Objective To analyze the distribution characteristics of 13 common respiratory pathogens in children in Zibo area from 2020 to 2022.Methods A total of 3091 hospitalized children with respiratory infections admitted to Zibo Maternal and Child Health Hospital from January 2020 to December 2022 were selected as the subjects.Throat swabs or bronchoalveolar lavage fluid samples were collected from the patients,and 13 common respiratory pathogens were tested to analyze the distribution differences among different genders,ages,and seasons.Results Among 3091 pediatric patients,1794 were found to be infected with pathogens.The top three pathogens were Mycoplasma pneumoniae,rhinovirus,and respiratory syncytial virus(RSV).The single infection rate was 47.75％,while the mixed infection rate was 10.28％,with the most common scenario being a mixed infection of two pathogens.There were statistically significant differences in the pathogen profiles across different age groups(P＜0.001):infants had the highest detection rate of RSV,young children were primarily infected with rhinovirus,preschool and school-age children were predominantly infected with Mycoplasma pneumoniae.Seasonal distribution showed that the highest positive rate was in autumn,while the lowest was in spring(P＜0.05).In spring,the main pathogens were rhinovirus and Mycoplasma pneumoniae;in summer,they were rhinovirus and parainfluenza virus;in autumn,they were Mycoplasma pneumoniae and RSV;and in winter,the detection rates of Mycoplasma pneumoniae and influenza B virus were higher.Conclusion From 2020 to 2022,Mycoplasma pneumoniae,rhinovirus and RSV were the main pathogens of children's respiratory tract infection in Zibo area,and there were significant differences in the distribution of pathogens among different ages and seasons.

Objective To analyze the distribution characteristics of 13 common respiratory pathogens in children in Zibo area from 2020 to 2022.Methods A total of 3091 hospitalized children with respiratory infections admitted to Zibo Maternal and Child Health Hospital from January 2020 to December 2022 were selected as the subjects.Throat swabs or bronchoalveolar lavage fluid samples were collected from the patients,and 13 common respiratory pathogens were tested to analyze the distribution differences among different genders,ages,and seasons.Results Among 3091 pediatric patients,1794 were found to be infected with pathogens.The top three pathogens were Mycoplasma pneumoniae,rhinovirus,and respiratory syncytial virus(RSV).The single infection rate was 47.75％,while the mixed infection rate was 10.28％,with the most common scenario being a mixed infection of two pathogens.There were statistically significant differences in the pathogen profiles across different age groups(P＜0.001):infants had the highest detection rate of RSV,young children were primarily infected with rhinovirus,preschool and school-age children were predominantly infected with Mycoplasma pneumoniae.Seasonal distribution showed that the highest positive rate was in autumn,while the lowest was in spring(P＜0.05).In spring,the main pathogens were rhinovirus and Mycoplasma pneumoniae;in summer,they were rhinovirus and parainfluenza virus;in autumn,they were Mycoplasma pneumoniae and RSV;and in winter,the detection rates of Mycoplasma pneumoniae and influenza B virus were higher.Conclusion From 2020 to 2022,Mycoplasma pneumoniae,rhinovirus and RSV were the main pathogens of children's respiratory tract infection in Zibo area,and there were significant differences in the distribution of pathogens among different ages and seasons.

Malignant cerebral edema after ischemic stroke can lead to increased intracranial pressure, rapid deterioration of neurological symptoms, and formation of cerebral hernia. Given the high mortality and disability of malignant cerebral edema, its early detection and treatment are the focus of researches on ischemic stroke. This review summarizes the formation mechanism, predictive factors and treatment methods of malignant cerebral edema after ischemic stroke.

Objective To explore the effect of drug injection under bronchoscopy on the retreatment of smear positive cavitary pulmonary tuberculosis. Methods From June 2016 to December 2017,164 cases of pul-monary tuberculosis with smear Yang cavity type were selected,which were divided into 2 groups according to the random digital table method,each groups has 82 cases.The control group received routine treatment,the observa-tion group underwent bronchoscopy with Kangfuxin Liquid combined with drug injection therapy.The clinical effect of the two groups,the changes of lung function before and after treatment and the improvement of clinical symp-toms were compared.Results The clinical curative effect of the treatment group was better than the control group, which difference was statistically significant(P < 0.05). FEV1,FEV1/FVC,PEF index in the observation group were better than the control group,which difference was statistically significant(P<0.05).The complication rate of observation group was lower than the control group,which difference was statistically significant(P < 0.05). Conclusion Drug injection under bronchoscopy can significantly improve the clinical efficacy and lung function and promote clinical symptoms in patients with retreated smear positive pulmonary tuberculosis.It is worthy of popu-larization and application.

Objective To observe the effects of tracer methodology when used to trace and manage emergency intravenous thrombolysis processes in patients with acute ischemic stroke (AIS). Methods The patients' attendance process was traced, improved and constantly optimized according to the theoretical basis of tracer methodology. A total of 112 AIS patients who received thrombolysis from September 2015 to August 2016 (before tracer methodology was implemented) were divided into the control group, while another 160 AIS patients who received thrombolysis between September 2016 and August 2017 (after tracer methodology was implemented). The time between arrival and thrombolysis administration and hospital treatment were compared between the two groups. Results After tracer methodology was carried out, the time used between arrival and admission by our stroke treatment team in the observation group was (4.1±1.2)min; the time between arrival and imaging examination was (18.8±11.2)min; the time between imaging examination and thrombolysis administration was (22.5±10.2)min; and the time between arrival and thrombolysis administration was (44.6±12.5)min, all shorter than that of the control group (P＜0.05). Conclusions The application of tracer methodology effectively reduces door to needle time, improves the efficiency of intravenous thrombolysis in AIS patients.

