Objective:To investigate the value of bronchoalveolar lavage fluid (BALF) genechip analysis for the identification of pathogens in children with refractory pneumonia.Methods:A retrospective study of 500 children clinically diagnosed with refractory pneumonia in the Department of Respiratory and Critical Care Medicine, Kunming Children′s Hospital, Kunming Medical University between January 2020 to January 2022 was made.During hospitalization, bronchoscopic examination and bronchoalveolar lavage were performed.BALF was collected and analyzed using genechip technology to detect potential pathogens.At the same time, bacterial culture tests of sputum and BALF samples from the patients were performed. χ2 test was used to compare the positive rates of pathogens detected by different detection methods. Results:Of the 500 children patients, 482 cases (96.4%) were positive of BALF genechip analysis for pathogen identification.There were 71 cases (14.7%) infected with a single pathogen, and 411 cases (85.3%) with 2 or more pathogens.The top 3 bacteria were Streptococcus pneumoniae [117 cases (8.3%)], Haemophilus influenzae [63 cases (4.5%)], and Bordetella pertussis [32 cases (2.3%)]. The patients were mostly infected with respiratory syncytial virus [269 cases (19.1%)], followed by parainfluenza virus [217 cases (15.4%)], and adenovirus [132 cases (9.3%)]. Among the 500 patients, 116 cases (23.2%) were positive of BALF genechip analysis for bacteria identification, 47 cases (9.4%) had a positive BALF culture, 43 cases (8.6%) had a positive sputum culture.The bacterial detection rate of BALF genechip analysis was statistically significantly higher than that of BALF culture and sputum culture tests ( χ2=34.90, 39.85; all P<0.001). Conclusions:Most patients with refractory pneumonia have mixed infections.The genechip technology can rapidly and efficiently identify the pathogens, thus providing clinical guidance for anti-infection treatment.

Objective To analyze the results of national personal dose monitoring intercomparison and assessment of Hubei Provincial Hospital for Occupational Disease in 2016—2021, to investigate the influencing factors for monitoring results, and to improve the ability of personal dose monitoring. Methods The assessment was completed according to the requirements of The National Comparison Scheme for Individual Dose Monitoring Ability and Testing Criteria of Personnel Dosimetry Performance for External Exposure (GBZ 207—2016). Results The assessment results were qualified in 2016—2017 and 2020 and excellent in 2018—2019 and 2021. Conclusion The ability of personal dose monitoring in our laboratory has been continuously improved. The monitoring results are accurate and the data processing is standardized, which meet the requirements of relevant standards for personal external exposure dose monitoring.

Objective To discuss clinical efficacy of the modified Stoppa approach in the treatment of acetabular anterior fractures.Methods From January 2011 to December 2014,22 patients with acetabular anterior fracture were treated at our department.They were 14 males and 8 females,with an average age of 36.6 years (range,from 18 to 49 years).By the LetourneI-Judet classification system,there were 9 anterior wall fractures,12 anterior column fractures,and one transverse fracture.The modified Stoppa approach was used for fracture reduction under direct visualization in this cohort.Fixation with reconstruction plate was conducted after satisfactory reduction was confirmed by the X-ray examination.The operative duration,incision length,bleeding volume,fracture reduction quality,function of the affected hip and complications were recorded.Results In this cohort,the incision length ranged from 6 to 15 cm,averaging 9.5 cm;the intraoperative bleeding volume ranged from 100 to 1,000 mL,averaging 550 mL;the operative duration ranged from 40 to 160 minutes,averaging 126.2 min.The 22 patients were followed up for an average of 15.5 months (from 12 to 18 months).According to the Matta imaging evaluation,the fracture reduction was rated as excellent in 18 cases,as good in 3 cases and as poor in one,yielding an excellent to good rate of 95.5％.According to the Harris scoring system,the function of the affected hip was assessed at the final follow-up as excellent in 12 cases,as good in 9 cases,and as poor in one case,giving an excellent to good rate of 95.5％.Traumatic arthritis occurred in one case;there were no such complications as reduction loss or implant failure.Conclusion The modified Stoppa approach is a satisfactory one for the treatment of unstable acetabular anterior fractures,owning to its advantages like minimal invasiveness,simple dissection,excellent visual control of reduction and fixation,and a low rate of complications.

OBJECTIVETo develop a brief version scale with good validity and reliability to evaluate self-management knowledge, attitude and behavior (KAB) of diabetes patients in a shorter time.

