Objective:To analyze the epidemiological and clinical characteristics of pertussis cases identified through active surveillance.Methods:Active surveillance for pertussis was conducted in three sentinel hospitals in Yiwu, Zhejiang Province, and Yongcheng, Henan Province. The study population included cases that met the surveillance case definition and sought medical care at outpatient/emergency departments or were hospitalized between June 1, 2021, and May 31, 2022. Samples were collected for bacterial culture and PCR detection. Case information and clinical data were collected. Differences in rates were assessed using the chi-square test or Fisher's exact probability test, and the differences in cough time were compared using the Mann-Whitney U test. Results:Among 1 423 cases of pertussis surveillance, the positive rate of pertussis was 28.11% (400/1 423), with a median age of 5 years (interquartile range: 2, 8). The positive rate in Yongcheng, Henan Province, and Yiwu, Zhejiang Province were 39.27% (216/550) and 21.08% (184/873), respectively; the positive rate of pertussis was highest in July 2021, and the highest positive rate of pertussis was among those aged 10-14. The positive rate of pertussis in hospitalized cases was higher than in outpatient/emergency cases (26.68%) ( χ2=4.16, P=0.041). Among the 400 laboratory test-positive cases, the highest proportion of atypical symptom cases was in adults aged 20-59 (43.33%, 13/30). The specificity rates of apnea and worsening nocturnal cough in monitored cases under 3 months of age were 100.00% and 73.81%, respectively. Among monitored cases aged 3 months to 9 years, the proportions of symptoms including worsening nighttime cough (63.00%) and night sweats (4.59%) in test-positive cases were significantly higher than those in the test-negative group (47.77% and 0.56%, respectively), with statistically significant differences (both P<0.05). The specificity rates of worsened nighttime coughing and night sweats were 52.23% and 99.44%, respectively. Conclusions:The active surveillance results for pertussis showed that the 10-14 age group exhibited the highest positivity rate. Active surveillance enhanced the detection rate of pertussis. Among laboratory-confirmed cases, the proportion of atypical symptoms was the highest in adults, suggesting that laboratory testing should be combined to diagnose programs of pertussis. For infants under 3 months, worsening nighttime cough and apnea increase the diagnostic specificity, while for individuals aged 3 to 9 years old, worsening nighttime cough and night sweats increase the diagnostic specificity.

Objective:To analyze the epidemiological and clinical characteristics of pertussis cases identified through active surveillance.Methods:Active surveillance for pertussis was conducted in three sentinel hospitals in Yiwu, Zhejiang Province, and Yongcheng, Henan Province. The study population included cases that met the surveillance case definition and sought medical care at outpatient/emergency departments or were hospitalized between June 1, 2021, and May 31, 2022. Samples were collected for bacterial culture and PCR detection. Case information and clinical data were collected. Differences in rates were assessed using the chi-square test or Fisher's exact probability test, and the differences in cough time were compared using the Mann-Whitney U test. Results:Among 1 423 cases of pertussis surveillance, the positive rate of pertussis was 28.11% (400/1 423), with a median age of 5 years (interquartile range: 2, 8). The positive rate in Yongcheng, Henan Province, and Yiwu, Zhejiang Province were 39.27% (216/550) and 21.08% (184/873), respectively; the positive rate of pertussis was highest in July 2021, and the highest positive rate of pertussis was among those aged 10-14. The positive rate of pertussis in hospitalized cases was higher than in outpatient/emergency cases (26.68%) ( χ2=4.16, P=0.041). Among the 400 laboratory test-positive cases, the highest proportion of atypical symptom cases was in adults aged 20-59 (43.33%, 13/30). The specificity rates of apnea and worsening nocturnal cough in monitored cases under 3 months of age were 100.00% and 73.81%, respectively. Among monitored cases aged 3 months to 9 years, the proportions of symptoms including worsening nighttime cough (63.00%) and night sweats (4.59%) in test-positive cases were significantly higher than those in the test-negative group (47.77% and 0.56%, respectively), with statistically significant differences (both P<0.05). The specificity rates of worsened nighttime coughing and night sweats were 52.23% and 99.44%, respectively. Conclusions:The active surveillance results for pertussis showed that the 10-14 age group exhibited the highest positivity rate. Active surveillance enhanced the detection rate of pertussis. Among laboratory-confirmed cases, the proportion of atypical symptoms was the highest in adults, suggesting that laboratory testing should be combined to diagnose programs of pertussis. For infants under 3 months, worsening nighttime cough and apnea increase the diagnostic specificity, while for individuals aged 3 to 9 years old, worsening nighttime cough and night sweats increase the diagnostic specificity.

