ObjectiveTo evaluate the measles surveillance system （MSS） in Jiading District， Shanghai from 2020 to 2022， and to provide evidence for the elimination of measles. MethodsDescriptive methods were used to analyze the MSS data and confirmed measles cases from 2020 to 2022 and to evaluate MSS performance indicators. ResultsA total of 120 suspected cases were reported through the MSS from 2020 to 2022， of which 12 were classified as measles， 9 as rubella， and 99 as non-measles /rubella. The incidence of reported non-measles /rubella was 1.44 per 100 000 population in 2020， 2.01 per 100 000 population in 2021， and 1.99 per 100 000 population in 2022. The rates of complete investigation within 48 hours， blood samples and etiology collection， timely delivery， and timely reporting were all 100%. Among the 12 confirmed measles cases from 2020 to 2022， seven routine immunization subjects completed the required doses of measles vaccines， while two out five adult cases had a history of measles vaccine-related immunization. The confirmed cases comprised six with fever accompanied by rash， five with rash alone， and one with fever alone. ConclusionThe MSS results in Jiading District， Shanghai are overall satisfactory. However， there is a need to improve sensitivity， especially in detecting and reporting cases with atypical symptoms. It is imperative to maintain high vaccination coverage for age-appropriate children， promote supplementary immunization activities， and elevate the overall immunity of the entire population.

Objective:To compare the clinical effects of endoscopic thyroidectomy using the modified gasless transaxillary approach (TA group) and transsubclavian approach (TS group) in the treatment of cN0 papillary thyroid carcinoma (PTC) .Methods:A total of 190 PTC patients (mean age 39.88±9.35 years,38 males, 152 females), who underwent unilateral thyroidectomy in the Department of Thyroid Surgery, the First Hospital of Jilin University from Oct. 2020 to Oct. 2022 were retrospectively analyzed, including 65 cases in TA group, 43 cases in TS group and 82 cases through traditional neck approach (TN group). The endoscopic group (TA+TS) consists of the TA group and the TS group. Comparative analyses were performed on operation time, full exposure rate of central compartment, postoperative hospitalization time, postoperative drainage, hospitalization costs, the number of dissected lymph nodes and postoperative complications. The t-test or Wilcoxon rank sum test, the χ2 test or the exact probability method were used for statistical analysis. Results:All endoscopic operations were successfully completed without conversion to traditional neck approach. ① Compared with the TN group, the endoscopic group (TA+TS) had longer operation time[TN group =74.5 (65-87) min, (TA+TS) group =102 (89-121) min, P<0.001], lower full exposure rate of central compartment (TN group=100%, (TA+TS) group=89.8%, P=0.008), more postoperative drainage[TN group=60 (45-76) ml, (TA+TS) group =100 (80-130) ml, P<0.001], higher hospitalization costs[TN group=￥23638 (22158-25901), (TA+TS) group =￥26967 (25572-28284), P<0.001], and higher parathyroid autotransplantation rate (TN group=4.9%, (TA+TS) group =50.9%, P<0.001). There were no significant differences in the number of dissected lymph nodes, the number of metastatic lymph nodes, preoperative and postoperative parathyroid hormone (PTH) ( P>0.05). ② Compared with the TS group, the TA group had longer operation time[TA group=110 (97-127) min, TS group=89 (80-111) min, P<0.001], lower full exposure rate of central compartment (TA group=83.1%, TS group=100%, P=0.012), longer postoperative hospitalization time[TA group=3 (3-4) d, TS group=3 (3-3) d, P=0.002], more postoperative drainage[TA group=110 (82-140) ml,TS group=95 (65~120) ml, P=0.046] and higher hospitalization costs (TA group=￥27510±2578,TS group=￥26609±1878, P=0.038). There were no significant differences in the number of dissected lymph nodes, the number of metastatic lymph nodes, preoperative and postoperative PTH, and parathyroid autotransplantation between the two groups ( P>0.05) . Conclusions:Endoscopic thyroidectomy through axillary/subclavian approach is safe and feasible for the treatment of cN0 PTC. There was no significant difference in the number of dissected central lymph nodes compared with conventional surgery, and the incision was well concealed. In comparison, transsubclavian endoscopic surgery has better clinical application value, with shorter operation time, higher full exposure rate of central compartment and faster postoperative recovery.

