Objective To explore the influence of different anesthetics on emergence agitation (EA) after general anesthesia. Methods 134 EA patients after general anesthesia were randomly divided into three groups. Group A (n=42), Group B (n=45) and Group C (n=47) was given intravenously parecoxib 40 mg, butorphanol 20μg/kg and tramadol 1 mg/kg, respectively. The improvement of agitation, VAS score and Ramsay score were compared and analyzed among the groups. Results After treatment, the degree of EA in Group A, Group B was significantly lower than that in Group C ( <0.05) . VAS score in all the cases was reduced, and Ramsay score was increased compared with that before treatment ( <0.05) . VAS score in Group C was significantly higher than that in Group A, Group B (<0.05) . Ramsay score in Group B was significantly higher than that in Group A, Group C (<0.05) . After treatment, awaking time and postanesthesia care unit (PACU) stay in Group B was significantly higher than that in Group A, Group C (<0.05) .Conclusions Parecoxib is safe and effective for EA after general anesthesia, it can effectively improve the degree of EA, increase postoperative sedative effect, and shorten PACU stay.

Objective To test the association between mitochondrial DNA(mtDNA) point mutations and praecox Parkinson's disease (PPD),and to investigate the characteristics of mtDNA mutations in Chinese patients with PPD. Methods Screening mtDNA A4336C, G5460A,A10398G,A13780G point mutations in 40 patients with PPD and 48 in control group was carried out by using Polymerase Chain Reaction (PCR), dot blotting, radiant developing. And sequencing was given to the nucleotide position (np)10256～np10577mtDNA of 20 patients with PPD and 20 subjects in control group.Results Out of the 40 patients with PPD, 20 (50%)had A10398G mutation. 6 (15%) had G5460A, 5(12.5%) had A13780G, 2 (5%)had A4336C, 19 (47.5%)had C10400T mutation. Out of the 48 controls, 7(14.6%) had A10398G, 24.2% had G5460A, 1 (2.1%)had A13780G and 20 (41.7%)had C10400T, but no any A4336C mutation was found in the controls. Thus, the ratios of A10398G,G5460A,A4336C,A13780G in patients with PPD were separately higher than those in the control group. Moreover significant difference was found in A10398G point mutation (P

Objective This study aims to define the effects of hypothyroidism on c-fos and c-jun mRNA expression in rat testes to provide a theoretical basis for prevention and control of iodine deficiency disorders (IDD). Methods According to body weight (200 - 240 g), 20 Wistar male rats were divided into control group and hypothyroidism group (1 ml/100 g, 0.1% propylthiouracil by intragastric administration) by digital table. There were 10 male rats in each group and body weight was observed every 3 days. After 60 days, all rats were killed. The levels of thyroid hormones [total triiodothyronine (TT3), total thyroxine (TT4), and thyroid stimulating hormone (TSH)] were measured by radioimmunoassay. The mRNA expression levels of c-fos and c-jun in testes were detected by real-time quantitative PCR. Results Compared with control groups [(298.20 ± 12.15), (344.00 ± 13.73) g], the weights of hypothyroidism groups in 30 days [(239.00 ± 15.02) g] and in 60 days [(232.67 ± 17.86) g] were significant decreased (t=7.704, 11.380, all P<0.05). The levels of TT3 [(373.32 ± 101.31) ng/L] and TT4 [(4.00 ± 0.89) × 103 ng/L] in serum of hypothyroidism group were found to be significantly decreased, whereas the level of TSH [(5.77 ± 0.89) × 103 U/L] was increased in comparison with those of the control groups [(1 000.01 ± 273.53) ng/L, (44.33 ±7.84) × 103 ng/L, (1.87 ± 0.70) × 103 U/L, t = 5.262, 12.520, 8.413, all P< 0.05]. Compared with control group (1.00 ± 0.08, 1.01 ± 0.04), the c-fos and c-jun mRNA expression (0.67 ± 0.03, 0.75 ± 0.02) of hypothyroidism group was significant decreased (t = 12.382, 13.784, all P < 0.05). Conclusion Hypothyroidism may reduce mRNA expression levels of testicular c-fos and c-jun, and then damage the reproductive system in male rats.