METHODS20 authority experts who specialized in the field of diabetes clinical and non-communicable disease self-management, and familiar with the relevant content of diabetes self-management were selected. Face to face and Email consultation methods were applied in two rounds delphi expert consultations to choose items from the Diabetes Self-management Knowledge, Attitude, and Behavior Assessment Scale (DSKAB, total scale, 98 items). In the first round of expert consultation, experts were asked to select the core items from every dimension and score the extent of familiarity and basis of judgment. In the second round of expert consultation, the significance of the core items which were selected by experts in first round, were graded. The items which entered into the brief scale were determined by harmonious condition of expert opinions.

RESULTSTwo rounds of consultation reclaimed 16 and 15 responses respectively, Positive coefficients of experts were 80% and 94% respectively, and both authoritative coefficients were 0.90. In the first round of consultation, experts selected 44.3 ± 6.2 items on average, 42 items were selected according to the integrity of the scale for measuring dimension and content at last. In the second round of consultation, experts thought that the 42 items could measure the important contents of each dimension comprehensive and representative, the item importance scores of knowledge, attitude, and behavior subscale were 8.42 ± 1.17, 8.61 ± 1.24, 8.61 ± 1.02 respectively, and the coordination coefficients of the three subscale were 0.36, 0.20, 0.49 (χ(2) were 89.74, 11.13, 96.03, P<0.05). The total coordination coefficient was 0.38 (χ(2) =199.36, P<0.001), which indicated the concentration of experts(')opinion was acceptable, showed the brief scale with good face validity and content validity.

CONCLUSIONThe brief scale could evaluate Diabetes Self-management KAB Scale rapidly and relatively comprehensive in groups or individuals diabetes with good face validity and content validity.

Objective To understand the changes on patterns of sleep duration of the China Health and Nutrition Survey (CHNS) cohort in 9 provinces from 2004 to 2011.Methods Four rounds of CHNS data were used.Urban/rural,age and gender specific insufficient sleeping rates and excessive sleeping rates were analyzed.Results In 2004,2006,2009 and 2011,a total of 274,281,329 and 304 children aged 3-5 years;874,806,768 and 742 children aged 6-12 years;789,529,426 and 367 children aged 13-17 years;9 568,9 530,9 942 and 9 609 adults aged ≥18 years were surveyed respectively.The lowest insufficient sleeping rate was 53.9％ (200/371) in 3-17 years old children in rural area in 2006,the highest insufficient sleeping rate was 77.2％ (44/57) in 3-5 years old children in urban area in 2004.The insufficient sleeping rate increased in rural 3-5 years old children from 2004 to 2011.For the adults aged ≥ 18 years,the insufficient sleeping rate ranged from 4.2％ (82/ 1 954) in females aged 18-44 years in 2004 and 2009 to 20.8％ (211/1 015) in urban residents aged ＞ 60 years in 2011.The insufficient sleeping rate in age-groups 44-59 years and ≥60 years increased in both males and females and in both urban area and rural area from 2004 to 2011.The gender specific excessive sleeping rate in 3-17 years old children was very low in both urban area and rural area and no difference was found in different rounds of survey.The excessive sleeping rate in adults ranged from 18.4％ (569/3 093) in urban population in 2011 to 32.5％ (1 617/4 969) in females in 2004.The excessive sleeping rate of adult decreased from 2004 to 2011.Conclusion We should pay attention to the fact that the insufficient sleeping rate in adolescents is high and in increase in rural 3-5 years old children and adults aged ≥45 years.

