Objective:To analyze the pneumococcal vaccination rate and the influencing factors among residents aged≥50 in Zhejiang Province.Methods:This cross-sectional study was conducted between March and May 2024. A multi-stage intercept survey was used to intercept and survey 10 500 residents who visited or underwent physical examinations at 175 community health service centers/clinics in 35 counties (cities, districts) of Zhejiang Province. The questionnaire included basic demographic characteristics, history of pneumonia, chronic disease conditions, pneumococcal vaccination status, doctor recommendation, reasons for vaccination/non-vaccination, and channels for obtaining pneumococcal vaccine information. Participants were grouped based on demographic characteristics, chronic diseases conditions, history of pneumonia and doctor recommendations. The chi-square test was used to assess differences in vaccination rates among demographic groups while binary logistic regression models were used to identify factors affecting the vaccination rate.Results:Among the 10 500 surveyed participants, 1 724 (16.42%) had received pneumococcal vaccination. Binary logistic regression analysis revealed significantly higher vaccination rates among those who received a doctor recommendation compared to those without (26.25% vs 7.59%; OR=4.414, 95% CI: 3.851-5.059). Participants benefiting from the free vaccination policy showed higher vaccination rates than those who didn′t (47.59% vs 5.18%; OR=12.527, 95% CI: 10.723-14.634). The top three reasons for getting vaccinated against pneumonia were the free vaccination policy (65.43%), community promotion (52.15%), and family recommendations (42.34%). The top three sources through which respondents learned about the pneumococcal vaccine were television (64.64%), doctors (59.81%) and family members (50.92%). Conclusion:The pneumococcal vaccination rate among residents aged≥50 years in Zhejiang Province is relatively high but still needs further improvement, with vaccination rates closely associated with factors such as free vaccination policy and doctor recommendation.

Objective To develop a refined management model for operating rooms and assess its clinical impact on op-erational efficiency and cost control.Methods The study included 10,728 elective surgeries from January to June 2024 as the study group and 9 414 elective surgeries from January to June 2023 as the control group.The differences in operational metrics before and after implementing the refined management model were compared.The model was developed through comprehensive management by hospital leadership and multi-department collaboration,focusing on management structure,systems,processes,information technology,and resource allocation.Results In terms of efficiency,the on-time start rate of the first surgeries in the study group was significantly higher than in the control group(P＜0.05).The turnover time between surgeries was shorter in the study group(P＜0.01),and the rate of unexpected surgery cancellations was lower(P＜0.01).The average cost per surgery for consumables,excluding the impact of centralized procurement of consumables,was approximately 971 yuan,representing an 11% reduction compared to the previous year,despite a 14% increase in surgical volume.The average daily operating cost per operating room was about 12 303 yuan,a 7% reduction.Economic benefits increased by 8.43 million yuan,a 38% year-on-year increase.Conclusion Implementing a refined management model in operating rooms can significantly enhance efficiency,re-duce costs,and achieve dual improvements in social and economic benefits.

Objective To develop a refined management model for operating rooms and assess its clinical impact on op-erational efficiency and cost control.Methods The study included 10,728 elective surgeries from January to June 2024 as the study group and 9 414 elective surgeries from January to June 2023 as the control group.The differences in operational metrics before and after implementing the refined management model were compared.The model was developed through comprehensive management by hospital leadership and multi-department collaboration,focusing on management structure,systems,processes,information technology,and resource allocation.Results In terms of efficiency,the on-time start rate of the first surgeries in the study group was significantly higher than in the control group(P＜0.05).The turnover time between surgeries was shorter in the study group(P＜0.01),and the rate of unexpected surgery cancellations was lower(P＜0.01).The average cost per surgery for consumables,excluding the impact of centralized procurement of consumables,was approximately 971 yuan,representing an 11% reduction compared to the previous year,despite a 14% increase in surgical volume.The average daily operating cost per operating room was about 12 303 yuan,a 7% reduction.Economic benefits increased by 8.43 million yuan,a 38% year-on-year increase.Conclusion Implementing a refined management model in operating rooms can significantly enhance efficiency,re-duce costs,and achieve dual improvements in social and economic benefits.

