV was 45.48%(14 259/31 354),among which the positive detection rate of boys was 27.20%and that of girls was 18.28%,the difference was statistically significant(P<0.01).The positive detection rate of EV in children of different ages decreased with the increase of age,and the positive detection rate of EV in children under 5 years old accounted for 90.38%of all positive children.Seasonally,enteroviruses were detected throughout the year,but the incidence was high in summer,and the total positive number from May to July accounted for 49.16%of the total detected number.In terms of year,the positive detection rate of EV has shown a downward trend year by year since 2016.Conclusion There are gender differences in enterovirus infection in Hangzhou,and boys are more susceptible to enterovirus infection,especially children under 5 years old need to pay attention to EV protection.In addition,HFMD has a certain seasonality,with a high incidence in summer,and the annual detection rate has declined year by year since 2016,which may be related to the promotion of vaccines and the improvement of health awareness.