Factors affecting hospitalization costs among stroke patients in Nanshan District / 预防医学

Objective@#To analyze the influencing factors for hospitalization costs among stroke patients with different subtypes, so as to provide the reference for reducing the economic burden of patients.@*Methods@#Data of patients with hemorrhagic or ischemic stroke who were discharged from hospitals in Nanshan District, Shenzhen City from January 1, 2016 to December 31, 2021 were collected through Hospital Information System. Hospitalization costs were analyzed between hemorrhagic and ischemic stroke patients, and factors affecting hospitalization costs among stroke patients with different subtypes were identified using a structural equation model.@*Results@#A total of 10 298 patients with stroke were recruited, including 2 820 patients with hemorrhagic stroke (27.38%) and 7 478 patients with ischemic stroke (72.62%). The patients with hemorrhagic stroke had a median duration of hospital stay of 19.00 (interquartile range, 18.00) d, and a median hospitalization cost of 26 759.48 (interquartile range, 51 000.87) Yuan. The patients with ischemic stroke had a median duration of hospital stay of 12.00 (interquartile range, 10.00) d, and a median hospitalization cost of 12 199.87 (interquartile range, 13 290.20) Yuan. Structural equation model analysis showed that department of hospitalization, discharge status, ways of leaving hospital, surgery and hypertension had direct effects on hospitalization costs and indirect effects on hospitalization costs through duration of hospital stay among hemorrhagic stroke patients, and duration of hospital stay had the highest total effect (0.684), followed by surgery (0.632). Employment status, admission route, department of hospitalization, ways of leaving hospital, payment mode, surgery and dyslipidemia had direct effects on hospitalization costs and indirect effects on hospitalization costs through duration of hospital stay among ischemic stroke patients, and duration of hospital stay (0.746), surgery (0.424) and department of hospitalization (0.151) ranked the top three in total effects.@*Conclusion@#The hospitalization cost is relatively high among stroke patients in Nanshan District, and duration of hospital stay and surgery have great influence on hospitalization costs among stroke patients with different subtypes.

Synthesis and biological activity evaluation of phthalimide-donepezil hybrids / 药学学报

A series of phthalimide-donepezil (PTA-DPZ) hybrids (5a-e, 6a-l) were designed, synthesized and evaluated as selective inhibitors of acetylcholinesterase (AChE). The results showed that some hybrids had strong AChE inhibitory activity with half maximal inhibitory concentration (IC50) at nanomolar range, which was better than the control drugs galanthamine and tacrine, and equivalent to DPZ. Compound 6k exhibited the strongest inhibition to AChE with an IC50 value of 0.13 μmol·L-1. Kinetic and molecular modeling studies showed that 6k targeted both catalytic active site and peripheral anionic site of AChE. Moreover, some compounds could inhibit AChE-induced β-amyloid (Aβ) aggregation. In addition, absorption, distribution, metabolism and excretion prediction results showed 6k conforms to the Lipinski's rule of five and had high partition coefficient P value. These compounds, especially 6k, may be considered as a dual-functional lead compound for in-depth research.

Epimedin B exhibits pigmentation by increasing tyrosinase family proteins expression,activity,and stability / 药物分析学报

Epimedin B(EB)is one of the main flavonoid ingredients present in Epimedium brevicornum Maxim.,a traditional herb widely used in China.Our previous study showed that EB was a stronger inducer of melanogenesis and an activator of tyrosinase(TYR).However,the role of EB in melanogenesis and the mechanism underlying the regulation remain unclear.Herein,as an extension to our previous investi-gation,we provide comprehensive evidence of EB-induced pigmentation in vivo and in vitro and eluci-date the melanogenesis mechanism by assessing its effects on the TYR family of proteins(TYRs)in terms of expression,activity,and stability.The results showed that EB increased TYRs expression through microphthalmia-associated transcription factor-mediated p-Akt(referred to as protein kinase B(PKB))/glycogen synthase kinase 3β(GSK3β)/β-catenin,p-p70 S6 kinase cascades,and protein 38(p38)/mitogen-activated protein(MAP)kinase(MAPK)and extracellular regulated protein kinases(ERK)/MAPK pathways,after which EB increased the number of melanosomes and promoted their maturation for melanogenesis in melanoma cells and human primary melanocytes/skin tissues.Furthermore,EB exerted repigmentation by stimulating TYR activity in hydroquinone-and N-phenylthiourea-induced TYR inhibitive models,including melanoma cells,zebrafish,and mice.Finally,EB ameliorated monobenzone-induced depigmentation in vitro and in vivo through the enhancement of TYRs stability by inhibiting TYR misfolding,TYR-related protein 1 formation,and retention in the endoplasmic reticulum and then by downregulating the ubiquitination and proteolysis processes.These data conclude that EB can target TYRs and alter their expression,activity,and stability,thus stimulating their pigmentation function,which might provide a novel rational strategy for hypopigmentation treatment in the pharmaceutical and cosmetic industries.

