Objective To analyze the distribution characteristics of 13 common respiratory pathogens in children in Zibo area from 2020 to 2022.Methods A total of 3091 hospitalized children with respiratory infections admitted to Zibo Maternal and Child Health Hospital from January 2020 to December 2022 were selected as the subjects.Throat swabs or bronchoalveolar lavage fluid samples were collected from the patients,and 13 common respiratory pathogens were tested to analyze the distribution differences among different genders,ages,and seasons.Results Among 3091 pediatric patients,1794 were found to be infected with pathogens.The top three pathogens were Mycoplasma pneumoniae,rhinovirus,and respiratory syncytial virus(RSV).The single infection rate was 47.75％,while the mixed infection rate was 10.28％,with the most common scenario being a mixed infection of two pathogens.There were statistically significant differences in the pathogen profiles across different age groups(P＜0.001):infants had the highest detection rate of RSV,young children were primarily infected with rhinovirus,preschool and school-age children were predominantly infected with Mycoplasma pneumoniae.Seasonal distribution showed that the highest positive rate was in autumn,while the lowest was in spring(P＜0.05).In spring,the main pathogens were rhinovirus and Mycoplasma pneumoniae;in summer,they were rhinovirus and parainfluenza virus;in autumn,they were Mycoplasma pneumoniae and RSV;and in winter,the detection rates of Mycoplasma pneumoniae and influenza B virus were higher.Conclusion From 2020 to 2022,Mycoplasma pneumoniae,rhinovirus and RSV were the main pathogens of children's respiratory tract infection in Zibo area,and there were significant differences in the distribution of pathogens among different ages and seasons.

Neurodegenerative diseases(NDD)are a heterogeneous group of disorders characterized by neuronal degeneration and functional impairment,in which neuroinflammation plays a pivotal role throughout disease onset and progression.The 18 kDa translocator protein(TSPO)serves as an important molecular biomarker of neuroinflammation,with its expression closely associated with activation of microglia and astrocytes.TSPO-PET enables noninvasive and dynamic mapping of spatiotemporal distribution of cerebral neuroinflammation,providing crucial molecular imaging evidence for early diagnosis,disease evaluation and therapeutic response assessment of NDD.The advances and challenges of TSPO-PET imaging in NDD were reviewed in this article.

OBJECTIVE To understand the surveillance data regarding to prevalence of hospital-associated infections(HAIs)in a three-A children's specialized hospital of Henan Province and analyze the change trends so as to pro-vide bases for developing precise prevention strategies and optimizing the allocation of infection control resources.METHODS The data involving the case information,case-time infection rates,infection sites,distribu-tion of departments and pathogens were collected from the children who were hospitalized in Children's Hospital Affiliated to Zhengzhou University from 2020 to 2024.The statistical analysis was performed by SPSS 25.0 soft-ware.RESULTS A total of 460,516 children who were hospitalized for treatment from 2020 to 2024,3700 of whom had hospital-associated infections,with the incidence of HAIs 0.80％;totally 3907 case-times of children had HAIs,with the case-time infection rate 0.85％.The departments ranking the top 5 incidence rates of HAIs were as follows:hematopoietic stem cell transplantation ward,ward 2 of hemooncology department,ward 1 of hemooncology department,ward of rehabilitation center,neonatal surgery department.The lower respiratory tract was the major infection site,accounting for 41.13％.The children who had respiratory system infections accounted for 65.29％.The gram-negative bacteria were dominant among the pathogens causing the HAIs,accounting for 48.15％;the percentage of viruses showed an upward trend.CONCLUSIONS The incidence of HAIs shows fluctu-ating downward trend.It is necessary to further strengthen the refined management and take targeted infection prevention and control measures for the departments at high risk of HAIs and the high-risk links so as to continu-ously improve the medical quality and safety.

