Objective: To investigate the spatial clustering characteristics of varicella public health emergency events in Nanjing City from 2017 to 2022, so as to provide the evidence for the development of varicella prevention and control strategies. Methods: Data of varicella public health emergency events in Nanjing City from 2017 to 2022 were collected through Emergency Public Health Management Information System of Chinese Disease Prevention and Control Information System. The software ArcGIS 10.2 was employed for trend-surface analysis, spatial autocorrelation analysis and hotspot analysis to understand the spatial clustering characteristics of varicella public health emergency events. Results: A total of 84 varicella public health emergency events were reported in Nanjing City from 2017 to 2022, with an average attack rate of 2.53% (2 558 cases). Ⅳ-level events were predominant, accounting for 90.48% (76 events). The trend-surface analysis showed lower incidence of varicella public health emergency events in the west of Nanjing City and higher in the east, and lower in the north and higher in the south. The global spatial autocorrelation analysis showed that there was a positive spatial correlation in varicella public health emergency events in 2017 and 2019, indicating spatial clustering (P<0.05). The hot spots were Jiangning District, Gaochun District, Yuhuatai District and Jianye District. Conclusion The incidence of varicella public health emergency events in Nanjing City from 2017 to 2022 has spatial aggregation, with a concentration in suburban areas such as Jiangning District and Gaochun District.

Objective:To investigate the concern about pollen broadcasting in Chinese population from multiple dimensions and to understand the information about allergic rhinitis (AR) in China by analyzing related factors.Methods:From March 1 to September 30, 2022, a large-scale multi-center cross-sectional survey was conducted based on the Questionnaire Star platform in 21 Chinese hospitals. A total of 7 056 subjects from 7 regions in China: Northeast, North, East, Central, South, Southwest, and Northwest China were included. Basic characteristics (including social demographic characteristics and disease characteristics of AR patients), concern about pollen broadcasting, the willingness of pollen-induced AR (PiAR) patients to receive pollen broadcasting, and the treatment satisfaction rate of AR patients were collected. The chi-square test, multivariate linear regression model, and Logistic regression analysis were used to analyze the concern about pollen broadcasting in the Chinese population and related factors from multiple dimensions.Results:Among 7 056 subjects, 23.02% were concerned about pollen broadcasting. Among 3 176 self-reported AR and 1 019 PiAR patients, 25.60% and 39.16% were concerned about pollen broadcasting, respectively, which was higher than that of non-AR or non-PiAR subjects ( χ2 value was 21.74 and 175.11, respectively, both P<0.001). Among AR patients, the proportion of spring and autumn allergen-positive patients concerned about pollen broadcasting was higher than that in perennial allergen-positive patients ( χ2 value was 20.90 and 19.51, respectively, both P<0.001). The proportion of AR patients with asthma, sinusitis, allergic conjunctivitis, and cardiovascular and cerebrovascular diseases was higher than those without complications ( χ2 value was 50.83, 21.97, 56.78, 7.62, respectively, all P<0.05). The proportion of AR patients in North China who could find pollen broadcasting locally was 31.01%, significantly higher than those in other regions (all P<0.05). Multivariate linear regression model analysis showed that among PiAR patients, those with higher per capita household income and higher AR disease cognition levels had been concerned about pollen broadcasting in the past, and those complicated with allergic conjunctivitis had stronger intention to receive pollen broadcasting (B value was 0.24, 0.13, 0.66, 0.47, respectively, all P<0.05). The higher the disease cognition level of PiAR patients, the stronger their willingness to actively participate in treatment ( R2=0.72, P<0.001). Only 18.89% of AR patients felt satisfied with the treatment effect. Logistic regression analysis showed that in AR patients, the treatment satisfaction rate was significantly higher among those concerned about pollen broadcasting compared to those who were not ( OR=1.83, P<0.001). Conclusions:Currently, the dissemination of pollen broadcasting in China is hindered by various factors such as disease cognition level. The treatment satisfaction among AR patients remains unsatisfactory.

