Humans ; Diverticulum, Colon ; Fecal Impaction ; Hydrodynamics

Objective: To study the dose-response relationship between maternal thyroid hormone levels in the first twenty weeks of pregnancy and the infant physical and neuropsychological development. Methods: In this prospective cohort study, a total of 945 women and their children were included. Maternal serum samples during first half of the pregnancy were collected and analyzed for levels of thyroid hormones by using the electro-chemiluminescence immunoassay. Maternal social demographic information was collected by using the a self-administered questionnaire. Physical measurements of newborns and neuropsychological evaluation of infants were performed by doctors of maternal and child health care. Results: The differences in newborns' birth length and head circumference were significant among the newborns of mothers with different percentiles of maternal serum (thyroid-stimulating hormone, TSH) levels (P<0.05). Newborns with maternal TSH level ≥P(95) or <P(5) had significantly lower birth length and birth head circumference, compared with the newborns with maternal TSH level between P(25)-P(75) (P<0.05). Newborns' birth head circumferences showed an inverted U-shaped association with maternal serum TSH level (Y=33.940+0.003X-0.109X(2), F=4.685, P=0.009). The difference in mental development index (MDI) of the infants at 18-30 months were significant among the infants of mothers with different percentiles of maternal serum TSH level (P<0.05). Infants with maternal TSH level ≥P(90) showed lower MDI (6.39, 95%CI: 2.29-10.49, P=0.002) compared with the infants with maternal TSH level between P(25)-P(75). Infant's MDI at 18- 30 months also showed an inverted U-shaped association with maternal serum TSH level (Y=103.249-1.524X-0.939X(2), F=6.616, P=0.001). Conclusions: Maternal TSH level was associated with newborn's birth length, birth head circumference and infant's MDI at 18-30 months. Newborn's birth head circumference and infant's MDI at 18-30 months showed an inverted U-shaped association with maternal serum TSH-Z score.
Birth Weight/physiology* ; Child ; Child Development/physiology* ; China ; Female ; Fetal Blood/metabolism* ; Humans ; Infant ; Infant, Newborn/blood* ; Pregnancy ; Prenatal Exposure Delayed Effects/blood* ; Prospective Studies ; Thyroid Gland/physiology* ; Thyroid Hormones/metabolism* ; Thyrotropin/blood*

Inhalation injury is caused by inhalation of heat, toxic or irritating gases which lead to respiratory and pulmonary parenchyma damage. At present, the clinical understanding about it is still limited and lack of effective diagnosis and treatment standard. Based on the experience of diagnosis and treatment of domestic inhalation injury, combined with reports of international researches, criteria (expert consensus) for inhalation injury were systematically discussed from pathological and pathophysiological changes, clinical diagnosis and evaluation, and clinical treatment, which provides reference for clinical diagnosis and treatment of patients inflicted with inhalation injury.
Burns, Inhalation ; Consensus ; Humans ; Lung ; Smoke Inhalation Injury ; diagnosis ; therapy

Objective: To evaluate the effectiveness of hepatitis B vaccination in Fujian province. Methods: Based on the hepatitis B immunization strategy of China, a cohort study was designed, involving the population in Fujian province. The population under study was divided into natural exposure birth cohort before 1992 and the immunization birth cohort after 1992 (including voluntary vaccination cohort and standardized vaccination cohort). By cleaning the database of hepatitis B cases which directly reported through network and looked into the incidence and related death outcomes of acute hepatitis B from 2004 to 2017, the incidence levels of hepatitis B and immunization effects were analyzed and evaluated among different birth cohorts. Results: During the observation period, the overall prevalence of hepatitis B in Fujian province was 44.594 per 100 000, with mortality rate as 0.010 per 100 000. The incidence of natural exposure cohort of birth was 56.885 per 100 000. The incidence of voluntary vaccination cohort of birth was 14.502 per 100 000. Compared with the voluntary vaccination cohort, the risk of hepatitis B increased significantly in the natural exposed cohort (RR=3.923), and the difference was statistically significant (P=0.000 7), with attributable risk as 42.383 per 100 000. The attributable risk ratio was 74.507. The population attributable risk ratio was 70.967%. The population attributable risk was 35.448 per 100 000. The attributable rate in standardized vaccination cohorts born after 2002 was 2.336 per 100 000. Compared with the cohorts born before 1992, the RR was 24.347 (P=0.000 0), the attributable risk was 54.549 per 100 000, and the attributable risk ratio was 95.893%, the population attributable risk ratio was 95.300%, the population attributable risk was 47.371 per 100 000, comparing to the natural exposed population. Conclusions: The effectiveness of hepatitis B immunization program had been remarkable in Fujian province since 1992. However, further studies on the persistency of hepatitis B vaccine immunization and its public health significance still needed to be carried out.
China/epidemiology* ; Cohort Studies ; Hepatitis B/prevention & control* ; Hepatitis B Vaccines/administration & dosage* ; Humans ; Immunization ; Incidence ; Odds Ratio ; Prevalence ; Risk Factors ; Vaccination/statistics & numerical data*

