Owing to the increasing use of antibiotics in human beings and animals at present, the problem of microbial drug resistance has developed into one of the major global public health problems. As one of the largest producers and consumers of antibiotics, the transmission of drug-resistant genes is a cause for concern. Given the global attention towards probiotics, it is necessary to pay close attention to the transmission of drug-resistant genes that may be brought about by probiotics while fully affirming their health efficacy. Studies have shown that drug-resistant genes presented in probiotics can be transmitted to pathogenic bacteria in the human gut via horizontal gene transfer and lead to the development of drug-resistant infections. Hence it is imperative to further explore the mechanism of drug resistance and transmission characteristics of drug resistance genes in probiotics. In this review, we provide an overview of the composition and transmission mechanism of drug-resistant genome in human intestinal flora. Furthermore, we review the mechanism of drug resistance in probiotics and the development characteristics of drug resistance in probiotics driven by drug-resistant genes, and summarize the current research bottleneck of mechanism of drug resistance in probiotics and the safety evaluation of probiotics for future research.

The pathogenesis of lung cancer is related to the malignant transformation of lung tissue cells induced by carcinogens in cigarette smoke, but the individuals' dissimilar abilities to metabolize these carcinogens make the prevalence of lung cancer different in smoking population, and human genetic polymorphism plays a key role in the carcinogenic effect of cigarette carcinogens. Studies have shown that genes related to smoking population are significantly associated with lung cancer susceptibility. Gene mutations like CYP450, GSTs, ERCC1, CHRNA5, EGFR and FHIT can increase the risk of lung cancer in smoking population. By clarifying the role mechanism of involvement of relevant genes in the occurrence and development of lung cancer and their impacts on chemotherapy drug resistance, it will help guide clinical rational drug use. This study reviews the relationships of genes related to smoking population with the occurrence and development of lung cancer so as to provide new ideas for lung cancer prevention and treatment in smoking population.

Objective One year after the outbreak of the SARS-CoV-2 infection, the composition of pathogenic spectrums of patients with respiratory tract infections in Wuhan in winter was clarified under non-drug intervention measures, and the etiological basis for prevention and treatment of respiratory tract infectious diseases was provided. Methods We collected throat swab samples from acute respiratory tract infection (ARTI) cases in fever clinics of eight large hospitals in Wuhan from December 28, 2020 to February 14, 2021.Nucleic acid extraction was performed using an automatic nucleic acid extractor, and real-time fluorescence quantitative PCR technology was used to detect 23 respiratory pathogens. Microsoft Office Excel 2016 was used to input and organize the data, and then a databasewas established. Statistical analysis was performed with SPSS 20.0 software. Results A total of 596 ARTI cases were collected, including 335 males and 261 females, with a male-to-female ratio of 1.28:1.The youngest was 5 months old and the oldest 91 years old. The total positive rate of 23 respiratory pathogens was 86.24% (514/596), and a total of 13 pathogens of 23 respiratory pathogens were positive. The top three pathogens wereStreptococcus pneumoniae (SPN) (30.47%, 323/1,060), Klebsiella pneumoniae (KPN) (24.25%, 257/1,060) and Haemophilus influenzae (HIN) (19.43%, 206/1,060). Among the 514 positive cases, 331 were mixed infections, accounting for 64.40% (331/514). The proportion of mixed infection between bacteria (54.68%, 181/331) was higher than that of bacteria and virus (45.01%, 149/331). Among the 331 cases of mixed infections, only one case of mixed infection betweenhuman metapneumovirus (HMPV) and respiratory syncytial virus (RSV)was detected, accounting for 0.30% (1/331) . There were statistically significant differences in the detection rates of HIN, KPN, SPN, HMPV, RSV, respiratory adenovirus (RA), human bocavirus (HBoV) and human enterovirus (HEV) in patients of different ages as well as in the detection rates of HIN, KPN, SPN, HMPV and RSV in patients of different body temperatures. No statistically significant differences were found in the detection rates of all pathogens between male and female patients. The detection rates of group A streptococcus (GAS) and RSV between national and non-national influenza sentinel hospitals showed statistically significant differences. Conclusion SPN, KPN, HIN, HMPV and Staphylococcus aureus (SA) were the main respiratory pathogens in Wuhan in winter under non-drug intervention measures. Strengthening monitoring and prevention of these pathogens is the focus of prevention and control of respiratory tract infections in Wuhan in winter.

Objective To perform nucleic acid tests on influenza-like illness (ILI) cases in Zhanjiang City, Guangdong Province during 2017-2022, to analyze the epidemiological characteristics of influenza, and to provide a basis for furtheroptimizing influenza prevention and control measures. Method The monitoring data from influenza sentinel posts from April 2017 to March 2023 were collected and statistically analyzed. Results A total of 87,946 ILI cases were cumulatively reported in Zhanjiang City during 2017-2022, and the annual ILI% in the 6 monitored years ranged from 1.71% to 3.53%, with an average ILI% of 2.55%. 6,518 samples of ILI were collected for influenza virus nucleic acid test, 782 of which were positive, with the positive rate of 12.00%. The positive rates for each monitored year were 17.07%, 18.75%, 17.65%, 0.18%, 10.12% and 8.70% respectively. The detection rate of influenza A virus H3N2 was the highest (39.6%), followed by influenza B virus Victoria, influenza A virus H1N1 and influenza B virus Yamagata. There were three influenza epidemic peaks in spring, summer and winter. Influenza A virus H1N1 and influenza B virus Yamagata were mainly detected in spring and winter, while influenza A virus H3N2 and influenza B virus Victoria were prevalent in summer. There were statistically significant differences in the positive rates among different age groups, and the positive rate was found to be the highest in the group aged 5-14 years (20.46%), followed by the group aged 15-24 years (19.94%) and the group aged 0-4 years (6.68%). No statistically significant difference was found in the positive rates between males and females (P=0.903). Conclusion Influenza was common in spring, summer and winter in Zhanjiang City during 2017-2022. The high-incidence people were concentrated in the group aged 5-24 years. Therefore, it is essential to strengthen the publicity and education on knowledge about influenza prevention and control and improve the activity of vaccination.

Objective To identify the causes and pathogenic factors of an outbreak of infectious diarrhea in a middle school in a town of Jianshui County in 2021. Methods Descriptive epidemiological methods were used to describe the clinical manifestations and spatial, temporal and population distribution of the cases. We searched for suspected foods with pathogenic bacteria combined with the results of case-control studies. On-site hygienic investigation was carried out, and case specimens, samples of domestic water, drinking water and food, and smeared samples of food processing tools were collected for norovirus PCR detection and gene sequencing. Results A total of 263 cases were found. The main symptoms were diarrhea (83.65%), abdominal pain (78.33%), nausea (68.44%) and vomiting (65.02%). The results of field epidemiological investigation revealed that 4 water samples from the reservoir on the roof of student dormitory and 1 sample from the reservoir on the roof of teaching building were positive for norovirus nucleic acid. Meanwhile, water from Laohongshan Reservoir was found to be directly supplied to the school without disinfection. The cases' distribution range was consistent with the water range within the school supplied by Laohongshan Reservoir. 31 cases were tested positive for norovirus nucleic acid. Conclusion This is an outbreak of infectious diarrhea caused by norovirus contamination of school water supply, suggesting that water source management, school water sanitation management, secondary water supply supervision and hygienic monitoring should be strengthened, and well water and river water which have not been strictly disinfected are prohibited to use as domestic water.

Objective To analyze the epidemiological features of foodborne diseases and spatial clustering of the cases in Beijing from 2018 to 2022, to identify hot spots for case distribution, and to provide a basis for scientific and precise prevention and control. Methods Descriptive epidemiological methods were used to analyze the epidemiological characteristics of themonitoring data regarding foodborne diseases in Beijing from 2018 to 2022, and the Acrgic10.8 spatial autocorrelation method was applied to studying their spatial clustering. Results A total of 31,404 cases were reported in Beijing from 2018 to 2022, and the average annual reported incidence rate in the 5-year period was 28.89/100,000. The male to female ratio was 1.18:1.The group aged 20-39 years reported the most cases, with statistically significant differences (P<0.05). August had the highest number of reported cases, accounting for 13.64% (4,285/31,404). Among the self-reported suspicious exposure food, meat and meat products were the highest, accounting for 23.59% (5,403/22,901). Households were the most common places to eat, accounting for 71.73% (16,428/22,901). The highest incidence rate was reported in Huairou District, reaching 107.74/100,000. The results of spatial autocorrelation analysis displayed that the Moran's I values during the 5-year period ranged from 0.36 to 0.63, with statistically significant differences (P<0.05), indicating a spatial clustering of foodborne diseases. Hot spots were mainly distributed in Huairou District and Miyun District in the north, while cold spots in the central urban area of Beijing. Conclusion There was a significant spatiotemporal clustering of foodborne diseases in Beijing from 2018 to 2022. The high incidence areas were Huairou District and Miyun District, and August was the high incidence period. Therefore, prevention and control should be strengthened in the key districts and the high incidence period.

