Objective:To analyze the epidemiological and clinical characteristics of respiratory pathogens in China.Methods:This study was a cross-sectional study, which encompassed 19 core units of the clinical pathogen network and established a three-tiered clinical pathogen surveillance system. Thirty respiratory samples were collected every two weeks from various units from January to December 2024, and the clinical and pathogen diagnostic information were gathered. A total of 11 864 samples were tested using this system. The tier-1 clinical pathogen surveillance system covered influenza A virus (Flu-A), influenza B virus (Flu-B), respiratory syncytial virus (RSV), and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The tier-2 clinical pathogen surveillance system focused on 18 key respiratory pathogens. The tier-3 clinical pathogen surveillance system further clarified whether any emerging infectious diseases had occurred.Results:The tier-1 clinical pathogen surveillance system showed Flu-A predominated in December, Flu-B predominated in January, SARS-CoV-2 peaked in March and August, whereas RSV circulated sporadically throughout the year. Geographic trends were broadly consistent across the seven major regions, although Flu-A detection in December was notably higher in Northeast China (48.1%(111/231)) and East China (36.2%(148/409)), and RSV detection was concentrated in the Northwest and South China from January to March. Data from the tier-2 clinical pathogen surveillance system indicated that Streptococcus pneumoniae, Mycoplasma pneumoniae, rhinovirus, and adenovirus were detected year-round, of these, Streptococcus pneumoniae and rhinovirus showed elevated positive detection rates from August to September, while adenovirus peaked in January. Legionella pneumophila was not detected throughout the year, and other pathogens fluctuated throughout the year without a consistent pattern. The predominant etiologic agents of pediatric pneumonia were Mycoplasma pneumoniae (35.0%(105/300)), rhinovirus (25.7%(77/300)), and adenovirus (17.3%(52/300)), whereas adult pneumonia was mainly caused by Streptococcus pneumoniae (10.5%(29/277)), Staphylococcus aureus (6.9%(19/277)), Mycoplasma pneumoniae (6.9%(19/277)), and Flu-A (6.1%(17/277)). The tier-3 clinical pathogen surveillance system did not identify any emerging respiratory pathogens. Conclusion:Respiratory pathogens in China in 2024 exhibit distinct temporal and spatial distribution patterns and vary among different populations.

Objective:To investigate the clinical effect of tibial periosteal lateral distraction combined with compound Ziyin ointment in the treatment of diabetic foot.Methods:A total of 62 patients with diabetic foot treated in the First People′s Hospital of Wuhu from July 2022 to September 2023 were prospectively selected and divided into routine group and combination group according to random number table method, with 31 cases in each group. The conventional group was treated with tibial periosteal lateral stretch, and the combined group was treated with tibial periosteal lateral distraction combined with compound Ziyin ointment, and the treatment lasted for 2 weeks. Traditional Chinese Medicine (TCM) syndrome scores, serum inflammatory factors, growth factors, foot temperature, toe oxygen saturation, pain and quality of life scores, clinical efficacy and complications were observed before and after treatment in the two groups.Results:After treatment, TCM syndrome score, serum inflammatory factor level and pain score were lower than before treatment, serum growth factor level, life quality score, foot temperature and toe end blood oxygen saturation were higher than before treatment (all P<0.05). After treatment, the pain score, TCM main disease score, TCM secondary disease score and inflammatory factor levels in the combined group were lower than those in the conventional group (all P<0.05), and the serum growth factor level, life quality score, foot temperature and toe end blood oxygen saturation were higher than those in the conventional group (all P<0.05). The total effective rate of combined group was higher than that of conventional group [93.55%(29/31) vs 70.97%(22/31), P<0.05]. There was no significant difference in the total incidence of adverse reactions between the two groups ( P>0.05). Conclusions:Tibial periosteal lateral distraction combined with compound Ziyin ointment can improve the levels of serum inflammatory factors, growth factors, foot temperature and toe oxygen saturation, reduce TCM syndrome score and relieve pain degree, improve patients′ quality of life and clinical efficacy, and have high safety.