Real-world setting comparison of bridging therapy versus direct mechanical thrombectomy for acute ischemic stroke: A meta-analysis

Abstract Background and purpose Intravenous Thrombolysis (IVT) prior to Mechanical Thrombectomy (MT) for Acute Ischaemic Stroke (AIS) due to Large-Vessel Occlusion (LVO) remains controversial. Therefore, the authors performed a meta-analysis of the available real-world evidence focusing on the efficacy and safety of Bridging Therapy (BT) compared with direct MT in patients with AIS due to LVO. Methods Four databases were searched until 01 February 2023. Retrospective and prospective studies from nationwide or health organization registry databases that compared the clinical outcomes of BT and direct MT were included. Odds Ratios (ORs) and 95 % Confidence Intervals (CIs) for efficacy and safety outcomes were pooled using a random-effects model. Results Of the 12 studies, 86,695 patients were included. In patients with AIS due to LVO, BT group was associated with higher odds of achieving excellent functional outcome (modified Rankin Scale score 0-1) at 90 days (OR = 1.48, 95 % CI 1.25-1.75), favorable discharge disposition (to the home with or without services) (OR = 1.33, 95 % CI 1.29-1.38), and decreased mortality at 90 days (OR = 0.62, 95 % CI 0.56-0.70), as compared with the direct MT group. In addition, the risk of symptomatic intracranial hemorrhage did not increase significantly in the BT group. Conclusion The present meta-analysis indicates that BT was associated with favorable outcomes in patients with AIS due to LVO. These findings support the current practice in a real-world setting and strengthen their validity. For patients eligible for both IVT and MT, BT remains the standard treatment until more data are available.

Analysis of an outbreak of influenza A in a primary school in Jing an District, Shanghai / 中国学校卫生

Objective@#To investigate the epidemiological data of an outbreak of influenza A in a primary school in Shanghai, to provide reference for targeted prevention and control measures.@*Methods@#A field epidemiological method was used to investigate and collect the data of influenza A outbreak in a primary school in Jing an District from November 8 to December 6, 2022, through on site follow up and telephone return visit to health teachers and cases. The distribution characteristics of the epidemic were analyzed by descriptive epidemiology.@*Results@#The first case developed symptoms of cough, sore throat, and fever on the morning of November 8th 2022, with a maximum body temperature of 38.6 ℃. Later, the clinical diagnosis was influenza A. The total number of influenza like cases reported in this outbreak is 99, including 92 students and 7 teachers. The total incidence rate was 9.45%. The clinical symptoms of all cases were fever, sore throat, and cough; 27 cases of influenza A were diagnosed by hospital rapid diagnostic reagents. The second grade students had the highest case incidence rate(24.46%), and there was a statistically significant difference in case incidence rates among students of different grades ( χ 2=48.28, P ＜0.01). The case incidence rate on the second floor was the highest (23.47%), and there was a statistically significant difference between the case incidence rates on different floors ( χ 2=52.38, P ＜ 0.01 ). Etiological testing showed that the influenza virus causing this outbreak was type A H3N2 virus.@*Conclusion@#This outbreak is a campus cluster outbreak caused by influenza A (H3N2) virus. The health and education departments should strengthen cooperation to effectively implement prevention and control measures of infectious diseases, and timely identify the source of infection and cut off the transmission route.

Toxic Epidermal Necrolysis Induced by Sintilimab: A Case Report

Sintilimab is an anti-programmed cell death receptor-1 antibody. The phase III clinical trial ORIENT-12 confirmed the safety of sintilimab combined with pemetrexed/platinum in the treatment of advanced squamous non-small cell lung cancer. Skin reactions are the most commonly reported adverse events of immune checkpoint inhibitors and are rarely severe.We describe a case of toxic epidermal necrolysis related to sintilimab in an elderly oncologic patient. 3 weeks after immunotherapy, the patient developed an extensive rash and diffuse itching, rapidly evolving into macules, blisters, bullae and erosions. Causal evaluation was performed based on the algorithm of drug causality for epidermal necrolysis and national Food and Drug Administration qualitative analysis. The patient responded to high-dose glucocorticosteroid and supportive therapy, alongside with local wound care. If immune checkpoint inhibitors need to be extrapolated clinically, strictly following evidence-based research, promptly detecting and treating adverse reactions is crucial.

