Informed consent is the important thesis in life ethics and life law,which gives the patients and experimenters the right of self-decision making on medical procedures and experiments.As the development of public health and public health ethics,informed consent has been paid more attention,especially on informed consent problems in epidemiology and public health practice.The requirement of informed consent varies in different research fields.According to different practice purposes,the researchers choose relevant applicable methods.

Objective To study the value of MRI and proton magnetic resonance spectroscopy(H 1-MRS)for neonatal hypoxic-is-chemic encephalopathy(HIE).Methods Magnetic resonance imaging (MRI)and proton magnetic resonance spectroscopy (H 1-MRS)were performed in 30 cases of full-term neonates with HIE,and 10 infant control group without evidence of birth asphyxia. Cerebral MRI and H 1-MRS were performed within 1 5 days after birth.The results of H 1-MRS such as subwave crest values of me-tabolites in lesion areas were recorded.The data were analyzed statistically.Results (1)MRI showed abnormal fetures of HIE such as diffuse cerebral edema,loss of hyperintensity in the posterior limb of the internal capsule on T1 WI,gyrus sign,diffuse parenchy-mal hemorrhage,which could predict the severity of brain damage.(2)On H 1-MRS,the ratio of Lac/Cr in HIE group was much higer than that in control group,which was statistically significant (P <0.05).The ratio of Lac/Cr showed a rising trend with clini-cal grading of HIE.The ratio of NAA/Cr and NAA/Cho were lower in HIE group than that in control group (P <0.05),which showed a trend of gradually reduce with clinical grading of HIE.The difference between ratio of Glx-α/Cr in HIE group and control group was also significantly,the moderate-severe group was much higher than the mild group and control group.There was no sig-nificant difference in the ratio of Cho/Cr between the 4 groups.Conclusion The combination of MRI and H 1-MRS can objectively re-flect brain morphology and metabolic changes of HIE,and evaluate the severity of the brain injury,and provide an effective evidence for clinical diagnosis and treatment.

Objective:To research the clinical effect of HeDanPian combined with edaravone in the treatment of acute cerebral in farction and the influence on serum levels of interferon-γ (IFN-γ),promote angiogenin Ⅱ (Ang-2),homocysteine (Hcy).Methods:102 cases of patients with acute cerebral infarction were selected and randomly divided into the control group and the experimental group,with 51 cases in each group.The control group was treated with edaravone,intravenous infusion of30mg edaravone,1 time in the morning and night;The experimental group was treated based on the control group treated with HeDanPian,oral HeDanPian 14.6 g,1 time in the early to middle.The curative effect,nerve function defect score (NIHSS),serum IFN-γ Ang-2,Hcy,propylene glycol (MDA),superoxide disproportionation alcohol (SOD),interleukin 6,10 (IL-6,IL-10),tumor necrosis factor-α(TNF-α) levels,incidence of adverse reactions were compared between two groups.Results:After treatment,the total effective rate,serum Ang-2,SOD,IL-10 levels of experimental group were higher than those of the control group (P＜0.05),the NIHSS,serum IFN-γ,Hcy,MDA,IL-6,TNF-α levels of experimental group were lower than those of the control group (P＜0.05).No significant difference was found in the incidence of adverse reactions was found between the two groups (P＞0.05).Conclusion:HeDanPian combined with edaravone was effective in the treatment of acute cerebral infarction,which could regulate the expression of serum IFN-γ,Ang-2 and Hcy,improve the oxidative stress and inflammation.

Objective To understand the prevalence of Toxoplasma gondii infection and related factors among special popu?lation in Changzhou City,so as to provide the evidence for formulating toxoplasmosis prevention measures. Methods The ve?nous blood was collected from participants in Changzhou City for detecting IgG and IgM antibodies against T. gondii by ELISA;and an epidemiological questionnaire investigation was also conducted. Results Among the total 400 respondents detected,the prevalence of T. gondii infection was 15.0%and the positive rates of IgG and IgM were 15.0%and 0.8%,respectively. The T. gondii infection rates of pregnant women,HIV/AIDS patients,patients with neoplasia,and livestock and poultry breeding and processing workers were 11.0%,11.0%,24.0%and 14.0%,respectively. As the age increased,the infection rate of T. gondii showed an upward trend,with the highest infection rate(21.6%)among the group of respondents aged above 50 years. The in?fection rates of groups with different education levels were statistically different(χ2=11.443,P<0.05),and there was a trend that the infection rate decreased with the increase of education level. The prevalence of T. gondii infection in pregnant women was not significantly associated with the number of pregnancies and gestational age. The infection rate of T. gondii in the live?stock and poultry breeding and processing workers increased with the length of their working years. Conclusions The preva?lence of T. gondii infection among the special population in Changzhou City is high. Therefore,it is necessary to enhance the health education on the knowledge and information of prevention and control of toxoplasmosis,and to improve the awareness of personal protection,the hygiene practices and diet habits. In addition,more attention should be paid to T. gondii monitoring in the special population.

