Objective To analyze the risk factors for perioperative acute cerebral vascular accident (PACVA) and put forward the corresponding preventive measures.Methods The clinical data of elderly patients in our hospital who suffered from PACVA in recent 5 years were retrospectively studied.The correlation between risk factors and the occurrence of PACVA was analyzed.Results One hundred and fifty cases were enrolled in the study.Seventy eight cases of them suffered from PACVA with the average age of 70 years ranging from 60 to 98 years.Fifty six cases(71.8%)were found PACVA in one week after operation.Multiple regression analysis showed that hypertension, history of cerebrovascular disease, unstable blood pressure and obesity were independent risk factors for PACVA.The newly diagnosed perioperative atrial fibrillation and carotid atheroselerosis were the high risk factors for PACVA.Conclusions PACVA is one of the common perioperative complications.Necessary check, monitor and treat measures should be taken in the perioperative period, especially for patients with risk factors.

Objective To investigate the risk factors for postpartum cardiac events in pregnant women with heart diseases and to provide prenatal counseling for them.Methods A retrospective analysis was made in cases of pregnant women with heart diseases admitted to the surgical intensive care unit (SICU) of Anzhen Hospital from May 2004 to May 2012.Data were used to identify univariate and multivariate predictors for postpartum cardiac events.Results A total of 190 patients (≥ 20 weeks gestation) were enrolled in the study with 134 (70.5％) of congenital heart disease,30 (15.8％) of rheumatic heart disease,10 (5.3％) of cardiomyopathy,2 (1.1％) of peripartum cardiomyopathy and 14(7.4％) of hypertensive heart disease.Postpartum cardiac events were observed in 42 cases with the incidence of 22.1％.A total of 7 cases resulted in death with the mortality rate of 3.7％.Among them,5 cases were dead of circulatory collapse and pulmonary hypertensive crisis postpartum,while the other 2 cases with secondary pulmonary infection were died of respiratory and circulatory collapse.The baseline parameters of New York Heart Academy(NYHA) ＞ 1,left ventricular ejection fraction (LVEF) ＜ 50％,use of cardiac drugs and pulmonary artery hypertension(PAH) ＞ 80 mm Hg(1 mm Hg =0.133 kPa) were the independent predictors for postpartum cardiac events by univariate and multivariate logistic regression analysis.Conclusions The incidence of postpartum cardiac events is high in pregnant women with heart diseases.Pulmonary artery hypertension and heart failure are the main causes of death.

Objective To screen possible factors affecting prognosis of chondrosarcoma.Methods A total of 37 patients with chondrosarcoma,who had undergone surgical treatment from December 2005 to March 2008 in our hospital and had complete follow-up data and definitive pathological diagnosis,were enrolled in this retrospective study.There were 16 males and 21 females,ageing from eleven to eighty-four years (average,42.8 years).The univariate analysis of survival rate was performed with Kaplan-Meier method and tested with the Log-rank test.Chi-squared test or Fisher's exact test were used to analyze numeration data,and then the significant indexes after univariate analysis were performed multivariate analysis with COX regression model to screen the independent factors affecting prognosis.On the basis of literatures,8factors including gender,age,duration of disease,tumor site,Enneking stage,surgical approach,distant metastasis and local recurrence were analyzed.Results Statistical significance was found in Enneking stage,surgical approach and distant metastasis,which indicated that they were related to survival rate 3years after surgery.However,gender,age,duration of disease,tumor site,and local recurrence had no significant correlation with prognosis.After multivariate analysis of Enneking stage,surgical approach,distant metastasis,the results showed that Enneking stage and surgical procedure were the independent prognostic factors,while distant metastasis was not an independent prognostic factor.Conclusion Enneking stage and surgical approach are the independent prognostic factors for chondrosarcoma,which can be used to evaluate prognosis of chondrosarcoma.

