Diagnostic status and epidemiological characteristics of community-acquired bacterial meningitis in children from 2019 to 2020: a multicenter retrospective study.

Community-acquired bacterial meningitis (CABM) is the main cause of morbidity and mortality in children. The epidemiology of CABM is regional and highly dynamic. To clarify the diagnostic status and epidemiological characteristics of children with CABM in this region, and pay attention to the disease burden, so as to provide evidence for the prevention and treatment of CABM. By retrospective case analysis, the clinical data of 918 CABM cases in children aged 0-14 years in Zhejiang Province from January, 2019 to December, 2020 were collected. The etiological diagnosis rate of CABM in children was 23.1%, the annual incidence rate 4.42-6.15/100,000, the annual mortality rate 0.06-0.09/100,000,the cure and improvement rate 94.4%, and the case fatality rate 1.4%. The total incidence of neuroimaging abnormalities was 20.6%. The median length of stay for CABM children was 20(16) days, with an average cost of 21,531(24,835) yuan. In addition, the incidence rate was decreased with age. Escherichia coli(E.coli) and group B Streptococcus agalactiae(GBS) were the principal pathogens in CABM infant<3 months(43.3%, 34.1%), and Streptococcus pneumoniae(S. pneumoniae) was the most common pathogen in children ≥ 3 months(33.9%). In conclusion, the annual incidence and mortality of CABM in children aged 0-14 years in Zhejiang Province are at intermediate and low level. The distribution of CABM incidence and pathogen spectrum are different in age; the incidence of abnormal neuroimaging is high; and the economic burden is heavy.

Systematic evaluation of guidelines for laparoscopic surgery and endoscopic management for colon cancer.

PURPOSE: To understand the methodological quality of recent guidelines for laparoscopic surgery and endoscopic management for colon cancer and to analyze the heterogeneity and possible reasons for the main recommendations. METHODS: A systematic and comprehensive search of databases and relevant websites was conducted to collect guidelines for laparoscopic surgery for colon cancer in the last 10 years that met the inclusion criteria. The AGREE II manual was used to evaluate the included guidelines and to assess and analyze the heterogeneity and reasons for key recommendations about the surgery. RESULTS: A total of fifteen guidelines were included in this study. Only two guidelines had an overall score greater than 60% and were recommended for clinical use. Eleven guidelines had an overall score of 30-60%, and two guidelines had an overall score of less than 30%. Further analysis of the reasons for heterogeneity in the guideline recommendations and evidence was performed for nine guidelines. This study found that only 36.1% of the evidence levels recommended in the guidelines were high. Significant heterogeneity exists in the main recommendations, mainly because the relevant content is not mentioned or described in detail. CONCLUSION: The quality of guidelines for laparoscopic colon cancer surgery is variable, and there is significant heterogeneity among key recommendations. And the level of evidence underlying the recommendations was generally not high. Further guideline updates should address the causes of the above heterogeneity.

[Relationship of epidermal growth factor receptor in lung development].

The epidermal growth factor receptor (EGFR), a transmembrane protein receptor, is a member of ErbB family with signal-transducing tyrosine kinase activity. After combined with the ligand, EGFR homologous or heterologous dimers are formed to induce intracellular signal transduction, activate downstream signal transduction pathways, and then produce a series of biological effects. RAF/MEK/RAS/ERK pathway is relevant to cell proliferation, differentiation and apoptosis; while PDK1/AKT /PI3K pathway is involved in cell migration and adhesion. EGFR can promote the maturity of pulmonary type II epithelial cells and the synthesis and secretion of pulmonary surfactant. EGFR shows the effect on mammal lungs in a time-space and dose-dependent manner. The down-regulated expression of it will lead to immature lung development, while the over-expression can promote the cell proliferation, invasion and metastasis of the lung cancer cells. This paper reviewed advances in the study for EGFR and its signal pathway, as well as the relationship among EGFR, atelectasis and lung cancer.

[Viral etiology of acute respiratory infection in children from Wenzhou between 2007 and 2008].

OBJECTIVE: To study the viral etiology of acute respiratory infection (ARI)in children from Wenzhou, Zhejiang between 2007 and 2008. METHODS: The nasopharyngeal aspirate samples were obtained from 5 097 hospitalized children with ARI. Seven common respiratory viruses, including respiratory syncytial virus (RSV), influenza virus A and B, parainfluenza viruses 1, 2 and 3 and adenovirus, were detected using direct immunofluorescence. RESULTS: Viral agents were identified in 2 209 cases (43.3%).Of the 2 209, RSV was the most frequent (78.1%), followed by parainfluenza 3 (12.4%), influenza virus A (3.0%), adenovirus (2.8%), parainfluenza 1 (1.7%), influenza B (0.5%) and parainfluenza 2 (0.3%). The infants at ages of <3 months and <6 months had higher detection rate of viruses (53.6% and 49.2%, respectively). A highest detection rate of viruses was found in winter. CONCLUSIONS: RSV is the leading pathogen of ARI in children from Wenzhou, Zhejiang between 2007 and 2008. The children at age of less than 6 months are susceptible to respiratory viruses. The viral activity peaks in winter.