Objective To analyze the operation of Measles Surveillance System (MSS) in Hebei Province, and to provide evidence for measles elimination. Methods Measles surveillance data was collected from the MSS from 2020 to 2023, and a modified weighted technology for order preference by similarity to an ideal solution (TOPSIS) method was used to evaluate the surveillance indexes of measles in Hebei Province. Results The operation quality of the measles surveillance system in Hebei Province was improved year by year, with the highest quality in 2023, and all the indicators reached the monitoring program standards. The quality of measles surveillance system was not balanced among cities, and the main influencing factor was the substandard sensitivity indicators. The quality of measles surveillance system was the highest in Baoding City and the lowest in Zhangjiakou City. Conclusion The measles surveillance system in Hebei province is running well, and the sensitivity of the surveillance system should be improved to keep the high-quality operation of the surveillance system.

Background A large number of power supply workers are involved in live working and are exposed to multiple risk factors for long periods of time during outdoor work, which in turn causes occupational health problems. Objective To identify potential ergonomic factors related to work-related musculoskeletal disorders (WMSDs) and estimate the ergonomic risk of electricians. Methods A total of 31 workers were randomly selected from a training base under a power supply enterprise in Guangxi, and their operation processes were recorded by video. Using the Rapid Upper Limb Assessment (RULA) method, the workers were scored by the posture of their arms, neck, and torso during operation, and the final scores were summarized to assess their risk level. Two independent samples t-tests were used to compare the differences in RULA scores. Results A total of 31 videos for mounting/dismounting insulation mask and 29 videos for breaking/connecting contact terminal were collected. The RULA score for mounting/dismounting insulation mask was 6.6 ± 0.7 (left side) and 7.0 ± 0.2 (right side), most of the workers had a score of 7 (71.0% on the left side and 96.8% on the right side), and the upper limb and overall scores on the right side were higher than those on the left side (P < 0.05). The RULA score for breaking/connecting contact terminal was 6.9 ± 0.4 (both right and left sides), most of workers had a score of 7 (89.7% on the left side and 93.1% on the right side), and the difference of the overall scores between the right and left side for this operation were not statistically significant (P > 0.05). The ergonomic risk levels for both operations were level 3 or higher. Conclusion Mounting/dismounting insulation mask and breaking/connecting contact terminal are typical upper limb operations, and have a high level of ergonomics risk, requiring effective preventive and protective measures.

OBJECTIVE: To observe the effects of enhanced rehabilitation on the prognosis of critically ill patients in the intensive care unit (ICU). METHODS: A single-center retrospective historical controlled study was conducted, patients admitted to the ICU of Peking University First Hospital from May 1, 2020, to April 30, 2021, and from October 1, 2021, to September 30, 2022 were enrolled. According to the different rehabilitation treatment strategies during different periods, patients were divided into the conventional rehabilitation group (patients receiving conventional rehabilitation treatment from May 1, 2020, to April 30, 2021) and the enhanced rehabilitation group (patients receiving the therapy of multidisciplinary team, ie medical care-rehabilitation-nursing care from October 1, 2021, to September 30, 2022). General data, acute physiology and chronic health evaluation II (APACHE II), and study endpoints were collected. Primary endpoints included rehabilitation-therapy rate, intervention time for rehabilitation, rehabilitation-related adverse events, and prognostic indicators such as (length of stay in hospital, length of stay in the ICU, and duration of mechanical ventilation). Secondary endpoints included incidence of deep vein thrombosis and hospital mortality. Kaplan-Meier curves were used to analyze cumulative discharge rates within 50 days. RESULTS: A total of 539 ICU patients were enrolled, with 245 in the conventional rehabilitation group and 294 in the enhanced rehabilitation group; 322 patients had an APACHE II score ≤ 15, while 217 patients had an APACHE II score > 15. Compared to the conventional rehabilitation group, the enhanced rehabilitation group demonstrated significantly higher rehabilitation-therapy rate [51.70% (152/294) vs. 11.43% (28/245)], earlier intervention time for rehabilitation [days: 2.00 (1.00, 3.00) vs. 4.00 (3.00, 7.00)]; shorter length of stay in hospital [days: 18.00 (12.00, 30.00) vs. 21.00 (13.00, 36.00)] and lower incidence of DVT [17.01% (50/294) vs. 24.08% (59/245)]. The differences were all statistically significant (all P < 0.05). There were no rehabilitation-related adverse events occurred in either group. Kaplan-Meier analysis demonstrated a significantly higher cumulative discharge rate within 50 days in the enhanced rehabilitation group compared to the conventional rehabilitation group [86.7% (255/294) vs. 82.9% (203/245); Log-Rank test: χ² = 4.262, P = 0.039]. Subgroup analysis showed that for patients with APACHE II score ≤ 15, the enhanced rehabilitation subgroup had higher rehabilitation-therapy rate [44.32% (78/176) vs. 6.16% (9/146), P < 0.05]. For patients with APACHE II score > 15, compared to the conventional rehabilitation group, the enhanced subgroup demonstrated higher rehabilitation-therapy rate [62.71% (74/118) vs. 19.19% (19/99), P < 0.05] and shorter length of stay in hospital [days: 20.50 (12.00, 31.25) vs. 26.00 (16.00, 43.00), P < 0.05]. CONCLUSIONS Enhanced rehabilitation therapy with medical care, rehabilitation and nursing care, improved rehabilitation-therapy rate, advanced time of rehabilitation treatment, reduced length of stay in hospital and incidence of deep vein thrombosis in critically ill patients, particularly benefited those with APACHE II score > 15. The enhanced rehabilitation was beneficial to the patient in the intensive care unit with safety and worth more investigation.
Humans ; Retrospective Studies ; Critical Illness/rehabilitation* ; Intensive Care Units ; Prognosis ; Length of Stay ; APACHE ; Historically Controlled Study ; Male ; Female ; Middle Aged ; Aged

