Objective To observe the effect of treating DPN with xuesaitong tablet and mecobalamine. Methods 112 patients with DPN were randomly recruited into a treatment group (60 cases) and a control group (52 cases). The control group was treated with mecobalamine, 0.5 mg. Rid., while the treatment group was treated with Xuesaitong tablet, 50mg tid.,On the basis of the control group. Both groups were treated for successive three months. Results The total effective rate was 78.33% and 57.70% in the treatment group and the control group respectively, showing a statistical difference (t= 1.9804, P=0.0271). Conclusion The combined therapy of xuesaitong tablet and mecobalamine was more effective on DPN than mecobalamine used only.

Objective To observe the effect of treating diabetic peripheral neuropathy(DPN) with methylcobalamin and Chinese medicines with the funetious of nourishing Yin and promoting blood circulation. Methods 72 patients with DPN were randomly recruited into a control group and a treatment group.Symptoms, NCV,value of blood routine examination,blood biochemistry check and ECG were compared before and after the treatment. Results The total effective rate was 88.0% and 68.2% in the treatment group and the control group respectively,showing significant difference (t=3.14, P<0.01).The value of blood routine examination, blood biochemistry check (except blood sugar level) and ECG showed no obvious changes before and after the treatment in both groups.Conclusion Therapy of methylcobalamin Tablets with Chinese medicines of nourishing Yin and promoting blood circulation is effective on DPN and worth of clinical promotion.

Objective:To explore the effectiveness and safety of tirofiban in patients with reocclusive ischemic stroke after intravenous thrombolysis with alteplase.Methods:Eighty-four patients with re-occlusive ischemic stroke after intravenous thrombolysis with alteplase, admitted to our hospital from January 2018 to May 2020, were prospectively chosen; these patients were divided into tirofiban group and routine (non-tirofiban) group ( n=42). In addition to thrombolysis, patients in the routine group received intensive lipid-lowering, collateral circulation improvement, blood glucose control, and early rehabilitation therapy; after thrombolysis for 24 h, patients without intracranial hemorrhage were given oral aspirin, 0.1 g/d, for 90 d. After thrombolysis and re-occlusion, patients in the tirofiban group were intravenously pumped with 0.4 μg/(kg·min), which was changed to 0.1 μg/(kg·min) after 30 min for 24 h; at 24 h after thrombolysis, brain CT was reexamined: tirofiban was discontinued for patients with intracranial hemorrhage, and intravenous pumping of tirofiban was continued for patients without intracranial hemorrhage for 24 h. Effectiveness was evaluated by comparing the general clinical data, National Institutes of Health Stroke Scale (NIHSS) scores 7 d after treatment, and modified Rankin Scale (mRS) scores 90 d after treatment between the two groups. Safety was assessed by comparing the intracranial hemorrhage, symptomatic intracranial hemorrhage, and mortality within 90 d of treatment between the two groups. Results:There were no significant differences in age, gender, underlying diseases, risk factors, baseline NIHSS scores, time from onset to start of treatment, infarction sites, and TOAST classification between the 2 groups ( P>0.05). NIHSS scores 7 d after treatment ([10.05±4.73] min vs. [7.93±4.68] min), mRS scores 90 d after treatment (3.48±1.48 vs.2.55±1.93), and good prognosis rate 90 d after treatment (21.4% vs. 42.9%) showed significant differences between the routine group and tirofiban group ( P<0.05). In terms of safety, there were no significant differences in intracranial hemorrhage rate (4.76% vs. 7.14%), symptomatic intracranial hemorrhage incidence (2.38% vs. 2.38%) and mortality (2.38% vs. 2.38%) between the 2 groups ( P>0.05). Conclusion:It is safe and effective for tirofiban in patients with re-occlusive ischemic stroke after intravenous thrombolysis with alteplase.

