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.

[A multi-center epidemiological study on pneumococcal meningitis in children from 2019 to 2020]. / 2019­2020å¹´160ä¾‹å„¿ç«¥è‚ºç‚Žé“¾çƒèŒè„‘è†œç‚Žä¸´åºŠæµè¡Œç— å­¦å¤šä¸­å¿ƒç ”ç©¶.

OBJECTIVES: To investigate the clinical characteristics and prognosis of pneumococcal meningitis (PM), and drug sensitivity of Streptococcus pneumoniae (SP) isolates in Chinese children. METHODS: A retrospective analysis was conducted on clinical information, laboratory data, and microbiological data of 160 hospitalized children under 15 years old with PM from January 2019 to December 2020 in 33 tertiary hospitals across the country. RESULTS: Among the 160 children with PM, there were 103 males and 57 females. The age ranged from 15 days to 15 years, with 109 cases (68.1%) aged 3 months to under 3 years. SP strains were isolated from 95 cases (59.4%) in cerebrospinal fluid cultures and from 57 cases (35.6%) in blood cultures. The positive rates of SP detection by cerebrospinal fluid metagenomic next-generation sequencing and cerebrospinal fluid SP antigen testing were 40% (35/87) and 27% (21/78), respectively. Fifty-five cases (34.4%) had one or more risk factors for purulent meningitis, 113 cases (70.6%) had one or more extra-cranial infectious foci, and 18 cases (11.3%) had underlying diseases. The most common clinical symptoms were fever (147 cases, 91.9%), followed by lethargy (98 cases, 61.3%) and vomiting (61 cases, 38.1%). Sixty-nine cases (43.1%) experienced intracranial complications during hospitalization, with subdural effusion and/or empyema being the most common complication [43 cases (26.9%)], followed by hydrocephalus in 24 cases (15.0%), brain abscess in 23 cases (14.4%), and cerebral hemorrhage in 8 cases (5.0%). Subdural effusion and/or empyema and hydrocephalus mainly occurred in children under 1 year old, with rates of 91% (39/43) and 83% (20/24), respectively. SP strains exhibited complete sensitivity to vancomycin (100%, 75/75), linezolid (100%, 56/56), and meropenem (100%, 6/6). High sensitivity rates were also observed for levofloxacin (81%, 22/27), moxifloxacin (82%, 14/17), rifampicin (96%, 25/26), and chloramphenicol (91%, 21/23). However, low sensitivity rates were found for penicillin (16%, 11/68) and clindamycin (6%, 1/17), and SP strains were completely resistant to erythromycin (100%, 31/31). The rates of discharge with cure and improvement were 22.5% (36/160) and 66.2% (106/160), respectively, while 18 cases (11.3%) had adverse outcomes. CONCLUSIONS: Pediatric PM is more common in children aged 3 months to under 3 years. Intracranial complications are more frequently observed in children under 1 year old. Fever is the most common clinical manifestation of PM, and subdural effusion/emphysema and hydrocephalus are the most frequent complications. Non-culture detection methods for cerebrospinal fluid can improve pathogen detection rates. Adverse outcomes can be noted in more than 10% of PM cases. SP strains are high sensitivity to vancomycin, linezolid, meropenem, levofloxacin, moxifloxacin, rifampicin, and chloramphenicol.

Artifact removal for unpaired thorax CBCT images using a feature fusion residual network and contextual loss.

