Objective: To estimate the transmission capacity of influenza clustering in schools and nurseries, and to evaluate the effect of suspension measures, providing a basis for formulating disease management strategies and control measures. Methods: The SEIAR dynamics model was used to simulate the epidemic data, calculating the basic regeneration coefficient R 0 of the epidemic to evaluate the epidemic transmission capacity, and calculating the cumulative incidence rate of the epidemic to evaluate the prevention and control effect of the suspension measures. Results: The basic regeneration coefficient R 0 was 8.44(8.01,8.89) without intervention. There were statistically significant differences in R 0 of influenza epidemic among different types of school(F=9.52, P<0.01). The R 0 of influenza epidemic in primary and secondary schools were higher than that in nurseries(P<0.05). R 0 of influenza A was higher than that of influenza B(t=2.71, P<0.01). R 0 of influenza A(H3) was higher than of influenza B(Victoria)(P<0.05). The cumulative incidence of the outbreaks which were suspended for 4 days and 7 days was significantly lower than that in the non-suspensions(P<0.05). However, there was no significant difference in the cumulative incidence of the outbreaks between the 4-day suspension and the 7-day suspension(P>0.05). Conclusion Transmission capacity of school-based influenza epidemic is high, especially among primary and secondary schools. When the epidemic situation of infected class meets the suspension standard, it is recommended to suspend classes for 4 days.

Objectives:To explore the GAA varient spectrum and the genotype-phenotype correlations in patients with glycogen storage disease type Ⅱ (Pompe disease, PD), as well as to estimate the disease incidence based on carrier rate of GAA varients in Guangzhou population.Methods:A total of 57 PD cases were retrospectively enrolled at Guangzhou Women and Children′s Medical Center from January 1, 2010 to May 31, 2020. All patients presented symptoms before the age of 18 years. Each diagnosis was further confirmed by GAA enzyme activity and GAA variants. The carrier rate of GAA varients was calculated based on variants detected by whole exon sequencing among 2 395 healthy children in Guangzhou.Results:Among the 57 PD patients (including male 26, female 31),twenty-eight patients with infantile onset PD (IOPD) presented with progressive general muscle weakness and cardiomyopathy. The mean ages of symptom onset and diagnosis were (2.5±1.4) and (5.0±3.0) months, respectively. Twenty-six cases died in the first year after birth.Twenty-three patients with late onset PD (LOPD) presented with progressive muscle weakness. Seven of them had respiratory failure at diagnosis. The mean ages of symptom onset and diagnosis were (12.0±5.0) and (17.0±7.5) years, respectively. Six children with atypical IOPD showed motor delay, muscle weakness and cardiomyopathy. Their diagnosis was confirmed at 2.5-7.0 years of age. Among the 57 patients, 47 different variants were identified in the GAA gene. Three variants: c.797C>T, c.1109G>A and c.1757C>T were novel. c.1935C>A (25/114, 21.9%) and c.2238G>C (15/114, 13.2%) were the most common variants, detected in 57.1% of IOPD and 65.2% (15/23) of LOPD patients, respectively. Among the 28 IOPD patients, 26 cases (92.9%) carried at least one missense variant which indicated positive cross-reactive immunologic material (CRIM). The carrier rate of pathogenic variants in GAA gene among healthy children was 24/2 395. The estimated incidence of PD in this population is about 1/40 000. The frequencies of pseudodeficiency variants c.1726G>A and c.2065G>A homozygotes were 26.3% (15/57) and 35.1% (20/57) in PD patients, which were significantly higher than those (1.7% (40/2 395) and 3.9% (94/2 395)) in healthy children (χ2=151.2, 121.9; both P<0.01). Conclusions:PD presents as a spectrum, some as atypical IOPD. The c.1935C>A and c.2238G>C are common variants, correlated with IOPD and LOPD respectively. The c.796C>T and c.1082C>T are usually found in atypical IOPD. The majority of IOPD patients is predicted to be CRIM positive. The estimated incidence of PD is about 1/40 000.

