OBJECTIVE To standardize the strategies for prevention and control of Chikungunya(CHIK)in healthcare in-stitutions so as to reduce the risk of transmission in the institutions.METHODS A working group comprising the ex-perts in hospital infection control,infectious diseases,and microbiology systematically reviewed domestic and international evidence and current guidelines,integrated China's vector ecology and healthcare realities,conducted two rounds of Delphi to achieve expert consensus,and graded the evidence and recommendation strength using the Oxford Centre for Evidence Based Medicine system.RESULTS The consensus issues 18 actionable recommendations on triage,patient mosquito-proof isolation,integrated vector control,protection of susceptible populations,environmental cleaning and disinfection,specimen management,medical textile handling,and outbreak emergency response,with each statement assigned an evi-dence level and recommendation strength.CONCLUSION This consensus is for the first time in China to provide evidence-graded strategies for control of CHIK in healthcare institutions,offering work flow-oriented,implementable guidance for clinicians,laboratorians,and infection-control personnel under different risk scenarios and enhancing the comprehensive coping capacity of the healthcare institutions.

OBJECTIVE To standardize the strategies for prevention and control of Chikungunya(CHIK)in healthcare in-stitutions so as to reduce the risk of transmission in the institutions.METHODS A working group comprising the ex-perts in hospital infection control,infectious diseases,and microbiology systematically reviewed domestic and international evidence and current guidelines,integrated China's vector ecology and healthcare realities,conducted two rounds of Delphi to achieve expert consensus,and graded the evidence and recommendation strength using the Oxford Centre for Evidence Based Medicine system.RESULTS The consensus issues 18 actionable recommendations on triage,patient mosquito-proof isolation,integrated vector control,protection of susceptible populations,environmental cleaning and disinfection,specimen management,medical textile handling,and outbreak emergency response,with each statement assigned an evi-dence level and recommendation strength.CONCLUSION This consensus is for the first time in China to provide evidence-graded strategies for control of CHIK in healthcare institutions,offering work flow-oriented,implementable guidance for clinicians,laboratorians,and infection-control personnel under different risk scenarios and enhancing the comprehensive coping capacity of the healthcare institutions.

Immunotherapy has become the first-line standard treatment option for driver gene-negative advanced non-small cell lung cancer (NSCLC). But not all patients can benefit from immunotherapy, and can even have serious adverse reactions. It is crucial to identify the predictors of clinical response to immunotherapy. Several studies have shown that elevated baseline C-reactive protein (CRP) or persistent elevation of CRP during the treatment process may indicate a poorer prognosis for patients, and high CRP may be correlated with adverse reactions. Attention to the dynamic changes of CRP during immunotherapy for NSCLC may become an important predictor of prognosis.

Objective: To investigate the relationship between fine motor skills and executive function in school aged boys with attention deficit hyperactivity disorder (ADHD) aged 6-10 years, so as to provide a reference for promoting executive function. Methods: From November 2022 to May 2021,65 boys with ADHD were recruited from a tertiary hospital in Beijing and a public elementary school in Beijing, and 65 boys with typical development according to age and sex were recruited as controls. Children s fine motor skills were assessed using the movement assessment battery for children, second version (MABC-2), and children s inhibitory control, working memory, and cognitive flexibility were assessed using the Stroop color word test (SCWT), Rey osterrich complex figure test (ROCFT) and trail making test (TMT), respectively. Independent samples t-tests were used to analyze the differences between the two groups, and Pearson correlation analysis and stratified regression analysis were used to explore the relationship between fine motor skills and executive functioning in boys with ADHD. Results: In the fine motor skills test, boys with ADHD scored significantly lower (8.68±3.62) than control boys (11.22±2.27)( t =4.80, P <0.05); in the executive function test, the results of SCWT, ROCFT, and TMT tests were significantly worse in boys with ADHD than in normal boys ( t =-4.53-4.42, P < 0.05). Correlation analysis showed that the fine motor skill scores of boys with ADHD were negatively correlated with the number of word sense errors ( r =-0.35) and color errors ( r =-0.42), and positively correlated with memory scores for delayed structure ( r =0.30) and detail ( r =0.25), which were negatively correlated with TMT-A ( r =-0.34),TMT-B reaction time ( r =-0.26), number of errors ( r =-0.43) ( P <0.05). Stratified regression analysis showed that fine motor skill scores of boys with ADHD were predictive of test results for inhibitory control, working memory and cognitive flexibility, with explanatory rates of 15%, 7%, and 19%, respectively. Conclusion Fine motor skills in boys with ADHD are correlated with executive functions, and fine motor skills could predict inhibitory control, working memory and cognitive flexibility to some extent. The development of fine motor skills in boy with ADHD could promote their executive functions.

