Good sleep is essential for children′s physical and mental health, growth, and development.Adequate and high-quality sleep positively impacts children′s quality of life, memory, learning, attention, mood, and behavior.Children of different ages have different sleep needs.Children have various sleep problems in different cultures.Therefore, it is significant to guide children to get healthy sleep by popularizing the sleep problems of Chinese children of all ages and in all dimensions.Based on China′s social and cultural background, this paper summarizes the contents related to children′s sleep physiology, good sleep habits, common sleep problems, sleep apnea disorders, hypnagogic sleep, narcolepsy, insomnia, and other issues that interfere with children′s sleep.Chinese sleep experts summarize and interpret the 100 sleep health problems of children that medical workers and parents are most concerned about.To promote children′s sleep health and popularize solutions to sleep problems.

Objective: To understand the status of childcare center disinfection around the COVID-19 pandemic, the needs of professional technical support, so as to give advice for improvement measures. Methods: Using multi stage stratified sampling method, one was selected from each area of northern and southern Anhui Province, with 3 counties/districts selected from each city. A total of 54, 58, 60 childcare institutions were selected. A questionnaire survey, as well as on site visits and data check were administered in these childcare centers in Anhui Province were implemented. Information regarding the three stage disinfection work from 2019 to 2022 and technical support needs were collected. Results: A total of 54, 58, 60 childcare centers were investigated in 2019, 2020 and 2021-2022. Most of the childcare centers recorded disinfection work (96.3%, 96.6%, 98.3%), while few of them ( 26.4% , 26.3%, 58.3%) monitored disinfection factor intensity. The implementing rate of disinfection effect evaluation was 68.3% at the stage of normal prevention and control, the highest demand rate for professional technical support was guidance and training ( 95.0% ), and the highest demand rate for training content was disinfectant preparation method (81.7%). There were significant differences in the rate of disinfection tableware room allocation (A: 93.3%, B: 70.0%), and the rate of disinfection effect evaluation among different cities (A: 53.3%, B: 83.3%)( χ 2=6.24, 5.46, P <0.05). Conclusions From 2019 to 2022, childcare center disinfection has significantly improved, however, disinfection factor intensity monitoring and disinfection effect evaluation are neglected during the stage of normal prevention and control. The demand for professional technical institutions to provide disinfectant preparation method guidance and training is high.It is suggested to strengthen the monitoring and evaluation of disinfection and related technical guidance.

Objective:To investigate the correlation between serum indexes of children with simple obesity in Xinjiang area and the renin-angiotensin-aldosterone (RAS)system, thus providing evidence to clarify the pathogenesis of childhood obesity.Methods:It was a cross-sectional study involving 41 children with simple obesity (case group) and 41 age-matched healthy children (control group) through the cluster random sampling in Tacheng area of Xinjiang.The mean age of in both groups was (10.04±1.66) years and (10.12±1.68) years, respectively.Serum adipokines, insulin level and RAS indexes between groups were compared by the Student′s t test.The correlation between serum adipokines and RAS activity in children with simple obesity was assessed by the Pearson′ s correlation test. Results:The serum adiponectin(APN) level[(7.90±1.96) μg/L vs.(8.87±1.61) μg/L, P=0.017]was significantly lower in case group than that of control group, while leptin[(6.81±1.88) ng/L vs.(5.87±1.79) ng/L, P=0.023]and resistin levels[(12.61±3.63) ng/L vs.(10.18±3.07) ng/L, P=0.002] were significantly higher.RAS indexes, including the renin[(35.78±10.08) ng/L vs.(29.24±10.69) ng/L, P=0.007], aldosterone (ALD)[(106.90±20.18) ng/L vs.(97.68±17.60) ng/L, P=0.028] and angiotensin-Ⅱ (Ang-Ⅱ)[(55.65±10.37) ng/L vs.(48.78±9.26) ng/L, P=0.002] levels were significantly higher in case group than those of control group.In the case group, serum APN level was negatively correlated with renin, ALD and Ang-Ⅱ levels ( r=-0.646, -0.752, -0.839, all P<0.001), while serum leptin and resistin levels were positively correlated with renin, ALD and Ang-Ⅱ levels ( r=0.940, 0.871, 0.875; 0.877, 0.892, 0.914, all P<0.001). Conclusions:Serum adipokine in school-age children with simple obesity in Xinjiang area is dysregulated, which interferes with the activity of RAS.

Group A Streptococcus (GAS) is a very important pathogen, especially for children.On a global scale, GAS is an important cause of morbidity and mortality.But the burden of disease caused by GAS is still unknown in China and also has not obtained enough attention.For this purpose, the expert consensus is comprehensively described in diagnosis, treatment and prevention of GAS diseases in children, covering related aspects of pneumology, infectiology, immunology, microbiology, cardiology, nephrology, critical care medicine and preventive medicine.Accordingly, the consensus document was intended to improve management strategies of GAS disease in Chinese children.