Objective To investigate the prevalence of Toxoplasma gondii infection and related knowledge and behavior among special population in Changzhou City,so as to provide the evidence for formulating effective measures of toxoplasmosis prevention. Methods The pregnant women and patients with neoplasia in Changzhou hospitals,and livestock and poultry breeding or processing workers were selected as the subjects of the study. Venous blood samples were collected from each partici-pant for detecting IgG and IgM antibodies against T. gondii by ELISA. A questionnaire investigation on knowledge and behavior about T. gondii infection was conducted. Results Among the total 300 respondents investigated from March to May,2015,the prevalence of T. gondii infection was 16.3％(49/300). Totally 52 respondents knew the knowledge about the prevention and con-trol of T. gondii infection with an awareness rate of 17.3％(52/300). The proportion of participants who frequently contacted with cats/dogs(25.0％,13/52)in the group who knew the knowledge about the prevention and control of T. gondii infection was lower than that of participants(50.8％,126/248)in the group who did not know the knowledge about the prevention and control of T. gondii infection,and the difference was statistically significant(X2=11.51,P<0.05). The proportion of participants sepa-rating chopping boards for raw and cooked food(61.5％,32/52)in the group who knew the knowledge about the prevention and control of T. gondii infection was statistically higher than that of the participants(9.3％,23/248)in the group who did not know the knowledge about the prevention and control of T. gondii infection,and the difference was statistically significant (X2=78.43,P<0.001). There was a negative correlation between the awareness rate of the knowledge about the prevention and con-trol of T. gondii infection and the infection rate of T. gondii. The infection rate of T. gondii(5.8％,3/52)in the group who knew the knowledge about the prevention and control of T. gondii infection was lower than that(18.5％,46/248)of the group who did not know the knowledge about the prevention and control of T. gondii infection,and the difference was statistically significant (X2=5.14,P<0.05). Conclusions The awareness rate of the knowledge about the prevention and control of T. gondii infec-tion among special population in Changzhou City is low. The health education on the knowledge of the prevention and control of toxoplasmosis should be strengthened,in order to improve the awareness of personal hygiene and change the unhealthy lifestyles and dietary habits.

Objective:To search and summarize the literature in the field of joint replacement tele-rehabilitation at home and abroad and carry out visual analysis to discuss the development status, research hotspots and development trends in this field.Methods:Based on the Web of Science index database, literature related to application of tele-rehabilitation in joint replacement was searched from the establishment of the database to December 31, 2022. The literature metrology and knowledge visualization analysis of tele-rehabilitation after joint replacement were carried out by using the cooperative network and co-occurrence network analysis function of CiteSpace visual analysis tool and the result analysis report of Web of Science database.Results:As of December 2022, a total of 1 042 articles were published on research related to remote rehabilitation after joint replacement surgery, with an increasing number of articles published year by year. From 2020 to 2022, the annual number of articles published exceeded 100. The United States ranked first in both the number of articles published (404) and the H-index (44). The journal with the highest publication volume was Journal of Arthroplasty (106 articles), and the author with the highest publication volume was Mont (22 articles). Research hotspots focused on rehabilitation content, outcome evaluation and intervention implementation forms. Conclusions:The application of tele-rehabilitation in the field of joint replacement is becoming increasingly widespread. Foreign countries have started this research field early, while China is still in its infancy, and it is urgent to enrich the implementation of intervention forms, feasibility and effectiveness evaluation. The content optimization of tele-rehabilitation program, the accurate evaluation of curative effect and the optimization of implementation approach are the future research hotspots, and the study of cost effectiveness of tele-rehabilitation is the future research direction.

ObjectiveTo investigate the impact of acute respiratory infections in children under 12 years old in Pudong New Area， Shanghai from 2019 to 2023. MethodsAcute respiratory infection samples of children under 12 years old from three sentinel hospitals in Pudong New Area， Shanghai from 2019 to 2023 were collected， and 42 respiratory infection pathogens， including influenza virus， adenovirus， parainfluenza virus， respiratory syncytial virus， human enterovirus/rhinovirus， human pulmonary virus， human bokavirus， coronavirus （229E， HKU1， NL63 and OC43）， and novel coronavirus， were detected with microfluidic chips. The situation of acute respiratory infections among outpatient and inpatient children in this area was analyzed for the before the implementation of non pharmacological intervention measures （2019.12‒2020.1）， during the period of non pharmacological intervention measures （2020.2‒2022.12）， and after non pharmacological intervention measures （2023.1‒2023.6）. ResultsFrom 2019 to 2023， a total of 1 770 samples were collected， and 445 pathogens were detected， with a detection rate of 25.14% （445/1 770）. The main pathogens detected during the study period were influenza virus： 8.70% （154/1 770）， respiratory syncytial virus： 4.41% （78/1 770）， human enterovirus/rhinovirus： 2.66% （47/1 770）， human adenovirus： 2.49% （44/1 770）， and parainfluenza virus： 2.20% （39/1 770）. Before the implementation of non pharmacological intervention measures， outpatients were primarily infected with influenza， parainfluenza virus， and respiratory syncytial virus， with detection rates of 8.09%， 4.49%， and 4.04%， respectively； inpatients were mainly infected with influenza， respiratory syncytial virus， and parainfluenza virus， with detection rates of 4.49%， 3.82%， and 3.15%， respectively. During the period of non pharmacological intervention measures， influenza， rhinovirus and respiratory syncytial virus were the main viruses detected in the samples of outpatient children， with detection rates of 4.04%， 3.60%， and 2.47%， respectively； inpatient samples mainly detected respiratory syncytial virus， rhinovirus， and influenza virus， with detection rates of 3.60%， 2.02%， and 1.80%， respectively. After non pharmacological intervention measures， influenza， rhinovirus and respiratory syncytial virus were the main pathogens detected in the outpatients， with detection rates of 9.89%， 2.92% and 2.02%， respectively； influenza， respiratory syncytial virus， and rhinovirus were the main pathogens detected in inpatient children， with detection rates of 6.29%， 1.57%， and 1.35%， respectively. ConclusionThe prevalence of pathogens related to acute respiratory infections in children is influenced by non pharmacological preventive measures.