Objective:To evaluate the efficacy and safety of nebulized inhalation of recombinant human interferon (IFN) α1b injection in the treatment of respiratory syncytial virus (RSV) associated lower respiratory tract infections (pneumonia and bronchiolitis) in children.Methods:A randomized, double-blind, parallel, placebo-controlled add-on design was used.Children with pneumonia or bronchiolitis aged 2 months to 5 years who tested positive for RSV antigen within 72 hours of onset from 30 clinical trial sites including Beijing Children′s Hospital, Capital Medical University between February 2021 and December 2022 were included in this study and randomly divided into 2 groups at a ratio of 1∶1 based on a stratified-block method.Both groups received basic treatments such as cough control, asthma relieving, expectorant treatment, fever reduction, oxygen therapy, etc.The experimental group received additional nebulized inhalation of IFN α1b injection at a dose of 2.0 μg/(kg·time), twice a day.The control group received nebulized inhalation of placebo twice a day.Clinical efficacy was evaluated based on indicators such as the duration of clinical symptoms and signs, and the Kaplan-Meier method was used to calculate the median and 95% CI of the duration of clinical symptoms and signs.The Log-rank test was used to compared data between groups.Safety was assessed through the incidence of adverse reactions and laboratory tests, and the Chi-square test was used to analyze the difference between groups. Results:There were 123 children in the experimental group and 122 children in the control group.The median durations of all the 5 clinical symptoms and signs [including shortness of breath, wheezing, dyspnea (visible retractions), decreased transcutaneous oxygen saturation, and abnormal mental state] in the experimental group after treatment were slightly shortened than those in the control group [2.7 d(95% CI: 1.9-3.0 d)] vs.[2.9 d(95% CI: 2.6-3.6 d), P=0.027].The improvement in dyspnea (retractions) was especially pronounced in the experimental group, with a relief rate of 50.0% (0, 100%) on the first day of administration[compared with 0 (0, 50.0%) in the control group ( Z=2.002, P=0.025)].The median duration of dyspnea in the experimental group was nearly 1 day shorter than that in the control group [1.0 d(95% CI: 0.7-1.7 d) vs.1.8 d(95% CI: 1.0-2.5 d), P=0.046].There were no significant difference in hospital stay [6.0(5.0, 8.0) d vs.6.5(5.0, 8.0) d, Z=0.675, P=0.500], oxygen therapy duration [32.0(14.0, 96.3) h vs.39.0 (24.0, 83.2) h, Z=0.094, P=0.925], the recovery rate from clinical symptoms during treatment [(105/106, 99.1%) vs.(96/101, 95.0%)], and recurrence rate [(0/106, 0) vs.(2/101, 2.0%)] between the 2 groups (all P>0.05).However, the above-mentioned four indicators in the experimental group showed a trend of clinical benefits.The quantitative virus detection results showed that the RSV viral load in both groups decreased after treatment compared to before treatment.After 2 days of treatment, the decline rate of RSV viral load from the baseline was 0.90 lg copies/(mL·d) in the experimental group and 0.25 lg copies/(mL·d)in the control group, with a statistically significant difference ( P<0.05).Furthermore, there was no statistically significant difference in the incidence of adverse reactions between the 2 groups ( P>0.05).Importantly, no drug-related serious adverse reactions occurred in both groups. Conclusions:The nebulized inhalation therapy of IFN α1b demonstrates efficacy and safety in treating pediatric RSV associated lower respiratory tract infections.It particularly offers outstanding clinical therapeutic value for severe children.

