Against the backdrop of the global acceleration of cervical cancer elimination, China has been promoting pilot programs offering free or subsidized HPV vaccination for eligible girls. In 2022, Zhejiang Province initiated a free bivalent HPV vaccination program for eligible girls, expanding from pilot areas to the whole province. Through key measures such as effective multi-sectoral collaboration, full financial support, comprehensive health education and high-quality vaccination services, the program was successfully implemented. However, challenges were encountered during the implementation of the program, including difficulties in target population definition and HPV vaccine selection, as well as significant gap between vaccination intention and behavior. This article systematically analyzes the practices and challenges faced by Zhejiang Province, and proposes corresponding strategies and suggestions based on the best practices both domestically and internationally. It aims to provide references for the implementation of similar programs in other regions or even integrating HPV vaccine into the immunization program.

Since the introduction of human papillomavirus (HPV) vaccines, countries around the world have actively promoted large-scale vaccination with HPV vaccines to improve their coverage for target populations. This study conducts a multidimensional analysis to quantify the policies, implementation models and evaluation outcomes of the free HPV vaccination program across countries at high, upper-middle and lower-middle income levels. The results reveal distinct patterns in implementation and evaluation among these countries. The results also suggest that China can learn from successful international experiences to explore more effective vaccination strategies to increase coverage. In parallel, it is essential to develop a scientifically grounded evaluation framework and conduct systematic evaluations to effectively support the continuous implementation of the free HPV vaccination program for target populations in China. Furthermore, China may consider incorporating appropriate HPV vaccines into the National Immunization Program and dynamically adjusting vaccine types as needed to accelerate the elimination of cervical cancer.

Objective:To analyze the epidemiological characteristics of herpes zoster (HZ) in Zhoushan and Shaoxing cities of Zhejiang Province from 2022 to 2024.Methods:The HZ data were obtained from the Zhejiang Regional Health Information Platform. Specifically, information was sourced from 42 public hospitals and 149 primary healthcare institutions in Zhoushan and Shaoxing, covering both outpatient and inpatient records (e.g., name, sex, date of birth, ID number, visit date, diagnosis code, admission/discharge dates, and medical expenses). Additionally, vaccination records were matched by ID number from the Zhejiang Immunization Planning Smart Service Information System, including vaccination date, dose, and manufacturer. Permanent resident population data for both cities were collected and stratified by age, sex, and district/county. Based on these data, the epidemiological characteristics of HZ, such as incidence rate, hospitalization rate, and recurrence rate, as well as the occurrence of complications and vaccination, were analyzed.Results:From 2022 to 2024, a total of 45 280 initial HZ cases were identified. The mean age of patients was 57.82 years, with 52.69% being female patients and 95.01% being outpatient cases. Notably, the overall incidence rate of HZ was 3.18‰, showing a significant upward trend ( P<0.001). HZ occurred throughout the year without marked seasonality. The incidence rate increased with age ( P<0.001). The incidence rate was higher in females than males (3.46‰ vs. 2.91‰, P<0.001) and also higher in Shaoxing than Zhoushan (3.38‰ vs. 1.87‰, P<0.001). Regarding complications, these occurred in 44.51% (20 157/45 280) of patients, with the most common complication being postherpetic neuralgia. The incidence rate of HZ with complications was lower than that without complications (1.41‰ vs. 1.76‰, P<0.001), but both hospitalization (0.14‰ vs. 0.03‰, P<0.001) and recurrence rates (27.43‰ vs. 6.69‰, P<0.001) were higher for cases with complications. Additionally, among individuals aged ≥40 years, the overall HZ vaccination rate was 1.42‰. Conclusion:Herpes zoster imposes a substantial disease burden in Zhejiang Province, while the vaccination rate remains low.

Against the backdrop of the global acceleration of cervical cancer elimination, China has been promoting pilot programs offering free or subsidized HPV vaccination for eligible girls. In 2022, Zhejiang Province initiated a free bivalent HPV vaccination program for eligible girls, expanding from pilot areas to the whole province. Through key measures such as effective multi-sectoral collaboration, full financial support, comprehensive health education and high-quality vaccination services, the program was successfully implemented. However, challenges were encountered during the implementation of the program, including difficulties in target population definition and HPV vaccine selection, as well as significant gap between vaccination intention and behavior. This article systematically analyzes the practices and challenges faced by Zhejiang Province, and proposes corresponding strategies and suggestions based on the best practices both domestically and internationally. It aims to provide references for the implementation of similar programs in other regions or even integrating HPV vaccine into the immunization program.

