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ObjectiveTo determine the serum antibody level and risk factors in the adolescent population in a county in Zhejiang Province， following the immunization with inactivated COVID-19 vaccine， and to construct a prediction model for antibody concentration. MethodsWe conducted the study in a county in Zhejiang Province， employing a stratified cluster random sampling strategy in school children who had received the inactivated COVID-19 vaccine. Data on gender， age， type of vaccine， and time of vaccination was collected. Serum samples were also collected to test for anti-S and N IgG antibody against the SARS-CoV-2 by using chemiluminescent immunoassay （CLIA）. Risk factors were determined to construct a prediction model for antibody concentration. ResultsThe IgG antibody concentration was significantly higher in girls， those who received two doses， and those who had simply received the KX vaccine . It decreased with age and time interval between the sampling and last vaccination. The prediction model constructed by random forest regression in the study had a better model fit and predictive ability than that by the multivariable linear stepwise regression. ConclusionGender， age， vaccination dose， type of vaccine， and time of vaccination are associated with vaccination effectiveness of inactivated COVID-19 vaccines in adolescents. Prediction model could predict the antibody level in the vaccinated population， which can provide a new tool for better evaluation of vaccination effectiveness against emerging infectious diseases in future.
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ObjectiveTo understand the usage of antibiotics in outpatients in a county of Zhejiang Province from 2015 to 2020， so as to provide a basis for further standardizing the clinical application of antibiotics in this region. MethodsOutpatient records and prescription records of 146 public medical institutions from 2015 to 2020 were extracted from the electronic medical record data sharing platform system of medical institutions in a county of Zhejiang Province. The utilization rates and the number of types of antibiotics used in outpatient patients were described. According to the drug anatomy， therapeutic and chemical classification system （ATC）， clinical application classification and dosage form， the use status of different types of antibiotics was observed. The annual percentage change （APC） was used to analyze the time trend of antibiotic use. Among the antibiotic prescriptions in each year， the proportions of prescriptions aimed for different use reasons and patients were compared to analyze the changes in the structures of antibiotic prescriptions. ResultsDuring 2015‒2020， a total of 2 861 438 prescriptions were issued in146 primary public medical institutions in this county， including 314 642 prescriptions for antibiotics， and the overall utilization rate of antibiotics was 11%. The utilization rate of antibiotics showed a decreased trend across the years （from 14.23% in 2015 to 7.59% in 2020，APC=-11.51%， 95%CI=-0.01%‒-21.7%， t=-12.05， P<0.001） and an obvious seasonal variation character （higher in winter and spring， lower in summer and autumn）. Cefoxitin sodium for injection was the most used antibiotic in 2015， and cefuroxime was the most used antibiotic from 2015 to 2020， respectively. The utilization rates of cephalosporins （APC=-11.06%， 95%CI=0‒-20.89%， t=-22.233， P<0.001）， quinolones （APC=-9.74%， 95%CI=0‒-18.53%， t=-7.652， P=0.002）， macrolides （APC=-17.52%， 95%CI=0‒-17.52%， t=-3.626， P=0.022） and lincoamides （APC=-49.01%， 95%CI=0‒-74%， t=-3.35， P=0.029） showed a decreasing trend across the years. There were differences in the distribution of drug use reasons （χ2=9 458.427， P<0.001）， as well as the age （χ2=5 421.709， P<0.001） and sex （χ2=245.322， P<0.001） of patients. During the observation period， 50.69% of antibiotic prescriptions were used to treat respiratory diseases， with the highest proportion of 57.67% in 2015 and the lowest proportion of 34.93% in 2020. 58.37% of patients were aged 50‒70 years， with a decreasing proportion of patients under 50 years （17.83% in 2015， 6.64% in 2020） and an increasing proportion of patients over 70 years （24.1% in 2015， 38.41% in 2020）. ConclusionThe utilization rate of antibiotics used in outpatients from primary public medical institutions in a county of Zhejiang Province shows a decreasing trend across the years， but higher than that of secondary and above hospitals in China， and also higher than that of primary medical institutions in economically-developed areas. The management and monitoring of the clinical use of antibiotics in the county should be actively strengthened.
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Gaming addiction， as a main manifestation of internet addiction， is characterized by a pattern of persistent or recurrent gaming behaviors. Gaming behaviors are common among adolescents and can result in marked distress or significant impairment in personal， family， social or other important areas of functioning. Recent research on health hazards of gaming addiction is relatively scattered. This article reviews the harm of adolescent game addiction to physical and mental health.
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ObjectiveTo investigate the specific anti-SARS-CoV-2 antibody in adults and above after initial vaccination with inactivated COVID-19 vaccine， and determine the influencing factors. MethodsIn this study， residents aged 18 and above who had completed two doses of inactivated COVID-19 vaccine in Deqing County， Huzhou City， Zhejiang Province were included. Information such as gender， age， type of vaccine and vaccination time were collected， and serum specimens were sampled. Anti-SARS-CoV-2 receptor binding domain （RBD） antibody was quantitatively examined by enzyma-linked immunosorbent assay （ELISA） and influencing factors were determined. ResultsThe median concentration of anti-SARS-CoV-2 IgG antibody in the residents vaccinated with an inactivated booster vaccine was higher than that in those vaccinated with only two doses of COVID-19 vaccine or single dose （P<0.05）. The median concentration of IgG antibody in males was 9.73 （4.01‒23.70） RU‧mL-1， lower than 17.76 （7.07‒49.23） RU‧mL-1 in females （P<0.05）. The median concentration in the residents vaccinated with BBIBP-CorV （Sinopharm） was 6.53 （0.97‒13.69） RU‧mL-1， which was lower than that in those vaccinated with CoronaVac （Sinovac） that was 17.29 （8.54‒43.73） RU‧mL-1 （P<0.05）. The median concentration in those with BBIBP-CorV was also lower than 12 （5.45‒40.06） RU‧mL-1 in those with heterologous booster vaccine （P<0.05）. The median concentration was 9.73 （3.83‒23.63） RU‧mL-1 in the residents with an interval of more than 6 months from the second dose， which was lower than 14.66 （6.36‒35.98） RU‧mL-1 in those with an interval of 3‒6 months （P<0.05）. Moreover， immune effect was better in females （χ²=16.464， P<0.05）， 18‒45 years（χ²=7.158， P<0.05）， and those vaccinated with CornaVac （χ²=49.637， P<0.05）， while decreased in those with an interval of more than 6 months from the second dose （χ²=8.447， P<0.05）. ConclusionGender， age， and type of vaccine may affect the effect of immunization. The COVID-19 vaccination shows an acceptable immunogenicity in adults； however， it declines in 6 months after vaccination. It warrants strengthening the booster vaccination to maintain the immune response.