Abstract Vaccine literacy is related to residents' access to and use of vaccine-related information and services, and improving vaccine literacy can enhance vaccine confidence, reduce vaccine hesitancy, and improve vaccination compliance. Carrying out vaccine literacy evaluation is helpful to understand the awareness of and attitudes towards vaccines among residents, and provides the reference for clarifying influencing factors for vaccine literacy and finding a path for vaccine literacy improvement. This paper retrieved the literature related to vaccine literacy evaluation and extracted eight vaccine literacy evaluation tools, including The Human Papillomavirus Vaccine Literacy Questionnaire, Questions on Vaccine Literacy, Vaccine Literacy Scale for Italian adults, COVID-19 Vaccines Literacy Scale, The English HLS19 instrument for measuring Vaccination Health Literacy in the general population, Digital Vaccine Literacy Scale, The Chinese Version of the COVID-19 Vaccine Literacy Scale and Community Residents Vaccine Literacy Scale, and reviewed the evaluation objects, content, reliability, validity and application, providing countermeasures and suggestions for the promotion of vaccine literacy evaluation in China.

Objective To learn the present pain management quality at tertiary hospitals in China and the application of the quality evaluation system for acute pain management quality recommended by American Pain Society.Methods Analyzing the present pain management at five tertiary hospitals in China by using the evaluation system recommended by American Pain Society,questionnaires and medical records reading.Results The hospitals were found with setbacks in describing pains,recording pains with tools,using the right pain controls,using non-drug pain control measures and pain management outcomes; differences were found between the acute pain service group and non-acute pain service group in pain management quality,as the pain impacts of both groups on activities,emotion and sleep were 3.12±2.82 and 5.16±2.07 (P＜0.05) respectively.Conclusion Setbacks exist in both the process and outcomes of post-surgery pain management at these hospitals; those with acute pain service management are better than those without in terms of post-surgery pain management quality.The evaluation system recommended by American Pain Society is scientific,sensitive,practical and operable,extensively applicable to evaluation of acute pain management quality at hospitals in China.

Objective:To investigate the clinical efficacy and action mechanism of abdominal acupuncture plus plum-blossom needle tapping for primary insomnia.Methods:A total of 66 eligible cases were randomly allocated into an observation group (n=33) and a control group (n=33). Cases in the observation group received abdominal acupuncture plus plum-blossom needle tapping, whereas cases in the control group received abdominal acupuncture alone. After 2, 6 weeks of treatment and 4 weeks after end of treatment, the patients in both groups were evaluated using the Pittsburgh sleep quality index (PSQI) and measure your medical outcome profile (MYMOP) based on the patients' self-report. Results:After 2 weeks of treatment, the total effective rate was 90.9% in the observation group, versus 63.6% in the control group, showing a statistical difference (P<0.05). After 6 weeks of treatment, there were no between-group statistical differences in total effective rate (P>0.05). After 6 weeks, the sleep quality and efficiency scores in the observation group were better than those in the control group. Four weeks after end of treatment, the scores of sleep quality and MYMOP in the observation group were better than those in the control group (P<0.05). Conclusion: Abdominal acupuncture plus plum-blossom needle tapping can obtain fast, accurate effect for primary insomnia and improve patients' sleep quality and efficiency.

Objective To investigate the correlation factors of neonatal lenticulostriate vasculopathy. Method Four hundred and forty-seven newborns from Guangdong Women and Children Hospital were enrolled in this study. Clinical data of the newborns were obtained . Brain ultrasound studies of lenticulostriate artery were performed on the newborns. The logistic regression was performed for screening the correlation factors of neonatal lenticulostriate vasculopathy (P < 0.05). Results Results of the univariate logistic regression reveal the correlation factors tcontributing to LSV include congenital cytomegalovirus infection、neonatal asphyxia、congenital heart disease (CHD),hypertensive disorder in pregnancy (P < 0.05, respectively). Multivariate logistic regression analysis was performed on these factors. The congenital cytomegalovirus infection, neonatal asphyxia, CHD,hypertensive disorder in pregnancy were significantly associated with LSV (P < 0.05). Conclusion The congenital cytomegalovirus infection,neonatal asphyxia,CHD,hypertensive disorder in pregnancy are the correlation factors of neonatal lenticulostriate vasculopathy. LSV could be a predictive marker for the future development of neuropsychiatric disorders. The brain ultrasound studies of lenticulostriate artery is suggested to be performed on all infants with the correlation factors.

