Objective To explore the necessity and models of developing community health services in rural areas. Methods Both quantitative and qualitative studies were conducted. Results Those who regarded developing community health services in rural areas as highly necessary accounted for 35% while those who regarded it as necessary accounted for 58% . The model of cooperation between township and village or between hospital and village was advocated for areas with an average income of 1 000 yuan and above; the model of combining the hospital with the health station or three "five in ones" was advocated for areas with an average income of 2 000 yuan and above; and the model of "three in one" was advocated for areas with an average income of 3 000 yuan and above. Conchusion There are many factors that influence the development of community health services in rural areas, but the models selected vary mainly because of the difference in income levels and the difference between various areas.

Objective:To analyze the molecular characteristics of Echovirus 11 (Echo11) strains isolated in Xiangyang, Hubei Province from 2016 to 2017 based on the sequences of VP1 gene.Methods:Rectal and throat swab specimens were collected from children with hand, foot and mouth disease (HFMD) in Xiangyang from 2016 to 2017. Echo11 strains were detected by real-time reverse transcriptase PCR (RT-PCR) and isolated after cultured in human rhabdosarcoma (RD) cells. The VP1 regions of Echo11 strains isolated from RD cells and the whole genomes of three representative Echo11 strains were amplified by conventional RT-PCR and the sequences were analyzed. DNAStar7.0 (MegAlign) and MEGA6.0 (Data) were used to analyze the homology and mutation sites in nucleotide and amino acid sequences. Neighbor-joining method was used to construct phylogenetic trees. Recombination analysis was performed with SimPlot software (BootScanning).Results:A total of 11 Echo11 strains were isolated from 3 494 HFMD cases, accounting for 0.31%. They were highly homologous in the VP1 gene. These strains shared 98.4%-100.0% homology in nucleotide sequences and 98.3%-100.0% homology in amino acid sequences. The homology between the 11 Echo11 strains and the prototype strain (Echo11/Gregory, X80059) was 73.9%-74.8% in nucleotide sequences and 87.7%-88.7% in amino acid sequences. All of the Echo11 strains circulating in Xiangyang were classified into lineage D, having a similarity to the strains circulating in some regions of mainland China since 2013. In multiple regions of the genome, the Echo11 strains isolated in Xiangyang were highly similar to the Henan Echo1 strains in 2010 and the Hubei Echo6 strains in 2015, suggesting there was recombination within the genome of Echo11 strains in Xiangyang.Conclusions:The Echo11 strains circulating in Xiangyang from 2016 to 2017 belonged to lineage D and were recombinant strains.

Objective To clarify the age patterns and types of differences so as to provide reference on prevention and interventions of hand,foot and mouth disease (HFMD) cases,in Hubei province.Methods We collected the HFMD case information of Hubei province from the Chinese National Notifiable Infectious Disease Reporting System in 2009-2015 while the information on pathogens from the laboratory monitoring system of Center for Disease Control and Prevention at all levels in Hubei province.All the data were stratified by age,disease severity,laboratory confirmation status,and serotypes of enterovirus.Results There were 495 783 reported HFMD cases from 2009 to 2015,in Hubei province,of which 1 045 were severe with 99 fatal.The annual notification rate was 1 231.0/106.HFMD cases were concentrated mainly in 0.5-5 year olds,with highest severity and mortality seen in 6-11 month-olds.The predominated pathogen in mild laboratory-confirmed cases each year,in order during 2009-2015 as:EV71,Cox A16,Cox A16,Cox A16,EV71,Cox A16 and other EV.HFMD showed semiannual peaks in April-June,November-December,and with more cases in the even years than in the odd years.Conclusions Children aged 0.5 to 5 years with 6 to 11 month-olds in particular,were the focused groups of attention in Hubei province.Our findings provided evidence for the improvement on monitoring program.Targeted intervention approaches should be strengthened to reduce the mortality and morbidity of HFMD in the province.

