ObjectiveTo investigate the impact of acute respiratory infections in children under 12 years old in Pudong New Area， Shanghai from 2019 to 2023. MethodsAcute respiratory infection samples of children under 12 years old from three sentinel hospitals in Pudong New Area， Shanghai from 2019 to 2023 were collected， and 42 respiratory infection pathogens， including influenza virus， adenovirus， parainfluenza virus， respiratory syncytial virus， human enterovirus/rhinovirus， human pulmonary virus， human bokavirus， coronavirus （229E， HKU1， NL63 and OC43）， and novel coronavirus， were detected with microfluidic chips. The situation of acute respiratory infections among outpatient and inpatient children in this area was analyzed for the before the implementation of non pharmacological intervention measures （2019.12‒2020.1）， during the period of non pharmacological intervention measures （2020.2‒2022.12）， and after non pharmacological intervention measures （2023.1‒2023.6）. ResultsFrom 2019 to 2023， a total of 1 770 samples were collected， and 445 pathogens were detected， with a detection rate of 25.14% （445/1 770）. The main pathogens detected during the study period were influenza virus： 8.70% （154/1 770）， respiratory syncytial virus： 4.41% （78/1 770）， human enterovirus/rhinovirus： 2.66% （47/1 770）， human adenovirus： 2.49% （44/1 770）， and parainfluenza virus： 2.20% （39/1 770）. Before the implementation of non pharmacological intervention measures， outpatients were primarily infected with influenza， parainfluenza virus， and respiratory syncytial virus， with detection rates of 8.09%， 4.49%， and 4.04%， respectively； inpatients were mainly infected with influenza， respiratory syncytial virus， and parainfluenza virus， with detection rates of 4.49%， 3.82%， and 3.15%， respectively. During the period of non pharmacological intervention measures， influenza， rhinovirus and respiratory syncytial virus were the main viruses detected in the samples of outpatient children， with detection rates of 4.04%， 3.60%， and 2.47%， respectively； inpatient samples mainly detected respiratory syncytial virus， rhinovirus， and influenza virus， with detection rates of 3.60%， 2.02%， and 1.80%， respectively. After non pharmacological intervention measures， influenza， rhinovirus and respiratory syncytial virus were the main pathogens detected in the outpatients， with detection rates of 9.89%， 2.92% and 2.02%， respectively； influenza， respiratory syncytial virus， and rhinovirus were the main pathogens detected in inpatient children， with detection rates of 6.29%， 1.57%， and 1.35%， respectively. ConclusionThe prevalence of pathogens related to acute respiratory infections in children is influenced by non pharmacological preventive measures.

The dental operative microscope has been widely employed in the field of dentistry, particularly in endodontics and operative dentistry, resulting in significant advancements in the effectiveness of root canal therapy, endodontic surgery, and dental restoration. However, the improper use of this microscope continues to be common in clinical settings, primarily due to operators' insufficient understanding and proficiency in both the features and established operating procedures of this equipment. In October 2019, Professor Jingping Liang, Vice Chairman of the Society of Cariology and Endodontology, Chinese Stomatological Association, organized a consensus meeting with Chinese experts in endodontics and operative dentistry. The objective of this meeting was to establish a standard operation procedure for the dental operative microscope. Subsequently, a consensus was reached and officially issued. Over the span of about four years, the content of this consensus has been further developed and improved through practical experience.
Humans ; Dentistry, Operative ; Consensus ; Endodontics ; Root Canal Therapy ; Dental Care