BACKGROUND AND OBJECTIVE: Cone-beam computed tomography (CBCT) has become a more and more active cutting-edge topic in the international computed tomography (CT) research due to its advantages of fast scanning speed, high ray utilization rate and high precision. However, scatter artifacts affect the imaging performance of CBCT, which hinders its application seriously. Therefore, our study aimed to propose a novel algorithm for scatter artifacts suppression in thorax CBCT based on a feature fusion residual network (FFRN), where the contextual loss was introduced to adapt the unpaired datasets better. METHODS: In the method we proposed, a FFRN with contextual loss was used to reduce CBCT artifacts in the region of chest. Unlike L1 or L2 loss, the contextual loss function makes input images which are not aligned strictly in space available, so we performed it on our unpaired datasets. The algorithm aims to reduce artifacts via studying the mapping between CBCT and CT images, where the CBCT images were set as the beginning while planning CT images as the end. RESULTS: The proposed method effectively removes artifacts in thorax CBCT, including shadow artifacts and cup artifacts which can be collectively referred to as uneven grayscale artifacts, in the CBCT image, and perform well in preserving details and maintaining the original shape. In addition, the average PSNR number of our proposed method achieved 27.7, which was higher than the methods this paper referred which indicated the significance of our method. CONCLUSIONS: What is revealed by the results is that our method provides a highly effective, rapid, and robust solution for the removal of scatter artifacts in thorax CBCT images. Moreover, as is shown in Table 1, our method has demonstrated better artifact reduction capability than other methods.

Prevalence of postpartum post-traumatic stress disorder and its determinants in Mainland China: A systematic review and meta-analysis.

BACKGROUND: The prevalence and risk factors of postpartum posttraumatic stress disorder reported by population-based studies have significantly varied and the data are all collected from regional populations in Mainland China. AIMS: To utilize published data to estimate the overall prevalence of postpartum posttraumatic stress disorder and its determinants in Mainland China. METHODS: Comprehensively electronic searches were performed across six English databases and three Chinese databases. Random effects of the meta-analysis were performed to evaluate the pooled prevalence of postpartum posttraumatic stress disorder. Meta-regression was performed with the variable of study design, sample size, setting, measures, region, time points, and publication year. RESULTS: Totaling of nineteen studies was included, with a sample size of 13,231 postpartum women. The pooled prevalence of postpartum posttraumatic stress disorder was 11.2 % in Mainland China, with a higher prevalence at the timepoint within 1 month postpartum (18.1 %). Significant publication bias and heterogeneity were found (I2 = 97.1 %). Sample size and measurements were conditional on the prevalence of postpartum posttraumatic stress disorder. Postpartum depressive symptoms, sleep problems, cesarean section, and low levels of social support were the major risk factors for postpartum posttraumatic stress disorder. While being the one child in the family was the protective factor. CONCLUSION: An increasing prevalence of posttraumatic stress disorder within one month postpartum significantly arises awareness to provide screening and more mental health services during this period. Screening programs for postpartum posttraumatic stress disorder are still needed in Mainland China.

[Clinical characteristics and drug sensitivity in children with invasive pneumococcal disease: a multicenter study].

OBJECTIVE: To study the clinical characteristics, drug sensitivity of isolated strains, and risk factors of drug resistance in children with invasive pneumococcal disease (IPD). METHODS: The clinical characteristics and drug sensitivity of the isolated strains of 246 hospitalized children with IPD in nine grade A tertiary children's hospitals from January 2016 to June 2018 were analyzed. RESULTS: Of the 246 children with IPD, there were 122 males and 124 females. Their ages ranged from 1 day to 14 years, and among them, 68 (27.6%) patients were less than 1 year old, 54 (22.0%) patients were 1 to 2 years old, 97 (39.4%) patients were 2 to 5 years old, and 27 (11.0%) patients were 5 to 14 years old. Pneumonia with sepsis was the most common infection type (58.5%, 144/246), followed by bloodstream infection without focus (19.9%, 49/246) and meningitis (15.0%, 37/246). Forty-nine (19.9%) patients had underlying diseases, and 160 (65.0%) had various risk factors for drug resistance. The isolated Streptococcus pneumoniae strains were 100% sensitive to vancomycin, linezolid, moxifloxacin, and levofloxacin, 90% sensitive to ertapenem, ofloxacin, and ceftriaxone, but had a low sensitivity to erythromycin (4.2%), clindamycin (7.9%), and tetracycline (6.3%). CONCLUSIONS: IPD is more common in children under 5 years old, especially in those under 2 years old. Some children with IPD have underlying diseases, and most of the patients have various risk factors for drug resistance. Pneumonia with sepsis is the most common infection type. The isolated Streptococcus pneumoniae strains are highly sensitive to vancomycin, linezolid, moxifloxacin, levofloxacin, ertapenem, and ceftriaxone in children with IPD.

