Objective : To analyze the epidemiological characteristics of pertussis among the population aged ≤18 years in Zhejiang Province from 2016 to 2023, so as to provide a basis for optimizing pertussis prevention and control measures as well as immunization strategies. Methods: Data on pertussis cases among individuals aged ≤18 years in Zhejiang Province from 2016 to 2023 were collected through the Infectious Disease Reporting Information System of Chinese Disease Prevention and Control Information System. Vaccination records were obtained from the specialized pertussis epidemiological survey conducted in Zhejiang Province. The descriptive epidemiological method was employed to analyze the epidemiological characteristics of pertussis among the population aged ≤18 years, as well as the interval between disease onset and the last immunization among breakthrough cases. Results: A total of 7 431 pertussis cases aged ≤18 years were reported in Zhejiang Province from 2016 to 2023, with an average annual reported incidence of 8.68/105. The overall trend showed no statistical significance (P>0.05). The reported incidence remained relatively low from 2016 to 2021, consistently below 10.00/105. In contrast, the incidence rose to 33.98/105 in 2022 and 13.39/105 in 2023. The peak incidence period was from April to August, during which 4 024 cases were reported, accounting for 54.15%. Hangzhou City, Wenzhou City, and Ningbo City reported the highest number of cases, with 3 844, 1 581, and 646 cases, representing 51.73%, 21.28%, and 8.69%, respectively. In terms of average annual incidence, Hangzhou City, Wenzhou City, and Huzhou City ranked the highest, with rates of 33.98/105, 12.38/105, and 12.27/105, respectively. Among age groups, the highest reported incidence was observed in children aged 0-<1 years, at 48.87/105. From 2016 to 2023, the incidence in the 5-<10 years and 10-18 years age groups showed upward trends (AAPC=108.193%, 106.709%, both P<0.05). The proportion of cases in the 5-<10 years age group also increased during this period (P<0.05). A total of 109 breakthrough pertussis cases were identified. The median interval between disease onset and the last immunization was 4.00 (interquartile range, 4.00) years. The numbers of cases with intervals of 1-<2 years and ≥6 years were both relatively high, comprising 25 cases and 37 cases, which accounted for 22.94% and 33.94%, respectively. Conclusions From 2016 to 2021, the reported incidence of pertussis in Zhejiang Province remained relatively stable. However, a sharp increase was observed in 2022. The disease peaked during spring and summer. Key populations for targeted prevention and control included children aged 0-<1 year, 5-<10 years, and 10-18 years. The interval between disease onset and the last immunization among breakthrough pertussis cases exhibited a bimodal distribution.

Computational analysis can accurately detect drug-gene interactions (DGIs) cost-effectively. However, transductive learning models are the hotspot to reveal the promising performance for unknown DGIs (both drugs and genes are present in the training model), without special attention to the unseen DGIs (both drugs and genes are absent in the training model). In view of this, this study, for the first time, proposed an inductive learning-based model for the precise identification of unseen DGIs. In our study, by integrating disease nodes to avoid data sparsity, a multi-relational drug-disease-gene (DDG) graph was constructed to achieve effective fusion of data on DDG intro-relationships and inter-actions. Following the extraction of graph features by utilizing graph embedding algorithms, our next step was the retrieval of the attributes of individual gene and drug nodes. In this way, a hybrid feature characterization was represented by integrating graph features and node attributes. Machine learning (ML) models were built, enabling the fulfillment of transductive predictions of unknown DGIs. To realize inductive learning, this study generated an innovative idea of transforming known node vectors derived from the DDG graph into representations of unseen nodes using node similarities as weights, enabling inductive predictions for the unseen DGIs. Consequently, the final model was superior to existing models, with significant improvement in predicting both external unknown and unseen DGIs. The practical feasibility of our model was further confirmed through case study and molecular docking. In summary, this study establishes an efficient data-driven approach through the proposed modeling, suggesting its value as a promising tool for accelerating drug discovery and repurposing.