目的 调查医养结合背景下合肥市老年人居家养老服务需求现状,为居家养老服务发展提供一定的依据。方法 2022年1—12月采用分层随机抽样方法选取合肥市9个区389名老年人作为研究对象。采用课题组自制的“医养结合养老服务现况调查问卷”调查其一般资料、健康状况、对居家养老服务的知晓和需求情况以及老年人居家护理服务需求得分情况,采用SPSS 20.0软件描述性分析合肥市老年人居家养老服务需求情况。结果 389名老年人中,有49.87%的老年人年龄在75~89岁,32.13%的老年人为未婚/离婚/分居/丧偶的状态,53.21%的老年人学历在中专及以上,家庭人均月收入3 000元以上者占85.86%,有40.87%的老年人有照护人员,生活经济来源97.94%的老年人有退休工资。有58.87%的老年人合并≥3种的慢性疾病,但仅有10.80%自觉健康状况很差,完全不能自理的老年人占16.20%。有20.82%的老年人不知道医养结合养老服务,而希望居家提供医疗保健相关养老服务的老年人则占68.89%,仅有3.08%的老年人不知晓哪些机构可以提供居家护理服务,有22.11%的老年人不知道居家护理服务有哪些项目。老年人在居家健康护理方面需求较高的两项分别为输液49.10%、抽血检验36.76%。389名调查对象,居家护理服务需求得分平均为(59.86±21.47)分。相较于其他情况,≥90岁、男性、未婚/离婚/分居/丧偶、文化程度小学及以下、家庭人均月收入≤2 000元、没有照护人员、生活来源为退休工资、合并慢性疾病情况≥3种、自觉健康状况很差、完全不能自理的老年人的居家护理服务需求得分相对更高,差异有统计学意义(P<0.05)。结论 合肥地区居家养老的老年人年龄普遍偏大,且大多患有多种慢性病,家庭收入较低、缺乏照顾、自理能力低下的老年人迫切需要居家养老护理服务,建议政府对应增加投入,卫生社区服务到位,加强宣传,增加老年人对医养结合养老服务的知晓率,同时针对居家养老老年人的需求,建立健全医养结合背景下的居家养老护理服务模式,帮助提高老年人居家养老的生活质量。

Objective To explore the relationship between prognostic nutritional index (PNI) and the risk of depression in stroke patients so as to provide references for prognostic management of patients with stroke. Methods Stroke survivors selected from the National Health and Nutrition Examination Survey (NHANES) database from 2017 to 2020 served as the research subjects. Their depression status was assessed, and PNI was calculated. Multivariate logistic regression was used to analyze the effect of PNI on the risk of depression in the stroke patients. Results A total of 443 subjects were enrolled into this survey, including 220 males and 223 females, with the average age of (65.22±12.44) years. A total of 95 (21.44%) cases of depression were detected. The PNI score was lower in post-stroke depression patients than in non-depressed patients ((47.23±7.01) vs. (49.59±5.51)), showing a statistically significant difference between the two groups (P<0.05). The results of multivariate logistic regression displayed that after adjusting for confounding factors such as gender, age, education level, marital status and smoking history, the increase of PNI score had a significantly protective effect on post-stroke depression (OR=0.929, 95%CI:0.892-0.968, P<0.05). Conclusion The increase of PNI score has a certain effect on reducing the risk of depression in the stroke patients. It is of great significance for preventing depression and improving prognosis in the stroke patients to maintain better nutritional status and immune function.

Objective To investigate the status quo of breastfeeding amongst infants under 2 years old in Fangchenggang City, Guangxi Zhuang Autonomous Region, and to analyze its possible influencing factors. Methods A retrospective questionnaire survey was conducted on 592 children aged 2 to 2 years and 3 months and their parents from 28 community health service centers and township health centers in Fangchenggang City from June to December 2021 by a cluster sampling method. The status quo of breastfeeding in infants at 3, 6, 12, 18 and 24 months were investigated. The factors influencing exclusive breastfeeding at 6 months of age and continued breastfeeding at 12 and 18 months of age were surveyed. Results Of the 536 infants aged 2 to 2 years and 3 months, 466 were exclusively breast-fed at 3 months of age, and the rate of exclusive breastfeeding at 3 months was 86.9%. 329 were exclusively breastfed at 6 months of age, the rate of exclusive breastfeeding at six months of age was 61.4%, and the rates of continued breastfeeding at 12, 18 and 24 months were 29.9% (160/536), 4.3% (23/536) and 0.6% (3/536) respectively. Multifactor logistic stepwise regression model revealed that urban area as the family residence (OR=1.678, 95%CI:1.126-2.501), mother as the primary caregiver (OR=2.208, 95%CI:1.357-3.593) and breast milk as the first mouthful of food after birth (OR=2.417, 95%CI:1.482-3.942) were the factors influencing continued breastfeeding at 12 months of age among infants aged 2 to 2 years and 3 months. Time to initiation of breastfeeding less than or equal to 1 hour of birth (OR=3.005, 95%CI:1.203-7.504) and time to initiation of complementary food supplementation within 4 months (OR=4.392, 95%CI:1.479-13.039) were the influential factors for promoting continued breastfeeding at 18 months of age among infants aged 2 to 2 years and 3 months. Conclusion The rate of exclusive breastfeeding at 6 months of age has met the requirements of the Program for the Development ofChinese Children (2011-2020), and the breastfeeding rate decreases with the infants’ increasing age. The results suggest that the health policy and measures of exclusive breastfeeding under 6 months of age in Fangchenggang City are effective. Grass-roots health care workers should strengthen the publicity of importance of continued breastfeeding. Breastfeeding is recommended up to 2 years of age or above 2 years old.

Objective To analyze the literatures related to osteoporosis and intestinal flora research based on Web of Science database, to clarify its research hotspots and trends, and to provide references for related research in future. Methods The Web of Science Core Collection database was searched by subject term fields. The time was set from the establishment of the database to 2022, and the search was completed on May 9, 2023. The bibliometric method and CiteSpace software were employed to statistically analyze the literature characteristics such as country/region, institution, journal and keywords. Results A total of 376 valid papers were obtained, including 247 papers and 129 reviews. The study started in 1998, and the overall number of studies kept growing, especially the most significant increase in the number of literatures after 2019. The research countries were mainly distributed in Asia, the United States and Europe, and the research institutions were mainly universities. The countries with the top 10 journals with published literatures were the United States and Switzerland. Nutrients (16 articles, 4.26%) published the largest number of articles, and Bone had the highest average citation frequency, with 36.17 times. Four of the top 10 cited studies were related to the role of probiotics in the prevention and treatment of postmenopausal bone loss, with the title of “sex steroid deficiency-associated bone lossis microbiota dependent and prevented by probiotics” being cited the most frequently and the number of citations being 96. Hot topics of research included the correlation between osteoporosis and gut flora (keywords: mineral density, health, bone density, bone loss, etc.) and the focus on potential targets of gut flora to prevent osteoporosis (keywords: gut permeability, gut-bone axis, short-chain fatty acids, etc.). The research trend was hip fracture. Conclusion The attention of osteoporosis and intestinal flora research has continued to increaseduring the past 20 years. It is recommended that multi-center and large-scale clinical studies should be conducted to validate and promote the relevant intestinal flora regulatory mechanisms and therapeutic targets.

