Objective:Pediatric chronic sinusitis （CRS） is a common disease within the field of otolaryngology-head and neck surgery. Due to the immaturity of sinus development and immune competence in children, its etiology and pathophysiology are complex, and its clinical features and outcomes differ significantly from those in adult patients. Currently, there are issues in the diagnosis and treatment of pediatric CRS, particularly in areas such as antibiotic use and surgical interventions, owing to a lack of sufficient attention. In recognition of this, the Chinese Rhinopathy Research Cooperation Group developed this expert consensus based on a systematic review of the latest literatures from both domestic and international sources, with reference to the latest evidence-based medical evidence worldwide, and in combination with their own clinical experience. The consensus covers various aspects including epidemiology, predisposing factors, pathophysiology, diagnosis and differential diagnosis, as well as treatment strategies such as medical therapy and surgical intervention. It aims to standardize the clinical diagnosis and treatment of pediatric CRS, improve clinical efficacy and patient satisfaction, reduce clinical expenditures, and decrease the occurrence of adverse reactions.
Humans ; Sinusitis/therapy* ; Chronic Disease ; Child ; Consensus ; Anti-Bacterial Agents/therapeutic use*

Objective:To explore the safety and efficacy of 20% glucose solution in the treatment of adult diabetic patients with hypoglycemia.Methods:A non-randomized controlled paired design trial was conducted. The diabetes patients with hypoglycemia (blood glucose < 3.9 mmol/L) who were admitted to the department of endocrinology and metabolism of Affiliated Hospital of Jiangsu University from December 2020 to May 2021 were enrolled. When the patients developed hypoglycemia for the first time, 75 mL of 20% glucose solution was pumped intravenously at a constant speed within 15 minutes, which was named the 20% glucose solution group. When the patients had hypoglycemia again, 30 mL of 50% glucose solution was pumped intravenously at a constant speed within 3 minutes, which was named the 50% glucose solution group. If the blood glucose was still ≤ 3.9 mmol/L at 15 minutes of hypoglycemia treatment, or the patients were uncomfortable due to too fast drip speed, it should be terminated immediately. The hypoglycemia treatment should be handled according to the Chinese guidelines for the prevention and treatment of type 2 diabetes (2020 edition). The peripheral blood glucose level and the range of increase at 15 minutes of treatment, the success rate of one treatment, the peripheral blood glucose values at 60 minutes after successful hypoglycemia treatment, the incidence of phlebitis and exudation after hypoglycemia treatment, and the pain of local blood vessels in patients with hypoglycemia treatment were analyzed and compared between the two groups. Results:A total of 65 patients completed the treatment of hypoglycemia with 20% glucose solution and the success rate of one treatment was 100%. The peripheral blood glucose value at 15 minutes of hypoglycemia treatment was (8.30±1.37) mmol/L, and the increased range was (4.86±1.30) mmol/L. The peripheral blood glucose value at 60 minutes after successful hypoglycemia treatment was (6.96±1.48) mmol/L, which indicated that 20% glucose solution could effectively increase blood glucose. Among 65 patients, 32 patients had hypoglycemia again, who were treated with 50% glucose solution, and the success rate of one treatment was 100%. When patients who received 50% glucose solution for hypoglycemia formed a paired design with the first 20% glucose solution treatment, the results showed that there was no significant difference in the peripheral blood glucose value and the increased range in blood glucose at 15 minutes of hypoglycemia treatment between the 20% glucose solution and the 50% glucose solution groups [peripheral blood glucose (mmol/L): 8.20 (7.70, 9.70) vs. 8.30 (7.80, 8.80), increase in blood glucose (mmol/L): 4.96±1.39 vs. 4.70±1.32, both P > 0.05], indicating that the glucose changing at 15 minutes of hypoglycemia treatment with 20% glucose solution was similar to that with 50% glucose solution. The peripheral blood glucose value at 60 minutes after successful hypoglycemia treatment of 20% glucose solution group was significantly lower than that of 50% glucose solution group (mmol/L: 6.37±1.04 vs. 7.20±1.36, P < 0.01), which meant that the blood glucose tended to be more stable. There was no phlebitis and exudation after hypoglycemia treatment in both groups. The pain score of 20% glucose solution group was 0, however, 3 patients in 50% glucose solution group complained of local vascular pain, and the pain score was 1. Conclusions:20% glucose solution can effectively treat hypoglycemia in diabetic patients, which has the same curative effect as 50% glucose solution and much safer. It can be used in patients with severe hypoglycemia.

