Objective: To analyze the status and influencing factors of healthcare-seeking delay and definitive diagnosis delay among elderly patients with pulmonary tuberculosis in Jiashan County, Zhejiang Province from 2014 to 2023, so as to provide evidence for improving tuberculosis prevention and control strategies. Methods: Data on pulmonary tuberculosis patients aged ≥60 years registered in Jiashan County from 2014 to 2023 were collected through the Tuberculosis Information Management System of the Chinese Disease Prevention and Control Information System. The data included demographic information such as age and current address, as well as diagnostic and treatment information, including first-diagnosed hospital and etiological results. The rates of healthcare-seeking delay and definitive diagnosis delay were analyzed. Factors affecting delay in healthcare-seeking and definitive diagnosis among elderly patients with pulmonary tuberculosis were analyzed using a multivariable logistic regression model. Results: A total of 508 elderly patients with pulmonary tuberculosis registered in Jiashan County from 2014 to 2023 were included. The median age was 71.00 (interquartile range, 12.00) years. There were 403 males (79.33%) and 105 females (20.67%). There were 273 patients with healthcare-seeking delay, with a healthcare-seeking delay rate of 53.74%, showing an increasing trend from 2014 to 2023 (P<0.05). There were 73 patients with definitive diagnosis delay, with a definitive diagnosis delay rate of 14.37%, and no statistically significant trend was observed during the same period (P>0.05). Multivariable logistic regression analysis showed that elderly patients with pulmonary tuberculosis whose first-visit institution was located in Jiashan County (OR=4.453, 95%CI: 3.007-6.593) and those with negative etiological results (OR=1.738, 95%CI: 1.112-2.717) had a higher risk of healthcare-seeking delay. Patients with first-diagnosed hospital located in Jiashan County (OR=7.728, 95%CI: 3.550-16.820) and those with current address in Yaozhuang Town (OR=5.318, 95%CI: 2.012-14.056) or Taozhuang Town (OR=3.848, 95%CI: 1.299-11.404) had a higher risk of definitive diagnosis delay. Conclusions From 2014 to 2023, the healthcare-seeking delay rate among elderly patients with pulmonary tuberculosis in Jiashan County was relatively high and showed an increasing trend, while the definitive diagnosis delay rate was relatively low. First-diagnosed hospital location, etiological results, and current address were the main influencing factors.

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In recent years,the incidence of hand foot and mouth disease has been on the rise with severe and fatal cases often caused by enterovirus 71(EV71) infection. EV71 possesses powerful ability of neural inva-sion,and severe nerve damage is one of the signs of its infection,including aseptic meningitis,poliomyelitis-like paralysis,acute brainstem encephalitis and other severe neurological syndrome,which may make the neurological sequelae difficult to reverse,and even death. At present,EV71 has become one of the main viral pathogens cau-sing central nervous system diseases in infants and young children,which seriously threatens the life and health of infants and young children. The pathogenesis of EV71 has not yet been totally clarified. Clinically,it mainly focuses on symptomatic supportive care and prevention of complications. This article starts with the introduction of the etiology of EV71 and briefly describes its relative pathogenesis with the view of providing new ideas for its intervention at the level of primary prevention.

OBJECTIVE:To establish a method for simultaneous determination of 5 kinds residual ethanol,acetone,ethylacetate,N,N-diisopropylethylamine and toluene in favipiravir.METHODS:Headspace GC was adopted.The determination was performed on DB-624 capillary column,temperature programmed.The inlet temperature was 220 ℃,and detector was flame ionization detector with temperature of 250 ℃.Nitrogen was used as carrier gas at flow rate of 2.0 mL/min,split ratio was 10 ∶ 1,headspace equilibrium temperature was 80 ℃,equilibrium time was 20 min and headspace sample size was 1 mL.RESULTS:The linear range was 10.0-501.4 μg/mL for ethanol(r=0.999 9),10.0-501.4 μg/mL for acetone (r=0.999 9),10.1-502.6 μg/mL for ethylacetate (r=0.999 9),0.2-11.4 μg/mL for N,N-diisopropylethylamine (r=0.999 9)and 1.8-89.4 μg/mL for acetone(r=0.999 7).The limits of quantification were 5.3,3.4,5.2,6.1 and 20.4 μg/mL,and the limits of detection were 1.4,1.1,1.3,1.6,5.9 μg/mL.RSD of precision test was lower than 4.0％,and RSDs of acetone in stability and reproducibility tests were both lower than 4.0％.The recoveries were 96.61％-99.70％ (RSD=1.01％,n=9),95.81％-99.50％ (RSD=1.29％,n=9),96.42％-99.76％ (RSD=1.24％,n=9),96.36％-99.30％ (RSD=1.19％,n=9),97.00％-99.51％ (RSD=0.82％,n=9).CONCLUSIONS:The method is simple,accurate,reproducible and can be used for simultaneous determination of 5 organic solvents in favipiravir.