Occupational health literacy level and its influencing factors among key populations in China in 2022 / 中国职业医学

Objective To analyze the level of occupational health literacy (OHL) and its influencing factors among key populations in China. Methods The front-line workers from 31 provinces, autonomous regions, municipalities, and Xinjiang Production and Construction Corps in China were selected as the research subjects using a combination of stratified cluster random sampling and probability proportional sampling. The Occupational Health Literacy Questionnaire of National Key Populations was used to investigate the OHL level. Results In 2022, a total of 340 506 people from 23 industries were surveyed. Among them, 168 455 and 172 051 people were surveyed in the secondary and tertiary industries, respectively. The OHL level of the research subjects was 52.6%. The OHL levels of workers in the secondary and tertiary industries were 56.5% and 48.9%, respectively. The results of multivariate logistic regression analysis showed that gender, age, marital status, educational level, household registration, monthly income, employment nature, years of service and industry category were independent influencing factors for OHL level of the research subjects (all P<0.01). Specifically, females had a higher OHL level than males (P<0.01); the older the age, the higher the education level, the higher the monthly income level, the higher the OHL level (all P<0.01); the level of OHL in unmarried people was higher than that in married people (P<0.01); the OHL level of workers with non-agricultural household registration was higher than that of workers with agricultural household registration (P<0.01); the OHL levels of workers in state-owned enterprises, foreign-funded enterprises and public institutions were higher than those in private enterprises (all P<0.01); the level of OHL in the group with 21.0-43.0 years of service was lower than that in the other years of service groups (all P<0.01); the OHL level of workers in the secondary industry was higher than that in the tertiary industry (P<0.01). Conclusion The workers in the key industries selected by the tertiary industry, the private enterprises in the secondary industry, those with more than 21.0 years of service, and the disadvantaged groups with younger age low income, low education level, and the agricultural household registration are the key groups for the improvement of OHL level in the future. Appropriate intervention methods and strategies should be actively explored to improve the OHL of these key populations.

Epidemiological characteristics of traumatic spinal cord injury in China in 2018 / 中华创伤杂志

Objective:To analyze the incidence and epidemiological characteristics of traumatic spinal cord injury in China in 2018.Methods:Multi-stage stratified cluster sampling was used to randomly select hospitals capable of treating patients with spinal cord injury from 3 regions，9 provinces and 27 cities in China to retrospectively investigate eligible patients with traumatic spinal cord injury admitted in 2018. National and regional incidence rates were calculated. The data of cause of injury，injury level，severity of injury，segment and type of fracture，complications，death and other data were collected by medical record questionnaire，and analyzed according to geographical region，age and gender.Results:Medical records of 4，134 patients were included in this study，with a male-to-female ratio of 2.99∶1. The incidence of traumatic spinal cord injury in China in 2018 was 50.484 / 1 million （95% CI 50.122-50.846）. The highest incidence in the Eastern region was 53.791 / 1 million （95% CI 53.217-54.365）. In the whole country，the main causes of injury were high falls （29.58%），as well as in the Western region （40.68%），while the main causes of injury in the Eastern and Central regions were traffic injuries （31.22%，30.10%）. The main injury level was cervical spinal cord in the whole country （64.49%），and the proportion of cervical spinal cord injury in the Central region was the highest （74.68%），and the proportion of lumbosacral spinal cord injury in the Western region was the highest （32.30%）. The highest proportion of degree of injury was incomplete quadriplegia （55.20%），and the distribution pattern was the same in each region. A total of 65.87% of the patients were complicated with fracture or dislocation，77.95% in the Western region and only 54.77% in the Central region. In the whole country，the head was the main combined injury （37.87%），as well as in the Eastern and Central regions，while the proportion of chest combined injury in the Western region was the highest （38.57%）. A total of 32.90% of the patients were complicated with respiratory complications. There were 23 patients （0.56%） died in hospital，of which 17（73.91%） died of respiratory dysfunction. Conclusions:The Eastern region of China has a high incidence of traumatic spinal cord injury. Other epidemiological features include high fall as the main cause of injury cervical spinal cord injury as the main injury level，incomplete quadriplegia as the main degree of injury，head as the main combined injury，and respiratory complications as the main complication.

