Objective To investigate the clinical outcome and treatment characteristics of viral encephalitis with bilateral thalamic damage so as to improve its prognosis.Methods Twelve cases of viral encephalitis with bilateral thalamic damage were collected during September 2012 to June 2013 by head MRI.These cases were retrospectively studied with the data of medical history,physical examination,laboratory and brain function monitoring and treatment.The relationship between treatment and prognosis was studied during 2 years of follow-up.Results All patients began with the rapid onset,accompanied by fever,coma,and convulsions.Delirium and involuntary movement occurred during the recovery period.Six cases(50.0％) received ventilator assisted ventilation.In the acute phase,electroencephalogram (EEG) showed diffuse slow wave and 4 cases(33.3％) had status epilepticus on EEG.Ten cases discharged from hospital had long-term oral anti epileptic drugs,which lasted 6 months in 3 cases,1 year in 4 cases,and 2 years in 3 cases for maintaining EEG stability.Head MRI indicated white matter demyelination besides the gray matter damage within the thalamus.All 12 patients underwent methylprednisolone impact treatment and 6 cases had effective reversal within 1 week of onset with better tolerance,and the other 6 cases received treatment in subacute stage and 5 of them accelerated recovery and 1 case had sense improvement,but died after giving up therapy.After 3 months courses,8 cases(66.7％) got gross motor and swallowing function recovered to normal,and 3 cases had left unilateral limb movement disorder.After 2 years of follow-up,11 cases had normal motor,intelligence returned to normal in 9 cases,and 2 cases had mild mental retardation.Conclusions Viral encephalitis complicated with bilateral thalamic damage is characterized by acute onset,serious manifestations,idiopathic progress;in the subacute stage it is most likely to develop white matter demyelination.The key to control the disease is to block the inflammatory immune response quickly,and give patients large dose methylprednisolone treatment can effectively curb the progress of the disease.In the sub acute phase,it can promote the recovery,safe and effective.The long-term prognosis will be good with the reasonable treatment at early stage of the disease.

Objective : To investigate the fertility level of registered population in Baoshan District, Shanghai Municipality and the incidence of adverse birth outcomes of live births from 2013 to 2022, so as to provide the evidence for improving maternal and child health care strategies. Methods: The data pertaining to live births registered in Baoshan District from 2013 to 2022 were collected through the Shanghai Birth Medical Information System, including the basic information of live births and maternal fertility. The indicators such as fertility level, parity, birth age and incidence of adverse birth outcomes of live births were descriptively analyzed. The trend of crude birth rate and total fertility rate was analyzed by annual percent change (APC). Results: A total of 56 719 live births were registered in Baoshan District from 2013 to 2022. The crude birth rate was 6.54‰, the total fertility rate was 31.78‰, and the sex ratio at birth was 105.61. The crude birth rate showed a downward trend from 2016 to 2022 (APC=-11.054%, P<0.05), and the total fertility rate showed a downward trend from 2017 to 2022 (APC=-10.377%, P<0.05). The proportion of second parity and above showed an increasing trend from 2013 to 2017 (P<0.05) and a decreasing trend from 2017 to 2022 (P<0.05). The maternal childbearing age showed an increasing trend from 2013 to 2022 (P<0.05), the incidence of premature infants and low birth weight infants showed an increasing trend (both P<0.05). The incidence of premature infants and low birth weight infants increased with the rising childbearing age (both P<0.05). Conclusions The fertility level in Baoshan District was relatively low from 2013 to 2022. The proportion of second parity and above showed an upward trend followed by a downward trend. The incidence of premature infants and low birth weight infants increased with the rising childbearing age.

ObjectiveTo investigate the epidemiological characteristics of respiratory disease mortality in Baoshan residents during the period of 2009‒2020. MethodsRespiratory disease deaths of Baoshan residents from 2009‒2020 were collected. ICD-10 codes were used to classify the causes of death， and R-4.2.1 was applied for statistical analysis. The average annual percent change （AAPC） of standardized mortality rates of different respiratory diseases were analyzed by using Joinpoint 4.9.0.0. ResultsThe average annual mortality rate of respiratory diseases in Baoshan from 2009 to 2020 was 58.86/10⁵， and the standardized mortality rate was 35.62/10⁵， which was the 3rd leading cause of mortality. The mortality rate of respiratory diseases was higher in men than in women （χ²=46.70， P<0.001）. COPD ranked first among respiratory diseases in Baoshan from 2009 to 2020， followed by pneumonia， asthma and pneumoconiosis in that order. The standardized mortality rate for COPD decreased from 38.66/10⁵ in 2009 to 19.88/10⁵ in 2020 （AAPC=-6.6%， 95%CI： -8.2% to -4.9%， P<0.001）. The standardized mortality rate of asthma decreased from 2.86/10⁵ in 2009 to 1.43/10⁵ in 2020 （AAPC=-5.8%， 95%CI： -8.8% to -2.8%， P<0.01）. The standardized mortality rate of pneumoconiosis decreased from 0.64/10⁵ in 2009 to 0.12/10⁵ in 2020 （AAPC=-7.4%， 95%CI： -13.0% to -1.5%， P<0.05）. The standardized mortality rate for pneumonia decreased from 2.63/10⁵ in 2009 to 0.70/10⁵ in 2020 （AAPC=-6.2%， 95%CI： -12.2% to 0.2%， P=0.056）， but not statistically significant. The annual average mortality rates of COPD， pneumonia and asthma were all highest in January. Crude mortality rates for COPD （χ²=2 669.01， P<0.001）， pneumonia （χ²=217.82， P<0.001）， asthma （χ²=100.09， P<0.001）， pneumoconiosis （χ²=26.46， P<0.001） and all categories of respiratory diseases （χ²=2 995.84， P<0.001） increased with age showed an increasing trend. The crude mortality rates for COPD （χ²=101.69， P<0.001）， pneumonia （χ²=7.39， P<0.01） and asthma （χ²=7.41， P<0.01） were higher in the central than in the northern part of Baoshan District， while the crude mortality rate for COPD （χ²=19.97， P<0.001） was higher in the central than in the southern part. ConclusionThe attention should be focused on COPD； increased detection in males and the elderly， especially in winter and spring； and a good balance between environmental and economic when planning the regional development.