Objective To develop a screening questionnaire on the pragmatic competence of children aged 5-10 years old in the context of Chinese language and culture,and to verify its reliability and validity.Methods The revelant questionnaire was developed by compiling and screening the questions on the basis of the literature research method,then 376 ordinary children aged 5-10 years in kindergartens and primary schools in Shanghai were used as subjects for the pre-experiment,and the results of the pre-experiment were analysed by the item analysis and invalid items were excluded.Finally,the questionnaire was formally evaluated by 414 ordinary children and the results of the evaluation were validated for reliability and validity.Results The initial questionnaire contained 49 items,and 43 items were retained after item analysis,covering four dimensions:pragmatic language ability(16 items),social-emotional regulation ability(17 items),general rule ability(6 items),and extra-verbal comprehension ability(4 items).The Cronbach's alpha for the overall questionnaire was 0.979,and the Cronbach's alpha for each dimension ranged from 0.874 to 0.962,the questionnaire had good reliability.The correlation coefficients between each item and total questionnaire ranged from 0.637 to 0.806,and the correlation coefficients between each dimension as well as each dimension and total questionnaire ranged from 0.669 to 0.920,which reached a moderately high degree of correlation.The validated factor analysis was with an x2/df value of 2.945 and an RMSEA value of 0.075 which had a good fit.Conclusion The questionnaire has a certain degree of reliability and validity,and a more scientific and effective screening questionnaire for children's pragmatic competence can be developed by optimising the struc-ture.

Objectives:To investigate the epidemiological characteristics and ethnic differences of cardiovascular-kidney-metabolic syndrome(CKM)among the Hani,Dai,Bai,and Lisu populations in Yunnan Province,and to provide evidence for developing effective prevention and control strategies for CKM.Methods:A cross-sectional survey was conducted among four ethnic minority groups.A total of 3 906 permanent residents aged 18 years and older were enrolled using a multistage cluster random sampling method.CKM stages(0-4)were defined based on the 2023 American Heart Association criteria,stages 3-4 were classified as advanced CKM.Descriptive statistics and chi-square tests were used to compare the prevalence of CKM stages across ethnic groups.Modified Poisson regression was applied to estimate relative risk(RR)and 95%confidence intervals(CI)for factors associated with advanced CKM.Results:The prevalence rates of CKM stage 1 and above among the Hani,Dai,Bai and Lisu ethnic groups were 80.1%,87.3%,84.8%and 67.8%,respectively.The prevalence of CKM was generally higher in males than in females,and the prevalence of CKM increased significantly with age.The Dai ethnic group had the highest prevalence of advanced CKM(24.7%,95%CI:22.1%-27.4%),while the Lisu ethnic group had the lowest prevalence of advanced CKM(13.7%,95%CI:11.5%-15.9%).Modified Poisson regression analysis showed that older age and higher body mass index were common risk factors for advanced CKM across all four ethnic groups.Additionally,except for the Lisu ethnic group,the other three ethnic groups had specific individual risk factors:among the Hani ethnic group,low educational attainment(RR=2.18,95%CI:1.12-4.25)and low income(RR=1.47,95%CI:1.00-2.18)were the primary risk factors of CKM.Among the Dai ethnic group,smoking(RR=1.60,95%CI:1.07-2.37)and a family history of cardiovascular disease(RR=1.61,95%CI:1.14-2.27)are the primary risk factors of CKM.Among the Bai ethnic group,male gender(RR=0.48,95%CI:0.29-0.79)was the primary risk factor of CKM.Conclusions:The prevalence of CKM stage 1 or higher is relatively high among the four minority ethnic groups in Yunnan province.There are significant differences in staging characteristics and primary risk factors across ethnic groups,necessitating the development of stratified,differentiated intervention strategies to achieve precise prevention and control and ethnic health equity in terms of CKM.