Since the introduction of human papillomavirus (HPV) vaccines, countries around the world have actively promoted large-scale vaccination with HPV vaccines to improve their coverage for target populations. This study conducts a multidimensional analysis to quantify the policies, implementation models and evaluation outcomes of the free HPV vaccination program across countries at high, upper-middle and lower-middle income levels. The results reveal distinct patterns in implementation and evaluation among these countries. The results also suggest that China can learn from successful international experiences to explore more effective vaccination strategies to increase coverage. In parallel, it is essential to develop a scientifically grounded evaluation framework and conduct systematic evaluations to effectively support the continuous implementation of the free HPV vaccination program for target populations in China. Furthermore, China may consider incorporating appropriate HPV vaccines into the National Immunization Program and dynamically adjusting vaccine types as needed to accelerate the elimination of cervical cancer.

Objective:To analyze the epidemiological characteristics of herpes zoster (HZ) in Zhoushan and Shaoxing cities of Zhejiang Province from 2022 to 2024.Methods:The HZ data were obtained from the Zhejiang Regional Health Information Platform. Specifically, information was sourced from 42 public hospitals and 149 primary healthcare institutions in Zhoushan and Shaoxing, covering both outpatient and inpatient records (e.g., name, sex, date of birth, ID number, visit date, diagnosis code, admission/discharge dates, and medical expenses). Additionally, vaccination records were matched by ID number from the Zhejiang Immunization Planning Smart Service Information System, including vaccination date, dose, and manufacturer. Permanent resident population data for both cities were collected and stratified by age, sex, and district/county. Based on these data, the epidemiological characteristics of HZ, such as incidence rate, hospitalization rate, and recurrence rate, as well as the occurrence of complications and vaccination, were analyzed.Results:From 2022 to 2024, a total of 45 280 initial HZ cases were identified. The mean age of patients was 57.82 years, with 52.69% being female patients and 95.01% being outpatient cases. Notably, the overall incidence rate of HZ was 3.18‰, showing a significant upward trend ( P<0.001). HZ occurred throughout the year without marked seasonality. The incidence rate increased with age ( P<0.001). The incidence rate was higher in females than males (3.46‰ vs. 2.91‰, P<0.001) and also higher in Shaoxing than Zhoushan (3.38‰ vs. 1.87‰, P<0.001). Regarding complications, these occurred in 44.51% (20 157/45 280) of patients, with the most common complication being postherpetic neuralgia. The incidence rate of HZ with complications was lower than that without complications (1.41‰ vs. 1.76‰, P<0.001), but both hospitalization (0.14‰ vs. 0.03‰, P<0.001) and recurrence rates (27.43‰ vs. 6.69‰, P<0.001) were higher for cases with complications. Additionally, among individuals aged ≥40 years, the overall HZ vaccination rate was 1.42‰. Conclusion:Herpes zoster imposes a substantial disease burden in Zhejiang Province, while the vaccination rate remains low.

