To clarify the epidemiological characteristics of pertussis in children in Hanzhong during the nationwide surge in pertussis, this study retrospectively collected nucleic acid testing data of 4 565 children with pertussis from a tertiary hospital in Hanzhong City from September 2023 to August 2024, and collected demographic and clinical information of confirmed cases for analysis. The results showed that among 4 565 cases tested, there were 1 224 positive cases for pertussis nucleic acid testing, with a total positive rate of 26.81%. Since September 2023, the number of tests and positive cases had continuously increased, reaching a peak in May 2024, with 1 174 samples tested and 319 positive cases. Notably, the number of confirmed cases from April to July 2024 accounted for 82.03% (1 004/1 224) of the total confirmed cases during the study period. Among the 1 224 confirmed cases of pertussis, there were 647 male patients (52.86%) and 577 female patients (47.14%). The highest proportion of cases was found in school-age and preschool children, accounting for 88.81% (1 087/1 224). Among outpatients, school-age and preschool children accounted for 93.44% (897/960), while inpatient cases were mainly preschool, school-age children, and infants (94.32%, 249/264). The positive detection rates of outpatient and inpatient children in the same age group were compared. Except for the infant group, the positive rates of the other four groups were higher than those of the inpatient group (all P<0.05). Among 264 hospitalized children with pertussis, 70 cases (26.52%, 70/264) were infected with Bordetella pertussis alone, and 194 cases (73.48%, 194/264) had co-infections with other pathogens. Rhinovirus, Mycoplasma pneumoniae, and Staphylococcus aureus were the most common pathogens in co-infections.

To clarify the epidemiological characteristics of pertussis in children in Hanzhong during the nationwide surge in pertussis, this study retrospectively collected nucleic acid testing data of 4 565 children with pertussis from a tertiary hospital in Hanzhong City from September 2023 to August 2024, and collected demographic and clinical information of confirmed cases for analysis. The results showed that among 4 565 cases tested, there were 1 224 positive cases for pertussis nucleic acid testing, with a total positive rate of 26.81%. Since September 2023, the number of tests and positive cases had continuously increased, reaching a peak in May 2024, with 1 174 samples tested and 319 positive cases. Notably, the number of confirmed cases from April to July 2024 accounted for 82.03% (1 004/1 224) of the total confirmed cases during the study period. Among the 1 224 confirmed cases of pertussis, there were 647 male patients (52.86%) and 577 female patients (47.14%). The highest proportion of cases was found in school-age and preschool children, accounting for 88.81% (1 087/1 224). Among outpatients, school-age and preschool children accounted for 93.44% (897/960), while inpatient cases were mainly preschool, school-age children, and infants (94.32%, 249/264). The positive detection rates of outpatient and inpatient children in the same age group were compared. Except for the infant group, the positive rates of the other four groups were higher than those of the inpatient group (all P<0.05). Among 264 hospitalized children with pertussis, 70 cases (26.52%, 70/264) were infected with Bordetella pertussis alone, and 194 cases (73.48%, 194/264) had co-infections with other pathogens. Rhinovirus, Mycoplasma pneumoniae, and Staphylococcus aureus were the most common pathogens in co-infections.

To analyze the factors associated with infection and death of carbapenem-resistant Klebsiella pneumoniae (CRKP) in patients. Using a case-control study method, patients with CRKP infection from January 2019 to December 2021 in the 3201 Hospital were selected as the case group, and patients with carbapenem-susceptible Klebsiella pneumoniae (CSKP) infection in the same period were selected as the control group in a ratio of 1∶1. The study subjects were followed up for 30 days. The two groups of patients were categorized into survival and death groups based on whether they died or not, respectively, and the 30-day morbidity and mortality rates of the CRKP case group and the CSKP control group were compared. The logistic regression model was used to analyze the factors associated with CRKP infection and death after CRKP infection. This study included 59 cases in the CRKP case group and 59 in the CSKP control group. The 30-day mortality rate of CRKP-infected patients and CSKP-infected patients were 30.5% (18/59) and 5.1% (3/59), with statistically significant differences ( P<0.001). Surgery within three months prior to KP infection ( OR=17.285, P=0.001), use of carbapenems within three months prior to KP infection ( OR=11.235, P=0.002), use of more than three types of antibiotics ( OR=7.993, P=0.016), albumin<30 g/L in patients prior to KP infection ( OR=10.463, P=0.002), sex ( OR=0.078, P<0.001), and diabetes ( OR=0.076, P=0.011) were associated factors of CRKP infection. Higher age-corrected Charlson Comorbidity Index scores of patients ( OR=1.522, P=0.024) and use of carbapenems by the patients with in the first three months prior to the KP infection ( OR=4.902, P=0.029) were associated factors for the deaths of patients with CRKP. In conclusion, medical personnel should be cautious in performing invasive procedures, strictly control the use of antibiotics, and provide targeted protection and treatment for high-risk patients as soon as possible.

