Diagnosis, treatment and prevention of severe acute respiratory syndrome coronavirus 2 infection in children: experts′ consensus statement (Fifth Edition)updated for the Omicron variant / 中华实用儿科临床杂志

China has classified the Corona Virus Disease 2019(COVID-19) as a statutory category B infectious disease and managed it according to Category B since January 8, 2023.In view that Omicron variant is currently the main epidemic strain in China, in order to guide the treatment of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2) infection in children with the times, refer to the Diagnosis and Treatment Protocol for Novel Coronavirus Infection (Trial 10 th Edition), Expert Consensus on Diagnosis, Treatment and Prevention of Novel Coronavirus Infection in Children (Fourth Edition) and the Diagnosis and Treatment Strategy for Pediatric Related Viral Infections.The Expert Consensus on the Diagnosis, Treatment and Prevention of Novel Coronavirus Infection in Children (Fifth Edition) has been formulated and updated accordingly on related etiology, epidemiology, pathogenic mechanism, clinical manifestations, auxiliary examination, diagnosis and treatment, and added key points for the treatment of COVID-19 related encephalopathy, fulminating myocarditis and other serious complications for clinical reference.

Occupational stress and its influencing factors of primary health care workers during COVID-19 / 环境与职业医学

Background Since the outbreak of COVID-19, primary health care workers have been facing unprecedented work pressure, and their occupational stress should be taken seriously. Objective To analyze the occupational stress situation and its influencing factors of primary health care workers in Guangdong Province, and to propose targeted interventions. Methods Using a multi-stage stratified random sampling method, each prefecture-level city in Guangdong Province was classified into "good", "medium", or "poor" category based on its gross domestic product (GDP) in 2019 released by the Guangdong Provincial Bureau of Statistics. In September 2021, four primary health care institutions were randomly selected from each stratum, and a total of 1327 staff members were selected for the study. The Core Occupational Stress Scale (COSS) and a basic information questionnaire designed by the authors were used. Mann-Whitney U test was used to compare the means between two groups, and Kruskal-Walis H test was used to compare the means among multiple groups. The comparison of categorical data was performed by trend χ2 test or Pearson χ2 test; the analysis of factors influencing occupational stress was performed by dichotomous multiple logistic regression analysis. Results There were 365 health care workers reporting occupational stress in this survey, and the positive rate of occupational stress was 27.5%. The total occupational stress score in M (P25, P75) and the scores of social support, organization and reward, demand and effort, and control were 45.0 (40.0, 50.0), 20.0 (17.0, 21.0), 14.0 (12.0, 17.0), 12.0 (10.0, 15.0), and 5.0 (4.0, 6.0), respectively. The results of dichotomous multiple logistic regression analysis showed that high education, low income, doctor positions, long working hours in a day, and shift work were associated with the occurrence of reporting occupational stress (P<0.05). Conclusion Education, average monthly income, job category, daily working hours, and shifts are factors influencing the occurrence of reporting occupational stress in primary health care workers; targeted interventions should be implemented to reduce their occupational stress levels.

Analysis of KIF1A gene variant in a Chinese pedigree affected with Spastic paraplegia type 30 / 中华医学遗传学杂志

OBJECTIVE@#To explore the genetic basis for a Chinese pedigree affected with hereditary spastic paraplegia type 30 (HSP30).@*METHODS@#A proband presented at the Second Hospital of Shanxi Medical University in August 2021 was selected as the study subject. The proband was subjected to whole exome sequencing, and candidate variant was verified by Sanger sequencing and bioinformatic analysis.@*RESULTS@#The proband was found to have harbored a heterozygous c.110T>C variant in exon 3 of the KIF1A gene, which can cause substitution of isoleucine by threonine at position 37 (p.I37T) and alter the function of its protein product. The same variant was not found in his parents, elder brother and elder sister, suggesting that it has a de novo origin. Based on the guidelines of the American College of Medical Genetics and Genomics (ACMG), the variant was rated as likely pathogenic (PM2_Supporting+PP3+PS2).@*CONCLUSION@#The c.110T>C variant of the KIF1A gene probably underlay the HSP30 in the proband. Above finding has enable genetic counseling for this family.

