Objective:To explore the clinical characteristics and serogroup distribution of meningococcal meningitis.Methods:This study was a case series summary of the demographic data, laboratory results, vaccination history, clinical diagnoses,treatment and prognosis of 16 children with meningococcal meningitis who were hospitalized in Department of Infectious Diseases, Hunan Children′s Hospital from April 2014 to March 2024. According to ages, these patients were divided into infants and toddlers (≤3 years) and school-aged children (6-15 years) groups. Between-group comparison was performed using Independent samples t-test and Mann-Whitney U test. Results:A total of 16 hospitalized patients were included, of whom 8 were male and 8 female. The age of these patients at visit was 4.25 (0.33, 12.30) years. The cases presented a sporadic distribution. There were 11 cases from rural regions, 6 patients were unvaccinated due to age restriction.All patients presented with acute onset, with neurological symptoms manifesting within 0.6 (0.5, 1.0) days, and the duration of hospitalization was 20 (12, 28) days. There were 10 typical cases and 6 fulminant cases, with fever duration ≤7 days in 7 cases. Clinical manifestations included petechiae and purpura in 8 cases, shock in 3 cases, respiratory failure in 3 cases, and disseminated intravascular coagulation in 4 cases. There were 8 cases in both the infant and toddlers group and the school-aged childrengroup, 5 cases in the infant and toddler group manifested seizures. In contrast, in the school-aged children group, 6 individuals exhibited headache, nausea, and vomiting, while 4 cases demonstrated signs of altered consciousness. The C-reactive protein level in the 16 patients was 124.5 (71.3, 212.3) mg/L, and the procalcitonin level was 26.8 (11.0, 92.8) μg/L, the normal values are 0-8.0 mg/L for C-reactive protein and 0-0.5 μg/L for procalcitonin. Compared to the school-aged children group, the infants and toddlers group showed lower white blood cell counts ((7±4)×10 9vs. (17±10)×10 9/L, t=-2.36, P=0.034). All patients tested positive for pathogens, serogroup identification revealed a diverse distribution, including 1 case each of serogroups C, W135, and X; 4 cases of serogroup B; 3 cases of serogroup Y; and 6 cases that remained ungrouped. A total of 10 strains of Neisseria meningitidis were cultured, 7 strains were resistant to sulfonamides, 5 strains to penicillin, and 3 strains to levofloxacin and ciprofloxacin. A total of 9 patients treated with meropenem, and all cases showed improvement and were discharged without any fatalities. At discharge, 1 case had profound sensorineural hearing loss, and 5 patients required rehabilitation treatment due to sequelae. Conclusions:Meningococcal meningitis predominantly affected children aged ≤3 years and 6-15 years. The white blood cell count in meningococcal meningitis patients aged ≤3 years was lower. The serogroups of Neisseria meningitidis were highly diverse, with cases of serogroups X and Y identified. Since isolated Neisseria meningitidis has shown resistance to penicillin and other antibiotics, it is crucial to be vigilant about potential antimicrobial susceptibility when clinical efficacy is poor.

Objective:To investigate the efficacy of modified fire dragon moxibustion in patients with phlegm-dampness obesity and prediabetes.Methods:From April 2024 to March 2025, 62 patients with phlegm-dampness obesity and prediabetes who visited the Department of Endocrinology of Ningbo Hospital of Traditional Chinese Medicine were selected as study subjects using convenience sampling. The study subjects were divided into an intervention group and a control group using a random number table method, with 31 cases in each group. Control group received conventional medication, dietary and exercise management, while intervention group received modified fire dragon moxibustion in addition to conventional medication, dietary and exercise management. Both groups underwent the intervention for 60 days. Fasting blood glucose (FBG) , glycated hemoglobin (HbA1c) , triglycerides (TG) , body mass index, fasting insulin (FINS) , and homeostatic model assessment of insulin resistance (HOMA-IR) were compared between the two groups before and after intervention.Results:After intervention, the body mass index, FBG, HbA1c, FINS, and HOMA-IR of intervention group were lower than those of control group, and the differences were statistically significant ( P<0.05) . Conclusions:The modified fire dragon moxibustion can reduce the body mass index, improve glucose metabolism indicators, and FINS and HOMA-IR levels in patients with phlegm-dampness obesity and prediabetes.

