Objective To undenstand the effects of performing the project of water and environmental sanitation (WES) on the environmental sanitation in countryside. Methods In the WES project-performed counties, the densities of fly and maggot, and the odor complains in household latrines were investigated, the status of peasants' hygienic knowledge and personal sanitary behavior and habits, and satisfaction at the sanitary latrines were investigated by means of a unified questionaire in 8 latrine-improved villages and one latrine-unimproved village (control village). Results The densities of fly and maggot and the oder complains in household improved latrines were all significantly lower than those in control household latrines. In the WES project-performed villages, higher levels of hygienic knowledge, better sanitary behavior and habit were observed in peasants compared with those in control village. 94.0% of the peasants in latrine-improved households satisfied the sanitary latrines. Conclusion Performance of WES project rose the whole level of the environmental sanitation in rural area.

Objective To understand the prevalence of unsafe riding practice among electric bicycle riders,and to provide scientific basis for intervention strategies in Ma'anshan city of Anhui Province.Methods Observational method was used to observe electric bicycle riders' behavior of running red light,wearing a helmet,and manned act.The radar speed measuring instrument was used to measure the speed of electric bicycle.Results The rate of electric bicycle riders' running red light was 13.09％ (1 285/9 815),helmet wearing rate was 5.90％ (1 510/25 576),and manned rate was 20.28％ (5 187/25 576).The average speed was 24 ki/h,and the electric bicycles whose speed were ＞ 20 km/h accounted for 74.60％.There were significant differences in the running red light rate,helmet wearing rate and the average speed of travel among different time periods and dates (all P ＜ 0.05).More running the red light occurred during 13:30-14:30 and 15:00-16:00.Less helmet wearing occurred during 10:00-11:00 and 08:30-09:30.The periods with highest average speed were at07:00-08:00,08:30-09:30,11:30-12:30,and 13:30-14:30,which was 24 km/h.The helmet wearing rate of females (6.54％) was higher than that of males(5.46％),the men's average speed (24 km/h) was higher than women's (23 ki/h),and the differences were both statistically significant(all P ＜ 0.001).Conclusion The electric bicycle riders in Ma'anshan city of Anhui Province have the dangerous behavior of running red lights,not wearing a helmet,manned act and speeding.Targeted interventions should be taken to reduce the occurrence of related risk behaviors.

Objective To analyze the demographic characteristics and the death causes of the residents in Anhui province,and provide evidence for the disease prevention and control.Methods Using descriptive epidemiological analysis,the demographic characteristics and death data of the national disease surveillance points (DSPs) in Anhui province in 2013 were analyed by areas.Results The aging of the population was observed in all the areas in Anhui,which was most obvious in Jianghuai,followed by Wannan and Huaibei.The overall mortality was 627.10/100 000.The mortalities of diseases varied with sex,area and age.Among the 3 areas,the overall mortality,chronic disease mortality and injury mortality were highest in Huaibei and lowest in Wannan.The area specific difference in mortality of infectious diseases was small.Regardless of areas or the types of diseases,the mortality was higher in males than in females.Deaths caused by diseases with unknown origins were common in residents aged ＞ 65 years.The mortality of chronic diseases was higher in residents aged ＞45 years,especially in those aged 65-84 years.The mortality of injuries was higher in age groups ＞15 years and ＞45 years.The mortality of infectious diseases peaked at both young age group and old age group.The top five death causes were cerebrovascular diseases,malignant tumors,heart diseases,respiratory diseases and injuries.Regardless of sex or area,the major death causes were similar,but the ranks were slightly different.The major death causes varied in different age groups,but they were similar in same age group in different areas.The major death causes were diseases originated in perinatal period,and congenital malformations,deformations and chromosomal abnormalities in children aged ＜ 1 year.The major death causes in children aged 1-14 years were injuries,diseases originated in perinatal period,congenital malformations,deformations and chromosomal abnormalities.Injuries and malignant tumors were the first and second death causes in residents aged 15-44 years.Malignant tumors,injuries,cerebrovascular diseases and heart diseases were the major death causes in residents aged 45-64 years.The major death causes were cerebrovascular diseases,malignant tumors,heart diseases and respiratory diseases in residents aged 65-84 years and heart diseases,cerebrovascular diseases,respiratory diseases and malign tumors in residents aged ≥85 years.Conclusion The major death causes in residents in Anhui province were cerebrovascular diseases,malignant tumors and injuries.Close attention should be paid to the prevention and control of cerebrovascular diseases,malignant tumors and heart diseases in age group ≥45 years.It is necessary to strengthen the prevention and control of injuries in age group 15-44 years.Huaibei is a key area of disease prevention and control in Anhui,especially chronic disease and injury preventions.

