Objective:To analyze the status of respiratory pathogen detection and the clinical features in children with Mycoplasma pneumoniae pneumonia (MPP). Methods:A prospective, multicenter study was conducted to collect clinical data, including medical history, laboratory examinations and multiplex PCR tests of children diagnosed with MPP from 4 hospitals in China between November 15 th and December 20 th, 2023. The multiplex PCR results and clinical characteristics of MPP children in different regions were analyzed. The children were divided into severe and mild groups according to the severity of the disease. Patients in the severe group were further divided into Mycoplasma pneumoniae (MP) alone and Multi-pathogen co-detection groups based on whether other pathogens were detected besides MP, to analyze the influence of respiratory pathogen co-detection rate on the severity of the disease. Mann-Whitney rank sum test and Chi-square test were used to compare data between independent groups. Results:A total of 298 children, 136 males and 162 females, were enrolled in this study, including 204 children in the severe group with an onset age of 7.0 (6.0, 8.0) years, and 94 children in the mild group with an onset age of 6.5 (4.0, 7.8) years. The level of C-reactive protein, D-dimer, lactic dehydrogenase (LDH) were significantly higher (10.0 (5.0, 18.0) vs. 5.0 (5.0, 7.5) mg/L, 0.6 (0.4, 1.1) vs. 0.5 (0.3, 0.6) mg/L, 337 (286, 431) vs. 314 (271, 393) U/L, Z=2.02, 2.50, 3.05, all P<0.05), and the length of hospitalization was significantly longer in the severe group compared with those in mild group (6.0 (6.0, 7.0) vs. 5.0 (4.0, 6.0) d, Z=4.37, P<0.05). The time from onset to admission in severe MPP children was significantly shorter than that in mild MPP children (6.0 (5.0, 9.5) vs. 9.0 (7.0, 13.0) d, Z=2.23, P=0.026). All patients completed the multiplex PCR test, with 142 cases (47.7%) MPP children detected with 21 pathogens including adenovirus 25 cases (8.4%), human coronavirus 23 cases (7.7%), rhinovirus 21 cases (7.0%), Streptococcus pneumoniae 21 cases (7.0%), influenza A virus 18 cases (6.0%). The pathogens with the highest detection rates in Tianjin, Shanghai, Wenzhou and Chengdu were Staphylococcus aureus at 10.7% (8/75), adenovirus at 13.0% (10/77), adenovirus at 15.3% (9/59), and both rhinovirus and Haemophilus influenzae at 11.5% (10/87) each. The multi-pathogen co-detection rate in severe MPP children was significantly higher than that in mild MPP group (52.9% (108/204) vs. 36.2% (34/94), χ2=10.62, P=0.005). Among severe MPP children, there are 89 cases in the multi-pathogen co-detection group and 73 cases in the simple MPP group. The levels of LDH, D-dimer and neutrophil counts in the multi-pathogen co-detection group were significantly higher than those in the simple MPP group (348 (284, 422) vs. 307 (270, 358) U/L, 0.8 (0.5, 1.5) vs. 0.6 (0.4, 1.0) mg/L, 4.99 (3.66, 6.89)×10 9vs. 4.06 (2.91, 5.65)×10 9/L, Z=5.17, 4.99, 6.11, all P<0.05). Conclusions:The co-detection rate of respiratory pathogens, LDH and D-dimer in children with severe MPP were higher than those with mild MPP. Among severe MPP children the stress response of children in co-detection group was more serious than that of children with simple MPP.

