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Background: Surgical site infections is the third most commonly reported nosocomial infection which has an adverse impact on the hospital as well as the patient. This study was designed to evaluate the frequency, clinical presentation, common risk factors and different organisms involved.Methods: This study was performed at NRI Medical college, Chinnakakani. This is an Observational descriptive study over a period of one year from September 2022 to September 2023. Biodata of the patients together with their clinical features, diagnosis, type of surgery performed and the development of any complications including wound infection was noted and the data analyzed.Results: Out of 1509 patients in the study, 1101 belonged to obstetrics and 408 to gynaecology surgery. The overall incidence of surgical site infection in the study was 7.9%; 86 (7.8%) in obstetrics group and 33 (8%) in gynaecology group developed infection. Age more than 50 years was found to be a risk factor for postoperative wound infection. Obesity is known to be a well-established risk factor for postoperative wound infection. It was noted that surgical site infection was more common in patients that had low haemoglobin levels pre-operatively. The increased susceptibility to infection in diabetics is an established risk factor.Conclusions: Meticulous surgical technique, proper sterilization, judicious use of antibiotics, improvement of ward environments, control of malnutrition and obesity, treatment of infective foci and diseases like diabetes helps control the morbidity of surgical wound infections.
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Objective To analyze the main factors influencing the management effect of rural epilepsy prevention and control projects in Hubei Province, and to provide reference for further improving the management effect. Methods According to the phenobarbital treatment and management plan of the rural epilepsy project, the target population was screened and reviewed, and patients who met the inclusion criteria were enrolled into the project management. Regular follow-up visits, free drug treatment, health education and other measures were carried out, and all relevant information was collected and integrated into the survey data. After the data was reviewed level by level, SPSS20.0 software was used for statistical analysis. Results From January 1, 2015 to December 31, 2020, among patients treated and managed with phenobarbital in 6 project counties, 1430 patients were treated and managed for more than 1 year, of whom 1119 (78.25%) had no seizures or had more than 75% reduction in the number of seizures during the observation period. Compared with other age groups, the age group of 65 years and above had the highest markedly effective/effective ratio (95.77%). From the point of follow-up, the markedly effective/effective ratio of 5 years and above was the highest (91.51%). Compared with those who received no treatment prior to enrollment and those who received regular treatment, the patients receiving informal treatment had the lowest markedly effective/effective ratio (82.43%). 1213 cases (84.83%) had good compliance during the observation period, of whom 1062 cases (87.55%) had a reduction in the number of seizures by more than 50% compared with that before treatment. Univariate analysis showed that the age of patients, the length of follow-up, the treatment status before enrollment, the average daily dose of phenobarbital and the compliance of patients all had an impact on the management effect, and the difference was statistically significant (P<0.05). Multivariate analysis showed that the markedly effective/effective rate of patients in the age group of 65 years and above was 6.749 times that of the younger age group. Receiving informal treatment prior to enrollment was a risk factor for difficult-to-control epilepsy. The markedly effective/effective rate of patients receiving informal treatment was 0.29 times that of patients never receiving treatment. Good compliance was a protective factor for epilepsy control, and the markedly effective/effective rate of patients with good compliance was 2.058 times that of patients with poor compliance. Conclusion The epilepsy prevention and management project in rural areas has a significant effect on seizure control. Early treatment, standardized treatment, and improvement of treatment compliance are effective ways to improve the management effect of epilepsy patients.
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Objective To analyze the incidence characteristics and pathogen epidemic characteristics of respiratory tract children in Chongqing Kaizhou area. Methods A total of 5 328 children admitted to our hospital from January 2019 to December 2022 were selected as the research subjects. Indirect immunofluorescence method was used to detect 8 common respiratory pathogens in the serum of the children; Using SPSS 22.0 software, analyze the incidence characteristics and pathogen prevalence of 8 pathogens in respiratory tract children. Results (1) The highest detection rate was MP (χ2=12.141, P2=7.923, P2=1.872, P2=3.928, P<0.05). Conclusion The detection rate of respiratory pathogens varies in age and sex, which is highest in spring, so pay attention to the respiratory tract infection in spring, focusing on the prevention and treatment of mycoplasma pneumoniae.