Curative effect of full-femtosecond small incision lenticule extraction on the treatment of high myopia based on propensity score matching / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To analyze the effect of full-femtosecond small incision lenticule extraction(SMILE)on the treatment of high myopia based on propensity score matching.METHODS: A total of 48 cases(48 eyes)of high myopia patients who underwent SMILE surgery in our hospital from May 2019 to May 2021 were selected as the observation group, and 48 cases(48 eyes)of high myopia patients who underwent FS-LASIK surgery were matched using propensity score matching as the control group. Follow up for 6mo after surgery, the changes in cylindrical, central corneal thickness, uncorrected visual acuity(UCVA), corneal endothelial cell related indicators [percentage of hexagonal endothelial cells(6A), coefficient of variation(CV)of endothelial cell area, central corneal endothelial cell density(ECD)] and corneal biomechanical indicators [simulated Goldman intraocular pressure(IOPg), corneal hysteresis(CH), corneal resistance factor(CRF), corneal compensated intraocular pressure(IOPcc)] between the two groups were compared, and the incidence of complications in both groups of patients was recorded.RESULTS: Both groups of patients showed significant improvements in cylindrical and UCVA at 3 and 6mo after surgery, as well as decreased central corneal thickness, corneal endothelial cells, and corneal biomechanics related indicators. The changes in the observation group were more significant(all P&#x003C;0.05). During the follow-up period, there was no significant difference in the incidence of complications between the observation group and the control group(8% vs. 17%, P&#x003E;0.05).CONCLUSION: SMILE has a definite effect on patients with high myopia and is helpful to improve visual acuity.

Advances in research on mechanism of lactate dehydrogenase B in tumors / 中国药科大学学报

@#Increased glycolysis is a major feature of metabolic reprogramming in cancer.Glycolysis provides not only energy for cancer cells but also necessary precursors for biosynthesis, which is important for promoting tumor growth.Cancer cells meet their own needs by regulating glycolytic enzymes, which play an active role in promoting cancer survival, metastasis, and invasion.Lactate dehydrogenase (LDH), as a key enzyme in glycolysis, consists of two subunits: lactate dehydrogenase A (LDHA) and lactate dehydrogenase B (LDHB).LDHA is known to play a key role in aerobic glycolysis and has been extensively studied, whereas less has been done on LDHB.However, at present, more and more reports have revealed the important effects of LDHB on the progression of various cancers.A large number of studies have shown that LDHB is abnormally expressed in a variety of cancers, which is related to the malignant progression of tumors.The article reviews the research progress of LDHB in recent ten years, including its regulatory mechanism in tumor, its relationship with cancer development and its role as a biomarker in clinical diagnosis of cancer, which provides some insight for further investigation of the mechanism of LDHB in cancer research.

Preliminary exploration on operation process for autologous ozonized blood transfusion / 中国输血杂志

Autologous ozonized blood transfusion(AOBT) is a therapy of re-transfusion of 100-200 mL of autologous blood after shaking and agitation with appropriate amount of oxygen-ozone in vitro. The oxidation of blood through the strong oxidation of ozone can enhance the non-specific immune response of the body, regulate the internal environment and promote health. This therapy has been increasingly applied in clinical practice, while no unified standard for the operation process in terms of ozone concentration, treatment frequency and treatment course had been established. This operation process of AOBT is primarily explored in order to standardize the operation process and ensure its safety and efficacy.

Determination of mineral oil mist in workplace air using infrared spectrophotometry / 中国职业医学

Objective To establish an infrared spectrophotometric method for determination of mineral oil mist in workplace air. Methods The mineral oil mist in workplace air was sampled with glass fiber filter membrane and eluted with carbon tetrachloride. Petroleum-like standard solution of carbon tetrachloride was used as the calibration standard, and quantitative analysis was performed using infrared spectrophotometric oil analyzer. Results The sampling efficiency of the glass fiber filter membrane ranged from 94.8% to 99.2%, and the extraction efficiency ranged from 95.6% to 104.2%. The linear range of mineral oil mist was 1.00-120.00 mg/L, with a correlation coefficient of 0.999 4. The detection limit was 0.52 mg/L, and the quantification limit was 1.74 mg/L. The average recovery rate ranged from 98.8% to 104.1%. The within- and between- run relative standard deviations were 2.2%-6.4% and 2.3%-5.2%, respectively. The samples were stable at room temperature for seven days. This method could be used for air sampling of mineral oil mist in workplaces where mineral oil is used. Conclusion The method is sensitive, accurate, and efficient, which is suitable for determining the concentration of mineral oil mist in workplace air.

