Objective: To investigate the availability and use of child safety seats among children aged 0-3 years, so as to provide the basis for improving riding safety for children. Methods: Parents of children aged 0-3 years in Huangpu District, Shanghai Municipality, were recruited using the stratified multistage random sampling method from May to July 2024. Demographic information, family travel patterns, the use of child safety seat and related health beliefs were collected using questionnaire surveys. Factors affecting the use of child safety seats were identified using a multivariable logistic regression model. Results: Totally 514 valid questionnaires were recovered, with an effective rate of 96.98%. The respondents included 122 fathers (23.74%) and 392 mothers (76.26%), with a median age of 34.00 (interquartile range, 5.00) years. There were 446 families equipping with child safety seats, accounting for 86.77%; and 169 families using child safety seats, accounting for 32.88%. Multivariable logistic regression analysis showed that the parents who had children aged >1-2 years (OR=0.597, 95%CI: 0.366-0.973), travelled 2-4 times per month (OR=0.359, 95%CI: 0.213-0.607) or once per month or less (OR=0.384, 95%CI: 0.202-0.729), and scored high in perceived barrier (OR=0.634, 95%CI: 0.486-0.827) were less likely to use child safety seats; the parents who had children with local household registration (OR=2.506, 95%CI: 1.356-4.633), travelled 5-<10 km (OR=1.887, 95%CI: 1.148-3.101) or ≥10 km (OR=2.319, 95%CI: 1.355-3.967), always wore seat belts (OR=2.342, 95%CI: 1.212-4.524), scored high in perceived susceptibility (OR=1.392, 95%CI: 1.091-1.778) and self-efficacy (OR=1.413, 95%CI: 1.156-1.727) were more likely to use child safety seats. Conclusions Equipping family cars with child safety seats and using them can prevent and reduce traffic injuries among children aged 0-3 years. It is recommended to strengthen publicity to promote the use of child safety seats.

Objective:To investigate the relationship between symptoms of vertigo and vestibular functions and short-term hearing outcomes in patients with flat descending sudden sensorineural hearing loss （SSNHL）. Methods:A retrospective review was conducted of the vestibular symptoms observed in 48 patients with unilateral flat-down sudden sensorineural hearing loss treated at the Department of Otolaryngology Head and Neck Surgery, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine. Symptoms of vertigo and the results of cervical vestibular-evoked myogenic potentials （cVEMP）, ocular VEMP （oVEMP）, caloric test and video head-impulse test （vHIT） were collected to determine whether these factors could predict therapeutic efficacy. Results:The symptoms of vertigo was not correlated with prognosis （P>0.05） or with abnormal vestibular functions （P>0.05）. Patients with abnormal cVEMP, oVEMP, caloric test or vHIT showed significantly lower effective rates （32.0%, 44.0%, 32.0%, and 24.0%, respectively）; the greater the number of abnormal tests, the poorer the outcome. Patients with all four tests abnormal gained only （3.13±15.97） dB HL in hearing recovery, whereas those with normal cVEMP, oVEMP, caloric test or vHIT showed better chances of hearing improvements by （29.22±20.31）, （31.18±21.59）, （26.17±21.31）, and （26.38±24.05） dB HL, respectively. Conclusion:Vestibular function effectively predicts prognosis in flat descending SSNHL. Patients with abnormal vestibular tests, regardless of symptoms of vertigo, responded poorly to treatment, whereas those with normal cVEMP, oVEMP, caloric test and vHIT results achieved better hearing recovery. Abnormal vestibular function implies more extensive and severe inner-ear lesions in patients with SSNHL.
Humans ; Male ; Female ; Retrospective Studies ; Prognosis ; Adult ; Middle Aged ; Vertigo/diagnosis* ; Hearing Loss, Sensorineural/diagnosis* ; Young Adult ; Hearing Loss, Sudden/diagnosis* ; Adolescent ; Aged ; Vestibular Evoked Myogenic Potentials