Objective:To evaluate the effect of oropharyngeal colostrum administration on building adequate enteral feeding process of very low birth weight neonates and extremely low birth weight neonates.Methods:A total of 62 very/extremely low birth weight neonates in NICU were selected from a tertiary hospital in shandong province. They were randomly assigned to the observation group ( n=32) and the control group ( n=30) according to the random number table. The observation group was given oropharyngeal colostrum administration. The control group was given oral care with 0.9% sodium chloride solution, and the wiping method and frequency was the same as the observation group. Gastric retention, enteral feeding time, adequate enteral feeding time, the weight at the time of discharge, etc. were compared between two groups. Results:Gastric retention times on the 10th day in the observation group (1.90±1.30) was significantly lower than that in the control group (2.77±1.50), and the two groups were statistically significant ( t value was -2.449, P<0.05). The duration of 100 ml·kg -1·d -1 enteral feeding and adequate enteral feeding (150 ml·kg -1·d -1) in the observation group [(24.63±9.42) days, (29.75±10.15) days] were significantly shorter than those in the control group [(33.90±2.73) days, (35.13±9.29)days], and the two groups were statistically significant ( t value was-4.621, P<0.01; t value was -2.362, P<0.05). The weight of the observation group was higher than that in the control group at the time of discharge ( t value was 4.677, P<0.05). Conclusion:Oropharyngeal colostrum administration can reduce gastric retention times, shorten the adequate enteral feeding time, promote growth and development in very low birth weight neonate and extremely low birth weight neonate.But it had not been proved to reduce the incidence of related infection indicators.

Objective To compare the efficacy of less invasive surfactant administration (LISA) and intubation-surfactant-extubation to CPAP (INSURE) techniques in premature infants with respiratory distress syndrome (RDS).Method From January 2016 to January 2017,premature infants with RDS admitted to our hospital were prospectively and randomly assigned into the LISA group and the INSURE group.A 6F suction tube was used to drip pulmonary surfactant (PS) into the trachea with non-invasive respiratory support in the LISA group.INSURE technique and endotracheal intubation with surfactant administration were used in the INSURE group.The following indicators were examined:the time needed for intubation,the change of percutaneous oxygen partial pressure and the incidence of bradycardia during administration,regurgitation after administration,oxygen therapy duration,mechanical ventilation duration,re-administration of PS and apnea.Secondary indicators included the incidences of pneumothorax,pulmonary hemorrhage,neonatal necrotizing enterocolitis (NEC),intraventricular hemorrhage (IVH),bronchopulmonary dysplasia (BPD),preterm retinopathy (ROP),and periventricular leukomalacia (PVL).Result A total of 145 cases were included including 76 in LISA group and 69 in INSURE group.The gestational age was 27～34 weeks.The birth weight was (1 650±480) g.No statistically significant differences existed between the two groups on the time needed for intubation,the change of percutaneous oxygen partial pressure,mechanical ventilation duration,oxygen therapy duration,the incidence of bradycardia,re-administration of PS,apnea and other complications (P＞0.05).Statistically significant differences existed in the incidence of regurgitation (46.1％ in LISA group vs.29.0％ in INSURE group),mechanical ventilation within 72 hours (13.2％ in LISA group vs.27.5％ in INSURE group) and the incidence of BPD (6.6％ in LISA group vs.17.4％ in INSURE group) (P＜0.05).Conclusion Compared with INSURE,LISA technique is effective for the treatment of RDS and reduce invasive ventilation duration and the occurrence of BPD.

Objective To study the value of lung ultrasonography (LUS) in the diagnosis of pneumothorax in critically ill neonates.Method The neonates admitted to our NICU and suspected to have pneumothorax were prospectively enrolled from June 2017 to December 2018.All eligible infants received both LUS examination and chest X-ray.The characteristics of LUS imaging was analyzed based on the chest X-ray which was used as the golden standard for the diagnosis of pneumothorax.The sensitivity,specificity,positive predictive value and negative predictive value of LUS is computed.The duration of LUS and chest X-ray were compared.The outcome and complications were also observed.Result Fifty neonates with suspected pneumothorax were collected.Among them,pneumothorax was confirmed with chest X-ray in 31 neonates (62.0％).Ultrasound signs of pneumothorax included absence of lung sliding (100％),absence of B lines (100％),stratosphere sign (100％) were observed in all of the 31 neonates.Presence of lung point was also observed in 90.3％ of the patients.The sensitivity,specificity,positive predictive value,negative predictive value and X-ray coincidence rate of LUS in the diagnosis of pneumothorax were 100％.LUS and chest X-ray examination took (5.6 ±5.1) min and (20.1 ± 12.2) min,respectively,the difference was statistically significant (P ＜ 0.05).All 31 infants with pneumothorax survived.15 infants underwent closed thoracic drainage after emergency thoracic puncture or aspiration assisted by LUS.No postoperative complications occurred.Conclusion LUS showed high accuracy,sensitivity and specificity in detecting pneumothorax in critically ill neonates.It is simple to operate and can guide clinical rescue more promptly and quickly.