Following the principles of evidence-based medicine,in accordance with the structure and drafting rules of standardized documents,based on literature research,according to the characteristics of chronic cough in children and issues that need to form a consensus,the TCM Guidelines for Diagnosis and Treatment of Chronic Cough in Children was formulated based on the Delphi method,expert discussion meetings,and public solicitation of opinions.The guideline includes scope of application,terms and definitions,eti-ology and diagnosis,auxiliary examination,treatment,prevention and care.The aim is to clarify the optimal treatment plan of Chinese medicine in the diagnosis and treatment of this disease,and to provide guidance for improving the clinical diagnosis and treatment of chronic cough in children with Chinese medicine.

Objective To explore the effects of hot compress by aconite tincture combined with medium-frequency electrotherapy on lumbar spine function, lumbar muscle endurance, and inflammatory factors in patients with chronic non-specific low back pain. Methods A total of 120 patients with chronic non-specific low back pain were randomly divided into two groups, with 60 patients in each group. The control group was treated with medium-frequency electrotherapy, while the research group was treated with aconite tincture hot compress based on the treatment of the control group. The symptom improvement, lumbar spine function, lumbar muscle endurance, and serum inflammatory factor levels after treatment were compared between the two groups. Results The total effective rate of the research group was 96.67%, which was higher than 83.33% of the control group (P < 0.05). After treatment, the Visual Analogue Scale (VAS) score of the research group was lower than that of the control group, and the Japanese Orthopaedic Association (JOA) score was higher than that of the control group (P < 0.05). The lumbar muscle endurance test time was prolonged in both groups after treatment, and was longer in the research group than that of the control group (P < 0.05). After treatment, the serum levels of tumor necrosis factor-α (TNF-α) and interleukin-8 (IL-8) in the research group were lower than those in the control group(P < 0.05). The total incidence of adverse reactions in the control group was 30.00% (18/60), and 23.33% (14/60) in the research group, but no statistically significant difference was found (χ²=0.682, P=0.409). Conclusion The combination of hot compress by aconite tincture and medium-frequency electrotherapy has significant therapeutic effects in patients with chronic non-specific low back pain, which can significantly reduce the pain symptoms ofthe lumbar spine, improve lumbar spine function, and reduce the level of inflammatory factors.

Objective:To investigate the status of iodine deficiency disorders in children and pregnant women in Ganzhou City, Jiangxi Province, and to provide a basis for scientific iodine supplementation and adjustment of prevention and control strategies.Methods:According to the requirements of the National Iodine Deficiency Disorders Surveillance Program (2016 Edition), iodine deficiency disorders surveillance was carried out in 18 counties (cities, districts) under the jurisdiction of Ganzhou City from 2018 to 2022. Edible salt and urine samples taken from children aged 8 to 10 and pregnant women were collected to detect salt and urine iodine levels. At the same time, B-ultrasound method was adopted to measure children's thyroid volume, and the goiter rate was calculated.Results:From 2018 to 2022, a total of 27 075 edible salt samples were collected from key populations (children aged 8 - 10 and pregnant women), with a median salt iodine of 25.00 mg/kg and a qualified iodized salt consumption rate of 96.24% (26 057/27 075). The difference in the qualified iodized salt consumption rate among key populations in different years was statistically significant (χ 2 = 29.09, P < 0.001). A total of 18 061 urine samples were collected from children, with a median urine iodine of 192.10 μg/L, there was a statistically significant difference in the urine iodine level of children between different years ( H = 82.59, P < 0.001). A total of 9 014 urine samples were collected from pregnant women, with a median urine iodine of 177.20 μg/L, there was a statistically significant difference in urine iodine level of pregnant women between different years ( H = 78.78, P < 0.001). A total of 8 621 children's thyroid glands were examined, including 34 cases of goiter, with a goiter rate of 0.39%, and the goiter rate showed a decreasing trend year by year (χ 2trend = 11.09, P < 0.001). Conclusions:From 2018 to 2022, the iodine nutrition of children and pregnant women in Ganzhou City is at an appropriate level, the consumption rate of qualified iodized salt (> 90%) and the children's goiter rate (< 5%) met the national iodine deficiency disorders elimination standards. Ganzhou City continues to maintain the status of eliminating iodine deficiency disorders.