BACKGROUNDAttention deficit hyperactivity disorder (ADHD) is one of the most commonly diagnosed psychiatric disorder in childhood. ADHD children with overlapping symptoms and signs of motor problems have more serious prognosis than that of children with ADHD only. However, the motor and sensory processing problems in children with ADHD have not been studied well. Few people adopt the technique of computerized dynamic posturography (CDP) in the study of ADHD, which is applied widely in clinical and laboratory research to objectively evaluate human's balance performance. This study aimed to assess the characteristics of postural control and sensory information processing of boys with two subtypes of ADHD by using CDP, so as to provide the proof for non-drug therapy of ADHD.

METHODFrom June 2003 to September 2004, a total of 73 boys (7-15 years of age) with ADHD and 73 normal developing boys matched by age and intelligence quotient from Peking University Institute of Mental Health were recruited in the study. The Sensory Organization Test was adopted to test the static balance performance under six sensory input conditions by SMART EquiTest 8.0 (NeuroCom) instrument. The sensory information from three sensory systems were available under condition 1, the visual inputs were removed or distorted under condition 2 or 3, the somatosensory inputs were in conflict with or without the visual inputs removed under condition 4 or 5, and both the visual and somatosensory inputs were in conflict under condition 6. The indexes of equilibrium score, somatosensory, vestibular, and visual ratios, and strategy scores were analyzed to indicate the subjects' postural control ability.

RESULTSADHD boys had significantly lower composite equilibrium score (CES) than the normal group (P < 0.05). Under condition 1 and conditions 3-6, the equilibrium scores (ES) of the ADHD group were significantly lower (all P < 0.05) than those of the control. Significantly lower visual and vestibular ratios and strategy scores under conditions 4-6 were found in boys with ADHD compared with the control group (P < 0.05). Boys of ADHD-predominantly inattentive (ADHD-I) type had a significantly lower CES and ES under conditions 4-6 than the controls (all P < 0.05) while the ESs of ADHD-combined type (ADHD-C) boys under each condition were similar with that of boys with ADHD-I and no significant difference was found between boys with ADHD-C and the control group (all P > 0.05). Compared with the control group, the ADHD-I boys showed significantly lower visual and vestibular ratios and strategy scores under conditions 4-6 whereas the ADHD-C boys showed a trend of lower visual ratio (all P < 0.05).

CONCLUSIONSADHD boys had a poorer static postural control ability and impaired function of processing visual and vestibular information compared with the normal control. Boys with ADHD-I showed particularly severe defect of static postural control and vestibular function integrating conflict information than normal boys. These deficits may be an important contributor to the clinical presentation of ADHD children and their cognitive deficits. Assessment and training of postural control function would be suggested during the diagnosis and treatment of ADHD children.

Background Attention deficit hyperactivity disorder (ADHD) is one of the most commonly diagnosed psychiatric disorder in childhood.ADHD children with overlapping symptoms and signs of motor problems have more serious prognosis than that of children with ADHD only.However,the motor and sensory processing problems in children with ADHD have not been studied well.Few people adopt the technique of computerized dynamic posturography (CDP) in the study of ADHD,which is applied widely in clinical and laboratory research to objectively evaluate human's balance performance.This study aimed to assess the characteristics of postural control and sensory information processing of boys with two subtypes of ADHD by using CDP,so as to provide the proof for non-drug therapy of ADHD.Method From June 2003 to September 2004,a total of 73 boys (7-15 years of age) with ADHD and 73 normal developing boys matched by age and intelligence quotient from Peking University Institute of Mental Health were recruited in the study.The Sensory Organization Test was adopted to test the static balance performance under six sensory input conditions by SMART EquiTest 8.0 (NeuroCom) instrument.The sensory information from three sensory systems were available under condition 1,the visual inputs were removed or distorted under condition 2 or 3,the somatosensory inputs were in conflict with or without the visual inputs removed under condition 4 or 5,and both the visual and somatosensory inputs were in conflict under condition 6.The indexes of equilibrium score,somatosensory,vestibular,and visual ratios,and strategy scores were analyzed to indicate the subjects' postural control ability.Results ADHD boys had significantly lower composite equilibrium score (CES) than the normal group (P ＜0.05).Under condition 1 and conditions 3-6,the equilibrium scores (ES) of the ADHD group were significantly lower (all P ＜0.05) than those of the control.Significantly lower visual and vestibular ratios and strategy scores under conditions 4-6 were found in boys with ADHD compared with the control group (P ＜0.05).Boys of ADHD-predominantly inattentive (ADHD-I) type had a significantly lower CES and ES under conditions 4-6 than the controls (all P ＜0.05) while the ESs of ADHD-combined type (ADHD-C) boys under each condition were similar with that of boys with ADHD-I and no significant difference was found between boys with ADHD-C and the control group (all P ＞0.05).Compared with the control group,the ADHD-I boys showed significantly lower visual and vestibular ratios and strategy scores under conditions 4-6 whereas the ADHD-C boys showed a trend of lower visual ratio (all P ＜0.05).Conclusions ADHD boys had a poorer static postural control ability and impaired function of processing visual and vestibular information compared with the normal control.Boys with ADHD-I showed particularly severe defect of static postural control and vestibular function integrating conflict information than normal boys.These deficits may be an important contributor to the clinical presentation of ADHD children and their cognitive deficits.Assessment and training of postural control function would be suggested during the diagnosis and treatment of ADHD children.