Objective　To analyze the epidemiological characteristics of hepatitis B in Hainan from 2015 to 2021, and to predict the incidence trends among different populations, so as to provide a scientific basis for the prevention and control of hepatitis B based on the epidemiological characteristics and prediction. Methods　Descriptive epidemiological characteristics of hepatitis B in Hainan were analyzed, and the incidence of hepatitis B among different populations in Hainan was studied based on the grey prediction model and polynomial model. The optimal model was selected by the principle of least absolute mean relative error, and future incidences were predicted. Results　The reported incidence of hepatitis B in Hainan Province from 2015 to 2019 basically showed an annual upward trend, but a decreasing trend was observed in 2020. From 2017 to 2021, the reported incidence rates in the age groups of 0-<15 and 15-<30 showed a declining trend, while the incidence of the age groups of 60-<75 and ≥75 years old basically stabilized in Hainan. The annual average number and annual incidence of the population aged 30-<45 and 45-<60 were both higher. The male-to-female sex ratio of the annual average reported incidence of hepatitis B was approximately 2:1. Among the various occupations, the incidence was mainly among farmers, with an annual average proportion of hepatitis B of 43.06%. Regional disparities in the number of reported annual hepatitis B cases were found, with 5 cities decreasing year by year, 1 city increasing first and then decreasing, 2 cities being stable and other cities increasing year by year. The predicted incidence rates for 2022-2024 years were 127.43/100 000, 116.05/100 000, and 102.09/100 000, respectively. Conclusions　In recent years, the incidence of hepatitis B among people under 30 years old in Hainan Province has shown a decreasing trend, indicating that policies such as hepatitis B vaccine included in the immunization program for children in Hainan have a good effect on the prevention and control of hepatitis B. Therefore, it is necessary to focus on strengthening the prevention and control of the high incidence rate in the age groups and gender. The existence of regional differences in the incidence of Hepatitis B suggests that comprehensive prevention and control measures should be continued to strengthen in areas where the incidence is increasing year by year, such as knowledge and health promotion of hepatitis B prevention and control, screening treatment, and vaccinatio.

Objective To analyze the occurrence characteristics of adverse events following immunization (AEFI) of 23-valent pneumococcal polysaccharide vaccine (PPSV-23) in Hebei Province and to evaluate the safety of the vaccine. Methods AEFI cases related to vaccination of PPSV-23 in Hebei Province from January 1, 2020 to December 31, 2022 were collected through the AEFI surveillance module of Chinese Center for Disease Control and Prevention Information System. The incidence of reported AEFI cases were then analyzed and compared. Results The reported incidence rate of AEFI of PPSV-23 was 56.12 /100,000 doses, and the incidence rate of adverse reactions was 55.50 /100 000 doses. The incidence rate of common adverse reactions was 53.94/100 000 doses, and the incidence rate of rare adverse reactions was 1.56/100 000 doses. Most of the reported AEFI cases caused by PPSV-23 were common adverse reactions, which occurred mainly within one day after vaccination, and the overall regression was positive. Conclusion The 23-valent pneumococcal polysaccharide vaccine used in Hebei Province is safe，but its safety monitoring still needs to be strengthened.

