Objective To perform the comparison and deviation analysis on the detection results among 7 automatic biochemical analyzers in the Abbott pipeline ,and to investigate the comparability of the same item results detected by different biochemical anal‐ysis systems .Methods The sixth analyzer was used as a reference ,the remaining six analyzers as the inspection systems .When the precision reached the requirement ,different concentrations of fresh mixed serum samples were detected by different instruments . The detection results of various items were performed the comparison and deviation analysis .The systematic error of medical deci‐sion level was served as the standard of methodological comparison .The clinical acceptability of different detection systems was judged with 1/2CLIA′88 allowable total error range as the standard .Results The SE% of TP ,ALB ,ALT ,AST ,GGT ,TBIL , BUN ,Cr ,GLU ,UA ,K ,Na ,P ,TC and TG were in the allowable ranges regulated by 1/2CLIA′88 ,the test results were in the clini‐cally acceptable levels ;the SE% of Cl and Ca were in the outside of the allowable ranges ,the results had no comparability ,but the results could reach the comparability by calibrating the self‐built detection system .Conclusion Conducting the comparison and de‐viation analysis of the results detected by different biochemical analyzers in the pipeline system at regular intervals is conducive to ensure the constancy of detection systems in the same laboratory and the traceability of their results to provide more accurate and reliable results for clinic .

Objective To evaluate the effect of isoflurane or sevoflurane inhalation before and after gestation on the offspring brain development. Methods Thirty female adult Sprague Dawley rats were randomly assigned into 5 groups(n=6 each):control group(group C),group that ex?posed to isoflurane with the concentration of 1.6%for 6 hours before gestation(group BI),group that exposed to isoflurane with the concentration of 1.6%at the 6th,10th,14th and 18th day for 6 hours(group PI),group that exposed to sevoflurane with the concentration of 2.4%for 6 hours before gestation(group BS),and group exposed to sevoflurane with the concentration of 2.4%at the 6th,10th,14th and 18th day for 6 hours after gestation (group PS). Twelve offspring rats from pregnant rats in each group were chosen on the day of birth(T1),and 7th,14th and 28th days after birth(T2, T3 and T4)and sacrificed,and the hippocampi were then isolated. Hematoxylin and eosin stain were adopted to observe the tissue pathological change. Electron microscope was used to observe the neuron ultrastructure change of hippocampus. Immolunohistochemistry was used to detect cas?pase?3,the expression of growth associated protein?43(GAP?43)and neuronal nitric oxide synthase(nNOS). Results Compared with group C, no significant change was found in caspase?3,GAP?43 and nNOS expression in offspring rat hippocampus in groups BI and BS(P>0.05),and no damage change in hippocampal was seen by HE staining and electron microscopy. In group PI and PB,the expression of caspase?3 was significantly up?regulated,the expression of GAP?43 and nNOS was down?regulated at T1 to T3(P<0.01),and structural changes in cell were seen by electron microscopy. In group PI,significant pathological changes in hippocampal were seen by HE staining at T1 to T3. Compared with group PI,the expres?sion of GAP?43 and nNOS was significantly up?regulated(P<0.01),and the expression of caspase?3 was down?regulated at T1 to T3(P<0.01). Conclusion Isoflurane or sevoflurane inhalation before gestation does not affect the offspring brain development,while isoflurane or sevoflurane in?halation after gestation can induce transient abnormal change of offspring brain development,and isoflurane′s toxicity was greater than sevoflurane.

Objective To evaluate the effect of isoflurane or sevoflurane inhalation before and after gestation on the N-methyl-D-aspartate (NMDA) receptor expression in offspring rat hippocampus.Methods Thirty female adult Sprague-Dawley rats,aged 3 months,weighing 250-300 g,were randomly assigned into 5 groups (n =6 each):control group (group C),exposure to isoflurane before gestation group (group BI),exposure to isoflurane during gestation period group (group PI),exposure to sevoflurane before gestation group (group BS),exposure to sevoflurane during gestation period group (group PS).The rats inhaled 1.6％ isoflurane for 6 h at 1 day before gestation in group BI.The rats inhaled 1.6％ isoflurane for 6 h at 6,10,14 and 18 day gestation in group PI.The rats were exposed to 2.4％ sevoflurane for 6 h before gestation in group BS.The rats were exposed to 2.4％ sevoflurane for 6 h at 6,10,14 and 18 day gestation in group PS.Twelve offspring rats from pregnant rats in each group were chosen on the day of birth (T1),and 7th,14th and 28th days after birth (T2-4) and sacrificed,and the hippocampi were then isolated for determination of the expression NMDA receptor (NR1,NR2A and NR2B).Results Compared with group C,no significant change was found in NMDA receptor expression in off spring rat hippocampus in groups BI and BS (P ＞ 0.05),and the expression of NR1 and NR2A protein and mRNA was significantly up-regulated,and the expression of NR2B protein and mRNA was down-regulated at T1-3 (P ＜0.05),and no significant change was found in NMDA receptor expression at T4 in groups PI and PS (P ＞ 0.05).Compared with group PI,the expression of NRI and NR2A protein and mRNA was significantly up-regulated,and the expression of NR2B protein and mRNA was down-regulated at T1 3 (P ＜ 0.05 or 0.01),and no significant change was found in N MDA receptor expression at T4 in group PS (P ＞ 0.05).Conclusion Isoflurane or sevoflurane inhalation before gestation does not affect the NMDA receptor expression in offspring rat hippocampus,while isoflurane or sevoflurane inhalation after gestation can induce abnormal expression of the NMDA receptor in offspring rat hippocampus,which may result in apoptosis in hippocampal cells and abnormality in the development of nervous system and cognitive function.