The properties of ZnO nanofilms on titanium surface by atomic layer deposition / 口腔医学

Objective@#To compare and investigate the physicochemical characteristics and antibacterial effect of ZnO nanofilms prepared by atomic layer deposition(ALD) at different deposition cycles.@*Methods@#According to different ALD cycles, four groups were set up (control group, 300, 600 and 1 200 cycles group). Using DEZn and water as precursors, ZnO nanofilms were prepared by ALD on the surface of pure titanium specimens. Surface morphology of the films was observed by scanning electron microscope (SEM); the element composition and crystal type of the films were observed by energy dispersive spectrometer (EDS) and X-Ray Diffraction (XRD); the hydrophilicity and thickness of the films were detected by water contact angle detector and ellipsometer. The cytotoxicity of the films was evaluated by CCK-8 assay. The antibacterial effect against S. aureus in vitro of the films was evaluated by optical density method.@*Results@#The surface morphology of the films was uniform and compact as shown through SEM. The grain size increased with the increase of the number of ALD cycles. EDS results showed that the films were mainly composed of Zn and O elements. XRD results confirmed that the composition of the films was ZnO. Results of water contact angle showed that the films were hydrophobic. The thickness of the films was nanoscale and there was a linear relationship between the thickness and ALD cycles. All experimental groups showed no cytotoxicity. The 1 200 cycles group showed the highest antibacterial rate of 65.9% and 52.3% at 24 and 48 hours respectively, which was the best among all experimental groups. @*Conclusion@#The ZnO nanofilms prepared by ALD at different cycles on pure titanium surface are uniform and compact. Thickness of the films increases with the increase of ALD cycles. The films have good biocompatibility and anti-S. aureus effect in vitro. The 1 200 cycles group has the best antibacterial effect.

Effect of gingival stem cells-derived exosomes on interlukin (IL)-6 and tumor necrosis factor (TNF)-α expression in rats with periodontitis / 预防医学

Objective @#To evaluate the effect of gingival stem cells-derived exosomes (GMSC-Exos) treatment on the expression of interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) in rats with periodontitis, so as to provide the evidence for periodontitis treatment.@*Methods@#Forty specific pathogen-free (SPF) rats at ages of 8 weeks were randomly divided into 4 groups, including the blank group, periodontitis group, GMSC-Exos group and PBS group. Rats in the periodontitis group, GMSC-Exos group and PBS group were modeled for periodontitis using the ligature method. Rats in the blank group and periodontitis group were given no treatment, while rats in the GMSC-Exos group and PBS group were given 20 μL GMSC-Exos and PBS by injection, respectively. The periodontal index was measured in all rats 4 weeks post-treatment, and the TNF-α and IL-6 levels were measured in rat serum samples using enzyme-linked immunosorbent assay (ELISA). The TNF-α and IL-6 gene expression was quantified using the polymerase chain reaction (PCR) assay in the gingival tissues of the rat left upper maxillary area, and the periodontal tissues in the left upper maxillary areas were sampled for pathological examinations. Periodontal clinical indexes, IL-6 and TNF-α levels were compared in each group.@*Results@#The gingival sulcus bleeding index, gingival index, probing depth, and plaque index in the GMSC-Exos group (1.87±0.41, 1.03±0.19, 1.91±0.09 and 1.11±0.17) were higher than those in the blank group (0.96±0.31, 0.83±0.31, 1.09±0.05 and 1.01±0.38), but lower than those in the periodontitis group (2.65±0.50, 1.36±0.22, 2.61±0.07 and 1.51±0.26) and PBS group (2.44±0.50, 1.23±0.20, 2.49±0.10 and 1.39±0.28) (all P<0.05). The serum IL-6 and TNF-α levels in the GMSC-Exos group [(205.97±11.47) and (90.11±8.57) pg/mL] were higher than those in the blank group [(143.10±4.87) and (80.07±5.13) pg/mL], but lower than those in the periodontitis group [(367.33±13.89) and (158.29±13.10) pg/mL] and PBS group [(364.23±13.62) and (140.60±11.73) pg/mL] (all P<0.05). The IL-6 and TNF-α mRNA expression in the rat gingival tissues in the GMSC-Exos group (1.09±0.14 and 1.61±0.29) was higher than that in the blank group (0.99±0.10 and 1.06±0.14), but lower than that in the periodontitis group (1.63±0.09 and 3.63±0.26) and PBS group (1.58±0.11 and 3.79±0.32) (all P<0.05). Pathological examinations showed alleviation of periodontal tissue destruction, inflammatory cell infiltration and alveolar bone resorption, and no obvious root dental root regeneration in the junctional combined epithelium in the GMSC-Exos group relative to the periodontitis group and the PBS group. @*Conclusion@#Administration of GMSC-Exos may reduce periodontal inflammation and alveolar bone resorption by inhibiting IL-6 and TNF-α expression in rats with periodontitis.