Objective:To summarize the clinical-imaging features and prognoses of acute encephalopathy combined with biphasic seizures and late reduced diffusion (AESD).Methods:A retrospective analysis was performed. The clinical and imaging data and follow-up results of 8 children with AESD, admitted to Departments of Neurology and Rehabilitation Medicine, Wuhan Children's Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology from January 2020 to April 2022 were collected.Results:The antecedent infections in 8 children were predominantly gastrointestinal and respiratory tract infections and convulsive seizures occured within 24 h of fever. The clinical presentation was biphasic: 3 had sustained convulsive state in the first phase of the disease, and all showed cluster seizures with worsening impairment of consciousness in the second phase of the disease, including 4 with involuntary movements during recovery from the disease. Seven children required admission to Intensive Care Unit, 4 required tracheal intubation for assisted ventilation, and 1 was combined with septic shock. Brain MRI findings of 8 children were "bright tree" in the second phase of the disease, including bilateral symmetrical and bilateral asymmetrical involvements, with diffuse and focal involvements. All 8 children were treated with glucocorticoids and/or gammaglobulin, and 2 were given mild hypothermia brain protection. Follow-up was performed for more than 3 months, and brain MRI indicated cerebral atrophy, subdural effusion and cerebral malacia. All the 8 children survived with different degrees of sequelae. Two children had Extended Glasgow Outcome Scale scores of 4, 4 had scores of 5, and 2 had scores of 7.Conclusion:AESD is a special clinical-maging syndrome, characterized by biphasic seizure and "bright tree" on head MRI; the survival is high, but neurological sequelae of different degrees are easily left behind.

Critical ultrasonography is widely used in ICU and has become an indispensable tool for clinicians. However, besides operator-dependency of critical ultrasonography, lack of standardized training mainly result in the physicians′ heterogenous ultrasonic skill. Therefore, standardized training as well as strict quality control plays the key role in the development of critical ultrasonography. We present this quality control standards to promote better development of critical ultrasonography.

Genomic disorders caused by pathogenic copy number variation (pCNV) have proven to underlie a significant proportion of birth defects. With technological advance, improvement of bioinformatics analysis procedure, and accumulation of clinical data, non-invasive prenatal screening of pCNV (NIPS-pCNV) by high-throughput sequencing of maternal plasma cell-free DNA has been put to use in clinical settings. Specialized standards for clinical application of NIPS-pCNV are required. Based on the discussion, 10 pCNV-associated diseases with well-defined conditions and 5 common chromosomal aneuploidy syndromes are recommended as the target of screening in this consensus. Meanwhile, a standardized procedure for NIPS-pCNV is also provided, which may facilitate propagation of this technique in clinical settings.
Aneuploidy ; Cell-Free Nucleic Acids/genetics* ; Consensus ; DNA Copy Number Variations ; Female ; High-Throughput Nucleotide Sequencing ; Humans ; Pregnancy ; Prenatal Diagnosis

