Diagnostic value of 3D time-of-flight magnetic resonance angiography for detecting intracranial aneurysm: a meta-analysis.

PURPOSE: This meta-analysis is to comprehensively evaluate the diagnostic performance of three-dimensional time-of-flight magnetic resonance angiography (3D-TOF-MRA) for detecting intracranial aneurysm (IA). METHODS: PubMed, Embase, Web of Science, and the Cochrane library were systematically searched for retrieving eligible studies. Study inclusion, data extraction, and risk of bias assessment were performed by two researchers independently. Pooled sensitivity (SEN), specificity (SPE), positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and area under the curve (AUC) were calculated to assess the diagnostic value. In addition, heterogeneity and subgroup analysis were carried out. RESULTS: In total, 18 studies comprising 3463 patients were selected. The results of 3D-TOF-MRA for diagnosing IA were SEN 0.89 (95% CI 0.82-0.94), SPE 0.94 (0.86-0.97), PLR 13.79 (5.92-32.12), NLR 0.11 (0.07-0.19), DOR 121.90 (38.81-382.94), and AUC 0.96 (0.94-0.98), respectively. In the subgroup analysis, studies without subarachnoid hemorrhage (SAH) tend to perform statistical significantly better (P < 0.05) in detecting IAs than studies with SAH 0.99 (0.98-1.00) vs. 0.89 (0.86-0.91). The diagnostic value of studies with a two-image reconstruction method was higher than studies with only one image reconstruction method: 0.99 (0.98-1.00) vs. 0.91 (0.89-0.94) with P < 0.05. The 3D-TOF-MRA had better SEN in aneurysms > 3 mm than the aneurysms ≤ 3 mm in diameter: 0.89 (0.87-0.92) vs. 0.78 (0.71-0.84) with P < 0.05. CONCLUSION: This study demonstrated that 3D-TOF-MRA has an excellent diagnostic performance for the overall assessment of IA and may serve as an alternative for further patient management with IA.

Aminated N-doped graphene hydrogel for long-term catalytic oxidation in strong acidic environment.

Metal-based catalysts in advanced oxidation processes (AOPs) are not stable under strong acidic condition due to the remarkable leaching, which will also lead to a secondary pollution. In this study, an aminated N-doped graphene hydrogel (ANGH) is synthesized from graphene oxide and ethylenediamine (EDA) via an in-situ hydrothermal process. The ANGH shows a free-standing structure and has high catalytic activity especially in phenol degradation under strong-acidic condition because of a non-radical dominated mechanism determined in this process. On the large scale, a longer lifetime of ∼1700 min for ANGH is obtained under strong-acidic condition on a dynamic amplifying device, 2.9 times longer than that at neutral condition. It is proposed that amine N can be protected by hydrogen ions from being oxidized, thus leading to the better stability. Meanwhile, the active sites of ANGH can transform from N containing groups into oxygenous groups, and the deactivated material can be reutilized 10 times for rhodamine B degradation on a large scale. The ANGH synthesized facilely and could be recycled repeatedly, which is also very stable in the strong acidic environment, thus should have great potential in wastewater remediation.

Diagnosis, treatment and research progress of hypersensitivity pneumonitis in children / 中华实用儿科临床杂志

Hypersensitivity pneumonitis (HP) is an immune-mediated interstitial lung disease (ILD). It is a disease with highly heterogeneous clinical manifestations, severity and outcomes, which are associated with individual sensitivity, as well as property, dosage, duration and frequency of exposure to the antigens.The 2020 adult HP guideline reclassifies it and describes its radiographic features in detail.HP often occurs in adults, also affects the pediatric population and is one of the most common ILDs in children.The most common factors causing HP in children are avian and fungal antigens in the home environment.The diagnosis of HP is based on clear antigens, typical symptoms and characteristic radiological manifestations.The serum-specific IgG antibody, bronchoalveolar lavage fluid, and pulmonary function tests can help diagnose HP clearly, and lung histopathology is required for children whose diagnosis cannot be confirmed.Early diagnosis and adequate avoidance of antigen exposure are the keys to its treatment and prognosis.

