Hirschsprung disease (HSCR) is a common gastrointestinal malformation in pediatric surgery, and the prognosis of most children after surgery is good.However, there are still a small number of children who have to undergo unplanned reoperation for various reasons.Unplanned reoperation is not only the focus of medical quality management in hospitals, but also one of the key indicators of medical quality evaluation.Reoperation not only increases patient costs and disease risks, but also produces a negative impact on medical safety.Studies have shown that residual aganglionosis, transition zone pull-through, acquired agangliocytosis, allied disorders of HSCR, HSCR-associated enterocolitis, rectourinary fistula and skip segment HSCR can lead to the occurrence of long-term unplanned reoperation.In this article, relevant literature in recent years was reviewed and the latest progress of factors related to long-term unplanned reoperation of HSCR was summarized.

Hirschsprung disease (HSCR) is a common gastrointestinal malformation in pediatric surgery, and the prognosis of most children after surgery is good.However, there are still a small number of children who have to undergo unplanned reoperation for various reasons.Unplanned reoperation is not only the focus of medical quality management in hospitals, but also one of the key indicators of medical quality evaluation.Reoperation not only increases patient costs and disease risks, but also produces a negative impact on medical safety.Studies have shown that residual aganglionosis, transition zone pull-through, acquired agangliocytosis, allied disorders of HSCR, HSCR-associated enterocolitis, rectourinary fistula and skip segment HSCR can lead to the occurrence of long-term unplanned reoperation.In this article, relevant literature in recent years was reviewed and the latest progress of factors related to long-term unplanned reoperation of HSCR was summarized.

Objective To identify signals of adverse events associated with vaccines in electronic medical record data. Methods Data cleaning was performed on electronic medical records and vaccination data in Gansu Province from 2020 to 2022. Signal identification was performed using Apriori algorithm and Empirical Bayes Gamma-Poisson Shrinker (GPS) with stratification by gender and age group. Results A total of 33 statistical signals were identified, with 7 signals identified by the Apriori method and 26 signals identified by the GPS method. No overlapping signals were found between the two methods at two different signal thresholds. Conclusion The vaccine safety signals identified by GPS and Apriori in electronic medical records are reliable and accurate, but further research is needed to determine the correlation between the vaccine safety signals recognized by GPS algorithms.

Objective:To explore the characteristics of natural foci of hemorrhagic fever with renal syndrome (HFRS) in Gansu Province.Methods:The information of HFRS case data and rodent density monitoring data from 2012 to 2022 in Gansu Province were collected and epidemiological methods were used to analyze and investigate the characteristics of the epidemic focus.Results:A total of 869 cases of HFRS were reported, and four patients died from 2012 to 2022. The annual incidence rate is between 0.05 per 100 000 and 1.21 per 100 000. The cases were mainly distributed in the eastern, southeast, southern, and south of the central region of Gansu Province. Most cases were distributed between age 20-60, and the sex ratio was 1.85∶1 (564∶305). Most cases were farmers (61.80%, 537/869), herdsmen (19.79%,172/869) and students (6.33%, 55/869). In a wild rat-type epidemic focus,the incidence peak was from November to January of the following year. The natural rodent hosts of HFRS were Rattus norvegicus, Apodemus agrarius, and Mus musculus. The hantaan virus carriage rates were 2.79% (21/754), 0.42% (5/1 179) and 0.31% (2/643),respectively. Three epidemic foci were defined: two derived from the Pingliang and Gannan prefecture new outbreaks epidemic foci, respectively, while the other was the residue of the Dingxi epidemic focus. Conclusions:The southern, south of the central region and eastern part of Gansu Province are current key HFRS epidemic foci dominated by Rattus norvegicus, Apodemus agrarius, and Mus musculus, respectively. The virus genotype is hantaan virus. Case reporting areas should strengthen epidemic monitoring; the key epidemic areas should strengthen and implement various prevention and control measures to reduce the harm caused by HFRS.