Objective:To evaluate the efficacy and safety of nebulized inhalation of recombinant human interferon (IFN) α1b injection in the treatment of respiratory syncytial virus (RSV) associated lower respiratory tract infections (pneumonia and bronchiolitis) in children.Methods:A randomized, double-blind, parallel, placebo-controlled add-on design was used.Children with pneumonia or bronchiolitis aged 2 months to 5 years who tested positive for RSV antigen within 72 hours of onset from 30 clinical trial sites including Beijing Children′s Hospital, Capital Medical University between February 2021 and December 2022 were included in this study and randomly divided into 2 groups at a ratio of 1∶1 based on a stratified-block method.Both groups received basic treatments such as cough control, asthma relieving, expectorant treatment, fever reduction, oxygen therapy, etc.The experimental group received additional nebulized inhalation of IFN α1b injection at a dose of 2.0 μg/(kg·time), twice a day.The control group received nebulized inhalation of placebo twice a day.Clinical efficacy was evaluated based on indicators such as the duration of clinical symptoms and signs, and the Kaplan-Meier method was used to calculate the median and 95% CI of the duration of clinical symptoms and signs.The Log-rank test was used to compared data between groups.Safety was assessed through the incidence of adverse reactions and laboratory tests, and the Chi-square test was used to analyze the difference between groups. Results:There were 123 children in the experimental group and 122 children in the control group.The median durations of all the 5 clinical symptoms and signs [including shortness of breath, wheezing, dyspnea (visible retractions), decreased transcutaneous oxygen saturation, and abnormal mental state] in the experimental group after treatment were slightly shortened than those in the control group [2.7 d(95% CI: 1.9-3.0 d)] vs.[2.9 d(95% CI: 2.6-3.6 d), P=0.027].The improvement in dyspnea (retractions) was especially pronounced in the experimental group, with a relief rate of 50.0% (0, 100%) on the first day of administration[compared with 0 (0, 50.0%) in the control group ( Z=2.002, P=0.025)].The median duration of dyspnea in the experimental group was nearly 1 day shorter than that in the control group [1.0 d(95% CI: 0.7-1.7 d) vs.1.8 d(95% CI: 1.0-2.5 d), P=0.046].There were no significant difference in hospital stay [6.0(5.0, 8.0) d vs.6.5(5.0, 8.0) d, Z=0.675, P=0.500], oxygen therapy duration [32.0(14.0, 96.3) h vs.39.0 (24.0, 83.2) h, Z=0.094, P=0.925], the recovery rate from clinical symptoms during treatment [(105/106, 99.1%) vs.(96/101, 95.0%)], and recurrence rate [(0/106, 0) vs.(2/101, 2.0%)] between the 2 groups (all P>0.05).However, the above-mentioned four indicators in the experimental group showed a trend of clinical benefits.The quantitative virus detection results showed that the RSV viral load in both groups decreased after treatment compared to before treatment.After 2 days of treatment, the decline rate of RSV viral load from the baseline was 0.90 lg copies/(mL·d) in the experimental group and 0.25 lg copies/(mL·d)in the control group, with a statistically significant difference ( P<0.05).Furthermore, there was no statistically significant difference in the incidence of adverse reactions between the 2 groups ( P>0.05).Importantly, no drug-related serious adverse reactions occurred in both groups. Conclusions:The nebulized inhalation therapy of IFN α1b demonstrates efficacy and safety in treating pediatric RSV associated lower respiratory tract infections.It particularly offers outstanding clinical therapeutic value for severe children.

