Objective:To analyze the genetic variation characteristics of the HA gene of influenza A virus (H3N2) in Guizhou province from 2017 to 2019. Methods:Twenty strains of influenza A virus (H3N2) were randomly selected from 10 network laboratories in Guizhou province for RNA extraction. Reverse transcriptase-polymerase chain reaction and sequencing were performed. The products were analyzed using bioinformatics software.Results:The nucleotide homology of the HA gene of the 20 strains was 97.7%-100%, which was highly homologous to the vaccine strains A/Hong-Kong/4801/2014 recommended by WHO in 2017 and A/Singapore-INFIMH/16-0019/2016 recommended by WHO in 2018, but they were significantly different from the vaccine strain A/Kansas/14/2017 recommended by WHO in 2019. Genetic analysis showed that the 20 strains were divided into two branches, and the strains that were prevalent in 2019 were located in different branches, with marked genetic differences. Key site analysis showed mutations in antigenic determinants A, B, C, and E and mutations in the anterior and posterior walls of receptor binding sites. Key site analysis also showed that there was an increase in the number of glycosylation sites compared with the vaccine strains prevalent in the same year. Genetic distance, antigen sites, and glycosylation sites were slightly different between virus strains prevalent in 2017-2018 and virus strains prevalent in 2019. Conclusion:The HA gene of the influenza A virus subtype H3N2 in Guizhou province from 2017 to 2019 showed heterogeneity and gene mutation, especially in 2019. Therefore, close monitoring of the genetic evolution of the influenza A virus subtype H3N2 is necessary.

Objective To establish the quality standards of Hirtula Roses for the quality control of production, supervision, circulation and application. Methods The moisture content, total ash, ethanol extract content and characteristic chromatogram of Rosa roxburghii Tratt. were determined according to the related determination method in Ⅳ-Part of Chinese Pharmacopeia 2020. Results There should be 6 characteristic peaks in the characteristic chromatogram of Rosa roxburghii Tratt., which should correspond to the retention time of 5 characteristic peaks in the reference chromatogram of the standard herbs, and another peak should correspond to the retention time of the reference chromatogram of isoquercitrin. The moisture content of Rosa roxburghii Tratt. should be less than 14.0%; the total ash content should be less than 5.0%; the ethanol extract content should be more than 20.0%. Conclusion According to the experimental results, the quality standard of Rosa roxburghii Tratt. is conformed to the national requirements of quality standards for traditional Chinese medicine, which could provide a reference for the quality control of Hirtula Roses.

Objective:To summarize the clinical and laboratory characteristics of infectious mononucleosis (IM) in children.Methods:Clinical features and laboratory results of 270 cases with IM admitted to the Department of Pediatrics in Strategic Support Force Medical Center of People′s Liberation Army from January 2012 to December 2020 were retrospectively analyzed. χ2 test was used for comparison between groups. Results:IM mainly occurred in children aged 5 months to 18 years old in autumn and spring.The highest incidence rate (105 cases, 38.9%) was 3-<6 years old (preschoolers). There were 253 cases (93.7%) with fever, 266 cases (98.5%) with adenopharyngitis, 196 cases (72.6%) with tonsil pseudomembrane or exudation, 248 cases (91.9%) with cervical lymphadenopathy, 92 cases (34.1%) with eyelid edema, 202 cases (74.8%) with nasal obstruction, 124 cases (45.9%) with nasal obstruction and snoring, 24 cases (8.9%) with rash, and 112 cases (41.5%) with splenomegaly.A total of 225 cases (83.3%) presented with typical triplets of IM (fever, adenopharyngitis and cervical lymphadenopathy). Sixty-two IM patients were complicated with pulmonary infections and 3 cases with diarrhea.The main co-infection pathogens in children with IM were Mycoplasma pneumonia (MP) (79 cases, 29.3%), influenza A or B virus (34 cases, 12.6%), Streptococcus pneumonia (SP) (18 cases, 6.7%), adenovirus (22 cases, 8.1%) and cytomegalovirus (3 cases, 1.11%). A total of 46 cases (17.0%) had multiple infections.Laboratory test results suggested that absolute lymphocyte count ≥5.0×10 9/L was found in 199 cases (73.7%), and abnormal lymphocyte ratio >0.10 was found in 225 cases (83.3%). Some children had elevated transaminase levels.Epstein-Barr virus capsid antigen-immunoglobulin M (EBV-VCA-IgM) was positive in 249 cases (92.2%), Epstein-Barr virus capsid antigen-immunoglobulin G (EBV-VCA-IgG) was positive in 238 cases (88.1%), and Epstein-Barr virus nuclear antigen-immunoglobulin G (EBV-NA-IgG) was negative in all cases.EBV-VCA-IgG showed low affinity in all cases (<40%). EBV DNA tests of peripheral blood plasma were carried in 153 cases, of which 118 cases (77.1%) were positive. Conclusions:EBV related IM mainly attacks preschoolers.Most patients are presented with typical triplets of IM.Eyelid edema, nasal obstruction, snoring, splenomegaly and elevated transaminase levels are prevalent in IM children.Most cases have a favorable prognosis.