INTRODUCTION: Frontline healthcare workers (HCWs) exposed to coronavirus disease 2019 (COVID-19) are at risk of psychological distress. This study evaluates the psychological impact of COVID-19 pandemic on HCWs in a national paediatric referral centre. METHODS: This was a survey-based study that collected demographic, work environment and mental health data from paediatric HCWs in the emergency, intensive care and infectious disease units. Psychological impact was measured using the Depression, Anxiety, Stress Scale-21. Multivariate regression analysis was performed to identify risk factors associated with psychological distress. RESULTS: The survey achieved a response rate of 93.9% (430 of 458). Of the 430 respondents, symptoms of depression, anxiety and stress were reported in 168 (39.1%), 205 (47.7%) and 106 (24.7%), respectively. Depression was reported in the mild (47, 10.9%), moderate (76, 17.7%), severe (23, 5.3%) and extremely severe (22, 5.1%) categories. Anxiety (205, 47.7%) and stress (106, 24.7%) were reported in the mild category only. Collectively, regression analysis identified female sex, a perceived lack of choice in work scope/environment, lack of protection from COVID-19, lack of access to physical activities and rest, the need to perform additional tasks, and the experience of stigma from the community as risk factors for poor psychological outcome. CONCLUSION A high prevalence of depression, anxiety and stress was reported among frontline paediatric HCWs during the COVID-19 pandemic. Personal psychoneuroimmunity and organisational prevention measures can be implemented to lessen psychiatric symptoms. At the national level, involving mental health professionals to plan and coordinate psychological intervention for the country should be considered.
Adult ; Anxiety/etiology* ; COVID-19/psychology* ; Depression/etiology* ; Female ; Health Surveys ; Hospitals, Pediatric ; Humans ; Logistic Models ; Male ; Middle Aged ; Multivariate Analysis ; Occupational Diseases/etiology* ; Pandemics ; Personnel, Hospital/psychology* ; Prevalence ; Risk Factors ; Self Report ; Severity of Illness Index ; Singapore/epidemiology* ; Stress, Psychological/etiology*

Objective: To carry out a quantitative estimate that related to the effects of short-term exposure to PM(2.5) on all-cause mortality and emergency visits in China by using the systematic review and Meta-analysis. Methods: We selected all the studies published before March 2018 from China National Knowledge Infrastructure, Wanfang database, PubMed and EMBASE and data on relative risk (RR), excess risk (ER) and their 95%CIs: appeared in these papers were extracted. According to the differences in the size or direction (heterogeneity) of the results, we computed summary estimates of the effect values using a random-effect or fixed effect model. We also conducted the subgroup analysis and Meta-analysis to have assessed the selected studies for the evidence of study bias. Results: A total of 33 original studies, indexed in databases, were identified. Among those studies, 39 sets of data on mortality and 4 sets of data on emergency were valid to show that within the daily concentration range from 47.7 to 176.7 μg/m(3), for 10 μg/m(3) increases in PM(2.5) concentrations, it would increase the daily numbers of deaths by 0.49% (95%CI: 0.39%-0.59%) and 0.30% (95%CI: 0.10%-0.51%) for all-cause deaths and all-cause emergency-room visits, respectively. For subgroup analysis, the combined effect of PM(2.5) in causing short-term all-cause deaths in the northern areas (ER=0.42%, 95%CI: 0.30%-0.54%) seemed lower than that in the southern areas (ER=0.63%, 95%CI: 0.44%-0.82%). The combined effect of PM(2.5) concentration below 75 μg/m(3) (ER=0.50%, 95%CI: 0.37%-0.62%) was higher than that of PM(2.5) concentration ≥75 μg/m(3) (ER=0.39%, 95%CI: 0.26%-0.52%). Conclusion: Within the concentration range from 47.7 to 176.7 μg/m(3), short-term exposure to current level of PM(2.5) might increase both the all-cause daily mortality and daily emergency visits in China.
Air Pollutants ; Air Pollution/statistics & numerical data* ; China ; Databases, Factual ; Emergency Service, Hospital/statistics & numerical data* ; Environmental Exposure/statistics & numerical data* ; Female ; Humans ; Male ; Particulate Matter/toxicity* ; Time Factors