Objective: To analyze the occurrence features of adverse events following immunization (AEFI) of Seasonal Influenza Vaccines (InfV) used in China, 2015-2018 influenza season. Methods: InfV (including concurrent administered with other vaccines) AEFI data were collected through the Chinese national AEFI information system during 2015.9.1-2018.8.31 (excluding Chinese Hong Kong, Macao and Taiwan data). The vaccine lot release data were collected from National Institutes for Food and Drug Control published database. Time periods of three influenza season were 2015.9.1-2016.8.31, 2016.9.1-2017.8.31, 2017.9.1-2018.8.31. The vaccines used and included in this analysis were trivalent inactivated influenza vaccine (IIV3)-Split, IIV3-Split (Children) and IIV-subnit. The incidence of AEFI were calculated (per 100 000 release doses), and epidemiological characteristic were analyzed using descriptive methodology. Results: A total of 8 464 InfV AEFIs were collected in 2015-2018 influenza season from National AEFI Information System, in which 5 646 were IIV3-split, with the rate of 10.64/100 000 release doses, 2 818 were IIV3-split (Children), with the rate of 9.355/100 000 release doses. The most common symptom was fever (axillary temperature ≥37.1 ℃) within vaccine reactions, with a number of 6 207 cases. In which, there were 3 554 cases with fever (axillary temperature ≥38.6 ℃) and the estimated reporting rate was 4.274/100 000 release doses. In all rare vaccine reactions, the most common diagnosis was anaphylactic rash(442, 0.531/100 000 release doses) and angioedema (70, 0.084/100 000 release doses). Even the rates of serious rare vaccine reactions were low, febrile Convulsion (27, 0.032/100 000 release doses) and Henoch-Schönlein Purpura(HSP) (21, 0.025/100 000 release doses) were relatively common in serious rare vaccine reactions during the study period. Conclusion The estimated rate of rare vaccine reactions related toInfV was relatively low. In all vaccine reactions, fever was the most common symptoms. The most common diagnosis of non-serious rare vaccine reaction were anaphylactic rash and angioedema. The incidence of serious rare vaccine reactions was low.

Objective To analyze the occurrence features of adverse events following immunization (AEFI) of Seasonal Influenza Vaccines (InfV) used in China, 2015-2018 influenza season. Methods InfV (including concurrent administered with other vaccines) AEFI data were collected through the Chinese national AEFI information system during 2015.9.1-2018.8.31 (excluding Chinese Hong Kong, Macao and Taiwan data). The vaccine lot release data were collected from National Institutes for Food and Drug Control published database. Time periods of three influenza season were 2015.9.1-2016.8.31, 2016.9.1-2017.8.31, 2017.9.1-2018.8.31. The vaccines used and included in this analysis were trivalent inactivated influenza vaccine (IIV3)?Split, IIV3?Split (Children) and IIV?subnit. The incidence of AEFI were calculated (per 100 000 release doses), and epidemiological characteristic were analyzed using descriptive methodology. Results A total of 8 464 InfV AEFIs were collected in 2015-2018 influenza season from National AEFI Information System, in which 5 646 were IIV3?split, with the rate of 10.64/100 000 release doses, 2 818 were IIV3?split (Children), with the rate of 9.355/100 000 release doses. The most common symptom was fever (axillary temperature≥37.1℃) within vaccine reactions, with a number of 6 207 cases. In which, there were 3 554 cases with fever (axillary temperature≥38.6℃) and the estimated reporting rate was 4.274/100 000 release doses. In all rare vaccine reactions, the most common diagnosis was anaphylactic rash (442, 0.531/100 000 release doses) and angioedema (70, 0.084/100 000 release doses). Even the rates of serious rare vaccine reactions were low, febrile Convulsion (27, 0.032/100 000 release doses) and Henoch?Sch?nlein Purpura(HSP) (21, 0.025/100 000 release doses) were relatively common in serious rare vaccine reactions during the study period. Conclusion The estimated rate of rare vaccine reactions related toInfV was relatively low. In all vaccine reactions, fever was the most common symptoms. The most common diagnosis of non?serious rare vaccine reaction were anaphylactic rash and angioedema. The incidence of serious rare vaccine reactions was low.

