Objective　To appraise the real situation of lega l contagious diseases exactly, to find and to correct the problems in reportin g epidemic diseases in time. Methods　Census and sampling surve y were applied in the different level medical institutions and inhabitants to in vestigate the legal contagious diseases failed to report. Results　13 species of legal contagious diseases were found out in medical institutio ns, amouted to 5 917 cases, and the rate failed to report was 29.85%; there wa s signifi cant difference in different medical institutions; 9 species of legal contagious diseases amouted to 546 cases were found out in 56 947 inhabitants, and its inc idence rate was 505.73 per 100 000, while the rate failed to report was 48.71%. C onclusions　We should strengthen the reporting of epidemic disease in ru ral and indiviual medical institutions.

Sepsis is a life-threatening organ dysfunction caused by dys-regulated host response to infection. Acute kidney injury (AKI) caused by sepsis is one of the most common and severe clinical disease, which incidence and mortality remains high level, and has poor clinical outcomes. Continuous renal replacement therapy (CRRT) is an indispensable tool for the treatment of critically ill patients with severe AKI, but there is no consensus on the appropriate treatment dose of CRRT. By reviewing the process of high volume hemofiltration (HVHF) and standard volume hemofiltration (SVHF), comparing their benefits and risks, and making suggestions for therapeutic schedule improvement, reference for clinical work was provided.

Medical service data center could play a pivotal role in the assessment and improvement of patient safety,assist of medical quality management,providing guidance for patients,promoting the development of biological bank,by collection,storage,maintenance and analysis of medical data.Even though the building of medical service data center in China is relatively late compared with developed countries,however,China has made some achievements in guiding medical service and medical service management.

Objective To investigate the effect of irrigation with hypothermic artificial cerebral-spinal fluid (aCSF)on expression of aquaporin-4(AQP-4) in the spinal cord following spinal ischemia-reperfusion (I/R) in rabbits.Methods Fifty-four adult male New Zealand white rabbits weighing 2.0-2.5 kg were randomly divided into 3 groups (n=18 each):group sham operation(S group); group I/R and group irrigation with hypothermic aCSF (FI group). Spinal I/R was induced by clamping the abdominal aorta below renal artery for 60 min. Hypothermic aCSF(25 X.)was infused at L4,5 interspace at a rate of 30 ml/h and drained from L7,8 interspace during spinal ischemia.Neurological function was evaluated at 4, 24, 48 and 72 h of reperfusion and scored (0=no hind limb activity, 4=hind limb function completely recovered) in 6 animals in each group. Six animals were sacrificed at 4, 24 and 72 h respectively in each group.The lumbar segment (L5-8) was removed for measurement of water content and AQP-4 protein expression (by immuno-histochemistry).Results Neurological function scores were significantly lower,water content was higher and AQP-4 expression smaller in group I/R than in group S. I/R-induced effects were significantly attenuated by irrigation of hypothermic aCSF. Conclusion Irrigation with hypothermic aCSF can ameliorate the spinal cord I/R injuries by up-regulation of AQP-4 expression.

Objective To investigate the application of electronic bronchoscopy in diagnosis of recurrent tracheoe-sophageal fistula of type Ⅲ esophageal atresia. Methods 5 patients were reviewed who were suspected postopera-tive tracheoesophageal fistula recurrence of type Ⅲ esophageal atresia and examined through electronic bron-choscopy combined with injecting Methylene blue into stomach tube from Jan 2010 to Aug 2014. Male to female ra-tio was 4:1. The age was 2~15 months, median age was 7.4 months. Results The 5 cases were found trachea mem-brane fistula by electronic bronchoscope, recurrent tracheoesophageal fistula was diagnosed with Methylene blue in-jected into stomach tube and overflowed from trachea membrane fistula. Examination time is 3~7 minutes, the aver-age is 4.2 minutes. The 5 cases were confirmed by operation. Conclusion Electronic bronchoscopy combined with injecting Methylene blue into stomach tube to diagnose recurrent tracheoesophageal fistula is safe and feasible, the time is short and the diagnosis rate is high.

