Objective To analyze two kinds of hysteromyoma resection for patients with ovarian and sexual function.Methods 32 patients with uterine fibroids were based on different surgical procedure was divided into the observation group and control group,the control group total excision of the uterine surgery,observation group Yin type uterine fibroids rejecting operation,the postoperative patients with ovarian function and function change were observed. Results Gonadotropin in postoperative observation group was (6.52 ±1.13) mIU/L,luteinizing hormone (7.62 ± 2.01)mIU/L;Postoperative gonadotropin controls (8.65 ±2.67) mIU/L,luteinizing hormone (9.43 ±2.89) mIU/L, there was statistically significant difference between the two group(t=2.939,2.057,all P<0.05).Observation group of patients with postoperative sexual function in each dimension score:sexual desire (133.47 ±26.29) points,sexual arousal (131.03 ±22.19) points,orgasm (139.93 ±26.79),(136.27 ±31.05),psychological sex abnormalities (136.24 ±33.22)points,ejaculation time (141.29 ±33.71)points were higher than those of the control group(t=2.778,2.691,2.550,1.988,1.979,3.496,all P<0.05).Conclusion Yin uterine fibroids eliminate surgery for patients has less effects on ovarian function and sexual function,so patients with uterine fibroids should be suggested to retain the womb,in order to improve patients postoperative quality of life and the stability of the endocrine system.

Objective To compare the detection situation of influenza-like illnesses with different symptoms and analyze the impact on the influenza surveillance by adopting different case definitions of influenza-like illness.Methods Data was collected from 2 national influenza surveillance sentinel hospitals in Shanghai,2015.We compared the positive rate of influenza virus among patients with different symptoms (with cough and sore throat,with cough only and with sore throat only),and utilized Logistic regression model to analyze the influencing factors of the detection rate of influenza virus.Results Among 2 010 influenza-like illnesses,1 105 patients were with cough and sore throat,270 patients were with cough,635 patients were with sore throat,and the positive rate of influenza was 36.2％,39.3％ and 15.9％ respectively.The patients with cough and sore throat or with cough only had a higher positive rate of influenza than patients with sore throat (all P ＜ 0.05).For patients with specimens collected within 3 days,patients with cough and sore throat,or with cough only had a higher positive rate than patients with sore throat only (all P ＜ 0.05).Logistic regression results showed that fever (body temperature≥39 ℃) (OR =1.719,95％ CI:1.389-2.127) and cough (OR =3.046,95％ CI:2.377-3.905) were associated with the detection of influenza virus.Conclusions We suggested that we can adopt the case definition of influenza-like illness'fever (body temperature ≥38 C) and cough'in the influenza surveillance system.

Objective:To explore the clinical significance of cervical length (CL) measured by transabdominal ultrasound during fetal structural anomalies screeing at 20-24 +6 weeks of gestation. Methods:This was a retrospective nested case-control study based on a prospective longitudinal cohort of "Prediction and Prevention of Early-onset Preeclampsia", which recruited 4 995 singleton pregnant women at the gestational age of 11-13 +6 weeks in Nanjing Drum Tower Hospital from April 2019 to August 2022. All the subjects underwent second-trimester ultrasound screening for fetal structural anomalies in our hospital with image records. This study excluded the women who were lost to follow-up, underwent cervical cerclage, terminated the pregnancy due to personal or social factors, or had miscarriage before 20 weeks of gestation, and those with iatrogenic preterm births, intrauterine fetal death or no second-trimester cervical sonography images. Propensity score matching was used to match pregnant women with spontaneous preterm birth ( n=101) and those with full-term delivery ( n=101) in a 1∶1 ratio, with factors of maternal age, body mass index, preterm birth history, cesarean section history, and pregnancy interval ≥5 years. CL was measured based on the retained ultrasound images. Nonparametric test or Chi-square test were used for statistical analysis. Receiver operating characteristic (ROC) curve was used to evaluate the correlation between CL measured by transabdominal ultrasound in the second trimester and spontaneous preterm birth. Results:The CL measured by transabdominal ultrasound at 20-24 +6 weeks of gestation was significantly shorter in the spontaneous preterm birth group than that in the full-term group [2.8 cm (2.5-3.3 cm) vs. 3.4 cm (3.0-3.9 cm), Z=－5.85, P<0.001]. If CL<3.4 cm was used as the cut-off value for predicting spontaneous preterm birth (20-36 +6 weeks), the specificity and the sensitivity were 0.50 and 0.77, respectively, and the sensitivity reached 0.92 for predicting preterm birth before 32 weeks and 1.00 for predicting preterm birth before 28 weeks. If CL<3.7 cm was used as the cut-off value, the specificity and the sensitivity were 0.36 and 0.87, respectively, and the sensitivity was 1.00 for predicting preterm birth before 32 weeks. The efficacy of preterm birth screening at 28-36 +6 weeks of gestation was comparable to that at 20-36 +6 weeks, if CL<3.4 cm and CL<3.7 cm were used as the cut-off value, the sensitivity were 0.76 and 0.86, respectively. Conclusion:Transabdominal ultrasound measurement of CL in the second trimester can be a preliminary screening to determine whether further transvaginal ultrasound measurement of CL is needed for women without a history of preterm birth or late spontaneous abortion.

