Objective:In order to explore the impact of corona virus disease 2019(COVID-19)on the hospitalization of children with bronchiolitis and to improve clinicians′ understanding of the characteristics of bronchiolitis during the COVID-19 epidemic.Methods:This was a multicenter clinical study, and the data have been collected from 23 children′s medical centers in China.All the clinical data were retrospectively collected from children with bronchiolitis who were hospitalized at each study center from January 1, 2019 to December 31, 2021.The results included gender, age at hospitalization, length of stay, respiratory syncytial virus(RSV) test results, severity rating, ICU treatment, and the total number of children hospitalized with respiratory tract infection during the same period.The clinical data of children with bronchiolitis in 2019 before COVID-19 epidemic and in 2020、2021 during COVID-19 epidemic were statistically analyzed and compared.Results:According to a summary of data provided by 23 children′s medical centers, there were 4 909 cases of bronchiolitis in 2019, 2 654 cases in 2020, and 3 500 cases in 2021.Compared with 2019, the number of bronchiolitis cases decreased by 45.94% in 2020 and 28.70% in 2021.In 2019, 2020 and 2021, there were no significant differences in gender ratio, age, and duration of hospitalization.Compared with 2019, the ratio of bronchiolitis to the total number of hospitalizations for respiratory tract infection decreased significantly in 2020 and 2021( χ2=12.762, P<0.05; χ2=84.845, P<0.05).The proportion of moderate to severe bronchiolitis cases in both 2020 and 2021 was lower than that in 2019, and the difference was statistically significant ( χ2=4.054, P<0.05; χ2=8.109, P<0.05).There was no statistically significant difference in the proportion of bronchiolitis cases requiring ICU treatment between 2019, 2020, and 2021 ( χ2=1.914, P>0.05).In 2019, a total of 52.60%(2 582/4 909) of children with bronchiolitis underwent RSV pathogen testing, and among them, there were 708 cases with RSV positive, accounting for 28.00%.In 2020, 54.14%(1 437/2 654) of children with bronchiolitis underwent RSV pathogen testing, and there were 403 cases with RSV positive, accounting for 28.04%.In 2021, 66.80%(2 238/3 500) of children with bronchiolitis underwent RSV pathogen testing, and there were 935 cases with RSV positive, accounting for 41.78%.Compared with 2019 and 2020, the RSV positive rate in 2021 showed a significant increase( χ2=99.673, P<0.05; χ2=71.292, P<0.05). Conclusion:During the COVID-19 epidemic, the implementation of epidemic prevention and control measures reduced the hospitalization rate and severity of bronchiolitis, but did not reduce the positive rate of RSV detection.

Objective:To develop the Sexual Health Education Needs Assessment Scale for Breast Cancer Patients and test its reliability and validity.Methods:Guided by Maslow's hierarchy of needs theory and knowledge, belief, and practice theory, an initial scale was formed through literature review, semi-structured interviews and Delphi expert consultation. Through cognitive interviews with 9 patients, the scale was further revised and improved to form a clinical trial version. From December 2021 to September 2022, 397 breast cancer patients from 9 ClassⅢ hospitals in 6 provinces, municipalities and autonomous regions were selected by convenience sampling to conduct a questionnaire survey, test the reliability and validity of the scale and grade it.Results:The Sexual Health Education Needs Assessment Scale for Breast Cancer Patients included four dimensions and 32 items in total. Exploratory factor analysis extracted a total of four common factors, with a cumulative variance contribution rate of 72.258%. The content validity index of the scale was 0.865, and the content validity index of each item was 0.929 to 1.000. The correlation coefficients between each dimension of the scale and the total scale were 0.789 to 0.956, and the correlation coefficients between dimensions were 0.635 to 0.863. The Cronbach's α coefficient of the total scale was 0.979, and the Cronbach's α coefficients of each dimension were 0.897 to 0.969. The half reliability of the total scale was 0.941, and the half reliability of each dimension was 0.851 to 0.946. The total score of the scale was 32 to 160, with 32 to 77 being at a low level, 78 to 117 being at a medium level, and 118 to 160 being at a high level.Conclusions:The developed Sexual Health Education Needs Assessment Scale for Breast Cancer Patients has good reliability and validity, and is suitable for breast cancer patients' sexual health education needs assessment.