Objective To evaluate the iodine nutritional status and thyroid function of pregnant women in different periods of pregnancy,analyze the relationship between iodine nutritional status and thyroid function and provide a basis for scientific supplementation of iodine to pregnant women.Methods In 2013 and 2014,using stratified random sampling method,six counties were selected in the city;around 30 early,middle and late pregnant women each in every county were selected;a total of 545 (173 early,203 middle and 169 late) pregnant women were investigated in the 6 counties;instant random urine samples of 25 ml were collected and urinary iodine was tested.A total of 151 (52 early,55 middle and 44 late) pregnant women were selected to collect 3 ml venous blood samples for determination of thyroid hormone and thyroid autoantibodies.Results Median urinary iodine levels of early,middle and late pregnant women were 132.2,128.9 and 113.5 μg/L,respectively,under the condition of iodine deficiency.Prevalence rates of low frce thyroxine FT4,subclinical hypothyroidism,hypothyroidism and hyperthyroidism in pregnant women were 0.66％ (1/151),15.23％ (23/151),0.66％ (1/151) and 0.66％ (1/151),respectively.The positive rate of TgAb and TPOAb was 15.23％ (23/151) and 11.92％ (18/151),respectively.There were significant differences in the levels of free three iodine thyroid (FT3) in different periods of pregnancy (F =7.723,P ＜ 0.05);FT3 in late pregnancy was lower than that in early and middle pregnancy (P ＜ 0.05).There were significant differences in the levels of FT4 in different periods of pregnancy (F =3.762,P ＜ 0.05);FT4 in late pregnancy was lower than that in early and middle pregnancy (P ＜ 0.05).There were significant differences in the levels of thyroid stimulating hormone (TSH) in different periods of pregnancy (F =13.199,P ＜ 0.05);TSH in early pregnancy was higher than that in middle and late pregnancy (P ＜ 0.05).Subclinical hypothyroidism prevalence rate in late pregnancy was higher than that in middle pregnancy (x2 =3.912,P ＜ 0.05).The positive rate of TgAb in early and middle pregnancy was higher than that in late pregnancy (x2 =9.883,3.906,all P ＜ 0.05).Urinary iodine ≥250 μg/L was a risk factor for subclinical hypothyroidism in pregnant woman [odds ratio (OR) =5.076,P ＜ 0.05].Conclusions The iodine nutrition of pregnant women in Tianjin is insufficient.Excessive urinary iodine is an increased risk of subclinical hypothyroidism.We should monitor the urinary iodine and thyroid function in pregnant women.

Objective To explore influence of dexmedetomidine-assisted general anesthesia on hemodynamics,anesthetic dosage and postoperative sedation and analgesia in patients with radical gastrectomy for gastric cancer.Methods A total of 50 patients with gastric cancer were randomly divided into experimental group and control group.The experimental group was treated with dexmedetomidine before anesthesia induction,while control group was treated with the same volume of normal saline.Heart rate,mean arterial pressure,bispectral index were recorded at the time points of exploration,immediately after extubation,skin incision,before injection,immediately before intubation,before induction of anesthesia,duration of anesthesia,1 min after intubation,and doses of remifentanil and propofolwere compared,and VAS and sedation score 1 and 4 h were compared.Results Before induction of anesthesia,bispectral index of the experimental group was significantly lower than the control group (P<0.01).At the time points of induction of general anesthesia,1 min after intubation,skin incision,exploration,extubation,the mean arterial blood pressure in experimental group decreased significantly (P<0.05),and the heart rate reduced significantly (P<0.01).The dosages of remifentanil and propofol in the experimental group were significantly lower than those in the control group.The sedation scores 1 and 4 h in the experimental group were significantly higher than the control group,and the VAS score was significantly lower than the control group (P<0.05).Conclusion Dexmedetomidine can reduce the hemodynamic changes and maintain the stability of the patients during tracheal intubation and general anesthesia induction.

