Uncontrolled hemorrhage leads to high death risk both in military and civilian trauma. Current hemostatic agents still have various limitations and side effects. In this study, natural diatom silica obtained from diatomite and diatom culture was purified and developed for hemorrhage control. To improve the biocompatibility and hemostatic performance of diatom silica, a series of chitosan-coated diatom (CS-diatom) was developed. The composition of CS-diatom prepared was optimized by in vitro hemocompatibility and blood coagulation evaluation for that prepared with 0.5%, 1%, 3%, and 5% chitosan. The results demonstrated that the CS-diatom prepared with 1% chitosan exhibited favorable biocompatibility (hemolysis ratio < 5%, no cytotoxicity to MEFs), great fluid absorbility (24.39 ± 1.53 times the weight of liquid), and desirable hemostasis effect (351 ± 14.73 s at 5 mg/mL, 248 ± 32.42s at 10 mg/mL). Further blood coagulation mechanism study indicated that CS-diatom could provide an ideal interface to induce erythrocyte absorption and aggregation, along with activating the intrinsic coagulation pathway and thus accelerated blood coagulation. Benefitting from the multiple hemostatic performances, CS-diatom showed the shortest clotting time (98.34 ± 26.54 s) and lowest blood loss (0.31 ± 0.11 g) in rat-tail amputation model compare to diatomite and diatom as well as gauze and commercial QuikClot zeolite. The results evidenced that the CS-diatom was a safe and effective hemostatic agent and provided a new understanding of nonsynthetic mesoporous materials for hemorrhage control.

Adenovirus, respiratory syncytial virus, and influenza virus are common causes of respiratory infections. The COVID-19 pandemic had a significant impact on their prevalence. The aim of this study was to analyze the epidemic changes of common respiratory viruses in the Affiliated Hospital of Hangzhou Normal University in Hangzhou, China, from October of 2017 to February of 2021. We collected statistics from 121,529 patients in the outpatient and inpatient departments of the hospital who had throat or nose swabs collected for testing for four virus antigens by the colloidal gold method. Of these, 13,200 (10.86%) were positive for influenza A virus, 8,402 (6.91%) were positive for influenza B virus, 6,056 (4.98%) were positive for adenovirus, and 4,739 (3.90%) were positive for respiratory syncytial virus. The positivity rates of the influenza A virus (0-14 years old, P = 0.376; over 14 years old, P = 0.197) and respiratory syncytial virus (0-14 years old, P = 0.763; over 14 years old, P = 0.465) did not differ significantly by gender. After January of 2020, influenza virus infection decreased significantly. The positivity rate of respiratory syncytial virus remained high, and its epidemic season was similar to before. Strict respiratory protection and regulation of crowd activities have a great impact on the epidemic characteristics of viruses. After major changes in the public health environment, virus epidemics and their mutations should be monitored closely, extensively, and continuously.

ObjectiveTo study the diagnosis efficacy of controlled attenuation parameters (CAP) and liver stiffness measurement (LSM) in the transient elastography of non-alcoholic fatty liver disease (NAFLD) and its subtypes in children with obesity.MethodsRetrospectively analyze children with obesity in the Childhood Obesity Clinic of the Affiliated Hospital of Hangzhou Normal University from July 2020 to March 2021. The correlation between clinical data and NAFLD subtypes was analyzed, and included the relevant clinical data into the receiver operating characteristic curve for diagnosis and prediction.Results120 children aged between 6.1 and 17.8 years, with 70 males (58.33%), 50 females (41.67%), and a ratio of 1.4:1, were enrolled in the study. CAP and LSM correlated in all subtypes of NAFLD. The correlation was significant for diagnosing NAFLD in children with obesity when CAP &gt; 258.00 dB/m and LSM &gt; 4.65 kPa. It was also significant for NASH diagnosis when CAP &gt; 276.00 dB/m and LSM &gt; 5.15 kPa, while it was less significant for diagnosing NAFLD in children with obesity.ConclusionsCAP and LSM have diagnostic efficacy for NAFLD and its subtypes in children with obesity, with optimal predictive values of CAP &gt; 258.00 dB/m and LSM &gt; 4.65 kPa for NAFLD in children with obesity, and CAP &gt; 276.00 dB/m and LSM &gt; 5.15 kPa for NASH in children with obesity.

