Abstract As a common public health problem in society, it can seriously affect sleep, and lead to sleep structure disorder, sleep pattern changes, and sleep disturbance. Poor sleep can adversely affect the normal development of physiological, psychological, cognitive, and behavioral functions, and reduce quality of life. On the basis of summarizing the definition, classification, and epidemic status of child abuse, this paper summarizes the sleep characteristics and influencing factors of childhood abuse victims. It aims to provide a scientific basis for developing prevention and intervention measures to address sleep problems among childhood abuse victims, so as to improve sleep quality, and promote their physical and mental health.

Objective: To screen the hospitalized children with pectus excavatum for nutritional status, and to analyze the influencing factors of nutritional status, then to provide the scientific basis for comprehensive management of clinical nutrition. Methods: The body mass index (BMI) of 360 hospitalized children with pectus excavatum in Guangzhou Women and Children′s Medical Center from January 2013 to December 2017 were reviewed and compared with World Health Organization standard and the emaciation rate was calculated.The influencing factors such as CT index, age, weight, height, sex, the width of thorax and surgical treatment were analyzed with BMI. Results: Compared with the lowest standard of BMI, the whole emaciation rate of hospitalized children with pectus excavatum was 93.61% (337/360 cases): in which severe, moderate and slight emaciation were 74.17% (267/360 cases), 13.33% (48/360 cases), and 6.11% (22/360 cases), respectively.BMI was negatively related with CT index (r=-0.172, P=0.001), but positively related with age, weight, height, and the width of thorax (r=0.129, 0.342, 0.022, 0.179, P=0.014, 0.001, 0.673, 0.001). Three years after Nuss procedure, both the whole and severe emaciation rate decreased (93.62% vs. 95.74%; 65.96% vs. 78.72%), but the weight, height and BMI increased [25.5(12.5, 38.5) kg vs.17.0(10.0, 24.0) kg; 126.0(99.0, 153.0) cm vs.108.0(74.5, 143.5) cm; 14.69(12.38, 17.00) kg/m² vs. 14.36(12.17, 16.56) kg/m²], and the differences were significant (all P<0.01). Conclusions There is a high nutritional risk in hospitalized children with pectus excavatum, and the deformity severity is the main risk factor.Surgical treatment can improve the nutritional status effectively, but the malnutrition in pectus excavatum can not be corrected completely.

Objective The age and seasonal variation in children's serum 25-hydroxyvitamin D (25(OH) D] were analyzed retrospective and to provide some guides on clinical application.Methods The serum 25(OH) D level was detected by using enzyme-linked immunosorbent assay kit in 13 502 children that took health examination in Guangzhou Women and Children's Medical Center in February,march,September and October from 2009 to 2011.The cases were divided into five age groups.The average levels,deficiency and overdose of vitamin D (VD),were analyzed.Results The average 25(OH)D in serum was (80.81±42.39) nmol/L in 13 502 cases,(72.71 ± 33.47) nmol/L in Feb.and Mar.group,(89.91 ± 49.01) nmol/L in Sep.and Oct.group.There was statistically significant difference on serum 25 (OH)D level between seasons and between boys and girls for 6 years older groups.The serum 25 (OH) D levels significantly decreased with increasing age.There were statistically significant differences in serum 25 (OH) D levels and between the VD deficiency and the lack of number of cases in the 5 age groups of the two seasons.The number of VD deficiency was 482 cases (3.57％) whose 25 (OH) D ＜ 37.5 nmol/L,and 1850 cases (13.7％) whose 25 (OH) D ＜ 50.0 nmol/L.The VD deficiency in each age group was 8.19％,13.97％,37.72％,52.63％,57.92％ in Spring,and 2.38％,4.15％,10.36％,16.85％,27.47％ in Summer.The number of lack of VD was in 6 973 cases (51.64％);Excessive and poisoning of VD were 34 cases (0.25％) and 35 cases (0.26％).Conclusions Children had a relatively low level of VD in Guangzhou area,especially in the spring and school-age children with more severe VD deficiency.It is necessary to supplyVD timely in accordance with the age and season,and children were encouraged to spend more time outdoors.