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Objective To explore the clinical value of ultrasound bronchoscopy combined with met-agenomic next-generation sequencing(mNGS)in the etiological diagnosis of pneumonia with poor absorption and dissipation.Methods The clinical data of the patients with pneumonia with poor absorption and dissipa-tion in this hospital from January 2022 to February 2023 were retrospectively collected.Among them,73 cases received the endobronchial ultrasound guided tranbronchial needle aspiration(EBUS-TBNA)and 36 cases re-ceived endobronchial ultrasound transbronchial lung biopsy using guide sheath(EBUS-GS-TBLB).The distri-bution of causes and incidence of examination related complications were analysed.Results The results of ul-trasound bronchoscopy combined with mNGS examination showed that the benign lesions accounted for 33.03％,mainly chronic inflammation(9.17％)and infectious disease(20.18％),and tuberculosis was the main cause of infectious diseases(7.34％).The malignant lesions accounted for 57.80％,mainly adenocarcinoma(28.44％).The diagnostic positive rate was 90.83％,and no definite diagnosis accounted for 9.17％.There was no statistically significant difference in the diagnostic positive rate between the patients receiving EBUS-TBNA combined with mNGS examination and the patients receiving EBUS-GS-TBLB combined with mNGS examination(94.52％vs.83.33％,P＞0.05),and there was no statistically significant difference in the inci-dence rates of complications such as less bleeding,anoxia,pneumothorax and delayed resuscitation.No serious complications such as mediastinal emphysema,large vessel injury,shock and death were observed in all pa-tients.Conclusion Ultrasound bronchoscopy combined with mNGS has the characteristics of high diagnostic positive rate and few complications in the etiological diagnosis of pneumonia with poor absorption and dissipa-tion.It can help clinical physicians clarify the diagnosis as soon as possible,and may become a new method for diagnosing respiratory system diseases in recent years.
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The clinical manifestations of colorectal polyps are consistent with the characteristics of dampness, stickiness and heaviness. The TCM constitutions in the prone population are mostly related to dampness. The pathological changes of intestinal flora imbalance, intestinal micro inflammation, neuroendocrine immune network and abnormal aquaporin in colorectal polyps are consistent with the research results of modern mechanism of dampness pathogen. This article believed that the TCM pathogenesis of colorectal polyps caused by damp pathogen is the accumulation of spleen deficiency and dampness caused by improper diet, poor emotion and other factors, and the interweaving of various diseases and pathogens to form tangible foreign bodies. According to the pathogenic characteristics of damp pathogen and the pathogenic factors of colorectal polyps, the influence of damp pathogen on the pathogenesis of colorectal polyps was discussed, in order to provide an effective TCM theoretical basis for the diagnosis and treatment of colorectal polyps in clinic.
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Objective:To establish an environmental management strategy for the prevention of ventilator-associated pneumonia from the perspective of etiological characteristics and to verify its application effect.Methods:Based on a sampling survey, this study constructed preventive management strategies for ventilator-associated pneumonia by blocking pathogen characteristics from the perspective of both colonization and infection management in patients. From July 2021 to June 2023, a non-synchronous randomized controlled study was conducted, including a control group of 59 cases and an experimental group of 57 cases from ICU of Tianjin Teda Hospital, all of them were mechanically ventilated patients. The effectiveness of the strategy was confirmed.Results:In the control group, there were 35 males and 24 females, with an average age of (46.97 ± 18.84) years. In the experimental group, there were 39 males and 18 females, with an average age of (47.49 ± 13.85) years. During the study period, there were 9 cases of ventilator-associated pneumonia (VAP) in the control group and 2 cases in the experimental group, the difference between the two groups was statistically significant (exact odds ratio=0.031). The duration of mechanical ventilation in the experimental group (122.41 ± 18.36) h, which was shorter than that in the control group (187.62 ± 18.05) h, and the difference was statistically significant ( t=19.28, P<0.05). The length of ICU stay in the experimental group was (8.38 ± 0.79) d, in the control group was (10.99 ± 1.10) d, the difference between them was statistically significant ( t=14.66, P<0.05). On the 7th day, there were 7 cases of positive pathogenic bacteria in sputum culture in the experimental group, which was significantly different from the 29 cases in the control group ( χ2=16.73, P<0.05). Conclusions:The vector management strategy for preventing ventilator-associated pneumonia by blocking etiological characteristics can reduce the incidence of VAP, shorten the duration of mechanical ventilation and ICU stay, and reduce the pathogen load in the sputum of mechanically ventilated patients on the 7th day.
