Objective To investigate the influencing factors of antibiotic-associated diarrhea(AAD)following congenital heart disease(CHD)surgery in pediatric patients,develop a nomogram-based predictive model,and validate its efficacy.Methods A retrospective analysis was conducted on the clinical data of pediatric patients who underwent CHD surgery in the Pediatric Intensive Care Unit(PICU)of a tertiary hospital in Guang-dong Province from July 2022 to July 2024.Patients were categorized into an AAD group and a non-AAD group.Univariate and multivariate logistic regression analyses were performed to identify risk factors for AAD occurrence following CHD surgery.A risk prediction model was developed,and a nomogram was constructed.The predictive performance of the model was evaluated using the Receiver Operating Characteristic(ROC)curve to calculate the area under the curve(AUC),the Hosmer-Lemeshow goodness-of-fit test,calibration curves,and clinical decision curve analysis.External validation of the model was conducted using data from patients in the Surgical Intensive Care Unit(SICU).Results The incidence of AAD following CHD surgery was 48.52%(229 out of 472 cases).Risk factors for AAD included the combined use of antibiotics,mechanical ventilation,elevated C-reactive protein levels,prolonged surgical duration,and extended antibiotic usage time(all with OR>1,P<0.05).Conversely,probiotic administration was identified as a protective factor(OR<1,P<0.05).The predictive model demon-strated excellent discrimination,as evidenced by the ROC curve areas:0.922(95%CI:0.894～0.951)in the modeling group,0.886(95%CI:0.838～0.915)in the internal validation group,and 0.862(95%CI:0.784～0.941)in the external validation group.Additionally,the model exhibited satisfactory calibration,as indicated by the Hosmer-Lemeshow test results:χ2=7.96,P=0.538 in the modeling group;χ2=4.24,P=0.895 in the inter-nal validation group;and χ2=9.923,P=0.270 in the external validation group.Furthermore,the model provided significant clinical utility.Conclusions Combined antibiotic use,duration of antibiotic therapy,mechanical ventilation,surgical duration,C-reactive protein(CRP)levels,and probiotic administration are key factors influ-encing the occurrence of AAD.The risk prediction model developed based on these variables demonstrates robust predictive performance and can serve as a valuable reference for the development and implementation of preventive and therapeutic strategies in clinical practice.

Objective To investigate the influencing factors of antibiotic-associated diarrhea(AAD)following congenital heart disease(CHD)surgery in pediatric patients,develop a nomogram-based predictive model,and validate its efficacy.Methods A retrospective analysis was conducted on the clinical data of pediatric patients who underwent CHD surgery in the Pediatric Intensive Care Unit(PICU)of a tertiary hospital in Guang-dong Province from July 2022 to July 2024.Patients were categorized into an AAD group and a non-AAD group.Univariate and multivariate logistic regression analyses were performed to identify risk factors for AAD occurrence following CHD surgery.A risk prediction model was developed,and a nomogram was constructed.The predictive performance of the model was evaluated using the Receiver Operating Characteristic(ROC)curve to calculate the area under the curve(AUC),the Hosmer-Lemeshow goodness-of-fit test,calibration curves,and clinical decision curve analysis.External validation of the model was conducted using data from patients in the Surgical Intensive Care Unit(SICU).Results The incidence of AAD following CHD surgery was 48.52%(229 out of 472 cases).Risk factors for AAD included the combined use of antibiotics,mechanical ventilation,elevated C-reactive protein levels,prolonged surgical duration,and extended antibiotic usage time(all with OR>1,P<0.05).Conversely,probiotic administration was identified as a protective factor(OR<1,P<0.05).The predictive model demon-strated excellent discrimination,as evidenced by the ROC curve areas:0.922(95%CI:0.894～0.951)in the modeling group,0.886(95%CI:0.838～0.915)in the internal validation group,and 0.862(95%CI:0.784～0.941)in the external validation group.Additionally,the model exhibited satisfactory calibration,as indicated by the Hosmer-Lemeshow test results:χ2=7.96,P=0.538 in the modeling group;χ2=4.24,P=0.895 in the inter-nal validation group;and χ2=9.923,P=0.270 in the external validation group.Furthermore,the model provided significant clinical utility.Conclusions Combined antibiotic use,duration of antibiotic therapy,mechanical ventilation,surgical duration,C-reactive protein(CRP)levels,and probiotic administration are key factors influ-encing the occurrence of AAD.The risk prediction model developed based on these variables demonstrates robust predictive performance and can serve as a valuable reference for the development and implementation of preventive and therapeutic strategies in clinical practice.