Association of serum complement C3, C4 with renal pathological lesion degree in IgA nephropathy patients / 中华肾脏病杂志

Objective:To explore the relationship between the levels of serum complement C3 and C4 and the degree of renal pathological injury in patients with IgA nephropathy (IgAN).Methods:It was a retrospective study. The clinical and pathological data of patients with primary IgAN diagnosed by renal biopsy in the Department of Nephrology of the Second People's Hospital of Qujing City, Yunnan Province from December 1, 2019 to December 31, 2022 were collected. According to the IgAN Oxford classification criteria, the patients were divided into mild renal pathological injury group (mild group, <3 pathologic types) and severe renal pathological injury group (severe group, ≥3 pathological types). The levels of serum C3 and C4 and other clinical data were compared between the two groups. Spearman correlation method was used to analyze the correlation between serum C3, C4 levels and estimated glomerular filtration rate (eGFR) during renal biopsy.Multivariate logistic regression model was used to analyze the influencing factors of the pathological injury degree in IgAN patients and the forest map depicted the effect of risk factors.Results:A total of 164 IgAN patients were included in the study, including 77 males (47.0%), aged (35.5±12.9) years old. There were 60 patients in the mild group and 104 patients in the severe group. Compared with the mild group, the patients in the severe group were older, had higher levels of serum C4, serum uric acid, low density lipoprotein cholesterol and 24 h urinary protein, higher proportions of hypertension, glucocorticoids/immunosuppressant therapy, C3 deposition in renal tissues and microscopic hematuria, and had lower hemoglobin and serum C3 level (all P<0.05). The results of Spearman correlation analysis showed that the level of serum C3 was positively correlated with eGFR ( r=0.303, P<0.001), and the level of serum C4 was negatively correlated with eGFR ( r=-0.238, P=0.002). Multivariate logistic regression analysis results showed that serum C3 (every 0.01 g/L increase, OR=0.976, 95% CI 0.957-0.996, P=0.018), serum C4 (every 0.01 g/L increase, OR=1.091, 95% CI 1.020-1.166, P=0.011), hemoglobin ( OR=0.969, 95% CI 0.950-0.988, P=0.002), and serum uric acid ( OR=1.005, 95% CI 1.001-1.009, P=0.012) were independent related factors of renal pathological damage (severe injury /mild injury) in IgAN patients. Conclusions:Serum C3 and C4 are independent related factors of the severity of renal pathological injury in IgAN patients.

Application of a pharmacokinetics solving program based on Excel in pharmacokinetics teaching / 中华医学教育探索杂志

To solve the problems in the course teaching of Pharmacokinetics and change the current situation of the course, a pharmacokinetic solution program based on Excel has been developed. The program, based on Excel, is the most widely used data processing software. The data processing and drawing functions of Excel are used and encapsulated as a program by Excel-VBA. The program is specially used in pharmacokinetic teaching, which includes 25 solution templates arranged according to the 5th edition of Biopharmaceutics and Pharmacokinetics, a textbook published by the People's Medical Publishing House Co., LTD. Each solution template includes six functional areas: operation setting area, data input area, data relationship display area, return parameter output area, pharmacokinetic parameter output area and chart area. In this course, the teaching content is reorganized. Starting from a case, the concept and knowledge of pharmacokinetics are taught by explaining how to apply the program to solve case problems. After years of practice, the teaching effect has been significantly improved.

Diagnosis, treatment and prevention of severe acute respiratory syndrome coronavirus 2 infection in children: experts′ consensus statement (Fourth Edition) / 中华实用儿科临床杂志

Since December 2019, severe acute respiratory syndrome coronavirus 2(SARS-CoV-2) infections have raged globally for more than 2 years.China has always adopted scientific and effective prevention and control measures to achieved some success.However, with the continuous variation of SARS-CoV-2 cases and imported cases from abroad, the prevention and control work has become more difficult and complex.With the variation of the mutant strain, the number of cases in children changed, and some new special symptoms and complications were found, which proposed a new topic for the prevention and treatment of SARS-CoV-2 infection in children in China.Based on the third edition, the present consensus according to the characteristics of the new strain, expounded the etiology, pathology, pathogenesis, and according to the clinical characteristics and experience of children′s cases, and puts forward recommendations on the diagnostic criteria, laboratory examination, treatment, prevention and control of children′s cases for providing reference for further guidance of effective prevention and treatment of SARS-CoV-2 infection in children in China.