Fabrication of Isolated Metal-Organic Polyhedra in Confined Cavities: Adsorbents/Catalysts with Unusual Dispersity and Activity.

Metal-organic polyhedra (MOPs) have attracted great attention due to their intriguing structure. However, the applications of MOPs are severely hindered by two shortcomings, namely low dispersity and poor stability. Here we report the introduction of four MOPs (constructed from dicopper and carboxylates) to cavity-structured mesoporous silica SBA-16 via a double-solvent strategy to overcome both shortcomings simultaneously. By judicious design, the dimension of MOPs is just between the size of cavities and entrances of SBA-16, MOP molecules are thus confined in the cavities. This leads to the formation of isolated MOPs with unusual dispersion, making the active sites highly accessible. Hence, the adsorption capacity on carbon dioxide and propene as well as catalytic performance on ring opening are much superior to bulk MOPs. More importantly, the structure and catalytic activity of MOPs in confined cavities are well preserved after exposure to humid atmosphere, whereas those of bulk MOPs are degraded seriously.

Marker-assisted breeding for transgressive seed protein content in soybean [Glycine max (L.) Merr].

KEY MESSAGE: After two cycles of marker-assisted breeding on three loci, lines with transgressive segregation of 8.22-9.32 % protein content were developed based on four original soybean parents with 35.35-44.83 % protein content. Marker-assisted breeding has been an innovative approach in conventional breeding, which is to be further demonstrated, especially for quantitative traits. A study on continuous transgressive breeding for seed protein content (SPC) in soybean using marker-assisted procedures is reported here. The SPC of the recombinant inbred line (RIL) population XG varied in 38.04-47.54 % under five environments with P 1 of 35.35 %, P 2 of 44.34 % and total heritability of 89.11 %. A transgressive segregant XG30 with SPC 45.53 % was selected for further improvement. The linkage mapping of XG showed its genetic constitution composed of five additive QTL (32.16 % of phenotypic variation or PV) and two pairs of epistatic QTL (2.96 % PV) using 400 SSR markers with the remnant heritability 53.99 % attributed to the undetected collective of minor QTL. Another transgressive segregant WT133 with SPC 48.39 % was selected from the RIL population WT (44.83 % SPC for both parents). XG30 and WT133 were genotyped on the three major additive QTL (Prot-08-1, Prot-14-1 and Prot-19-2) as A 2 A 2 B 2 B 2 L 1 L 1 and A 1 A 1 B 1 B 1 L 2 L 2 , respectively. From WT133×XG30, surprising transgressive progenies were obtained, among which the recombinants with all three positive alleles A 2 _B 2 _L 2 _ performed the highest SPC, especially that of Prot-08-1. The five F 2-derived superior families showed their means higher than the high parent value in F 2:3 and F 2:4 and more transgressive effect in F 2:5:6, with the highest as high as 54.15 %, or 4.82 and 9.32 % more than WT133 and its original high parent, respectively. This study demonstrated the efficiency of marker-assisted procedure in breeding for transgressive segregation of quantitative trait.

Low concentrations of chloroquine and 3-methyladenine suppress the viability of retinoblastoma cells synergistically with vincristine independent of autophagy inhibition.