Objective To explore influence of dexmedetomidine-assisted general anesthesia on hemodynamics,anesthetic dosage and postoperative sedation and analgesia in patients with radical gastrectomy for gastric cancer.Methods A total of 50 patients with gastric cancer were randomly divided into experimental group and control group.The experimental group was treated with dexmedetomidine before anesthesia induction,while control group was treated with the same volume of normal saline.Heart rate,mean arterial pressure,bispectral index were recorded at the time points of exploration,immediately after extubation,skin incision,before injection,immediately before intubation,before induction of anesthesia,duration of anesthesia,1 min after intubation,and doses of remifentanil and propofolwere compared,and VAS and sedation score 1 and 4 h were compared.Results Before induction of anesthesia,bispectral index of the experimental group was significantly lower than the control group (P<0.01).At the time points of induction of general anesthesia,1 min after intubation,skin incision,exploration,extubation,the mean arterial blood pressure in experimental group decreased significantly (P<0.05),and the heart rate reduced significantly (P<0.01).The dosages of remifentanil and propofol in the experimental group were significantly lower than those in the control group.The sedation scores 1 and 4 h in the experimental group were significantly higher than the control group,and the VAS score was significantly lower than the control group (P<0.05).Conclusion Dexmedetomidine can reduce the hemodynamic changes and maintain the stability of the patients during tracheal intubation and general anesthesia induction.

Abstract Spinal curvatures has emerged as the third major chronic condition seriously threatening the physical and mental health of Chinese children and adolescents, with significant regional differences. Its etiology is complex and diverse, and early prevention and treatment are feasible, whereas treatment in later stages entails considerable difficulty and economic burden. Currently, the prevention and control of student spinal curvatures has been elevated to a national health strategy. A series of policy documents have been successively issued, and it has greatly facilitated the institutionalization and normalization of national routine screening for student spinal curvatures. However, it is still inadequate considering current prevention and control system for spinal curvatures in children and adolescents. There is an urgent need to establish a closed loop model based on China s institutional advantages, comprising Initial Screening-Diagnosis-Treatment-Preventive Control-Followup Assessment, to strengthen the safeguarding of spinal health in children and adolescents.

Objective: To explore the current status and progress of regional school health work to provide policy reference for school health improvement. Methods: Survey data on school health work in Tianjin from 2019, 2021 and 2023 was used. School health staff allocation and expenditure of the health administrative department, CDC and education department, as well as the annual implementation of health education, prevention and control of common diseases and infectious diseases, sports activities and food nutrition in primary and secondary schools were analyzed. Statistical analysis was conducted using KruskalWallis test, Chisquare test, and Fishers exact test. Results: The number of school health staff in the health commissions and education departments from 2019, 2021 and 2023 was relatively stable. Parttime staffs were often employed by health commissions while fulltime staffs were mainly employed by education departments. The number of school health staff at CDCs increased gradually (H=12.65, P<0.01). School health expenditure of administrative departments and schools in 2021 and 2023 increased significantly compared with that in 2019 (H=22.28, 23.75, P<0.05). More than 95% of schools set up clinics or health care rooms, and about 97% of schools had school health technicians or health teachers. More than 90% of schools had health education courses over 4 hours per semester. The rate of mental health education increased by year (86.87%, 89.91%, 96.30%, Z=2.40，P<0.05). Lack of courses regarded safety emergency and risk avoidance, growth and development, and adolescent health education. The provision rate of psychological counseling services (89.00%, 97.25%, 100.00%) and psychological problem prevention and control (56.12%, 71.56%, 81.48%) also increased by year (Z=3.83, 3.96, P<0.01). The implementation rates of prevention and control of poor vision, dental caries, overweight and obesity were all higher than 80%, and the prevention and control rate of abnormal spinal curvature showed an increasing trend (38.78%, 77.06%, 72.22%, Z=4.87, P<0.01). More than 90% of schools met the standard for physical education class hours, and the proportion of schools conducting at least 30 minutes of recess physical activities every day increased year by year (65.00%, 80.73%, 85.98%, Z=3.59, P<0.01). All schools did not have shops. Conclusions School health work in Tianjin is effective and constantly developing. It is necessary to continue to increase the investment of human resources and expenditure in school health, explore the approaches of cooccurrence and prevention of common diseases, and improve the school sports and nutrition environment.