Objective To investigate the proactive coping of schizophrenia patients with auditory hallucinations and to analyze its influencing factors.Methods A total of 240 schizophrenia patients with auditory hallucinations hospitalized in Shandong Mental Health Center from February to October 2023 were selected as subjects.General information questionnaire,simplified coping style questionnaire,perceived social support scale,insight and treatment attitude questionnaire were used to conduct the survey.Results A total of 236 valid questionnaires were collected,and effective questionnaire response rate was 98.33％.The proactive coping score of schizophrenia patients with auditory hallucinations was(18.55±7.74)points,which was at a moderate level.The results of multiple linear regression analysis showed that education level,perceived of social support,and self-awareness were the influencing factors of proactive coping to schizophrenia patients with auditory hallucinations(P＜0.05).Conclusion The proactive coping of schizophrenia patients with auditory hallucinations needs to be further improved,and nursing staff can focus on patients with low education level,low ability to perceive social support and poor self-awareness,and formulate targeted interventions to improve their proactive coping to auditory hallucinations.

Objective To explore and analyze the application effect of enzymatic debridement combined with traditional Chinese medicine fumigation-sitting bath therapy on postoperative wounds of perianal abscess.Methods Eighty patients with simple perianal abscess were randomly divided into observation group(enzymatic debridement+traditional Chinese medicine fumigation-washing)and control group(potassium permanganate sitting bath+conventional debridement),with 40 cases in each group.The white blood cell(WBC)count,C-reactive protein(CRP)levels,wound healing rate,Visual Analogue Scale(VAS)pain score,and wound-related symptoms were observed in both groups after surgery.Results WBC and CRP levels in the observation group were lower than those in the control group.The observation group showed superior results compared to the control group in terms of wound pain,edema,exudation,and wound healing rate.Additionally,the improvement in wound area,healing time,and longitudinal wound diameter in the observation group was significantly better than that in the control group(P＜0.05).Conclusion Enzymatic debridement combined with traditional Chinese medicine fumigation-washing can accelerate wound healing,alleviate pain and inflammatory responses after perianal abscess surgery,showing superior efficacy compared to traditional methods.

Objective To explore the influence of different doses of remimazolam for general anesthesia induction on tracheal intubation stress response and hemodynamics in patients undergoing radical resection of colon cancer.Methods From August 2020 to August 2023,75 patients undergoing radical resection of colon cancer were induced by general anesthesia using remazolam.According to the random number table method,they were divided into group A(25 cases,0.2 mg/kg of remimazolam),group B(25 cases,0.3 mg/kg of remimazolam)and group C(25 cases,0.4 mg/kg of remimazolam).The stress response status[cortisol(Cor),epinephrine(E),norepinephrine(NE)]and hemodynamics[heart rate(HR),mean arterial pressure(MAP)]before anesthesia(T0),at tracheal intubation(T1),at 30 min after intubation(T2)and at 10 min after extubation(T3),anesthesia recovery status and total incidence rate of adverse anesthesia reactions were compared among the three groups.Results At T0,there were no obvious differences in the levels of Cor,E,NE,HR,SVI and MAP among the three groups(P＞0.05).At T1-T3,the levels of Cor,E and NE in group A[T1:(181.76±12.49)pg/ml,(67.94±2.66)ng/ml,(355.12±19.82)ng/ml;(231.90±15.82)pg/ml,(72.15±2.83)ng/ml,(379.86±20.31)ng/ml;T3:(300.65±17.43)pg/ml,(77.82±2.85)ng/ml,(405.31±24.36)ng/ml]were higher than those in group B[T1:(172.31±12.07)pg/ml,(66.22±2.73)ng/ml,(326.47±19.24)ng/ml;T2:(214.75±14.88)pg/ml,(70.34±2.79)ng/ml,(354.18±20.66)ng/ml;T3:(279.08±16.62)pg/ml,(75.03±2.81)ng/ml,(387.05±22.82)ng/ml]and group C[T1:(165.44±11.74)pg/ml,(64.01±2.75)ng/ml,(300.66±19.50)ng/ml;T2:(200.42±14.35)pg/ml,(67.59±2.80)ng/ml,(330.18±21.05)ng/ml;T3:(251.33±16.08)pg/ml,(72.44±2.70)ng/ml,(354.11±22.07)ng/ml](P＜0.05).At T1-T2,the HR and MAP were higher in group A[T1:(79.49±4.05)beats/min,(96.09±1.77)mmHg;T2:(76.55±3.83)beats/min,(94.88±1.55)mmHg]than those in group B[T1:(76.22±3.89)beats/min,(95.01±1.63)mmHg;T2:(74.23±3.76)beats/min,(93.89±1.51)mmHg]and group C[T1:(73.65±3.81)beats/min,(94.02±1.61)mmHg;T2:(71.55±3.61)beats/min,(92.97±1.46)mmHg](P＜0.05).There were no significant differences in HR and MAP among the three groups at T3(P＞0.05).The time of breathing recovery,open eye and extubation in group C was significantly longer compared with that in group A and group B(P＜0.05).There were no significant difference in total incidence rate of anesthesia adverse reactions between group B and group A,group C(P＞0.05).Conclusion 0.3 mg/kg remimazolam in patients undergoing radical resection of colon cancer has an ideal sedative effect,and it has small impact on stress response and hemodynamics,and has fast postoperative recovery and high safety.