Objective:To investigate the effects of compound matrine injection on the proliferation of bladder cancer cell line BIU-87 and bladder orthotopic transplantated tumor in nude mice.Methods:BIU-87 cells in logarithmic growth phase were divided into experimental group (adding 300.00, 150.00, 75.00, 37.50, 18.75 μl/ml compound matrine injection 200μl) and negative control group (adding equal volume of culturing medium). The proliferation inhibition rate and the half inhibitory concentration ( IC50) of BIU-87 cells were detected and calculated by methyl thiazole tetrazolium (MTT) method. Twenty BALB/c-nu female nude mice were injected with 100 μl of BIU-87 cell suspension with a cell density of 2×10 7/ml in the bladder to establish an animal model of bladder orthotopic transplanted tumor. After 24 hours of perfusion of BIU-87 cell suspension, intravesical perfusion administration (100 μl per nude mouse) was started, and the mice were divided into compound matrine injection group (intravesical perfusion of matrine solution) and pirarubicin group (intravesical perfusion of 1 mg/ml pirarubicin), model control group (intravesical perfusion of the same volume of sterile water), blank control group (without intravesical perfusion of BIU-87 cell suspension or administration). The observation time was 90 d. The survival status and bladder wet weight of the animals were observed and recorded, and the tumor formation rate, tumor inhibition rate and life prolongation rate were calculated. Results:Different concentrations of compound matrine injection acted on BIU-87 cells for 48 hours, and the absorbance ( A) values ??of 300.00, 150.00, 75.00, 37.50, 18.75 μl/ml compound matrine injection group and negative control group were 0.027±0.006, 0.065±0.010, 1.695±0.105, 2.387±0.017, 2.427±0.134 and 2.721±0.080 ( F = 742.67, P < 0.05), the A values ??of each concentration of compound matrine injection group were compared with the negative control group, and the differences were statistically significant (all P < 0.05). The IC50 of compound matrine injection on BIU-87 cells was 70.05 μl/ml. On the 90th day of observation, the bladder wet weights of nude mice in blank control group, model control group, pirarubicin group and compound matrine injection group were (0.018±0.004) mg, (0.422±0.130) mg, (0.219±0.136) mg and (0.237±0.113) mg ( F = 14.01, P < 0.001), and the survival time of nude mice was (90±0) d, (54±12) d, (72±4) d and (69±8) d ( F = 18.53, P < 0.001). The inhibition rates of bladder cancer in the pirarubicin group and compound matrine injection group were 48.10% and 43.84%, and the life prolongation rates of the nude mice were 34.95% and 29.53%. Conclusions:Compound matrine injection can inhibit the proliferation of BIU-87 cells in a concentration-dependent manner. Compound matrine injection can increase the tumor inhibition rate and prolong the survival time of nude mice models of bladder orthotopic transplanted tumor.