Expert consensus on the diagnosis, treatment and prevention of monkeypox in children / 中华实用儿科临床杂志

Monkeypox is a zoonotic disease.Previous studies have shown that children are vulnerable to monkeypox and are also at high risk for severe disease or complications.In order to improve pediatricians′ understanding of monkeypox and achieve early detection, early diagnosis, early treatment and early disposal, the committee composed of more than 40 experts in the related fields of infectious diseases, pediatrics, infection control and public health formulate this expert consensus, on the basis of the latest clinical management and infection prevention and control for monkeypox released by the World Health Organization (WHO), the guidelines for diagnosis and treatment of monkeypox (version 2022) issued by National Health Commission of the People′s Republic of China and other relevant documents.During the development of this consensus, multidisciplinary experts have repeatedly demonstrated the etiology, epidemiology, transmission, clinical manifestations, laboratory examinations, diagnosis and differential diagnosis, treatment, discharge criteria, prevention, case management process and key points of prevention and control about monkeypox.

Peripheral circulation and peripheral nerve injury in workers exposed to vibration at two different frequencies / 环境与职业医学

Background Hand-arm vibration disease is harmful to human body, but there are no effective diagnosis and treatment so far, and current occupational exposure limits underestimate the health damage caused by high-frequency vibration exposure. Objective To evaluate and compare the damage to workers' peripheral circulation and peripheral nerve caused by different frequencies of vibration operation. Methods Drilling workers (n=187) from a mining company in Shandong Province and golf club head grinding workers (n=228) from a sports equipment factory in Guangdong Province were selected as study subjects. Hand symptoms were investigated. SV106 vibration meter was used to measure the target operation-associated vibration frequency spectrum. The 8 h energy-equivalent frequency weighted acceleration, cumulative vibration exposure level (CVEL), and the working age related to causing white finger in 10% of an exposed group were calculated. Result The study subjects were all male. More grinding workers reported hand symptoms than the drilling workers, e.g. peripheral circulation injury (52.6% vs 19.3%), peripheral nerve injury (71.5% vs 23.0%), hand stiffness (64.0% vs 7.0%), and deformed fingers (69.7% vs 4.3%) (all P<0.001). The main vibration frequencies of grinding operation (500-800 Hz) were much higher than those of drilling operation (125~160 Hz). CVEL and working age of vibration exposure showed a linear rising relationship with the cumulative prevalence rate of peripheral circulation and peripheral never injury, the fitting lines all showed good fitting effects (R2=0.812-0.988), and the slope of the fitting line of the grinding workers was larger than that of the drilling workers. The working age of vibration exposure associated with 10% cumulative prevalence of white finger was shorter in the grinding workers than in the drilling workers (6.81 years vs 10.27 years). According to the ISO prediction formula, the working age of vibration exposure was associated with 10% white finger prevalence shorter in the drilling workers than in the grinding workers (3.12 years vs 8.23 years). Conclusion Both the vibration exposure level and the prevalence of hand symptoms are high in two groups of workers with different vibration frequencies, and vibration exposure at a higher frequency tends to have severer damage to workers' hands.

Digital technology in repair of soft tissue defect in hand by anterior tibial artery perforator flap / 中华显微外科杂志

Objective:To investigate the clinical value of digital technology in repair of soft tissue defect in hand by anterior tibial artery perforator flap.Methods:From January 2015 to February 2021, 9 patients with soft tissue defects in hand were repaired with anterior tibial artery perforator flap assisted by digital technology in flap design, including 6 males and 3 females aged from 19 to 63 years with a mean age of 33 years. The size of defects varied from 2.0 cm×1.5 cm to 4.0 cm×3.0 cm, with exposed bones or tendons. Preoperative CTA scan of lower limb was performed and three-dimensional image was reconstructed with Mimics 20.0. The anterior tibial artery perforator flap was designed according to the shape and size of the defect, then the resection of flap was digitally simulated. The flap based on the digital design was harvested and the defect was repaired in the operation. The size of flap was 2.5 cm×2.0 cm~4.5 cm×3.5 cm. Outpatient clinic follow-up was performed to evaluate the survival of flaps. Disability of Arm, Shoulder and Hand(DASH) was used for function evaluation.Results:All flaps were harvested successfully and all donor sites were closed directly. After surgery, 8 flaps survived completely. One flap developed venous occlusion that showed partial necrosis of the flap, and it was rescued after exploration and re-anastomosis. The follow-up period ranged from 6 to 21 months, with an average of 13 months. The DASH scores of the affected limb were 2 to 15 points at the last follow-up, with an average of 6.4 points. Mild scar hyperplasia occurred at donor site in 1 case without sensory abnormality.Conclusion:The digital technology is able to accurately locate the perforators by allowing an individualised design of the anterior tibial artery perforator flap. The flap is suitable for repair of small and medium-sized soft tissue defect in hand, and the digital technology has certain value in clinical application.

