OBJECTIVES: To investigate the predictive factors for plastic bronchitis (PB) in children with Mycoplasma pneumoniae pneumonia (MPP) and to establish a nomogram prediction model for PB occurrence. METHODS: A retrospective analysis was conducted on children with MPP hospitalized at The Affiliated Hospital of Xuzhou Medical University from January 2023 to June 2024. The patients were randomly divided into a training set (n=562) and a validation set (n=240) at a ratio of 7:3 using simple random sampling. In the training set, patients were categorized into a PB group (n=70) and a non-PB group (n=492) based on the occurrence of PB. Spearman correlation analysis was performed to exclude collinearity among variables, followed by univariate analysis and LASSO regression to identify predictive factors. A nomogram prediction model for PB in children with MPP was constructed. The discriminative ability of the model was assessed using receiver operating characteristic (ROC) curve analysis, model calibration was evaluated with calibration curves, and clinical utility was appraised through decision curve analysis. RESULTS: Compared with the non-PB group, the PB group exhibited significantly longer disease duration prior to bronchoscopy, prolonged fever duration, higher fever peaks, higher proportions of patients with a family history of allergy and personal allergy history, and a higher proportion of patients with pleural effusion, as well as significantly elevated levels of white blood cell count, neutrophil percentage, C-reactive protein, procalcitonin, fibrinogen, D-dimer, aspartate aminotransferase, alanine aminotransferase, creatine kinase, lactate dehydrogenase, immunoglobulin A, and interleukin-6, along with a significantly lower lymphocyte percentage (all P<0.05). LASSO regression analysis identified pleural effusion, procalcitonin, D-dimer, and lactate dehydrogenase as major predictive factors for PB occurrence in children with MPP. The nomogram model based on these factors demonstrated good discriminative ability (area under the ROC curve: 0.852 in the training set and 0.830 in the validation set), with satisfactory calibration and clinical benefit. CONCLUSIONS The nomogram prediction model based on pleural effusion, procalcitonin, D-dimer, and lactate dehydrogenase provides effective predictive performance for the occurrence of PB in children with MPP.
Humans ; Pneumonia, Mycoplasma/complications* ; Nomograms ; Male ; Female ; Child ; Child, Preschool ; Retrospective Studies ; Bronchitis/etiology* ; Infant ; ROC Curve ; Adolescent

Objective:To study the effects of manual inspection and special equipment inspection for light guiding components of hard endoscope after cleaning and disinfection,so as to provide scientific data and evidence for the application of special inspection equipment of hard endoscope in Central Sterile Supply Department(CSSD).Methods:A total of 100 hard endoscopes after cleaning and disinfection,which were in CSSD of the Fifth Medical Center of Chinese PLA General Hospital during July and August 2024,were selected.Each light guiding components of hard endoscope was respectively inspected by manual method and special functional detector for endoscope(inspection method with equipment).The positive rates of fog,stains and glass shards,and overall failure rate of light guiding components of hard endoscope,as well as the difference with the effect of clinical use,between two kinds of inspection methods were compared.Results:In 100 hard endoscopes,the inspection method with equipment found 2 cases were overall failure,which fog,strains and glass shards were respectively 2,0 and 0.The overall failure rate,and the positive rates of fog,stains and glass shards of the inspection method with equipment were respectively 2%,2%,0 and 0,which all lower than overall failure rate(23%),and the positive rates of fog(17%),stains(2%)and glass shards(4%)of manual inspection.There was significant difference in overall failure rate and positive rat of fog between the two kinds of inspection methods(x2=18.286,11.399,P＜0.05).The overall failure rate that was reflected by clinical users was 3%,which was significant lower than 23%of manual inspection,and the difference of that between two methods was significant(x2=15.959,P＜0.05).Conclusion:The inspection for light guiding components of hard endoscopes after cleaning and disinfection can be carried out by manual inspection and special inspection equipment,and results of special inspection equipment is getting closer the usage effect of clinical users.It has a series of advantages include being intuitive,easy use,high accuracy,convenient observation,and archivable.

To formulate an expert consensus on the principles of preoperative hair removal and provide scientific guidance for standardized removal of hair before surgical procedures so as to reduce the incidence of surgical site infections.METHODS Led by the Hospital Management Institute of National Health Commission of the People's Republic of China,this consensus was reached with the joint efforts from the expects of relevant fields such as surgeries,interventional therapies,nursing,and infection prevention and control.The consensus facilitates the classification and evaluation of literatures by following the evidence grade formulated by Oxford Evidence-based Medicine Center and focuses on the association of preoperative hair removal with surgical site infection,it reaches the evidence grade of expert consensus and recommendation intensity by integrating with discussions on meetings and clinical experience of the expects from relevant fields.RESULTS A total of 6 items of consensus were reached by summarizing the latest evidence on the aspects including the indications for preoperative hair removal,tools,range,timing and places.CONCLUSION The consensus,to some extent,make supplements to and complete the exiting regulations and standards.It provides guidance for the medical institutions to carry out the preoperative hair removal.

