Objective To observe the therapeutic effect of traditional Chinese medicine sequential therapy combined with functional endoscopic nasal sinus surgery and peri-operative comprehensive treatment for chronic rhinosinusitis patients, thus to screen out more effective therapy for rhinosinusitis. Methods Sixty-six chronic rhinosinusitis patients admitted into our hospital from January of 2013 to December of 2013 were selected as the treatment group, and 63 chronic rhinosinusitis patients admitted into our hospital from January of 2012 to December of 2012 were selected as the control group. Both groups received functional endoscopic nasal sinus surgery and peri-operative comprehensive treatment, and the treatment group was given traditional Chinese medicine sequential therapy additionally, which included oral use of herbal medicine for expelling toxins to evacuate pus one month after operation, and acupoint catgut embedding therapy 2 months after operation. The scores of Sino-Nasal Outcome Test 20 ( SNOT-20) in both groups were observed 3, 6 months after operation, the therapeutic effect and patients’ satisfaction in both groups were also compared 6 months after operation. Results (1) Treatment group had better effect on improving the scores of nasal symptoms, associated symptoms, sleep disorders, emotional outcome and signs of SNOT-20, and on improving symptoms and signs integral scores than the control group 3, 6 months after operation (P<0.05). (2) In the treatment group, 57 cases were cured, 7 were relieved, 2 were ineffective, and the total effective rate was 97.0%; in the control group, 48 cases were cured, 10 were relieved, 5 were ineffective, and the total effective rate was 92.1%. The treatment group had better therapeutic effect than the control group (P<0.05). (3) The treatment group had higher patients’ satisfaction than the control group ( P<0.05). Conclusion Traditional Chinese medicine sequential therapy combined with functional endoscopic nasal sinus surgery and peri-operative comprehensive treatment is effective for the treatment of chronic nasal sinusitis patients, which can significantly relieve the general symptoms of the patients, enhance the total effective rate, and improve patients’ satisfaction.

BACKGROUND:Because chondrocytes have no regeneration ability, to select suitable seed cels is the primary problem to repair cartilage defects.
OBJECTIVE:To investigate the effect of alogeneicversus heterologous bone marrow mesenchymal stem cels (BMSCs) in repairing laryngeal cartilage defects after chondrogenic induction.
METHODS:BMSCs from human and rabbits were isolated and cultured. Passage 3 cels were cultured in chondrogenic induction medium containing transforming transforming growth factor beta 1 and bone morphogenetic protein, and then were dropped onto a poly(lactic-co-glycolic acid) (PLGA) scaffold. Thirty New Zealand rabbits were randomly assigned into three groups: blank control group, human BMSCs group, rabbit BMSCs group. Animal models of laryngeal cartilage defects were made in the three groups. After modeling, saline-soaked PLGA scaffold, PLAG scaffold with human BMSCs or with rabbit BMSCs were implanted respectively into the rabbits in the normal blank, human BMSCs and rabbit BMSCs groups. The expression of type II colagen in the larynx and its surrounding tissues was detected by immunohistochemistry at 4 and 8 weeks postoperatively.
RESULTS AND CONCLUSION: The animals in each group breathed normaly with no presence of wheezing, and their eating and activity were good. Moreover, there was no purulency or infection in the three groups. At 4 and 8 weeks after operation, the positive rates of type II colagen in the two BMSCs groups were significantly higher than that in the blank control group (P < 0.05). There was no significant difference between two BMSCs groups (P > 0.05). These results show that both alogeneic and heterologous BMSCs have good therapeutic effects on the repair of laryngeal cartilage defects in rabbits.

Population-based lifetime health services rely on health management practice. Collection, management and analysis of big data are highly suitable for the huge population base in China. Nowadays, more and more research focus on the methods, security and ethnicity of health management and big data, and a plenty of instructive results have been made, which could be used to guide the future practice and development. Yichang mode has set a precedent for construction and use of big data for health management.
Big Data ; China ; Delivery of Health Care ; Health Services Research ; Population Health Management ; Population Surveillance/methods*