Objective:The composition of thrombi obtained during mechanical thrombectomy in patients with acute ischemic stroke is analyzed to investigate its relation with stroke etiology and its influence in surgical parameters and clinical prognoses.Methods:The thrombi and clinical data of 41 patients with acute ischemic stroke directly treated by mechanical thrombectomy in our hospital from January 2019 to December 2019 were collected. Hematoxylin-eosin (HE) staining was used to quantitatively analyze the composition of thrombi, and the components of thrombi in patients with different causes of stroke (large artery atherosclerosis [LAA], cardiogenic embolism [CE], and unexplained type) were compared. These patients were divided into erythrocyte-rich group (erythrocyte content>fibrin content) and fibrin-rich group (erythrocyte content0.05). Conclusion:Thrombus composition has influence in surgical parameters, but no influence in clinical prognoses.

Objective To investigate the effect of hyperbaric oxygen ( HBO ) combined with escitalopram oxalate on the patients with post-stroke depression ( PSD) and the expression levels of serum Hp and retinol-binding protein 4 (RBP4). Methods Sixty patients with PSD treated in the Qingdao Mental Health Center from January 2017 to January 2018 were enrolled as research subjects. By random double-blind lottery method, the patients were divided into the control group and the observation group, each consisting of 30 patients. The patients in the control group were treated only with escitalopram oxalate, while the patients in the observation group received HBO in addition to the treatment received by the control group. The expression levels of monoamine neurotransmitters and inflammatory factors were detected before and after treatment, and the scores of depression and neurological function were assessed as well. At the same time, the expression levels of Hp and RBP4 were also detected. Results Three months after treatment, monoamine neurotransmitter level of the observation group significantly elevated, while inflammatory factor level obviously decreased, with the change rate of the observation group all being higher than those of the control group, and statistical significance could be seen when comparisons were made between the 2 groups (P<0. 05 or P<0. 01). Scores of Montgomery Asberg Depression Rating Scale ( MADRS ) and Chinese Stroke Scale ( CSS ) scores in the observation group were significantly lower than those in the control group, and improvement was superior to that in the control group, and statistical significance could be noticed when comparisons were made between them (P<0. 05 or P<0. 01). The levels of serum Hp and RBP4 in the observation group significantly decreased as compared with those before treatment, and were also lower than those in the control group, also with statistical significance (P<0. 05 or P<0. 01). Conclusion HBO combined with escitalopram oxalate could improve patient depression and clinical efficacy by the approaches of increasing serum monoamine neurotransmitter level and decreasing inflammatory factor and serum Hp/RBP4 levels in the treatment of the patients with post-stroke depression.

Objective To investigate the effect of hyperbaric oxygen ( HBO ) combined with escitalopram oxalate on the patients with post-stroke depression ( PSD) and the expression levels of serum Hp and retinol-binding protein 4 (RBP4). Methods Sixty patients with PSD treated in the Qingdao Mental Health Center from January 2017 to January 2018 were enrolled as research subjects. By random double-blind lottery method, the patients were divided into the control group and the observation group, each consisting of 30 patients. The patients in the control group were treated only with escitalopram oxalate, while the patients in the observation group received HBO in addition to the treatment received by the control group. The expression levels of monoamine neurotransmitters and inflammatory factors were detected before and after treatment, and the scores of depression and neurological function were assessed as well. At the same time, the expression levels of Hp and RBP4 were also detected. Results Three months after treatment, monoamine neurotransmitter level of the observation group significantly elevated, while inflammatory factor level obviously decreased, with the change rate of the observation group all being higher than those of the control group, and statistical significance could be seen when comparisons were made between the 2 groups (P<0. 05 or P<0. 01). Scores of Montgomery Asberg Depression Rating Scale ( MADRS ) and Chinese Stroke Scale ( CSS ) scores in the observation group were significantly lower than those in the control group, and improvement was superior to that in the control group, and statistical significance could be noticed when comparisons were made between them (P<0. 05 or P<0. 01). The levels of serum Hp and RBP4 in the observation group significantly decreased as compared with those before treatment, and were also lower than those in the control group, also with statistical significance (P<0. 05 or P<0. 01). Conclusion HBO combined with escitalopram oxalate could improve patient depression and clinical efficacy by the approaches of increasing serum monoamine neurotransmitter level and decreasing inflammatory factor and serum Hp/RBP4 levels in the treatment of the patients with post-stroke depression.