AIM: To investigate the characteristics of clinical trials of inhalation in pediatric population in China. METHODS: The pediatric clinical trials of inhaled drugs in China registered on the www.Chinadrugtrials.org.cn and Clinical Trials in USA respectively until November 20, 2021 were reviewed. The characteristics of pediatric clinical trials of inhaled drugs including the clinical trial phases, drug indications and classificatio etc. were analyzed. RESULTS: There were 21 pediatric clinical trials of inhaled drugs registered on the www.Chinadrugtrials.org.cn, accounted for 8.9%(21/235) of inhalation clinical trials in all populations. 47.6% of them were generic drugs, mainly focusing on expectorants for Phlegm symptoms and inhaled preparations for asthma, which accounting for 71.4%(15/21). There were 34 pediatric clinical trials of inhaled drugs registered on the Clinical Trials in USA, the drug indications of which were mainly asthma and anesthesia, accounting for 76.5%(26/34). CONCLUSION: The pediatric clinical trials of inhalations in China started later, and the total number is small compared to adults, mainly focusing on generic drugs. We should pay attention to the research and development of new inhalation drugs, standardizing and promoting the clinical trials of inhaled drugs in pediatric population actively.

Objective:To investigate the diagnostic value of plaque type and nature of coronary artery angiography in patients with coronary heart disease.Methods:The clinical data of 80 patients with coronary heart disease in Hangzhou Red Cross Hospital were retrospectively analyzed.According to the CT value of plaque, 20 cases were classified into calcified plaque group (CT value ≥130 HU) and soft plaque group (CT value ≤60 HU). Mixed plaque group (CT value 60-130 HU) had 40 cases.The association between coronary stenosis and plaque type, platelet function, serum biochemical and adipocytokine indicators were compared among the three groups.Results:There was a certain correlation between the proportion of different types of plaque and the degree of stenosis.There were 12 cases of mild stenosis, 3 cases of moderate stenosis and 5 cases of severe stenosis in calcified plaque group, 11 cases of mild stenosis, 14 cases of moderate stenosis and 15 cases of severe stenosis in mixed plaque group, 2 cases of mild stenosis, 7 cases of moderate stenosis and 11 cases of severe stenosis in soft tissue plaque group, the difference was statistically significant (χ 2=13.27, P<0.05). Comparison of platelet function, the calcified plaque group, mixed plaque group and soft tissue plaque group had no statistically significant difference in platelet count (PLT) ( F=1.56, P>0.05). The PDGF-BB, TEG-MA and P-selectin levels in the soft tissue plaque group were higher than those in the mixed plaque group and the calcified plaque group, the differences were statistically significant ( F=11.57, 6.47, 18.74, all P<0.05). As to the adipose cytokines, the levels of CRP, IL-6, IL-12, leptin and SFRP5 in the soft tissue plaque group were higher than those in the mixed plaque group and the calcified plaque group, the differences were statistically significant( F=7.95, 21.31, 14.58, 9.37, 13.58, all P<0.05). Conclusion:Coronary CT angiography can evaluate the severity of coronary heart disease by evaluating the type of plaque, and provide a theoretical basis for clinical treatment.It is worthy of clinical promotion.

ObjectiveTo investigate the features and changing trend of drug-induced liver injury (DILI) in the elderly from 2009 to 2019, and to provide a reference for clinical prevention and treatment of DILI in the elderly. MethodsA retrospective analysis was performed for the clinical data of 2107 elderly patients, aged ≥60 years, who were diagnosed with DILI in The Fifth Medical Center of Chinese PLA General Hospital from January 2009 to December 2019, and they were divided into groups according to age. Related clinical data were analyzed, including age, sex, clinical features, prognosis, and regional distribution. The Chi-square test was used for comparison of categorical data between groups. ResultsAmong the 2107 patients with DILI, there were 802 male patients and 1305 female patients, with a male/female ratio of 1∶1.63. Cholestasis type was the most common clinical type and was observed in 1439 patients (68.3%). There was the highest number of patients in the 60-64 years group (942 patients, 44.7%), among whom 618(65.6%) were female, 589(62.5%) had cholestasis type, 471(50.0%) had chronic DILI, 421(44.7%) had drug-induced liver cirrhosis, and 25(2.7%) had drug-induced liver failure. There were 187 patients in the 75-79 years group, among whom 110 (58.8%) patients were male, 137(73.3%) had cholestasis type, 114(60.9%) had liver cirrhosis, 4(2.1%) had drug-induced liver failure. The results showed that chronic DILI was more common in the 60-64 years group, and liver cirrhosis was more common in the 75-79 years group. As for prognosis, in the 60-64 years group, 27 patients (2.9%) were cured, 885 (93.9%) were improved, 30(32%) had no response or died; in the 65-69 years group, 16 (2.8%) were cured, 528 (92.0%) were improved, and 30(5.2%) had no response or died; in the 70-74 years group, 9(2.8%) were cured, 305(94.1%) were improved, and 10 (3.6%) had no response or died. The results showed that there was no significant difference in mortality rate between the different age groups (P＞0.05). The proportion of elderly DILI patients among hospitalized DILI patients increased from 15.90% in 2009 to 22.05% in 2013 and 27.51% in 2019, with a 1.73-fold increase in 11 years. As for regional distribution, the patients in North China accounted for the highest proportion of 47.08% (the patients from Hebei, Shanxi, and Inner Mongolia accounted for 24.92%, 10.96%, and 10.25%, respectively), followed by those in Northeast China who accounted for 17.85%. The patients in Beijing accounted for 11.53%. ConclusionThe proportion of elderly DILI patients among hospitalized DILI patients tends to increase in these years. Cholestasis type is the most common clinical type, and most of the patients with this clinical type progress to chronic DILI and drug-induced liver cirrhosis. Early diagnosis, early intervention, and standardized treatment of elderly DILI should be taken seriously.