Coronavirus Disease 2019 (COVID-19) is an infectious disease caused by 2019 novel Coronavirus (2019-nCoV). At present, the most used method to diagnose 2019-nCoV is nucleic acid test. Suspected cases underwent real-time fluorescent RT-PCR examination, and those who were 2019-nCoV nucleic acid positive were confirmed cases. However, in the process of nucleic acid test, factors such as specimen quality, specimen transportation and storage conditions, detection reagents and methods may cause false negative or false positive results. This article reviews the factors that may affect the results of 2019-nCoV nucleic acid test, and provides a basis for the diagnosis of suspected COVID-19 cases.

Objective To explore the prevalence and epidemic characteristics of overweight, obesity, and central obesity in Shanghai Pudong New Area. Methods Multi-stage stratified random sampling method was conducted in Pudong New Area in 2013. Residents over 15 years old were randomly selected from 13 communities and participated in the cross-sectional study. A structured questionnaire was used to collect the information and physical examination, biochemical assays were also conducted. SPSS 20. 0 was used to analyze the results. Results The averagebodymassindexofparticipantswas(25.04±3.79)kg/m2andtheaveragewaistcircumferencewas(82.44± 9. 51) cm. The prevalences of overweight, obesity, and central obesity were 41. 67%, 17. 70%, and 31. 32%respectively. Standardized prevalences of overweight, obesity, and central obesity were 34. 39%, 16. 96%, and 25. 66% respectively, according to 2010 national age composition of population. Statistically significant sex differences were found among the prevalence of overweight, obesity, and central obesity groups(all P<0. 05). The prevalence of central obesity in female was raised by increasing age. Residents with hypertension, hyperglycemia, dyslipidemia, and metabolic disorders had higher prevalences in overweight, obesity, and central obesity ( all P<0. 05). Conclusion The prevalences of overweight, obesity, and central obesity among the residents in Shanghai Pudong New Area were relatively high. Relevant risk factors should be explored to promote health education that may enhance people′s awareness of weight management.

BACKGROUND:As a routine method after lumbar spine surgery,a drainage tube is convenient for postoperative bleeding drainage and management,and there is still no consensus on the choice of postoperative removal time for short-segment lumbar spine surgery with less risk. OBJECTIVE:To explore the effect of different drainage times on early clinical efficacy after short-segment lumbar fusion. METHODS:A prospective randomized controlled study was performed on 220 patients in the Affiliated Hospital of Southwest Medical University who underwent posterior lumbar interbody fusion for lumbar degenerative diseases from March 2017 to April 2021.According to the different drainage times,the patients were randomly divided into removal on the second day after operation(group A),removal on the third day after operation(group B),and removal after the observation method 24-hour drainage volume<30 mL(group C).The perioperative indicators and follow-up results of the three groups of patients were observed and compared. RESULTS AND CONCLUSION:(1)Because 7 patients were lost to follow-up,2 patients were excluded,and 211 patients were finally included(72 patients in group A,71 patients in group B,and 68 patients in group C).(2)The average drainage time of group C was 2.91 days.The postoperative drainage volume in group A was significantly less than that in groups B and C,and the difference was statistically significant(P<0.05).On day 3 after operation,the hematocrit value of group C was lower than that of group A and group B,and the difference was statistically significant(P<0.05).Postoperative activity time and hospital stay in group A were shorter than those in groups B and C,and the difference was statistically significant(P<0.05).(3)Four patients in group A,two patients in group B and three patients in group C received an allogeneic blood transfusion.There was no significant difference among the groups(P>0.05).(4)In terms of postoperative complications,there were no statistical differences in postoperative wound leakage and surgical site infection in all three groups(P>0.05).(5)All patients were followed up for more than 12 months.Visual analog scale score and Oswestry dysfunction index of the three groups of patients before discharge and at the last follow-up were significantly improved compared with those before surgery(P<0.05).There was no statistical significance among the groups(P>0.05).(6)It is indicated that the removal of the drainage tube on the second day after a posterior lumbar fusion can effectively reduce the time to get out of bed and hospital stay,without increasing the postoperative blood loss and the risk of complications.