Objective:To investigate the effects of a perioperative whole course composite thermal insulation strategy on complications of cesarean section, maternal coagulation function and serum inflammatory indexes.Methods:A total of 250 pregnant women who were subjected to cesarean section in Zhoushan Hospital between June 2020 and August 2021 were included in this study. The 125 pregnant women who gave birth using a routine simple thermal insulation strategy from June to November 2020 were assigned to the routine simple thermal insulation group, and those who gave birth using a perioperative whole course composite thermal insulation strategy were assigned to whole course composite thermal insulation group. Two groups of pregnant women underwent cesarean section under subarachnoid block. Volume of intraoperative blood loss was recorded. The incidence of complications such as shivering and postoperative infection was calculated. Platelet count, prothrombin time, activated partial thromboplastin time, thrombin time measured before surgery and 48 hours after surgery were compared between the two groups. Peripheral blood white blood cell count, neutrophil count (N%), C-reactive protein, procalcitonin, interleukin-6 measured 48 hours after surgery were compared between the two groups.Results:Volume of intraoperative blood loss in the whole course composite thermal insulation group was significantly lower than that in the routine simple thermal insulation group [(393.84 ± 79.78) mL vs. (434.80 ± 123.49) mL, t = 3.11, P < 0.05). The incidence of shivering and postoperative infection in the whole course composite thermal insulation group was 10.4% (13/125) and 7.2% (9/125), respectively, which was significantly lower than that in the routine simple thermal insulation group [25.6% (32/125), 18.4% (23/125), χ 2 = 9.78, 7.02, both P < 0.05]. At 48 hours after surgery, prothrombin time, activated partial thromboplastin time, thrombin time in the whole course composite thermal insulation group were (10.28 ± 0.48) seconds, (26.97 ± 2.27) seconds, and (14.09 ± 1.36) seconds, respectively, which were significantly shorter than those in the routine simple thermal insulation group [(11.71 ± 0.27) seconds, (27.96 ± 2.25) seconds, (15.91 ± 1.09) seconds, t = 7.34, 3.43, 11.66, all P < 0.05]. At 48 hours after surgery, white blood cell count, neutrophil count, C-reactive protein, procalcitonin, and interleukin-6 in the whole course composite thermal insulation group were (10.38 ± 2.38) ×10 9/L,(0.79 ± 0.06), (52.79 ± 20.73) mg/L, (0.13±0.42) μg/L, and (55.73 ± 24.38) ng/L, respectively, which were significantly lower than those in the routine simple thermal insulation group [(12.24 ± 7.05) × 10 9/L, 0.81 ± 0.05, (65.38 ± 25.92) mg/L, (0.20 ± 0.97) μg/L, (76.22 ± 39.08) ng/L, t = 2.79, 2.92, 4.24, 8.12, 4.97, all P < 0.05]. Conclusion:Perioperative whole course composite thermal insulation strategy can improve the coagulation function of pregnant women who are subjected to cesarean section under subarachnoid block, reduce volume of intraoperative blood loss, and decrease incidence of shivering, inflammatory reaction, and postoperative infection.

Objective:To explore the performance of the commonly used whole blood C-reactive protein (CRP) detection systems and give related recommendation on the performance requirements of detection systems.Methods:A total of 7 540 venous blood samples from 26 maternal, child and children′s hospitals were collected to conduct this multi-center study on the analytical performance of 5 commonly used whole blood CRP detection systems from March to April in 2019. The blank check, carryover, repeatability, intermediate precision, linearity, sample stability, influence of hematocrit/triglyceride/bilirubin, comparison with SIEMENS specific protein analyzer and trueness were evaluated. The 5 systems included BC-5390CRP autohematology analyzer, AstepPLUS specific protein analyzer, Ottoman-1000 Automated Specific Protein POCT Workstation, i-CHROMA Immunofluorometer equipment Reader and Orion QuikRead go detecting instrument. The 5 systems were labeled as a, b, c, d and e randomly.Results:Within the 5 systems, all values of blank check were less than 1.00 mg/L, the carryovers were lower than 1.00%. The repeatability of different ranges of CRP concentrations including 3.00-10.00, 10.00-30.00 and>30.00 mg/L were less than 10.00%, 6.00% and 5.00%, respectively, and the intermediate precision was less than 10.00%. The linearity correlation coefficients of the 5 systems were all above 0.975, while the slope was within 0.950-1.050. Whole blood samples were stable within 72 hours both at room temperature (18-25 ℃) and refrigerated temperature (2-8 ℃). The CRP results were rarely influenced by high triglyceride or bilirubin, except for the immmunoturbidimetric test based on microparticles coated with anti-human CRP F(ab) 2 fragments. When triglyceride was less than 15.46 mmol/L, the deviation of CRP was less than 10.00%. When bilirubin was less than 345.47 μmol/L, the deviation of CRP was less than 10.00%. CRP was more susceptible to Hct on the systems without Hct correction. The deviation of CRP between different Hct dilution concentration and 40% dilution concentration can reach as high as 67.48%. The correlation coefficients ( r) of 5 systems were all more than 0.975 in the range of 0-300.00 mg/L compared with Siemens specific protein analyzer. All systems passed the trueness verification using the samples with specified values of 12.89 and 30.60 mg/L. Conclusion:The performance of 5 systems can basically meet the clinical needs, but it is suggested that the whole blood CRP detection system without automatic Hct correction should be modified manually.