Objective:To analyze the pneumococcal vaccination rate and the influencing factors among residents aged≥50 in Zhejiang Province.Methods:This cross-sectional study was conducted between March and May 2024. A multi-stage intercept survey was used to intercept and survey 10 500 residents who visited or underwent physical examinations at 175 community health service centers/clinics in 35 counties (cities, districts) of Zhejiang Province. The questionnaire included basic demographic characteristics, history of pneumonia, chronic disease conditions, pneumococcal vaccination status, doctor recommendation, reasons for vaccination/non-vaccination, and channels for obtaining pneumococcal vaccine information. Participants were grouped based on demographic characteristics, chronic diseases conditions, history of pneumonia and doctor recommendations. The chi-square test was used to assess differences in vaccination rates among demographic groups while binary logistic regression models were used to identify factors affecting the vaccination rate.Results:Among the 10 500 surveyed participants, 1 724 (16.42%) had received pneumococcal vaccination. Binary logistic regression analysis revealed significantly higher vaccination rates among those who received a doctor recommendation compared to those without (26.25% vs 7.59%; OR=4.414, 95% CI: 3.851-5.059). Participants benefiting from the free vaccination policy showed higher vaccination rates than those who didn′t (47.59% vs 5.18%; OR=12.527, 95% CI: 10.723-14.634). The top three reasons for getting vaccinated against pneumonia were the free vaccination policy (65.43%), community promotion (52.15%), and family recommendations (42.34%). The top three sources through which respondents learned about the pneumococcal vaccine were television (64.64%), doctors (59.81%) and family members (50.92%). Conclusion:The pneumococcal vaccination rate among residents aged≥50 years in Zhejiang Province is relatively high but still needs further improvement, with vaccination rates closely associated with factors such as free vaccination policy and doctor recommendation.

Nonalcoholic fatty liver disease (NAFLD) is a typical chronic liver disease closely associated with gut dysbiosis, and dietary factor may be the most important driving factor affecting the composition and function of intestinal bacteria. Based on the concept of enterotype, this article summarizes the effect of diet on enterotype-related gut microbiota in NAFLD, including Firmicutes/Bacteroidetes ratio, Bacteroides, Prevotella, Ruminococcus, Proteobacteria, Actinobacteria, and other bacteria. It is pointed out that improving diet to regulate gut microbiota is one of the important strategies for the prevention and treatment of NAFLD and has a good prospect, which needs further mechanism and clinical research.

Objective:To explore the effect of unplanned removal of elastic bandages on patients after transfemoral artery puncture digital subtraction angiography (DSA) .Methods:The cluster sampling method was used to select 1 051 patients who underwent DSA examination by femoral artery puncture in the Second Ward of Department of Neurology in the First Medical Center of Chinese PLA General Hospital from January to December 2019. According to whether unplanned removal of elastic bandage occurred after operation, they were divided into the control group (943 cases) and the observation group (108 cases) . Patients in the control group received routine care after neurological intervention, and the elastic bandage was removed after lying still for 24 hours. In the observation group, the bandage was removed before being in bed for 24 hours after the operation. The reasons included the patients' strong request to go to the toilet to defecate after the operation, the need to go out for examination, severe skin allergies, poor patient compliance and random limb movement at the puncture side. The incidence of postoperative complications such as bleeding and congestion at the puncture site and the comfort level of the patients were compared between the two groups.Results:There was no statistically significant difference in the incidence of complications such as blood oozing and congestion at the puncture site in patients between the two groups ( P>0.05) . The incidence of lower back pain in the observation group was lower than that in the control group, and the quality of sleep was better than that of the control group, and the differences were statistically significant ( P<0.05) . There was no statistically significant difference in the incidence of postoperative dysuria in patients between the two groups ( P>0.05) . Conclusions:After transfemoral artery puncture DSA, the removal of elastic bandages for less than 24 hours in bed will not increase the incidence of postoperative complications. At the same time, it can alleviate lower back pain of patients, improve their sleep quality and increase their comfort.

Objective Through analyzing the surveillance data on typhoid fever and paratyphoid fever in 2015 to understand the related epidemiological features and most possible clustering areas of high incidence.Methods Individual data was collected from the passive surveillance program and analyzed by descriptive statistic method.Characteristics on seasonal,regional and distribution of the diseases were described.Spatial-temporal clustering characteristics were estimated,under the retrospective space-time method.Results A total of 8 850 typhoid fever cases were reported from the surveillance system,with incidence rate as 0.65/100 000.The number of paratyphoid fever cases was 2 794,with incidence rate as 0.21/100 000.Both cases of typhoid fever and paratyphoid fever occurred all year round,with high epidemic season from May to October.Most cases involved farmers (39.68％),children (15.89％) and students (12.01％).Children under 5 years showed the highest incidence rate.Retrospective space-time analysis for provinces with high incidence rates would include Yurnan,Guangxi,Guizhou,Hunan and Guangdong,indicating the first and second class clusters were mainly distributed near the bordering adjacent districts and counties among the provinces.Conclusion In 2015,the prevalence rates of typhoid fever and paratyphoid fever were low,however with regional high prevalence areas.Cross regional transmission existed among provinces with high incidence rates which might be responsible for the clusters to appear in these areas.