Objective:To investigate the distribution of health needs and healthcare workforce demands among potential service users in community health service institurions (CHSIs) and establish a comprehensive health needs profile for targeted service development.Methods:This is a cross-sectional study. A questionnaire survey (55 items for adults and 39 items for minors) was conducted among 564 residents aged 3-65 in Dapuqiao Subdistrict, Shanghai from March to May 2024. A health sketch model was developed, encompassing five dimensions (intake, basal metabolism, consumption, influencing factors, and somatosensory perception). Health issues were mapped to standardized healthcare services, and annual standardized workloads (SW) were calculated to quantify human resource demands. Results:Among 534 valid responses (94.68% response rate), 355 from the adults and 179 from minors, the top health issues for adults were irregular diet, nutritional imbalance, obesity, somatic fatigue, and disordered eating; for minors, they were nutritional imbalance, medication overuse, insufficient physical activity, picky eating, and anorexia. The total annual SW required to address these needs was 3 906 807.93. Among them, the total SW for each age group was as follows: the total annual SW demand for children aged between 3 and 5 years old was 24 108.90, for children aged between 6 and 11 years old was 141 355.70, for adolescents aged between 12 and 17 years old was 29 813.74, 223 475.50 for 18-24 year olds, 476 426.53 for 25-34 year olds, 1 221 105.84 for 35-44 year olds, 812 200.22 for 45-54 year olds; and 978 321.50 for 55-65 year olds. Workforce allocation analysis revealed a total demand for 139.84 standardized personnel, with rehabilitation therapists (38.16), general practitioners (35.69), and nurses (27.34) being the top three required roles.Conclusions:Health needs and workforce demands vary significantly across age groups. This study provides a data-driven framework for optimizing community health services through stratified health needs profiling and precision resource allocation. Future strategies should prioritize tailored interventions and workforce planning to bridge service gaps and enhance health outcomes.

Objective:To investigate the descrepancy between current supply and demand based on standardiized workload for rational human resource allocation in community health service centers.Methods:A retrospective study was conducted in Dapuqiao Community Health Service Center of Shanghai Huangpu District from January 1st to December 3lst 2023. The current status of demand and supply were analyzed using the 2023 data of the institution. The standardised workload was measured according to the potential basic medical and public health service needs based on the disease profile and population groups in the community. The discrepancy between the current supply and theoretical demand was analyzed.Results:A total of 36 634 patients paid 277 262 visits in outpatient clinics of Dapuqiao Community Health Service Center in 2023. There are total 161 employees in the center, 124 of whom are female (77.02%). The actual calibrated workload of basic medical care and public health service in the center calculated on fee-based medical service items in 2023 was 2 888 425.61 and 455 898.35, respectively; while the theoretically calibrated workload was 5 416 492.42 and 711 230.94, respectively. The center employed 131 medical and health workers currently, calibrated as 90.67 employees based on current demand, while it should be 183.74 calibrated on the theoretical demand, there was a certain discrepancy between the current staffing and the standard staffing based on the standardized workload calculation.Conclusion:At present, the actual standardized workload of basic medical and public health services in Dapuqiao Community Health Service Center still has room for improvement, but there is a certain gap between the current human resource allocation and the demand.

Objective:To investigate the effect of continuous renal replacement therapy (CRRT) on energy metabolism and thermal balance in ICU patients with acute kidney injury (AKI).Methods:This study was a prospective observational study, which included AKI patients who underwent CRRT in ICU of the Sir Run Run Shaw Hospital, Zhejiang University School of Medicine from May 2020 to December 2023. The patients' general clinical characteristics, comorbidities, body temperature, disease severity score, CRRT treatment time and filter lifespan were recorded. The concentrations of glucose and lactate in blood and ultrafiltrate, and the citrate level in the ultrafiltrate when regional citrate anticoagulation adopted were analyzed regularly. Subgroup analysis was carried out according to different anticoagulation modes and whether the patients with diabetes or shock. The changes of energy metabolism and thermal balance corresponding to the changes in glucose, lactate, citrate and body temperature induced by CRRT were calculated daily.Results:This study included 420 AKI patients undergoing CRRT. When the blood lactate was between 14-18 mmol/L, there was a loss of approximately 200-250 kcal of energy per day, while the blood lactate was between 6.5-11.5 mmol/L, the daily corresponding energy loss was about 100-150 kcal. During CRRT on the first day, the patients with diabetes or shock had a mild decrease of blood glucose, while patients without diabetes and shock had mild increase of blood glucose. When the target of blood glucose was gradually achieved, the mean daily increase of energy corresponding to blood glucose intake was about 100-130 kcal in patients undergoing CRRT. The mean daily increase of energy corresponding to citrate intake was approximately 330 kcal, when the patient was undertaken by CRRT with regional citrate anticoagulation. For every 1℃ decrease in body temperature, the mean daily heat loss caused by extracorporeal thermal radiation during CRRT was about 200 kcal.Conclusions:When conducting nutritional assessment and prescription for AKI patients supported by CRRT in the ICU, it is essential to fully consider the impact of CRRT on the patient's energy metabolism and heat balance. This includes the clearance of lactate, the balance of blood glucose, the intake of citrate, and the reduction in body temperature. Additionally, the type and stage of the disease, as well as individual differences, must be taken into account to achieve personalized nutritional assessment and precise implementation.