AIM: To evaluate the refractive status through computer refractometer and OPD-Scan III auto refractometer in cataract patients after extended depth of focus(EDOF)intraocular lens implantation.METHODS: Retrospective observational study. A total of 61 cases(76 eyes)that received phacomulsification and implanted with TECNIS® Symfony ZXR00 intraocular lens in Shanghai Eye Diseases Prevention & Treatment Center from May 2022 to May 2023 were collected. Measurements from the computer refractometer, OPD-Scan III auto refractometer, and subjective refraction, were taken from all patients on the same day postoperatively.RESULTS: There were statistical significant difference in sphere(S)and spherical equivalent(SE)readings from the computer refractometer and subjective refraction(all P<0.01), with mean differences of -0.67±0.37 D and -0.75±0.35 D, respectively, and the S and SE obtained from computer refractometer more incline to myopia than those from subjective refraction; there were statistical significant difference in computer refractometer and subjective refraction(P<0.01), with a relative small absolute difference(0.21±0.24 D). The S, cylinder(C)and SE of computer refractometer(S, C, SE)were positively correlated with subjective refraction(r=0.7994, 0.7929, and 0.8118, respectively, all P<0.01). Additionally, there were statistical significant differences in S, C and SE of OPD-Scan Ⅲ and subjective refraction(P<0.01), and the absolute differences of S(0.63±0.36 D), C(0.35±0.26 D)and SE(0.53±0.36 D)were small. Furthermore, the S, C and SE of OPD-Scan Ⅲ were positively correlated with subjective refraction(r=0.4410, 0.4982, 0.5224, all P<0.01).CONCLUSION: In patients who received implantation of EDOF lenses, the consistency of computer refractometer, OPD-Scan III auto refractometer and subjective refraction was good. The average difference of the S and SE obtained via computer refractometer was large, but both exhibited a myopic shift relative to those derived from subjective refraction, and the C values demonstrated minimal discrepancy. Furthermore, the differences between OPD-Scan III auto refractometer and subjective refraction were small, but the direction of the difference is unstable, sometimes it is myopic deviation, while sometimes it is hyperopic deviation.

The objective of this study is to assess the current status of vaccination against respiratory disease among the elderly aged ≥60 and analyze the factors influencing vaccination rates at both service provider and recipient levels in Zhejiang Province. Using a stratified random sampling method, a questionnaire survey was conducted from September 2022 to January 2023 among elderly people aged ≥60 in 30 townships/streets in Zhejiang Province, as well as immunization planning staff at the provincial, municipal, county/district, and township/street levels. Logistic regression models were used to analyze the factors related to vaccination among elderly people in Zhejiang Province. Based on the Zhejiang Provincial Comprehensive Management Information System for Vaccine and Vaccination, the systematic coverage rates of influenza vaccine and pneumonia vaccine for the elderly were 21.76% and 4.57%, respectively. Multivariate logistic regression analysis indicated that advanced age ( OR=1.74, 95% CI: 1.51-1.99), knowing that influenza is more severe than the common cold ( OR=1.67, 95% CI: 1.37-2.04) and having heard of the influenza vaccine ( OR=9.78, 95% CI: 7.03-13.59) were motivating factors for elderly to receive influenza vaccines. Advanced age ( OR=1.71, 95% CI: 1.43-2.06), knowing the serious consequences of pneumonia in the elderly ( OR=1.93, 95% CI: 1.47-2.55) and knowing that pneumonia vaccines can prevent pneumonia ( OR=6.36, 95% CI: 4.84-8.36) were motivating factors for elderly to receive pneumonia vaccines. Zhejiang Immunization Program staff believed that the main reasons why the elderly aged ≥60 would not be vaccinated against influenza or pneumonia were that they felt they would not get sick (55.52% and 56.35% respectively), it would not be serious if get sick (47.73% and 37.46% respectively), lacking trust in vaccine efficacy and safety (38.31% and 43.69% respectively). Vaccination rates for influenza and pneumonia vaccines among the elderly aged ≥60 in Zhejiang Province are suboptimal. Advanced age, awareness of the severity of respiratory diseases and awareness of vaccines against such diseases are related factors for elderly individuals to receive influenza and pneumonia vaccines.

The objective of this study is to assess the current status of vaccination against respiratory disease among the elderly aged ≥60 and analyze the factors influencing vaccination rates at both service provider and recipient levels in Zhejiang Province. Using a stratified random sampling method, a questionnaire survey was conducted from September 2022 to January 2023 among elderly people aged ≥60 in 30 townships/streets in Zhejiang Province, as well as immunization planning staff at the provincial, municipal, county/district, and township/street levels. Logistic regression models were used to analyze the factors related to vaccination among elderly people in Zhejiang Province. Based on the Zhejiang Provincial Comprehensive Management Information System for Vaccine and Vaccination, the systematic coverage rates of influenza vaccine and pneumonia vaccine for the elderly were 21.76% and 4.57%, respectively. Multivariate logistic regression analysis indicated that advanced age ( OR=1.74, 95% CI: 1.51-1.99), knowing that influenza is more severe than the common cold ( OR=1.67, 95% CI: 1.37-2.04) and having heard of the influenza vaccine ( OR=9.78, 95% CI: 7.03-13.59) were motivating factors for elderly to receive influenza vaccines. Advanced age ( OR=1.71, 95% CI: 1.43-2.06), knowing the serious consequences of pneumonia in the elderly ( OR=1.93, 95% CI: 1.47-2.55) and knowing that pneumonia vaccines can prevent pneumonia ( OR=6.36, 95% CI: 4.84-8.36) were motivating factors for elderly to receive pneumonia vaccines. Zhejiang Immunization Program staff believed that the main reasons why the elderly aged ≥60 would not be vaccinated against influenza or pneumonia were that they felt they would not get sick (55.52% and 56.35% respectively), it would not be serious if get sick (47.73% and 37.46% respectively), lacking trust in vaccine efficacy and safety (38.31% and 43.69% respectively). Vaccination rates for influenza and pneumonia vaccines among the elderly aged ≥60 in Zhejiang Province are suboptimal. Advanced age, awareness of the severity of respiratory diseases and awareness of vaccines against such diseases are related factors for elderly individuals to receive influenza and pneumonia vaccines.

