Objective: To explore the relative risks of rotavirus diarrhea after exposure to different levels of atmospheric pressure in children in Guangzhou City, so as to provide reference for improving public awareness of high atmospheric pressure exposure. Methods: The study used the China Notifiable Communicable Diseases Network System and China Meteorological Science Data Sharing Service Network to collect meteorological data and data relating to daily cases of rotavirus diarrhea in children at Guangzhou Women and Children s Medical Center from 2012 to 2020. The association between rotavirus diarrhea and atmospheric pressure was analyzed using distributed lag non linear models (DLNM). The relative risks of different sex and age sub groups exposed to different atmospheric pressures were also evaluated. Results: A total of 18 587 cases of rotavirus diarrhea were reported from 2012 to 2020, among which 11 662 cases (62.7%) were boys, and 12 582 cases (67.7%) were children aged 6 to 24 months old, which represented the highest proportion. The results of the DLNM showed that the relative risk of rotavirus diarrhea was the highest on the day of exposure to extreme high atmospheric pressure ( RR =1.50, 95% CI =1.24-1.82, P <0.05) and the effect could last for 28 days. Risk of rotavirus diarrhea was low for exposure to low pressure within 2 weeks ( P <0.05). During extremely high atmospheric pressure weather, RR was higher in girls ( RR =3.31, 95% CI =1.46-7.49， P <0.05) than that in boys ( RR =1.98, 95% CI =0.96-4.07， P >0.05). Among different age sub groups, RR was the highest in children aged 24 to 60 months after exposure to the highest level of atmospheric pressure exposure ( RR =3.36, 95% CI =1.27-8.89, P <0.05). Conclusion In Guangzhou, exposure to high pressure increases the risk of rotavirus diarrhea in children. In the future, public awareness should be raised regarding the risk after exposure to high atmospheric pressure.

Objective To explore the hospitalization time and family financial burden of children under 14 years old with severe asthma in this region. Methods Children under 14 years old with severe asthma who were admitted to our hospital from January 2017 to December 2019 as a result of an acute attack were selected in this study. Questionnaire surveys, hospital charging system, and follow-up methods were used to collect clinical data, length of hospital stay, and direct and indirect costs of the children with asthma. Stepwise regression was applied to analyze the factors influencing the total cost. Results A total of 206 children were enrolled from 2017 to 2019, including 117 males and 89 females, with an average age of (7.24±1.53) years old. The total age distribution mainly consisted of six months to 3 years old (33.01%), >3 to 4 years old (24.27%), and >6-13 years old (20.39%). The onset season was mainly autumn and winter (33.01%). The average length of hospital stay was (8.50±1.42) d. The annual average family cost was (6884.20±957.61) RMB. The length of hospital stay decreased year by year, while the total cost increased year by year (P<0.05). Multiple stepwise regression analysis showed that the length of hospitalization, antibiotic use time, and presence/absence of allergic rhinitis, pulmonary heart disease and GINA standard treatment were the related factors affecting the total cost in children with severe asthma (P<0.05). Conclusion From 2017 to 2019, the hospitalization time of children under 14 years old with severe asthma in this region decreased over time, while the total cost gradually increased. Shortening the hospitalization time, actively preventing and controlling complications, and standardizing treatment can effectively reduce the financial burden of children's families.

Objective:To investigate the value of N-terminal pro-brain natriuretic peptide (NT-proBNP) combined with bedside echocardiography in diagnosis and treatment of neonatal sepsis with cardiac dysfunction.Methods:A total of 56 children diagnosed with neonatal sepsis in the Neonatal Intensive Care Unit, Liaocheng People′s Hospital from July 2016 to July 2017 were enrolled and divided into 2 groups, namely, the cardiac dysfunction group (26 cases) and the non-cardiac dysfunction group (30 cases). Children with general infection (45 cases) hospita-lized at the same period were taken as the control group.The clinical characteristics, related laboratory indexes and prognosis were compared among 3 groups.The related factors of neonatal sepsis with cardiac dysfunction were analyzed by the multivariate Logistic regression approach, and the value of related indexes in the early prediction neonatal sepsis with cardiac dysfunction was analyzed by using the receiver operating characteristic curve (ROC). Results:The onset age of sepsis patients with cardiac dysfunction [63.0 h (30.5 h, 185.6 h)] was significantly earlier than that of the patients without cardiac dysfunction [65.0 h (34.5 h, 170.6 h)] and the control group [80.0 h (45.5 h, 202.3 h)] ( P<0.05). The main primary site of the disease was the lung, which was not statistically significant among the 3 groups ( P>0.05). The NT-proBNP level and the high sensitivity-C-reactive protein (hs-CRP)/albumin (ALB) ratio in the cardiac dysfunction group [20 230.6 ng/L (15 890.0 ng/L, 35 000.0 ng/L); 0.33(0.29, 0.81)] were significantly higher than those in the control group [7 324.5 ng/L (2 426.5ng/L, 13 890.0 ng/L); 0.06(0, 0.21)] (all P<0.05). The right ventricular diameter and the Tei index of the cardiac dysfunction group [(8.74±2.42) mm; 0.52±0.03] were significantly higher than those in the control group [(8.55±1.41)mm; 0.30±0.04], while the EF of the cardiac dysfunction group [(62.61±2.56)%] was significantly lower than that in the control group [(70.03±0.35)%] (all P<0.05). The ROC curve analysis showed that NT-proBNP and the Tei index could effectively predict sepsis with cardiac dysfunction.Specifically, NT-proBNP had a cutoff value of 12 291.5 ng/L, with sensitivity of 80%, specificity of 79%, and the area under ROC curve (AUC) of 0.81.The Tei index had a cutoff value of 0.45, with sensitivity of 74%, specificity of 77%, and the AUC of 0.78. Conclusions:NT-proBNP can be used as a marker of early cardiac dysfunction.Its combination with the Tei index of bedside echocardiography can quickly diagnose cardiac dysfunction of children with sepsis, better guide clinicians in drug use, improve cardiac function of patients and enhance the treatment effect.