Objective:To investigate the correlation between serum indexes of children with simple obesity in Xinjiang area and the renin-angiotensin-aldosterone (RAS)system, thus providing evidence to clarify the pathogenesis of childhood obesity.Methods:It was a cross-sectional study involving 41 children with simple obesity (case group) and 41 age-matched healthy children (control group) through the cluster random sampling in Tacheng area of Xinjiang.The mean age of in both groups was (10.04±1.66) years and (10.12±1.68) years, respectively.Serum adipokines, insulin level and RAS indexes between groups were compared by the Student′s t test.The correlation between serum adipokines and RAS activity in children with simple obesity was assessed by the Pearson′ s correlation test. Results:The serum adiponectin(APN) level[(7.90±1.96) μg/L vs.(8.87±1.61) μg/L, P=0.017]was significantly lower in case group than that of control group, while leptin[(6.81±1.88) ng/L vs.(5.87±1.79) ng/L, P=0.023]and resistin levels[(12.61±3.63) ng/L vs.(10.18±3.07) ng/L, P=0.002] were significantly higher.RAS indexes, including the renin[(35.78±10.08) ng/L vs.(29.24±10.69) ng/L, P=0.007], aldosterone (ALD)[(106.90±20.18) ng/L vs.(97.68±17.60) ng/L, P=0.028] and angiotensin-Ⅱ (Ang-Ⅱ)[(55.65±10.37) ng/L vs.(48.78±9.26) ng/L, P=0.002] levels were significantly higher in case group than those of control group.In the case group, serum APN level was negatively correlated with renin, ALD and Ang-Ⅱ levels ( r=-0.646, -0.752, -0.839, all P<0.001), while serum leptin and resistin levels were positively correlated with renin, ALD and Ang-Ⅱ levels ( r=0.940, 0.871, 0.875; 0.877, 0.892, 0.914, all P<0.001). Conclusions:Serum adipokine in school-age children with simple obesity in Xinjiang area is dysregulated, which interferes with the activity of RAS.

Group A Streptococcus (GAS) is a very important pathogen, especially for children.On a global scale, GAS is an important cause of morbidity and mortality.But the burden of disease caused by GAS is still unknown in China and also has not obtained enough attention.For this purpose, the expert consensus is comprehensively described in diagnosis, treatment and prevention of GAS diseases in children, covering related aspects of pneumology, infectiology, immunology, microbiology, cardiology, nephrology, critical care medicine and preventive medicine.Accordingly, the consensus document was intended to improve management strategies of GAS disease in Chinese children.

Objective:To investigate the knowledge, attitudes, and practices (KAP) of pulse oximetry among pediatric healthcare providers in China and analyze the factor influencing the KAP.Methods:A self-developed questionnaire was used for an online research on the KAP of 11 849 pediatric healthcare providers from 31 provinces, autonomous regions, and municipalities of China from March 11 to 14, 2022.The factors influencing the KAP of pulse oximetry among pediatric healthcare providers were examined by Logistic regression. Results:The scores of KAP, of pulse oximetry were 5.57±0.96, 11.24±1.25 and 11.19±4.54, respectively.The corresponding scoring rates were 69.61%, 74.95%, and 55.99%, respectively. Logistic regression results showed that the gender and working years of pediatric healthcare providers, the region they were located, and whether their medical institution was equipped with pulse oximeters were the main factors affecting the knowledge score (all P<0.05). Main factors influencing the attitude score of pediatric healthcare providers included their knowledge score, gender, educational background, working years, region, medical institution level, and whether the medical institution was equipped with pulse oximeters (all P<0.05). For the practice score, the main influencing factors were the knowledge score, gender, age, and whether the medi-cal institution was equipped with pulse oximeters (all P<0.05). Conclusions:Chinese pediatric healthcare providers need to further improve their knowledge about and attitudes towards pulse oximetry.Pulse oximeters are evidently under-used.It is urgent to formulate policies or guidelines, strengthen education and training, improve knowledge and attitudes, equip more institutions with pulse oximeters, and popularize their application in medical institutions.