Objective:To analyze the clinical characteristics of adult Chinese patients with syncope.Methods:This is a cross-sectional survey study. Patients with preliminary diagnosis of syncope in the Emergency Department, Geriatrics and Cardiology Outpatient Department, or Syncope Unit of 37 hospitals in 19 provinces, autonomous regions and the Hong Kong Special Administrative Region from June 2018 to March 2021 were included in this study. The clinical features of these patients with syncope were analyzed.Results:A total of 4 950 consecutive patients with syncope were included in this study. The age was (56.3±16.8)years, and 2 604 cases (52.6%) were male. The most common type of syncope was neurally mediated syncope (2 345 (47.4%)), followed by cardiac syncope (1 085 (21.9%)), orthostatic hypotensive syncope (311 (6.3%)), and unexplained syncope accounted for nearly one third (1 155 (23.3%)). Predisposing syncope was more common in patients under 65 years of age(2 066(72.4%) vs. 786(27.6%),χ 2=136.5, P<0.001). Presyncope was more common in patients with neurally mediated syncope (1 972(79.0%) vs.1 908(73.9%), χ 2=17.756, P<0.001). Premonitory symptoms were more common in women(1 837(80.0%) vs. 1 863(73.0%),χ 2=33.432, P<0.001). Presyncope syndrome was more common in patients under 65 years of age (2 482(77.8%) vs. 1 218(73.4%),χ 2=17.523, P=0.001). Cyanosis was more common in ≥65 years old patients (271(18.2%) vs. 369(12.7%), χ 2=23.235, P<0.001). Urinary incontinence was more common in old patients aged ≥65 years(252(15.2%) vs. 345(10.8%), χ 2=19.313, P<0.001). Family history was more common in patients with cardiogenic syncope compared with other types of syncope (264(24.3%) vs. 754(19.5%), χ 2=11.899, P=0.001). Hypertention(1 480(30.5%)), coronary heart disease(1 057(21.4%)), atrial flutter and atrial fibrillation(359(7.2%)), second degree atrioventricular block(236(4.8%)) were common complications of syncope. The proportion of patients with coronary heart disease was significantly higher in cardiac syncope than that of other types of syncope(417(38.4%) vs. 640(16.6%), χ 2=241.376, P<0.001). Other common complications included cerebrovascular diseases (551 (11.1%)) and diabetes mellitus (632(12.8%)). Conclusions:Neurally mediated syncope is the most common syncope in adult Chinese population. Patients with predisposing conditions and premonitory conditions are younger. Presyncope is more common in women. The proportion of family history and coronary heart disease is higher in patients with cardiogenic syncope.

Objective:To investigate the relationship between renal function and the total cerebral small vessel disease(CSVD)score in elderly patients with a mild stroke.Methods:Patients with a mild stroke(National Institutes of Health Stroke Scale score≤3)and aged 60 years and above hospitalized in our hospital from March to December 2019 were consecutively enrolled.Total CSVD scores were evaluated based on enlarged perivascular spaces, cerebral microbleeds, white matter hyperintensities of presumed vascular origin and lacunes of presumed vascular origin.The estimated glomerular filtration rate(eGFR)was derived by using the formula of chronic kidney disease epidemiology collaboration based on serum creatinine(CKD-EPI Scr). The relationship between eGFR and the total CSVD score was analyzed. Results:Of the 152 patients enrolled, 35, 38, 39, 28 and 12 had total CSVD scores of 0, 1, 2, 3 and 4, respectively.The age of patients increased and eGFR decreased with the increase of total CSVD scores(CSVD from 0 to 4, [(67.43±6.59), (68.42±6.83), (72.18±7.94), (76.46±7.75) vs.(79.92±6.17)years old, F=12.018, P<0.001]; [(92.94±12.45)ml·min -1·1.73m -2, (90.52±8.62)ml·min -1·1.73m -2, (89.45±8.48)ml·min -1·1.73m -2 and(83.90±7.19)ml·min -1·1.73m -2vs.(79.16±7.77)ml·min -1·1.73m -2, F=7.210, P<0.001]. Spearman correlation analysis showed that eGFR was negatively correlated with the total CSVD score( r=-0.399, P<0.001). After adjusting for risk factors including age, gender and hypertension, multivariate ordinary regression analysis showed that decreased eGFR was an independent risk factor for the total CSVD score( OR=0.957, 95% CI: 0.924-0.990, P=0.012). Conclusions:In elderly patients with a mild stroke, eGFR is an independent risk factor for the total CSVD score, which shows an increased burden as eGFR decreases.

