Objective To investigate and analyze epidemiological characteristics of patients with mycoplasma pneumoniae pneumonia (MPP) from 2020 to 2023, and the risk factors for plastic bronchitis (PB), To provide data support for developing preventive measures. Methods The medical records of 2 257 patients with respiratory tract infection treated at Huai'an Hospital Affiliated to Xuzhou Medical University from 2020 to 2023 were collected. Count the number of MPP patients and analyze the MP detection rate. Multivariate logistic regression analysis and ROC curve was used to screen the risk factors for PB. Results A total of 858 cases were positive for MP antibodies, and the detection rate was 38.02%. There are statistically significant differences in MP detection rates among different genders, age groups, and years (P<0.05). Among the 286 patients diagnosed with MPP and undergoing bronchoscopy, 68 (23.78%) patients had PB. According to univariate and multivariate logistic regression analysis, small age, higher N%, D-D, LDH and AST levels were independent risk factors for PB (P<0.05). ROC curve analysis shows that age and combined detection are the most effective indicators for PB prediction, with areas under the curve of 0.998 and 0.961, respectively. Conclusion MP is the main pathogen of respiratory tract infections in the area from 2020 to 2023. Women and children are more susceptible to MP infection. Small age, high N%, DD, LDH and AST levels are independent risk factors for PB in patients with MPP. Targeted preventive measures should be taken for MP susceptible population, and close attention should be paid to PB related risk factors to prevent disease progression and the occurrence of PB.

Objective To investigate and analyze epidemiological characteristics of patients with mycoplasma pneumoniae pneumonia (MPP) from 2020 to 2023, and the risk factors for plastic bronchitis (PB), To provide data support for developing preventive measures. Methods The medical records of 2 257 patients with respiratory tract infection treated at Huai'an Hospital Affiliated to Xuzhou Medical University from 2020 to 2023 were collected. Count the number of MPP patients and analyze the MP detection rate. Multivariate logistic regression analysis and ROC curve was used to screen the risk factors for PB. Results A total of 858 cases were positive for MP antibodies, and the detection rate was 38.02%. There are statistically significant differences in MP detection rates among different genders, age groups, and years (P<0.05). Among the 286 patients diagnosed with MPP and undergoing bronchoscopy, 68 (23.78%) patients had PB. According to univariate and multivariate logistic regression analysis, small age, higher N%, D-D, LDH and AST levels were independent risk factors for PB (P<0.05). ROC curve analysis shows that age and combined detection are the most effective indicators for PB prediction, with areas under the curve of 0.998 and 0.961, respectively. Conclusion MP is the main pathogen of respiratory tract infections in the area from 2020 to 2023. Women and children are more susceptible to MP infection. Small age, high N%, DD, LDH and AST levels are independent risk factors for PB in patients with MPP. Targeted preventive measures should be taken for MP susceptible population, and close attention should be paid to PB related risk factors to prevent disease progression and the occurrence of PB.

Pulmonary blast injury has become the main type of trauma in modern warfare, characterized by externally mild injuries but internally severe injuries, rapid disease progression, and a high rate of early death. The injury is complicated in clinical practice, often with multiple and compound injuries. Currently, there is a lack of effective protective materials, accurate injury detection instrument and portable monitoring and transportation equipment, standardized clinical treatment guidelines in various medical centers, and evidence-based guidelines at home and abroad, resulting in a high mortality in clinlcal practice. Therefore, the Trauma Branch of Chinese Medical Association and the Editorial Committee of Chinese Journal of Trauma organized military and civilian experts in related fields such as thoracic surgery and traumatic surgery to jointly develop the Clinical treatment guideline for pulmonary blast injury ( version 2023) by combining evidence for effectiveness and clinical first-line treatment experience. This guideline provided 16 recommended opinions surrounding definition, characteristics, pre-hospital diagnosis and treatment, and in-hospital treatment of pulmonary blast injury, hoping to provide a basis for the clinical treatment in hospitals at different levels.

Objective To investigate the epidemiological characteristics of respiratory syncytial virus (RSV) positive children in Jiangsu, and to provide reference for the prevention and treatment of RSV infection. Methods A total of 11 574 children with respiratory tract infection from June 2018 to June 2020 were selected. RSV antigen was detected by direct immunofluorescence assay in all children. Other 6 kinds of respiratory viruses were detected in RSV positive specimens to understand the mixed infection. Results The positive rate of RSV in 11 574 samples was 12.34%(1 428/11 574), and the male to female ratio of RSV positive children was 1.92:1 (915/476). The detection rate of male children (12.79%) was significantly higher than that of female children (10.77%)(χ²=10.951, P<0.05). The positive rate of RSV in infants aged 1-12 months was significantly higher than that in infants aged over 12 months (χ²=27.48, P<0.05). There was no significant difference in RSV positive rate between 12-24 months group, 24-36 months group, 36-month-old group and 6-12 years group (P>0.05). The positive rate of RSV from November to March was significantly higher than that from other months (χ²=9.451, P<0.05). The highest positive rate was 2 months (16.99%). Of the 1428 RSV-positive cases, 148 were co-infected with at least one other respiratory virus, accounting for 10.36%(148/1 428) of the RSV-positive cases. Among them, 117 cases were double infection and 31 cases were triple infection. RSV combined with PIV3 infection was the most common in 39 cases (26.35%). Conclusion RSV positive children are mainly concentrated in infants under 12 months of age in Jiangsu province, and the incidence is high from November to March. The protection of infants under 12 months of age should be strengthened, especially in hospitalized cases and male cases, which are often mixed with infection..