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Objective:To explore the distribution characteristics and antibiotic resistance of pathogen in children with hematological disorders and cancers complicated with sepsis in pediatric intensive care unit (PICU).Methods:The clinical data of children with hematological disorders and cancers complicated with sepsis hospitalized at Shenzhen Children′s Hospital affiliated to China Medical University from January 2016 to August 2023 were retrospectively analyzed. Patients were divided into survival group and death group based on the outcome of sepsis on 28 days after diagnosis.Results:A total of 202 sepsis episodes occurred in 176 children were enrolled in this study. Among all, 144 (71.3%) cases of bloodstream infection, 59 (29.2%) cases of pulmonary infection, 21 (10.4%) cases of abdominal infection, 9 (4.5%) cases of soft tissue infection, 9 (4.5%) cases of nervous system infection, and 3 (1.5%) cases of urinary tract infection. A total of 244 pathogenic strains were identified, in which 74 (30.3%) cases were gram-positive bacteria. The top 3 pathogens isolated were Coagulase negative Staphylococcus (21 strains), Staphylococcus aureus (19 strains) and Streptococcus pneumoniae (13 strains). Gram-negative bacteria accounted for 122 (50.0%) strains, in which top 3 were Klebsiella pneumonia (33 strains), Escherichia coli (25 strains), and Pseudomonas aeruginosa (23 strains). Fungi comprised 48 (19.7%) strains:the top 3 were Candida tropicalis (14 strains), Candida albicans (10 strains), Aspergillus and Pneumocystis jirovecii (7 strains each). The incidence of Acinetobacter baumannii, Stenotrophomonas maltophilia, and Pseudomonas aeruginosa were significantly higher in death group compared to survival group[9.0%（6/67）vs. 2.3%（4/177）, χ2＝3.971 ，P＝0.046; 9.0%（6/67）vs. 1.1%（2/177）, χ2＝7.080 ，P＝0.008;16.4%（11/67）vs. 6.8%（12/177）, χ2＝5.288 ，P＝0.021]. The samples of 57 cases were simultaneously detected by both culture and metagenomic next-generation sequencing (mNGS). Pathogens were detected in 25 cases by both culture and mNGS. In 30 cases, pathogen detection were mNGS positive but culture negative. Two cases showed positive results only with culture. A total of 79 (46.8%) strains were multi-drug resistant bacteria, including 27 (34.2%) strains of gram-positive bacteria and 52 (65.8%) strains of gram-negative bacteria. A total of 174 (86.1%) children with sepsis received empirical anti-infective drugs within 24 hours of fever onset. A total of 124 (61.4%) cases were appropriately covered by the initial empirical antibiotics, while 40 (19.8%) cases were not adequately covered and 10 (5.0%) cases had incomplete coverage. Despite the inclusion of pathogenic in the coverage, resistance to initial antibiotics was observed in 22 (10.9%) cases. Fifty-one patients died. Conclusion:The predominant pathogens responsible for sepsis in PICU with hematological disorders and cancers is gram-negative bacteria, followed by gram-positive bacteria and fungi. In comparison to healthy children with sepsis, there is a higher incidence of fungal infections among hematological disorders and cancers. The proportion of multi-drug resistant bacteria infection is high. Early identification and combination of local etiological distribution and drug resistance, along with the empirical selection of appropriate anti-infection treatment strategies, can greatly enhance survival rate.
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Objective:Distribution and antibiotic resistance of pathogen isolated from children with intra-abdominal infection (IAI) associated sepsis in the intensive care unit (ICU) were analyzed to provide a reference for the empirical anti-infective treatment of IAI in children.Methods:We retrospectively analyzed the data of 116 children with culture-positive IAI-associated sepsis admitted to Children's Hospital of Zhejiang University School of Medicine from January 2019 to December 2021. Clinical isolation and drug resistance analysis were conducted based on different years of onset, locations of onset, and primary diseases.Results:A total of 186 strains of pathogens causing children with IAI-associated sepsis in ICU were collected. The distribution and antibiotic resistance of pathogen were as follows: the percentages of gram-positive bacteria, gram-negative bacteria, and fungi were 53.2%, 40.9%, and 5.9%, respectively; the top four strains were Enterococcus faecium, Escherichia coli, Klebsiella pneumoniae, and Enterococcus faecalis, accounting for 57.0% of all isolates; Enterococcus faecium(19.9%) and Enterococcus faecalis (10.2%) were the dominating gram-positive bacteria; Escherichia coli (13.4%) and Klebsiella pneumoniae (13.4%) were more common gram-negative bacteria; Fungi were dominated by Candida albicans (3.8%).Fifty-seven strains of gram-positive bacteria were detected in 61 children with infectious diseases, mainly Enterococcus faecium (28 strains). There were 53 gram-negative strains, mainly Klebsiella pneumoniae (21 strains). Thirty-two strains of gram-positive bacteria were detected in 40 children with digestive tract malformation, and Enterococcus faecalis (six strains) were the most common. There were 14 gram-negative strains, mainly Escherichia coli (six strains). In 13 children with malignant tumors of digestive system, nine strains of gram-positive bacteria were