Objective: To understand the status of childcare center disinfection around the COVID-19 pandemic, the needs of professional technical support, so as to give advice for improvement measures. Methods: Using multi stage stratified sampling method, one was selected from each area of northern and southern Anhui Province, with 3 counties/districts selected from each city. A total of 54, 58, 60 childcare institutions were selected. A questionnaire survey, as well as on site visits and data check were administered in these childcare centers in Anhui Province were implemented. Information regarding the three stage disinfection work from 2019 to 2022 and technical support needs were collected. Results: A total of 54, 58, 60 childcare centers were investigated in 2019, 2020 and 2021-2022. Most of the childcare centers recorded disinfection work (96.3%, 96.6%, 98.3%), while few of them ( 26.4% , 26.3%, 58.3%) monitored disinfection factor intensity. The implementing rate of disinfection effect evaluation was 68.3% at the stage of normal prevention and control, the highest demand rate for professional technical support was guidance and training ( 95.0% ), and the highest demand rate for training content was disinfectant preparation method (81.7%). There were significant differences in the rate of disinfection tableware room allocation (A: 93.3%, B: 70.0%), and the rate of disinfection effect evaluation among different cities (A: 53.3%, B: 83.3%)( χ 2=6.24, 5.46, P <0.05). Conclusions From 2019 to 2022, childcare center disinfection has significantly improved, however, disinfection factor intensity monitoring and disinfection effect evaluation are neglected during the stage of normal prevention and control. The demand for professional technical institutions to provide disinfectant preparation method guidance and training is high.It is suggested to strengthen the monitoring and evaluation of disinfection and related technical guidance.

Objective:To investigate Helicobactor pylori (H. pylori) infection status and interfamilial transmission pattern in Zhengzhou area. Methods:A cross-sectional study was conducted from September 2020 to march 2021, among 731 individual from 266 families randomly selected from 9 communities of Zhengzhou area. H. pylori infection status was determined by serum antibody tests, and 13C-urea breath test was performed in the previously eradicated population to clarify the current infection status. The individual and familial infection rate, infection status for couples and children and adolescent were analyzed. Results:Among 731 individuals from 266 families, 397 of them were H. pylori positive. The individual infection rate was 54.31% (397/731); among infected individuals 77.83% (307/397) were infected with type Ⅰ strain, 22.67% (90/397) were infected by type Ⅱ strain. Annual household income ( χ2=0.419, 0.410, 0.213, all P>0.05), smoking history (χ 2=0.071, P>0.05), drinking history ( χ2=0.071, P>0.05), dining place ( χ2=0.009, P>0.05), gastrointestinal symptoms ( χ2=0.047, P>0.05), family history of gastric disease ( χ2=0.069, P>0.05), and history of gastric cancer ( χ2=0.004, P>0.05) had no significant differences between H. pylori-positive and -negative groups, but the infection rate in individuals with higher education level was lower ( χ2=4.449, P<0.05). The infection rate was significantly higher in≥18 age groups compared with<18 age groups ( χ2=6.531, 23.362, 20.671, 24.244, 37.948, 14.597 and 5.170, all P<0.05). The familial H. pylori infection rate was 87.59% (233/266), and in 61 families all member were infected (26.18%, 61/233). The positive rate was 23.08% (6/26) in 50 families with children under 18 years when both parents were infected. Among 231 coupled families, both couples were infected in 78 families (33.76%), one couple was infected in 113 families (48.92%), and both couples were not infected in 40 (17.32%). With the increase of marriage time, the infection rate of both spouses increased significantly ( χ2=7.775, 12.662, 15.487, all P<0.05). Conclusions:The distribution of H. pylori infection presents a family cluster pattern, and intrafamilial infection is an important transmission rout of H. pylori. The type I strain of H. pylori is the dominate strain in this area.

