Objective:To compare the clinical characteristics and prognosis of children with necrotizing pneumonia (NP) infected by bacteria and Mycoplasma pneumoniae (MP). Methods:The clinical data of 69 children with NP from January 2012 to June 2019 in Dalian Central Hospital Affiliated to Dalian Medical University were retrospectively analyzed. Among them, there were 27 cases of bacterial infection NP (bacterial infection group) and 42 cases of MP infection NP (MP group). The clinical symptoms and signs, extrapulmonary complications, laboratory examination, imaging examination, treatment, outcome and follow-up were compared between 2 groups.Results:There were no significant differences in the rale rate, respiratory tone reduction rate and total fever time between 2 groups ( P>0.05); the incidence of shortness of breath in bacterial infection group was significantly higher than that in MP group: 77.8% (21/27) vs. 14.3% (6/42), and there was statistical difference ( P<0.01). There were no significant differences in the incidence of extrapulmonary complications between 2 groups ( P>0.05). The white blood cell, C-reactive protein (CRP), procalcitonin (PCT) and interleukin (IL) -10 in bacterial infection group were significantly higher than those in MP group, the tumor necrosis factor (TNF)-α and interferon (IFN) -γ in bacterial infection group were significantly lower than those in the MP group, and there were statistical differences ( P<0.05). There were no significant differences in neutrophils, lactate dehydrogenase (LDH) and IL-6 between 2 groups ( P>0.05). The time of necrosis in bacterial infection group was significantly earlier than that in MP group: (14.5 ± 4.2) d vs. (21.7 ± 6.4) d, and there was statistical difference ( P<0.05); there was no significant difference in the incidence of pleural effusion between 2 groups ( P>0.05), but the incidence of pleural effusion separation in bacterial infection group was significantly higher than that in MP group: 70.4% (19/27) vs. 2.4% (1/42), and there was statistical difference ( P<0.01). There were no significant differences in antibiotic application time, CRP recovery time and hospital stay between 2 groups ( P>0.05); the oxygen uptake rate and closed thoracic drainage rate in bacterial infection group were significantly higher than those in MP group: 88.9% (24/27) vs. 35.7% (15/42) and 25.9% (7/27) vs. 11.9% (5/42), the recovery times of WBC and PCT in bacterial infection group were significantly longer than that in MP group: (12.8 ± 4.1) d vs. (9.2 ± 2.0) d and (10.5 ± 2.5) d vs. (7.6 ± 1.9) d, the bronchoalveolar lavage rate was significantly higher than that in MP group: 25.9% (7/27) vs. 76.2% (32/42), and there were statistical differences ( P<0.01 or <0.05). There was no significant difference in the absorption time of necrotic lesions between 2 groups ( P>0.05). Conclusions:Compared with MP infection, the clinical process of bacterial infection NP is serious, the necrosis time appears earlier, and the course of disease is longer. However, most of the children with NP can obtain a good prognosis after active symptomatic and antiinfective treatment.

Objective:To investigate the clinical effect of using free bilateral anterolateral thigh flaps(ALTF) in series to repair large area soft tissue defects of forearm.Methods:The clinical data of 11 patients with large soft tissue defects of forearm admitted in the Department of Plastic(Repair and Reconstruction) Surgery, Lishui Hospital of Zhejiang University from March 2014 to December 2021 were retrospectively analyzed, including 8 males and 3 females. Aged 36 to 68 years old, with an average of 48 years old. VSD treatment was performed after debridement, and until fresh removed 3 to 5 days after the operation. Until the wound was fresh. The wound was repaired with free bilateral ALTF in series until fresh. The size of the forearm wound was 18 cm×15 cm-28 cm×13 cm. The cut area of a single flap was 10 cm×8 cm-20 cm×13 cm. The series of bilateral flaps: One of the flaps was used as the proximal flap, and its vascular pedicle was anastomosed with the arteries and veins of the recipient area. The other flap was used as the distal flap, and the arteries and veins between the 2 ALTFs on both sides were anastomosed. The vascular pedicle beyond the distal flap was ligated or anastomosed to the distal end of the ulnar artery or the distal end of the radial artery. The flap and the surrounding skin of the recipient area were sutured immediately. The donor sites of the flap was closed directly. Periodic and regular outpatient follow-up was performed after operation and the clinical efficacy was analyzed.Results:All the flaps successfully survived after the surgery. The postoperative follow-up lasted for 6-18 months, 12 months in average. The flaps survived well with good soft texture, without swelling, the capillary reaction time was normal, without surface ulceration, in rosy colour and restored protective sensations. The hand function of the affected limb recovered well. The wound at donor sites healed well without complications. At the last follow-up, the hand function of the affected limb was evaluated by the Evaluation Trial Standards of Upper Limb Partial Functional of Hand Surgery of Chinese Medical Association, the result was 7 in excellent and 4 in good. The patients were satisfied with the flap and the therapeutic effect.Conclusion:The free bilateral ALTF in series can be used to repair a wound surface with large area, and the donor site can be closed at the same time. It is an effective method to repair large soft tissue defect of forearm.