During pandemic of corona virus disease 2019 (COVID-19), emergency orthopedic trauma is commonly seen. It is particularly important to ensure the emergency treatment quality of orthopedic trauma but avoid cross-infection between doctors and patients. The double-buffered diagnosis and treatment mode refers to the model of patients first undergoing medical observation in the comprehensive buffer ward and the inpatient buffer rooms of various disciplines after admission to confirm the exclusion of COVID-19 and then receiving specialist diagnosis and treatment. The authors summarize the experiences of using the double-buffered diagnosis and treatment model in the Department of Orthopedics, Renmin Hospital of Wuhan University during the prevention and control of COVID-19 pandemic so as to provide a reference for treatment of orthopedic patients.

Objective:To analyze factors associated with timely vaccination of pertussis-containing vaccines in children born in Shanghai from 2019 to 2023.Methods:Children born in Shanghai between 2019 and 2023 were selected using a stratified random sampling method, and their vaccination data were obtained from the Shanghai Vaccine Management and Vaccination Service Information System. The vaccination rates, timely vaccination rates, and the proportions of diphtheria-tetanus-acellular pertussis-haemophilus influenzae type b combination vaccine (DTaP-Hib) and diphtheria-tetanus-acellular pertussis-inactivated poliovirus-haemophilus influenzae type b combination vaccine (DTaP-IPV-Hib) for the substitution of diphtheria- tetanus-acellular pertussis vaccine (DTaP) were calculated. Also, the factors associated with timely vaccination rate was analyzed with multivariate logistic regression analysis.Results:The average vaccination coverage rate of pertussis-containing vaccines in children born in Shanghai from 2019 to 2023 ranged from 94.71% to 99.53%. There were significant differences in the vaccination coverage of the 1 st-4 th doses of pertussis-containing vaccines among children born in different years (all P<0.05), but no gender and area specific significant differences were observed (all P>0.05). Non-national immunization program (non-NIP) vaccines were used to substitute DTaP vaccines in some children, with the proportion of DTaP-IPV-Hib vaccine accounting for 50.11%-52.69% and the proportion of DTaP-Hib vaccine accounting for 27.22%-28.43%. The proportions of DTaP-Hib and DTaP-IPV-Hib for the substitution of DTaP had increasing trends over the years. The overall timely vaccination rate of pertussis-containing vaccine vaccination was 84.09%. Analysis on the factors affecting the timely vaccination rate showed that the rate gradually decreased with the increase of the doses. Children who received the self-paid quadrivalent or pentavalent vaccines were less likely to have vaccination delays. Birth year had a significant impact on the timely vaccination rate, while the area had less impact. Additionally, the timely vaccination rate was also influenced by the degree of non-pharmaceutical intervention measures. Conclusions:The substitution of pertussis- containing vaccines with non-NIP vaccines was common in Shanghai. The coverage and timeliness of pertussis-containing vaccine vaccination were relatively high. The timely vaccination rate was significantly associated with gender, dose, vaccine type, and the degree of non-pharmaceutical interventions. There was a certain proportions of delayed and missed vaccinations, and it is necessary to pay attention to children who are not vaccinated timely and conduct high-quality catch-up vaccination to ensure timely and complete vaccination of pertussis-containing vaccines.