The design of interrupted time series and its analytic methods / 中华预防医学杂志

Interrupted time series (ITS) is a statistical method for the quasi-experimental design specific to the outcome of time series, in which the effectiveness of an intervening measure is evaluated by examining change in slope and immediate change in level. The key feature of ITS is that the secular trend of time series prior to the intervention can be effectively controlled so as to accurately estimate the intervention effect. The design principle and statistical method for ITS were illustrated by an example of evaluating halving policy for the expert registration fee in the general hospital of a city. The segmented linear regression was used to fit the above time series data and the results were explained in detail. Meanwhile, the study design and model fitting along with explanations of the results with respect to the effects of two types of successive interventions and on different time-points of an intervention were illustrated as well in this paper. The existed upward or downward trend should be taken into account in order to accurately estimate the intervention effect as it exists in most of the public health surveillance data. Two parameters, known as change in slope and immediate change in level, were employed to evaluate the effect of the intervention. The ITS analysis can be widely applied to the program evaluation as it could enrich methods of the evaluation compared to the traditional model of the program evaluation.

Overview of multivariate regression model analysis and application / 中华预防医学杂志

Analyses of the multivariate regression model are ued very widely in the medical research. Analytical methods of the mutivariate regression model including multiple linear regression, logistic regression, Poisson regression and Cox proportional hazard model were introduced in this article. The contents of the article covered the application conditions of regression models, analytical procedures, strategies of selecting independent variables, extended discussions of regression models and application notes. It is expected that authors could understand the principle of the mutivariate regression model, accurately use these analytical methods in their research, improve the efficiency of data utilization, and enhance the level of statistical analyses.

Overview of logistic regression model analysis and application / 中华预防医学杂志

Logistic regression is a kind of multiple regression method to analyze the relationship between a binary outcome or categorical outcome and multiple influencing factors, including multiple logistic regression, conditional logistic regression, polytomous logistic regression, ordinal logistic regression and adjacent categorical logistic regression. This paper illustrates the basic principle, independent variable selection and assignment, applied condition, model evaluation and diagnosis for multiple logistic regression model. Moreover, the principle and application for polytomous logistic regression and ordinal logistic regression models were also introduced. By providing SAS codes and detailed explanations of the result for an example of obesity, readers could be able to better understand logistic regression model, and apply this method correctly to their research and daily work, so as to improve their capacity of the data analysis.

Design and analysis of two groups interrupt time series / 中华流行病学杂志

Interrupted time-series (ITS) is a quasi-experimental design which evaluates the effectiveness of an intervention based on time-series outcome variables. Compared with the single group of ITS, the two groups of ITS can better control the influence of pre-interventional confounding factors and evaluate the effectiveness of the intervention. This paper summarizes the principles and statistical methods of two groups of ITS by an example of evaluating vaccine effect on the incidence of a disease in two cities. The regression model is fitted by Prais-Winsten method and Newey-West method and the results are explained and compared in detail. When the intervention is performed with other confounding interventions at the same time, the two groups of ITS can be more effective to balance the existing trends before the intervention, and evaluate the effectiveness of intervention. The method of two groups of ITS has important practical significance, providing new insights in program evaluation.

An overview of multiple linear regression model and its application / 中华预防医学杂志

Multiple Linear Regression (MLR) is a generalization of simple linear regression and is one of the commonly used models in multivariate statistical analysis. This article introduces the MLR model from the perspective of practical application. Four parts, including basic principle, application examples, the application condition and diagnosis, and the extension of the model, are sequentially illustrated in this article. Particularly, in the last part, alternative methods of the model are introduced when the application condition of the model is not met. We sincerely hope that this article could make our audiences have a better understanding of the MLR model in order to improve the efficiency of data utilization and statistical analysis by correctly performing this model in their research.