Objective To evaluate the construction status of a healthy city in central China, and clarify the weak links and construction results in the construction of a healthy city, and to provide a basis for the relevant government departments to issue policies. Methods Healthy city construction evaluation system in this city was established according to the National Healthy City Construction Evaluation System (2018) of the National Healthy City Evaluation Office Forty-two sets of health city construction index data in 2017-2018 were collected and analyzed. The single index was calculated according to the Guidance Manual for Filling in the Healthy City Evaluation Data, and the single index data was then standardized. The Delphi method was used to consult the weights of the three-level index. Finally, the sub-index and the total index of each dimension of the city's healthy city construction were calculated based on the health index method. Results The results of the 2017-2018 healthy city construction evaluation showed that 35 of the 42 indexes participated in the evaluation, and the total-indices of the two years were 77.71 and 79.95, respectively. The two-year sub-indices of the five dimensions of health service, health culture, health environment, healthy population, and healthy society were 17.17 and 18.32, 11.39 and 12.85, 19.21 and 17.94, 13.81 and 13.81, 16.12 and 17.04, respectively. Except for the decline in the health environment dimension, the other four sub-indices and the total healthy city index showed an upward trend year by year. In the past two years, the comprehensive proportions of the corresponding weight of the five dimensions sub-indices were 95.58% in health culture, 95.47% in health service, 73.99% in health environment, 73.27% in healthy society, and 69.52% in healthy people. Conclusion After the construction of national healthy city and the pilot construction of national healthy city, a city in central China achieved its first results in five dimensions of healthy city. In 2018, among the 35 indexes participated in the evaluation in this city, 30 were positive, and 26 were better than the national/ provincial target value. However, some construction indices were still far from the standard values. The development of the five dimensions was unbalanced, and there were weak links in different degrees.

Objective To analyze the changes of CD4⁺ T cell numbers at different periods of antiviral therapy in HIV-infected and AIDS patients (HIV/AIDS) in Yichang City. Methods The relevant information was retrieved from the National AIDS Comprehensive Prevention Information System-Antiretroviral Treatment Management Database. Changes in the number of CD4⁺ T cells were analyzed in HIV/AIDS patients who started receiving highly active antiretroviral therapy (HAART) and continued the treatment for 3 years from January 1, 2003 to December 31, 2017 in Yichang. Results The number of CD4⁺T lymphocytes in 550 HIV/AIDS cases increased significantly at various time points within 3 years after treatment, and increased with the increase of treatment time（F=100.20，P<0.001）. The CD4+T cell counts of different baseline level groups were statistically different before and after treatment（F=8.57，P<0.01）. The CD4+ T cell counts of patients who started treatment at age of 15-30 years old increased faster than those who started treatment at age of over 30 years old（F=1.27，P<0.05）. Conclusion HAART has a significant effect on the increase of CD4+T cells, and the early treatment is more effective. Early detection, diagnosis and treatment should be promoted, and anti-viral treatment should be actively carried out.

Objective To analyze the epidemiological characteristics of syphilis in Yichang City from 2011 to 2020, and provide a scientific basis for developing effective control measures. Methods The data of syphilis cases reported in Yichang City from 2011 to 2020 were collected and analyzed by descriptive epidemiological methods. Results A total of 8 107 cases of syphilis were reported in Yichang City from 2011 to 2020, with an average annual reported incidence rate of 19.76 per 100 000.The reported incidence of syphilis increased from 17.39/100 000 in 2011 to 24.49/100 000 in 2018 （APC=6.82%，95%CI：2.34%~11.49%， P＜0.05）, from 24.49/100 000 in 2018 Decline to 17.55/100 000 in 2020（P＞0.05）. Recessive syphilis is the main type, with 5 837 cases (72.00%), and the annual reported incidence rate is 14.23 per 100 000. The number of cases peaked in July, at 836 (10.31%), and 433 (5.34%) of the lowest in February . The top 3 counties with annual average reported incidence rates were Zigui County (28.51/100 000) , Xiling District (25.01/100 000), and Dangyang City (23.73/100 000). There were a statistically significant differences in reported incidence between counties (2 =933.92, P＜0.01). Gender ratio was 0.72. Cases mainly concentrated in people over 20 years old, 7901 cases (97.46%). The occupation distribution is mainly farmers, housework, unemployed, and retired people. Conclusion The incidence of syphilis in Yichang City has been on the rise in recent ten years, and there is still a long way to go to prevent and control syphilis. We suggested to continue to strengthen the prevention and control of syphilis and comprehensively prevent and control the spread of syphilis.

Objective To clarify the basic situation of enterprises with occupational hazard factors and current situation of occupational health management in enterprises in Yichang City. Methods Using big data and spatial geography technology, combined with enterprise on-site review, conduct a thorough investigation of the basic situation of the existing occupational disease hazard enterprises in the city. Results A total of 2 219 enterprises with occupational hazard factors were investigated in the city. The largestindustry distribution were in non-metallic mineral products, electric power, heat production and supply, and metal products. The most common types of economy were other foreign-invested enterprises, cooperative enterprises (Hong Kong or Macao, Taiwan-funded), and collective enterprises. The scale of the enterprises was mainly small and micro-quantity. Noise, dust and chemical poisons are the main hazards of the people exposed to the victims, accounting for 65.23%, 53.58%, and 29.76% of the total number of people exposed. The city's overall regular on-site inspection rate in the past three years was 20.73%, and the occupational health examination rate was 23.56%. Conclusion The occupational health management of industrial enterprises in our city needs to be further strengthened.

