Objective To describe the vaccine inoculation rate of hemorrhagic fever with renal syndrome (HFRS) and the movement characteristics of rural population in the Xi'an epidemic area.Methods This was a cross-sectional study.The study covered all the four HFRS traditional high incidence areas (counties):Zhouzhi,Huxian,Chang'an and Lintong.Three villages were selected in each county and 20 households were selected in each village in 2013.Participants included all the persons of these families.People 16-60 years old were interviewed face to face about their sociodemographic and environmental information,and at the same time related HFRS vaccine history and characters of migrant workers were collected.Results Nine hundred and ninety-six persons were investigated,69.3 percent (690/996) were vaccinate-age population.Of all,49.0 percent (338/690) had HFRS vaccine history and 53.9 percent (372/690) had worked away from home most of the year.The inoculation proportion of workers which worked in their own counties (56.8％,67/118) were higher than that of workers worked outside (37.0％,60/162;39.1％,36/92,x2 =10.74,6.44,all P ＜ 0.017).In the workers that went back home every week,60.3 percent (76/126) had vaccinated.Workers that went back home once a year had the lowest proportion of inoculation (16.7％,7/42).The morbidity of HFRS decreased significantly accompany with ascend of inoculation rate (Y =-0.524X + 38.319,t =-4.581,P ＜ 0.05).Conclusions After the free vaccinations,there is still a gap between the vaccine inoculation rate and prevention benefit.The current vaccination strategies need to be adjusted.

OBJECTIVETo investigate the pathogenic and clinical presentation and laboratory tests of bullous rash in hand, foot and mouth disease (HFMD) in Xi'an from January 2013 to December 2014 by retrospective analysis.

METHODA total of 224 specimens were collected from clinically diagnosed HFMD cases who were characterized by widespread mucocutaneous bullous reactions in Xi'an Children's Hospital from January 2013 to December 2014, the identification and subtyping of the isolates were conducted with real-time fluorescent quantitative RT-PCR. A retrospective analysis was performed to analyze the clinical presentation, laboratory tests and late follow-up problems of the HFMD.

RESULTIn the clinically diagnosed HFMD cases who were characterized by widespread mucocutaneous bullous reactions, 207 were caused by coxsackievirus A6 (CA6), accounting for 92. 4% of all cases with bullous, 4 were caused by enterovirus 71 (EV71), accounting for 1.8%, 10 were caused by coxsackievirus A16 (CA16), accounting for 4. 5%; 4 cases were negative for these viruses. In the cases positive for intestinal virus-nucleic acid, 130 were male, 90 were female; male to female ratio was 1. 44: 1, 203 were <5 years old, accounting for 92. 3%. Leukocytosis was found in 75 cases (34. 1%); high-sensitivity C-reactive protein (hsCRP) increased in 200 cases (90. 9%); elevated myocardial enzyme CK-MB was found in 35 cases (15. 9%), alanine aminotransferase increased in 15 cases (6. 8%); 187 cases had fever (85. 0%). None of the cases had serious complications such as encephalitis or myocarditis. In the course of the critical phase bullous rash or large vesicle-like changes, obvious itching, and facial rash appeared. After the fluid in the bullae was absorbed or the bullae ruptured or became ulcerated, scar formation and large areas of exfoliation occurred, with no effusion on the newly formed epithelium in the base, without significant pigmentation on later follow-up. In the late follow up process, 52 cases in CA6-positive patients (25. 1%) developed onychomadesis within 2-4 weeks after onset, 1 to 8 nails, an average of 4. 3 fell off, new nails grew, the nail bed showed no structural abnormalities and hyperplasia after falling off, the surface was smooth, had no hypertrophy, left no sequelae.

CONCLUSIONThe pathogen in HFMD characterized by widespread bullous reactions was mainly the CA6, this kind of HFMD was mainly mild type, with significant itching, later the bullae may have scar formation and skin exfoliation, in some cases onychomadesis may occur.

Child ; Enterovirus A, Human ; Enterovirus Infections ; pathology ; Exanthema ; pathology ; Female ; Fever ; Hand, Foot and Mouth Disease ; pathology ; Humans ; Male ; Pruritus ; Retrospective Studies

