Objective:This study aims to obtain the prevalence and features associated with Violence Against Children (VAC) in China and, thus, formulate a prevention strategy.Methods:The mortality-related data of VAC was sourced from the National Disease Surveillance Points System (DSP) during 2013-2021. We analyzed the DSP data regarding children aged 0-17 years old who died from violence. The hospital cases of VAC was sourced from the National Injury Surveillance System (NISS), 2013-2021. We analyzed the data from NISS with the parameter of "intentional injury" caused by VAC in children aged between 0-17 years. Using robust linear regression, we analyze the time trend in the proportion of violence incidence. To understand the variations in the incidence of different types of violence across genders, we apply the chi-square test and adjusted Pearson residuals.Results:The overall trend of death caused by VAC has declined; it was reduced to 0.14/100 000 in 2021 from 0.33/100 000 in 2013. In 2021, male VAC mortality (0.15/100 000) was higher than females (0.13/100 000). The proportion of VAC cases to all injury cases has declined from 3.34% in 2013 to 2.29% in 2021. Among 9 344 VAC cases supervised by hospitals in 2021, the number of males (7 503 cases) was around 4 times that of females (1 841 cases), and the top three modes of violence were blunt tools (64.77%), falls (7.46%) and sharp instruments (6.18%), and 45 cases of sexual violence included 38 girls and 7 boys.Conclusions:The declining death rate due to VAC may be related to the benign development of Chinese society. Prevention strategies targeting training in parenting skills and problem-solving should be prioritized.

Objective:To explore the factors affecting the prognosis of severe pediatric acute respiratory distress syndrome (ARDS) after receiving extracorporeal membrane oxygenation (ECMO) support.Methods:It was a multicenter prospective observational study. A total of 95 children with severe ARDS who were treated with ECMO salvage therapy from January 2018 to December 2022 in 9 pediatric ECMO centers in China were enrolled in the study. The general data, disease severity, organ function, comprehensive treatment and prognosis were recorded, and they were divided into survival group and death group according to the outcome at discharge. T test, chi-square test, multivariate Logistic regression and mixed linear model were used to analyze the relationship among baseline before ECMO treatment, some important indicators (pediatric critical scores, platelet count, albumin, fibrinogen, etc) during ECMO treatment and prognosis. Results:Among the 95 children with severe ARDS who received ECMO, 55 (58%) were males and 40 (42%) were females, aged 36.9 (0.5, 72.0) months. Twelve children (13%) were immunodeficient. Sixty-eight (72%) children were treated with venous artery (VA) mode and 27 (28%) with venous vein (VV) mode. The discharge survival rates of overall, VA, and VV mode children were 51% (48/95), 47% (32/68), and 59% (16/27), respectively. The number of immunodeficient children in the death group was higher, and there were lower pediatric critical scores, platelet count, albumin, fibrinogen and arterial oxygen partial pressure/fraction of inspired oxygen (PaO 2/FiO 2), higher ventilator driving pressure (ΔP), oxygenaion index (OI), and longer ARDS duration before ECMO (all P<0.05). There were no statistically significant differences in other indicators, including age, gender, weight, and ECMO mode among different prognostic groups (all P>0.05). High ΔP, high OI, low P/F, and low albumin were high-risk factors affecting prognosis(all P<0.05). After further grouping, it was found that ΔP≥25 cmH 2O (1 cmH 2O=0.098 kPa), P/F≤67 mmHg (1 mmHg=0.133 kPa) and OI≥35 were the thresholds for predicting poor prognosis ( P<0.05). From 24 h after ECMO, there were significant differences in ΔP, P/F and OI between the dead group and the survival group (all P<0.05), and the differences gradually increased with the ECMO process. The platelet level was significant from 7 days after ECMO ( P<0.05) and gradually expanded. Blood lactate levels showed a significant difference between the 2 groups on before and after ECMO ( P<0.05) and gradually increased from 24 h after ECMO. Conclusions:The risk factors affecting the prognosis of severe ARDS in ECMO include high ΔP, high OI, low P/F and low albumin purification therapy before ECMO. The gradual decrease of ΔP, OI and increase of P/F from 24 h of ECMO predicted a good prognosis, while the gradual increase of lactate after ECMO application showed a poor prognosis.