Objective: To understand the prevalence of major human parasitic diseases and related factors in Henan province. Methods: This stratified sampling survey was carried out according to the requirement of national survey protocol of major human parasitic diseases, 2014-2015. The prevalence of soil-transmitted helminths infection, taeniasis and intestinal protozoiasis were surveyed in 104 sites selected from 35 counties (districts) and the prevalence of clonorchiasis was surveyed in 62 sites selected from 37 townships. In each survey spot, 250 persons were surveyed. A total of 26 866 persons and 15 893 persons were surveyed. Modified Kato-Katz thick smear was used to detect the eggs of intestinal helminthes. Tube fecal culture was used to identify the species of hookworm. The Enterobius eggs were detected in children aged 3 to 6 years by using adhesive tape. The cyst and trophozoite of intestinal protozoa were examined with physiological saline direct smear method and iodine stain method. Results: The overall infestation rate of intestinal parasites was2.02% in Henan, and the worm infection rate was higher than protozoa infection rate. Fourteen kinds of intestinal parasites were found, including nematode (5 species), trematode (2 species), and protozoan (7 species). The infection rate of Enterobius vermicularis was highest, and Qinba Mountain ecological area had the highest infestation rate of intestinal parasites in 4 ecological areas of Henan. There was no significant difference in intestinal parasite infection rate between males and females (χ(2)=3.630, P=0.057), and the differences in intestinal parasite infection rate among different age groups had significance (χ(2)=124.783, P=0.000 1). The infection rate reached the peak in age group ≤9 years and the major parasite was Enterobius vermicularis. Furthermore the overall human infection rate of parasite showed a downward trend with the increase of educational level of the people (χ(2)=70.969, P=0.000 1), the differences had significance (χ(2)=120.118, P=0.000 1). For different populations, the infection rate of intestinal parasites was highest among preschool children. The infection of intestinal helminth was mainly mild, only 2 severe cases were detected. The infection rate of Clonorchis sinensis in urban residents was only 0.006%. Logistic regression analysis showed that being preschool children (χ(2)=15.765, P=0.000 1) and drinking well water (χ(2)=45.589, P=0.000 1) were the risk factors for intestinal parasite infection, and annual income per capita of farmers was the protective factor against intestinal parasite infection. The infection rates of protozoa and intestinal parasites decreased sharply compared with the results of previous two surveys, and the rate of intestinal helminth infection also dropped sharply compared with the second survey. The numbers of protozoa, helminth and intestinal parasites detected in this survey were all less than the numbers found in the previous two surveys. Conclusions: Compared the results of three surveys in Henan, the infection rate of protozoa and intestinal parasites showed a downward trend. The prevention and treatment of Enterobius vermicularis infection in children should be the key point of parasitic disease control in the future.
Animals ; Child ; Child, Preschool ; Clonorchiasis/epidemiology* ; Farmers ; Feces/parasitology* ; Female ; Helminthiasis/epidemiology* ; Helminths ; Humans ; Intestinal Diseases, Parasitic/parasitology* ; Male ; Prevalence ; Protective Factors ; Risk Factors ; Rural Population ; Soil Microbiology ; Surveys and Questionnaires ; Taeniasis/epidemiology* ; Trematode Infections/parasitology* ; Urban Population ; Water Wells

Humans ; Solitary Fibrous Tumors/pathology* ; Osteosarcoma/pathology* ; Fibrosarcoma ; Bone Neoplasms/surgery*