Objective To explore whether the lung ultrasound( LUS) score can be used to assess and predict the criticality of neonates with pulmonary disease at an early stage . Methods T he new borns born in the obstetrics department of Affiliated Hospital of Jining M edical University from April to October 2018 were transferred to the neonatal intensive care unit due to respiratory distress . T he children underwent LUS examination and scoring at 2 hours after birth . T he correlation analysis were performed between LUS score and neonatal critical illness score ( NCIS ) ,NCIS +single index ,respectively . And the ROC curve was used to analyze the value of LUS score in predicting neonatal criticality . Results ①T he LUS score of non‐critical neonates was significantly lower than that of critically ill newborns , the difference was statistically significant ( P ＝0 .005) ; LUS score was an independent risk factor for critical neonates ( OR＝1 .71 ,95%CI :1 .059－2 .765 , P ＝ 0 .028 ) . ② T he correlation coefficient between LUS score and NCIS was －0 .48 ( P ＝0 .002) . T he correlation coefficient between the LUS score and the NCIS + single index was －0 .44 ( P＝0 .005) . ③T he area under the ROC curve of LUS score predicting neonatal criticality was 0 .88 ( 95%CI :0 .725－0 .965 , P ＜0 .000 1) ,the optimal diagnostic threshold was 6 points with sensitivity of 80% and specificity of 100% . Conclusions The LUS score at a postnatal age of 2 hours after birth can early assess and predict the criticality of neonates with pulmonary disease . And the LUS score greater than 6 has the highest diagnostic value .

Objective: To investigate the regulatory effect of miR-1297 on the malignant biological behaviors of breast cancer cells and its underlying mechanism. Methods: Twenty pairs of breast cancer tissues and para-cancer tissues resected at the Department of Thyroid and Breast Surgery of Leshan People′ s Hospital from May 2016 to May 2018, as well as breast cancer cell lines MCF-7, SW626, HCC1937 and human breast epithelial MCF-10A cells were collected for this study. qPCR was performed to evaluate the expression of miR-1297 in breast cancer tissues and cell lines. The experimental cells were divided into control group, miR-1297 inhibitor group; TET3 over-expression group and simultaneous over-expression of TET3 and miR-1297 group. CCK-8 assay was used to detect the cell proliferation of MCF-7 cells; Transwell assay was carried out to detect the migration and invasion of MCF-7 cells; and WB was used to measure the expressions of TET3 and EMT related proteins (E-cadherin, N-cadherin and vimentin). Dual luciferase reporter gene assay was used to verify the relationship between miR-1297 and TET3. Results: miR-1297 was up-regulated in both breast cancer tissues and cell lines (P<0.01 or P<0.05). Knockdown of miR-1297 dramatically repressed the proliferation, migration, invasion and EMT of MCF-7 cells (P<0.01 or P<0.05). Over-expression of TET3 significantly up-regulated the expression of TET3 in MCF-7 cells (P<0.05). Simultaneous over-expression of TET3 and miR-1297 could reverse the expression level of TET3 in MCF-7 cells and the inhibitory effect of TET3 on the proliferation, migration, invasion and EMT of MCF-7 cells. Dual luciferase reporter gene assay results showed that miR-1297 targetedly bound to the 3' UTR of TET3. Further experiment results demonstrated that miR-1297 targetedly down-regulated TET3 and promoted the malignant biological behaviors of MCF-7 cells. Conclusion: miR-1297 is up-regulated in breast cancer tissues and cells; it promotes the malignant biological behaviors such as proliferation, migration, invasion and EMT through targetedly down-regulating the expression of TET3.

Objective: To explore whether the lung ultrasound(LUS) score can be used to assess and predict the criticality of neonates with pulmonary disease at an early stage. Methods: The newborns born in the obstetrics department of Affiliated Hospital of Jining Medical University from April to October 2018 were transferred to the neonatal intensive care unit due to respiratory distress. The children underwent LUS examination and scoring at 2 hours after birth. The correlation analysis were performed between LUS score and neonatal critical illness score (NCIS ), NCIS+ single index, respectively. And the ROC curve was used to analyze the value of LUS score in predicting neonatal criticality. Results: ①The LUS score of non-critical neonates was significantly lower than that of critically ill newborns, the difference was statistically significant (P=0.005); LUS score was an independent risk factor for critical neonates (OR=1.71, 95% CI: 1.059-2.765, P=0.028). ②The correlation coefficient between LUS score and NCIS was -0.48 (P=0.002). The correlation coefficient between the LUS score and the NCIS+ single index was -0.44 (P=0.005). ③The area under the ROC curve of LUS score predicting neonatal criticality was 0.88 (95% CI: 0.725-0.965, P<0.000 1), the optimal diagnostic threshold was 6 points with sensitivity of 80% and specificity of 100%. Conclusions The LUS score at a postnatal age of 2 hours after birth can early assess and predict the criticality of neonates with pulmonary disease. And the LUS score greater than 6 has the highest diagnostic value.

