Objective To investigate influenza awareness of community residents in Nanchang under routine epidemic management using the Knowledge-Attitude-Practice(KAP)framework.Methods A structured questionnaire,including four do-mains(disease overview,prevention,diagnosis,and treatment),was designed and administered via street and online surveys from December 2023 to February 2024.Statistical analyses,including chi-square tests and logistic regression,were performed to identify determinant factors.Results A total of 303 valid questionnaires were retrieved,with an effective rate of approximately 94.7％.Community residents in Nanchang demonstrated a certain degree of understanding of the overview,prevention,diagno-sis,and treatment of influenza,although some gaps were identified.Univariate analysis revealed statistically significant differ-ences in influenza cognition scores among urban and rural residents(P＜0.05),residents with different educational levels(P＜0.05)and exposure levels to influenza education(P＜0.05).Multivariate regression analysis identified these as influencing fac-tors for influenza awareness.Conclusion Collaborative efforts from the government,individuals,and various societal sectors are essential to enhance the public's overall ability to prevent and control influenza.

Objective To investigate influenza awareness of community residents in Nanchang under routine epidemic management using the Knowledge-Attitude-Practice(KAP)framework.Methods A structured questionnaire,including four do-mains(disease overview,prevention,diagnosis,and treatment),was designed and administered via street and online surveys from December 2023 to February 2024.Statistical analyses,including chi-square tests and logistic regression,were performed to identify determinant factors.Results A total of 303 valid questionnaires were retrieved,with an effective rate of approximately 94.7％.Community residents in Nanchang demonstrated a certain degree of understanding of the overview,prevention,diagno-sis,and treatment of influenza,although some gaps were identified.Univariate analysis revealed statistically significant differ-ences in influenza cognition scores among urban and rural residents(P＜0.05),residents with different educational levels(P＜0.05)and exposure levels to influenza education(P＜0.05).Multivariate regression analysis identified these as influencing fac-tors for influenza awareness.Conclusion Collaborative efforts from the government,individuals,and various societal sectors are essential to enhance the public's overall ability to prevent and control influenza.

Objective:To explore the incidence and the risk factors of post-polypectomy bleeding and polyp recurrence after colonoscopic high-frequency electrocoagulation snare polypectomy.Methods:Clinical data of 1 826 children who underwent colonoscopic high-frequency electrocoagulation snare polypectomy in the Children′s Hospital, Zhejiang University School of Medicine from January 2009 to December 2020 was retrospectively analyzed. Demographic characteristics, endoscopic manifestations, pathological features, diagnosis, occurrence of post-polypectomy bleeding and polyp recurrence were collected. The associated risk factors were analyzed by Logistic regression.Results:A total of 1 826 children (1 191 males and 635 females) with 1 967 polypectomies were included. The age was 4.6 (3.2, 6.4) years at initial diagnosis. According to the initial colonoscopy, 1 611 children (88.2%) had solitary polyps, 1 707 children (93.5%) had pedicled polyps, 1 151 children (63.0%) had polyps involving the rectum, and 1 757 children (96.2%) had hamartomatous polyps. Polyposis syndromes were diagnosed in 73 children (4.0%). The post-polypectomy bleeding occurrence was 3.8% (75/1 967). Polyps recurred in 88 children (4.8%). Girls ( OR=2.01, 95% CI 1.26-3.23) and sessile polyps ( OR=2.28, 95% CI 1.15-4.49) were risk factors for post-polypectomy bleeding (both P<0.05). Multiple polyps ( OR=17.49, 95% CI 9.82-31.18), right-colon involvement ( OR=3.44, 95% CI 1.89-6.26) and non-hamartoma ( OR=2.51, 95% CI 1.04-6.07) were risk factors for polyp recurrence (all P<0.05). Conclusions:Colonoscopic high-frequency electrocoagulation snare polypectomy has low incidence of post-polypectomy bleeding and polyp recurrence. Female patients and sessile polyps have higher risk for post-polypectomy bleeding. Multiple polyps, right-colon involvement and non-hamartoma polyps increase the risk for polyp recurrence.

Objective:To observe the efficacy of maintenance treatment of thiopurines after exclusive enteral nutrition (EEN) therapy for Crohn′s disease (CD) children, and explore the influencing factors of recurrence.Methods:A retrospective case-control study was conducted. CD children treated in the Children′s Hospital of Zhejiang University School of Medicine from March 2013 to March 2021 were included retrospectively. Data before EEN were collected including general demographics, Paris classification, the pediatric Crohn′s disease activity index (PCDAI), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) and serum albumin levels. According to the recurrence at 1 year of follow-up, patients were divided into remission group and recurrence group. The differences in clinical data before EEN between the 2 groups were analyzed. The factors influencing the recurrence were analyzed.Results:Thirty-five children were enrolled, including 25 (71.4%) males and 10 (28.6%) females. The age at diagnose was (11.2 ± 3.1) years old and the disease duration was 3.5 (2.2, 6.9) months. After 1 year of follow-up, 15 children had recurrence at least for one time and were divided into the recurrence group. Twenty (57.1%) children continued to maintain 6-mercaptopurine (6-MP) monotherapy and were divided into the remission group. There was no significant differences in gender, diagnostic age, and CRP, ESR, serum albumin and PCDAI before EEN between the two groups (all P>0.05). There was significant difference in the percentage of patients with disease duration of longer than 1 year before EEN between the two groups ( P = 0.026) . Conclusions:The children with the disease duration of longer than 1 year before EEN may be in high risk of recurrence on the regimen of maintenance treatment of thiopurines after EEN.