BACKGROUND:Some patients with cervical spondylosis have not been fully corrected sagittal position balance after cervical surgery,and this continuous sagittal position imbalance may be an important reason for the poor long-term clinical outcome of patients. OBJECTIVE:To analyze the correlation between the cervical sagittal position balance parameters and their changes and the clinical efficacy of patients in the unbalanced state after anterior cervical decompression and fusion and to explore the necessity of surgical correction of sagittal balance in order to improve the clinical effect in the later stage. METHODS:A retrospective analysis was performed on 125 patients with cervical spondylosis who underwent anterior cervical decompression and fusion in the Department of Spinal Surgery of Affiliated Hospital of Southwest Medical University from July 2019 to July 2022.Follow-up patients had good postoperative recovery(neck disability index score less than 10%one week after surgery)and had complete follow-up data.According to the axial vertical distance(C2-7 SVA)in sagittal position one week after surgery,patients were divided into type I imbalance group(C2-7 SVA loss≤5 mm,n=27),type Ⅱ imbalance group(C2-7 SVA loss>5 mm,and≤10 mm,n=19),and type Ⅲ imbalance group(C2-7 SVA loss>10 mm,n=12),and non-unbalanced group(C2-7 SVA in the normal range,n=67).The changes of visual analog scale score and neck disability index were compared among groups postoperatively and the last follow-up,as well as the changes of imaging sagittal balance parameters C2-7 cobb angle,C2-7 SVA value,neck inclination angle,T1 inclination angle,and thoracic entrance angle.The correlation between the late clinical effect and postoperative cervical sagittal disequilibrium was explored. RESULTS AND CONCLUSION:(1)There was no statistical difference in general data among the four groups(P>0.05).All patients underwent successful surgery without serious complications and postoperative wound infection.The follow-up time was more than 1 year.(2)There was no significant difference in preoperative symptom score and clinical efficacy one week after surgery(P>0.05).At the last follow-up,pain visual analog scale score,neck disability index and C2-7 SVA were lower than those before surgery but higher than those one week after surgery(P<0.05).C2-7 cobb angle was increased compared with those before operation(P<0.05).T1 inclination angle was decreased compared with those before operation(P<0.05).(3)Pearson correlation test showed that the change of neck disability index was positively correlated with the change of C2-7 SVA(P<0.05).(4)It is indicated that anterior cervical decompression and fusion is effective in the treatment of cervical spondylosis,and can effectively relieve the symptoms of patients.Patients with more severe cervical sagittal disequilibrium after surgery had worse curative effect in the later period.Continuous sagittal disequilibrium in patients with cervical spondylosis after surgery is an important cause of poor curative effect in the later stage.Clinicians should pay more attention to the correction of cervical sagittal balance before and during surgery,formulate surgical strategies and plans according to sagittal balance parameters before surgery,and correct C2-7 SVA intraoperatively to the normal range.

Objective:To establish an indicator system for surveillance of data sources to provide a theoretical basis for respiratory infectious disease surveillance and early warning.Methods:Indicators for data sources in the surveillance of acute respiratory infectious diseases were initially compiled through a literature search. Subsequently, two rounds of expert consultations were conducted with 22 experts using the Delphi method to refine the indicators.Results:The questionnaire recovery rates for the two rounds of expert consultation were 100.00% and 86.36%, respectively. The authority coefficient of the experts was 0.83. The coordination coefficient of the second round of Delphi expert consultation was 0.32, and the coefficient of variation of each indicator was less than 0.25. Finally, the indicators system of data source for the surveillance of acute respiratory infectious diseases includes 4 first-level indicators, 10 second-level indicators, and 26 third-level indicators.Conclusion:The indicator system of data sources for the surveillance of acute respiratory infectious diseases constructed in this study is reasonable and reliable, providing a valuable reference for surveillance, early warning and policy formulation of acute respiratory infectious diseases.