Objective To analyze the nucleotide sequences and genetic polymorphisms of UL138 gene of low passage human cytomegalovirus ( HCMV) strains isolated from infants in Guangzhou province. Methods The low passage strains of HCMV were isolated from urine samples of 10 infants with HCMV in-fection in Guangzhou province and identified by multiplex PCR.The UL138 genes were amplified, cloned and identified with sequencing.The sequences were analyzed together with the homologous sequences of 10 clinical isolates published in GenBank.The sequences of UL138 genes were analyzed by using bioinformatics softwares for investigation of the post-translational modification sites, isoelectric points and second structures of UL138 proteins.Results Three low passage strains of HCMV ( D2, D3 and D52) were isolated from in-fants with congenital HCMV infection.The complete sequences of UL138 genes of the three strains were sub-mitted to GenBank after sequencing identification with the GenBank accession numbers of DQ180375, DQ180387 and DQ180359, respectively.The UL138 gene sequences of the three clinical isolates were high-ly conservative.Among the 841 base pairs of the UL138 gene sequences, mutations were identified in 16 sites with base substitution, no any insertion and deletion mutation was found.The 16 mutations resulted in 7 amino acid changes.No additional or deleted sites were found with regard to the post translational modifi-cation sites of UL138 protein in all clinical isolates except the Toledo strain.The isoelectric point of UL138 protein was 6.51 for all clinical isolates.Conclusion The UL138 genes and the deduced amino acid se-quences of HCMV strains isolated from infants in Guangzhou were highly conservative, regardless of the poly-morphism of UL138 gene.This study paved the way for further investigation on HCMV infection and its path-ogenic mechanism.

Abstract Enhancing the health literacy of the entire population is a prerequisite for improving the health of the entire population, and since the health attitudes and behaviors formed during childhood and adolescence have a profound impact on the health patterns of adulthood, the enhancement of health literacy of children and adolescents is of particular importance. As the main place for children and adolescents to receive education, schools should better fulfil the function of education and promotion of health literacy. China has been carrying out the pilot and promotion of health promoting schools (HPS) since 1995, and is currently in the stage of comprehensive improvement of HPS construction. This paper introduces the background and characteristics of Health-Literate Schools (HeLit-Schools) in foreign countries and compares them with HPS in China, drawing on the advantages of HeLit-Schools to provide a new idea and a new way of thinking for the construction of HPS in China and for the practice of the "Healthy China Initiative".

Animal experiments and clinical studies have shown that intracerebral hemorrhage may damage the white matter.The pathophysiology mechanisms of cerebral white matter injury and repair after intracerebral hemorrhage is very complicated.This article reviews the related clinical and experimental evidence,pathophysiological mechanisms,and possible intervention strategies of cerebral white matter injury after intracerebral hemorrhage.

Objective To investigate the ATP binding cassette transporter A1 (ABCA1) expression in perihematomal tissue of mouse cerebral hemorrhage model induced by collagenase. Methods Stereotactic injection of type Ⅳ collagenase was used to induce a model of caudate putamen intracerebral hemorrhage in mice. The behavioral scores were use to assess neurological deficits at 24 h, 48 h and 72 h after model making. Neisserian staining was used to detect the morphology of neurons around hematomas.Immunohistochemical staining and Western blot analysis were used to detect the expression of ABCA1 around hematomas. Results Nissl bodies reduction, atrophy, necrosis of perihematomal neurons were observed and aggravated over time. Immunohistochemical staining and Western blot analysis showed that the expression level of ABCA1 in the perihematomal tissue was significantly higher than that in the sham operation group (all P < 0. 05), and the expression level increased significantly with time (all P < 0. 05 ).Conclusion ABCA1 was up-regulated after cerebral hemorrhage, suggesting that it might be involved in the pathological process of cerebral hemorrhage.