Objective To explore the effect of virtual laboratory (VL) + flipped classroom in teaching of virus infection diagnosis.Methods 40 students of Class One from clinical medical undergraduates of Grade 2014 were randomly taken as the experimental group,with 40 students of Class Two as the control group.The experiment group adopted flipped classroom teaching by virtual lab platform and classroom activities,while the control group adopted traditional classroom teaching such as watching video and lecturing.Finally post-test scores were compared by the independent samples t-test of SPSS 18.0 statistical software between the two groups.The teaching effects were evaluated through questionnaires survey in experimental group.Results The scores (82.73 ± 2.62) of comprehensive assessments were superior to the control scores (57.94 ± 4.65).Difference between the two groups was statistically significant (t=29.380,P=0.000).Students' satisfaction concerning the teaching methods and effects of the flipped classroom in experimental group was up to 85％.Conclusion Flipped classroom based on internet virtual lab platform in teaching of virus infection diagnosis can enhance the teaching quality and improve students' learning enthusiasm and thinking ability.

Objective To investigate the correlation between serum procalcitonin (PCT) levels and infection sites,as well as between PCT and bacterial species in gram negative (G-) bacteria induced sepsis,so as to provide rationale for therapeutic strategy of using antibiotic in sepsis.Methods The data of patients with sepsis admitted in Emergency Department and ICU from January 2014 to June 2015 were retrospectively analyzed.The blood culture of G-bacteria and PCT detection were carried out simultaneously within 24 hours after admission.The clinical data was analyzed to find out the correlation between PCT levels and infection sites,as well as between PCT levels and pathogenic bacterial species.Results A total of 187 specimens (came from 162 patients) were enrolled in the study with a median age of 70 years old and a median sequential organ failure assessment (SOFA) score of 4.PCT levels were found to be associated with bacterial species.PCT level caused by Escherichia coli bacteremia infection was higher than that caused by Acinetobacter baumannii bacteremia and Burkholderia cepacia bacteremia infection (4.62 ng/mL vs.2.44 ng/mL;4.62 ng/mL vs.0.81 ng/mL;P ＜ 0.05).Receiver operating characteristic (ROC) analysis showed an area under the curve (AUC) for PCT was 0.61 to discriminate Escherichia coli infection from Acinetobacter baumannii infection and an AUC was 0.66 to discriminate Escherichia coli infection from Burkholderia cepacia infection.When the cutoff point of PCT was 30.32 ng/mL,it could predict Escherichia coli infection rather than Acinetobacter baumannii infection with 94.10％ specificity,90.00％ positive predictive value and positive likelihood ratio for 4.24.When the cutoff point of PCT was 8.01 ng/mL,it could predict Escherichia coli infection rather than Burkholderia cepacia infection with 85.70％ specificity,93.94％ positive predictive value,and positive likelihood ratio for 3.01.When PCT cutoff value reached 47.31 ng/mL,the specificity and positive predictive value were both 100.00％.PCT level caused by urinary tract infection was higher than that caused by pulmonary infection (11.58 ng/mL vs.2.07 ng/mL,P ＜ 0.05),and the AUC was 0.69.When the cutoff point of PCT was 32.11 ng/mL,it could predict Escherichia coli infection rather than Acinetobacter baumannii infection with 90.60％ specificity,86.18％ negative predictive value and positive likelihood ratio for 3.68.Conclusions PCT elevation in G-bacteria induced sepsis might be associated with infection sites and bacterial species.

Objective To analyze the characteristics of toxin, the PCR-ribotyping(RT) and the multilocus sequence typing(MLST) of Clostridium difficile strains isolated from China-Japan Friendship Hospital in order to provide a basis for monitoring the outbreak of nosocomial Clostridium difficile infection.Methods A total of 321 samples were collected from the patients with suspected Clostridium difficile infection(CDI) in China-Japan Friendship Hospital(CJFH) during 2012 to 2013.All Clostridium difficile strains were isolated and identified by the standard phenotypic culture method.Cytotoxicity test was performed to detect toxin B.Toxin genes (tcdA and tcdB) and binary toxin genes (cdtA and cdtB) harbored by those strains were analyzed.RT and MLST were used for homologous analysis.Clinical data of the patients were collected to analyze the isolation rate of Clostridium difficile in different populations.Results Forty-eight strains of Clostridium difficile were isolated from 46 patients with diarrhea and three of them were isolated from the same patient.The incidence of CDI among all patients, outpatients and inpatients were 14.3%(46/321), 12.8%(5/39) and 14.5%(41/282), respectively.Toxin B was detected in all of the strains as indicated by the cytotoxicity test.Strains of sequence type 1(ST1) showed the strongest cytotoxicity of all the isolated Clostridium difficile strains.Ten out of the 48 strains (20.8%) were tcdA(-)/tcdB(+) strains, which belonged to either ST37 or ST81.The results of RT and MLST were consistent in assigning the strains into nine types, in which the predominant type was ST1/RT027 accounting for 27.1% (13/48).All of the ST1/RT027 strains presented a toxin gene profile of tcdA(+)/tcdB(+) and cdtA(+)/cdtB(+).Most of the ST1/RT027 strains were isolated from the Traditional Chinese Medicine Department of Respiratory, where smallnosocomial outbreaks of ST1/RT027 strain infection might happen.Conclusion CDI diagnosed in CJFH mainly belongs to nosocomial infection.Most of the isolated strains harbor tcdA(+)/tcdB(+) genes.Surveillance for the outbreaks of CDI caused by ST1/RT027 strains over producing toxins A and B should be strengthened in hospitals.