Objective To investigate the levels and clinical significance of homocysteine (Hcy) and neutrophil-to-lymphocyte ratio (NLR) in patients with nonalcoholic fatty liver disease (NAFLD) and type 2 diabetes mellitus (T2DM). Methods A total of 528 patients with NAFLD who were treated in Department of Endocrinology, The First Affiliated Hospital of Jinzhou Medical University, from January to December 2019 were enrolled, and according to the presence or absence of T2DM, they were divided into non-T2DM group and T2DM group. A total of 79 T2DM patients without NAFLD were selected randomly. General data and laboratory markers were recorded for the three groups. A one-way analysis of variance was used for comparison of normally distributed continuous data between groups, and the chi-square test was used for comparison of categorical data between groups; a binary logistic regression analysis was used to determine risk factors, and odds ratio ( OR ) and its 95% confidence interval ( CI ) were used to represent relative risk; the receiver operating characteristic (ROC) curve was used to evaluate predictive efficiency. Results The T2DM group had significantly higher systolic blood pressure (SBP), diastolic blood pressure, and body mass index than the non-T2DM group (all P < 0.05), and there were significant differences between any two of the three groups in Hcy, NLR, alanine aminotransferase, aspartate aminotransferase, gamma-glutamyl transpeptidase, uric acid, and fasting blood glucose (all P < 0.05). There were significant differences in neutrophil count, lymphocyte count, and high-density lipoprotein cholesterol (HDL-C) between the T2DM group and the non-T2DM group (all P < 0.05), and there was a significant difference in total cholesterol between the T2DM group and the simple T2DM group and between the non-T2DM group and the simple T2DM group ( P < 0.05). SBP ( O R =1.040, 95% C I : 1.015-1.065), HDL-C ( OR =0.040, 95% CI : 0.007-0.228), NLR ( OR =6.285, 95% C I : 1.504-27.108), and Hcy ( O R =1.291, 95% C I : 1.127-1.423) were independent risk factors for NAFLD with T2DM. Hcy had an area under the ROC curve (AUC) of 0.741 (95% CI : 0.698-0.783, P < 0.01) in predicting NAFLD with T2DM, with a Youden index of 0.394, a sensitivity of 69.6%, and a specificity of 69.8% at the optimal cut-off value of 15.31 μmol/L. NLR had an AUC of 0.782 (95% C I : 0.744-0.820, P < 0.01) in predicting NAFLD with T2DM, with a Youden index of 0.443, a sensitivity of 72.1%, and a specificity of 72.2% at the optimal cut-off value of 2.12. Hcy combined with NLR had an AUC of 0.845 (95% C I : 0.812-0.878, P < 0.01) in predicting NAFLD with T2DM, with a Youden index of 0.549, a sensitivity of 71.8%, and a specificity of 83.1%. Conclusion Hcy and NLR are risk factors for NAFLD with T2DM and have a certain predictive value. Combined measurement of Hcy and NLR can improve the diagnostic efficiency of NAFLD with T2DM and help clinicians with diagnosis in the early stage.

Objective:To investigate clinical manifestations and dermoscopic characteristics of lichen planus-like keratosis (LPLK) .Methods:Clinical data were collected from 21 patients with LPLK who visited Shanghai Skin Disease Hospital and underwent both dermoscopic and histopathological examinations from January 2017 to September 2019, and clinical and dermoscopic features were retrospectively analyzed.Results:These patients were aged 64.69 ± 13.29 years, and the ratio of males to females was 1∶2. Skin lesions were located on the face of 18 cases and legs of 3 cases, and were red/violaceous in color in 7 cases, reddish-brown in 5, brown/gray in 8, and brown/reddish in 1. There were 3 types of skin lesions, including plaque-like type in 10 cases, flat pigmented patch type in 6, and flat erythema-like type in 5. As dermoscopy showed, 12 cases were non-pigmented LPLK, and 9 were pigmented LPLK. Pigment granules were found in 13 lesions, and there was no significant difference in the prevalence of pigment granules between pigmented and non-pigmented LPLK ( P=0.07) ; pigment granules were often diffusely distributed (9/13) , and the diffuse distribution pattern was common paticularly in pigmented LPLK (8/9) ; locally distributed pigment granules were found in 4 cases of non-pigmented LPLK. Coarse pigment granules were seen in 10 cases (10/13) , including 8 of pigmented LPLK and 2 of non-pigmented LPLK, and the prevalence rate of coarse pigment granules significantly differed between the pigmented LPLK and non-pigmented LPLK groups ( P=0.002) . Moreover, special distribution patterns of pigment granules included the annular granular pattern (8/13) and peppered pattern (7/13) , and no significant difference was observed in the prevalence of the 2 special distribution patterns between the pigmented LPLK and non-pigmented LPLK groups (both P > 0.05) . Scales were seen in 13 cases (13/21) , and vascular structures in 7 (7/21) , and there was no significant difference in the prevalence of the 2 structures between the pigmented and non-pigmented LPLK groups ( P=0.67, 0.16, respectively) . Conclusions:LPLK mostly occurs on the face, and manifests as solitary red, reddish-brown or brownish-gray plaques or patches, whose surfaces may be covered with scales. The characteristic dermoscopic feature of LPLK is the presence of pigment granules, which are coarse, often diffusely distributed, and commonly observed in pigmented LPLK.