Objective To evaluate the validity, reliability, and acceptability of the brief version of the self-management knowledge, attitude, and behavior (KAB) assessment scale for diabetes patients. Methods Diabetes patients who were managed at the Xinkaipu Community Health Service Center of Tianxin in Changsha, Hunan Province were selected for survey by cluster sampling. A total of 350 diabetes patients were surveyed using the brief scale to collect data on knowledge, attitudes, and behaviors of self-management. Content validity was evaluated by Pearson correlation coefficient between the brief scale and subscales of knowledge, attitude, and behavior. Structure validity was evaluated by factor analysis, and discrimination validity was evaluated by an independent sample t-test between the high-score and low-score groups. Reliability was tested by internal consistency reliability and split-half reliability. The evaluation indexes of internal consistency reliability were Cronbach's α coefficients, θ coefficient, and Ω coefficient. Acceptability was evaluated by valid response rate and completion time of the brief scale. Results A total of 346(98.9%) valid questionnaires were returned, with average survey time of (11.43±3.4) minutes. Average score of the brief scale was 78.85 ± 11.22; scores of the knowledge, attitude, and behavior subscales were 16.45 ± 4.42, 21.33 ± 2.03, and 41.07 ± 8.34, respectively. Pearson correlation coefficients between the brief scale and the knowledge, attitude, and behavior subscales were 0.92, 0.42, and 0.60, respectively;P-values were all less than 0.01, indicating that the face validity and content validity of the brief scale were achieved to a good level. The common factor cumulative variance contribution rate of the brief scale and three subscales was from 53.66%to 61.75%, which achieved more than 50%of the approved standard. There were 11 common factors;41 of the total 42 items had factor loadings above 0.40 in their relevant common factor, indicating that the brief scale and three subscales had good construct validity. Patients were divided into a high-score group and a low-score group, then scores of the brief scale and three subscales were compared between the groups using a t-test. The results were all significant, indicating that the brief scale and three subscales had good discriminate validity. Mean scores of the brief scale and three subscales of the high-score group were 91.55±6.81, 19.51±2.17, 22.74±1.88, and 49.30±6.20, respectively;these were higher than the low-score group (65.89 ± 5.79, 12.29 ± 4.76, 20.22 ± 1.88, and 33.39 ± 6.17, respectively) with t-values 27.76, 13.31, 9.20, and 17.56 (P-values were less than 0.001). The Cronbach's α coefficient, θ coefficient,Ω coefficient, and split-half reliability of the brief scale were 0.83, 0.87, 0.96, and 0.84, respectively. These values for the three subscales were all above 0.70, except for theθcoefficient of the attitude subscale with 0.64, indicating that the brief scale and three subscales had acceptable internal consistency reliability. Conclusion The brief version of the diabetes self-management knowledge, attitude, and behavior assessment scale showed good acceptability, validity, and reliability, to responsibly evaluate self-management KAB among patients with diabetes.

Objective To evaluate the validity, reliability, and acceptability of the brief version of the self-management knowledge, attitude, and behavior (KAB) assessment scale for diabetes patients. Methods Diabetes patients who were managed at the Xinkaipu Community Health Service Center of Tianxin in Changsha, Hunan Province were selected for survey by cluster sampling. A total of 350 diabetes patients were surveyed using the brief scale to collect data on knowledge, attitudes, and behaviors of self-management. Content validity was evaluated by Pearson correlation coefficient between the brief scale and subscales of knowledge, attitude, and behavior. Structure validity was evaluated by factor analysis, and discrimination validity was evaluated by an independent sample t-test between the high-score and low-score groups. Reliability was tested by internal consistency reliability and split-half reliability. The evaluation indexes of internal consistency reliability were Cronbach's α coefficients, θ coefficient, and Ω coefficient. Acceptability was evaluated by valid response rate and completion time of the brief scale. Results A total of 346(98.9%) valid questionnaires were returned, with average survey time of (11.43±3.4) minutes. Average score of the brief scale was 78.85 ± 11.22; scores of the knowledge, attitude, and behavior subscales were 16.45 ± 4.42, 21.33 ± 2.03, and 41.07 ± 8.34, respectively. Pearson correlation coefficients between the brief scale and the knowledge, attitude, and behavior subscales were 0.92, 0.42, and 0.60, respectively;P-values were all less than 0.01, indicating that the face validity and content validity of the brief scale were achieved to a good level. The common factor cumulative variance contribution rate of the brief scale and three subscales was from 53.66%to 61.75%, which achieved more than 50%of the approved standard. There were 11 common factors;41 of the total 42 items had factor loadings above 0.40 in their relevant common factor, indicating that the brief scale and three subscales had good construct validity. Patients were divided into a high-score group and a low-score group, then scores of the brief scale and three subscales were compared between the groups using a t-test. The results were all significant, indicating that the brief scale and three subscales had good discriminate validity. Mean scores of the brief scale and three subscales of the high-score group were 91.55±6.81, 19.51±2.17, 22.74±1.88, and 49.30±6.20, respectively;these were higher than the low-score group (65.89 ± 5.79, 12.29 ± 4.76, 20.22 ± 1.88, and 33.39 ± 6.17, respectively) with t-values 27.76, 13.31, 9.20, and 17.56 (P-values were less than 0.001). The Cronbach's α coefficient, θ coefficient,Ω coefficient, and split-half reliability of the brief scale were 0.83, 0.87, 0.96, and 0.84, respectively. These values for the three subscales were all above 0.70, except for theθcoefficient of the attitude subscale with 0.64, indicating that the brief scale and three subscales had acceptable internal consistency reliability. Conclusion The brief version of the diabetes self-management knowledge, attitude, and behavior assessment scale showed good acceptability, validity, and reliability, to responsibly evaluate self-management KAB among patients with diabetes.