Objective To evaluate the general level of asthma management in urban areas of China and further promote the national asthma management plan. Methods A multi-center, cross-sectional survey was carried out in 30 provinces of China (except for Tibet) during Oct 2015 to May 2016. It's a questionnaire-based face-to-face survey which included asthma management using peak flow meter (PFM) and pulmonary function test,medication choice of maintenance therapy and asthma education.Results A total of 3 875 asthmatic outpatients were recruited including 2 347(60.6%)females and 1 528(39.4%)males. The mean age was(50.7±16.7)years ranging from 14 to 99.Only 10.1%(388/3 837)patients used PFM as monitoring, whereas 62.1%(2 405/3 874) patients underwent pulmonary function test during the past year. There were 57.4%(2 226/3 875) patients treated with inhaled cortical steroid plus long-acting β2-agonist combinations (ICS+LABA) as daily medication. 43.3%(1 661/3 836) patients were followed up by physicians. Among this population, 1 362 asthmatic outpatients were recruited, who also took part in the asthma control survey in 2007-2008 in 10 cities.In this subgroup,17.9%(244/1 360)were tested by PFM and 66.6%(907/1 362)by pulmonary function test during last year.As to the medication,63.1%(860/1 362) selected ICS+LABA for daily control. There were 50.4%(685/1 359) patients in the follow-up cohort by physicians.Compared to the similar survey conducted in 2007-2008,the proportion of patients with ICS+LABA regimen and follow-up by physicians were markedly higher,while the rate of PFM use did not have significant improvement. Conclusion Although the present level of asthma management in China is still far from ideal, asthma management has improved compared to 8 years ago. Yet the use of PFM does not significantly improve.Asthma action plan and application of PFM should be further promoted to improve the level of asthma management.

Objective To study the clinical effect of interventional therapy and cryosurgery by bronchoscopy in the treatment of bronchial tuberculosis.Methods 70 cases with bronchial tuberculosis were randomly divided into two groups 35 cases in each group.The drug treatment group was treated by internal medicine,and the combination therapy group was treated by the interventional therapy of the bronchus mirror on the basis of the drug treatment group.The total effective rate,the improvement time of cough and dyspnea,the number of treatment,the quality of life of patients were compared between the two groups.Results The total effective rate of the combination therapy group was higher than the drug treatment group (94.24％ vs 77.14％,x2 =4.200,P =0.04).The improvement time of cough and dyspnea in the comprehensive treatment group was shorter than those in the drug treatment group,the treatment times was less than that in the drug treatment group[comprehensive treatment group:(7.51 ± 1.41) d,(4.51 ± 1.61) d,(5.62 ± 1.21) times;drug treatment group:(9.39 ± 2.77) d,(5.39 ± 2.57) d,(7.61 ± 2.59) times;t =8.213,9.153,10.242,all P =0.00].Before treatment,the life quality scores between the two groups had no significant difference (P ＞ 0.05).After treatment,the improvement of quality of life in the combination therapy group was more significant[before treatment and after treatment of combination therapy group:physiological function:t =15.539,P ＜ 0.001;emotional function:t =11.789,P ＜ 0.001;social function:t =8.753,P ＜ 0.001.Before treatment and after treatment of drug treatment group:physiological function:t =10.128,P ＜ 0.001;emotional function:t =8.132,P ＜ 0.001;social function:t =6.931,P ＜ 0.001.After treatment,combination therapy group compared with drug treatment group:physiological function:t =7.433,P ＜ 0.001;emotional function:t =4.692,P ＜0.001;social function:t =3.297,P ＜ 0.001].Conclusion The clinical efficacy of bronchoscopic interventional cryotherapy in the treatment of bronchial tuberculosis is effective,it can effectively improve the clinical symptoms,improve lesions absorption,shorten symptoms subsided time,reduce the number of treatment,it is helpful to improve the quality of life of patients and worthy of popularization and application.