Objective:To analize the selection rules of acupoints treating diarrhea-predominant irritable bowel syndrome (IBS-D).Methods:To earch for the clinical research literatures on acupuncture treating IBS-D from the database of China National Knowledge Resource Database (CNKI), Chinese science and technology journal database (Chongqing VIP) and Chinese academic journal database (Wanfang Data) by December 31, 2019. The acupuncture prescriptions of IBS-D were selected and statistically analyzed, and a database was established. IBM SPSS 25.0 and clintine 12.0 were used to cluster and correlate the acupuncture point prescriptions.Results:A total of 190 literatures and 215 acupuncture prescriptions were included, including 75 acupoints, among which the most commonly used acupoints were Tianshu, Zusanli, Shangjuxu, Taichong, Guanyuan, Zhongwan, Sanyinjiao, Dachangshu, Shenque, Pishu. The most frequently used Meridian is Stomach Meridian of Foot-Yangming, St; The acupoints are mainly located in the lower limbs and the abdomen and Thorax; the most commonly used specific acupointis He-sea point; Zusanli and Tianshu both play an important role in treating IBS-D. Conclusion:Treating IBS-D with acupuncture and moxibustion follow the principles of choosing acupoints mainly according to Meridians, while selecting the acupoints with syndrome differentiation as the assistance, and also use the specific acupoints.to treat IBS-D.

Objective:To explore the clinical efficacy and safety of Ruxolitinib, a Janus kinase inhibitor, in combination with Methylprednisolone as a bridge to allogeneic hematopoietic stem cell transplantation (allo-HSCT) for relapsed/refractory Epstein-Barr virus-associated hemophagocytic syndrome (EBV-AHS) in pediatric patients.Methods:The clinical data of 4 patients with relapsed/refractory EBV-AHS treated with Ruxolitinib in combination with Methylprednisolone as a bridge to allo-HSCT at the Department of Pediatrics, the First Affiliated Hospital of Zhengzhou University from August 2018 to February 2020 were retrospectively analyzed, and the disease characteristics, diagnosis and treatment process, clinical experience and related research progress were analyzed and summarized.Results:Among 4 patients with relapsed/refractory EBV-AHS, 2 patients were treated with low-dose Ruxolitinb in combination with Methylprednisolone for 6-10 weeks after partial remission.The disease did not progress, and they survived after being bridged to allo-HSCT.One patient was treated with large-dose Ruxolitinib in combination with Methylprednisolone due to the intolerance to chemotherapy, with the biochemical indicators of hemophagocytic syndrome significantly improved, and then the bridging to allo-HSCT was performed 2 months ago and this patient survived.One patient with EBV-AHS relapsed was relieved by chemotherapy again, then was given maintenance therapy with Ruxolitinib and Methylprednisolone, but the condition still progressed and the treatment was ineffective.This patient underwent allo-HSCT for salvage treatment more than 1 year ago and survived.Except that 1 patient developed mild anemia, the other 3 patients had no significant Ruxolitinib-related toxicities.Conclusions:Ruxolitinib in combination with Methylprednisolone can be safely employed as a salvage treatment for pediatric patients with relapsed/refractory EBV-AHS and a bridge to allo-HSCT, which has favorable safety, efficacy and tolerance in clinical practice.

Objective:To compare the efficacy of haploid hematopoietic stem cell transplantation (haplo-HSCT) and intensive immunosuppressive therapy (IST) in children with severe aplastic anemia (SAA).Methods:The medical records of children newly diagnosed as SAA in the First Affiliated Hospital of Zhengzhou University from January 2013 to June 2018 were retrospectively analyzed.Among them, 33 patients received haplo-HSCT and 24 patients received IST that combined anti-thymocyte globulin(ATG) with Cyclosporine (CsA). The effective rate, overall survival (OS) rate, and failure free survival(FFS) rate of children in the haplo-HSCT group and the IST group were compared.Results:The median follow-up period was 25 months (9-60 months). There were 5 cases of early death in the haplo-HSCT group and 4 cases in the IST group, and the differences were not statistically significant ( P=0.822). Leaving out the early death cases, the effective rate in the haplo-HSCT group [100%(28/28 cases)] was higher than that in the IST group [30%(6/20 cases)] after 3 months of treatment, the difference was statistically significant ( χ2=27.671, P<0.01). After 6 months of treatment, the effective rate in the haplo-HSCT group [92.9%(26/28 cases)] was higher than that in the IST group [65.0%(13/20 cases)], and the difference was statistically significant ( χ2=5.943, P=0.015). After 12 months of treatment, the effective rate in the haplo-HSCT group [89.3%(25/28 cases)] was higher than that in the IST group [70.0%(14/20 cases)], but the difference was not statistically significant( P>0.05). The 3-year expected OS rate of children in the haplo-HSCT group and the IST group were 75.0% and 70.3%, respectively, with no statistically significant difference ( χ2=0.133, P=0.716). The 3-year expected FFS rate of children in the haplo-HSCT group (74.2%) was significantly higher than that in the IST group (48.7%), and the difference was statistically significant ( χ2=4.036, P=0.045). Conclusion:For children with SAA, haplo-HSCT is also an effective treatment if there is no sibling donor of hematopoietic stem cell transplantation.