Objective To analyze the epidemiological and clinical characteristics of an outbreak of tsutsugamushi disease in Fuyang City of Anhui Province.Methods Epidemiological information was collected by case investigation questionnaire of tsutsugamushi disease.Diagnosis was determined by the detection of OXK antigen by Weil-Felix test.Results Seventy-eight cases with tsutsugamushi disease were discovered in the outbreak.All the patients had an experience of working in this area before the starting of symptoms.The clinical features of the patients were fever,headache,skin eschar,tetter and lymphadenectasis.No severe complications occurred in each patient.All the patients recovered after getting deoxycycline.Conclusions This was the first report for the tsutsugamushi disease occurred in Fuyang City of Anhui Province.And the declaration for the new happened tsutsugamushi disease would provide strong support evidence for the prevention and control of this event and ensure the safety for working in this area.Also the deoxycycline was very effective for the treatment of tsutsugamushi disease.

Objective To investigate the epidemiological characteristics and factors of hemorrhagic fever with renal syndrome (HFRS) during 1958 to 2007 in Fuyang.Methods Descriptive study method was used to analyze the epidemiological characteristics of hemorrhagic fever with renal syndrome.The incidence peak of hemorrhagic fever with renal syndrome was computed by using rotundity distribution.The correlation was analyzed between incidence and virus index by Pearson correlation.Results 40 002 HFRS cases was reported during 1958 to 2007 in Fuyang and 2381 cases were dead.The average incidence and fatality rate of HFRS were 11.99 per 100 thousand and 5.95 percent respectively.Eight counties all had cases.Yingshang county had the highest cases and Jieshou city had the highest fatality rate.Since 1958,there're 4 incidence peak in Fuyang.The period of high incidence was during November to January of next year and the peak of incidence rate was on December 13.Indoor density and field density of mouse were 9.84 percent and 7.91 percent respectively.Virus rate of indoor and field of mouse were 9.21 percent and 6.99 percent respectively.During 1984 to 2007,the correlation coefficient between virus index and incidence was 0.58.In room brown mouse was the most before 2000,but then house mouse become the most.In open country heavy line Japanese fieldmouse is the most mouse all the time.Conclusions In Fuyang,the focus of HFRS is exist widely.Density and virus rate of mouse will directly affect the incidence.So surveillance among mouse should be strengthened.

Objective To investigate the change of gastroesophageal reflux including acid reflux,duodenogastroesophageal reflux (DGER) and its effect on expression of COX-2 and TNF-α in the remnant esophagus in different period after esophagectomy for cancer.Methods Thirty-two patients who underwent esophagectomy for cancer were selected randomly.Twentyfour-hour pH and spectrometric bilirubin monitoring,endoscopy were periodically performed.Esophageal mucosa samples were obtained by endoscopic biopsy.Expression of COX-2 and TNF-α within remnant esophageal mucosa was detected using immunohistochemical assay.Results ( 1 ) The incidence of reflux esophagitis and extent of acid reflux gradually increased over time after surgery for cancer ( P ＜ 0.05 ).(2) Very low level of COX-2 and TNF-α expression was detected in normal esophageal squamous mucosa.The expression of COX-2 and TNF-α was observed in cytoplasm of basal cell of esophageal epithelium after esophagectomy for cancer.High intensity of COX-2 and TNF-α expression was detected in the metaplastic columnar mucosa.The level of TNF-α expression in the remnant esophagus where reflux esophagitis occurred was higher than that in the normal remnant esophagus ( P =0.0274 ).There was no significant difference in level of COX-2 expression in the remnant esophagus between reflux esophagitis occurred and not ( P =0.7403 ).Conclusion ( 1 ) The extent of acid reflux and incidence of esophagitis gradually increases over time.(2) The expression of COX-2 and TNF-α may represent an early change associated with gastroesophageal reflux.The expression of COX-2 may serve as a molecular marker of gastroesophageal reflux occurred.( 3 ) The durative expression TNF-α is likely involved with the pathogenesis of chronic reflux esophagitis.