Objective:To describe the incidence and epidemiological characteristics of immune thrombocytopenia (ITP) in Gansu Province from 2019 to 2022, and provide evidence for the diagnosis and treatment of ITP, related etiological research, and the association between ITP and vaccination.Methods:Descriptive epidemiological method was used to describe the characteristics of new confirmed ITP cases during 2019-2022 by using the data collected from the electronic medical record database of Gansu.Results:A total of 4 159 cases of ITP were newly diagnosed in Gansu from 2019 to 2022; with an overall incidence of 4.11/100 000 (95% CI: 3.98/100 000- 4.23/100 000), the incidence was 3.49/100 000 in men (95% CI: 3.33/100 000-3.65/100 000), and 4.74/100 000 in women (95% CI: 4.56/100 000-4.94/100 000), the difference was significant ( P<0.001). The incidence in children and the elderly was high, and the risk for ITP was higher in boys aged <10 years and men aged ≥80 years than in girls, and the risk was higher in adult women (20- 69 years) than in adult men. The incidence peak of ITP occurred in summer (June, July and August), and the incidence trough was in February or October in Gansu, and the annual incidence level in each age group showed cyclical changes. The risk for ITP was high in eastern and western areas, and low in central area. Conclusions:The incidence of ITP were high in children and the elderly in Gansu in 2019-2022, and men were at higher risk for ITP compared with women, and higher risk for ITP was observed in women in total population. There were also seasonal and regional specific high incidence.

Sepsis associated acute kidney injury(SA-AKI)is one of the common complications of sepsis,a syndrome of acute functional and organ damage associated with long-term adverse outcomes due to sepsis,and its incidence is gradually increasing and its mortality rate is much higher than that of sepsis alone.Early identification of SA-AKI and prediction of disease progression using biomarkers and corresponding interventions are essential to reduce the risk of death and long-term sequelae of SA-AKI.Until now,few biomarkers have been proposed to specifically identify SA-AKI,clinical use of biomarkers associated with acute kidney injury(AKI)to identify the occurrence or predict the progression of SA-AKI is essential to understand the differences between AKI-associated biomarkers produced or changed in AKI and SA-AKI,and to evaluate the role of AKI-associated biomarkers in identifying SA-AKI related biomarkers in identifying the occurrence and predicting the progression of SA-AKI is a key aspect.This article outlines the differences between AKI-related biomarkers in the occurrence and progression of AKI and SA-AKI,and provides a reference for identifying biomarkers for the occurrence and predicting the progression of SA-AKI.

AIM: To establish a HPLC-QqQ-MS with multiple reaction monitoring (MRM) method for pharmacokinetics and tissue distribution study of ribavirin by oral and respiratory administration. METHODS: The experiment established a high-sensitivity LC-MS analytical method for the detection of ribavirin, and the linearity, specificity, recovery, accuracy, and precision were investigated. The established methods were used to investigate the pharmacokinetics and tissue distribution of the oral and respiratory administration methods. RESULTS: The concentration of drugs in the blood through respiratory tract administration is higher, and the drug absorption is faster. Respiratory tract administration C

Objective:To analyze the epidemiological characteristics of COVID-19 caused by 2019-nCoV Delta variant (B.1.617.2) in Gansu province, and provide evidence for the prevention and control of COVID-19.Methods:The information of COVID-19 cases, including demographic characteristics, epidemiological history, onset date, diagnosis date, exposure place, detection way and infection source, in Gansu from 17 October to 25 November, 2021 were collected. Software Excel 2016,SPSS 22 and ArcGIS 10.7 were used for data process and analysis.Results:As of November 25, 2021, a total of 146 COVID-19 cases had been reported in Gansu and the epidemic affected 10 counties (districts) in 5 cities. The epidemic of COVID-19 in Gansu had three stages: imported case stage,imported-local case stage and local case stage. The age of cases ranged from 1 to 87 years,and the cases in age group 18-59 years accounted for 59.59% (87/146). The male to female ratio of the cases was 1∶1.12 (69∶77). The cases were mainly people engaged in business services (17.12%, 25/146),retirees (15.75%, 23/146),students (13.70%, 20/146),the jobless and unemployed (12.33%, 18/146). In 3 epidemic stages, the cases aged 18-59 years accounted for 44.44%,54.41% and 70.00% respectively,showing an upward trend,and there were differences among different populations (trend χ2=23.24, P<0.001). Also, the incubation period of the cases tended to decrease, and severe cases accounted for 33.33% (6/18), 19.12% (13/68) and 3.33% (2/60) respectively, showing a downward trend. Community screening (25.34%, 37/146) and close contact screening were the main ways to detect cases,the cases detected by close contact screening in 3 epidemic stages accounted for 50.00% (9/18), 66.18% (45/68) and 86.67% (52/60) respectively. The epidemic had obvious case clustering in confined places,and the main exposure modes were living together (24.66%), working/studying together (11.64%), taking same transportation (9.59%) and dining together (9.59%). Conclusions:The COVID-19 epidemic in Gansu was caused by 2019-nCoV Delta variant from imported cases. The virus was mainly transmitted through travel, sharing transportation, dining together and home contact. The characteristics of COVID-19 epidemic in Gansu changed with time, the case's clinical symptoms were not obvious and the incubation period became shorter. The infections mainly occurred in group aged 18 years and above.