Objective To explore the role and efficacy of VEGF and HGF gene adenovirus vector in promoting angiogenesis in ischemic tissue.Methods 84 Kunming mice were randomly divided into sham group,control group,VEGF group,HGF group and VEGF+HGF group,and the left lower limb ischemia model was established.The blood supply of ischemic tissue was observed by rheometer,and the expression levels of VEGF and HGF in each group were detected by Western Blot and ELISA.Immunohistochemical staining was used to detect angiogenesis(CD31,SMA)in ischemic tissues.Safety was assessed by side effects during treatment in mice.Results After the successful modeling,the blood flow velocity of the left lower limb in each group decreased significantly.On the 7th day after operation,the blood flow of the left lower limb in each group was significantly better than that on the 0th day after operation(P<0.05),and the blood flow of the left lower limb in Ad-VEGF-HGF group was significantly better than that in other groups(P<0.05).On the 28th day after operation,the blood flow of the left lower limb in Ad-VEGF-HGF group gradually stabilized,the blood flow in Ad-VEGF-HGF group was significantly better than that in other groups,and both VEGF group and HGF group were significantly better than the control group(P<0.05).On the 7th,14th,and 28th days following surgery,HGF and VEGF protein levels in the Ad-HGF,Ad-VEGF,and Ad-VEGF-HGF groups were substantially greater than those in the control group(P<0.05).The expression level in the Ad-VEGF-HGF group peaked on the 14th day(all P<0.001)and subsequently declined to preoperative levels on the 28th day after operation.Conclusion Ad-VEGF-HGF gene injection can effectively boost VEGF and HGF protein expression and rapidly reach the relative peak level,encour-aging angiogenesis after lower limb ischemia,increasing blood flow,and improving lower limb circulation.

Objective:To provide references for the vestibular function stability training of military pilots by evaluating the stability of vestibular function of military pilots.Methods:An electric swivel chair was used to train the vestibular function stability of military pilots. According to the order of admission, they were divided into 21-30 years old, 31-40 years old, 41-50 years old and ≥51 years old group, with 30 pilots in each group. The changes of excellent rate, good rate, qualified rate, unqualified rate and tolerance time of the stability of vestibular function by training were compared among different age groups, and the correlation between age and tolerance time was analyzed.Results:There were significant differences of unqualified rate in pilots aged 31-40 and ≥51 years group before and after training ( χ2=4.32, 4.80, Ρ=0.038, 0.028). The failure rate after training was lower than that before training, with a significant difference ( χ2=13.02, P<0.001). The total tolerance time was higher than that before training, and the difference was statistically significant ( t=17.61, P<0.001). The stability tolerance time of pilots in different age groups after vestibular function training were increased compared with that before training, and the differences were statistically significant ( t=6.50, 8.82, 9.48, 13.56, all P<0.001). The stability of vestibular function of military pilots gradually declined with the increase of age, and there was a negative correlation between age and training tolerance time ( r=-0.38, P<0.001). Conclusions:The training of electric swivel chair can improve the vestibular function stability of military pilots, increase the tolerance time, and enhance the tolerance ability of military pilots when vestibular function is stimulated.

Objective:To provide references for the vestibular function stability training of military pilots by evaluating the stability of vestibular function of military pilots.Methods:An electric swivel chair was used to train the vestibular function stability of military pilots. According to the order of admission, they were divided into 21-30 years old, 31-40 years old, 41-50 years old and ≥51 years old group, with 30 pilots in each group. The changes of excellent rate, good rate, qualified rate, unqualified rate and tolerance time of the stability of vestibular function by training were compared among different age groups, and the correlation between age and tolerance time was analyzed.Results:There were significant differences of unqualified rate in pilots aged 31-40 and ≥51 years group before and after training ( χ2=4.32, 4.80, Ρ=0.038, 0.028). The failure rate after training was lower than that before training, with a significant difference ( χ2=13.02, P<0.001). The total tolerance time was higher than that before training, and the difference was statistically significant ( t=17.61, P<0.001). The stability tolerance time of pilots in different age groups after vestibular function training were increased compared with that before training, and the differences were statistically significant ( t=6.50, 8.82, 9.48, 13.56, all P<0.001). The stability of vestibular function of military pilots gradually declined with the increase of age, and there was a negative correlation between age and training tolerance time ( r=-0.38, P<0.001). Conclusions:The training of electric swivel chair can improve the vestibular function stability of military pilots, increase the tolerance time, and enhance the tolerance ability of military pilots when vestibular function is stimulated.