Objectives:To investigate the epidemiological characteristics and ethnic differences of cardiovascular-kidney-metabolic syndrome(CKM)among the Hani,Dai,Bai,and Lisu populations in Yunnan Province,and to provide evidence for developing effective prevention and control strategies for CKM.Methods:A cross-sectional survey was conducted among four ethnic minority groups.A total of 3 906 permanent residents aged 18 years and older were enrolled using a multistage cluster random sampling method.CKM stages(0-4)were defined based on the 2023 American Heart Association criteria,stages 3-4 were classified as advanced CKM.Descriptive statistics and chi-square tests were used to compare the prevalence of CKM stages across ethnic groups.Modified Poisson regression was applied to estimate relative risk(RR)and 95%confidence intervals(CI)for factors associated with advanced CKM.Results:The prevalence rates of CKM stage 1 and above among the Hani,Dai,Bai and Lisu ethnic groups were 80.1%,87.3%,84.8%and 67.8%,respectively.The prevalence of CKM was generally higher in males than in females,and the prevalence of CKM increased significantly with age.The Dai ethnic group had the highest prevalence of advanced CKM(24.7%,95%CI:22.1%-27.4%),while the Lisu ethnic group had the lowest prevalence of advanced CKM(13.7%,95%CI:11.5%-15.9%).Modified Poisson regression analysis showed that older age and higher body mass index were common risk factors for advanced CKM across all four ethnic groups.Additionally,except for the Lisu ethnic group,the other three ethnic groups had specific individual risk factors:among the Hani ethnic group,low educational attainment(RR=2.18,95%CI:1.12-4.25)and low income(RR=1.47,95%CI:1.00-2.18)were the primary risk factors of CKM.Among the Dai ethnic group,smoking(RR=1.60,95%CI:1.07-2.37)and a family history of cardiovascular disease(RR=1.61,95%CI:1.14-2.27)are the primary risk factors of CKM.Among the Bai ethnic group,male gender(RR=0.48,95%CI:0.29-0.79)was the primary risk factor of CKM.Conclusions:The prevalence of CKM stage 1 or higher is relatively high among the four minority ethnic groups in Yunnan province.There are significant differences in staging characteristics and primary risk factors across ethnic groups,necessitating the development of stratified,differentiated intervention strategies to achieve precise prevention and control and ethnic health equity in terms of CKM.

Objective To develop a screening questionnaire on the pragmatic competence of children aged 5-10 years old in the context of Chinese language and culture,and to verify its reliability and validity.Methods The revelant questionnaire was developed by compiling and screening the questions on the basis of the literature research method,then 376 ordinary children aged 5-10 years in kindergartens and primary schools in Shanghai were used as subjects for the pre-experiment,and the results of the pre-experiment were analysed by the item analysis and invalid items were excluded.Finally,the questionnaire was formally evaluated by 414 ordinary children and the results of the evaluation were validated for reliability and validity.Results The initial questionnaire contained 49 items,and 43 items were retained after item analysis,covering four dimensions:pragmatic language ability(16 items),social-emotional regulation ability(17 items),general rule ability(6 items),and extra-verbal comprehension ability(4 items).The Cronbach's alpha for the overall questionnaire was 0.979,and the Cronbach's alpha for each dimension ranged from 0.874 to 0.962,the questionnaire had good reliability.The correlation coefficients between each item and total questionnaire ranged from 0.637 to 0.806,and the correlation coefficients between each dimension as well as each dimension and total questionnaire ranged from 0.669 to 0.920,which reached a moderately high degree of correlation.The validated factor analysis was with an x2/df value of 2.945 and an RMSEA value of 0.075 which had a good fit.Conclusion The questionnaire has a certain degree of reliability and validity,and a more scientific and effective screening questionnaire for children's pragmatic competence can be developed by optimising the struc-ture.