To investigate the clinical efficacy of extended thymectomy by subxiphoid approach video-assisted thoracoscopic surgery(VATS) for myasthenia gravis. Methods We retrospectively analyzed the clinical date of 64 cases of myasthenia gravis treated by subxiphoid approach VATS in the same surgical team from September 2015 to April 2018. The patients were equally divided into 4 groups(A, B, C and D) according to the date of operation. Comparisons were made among the four groups in operation time, blood loss during operation, rate of conversion to thoracotomy, postoperative complications, postoperative hospital stay, duration and amount of postoperative chest tube drainage, frequenlly of surgery. The operative effect of different stage was analyzed. Results There were no intraoperative deaths. 1 patient(group A) was converted to thoracotomy. 3 patients(2 cases of group A; 1 case of group D) had lung infection. 1 patient(group B) developed myasthenia crisis after surgery, and the rest patients showed obvious improvement in postoperative myasthenia symptoms. No significant differences were found in postoperative complications, rate of conversion to thoracotomy, postoperative hospital stay, duration and amount of postoperative chest tube drainage among the 4 groups(P >0. 05). The operation time was significantly longer in group A(186. 25 ± 25. 79) min than the other 3 groups [B(128. 75 ± 16. 28) min, C(135. 00 ± 21. 29) min, D(128. 75 ± 19. 62)min], P <0. 05. The blood loss in surgery was significsntly more in group A(110. 00 ±38. 82)ml than that in the other 3 groups[B(63. 75 ±28. 26)ml, C(58. 13 ±27. 86)ml, D(58. 75 ±25. 00)ml], P <0. 05, while no statistical difference was found among group B, C and D. The frequency of surgery was increased from 1. 6 cases in group A to 2. 3, 2. 7 and 2. 7 cases one month in B, C and D, respectively. Conclusion The results of the present study have shown that subxiphoid approach VATS thymectomy is safe and feasible for the treatment of MG patients. For thoracic surgeons with certain experience in thoracoscopic technique, a plateau of the surgical skill of the subxiphoid opproach can be reached after learning curve procedures.

Objective To understand the incidence pattern of fall among older adults in Anhui province during 2006-2014,and provide scientific basis for intervention strategies and decision-making.Methods The incidence data of fall in elderly adults from 6 sentinel hospitals in 2 national injury surveillance areas in Anhui province between 2006 and 2014 were collected for this descriptive epidemiological analysis of the overall incidence trend,demographic characteristics,case distribution and clinical characteristics of fall cases in the elderly.Results The fall case number,the proportions of fall cases to injury cases and to overall fall cases in the elderly all increased from 2006 to 2014.The fall was the first cause of the elderly injury during the past 9 years.The sex ratio was 0.74 and the cases in males decreased with age.In both males and females,the cases in retirees and the jobless accounted for the highest proportions.The annual incidence peak was during August to October,and two daily incidence peaks were during 9 am-ll am and 16 pm-18 pm.The elderly falls mainly occurred at home (62.07％),and more females were affected than males (70.27％ vs.50.97％).Leisure activity and homework related falls accounted for 49.18％ and 28.67％ respectively,and more housework related falls occurred in females than in males.Contusion/abrasion was the first injury caused by fall in males (42.63％) and fracture was the first injury caused by fall in females (47.27％).Head was the first injury site in males (38.04％) and leg was the first injury site in females (29.29％).Most injuries caused by fall were mild (55.12％) and moderate (41.84％) in severity,but the proportions of moderate and severe cases increased gradually with age.Conclusion Fall in the elderly has become a public health problem.It is necessary to take targeted prevention and control measures according to the gender and age distributions of the fall in the elderly.