Objective To assess the effect of repetitive transcranial magnetic stimulation (rTMS) at different frequencies on behavioral and psychological symptoms and cognitive function in patients with Alzheimer's disease.Methods Seventy-two patients were randomly divided into a high frequency group,a low frequency group and a control group (n =24 for each),and given 10 Hz,1 Hz or sham rTMS over the left and right dorsolateral prefrontal cortex at an intensity was 80％ of each patient's movement threshold.The stimulation was for 30 min a day,five days a week.During the 4 weeks of treatment,risperidone was used at a fixed dose of 1 mg per day for all patients.Before and after the treatment,all 3 groups were assessed using the behavioral pathology in Alzheimer's disease rating scale (BEHAVE-AD) and the mini-mental state examination (MMSE).Results Two weeks after the treatment,the average BEHAVE-AD score of the high frequency group had decreased significantly from (16.75±6.26) to (13.84± 6.10),significantly lower than the low frequency and the control groups' averages.Two weeks later,the average BEHAVE-AD scores of the 3 groups were significantly lower than before the treatment,but the decrease of the high frequency group was of significantly greater compared to the other 2 groups.Four weeks after the treatment the average MMSE score of the high frequency group was significantly better than before the treatment (P＜0.01),and better than the low frequency and the control group's averages.The effectiveness rates of the high frequency group,the low frequency group and the control group were 88％,58％ and 54％ respectively,all significantly different.Conclusion High frequency (10 Hz) rTMS combined with risperidone can improve the behavioral and psychological symptoms and cognitive function of AD patients,while low frequency (1Hz) rTMS does not have obvious effects.

Objective: To study the characteristics of attentional bias to emotional stimulus in medical workers of emergency department and explore the relationship between the emotional Stroop effect and mood states, thus providing a reference to the assessment and intervention of emergency medical workers’ mental health. Methods: Two kinds of emotional Stroop tasks with words and pictures and the Profile of Mood States (POMS) were administered to thirty-six medical workers of emergency department and thirty-six medical workers of other departments. Results: The reaction time to negative and positive words and pictures were all higher than the reaction time to neutral stimulus, thus showing the significant Stroop effect in medical workers. The Stroop effect to negative emotional stimulus in medical workers of emergency department was significantly smaller than that in medical workers of other departments, while the difference of Stroop effect to positive stimulus was not significant between the two groups. Correlation analyses revealed that the correlations between Stroop effect size to positive pictures and tension and angry of POMS were all negatively significant (r value was -0.314 and -0.330 respectively) , and the correlation between Stroop effect size to negative pictures and fatigue was negatively significant (r=-0.303) . Conclusions There is a significant emotional Stroop effect in medical workers. Although the ability of anti-interference to emotional stimulus in medical workers of emergency department was better than medical workers of the other departments, the long-term avoidance to negative emotional stimulus was still has a negative effect on the mood states of individuals.

Objective To evaluate the effect on salvage treatment of sudden deafness with comprehensive Chinese medicine therapy. Methods Fifty-three sudden deafness patients failing in conventional western medicine treatment were given comprehensive Chinese medicine therapy, and the salvage treatment followed by oral use of Chinese medicine, intravenous injection of Chinese patent medicine, acupoint injection, ear acupoint plastering, acupoint application, acupuncture, sound healing, and massage. The therapeutic effect and the relief of major accompanying symptoms were evaluated after treatment, and the relationship of disease course with clinical efficacy was also investigated. Results (1) After treatment, 4 cases were cured, 9 were markedly effective, 13 were effective, 27 were ineffective, and the total effective rate was 49.06%. (2) Except for the 2 excluded cases, the major accompanying symptoms such as tinnitus, auricular distress, and vertigo were relieved to various degrees in other cases. ( 3) Twenty-two patients had a course of disease within 14 days, and the total effective rate for them was 72.73%. A total effective rate of 32.26% was achieved in 31 cases with disease course over 14 days. It is indicated that the therapeutic effect for patients with a disease course less than 14 days was superior to that with a disease course over 14 days (P<0.01). Conclusion Comprehensive Chinese medicine therapy exerts inspiring therapeutic effect on salvage treatment of sudden deafness, and earlier intervention results into better effect.

Objective To develop a Quick Cognitive Screening Scale for Elder(QCSS-E) and examine its reliability and validity.Methods In the light of rating model of MMSE and MoCA,a screening scale was developed to assess cognitive function,which contained 47 items across twelve domains.Five hundred community subjects were interviewed with the QCSS-E,then 150 subjects were retested after two weeks,and 75 subjects were assessed with MMSE and CCAS.The test-retest reliability,internal consistency reliability,empirical validity and constmct validity of QCSS-E were calculated.Results The test-retest reliability and Cronbach's α coefficient were 0.972 and 0.814 for QCSS-E total score,0.656-0.911 and 0.679-0.746 for domain scores.There were low to moderate correlation of 0.133-0.612 among domain scores,correlation domain scores with total score ranged from 0.303-0.664.QCSS-E scores decreased with increasing agc,increased with the level of education increasing,and decreased with the aggravation of brain damage.The QCSS-E was significantly correlated with MMSE(r=0.886) and CCAS (r=0.899).Factor analysis got two factors accounting for 49.4％ of variance,which were named vulnerability factor and resistance to damage factor.Conclusion The stability,internal consistency,and validity of the QCSS-E are good and meet with psychometric standard.