Objective:To compare the clinical efficacy of a fixed exoskeleton robot with that of an exoskeleton walker in training the balance of stroke survivors in the subacute stage.Methods:Thirty persons with subacute stroke were divided at random into a fixed robot group (15 cases) and a walking robot group (15 cases). In addition to conventional rehabilitation treatment, the fixed robot group underwent daily 20-minute treadmill-based fixed exoskeleton robot training, 5 days a week for 2 weeks. The walking group was trained with an exoskeleton walking robot on the same schedule. Before and after the treatment, the Berg balance scale, the sitting modified functional stretch test (SMFRT), an isokinetic muscle strength test and the modified Barthel index (MBI) were used to evaluate the subjects′ global balance, self-dynamic balance, knee proprioception and ability in the activities of daily living (ADL).Results:After the treatment, both groups′ average Berg score, SMFRT extension difference, proprioceptive absolute error angle in the affected knee and MBI had improved significantly. The average SMFRT extension difference after treatment in the walker group was then significantly better than the fixed robot group′s average. However, the fixed robot group′s proprioception in the affected knee joint was then significantly better, on average, than among the walking robot group.Conclusions:Both fixed exoskeleton robot training and exoskeleton walker training can improve the balance, proprioception and ADL ability after a stroke. The former better improves dynamic balance; the latter better improves proprioception in the affected knee joint.

AIM:To investigate the potential mechanism of licorice on liver injury induced by Se-men Strychni based on network pharmacology,mo-lecular docking combined with animal experiments,providing an effective strategy for prevention and treatment of liver injury induced by Semen Strych-ni.METHODS:Firstly,the active ingredients of Se-men Strychni and licorice were obtained through the ETCM,TCMSP database and analysis platform,CTD database and literature supplementation.Then,the potential toxic ingredients of Semen Strychni were further screened based on the Swis-sADME platform,and the targets corresponding to the active ingredients were predicted through the SwissTargetPrediction platform.By using the Gene-Cards and OMIM databases to collect DILI-related targets,the potential targets for licorice to alleviate liver injury caused by Semen Strychni were ob-tained.By constructing the active ingredient-target network,the core ingredients of licorice in alleviat-ing liver injury caused by Semen Strychni were screened.The key targets obtained were used to construct and analyze the protein-protein interac-tion networks(PPI)through the STRING database and Cytoscape 3.9.0 software.The potential targets were subjected to GO and KEGG pathway enrich-ment analysis with the aid of the DAVID database,and constructed a network of active ingredient-tar-get-pathway.Molecular docking study was ap-proved for the core targets and the active ingredi-ents by using Schrodinger 2023-1 software,and the visualization operation was conducted through Py-mol.Finally,the regulatory effect of licorice on the key pathway of liver injury caused by Semen Strych-ni was validated by establishing a rat model of liver injury induced by Semen Strychni.RESULTS:After screening,6 potential toxic components of Semen Strychni and 104 corresponding targets,89 active components of licorice and 347 corresponding tar-gets,and 3 200 DILI targets were obtained.A total of 23 intersection targets were obtained through Venn analysis.By constructing the active ingredi-ent-target network,it was found that the main core ingredients were 7-methoxy-2-methyl isofla-vone,medicarpin,shinpterocarpin,quercetin,for-mononetin and isoliquiritigenin.The PPI network indicated that the core targets were protein kinase B1(AKT1),epidermal growth factor receptor(EG-FR),human epidermal growth factor receptor 2(ERBB2),glycogen synthase kinase 3 beta(GSK3B),kinase insert domain receptor(KDR)and Janus ki-nase 2(JAK2).A total of 39 relevant pathways were enriched in KEGG(P＜0.01),among which the phos-phatidylinositol 3-kinase(PI3K)-protein kinase B(AKT)(PI3K-AKT)signaling pathway,which has been confirmed and ranks first in enrichment,and was closely related to liver injury.Molecular docking re-sults showed that the core components have good binding ability with the core targets.In vivo animal experiments demonstrated that,compared to the model group,licorice significantly reduced the liver index(P＜0.01),serum levels of alkaline phospha-tase(ALP),alanine aminotransferase(ALT),aspar-tate aminotransferase(AST),indirect bilirubin(IBIL),and total bilirubin(TBIL)in rats with liver in-jury,while increasing total protein(TP)levels(P＜0.05 or P＜0.01).Additionally,licorice alleviated con-gestion in the central veins and hepatic sinusoids,improved the alignment of hepatocytes,and re-duced inflammatory cell infiltration.Furthermore,licorice significantly decreased the levels of malo-ndialdehyde(MDA),tumor necrosis factor-α(TNF-α),interleukin-1β(IL-1β),and interleukin-6(IL-6)in the liver tissue of injured rats,while elevating the levels of superoxide dismutase(SOD)and glutathi-one peroxidase(GSH-Px)(P＜0.01).It also markedly downregulated the phosphorylation levels of PI3K and AKT(P＜0.01).CONCLUSION:Licorice has multi-component and multi-target properties in the treat-ment of liver injury induced by Semen Strychni,which may play a hepatoprotective role by inhibit-ing the activation of PI3K-AKT signaling pathway.