Objective To compare the benefits and drawbacks of primary patch expansion versus pericardial tube right ventricular-pulmonary artery connection in patients diagnosed with pulmonary atresia with ventricular septal defect (PA/VSD). Methods A retrospective study was conducted on patients diagnosed with PA/VSD who underwent primary right ventricular-pulmonary artery connection surgery at our center between 2010 and 2020. Patients were categorized into two groups based on the type of right ventricular-pulmonary artery connection: a pericardial tube group and a patch expansion group. Clinical data and imaging findings were compared between the two groups. Results A total of 51 patients were included in the study, comprising 31 males and 20 females, with a median age of 12.57 (4.57, 49.67) months. The pericardial tube group included 19 patients with a median age of 17.17 (7.33, 49.67) months, while the patch expansion group consisted of 32 patients with a median age of 8.58 (3.57, 52.72) months. In both groups, the diameter of pulmonary artery, McGoon index, and Nakata index significantly increased after treatment (P<0.001). However, the pericardial tube group exhibited a longer extracorporeal circulation time (P<0.001). The reoperation rate was notably high, with 74.51% of patients requiring further surgical intervention, including 26 (81.25%) patients in the patch expansion group and 12 (63.16%) patients in the pericardial tube group. No statistical differences were observed in long-term cure rates or mortality between the two groups (P＞0.005). Conclusion In patients with PA/VSD, both patch expansion and pericardial tube right ventricular-pulmonary artery connection serve as effective initial palliative treatment strategies that promote pulmonary vessel development and provide a favorable foundation for subsequent radical operations. However, compared to the pericardial tube approach, the patch expansion technique is simpler to perform and preserves some intrinsic potential for pulmonary artery development, making it the preferred procedure.

BACKGROUND: Without timely and effective rehabilitation, hearing loss may profoundly affect human life quality. China has a large population of hearing-impaired individuals, which imposes a heavy health burden on society. Moreover, this population is projected to increase rapidly owing to China's aging society. METHODS: We used data from a population-representative epidemiological investigation of hearing loss and ear diseases in four Chinese provinces. We estimated the national prevalence using multiple linear regression of the age-group proportions and prevalence in 31 provinces with clustering analysis. We used years lived with disability (YLDs) to analyze the disease burden and forecasted the prevalence of hearing loss by 2060 in China. RESULTS: An estimated 115 million people had moderate-to-complete hearing loss in 2015 across the 31 provinces of China (8.4% of 1.37 billion people). Of these, 85.7% were older than age 50 years (99 million people) and 2.4% were younger than 20 years old (2.8 million people). Of all YLDs attributable to hearing loss, 68.9% were attributable to moderate-to-complete cases. By 2060, a projected 242 million people in China will have moderate-to-complete hearing loss, a 110.0% increase from 2015. CONCLUSIONS The hearing loss prevalence in China is high. Population aging and socioeconomic factors substantially affect the prevalence and severity of hearing loss and the disease burden. The prevalence and severity of hearing loss are unevenly distributed across different provinces. Future public health policies should take these trends and regional variations into account.
Humans ; China/epidemiology* ; Hearing Loss/epidemiology* ; Prevalence ; Middle Aged ; Male ; Female ; Adult ; Aged ; Adolescent ; Young Adult ; Child ; Child, Preschool ; Infant ; Aged, 80 and over ; Cost of Illness

Objective:To explore the clinical characteristics and serogroup distribution of meningococcal meningitis.Methods:This study was a case series summary of the demographic data, laboratory results, vaccination history, clinical diagnoses,treatment and prognosis of 16 children with meningococcal meningitis who were hospitalized in Department of Infectious Diseases, Hunan Children′s Hospital from April 2014 to March 2024. According to ages, these patients were divided into infants and toddlers (≤3 years) and school-aged children (6-15 years) groups. Between-group comparison was performed using Independent samples t-test and Mann-Whitney U test. Results:A total of 16 hospitalized patients were included, of whom 8 were male and 8 female. The age of these patients at visit was 4.25 (0.33, 12.30) years. The cases presented a sporadic distribution. There were 11 cases from rural regions, 6 patients were unvaccinated due to age restriction.All patients presented with acute onset, with neurological symptoms manifesting within 0.6 (0.5, 1.0) days, and the duration of hospitalization was 20 (12, 28) days. There were 10 typical cases and 6 fulminant cases, with fever duration ≤7 days in 7 cases. Clinical manifestations included petechiae and purpura in 8 cases, shock in 3 cases, respiratory failure in 3 cases, and disseminated intravascular coagulation in 4 cases. There were 8 cases in both the infant and toddlers group and the school-aged childrengroup, 5 cases in the infant and toddler group manifested seizures. In contrast, in the school-aged children group, 6 individuals exhibited headache, nausea, and vomiting, while 4 cases demonstrated signs of altered consciousness. The C-reactive protein level in the 16 patients was 124.5 (71.3, 212.3) mg/L, and the procalcitonin level was 26.8 (11.0, 92.8) μg/L, the normal values are 0-8.0 mg/L for C-reactive protein and 0-0.5 μg/L for procalcitonin. Compared to the school-aged children group, the infants and toddlers group showed lower white blood cell counts ((7±4)×10 9vs. (17±10)×10 9/L, t=-2.36, P=0.034). All patients tested positive for pathogens, serogroup identification revealed a diverse distribution, including 1 case each of serogroups C, W135, and X; 4 cases of serogroup B; 3 cases of serogroup Y; and 6 cases that remained ungrouped. A total of 10 strains of Neisseria meningitidis were cultured, 7 strains were resistant to sulfonamides, 5 strains to penicillin, and 3 strains to levofloxacin and ciprofloxacin. A total of 9 patients treated with meropenem, and all cases showed improvement and were discharged without any fatalities. At discharge, 1 case had profound sensorineural hearing loss, and 5 patients required rehabilitation treatment due to sequelae. Conclusions:Meningococcal meningitis predominantly affected children aged ≤3 years and 6-15 years. The white blood cell count in meningococcal meningitis patients aged ≤3 years was lower. The serogroups of Neisseria meningitidis were highly diverse, with cases of serogroups X and Y identified. Since isolated Neisseria meningitidis has shown resistance to penicillin and other antibiotics, it is crucial to be vigilant about potential antimicrobial susceptibility when clinical efficacy is poor.