Urinary stone composition analysis of 4 423 cases in Zhejiang province / 中华泌尿外科杂志

Objective To study the constituents of urinary stones in patients in Zhejiang,and analyze the composition difference between patients from northern Zhejiang province and southern Zhejiang province.Methods From October 2012 to October 2018,clinical data of 4 423 urinary stone patients treated in Sir Run Run Shaw Hospital,the Second Affiliated Hospital of Wenzhou Medical University,and Huzhou First People's Hospital was retrospectively analyzed.Infrared spectrum was used to analyze urinary calculi constituents.Among 4 423 patients,there were 3 041 males and 1 382 females,male to female ratio was 2.2∶ 1,and the mean age was (51.2 ±16.5) years.There were 2 974 northern Zhejiang patients and 1 449 southern Zhejiang patients.High incidence age group was 41-60 years [48.2％ (2 136/4 423)].The distribution characteristics of urinary calculi constituents in different groups of sex,age,and region were analyzed.Results Among the 4 423 cases,the mixed urinary stones were dominant in the urinary calculus [73.1％ (3 235/4 423)],in which,the most component was the calcium oxalate monohydrate + calcium oxalate dehydrate + carbonated apatite [36.2％ (1 604/4 423)];among the pure stones,the most component was the calcium oxalate monohydrate [16.3 ％ (719/4 423)].Carbonated apatite stones [70.1％ (970/1 382) vs.61.0％ (1 856/3 041),P ＜0.05] and magnesium ammonium phosphate stones [12.7％ (176/1 382) vs.4.9％ (150/3 041),P ＜ 0.05] were both more prevalent in females than males,but uric acid stones[10.6％ (325/3 041) vs.5.8％ (81/1 382),P ＜0.05] were more common in males than females.The proportions of calcium oxalate stones[90.6％ (961/1 060) vs.76.2％ (935/1 227),P ＜0.05],carbonated apatite stones [77.6％ (823/1 060) vs.50.7％ (623/1 227),P ＜ 0.05],and magnesium ammonium phosphate stones[9.1％ (97/1 060) vs.6.5％ (80/1 227),P ＜0.05] of 0-40 years group were all higher than ＞ 60 years group,however,uric acid stones were more frequent in ＞ 60 years group [3.5％ (38/1 060) vs.17.0％ (209/1 227),P ＜ 0.05].The proportion of calcium oxalate stones in southern Zhejiang was lower than northern Zhejiang [79.0％ (1 145/1 449) vs.89.4％ (2 661/ 2 974),P ＜ 0.05].However,carbonated apatite stones [71.5％ (1 037/1 449) vs.60.1％ (1 789/2 974),P ＜ 0.05],magnesium ammonium phosphate stones [15.1％ (220/1 449) vs.3.5％ (106/ 2 974),P ＜ 0.05],and uric acid stones [10.7％ (156/1 449) vs.8.4％ (250/2 974),P ＜ 0.05] were more prevalent in southern Zhejiang than northern Zhejiang.Conclusions The distribution of constituents of urinary stones in Zhejiang was different in genders,age,and regions.Carbonated apatite stones and magnesium ammonium phosphate stones were more prevalent in females and young people,and uric acid stones were more common in males and old people.Calcium oxalate stones were more common in youths.Moreover,calcium oxalate stones were more frequent in northern Zhejiang,and carbonated apatite stones,magnesium ammonium phosphate stones and uric acid stones were common in southern Zhejiang.

Characteristics of homocysteine in patients with Coronary Heart Disease and the effect of folic acid on its intervention / 中国生化药物杂志

Objective To investigate the characteristics of homocysteine in patients with coronary heart disease (CHD) and the intervention effect of folic acid.Methods90 patients with coronary heart disease form internal medicine-cardiovascular department in the third affiliated Liwan hospital of Guangzhou Medical University from December 2015 to December 2016 as the study group.They were randomly divided into group A and group B, 45 patients in each group.The group A received routine treatment and Group B on the basis of conventional treatment plus folic acid.Another 90 healthy people who came to our hospital during the same period were selected as control group.The plasma homocysteine level of study group and control group were compared and plasma homocysteine level and angina status(frequency and duration of disease) of A and B group were compared before and after treatment.ResultsThe plasma homocysteine level of study group was significantly higher than that of the control group (P<0.05).After treatment, plasma homocysteine level,frequency and duration of disease of two groups were better than that of before treatment and B group was lower than that of A group(P<0.05).ConclusionThe results of plasma homocysteine levels can be used as an important basis for the clinical diagnosis of coronary heart disease and to determine its efficacy.