Computational analysis can accurately detect drug-gene interactions(DGIs)cost-effectively.However,transductive learning models are the hotspot to reveal the promising performance for unknown DGIs(both drugs and genes are present in the training model),without special attention to the unseen DGIs(both drugs and genes are absent in the training model).In view of this,this study,for the first time,proposed an inductive learning-based model for the precise identification of unseen DGIs.In our study,by integrating disease nodes to avoid data sparsity,a multi-relational drug-disease-gene(DDG)graph was constructed to achieve effective fusion of data on DDG intro-relationships and inter-actions.Following the extraction of graph features by utilizing graph embedding algorithms,our next step was the retrieval of the attributes of individual gene and drug nodes.In this way,a hybrid feature charac-terization was represented by integrating graph features and node attributes.Machine learning(ML)models were built,enabling the fulfillment of transductive predictions of unknown DGIs.To realize inductive learning,this study generated an innovative idea of transforming known node vectors derived from the DDG graph into representations of unseen nodes using node similarities as weights,enabling inductive predictions for the unseen DGIs.Consequently,the final model was superior to existing models,with significant improvement in predicting both external unknown and unseen DGIs.The practical feasibility of our model was further confirmed through case study and molecular docking.In summary,this study establishes an efficient data-driven approach through the proposed modeling,suggesting its value as a promising tool for accelerating drug discovery and repurposing.

Objective To investigate the current status of nurses'knowledge,attitude and practice regarding sleep management of critically ill children in pediatric ICU,and to analyze its impact factors.Methods A self-designed questionnaire on general information and a questionnaire on knowledge and practical behaviors of pediatric ICU nurses on child's sleep management were used.In March 2023,902 pediatric ICU nurses from 24 hospitals in China were surveyed using a convenient sampling method,and the impact factors were analyzed using multiple stepwise linear regression.Results 893 valid questionnaires were collected and the recovery rate of valid questionnaires was 99.00％.Nurses in pediatric ICU scored(33.71±7.76)in knowledge dimension,(37.38±4.86)in attitude dimension and(80.60±16.78)in practice dimension,with a total score of(151.78±24.27).The scores of knowledge and attitude,knowledge and practice,attitude and practice are all positively correlated(r=0.393,P＜0.001;r=0.495,P＜0.001;r=0.320,P＜0.001).The results of multiple stepwise linear regression analysis showed that gender,region,whether they had received sleep management training were the influencing factors of pediatric ICU nurses'total score of knowledge,attitude and practice towards children's sleep management(P＜0.05).Conclusion Nurses in pediatric ICU are positive about sleep management for critically ill children,but their knowledge and practice levels need to improve.Nursing managers should strengthen the theoretical knowledge and practical behavioral training of pediatric ICU nurses on child sleep management,develop scientific sleep management plans,and guide nurses to make reasonable evaluation and interventions to improve children's sleep quality.