Objective:To observe the efficacy of maintenance treatment of thiopurines after exclusive enteral nutrition (EEN) therapy for Crohn′s disease (CD) children, and explore the influencing factors of recurrence.Methods:A retrospective case-control study was conducted. CD children treated in the Children′s Hospital of Zhejiang University School of Medicine from March 2013 to March 2021 were included retrospectively. Data before EEN were collected including general demographics, Paris classification, the pediatric Crohn′s disease activity index (PCDAI), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) and serum albumin levels. According to the recurrence at 1 year of follow-up, patients were divided into remission group and recurrence group. The differences in clinical data before EEN between the 2 groups were analyzed. The factors influencing the recurrence were analyzed.Results:Thirty-five children were enrolled, including 25 (71.4%) males and 10 (28.6%) females. The age at diagnose was (11.2 ± 3.1) years old and the disease duration was 3.5 (2.2, 6.9) months. After 1 year of follow-up, 15 children had recurrence at least for one time and were divided into the recurrence group. Twenty (57.1%) children continued to maintain 6-mercaptopurine (6-MP) monotherapy and were divided into the remission group. There was no significant differences in gender, diagnostic age, and CRP, ESR, serum albumin and PCDAI before EEN between the two groups (all P>0.05). There was significant difference in the percentage of patients with disease duration of longer than 1 year before EEN between the two groups ( P = 0.026) . Conclusions:The children with the disease duration of longer than 1 year before EEN may be in high risk of recurrence on the regimen of maintenance treatment of thiopurines after EEN.

Objective: To explore the clinical features and complications of foreign bodies in the upper gastrointestinal tract in children and to investigate the effectiveness of endoscopic management. Methods: Data of patients with foreign bodies in upper gastrointestinal tract were collected retrospectively at Endoscopy Center, the Children's Hospital, Zhejiang University School of Medicine, from January 2011 to December 2016. Clinical characteristics, the types of foreign bodies, the location and duration of foreign body impaction were summarized. The risk factors of complications and endoscopic removal failure were analyzed by using Logistic regression analysis. Results: A total of 1 334 patients (825 males and 509 females) were enrolled. The median age was 2.5 years, with a range from 0.25 to 15 years and peak age 1-3 years. Twenty patients had esophageal diseases. The most common foreign body ingested was coin (n=964, 72.3%). Foreign bodies were most commonly located in the esophagus (n=1 002, 75.1%), especially in the upper esophagus (n=857, 85.5%). The duration of foreign body impaction ranged from 3 hours to 5 years. Among 1 334 patients, 252 patients (18.9%) developed complications, including ulcers (n=101, 40.0%) and perforations(n=13, 5.2%). The success rate of endoscopic removal was 96.6% (n=1 288). By Logistic regression analysis, sharp foreign body ingestion (OR=6.893, 95%CI: 4.421-10.746) , esophageal impaction (OR=5.253, 95%CI:3.352-8.233) and foreign body impaction longer than 24 hours (OR=4.336, 95%CI:3.091-6.082) were risk factors of complications. Sharp foreign body ingestion was the risk factor of endoscopic failure (OR=5.372, 95%CI:2.773-10.406) . Conclusions Coin is the most common foreign body in upper gastrointestinal tract. Sharp foreign bodies impacted in the esophagus over 24 hours increase the risk of complications. Endoscopic removal of foreign bodies from the upper gastrointestinal tract in children has a high success rate. Sharp foreign body ingestion increases the risk of failure in endoscopic removing.