Aquatic sports rehabilitation on functional recovery of knee joint injury / Reabilitação esportiva aquática na recuperação funcional de lesão do joelho / Rehabilitación deportiva acuática en la recuperación funcional de lesión de la rodilla

ABSTRACT Introduction Knee joint injury is a common sports injury and how to speed up the recovery process is a concern for all athletes. Objective Determine whether aquatic sports rehabilitation nursing can accelerate the rehabilitation process of knee joint injuries. Methods Thirty patients with knee ligament or meniscal injury were divided into an aquatic sports group and a control group. The control group assumed general recovery measures, while the aquatic exercise group was added another 8 weeks of rehabilitation nursing with aquatic exercises. The evolution of the degree of knee joint pain, knee joint range of motion, knee joint muscle strength and other indicators before and after the experiment were compared. Results After 8 weeks of intervention, pain and activities of daily living in the aquatic exercise group improved significantly compared with those before the experiment; the degree of recovery from knee joint injury in the aquatic exercise group was significantly better than that in the control group, and knee joint flexion range of motion, flexor and extensor muscle strength, and other indicators in the aquatic exercise group were significantly better than those in the control group. Conclusion Aquatic rehabilitation exercise can accelerate the recovery process of patients with knee joint injuries. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.

RESUMO Introdução A lesão articular do joelho é uma lesão esportiva corriqueira e a maneira de acelerar o processo de recuperação é uma preocupação para todos os atletas. Objetivo Determinar se a enfermagem de reabilitação esportiva aquática pode acelerar o processo de reabilitação das lesões nas articulações do joelho. Métodos Trinta pacientes com lesão ligamentar ou meniscal do joelho foram divididos em grupo de esportes aquáticos e grupo de controle. O grupo de controle assumiu medidas gerais de recuperação, enquanto ao grupo de exercícios aquáticos acrescentou-se mais 8 semanas de enfermagem de reabilitação com exercícios aquáticos. Comparou-se a evolução do grau de dor na articulação do joelho, a amplitude de movimento da articulação do joelho, a força muscular da articulação do joelho e outros indicadores antes e depois da experiência. Resultados Após 8 semanas de intervenção, a dor e as atividades das atividades de vida diária no grupo de exercícios aquáticos melhoraram significativamente em comparação com aquelas antes do experimento; o grau de recuperação da lesão da articulação do joelho no grupo de exercícios aquáticos foi significativamente melhor do que o do grupo controle, e a amplitude de flexão da articulação do joelho, a força muscular flexora e extensora e outros indicadores no grupo de exercícios aquáticos foram significativamente melhores do que os do grupo controle. Conclusão O exercício de reabilitação aquática pode acelerar o processo de recuperação de pacientes com lesões articulares no joelho. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.