Objective:To investigate the clinical efficacy of radical resection of pancreatic cancer after neoadjuvant conversion therapy.Methods:The retrospective and descriptive study was conducted. The clinicopathological data of 23 patients who underwent radical resection of pancreatic cancer after neoadjuvant conversion therapy in Nanjing Drum Tower Hospital Affiliated to Nanjing University Medical School from January 2019 to May 2022 were collected. There were 17 males and 6 females, aged 58(range, 33-73)years. After neoadjuvant conversion therapy, the three-dimensional (3D) visualization was used to evaluate and classify tumor vascular invasion, and surgical plan was planned and implemented. Observation indicators: (1) situations of neoadjuvant conversion therapy; (2) surgical situations; (3) postoperative histopathological examination; (4) postoperative recovery; (5) follow-up. Measurement data with normal distribution were represen-ted as Mean± SD, and measurement data with skewed distribution were represented as M(range) or M( Q1, Q3). Count data were described as absolute numbers. Results:(1) Situations of neoadjuvant conversion therapy. All 23 patients received the AG combination chemotherapy (albumin-paclitaxel+gemcitabine), including 14 patients combined with stereotactic body radiation therapy. Of the 23 patients, 22 cases achieved partial response, and 1 case showed stable disease. The CA19-9 of the 23 patients was 85.06(29.74,634.5)U/mL and 13.96(9.74,25.02)U/mL before and after neoadjuvant conversion therapy, respectively. (2) Surgical situations. According to the results of preoperative 3D visualization of tumor vascular invasion, 7 of the 23 patients were evaluated as arterial invasion, 8 cases were evaluated as venous invasion, 5 cases were evaluated as arterial and venous invasion, and there were 3 cases showing negative of vascular invasion. Of the 23 patients, 12 cases underwent pancreaticoduodenectomy, 4 cases underwent radical antegrade modular pancreatosplenectomy, 7 cases underwent total pancreaticoduodenectomy. For vascular reconstruction, there were 10 patients without vascular reconstruction, and there were 13 patients undergoing artificial vascular vein reconstruction. The operation time and volume of intraoperative blood loss of the 23 patients was (524±171)minutes and 1 000(400,1 600)mL, respectively. (3) Postoperative histopathological exami-nation. Results of postoperative histopathological examination in 23 patients showed that there were 2 cases with moderate-well differentiated tumor, 10 cases with moderate differentiated tumor, 7 cases with moderate-poorly differentiated tumor, 2 cases with poorly differentiated tumor, and 2 cases negative of tumor. The number of lymph node dissected in 23 patients was 16±7. There were 5 cases with lymph node metastasis and 18 cases without lymph node metastasis. There were 17 cases with nerve invasion and 6 cases without nerve invasion. All 23 patients were negative of vascular invasion. Of the 23 patients, there were 21 cases with R 0 resection and 2 cases with R 1 resection. For pathological TNM staging, there were 2 cases with 0 stage, 13 cases with Ⅰ stage, 7 cases with Ⅱ stage, and 1 case with Ⅳ stage. For postoperative pathological scoring, there were 2 cases achieved 0 point (complete pathological remission), 16 cases achieved 2 points (partial remission), and 5 cases achieved 3 points (no significant effect). (4) Postoperative recovery. The postoperative duration of hospital stay of 23 patients was 19(14,31)days. There were 17 of 23 patients underwent postoperative complications, including 11 cases with Clavien-Dindo Ⅱ stage complications, 3 cases with Clavien-Dindo Ⅲa stage complications, 1 case with Clavien-Dindo Ⅲb stage complication, 1 case with Clavien-Dindo Ⅳ stage complication, and 1 case with Clavien-Dindo Ⅴ stage complica-tion. (5) Follow-up. There were 22 patients underwent follow-up, with follow-up time as 12(9,23)months. There were 9 patients underwent postoperative recurrence and metastasis, with recurrence and metastasis time as 7.8(range, 6.0-12.0)months. During the follow-up, 15 of the 22 patients survived. Conclusion:Radical resection of pancreatic cancer after neoadjuvant conversion therapy is feasible.

Objective:Based on a cross-sectional survey about the status of analgesia and sedation nursing behavior of PICU nurses in Northeast China and Inner Mongolia, to analyze the influencing factors and to provide reference for further constructing standardized training programs and developing standardized for analgesia and sedation nursing process.Methods:The self-designed questionnaire was made for investigation from 435 PICU nurses in 18 hospitals in Northeast China and Inner Mongolia.Results:The average questionnaire score of the analgesia and sedation nursing behavior of PICU nurses was(70.54±13.63)in Northeast China and Inner Mongolia.The behavioral scores were different in each group between different age, nursing age, PICU nursing age, educational background, professional title, and whether was the intensive care unit nurse, whether trained in analgesia and sedation, whether have experience in caring children with analgesia and sedation, and the differences were all statistically significant( P<0.05). The main factors influencing the analgesia and sedation behavior of PICU nurses were whether have received training in analgesia and sedation, whether have experience in caring children with analgesia and sedation treatment and their attitude score to analgesia and sedation. Conclusion:There is still much space for development in analgesia and sedation nursing behavior of PICU nurses in Northeast China and Inner Mongolia.The more analgesia and sedation training PICU nurses take participate in, the more experience and positive attitudes they have in nursing children with analgesia and sedation, their clinical nursing practice ability could become more stronger.

Objective:To investigate post-traumatic stress disorder (PTSD) in children after major car accidents and explore the effects of psychological nursing intervention based on the theory of stress system on post-traumatic growth (PTG) in children.Methods:Totally 134 children injured in car accidents who were hospitalized in the pediatric intensive care unit (PICU) of Shengjing Hospital of China Medical University from January 2017 to February 2019 were selected by convenient sampling and divided into the observation group and the control group according to the random number table, with 67 cases in each group. During the hospital stay, children in the two groups received the same psychological nursing and were followed up once a month after discharge. Children in the observation group received psychological nursing intervention based on the theory of stress system. The PTSD Checklist-Civilian Version (PCL-C) , Post-Traumatic Growth Inventory (PTGI) and Medical Coping Modes Questionnaire (MCMQ) were used to evaluate the children before and after intervention and compare the effects of intervention.Results:After intervention, the PTSD score of the observation group was lower and the PTG score was higher than that of the control group; the facing score in MCMQ of the observation group was higher, and the avoidance and yield scores were lower than that of the control group, and the differences were statistically significant ( P<0.05) . Conclusions:PTSD is prevalent in children after major car accidents. Psychological nursing intervention based on the theory of stress system can alleviate PTSD in children and promote their PTG.