Objective To analyze the factors influencing myopia and the interactions of outdoor activities and use of electronic products with myopia among pupils in Beijing in 2022. Methods A multi-stage cluster random sampling method was used to randomly select 6 districts in Beijing in July 2022, and then 11 primary schools were randomly selected from the 6 districts. A questionnaire survey was conducted on all pupils in Grades I-V from the selected schools. Univariate t test or χ² test and multivariate logistic regression analysis were performed to identify the factors influencing myopia and analyze the multiplicative interactions between outdoor activities and use of electronic products. Results A total of 15,033 pupils were surveyed in this study. The mean age was (9.12±1.35) years, and the overall prevalence rate of myopia 23.63%. The prevalence rate of myopia in girls was 24.91%, and that in boys was 22.42%. The proportion of Grade I-V pupils who spent >1 hour per day in outdoor activities after school decreased gradually (P_trend<0.001), while the proportions of pupils who spent > 30 minutes on use of electronic products (P_trend<0.001) or > 1 hour on using eyes at a close distance without screen per day after school increased gradually (P_trend<0.001). Older age (OR=1.872, 95%CI:1.810-1.936, P<0.001), girls (OR=1.160, 95%CI:1.068-1.260, P<0.001), myopic parents (father or mother with myopia: OR=2.268, 95%CI:2.020-2.547, P<0.001; father and mother with myopia: OR=5.053, 95%CI:4.485-5.694, P<0.001) and longtime using eyes at a close distance without screen (OR=1.224, 95%CI:1.095-1.368, P<0.001) were risk factors for myopia. Reading at a close distance (11-20 cm: OR=0.833, 95%CI:0.708-0.981, P=0.028; 21-30 cm: OR=0.609, 95%CI:0.514-0.721, P<0.001; > 30 cm: OR=0.558, 95%CI:0.457-0.681, P<0.001) and doing eye exercises once or twice a day (once a day: OR=0.853, 95%CI:0.761-0.957, P=0.007; twice a day: OR=0.880, 95%CI:0.796-0.973, P=0.013) were protective factors for myopia. There were multiplicative interactions between time of outdoor activity after school and time of using electronic products. With the increase of the time of outdoor activities, the effect of using electronic products on the prevalence rate of myopia was weakened (OR=0.803, 95%CI:0.666-0.969, P=0.022). Conclusion Outdoor activities can reduce the effect of using electronic products on myopia. It can be considered to increase children’s outdoor activity time so as to make up for the effect of longtime using electronic products on myopia.

Objective To analyze the distribution characteristics of major acute infectious disease clusters/outbreaks in Changping District of Beijing from 2016 to 2021, and to provide a basis for early detection of the epidemics and taking targeted prevention and control measures in advance. Methods The epidemiological and pathogenic data about fever, vomiting/diarrhea, hand-foot-mouth disease (HFMD) clusters or outbreaks in Changping District from 2016 to 2021 were collected, and descriptive epidemiological methods were used to analyze the composition, time, place, etiology and other distribution characteristics of the epidemics. Results From 2016 to 2021, a total of 670 clusters/outbreaks were reported in Changping District, and most of them were clusters (95.22%). In the clusters reported, the proportion of HFMD was the highest (46.08%). In the outbreaks reported, the proportion of vomiting/diarrhea was the highest (50.0%). The median reporting interval for all the clusters/outbreaks was 2 days, and the duration of the epidemic 2 days. The reporting interval of the epidemic was positively correlated with the duration of the epidemics, with correlation coefficients being r_fever=0.426, r_{vomiting/diarrhea}=0.519, and r_HFMD=0.720 (all P<0.001) respectively. Childcare institutions and primary schools were the main places where the epidemic occurred, accounting for 55.07% and 27.91% of the total number of reported epidemics respectively. May-July and November-December were the peak periods for epidemic reporting each year, with 64.18% of fever outbreaks occurring from December to January of the next year, 77.88% of vomiting/diarrhea outbreaks occurring in November-December and March-June, and 50.0% of HFMD outbreaksconcentrating in May-July. Conclusion From 2016 to 2021, the clusters/outbreaks of key acute infectious diseases in Changping District were mainly influenza, HFMD and norovirus infection related fever, HFMD and vomiting/diarrhea. Early detection and timely reporting could shorten the duration of the epidemic. The epidemics were mainly occurred in primary and secondary schools as well as kindergartens.Targeted prevention and control measures should be taken in combination with seasonal characteristics.

The public health industry has developed rapidly in China in recent years, which has greatly protected the health of our people. In order to coordinate with the sustained, long-term and effective development of public health, the emergency material reserves related to public health emergencies also need to be further strengthened to comprehensively improve the on-site disposal and support capabilities of disease prevention and control institutions and emergency teams at all levels in China. Based on the status quo of domestic health emergency material reserves and combined with foreign practice and case study, this paper draws on the experience of Chinese government’s medical reserve management system construction and the practical experience of China CDC’s health emergency reserve, and puts forward suggestions on strengthening and developing health emergency material reserves for public health emergencies.

Objective To analyze the features and potential life loss of injury-induced deaths among residents in Xi’an City during 2014-2020, and to provide a scientific basis for further conduct the work on injury prevention and control. Methods We collected the monitoring data and population data regarding causes of deaths based on the whole population in 2014-2021 from the Population Death Information Registration and Management System in Xi’an City. Microsoft Excel 2010 was employed to calculate the mortality rate, age-standardized death rate, constituent ratio of causes of death, potential years of life lost (PYLL), potential years of life lost rate (PYLLR), average years of life lost (AYLL) and other indexes. SPSS18.0 software was applied to statistical analysis of the data, and χ² test was used for comparing the rates. Results The average mortality rate of injuries among residents in Xi’an City during 2014-2021 was 29.08/100,000, and the age-standardized death rate 27.16/100,000. The injury-induced mortality rates in males and females were 37.29/100,000 and 20.41/100,000, respectively, and the rate in males was 1.83 times that in females. The injury-induced mortality rates in suburban counties and urban areas were 35.33/100,000 and 22.26/100,000 respectively, and the rate in suburban counties was 1.59 times that in urban areas. There were statistically significant differences in the injury-induced mortality rates between genders as well as between suburban counties and urban areas (χ²=1,907.990, χ²=1,141.569, both P<0.05). The top five causes of deaths due to injuries among residents in Xi’an City from 2014 to 2021 were road traffic injury, accidental fall, suicide, accidental poisoning and other accidental injuries, and the deaths owing to above-mentioned causes accounted for 89.09% of the total injury-induced deaths. The main causes of injury-induced deaths varied greatly among different age groups. The top five causes of injury-induced deaths among residents aged 0-14 years were road traffic injury, accidental suffocation, accidental fall, drowning and suicide. The top five causes of injury-induced deathsamong residents aged 15-44 years were road traffic injury, suicide, accidental fall, accidental poisoning and other accidental injuries. The top five causes of injury-induced deaths among residents aged 45-64 years were road traffic injury, accidental fall, suicide, other accidental injury and accidental poisoning. The top five causes of injury-induced deaths among residents aged 65 years and above were unintentional fall, road traffic injury, suicide, other unintentional injury and accidental poisoning. PYLLR caused by injuries among residents in Xi’an City during 2014-2021 was 4.82%, with the top three causes being road traffic injury, accidental fall and suicide. AYLL induced by injuries among residents in Xi’an City in 2014-2021 was 16.56, with the top three causes being homicide, drowning and electrocution. Conclusion The injury-induced mortality rate among residents in Xi’an City during 2014-2021 was high. Injuries have become an important public health problem that threatens the health and life safety of residents in Xi’an City. Road traffic injury is the main cause of deaths due to injuries. Corresponding injury prevention strategies and measures should be formulated based onthe population'sdifferent characteristics such as age, area and gender.

Objective To observe the pathological changes of renal tissue and laws of polarization of renal macrophages after acute renal injury in rats with sepsis. Methods Rat sepsis models were constructed by cecal ligation and perforation. Rats in the sepsis groups were euthanized at 12, 24, 48, 48 and 72 hours after surgery respectively, and then renal tissue samples were obtained. Rats in the sham-surgery group received the same treatment as the sepsis groups except cecal ligation and perforation, and then were euthanized at 24 hours after surgery for collecting renal tissue samples. The samples were stained by HE staining, and then the status of renal tissue edema was observed.Quantitative real-time polymerase chain reaction (qRT-PCR) was used to detect mRNA expression in M1 and M2 macrophages in renal tissues. The protein expression of M1-type marker CD86 and M2-type marker CD206 was observed by Western blotting, and semiquantitative analysis was conducted by Image-Pro Plus software. Results Compared with the sham-surgery group, the volume of glomerulus cavity at 12, 24, 48 and 72 hours after surgery in the sepsis groups decreased, and the edema degree was significantly aggravated. The mRNA expression of M1-type surface marker CD16 (10.39±0.67), CD86 (7.59±1.11) and iNOS (7.36±1.36) increased significantly at 12 hours after surgery, but gradually decreased over time (P<0.001). The mRNA expression of M2-type surface marker Arg1 (1.05±0.15), CD163 (1.56±0.36) and IL-4 (1.38±0.11) slightly increased at 12 hours after surgery, but the difference was not statistically significant (P>0.05). The mRNA expression of M2-type surface marker Arg1, CD163 and IL-4 gradually increased at 24 and 48 hours after surgery, with statistically significant differences (P<0.001). At 72 hours after surgery, the mRNA expression of Arg1 (4.88±0.53), CD163 (3.70±0.59) and IL-4 (4.94±1.10) maintained the rise, showing statistically significant differences (P<0.001). The detection results of Western blotting were consistent with those ofqRT-PCR, and Western blotting displayed that the expression of M1-type marker CD86 (4.44±0.12) increased in the early postoperative period after sepsis (within 24 hours), but the expression of M2-type marker CD206 (7.76±0.22) increased at 24-72 hours after surgery. Conclusion The laws of M1 and M2 macrophages polarization at different time points after sepsis-induced acute kidney injury provide a theoretical basis for the early intervention of renal injury after sepsis from the perspective of macrophage immune regulation.

