Objective: To explore the sensitivity and specificity of the Chinese version of the volume and viscosity swallowing test with modified safety and effectiveness indicators (VVST-CV) in assessing deglutition disorders. Methods: The solvent, volume, viscosity, and test index of the volume and viscosity swallowing test were modified before it was used to evaluate 89 patients with swallowing disorders. The positive rates of the safety indexes (coughing, voice changes and blood oxygen saturation decline at least 3%) and the efficiency indexes (poor lip closure, oral residue, pharynx residue and swallowing) were recorded and compared and compared with the positive rates of penetration, aspiration and food residue determined by means of according to the videofluoroscopic swallowing study, then the sensitivity, specificity, positive predictive value and negative predictive value of the modified VVST-CV with regard to the safety and efficiency of swallowing were calculated. Results: The VVST-CV′s sensitivity in detecting dysphagia was 0.97. For impaired safety it was 0.85 and for impaired swallowing efficiency it was 0.95. The sensitivity of the coughing index was 0.65, that of sound change was 0.60 and that of oxygen saturation decrease was 0.42. The positive predictive values for coughing, sound change and oxygen saturation decrease were 0.98, 0.94 and 0.94, respectively. Conclusion The VVST-CV is simple, feasible and sensitive. It can be widely useful in the evaluation of dysphagia in clinical practice.

Objective:To analyze the epidemiological characteristics and co-infections of pathogens in children with pneumonia in autumn and winter of 2019 in Qingdao.Methods:From August to November in 2019, 77 children with pneumonia in three hospitals in Qingdao were selected as the research subjects. Throat swabs were collected, nucleic acid was extracted, and 20 common respiratory pathogens were detected by single tube multiplex PCR.Results:Among the 77 cases, the incidence of pneumonia in boys (53.2%) was slightly higher than that in girls (46.7%). Children aged 1-2 years accounted for 10.3% of the total cases, children aged 3-6 years accounted for 61%, and children aged 7-13 years accounted for 20.7%. Twenty-nine cases (38.10%) had high white blood cells; 16 cases (20.77%) had high neutrophil count; 30 cases (38.96%) had high lymphocyte count; the pathogen detection rate was 77.92% of cases, among whom Mycoplasma pneumoniae (MP) was 59.74%, Bocavirus was 10.39%(8/77), adenovirus was 7.79% (6/77), rhinovirus was 3.89% (3/77), parainfluenza virus type 4 was 3.89% (3/77), Bordetella pertussis was 3.89% (3/77), parainfluenza virus type 2 was 2 2.59% (2/77), coronavirus nl63/hku1 was 2.59% (2/77), coronavirus OC43 was 2.59% (2/77), human metapneumovirus was 1.29% (1/77), Parainfluenza virus type 3 was 1.29%(1/77). The 24 cases of virus infection accounted for 31.16% (24/77). The co-infection with two pathogens accounted for 18.18%.Conclusions:Many kinds of pathogens were detected in children with pneumonia in autumn and winter of 2019, in Qingdao. The prevalence of Mycoplasma pneumoniae infection was the highest. Many common viral infections were found in the cases. A high proportion of co-infection was detected in these pneumonia cases.

Objective:To explore the application of digital acoustic analysis in assessing the risk of aspiration among persons with dysphagia using the Praat speech analysis software.Methods:The swallowing of 46 stroke survivors with dysphagia was studied using video fluoroscopy. Each patient was required to pronounce " yi/i/" 3 times before and after taking each mouthful of food, and their voice samples were collected. The subjects were divided into a non-aspiration group of 16 and an aspiration group of 30 based on their penetration-aspiration scale scores. Fundamental frequency, relative average perturbation (RAP), jitter, shimmer, amplitude perturbation quotient and harmonic-to-noise ratio were compared between the two groups before and after taking food.Results:For the non-aspiration group, there was no significant difference in the acoustic data before and after eating. For the aspiration group there were significant differences in fundamental frequency, relative average perturbation and jitter before and after taking food. The average RAP and jitter of the non-aspiration group were significantly better than the aspiration group′s averages before eating. After eating, however, significant differences were observed only in average jitter.Conclusions:Analyzing perturbation and jitter can help to identify persons at risk of aspiration.

Objective:To explore the effect of the pharyngeal pressure feedback training on pharyngeal constriction in persons with swallowing disorders caused by brainstem lesions.Methods:Twenty patients with disordered swallowing caused by a brainstem lesion were randomly divided into a control group and an intervention group, each of 10. Both groups received routine swallowing training including oral sensorimotor training, neuromuscular stimulation and balloon catheter dilation, while the intervention group was additionally provided with two weeks of pharyngeal pressure feedback training. Before and after the treatment, both groups were evaluated in terms of the peak pressure of superior and inferior pharyngeal constriction, endoscopically and also using the functional oral intake scale.Results:There was no significant difference between the two groups in any measure before the intervention. Afterward, both groups had improved significantly by all of the measurements, but the average peak upper pharyngeal pressure, the average intake scale score and the endoscopy results of the intervention group were all significantly better than the control group′s averages.Conclusions:Pharyngeal pressure feedback training can significantly relieve swallowing disorders caused by brainstem lesions.