Objective:To evaluate the impact of the Japanese encephalitis vaccine included in an expanded immunization program on the reported incidence rate of Japanese encephalitis in Gansu province.Methods:Information on the reported incidence rate of Japanese encephalitis in Gansu province from 1987 to 2019 was collected through the National Population Health Science Data Center and the China Disease Prevention and Control Information System. In addition, the trend of Japanese encephalitis reported incidence rate in Gansu province before and after the inclusion of the Japanese encephalitis vaccine in the expanded immunization program was analyzed using an interrupted time-series design.Results:The annual reported incidence rate of Japanese encephalitis in Gansu province from 1987 to 2019 was 0.448/per 100 000. However, after the inclusion of the Japanese encephalitis vaccine in the expanded immunization program in Gansu province in 2008, the amount of change in the level of Japanese encephalitis reported incidence rate was -2.223/per 100 000 ( t=-2.90, P=0.007), the amount of change in the slope of Japanese encephalitis reported incidence rate was 0.082 ( t=2.87, P=0.008) with the slope of Japanese encephalitis reported incidence rate as 0.071 ( β1+ β3=0.071). Conclusions:The Japanese encephalitis vaccine has achieved good prevention and control effects in Gansu province in the short term after its inclusion in the expanded immunization program, but outbreaks of Japanese encephalitis have still occurred. Therefore, in the future, Gansu province should promptly adjust the immunization strategy of the Japanese encephalitis vaccine, and strengthen the vaccination of the adult population, especially the rural adult population in the southeastern region of Gansu province, based on the continued focus on the works on Japanese encephalitis vaccination for children and adolescents.

Objective:To determine neutralizing antibodies against Japanese encephalitis virus (JEV) among healthy people of Southeast Gansu province, and to evaluate immunologic barrier, and provide the data for Japanese encephalitis (JE) control.Methods:Healthy people were divided into the following 3 groups: less than 14 years, 15-39 years, and above 40 years in 2018 in four cities (Pingliang city, Qingyang city, Longnan city, Tianshui city) of Southeast Gansu province. Serum samples of the participants were obtained, and JEV antibody was detected by plaque reduction neutralization assays. The JEV neutralizing antibody positive rates among different groups were compared by chi square test.Results:A total of 1 590 people were investigated. The total positive rate of JEV neutralizing antibody was 28.81%, and the geometric mean titer (GMT) of JEV neutralizing antibody was 1∶27.09. The antibody positive rates of 0-14, 15-39 and ≥ 40 years groups were 32.96%, 20.32%, 30.63%, the difference of antibody positive rates among different age groups was statistically significant ( χ2=22.29, P<0.001). The antibody positive rates in Pingliang city, Qingyang city, Longnan city, Tianshui city were 29.62%, 22.22%, 33.00%, 30.30%, the difference of antibody positive rates among cities was statistically significant( χ2=12.39, P=0.006). Conclusions:The positive rates of neutralizing antibodies against JEV was low among healthy people in Southeast Gansu province, and there is an epidemic risk of JE.