Background With the development of refractive surgery,phakic intraocular lens implantation (PIOL) for high myopia is proving its outstanding merits in short-term treating outcomes.However,its long-term safety and effectiveness were still in more attention.Objective This study was to evaluate and compare the long-term safety,stability and efficacy of Verisyse PIOL implantation with implantable contact lens (ICL) implantation for high myopia.Methods The clinical data of 18 eyes (9 patients) who received Verisyse iris-claw intraocular lens implantation for high myopia and matched 22 eyes (11 patients) who received ICL implantation for high myopia from 2009 to 2011 were retrospectively analyzed.The patients were followed-up for 2 years after surgery.Uncorrected visual acuity (UCVA),best corrected visual acuity (BCVA),spherical equivalence (SE),axial length,corneal endothelial cell density (ECD),contrast sensitivity (CS),wave-front aberrations and postoperative complications were recorded during the following-up.The efficacy index,predictable and safety index were compared between the two groups.Results There was no significant difference in UCVA,BCVA and SE between Verisyse group and ICL group(t =0.92,1.32,4.32;all at P＞0.05).Non-glare CS under the 1.5,3.0,6.0,12.0 and 18.0 c/d spatial frequencies were insignificantly different between the two groups(Z=0.782,0.956,0.495,0.874,0.293;all at P＞0.05),and the similar outcomes were found in glare CS (Z=0.985,1.254,0.896,1.652,0.492;all at P＞0.05) in postoperative 2 years.Root meas square of total high order aberration (RMSh),vertical-trefoil,vertical-coma,horizontal-coma,spherical aberration(SA),were significantly elevated in the Verisyse group compared with the ICL group (Z =4.72,4.24,3.12,3.65,2.16;all at P ＜ 0.05).The mean efficacy index was 108.49 ± 16.62 in the V erisyse group and 106.71±15.88 in the ICL group,showing a significant difference (t =0.54,P＞0.05).The mean safety index was 140.56±33.89 in the Verisyse group and 143.34±34.56 in the ICL group,with a significant difference between them (t=0.29,P＞0.05).The mean predictable index was-0.25(-0.97,4.23)in the Verisyse group and 0.98 (-1.44,1.52) in the ICL group,and the difference was significant (Z =-2.68,P ＜ 0.05).Conclusions Both Verisyse PIOL implantation and ICL implantation for high myopia are safe,predictable and effective.The vusial quality and predictability of ICL implantation are much better than Verisyse PIOL implantation.A long-term effect should be observed for the further evaluation.

Objective: To observe the effect of ticagrelor for non-ST-segment elevation acute coronary syndrome after percutaneous coronary intervention (PCI). Methods: A total of 200 patients with non-ST-segment elevation acute coronary syndrome after PCI were enrolled in this study.And the patients were randomly divided into the observation group (18 months treatment group, 100 cases) and control group (12 months treatment group, 100 cases) according to the digital table.The control group was given dual antiplatelet therapy (DAPT) for 12 months, and then, suspended the usage of ticagrelor.The observation group was treated by DAPT for 18 months.The major adverse cardiovascular events (MACCE) and the secondary end point events were observed. Results: The incidence rate of MACCE between the two groups had no statistically significant difference (χ²=0.298, P=0.862). And there was no statisticallysignificant difference in the incidence of the secondary end point events between the two groups (χ²=1.963, P=0.375). Conclusion The usage of DAPT beyond or equal 12 months doesn't reduce the incidence of MACC and it will not increase the blooding rate.The use of DAPT (aspirin and ticagrelor) should be used less than 12 months.

Gastric cancer is one of the common tumors in the world and a major cause of cancer death.Although the 5-year survival rate of gastric cancer patients has increased greatly with the improvement levels of diagnosis and treatment,the high malnutri-tion rate of gastric cancer patients still has a significant impact on their overall survival and quality of life.Malnutrition is considered an independent prognostic factor for cancer patients,early detection of malnutrition in gastric cancer patients and more reasonable peri-operative nutritional support play an important role in the survival and prognosis of gastric cancer patients.This article combines exist-ing research at domestic and abroad to review the nutritional risk screening and assessment of gastric cancer patients during periopera-tive period,as well as the research progress of perioperative nutritional support and immunonutrition,in order to provide more compre-hensive nutritional management strategies for patients with gastric cancer during the perioperative period.

Objective:To investigate the current situation of pregnancy distress and related factors in the third trimester of pregnancy,and explore its association with self-compassion and emotional inhibition.Methods:A total of 214 women in the third trimester of pregnancy were selected and measured the pregnancy pain,self-compassion and emotional depression levels of pregnant women in the third trimester with the Tilburg Pregnancy Pain Scale(TPDS),Self-Compassion Scale(SCS),and Emotional Suppression Scale(EIS).Results:The average score of pregnancy distress of 214 pregnant women in the third trimester was(26.7±4.9),with a medium level of pregnan-cy distress.Multiple linear regression analysis showed that the total scores of pregnancy distress in the third trimes-ter of pregnancy were negatively associated with the accompanying situation of the lover(β=-0.15,P＜0.05),the number of accompanying prenatal examinations(β=-0.24,P＜0.05)and the total scores of self-compassion(β=-0.12,P＜0.05),while positively correlated with gestational age(β=0.14,P＜0.05),complications(β=0.15,P＜0.05),and the total score of emotional suppression(β=0.17,P＜0.05).Conclusion:Pregnancy distress is common in pregnant women in the third trimester,which may be related to gestational age and complications,companionship of loved ones,number of accompanying prenatal examinations,self-compassion level and emotional inhibition.