Polyhydroxyalkanoate depolymerase (PHAD) can be used for the degradation and recovery of polyhydroxyalkanoate (PHA). In order to develop a PHAD with good stability under high temperature, PHAD from Thermomonospora umbrina (TumPHAD) was heterelogously expressed in Escherichia coli BL21(DE3). At the same time, a mutant A190C/V240C with enhanced stability was obtained via rational design of disulfide bonds. Characterization of enzymatic properties showed that the mutant A190C/V240C had an optimum temperature of 60 ℃, which was 20 ℃ higher than that of the wild type. The half-life at 50 ℃ was 7 hours, at 50 ℃ which was 21 times longer than that of the wild type. The mutant A190C/V240C was used for the degradation of polyhydroxybutyrate (PHB), one of the typical PHA. At 50 ℃, the degradation rate of PHB being treated for 2 hours and 12 hours was 2.1 times and 3.8 times higher than that of the wild type, respectively. The TumPHAD mutant A190C/V240C obtained in this study shows tolerance to high temperature resistance, good thermal stability and strong PHB degradation ability, which may facilitate the degradation and recovery of PHB.
Thermomonospora ; Actinomycetales ; Escherichia coli/genetics* ; Polyhydroxyalkanoates

Objective To construct a structural equation model to analyze the effect of various factors on the quality of life in stroke patients.Methods In this cross-sectional study,a total of 657 stroke patients from 2 ter-tiary A hospitals in Shanghai were enrolled as investigation subjects via convenience sampling methodology.General information questionnaire,Sense of Coherence Scale-13,Perceived Social Support Scale,Medical Coping Modes Questionnaire,National Institutes of Health Stroke Scale,Self-Esteem Scale and Stroke-Specific Quality of Life were utilized as the investigating tools;Mplus 7.4 was used to construct a structural equation model.Results The aver age score of quality of life in stroke patients was(178.30±30.30);neurological status,self-esteem were negatively cor-related with quality of life(P＜0.05);sense of coherence,social support,coping style were positively correlated with quality of life(P＜0.05);sense of coherence,taking a confrontational approach for coping,yielding and neurological status had a direct impact on quality of life(path coefficients were 0.471,0.169、0.135,-0.089,P＜0.05);social sup-port,self-esteem,sense of coherence and neurological status had an indirect impact on quality of life(path coefficients were 0.232,0.108,0.058,-0.058,P＜0.001).Conclusion The quality of life in stroke patients is influenced by multi-ple factors interactively,and sense of coherence is an important factor affecting the quality of life;adopting a confron-tational approach as coping styles,good social support and high self-esteem can improve the level of quality of life.