Segmentation of core infarct in acute ischemic stroke in diffusion weighted imaging using cascaded VB-Net / 中华放射学杂志

Objective:To explore the detection and segmentation of ischemic core infarct volume of the acute stroke in diffusion weighted imaging (DWI) images using cascaded VB-Net.Methods:MRI data of 1 500 patients (2 456 lesions) with acute ischemic stroke in Henan Provincial People′s Hospital from December 2016 to December 2018 were retrospectively analyzed. Firstly, manual segmentation of ischemic core was performed on DWI images (b=1 000 s/mm 2), and then all data were divided into training set, validation set and independent test set by 8∶1∶1. Then, the cascaded VB-Net was constructed, and the core infarct was automatically detected and segmented in the test set. Interclass correlation coefficient (ICC) was used to evaluate the consistency of volume size measured by manual segmentation and cascaded VB-Net. The patients were divided into large ischemic core lesion group (ischemic core volume ≥10 ml) and small ischemic core lesion group (ischemic core volume<10 ml), and the Dice coefficient difference between the two groups was compared using Mann-Whitney U test. Results:In independent test set, cascaded model had the detection rate of 94.6% (243/257) with Dice coefficient of 0.76 (0.68, 0.84). The agreement of cacade VB-Net segmented [4.19(1.21,14.13)ml] and manual segmented ischemic core infarct volume [4.08(1.19,17.92)ml] was high (ICC=0.97, P<0.001). There was no significant difference in Dice coefficient between large and small lesion groups [0.76 (0.69, 0.85), 0.76 (0.67, 0.84), Z=-0.44, P=0.657]. Conclusions:The cascaded VB-Net model provided a tool to realize automatic detection, segmentation, and calculation of ischemic core infarct volume. It has good segmentation accuracy and high consistency with manual segmentation, which can provide an auxiliary decision-making tool for the selection of treatment plans.

Effects of plant growth-promoting rhizobacteria Klebsiella michiganensis TS8 and Lelliottia jeotgali MR2 on the growth and cadmium uptake of Arabidopsis thaliana under cadmium stress / 生物工程学报

In this study, the effects of two plant growth-promoting bacteria Klebsiella michiganensis TS8 and Lelliottia Jeotgali MR2 on the growth and cadmium (Cd) uptake of Arabidopsis thaliana under Cd stress were explored. A wild-type Arabidopsis thaliana was selected as the experimental plant and was planted at different Cd concentrations. MR2 and TS8 bacterial suspensions were sprayed onto the rhizospheric soil during the planting process. The initial Cd concentration of the bought soil was 14.17 mg/kg, which was used as the pot soil of the low-concentration Cd treatment group (LC). The concentration of soil Cd at high-concentration Cd treatment group (HC) were 200 mg/kg higher than that at LC group. Compared with the control group, MR2 suspension significantly promoted the growth of A. thaliana at both low and high concentrations, while TS8 strain and MR2_TS8 mixture only exhibited growth-promoting effect at high concentration. However, it was noteworthy that, TS8 suspension significantly reduced the Cd content in the underground parts of A. thaliana (60% and 59%), and significantly improved the Cd content in the aboveground parts of A. thaliana (234% and 35%) at both low and high concentrations. In addition, at low concentration, both single strain and mixed strains significantly improved the transformation from reducible Cd to acid-extractable Cd in soil, promoted Cd intake, and thereby reduced the total Cd content in soil. Therefore, the rational application of plant growth-promoting bacteria may improve crop yield and remediate Cd contamination in soil.