Objective To study the HIV-1 drug resistance transmission level in HIV infected persons receiving no antiviral therapy in Dehong prefecture of Yunnan province in 2015.Methods A total of 72 plasma samples were collected from recently reported HIV-infected persons aged 16-25 years in Dehong from January to July 2015 for drug resistance gene detection.Results Forty eight samples were successfully sequenced and analyzed.Among them,31.2％ (15/48) were from Chinese,and 68.8％ (33/48) were from Burmese.Based on pol sequences,HIV genotypes included URF (52.08％,25/48),CRF01_AE (16.67％,8/48),RF07_BC (10.42％,5/48),subtype B (6.25％,3/48),subtype C (6.25％,3/48),CRF57_BC (6.25％,3/48) and CRF08_BC (2.08％,1/48).One drug resistant mutation site to non-nucleoside analog reverse transcriptase inhibitor (NNRTI) and two drug resistant mutation site to nucleoside analog reverse transcriptase inhibitor (NRTI) were detected in four sequences.Based on the statistical method of HIV drug resistance threshold survey,the prevalence of HIV-1 drug resistant strain was 5％-15％.Conclusions The proportion of Burmese among newly reported HIV-infected individuals aged 16-25 years in Dehong in 2015 was higher.HIV-1 genetic diversity was found in Dehong.The prevalence of HIV-1 drug resistant strain had reached a moderate level in Dehong.

OBJECTIVETo understand the prevalence of high risk behaviors and influencing factors among HIV infected persons aged ≥50 years.

METHODSFace to face questionnaire interview was conducted among the HIV infected persons selected in Jianshui, Gejiu and Mengzi counties in Yunnan province through random sampling in June 2015. The sample size was 450.

RESULTSAmong the HIV infected persons surveyed, 41.2% (122/296) had sexual behaviors with their spouses during past year, and the consistent condom use rate was 66.4% (81/122). Among the HIV infected males, 8.9% (28/313) had commercial sexual behaviors during past year, and the consistent condom use rate was 17.9% (5/28). Among the HIV infected females, 0.7% were still engaged in commercial sex service during past year. Among the 450 HIV infected persons, 32 (7.1%) reported having casual sex behaviors during past years, and the consistent condom use rate was 18.7% (6/32). The rate of commercial sexual behavior in urban residents (13.4%, 19/115) was higher than that in rural residents (4.5%, 9/198), the difference was statistically significant (χ(2)=11.715, P=0.001). The risk factors for commercial sex behaviors included lack of family and social support, aged 50-59 years, living in urban area, higher income and being male. The risk factors for using no condom included living in rural area, lower education level, lack of family and social support and higher income.

CONCLUSIONSRisk sex behaviors are still prevalent in HIV infected people aged >50 years, which exacerbated HIV transmission. Further efforts should be focused on the education about AIDS prevention and control and promoting protected sexual behaviors. Additional effort should be done to improve the family and social support for HIV infected people aged >50 years. Moreover, comprehensive intervention for low-paid female sex workers also needs to be strengthened.

China ; epidemiology ; Condoms ; utilization ; Female ; HIV Infections ; epidemiology ; Humans ; Male ; Middle Aged ; Prevalence ; Risk Factors ; Risk-Taking ; Sex Work ; psychology ; statistics & numerical data ; Sexual Behavior ; psychology ; statistics & numerical data ; Surveys and Questionnaires