RESUMEN Introducción La lesión de la articulación de la rodilla es una lesión deportiva común y acelerar el proceso de recuperación es una preocupación para todos los atletas. Objetivo Determinar si la enfermería de rehabilitación deportiva acuática puede acelerar el proceso de rehabilitación de las lesiones articulares de rodilla. Métodos Treinta pacientes con lesiones de ligamentos o meniscos de rodilla se dividieron en un grupo de deportes acuáticos y un grupo de control. El grupo de control asumió medidas generales de recuperación, mientras que al grupo de ejercicios acuáticos se le añadieron 8 semanas adicionales de enfermería de rehabilitación con ejercicios acuáticos. Se comparó la evolución del grado de dolor de la articulación de la rodilla, la amplitud de movimiento de la articulación de la rodilla, la fuerza muscular de la articulación de la rodilla y otros indicadores antes y después del experimento. Resultados Tras 8 semanas de intervención, el dolor y las actividades de la vida diaria en el grupo de ejercicio acuático mejoraron significativamente en comparación con los anteriores al experimento; el grado de recuperación de la lesión de la articulación de la rodilla en el grupo de ejercicio acuático fue significativamente mejor que el del grupo de control, y la amplitud de la flexión de la articulación de la rodilla, la fuerza muscular flexora y extensora y otros indicadores en el grupo de ejercicio acuático fueron significativamente mejores que los del grupo de control. Conclusión El ejercicio de rehabilitación acuática puede acelerar el proceso de recuperación de los pacientes con lesiones articulares de rodilla. Nivel de evidencia II; Estudios terapéuticos - investigación de los resultados del tratamiento.

Value of bedside echocardiography in predicting persistent patency of the ductus arteriosus during the early postnatal period in very low birth weight infants / 中国当代儿科杂志

OBJECTIVES@#To study the value of bedside echocardiography in predicting persistent patency of the ductus arteriosus during the early postnatal period in very low birth weight (VLBW) infants.@*METHODS@#A retrospective analysis was performed for 51 VLBW infants who were admitted from March 2020 to June 2021, with an age of ≤3 days and a length of hospital stay of ≥14 days. According to the diameter of patent ductus arteriosus (PDA) on days 14 and 28 after birth, the infants were divided into three groups: large PDA group (PDA diameter ≥2 mm), small PDA group (PDA diameter <2 mm), and PDA closure group (PDA diameter =0 mm). The echocardiographic parameters measured at 72 hours after birth were compared among the three groups. The receiver operating characteristic (ROC) curve was used to evaluate the value of the echocardiographic parameters in predicting persistent patency of the ductus arteriosus (PDA≥2 mm) at the ages of 14 and 28 days.@*RESULTS@#On day 14 after birth, there were 17 infants in the large PDA group, 11 in the small PDA group, and 23 in the PDA closure group. On day 28 after birth, there were 14 infants in the large PDA group, 9 in the small PDA group, and 26 in the PDA closure group. There were significant differences in gestational age, birth weight, rate of pulmonary surfactant use, and incidence rate of hypotension among the three groups (P<0.05). PDA diameter, end-diastolic velocity of the left pulmonary artery, left ventricular output, and left ventricular output/superior vena cava flow ratio measured at 72 hours after birth were associated with persistent patency of the ductus arteriosus at the ages of 14 and 28 days (P<0.05), and the ratio of the left atrium to aorta diameter was associated with persistent patency of the ductus arteriosus at the age of 28 days (P<0.05). The ROC curve analysis showed that the area under the curve that the PDA diameter measured at 72 hours after birth predicting the persistent patency of the ductus arteriosus at the ages of 14 and 28 days was the largest (0.841 and 0.927 respectively), followed by end-diastolic velocity of the left pulmonary artery, with the area under the curve of 0.793 and 0.833 respectively.@*CONCLUSIONS@#The indicators obtained by beside echocardiography at 72 hours after birth, especially PDA diameter and end-diastolic velocity of the left pulmonary artery, can predict persistent patency of the ductus arteriosus at the ages of 14 and 28 days in VLBW infants, which provides a basis for the implementation of early targeted treatment strategy for PDA.

A followup study on academic pressure and Internet addiction of college students in Jiangsu / 中国学校卫生