BACKGROUND: To study the inhibition of retinoblastoma cell viability by two commonly used autophagy inhibitors, chloroquine (CQ) and 3-methyladenine (3-MA), alone or in combination with the conventional chemotherapeutic drug vincristine (VCR), and to investigate whether the mechanisms of these drugs are related to inhibition of autophagy. METHODS: On retinoblastoma cell line HXO-Rb44, VCR, CQ and 3-MA were used individually or combined. The cell viability was determined by CCK8 method, and the cellular autophagic activity was determined by Western blotting of LC3 and p62. Caspase 3 fragmentation and Akt activation was also determined by Western blotting. RESULTS: VCR induced cell cycle arrest and apoptosis in HXO-Rb44 cells, but only inhibited autophagy at relatively high doses. Both CQ and 3-MA were synergistic with VCR to inhibit the growth of retinoblastoma cells and the combinational use significantly reduced the dosage of each drug. The lowest effective dose of CQ and 3-MA was most efficient to add on VCR; however, such dose was not sufficient to suppress autophagy in these cells. CQ could directly induce caspase activation, while 3-MA significantly inhibited Akt phosphorylation. CONCLUSIONS: CQ and 3-MA were synergistic with VCR to inhibit retinoblastoma cells. Our result suggested a novel strategy to combine CQ or 3-MA with VCR to reduce the side effects of each drug. However, lack of change in the autophagic activity when using the two drugs at lower doses suggests multiple mechanisms of action of the same drug at different doses. At higher doses, the drugs could inhibit autophagy, while at lower doses, they suppress tumor growth via autophagy-independent mechanisms.

The polymorphism of ARNTL2 (BMAL2) gene rs2306074 C>T is associated with susceptibility of Alzheimer disease in Chinese population.

In the present study, we investigated whether polymorphism of ARNTL2 (BMAL2) gene rs2306074 T/C was associated with susceptibility of Alzheimer disease (AD) in Chinese population. A case-control method was employed in this study. 296 unrelated AD patients and 423 control subjects were recruited in current study. The prevalence of C carriers in BMAL2 gene rs2306074 T/C in AD patients was significantly higher than that of control subjects in both the whole sample and APOE ε 4 non-carriers (in the whole sample: χ (2) = 5.938, P = 0.012; in APOE ε 4 non-carriers: χ (2) = 9.048, P < 0.0001). In addition, both in the whole sample and APOE ε 4 non-carriers, prevalence of CC genotypes in BMAL2 gene rs2306074 of AD patients was also significantly higher than that in controls (in the whole sample: χ (2) = 5.126, P = 0.018; in APOE ε 4 non-carriers: χ (2) = 7.389, P = 0.023). However, there was no significant difference of prevalence of C carriers and CC genotypes in BMAL2 gene rs2306074 T/C between AD patients and control subjects among APOE ε 4 carriers (C carriers: χ (2) = 0.020, P = 0.900; CC genotypes: χ (2) = 0.017, P = 0.946). C carriers in BMAL2 gene rs2306074 T/C are associated with a high susceptibility of AD among APOE ε 4 non-carriers but not among APOE ε 4 carriers in Chinese population.

Advances in the study of autophagy in breast cancer.

Breast cancer is the most prevalent malignant tumor among women, with a high incidence and mortality rate all year round, which seriously affects women's health. Autophagy, a well-conserved cellular process inherent in eukaryotic organisms, plays a pivotal role in degrading damaged proteins and organelles, recycling their breakdown products to aid cells in navigating stress and gradually restoring homeostatic equilibrium. Recent studies have unveiled the intricate connection between autophagy and breast cancer. Autophagy is a double-edged sword in breast cancer, demonstrating a dual role: restraining its onset and progression on one hand, while promoting its metastasis and advancement on the other. It is also because of this interrelationship between the two that regulation of autophagy in the treatment of breast cancer is now an important strategy in clinical treatment. In this article, we systematically survey the recent research findings, elucidating the multifaceted role of autophagy in breast cancer and its underlying mechanisms, with the aim of contributing new references to the clinical management of breast cancer.

A cross-sectional exploratory survey of knowledge, attitudes and daily self-reported pain assessment practice among nurses in Mainland China.