Objective To analyze the occurrence features of adverse events following immunization (AEFI) of Seasonal Influenza Vaccines (InfV) used in China, 2015-2018 influenza season. Methods InfV (including concurrent administered with other vaccines) AEFI data were collected through the Chinese national AEFI information system during 2015.9.1-2018.8.31 (excluding Chinese Hong Kong, Macao and Taiwan data). The vaccine lot release data were collected from National Institutes for Food and Drug Control published database. Time periods of three influenza season were 2015.9.1-2016.8.31, 2016.9.1-2017.8.31, 2017.9.1-2018.8.31. The vaccines used and included in this analysis were trivalent inactivated influenza vaccine (IIV3)?Split, IIV3?Split (Children) and IIV?subnit. The incidence of AEFI were calculated (per 100 000 release doses), and epidemiological characteristic were analyzed using descriptive methodology. Results A total of 8 464 InfV AEFIs were collected in 2015-2018 influenza season from National AEFI Information System, in which 5 646 were IIV3?split, with the rate of 10.64/100 000 release doses, 2 818 were IIV3?split (Children), with the rate of 9.355/100 000 release doses. The most common symptom was fever (axillary temperature≥37.1℃) within vaccine reactions, with a number of 6 207 cases. In which, there were 3 554 cases with fever (axillary temperature≥38.6℃) and the estimated reporting rate was 4.274/100 000 release doses. In all rare vaccine reactions, the most common diagnosis was anaphylactic rash (442, 0.531/100 000 release doses) and angioedema (70, 0.084/100 000 release doses). Even the rates of serious rare vaccine reactions were low, febrile Convulsion (27, 0.032/100 000 release doses) and Henoch?Sch?nlein Purpura(HSP) (21, 0.025/100 000 release doses) were relatively common in serious rare vaccine reactions during the study period. Conclusion The estimated rate of rare vaccine reactions related toInfV was relatively low. In all vaccine reactions, fever was the most common symptoms. The most common diagnosis of non?serious rare vaccine reaction were anaphylactic rash and angioedema. The incidence of serious rare vaccine reactions was low.

Objective To investigate the effects of pregnancy on long-term outcomes of pulmonary arterial hypertension associated with congenital heart disease (PAH-CHD).Methods Women with PAH-CHD who had undergone pregnancy under the care of Beijing Anzhen Hospital from 2004 to 2013 were retrospectively identified and 1∶1 matched to nulliparous PAH-CHD females (controls).Functional status and other clinical data were recorded for each group at baseline and follow-up.Results We successfully matched 40 pairs of pregnant and non-pregnant women with PAH-CHD.The patients were followed up for a mean of (6.5 ± 1.9) years,the outcomes of patients were documented during April 2016 to October 2016.No deaths occurred in either group during the study period.There were no statistically significant differences in long-term cardiac function between the two groups (Z =-1.41,P =0.16).After adjusting age,timing of follow-up,specific drug therapy and Eisenmenger's syndrome,pregnancy didn't have significant effect on the long-term deterioration of cardiac function in PAH-CHD patients (OR =1.32,95％ CI:0.33-5.37,P =0.70).Conclusion Pregnancy may not have significant effect on long-term cardiac function in PAH-CHD patients,but this conclusion needs to be confirmed by further studies.

Objective To investigate the correlation between aryl hydrocarbon receptor (A hR) gene polymorphisms and haplotypes and susceptibility of ulcerative colitis (UC) .Methods From January 2010 to October 2017 ,at the Second Affiliated Hospital of Wenzhou Medical University ,the First Affiliated Hospital of Wenzhou Medical University , Central Hospital of Wenzhou City and Wenzhou People Hospital ,a total of 396 UC patients were recruited as the UC group .In the same period ,573 age-and gender-matched healthy individuals were taken as the healthy control group . Three single nucleotide polymorphisms (SNP) of A hR (rs10249788 ,rs2066853 ,rs2158041) were examined by modified multiple ligase detection reaction technique .The correlation between the differences in the frequency of each SNP mutant alleles ,genotypes and clinical pathological features of UC was analyzed by unconditional logistic regression analysis .Haploview 4 .2 software was applied to analyze the linkage disequilibrium (LD) . Results The frequency of mutant allele C and genotype TC+CC of AhR (rs10249788) of UC group were higher than those of the healthy control group (75 .00％ ,594/792 vs .69 .98％ ,802/1146 ;95 .45％ , 378/396 vs .91 .10％ ,522/573) ,the differences were statistically significant (odds ratio (OR)=1 .287 , 95％ confidence interval (CI) 1 .049 to 1 .579 , P=0 .016 ;OR=2 .052 ,95％ CI 1 .180 to 3 .568 , P=0 .011) .Compared with the patients with distal colitis ,the frequencies of mutant allele C and genotype TC +CC of AhR (rs10249788) were higher in the patients with extensive colitis (71 .34％ ,341/478 vs . 80 .57％ ,253/314;93 .31％ ,223/239 vs .98 .73％ ,155/157) ,and the differences were statistically significant (OR=1 .666 ,95％ CI 1 .183 to 2 .347 ,P=0 .003 ;OR=5 .561 ,95％ CI 1 .260 to 24 .530 ,P=0 .023) .The results of LD analysis indicated that rs10249788 and rs2066853 ,rs10249788 and rs2158041 , rs2066853 and rs2158041 were linked to each other (D′=0 .636 ,0 .430 and 0 .980 ;r2 =0 .270 ,0 .023 and 0 .177 ) . Compared with the healthy control group , the frequency of haplotype TAC of UC group decreased (20 .20％ ,231 .5/1146 .0 vs .16 .24％ ,128 .6/792 .0) ,however the frequency of haplotype CAC increased (14 .43％ , 165 .4/1146 .0 vs . 20 .47％ , 162 .1/792 .0 ) , and the differences were statistically significant (OR=0 .767 ,95％ CI 0 .605 to 0 .973 , P=0 .029 ;OR=1 .529 ,95％ CI 1 .204 to 1 .941 ,P<0 .01) .The results of further analysis demonstrated that the frequency of haplotype CGC was higher in patients with extensive colitis than that of patients with distal colitis (38 .69％ ,121 .5/314 .0 vs . 29 .48％ ,140 .9/478 .0) ,and the difference was statistically significant (OR=1 .511 ,95％ CI 1 .119 to 2 .040 ,P= 0 .007) ,while the frequency of haplotype TAC in patients with extensive colitis was lower than that of patients with distal colitis (12 .10％ , 38/314 .0 vs . 17 .55％ , 83 .9/478 .0 ) , and the difference was statistically significant (OR= 0 .646 ,95％ CI 0 .483 to 0 .983 , P= 0 .037) .Conclusion A hR (rs10249788) may be a potential locus affecting susceptibility to UC ,and synergistically influence the risk and the location of UC .