Background Quality sleep is essential for physical and mental health. We aimed to analyze sleep disorders in children with acute leukemia and explore associated factors. Methods General data and sleep disorders in children with acute leukemia during chemotherapy were collected by general questionnaires, Children's Sleep Disorders Scale and the Parenting Stress Index-short form. Results In total, 173 valid questionnaires were collected. The total Sleep Disorder Scale score > 39 is considered a sleep disorder, while sleep disorders accounted for 45.66% (79/173). In the cohort, 167 children had acute lymphoblastic leukemia, with 40.12% (67/167) having sleep disorders, while six children had acute non-lymphoblastic leukemia, with 50.00% (3/6) having sleep disorders. Single- and multi-factor regression analyses of age, gender, number of children in the family, and time spent using electronic devices showed that factors influencing sleep disorders in these children were mainly parental scolding and adenoid hypertrophy. Children with sleep disorders had more parental stress than those without sleep disorders (P < 0.05). Conclusions The high incidence of sleep disorders in children with acute leukemia is related to airway conditions and parental behaviors. Sleep disorders in children can increase parenting stress. Factors potentially affecting sleep quality should be addressed as early as possible, while parental education should be strengthened to better facilitate the physical and psychological recovery of their children.

ObjectiveTo explore the correlation between sleep disorders and attention-deficit–hyperactivity disorder (ADHD) in children.MethodsWe studied 100 Chinese children (70 boys and 30 girls; mean age, 8.77 ± 2.39 years). Parents completed the Children's Sleep Disturbance Scale (SDSC) and the Swanson Nolan and Pelham Version IV Scale (SNAP-IV) questionnaires. SNAP-IV and SDSC scores were compared in children with and without sleep disorders and ADHD.ResultsThere were significant differences in SDSC scores, Arousal Disorder (AD) scores, and Sleep Breathing Disorder (SBD) scores between children with and without ADHD (P &lt; 0.05). The sleep disorder group had higher SNAP-IV scores than the non-sleep disorder group (P &lt; 0.05). Children with sleep disorders showed higher ADHD symptom values (inattention, hyperactivity/impulsivity, and oppositional defiance) than children without sleep disorders (P &lt; 0.01). There was a moderate correlation between SDSC scores and SNAP-IV scores (r = 0.486, P &lt; 0.05). Using SNAP-IV scores as the dependent variable, multiple linear regression analysis was applied, and a statistically significant effect of AD and Sleep–Wake Transition Disorder (SWTD) scores on SNAP-IV scores was found (P &lt; 0.05). The area under the curve (95% CI) of the SDSC score for predicting sleep disorders with ADHD was 0.714 (0.606, 0.821; P = 0.0005).ConclusionChildren with ADHD are prone to sleep disorders. The higher the ADHD symptom score, the more sleeping problems. Sleep disorders can also cause or exacerbate ADHD symptoms, and the ADHD symptom score correlates with sleep disorder severity. We can reduce the severity of attention-deficit–hyperactivity in children with ADHD by improving their sleep with behavioral sleep interventions.