Objective To investigate the effects of fluoxetine and pyrrolidine dithidarbamate (PDTC) on the lipopolysaccharide(LPS)-induced interleukine-6(IL-6) release in cultured rat astrocytes.Methods The purified astrocytes were cultured in 48-well tissue culture plate and classified into control group,LPS group,fiuoxetine group and PDTC group.Control group and LPS group were cultured as usual,and fluoxetine group and PDTC group were cultured with fluoxetine or PDTC at different concentrations for 48 hours,and then LPS group,Fluoxetine group and PDTC group were incubated with 1 ug/ml LPS for 24 hours.Finally,the levels of IL-6 in the cell supernatant were detected by enzymatic linked immunosorbent assay (ELISA) method.Results The level of IL-6 in LPS group ((1975.46 ± 171.54) pg/ml) was significantly higher than that in control group((10633 ± 782.15)pg/ml) (P ＜ 0.01).The levels of IL-6 were (6198.6 ± 379.4) pg/ml,(4973.6 ± 132.5) pg/ml and (4747.9 ±473.9) pg/ml respectively when the concentrations of fluoxetine were 10 μM,20 μM and 40 μM,and (4821.6 ±180.8) pg/ml,(4735.7 ±620.0)pg/ml and (3525.9 ± 240.0)pg/ml respectively when the concentrations of PDTC were 100 μM,150 μM and 200 μM.There was significant difference in the levels of IL-6 between LPS group and fluoxetine group (P ＜ 0.05),as well as between LPS group and fluoxetine group (P ＜ 0.05).Conclusion LPS can induce IL-6 release from astrocytes,while fluoxetine or PDTC at some concentrations can suppress LPS-induced IL-6 release.

Objective To investigate the methods used for evaluating the severity of the patients with acute pancreatitis induced by hyperlipidemia in order to find out some simple and practical biomarkers for predicting the severity of the illness.Methods Sixty-two patients with acute pancreatitis resulted from hyperlipidemia were selected from the in-patients of our hospital from January 2007 to July 2011 and were divided into two groups,namely the mild acute pancreatitis group(MAP,n =32)and the severe acute pancreatitis group(SAP,n =30)as per the Chinese Acute Pancreatitis Guideline.Two groups were comparable verified by the test of homogeneity of variance after grouping.Arterial blood gas analyses were done immediately after admission:Venous blood was taken from forearm for determining renal function and blood coagulation at 6 o＇lock of next day after admission.The data of base excess(BE),creatinine(CR),C-reactive protein(CRP),fibrin(FIB)and D-Dmmer(D-D)were documented.The contrast CT imaging of pancreas was done within 48 hours after admission in all patients.APACHE Ⅱ scores and computed tomography severity index(CTSI)were calculated.The differences in BE,CR,CRP,FIB and D-D between 2 groups were analyzed by using t-test,and the correlation among them and APACHE Ⅱ score and CTSI were analyzed by Spearman test done with SPSS 18.0 software.As BE ＜-4.5 mnol/L,CR ＞ 120μmol/L,CRP ＞ 100 mg/L,FIB ＞5.5 g/L and D-D 800 ng/L were set respectively as a positive screening criterion,positive prediction value(PPV),negative prediction value(NPV),sensitivity and specificity of each marker and combined markers were calculated after they were set at different positive scales in order to get the optimal predictors for evaluating the severity of acute pancreatitis induced by hyperlipidemia.Results The absolute values of BE,CR,CRP,FIB and D-D in group SAP were much higher than those in group MAP(P ＜ 0.01).Each of them had good correlation with APACHE Ⅱ score and CTSI,especially BE and D-D more significant.Each of them used separately for predicting the severity of acute pancreatitis showed PPV and NPV with high specificity but the sensitivity was hot high.The joint use of BE,CR and CRP,and joint use of FIB and D-D could be more valid as PPV and NPV with high specificity for predicting the severity of acute pancreatitis,but the sensitivity decreased.Conclusions BE,CR,CRP,FIB and D-D were good biomarkers for quickly and accurately evaluating and predicting the severity of the acute pancreatitis caused by hyperlipidemia.