Early Efficacies of Drainage in Arthroscopic Reconstruction with Anterior Cruciate Ligament Reconstruction / 昆明医科大学学报

Objective To investigate the impact of not using drainage on clinical outcomes after arthroscopic autologous semitendinosus tendon reconstruction with anterior cruciate ligament reconstruction.Methods From March 2022 to June 2023,59 patients undergoing arthroscopic autologous semitendinosus tendon reconstruction with anterior cruciate ligament reconstruction in Lincang People's Hospital were collected and randomly divided into the non-drainage group consisting of 29 cases(observation group)and the 24-hour drainage group consisting of 30 cases(control group).The pain levels of the two groups of patients were recorded on the 1st,3rd,7th,14th,and 30th day after the surgery by using a visual analog scale.Additionally,the knee joint range of motion,length of hospital stay,and occurrence of postoperative complications were monitored.The circumference of the thigh was measured before and after the surgery,and the difference was calculated.Results Repeated measures analysis of variance revealed that there were statistically significant within-subject differences in pain ratings,thigh circumference,and knee joint range of motion(P<0.05),but no statistically significant between-subject differences(P>0.05).Independent samples t-tests showed that on the first day after the surgery,the observation group had lower pain ratings(P<0.001),and higher thigh circumference and knee joint range of motion compared to the control group(P<0.05).There were no statistically significant differences in pain ratings,knee joint range of motion,and thigh circumference between the two groups at the remaining follow-up times(P>0.05);The observation group had a shorter hospital stay than the control group(P<0.001);Both groups of patients had no complications such as lower limb nerve damage,deep vein thrombosis,knee joint infection,or hematomas requiring puncture and aspiration.Conclusion In the early postoperative period following arthroscopic autologous hamstring tendon reconstruction of the anterior cruciate ligament,the omission of drainage does not affect the clinical outcomes in terms of pain,knee joint mobility,and thigh circumference.Moreover,omitting drainage reduces the level of pain experienced by patients on the first day after the surgery,improves the knee joint mobility,and decreases the length of hospital stay.Therefore,in arthroscopic autologous hamstring tendon reconstruction of the anterior cruciate ligament,it is not recommended to routinely use drainage for preventive purposes.

Thrombolytic therapy for 2 children with Mycoplasma pneumoniae pneumonia complicated with intracardiac thrombosis and pulmonary embolism / 中华实用儿科临床杂志

The clinical data of 2 children with refractory Mycoplasma pneumoniae pneumonia complicated with intracardiac thrombosis and pulmonary embolism, treated in Tianjin Children′s Hospital from July 2019 to January 2020, were analyzed retrospectively.One patient was an 8-year-old girl, who was admitted to the hospital mainly because of " fever for 5 days and cough for 2 days" . The other patient was a 7-year-old boy, who was admitted due to " intermittent fever with cough for 24 days and chest pain for 1 day" . Both children were complicated with elevated D-dimer levels and positive antiphospholipid antibody.During the treatment, right cardiac thrombosis and pulmonary embolism occurred in both cases, and the manifestations of thrombosis related symptoms were not typical.After the patients received anticoagulation treatment and thrombolytic therapy with urokinase, the cardiac thrombus dissipated and the pulmonary embolism improved.For refractory Mycoplasma pneumoniae pneumonia complicated with intracardiac thrombosis and pulmonary embolism, thrombolytic therapy can be applied to some children in addition to anticoagulant therapy.

Randomized， Double-blind， Single-simulation， Placebo-controlled， Multicenter Clinical Trial of An'erning Granules in Reducing Use of Antibiotics for Children's Community-acquired Pneumonia / 中国实验方剂学杂志