Objective:To analyze the influenza vaccination status of chronic disease management patients in Qingpu district of Shanghai and the vaccination characteristics of different characteristic populations, so as to provide scientific basis for improving the influenza vaccination rate of chronic disease patients in the community.Methods:By comparing the data of Shanghai chronic disease management information system, immunization planning information system and medical association platform, 89 453 subjects who met the inclusion and exclusion criteria in Qingpu district were selected as the research objects. The vaccination coverage rate of the study subjects was calculated according to gender, age group, urban and rural distribution, occupation, chronic disease type and quantity, and the vaccination coverage rate of different subgroups was compared to analyze the influencing factors of vaccination coverage rate.Results:Most of the 89 453 patients with chronic diseases were 60 years old and above (71.93%). Patients with hypertension, diabetes, chronic obstructive pulmoriary disease (COPD) and three chronic diseases accounted for 87.12%, 28.67%, 8.71% and 1.83%, respectively. Influenza vaccination coverage in the 2016/2017 flu season was low, at 0.32%. Influenza vaccination coverage rate of women (0.37%) was higher than that of men (0.27%), which was 1.41 times respectively(95% CI: 1.16, 1.72) that of men patients. The coverage rate of influenza vaccination for the 70-79 year-old group was the highest (0.74%), which was 1.74 times respectively(95% CI: 1.39, 2.19) that of 60-69 year-old patients. The vaccination coverage rate of government departments and institutions was the highest (1.14%), which was 12.58 times respectively(95% CI: 4.52, 34.99) that of retirees. The vaccination rate of COPD patients (3.68%) was 2.50 times (95% CI: 1.66, 3.77) higher than that of patients without COPD.Conclusions:Influenza vaccination rate for chronic disease management patients in Qingpu district of Shanghai is low. Gender, occupation, age and types of chronic diseases are the influencing factors. Patients with chronic disease management should be included in the priority vaccination targets for influenza vaccines, and vaccination intervention for occupational chronic diseases such as non-retired agriculture and forestry patients, especially male patients, should be strengthened to improve influenza vaccination coverage rate.

ObjectiveTo evaluate the effect of standardized blood pressure measurement in consulting room （SBPM） model on blood pressure screening of non-hypertensive patients in community. MethodsFour communities were randomly selected from Fengxian District of Shanghai， and non-hypertensive patients in the communities were included for screening. Based on the communities， participants were further classified into the intervention group and control group. A one-year intervention study was conducted from January 1， 2021 to December 31， 2021. The intervention group received the intervention measures of standardized measurement， and the control group remained the routine measurement. The distribution of blood pressure values and last digit of the values between the intervention group and control group were tested using Chi-square test and normality test. Then changes in abnormal blood pressure rate before and after the intervention were determined by double difference method. Statistical analysis was performed using SPSS 20.0. ResultsA total of 15 368 participants were included in the intervention group， and 19 811 participants in the control group. After the intervention， range of the last digit of blood pressure values in the intervention group was 9.55%‒10.41%， of which that of systolic and diastolic blood pressure were equally distributed （P=0.932 and 0.871， respectively）. The range of the last digit in the control group was 1.31%‒42.58%， of which that of systolic and diastolic blood pressure showed unequal distribution （P<0.001）. Through one-year standardized measurement intervention， the abnormal rate of blood pressure in the intervention group was 26.29%， which was 7.61 times as high as that in the control group （OR=7.55， 95%CI： 6.75‒8.57， P<0.001）. ConclusionStandardized blood pressure measurement in consulting room is suitable for the screening of blood pressure measurement in community， which has higher data quality than that of routine measurement.