Objective To retrospectively analyze the results of neonatal diseases screening in Yichang from 2017 to 2019, understand the incidence and recall of the diseases, and explore the management mode of neonatal disease screening suitable for this region. Methods The subjects were newborns who were delivered in Yichang midwifery institutions from 2017 to 2019 and were screened for neonatal diseases. Heel blood of the newborns was collected for the screening of neonatal diseases, including congenital hypothyroidism (CH), phenylketonuria (PKU), G6PD deficiency, congenital adrenal hyperplasia (CAH) and thalassemia. Those newborns with positive initial screening were recalled for reexamination and confirmation. The recall rates of different diseases were compared by Chi-square test. Results There were 85 891 live births in Yichang area from 2017 to 2019, and 84 063 cases were screened for neonatal diseases, with a screening rate of 97.87%. A total of 6 043 cases were positive in the initial screening, of which 5,047 cases were recalled, with a recall rate of 83.52%. The recall rates of the traditional two diseases (CH and PKU) and the new three diseases (CAH, G6PD deficiency and thalassemia) were significantly different ( χ²= 197.93, P＜0.01). A total of 501 cases were diagnosed. The incidence rate of CH was 1/1,911, the incidence rate of PKU was 1/12 009, the incidence rate of CAH was 1/28 021, the incidence rate of G6PD deficiency was 1/1 121, and the incidence rate of thalassemia was 1/226. Conclusions The neonatal disease screening rate increased year by year in Yichang, but the recall rate of suspicious positive initial screenings decreased. It is necessary to explore a more suitable management mode for the five neonatal disease screenings in this region, improve the recall rate of children with positive screening, reduce the incidence of disabled children, and improve the quality of the birth population.

Objective To investigate the distribution characteristics of antibiotics in source water and their health risks to human body in Yichang City, and to provide a scientific basis for the prevention and control of new types of pollution such as antibiotics in drinking water. Methods Solid phase extraction (SPE) was used for enrichment, and ultra-high performance liquid chromatography tandem mass spectrometry (UPLC-MS/MS) was used to detect and analyze the content of five types of antibiotics including sulfonamides, tetracyclines, chloramphenicol, quinolones and β-lactams in the main drinking water sources of Yichang City. The human health risk assessment of these antibiotics was conducted. Results All five types of antibiotics were detected in the source water of Yichang City, and the detection rate was 6.25% to 81.25%. The total detection rate of β-lactam antibiotics was the highest, and the highest detection concentration of norfloxacin was 213.9 ng/L. The health risk assessment of 11 antibiotics detected in the source water showed that these antibiotics would not cause obvious health harm to human body, but the risk entropy (RQ_H) tended to increase with the younger age. Conclusion The distribution level of antibiotics in source water of Yichang City will not cause obvious health harm to human body.

Objective To provide reference for the development of prevention and control strategies for HIV/AIDS cases aged 50 and above in Yichang city from 2013 to 2020 by epidemiological characteristics anaylsing. Methods Descriptive epidemiological method was used to analyze the epidemic situation and epidemiological data. Results A total of 1 126 HIV/AIDS cases were reported during the monitoring period, and 296 cases were 50 years old and above, accounting for 26.29%. The proportion of cases aged 50 years and above to the total number of cases and the annual reported incidence rate both showed an upward trend (P＜0.01). The cases were mainly male (74.66%), and the older the age, the greater the proportion of males (P=0.02). The age of confirmed cases is mainly concentrated in 50-59 years (68.58%), of which 49.66% were married and 74.32% were at junior high school and below. Sexual contact (accounting for 99.66%) was the main route of infection, the proportion of non-marital heterosexual sex was relatively high, especially in female cases (accounting for 74.67%). Those who had been infected for more than 8 years accounted for 48.75%, and the proportion of infected age ≥50 years in the total number of cases showed an upward trend. Cases were found mainly from medical institutions (74.66%). Conclusion The HIV/AIDS epidemic situation of people aged 50 and above in Yichang City was relatively severe and has became a key population for prevention and control. Targeted and effective prevention and control measures should be taken to reduce the harm of AIDS to the population.