Objective:To analyze the epidemiological and clinical characteristics of respiratory pathogens in China.Methods:This study was a cross-sectional study, which encompassed 19 core units of the clinical pathogen network and established a three-tiered clinical pathogen surveillance system. Thirty respiratory samples were collected every two weeks from various units from January to December 2024, and the clinical and pathogen diagnostic information were gathered. A total of 11 864 samples were tested using this system. The tier-1 clinical pathogen surveillance system covered influenza A virus (Flu-A), influenza B virus (Flu-B), respiratory syncytial virus (RSV), and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The tier-2 clinical pathogen surveillance system focused on 18 key respiratory pathogens. The tier-3 clinical pathogen surveillance system further clarified whether any emerging infectious diseases had occurred.Results:The tier-1 clinical pathogen surveillance system showed Flu-A predominated in December, Flu-B predominated in January, SARS-CoV-2 peaked in March and August, whereas RSV circulated sporadically throughout the year. Geographic trends were broadly consistent across the seven major regions, although Flu-A detection in December was notably higher in Northeast China (48.1%(111/231)) and East China (36.2%(148/409)), and RSV detection was concentrated in the Northwest and South China from January to March. Data from the tier-2 clinical pathogen surveillance system indicated that Streptococcus pneumoniae, Mycoplasma pneumoniae, rhinovirus, and adenovirus were detected year-round, of these, Streptococcus pneumoniae and rhinovirus showed elevated positive detection rates from August to September, while adenovirus peaked in January. Legionella pneumophila was not detected throughout the year, and other pathogens fluctuated throughout the year without a consistent pattern. The predominant etiologic agents of pediatric pneumonia were Mycoplasma pneumoniae (35.0%(105/300)), rhinovirus (25.7%(77/300)), and adenovirus (17.3%(52/300)), whereas adult pneumonia was mainly caused by Streptococcus pneumoniae (10.5%(29/277)), Staphylococcus aureus (6.9%(19/277)), Mycoplasma pneumoniae (6.9%(19/277)), and Flu-A (6.1%(17/277)). The tier-3 clinical pathogen surveillance system did not identify any emerging respiratory pathogens. Conclusion:Respiratory pathogens in China in 2024 exhibit distinct temporal and spatial distribution patterns and vary among different populations.

Objective:To investigate the clinical effect of tibial periosteal lateral distraction combined with compound Ziyin ointment in the treatment of diabetic foot.Methods:A total of 62 patients with diabetic foot treated in the First People′s Hospital of Wuhu from July 2022 to September 2023 were prospectively selected and divided into routine group and combination group according to random number table method, with 31 cases in each group. The conventional group was treated with tibial periosteal lateral stretch, and the combined group was treated with tibial periosteal lateral distraction combined with compound Ziyin ointment, and the treatment lasted for 2 weeks. Traditional Chinese Medicine (TCM) syndrome scores, serum inflammatory factors, growth factors, foot temperature, toe oxygen saturation, pain and quality of life scores, clinical efficacy and complications were observed before and after treatment in the two groups.Results:After treatment, TCM syndrome score, serum inflammatory factor level and pain score were lower than before treatment, serum growth factor level, life quality score, foot temperature and toe end blood oxygen saturation were higher than before treatment (all P<0.05). After treatment, the pain score, TCM main disease score, TCM secondary disease score and inflammatory factor levels in the combined group were lower than those in the conventional group (all P<0.05), and the serum growth factor level, life quality score, foot temperature and toe end blood oxygen saturation were higher than those in the conventional group (all P<0.05). The total effective rate of combined group was higher than that of conventional group [93.55%(29/31) vs 70.97%(22/31), P<0.05]. There was no significant difference in the total incidence of adverse reactions between the two groups ( P>0.05). Conclusions:Tibial periosteal lateral distraction combined with compound Ziyin ointment can improve the levels of serum inflammatory factors, growth factors, foot temperature and toe oxygen saturation, reduce TCM syndrome score and relieve pain degree, improve patients′ quality of life and clinical efficacy, and have high safety.

China has classified the Corona Virus Disease 2019(COVID-19) as a statutory category B infectious disease and managed it according to Category B since January 8, 2023.In view that Omicron variant is currently the main epidemic strain in China, in order to guide the treatment of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2) infection in children with the times, refer to the Diagnosis and Treatment Protocol for Novel Coronavirus Infection (Trial 10 th Edition), Expert Consensus on Diagnosis, Treatment and Prevention of Novel Coronavirus Infection in Children (Fourth Edition) and the Diagnosis and Treatment Strategy for Pediatric Related Viral Infections.The Expert Consensus on the Diagnosis, Treatment and Prevention of Novel Coronavirus Infection in Children (Fifth Edition) has been formulated and updated accordingly on related etiology, epidemiology, pathogenic mechanism, clinical manifestations, auxiliary examination, diagnosis and treatment, and added key points for the treatment of COVID-19 related encephalopathy, fulminating myocarditis and other serious complications for clinical reference.