Objective:To analyze the clinical and pathological characteristics of chronic hepatitis B (CHB) patients with normal alanine aminotransferase (ALT) and not receiving antiviral therapy.Methods:This study retrospectively included CHB patients diagnosed by liver biopsy at the Third Hospital of Hebei Medical University from January 2008 to December 2022. According to the HBV DNA and HBeAg status of "immune tolerance period and immune control period", these patients were divided into three groups: chronic HBV carrier group, inactive HBsAg carrier group and indeterminate group including the patients that did not meet the inclusion criteria of the above two groups. Kruskal-Wallis H test was used for comparison of continuous data between multiple groups. Mann-Whitney U test was used for comparison of continuous data and ordered categorical data between two groups. Chi-square test or Fisher′s exact test was used for comparison of categorical data between two groups. Results:A total of 284 CHB patients with normal ALT were enrolled. There were 64, 88 and 132 cases in the chronic HBV carrier group, inactive HBsAg carrier group and indeterminate group, respectively. Histopathological analysis revealed that there were 182 (64.08%) cases with pathological inflammation grade (G) and/or fibrosis stage (S)≥2, 155 (54.58%) with S≥2 and 120 (42.25%) with G≥2. The proportion of patients with G and/or S≥2 in the indeterminate group [70.45% (93/132)] was higher than that in the chronic HBV carrier group [48.44% (31/64)] and inactive HBsAg carrier group [65.91% (58/88)] (both P<0.05). Patient′s age and the ratio of patients with S≥2 in the chronic HBV carrier group [33 years old, 39.06% (25/64)] were smaller than those in the inactive HBsAg carrier group [39 years old, 56.82% (50/88)] and the indeterminate group [39 years old, 60.61% (80/132)] (all P<0.05). Patients in the inactive HBsAg carrier group (19 U/L) had lower ALT levels than those in the chronic HBV carrier group (26 U/L) and the indeterminate group (23 U/L) (both P<0.05). The proportion of patients with cytoplasmic/cytoplasmic nuclear-type HBcAg was higher in patients with G and/or S≥2 than in patients with G and S<2 [73.08% (57/78) vs 32.08% (17/53), P<0.05], and the proportion of patients with cytoplasmic/cytoplasmic nuclear-type HBcAg increased gradually with age. The proportion of patients with cytoplasmic/cytoplasmic nuclear-type HBcAg was higher in patients with G and/or S≥2 than in patients with G and S<2 in the chronic HBV carrier status and indeterminate groups [93.33% (28/30) vs 43.33%(13/30), P<0.05; 59.46% (22/37) vs 12.50% (2/16); both P<0.05]. There was a statistically significant difference in the incidence of significant liver injury between patients≤ 30 years old and >30 years old [52.7% (39/74) vs 68.1% (143/210), P<0.05]. Conclusions:Significant liver injury occurred in 64.08% (182/284) of CHB patients with normal ALT not receiving antiviral therapy, which required the attention of clinicians. Among CHB patients with normal ALT, the expression site of HBcAg in hepatocytes was related to the occurrence of significant liver injury and could be expected to serve as an important indicator for predicting the patient′s status and the necessity of antiviral treatment. CHB patients with positive HBV DNA who were older than 30 years required antiviral treatment, and CHB patients≤30 years with normal ALT and significant hepatic tissue damage also required antiviral treatment.

Objective:To explore the computer-aided navigation technology combined with personalized three-dimensional(3D) printing in the reduction and fixation of the multiple midface fractures.Methods:A retrospective analysis was performed on clinical data of patients suffering from multiple midface fractures treated at the Department of Oral and Maxillofacial Surgery, the First Affiliated Hospital of Anhui Medical University from August 2019 to December 2021. According to the operational method, the patients in the experimental group received the operation applied by AccuNavi-A 2.1 navigation software for surgical planning and surgical simulation, printing 3D head model before the operation, and reducing and fixing fractures with the aid of computer navigation technology. Patients in the control group received the operation applied by traditional surgery. Marking facial landmarks on the head CT 3D model of patients and constructing a spatial coordinate system before and 1 week after surgery, measuring and calculating the facial asymmetry index (AI) for each landmark, including the orbitale (O), the most outside of the zygomaticomaxillary suture of the 1/3 below of the margo infraorbitalis(MZ), the most concave point between the frontal process of zygomatic bone and the superior margin of processus temporalis(C), the most concave point of the superjacent of C of posterior margin of frontal process(SC) and the outermost point of zygomatic arch(Z). The duration of operation were recorded. Complications including diplopia, difficulty in mouth opening, facial numbness, malocclusion, scarring and pupil height were evaluated by patents 3 months after the operations. AI is represented by M( Q1, Q3), Wilcoxon rank test was used for intra-group comparison before and after operations, and Mann-Whitney U test was used for comparison between two groups. Operation time was represented by Mean±SD, and t-test was used for comparison between two groups. The result of self-assessment of patients’ complications are expressed as cases (%), and the chi-square test or Fisher’s exact test was used. Results:A total of 32 patients were included. There were 16 patients in the experimental group, 9 males and 7 females, aged 17-60 years. There were 16 patients in the control group, 8 males and 8 females, aged 18-65 years. The preoperative O, MZ, C, SC, and Z point in the experimental group were 8.9(6.9, 12.8), 10.0(7.7, 12.6), 7.6(5.9, 14.9), 10.7(7.2, 22.0), 11.2(10.1, 17.4), and 2.2(1.6, 3.4), 2.5(1.7, 3.4), 2.2(1.9, 2.9), 2.6(1.7, 3.1), 2.4(1.4, 2.8). The preoperative O, MZ, C, SC, and Z point in control group were 10.4(8.1, 12.5), 10.5(9.0, 12.6), 6.6(5.3, 8.2), 10.6(8.7, 13.1), 10.9(9.8, 13.4), and the postoperative were 4.0(3.6, 4.8), 4.3(3.8, 5.4), 5.2(4.8, 6.7), 4.3(3.1, 5.1), 4.6(3.2, 5.3). There was no significant difference in AI of each marker point between the two groups before surgery ( P>0.05). The AI of each landmark in the two groups was reduced after operation compared with that before operation to some extent ( P<0.01 or 0.05). The AI of each landmark in the experimental group was significantly lower than that in the control group( P<0.01). The operation time of the experimental group[(3.7±1.1) h] was shorter than that of the control group[(4.8±1.9) h] ( P<0.05). The incidence of scar[12.5% (2/16)] and inconsistent pupil height[6.3% (1/16)] in the experimental group was lower than that in the control group [43.8% (7/16), 37.5% (6/16)] ( P<0.05). And there was no significant difference in other items ( P>0.05). Conclusions:The computer-aided navigation technology combined with personalized 3D printing can shorten the time of operation, expedite the patients’ facial recovery with more symmetry and less likely to have complications.