Objective:To analyze the epidemiological characteristics and genotypes of human rhinovirus (HRV) in patients with upper respiratory tract infection in Qingdao in the winter of 2020.Methods:Throat swab samples were collected from 101 patients with upper respiratory tract infection in Qingdao from November 2020 to January 2021. Quantitative PCR was used to detect 15 common respiratory viruses in the samples. HRV-positive samples were further analyzed with RT-PCR to amplify and sequence HRV VP4/VP2 gene. A phylogenetic tree was constructed based on the sequencing results and homology analysis was conducted.Results:Six common respiratory viruses were detected in the 101 patients. Thirty-four cases (34/101, 33.66%) were single pathogen infection and two cases were multiple infection (2/101, 1.98%). The positive rate of HRV was the highest (21.78%, 22/101). Twenty HRV VP4/VP2 sequences were successfully amplified. Phylogenetic analysis showed that there were 16 strains of HRV-A subtype and four strains of HRV-C subtype and 14 serotypes were involved.Conclusions:HRV was one of the leading viral pathogens causing upper respiratory tract infection in Qingdao in the winter of 2020 and the predominant subtype was HRV-A.

Objective:To understand the prevalence of coxsackievirus A6 (CV-A6) in hospitalized patients with hand, foot and mouth disease in autumn and winter of 2019, and the genetic characteristics of VP1 region and the relation-ship between germline evolution.Methods:A total of 104 throat swabs from hospitalized patients with hand, foot and mouth disease in Qingdao in autumn and winter of 2019, and screen positive specimens were collected using enterovirus universal real-time PCR technology. Then the universal typing primers in the VP1 region were used to amplify the positive samples, the amplified segments were sequenced and BLAST comparison was performed. CV-A6 VP1 full-length primers were used to amplify the BLAST comparison of CV-A6 positive samples, sequence the ampli-fied products, analyze the homology of nucleotides and amino acids through DNAstar and MEGA software, and construct a phylogenetic tree.Results:Among 104 throat swab samples, 60 were positive for enterovirus, and the overall positive rate was 57.7%, of which the positive rate of CV-A6 was 26.9% (28/104), and the rate of coxsackievirus A16 (CV-A6) was 30.8% (32/104). Twenty-eight CV-A6 positive samples were subjected to full-length amplification, sequencing, comparison and homology analysis of the VP1 region, and 22 positive sequences were obtained. The nucleotide homology was 93.6% to 99.9%, and the amino acid homology was 98.0%-100%. Phylogenetic analysis showed that 22 CV-A6 strains belonged to the D3 subtype in the D genotype.Conclusions:The pathogens causing hospitalized hand, foot and mouth disease in Qingdao in autumn and winter of 2019 were CV-A6 and CV-A16. The prevalent strains of CV-A6 were mainly D3 subtypes.

Objective:To Isolate and identify human rhinovirus (HRV) in hospitalized children with pneumonia in Qingdao in 2020.Methods:A total of 98 throat swab samples were collected from hospitalized children with pneumonia in 2020. Common respiratory viruses were screened through RT-qPCR. The HRV positive samples were inoculated into H1-HeLa cells. Viruses with typical cytopathic effect (CPE) were identified by HRV specific RT-PCR. Subsequently, sequences of HRV-VP4/VP2 gene were used to construct phylogenetic trees and analyze homology with sequences of reference strains through MEGA software.Results:Among 98 hospitalized children with pneumonia, 11 samples were HRV positive in 98 throat swab samples. After the typical CPE appeared in HeLa cells, two strains of HRV were identified by specific RT-PCR. The HRV-A28 and HRV-A58 were confirmed by comparison and analysis of VP4/VP2 sequence. Phylogenetic tree found that the isolated HRV-A28 strain was genetically close to strains of Singapore in 2011, of Tunisia in 2017, and Kenya in 2017. The isolated HRV-A58 strain was genetically close to the strains of Australia in 2009, Venezuela in 2011, Mongolia in 2011, and the United States in 2014.Conclusions:The HRV-A28 and HRV-A58 strains were isolated from the throat swabs of children patients with pneumonia in Qingdao.

Objective:To determine the viral load of human herpesvirus 6 A (HHV-6A), HHV-6B and chromosomal integrated HHV-6 (ciHHV-6) simultaneously through a triple chip digital PCR (tcdPCR) method for detection of HHV-6A/6B and ribonuclease P-30 (RPP30).Methods:According to optimal reaction conditions of real-time fluorescence quantitative PCR (RT-qPCR) method, the tcdPCR mehod of HHV-6A, HHV-6B and RPP30 was established. The sensitivity of tcdPCR was determined by virus cultures and the specificity of tcdPCR was detected with other herpesviruses. Subsequently, the tcdPCR of HHV-6A, HHV-6B and RPP30 was verified through 127 whole blood samples.Results:The consistency between RT-qPCR and tcdPCR for HHV-6 detection was good (R 2>0.97). And there was no cross-reaction with other herpesviruses. The 14 positive samples could be detected effectively by the tcdPCR of HHV-6A, HHV-6B and RPP30. The lowest detectable viral load of HHV-6A and HHV-6B was 50 copies/ml and 105 copies/ml, respectively. And the ratio of HHV-6/(RPP30/2) in 14 positive samples was less than 1. Conclusions:The tcdPCR has good sensitivity and specificity. And HHV-6 tcdPCR method can quantitatively detect the viral load of HHV-6 infection and the copy number of RPP30, and ciHHV-6 can be judged by ratio of HHV-6/(RPP30/2) in clinical samples.