cultured, and Enterococcus faecium (four strains) was the most common. There were eight gram-negative strains, mainly Escherichia coli (four strains).In the 46 community-acquired IAI patients,30 gram-positive isolates were cultured,mainly including Enterococcus faecium (12 strains), Staphylococcus epidermidis (seven strains), and Viridans streptococci (six strains); Forty gram-negative isolates mainly contained Escherichia coli (16 strains), Klebsiella pneumoniae (14 strains), and Enterobacter cloacae (five strains). In the 70 hospital-associated IAI patients, 69 gram-positive isolates such as Enterococcus faecium (25 strains), Enterococcus faecalis (17 strains), Enterococcus gallinarum (eight strains), and Staphylococcus aureus (seven strains) were cultured;Tirty-six gram-negative isolates were dominated by Klebsiella pneumoniae (11 strains), Escherichia coli (nine strains), Pseudomonas aeruginosa (four strains), and Acinetobacter baumannii (four strains). The mixed infection rate of clinical pathogens was up to 46.6%, and the overall resistance rate was 43.4%, in which gram-negative bacteria had high sensitivity to piperacillin/tazobactam, cefoperazone/sulbactam, imipenem, and tigecycline.The detection rates of Klebsiella pneumoniae and Escherichia coli producing extended-spectrum β-lactamases were 36.0% and 24.6%, respectively, with 100% sensitivity to tigecycline. Gram-positive bacteria showed 100% sensitivity to vancomycin, linezolid, and tigecycline. Conclusion:Pathogen isolated from children with IAI-associated sepsis in ICU were dominated by Enterococcus faecium, Escherichia coli, Klebsiella pneumoniae, and Enterococcus faecalis,respectively. Before confirmation of pathogenic bacteria, antibacterial agents can be selected according to the infection type. It is important to note that a single broad-spectrum antibacterial agent or combination medication can be considered the initial empirical choice due to the large variety of pathogens, high rates of mixed infections, and high overall resistance.
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Objective:To understand the pathogen distributions of community-acquired pneumonia (CAP) in children, and to provide evidence for clinical diagnosis and treatment.Methods:The hospitalized children with CAP in Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine from January to December 2022 were selected as the research subjects. They were divided into infant group (28 d to less than one year), toddler group (one year to less than three years), preschool age group (three years to less than six years), and school age group (not less than six years) by age. According to the onset season, they were divided into spring group (February to April), summer group (May to July), autumn group (August to October), and winter group (January, November to December). Deep airway sputum samples were collected from all patients for bacterial culture identification. Respiratory viruses (influenza A virus (IVA), influenza B virus (IVB), respiratory syncytial virus (RSV), adenovirus, parainfluenza virus type 1 (PIV1), parainfluenza virus type 2 (PIV2), parainfluenza virus type 3 (PIV3)) were detected using direct immunofluorescence assay. Mycoplasma pneumoniae (MP) DNA was detected using fluorescent quantitative polymerase chain reaction, and particle agglutination was used to detect serum MP antibodies. Statistical analysis was performed using the chi-square test. Results:Among the 397 cases of CAP in children, pathogens were detected in 269 cases, with a positivity rate of 67.8%. A total of 309 pathogens were identified, including 204 strains of MP (66.0%), 60 strains of bacteria (19.4%), 42 strains of viruses (13.6%), and three strains of fungi (1.0%). Staphylococcus aureus (19 strains), Haemophilus influenzae (15 strains) and Streptococcus pneumoniae (five strains) were the predominant bacteria, while RSV (19 strains) and PIV3 (nine strains) were the main viruses. The distribution rates of MP, bacteria, and viruses showed statistically significant differences among different age groups ( χ2=99.82, 24.71 and 17.40, respectively, all P<0.05). MP infection was mainly observed in the preschool age group and school age group, and bacterial infection predominantly occurred in the infant group, and viral infection was most common in the toddler group. Among virus infected patients, RSV was detected in the toddler group and the preschool age group, while three cases of PIV3 cases were found in children over five years old. The distribution differences of MP, bacterial and viral infections between different seasons were statistically significant ( χ2=141.65, 20.44 and 31.87, respectively, all P<0.001), with a higher prevalence in winter. RSV infections demonstrated a clear seasonal trend, with 16 cases of RSV infections occurring in winter and spring. Conclusions:MP is the most frequently detected pathogen in children with CAP. Bacterial infection is the most common pathogen in infants with CAP. RSV is the most common viral pathogen, with infections concentrated in the toddler group and the preschool age group, and prevalence in winter and spring. Attention should be paid to PIV3 pneumonia in children over five years old. Rational drug use should be based on the pathogen spectrum characteristics of different seasons and age groups before selecting empirical treatment combinations.