Objective To study the health status ,the current health service needs and the influencing factors concerning the rural elderly population in Northern Jiangsu. Methods Multi-stage stratified cluster sampling was conducted in elderly people over 60 in Xuzhou ,Lianyungang ,and Suqian.Participants were face-to-face interviewed with questionnaires.Information on health status and health service needs was collected and analyzed. Results A total of 2655 elderly people were enrolled in this study ,including 1252 males (47.2%)and 1403 (52.8%)females with a mean age of (70.9 ± 6.7)years.Self-assessed health was generally poor ,with the two-week morbidity at 26.6%and the prevalence of chronic diseases at 60.1%;46.5% of the participants regularly took medications ;4.1% of them had physical disability ;8.2% had impaired daily activities ;The two-week hospital visit rate was 29.4%;The one-year hospitalization rate was 18.5%;The rate of non-hospitalization for people in need of hospitalization was 27.6%.Multivariate analysis showed that old age(OR＝5.51) ,adequate income(OR＝2.29)and short journey to a medical institution (OR＝7.90) were associated with high two-week hospital visit rates ;old age(OR ＝ 1.76) ,female gender(OR ＝1.36) ,empty-nest(OR＝ 1.37 ) ,family harmony (OR＝ 1.91 ) ,having chronic diseases (OR＝ 3.49 ) , and high frequency in taking medications (OR＝1.69)were correlated with high hospitalization rates. Conclusions The elderly population in rural areas of Northern Jiangsu shows poor health ,has high needs for health services ,and lacks sufficient service utilization.

Objective To discuss the clinical symptoms of severe traumatic cerebral injury patients with paroxysmal sympathetic hyperactivity (PSH). These patients were given positive and effective prevention and treatment to reduce complications in order to improve prognosis. Methods Twenty patients with PSH were selected from October 2010 to October 2014 and were analyzed by gender, age, diagnosis, clinical symptoms, laboratory and equipment inspection to summary the treatment experiences of such patients. Results Of the 20 patients,14 were males and 6 were females,with age of 22-65 (35.4±9.5) years. Sixteen patients underwent unilateral or bilateral intracranial hematoma and decompressive craniectomy,and 4 patients were given conservative treatment. PSH occurred in these patients within 1 week after cerebral injury or surgery. However, the elderly might occur in the course of a few weeks or even months later. Each patient' s seizure frequency and duration had no significant regular pattern. The frequency varied from one time in several days to several times one day. Seizure duration was generally less than half an hour. All of the patients underwent CT and MRI examinations and showed different parts of the brain injury. But the damage of the brain stem, corpus callosum, basal ganglia and lateral ventricles beside sympathetic overactivity could lead to the occurrence of PSH. Most of the patients had a good effect after active drug treatment and symptomatic therapy. Conclusions PSH often occurs in severe traumatic cerebral injury patients. The doctor should pay attention to PSH. Early active and effective prevention and treatment can improve the prognosis of patients with PSH.

Objective To understand the clinical distribution and monitoring the change of resistance of Streptococcus pneumoni‐ae ,effective for clinical anti infection to provide reference .Methods Using VITEK 2 Compact to analyze the bacteria identification and drug sensitivity data ,and using WHONET5 .3 software and SPSS13 .0 software for statistical analysis .Results From 2008 to 2013 ,588 strains of Streptococcus pneumoniae were isolated ,mainly distributed in the intensive care unit (ICU) ,followed by respir‐atory department of internal medicine ,general pediatrics ;mainly from sputum samples ,followed by the throat swabs and blood samples .The highest resistant rate was erythromycin ,followed by penicillin and cotrimoxazole ;Streptococcus pneumoniae remains sensitive to ofloxacin ,levofloxacin ,vancomycin ,linezolid ,chloramphenicol .Conclusion The resistance rate of Streptococcus pneu‐moniae was rising ,and that great attention should be paid to the bacterial drug resistance so as to reasonably use a antibiotics based on the result of drug susceptibility testing .

Objective To evaluate the efficacy of surgical excision combined with iodine-125 implants intmcavitary radiotherapy for neumglioma Method After excision,27 patients with nenroglioma were implanted with the iodine-125 into the tumor bed or the residual tumor tissues.Results Of all cases,there were no operative mortality and no serious complication.The survival time of 25 cases exceeded 6 months and 1 glioblastoma recurrence,22 cases exceeded 12 months,3 glioblastoma and 1 astrocytoma Ⅲgrade recurrence.There were 19 cases exceeding 24 months,15 cases no recurrence,3 cases died for cere bral hernia because of giving.up further tremment,1 case surviving.Conclusions Surgical excision Combined with iodine-125 implants intracavitary radiotherapy can improve partial control rate,prolonged the survival time of patients with neuroglioma,and complications is rare.It is an efficient therapy for neu roglioma