Objective:To explore the relationship between neck muscle strength and elastic strain of flying personnel by comparing the changes of neck muscle elastic strain values and neck muscle strength before and after neck muscle training in flying personnel with neck pain.Methods:By using CME-1 neck muscle strength trainer, 56 flying personnel were trained under isometric and changeable velocity and resistant (CVR) training mode for 2 weeks. The neck muscle strength and neck muscle elastic strain values before and after training were compared.Results:The elastic strain values of longus colli, splenius capitis and levator scapula were significantly increased by neck muscle training ( t=4.154, 2.348, 2.745, P<0.001, P=0.040, 0.006). The relative growth rate of the average elastic strain values of longus colli, splenius capitis and levator scapula after training was 13.75%, 4.18% and 2.8%, respectively. After neck muscle training, the average maximum neck muscle strength and average 10 s maximum impulse in the directions of forward flexion, backward extension, left flexion and right flexion were higher than those before training, and the difference was statistically significant ( t=3.364-8.284, all P<0.01); The relative growth rate of the average maximum neck muscle strength in each direction was 39.3%, 34.6%, 35.2% and 28.4%, respectively, and the relative growth rate of the average 10 s maximum impulse was 51.4%, 33.6%, 42.7% and 34.5%, respectively. The elastic strain values of levator scapula and longus colli were negatively correlated with the average maximum muscle strength of anterior flexor ( r=-0.281, -0.387, P=0.036, 0.004). Conclusions:Neck muscle training can effectively improve the strength of neck muscle groups and the elastic strain of some muscle groups. The elastic strain values of levator scapula and longus colli are negatively correlated with the average maximum muscle strength of anterior flexor, those suggesting that neck muscle training has a certain effect on enhancing the activity of anterior flexor muscle groups and maintaining the physiological lordosis of cervical spine.

Objective:To explore the relationship between neck muscle strength and elastic strain of flying personnel by comparing the changes of neck muscle elastic strain values and neck muscle strength before and after neck muscle training in flying personnel with neck pain.Methods:By using CME-1 neck muscle strength trainer, 56 flying personnel were trained under isometric and changeable velocity and resistant (CVR) training mode for 2 weeks. The neck muscle strength and neck muscle elastic strain values before and after training were compared.Results:The elastic strain values of longus colli, splenius capitis and levator scapula were significantly increased by neck muscle training ( t=4.154, 2.348, 2.745, P<0.001, P=0.040, 0.006). The relative growth rate of the average elastic strain values of longus colli, splenius capitis and levator scapula after training was 13.75%, 4.18% and 2.8%, respectively. After neck muscle training, the average maximum neck muscle strength and average 10 s maximum impulse in the directions of forward flexion, backward extension, left flexion and right flexion were higher than those before training, and the difference was statistically significant ( t=3.364-8.284, all P<0.01); The relative growth rate of the average maximum neck muscle strength in each direction was 39.3%, 34.6%, 35.2% and 28.4%, respectively, and the relative growth rate of the average 10 s maximum impulse was 51.4%, 33.6%, 42.7% and 34.5%, respectively. The elastic strain values of levator scapula and longus colli were negatively correlated with the average maximum muscle strength of anterior flexor ( r=-0.281, -0.387, P=0.036, 0.004). Conclusions:Neck muscle training can effectively improve the strength of neck muscle groups and the elastic strain of some muscle groups. The elastic strain values of levator scapula and longus colli are negatively correlated with the average maximum muscle strength of anterior flexor, those suggesting that neck muscle training has a certain effect on enhancing the activity of anterior flexor muscle groups and maintaining the physiological lordosis of cervical spine.