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Infectious diarrhea is a gastrointestinal infectious disease caused by a wide range of pathogens and found throughout the world. It is one of the most important public health problems in the world and the second leading cause of death among children under five years of age. The pathogens of infectious diarrhea include viral diarrhea pathogens, bacterial diarrhea pathogens, and parasites. Viruses are the most frequent pathogens, mainly including norovirus, rotavirus, astrovirus and sapovirus. The most frequently identified organisms causing bacterial diarrhea are diarrheagenic Escherichia coli, Salmonella, Shigella, Vibrio parahaemolyticus and Campylobacter. This paper provides an overview of the epidemiological trends and changes in the pathogen spectrum of infectious diarrhea for better understanding the distribution and epidemiological features of infectious diarrhea in China, and hopes to provide reference for developing prevention and control strategies and reducing the disease burden.
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The application of Raman spectroscopy in the field of laboratory medicine is making continuous progress and development. The biosensor platform based on Raman spectroscopy provides a new means for accurate molecular diagnosis of diseases. In particular, as a fast and non-destructive detection method, surface-enhanced Raman scattering has the advantages of simple sample preparation, little interference from water and real-time detection, and shows great application potential in the field of medical examination. At the same time, with the integration of SERS and other technologies, including electrochemistry, new nano-materials, microfluidic, biochip, DNA nano-machine, artificial intelligence and machine learning, it will play a more and more important role in the field of medical laboratory. With the deepening of SERS research and the cross-integration between multiple disciplines, it will be widely used in biomedical detection and is expected to become an important technology platform for the next generation of precision diagnosis.
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[Objective]To investigate the traditional Chinese medicine(TCM)theory of diabetes mellitus associated with novel coronavirus infection based on the"theory of incubative pathogen"and to broaden the idea of prevention and treatment.[Methods]Using"theory of incubative pathogen"as the cornerstone and combining ancient and modern literature,the etiology,pathogenesis and treatment methods of diabetes mellitus associated with novel coronavirus infection are analyzed.[Results]The theory of incubative pathogen is a theory that describes that the body feels the evil within the body,and the disease develops when it is overdue,which includes the Chinese medical concept of treating the disease before it occurs in a holistic view.Diabetes mellitus associated with novel coronavirus infection is a miscellaneous disease caused by epidemic and plague evils,medicial poisons lie dormant in the body and develop over a long period of time,and its latent and recurring characteristics are common to those of incubative pathogens.The main mechanism is that dampness and poisonous evils enter the body through the mouth and nose,sink into the membranes,flow through the tri-Jiao,diffuse and do not collect,and become feverish over a long period of time and consume Qi and Yin.The pathogenesis is mainly related to pancreatic β cell injury,inflammatory factor release and steroid induction,all of which are intrinsically related to the doctrine of"theory of incubative pathogen".In the treatment of the infectious period,it is important to support the righteousness and drive away the evil,penetrate the membrane,clear the tri-Jiao,and stop the internal growth of volatile evil.As well as in the recovery period,the combination of clearing heat,benefiting Qi and nourishing Yin,and resolving phlegm and eliminating stasis was used to remove the evil at an early stage and prevent the progression of the disease.[Conclusion]Incubative pathogen is closely related to the development of diabetes mellitus associated with novel coronavirus infection.The discussion of diabetes mellitus associated with novel coronavirus infection based on the theory of incubative pathogen opens up a new way of thinking for its clinical prevention and treatment.
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[Objective]To explore the etiology,pathogenesis and clinical treatment of histiocytic necrotizing lymphadenitis(HNL)based on the insidious pathogen warm disease theory.[Methods]To analyze the etiology,pathogenesis,characteristics of symptoms and transmission of the disease in Chinese medicine,and summarize the treatment principles based on the descriptions about insidious pathogen warm disease in ancient literature and modern researches on HNL,and cite a clinical case for verification.[Results]The pathogenesis of the HNL is mainly characterized by deficient healthy Qi leading to latent evil.The specific manifestation is that exogenous evils are latent in the Moyuan,which causes Yang Qi to be blocked and depressed and turns into heat.Evil heat spreads from the Moyuan to the Shaoyang tri-Jiao,leading to the generation of phlegm,static blood,turbid evil and toxin in the body,which in turn leads to disease.In terms of treatment,supporting healthy Qi and eliminating the evil is regarded as the law of treatment,and the emphasis is eliminating the evil.Aiming at the three pathogenetic links of latent evil,depressed heat and internal production of pathological products,the following treatment principles are formulated:expelling evils from Moyuan,dredging tri-Jiao and promoting the flow of Qi to make the evil heat go out,clearing away endogenous pathological products,removing toxin and dispersing knots.The focus of supporting healthy Qi is the protection of Qi and Yin as well as recuperation after recovery,which prevents evil Qi from remaining and causing the disease to reoccur.The medical case cited was a patient with HNL treated by applying the theory of insidious pathogen warm disease.Damp-heat and toxin brewing,phlegm combined with static blood was the traditional Chinese medicine(TCM)pattern of this case.The the prescriptions were based on Shengjiang Powder combined with Sanren Decoction,and Ganlu Xiaodu Pill successively,added and subtracted according to the syndrome,and the case achieved a significant effect.[Conclusion]The effect of treating HNL based on the insidious pathogen warm disease theory is quite good,which can provide new ideas and methods for the diagnosis and treatment of HNL.