ObjectiveTo evaluate the efficacy and safety of An'erning granules in the treatment of community-acquired pneumonia in children. MethodA randomized， double-blind， single-simulation， placebo-controlled trial was designed in this study. The children were randomly assigned into an observation group （An'erning granules combined with ceftriaxone sodium） and a control group （An'erning granules placebo combined with ceftriaxone sodium） according to the ratio of 2∶1. The disease cure rate was taken as the main indicator of efficacy， and the safety of An'erning granules was observed. ResultA total of 206 children （137 in the observation group and 69 in the control group） were included in this study. Before treatment， the age， sex， body height， body weight， diagnosis time of pneumonia， and symptom and sign scores had no significant differences between the two groups. After 8 days of continuous medication， the observation group［70.80%（97/137）］ had higher cure rate than the control group［56.52%（39/69）］（χ2=4.17，P<0.05） and total effective rate of chest X-ray ［97.98%（97/99）］ than the control group［86.27%（44/51）］ （χ2=12.98，P<0.01）. The observation group was superior to the control group in the alleviation of TCM syndrome under the condition of 0-3 g dose stratification on day 3 of medication （P<0.01）. The recovery time， time to complete fever abatement， time to fever abatement and expectoration alleviation， rate of conversion to severe case， and reduction in the frequency of antibiotic use showed no significant differences between the two groups. In terms of safety， 13 and 7 adverse events occurred in the observation group and control group， respectively， which were relieved or disappeared after drug withdrawal or symptomatic treatment and showed no significant difference between the two groups. ConclusionIntravenous drip of ceftriaxone sodium combined with An'erning granules is effective in the treatment of community-acquired pneumonia in children. It can accelerate the absorption of pulmonary inflammation， alleviate the clinical symptoms in a short time for young children or the children with mild symptoms， and is safe in clinical application.

Randomized， Double-blind， Single-simulation， Placebo-controlled， Multicenter Clinical Trial of An'erning Granules in Reducing Use of Antibiotics for Children's Community-acquired Pneumonia / 中国实验方剂学杂志

ObjectiveTo evaluate the efficacy and safety of An'erning granules in the treatment of community-acquired pneumonia in children. MethodA randomized， double-blind， single-simulation， placebo-controlled trial was designed in this study. The children were randomly assigned into an observation group （An'erning granules combined with ceftriaxone sodium） and a control group （An'erning granules placebo combined with ceftriaxone sodium） according to the ratio of 2∶1. The disease cure rate was taken as the main indicator of efficacy， and the safety of An'erning granules was observed. ResultA total of 206 children （137 in the observation group and 69 in the control group） were included in this study. Before treatment， the age， sex， body height， body weight， diagnosis time of pneumonia， and symptom and sign scores had no significant differences between the two groups. After 8 days of continuous medication， the observation group［70.80%（97/137）］ had higher cure rate than the control group［56.52%（39/69）］（χ2=4.17，P<0.05） and total effective rate of chest X-ray ［97.98%（97/99）］ than the control group［86.27%（44/51）］ （χ2=12.98，P<0.01）. The observation group was superior to the control group in the alleviation of TCM syndrome under the condition of 0-3 g dose stratification on day 3 of medication （P<0.01）. The recovery time， time to complete fever abatement， time to fever abatement and expectoration alleviation， rate of conversion to severe case， and reduction in the frequency of antibiotic use showed no significant differences between the two groups. In terms of safety， 13 and 7 adverse events occurred in the observation group and control group， respectively， which were relieved or disappeared after drug withdrawal or symptomatic treatment and showed no significant difference between the two groups. ConclusionIntravenous drip of ceftriaxone sodium combined with An'erning granules is effective in the treatment of community-acquired pneumonia in children. It can accelerate the absorption of pulmonary inflammation， alleviate the clinical symptoms in a short time for young children or the children with mild symptoms， and is safe in clinical application.

Clinical evidence-based guideline for the diagnosis and treatment of anterior cruciate ligament injury (2022 version) / 中华创伤杂志

The anterior cruciate ligament (ACL) injury is a common sports injury that has a significant impact on knee function and patients′ mobility. With the popularity of national fitness campaign in China, the incidence of ACL injury is increasing year by year. Currently, there still lacks clinical standards or guidelines on how to choose appropriate treatment methods, surgical plans and rehabilitation protocols for ACL injury. In order to timely reflect the new treatment concept of ACL injury, standardize its diagnosis and treatment and improve the curative effect, the Sports Medicine Society of Chinese Research Hospital Association and the Editorial Board of Chinese Journal of Trauma organized domestic orthopedic and sports medicine experts to formulate the "clinical evidence-based guideline for the diagnosis and treatment of anterior cruciate ligament injury (2022 version)" based on the level of evidence-based medicine and in compliance with the principle of scientificity, practicability and advancement. The present guideline includes 12 recommendations for the diagnosis, treatment and rehabilitation of ACL injury in order to provide guidance and assistance for the clinical diagnosis and treatment of ACL injury in China.