Effect of initial intervention based on white blood cell count measured within 2 hours postoperatively to treat uroseptic shock induced by upper urinary tract endoscopic lithotripsy (UUTEL) : animal experiments and clinical study / 中华泌尿外科杂志

Objective To investigate whether initial intervention based on WBC measured within 2 hours postoperatively can reverse the uroseptic shock induced by UUTEL.Methods From May,2015 to July 2015,24 female New Zealand rabbits,weighing 2.0-2.5 kg,born 2-3 months,used as uroseptic shock model.Their ureters were ligated and followed by injection of Escherichia coli solution into the renal pelvis.Then,those animals were randomly assigned into control group(the first group)and experimental groups (the second group,the third group).Each group had 8 rabbits initially.The first group did not receive sensitive antibiotic or fluid resuscitation.The second group received imipenem and cilastatin sodium 15mg/kg and normal saline 5 ml/kg 2 hours postoperatively.The third group received sensitive antibiotic and fluid resuscitation the same dosage as the second group 6 hours postoperatively.Mean arterial pressure(MAP) was recorded for 10 hours and survival rate of all groups for 72h postoperatively was recorded..The clinical data of 46 patients whose WBC count less than 2.85 × 109/L within two hours after UUTEL were analyzed retrospectively.These patients were divided into two groups based on the time of intervention.Group A including 19 patients received routine antibiotic,fluid therapy,low-dose corticosteroids when there was symptom of shock.Group B including 27 patients immediately received resuscitation bundle protocol when there was a drastic decrease in WBC.The incidence of septic shock,the rate of intubation,length of stay in ICU,length of stay in hospital postoperatively,hospitalization cost and survival rate of these two groups were compared.Results All 8 rabbits of the first group died within 72 h,postoperatively and the median time of survival was 11 h.None of the second group rabbits developed shock and all rabbits survived 72 h after operation.6/8 rabbits of the third group survived 72 h after operation.15 patients in Group A and 3 patients in Group B experienced acute uroseptic shock (P ＜ 0.05).11 patients in Group A and one patients in Group B underwent tracheal intubation (P ＜ 0.05).18 patients in Group A and 6 patients in Group B were transferred to ICU(P ＜ 0.05),and their length of stay in ICU was (10.8 ± 5.4) d and (7.5 ± 2.8) d,respectively(P ＞ 0.05).The length of stay in hospital and hospitalization cost of Group A and B were (19 ± 9.8)d vs.(7 ±4.7)d(P ＜0.05),(94 583 ±51 623) RMB vs.(35 389 ± 16 342) RMB respectively (P ＜ 0.05).One patient in Group A died due to acute uroseptic shock and none of Group B died.Conclusions Our animal model and clinical cohort study showed that initial intervention based on WBC mneasured within 2 hours postoperatively can reverse the uroseptic shock induced by UUTEL and improve the prognosis.

Applications of syphon system in transurethal resection of prostate / 中国内镜杂志

Objective To explore the availability and safety of conducting low-pressure TURP assisted by a home-made cystometry and warning system.Methods 167 benign prostatic hyperplasia (BPH) patients admitted from Jan 2014 to Jan 2016 were randomly assigned into cystostomy group (group A) and non-cystostomy group (group B). In group A (n = 85), 42 patients (group A1) were performed percutaneous cystostomy + TURP, and 43 (group A2) were performed continuous flushing sheath TURP. In group B (n = 82), 42 patients (group B1) were received percutaneous cystostomy + TURP, and 40 (group B2) were received continuous lfushing sheath TURP. In group A, bladder pressure was monitored in real time with a cystometry and was monitored by bladder puncture using a home-made siphon, ensuring low bladder pressure throughout TURP. Serum Na+ levels were measured before and after operation in all four groups. The operation time, the intraoperative bleeding, the weight of resected prostates and the time before which urine turned clear were recorded. The IPSS, maximum lfow rate (Qmax), postvoid residual volume (PVR) and life quality score (QOL) were evaluated.Results While no significant differences were found between group A1 and A2, there were significant differences between group B1 and B2, indicating cystostomy group was safer than non-cystostomy group. When compared group A1 with B1, or group A2 with B2, it showed that the safe operation time to perform prostate tissue resection was longer in cystostomy group; the weight of the resected prostates was heavier; the time before which urine turned clear were shorter; and the IPSS improvement was better. These findings presented better therapeutic effects in cystostomy group than in non-cystostomy group.Conclusions This home-made cystometry and warning system could timely detect high bladder pressure state during TURP, making it possible to avoid of high pressure, ensuring low bladder pressure lfushing during the operation, lengthening the safe operation time, increasing tissue resection ratio, reducing transurethral resection syndrome, thus helping TURP to be safer.