Febrile seizures are the most common cause of convulsions in children.It is believed that the pathogenesis of febrile seizures involves a variety of factors, with most domestic and international studies focusing on genetic susceptibility; in contrast, the role of environmental factors, especially viral infections, is a relatively neglected field.Children are at high risk for various viral infections, many of which are prone to cause hyperthermia and induce febrile seizures when the individual convulsive temperature threshold is exceeded; in addition, inflammatory cytokines produced during viral infections may cross the blood-brain barrier affecting nerve cells.Focusing on the clinical characteristics and pathogenesis of febrile seizures caused by various viral infections in children, such as human herpesvirus-6, respiratory viruses(influenza virus, respiratory syncytial virus, adenovirus, severe acute respiratory syndrome coronavirus 2), gastroenteritis-associated viruses(rotavirus, norovirus), enteroviruses, this review may help clinicians understand the role of different viral infections in febrile seizures.

Objective:To investigate the efficacy of antiviral therapy and its selection in hospitalized children with infectious mononucleosis (IM).Methods:The IM children admitted to Shenzhen Children’s Hospital from January 2017 to December 2021 were divided into acyclovir (ACV) treatment group and non-antiviral treatment group, and the clinical data were collected for retrospective analysis.Results:A total of 370 children were included, the median age was 3.6 years, each age group proportion: <3 years (25.9%), 3-<6 years (53.0%). 6-<10 years (17.6%) and ≥10 years (3.5%). Male∶Female=1.5∶1. While 42.4% (157/370) of the 370 children received ACV, 57.6% (213/370) did not receive antiviral therapy; 52 cases were treated in infectious disease department, and none of them received antiviral treatment, and 318 cases were treated in non-infectious disease department, of which 157 cases were in ACV group. There was significant difference between the two groups ( P <0.001); Thirty-eight cases of children in non-infectious disease department complicated with abnormal liver function, of which 23 cases (60.5%) were in the ACV group and 15 cases (39.5%) were in the non-antiviral treatment group. There was no significant difference between the two groups ( P=0.060). Compared with the non-antiviral treatment group, the ACV group has longer hospitalization days and higher hospitalization expenses ( P<0.01). There was no significant difference in duration of fever ( P>0.05). The number of atypical lymphocytes recovered faster in ACV group ( P=0.001). Conclusions:The hospitalized children with IM were mostly boys, and most of them were from 3 to 6 years old. ACV treatment could not shorten the duration of fever and hospitalization days of IM children, nor could it reduce the hospitalization expenses. Abnormal liver function did not affect the decision of antiviral treatment, and infectious disease specialists prefer not to use antiviral drugs. The authors advocate reducing the use of antiviral drugs for IM.

Salmonella are important food-borne infectious bacteria causing gastroenteritis, enteric fever, bloodstream infection and focal extraintestinal infection and other salmonellosis.It is a major global public health problem.Antibiotics play an important role in the prevention and treatment of salmonellosis.With the emergence of resistance to traditional first-line drugs for the treatment of salmonellosis, azithromycin has become one of the commonly used antibiotics.However, studies have reported azithromycin resistant Salmonella strains, and azithromycin resistance in Salmonella is becoming more common and increasing year by year.Enhanced activity of active efflux pump, destruction of lactone ring structure, methylation of ribosome, carrying ICE_erm42 gene may be related mechanisms of drug resistance.The discovery, monitoring and in-depth study of azithromycin resistance in Salmonella play an important role in the rational use of antibiotics and delaying the trend of resistance.This article reviews the research progress on the epidemiology and related mechanisms of azithromycin resistance in Salmonella.