Objective@#To examine the longitudinal relationship between academic pressure and Internet addiction of college students and to provide reference for the development of college students mental health.@*Methods@#In October 2016, a longitudinal 4 waves (T1 to T4) of follow up study was conducted among 5 372 college students from a university in Jiangsu, with an interval of 1 year each time. Academic pressure and Internet addiction were derived from the College Students Mental Health Screening Scale. A cross lag analysis was used to explore the relationship between college students academic pressure and Internet addiction.@*Results@#Repeated measures analysis of variance showed that the main effect of time for academic pressure was significant[ F(3,16 113)= 767.28 , P<0.01,η 2=0.13]. The academic pressure of college students showed a downward trend over time, with the highest at T1 stage and the lowest at T4 stage. The main effect of time for college students Internet addiction was significant[ F(3,16 113)= 165.22 , P<0.01, η 2=0.03]. The Internet addiction of college students showed a trend of decreasing after increasing over time, with the highest stage T2 and the lowest stage T4. The cross lag analysis showed that academic pressure of T1 could significantly predict the Internet addiction of T2, and academic pressure of T3 could significantly predict the Internet addiction of T4, and the path coefficients are 0.07 and 0.07( P <0.01). In addition, the pre test (T n ) Internet addiction can significantly predict the post test [T( n +1)] academic pressure, and the path coefficients were 0.06, 0.06, 0.08( P <0.01).@*Conclusion@#Academic pressure can partially predict Internet addiction among college students, while Internet addiction can also significantly predict academic pressure. Colleges and universities should strengthen the construction of learning style, reduce the academic pressure of students,and reduce the Internet addiction of college students through various ways, so as to promote the healthy development of college students.

Research Progress of Exercise Intervention on Breast Cancer: A Visualization Analysis / 肿瘤防治研究

Objective To analyze the research focuses and frontiers of exercise intervention on breast cancer patients. Methods We collected 7134 pieces of literature about exercise intervention on breast cancer in the Web of Science Core Collection database in recent five years, and CiteSpaceⅤ was used to conduct visual knowledge map analysis and generate a visual map including discipline distribution, country or region distribution, keyword co-occurrence or highlighting, keyword timeline maps, etc. Results In recent years, the domain of exercise intervention on breast cancer has achieved rapid development. The disciplines were mainly cardiovascular system and cardiology as well as oncology. Countries such as the United States, the United Kingdom and Italy ranked in the first places with regard to the number of papers. The body mass index and the quality of life betweeness centrality were respectively 0.81 and 0.52, which played an important role in the knowledge map. The keyword highlighting map and the timeline map showed that cardiac toxicity was a research focus in this domain. Conclusion The research focuses of exercise intervention on breast cancer are mainly cardiovascular and related fields, in a rapid development stage. Future research directions include weight control, quality of life and cardiac toxicity.

Synthesis, cholinesterase inhibition and hepatotoxicity of tacrine-phenol-bifendate hybrids / 药学学报

A series of tacrine-phenol-bifendate hybrids (7a-7e, 8a-8e) were designed, synthesized and evaluated as inhibitors of cholinesterases (ChEs) with low hepatotoxicity. All the compounds had potent ChEs inhibitory activity with half-inhibitory concentration (IC50) values at the nanomolar range. Compound 8d exhibited the strongest inhibition to acetylcholinesterase (AChE) with an IC50 value of 156.39 nmol·L-1 and compound 7b showed the most potent inhibition for butyrylcholinesterase with IC50 value of 16.33 nmol·L-1. Kinetic and molecular modeling studies showed that 8d targeted both the catalytic active site and the peripheral anionic site of AChE. In addition, these compounds showed low toxicity to hepatocytes, and compound 8d did not increase the level of reactive oxygen species in HepG2 cells.

Analysis of the growth and development of HIV-infected children on initiated ART in Guangxi, 2004-2019 / 中国热带医学