AIMS AND OBJECTIVES: To describe the level of knowledge, attitudes, and self-reported quality of practice in pain assessment among nurses of Mainland China and explore links with current hospital pain policy and continuing education. BACKGROUND: Knowledge is necessary for skilled pain assessment among nurses. Little is currently known regarding knowledge, attitude toward, and self reported pain assessment by nurses from Mainland China. METHODS: Quantitative research and cross-sectional convenience sampling assessed nursing knowledge, attitude, and practice among 101 nurses working in high-level hospitals in Mainland China. RESULTS: 81.2% of nurses participating in the survey were from high-level (level three) hospitals in Mainland China. 24.8% of the nurses attended continuing education in pain assessment. No nurses from the 76 hospital staffs surveyed were able to recall any hospital policy regarding pain assessment. Knowledge regarding pain assessment was rated at 1.9 (SD = 1.6) on a (0-7) scale. 27.7% of nurses possessed a positive attitude toward pain assessment. Pain assessment was not routine in most of the hospitals surveyed. Nurses who attended continuing education showed greater knowledge and more positive attitudes regarding pain assessment but did not show improvement in their quality of practice. CONCLUSIONS: This study identified inadequate knowledge and low level of self-reported pain assessment practice among nurses working in high-level hospitals in Mainland China. Current education did not influence nursing self-reported pain assessment practice. Knowledge of pain evaluation should be improved through newer approaches to education. A better policy framework for pain evaluation may also contribute to improvement.

Blood pressure variability related to early outcome of acute ischemia stroke in a prospective observational study.

Hypertension is a well-known risk factor for stroke, but the relationship between blood pressure variation (BPV) and prognosis remains unclear. This prospective observational study assessed the association between BPV and early functional outcomes in acute ischemic stroke patients. A total of 871 patients with acute ischemic stroke within 24 h of symptom onset were recruited from the Third Affiliated Hospital of Qiqihar Medical University between 2013 and 2016. Within 6 days of hospitalization, blood pressure was continuously measured from 8:00 to 9:00 every day, and the coefficient of variation (CV) of blood pressure was calculated (including systolic blood pressure [SBP] and diastolic blood pressure [DBP]). The modified Rankin scale was used to evaluate early functional outcomes at discharge. The coefficients of variation of SBP, DBP, and functional outcomes were included as primary outcome variables. Demographic characteristics and medical history were recorded as secondary outcome variables. We found that a greater CV level of SBP and DBP were associated with the poor early functional outcome at hospital discharge, and the odds ratio (OR) and 95% confidence interval (95%CI) of them were 1.56 (1.04-2.35) and 1.99 (1.31-3.03) respectively. A higher standard deviation (SD) of SBP and DBP significantly increased risk of poor early prognosis, OR (95%CI) was 1.78 (1.17-2.71) and 2.25 (1.47-3.45) respectively. Similar results were observed for SBP and DBP. The larger the range of SBP and DBP, the worse is the prognosis. In conclusion, the present study suggests that high BPV is a risk factor for poor early prognosis in acute ischemic stroke.

Diagnosis, treatment, and prevention of severe acute hepatitis of unknown etiology in children.

BACKGROUND: Severe acute hepatitis of unknown etiology in children has recently exhibited a global trend of concentrated occurrence. This review aimed to summarize the current available information regarding the outbreak of severe acute hepatitis and introduce our hospital's previous experiences with the diagnosis and treatment of severe acute hepatitis for reference. DATA SOURCES: Websites including the UK Health Security Agency, European Centre for Disease Prevention and Control, CDC, WHO, and databases including PubMed/Medline, Cochrane Library, Embase and Web of Science were searched for articles on severe acute hepatitis in children. RESULTS: As of May 26, 2022, a total of 650 cases have been reported in 33 countries; at least 38 (6%) children required liver transplantation, and nine (1%) died. Cases are predominantly aged between 3 and 5 years old, and there are no epidemiological links among them. The common manifestations are jaundice, vomiting and pale stools. Adenovirus tested positive in most cases, and SARS-CoV-2 and other viruses were detected in a few cases, but virus particles were not found in liver tissue. Adenovirus immunohistochemistry showed immunoreactivity in the intrasinusoidal lumen from some liver samples. The hierarchical treatment includes symptomatic and supportive therapy, management of coagulation disorders and hepatic encephalopathy, artificial liver support, and liver transplantation (approximately 6%-10% of cases require liver transplant). CONCLUSIONS: The etiology of this severe acute hepatitis in children is not clear. The clinical features are severe acute hepatitis with significantly elevated liver enzymes. Clinicians need to be alert to children with hepatitis.