Objective:To investigate the clinical features and prognosis of acute necrotizing encephalopathy (ANE) in children.Methods:The clinical data and follow-up information of 41 pediatric patients with ANE treated in Wuhan Children′s Hospital, Tongji Medical College, Huazhong University of Science & Technology from January 2014 to September 2019 were retrospectively reviewed.Results:The 41 patients included 23 males and 18 females with the onset age of (4.4±3.2) years.The main prodromal symptoms were gastrointestinal (20/41 cases, 48.8%) and respiratory infections (19/41 cases, 46.3%). Acute encephalopathy progressed rapidly following the prodromal infection [29 cases (70.7%) ≤2 days], and patients had clinical manifestations of coma (32/41 cases, 78.0%), convulsion (32/41 cases, 78.0%), multiple organ dysfunction (27/41 cases, 65.9%), shock and disseminated intravascular coagulation were rarely occured, and 28 cases (68.3%) were admitted to intensive care unit for treatment.Brain magnetic resonance imaging (MRI) showed lesion involving thalamus (41/41 cases, 100.0%), periventricular white matter (34/41 cases, 82.9%), brainstem (31/41 cases, 75.6%), basal ganglia (26/41 cases, 63.4%), cerebral cortex and subcortex (20/41 cases, 48.8%) and cerebellum (18/41 cases, 43.9%). The common presentations on the apparent diffusion coefficient mapping of brain MRI were " tricolor pattern" or " bicolor pattern" of the thalamus.During follow-up (≥ 6 months), MRI showed that hemorrhage, cystic degeneration and atrophy changed dynamically with the progression of ANE.All cases were treated with glucocorticoids, 38 cases(92.7%) with intravenous immune globulin.Seven cases (17.1%) were died and the 34 survivors had different degrees of neurological dysfunction.Conclusions:ANE in children is a distinctive type of clinicoradiologic syndrome with rapid progression and various presentations.Brain MRI has typical imaging characteristics and dynamically indicates the progression of this disease.The treatment options are still limited, the prognosis is poor and the survivors are often with neurological dysfunction.

Objective:To describe the features of point-of-care cardiopulmonary ultrasound (POCUS) in the critically ill patients and analyze the independent factors associated with treatment changes after POCUS assessment.Methods:This was a prospective multicentric observational study from January to December 2018 in 13 intensive care units (ICU) in China. Consecutive patients admitted to the ICU were enrolled, POCUS were performed within the first 24 h of admission. The POCUS parameters included acute or chronic cardiac abnormality, diameter of inferior vena cava (IVC) at end-expiration, right ventricular systolic function, systolic and diastolic function of left ventricle (LV) and lung ultrasound score. The general features of patients and performers were recorded. Based on the treatment proposed by the performer before and after POCUS assessment, the patients were divided into treatment changed and unchanged groups. Factors associated with treatment changes were identified by multiple logistic regression analysis.Results:Totally 1 913 patients were enrolled including 322 (16.8%) patients with shock, 638 (33.3%) patients with respiratory failure, 139 (7.3%) patients with both shock and respiratory failure and 814 (42.6%) perioperative patients. POCUS had contributed to treatment changes in 1 204 (62.9%) patients, including 867 (72.0%) cases involved fluid management. Univariate analysis showed that there were significant differences in general characteristics of patients, performers and POCUS parameters between groups(all P<0.05). Logistic regression analysis showed that independent factors of treatment changes included ministry of education or university affiliated teaching hospitals (vs.general hospitals, OR=1.891, 95% CI=1.314-2.722, P<0.001 and OR=1.644, 95% CI=1.152-2.347, P=0.006 separately), middle and senior title performers (vs.primary title, OR=2.112, 95% CI=1.358-3.284, P=0.001, OR=3.271, 95% CI=2.129-5.025, P<0.001 separately), mechanical ventilation (vs.without, OR=0.488, 95% CI 0.381-0.626, P<0.001), IVC diameter ≤1 cm (vs.1-2 cm, OR=0.317, 95% CI 0.231-0.434, P<0.001), LV ejecting fraction <50% (vs.≥50%, OR=0.328, 95% CI=0.210-0.512, P<0.001), lung ultrasound score of 6-12 and >12 points(vs.score ≤ 6 points, OR=0.237, 95% CI=0.178-0.315, P<0.001 and OR=0.619, 95% CI=0.457-0.837, P=0.002 separately). Conclusions:POCUS assessment contributes to treatment changes, most of which involves fluid management strategy, in 62.9% critical patients. The independent influencing factors associated with POCUS parameters includes IVC diameter at end-expiratory, LV systolic function and lung ultrasound score. The performers′ title and hospital grade also have a noticeable effect.