Objective:To investigate the effects of Streptococcuspneumoniae (Spn) colonization and the change of upper airway microbiome on the clinical manifestations in children with respiratory syncytial virus (RSV) infection. Methods:A retrospective cohort included 508 RSV-infected children with pneumonia and hospitalized in Respiratory Department of Children′s Hospital of Chongqing Medical University from July 2009 to July 2018. A total of 508 cases of RSV-infected children (RSV non-sequencing group) were divided into 2 groups: children with Spn airway colonization (RSV+Spn group) and children without with Spn airway colonization (RSV group) according to the detection for virus and bacteria in nasopharyngeal aspirate, and these 2 groups were compared in terms of clinical manifestations by chi-square test in different age groups. In addition, in RSV pandemic season from November 2018 to February 2020, nasopharyngeal aspirates were collected from 20 children hospitalized in Respiratory Department of Children′s Hospital of Chongqing Medical University and infected with RSV but without any positive detection of bacteria (RSV 16 S-sequencing group) and from children undergoing surgery without any sign of respiratory infection (control group). The difference of microbiome detected by 16 S RNA sequencing was compared using rank sum test between RSV 16 S-sequencing group and control group, and also between children with severe and mild pneumonia in RSV 16 S-sequencing group.Results:A total of 508 RSV non-sequencing group included 346 males and 162 females, and the visiting age was 6 (2, 12) ?months. RSV group included 443 cases and RSV+Spn group included 65 cases. In the study 244 cases were aged <6 months and 264 cases were aged ≥6 months. In children aged ≥6 months of RSV non-sequencing group, the proportion of cases presenting fever over 38 ℃ and cases with severe pneumonia in RSV+Spn group were higher than those in RSV group (53.2% (25/47) vs. 34.6% (72/217), 38.3% (18/47) vs. 21.2% (46/217), χ2=5.70,6.15, both P<0.05). RSV 16 S-sequencing group included 16 males and 4 females and the visiting age was 3.0 (1.9, 8.0) months. Airway microbiome diversity in RSV 16 S-sequencing group was lower than that in control group (alpha index: 0.93 (0.42, 2.51) vs. 3.05 (2.88, 3.61), U=60.00, P=0.001). Conclusions:RSV infection is associated with the changes of the upper airway microbiome. When the balance of airway microbiome is broken and the presence of the dominant colonization of Spn follows, it may aggravate the severity of RSV infection in children aged ≥6 months.

The prevalence of type 2 diabetes mellitus(T2DM)in China is about 9.1%.Compared with healthy adults, life expectancy for patients with T2DM at 60 years of age can be cut short by 7.3-9.5 years and time for a good quality of life by 11.1-13.8 years.It is important for elderly patients with T2DM to stay functionally active.Frailty, as a common geriatric syndrome, is an important factor affecting the functional status of the elderly, a strong predictor for disability, death and hospitalization, and also a strong predictor for adverse health outcomes in elderly patients with T2DM.This article reviews the relationship between frailty/sarcopenia and T2DM, and the management and treatment of elderly T2DM patients with frailty/sarcopenia.

Objective To investigate the relationship between single nucleotide polymorphisms of interleukin 23 receptor (IL-23R) gene and Keshan disease (KD) in Northwest Chinese Han population.Methods A total of 285 Chinese Han subjects from Huangling,Shaanxi,including 79 KD patients (case group) and 206 control subjects (control group) were involved in this study.Genomic DNA was extracted from peripheral venous blood.The polymorphism of genetic variation was genotyped by matrix-assisted laser desorption/ionization-time of flight (MALDI-TOF).All sample groups were tested for Hardy-Weinberg equilibrium using goodness-of-fit x2 test.Differences in genotype distribution between two groups were compared by x2 test.Logistic regression analysis was applied to detect association using age as a confounding factor.Results The gene frequency distribution of IL-23R gene rs10889677 in case group and control group conformed to the Hardy-Weinberg equilibrium (x2 =0.254,P ＞ 0.05).Correlation analysis results:the difference of genotype frequency of IL-23R gene rs10889677 in case group (CC,CA,AA were 6.3％,36.7％,57.0％,respectively) and control group (CC,CA,AA were 5.3％,43.2％,51.5％,respectively) was not statistically significant (x2 =1.008,P ＞ 0.05).After age adjustment,there was no significant difference in genotype frequency of IL-23R gene rs10889677 (x2sdj =0.669,P ＞ 0.05) between two groups.Conclusion There is no correlation between IL-23R gene rs10889677 and KD in Northwest Chinese Han population.

