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Objective@#To learn the knowledge,attitude and practice（KAP）of primary healthcare workers on influenza vaccine and 23-valent pneumonia vaccine in Xiuzhou District of Jiaxing,and to provide basis for vaccination of influenza vaccine and 23-valent pneumonia vaccine.@*Methods@#From November 2018 to January 2019,the primary healthcare workers from eight community health service centers in Xiuzhou District were selected by multi-staged random sampling method. A self-designed questionnaire was used to investigate the KAP of influenza vaccine and 23-valent pneumonia vaccine among primary healthcare workers. Logistic regression analysis was employed to select the influencing factors for vaccination and recommendation behaviors of primary healthcare workers. @*Results@# Totally 105 healthcare workers（95.45%）completed the survey. Among them,86（81.90%）and 76（72.38%）workers believed influenza vaccine and 23-valent pneumonia vaccine effective;87（82.85%）and 88（83.81%）workers believed the two vaccines safe;82（78.10%）and 58（55.24%）workers knew the vaccination procedures;58（55.24%）and 34（32.38%）workers knew the key recommended population of vaccines;77（73.33%）workers knew that the vaccine costs could be paid by medical insurance. The vaccination rate of influenza or（and）pneumococcal vaccine among the respondents was 27.62%,and the recommendation rate was 46.67%. The results of multivariate logistic regression analysis showed that healthcare workers who were female（OR=7.250,95%CI：1.388-37.883）,believed the two vaccines effective（OR=4.390,95%CI：1.167-16.515）,believed the two vaccines safe（OR=11.977,95%CI：2.417-59.343）and knew the payment method of vaccine cost（OR=11.945,95%CI：2.924-48.793）were more likely to vaccinate;healthcare workers who majored in public health（OR=2.641,95%CI：1.338-5.214）,believed the two vaccines effective（OR=6.944,95%CI：1.655-29.134）,knew the key recommended population of vaccines（OR=4.380,95%CI：1.125-17.053）,had vaccinated the two vaccines（OR=7.902,95%CI：1.693-36.877）were more likely to recommend. @*Conclusion@#Primary healthcare workers in Xiuzhou District have less awareness of influenza vaccine and 23-valent pneumonia vaccine,then have lower vaccination rate（27.62%）and recommendation rate（46.67%）.
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Objective@#The objective of this study was to analyze the disease burden of influenza in schools and child care settings in rural areas of Hangzhou.@*Methods@#Hospital visit influenza cases aged 3-17 years in hospitals that reported based on influenza surveillance system from 2016 to 2018 in Chun′an county, Hangzhou city were selected as study subjects and a total of 294 confirmed cases of influenza were selected using system sampling method. Questionnaires were designed to investigate the basic information and data on inpatients and outpatients among, health care and life quality, etc.. Direct and indirect economic burden and disability adjusted life year (DALY) were analyzed and compared among different age groups.@*Results@#The mean age of investigated subjects was (8.88±3.92) years. A total of 143 (48.64%) investigated cases were male. In total of 283 (96.26%) cases were outpatients. The total economic burden was 124 743.95 CNY. The mean economic burden was 424.30 CNY per person. The mean direct and indirect economic burden was 361.33 and 62.97 CNY per person respectively. The difference of the mean direct, indirect and total economic burden per person between different age group was statistically significant (P<0.001). The 3-5 years age group showed the highest economic burden with the median value of direct, indirect and total economic burden per person being 276.24, 50.98 and 321.26 CNY, respectively, while the 12-17 years age group showed the lowest values with 175.30, 26.54, 201.79 CNY, respectively. The DALY of 294 influenza cases was 1.18, and the median of burden strength was 3.21 DALY/thousand. The difference of the burden of strength between different age group influenza case was statistically significant (P<0.001), of which the 12-17 years age group showed the highest value with 4.25 DALYs/thousand while the 3-5 years age group showed the lowest value with 2.60 DALY/thousand.@*Conclusion@#The disease burden of influenza was heavy in schools and kindergartens in rural areas of Hangzhou city, with the cases aged from 3 to 5 years showing higher economic burden and cases aged from 12 to 17 years showing greater burden strength.
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Objective To evaluate the application of a self-designed handy body position scaffold in the fluoroscopy for lower limb surgery.Methods We reviewed the intraoperative X-ray films of 161 patients with lower limb fracture who had undergone intraoperative fluoroscopy using our self-made handy body position scaffold during surgery from October 2013 to May 2017.They were 105 males and 56 females,aged from 10 to 91 years (mean,39.7 years).There were 42 femoral fractures of middle or lower shaft,12 fractures of medial or lateral condyle or tibial plateau,96 tibiofibular fractures,7 ankle fractures and 4 foot fractures.The operation time,intraoperative fluoroscopy time,intraoperative bleeding,rate and time of fracture union,and complications were recorded.Results All the 161 patients completed intraoperative fluoroscopy and radiography uneventfully,indicating that the handy body position scaffold effectively maintained the body position of the affected ipsilateral lower limb.The body position scaffold was slightly deviated due to one overweight (121 kg) patient when the knee joint was flexed 90°,but the fluoroscopy and radiography was completed after adjustment of the C-arm roentgenographic machine.The operation time averaged 71.5 minutes (from 28 to 119 minutes),the X-ray exposure time 9.8 seconds (from 6 to 31 seconds),and the intraoperative bleeding 157.2 mL (from 80 to 500 mL).The 161 patients obtained follow-up for 5 to 22 months (average,14.1 months).The rate of primary union was 97.5％ (157/161).The time for fracture union averaged 8.8 weeks (from 4 to 17 weeks).Fracture nonunion occurred in one case,and delayed union in 3 cases.The final follow-ups revealed normal functional recovery of the affected knees and ankles,but no limb shortening,or no rotational,lateral or anteroposterior angulation deformity.Conclusion In the lower limb surgery,the intraoperative fluoroscopy can be completed better with the aid of our self-designed handy body position scaffold that prevents movement of the affected lower limb and lowers the risk of radiation exposure.