@#Abstract: Objective　To investigate the growth and development of HIV-infected children initiating antiretroviral therapy (ART) and its influencing factors. Methods　This retrospective cohort study was conducted in Guangxi. HIV-infected children initiating free antiretroviral therapy (ART) from 2004 to 2019 were included. Z-score was calculated according to the Chinese Child Growth and Development Standard, the Cox-Stuart test was used for trend analysis, and the generalized estimating equation was used to analyze HAZ (Height-for-age Z-score)≥-2 and WAZ (Weight-for-age Z-score)≥-2 influencing factors. Results　A total of 943 children with HIV infection were enrolled in the cohort. The median HAZ at baseline and 1, 2, 5, and 10 years after treatment was -2.47, -2.14, -1.94, -1.55, -1.23, respectively, and the median WAZ was -1.85, -1.40, -1.30, -1.21, -1.09, respectively. By Cox-Stuart trend test, HAZ and WAZ showed an upward trend with the treatment time (P<0.05). The proportions of HAZ≥-2 at baseline and at 1, 2, 5, and 10 years after treatment were 38.1%, 46.5%, 51.6%, 66.8%, and 74.6%, respectively, and the proportions of WAZ≥-2 were 57.1%, 76.9%, 81.1%, 85.8% and 89.2%, respectively. According to Cox-Stuart trend test, the proportions of HAZ≥-2 and WAZ≥-2 increased with the treatment time (P<0.05). The results of multivariate generalized estimating equation analysis showed that the associated factors with HAZ≥-2 were that age at ART initiation was 3-7 years old (aOR=0.71, 95%CI: 0.53-0.94), age at ART initiation was >7 years old (aOR=0.66, 95%CI: 0.47-0.93), CD4 cell counts before ART was <200/μL (aOR=0.64, 95%CI: 0.47-0.87), WHO clinical stage before ART was Stage Ⅲ/Ⅳ (aOR=0.74, 95%CI: 0.56-0.97) and time on ART (aOR=1.01, 95%CI: 1.01-1.01); the associated factors with WAZ≥-2 were male (aOR=0.72, 95%CI: 0.53-0.97), WHO clinical stage before ART was Stage Ⅲ/Ⅳ (aOR=0.63, 95%CI: 0.45-0.86) and time on ART (aOR=1.01, 95%CI: 1.01-1.01). Conclusion　Antiretroviral therapy can effectively improve the growth and development status of children with HIV infection, but a large proportion of children still have stunted growth and development in the 10th year after treatment. It is necessary to strengthen the training of antiretroviral treatment staff and the publicity and education of parents of children infected with HIV. Improve the effect of antiviral treatment and guide children's nutrition reasonably.

A 4-year follow up study on suicidal ideation of college students in one university / 中国学校卫生

Objective@#To explore the dynamic changes of suicidal ideation in college students, and to provide evidence for the early prevention and intervention of suicidal ideation.@*Methods@#A cluster sampling of 5 372 college students from one university in Jiangsu was selected and followed up for four years (2016—2019) using the College Students Mental Health Screening Scale.@*Results@#The detection rates of suicidal ideation among college students in the first to four (T1-T4) stages were 4.36%, 8.99%, 7.32 %, and 5.90%, respectively, showing decreasing after increasing trend. Stage T2 was the turning point, and the trend of change was significantly different ( P <0.01). The detection rate of suicidal ideation of girls in T1 stage was significantly higher than that of boys ( χ 2=10.55, P <0.01). In the T1-T2 stages, the rate of suicidal idea detection among boys increased faster than that of girls, and the rate of boys in T4 stage surpassed that of girls. The detection rate of suicidal ideation in T1-T4 stage of students in big cities was higher than that of students in small and medium sized cities, towns and rural areas, and the difference in stage T4 was very significant ( χ 2=32.11, P <0.01). The contingency table analysis found that the proportion of suicidal ideation at the same time in the two stages before and after was between 18.63%-35.04% ( P <0.01). There was no suicidal ideation in the previous stage, and the proportion of suicidal ideation in the latter stage was between 4.48%-7.80% ( P <0.01). There were 11 participants who had suicidal ideation in the T1-T4 stages, accounting for 0.20% of the total number, and 4.70% of the suicidal ideation number.@*Conclusion@#Colleges and universities should pay more attention to suicidal ideation prevention for vulnerable groups in important periods, and grasp the dynamic information of students through a variety of ways.

Dynamic developmental trajectory of problem eating behavior among students from one university of Jiangsu Province / 中国学校卫生

Objective@#To explore the dynamic developmental trajectory of problem eating behavior among college students, and to provide evidence for the early prevention and intervention of eating problems.@*Methods@#A cluster sample of 5 372 freshmen from a university in Jiangsu Province were included and followed up for 4 years by using the eating behavior problems scale.@*Results@#The problem eating behavior of college students in Jiangsu Province showed a decreasing after increasing trend(5.17±1.36, 5.39± 1.53 , 5.14±1.42, 4.96±1.37)( F =112.12, P <0.01), and prevalence of problem eating behavior was highest among sophomores. The developmental trajectory of eating behavior problems in college students could be divided into slow decreasing (86.7%) and slow increasing (13.3%) groups. In addition, sex specific developmental trajectory of problem eating behavior was observed, with initial mean level and change speed of female students were signicantly higher than that of male students.@*Conclusion@#There are group heterogeneity and sex specific effect in problem eating behavior of college students, which needs specific intervention strategies provided from colleges.