To formulate an expert consensus on the principles of preoperative hair removal and provide scientific guidance for standardized removal of hair before surgical procedures so as to reduce the incidence of surgical site infections.METHODS Led by the Hospital Management Institute of National Health Commission of the People's Republic of China,this consensus was reached with the joint efforts from the expects of relevant fields such as surgeries,interventional therapies,nursing,and infection prevention and control.The consensus facilitates the classification and evaluation of literatures by following the evidence grade formulated by Oxford Evidence-based Medicine Center and focuses on the association of preoperative hair removal with surgical site infection,it reaches the evidence grade of expert consensus and recommendation intensity by integrating with discussions on meetings and clinical experience of the expects from relevant fields.RESULTS A total of 6 items of consensus were reached by summarizing the latest evidence on the aspects including the indications for preoperative hair removal,tools,range,timing and places.CONCLUSION The consensus,to some extent,make supplements to and complete the exiting regulations and standards.It provides guidance for the medical institutions to carry out the preoperative hair removal.

Objective:To study the effects of manual inspection and special equipment inspection for light guiding components of hard endoscope after cleaning and disinfection,so as to provide scientific data and evidence for the application of special inspection equipment of hard endoscope in Central Sterile Supply Department(CSSD).Methods:A total of 100 hard endoscopes after cleaning and disinfection,which were in CSSD of the Fifth Medical Center of Chinese PLA General Hospital during July and August 2024,were selected.Each light guiding components of hard endoscope was respectively inspected by manual method and special functional detector for endoscope(inspection method with equipment).The positive rates of fog,stains and glass shards,and overall failure rate of light guiding components of hard endoscope,as well as the difference with the effect of clinical use,between two kinds of inspection methods were compared.Results:In 100 hard endoscopes,the inspection method with equipment found 2 cases were overall failure,which fog,strains and glass shards were respectively 2,0 and 0.The overall failure rate,and the positive rates of fog,stains and glass shards of the inspection method with equipment were respectively 2%,2%,0 and 0,which all lower than overall failure rate(23%),and the positive rates of fog(17%),stains(2%)and glass shards(4%)of manual inspection.There was significant difference in overall failure rate and positive rat of fog between the two kinds of inspection methods(x2=18.286,11.399,P＜0.05).The overall failure rate that was reflected by clinical users was 3%,which was significant lower than 23%of manual inspection,and the difference of that between two methods was significant(x2=15.959,P＜0.05).Conclusion:The inspection for light guiding components of hard endoscopes after cleaning and disinfection can be carried out by manual inspection and special inspection equipment,and results of special inspection equipment is getting closer the usage effect of clinical users.It has a series of advantages include being intuitive,easy use,high accuracy,convenient observation,and archivable.

Further evidence is needed to explore the impact of high-altitude environments on the neurologic function of neonates.Non-invasive techniques such as cerebral near-infrared spectroscopy and amplitude-integrated electroencephalography can provide data on cerebral oxygenation and brain electrical activity.This study will conduct multiple cerebral near-infrared spectroscopy and amplitude-integrated electroencephalography monitoring sessions at various time points within the first 3 days postpartum for healthy full-term neonates at different altitudes.The obtained data on cerebral oxygenation and brain electrical activity will be compared between different altitudes,and corresponding reference ranges will be established.The study involves 6 participating centers in the Chinese High Altitude Neonatal Medicine Alliance,with altitude gradients divided into 4 categories:800 m,1 900 m,2 400 m,and 3 500 m,with an anticipated sample size of 170 neonates per altitude gradient.This multicenter prospective cohort study aims to provide evidence supporting the impact of high-altitude environments on early brain function and metabolism in neonates.[Chinese Journal of Contemporary Pediatrics,2024,26(4):403-409]

Objective To investigate the incidence rate,clinical characteristics,and prognosis of neonatal stroke in Shenzhen,China.Methods Led by Shenzhen Children's Hospital,the Shenzhen Neonatal Data Collaboration Network organized 21 institutions to collect 36 cases of neonatal stroke from January 2020 to December 2022.The incidence,clinical characteristics,treatment,and prognosis of neonatal stroke in Shenzhen were analyzed.Results The incidence rate of neonatal stroke in 21 hospitals from 2020 to 2022 was 1/15 137,1/6 060,and 1/7 704,respectively.Ischemic stroke accounted for 75％(27/36);boys accounted for 64％(23/36).Among the 36 neonates,31(86％)had disease onset within 3 days after birth,and 19(53％)had convulsion as the initial presentation.Cerebral MRI showed that 22 neonates(61％)had left cerebral infarction and 13(36％)had basal ganglia infarction.Magnetic resonance angiography was performed for 12 neonates,among whom 9(75％)had involvement of the middle cerebral artery.Electroencephalography was performed for 29 neonates,with sharp waves in 21 neonates(72％)and seizures in 10 neonates(34％).Symptomatic/supportive treatment varied across different hospitals.Neonatal Behavioral Neurological Assessment was performed for 12 neonates(33％,12/36),with a mean score of(32±4)points.The prognosis of 27 neonates was followed up to around 12 months of age,with 44％(12/27)of the neonates having a good prognosis.Conclusions Ischemic stroke is the main type of neonatal stroke,often with convulsions as the initial presentation,involvement of the middle cerebral artery,sharp waves on electroencephalography,and a relatively low neurodevelopment score.Symptomatic/supportive treatment is the main treatment method,and some neonates tend to have a poor prognosis.