Objective: The urine concentrations of phthalate metabolites were used to estimate the cumulative risk assessment in preschool children in Ma’anshan of Anhui province. Methods: Based on the China-Anhui Birth Cohort, the demographic information and urine samples of 3 743 children were collected in Ma’anshan from April 2014 to April 2015. The concentrations of 7 metabolites’ [monomethyl phthalate (MMP), monoethyl phthalate (MEP), monobutyl phthalate (MBP), monobenzyl phthalate (MBzP), mono (2-ethylhexyl) phthalate (MEHP), mono (2-ethyl- 5-oxohexyl) phthalate (MEOHP) and mono (2-ethyl-5-hydroxyhexyl) phthalate (MEHHP)] of 5 phthalates [dimethyl phthalate (DMP), diethyl phthalate (DEP), dibutyl phthalate (DBP), butyl benzyl phthalate (BBzP), and di (2-ethylhexyl) phthalate (DEHP)] in the urine samples of the children were measured by solid-phase extration-triple quadrupole high performance liquid chromatography-tandem mass spectrometry-isotope method. In addition, the estimated daily intakes (EDIs) of 5 phthalates were calculated according to the metabolites’ concentrations. Cumulative risk assessment was performed using hazard quotient (HQ) and hazard index (HI) methods. Results: The M (Q_R) of seven metabolite concentrations were 29.58 (18.69-48.26), 26.65 (13.44-56.09), 256.86 (150.99-438.51), 0.12 (0.04-0.32), 6.27 (3.71-11.13), 17.94 (11.94-28.42) and 24.80 (16.05-40.32) μg/g creatinine, respectively. For the EDIs of 5 phthalates, DBP ranked first, followed by DEHP, DMP, DEP and BBzP with the M (Q_R) of 7.54 (4.41-12.85), 3.35 (2.20-5.42), 0.75 (0.47-1.24), 0.71 (0.36-1.52) and 0.003 (0.001-0.009) μg/(kg·d), respectively. The HQ and HI varied with age, gender and sampling season, the differences were significant (P<0.05). Conclusions These results indicated that risk of cumulative exposure to phthalates was high in preschool children aged 3-6 years in Ma’anshan. Age, gender and sampling season were influencing factors.

ObjectiveTo investigate the level of positive aspects and current status of their general self-efficacy among the family caregivers of disabled elderly,and to explore the correlation between them. MethodsBy convenience sampling, a cross-sectional survey was conducted among 120 family caregivers of disabled elderly in Fangzhuang Community, Heping Li Community, Tiancun Community and Peking Union Medical College Hospital from April to June 2018 by Self-designed General Questionnaire,Activities of Daily Living Scale(ADL), General Self-Efficacy Scale(GSES) and Positive Aspects of Caregiver(PAC) to investigate the current status of the caregivers' self-efficacy and positive aspects and analyze the correlation between them using statistical software. ResultsThe 120 caregivers of disabled elderly got (27.98±7.82)points from GSES, which is at a moderate level; the caregivers achieved (35.60±8.16)points from PAC among which the score of"self-affirmation"dimension was (19.93±4.51) points, and "life prospects" dimension was (15.68±4.24)points;the total score of GSES and PAC as well as all dimensions of the family caregivers of disabled elderly showed a moderate level of positive correlation (r=0.524, 0.435, 0.541;P＜0.01). ConclusionsThe family caregivers of the disabled elderly had positive aspects which correlated positively with their general self-efficacy. Medical staff can take corresponding measures to improve the family caregivers' self-efficacy and positive aspect so as to improve the quality of their care and as well as the life quality of the elderly.