Objective To get an understanding of the patient experience in public hospitals nationwide, and to evaluate the implementation of the Action Plan to Improve Health Care. Methods Supported by the mobile technology, from September 6, 2017 to December 15, 2018, the authors conducted an online survey that measured the satisfaction of both inpatients and outpatients at secondary and tertiary hospitals across the country. 15 questions from six dimensions including registration experience, patient-doctor communication, nurse-patient communication, the healthcare signage system, responsiveness of care providers and privacy protection were prepared for outpatients, while 20 questions from nine aspects such as nurse-patient communication, patient-doctor communication, pain management, medication communication, admission and discharge information, responsiveness of care-givers, food service, friendliness to patient family, and the healthcare signage system were directed at inpatients. Descriptive statistical analysis was used to describe the basic features of the data. Results 9.18 million valid responses from outpatients and another 5.38 million from inpatients were obtained. The overall satisfaction rate with outpatient services had reached a score of 90.45 points where nurse-patient communication stands out as the top-rated dimension and privacy protection gets the lowest rating. On the other hand, the inpatient satisfaction stands at a score of 93.01 with friendliness to patient family receiving the top score and patient-doctor communication the lowest. Conclusions Despite the positive feedback Chinese patients give on the outpatient care they receive, we should make efforts to improve the outpatient care environment, the wayfinding system, privacy protection, and responsiveness of care-givers.

Objective To investigate the influencing factors of adverse pregnancy outcomes in patients with preeclampsia and the predictive value of serum trace elements in the second trimester.Methods A total of 98 patients with preeclampsia admitted to Qujing First People's Hospital from January 2019 to June 2022 were enrolled in the study.Patients were divided into poor outcome group and good outcome group according to whether they had adverse pregnancy outcomes.The clinical data of all patients enrolled in the study were col-lected and the serum levels of trace elements calcium,copper,zinc and iron were detected in the second trimes-ter.Univariate analysis and multivariate Logistic regression were used to analyze the influencing factors of ad-verse pregnancy outcomes in patients with preeclampsia.The levels of serum trace elements in the second tri-mester of pregnancy were compared between the poor outcome group and the good outcome group.The re-ceiver operating characteristic(ROC)curve was used to evaluate the predictive value of serum trace elements calcium,copper,zinc and iron for adverse pregnancy outcomes in patients with preeclampsia.Results Univari-ate analysis showed that compared with the good outcome group,the poor outcome group had significantly higher systolic blood pressure,24 h urinary protein quantitation,and D-dimer level(P＜0.05)and significantly less gestational age and platelet count at admission(P＜0.05).Multivariate Logistic regression analysis showed that 24 h urinary protein quantification,D-dimer and platelet count were the influencing factors of ad-verse pregnancy outcomes in patients with preeclampsia(P＜0.05).The levels of serum trace elements calci-um,copper,and zinc in the poor outcome group were significantly lower than those in the good outcome group(P＜0.05),and the level of iron was significantly higher than that in the good outcome group(P＜0.05).ROC curve analysis showed that the areas under the curves(AUCs)of serum calcium,copper,zinc,and iron in the second trimester of pregnancy for predicting adverse pregnancy outcomes in preeclampsia patients were 0.830(95％CI:0.780-0.880),0.855(95％CI:0.805-0.905),0.847(0.797-0.897)and 0.861(95％CI:0.811-0.911),respectively.Conclusion Adverse pregnancy outcomes in patients with preeclampsia are re-lated to 24 h urine protein,D-dimer and platelet count.The levels of serum trace elements calcium,copper,zinc and iron in the second trimester of pregnancy change significantly in patients with adverse pregnancy out-comes,which may become predictive markers of adverse pregnancy outcomes.