Hunan Normal University

To compare clinical and imaging features in children with macrolide-susceptible (MSMP) and macrolide-resistant Mycoplasma pneumoniae pneumonia (MRMP) in a real-world clinical setting. We retrospectively analysed paediatric M. pneumoniae (MP) cases at Hunan People's Hospital from June to December 2023, utilizing polymerase chain reaction (PCR) to categorize infections into MRMP and MSMP groups based on 23S rRNA mutations. We compared symptoms, laboratory findings, imaging results and treatment outcomes between MRMP and MSMP groups. Additionally, univariate and multivariate logistic regression analyses were performed to identify factors associated with the switch to doxycycline in MRMP patients. Of 199 children with MP, 151 were categorized as MRMP due to 23S rRNA mutations, while 48 were classified as MSMP. The MRMP group included more preschool- and school-aged children, with more severe symptoms (persistent high fever and extensive lung consolidation). MRMP patients received longer antibiotic courses, with imaging showing segmental or lobar infiltrates. Consequently, treatment was switched from azithromycin to doxycycline in 66.2% of MRMP patients. Multivariate logistic regression analysis revealed that segmental or lobar parenchymal infiltration was independently associated with an increased likelihood of receiving doxycycline (OR = 3.942, p < 0.001). These real-world data suggest that MRMP may present with more severe clinical manifestations and radiological features than MSMP among hospitalized children during an atypical post-COVID resurgence of MP. Doxycycline could be considered as the second-line therapy for MRMP patients exhibiting severe symptoms or lung consolidation when macrolides fail to achieve clinical improvement.

Mobile phone addiction represents a menace to adolescents' physical and mental well-being and academic advancement, as this addiction exerts adverse impacts on cognitive, behavioral, and social functions. This is an extremely significant issue that families, schools, and society must address without delay. Studies to date have examined the relationship and the mechanism linking alexithymia to mobile phone addiction in adolescents from a cross-sectional perspective. Nonetheless, the longitudinal impact and underlying mechanisms of this connection are still largely unexplored. This research delves into the longitudinal association between alexithymia and mobile phone addiction among adolescents. The distinct and chain mediating effects of rumination and loneliness are examined, along with the moderating influence of psychological resilience. A total of 961 Chinese adolescents took part in this study, including 445 males (46.3%) and 516 females (53.7%). The ages of the participants ranged from 12 to 18years (Mage =16.51years, SD =1.48). A two-wave longitudinal study was conducted with a six-month interval. The Chinese version of the Toronto Alexithymia Scale (TAS-20), rumination scale, the Chinese version of the UCLA Loneliness Scale, the mobile phone addiction index (MPAI), and the Chinese Connor-Davidson Resilience Scale (CD-RISC) were all completed by the participants. Of 1003 adolescents at T1, 961 completed T2 six months later. Controlling for gender and grade, T1 alexithymia positively predicted T2 mobile phone addiction (β=0.16, 95% CI [0.10, 0.23]). Mediation analyses revealed significant indirect effects through T1 rumination (β=0.04), T2 loneliness (β=0.04), and their chain mediation (β=0.01), accounting for 36% of the total effect. Psychological resilience moderated the alexithymia→rumination pathway (β=-0.09, p<.001), buffering effects for high-resilience adolescents, but did not moderate subsequent pathways. This study found a longitudinal association between adolescent alexithymia and mobile phone addiction, with indirect effects through rumination and loneliness (individually and in chain mediation, the latter interpreted cautiously). Psychological resilience moderated the alexithymia-rumination link, attenuating effects for high-resilience adolescents, but did not moderate subsequent pathways. Findings suggest prevention efforts should target early cognitive-emotional processes (alexithymia → rumination), particularly among adolescents with low psychological resilience.