Objective To explore the influence of different doses of remimazolam for general anesthesia induction on tracheal intubation stress response and hemodynamics in patients undergoing radical resection of colon cancer.Methods From August 2020 to August 2023,75 patients undergoing radical resection of colon cancer were induced by general anesthesia using remazolam.According to the random number table method,they were divided into group A(25 cases,0.2 mg/kg of remimazolam),group B(25 cases,0.3 mg/kg of remimazolam)and group C(25 cases,0.4 mg/kg of remimazolam).The stress response status[cortisol(Cor),epinephrine(E),norepinephrine(NE)]and hemodynamics[heart rate(HR),mean arterial pressure(MAP)]before anesthesia(T0),at tracheal intubation(T1),at 30 min after intubation(T2)and at 10 min after extubation(T3),anesthesia recovery status and total incidence rate of adverse anesthesia reactions were compared among the three groups.Results At T0,there were no obvious differences in the levels of Cor,E,NE,HR,SVI and MAP among the three groups(P＞0.05).At T1-T3,the levels of Cor,E and NE in group A[T1:(181.76±12.49)pg/ml,(67.94±2.66)ng/ml,(355.12±19.82)ng/ml;(231.90±15.82)pg/ml,(72.15±2.83)ng/ml,(379.86±20.31)ng/ml;T3:(300.65±17.43)pg/ml,(77.82±2.85)ng/ml,(405.31±24.36)ng/ml]were higher than those in group B[T1:(172.31±12.07)pg/ml,(66.22±2.73)ng/ml,(326.47±19.24)ng/ml;T2:(214.75±14.88)pg/ml,(70.34±2.79)ng/ml,(354.18±20.66)ng/ml;T3:(279.08±16.62)pg/ml,(75.03±2.81)ng/ml,(387.05±22.82)ng/ml]and group C[T1:(165.44±11.74)pg/ml,(64.01±2.75)ng/ml,(300.66±19.50)ng/ml;T2:(200.42±14.35)pg/ml,(67.59±2.80)ng/ml,(330.18±21.05)ng/ml;T3:(251.33±16.08)pg/ml,(72.44±2.70)ng/ml,(354.11±22.07)ng/ml](P＜0.05).At T1-T2,the HR and MAP were higher in group A[T1:(79.49±4.05)beats/min,(96.09±1.77)mmHg;T2:(76.55±3.83)beats/min,(94.88±1.55)mmHg]than those in group B[T1:(76.22±3.89)beats/min,(95.01±1.63)mmHg;T2:(74.23±3.76)beats/min,(93.89±1.51)mmHg]and group C[T1:(73.65±3.81)beats/min,(94.02±1.61)mmHg;T2:(71.55±3.61)beats/min,(92.97±1.46)mmHg](P＜0.05).There were no significant differences in HR and MAP among the three groups at T3(P＞0.05).The time of breathing recovery,open eye and extubation in group C was significantly longer compared with that in group A and group B(P＜0.05).There were no significant difference in total incidence rate of anesthesia adverse reactions between group B and group A,group C(P＞0.05).Conclusion 0.3 mg/kg remimazolam in patients undergoing radical resection of colon cancer has an ideal sedative effect,and it has small impact on stress response and hemodynamics,and has fast postoperative recovery and high safety.