Objective:To summarize the surgical treatment experience of extended thymectomy for myasthenia gravis(MG), and to explore the surgical treatment of MG.Methods:Retrospectively analyzed the clinical data of 527 MG patients undergoing extended thymectomy in our hospital from June 1996 to October 2017, including 242 males and 285 females, aged 5 to 77 years, with a mean age of(52.6±13.7) years old. The course of illness was 12 days to 18 years. There were 22 cases of hyperthyroidism, 7 cases of pure red blood cell aplastic anemia, 1 case each of hypothyroidism, irritable bowel disease, rheumatoid arthritis, ankylosing spondylitis and thrombocytopenia syndrome. There were 272 cases of MG in Osserman Ⅰ, 72 cases inⅡa, 78 cases inⅡb, 81 cases in Ⅲ, and 24 cases in Ⅳ, respectively. The muscle fatigue test and neostigmine test of all patients were positive, and the diagnosis was confirmed by chest CT examination. Meanwhile, summarize the perioperative data and postoperative follow-up.Results:3 cases died during the postoperative period, all of which were thymoma with MG, including 2 cases of Osserman Ⅲ MG and 1 case of Ⅳ MG; 15 cases of postoperative myasthenia crisis, including 2 OssermanⅡb cases, 11 Osserman Ⅲ cases and 2 Osserman Ⅳ cases, also including 7 cases of tracheotomy; 70 cases of plasma exchange, of whom 2 cases of hypotonic syndrome and 2 cases of lower extremity venous thrombosis. The postoperative pathological types were followed by thymic hyperplasia 293 cases(55.60%), thymoma 207 cases(39.28%), thymic cyst 24 cases(4.55%) and thymic atrophy 3 cases(0.57%) in descending order. 378 cases were followed up with an average follow-up of(85.9±58.5)months; MG with complete remission, partial remission, no change and deterioration accounted for 135(35.71%), 192(50.79%), 41(10.85%) and 10(2.65%)cases, respectively. Complete remission rate ranked as Osserman typeⅠ>Ⅱa>Ⅳ>Ⅱb>Ⅲ, the deterioration rate from high to low was Osserman type Ⅲ>Ⅳ>Ⅰ. 18 OssermanⅠcases showed no effects, whose preoperative course of disease> 5-10 years; 1 OssermanⅠcase was worsening who initially was diagnosed with ophthalmic MG and underwent video-assisted thoracoscopic thymectomy. The left thymus lobe was left unresected and developed 6 years later. Another operation was performed to remove the left lobe thymus, confirming the compensatory hypertrophy of the left lobe thymus. Among the worsening patients, 6 died, all of them were thymoma with MG, including 5 cases of type Ⅲ and one case of type Ⅳ. The cause of death was omyasthenia crisis(3 cases), sudden respiratory arrest after 3 months of rapid stopping of brompistigmine(2 cases)and cholinergic crisis(1 case).Conclusion:Standardized extended thymectomy is an effective method for the treatment of MG. Earlier surgery for ocular muscle type MG can effectively reduce the risk of generalization. MG with Osserman Ⅱb or higher is prone to myasthenia crisis. Comprehensive treatments should be taken to reduce MG-related risks. Myasthenia crisis can occur repeatedly in severe patients in the long term after surgery, requiring regular medication and comprehensive MG treatments.