Objective:To analyze the epidemic characteristics and periodicity of hemorrhagic fever with renal syndrome (HFRS) in Jingzhou City, Hubei Province, and provide a basis for scientific prevention and control of HFRS in Jingzhou City.Methods:Retrospective analysis was used to collect HFRS case data and population data of Jingzhou City and 8 counties (cities, districts) within its jurisdiction, including Shashi District, Jingzhou District, Gongan County, Jianli City, Jiangling County, Shishou City, Honghu City, and Songzi City from 1962 to 2020, from the Archives of the Jingzhou Center for Disease Control and Prevention and the Infectious Disease Report Information Management System of the China Disease Control and Prevention Information System; and the epidemic characteristics of HFRS was analyzed in Jingzhou City and 8 counties (cities, districts) within its jurisdiction. The periodicity of HFRS onset was determined using wavelet analysis.Results:From 1962 to 2020, 18 936 HFRS cases were reported in Jingzhou City, with an average incidence rate of 5.95/100 000. There were a total of three epidemic peaks, namely from 1972 to 1973 (24.82/100 000, 24.84/100 000), 1983 (60.08/100 000), and 1995 (14.57/100 000). According to different regions, the high incidence areas of HFRS showed a phased transfer trend: from the 1960s to the 1970s, the Jiangbei area (Honghu City, Jianli City) was the highest incidence area; in the 1980s and 1990s, the high incidence areas were transferred to Jiangnan area (Songzi City, Shishou City, and Gongan County); after 2005, high incidence areas were relocated to Jiangbei area (Honghu City, Jianli City, Jiangling County). The wavelet analysis results showed that there were 12.30 and 21.77 years of HFRS epidemic cycles in Jingzhou City before 2000 ( P < 0.05); among them, the periodicity of Shashi District, Gongan County, Jiangling County, Shishou City, and Honghu City was relatively consistent with that of Jingzhou City, with epidemic cycles of about 12 or 22 years ( P < 0.05). Conclusions:Jingzhou City is currently at the peak of a 22-year epidemic cycle of HFRS, with Jiangbei area as the high incidence areas. The 12-year epidemic cycle in Jingzhou City has ended after 2000.

Objective To explore the progress and prospect of preventive, predictive, personalized and participatory (4P) medicine in China in order to promote the ^“4P^” medicine and provide reference for the government and medical institutions to strengthen health management. Methods An in-depth analysis and review of the ^“4P^” medical service model was conducted through literature review. The prospect of the future development of the ^“4P^” medicine was discussed. Results In recent years, with the advancement of human health concepts and the completion of the genome project, the human healthcare model has been gradually shifting to the ^“4P^” medical service model, namely preventive-predictive-personalized-participatory integrated medicine. It can be seen that modern medical model has been in the process of continuous transformation, which is more human-oriented and emphasizes people^’s initiative. Conclusions With the widespread and understanding of the ^“4P^” medicine among healthcare workers, the value of the “4P” medicine in public health and clinical practice has been continuously proven.

Since the outbreak of the COVID-19 at the end of December 2019, Hubei province has actively adopted a series of prevention and control measures such as ^“quarantine, treatment, testing, and containment^”, and have basically blocked the spread of COVID-19. However, with the development of overseas epidemics and the occurrence of case clusters in local areas, we not only face the threat of imported cases, but also face the urgent need to resume normal work and daily life. This puts forward higher requirements for regular prevention and control of COVID-19. Therefore, we should more deeply understand the significance of regular prevention and control as well as the epidemic situation in our province, summarize experience and lessons, and adhere to the prevention and control strategy of ^“government-led, group-specialist combination, and specialized-oriented^”. Meanwhile, it is necessary to implement the working requirement that combines regular prevention and control surveillance with rapid emergency response to local COVID-19 outbreaks. Furthermore, we should establish a regular multi-point trigger early warning mechanism for COVID-19, strengthen the reserve of emergency supplies and carry out training and drills on epidemic prevention and control across the province to make full preparations for the coming autumn and winter epidemics. The most important is to reform the system of disease prevention and control and public health, comprehensively improve the ability of prevention and treatment, and promote the modernization of public health governance.