Objective To understand the global economic burden of diseases due to needle stick injuries(NSIs), obtain relevant evidence,and prompt the relevant departments to pay attention to the precaution of NSIs.Methods Literatures about NSIs published from 1990 to May 2016 were searched from PubMed,ScienceDirect,EBSCO-host,Cochrane,CNKI,and Wanfang database.According to world bank inflation rate and currency rate in 2015, cost of needle stick injury in each study was adjusted to US dollars in December 2015,merge comparison analysis was performed.Results A total of 7 literatures were included,3 American studies and 4 studies from Sweden,Ko-rea,Belgium,and Taiwan Region of China respectively.Studies in mainland China only focused on the incidence of NSIs,studies about cost were not found.Two studies did not identify studied population,the remaining 5 studies were about all staff in the medical institutions.Cost analysis method:Of 7 literatures,3 were first-hand data analy-sis,4 were derived from the model.Scope of cost research:4 studies estimated the direct cost,2 calculated direct and indirect cost respectively,only 1 study estimated the summation of direct and indirect cost.The total cost per inj ury (direct cost + indirect cost)was $747-$2173,direct and indirect cost were $167-$617 and $322-$455 respectively.Conclusion Global economic burden of NSIs is heavy and still undervalued;NSIs occur frequently in China,but attention is inadequate,research on economic burden is lacking,relevant departments should pay atten-tion to the prevention and follow-up treatment process of NSIs.

As a standard method for early stage prostate cancer, 125Ⅰ seed implantations are used widely in America. Although there are guidelines from American Brachytherapy Society and American Association of Physicists in Medicine, some hospitals still cannot implant the seeds properly according to the guidelines. Complications were observed inevitably. The medical events about seeds implantation in America from 2002 were investigated and the reasons were analyzed in this paper. Additionally, some solutions were given to avoid the medical events, so that the practitioners in China can learn from it and make sure the 125Ⅰ seeds implantation can be developed healthily and smoothly.

Objective To estimate the bladder symptoms, and explore its impact on patients′ quality of life in type 2 diabetes mellitus. Methods Overactive bladder symptom score (OABSS) was used to evaluate patients′ bladder symptoms, and Medical Outcome Study 12-Item Short Form Health Survey Scale (SF-12), Overactive Bladder Questionnaire Short Form(OABq-SF)were conducted to test the effect of bladder symptoms on general and disease-specific quality of life. Results Among the four bladder symptoms, nocturia was the most prevalent symptom (46.7%,479/1025 ), followed by urinary frequency (14.9%,153/1025 ),urinary urgency (14.2%,146/1025 ), urge urinary incontinence (7.9%, 81/1025). Nocturia and urge urinary incontinence significantly increased symptom bother (nocturia B=0.337,P<0.01;urge urinary incontinence B=0.437,P<0.01) and decreased disease-specific quality of life (nocturia B=-0.364,P<0.01;urge urinary incontinence B=-0.346, P<0.01) in these patients. Meanwhile, urge urinary incontinence was negatively associated with general mental health (B=-0.255, P=0.011). Conclusions The prevalence of bladder symptoms in type 2 diabetes patients was high, and was found to be associated with patients′general and disease-specific quality of life. Health care providers should be aware of the high prevalence of bladder symptoms and its impact on QOL to facilitate early diagnosis and treatment of bladder symptoms during diabetic care.

Traditional Chinese medicine (TCM) emphasizes treatment based on syndrome differentiation, which em-bodies the concept of individualized diagnosis and dynamic treatment on a holistic view. RCT was frequently used in TCM clinical study. However, it cannot reflect the concept of treatment based on syndrome differentiation. The use of adaptive treatment strategies (ATS) in clinical research can adjust therapy in patients according to the change of disease, so it can reflect personalized medicine and dynamic treatment. From this perspective, the process of treat-ment based on syndrome differentiation was a process of adaptive treatment decision. So the method for developing ATS can effectively evaluate the efficacy of different treatment strategies in TCM clinical study. ATS had been used in some clinical studies from published literatures abroad. However, the use of ATS in domestic clinical research was seldom been reported. This paper gave an outline of the concept of ATS. In addition, this paper focused on three methods which can take the delayed effects of current treatment action into consideration and can compare the over-all effect of different ATS. It was hoped to lay foundation for future scientific research of TCM in the implementation of SMART and provide a new idea.

Traditional Chinese medicine (TCM) emphasizes treatment based on syndrome differentiation, which is the core technology that can embody the characteristics and advantages of TCM diagnosis and treatment. This is based on holistic view to illustrate individual diagnosis and treatment and dynamic treatment. However, RCT, which is frequently used in TCM clinical studies, can not reflect the concept of treatment based on syndrome differentiation. The use of adaptive treatment strategies in clinical researches can adjust therapy in patients according to the changes of diseases, so it can reflect individual diagnosis and treatment and dynamic treatment. From this perspective, the process of treatment based on syndrome differentiation is a process of decision-making of adaptive treatment. So the method for developing adaptive treatment strategies can effectively evaluate the efficacy of different treatment strategies in TCM clinical studies. Adaptive treatment strategies have been used in some clinical studies from some published foreign literatures. However, the use of adaptive treatment strategies in domestic clinical researches is seldom reported. This article discussed the concept of adaptive treatment strategies and their important components in detail. In addition, it presented three methods which can take the delayed effects of the current treatment action into consideration and can compare the overall effect of different adaptive treatment strategies, with a purpose to lay some foundation for future TCM researches in the development of optimal clinical pathway and provide new ideas and methods for researches.