OBJECTIVETo assess the association of polymorphisms of N-acyl-phosphatidylethanolamine-phospholipase D (DAPE-PLD) and fatty acid amide hydrolase (FAAH) genes, as well as their interaction, with schizophrenia.

METHODSPolymorphisms of NAPE-PLD rs12540583 and FAAH rs324420, rs2295633, and rs6429600 were determined with PCR - restriction fragment length polymorphism assay and Sanger sequencing. The genotypes of 345 subjects of Han Chinese origin diagnosed with schizophrenia and a 403 controls were compared. The results were analyzed with SPSS 17.0, and the interaction of the two genes was analyzed using a multifactor dimensionality reduction (MDR) method.

RESULTSThe frequency of NAPE-PLD rs12540583 polymorphism was significantly different between the two groups under both dominant and additive models (χ2=17.18 vs. χ2=18.94, P<0.0125). The frequencies of AC genotype and C allele of the patient group at rs12540583 were higher than those of the controls, and the interaction of NAPE-PLD and FAAH was associated with schizophrenia. A four-loci model (rs12540583, rs324420, rs2295633 and rs6429600) can best model the interaction between NAPE-PLD and FAAH.

CONCLUSIONThe AC genotype and C allele of NAPE-PLD rs12540583 locus are risk factors for schizophrenia, and the interaction between NAPE-PLD rs12540583 and FAAH rs324420, rs2295633 and rs6429600 is associated with schizophrenia.

Adult ; Amidohydrolases ; genetics ; Asian Continental Ancestry Group ; genetics ; China ; ethnology ; Female ; Genotype ; Humans ; Male ; Middle Aged ; Phospholipase D ; genetics ; Polymorphism, Genetic ; Schizophrenia ; genetics

Objective To explore the bacterial flora distribution characteristics and drug resistance of pus bacterial culture in a‐cute mastitis and to analyze thechange trend of drug resistance spectrum to provide a evidence‐based basis for the rational use of an‐timicrobial agents in clinic .Methods The pus collected from 207 cases of acute mastitis was conducted the bacterial culture .The bacterial identification and antibacterial susceptibility test were performed by adopting the manual experiment combined with the DL‐96 system .Partial drug susceptibility test was performed by combining with the K‐B method .Results Among 207 specimens , 82 strains of pathogenic bacteria were detected with the detection rate of 39 .6% ,including 51 strains (62 .2% ) of staphylococcus aureus ,7 strains (8 .5% ) of pseudomonas aeruginosa ,4 strains (4 .9% ) of staphylococcus intermedius ,4 strains (4 .9% ) of staphy‐lococcus epidermis ,3 strains (3 .7% ) of acid‐producing klebsiella bacteria and each 1 strain of staphylococcus hemolyticus and other 13 kinds of bacterium .The resistance rates of staphylococcus aureus to azithromycin ,erythromycin and clarithromycin were 92 .2% ,84 .3% and 84 .3% respectively ,indicating that macrolides drugs had a higher overall drug resistance rate and were not suitable for selection and use;the resistance rates of moxifloxacin and ciprofloxacin were 3 .9% and 4 .1% respectively ,the MRSA detection rate was 27 .5% .The resistance rates of Pseudomonas aeruginosa to ticarcillin/clavulanic acid was 85 .7% ;the drug resitance rate of cefoperazone was 83 .3% ;which of gentamycin and amikacin was 71 .4% ;which of aztreonam was 14 .3% ;which of ceftazidime was 28 .6% and which of meropenem was 28 .6% .Conclusion The majority of detected bacteria in pus from the pa‐tients with acute mastitis are Staphylococcus aureus ,followed by pseudomonas aeruginosa ,which is different from that reported by other literatures ,showing the bacterial distribution has regional difference .Staphylococcus aureus has high resistance rate to macrol‐ides antibacterial drugs ,but is highly sensitive to ciprofloxacin and moxifloxacin;Pseudomonas aeruginosa has higher resistant rate to ticarcillin/clavulanic and cefoperazone ,but it is highly sensitive to aztreonam ,ceftazidime and meropenem .Empirical medication should be comprehensively considered by combining with drug resistance spectrum of Staphylococcus aureus and Pseudomonas aeruginosa ,and the sensitive drugs should be selected according to the drug susceptibility results after the antimicrobial susceptibili‐ty test for conducting the targeted medication .