{L-End}Objective To explore the status of quality control assessment of pure tone audiometry (PTA) and to analyze its influencing factors in occupational medical examination (OME) institutions in Guangzhou City. {L-End}Methods A total of 41 OME institutions in Guangzhou City were selected as the research subjects from 2021 to 2022 using random sampling method, and its status of on-site quality and PTA quality for individuals exposed to noise were assessed. {L-End}Results A total of 205 rectification items were identified among the 41 OME institutions from 2021 to 2022. Among them, 19, 28, 30, and 28 OME institutions did not meet the requirements of organizational structure, quality management system, quality control of OME, and health examination information reporting, respectively. A total of 1 095 OME reports for individuals exposed to noise were assessed, with 820 reports having correct results and conclusions, resulting in an accuracy rate of 74.9%. The results of the multiple logistic regression analysis showed that OME institutions without meeting the requirements for the quality management system had a higher risk of failing the PTA quality control assessment and having inaccurate hearing test results compared with those meeting the requirements (all P<0.05). OME institutions with a filing period less than one year had a higher risk of having inaccurate hearing test results than those with a filing period of one year or more (P<0.05). OME institutions not meeting the requirements for quality control of OME had a higher risk of having abnormal OME conclusions than those meeting the requirements (P<0.05). OME institutions not meeting the requirements for health examination information reporting had a higher risk of having abnormal conclusions in suspected occupational disease than those meeting the requirements (P<0.05). OME institutions not meeting the requirements for the quality management system had a higher risk of having abnormal conclusions of occupational contraindications than those meeting the requirements (P<0.05). {L-End}Conclusion The quality of PTA in OME institutions in Guangzhou City needs to be improved. And a well-established quality management system for OME is beneficial for improving the quality of PTA.

Objective: To analyze the gene characterization on the first imported D8 genotype measles virus in Liaoning province. Methods: In this study, Vero/Slam cells were used to isolate measles viruses from throat swabs. Fragments of the H gene (1854 nucleotides) and N gene (450 nucleotides) were amplified by reverse transcription-polymerase chain reaction (RT-PCR) and the PCR products were sequenced and analyzed. Results: The measles virus isolates and World Health Organization (WHO) D8 genotype reference strain (MVi/Manchester.GBR/30.94) belonged to the same branch in the genetic relationship tree. The nucleotide homology of the N and H gene was 98.9%. Phylogenetic trees were constructed with reference strains of the genotype D8 measles virus of China downloaded from GenBank. The result showed that the nucleotide similarities between the measles virus isolated in this study and the D8 genotype measles virus prevalent in Hong Kong from 2012 to 2016 and MVi/LosPatios.COL/11.18/D8 in Columbia was 100%. Conclusions It is the first time to do surveillance for the D8 genotype measles virus since measles virus surveillance was carried out. It was of great significance to accumulate the bases of measles virus molecular epidemiology in Liaoning province, and helpful to analyze and trace the transmission of measles virus in the whole country and the world.

OBJECTIVETo provide data for the occupational health supervision by analyzing the occupational health status in manufacturing industry in Guangzhou, China.

METHODSThe occupational health investigation was performed in 280 enterprises randomly selected from 8 industries based on industry stratification. According to the occupational health standards, 198 out of the 280 enterprises were supervised and monitored. Sample testing was performed in 3~5 workplaces where workers were exposed to the highest concentration/intensity of occupational hazard for the longest time. Comparative analyses of the overproof rates of hazard were performed among enterprises, workplaces, and testing items from different industries.

RESULTSThe concentrations of occupational hazard in 42.93% (85/198) of enterprises and 22.96% (200/871) of workplaces were above the limit concentration. The most severe hazards were the noises in shipbuilding and wooden furniture industries and the welding fumes in shipbuilding industry. Less than 30% of enterprises were able to provide occupational health examination and periodic test reports of occupational hazard in workplaces. The rate of the workers with abnormal occupational health examination results and the need for reexamination reached 6.63% (832/12 549), and they were mostly from shipbuilding, wooden furniture, and chemical industries.

CONCLUSIONThe occupational health supervision should be strengthened in enterprises, and hazard from noises and dusts should be selectively controlled or reduced. The publication of relevant data and information of occupational health in enterprises should be promoted to enhance social supervision.

Chemical Industry ; China ; Dust ; Humans ; Interior Design and Furnishings ; Manufacturing Industry ; statistics & numerical data ; Noise, Occupational ; Occupational Exposure ; statistics & numerical data ; Occupational Health ; statistics & numerical data ; Welding ; Workplace

Objective: To analyze the genetic characterization of 2B genotype rubella virus strains first isolated in Liaoning province. Methods: Vero/Slam cells were used to isolate rubella viruses from throat swabs. Fragments of the E1 gene (739 nucleotides) were amplified by reverse transcription-polymerase chain reaction (RT-PCR) and the PCR products were sequenced and analyzed. The phylogenetic trees were constructed with rubella 2B genotypes reference strains. Results: RVi/Liaoning.CHN/13.18/1[2B] was isolateded from the case which had a history of international travel and probably imported from abroad. RVi/Liaoning.CHN/13.18/1[2B] was in the same 1ineage with RVs/Edinburgh.GBR/6.12[2B] and RVs/Kawasaki.JPN/17.11/1[2B], but far from the epidemic strains isolated in China in recent years. RVi/Liaoning.CHN/14.18/1[2B] belonged to the same lineage with rubella virus 2B genotype strains isolated in China from 2014 to 2015, and had the highest homology with RVi/Chouzhou.Anhui.CHN/17.15/2[2B] and RVi/Shaoyang.Zhejiang. CHN/13.13[2B]. Conclusions It was the first time to isolate the 2B genotype rubella virus in Liaoning province and the strain belonged to different 1ineage.

Aberrant activation of NLRP3 inflammasome in colonic macrophages strongly associates with the occurrence and progression of ulcerative colitis. Although targeting NLRP3 inflammasome has been considered to be a potential therapy, the underlying mechanism through which pathway the intestinal inflammation is modulated remains controversial. By focusing on the flavonoid lonicerin, one of the most abundant constituents existed in a long historical anti-inflammatory and anti-infectious herb