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 screen differential metabolites and metabolic pathways in urine of adult patients with Kashin-Beck disease (KBD), so as to provide scientific basis for finding specific biomarkers and pathogenesis of KBD.Methods:In Yongshou County, the KBD area in Shaanxi Province, adult KBD patients were selected as the case group, and healthy people without clinical symptoms of KBD were selected as the control group in the same disease area. The subjects' fasting mid-morning urine was collected, and liquid chromatography-mass spectrometry (LC-MS) technology was used to detect small-molecule metabolites in the urine. Multivariate statistical analysis [partial least square discriminant analysis (PLS-DA)] and comparison with KEGG and human metabonomics database (HMDB) were used to identify and screen differential metabolites and metabolic pathways in KBD patients.Results:A total of 58 subjects were included, 39 cases in the case group, including 23 males and 16 females; the age was (61.2 ± 7.8) years old; the body mass index was (22.7 ± 6.5) kg/m 2. There were 19 cases in the control group, including 10 males and 9 females; the age was (50.0 ± 9.0) years old; the body mass index was (24.3 ± 5.5) kg/m 2. Three first-order differential metabolites (HT-2 toxin, T-2 tetraol and seleno-adenosine selenomethionine) were identified and screened, which were highly related to the pathogenesis of KBD, and all were down-regulated. There were 38 second-order differential metabolites, among them, 10 were up-regulated and 28 were down-regulated. Nine differential metabolic pathways were screened, mainly involving amino acid metabolism, lipid metabolism and energy metabolism. Conclusions:The urine metabolism profiles of adult KBD patients and healthy people are significantly different, mainly involving amino acid metabolism, lipid metabolism and energy metabolism. The first-order differential metabolites HT-2 toxin, T-2 tetraol and seleno-adenosine selenomethionine are highly correlated with the pathogenesis of KBD.

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 compare the reliability between infrared thermal imaging technology(IRT) and colour Doppler ultrasound (CDU) in the detection of perforators for anterolateral femoral perforator flap(ALTPF).Methods:From September, 2017 to September, 2019, a total of 25 patients(16 males and 9 females, aged 12-53 years old with an average age of 38.7 years old) underwent ALTPF surgery for the purpose of resurfacing and reconstruction. All patients had pedicled or free ALTPF sized from 5.0 cm×8.0 cm to 7.5 cm×30.0 cm. Among all cases, 21 received free flaps and 4 received pedicled flaps. All patients underwent routine IRT and CDU examinations to locate the perforators preoperatively.Results:Of the 25 patients, CDU detected 53 perforators and IRT detected 51 "hot spots". There were 50 "hot spots" that corresponded to the findings of CDU with a κ index at 0.712( P<0.05), representing a high degree of consistency. The sensitivity and specificity were 94.3% and 85.7%, respectively. Conclusion:IRT has a high consistency in detecting perforators for ALTPF in comparison with CDU. IRT features portable, low cost, non-invasive, and easy to operate. At the same time, IRT has advantages in the patients who have thin subcutaneous tissue. With higher accuracy, IRT is expected to become an important part of preoperative perforator navigation.

Objective To evaluate the protective effect of dietary n-3 polyunsaturated fatty acids (PUFA) on ultraviolet-induced acute skin photodamage in SKH-1 hairless mice,and to explore its mechanism.Methods Totally,50 SKH-1 hairless mice were equally divided into 5 groups to be fed with forages with the ratios of n-3 PUFA to fatty acid being 0,12.5％,25％,50％ and 100％ respectively (control group,12.5％,25％,50％ and 100％ n-3 PUFA groups).On day 8 after feeding,the back of mice in the 5 groups were irradiated by a solar ultraviolet simulator at 2 minimum erythema doses (MED) to establish an acute photodamage model.After 24 hours,cutaneous reactions on the back of mice were observed by naked eyes and dermoscopy,and skin biopsy specimens were subjected to hematoxylin and eosin (HE) staining for observing the epidermal structure,intercellular edema,inflammatory cell infiltration and photodamaged cells.Immunohistochemical staining was performed to determine the expression of inflammatory cytokines including interleukin-1 beta (IL-1β),IL-6 and tumor necrosis factor alpha (TNF-α),and enzyme-linked immunosorbent assay (ELISA) to measure the protein expression of the above 3 inflammatory cytokines in the tissue homogenate.Results Compared with the control group and 12.5％ n-3 PUFA group,the 25％,50％ and 100％ n-3 PUFA groups all showed a milder degree of acute skin photodamage,epidermis thickening,intercellular edema,and inflammatory cell infiltration.The number of photodamaged cells per high-power field (× 100) was significantly higher in the control group and 12.5％ n-3 PUFA group (17.50 ± 4.93,14.25 ± 1.71,respectively) than in the 25％,50％ and 100％ n-3 PUFA groups (6.50 ± 1.73,4.75 ± 2.06,4.50 ± 1.73,respectively;F =19.1,P ＜ 0.001).Immunohistochemical results showed that IL-1β,IL-6 and TNF-α were expressed to different extents in the epidermis and dermis among the 5 groups at 24 hours after ultraviolet radiation.Compared with the control group and 12.5％ n-3 PUFA group,the 25％,50％ and 100％ n-3 PUFA groups showed significantly lower expression of the above 3 inflammatory cytokines (P ＜ 0.001).ELISA revealed that the levels of IL-1β,IL-6 and TNF-α in the skin tissues of the mice were significantly lower in the 25％,50％ and 100％ n-3 PUFA groups than in the control group and 12.5％ n-3 PUFA group (P ＜ 0.05).Conclusions When the ratio of n-3 PUFA to fatty acid reaches more than 25％,dietary n-3 PUFA has protective effects against ultraviolet-induced acute photodamage,.Moreover,the higher the content of n-3 PUFA is,the stronger the protective effect is.It is suggested that n-3 PUFA may inhibit the inflammatory reaction through the arachidonic acid pathway.

Objective Obstructive sleep apnea hypopnea syndrome (OSAHS) is one of the common diseases in pediatrics.OSAHS morbidity getting rising recently.Parents and doctors start to pay more attention to this disease because of its severity.Researches show that it affect children development seriously,in both physiological and psychological aspects,even can responsible for suddenly death in children.In our country researches about OSAHS start late.The researches about OSAHS are getting more in recent years.This article reviews recent researches about OSAHS in global and sum up its diagnosis.