Objective To analyze the monitoring data of human adenovirus (HAdV) and influenza virus (IFV) in children cases of influenza-like illness (ILI) in Hunan Province, and to provide a reference basis for prevention and control of related diseases. Methods Throat swab samples of ILI cases from Fever Clinic of Hunan Children's Hospital from June 2019 to October 2020 were collected, and nucleic acids of HAdV and influenza A/B virus (IFV A/B) were detected by fluorescent polymerase chain reaction (PCR). Hexon gene sequences were amplified by PCR for HAdV nucleic acid positive specimens, and thensequenced, genotyped and constructed a phylogenetic tree. Specimens positive for IFV A/B nucleic acid were identified byfluorescent reverse transcription PCR (RT-PCR) for corresponding subtypes/lineages. Results A total of 1,447 swab samples from children cases of ILI were collected, and 108 samples were positive for HAdV nucleic acid, with the positive rate being 7.46%. 67 samples of 7 subtypes were further classified, including 28 samples of HAdV-3, 21 of HAdV-7, 9 of HAdV-4, 5 of HAdV-55, 2 of HAdV-2, and 1 of HAdV-1 or HAdV-14. The positive rate of IFV A/B nucleic acid was 7.81% in 113 samples, including 81 samples of IFV-A H3 subtype and 32 samples of influenza B virus Victoria lineage (BV). 3 samples were detected to be HAdV and IFV mixed infection. The HAdV and IFV positive rates of ILI samples in 2019 were 14.65% and 12.44% respectively, which were higher than those in 2020 (2.56% and 4.65% respectively). No statistically significant differences were found in the HAdV and IFV positive rates between male and female children patients. The positive rate of HAdV or IFV was statistically significant different among different age groups. Conclusion During the monitoring period, HAdV detected in the children cases of ILI in Hunan Province belonged to 7 subtypes, mostly HAdV-3 and HAdV-7, and IFV detected were mainly IFV-A H3 subtype and influenza B virus BV. HAdV and IFV infections are prevalent in children of all ages. Surveillance, prevention and control of HAdV and IFV should be strengthened to reduce the occurrence of related diseases.

Objective To analyze the epidemic features of HIV/AIDS in Chongqing Municipality from 2011 to 2021 so as to provide a reference basis for developing strategies for HIV/AIDS prevention and control. Methods We downloaded the data about reported cases of HIV/AIDS in Chongqing Municipality during 2011-2021 from the Information System for HIV/AIDS Comprehensive Prevention and Treatment of the Chinese Disease Prevention and Control Information System, and then analyzed the cases' distribution features of time, groups and regions. P<0.05 was considered to demonstrate statistically significant differences. Results A total of 71,221 HIV/AIDS cases were cumulatively reported during 2011-2021. The newly reported cases rose from 3,016 cases in 2011 to 8,072 cases in 2021, showing an overall upward trend. Most of the cases were males (75.6%), farmers (37.3%) and people with primary education (34.8%). The majority of the cases were aged 50 years and above (50.5%), and the proportion of cases aged 50 years and above showed an increasing trend year by year (χ²_trend=3,377.030, P=0.000). 83.1% of the caseswere concentrated in the main downtown areas, and 78.8% were infected by heterosexual sex. Most of the cases were detected in medical institutions, accounting for 57.6%. Conclusion The epidemic of HIV/AIDS in Chongqing Municipality from 2011 to 2021 showed an overall upward trend. The situation of prevention and treatment in people aged 50 years and above is grim, and sexual transmission is the main route of transmission currently. Interventions for sexual transmission in key populations need to be further enhanced.

Objective To analyze the association between parental emotional symptoms and preschoolers' autistic behavior problems, and to provide a basis for prevention and control of autistic behavior problems in children. Methods A stratified cluster sampling method was used to select 3,575 children from 12 kindergartens in Hefei City from October 2021 to January 2022. Their parents were asked to fill in the21-ItemDepression, Anxiety and Stress Scale respectively, and their mothers were asked to complete the questionnaire about family general situation and Clancy Autism Behavior Scale. A multivariate logistic regression model was established to analyze the correlation between parental emotional symptoms and preschool children's autistic behavior problems. We explored whether there was an association between parental emotional symptoms and autism behavior problems in the preschoolers. Results The detection rate of autistic behavior problems in the preschool children was 6.13%, and the detection rate was higher in boys than in girls (7.57% vs. 4.53%, χ²=14.366, P<0.001). Logistic regression analysis demonstrated that compared with the reference of fathers and mothers without anxiety, fathers with anxiety and mothers without anxiety (OR=1.817, 95%CI:1.053-3.135), fathers without anxiety and mothers with anxiety (OR=4.834, 95%CI:3.519-6.641) and fathers and mothers with anxiety (OR=6.740, 95%CI:3.902-11.640) were associated with increased risks of suffering from autism behavior problems in the preschool children (all P<0.05). Logistic regression analysis revealed that compared with the reference of fathers and mothers without depression, fathers without depression and mothers with depression (OR=5.148, 95%CI:3.690-7.181) and fathers andmothers with depression (OR=9.070, 95%CI:4.413-18.641) were related to increased risks of suffering from autism behavior problems in the preschool children (both P<0.001). Logistic regression analysis displayed that compared with thereference offathers and mothers without stress, fathers without stress and mothers with stress (OR=4.644, 95%CI:3.131-6.886) and fathers and mothers with stress (OR=8.450, 95%CI:2.827-25.262) were correlated with increased risks of suffering from autism behavior problems in the preschool children (both P<0.001). Conclusion Parents with negative emotional symptoms are associated with increased risks of autism behavior problems in the preschool children, and special attention should be paid to preschoolers with mothers or both parents having negative emotional symptoms.

Objective To analyze the epidemiological features of other infectious diarrhea and long-term changing trends of their incidence rates in Fuling District of Chongqing Municipality from 2013 to 2022, and to provide a scientific basis for other infectious diarrhea prevention and control in Fuling District. Methods Data about other infectious diarrhea cases in Fuling District from 2013 to 2022 were collected from the China Information System for Disease Prevention and Control, and the time, regional and population distribution was analyzed through descriptive research. ArcMap 10.7 was used to draw point density map to visualize the regional distribution of the incidence. Excel 2019 and SPSS 20.0 were applied to calculating the age-standardized incidence rate of the Chinese population. Joinpoint regression model was employed to calculate annual percent of change (APC) and average annual percent change (AAPC), and then the long-term changing trends of the incidence rates were analyzed. Results A total of 11,380 cases ofother infectious diarrhea were reported in Fuling District from 2013 to 2022, with the average annual reported incidence of 1,138cases and the average annual reported incidence rate of 100.87/100,000. There were two incidence peaks in winter and summer. In the population distribution, the number of reported cases in males (n=6,359) was higher than that in females (n=5,021), the number of reported cases in 0-3 years old was 9,995 (accounting for 87.83%). As for the population classification, most of the cases were scattered children (n=9,797, 86.09%). As for the regional distribution, the cases were mainly distributed in Lizhi Street (n=2,485, 21.84%), Chongyi Street (n=2,355, 20.69%), Dunren Street (n=2,119, 18.62%), Ma’an Street (n=1,313, 11.54%) and Jiangdong Street (n=380, 3.34%). One outbreak was reported, whichoccurred in a primary school. Joinpoint regression analysis revealed that the overall trend of the age-standardized incidence rates in Fuling District from 2013 to 2022 showed an increasing trend, with statistical significant differences in the trend (AAPC=8.50%, 95%CI:3.98-13.22, P=0.002). The crude incidence rates of other infectious diarrhea in Fuling District from 2013 to 2018 presented an upward trend, with statistical significant differences in the trend (APC=16.75%, 95%CI:2.73-32.69, P=0.026), but the crude incidence rates from 2018 to 2022 showed a decreasing trend, without statistical significant differences in the trend (APC=-9.89%, 95%CI:-24.81-7.98, P=0.199). Conclusions Other infectious diarrhea in Fuling District during 2013-2022 mainly affected scattered children, and the incidence peak in winter was higher than that in summer. Most of the cases were scattered in the urban areas like Lizhi Street, Chongyi Street and Dunren Street, and schools (primary schools) were the high incidence places. The overall trend in the incidence of other infectious diarrhea in Fuling District from 2013 to 2022 showed a significant increasing trend, but the crude incidence rates from 2018 to 2022 showed a certain decreasing trend under the influence of the SARS-CoV-2 pandemic.Based on the epidemiological characteristics of other infectious diarrhea in Fuling District,targeted prevention and control measures should be taken for high incidence populations in different seasons and regions.