Objective To study the relationship between the lung ultrasonography and the chest X-ray and to study the value of lung ultrasonography score (LUS) in evaluating the effect of pulmonary surfactant (PS) on respiratory distress syndrome (RDS) of newborn.Method Preterm infants admitted to the neonatal intensive care unit of our Hospital from January 2016 to December 2017 and diagnosed with RDS were prospectively studied.LUS examinations were performed prior to,and within the first 6～12 hours after surfactant administration,chest X-rays were also performed at the same time so as to evaluate the effects of surfactant replacement therapy and the correlation between the lung ultrasonography and the chest X-rays.Lung ultrasonography findings at a total of six sites,with three sites in each lung were scored based on the presence of normal finding,the amount of B-lines and subpleural consolidations.Result A total of 45 preterm infants with RDS were enrolled.The cases of X-ray grades Ⅰ,Ⅱ,Ⅲ and Ⅳ before PS administration were 5 cases,21 cases,12 cases and 7 cases respectively.The scores of LUS 0～6,7～12,13～ 18 were 5 cases,37 cases and 3 cases respectively,and the median of LUS was 10 points.Chest X-ray grades Ⅰ,Ⅱ,Ⅲ and Ⅳ within 6～12 hours after PS administration were 18 cases,17 cases,8 cases and 2 cases respectively.LUS of 0～6,7～12,13～18 were 21 cases,20 cases and 4 cases respectively.The median of LUS after PS was 7 points.LUS after PS application was significantly lower than that before PS application (P＜0.001).The LUS was positively correlated with the grades of X-ray before and after surfactant administration (before surfactant administration r =0.688,P＜0.001,after surfactant administration r =0.777,P＜0.001).Conclusion LUS is positively correlated with the grade of chest X-ray and might enable an early detection of the surfactant replacement therapy effects in RDS.Further studies are necessary to define the role of LUS in this field.

Objective? To establish a individualized predictive nomogram model for enteral nutrition feeding intolerance (ENFI) by analyzing the risk factors of ENFI in patients with severe acute pancreatitis (SAP). Methods? The clinical data of 188 SAP patients hospitalized in Shandong Provincial Hospital Affiliated to Shandong University from January 2015 to December 2017 were retrospectively collected by objective sampling. Univariate and multivariate Logistic regression analysis were used to identify the independent risk factors of ENFI. R software was used to establish a predictive nomogram model. Bootstrap method was used to validate the nomogram model and ROC curve was used to explore the predictive efficacy of the model in predicting the ENFI. Results? A total of 49 cases out of 118 SAP patients developed ENFI, with an incidence of 41.5%. The result of Logistic regression analysis showed that the independent risk factors of ENFI in SAP patients were age≥ 70 years old (OR=1.377, 95%CI: 1.088-1.743), fasting blood glucose≥ 11.0 mmol/L (OR=3.222, 95%CI:1.545-6.719), enteral nutrition starting time≥72 h (OR=3.800, 95%CI: 1.541-9.370), no dietary fiber added (OR=7.419, 95%CI: 2.651-20.760) and intra-abdominal pressure≥ 15 mmHg (OR=3.881, 95%CI: 1.735-8.679)(P＜ 0.05). The nomogram model showed that the consistency index for predicting the risk of ENFI in SAP patients was 0.869, while ROC curve showed that the area under the curve for the nomogram model predicting ENFI was 0.857 (95%CI: 0.779-0.931). Conclusions? The independent risk factors of ENFI in SAP patients are age≥70 years old, fasting blood glucose≥11.0 mmol/L, enteral nutrition starting time≥72 h, no dietary fiber added and intra-abdominal pressure ≥15 mmHg. The nomogram established in this study can predict the risk of ENFI in SAP patients with good discrimination and accuracy, which could be used for predicting individual ENFI in SAP patients.