Objective:To observe the application effect of dexmedetomidine combined with esketamine nasal drops in pediatric flexible bronchoscopy (referred to as bronchoscopy) surgery with spontaneous respiration retained.Methods:A total of 96 children undergoing bronchoscopy in the Changsha Hospital for Maternal & Child Health Care from May 2022 to December 2023 were selected and divided into the dexmedetomidine nasal drop group (group D, 47 cases) and the dexmedetomidine combined with esketamine nasal drop group (group DE, 49 cases) by random number table method. The mean arterial pressure (MAP), heart rate (HR), blood oxygen saturation (SpO 2) and respiratory rate (RR) of the two groups were observed before nasal drops (T 0), 30 minutes after nasal drops (T 1), 5 minutes after surgery started (T 2), and 10 minutes (T 3), 30 minutes (T 4), 60 minutes (T 5) and 120 minutes (T 6) after surgery. The separation anxiety and mask cooperation scores at T 1, modified Aldrete scores and Pediatric Anesthesia Emergence Delirium Scale (PEAD) scores at T 3-T 6 were evaluated; the number of children with PEAD score>10 was recorded, as well as the time to postoperatively take food and clear water. Results:There was no statistically significant difference in MAP and HR at T 0 between the two groups (all P>0.05); the MAP and HR of Group DE at T 1-T 6 were significantly higher than those of group D (all P<0.05). There was no statistically significant difference in SpO 2 and RR between the two groups within the group or between the groups at each time point (all P>0.05), while the incidence of hypoxemia (SpO 2≤92%) in group D at T 2 was significantly higher than that in group DE ( P<0.05). The separation anxiety and mask cooperation scores of group DE at T 1 were significantly better than those of group D ( P<0.05). The modified Aldrete scores of group DE at T 3, T 4 and T 5 were significantly higher than those of group D (all P<0.05). The PEAD score of group DE at T 3 was significantly lower than that of group D ( P=0.001); there was no statistically significant difference in PEAD scores between the two groups at T 4, T 5 and T 6 (all P>0.05), and no child in either group had PEAD scores>10 at T 4, T 5 and T 6. The time to take clear water and food in group DE was significantly earlier than that in group D (all P<0.05). Conclusions:In pediatric bronchoscopy surgery with spontaneous respiration retained, dexmedetomidine combined with esketamine nasal drops can more effectively relieve children′s separation anxiety, meet surgical needs, improve recovery quality, shorten the postoperative time to take food, and better implement the concept of enhanced recovery after surgery (ERAS) compared with dexmedetomidine alone.

Objective To investigate the requirement of blood sugar management in elderly patients with Type Ⅱ diabetes and to provide a reference for development of a program in management of blood sugar.Methods Using interpretive decriptive phenomenological research,an interview outline based on the theoretical domain framework was developed and face-to-face semi-structured interviews were conducted with 16 aged patients who had Type Ⅱ diabetes in the Department of Endocrinology and Metabolism of a Grade ⅢA hospital in Jiangxi Province.The participants were selected by purposive sampling.Colaizzi 7-step analytical method,in conjunction with Nvivo 11 software,was used to analyse,summarise and extract the themes.Results Seven themes related to the theoretical domain framework were extracted,which included knowledge,skills,environmental context and resources,behavioural adjustment,motivation and goals,emotions and self-efficacy.After refinement,nine sub-themes on major requirement for blood glucose management were extracted,which included the requirements for knowledge and skills in blood sugar management,support from the community and healthcare resources,support from the family,changes in maladaptive behaviours,individualised blood sugar management,motivation for self-management,clarity in goals of blood sugar control,emotional support and psychological adjustment,and support for strengthened beliefs(9 sub-themes).Conclusion Elderly patients with Type Ⅱ diabetes have diverse and individualised needs in management of blood sugar.In the future,healthcare staff should develop appropriate strategies or programs to meet the individual needs of patients by addressing the actual needs of patients,improving the self-management behaviours of patients so as to improve the effects of the blood sugar control.