Objective To describe the prevalence of tobacco use among teenagers in different populations by sex and grades at school,and to provide evidence for the development of smoking control and health promotion programs.Methods A total of 4 797 teenagers selected from 36 schools through stratified multi-stage cluster sampling in Zhejiang province and were surveyed by using a questionnaire with 3 886 eligible ones for analysis.Indicators as tried smoking,current smoking,and secondhand smoke exposure,etc.,were calculated by weight on age proportions from the numbers of juniors in Zhejiang province.Results Prevalence rates of tried smoking and current smoking among teenagers were 10.91％ and 2.07％,respectively.7.72％ of the juniors were susceptible to future tobacco use.The prevalence rates of tried smoking were 15.65％ for boys and 5.58％ for girls,12.13％ in rural and 9.24％ in urban areas.Students from the 9th grade showed the highest rate (15.15％) while the 7th graders appeared the lowest level of susceptibility to future tobacco use (5.22％).The highest level of current smoking was seen in the group of "weekly allowance more than 30 Yuan,from parents"(4.07％).The prevalence of secondhand exposure to smoke in outdoor and indoor places,public transport,or at home were 57.60％,54.45％,46.97％,and 43.16％,respectively,among the teenagers.3 071 juniors (77.33％) saw the smoking scenes in the past 30 days but only 1 367 juniors (28.30％) were aware of the basic knowledge on tobaccos in class,in the past 12 months.Conclusions There were juniors who tried to smoke or were current smokers.The rate of secondhand exposure to smoking was high.A large number of the juniors were lack of education on knowledge related to tobacco control,in the classroom.It was important to promote and publicize the knowledge on tobacco so as to reduce the number of teenagers who were susceptible to future tobacco use.

This study investigated the effect of prolonged walking with load carriage on body posture, muscle fatigue, heart rate and blood pressure of the tested subjects. Ten healthy volunteers performed 30 min walking trials on treadmill (speed = 1.1 m/s) with different backpack loads [0% body weight (BW), 10% BW, 15% BW and 20% BW]. The change of body posture, muscle fatigue, heart rate and blood pressure before and after walking and the recovery of muscle fatigue during the rest time (0, 5, 10 and 15 min) were collected using the Bortec AMT-8 and the NDI Optotrak Certus. Results showed that the forward trunk and head angle, muscle fatigue, heart rate and blood pressure increased with the increasing backpack loads and bearing time. With the 20% BW load, the forward angle, muscle fatigue and systolic pressure were significantly higher than with lighter weights. No significantly increased heart rate and diastolic pressure were found. Decreased muscle fatigue was found after removing the backpack in each load trial. But the recovery of the person with 20% BW load was slower than that of 0% BW, 10% BW and 15% BW. These findings indicated that the upper limit of backpack loads for college-aged students should be between 15% BW and 20% BW according to muscle fatigue and forward angle. It is suggested that backpack loads should be restricted to no more than 15% BW for walks of up to 30 min duration to avoid irreversible muscle fatigue.
Blood Pressure ; Body Weight ; Exercise Test ; Healthy Volunteers ; Heart Rate ; Humans ; Muscle Fatigue ; Posture ; Walking ; physiology ; Weight-Bearing

Objective To describe the prevalence rates of smoking,quitting and passive smoking in different populations on their status of education,occupation and geographic distribution.Methods A total of 13 408 residents aged 15-69 from 45 counties through stratified multi-stage cluster sampling from Zhejiang province were selected and surveyed,using questionnaires.Data from 13 326 subjects were used for analysis.Indicators as smoking,current smoking,and secondhand smoke exposure,etc.,were calculated by weight on age proportions from the 2010 census.Results Among the adults aged 15 years and older,there were an estimated number of 12.90 million (29.59％) smokers,with 9.99 million (22.92％) current smokers,8.45 million (19.38％) daily current smokers.The prevalence rates of smoking were 41.18％ for men,3.69％ for women,with 45-54 year-old group the highest (51.66％) for men while the group of 65-69 year-olds was the highest (4.62％) in women.The overall rate of quitting was 22.56％.40.19％ of the smokers had thought about quitting,with the main means as self-restriction (87.59％) in conducting the behavior of smoking cessation.Among those non-smokers at age 15 or older,it was estimated that 67.90％ (22.77 million) of them had been exposed to secondhand smoke.SHS exposure was the highest in the indoor workplace (62.84％),among all the venues.Knowledge on tobacco among residents seemed to be relatively poor,with only 31.52％ of the population were aware that smoking could cause serious three diseases (stoke,heart disease,and lung cancer).34.04％ of the population were aware that secondhand smoking could cause all the three diseases (heart disease,lung disease,and lung cancer).Conclusion Current prevalence of smoking in males in Zhejiang province remained at a high level,indicating that the publicity programs on the knowledge of smoking tobacco was not strong enough and the task of control smoking should be taken more arduously.