Background: To investigate the relationship between the occurrence of convulsions in children and air pollution in Hangzhou. Methods: From January 1, 2018, to December 31, 2020, 775 children admitted with convulsion to the pediatric outpatient clinic of The Affiliated Hospital of Hangzhou Normal University (Hangzhou, China) were enrolled in this study. The clinical data and the corresponding weather data of the day in Hangzhou were collected and analyzed. Also, the monthly etiological classification of convulsions and the monthly average air data of Hangzhou were statistically analyzed. Results: The highest incidence of convulsion was observed in children 1 to 2 years old, and higher in boys than in girls. The top three main causes were febrile seizure, benign infantile convulsion with mild gastroenteritis, and epilepsy. Among the meteorological factors, the increase in the level of 2.5 micron particulate matter (PM 2.5) in the air per month led to an increase in the number of patients with febrile seizure, benign infantile convulsion with mild gastroenteritis, and epilepsy, where the increase of ozone in 8 hours (O3-8h) per month led to a decrease in the number of patients with such conditions. Conclusions: PM2.5, PM10, and SO2 are the main meteorological factors affecting the occurrence of convulsions in children in Hangzhou, and PM2.5 and SO2 are risk factors. The increase in the level of PM2.5 in the air per month could increase occurrence of child convulsions, but the increase of O3-8h per month could decrease occurrence of child convulsions.

ObjectiveThe purpose of this study is to analyze the clinical data of a child with acute empyema caused by Haemophilus influenzae, and to investigate the diagnosis and treatment of this disease through literature review to improve the clinical understanding of this kind of disease.MethodsA 6-year-old female with acute H. influenzae empyema was treated at the Department of Pediatrics of The Affiliated Hospital of Hangzhou Normal University, Hangzhou, China. The pleural puncture fluid turned out to be yellow turbid pus, and the pleural effusion was diagnosed as empyema according to the classification of pleural effusions. High-throughput sequencing revealed the presence of H. influenzae. After comprehensive treatment, including antibiotics, closed pleural drainage, and intrapleural injection of urokinase, the pleural effusion was absorbed and discharged. A systematic literature search in Pubmed, Embase, Scopus, CNKI, Wanfang, and VIP Chinese databases revealed no cases of acute empyema in children caused by H. influenza and treated with urokinase.ResultsThere was no bronchopleural fistula and tension pneumothorax during the treatment. One month after discharge, chest computed tomography (CT) revealed no pleural thickening and normal pulmonary function.ConclusionPneumonia in the child worsened after an initial improvement of symptoms, which is an issue that requires further medical attention. High-throughput sequencing of pathogens in pleural effusion can improve the detection rate. This study indicated that closed pleural drainage combined with intrapleural injection of urokinase is an effective treatment for H. influenzae empyema in children.

Background: To investigate the relationship between the occurrence of convulsions in children and air pollution in Hangzhou.Methods: From January 1st, 2018, to December 31st, 2020, 775 children admitted with convulsion to the pediatric Outpatient clinic of The Affiliated Hospital of Hangzhou Normal University (Hangzhou, China) were enrolled in this study. The clinical data and the corresponding weather data of the day in Hangzhou were collected and analyzed. Also, the monthly etiological classification of convulsions and the monthly average air data of Hangzhou were statistically analyzed.Results: The highest incidence of convulsion was observed in children 1 to 2 years old, and more in males than in females. The top three main causes were febrile seizure, benign infantile convulsion with mild gastroenteritis and epilepsy. Among the meteorological factors, the daily mean concentration of particulate matter 2.5 (PM2.5), PM10 and sulfur dioxide (SO2) were associated with the number of children with convulsion admitted to the outpatient clinic on each day, while SO2 was the most influential factor among all the air pollutants. The increase in the level of PM 2.5 in the air per month could increase the number of patients with febrile seizure, benign infantile convulsion with mild gastroenteritis and epilepsy, but the increase of ozone in 8 hours(O3-8h) per month could decrease the number of patients with febrile seizure, benign infantile convulsion with mild gastroenteritis and epilepsy.Conclusions: PM2.5, PM10 and SO2 are the main meteorological factors affecting the occurrence of convulsions in children in Hangzhou, and PM2.5 and SO2 are correlative factors. The increase in the level of PM2.5 in the air per month could increase occurrence of child convulsions, but the increase of O3-8h per month could decrease occurrence of child convulsions.