Progress in the treatment of respiratory virus infection in children / 国际儿科学杂志

Respiratory virus remains to be an important pathogen of respiratory disease in children.The disease can occur in all age groups, especially in young children.Most viral infections have a good prognosis, but special viruses still cause great harm to the health of children.Respiratory viral therapy includes symptomatic therapy, broad-spectrum antiviral drugs, drugs that directly target the viral replication cycle, drugs that attenuate the inflammatory response, and anti-viral nanodrugs.New antiviral drugs are urgently needed to develop.The repurposing of the existing therapeutic agents previously designed for other virus infections is also an effective way.The treatment of respiratory virus infection has become an important topic in clinical research.

Chronic granulomatous disease caused by compound heterozygous mutation in NCF2 gene: case report and literature review / 中华实用儿科临床杂志

Objective:To explore the relationship between the type of mutation and clinical features, prognosis, and clinical characteristics of chronic granulomatous disease (CGD) caused by compound heterozygous mutations in the NCF2 gene in children. Methods:The clinical data of 1 case of neonatal CGD caused by compound heterozygous mutations of NCF2 gene at Tianjin Children′s Hospital in August 2019 was analyzed, and domestic and international literatures were searched to summarize the clinical characteristics, gene mutation type and prognosis of CGD caused by NCF2 mutation. Results:The diagnosis of CGD was confirmed by the presence of compound heterozygous mutations c. 196_197insA (p.Arg66Glnfs23X) and c. 1180T>G (p.Tyr394Asp) in the NCF2 gene, accompanied with the clinical manifestations of fever, cough, multiple clumps and nodules in the chest CT at 25 days after birth, and the neutrophil respiratory burst test stimulation index(SI) 23.This new mutation was not reported in the Human Genetic Mutation Database.The child had a residual portion of nicotinamide adenine dinucleotide phosphate (NADPH) oxidase activity and was followed up until the age of 9 months with an antifungal drug without recurrent infection.A total of 101 cases of CGD patients with NCF2 gene mutation were reported in domestic and international databases.Totally, 33 cases had SI results, with 22 cases below 3, 11 cases above 3, and 8 cases of missense mutations. Conclusions:c. 196_197insA and c. 1180T>G are new mutations in NCF2 gene that can lead to CGD.CGD patients containing missense mutations in the NCF2 gene may have more residual NADPH oxidase activity.

Therapeutic effect of human umbilical cord mesenchymal stem cells on imiquimod-induced psoriasis-like mouse models / 中华皮肤科杂志

Objective:To investigate the therapeutic effect of human umbilical cord mesenchymal stem cells (MSCs) on psoriasis-like mouse models induced by imiquimod and the underlying mechanisms.Methods:Eighteen C57BL/6 mice were randomly and equally divided into vaseline group, model group and treatment group according to a random number table. The mice in the model group and treatment group received topical treatment with 5% imiquimod cream at a dose of 62.5 mg once a day for 6 consecutive days on the shaved back, and those in the vaseline group received the treatment with the same amount of vaseline ointment; the mice in the treatment group were injected with 1.5×10 6 human umbilical cord MSCs via the caudal vein on days 1 and 4. The severity of skin lesions on the back of the mice was assessed everyday according to the psoriasis area and severity index (PASI) . Twenty-four hours after the last treatment, that is, on day 7, blood samples were taken, and the mice were sacrificed. The dorsal skin tissues were resected and subjected to hematoxylin and eosin (HE) staining. A single cell suspension of the resected spleen was prepared, and flow cytometry was performed to detect the Th1 and Th17 cell subsets in the spleen cells. Enzyme-linked immunosorbent assay was conducted to detect serum levels of cytokines interleukin (IL) -17A and tumor necrosis factor (TNF) -α. One-way analysis of variance was used for comparisons among groups, Tukey test for multiple comparisons, and repeated measures analysis of variance for the analysis of changes in the PASI score over time. Results:On day 7, there was obvious scaly erythema on the back of the mice in the model group, and the skin thickness and number of infiltrating inflammatory cells were significantly higher in the model group (78.73 ± 23.11 μm, 36.16 ± 2.95 cells/mm 2) than in the vaseline group (13.28 ± 4.57 μm, 13.33 ± 1.15 cells/mm 2, q=19.25, 7.21, respectively, both P < 0.001) . The treatment group showed significantly decreased PASI score, epidermal thickness and number of infiltrating inflammatory cells compared with the model group (all P < 0.001) . The percentage of Th17 cell subsets in the spleen cells and serum level of TNF-α were significantly lower in the treatment group than in the model group (both P < 0.05) . There were no significant differences in the spleen weight, spleen index, spleen cell count, Th1 cell percentage or serum IL-17A level between the treatment group and the model group (all P>0.05) . Conclusion:Human umbilical cord MSCs can effectively alleviate skin inflammation induced by imiquimod in the psoriasis-like mouse models, likely by inhibiting Th17 cell formation and TNF-α expression.