目的 分析影响精神分裂症患者病耻感的相关因素,为改善精神分裂症患者病耻感提供依据。 方法 选取2020年8月—2023年8月湖州市第三人民医院收治的585例精神分裂症患者为研究对象,对以上受试者进行病耻感问卷调查,并通过多元logistic回归分析精神分裂症患者病耻感的影响因素。 结果 经精神疾病内在病耻感量表(Internalized Stigma of Mental Illness Scale,ISMI)调查显示,585例精神分裂症患者存在病耻感有458例(78.29%),其中187例(31.97%)患者为中重度病耻感。病耻感总分平均为(2.38±0.45)分,其中ISMI量表中疏远、刻板印象认同、歧视经历、社交退缩、病耻感抵抗共5个条目均分分别为(2.36±0.41)分、(2.46±0.43)分、(2.31±0.35)分、(2.51±0.49)分、(2.36±0.39)分;多因素logistic回归分析显示,有工作能力(OR=0.360,95%CI:0.179～0.722)和高家庭收入(OR=0.255,95%CI:0.135～0.482)是精神分裂症患者病耻感的保护因素(P<0.05),精神分裂症阳性症状(OR=3.881,95%CI:1.677～8.979)、病程＞5年(OR=3.360,95%CI:1.461～7.729)、年住院次数≥3次(OR=3.177,95%CI:1.387～7.280)以及简明精神病评定量表(Brief Psychiatric Rating Scale,BPRS)评分≥35分(OR=3.370,95%CI:1.474～7.707)是精神分裂症患者病耻感的危险因素(P<0.05)。 结论 精神分裂症患者普遍存在病耻感,其中影响精神分裂症患者病耻感的影响因素涉及工作能力、家庭收入、精神分裂症阳性症状、病程、年住院次数以及BPRS评分,医护人员应重视此问题,并需对症实施一系列干预,以缓解病人的病耻感。

Objective To analyze the factors affecting recurrent respiratory tract infection (RRTI) in children, to construct a predictive model, and to explore the predictive value of the model. Methods Using retrospective research, we collected the clinical data and evaluation results of Dietary Inflammatory Index (DII) of 589 children with respiratory tract infections who were treated in Suzhou Municipal Hospital from February to December 2021. The cases were randomly allocated to the modeling set (n=412) and the validation set (n=177) in a ratio of 7:3. Single and multiple logistic regression analyses were performed on the modeling set data to screen the factors influencing RRTI in the children, and a column chart prediction model was constructed. The performance and clinical practicality of the model were evaluated using receiver operating characteristic (ROC) curve, calibration curve and decision curve respectively. Validation set data were simultaneously introduced for external validation of the model. Results In the modeling set of 412 children with respiratory tract infections, 64 (15.53%) had RRTI during the one-year follow-up after their first diagnosis. Multivariate logistic regression analysis revealed that age (OR=0.666, 95%CI:0.485-0.915) and parental awareness of RRTI prevention and control (OR=0.689, 95%CI:0.526-0.903) were protective factors for RRTI in the children (P<0.05). Allergic history (OR=2.809, 95%CI:1.459-5.407), high C-reactive protein (OR=2.296, 95%CI:1.275-4.101), high DII (OR=2.125, 95%CI:1.242-3.637) and family smoking (OR=1.467, 95%CI:1.080-1.991) were risk factors for RRTI in the children (P<0.05). A column chart model for prediction of RRTI in the children was constructed based on the above-mentioned factors. The area under the ROC curve of the model was 0.867 (95%CI:0.815-0.935), and the optimal cutoff value (threshold probability) 0.37, with the sensitivity and specificity at this point being 0.860 and 0.824 respectively. The Brier index for calibration curve analysis was 0.097 (P>0.05). Introducing validation sets for external model validation found that the area under the ROC curve of the model was 0.851 (95%CI:0.793-0.924), with the sensitivity and specificity being 0.850 and 0.805 respectively. The Brier index for calibration curve analysis was 0.112 (P>0.05). When the threshold probability value in the decision curve was set to 37.0%, the clinical benefit rates for the modeling and validation sets were 54% and 59% respectively, which indicated that the prediction model had clinical validity. Conclusion The prediction model constructed based on age, allergy history, C-reactive protein, DII, smoking of family members and parents' awareness of RRTI prevention and control has a certain predictive value for RRTI risk in the children.

目的 核实及查明百日咳聚集性疫情波及范围、探讨百日咳传播可能的影响因素,为下一步防控提供科学依据。方法 对病例开展流行病学调查及对其密切接触者进行疫苗接种史的调查。采集患儿及其密切接触者鼻咽拭子,采用荧光PCR方法进行百日咳鲍特菌核酸检测。结果 该起疫情共搜索到4例病例,均为确诊病例。首发病例为4月龄患儿,未接种疫苗,感染来源可能是广泛的人群接触,传播方式是儿童→成人。实验室结果显示,患儿父母和奶奶鼻拭子百日咳鲍特菌核酸阳性。结论 该起疫情为一起百日咳家庭聚集性疫情,由于对首发病例诊断不及时,及密接人员缺乏防护导致疫情传播。建议加强对百日咳病例主动监测,掌握百日咳真实的发病水平;增强医务人员和易感者对百日咳疾病的敏感性,及时诊断和报告病例、做好自我防护。

目的 调查分析深圳市龙岗区一起由甲型H1、H3合并感染引起的流行性感冒(简称流感)暴发疫情的流行病学特征,为今后预防控制流感病毒合并感染引起的暴发疫情提供科学依据。 方法 参照《流感样病例暴发疫情处置指南(2018年版)》对该学校疫情进行调查处置,采用描述性方法对病例特征进行分析,采用病例对照研究分析此次暴发的相关危险因素。 结果 本次流感疫情共报告病例19例,均为该学校四(3)班学生,其中男生9例,罹患率26.47%(9/31),女生10例,罹患率38.46%(10/26),男女生罹患率差异无统计学意义(χ²=0.005,P>0.05)。患者年龄均为10岁。病例中发热100.00%(19例),咳嗽78.95%(15例),咽痛36.84%(7例),头晕、头痛31.58%(6例),乏力15.79%(3例)。共采集7名病例咽拭子7份,其中1份样本甲型H1合并H3亚型核酸阳性,2份甲型H1亚型核酸阳性,1份甲型H3亚型核酸阳性,无重症及住院病例。 结论 经过流行病学调查及实验室检测,该起疫情为甲型H1合并H3亚型流感暴发疫情。部分病例隔离不及时、隔离时间不够造成了疫情在该学校的暴发。 为预防学校流感疫情暴发,学校应加强宣传教育,指导学生勤洗手,洗手时使用洗手液,并加强体育锻炼;加强晨检,及时识别并隔离患病学生,隔离的时限严格按照规定执行;调整紫外灯灯管的高度,同时在流感季节,建议学生尽量少去人群聚集场所。

Objective To analyze the prevalence and affecting factors of overweight and obesity amongst pupils and secondary school students in Puyang City, and to provide a scientific theoretical basis for more accurate formulation of measures to prevent and control overweight and obesity in primary and secondary school students. Methods A total of 4,776 primary and secondary school students from 16 schools in 1 district and 2 counties of Puyang City were selected by stratified cluster random sampling method for height and weight measurement as well as a questionnaire survey. χ² test and multiple logistic regression model were used to analyze the factors affecting overweight and obesity. Results In 2021, the detection rate of overweight and obesity among the primary and secondary school students in Puyang City was 37.08%, with the detection rates of overweight and obesity being 17.69% and 19.39% respectively. The detection rates of obesity (22.96%) and overweight and obesity (42.08%) in male students were higher than those in female students (15.65%, 31.85%), showing statistically significant differences (χ²=40.89, χ²=53.55, both P<0.001). With the increase of school stage, the detection rates of obesity and overweight and obesity both showed downward trends. Multiple logistic regression analysis revealed that female students (OR=0.638, 95%CI:0.550-0.740) were the protective factor for obesity in the primary and secondary school students, while primary and junior high schooling stages (primary school OR=1.843, 95%CI:1.424-2.386; middle school OR=1.325, 95%CI:1.038-1.691)and the frequency of fruit consumption in the past 7 days (OR=1.424, 95%CI:1.204-1.684) were the risk factors for obesity in the primary and secondary school students. Conclusion The problem of overweight and obesity among the primary and secondary school students in Puyang City is serious, and it is necessary to accurately intervene the factors affecting overweight and obesity so as to control the problem of overweight and obesity among the primary and secondary school students.