Objective To evaluate the efficacy of itraconazole combined with glucocorticosteroid in allergic bronchopulmonary aspergillosis.Methods The clinical characteristics and data of 11 allergic bronchopulmonary aspergillosis patients treated with itraconazole combined with glucocorticosteroid were retrospectively collected before treatment and two months after treatment.Then the clinical characteristics and data before and after treatment were compared to evaluate the efficacy of the treatment.Results The symptoms and signs got better after two months' treatment.C reactive protein,IgE and eosinophile granulocyte count after two months' treatment were significantly lower than that before treatment [(7 ±2) mg/L vs.(42± 13) mg/L,(742 ± 236) kU/L vs.(1 685 ±477) kU/L,(343 ± 112) × 106/L vs.(1 925 ± 318) × 106/L],and forced expired volume in one second percentage of predicted and arterial partial pressure of oxygen after two months' treatment were significantly higher than those before treatment [(77.5 ± 8.6)％ vs.(32.4 ± 9.1)％ and (81 ± 12) mmHg (1 mmHg =0.133 kPa) vs.(53 ± 6) mmHg],there were statistical differences (P ＜ 0.01 or ＜ 0.05).The inflammatory exudates resolved as demonstrated in pulmonary CT scan.Conclnsion Itraconazole combined with glucocorticosteroid can effectively neat allergic bronchopulmonary aspergillosis.

Objective To summarize and evaluate the clinical feature and misdiagnosis of pulmonary granulomatosis with polyangitis (GPA).Methods The clinical data of 47 patients of pulmonary GPA were analyzed retrospectively.The clinical feature and misdiagnosis were summarized.Results These patients were most commonly misdiagnosed as pulmonary infectious disease (61.8％,34/55) and pulmonary malignancy (27.3％,15/55) was the next in line.70.2％(33/47) patients had nose and sinus involvement,40.4％(19/47) patients had kidney involvement,25.5％ (12/47) patients had rash,19.1％(9/47) patients had eyes involvement,6.4％ (3/47) patients had peripheral neuritis,6.4％ (3/47) patients had gastrointestinal bleeding,4.3％(2/47) patients had pericardial effusion,87.2％(41/47) patients had positive for antineutrophil cytoplasmic(cANCA),76.6％(36/47) patients had positive for proteinase-3.Conclusions Almost all pulmonary GPA patients have extra-pulmonary multi-systemic involvement.They are often misdiagnosed as pulmonary infectious diseases and malignancy.Educating doctors on GPA constantly and screening possible patients with cANCA testing may help reduce the misdiagnosis.

Objective To evaluate the clinical value of pulmonary embolism severity index (PESI) in non high-risk acute pulmonary thromboembolism (APTE) patients treated with sequential anticoagulation.Methods Non high-risk APTE patients treated with sequential anticoagulation were divided into two groups according to PESI:high-value group and low-value group.Prognosis and treatment response was compared between two groups.Results There were 82 cases in high-value group,and 76 cases in low-value group.The rate of adverse events in high-value group was significantly higher than that in low-value group [23.2％(19/82) vs.7.9％ (6/76)] (x2 =5.0698,P =0.009),and 30 days cumulative hazard was also significantly higher than that in low-value group (P ＜ 0.05).The sensitivity of predicting adverse events by PESI was 76.0％,specificity was 52.6％,positive predicting value was 64.6％,and negative predicting value was 65.9％.The mortality in high-value group was significantly higher than that in low-value group [9.8％(8/82) vs.1.3％ (1/76)] (P =0.022).After 30 days of anticoagulation,the pulmonary artery systolic pressure,internal diameter of right ventricle in high-value group was significantly higher than that in low-value group [(39.4 ± 8.1) mm Hg (1 mm Hg =0.133 kPa) vs.(27.2 ± 5.5) mm Hg,(33.0 ± 7.8) mm vs.(21.7 ± 4.6) mm] (P =0.034,0.021),and arterial oxygen partial pressure was significantly lower than that in low-value group[(75.15 ± 12.41) mm Hg vs.(86.36 ± 9.22) mm Hg](P=0.016).Conclusions PESI can effectively predict short-term prognosis of non high-risk APTE patients treated with sequential anticoagulation.At least some of these patients might need treatment other than sequential anticoagulation.