Novel Coronavirus Pneumonia (NCP) is a class B infectious disease, which is prevented and controlled according to class A infectious diseases. Recently, children′s NCP cases have gradually increased, and children′s fever outpatient department has become the first strategic pass to stop the epidemic. Strengthening the management of the fever diagnosis process is very important for early detection of suspected children, early isolation, early treatment and prevention of cross-infection. This article proposes prevention and control strategies for fever diagnosis, optimizes processes, prevents cross-infection, health protection and disinfection of medical staff, based on the relevant diagnosis, treatment, prevention and control programs of the National Health and Health Commission and on the diagnosis and treatment experience of experts in various provinces and cities. The present guidance summarizes current strategies on pre-diagnosis; triage, diagnosis, treatment, and prevention of 2019-nCoV infection in common fever, suspected and confirmed children, which provide practical suggestions on strengthening the management processes of children′s fever in outpatient department during the novel coronavirus pneumonia epidemic period.

Children′s unique physiological, developmental and psychological attributes make them one of the most vulnerable groups in large-scale flood disasters.Formulating a reasonable and feasible emergency preparedness plan for flood disasters can improve their ability to cope with flood disasters and optimize the outcomes of children suffering from flood disasters.The emergency preparedness plan for children′s flood disaster should cover the allocation and utilization of various resources during disasters, regional cooperative rescue and evacuation of children, ethical problems in treatment under special circumstances, psychological counseling of children, family members and medical personnel.Relevant staff of pediatric emergency rescue need to consider all aspects and make reasonable plans so that the rescue work of children affected by disasters can be carried out in an orderly manner.

Objective:To compare the accuracy of influenza-like illness (ILI) surveillance by automatic computer analysis based on electronic medical records and by doctor’s report.Methods:A total of 3 542 patients who presented to Yichang Central Hospital fever clinic, respiratory department or emergency department between April to October 2019 with an ICD-10 code for acute respiratory illness (J00-J22) and complete electronic medical information of ILI related syndromes were drawn as the study sample. Taking the classification of the study sample according to the ILI case definition by influenza surveillance professionals as the gold standard, draw the receiver operating characteristic (ROC) curve and calculate sensitivity, specificity, diagnostic consistency to compared the accuracy of ILI surveillance by automatic computer analysis and by doctor's report.Results:Median age of 3 542 cases was 30 (24, 38) years old; 1 179 cases (33.29%) compliance with the case definition, ILI reported by doctors was 1 306 cases (36.87%), and computer automatic identification ILI were 1 150 cases (32.47%); 1 391 (39.27%) cases were men. The results of automatic computer analysis and doctor report consistency of kappa values with gold standard judgment were 0.97 and 0.66 respectively; area under the ROC curve was 0.98 and 0.84, respectively. And the sensitivity and specificity of automatic computer analysis were higher than that of doctor's report (all P values were <0.001), the sensitivity was 96.95% and 82.27%, and the specificity was 99.70% and 85.78%, respectively. Conclusion:The automatic computer analysis based on electronic medical records can identified ILI cases with good sensitivity and specificity in ILI case surveillance.

Objective:To compare the accuracy of influenza-like illness (ILI) surveillance by automatic computer analysis based on electronic medical records and by doctor’s report.Methods:A total of 3 542 patients who presented to Yichang Central Hospital fever clinic, respiratory department or emergency department between April to October 2019 with an ICD-10 code for acute respiratory illness (J00-J22) and complete electronic medical information of ILI related syndromes were drawn as the study sample. Taking the classification of the study sample according to the ILI case definition by influenza surveillance professionals as the gold standard, draw the receiver operating characteristic (ROC) curve and calculate sensitivity, specificity, diagnostic consistency to compared the accuracy of ILI surveillance by automatic computer analysis and by doctor's report.Results:Median age of 3 542 cases was 30 (24, 38) years old; 1 179 cases (33.29%) compliance with the case definition, ILI reported by doctors was 1 306 cases (36.87%), and computer automatic identification ILI were 1 150 cases (32.47%); 1 391 (39.27%) cases were men. The results of automatic computer analysis and doctor report consistency of kappa values with gold standard judgment were 0.97 and 0.66 respectively; area under the ROC curve was 0.98 and 0.84, respectively. And the sensitivity and specificity of automatic computer analysis were higher than that of doctor's report (all P values were <0.001), the sensitivity was 96.95% and 82.27%, and the specificity was 99.70% and 85.78%, respectively. Conclusion:The automatic computer analysis based on electronic medical records can identified ILI cases with good sensitivity and specificity in ILI case surveillance.