Objective To explore the efficacy and safety of the application of enteral nutrition (EN) in gastrointestinal disease in children,and to explore the possibility of the implementation of family EN.Method Retrospective analysis of disease spectrum,EN approach,preparation,speed and time as well as adverse reactions and outcomes in 47 pediatric patients with gastrointestinal disease underwent EN therapy during July 2014 to March 2015.The nutrition indicators before and after EN therapy were compared by paired t-test.Result A total of 47 patients were selected,27 male (57％) and 20 female (43％),aged 0.8 (0.3,4.0) years,9 with mechanical or chemical damage to the esophagus,7 with inflammatory bowel disease (including ulcerative colitis and Crohn's disease),6 with chronic diarrhea,5 with acute pancreatitis,3 with acute diarrhea and severe malnutrition,3 with short bowel syndrome,3 with improper feeding,3 with feeding difficulties,3 with protein losing enteropathy,2 with post-enterostomy,2 with enterocolitis,1 with gastroesophageal reflux,were diagnosed.Of 47 cases,22 were given oral nutrition,28 were fed with nasogastric tube and 4 with nasojejunal tube feeding,2 with percutaneous endoscopic gastrojejunostomy tube feeding for each.In these tube-feeding cases,20 cases were treated with continuous infusion and 21 cases with intermittent infusion.Eleven cases were fed with amino acid formula;21 cases took the choice of peptide formulations;16 cases chose whole protein formula,including six cases who chose 3.3-4.2 kJ/ml higher energy density formula,10 cases selected common energy density formula including breast milk.Twenty-one cases suffered from different degrees of adverse reactions,including vomiting in 7 cases,abdominal pain and bloating in 3,diarrhea in 12,secondary respiratory infections in 5.Five patients were discharged after giving up of treatment by parents due to poor efficacy on primary disease;3 cases were transferred to other departments for further treatment;15 cases were discharged with a feeding tube for family nutrition and specialist out-patient treatment.The rest 24 cases were all improved and discharged.There were significant differences in nutrition indicators before and after EN,weight-for-age Z score (WAZ)(-2.3 ± 1.9 vs.-1.9 ± 1.8,t =4.156,P =0.000),weight-for-height Z score (WHZ) (-1.9 ± 1.7 vs.-1.2±1.5,t=3.714,P=0.001),albumin ((35 ±9)g/L vs.(39 ±6) g/L,t=3.017,P=0.005) and prealbumin ((0.11 ±0.05)g/L vs.(0.18 ±0.07)g/L,t=5.144,P=0.000).Conclusion EN is suitable for a variety of children's digestive diseases,which can improve the nutritional status of the patients and was safe for clinical application.As the implementation of EN is simple and has good compliance,family EN is proven to be feasible.

BACKGROUNDShang Ring male circumcision (MC) is a safe surgery with good short-term effects. This retrospective study was performed to investigate the long-term result of patients who had undergone Shang Ring MC.

METHODSA total of 103 patients who underwent the surgery were recruited in the study. Before and after the surgery, a questionnaire inquiring sexual function and sexual satisfaction was filled up. Face-to-face interview was executed. Physical examination of the external genitals was performed and complications were evaluated.

RESULTSThe median follow-up duration was 19.1 months (range from 9 to 28 months). The mean width of penile mucosa was (9.3 ± 2.5) mm. The mean width of scar was (3.7 ± 1.6) mm. No tender pain was found in participants when palpating the penis. No significant or functional complication was observed except of mucosa asymmetry in one case and scar hyperplasia in two cases. The postoperative sexual function did not differ from the preoperative one, although partners showed better satisfaction toward sexual life.

CONCLUSIONShang Ring MC represents a good long-term cosmetic result with no significant complication or adverse effects on sexual function.

Adult ; Cicatrix ; diagnosis ; Circumcision, Male ; Follow-Up Studies ; Humans ; Male ; Retrospective Studies ; Sexual Behavior ; physiology ; Surveys and Questionnaires ; Young Adult

Objective To compare the efficacy and complications of Chinese Shang Ring circumcision with conventional circumcisiom Methods Clinical data of 479 cases of Chinese Shang Ring circumcision and 354 cases of conventional circumcision with complete follow-up were analyzed.Comparisons were made between the two groups on operation time,pain score,blood loss,postoperative complications,postoperative satisfaction with penile appearance,wound healing time and treatment costs. Results There was no statistical difference in age and foreskin status between the two groups (P＞0.05).For the Shang Ring group,the operation time was(5±1)rain,blood loss was (0.98±1.14)ml,pain score during operation was 0.25±0.54,24-hour pain score after operation was 1.63±0.87,the postoperative complication rate was 6.89% (33/479),wound healing time was (20±5)d,the satisfaction rate of appearance was 99.79% (478/479),and treatment cost was (871±52) yuan.For the conventional group,the operation time was (27±5) min,blood loss was (8.30±3.60)ml,pain score during operation was 3.29±1.57,24-hour pain score after operation was 5.56±1.42,the postoperative complication rate was 13.28%(47/354),wound healing time was (13±2)d,satisfaction rate of appearance was 92.37% (327/354),and treatment cost was (554±46) yuan.Compared with the conventional group,the Shang Ring group had a shorter operation time,less blood loss,less pain score,higher appearance satisfaction rate and a lower complication rate (P＜0.05).But wound healing time was longer and treatment cost was higher in the Shang Ring group (P＜0.05). Conclusions Chinese Shang Ring circumcision is simpler and an improved approach over conventional circumeision with shorter operative time,less blood loss,less pain,relatively lower complication rate and higher satisfaction and acceptability.