To analyze the factors associated with infection and death of carbapenem-resistant Klebsiella pneumoniae (CRKP) in patients. Using a case-control study method, patients with CRKP infection from January 2019 to December 2021 in the 3201 Hospital were selected as the case group, and patients with carbapenem-susceptible Klebsiella pneumoniae (CSKP) infection in the same period were selected as the control group in a ratio of 1∶1. The study subjects were followed up for 30 days. The two groups of patients were categorized into survival and death groups based on whether they died or not, respectively, and the 30-day morbidity and mortality rates of the CRKP case group and the CSKP control group were compared. The logistic regression model was used to analyze the factors associated with CRKP infection and death after CRKP infection. This study included 59 cases in the CRKP case group and 59 in the CSKP control group. The 30-day mortality rate of CRKP-infected patients and CSKP-infected patients were 30.5% (18/59) and 5.1% (3/59), with statistically significant differences ( P<0.001). Surgery within three months prior to KP infection ( OR=17.285, P=0.001), use of carbapenems within three months prior to KP infection ( OR=11.235, P=0.002), use of more than three types of antibiotics ( OR=7.993, P=0.016), albumin<30 g/L in patients prior to KP infection ( OR=10.463, P=0.002), sex ( OR=0.078, P<0.001), and diabetes ( OR=0.076, P=0.011) were associated factors of CRKP infection. Higher age-corrected Charlson Comorbidity Index scores of patients ( OR=1.522, P=0.024) and use of carbapenems by the patients with in the first three months prior to the KP infection ( OR=4.902, P=0.029) were associated factors for the deaths of patients with CRKP. In conclusion, medical personnel should be cautious in performing invasive procedures, strictly control the use of antibiotics, and provide targeted protection and treatment for high-risk patients as soon as possible.

Objective:To observe and compare the clinical characteristics between post-chronic pancreatitis diabetes mellitus(PPDM-C)patients and type 2 diabetes mellitus(T2DM).Methods:Data of 142 cases of CP patients confirmed in Shanghai Pudong New Area Gongli Hospital from January 2018 to December 2021 were collected, all the patients were divided into CP group without diabetes mellitus ( n=60) and PPDM-C group with diabetes mellitus ( n=82) based on whether with or without diabetes mellitus. And 82 cases T2DM without CP (T2DM group, n=82) hospitalized simultaneously were collected as control group. The age, sex, body mass index, onset characteristics, laboratory examination indicators at admission (fasting blood glucose, glycosylated hemoglobin, blood creatinine, and alanine transaminase), imaging characteristics of the pancreas (pancreatic atrophy, multiple calcifications of the pancreas, pancreatic duct stones, pancreatic duct dilation, and pancreatic duct obstruction), and treatments and efficacy of diabetes were recorded. Results:Compared with T2DM group, PPDM-C group had lower body mass index (22.2 kg/m 2vs 24.6 kg/m 2), and glycosylated hemoglobin levels (7.34% vs 9.20%) (all P values <0.001), higher alanine transaminase levels (33.00 U/L vs 18.65 U/L, P =0.021). And they had more upper abdominal pain, nausea, vomiting, weight loss and diarrhea symptoms. In addition, they had less use of combination of insulin and hypoglycemic drugs to control blood glucose. And compared with CP group, PPDM-C group had higher body mass index (22.06 kg/m 2vs 21.18 kg/m 2), higher glycosylated hemoglobin levels (7.34% vs 5.70%), higher fasting blood-glucose levels (7.91 mmol/l vs 5.31 mmol/l), higher alanine transaminase levels (33.00 U/L vs 26.50U/L), and their differences were statistically significant (all P values <0.05). And they had higher incidence of pancreatic atrophy, multiple calcifications in the pancreatic duct and pancreatic duct obstruction (all P values <0.05). Conclusions:PPDM-C patients are more likely to experience digestive system symptoms such as abdominal pain than T2DM patients, while their pancreatic malfunction is more likely to occur compared to CP patients. More attentions to PPDM-C associated clinical manifestations, biochemical and imaging changes could identify patients at potential risk for early diagnosis and treatment earlier.