Objective:To investigate the changes of T-lymphocyte subsets, T-cell immunoglobulin and mucin domain molecule-1 (TIM-1) and TIM-3 levels, and cytokines in the peripheral blood of patients with active tuberculosis.Methods:From December 2017 to December 2018, 50 tuberculosis patients and 50 cured tuberculosis patients in Zhejiang Hospital of Integrated Chinese and Western Medicine were selected as the tuberculosis group and cured tuberculosis group, respectively. Fifty healthy individuals in the same period were selected as the control group. Flow cytometry was used to detect the T-lymphocyte subsets in the peripheral blood. The mRNA levels of TIM-1, TIM-3, interferon(IFN)-γ and interleukin(IL)-4 in peripheral blood mononuclear cells (PBMC) were detected by quantitative real-time polymerase chain reacticn (PCR). T test was used for statistical analysis. Results:The ratio of CD4 + /CD8 + T lymphocytes in the tuberculosis group (1.21±0.50) decreased significantly, comparing with those in the cured tuberculosis group (1.88±0.62) and the control group (1.92±0.82). The differences were statistically significant ( t=2.148 and 2.207, respectively, both P<0.05). The mRNA levels of TIM-1, TIM-3 and IL-4 in PBMC in the tuberculosis group were 2.16±0.37, 1.59±0.36 and 1.52±0.69, respectively, which were all higher than those in the cured tuberculosis group (1.60±1.23, 1.01±0.52 and 0.91±0.36, respectively) and the healthy control group (1.40±0.27, 0.92±0.34 and 0.79±0.42, respectively). All of these differences were statistically significant ( t=14.120, 11.440, 17.130, 12.090, 12.050 and 17.030, respectively, all P<0.05). However, the IFN-γ mRNA level (0.43±0.11) was lower than that in the cured tuberculosis group (1.74±0.72) and the control group (1.82±1.17), and the differences were both statistically significant ( t=13.880 and 11.430, respectively, both P<0.05). Conclusion:The immune dysfunction in patients with active tuberculosis may be related to the low ratio of CD4 + /CD8 + T lymphocytes, the increased expressions of TIM-1 and TIM-3, and the imbalance of helper T lymphocyte (Th)1/Th2 cytokines.

Objective To examine the effect of a Caregiving Self-Management Support (C-SMS) Program on self-efficacy, social support for family caregivers of people with dementia and psychological symptom of patients. Methods Using the convenient sampling method, 41 caregivers of dementia patients were selected as the study objects from September 2016 to September 2017 in the Memory Disorders Outpatient Department of two ClassⅢ Grade A hospitals in Shanghai. They were divided into the experimental group(n=26) and control group(n=15) according to their willingness. Totally 4 participants in each of the two groups dropped out of the study in the middle. In the experimental group, a total of 6 times, once in 2 weeks social support group activities were carried out; in the control group, a total of 3 telephone instruction, once a month was carried out, all participants were distributed with the Caregiver Educational Booklet prepared by the research team and participated 3 education seminars during the follow-up visit. Self-Efficacy Questionnaire for Chinese Family Caregivers(SEQCFC) and Medical Outcome Study Social Support Survey(MOS-SSS) and Revised Memory and Behaviour Problems Checklist(RMBPC) were used to compare the effect of intervention. Results The time effect of the total score of SEQCFC was significant (P＜ 0.01). There was a statistically significance in the interaction on social support score between groups and time (P＜ 0.05). After intervention and follow-up, the self-efficacy scores of family caregivers in the experimental group were higher than the baseline (P＜0.05). There were significant time effect in the total score of behavioral and psychological symptom behavioral symptoms, memory and depression related problems (P＜0.05). The total score of behavioral and psychological symptom, score of the disruptive behaviour dimension after follow-up visit, scores of the depression dimension after intervention and follow-up visit in the experimental group were all lower than the baseline (P＜ 0.05). Conclusions The self-management support project of caregivers can improve the self-efficacy of family caregivers and alleviate the behavioral and psychological symptom of dementia patients.

Dementia care is a chronic stressor severely influencing on physical and mental health and social life of family caregivers.In the research field of dementia care,the studies are inadequate regarding to the influence of caregiving stress on physical and mental health,especially on the risk of suffering from common chronic disease of family caregivers.So far,the studies are mainly based on hypotheses associated with chronic stress-induced three perspectives,i.e.,excessive activation of sympathetic nervous system,endothelial injury,and excessive activation of pro-inflammatory and procoagulant factors.This paper summarizes the research progress from these three perspectives.

Objective To study the role of Vibrio vulnificus cytolysin(rVvhA) induced THP-1 apoptosis and calcium influx.Methods CCK-8 cell proliferation kit,Fluo3/AM staining and AnnexinV/PI staining were performed to identify the apoptosis and calcium influx induced by rVvhA in THP-1 cells.Results rVvhA could induce THP-1 apoptosis and up-regulate the cellular calcium concentration.BAPTAAM could enhance the calcium influx induced by rVvhA in THP-1.Conclusion rVvhA had cytotoxic to THP-1 cells by inducing apoptosis and triggering extracellular calcium influx.