Application of positron emission tomography in the clinical evaluation and treatment of hypothalamic-pituitary diseases.

Positron emission tomography (PET) and PET/CT are playing increasingly important roles in the clinical evaluation and treatment of tumors. As neuroendocrine tissues, the hypothalamus and pituitary gland have their unique features, and PET can be valuable in evaluating hypothalamic-pituitary diseases lesions. This article reviews the application of PET in the clinical evaluation and treatment of hypothalamic-pituitary diseases.

[Mannose-binding lectin (MBL) inhibits human cytomegalovirus infection of human MD-DC].

OBJECTIVE: To explore the inhibitory effect of different sources, different concentrations of Mannose-binding lectin (MBL) on human cytomegalovirus infection of human MD-DC cells. METHODS: The recombinant MBL was acquired by vector construction, and the natural MBL was purified from human plamsa. MD-DC were pre-exposed to several dilutions of the hMBL/rMBL for 30 min, then HCMV suspensions were added to MD-DC for 2 h to compare the inhibitory effect of hMBL/rMBL on the HCMV infection of MD-DC. MD-DC infected by HCMV co-culture with hMBL/rMBL to compare the inhibitory effect of hMBL/rMBL on the HCMV diffusion between MD-DC. HCMV-DNA in MD-DC was detected by fluorescence quantitative PCR. HCMV-PP65 in MD-DC was analyzed with flow cytometry, the ability of MD-DC to capture HCMV was observed with immunofluorescence confocal microscope. RESULTS: In hMBL/rMBL inhibition the ability of MD-DC capture HCMV experiments, the fluorescent quantitative PCR demonstrated that the amount of HCMV-DNA in 1 microg/mL of hMBL/rMBL treated cells was not significantly different from that of control group (P < 0.05). But the HCMV-DNA in 5 microg/mL and 10 microg/mL hMBL/rMBL treated group were significantly lower than that of control group (P < 0.05). The significant inhibit effects of 10 microg/mL hMBL/rMBL on the ability of MD-DC capture HCMV were observed by immunofluorescence confocal microscopy and flow cytometry. The inhibit effects of hMBL/rMBL on HCMV diffusion between MD-DC were also observed in 5 microg/mL and 10 microg/mL hMBL/rMBL treated groups at 72 hours. CONCLUSION: The hMBL/rMBL in physiological concentration range (5-10 microg/mL) can significantly inhibit human cytomegalovirus infection of human MD-DC cells, and the hMBL is more effective than rMBL.

Observation of mother-perpetrated infanticide in golden takins ( Budorcas taxicolor bedfordi).

Infanticide by unrelated individuals is widely reported in the animal kingdom; however, little is known about cases perpetrated by a parent, particularly the mother. This article reports on three cases of mother-initiated infanticide in Qinling golden takins ( Budorcas taxicolor bedfordi) recorded from video and camera images. Based on previous reports in other animals, we propose that the infanticide events observed in golden takins were related to the parental manipulation mechanism - i.e., killing an unhealthy infant to allow the mother to invest more care in potentially healthy offspring, and gain more fruitful reproductive opportunities. This appears to be an evolutionary-based selection strategy, whereby a species can prosper and succeed under the challenges of natural selection. However, further studies on both captive and wild populations are required to answer the various questions raised from our observations.