Objective To understand the epidemiological characteristics of the novel coronavirus diseases 2019 (COVID-19), and to scientifically guide the prevention and control of COVID-19 in Hubei Province. Methods All COVID-19 cases reported online in Hubei Province as of March 31, 2020 were extracted from Hubei^'s Infectious Disease Information System. The epidemic curve, age and sex characteristics, and spatiotemporal distribution characteristics of the COVID-19 cases were analyzed. Results As of March 31, 2020, a total of 70 764 cases were reported in Hubei Province, including 49 195 confirmed cases. A total of 4 579 deaths occurred among the confirmed cases, and the reported case fatality rate was 6.47%. The peak of the onset of symptoms occurred from January 20 to February 14, 2020. The sex ratio of male to female of the confirmed cases was 0.99: 1, and most were 30-69 years old. The cases diagnosed before January 5 were mainly reported by Wuhan City. From January 6 to January 31, all counties and districts in the province reported that the incidence of confirmed COVID-19 cases began to rise, and about 50% counties reported that the morbidity rate of confirmed COVID-19 cases was over 10 cases per 100 000. The morbidity rate of COVID-19 cases rose rapidly between February 1-15, and then gradually reached its peak after February 16. Conclusion Wuhan City of Hubei Province first discovered and reported the COVID-19 outbreak. The onset of symptoms peaked in January 20 to February 14, and the 30-69 years old group was the key population. Many measures such as restricting personnel movement, reducing contact, and strengthening health education played an important role in controlling the outbreak of COVID-19 in Hubei.

Osteoporotic vertebral compression fracture (OVCF) can lead to lower back pain and may be even accompanied by scoliosis, neurological dysfunction and other complications, which will affect the daily activities and life quality of patients. Vertebral augmentation is an effective treatment method for OVCF, but it cannot correct unbalance of bone metabolism or improve the osteoporotic status, causing complications like lower back pain, limited spinal activities and vertebral refracture. The post-operative systematic and standardized rehabilitation treatments can improve curative effect and therapeutic efficacy of anti-osteoporosis, reduce risk of vertebral refracture, increase patient compliance and improve quality of life. Since there still lack relevant clinical treatment guidelines for postoperative rehabilitation treatments following vertebral augmentation for OVCF, the current treatments are varied with uneven therapeutic effect. In order to standardize the postoperative rehabilitation treatment, the Spine Trauma Group of the Orthopedic Branch of Chinese Medical Doctor Association organized relevant experts to refer to relevant literature and develop the "Guideline for postoperative rehabilitation treatment following vertebral augmentation for osteoporotic vertebral compression fracture (2022 version)" based on the clinical guidelines published by the American Academy of Orthopedic Surgeons (AAOS) as well as on the principles of scientificity, practicality and advancement. The guideline provided evidence-based recommendations on 10 important issues related to postoperative rehabilitation treatments of OVCF.

OBJECTIVETo estimate the hospitalization rate of severe acute respiratory infection (SARI) cases attributable to influenza in Jingzhou city, Hubei province from 2010 to 2012.

METHODSSARI surveillance was conducted at four hospitals in Jingzhou city, Hubei province from 2010 to 2012. Inpatients meeting the SARI case definition and with informed consent were enrolled to collect their demographic information, clinical features, treatment, and disease outcomes, with their respiratory tract specimens collected for PCR test of influenza virus.

RESULTSFrom April, 2010 to September, 2012, 19 679 SARI cases enrolled were residents of Jingzhou, and nasopharyngeal swab was collected from 18 412 (93.6%) cases of them to test influenza virus and 13.3% were positive for influenza. During the three consecutive 2010-2012 flu seasons, laboratory-confirmed influenza was associated with 102 per 100 000, 132 per 100 000 and 244 per 100 000, respectively. As for the hospitalization rate attributable to specific type/subtype of influenza virus, 48 per 100 000, 30 per 100 000 and 24 per 100 000 were attributable to A (H3N2), A (H1N1) pdm2009, and influenza B, respectively in 2010-2011 season; 42 per 100 000 [A (H3N2)] and 90 per 100 000 (influenza B) in 2011-2012 season; 90 per 100 000 [A (H3N2)] and one per 100 000 [influenza B] from April, 2010 to September, 2012. SARI hospitalization caused by influenza A or B occurred both mainly among children younger than five years old, with the peak in children aged 0.5 year old.

CONCLUSIONInfluenza could cause a substantial number of hospitalizations and different viral type/subtype result in different hospitalizations over influenza seasons in Jingzhou city, Hubei province. Children less than five years old should be prioritized for influenza vaccination in China.

Child ; Child, Preschool ; China ; epidemiology ; Demography ; Hospitalization ; Hospitals ; Humans ; Infant ; Influenza A Virus, H1N1 Subtype ; Influenza A Virus, H3N2 Subtype ; Influenza, Human ; epidemiology ; Inpatients ; Laboratories ; Orthomyxoviridae ; Polymerase Chain Reaction ; Respiratory Tract Infections ; Seasons ; Vaccination