The group standard entitled Specification for Water Treatment Units Making and Selling Purified Water on Site (T/BPMA 0010-2021) was issued by the Beijing Association of Preventive Medicine on December 7th, 2021. The standard specifies the basic, facility, management and emergency treatment requirements of water treatment units making and selling purified water on site. In order to better understand and use the standard, this article gives an interpretation of the standard from the aspects of the formulating background, compiling principles and main contents and help users implement this document correctly.

Objective To analyze the epidemic features and trends of HIV/AIDS in Guangzhou City during 2008-2021, and to provide a scientific basis for formulating precise and high-efficient prevention and control measures. Methods The information about newly reported HIV/AIDS cases and population in Guangzhou from 2008 to 2021 was obtained from the China Information System for Disease Control and Prevention, and the incidence rates of HIV/AIDS in total population, different genders, age groups and urban and rural areas were calculated. Joinpoint regression analysis was used to establish a regression model to analyze the trend in the HIV/AIDS epidemic in Guangzhou City. Results A total of 16,280 HIV/AIDS cases were reported in Guangzhou City from 2008 to 2021, with the annual average incidence rate of 8.66/100,000. The ratio of male to female cases was 6.27:1, and the incidence rate was higher in males than in females (χ²=7,388.534, P<0.001). Joinpoint regression analysis revealed that the incidence rates increased annually from 2008 to 2015 (APC=20.87%, 95%CI:17.18%-24.67%), but showed no significant changing trend from 2015 to 2018 (APC=0.26%, 95%CI:-13.58%-16.32%) and a downward trend from 2018 to 2021 (APC=-8.58%, 95%CI:-14.94%--1.75%). The middle-aged and young (20-59 years old) were the highest incidence group for HIV/AIDS, with a total of 14,530 cases cumulatively reported, accounting for 89.25% of all cases. After a long-term increase, the incidence rates of HIV/AIDS in all age groups showed a downward trend from 2015, 2016 and 2017 respectively. The ratio of reported cases in the urban and rural areas was 14.07:1, and the incidence rate was higher in the urban areas than in the rural areas (χ²=842.866, P<0.001). The incidence rate in the rural areas continued to rise (APC=16.90%, 95%CI:13.67%-20.22%), and had a tendency to surpass the incidence rate in the urban areas. Conclusion The incidence rates of HIV/AIDS in Guangzhou City during 2008-2021 showed downward trends, but were still higher than the national average level. The prevention and control situation is still grim, and hence it is necessary to pay high attention to high-risk groups and the rural areas, raise the residents’ awareness of voluntary testing, and ensure timely self-testing to know the infection situation as soon as possible so as to play a role in promoting further control the epidemic of HIV/AIDS in Guangzhou City.

目的 探讨老年痴呆患者精神行为症状发生现状及影响因素,为临床预防老年痴呆患者精神行为症状的发生提供依据。 方法 回顾性分析2020年1月—2023年1月武汉市第三医院收治的403例老年痴呆患者的临床资料,根据患者是否发生精神行为症状分为发生组和未发生组。比较两组临床资料,分析老年痴呆患者精神行为症状的发生现状;采用单因素χ²检验及多因素logistic回归分析老年痴呆患者精神行为症状发生的危险因素。 结果 老年痴呆患者精神行为症状发生率为67.74%(273/403),占比最高的前三位分别为睡眠/夜间行为158例(57.88%)、幻觉131例(47.99%)及妄想111例(40.66%)。多因素logistic回归分析结果显示,年龄≥80岁(OR=1.895,95%CI:1.042~3.445)、病程≥5年(OR=2.004,95%CI:1.119~3.586)、混合型痴呆(OR=1.772,95%CI:1.195~2.627)、重度痴呆(OR=2.489,95%CI:1.061~5.839)、丧偶(OR=1.941,95%CI:1.055~3.570)、独居(OR=2.219,95%CI:1.007~4.888)、有睡眠障碍(OR=1.912,95%CI:1.091~3.349)、住院期间家人探视频率低(OR=2.040,95%CI:1.035~4.020)均是老年痴呆患者精神行为症状的影响因素。结论 老年痴呆患者精神行为症状发生率较高,多表现为睡眠/夜间行为、幻觉及妄想。老年痴呆患者精神行为症状的发生与年龄、病程、痴呆类型、痴呆程度、伴侣、居住情况、睡眠质量、家人探视情况相关,需采取针对性治疗及干预措施,降低老年痴呆患者精神行为症状的发生风险。

Objective To explore the value and application of multiple nucleic acid tests in the early diagnosis of lower respiratory tract infections caused by pathogenic bacteria through a comparative study of multiple nucleic acid tests and traditional bacterial culture methods. Methods We collected the specimens undergoing nucleic acid tests for six kinds of pathogens in the lower respiratory tract from July 12, 2022 to July 26, 2023, and the specimens underwent traditional bacterial cultures during the same period. The differences in the detection rates of pathogens between the two methods were analyzed and compared. Results The detection rates of Haemophilus influenzae and Streptococcus pneumoniae in sputum specimensundergoing multiple nucleic acid tests were higher than those in sputum specimens undergoing traditional bacterial cultures (12.39% vs. 4.42%, P=0.012; 27.43% vs. 0.00%), but no statistically significant differences were found in the detection rates of Pseudomonas aeruginosa, Staphylococcus aureus, and Klebsiella pneumoniae between the two methods (all P>0.05), with a fair to moderate concordance (kappa=0.328 & 0.387 & 0.490, all P<0.001). As for Klebsiella pneumoniae and Streptococcus pneumoniae in specimens of bronchoalveolar lavage fluid, the detection rates based on multiple nucleic acid tests were higher than those based on traditional bacterial cultures (29.87% vs. 14.29%, P<0.001; 14.29% vs. 0.00%), but no statistically significant differences were observed in the detection rates of Staphylococcus aureus and Pseudomonas aeruginosa between the two methods (P>0.05), with a fair to moderateconcordance (kappa=0.252 & 0.490, both P<0.05). The intra-laboratory turnaround time based on multiple nucleic acid tests was less than that based on traditional bacterial cultures (χ²=7,905.733, P<0.001). Conclusion Multiple nucleic acid tests are more advantageous in the detection of some lower respiratory tractpathogens. The detection of some bacteria based on multiple nucleic acid tests has a certain degree of consistency with that based on traditional cultures, moreover, multiple nucleic acid tests show a shorter intra-laboratory turnaround time, and can rapidly and accurately provide diagnostic and therapeutic information for clinical practice. There is a certain degree of complementarity between the two methods, and the combination of the two methods can effectively avoid the leakage of diagnosis and misdiagnosis.

Objective To analyze the relationships of electronic cigarette (e-cigarette) use behavior with knowledge and cognition among medical students by structural equation model, and to provide new strategies for e-cigarette control activity. Methods From May to November 2022, a stratified multi-stage cluster random sampling method was used to select 4,126 medical students from 3 medical universities in Guizhou Province to conduct a questionnaire survey. The questionnaire was designed based on the China Youth Tobacco Epidemic Survey Questionnaire-2019 and related literatures, and the structural equation model was constructed and evaluated by AMOS 26.0 software. Results A total of 4,126 students were surveyed in this study, including 2,052 (49.73%) males and 2,074 (50.26%) females. There were 1,613 (39.09%)studeutsin the group aged 18 years and younger, 1,966 (47.65%) in the group aged 19-21 years, 547 (13.26%) in the group aged 22 years and above, 1,031 (24.99%) in the urban area group and 3,095 (75.01%) in the rural area group. The utilization rate of e-cigarette attempts among the medical students was 6.54%, the awareness rate of e-cigarette 89.99%, and the awareness rates of knowledge about different e-cigarettes were between 54.89% and 74.29%. As for attitude towards use of different e-cigarettes, the rates of positive attitude were between 4.56% and 21.43%. The goodness-of-fit effect of the final model was better. Results of the structural equation model displayed that factors influencing the medical students' e-cigarette usebehavior were knowledge (β=0.073, P< 0.05), cognition (β=0.051, P<0.05) and attitude (β=-0.150, P<0.05). The direct effect of knowledge on e-cigarette use behavior was higher than the indirect effect. Cognition and attitude had a direct effect on e-cigarette use behavior. Conclusion The levels of knowledge and cognition on e-cigarettes among the medical students need to be improved. The medical students' status of knowing knowledge regarding e-cigarettes can directly affect the use behavior of e-cigarettes, and also indirectly affect the use behavior of e-cigarettes through cognition and attitude. Comprehensive interventions should be conducted from three aspects of knowledge, cognition and attitude so as to promote the formation of anti-smoking awareness and reduce e-cigarette use behavior.