Objective:To correlate serum levels of neuron specific enolase (NSE) and inflammatory factors with recovery of neurological function in patients with severe traumatic brain injury.Methods:Ninety-six patients with severe traumatic brain injury who received treatment from January 2018 to January 2020 in Taizhou Hospital were included in this study. These patients were divided into a mild-to-moderate group ( n = 51) and a severe group ( n = 45). Additional 60 healthy controls who concurrently received health examination were included in the healthy control group. Serum NSE level was detected by enzyme-linked immunosorbent assay, serum C-reactive protein (CRP) level by immunoturbidimetry, serum procalcitonin (PCT) level by chemiluminescent assay, and serum interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) levels by enzyme-linked immunosorbent assay. All patients were followed up for 3 months. Recovery of neurological function was evaluated by modified Rankin Scale. Results:Serum NSE level was (50.42 ± 13.25) μg/L and (36.79 ± 10.28) μg/L in the severe and mild-to-moderate groups, respectively, which was significantly higher than that in the healthy control group [(6.13 ± 1.78) μg/L, t = 25.641, 22.688, both P < 0.05). Serum NSE level in the severe group was significantly higher than that in the mild-to- moderate group ( t = 5.576, P < 0.05). Serum CRP, PCT, IL-6 and TNF-α levels were (78.95 ± 15.46) mg/L, (3.46 ± 0.75) μg/L, (432.15 ± 78.29) μg/L and (36.57 ± 8.98) μg/L] respectively in the severe group, (34.65 ± 7.48) mg/L, (1.68 ± 0.51) μg/L, (285.41 ± 36.75) μg/L and (17.54 ± 5.26) μg/L] respectively in the mild-to-moderate group and (3.25 ± 0.86) mg/L, (0.08 ± 0.02) μg/L, (73.52 ± 13.89) μg/L and (1.64 ± 0.50) μg/L, respectively in the healthy control group. Serum CRP, PCT, IL-6 and TNF-α levels in the severe and mild-to-moderate groups were significantly higher than those in the healthy control group ( t = 37.890, 34.922, 34.870, 30.099, 32.284, 24.315, 40.980, 23.312, all P < 0.05). Serum levels of these indicators in the severe group were significantly higher than those in the mild-to-moderate group ( t = 17.493, 13.414, 11.500, 12.451, all P < 0.05). In the severe group, neurological function recovered well in 34 patients and poorly in 17 patients. Serum NSE level in patients with poor neurological function recovery was significantly higher than that in patients with good recovery [(68.93 ± 14.25) μg/L vs. (34.61 ± 12.36) μg/L, t = 8.457, P < 0.05). Serum CRP [(113.24 ± 27.39) mg/L], PCT [(4.57 ± 0.87) μg/L], IL-6 [(598.90 ± 43.52) μg/L] and TNF-α [(58.78 ± 12.13) μg/L] levels in patients with poor recovery were significantly higher than those in patients with good recovery [(32.19 ± 6.90) mg/L, (2.23 ± 0.65) μg/L, (261.39 ± 26.56) μg/L and (14.53 ± 4.26) μg/L, t = 11.956, 9.788, 29.280 and 14.537, all P < 0.05). Serum NSE, CRP, PCT, IL-6 and TNF-α were positively correlated with poor prognosis ( r = 0.849, 0.743, 0.795, 0.683, 0.701, all P < 0.05). Conclusion:In patients with severe traumatic brain injury, serum NSE, CRP, PCT, IL-6 and TNF-α levels increase, which are positively correlated with poor prognosis.

Activating metabolite glutamate receptor 8 (mGluR8) has anti-hyperpathia effect in central nervous system, however, studies of effects in gastrointestinal tract are rare. Visceral hypersensitivity is one of the pathogenesis factors of irritable bowel syndrome (IBS). Aims: To investigate the effect and potential mechanism of activating mGluR8 on visceral hypersensitivity in neonatal maternally separated (NMS) rats. Methods: Twenty-four male newborn SD rats were randomly divided into normal control (NC) group, NMS group and mGluR8 agonist (S)-3, 4-DCPG group (3, 10 mg/kg). Newborn rats were subjected to 3 hours daily maternal separation on postnatal day 2-14 to establish the NMS model; in (S)-3, 4-DCPG group, (S)-3, 4-DCPG (3 or 10 mg/kg) were administered 1 hour prior to the visceral sensitivity test in NMS rats. Abdominal withdrawal reflex (AWR) score and abdominal electromyography (EMG) activity were used to measure visceral sensitivity. mGluR8 mRNA and protein expressions in colon mucosa were measured by RT-PCR and Western blotting, respectively; TNF-α, IL-1β and IL-6 mRNA expressions in colon mucosa were measured by RT-PCR. The protein expression of myeloperoxidase (MPO) was measured by immunohistochemistry. Results: AWR score and EMG activity in NMS group were significantly higher than those in NC group under different colorectal distension (CRD) pressure. AWR score and EMG activity were significantly decreased in (S)-3, 4-DCPG group. mGluR8 mRNA and protein expressions in NMS group were significantly higher than those in NC group (P<0.05). Compared with NMS group, TNF-α mRNA expression was significantly decreased in 3 mg/kg (S)-3, 4-DCPG group (P<0.05), and MPO protein expression was significantly decreased in 10 mg/kg (S)-3, 4-DCPG group (P<0.05). Conclusions: Activating mGluR8 attenuates visceral hypersensitivity in NMS rats, the mechanism may be related to decrease of pro-inflammatory cytokine TNF-α.