Objective: To understand the dynamic variation of BMI and influencing factors among HIV/AIDS patients receiving highly active anti-retroviral therapy (HAART) in Liuzhou, Guangxi Zhuang Autonomous Region (Guangxi). Methods: HIV/AIDS patients receiving HAART for the first time since 1 January 2013 were selected. Data on BMI was analyzed among patients receiving HAART at baseline,6 months and 12 months after treatment. By using the general linear model repeated measures of analysis of variance, BMI dynamic variations and influencing factors were described and analyzed. Results: The average BMI of 2 871 patients at baseline, 6th months and 12th months appeared as (20.65±3.32), (20.87±3.22) and (21.18±3.20), respectively, with differences all statistically significant (F=18.86, P<0.001). BMI were increasing over time with treatments (F=37.25, P<0.001). Main influencing factors were noticed as: age, sex, marital status, baseline data of CD(4)(+)T cells and the WHO classification on clinical stages. Conclusions: Higher proportion of BMI malnutrition counts was seen among patients before receiving HAART in Liuzhou. BMI of the patients that were on HAART seemed being influenced by many factors. It is necessary to select appropriate treatment protocols on different patients so as to improve the nutritional status of the patients.
Acquired Immunodeficiency Syndrome ; Antiretroviral Therapy, Highly Active ; Body Mass Index ; CD4 Lymphocyte Count ; China/epidemiology* ; HIV Infections/drug therapy* ; Humans ; Linear Models ; Marital Status ; Nutritional Status ; T-Lymphocytes

Objective: To describe the prevalence of preterm birth (PB), low birth weight (LBW), and small for gestational age (SGA) among HIV-infected pregnant women and to identify associated risk factors in Hunan province. Methods: This study appeared a retrospective one on HIV-infected pregnant women retrieved from Information System of Prevention of Mother-to-child Transmission of HIV management in Hunan province, between January 2011 and December 2017. Information regarding demographic characteristics, pregnancy, antiretroviral therapy (ART), husbands/partners' relevant situation and pregnancy outcomes, among these HIV-infected pregnant women were collected and analyzed. The incidence rates on PB, LBW and SGA were calculated. Multivariate logistic regression was used to analyze the associated risk factors. Results: A total of 780 HIV-infected pregnant women were enrolled. The prevalence rates on PB, LBW and SGA in HIV- infected pregnant women appeared as 7.9% (62/780), 9.9% (77/780) and 21.3% (166/780), respectively. Results from the multivariate logistic regression analysis showed that factors as pregnancy related diseases as moderate/severe anemia, hypertensive, initial time of ART <14 gestational weeks (compared to those women without ART during pregnancy) and husbands/partners' age >35 years old (compared to husbands/partners' age 26-30 years old) etc., were associated with an increased risk of PB with adjusted OR as 4.59 (95%CI: 1.51-13.95), 4.90 (95%CI: 1.56-15.46), 2.40 (95%CI: 1.26- 4.56) and 2.29 (95%CI: 1.21-4.36). For LBW, pregnancy moderate/severe anemia, pregnancy HBV infection and initial time of ART <14 gestational weeks were associated with an increased risk of LBW, with adjusted OR as 3.28 (95%CI: 1.13-9.54), 4.37 (95%CI: 1.42-13.44) and 2.68 (95%CI: 1.51-4.76), respectively. For SGA, pregnancy HBV infection and initial time of ART <14 gestational weeks were risk factors for SGA, with adjusted OR as 4.41 (95%CI: 1.43-13.63) and 2.67 (95%CI: 1.51-4.73), respectively. Conclusion: Preterm birth, LBW and SGA were common adverse pregnancy outcomes for HIV-infected pregnant women and were associated with factors as pregnancy complications, ART and husbands/partners' age.
Adult ; Birth Weight ; Child ; China/epidemiology* ; Female ; Gestational Age ; HIV Infections/epidemiology* ; Humans ; Infant, Low Birth Weight ; Infant, Newborn ; Infant, Small for Gestational Age ; Pregnancy ; Pregnancy Complications, Infectious/virology* ; Premature Birth/etiology* ; Prevalence ; Retrospective Studies ; Risk Factors