Objective To investigate the role of early detecting macrophage inflammatory protein‐1β(MIP‐1β) and proealcitonin (PCT ) level for the diagnosis of spontaneous bacterial peritonitis (SBP) in the decompensated stage of liver cirrhosis .Methods 384 cases of decompensated stage of liver cirrhosis complicating SBP collected in the Affiliated 3201 Hospital of Xi ′an Jiaotong Univer‐sity from May 2011 to February 2015 were included into the SBP group ,while other 377 cases of decompensated stage of liver cir‐rhosis complicating ascites were included into the control group .The serum and ascites samples were collected for detecting PCT by using electrochemical luminescence method and MIP‐1β by using the enzyme‐linked immunoassay .The significance of these two in‐dicators was compared between the serum detection and ascites detection .At the same time the clinical application value of these two indicators was analyzed by using the receiver operating characteristic curve .Results The serum and ascites PCT and MIP‐1βlevels in the SBP group were significantly higher than those in the control group ,the difference was statistically significant (P<0 .05) ;the serum PCT level in the SBP group had statistical difference between the patients with Gram‐negative bacteria infection and the patients with Gram positive bacteria infection (P< 0 .05) ;the ascites MIP‐1β level in the patients with Gram‐negative bacte‐ria infection of the SBP group was higher than that with Gram positive bacteria infection ,the difference was statistically significant (P< 0 .05) .Conclusion The serum and ascites PCT and MIP‐1β detection can help to the differentiation diagnosis of early decom ‐pensated stage of liver cirrhosis complicating SBP ;the serum PCT detection is superior to the MIP‐1β detection ,while ascites MIP‐1β detection is superior to the PCT detection .

Objective Previous studies have shown that genetic variants in the interferons regulatory factor 5 (IRF5) gene are associated with rheumatoid arthritis (RA) in European and Japanese, but not found in Han Chinese. We conducted this study to investigate whether genetic variants in the IRF5 gene are associated with RA in ShaanXi Han Chinese population. Methods This study was collected 576 RA patients and 768 normal controls. Six IRF5 gene polymorphisms (rs729302, rs2004640, rs752637, rs3807306, rs10954213 and rs2280714) were genotyped by the SNaPshot method. T-test and χ2 test were used for statistic analysis. The genotype and allele frequencies were evaluated using the chi square tests. Genotyping data were adjusted by Logistic regression method by age and gender. The linkage disequilibrium (LD) block structure was examined using Hapview 4.2 software. Results Six SNPs inspected complied with Hardy-weinberg equilibrium (P>0.05). Two SNPs were significantly associated with RA: rs729302 A risk allele [OR=1.29, 95%CI (1.10, 1.50), P=5.57×10-3];dominant model [OR=1.58, 95%CI (1.10, 2.27), P=0.024], recessive model [OR=1.31, 95%CI (1.17, 1.64), P=0.028]. rs2004640 T risk allele [OR=1.28, 95%CI (1.08, 1.54), P=0.039]; dominant model [OR=1.27, 95%CI (1.03, 1.58), P=0.036]. In addition, there was no significant difference in rs752637, rs3807306, rs10954213 and rs2280714 SNPs between RA group and control and genotyped polymorphisms were significantly associated with RA susceptibility. Conclusion The present study confirm that rs729302 and rs2004640 in the IRF5 gene is significantly associated with increased risk of RA in ShaanXi Han Chinese population.