Objective Non-motor symptoms are important prodromal characteristics of Parkinson's disease (PD).The siblings and the spouses of PD patients do not have classic motor symptoms.This study aimed to investigate if they have PD prodromal symptoms.Methods A total of 98 PD patients from the Affiliated Hospital of Yangzhou University were recruited between January 2015 and August 2017;256 siblings of these patients were included in a siblings group,87 spouses of PD patients were included in a spouses group and 250 healthy individuals were included in a control group.Various scales were used to assess non-motor symptoms,including depression,anxiety,cognitive function,sleep status,constipation,daytime sleepiness,subjective olfactory disorder,rapid-eye-movement sleep behavior disorder (RBD),and restless legs syndrome (RLS).Results The incidence of anxiety (OR=3.06,95％CI 1.86-5.05,P＜0.01),depression (OR=2.16,95％CI 1.16-4.04,P=0.01),RBD (OR=3.83,95％CI 1.79-8.19,P＜0.01) and subjective olfactory disorder (OR=4.48,95％CI 2.02-9.90,P＜0.01) was higher in the siblings group than the control group.There were not statistically significant differences in constipation,cognitive impairment,sleep disorder,daytime sleepiness,and RLS between the two groups.There were not statistically significant differences in non-motor symptoms between the spouses group and the control group,except that the mild depression (OR=2.58,95％CI 1.07-6.20,P =0.03) in the spouses group was more obvious.Conclusions The siblings of PD patients are more likely to have PD prodromal symptoms compared with those without PD family history,perhaps because PD patients and their siblings have common pathogenic genetic factors and early living environment for neurodegeneration.There are no obvious non-motor symptoms in the spouses of PD patients.It can be concluded that the onset of PD is not related to the family life environment in adulthood.

Objective To investigate the effect of different treatment regimens guided by magnetic resonance angiography (MRA) and diffusion weighted imaging (DWI) mismatch on the outcomes of patients with mild ischemic stroke caused by acute middle cerebral artery (MCA) M1 segment occlusion. Methods From January 2013 to February 2018, the clinical data of patients with mild ischemic stroke caused by acute MCA M1 segment occlusion and admitted to the Department of Neurology, the Affiliated Hospital of Yangzhou University were analyzed retrospectively. Mild stroke was defined as the National Institutes of Health Stroke Scale (NIHSS) score ≤5, and the MRA-DWI mismatch was defined as MCA M1 segment occlusion confirmed by MRA and the DWI-Alberta Stroke Program Early Computed Tomography Score ≥6. According to the clinical decision, they were divided into endovascular treatment group and intravenous thrombolytic therapy group. The primary outcome measure was the modified Rankin Scale score at 90 days after onset, ≤2 was defined as good outcome. The secondary outcome measure was the incidence of symptomatic intracranial hemorrhage (sICH) within 7 days after treatment and the mortality rate at 90 d. Multivariate logistic regression analysis was used to determine the independent effects of different treatment regimens on outcomes. Results A total of 38 patients were enrolled, 19 (50. 00％) in the intravenous thrombolytic therapy group, and 19 in the endovascular treatment group (50. 00％, including 5 patients with intratracheal thrombectomy after intravenous thrombolysis); 27 patients had good outcomes (71. 05％) and 11 had poor outcomes (28. 95％). Except for total cholesterol level, there were no significant differences in demography, vascular risk factors, and all baseline clinical data between the endovascular treatment group and the intravenous thrombolytic therapy group. The rate of good outcome in the endovascular treatment group was significantly higher than that in the intravenous thrombolytic therapy group (89. 47％ vs. 2. 63％; P = 0. 029), and there was no significant difference between the incidence of sICH within 7 days (15. 79％ vs. 5. 26％; P = 0. 604) and 90-day mortality (0％ vs. 10. 53％; P = 0. 486). The proportion of patients who underwent endovascular treatment in the good outcome group was significantly higher than that in the poor outcome group (62. 96％ vs. 18. 18％; P = 0. 029). Multivariate logistic regression analysis showed that endovascular treatment was an independent predictor of good outcome (odds ratio 0. 103, 95％ confidence interval 0. 015-0. 714; P = 0. 021). Conclusion Endovascular treatment is an independent predictor of good outcome in patients with mild ischemic stroke caused by acute MCA M1 segment occlusion.