Objective:To explore the computer-aided navigation technology combined with personalized three-dimensional(3D) printing in the reduction and fixation of the multiple midface fractures.Methods:A retrospective analysis was performed on clinical data of patients suffering from multiple midface fractures treated at the Department of Oral and Maxillofacial Surgery, the First Affiliated Hospital of Anhui Medical University from August 2019 to December 2021. According to the operational method, the patients in the experimental group received the operation applied by AccuNavi-A 2.1 navigation software for surgical planning and surgical simulation, printing 3D head model before the operation, and reducing and fixing fractures with the aid of computer navigation technology. Patients in the control group received the operation applied by traditional surgery. Marking facial landmarks on the head CT 3D model of patients and constructing a spatial coordinate system before and 1 week after surgery, measuring and calculating the facial asymmetry index (AI) for each landmark, including the orbitale (O), the most outside of the zygomaticomaxillary suture of the 1/3 below of the margo infraorbitalis(MZ), the most concave point between the frontal process of zygomatic bone and the superior margin of processus temporalis(C), the most concave point of the superjacent of C of posterior margin of frontal process(SC) and the outermost point of zygomatic arch(Z). The duration of operation were recorded. Complications including diplopia, difficulty in mouth opening, facial numbness, malocclusion, scarring and pupil height were evaluated by patents 3 months after the operations. AI is represented by M( Q1, Q3), Wilcoxon rank test was used for intra-group comparison before and after operations, and Mann-Whitney U test was used for comparison between two groups. Operation time was represented by Mean±SD, and t-test was used for comparison between two groups. The result of self-assessment of patients’ complications are expressed as cases (%), and the chi-square test or Fisher’s exact test was used. Results:A total of 32 patients were included. There were 16 patients in the experimental group, 9 males and 7 females, aged 17-60 years. There were 16 patients in the control group, 8 males and 8 females, aged 18-65 years. The preoperative O, MZ, C, SC, and Z point in the experimental group were 8.9(6.9, 12.8), 10.0(7.7, 12.6), 7.6(5.9, 14.9), 10.7(7.2, 22.0), 11.2(10.1, 17.4), and 2.2(1.6, 3.4), 2.5(1.7, 3.4), 2.2(1.9, 2.9), 2.6(1.7, 3.1), 2.4(1.4, 2.8). The preoperative O, MZ, C, SC, and Z point in control group were 10.4(8.1, 12.5), 10.5(9.0, 12.6), 6.6(5.3, 8.2), 10.6(8.7, 13.1), 10.9(9.8, 13.4), and the postoperative were 4.0(3.6, 4.8), 4.3(3.8, 5.4), 5.2(4.8, 6.7), 4.3(3.1, 5.1), 4.6(3.2, 5.3). There was no significant difference in AI of each marker point between the two groups before surgery ( P>0.05). The AI of each landmark in the two groups was reduced after operation compared with that before operation to some extent ( P<0.01 or 0.05). The AI of each landmark in the experimental group was significantly lower than that in the control group( P<0.01). The operation time of the experimental group[(3.7±1.1) h] was shorter than that of the control group[(4.8±1.9) h] ( P<0.05). The incidence of scar[12.5% (2/16)] and inconsistent pupil height[6.3% (1/16)] in the experimental group was lower than that in the control group [43.8% (7/16), 37.5% (6/16)] ( P<0.05). And there was no significant difference in other items ( P>0.05). Conclusions:The computer-aided navigation technology combined with personalized 3D printing can shorten the time of operation, expedite the patients’ facial recovery with more symmetry and less likely to have complications.