Objective:To investigate the clinical efficacy of avatrombopag combined with recombinant human thrombopoietin (rhTPO) versus avatrombopag in the treatment of severe thrombocytopenia associated with chronic liver disease.Methods:The retrospective cohort study was conducted. The clinical data of 56 patients with severe thrombocytopenia associated with chronic liver disease who were admitted to the First Affiliated Hospital of University of Science and Technology of China from May 2020 to October 2021 were collected. There were 36 males and 20 females, aged from 33 to 74 years, with a median age of 54 years. Of 56 patients, 21 cases undergoing treatment of avatrombopag combined with rhTPO were allocated into the combined treatment group and 35 cases undergoing treatment of avatrombopag were allocated into the monotherapy group. Observation indicators: (1) changes of platelet after treatment; (2) adverse drug reaction. Follow-up was conducted using outpatient examination and telephone interview to detect changes of platelet and effects of treatment within 2 weeks after treatment. The follow-up was up to October 2021. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was analyzed using the t test. Measurement data with skewed distribution were represented as M(range), and comparison between groups was analyzed using the Mann-Whitney U test. Count data were described as absolute numbers or percentages, and compari-son between groups was analyzed using the chi-square test or Fisher exact probability. Repeated measurement data were analyzed using the repeated ANOVA. Results:(1) Changes of platelet after treatment. The platelet level within 1 to 5 days and 6 to 10 days after treatment in the combined treatment group were (35±19)×10 9/L and (73±41)×10 9/L, respectively. The above indicators of the monotherapy group were (40±30)×10 9/L and (70±51)×10 9/L, respectively. There was no significant difference in change trends of platelet before and after treatment between the two groups ( Fgroup=0.30, P>0.05). There was a significant difference in platelet count before and after treatment between the two groups ( Ftime=59.96, P<0.05). There was no interaction effect in change trends of platelet between the two groups ( Finteraction=0.40, P>0.05). The effective rates were 66.67%(14/21) in the combination therapy group and 54.29%(19/35) in the monotherapy group. There was no significant difference in the effective rate between the two groups ( χ2=0.83, P>0.05). (2) Adverse drug reaction. Cases with headache, dizziness, blood transfusion reaction, hematuria, proteinuria, fever, abdominal pain, diarrhea, dyspepsia, fatigue, nausea or peripheral tissue edema were 2, 4, 1, 2, 2, 7, 10, 6, 8, 14, 12, 5 in the combined treatment group, versus 5, 8, 1, 3, 5, 7, 19, 11,20, 19, 14, 5 in the monotherapy group, respectively. There was no significant difference in cases with headache, dizziness, blood transfusion reaction, hematuria, proteinuria between the two groups ( P>0.05), and there was no significant difference in cases with fever, abdominal pain, diarrhea, dyspepsia, fatigue, nausea, peripheral tissue edema between the two groups ( χ2=1.24, 0.23, 0.05, 1.91, 0.83, 2.04, 0.81, P>0.05). Conclusion:Both of avatrombopag combined with rhTPO and monotherapy of avatrom-bopag can be used to promote the platelet level in patients with severe thrombocytopenia associated with chronic liver disease, and avatrombopag combined with rhTPO does not provide better clinical benefits compared with monotherapy avatrombopag.