【Objective】 To evaluate the value of Six Sigma quality management method in improving the efficacy of red blood cell transfusion. 【Methods】 The five steps of definition, measurement, analysis, improvement and control in Six Sigma quality management were used to analyze the existing process capability and influencing factors, so as to formulate corresponding optimized measures and control plans for continuous improvement. The transfusion effect of RBCs in hemodynamically stable patients in our hospital from January to November in 2019 were assessed in three phases: January to March(prior to the application of Six Sigma), April to August (tracking the application of Six Sigma), and September to November(determining the effect of Six Sigma). The efficacy and process ability of RBC transfusion in patients with stable hemodynamics before and after the improvement were analyzed and compared. 【Results】 After the improvement, the effective rate of RBC transfusion for hemodynamically stable patients in our hospital increased from 76.9% to 90.5%(P<0.05). The Z value of process capacity increased from 0.408 0 to 1.330 8, with a significant improvement. 【Conclusion】 Application of Six Sigma quality management method can effectively improve the effect of red blood cell transfusion in patients with stable hemodynamics.

Objective:To explore the clinical value of magnetic resonance (MRI) multi-b-value scatter weighted imaging (DWI) combined with spectral imaging (MRS) in the diagnosis of prostate cancer.Methods:From November 2016 to August 2018, 33 patients with prostate cancer and 62 patients with benign prostatic lesions in the People's Hospital of Yongjia County were selected.DWI and MRS scans were performed and compared with pathological findings.Results:The DWI signal intensity of prostate cancer at the b value of 600s/mm 2, 1 000s/mm 2, 2 000s/mm 2 and 3 000s/mm 2 were significantly higher than those of benign prostatic lesions (all P<0.05). With the increase of b value, the sensitivity, specificity and accuracy of DWI in diagnosis of prostate cancer increased, under 3 000s/mm 2, the sensitivity, specificity and accuracy of DWI in the diagnosis of prostate cancer were 87.88%(29/33), 82.26% (51/62) and 84.21%(80/95), respectively.The sensitivity, specificity and accuracy of MRS in diagnosing prostate cancer were 69.70%(23/33), 79.03%(49/62) and 75.79%(72/95), respectively.The (choline+ creatine)/(citrate) (CC/C) value of prostate cancer (2.50±0.94) was significantly higher than that of benign prostatic lesions (0.93±0.23)( t=12.519, P<0.05). The sensitivity, specificity and accuracy of DWI at b value of 3 000s/mm 2 combined with MRS in the diagnosis of prostate cancer were 96.97%(32/33), 88.71%(55/62) and 91.58%(87/95), respectively. Conclusion:DWI combined with MRS has good application value in the diagnosis of prostate cancer.

OBJECTIVE: To analyze the influencing factors of drinking behavior of manufacturing workers and their impact on their quality of life. METHODS: A total of 594 manufacturing workers were selected as research subjects using stratified cluster sampling method. Their drinking behavior, physical activity status and quality of life were investigated by the Drinking Behavior Questionnaire, International Physical Activity Questionnaire-Short Form and Short Form 36 Health Survey Questionnaire, respectively. RESULTS: The overall drinking rate of the subjects was 32.2%(191/594). Multivariate logistic regression analysis results showed that male workers had higher risk of drinking behavior than female workers(P<0.01). The risk of drinking behavior of smoking workers was higher than that of non-smokers(P<0.01). The risk of drinking behavior of workers with medium or high physical activity levels was higher than that of workers with low activity levels(P<0.01). The results of multiple linear regression analysis showed that after adjusting for the effects of gender, age, marital status, education level, monthly income, household registration, length of service, work shift, weekly work hours, industry type, smoking, physical activity level and other confounding factors, drinking did not affect the physical or psychological quality of life of workers(P>0.05). CONCLUSION: Gender, smoking and physical activity may be important factors influencing the drinking behavior of manufacturing workers. Drinking may have no effect on quality of life of manufacturing workers.