ObjectiveTo analyze the monitoring data of schistosomiasis from 2004 to 2021 in Suzhou New District， Jiangsu Province， and to provide evidence for improving schistosomiasis elimination strategies. MethodsFollowing the Opinions on Prevention and Control of Schistosomiasis， Parasitic Diseases and Endemic Diseases in Suzhou and the Technical Plan for Prevention and Control of Schistosomiasis， Parasitic Diseases and Endemic Diseases in Suzhou， the monitoring of schistosomiasis in the population and snail habitats from 2004 to 2021 was conducted. The Mann-Kendall method and Joinpoint regression method were employed to analyze the trend of epidemic indicators （such as seropositive rate， prevalence of snail frames， etc.）. Time series analysis （exponential smoothing model） was conducted to predict snail occurrence. ResultsFrom 2004 to 2021， a total of 73 680 people were serologically tested for schistosomiasis， with a positive rate of 0.084%. The seropositivity rate showed statistically significant differences between different years （χ²=70.73， P<0.05）， but there was no significant trend over time. In addition， 3 053 fecal tests were conducted and no positive result was found. The snail habitats covered an area of 70.11 hm² and showed a decreasing trend （Z=-1.97， P<0.05）. A total of 30 093 frames were surveyed， of which 19.038% contained snails. The difference in the prevalence of snail frames between different years was statistically significant （χ²=7 203.09， P<0.05）， with a decreasing trend in the prevalence of snail frames （Z=-2.05， P<0.05）. A total of 26 296 live snails were seized and density of live snails was 0.874 snails per frame， showing a decreasing trend in the density of live snails （Z=-2.35， P<0.05）. A total of 12 391 snails were dissected and no infected snail was found. The areas treated with molluscicides remained stable at 264.60 hm². An area of 27.77 hm² achieved the goal of snail eradication through environmental modification， with a decreasing trend （Z=-2.44， P<0.05）. It is estimated that the prevalence of snail frames and snail density will remain relatively stable from 2022 to 2026， but the snail habitat area will fluctuate significantly， showing an increasing trend. ConclusionNo indigenous cases of schistosomiasis and no infected snails are reported， indicating the successful consolidation of schistosomiasis prevention and control measures. However， the snail habitat area fluctuates greatly with an increasing trend， suggesting the need for long-term Oncomelania snail monitoring in local areas.

ObjectivesTo investigate characteristics and influencing factors of short-term variation of systolic blood pressure of community hypertension patients in Shanghai. MethodsBased on the standardized blood pressure measurement data of hypertensive patients in Shanghai （2018‒2021） and the noninfectious chronic disease management system database， coefficient of variation of systolic blood pressure （CV_S） was described and the influencing factors were analyzed. ResultsAmong 112 680 community hypertension patients， males accounted for 46.87% with a median age of 69 years. CV_S was 0.038 6 ± 0.035 0. Generalized linear model analysis showed the following influencing factors of CV_S： gender， females were higher than males， B=0.032， P<0.001； age group， 60‒69 years， 70‒79 years old group， and ≥80 years groups were all higher than <50 years group， B=0.042， 0.056， and 0.074 respectively with P values of 0.020， 0.002， and <0.001 respectively； smoking， smoking cessation and smoking everyday was lower than never smoking， B=-0.032 and-0.028 respectively with P values of 0.023 and 0.007 respectively； systolic blood pressure， 140‒159 mmHg group， 160‒179 mmHg group， and ≥180 mmHg group were lower then <140 mmHg group， B=-0.039， -0.091， and -0.175 respectively with P values all <0.001； and measurement season， autumn was lower than spring， （B=-0.056， P<0.001）. The paired test showed that CV_S calculated from the three measurements was 1.04% higher than that calculated from the two measurements （P<0.001）. ConclusionThe coefficient of variation of systolic blood pressure of community hypertension patients in Shanghai has large variation， and was influenced by many factors.

China’s chronic disease management suffers from problems such as unclear institutional function， insufficient information technology application， and weak regulation support. On the basis of current chronic disease management condition in China， this paper proposes to apply the concept of “people-centered” integrated health management to community chronic disease management and discusses the content and procedure of establishing an integrated community-based chronic disease management model driven by massive databases. The model innovatively combines technology integration， data integration and service integration， and can accurately and efficiently realize the "people-centered" full-course health management of various chronic diseases. Shanghai has provided integrated community-based chronic disease management service for 1.98 million citizens through applying this model. The model warrants further effectiveness and economic evaluation. This study provides precious experience for the development of chronic disease prevention and treatment in China.