In order to investigate the fine distinction of the tomographic images and the dominant anatomic distributions, we carefully reviewed and analyzed the features and predominant anatomic distribution of forty-nine pneumoconiosis patients with confirmed diagnosis on multi-detector row CT (MDCT). It was found that the round and small opacity p and irregular small opacity were mostly shown in the MDCT features of pneumoconiosis, while the large opacity and progressive massive fibrosis (PMF) were less frequently depicted in the MDCT. Distributions of round and small opacity and irregular small opacity in the six lung lobes were significantly different (P < 0.01). The most common p opacity was significantly seen in the upper and lower left lungs as well as in the upper right lung's opacity was in the upper left lung as well as lower left and right lungs. The large opacity commonly distributed in upper left and right lungs, while the PMF was often shown in both of two lungs. The results demonstrated that the MDCT could be an effective modality for detecting tiny lesions and anatomic distribution of pneumoconiosis, and it would be helpful for early diagnosis and accurate staging of the pneumoconiosis disease.
Adult ; Aged ; Early Diagnosis ; Female ; Humans ; Lung ; diagnostic imaging ; pathology ; Male ; Middle Aged ; Multidetector Computed Tomography ; methods ; Pneumoconiosis ; diagnostic imaging ; pathology ; Silicosis ; diagnostic imaging ; pathology

Long-term exposure of the human body to powder-dust environment commonly results in pneumoconiosis, such as silicosis, coal worker's pneumoconiosis and asbestosis. The pathological features of pneumoconiosis include lung's nodules and fibrosis. Plain film and computed tomography (CT) are the main imaging modalities for detecting pneumoconiosis, especially the high-resolution CT (HRCT), multi-detector row CT (MDCT) and related post-processing techniques are helpful in detecting the tiny pathological manifestations of pneumoconiosis so as to make early diagnosis. Furthermore, the functional MDCT could comprehensively assess the pulmonary physiological functions of the patient with pneumoconiosis.
Humans ; Pneumoconiosis ; diagnostic imaging ; pathology ; physiopathology ; Tomography, X-Ray Computed ; methods

The objective of this study was to elucidata the correlation of 16-detector row CT features with the complications and anatomic-pathology of the disease in patients with idiopathic pulmonary fibrosis (IPF). The 16-detector row CT appearances and predominant anatomic distribution were analyzed in 38 cases of IPF. Of the 14 patients (36.8%) with honeycomb lung, 10 (71.4%) had honeycomb appearances predominantly distributed in the peripheral zone of the middle and lower lobes, particularly in the basal segments of the lower lobes. 11 patients (78.6%) had the clinical duration of honeycomb lung for more than 3 years. The interlobular interstitial thickening was seen in 16 cases (42.1%), the interlobular septa thickening in 20 cases (52.6%); and the thickened bronchus-vascular bundle in 9 cases (23.7%). The above-mentioned three kinds of CT features observably distributed in the peripheral zone of the middle and lower lobes, in the basal segments of the lower lobes, and in the lower lobes and middle lobe of right lung in the middle of the zone, respectively. In 15 patients (39.5%), ground-glass opacity was predominantly distributed in the peripheral zone of lung and in the basal segments of the lower lobes; and the clinical duration lasted less than 1 year was seen in 10 cases (66.7%). These results indicated that some characteristic manifestations with pathologic variation and predominant anatomic distribution of IDF can be shown on 16-detector row CT.
Adult ; Aged ; Female ; Humans ; Idiopathic Pulmonary Fibrosis ; diagnostic imaging ; pathology ; Male ; Middle Aged ; Tomography, Spiral Computed ; methods

Objective:To observe the clinical efficacy of combined acupuncture and scraping therapy for simple obesity and its effects on phlegm-dampness constitution.Methods:Seventy subjects with phlegm-dampness constitution were divided into treatment group and control group with a randomized digital table.Control group was given health education and dietary instructions,and treatment group was given acupuncture and scraping therapy besides health education and dietary instructions.After four-week treatments,the scores of obesity and phlegm-dampness constitution were recorded to assess the clinical efficacy.Results:There was a striking difierence in the total effective rate in treating obesity between the two groups (P＜0.01);combined acupuncture and scraping therapy can relieve the phlegm-dampness symptoms(P＜0.01);but the phlegm-dampness symptoms were not improved in the control group(P＞0.05).Conclusion:Combined acupuncture and scraping therapy is quite effective for simple obesity and in improving phlegm-dampness constitution of simple obesity people.