Twenty key issues on severe acute respiratory syndrome coronavirus-2 vaccination in children / 中华实用儿科临床杂志

Severe acute respiratory syndrome coronavirus-2(SARS-CoV-2)infection is still worldwide.As a vulnerable group, severe and dead pediatric cases are also reported.Under this severe epidemic situation, children should be well protected.With the widespread vaccination of SARS-CoV-2 vaccine in adults, the infection rate have decreased.Therefore, SARS-CoV-2 vaccine inoculation for children groups step by step is of great significance to the protection of children and the prevention and control of corona virus disease 2019(COVID-19) as a whole.But the safety of children vaccinated with SARS-CoV-2 vaccine is a main concern of parents.Therefore, in order to ensure the safety of vaccination and the implementation of vaccination work, National Clinical Research Center for Respiratory Diseases, National Center for Children′s Health and the Society of Pediatrics, Chinese Medical Association organized experts to interpret the main issue of parents about SARS-CoV-2 vaccine for children, in order to answer the doubts of parents.

Experts′ consensus on severe acute respiratory syndrome coronavirus-2 vaccination of children / 中华实用儿科临床杂志

At present, severe acute respiratory syndrome coronavirus-2(SARS-CoV-2)infection is still rampant worldwide.As of September 10, 2021, there were about 222 million confirmed cases of corona virus disease 2019(COVID-19)and more than 4.6 million deaths worldwide.With the development of COVID-19 vaccines and the gradual vaccination worldwide, the increasing number of cases in children and unvaccinated young people has drawn attention.According to World Health Organization surveillance data, the proportion of COVID-19 infection cases in children gradually increased, and the proportion of cases in the age groups of under 5 years and 5-14 years increased from 1.0% and 2.5% in January 2020 to 2.0% and 8.7% in July 2021, respectively.At present, billions of adults have been vaccinated with various COVID-19 vaccines worldwide, and their protective effects including reducing infection and transmission, reducing severe disease and hospitalization, and reducing death, as well as high safety have been confirmed.Canada, the United States, Europe and other countries have approved the emergency COVID-19 vaccination in children and adolescents aged 12 to 17 years, and China has also approved the phased vaccination of COVID-19 vaccination in children and adolescents aged 3 to 17 years. For smooth advancement and implementation of COVID-19 vaccination in children, academic institutions, including National Clinical Research Center for Respiratory Diseases, National Center for Children′s Health, and The Society of Pediatrics, Chinese Medical Association organized relevant experts to reach this consensus on COVID-19 vaccination in children.

Investigation of posttraumatic stress disorder and coping style in medical school undergraduates / 中国实用护理杂志

Objective:To investigate the occurrence and characteristics of post-traumatic stress disorder (PTSD) in medical school undergraduates, in order to provide reference to promote their mental health.Methods:Adopting stratified and cluster sampling method, 883 undergraduates from Xi ′an Medical College were selected and surveyed on March 9-16, 2020 by general condition questionnaire, PTSD Checklist-Civilian Version (PCL-C) and Simplified Coping Style Questionnaire (SCSQ). Results:The total score of PCL-C was (24.34 ± 8.12) points, (7.19 ± 2.61) points for re-experiencing symptoms, (9.87 ± 3.49) points for avoidance symptoms, and (7.28 ± 2.85) points for arousal symptoms. The incidence of PTSD was 8.2% (72/883). The scores of PTSD symptoms were higher in grade four students and whose coping tendency was negative, (26.37 ± 9.26) and (26.49 ± 9.48), respectively ( F value was 3.065, P<0.05; t value was -9.357, P<0.001). Positive coping scores were negatively correlated to PTSD symptoms ( r value was -0.130, P<0.001), while negative coping scores were positively correlated to PTSD ( r value was 0.244, P<0.001). Medical students with strong professional attitude had lower PTSD scores (23.23 ± 6.92)( F value was 21.650, P<0.001) and lower negative coping scores (8.21 ± 4.65) ( F value was 6.567, P<0.001). Conclusions:The incidence of PTSD was 8.2% in medical school undergraduates, whose severity was related to grade and coping tendency. Appropriate crisis intervention should be taken among medical students to improve their positive coping style, strengthen their professional identification and promote their mental health.