Objective:To explore the possibility of using a inferior gluteal artery perforator flap (IGAPF) for breast reconstruction in the patient who did not have suitable donor site in back and abdomen.Methods:In November 2024, a 25-year-old unmarried and childless woman with right breast cancer received immediate right breast reconstruction by a right free IGAPF after modified right mastectomy in the Department of Breast and Thyroid Surgery, Second Affiliated Hospital of Hainan Medical University. The locations of perforators were confirmed by both Multi-detector computed tomography angiography (MDCTA) and portable Doppler blood flow detector before surgery. The IGAPF was designed to take the inferior gluteal wrinkle as the lower edge, the axis of the flap was parallel to the inferior gluteal wrinkle, and the width of the flap was estimated where the incision could be directly closed. The size of right IGAPF was 6.0 cm×19.0 cm. Sharp dissection was performed between the sarcolemma and muscle fibres of gluteus, then the perforators were dissected along the direction of muscle fibres of gluteus. The vascular pedicle was kept at about 8.0 cm in length. The diameter of artery was about 2.0 mm and that for the veins was about 1.5 mm. End-to-end anastomoses with the right thoracodorsal artery and vein were successfully carried out. The donor site was directly closed, and it was hidden in the inferior gluteal wrinkle. Postoperative outpatient clinical review was made.Results:Pathological examination reported: an invasive carcinoma of right breast, axillary lymph node metastasis (2/10). The patient recovered well and the flap survived without any complication, i.e. ischemic necrosis, infection and haematoma. The patient was off-bed at 3 days and discharged at 13 days after surgery. At the 40 days of postoperative follow-up, the patient achieved a good recovery and the lower limb activity was not affected by the surgery. The patient was satisfied with the reconstructed breast and donor site recovery. The patient followed with scheduled chemotherapy and subsequent radiotherapy. The volume of reconstructed breast was smaller than the other breast, of which the patient was fully informed before the surgery.Conclusion:A free IGAPF provides an alternative donor sites for achieving a breast reconstruction due to the reliable pedicle vessels and invisible donor scars.

Objective:To explore the possibility of using a inferior gluteal artery perforator flap (IGAPF) for breast reconstruction in the patient who did not have suitable donor site in back and abdomen.Methods:In November 2024, a 25-year-old unmarried and childless woman with right breast cancer received immediate right breast reconstruction by a right free IGAPF after modified right mastectomy in the Department of Breast and Thyroid Surgery, Second Affiliated Hospital of Hainan Medical University. The locations of perforators were confirmed by both Multi-detector computed tomography angiography (MDCTA) and portable Doppler blood flow detector before surgery. The IGAPF was designed to take the inferior gluteal wrinkle as the lower edge, the axis of the flap was parallel to the inferior gluteal wrinkle, and the width of the flap was estimated where the incision could be directly closed. The size of right IGAPF was 6.0 cm×19.0 cm. Sharp dissection was performed between the sarcolemma and muscle fibres of gluteus, then the perforators were dissected along the direction of muscle fibres of gluteus. The vascular pedicle was kept at about 8.0 cm in length. The diameter of artery was about 2.0 mm and that for the veins was about 1.5 mm. End-to-end anastomoses with the right thoracodorsal artery and vein were successfully carried out. The donor site was directly closed, and it was hidden in the inferior gluteal wrinkle. Postoperative outpatient clinical review was made.Results:Pathological examination reported: an invasive carcinoma of right breast, axillary lymph node metastasis (2/10). The patient recovered well and the flap survived without any complication, i.e. ischemic necrosis, infection and haematoma. The patient was off-bed at 3 days and discharged at 13 days after surgery. At the 40 days of postoperative follow-up, the patient achieved a good recovery and the lower limb activity was not affected by the surgery. The patient was satisfied with the reconstructed breast and donor site recovery. The patient followed with scheduled chemotherapy and subsequent radiotherapy. The volume of reconstructed breast was smaller than the other breast, of which the patient was fully informed before the surgery.Conclusion:A free IGAPF provides an alternative donor sites for achieving a breast reconstruction due to the reliable pedicle vessels and invisible donor scars.