Genotype analysis and clinical characteristics of Mycoplasma pneumoniae infection in children in Tianjin / 中华微生物学和免疫学杂志

Objective:To investigate the prevalence and clinical characteristics of Mycoplasma pneumoniae( Mp) genotypes and subtypes in children in Tianjin. Methods:Children with pneumonia admitted to Tianjin Children′s Hospital from December 2017 to December 2019 were selected as the research objects. Bronchoalveolar lavage fluid was collected by fiberoptic bronchoscopy. The positive samples were detected by real-time fluorescent quantitative PCR and Mp culture. PCR-restriction fragment length polymorphism(RFLP) and multiple variable number tandem repeats were used for genotyping. Detailed clinical and laboratory data were collected for all cases. Results:The results of RFLP showed that there were 138 cases (78.9%) of typeⅠand 37 cases (21.1%) of type Ⅱ; 37 cases of type M3-5-6-2, including six subtypes B, G, M, S, V and Y; 138 cases of M4-5-7-2 were detected, including seven subtypes of E, J, P, U, X, Z and a. In M3-5-6-2 type, there were 1 case of P1-Ⅰtype (2.7%), 36 cases of P1-Ⅱtype (97.3%), 137 cases of P1-Ⅰ type (99.2%) and 1 case of P1-Ⅱ type (0.7%) in M4-5-7-2 type. There was no significant difference in genotype distribution among different age groups. There were statistical differences in the distribution of four seasons among the 13 genotypes of B, G, M, S, V, Y and E, J, P, U, X, Z, a. All Mp infected children had symptoms of fever and cough. The hospitalization time, fever duration, high fever (>39℃), cough duration, skin changes, digestive system symptoms and liver function injury rate of P1-Ⅰ/M4-5-7-2 pneumonia children were higher than those of P1-Ⅱ/M3-5-6-2 pneumonia children, but the difference was not statistically significant. The WBC count of P1-Ⅱ/M3-5-6-2 types was higher than that of typeⅠand M4-5-7-2; the LDH of P1-Ⅰ/M4-5-7-2 was higher than that of Ⅱ and M3-5-6-2, with statistical difference. There was no significant difference in the incidence of inflammatory consolidation, atelectasis, pleural thickening and pleural effusion among different genotypes. Conclusions:Mp infection in children with pneumonia in Tianjin is mainly P1-Ⅰ/ M4-5-7-2, and P1-Ⅱ is on the rise. P1-Ⅰ and M4-5-7-2 were associated with fever and severe symptoms.

Progress of anticholinergic drugs in the treatment of childhood asthma / 国际儿科学杂志

Anticholinergic drugs play an important role as bronchodilators in the treatment of obstructive airway diseases, including chronic obstructive pulmonary disease and asthma.Anticholinergic drugs are divided into short-acting muscarinic antagonists(SAMA)and long-acting muscarinic antagonists(LAMA). Ipratropium bromide is a commonly used SAMA in pediatrics and is administered by inhalation.The combination of ipratropium bromide and β 2 receptor agonist can control the acute attack of asthma patients of different ages and degrees.Tiotropium bromide is not only LAMA, but also a long-acting bronchodilator, which selectively and competitively binds to M1, M2, and M3 receptors.Tiotropium bromide can reduce Th2 cytokines and airway inflammation, reduce airway hyperresponsiveness, and inhibit airway remodeling.This article reviews the recent progress of anticholinergic drugs in the treatment of childhood asthma.

Advances in the treatment of refractory mycoplasma pneumoniae pneumonia in children with different doses of glucocorticoids / 国际儿科学杂志

Mycoplasma pneumoniae is one of the most common pathogens in children with community-acquired pneumonia.Some cases of mycoplasma pneumoniae pneumonia may develop into refractory mycoplasma pneumoniae pneumonia(RMPP). Glucocorticoid therapy can delay the disease and shorten the hospital stay, which is an effective method for the treatment of children with RMPP.This paper reviews the progress of glucocorticoids in the treatment of RMPP in children.