Effects of hepatitis B virus coinfection on anti-retroviral therapy in human immunodeficiency virus infected people / 中华传染病杂志

Objective:To investigate the influence of hepatitis B virus (HBV) combined with human immunodeficiency virus (HIV) infection on the efficacy of anti-retroviral therapy (ART).Methods:The data of 269 HIV-infected patients treated in Chongqing Public Health Medical Center from September 2016 to October 2019 were collected. The patients were divided into HIV monoinfection group and HIV/HBV coinfection group. The changes in liver function, CD4 + T lymphocyte count, and HIV RNA level between the two groups were compared when ART started and at different time points (2, 4, 8, 12, 24, 36, 48, and 96 weeks) after ART started. Statistical analysis were performed by independent sample t test, rank sum test and chi-square test. Results:A total of 145 patients with HIV monoinfection and 124 patients with HIV/HBV coinfection were collected. There were no statistically significant differences in liver function indexes (aspartate aminotransferase ( t=9.566), alanine aminotransferase ( t=-4.652) and total bilirubin ( t=-25.476)) between the two groups of patients when ART started (all P>0.05). At 24, 48 and 96 weeks after ART, the CD4 + T lymphocyte counts in the HIV monoinfection group and the HIV/HBV coinfection group were (305.9±156.9)/μL vs (266.2±172.5)/μL, (388.5±226.1)/μL vs (380.8±287.4)/μL and (369.5±191.4)/μL vs (453.6±179.6)/μL, respectively. At 48, 72 and 96 weeks after ART, the CD4 + T lymphocyte count increasing values were 121.0(-52.5, 144.5)/μL vs 156.0(-35.8, 185.8)/μL, 139.0(-116.0, 176.8)/μL vs 114.5(-59.5, 229.0)/μL and -91.0(-110.0, 153.3)/μL vs -94.0(-130.8, 114.3)/μL, respectively. The differences were all not statistically significant ( t=-0.516, -0.066 and -1.414, Z=-1.715、-0.802 and -1.602, respectively, all P>0.05). At 24, 48, and 96 weeks after ART, the HIV RNA inhibition rates in the HIV monoinfection group were 89.7%(130/145), 96.6%(140/145), and 96.6%(140/145), respectively, and those in the HIV/HBV coinfection group were 87.1%(108/124), 92.7%(115/124) and 94.4%(117/124), respectively. The differences were all not statistically significant ( χ2=0.026, 0.053 and 0.017, respectively, all P>0.05). In the second and fourth weeks after ART, the abnormal liver function rates of the HIV monoinfection group were 3.4%(5/145) and 6.2%(9/145), respectively, which were lower than those in the HIV/HBV coinfection group (21.0%(26/124) and 13.7%(17/124), respectively). The differences were both statistically significant ( χ2=20.121 and 4.309, respectively, both P<0.05). However, the abnormal liver function rates in the two group in the 8th week after ART were 10.3%(15/145) and 9.7%(12/124), respectively, and those in the 12th week were 9.0%(13/145) and 9.7%(12/124), respectively, and those in the 24th week were 9.7%(14/145) and 8.9%(11/124), respectively, and those in the 36th week were 9.7%(14/145) and 10.5%(13/124), respectively, and those in the 48th week were 8.3%(12/145) and 8.1%(10/124), respectively, and those in the 96th week were 2.8%(4/145) and 0(0/124), respectively. The differences were all not statistically significant ( χ2=0.330, 0.040, 0.049, 0.051, 0.004 and 3.472, respectively, all P>0.05). Conclusion:HBV coinfection has no adverse effect on the ART effect of HIV-infected patients.

Diagnosis, treatment and prevention of 2019 novel coronavirus infection in children: experts′ consensus statement (Third Edition) / 中华实用儿科临床杂志

2019 novel coronavirus(2019-nCoV) outbreak is one of the public health emergency of international concern.Since the 2019-nCoV outbreak, China has been adopting strict prevention and control measures, and has achieved remarkable results in the initial stage of prevention and control.However, some imported cases and sporadic regional cases have been found, and even short-term regional epidemics have occurred, indicating that the preventing and control against the epidemic remains grim.With the change of the incidence proportion and the number of cases in children under 18 years old, some new special symptoms and complications have appeared in children patients.In addition, with the occurrence of virus mutation, it has not only attracted attention from all parties, but also proposed a new topic for the prevention and treatment of 2019-nCoV infection in children of China.Based on the second edition, the present consensus further summarizes the clinical characteristics and experience of children′s cases, and puts forward recommendations on the diagnostic criteria, laboratory examination, treatment, prevention and control of children′s cases for providing reference for further guidance of treatment of 2019-nCoV infection in children.