Objective To evaluate the relationship between vitamin D receptor(VDR) (rs731236)single nucleotide polymorphisms and genetic susceptibility to overweight/obesity in school-age children of Han and Kazakh in Xinjiang Uygur Autonomous Region.Methods The VDR gene rs731236 genotypes were detected by using polymerase chain reaction-restriction fragment length polymorphism method in 250 overweight/obesity school-age children(127Han,123 Kazakh) and 255 healthy controls(131 Han,124 Kazakh) as well.Results (1)There were statistically significant differences in the frequencies of rs731236 genotypes and alleles between the healthy controls of Han and Kazakh (x2 =9.904,P =0.005;x2 =9.312,P =0.002).(2)There were statistically significant differences in the frequencies of TT/Tt + tt genotype and the alleles between the overweight/obesity cases and healthy controls of Kazakh (x2 =3.891,P =0.049 ; x2 =5.871,P =0.015).But the difference in frequencies of rs731236 genotypes and alleles between the overweight/obesity cases and controls of Han were not statistically significant (x2 =0.064,P =0.800 ; x2 =0.190,P =0.663).(3)There were statistically significant differences in the frequencies of TT/Tt + tt genotype and alleles between the overweight/obesity cases and healthy controls of male school-age children of Kazakh (x2 =5.25,P =0.02;x2 =4.57,P =0.03),but the differences in frequencies of rs731236 genotypes and alleles between the overweight/obesity cases and controls were not statistically significant in female school-age children of Kazakh (x2 =0.06,P =0.80 ; x2 =1.40,P =0.24).There was no statistically significant difference in the frequencies of TT/Tt + tt genotype and alleles between the overweight/obesity cases and healthy controls of female school-age children of Han (x2 =0.04,P =0.84 ; x2 =0.04,P =0.84),and there was no statistically significant difference in male school-age children of Han(x2 =0.05,P=0.82;x2 =0.18,P=0.67).Conclusions VDR gene(rs731236)polymorphism bears ethnic diffe-rence.The polymorphisms of VDR gene polymorphism rs731236 are not associated with the susceptibility to overweight/obesity in school-age children of Han,while it is associated with the susceptibility to overweight/obesity school-age children in Kazakh,especially in male school-age children.

Objective Currently, the prefabricated flap is used for reconstructing the post-burn scar in head and face.The aim is to analyze the nature of the post-op edema in the prefabricated flaps, to determine whether it is lymphedema, and to study the prognosis of the edema.Methods From January, 2011 to March, 2015, 18 cases of post-operation edema in superficial temporal fascia prefabricated flaps were studied and each case was followed for 5 months.We used ultrasound and indocyanine green (ICG) fluorescent imaging to study the nature of the edema.Apart from that, we monitored the recovery process of the post-operation edema by a) measuring the horizontal diameter of the flap by a tape, b) measuring the thickness of the flap by the ultrasound, c) monitoring the condition of edema by ICG and d) monitoring the reconstruction and recanalization of the lymphatic system by ICG.Results Pitting edema always occurred in the prefabricated flap from the first day after operation.These patients were diagnosed as mild lymphedema (7 cases), moderate lymphedema (10 cases), and severe lymphedema (1cases) by ultrasound and ICG florescent imaging.The degree of flap lymphedema improved gradually and it improved significantly from 3 days to 6 days post-op eration.The condition of flap lymphedema became stable from the 12 days post-operation.The fluorescence image of ICG showed that the stage of flap lymphedema improved from 3 weeks post-operation and the transportation capability of lymphatic vessels increased most from the 3 days to 6 days post-op eration.We also found lymphatic vessels reconnected from the 6 days post-operation and lymphatic system reconstructed following the direction to lymph nodes.We could discover the collecting lymphatic vessels from 2 months post-operation and the lymphatic system in prefabricated flap matured from 5 months post-operation.Conclusion The post-operation edema in the prefabricated flaps is lymphedema, the incidence rate of which is high.The lymphatic drainage system recovers in 6 days after the operation.It is reconstructed along the lymph nodes.The edema disappears in 2-3 weeks post-operation, the reconstructed the lymph system matures in 5 months.