Objective To investigate the proactive coping of schizophrenia patients with auditory hallucinations and to analyze its influencing factors.Methods A total of 240 schizophrenia patients with auditory hallucinations hospitalized in Shandong Mental Health Center from February to October 2023 were selected as subjects.General information questionnaire,simplified coping style questionnaire,perceived social support scale,insight and treatment attitude questionnaire were used to conduct the survey.Results A total of 236 valid questionnaires were collected,and effective questionnaire response rate was 98.33％.The proactive coping score of schizophrenia patients with auditory hallucinations was(18.55±7.74)points,which was at a moderate level.The results of multiple linear regression analysis showed that education level,perceived of social support,and self-awareness were the influencing factors of proactive coping to schizophrenia patients with auditory hallucinations(P＜0.05).Conclusion The proactive coping of schizophrenia patients with auditory hallucinations needs to be further improved,and nursing staff can focus on patients with low education level,low ability to perceive social support and poor self-awareness,and formulate targeted interventions to improve their proactive coping to auditory hallucinations.

Objective: To investigate the trends in incidence and mortality of prostate cancer in Huangpu District, Shanghai Municipality from 2002 to 2019, so as to provide insights into the prevention and treatment of prostate cancer. Methods: The incidence and mortality of prostate cancer among men in Huangpu District from 2002 to 2019 were collected from the Shanghai Cancer Registry System. The crude incidence, crude mortality, truncated age-standardized incidence (aged 35 to 64 years) and cumulative incidence (aged 0 to 74 years) of prostate cancer were calculated. The Chinese Fifth National Population Census in 2000 and the Segi's world standard population in 1960 were used to calculate Chinese-standardized rate and world-standardized rate. The trends in incidence and mortality of prostate cancer were evaluated using annual percent change (APC) and average annual percent change (AAPC). Results: A total of 2 672 cases of prostate cancer were reported in Huangpu District from 2002 to 2019, and the crude incidence was 33.35/105, the Chinese-standardized incidence was 14.93/105 and the world-standardized incidence was 12.37/105 (AAPC=7.675%, 4.886% and 4.983%, all P<0.05). The incidence of prostate cancer among males at ages of 60 to <70 years and 70 to <80 years appeared increasing trends (AAPC=4.554% and 5.045%, both P<0.05). A total of 1 214 deaths of prostate cancer were reported, and the crude mortality was 15.15/105, the Chinese-standardized mortality was 6.01/105 and the world-standardized mortality was 4.61/105 (AAPC=5.500%, 2.057% and 1.784%, all P<0.05). The mortality of prostate cancer among males at ages of 80 years and above appeared an increasing trend (AAPC=4.220%, P<0.05). Conclusions The incidence and mortality of prostate cancer appeared increasing trends in Huangpu District from 2002 to 2019, and the incidence among males at ages of 60 years and above also increased. The screening for prostate cancer among males at ages of 60 years and above should be strengthened.