With the development of information technology and the increasing demand for vaccination services among the people, it is a definite trend to enhance the quality of vaccination services through digitization. This article starts with a clear concept of digital services for vaccination, introduces the current development status in China and abroad, analyzes the advantages and disadvantages of existing models in leading regions, takes a glean from the summation, and proposes targeted solutions. This study suggests establishing a departmental coordination mechanism for data interconnection and sharing, formulating data standards and functional specifications, enhancing the functionalities of the immunization planning information system, strengthening data collection and analytical usage, and intensifying appointment management and science and health education to provide expert guidance for the construction of digital vaccination services across the country in the future.

Objective:To understand the overall satisfaction rate with vaccination services in parents of children, and the impact of additional time consumed for vaccination service on overall satisfaction rate.Methods:From December 2019 to January 2020, a total of 3 178 parents of 0-3 years old children were investigated to collect the information about their basic characteristics, additional time spent for vaccination service and overall satisfaction through questionnaires. Binary logistic regression model and restricted cubic spline model were used to evaluate the impact of additional time spend on the overall satisfaction rate.Results:The overall satisfaction rate of parents with vaccination services was 92.32%. The median time for parents to move from home to vaccination clinic was 10.00 (10.00, 20.00) minutes, the median waiting time to make an appointment was 10.00 (5.00, 15.00) minutes, the median waiting time for vaccination was 5.00 (3.00, 10.00) minutes, and the median total additional time spent was 30.00 (20.00, 45.00) minutes. The binary logistic regression analysis showed that after adjusting the relevant factors, the main factors affecting the overall satisfaction rate were the waiting time for making an appointment (the 4- minutes group vs. 8- minutes group: OR=1.863, 95% CI: 1.307-2.657), waiting time for vaccination (the <4 minutes group vs. 8- minutes group: OR=1.529, 95% CI: 1.102-2.120; the 4- minutes group vs. 8- minutes group: OR=1.534, 95% CI: 1.104-2.130), total additional time spent (the 15- minutes group vs. 30- minutes group: OR=1.470, 95% CI: 1.094-1.976). Restricted cubic spline analysis showed that the waiting time for making an appointment (non-linear: χ2=13.18, P=0.001), the waiting time for vaccination (non-linear: χ2=13.50, P=0.001), and the total additional time consumed (non-linear: χ2=9.38, P=0.009) showed a non-linear inverted "V" dose response relationship to the overall satisfaction of vaccination services. Conclusions:The waiting time for parents to make an appointment, the waiting time for vaccination and the total additional time spent for receiving vaccination services affected the overall satisfaction rate of the vaccination services. And the waiting time for making an appointment was the most important factor, and it is necessary to shorten the waiting time for appointment. It is suggested that the vaccination clinic should make use of information technology (such as WeChat public account, APP) to make accurate appointments, make appointments to the time period to control the number of people within time period.