Objective To investigate the status and needs of professional training in the rehabilitation institutes associated to Shanghai Disabled Persons' Federation. Methods All the rehabilitation institutes associated to Shanghai Disabled Persons' Federation were surveyed with their theme, frequency and targeted participants of training in 2010. The intention of training of rehabilitation personnel were investigated and ranged as importance and urgency. Results There were some trainings in all the rehabilitation institutes, which varied with the property and level of the institutions. The theme of training did not meet the intention of the personnel. Conclusion A preliminary training system for the rehabilitation personnel has been established in Shanghai Disabled Persons' Federation system. It is needed to improve the needs assessment,curriculum, and teaching.

ObjectiveTo analyze application of screening and assessment scales for senile dementia in China.MethodsVarieties of screening and assessment scales were found in the studies on screening and assessment of senile dementia in China, as well as their common features and epidemiological results. A combination of qualitative and quantitative methods was used in the analysis.ResultsMini Mental State Examination (MMSE) is preferred tool in screening and Activity of Daily Living Scale (ADL) is the secondary.ConclusionThe future research direction should include: studying the appropriate boundary value in MMSE for China; optimizing the combination of screening scale and developing more appropriate screening tool.

ObjectiveTo explore the risk factors related to senile dementia to develop intervention method.MethodsA combination of qualitative and quantitative methods was used to analyze the factors and their degree related to the incidence of dementia for the elderly.ResultsAgeing was the deterministic factor to senile dementia, and vascular factor was common risk for Alzheimer's disease (AD) and vascular dementia (VD).ConclusionActive intervention in early life, concern about women's groups especially in the mental health, and detemination of value range of the risk factors are needed.

Objective To investigate and assess the current situations on information management of rehabilitation service in Shanghai. Methods The information management in 6 districts in Shanghai were assessed in field, the fulfilling of the first- and second-degree index and the standard-reaching rate of the third-degree index were calculated separately according to the first-degree index- information management of the Evaluation Index System of Rehabilitation Service for All Disabled in Shanghai. Results The average fulfilling degree of the first-degree index was 73.1%. There were only 2 districts reached the standard of Registration of Rehabilitation. The average fulfilling degrees of the Development and Dynamic Maintenance of Rehabilitation Service Information Database were 50.0% and 66.7%, respectively. The standard-reaching rate of the Disabled Children First-diagnose Report System, Effectual Providing Referral Rehabilitation Service Across-the-board, Suspicious Disabled Persons Report System in Community were 16.7%, 16.7% and 50%, respectively. Conclusion The development and supervision of rehabilitation service information should be reinforced and the referral rehabilitation service should be improved.

Objective To investigate and assess the current situations of propagandizing and inculcating rehabilitation information in Shanghai. Methods The propagandizing and inculcating rehabilitation information in 6 districts in Shanghai were assessed in field, the fulfilling of the first- and second-degree index and the standard-reaching rate of the third-degree index were calculated separately according to the first-degree index- propagandizing and inculcating rehabilitation information of the Evaluation Index System of Rehabilitation Service for All Disabled in Shanghai.Results The average fulfilling degree of the first-degree index was 82.3%. There was 1 district reached the standard of Propagandizing Rehabilitation Information by Broadcast, Television, Newspaper, Magazine and Internet; the average fulfilling degrees of the Community Rehabilitation Function for the Disabled and the Community School Propagandizes and Inculcates the Rehabilitation Information for the Disabled are 66.7% and 33.3%, respectively. Conclusion The support from the government could make propagandizing and inculcating rehabilitation information carry out more successfully; utilizing the media adequately is important; propagandizing and inculcating rehabilitation information must be strengthened in community.

This paper introduced the project of "the Study on the Evaluation Index System of Rehabilitation Service for All Disabled in Shanghai" in brief, including research background, objectives, researching objects and sampling. The project aimed at constructing the evaluation index system of rehabilitation service for all disabled in Shanghai. According to the research purpose, the persons with disability in 19 regions (or counties) and 2 towns were investigated with 12 consultation conference and 3 Delphi's surveys to find out the rehabilitation demand and service. The Evaluation Index System of Rehabilitation Service for All Disabled in Shanghai that finally comes into being includes 8 first-degree index, 32 second-degree index and 100 third-degree index.