Objective To investigate the association of glyoxalase Ⅰ (GLO1) gene polymorphisms with susceptibility to atherosclerotic cerebral infarction (ACI).Methods Single nucleotide polymorphisms (SNPs) rs1130534 and rs1049346 in the GLO1 gene were genotyped in 300 ACI patients and 300 healthy controls using the SNaPshot technique.Additionally,quantitative real-time PCR was employed to determine the GLO1 expression levels in 50 ACI patients and 50 healthy controls,respectively.Results In terms of the rs1049346 polymorphism,the respective frequencies of CC,CT and TT genotypes were 9.3％,42.7％ and 48.0％ in the ACI patients,and 14.0％,47.7％ and 38.3％ in the control group.The respective frequencies of C and T alleles were 30.7％ and 69.3％ in the ACI patients,and 37.8％ and 62.2％ in the control group.There were statistically significant differences in the genotype and allele frequencies of rs1049346 between the ACI patients and controls (genotype:x2 =6.877,P =0.032;allele:x2 =6.842,P=0.009).For rs1130534,the respective frequencies of AA,AT and TT genotypes were 52.0％,42.0％ and 6.0％ in the ACI patients,and 60.0％,33.7％ and 6.3％ in the control group.The respective frequencies of A and T alleles were 73.0％ and 27.0％ in the ACI patients,and 76.8％ and 23.2％ in the control group.However,no statistically significant differences were found in the distribution of genotypes or alleles of the rs1130534 SNP between the ACI patients and controls (all P ＞ 0.05).The results of haplotype analysis revealed that the frequencies of the A-T and T-T (rs1130534-rs1049346) haplotypes in the ACI patients were all significantly higher compared to the controls (42.3％ vs 39.0％,x2 =4.733,P =0.030;27.0％ vs 23.2％,x2 =5.699,P =0.017).Additionally,the GLO1 expression levels in the ACI patients were significantly lower than that in the healthy controls (Mann-Whitney U =911.5,P =0.020).Conclusion The results indicate that the rs1049346 polymorphism of GLO1 gene is associated with the susceptibility to ACI.

Objective To evaluate the clinical outcomes of submental island pedicled flap (SIPF) combination with bio-membrane in reconstructing palate defects after maxillofacial or palatal neoplasm resection.Methods There were 12 patients with squamous cell carcinoma and one patient with adenoid cystic carcinoma.The clinical stages of tumours were]] in two patients,Ⅲ in four patients,Ⅳ in six patients(UICC 2002),and one patient with adenoid cystic carcinoma no staged.SIPFs were designed and created,and the tissue sides of the SIPFs were covered with bio-membrane to reconstruct the oral and the nasal sides of the defects respectively.Speech and swallowing functions and opening mouth were evaluated 6 months postoperatively.Results All flaps survived and no serious complications occurred.Ten patients achieved normal speech,two had intelligible speech,and one was with slurred speech;Nine patients resumed a solid diet,three with a soft diet,and one on a liquid diet.Eight patients recovered normal mouth opening,four emerged minor limitation of mouth opening,and one had serious limitation of mouth opening.Conclusions SIPF combined with bio-membrane is a safe,simple,and reliable method for reconstruction of piercing palate defect following neoplasm ablation,with satisfactory oral functions.

Objective:To determine the change in the dietary patterns of Hunan urban residents from1982 to 2012. Methods:A 24 hour dietary recall method was used for 3 consecutive days to collect information on food intake, and the condiment intake was collected by weighting method. Results:Rice products and potato consumption were 449.0 g per person per day and 44.0 g per person per day in 1982, and dropped to 150.0 g per person per day and 9.0 g per person per day in 2012. In 2012, vegetable (277.1 g per person per day), fruits (47.8 g per person per day), milk and dairy products (16.6 g per person per day) consumption were still insuffcient. Fat (59.3 g per person per day) and salt (10.1 g per person per day) consumption was still high. Conlusions:hTe dietary quality of urban residents in Hunan has been greatly improved, but is still seriously imbalanced. To consume more fruits, milk and dairy products and reduce fat and salt intake are very important.