Objective:To analyze the changes in the epidemiological characteristics of scarlet fever cases in Shanghai City before and after the outbreak of coronavirus disease 2019 (COVID-19), and to provide a reference for scientific prevention and control of scarlet fever.Methods:The information of scarlet fever reported cases in Shanghai City from January 2016 to June 2021 in the information system of Chinese Disease Prevention and Control was collected, and the differences in time trend, regional distribution, age and gender distribution of cases before and after the outbreak of COVID-19 in Shanghai City were analyzed by descriptive epidemiologic method.Results:The incidence rate of scarlet fever reported in 2016-2019 was (0.22-4.02)/100 000 in each month, with a median of 1.13/100 000. During January 2020 (the outbreak began in Shanghai City) and June 2021, the incidence rate of scarlet fever was (0.01-1.64)/100 000, with a median of 0.14/100 000, which was 12.39% of that before the outbreak of COVID-19. During February and June 2020, the monthly reported incidence rate of scarlet fever was (0.18-0.58)/100 000, showing an upward trend compared with the same period in 2020 ((0.01-0.05)/100 000). From 2016 to 2019, the annual reported incidence rate of each district was (0.55-65.48)/100 000, with a median of 9.57/100 000; while in 2020, the annual reported incidence rate of each district was (0.29-9.85)/100 000, with a median of 2.18/100 000, which was 22.78% of that before the outbreak of COVID-19. The incidence of scarlet fever dropped significantly. The incidence rate in Minhang District was still the highest. The cases were mainly four to eight years old, and there was no substantial difference of the proportions before and after COVID-19 pandemic, with the incidence rate of six years old group the highest. The proportion of male was more than female in reported case, while the male ratio in reported cases was not significantly different before and after COVID-19 pandemic.Conclusions:The incidence rate of scarlet fever in Shanghai City has dropped sharply after COVID-19 pandemic. The main epidemiological characteristics of the regional and population distribution of cases remain unchanged.

ObjectiveTo predict the incidence trend of influenza-like illness proportion （ILI%） in Shanghai using the seasonal autoregressive integrated moving average model （SARIMA）， and to provide an important reference for timely prevention and control measures. MethodsTime series analysis was performed on ILI% surveillance data of Shanghai Municipal Center for Disease Control and Prevention from the 15^th week of 2015 to the 52^nd week of 2019， and a prediction model was established. Seasonal autoregressive integrated moving average （SARIMA） model was established using data from the foregoing 212 weeks， and prediction effect of the model was evaluated using data from the latter 36 weeks. ResultsFrom the 15^th week of 2015 to the 52^nd week of 2019， the average ILI% in Shanghai was 1.494%， showing an obvious epidemic peak. SARIMA（1，0，0） （2，0，0） ₅₂ was finally modeled. The residual of the model was white noise sequence， and the true values were all within the 95% confidence interval of the predicted values. ConclusionSARIMA（1，0，0） （2，0，0） ₅₂ can be used for the medium term prediction of ILI% in Shanghai， and can play an early warning role for the epidemic and outbreak of influenza in Shanghai.

Objective: To analyze the etiologic and epidemiological characteristics of adult acute respiratory infections in Shanghai during 2015-2017. Methods: Data was collected from outpatients with acute respiratory infections who visited the Fever Clinics in three hospitals of different levels in three administrative regions of Shanghai, from 2015 to 2017. Basic information and nasopharyngeal swabs were collected from cases in line with the inclusion criteria. Multiplex RT-PCR and bacterial cultures were performed to detect the respiratory pathogens. Results: A total of 806 individuals were enrolled from 2015 to 2017. Respiratory pathogens were identified in 73.45% (592/806) of the cases, with the virus detection rate as 66.75% (538/806). It was found that the major respiratory pathogens for virus detection were influenza A in 326 (40.45%), influenza B in 116 (14.39%), rhinovirus/enterovirus in 39 (4.84%) of the cases. The overall detection rate of bacteria was 16.13% (130/806), including Klebsiella pneumoniae in 90 (11.17%) cases, Staphylococcus Aureus in 46 (5.71%) cases. Other kind of bacteria were not detected in our study. The detection rates on Mycoplasma pneumoniae was 5.33% (43/806) and on Chlamydia pneumonia was 0.37% (3/806). Co-infection with multiple pathogens was detected in 18.61% (150/806) of the cases, including 135 with double infection (accounting for 90.00%), 14 with triple infection and 1 with quadruple infection (accounted for 9.33% and 0.67%, respectively). Among the 150 cases with co-infections, the main identified pathogens were influenza A, Klebsiella pneumoniae, Staphylococcus aureus, and Mycoplasma pneumoniae. Pathogens of acute respiratory infections that identified among the outpatients from the Fever Clinics at different time, region or population, the characteristics were different (P<0.001). Conclusions In 2015-2017, outpatients with acute respiratory infections in Shanghai were mainly caused by influenza virus or other viruses, however dynamically with its composition, time, region and characteristics of the population. It is necessary to strengthen and combine related medical and preventive services and to develop the appropriate strategies regarding clinical diagnosis and treatment.