目的 研究重症监护室(intensive care unit, ICU)呼吸机相关性肺炎(ventilator associated pneumonia,VAP)产生的经济损失,为合理分配医疗资源及制定医院感染防控策略提供依据。 方法 回顾性分析2016年1月—2020年12月某三甲医院综合ICU收治的机械通气患者,按性别、年龄、基础疾病等变量采用1∶1选择病例作为对照组,比较两组之间住院费用、住院天数的差异。 结果 病例组总费用、床位费、西药费、护理费、监护费、注射费、治疗费、检查费、化验费、输血费、耗材费高于对照组(P<0.05),病例组和对照组的住院总费用分别为160 309.80(92 617.81,237 660.00)元和86 599.98(54 390.90,128 029.73)元,其中西药费、化验费、治疗费位居前三;病例组较对照组住院天数延长6.5 d,ICU住院时间延长5.5 d,较对照组预后更差,死亡率达40.0%;病例组入住ICU至出现VAP的间隔时间平均为8.0(4.0,12.3)d,大部分气管切开时间在VAP事件之前;病原学以耐碳青霉烯类鲍曼不动杆菌为主。 结论 VAP加速病情恶化,占用更多医疗资源,增加大量住院费用,需制定可行的感染防控策略予以干预。

Objective To investigate the detection rate and epidemiological characteristics of pulmonary nodules among medical professionals in a tertiary hospital in Hefei City, and to analyze the related influencing factors. Methods A cross-sectional study was conducted in medical staff undergoing pulmonary nodule screening using low-dose spiral computed tomography and taking part in completed questionnaire survey in the Health Management Center, the First Affiliated Hospital of University of Science and Technology of China (Anhui Provincial Hospital) in 2021. Results A total of 1,280 patients with pulmonary nodules were detected among 3,475 subjects undergoing physical examination, with a positive rate of 36.83%. The detection rate was higher in males (45.16%, 443/981) than in females (33.56%, 837/2,494). Among the patients with pulmonary nodulesdetected, patients with bilateral pulmonary nodules accounted for the largest proportion (58.36%, 747/1,280), while patients with left pulmonary nodules accounted for the lowest proportion (13.98%, 179/1,280). By multivariate logistic regression analysis, it was found that the age of 31-40 years old (OR=2.372, 95%CI:1.768-3.183), 41-50 years old (OR=36.394, 95%CI:25.803-51.333), 51-60 years old (OR=51.876, 95%CI:34.380-78.275), family history of lung cancer (OR=1.521, 95%CI:1.056-2.192) and frequent light-headedness or dizziness (OR=1.625, 95%CI:1.072-2.462) were independent risk factors affecting the detection of pulmonary nodules in the medical staff (all P<0.05). Conclusion The detection rate of pulmonary nodules is higher in medical staff with older age and a family history of lung cancer. Special attention should be paid to frequent light-headedness or dizziness as a common symptom of pulmonary nodules.

Objective To understand the prevalence rate of screening myopia and its influencing factors among primary and secondary school students in Jiangjin District, Chongqing Municipality, and to provide a scientific basis for formulating policies and measures for prevention and control of juvenile myopia. Methods A random cluster sampling method was used to select a total of 5,741 primary and secondary school students in Jiangjin District in February 2023. The content of the survey involved vision screening and questionnaire survey. Results The prevalence rates of screening myopia in primary, junior middle and high school students in Jiangjin District were 59.30%, 78.07% and 89.34% respectively, and the rates of wearing glasses in screening myopia students from primary, junior middle and high schools were 45.33%, 66.93% and 79.13% respectively. The prevalence rate of screening myopia was higher in female students than in male ones, and increased with school phase and grade level. Six factors, including female students, school phase, parents’ myopia, lack of eye exercises, intake of sugary drinks for 1 day/time and length of outdoor activities, were risk factors for myopia. Conclusion The prevalence rate of screening myopia among the primary and secondary school students in Jiangjin District of Chongqing Municipality was at a high level. A variety of factors affect the occurrence and development of myopia in the students, reminding parents and schools to carry out relevant interventions.

目的 分析不同品牌血细胞分离机采集血小板冲红的原因,以保证单采血小板质量、确保临床输血安全。 方法 从2018年1月1日—2022年12月31日在本中心用的三种血细胞分离机(Trima、Amicus、MCS+)采集的血小板中收集冲红血小板,分析比较血小板冲红和未冲红献血者的各项指标,并对冲红血小板离心前后指标进行检测。 结果 84 260(人)份单采血小板中出现冲红的血小板共46(人)份(占比0.05%),血细胞分离机Trima、Amicus、MCS+的冲红数分别为4、10、32(人)份。冲红观察组的Hb、Hct、MCV、MCH、MCHC均低于未冲红对照组;冲红观察组的献血间隔期短于未冲红对照组;冲红观察组的一年内献血间次数多于未冲红对照组,差异有统计学意义。冲红血小板离心后外观、容量、血小板含量、白细胞混入量、红细胞混入量均符合《全血及成分血质量要求》的规定。 结论 血细胞分离机单采血小板冲红主要与献血者血常规个体差异有关,因此对单采献血者开展一定有针对性的体检筛查,能够减少单采血小板冲红的发生。

Objective To analyze the risk factors affecting periodontal disease onset and construction of a nomogram prediction model. Methods One hundred periodontal tissue disease patients who attended Beijing Hospital of Traditional Chinese Medicine from April 2018 to November 2021 were selected as the research subjects, namely, the observation group, and another 100 patients undergoing health check-ups at the hospital during the same period were selected as the control group. The baseline data of the two groups were recorded. Multi-factor logistic regression analysis was used to identify the risk factors influencingonsetof periodontal tissue disease, and a nomogram prediction model was constructed. Internal data were employed to verify the clinical efficacy of the nomogram model. Results In the comparison of general information such as age and gender between the two groups, the differences were not statistically significant (P>0.05). Compared with the control group, the observation group had shorter brushing time, more smokers and irregular brushes, fewer early and late brushes and fewer rinses after meals, all with statistically significant differences (P<0.05). The area under the curve (AUC) for brushing time was 0.787, and the best cut-off value 2 minutes. The time spent brushing (≤2 min), smoking (yes), irregular brushing (yes), brushing early and late (no) and rinsing after meals (no) were risk factors for the development of periodontal disease (P<0.05). The internal validation results showed that the C-index of the nomogram model for predicting the risk of developing periodontal disease in the patients was 0.733 (95%CI:0.669-0.801). DCA results displayed that the model predicted a risk threshold of >0.07 for patient morbidity. Conclusion Brushing time (≤2 min), smoking (yes), irregular brushing (yes), brushing early and late (no) and rinsing after meals (no) are risk factors for the development of periodontal disease in the patients, moreover, the prediction model constructed based on the risk variables in this study can better predict the patients' development of the disease.

Objective To clarify the impact of high serum lipoprotein (a) levels on the prognoses of patients with acute ischemic stroke. Methods We searched PubMed, Web of Science, CNKI and Wan-fang database to identify the literatures regarding lipoprotein (a) levels and prognoses of patients with acute ischemic stroke from the establishment of the databases to April 2022 by using subject words combined with free words, and the extracts included authors, year of publication, study population, study types, key outcome indicators and conclusions. Results Fifteen relevant papers were finally enrolled into this study, and then evaluated in terms of functional prognosis, recurrent event, cognitive impairment and deep vein thrombosis. Acute ischemic stroke patients with high serum lipoprotein (a) levels had a poor prognosis in functional impairment, a high risk of recurrence, severer cognitive impairment and a high incidence of deep vein thrombosis. Conclusion Acute ischemic stroke patients with high serum lipoprotein (a) levels have poor prognoses compared with those with the normal level ofserum lipoprotein (a).