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ObjectiveTo investigate the impact of acute respiratory infections in children under 12 years old in Pudong New Area， Shanghai from 2019 to 2023. MethodsAcute respiratory infection samples of children under 12 years old from three sentinel hospitals in Pudong New Area， Shanghai from 2019 to 2023 were collected， and 42 respiratory infection pathogens， including influenza virus， adenovirus， parainfluenza virus， respiratory syncytial virus， human enterovirus/rhinovirus， human pulmonary virus， human bokavirus， coronavirus （229E， HKU1， NL63 and OC43）， and novel coronavirus， were detected with microfluidic chips. The situation of acute respiratory infections among outpatient and inpatient children in this area was analyzed for the before the implementation of non pharmacological intervention measures （2019.12‒2020.1）， during the period of non pharmacological intervention measures （2020.2‒2022.12）， and after non pharmacological intervention measures （2023.1‒2023.6）. ResultsFrom 2019 to 2023， a total of 1 770 samples were collected， and 445 pathogens were detected， with a detection rate of 25.14% （445/1 770）. The main pathogens detected during the study period were influenza virus： 8.70% （154/1 770）， respiratory syncytial virus： 4.41% （78/1 770）， human enterovirus/rhinovirus： 2.66% （47/1 770）， human adenovirus： 2.49% （44/1 770）， and parainfluenza virus： 2.20% （39/1 770）. Before the implementation of non pharmacological intervention measures， outpatients were primarily infected with influenza， parainfluenza virus， and respiratory syncytial virus， with detection rates of 8.09%， 4.49%， and 4.04%， respectively； inpatients were mainly infected with influenza， respiratory syncytial virus， and parainfluenza virus， with detection rates of 4.49%， 3.82%， and 3.15%， respectively. During the period of non pharmacological intervention measures， influenza， rhinovirus and respiratory syncytial virus were the main viruses detected in the samples of outpatient children， with detection rates of 4.04%， 3.60%， and 2.47%， respectively； inpatient samples mainly detected respiratory syncytial virus， rhinovirus， and influenza virus， with detection rates of 3.60%， 2.02%， and 1.80%， respectively. After non pharmacological intervention measures， influenza， rhinovirus and respiratory syncytial virus were the main pathogens detected in the outpatients， with detection rates of 9.89%， 2.92% and 2.02%， respectively； influenza， respiratory syncytial virus， and rhinovirus were the main pathogens detected in inpatient children， with detection rates of 6.29%， 1.57%， and 1.35%， respectively. ConclusionThe prevalence of pathogens related to acute respiratory infections in children is influenced by non pharmacological preventive measures.
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It is believed that wind pathogen is one of the core pathogenic factors of small cell lung cancer （SCLC）. The nature and pathogenic characteristics of wind pathogen are closely related to the occurrence and metastasis of SCLC. Mainly manifested as deficiency of both qi and yin， healthy qi deficiency of SCLC makes it susceptible to invasion of external wind. Simultaneously， there are internal wind pathogenesis such as yin deficiency causing wind， blood deficiency causing wind， phlegm， stasis and toxin causing wind， liver yang transforming into wind. The internal and external winds together lead to the disease. Therefore， it is proposed to treat SCLC from wind theory， that is， boosting qi and nourishing yin to extinguish wind with taizishen （Radix Pseudostellariae）， wuweizi （Fructus Schisandrae Chinensis） and others； resolving phlegm and moving stasis to dispel wind with wind-dispelling and phlegm-resolving medicinals such as jiangcan （Bombyx Batryticatus）， muhudie （Semen Oroxyli）， fangfeng （Radix Saposhnikoviae）， tianma （Rhizoma Gastrodiae）， quanxie （Scorpio） and blood-invigorating and wind-dispelling medi-cinals such as danggui （Radix Angelicae Sinensis）， chuanxiong （Rhizoma Chuanxiong） and danshen （Radix et Rhizoma Salviae Miltiorrhizae）； attacking toxin and dissipating masses to dispel wind with shuizhi （Hirudo）， dilong （Pheretima）， fengfang （Nidus Vespae）， quanxie， baihuashe （Agkistrodon）， jiuxiangchong （Aspongopus） and other drastic medicinals； calming liver and extinguishing wind to prevent brain metastasis of SCLC with Tianma Gouteng Beverage （天麻钩藤饮） modification.