Paradoxical reactions in antitubercular therapy / 中华实用儿科临床杂志

Some patients with tuberculosis will undergo abnormal deterioration after appropriate anti-tubercu losis treatment,manifested by deterioration of the original lesions or new lesions,known as contradictory reactions,in patients co-infected with human immunodeficiency virus (HIV),this phenomenon is called immune reconstruction inflammatory response syndrome.It is generally believed that the contradictory reaction is an excessive inflammatory reaction,which is related to the host immune response and the direct action of Mycobacterium products.Before diagnosing contradictory reactions,factors such as treatment failure,drug resistance,re-infection,surgical impact and adverse drug events should be excluded.Regulating host immune response is the main way to deal with contradictory reactions.Some patients may need more active treatment.

Paradoxical reactions in antitubercular therapy / 中华实用儿科临床杂志

Some patients with tuberculosis will undergo abnormal deterioration after appropriate anti-tuberculosis treatment, manifested by deterioration of the original lesions or new lesions, known as contradictory reactions, in patients co-infected with human immunodeficiency virus(HIV), this phenomenon is called immune reconstruction inflammatory response syndrome.It is generally believed that the contradictory reaction is an excessive inflammatory reaction, which is related to the host immune response and the direct action of Mycobacterium products.Before diagnosing contradictory reactions, factors such as treatment failure, drug resistance, re-infection, surgical impact and adverse drug events should be excluded.Regulating host immune response is the main way to deal with contradictory reactions.Some patients may need more active treatment.

Pulmonary function test and pulmonary interstitial disease / 中华实用儿科临床杂志

Interstitial lung diseases (ILD) are a heterogeneous group of disorders, which are functionally cha-racterized by a restrictive ventilatory defect and exercise induced hypoxemia.Most lung function abnormalities in ILD share common features but are not specific.Pulmonary function is important for the diagnosis of patients with suspected ILD.For the diagnosis of ILD cases, pulmonary function test can assess the severity of the diseases and monitor progre-ssion of diseases.

Lymphadenitis associated with Bacillus Calmette-Guérin vaccination / 中华实用儿科临床杂志

Bacillus Calmette-Guérin(BCG) is still an effective way to prevent tuberculosis,but BCG vaccination reaction has various forms,mainly including lymphadenitis associated with BCG vaccination and disseminated BCG disease,the latter is relatively rare,lymphadenitis associated with BCG vaccination is relatively common,it is unclear that diagnosis and treatment,especially the timing of treatment and the choice of treatment methods,and lack of authoritative guidelines.Through further understanding of the pathogenesis,risk factors,clinical classification and diagnosis of this disease,clinicians can choose the optimized treatment plan for this disease.At the same time,the development and use of new vaccines are expected to reduce the occurrence of this disease.

Current status of the imaging diagnosis of liver fibrosis / 临床肝胆病杂志

Liver fibrosis is the result of the progressive development of various chronic liver diseases and can develop into liver cirrhosis and liver cancer with high mortality rates. Early diagnosis of liver fibrosis is of great significance for disease reversal. At present, liver biopsy is considered the gold standard for the diagnosis of liver fibrosis, but it cannot be used as a routine screening method due to its shortcomings. In recent years, progress has been made in various noninvasive imaging methods, and this article reviews the current status of the research on computed tomography, magnetic resonance imaging, nuclear medicine, and ultrasound in the diagnosis of liver fibrosis.

Lymphadenitis associated with Bacillus Calmette-Guérin vaccination / 中华实用儿科临床杂志

Bacillus Calmette- Guérin(BCG) is still an effective way to prevent tuberculosis, but BCG vaccination reaction has various forms, mainly including lymphadenitis associated with BCG vaccination and disseminated BCG disease, the latter is relatively rare, lymphadenitis associated with BCG vaccination is relatively common, it is unclear that diagnosis and treatment, especially the timing of treatment and the choice of treatment methods, and lack of authoritative guidelines.Through further understanding of the pathogenesis, risk factors, clinical classification and diagnosis of this disease, clinicians can choose the optimized treatment plan for this disease.At the same time, the development and use of new vaccines are expected to reduce the occurrence of this disease.