Objective:To analyze the distribution of clopidogrel metabolism-related gene variability in Kawasaki disease (KD) children with coronary artery lesions (CAL) across different age groups and the impact of genetic variability on the efficacy of clopidogrel antiplatelet therapy.Methods:A retrospective cohort study was conducted. Clinical data were collected from 46 KD children with CAL who were hospitalized in the Cardiovascular Center of Children′s Hospital of Fudan University between January 2021 and August 2022 and were treated with clopidogrel, including gender, age, body mass index, course of KD, CAL severity grade, and baseline platelet count. According to their age, the children were divided into ≥2-year-old group and <2-year-old group. Their platelet responsiveness was assessed by adenosine diphosphate-induced platelet inhibition rate (ADPi) calculated via thromboelastography, and children were categorized into high on-treatment platelet reactivity (HTPR) and normal on-treatment platelet reactivity (NTPR) groups. Genotypes of CYP2C19, PON1 and ABCB1 were detected. The t test, one-way analysis of variance and Chi-square test were used for intergroup comparison. Results:Among the 46 KD children with CAL, 34 were male and 12 were female; 37 were ≥2-year-old and 9 were <2-year-old; 25 cases were in the HTPR group and 21 cases were in the NTPR group, with 19 HTPR and 18 NTPR in the ≥2-year-old group, and 6 HTPR and 3 NTPR in the <2-year-old group. Genetic analysis showed that 92 alleles among the 46 children, with frequencies of CYP2C19*1, CYP2C19*2, CYP2C19*3, CYP2C19*17, PON1 192Q, PON1 192R, ABCB1 3435C, ABCB1 3435T at 59% (54/92), 32% (29/92), 9% (8/92), 1% (1/92), 36% (36/92), 64% (59/92), 63% (58/92) and 37% (34/92), respectively. Analysis of the impact of genotype on ADPi revealed that in children aged ≥2 years, those with CYP2C19*1/*3 genotype had significantly lower ADPi than those with CYP2C19*1/*1 genotype ((34±15)% vs. (61±29)%, t=2.18, P=0.036). There were also no significant difference in ADPi among children with PON1 192Q homozygous, PON1 192R heterozygote and PON1 192R homozygous genotypes ((40±22)% vs. (52±33)% vs. (65±27)%, F=2.17, P=0.130), or among those with ABCB1 3435C homozygous, ABCB1 3435T heterozygote and ABCB1 3435T homozygous genotypes ((55±34)% vs. (60±27)% vs. (49±24)%, F=0.33, P=0.719). In <2-year-old group, there were no significant differences in ADPi across CYP2C19*1/*1, CYP2C19*1/*2 and CYP2C19*2*2 genotypes ((40±20)% vs. (53±37)% vs. (34±16)%, F=0.37, P>0.05). There were no significant differences in ADPi across CYP2C19*1/*1 and CYP2C19*1/*3 genotypes ((44±27)% vs. (42±20)%, t=0.08, P>0.05). There were no significant differences in ADPi across PON1 192Q homozygous, PON1 192R heterozygote and PON1 192R homozygous genotypes (45% vs. (55±27)% vs. (24±5)%, F=1.83, P>0.05). There were no significant differences in ADPi across ABCB1 3435C homozygous, ABCB1 3435T heterozygote and ABCB1 3435T homozygous genotypes ((36±16)% vs. (50±35)% vs. 45%, F=0.29, P>0.05). The risk analysis of HTPR in different genotypes revealed that in children aged ≥2 years, carrying at least 1 or 2 loss-of-function alleles of CYP2C19 was a risk factor for HTPR ( OR=4.69, 10.00, 95% CI 1.11-19.83, 0.84-119.32, P=0.033, 0.046, respectively), and PON1 192R homozygosity and carrying at least one PON1 192R allele were protective factors against HTPR ( OR=0.08, 0.13, 95% CI 0.01-0.86, 0.01-1.19, P=0.019, 0.043, respectively). Conclusion:KD children aged ≥2 years carrying CYP2C19 loss-of-function alleles and PON1 192Q are more likely to develop HTPR.

Objective To investigate the correlation between the total CSVD burden and fundus vasculopathy,and evaluate significance of fundus vasculopathy for cognitive impairment in CSVD patients.Methods A total of 290 inpatients who taking physical examination in our department from May 2021 to August 2022 were consecutively recruited,and according to their score of CSVD,they were divided into group 0(129 cases),group 1(51 case),group 2(42 cases),group 3(44 cases),and group 4(24 cases).All the subjects underwent brain magnetic resonance imaging,fundus fluorescein angiography,and cognitive function assessment.The total CSVD burden and fundus vasculopathy were evaluated.The general clinical data,results of laboratory tests,fundus vascularization,and cognitive function were compared among the groups with different CSVD burden scores.Spearman correlation analysis and linear correlation analysis were used to explore the correlation between total CSVD burden score and fundus vascular disease.Results Significant differences were observed in terms of age,years of education,cerebral infarction/TIA,total cho-lesterol,LDL-C,creatinine,MoC A and MMSE scores,positive results of connectivity test,digit-symbol conversion test,Stroop colour-word interference test and verbal fluency test,values of CRAE,CRVE,AVR,Scheie grade,DWMH and PVWMH,enlarged perivascular space in the basal ganglia(BG-EPVS),lacunar infarct and cerebral microbleeds(CMB)in different CSVD total bur-den groups(P＜0.05,P＜0.01).Spearman correlation analysis showed that total CSVD burden was negatively correlated with CRAE and AVR(r=-0.655,P=0.000;r=-0.679,P=0.000),and positively with CRVE and Scheie grade(r=0.560,P=0.000;r=0.685,P=0.000).Multivari-ate linear analysis showed that the total CSVD burden after adjusting for relevant risk factors was significantly correlated with CRAE,CRVE,AVR and Scheie grades(P＜0.01).Conclusion Fun-dus vasculopathy is strongly associated with increased total CSVD burden,and it can be regarded as a valid predictor of CSVD-related cognitive impairment.