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Paroxysmal atrial fibrillation can be attributed to the category of xinji （palpitations） and zhangchong （severe palpitations） in traditional Chinese medicine， and its onset has the characteristics of urgency， change， and movement， which is similar to the characteristics of diseases induced by wind pathogen. It is believed that the internal movement of wind pathogen runs through the whole course of this disease， and palpitations due to wind as the direct pathogenesis. Palpitations caused by wind pathogen showed different characteristics of deficiency and excess pattern. In the acute exacerbation period， excess wind is the main cause of disease. For excessive heat generating wind， the treatment is to clear the liver and extinguish wind by self-modified Lingxia Qinggan Decoction （羚夏清肝汤）； for blood stasis generating wind， the treatment is to remove blood stasis and stop wind by self-modified Yandan Limai Decoction （延丹理脉汤）； for phlegm-heat accumulation with wind， the treatment is to dissolve phlegm and eliminate wind by self-modified Lianlou Danxing Decoction （连蒌胆星汤）. In the prolonged recovery period， deficiency wind is more common. For stirring of wind due to yin deficiency， the treatment is to nourish yin and extinguish wind by self-modified Zaoshao Zhenzhu Deoction （枣芍珍珠汤）； for spleen deficiency generating wind， the treatment is to strengthen spleen and nourish wind by self-modified Shenying Dingji Deoction （参英定悸汤）. Clinical prescriptions closely follow the characteristics of wind， weigh the changes of deficiency and excess， tailor with the patterns， and regulate qi and blood of the zang-fu organs， in order to extinguish wind and arrest convulsion.
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ObjectiveTo explore the evolution principles of symptoms including deficiency， phlegm and blood stasis， and of the functional near-infrared spectroscopy （fNIRS） cerebral hemodynamic characteristics at various stages in patients of Alzheimer's disease. MethodsA total of 497 patients with complaint of memory loss were included， and were divided into subjective cognitive decline （SCD） group （198 participants）， mild cognitive impairment （MCI） group （228 participants） and dementia （AD） group （71 participants）. Neuropsychological evaluation， traditional Chinese medicine （TCM） syndrome investigation， and fNIRS data collection of prefrontal cortex were performed in each group. Descriptive statistics were used to analyze the distribution of TCM syndromes and the difference of TCM syndrome scores in each group； logistic regression was used to analyze the influence of TCM syndromes on the incidence of the patients； association rules were used to analyze the TCM syndromes of the patients； the hemodynamic characteristics of fNIRS in the prefrontal cortex of each group were compared. ResultsKidney essence deficiency syndrome was the dominant syndrome in all stages of AD. There were statistically significant differences in the distribution frequency of kidney essence deficiency， phlegm turbidity obstructing orifices， blood stasis obstructing collaterals， qi and blood deficiency， heat toxin in the interior， and fu-organ stagnation and turbidity retention syndromes among the three groups （P＜0.01）， and the scores of kidney essence deficiency syndrome among the three groups were statistically significant （P＜0.01）. Logistic regression analysis showed that kidney essence deficiency， and qi and blood deficiency syndromes were the main risk factors for the SCD group （P＜0.05）， phlegm turbidity obstructing orifices syndrome was the main risk factor for the MCI group （P＜0.05）， and heat toxin in the interior， and fu-organ stagnation and turbidity retention syndromes were the main risk factors for the AD group （P＜0.05）. The association rule analysis showed that the combination of kidney essence deficiency plus phlegm turbidity obstructing orifices had the highest support （33.33%） in the SCD group， and the combination of kidney essence deficiency plus blood stasis obstructing collaterals had the highest support （32.90% and 52.13%） in both the MCI and AD group. The prefrontal fNIRS results showed that the mean ∆HbO2 concentration in the left dorsolateral prefrontal cortex （LDLPFC） decreased sequentially among the three groups （P＜0.05）， and the mean ∆HbO2 concentration in the LDLPFC was negatively correlated with the MoCA score among the three groups （r = -0.142， P＜0.05）. Further analysis showed that the mean ∆HbO2 concentration in the LDLPFC of patients with kidney essence deficiency syndrome were statistically significant differences among the three groups （P＜0.05）. ConclusionKidney deficiency is the basis of the pathogenesis of AD， and the key brain area damaged is the LDLPFC. Turbid pathogens such as phlegm and blood stasis are the pathological factors that aggravate the disease， and the syndromes of AD show the evolution law of deficiency and excess as “kidney deficiency→phlegm turbidity→blood stasis→turbid toxin”. The changes in prefrontal hemodynamics based on fNIRS are consistent with the changes in the characteristics of symptoms， which can be used to assess the degree of cognitive impairment in AD patients.