The ninth edition of TNM staging for lung cancer has been announced at the 2023 World Lung Cancer Congress and implemented from January 1, 2024. The focus of the ninth TNM staging change is dividing N2 into N2a and N2b, as well as M1c into M1c1 and M1c2. Although the T staging has not changed, it has played an important role in verifying the eighth edition of the T staging. The subdivision of stage N2 has led some patients with ⅢA of the eighth edition to experience ascending or descending stages, which will more accurately help to assess the condition and prognosis of patients with mediastinal lymph node metastasis, as well as the design of related clinical studies. Modifying the M1c staging will help define oligometastasis and explore new treatment models in the future. The ninth edition of the TNM staging system provides a more detailed division of different tumor loads, but there is no clear explanation for the staging of lung cancer after neoadjuvant therapy. Further data analysis is needed, and it is expected to be answered in the tenth edition of TNM staging.

The ninth edition of TNM staging for lung cancer has been announced at the 2023 World Lung Cancer Congress and implemented from January 1, 2024. The focus of the ninth TNM staging change is dividing N2 into N2a and N2b, as well as M1c into M1c1 and M1c2. Although the T staging has not changed, it has played an important role in verifying the eighth edition of the T staging. The subdivision of stage N2 has led some patients with ⅢA of the eighth edition to experience ascending or descending stages, which will more accurately help to assess the condition and prognosis of patients with mediastinal lymph node metastasis, as well as the design of related clinical studies. Modifying the M1c staging will help define oligometastasis and explore new treatment models in the future. The ninth edition of the TNM staging system provides a more detailed division of different tumor loads, but there is no clear explanation for the staging of lung cancer after neoadjuvant therapy. Further data analysis is needed, and it is expected to be answered in the tenth edition of TNM staging.

Objective:To investigate the incidence and potential risk factors associated with postopera-tive spinal epidural hematoma(SEH)following anterior cervical spine surgery(ACSS).Methods:A retrospective analysis was conducted on the clinical data of patients who underwent ACSS for cervical spondylosis at Peking University Third Hospital between March 2013 and February 2022.Patients who developed postoperative SEH were categorized as the SEH group,while those in the cohort without SEH were randomly selected as the non-SEH group by individually matching with the same operator,same gender,same surgery year,and similar age(±5 years)at a ratio of 4:1.The general condition,pre-operative comorbidities,anticoagulant or antiplatelet therapy,preoperative coagulation and platelet counts,American society of Anesthesiologists physical status classification,cervical spondylosis classifi-cation,preoperative modified Japanese Orthopaedic Society score and cervical disability index score,sur-gical modality,surgical segment levels,ossification of the posterior longitudinal ligament among the surgi-cal level,surgery duration,estimated blood loss,postoperative drainage volume,preoperative mean arte-rial pressure,mean arterial pressure during postoperative awakening periods,hospital stay and hospitali-zation cost were compared between the two groups.A bivariate Logistic regression model was applied to screen out the independent risk factors and calculate the odds ratios of indicators associated with SEH.Receiver operating characteristic curve and area under the curve(AUC)were used to describe the dis-crimination ability of the indicators.Results:A total of 85 patients were enrolled in the study,including 17 patients in the SEH group and 68 patients in the non-SEH group.Seventeen patients with SEH under-went hematoma evacuation,and all of them were successfully treated and discharged from the hospital.Corpectomy(OR=7.247;95％CI:1.962-26.766;P=0.003)and the highest mean arterial pressure during awakening(OR=1.056;95％CI:1.002-1.113;P=0.043)were independent risk factors for SEH.The AUC values were 0.713(95％CI:0.578-0.848)and 0.665(95％CI:0.51-0.82)re-spectively.The patients with SEH had longer hospital stays(P＜0.001)and greater hospitalization costs(P=0.035).Conclusion:Corpectomy and elevated maximum mean arterial pressure during awakening are independent risk factors for the development of postoperative SEH following ACSS.High-risk patients should be closely monitored during the perioperative period.