Downscaling research of spatial distribution of incidence of hand foot and mouth disease based on area-to-area Poisson Kriging method / 中华流行病学杂志

Objective To understand the spatial distribution of incidence of hand foot and mouth disease (HFMD) at scale of township and provide evidence for the better prevention and control of HFMD and allocation of medical resources.Methods The incidence data of HFMD in 108 counties (district) in Shandong province in 2010 were collected.Downscaling interpolation was conducted by using area-to-area Poisson Kriging method.The interpolation results were visualized by using geographic information system (GIS).The county (district) incidence was interpolated into township incidence to get the distribution of spatial distribution of incidence of township.Results In the downscaling interpolation,the range of the fitting semi-variance equation was 20.38 km.Within the range,the incidence had correlation with each other.The fitting function of scatter diagram of estimated and actual incidence of HFMD at country level was y=1.053 1x,R2=0.99.The incidences at different scale were consistent.Conclusions The incidence of HFMD had spatial autocorrelation within 20.38 km.When HFMD occurs in one place,it is necessary to strengthen the surveillance and allocation of medical resource in the surrounding area within 20.38 km.Area to area Poisson Kriging method based downscaling research can be used in spatial visualization of HFMD incidence.

Downscaling research of spatial distribution of incidence of hand foot and mouth disease based on area-to-area Poisson Kriging method / 中华流行病学杂志

Objective To understand the spatial distribution of incidence of hand foot and mouth disease (HFMD) at scale of township and provide evidence for the better prevention and control of HFMD and allocation of medical resources.Methods The incidence data of HFMD in 108 counties (district) in Shandong province in 2010 were collected.Downscaling interpolation was conducted by using area-to-area Poisson Kriging method.The interpolation results were visualized by using geographic information system (GIS).The county (district) incidence was interpolated into township incidence to get the distribution of spatial distribution of incidence of township.Results In the downscaling interpolation,the range of the fitting semi-variance equation was 20.38 km.Within the range,the incidence had correlation with each other.The fitting function of scatter diagram of estimated and actual incidence of HFMD at country level was y=1.053 1x,R2=0.99.The incidences at different scale were consistent.Conclusions The incidence of HFMD had spatial autocorrelation within 20.38 km.When HFMD occurs in one place,it is necessary to strengthen the surveillance and allocation of medical resource in the surrounding area within 20.38 km.Area to area Poisson Kriging method based downscaling research can be used in spatial visualization of HFMD incidence.

The burden of infectious disease and changing pattern from in 1990 and 2010, China / 中华预防医学杂志

<p><b>OBJECTIVE</b>To investigate the burden of infectious disease of the Chinese population in 1990 and 2010 and changing pattern in the past 20 years.</p><p><b>METHODS</b>Results of the Global Burden of Disease Study 2010 (GBD 2010) were used to demonstrate the burden of infectious disease of the Chinese population in 1990 and 2010 and changing pattern from 1990 to 2010 by gender and age groups, including indicators of incidence, mortality, years of life lost due to premature mortality (YLL), years lived with disability (YLD), disability-adjusted life years (DALY), and their age-standardized rates using data of the 2010 National Census as a standard population.</p><p><b>RESULTS</b>In 1990 incidence, standardized incidence rate, mortality, standardized mortality rate, DALY, standardized DALY rate, YLL, standardized YLL rate, YLD, and standardized YLD rate of infectious disease in China were 3 067 469 200 cases, 242 669.34 cases/100 000, 824 300 cases, 72.27 cases/100 000, 58 937 700 person-years (PYRS), 3 992.85 PYRS/100 000, 46 504 100 PYRS, 2 932.99 PYRS/100 000, 12 433 600 PYRS, and 1 059.86 PYRS/100 000, respectively. All the aboved indicators were declined from 1990 to 2010, in 2010 they were 3 065 985 800 cases, 224 351.66 cases/100 000, 388 600 cases, 30.74 cases/100 000, 19 492 200 PYRS, 1 440.75 PYRS/100 000, 12 045 700 PYRS, 891.87 PYRS/100 000, 7 446 500 PYRS, and 548.89 PYRS/100 000, respectively. When 2010's indicators were compared to those in 1990, the rates of increase of incidence, incidence rate, mortality, mortality rate, DALY, DALY rate, YLL, YLL rate, YLD, and YLD rate were 56.84%, -9.85%, -33.07%, -61.54%, -27.68%, -58.42%, -32.46%, -61.17%, -16.75%, and -52.13% for 50-69 age group; for ≥ 70 age group, 57.90%, -5.86%, 7.41%, -36.12%, -5.00%, -43.51%, -5.14%, -43.59%, -4.52%, and -43.2%.</p><p><b>CONCLUSIONS</b>The burden of infectious disease of the Chinese population was declined from 1990 to 2010; however, the incidence of infectious disease was increased in ≥ 50 age groups.</p>