To investigate the clinical efficacy of one-stage repairing the wounds after excision of soft tissue malignant tumor in lower limb with deep inferior epigastric perforator (DIEP) flaps. Methods From Au-gust, 2016 to July, 2018, 11 patients(8 males and 3 females; aged 35-76 years) with the soft tissue defects in the low-er limb underwent immediate reconstructive operations with DIEP flap after their tumor resection. The defects ranged in area from 11 cm×7 cm to 25 cm×10 cm after extended resection, including 5 cases of bone exposure. The DIEP flap area ranged from 11 cm×8 cm to 26 cm×18 cm.Among them, 9 cases were treated with free transplantation and 2 cases with pedicle transplantation.The donor sites were closed directly. The patients’ limb function, tumor recurrence and the healing of surgical incision had been followed-up. Results Eleven flaps survived and the donor sites healed directly. One flap had skin pigmentation due to postoperative vascular crisis, and the other flaps had satisfied texture and appearance. All patients were followed-up from 6 to 30 months. The lower limb movement was normal. All the donor sites had a good healing with no pain and abdominal complications. No tumor recurrence was observed during the followed-up period. Conclusion DIEP flap have many advantages, such as large cutting area, which is suitable for large-area wound repair after extended excision of soft tissue malignant tumor in lower limb. At the same time, the perforator vessel is constant and the caliber are thick, also the donor area is concealed and can be sutured directly.This kind of the technique for reconstruction of lower limb soft tissue defects after malignant tumor resection is well acceptable.

Objective To explore the method and clinical efficacy of microsurgical reconstructive surgery af-ter malignant tumors radical resection on the surface. Methods From June, 2015 to March, 2017, a total of 32 pa-tients in this group underwent radical resection of malignant tumors. All of them resulted in a large area of soft tissue defect with loss of function.The average defect area was 10.0 cm×12.0 cm.All types of free flap and pedicle flap were selected. Myocutaneous flaps or local flaps were used to repair large areas of soft tissue defect on the basis of micro-surgical techniques to protect the blood supply of the flaps and to reduce the damage to the donor area by evaluating the defect size, surrounding anatomical characteristics, and other factors. Results Thirty-two flaps survived com-pletely. After 4 to 18 months of followed-up, the color of flap was close to that of the surrounding skin. The texture was good. There was no bloated swelling, and the skin protective sensation was restored. There was no obvious scar hyperplasia, no chills, no pain and no other complications in the donor site. Conclusion After the radical mastec-tomy of the body surface, different types of flaps can be selected for the first-stage microsurgery according to the characteristics of the different parts and the tumor excision wounds to obtain a good clinical efficacy.

Objective To estimate the clinical effect of fuzhenghuayu capsule in treatment of early hepatocirrhosis by liver instantaneous elastic imaging. Methods Eighty patients with early hepatocirrhosis were divided into experiment group and control group according to the treatment method with 40 cases each. All the patients in 2 groups were given the same antiviral treatment with entecavir dispersible tablets, and the patients in experiment group combined with fuzhenghuayu capsule. All treatment lasted for 6 months. The liver stiffness measurement (LSM) was measured before treatment and 1, 3 and 6 months after treatment by liver instantaneous elasticity imaging. The serum hyaluronic acid was measured, and the Child-Pugh score was evaluated at the same time. Results The LSM, hyaluronic acid and Child-Pugh scores 6 months after treatment in experiment group were significantly lower than those in control group:(19.3 ± 0.9) kPa vs. (29.6 ± 1.3) kPa, (215.6 ± 59.3)μg/L vs. (344.4 ± 39.6)μg/L and (2.1 ± 1.3) scores vs. (3.9 ± 0.9) scores, and there were statistical differences (P<0.05). No obvious adverse reactions related to the use of fuzhenghuayu capsule were found during the course of treatment. Conclusions Liver instantaneous elasticity imaging can be used to evaluate and monitor early hepatocirrhosis. Fuzhenghuayu capsule on patients with early hepatocirrhosis has a certain degree of curative effect.