Objective To investigate the epidemiological trends,temporal and spatial distribution characteristics of pulmonary tuberculosis in Lanping County.Methods Based on tuberculosis management data and basic information systems from the"China Disease Prevention and Control Information System,"pulmonary tuberculosis data from Lanping County for 2018-2023 were obtained.Descriptive epidemiology,concentration method,circular distribution method,and spatial autocorrelation analysis were used to conduct epidemiological and spatial analyses of the pulmonary tuberculosis data.Results A total of 2836 TB cases were reported in Lanping County from 2018 to 2023,with an average annual incidence rate of 233.26 per 100000,showing a declining trend.The male-to-female ratio was 1.95∶1,with the highest incidence among individuals aged 60 and above(932 cases,32.86%).Cases were predominantly among farmers(91.01%)and the Lisu ethnic group(52.68%).TB incidence showed weak seasonality with a bimodal distribution,with primary peak occurring from October to March and secondary peak from June to August.Tu'e Township(324.74 per 100,000),Shideng Township(307.42 per 100000),and Jinding Town(260.98 per 100,000)had the highest incidence rates,accounting for 1,284 cases or 45.28%of the county's total cases.In 2020,the incidence of pulmonary tuberculosis in Lanping County showed a spatial clustering distribution(global Morans's I value<0,P value<0.05),with Shideng Township consistently showing high-low aggregation characteristics.Conclusion Between 2018-2023,while the tuberculosis incidence rate in Lanping County has declined,it still falls short of Yunnan Province's tuberculosis prevention and control targets,and the prevention and control work continues to face significant challenges.Strengthening screening of high-risk populations and providing medical support to remote areas will be key measures for future prevention and treatment.

OBJECTIVE To evaluate the economic burden of the intensive care unit(ICU)patients due to hospital-associated multidrug-resistant organisms(MDROs)infections based on propensity score matching(PSM)so as to provide evidence-based bases for prevention and control of hospital-associated MDROs infection and improvement of utilization efficiency of medical resources.METHODS A total of 2118 patients who were hospitalized in Zibo Central Hospital from Jan.1,2023 to Dec.31,2024 and conformed to the inclusion and exclusion criteria were re-cruited as the research subjects.The patients with hospital-associated MDROs infections were matched in a 1∶1 ratio by PSM(with the clamp value 0.02).Totally 309 pairs were successfully matched.The length of hospital stay and the costs were observed and compared between the MDROs group and the non-MDROs group.RESULTS The MDROs group was with the length of hospital stay 14.00 days longer than the non-MDROs group after the matching(Z=-5.750,P＜0.001),with the total cost of hospitalization increased by 91,420.84 yuan(Z=-8.271,P＜0.001).With the respect to the medical treatment expenses,the expenses of the MDROs group were higher than those of the non-MDROs group,covering the cost of medical service,therapeutic procedures,nursing,western medicine and TCM,and there were significant differences(P＜0.05).Among the differences in the costs between the two groups,the difference in the cost of western medicine was the most signif-icant(22,182.91 yuan),followed by the cost of clinical laboratory test for diagnosis(19,529.60 yuan)and the cost of therapeutic procedures(16,333.50 yuan).CONCLUSIONS The hospital-associated MDROs infections may lead to the extension of hospital stay length of the ICU patients,which then increases the economic burden.There-fore,it is necessary to strengthen the multidisciplinary collaboration and formulate corresponding measures so as to reduce the risk of such infections among the ICU patients.