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As one of the pathogenic mechanisms contained in The Inner Canon of Yellow Emperor （《黄帝内经》）， “disease with latent pathogen induced by a new pathogen” means that the induced new pathogen resulted to a combination of the latent previous pathogen and the new pathogen， which caused the disease. Based on this， it is believed that the change of “nodule-cancer transformation” of pulmonary nodules is actually based on the deficiency of original qi， and the new pathogen induces the latent pathogens like phlegm coagulation， qi stagnation， blood stasis， toxicity， so healthy qi can not drive the pathogens out， and the long-time detention generated into cancerous turbidity， and deve-loped into cancerous tumour at the end. Therefore， based on the three-stage treatment of unformed cancer， dense cancerous toxin， and developed cancer， the clinical practice applied six methods of clearing， expelling， dissipating， tonifying， harmonizing， and transforming， taking into account both the manifestation and root cause， moving the treatment window of pulmonary nodules forward， attacking the pathogens when the toxin was not yet overbearing， supporting the healthy qi before declining， delaying the process of nodules-cancer transformation， and providing ideas for the prevention and treatment of pulmonary nodules “nodule-cancer transformation” in traditional Chinese medicine.
ABSTRACT
Objective To analyze the seasonal and epidemiological characteristics of community-acquired pneumonia (CAP) in Chuzhou from 2010 to 2022. Methods The epidemiological data of CAP in Chuzhou from 2010 to 2022 were obtained from the center for diseases control and prevention of Chuzhou City, Anhui Province. After inclusion and exclusion, a total of 1 053 cases were enrolled. General data were collected. Then the characteristics of CAP patients in terms of gender, age, regional and seasonal distribution and pathogenic bacteria distribution were analyzed. Results A total of 316 patients with CAP, with a prevalence rate of 30.01%, including 152 males (48.10%) and 164 females (51.90%). Regarding age, 86 cases (27.22%) at 19-40 years, 106 cases (33.54%) at 41-60 years, and 124 cases (39.24%) at >60 years, suggesting a statistical difference in the CAP detection rate among different genders and ages (P<0.05). Seasonally, 118 cases (37.34%) were detected in spring, 13 cases (4.11%) in summer, 49 cases (15.51%) in autumn, and 136 cases (43.04%) in winter, with the highest CAP detection rate in winter, followed by spring. Pathogenic bacteria were positive in 198 of 316 patients, with a detection rate of 62.66%. A total of 125 strains of pathogenic bacteria were detected in sputum culture, of which 138 cases were Gram-negative, mainly Escherichia coli (24.24%, 48/198), and 60 cases were Gram-positive, mainly Streptococcus pneumoniae (14.14%, 28/198). Among 198 patients positive for pathogen detection, 41 cases were detected in spring, 37 cases in summer, 56 cases in autumn and 64 cases in winter. The drug sensitivity results showed that Escherichia coli had the highest resistance rate to ampicillin and cefazolin, and was sensitive to imipenem and other antibiotics; Streptococcus pneumoniae has the highest resistance rate to penicillin and erythromycin, and is sensitive to vancomycin. Conclusion CAP is quite common in elderly population in Chuzhou from 2010 to 2022, with a high prevalence rate in spring and winter, and the prevention work of high-risk groups should be strengthened.
ABSTRACT
Objective To explore the viral pathogen spectrum characteristics of acute intestinal infection in Hanzhong from 2019 to 2022. Methods Fecal samples from patients with acute intestinal infection in the outpatient clinic of 3201 Hospital from January 2019 to December 2022 were collected. Common enteroviruses such as enterovirus 71 (EV-A71), coxsackievirus 16 (CV-A16), CV-A10, CV-A6, CV-A2, CV-A4, and CV-B3 were detected and analyzed by real-time fluorescence quantitative PCR. Results A total of 5 194 fecal samples were collected, and the positive rate of nucleic acid detection was 23.95%. In terms of the enteroviruses, the highest detection rate was 9.82% for EV-A71, followed by 4.58% for CV-A16 and 3.37% for CV-A6. The positive detection rate of common enteroviruses showed statistical difference among different age groups (P0.05). EV-A71 infection showed no seasonal characteristics, whereas the detection of CV-A16 and CV-A6 infections was concentrated in summer and autumn. There were 106 cases of mixed infection, and the prevalence rate was 2.04%, with EV-A71 and CV-A6 mixed infections accounting for the majority of cases. Conclusion The main pathogens of acute intestinal infections in the Hanzhong area from 2019 to 2022 are EV-A71, CV-A16, and CV-A6. It is necessary to strengthen the monitoring of acute intestinal infections in children aged 4 years and below.