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.

Objective:To investigate clinical manifestations and dermoscopic characteristics of lichen planus-like keratosis (LPLK) .Methods:Clinical data were collected from 21 patients with LPLK who visited Shanghai Skin Disease Hospital and underwent both dermoscopic and histopathological examinations from January 2017 to September 2019, and clinical and dermoscopic features were retrospectively analyzed.Results:These patients were aged 64.69 ± 13.29 years, and the ratio of males to females was 1∶2. Skin lesions were located on the face of 18 cases and legs of 3 cases, and were red/violaceous in color in 7 cases, reddish-brown in 5, brown/gray in 8, and brown/reddish in 1. There were 3 types of skin lesions, including plaque-like type in 10 cases, flat pigmented patch type in 6, and flat erythema-like type in 5. As dermoscopy showed, 12 cases were non-pigmented LPLK, and 9 were pigmented LPLK. Pigment granules were found in 13 lesions, and there was no significant difference in the prevalence of pigment granules between pigmented and non-pigmented LPLK ( P=0.07) ; pigment granules were often diffusely distributed (9/13) , and the diffuse distribution pattern was common paticularly in pigmented LPLK (8/9) ; locally distributed pigment granules were found in 4 cases of non-pigmented LPLK. Coarse pigment granules were seen in 10 cases (10/13) , including 8 of pigmented LPLK and 2 of non-pigmented LPLK, and the prevalence rate of coarse pigment granules significantly differed between the pigmented LPLK and non-pigmented LPLK groups ( P=0.002) . Moreover, special distribution patterns of pigment granules included the annular granular pattern (8/13) and peppered pattern (7/13) , and no significant difference was observed in the prevalence of the 2 special distribution patterns between the pigmented LPLK and non-pigmented LPLK groups (both P > 0.05) . Scales were seen in 13 cases (13/21) , and vascular structures in 7 (7/21) , and there was no significant difference in the prevalence of the 2 structures between the pigmented and non-pigmented LPLK groups ( P=0.67, 0.16, respectively) . Conclusions:LPLK mostly occurs on the face, and manifests as solitary red, reddish-brown or brownish-gray plaques or patches, whose surfaces may be covered with scales. The characteristic dermoscopic feature of LPLK is the presence of pigment granules, which are coarse, often diffusely distributed, and commonly observed in pigmented LPLK.

Objective : To learn the awareness of chronic diseases prevention and control and its influencing factors among high school students in regions inhabited by ethnic groups,so as to strengthen the prevention of chronic diseases among adolescents in these regions. Methods: Totally 1 050 high school students in Tuquan County,Hinggan League,Inner Mongolia were selected by cluster sampling method. The general information,family factors,attitude to learning,psychological factors,behavioral styles and awareness of chronic diseases prevention and control were investigated,and the influencing factors for the awareness were analyzed by multivariate logistic regression model. Results: There were 1 001 valid questionnaires recovered,with a response rate of 95.33%. There were 685 Han students,accounting for 68.43%,241 Mongol students,accounting for 24.08%,and 75 students with other ethnic minorities,accounting for 7.49%. The average awareness rate of chronic diseases prevention and control was 53.25%;the awareness rates of hypertension prevention measures,smoking and drinking hazards,food susceptible to aflatoxin pollution and high cholesterol food were high,all more than 70%;while the awareness rates of long-term high lipid hazards,high blood pressure diagnosis standard and diabetes symptoms was low,all less than 40%. There was no significant difference in the awareness rate of chronic diseases prevention and control among different nationalities（P>0.05）. The results of multivariate logistic regression analysis showed that the students who were female（OR=1.309,95%CI：1.008-1.700）,had high achievement（OR=1.509,95%CI：1.055-2.159）,and thought exams were important（OR=1.570,95%CI：1.204-2.046）were more likely to have high awareness,while the students who spent five to less than eight hours a day on screens（OR=0.514,95%CI：0.335-0.789）were less likely to have high awareness. Conclusions The awareness rate of chronic diseases prevention and control of high school students in Tuquan County is 53.25%,and there is no significant difference between Mongol and Han students. Gender,academic performance,attitude to examination and time spent on screens can affect the awareness rate.

Objective: To learn the trend of death from injury in Fengcheng residents from 2009 to 2017 and predict from 2018 to 2021,in order to provide the basis for injury prevention and control. Methods: All cause of death monitoring data and demographic data of Fengcheng from 2009 to 2017 were collected,injury mortality,standardized mortality and annual change percentage（APC）were calculated,and GM（1,1）was established to predict the injury mortality from 2018 to 2021. Results: From 2009 to 2017,the injury death rate in Fengcheng was 52.68 per 100 000 and the standardized death rate was 46.50 per 100 000. The APC of the total standardized mortality was -5.10%,showing a decreasing trend year by year（P<0.05）. The injury mortality and standardized mortality in males were higher than that in female（both P <0.05）. The highest injury mortality lay in the group aged 65 years and above,which was 108.13 per 100 000. The top five causes of injury death were traffic accident,suiside,poisoning,fall and drowning,their mortality rate were 27.03 per 100 000,7.84 per 100 000,5.62 per 100 000,5.08 per 100 000 and 2.36 per 100 000,respectively. The mortality of traffic accident in males and suicide in females showed a decreasing trend（P<0.05）,while the mortality of fall showed an increasing trend（all P<0.05）. The model of GM（1,1）predicted that the injury mortality from 2018 to 2021 would be 48.00 per 100 000,44.15 per 100 000,40.61 per 100 000 and 37.35 per 100 000,which showed a decreasing trend year by year. Conclusion The injury death rates in Fengcheng dropp year by year from 2009 to 2017 and will probably keep dropping from 2018 to 2021. Men and people aged 65 years or over are at high risk of death from injury,traffic accident and fall are the main causes.

Objective : To study the association between bleeding sites and the quality and quantity of sleep in patients with cerebral hemorrhage. Methods: The hospitalized patients with cerebral hemorrhage in Liaoning Thrombus Hospital from September 2017 to June 2018 were included. Information about gender,age,history of smoking and alcohol,previous history and the sites of cerebral hemorrhage was collected;the levels of blood glucose and lipids were measured;the quantity and quality of sleep were evaluated by Pittsburgh sleep quality index（PSQI）. A logistic regression model was used to analyze the association between cerebral hemorrhage and sleeping status. Results : A total of 249 patients with cerebral hemorrhage were enrolled. The main bleeding sites of the patients were basal ganglia and thalamus,accounting for 59.84% and 22.89%. The proportions of the patients with sleep duration less than 7 hours,7 to 8 hours and more than 8 hours were 23.29%,41.37% and 35.34%. The proportion of the patients with good sleep was 76.31%. The proportions of the patients with or without noon break were 36.55% and 63.45%. The results of multivariate logistic regression analysis showed that taken basal ganglia hemorrhage as the reference group,thalamic hemorrhage was associated with poor sleep quality（OR=2.387,95%CI：1.144-4.985）;lobar hemorrhage was associated with frequent noon break（OR=13.027,95%CI：1.545-109.849）;brain stem hemorrhage was associated with short sleep duration（OR=9.434,95%CI：1.387-64.173）. Conclusion Short sleep duration may be a risk factor for brain stem hemorrhage,poor sleep quality may be a risk factor for thalamic hemorrhage,and frequent siestas may be a risk factor for lobar hemorrhage.