Diagnosis and treatment recommendations for pediatric respiratory infection caused by the 2019 novel coronavirus.

Since December 2019, an epidemic caused by novel coronavirus (2019-nCoV) infection has occurred unexpectedly in China. As of 8 pm, 31 January 2020, more than 20 pediatric cases have been reported in China. Of these cases, ten patients were identified in Zhejiang Province, with an age of onset ranging from 112 days to 17 years. Following the latest National recommendations for diagnosis and treatment of pneumonia caused by 2019-nCoV (the 4th edition) and current status of clinical practice in Zhejiang Province, recommendations for the diagnosis and treatment of respiratory infection caused by 2019-nCoV for children were drafted by the National Clinical Research Center for Child Health, the National Children's Regional Medical Center, Children's Hospital, Zhejiang University School of Medicine to further standardize the protocol for diagnosis and treatment of respiratory infection in children caused by 2019-nCoV.

Diagnosis and treatment of herpangina: Chinese expert consensus.

BACKGROUND: Herpangina is a common infectious disease in childhood caused by an enterovirus. This consensus is aiming to standardize and improve herpangina prevention and clinical diagnosis. METHODS: The Subspecialty Group of Infectious Diseases, the Society of Pediatric, Chinese Medical Association and Nation Medical Quality Control Center for Infectious Diseases gathered 20 experts to develop the consensus, who are specialized in diagnosis and treatment of herpangina. RESULTS: The main pathogenic serotypes of herpangina include Coxsackievirus-A, Enterovirus-A and Echovirus. Its diagnosis can be rendered on the basis of history of epidemiology, typical symptoms, characteristic pharyngeal damage and virological tests. The treatment is mainly symptomatic, and incorporates topical oral spray with antiviral drugs. The course of herpangina generally lasts 4-6 days with a good prognosis. CONCLUSION: The consensus could provide advices and references for the diagnosis, treatment and management of herpangina in children.

Analysis of the Disease Burden of Type 2 Diabetes Attributable to High BMI in China from 1990 to 2019 based on Joinpoint Regression Model / 中国卫生统计

Objective To analyze the disease burden of type 2 diabetes mellitus(T2DM)attributable to high body mass index(BMI)in China from 1990 to 2019 in the context of rapid growth in high BMI rates.Methods Data was extracted from GBD 2019,and the disease burden of T2DM attributable to high BMI in China from 1990 to 2019 was analyzed for overall and subgroups defined by age and sex separately and jointly.The joinpoint regression models were used to analyze the trends of standardized death rate and standardized disability-adjusted life year(DALY)rate.Results From 1990 to 2019,the prevalence of T2DM increased from 2928.78 per 100000 to 6328.79 per 100000 in China.The number of T2DM deaths attributed to high BMI increased from 10500 to 47500 and the standardized death rate increased from 1.25 per 100000 to 2.39 per 100000.The attributed DALY increased from 771800 person-years to 3737600 person-years,and the standardized DALY rate increased from 80.21 per 100000 to 181.54 per 100000.Years of life lost(YLL)and years lived with disability(YLD)and their standardized rates also increased.From 1990 to 2019,the annual average percentage change of the standardized death rate and the standardized DALY rate of T2DM attributable to high BMI were 2.28%and 2.81%,respectively,which were statistically significant(P<0.05)and males were both higher than females.The standardized DALY rate and the standardized death rate of males exceeded that of females in 2010 and 2014,respectively.Age-stratified results showed that the burden of T2DM,which is attributed to a high BMI,is even greater in people over 50 years old.The YLD rate attributable to high BMI increased the most among the 15～49 age group,reaching 323.99%.Conclusion From 1990 to 2019,the disease burden of T2DM that can be attributed to high BMI increased significantly in China.It is necessary to strengthen prevention and control efforts,effectively manage population BMI,and adopt key interventions for high-risk groups to reduce the disease burden of T2DM.