Simulation on design-based and model-based methods in descriptive analysis of complex samples / 中华预防医学杂志

<p><b>OBJECTIVE</b>To compare design-based and model-based methods in descriptive analysis of complex sample.</p><p><b>METHODS</b>A total of 1 000 samples were selected and a multistage random sampling design was used in the analysis of the 2010 China chronic disease and risk factors surveillance. For each simulated sample, cases with probability proportional age were randomly deleted so that sample age structure was deviated systematically from that of the target population. Mean systolic blood pressure (SBP) and prevalence of raised blood pressure, as well as their 95% confidence intervals (95%CI) were determined using design-based and model-based methods (routine method and multi-level model). For estimators generated from those 3 methods, mean squared error(MSE) was computed to evaluate their validity. To compare performance of statistical inference of these methods, the probability of 95%CI covering the true parameter(mean SBP and raised blood pressure prevalence of the population) was used.</p><p><b>RESULTS</b>MSE of mean estimator for routine method, design-based analysis and multilevel model was 6.41, 1.38, and 5.86, respectively; and the probability of 95%CI covering the true parameter was 24.7%, 97.5% and 84.3%, respectively. The routine method and multi-level model probably led to an increased probability of type I error in statistical inference. MSE of prevalence estimator was 4.80 for design-based method, which was far lower than those for routine method (20.9) and multilevel model (17.2). Probability of 95%CI covering the true prevalence for routine method was only 29.4%, and 86.4% for multilevel model, both of which were lower than that for design-based method (97.3%).</p><p><b>CONCLUSION</b>Compared to routine method and multi-level model, design-based method had the best performance both in point estimation and confidence interval construction. Design-based method should be the first choice when doing statistical description of complex samples with a systematically biased sample structure.</p>

The application of trajectory model in epidemiological research / 中华流行病学杂志

This article introduced the application of trajectory model in epidemiological study on fat development in sixty teenagers.Results showed that fat developing trend on three trajectories-normal fat group,high fat group and very high fat group,with independently different developing trend.Trajectory model seemed a suitable model for fitting the longitudinal data with heterogeneity.

Temporal and spatial clustering characteristics and changes of severe hand, foot, and mouth disease in mainland of China, from 2008 to 2013 / 中华流行病学杂志