Objective To investigate the psychological health status of freelance women with second child pregnancy, to analyze its influencing factors, and to provide a theoretical basis for formulating psychological intervention strategies. Methods A convenient sampling method was used to select 282 freelance women with second child pregnancy from departments of obstetrics, the Seventh People's Hospital of Changzhou City and the People's Hospital of Wuxi City from January to November 2022, and then they served as the surveyed subjects. The general information questionnaire, Psychological Capital Scale, Pregnancy Stress Scale, Social Support Rating Scale, Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS) were used for the survey. Pearson correlation analysis was performed to analyze the correlations of psychological capital, gestational stress and social support with mental health status among the freelance women with second child pregnancy. Hierarchical multiple linear regression analysis was conducted to identify the factors affecting anxiety and depression in the freelance women with second child pregnancy. Results Among the 282 freelance women with second child pregnancy, the incidence rate of anxiety during pregnancy was 32.27%, with the average score of SAS being (54.28±7.62) points, and the incidence rate of depression was 24.11%, with the averagescore of SDS being (56.42±8.66) points. There were 54 pregnant women with anxiety and depression, with the incidence rate being 19.15%. Among the freelance women with second child pregnancy, there were negative correlations between the score of psychological capital and the scores of anxiety and depression (both P<0.01), positive correlations between the score of gestational stress and the scores of anxiety and depression (both P<0.01), and negative correlations between the score of social support and the scores of anxiety and depression (both P<0.01). There were statistically significant differences in the anxiety scores of freelance women with second child pregnancy who had different ages, education levels, gestational weeks, monthly incomes, mother-in-law and daughter-in-law relationships, marital relationships, pregnancy complications and abortion experiences (all P<0.05). There were statistically significant differences in the depression scores of freelance women with second child pregnancy who had different education levels, gestational weeks, monthly incomes, mother-in-law and daughter-in-law relationships, marital relationships and abortion experiences (all P<0.05). Psychological capital, gestational stress and social support jointly explained 34.8% variation of anxiety in the freelance women with second child pregnancy. Psychological capital, gestational stress and social support jointly explained 30.4% variation of depression in the freelance women with second child pregnancy. Conclusion The freelance women with second child pregnancy had different degrees of anxiety and depression, and were affected by various factors. Intervention measures should be formulated according to possible relevant factors so as to improve their mental health.

Liver fibrosis is a pathological repair response to chronic liver disease, amd is characterized by the overaccumulation and reorganization of extracellular matrix. Liver biopsy is the gold standard for liver fibrosis determination. The use of non-invasive serum markers of liver fibrosis is particularly important due to the various limitations of this method, including patient injury and the risk of sampling errors. With intensive researches, some emerging biological markers are providing new clues to early predicting the severity of liver fibrosis in the clinical setting, assessing the effectiveness of treatment, improving the prognosis and finding out new therapeutic targets.

Objective To analyze the changing trends in the mortality and premature death probability of chronic respiratory diseases (CRD) in Benxi City, Liaoning Province from 2010 to 2021, and to provide a basis for developing CRD prevention and control measures. Methods The death data were collected from the Surveillance System for Death Causes in Benxi City. SPSS 24.0 software was used to statistically analyze the mortality, standardized mortality, premature death probability, etc. Mortality difference dissembling method was employed to perform differential decomposition analysis on the mortality of population. Differences in the mortalities of males and females were compared by using χ² test, and Joinpoint 4.9.1 software was applied tocalculating the changing trends in the rates. Results From 2010 to 2021, the crude mortality of CRD in the residents in Benxi City was 31.83/100,000, and the standardized mortality 35.87/100,000. Differences in the changing trends in the crude mortality and standardized mortality were not statistically significant (P>0.05). The crude mortality of chronic obstructive pulmonary disease (COPD) in 2010-2021 was 21.40/100,000, and the standardized mortality 24.76/100,000. Differences in the changing trends in the crude mortality was not statistically significant (P>0.05), and the standardized mortality showed a downward trend (APC=-6.34%, P<0.05). The mortalities of CRD and COPD were both higher in the males than in the females. The probability of premature death from CRD decreased from 0.78% in 2010 to 0.39% in 2021, and the probability of premature death from COPD from 0.64% in 2010 to 0.25% in 2021, with statistically significant differences in both the changing trends (APC=-6.02%, APC=-8.34%, both P<0.05). The analysis results based on the difference dissembling method revealed that the crude mortalities of CRD in 2010-2021 increased from 22.03/100,000 to 28.31/100,000 due to the population factor, with a population contributing rate being 592.20%. The crude mortality of COPD increased from 17.41/100,000 to 21.40/100,000 on account of the population factor, with a population contributing rate of 2,858.74%. Conclusion The crude mortalities of CRD and COPD in Benxi City during 2010-2021 showed upward trends, while the standardized mortality and premature death probability presented decreasing trends. Population aging is the main cause for the increase of crude mortality as well as the decrease of standardized mortality and premature death probability. The elderly and male residents are the key groups for prevention and control.

Objective To analyze and evaluate the effect of average daily temperature on the total number of non-accidental deaths (A00-R99) in the population at seven national cause-of-death monitoring sites in Xinjiang, and to provide a scientific basis for health decision making. Methods We collected the total non-accidental death information and meteorological and air quality data of the seven national cause-of-death monitoring sites in Xinjiang from 2015 to 2019. The influence and lag effect ofaverage daily temperature and non-accidental deaths were studied by using the distributed lag non-linear model (DLNM). Results The average daily temperature of the seven monitoring sites in Xinjiang showed a “J” shaped relationship with the non-accidentaldeaths of residents, and the lowest risk temperature of death was 17 ℃. The relative risk value (95%CI) ofresidents' total non-accidentaldeaths on high temperature day was 1.031(1.019-1.043), and the harm effect reached the maximum, with a lag being 5 days. Among different ages and gender groups, high temperature had a greater impact on the risk of non-accidental death in women and people aged ≥65 years. Hypothermia showed no significant health risk and lagging effect on total deaths and in different ages and sexes. Conclusion High temperature can increase the risk of non-accidental death of residents, with obvious acute effects in the early stage. Moreover, there is a lagging effect, and women and people aged ≥65 years are sensitive groups.

Objective To analyze the clinical characteristics and prognostic factors of children with severe pneumonia (SP), and to provide evidence for clinical treatment of SP children. Methods A prospective study was conducted among 195 SP children from Children's Hospital of Nanjing Medical University from June 2019 to June 2022. The SP children's clinical characteristics and prognoses after 3 months of illness were statistically analyzed, and then they were divided into the good prognosis group and the poor prognosis group according to their prognoses. The two groups' clinical data were compared, and the factors influencing their prognoses were analyzed. A line graph prediction model was constructed based on the influencing factors, and the value and clinical utility of the model in predicting poor prognosis in the SP children were evaluated. Results The 195 SP children had cough, fever, sputum and pulmonary wheezing when they sought medical treatment. Among them, 22.05% were accompanied by tachycardia, 9.74% by tachypnea, 5.64% by trisfoveal sign, and 55.90% by multiple organ failure. The age of the poor prognosis group was younger than that of the good prognosis group, and the proportion of 71-80 score based on Pediatric Critical Illness Score (PCIS) was lower in the poor prognosis group than in the good prognosis group. The proportions of children with a history of pulmonary infection, ≥ 5 d from illness to treatment, complications, Krebs von den lungen-6 (KL-6), tissue inhibitor of metalloproteinase-1 (TIMP-1) and soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) levels in the poor prognosis group were all higher than those in the good prognosis group, with statistically significant differences (all P< 0.05). Multi-factor logistic regression analysis revealed that age, previous history of pulmonary infection, time interval from symptom onset to hospital visiting, PCIS score and serum levels of KL-6, TIMP-1 and sTREM-1 were factors influencing the SP children's prognoses (all P<0.05). A histogram prediction model for poor prognosis of the SP children was established based on the influencing factors. The area under the curve (ACU) of this model for predicting poor prognosis of the SP children was 0.922 (95%CI:0.807-0.958), and the prediction sensitivity and specificity were 96.81% and 88.64% respectively, showing good clinical efficacy. Conclusion The SP children's clinical characteristics are complex and varied. Age, history of previous pulmonary infection, time interval from symptom onset to hospital visiting, PCIS score and serum levels of KL-6, TIMP-1 and sTREM-1 are factors affecting the SP children's prognoses. The line graph prediction model constructed based on the influencing factors has good predictive efficacy and clinical utility in forecasting the SP children's poor prognoses.