Objective To explore the changes of T-lymphocyte subsets,D-Dimer and immunoglobulin in mycoplasma pneumonia children and its significance.Methods The levels of T lymphocyte subsets (CD3 +、CD4 +、CD8 +、CD4 +/CD8 +)in 50 children with mycoplasma pneumonia (MPP Group)and 50 healthy children were detected by flow cytometry;The levels of D-Dimer were detected by immunoturbidimetry;The levels of serum immunoglobulin were detected by immune turbidimetric method.Results The results of T lymphocyte subsets:Compared with normal control group, CD3 +and CD4 +peripheral blood cells in MPP group were significantly declined(P<0.001)、CD8 +cells were increased slightly,but with no significant difference、CD4 +/CD8 +ratios were decreased slightly.The results of D-Dimer:Compared with normal control group,the levels of D-Dimer in MPP group were significantly escalated(P<0.001).The results of immunoglobulin:IgA and IgMin MPP group were both significantly higher than those of normal group,but IgG was not different from that in normal group.Conclusion Children with mycoplasma pneumonia have immune disorder,which may generate abnormal clotting.Therefore,besides the conventional anti-mycoplasma pneumonia treatment,we need to detect the levels of D-Dimer according to the clinical symptoms and disease progression and strength the regulation and treatment of the immune system.

Objective To study the T Lymphocyte Subsets and the cytokines in the newborns with infectious diseases. Methods Twenty cases of neonatal bacterial pneumonia (bacterial group), 15 cases of rotavirus enteritis (virus group) and 20 newborns with jaundice (control group) were recruited in this study. The peripheral CD4+T Cells and lymphocyte subsets were assessed by flow cytometry. Results The IL-4 level was significantly different among different groups (F=3.39, P=0.041). The levels of IL-17 and IFN-γdid not differ signiifcantly among different groups (F=0.28 and 1.24 respectively, P>0.05). The IL-4 level was higher in bacterial group than that in virus group and control group (P<0.05). The percentages of CD3+, CD4+, CD19+and NK cells and the ratio of CD4+/CD8+ had significant difference among different groups (F=3.30-26.69, P<0.05). The percentages of CD3+and CD4+cells and the ratio of CD4+/CD8+were lower in bacterial group and virus group than those in control group (P<0.05). The percentage of CD19+cells was higher in bacterial group and virus group than that in control group (P<0.05). The percentage of NK cells was lower in virus group than that in bacterial group and control group (P<0.05). Conclusions The pattern of cytokines level is different in newborns with infection caused by different pathogens. Newborns with infectious diseases have immune dysfunction and Th2-dominated imbalance. The low percentages of T lymphocyte subsets indicate the depressed cellular immunity after infection, which may result in atypical symptom and prolonged disease course.

Objective The purpose of this study was to evaluate the feasibility of expiratory flow limitation(EFL) detected by negative(NEP) and the correlation between EFL and routine lung function measurements(Forced expiratory volume in first second,FEV1),EFL and MRC dyspnea scale,in patients with stable and acute asthma,to find a simple,reliable and objective method for the diagnosis,differential diagnosis,the severity of disease and evaluation of severity and efficacy of treatment for asthma,and a objective method reflecting the severity of dyspnea.Methods Sixty-four children enrolled in No.306 Hospital of PLA from Jun.to Dec.in 2012 were included in this study.The severity of dyspnea was rated according to the dyspnea scale proposed by the Medical Research Council(MRC).Then routine pulmonary ventilation function tests and NEP technique were performed respectively.Result (1) All asthmatic patients tolerated NEP well.(2) Pulmonary ventilation function tests:The mean FEV1 in 64 was 71.33 ± 13.92％ pred.(3) MRC dyspnea scale:MRC dyspnea scale was 2 in 10,1 in 54 of 64 children with stable asthma.The Spearman' s correlation coefficient of MRC dyspnea scale with FEV1 was-0.635(P ＜0.05).(4)EFL detected by NEP:There were no EFL in 46 children with asthma both in seated and supine positions.There were EFL in 8 children both in seated and supine positions and in 10 only in supine position..The Spearman's correlation coefficient of three-point EFL score with FEV1 and MRC dyspnea scale was-0.607 and 0.964(P ＜ 0.05) respectively.The Spearman's correlation coefficient of five-point EFL score with FEV1 and MRC dyspnea scale was-0.626 and 0.966 (P ＜ 0.05)respectively.Conclusion (1) NEP technique can be used in children with asthma.(2) There was a significant correlation between EFL detected by NEP technique and FEV1.(3) There is a stronger correlation between EFL and MRC dyspnea scale than that between FEV1 and MRC dyspnea scale.