Objective The purpose of this study was to analyze the distribution,temporal and spatial clustering characteristics and changes of severe hand,foot,and mouth disease (HFMD) in order to provide evidence-based decision making strategy for control and prevention of severe HFMD cases.Methods Severe HFMD cares were extracted from the National Diseases Reporting System of Chinese Center for Disease Control and Prevention (CDC) between 2008 and 2013.Definition and clinical diagnostic criteria of severe HFMD cases were set up by China CDC in the Hand,Foot,and Mouth Disease Control and Prevention Guideline,version 2010.Spatial scan unit was under the district/county of 2 900 in mainland China with temporal scan unit as month and time span as from May 2008 to August 2013.Kulldorff scan statistics was applied and analyses were conducted by SaTScanTM 9.1.Mapping and visualizing the results were carried out with ArcGIS 10.0.Results Data related to the monitoring program on severe HFMD from 2008 to 2013 demonstrated that above 96％ of the severe HFMD cases occurred under 5 years old,mostly males,with the ratio of males to females as 1.73-1.80 and over 84％ of the children were ‘scattered'.Results from SaTScan illustrated that the temporal and spatial clustering existed among severe HFMD cases.The temporal dimension of severe HFMD was from May to July each year.Spatial dimension was located in south-east coastal area and middle-east area.With respect to the changes of temporal and spatial clustering phenomena,Class 1 clustering area was located in south-east coastal region in 2008 and in middle-east region in 2009 and was shifting to the west from middle-east region in 2010.It moved to the north-east from middle-east region in 2011 and to the north-west and south-west from middle-east region in 2012.Class 1 clustering area covered districts/countries from 18 provinces in 2012.The same pattem of Class 1 clustering area was observed as in the previous year-2013,but with less districts/countries from the 13 provinces.Conclusion Temporal and spatial clustering areas of severe HFMD were presented in this report,and the yearly changing pattern of the clustering areas was noted.Findings from this study provided evidence-based data to the decision-making authorities so as to prevent deaths from severe HFMD cases under reasonable prevention and control strategies.

Montelukast as a successful treatment for eosinophilic cystitis in an asthmatic woman patient

Eosinophilic cystitis [EC] is a rare inflammatory disorder. We herein report a case of EC in an asthmatic female patient who had a recent exacerbation with none known allergen. She was administered montelukast sodium orally for four weeks and received complete remission. This medication was successfully discontinued after a three-month follow up period. This case report about successful treatment of an adult EC patient using montelukast sodium may provide a new option for EC patients with allergic history

Surveillance of hand, foot, and mouth disease in mainland China (2008-2009) / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>Since HFMD was designated as a class C communicable disease in May 2008, 18 months surveillance data have been accumulated to December 2009. This article was to describe the distribution of HFMD for age, sex, area, and time between 2008 and 2009, to reveal the characteristics of the epidemic.</p><p><b>METHODS</b>We analyzed weekly reported cases of HFMD from May 2008 to December 2009, and presented data on the distribution of age, sex, area and time. A discrete Poisson model was used to detect spatial-temporal clusters of HFMD.</p><p><b>RESULTS</b>More than 1 065 000 cases of HFMD were reported in Mainland China from May 2008 to December 2009 (total incidence: 12.47 per 10 000). Male incidence was higher than female for all ages and 91.9% of patients were <5 years old. The incidence was highest in Beijing, Shanghai, Zhejiang and Hainan. The highest peak of HFMD cases was in April and the number of cases remained high from April to August. The spatial-temporal distribution detected four clusters.</p><p><b>CONCLUSION</b>Children <5 years old were susceptible to HFMD and we should be aware of their vulnerability. The incidence was higher in urban than rural areas, and an annual pandemic usually starts in April.</p>

Case report of primary pigmented nodular adrenocortical disease and literature review / 中华泌尿外科杂志

Objective To investigate the clinical features and the management of primary pigmented nodular adrenocortical disease PPNAD) and to evaluate its relationship with Carney complex. Methods One case of PPNAD reported. The patient was a 52 years oldmale. He was hospitalized because of hypertension for one year. The patient had a Cushing's face with elevated plasma and urine cortisone levels which could not be suppressed by both low dose and high dose dexamethasone tests. Ultrasonography howed normal bilateral adrenal glands. CT scan found a 1.6 cm × 2.0 cm mass in the left adrenal gland and normal on tralateral adrenal gland. Results The patient had accepted left laparoscopic adrenalectomy. The pathological examination onfirmed the diagnosis of PPNAD. Micro scopic study showed that there were black-gray spots in the center of the specimen. Hyperplasia was found in all the three adrenal zones. Lipofuscin was observed in the cytoplasm of reticular zone cells. The patient's blood pressure had returned to normal level after the surgery. Conclusions PPNAD is a rare type of ypercortisolism. As there is no specific feature in clinical manifestation and radiological examination of this disease, it is very easy to make a misdiagnosis in clinical practice. PPNAD itself can be the comorbidity of Carney complex, careful differentiation is needed.