Objective To investigate the effects of inhaled aerosolized low dose ambroxol on the inflammatory response to one-lung ventilation (OLV) in patients undergoing open-chest esophagus surgery.Methods Sixty patients (aged 39-64 years,weighing 50-85 kg and with height of 153-181 cm) with normal heart and lung function undergoing open-chest esophagus surgery were randomly divided into three groups:20 patients receiving intravenous infusion of normal saline (control group,group C),20 receiving intravenous infusion of ambroxol 10 mg/kg after induction of anesthesia (group IA) and 20 inhaling aerosolized ambroxol 30 mg after induction of anesthesia (group AIA).Arterial blood samples were taken after induction of anesthesia before ambroxol administration (T0,baseline),after 90 minutes of OLV (T1) and at 30 minutes after OLV (T2) for determination of plasma concentrations of tumor necrosis factor-alpha (TNF-α),interleukin-1 beta (IL-1β),IL-8 and IL-10 by enzyme linked immunosorbent assay (ELISA).Results The levels of TNF-α,IL-1β,and IL-8 in plasma significantly increased while the level of IL-10 in plasma significantly decreased at T1 and T2 as compared with the baseline at T0 in all the three groups.The levels of TNF-α,IL-1β,and IL-8 in plasma were significantly lower and the level of IL-10 in plasma was significantly higher at T1 and T2 in groups IA and AIA than in group C.Conclusion Both intravenous injection of large dose ambroxol and inhaled aerosolized low dose ambroxol can inhibit the inflammatory response to OLV in patients undergoing open-chest esophagus surgery.

Objectives To investigate characterization of imipenem resistance among imipenem non susceptible Pseudomonas aeruginosa isolated from patients who treated without imipenem and explore risk factors of imipenem resistance.Methods From April,2006 to March,2008,a total of 37 non-susceptible to imipenem without imipenem therapy isolates were collected from affiliated 3201st Hospital of Medical College of Xi'an Jiaotong University.The minimum inhibition concentration (MIC) to 11 antimicrobial agents were determined by the broth dilution method.We also tested imipenem MIC combined with efflux pump inhibitor PAβN.PCR was performed to check for the presence of carbapenem-hydrolylzing MBL genes and oprD gene.The expression level of oprD2 and ampC were evaluated by qRT-PCR.Molecular typing was performed using PFGE.Results There is significant difference ( t =- 2.9004,P ＜ 0.01 ) of the average number days of therapy between with two or more antibiotics in the 16 patients (20.0 ± 9.5 ) d and that with only one antibiotic in the other 21 patients ( 12.6 ± 4.4 ) d before imipenem-non-susceptible strains were isolated.In all 37 strains,32 strains showed resistance to more than three antibiotics.The MBL gene ( IMP-9 ) was only found in one strain,but its phenotype is negative,oprD2 gene from the 29 strains were found forward inserted by ISpa1328.Thirty-five isolated were considered to have no oprD expression.The patterns of the total DNA of 37 strains appeared six PFGE types.The 26 strains belonged to C2 PFGE type.In the presence of PAβN,all 37 strains increased sensitivity to meropenem.Conclusion Fluoroquinolones and cephalosporins treatment could play an important role in imipenem non-susceptible production in the research isolates.

Objective To investigate the effects of inhaled aerosolized low dose ambroxol on the inflammatory response to one-lung ventilation ( OLV) in patients undergoing open-chest esophagus surgery. Methods Sixty patients with normal heart and lung function undergoing open-chest esophagus surgery were randomly divided into 3 groups ( n = 20 each): control group (group C) ; group IA received Ⅳ ambroxol 10 mg/kg after induction of anesthesia and group AIA inhaled aerosolized ambroxol 30 mg after induction of anesthesia. Arterial blood samples were taken after induction of anesthesia before ambroxol administration (T0, baseline) , at 90 min of OLV (T1 )and at 30 min after OLV (T2) for determination of plasma concentrations of TNF-α, IL-1β, IL-8 and IL-10 by ELBA.Results Plasma TNF-α, IL-1β, and IL-8 concentrations were significantly increased while plasma IL-10 concentration was significantly decreased at T1 and T2 as compared with the baseline at T0 in all 3 groups. Plasma TNF-α, IL-1β, and IL-8 concentrations were significantly lower and plasma IL-10 concentration was significantly higher at T1 and T2 in groups IA and AIA than in group C. Conclusion Both Ⅳ large dose ambroxol and inhaled aerosolized low dose ambroxol can inhibit the inflammatory response to OLV in patients undergoing open-chest esophagus surgery.