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 explore stigma and related factors among family members of patients with mental disorders in psychiatric hospitals.Methods:Totally 1 365 family members of inpatients with mental disorders were-surveyed,and were assessed with the Perceived Devaluation-Discrimination Scale and a self-made demographic characteristics questionnaire.Results:The screening rate of stigma among the patient's family members was 61.5％.Males(OR=2.26,95％CI:1.06-5.01),age group of 18-29 years(OR=1.91,95％CI:1.15-3.20),monthly income ≥500 yuan(P＜0.05),disease duration of 0.5-＜lyear(OR=3.14,95％CI:1.66-6.03),care for patients within＜lyear(P＜0.05),teachers(OR=2.32,95％CI:1.24-3.44),self-employed person(OR=1.63,95％CI:1.02-2.24),civil servants(OR=1.77,95％CI:1.09-2.45),schizophrenia(OR=1.87,95％CI:1.32-2.42),affective disorders(OR=1.52,95％CI:1.03-2.016)were the main riskfactors of stigma.Conclusions:Family members of patients with mental disorders generally have a severe stigma,especially of patients with schizophrenia and affective disorders.

Objective:To compare the therapeutic efficacies of mechanical thrombectomy (MT) and intravenous thrombolysis (IT) in patients with acute vertebrobasilar occlusive cerebral infarction.Methods:A prospective inclusion of 111 patients with acute vertebrobasilar artery occlusion admitted to our hospital from February 2014 to December 2019 was performed; these patients were divided into MT group ( n=66) and IT group ( n=45) according to the wishes of their families. MT was performed directly in patients from the MT group; IT was performed firstly in those from the IT group, and MT (also known as bridging treatment) was then used for those who showed no efficacy in IT when condition permission and having family member's willing. Vascular recanalization rate, incidence of symptomatic intracranial hemorrhage, National Institutes of Health Stroke Scale (NIHSS) scores, modified Rankin Scale (mRS) scores and mortality rate were assessed in the two groups after treatment. Results:During the course of the study, 7 patients (4 in the MT group and 3 in the IT group) dropped out, and finally 104 (62 in the MT group and 42 in the IT group) were included in the statistical analysis. Fifty-four patients in MT group had succeeded recanalization, and the recanalization rate (87.1%) was statistically higher than that in IT group (61.9%, P<0.05). There were 8 patients (12.9%) with symptomatic intracranial hemorrhage in MT group and 6 patients (14.3%) in IT group, without significant difference ( P>0.05). The treatment effective rate (difference value of NIHSS scores before and after treatment≥4 or NIHSS score after treatment=0) in patients from MT group (67.7%) was significantly higher than that in IT group (38.1%), the good prognosis rate (58.1%) was statistically higher than that in IT group (28.6%), and the mortality rate (3.2%) was statistically lower than that in IT group (14.3%, P<0.05). Among the 16 patients who did not receive IT, 14 patients changed to accept bridging treatment (2 family members refused re-thrombectomy); the vascular recanalization rate (78.6%), intracranial hemorrhage rate (14.3%), treatment effective rate (50.0%), good prognosis rate (57.1%), and mortality rate (7.1%) showed no significant differences as compared with those in the MT group ( P>0.05). Conclusion:For patients with acute vertebrobasilar occlusive cerebral infarction, MT can improve the vascular recanalization rate and clinical prognosis; even after the failure of IT, re-thrombectomy (bridging treatment) is still safe and effective.

Objective To measure the sagittal diameter of vertebral plate(SDVP) in the developmental cervical stenosis (DCS) group by cervical vertebral lateral X-ray film to provide a new idea for diagnosing DCS.Methods A total of 401 cervical vertebral X-ray films conforming to the standard were collected and divided into the non-DCS group and DCS group.On the lateral radiographs of the cervical spine,SDVP(the distance from the posterior edge of zygapophysial joint to spinal laminar line) at C3-C6 segments was measured,and the differences in SDVP were compared between the non-DCS group and DCS group.Then the differences were also compared between sexes.Results SDVP at C3-C6 segments was(5.23 ± 0.93),(5.55 ± 0.94),(5.64±0.97) and (5.12±0.84) mm in the non-DCS group,and (3.87±1.11),(3.66± 1.00),(3.77±0.92) and (2.99±0.72) mm in the DCS group,the differences between the two groups were statistically significant(P＜0.05),moreover SDVP had the same statistical difference between sexes(P＜0.05).Conclusion SDVP at C3-C6 segments in DCS patients is significant shortened compared with the normal person.

BACKGROUND: The spinal instability would accelerate the degeneration of normal disk. The injuries of anterior longitudinal ligament (ALL) and intervertebral disk were usually caused by cervical trauma, which leaded to spinal instability. Currently, there were few animal researches about the degeneration of injured intervertebral disk affected by ALL destruction.OBJECTIVE: To investigate the degeneration of injured intervertebral disk after spinal instability in the rabbit model of different degrees of ALL and disc destruction.METHODS: A total of 24 New-Zealand rabbits were randomly divided into intervertebral disk injury group (Group A, n=6), partial injury of ALL with disc injury group (Group B, n=6), injury of bony attachment point of ALL with disc injury group (Group C, n=6) and entirely injury of ALL with disc injury group (Group D, n=6). The L2-L3 intervertebral disk and ALL were injured through abdominal cavity. Different groups received different treatments. Computed tomography (CT) scans of the injured disc were performed at the postoperative 4 and 8 weeks, and the middle high of injured discs was calculated on CT sagittal reconstruction. Three rabbits were selected from each group. Hematoxylin-eosin staining of injured disc was performed after the animals were killed. Results were examined under the light microscope.RESULTS AND CONCLUSION: (1) At postoperative 4 weeks, the middle height of injured discs in Group D was decreased significantly compared with Group A (P < 0.05). There were hyperosteogeny and calcification in Group C and Group D. There were nucleus pulposus cells reduction and inflammatory reaction in Group C and Group D on histological staining. (2) At postoperative 8 weeks, the middle height of injured discs respective was decreased significantly compared with Group A (P < 0.05). The hyperosteogeny and calcification became clearer in Group C and Group D than before. There were morphologic changes of nucleus pulposus cells and fibrillation by hematoxylin-eosin staining, and the degree of disc degeneration was Group D > Group C > Group B > Group A. (3) In conclusion, the injury of ALL would accelerate the degeneration of correspondingly injured disk, and the degree of injury of ALL was positively correlated with the degeneration of disk.

Forty six children with Kawasaki disease (observer group) were classified as coronary artery lesions (CAL) subgroup (19 cases) and non-coronary artery lesions (NCAL) subgroup (27 cases)according to echocardiography; 50 healthy children served as control group.Serum heart-type fatty acidbinding protein (h-FABP), platelet activating factor (PAF), cardiac tropnin Ⅰ (cTnI) and creatine kinase isoenzyme MB (CK-MB) levels of all subjects were detected.The results showed that the h-FABP and cTnI levels and positive rate in observer group were higher those in control group (P ＜ 0.05 ), while there were no differences in CK-MB level and positive rate between two groups ( P ＞ 0.05 ).The h-FABP positive rate in observation group was higher than the positive rates of cTnI and CK-MB (P ＜0.05).The PAF level, PLT and polymorphonuclear neutrophil count in observer group were higher than those in control group ( P ＜0.05).The h-FABP and PAF levels in CAL subgroup were higher than those in NCAL subgroup (P ＜0.05).The results suggest that serum h-FABP and PAF can be used as diagnostic indicators for Kawasaki disease complicated with coronary artery lesions.