Objective: To monitor the hemodynamics of children with congenital heart disease after operation by using ultrosonic cardiac output monitor (USCOM) to understand the changes of cardiac function in children with congenital heart disease after operation. Methods: Twenty-four children with congenital heart disease underwent operation in the pediatric intensive care unit of Shengjing Hospital Affiliated to China Medical University from January 2017 to March 2018 were selected.Cardiac index (CI), lactate (Lac) concentration, central venous oxygen saturation (ScvO₂), heart rate (HR) and mean arterial pressure (MAP) were recorded at four time points after operation by USCOM. Results: The CI reached the highest level of 6.5L·min^-1·(m²)^-1 in 4h, the lowest level of 5L·min^-1·(m²)^-1 in 8h, and the same level in 24h as that in 1h.ScvO₂ was correlated with CI: P values of 1h, 4h, 8h and 24h were 0.003, 0.02, 0.034 and 0.03, respectively (all P<0.05), while ScvO₂ was not correlated with HR, MAP and Lac (P>0.05), and could not be used to judge the cardiac function of children with early congenital heart disease after operation. Conclusion USCOM is a non-invasive method for monitoring cardiac output, which can reflect the changes of cardiac function in children with congenital heart disease after operation.

Objective: To explore the effect of family need-based health education mode on family members under stress caused by transferring their children out of pediatric intensive care unit(PICU). Methods: A total of 40 family members of children transferred from PICU of Shengjing Hospital of China Medical University from July to December 2017 were selected as the control group, and 40 family members of children transferred from April to September 2018 were selected as the observation group. In the control group, daily routine health education mode were implemented by nurses on the relatives, while in the observation group, nurses provide the family members of children with corresponding graphic and text materials of health education according to the 2 copies of Critical Care Family Needs Inventory completed by their relatives within 24 hours and 72-96 hours of admission, and implement the daily health education combined with the Flipped Classroom method. The level of uncertainty in illness, stress in transfer and the satisfaction for family-centered nursing were compared between the groups. Results: In the observation group, the total score of the family members′ level of uncertainty in illness and stress in transfer were (80.05 ± 3.96) and (39.65 ± 2.41) points respectively, which were lower than those in the control group (99.70 ± 3.78) and (67.15 ± 2.38) points, and all the differences were statistically significant (t=-22.60, -50.21, P<0.01). The satisfaction for family-centered nursing in the observation group was higher than the control group, and the difference was statistically significant (P < 0.05). Conclusions The implementation of health education mode based on family needs is beneficial to reduce the level of uncertainty in illness of the family members of critically ill children transferred out of PICU, relieve the stress in transfer, and thus improving the family-centered high-quality nursing services in PICU.

Objective To investigate the development and application of blood purification in PICU. Methods The demographic data,diagnosis,length of stay,prognosis,patterns and frequency of blood purifi-cation and complications of PICU patients treated with blood purification in our hospital from 2010 to 2017 were retrospectively analyzed. Results The patients with blood purification accounted for 3. 1％ of hospital-ized children in the same period. From 2010 to 2017,the patients and times with blood purification increased by 370. 6％ and 398. 3％ respectively. The times of continuous veno-venous hemodiafiltration(CVVHDF), plasma exchange and hemoperfusion increased by 135. 2％,6300％ and 1600％ respectively. The frequency of CVVHDF,plasma exchange and hemoperfusion accounted for 42. 8％(492/1151),33. 5％(386/1151), and 23. 7％ (273/1151) respectively. Drug and toxic poision accounted for the highest proportion of 28. 6％(81/284),neurological diseases accounted for 20. 8％(59/284),sepsis with multiple organ dysfunction syn-drome accounted for 18. 0％( 51/284 ) , digestive system diseases, autoimmune diseases, renal diseases and metabolic diseases accounted for 14. 4％( 41/284 ) ,4. 9％( 14/284 ) ,4. 9％ ( 14/284 ) and 4. 2％( 12/284 ) respectively. The cure rate was 63. 8％. Complication included thrombus. Conclusion Blood purification has become the preferred modality for the management of critically ill children. Pediatric blood purification tech-niques have developed rapidly in our PICU and domestic pediatric. Further specification is required,so that it may represent the adequate choice for critical ill children.