Objective:To investigate the efficacy of modified fire dragon moxibustion in patients with phlegm-dampness obesity and prediabetes.Methods:From April 2024 to March 2025, 62 patients with phlegm-dampness obesity and prediabetes who visited the Department of Endocrinology of Ningbo Hospital of Traditional Chinese Medicine were selected as study subjects using convenience sampling. The study subjects were divided into an intervention group and a control group using a random number table method, with 31 cases in each group. Control group received conventional medication, dietary and exercise management, while intervention group received modified fire dragon moxibustion in addition to conventional medication, dietary and exercise management. Both groups underwent the intervention for 60 days. Fasting blood glucose (FBG) , glycated hemoglobin (HbA1c) , triglycerides (TG) , body mass index, fasting insulin (FINS) , and homeostatic model assessment of insulin resistance (HOMA-IR) were compared between the two groups before and after intervention.Results:After intervention, the body mass index, FBG, HbA1c, FINS, and HOMA-IR of intervention group were lower than those of control group, and the differences were statistically significant ( P<0.05) . Conclusions:The modified fire dragon moxibustion can reduce the body mass index, improve glucose metabolism indicators, and FINS and HOMA-IR levels in patients with phlegm-dampness obesity and prediabetes.

OBJECTIVE To evaluate the economic burden of the intensive care unit(ICU)patients due to hospital-associated multidrug-resistant organisms(MDROs)infections based on propensity score matching(PSM)so as to provide evidence-based bases for prevention and control of hospital-associated MDROs infection and improvement of utilization efficiency of medical resources.METHODS A total of 2118 patients who were hospitalized in Zibo Central Hospital from Jan.1,2023 to Dec.31,2024 and conformed to the inclusion and exclusion criteria were re-cruited as the research subjects.The patients with hospital-associated MDROs infections were matched in a 1∶1 ratio by PSM(with the clamp value 0.02).Totally 309 pairs were successfully matched.The length of hospital stay and the costs were observed and compared between the MDROs group and the non-MDROs group.RESULTS The MDROs group was with the length of hospital stay 14.00 days longer than the non-MDROs group after the matching(Z=-5.750,P＜0.001),with the total cost of hospitalization increased by 91,420.84 yuan(Z=-8.271,P＜0.001).With the respect to the medical treatment expenses,the expenses of the MDROs group were higher than those of the non-MDROs group,covering the cost of medical service,therapeutic procedures,nursing,western medicine and TCM,and there were significant differences(P＜0.05).Among the differences in the costs between the two groups,the difference in the cost of western medicine was the most signif-icant(22,182.91 yuan),followed by the cost of clinical laboratory test for diagnosis(19,529.60 yuan)and the cost of therapeutic procedures(16,333.50 yuan).CONCLUSIONS The hospital-associated MDROs infections may lead to the extension of hospital stay length of the ICU patients,which then increases the economic burden.There-fore,it is necessary to strengthen the multidisciplinary collaboration and formulate corresponding measures so as to reduce the risk of such infections among the ICU patients.

OBJECTIVE To investigate the mechanism of catalpol affecting the differentiation of helper T cell 17 （Th17） by interfering the expressions of pyruvate kinase M2 （PKM2） and lactate dehydrogenase A （LDHA）. METHODS The naive CD4+ T cells were selected from the spleen of C57BL/6 mice， and were differentiated into Th17 cells by adding directional differentiation stimulants for 72 hours. At the same time， the cells were treated with 0 （directed control）， 20， 40 and 80 μg/mL catalpol. The flow cytometry was used to detect the proportion of Th17 cell differentiation in cells； the colorimetric method was adopted to detect the levels of pyruvate and lactate in cell culture supernatant； mRNA expressions of retinoid-related orphan nuclear receptor gamma t （RORγt）， PKM2 and LDHA were detected by qRT-PCR method； Western blot was used to detect the expression levels of PKM2， LDHA， signal transducer and activator of transcription 3 （STAT3）， and phosphorylated STAT3 （p-STAT3） proteins in cells. RESULTS Compared with the directed control group， after 72 hours of treatment with 20， 40， 80 μg/mL catalpol， the differentiation ratio of Th17 cells were decreased by 6.74%， 8.41%， 9.24%， and the levels of pyruvate and lactate in the cell culture supernatant， the mRNA expressions of PKM2， LDHA and RORγt as well as the protein expressions of PKM2 and LDHA and the phosphorylation of STAT3 were significantly reduced （P＜0.05）. CONCLUSIONS Catalpol can reduce the glycolysis level by down-regulating the expressions of PKM2 and LDHA， thereby inhibiting the differentiation of Th17 cells.