Objective: To understand the occupational hazard and distribution of silica dust (free SiO₂≥10%) in the workplace environment of the enterprises in Fengxian District, and to provide scientific basis for improving the working environment and protecting the physical and mental health of the workers. Methods: Individual sampling monitoring and on-site labor hygiene investigation were conducted on 421 workers involved in 87 silicon dust enterprises in the jurisdiction from 2014 to 2018, and measured concentration-time weighted average (C_TWA) . Results: The results showed that the range of the C_TWA was (0.021~17.000) mg/m³, the median was 1.600 mg/m³, and the qualified rate of 30.88%. The difference of total dust concentration was statistically significant in different years (Z=38.831, P<0.05) . The qualified rate of small-scale enterprises is higher than that of medium-scale enterprises (χ²=9.472, P<0.05) . The qualified rate of other domestic enterprises is higher than that of private enterprises and foreign enterprises (χ²=10.089, P<0.05) . The acceptance rate of metal products manufacturing is lower than that of general equipment manufacturing and other manufacturing enterprises (χ²=64.626, P<0.05) . The qualification rate of natural ventilation is higher than that of mechanical ventilation (χ²=6.278, P<0.05) . Conclusion The enterprises involved in silicon production in Fengxian District need to further strengthen the production process reform and improve the ventilation and dust removal protection measures. Widely carry out the publicity of occupational disease prevention and control law, conduct targeted pre-job training, improve workers' awareness of self-protection, and protect the occupational health of workers in many ways.

Objective To observe any curative effect of applying comprehensive pulmonary rehabilitation in moderate and severe cases of chronic obstructive pulmonary disease (COPD).Methods A total of 135 persons hospitalized with moderate or severe COPD were randomly divided into a rehabilitation group of 75 and acontrol group of 60.Both groups were given routine treatment,while the rehabilitation group was additionally provided with a comprehensive pulmonary rehabilitation regimen,including health education,exercise training,respiratory function training,respiratory muscle training,psychological support and nutritional intervention for six months.Before and after the treatment,both groups were evaluated using their walking distance within 6 minutes (6MWD),an anhelation index,a COPD assessment test (CAT),the Beck anxiety and depression scale,a nutritional assessment and indexes of pulmonary function and blood gases.Results After the intervention the average 6 MWD,anhelation index,CAT score,Beck anxiety and depression scores,forced expiratory volume,forced vital capacity and PaO2 of the rehabilitation group were all significantly better than before the treatment and better than those of the control group.Conclusion For moderate and severe COPD patients,comprehensive pulmonary rehabilitation effectively strengthens their moving ability,pulmonary function and arterial partial pressure of oxygen,while relieving anhelation,anxiety and depression.

Objective To observe the effect of malnutrition on cognitive function of patients with chronic obstructive pulmonary disease(COPD) in stable period.Methods According to score of Mini Nutritional Assessment (MNA) ＞ 17 points and ≤ 17 points,120 patients with stable COPD were divided into control group and malnutrition group.The mini-mental stat examination (MMSE) was used to detect the cognitive function of patients,and oxygen saturation,pulmonary function,serum NSE and S-100β were detected as well.Results Compared with the control group,the disease course of the malnutrition group was longer,and measured value to expected value of the first second forced expiratory volume (FEV1) and blood oxygen saturation were significantly lower,but there were no significant differences in the age and education level between the two groups (P ＞ 0.05).There were significant differences in total score,directive force,delayed memory,attention and calculating ability,recollection ability,language between two groups (P ＜ 0.05).Multiple Logistic regression analysis showed that the MMSE score was mainly related to age,education,measured value to expected value of FEV1,blood oxygen saturation,and MNA score.Both NSE and S-100β protein were negatively correlated with MMSE score (r =-0.365、-0.441,P ＜ 0.05).Conclusion Malnutrition can aggravate the cognitive impairment of COPD patients in stable stage.Serum S-100β and NSE levels may be used as predictors for cognitive impairment in COPD patients with malnutrition.