Objective To explore the relationship between microelement intake and metabolic syndrome (MS) in elderly males and females in Zhejiang province. Methods Non-parametric Kruskal-Wallis tests were used to compare the intake of microelements by sex among different groups according to the diagnostic criteria of MS in 780 people(404 male,376 female).Logistic regression was used to explore the association between microelements and MS and its components.Results The percentages of inadequate intake of Mn,Zn and Se were relatively high among elderly people of Zhejiang province(males:30.45%,72.52%,75.74%;females:47.34%,33.78%,80.59%,respectively).Microelement intake in males were higher than females(P<0.05).The intake of Fe and Se were higher in the abdominal obesity group than the non-abdominal obesity group among elderly males,the intakes of Fe,Zn,Se in hypertension group were lower, and Se intake was higher in hyperglycemia and hypertriglyceridemia groups. Furthermore, enough intake of Fe(odds ratio OR,0.41;95% confidence interval CI:0.19,0.87)and Se(OR,0.30;95% CI:0.14, 0.63)decreased the risk of hypertension,and high Cu(OR,2.35;95% CI:1.18,4.71)intake increased the risk of hyperglycemia.Among females,Zn intake in the MS group was lower than in the non-MS group;the intakes of Cu, Zn and Se in the hypertension group were lower; the intakes of Fe, Mn and Zn in the hyperglycemia group were lower as well;and Se intake was lower in the low HDL-C group.Again,the high intake of Zn (OR, 3.21; 95% CI: 1.36, 7.59) and Se (OR, 2.79; 95% CI: 1.24, 6.27) increased the risk of abdominal obesity, but moderate intake of Cu (OR, 0.37; 95% CI: 0.19, 0.72) had a protective effect on hypertension. Conclusions The percentages of inadequate microelement intake were relatively high in elderly people of Zhejiang province. There is a relationship between dietary microelements and MS or its components. It is necessary to guide elderly people to adopt reasonable diet by referring to the Chinese dietary reference intake and Dietay Guidelines in order to improve the situation of microelements intake and promote health.

Objective To explore the correlation between apolipoprotein E (ApoE) gene polymorphism and urine Alzheimer-associated neuronal thread protein (AD7c-NTP) level in patients with Alzheimer's disease (AD) and mild cognitive impairment (MCI).Methods The cognitive function of 30 AD patients (AD group),30 MCI patients (MCI group) and 30 normal controls (NC group) was evaluated by neuropsychological batteries like MMSE,the Cambridge Cognitive Examination-Chinese Version (CAMCOG-C),etc.ELISA was used to test the urine level of AD7c-NTP.The genotypes of ApoE were analyzed by the high-resolution melting assay in blood samples.Results Compared with the NC group (0.59 (0.40,0.66) ng/ml),the urine level of AD7c-NTP in the AD group (1.03(0.80,1.41) ng/ml) and the MCI group (0.69(0.53,0.91) ng/ml) was increased (Z =33.727,P ＜0.01).The urine level of AD7c-NTP in the AD group was higher than that in the MCI group (Z =8.232,P ＜ 0.05).The level of AD7c-NTP in urine was negatively correlated with MMSE and CAMCOG-C scores (rMMSE =-0.604,P ＜ 0.01;rCAMCOG-C =-0.486,P ＜ 0.01).According to receiver operating characteristic curve,the optimal cutoff point of AD7c-NTP in urine for diagnosis of patients including AD and MCI was 0.70 ng/ml,with sensitivity of 71.7％ and specificity of 83.3％,and area under the curve of 0.82 (95％ CI 0.73-0.90,P ＜0.05).There were four genotypes comprising ε2/3,ε3/3,ε3/4 and ε4/4 for ApoE gene.The frequencies of ε4 carriers were 46.7％ (14/30),23.3％ (7/30) and 23.3％ (7/30) in the AD,MCI and NC groups,respectively.There was a notable increase in urine AD7c-NTP and a significant decrease in CAMCOG-C scores in MCI patients who harbored the ApoE ε4 allele (ZAD7c-NTP =4.857,P ＜ 0.05;ZCAMCOG-C =4.284,P ＜0.05).Conclusions The urine level of AD7c-NTP was significantly increased in AD and MCI patients,the higher the level of AD7c-NTP,the more serious the cognitive impairment.The ε4 carriers exhibited higher urine level of AD7c-NTP,but worse cognitive function compared to ε4 non-carriers in the MCI group.