Objective To investigate the infection status, serotype distribution, drug sensitivity and molecular characteristics of diarrheagenic Escherichia coli (DEC) in patients with diarrhea in Guangdong Province. Methods Fecal samples were collected, cultured and isolated by traditional methods. Suspected Escherichia coli isolates were confirmed by multiplex PCR used for detecting specific virulence genes and bio-chemical methods. Positive strains were serotyped, characterized for drug sensitivity and analyzed by pulsed-field gel electrophoresis ( PFGE). Results The total positive rate of DEC in patients with diarrhea was 6.26%. The positive rates of enteropathogenic Escherichia coli (EPEC), enterotoxigenic Escherichia coli (ETEC), enterohemorrhagic Escherichia coli (EHEC), enteroadherent Escherichia coli (EAEC) and en-teroinvasive Escherichia coli (EIEC) were 2. 47% , 1. 54% , 1. 32% , 0. 62% and 0. 09% , respectively, with infections primarily in children aged 0-<7 years. The total seropositive rate was 52. 54% , with EHEC accounting for 15. 00% . DEC showed high sensitivity to imipenem, ciprofloxacin, ceftazidime and cefo-taxime. The multidrug resistance rate of DEC was 58. 45% , with EPEC being the most serious for multidrug resistance. PFGE results showed that ETEC, EHEC, EPEC and EAEC had a high degree of polymorphism. Conclusion EPEC is the predominant type of DEC circulating in Guangdong Province. Third-generation cephalosporins are the first drugs of choice for treating infections in children. Ciprofloxacin can be used to treat adults. The problem of multiple drug resistance of DEC is severe and efforts to monitor DEC infections and drug resistance should be strengthened.

Objective To analyze the serotype distribution and antibiotic resistance characteristics of Salmonella strains isolated in Guangdong province for better understanding the condition of Salmonella infection in patients with diarrhea.Methods Fecal samples collected from patients with diarrhea in Guangdong province were used to isolate Salmonella strains.Biochemical analysis was performed to identify these isolated strains.Serotyping and antimicrobial susceptibility testing were carried out for further analysis of the isolated Salmonella strains.Results The rate of Salmonella infection was 7.64％in 2015, and the male to female patient ratio was 1.52∶1.A total of 2 377 patients of all age groups were positive for Salmonella infection and the patients aged 0-6 years accounted for 81.74％.The isolation rate of Salmonella strains in the summer and autumn was higher than that in the winter and spring (10.73％ vs 4.24％;X2=463.77, P<0.01).The Salmonella isolation rates in different areas were as follows: 16.82％ in Zhuhai, 15.85％ in Heyuan, 11.81％ in Yangjiang, 10.68％ in Jiangmen, 8.49％ in Zhongshan, 8.07％ in Maoming, 8.05％ in Jieyang, 7.35％ in Shaoguan, 6.97％ in Foshan, 6.03％ in Dongguan, 5.48％ in Guangzhou and 0.00％ in Zhanjiang.And the differences between different regions were statistically significant (X2=367.67, P<0.01).The 2 377 isolated Salmonella strains were classified into 108 serotypes except for oneSalmonella strain that could not be classified.The top four predominant serotypes were 4,5,12:i:-, Salmonella enteritidis,Salmonella stanley and Salmonella typhimurium.Most Salmonella strains were sensitive to imipenem, azithromycin, ceftazidime, cefotaxime and trimethoprim/sulfamethoxazole, but multidrug resistance was common among those strains.Conclusion Salmonella serotypes of 4,5,12:i:-and Salmonella enteritidis are the predominant pathogens causing human Salmonella infections in Guangdong province.Ceftazidime and cefotaximeare are preferred in the treatment of Salmonella infections.Surveillance for drug resistance in Salmonella should be strengthened as multidrug resistant strains have become a serious problem in Guangdong province.

Objective To prepare simulated stool specimens for proficiency testing ( PT) by mix-ing lentils with Salmonella, Shigella and Escherichia coli strains and to establish an assessment scheme for the detection of Salmonella and Shigella in clinical samples. Methods Salmonella, Shigella and Escherich-ia coli strains were respectively spiked to lentils in Cary-Blair transport medium to create simulated stool specimens. Various ratios of Escherichia coli to Salmonella strains were spiked to lentils to prepare mixed simulated stool specimens. The accuracy and stability of prepared stool samples for PT were tested in-house. Results of sample detection were collected from participating laboratories for further external quality assess-ment. Results The Escherichia coli and Salmonella strains mixed at ratios of 100 ∶ 1 to 106 ∶ 1 could be ef-ficiently isolated from the media. Enrichment was needed in order to effectively isolate Salmonella strains from the media when the ratios of Escherichia coli to Salmonella strains were 104 ∶ 1 to 106 ∶ 1. Of the16 participating laboratories, 14 laboratories (87. 5%) received a grade of“satisfactory” and the other 2 labo-ratories (12. 5%) received a grade of “mainly satisfactory”. Conclusion The simulated stool specimens and the PT procedures designed in this study were suitable for proficiency testing program on the detection of Salmonella, Shigella and other similar microbes.