Determinants of the delay in case finding, treatment, and diagnosis among students tuberculosis patients in Guiyang from 2014 to 2020 / 中国学校卫生

Objective@#To analyze factors affecting the delay in the case finding, treatment and diagnosis of tuberculosis among students during 2014-2020，and to provide a reference for the prevention and control measures of tuberculosis among students in Guiyang City.@*Methods@#The medical cases of students with tuberculosis from 2014 to 2020 recorded by "China Disease Prevention and Control Information System" were collected and trend of delays in the detection, treatment, and diagnosis of students with tuberculosis were analyzed, and χ 2 test and multivariate Logistic regression were used to analyze influencing factors.@*Results@#From 2014 to 2020, the rate of delay in the case finding, treatment, and diagnosis of tuberculosis among students in Guiyang showed a relatively stable trend. From 2014 to 2020, Guiyang City reported a total of 1 323 valid cases, the median number of case finding was 16 days,and 48.75% of student TB patients were delayed; the median number of treatment was 11 days, the delay rate of treatment was 43.46%; the median number of diagnosis was 0 day, the diagnosis delay rate was 11.87%. The results of multivariate Logistic regression analysis showed that the floating population was a risk factor for delay in case finding ( OR =1.45), the classification of the source of patients as "other" ( OR =0.19), the level of the first diagnosed unit was county ( OR =0.44), and the type of the first diagnosed unit was general hospital ( OR =0.58) were the protective factors for the delayed case finding of tuberculosis in students( P <0.05). Female ( OR =1.32) and floating population ( OR =1.38) were risk factors for delayed treatment. Floating population ( OR =1.51), rural areas ( OR =4.30), urban fringe ( OR =2.76),non severe patients ( OR =5.99) were risk factors for delayed diagnosis,females ( OR =0.65), ethnic minorities ( OR =0.38), college degree ( OR =0.53), and the first diagnosis unit wae a specialist hospital ( OR =0.22) were protective factors for delayed diagnosis of tuberculosis in students ( P <0.05).@*Conclusion@#The rates of tuberculosis case finding and treatment delay among students are common, which warrants targeted prevention and control measures to reduce the incidence of student delays and reduce the risk of tuberculosis cluster epidemics in schools.

Effect evaluation of two labor analgesia methods with Doula services / 预防医学

Objective @#To evaluate the effects of transcutaneous electrical nerve stimulation ( TENS ) and waterbirth with Doula services on the outcome of delivery. @*Methods@#From July 2018 to December 2019, 150 primiparas in Hangzhou Women's Hospital were randomly divided into three groups: TENS, waterbirth and control groups. They were given TENS, waterbirth and conventional midwifery, accompanied by Doula services. The visual analogue scores ( VAS ) , length of labor stages and neonatal asphyxia were compared.@*Results@#It finally included 45 cases in the TENS group, 45 cases in the waterbirth group and 44 cases in the control group. There were no significant differences in gestational weeks, age, height, weight, fetal biparietal diameter and newborn birth weight among the three groups ( P>0.05 ) . The VAS scores of TENS group and waterbirth group were lower than those of the control group ( P<0.05 ) , but there were no significant differences between the two groups ( P>0.05 ) with the cervix open to 2.5-3 cm, 5-7 cm ( 0.5 hours later ) and 10 cm. There was no interaction between the analgesia methods and cervix diameter ( P>0.05 ) . The duration of the first stage of labor in the TENS group and the waterbirth group was less than that in the control group ( P<0.05 ) , and there was no significant difference between the TENS group and the waterbirth group ( P>0.05 ) . The asphyxia rate of neonates in TENS group, waterbirth group and control group were 2.22%, 2.22% and 4.55%, respectively, with no significant difference ( P>0.05 ) . @*Conclusion@#Under Doula services, both TENS and waterbirth can effectively relieve the pain of delivery and shorten the first stage of labor, without obvious differences.

HIV/AIDS related frailty syndrome in the elderly and related research progress / 中华流行病学杂志

Frailty syndrome, caused by degenerative changes in the body and the body vulnerability due to a variety of chronic diseases, is associated with adverse outcomes, such as fall, disability and mortality. With the development of antiretroviral therapy, the average life span of HIV/AIDS patients is extended, the number of elderly living with HIV/AIDS has increased, resulting the increase of the incidence of frailty syndrome in this population. The incidence of frailty syndrome in the elderly is associated with HIV infection and adverse reaction of antiretroviral therapy. Early assessment and intervention of frailty syndrome in elderly HIV/AIDS patients can reduce adverse clinical events and improve the quality of life.