Objective:To understand the epidemiological characteristics of infectious diarrhea pathogens in Pudong New Areas of Shanghai from 2013 to 2017 to provide evidence for control and prevention of the disease.Methods:From Jan 2013 to Dec 2017, active surveillance program on diarrhea was conducted in 14 sentinel hospitals (three tertiary-level and nine secondary-level, and two primary-level hospitals) in Pudong New Areas of Shanghai, based on location, catchment areas and number of patients. All recruited outpatients were interviewed in hospitals, using a standard questionnaire. Stool specimens were collected and tested for five viral and eight bacterial pathogens.Results:A total of 9 301 cases with infectious diarrhea were included, and the overall positive rate was 55.7 % (5 179). Positive rates of single virus, single bacteria and mixed infections were 26.7 % (2 481), 17.0 % (1 579) and 12.0 % (1 119), respectively. For single infection, the most commonly detected viruses appeared as norovirus (15.4 %, 1 428/9 301) and rotavirus (7.2 %, 667/9 301). The most commonly detected bacteria were diarrheagenic Escherichia coli (6.7 %, 619/9 301) and non-typhoid Salmonella (3.3 %, 305/9 301). The most common mixed infections were caused by virus-bacteria (4.9 %, 459/9 301). Norovirus (17.0 %, 838/4 938) showed the highest positive rates, followed by Escherichia coli (7.2 %, 354/4 938), both seen in the age group of 20-59 years old group. Rotavirus (9.4 %, 178/1 896) and non-typhoid Salmonella (4.9 %, 93/1 896) were the most common pathogens found in the age group of 0-4 years old. The prevalence of norovirus peaked both in spring and autumn. The other peaks were seen as: Rotavirus in winter, diarrheagenic Escherichia coli in summer and non-typhoid Salmonella in summer. Conclusions:Our data showed that the positive rates of infectious diarrhea pathogens were high in Pudong New Areas of Shanghai from 2013 to 2017. The dominant pathogens would include norovirus, rotavirus and diarrheagenic Escherichia coli but with differenct distributions in age groups. Obvious seasonal patterns were also observed.

ObjectiveTo analyze the epidemic characteristics of measles and rubella in Pudong New Area of Shanghai from 2013 to 2022， and to provide data support for the elimination of measles and rubella. MethodsEnzyme linked immunosorbent assay was used to detect IgM antibodies in serum samples. The sequence of 630 nucleotides at the C-terminal of N gene of measles virus was amplified by reverse transcription-polymerase chain reaction and the phylogenic tree was constructed. ResultsA total of 1 529 suspected cases of measles were detected from 2013 to 2022， among which the positive rate of measles IgM antibody was 33.55% （513/1 529）. The highest positive rate （20.73%） was from March to May ， and the positive rate of rubella IgM antibody was 6.80% （104/1 529）. The positive rate of both IgM was higher in males than that in females （P<0.05）. The IgM against measles was mainly detected in 0‒ years old （63.16%， 96/152） and 20‒ years old （45.61%， 161/353）. The IgM against rubella was mainly detected in 10‒20 years old （27.27%， 18/66）. The IgM antibody could be detected more easily from 4 to 28 days after eruption， and the IgM antibody positive rate of measles/rubella from 2020 to 2022 was significantly lower than previous years （2013‒2019）. There were 2 D8 genotype strains， and the rest were H1a gene subtypes. ConclusionThe positive rate of IgM antibodies against measles/rubella in Pudong New Area of Shanghai decreased significantly. People aged 0‒ years and 20‒ years old are more susceptible to measles， and rubella is concentrated in 10‒ years old. It is necessary to strengthen the vaccination of school-age children， in order to achieve the goal of eliminating measles. The age group with high risk of exposure should be checked for vaccination status to ensure the enhanced immunization， and the surveillance of imported measles cases should be strengthened.