To compare and evaluate the discriminatory ability and potential value of pulsed field gel electrophoresis (PF-GE) and multiple locus VNTRs analysis (MLVA) on the genotyping of Brucella ,a total of 60 strains of Brucella and three standards (16M ,544A ,1330S) were genotyped simultaneously by PFGE and MLVA .The result indicated that the similarity coefficient among the 63 isolates was from 72 .1-100 .0% by PFGE ,and could distinguish three species of B .melitensis ,B .su-is and B .abortus at the similarity level of 94 .4% .There were 14 clusters and 29 PFGE types identified by PFGE with discrim-inatory index (DI) of 0 .957 5 at the similarity level of 100% ;the similarity coefficient among the 63 isolates was from 16 .9-100 .0% by MLVA ,and could distinguish three species of Brucella at the similarity level of 52 .3% .There were 8 clusters and 47 MLVA types identified by MLVA with discriminatory index (DI) of 0 .985 2 at the similarity level of 100% .It's suggested that PFGE and MLVA could be used to distinguish three species of Brucella in the similarity coefficient of certain ,but could not effectively distinguish the type in the same species .Both of these two methods could be used for Brucella molecular typing , but MLVA is better than PFGE for its relatively higher discriminating ability .

Objective To investigate the polymorphism of Brucella melitensis biovar 3 ( B.melitensis biovar 3) strains isolated from Guangdong province .Methods PCR assays followed by agar-ose gel electrophoresis and capillary electrophoresis based on the multiple locus variable number of tandem repeats (VNTR) analysis (MLVA) were performed to analyze 43 clinic isolates of B.melitensis biovar 3 strains isolated from clinical patients in Guangdong province .Results MLVA typing showed that the simi-larities of the analyzed locus among 43 strains of Brucella ranged from 68.2%to 100%.32 genotypes identi-fied among the isolates were identical (100%similarity).27 out of 43 strains (62.8%) were single geno-types, while the other 16 strains (37.2%) belonged to 5 other genotypes with 2 to 5 strains in each of them . Conclusion B.melitensis biovar 3 isolates showed polymorphism distribution in Guangdong province as in-dicated by MLVA typing analysis .Single-genotype isolates accounted for 62.8% of all studied strains.No predominant genotype was found among all isolates .

Objective To investigate the etiological characteristics of Streptococcus pyogenes that caused scarlet fever in different periods in Guangdong province.Methods 22 isolates from different periods were analyzed through emm typing,PCR detection for super antigen genes,antibiotic susceptibility test and pulsed-field gel electrophoresis (PFGE).Results All isolates were susceptible to cefotaxim,levofloxacin and penicillin.Streptococcus pyogenes isolated after the year 2000 were 100％ resistant to erythrocin and clindamycin,but the resistant rate for strains isolated before the year 2000 was 9.1％ (1/11).There were 3 emm types indentified from 22 isolates including emm12.0 (59.09％,13/22),emm6.0 (36.36％,8/22) and emm1.0 (4.55％,1/22),which were detected in the isolates from the year 1997 and 2011,from 1978 and 1986,and from 2008,respectively.The positive rates for speA,speB,speC,speF,speG,speH,smeZ,and ssa genes detected by PCR were 54.55％,100％,100％,100％,100％,54.55％,0％,and 86.36％ respectively.Among all strains,95.45％ of the isolates carried 6 superantigen genes simultaneously.Three clusters of 10 PFGE subtypes were identified in 22 isolates.Cluster Ⅰ consisted of all strains from 1997 and one strain from 2011.Cluster Ⅱ consisted of strains isolated from 1978 and 1986.Cluster Ⅲ consisted of nine strains from 2011 and one from 2008.Conclusion S.pyrogenes isolates in Guangdong province were susceptible to penicillin but resistant to erythrocin.emm 12.0 accounted for the majority of the three types and there was a high frequency of super antigen genes.

Objective To investigate the changes of fractional exhaled nitric oxide (FENO)) and their relation with lung function in bronchial asthma.Methods FENO and forced expiratory volume in the first second (FEV1) were measured during the periods of acute onset,chronic persistence and paracmasis in 54 patients with asthma and 19 healthy persons.Results There were significant differences in the levels of FENO and FEV1 among the course of acute onset [(57.59 ± 32.24) ppb and (1.72± 0.33) L],chronic persistent course [(40.02 ± 15.68) ppb and (2.41 ± 0.23) L],paracmasis [(26.71±6.07) ppb and (2.82±0.29 )L]and control[(14.74±3.42 ) ppb and (2.93±0.13)L] (F=19.555,163.096,P＜0.01) except for the levels of FEV1 between paracmasis and control group(P＞0.05).The negative correlation between FENO and FEV1 was found in the course of acute onset(r=- 0.666,P =0.005 ),but not in the chronic persistent course ( r =- 0.288,P =0.176) and paracmasis(r=-0.246,P=0.457).Conclusions The level of FENO is increased and may be useful to evaluate control degree in patients with asthma.