Objective:To investigate the molecular epidemiological characteristics and antibiotic resistance of Clostridioides difficile ( Cd) in hospitalized diarrhea patients in a tertiary hospital in Shaanxi Province. Methods:This study collected 425 stool samples of hospitalized diarrhea patients from October 2018 to December 2021 for isolation and identification of Cd. Toxin genes carried by the isolates were detected. Multilocus sequence typing (MLST) was performed to analyze the phylogenetic profile. Antibiotic susceptibility was analyzed by E-test. Results:Forty-nine strains of Cd were isolated from the 425 samples, including 37 strains of toxigenic Cd (75.5%, 37/49). The detection rate of Cd was 14.0% (25/179) in diarrhea patients aged ≥65 years old and 36.4% (4/11) in Nephrology Department. In the 37 toxigenic Cd strains, A -B + CDT -Cd, A + B + CDT -Cd and A + B + CDT +Cd accounted for 18.9% (7/37), 78.4% (29/37) and 2.7% (1/37), respectively. There were 24 ST types, among which ST2, ST3 and ST54 were the predominant types, each accounting for 12.2% (6/49). All strains were sensitive to metronidazole and vancomycin, with a high resistance rate of 93.9% (46/49) to ciprofloxacin and a low resistance rate of 12.2% (6/49) and 10.2% (5/49) to rifampicin and meropenem, respectively. Conclusions:The main type of toxigenic strains was A + B + CDT -. ST2, ST3 and ST54 were the predominant types and the distribution of ST types was scattered. All isolates were sensitive to metronidazole and vancomycin and most of them were resistant to ciprofloxacin.

3D printing,an emerging technology,can assist improving surgical efficiency of liver surgery.3D-printed organ models facilitate surgeons in surgical planning,enabling the simulation of surgical procedures and guiding interventions through surgical navigation.Furthermore,3D printing harnesses the potential of utilizing tissue or cells from specific individuals to generate grafts for liver surgeries,thereby addressing the issue of graft shortage and advancing the development of personal-ized medicine.

3D printing,an emerging technology,can assist improving surgical efficiency of liver surgery.3D-printed organ models facilitate surgeons in surgical planning,enabling the simulation of surgical procedures and guiding interventions through surgical navigation.Furthermore,3D printing harnesses the potential of utilizing tissue or cells from specific individuals to generate grafts for liver surgeries,thereby addressing the issue of graft shortage and advancing the development of personal-ized medicine.

Objective To explore the clinical effect of a trapezoidal transparent corneal incision during phacoemulsi-fication.Methods A total of 57 patients(68 eyes)undergoing phacoemulsification were selected and divided into a con-ventional incision group and a trapezoidal incision group using a random number table method.There were 28 patients(34 eyes)in the conventional incision group,including 15 eyes(males)and 19 eyes(females),with an age range of 41-82(65.0±10.1)years;and there were 29 patients(34 eyes)in the trapezoidal incision group,including 21 eyes(males)and 13 eyes(females),with an age range of 46-87(66.0±11.1)years.All patients underwent cataract phacoemulsification combined with intraocular lens(IOL)implantation.A 3.0 mm transparent corneal incision was made for patients in the conventional incision group,while an improved trapezoidal transparent corneal incision was made for patients in the trape-zoidal incision group.The uncorrected visual acuity,intraocular pressure,corneal astigmatism,and incidence of intraoper-ative and postoperative complications were compared between the two groups.Results The uncorrected visual acuity of patients in the trapezoidal incision group was better than that of patients in the conventional incision group at 1 week and 3 months after surgery,and the differences were statistically significant(both P＜0.05).There was no statistically significant difference in intraocular pressure and corneal astigmatism between the two groups of patients at 1 week,1 month,and 3 months after surgery(all P＞0.05).The number of eyes with anterior chamber collapse and the number of eyes requiring a watertight incision in the conventional incision group were greater than those in the trapezoidal incision group during sur-gery,and the differences were statistically significant(both P＜0.05).The number of eyes with incision edema and the number of eyes with incision gap in the conventional incision group were greater than those in the trapezoidal incision group after surgery,and the differences were statistically significant(both P＜0.05).In the conventional incision group,IOL was displaced in 18 eyes due to the shallow anterior chamber and then returned to normal after the formation of the anterior chamber through a watertight incision during surgery;during the formation,iris prolapse and incarceration occurred in 2 eyes,and IOL rotation or incarceration occurred in 3 eyes.In the trapezoidal incision group,3 eyes had a shallow anterior chamber after surgery,and a watertight incision was used to form the anterior chamber;there was no IOL incarceration or displacement or iris prolapse.Conclusion The improved trapezoidal transparent corneal incision can effectively prevent IOL displacement caused by anterior chamber collapse during cataract surgery while ensuring the stability of the anterior chamber.It can also reduce the related complications caused by the watertight incision using a flushing needle and restore patients'vision as early as possible.